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In this article, I describe the complex nature of the final phases of the Indian smallpox eradication program. I examine the unfolding of policies at different levels of administration and the roles played by a wide range of national and international actors. A careful examination of unpublished official correspondence, on which this article is largely based, shows that the program's managers were divided and that this division determined the timing of the achievement of eradication. This material also reveals that Indian health workers and bureaucrats were far more capable of reshaping policies in specific localities, often in response to local infrastructural and political concerns, than has been acknowledged in the historiography.
THE ERADICATION OF SMALLPOX in India would not have been possible but for the contributions of many actors. The headquarters of the World Health Organization (WHO) in Geneva, Switzerland, and its South East Asia Regional Office, based in New Delhi, India, played a prominent role. So did the health ministries of the Indian central and state governments. All of these agencies set up a series of special "eradication units," which deployed several energetic medical and public health personnel all over the subcontinent. The Soviet Union, the United States, Sweden, and a host of other Asian and European countries provided generous doses of aid, often bilaterally (without involving intermediary non-governmental agencies), in the form of field operatives, vaccine, operating kits, and money. Indian and international charitable institutions made significant contributions at crucial junctures as well.1
The involvement of such a great variety of workers is not surprising considering how complicated the organization of the final stages of the Indian smallpox eradication campaign turned out to be. The country was huge, with stretches of very difficult terrain, often with no access to transportation links. The topography was varied, and specific campaign methods had to be organized for each territorial context. Language and culture were equally varied. More than 20 major languages and several local dialects were spoken, and there was a wide variety of religious traditions and class configurations in the localities of each Indian state. The administrative challenges did not end there. Many sections of the Indian population were often not only uncooperative but also openly hostile to the quest for smallpox eradication.
Even...