The End of Smallpox

smallpox

Yesterday, December 9th, came and went like any other day. But on that day in 1979, one of the most groundbreaking endeavors in human history was accomplished: a group of eminent scientists commissioned by the United Nations World Health Organization (WHO) certified the global eradication of smallpox, the only human disease thus far to have been completely eliminated from nature. The WHO officially confirmed and announced this momentous achievement a few moments later:

Having considered the development and results of the global program on smallpox eradication initiated by WHO in 1958 and intensified since 1967 … Declares solemnly that the world and its peoples have won freedom from smallpox, which was a most devastating disease sweeping in epidemic form through many countries since earliest time, leaving death, blindness and disfigurement in its wake and which only a decade ago was rampant in Africa, Asia and South America.

Less than a decade before, the end of smallpox would have seemed the remotest possibility. As recently as 1967, the WHO had estimated that 15 million people contracted the disease, and that two million had died that year alone — the average number of annual deaths since the turn of the century.

Indeed, smallpox had been a scourge of humanity for thousands of years, with the earliest physical evidence dating back to the 12th century BCE. An average of 400,000 Europeans died annually towards the end of the 18th century, with one-third of blindness being due to the disease. Perhaps most infamously, an estimated 72 million indigenous North Americans — 90 percent of the total population — died from smallpox between the 15th and 19th centuries following its introduction by Europeans. The disease was also highly deadly: once infected, 20 to 60 percent of adults, and 80 percent of children, died.

Although English physician Edward Jenner developed the first smallpox vaccine (and the first vaccine ever) in 1796, it would take time before the concept of public health took root in various nation states, let alone on an international scale. In the meantime, deaths continued to mount, especially in the developing world; the 20th century alone would see another 300 to 500 million lives ended by smallpox.

With over 50 million cases emerging every year in the early 1950s, Soviet virologist Viktor Zhdanov was the first to call on the WHO to lead a global eradication effort in 1958. With progress being patchy, particularly in the worst-affected areas of Africa and South Asia, in 1966 Canadian-American epidemiologist Donald Henderson formed the Smallpox Eradication Unit to assist in the endeavor. A year later, the WHO intensified global smallpox eradication with millions of dollars in funding and thus of a method developed by Czech epidemiologist Karel Raska.

By 1975 — less than a decade later — following extensive international cooperation under the auspices of the WHO, the last naturally occurring case of one of smallpox’s deadliest strains was detected (and cured) in two-year-old Bangladeshi girl Rahima Banu. Since eradication, all known stocks of smallpox have either been destroyed or transferred to two secure, WHO-designated labs: one in the United States, the other in Russia.

Needless to say, we are fortunate to live in a time when something so deadly is no longer a fact of life. The end of smallpox was a watershed moment not only for public health and epidemiology, but for human ethics, which had gradually expanded beyond the confines of a particular tribe, ethnic group, faith, or nation to encompass the whole of humanity. Individuals and institutions from around the world — even from enemy nations — came together to better the lives of billions of strangers. This is an inspiring and well needed reminder of what humanity is capable of when it concentrates its resources and goodwill towards problems that impact us all. Here’s hoping we continue to apply this lesson into the future, as we grapple with many more global problems.

Photo: Johns Hopkins University

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