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FPRI REPORTS: ANTHRAX 2000

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ANTHRAX VACCINATION AND THE DEEPER PROBLEMS OF LEADERSHIP By Andrew Bacevich

March 10, 2000

Andrew J. Bacevich directs the Center for International Relations at Boston University. This essay is adapted from a longer article appearing in the Spring 2000 issue of Orbis, the quarterly journal of the Foreign Policy Research Institute.

ANTHRAX VACCINATION AND THE DEEPER PROBLEMS OF LEADERSHIP

By Andrew Bacevich

For several years now, the Clinton administration has warned of the specter of biological terrorism stalking the United States. As Secretary of Defense William S. Cohen wrote in an op-ed portraying the horror that could ensue: "Hospitals would become warehouses for the dead and dying. A plague more monstrous than anything we have experienced could spread with all the irrevocability of ink on tissue paper." The question confronting the United States, Cohen insists, is not if such an incident will occur, but when.

As a result of such fears, the administration has made biological defense a top priority. Testifying to that priority, in December 1997 Secretary Cohen announced the mandatory vaccination against anthrax of more than two million U.S. military personnel. But growing controversy surrounding that program is exposing the larger flaws in U.S. preparations for biological war.

OPPOSITION IN THE RANKS Much to the chagrin of top civilian and military leaders, the vaccination program has prompted vocal opposition -- not from antiwar activists or conspiracy theorists, but from members of the armed forces. Steadily increasing numbers of service personnel -- now totaling more than 300 -- have refused to be inoculated. Some have even left the military to avoid taking the shots. The vaccination policy's most impassioned critics are pilots, many of them seasoned officers and combat veterans. Hence, they are not easily dismissed as naive, misinformed, or easily manipulated. These critics insist that the anthrax vaccine is unsafe and endangers their health. Already short of pilots, the services can ill-afford to lose more. Yet suspending the vaccinations in the face of protests from the ranks could prove difficult and costly.

First, Pentagon leaders understandably worry that such a retreat may undermine the integrity of the chain of command, setting a precedent to challenge other onerous or unpopular orders.

Second, Defense Department officials have made "force protection" a high priority, terminating the careers of officers deemed insufficiently attentive to protecting the soldiers under their command. Anthrax vaccinations are the paramount expression of this priority. Defending the program, Secretary Cohen has told his troops, "I would be derelict in my duties sending you out in an environment in which you weren't properly protected."

Third, the vaccination program serves as the public expression of the administration's overall bio-defense policy. Abandoning it would call the entire policy into question.

Not surprisingly, therefore, the Department of Defense has tenaciously defended its anthrax policy and rejects criticism of the vaccine as just wrong. "It's safe and reliable," Pentagon spokesman Kenneth Bacon flatly states. The vaccine is also essential, Pentagon officials assert, because at least ten nations possess or are developing biological weapons, and anthrax is "the weapon of choice for germ warfare." Senior defense officials counter reports of debilitating side effects to anthrax vaccine by insisting that adverse reactions are occurring at a lower rate than with mumps or measles vaccines. As if to prove the point, civilian and military leaders alike, beginning with Secretary Cohen and the joint chiefs, have rolled up their sleeves and been vaccinated. But such attempts, rather than quelling criticism, have only seemed to confirm the suspicion that the anthrax vaccination program is as much about public relations as about military prophylaxis.

BROADER CONCERNS Skeptics of the program have raised a plethora of concerns ranging far beyond safety. Those revelations suggest a program plagued by mismanagement, reeking of impropriety, and based on a defective strategy. At this point, even if the Pentagon were to sustain its claims that the vaccine has no malign effects, more than sufficient cause exists to indict the administration's biological warfare policy.

The broad critique of the administration's biological warfare program consists of four major points.

