The World Health Organization is justly proud of the global effort that led to the eradication of smallpox; but the truth is that the job remains unfinished. Although it is almost 30 years since the last natural transmission of smallpox virus (Variola
laboratories in the United States and Russia retain virus stocks.
The destruction of remaining Variola stocks is an overdue step forward for global public health and security that will greatly reduce the possibility that this scourge will kill again, by accident or design. Although deploying modern scientific techniques such as genetic engineering on smallpox virus may be intellectually intriguing, the risks far outweigh the potential benefits.
In 1990, the US secretary of health and human services, Louis Sullivan, made a pledge on behalf of the US government. “There is no scientific reason not to destroy the remaining stocks of wild virus,” he declared, “So I am pleased to announce today that after we complete our sequencing of the smallpox genome, the United States will destroy all remaining virus stocks.”2
Although the genome was published in 1994,3
the US still hasn't honoured its commitment.
WHO member states concur that the virus stocks must be destroyed. For more than a decade, the US and Russia have paid lip service to the WHO consensus while trying to outmanoeuvre actual destruction of the virus. In 1999 Russia and the US balked at the World Health Assembly resolution calling on them to destroy the virus (resolution 49.10). Since then, both countries have accelerated smallpox research. Particularly risky experiments are underway to create a monkey model of human smallpox infection.4
The US has also proposed genetic engineering experiments with the virus.5
WHO's experts have agreed that no valid reason exists to retain smallpox virus stocks for DNA sequencing, diagnostic tests, or vaccine development.6
In 2006, WHO's experts concluded: “Sufficient sequence information on the virus was now available; no further research requiring access to live variola virus was considered essential.” They also determined that “the number of detection and diagnostic systems for variola virus now available was adequate.”6
Antivirals are not absolutely required because existing vaccines are effective and diagnostic tests are rapid and accurate. And WHO experts have recently suggested that drugs against smallpox could be developed without the dangerous US experiments with live smallpox virus intended to create an animal model of human infection. WHO advisers suggest that this could be accomplished through the far safer route of using monkeypox virus.7