Abstract
To the Editors:
In a recent issue of Biosecurity and Bioterrorism (March 2011), Tucker discussed partial retention of smallpox virus stock for continuation of smallpox research at 2 laboratories, 1 in the U.S. and 1 in Russia. A recent editorial in Nature (January 20, 2011) supported his opinion, saying “smallpox is a disease of history, but it cannot be consigned to the past.”
I worked for the WHO smallpox eradication program for many years, including during the disposal of smallpox virus stocks in the last phase and posteradication. While I agree with the retention of the virus for research, I feel that retaining the virus at a UN/WHO facility would be better, as I have already briefly suggested in my book Smallpox Eradication Saga (2010). I would like to give the rationale for my point: Why have a UN/WHO facility for retention? And what research is needed?
Some experts do not agree with the retention of smallpox virus in designated laboratories. They urge the total destruction of all known stocks of variola. What concerns me is that destruction of entire virus stocks in the 2 remaining labs would mean the stoppage of all live variola virus research in the future. If this smallpox research capability a lost, it will be difficult if not impossible to regain our research abilities in the future.
Certainly the 2 existing labs should have today's highest security system with retention of partial stocks of the virus, but the risk of a virus escape is not zero. Thus, the retention for research would be acceptable only if the research offers significant likelihood of reduction of threat or disaster if smallpox returned. WHO's 2007 annual report indicated “the greatest fear … in the absence of global capacity to contain the outbreak [is that the virus] might reestablish endemicity. …” The concern would be justified, especially in imported outbreaks occurring in Africa or South Asia. Notably, the global population vaccinated against smallpox would be only 30% in 2050 worldwide.
What is the current research situation? Fortunately, today we have good research results owing to the 2 laboratories and other enterprises: working with attenuated vaccines, therapeutic drugs, and diagnostic technologies. Unfortunately, many questions remain regarding real world practices that need to be activated if and when smallpox outbreaks occur, especially in poor regions. There is a real need for practical and managerial research pertaining to vaccine quality standardization, methods for stockpile maintenance, epidemiologic surveillance, vaccine efficacy assessments—there are many practical problems needing research.
This research can be done without live smallpox virus, as was done during the smallpox eradication program. Thus, while the transfer of a smallpox laboratory to a newly constructed UN/WHO repository will take time, initiation of the research noted above may continue at the 2 presently designated laboratories and others under WHO guidance and leadership.
In the future, the UN/WHO repository might become the UN Research Laboratory for Biosecurity, whose functions could include surveillance for hidden virus stocks and work on virus synthesis, with labs engaged in research that has the potential for dual-use research dilemmas. Such a research laboratory could also seek research proposals from the scientific community and offer a secure lab facility for researchers. Future development of molecular biology could lead us to many new developments.
Because of the success of the smallpox eradication, the saving of global health dollars is estimated to be, from 1981 on, $1 billion annually, as estimated by the WHO Certification Committee Report (1980). This is a good justification for funding. Any new ideas, queries, or differing viewpoints would be most welcome.