Bioweapons and the Dangers to Public Health (03/02)

One of the great accomplishments during the second half of the 20th century was the effort that culminated in the eradication of smallpox, the killer that claimed more lives than all of the century’s wars combined. Judith Miller, Stephen Engelberg, and William Broad, the authors of Germs: Biological Weapons and America’s Secret War  (Simon & Schuster), are concerned with smallpox and a plethora of other virulent diseases. But the story they tell is anything but inspirational.

It starts at the beginning of World War II, when the US began to mobilize against possible biological weapons attack, and to retaliate in kind. By 1943, the investigation of germ weapons, headquartered at Camp Detrick in Maryland, was expanding rapidly with 250 buildings and living quarters for 5000 people. The program received a windfall after the war: US officials granted the head of Japan’s notorious Unit 731, and several of his associates, immunity from prosecution in exchange for the voluminous records of Japan’s germ program. That program had used anthrax, typhoid, and plague to kill thousands of Chinese.

At one point, the US military concluded that killing the enemy wasn’t always necessary; viral crippling was sometimes preferable because an ailing soldier tied up more enemy doctors, nurses, hospitals, drugs, and equipment. One of the plans drawn up to unseat Fidel Castro called for a biological strike of this kind, followed by a huge assault by US troops. Thousands of gallons of a debilitating cocktail were prepared; the idea was to produce severe illness for a few days, with fevers up to 106 degrees (close to what produces coma, seizures, and death), followed by longer periods of weakness. Although the scientific director at Detrick described use of the cocktail as “a humane act” compared to use of a nuclear weapon, planners estimated that as many as 70,000 Cubans might die. For reasons that remain unclear, the plan was never implemented.

In 1969, President Nixon abruptly ended what was then the largest bioweapons program in the world, confining US research to “defensive measures.” A

few years later, the US, the Soviet Union, and more than 100 other nations signed the Biological and Toxin Weapons Convention, which prohibited possession of deadly biological agents except for defensive research. But, as the authors of Germs point out, “the treaty was filled with loopholes.” For example, no standards were set for distinguishing between defensive and offensive work, and no enforcement mechanisms were established. Congressional investigations later found that even after the Nixon ban, the Central Intelligence Agency kept a diverse arsenal of biological agents that included anthrax, smallpox, tularemia, and encephalitis.

Secret Arsenals

With the collapse of the Soviet Union, evidence began accumulating that, despite the treaty, it had not stopped its development of offensive bioweapons – in part because officials there believed that the US had never abandoned its germ warfare program. Kazakhstan, a newly independent republic eager for closer ties to the West, opened for inspection the most advanced Soviet germ-warfare plant, and the only one outside the Russian heartland. A team of visitors found a facility of enormous production capacity, which had become a decaying wreck. One member of the team calculated that the output of this plant alone was more than enough to have killed the entire US population. 

This was only one of at least six Soviet bioweapons production facilities. Some of these, perhaps still containing large amounts of lethal strains, may also be deteriorating. Equally daunting, many of the tens of thousands of personnel once active in bioweapons research, now underemployed or unemployed, are potential assets for any nation or group that wants to develop its own arsenal. Germs reveals the inadequate attempts of the wealthy nations to solve the problem. It has been aggravated by the flight from Iraq of some top scientists engaged in that country’s extensive germ program, and by a project in South Africa during White-minority rule that was aimed at developing biological agents intended to cripple or kill foes of apartheid.

The authors have used their considerable skills as investigative reporters for the New York Times to produce a book that gives a detailed account of biological weapon development over the past half-century. Strengthened by hundreds of interviews, Germs provides an extensive chronicle of the US and Soviet programs, of attempts by UN investigators to determine the extent of the Iraqi program and its status after the Gulf War, and the perhaps prototypical bioterrorism of the Rajneesh attack in Oregon and Aum Shinrikyo in Japan.

As Germs makes clear, virulent bioweapons are here today in abundance, and their effective use against populations will become increasingly possible in the future. Unfortunately, readers will take away little that is helpful on two centrally important issues. The first, and more obvious, is how to achieve international agreements that will limit use of these weapons. The second is how to defend against biological weapon use, should it actually occur. This, in turn, is part of a more formidable problem – defending against all pathogens.

