This paper reviews episodes during 1973-1975 when American physician-epidemiologists in South Asia, working under the auspices of the World Health Organization, intimidated local health officials and resorted to coercive methods in the final stages of the Smallpox Eradication Programme. While intimidation and coercion were successful in the short-run in ensuring disease containment, they evoked health-professional and popular resentments, and the long-term effect may have been to foster negative attitudes toward subsequent vaccination campaigns. At the very least these episodes suggest a need for paying attention to actual and perceived abuses when global health measures are introduced from 'above' into regional settings.