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measure, if viewed in isolation, has substantial limitations and can be
sidestepped by someone who is suf¬ciently motivated to commit biovio-
lence. Policies must, therefore, be integrative; each measure gains strength
from pursuit of all the others. It is a challenge, however, to knit a compre-
hensive and interwoven policy fabric with threads from three dozen skeins.
Fortunately, across a broad range of technical issues, we know how
to augment safety from bioviolence. Virtually every proposed measure is
well understood and doable; there is some organization, expert, or gov-
ernment agency that is vigorously trying to do something positive. These
activities are certainly making a bene¬cial contribution “ albeit less advan-
tageously than if part of a larger tapestry. We know less, however, about how
244 BIOVIOLENCE: PREVENTING BIOLOGICAL TERROR AND CRIME

to integrate technical knowledge and experience into a global system that
can keep pace with the advance of science and its accompanying perils.
The conundrum is how to arrange disaggregated expertise and energy and
how to align a critical mass of constituencies so that bioviolence preven-
tion initiatives are mutually reinforcing. Thus, the issue is not why doesn™t
somebody do something as much as how can we effectively create synergies
among what a lot of people are already doing. How can activity be organized
into strategy?
Most needed today are not so much de¬nitive answers to discrete prob-
lems but rather parameters that help decision makers create and imple-
ment multiple policies over time. Today™s leaders, lacking clear experi-
ence and hearing fractured proposals to take action, have been dissuaded
from moving forward by a pervasive ambiguity about how policy pieces
¬t together. Rather than stumble counterproductively among hidden pit-
falls of ill-considered policies, it may have seemed safer to wait and react
instead of focusing on prevention. This book has sought, therefore, to clar-
ify how potentially bene¬cial initiatives might be more comprehensively
embraced.
There is another context for highlighting integration “ bioviolence pre-
vention policies must be integrated with other important policy agendas.
Indeed, the important implications of bioviolence “ for international secu-
rity, for the future of science, and for combating pandemic disease “ call
for appreciating bioviolence prevention as one agenda priority among oth-
ers. Just as the many measures discussed in this book gain strength from
mutual integration, the pursuit of bioviolence prevention gains strength
from integration with other global priorities including the advance of bio-
science and health.
The fact that various bioviolence prevention measures should be inte-
grated with each other as well as with separate policy agendas is not a
justi¬cation for moving slowly. At some point, the lack of policy initiative
must be viewed more harshly. As dangers mount, the inescapable conclu-
sion must be that a lack of political commitment to advance prevention
policies is testimony to our leaders™ feeble unwillingness to face the major
threats that confront our era. Bluntly offered, this situation must not long
continue.
The third and most important “I” is international. For centuries,
destructive power was primarily an attribute of States. Although State con-
¬‚ict certainly posed security nightmares, at least there was a clear idea
of the enemy™s identity. Borders separated friend from foe and de¬ned
imminent threats. Advancing science, however, has eviscerated the
245
CONCLUSION

nation-State™s monopoly of destructive force, and national borders are
decreasingly relevant to the pursuit of security. Globalization is dissemi-
nating productive and destructive capabilities around the world.
Bioscience is promoting and bene¬ting from globalization. In an even
more profound sense, bioscience is the palpable manifestation of our
common genome and our shared existence. Our era™s increasing agility
in manipulating the genetic tools of life opens potential for improving the
human condition as well as for in¬‚icting horror. Bioviolence is, accordingly,
tightening the fabric of humanity with irreversible implications about what
can threaten all of us; the very life force that connects us all simultaneously
imperils us all.
Human existence, of course, has always been a struggle against disease,
but the introduction of human knowledge and intention on the side of
disease is threatening to recon¬gure this struggle. It™s us against them in
the eternal war between humans and microbes; the prospect of traitors
tipping the balance demonstrates that the rest of us are in this together. We
will be more secure if we can get better organized to pursue our common
objectives. Ultimately, therefore, the pathways for bioviolence prevention
demand governance structures and processes for all humanity.
This need for a new humanity-governance evokes this book™s intended
thesis: the imperative of security from bioviolence is fundamentally trans-
formative of international law. The predominant view of international law
has long been that sovereign States de¬ne the law™s content through their
treaties or customary practices; international law is the law of nations. A
weaker, alternative view is that international law is a set of organizing prin-
ciples embodying a categorical imperative to advance humanity™s survival
and progress. The difference between these two perspectives has to do
with States: for proponents of the law of nations, States are the fundamen-
tal units of human organization; for proponents of the law of humanity,
States can be useful mechanisms for establishing order amid evolving yet
still anarchic conditions, but their parochial interests are not the law™s
primary concern. Unquestionably, the ¬rst view has dominated political
affairs and scholarly thought for centuries.
Looking to the future of bioviolence and the mechanisms of its pre-
vention is to open visions of an evolving paradigm of international law
where the imperative of advancing the human community must be ascen-
dant. In the same sense that fortressed cities became obsolete when
the security they offered became a mirage, today™s security challenges
erode the illusion that separate sovereign States can keep us safe from
impending catastrophe. Bioviolence is not the only challenge that calls for
246 BIOVIOLENCE: PREVENTING BIOLOGICAL TERROR AND CRIME

