There are few people in the field of global public health so well-known that you merely need to utter two initials to evoke instant recognition.
But to raise in conversation Dr. Donald Ainslee Henderson, the man who led the successful effort to eradicate smallpox, all anyone ever bothered to say was “D.A.”
Henderson, a few weeks shy of his 88th birthday, died late Friday of complications that arose after he recently fractured a hip.
Towering in physical stature as well as in reputation, Henderson had a booming voice, which he used to great effect. He did not hesitate to express his views — even if they were not shared by others.
“D.A. was a giant intellectually, he was a giant in his personality, and he didn’t shy away from controversy,” said his friend Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy.
Dr. Bill Foege, a friend and colleague for over 50 years, agreed.
“He was a person of strong convictions,” said Foege, who served as director of the Centers for Disease Control and Prevention from 1977 to 1983 and who first met Henderson at the CDC in 1962.
“I always think that was one of the attributes that provided for leadership because people don’t like to follow someone who’s uncertain about where they’re going. He brought a certain certainty to everything he did.”
Before taking the lead in the smallpox eradication program, Henderson was the CDC’s director of disease surveillance. His mentor had been Alexander Langmuir, the epidemiologist who founded the CDC’s renowned program to train disease detectives.
“I remember with Alex once talking about a subject and he presented his side and I said: ‘But it’s worth looking at the other side,’” Foege recalled. “And he slammed his fist down on his desk and said ‘There is no other side.’”
“D.A. got part of his training in this environment of absolute certainty.”
Henderson also shared Langmuir’s core belief that good surveillance is crucial to disease control.
“He always stressed the fact that without comprehensive disease surveillance, you just couldn’t run an effective public health program,” said Osterholm.
Tapped to lead the smallpox eradication program in 1966, Henderson moved to the World Health Organization, working as chief medical officer for the program.
In 1977 the world saw its last case of wild smallpox infection — a few cases infected through lab accidents happened later — and the disease was declared eradicated in 1980. To this day smallpox remains the only human disease ever eradicated.
The project had been an 11-year grind, and rather than being buoyed by that extraordinary achievement, it left Henderson deeply skeptical of other eradication efforts.
Though he held out hope for the prospects of Guinea worm eradication, Henderson argued other diseases were out of reach.
“He was very impatient with people claiming that they were going to be able to eradicate this, that, and the other thing,’’ said Dr. Donald Hopkins, special adviser to the Guinea worm eradication program.
Hopkins, formerly with the CDC, worked on the smallpox program as it neared its successful completion. “I really, really regret that he didn’t get to see the end of Guinea worm,” he told STAT.
Henderson’s pessimism about eradication prospects extended to the effort to rid the world of polio, though in 2011 he told the New York Times he’d come to conclude that the job might get done.