Defeating Smallpox

Pitt marks 30th anniversary of smallpox eradication with D.A. Henderson book launch

D.A. Henderson

In 1967, D.A. Henderson launched a decade-long World Health Organization (WHO) endeavor to eradicate smallpox, an effort that involved as many as 150,000 workers in 70 nations tracking one of humankind’s deadliest diseases through countries ravaged by flood, famine, and war. In 1979, two years after the end of that campaign, the virus that had killed many millions—commoners and kings alike since at least the time of the pharaohs—was officially declared the first infectious human disease to be eradicated.

On June 4, Pitt commemorated the 30th anniversary of smallpox’s elimination and honored Henderson—now a Pitt professor of public health and medicine and Distinguished Scholar in UPMC’s Center for Biosecurity—with an event to launch his new book, Smallpox—The Death of a Disease: The Inside Story of Eradicating a Worldwide Killer (Prometheus). Pitt’s Center for Global Health, which was established in May to promote multidisciplinary international health research and scholarship, was a sponsor of the launch.

Pitt Chancellor Mark A. Nordenberg placed Henderson’s work and that of the Center for Biosecurity against the backdrop of Pitt’s past and continuing contributions to medicine, from Pitt’s Center for Global Health to the development of the polio vaccine and the trailblazing work in organ transplantation by Thomas E. Starzl, Distinguished Service Professor of Surgery in the University of Pittsburgh School of Medicine and director emeritus of the Thomas E. Starzl Transplantation Institute at the University of Pittsburgh Medical Center (UPMC), who attended the event.

“The University of Pittsburgh is proud to claim connections to a number of global health giants,” commented Nordenberg. “Among them are Jonas Salk, Julius Youngner, and the other members of the Pitt team who developed the vaccine that won this country’s war against polio; Thomas Parran, who served as the U.S. Surgeon General and worked passionately to establish the World Health Organization; John C. Cutler, who led landmark research that became the foundation for treating and containing sexually transmitted diseases worldwide; and D.A. Henderson, under whose leadership the World Health Organization oversaw what has been described as history’s first—and, to date, only—vanquishing of an infectious disease, smallpox.

“We are very fortunate that Dr. Henderson chose Pitt’s School of Medicine, its Graduate School of Public Health, and the UPMC Center for Biosecurity as his professional home. We also are delighted to celebrate his life of public health leadership and the eagerly anticipated publication of his story chronicling the demise of a deadly disease.”

During the event, Henderson relayed the struggle to wipe out a swift and deadly disease that, as he noted, many in the audience of approximately 100 people had little experience with because of the WHO eradication campaign. He compared their dissociation with smallpox to the earliest years of the WHO effort when many public health officials thought that smallpox’s longevity and ferocity made it impossible to eliminate. He supported his account with images of a person in the throes of smallpox, from the onset of the virus to its scar-producing end.

When Henderson was tapped to lead the WHO Smallpox Eradication Unit in 1966, the highly contagious disease infected 10 million people and killed approximately 2 million each year. In 1960, he had been put in charge of a federal program to prevent smallpox brought to the United States from abroad. The virus had not naturally occurred in the United States since 1949; nonetheless, smallpox prevention was primarily defensive—quarantine officers would check travelers entering the country—and Henderson proposed attacking smallpox directly in the countries where it thrived.

The WHO team was determined to wipe out smallpox in 10 years despite a small budget and infections in scores of countries. Henderson and his colleagues pressed targeted nations for donations and cooperation. They recruited village doctors who couldn’t read or write but who could quickly diagnose smallpox. Henderson and his staff coped with civil wars, floods, impassable roads, and bureaucratic and cultural obstacles. They also worked through two smallpox outbreaks, the first in Yugoslavia in 1972 and then in India in 1974. Finally, the last naturally occurring case of smallpox was reported in Somalia in 1977—only nine months beyond the  10-year goal.

Afterward, Henderson worked to contain smallpox cultured in labs around the world and helped develop preparedness programs for biological attacks using smallpox. He helped establish the Center for Biosecurity in 1998 after it was revealed in 1995 that the Soviet Union had supported a bioweapons program on as large a scale as its nuclear program—and smallpox was the number one agent.

In 2002, Henderson received the Presidential Medal of Freedom, the nation’s highest civilian honor, for his work. He also has received the National Medal of Science, the National Academy of Sciences’ Public Welfare Medal, shared the Japan Prize with two colleagues, and was knighted by the King of Thailand in 2008.

In the event’s opening remarks, host Donald S. Burke, dean of Pitt’s Graduate School of Public Health, Pitt’s associate vice chancellor for global health, and founder of the Center for Global Health, indicated the scale of the disease Henderson faced by reading from the book’s forward, written by author Richard Preston: “In the last hundred years of its existence, smallpox is thought to have killed at least half a billion people. All of the wars on the planet during that time killed perhaps a hundred and fifty million. In the contest of Smallpox vs. War, War lost. Smallpox killed roughly one-third of the unimmunized people it infected, and the disease was grisly.”

Tommy Thompson, the U.S. Secretary of Health and Human Services under President George W. Bush, introduced Henderson and framed the eradication of smallpox as the archetype of medical diplomacy, or the extension of health-care resources to other nations. Thompson named Henderson as the inaugural director of the national Office of Public Health Emergency Preparedness in 2001 shortly after the Sept. 11 terrorist attacks made him realize that “disease from the 17th century” such as smallpox could be used as weapons, he told the audience.

During his tenure as secretary, Thompson advocated for providing medical facilities, medicine, and health care workers to poor, volatile nations as a method for stabilizing them and sowing goodwill. Henderson exemplified medical diplomacy when he encouraged governments marked by internal and external rivalries to collaborate on eliminating the disease that plagued their people.

“This country needs more medical diplomacy,” Thompson said. “Every time we practice medicine in a country that really needs it, I see the benefit in the faces of individuals and in their responses. The best way to tear down hatred is through medicine, a practice led by D.A. Henderson.”