BOOK REVIEWS THE SELF-FULFILLING PROPHECY OF BIOTERRORISM Milton Leitenberg – 2009 Bracing for Armageddon? The Science and Politics of Bioterrorism in America, by William R. Clark. Oxford University Press, 2005. 221 pages, $21.95. KEYWORDS: Biologicalweapons;terrorism;anthrax;nerveagents;AlQaeda;AumShinrikyo ‘‘Barringa miracle,the UnitedStates ofAmerica willbedevastated by nuclearand CBR [chemical, biological,orradiological] warfare notlaterthan 1980.’’ *John F. Wharton,‘‘Diary ofaMan Struggling WithReality,’’ Saturday Review,August 19, 1961 Various forms of cancer kill roughly 565,000 Americans per year; tobacco kills around 440,000, and obesity causes perhaps 400,000 or more deaths.1 Approximately 1.7 million patients develop infections annually while undergoing treatment in U.S. hospitals, resultinginanestimated99,000deaths.2Togetherthesefourcausesaccountforroughly 1.5 million U.S. deaths per year, every year. Bioterrorism killed zero U.S. citizens in the twentiethcenturyandfivetodateinthetwenty-firstcentury.Why,then,areviewessayon ‘‘bioterrorism’’? Mostimmediately,toreviewWilliamR.Clark’s BracingforArmageddon?TheScience andPoliticsofBioterrorisminAmerica,anintroductoryvolumetobiologicalweapons(BW) issues. More importantly, because following the ‘‘Amerithrax’’ scare of October and November2001*inwhichtwenty-twopeopleweresickened,ofwhomfivedied*theU.S. government has authorized $57 billion for biological weapons prevention and defense. Theproposedcurrentrateofannualauthorizationforthispurposeis$10billion,whichcan be expected to continue in the future.3 According to many U.S. leaders and experts, this is money well spent fighting a dangerous threat. For example, ‘‘Biodefense for the 21st Century’’*otherwise known as Homeland Security Presidential Directive 10 (HSPD-10)*states that, ‘‘biological weapons inthepossessionofhostilestatesorterroristsposeuniqueandgravethreatstothesafety and security of the United States and our allies.’’ A recent panel established by the NationalAcademyofSciences(NAS)wentfurther:‘‘Thethreatposedbybiologicalagents employed in a terrorist attack on the United States is arguably the most important homeland security challenge of our era.’’4 And then-Senator William Frist (Republican of Tennessee),whocoauthoredthelegislationthatinitiatedtheseexpenditures,saidin2005, Nonproliferation Review, Vol. 16, No. 1, March 2009 ISSN1073-6700print/ISSN1746-1766online/09/010095-15 DOI:10.1080/10736700802645676 96 MILTONLEITENBERG ‘‘The greatest existential threat we have in the world today is biological ...an inevitable bio-terror attack [would come] at some time in the next 10 years.’’5 Fortwodecades,theoverwhelmingcontextinwhichthepotentialforbioterrorism was presented was that it would be carried out by terrorist groups with an international presence and international political objectives. These groups, however, have little or no scientific competence, little or no knowledge of microbiology, and no known access to pathogenstrainsorlaboratoryfacilities.ThemostrecentU.S.NationalIntelligenceCouncil terrorist assessment makes no reference to any such capabilities.6 The report of the Commission on the Prevention of Weapons of Mass Destruction (WMD) Proliferation and Terrorism, released in December 2008, stated, ‘‘We accept the validity of intelligence estimates about the current rudimentary nature of terrorist capabilities in the area of biological weapons.’’7 Nevertheless, in July 2008 congressional testimony, Jeffrey Runge, an assistant secretaryoftheDepartmentofHomelandSecurity(DHS),claimedthat,‘‘Theriskofalarge- scalebiologicalattackonthenationissignificant.Weknowthatourterroristenemieshave soughttousebiologicalagentsasinstrumentsofwarfare,andwebelievethatcapabilityis withintheirreach.’’8Rungesaidthatwhatkeepshimupatnight‘‘isapossibilityofalarge- scale biological attack on our homeland’’ and that he would demonstrate ‘‘the current biologicalthreatenvironmentasillustratedbytheeffectabiologicalattackmighthavein a city like Providence’’ in Rhode Island. But such a scenario of BW use*created under certain parameters by modelers*does not at all represent ‘‘the current biological threat environment.’’ It is instead a classic vulnerability assessment, without any reference to a specific validated threat. Even with a validated threat, one cannot know in advance how devastatinganattackmightbe.Thisisillustratedbytwoexamples:theuseofthechemical agent sarin by the Japanese cult Aum Shinrikyo in Tokyo in 1995, and the anthrax dispersion in the United States in 2001. These attacks (for different reasons) resulted in only a small fraction of the casualties that might have occurred. Joint testimonyby a triumvirate of Runge’s DHScolleagues echoed theidea thata serious BW threat to the United States exists: The Nation continues to face the risk of a major biological event that could cause catastrophic loss of human life, severe economic damages and significant harm to our Nation’scriticalinfrastructuresandkeyresources. ...Thethreatofbioterrorismhasnot subsided, and the impact of a large-scale bioterrorism event, such as the widespread dissemination of an aerosolized form of anthrax or other deadly biological pathogen, wouldhave aserious effect onthe healthand securityofthe Nation.9 Theselines,intermingledwithsomeotherscontainingafairamountofdistortedand misleadinginformationregardingthesimplicityofpreparationandevenweaponizationof pathogens, are typical. Pages could be filled with examples of ignorance and/or disinformation on the subject. All beat a tocsin of the bioterrorist threat. Other examples of the general tenor include successive reports and special commissionsemphasizingthesupposedthreatofbioterrorismthatwerereleasedduring the fall of 2008. In October 2008, the Washington Post reported that unidentified ‘‘senior military officials and national security experts say major threats before and after the THESELF-FULFILLING PROPHECYOFBIOTERRORISM 97 elections include an al-Qaeda strike on the United States ...as well as a terrorist attack involvingnuclear,biologicalorchemicalweapons.’’10(Itisworthmentioningthatin2004, thepublichealthcommunitynoticedanapparentcorrelationbetweenOrangeAlertsand political events, primarily before the presidential election.)11 In September 2008, the PartnershipforaSecureAmericareleaseditsevaluationofU.S.effortstopreventnuclear, chemical,andbiologicalterrorismsince2005,andmaintainedthat,‘‘anuclear,chemicalor biological weapon in the hands of terrorists was ‘the single greatest threat to our nation.’’’12 Also in September, the congressionally mandated Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism previewed its reportdesignedto‘‘deepenbothourassessmentofthethreattodayandwhatwecando about it.’’13 The commission’s co-chair, former Senator Robert Graham (Democrat of Florida),statedthat,‘‘Myownassessmentatthispointisthemorelikelyformofattackis going to be in a biological weapon.’’14 In contrast to this alarmist attitude, a proposed platformstatementsubmittedinAugust2008bytheFederationofAmericanSocietiesfor Experimental Biology, an organization composed of twenty-one biomedical research societies and the largest life sciences group in the United States, did not refer to ‘‘bioterrorism’’ at all.15 Thatsamemonth,theFederalBureauofInvestigation(FBI)announcedthatBruceE. Ivins, a staff scientist at the U.S. Army Medical Research Institute for Infectious Diseases (USAMRIID), was responsible for the2001 anthrax attacks. Ivins had worked at USAMRIID fortwenty-sevenyears,includingtwentyyearsofworkwithanthrax.Thisdisclosure*that alongtimeinsider,notanon-stateterroristgroup,wasresponsibleforadeadlyBWattack on U.S. soil*changed the entire construct of where the primary risks of bioterrorism lay and of what the likely capabilities of a perpetrator might be. In2003theDepartmentofDefensecommissionedacontractorstudytoinvestigate journals such as Scientific American, Science, and Molecular Microbiology to see what information contained therein might be used for ‘‘Biological Weapons Development Utility,’’ presumably by unauthorized entities.16 Five years later, a