The Role of Smallpox Vaccination in Mortality Decline in the Great Britain through Eradicating the Disease between XVIII-XX centuries - Facts or a Political Arithmetick? "

Mamurjon Rahimov

University of Illinois at Chicago

Department of Economics

"Whoever would understand the political phenomenon known as 'The Anti-Vaccination Agitation "- and its magnitude would seem to indicate it as being at least worth understanding - must remember some one or two facts, facts obvious enough indeed, but constantly forgotten. And chief amongst them this, that every opponent of the practice, every skeptic, without exception, as to its benefits, has in the first instance approached the question in a spirit at least of impartiality, and probably all his prejudices strongly in its favor "

Alfred Milnes

Introduction

In October of 1979, The World Health Organization (WHO), officially declared smallpox, also known as variola, eradicated. The disease that was known to mankind as early as 1122 BC in China, took millions of lives throughout the world (Britannica.com). We all know that WHO is a branch of the United Nations Organization, and is dedicated to protect the health of the mankind. However, UN also has many other branches dealing with issues like business, economy, culture, education, migration, to name a few, and furthermore, the eradication of smallpox is believed to be a collaborative achievement of most of these branches, both on local and on global level. If so, this eradication must have been announced jointly with, if not all, then at least few other UN branches such as World Bank, UNDP, and UNICEF. It would be very unfair for medical men to appropriate this great achievement of mankind all to themselves. Although medical men do not like to mention it too much, they all recognize that eradication of smallpox was not only their merit.

Economic history has contributed significantly to the formulation of various economic theories. Among the economists who have found history to be an important source for their ideas one can cite Adam Smith, Thomas Malthus, Alfred Marshall, John Maynard Keynes, Milton Friedman, Robert Solow, and Gary Becker. For economists it is very important to study population history in order to come up with policies that decrease mortality and morbidity of the population. Factors like life expectancy, infant mortality are considered to be key indicators of progress in any country. Longer life expectancy means more manpower to move the industry, larger consumer base for products and services.

My purpose here is to elaborate in theoretical and statistical plausibility of smallpox vaccination eradicating the disease based on papers written about the smallpox disease, and to seek whether the vaccination, if efficient at all, weighed substantially in the light of other forces that caused decline in mortality. It is quite striking to read from Memoirs of Jacques Casanova, a contemporary, that "More people perish at the hands of doctors than are cured by them "in those centuries, and in contrast the common belief that in those centuries medical men suddenly came up with "One-size-fits-all" cure for one of the most dreadful diseases of all time, which, with little modifications, if any, continued to be administered worldwide up until the second half of the XX century.

For several centuries until now, proponents of vaccination hailed smallpox vaccination to be a proven wonder weapon in the hands of mankind in eradicating the disease in the world, although there have been a number of schools of thought that, if not disprove, then diminish the role of smallpox vaccination in fighting the disease to an insignificant level, which is the change in the virulence of smallpox.

We must remember from European history that the period in which the most drastic decline in British smallpox mortality took place coincides with the time Britain experienced industrial revolution, and thus improved standards of living must have played crucial role in reducing susceptibility of the population towards infectious diseases (Krause, 1958). A good example is a paper written by several researchers from the University of Liverpool and Manchester that used time-series analysis to study the dynamics of smallpox in Britain in 1550-1800, and found a striking correlation between wheat price fluctuations and epidemics (Duncan, 1993; also see Helleiner, 1957).

Economists almost always try to use models in order to come up with logical interpretations of current and past events. One such paper (Mokyr, 1993) that tries to explain decline in mortality in the light of economic forces, used standard theory of utility maximization as a starting point: Uj = Uj (Xij ... Xnj, Lj) where L is composite family life expectancy variable, subject to the usual budget constraint