We Are Totally Unprepared
Nine years after 9/11, a chilling complacency about WMD attacks.

Peggy Noonan

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Bioterrorism: Redefining Prevention

Bob Graham and Jim Talent
Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, June 2009

Congress created the Commission on the Prevention of WMD Proliferation and Terrorism early in
2008, as an outcome of the work of the 9-11 Commission, and gave us the task of assessing the risk of WMD terrorism and recommending steps that could be taken to prevent a successful attack on the United States. Our Commission interviewed hundreds of experts and reviewed thousands of pages of information. As this work began, it became clear that the United States faced a growing threat of biological terrorism.

What we found is that developing and using a biological weapon is as expensive and as technologically difficult as it will ever get. That is to say, it will only get easier and cheaper. What’s more, the lethality of a biological weapon could rival a nuclear bomb, but it is much less expensive to produce, the starting materials are accessible, and the diversity of technological expertise required is not nearly as great.

For these and many more reasons, in our commission report, World at Risk, we stated that terrorists are more likely to obtain and use a biological weapon than a nuclear weapon. In the late fall of 2008, we concluded that unless we act urgently and decisively, it was more likely than not that terrorists would use a weapon of mass destruction somewhere in the world by the end 2013. On December 2,
2008, the Director of National Intelligence publicly agreed with this assessment.

Since then, Congress has reconstituted our Commission with a new task: to communicate our assessment, explain the evidence behind it, and work with Congress and the Administration to enact our recommendations. In other words, we are now charged to ensure that Congress and the Administration take those decisive actions to prevent such an act of mass lethality from taking place on American soil.

Biotechnology Is Not Rocket Science

Any strategy for preventing biological WMD needs to take into account fundamental differences between the technologies used for making nuclear and biological weapons.

First, there is the accessibility of the weapons material: highly enriched plutonium and uranium do not exist in nature, but anthrax and many other biological agents do, in almost every part of the world. Second, there is the diversity of potential weapons: there are only so many ways to build an improvised nuclear device, but there is an almost limitless array of disease-causing organisms and scenarios for their nefarious use. A third difference is the accessibility of weapons technology: engineering a nuclear weapon is a closely guarded skill, whereas every crop-dusting farmer knows the process for spraying live biological materials.

This leads to the most fundamental difference between nuclear technologies and biotechnologies—the very nature of the interest in these technologies. There is no peaceful pursuit of nuclear weapons technologies. But many countries are aggressively pursuing peaceful applications of biotechnologies, whether they see it as an economic driver or are taking steps against endemic disease. There are hundreds of thousands of scientists, chemists, medical doctors, veterinarians, and even mathematicians working in biology worldwide. Most, of course, are working for beneficent causes, such as trying to understand and defeat disease.

But not all will be working for the benefit of humanity. It has been suggested that specialized knowledge is needed to make a biological weapon, but U.S. Department of Defense studies suggest otherwise. And if the FBI allegations about the Amerithrax mailer are correct, one person with biotechnical expertise but no specific weapons experience or training can produce a sophisticated weapon. Graduating from the small quantities produced for the Amerithrax attack to the amount needed to attack a city will not take a great deal of time or additional technology.

A Bio-specific Strategy Is Needed to Prevent a Biological Weapons Attack

Given the vast differences in the weaponization of nuclear and biological technologies, it is important to have a biological weapons prevention strategy that does not merely involve crossing out ‘‘nuclear’’ and adding ‘‘bio.’’ There will be some similarities of approach, which we have detailed in our report: for example, preventing a biological attack will require continued support and investment in international treaties, such as the Biological Weapons Convention and UN Resolution 1540. It will also require that U.S. labs are safe and secure and that personnel who work in them are trustworthy. But as a recently released Defense Science Board report asserted, ‘‘A determined adversary cannot be prevented from obtaining very dangerous materials for nefarious purposes. . . . The best we can do is to make it more difficult. We need to recognize this reality and be prepared to mitigate the effects of a biological attack. We, as a nation, are not prepared.’’

There is, indeed, a great deal of work to do, but biological weapons give the good guys opportunities that nuclear weapons don’t: a biological weapon can be prevented from causing mass lethality after an attack. This cannot happen after a nuclear detonation, but it is theoretically possible to significantly limit the loss of life after the deliberate infliction of disease. It may be an expansion of what is normally thought of as prevention, but it capitalizes on the unique traits of biology. There may be a time period after an attack when a prepared, efficient response could limit the size and scope of the attack by orders of magnitude. A well-prepared nation can use the incubation period of a disease-causing agent to its people’s advantage.

As we wrote in our report, ‘‘A prompt response with effective medical countermeasures, such as antibiotics and vaccination, can potentially blunt the impact of an attack and thwart the terrorists’ objectives.’’ Some have referred to this as ‘‘pushing the decimal point to the left.’’ Casualties would not be counted in hundreds of thousands, tens of thousands, or even thousands. In addition to saving lives, limiting the effectiveness of a biological weapon makes it less attractive to those who wish to inflict harm by using it.

Preventing an Epidemic

Being able to detect that a biological weapon has been used, to treat the population before illness sets in, and to vaccinate those who could be exposed in the future requires much greater logistical and technological capability than we have at our disposal today. However, within these enormous challenges lies an opportunity for no-regret investments in our national security, our economic growth, our public health infrastructure, and our technological dominance.

Strengthening the infrastructure to respond to a public health crisis is an opportunity to improve U.S. national security and to boost global American leadership, technical innovation, and economic stimulus. The United States has an opportunity to lead the world in the way vaccines and medicines are developed and produced, so that they can be made more rapidly and less expensively.

Right now, there is a lot of room for improvement: it takes 10 to 15 years and approximately $800 million from start to finish to develop one product, and 80% of all drug candidates that enter clinical trials ultimately fail to get FDA approval. Reducing costs and delay would position the country to make unprecedented contributions to global health.

It goes without saying that the best medicines in the world will do no good if they don’t reach the people who need them. Hospitals and public health systems need to be prepared to receive medicines and have the capacity to deliver life-saving care.

An Ounce of Prevention

The investment for making a bioweapon is small and getting smaller, and the outcome could be destabilizing for the nation that is attacked, with spillover effects to other countries, particularly if the weapon is contagious. As the old saying goes, ‘‘An ounce of prevention is worth a pound of cure.’’
But for biological weapons, preventing an attack from causing mass lethality may be a matter of delivering an antibiotic or another medical countermeasure in a timely way.

Fully developing our capacity to limit a biological attack means that future WMD commissions tasked with assessing U.S. security could note that biological attacks are a horrible, regrettable crime that could claim innocent lives—similar to improvised explosive devices or car bombs—but they do not have the potential for mass destruction. A major part of our biodefense strategy should be based on reaching a level of preparedness that will effectively remove bioweapons from the category of WMD. This will happen neither quickly nor cheaply, but it will be well worth the investment.

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Reprinted with permission