team from the Centers for Disease Control and the U.S. Army’s Dugway Proving Ground published a peer- reviewed paper describing the methodology for production and aerosol dispersion of weaponizeddrypowderB.anthracispreparations.17Thisinformationwasalmostcertainly notpreviouslypubliclyavailable,anditspublicationmakesamockeryoftheoft-repeated claimthat‘‘recipes’’forBWarereadilyavailableonjihadiwebsites,wheretheinformation ispracticallyuseless.Moreimportantly,theresearchandpublicationalsoviolatethespirit andpossiblythewordsofArticleIoftheBiologicalWeaponsConvention(BWC).Hadsuch adocumentbeenunearthedinIraqbefore2002,itprobablywouldhavebeenconsidered a casus belli. Whatthenisthecurrent BW threattotheUnited States? Theproblem canusefully beseparatedintofourconsiderations:thestateofoffensivebiologicalweaponsprograms beingcarriedoutbystates;evidenceofproliferationfromstateBWprograms;evidenceof stateassistance to non-stateactors to develop orproduce biologicalagents or weapons; and efforts to develop biological agents or weapons by non-state actors that are true international terrorist groups. 98 MILTONLEITENBERG Official U.S. government statements of the late 1980s said that four nations possessedoffensivebiologicalweaponsprogramsatthetimetheBWCwassignedin1972 andthatthisnumberhadincreasedtotenby1989.18InNovember1997,U.S.government officials raised the estimate to twelve*nine of which the United States identified by name in the intervening years*and in July 2001 to thirteen. Since then, the U.S. governmenthasremovedLibya,Iraq,andCubafromthelist(ithadremovedSouthAfrica inthemid-1990s)*areductionofessentiallyathird.Butstrikingly,asearlyas2003,official U.S. intelligence assessments became markedly more qualified about which countries were definitively developing biological weapons.19 Defense Intelligence Agency (DIA) Director Michael Maples’s threat assessment presentation on January 11, 2007 accentu- ated the lack of specifics on the number and status of offensive state BW programs: . ‘‘North Korea’s resources include a biotechnical infrastructure that could support the production of various biological warfare agents.’’ . ‘‘Iranhasagrowingbiotechnologyindustry,significantpharmaceuticalexperience and the overall infrastructure that could be used to support a biological warfare program. DIA believes Iran is pursuing development of biological weapons.’’ . ‘‘Chinapossessesasufficientlyadvancedbiotechnologyinfrastructuretoallowitto develop and produce biological agents.’’ . ‘‘WejudgeRussiaalsocontinuesresearchanddevelopmentthatcouldsupportits chemical and biological warfare programs.’’ . ‘‘India and Pakistan ...both ...have the infrastructure to support biological and some aspects of the chemical warfare programs.’’ . ‘‘Syria’sbiotechnicalinfrastructureiscapableofsupportinglimitedbiologicalagent development. DIA assesses Syria has a program to develop select biological agents.’’20 ThesestatementsregardingChina,Russia,NorthKorea,India,andPakistanwould,of course, be equally applicableto the United Statesand tonearly every European country, andtomanyothercountriesaswell.OnlythestatementsonIranandSyriareferexplicitly tooffensiveBWprograms;theotherstatementsareactuallyrathershockingsincetheyfail tosupportthesuggestionthattheseparticularcountriespossessanoffensiveBWprogram. ThissuggeststhatnotasmanycountriespossessedoffensiveBWprogramsaspreviously believed. In fact, these evolving assessments*and the Maples testimony in particular* raiseseriousquestionsaboutwhethertheestimatesofnationalBWprogramsinthe1970s and1980s,excludingtheSovietUnion,hadmuchbasisinreality.Becausethemostrecent estimates are so noncommittal and uncertain, and yet have had the benefit of accumulatedintelligence,itimpliesthatpastestimates,whichwerepresumablygenerated on less intelligence, should be questioned. It now seems possible that the number of countriesthoughttohaveoffensiveprogramsintheearly1970sthrough1989mightmore accurately be estimated at four or five. Statements by innumerable U.S. government officials, academic analysts, and