The Nightmare of Bioterrorism

Laurie Garrett

From Foreign Affairs, January/February 2001

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Summary:  Biological terrorism is now a greater menace than ever, yet the world remains woefully unprepared to protect itself. Public health systems must stockpile vaccines and develop response strategies -- but they risk losing legitimacy if governments continue to rely on the military and the police for defense against bioterrorism. It is time to seriously rethink the U.S. approach to this deadly threat.

Laurie Garrett is a Pulitzer Prize-winning science and medical writer for Newsday. This article is adapted from her new book, Betrayal of Trust: The Collapse of Global Public Health. Copyright (c) 2000 by Laurie Garrett. Published by Hyperion.

TOOLS IN HAND

As the twenty-first century begins, the following nations possess biological weapons: Iraq, Iran, Syria, Libya, China, North Korea, Russia, Israel, Taiwan, and possibly Sudan, India, Pakistan, and Kazakhstan. The list cuts across lines of ideology, politics, and geography. In addition, according to intelligence sources in Europe and the United States, militant political groups across the globe are now developing or seeking to purchase biological weapons for terrorist use.

Meanwhile, the sophistication of biological weaponry has improved by leaps and bounds. Until 1985, all of the world's biological-weapons makers were stuck with the same list of pathogens and toxins that could kill thousands of enemies and be delivered with missiles or large-scale aerosol systems. Each nation knew the list and stocked antidotes and vaccines. It was a standoff.

But biology in the last decade has been what physics was in the 1940s and 1950s: a field of exponential discovery. What seemed impossible in 1980 was accomplished by 1990 and, by 2000, had become ho-hum fodder for high school biology classes. By the late 1990s, a massive pool of bioengineers, equipped with genetic blueprints to guide their efforts, had emerged. Determining the genetic sequence of a virus, such as Ebola, was no longer much of a feat. In 1998, scientists at the Frederick Cancer Research Center in Maryland determined, at the genetic level, exactly how anthrax kills human cells.

In response to such advances, Western militaries hardened their defenses against biological warfare as they vaccinated troops, stockpiled antitoxins, stored appropriate antibiotics, purchased protective suits and masks, practiced war-game drills involving biological weapons, and supported research on potential microbe-detecting devices. But no one had a master plan for dealing with the collateral impact of biological weapons on civilians located around the combat zone -- or the deliberate impact of bioterrorist damage inflicted on an unsuspecting community. Were a terrorist to disperse the smallpox virus, for example, populations that were once universally vaccinated would now be horribly vulnerable. Today the U.S. government stows only about 15.4 million doses of the smallpox vaccine -- enough for less than seven percent of the American population. The World Health Organization (WHO) keeps another 500,000 doses in the Netherlands, and other national stockpiles total about 60 million more doses of varying quality and potency. If the smallpox virus were released today, the majority of the world's population would be defenseless, and given the virus' 30 percent kill rate, nearly two billion people could die.

The picture worsened in 1999, when scientists discovered that the U.S. samples of the smallpox vaccine had severely deteriorated. Originally made in the 1970s by the Wyeth pharmaceutical company, the samples were stored at the Centers for Disease Control and Prevention (CDC) in Atlanta in the form of freeze-dried crystals parceled out in 100-dose quantities inside vacuum-sealed glass tubes. The tubes were further sealed with rubber stoppers secured by metal clamps. To their dismay, CDC investigators discovered condensation in many of the glass tubes, indicating that the rubber stoppers had ...

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