Bioweapons

Biological weapons have been used throughout history.¹,² For example, in medieval sieges infected animal corpses were thrown over the walls to start epidemics. In the first world war attempts were made to infect horses with glanders, and throughout history invading armies have poisoned wells and other water sources. Despite the 1972 international convention banning their use,³ attempts have been made to use these weapons—the Aum Shinrikyo sect in Japan tried to use them in 1995. The attacks on media and government offices in the United States with anthrax in 2001 in the aftermath of the events of September 11 reminded all of us of our vulnerability to biological and toxin weapons. Whether those attacks were the work of organised groups, rogue states and their supporters, or individuals with perceived grievances against the US government and its agents is irrelevant. The key point is that they show that the clandestine manufacture and distribution of effective biological weapons is possible today, and as genetic and other technology becomes more easily available the risk of further attacks must be increasing.

The reality is that our protection from biological and toxin weapons has been based on the scientific difficulty of producing robust weapons grade materials and packaging them so that they survive transport and distribution. In relation to the anthrax produced and distributed in the United States it is clear that these problems were largely solved—the anthrax was produced in large quantities and was sufficiently fine to be suspended in the air and inhaled after some of the releases. Anthrax is easier than some agents to release—the spores are relatively resistant to drying and changes in heat, and hence the postal distribution was effective.

Advances in biotechnology and genetic engineering are making it easier to manufacture and handle other agents. With simple automated systems, weapons grade material can be manufactured with reduced risk to the people making it. In addition genetic technology is likely to make it possible in the very near future to design into organisms and agents changes that make them more infectious, resistant to antibiotics or vaccinations, and easier to distribute. But even without these changes bioterrorists could readily infect themselves with a lethal agent and start an epidemic by walking among us—for example, in an airport.

The only current legal protection that we have against the use of such weapons is that of the Biological and Toxin Weapons Convention. Although this convention outlaws biological weapons, it has no teeth; no provision has been made for inspection or verification visits to ensure that state sponsored or privately owned laboratories are not engaged in the development or production of weapons. Despite eight years of work by a group, under the chairmanship of Hungarian ambassador Tibor Toth, the convention stands alone. States have signed and promised to abide by its provisions, but we cannot check their veracity. Last November the experts of 144 states that are party to the convention met to consider the “verification protocol,” but the United States opposed its introduction and so the protocol was lost. However tempting it might be to criticise the US government's position, we need to move on instead, to attempt to achieve some better measure of security, taking all states with us in that process.

Many groups have expressed concerns about the risks and are searching for ways to reduce them. The US National Academy of Sciences, through its working group on biological weapons and its subcommittee on security issues, is currently talking to scientists from around the world on ways to reduce risk. The World Medical Association (www.wma.net), meeting in Washington DC in the first week of October, is considering a “declaration of Washington” on biological weapons. The BMA's own book identified concepts including the so called web of deterrence—getting scientists to abide by an overarching ethical framework and informally monitoring each others' work to identify those with the knowledge base and the physical infrastructure to produce weapons.

The scientific concern is there; political will is now needed to make this happen. On 25 September, the International Committee of the Red Cross launched an appeal to attempt to capture this scientific will and fuse it with political concern (www.icrc.org/). Doctors and scientists have recognised the risks that face us; now we must manage them. As we reach the anniversary of the anthrax attacks we have an opportunity to reaffirm the rules and share responsibility with governments for ensuring that the advances in biotechnology and genetic engineering are never again used for poisoning or the deliberate spread of disease.