Hiding the Offense

Negotiations have been underway for more than a decade to add a verification protocol to the 1972 biological weapons treaty, but several US administrations have resisted rigorous on-site inspection requirements. Last spring, the chairman overseeing the negotiations proposed a compromise draft of the protocol’s text. In its paltry one-page treatment of verification, Germs merely states that in mid-2001, “the Bush Administration announced its opposition to the protocol,” claiming that it was “overly intrusive and unlikely to deter cheaters.” An international conference was held at the end of 2001 to try again. It ended in the same way, with the US proposing to terminate the effort, and renewed complaints from many European countries that President Bush was acting unilaterally and not heeding the concerns of US allies.

That the administration rejects the inspection protocol as “overly intrusive” may reflect the frequent allusion in Germs that many of the more recent US biodefense projects have possibly overstepped the boundary between “defensive” and “offensive.” Milton Leitenberg, a specialist in biological warfare at the University of Maryland, puts it more strongly: “If the United States found the same projects taking place in Russia, Iraq, Iran or any of several other countries, it would consider them to be part of an offensive biological weapons program.” As for deterrence, no inspection protocol is perfect, but even an imperfect effort would make it extremely difficult to hide a large, state-sponsored bioweapons program.

The bombing of US facilities at home and overseas, combined with awareness that bioweapons and the expertise to use them might be widespread, produced a sharp increase in the biodefense budget during the Clinton presidency. Regrettably, expenditures to strengthen the public health system were inadequate and came late in Clinton’s second term in office. Miller et al correctly describe public health as “the heart of meaningful biodefense preparedness,” yet fail to elaborate coherently on the importance of this point.

The Prevention Gap

Whether threatened by a biological weapon attack or naturally arising epidemic, the public’s first line of defense is the local, national, or perhaps global health network. When, in 1984, the Rajneesh religious cult waged the first significant biological attack on a community in the US using salmonella, it was local public health officials who recognized what had happened and responded. Without the then still-effective disease surveillance system in Wasco County, Oregon, the attack might have gone undetected until followed by a more lethal assault.

Unfortunately, in what analyst Laurie Garrett has called a betrayal of trust, financial starvation has produced disastrous deterioration of the public health infrastructure in the US (and throughout the world). Ironically, the Wasco County hospital, which had its 125 beds occupied by salmonella patients at one point, now has less than half that capacity. More generally, many health departments have limited computer technology and don’t use e-mail for rapid communication. Some are still saddled with rotary telephones. Much of the epidemic-surveillance system is in tatters. While biodefense planners contemplate enormous expenditures for anthrax and smallpox vaccines that may never be needed, the vital tetanus vaccine is in short supply. Asthma and chronic lung disease patients most in need of flu shots don’t always get them.

The neglect of public health has been occurring at a time when the infrastructure is especially in need of strengthening – to deal with bioterrorism, but more importantly, to confront changing patterns of disease. A comment by some leading members of the US health community about the Rajneesh attack, which sickened about 750 people, is appropriate. While an instance of “intentional salmonella contamination may be persuasive to advocates of bioterrorist” defense measures, they wrote, “perhaps public health would be better served by preventing millions of illnesses and thousands of deaths from food-borne infections that occur annually” in the US.

As for infectious disease, deaths fell steadily in most countries following World War II. But toward the end of the 20th century, they began rising again in the US, Russia, and the Third World. Through the natural process of evolutionary selection, germs are becoming increasingly resistant to the antibiotics that once seemed capable of wiping out infectious disease. New diseases are emerging (AIDS, Ebola) and old ones are reappearing in more virulent form (tuberculosis) or new places (cholera), promoted by penetration of people into new environments, the disruption of war, widespread and extreme poverty, and rapid methods of transportation, among other reasons. The effects of global climate change, while not yet completely clear, are likely to make the situation worse.

In the face of these assaults on world health, the bioweapons programs described in Germs may be the lesser threat, although they certainly can’t be ignored. Renewal of negotiations to place existing bioweapons under control, to the maximum extent possible, is essential. Restoration of the trust that has been betrayed – by launching vigorous campaigns against disease locally, nationally, and globally – could mitigate any remaining threat from bioweapons. More important, it will put the world back on the road to better health and the innumerable benefits that flow from it.

Albert Huebner teaches at California State University, Northridge. He can be reached at