Principles and lessons from the smallpox eradication programme.

The eradication of smallpox required a unique, fully collaborative international effort on the part of WHO and Member States. In the course of the programme, many lessons were learned in its organization, execution and evaluation which have implications for other international activities. Most important among these was the need to establish measurable objectives and to evaluate progress and performance in terms of these; to establish procedures for quality control both of vaccines and performance; to recruit the best possible personnel and support them; and to assure an on-going programme of problem-oriented research which can facilitate activities and resolve apparently paradoxical observations. The inherent capacities of national health services to execute their smallpox eradication programmes was gratifying. It encouraged the belief that other, more complex health measures could be undertaken. Although this would necessitate that adequate numbers of competent leaders be recruited and given delegated responsibility, such persons were usually found to be available although often inexperienced. WHO's roles in catalysing and orchestrating this great effort were critical. Its potential for promoting other efforts in disease prevention and health promotion was apparent although still only partially realized.