- The Washington Times - Thursday, December 12, 2002

President Bush is expected to make his long-awaited decision on smallpox vaccinations soon. While we certainly hope that he will decide to release the vaccine to the public, even if he does so, it will not be sufficient to defend all Americans.

Those Americans whose immune systems have been compromised (for instance, due to an HIV infection) will not be able to risk the vaccine. Other healthy individuals may not choose to take the chance on a vaccine that could have lethal side effects.

Another alternative is clearly needed, and antivirals seem to offer some promise. Researchers have been attempting to develop a smallpox antiviral for some time, but, as Dr. Scott Gottleib recently pointed out in an op-ed in this newspaper, few public-health officials have taken the idea seriously.

In fact, of the $16.7 billion in grants the National Institutes of Health handed out last year, only a tiny percent of the money was specifically designated for research on smallpox antivirals.

Not that those grants haven't helped. Last March, scientists announced that they had developed an orally administered antiviral that showed some promise in lab tests. Thanks to government funding, the drug has moved into pre-clinical trials. Another possibility, specially designed antibodies against the virus, is being developed by Harvard scientists.

Still, as Dr. Gottleib noted, more public help is necessary, since the private sector hasn't seen that much market potential in smallpox antivirals, and public officials simply haven't seen that much of a need for them.

That must change, even at the price of adding to the budget deficit. In the short term, development of a reasonably safe, easy-to-administer smallpox antiviral would give Americans, particularly those with compromised immune systems, another layer of protection. In the event of a smallpox attack, the antiviral would provide a probably life-saving measure of protection in those for whom the short window of vaccination has closed, and a measure of comfort to those unsure if they have been exposed. Even those already vaccinated against smallpox could take the vaccine safely. In the long term, development of a smallpox antiviral is almost critical, since it would not be difficult for potential terrorists to engineer a version of the smallpox virus able to beat the only existing vaccine.

In its quest to provide smallpox protection to Americans, the administration must not fail to provide the support necessary to develop a smallpox antiviral.

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