Smallpox eradication , laboratory visits , and a touch of tourism : travel notes of a Canadian scientist in Brazil

The paper presents and discusses the travel notes diary of Canadian scientist Robert J. Wilson when he visited Brazil in April 1967 during the Smallpox Eradication Programme run by the World Health Organisation. Wilson’s report makes it possible to reflect on the smallpox eradication campaign in Brazil; on the Canada–Brazil cooperation to improve the quality of the smallpox vaccine; on his assessment by of scientists and Brazilian laboratories; on the effects of intersections between scientific activity and social and cultural activities; on the role played by specialist communities of experts role in international scientific cooperation projects; and on a Canadian traveller’s concepts and prejudices about Brazil at the end of the 1960s.


Introduction
In 1966, the Connaught Medical Research Laboratories, then part of the University of Toronto (today Aventis Pasteur Canada), was invited by Donald A. Henderson, director of the Smallpox Eradication Programme of the World Health Organisation (WHO), to play a leading role in supervising the quality of the smallpox vaccine.Connaught's work would involve testing the batches of vaccine produced by Latin American laboratories, visiting the actual laboratories in the region and training personnel to assure that the vaccines produced locally meet international standards (Rutty, 2008).The assistant director of Connaught, Robert (Bob) J. Wilson (1915Wilson ( -1989)), took over the mission together with Paul Fenje , a vaccine specialist, who was also working in the Canadian laboratory.One of its main spokesmen in Brazil was José Fonseca da Cunha (1914Cunha ( -2005)), head of vaccine production in the Oswald Cruz Institute (IOC) and who had trained in Connaught in 1959.
The Connaught collaboration with WHO and benchmark laboratories in Latin America characterizes the importance of what are called epistemic communities, or networks of specialists with recognised knowledge in a particular area (Haas, 1992), as valuable facilitating mechanisms working with international cooperation.Officially the Canadian government only played an indirect role in the Smallpox Eradication Programme as a WHO Member State.Canada has always been a "reluctant partner" (Dmitrienko, 2006;Dmitrienko, Birn, 2006) in regional cooperation, having joined the Pan American Health Organization (PAHO) only in 1971.Between 1967 and1973 the Canada-Brazil scientific collaboration was run without explicit inter-government agreements (Barreto, Rutty, 2002) and strongly based on the relations between Canadian and Brazilian scientists, under the sponsorship of PAHO and WHO.The personal and professional relations between Henderson, Wilson, Fenje and Fonseca da Cunha were what boosted the cooperation between Canada and Brazil in the area of quality of the smallpox vaccine, and Henderson and Wilson were to be those who urged the Canadian government to adopt a more active role in the WHO smallpox eradication programme (Palmer, Hochman, 2010).
The Canadian laboratory's role in eradicating smallpox produced a large quantity of documents that are currently kept in the Aventis Pasteur, Connaught Campus Archives in Toronto.The collection, which has a good part of the technical documentation, helps reconstruct the scientific practices involved in the vaccine's production.The administrative and political material provides information about how the laboratories in the developed and developing countries were run, has more personal documents about scientific friendships and the nature of the collaboration, and also addresses the disputes in the field of international health.In some case, the files contain sources that combine all these three dimensions of historic experience.One such case is Wilson's first trip to Brazil, one of the most important countries -from the geopolitical, diplomatic and epidemiological viewpoints -for the WHO Smallpox Eradication Programme, the last endemic country in the region of the Americas.
Wilson's journey in April 1967, amidst the enthusiasm in Canada for the commemorations of the country's centenary, was made during the first years of the military dictatorship in Brazil (1964Brazil ( -1985)).His travel notes, rewritten on his return to Canada, are intriguing from the different levels of reported experiences and observations.Wilson visited IOC, Butantan, and the Recife and Porto Alegre laboratories.Notes about addresses and phone numbers of institutions and scientists are found alongside technical descriptions of vaccine production methods; admiration for the natural wonders, national monuments and tourist attractions; appreciation of sounds and symbols are followed by assessments of the personalities of the top scientists in public health or comments on how public administration works.
