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ANTHRAX VACCINATION
AND THE DEEPER PROBLEMS OF LEADERSHIP
By Andrew Bacevich
March 10, 2000
Andrew J. Bacevich directs the Center for International
Relations at Boston University. This essay is adapted from a
longer article appearing in the Spring 2000 issue of Orbis,
the quarterly journal of the Foreign Policy Research
Institute.
ANTHRAX VACCINATION
AND THE DEEPER PROBLEMS OF LEADERSHIP
By Andrew Bacevich
For several years now, the Clinton administration has warned
of the specter of biological terrorism stalking the United
States. As Secretary of Defense William S. Cohen wrote in an
op-ed portraying the horror that could ensue: "Hospitals
would become warehouses for the dead and dying. A plague
more monstrous than anything we have experienced could
spread with all the irrevocability of ink on tissue paper."
The question confronting the United States, Cohen insists,
is not if such an incident will occur, but when.
As a result of such fears, the administration has made
biological defense a top priority. Testifying to that
priority, in December 1997 Secretary Cohen announced the
mandatory vaccination against anthrax of more than two
million U.S. military personnel. But growing controversy
surrounding that program is exposing the larger flaws in
U.S. preparations for biological war.
OPPOSITION IN THE RANKS
Much to the chagrin of top civilian and military leaders,
the vaccination program has prompted vocal opposition -- not
from antiwar activists or conspiracy theorists, but from
members of the armed forces. Steadily increasing numbers of
service personnel -- now totaling more than 300 -- have
refused to be inoculated. Some have even left the military
to avoid taking the shots. The vaccination policy's most
impassioned critics are pilots, many of them seasoned
officers and combat veterans. Hence, they are not easily
dismissed as naive, misinformed, or easily manipulated.
These critics insist that the anthrax vaccine is unsafe and
endangers their health. Already short of pilots, the
services can ill-afford to lose more. Yet suspending the
vaccinations in the face of protests from the ranks could
prove difficult and costly.
First, Pentagon leaders understandably worry that such a
retreat may undermine the integrity of the chain of command,
setting a precedent to challenge other onerous or unpopular
orders.
Second, Defense Department officials have made "force
protection" a high priority, terminating the careers of
officers deemed insufficiently attentive to protecting the
soldiers under their command. Anthrax vaccinations are the
paramount expression of this priority. Defending the
program, Secretary Cohen has told his troops, "I would be
derelict in my duties sending you out in an environment in
which you weren't properly protected."
Third, the vaccination program serves as the public
expression of the administration's overall bio-defense
policy. Abandoning it would call the entire policy into
question.
Not surprisingly, therefore, the Department of Defense has
tenaciously defended its anthrax policy and rejects
criticism of the vaccine as just wrong. "It's safe and
reliable," Pentagon spokesman Kenneth Bacon flatly states.
The vaccine is also essential, Pentagon officials assert,
because at least ten nations possess or are developing
biological weapons, and anthrax is "the weapon of choice for
germ warfare." Senior defense officials counter reports of
debilitating side effects to anthrax vaccine by insisting
that adverse reactions are occurring at a lower rate than
with mumps or measles vaccines. As if to prove the point,
civilian and military leaders alike, beginning with
Secretary Cohen and the joint chiefs, have rolled up their
sleeves and been vaccinated. But such attempts, rather than
quelling criticism, have only seemed to confirm the
suspicion that the anthrax vaccination program is as much
about public relations as about military prophylaxis.
BROADER CONCERNS
Skeptics of the program have raised a plethora of concerns
ranging far beyond safety. Those revelations suggest a
program plagued by mismanagement, reeking of impropriety,
and based on a defective strategy. At this point, even if
the Pentagon were to sustain its claims that the vaccine has
no malign effects, more than sufficient cause exists to
indict the administration's biological warfare policy.
The broad critique of the administration's biological
warfare program consists of four major points.
First, the Defense Department has entrusted the manufacture
of anthrax vaccine to a single firm. Serious doubts exist
regarding the ability of this firm to produce a vaccine that
meets established standards of purity and potency. Efforts
by the Defense Department to ease those doubts have been
less than persuasive. The company in question is the
BioPort Corporation of Lansing, Michigan, a start-up firm
that bought the assets of the previous manufacturer -- which
went out of business after repeatedly failing FDA
inspections. Despite winning the DOD contract to supply the
vaccine in late 1998 and despite generous
Defense Department subsidies, BioPort -- relying on the same
work force and same plant management as its predecessor --
has not yet achieved the FDA certification to produce
anthrax vaccine.