worldwide collaborative action, but perhaps it most graphically crystal-
lizes the shortcomings of our inherited allegiance to divisive concepts of
State sovereignty. Humanity is now compelled to turn to a broader con-
ception of international law so that arrays of policies and initiatives can be
effectively focused. This is not a preference or a choice; it is the inherent
implication of scienti¬c progress.
The need to prevent bioviolence has emerged from the con¬‚uence of
radically accelerating progress in bioscience along with the post-2001 pre-
eminence of non-State violence atop the world™s strategic agenda. Prevent-
ing bioviolence is increasingly too complicated for two hundred squab-
bling sovereigns to accomplish, and the consequences of getting it wrong
are too dire for us to long tolerate their imprudence. Thus, bioviolence
prevention portends a new chapter in the human species™ most basic and
most long-lasting struggle against lethal microbes and offers a new vision
of how to globally organize strategic security under law. As this is a strug-
gle we must win, international legal pursuit of prevention policies is a
paramount priority.
Notes




Introduction
1. A recent and noteworthy exercise was “Black Ice” (Bioterrorism International Coor-
dination Exercise), which the United States and Switzerland co-hosted in Montreux,
Switzerland, in September 2006, with high-level of¬cials from twelve international
organizations. The exercise involved a smallpox scenario, focusing on the interna-
tional community™s capabilities and challenges to bioterrorism response coordina-
tion, including public communication, information sharing, operational readiness,
and the impact of national interests on organizational missions.
2. See G. John Ikenberry & Anne-Marie Slaughter, Forging a World of Liberty Under
Law: U.S. National Security in the 21st Century, The Princeton Project Papers, The
Woodrow Wilson School of Public and International Affairs (September 27, 2006).
3. Michael Foucault set forth the term biopolitics to refer to “that mode of organiz-
ing, managing, and above all regulation ˜the population™ considered as a biological
species entity.” Biopolitics refers to the object of governing as “addressed to a mul-
tiplicity of men, not to the extent that they are nothing more than their individual
bodies, but to the extent that they form, on the contrary, a global mass . . . ” See
generally, Eugene Thacker, The Global Genome, MIT Press, pp. 21“36 (2005).
4. Gro Harlem Brundtland, Global Health and International Security; Global Insights,
Global Governance (October 1, 2003).


Chapter 1. Why Worry?
1. Proliferation of Weapons of Mass Destruction, Of¬ce of Technology Assessment, US
Congress, OTA-ISC-559, pp. 53“55 (1993), cited in, Anthrax as a Biological Weapon:
Medical and Public Health Management, Journal of the American Medical Asso-
ciation, Vol. 281, No. 18, p. 1735 (May 12, 1999).
2. According to the Stockholm International Peace Research Institute, the cost to in¬‚ict
civilian casualties is $2,000 per square kilometer with conventional weapons, $800
with nuclear weapons, and $1 with biological weapons. In 1999, the U.S. Defense
Threat Reduction Agency built a small facility that could be used to produce biolog-
ical warfare agents for only $1.6 million. See Judith Miller et al., Germs: Biological
Weapons and America™s Secret War, Simon & Schuster, pp. 297“298 (2001).



