History of Medicine
The success of vaccination programs inspired the new concept of disease eradication-the idea that a selected disease could be wiped out or destroyed from all human populations through global cooperation. In 1977, after a decade-long campaign, smallpox was the first disease to be eradicated from such a worldwide effort. This success reawakened interest in disease eradication as a public health strategy after the failures of an earlier malaria eradication program. There were, however, critics of the eradication strategy who suggested the smallpox campaign epitomized the worst of anachronistic, authoritarian, "top-down" programs, which they saw as anathema to the ideal of national autonomy. Subsequent moves toward the eradication or elimination of other target diseases including polio, leprosy, and chagas disease have experienced only limited success. Posters, nonetheless, have proven valuable tools in eradication efforts. They provide a forum for promoting preventive behaviors and encouraging participation in public health surveillance programs.
From the 1950s to the 1980s, malaria eradication campaigns dominated the international health agenda. Particularly active programs in Latin America, South Asia, and Africa consumed a substantial proportion of national health expenditures as well as major inputs from the World Health Organization and the U.S. Agency for International Development. Optimists argued that given enough insecticide, medicine, and money, the disease-causing mosquito could be eliminated from the planet. It gradually became apparent that the strength of the parasite to survive and continue causing disease in human hosts had been grossly underestimated and the program ultimately failed. Lack of community involvement in campaigns, cultural and organizational inflexibility, and inadequate research support were all contributing factors in the program's demise. This poster from India reflects the overconfidence in eradication. The embellished image of a man spraying insecticide on a larger-than-life mosquito suggests that wiping out the insects, by using insecticides such as DDT, would lead to the elimination of the disease. It did not.
The lessons of the failed malaria eradication campaign were key to the eventual success of the smallpox program. In addition to more cooperation with existing community health practitioners and more investment in research, surveillance for smallpox cases was a key strategy of the campaign. Surveillance proved to be the ultimate quality control measure, the guide to improved operations, and the yardstick of progress. One of the major reasons for the success of the smallpox program was the understanding that interdependence would be required if global results were to be achieved. These principles have subsequently been adopted in other recent eradication battles. This poster, designed by René Gauch, offers a reward of $1000 to "the first person reporting an active smallpox case resulting from human to human transmission and confirmed by laboratory tests." The reward was valid until the global eradication of smallpox was certified in 1980. Featuring an abstraction of a human face in a pointillist style, the symbolism in the design exhibits a haunting quality appropriate to the subject. The points are presumably meant to represent smallpox lesions.