Parliamentary Assembly
Assemblée
parlementaire

Bio-terrorism: a serious threat for citizens’ health

Doc. 10067
9 February 2004

Report
Social, Health and Family Affairs Committee
Rapporteur: Mr Denis Jacquat, France, non registered

For debate in the Standing Committee — see Rule 15 of the Rules of Procedure


Summary

The threat of large-scale terrorism against the public is not in the realms of the unthinkable. The risk of bio-terrorism, i.e. chemical, biological or nuclear terrorism, is not restricted to science fiction. For some, the likelihood that such weapons will be used appears to be rising, due to an increase in inter-ethnic and religiously inspired violence and a decline in prohibitions based on humanitarian values. For others, the probability remains low but the consequences would be such that it would be unwise not to prepare for it. Therefore, we must prepare for the worst; but it is important not to lapse into hysteria and a terrorism psychosis.

The Parliamentary Assembly therefore invites states to take a number of measures relating to public health.

Moreover, the nature of the potential risks and the need for effective public protection makes it necessary to rise above national interests; the Assembly therefore calls for strengthened co-operation particularly at European level. The creation of a two-speed Europe in the area of public health and safety must be refused.

I.         Draft resolution [[Link to the adopted text]

1.         Since 11 September the threat of large-scale terrorism against the public is no longer in the realms of the unthinkable.  Some believe that the risk of nuclear, biological or chemical attack by a terrorist organisation is imminent; for others the probability remains low. However, everyone agrees that such an eventuality would have disastrous consequences for populations and wonders as to the ability of most states to cope with them.

2.         In a globalised and economically interdependent world, the recent SARS epidemic originating from China gave a particularly clear illustration of the difficulties and challenges faced by states in the event of the spread of an infectious disease as well as the devastating economic impact this could have.  The SARS threat helped to increase awareness of what bio-terrorism could mean for the public.

3.         The Parliamentary Assembly believes therefore that, given the possible consequences of the bio-terrorist threat to the public, it would be unwise to underestimate it; states should prepare for the worst.

4.         The Assembly reiterates that there can be no justification for terrorism.  The international community, without exception, must rally to the common aim of combating this scourge which is global. International co-operation must be pursued unremittingly if political decision-makers are not to stand accused of an irresponsible attitude towards the populations to whom they are accountable.

5.         The nature of the potential risks and the need for effective public protection make it necessary to rise above national interests and call for strengthened co-operation particularly at European level. The creation of a two-speed Europe in the area of public health and safety must be refused.  However, public safety has a high cost which presupposes, at national and European level, budgetary priorities and financial solidarity between states.

6.         The Assembly invites the member states to:

i.          inform and educate the public as regards the inherent dangers of bio-terrorism;

ii.         draw up an objective assessment of the potential sources of bio-terrorist danger and an inventory of dangerous and sensitive sites in view of securing them and of acquiring efficient and effective surveillance and warning systems;

iii.        devise emergency intervention and public health relief plans in case of bio-terrorist attack and to test them on a regular basis; 

iv.         provide the professionals required to work in intervention teams with training in the special characteristics of the bio-terrorist threat, particularly healthcare staff;

v.          introduce or step up teaching concerning transmissible, infectious native and tropical diseases in medical studies;

vi.         frame a suitable public vaccination policy, to compile adequate stocks of vaccines and to consider the necessity of vaccinating animals;

vii.        introduce strict procedures for controlling the purchase and movement of dangerous substances.

7.         The Assembly welcomes in particular the recent setting up by the European Union of the European Centre for Disease Prevention and Control, which should be operational by 2005, and wishes further measures to strengthen European solidarity.

8.         Finally, it invites member states to accede to the existing international instruments aimed at combating terrorism, to reinforce them through appropriate supervision procedures and to establish binding instruments protecting against potential threats that are not well or not at all covered.

II.         Explanatory memorandum by Mr Jacquat

Introduction

1.         The committee had referred to it a motion for a resolution on joint development of public health measures against bio-terrorism in Europe (doc. 9356) tabled by Mrs Gatterer (Austria, EPP) who was appointed rapporteur. A second motion on biological safety (doc. 9346) presented by Mr Grachev (Russia, EPP) was also referred to the committee. Mrs Gatterer is no longer a member of the Austrian delegation to the Parliamentary Assembly and Mr Jacquat (France, EDG) took over from her as rapporteur.

