Smallpox eradication

An intensified global programme to eradicate smallpox within 10 years was initiated by the World Health Organization in January 1967. This goal will virtually be achieved. Whereas an estimated 10-15 million cases had occurred in 44 countries in 1967, only one small focus and two known active cases still remained in December 1976. The achievement reflects the dedicated work of hundreds of thousands of health workers throughout the world and a close, effective working relationship between W.H.O. and its Member States. A number of key factors are identified as important to the strategy and execution of the programme. Most important was the recognition that since a nil incidence of smallpox was the ultimate objective, an effective reporting-surveillance mechanism was essential to guide programme execution and to assess progress. In response to information provided through the surveillance network and depending on national health care, social and cultural patterns, the nature of programmes in each of the endemic countries developed and changed from year to year. No two programmes, however, were identical. Participation and involvement of staff in the existing health structure and village populations was essential. Assessment mechanisms for quality control of activities were an integral part of each phase of the programme. Production of improved vaccines and better methods of vaccination also played important roles. International assistance for smallpox eradication averaged $$\$$$8 million per year or less than 6% of what a study in the United States showed that it alone had been spending annually to protect against importations.