In a few weeks, member states of the World Health Organization will consider the destruction of the last known samples of smallpox virus, currently held in secure labs by the United States and Russia. Some have sought to publicly frame this issue as a contentious disagreement between our two countries and the rest of the world over whether the virus should be destroyed. This is misleading. Smallpox was one of the most devastating diseases humanity has ever faced, killing more than 300 million people in the 20th century alone. The victims it didn’t kill were often left scarred and blind. But thanks to the most successful global vaccination campaign in history, the disease was completely eradicated by 1980.
At that time, the WHO called on all nations to destroy their collections of smallpox virus or transfer them to the WHO-sanctioned collections at one of two labs in Russia or the United States. The global public health community assumes that all nations acted in good faith; however, no one has ever attempted to verify or validate compliance with the WHO request.
It is quite possible that undisclosed or forgotten stocks exist. Also, 30 years after the disease was eradicated, the virus’ genomic information is available online and the technology now exists for someone with the right tools and the wrong intentions to create a new smallpox virus in a laboratory. Furthermore, there are additional pox viruses that infect humans, and while they are not likely to produce the same degree of suffering that smallpox historically inflicted, they could still be dangerous.
Fortunately, in the three decades since eradication, science has come a long way. The vaccine used until the 1970s was little different from the crude vaccine developed by Edward Jenner more than 200 years ago. Today, new technologies and advances in vaccine development exist that could allow us to produce a vaccine without the rare but dangerous side effects of the original. Globally, work is under way to develop and test these vaccines. We should not stop now.
Even with an improved vaccine, vaccination alone will not save those who have already been infected once an outbreak has begun. That is why we are also working on developing, testing and licensing effective new drugs to treat smallpox for those patients with the disease. Scientists in laboratories in a number of countries are making progress on these new antiviral drugs and alternative therapeutic agents that, in the event of a new smallpox outbreak, could control the disease’s progression and greatly reduce the risk of death.
Destruction of the last securely stored viruses is an irrevocable action that should occur only when the global community has eliminated the threat of smallpox once and for all. To do any less keeps future generations at risk from the re-emergence of one of the deadliest diseases humanity has ever known. Until this research is complete, we cannot afford to take that risk.