House on Fire: The Fight to Eradicate Smallpoxvolume 21

and#147;Bill Foege takes us inside the world's greatest public health triumph: the eradication of smallpox. It's a story of true determination, passion and courage. The story of smallpox should encourage all of us to continue the critical work of worldwide disease eradication.and#8221;--Bill Gates, Co-Chair of the Bill and Melinda Gates Foundation

and#147;Bill Foege is one of the public health giants of our times. He was responsible for the design of the campaign that eradicated smallpoxand#151;the most important global health achievement in history and possibly the greatest feat in any field of international cooperation. His insights into the nature of this major event will undoubtedly help to meet the global health challenges of the 21st century.and#8221;and#151;Julio Frenk, M.D, PhD, Dean, Harvard School of Public Health

and#147;The eradication of a disease has long been the holy grail of global health and Bill Foege found it: more than any other person, he was responsible for the eradication of smallpox from the face of the earth. This is a story told by a remarkably humble man, about the extraordinary coalition that he helped to build, and the most impressive global health accomplishment the world has ever seen.and#8221;and#151;Mark Rosenberg, author of Real Collaboration: What It Takes for Global Health to Succeed

and#147;I am thrilled that Bill Foege, one of the great heroes of the smallpox eradication campaign, has written this important book. It tells a beautiful human story of an incredible public health triumph, and is full of lessons that could be applied to many of the global challenges we face today.and#8221;and#151;Helene D. Gayle MD, President and CEO, CARE USA

and#147;Bill Foegeand#8217;s House on Fire is the first-hand account of how a revised strategy to eradicate smallpox was tested, validated, and applied. Without the global adoption of this new surveillance strategy, the final deathblow to this longtime global menace might never have been dealt.and#8221;and#151;Adetokunbo O. Lucas, MD, DSc, author of It Was The Best of Times: From Local to Global Health

and#147;Smallpox is the most devastating disease the world has known, as it destroyed lives and shaped history over the centuries. House on Fire provides a day-to-day account by my friend Dr. Bill Foege of the battle required to defeat this wily and diabolic virus."--President Jimmy Carter

“Dr. Foeges book . . . remind[s] us how fragile life looks.” New York Times

and#8220;Bounces the reader along with him in his jeep, on motorbikes over rugged terrain and on bustling trains. . . . (And) shows what can be accomplished when governments and thousands of health workers focus on a single objective. and#8220;

and#8220;[Foege] writes a mixture of memoir, dry public health guide and riveting tale of an all-consuming mission.and#8221;

and#8220;A readable and thorough account by a key player in this outstanding victory for public health.and#8221;

and#8220;Gives an intimate sense of what it is like to work on the ground in some of the world's most impoverished countries -- and tells what it is like to contribute to programs that really do change the world.and#8221;

and#8220;A reminder of the importance of preventive medicine.and#8221;

“A reminder of the importance of preventive medicine.” Library Journal

and#8220;A great, quick, and intensely personal read about the inside story of Foege's revolutionary idea and powerful actions. . . . Foege was wise before his time.and#8221;

and#8220;Demonstrate[s] the enormous benefit that can accrue to mankind when a determined and ambitious band of individuals come together.and#8221;

and#8220;Inspiring. . . . A fascinating human interest account that is expertly merged with scientific facts.and#8221;

“A fascinating account” Pascal James Imperato - Jrnl Of Community Health

and#8220;Dr. Foegeand#8217;s book . . . remind[s] us how fragile life looks.and#8221;

and#8220;A fascinating accountand#8221;

A story of courage and risk-taking, House on Fire tells how smallpox, a disease that killed, blinded, and scarred millions over centuries of human history, was completely eradicated in a spectacular triumph of medicine and public health. Part autobiography, part mystery, the story is told by a man who was one of the architects of a radical vaccination scheme that became a key strategy in ending the horrible disease when it was finally contained in India. In House on Fire, William H. Foege describes his own experiences in public health and details the remarkable program that involved people from countries around the world in pursuit of a single objectiveand#151;eliminating smallpox forever. Rich with the details of everyday life, as well as a few adventures, House on Fire gives an intimate sense of what it is like to work on the ground in some of the worldand#8217;s most impoverished countriesand#151;and tells what it is like to contribute to programs that really do change the world.

William H. Foege, Senior Fellow at the Gates Foundation, has held a succession of distinguished positions, including Director of the Centers for Disease Control and Prevention and Professor and Health Policy Fellow at Emory University. Before becoming director of the CDC, he was chief of its Smallpox Eradication Program. Foege is the author of Global Health Leadership and Management.

List of Illustrations

Foreword by Carmen Hooker Odom and Samuel L. Milbank

Foreword by David J. Sencer

Preface

Part One. Africa: Identifying the Key Strategy

1. A Loathsome Disease

2. A Succession of Mentors

3. Practicing Public Health in Nigeria

4. Fire Line around a Virus

5. Extinguishing Smallpox in a Time of War

Part Two. India: Meeting the Challenge of Eradication

6. Under the Rule of Variola

7. Unwarranted Optimism

8. A Gorgeous Coalition

9. Rising Numbers, Refining Strategy

10. Water on a Burning House

11. Smallpox Zero

Conclusion

Postscript

Appendix: A Plan in the Event of Smallpox Bioterrorism

Notes

Glossary

Index