Measures for controlling the - Royal Society · 2014. 3. 10. · Measures for controlling the threat from biological weapons Published by the Royal Society 6 Carlton House Terrace

Measures for controlling thethreat from biological weapons

Published by the Royal Society6 Carlton House TerraceLondon SW1Y 5AG

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Foreword v

Summary vii

Measures for controlling the threat from biological weapons

Appendix 1 xThe nature of biological weapons, their effectiveness and an assessment ofagents that are most likely to be usedH Smith, P Biggs, D Kelly, J Smith and PG Blain

Appendix 2 xInternational control measures: The Biological Weapons Convention and itsprojected ProtocolJP Robinson and G Poste

Appendix 3 xNational control measures: Management of the consequences of biologicalweapons attacks on civiliansJ Smith and PG Blain

Appendix 4 xMembership of the Royal Society working group on biological weapons

Contents

In May 1999, the Royal Society hosted a meeting to discuss aspects of the control of biological weapons with the National Academyof Sciences (United States) and the Acadèmie des Sciences (France). Following the meeting, the Royal Society decided to prepare adocument that would examine this topic from a UK perspective, and which would inform policy-makers and the public about themeasures required to counter the threat posed by biological weapons to civilian populations.

The main message to arise from this study is that the threat from biological weapons must be taken seriously, but it is equallyimportant not to cause undue alarm by exaggerating it. It is our conviction that co-ordinated national contingency arrangementsmust be made in the UK for dealing with a possible attack. In addition, every effort must be made to conclude successfully thenegotiations over the Protocol for verification of the Biological Weapons Convention, which offers the best opportunity for reducingthe possibility of biological weapons being used in warfare or terrorism.

We commend this document to UK policy-makers at national and local level in both civilian and military administrations, and to thewider public who should be aware not only of the threat from biological weapons, but also of the measures that can, and are, beingtaken to counter it.

Sir Aaron Klug OM PRSPresidentRoyal Society

July 2000

Measures for controlling the threat from biological weapons | July 2000 | v

Foreword

The possible use of biological weapons (BW) is a matter ofnational and international importance. In May 1999, the RoyalSociety considered BW in conjunction with representatives ofthe National Academy of Sciences (United States) and theAcadèmie des Sciences (France). As a result, the Royal Societydecided to publish this report about the main issues affectingthe control of BW. It is primarily concerned with the use of BWagainst civilian, rather than military, targets and deals with threetopics:

• The nature of BW, their effectiveness and an assessment ofthe agents that are most likely to be used.

• International control measures: The Biological WeaponsConvention (BWC) and its projected Protocol.

• National control measures: Management of theconsequences of BW attacks on civilians.

Details of these topics are covered in Appendices 1-3. Appendix4 lists the members of the Royal Society working group onbiological weapons that produced this report.

The overall recommendations are:

• Mercifully, the scale of effectiveness of BW against humanpopulations in war and by terrorist attack has not beenproven in practice. While it would be irresponsible to becomplacent about the possible effects of BW, it would alsoseem prudent not to overestimate them.

• As a basis for the management of the consequences of BWattacks and for ensuring balanced and accurate informationabout them, a scientifically sound and realistic assessment ofthese effects should be made by a panel of government andindependent scientists.

• The agents that are most likely to be deployed by particularaggressors or terrorists should be assessed from intelligence

data and scientific knowledge of the properties of theagents, and the possibility of attacks with unexpected agentsshould be kept in mind.

• The Royal Society could support the BWC Protocol forverification by providing independent advice on theapplication of the latest scientific developments and byencouraging the co-operation of industry in finding asolution to the problem of on-site visits.

• International consultations are needed to establish aprocedure for dealing with transgressors of the BWC.

• To manage the consequences of a BW attack on civilians, anoverall structure is needed within which attacks by specificagents can be handled. Collaborative plans should be set upbetween the police, public health authorities, the clinical andhospital services, the intelligence agencies and the military.The authorities who would co-ordinate the local and nationalresponses should be made clear. These plans should betested in simulated attacks.

• Detection of BW attacks should be based on the existing civilarrangements in the United Kingdom for dealing withnatural outbreaks, and advice from the military on specificagents.

• Key medical staff should be trained to recognise diseasescaused by BW.

• The UK Government should consider the need for makingspecial arrangements to obtain stocks for countermeasuresagainst the BW agents that are most likely to be used.

• Attempts should be made to reduce panic by issuingaccurate information to the public and the media.

• Analyses of attacks should be made and documented to aidfuture responses.

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Summary

The Royal Society considers and forms views on importantscientific matters that affect the community in order to provideinformation and independent advice to scientists, the publicand government departments. At present, the possible use ofbiological weapons (BW) is a matter of national andinternational concern. Many of the aspects are scientific. In1994, after the potential threat from BW had been underlinedby the Gulf War, the Royal Society published a report onScientific Aspects of Control of Biological Weapons. This reportwas comprehensive and highly technical. It was intended to beread by the scientific community and those governmentofficials engaged in national and international efforts to controlBW.

In May 1999, the Royal Society considered BW again inconjunction with representatives of the National Academy ofSciences (United States) and the Acadèmie des Sciences(France). As a result, the Royal Society decided to publish adocument, in a less technical form than its 1994 report, aboutthe main issues affecting the control of BW. This new documenthas been endorsed by the Council of the Royal Society. It doesnot necessarily represent the views of the National Academy ofSciences and the Acadèmie des Sciences . This document shouldhelp the public and government officials, as well as scientists, tounderstand the threat from BW, and it makes recommendationsfor coping with it.

This document is primarily concerned with the use of BWagainst civilian, rather than military, targets and deals with threetopics:

• The nature of BW, their effectiveness and an assessment ofthe agents that are most likely to be used.

• International control measures: The Biological WeaponsConvention (BWC) and its projected Protocol.

• National control measures: Management of theconsequences of BW attacks on civilians.

Appendices 1-3 cover these topics in detail. Military aspects arenot considered, although parts of the topics listed above requireliaison with military establishments. Appendix 4 lists themembers of the Royal Society working group on biologicalweapons that produced this document.

1 The nature of BW, their effectiveness and anassessment of agents that are most likely to be used

Biological warfare can be waged against human populations,crops and farm animals. Only those BW that directly affecthuman populations are considered here.

1.1 The nature of BW

BW include living micro-organisms and toxins (non-livingpoisons of biological origin) that are intended to be spreaddeliberately in aerosols, food or water to cause disease, death orother harm to man, animals and plants. They are potentially aserious threat. In the past, about 25 naturally occurring micro-organisms (bacteria and viruses) and toxins have beenconsidered for use as BW.

Most of these agents can be spread by aerosols (eg Bacillusanthracis) and some by food or water (Vibrio cholerae,Salmonella typhi). They include highly infectious agents (Yersiniapestis, smallpox virus) and those not normally transmissiblebetween humans (Bacillus anthracis). Many of them have beenused in experimental BW trials with animal models and somehave been made into weapons.

Over the last decade, genetically-modified potential agentshave been made possible by advances in biotechnology. Micro-organisms and toxins can be made more effective or able toovercome medical countermeasures. Also, knowledge of thehuman genome and technical advances in gene therapy anddelivery systems may lead to harmful manipulation of geneexpression in people; some have even claimed that it might bepossible to target ethnic groups. However, these developmentsare some years away and in some cases are likely to be morefictional than real.

There is increasing concern over the possible use of BW forthree reasons. First, there is fear of the unknown effects of newagents that might be produced by genetic manipulation.Second, production of BW is relatively cheap and easilyconcealed under the cover of peaceful activities (eg inpharmaceutical plants), so the weapons could becomeattractive to those nations with low budgets seeking a counterto nuclear weapons. Third, living BW seem to be particularlysuitable for certain forms of terrorism. Given the relevanttechnology, they are simple to produce in small quantity. Theirslow action allows the perpetrators to escape before the effectsare apparent. They could be used for either maverick or state-sponsored terrorism.

1.2 The effectiveness of BW

Unlike nuclear and chemical weapons, the effectiveness of BWspread in aerosol form against human populations in war or byterrorist activity has not been proven (see Appendix 1).Mercifully, the impact of BW has not been demonstrated inpractice. Estimates of the possible effects of BW come fromexperiments with animal models.

Micro-organisms and toxins may be lethal or infectious to allof a population if administered by injection or orally, butachieving such effects by spread of aerosols in the field is adifferent matter. Observations on naturally-occurring andexperimental infectious diseases indicate that those BW thatmay be available now or in the near future are unlikely to have asdevastating an effect on human populations as nuclearweapons. The use of BW would cause sickness and some of theagents would cause death in a proportion of the population.Perhaps some would spread to cause wide-scale epidemics.While it would be irresponsible to be complacent about thepossible effects of BW, it would also seem prudent not tooverestimate them.

The use of BW in war or terrorist activity would probably causesome panic, with consequent disruption of public services. Thiswould occur to some extent even if the number of casualties wassmall. However, almost certainly, the panic would be greater if thepossible effects of BW had been exaggerated beforehand.

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Measures for controlling the threat from biological weapons

As a basis for managing the consequences of BW attacks andfor issuing balanced and accurate information, there should bea scientifically sound and realistic assessment of the possibleeffects of those BW that are most likely to be used. This will notbe easy because many BW produce diseases that are rare undernormal circumstances in the UK, so relevant and reliableinformation on their effects will be limited. Independent, as wellas government, scientists should be involved in this assessment.Attention must be given to clinical and epidemiological data ofnatural human infection as well as the results of aerosolexperiments with animal models. Computer modelling ofaerosol cloud travel in different situations and of humanepidemics should be used. Also, it may be possible to modelmathematically the progression of infection in individuals. It isprobable that such assessments are being conducted ingovernment laboratories, so it would be helpful if theselaboratories could share as much information as securityconsiderations would allow.

1.3 Assessment of the BW agents that are most likely to beused

Although any of the agents listed in Appendix 1 could be used,as well as others including those produced by geneticmanipulation, an analysis of the capabilities and intentions ofeach potential perpetrator may indicate that the number ofagents likely to be deployed would be sufficiently small to makethe preparation of tailored contingency plans feasible. Riskassessment should aim to determine:

• the agents that are most likely to be used by each probableaggressor country or known terrorist group;

• the means of delivery that each might use;• the probable effects of an attack and the response to it; and• the probable intent of the attacker.

