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Overcoming Challenges: Eradicating Smallpox

Fernando Medrano II

April 21, 2019

Midwestern State University

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Abstract

The purpose of this paper is to present a challenge the World Health Organization has faced in

the past and will explain how the World Health Organization overcame the challenge by

discussing who the organization worked with or is working with to minimize and eliminate said

challenge. I have examined a varity of communicable diseases as transnational threats to human

health and non-communicable diseases that have set a heavy burden on global health and have

chosen to examine the challenge smallpox gave the world, specifically the World Health

Organization. I will delve in the successive work the organization had by eradicating smallpox in

the mid-1960’s. I will use two different resources the first a textbook titled: “Global Health in the

21st Century: The Globalization of Disease and Wellness” By: Debra L. DeLaet & David E.

DeLaet, and the second the “Disease” section titled “Emergencies preparedness, response-

Smallpox” section in the World Health Organization website.

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Overcoming Challenges: Eradicating Smallpox

What exactly is smallpox? you might ask. Well, smallpox is a very ancient disease caused

by the variola virus. The recognition of the virus causes the body to experience high fever and

body aches causing fatigue like symptoms. The virus also causes small welts or spots mainly on

all limbs and face these welts/rashes will proceed to fill with fluid and turn into pus. (WHO,

2016) The smallpox disease happens to be a prime example of the most communicable disease

there was since many who came in contact with an infected person was almost certain to also be

infected.

Despite the devastation the disease brought upon the world the World Health

Organization played a key role in eradicating the disease during which smallpox was endemic in

over fifty countries and killed about 1.5- 2 million people annually. The world saw an increase of

smallpox cases in the mid-1960s estimated at 10-15 million cases each year.

Early Challenges

There were early efforts to decrease cases of smallpox around the world. The efforts were

received very well but were stalled due to many reasons and one big reason being that WHO

officials thought the World Health Organization shouldn’t be responsible in making efforts to

eradicate the disease and felt that this responsibility was to be of the national governments.

(Debra L. DeLaet, et all, pg. 162) The World Health Organization initially invested around $500,

000 on smallpox eradication efforts between 1960-1965 annually. Even after knowing such

eradication effort would cost roughly $98,000,000 dollars. In addition, officials at the World

Health Organization did not devote staffing resources to the campaign and member countries did

not allocate the necessary financial resources for a successful global campaign. In the end, it is

quite obvious a great challenge against eradication of smallpox came from the WHO in the form
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of lack of political will power and leadership that was needed to tackle such a monumental

campaign. (Debra L. DeLaet, pg. 162)

Reading the text by Debar L. DeLaet it is noted that the were far more complex issues on

hand withholding the proper help to the eradication of smallpox campaign. The author states:

“Some actors within the WHO system placed a lower priority on smallpox than on other

diseases, such as malaria...action stalled as various departments and offices within the WHO

system tried to reach agreement on what the plan should look like. The Executive Board sought

to create a top-down campaign centralized in Geneva Headquarters, whereas representatives

from the WHO regional offices argued that the global campaign would need to take into account

specific local contexts. Also, the emerging smallpox eradication campaign involved a

complicated array of international, national, local, and nongovernmental actors, creating

challenges for the WHO in its efforts to coordinate this international initiative.” (Debra L.

DeLaet, pg. 162) In other words the organization suffered disorganization on this specific topic

from the get-go and delayed much help around the world.

Working It Out

The World Health Organization eventually worked out the main issues on hand which

were internal and international political challenges. The organization created and initiated a

global campaign in 1965 called the Smallpox Eradication Unit. The unit was meant to provide

global leadership and coordination. This prompted the campaign to receive an increase in

financial support by then President Lyndon Johnson. The WHO then partnered with the U.S

Communicable Disease Center and provided much needed support and leadership from a major

world power, the United States. The smallpox eradication cause started receiving much political
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support and in 1966 the World Health Assembly adopted the Intensified Smallpox Eradication

Program, which allocated $2.4 million to the program. (Debra L. DeLaet, pg. 162)

Taking It Seriously

One big shift the World Health Organization took in order to eradicate the smallpox

disease was to adopt more proactive vaccination strategies. In the past the WHO relied on

general vaccination programs to promote eradication, but soon recognized the persistence of the

disease in countries that were in civic turmoil or going through natural disasters. This caused the

WHO to take more aggressive methods involving surveillance and containment of the infected.

(Debra L. DeLaet, pg. 162) The disease itself made it quite easy to find who was infected by its

symptoms and characteristics so containment was not difficult. The fact that smallpox disease

needed human-to-human transmission rather another vector for transmitting the disease this

eliminated the concern that a non-human reservoir existed. (Debra L. DeLaet, pg. 162). With the

allocation of financial and manpower resources from all governments facilitated by the WHO

containment was done easily and vaccinations were done worldwide thanks to a freeze-dried

variant of the vaccine making it easy to store the vaccine for long periods of time.

Eradicated

The collaboration between The World Health Organization and its member states plus the

recognition of severity helped eradicate this ancient disease in the 1970s with the last case

documented being in 1978. In the end, the campaign against the smallpox disease cost

approximately $298 million dollars. Debra L. DeLaet mentions that this campaign did bring one

last great thing and that was the WHO “contributed to a growing global commitment to routine

vaccination, a practice that saves millions of lives each year. (Debra L. DeLaet, pg. 162)
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References:

World Health Organization. 1966. Emergencies preparedness, response. [ONLINE] Available at:

https://www.who.int/csr/disease/smallpox/en/. [Accessed 20 April 2019].

Global Health in the 21st Century: The Globalization of Disease and Wellness, Debra L. DeLaet

& David E. DeLaet, ISI, Paradigm Publishers. 2012.