Jan 11, 2011 (CIDRAP News) Given the potential for a bitter diplomatic battle at the World Health Assembly (WHA) in May, an expert on smallpox-related policy is recommending that the United States agree to the destruction of the remaining stocks of smallpox virusor at least be prepared to destroy all but a remnant of them.
Smallpox was eradicated in the late 1970s, but the United States and Russia, citing concern that some countries may have kept hidden caches of the virus for biological warfare purposes, have maintained stocks of the virus for research on medical countermeasures.
The WHA, the annual gathering of World Health Organization (WHO) member states, agreed in the 1990s and again in 2002 to permit retention of virus stocks for continued research, notes Jonathan Tucker, PhD, in a lengthy article in Biosecurity and Bioterrorism. The WHA is scheduled to address the issue at its May meeting, and pressure to destroy the supply is building, Tucker writes. This could lead to "a diplomatic train wreck," he adds.
"In order to avoid an international confrontation at the 2011 World Health Assembly that would be harmful to all concerned, the US should accept a firm deadline (eg, by the end of 2012) for ending the smallpox research program and destroying the WHO-authorized stocks of variola virus," states Tucker, who is Georg Zundel Professor of Science and Technology for Peace and Security at Darmstadt University of Technology in Germany and author of Scourge: The Once and Future Threat of Smallpox.
If this option won't work because of opposition from Russia or other WHO members, the United States should stand ready to negotiate a compromise calling for destruction of most of the remaining stockpile while taking steps to share the results of smallpox research among WHO members, Tucker recommends.
In his view, Russia clearly opposes destroying its variola virus stocks, but if the United States dropped its opposition to destruction, Russia would probably not stand alone against a united WHA. Many developing countries in Africa and Asia want the virus caches destroyed, he says.
Tucker writes that US preparedness for a deliberate release of smallpox virus is far better now than when the research program began in 1999, reducing the need for continued countermeasure research. The nation has enough doses of smallpox vaccine to protect the whole population and a supply of a third-generation vaccine that's considered safer than earlier versions, he notes. Also, two promising antiviral drugs, ST-246 and CMX001, "are in advanced development and could be given under an Emergency Use Authorization."
Tucker proposes three elements for a compromise on the fate of the variola stocks, if complete destruction is not an option.
First, the United States and Russia would agree to reduce the WHO-authorized stocks in their possession to fewer than 10 representative strains in each country. Though this step would leave many unsatisfied, it would be "a major step toward reconciliation," he argues.
Second, the WHA would take steps to prevent the synthesis of variola virus from scratch. This would involve reaffirming the WHO's 2008 guidelines on the handling of variola virus DNA and incorporating them into national laws and regulations.
Third, the United States and Russia would take steps to share the benefits of smallpox research among WHO member countries. That would mean providing royalty-free licenses to any countries that want to produce drugs or vaccines developed under the program, setting up a WHO-controlled stockpile of antiviral drugs for victims of a smallpox attack anywhere in the world, and increasing the two countries' contributions to the WHO's global smallpox vaccine reserve.
Tucker JB. Breaking the deadlock over the destruction of the smallpox virus stocks. (Commentary) Biosecur Bioterror 2011 (published online Jan 10) [First page]
