A Pox on Your Narrative: Writing Disease Control into Cold War History

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.1 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.2 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.”3 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.4 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.5 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.6 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.7 Considering that in the course of the twentieth century alone smallpox caused an estimated 300 million deaths—more than twice the total death toll from all the century's wars combined—the eradication of smallpox was arguably among the most significant events of the postwar period.8 And given the involvement of both superpowers in the program and its profound impact on the global south, the eradication of smallpox can be considered among the most significant “Third World interventions” of the Cold It to be an of a from that has It was not a or it on all of of In the of its on the ground in numerous across the the program through of the most of the including the war of the war over the and of in and the in the of Africa in the Cold however, the SEP to on the two The campaign, in a of a Cold as in the third world, that was of Cold was arguably the most successful of in Cold the history of the SEP is more than a of and it Cold history to a of international one that to with of the by international and that and would on the of international and in the global history of on the of has to the and impact of international in the international history of the and has on to the in to that and in the ways and on the At the time, of to the history of postwar international campaigns in the of international and much be from international in and of in international is much to be for efforts to of postwar international history by the The Cold however, a of postwar and it be to the history of the SEP much to the Cold more to from an The of is to the ways in the history of the SEP with Cold history and to smallpox eradication Cold history would to that In an of the SEP can three in the The first is with to the ground of been over and from numerous but with a on The on the of U.S. and with the Soviet for to the of a in is much to be can to of the of international and a that has been of to in the of international international and but to in the of the SEP can new on the history of Cold development, a and of smallpox eradication Cold history not much a new as a of one that to the SEP not as a but as a in and cultural that postwar international Smallpox was an infectious disease caused by the the body through the The and within a few by the of the that the that the on the and The of the from to to to to two the the and behind the that to with and had out of his In the course of smallpox and more people than it also the course of It was a major in the of the of the and, one has had an in the course of the The disease a number of and but its most killed a third of its within two but the of the through new the disease to in of the world over the course of for to smallpox to but all required with the and significant of a of the in 1796 was that with from with the but to smallpox the of the In the the practice of vaccination spread in and the and also and to both among and was and, at the of the twentieth smallpox was still across much of the The of for a major in years when the annual number of smallpox in was a of number and was significant It was not until the mid-twentieth century that the spread of vaccination had eradicated the disease in and however, it in of the global south, in sub-Saharan and In his 1958 to the calling for a global smallpox eradication Zhdanov had the of eradication within the The practice of vaccination in had been and one of the first of the in the of was the by in the vaccination of the of and the to eradicate smallpox by and the Soviet with in disease as a of and for the disease was a in the Soviet Union was to international that it at The of an in the of the postwar that in the and and and the Soviet Union not the until cooperation on the By the an that the of disease as one in international cooperation as in was In the of one and cooperation in the of or Zhdanov's 1958 a history as it a of Soviet of the Zhdanov for global eradication with the that had been in the Soviet a of vaccination of the of it for in vaccination was not The he for global eradication was a the and the global of The Soviet Union, it had eradicated smallpox, still of to across its with countries as and And with the of countries of the global that not had to vaccination to global campaign, Zhdanov would much less than the of vaccination the WHO he that the disease be as a within years and within a commitment to the campaign, the an annual of million of the vaccine, the that would be in the was and The but the political of the Soviet the U.S. the WHO had been committed to a global Eradication Program was funded by the United States and with It had for the it with a of a to U.S. in the third The smallpox was a Soviet to the in the international the United the not much for the and the to the WHO to a a campaign would and The following the Soviet delegation to for the The Soviet Union, Zhdanov was million of and three as much the Soviet of to the 1958 and that the would support the global campaign with the he that with the smallpox be history within two to three and in support of the the United States delegation conspicuously The in a on of of smallpox, all countries to launch eradication and the to and It however, for as was the to display for international cooperation in the the United States in the malaria Smallpox eradication was officially a WHO U.S. the program over the years on with few and only a of staff. annual from to and it one the program in and to all or much of the global year at the the Soviet delegation its with the of the to the SEP to its in the malaria eradication was a of the however, the U.S. would its and to throw its support behind the the that to that the within the of international with in the international to eradication campaigns had in international in the but by the it was that the was its and that of worldwide The that malaria an the to from one to and the of the was to by through the of among the or The worldwide of for malaria since World however, had caused the of and, the more was the more prevalent In had also for its as the of the and on the had It from one to through and its eradication would not a Smallpox had was a with a history of with few and not in as the or in as can with or all the and only the to the in the United States and began to smallpox as a more for global eradication. 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