Book Reviews

Until recently, most of us never thought about biological warfare. Few of us know anything factual about it. Now, however, and most timely, three staff writers from The New York Times have given us an important, well-written book about biological warfare.

Many people have largely written off biological warfare as merely a highly effective form of psychological warfare and too uncontrollable for serious military use. After all, these people have reasoned, how could anyone send soldiers into an area rendered contagious? That thinking made sense until September 11, when it became clear that the great technical skill of responsible personnel could be circumvented by the theft or illicit purchase of biohazardous materials for suicidal destruction, not conquest, of innocent civilian people and property; and that the perpetrators and supporters of this destruction could represent it as an act of martyrdom.

Germs opens with a detailed description of the planned, complex bioterrorist attacks carried out in Oregon in the 1980s by a religious group known as the Rajneeshees. Many of us have only a dim memory of those episodes. Like many topics in this Winter issue of TPJ, they seemed improbable events. They were terribly disturbing if true, and they were only fractionally reported in the press because of governmental concern that full exposure might lead to copycat episodes. Secrecy, threat, and implausibility are the engines that drive denial. We all tend to deny the existence of things with which we can't cope.

The book then delves into the complex psychology that interprets any significant change as an ordeal, even if the change is for the better. And acknowledging the realistic threat of biological warfare involves changing a basic concept of warfare; changing such a basic concept does not happen easily, especially in hierarchical organizations like the military. Yet, in the years since 1969, when President Nixon shut down all American biological warfare production at the US Army Pine Bluff Arsenal, Arkansas, the realization slowly emerged that the USSR had begun its own biowarfare version of the Manhattan Project (the World War II US-sponsored project to develop the atom bomb). The authors describe and document this activity so extensively as to eliminate all doubt. In this context, the recently announced American decision not to destroy our stores of smallpox virus becomes reassuring.

The book's main revelation is the magnitude and remarkable skill of the Soviet Union's biological warfare efforts: These activities dwarf any of ours that had been underway when we stopped research and production. For instance, the Soviets successfully reengineered bacteria and viruses that can induce demyelinating disease (p 302) long after all signs of initial infection disappear; this process thus makes detection of the initiating cause nearly impossible. Soviet researchers also spliced the diphtheria toxin gene into the plague bacillus to create an entirely new disease (p 303). The staggering amounts of biological warfare material they stockpiled include tons of smallpox virus (p 311). Worse yet, with the collapse of the USSR, responsible control of these products disappeared, leaving large numbers of sophisticated biowarfare scientists suddenly unemployed in a dead economy. These highly skilled scientists instantly became prime candidates for employment by Iraq, Iran, Syria, and North Korea--nations that now have dangerous biological warfare capabilities.

Complicating this scenario is the related story of how this information is obtained by the CIA or provided by defectors. After such information is validated, it has a long and difficult passage through the government bureaucracy, where it is buffeted by the emotions as well as the politics of multiple officials. Germs makes it clear that few officials wish to take any stand that creates a paradigm shift. Nonetheless, some ingenious partial solutions at times have occurred, such as the US Government's purchase of dangerous USSR biowarfare materials and joint US-Russian research projects designed to employ at least some former Soviet researchers, thus diverting their expertise from terrorist nations. However, most of the problem remains unsolved, and a few nations--such as Iraq, which in 1995 admitted to producing thousands of gallons of germ warfare materials (p 289)--are totally beyond the reach of even these partial solutions.

The remarkable Harvard biologist Edward O Wilson once commented that the Nobel Prize is won by bright children whom no one ever sufficiently loved (Personnal communication, December 12, 2001).^a Who, then, are these people who become terrorists? And how does that question relate to articles in this issue, whose focus is pediatric topics? The seemingly powerless--whose childhoods may have been influenced in ways we cannot readily know--now can wreak great damage on a modern, powerful country if they are willing to die in the attempt by flying airplanes into buildings or by volunteering to become a smallpox carrier. Who are these people, and how do they come to be?

For all the information and insight contained in the book, however, vast problems remain. The current anthrax scare mainly demonstrates the psychological power of biological warfare; the main biological dangers have not yet been seen. We are not prepared for them. The problem is not simple, and the solution is not self-evident.

^a University Research Professor, Harvard University, Cambridge, MA.

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