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UPMC researcher's book explores eradication of smallpox
Monday, June 01, 2009

When epidemiologist D.A. Henderson wanted to visit a health care center in rural East Pakistan to discuss smallpox eradication in 1971, he had two options: travel with a military escort and risk a rebel attack, or drive on an unpaved road laced with land mines.

Dr. Henderson, now a resident scholar at UPMC's Center for Biosecurity, chose the latter.

"It think it was the longest 20 miles I ever rode, wondering when the front end of the Jeep was going to blow off and take us with it," Dr. Henderson said. "It was better in the telling than it was in the living."

In a new book slated for release tomorrow, Dr. Henderson, who, as head of the World Health Organization's smallpox eradication unit, led the global effort to eliminate the disease 30 years ago, is now opening up about the personal challenges he faced in the 1960s and '70s. Dr. Henderson will discuss his book Thursday at 5 p.m. in the J. W. Connolly Ballroom at the University of Pittsburgh in Oakland.

A professor at Pitt's Graduate School of Public Health, Dr. Henderson planned the release of his book to coincide with the May opening of the University of Pittsburgh Center for Global Health, center Director Joanne Russell said.

Dr. Henderson "is a real supporter" of the center, added Clare Collins, spokeswoman for the Graduate School of Public Health.

His book, "Smallpox: The Death of a Disease," is significantly more "personal" than anything Dr. Henderson has written about the smallpox eradication process before, he said Friday. In the book, Dr. Henderson said he describes bureaucratic and governmental obstructions that threatened to extinguish global efforts to permanently wipe out the disease.

"We had to push the edge of the envelope, and sometimes we moved outside of the envelope to solve problems. We had somewhat of a reputation that we were moving beyond what rules and regulations would really call for," Dr. Henderson said. "But in fact, we got the job done."

At one point, Dr. Henderson flew to Addis Ababa to convince Ethiopia's minister of health to fund smallpox vaccinations in the African nation -- even after the minister had for three years denied Dr. Henderson permission to enter the country. Ultimately, Dr. Henderson convinced the health minister to fund a smallpox eradication program by pressing the personal physician to the emperor of Ethiopia to persuade the emperor to persuade the health minister.

"It was not exactly through normal diplomatic channels that we solved this problem," Dr. Henderson said. "It was not through the ambassador or the foreign minister, but by the back door."

WHO officially declared smallpox had been eradicated in 1979. After the organization's smallpox eradication unit was dissolved, Dr. Henderson was appointed dean of John Hopkins University's School of Public Health, while also serving as a professor of public health and medicine at Pitt.

Several public health scientists who worked on the eradication effort said that Dr. Henderson's work was crucial, and his strategies now are used by scientists to defeat other diseases.

But 30 years later, no other disease has been eradicated.

Scientists said that although a handful of diseases may be eradicated in the next few years -- such as polio and guinea worm disease -- global strife and lack of world cooperation have delayed further successes.

Former WHO Assistant Director-General for Health Security and Environment David Heymann said the conflict in southern Sudan, a location where guinea worms thrive, has prevented eradication in the region.

"Governments must be committed to do it, and there must be workers in the community committed to do the job," added Dr. Heymann, who worked in India to vaccinate smallpox victims.

In 2002, President George W. Bush awarded Dr. Henderson the Presidential Medal of Freedom.

In recent years, Dr. Henderson's career shifted away from virus eradication programs. He now focuses on exploring methods of combating biological terrorism and modern pandemics such as bird flu and swine flu.

Dr. Henderson said he believes the United States is better prepared than most other countries to deal with a biological attack or a large-scale spread of a deadly virus, but said every nation could do more to protect its citizens from biological attack.

He has butted heads with the Department of Defense and some scientists in the epidemiology community by calling on the United States and Russia to destroy existing stockpiles of smallpox samples. If the samples were to end up in the wrong hands, Dr. Henderson said, they could easily be used as biological weapons.

Because people travel more quickly and more easily than ever before, the time frame for controlling an epidemic has shrunk dramatically, Dr. Henderson said. Now, scientists would only have months, rather than years, to develop vaccines for new strands of deadly viruses, he said.

"One has to be mindful of the fact that we are not more than 36 hours from almost any place in the world. Somebody can be in the middle of the jungle in central Africa, and they can be in Pittsburgh within a day," Dr. Henderson said. "The world is much smaller, and the real threat is that you get one of these new organisms that could really cause serious devastation."


Correction/Clarification: (Published June 2, 2009) D.A. Henderson, the epidemiologist who led a World Health Organization campaign to eradicate smallpox 30 years ago, is affiliated with the University of Pittsburgh Center for Global Health. This story as originally published June 1, 2009 had an incorrect name for the center.
Victor Zapana can be reached at vzapana@post-gazette.com or 412-263-1956. Martine Powers can be reached at mpowers@post-gazette.com or 412-263-1308.
First published on June 1, 2009 at 12:00 am
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