2.         In connection with the preparation of the report, at a meeting held in Paris in November 2001, the Social, Health and Family Affairs Committee held an exchange of views with Mr Bernard Kouchner, French Health Minister, representatives of the World Health Organisation (WHO), and Dr Mike Ryan and Dr Timothy Meredith. In November 2002 the committee heard two Austrian experts, Commander Anton Eischer and Dr Peter Grohr of the Médecins sans frontières organisation, and in September 2003 in Paris, Mr Lepick, expert with the French foundation for strategic research, and Mr Dumont, coordinator for bio-terrorism risks at the French Ministry of Health, Institute of safety and nuclear protection.

Bio-terrorism: hypothetical risk or real threat?

3.         Since 11 September 2001, the threat of large-scale terrorism against the public is no longer in the realms of the unthinkable. The risk of bio-terrorism, ie chemical, biological or nuclear terrorism, is no longer restricted to science fiction. For some, the likelihood that such weapons will be used appears to be rising, due to an increase in inter-ethnic and religiously inspired violence and a decline in prohibitions based on humanitarian values. It is important not to lapse into hysteria and a terrorism psychosis; equally, however, we must be vigilant.

4.         What is meant by the term “bio-terrorism”? It refers to chemical, nuclear or biological terrorism. Biological terrorism in particular is not new. Endless examples are being cited by the majority of newspapers and publications.

5.         Without going too far back, we can mention the contamination of Native Americans by English troops in the 18th century, via smallpox-infected blankets. A more recent example is the release of sarin gas in the Tokyo underground in 1995 by the Japanese group Aum Shinrikyo, which also possessed anthrax and botulism cultures and drones equipped with spraying devices, and had attempted to obtain samples of the Ebola virus.

6.       In 1997, in the United States, the Rajneeshee sect contaminated salad bars in Oregon with a salmonella culture. In November 2001, two atomic engineers were arrested in Pakistan; they had set up an NGO in Kabul on premises where construction plans for sounding balloons, intended for releasing anthrax spores, were later found. Even more recently, in January 2003, police in Great Britain seized ricin samples.

7.         Bio-terrorism can also target agriculture, striking at livestock and crops. It appears that this form of terrorism is equally easy to implement, and that experiments and programmes have already been tried, most notably in Iraq in 1995, with loose smut of wheat, which reduces yield and produces an inflammable gas. The former USSR would appear to have carried out research into African swine fever, ovine smallpox etc.

8.         Indeed, facility is one of the main characteristics of biological terrorism, which goes hand-in-hand with low costs and an undoubted impact. It is difficult to detect, leaves infrastructure intact and has major economic effects, making it particularly attractive to terrorists. The main biological risks include viruses such as smallpox and botulism or bacteria such as anthrax, the plague and cholera. According to the Centres for Disease Control in the United States, tularaemia and hemorrhagic fevers should be added to this list.

9.         The ease with which bio-terrorism, especially chemical terrorism, can be used is illustrated only too clearly in the access enjoyed by all and sundry to the Internet, the supreme highway for information and training. Anyone and everyone can find instructions on the Internet for preparing Molotov cocktails, bombs, poisons etc.  We have all seen television broadcasts in recent months of Al Qaeda tapes showing chemical gas experiments on dogs. The spectre of bio-terrorism should concern researchers and scientists. In future, it will certainly be necessary to ask them to show restraint and exercise self-censure, so that all their results are not systematically published and do not fall into the hands of ill-intentioned people. Biotechnology industry professionals should also discuss new developments in their field, share information regarding the risk of terrorism, and agree on codes of conduct in this area.

10.       A nuclear, biological or chemical strike by a terrorist organisation against a western city would "only be a question of time". That in any case is the view of Mrs Manningham-Buller, director general of the UK's intelligence service MI5, who considers this a very real possibility. For others the probability of a biological strike in particular remains low, but the consequences would be such that it would be unwise not to prepare for it. Therefore, we must prepare for the worst. 

Preparing for the worst

11.       An objective assessment of the dangers and an inventory of vulnerable sites such as nuclear power stations, hazardous industrial plants and water towers should be drawn up in each State and in Europe by the relevant political authorities. Very often, for economic reasons, sensitive sites are located close to zones of high population density. Measures pertaining to public health should be discussed and recommended, such as an increase of chlorine levels in water supply circuits, the possible distribution of gas masks and iodine tablets, the installation of gas detectors in public places, mandatory notification of certain diseases… or even the setting up of a public health observatory. The necessary budgetary resources for implementing these measures must be set aside. The public must be informed and trained.

12.       A major problem concerns the detection and recognition of various diseases which are either rare or have now disappeared by doctors themselves. In France, as in other countries, there are certainly very few practising doctors who have seen a case of smallpox in the course of their working lives. Informing and training health professionals about the threat of bio-terrorism is a priority, and it would be appropriate to introduce, or re-introduce, suitable courses at university level.

