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World History Project - Origins to the Present
Course: World History Project - Origins to the Present > Unit 7
Lesson 6: Global Interactions and Institutions | 7.5- READ: Introduction to Globalization
- READ: International Institutions
- READ: Rise of China
- BEFORE YOU WATCH: Eradicating Smallpox
- WATCH: Eradicating Smallpox
- BEFORE YOU WATCH: Global China into the 21st Century
- WATCH: Global China into the 21st Century
- READ: Goods Across the World
- BEFORE YOU WATCH: Globalization I - The Upside
- WATCH: Globalization I - The Upside
- BEFORE YOU WATCH: Nonviolence and Peace Movements
- WATCH: Nonviolence and Peace Movements
- READ: Population and Environmental Trends, 1880 to the Present
- READ: Is the World Flat or Spiky?
- Global Interactions and Institutions
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WATCH: Eradicating Smallpox
As we battle this pandemic and seek to prevent the next, we might look to history for lessons. The worst disease that has ever afflicted humanity is also the only one we’ve ever eradicated. Dr. Larry Brilliant lived this history as part of the global campaign to end smallpox. In this video, he reflects on the long history of humanity’s battle against smallpox and how the world finally found the public will to defeat its old foe at the end of the twentieth century. Like what you see? This video is part of a comprehensive social studies curriculum from OER Project, a family of free, online social studies courses. OER Project aims to empower teachers by offering free and fully supported social studies courses for middle- and high-school students. Your account is the key to accessing our standards-aligned courses that are designed with built-in supports like leveled readings, audio recordings of texts, video transcripts, and more. Register today at oerproject.com!
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Video transcript
An invisible enemy stalked our species for
thousands of years. It killed 3 out of 10 people it touched. Those who survived were left
scarred for life. The killer's name? Smallpox. Among the many diseases that have plagued
human history, few are so deadly or so enduring as the smallpox virus. It brought mighty
empires to their knees, killing king and commoner alike. In the 20th century alone,
smallpox killed more people than World War I, more than the Spanish Flu, and more than World
War II combined. All this long, terrible history, and you probably never think about smallpox,
do you? Why not? Because it's gone—eradicated. Humanity declared victory against its old enemy
on May 8th, 1980. Today in the year 2022, we look back on over two years of the COVID-19 pandemic.
Many questions about our future remain unanswered: when will the pandemic end? Can we eradicate
COVID-19 virus altogether, like we did with smallpox? As we confront this uncertain future,
we might look to history for guidance. History won't help us predict the future, but as the only
human infectious disease we've ever eradicated, the long history of smallpox holds important
lessons for today and for tomorrow as we seek to prevent the next pandemic.
To understand this history, I turned to someone who lived it, Dr Larry
Brilliant, an epidemiologist. In the 1970s, Dr Larry joined the WHO in India as part
of a global effort to eradicate smallpox. Smallpox is the worst, the most lethal
disease in history. It has that combination of how rapidly it spreads and how many people it
kills to make it the worst disease in history. One case of smallpox would lead to four or five
or six other cases. It's very transmissible. But unlike COVID or flu, instead of killing one
person out of a thousand, out of a hundred, one out of every three people who got smallpox
died, and they were usually little children. 90- 95 percent of the time, it was spread by
respiration like the flu or like COVID. But when it got into your body, it attacked all of
the mucous surfaces: the inside of your nose, the inside of your mouth, the inside of your throat,
your intestinal system, all throughout your body. And every place on your skin, you would
get pustules and boils. And in some of the worst cases that I saw, there wasn't
a single piece of skin that was normal, you could put your finger,
it was covered with boils. Human societies in every part of the world
have suffered from smallpox outbreaks for centuries. It traveled with
us, spreading between societies. But as the disease spread, so too did methods
of fighting it: first in China and India, and then spreading through the Islamic world to
Europe and West Africa. Physicians experimented with Variolation: a method of giving people a
tiny bit of smallpox virus from another person's pistols in the hope of provoking a milder
infection and lifelong immunity. It wasn't a safe procedure by today's standards. One
out of every 10 who got Variolated would die. But it's far better if you think about the
mathematics of survival to risk one out of ten dying than the inevitable three or four
out of ten dying. To this day, we don't have a treatment for smallpox, which is why in the
end we had to prevent it and eradicate it. In 1796, a country doctor in Berkeley,
England, named Edward Jenner, sparked a major innovation in the fight against smallpox:
the first vaccine. And this country doctor couldn't understand why one community didn't
have pox, didn't have scars, and he noticed a milkmaid named Sarah Nelms, who was milking a
cow named Blossom—that was the name of the cow— and a Blossom had an infection on her udders that
were like pox marks, and when Sarah Nelms was milking Blossom the disease spread
from the cow to her fingers. And somehow, Edward Jenner thought, "That
must be it, if you have a pox on your finger, you won't get punks on your face." And it has
to be considered a great leap of imagination—a great belief that there could be special
transmission of immunity. Using material from a cowpox sore, on milkmaid Sarah Nelson's hand,
he inoculated the eight-year-old James Phipps, later exposing him to smallpox as an experiment.
