February 20, 2024

Smallpox Remains a Threat Despite Eradication 40 Years Ago

Contact:   Steve Aaron
SRA Communications
(717) 554-8614 


Bipartisan Commission on Biodefense shares specific recommendations to reduce risk and prepare for outbreak response even as Alaska reports death from virus closely related to smallpox and mpox outbreaks continue

WASHINGTON, D.C. (Feb. 20, 2024) – Despite the global eradication of smallpox more than 40 years ago, the Bipartisan Commission on Biodefense reports smallpox and other orthopoxviruses remain a significant threat to public health and today released a new plan with nine actionable recommendations for the Administration and Congress to significantly mitigate the biological risk to our Nation and the world.

Just this month, epidemiologists at the Alaska Department of Health reported the first known fatal case of Alaskapox, a novel orthopoxvirus first identified in 2015. Box the Pox: Reducing the Risk of Smallpox and Other Orthopoxviruses (click the title to view the report) details how Alaskapox, smallpox, and other orthopoxviruses pose significant risks due to their potential for weaponization, accidental release, and vulnerability of populations who stopped routinely vaccinating against smallpox in the 1970s.

“With a mortality rate of thirty percent, the traditional global strategy of reacting to biological events after they begin is not viable for a disease like smallpox. The impact of a third of the population perishing within two to three weeks would be catastrophic for society, national security, and the global economy,” said former U.S. Senate Majority Leader, Commissioner Tom Daschle. “There is no benefit in waiting and every reason to act now. By implementing the nine recommendations in our new plan, we can ensure the continued elimination of smallpox and address the threat of diseases caused by orthopoxviruses preemptively.”

Experts who have spoken with the Commission worry that the current contents of the U.S. Strategic National Stockpile to combat smallpox are depleted or expired, with not nearly enough vaccine, antivirals, and other medical countermeasures to deal with the consequences of an attack with this disease.

“Should a smallpox attack occur, we would need to immunize within 7 days for the vaccines to be effective,” said former Michigan Congressman and former Chairman of the House of Representatives Committee on Energy and Commerce, Commissioner Fred Upton. “There wouldn’t be enough time to manufacture, procure, distribute, and deliver enough smallpox vaccines, antivirals, and diagnostic tests to protect our Nation or prevent the disease from spreading. This Commission urges the Administration and Congress to reassess the contents of the Stockpile and ensure that they are commensurate with today’s threats.”

Additionally, the Commission’s plan details why the Intelligence Community (IC) must reinvigorate its efforts to produce biological intelligence. Over the years since the United States ceased its own biological weapons program, the IC reduced its emphasis on the biological weapons threat. Today, however, the threat has never been greater. The growth of synthetic biology also means that even non-state actors could have the capacity to produce smallpox. The Commission recommends that the Central Intelligence Agency identify activities occurring in foreign laboratories involved in biological weapons research and determine the physical disposition of previously weaponized smallpox produced by the Former Soviet Union, among other intelligence actions. The Commission also recommends that the Department of Defense makes sure U.S. and allied military forces can fight and win in areas biologically contaminated with smallpox. This is no time to depend on old personal protective equipment and filters that wear out in days or weeks.

Those interested in learning more can download and read the full report here.

Five Fast Facts

  • Smallpox is highly infectious, with an average incubation period of 10-14 days, and 20 days contagious once symptoms begin.
  • After a few days of high fever, aches, and nausea, those infected will develop a rash that spreads all over their bodies within 24 hours.
  • The United States stopped routine smallpox vaccination in 1972 after eradicating the disease within its borders.
  • The World Health Organization declared smallpox eradicated in 1980.
  • The Former Soviet Union and other countries previously weaponized smallpox.

About the Bipartisan Commission on Biodefense

The Bipartisan Commission on Biodefense was established in 2014 to conduct a comprehensive assessment of the state of U.S. biodefense efforts, and to issue recommendations to foster change. The Commission’s 2015 report, National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts, identified capability gaps and recommended changes to U.S. policy and law to strengthen national biodefense while optimizing resource investments. Subsequent Commission publications have addressed critical needs for an Apollo Program for Biodefense, risk reduction, biodetection, agrodefense, budget reform, diagnostics, critical infrastructure, and state, local, tribal and territorial response capabilities. In September 2018 and in October 2022, the White House released the National Biodefense Strategy, and in January 2023, OMB released a biodefense budget crosscut, top recommendations from the Blueprint. In September 2021 the White House released the American Pandemic Preparedness Plan, taking up recommendations from the Commission’s Apollo Program and Athena Agenda reports. The Commission continues to address biodefense challenges and to urge reform. Former Senator Joe Lieberman and Governor Tom Ridge co-chair the Commission. Hudson Institute is the Commission’s fiscal sponsor.