2025-05-09 06:12:00
This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.
Welcome to The Logoff: The US and UK announced a framework for a new trade deal today, and while Trump administration officials touted the pact as a straightforward victory for the president’s tariff policy, the real story is far more complicated.
What’s the latest? The US and the UK have a trade deal — in principle. Nothing has been signed yet, but the framework announced Thursday would lower some tariff barriers on both countries. The UK would still be subjected to President Donald Trump’s 10 percent global tariff, a baseline rate he imposed on imports from around the world.
What would this trade deal change? If signed, it would reduce US tariff barriers on UK cars, steel, and other items, and the UK would make it easier for the US to sell beef, ethanol, and agricultural goods, among other provisions.
Is this because of the tariffs? While the deal would reduce — but not eliminate — the tariffs Trump has imposed on the UK, interest in a trade deal has been a topic of discussion since Trump’s first term, driven in part by the UK’s decision to leave the EU.
What’s the big picture? Trump has promised tariffs will bring trading partners to the negotiating table, leading to deals that help the US economy via better access to foreign markets. And administration officials portrayed today’s deal as proof that strategy is working. That’s not entirely wrong: While the two countries were already moving in that direction, the tariffs likely gave the UK added incentive to negotiate.
But the benefits US exporters would win under this agreement have to be weighed against the costs: US consumers are still paying higher taxes on UK goods than they were before Trump’s tariffs — and higher taxes on goods from everywhere else in the world as well.
Speaking of the UK, here’s a fun (and reasonably short) article about how a British town turned a discarded sofa into a performance art piece. Thanks so much for reading. Andrew Prokop is holding down the fort Friday, and I’ll see you back here Monday.
2025-05-09 02:50:00
If there’s one succinct way to describe Pope Francis’s stewardship of the Catholic Church over the last 12 years, it might best be done with three of his own words: “todos, todos, todos” — “everyone, everyone, everyone.”
Now, Pope Leo XIV, the church’s new leader and its first American pope, has signaled he plans to continue in that direction. “Allow me to continue that same blessing,” he said in his first public address as pontiff, in a reference to Francis’s final Easter prayers. “God loves us. God loves everyone; evil will not prevail. We are all in the hands of God.”
The new pope, known formerly as Robert Francis Prevost, is Augustinian-trained, a dual citizen of Peru (where he worked for years), and in line with Francis’s vision for the church. And, like Francis, it will be hard to place him on an American political spectrum.
He’s conservative on issues of church doctrine, but progressive on social justice and care for the marginalized.
So while Pope Leo XIV’s (apparent) social media posts and criticism of American domestic policy under the Trump administration are getting extra attention right now, Pope Francis’s legacy should be a cautionary tale about viewing popes through an American-style “liberal or conservative?” lens.
Francis, who died April 21 in Vatican City, was both a reformer and a traditionalist. He didn’t change church doctrine, didn’t dramatically alter the Church’s teachings, and didn’t fundamentally disrupt the bedrock of Catholic belief.
Catholics still believe there is one God who exists as three divine persons, that Jesus died and was resurrected, and that sin is still a thing. Only men can serve in the priesthood, life still begins at conception, and faith is lived through both prayer and good works.
To try to neatly place either Francis or Leo on the US political spectrum is a bit of a fool’s errand: Things like “liberal” and “conservative” mean very different things within the Church versus outside of it.
Instead, it’s more helpful to realize just how much Francis changed the Church’s tone and posturing toward openness and care for the least well off — and how he set up the Church to continue in that direction after he’s gone. He was neither liberal nor conservative: He was a bridge to the future who made the Church more relevant, without betraying its core teachings.
Francis’s papacy is a prime example of how unhelpful it is to try to think of popes, and the Church, along the right-left political spectrum we’re used to in Western democracies.
When he was elected in 2013, Francis was a bit of an enigma. Progressives cautioned each other not to get too hopeful, while conservatives were wary about how open he would be to changing the Church’s public presence and social teachings.