247
248 NOTES TO PAGES 24“29


Chapter 2. Methods of Bioviolence
1. Smallpox as a Biological Weapon: Medical and Public Health Management, Journal
of the American Medical Association, Vol. 281, No. 22 (June 9, 1999).
2. CDC, Smallpox Fact Sheet: Side Effects of Smallpox Vaccination, available at http://
www.bt.cdc.gov/agent/smallpox/vaccination/reactions-vacc-public.asp.
3. Smallpox as a Biological Weapon: Medical and Public Health Management, Journal
of the American Medical Association, Vol. 281, No. 22 (June 9, 1999).
4. See K. T. Chelvi, The Pox Maybe on You, New Straits Times (April 4, 2005); See also,
Ewen MacAskill et al., Threat of War: Powell™s Evidence Against Saddam: Does It Add
Up? The Guardian (London) (February 6, 2003).
5. Quoted in Meridith Wadman US Scientists Split on Smallpox Decision, Nature, Vol.
398, p. 741 (April 29, 1999), available at http://www.nature.com/wcs/b32.html.
6. Ken Alibek, Behind the Mask: Biological Warfare, Perspective, Vol. IX, No. 1
(September“October, 1998).
7. See generally, Myrna Watanabe, The Bioterror Error, Hartford Courant (Septem-
ber 5, 2004).
8. See WMD 411 Chronology “ 2002, Nuclear Threat Initiative, available at http://
www.nti.org/f wmd411/2002.html, stating “The Washington Post reports that U.S.
intelligence believes that France, Russia, Iraq, and North Korea maintain stockpiles
of weaponized smallpox. Days later, France of¬cially denies the charges, maintain-
ing that France has always strictly adhered to the 1972 BWC.”; See also, Barton
Gellman, 4 Nations Thought to Possess Smallpox; Iraq, N. Korea named, Two Offi-
cials Say, Washington Post (November 5, 2002), stating “The CIA now assesses that
four nations “ Iraq, North Korea, Russia and, to the surprise of some specialists,
France “ have undeclared samples of the smallpox virus.”
9. U.S. Department of Defense, Smallpox Vaccination Program Information State-
ment and Acknowledgement, available at http://www.smallpox.mil/documents/
118Smallpoxack.pdf.
10. The Ecology of Flu, ZKEA Emerging Diseases: Biological Terrorism: Biological
Warfare, available at http://www.zkea.com/articles/¬‚u2.html.
11. Michael T. Osterholm, Preparing for the Next Pandemic, Foreign Affairs, p. 24 (July“
August, 2005).
12. See Laurie Garrett, The Next Pandemic? Foreign Affairs, p. 3 (July/August 2005); See
also, Klaus Stohr & Marja Esveld, Will Vaccines be Available for the Next Influenza
Pandemic? Science, Vol. 306, No. 5705 (December 24, 2004).
13. K. Y. Yuen & S. S. Y. Wong, Human Infection by Avian Influenza A H5N1, Hong Kong
Medical Journal, Vol. 11, No. 3 (June, 2005).
14. The Ecology of Flu, ZKEA Emerging Diseases: Biological Terrorism: Biological
Warfare, available at http://www.zkea.com/articles/¬‚u2.html; See also, David A.
Relman, Bioterrorism “ Preparing to Fight the Next War, New England Journal of
Medicine, p. 113 (January 12, 2006).
15. Graeme Laver & Elspeth Garman, The Origin and Control of Pandemic Influenza,
Science, Vol. 293, No. 5536, p. 1,776 (September 7, 2001).
16. Researchers Reconstruct 1918 Pandemic Influenza Virus; Effort Designed to Advance
Preparedness, Centers for Disease Control and Prevention, Press Release (Octo-
ber 5, 2005) available at http://www.cdc.gov/od/oc/media/pressrel/r051005.htm.
17. Influenza (Flu) Questions and Answers: Reconstruction of the 1918 Influenza Pan-
demic Virus, Centers for Disease Control and Prevention, available at www.bt.
cdc.gov/scripts/emailprint/print.asp.
249
NOTES TO PAGES 29“31