How important was it for this Canadian, involved in his own also nationalist commemorations of Canada's centenary, to understand Brazilian scientific and political nationalism?Would the quality of the hotel where he stayed or the meal in the restaurant be of importance for his opinions on the technical problems of producing the smallpox vaccine in Brazil, particularly in IOC? Would his appreciation of the quality of the laboratory facilities be affected by the unexpected interruption of children running in and out in the middle of his visit?These are questions that can be raised for history and sociology of international scientific cooperation.
Wilson's travel notes presuppose a self-attribution of higher scientific sophistication than his hosts.For example, he classifies those who are part of his community (those who graduated or trained in North America) and outsiders.But if such filters can raise questions about the reliability of his portrait of the Brazilian research institutions, should the same doubts be raised about his refined appreciation of the temperament found in the scientific community -for example, the aspirations of senior administrators in Rio de Janeiro, or low regard for the personnel in peripheral laboratories?His scathing comments about the meeting with the director of the Oswald Cruz Institute, Rocha Lagoa (who was to become the Health Minister in the years 1969 to 1972 during the darkest days of the military dictatorship) are paradigmatic from these viewpoints.Why is he dismissive about the Brazilians' experiment in some research areas and does positively assess the scientific capacity and of producing some vaccines, particularly for yellow fever commanded by Fonseca da Cunha?Should we take these personal views as an obstacle to scientific objectivity, or adopt the idea of how it fits and is built into his narrative?
Wilson's travel diary is a thick volume and hard to classify.He returned to the country on a scientific mission on several occasions, and in August 1973 was vice-president of the Commission that certified the smallpox eradication in Brazil.There is nothing in his dispassionate technical reports about these journeys that he sent to PAHO to indicate this almost natural combination of his personal and scientific assessments of notes made for Connaught in 1967.Perhaps it is because they are notes written under the impact of his first experience of South America.The highly personal memories of a scientific-technical visit experienced by the scientist within a certain particular social network and national culture are included in a complex field of administrative and political institutions, which forces us to reflect on what might be lost when these different dimensions are separated from each other in the history of science, medicine and public health.

NOTAS DOS AUTORES
A referência arquivística do documento é R.J. Wilson, "Daily Memoranda -First Trip, South America", Aventis Pasteur, Connaught Campus Archives, 88-001-49.O texto original de Wilson, que era em essência um rascunho, foi preservado.Relatos mais longos de seções técnicas foram editados para tornar o documento mais acessível ao leitor; a síntese dos trechos suprimidos encontra-se entre colchetes.Uma primeira versão do documento foi publicada em Cultures of Health -An historical anthology, em 2009 (http://hih.uwindsor.ca/wordpress/).After some general exchange of information in a most amicable atmosphere, we examined their facilities for calf vaccine and their equipment.We met Dr. Rocha Lagoa and had lunch with his staff later.He is a young, energetic, ambitious, and aggressive man of about 45 who was head of the Rickettsial Division under Penna and was promoted to Director some 3 years ago.We returned after lunch to discussions with Penna and Fonseca, who speaks excellent English.Penna worked with Theiler in New York and Fonseca studied production of smallpox vaccine in eggs in Texas.While Fenje and Fonseca discussed production methods, I went with Penna to see their yellow fever vaccine production.
The yellow fever vaccine unit is a separate building erected about 15 years ago (see picture).They produce two lots per week, each about 1000 eggs.The embryos are pooled in lots of 100 and bacteriological tests done on each pool.Then the embryos are blended in Waring blenders, centrifuged, to get rid of gross debris.The material is filtered through flannel and filled into vials on which the lot numbers are etched.1000 Embryos yield about 2 liters of fluid at a titer of 100,000 mouse LD/50 per ml.Each vial contains 2ml.This is shell frozen and dried overnight on a manifold.They are filled with dry nitrogen and flame sealed.Each vial contains 200 doses of 0.5c.c.so it is reconstituted to 100c.c. with ordinary saline.No preservative is used.The vials are not labeled other than for an etched lot number.They manufacture 400,000 doses per week for 8 or so months a year -for a total of 10-12 or so million doses a year.They don't lose too many eggs through bacterial contamination except in the summer months.They ignore leucosis virus and do not even test for it.The whole operation is carried out with great efficiency and simplicity using simple but ingenious techniques.They supply Brazil, other countries of South America; have supplied some to Ethiopia, and other African countries.They are quite aware that they would not meet the standards of most developed countries but this does not concern them.They make a good inexpensive product for Brazil.I was most impressed with the operation.The unit has a generator and so is not affected by power shortages and power cuts.Dined at restaurant Belacap, Hotel Luxor, Copacabana.
