Although Viktor Zhdanov’s name is little known today, he spearheaded one of the greatest projects in history. Who was he and what did he do?
Is it possible for us to eradicate a disease that has plagued humankind for thousands of years? That was the question posed to the World Health Organisation in 1958.
For over three thousand years, the disease smallpox devastated people across the world. The variola virus, which caused smallpox, was inhaled by individuals through the air or contracted through fluids and surfaces. For several days, they would experience fevers, fatigue and muscle pain, before spots would appear on their mouths and tongues. Then pimples and rashes would develop on their faces, their chests, and then all over their bodies. These spots and rashes erupted, releasing new particles of the variola virus into the air or fluids, where they could infect more people.
During this time, some patients started bleeding internally. The virus could replicate so considerably that it could overwhelm their immune system (causing sepsis), their lungs (causing fatal pneumonia), their cornea (causing blindness), their bones (causing arthritis and deformation), and their heart (causing heart failure).
Altogether, around 30% of people who contracted the virus were estimated to die from the disease. Smallpox wiped out hundreds of thousands of people each year in Europe (and countless more across the world) in the 18th century, and the anguish it caused spurred the development of several preventative measures. These measures included quarantines, border closures, and new medical procedures. Variolation, which involved inoculating people with weakened forms of the variola virus, was practiced informally in communities around the world. Vaccination, on the other hand, was entirely novel. The smallpox vaccine, which was developed by the English physician Edward Jenner at the end of the 18th century, was the first vaccine ever produced against a contagious disease.
Over the 19th century, states in many parts of the world instituted vaccination programmes and inoculated their citizens against the fatal disease. But the fight was still not over. Even in the 1950s, the virus infected around 50 million people every year, particularly in Africa and South Asia.
Going back to 1958, where this piece began, the position of the World Health Organisation on the matter was simply to urge health administrations to conduct their own campaigns against the virus, as part of their regular public health programmes.
Where the other ministers in the WHO saw doubt and despair – pointing to the failed campaigns to eliminate hookworm disease and yellow fever – a scientist named Viktor Mikhaĭlovich Zhdanov saw opportunity.
Although Zhdanov’s name is little known today, he was an influential scientist at the time. With a background in virology and epidemiology, and a position as the deputy health minister of the Soviet Union, he had already led a successful campaign which contained smallpox in the Soviet Union and another campaign which contained Guinea-worm disease in the Central Asian republics.
In 1958, Zhdanov argued at length that the WHO should lead worldwide campaigns to quarantine, isolate and vaccinate people around the world until the disease was finally eliminated. He argued that the variola virus would be easier to contain than other pathogens because humans were its only host. It mattered because the disease remained endemic in many developing regions, which lacked the resources and political ability to vaccinate their populations, and it threatened other regions that were susceptible to reintroductions of the virus.
Zhdanov also brought his technical expertise to the table – he argued that a new procedure (lyophilisation) could be used to preserve stocks of the smallpox vaccine, allowing them to be transported easily to where they were needed.
His argument was so convincing that the World Health assembly voted unanimously in favour of the global campaign, when a similar proposal had been rejected for being too unrealistic just three years previously.
The process was neither simple nor usual, but it was possible. After struggling for years to find the financial support and the political resources to eliminate the disease in poor and dense countries such as India, smallpox was declared eradicated across the entire world two decades later, in 1980.
Zhdanov is not the only figure who deserves credit for this effort, of course, as countless other scientists, ministers, healthcare workers and ordinary people were involved in the gargantuan effort to eliminate smallpox once and for all.
But in many ways, his vision and undertakings on the campaign represent the ideals of Works in Progress: to see possibility where others see despair, to persuade with reason and evidence, and to push the boundaries of global welfare with human ingenuity.
The ideas we aspire to spread may not be as successful as the smallpox eradication programme was, and the stories of how progress came to be may not be so complete, but they will positively be, in more ways than one, works in progress.