Before being elected pope, he was described as more traditional — not as activist as some of his Latin American peers who embraced progressive, socialist-adjacent liberation theology and intervened in political developments in Argentina, for example.
Francis was orthodox and “uncompromising” on issues related to the right to life (euthanasia, the death penalty, and abortion) and on the role of women in the church, and advocated for clergy to embrace austerity and humility. And yet he was known to take unorthodox approaches to his ministry: advocating for the poor and the oppressed, and expressing openness to other religions in Argentina. He would bring that mix of views to his papacy.
The following decade would see the Church undergo few changes in theological or doctrinal teachings, and yet it still appeared as though it was dramatically breaking with the past. That duality was in part because Francis was essentially both a conservative and a liberal, by American standards, at the same time, as Catholic writer James T. Keane argued in 2021.
Francis was anti-abortion, critical of gender theory, opposed to ordaining women, and opposed to marriage for same-sex couples, while also welcoming the LGBTQ community, fiercely criticizing capitalism, unabashedly defending immigrants, opposing the death penalty, and advocating for environmentalism and care for the planet. That was how Francis functioned as a bridge between the traditionalism of his predecessors and a Church able to embrace modernity. And that’s also why he had so many critics: He was both too liberal and radical, and not progressive or bold enough.
Francis used the Church’s unchanging foundational teachings and beliefs to respond to the crises of the 21st century and to consistently push for a “both-and” approach to social issues, endorsing “conservative”-coded teachings while adding on more focus to social justice issues that hadn’t been traditionally associated with the church. That’s the approach he took when critiquing consumerism, modern capitalism, and “throwaway culture,” for example, employing the Church’s teachings on the sanctity of life to attack abortion rights, promote environmentalism, and criticize neo-liberal economics.
None of those issues required dramatic changes to the Church’s religious or theological teachings. But they did involve moving the church beyond older debates — such as abortion, contraception, and marriage — and into other moral quandaries: economics, immigration, war, and climate change. And he spoke plainly about these debates in public, as when he responded, “Who am I to judge?” when asked about LGBTQ Catholics or said he wishes that hell is “empty.”
Before Leo was named pope, there was speculation, given who Francis appointed as cardinals, that his successor would also be non-European and less traditional.
As Francis himself showed through his papacy, the Church has the benefit of time and taking the long view on social issues. He reminded Catholics that concern for the poor and oppressed must be just as central to the Church’s presence in the world as any age-old culture war issue. And to try to apply to popes and the Church the political labels and sets of beliefs we use in America is pointless.
Update, May 8, 2:50 pm ET: This post was updated to include news and information about the election of the new pope.
2025-05-09 01:00:00
Universal pre-K, an ambitious social program usually championed by progressives, has been in place in one of the most conservative US states since 1998. Oklahoma’s universal pre-K program was just the second in the country (behind Georgia) and has since become a model for how these programs can boost school readiness, economic well-being, and community health.
The story of how Oklahoma enacted this big early childhood education program involves a little bit of political mischief, and a lot of motivated educators who saw a need for high-quality pre-kindergarten in the ’90s — and made it happen.
We went to Tulsa, Oklahoma, to hear from the people who were there at the beginning of this beloved program, and the ones carrying it forward in pre-kindergarten classrooms in Oklahoma today.
You can see our reporting from Tulsa and other Vox videos on YouTube.
This work was supported by a grant from the Bainum Family Foundation. Vox Media had full discretion over the content of this reporting.
2025-05-08 23:18:35
This story originally appeared in Kids Today, Vox’s newsletter about kids, for everyone. Sign up here for future editions.
We often hear about the isolation of contemporary American family life — the parents forced to go it alone, the kids stuck inside, the disappearing village. But there’s another trend pushing American childhood in a more communal direction: Grandparents are playing a larger and more enduring role in kids’ lives.
For starters, there’s a demographic shift at play. As birth rates fall, the average number of grandchildren per grandparent has fallen as well. Susan Miller, a 67-year-old grandma in the Washington, DC, area, told me that while her mom had 13 granddaughters, she has four grandchildren. Having fewer grandkids “gives you more time with them,” she said.
