The History of Vaccine Diplomacy
The Beginning, #1
In fields of diplomacy, vaccine diplomacy is a relatively novel subset, structured around using medicines, trained personnel, and scientific knowledge to support and further foreign policy. Of all the forms of diplomacy, this is surely the one that is most inextricably linked to kindness and courage, for the importance of vaccine diplomacy arises when the world is most crippled by the invisible and unknown. Clever diplomats might avert sanctions or extract favorable treaties, but what use are words when faced with a virus so small it can halt life as we know it for a year and yet fit all its particles inside of a coke can? Words matter less than the reality of saving a person’s life. And that is exactly what a vaccine represents: a lifeline.
The history of vaccine diplomacy is not very long, but from its birth its use as a tool for maintaining ties and advancing national interests was obvious. Edward Jenner discovered vaccines in 1798; before 1815, they had been used as a bridge between cultures, as a lifeline to a ravaged continent, and as a bargaining tool between two warring nations. Over the following two centuries, the pace and importance of vaccine diplomacy has only picked up.
Variolation in India
The practice of variolation was a precursor to vaccination- less safe, perhaps, but a source of hope in a world in which periodic smallpox outbreaks often had mortality rates of thirty percent or higher.
One of the best sources to date to determine variolation’s importance is the British surgeon John Holwell’s “An account of the manner of inoculating for the small pox in the East Indies: with some observations on the practice and mode of treating that disease in those parts,” which is aptly named; it not only describes folk remedies (milk and mangos were used to restore victims of smallpox to their original health), but also how “Inoculating Bramins” would come annually to the city, variolating the individuals and prescribing a regimen of cold-water bathing, an exposure to open air, and a month-long fast of fish, milk and ghee. Holwell was unstinting in his praise for the practice, claiming, “I thought the practice of the Bramins carried [it] to a bold, rash and dangerous extreme; but a few years experience gave me full conviction of the propriety of their method.”
Holwell’s praise and the effective immunity offered by variolation led to its incredible popularity in Europe, supported by not just Holwell’s account but royalty, ranging from Empress Maria Theresa of Austria to King Charles IV of Spain.
Balmis expedition
Spanish invasion of South America led to devastating waves of illness all over the New World, decimating the Native American population by more than 93%. In 1803, another smallpox outbreak was reported in Colombia, and King Charles IV- who’d already lost a child to smallpox- launched an expedition to vaccinate the Spanish colonies of Puerto Rico, Venezuela, Colombia, Ecuador, Peru, Chile and Bolivia.
This expedition was led by the physician Francisco de Balmis, undertaken over a vast, harsh terrain with no guarantee of a warm welcome. De Balmis resolved this issue as best he could by using modern-day tactics of promoting public education and using local experience to bolster the vaccinators’ credentials. The vaccine diplomacy propagated by Charles IV- though driven more by de Balmis’ fervor than by any formal decree- had many effects for the decades to come.
Later vaccination drives in the area built off of de Balmis’ efforts. These drives all allowed a population growth over the rest of the century- and, 150 years after de Balmis’ expedition, finally resulted in the eradication of smallpox.
Edward Jenner and Napoleon
Even as Britain went to war against Napoleonic France, the traffic of ideas and interaction between scientists continued without issue. These conversations did not remain entirely absorbed in science either; Sir Joseph Banks wrote to the Antoine-Laurent de Jussieu (who would go on to publish the first classification of flowering plants) to tell him that the English government had granted a passport to Nicolas Baudin, a friend of de Jussieu.
Edward Jenner himself was offered a medal by Napoleon after the French army was vaccinated against smallpox, and Jenner later went on to converse with Napoleon directly, going so far as to “request a favour from your Imperial Majesty, who early appreciated the importance of vaccination and encouraged its propagation.” This favor was to release two scientists from Napoleon’s custody- and Napoleon responded, allegorically, by stating that, “Nothing can be denied to this man.” Both scientists returned to England less than a year and a half later.
Even as the scope and ability of vaccines was being explored, it is clear that it was being used. Vaccine diplomacy is therefore a natural act- a springboard off which we can dive into the waters of compassion. It has been used as a tool from which to rescue people, and an avenue of communication even as every other path was being cut off, and a gift with which to save entire cultures.
The renowned author and activist, Howard Zinn, writes, “To be hopeful in bad times is not just foolishly romantic. It is based on the fact that human history is a history not only of cruelty, but also of compassion, sacrifice, courage, kindness. […] If we see only the worst, it destroys our capacity to do something. If we remember those times and places- and there are so many- where people have behaved magnificently, this gives us the energy to act, and at least the possibility of sending this spinning top of a world in a different direction.”
The history of vaccine diplomacy is one of those times and places where people have behaved magnificently, going above and beyond to help people around them- and not just around them, but also half a world away. It is a history of hope. It is a history of the kinds of things that are possible when we choose to look at the best that we can do, and then do it.
