The Man Who Beat Smallpox by Cook & Bynum

Smallpox was responsible for an estimated 400 million deaths during the 1900’s, making it one of the 20th century’s greatest killers. The World Health Organization tapped D.A. Henderson, who passed away a few weeks ago, to eradicate the disease. The WHO did not expect him to be successful.

Smallpox
Image source: Wikimedia Commons
Smallpox

The director of the World Health Organization knew the plan would fail. To rid the world of smallpox was impossible. Each year, 2m people still died of it. Total global vaccination was a chimera. Besides, no disease had ever been eradicated. But since he had been pushed into it by the Soviet Union and the United States, he would put an American at the head of it, so that when everything went down the tubes it would be America’s fault. The year was 1966; he asked for Donald Henderson.

In terms of revenge, he picked wrong. D.A., as everyone called him, was not at all inclined to fail. Brawny, brimming with confidence and not a sufferer of fools, he was already fixed on smallpox. He dated his obsession to 1947, when in supposedly smallpox-clear New York a man visiting from Mexico died of the disease, 12 others caught it, and the city went wild with fear—that age-old fear of a disease that killed a third of its victims, had ravaged the native tribes of the Americas, and left the faces of survivors gouged with scars.

After that, he had no interest in any old dull doctor’s life. He wanted to study the causes, spread and suppression of epidemics. Rather than serve in the army he joined the Epidemic Intelligence Service at the Communicable Disease Centre in Atlanta, for what he called “firefighter” training. As soon as a disease broke out anywhere in the world, he would dash to tackle it – becoming a proper “shoe-leather” epidemiologist, as opposed to a “shiny-pants” desk-bound sort. When he was hauled away from his anti-smallpox work in west Africa and sent to Geneva for the WHO in 1967, at 38, he wasn’t thrilled. But if they wanted the world rid of the virus in ten years, he would give it his best shot.

Not by himself, of course. “Target Zero” came to involve almost everyone in the affected countries, from scientists in labs to government ministers to local health officers and elders who could neither read nor write. His modus operandi, “surveillance-containment”, required not mass vaccination but pinning down each case and vaccinating all contacts; it needed the co-operation even of villagers and schoolchildren, who learned to spot the tell-tale rash of Variola major, like buckshot embedded in the skin. His own staff was tiny; but some 200,000 locally recruited people also worked for him, in 50 countries…

Overall – and only he had the full picture – the effort ebbed and flowed. Good progress in a country might be suddenly reversed by war, as in Biafra, Ethiopia and Bangladesh, by flows of infected refugees or, in Somalia, by nomads wandering across a border. Heartening figures might turn out to be colossal under-reporting. By 1975, however, almost all of Asia and Africa was free of smallpox. The last naturally occurring case, a Somali cook, was recorded in 1977. There followed two anxious years of more surveillance, when Dr Henderson was not quite sure they had really done it. By December 1979 he knew they had.

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