NEW YORK — Dr. J. Donald Millar, a physician and public health official whose work helped eradicate smallpox in Africa and with it, the world, died Aug. 3 of kidney failure at his home in Murrayville, Ga. He was 81.
A retired assistant surgeon general of the US Public Health Service, Dr. Millar 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 he assumed his post, the disease remained an urgent international health concern: From 1880 to 1980, it killed an estimated 500 million people worldwide.
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The CDC (known in the late 1960s as the National Communicable Disease Center) began its overseas eradication campaign in West and Central Africa.
From the center’s 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. Millar’s 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. Millar’s 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 CDC 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 3½ years.”
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The Africa program became a model for smallpox eradication campaigns in other countries, among them India, Pakistan, Bangladesh, Afghanistan, and Brazil.
“Over the years, CDC 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 WHO,” Foege said.
The world’s last case of naturally transmitted smallpox was recorded in Somalia in 1977. In 1980, the WHO 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 coauthor, J. Michael Lane, he argued that by then, the vaccine’s 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.
Dr. Millar was born in Newport News, Va. After receiving a bachelor’s degree in chemistry from the University of Richmond in 1956, he earned an MD 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 US Public Health Service Commissioned Corps, which, with the Army, Navy and other branches, is one of the country’s seven federal uniformed services.
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