Dr. Thomas Mack, professor of medicine at the University of Southern California, has raised very serious questions regarding the smallpox vaccine assault of the Bush administration’s phony war on terrorism. In an article in the New England Journal of Medicine, Mack said, “A terrorist introduction of smallpox could produce a short outbreak of cases and deaths, but the current vaccination policy will provide little protection, and the cost in deaths from vaccine complications will outweigh any benefit. … the authorities and the media should provide more detail about the dangers of vaccination and more accurate, less inflammatory information about the potential for the spread of smallpox.”

Unfortunately, Mack’s was not the Journal’s lead article. Instead it was a response to the issue’s lead article, which could easily be used by the Bush administration to further its campaign of misinformation and continues the growing suspicion regarding the motivation of the NEJM. A few years ago, the publication’s editorial leadership changed from an anti-corporate, pro national health care approach to one very sympathetic to that of Corporate America and, more specifically, that of the prescription drug companies. It is the growing suspicion of the Bush administration’s motives among medical professionals that forced the Journal to provide an alternative viewpoint in the smallpox debate.

At the recent annual meeting of the American Public Health Association participants made clear their lack of trust in the Homeland Security proposals of Bush and its director Tom Ridge. In fact, the leadership of APHA had invited Ridge to be its keynote speaker. When this became known there was a massive outcry among the membership demanding that the invitation be withdrawn and Ridge withdrew, saying there were scheduling conflicts.

Ridge understood that his advocacy of capital punishment, his attack on Mumia Abu Jamal and other right-wing policies while governor of Philadelphia would have engendered major demonstrations. The Ridge/smallpox program would have been just one more insult to the APHA membership.

The smallpox strategy by the Bush administration has almost nothing to do with the potential of this very dangerous disease. Rather, it has to do with keeping the fires of fear burning so that Bush’s drive to war with Iraq can be kept on the front burner.

This however is wearing thin. People are beginning to understand that when, for example, the unemployment rate rises, the FBI and Homeland Security find a terrorist threat looming. And, when corporate criminals from Enron and their ilk are finally being indicted and pictured in the press, you can be sure a terrorist attack warning is on the way.

The public health community desperately wants to respond to infectious diseases. In fact, the APHA meeting made it clear that the nation’s public health infrastructure is in dire need of millions of dollars of federal spending.

In past APHA meetings the issue of bioterrorism became a divisive issue with anti-war advocates arguing that the “threat” of bioterrorism is simply a cover for pro-war developments. Others saw federal money for bioterrorism as the only way for local health departments to get needed funds. The reality finally came to the fore when it became clear that there was very little bioterrorism money being sent to local health departments; and that, when the money was made available, there was not a sufficient infrastructure of public health to even use it effectively.

The elected officers and Governing Board of APHA sent a powerful message to Congress and the White House that they reject this cynical use of public policy and federal monies and, instead, demanded that the federal government support public health infrastructure activities in rural and urban areas as soon as possible.

The author can be reached at pww@pww.org