Smallpox has afflicted humankind for more than 3,000 years. In the 20th century alone, it took the lives of more than 300 million people. This terrible disease was characterized by a very high mortality rate and extreme complications such as blindness. The World Health Organization officially declared it eradicated on December 9, 1979. In May of 1980, the 33rd World Health Assembly went on record, honoring a monumental achievement. This unfortunate event would turn out to be a critical turning point in the history of global health.
In the 1970s, a remarkable international collaborative effort succeeded in eradicating smallpox entirely. This effort was originally hashed out under the auspices of the World Health Organization (WHO) in 1966. The reason for this initiative was not entirely noble. Economic factors were a major driving force. It is estimated that the eradication of smallpox will save $1 billion annually. This decrease is due to reduced quarantine facilities and the stopping of vaccinations and treatments related to the disease.
The Global Response to Smallpox
For centuries, smallpox left a trail of destruction, impacting populations across continents. By the 1950s it had been eradicated in Western Europe, North America, and Japan. But along with its devastation, millions felt the healing effects throughout the world. The disease claimed the lives of more than one-third of its victims. Survivors frequently lived with permanent effects such as blindness or infertility.
In response to the persistent threat of smallpox, mandatory vaccination programs were established in the UK and US during the 1840s and 1850s. These initial activities served as an important foundation for subsequent efforts. In 1958, the WHA adopted a global eradication strategy. They recognized that in order to combat this terminal illness, a concerted effort was needed.
William Foege proved to be a key architect of this campaign. Along with other public health officials, he developed a surveillance-and-containment technique that emphasized finding and isolating cases over mass vaccination. This method was successful at stopping outbreaks and ultimately eradicating smallpox.
“Some things have to be believed to be seen.” – William Foege
The Role of International Collaboration
One of the most extraordinary features of the smallpox eradication campaign was the unprecedented cooperation and collaboration between nations. During this great global undertaking, the partnership between the United States and the Soviet Union was critical to success. Amidst the Cold War tensions, both superpowers recognized the significance of eradicating a disease that posed a threat to all humanity.
Foege noted this unique collaboration by stating, “There was a historian who said, ‘You’ll never really get the world to collaborate unless there’s an alien invasion.’ Smallpox turned out to be a minor surrogate for an alien invasion because we could all see ourselves at risk.” This perspective highlighted how shared vulnerability can unite diverse nations toward a common goal.
This international effort soon resulted in massive vaccination campaigns coupled with precise monitoring networks that followed smallpox outbreaks like clockwork. Countries worked together to share learning and innovate on a collective scale. This partnership underscores the importance of collective action in addressing the great challenges to global health.
Economic Incentives Behind Eradication
The economic relief that smallpox eradication brought were massive and should not be underestimated. Lawrence K. Altman emphasized the dual motivations behind this campaign when he stated, “Smallpox eradication was undertaken as much for economic as altruistic reasons. In this era of cost‐benefit analysis, justification for wiping out smallpox comes from the savings of $1 billion that will be realized each year from reducing quarantine services, eliminating vaccinations, and the treatment of smallpox cases and complications of vaccination.”
These financial benefits offered enormous leverage in gaining political support for eradication programs. Governments came to understand that by vaccinating their populations against smallpox they could save millions of lives. In addition, this move would result in significant savings in health care costs.
In reflecting on modern global health challenges, Foege posited that crises like COVID-19 could serve as opportunities for similar collaboration. He stated, “I think COVID-19 is a great opportunity to say, ‘We’re all at risk, so what do we do as a world to make this truly a surrogate for an alien invasion?’” This story sums up the importance of shared experiences in creating solidarity to tackle health catastrophes.
