New buffer for bioterror's tempest

The effort to bring the drug and biotech industries into the process augments the basic research on bioterrorism already being done at the National Institutes of Health. "The NIH has a spectacular record on research, but it doesn't have a good track record in bringing products to market," says Jerome Hauer, director of the Response to Emergencies and Disasters Institute at George Washington University and a former public health emergency preparedness official at HHS. "That's got to be done in the private sector."

At the same time, Dr. Hauer and others point out that much more than Project Bioshield will be needed. "This doesn't fix the bio-defense problem," he says. For example, the country is unprepared for a sudden surge of hospital patients. "If we had 10,000 patients from a biological or nuclear or radiation attack in any city, such as New York or Los Angeles, it would overwhelm the ability of the healthcare system to deal with it.

"We have to be focused on more than just biodefense and terrorism," he says, noting that the country also needs a focused approach to nonterrorist threats, such as a flu epidemic or SARS outbreak.

Bioshield will provide "some protection against what are arguably the most plausible forms of terrorist action, which would be release of known pathogens," says John Steinbruner, director of the Center for International and Security Studies at the University of Maryland. But it fails to take into account the big picture, he says.

"The whole world, ourselves included, is at the very early stages of understanding the nature and magnitude of this problem and designing sensible responses that themselves do more good than harm," Mr. Steinbruner says. Of urgent concern is the inadvertent development of even more dangerous pathogens, which demands a much more active oversight process. "The one thing we most have to worry about are people going off in a dark corner somewhere and doing God knows what and not telling anybody about it," he says. The rules should demand "transparency and independent oversight," he says. "And we should never ever allow any of it to be done under national-security secrecy rules."

The proof will be in what results. If all the US ends up with is $6 billion worth of anthrax vaccine, Fischer says, "we will not really have achieved very much."

• The most likely bioterrorism threats are anthrax, smallpox, and plague.

• The US maintains a repository of supplies for bioterrorism emergencies. In 2002, it was renamed the Strategic National Stockpile and put under the jurisdiction of the Department of Homeland Security. It includes antibiotics, chemical antidotes, life-support medications, respirators and other breathing maintenance supplies, and surgical items.

• Nearly a dozen nations are suspected of having the capability to produce biological weapons, including China, Iran, Israel, Libya, North Korea, and Sudan. The US and Russia signed a treaty to destroy their arsenals. Iraq's bioweapons have not been found.

SOURCES: Centers for Disease Control and Prevention, Carnegie Endowment for International Peace

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