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From 1966 to 1977, a global vaccination campaign under the auspices of the World Health Organization (WHO) eradicated smallpox from the planet in one of the greatest public health achievements of the 20th century. [...] the absence of the disease has saved an estimated 60 million lives. Because the WHO director-general believed that eradication was impossible, he insisted on putting an American in charge so that when the program failed, the United States would be held responsible for the debacle.
A pox on smallpox BOOKS noble cause. The reader vicariously experiences the deep emotional lows and demics by collecting data and inter- viewing patients. Eventually, he became exhilarating highs of participating in a deeply engaged by public health and Smallpox—The Death of a hugely ambitious international effort decided to devote his career to it. whose ultimate success depended on the At the time, smallpox imposed a Disease: The Inside Story of vision, dedication, and teamwork of a major burden of illness and death on Eradicating a Worldwide relatively small group of individuals. the developing world. Although the Killer Although the technical recounting of last case in the United States had been the eradication program is at times in 1949, the CDC considered it almost by D. A. Henderson. Amherst, NY: overly detailed for the general reader, inevitable that a traveler from a coun- Prometheus Books, 2009, 334 pp. the book provides valuable lessons for try where smallpox was endemic would Jonathan B. Tucker anyone interested in global health or the reintroduce the disease. Several aspects management of large and complex of smallpox made it theoretically sus- Smallpox is a severe viral disease that multinational projects. Those seeking ceptible to eradication, including the eas- claimed hundreds of millions of lives a balanced, objective treatment of small- ily diagnosed facial rash and the lack during the course of history. A uniquely pox-related issues should look else- of an animal reservoir. In 1958, the human affliction, it killed a third of its where, however. Henderson pulls no Soviet Union had persuaded WHO to victims and left the survivors disfigured punches in assigning credit or blame launch a smallpox eradication pro- with pockmarks and sometimes blind. where he considers it due and in con- gram, but it was seriously underfunded From 1966 to 1977, a global vaccina- veying strong personal views on a vari- and made little headway. tion campaign under the auspices of the ety of controversial topics. After Henderson was promoted to World Health Organization (WHO) The book weaves Henderson’s per- section chief at the CDC, he submit- eradicated smallpox from the planet sonal history with that of the small- ted a proposal to the U.S. Agency for in one of the greatest public health pox virus. An Ohio native, he attended International Development for a five- achievements of the 20th century. Since Oberlin College and then went to med- year program of smallpox eradication then, the absence of the disease has ical school at the University of Rochester. and measles control in 18 countries of saved an estimated 60 million lives. In In 1955, he was drafted for two years West Africa. Unexpectedly, President a dark irony, however, eradication cre- of military service and offered a posi- Lyndon Johnson decided to fully fund ated a new vulnerability with respect tion with the Epidemic Intelligence the project in late 1965 and later to the potential use of the smallpox Service of the Communicable Disease expanded it. This U.S. engagement virus as a biological weapon. Center (CDC), later renamed the Cen-
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