I. Introduction -- II. Personnel Relationships -- III. Outline of Operations -- IV. Assessment -- V. Surveillance -- VI. Technical Considerations: I . Measles vaccines; II . Smallpox vaccines -- VII. Areas of Interest for Field Research and Investigation -- VIII. Administrative Support -- IX. Suggested Operations for Storage and Maintenance of Parts Inventory -- X. Records and Reports.

This Manual is intended to serve as a guide for the development of the Smallpox Eradication/Measles Control Program in Africa. The principles set forth and procedures suggested have been developed on the basis of diverse staff and consultant experience in field epidemiology and vaccination programs in many parts of the world and on the basis of a decade of experience with vaccination and surveillance programs in the United States. However, no program has ever been undertaken of the general character and dimensions planned in West Africa. It must be recognized therefore, that this manual represents only an informed judgment regarding the principles involved and possible methods and procedures applicable to the various country programs. These require tempering in the crucible of practical field experience. In addition, each of the separate country programs necessarily will require adaptation and modification to fit the needs of the country in question, for each country has its unique administrative structure, customs and policies. The manual is printed as a "draft" rather than as a formal document. After a year's experience, a more definitive document can be prepared.

In preparing this document, full cognizance has been taken of policies and guidelines for smallpox eradication developed by the World Health Organization. We believe there are no basic conflicts in approach or in philosophy. Because of the nature of the assistance we are able to provide, the structure and organization of this Program, and the early inception of the Program compared to the present timing of the global program, the manual provides a more detailed modus operandi than has yet been developed by WHO.

The Manual first takes up the important question of relationships of CDC staff to national authorities, other American personnel, WHO and other regional health organizations and personnel and other Program staff. Next to be dealt with, in Sections III, IV and, are the three principal functional components of the Program: Operations, Assessment and Surveillance. Technical information pertaining to vaccines is provided under Section VI. General areas of interest with respect to field research and investigation are outlined in Section VII. General administrative procedures and procedures relating to inventory and supply are described in Sections VIII and IX. In Section X, Reports and Records to be provided to the Regional Project Office are presented as a unit.

This material has been prepared in loose-leaf binder form to permit expansion and to allow for revisions to be made as dictated by experience.

David J. Sencer CDC Museum