Plagues and other great diseases are important parts of history and some settings. They defy man and may even defy God in their swift and terrible punishment upon the body of society.
My issue with modifying/removing dwarves and elves is that the PC’s may want to play them.
One of the most powerful tools found in the World Building 102b article is the Worksheet. Here is a place to put the settings you might make with them.
After the PCs defeat (or force the rapid retreat of) a villanous necromancer/demon summoner, they discover a book. This book outlines how to summon a demon whose power increases according to the size of the summoning circle used to summon it. And after the PCs examine a map of the country, they find that the layout of the cities and roads match up with the required summoning circle. In fact, the final road that would complete the circle is currently in construction.
With anyone who can find out about the circle and the ritual to summon the demon able to somehow make the final road/line, and destruction of the cities and roads currently in existence out of the question (unless this is an evil campaign- that removes the moral quandary), how are the PCs going to solve this problem?