Bob H. Reinhardt: The Fascinating Puzzlement over Smallpox Eradication

reinhardt_endWe welcome to the blog a guest post by Bob H. Reinhardt, author of The End of a Global Pox: America and the Eradication of Smallpox in the Cold War Era. By the mid-twentieth century, smallpox had vanished from North America and Europe but continued to persist throughout Africa, Asia, and South America. In 1965, the United States joined an international effort to eradicate the disease, and after fifteen years of steady progress, the effort succeeded. Reinhardt demonstrates that the fight against smallpox drew American liberals into new and complex relationships in the global Cold War, as he narrates the history of the only cooperative international effort to successfully eliminate a disease.

In a previous post, Reinhardt argues for vaccination discussions that consider the past, present, and future. In today’s post, he discusses the phenomenon of smallpox eradication and the uneasiness created by the possibility of such a disease vacuum.


Whenever I mention that I have written a book about the eradication of smallpox, people usually look at me with equal parts fascination—“Wow, that’s a great story to tell!”—and puzzlement—“Wait a second . . . smallpox? Eradicated? Really?” I love seeing this reaction. After more than six years of working on the topic, I sometimes forget that that’s exactly where I started. My initial reaction of familiarity with smallpox quickly gave way to confusion about the disease’s past and present. That led to years of reading, research, and writing, and I’d like to think that the book that came out of it all addresses some of that puzzled fascination.

That fascination often starts with a vague sense of familiarity with smallpox. Despite the fact that the global smallpox eradication campaign—led by the World Health Organization (WHO) working in cooperation with the Communicable Disease Center (CDC, now the Centers for Disease Control and Prevention) and dozens of other national health authorities—achieved success in 1980, smallpox seems oddly present. That presence comes partially from the repeated appearance of smallpox in pop culture—my favorite show, The X-Files, featured the smallpox eradication program as the tool of a vast global conspiracy preparing for alien invasion.

Smallpox also appears in the news media; my Google news feed for “smallpox” provides at least three new articles a week, ranging from alleged reappearances of the disease to the latest efforts to develop a smallpox drug, a millennia-old chimera. Smallpox has also developed a prominent, almost mythical, role in North American history, particularly the devastating role it played in decimating Native American populations. In these and other ways, smallpox—a disease that hasn’t been seen in more than thirty years—seems strangely present and familiar.

At the same time, people are also vaguely aware that smallpox no longer exists . . . maybe. This sense of the success of eradication is literally tangible—anyone born in the United States after 1972 (usually) has no smallpox vaccination scar, because they were never vaccinated, because smallpox eradication actually happened. But this awareness of eradication is often coupled with an uneasy sense that maybe eradication wasn’t actually so successful, and that maybe the disease really does still exist. Some of this, again, comes from pop culture; smallpox, like any other good boogeyman, plays such a haunting role precisely because it is not supposed to exist . . . but if it did, how horrible it would be!

More seriously and troublingly, some of the doubt about eradication stems from the fact that while the disease smallpox has been eliminated, the causative agent—variola, the smallpox virus—still exists. The virus has been deliberately preserved at the CDC in Atlanta and a lab in Koltsovo, Russia, and it might still exist in other, unknown places, like the National Institutes of Health storage facility in Maryland where smallpox samples were discovered in the summer of 2014.

At an even deeper level, I think people question smallpox eradication because that event suggests a level of mastery over the nonhuman natural world that we have come to doubt is either possible or wise. Eradicating a disease means absolute and total control over nature, and other such efforts have proved impossible to sustain (see: 2011 Fukushima Daiichi nuclear disaster) or very, very unsafe (ibid.). In either case, people sense the danger in smallpox eradication: maybe it does still exist, and, if it doesn’t, what kind of ecological havoc might such a disease vacuum cause?

I’m lucky to have had the opportunity to write a book about a topic that generates so much confusion, anxiety, and interest. I hope readers are intrigued by my approach—seeing smallpox eradication as an effort to improve global health and achieve Cold War-era foreign policy objectives by mastering the nonhuman natural world—and persuaded, if not totally comforted, by my thoughts about these puzzles: yes, smallpox eradication was successful, but no, we haven’t mastered nature, and instead we should appreciate how the internationalist approach of Great Society liberalism made smallpox eradication possible. This approach and these answers should, I hope, make smallpox eradication less puzzling and perhaps even more fascinating.

Bob H. Reinhardt is executive director of the Willamette Heritage Center in Salem, Oregon. His book The End of a Global Pox: America and the Eradication of Smallpox in the Cold War Era is now available. Follow him on Twitter @bobhreinhardt.