Longer life expectancy also means kids actually get more years with their grandparents than they used to, even though people are having kids later in life, according to Ashton Verdery, a sociologist at Penn State University. These trends are “likely leading to deeper relationships between grandchildren and grandparents,” Verdery said.
Miller and her husband spend the summers in Minnesota with their grandkids, cooking, crafting, roughhousing, and putting on plays and puppet shows. Her 11-year-old granddaughter has “my husband really wrapped around her finger,” she said.
“He’ll dress up,” Miller said. “He’ll pretend to be a ballerina.”
Beyond participating in impromptu ballet performances, grandparents provide a host of benefits for kids. Across cultures, spending more time with grandmothers and grandfathers is linked to better educational and mental health outcomes, Verdery said. They can also offer kids a fresh perspective and sometimes come at child care with a more relaxed outlook than their stressed-out adult children, said Susan Kelley, a professor emerita of nursing at Georgia State University who has studied grandparents raising grandchildren.
But grandparents are also increasingly stepping in to plug holes in America’s crumbling child care system, a role they’re not always excited about filling. Experts say policymakers should embrace reforms that allow grandmothers and grandfathers to spend time with their grandkids because they want to — not because their families have no other choice.
Close relationships between grandparents and grandchildren are far from new. “Intergenerational caregiving by grandparents, especially grandmothers, reaches back to the dawn of our species,” Tobi Adejumo, a doctoral candidate at the University of Colorado Denver who has studied grandparent care, told me. Multigenerational households have long been common in many communities, with Asian American, Black, and Latino families all more likely than white ones to have grandparents and grandkids under one roof.
Still, the idea that grandparents used to provide a lot of child care isn’t necessarily accurate, as Faith Hill reports at The Atlantic. In the early US, people often became grandparents while still raising their own young kids, limiting how much time they could spend with grandkids.
But today, smaller families and later childbirth mean grandparents are less likely to still be actively parenting. While the falling birth rate may be bad news for older adults who want lots of grandkids to spoil (or for those who end up not having grandchildren at all), it also means grandmothers and grandfathers have more quality time to spend with each child. While white grandfathers born in 1880 had an average of nine grandchildren, grandpas born in 1960 have fewer than six. The drop for Black men has been even steeper, from around 11 to around six.
The way grandparents and grandchildren relate to each other is also shifting. Older adults are more active than they once were, making them more able to play with their grandkids, said Donna Butts, executive director of Generations United, a nonprofit that works to connect children and older people.
They’re also richer — prior to the 1960s, older age groups had the highest rates of poverty, but now they have the highest rates of wealth, Verdery said. So not only can grandparents buy their grandkids presents, but they can also take them on outings and travel to visit them more easily.
Meanwhile, skyrocketing child care costs and parents’ increasingly demanding jobs have led to an increased need for help from grandma and grandpa, said Jennifer Utrata, a sociologist at the University of Puget Sound who studies grandparenting. More grandparents are responding to this need by providing child care on a regular basis, sometimes stepping in for multiple days per week, a phenomenon some call “intensive grandparenting.”
While grandparent care has historically been more common in communities of color and immigrant communities, it’s now on the rise among white, middle-class families, Utrata said. One 2023 poll found that more than 40 percent of working parents relied on their children’s grandmother for child care, Hill reports.
Miller, the DC grandma, often cares for her grandchildren in the summer and on visits, including staying with them while their parents took a two-week trip. Her granddaughter becomes “like a child, almost” rather than a grandchild when her parents are away, Miller said. “She’s comfortable with us.”
In addition to taking some pressure off parents, grandparents can have a big impact on kids’ worldview, experts say. They can serve as role models but may also be less focused on work than parents in the middle of their careers, and more able to make kids the center of attention, Kelley said.
Spending time with grandparents can also transform a child’s view of aging. People who have close relationships with grandparents will often say they “don’t look at older people as icky” but rather as “vibrant,” Butts said.
