Sunday, February 2, 2014

The Annual Smallpox Retention Debate: WHO Global Smallpox Bio-Safety



Author's note: Years ago I was invited to speak at Vector in Novosibirsk, one of two official repositories for the remaining smallpox strains.  Over the course of those years Sergei Netesov and Lev Sandakhchiev exchanged email on topics related to variola major and WHO Bio-safety which I had spent time working on.  Unfortunately Lev Sandekhchieve died in 2006 sometime after our exchanges. When I ran a bio-terrorism group funded by the EU and NATO in Brussels I would invite Netesov to our meetings.The program and reports we worked on are available at: .https://www.google.nl/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CDEQFjAB&url=http%3A%2F%2Fmercury.ethz.ch%2Fserviceengine%2FFiles%2FISN%2F1

Every year the smallpox debate arises and every year after three weeks of debate The WHO World Health Assembly has voted to maintain the last existing smallpox strains. "Smallpox lives on in the memories of those who witnessed its awful impact first hand. It is a terrifying spectre for those who warn that terrorists may seek to spread the disease." See: http://www.nature.com/nature/journal/v469/n7330/full/469265a.html 



It hybernates in two BSL 4 laboratories: Vector in Novosibirsk Russia and the CDC in Atlanta, Georgia (US). In a 2011 article entitled: Smallpox Should be Saved, the peer reviewed journal,  Nature previously argued that: "because the possiblity cannot be ruled out that other secret stocks of smallpox are being held elsewhere, the benefits of continued access to live virus stocks for research outweigh the risks of maintaining them. In 1999 (nature 398; 1999) wrote:



"Rightly public advocates bemoan the prospect of any measures that increases the risk of a re-emergence of this scourge. But given the impossibility of knowing who now possesses the virus, and from where it might appear, it is better to have a number of arrows in the quiver than to destroy the stock and cross our collective fingers." The world has changed much since then, and the US terrorist attacks of September 2001 and the subsequent focus on prospects for bioterrorism have increased the stakes further. Smallpox would be an effective weapon--it spreads easily and kills almost one third of the people it infects. Furthermore, the triumph of smallpox eradication after widespread vaccination in the 1960s and 1970s means that some 40% of the world's population has no immunity." The scientifc case for retaining live variola virus to improve public health is strong. The risk of doing so is largely political. The threat of an accidental release or theft from the biosecure repositories at which it is held--seems remote. Destruction of the stocks would be a largely symbolic step." See: http://www.nature.com/nature/journal/v469/n7330/full/469265a.html






On the other side of the debate, are academics and scientists, who have not generally worked in a military laboratory or dangerous pathogen unit and who have not worked in either repository although there are a couple noted exceptions to this rule. Two from USAMRIID and one from Porton Down that I'm aware of having gone over. Not that this is a dis-qualifier and there are certainly more exceptions,  but drawing from the Nature article, the opposition has tended to base their arguements for destruction on more political sentiment than scientific analysis. Nature rightly goes on to contend that "In an essay ( ) in the journal Biosecurity and Bioterrorism: Biodefence strategy, Practice, and Science, security expert Jonathan Tucker argues that many of the stated goals of the World Health Organization's smallpox research programme have been achieved--such as antiviral drugs and diagnostic tools---and that there is a diminished need for live virus to be retained (J.B. Tucker Biosecur Bioterror doi:10.1089/bsp.2010.0065; 2011). This may be true, but further study of the virus could still reveal a huge amount, both on the specifics of what makes it sucha a formidable foe and on the human immunology and viral pathogenesis in general." See:http://www.nature.com/nature/journal/v469/n7330/full/469265a.html  



So, as it does every year, the World Health Assembly will debate distruction of the last remaining live strains of smallpox. It is expected that it will be retained. Given the unknowns, it surely is better to err on the side of caution than to not.  I will revisit this topic after the May conference. 



For the upcoming WHO World Health Assembly Schedule see: http://www.who.int/mediacentre/events/governance/wha/en/

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