The deployment of chemical weapons is an ongoing issue of international concern, which resurfaced not long ago in Kim Jong-Nam’s assassination and the Syrian sarin attack in early April. Here, the implications of chemical warfare and steps taken to prevent it are summarized and discussed.

Nerve agent VX is the most potent of its kind in existence, surpassing sarin—the infamous gas deployed in the 1995 Tokyo subway attack, which killed 13 people and injured 6000 more. The UN considers it a weapon of mass destruction. Countries that stockpiled it have mostly destroyed their supplies since the 1997 Chemical Weapons Convention. Yet fun fact: its ingredients are all readily available at Hopkins’ Undergraduate Teaching Labs (UTL) and can be synthesized without sophisticated equipment. It looks like a harmless oily liquid derived from organophosphate pesticides. It was also recently used in the assassination of Kim Jong-Nam, the current North Korean president’s half-brother.

What exactly is nerve agent VX? Normally, a stimulated motor neuron releases the neurotransmitter acetylcholine to bring about muscle contraction. It is then degraded into acetic acid and choline by an enzyme, acetylcholinesterase (ACHE). Nerve agent VX inhibits the action of ACHE such that acetylcholine builds up in the synapses, leading to uncontrolled muscle contraction and eventually sustained paralysis of all muscles, including that of the diaphragm (OPHPR, 2015). Victims eventually suffocate to death. Depending on the administered dose, symptoms can appear within minutes or up to 18 hours, and they include dizziness, blurred vision, drooling, and convulsions. Nerve agent VX is a viscous liquid and does not evaporate once it is released in the environment, rendering it a long-term threat. Due to its tasteless, odorless, and colorless properties, it is also difficult to detect and identify without specific tests.

It is horrifying that nerve agent VX is easily accessible to the public, its individual components stored in many science labs. Controversy over bioweapons is not a novel issue—since the Chemical Weapons Convention of 1993, the international community has largely been cooperative in its effort to reduce the possibility of chemical warfare. If Kim Jong Nam’s death is indeed confirmed as a targeted mission, this event could have alarmingly sinister implications for everyone else around the world. As stated by Tom Ingelsby, the director of Johns Hopkins University’s Center for Health Security, the use of nerve agent VX in a political assassination is “a red line…it should be considered a new threshold that’s been crossed in terms of unconventional weapons.” In addition, ongoing research on its close relatives, the organophosphate pesticides, obviously isn’t intended to develop such deadly weapons either. This raises the question of the dual-use dilemma—scientific discoveries can uncover improvements that greatly improve humans’ quality of life, yet they can also be manipulated to produce substances capable of destroying entire populations. To what extent should research be disclosed to the public? Are there certain areas of science that should be barred from investigation, in the light of security concerns?

Indeed, the convergence of biomedicine and technology has led to exponential advances in the rate of scientific discovery, but this has come with the great challenge of protecting findings from falling into the wrong hands. The dual-use dilemma has appeared since the development of the smallpox vaccine in the 18th century, which pioneered research on immunization and caused “one of the largest and most complex” FBI investigations ever—the anthrax attacks in 2001. That same year, an Australian research team modified DNA from the mousepox virus, intending to sterilize infected mice and hence control the population of pests. Instead, they created a supervirus that wiped out naturally resistant mice; if this technology is transferred to the human-infecting smallpox, current vaccination programs could become dangerously ineffective. More recently, the sedative midazolam, formerly used to reduce anxiety in patients before surgery, has now been applied to 20 cases of capital punishment by lethal injection. Dr. Armin Walser, the chemist behind the drug, has explicitly told The New York Times that he is “not a friend of the death penalty or execution.” Scientists can promise to do no harm, but their serendipitous discoveries can have much more sinister applications.

So, what has been to done to counter potentially unethical uses of biomedicine? In 2003, several prominent research journals, including Science and Nature, published a joint “Statement on scientific publication and security”, indicating that they would “screen submissions for safety and security issues” and when appropriate, the paper would be “modified or not published.” In 2004, the National Research Council (NRC) published Biotechnology Research in an Age of Terrorism, also known as the “Fink Report”, which advocated for “increased education” about the dual-use dilemma and promoted “self-governance” of the scientific community. The National Science Advisory Board for Biosecurity (NSABB) was also created that year to oversee dual-use research, and to advise government agencies in such matters. Despite these attempts, during the NSABB’s 2006 meeting, Gigi Gronvall, a member of the Threat Reduction Advisory Committee (TRAC) and a colleague of Mr. Ingelsby’s, warned that although “information uncovered that has dual-use could be used to inform strategy”, eventually “prevention efforts are going to fail for a deliberate attack.”

In conclusion, a definitive agreement on the dual-use dilemma is unlikely to be reached any time soon. There is a fine line between disclosing scientific discoveries in the spirit of promoting “knowledge for the world”, and their possible applications in unethical situations. Returning to the initial issue of VX’s appearance in the news, there are now 4 suspects in Pyongyang, 3 of whom are wanted for questioning. North Korea has vehemently denied any involvement in the incident, and has not responded to the Malaysian government’s extradition requests. For now, we can only hope that Mr. Ingelsby’s “red line” will be drawn more firmly in the future.

References

Alfred, Charlotte. “20 Years Ago, A Shadowy Cult Poisoned The Tokyo Subway.” The Huffington Post. TheHuffingtonPost.com, 20 Mar. 2015. Web. 8 Mar. 2017.

Barrett, Brian. “Killing Kim Jong Nam With VX Nerve Agent Crossed a ‘Red Line’.” Wired. N.p., 24 Feb. 2017. Web. 9 Mar. 2017.

Office of Public Health Preparedness and Response (OPHPR). “Facts About VX.” Centers for Disease Control and Prevention, 18 Nov. 2015. Web. 8 Mar. 2017.

Nowak, Rachel. “Killer Mousepox Virus Raises Bioterror Fears.” New Scientist, 10 Jan. 2001. Web. 9 Mar. 2017.

Blinder, Alan. “When a Common Sedative Becomes an Execution Drug.” The New York Times. The New York Times, 13 Mar. 2017. Web. 15 Mar. 2017.

Selgelid, Michael J. “Governance of Dual-use Research: An Ethical Dilemma.” WHO. World Health Organization, 30 June 2009. Web. 10 Mar. 2017.

National Research Council (US) Committee on a New Government-University Partnership for Science and Security. “Biosecurity and Dual-Use Research in the Life Sciences.” Science and Security in a Post 9/11 World: A Report Based on Regional Discussions Between the Science and Security Communities. U.S. National Library of Medicine, 01 Jan. 2007. Web. 12 Mar. 2017.

BBC. “Kim Jong-nam: Main Players in Mysterious Killing.” BBC News. BBC, 08 Mar. 2017. Web. 10 Mar. 2017.

Posted by Fiona Pat

Fiona is a freshman studying Neuroscience, Psychology, and Bioethics. A member of HMR’s Medical Humanities team, she explores topics involving the more nuanced, “human” aspects of medicine, such as philosophy and the arts. The quintessential Hopkins pre-med, Fiona aspires to advance medicine by disseminating research findings through HMR, and by conducting research at the med campus’s Snyder lab. She also hopes to bridge the gap between healthcare and the local community by volunteering at the JHH’s Adult Emergency Department, the American Red Cross, and SHARE. You can catch her in Brody tweeting the latest medical news, drawing Orgo mechanisms, or hunting for crab cakes around Baltimore.

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