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Prospects and Implications for the Future

Robert P. Kadlec, MD, MTM&H; Allan P. Zelicoff, MD; Ann M. Vrtis, MD

JAMA. 1997;278(5):351-356.

Abstract
The Biological and Toxin Weapons Convention (BWC), which prohibits the acquisition of biological materials for hostile purposes and armed conflict, entered into force in 1975 and now has the participation of 140 nations (158 nations have signed the BWC, but only 140 of these have also ratified it). However, there is no monitoring mechanism associated with the BWC. Diplomatic efforts are now under way to create a supplemental, legally binding protocol to strengthen the convention. Measures to strengthen the BWC are analogous to the diagnostic processes familiar to physicians; the problem facing negotiators is to identify procedures with high positive and negative predictive value. Few proposed measures meet these criteria. However, the investigation of unusual disease outbreaks and allegations of use are highly diagnostic of illicit activities while avoiding false-positive accusations. At the same time, such information generated by the BWC can contribute to worldwide efforts to improve public health, control emergent disease, and establish an international norm against biological weapons proliferation.

Author Affiliations
From the Office of the Secretary of Defense, Washington, DC (Dr Kadlec); Sandia National Laboratories, Albuquerque, NM (Dr Zelicoff); and the Department of Anesthesiology, Malcolm Grow Medical Center, Andrews Air Force Base, Md (Dr Vrtis).

Footnotes
The views and opinions expressed in this article are those of the authors exclusively and do not represent the official position of the US government, the US Department of Defense, the US Department of Energy, the US Air Force, or Sandia National Laboratories.

Reprints: Robert P. Kadlec, MD, MTM&H, 11701 Tuscany Dr. Laurel, MD 20708.

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