Donald A Henderson, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Published online: May 2015
In 1967, the World Health Assembly undertook to eradicate smallpox worldwide. Priority was given to this disease, because,
throughout history, it had been the most devastating of all human infections. The key elements of program execution included
the World Health Organization's (WHO's) success in recruiting the global cooperation of all nations, an especially effective
vaccine, a new instrument that facilitated vaccination and a unique strategy for stopping the spread of smallpox infection.
The goal of the program was to eliminate smallpox throughout the world in 10 years. It missed the goal by only a few months.
Smallpox Eradication was declared by the WHO in 1980 and smallpox vaccination ceased everywhere. The program, its strategies
and organisation provided the impetus for a heightened global program of immunisation that includes poliomyelitis, measles,
diphtheria, pertussis and tetanus vaccines.
- The eradication of smallpox was far more than a mass vaccination campaign. It was an exceptionally complex effort requiring
global participation of countries, practical and applied research, vision and time.
- For a global program necessarily involving many different countries, there is need for a primary force to shape strategy,
to goad national authorities into action and to redirect the overall program as necessary. WHO is a basic necessity.
- A special effort for disease surveillance and epidemic control was a critical basic requirement.
- A heat‐stable vaccine meeting international standards was essential.
- Different countries and changing circumstances require continuing adaptation.
- The strategies and policies developed during the smallpox program proved to be highly relevant to other vaccination programs.
Keywords: vaccine; infectious disease; epidemics; plagues; eradication
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