First, the Defense Department has entrusted the manufacture of anthrax vaccine to a single firm. Serious doubts exist regarding the ability of this firm to produce a vaccine that meets established standards of purity and potency. Efforts by the Defense Department to ease those doubts have been less than persuasive. The company in question is the BioPort Corporation of Lansing, Michigan, a start-up firm that bought the assets of the previous manufacturer -- which went out of business after repeatedly failing FDA inspections. Despite winning the DOD contract to supply the vaccine in late 1998 and despite generous Defense Department subsidies, BioPort -- relying on the same work force and same plant management as its predecessor -- has not yet achieved the FDA certification to produce anthrax vaccine. Second, government officials, including qualified medical professionals, have themselves questioned the efficacy of the vaccine, which was developed decades ago not for combat but to protect tannery workers at risk from handling the hides of anthrax-infected animals. According to a 1995 report by the chief of the Bacteriology Division at U.S. Army Medical Research Institute, there exists "insufficient data to demonstrate protection against inhalational disease" -- the type that soldiers are most likely to encounter. The Pentagon, eager to allay fears, promised an external review of the vaccination program by an "expert panel." But the "panel" was in fact a single individual who was, of all things, a professor of obstetrics and gynecology. By his own admission, he had no expertise in anthrax and refused to testify before a congressional subcommittee regarding his evaluation of the program.

Third, immunizing U.S. forces in the field against one single strain of anthrax is woefully inadequate protection against any real biological threat. According to the administration's own analysis, toxins other than anthrax pose at least as great a danger -- as does a genetically modified anthrax. Furthermore, a biological attack against the United States would likely target civilians, not soldiers, and cities, not military installations. The implication that inoculating troops at Camp LeJeune will deter an anthrax-equipped terrorist is absurd.

Fourth, the current biological defense policy perpetuates the peculiarly American delusion that for every security problem there exists a technological fix. Erecting a barrier that relies on outdated means and leaves its flanks exposed, the anthrax vaccination policy is a bio-war Maginot Line.

A WAY OUT What is needed is an approach that avoids scare-mongering rhetoric and focuses the attention of senior leaders where it belongs -- on strategy rather than problem-solving. That approach would include several points.

First, policymakers can extricate themselves from the present ill-considered policy without having to admit openly its flaws. BioPort's obvious failures provide sufficient basis to suspend the anthrax vaccination program pending the identification of a reliable supplier of high-quality vaccine -- a process likely to take three years.

Second, as an interim defense against anthrax, the Defense Department should revert from prophylaxis to treatment. Administering antibiotics and vaccine to those exposed to the virus was, in fact, how the Pentagon intended to treat soldiers had U.S. forces encountered anthrax during the Persian Gulf War.

Third, the president and secretary of defense should restate unambiguously the intention of the United States to retaliate massively in response to any biological attack against Americans. As was the case with the nuclear threat during the Cold War, there is no substitute for a credible promise of swift and potent punishment.

Yet all of that is, in a sense, the easier part of the problem. The larger challenge is to restore to U.S. national security policy a sense of proportion. Obsessing over operational and tactical details -- like anthrax -- as a pretext for permitting leaders to dodge fundamental strategic issues has become unacceptable. Chief among those issues is the dominance of the international order by a highly ideological nation dedicated not simply to its own defense, but to the universal adoption of the values that it espouses.

Progress toward realizing this vision -- a world that is peaceful, democratic, and respectful of human rights and free enterprise, with the United States presiding as ultimate arbitrator -- has been at best uneven. But with the success of this project having become a predicate of national security, opposition in any form is construed as a "threat." As a result, the nation -- although by any measure at the height of its power and influence -- is (to judge by administration rhetoric) beset by growing danger, not just from terrorists, but also rogue states, paranoid dictators, and anarchic hackers.

At the heart of the problem lies policymakers' certainty as to their own good will and the universality of American values. Opposition to the further spread of American power, ideals, culture, and lifestyle is -- by definition -- perverse or irrational. This outlook guarantees a never- ending supply of enemies to confront. One need only consider the frequency with which the Clinton administration has found itself obliged to employ U.S. military forces to warn, coerce, punish, and occupy.

Fixating on the prospect of biological calamity, American leaders avert their eyes from a larger, disconcerting truth: the global transformation to which the United States has committed itself is not inspiring spontaneous compliance. As a result, there is no end in sight to the exertions that will be necessary if Americans are to realize their vision for the world. Are the aspirations implied by that vision feasible? What will it cost to fulfill them? How much are Americans, citizens as well as soldiers, willing to pay? However commendable their concern for protecting U.S. forces, addressing these larger questions forthrightly describes the duty that American policymakers dare not neglect.

RECENT FPRI BULLETINS Rethinking Bio-Chemical Dangers, Henry Sokolski The Feminization of the American Military, Walter A. McDougall National Missile Defense: Why Now?, Keith Payne

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