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The state of biodefense

August 17, 2008

Re "Our own worst bioenemy," Opinion, Aug. 13

Wendy Orent's commentary gives a picture of biodefense-related research that is out of date. It is true that the initial post-9/11 emphasis was on infections that are either rare, like anthrax, or eradicated, like smallpox. But that was justified because the social and economic consequences of an intentional release of these agents would be greatly out of proportion to the casualties. If even a single, nonfatal case of smallpox occurred in the United States, the country would be effectively quarantined, bringing travel and global commerce to a halt.

One could argue that the resources applied to this research were out of proportion too, but only in hindsight. Now there are stockpiles of vaccines and therapeutics available to partially offset the effects of an intentional release and to limit panic.

Currently, the emphasis in "biodefense" research is on other "priority pathogens," most of which have an effect on public health now, not just in terrorism or war-game simulations. These include dengue fever, which infects millions in Latin America, Asia and Africa and laps at the borders of the U.S. as the climate warms; salmonella; SARS; influenza; multidrug-resistant tuberculosis; and West Nile virus.

We should not abandon the original intent of biodefense research programs. Recent events in the nation of Georgia remind us of the former Soviet Union's advanced programs in biowarfare with anthrax, smallpox, plague, botulism and other infections. Neglecting prevention of the effects of state-sponsored biowarfare may be penny-wise but pound-foolish.

Alan Barbour

Irvine

The writer is director of the Pacific-Southwest Regional Center of Excellence for Biodefense and Emerging Infections.

Bravo to Orent. A bioterrorism attack on U.S. soil is recognized by both sides of the biodefense argument as a low-probability, high-consequence event. But a natural pandemic of influenza, SARS or other non-biodefense pathogens -- particularly the H5N1 variant of the avian flu virus -- is a virtual slam-dunk in the coming decades.

It almost certainly will claim thousands, perhaps tens of thousands, of lives in this country. Yet we continue to spend 10 times as much on defense against political bioterrorism as we do on preparing ourselves for a natural pandemic. The biodefense budget request for 2009 is $9 billion, topping even the outlandish amount we will spend this year.

Bioweapons are hard to transport, store and use; are subject to vagaries of weather and local environments and are notoriously imprecise. We must continue to be on guard against bombs, chemical weapons and nuclear devices -- and airplanes -- as instruments of terror.

But the real bioterrorist is Mother Nature. We need to rethink our spending on biodefense.

William Clark

Los Angeles

The writer is a professor emeritus of immunology at UCLA and the author of "Bracing for Armageddon? The Science and Politics of Bioterrorism in America."

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