THE THOMAS FRANCIS, JR. MEDAL IN GLOBAL PUBLIC HEALTH

First Recipient

William Foege, 2005

William Foege, the recipient of the first-ever Thomas Francis Jr. Medal in Global Public Health, pioneered a successful strategy to eradicate smallpox in the 1970s. Foege is the former director of the Carter Center and now senior advisor to the Bill and Melinda Gates Foundation.

Foege is an epidemiologist who became chief of the U.S. Centers for Disease Control (CDC) Smallpox Eradication Program; he was appointed director of the CDC in 1977. He joined the Carter Center as executive director in 1986 and became a senior adviser to the Bill and Melinda Gates Foundation in 1999, where he is now emeritus as a fellow.

As a medical missionary in Nigeria in 1966, Foege faced a fast-moving outbreak of smallpox without enough vaccine to protect the population in the traditional manner of inoculating as many members of a population as one can reach. Instead, he and his colleagues invented a new approach that modeled the most likely routes of transmission by geography, travel patterns, and familial relationships and then contained the outbreak by focusing the limited amount of vaccine on just three “hot spots.”

During another smallpox outbreak in India in 1973, Foege, then chief of the Centers for Disease Control’s smallpox eradication program, again proved that targeted containment vaccination worked better than mass vaccination. “In a year, India went from a country with the highest rate of smallpox to zero cases,” Foege recalls. Since then, his approach has become the standard of care for controlling outbreaks of emerging disease. In 1979, the World Health Organization declared smallpox eradicated.