On December 16, 2002, I was performing a search of the medical literature through a user-friendly on-line medical database, MDConsult, for a school-related project. I came across a caption, unrelated to my research, which caught my eye: â€œBush announces national smallpox vaccination plan.â€1 Unaccustomed to such â€œpoliticalâ€ content when undertaking a medicine-related academic exercise, I recently decided to investigate the matter.
The Indianapolis Star reported on December 21, 2002, that President Bush had received the smallpox vaccine. A week earlier the President had valiantly proclaimed: â€œas commander in chief, I do not believe I can ask others to accept this risk [of being vaccinated] unless I am willing to do the same.â€2 The article did not elaborate on whether his sanctimonious statement meant that the President would also be at the front lines of the U.S.-led invasion of Iraq, given the risks his military will be â€œacceptingâ€ then.
The vaccination plan
The original article described a 3-phase vaccination program which initially ordered â€œmandatory vaccination for military troops involved in overseas deployments and for members of military emergency response teams.â€3 In this first phase beginning December 16, 2002, a half-million U.S. troops would be inoculated.4 In the second phase, covering a period of two months, it would â€œsee 450,000 to 500,000 members of domestic emergency response teams receive voluntary smallpox shots.â€5 In the final phase, between â€œ5 million and 10 million more physicians, healthcare workers, police and fire fighters, will be vaccinated starting in the late spring or early summer of 2003 [â€¦] includ[ing] infectious disease experts, dermatologists, and hospital support staff.â€6
The American population, although heavily primed and effectively made paranoid by the ostensible threat of a bioterrorist smallpox attack, is not to be vaccinated. In the Presidentâ€™s words: â€œpublic health experts do not believe the vaccine is necessary for the general public.â€7 Of course, many of these very same â€œpublic health expertsâ€ are likely to be vaccinated as part of the 3-phase program, but this is an ancillary observation of presumably minimal importance.
The original 3-phase smallpox immunization plan, as proposed by the Department of Health and Human Services Secretary, Tommy G. Thompson, did include the eventuality that all 280 million Americans would be vaccinated.8 Following weeks of debate, however, American government officials decided against this, insinuating that the threat of a smallpox bioterrorist attack does not outweigh the risks of side-effects from the smallpox vaccine. Data from 1968 suggests that the vaccine may cause death in up to 2 people per million, life-threatening illness in 14 to 52 people per million, and serious but non-life-threatening reactions in up to 935 people per million.9 Nonetheless, the government has ordered 75 million doses of vaccine made by Aventis Pasteur Inc., and another 209 million doses from partners Acambis PLC and Baxter International Inc. in the event of an emergency. However, these vaccines will likely not be granted a licence until sometime in 2004.10
The vaccine currently being used is the Dryvax vaccine, which was last employed in the United States in 1972. The Food and Drug Administration granted a license for the federal governmentâ€™s 30-year-old stockpile of 15.4 million doses,11 which allowed for the immunisation program to proceed.
Meanwhile, a recent survey of 1,006 American adults selected by means of random-digit dialing conducted by the Harvard School of Public Health revealed that â€œthe majority of respondents said they wanted to be vaccinated; however, only 21% would want to be vaccinated if physicians declined vaccinationâ€. It goes on to confirm that â€œ[t]here was strong support among the respondents for several proposed state emergency powers,â€12 revealing the efficacy of the state campaign to instil fear and paranoia into the American people. The complete results of the survey are scheduled to be published in the January 30, 2003 issue of the New England Journal of Medicine. The survey did not comment on how many Americans felt the smallpox threat was being exploited as a means of gaining support for the seemingly inexorable path leading to the war against Iraq.
