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Ali Maow Maalin
Ali Maow Maalin (also Mao Moallim〔 and Mao' Mo'allim〔) (1954 – 22 July 2013) was a Somali hospital cook and health worker from Merca who is the last person known to be infected with naturally occurring ''Variola minor'' smallpox in the world. He was diagnosed with the disease in October 1977 and made a full recovery. Although he had many contacts, none of them developed the disease and an aggressive containment campaign was successful in preventing an outbreak. Smallpox was declared to have been eradicated globally by the World Health Organization (WHO) two years later. Maalin was subsequently involved in the successful poliomyelitis eradication campaign in Somalia, and he died of malaria while carrying out polio vaccinations after the reintroduction of the virus in 2013.
==Smallpox eradication in Africa==
Smallpox is an infectious disease caused by two strains of virus, ''Variola major'' and ''V. minor''. ''V. minor'' is the rarer of the two strains, and causes a much less severe disease (sometimes called alastrim), with a fatality rate of around 1%. No treatment is available, and the only protection is vaccination. The virus is usually transmitted by prolonged face-to-face contact with a person showing symptoms. The incubation period averages 12–14 days.〔(CDC: Smallpox Factsheet: Smallpox Disease Overview ) (accessed 15 February 2013)〕 One of the most feared diseases of human history, smallpox was still causing an estimated 2 million deaths every year as late as 1967.〔Porter, ed., p. 33〕〔Tucker, p. 3〕
The global effort to eradicate smallpox from endemic areas such as Africa began in 1959 with a mass vaccination campaign. This approach met with little success, and a more-effective targeted approach was developed in the late 1960s. This involved active surveillance by case hunting, combined with rapid containment of infection in areas reporting outbreaks by intensive vaccination.〔Behbehani, pp. 490–492〕 The majority of African countries were free from smallpox by 1972. By the end of 1975, the virus had been eradicated worldwide except in Ethiopia and Somalia in the Horn of Africa, and their neighbour Kenya.〔Behbehani, pp. 494, 496–497〕〔(''MMWR'': Smallpox Surveillance – Worldwide ) (accessed 15 February 2013)〕 The nomadic people of the Ogaden Desert retained endemic smallpox with an unusually mild form of the disease, which facilitated persistence in the population.〔Behbehani, p. 493〕 From 1975, WHO efforts were concentrated on this region. Ethiopia saw its last case in August 1976 and Kenya in February 1977.〔〔Tucker, pp. 115–116〕
Somalia proved particularly challenging because much of its population of 3.5 million was nomadic. A mass vaccination campaign in the country in 1969 had failed because many nomadic people in the region had cultural objections to vaccination, and either refused or avoided it.〔Behbehani, p. 497〕〔Tucker, pp. 113–114〕 Elimination efforts relied on an intensive reporting system. A severe drought in 1975 exacerbated the difficulties by increasing movement across the border with Ethiopia, and frequent outbreaks continued.〔 In March 1977, surveillance efforts found over 3000 cases in the south of the country.〔 The Somali government declared a state of emergency and successfully appealed to the United Nations for assistance. By June of that year, when the outbreak peaked, 3000 Somali health workers supervised by 23 international advisers were involved in the eradication efforts.〔〔 Eradication work was hampered in July when the Ogaden War broke out, limiting access to the desert.〔
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