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The proposal to destroy the virus stocks caused many to reflect upon the possibility of someone using the virus as a biological weapon. Suspicions arose that certain governments or terrorist groups may want--or already have--virulent strains of the virus. Concerned individuals have voiced passionate resistance to the destruction of the United States' stocks, arguing that if others secretly kept the virus and developed it as a biological weapon, we would be completely at their mercy.
Some
scientists oppose destruction of the virus at a time when
so many new techniques have been developed for studying
mammalian viruses. They believe this step would cause a
tragic loss of information about many pathogenic viruses,
perhaps those that cause AIDS and hepatitis. Their arguments
are countered by
others who point to the fact that the DNA of smallpox has been sequenced and cloned, and that, even if the viruses are destroyed, the cloned genes will be available for research. Such counter arguments provoke heated comments from those who would maintain the virus. "Anyone who says the DNA sequence (of the genes) is enough doesn't understand virology, and that includes some famous virologists," said one advocate of maintaining the virus. "To me, on a scientific basis, we're taking an extremely precious resource and destroying it...and destroying it ends the whole issue ofpossibly understanding it in the future." Henderson has been an outspoken advocate in the argument to destroy the smallpox vials. A professor at the Johns Hopkins School of Public Health, he is the founder and director of the Johns Hopkins Center for Civilian Biodefense Studies, a think tank that considers what could be done to protect Americans during a biological event or warfare. In 1988, Henderson's organization put together a working paper of deliberations regarding the destruction of the virus. "The deliberate reintroduction of smallpox into the population would be an international crime of unprecedented proportions," he says. "Spreading of a highly lethal epidemic in an essentially unprotected population, with limited supplies of vaccine, no therapeutic drugs, and with shortages of hospital beds suitable for patient isolation, is an ominous specter." The paper concluded by concurring with the WHO resolution to destroy the vials and encouraged readers to seek the support of all concerned governments in carrying it out. However,
arguments for keeping the virus carried the day, and on
April 22, 1999, President Clinton sought a delay in the
destruction of the stocks of virus based on a recommendation
of his advisors, reflecting agreement among all departments.
The president's message indicated that the research value
of keeping the virus and the uncertainty about who else
may have clandestine stores of it may have played a part
in his decision.
MORE QUESTIONS, FEW ANSWERS
Science, politics, economics, ideologies, and ethics have come crashing together as we grope toward a course of action. There is too much we don't know or that we're not being told. The WHO says it has about half a million doses of vaccine and can produce more. Henderson estimates that the stored vaccine supply in the United States might supply about seven million doses. But these are pitifully small numbers, and we don't know the quality of that vaccine and how effective it would be in preventing infection. One argument for maintaining our virus stocks is that our own supply might serve as a deterrent to potential aggressors. As Henderson says, "There are those who believe that unless it can be absolutely guaranteed that all stocks of virus are destroyed, no action internationally could or should be taken," a rationale similar to the nuclear deterrent strategy that we have lived with for half a century. "For nuclear weapons, the argument may have a rationale," he adds. "However, does a decision, for example, to destroy all known stocks of smallpox virus in the USA without assurance that Russia would do the same have comparable implications? Does this suggest that if one country were to use smallpox as a bioweapon that it would be the intent of the USA to retaliate in kind? It seems unlikely." Under what circumstances, then, would we ever use a deterrent? If the answer is none, then of what value is a deterrent? What other purposes might there be in maintaining our stocks? If we maintain stocks to continue research to perfect a new vaccine or to unlock the secrets of viral pathogenicity, a new series of questions arises. If these are meaningful and realistic benefits--which some people believe them to be--then it seems reasonable to ask whether these benefits also appeared meaningful and realistic years ago, when all but the two known remaining virus stocks were destroyed. Assuming the same concerns were apparent then, we ask what has been done in the area of vaccine development in the last 20 years. If there has been progress, we should know. If there has been no effort, we must ask why. If work hasn't been done along these applied public health lines, it could be that our policy makers see no value in developing a vaccine for a disease that no longer exists, which on the surface seems quite reasonable. If so, what has been the value in maintaining any stocks of virus for the last 25 years? Henderson's argument against the issue is clear: the smallpox virus simply isn't needed to create more vaccines. "The smallpox virus is a wholly different organism and has never been used in vaccine development," he says. "Vaccines made today would still be made from the vaccinia virus, which provides a broad immunity that is effective against all known strains of smallpox." If, he said, smallpox were to be released in a metropolitan area, 100 to 135 million doses of the vaccine would be made available--"enough to handle the need and not create a panic situation." A standby facility would be ready to produce 20 million more doses each month. "With that amount we could feel confident that we're covered in this country, and make the vaccine available to other countries." As
the June 1999 deadline for the destruction of the known
virus stocks approached, the World Health Assembly (the
highest governing body of the WHO) must have known that
the U.S. and Russia were far from agreement about destroying
them. Perhaps as a compromise, the Health Assembly amended
the WHO position to one advocating "temporary retention,
up to not later than 2002, for the purpose of further
international research." The recommendation was reaffirmed
by an international group of scientific and public health
experts meeting at WHO headquarters in December 1999.
Perhaps it is impossible to eradicate any disease in the absolute sense. Nobody knows how the smallpox virus originated. There are, however, striking similarities between smallpox virus and other primate viruses, suggesting an evolutionary relationship. If the smallpox virus evolved as a human pathogen some 10,000 years ago from, say, the milder monkeypox virus, there is no reason to believe that such an evolutionary event could happen only once. It is difficult to imagine any microbial disease being permanently eradicated, and Pasteur's dying message, "The microbes will have the last word," takes on new urgency. The thought that someone could earnestly consider using the virus as a biological weapon deadens the spirit. If that is the case, it makes little difference whether or not we maintain our viral stores. The virus is not our enemy; it is only a vehicle. Our future will not be determined by whether or not we keep the virus, grow the virus, mutate the virus. Our hope is in the gossamer connection between our minds, our hearts, our music, our philosophy, our science, our courage, our dreams. All these are parts of the fabric of our lives. Nothing is separate. The poet Roethke summed it up in a few words, saying, "...And
everything comes to one,
As
we dance on, dance on, dance on."
Richard
Levin is a professor of biology at Oberlin.
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