http://www.nytimes.com/2001/11/18/national/18POX.html
November 18, 2001
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ASHINGTON,
Nov. 17 — In 1980, D. A. Henderson did what no one else in history has ever
done. He wiped a disease, smallpox, off the face of the earth. Now, smallpox is
back — not as a naturally occurring killer but as a potential bioterrorist
weapon. And D. A. Henderson is back, too.
At 73, the man who led the global effort to make the world safe from one of
its deadliest scourges has re-emerged as the director of a new government
program to make the nation safe from bioterrorism. His challenge is to prepare
the United States for a germ attack at a time when the country is already deep
into a war against terrorism.
"D. A. has, in essence, been the man for all seasons in science,"
said Dr. Michael T. Osterholm, director of the Center for Infectious Disease
Research and Policy at the University of Minnesota. "I think he is
obviously in his final season, but it may be the most important season he ever
had."
It is a season that is quickly becoming fraught with complications for Dr.
Henderson, who has spent the past decade waging a determined, passionate — and,
critics say, misguided — campaign to destroy the last remaining vials of the
smallpox virus, in part to prevent it from being misused. This week, the Bush
administration decided to retain the virus so scientists can use it to develop
a range of new vaccines and treatments for the disease.
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The decision means that the smallpox germ will very likely outlive Dr.
Henderson, who is now in the uncomfortable position of having to defend the White
House stance.
"There is a lot of concern about what D. A. in his new, highly exalted
position, is going to say," said Dr. Peter Jahrling, a virologist at the
Army's bioterrorism preparedness laboratory in Fort Detrick, Md., who has been
Dr. Henderson's chief opponent in the destruction controversy. "Is he
actually going to change his tune?"
In an interview on Friday, just as the administration was announcing its
decision, Dr. Henderson answered that question with diplomacy, if not
enthusiasm. "I'm a member of the administration at this point in
time," he said simply, "and so I necessarily have to be in accord
with the administration's position."
Formerly the director of the Johns Hopkins University Center for Civilian
Biodefense Studies, a research institution that he founded in 1997, Dr.
Henderson has been warning about bioterrorism since the mid- 1990's. On Nov. 1,
Tommy G. Thompson, the secretary of health and human services, named Dr.
Henderson to head the new Office of Public Health Preparedness. The appointment
came as the administration was facing criticism for lack of coordination in its
handling of the recent anthrax attacks, which killed four Americans and
sickened more than a dozen.
"He really didn't want to do it," Tara O'Toole, who now directs
the biodefense studies center, said. "But he didn't see any honorable way
to say no."
A burly man with a full head of white hair, silver-rimmed glasses and a
deep, gravelly voice, Donald Ainslie Henderson has a physical presence as
towering as his reputation. On a recent afternoon, he was seen in his
government office, a spartan affair with a cardboard nameplate propped atop a
fax machine. Standing against the sky-blue window treatments, suspenders
pressed close against a stark white shirt, he exuded confidence, looking like
the president in a Hollywood movie.
People in public health sometimes refer to Dr. Henderson as "the old
man," borrowing the term soldiers use for generals they respect. He is
uniformly described as a gracious mentor, albeit a demanding one.
"He does not suffer fools gladly," said Dr. Margaret A. Hamburg, a
bioterrorism expert at the Nuclear Threat Initiative, a nonprofit foundation in
Washington. "And he is accustomed to the power of command."
Those who know Dr. Henderson well wonder how his new mission will go. He
does not like bureaucracies, yet he is now in the belly of a bureaucratic
beast. The labyrinthine Health and Human Services Department is a collection of
agencies. President Bush has yet to fill the top posts at two, the National
Institutes of Health and the Food and Drug Administration. And an important
position at the parent agency, the job of assistant secretary for health, is
also vacant. It will be up to Dr. Henderson to draw these agencies together and
form alliances with law enforcement and intelligence authorities.
"He believes that rules are for mere mortals to follow," said
Jonathan B. Tucker, the author of "Scourge: The Once and Future Threat of
Smallpox" (Atlantic Monthly Press, 2001). "Sometimes I think he can
rub people the wrong way because he is such a formidable personality and is so
confident. Some people perceive that as arrogance," he said, adding that
that was not his own experience of Dr. Henderson. "I think that's the risk
of his approach. But of course, he has great credibility, given his
history."
