IT SEEMS hardly believable. Only two years ago the World Health Organization voted to keep alive the last official stocks of smallpox virus. Yet since that stay of execution, smallpox researchers have grown in ambition, and this week comes news that scientists will be permitted to modify the genes of live virus for the first time. Has our need to tinker with this killer virus changed so dramatically in the past two years? Have we thought this through?
Smallpox was one of humanity鈥檚 great scourges until in the late 1970s a global vaccination campaign eradicated it in the wild. Only two known stocks remain, in high-security labs in the US and Russia. In 2002, many of the WHO鈥檚 member countries wanted to destroy even these stocks, and were only just talked out of doing so. One argument for reprieve was the revelation that the Soviet Union had brewed up 100 tonnes of the virus as a biological weapon, and no one was sure who might have kept some after the country collapsed in the early 1990s. Another was that the US government was convinced someone, possibly Saddam Hussein, had a smallpox weapon and it needed those last stocks to test anti-smallpox drugs and vaccines.
We know now that Saddam did not have any such weapon, and the idea that others have one looks much less credible. Yet research into the virus is accelerating. US army scientists are infecting monkeys with it to develop a disease model for testing new drugs and vaccines. In Siberia, the Russians are sequencing the virus鈥檚 genetic diversity, which could in theory help trace the source of any outbreak. And last week a WHO advisory committee decided to let scientists put a marker gene in live virus and transfer smallpox genes to related viruses.
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The aim of the newly approved studies is to make the work of testing new drugs and vaccines against smallpox safer, by cutting down the risk that researchers are exposed to the virus (see 鈥淵es to pox tests鈥�). But every time someone takes smallpox out of the freezer to do an experiment there is a risk it will escape. So we must ask whether this work is really needed.
Some say it is pointless, arguing that no one will spend the vast sums needed to produce and stockpile new drugs and vaccines so long as there is no known threat of a smallpox outbreak or attack. As if to prove the point, a parallel case has arisen with a different disease. A few days after the smallpox meeting in Geneva, another meeting at the WHO deplored the fact that while we have done the research on a flu vaccine that could protect the world against a putative pandemic, almost nobody has put money into large-scale production. Yet flu is a far more pressing threat than smallpox.
On the other hand, some virologists argue that research on smallpox is worthwhile because it advances our understanding of viruses in general. In addition, some fear that now smallpox has gone, a related virus, such as monkeypox, may evolve to replace it.
鈥淣obody will even say who applied to do the experiments on smallpox that were approved last week鈥�
If such research is justified, who should do it? Nobody at the WHO will even say who applied to do the experiments approved last week, though US army researchers seem the most likely candidates. Should such risky research really be governed by a secretive committee that focuses mainly on issues of safety?
The WHO insists that research on smallpox should focus exclusively on drugs and vaccines. Yet research with smallpox鈥檚 relatives is already pushing on the door of biodefence, and US army scientists have added genes to several of them that make them more lethal. They justify their work with the argument that they must create these things before an enemy does the same. Yet every time they do so, they make a potential weapon. Do we assume there is no ill intent? What if scientists from China or Iran announced similar plans? What if someone applies to do the same with smallpox itself?
There are other questions to ask. If smallpox is of such importance to global public health, the research results should be published. But will this be deemed too risky? These thorny questions all demand thoughtful answers, and they must be arrived at through a more open process than the secretive committee meetings that govern smallpox research today.
We have decided to keep the beast alive in its cage. Now we want to poke it. We had better make sure that we know who鈥檚 holding the stick and that their reasons are sound.