The possibility of an attack by an unexpected agent must bekept in mind but, even if such an attack occurred, havingprocedures to detect, and therefore exclude, a range of knownagents would narrow the field and might help in identifying theunknown agent. The assessment should be based on intelligencedata about the capabilities of potential aggressor states and terroristgroups to produce and deploy BW, and on the latest scientificinformation about the nature and properties of the agents inrelation to producing agents and turning them into weapons. Theassessment would require the co-operation of intelligence agenciesand military establishments that deal with BW.

1.4 Conclusions

• In the past, only naturally occurring micro-organisms andtoxins have been considered for BW. Over the last decade,the derivation of additional agents has become possiblethrough advances in genetic manipulation and otherbiotechnology, a trend that will continue in the future.

• There is increasing concern about the possible use of BWbecause terrorists and poor nations seeking an alternative tonuclear arms may find them attractive.

• BW are potentially a serious threat, but mercifully the scale oftheir effectiveness against human populations in war and byterrorist attack has not been proven in practice. Observationsfrom natural infectious disease indicate that BW are unlikelyto have as devastating an effect on human populations asnuclear weapons.

• Exaggerating the possible effects of BW could increase panicthat would be likely to occur to some extent even if thenumber of casualties is small. A scientifically sound andrealistic assessment of the effects in humans of the agentsthat are most likely to be used should be made as a basis formanaging the consequences of BW attacks and for ensuringbalanced and accurate information about them.

• The agents that are most likely to be deployed by particularaggressors or terrorists may be relatively few in number.Analyses should be made, based on scientific knowledge ofthe properties of the agents and intelligence data aboutthose countries and known terrorist groups that might attackthe UK. However, it must be kept in mind that unexpectedagents might be used.

2. International control measures: The BiologicalWeapons Convention and its projected Protocol

The Biological Weapons Convention (BWC), which is intended toprevent the developing, testing, production and stockpiling of BW,was agreed in 1972. Most, but not all, nations have signed it,and/or the 1925 Geneva Protocol which prohibits use of BW. Atpresent, attempts are being made to strengthen the BWC byestablishing a verification Protocol that would deter acquisition ofBW and allow detection of infringements. The overall constrainton achieving success is that the technology has a dual use. Theknowledge of microbiology and biotechnology, and the researchfacilities and production plants, needed for the development ofBW are similar to those required to produce vaccines, drugs andagrochemicals. Thus, development of BW can be concealed underthe cover of peaceful activities. Three measures are envisaged forthe verification Protocol:

• declarations of information about biological facilities thatcould be used for the development or production of BW;

• on-site visits to these facilities by internationally appointedinspectors to check the declarations;

• and procedures for investigating possible infringements.

The progress of the negotiations is slow.

2.1 The core problems of verification

Two main problems face the negotiators of the verificationProtocol. The first is to ensure that the Protocol keeps up withscientific and technological advances, especially in relation torecognising future “other biological agents” in the broadGeneral Purpose Criterion for defining BW under Article I of theConvention. As mentioned in Section 1.1, these agents couldinclude those arising from manipulation of microbial and/or hostgene expression by the latest genetic technologies.

The second is to prevent the application of dual-usebiotechnology to the development of BW without damagingbeneficial applications in medicine, agriculture andenvironmental management. A major challenge in achievingthis is to design on-site inspection procedures that includetalking to staff, but that minimise the risks of revealingcommercial and national secrets. At present, some parts ofindustry are reluctant to accept on-site inspections in forms thatthey could not control.

The Royal Society could supply up-to-date independentscientific advice for defining “other biological agents”. On-site

2 | July 2000 | Measures for controlling the threat from biological weapons

inspections need a sensible definition of triggers for decidingwhich facilities are to be inspected, and acceptable surveillanceprocedures. Both need scientific advice and the active andconstructive involvement of biotechnology-based industry.Surveillance operations should be applied universally and withequity over small and large enterprises, within industry,government and academia. Properly trained, neutral, full-timeinspectors with a diplomatic approach, similar to those who areavailable to support the Chemical Weapons Convention, areessential. Only in this way can the co-operation of industry beobtained.

The Royal Society could encourage co-operation betweenindustrial management and potential inspectors. It could alsoprovide independent scientific advice on surveillanceprocedures. Recent advances in biotechnology should be usedto devise sensitive and specific methods for detecting BW with aminimum occurrence of false positives. Novel surveillance anddetection tools will be needed to deal with “other biologicalagents” that may emerge in the future. Also, the possible use ofremote sensing by ground, airborne, and satellite sensors shouldbe kept in mind for revealing more about the manufacture andtransport of large quantities of BW materials and their deliverysystems.

2.2 Dealing with illicit activities

An effective verification regime for the BWC may expose illicitactivity by a State Party, but this could not be stopped unless theParty agreed. The question arises, therefore, of how theinternational community should deal with nations that persist indeveloping BW or have actually used them. Obtainingagreement on a procedure to adopt for transgressors is essentialfor controlling BW. However, negotiations for such a proceduremay take as long as those for a verification regime. Article VII ofthe BWC deals with the situation to some extent. It states: “EachState Party to the Convention undertakes to provide or supportassistance in accordance with the United Nations Charter, to anyParty of the Convention which so requests, if the SecurityCouncil decides that such a Party has been exposed to danger asa result of a violation of the Convention”. Also, there is a recentproposal to prohibit biological and chemical armament underinternational criminal law. Non-state sponsored terrorist activityis not covered directly by the BWC. The first step in trying tocontrol it is for individual states to enact national legislationprohibiting and criminalising such activity.

2.3 Conclusions

• Attempts to establish a verification Protocol for the BWC arebased on declarations of facilities that could be used todevelop BW, on-site inspections and investigation of possibleinfringements. Progress is slow but the Royal Societyencourages the Parties involved to conclude successfullynegotiations over the Protocol as a matter of urgency.

• One core problem is keeping up with scientific advances sothat biological agents that might be used in the future can beanticipated and suitable methods of detection devised.Another is to ensure that dual-use biotechnology is notemployed to develop BW. This will require procedures thatminimise the risk of revealing commercial and nationalsecrets and do not damage beneficial applications of thetechnology.

• The co-operation of the pharmaceutical and biotechnologyindustries is essential and can be gained only through highlevel discussions with industrial management, particularly

about sensible triggers for deciding which facilities should beinspected, and surveillance procedures that are acceptable,neutral and diplomatic.

• The Royal Society could support the BWC Protocol forverification by providing independent scientific advice on theapplication of the latest scientific developments.

• There is no internationally agreed procedure for dealing withtransgressors of the BWC. This should be negotiated.

3. National control measures: Management of theconsequences of BW attacks on civilians

An effective response to a BW attack will depend on accuratescientific advice about the agents, their effects andcountermeasures, efficient civil incident management, and asound public health and medical infrastructure. An overallstructure involving scientific, administrative and medicalmeasures is needed, together with reliable contacts withintelligence sources and appropriate military establishments.The requirements for individual BW can be addressed within thegeneral structure. The methods for assessing which agentsmight be used and their effects have been discussed in Sections1.1, 1.2 and 1.3.

3.1 Detecting outbreaks

The detection of a BW attack should involve the existingarrangements in the United Kingdom for handling naturaloutbreaks of infection. The national surveillance centres (thePublic Health Laboratory Service Communicable DiseaseSurveillance Centre in London and the Scottish Centre forInfection and Environmental Health in Glasgow) should receiveintelligence advice from the military about the biological agentsthat are most likely to be deployed. They should be alertedwhenever intelligence suggests an increased risk of attack.Selected laboratories should be given training in methods forrapid identification. Clusters of undiagnosed infectious diseaseshould be reported immediately to designated departments ofthe national surveillance centres.

3.2 Clinical care

Clinical care could be difficult. Medical staff would be unfamiliarwith many of the diseases caused by BW, so appropriate trainingfor key medical staff is essential. There may be lack of facilitiesfor isolating infectious cases and possibly shortages ofantibiotics and other countermeasures. The possibility ofdealing with a previously unknown infectious disease must bekept in mind. In the case of a large scale attack, when facilitiesfor care may be limited, plans should be made to identify thepersons most in need of care. Plans to establish a cordonsanitaire and decontamination would be needed, depending onthe nature of the agent. For key facilities, sterilisation ofincoming air might be considered.

3.3 Provision of stocks of countermeasures

Provision of national vaccine banks and stockpiles of antibioticsagainst BW for civilian use will be difficult. Advances inbiotechnology provide the potential for producing vaccines,antibiotics and antitoxins against BW, but the cost would behigh. Efficacy testing in humans could not be accomplished forsuch rare diseases. The risks and benefits of different scales ofvaccination would need to be measured for particular agents. Itis not possible to provide protection of all civilians against all BW,nor for all persons exposed to a major attack with any given


agent. The overall conclusion is that only limited stocks ofcountermeasures for a few of the most likely BW can beaccumulated. This should be put into operation, but can it beaccomplished? Industry is normally not interested in counteringrare exotic diseases, so special arrangements would need to bemade by government. These could be made either with industryor in a specially designated government laboratory. Possibleinternational co-operation on the production of vaccines andneutralising antibodies should be explored.

3.4 Minimising panic

As discussed in Section 1.2, the main deleterious effect of a BWattack may be panic with consequent disruption of civilianservices. This may be reduced by the following measures. Beforean attack, key people such as police, medical staff, nurses,teachers and firemen should be informed on a regular basisabout the properly assessed effects of BW (see Section 1.2) andthe available countermeasures. Also, consideration should begiven to providing balanced and accurate information to thegeneral public, as appropriate. If an attack occurred, simpleexplanatory pamphlets ready for issue may be useful, buterroneous or irrelevant information, which might erode theconfidence in the authorities, must be avoided. Communicationwith the Press and other media must aim at avoidingsensationalism. This may be mitigated by a rapid, highly visibleand co-ordinated response from the authorities and well-informed Press Officers who know what is being done to copewith the incident.

3.5 An analysis of the attack

The main features of the attack (eg the BW used, the numberand outcome of clinical and sub-clinical cases, the numbers ofBW micro-organisms found in food, water and air samples, thereactions of the public and the media, and the nature andeffects of control measures) should be documented. This wouldsecure hard data to optimise the response to subsequentattacks.

3.6 Co-ordination of the efforts of different governmentauthorities

Effective countering of a BW attack would need co-ordinationof the efforts of the police, public health authorities, intelligenceservices and the military. The responsibilities of each authorityshould be defined and lines of communication establishedbefore an attack. Collaboration plans should be prepared andtested in simulated attacks.