That credibility goes a long way on Capitol Hill. Last week, when Dr.
Henderson appeared before a House committee, he was introduced by
Representative Billy Tauzin, Republican of Louisiana, as "a real American
hero." The lawmakers then gave him a standing ovation; he shook his head
and tried to wave off the applause. "In truth," he said later,
"it's a little embarrassing."
An ancient, contagious and particularly hideous disease, smallpox kills a
third of those infected with it, and Dr. Henderson is one of the few doctors in
this country today to have actually seen a case.
The World Health Organization's smallpox eradication program, which Dr.
Henderson ran from 1966 to 1977, was, he said, the effort of countless public
health workers who toiled under grueling conditions, often living in villages
without electricity and running water, in nations torn apart by war. They
operated under the principle of "ring vaccination," containing
outbreaks by vaccinating every patient infected, and everyone around those
patients, moving outward in concentric circles until the virus stopped
spreading.
Dr. Henderson's admirers say he should win a Nobel Prize, yet he was
recently passed over for another prestigious award, the Lasker Foundation Award
for public service. The prize went to Dr. William Foege, a former director of
the Centers for Disease Control and Prevention who participated in the smallpox
eradication effort and devised the ring vaccination strategy.
Despite the lack of official recognition, experts on smallpox say there is
little doubt that the eradication effort, conducted in partnership with the
former Soviet Union at the height of the cold war, succeeded in large part
because of Dr. Henderson's cunning and derring-do.
When the Ethiopian health minister refused to cooperate with him, Dr.
Henderson sneaked into the country and befriended the personal physician of the
emperor, Haile Selassie. When Dr. Henderson believed the Russians were
providing him with inferior smallpox vaccine, he went to Moscow — against
direct orders from his superiors, who feared a diplomatic disaster — and
demanded a better one.
"He created a lot of very loyal employees who were willing to go the
extra mile," Dr. Tucker said. "If vaccine had to be sent out on
Christmas Day, people would come in on Christmas Day to get the job done."
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The world's last case of smallpox occurred in 1978, in England, when the virus
escaped in a laboratory and infected a medical photographer. Two years later,
it was declared eradicated worldwide. Nations that held samples of the virus
were encouraged to either destroy them or transfer them to one of two official
repositories that still exist, one in Russia and the other at the Centers for
Disease Control, in Atlanta.
Dr. Henderson became dean of the Johns Hopkins School of Public Health, a
post he held until the first Bush administration, when he served as science
adviser to the White House. When Bill Clinton was elected president, Dr.
Henderson took a job in the health and human services agency, working as
science adviser to Donna E. Shalala, Mr. Thompson's predecessor. But he left in
1995, saying he was not being consulted on issues of importance to him.
That year, Dr. Henderson said, he learned of the work of Ken Alibek, who ran
the Soviet Union's biological weapons program and claimed to have developed
smallpox as a weapon. But while Dr. Henderson became more concerned about bioterrorism
— enough so that he founded the Johns Hopkins center — he nonetheless advocated
destroying the official smallpox stocks, for several reasons, he and those
close to him say.
First, the eradication program was an international effort, and other nations
wanted the virus destroyed. "We had countries around the world saying,
`Why are Big Brother United States and Big Brother Russia keeping the
virus?" Dr. Henderson said. Second, he said, there was a danger that the
virus could escape, as it did in England. Third, by destroying its stocks, the
United States could make possession of it a crime.
But national security experts and military scientists countered with the
argument that has prevailed: only by keeping the virus would the United States
be able to develop better treatments for a smallpox attack. Dr. Jahrling, of
Fort Detrick, said recently that Dr. Henderson viewed destruction as "the
crown jewel in his career" — a contention that Dr. Henderson dismissed in
Friday's interview as "mythology."
Dr. Henderson may not stay long in his new job; he said he was committed to
remaining with the government only as long as it took to create a bioterrorism
preparedness program that others might carry out. Asked how long that might be,
he replied by saying that he had promised the World Health Organization he
would stay in Geneva for 18 months. He stayed 11 years.
More than anything, Dr. Henderson said, he would like to figure out a way to
persuade the countries of the world to come together to condemn the use of germs
as weapons. Of smallpox, he said, "We've got to put the genie back in the
bottle."
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