U.S. exit from WHO: Potential impacts for smallpox virus biosafety
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The variola virus caused smallpox, an often deadly and disfiguring disease, for thousands of years until its global eradication, coordinated by the World Health Organization and formally announced in 1980. No reports of smallpox disease have occurred anywhere in the world since its eradication.
Since 1980, the variola virus has been kept in only two laboratories in the world, as authorized by WHO. One location is the U.S Centers for Disease Control and Prevention in Atlanta, Georgia. The other is a Russian facility, the State Research Centre of Virology and Biotechnology, also known as VECTOR, in Koltsovo, which is in the Novosibirsk Oblast region of Siberia.
Soon after taking office on Jan. 20, President Trump issued an executive order beginning the process to withdraw the U.S. from WHO. Although complete withdrawal from WHO is a one-year process, an initial directive has already been made to curtail communications between CDC staff and WHO officials.
Virus storage, lab inspections, reporting and other possible implications
As a result of the U.S. withdrawal, unprecedented and dangerous changes could occur relating to smallpox virus storage, experiments, reporting and inspections at CDC’s laboratory in Atlanta or any possible future new U.S. locations.
At this time, it is difficult to anticipate how the Russian Federation, other nations (such as China, North Korea, Iran and others), WHO or the United Nations would react to any potential changes in the way U.S. handles its smallpox virus repository.
In accordance with a 2007 resolution of the World Health Assembly, inspections of these two laboratories in the U.S. and the Russian Federation that contain smallpox virus are required every two years by the WHO Biosafety and Biosecurity Inspection Team.
WHO’s website has a chronological listing of “Variola virus repository safety inspections” since 2009. The site provides the most recent official report by WHO’s inspection team of the “Variola Virus Maximum Containment Laboratories to the Centers for Disease Control and Prevention (CDC)” that occurred May 2-6 in 2022. WHO’s site also provides the report of this same WHO team from its inspection of VECTOR, which occurred Oct. 2-7 in 2023.
The next scheduled inspection by the WHO team of the CDC laboratories is not stated; however, if the U.S. government does not allow the inspection to occur in the normal manner or timeframe, the international community and WHO will likely have grave concerns.
To emphasize the potential danger for smallpox virus management created by the U.S. withdrawal from WHO, it could be a wise precautionary action for the WHO Executive Board, which meets Feb. 3-11, to share its perspective, legal and otherwise, on the next scheduled WHO inspection at the CDC laboratories storing the smallpox virus.
Previous WHO involvement in the U.S.
An incident in July 2014 illustrates the crucial importance of WHO being directly involved with smallpox virus in the U.S.
Officials at the campus of the National Institutes of Health in Bethesda, Maryland, found six vials labelled as containing smallpox virus. The vials were found as officials began initiating a transfer of old laboratory samples — which did not ultimately occur — to a new laboratory location operated by Food and Drug Administration researchers. Even after many years, these six vials were found to contain live, replication-competent variola virus.
Subsequently, the official FDA report on the incident noted that the vials, following their discovery, had been transferred to CDC and “were destroyed by CDC under WHO observation.”
With the U.S. exit from WHO, would such in-person involvement by WHO occur today if additional smallpox virus was found outside of the only WHO-authorized U.S. location at CDC in Atlanta? If not, what would be the repercussions around the world? Most likely quite serious.
Public discussion by WHO leadership of the dangerous implications of the U.S. withdrawal from WHO for smallpox virus biosafety and biosecurity is warranted.
Take action: The United Nations Foundation has developed an action alert constituents in the U.S. can use to urge their members of Congress to support U.S. participation in WHO.
Photo: A statue outside the headquarters of the World Health Organization in Geneva, Switzerland, commemorates the 30th anniversary of the eradication of smallpox in 2010. (Credit: Thorkild Tylleskar / CC BY-SA 3.0)
