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Lessons from Smallpox Eradication

by Kaia

In 1980, smallpox was officially declared eradicated, marking a monumental achievement in global public health. However, it was in 1996, during an internship at the World Health Organization, that I delved into the intricate history of this disease. As a college student in the 1990s, I marveled at the monumental effort it took to eliminate smallpox from the face of the earth for the first time.

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Over the years, I continually returned to this history for inspiration and guidance on addressing contemporary public health threats. In the late 1990s, I had the privilege of meeting the dedicated healthcare professionals and eradication campaign workers who played pivotal roles in halting the spread of smallpox. Yet, I noticed that the narrative of this remarkable achievement primarily centered on the perspectives of white men from the United States, the Soviet Union, and Europe.

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Recognizing the need for a more inclusive narrative, I embarked on a journey to capture the untold stories of the countless local public health workers in South Asia who were instrumental in the smallpox eradication efforts. This endeavor culminated in the creation of a podcast series titled “Epidemic: Eradicating Smallpox.”

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My fieldwork led me to India and Bangladesh, where I interviewed aging smallpox workers who had tirelessly combated the disease, often under challenging conditions. Their narratives shed light on the complexities of the eradication campaign, from navigating dense urban slums to negotiating geopolitical tensions.

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One of the key insights gleaned from these interviews was the importance of visionary leadership in public health. Unlike contemporary policymakers who often demand data-driven evidence before supporting innovative programs, the leaders of the smallpox eradication era exhibited unwarranted optimism and moral imagination. They dared to envision a world free from smallpox and pursued bold strategies to achieve that vision.

In India, figures like Mahendra Dutta played a pivotal role in advocating for a more targeted vaccination strategy, despite resistance from policymakers. Their willingness to challenge conventional approaches ultimately proved instrumental in curbing the spread of smallpox.

However, the success of the eradication campaign was not without its shortcomings. While smallpox was defeated, the focus on the disease often overshadowed pressing socioeconomic issues, such as poverty and food insecurity, in affected communities. This oversight eroded trust in public health efforts and hindered long-term sustainability.

Moreover, the human cost of smallpox eradication became evident through encounters with individuals like Rahima Banu, whose life remained marred by poverty despite being hailed as a symbol of the eradication effort.

Reflecting on these lessons, it is evident that contemporary public health efforts must prioritize addressing the basic needs of communities while leveraging partnerships and cultural insights to foster trust and acceptance. Failure to do so not only undermines the effectiveness of public health interventions but also perpetuates disparities and erodes trust in institutions.

As we confront ongoing and future public health crises, we must heed the lessons of smallpox eradication and strive for a more equitable and inclusive approach to safeguarding global health.

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