Smallpox: Eradication Program

CDC maintained an Epidemiology Branch under the Direction of Dr. AD Langmuir. It included a Surveillance Section under the direction of Dr DA Henderson. It was reposnsible for domestic surveillance and disease conrol, and comprised units for the primary communicable diseases such as smallpox, measles, and polio. In the early 1960s, these were working on the development and testing of a jet injector for use in mass vaccination campaigns (measles and smallpox).

In 1961, the US Agency for International Development (later USAID) was created, inheriting an assortment of ongoing programs. In 1982, it successfully field-tested a measles vaccine in Upper Volta (now Burkina Faso). Other West African nations began to request USAID assistance in developing measles control programs, and USAID in turn requested CDC's help. CDC sent observer Dr Larry Altman (who became a NY Times medical reporter) to review the ongoing programs. In Henderson's words, "The 2-month observer began a 6-month rescue operation".

USAID had assigned 2 people, each at half-time, to oversee the measles control project. The new agency lacked the capability and knowledge to adequately support it. CDC felt that the methodology was flawed. Further, USAID would supply the vaccine only for the initial round of measles vaccination. Most countries would be unable to maintain the program among new births at US$ 1.25 per dose (over US$ 15 in 2026). Inevitably, there would be a resurgence of measles and all the effort wasted.

CDC prepared an alternate plan that would combine smallpox eradication and measles conotrol in a larger contiguous block of countries. Smallpox could be eradicated from a region of West Africa, CDC believed, so something useful at least would be accomplished. The total cost of such a program was much higher, and CDC did not expect that, ultimately, USAID would approve it.