Smallpox: a historical perspective
Smallpox was declared eradicated by the World Health Assembly on May 8, 198013 following the successful campaign led by the World Health Organisation (WHO) Global Smallpox Eradication Program, launched in 1967.14 The last natural-occurring case was detected in Somalia, in 1977. Following the eradication of smallpox, the stock of variola virus (the agent which causes the disease known as smallpox) was reduced and subsequently restricted to two WHO Collaborating Centres: the Centres for Disease Control and Prevention in Atlanta and the Institute for Viral Preparations in Moscow.15 The facilities in Moscow were later moved to the Russian State Centre for Research on Virology and Biotechnology in Koltsovo, in the Novosibirsk Region of the Russian Federation.16
In September of 1994, members of the Ad Hoc Committee on Orthopoxvirus Infections (a WHO international group of experts) unanimously recommended the â€œdestruction of the virus stocks kept in the two laboratories.â€17 This confirmed the recommendation of the preceding Committee meetings, in March 1986 and December 1990.18 The one stipulation was that the genetic blue-print of the variola virus should first be determined and archived prior to destruction of the stocks of the virus. In 1994, Dr. Bernard Moss of the National Institute of Health based in Bethesda, Maryland stated: â€œNow we are fully satisfied that the genetic blue-print of variola virus has been properly archived for posterity. Should the need arise, we will be able to conduct diagnostic tests with 100% accuracy.â€19
Almost a decade later, however, the stocks have not yet been destroyed. In the Fifty-Fifth World Health Assemblyâ€™s Report by the Secretariat dated April 5, 2002, the third meeting of the WHO Advisory Committee on Variola Virus Research concluded that much essential research would not be completed by the 2002 deadline set in its last meeting (in 1999). They suggested that â€œfurther goal-oriented research, extending beyond the expected 2002 destruction deadline, could be justified so that the world population could be adequately prepared for the unlikely, but potentially catastrophic, event of a re-emergence of smallpox.â€20 Thus, caught in a fit of circuitous logic from which it seemingly cannot extricate itself (i.e. maintaining stocks of the variola virus for research whilst thereby increasing the very risk that these stocks, or the scientists working with them, may be used for or engage in nefarious endeavours with smallpox) the Fifty-Fifth World Health Assembly decided to authorise that â€œ(â€¦) a proposed new date for destruction should be set when the research accomplishments and outcomes allow consensus to be reached on the timing of the destruction of variola virus stocks.â€21 Indeed, as recently as October 25, 2002, a press release describes how WHO-appointed biosafety teams had completed an inspection of the State Research Centre of Virology and Biotechnology (Vector) in Koltsovo, and were â€œpleased to note that all previous recommendations on procedures and safety had been addressed.â€22
In their October 2001 article, â€œRecent Events and Observations Pertaining to Smallpox Virus Destruction in 2002â€, Dr. Donald A. Henderson and Dr. Frank Fenner favoured the notion whereby â€œthe World Health Assembly [would] call on each country to destroy its stocks of smallpox virus and to state that any person, laboratory, or country found to have the virus after date x would be guilty of a crime against humanity.â€23 Although evidently not convincing enough for WHO officials, such a conclusion is laudable. However, articles by Dr. Henderson in prior years raise oneâ€™s suspicion with regard to how large a role he played in fuelling American societyâ€™s paranoia of a bioterrorist attack by using his highly influential position as platform to propagate conventionally-accepted truths (e.g. Iraqâ€™s weapons of mass destruction as maintained by American propagandists), while refraining from providing a more iconoclastic perspective (e.g. American complicity in distributing materials and technology for the potential development of weapons of mass destruction by Iraq and other â€œrogue statesâ€).
A physicianâ€™s responsibility
Dr. Henderson is the former Director of the WHO Smallpox Eradication Program and is the founding director of the Center for Civilian Biodefense Studies at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland. He is a senior advisor to the federal government and the Department of Health and Human Services on civilian biodefense matters. Dr. Henderson has been one of the more outspoken proponents of â€œ[s]trengthening the public health and infectious disease infrastructure [â€¦] toward averting the suffering that could be wrought by a terroristâ€™s use of a biological agentâ€24 and has been a leading voice in bringing the debate to the publicâ€™s eye. He was named as chair to a new national advisory council on public health preparedness in October 2001; the council is charged with recommending improvements to the nationâ€™s public health infrastructure to better prepare the country for bioterrorist attacks.25 Indeed, Dr. Henderson has written prolifically on the subject of bioterrorism and uses his knowledge as a physician to make cogent arguments about the need for preparedness in the event of a bioterrorist attack. Unfortunately, however, his writings are often suggestive of the same monolithic discourse which mars the work of many American â€œintellectualsâ€.
