At least 300 million people died in the 20th century because of smallpox, according to The World Health Organization.
In 1966, a global program was initiated by WHO. The U.S. Agency for International Development financed the first project: the Centers for Disease Control and Prevention’s effort to eliminate smallpox in 20 countries of West and central Africa.
I was part of that first experience, and we eliminated smallpox in that area in 3½ years, ahead of schedule and under budget. The U.S. had not had a case of smallpox since 1949 yet took a leadership role.
Why?
Because such leadership contributes greatly to all countries.
Investment in vaccines has paid off more than tenfold
The U.S. recoups its investment in smallpox eradication every three months because of savings in quarantine operations, the cost of vaccination programs and especially in the treatment of those harmed by smallpox vaccine.
The smallpox vaccine was crude and dangerous compared to modern vaccines, yet the disease was so frightening — with a third dying and a third scarred for life — that people accepted the risk of the vaccine.
That initial USAID-sponsored program also resulted in a simplified strategy for smallpox eradication, and all countries benefited. We have now recovered our total investment 160 times in the past 40 years.
The measure of civilization is how we treat each other. It measures a person, a political party, an institution or a country. There have been improvements in some measures over the centuries. It also measures our efforts to improve global health.
Yet, it is a thin facade, as demonstrated in Germany in the 1930s.
Loving our neighbors means extending help overseas
I live in Georgia, not because of birth but by choice. Over 65 years ago, a mentor in Seattle told me that if I was truly interested in global health I should go to Atlanta and join the CDC.
He said I would find colleagues with the same passion, and they would be friends for life.
He was right and it was a good choice for me. But it was a neglected field until the turn of the century when the Gates family — Bill Gates Sr., Bill Gates and Melinda French Gates — changed everything with their entry into the field.
Within a decade, there were resources to fight neglected diseases and to do research on problems of the poor around the world. Students flocked to global health programs worldwide.
Georgia, in the Bible Belt, is proud of religion promoting “Love your neighbor as yourself.” In truth, all major religions promote the Golden Rule. But the paradox is how often people identify as religious — many of them leaders — but promote the idea of America First and object to foreign assistance.
Imagine the agony as global health workers watched USAID dismantled over a weekend. At first it appeared to be the work of people who were both incompetent and uninformed. But then, a chain saw, displayed with glee, marked this as an act of incompetence, lack of knowledge and moral bankruptcy.
Lives will now be shortened, suffering will be increased and life quality will diminish for millions around the world.
The approach to the CDC is no less criminal. A comedian once said, to be geniuses, think of the most stupid thing you could do, and do the opposite.
The current administration seems to have gotten half of this right. They have figured out the worst thing they could do, but then they went on to do it.
The objective of global health workers is simple: Seek global health equity. This administration appears to seek global health equity by decreasing the health of the U.S. until we have reached the global norm.
Reducing Americans’ health goes against good medicine
Hollowing out the ability to track and understand disease problems, destroying the disease response capacity, reducing the support of key state programs, removing the work to protect workers in the workplace, reducing efforts to improve immunization programs and promoting misinformation — they are all indications of ignorance of medicine and public health but also a deep level of disdain for the plight of others.
Who is at fault? We all are. But especially at fault are politicians who view their reelection as more important than any oath they gave.
How is one to explain Sen. Bill Cassidy, R-Louisiana — a physician involved in good causes, such as establishing a free clinic for those who can’t afford health insurance — supporting Health and Human Services Secretary Robert Kennedy Jr., who is not simply neutral but a promoter of measures to reduce health?
I ask, “Was reelection really more important than your ideals, oaths, promises and the health of millions?”
Benjamin Rush, physician at the time of the American Revolution said, “National crimes require national punishment.” We are all part of the national crimes now playing out, and national punishment is the result.
Let us hope we are worthy of a pardon.
Credit: contributed
Credit: contributed
William H. Foege is a former director of the Centers for Disease Control and Prevention. He is a physician and epidemiologist whose global health contributions led to the eradication of smallpox in the late 1970s. He was awarded the Presidential Medal of Freedom in 2012.
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