Web. April 12 -Again met with Fonseca and Penna.While Fenje discussed details of production, I visited Dr. Estacio Monteiro.He is working with Herpes virus, polio virus.Dr. Milovanovic is working with him.They are concerned in Rio and in São Paulo about the high incidence of polio in children who have received Sabin Vaccine -2 doses, some 3 doses.They have received trivalent vaccine from: (1) R.I.T. Belgium (distributed by Hemoderivat Brazil) (2) Germany -Behringwecke (3) Russia (4) Yugoslavia Note: At the Oswaldo Cruz there is a small statue in the smallpox unit dedicated to: FELISBERTO CALDERA BRANT MARQUEZ DE BARBACENA who brought vaccinia to Brazil in slaves 1804.
The potency of type (1) is usually much below claimed potency.The potency of type (2) is usually much below claimed potency.Type (3) is usually all right.This is true of all but vaccine from Behringwecke … [A technical analysis of their vaccines and production methods ensues.]Also visited Dr. J. de Cervalho Loures.Mr. Binnerts had made contact with him in 1965.He had some early data on ERA strain and correspondence from Binnerts in 1965 on his desk when I went in.Also an Annual report which he had just received -very pleased.
They use the suckling mouse brain technique, which seems to produce high titer vaccine.But it also seems very expensive.They lack equipment, electricity from a dependable source, and seem thoroughly depressed.I did not manage effective contact with him.Fenje saw him later.He would like our latest data on ERA strain.Dined in the evening with Milovanovic.
Thur.April 13 -In the morning, more discussions with Fonseca and Penna.Lunch with the Director Dr. Rocha Lagoa.He took us to visit the new Institute of Microbiology and Immunology.It is a very large building of six floors and will mostly be occupied by relatively non-productive persons with tenure doing supposedly important research.In fact they do little.The Director has half the top floor elaborately equipped with expensive equipment not yet used.This is to do tumor research for which he is not equipped -when there are so many real problems of a practical nature which receive no support financially… I could not find out the formulation of their trivalent but type 1 is less than 10 6.0 .I told them of our experience with the various formulations and that Great Britain has gone back to 10 6.0 type 1.They were very interested.I also told them of the absorption to glass.Dr. Rivero de Vale would like data on formulations including Great Britain and on the absorption problem.Dr. Rivera left us with Dr. Murilo to discuss smallpox vaccine.
The facilities (space) at Butantan are very large.They have room for 20-30 calves at a time.The stabling is reasonable.They were not producing calf vaccine while we were there.They get only about 100g.pulp from a calf.They use about 0.063ml.per capillary tube.The capillaries are amber and the bore diameter varies widely.Therefore the operation is very inefficient.They use about 200 calves about a year to produce about 3-4 million doses per year of glycerinated vaccine.There must be a great waste of vaccine...
draft, was preserved.In longer reports, technical sections were edited to make the document more accessible to the reader, and a brief description of what is missing can be found in brackets.A first version of the document was published in Cultures of Health -An historical anthology in 2009 (http:// hih.uwindsor.ca/wordpress/).The study that is the basis of this article has the support of the National Council for Scientific and Technological Development (CNPq) and of Fiocruz and Canada Research Chair in History of International Health at the University of Windsor.

