In 1977, a 23-year-old cook at a hospital in Somalia who caught smallpox and survived became the last naturally occurring case of the disease. Three years later, in May 1980, the World Health Assembly, the supreme decision-making body of the World Health Organisation, declared that “the world and all its people have won freedom from smallpox.” No disease has ever been so instantly recognised or so widely known and feared, wrote D.A. Henderson, the man who led the worldwide eradication effort, in his book about the arduous campaign to immunise people in every part of the globe and its ultimate success. Thirty smallpox-free years later, we need to remember that even in the early 1950s this highly contagious disease was infecting 50 million people worldwide annually, killing up to a third of them in a horrible fashion.
Although smallpox is now seen as a scourge of yesteryear, the terrible virus that caused it is still very much around. The last stocks of the virus, running to hundreds of strains collected worldwide, are now held in only two high-security laboratories, one in the United States, the other in Russia. While many developing countries where the disease was once endemic want those stocks destroyed, the U.S., in particular, has been dragging its feet. It argues that those viruses are needed for research to develop better vaccines and anti-viral drugs. Such research, it says, is necessary in case rogue states or terrorists use undeclared stocks of the virus as bioweapons. In a letter published in the journal Science in 1994, Nobel laureate David Baltimore observed: “I doubt that we so desperately need to study smallpox that it would be worth the risk inherent in experimentation.” Much the same research could be achieved by studying related viruses. A WHO-appointed group of independent experts, who submitted their comments in December 2010, pointed out that closely related viruses could be used on surrogate animal models to study disease-causing mechanisms as well as drug and vaccine efficacy. If there is indeed a threat of smallpox being reintroduced, what the world needs is not more research with the actual virus but a sufficient global stockpile of vaccine that can be deployed in such an emergency. The WHO currently possesses a grossly inadequate 32 million doses of vaccine. The just-concluded World Health Assembly, while reaffirming the commitment to destroying all remaining stocks of the smallpox virus after crucial research had been completed, has kicked the can down the road. The issue is to be looked at again three years hence. Will this be the last reprieve granted to a virus that has caused so much havoc in the world?