3.7 Conclusions

• To manage the consequences of a BW attack on civilians,overall co-ordination involving scientific, administrative andmedical measures is needed, with appropriate militaryintelligence and advice.

• Detection of BW attacks should be based on the existing civilarrangements in the United Kingdom for dealing withnatural outbreaks and advice from the military of specificbiological agents.

• Clinical care could be difficult in the event of a large scaleattack. Key medical staff must be trained to recognisediseases caused by BW.

• It is not possible to provide protection of all civilians againstall BW, or even one BW. Only limited stocks ofcountermeasures against a few of the most likely BW can be

accumulated. This should be done either by specialarrangements with industry or by designated governmentlaboratories.

• Measures should be taken to minimise panic by informingthe public and key people of the properly assessed effects ofBW and available countermeasures. Attempts should bemade to mitigate sensationalism.

• An analysis of an attack should be documented to aid theresponse to an attack on a future occasion.

• The efforts of different government departments should beco-ordinated, and collaborative plans should be testedthrough simulated attacks.

4 Overall recommendations

• Mercifully, the scale of effectiveness of BW against humanpopulations in war and by terrorist attack has not beenproven in practice. The possible effects of BW should not beexaggerated as this could increase the panic that is likely tooccur even if the number of casualties is small.

• As a basis for the management of the consequences of BWattacks and for ensuring balanced and accurate informationabout them, a scientifically sound and realistic assessment ofthese effects should be made by a panel of government andindependent scientists.

• The agents that are most likely to be deployed by particularaggressors or terrorists should be assessed from intelligencedata and scientific knowledge of the properties of theagents, and the possibility of attacks with unexpected agentsshould be kept in mind.

• Progress on the BWC Protocol for verification is slow, but theRoyal Society encourages the Parties involved to concludesuccessfully their negotiations as a matter of urgency. The co-operation of the pharmaceutical and biotechnologyindustries is essential and can be gained only through highlevel discussions with industrial management.

• The Royal Society could support the BWC Protocol forverification by providing independent advice on theapplication of the latest scientific developments.

• International consultations are needed to establish aprocedure for dealing with transgressors of the BWC.

• To manage the consequences of a BW attack on civilians,collaborative plans should be set up between the police,public health authorities, the clinical and hospital services,the intelligence agencies and the military. The authoritieswho would co-ordinate the local and national responsesshould be made clear. These plans should be tested insimulated attacks.

• Detection of BW attacks should be based on the existing civilarrangements in the United Kingdom for dealing withnatural outbreaks, and advice from the military on specificagents.

• Key medical staff should be trained to recognise diseasescaused by BW.

• The government should consider the need for making specialarrangements to obtain stocks for countermeasures againstthe BW agents that are most likely to be used.

• Attempts should be made to reduce panic by issuingaccurate information to the public and the media.

• Documented analyses of attacks should be made to aidfuture responses.


The nature of biological weapons, theireffectiveness and an assessment of agents that aremost likely to be used

H Smith, P Biggs, D Kelly, J Smith and PG Blain

1 Introduction

Biological warfare can be waged against human populations,crops and farm animals. Only those biological weapons (BW)that directly affect human populations are considered here.

2 The nature of BW

BW include living micro-organisms and toxins (non-livingpoisons of biological origin) that are intended to be spreaddeliberately in aerosols, food or water to cause disease, death orother harm to humans, animals and plants [1]. They arepotentially a serious threat. In the past only naturally occurringmicro-organisms and toxins were considered for use as BW(Table 1).

Most of these agents can be spread by aerosols (eg Bacillusanthracis) and some by food or water (eg Vibrio cholerae,Salmonella typhi). They include highly infectious agents (Yersiniapestis, smallpox virus) and those not normally transmissiblebetween humans (Bacillus anthracis). Many of them have beenused in experimental BW trials with animal models and somehave been made into weapons.

Over the past decade, genetically-modified potential agentshave been made possible by advances in biotechnology. Micro-organisms and toxins can be made more effective or able toovercome medical countermeasures. Also, knowledge of thehuman genome and technical advances in gene therapy anddelivery systems, may lead to harmful manipulation of geneexpression in people; some have even claimed that it might bepossible to target ethnic groups. However, these developmentsare some years away and in some cases are likely to be morefictional than real.

There is increasing concern over the possible use of BW forthree reasons. First, there is fear of the unknown effects of newagents that might be produced by genetic manipulation.Second, production of BW is relatively cheap and easily

concealed under cover of peaceful activities (eg inpharmaceutical plants), so the weapons could becomeattractive to those nations with low budgets seeking a counterto nuclear weapons. Third, living BW seem to be particularlysuitable for certain forms of terrorist activity. Given the relevanttechnology, they are simple to produce in small quantity. Theirslow action allows the perpetrators to escape before the effectsare apparent. They could be used for either maverick or state-sponsored terrorism.

3 The effectiveness of BW

The effectiveness of BW in war has not been as clearlydemonstrated as it has for nuclear and chemical weapons. In theperiod 1932-45, BW were deployed by the Japanese againstChinese troops and civilians, apparently in an experimentalfashion [2]. Water supplies and food were contaminated withtyphoid, paratyphoid, cholera and dysentery bacilli. Plagueinfected fleas were spread. Some epidemics occurred that havebeen attributed to these BW, but their differentiation fromoutbreaks of natural endemic disease is no easy task [2].Dissemination of BW by aerosols was not used on a large scaleby the Japanese and, since no other nation is reported to haveused BW in war, the effectiveness of such aerosols against humanpopulations in the field has not been proven and their practicallimitations have not been characterised. The same applies toterrorist activity; mercifully the impact of BW has not beendemonstrated in practice. Estimates of the possible effects of BWcome from controlled experiments on aerosol dispersal andanimal models. Certainly, live BW will be slow-acting comparedwith nuclear or chemical weapons, which is a shortcoming on thebattlefield but an advantage for terrorist activity and covertoperations against strategic sites or key personnel.

Observations on naturally occurring and experimentalinfectious disease indicate that those BW which may beavailable now or in the near future are unlikely to have asdevastating an effect on human life as nuclear weapons. Initialinfection rates by the respiratory and oral routes are likely to belower than 100% and not all initial infections would progress todisease. The use of BW would cause sickness and some of theagents would cause death in a proportion of the population.Perhaps some would spread to cause wide-scale epidemics. Theextent of subsequent spread would be unpredictable but it isunlikely to affect all members of the population. Furthermore,given some warning by rapid diagnosis, effective prophylaxis is


Appendix 1

Table 1. Natural biological agents

Bacteria Viruses Toxins RickettsiaBacillus anthracis Venezuelan equine encephalitis Botulinum Coxiella burnetti

(Q fever)Yersinia pestis Tick borne encephalitis Ricin Rickettsia prowazekiiFrancisella tularensis Russian Spring/Summer encephalitis Clostridium perfringensBrucella species Congo Crimea haemorrhagic fever Staphylococcus enterotoxin BVibrio cholerae Ebola SaxitoxinBurkholderia pseudomallei Marburg Some mycotoxinsBurkholderia mallei SmallpoxSalmonella typhi Influenza

Yellow fever

available for many diseases and could be used to prevent spreadof disease after an initial attack. Antibiotics provide effectivetherapy for bacterial diseases. Also, it is sometimes forgottenthat many people survived the ancient epidemics; death rateswere rarely over 30%. Toxins are not naturally dispersed byaerosols, so judging their possible effects by this route isdifficult. While it would be irresponsible to be complacent aboutthe possible effects of BW, it would also seem prudent not tooverestimate them.

The use of BW in war or terrorist activity would probablycause some panic with consequent disruption of public services.This would occur to some extent even if the number ofcasualties was small. However, almost certainly, the panic wouldbe greater if the possible effects of BW had been exaggeratedbeforehand.

As a basis for managing the consequences of BW attacks andfor issuing balanced and accurate information, there should bea scientifically sound and realistic assessment of the possibleeffects of those BW that are most likely to be used.

The difficulty of such an assessment is exemplified byanthrax. Estimates based on figures for aerosol spread and thelethal dose of anthrax spores for non-human primates havesuggested that 100 kilograms of anthrax spores spread over theWashington DC area might cause three million fatalities [3]. Onthe other hand, fatal industrial respiratory anthrax cases wererare in mills that processed animal hides and hair, where, at thetime (1950s), anthrax spores were known to be present in the air[4, 5, 6]. In the 1950s, 50-60 cases of anthrax occurred per yearin the USA; over 95% were cutaneous and deaths were rareafter the introduction of antibiotics [4]. In four mills processingimported goat hair and employing about 1330 people, therewere 1-2 cases per 100 persons per year during the 7-10 yearspreceding a trial of an anthrax vaccine [5]. Inhalation anthraxoccurred only rarely. During a closely monitored trial of ananthrax vaccine over four years in the goat hair mills, 23 cases ofanthrax occurred in 754 employees who did not receive thevaccine, and only five were inhalation cases [5]. It is possible thatmill workers might gradually become immune to anthrax, butthis would not be the case for new staff.

Additional information about the effects of anthrax comesfrom the Sverdlovsk incident of 1979, when an unknownamount of anthrax spores escaped from a Russian militarymicrobiological facility [7]. This clearly showed that an aerosol ofanthrax spores can cause fatal inhalation anthrax, but thenumber of acknowledged deaths (77) was small in relation tothe size of the exposed population in a residential area of severalsquare kilometres with a population density of about 10,000 persquare kilometre [7]. The military microbiological facilitycontained about 15,000 persons.

Caution must be used in judging the effects of BW onhumans in the field from the amounts that can be delivered byaerosols and lethal doses for animal models. As mentionedabove, not all exposed persons will become infected and not allinfected persons will develop disease. Also, the susceptibility ofan animal model may be different from that of humans. Duringthe trial of an anthrax vaccine [5, 6], 91 cynomologuousmonkeys were exposed to air from a mill which employed about250 people. Nineteen cutaneous, but no inhalation, cases hadoccurred in the two and a half years prior to the vaccine trial. A

quarter of the monkeys died and it was estimated that they hadinhaled 1000-5000 spores over 3-5 days [6]. It appears thatthese monkeys were more susceptible than man to anthrax.

Even if there are reservations about the possible catastrophiceffects on people of aerosols of anthrax spores, this biologicalagent must not be underestimated. There is no doubt that suchaerosols can produce fatal inhalation anthrax in humans, andthe combined effect of some casualties and the panic that islikely to ensue, could cause major disruption of public services.