Of course, grandparents can also offer high-quality, trusted care at a time when that’s hard to come by. But regular caregiving can also be hard on grandparents, even if they’re in good health. The demands of intensive grandparenting fall disproportionately on grandmothers, who can struggle to balance their own needs with those of their grandkids, Utrata said.
Some grandparents retire early to help with grandchildren, which can be a financial strain, especially in low-income families, Adejumo said. Many grandparents pay for necessities like food and diapers while watching their grandkids, adding to the financial stress.
Vice President JD Vance has suggested that grandparents could “help out a little bit more” as a way of addressing the high cost of day care. But “we should not be foisting our child care challenges on an older generation,” Utrata said. Grandparents want to help out, but they want it to be a choice, not “the only way that their daughters are going to be able to work for pay.”
Affordable, accessible child care would help grandparents be involved in their grandkids’ lives without pressure or exhaustion, Utrata said. Paid parental leave would also help since many grandparents are called in to be with babies when their parents have to return to work, Adejumo said.
In California and other states, grandparents can receive subsidies for taking care of grandchildren, but they are often too low to cover the real cost of care, Adejumo said. One sentiment she’s heard a lot from grandparents: “I would really appreciate a living wage.”
There’s a growing recognition in American society that making sure parents are healthy and financially stable also benefits kids. Now, experts say, it’s time to extend that understanding to grandparents, too.
The Trump administration’s tariffs are indeed hitting baby goods, with stroller manufacturer UPPABaby announcing price hikes. Trump, meanwhile, says all costs are down, except for “the thing you carry the babies around in.” He also says tariffs might mean American kids have “two dolls instead of 30.”
Federal grants for STEM education and mental health support in schools have been terminated, which advocates say compromises education and services for kids.
However, after a legal challenge and widespread criticism, the administration is no longer planning to eliminate all funding for Head Start in its proposed budget.
My older kid and I just read the first book in the Lightfall series, about a young girl searching for her missing grandfather, a pig-wizard, in the mysterious realm she calls home.
Thanks so much to all of you who responded to my question a few weeks back: What do the kids in your life want to be when they grow up? What do they want to do in the world? If you’d still like to weigh in, we’ve created a Google Form to make it easier — feel free to share! And as always, you can still reach me anytime at [email protected].
2025-05-08 19:00:00
Reports of the GOP establishment’s death have been somewhat exaggerated.
In his second term, President Donald Trump has filled his administration with many hard-line ideologues, personal loyalists, and more recent converts to his cause — spurring many to conclude that this was a fully MAGA White House.
But, going against that trend, certain establishment figures continue to hold key administration posts — and their importance and influence have risen in recent weeks, as they’ve won internal battles and steered Trump’s policies in their preferred direction.
Take Scott Bessent, a financier close to Wall Street who Trump named Treasury secretary.
During and immediately after Trump’s “Liberation Day” tariffs, which made little rational sense, Bessent often appeared hapless and at a loss. But Bessent eventually convinced Trump to pause many of the tariffs and has since clearly taken the lead in the administration’s trade negotiations — sidelining hardliners like Peter Navarro, at least for now. He even took on Elon Musk and won, getting Trump to retract an acting IRS commissioner appointment that Musk had sneaked through without Bessent’s knowledge.
Or take Marco Rubio, a more traditional GOP hawk Trump named secretary of state.
The knives were out for Rubio from the start, with much of Washington joking about how he’d inevitably be fired. He too seemed hapless at first as Musk took a wrecking ball to USAID, real estate developer Steve Witkoff took over key foreign negotiations, and Vice President JD Vance gleefully helped scuttle a minerals deal with Ukraine that Rubio had championed — a deal that was, effectively, the hawks’ effort to win Trump over on a more supportive posture toward Ukraine.
But last week, when Trump suddenly needed an interim national security adviser, he turned to Rubio, giving him now two of the administration’s most prominent foreign policy jobs. Rubio also recently got White House permission to fire Pete Marocco, the hardliner who carried out the USAID cuts (in what a Politico source called “the first MAGA world killing from inside the White House”). And that US-Ukraine minerals deal? It was just finalized.
