President Bush has approved a plan to inoculate 500,000 U.S. military personnel against smallpox. The president, as commander in chief, will be vaccinated along with the troops. He also plans to make the vaccine available to up to ten million public safety workers.
The White House fears terrorists or rogue states may resort to biowarfare. Developing the policy took months of deliberation. When you consider the issues involved, you can see why.
The smallpox vaccine (like many drugs) has side effects. Historically, the current vaccine has caused about one to two deaths per million recipients. Simple math suggests that this would total between 300 and 600 deaths if the entire American population were vaccinated.
Thus ordering a mass vaccination program is not a trivial decision. But Iraq, North Korea, and several terrorist groups are known to be exploring biological weapons. The United States needs a cadre of people who can respond to an attack.
Smallpox could be an especially gruesome weapon. It is highly contagious and kills about a third of those infected. Those who survive are usually scarred, and many are crippled or blinded. Before a vaccine was invented in 1796, smallpox often killed hundreds of thousands of people each year.
The disease was considered eradicated almost a quarter century ago. Today the only specimens of smallpox virus exist in labs in the United States and Russia—at least, the only known specimens.
And that's the problem. We must be prepared for the chance that somehow Iraq, North Korea, or Al Qaeda has been able either to steal a sample of the virus or found some specimen that managed to escape eradication.
U.S. leaders today must deal with threats that are ambiguous, debatable, hard to verify but that could amass huge costs. Many other biological agents such as anthrax, Ebola, and plague could also be turned into weapons. Furthermore, many chemical, radiological, and nuclear weapons can be developed covertly.
The smallpox decision is the kind of complex national security calculation we can expect more of. Such decisions require public education, consensus building, and innovative thinking so as to limit risks without undo costs to the economy or burdens on the public. The most important ingredient, however, is leadership.
For years officials have expected the intelligence community to provide "actionable intelligence"—data so specific and unambiguous that the U.S. response would be obvious and unarguable. With today's threats, that is hard to provide and we should not expect it.
The best we can hope for is "inferential intelligence," whereby intelligence organizations indicate where the hard evidence leads and describe the possible threats that could result. Then officials must fill in the gray areas and decide how to respond.
September 11 showed what happens when you ignore an enemy abroad who threatens America. Taking action before an attack occurs may be the biggest—and most important—challenge of all.
