When Dr. Viktor M. Zhdanov, Deputy Minister of Health of the Soviet Union, arrived in Minneapolis, Minnesota, in May 1958 to attend the annual meeting of the World Health Assembly (WHA), the governing body of the World Health Organization (WHO), the visit was not routine. Reflecting Soviet premier Nikita Khrushchev's new policy of “peaceful coexistence” with the West, it marked the first time that a Soviet delegation had been sent to that forum since the establishment of the WHO ten years earlier. And Zhdanov made his mark, calling on the organization to launch a global campaign to eradicate smallpox, one of humankind's oldest and deadliest diseases. Mindful of the meeting's venue, he began his call with a quote from a letter that U.S. president Thomas Jefferson had written to Edward Jenner, discoverer of the smallpox vaccine, more than a century and a half earlier. The discovery, Jefferson had written the English physician in 1806, would ensure that “future nations will know by history only that the loathsome small-pox has existed.”
The Sage of Monticello, it turned out, was perceptive but premature. Though the practice of vaccination spread widely in the decades following Jenner's 1796 discovery, smallpox was not eradicated in the West until the mid-twentieth century and, at the time of Zhdanov's call, was still widely prevalent across much of the global south. In 1959, the year following Zhdanov's visit to Minneapolis, the WHO officially established a Smallpox Eradication Program (SEP). At the time, however, the organization was focused on a high-profile, U.S.-backed campaign for the worldwide eradication of malaria, and for a number of years the smallpox program languished with little funding and few staff. By the mid-1960s, however, the malaria campaign was conspicuously failing to make progress toward global eradication. With the escalating war in Vietnam battering the U.S. image in the developing world, the administration of President Lyndon Johnson, seeking ways to display its commitment to international cooperation and third world development, decided to throw its support behind global smallpox eradication. Echoing John F. Kennedy's man-on-the-moon pledge in 1962, Johnson announced in May 1965 that the United States was committed to wiping out smallpox within a decade.
In 1967, when the WHO finally began an “intensified”—that is to say, actually funded and staffed—global smallpox eradication campaign, smallpox still killed an estimated two million people worldwide annually. The SEP unfolded over the subsequent decade, operating more or less simultaneously in dozens of countries on three continents, in an arch stretching across the global south from Brazil through sub-Saharan Africa and the Indian subcontinent to the Indonesian archipelago. The program had its technical, scientific, and organizational aspects, but it also required the navigation of fraught political and cultural encounters on numerous levels. It involved political jockeying in the international forums in Geneva, diplomatic efforts to sign “country agreements” with numerous participating governments, and the negotiation of vaccination campaigns on the ground with a host of local actors, from Hausa emirs in northern Nigeria to Hindu villagers in rural Uttar Pradesh. With the United States providing much of the funding and the Soviet Union most of the vaccine, the global eradication of smallpox was achieved in 1977 and officially certified by the WHO in 1980. It marked the first successful eradication of a major human infectious disease and has served as a precedent for all subsequent disease eradication programs, including HIV/AIDS, tuberculosis, and polio.