The risk of smallpox was accepted as just an unfortunate part of life. Getting sick was a person’s fate. But in the late 1700s, Dr. Edward Jenner saw things differently and applied a “cause and effect” mindset. After years of observation, he was convinced that having cowpox protected people from contracting smallpox.

To apply the surveillance and containment strategy, it was necessary to know where the smallpox virus was, which villages had active cases of smallpox. The struggle against smallpox could not be won without knowing where the enemy was and what it was doing. But India did not have accurate surveillance data. Many villages with active cases had not been reported.