Author's note: In 2023 this piece received two edits for historical accuracy. See comment here for details.

We will never know their names.

The first victim could not have been recorded, for there was no written language to record it. They were someone’s daughter, or son, and someone’s friend, and they were loved by those around them. And they were in pain, covered in rashes, confused, scared, not knowing why this was happening to them or what they could do about it — victims of a mad, inhuman god. There was nothing to be done — humanity was not strong enough, not aware enough, not knowledgeable enough, to fight back against a monster that could not be seen.

It was in Ancient Egypt, where it attacked slave and pharaoh alike. In Rome, it effortlessly decimated armies. It killed in Syria. It killed in Moscow.  In India, five million dead. It killed a thousand Europeans every day in the 18th century. It killed more than ten million Native Americans. From the Peloponnesian War to the Civil War, it slew more soldiers and civilians than any weapon, any soldier, any army. (Not that this stopped the most foolish and empty souls from attempting to harness the demon as a weapon against their enemies.)

Cultures grew and faltered, and it remained. Empires rose and fell, and it thrived. Ideologies waxed and waned, but it did not care. Kill. Maim. Spread. An ancient, mad god, hidden from view, that could not be fought, could not be confronted, could not even be comprehended. Not the only one of its kind, but the most devastating.

For a long time, there was no hope — only the bitter, hollow endurance of survivors.

In China, in the 15th century, humanity began to fight back.

It was observed that survivors of the mad god’s curse would never be touched again: They had taken a portion of that power into themselves, and were so protected from it. Not only that, but this power could be shared by consuming a remnant of the wounds. There was a price, for you could not take the god’s power without first defeating it — but a smaller battle, on humanity’s terms. 

By the 16th century, the technique spread to India, then across Asia, the Ottoman Empire and, in the 18th century, Europe. In 1796, a more powerful technique was discovered by Edward Jenner.

An idea began to take hold: Perhaps the ancient god could be killed.

A whisper became a voice; a voice became a call; a call became a battle cry, sweeping across villages, cities, nations. Humanity began to cooperate, spreading the protective power across the globe, dispatching masters of the craft to protect whole populations. People who had once been sworn enemies joined in a common cause for this one battle. Governments mandated that all citizens protect themselves, for giving the ancient enemy a single life would put millions in danger.

And, inch by inch, humanity drove its enemy back. Fewer friends wept; fewer neighbors were crippled; fewer parents had to bury their children.

At the dawn of the 20th century, for the first time, humanity banished the enemy from entire regions of the world. Humanity faltered many times in its efforts, but there were individuals who never gave up, who fought for the dream of a world where no child or loved one would ever fear the demon ever again. Viktor Zhdanov, who called for humanity to unite in a final push against the demon; the great tactician Karel Raška, who conceived of a strategy to annihilate the enemy; Donald Henderson, who led the efforts in those final days.

The enemy grew weaker. Millions became thousands, thousands became dozens. And then, when the enemy did strike, scores of humans came forth to defy it, protecting all those whom it might endanger.

The enemy’s last attack in the wild was on Ali Maow Maalin, in 1977. For months afterwards, dedicated humans swept the surrounding area, seeking out any last, desperate hiding place where the enemy might yet remain.

They found none.

Thirty-five years ago, on December 9th, 1979, humanity declared victory.

This one evil, the horror from beyond memory, the monster that took 500 million people from this world, was destroyed.

You are a member of the species that did that. Never forget what we are capable of when we band together and declare battle on what is broken in the world.

Happy Smallpox Eradication Day.



This work is licensed under a Creative Commons Attribution 4.0 International License.

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The Rational Animations team has animated this, with narration by Robert Miles. It's great, as is the rest of their growing body of work.

I was pretty happy to see the animated-birds-explaining-things crossover with the animated-dogs-explaining-things, especially as I'm now working with the animated explainer dogs.

I'm curating this post, which is an EA classic. Curation isn't generally for older posts, but we have lots of new users coming in (so a classic might be more helpful than usual), and we're soon approaching smallpox eradication day, anyway.