13.       Vaccination is a key issue, and a controversial one. Should people be vaccinated? Should this procedure be reserved for a few target groups or offered to the population in general? The question of whether or not vaccination and medical treatment should be obligatory must also be raised, bearing in mind the principle of respect for human rights and fundamental freedoms. Quarantining or the blocking of free movement of individuals are further issues facing our democratic societies in the event of bio-terrorism.

14.       Some countries have already taken the threat of terrorism very seriously. In France the Biotox plan, introduced after 11 September, envisages the reconstitution of smallpox vaccine stocks. An emergency laboratory is ready to work around the clock. Hospitals and the ambulance service are specially equipped to deal with chemical threats. Chlorine levels in water have been increased in order to neutralise potential contamination of water channels etc. An institute that monitors public health has been given responsibility for detecting health emergencies as rapidly as possible and for centralising all incoming information on listeriosis, STDs, measles and so on, as well as warning signs regarding anthrax, meningitis etc. But does that mean that France is prepared for handling such threats? One might reasonably ask the question given the tragedy of summer 2003, when hundreds of deaths were caused by the heat wave.  

15.       Still in France, the Institut Pasteur has stepped up its research programme and is focusing on anthrax, the plague, botulism, Rift Valley fever and various hemorrhagic fevers ; it recently announced that a national centre was being set up for training individuals involved in providing immediate assistance (first-aid, health and safety workers) in techniques for combating the effects of terrorism. Some States, such as France and the United Kingdom, have carried out exercises, particularly in the underground train system, to test their ability to respond to a bio-terrorist attack and take the necessary civil protection measures.

16.       In the United States, plans to counter bio-terrorism exist at state level; the states have responsibility for public health and some, such as Colorado, had drawn up plans well before 11 September. Furthermore, in the area of trade, the United States have imposed security measures since 11 September, on grounds of preventing bio-terrorism, that go so far as to be tantamount to unjustified trade barriers; one striking example is the excessive security requirements imposed on French champagne producers, whose cost is certain to curb exports.

17.       Some countries are rebuilding their vaccine stocks. Australia is said to have purchased 50,000 doses of anti-smallpox vaccine in 2002. Israel has enough of this product to vaccinate its entire population. In France, 60 million people could, if necessary, be vaccinated within two weeks. Germany, which has 36 million doses of the anti-smallpox vaccine, hopes to have 100 million available by the end of 2003. All this means that there are budgetary choices to be made. In the United States, when Congress refused to approve specific funding, the White House decided to earmark funds – initially intended for HIV/AIDS research – for the development of a new vaccine against anthrax that would, unlike the previous vaccine, be administered to the vulnerable categories of the population. In France, the funding allocated to combating nuclear, radiological, bacteriological and chemical terrorism in 2001 totalled some 350 million euros.

A global threat 

18.       The risks are global. There are no borders when it comes to the spread of smallpox, the plague etc. The response must be concerted, at regional and world level. There can be no two-speed Europe in this area, and developing countries cannot be excluded from this particular dialogue.

19.       In a number of recent speeches, Mr Kofi Annan, Secretary General of the UN, has underlined the necessity of cooperation between international, regional and sub-regional organisations. In order to be effective, international action must, in his opinion, take the form of systematic cooperation and an appropriate distribution of tasks, depending on the comparative advantages. The threat is universal, and the responses must also be universal. The international community must prevent the holding or use of weapons of mass destruction by non-state groups and entities.

20.       Given its specific vocation, the Council of Europe has chosen to defend human rights. The European Union is taking part in the work of the multidisciplinary group on international action against terrorism. In February 2003, the Council of Europe’s Committee of Ministers adopted a Protocol amending the European Convention on the Suppression of Terrorism. The Council of Europe, OSCE and United Nations (Geneva, February 2003) "underlined the need for a common framework for combating terrorism more effectively … and called for increased intercultural and inter-religious dialogue in order to address the root causes of terrorism".

21.       Within the UN, numerous legal texts have been adopted against terrorism; inter alia, the development, manufacture and use of biological and chemical weapons have been outlawed by the 1925 Geneva Protocol, the 1972 Convention on biological or toxic weapons and the 1993 Convention on chemical weapons. Despite the favourable view taken by the 146 States adopting the latter text, the United States opposed the introduction of a supervision mechanism to guarantee compliance with this Convention, something that now, however, seems essential. Some have called for the adoption of an international convention against acts of nuclear terrorism, which does not currently exist.

22.       In December 2002, the United Kingdom and the United States signed a sort of anti-bio-terrorism pact and agreed on “collaboration to improve public health responses to emergency situations”, which entails coordinating the two countries’ health systems in terms of prevention, early detection and supervision of infectious diseases. This partnership should bring together groups of highly skilled and experienced scientists and experts, and guarantee a network of constant supervision and early warning. At the same time, the United States signed an agreement with Europol on the fight against organised crime and terrorism, which supplements bilateral agreements with European Union Member States.

