New biological weapons: Science fiction or moral imperative?

It was one of those chance meetings. Stockholm was hosting the 1991 International Surgical Week. I just finished my fresh-from-the-field presentation about ICRC war surgery and the little-known subject of anti-personnel mine injuries. A distinguished grey-haired gentleman walked up to me. I recognized his name; formerly a military surgeon, he was the senior defence scientist from a Nordic country.

We chatted about different bullets and the wounds they cause. He seemed in no hurry to move on. "What do you know about new biological weapons?" This took me by surprise; old biological weapons were not my strong point. "Advances in biotechnology will enable people to attack specific genetic traits such as black skin - or blue eyes - or even different ethnic groups," he said. This, I was sure, was pure science fiction. "And what's more," he continued, "only the Red Cross can do anything about it!" I smiled politely and pocketed his business card.

My return to the ICRC hospital on the Thai-Cambodian border took me through Geneva. With this conversation in mind, I asked who was responsible for ICRC's concerns about the effects of weapons. "Consult the lawyers," said my medical colleagues. "Genetic weapons - what are they?" the lawyer asked. "I don't really know," I replied, "but I've been told that we should do something about them." I explained what little I knew. "Oh, you mean it's a biological weapon?" His face lit up with understanding. "That's OK then; they would be prohibited by the Biological Weapons Convention." He was a busy man.
Science Fiction?
It was clear that the ICRC did not have the expertise to "do anything about" genetic or ethnic weapons - if such things existed. So, for seven years I have been asking different experts in the domains of molecular biology, genetic engineering and biological weapons the question: "Is it or will it soon be possible to target genetic or ethnic aspects of humans with biological agents." I naively stumbled into a complex maze of political, military, legal, scientific and commercial interests.

For every five experts I asked, four thought there was reasonable cause for concern. Their comments included: "My government is very worried; I can say no more," or "If it's not possible now, it will be soon," or "Yes, but this technology will provide huge medical advances - and the commercial stakes are enormous."

Behind these answers were the different and terrifying technical possibilities. Rendering the males of a particular population sterile was one example. Another was a virus that could spread like influenza but only among a certain ethnic group and which produced a toxin of the designer's choice. There was no doubt that advances in the biosciences would dramatically increase the threat of biological warfare or terrorism. The major question was whether such engineered bacteria, viruses or toxins could target differences in the genetic make-up of specific groups of humans. At one conference, a molecular biologist and myself were covering a paper tablecloth with notes and diagrams in an attempt to work out the necessary technical steps. We found that only one such step was not possible at present. (The table cloth has been burnt.) The remainder of the experts were "absolutely convinced" that the creation of such weapons would never be possible and believed even asking the question was irresponsible. Dilemma! If it is not possible, we should definitely not ring an alarm bell. If it is possible, we should sound it. The problem is we don't know! Even so, whether creating such a weapon is possible or not, we must nevertheless consider the responsibility that goes with saying that it is not possible.

In 1996, a symposium, the Medical Professional and the Effects of Weapons, was organized by the ICRC. The objective was to examine the responsibilities of doctors beyond treating the wounded person. As new biological weapons and medical science are subjects with obvious overlap, serious concerns for the medical profession were raised.

The British Medical Association followed up the issues raised during the symposium and made a study which started with the question: Will advances in biotechnology, genetic engineering and specific knowledge of the human genetic make-up permit the production of biological weapons which can target specific genetic characters or ethnic groups? The report, Biotechnology, Weapons and Humanity, published in January 1999, answers this question with a guarded "yes". It concludes that the medical profession has a responsibility to address this issue; the Biological Weapons Convention must be strengthened and supported; a strong and effective protocol to verify that states are abiding by the convention must be adopted; controls must be put in place within the medical and scientific communities to ensure that the know-how resulting from these remarkable scientific advances remains in the hands of responsible people.

The assertion of my Nordic colleague that "only the Red Cross can do something about it" seems unfounded. Or is it? How successful have governments and the scientific community been in avoiding the hostile use of technology which was developed and designed to improve the lives of human beings? The answer is "Not very!" Every major scientific or technical advance from chemistry to electronics to aviation to nuclear physics has been used in some way for hostile purposes. The next major scientific advance will be in the field of biotechnology and genetic engineering and it is already being looked at with hostile purpose in mind. The equilibrium that man has always held with microbes soon could be profoundly disturbed.

Moral imperative
In 1918, in response to the use of poison gas in World War I, the ICRC protested in a public statement against "une innovation barbare que la science tend à perfectionner." In response to the use of nuclear weapons in World War II, the president of the ICRC stated, "Their inevitable consequence is extermination, pure and simple." But must the weapon be used before morality is voiced? When blinding lasers were prohibited in July 1998, the president of the ICRC, Cornelio Sommaruga, referred to similar challenges that would face us in the next millennium: "New technologies for inflicting human injury are around the corner and the full range of their effects are unknown. International humanitarian law has an essential role to play in sparing humanity the worst consequences of its technical capabilities."

In relation to new biological weapons, the Red Cross and Red Crescent Movement can help make emergency plans for unexpected and bizarre epidemics. But in terms of preventing the intentional precipitation of such epidemics, are we not dealing here with something that surpasses states and international laws? Who is going to say: "Now we humans have gone too far; we do not have the collective wisdom to have this in our hands"?

Given the speed with which this branch of science is developing why don't we open the moral debate now? Let's engage not only scientific leaders and politicians but also military, moral and religious leaders as well. "Only the Red Cross can do something about it!" Maybe so! Maybe only the Red Cross and Red Crescent Movement has the moral force to make politicians and scientists learn the lessons drawn from the most awful chapters of human history.