And as often, I love the Our World in Data entry on the subject. Here's a chart from that entry:

I think this is one of the best pieces of EA creative writing of all time.

I agree. Literally felt the ebb and flow of history in that piece.

On December 9th, and probably for future Decembers 9th, we will feature this post on the front page to commemorate Smallpox Eradication Day. 

(Some places use May 8th as the date to celebrate smallpox eradication; we've seen both dates used in different places, so we'll stick with Jai's date.)

Remember that hard problems can be solved, and that we are capable of working together when the conditions are correct.

On the battle's cost and cost-effectiveness:

The annual cost of the smallpox campaign between 1967 and 1979 was $23 million. In total, international donors provided $98 million, while $200 million came from the endemic countries. The United States saves the total of all its contributions every 26 days because it does not have to vaccinate or treat the disease.



A French translation of this post is available here.

A Spanish translation is now also available.

A Norwegian translation of this post is available here.

Today, May 7 2023, I am planning to make some updates to this piece for historical accuracy. As part of this update, I'm including some citations and commentary in this comment.

I feel torn writing about some of these, because it's attempting to summarize and quantify an incomprehensible quantity of suffering and death. The numbers are important, to recognize what was lost, to honor the fallen as best we can, and to emphasize the importance of killing Smallpox. But quantifying that loss, for me at least, requires temporarily embracing a detached attitude, especially when the clues are many and uncertainty is abundant. So that is how I will be describing citations and numbers for the remainder of this comment - and then, when I've collected as many citations and clarified as many estimations as I can, I will grapple with them as a human.

Much of the narrative is just from Wikipedia's page on the History of Smallpox. This has changed a bit since 2014.

The figure "500 Million" comes from Donald Henderson by way of Our World in Data.

"Five million in India" comes from this article by Eugene D. Robin, Robert F. McCauley in the Indian Journal of Medical Ethics, 1997.

"[A] thousand Europeans every day in the 18th century" is from the Wikipedia page. Specifically, "400,000" annual deaths.

[Update] The text originally said that Smallpox killed "more than fifty million Native Americans". I cannot find any source I might have originally used for this claim. When attempting to research this more recently, I came across the 2019 paper "Earth system impacts of the European arrival and Great Dying in the Americas after 1492", which estimates 55 million all-cause deaths from European contact across the Americas between 1492 and 1600. "Counting the Dead: Estimating the Loss of Life in the Indigenous Holocaust, 1492-Present" is part of a body of literature exploring the interplay between disease and intentional violence, which further complicates things. Lots of things can make people vulnerable to disease. If a family is forced to relocate, goes hungry, and subsequently are weaker when they fall ill, it seems incorrect to say that the illness alone killed them. All told, disease is widely agreed to be the most significant contributor to the great dying of the Indigenous Peoples of the Americas, and of the diseases Smallpox was probably the most significant killer. Given the complexities and uncertainties here, when I finish writing this comment, I intend to update the text to "over ten million Native Americans" as a lower bound that I feel 80% confident about. I think I could refine this further with more research - this is still extremely ad hoc - but this is as much time as I can afford at the moment.

 "more soldiers and civilians than any weapon, any soldier, any army": See Wikipedia's "List of anthropogenic disasters by death toll"

[Update] "In China, in the 10th century, humanity began to fight back." I believe I originally got this figure from Our World In Data, but now believe it to be inaccurate. There are "references" that say the tradition dates back to the tenth century, but the evidence is sparse. Going by Wikipedia's article on Variolation, I'm updating this to "the 15th century". 

Edward Jenner, 1796: Wikipedia. I'm choosing the day of the first inoculation (James Phipps) on May 14, 1796 rather than the publication date of the resulting paper, Inquiry into the Variolae vaccinae known as the Cow Pox, in 1798.

