Donald Henderson

Eradication of smallpox

Henderson served as Chief of the CDC virus disease surveillance programs from 1960 to 1965, working closely with epidemiologist Alexander Langmuir. During this period, he and his unit developed a proposal for a United States Agency for International Development (USAID) program to eliminate smallpox and control measles during a 5-year period in 18 contiguous countries in western and central Africa.^[9] This project was funded by USAID, with field operations beginning in 1967.^[8]

The USAID initiative provided an important impetus to a World Health Organization (WHO) program to eradicate smallpox throughout the world within a 10-year period. In 1966, Henderson moved to Geneva to become director of the campaign. At that time, smallpox was occurring widely throughout Brazil and in 30 countries in Africa and South Asia. More than 10 million cases and 2 million deaths were occurring annually. Vaccination brought some control, but the key strategy was "surveillance-containment". This technique entailed rapid reporting of cases from all health units and prompt vaccination of household members and close contacts of confirmed cases. WHO staff and advisors from some 73 countries worked closely with national staff. The last case occurred in Somalia on October 26, 1977, only 10 years after the program began.^[8] Three years later, the World Health Assembly recommended that smallpox vaccination could cease. Smallpox is the first human disease ever to be eradicated.^[10] This success gave impetus to WHO's global Expanded Program on Immunization, which targeted other vaccine-preventable diseases, including poliomyelitis, measles, tetanus, diphtheria, and whooping cough.^[11] Now targeted for eradication are poliomyelitis and Guinea Worm disease; after 25 years, this objective is close to being achieved.^[6][12]

Later work

From 1977 through August 1990, Henderson was Dean of the Johns Hopkins School of Public Health. After being awarded the 1986 National Medal of Science by Ronald Reagan for his work leading the World Health Organization (WHO) smallpox eradication campaign, Henderson launched a public struggle to reverse the Reagan administration's decision to default on WHO payments.^[13] In 1991, he was appointed associate director for life sciences, Office of Science and Technology Policy, Executive Office of the President (1991–93) and, later, deputy assistant secretary and senior science advisor in the Department of Health and Human Services (HHS).^[8] In 1998, he became the founding director of the Johns Hopkins Center for Civilian Biodefense Strategies, now the Johns Hopkins Center for Health Security.^[4]

Following the September 11, 2001, attack on the World Trade Center, HHS Secretary Tommy G. Thompson asked Henderson to assume responsibility for the Office of Public Health Preparedness (later the Office of the Assistant Secretary for Preparedness and Response).^[14][15][16] For this purpose, $3 billion was appropriated by Congress.^[8]

In 2006, Henderson co-authored a paper in which the authors were skeptical of several potential pandemic measures, including social distancing: "Many could result in significant disruption of the social functioning of communities and result in possibly serious economic problems. Such negative consequences might be worth chancing if there were compelling evidence or reason to believe they would seriously diminish the consequences or spread of a pandemic. However, few analyses have been produced that weigh the hoped-for efficacy of such measures against the potential impacts of large-scale or long-term implementation of these measures."^[17]

At the time of his death, he served as the Editor Emeritus of the academic journal Health Security (formerly Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science).^[18]

Honors and awards

Seventeen universities conferred honorary degrees on Henderson.^[37]

Selected publications