Five years of freedom from smallpox.

In 1967, when the intensified global eradication programme was launched, smallpox was still endemic in 35 countries with a total population of 1200 million and caused an estimated 10-15 million cases, resulting in 2 million deaths. Ten years and ten months later, on 26 October 1977 through intensified public health activities, the chain of smallpox transmission was finally broken in Merka, south Somalia; the World Health Organization missed its ten-year target line by ten months. In December 1979, the Global Commission concluded that the global eradication of smallpox had been achieved and the Organization formulated its policy for the post-eradication era. In May 1980, the 33rd World Health Assembly endorsed the Commission's conclusion and officially confirmed the international acceptance of smallpox eradication as the most outstanding achievement in international public health. This achievement has unmistakably demonstrated that the concept of disease eradication is correct and feasible. WHO encouraged countries to discontinue smallpox vaccination and/or the need for a smallpox vaccination certificate from international travellers. However, WHO is continuing its vigilance over the disease and promoting further research on orthopox viruses. Globally, US$ 313 million were spent on the eradication of smallpox from the world. However, conservative calculations indicate that in the post-eradication era, concrete economic returns resulting from the eradication of smallpox throughout the world, are estimated at US$ 1000 to 2000 million, annually. For the last five years of smallpox-free status, savings of about US$ 5000-10 000 million could be diverted for other health projects, which has had a major impact on international public health. However, there are other dividends similarly worthy as those of economic value. The most important of these are the hundreds of thousands of experienced and dedicated health workers who remain now in the countries as a solid base for implementing other important public health programmes.