Japan needs to be better prepared with vaccines

The Asahi Shimbun, Tokyo

Smallpox vaccinations are being resumed in the United States, 30 years after such routine immunizations were stopped.

President George W. Bush has ordered inoculations for about a half-million U.S. soldiers in high-risk regions, including troops who will be sent to the Middle East, as a precaution against biological terrorism. The vaccine will also be offered on a voluntary basis for people considered most likely to encounter smallpox carriers, such as medical care workers and emergency workers, including police and firefighters. The vaccine will eventually be available to all Americans who want it. Bush himself received a shot, as he said he would when he ordered vaccinations for the military, in consideration of the risk of side effects.

The World Health Organization (WTO) declared the elimination of smallpox in 1980. But Bush decided to resume broad vaccinations because some nations hostile to the United States may have the smallpox virus.

When it declared that smallpox had been eradicated, the WTO ordered that samples of the virus be sealed at certain research facilities in the United States and the former Soviet Union to guard against contagion. But U.S. officials now suspect that some countries, including Iraq, might have obtained the virus and developed smallpox-based biological weapons.

Smallpox is regarded as one of the most devastating infectious diseases because of its high mortality rate and its highly contagious nature. There are no proven antiviral agents known to be effective treatments for smallpox.

If Iraq really has smallpox virus, as suspected, it is not only a gross violation of United Nations resolutions on its disarmament and a treaty on prohibition of biological weapons, but is also an unpardonable act from a humanitarian standpoint. We hope that the U.N. weapons inspectors now working in Iraq will clarify the suspicions through their inspection efforts.

Biological weapons are generally easy to transport. There is genuine concern that Iraq could unleash the smallpox virus in the United States through a terrorist group if attack seems near. Once the virus is released in a now very vulnerable and highly mobile population, smallpox could rapidly spread worldwide.

The fact that we must once again be on guard against a disease once wiped out is grim testimony to human stupidity. But reality, as seen in indiscriminate terrorism practically everywhere, demands effective measures to counter biological attacks that involve smallpox.

Despite the potential serious threat, Japan's preparedness for a smallpox outbreak is woefully inadequate. The United States already stockpiles enough vaccine for its entire population, but Japan has doses for 2.5 million, and these were obtained through an emergency appropriation included in the supplementary budget for fiscal year 2001.

The Ministry of Health, Labor and Welfare plans to spend 3.5 billion yen for 7.5 million doses-for 10 million vaccinations in all. This may seem adequate, but since control of an outbreak within one area requires that 2 million people be inoculated, 10 million vaccinations would cover just five areas.

The government must also consider how to safeguard Japanese who travel or live abroad. Experts say the smallpox vaccine is also effective even several days after exposure.

So the government should make smallpox vaccine available at Japanese diplomatic missions in major cities abroad. The Foreign Ministry has said it will bring Japanese home from a country where there is an outbreak. But hauling all the Japanese out of one area back to Japan could take too long to ensure the safety of everyone.

Only some Asian countries can produce smallpox vaccine. Tourist volume is huge among Japan and neighboring nations. It is thus important to consider how the vaccine could be provided for other countries in Asia.

Effective global measures to deal with potential smallpox outbreaks anywhere would remove the threat posed by one of the most devastating biological weapons. International effort toward such measures is urgently needed.