Thankfully for young James, and for us, the vaccine worked. And that was the moment that
the idea that you could prevent a disease—now remember, this is before Germ Theory, nobody
knew about viruses, bacterias, we didn't have microscopes then—and with that breakthrough,
came the idea that by getting the cowpox, you could prevent the more deadly
smallpox. That was the first vaccination. Armed with the new tool of vaccines,
wealthy nations launched programs to vaccinate their citizens against smallpox,
often facing anti-vaccination protests. By the end of the Second World War, most of
the world's wealthiest nations had eradicated smallpox within their borders. But smallpox was
far from defeated. Let's vaccinate everybody—we call that mass vaccination and some countries
were able to push smallpox out of the country by vaccinating everybody. Countries like Burma
and China, which had more strict governments, could accomplish that. Countries like the United
States, which were wealthy, could accomplish that by having routine vaccination mandatory of all
kids before they went to school and all travelers. But for most of the world it didn't work.
We had that smallpox vaccine for 200 years and we weren't able to eradicate smallpox. After
the Second World War, humanity had a new tool in its fight against smallpox: the United Nations,
more specifically, the World Health Organization, enabled international cooperation of a scale
and efficiency never seen before. In 1967, the organization launched the Intensified Smallpox
Eradication Program led by scientists and doctors like William Feige and D.A. Henderson. The
organization set out on an ambitious mission: to rid the world of smallpox. In 1972,
Dr Larry Brilliant joined their ranks. So Bill Feige—who was this wonderful
epidemiologist working in Nigeria during the Civil War in Nigeria in the 60s,
the Igbo Civil War—Bill was a missionary doctor and he was working in a little village, and he
had only a little bit of smallpox vaccine. And there was a big outbreak, and Bill, who was a
very moral person, asked himself, "What do I do with this little bit of vaccine? Who do I save?
Who do I protect?" And, you know, usually that may have been in a different scenario: the
richest person, or only women, or only children or something like that. Bill said, "I guess the most
important person that I need to vaccinate is the one who's going to give the disease to five
other people." And so he located those people who were surrounding, living
near somebody who had smallpox, and the people that he vaccinated. And suddenly,
the entire epidemic stopped. So Bill came up with the idea of surveillance and containment. People
later on called it ring vaccination. That strategy was what broke through the centuries
of difficulties that populist countries like India had, who couldn't do mass vaccination.
Now, we go far away from the realm of science, we have to understand that the most important
thing to eradicate a disease is public will. With public will you can do anything, without public
will you can't do anything. At the time that the smallpox eradication campaign began in the 70s,
there was public will to eradicate smallpox. It was a Russian professor who came to the World
Health Organization and said, "We must eradicate smallpox." The whole world assembly voted to have
a campaign. They hired an American, D.A Henderson, to run it. People came from 50 different countries
to work together. We had every language spoken. Our meetings—you would see people with every color
of skin. You had people who were Islamic, Jewish, Protestant, Catholic, Shintu, Hindu,
Buddhist—every religion you could think of speaking dozens of languages. But the horror, the
agony of this disease, and the fear that it would spread, made us forget about our differences
and look at what we cherished together, and what we cherished was a world free of this damn
disease. It evoked such a hatred for the disease. We thought of it as the demon, we thought of it as
our enemy, and we considered that we were at war with smallpox. Incredibly, despite civil wars
and a global Cold War, the campaign succeeded. In October 1977, Ali Maow Maalin, a Somalian
hospital cook, was the last person to be naturally infected with smallpox. He survived and
later became a vaccination campaigner himself, promoting the polio vaccine. On May 8, 1980,
the WHO officially declared smallpox eradicated. I hope that polio joins smallpox as the second
disease to be eradicated because those of us who worked in the smallpox program—we call
ourselves smallpox warriors—we're very lonely. We don't want to be in a world where
only one disease has been eradicated. And the next one is going to be polio—in fact,
I think this year there have only been about 15 cases of polio in the whole world. There are
only three or two, or maybe even one countries, that has not eradicated polio. So polio will
be eradicated in our lifetimes, and that's magic and wonderful. After that, it gets harder.
People talk about a measles eradication program, they talk about a malaria eradication program,
we've tried to eradicate three other diseases. Yaws is one of them. I'm hopeful that we can do
it. I don't think we have that feeling for COVID. It's unfortunate, because in its own way, COVID is
a horrible disease. And how many more will there be like that? We haven't done very well in trying
to stop COVID, a lot of great science and creating vaccines, anti-virals, treatments. But the guts
of it, the program, the communications, people working together as friends and not bringing
politics in it. We haven't done a very good job. So, we've missed the public will part.
So, we have smallpox, we will soon have polio, they should inspire us, they should
make you want to go into public health, they should make you get excited about global
health. But it isn't clear that the best science in the world is enough. And so, a lot of times
you hear public health people saying, "I don't want to get politics into it." Yes, we do. We have
to bring politics into it, and said another way, we have to bring public health into politics. And
that's my hope. That's my hope: for one of the great lessons of smallpox eradication. The long
history of humanity's struggle against smallpox and the story of its eradication is evidence
that we have the knowledge, resources, and ability to eradicate diseases and
prevent future pandemics before they start. Dr Larry has said before that "Outbreaks
are inevitable but pandemics are optional." Humanity can eradicate diseases. We can prevent
future pandemics. We need only to find the willpower to work together across borders and
differences and use the tools we already have.