Contenu
This book explores the topical issue of implementing a global vaccination programme. It illustrates why, despite being faced with overwhelming environmental and infrastructural challenges, the smallpox programme succeeded in Nepal.
The devastating disease of smallpox was common in Nepal in the 1960s. Implementing a global health programme highlights people's experiences with smallpox, and how this influenced ideas and behaviour, including attitudes to vaccination. It tells multiple and different stories, from the local to the global, and involves individual, community, state, extra-state, and foreign actors. Mass vaccination remained important throughout Nepal's smallpox programme, but after 1971 it was a time-limited annual campaign, administered in line with Nepali people's longstanding preference for it being given in winter.
Placing the country and people's perspectives at the centre, the volume offers an alternative to the top-down and centre-led standard narrative of the global smallpox programme. Project leaders in Nepal decentralised the programme's structure, not just on paper but in practice to achieve timely and effective response. Nowhere else in the official history in the conclusions drawn from different national programmes is such a decentralised strategy referred to as a reason for success - even the leader of the WHO-led global smallpox programme acknowledged the exceptionalism of Nepal. Although success with smallpox was more than forty years ago, implementing communicable disease health programmes with their many challenges remains highly topical and relevant today.