100 Million Vaccinations

Little Yaa Ansah Asamoa Ampofo, aged 3 1/2, was chosen for her role as carefully as a poster girl. Under a blazing sun in Mampong Akwapim, near Ghana's capital of Accra, the brass band played fortissimo. Then the drums beat. Then there were speeches in English, French and the local language, Twi. At last Yaa was handed up to the platform, where a technician stood poised with his jet gun. He placed it against Yaa's arm and pressed the pedal trigger. Yaa opened her mouth in a gap-toothed smile.

By the best available statistics, Yaa was the 25 millionth West African to be vaccinated against smallpox in the past twelve months. When the U.S. AID-financed program is completed in 31 years, it is expected that 110 million people in Ghana and 18 other African countries will have been vaccinated. In a parallel program, 5,000,000 children have already been inoculated against measles; eventually, 30 million will be.

Reservoir in Man. After Yaa got her shot, Paramount Chief Nana Kwame Ofori made a pronouncement that was officially translated: "This exercise will be given the maximum support." Dr. William H. Stewart, Surgeon General of the U.S. Public Health Service, replied that it was a good thing so many countries were cooperating in an onslaught against two of the region's deadliest infectious diseases. Stewart pointed out that although Ghana has rung up a fine vaccination record recently, reported cases of smallpox have actually increased, because the disease has been imported by travelers visiting the country from other regions.

Since the smallpox virus has no natural reservoir except in man, the disease can be wiped out from a large region, as it has been in North America and most of Europe, once the cycle of infection is broken by making 85% or more of the population immune. Until now, the cycle of infection has been spinning virtually unchecked in West Africa, killing 25% of the virus' victims and hideously disfiguring or blinding as many more. Measles, which carried a death rate of less than one-tenth of 1% in the U.S. even before vaccinations began, kills from 5% of children in some West African areas to 40% in others.

The program is now rolling well in 220 trucks, specially equipped to carry the freeze-dried smallpox vaccine and keep diluent solutions refrigerated. Inoculating people who live in towns and villages is relatively easy. Far tougher is trapping the nomads who wander across the map. To intercept them, the epidemiologists plot their seasonal visits to water holes and waylay them there. Timbuktu, the Sahara's ancient crossroads for commerce, is now a prime hunting ground for vaccinators.

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