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The 'What Ifs' of destroying smallpox stocks

Smallpox, declared eradicated in 1980, may be a specter that belongs in history books, but it's still a contentious topic today. The debate involves two factions: one that supports keeping stocks of live virus for research and another that wants the stocks destroyed.  Currently, there are only two known stocks of smallpox (variola virus).  The U.S. holds 451 vials, and Russia has another 120 vials.  The World Health Assembly (WHA) will decide the fate of those vials this May. 

People who support the destruction of variola stocks argue that we no longer need them.  We now know the entire genome of 48 different strains and partial sequences of over 20 other strains.  Overall, these strains have little genetic variation, which suggests that if a vaccine or drug works on one, it would work on all of them.   There are also other advancements to help us, including two new antiviral drug candidates, an improvement of the standard smallpox vaccine, and new vaccines for immune-compromised people. 

One thing that hasn't been accomplished is developing a nonhuman primate model for smallpox infection, but infectious-disease experts argue that a model isn't worth the pursuit, nor entirely feasible in the near future.  In addition, even without live variola virus, researchers can still work on related viruses, such as monkeypox, rabbitpox, or cowpox.  Thus, many say that we should get rid of virus stocks to finally eradicate smallpox from the world.

But, what if there are undisclosed stocks of smallpox elsewhere, and what if terrorists make smallpox into a weapon?  It could get ugly, as roughly 40% of people in the world have no immunity.  Would it be so bad just to keep some live virus on hand for emergencies? 

Even with 48 strains fully sequenced, it doesn't mean that scientists can readily make live virus from scratch.  They would still need to overcome some technical difficulties, which would cost precious time in a crisis.  Furthermore, if we reach a point where scientists can easily replicate variola virus, the question of destroying current stocks becomes moot.

Some also ponder the real harm of keeping smallpox stocks.  It seems unlikely that terrorists will successfully break into American and Russian facilities to steal vials of the virus.  It's equally doubtful that researchers will accidently release smallpox into the world. 

Of course, there is the risk that American and Russian governments will use their stocks for nefarious purposes.  Some say mistrust is part of the problem.  Developing countries have less access to vaccines and drugs, so they might favor the destruction of stocks.  Therefore, destroying the live virus will only serve symbolic and political purposes, instead of practical ones.

With good arguments coming from both sides of the debate, it's difficult to say who's right.  Some experts, like Jonathon Tucker (author of Scourge: The Once and Future Threat of Smallpox), suggest a compromise.  It's not necessary to destroy every vial, but facilities can get rid of nonessential ones, such as redundant samples of hybrids and animal poxviruses.  A compromise may not seem like much of a resolution, but it might be the only thing that will appease both sides for now.

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