If smallpox laboratory stocks are destroyed, we eliminate the risk of an accident which could lead to an outbreak, get rid of them and say goodbye to any future research on a how to respond to a biological weapon one day. What should be done about a disease that used to kill nearly 30% of infected patients, was declared eradicated in 1980, and still exists in two laboratories?

This week, WHO (World Health Organization) will decide on its position during the 64th World Health Assembly. This theme, which was first brought up in the Assembly in 1986, has been bouncing around debating circles ever since.

Getting rid of the smallpox stocks would address the problem of a possible accidental release one day. However, the USA and Russia are concerned that virus vials may exist elsewhere. In fact, as 50 variola virus strains have been fully sequenced, scientists could if they wanted to build one from scratch. This capability encourages the Americans and Russians to hold onto their stocks so that research can lead to ways of dealing with a biological attack.

Although scientists say there have been enormous advances in smallpox research, this has not been the case with drugs and vaccines. There are no infected humans to test the new candidate vaccines and drugs on. Put simply, there is no way of carrying out clinical trials these days.

Kathleen Sebelius, U.S. Secretary Of Health And Human Services, explained the US government’s position in a letter to the New York Times last month. She wrote that the smallpox samples held in secure laboratories should and will eventually be destroyed. However, when this is done will determine whether humans continue living with the risk of a re-emergence of the disease through deliberate misuse of the virus.

Sibelius warns of advocates who would like to destroy all stocks and believe another outbreak is impossible. She cautions that it might be naïve to ignore the need to be properly prepared for another outbreak – this can only be done if we hang on to the current samples.

Put simply, Sibelius explains that the US and Russia believe the dangers of destroying the existing smallpox samples are greater than if we hold on to them.

Sibelius explained that over 300 million people worldwide were killed by smallpox in the last century alone – there were also hundreds of millions of survivors who became blind or badly scarred. Thanks to the most effective vaccination campaign this planet has ever seen, the disease was totally eradicated by 1980.

When the disease was eradicated, WHO asked nations around the world to destroy their sample or send them to two laboratories, one in the USA and the other in Russia – both WHO-sanctioned laboratories. Sibelius says that we presume, in good faith, that every nation did what WHO asked. Unfortunately, we have no proof – nobody has ever tried to verify or validate compliance.

What if undisclosed or forgotten stocks are still around, Sibelius asks.

Sibelius wrote:

“In other words, we’ve beaten smallpox once, but we must be ready and prepared to beat it again, if necessary.”

Supporters for the destruction of the samples describe America’s and Russia’s reasons as “obscure”. They cannot see any reason for keeping them. All the productive research work that could ever be done has already been done, they add.

Some scientists believe it might be a mistake to destroy the stocks and say their concerns are purely scientific. In an interview with the BBC, Professor (virology) John Oxford, of Queen Mary University London, said:

“I don’t think there’s a strong argument to destroy stocks, just an instinctive feeling to do it, which is misplaced. It’s eradicating a whole species and you never know what the future might hold.”

Whatever WHO decides, if it does manage to agree on this, is not legally binding anyway. Russia and America can choose whether to follow the recommendations or ignore them. Developing countries tend to favor destroying the samples, while the industrialized nations are slanted more towards the US and Russian concerns.

Many believe WHO will decide on another date to discuss the issue again, thus avoiding the embarrassing situation of being ignored by the two nations.

According to The Wall Street Journal in January 2011, the WHO Executive Board “. . backed efforts by the U.S. and Russia to keep the last known stocks of the smallpox virus for research to combat terrorism, in an initial debate over the fate over what is left of one of the world’s most lethal pathogens,” (link)

Written by Christian Nordqvist