The main defenders and responders against bio-weapons would not be soldiers, para military and police personnel, but lab scientists, public health workers, health care providers and doctors

by Prashant K Singh

Bill Gates stated at the Munich Security Conference last year that “the next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus or a super contagious and deadly strain of the flu”. It created anxiety as it had underscored reality.

Throughout history, humans have used germs and biology as weapons. In the 5th century BC, Assyrians poisoned enemy wells with rye ergot, a fungus containing mycotoxins; in 1797, during the Siege of Mantua, Napoleon flooded fields to promote malaria; in 2001, US Senate offices and media outlets received Anthrax contaminated letters, to quote only a few examples.

While we respond to visible terrorist attacks through military, diplomatic and other means, our adversaries, bereft of any moral scruples, will exercise more unconventional options to hurt us. One of them is bio-terrorism — use of biological agents as weapons of terror.

It is a subject about which our attitude has bordered on being passive and indifferent. We treat bio-weapons attack as a rare unlikely event. But it will be one with extreme consequences, characteristics of a Black Swan event. This should be reason enough to prepare for such attacks.

Natural epidemics have wiped out large swathes of humanity. The great influenza or Spanish flu virus killed up to 100 million people in 1918. Not long ago, the 1994 plague in Surat claimed 52 lives. The widespread fear spread by Bird flu, Ebola and Nipah is all too familiar.

Therefore, a bio-weapon is a dream instrument for a desperate terrorist: release a synthetic or natural pathogen in the environment, and nature will do the rest.

It can be against humans, crops or livestock. It is low-cost, invisible, inflicts mass casualties and instils terror among the targeted population. It achieves its objectives just as conventional terrorism does, by extracting a heavy social, economic and psychological toll.

Unfortunately, a bio-weapon attack is no longer an academic or a fictional scenario, as Gates reminded us. It is realistic, owing to rapid changes in molecular biology.

Today, gene editing with CRISPR can devise synthetic viruses and modify existing ones.

DNA-synthesis firms regularly supply bases and specific pieces of DNA, on payment to researchers — a single base pair, on an average, costs around 30 cents.

A rogue element can buy a made-to-order DNA sequence, which poses a security threat, without great difficulty. Despite technological advancements, biotech companies cannot identify a DNA sequence as a potential threat due to the huge and unreliable DNA database.

Only artificial intelligence (AI) in the future offers hope for recognising potentially destructive DNA sequences, before bio-technicians stitch them.

Simply put, weaponising a pathogen is far easier, cheaper and effective than assembling an improvised nuclear device.

On the other hand, preparedness against such an attack is difficult, costly and complex.

After the attacker releases a dangerous biological agent, never diagnosed before and treated, the epidemic may not unfold over weeks or months, but lead to a sudden surge of patients.

The unknown incubation period may make it further difficult to estimate the vulnerable population exposed to it. If the numbers are large, quarantining an entire town or city is almost impossible. Moreover, it would be difficult to identify, whether a gene-edited virus or a natural one caused the epidemic, delaying the treatment as standard therapies turn ineffective.

In fact, WHO in its 2018 review, included Disease X, “representing a serious international epidemic caused by a pathogen currently unknown to cause human disease”.

Responding to a bio-terrorist attack may entail role reversals of frontline and support personnel in the traditional security architecture. The main defenders and responders against bio-weapons would not be soldiers, para military and police personnel, but lab scientists, public health workers, health care providers and doctors.

Microscope and prophylactics, not rifle and bullets, would be the weapon of defence. And our public health infrastructure, not the traditional security apparatus alone, would decide our response, resilience and recovery.

Author is director, coordination and strategy, Public Health Foundation of India