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.

Mass vaccination was the tried-and-true approach to smallpox eradication. Mass vaccination success was measured by the percentage of the population that was vaccinated, in order to achieve herd immunity. Most countries, WHO and other multilateral organizations were committed to this approach and operationally tied the goals to this strategic approach.