Lecture Vol. 13 #7 October 19, 1987 cover

Remarks
For the
Smallpox Eradication Celebration
By
C. Everett Koop, MD, ScD
Surgeon General

Of the

U.S. Public Health Service
U.S. Department of Health and Human Services

Presented to the Centers for Disease Control
Atlanta, Georgia
October 19, 1987

 

This was an inside party. Something that would be celebrated — we thought — only once in time.
As this introduction is being written in 2003, when we are constantly being bombarded about
preparedness or lack thereof in reference to a smallpox attack by terrorists, one cannot be so sure
that smallpox might sometime have to be eradicated all over again. An interesting little review
of things that went on behind the scenes: There were those who felt that it would be nice if the
only two major powers (in so far as we knew) who had any smallpox virus, both destroy
everything. If there was no smallpox there was no need to have the virus around to make a
vaccine. Russia was not prepared not to do that, and I was in the middle of that controversy,
because I was going back and forth to Moscow re-writing the health agreement between the
Soviet Union and the United States. Then, unfortunately, there were those trusting souls that
said, “If we destroy our supply of smallpox virus, the Soviet Union will do the same.” In my
opinion, fat chance then and fat chance now. Accordingly, I fought hard against such unilateral
action.

This was an inside party in one of our own agencies, but there James Mason, Director of CDC
was the Chair, thus I started in by citing the World Health Organization’s campaign probably as
the most ambitious undertaking in the history of medicine. I read a letter to Halfdan T. Mahler,
MD, Director-General, WHO from the President of the United States. The letter from President
Reagan to Dr. Mahler is included in this address in its entirety. The President described this
effort as having heroic dimensions. I repeated a little history about its beginning with the Soviet
resolution in 1958 to the effect that smallpox could theoretically be eliminated. The former
director of the CDC, David Sencer, shared the belief and was instrumental in making it happen.

The next historic advance was the famous jet-gun that was one of the key elements in the success
of vaccination. It was given a dress rehearsal in Brazil, and the campaign began in earnest in
1966-worldwide

It is hard to believe, but in 1966 smallpox was raging through South America, Asia, and Africa.
Two and a half million people reported as infected in 30 countries. A figure estimated to be
about one per cent of the actual incidence. The historic part of this to me was that hundreds of
public heath practitioners, white and black, Arab and Jew, Russian and American, worked side
by side to rid humanity of the scourge of smallpox.

In Africa for example, it was estimated they worked with 4,000 local health workers. Certainly
it would not have worked anyplace, if it had not been a grassroots campaign. For the United
States, it extended our public health network internationally, permitting us to help our friends
overseas, and for those who worked so hard with us, the experience helped build the public
health infrastructure necessary to prevent such epidemics.

Then, too, the World Health Organization began an expanded program on immunization, which
was an outgrowth of the effort to eradicate smallpox.

I noted that I was to be followed by Dr. D.A. Henderson, one of the prime movers and shakers,
in this country, in the whole effort. He was to deliver the Joseph W. Mountin Lecture.

I was there in my role of Surgeon General, and I presented 309 awards to those who had
participated in our side of the marvelous achievement. Just to mention a few of the outstanding
people, Dr. Donald Millar, a personal friend, who led the early vaccination and jet injector
studies in Brazil and then directed the WHO/CDC effort in West Africa, accepted the
representative campaign ribbon on behalf of the 110 members of the Commissioned Corps, who
participated in the smallpox campaign. Then Jane Cooley, who handled travel administrative
details for the CDC team, accepted the representative Surgeon General’s certificate of
appreciation on behalf of the 199 civil servants who participated. It was a great day for public
health.

A copy of President Reagan’s letter to Director General Mahler, is attached.

There is no index.