journalists between 1989 and 2003 nearly uniformly concluded that the proliferation of state-runBWprogramswasaconstantlyincreasingtrend.21Itnowseemsclearthatwasnot the case: THESELF-FULFILLING PROPHECYOFBIOTERRORISM 99 . The trend of proliferation of state BW programs was probably more or less flat. . In recent years, official U.S. estimates of the number of such programs have declinedbyatleastathird,leavingroughlyahalfdozenatmost.Infact,asof2008, the U.S. government apparently thinks the appropriate number is six.22 . The U.S. intelligence community has qualified its assessments of those remaining programstosuchasignificantdegreethatitisdifficult,ifnotimpossible,tojudge what degree of ‘‘offensive’’ nature*the development, testing, production or stockpiling of biological agents or weapons*exists in those programs. As for proliferation from any state-run offensive BW programs, available evidence indicates that it has been minimal. None at all is known to have taken place from the former South African or Iraqi BW programs. As for the Soviet Union, only about ten scientistsareknowntohaveemigratedtoanycountryofBWproliferationconcerninthe post-Soviet period. Some were recruited by Iran, but most of this group worked in institutes belonging to the former Soviet Academy of Sciences and not in research institutes primarily serving the former Soviet BW program. Several others emigrated to Israel.TheUnitedStatesneverincludedIsraelinitslistsofBWproliferantstates,although Israel almost certainly maintained an offensive BW program for many years and may still do so. Onecanbe evenmoredefinitiveregardingassistance fromstate-runBW programs toterroristorganizationsseekingtodeveloportoproducebiologicalagentsorweapons: there is no evidence whatsoever of any such activity. U.S. intelligence agencies have alwaysconsideredthelikelihoodofsuchassistancetobeextremelylow,andtheyexpect the same to be the case in the future.23 Finally, the history of attempts by non-state actors to develop or use biological agentshasbeenremarkablylimited.Thesignificantepisodesareallwellknown,andClark, a researchscientist and professorof immunology, briefly summarizes theminBracing for Armageddon?ThefirstwastheuseofSalmonella,abacteriumthatcausesdiarrhea,inthe UnitedStatesin1984bytheRajneeshsheecult,inTheDalles,Oregon,inafailedattempt to influence a local election. The second was Aum Shinrikyo’s 1990(cid:2)1993 failed effort to obtainandculturestrainsofClostridiumbotulinumandBacillusanthracisanddispersethe resultingproducts.Thegroupneversucceededinobtainingapathogenicstrainofeither organism, and its culturing and dispersal efforts also came to naught. The third was the effortbyAlQaedainAfghanistanbetween1997and2001toobtainapathogenicculture ofB.anthracisandtoinitiateworkwiththeorganism.Onceagain,theeffortfailed,asthe organizationwasunabletoobtainapathogenicstrainofB.anthracis.AlQaeda’sworkwas incompetent in the extreme and had barely advanced beyond early speculation by the time a joint allied military team raided and occupied its facilities in December 2001. The last significant episode was the dispersal of a purified, dry powder preparation of B. anthracis sent through the U.S. postal system to multiple addressees in September and October 2001*the so-called Amerithrax incidents. The Al Qaeda and the Amerithrax events are the most significant. The barely initiated,rudimentary,andfailedattemptbyAlQaedaisimportantbecauseofthenature of the group*a true international terrorist organization with a wide organizational 100 MILTONLEITENBERG structure,demonstratedinitiative,andarecordofsuccessful,albeitconventional,attacks. TheAmerithraxattacksaresignificantbecauseofthenatureofthematerialpreparedand the perpetrator; the mailings demonstrate what a professional is capable of, but identifying the perpetrator was essential to explaining who could make such a product andunderwhatconditions.Inotherwords,identificationwouldprovidecriticalinsightinto both the likelihood of international terrorist organizations developing similar capabilities