Dvacet let bez neštovic

Twenty Years without Smallpox

It is 20 years since the 33 rd World Health Assembly (WHA) declared that „worldwide eradication ofsmallpox“ was achieved. This was the outcome of many years intensive work of the World HealthOrganization (WHO) and its member countries. In 1958 the WHA adopted the recommendation thatWHO should initiate the eradication of smallpox on a worldwide scale. In 1967 the eradicationactivities in hitherto endemic countries became more intense. Smallpox affected 31 countries and15 countries recorded from occasional cases. Every year more than 10 million people contracted thedisease and two million of them died. A ten-year limit for the eradication was set. Gradually smallpoxwere eradicated in South America, then in Asia and last in Africa where the last case of endemicsmallpox was recorded in 1977 in Somalia. WHO ensured international collaboration, close coordi-nation of activities and mobilization of financial, personal and material resources. It ensured alsothat tested methods were fully applied in the affected countries regardless of their political, religiousand cultural differences. In the eradication activities participated hundreds of thousands of localand 700 health professionals from abroad, incl. 20 Czechoslovak epidemiologists. The worldwidecosts of eradication amounted to some 300 million dollars, i.e. some 23 million per year. The mostimportant contribution of the eradication of smallpox was in addition to the termination of humansuffering, worldwide financial savings estimated to 1–2 billion US dollars per year. These savedpersonal and financial resources could be used for other important health projects. The eradicationof variola was defined as eradication of clinical forms of smallpox not as the final eradication of thevariola virus. The importance of laboratories keeping the variola virus increased steeply at the timewhen clinical cases of smallpox were eradicated. From the beginning of the eighties WHO made aneffort to reduce their number to a minimum. Since 1984 strains of variola are officially kept only intwo centres collaborating with WHO. The Organization suggested destruction of the kept viruses in1987, i.e. ten years after the eradication of smallpox. Unfortunately some political and scientificcircles did not agree with this intention. Even recommendations to destroy the virus in 1993 andagain in 1999 were not accepted. In the nineties fear of bio-terrorism and secret modernization ofbiological weapons influenced some member countries to change their opinion on the intendeddestruction of the virus. Despite this in May 1999 the WHA adopted a resolution that the finaldestruction of all variola strains is the objective of all member countries of WHO and recommendedto postpone the destruction of the virus to the year 2002. The reason for postponement is currentresearch of new antiviral preparations and better vaccines. There is again hope that all that will beleft of the variola virus will be magnetic signals on computer diskettes.

Key words:
smallpox – eradication.