The dynamic is broader than Bessent and Rubio. In contrast to many policy areas where the hardliners are clearly ascendant — immigration, the “anti-wokeness” culture war, Trump’s retribution agenda — there’s something more akin to a tug of war on economic and foreign policy, with dueling factions seeking Trump’s favor.
Trump himself doesn’t yet appear to be ready for a “full MAGA” administration on these fronts. At times, he favors disruption and drama — but at other times, when he decides things have gotten too messy, he returns to establishment figures like Rubio and Bessent to help clean things up.
The establishment pushback isn’t happening quite the same way as in Trump’s first administration, when his position as leader of the GOP seemed more tenuous. Back then, you had incidents such as National Economic Council chair Gary Cohn physically taking trade papers off Trump’s desk to prevent him signing them and causing a crisis.
This time around, Trump signed the papers on “Liberation Day” and caused the crisis. Yet a similar situation unfolded, in which Bessent and Commerce Secretary Howard Lutnick reportedly waited until anti-trade hardliner Peter Navarro was sidelined in a meeting far from the Oval Office, then made a beeline for Trump to urge him to lift some of the tariffs — and succeeded.
There’s an important difference in those two anecdotes. Cohn took a decision out of Trump’s hands, because he didn’t believe he could be trusted to make good decisions. Bessent and Lutnick, however, fully accepted that Trump was the decider — and instead focused on convincing him to make what they thought was a better choice.
A similar shift has occurred on foreign policy. In Trump’s first term, establishment hawk officials like John Bolton often seemed to be focused on carrying out their own preferred policy rather than Trump’s. Top Defense Department officials and generals, meanwhile, repeatedly slow-walked and stymied Trump’s efforts to withdraw troops from Syria and Afghanistan.
Rubio, in contrast, has tried to make it very clear that he’s a team player — by, for instance, helping execute very harsh immigration policies like deporting people to an El Salvador prison and revoking the visas of foreign students criticizing Israel. When Trump criticized Ukrainian President Volodymyr Zelenskyy, so did Rubio.
Yet the big blowup with Vance and Zelenskyy in February was not actually followed by a total US-Ukraine breach, as many in the MAGA base wanted (and as many US allies feared). The minerals deal was revived, and Trump has taken a more critical line toward Putin in recent weeks, giving the Russian president some of the blame for prolonging the war as a peace deal remains elusive.
Now, it would be too much to characterize any of this as a GOP establishment victory.
Trump has already moved policy far away from their preferences with regards to tariffs and Russia and Ukraine, and he could at any point bring the chaos back. What it does show, though, is that the establishment has a pulse — and can still convince Trump that going full MAGA is a mistake.
At least sometimes.
2025-05-08 18:30:00
More than a million Americans have died of Covid-19, while the global death toll stands at over 15 million. It has been a horrifying and largely unnecessary tragedy, one that risks repeating itself as new diseases like bird flu knock on our door.
But for all that the world has lost in the last few years, the history of infectious disease has a grim message: It could have been even worse. That appalling death toll resulted even though the coronavirus kills only about 0.7 percent of the people it infects. Imagine instead that it killed 30 percent — and that it would take centuries, instead of months, to develop a vaccine against it. And imagine that instead of being deadliest in the elderly, it was deadliest for young children.
That’s smallpox.
The horrors of Covid have given us a brief glimpse into what it’s like to live in a world ravaged by infectious disease. It’s easy to take for granted now that very few babies in rich countries die of disease in infancy, that most infectious diseases are treatable, and that there are vaccines available when we need them. But humanity only made the transition into that new world fairly recently.
Smallpox eradication was a major part of that. Over the course of the 20th century, country after country fought it back. The World Health Assembly declared on May 8, 1980, that it was gone for good. Its gradual eradication meant ending the needless suffering and death of millions and millions of people every year.
It’s not minimizing the suffering wrought by the coronavirus pandemic — or forgiving the negligence that has left us still unprepared for possible future pandemics — to take a step back and realize that diseases can be much more contagious, and much deadlier, than this one. And there’s something reassuring about the fact that, at least in the case of smallpox, humanity eventually rose to the challenge.