As the example of anthrax illustrates, an assessment of theeffects of a BW attack will be difficult. These BW agents producediseases that are rare in normal circumstances in the UK, sorelevant information will be limited. Independent as well asgovernment scientists should be involved. Attention must begiven to clinical and epidemiological data of natural humaninfection as well as the results of aerosol experiments withanimal models. Computer modelling of aerosol cloud travel indifferent situations and of human epidemics should be used.Also, it may be possible to model mathematically the course ofinfection in individuals.

4 Assessment of the BW agents that are most likely to beused

Although any of the agents listed in Table 1 could be used aswell as others including those produced by geneticmanipulation, the number of different BW agents likely to bedeployed by a particular perpetrator is not infinite, nor are thecircumstances in which each might be deployed.

Risk assessment should aim to determine:

• the agents that are most likely to be used by each probableaggressor country or known terrorist group;

• the means of delivery each might use;• the probable effects of an attack with these agents and of

the measures applied in response, even though, in theabsence of hard data, estimates of the effects may be subjectto uncertainty; and

• the probable intent of the attackers.

Such analyses might show that, in contrast to the manytheoretical BW agents that could be listed, the number likely tobe deployed in practice by each potential aggressor would besufficiently small to make the preparation of tailoredcontingency plans feasible.

It should always be kept in mind that an attack might bemade with an unexpected agent eg an antibiotic-resistant strainor one produced by genetic manipulation. However, theadvantage of assessing the probable agents beforehand is thatspecific plans for dealing with them could be prepared,including specific tests to identify them and the training oflaboratory staff. This would optimise the chances of rapidly pin-pointing the agent that had been used, whilst negative resultswould help by excluding those particular agents. This approachis compatible with the well-tried procedures adopted inmicrobial diagnosis in medicine which aim at the earlyidentification of the cause of an infection by ensuring thatmethods to detect the probable causative micro-organisms areapplied as soon as possible.


Assessment should be based upon:

• Intelligence data about the capacity of potential aggressorstates and terrorist groups to manufacture and turn intoweapons the various possible agents, or to devise novel ones,and on their estimated willingness to deploy the differentagents. Intelligence may also be able to estimate theprobable intent of an attacker.

• Scientific information on the nature and properties of thevarious pathogens and their effects, on the limitations inmanipulating them, and on the practicalities of handling theagents and on turning them into weapons in different ways.Use could be made of data from past studies with presumedinnocuous micro-organisms in simulated attacks.

The assessments would need co-operation from theappropriate military establishments and should be updated asnew intelligence appears, taking into account scientificadvances that had occurred. Such analyses were made inrelation to the battlefield and the former Cold War threat to theUK population, but it would be valuable to have them updatedfor present day potential aggressors and terrorists.

The simplest example of the suggested assessmentprocedure concerns independent terrorist groups using BW fortheir own varying and possibly bizarre motives. The range ofpossible agents could well be limited by the desire of mostterrorists to ensure their own safety, by using agents from whichthey could separate themselves physically eg putting typhoidbacilli or botulinum toxin into food, or releasing Legionnaire’sbacilli into air-conditioning systems. Such groups might beunlikely to deploy plague or tularaemia or viruses that requiregood containment facilities for their cultivation. At first sight,smallpox virus would seem to be an agent that is likely to beused by terrorists because there is clear evidence of spread inhumans following accidents that are akin to possible terrorist

attacks. However, potential perpetrators may be deterredbecause, like most of the population, they have not beenvaccinated.

5 Conclusions

• In the past, only naturally occurring micro-organisms andtoxins have been considered as potential BW, but over thelast decade, the derivation of additional agents has becomepossible through advances in genetic manipulation andbiotechnology, a trend that will continue in the future. Thereis increasing concern about the possible use of BW becauseof these new potential agents and the fact that terrorists andpoor nations seeking an alternative to nuclear arms may findthem attractive.

• BW are potentially a serious threat but mercifully the scale oftheir effectiveness against human populations in war and byterrorist attack has not been proven. Observations fromnatural infectious diseases indicate that BW are unlikely tohave as devastating an effect on human populations asnuclear weapons.

• Exaggerating the possible effects of BW could increase panicthat would be likely to occur even if the number of casualtiesis small. A scientifically sound and realistic assessment of theeffects in humans of the agents that are most likely to beused should be made as a basis for managing theconsequences of BW attacks and for ensuring balanced andaccurate information about them.

• The agents that are most likely to be deployed by particularaggressors or terrorists may be relatively few in number.Analyses should be made, based on scientific knowledge ofthe properties of the agents and intelligence data aboutthose countries and terrorist groups that might attack theUK. However, it must be kept in mind that unexpectedagents might be used.


1 Report of a Royal Society Group (1994) Scientific Aspects of Control of Biological Weapons. The Royal Society, London.

2 Harris, S.H. (1994) Factories of Death: Japanese biological warfare 1932-45 and the American cover-up. Routledge, London andNew York.

3 Dando, M.R. (1999) The child of unfulfilled expectations. Nature 397, 311-2.

4 Brackman, P.S. and Fekety, F.R. (1958) Industrial anthrax. Ann. NY Acad. Sci. 70, 574-84.

5 Brackman, P.S., Gold, H., Plotkin, S.A., Fekety, F.R., Werrin, M., and Ingraham, N.R. (1964) Field evaluation of human anthraxvaccine. Am. J. Public Health 52, 632-45.

6 Brackman, P.S., Kaufmann, A.F., and Dalldorf, F.G. (1966) Industrial inhalation anthrax: with discussion by H N Glassman.Bacteriol. Rev. 30, 646-59.

7 Meselson, M., Guillemin, J., Hugh-Jones, M., Langmuir, A., Popova, I., Shelokov, A., and Yampolskaya, 0. (1994) The Svedlovskanthrax outbreak of 1979. Science 226, 1202-8.

References


International control measures: The BiologicalWeapons Convention and its projected Protocol

G Poste and J Robinson

1 Introduction

It is commonly said that the reason why international agreementcould be reached in 1972 on the Convention on the Prohibitionof the Development, Production and Stockpiling ofBacteriological (Biological) and Toxin Weapons and on TheirDestruction, otherwise known as the Biological WeaponsConvention (BWC), was because the great powers consideredthe weapons in question to be militarily worthless. Mostprobably the opposite is closer to the truth. As far as Britain,France and the United States were concerned, all of which hadinvested heavily in high-technology conventional weapons aswell as nuclear weapons, it surely made no sense to continuedeveloping a relatively cheap technology of mass destructionthat could serve as an equaliser in the hands of some futureadversary.

The feasibility of microbial aerosol weapons had beenestablished through a succession of large-area field trials thathad culminated in the Pacific in mid-1968; better now, it wasargued, to seek suppression of the technology altogether, if thatwere indeed something which the new practice of ‘armscontrol’ could achieve. Such a course of action would also findfavour with those who regarded the deliberate exploitation ofdisease for military purposes as something that ought not to becountenanced.

The ancient cross-cultural taboo against fighting with poisonor pathogen, reinforced by the 1925 Geneva Protocol thatoutlawed resort to chemical or biological warfare (CBW) - aninternational treaty that had been observed even during WorldWar II - was not easy to reconcile with defence strategiesemphasising retaliatory deterrence, and therefore seeming torequire possession of CBW weapons. Conclusion of the 1972treaty thus satisfied widely differing concerns, even interests.Today there is pressure to build upon the treaty and bring it intoline with standards that more recent arms-control agreementsare said to have set. Appendix 2 is about possible roles for thescientific community in this enterprise of strengthening theBWC.

Appendix 2 accords particular emphasis to the disturbingimplications of the accelerating pace of research progress ingenetics and computer technologies for the future nature of BWand for their design and deployment. In turn, these technicaldevelopments will demand adoption of novel surveillance anddetection tools. The widespread use of genetics in biologicaland medical research, and the increasing adoption of thesemethods by diverse industrial sectors concerned with health,agriculture, food and environmental management, will create adramatic upsurge in the technical ambiguities inherent in dual-use technologies and a related increase in the complexity ofinspection and compliance requirements.

2 Objectives

There are two main considerations of a scientific and technicalnature. First, it is probable that, over the coming decades, therewill be rapid technological change in the practical application ofthe life sciences, with developments in genetic technologiesbeing of particular importance. Second, it seems no lessprobable that much of the new technology will be as applicableto biological warfare as to the promotion of human well-beingand economic development.

For the long term, these two considerations, taken together,do not bode well for international security. On the one hand,our species has historically been unable to avoid exploiting thedominant technology of the age for warfare. On the other hand,as understanding of life processes becomes increasinglyprofound, biotechnology may become capable not simply ofdestroying life but of manipulating each and every one of theprocesses of life, including cognition, reproduction,development and inheritance. It therefore seems that we areobliged to anticipate changes of a fundamental kind in the wayour species fights its conflicts. Indeed, perhaps we must nowstart looking at that ancient taboo against CBW and at the BWCit has generated, not so much as a contribution to our nationalsecurity, but as essential underpinning for the welfare and eventhe survival of our species.

So for the short term, that is to say for the negotiation of theProtocol that is to strengthen the BWC, our two considerationsbecome two imperatives. The Protocol must not become lockedinto today’s technology, for that will soon be yesterday’s. And theProtocol must find some way of constraining the BW application ofdual-use biotechnology while at the same time leaving unaffectedor, better still, promoting the beneficent applications in medicine,agriculture and environmental management. As it stands, theBWC can in principle sustain both imperatives, which is testimonyto the wisdom of its original negotiators. The treaty has this powerbecause it defines the weapons and activities it prohibits, not interms of lists that would inevitably be characteristic only ofcontemporary knowledge, but in terms of intent - by using adevice of language which accommodates both technologicalchange and duality, the General Purpose Criterion. Thus, Article I.1of the BWC states that its prohibitions extend to Microbial or otherbiological agents, or toxins whatever their origin or method ofproduction, of types and in quantities that have no justification forprophylactic, protective or other peaceful purposes.

Given a proper breadth to what is meant by “other biologicalagents” (a matter that is considered in a Section 4.1), the BWC thusdraws strength from the General Purpose Criterion. A weakness,which the Protocol is intended to remedy, is that the BWCestablishes no international procedures whereby States Parties canacquire confidence in one another’s compliance with its obligations.The treaty has no international verification system. The reason forthis is not oversight on the part of the negotiators. On the contrary;Britain proposed a verification mechanism for its original draft of thetreaty, and France, while immediately enacting what was in effectdomestic implementing legislation for the treaty, remained outsideit until 1984, complaining of its lack of verification.


