There are two laboratories with smallpox samples in the world, one in Atlanta, Georgia, USA and the other near Novosibirsk, Russia. The World Health Organization (WHO) has been debating this week whether to recommend destroying the existing samples or holding on to them. WHO has decided to postpone the decision for another three years.

The USA, Russia and most industrialized nations argue that we need the samples for research. A bioterrorist attack would leave us extremely vulnerable if we did not know how to respond. Many nations believe that the longer we hold onto existing samples, the greater the risk of an accidental leak into the general population.

Some scientists view Russia and America’s position as obscure. They say all the productive research work that could ever possibly be done has already been carried out – they see no reason for holding onto existing stocks.

In 1980, when smallpox was eradicated, the World Health Organization asked countries worldwide to either destroy their smallpox samples or send them securely to the two laboratories in the USA and Russia. There is no compelling evidence that all countries did this, even though they all said they did. There may still be a rogue nation, leader or group that has access to smallpox samples. The USA and Russia say that we have to be prepared for a re-emergence of the disease through deliberate misuse of the virus.

U.S Department of Health and Human Services Secretary Kathleen Sebelius wonders about undisclosed and forgotten stocks. She explains that we have beaten smallpox once, but we must be prepared to beat it again if we have to.

These two arguments have been bouncing around for over 25 years. The World Health Organization tends to sit on the fence and not commit itself. A WHO recommendation is not binding; the USA and Russia can choose to ignore it. Many have commented that WHO postpones its recommendation for fear of being ignored and embarrassed.

US scientists argue that we need to find new smallpox vaccines that do not have the severe side effects associated with older generation ones. They say any research and breakthroughs would be shared with scientists throughout the world.

Smallpox is caused by the variola virus. It is an acute contagious disease and is transmitted from human-to-human through infected aerosols and droplets from infected individuals. Signs and symptoms generally appear between 12 and 14 days after initial infection, and include fever, headache, severe back pain, malaise and prostration – there is sometimes vomiting and abdominal pains. Two to three days later the fever drops and a skin-rash appears on the face and then the hands and forearms, and eventually the trunk.

Smallpox was declared eradicated in 1980 – it no longer occurs naturally.

Nils Daulaire, director of the Office of Global Health Affairs at the Department of Health and Human Services and head of the U.S. delegation to the World Health Assembly, said:

“This was a good outcome. It didn’t go as far as we would have liked, but the result is the research program central to the reason for maintaining the virus continues and we’ll be three years closer to having the countermeasures we’re aiming for.”

The US-Russian position is supported by the European Union, Australia and Canada. The following countries, led by Iran are against: Yemen, Peru, Kuwait, Philippines, Thailand, Saudi Arabia, Zimbabwe, the United Arab Emirates, Qatar, Bolivia, China, Bangladesh, and Indonesia.

Written by Christian Nordqvist