For example, he contends that â€œa mixture of rogue states and well-financed religious cults with scientists desperately seeking funds creates a volatile situation with potentially serious consequences.â€26 While this is entirely plausible, he invokes the â€œus versus themâ€ dichotomy later to be galvanised in the American political canon by George W. Bush following the attacks of September 11, 2001. This is further exemplified when he suggests such things as â€œwhere the [Russian] scientists have gone is unknown, but Libya, Iran, Syria, Iraq, and North Korea have actively been recruiting such expertiseâ€27 or, in the same article published in 1999, making unsubstantiated claims that â€œIraqâ€™s bioweapons capability remains intact.â€28 Around the same time, towards the end of the Clinton presidency, Scott Ritter, a United Nations (UN) weapons-inspector from 1991-1998, offered a very different perspective in an interview. He said: â€œthe biological weapons programs [in Iraq] had been declared, in its totality, late in the game, but it was gone, all the major facilities eliminatedâ€. Furthermore, â€œ[e]verything that we set out to destroy in 1991, the physical infrastructure had been eliminated. So, if I had to quantify Iraqâ€™s threat in terms of weapons of mass destruction, the real threat is zero. None.â€29 [transcribed from audio]
Henderson, referring to an article by G.W. Christopher,30 mentions that after World War II, â€œbioweapons programs began to receive substantial attention [â€¦] while [â€¦] programs in the United States, Canada, the Soviet Union and the United Kingdom expanded steadily until 1972.â€31 Meanwhile, other sources suggest that President Richard Nixon had officially put an end to the U.S. offensive biological weapons programme in November 1969.32,33 Regardless, as Henderson goes on to elaborate, the 1972 Convention on the Prohibition of the Development, Production, and Stockpiling of Bacteriological and Toxin Weapons and on Their Destruction (BWC) was opened for signatures and later ratified by 140 nations, â€œincluding the Soviet Union and Iraq.â€34 This Convention â€œprohibits the development, possession, and stockpiling of pathogens or toxins in â€˜quantities that have no justification for prophylactic, protective or other peaceful purposes.â€™ The BWC also prohibits the development of delivery systems intended to disperse biological agents and requires parties to destroy stocks of biological agents, delivery systems, and equipment within 9 months of ratifying the treaty. Transferring biological warfare technology or expertise to other countries is also prohibited.â€35 While Henderson seems to unconditionally accept that â€œthe Western countries compliedâ€36 with the treaty, he suggests other countries may be developing their own capacities to produce bioweapons, although â€œthere was no mechanism for verification of this.â€37
Henderson is quick to quote words of â€œdefectorsâ€ like Dr. Kanatjan Alibekov (a.k.a. Ken Alibek) from the Soviet Union (Chief Scientist at Biopreparat, a Russian civilian pharmaceutical company from 1987-1992)38 and Hussein Karnel Hassan (President Saddam Husseinâ€™s son-in-law) from Iraq to lend credence to his argument that â€œrogue statesâ€ (e.g. Russia and Iraq, respectively) are, or had been, developing bioweapons. Although he contends that 12 or more countries are known to be working on biological weapons, he admits that it is unknown whether they are working with smallpox virus specifically.39
Most, if not all, of Hendersonâ€™s contentions are probably accurate. The perspective from which he presents these, however, tends to overlook his own governmentâ€™s complicity in creating the bioterrorist threat. For example, while he is quick to suggest that â€œexisting expertise and equipment [relating to the threat of using smallpox as a bioweapon] might fall into non-Russian handsâ€40 as a result of the economic crisis which crippled the Soviet Union in the 1990s, he never attempts to scrutinise the potential role of American companies and governmental agencies in aiding the development of a panoply of weapons of mass destruction in Iraq, prior to Saddam Husseinâ€™s invasion of Kuwait in 1990.