Appendix 2

The fact of the matter is that the BWC was never supposedto be a stand-alone countermeasure against BW. Nor was it seenthat way by the countries that had studied the weapons closely.The function of the BWC was instead to serve as a consolidatinginfluence within a diverse array of countermeasures. This initiallycomprised the development and maintenance of the anti-BWprotective posture expressly permitted through the GeneralPurpose Criterion, and national intelligence machinery that hadat least some capacity for monitoring foreign BW capability. Itexpanded as national penal codes began to criminalise misuseof pathogenic microbes and toxins, law that could also bedirected against terrorists seeking access to such agents. Later,national export control measures would be added to the array asan anti-proliferation measure, with efforts to harmonise thecontrols subsequently being pursued through the AustraliaGroup. Later still, interest would arise in mobilising the resourcesof international criminal law to that same end.

Within all this, the primordial function of the BWC was toassert a norm of abstention from BW armament, to reassert thetaboo against resorting to the use of BW, and to provide anucleus around which international action against transgressorscould crystallise. Incorporating compliance-verificationmeasures was not at that time, unlike now, seen as a cost-effective addition to the array, especially since the technicalcomponent of such measures was relatively undeveloped.

3 A strategy for verification

The General Purpose Criterion makes the design of aworthwhile international verification system more difficult thanit would be, had a listing approach been used to define thescope of the BWC. Ascertaining intent is bound to be harderthan verifying compliance with lists of prohibited items oractivities. In particular, it may demand a degree of externalintrusion into plans, premises and capabilities deeper thanaffected enterprises might otherwise feel comfortable with,especially those enterprises in the private manufacturing sectorwhere investment in intellectual property and capital investmentin the highly specialised equipment that may also confercompetitive commercial advantage are both higher than inother parts of the industrial economy.

Here, one may think, is the essence of the BWC verificationproblem today, for those are exactly the enterprises wherebiotechnology is being most intensively developed andexploited, and where duality is at its most ambivalent.Transparency is poorly compatible with the confidentialities andprivacies that are the norm in a corporate enterprise having eventhe best intentions.

Yet possible solutions to the problem are rather easy tospecify, if only in principle, once duality has been identified as itscore. What duality does is provide a cheater with the cover oflegitimate activity. The cheater does not then have to hide awayall the plant, materials and activities which clandestinearmament would necessitate; only purposes would need to beconcealed, little else. Remove that cover, however, and theneverything must be concealed.

So, for the foundation upon which confidence enough incompliance can be built for States Parties not to desert thetreaty, what is needed is a system of measures that will operate

to reduce the degree of concealment that biotechnology-basedindustry would otherwise afford to potential cheaters: a systemcreating enough transparency to make the probability ofdetection great enough for the industry to becomeuncomfortable and inhospitable to cheaters. Their alternativewould then be to move out of the industry and enter a domainwhere, if they were to escape the notice of alert watchers, theywould have to do everything in the strictest secrecy, with totalcontrol over leaks, and without benefit of camouflage.

Additional measures would be needed to ensure that, withinthis new domain, cheaters when challenged could not simplyassume a guise of legitimate activity. With such measures inplace, the verification system would present cheaters withdiscouraging choices only. States wishing to preserve the optionof BW armament might accordingly decide against joining theBWC Protocol altogether, but in that case, if the take-up of thenew agreement were high, they would simply be drawingattention to themselves, and special scrutiny.

This, then, is a coherent strategy of verification. Concreteways for putting such concepts into practice have for somewhile been under examination by the diplomats and theirtechnical advisers who do the work of the Ad Hoc Group ofStates Parties (AHG) to the BWC, which has been meeting inGeneva since January 1995. The AHG has been taking forwardthe work of an earlier ad hoc group, not of diplomats primarilyconcerned with political questions and other matters of state,but of “governmental experts”. Known as VEREX, it had beentasked in the autumn of 1991 with studying potential BWCverification measures purely from a scientific and technicalstandpoint.

The final report that VEREX produced, in September 1993,addressed 21 possible verification measures. Within the AHG,agreement is now converging on a system of three types ofmeasure: declarations, visits and investigations - declarations ofinformation about individual biological facilities having a highpotential for abuse, visits to those facilities by an internationalinspectorate cognisant of the declarations, and procedures forinvestigations of complaints.

Within this strategy for verification, such declarations andvisits could operate to deny the cheater the camouflage of dual-use industry, while the possibility of investigations could menacecheaters thus forced out of the industry by operating to ensurethat all declarable facilities were actually declared and thusmade liable to inspection visits. At the time of writing, it is stillnot clear whether that strategic concept for visits within thetriad of measures will emerge intact from the consultationsbetween government and industry that have still to beconcluded in some countries, notably the United States.

Moreover, a disruptive leverage on the triad may yet developfrom a different area of AHG work, namely the question of howto, in the words of the Group’s mandate, “improve theimplementation of the Convention” in regard to Article X. This isthe article in which States Parties declare their commitment topromoting the use of biological agents and toxins for peacefulpurposes and undertake to implement the BWC in a mannerthat avoids hampering economic or technological development.States such as China, India, Iran and Pakistan have espoused aposition holding the Australia Group harmonisation of anti-proliferation export controls, which they know is valued highly


within the Western Group of negotiating states, to be acontravention of Article X.

That said, it nevertheless remains probable that all threetypes of measure will figure in the Protocol as eventually agreed(late 2000 is the newest of the targets that Western figures haveset for this, or at least for the initialling of a text acceptable tothe negotiators). We may therefore define the task ahead asensuring that the compromises which the negotiation willinevitably entail do not destroy a strategy for verification that isfocused on duality. Mostly that will be a political matter, butthere are scientific and technical elements as well. It is to thesethat we now turn.

4 The scientific and technical elements

Three scientific and technical elements seem particularlyimportant:

• the concept of “biological agent” that imbues the GeneralPurpose Criterion;

• the technical possibilities for acquiring information goodenough to justify an investigation; and

• the detailed specification of triggers for the declarations.

Beyond these strategic matters lie tactical ones, notably therole of instrumentation in on-site inspection, and the scientificand technical possibilities for enhancing that role withoutthreatening areas of legitimate confidentiality or privacy.

4.1 “Other biological agents”

A proper understanding of the term “other biological agents” isbeing made increasingly problematic by advancing knowledge,particularly by research in molecular genetics. More and moreways are presenting themselves for causing harm by inducingpathological dysregulation of natural genes in the body withoutrecourse to traditional pathogens. This potential expansion ofBW means, by definition, that the potential range of dual-useactivities and facilities will also expand.

An illustration of the problem is available in the possibility of‘integrated agents’, in which dangerous genes are inserted intotarget organisms - human beings, animals or plants - to remain‘silent/dormant’ until an attacker deems it appropriate toactivate them, by stimulating an inserted controller gene.Whether or not that particular possibility might come to lenditself to hostile purposes, it would seem prudent to take theterm “biological agents” in a broad rather than a narrow sense:in the BWC to allow it to accommodate, for example, a widevariety of natural human genes which if inserted into thegenome of individuals for malign purpose could be equally ascatastrophic as the traditional categories of pathogens.

This sinister option is also pertinent in the context of how‘dual-use’ facilities will come to be defined in the future.Similarly, the term “other peaceful purposes” used in theGeneral Purpose Criterion is also rendered ambiguous by newtechnological developments. The example just cited of how abroad spectrum of normal human genes could produce lethaland/or incapacitating disease means that facilities producingsuch genes, or their protein products, on any significant scalecould claim ‘peaceful’ intent when the reality might be quite

different. These are matters on which the Protocol negotiatorsmust have guidance from scientists.

4.2 Triggering investigations, and other roles forinstrumentation

The function of investigations within the verification strategymay be seen not only as a device for engaging cheaters driveninto secrecy by the possibility of declaration-checking visits.Investigations may also be seen as providing the strengthenedBWC regime with the safety net of verification by challenge.Techniques for acquiring information sufficient to triggerinvestigations will also have application elsewhere within thetotal array of countermeasures against BW.

The burgeoning repertoire of biological agents and processeswith potential BW applications will demand a proportionalexpansion in the diversity and complexity of the tools needed forsurveillance and detection, both for remote sensing and for on-site inspections. In practical terms, this is a technicallyproblematic and expensive trend, since the categories ofsurveillance/analysis methods will likely need to be increasinglycustomised to respond to the perceived/declared risk.

In addition to the rapid evolution of an expanded range ofbiological techniques with dual-use potential, the increasing useof computer-based methods in research and in bio-processcontrol systems dictates that clues to, or definitive evidence of,intent will require new inspectorate competencies in thedeconstruction of software programmes and the dissection ofsophisticated algorithms to detect data trails that establish thelegitimacy or illegality of the claimed intent. Once again, therapid pace of technical progress threatens to eclipse all but themost sophisticated software monitoring procedures.

Contemporary data-encryption methods predispose tocompliance evasion by enabling incriminatory ‘black’ datasets tobe fragmented by dispersal into multiple, innocuous ‘white’datasets which can pass muster as being of beneficent purposewhile allowing the ‘black’ data to be readily constructed forhostile purposes by re-assembly using encrypted context codesattached to each of the dispersed data sub-units.

Another novel vulnerability created by illicit cyber-manipulations must also be acknowledged. Weak security oflarge ‘white’ biological databases held for legitimate purpose byindustry will represent potential targets for illegal usurpation ofdual-use data by malefactors.

Perhaps less likely, yet still conceivable as a threat to anydatabase lacking adequate security, would be for hostileexternal parties to falsify ‘white’ databanks by plantingincriminating evidence of illicit application of dual-usetechnologies in order to damage the reputation, public trust oreconomic viability of a company or industrial sector, or toembarrass a national inspectorate. In extremis, this type of datacontamination could be used to create contrived grounds formilitary actions based on claimed cyber-forensic evidence ratherthan traditional analytical chemical or biological assays.

4.3 Triggering declarations

The strategic role of the declarations is to set bounds to theuniverse within which the international routines of the Protocolother than investigations are applicable: to define the sectors ofbiotechnological and other enterprise that are and are not to be


subject to the Protocol’s day-to-day international controls. Thedeclarations must accordingly capture those parts of dual-usecivil industry where the duality is particularly conducive to BWarmament and which must therefore be made transparentenough to discourage potential cheaters from exploiting theduality.