From here on most of the narrative can be traced through the Eradication section of Wikipedia's article on Smallpox:
 - "On August 26, 1807, Bavaria became the first country in the world to introduce compulsory vaccinations."
 - "In Northern Europe a number of countries had eliminated smallpox by 1900". 
 - "In 1958 Professor Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox."
 - "In 1966 an international team, the Smallpox Eradication Unit, was formed under the leadership of an American, Donald Henderson.[127] In 1967, the World Health Organization intensified the global smallpox eradication by contributing $2.4 million annually to the effort, and adopted the new disease surveillance method promoted by Czech epidemiologist Karel Raška."
 - "To eradicate smallpox, each outbreak had to be stopped from spreading, by isolation of cases and vaccination of everyone who lived close by.[129] This process is known as "ring vaccination"."
 - "The WHO established a network of consultants who assisted countries in setting up surveillance and containment activities."
 - "donations of vaccine were provided primarily by the Soviet Union and the United States"
 - "The last naturally occurring case of indigenous smallpox (variola minor) was diagnosed in Ali Maow Maalin, a hospital cook in Merca, Somalia, on 26 October 1977"
 - "The global eradication of smallpox was certified, based on intense verification activities, by a commission of eminent scientists on 9 December 1979 and subsequently endorsed by the World Health Assembly on 8 May 1980."

Thank you.

This post takes a well-known story about impact (smallpox eradication), and makes it feel more visceral. The style is maybe a little heavy-handed, but it brought me along emotionally in a way that can be useful in thinking about past successes. I'd like to see somewhat more work like this, possibly on lesser-known successes in a more informative (but still evocative) style.

The Effective Altruism Forum Podcast has created an audio version of this post here:

This reminds of Nick Bostrom's story, "The Fable of the Dragon-Tyrant". Maybe somebody will write a story like this about ageing instead of smallpox in the future.

In all of human history, there had been no other disease like smallpox. It was vicious: It killed at least a third of those infected, and scarred or blinded most of the survivors. It was fast-moving, traveling everywhere that men had gone, carried by armies and traders and missionaries and slaves. It was relentless, roaring up into periodic epidemics, but never fully disappearing in between.

And it had always been there. The written records of its assaults on humanity went back more than three thousand years. Over the centuries, smallpox had devastated cities, changed the course of battles, and stalled the growth of empires. It had shuffled the leadership of dynasties like a pack of playing cards, decimating the royal houses of England, Holland, France, and Austria, and killing rulers in India, China, and Japan.

— From Beating Back the Devil

Sharing this here for those viewing this post today (Dec. 9, 2020): 

The Future of Life Institute (an EA-aligned org) is awarding their annual Future of Life Award in about 8 hours time to Viktor Zhdanov and Bill Foege, for their critical contributions to the eradication of smallpox!

If you'd like to attend the event, learn more about it here:

The event will include the following people:
- Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases,
- Bill Gates, Microsoft co-founder and philanthropist,
- Jennifer Doudna, Berkeley Biochemist and 2020 Nobel Laureate.
Previous winners are Vasili Arkhipov, Stanislav Petrov and Mathew Meselson, who helped prevent two nuclear wars and one bioweapon arms race, and they/family members will join the celebration. The event will also feature a panel discussion moderated by MIT Prof. Max Tegmark about interesting issues relevant to this year’s award. You can find more information about the award here:

To attend the event, join via the following links:

Sadly just missed this -- is there a recording? Couldn't find one on the Youtube page, nor the award website.

You can see the recording here. It was a great ceremony.!

Thanks Jai! I thought this piece was outstanding. I also loved What Almost Was.

It is remarkable what humans can do when we think carefully and coordinate.

This short essay inspires me to work harder for the things I care about. Thank you for writing it.

Re-read this again just now and truly is a tremendous piece!

Maybe someone will write an essay like this about aging in a few decades when we find a solution for it.

How do I create my own post in this forum?

You can click on your username in the upper-right corner. Under "My Drafts", there will be an option for "New Post".

You can also hover over your username, and the drop-down menu that appears should include an option to create a new post.

Very well written, thanks for the show!

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