Perspective: Biological warfareBashar al-Assad’s Updated, Sinister Version of Biological Warfare

Published 29 July 2019

Biological warfare is generally understood as the deliberate wartime introduction of a lethal pathogen with the intent to kill or maim. Syria under President Bashar al-Assad is pursuing a sinister variation—one with long and dangerous historical precedents. Assad’s government has allowed pathogens normally controlled by public health measures—such as clean water, sanitation, waste disposal, vaccination, and infection control—to emerge as biological weapons through the deliberate destruction and withholding of those measures. The conflict has in effect reversed public health advances to achieve levels of disease not seen since the Napoleonic era.

Biological warfare is generally understood as the deliberate wartime introduction of a lethal pathogen with the intent to kill or maim. Syria under President Bashar al-Assad is pursuing a sinister variation—one with long and dangerous historical precedents. Assad’s government has allowed pathogens normally controlled by public health measures—such as clean water, sanitation, waste disposal, vaccination, and infection control—to emerge as biological weapons through the deliberate destruction and withholding of those measures. The conflict has in effect reversed public health advances to achieve levels of disease not seen since the Napoleonic era.

Annie Sparrow writes in Foreign Policy that biological weapons such as anthrax or sarin have significant drawbacks: they unpredictable and difficult to control, and are too visible and risk a global reaction. In war, they kill in far smaller numbers and much less reliably than common diseases and wound infections. In contrast, the behavior of Assad’s preferred pathogens is predictable. Here lies the key to a far more insidious strategy: By deliberately degrading an already precarious public health situation, the new biological warfare is able to fly under the radar.

Assad’s most visible mass atrocities include indiscriminate attacks on and the resulting forced displacement of civilians, devastating sieges, and assaults on hospitals. But an unappreciated dimension of his total-war strategy has been his attacks on public health infrastructure and programs in order to fast-track the epidemic diseases that thrive in the crowded living conditions created by mass displacement, while simultaneously withholding essential public health tools and medicines.

The aim is to weaken the entire population in these areas and overburden the rudimentary medical facilities that were able to survive in an effort to punish populations opposed to Assad.

Beyond bombing hospitals, primary health clinics, laboratories, and blood banks, Assad’s forces went after doctors, criminalizing those who treated civilians and arresting, torturing, and executing any health care worker who defied government policy. Assad withheld vaccinations against polio, measles, and all other vaccine-preventable diseases from populations deemed politically unsympathetic.

Sparrow, a medical doctor and assistant professor at the Arnhold Global Health Institute at the Icahn School of ­Medicine at Mount Sinai Hospital in New York, writes that “Assad’s war strategies have effectively returned Syria to 19th-century levels of conflict-driven disease—with one important difference. Most victims are now civilians—not soldiers—and measures to protect them are being deliberately destroyed and withheld.”