andhowquicklysuchathreatcouldemerge.Itisnotablethatsincetheinterruptionofthe Al Qaeda BW project in December 2001, there are no indications that the group has resumed those efforts.24 (Accounts of Al Qaeda offshoot groups in the United Kingdom, France,orIraqproducingricinareallspurious.)Therehavealsobeennopubliclyidentified indications that any other international terrorist group has initiated the development of BW agents in the intervening years.25 In terms of bioterrorism perpetrated by a terrorist organization, the Amerithrax events are an outlier, as they almost certainly were carried out by a U.S. scientist, fully trained, with access to pathogenic strains and optimum working conditions. A terrorist group has never carried out a mass-casualty bioterrorist event. Yet thanks to the steady streamofprognosticationsthatessentiallyexplaintoterroristswhyBWwouldbeofgreat utility to them, such an event may well happen sooner rather than later. Unfortunately, thatstreamwillcertainlybecontinuedbythoseinterestedinseeingthatthecurrentlevel of government funding for biodefense remains high. In the late 1990s and early 2000, several Government Accountability Office reports pointedly noted that the government had not performed a comprehensive bioterrorism threat assessment, notwithstanding federal expenditures to counter such a threat before October(cid:2)November 2001. Even after the initiation of greatly increased biodefense expenditures beginning in fiscal 2002, such a threat assessment was not performed. HSPD-10 states that, ‘‘the United States requires a continuous, formal process for conducting routine capabilities assessments to guide prioritization of our on-going investmentsinbiodefense-relatedresearch,development,planning,andpreparedness.’’26 In early 2008, Alan Pearson, director of the Biological and Chemical Weapons Control Program at the Center for Arms Control and Non-Proliferation, described the DHS Bioterrorism Risk Assessment (BTRA) model that was used to generate the DHS threat assessment. [T]heUnitedStatesrequiresaperiodicsenior-levelpolicynetassessmentthatevaluates progressinimplementingthispolicy,identifiescontinuinggapsorvulnerabilitiesinour biodefense posture, and makes recommendations for re-balancing and refining investmentsamong the pillars ofouroverallbiodefense policy. The Department of Homeland Security (DHS) is responsible for conducting these assessments, the firstonebiannually beginning in2006and the secondone everyfour yearsbeginningin2008.In2005,HomelandSecuritySecretary[Michael]Chertoffstated that DHS would use a risk-management approach to guide its strategies and activities, consistentwiththeintentoftheHomelandSecurityActof2002(Section201(d)(2)).Risk isdefinedasafunctionoflikelihoodandconsequence.DHShasadoptedthisapproach forthe firstofthe two assessments mandatedbyHSPD-10. THESELF-FULFILLING PROPHECYOFBIOTERRORISM 101 The first ‘‘Bioterrorism Risk Assessment,’’ prepared by the DHS National Biodefense Analysis and Countermeasures Center (NBACC) using a methodology developed by Battelle Memorial Institute, was completed on January 31, 2006 and a report on the assessmentwaspublishedonOctober1,2006.Theassessmentusedthreatscenariosand consequence modeling to rank 28 biological agents ...according to their relative risk. Forthispurpose,theestimatedlikelihoodofagentuseinarangeofdifferentscenarios (‘‘the probability that an adversary acquires, produces, and disseminates a biological weapon,’’ based on intelligence community input and the judgment of subject matter experts) was multiplied by the projected consequences resulting from each scenario (usingdatavettedbytheDepartmentofHealthandHumanServices).Theriskcalculation wasweighted towards high-consequenceevents.27 The computer model produced a massive compilation of more than one million different combinations ofvariables, many ofwhich were run inhundreds ofiterations. In September2008,anNASreviewcommitteereleasedanextensivecritiqueoftheBattelle/ DHS assessment model. The NAS review group described the DHS model as resulting from a complex federation of integrated computer-based models to estimate the risks associatedwiththeintentionalterroristreleaseofeachof27naturalpathogensandone engineeredagent(multidrugresistantBacillusanthracis).TheBTRArankseachpathogen according to its level of risk, based on subjective event probabilities and their consequences.Thesubjectiveeventprobabilitieswereelicitedfromdozensofbiological weaponsexperts.28 The DHS model claimed that frequency of initiation and ‘‘estimated likelihood of agent use’’ was to be promulgated at least in part ‘‘based on intelligence community input.’’ However, it seems likely that there was little or no information available to the intelligence community of that nature, particularly if there were very few or no terrorist groupsinthefieldactivelyoperatingBWdevelopmentprograms.The‘‘intelligenceinput’’ wastoincludeexpressionofinterest,almostalltheexamplesofwhicharepubliclyknown, and these almost never include reference to particular pathogens. That would turn the modelintoatheoreticalexercisenotbasedonactualintelligence,transformingtheentire exercisefromathreatassessmentintoariskassessment.ItisknownthattheBWprogram oftheformerSovietUnionpriorto1992haddevelopedamultidrug-resistantB.anthracis strain. However, the statement that the model depended on ‘‘subjective event probabilities ...elicited from ...experts’’ again suggests a lack of actual intelligence concerning all twenty-seven agents. Ostensibly in order to compensate for the lack of verifiedintelligenceinput,theNAScommitteeurgedthatthemodelshouldundertaketo evaluate the choices of an ‘‘intelligent,’’ or ‘‘adaptive,’’ adversary. That only drastically compoundsthemodel’sremovalfromrealityandfurtherbiases ittohigh-endestimates, atleastasfarasterroristsareconcerned.Theactualrecordoftheseorganizationsindicates thatnotasingleonehasyetmasteredthemostelementaryaspectsofmicrobiology.(Ricin extraction from a crushed seed pulp is a chemical process that requires no culturing of organisms.) To suggest that for purposes of ‘‘research, development, planning and preparedness’’ the U.S. government should now assume an ‘‘intelligent’’ and ‘‘adaptive’’ 102 MILTONLEITENBERG enemypositscapabilitiesthatnoterroristgroupcurrentlyhasorislikelytohaveforyears to come. The‘‘intelligent’’or ‘‘adaptive’’adversary wastheperpetrator of theAmerithrax events. The preceding discussion provides an introduction to Bracing for Armageddon?, a small,usefulbook forstudentsand thegeneralreader. Thebook isaprimer designed to introduce this subject matter to an uninitiated audience. At 221 pages, its ambition is perforce limited, and it cannot be very detailed. Unfortunately, perhaps as a tactical enticement,Clarkmadethedubiouschoiceofdevotingthefirstsixteenpagestoareplay ofthenotorious2001‘‘DarkWinter’’exercise,whichClarklaternoteswas‘‘intendedtoput a real scare into government policy makers and members of Congress.’’ It is space he cannot afford to waste, and it is difficult for the reader to have any idea exactly why the exercise*based on an extravagantly fictional scenario*was unrealistic until many chapters later. In ensuing chapters Clark recaps the history of bioterrorism and then essentially explains what the ‘‘select agents’’ are*those pathogens selected by the CentersforDiseaseControltobesubjectedtovariouscontrolsbecauseoftheirhistorical salienceasBWagents.Heexplainsanddiscussesgeneticallymodifiedpathogens,natural epidemics, and agroterrorism. These chapters, together with a very useful chapter in the second half of the book concerning pandemic influenza, comprise more than half the book. They provide essentially introductory material before Clark addresses larger policy questions. Themeatofthebookarrivesinitsfinalfiftypages.Inthepenultimatechapter,Clark turnstothebook’ssubtitletoexamine‘‘thepoliticsofbioterrorisminAmerica’’andasks, ‘‘How did we arrive at our current national posture regarding bioterrorism?’’ Answering this question should have been given significantly more pages than the eleven Clark dedicates to it. The answer is provided by a too-brief survey of developments between 1985 and 2001. (Presumably because it is targeted at a general reader, the book also containsonlyashortreferencesection.Ifthebookappearsinasecondedition,itshould expandthesourcesprovidedandcorrectasmallnumberoftechnicalerrors.Forexample, the destruction of the U.S. BW stockpile took place in 1970 and 1971, before the 1972 signature of the BWC, not between signature in 1972 and ratification in 1975.) To explain the situation after 2001, Clark quotes terrorism expert Bruce Hoffman: [Bioterrorism] was where the funding was, and people were sticking their hands in the pot.Itwasthesexiestofalltheterrorismthreatsanditwasbecomingacashcow.Sothe threat of bioterrorism became a kind of self-fulfilling prophecy. It was archetypical Washington politicsin the sensethat yougenerate an issue and it takes on a lifeof its own.29 The depiction is valid, although a bit expressionistic, but much more substantive detail shouldhave been provided,such as the instrumentalrole of VicePresidentDick Cheney, describedbrieflybelow.Clark’sfinalchapter,‘‘AssessingtheThreat,’’examinesthelessons of the Rajneeshshee, Aum Shinrikyo, and Amerithrax events and why these respectively failed or succeeded. He again reviews the specific pathogens usually considered likely candidatesforillegitimateuseandconsiderswhomightcarryoutabioterroristattack.He THESELF-FULFILLING PROPHECYOFBIOTERRORISM 103 compares the potential consequences of such an event to natural disease mortality (specifically HIV/AIDS mortality in the United States). Clark concludes: It’s time ...to refocus our attention*and our resources and creative energies*more specifically toward some of nature’s own threats, rather than depending on spin-offs from our concern about bioterrorism. ...The social and economic disruptions accom- panyingabioterroristattackdonotevenshowupasasinglepixelonthescreenofwhat willhappenwhentheworld’sglaciersaregoneandsealevelshaverisenbytwentyfeet. This even-keeled assessment is a very far cry from that reached in another 2008 book, Bioviolence: Preventing Biological Terror and Crime, which author Barry Kellman of DePaulUniversitysaysisbasedon‘‘therealizationthatnootherproblemfacinghumanity is so potentially cataclysmic and has been so inadequately addressed.’’30 Theintellectualhistoryoftoutingthebioterroristthreatisadubiousone.Itbeganin 1986 with an attack on the validity of the BWC by Douglas Feith, then an assistant to Richard Perle in President Ronald Reagan’s Defense Department and more recently undersecretary of defense for policy until August 2005. Feith introduced the idea that advances in the microbiological sciences and the global diffusion of the relevant technology heighten the threat of BW use. Though advances in molecular genetics and globalization increased drastically by 2008 in comparison to 1986, the number of states that maintain offensive BW programs has not. And despite the global diffusion of knowledge and technology, the threat of terrorist networks creating BW is low. But the invocation of overly alarmist themes continues. In 2005, Tara O’Toole, chief executive officer and director of the Center for Biosecurity at the University of Pittsburgh Medical Center,said,‘‘Thisisnotsciencefiction.TheageofBioterrorisnow.’’31Ithardlycomesasa surprisetolearnthattheofficeofVicePresidentCheneywasthedrivingforcebehindthe Bush administration’s emphasis on bioterrorism.32 But one vital point missed by Clark is thatCheneywasinfluencedby,amongotherthings,theverysame‘‘DarkWinter’’scenario withwhichClarkopenshisbook.TheotherinfluencesonCheneywereaveritablehysteria offearsandphantomsintheWhiteHousefollowingthe9/11andtheAmerithraxattacks, several ofwhich concernedthepotential of terroristuse ofBW and which reportedly led Cheney to believe he might soon become a victim.33 What must be noted is that although Al Qaeda’s interest in BW failed, the group’s efforts were specifically provoked by the severely overheated discussion in the United Statesabouttheimminentdangersofbioterrorism.AmessagefromAymanal-Zawahirito