The dean of the Johns Hopkins Bloomberg School of Public Health has denounced research being conducted by Army scientists to infect monkeys with smallpox, saying that it "morally undermines" the war against terrorism and sets a dangerous example for other countries.
Dr. Alfred Sommer, who helped battle a smallpox epidemic in Bangladesh three decades ago, has contacted other academic leaders in public health and urged them to call on the government to halt the research and lead a campaign to destroy all remaining stocks of the virus. He fears proliferating smallpox research could reverse the eradication of smallpox as a disease in the late 1970s, considered one of the triumphs of public health.
"We don't need this virus, which has caused so much horror and suffering for centuries," Sommer said in a telephone interview from Bangkok, Thailand, where he is attending a meeting. "It's one thing having the virus locked in a box - that's scary enough. Giving it to monkeys is another. It's just a terrible idea. ... If we don't lead a charge to get rid of smallpox, every country's going to scurry to build up its stocks."
Another public health dean, Dr. Allan Rosenfield of Columbia University's Mailman School of Public Health, took a similar view.
"I think the fact that the military is working with smallpox, no matter what we say, will raise the specter that it could be used as a weapon," Rosenfield said. "If we're doing research, other countries will say, 'Why can't everyone else?'"
In experiments during the past two years led by Peter B. Jahrling of the Army's biodefense center at Fort Detrick, scientists for the first time fatally infected monkeys with smallpox. The work was conducted at the federal Centers for Disease Control and Prevention in Atlanta, where one of only two known stocks of smallpox is stored; the other is in Russia.
Supporters of the work by Jahrling, a virologist who has worked at the U.S. Army Medical Research Institute of Infectious Disease in Frederick for 29 years, say it is an important breakthrough because it creates the first animal model for smallpox, which in nature causes serious illness only in humans. They say animal experiments are crucial for the development of tools for early diagnosis, safer vaccines and new antiviral drugs.
Informed yesterday of the criticism, Jahrling strongly defended the research, which involves CDC as well as Army scientists and has been approved by the World Health Organization.
"I think the U.S. government has made the decision that defense against smallpox as a bioterrorist weapon is a national priority," Jahrling said. "I think it's our moral obligation to bring our best scientific resources to bear on the problem."
He noted that the existing vaccine could be fatal for people with weakened immune systems, including people with AIDS or those taking post-transplant medication. As for the moral arguments for eliminating virus stocks, he said: "The guys who fly airplanes into buildings don't listen to moral arguments."
The fierce disagreement ignited by the monkey research is the latest phase of a battle fought in scientific and government circles since the 1970s.
"It's almost a theological debate," said Jonathan B. Tucker, a bioterrorism expert at the Monterey Institute of International Studies and author of Scourge: The Once and Future Threat of Smallpox.
On one side are the "retentionists," he said, who believe the United States must keep its smallpox samples for limited research to improve medical defenses, especially because some countries or terrorist groups may be keeping secret smallpox stocks. On the other are "destructionists," who argue that the world should make the attempt to eliminate smallpox from the Earth once and for all.
Until recently, the pre-eminent destructionist was Dr. Donald A. Henderson, Sommer's predecessor as public health dean, who led the World Health Organization's campaign to eradicate smallpox. But Henderson has had to mute his views since joining the Department of Health and Human Services as the top bioterrorism official last fall, shortly before the Bush administration announced that it would preserve the CDC's smallpox stock indefinitely for research.
Contacted yesterday, Henderson said he is "in a difficult position" but is obligated to support the decision for retention. He noted, however, that the last two cases of smallpox, one of them fatal, occurred in 1978 as a result of a leak from a research laboratory in Birmingham, England.
"There is a risk of virus escaping from a lab," he said. "Is it small? We hope it's zero, but it never is."
Henderson said there are serious questions about the usefulness of Jahrling's animal research. Because the experiments involved injecting monkeys with a large dose of smallpox virus, rather than inhaling virus particles as occurs in human transmission, the cases may not be appropriate for testing drugs and vaccines, he said.
Smallpox, which kills about one in three people infected and leaves survivors blind or disfigured with facial scars, was one of the great killers in human history. For at least 3,000 years, epidemics swept relentlessly through human settlements, causing particular devastation when European explorers brought the virus to the New World.
Sommer, who has written a letter to the editor that has not yet been published criticizing the monkey research, recalls witnessing "a classic epidemic" in Bangladesh in 1972. What he saw shapes his position today.
"The difference is seeing tens of thousands of people suffering, knowing there's not a thing you can do for them and knowing a third are going to die," he said. Now, he added, "We have the genie quite literally in a bottle."
Others aren't so sure. Dr. Frank M. Calia, an infectious disease specialist and vice dean of the University of Maryland School of Medicine, said the anthrax attacks of last fall have changed his view.
"Before October, I would have said, 'Get it off the planet,'" said Calia, who once worked in the Army's biological defense program at Fort Detrick. "But the anthrax experience has made me circumspect. ... Based on the current climate, and the fact that we're basically at war, I think we owe it to the American people to learn as much as possible about this virus."