{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T01:28:43Z","timestamp":1776821323055,"version":"3.51.2"},"reference-count":46,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ci\u00eanc. sa\u00fade coletiva"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:p>The 30th anniversary of the World Health Organization's (WHO) official certification of smallpox eradication was marked by a slew of events hailing the campaign's dramatic tale of technological and organizational triumph against an ancient scourge. Yet commemorations also serve as moments of critical reflection. This article questions the acclaim showered upon smallpox eradication as the single greatest public health success in history. It examines how and why smallpox eradication and WHO's concurrent social justice-oriented primary health care approach (following from the Declaration of Alma-Ata) became competing paradigms. It synthesizes critiques of eradication's shortcomings and debunks some of the myths surrounding the global eradication campaign as a public health priority and necessity, and as a Cold War victory of cooperation. The article concludes with thoughts on integrating technical and social-political aspects of health within the context of welfare states as the means to achieving widespread and enduring global public health success.<\/jats:p>","DOI":"10.1590\/s1413-81232011000200022","type":"journal-article","created":{"date-parts":[[2011,3,30]],"date-time":"2011-03-30T13:23:54Z","timestamp":1301491434000},"page":"591-597","source":"Crossref","is-referenced-by-count":10,"title":["Small(pox) success?"],"prefix":"10.1590","volume":"16","author":[{"given":"Anne-Emanuelle","family":"Birn","sequence":"first","affiliation":[{"name":"University of Toronto,  Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","series-title":"Smallpox and its eradication","author":"Fenner F","year":"1988"},{"key":"ref2","series-title":"Prepared remarks to the 2005 World Health Assembly","author":"Gates B","year":"2005"},{"key":"ref3","series-title":"Smallpox the death of a disease: the inside story of eradicating a worldwide killer","author":"Henderson DA","year":"2009"},{"issue":"4","key":"ref4","first-page":"465","article-title":"Lessons from the Big Eradication Campaigns","volume":"2","author":"Yekutiel P","year":"1981","journal-title":"World Health Forum","ISSN":"https:\/\/id.crossref.org\/issn\/0251-2432","issn-type":"print"},{"key":"ref5","series-title":"The Work of WHO 1978-1979: Biennial Report of the Director-General to the World Health Assembly and to the United Nation","year":"1980"},{"issue":"1","key":"ref6","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1080\/17441690802017797","article-title":"The stages of international (global) health: histories of success or successes of history?","volume":"4","author":"Birn A-E","year":"2009","journal-title":"Global Public Health"},{"issue":"4","key":"ref7","first-page":"315","article-title":"Mass campaigns versus general health services: what have we learned in 40 years about vertical versus horizontal approaches?","volume":"83","author":"Mills A.","year":"2005","journal-title":"Bulletin of the World Health Organization","ISSN":"https:\/\/id.crossref.org\/issn\/0042-9686","issn-type":"print"},{"key":"ref8","series-title":"Transcript of an oral interview with Dr. Joshua Cohen. 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Ups and downs of protection of breastfeeding, regulation of transnational corporations and Health for All","author":"Lhotska L","year":"2008"},{"key":"ref16","year":"1985"},{"key":"ref17","series-title":"Unicef, beware dangerous shoals ahead: backgrounder","author":"Brooks R","year":"1983"},{"key":"ref18","series-title":"The World Health Organization: resisting Third World ideological pressures","author":"Starrels J","year":"1985"},{"key":"ref19","year":"1981"},{"key":"ref20","year":"1989"},{"key":"ref21","first-page":"113","article-title":"Smallpox eradication: a Cold War victory","volume":"19","author":"Henderson DA","year":"1998","journal-title":"World Health Forum","ISSN":"https:\/\/id.crossref.org\/issn\/0251-2432","issn-type":"print"},{"issue":"2","key":"ref22","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1467-7709.2009.00850.x","article-title":"A pox on your narrative: writing disease control into Cold War history","volume":"34","author":"Manela 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1765-1910","first-page":"155","volume-title":"The revolta contra la vacina of 1904: the revolt against \"modernization\" in Belle-Epoque Rio de Janeiro","author":"Needell J.","year":"1996"},{"key":"ref28","series-title":"\"Civilizing\" Rio: reform and resistance in a Brazilian city, 18891930","author":"Meade TA","year":"1997"},{"key":"ref29","first-page":"536","article-title":"Morbosidad y mortalidad por viruela en la Republica durante el a\u00f1o 1909","volume":"6","year":"1911","journal-title":"Bolet\u00edn del Consejo Nacional de Higiene"},{"key":"ref30","series-title":"Decolonizing international health: India and Southeast Asia, 1930-65","author":"Amrith S","year":"2006"},{"key":"ref31","series-title":"Smallpox zero: an illustrated history of smallpox and its eradication","author":"Roy J","year":"2010"},{"issue":"5","key":"ref32","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/0277-9536(95)00035-6","article-title":"Intimidation, coercion and resistance in the final 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ground","volume":"40","author":"Dobson MJ","year":"1998","journal-title":"Parassitologia","ISSN":"https:\/\/id.crossref.org\/issn\/0048-2951","issn-type":"print"},{"key":"ref37","first-page":"1","article-title":"Eradication of infectious diseases: its concept, then and now","volume":"57","author":"Arita I","year":"2004","journal-title":"Japanese Journal of Infectious Diseases"},{"issue":"9","key":"ref38","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1001\/jama.289.9.1090","article-title":"The siren song of disease eradication: is it out of tune with the times?","volume":"289","author":"Vastag B","year":"2003","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"key":"ref39","first-page":"1","article-title":"Global disease elimination and eradication as public health strategies","volume":"76","author":"Goodman RA","year":"1998","journal-title":"Bulletin of the World Health 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