hisdeputyonApril15,1999,notedthat‘‘weonlybecameawareofthem[BW]whenthe enemy drew our attention to them by repeatedly expressing concerns that they can be producedsimplywitheasilyavailablematerials.’’34(Inasimilarvein,terrorismexpertBrian Jenkins of the RAND Corporation has been at pains to point out that, ‘‘We invented nuclear terror.’’)35 If in the coming decades we do see a successful attempt by a terrorist organization to use BW, blame for it can be in large part pinned on the incessant scaremongering about bioterrorism in the United States, which has emphasized and reinforced its desirability to terrorist organizations. In a recent book written by former national security advisers Brent Scowcroft and Zbigniew Brzezinski, Scowcroft refers to the propagation of an ‘‘environment of fear’’ in 104 MILTONLEITENBERG the United States, which Brzezinski adds has made us ‘‘more susceptible to demagogy’’ which ‘‘distorts your sense of reality’’ and ‘‘channels your resources into areas which perhaps are not of first importance.’’ He continues: Wehavesuccumbedtoafearfulparanoiathattheoutsideworldisconspiringthroughits massiveterroristforcestodestroyus.Isthatarealpictureoftheworld,orisitaclassic paranoia that’s become rampant and has been officially abetted? If I fault our high officials foranything,it is forthe deliberatepropagation offear.36 I know of no statistical survey, but warnings regarding the bioterrorist threat have certainly been one of the major components in producing that ‘‘environment of fear.’’ A major contribution to that has been the work of a few, very determined, and very vocal nongovernmental purveyors of the bioterrorism threat, backed by one or two private foundations. The Sloan Foundation has also funded at least fourteen conferences in the United States and overseas; four of these were held by Interpol and three by the DepartmentofHomelandSecurity.37Buildingonthefearemergingfromthe9/11andthe Amerithrax attacks, this movement has generated $57 billion in federal budget authority to date, a large federal bureaucracy, strong congressional advocates, multiple research institutes and journals, and a thriving contractor industry*the same ‘‘stakeholders’’ who now call for the continuation of efforts to fight and prevent bioterrorism. In October 2008, David Koplow, professor of law at Georgetown University Law Center and a former deputy legal counsel in the Department of Defense, wrote: It’sbadenoughwhenanimportantfederalgovernmentprogramdesignedtodealwitha pressing national security threat turns out to be mostly a waste of money; it’s worse whenthatprogramalsoturnsouttodistractpeopleandagenciesfromthemoreserious and fruitful approaches to the problem; it’s worst of all if that program actually contributestomakingtheproblemevenworsethanitotherwisewouldbe.Thecurrent bioterrorismprogram, tragically,accomplishes allthree ofthese. ... [F]artoolittlehasbeendonetoaddressthegenuinebiologicalthreatstoAmericansand to suffering people around the world*the quotidian scourges of AIDS, tuberculosis, malaria, measles, and cholera*that not just ‘‘threaten’’ us in the abstract, but that actuallykillandincapacitatemillionsofpeopleannually.Themostpressingpublichealth threattoournationalwell-beingmightbetheannualsurgeofordinaryinfluenza,butit hasnotbenefitedfromthesamesortofpoliticalanguish,emergencyfunding,andpublic attention that the national security entrepreneurs have discovered in the ever-looming fearof internationalbioterrorism.... Bioterrorismisaserious,importantdanger,onethatdeservesserious,focusedattention. But empowering a bioterrorism-industrial complex, and fostering a needless climate of fear, paranoia, and helplessness cannot lead to fashioning reliable, long-term solutions. Rational policy requires a genuine, level-headed risk assessment, and a sustained, balancedapproach, notaknee-jerk public relations drama.38 Thatsamemonth,aWorldHealthOrganizationreportnotedthat,‘‘Disproportionate investment ina limited numberof disease programmes considered as global priorities in