The forms that such particularly dangerous duality could takeneed to be specified in terms precise enough for the proprietorof an industrial facility to know whether the facility is of concernand therefore must be declared - or, no less important, that thefacility is not of concern and is therefore not declarable. Suchspecifications thus become the triggers for initiating thedeclaration process laid down in the Protocol. A recent draft forthe Protocol uses more than ten pages to set out possibletriggers, under seven headings: Current Defensive Programmes,Vaccine Production Facilities, Biosafety Level 4 Facilities,Biosafety Level 3 Facilities, Work with Listed Agents and/orToxins, Other Production Facilities, and Other Facilities.

Clearly the triggers will have to be defined with great careand understanding. Getting them wrong could mean either thatthe overall verification system became overwhelmed withirrelevant information and also unnecessarily burdensome toindustry, or that parts of the industry attractive to cheaters wereleft outside the system. Getting them right thus requiresintimate knowledge of how BW could be developed and made,and of whereabouts in industry or elsewhere the requisite skillsand capacities might be found. This is rare knowledge. A fewbiodefence workers may have some of it. A few people inbiotechnology-based industry may also have some of it. Fewpeople will have much of it, and those that do are likely to haveinhibitions about sharing it. Only scientists will be able to fill thegaps.

Although the industrial sectors engaged in dual-usetechnologies represent the principal locus of technicalknowledge and facilities that could be misapplied for malignpurposes, and thus fall logically within the inspectionrequirements of the convention, it is important to recognise thatthe nature of modern genetics research, and its highlyspecialised laboratory/facility requirements, dictate that a varietyof governmental and academic centres can now also beinterpreted as a theoretical risk. Any facility, industrial, academicor governmental, with large scale, on-site P3/P4 pathogen-handling capabilities, or other facilities that allow theproduction of genes, proteins, cells or micro-organisms inproduction units greater than 100 litres, must be considered as apotential site for production of BW or their precursors.

5 Industry engagement

The function of the triggers is to ensure, not that all dual-useindustry is covered by the declarations, only that its morecamouflaging weapons-conducive dualities are covered. Being arelative matter, this is amenable to negotiation. Such negotiation,whether between governments or between industry andgovernment, will be conditioned by other parts of the Protocolnegotiation, notably on what exactly is to be declared about thedeclarable facilities, to whom and with what degree ofconfidentiality, and, at present above all else, what the modalitiesare to be for inspectorate visits to declared facilities. Severalvarieties of visit, each one with variant forms and differing degrees

of access, are currently being contemplated, the chief amongthem now being Randomly-Selected or Transparency Visits,Clarification Visits, and Voluntary Assistance Visits.

For visits to serve their strategic purpose, the basicrequirement would seem to be a set of procedures that allowedpeople on site - trained people from a disciplined internationalinspectorate - and, while also providing for a managed accessprocedure, gave them freedom to observe, to talk with site staff,asking whatever questions they chose, and privately to recordtheir impressions. The purpose need not necessarily be thevalidation of every item of information declared for the facilitybut rather the opportunity for the inspectorate to noticepossibly significant divergences, in which event procedures formore probing inquiries, even including the collecting andanalysis of samples, would be set in motion if the internationaltreaty authority so chose. In Geneva, these matters remaincontroversial, which no doubt reflects the undeveloped state ofconsultations between government and industry in certaincountries.

The importance of suitably rigorous training, and theadoption of consistent, highly disciplined procedures byinspectorate teams, is a vital prerequisite for gaining andsustaining industry support. Previous industry experience, asconveyed in testimony by the Pharmaceutical Research andManufacturers of America (PhRMA), cites considerabledissatisfaction with bio-inspections of the past - notably onesconducted in 1994 within the framework of the September1992 Russo-UK-US Joint Statement on Biological Weapons -ranging from excessive disruption of site operations to a claim ofovert industrial espionage by a Soviet bloc representative on aninspection team. The complaints with respect to excessive timeand disruption of site operations appear to be attributable toindustrial sites being used as training exercises for nationalinspectors. Industry holds the view that training can be, andindeed should be, acquired via inspection of relevantgovernment laboratories, with subsequent field experienceinvolving industrial enterprises occurring only after appropriatecompetency has been achieved.

Irrespective of the triggering circumstances for an inspection,a managed access inspection should be pursued wheneverpossible. Agreement on the nature and scope of the informationrequired, and the types of facilities/equipment to be inspectedphysically, will greatly facilitate mutual goals and reducetensions. Any deviation from the agreed inspection protocolonce the inspection is underway is a guaranteed catalyst forinflammatory exchange and heightened suspicions aboutmotives. Particularly troubling to industry are examples ofundeclared photography by inspection teams and unwillingnessof the inspectorate to agree to host request for subjecting inertmaterials such as papers and outer clothing to decontaminationin order to prevent physical transfer of organisms or otherbiological samples of proprietary significance away from thefacility. Declared removal of overt samples for analysis is, ofcourse, a valid element of any inspection.

Procedures must be devised to resolve disputes in cases wherethe inspection team and the host company cannot agree oninspection terms. In order to demonstrate compliance, provisionshould also be made whereby the inspected party can shareinformation with the State Party on whose territory it is locatedthat it may not wish to disclose to international inspectors.


Transparent guidelines/procedures should also beincorporated in the inspection guidelines that allow the visitedparty to protect sensitive installations and to prevent disclosureof confidential business information not related to the objectand purpose of the visit. In carrying out their visit, the team ofinspectors should be required to comply with all legislative andregulatory mandates applicable to the visited site with respect tooccupational health and safety, compliance with GMPregulations and all other laws related to the protection ofpersonnel, animals and the environment.

In a new era of digital photography, the host facility shouldbe entitled to replicate all images taken by the inspectoratebefore the inspectorate departs from the site using a mutuallyagreed replication process. This is for mutual protection. Itallows the host to review the images for any evidence ofproprietary activities placed at risk and to communicate suchconcerns immediately after the visit. It also affords the hostcompany protection against digital falsification of images by anymember of the inspectorate team intent on creating mischief todamage or embarrass the host.

If, justifiably or not, the inspection team concludes thatpotential violations exist, the host company should be affordeda full listing of such claims by the State Party on whose territorythe facility exists to provide the company with the opportunityto explain and/or refute the allegations for purposes of theformal record. This protection is necessary to prevent erroneousrelease of black propaganda about a company, with resultingrisk of damage to its public standing or economic well-being.

Much of the relevant industry is subject to intrusive forms ofsurveillance by government already. Corporations benefit fromassurances thus imparted to the outside world and itsmarketplaces. Would they not also benefit from duality-controlmeasures under the BWC that were capable of reassuring apublic that is increasingly mistrustful of their industry, as yet forreasons unrelated to biological weapons? Surely they would.One may therefore think that, if experienced industry peoplewere engaged in the negotiation of terms for declarations andvisits under the Protocol, with support from the highest levels oftheir industry, there could be a worthwhile outcome. But if therewere no such high-level engagement of the industry - if contactswith negotiators instead continue to be left to trade-associationofficials, who are duty-bound, unless instructed otherwise, to beunwelcoming towards outside encroachment - then the presentopportunity would surely be lost.

That conclusion appears well supported by what hashappened with the Convention on the Prohibition of ChemicalWeapons (CWC). This is a treaty opened for signature in 1993and now in its third year of full implementation. Unlike theBWC, the CWC contains an elaborate international verificationsystem, which is operated from The Hague by 500 staff at itsheadquarters and in its inspectorate. The system still has majorproblems awaiting solution - notably, though not exclusively,ones created by the United States after signature of the treaty(as in the continuing failure of the United States to submit theindustry-data declarations required by the treaty, and in theexemption it is asserting from a sampling provision crucial tochallenge inspection). That said, it remains the case that theCWC verification system is required to function within a civilmanufacturing industry having dualities much like those of theindustry that the negotiators of the BWC Protocol are

contemplating. Indeed, there is substantial overlap between thetwo, for toxins whatever their method of production, areexpressly covered by both treaties. With justification we canassert that there would be no CWC today if the chemicalsindustry worldwide had not become involved in its negotiationfrom the mid-1980s onwards.

The central CWC negotiating issue at that time, namely thecontent of the declarations-plus-visit control regime and itstriggering by schedules of chemicals, is mirrored by the centralBWC Protocol issue today, which is how to structure adeclarations-plus-visits regime that will be effective without atthe same time unduly burdening, endangering or otherwiseconstraining the industry.

6 Importance of continuing scientific advice

A second parallel between the CWC and the BWC is that bothtreaties use a General Purpose Criterion to define their scope.Responsiveness to technological change no less than control ofduality is as much a requirement of the CWC as the BWC. Thispoints to the need for one further form of input from scientistsinto the BWC Protocol enterprise.

The experience of implementing the CWC is now drawingattention to a feature of the regime that ought to have beenapparent from the start: the CWC’s General Purpose Criterionnecessarily reaches beyond the chemicals listed in the CWC’sSchedules, meaning that its proper implementation is effectivelybeyond the competence of the international authority in TheHague, whose powers of initiative are formally circumscribed bythe Schedules. Putting the Criterion fully into effect is thereforea task that falls by default to the National Authorities, which arethe national bodies that the CWC requires each State Party toestablish “in order to fulfil its obligations”.

If the British CWC National Authority is anything to go by,these bodies, as currently constituted, are already overstretchedsimply in functioning as liaison between the chemicals industryof their countries and the international authority in The Hague.They have become obliged to see their primary duties asgathering the requisite industrial data for the declarations theymust compile and transmit to The Hague, and then supervisingon-site visits from the inspectorate. They have no time left formonitoring in any serious fashion the outer reaches of theGeneral Purpose Criterion that lie beyond the CWC trigger-listschedules.

The consequent tendency of the CWC National Authorities iseither to ignore altogether the work necessitated by this criticalpart of the Convention - its provision for ensuring that theverification system keeps up with new knowledge and changingtechnology - or to leave it to the national chemical defence andscientific intelligence communities or even to contract it out toprivate business, the interests of none of which can be expectedexactly to parallel those of the CWC.

For the BWC Protocol the lesson from this seems clear. Notonly must the Protocol establish strong national authoritiesalong the lines of the CWC, but those national bodies must alsohave access to the best possible scientific advice fromindependent sources, and should be expected to heed it. Thepossible reconvergence of chemical and biological armament


suggested in our discussion of “other biological agents”underscores the importance of establishing such well-advisedBWC National Authorities. Without such an arrangement, theBWC and its Protocol may simply lapse into obsolescence at justthe time when our security, even the future of our species, mostneeds a vigorous and assertive treaty regime.

