EU ‘unprepared’ for bioterror attack

Date: 11/09/03

By Karen Carstens

When it comes to bioterror, most member states fail to see eye-to-eye.

At least they do regarding the question of creating a central, EU-administered stockpile of vaccines in case of a terrorist assault using biological weapons such as anthrax or smallpox.

Advances in biotechnology and frequent lax security in protecting the microbial cultures which form the raw material for such weapons make it ever more likely that terrorists, as well as so-called rogue states, will have the ability to wage germ warfare.

The US has accused North Korea, Iran and others of seeking an offensive biological weapons capability and claims evidence in Afghanistan showed al-Qaeda aimed to add anthrax to its armoury. Meanwhile, others worry that the secrecy of America's own 'biodefense' projects conceals a more offensive approach.

Back in 'Old Europe', much has been done to prepare for nightmare scenarios since the 11 September attacks on New York and Washington two years ago.

A 24-hour medical alert network linking EU health authorities and laboratories became operational in June 2002. And the European Commission has set up a Health Security Committee which has issued clinical guidelines and drafted disease surveillance measures which will eventually become mandatory.

But member states have dismissed a Commission proposal to create a 'virtual' vaccines stockpile whereby 20% or 30% of all national stockpiles would be administered at EU level.

This was one of the main suggestions from a health security taskforce set up by the Commission in the wake of 9/11. A communication was published last June with its findings and recommendations. The upshot: "There is no agreement at present as to the need for a Community-level stockpile of any medicines at any time, with an appreciable number of member states feeling this is premature," as one EU official put it.

An idea of setting up an EU consortium to buy vaccines and antibiotics was also rejected.

A second major issue is whether there are enough vaccines to go round, and if the best vaccines are available.

"Most EU members only have first- generation vaccines against smallpox," warns Belgian arms-control scholar Jean Pascal Zanders, who heads the Swiss-based BioWeapons Prevention Project.

"Although these vaccines do not meet present-day quality standards, they do not plan to buy second-generation vaccines when they become available."

Toon Digneffe, government affairs manager at the Brussels office of Baxter, an Illinois-based healthcare multinational which produces second-generation smallpox vaccines for the US government, says EU citizens have real cause for concern.

"It's a bit worrying to know that two years later, the EU is not really prepared for an attack," he says.

Whereas first generation smallpox vaccines were essentially produced "on the skins of cows", he explains, the new generation are based on cell cultures and are supposed to have far fewer side effects.

Smallpox was eradicated more than 30 years ago, so most people born after 1970 have not been vaccinated. They would be particularly vulnerable to an attack.

According to Digneffe, a self-infected person could enter the metro and rapidly infect others. The disease has a 30% mortality rate.

Today, only a few controlled stocks of the smallpox virus exist in the US and Russia, but there are concerns that some of the latter stock may have gone missing.

In the event of an attack, France, the UK and Germany would have 'one dose per citizen' stocks, but many others do not, Digneffe warns.

Still, according to Commission officials there are regional agreements between the UK and Ireland or the Nordic countries, for instance, that would aim to ensure there were enough vaccines to meet demand.

But this still leaves the issue of 'dilution', essentially watering down first generation vaccines to make sure there is enough to go around. "It's a technique that some member states think is appropriate," Digneffe says.

The Commission's health security taskforce did not. "There are doubts over the feasibility of dilution in real conditions," it warned in its report last June.

Moreover, most national smallpox response strategies rely on so-called ring-fencing of outbreaks, in line with guidelines set by the World Health Organization.

But experts warn that these strategies, which involve vaccinating segments of the population to 'contain' an epidemic, do not anticipate attacks requiring mass vaccinations.

In the US, some 37,000 health care workers, plus military personnel and other 'first responders' to an attack have received precautionary smallpox jabs, but no such plans exist in the EU.

Adverse side effects from these vaccinations, which are mainly first generation so far, have however led the US government to rethink this strategy.

The Commission allocates EUR 2 million annually via its 2003-2008 health programme to combating bioterror, a figure which is supplemented by member states' own efforts, such as the recent mass emergency response exercise carried out by the UK government in London's tube system.

Whatever the final EU-wide sum might be, it is peanuts compared to US government's anti-terror budget, but perhaps the fear of bioterror attacks remains less acute in many EU member states?