With luck, aggressive vaccination, and ambitious international coordination, we made the toll of infectious disease lower than at any point in history, and though it won’t be easy, we can do it again. But this year’s anniversary of the eradication of smallpox comes at a moment when the US and other rich countries have unforgivably stepped back from the obligation to aid poor nations, and when vaccine rejection is rising at home. In doing so, we not only forget the lessons of how we ended smallpox, which required international cooperation even between geopolitical foes, but leave ourselves more vulnerable for the next great global health threat.
As we hopefully learn how to address current and future pandemics, it is worth understanding what we learned from the great infectious disease fights of the past.
Smallpox has been around for a very long time. It’s believed that pharaohs died of it in ancient Egypt. It devastated the Americas in the early 1500s after being introduced through contact with Europe. It altered the course of the Revolutionary War, with outbreaks in New England that cost the Continental Army the Battle of Quebec.
Its toll throughout history is hard to measure, but in the 20th century alone it is estimated to have killed between 300 million and 500 million people. “In the contest of Smallpox versus War, War lost,” D.A. Henderson, former director of disease surveillance at the Centers for Disease Control and Prevention, wrote in his 2009 book Smallpox: The Death of a Disease, noting that even the most devastating wars of the 20th century — World War I and World War II — had a combined death toll much smaller than that of smallpox.
Smallpox was spread by a virus (technically, two viruses: Variola major and the significantly less common Variola minor). It caused fever, then a rash, which over the course of a few days developed into the skin-covering lumps that are the disease’s trademark. The more serious strain, Variola major, killed about 30 percent of people infected with it, with even higher death rates in infants. Death usually occurred within eight to 16 days.
Variola minor had similar symptoms but was much less deadly, with death rates around 1 percent. No effective treatments were discovered by the time the disease was eradicated.
A year ago, most people were unaware of epidemiological statistics like a disease’s R0 (the number of people that an infected person will infect in a population without immunity), and a disease’s “case fatality rate” (the percentage of sick people who die). But the Covid-19 pandemic prompted an epidemiological crash course for many of us, which ought to give us a new perspective on the horror of smallpox.
The disease, like Covid-19, was primarily transmitted through close contact, especially in indoor spaces. Our best estimate, though, is that it had an infectiousness between 5 and 7, putting it between that of Covid’s delta (4) and omicron variants (8). Due to smallpox’s high R0 and the devastating mortality rate, it was not uncommon for an outbreak of smallpox in an area without preexisting immunity to kill 30 percent of everyone in the community. In some contexts, such as when it spread through the Americas after being introduced by Europeans, the death rate is believed to have been even higher.
Before modern vaccine development, humans had to get creative in slowing the spread of infectious disease. It was known that people who’d survived smallpox didn’t get sick again. In China, as early as the 15th century, healthy people deliberately breathed smallpox scabs through their noses and contracted a milder version of the disease. Between 0.5 percent and 2 percent died from such self-inoculation, but this represented a significant improvement on the 30 percent mortality rate of the disease itself.
In England, in 1796, doctor Edward Jenner demonstrated that contracting cowpox — a related but much milder virus — conferred immunity against smallpox, and shortly after that, immunization efforts began in earnest across Europe. By 1813, the US Congress passed legislation to ensure the availability of a smallpox vaccine that reduced smallpox outbreaks in the country throughout the 1800s.
In the rest of the world, similar efforts were undertaken, with varying levels of commitment and success. In 1807, Bavaria declared vaccination for smallpox mandatory. In 1810, Denmark followed. Cases fell across Europe. Efforts by the British Empire to conduct a smallpox vaccination program in India made less progress, due in large part to mistrust by the locals of the colonial government.
By 1900, smallpox was no longer quite as much of a scourge in the world’s richest countries. In the 1800s, about one in 13 deaths in London were caused by smallpox; by 1900, smallpox caused only about 1 percent of deaths. Several countries in Northern Europe had also declared the disease eradicated. Over the next few decades, more of Europe, and then the US and Canada, joined them.