7 Dealing with illicit activities

The work in Geneva on the BWC Protocol is making slow butsteady progress, although, as always in such internationalenterprise, its pace and final outcome remain sensitive to thedomestic politics of key negotiating countries. Success willstrengthen the consolidating role of the BWC within the overallarray of legal, political, military and technologicalcountermeasures now available against BW. This it may do by, forexample, enhancing the ability of national intelligence machineryto discriminate between licit and illicit activities. And it will amplifythe norm of abstention from BW armament, thereby increasingthe political costs of transgression and the probability ofconcerted international action against transgressors.

The Protocol itself, in its present draft form, prescribes actionto be taken to ensure compliance and to “redress and remedy”any situation contravening provisions of the BWC or theProtocol. Like the CWC, which here it largely copies, theProtocol does not specify what precise forms the action shouldtake, but instead assigns that decision, as and when an instanceoccurs, to the projected Conference of BWC States Parties,which is given the option of referring the matter on to theUnited Nations.

However, recent experience suggests that the likelihood ofthis process imposing effective sanction upon a transgressor

may not always be great, meaning that additional steps mayneed to be taken. In this regard, it might be worth institutingconsultations expressly on the question of how the internationalcommunity, broadly or narrowly defined, should deal with statesthat persist in developing BW or that have actually used them.The fact that the Protocol would have reaffirmed the normagainst such behaviour would have the effect of broadening therange of options available. There might be value, too, inintergovernmental action that brought biological (and chemical)weapons armament within the purview of international criminallaw, thereby enabling individuals, not only states, to be heldresponsible for illicit activities, whatever their nationality.

8 Conclusions

The core problem facing the negotiators of the BWC Protocol ishaving to ensure both that the Protocol keeps up with scientific andtechnological change and that it places confidence-buildingconstraint on maleficent application of dual-use biotechnology inbiological armament without damaging beneficent application inmedicine, agriculture and environmental management.

The solution lies in properly verified implementation of theGeneral Purpose Criterion which the BWC uses to define its scope.This requires, first, the active and constructive involvement ofbiotechnology-based industry and, second, the best possiblescientific advice. That advice is especially needed for guidance on theproper scope of the term “biological agent” used in the GeneralPurpose Criterion, for formulation of the triggers that are to governinternational on-site inspection under the Protocol, and, once theProtocol is in force, the proper scope of operations of the BWCNational Authorities.


National control measures: Management of theconsequences of biological weapon attacks oncivilians

J Smith and PG Blain

1 Introduction

The consequences of a successful BW attack would be sicknessin some of those directly exposed to the biological agent,possibly spread of infection from the initial cases to others, andperhaps panic. The numbers of sick, the nature and severity oftheir illness, and the degree of panic would depend upon thenature of the BW agent deployed, the scale of the attack andhow it was mounted; these aspects would in turn depend uponthe intent of, and the resources available to, the attacker.

In considering management of the consequences of an attack, aBW agent may be considered to fall into one of three groups:• pathogenic by the respiratory route but poorly or non-

transmissible eg anthrax, Legionnaire’s disease;• pathogenic by the respiratory or intestinal routes and

transmissible from person to person eg smallpox, typhoid; and• non-infectious biological products eg botulinum toxin.

Two examples may illustrate how management could differbetween these groups.

• Anthrax, dispersed into the air as an aerosol of spores, wouldcause severe acute pulmonary infections in a proportion ofthose who had inhaled some of the aerosol, but it would notspread significantly from person to person to cause anepidemic. Management would involve diagnosis andtreatment of casualties and decontamination. There wouldnevertheless be difficulties, as few doctors will have hadexperience of the disease and specialist advice would beessential. Supplies of appropriate antibiotics might be limitedin the event of a large-scale attack, whilst vaccine would beof little value unless it could be both manufactured and usedbefore exposure.

• Smallpox, which could spread to cause an epidemic, wouldpresent the urgent need to isolate as well as treat patientsand, possibly, the enforcement of a cordon sanitaire by theappropriate authorities. The resources of the National HealthService (NHS) could be insufficient if there were largenumbers of casualties, causing problems not only inproviding clinical care but also in managing such issues as theprotection of staff and the decontamination of ambulances.Vaccination would be valuable, but supplies of smallpoxvaccine are nowadays very limited and manufacturingcapacity is not currently available.

Potential BW include not only particularly dangerouspathogens, such as smallpox or tularaemia turned into weaponsfor military purposes, but also less dangerous agents, such asfood-poisoning organisms, which terrorists might use - or claimto have used, for example, in order to demand money from afood manufacturer. This spectrum of possibilities needs to betaken into account when considering the management of BWattacks.

Early identification of the agent deployed in any attack, togetherwith well-prepared and tested response plans for managing themost likely forms of attack, would contribute greatly tominimising the consequences. Owing to the possibility that aBW agent may have been genetically manipulated, for exampleto induce resistance to antibiotics or immune defences, it is alsonecessary to examine rapidly its biological properties.

2 The response to natural outbreaks of infection

There are well-tried arrangements in place in the UK (and inmany other countries) for the detection, investigation andcontrol of outbreaks of disease caused by microbial pathogens.Attacks with BW upon civilian targets will have many features incommon with such natural outbreaks and their managementshould therefore exploit the civilian arrangements andexperience that are described here.

2.1 Statutory responsibilities

Health and Local Authorities, through their respectivedepartments of Public Health and of Environmental Health, areresponsible for most aspects of the prevention and control ofinfectious illness in the community, and they have statutorypowers to enable them to discharge these duties. Each HealthAuthority employs a Consultant in Communicable DiseaseControl (CCDC) trained in infectious disease epidemiology.Clinical care of affected patients is managed by the NHS Trusthospitals and family doctors. Laboratory support is provided byhospitals and, in England and Wales, by the Public HealthLaboratory Service (PHLS). In managing outbreaks in thecommunity, these bodies generally work closely together, andmore serious or larger outbreaks will also involve RegionalDirectors of Public Health, Regional Epidemiologists (who areemployed by the PHLS) and the Department of Health (DoH).

2.2 The Public Health Laboratory Service and the ScottishCentre for Infection and Environmental Health

The PHLS is a major resource for contributing to themanagement of outbreaks in England and Wales, and it wouldbe potentially of equal value in dealing with BW attacks uponcivilian targets - indeed, it was created in 1938 specifically tohelp deal with possible wartime BW attacks upon the UK. It iscomposed of three linked parts:

• Peripheral laboratories strategically located in hospitalsacross England and Wales. These provide diagnosticmicrobiology and expertise to their local hospitals and topublic health and environmental health departments,including support for the investigation and control ofoutbreaks.

• The Central Public Health Laboratory (CPHL) in Colindale,London, where the main PHLS Reference Laboratories arelocated. These provide expertise, including epidemiologicalsub-typing, for their several specialist fields of microbiology.CPHL has facilities for identifying dangerous pathogens andin this work collaborates with the Centre for AppliedMicrobiology and Research (CAMR), at Porton Down.

• The Communicable Disease Surveillance Centre (CDSC), alsoat Colindale, which is staffed by infectious diseaseepidemiologists. CDSC is responsible for the national


Appendix 3

surveillance of microbial diseases and for providing expertepidemiological support for the investigation of outbreaksanywhere in the country. Its Regional Services Divisionincludes the Regional Epidemiologist of every Health Regionof England and Wales and provides support to NorthernIreland.

The constituent parts of the PHLS are managed and co-ordinated by its Headquarters at Colindale. It is understood thatthe PHLS is currently revising and updating its own plans forresponding in the event of a suspected BW attack.

In Scotland, the equivalent of CDSC is the Scottish Centre forInfection and Environmental Health.

2.3 Detection of outbreaks

The more quickly an outbreak is detected, the more likely itbecomes that it can be controlled before large numbers ofpeople are affected. Outbreaks of infection may be detectedlocally when an increase in the prevalence of a particularinfection is noticed, often by the CCDC or the local PHLSlaboratory. They may also be detected by the PHLS through itsnational surveillance, which can be remarkably sensitive. Forexample, salmonella contamination of imported Peperamisalami sticks was discovered after only 15 nationally-distributedcases of infection with an unusual salmonella serotype had beenidentified. These infections were rapidly traced to the foodarticle responsible by means of a case-control study, in which astructured questionnaire was administered to patients andmatched controls, supported by tests upon samples of thesuspect food by the reference laboratory. Numerous otherexamples could be cited.

2.4 Handling an outbreak

There are many aspects to dealing with an outbreak, including: co-ordination of the response; care of affected patients; identificationof risk groups; case-finding; identification of the causative agent,its source and the route by which it infects people, such as via theair, food, or water; implementation of measures to decontaminatethe source and to control the vehicle(s) of infection; use ofimmuno- and chemoprophylaxis; provision of information to thepublic and the media, including potentially life-saving guidanceabout the symptoms and signs of illness that might be due to theagent, and about precautions to be adopted. Two of these aspectsare commented upon below.

2.4.1 Co-ordination of the response

It is usual to set up an outbreak control team to co-ordinate allaspects of the response. The team will have a chairperson, whowill often be the CCDC, and it will normally include a localpublic health and an environmental health officer, a clinician,and a microbiologist, who may be from the PHLS. In moreserious outbreaks it can be valuable to include the RegionalEpidemiologist and a PHLS microbiologist and epidemiologistwith expertise in the scientific study of the suspect agent. In anyevent, the team can call upon the expertise and services of thePHLS. The team must ensure clear lines of decision andresponsibility, and that all appropriate expertise is fully utilised. Itshould also be responsible for the preparation of a report aboutthe episode, which should include any lessons for handlingfuture outbreaks.

2.4.2 The causative agent and its source

The early identification of the cause of the outbreak is of critical

value to most aspects of an effective response. Identification ofthe agent and its sensitivity to antibiotics, of its source(s), andalso of the route by which it spreads, frequently depends uponexpert clinical, epidemiological and microbiologicalinvestigations. The clinical and epidemiological description ofthe early cases will often indicate the probable infection routeand suggest the range of pathogens likely to be responsible. Indiagnostic microbiology, whether applied to patients or toenvironmental samples, trained staff will normally applytechniques designed to identify rapidly the pathogenresponsible, by the use of methods selective for the range ofprobable pathogens in a given situation, whilst less specific (butoften slower) methods will also be included to ensure thatunlikely pathogens are not missed.

