NYT OBITUARY: DR. J. DONALD MILLAR, WHO LED C.D.C. MISSION THAT HELPED ERADICATE SMALLPOX, DIES AT 81

Friday, 4th of September 2015

DR. J. DONALD MILLAR, WHO LED C.D.C. MISSION THAT HELPED ERADICATE SMALLPOX, DIES AT 81

New York Times, Sept. 3, 2015

Dr. J. Donald Millar, a physician and former public-health official whose work helped eradicate smallpox in Africa and with it, the world, died on Sunday at his home in Murrayville, Ga. He was 81.

The apparent cause was kidney failure, his wife, Joan, said.

A retired assistant surgeon general of the United States Public Health Service, Dr. Millar (pronounced mil-LAHR) was long associated with what is now the Centers for Disease Control and Prevention. He was the first director of its global smallpox eradication program, a position he held from 1966 to 1970.

Dr. Millar was later a director of the National Institute for Occupational Safety and Health.

The last case of smallpox in the United States occurred in 1949, but when Dr. Millar assumed his post, the disease remained an urgent international health concern: From 1880 to 1980, it killed a half-billion people worldwide.

The C.D.C. (known in the late 1960s as the National Communicable Disease Center) began its overseas eradication campaign in West and Central Africa. From the centers offices in Atlanta, Dr. Millar oversaw the training, deployment and support of dozens of health workers in some 20 countries there. Many, like Sierra Leone, Guinea, Niger and Togo, then had some of the highest rates of smallpox in the world.

Operating under the aegis of the World Health Organization, Dr. Millars program focused on locations, like marketplaces and festival sites, where inhabitants of remote rural settlements came together in large numbers. There, local workers trained by his staff gave smallpox vaccinations to as many people as possible.

Eventually, some 4,000 Africans were trained to administer the vaccine. By 1969, The New York Times reported, Dr. Millars program had vaccinated 100 million people in the region.

“This was considered to be the most difficult area of the world, because of communications and transportation and so forth,” Dr. William H. Foege, a former director of the C.D.C. who in the 1960s worked under Dr. Millar in Nigeria, said on Thursday. “The objective was to stop smallpox within five years, and the goal was actually reached in three and a half years.”

The Africa program became a model for smallpox eradication campaigns in other countries, among them India, Pakistan, Bangladesh, Afghanistan and Brazil.

“Over the years, C.D.C. became the largest contributor of people to the global smallpox effort, finally contributing about 300 people to smallpox eradication around the world, most of them detailed through W.H.O.,” Dr. Foege said.

The worlds last case of naturally transmitted smallpox was recorded in Somalia in 1977. (The next year, two cases resulted from the accidental release of the smallpox virus at a laboratory in Birmingham, England.) In 1980, the W.H.O. declared the disease eradicated.

As early as 1969, in an influential paper in The New England Journal of Medicine, Dr. Millar maintained that smallpox vaccinations, long an American childhood ritual, were no longer necessary in the United States. With his co-author, J. Michael Lane, he argued that by then, the vaccines potential complications — fatal in roughly one case per million — outweighed its potential benefits for most Americans.

The routine vaccination of Americans against smallpox ended in 1972.

The son of John Millar, a shipyard engineer, and the former Dorothea Smith, a secretary, John Donald Millar was born on Feb. 27, 1934, in Newport News, Va. After receiving a bachelors degree in chemistry from the University of Richmond in 1956, he earned an M.D. in 1959 from what was then the Medical College of Virginia and did his internship at the University of Utah.

Called up for military service in 1961, Dr. Millar fulfilled his obligation by joining the United States Public Health Service Commissioned Corps, which, with the Army, Navy and other branches, is one of the countrys seven federal uniformed services.

Assigned to the Communicable Disease Center, as the agency was then known, Dr. Millar began his career as a member of its epidemic intelligence service. In 1966, before assuming the leadership of the smallpox eradication program, he earned the equivalent of a masters in public health from the London School of Hygiene and Tropical Medicine.

In later years with the C.D.C., Dr. Millar led its public-health delivery program, which helps states administer services like tuberculosis prevention, dental hygiene and the tracking of sexually transmitted diseases. He served as the director of the National Center for Environmental Health, part of the C.D.C., from 1980 to 1981.

From 1981 to 1993, Dr. Millar was the director of the National Institute for Occupational Safety and Health, also part of the C.D.C. The issues on which he worked there included vibration syndrome, a set of circulatory and neural problems in the hands caused by the use of power tools like pneumatic hammers, and the prevention of tractor rollovers.

After retiring from the Public Health Service in 1993 with the rank of rear admiral, Dr. Millar ran a consulting company devoted to occupational health and safety.

Besides his wife, the former Joan Phillips, whom he married in 1957, Dr. Millars survivors include a brother, Douglas Paul Millar; three children, John Stuart Millar, Alison Millar McMillan and Virginia Millar Helms; and eight grandchildren.

His honors include the Distinguished Service Medal, the Public Health Services highest decoration, which he received in 1983 and 1989. He was a former adjunct professor of occupational and environmental health at Emory University.

Dr. Millar revised his 1969 position on smallpox vaccination in the wake of the Sept. 11 attacks. Fearing a terrorist strike involving weaponized smallpox, the United States government considered pre-emptively vaccinating the whole country. (Smallpox itself had long been eradicated, but the virus that causes it, variola, was thought to have been preserved in at least one laboratory in the former Soviet Union.)

Dr. Millar made clear that the existence of weaponized smallpox was an empirical question that needed to be addressed before a program of that scale was undertaken. While the plan to inoculate every American was ultimately not carried out, the government did stockpile enough vaccine for the entire population.

In light of this, Dr. Millar advocated voluntary peacetime vaccination for Americans desiring it.

“The more rational approach would be systematic availability of vaccine to people who want it, so you are not confronted with quite so demanding a task in quite so demanding a time frame,” he told The Washington Post in 2002. “If there is a real risk, we can do whatever is necessary.”

A version of this article appears in print on September 4, 2015, on page B14 of the New York edition with the headline: Dr. J. Donald Millar, 81; Led C.D.C. Mission That Helped Eradicate Smallpox. Order Reprints| Todays Paper|Subscribe