Lecture Notes: D.A. Henderson on Smallpox Eradication and Biosecurity

Introduction to D.A. Henderson

Distinguished scholar at the Center for Biosecurity.
Founding director at the center.
Key roles in public health:
- Director of the Office of Public Health Emergency Preparedness post-Anthrax attacks (2001).
- Associate Director, Office of Science and Technology Policy for President Bush.
- Dean, Faculty of the School of Public Health, Johns Hopkins.
- Director of the Smallpox Eradication Program.
- Chief of Surveillance Section, Epidemiology Branch, CDC.
Awards: Presidential Medal of Freedom, National Medal of Science, National Academies of Sciences Public Welfare Medal, Japan Prize, among others.
Authored books on smallpox.

Background: Debate on whether to destroy smallpox virus stocks, with intense political and diplomatic implications.
Global Discussions: WHO resolution in 1976 recommended destruction or transfer to select laboratories (CDC, Atlanta; Moscow).
Lab Incidents: Accidents in laboratories highlighted the risk (1975 in Munich; 1978 in Birmingham).
Current Status: Only two known laboratories retain the virus (USA and Russia), with ongoing debates about destruction.
WHO Involvement: WHO committee in 1980 began assessing the need for research and the virus's fate.
Developing Countries' Stand: Strong advocacy for destruction due to past burdens of smallpox.

Virus Destruction Attempts: U.S. and USSR discussed destruction post-genomic sequencing in 1993.
International Consensus: Most countries and virologists favored destruction. Research protocols under international oversight.
Vaccine Production Challenges: Post-9/11, the U.S. focused on rebuilding vaccine stockpiles due to bio-terrorism fears.
Strategic Planning: Need for strategic plans to handle possible outbreaks, including vaccine distribution and public education.

IOM Reports (1999, 2010): Evaluated the potential loss of scientific information if the virus were destroyed.
Vaccination Strategies: Discussions on the production of vaccines with minimal side effects and antiviral development.
Current Capabilities: Evaluation of state and city readiness for mass vaccination campaigns.

Rinderpest: Anticipation of a formal announcement of eradication by OIE and FAO.
Lessons from Smallpox: Importance of careful certification and cautious announcement of disease eradication.
Preparedness for New Viruses: Need for proactive strategies to deal with future viral threats.

CDC and DOD Plans: Availability of response plans for smallpox, including ring vaccination strategies.
National Response Framework: Issues with existing scenarios and the need for updated strategic plans across agencies.
Global Cooperation and Future Threats: Concerns about preparedness for future viruses similar to smallpox.