When War Is the Best Medicine
By Bill Frist

Physicians and policymakers have an imperative duty to help keep people healthy and alive. In doing so, preventive care is always preferable to the treatment of avoidable disease. Understanding the causes of disease and death enables prevention. Physicians and policymakers must gather and evaluate critical information to meet our obligation to protect humanity by preventing illness and death.

Today is the 15th anniversary of Saddam Hussein's horrific chemical attack on his own people in Halabja, Iraq. It is estimated that 5,000 Iraqis died terrible deaths and at least 10,000 were injured. Today the people of Halabja suffer from high rates of birth defects, cancer and blindness, and many have respiratory illnesses.

So we know that chemical weapons cause illness, disease and death. We also know that biological weapons using anthrax and botulinum toxin, plague and Ebola cause severe illness and death.

And we know that Hussein has admitted to having quantities of weaponized anthrax, botulinum toxin, aflatoxin and ricin. He has also tested plague, typhus, cholera, camel pox and hemorrhagic fever. And we know he has mustard gas and the VX nerve agent.

We know he has no compunction when it comes to killing people.

We know that there are no vaccines -- and sometimes no treatments -- for the disease and illness that would result from his use of many of these weapons.

Scientists in the best research facilities in the world are constantly seeking vaccines and cures. But as we know from the search for a vaccine and a cure for HIV/AIDS, it is a very slow process.

Should we gamble the health of our families and our nation on the likelihood that pharmaceutical vaccines and cures will be found before Hussein decides he would like to try an attack against Americans and our allies? Or should we look to nontraditional means of preventive care? Both physicians and policymakers must make that choice only when there is enough information to weigh the relative benefits of traditional vs. nontraditional.

We have the information that Hussein will use chemical and biological weapons. The question is whether he will use them against Americans, directly or indirectly.

During the Cold War, the controlled insanity of mutually assured destruction meant that we and the Soviet Union had a built-in deterrent to attacking each other. This worked because there was relative stability, even in the unfortunate spread of biological, chemical and nuclear weapons throughout the world. If attacked, each nation knew for certain the identity of the attacker -- and would retaliate.

The deterrence of Cold War discipline evaporated with the demise of the Soviet Union. The proliferation of non-state actors -- proliferators and terrorists -- eager to obtain and use weapons of mass destruction, combined with a global environment devoid of real penalties for the stockpiling of such weapons by rogue nations, means we inhabit a new world of uncontrolled insanity. Sept. 11, 2001, provided clear evidence that our enemies want to kill us. I have no doubt that Hussein would gladly provide weapons of mass destruction to nationally unaffiliated groups to use against us -- if he has not already -- and no doubt he would be just as glad to sit back and take no credit. This empowers him in the underworld of terror and accomplishes his desire to see us suffer.

To determine, then, the best preventive medicine in this case, we must combine our understanding of Hussein with an understanding of the impact his weapons would have on Americans.

In theory, just a single gram of botulinum toxin -- the deadliest toxin known to science -- could kill 1 million people if released into the air. Once the toxin enters the body it binds to nerve endings where they join with muscles. Victims would experience double or blurred vision, slurred speech, difficulty swallowing, nausea, vomiting and muscle weakness. If untreated, the disease will paralyze the arms, legs, trunk and respiratory muscles, perhaps resulting in suffocation. There is no reliable vaccine. Although an antitoxin is available, its supply is limited.

What about hemorrhagic fevers? The name itself tells us a lot about these infections. They cause high fever and widespread, uncontrollable bleeding. Ebola is a hemorrhagic fever, and we know that Hussein has experimented with it. In its most severe form, Ebola causes bleeding under the skin, in internal organs, and from the mouth, nose, ears and eyes and other openings in the body. There is no vaccine and no standard treatment. All we can do is provide supportive therapy.

What about the VX nerve agent? It can enter the human body through inhalation or through the skin. It can quickly cause convulsions, a loss of consciousness and death from suffocation because the muscles can no longer sustain breathing functions. In milder cases, victims will experience vomiting, headaches, difficulty in thinking, muscle twitches, weakness, diarrhea and involuntary urination. Antidotes are available, but they must be administered immediately. Because it is a chemical weapon, there is no possibility for a vaccine.

These are but three of the nightmares Hussein can inflict upon us.

I firmly believe that to wait for the long-term development of vaccines and cures is a losing-odds bet on the goodness of Hussein. Attacks on human beings designed for the maximum of unspeakable suffering call for nontraditional preventive care on our part.

Getting rid of Saddam Hussein's regime is our best inoculation. Destroying once and for all his weapons of disease and death is a vaccination for the world.

This column by Senator Bill Frist, Tennessee Republican and Senate majority leader who is also a physician, was published in the Washington Post March 16. The column is in the public domain. No republication restrictions.