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Anniversary of smallpox eradication

18 June 2010 -- A statue was erected to mark the 30th anniversary of smallpox eradication. In this podcast past members of the Smallpox Eradication Programme explain challenges they faced in eradicating the disease.

Transcript of the podcast

Veronica Riemer: You're listening to the WHO podcast. My name is Veronica Riemer. In this episode we look at an unprecedented achievement in the history of the World Health Organization, the eradication of smallpox.

Smallpox is an acute contagious disease caused by the variola virus. Having originated over 3 000 years ago in India or Egypt, smallpox is one of the most devastating diseases known to mankind. For centuries, repeated epidemics swept across continents and decimated populations. The disease, for which there was no effective treatment, killed as many as 30% of those infected and left survivors blind, disfigured and marginalized.

In 1967, when the disease threatened 60% of the world's population, WHO launched an intensified plan to eradicate smallpox. Through the success of the global eradication campaign, smallpox was finally pushed back to the horn of Africa with the last recorded case in Somalia in 1977. The World Health Assembly in 1980 declared smallpox eradicated from the face of the earth.

Last month, a statue to commemorate the 30th anniversary of smallpox eradication was erected in the gardens of WHO. At the unveiling ceremony, WHO's Director General Dr Margaret Chan applauded health workers from around the world whose dedicated work over 14 years made this possible.

Dr Margaret Chan: Leadership at WHO was important, but an achievement of this scale ultimately depended on tens of thousands of dedicated workers who literally crisscrossed this entire globe, by jeep, donkey, and fishing boats, on foot in jungle and desert journeys, from nomadic tribes in remote mountain areas to permanent dwellers in the scorching heat of Asia’s slums.

The history of smallpox and its eradication has been written, and public health continues to benefit from the many lessons learned. Success has been attributed to a strong research component, an emphasis on epidemiology and surveillance, and the flexibility to adapt to new findings and change course when needed.

Veronica Riemer: Dr D. A. Henderson was the Director of the WHO Smallpox Eradication Programme from 1966 to 1977. He spoke of the daunting challenges faced by health workers at that time.

Dr Donald Henderson: I have often been asked whether I thought the eradication of smallpox could have been accomplished in today's world with so much armed conflict in so many areas and with large populations inflicted by natural disasters such as in Chile, Indonesia and Haiti. But how soon we forget.

In 1960s and 70s the programme was beset by major floods, famines, civil war, hundreds of thousands of refugees in various parts of Africa and Asia and we did not have then cell phones, we did not have email, we did not have fax machines, we didn't have Facebook, we didn't have Twitter, telex was possible on some occasions but too expensive. I think it is a testimony to the skill and creativity of the international advisers from some 70 different countries as well as the ministers and health programme staff who managed to overcome all of these and achieve what had been deemed impossible.

Veronica Riemer: Dr Peter Carassco is a WHO Policy Adviser for vaccine security. During the eradication programme he was both a vaccinator and a field staff supervisor on three campaigns. The last one was in Somalia where he was responsible for tracking down and containing the last outbreak.

Dr Peter Carassco: The last phases in all the countries were basically the same. We used good surveillance, working with villagers, working with the health system to track down suspected cases and smallpox is one case that always has a rash and we had these little ID cards and we educated the population over years and we would get rumours. One thing that did help us at the end was a thousand dollar reward for a confirmed case of smallpox, and we got a lot of rumours from the last countries that had smallpox virus circulations. We were able to track down the chains of transmission, shut them down with vaccination and that is how we got to eradication.

Veronica Riemer: The statue to commemorate this event which is placed in the WHO grounds depicts a vaccinator kneeling before a child ready to be vaccinated. In one hand he holds the unique two-pronged needle which was instrumental in the eradication of the disease. Behind the child is a mother from the Asian region flanked by a man from the African region, all lined up to be vaccinated. The statue tells a story of a global battle against an ancient scourge and reminds us that smallpox affected not only children - everybody had to be vaccinated.

Veronica Riemer: Dr Henderson tells how this eradication success opened the doors for further WHO vaccination programmes.

Dr Henderson: We salute this historic milestone as one of the most brilliant accomplishments in medical history. But smallpox eradication was not an end in itself and in 1974 the Assembly agreed to set in motion an expanded programme on immunization whose goal was to ensure that the world's children would also be protected against measles, polio, diphtheria, pertussis (whooping cough) and tetanus. The goal was to reach 80%. UNICEF and Rotary international made this a priority as did a number of governments and a number of other agencies have participated. The 80% mark was reach in 1990, and with this a new era has emerged for public health achievement through vaccination.

Veronica Riemer: If you would like more information about smallpox eradication there are links to photo galleries on the transcript page of this podcast episode. That's all for this episode of the WHO podcast. Thanks for listening. For the World Health Organization, this is Veronica Riemer in Geneva.

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