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A physician travels to South Asia seeking enduring lessons from the eradication of smallpox

Céline Gounder, KFF Health News on

Published in News & Features

Smallpox was certified eradicated in 1980, but I first learned about the disease’s twisty, storied history in 1996 while interning at the World Health Organization. As a college student in the 1990s, I was fascinated by the sheer magnitude of what it took to wipe a human disease from the earth for the first time.

Over the years, I’ve turned to that history over and over, looking for inspiration and direction on how to be more ambitious when confronting public health threats of my day.

In the late 1990s, I had the opportunity to meet some of the health care professionals and other eradication campaign workers who helped stop the disease. I came to see that the history of this remarkable achievement had been told through the eyes mostly of white men from the United States, what was then the Soviet Union, and other parts of Europe.

But I knew that there was more to tell, and I worried that the stories of legions of local public health workers in South Asia could be lost forever. With its dense urban slums, sparse rural villages, complicated geopolitics, corrupt governance in some corners, and punishing terrain, South Asia had been the hardest battlefield the smallpox eradicators had to conquer.

I decided to capture some of that history. That work became a podcast, an eight-episode, limited-series audio documentary, called “Epidemic: Eradicating Smallpox.”

My field reporting began in summer 2022, when I traveled to India and Bangladesh — which had been the site of a grueling battle in the war on the disease. I tracked down aging smallpox workers, some now in their 80s and 90s, who had done the painstaking work of hunting down every last case of smallpox in the region and vaccinating everyone who had been exposed. Many of the smallpox campaign veterans had fallen out of touch with one another. Their friendships had been forged at a time when long-distance calls were expensive and telegrams were still used for urgent messages.


How did they defeat smallpox? And what lessons does that victory hold for us today?

I also documented the stories of people who contracted smallpox and lived. What can we learn from them? The survivors I met are not unlike my father, who grew up in a rural village in southern India where his childhood was shaped by family finances that limited access to opportunity. The stories he shared with me about the big social and economic divides in India fueled my decision to choose a career in public health and to work for equity. As we emerge from the covid pandemic, that connection is a big part of why I wanted to go back in time in search of answers to the challenges we face today.

Unwarranted Optimism

I sought out Indian and Bangladeshi public health workers, as well as the WHO epidemiologists — largely from the U.S. and Europe — who had designed and orchestrated the eradication campaigns across South Asia. Those smallpox leaders of the 1960s and ’70s showed moral imagination: While many doctors and scientists thought it would be impossible to stop a disease that had lasted for millennia, the eradication champions had a wider vision for the world — not just less smallpox or fewer deaths but elimination of the disease completely. They did not limit themselves to obvious or incremental improvements.


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©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.


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