Ultimately, the aim of control programmes for infectious diseases is global eradication. Smallpox is the only instance of a disease where this has been achieved. Polio (like guinea worm) continues to move towards eradication but frustratingly there have been setbacks, particularly in Nigeria and in India.
An article in the American Journal of Public Health (sadly, not an open-access publication) reminds us that India made little progress against smallpox during the 1950s and 1960s, and was regarded as one of the major barriers on the road towards eradication of the disease worldwide. It took a change in the way the eradication programme was run in India before progress was made.
The article describes how “the campaign was converted from a project in which a handful of officials tried to impose their ideas on a complex health bureaucracy to one in which its components were constantly adapted to the requirements of a variety of social, political, and economic contexts”. The change was achieved in the 1970s mainly through the active participation of workers drawn from local communities.
As the authors point out, there are many differences between smallpox and polio. Nevertheless, there are lessons from the experience of smallpox eradication in India that should not be forgotten in today’s efforts to eradicate polio.
One of the authors of the article, Sanjoy Bhattacharya, is involved in the organization of a series of seminars on the history of tropical diseases that is being broadcast over the internet - see TropIKA.net News.
1. Bhattacharya S, Dasgupta R (2009). A tale of two global health programs. Smallpox eradication’s lessons for the antipolio campaign in India.Am J Public Health99(7):1176-1184.