But as long as smallpox ravaged other parts of the globe, continual vaccination was necessary to make sure it wasn’t reintroduced, and millions of people continued to die of it. Data is spotty — this is before there was any international authority on infectious disease statistics worldwide — but it is estimated that 10 to 15 million people caught smallpox annually, with 5 million dying of it, during the first half of the 20th century.
It was not until the 1950s that a truly global eradication effort began to appear within reach, thanks to new postwar international institutions. The World Health Organization (WHO), founded in 1948, led the charge and provided a framework for countries that were not always on friendly terms to collaborate on global health efforts.
Even then, there were skeptics. “One hurdle the Eradicators faced was skepticism within the scientific community,” Henderson writes, “about the feasibility and practicality of eradicating an infectious disease.”
After all, no disease had ever been eradicated before. There were billions of people in the world, under myriad governments, many of them in regions actively at war. Global coordination on the scale eradication would demand was unprecedented. Plus, there had already been a failed attempt to eradicate malaria. The goal of eliminating every smallpox case in the world, rather than just suppressing the virus, sounded implausibly lofty.
“There was no shortage of people telling [the people involved in the eradication effort] that their effort was futile and they were hurting their career chances,” former Centers for Disease Control and Prevention (CDC) director William Foege wrote in his 2011 book House on Fire about the smallpox eradication effort.
But other advances had brought it within reach. Needle technology had improved, with new bifurcated needles making it possible to use less vaccine. Overseas travel improved, which made it easier to ship vaccines and get public health workers where they were most needed, and provided impetus for worldwide eradication as it made it more likely that a smallpox outbreak anywhere in the world could spread.
A 1947 outbreak in New York City, traced back to a traveler from Mexico, resulted in a frantic effort to vaccinate 6 million people in four weeks. Europe, Henderson says, repeatedly saw the virus reintroduced by travelers from Asia, with 23 distinct importations (different occasions of someone bringing smallpox into the country) in five years.
As both Covid-19 and the new measles outbreaks show us, we’re encountering the same challenge that the world faced with smallpox in the 1950s: It doesn’t matter if a vaccine exists unless there also exists the international will and creativity to get it to all the people who need it, many of whom will be reluctant and skeptical.
As Henderson and Foege detail in their books, there were extraordinary challenges that often looked utterly insurmountable in the quest to eradicate smallpox. In poor corners of the world, there were no roads or hospitals and no infrastructure to notify the WHO of a smallpox outbreak. Civil wars, famines, and refugee crises made disease surveillance and vaccination very difficult.
But other features of smallpox made it easier to eradicate than many other diseases. For one thing, it didn’t have animal reservoirs; that is, unlike diseases like Ebola, smallpox doesn’t live in animal populations that can reintroduce the disease in humans. That meant that once it was destroyed in humans, it would be gone forever. And, once a person has survived it, they are immune for life. Only one vaccine is needed for immunity in almost all cases.
Additionally, it largely doesn’t have asymptomatic transmission and has a fairly long incubation period of about a week. That made it possible for public health officials to stay on top of the disease with a strategy of “ring vaccination” — whenever a case was reported, vaccinating every single person who may have come into contact with the affected person, and ideally everyone in the community could keep the disease at bay.
Henderson calls the switch to ring vaccination a pivotal strategic change for the fight against smallpox. Instead of fighting for 100 percent vaccination, which was proving unachievable in low-income countries, it let public health teams focus their resources where they were needed most.
As large parts of the world were declared smallpox-free, resources could be more intensively focused in the areas where outbreaks were still happening. While in 1950 a smallpox outbreak in a developing country might attract little international interest, by 1970 it attracted the world’s best disease surveillance and response resources. Contact tracers tried to identify everyone exposed and figure out where the virus might have come from. Communities were swiftly vaccinated. Case numbers kept declining.
In 1975, the world marked the last wild Variola major case, in Bangladesh. In 1977, it marked the last wild Variola minor case, in Somalia. Doctors tracked down and vaccinated every potential contact of the case; none of them contracted the disease. Surveillance around the world found no more cases anywhere.