3 The response to BW attacks on civilian targets

3.1 Response plans

If the existing arrangements for managing outbreaks are to beexploited in dealing with BW attacks, it would be valuable forthose concerned - Local and NHS Health Authorities and thePHLS, together with the DoH and the corresponding bodies inScotland and Northern Ireland - to prepare plans to guide theirresponse, based on the procedures adopted for handlingnatural outbreaks. Their plans should be co-ordinated withthose of the other authorities that must be involved, such as theMinistry of Defence (MOD) and the Home Office and theirmilitary and police forces, which may have lead responsibility formanaging the episode.

Response plans should take into account the results ofassessments made of the most likely BW agents that might bedeployed by potential aggressor states and known terroristgroups, and of how they might be deployed. Such assessmentswould also be useful in guiding the training of clinicians andlaboratory staff in the diagnosis of unusual infectious diseases.

The preparation of realistic plans may well highlight issues forwhich action is advisable before the event, such as the need fortraining suitable laboratory staff in the rapid identification ofrare infectious agents. Selected clinicians could be trained in thediagnosis and care of these rare diseases, and printed clinicalguidelines prepared for distribution when needed; for thesetasks, doctors with relevant experience (eg from working in thetropics) could be especially valuable. The assessment of the likelyBW agents that could be deployed would help in prioritisingthese training needs. Planning might also clarify a need to moveahead on such questions as the supply of beds or respirators, thecreation of isolation facilities, the identification of key staff forvaccination or chemoprophylaxis, or the identification ofsuitable boundaries for setting up cordon sanitaires in the eventof serious attacks. The creation of stocks of appropriatedecontamination materials, antibiotics and vaccines should beconsidered, although this could, in some cases, be costly -nevertheless, the USA is understood to be preparing a stockpileof smallpox vaccine. It may also be possible to arrange foremergency access by the DoH to any existing stockpiles oftherapeutic products held by other agencies, such as themilitary, or by other countries.

Response plans should be, if possible, tested in simulatedepisodes. Whilst outbreaks are usually handled well in the UK,


when problems occur they often relate to poor collaborationand confusion of responsibilities between the individuals andauthorities concerned, and sometimes to a reluctance to callupon specialist expertise. The potential for demarcationproblems with the chain of responsibility becomes greater withoutbreaks involving more than one Local or Health Authority,and in a BW scenario there are added potential areas ofconfusion owing to the essential involvement of the police andother authorities. In PHLS experience, outbreak-handling isfacilitated when those involved know each other, have workedtogether previously, and follow agreed procedures. Practiceexercises can foster such good working relationships and help toidentify and resolve problems before the event.

Response plans must not only take into account both dangerousand less dangerous BW agents, but also:

• measures appropriate to local episodes, involving one or onlya few Local Authorities and NHS Health Districts;

• measures for dealing with regional episodes; and• measures for widespread, national episodes.

Prior agreement of clear lines of responsibility would beimportant in each case.

It is advisable for the planning to include both ‘generic’ and‘specific’ aspects.

• ‘Generic’ plans. It may be assumed that the Governmentholds contingency plans for dealing with major emergenciesand disasters. These plans will include general aspects of theresponse, such as mobilisation of police or hospital staff, aswell as measures applicable to specific sorts of emergency.General aspects are equally important in the response tolarge and small BW attacks and must be included in theplanning. The ‘generic’ plans would be followed until theycould be supplemented or changed once the BW agentdeployed was identified.

• ‘Specific’ plans. The control measures required to handle aBW attack will be most effective when tailored to the specificBW agent used. This may be unknown at first, but the morerapidly the cause can be established, the more quickly canspecific measures be applied. Although it may not be feasibleto prepare specific plans for all potential BW agents, it maywell be practicable to cover the most likely agents that couldbe deployed by those countries and known terrorist groupsthat might attack the UK.

3.2 Detection of an attack

Intelligence data would be of prime importance in detecting BWattacks, and long-range detection methods might reveal that anattack was being mounted. There are also increasingpossibilities of identifying specific agents at a distance. Theseprocedures are presumably the province of the military but mayhave applications to detecting covert attacks upon civiliantargets. It would be useful for the civilian authorities to begenerally aware of the technologies and resources available tothe military for the detection and identification of candidate BWagents.

Some BW attacks could be particularly difficult to detect, inparticular if the attack were made covertly, its effects insidious, andit caused illness similar to that prevalent in the population.

Detection could then depend heavily on alert surveillance which, asmentioned earlier, can be very sensitive. It would be made moreeffective if CDSC (and its equivalent in Scotland), together withselected laboratories trained in the identification of likely BWagents, were alerted whenever intelligence revealed a heightenedrisk of an attack, especially if the range of possible agents likely tobe deployed by the aggressor had been assessed.

3.3 Handling a BW attack

The response to a BW attack on civilian targets should follow thegeneral principles applied in natural outbreaks, as discussedabove, but two particular aspects should be mentioned:informing the public and analysis of the attack.

3.3.1 Informing the public

In natural outbreaks, informing the general public and themedia can be very demanding. It is likely to be more so in theevent of a BW attack. The information given needs to be asreliable as possible, and especially in the case of infections notnormally seen in the UK (eg plague, tularaemia, pulmonaryanthrax, etc), there would be advantages in preparing printedmaterial in advance so that it would be immediately available inthe event of an attack.

The dissemination of reliable prior information to the generalpublic before the event should also be considered. Reliableinformation for key personnel would be a necessary part of theprocess of preparing, testing and updating the response plans,and many of these key staff could have an important role ininforming others in the event of an attack. For example, CCDCscould well be key people for giving information through themedia in their health districts, and the Health and Safety Officersof factories, etc, could serve in providing sound guidance toemployees. But the provision of appropriate general informationto the public before the event could also be beneficial.

There would be constraints, for example, in respect ofinformation obtained by secret intelligence, and there is a risk ofcausing undue concern. The frequent BW hoaxes reported fromthe USA may be a consequence of its wider publicity in thatcountry. But some public statements have been exaggeratedand unnecessarily alarmist. Whilst some BW agents could haveconsequences of the sort conveyed by the phrase ‘the poorman’s nuclear weapon’, there are aspects that might berelatively reassuring to the public. Many less dangerous BWagents, especially if deployed on a small, local scale, would nothave devastating effects; several agents can be rapidly detected;and the clinical effects of many agents can be prevented ortreated. It could also be reassuring for the public to be awarethat vigilance is maintained and tested management plans are inplace.

3.3.2 Analysis of an attack

The opportunity must be grasped to study an attack scientifically -to secure hard data to guide response to possible subsequentattacks. Studies should include thorough clinical and sub-clinicalcase-finding, documentation of the clinical outcome of each case,quantification of the numbers of BW micro-organisms in samplesof food, water and air, documentation of the public’s reactions,and studies of the biological agent deployed, as this may also yieldfirm ‘fingerprint’ evidence to link the attack to a suspected source.Such research and observational studies should be planned inadvance in order to implement them without delay: they shouldform an integral part of response plans.


4 Conclusions

• The consequences of a BW attack upon civilian targets wouldvary greatly, depending on the nature of the agent deployed,the scale of the attack, and how it was mounted.Management of the consequences of an attack wouldinvolve scientific, medical and administrative measures,together with military intelligence and advice, and requiresoverall co-ordination of these activities. Management wouldbe most effective if the response had been well-planned andtested in simulated attacks, and when it could be tailored tothe particular, identified BW agent deployed.

• Management of the consequences of BW attacks shouldexploit the existing arrangements for handling naturaloutbreaks of infection. These involve, in particular, Public andEnvironmental Health Authorities, NHS Trust Hospitals, thePublic Health Laboratory Service and the Scottish Centre forInfection and Environmental Health.

• The detection of BW attacks may be difficult, not least in thecase of covert, small-scale attacks or where a novel agentwas deployed. Detection should involve the existing nationalsurveillance centres, and these should be informed aboutlikely BW agents and alerted whenever intelligence sourcessuggest an increased risk of attack. Selected laboratoriesshould be trained in the identification of the likely BWagents.

• Clinical care and treatment could be difficult, especially inlarge-scale attacks with agents causing diseases that fewdoctors would have encountered. Selected clinicians shouldbe trained in the diagnosis and care of such diseases. Theneed for additional isolation and treatment facilities shouldbe considered, as well as of countermeasures such asvaccines and antimicrobial agents.

• Countering alarmist misinformation about BW should beconsidered. Whilst BW are frightening, and novel BW agentscould be especially so, in nature most dangerous pathogensare not 100% infectious, not all infections progress to clinicaldisease or to death, many can be treated effectively, andplanned management can minimise their effects. Also, manyof the potential BW agents that might be deployed byterrorists are much less dangerous than those that may havebeen turned into weapons in the past for military use. Thereare also problems facing an aggressor who wishes to use BWand more easily-deployed alternatives are available, such asexplosives. Information provided to the public should besoundly-based, and suitable material also should be preparedin advance so that it is immediately available in the event ofan attack.

• The characteristics of all features of any attack, including theeffects of the management measures, should be analysedcarefully in order to learn lessons to guide plans forresponding on future occasions.


Membership of the Royal Society working group on biological weapons

Professor Peter Biggs, CBE FRS Formerly Director of Animal Disease Research, Agricultural and FoodResearch Council

Professor Peter Blain Department of Environmental and Occupational Medicine, University ofNewcastle upon Tyne

Dr Michael Crumpton CBE FRS Formerly Director of Research (Laboratories), Imperial Cancer ResearchFund

Professor Julian Hunt CB FRS Department of Space and Climate Physics, University College London

Dr David Kelly CMG Ministry of Defence

Dr George Poste CBE FRS Formerly Chief Science and Technology Officer, SmithKline Beecham andcurrently Chief Executive, Health Technology Networks, Arizona, USA

Mr Julian Perry Robinson Science Policy Research Unit, University of Sussex

Professor Harry Smith CBE FRS (Chairman) Emeritus Professor of Microbiology, University of Birmingham

Sir Joseph Smith Formerly Director, Public Health Laboratory Service

Professor Brian Spratt FRS Wellcome Trust Centre for the Epidemiology of Infectious Disease,Department of Zoology, University of Oxford

Mr Robert Ward Science Advice Section, Royal Society

Ms Sarah Wright Science Advice Section, Royal Society


Appendix 4

Documents

Measures for controlling the - Royal Society · 2014. 3. 10. · Measures for controlling the threat from biological weapons Published by the Royal Society 6 Carlton House Terrace