DANGER Color-enhanced transmission electron microscope image of smallpox (Variola major) virus. © GELDERBLOM, EYE OF SCIENCE, PHOTO RESEARCHERS INC.

Smallpox is a highly contagious and deadly disease caused by the variola virus. There is currently no effective treatment for smallpox, and the vaccine to prevent and control the disease is available in only limited supplies. This live-virus vaccine has a high incidence of adverse side effects and cannot be administered to people with weak immune systems.

An official familiar with the Bush Administration's decision-making process says, "The scientific aspects of the decision are interesting." He points to "a need for a safer vaccine, and the difficulty in finding drugs that are selective in targeting the replicating virus."

A safer vaccine is under development. But efforts to develop an antivariola monoclonal antibody that could also be used to protect immunosuppressed individuals is years off.

Until its eradication, smallpox "was a uniquely human disease with no animal reservoir," says Jonathan B. Tucker, a bioterrorism expert with the Monterey Institute of International Studies and author of "Scourge: The Once and Future Threat of Smallpox" (Atlantic Monthly Press, 2001). "Unless a realistic animal model of smallpox can be developed, there is no way to determine whether or not candidate antiviral drugs and vaccines are effective in treating or preventing the disease," he adds.

The Bush Administration intends to retain the smallpox virus stocks, now stored at the Centers for Disease Control & Prevention in Atlanta, until new diagnostic tools, at least two anti-smallpox drugs, and a next-generation vaccine are developed. "These ambitious tasks will take at least a decade to complete," Tucker says.

The U.S.'s smallpox decision is likely to be raised in Geneva, where 144 nations that have ratified the Biological Weapons Convention (BWC) are now meeting to review compliance with the treaty. The treaty bans the possession, production, and use of biological weapons (BW) but contains no verification mechanism.

A six-year effort to close this gap--a draft compliance protocol that would have set up an inspection regime--was rejected by the U.S. in July. At the time, the U.S. said the protocol would not prevent cheating and would harm U.S. national security and its pharmaceutical industry. Tucker believes the smallpox decision "will almost certainly heighten international criticism" of that decision.

Bolton. AFP PHOTO/LAURENT GILLIERON

Partly to deflect that criticism and to set the stage for making Iraq the next target in the U.S. war on terrorism, the U.S. at the Geneva meeting named the countries it believes have BW programs and offered alternatives to the protocol.

John R. Bolton, undersecretary of state for arms control and international security, accused Iraq and North Korea of producing and probably weaponizing biological warfare agents in violation of the BWC. He said the U.S. believes Iran has produced and weaponized such agents and that Libya and Syria have offensive BW programs at the R&D stage. He said the U.S. is "concerned about the growing interest of Sudan, a non-BWC party, in developing a BW program." Bolton offered no supportive details for his charges, which Iraq, Iran, and Libya angrily rejected.

Bolton then offered alternative measures to the protocol, including enacting national criminal laws to make it a criminal offense to engage in activities prohibited by the BWC and establishing stricter national standards for securing germ agents. Instead of the protocol's inspection scheme, the U.S. suggests setting up a voluntary mechanism for clarifying and resolving compliance concerns.

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