European Affairs

The United States has deployed atmospheric sensors for biohazards and biopathogens in several dozen cities. We have made a vital change in the rules for approving the efficacy of drugs so that animal studies can now be used to determine the efficacy of possible countermeasures. We have accumulated a huge stockpile of medical countermeasures, both drugs and other medical apparatus, that are on pallets ready to be deployed anywhere in the world at very short notice. We have enough smallpox vaccine to vaccinate the entire U.S. population, plus a small extra amount to help out with international crises. We have a very large bio-surveillance initiative which seeks to integrate the many different sensors now deployed.

We have engaged in an extraordinary bioforensic effort that has focused on the anthrax attacks of October 2001 and has significantly advanced the boundaries of science and bioforensics in dealing with the anthrax microbe. Huge grants for biodefense are being given to state and local public health agencies. Major exercises have been carried out, both at meetings of experts and in the field. Some of these exercises have involved the President, and many have involved cabinet secretaries, in order to create a realistic simulation of a bioterror attack and push the U.S. response system and vaccination efforts to the point of failure.

We have changed the criminal code to incorporate new bioterrorism offenses, making sure that all our actions are legal, and we have revised the regulations governing the Select Agent Program, administered by the Centers for Disease Control and Prevention, that monitors the possession of biological agents and toxins that could pose a severe threat to public health and safety.

This involves an intensity and scale of activity that are unique in the world. U.S. experts still criticize our activities as insufficient or wrongly focused. But there is huge asymmetry between U.S. efforts and those of the rest of the world that is already quite problematic, and will become acutely problematic in the event of an actual bioterror attack. I shall give just one example.

When I was at the White House, we considered an imaginary scenario involving contagious bioterror agents, such as smallpox, that started in another country, say, Turkey. Provided the threat is detected early enough, the right thing to do from a public health point of view is to ring vaccinate the source of contagion very quickly so as to try to contain the outbreak. The only country in the world that has a stockpile large enough to perform such a ring vaccination is the United States. But the stockpile is a finite resource.

So the United States would immediately be faced by one of the hardest decisions a President would ever have to make: whether to use the stockpile to ring vaccinate in Turkey or to vaccinate the entire U.S. population. The scenario did not provide the answer to this dilemma. But I have no doubt that any President would choose to vaccinate the U.S. population, leaving Turkey, Europe and others affected on their own until they could produce the vaccine fast enough. This is a highly unfortunate but realistic prospect. It brings home the need for dialogue and real cooperation on bioterrorism, both across the Atlantic and around the world.

Richard A. Falkenrath is a Senior Fellow in the Foreign Policy Studies Program at the Brookings Institution. He was previously Deputy Homeland Security Advisor and Deputy Assistant to the President. Before that, he was acting Deputy Homeland Security Advisor and Special Assistant to the President and Senior Director for Policy and Plans within the Office of Homeland Security, starting in 2001.


This article was published in European Affairs: Volume number VI, Issue number III in the Summer of 2005.