Second, government officials, including qualified medical
professionals, have themselves questioned the efficacy of
the vaccine, which was developed decades ago not for combat
but to protect tannery workers at risk from handling the
hides of anthrax-infected animals. According to a 1995
report by the chief of the Bacteriology Division at U.S.
Army Medical Research Institute, there exists "insufficient
data to demonstrate protection against inhalational disease"
-- the type that soldiers are most likely to encounter. The
Pentagon, eager to allay fears, promised an external review
of the vaccination program by an "expert panel." But the
"panel" was in fact a single individual who was, of all
things, a professor of obstetrics and gynecology. By his own
admission, he had no expertise in anthrax and refused to
testify before a congressional subcommittee regarding his
evaluation of the program.
Third, immunizing U.S. forces in the field against one
single strain of anthrax is woefully inadequate protection
against any real biological threat. According to the
administration's own analysis, toxins other than anthrax
pose at least as great a danger -- as does a genetically
modified anthrax. Furthermore, a biological attack against
the United States would likely target civilians, not
soldiers, and cities, not military installations. The
implication that inoculating troops at Camp LeJeune will
deter an anthrax-equipped terrorist is absurd.
Fourth, the current biological defense policy perpetuates
the peculiarly American delusion that for every security
problem there exists a technological fix. Erecting a barrier
that relies on outdated means and leaves its flanks exposed,
the anthrax vaccination policy is a bio-war Maginot Line.
A WAY OUT
What is needed is an approach that avoids scare-mongering
rhetoric and focuses the attention of senior leaders where
it belongs -- on strategy rather than problem-solving. That
approach would include several points.
First, policymakers can extricate themselves from the
present ill-considered policy without having to admit openly
its flaws. BioPort's obvious failures provide sufficient
basis to suspend the anthrax vaccination program pending the
identification of a reliable supplier of high-quality
vaccine -- a process likely to take three years.
Second, as an interim defense against anthrax, the Defense
Department should revert from prophylaxis to treatment.
Administering antibiotics and vaccine to those exposed to
the virus was, in fact, how the Pentagon intended to treat
soldiers had U.S. forces encountered anthrax during the
Persian Gulf War.
Third, the president and secretary of defense should restate
unambiguously the intention of the United States to
retaliate massively in response to any biological attack
against Americans. As was the case with the nuclear threat
during the Cold War, there is no substitute for a credible
promise of swift and potent punishment.
Yet all of that is, in a sense, the easier part of the
problem. The larger challenge is to restore to U.S. national
security policy a sense of proportion. Obsessing over
operational and tactical details -- like anthrax -- as a
pretext for permitting leaders to dodge fundamental
strategic issues has become unacceptable. Chief among those
issues is the dominance of the international order by a
highly ideological nation dedicated not simply to its own
defense, but to the universal adoption of the values that it
espouses.
Progress toward realizing this vision -- a world that is
peaceful, democratic, and respectful of human rights and
free enterprise, with the United States presiding as
ultimate arbitrator -- has been at best uneven. But with the
success of this project having become a predicate of
national security, opposition in any form is construed as a
"threat." As a result, the nation -- although by any measure
at the height of its power and influence -- is (to judge by
administration rhetoric) beset by growing danger, not just
from terrorists, but also rogue states, paranoid dictators,
and anarchic hackers.
At the heart of the problem lies policymakers' certainty as
to their own good will and the universality of American
values. Opposition to the further spread of American power,
ideals, culture, and lifestyle is -- by definition --
perverse or irrational. This outlook guarantees a never-
ending supply of enemies to confront. One need only consider
the frequency with which the Clinton administration has
found itself obliged to employ U.S. military forces to warn,
coerce, punish, and occupy.
Fixating on the prospect of biological calamity, American
leaders avert their eyes from a larger, disconcerting truth:
the global transformation to which the United States has
committed itself is not inspiring spontaneous compliance. As
a result, there is no end in sight to the exertions that
will be necessary if Americans are to realize their vision
for the world. Are the aspirations implied by that vision
feasible? What will it cost to fulfill them? How much are
Americans, citizens as well as soldiers, willing to pay?
However commendable their concern for protecting U.S.
forces, addressing these larger questions forthrightly
describes the duty that American policymakers dare not
neglect.
RECENT FPRI BULLETINS
Rethinking Bio-Chemical Dangers, Henry Sokolski
The Feminization of the American Military, Walter A.
McDougall
National Missile Defense: Why Now?, Keith Payne
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