A
pesquisa que embasa este artigo conta com o apoio do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), da Fundação Oswaldo Cruz (Fiocruz) e da Canada Research Chair in History of International Health, da University of Windsor.AGRADECIMENTOS Agradecemos especialmente ao doutor Luis Barreto, vice-presidente de Relações Públicas da Sanofi Pasteur Ltd.; ao bibliotecário Hugh McNaught, da mesma empresa, pela assistência prestada à nossa pesquisa; e ao doutor Christopher J. Rutty, pela orientação generosa que nos prestou no Connaught Campus Archives.Smallpox eradication, laboratory visits, and a touch of tourism Daily Memoranda -Dr.R.J. Wilson 1 st Trip South America Sat.April 8 -Arrived Rio 8:45 a.m.Met by Mr. Sampaio of Brazilian Light and Power.Provided us with car (black Aero Willis No. 23-66-22 -driver Helio) and letter from McCrimmon asking us to lunch with him.Checked in at Grande Hotel Novo Mundo and joined the McCrimmons for lunch at their town house Av.Ruy Barbosa 310, 16° Andar, Tel.45-8555.After lunch to the Jockey Club to watch races.McCrimmon's 2-year-old Expo 67 ran second.Then to Teresopolis, the McCrimmon summer home, about 130km from Rioabout 2500ft.altitude.Met the daughter and son-in-law Mary and Hugh Mill and daughter (II) Elizabeth -dined together.Sun.April 9 a.m.-To the village with Nancy (Mrs.McCrimmon) and at noon met Mr. and Mrs. Court -their son-in-law is a nephew of Oswaldo Cruz and works at the institute.Evening -with the McCrimmons alone.Mon.April 10 -Helio drove from Rio and picked us up at 9:00 a.m.Arrived at the hotel at 10:30 a.m. and contacted PAHO.Went to PAHO office, Zone 5, at Rua Paissandu 231, Tel.45-81-38.Meet Dr. S. R. Rao, acting for Dr. Raul Vera, who was on leave.Dr. Rao studied in Toronto at HSC and with MacHenry.Wishes to be remembered to Dr. Chute.Also met Dr. Juan Ponce de Leon, a Peruvian doctor who is consultant in Smallpox Eradication Zone V and who is to accompany us on our trip.He studied at Columbia University and got his MPH there.We had lunch with him and spent the afternoon being briefed on the eradication program and planning our tour of Brazil.Dr. Aleria Macedo, Director of the program, was in Ciera.We planned to meet him on our return to Rio later in April.Dined at the Hotel Novo Mundo.Tues.April 11 -Went with Dr. Ponce to the Institute Oswaldo Cruz (founded in 1908).Met Dr. Henrique A. Penna, Director of the Division of Virology.He used to work in the field of yellow fever with Soper, Lloyd, Mahaffey, Wilson etc. (see reprints) and now makes yellow fever vaccine.With him was Dr. J. Fonseca da Cunha who is in charge of production of calf vaccine.He visited me at Toronto in 1959.
[A technical analysis of the production of vaccines at the Institute of Microbiology and Immunology ensues.]In the p.m. to a cocktail party for one of the Deputy Director Generals of WHO -Ishmirov -at the residence of Dr. Rao.Rua Almirante Gonçalves 5, Apto.202, Copacabana Tel.27-6183.Dined at the Copacabana Palace Hotel.Fri.April 14 -Visited the Instituto again to clear up a few points.Returned to the PAHO office.Had lunch with Dr. Ponce de Leon and Leo Morris, a member of the eradication unit.He is a statistician on loan from CDC but taking an active part in the vaccination program.Friday afternoon, Major McCrimmon drove us to Corcovado and to see the Monument of Christ.Dinner with the Major.Sat.April 15 -At liberty.Sun.April 16 -2:30 p.m. Rio to São Paulo.Hotel Excelsior Av.Ipiranga 770, Tel.35-5141.Dined at hotel.Mon.April 17 -9:30 a.m. to the Institute Butantan.Acting Director Dr. Rivera do Vale [José Ribeiro do Vale].He is also in charge of the Department of Virology at the Instituto Adolfo Lutz.Director of smallpox production Dr. Murilo Soares.They are carrying out another polio campaign here.The last one was not too successful.Cases occurred even in the vaccinated.They are giving 2 doses to all infants and children 3 mo.-4 years of age.