18. The Ecology of Flu, ZKEA Emerging Diseases: Biological Terrorism: Biological
Warfare, available at http://www.zkea.com/articles/¬‚u2.html; See also, Terrence
M. Tumpey et al., Characterization of the Reconstructed 1918 Spanish Influenza
Virus, Science, Vol. 310, pp. 77“80 (October 7, 2005).
19. R. J. Webby & R. G. Webster, Are We Ready for Pandemic Influenza? Science, Vol. 302,
No. 5650, pp. 1519“1522 (November 28, 2003).
20. Mohamad Madjid et al., Influenza as a Bioweapon, Journal of the Royal Society
of Medicine, Vol. 96, p. 345 (July 2003); See also, Flu Bioweapon Fears, BBC News
(July 1, 2003), available at http://news.bbc.co.uk/1/hi/health/3031488.stm.
21. Michael T. Osterholm, Preparing for the Next Pandemic, Foreign Affairs, p. 24
(July/August, 2005).
22. Robert M. Krug, The Potential Use of Influenza Virus as an Agent for Bioterrorism,
Antiviral Research, Vol. 57, No. 1“2, pp. 147“150 (January 2003).
23. Laurie Garrett, The Next Pandemic? Foreign Affairs, p. 3 (July/August, 2005).
24. Flu Bioweapon Fears, BBC News (July 1, 2003), available at http://news.bbc.co.uk/
1/hi/health/3031488.stm.
25. Graeme Laver & Elspeth Garman, The Origin and Control of Pandemic Influenza,
Science, Vol. 293, No. 5536, p. 1776 (September 7, 2001).
26. See Klaus Stohr & Marja Esveld, Will Vaccines be Available for the Next Influenza
Pandemic? Science, Vol. 306, No. 5705 (December 24, 2004); See also, I. M. Longini
et al., Containing Pandemic Influenza with Antiviral Agents, American Journal of
Epidemiology, Vol. 159, No. 7, p. 623“633 (April 1, 2004); See also, Monica Schoch-
Spana, Implications of Pandemic Influenza for Bioterrorism Response, Clinical
Infectious Diseases, Vol. 31, p. 1413 (December 2000).
27. See Gigi Kwik Gronvall & Luciana L. Borio, Removing Barriers to Global Pandemic
Influenza Vaccination, Biosecurity and Bioterrorism: Biodefense Strategy, Prac-
tice, and Science, Vol. 4, No. 2 (2006); See also, Laurie Garrett, The Next Pandemic?
Foreign Affairs, p. 3 (July/August, 2005).
28. Klaus Stohr & Marja Esveld, Will Vaccines be Available for the Next Influenza
Pandemic? Science, Vol. 306, No. 5705 (December 24, 2004).
29. Michael T. Osterholm, Preparing for the Next Pandemic, Foreign Affairs, p. 24 (July
2005“August 2005).
30. Graeme Laver & Elspeth Garman, The Origin and Control of Pandemic Influenza,
Science, Vol. 293, No. 5536, p. 1776 (September 7, 2001).
31. World Health Organization, Global Stockpile of H5N1 Vaccine ˜Feasible,™ 26 April,
2007, available at http://www.who.int/mediacentre/news/releases/2007/pr21/en/
index.html.
32. Luzi Ann Javier, Bird Flu May Result in $200 Billion in Losses Worldwide, available
at http://www.bloomberg.com/apps/news?pid=20601086&sid=aCl7Rm0bVxlY
&refer=latin america.
33. The CDC groups the hemorrhagic fever viruses into a “High-Priority,” “Category
A Disease/Agent” because: (a) it can be easily disseminated or transmitted from
person to person; (b) it can result in high mortality rates and has the poten-
tial for major public health impact; (c) it might cause public panic and social
disruption and; (d) it requires special action for public health preparedness. See
Bioterrorism Agents/Diseases, The Centers for Disease Control and Prevention,
available at: http://www.bt.cdc.gov/agent/agentlist-category.asp#adef; See also,
Hemorrhagic Fever Viruses as Biological Weapons: Medical and Public Health Man-
agement, Journal of the American Medical Association, Vol. 287, No. 18 (May 8,
2002).
250 NOTES TO PAGES 31“35

34. Staff statement, U.S. Senate Permanent Subcommittee on Investigations (Minority
Staff), Global Proliferation of Weapons of Mass Destruction, A Case Study on the Aum
Shinrikyo, Hearing before the Permanent Subcommittee on Investigations, 104th
Congress, 1st Session (October 31, 1995).
35. Marburg Hemorrhagic Fever Fact Sheet, The Centers for Disease Control and Pre-
vention, available at http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/
Fact Sheets/Marburg%20Hemmorhagic%20Fever%20Fact%20Sheet.pdf.

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