Two years later, on May 8, 1980, the World Health Assembly declared victory over smallpox.
Humanity’s triumph over smallpox should stand out as one of our proudest moments. It called on scientists and researchers from around the world, including collaborations between rival countries in the middle of the Cold War.
Unfortunately, we’ve never replicated that success against another virus that affects humans. With some, such as polio, we’re drawing close. Wild polio has been eradicated in Africa and remains only in conflict-torn regions of Afghanistan and Pakistan. “Ring vaccination,” as practiced in the smallpox battle, has been successfully used in public health efforts against other diseases, most recently with the new Ebola vaccine, used against outbreaks in the Democratic Republic of Congo.
But in other cases, like HIV and Covid-19, we’ve let new diseases grow to pandemic proportions. And while those diseases have had devastating effects, it’s worth keeping in mind that they could have been even worse. Some viruses with the potential to escape laboratories or make the jump from animals to humans are as deadly and transmissible as smallpox, and Covid-19 has made it clear that we’re not prepared to handle them.
Why has it been so hard to build on our success with smallpox? One part of it is that many diseases present all the challenges that smallpox did — plus some additional ones. Some, like malaria or Ebola, have animal reservoirs, which means that ensuring no humans are sick isn’t sufficient to stamp them out. Some, like HIV or Covid-19, have asymptomatic transmission, which makes disease surveillance trickier. (An important public health clarification: HIV can be transmitted by people who don’t feel sick, which is “asymptomatic transmission,” but it cannot be transmitted by people whose virus levels are undetectable through medication management.)
But as far as things that we can control, there are some takeaways. The first is that the smallpox eradication program took both heroic efforts and a well-funded, well-supported public health system. People trying to do disease surveillance and vaccination in war-torn, dangerous, remote parts of the world are risking their lives in our current fight. They can only succeed if their efforts are matched by a commitment by governments of rich countries not to leave poor countries behind, to meet the funding needs of an eradication project, and not to undermine one with CIA spy operations that imitate vaccine campaigns.
“The coronavirus we are grappling with today is not smallpox,” Richard Horton, editor-in-chief of The Lancet, said in December 2020, but “those old enough to remember the story of smallpox eradication” will recognize many of the lessons we’re rapidly learning now, from the importance of vaccine distribution and infrastructure to the essential role of international coordination and leadership at the World Health Organization.
A better response to future pandemics requires a CDC and WHO that is well-funded, attracts top scientific talent, and isn’t subject to political manipulation that gets in the way of accurate disease surveillance. Unfortunately, with Elon Musk’s Department of Government Efficiency slashing funding for the CDC and international health efforts, Trump pulling out of the WHO, and with vaccine skeptic Robert F. Kennedy Jr. heading the country’s largest health agency, we’ve gone backwards in pandemic preparation.
Another critical takeaway is that once the work has succeeded, we have to make sure never to undermine it. After telling the history of the eradication of smallpox, Henderson’s account switches to a different theme: the vials remaining in the hands of governments. He wants them destroyed lest some accident or malicious act unleash smallpox on the world again. There have already been a few close calls. A year after smallpox was declared eradicated, bad lab safety procedures led to another outbreak in Birmingham in the UK. Just a few years ago, improperly stored smallpox vials were found in a lab in the US. We need to take biosecurity and pathogen research much more seriously.
In the broader context of humanity’s fight against infectious disease, it’s fair to think of the coronavirus as a close call. As bad as it has been, it could have been much worse. It could have been more transmissible; it could have been deadlier. Diseases far worse than Covid-19 have appeared throughout human history, and there’s every reason to believe we may someday face one again.
The devastation of Covid-19 has hopefully made us aware of the work public health experts and epidemiologists do, the crucial role of worldwide coordination and disease surveillance programs (which are still underfunded), and the horrors that diseases can wreak when we can’t control them.
We have to do better. The history of the fight against smallpox proves that we’re capable of it.
Update, May 8, 2025, 6:30 am ET: This piece was originally published on May 8, 2022, and has been updated to reflect the latest news.