Bill Foege: The Doctor who helped eradicate smallpox

In 1966 Dr Bill Foege was asked to go to Nigeria to help eradicate smallpox.

One night a small village called Bill on his radio. They thought they had a smallpox case, could he come and check? So Bill and some colleagues jumped on their motorbikes and headed out to help

This was one of the first patients Bill saw:

The village was right, they had smallpox. But they didn’t have enough vaccines for everyone.

Smallpox was one of the most lethal killers in history.

For example, add up all the people who died in wars and genocides in the 20th Century

• World War 1

• World War 2

• 1918 Spanish flu 

• The Armenian genocide

• The Cambodian genocide

• The Soviet Revolution

• The Chinese Revolution

• War in the Congo Free State

When you do that, you get around 150 - 200 million deaths.

In the 20th century, smallpox killed an estimated 300 million people

We had a vaccine for smallpox since 1796, but it was incredibly hard to reach everyone, especially in poor countries.

That’s why Bill’s trip to that village was important. Because he realised we didn’t have to vaccinate everyone.

That night Bill and his colleagues gathered in the house of a local missionary to plan their next move.

They asked a question: “If we were a smallpox virus what would we do next?”

The answer was simple. Find and infect a vulnerable person.

They knew two important facts about smallpox

1. The smallpox virus only lives for a few weeks.

2. Smallpox usually spreads by face-to-face contact.

So if they could find where smallpox was and vaccinate just the people close to the case (rather than everyone) they could create a ring of protection to stop smallpox from spreading.

That night Bill sent runners to nearby villages to find people who had smallpox. Within 24 hours they knew where smallpox was.

They vaccinated people in those villages and the places they thought smallpox was likely to spread, like local markets. Then they waited

Later, this strategy was called surveillance/containment. And it worked beautifully.

At the time, the World Health Organisation thought you had to vaccinate 80% of a country’s population to get rid of smallpox.

They did it by vaccinating 7%.

The surveillance/containment strategy changed how we fought smallpox. We could save more lives in less time and with less money.

It took some convincing, but soon countries started using the surveillance/containment strategy.

The results were awe-inspiring.

On May 8th 1980, smallpox became the first human disease to be eradicated.

For 3000 years smallpox killed millions of people. It was passed from person to person in an unbroken chain throughout history. Until that chain was broken.

We have many people to thank for eradicating smallpox eradication. One of those people is Bill Foege.

There is a project called Becoming Better Ancestors which teaches 9 lessons we learned from eradicating smallpox. Bill’s story is an example of lesson 1.

💡 Lesson: It’s a cause-and-effect world. The more we can understand the world, the more we can improve it.

Cheers,

The Problem Solvers