23.       The World Health Organisation provides assistance at national and international level in preparing for the consequences of chemical and biological weapons use and deliberate epidemics.

24.       The recent SARS epidemic helped to heighten awareness of the biological risks and the impact of economic damage caused by an epidemic in a globalised economy. To combat this and other infectious diseases, the European Union is proposing the setting up of a European Centre for Disease Prevention and Control, which should be operational by 2005 and allow coordinated responses to any epidemic and by the same token any bio-terrorist attack.

Conclusions

25.       The rapporteur believes that there must be political recognition of the genuine threat posed to the public by bio-terrorism, hence this report. Action must be taken, and each State must commit itself to protecting its population, now and in the future, from the consequences of terrorism, reconciling as far as possible two equally legitimate objectives: the lives and safety of people with respect for human rights and fundamental freedoms.

26.       The nature of the risks and the need to effectively protect the public make it necessary to rise above national interests and to recognise that, at the least, Europe provides a firm foundation for effectively combating the consequences of bio-terrorism. When it comes to protecting the public, we must reject the creation of a two-speed Europe – which is what would happen if such protection depended on the financial resources of each individual State. As well as a coordinated European approach to this fight, which should not be limited solely to the members of the European Union, this presupposes the establishment of a European fund to overcome the lack of financial resources in the new Council of Europe member States.

27.       Awareness of the risk is in its infancy, and preparatory measures are often at an extremely early stage: they must be speeded up. A decision must be taken to put aside secrecy and partial disclosure of information: this implies informing and training both the public and the professionals concerned, without lapsing into collective hysteria. An informed public is the best guarantee of an appropriate reaction to threats.

28.       Each State must draw up an objective assessment of the dangers and an inventory of dangerous and sensitive sites, secure them, acquire efficient and effective surveillance and warning systems, establish emergency relief and intervention plans, review the organisation of relief where necessary, notably in the area of healthcare, and provide the professionals required to work in intervention teams with training in the new threat posed by bio-terrorism. Debate is required on the vaccination policy to be followed.

29.       The States must accede to the existing instruments on combating terrorism, reinforce them through appropriate supervision procedures and establish binding instruments protecting against potential scenarios that are not well or not at all covered, such as nuclear terrorism.


Reporting committee : Social, Health and Family Affairs Committee

Reference to committee: Docs. 9356 and 9346, Ref. No. 2694, 26 March 2002

Draft resolution adopted on 27 January 2004, with a vote against

Members of the committee: MM. Glesener (Chair), Surjan (1st Vice-Chair), Mrs McCafferty (2nd Vice-Chair), Mr Maštálka (3rd Vice-Chair), Mrs Ahlqvist, MM Arnau, Arzilli, Mrs Azevedo, Mrs Bargholtz, Mrs Belohorská, Mr Berzinš, Mrs Biga-Friganovic, Mrs Bolognesi, MM. Braghis, Brunhart, Mrs Burataeva, MM. Buzatu, Çavusoglu, Christodoulides, Mrs Cliveti, MM. Colombier, Cox, Daban Alsina, Dees, Donabauer, Drljevic, Evin, Flynn (alternate : Hancock), Mrs Frimannsdóttir, MM. Geveaux, Giertych, Gonzi, Gregory, Gülçiçek, Gündüz, Gusenbauer (alternate : Mrs Schicker), MM. Hegyi, Herrera, Hladiy, Høie, Mrs Hurskainen, MM. Jacquat, Klympush, Baroness Knight, MM Kocharyan, Lomakin-Rumiantsev, Mrs Lotz, Mrs Lucic, MM Makhachev (alternate : Kovalev), Markowski, Mrs Milicevic, Mrs Milotinova, MM. Mladenov, Monfils, Ouzkı, Padilla, Pavlidis, Popa, Poty, Poulsen, Provera, Pysarenko, Rauber, Riester, Rigoni, Rizzi, Mrs Roseira, Mrs Saks, MM Schmied (alternate: Dupraz), Seyidov (alternate : Aliyev), Mrs Shakhtakhtinskaya, MM. Slutsky, Sysas, Mrs Tevdoradze, Mrs Topalli, Mr Vathias, Mrs Vermot-Mangold, Mrs Wegener, MM Van Winsen (alternate: Kox), Zernovski, ZZ…, ZZ ….

NB: The names of those members present at the meeting are printed in italics.

Secretariat of the Committee: Mr Mezei, Ms Meunier, Ms Karanjac, Mr Chahbazian