Two-Part Strategy To accomplish the massive feat of eradication, the WHO team had to come up with a plan that was simple, but effective. This led to the creation of the two-part strategy, which consisted of two parts: mass vaccination and surveillance-containment.
"Our original strategy was straightforward and consisted of two basic components: the first was preventive---vaccination to reduce the number of people who were susceptible to smallpox so as to diminish spread; the second was to organize a reporting-surveillance system and response teams to investigate and contain outbreaks. Implementation would have to adapt to national realities. Each country had its own health system and each was unique. Other differences had to be taken into account---the quality of personnel and the transportation system, religon and politics, climate conditions, and demographics. There was no possibility for a detailed plan that could be used everywhere. Creativity and flexibility in every program were not only welcome, they were to be encouraged and successful new concepts communicated to others."
- D.A. Henderson, MD; Smallpox: The Death of a Disease Although the plan was successful in the end, the team had to overcome many obstacles before achieving worldwide eradication. |
"West and Central Africa were among the first targets of the Intensified Smallpox Eradication Program, selected to demonstrate that WHO efforts could succeed even in countries with systemic poverty and starkly limited domestic health infrastructures. An early strategic breakthrough was the adoption of the "surveillance-containment" concept: instead of seeking to vaccinate everyone (i.e., attempting to achieve a near 100 percent compliance record in each country), a less ambitious but equally successful tactic was to reliably identify and locate each new smallpox outbreak and for each of these locales immediately vaccinate everyone who may have already, or still might, come into contact with the virus. Quarantining an area and sealing off the outbreak before the virus could spread very far proved more manageable than the Herculean task of vaccinating everyone.
Twenty countries in West Africa (including six of those previously identified as among the most highly endemic smallpox locales in the world) were declared to be smallpox free within three and one-half years of the campaign's initiation. Other successes followed: Brazil encountered its last smallpox case in April 1971, Indonesia in January 1972. By the end of that year, variola's formerly global range had been restricted to six countries: India, Pakistan, Bangladesh, Nepal, Ethiopia, and Sudan." - David Koplow; Smallpox: The Fight to Eradicate a Global Scourge |