A recent report leaked to the Die Tageszeitung newspaper based in Berlin links American, Britain, German and French companies with supplying â€œentire complexes, building materials and technical know-how for Saddam Husseinâ€™s programme to develop nuclear, chemical and biological weapons of mass destructionâ€41 since 1975. The U.S. corporation, American Type Culture Collection, specifically co-operated with Iraq in the production of biological weapons. Furthermore, â€œ[m]inistries for defence, energy, trade, and agriculture, as well as the foremost U.S. nuclear weapons laboratories at Lawrence, Livermore, Los Alamos, and Sandia, are designated as suppliers for the Iraqi arms programs for [biological] weapons.â€42, 43 Recently declassified American papers suggest that the â€œUS provided less conventional military equipment than British or German companies but it did allow the export of biological agents, including anthraxâ€44 in the 1980s. Furthermore, a â€œcongressional inquiry also found that dozens of biological agents, including various strains of anthrax, had been shipped to Iraq by US companies, under licence from the commerce department.â€45 Given these blatant violations of the BWC, canâ€™t it be reasonably postulated that the United States was conducting its own research on and development of potential biological weapons, such as anthrax and smallpox? Moreover, can one confidently assert that biological weapons do not continue to be developed in the United States presently? In Hendersonâ€™s most recent articles, these questions are made conspicuous by their absence.
Although Henderson cannot be faulted for attempting to institute an adequate response scheme in the event of a biological terrorist attack, it is disappointing that he doesnâ€™t deviate from the â€œus versus themâ€ doctrine which so drastically limits alternate solutions to dealing with â€œterrorismâ€. While he acknowledges that â€œthere is a need both now and in the longer term to pursue measures that will prevent acts of terrorism,â€46 he assigns â€œstrengthening the provisions of the BWCâ€ and â€œstrengthening [â€¦] our intelligence capabilities so as to anticipate and perhaps interdict terroristsâ€47 the highest priority. Even his suggestion of â€œfostering [â€¦] international cooperative research programs to encourage openness and dialogueâ€48 is restricted to laboratories, not peoples. In eschewing an attempt to break new ground in the discourse, Dr. Henderson neglects his responsibilities as physician, which include the well-being of all people, not exclusively those of oneâ€™s nation. Thus, as a strategy of confronting and avoiding terrorism, he never demands, for example, the immediate lifting of UN-imposed sanctions against Iraq. Instead, he seems to prefer pandering to the fear-mongers by acquiescing conventional, but often unsubstantiated, truths.
The very real possibility that the United States may have continued its own research and development work on the smallpox virus, sadly, is never even questioned by Henderson. Granted, this has little relevance to deploying an effective public health response to such an attack, but one should be able to expect the modicum of impartiality in such accredited scholarly academic work. To his credit, however, Henderson does address the use of smallpox as a bioweapon by Western powers, albeit over 200 years ago.
Weapon of genocide to Instrument of manufacturing consent
Speaking of the French and Indian Wars between 1754 and 1767, Henderson writes, â€œ[s]oldiers [of the British army] distributed blankets that had been used by smallpox patients with the intent of initiating outbreaks among American Indians. Epidemics occurred, killing more than 50% of many affected tribes.â€49 In the American best-seller â€œGuns, Germs and Steel: The Fates of Human Societiesâ€, Jared Diamond actually goes beyond the culpability of the British army and extends it onto the entire white American population, â€œ(â€¦) as when U.S. whites bent on wiping out â€˜belligerentâ€™ Native Americans sent them gifts of blankets previously used by smallpox patients.â€50 While Dr. Henderson attributes smallpox with having killed more than 50% of many affected Aboriginal tribes, in â€œThe fox guards the henhouse,â€ Sherry Sullivan suggests that by the 1880â€™s â€œsmallpox had already killed off, on average, more than 90% of them.â€51