A drug for smallpox has been approved, even though the disease no longer exists

I think it's just that nobody has both the ability and desire to destroy the world at the same time. Do we even know if smallpox would kill a modern human?

Smallpox on the other hand is much more likely to just get your home country nuked into oblivion if they find who deployed it. It's effectiveness as a weapon is going to be limited in first world countries with ring vaccination programs and epidemiologists. On the other hand it would be devastating to the countries that would have a ideological reason to deploy them.

Modern terrorism is a game of chicken. You want to be successful enough to degrade the enemy without triggering a backlash. Smallpox and nuclear weapons are great deterrents, however deploying them would mean the end of the countries and organizations using them.

Dr. Strangelove: "Of course, the whole point of a Doomsday Machine is lost, if you keep it a secret! Why didn't you tell the world, EH?"

And considering how much suffering this parasite has caused, it is a nice thought to think that humanity might get some benefit out of it beyond simply stopping the cycle of pain.

https://en.wikipedia.org/w/index.php?title=Resilience_(mater...

The extinctness of the dodo is present tense. Therefore, it is an extinct bird.

The dodo was a ground nesting bird that inhabited the island of Mauritius. But it's still extinct.

The term to use is "immune compromised host"

I think this is essentially unprecedented and I doubt any pharmacies would be allowed to stock it let alone dispense it without calling the FDA/manufacturer directly and getting case by case approval to apply it under clinical supervision. The approval does clear the bureaucratic hurdles to transporting across state lines and getting it into the hands of a doctor quickly in the emergency event that smallpox returns.

Edit: Their Phase 3 trial [1] appears to be the equivalent to a regular Phase 1 trial where the dosage of the drug is increased under clinical supervision until side effects become intolerable for 50% of the patients to find a safe maximum dose. This means that they tested safety in vivo on humans already and instead of showing efficacy (whether it actually does what it is supposed to do vs a placebo) on humans, they were allowed to do it with animals. They used 449 18 to 80 year old patients which is quite a bit more than usual for a safety phase so they can be reasonably certain it won't make the situation worse in the event of smallpox.

[1] https://clinicaltrials.gov/ct2/show/NCT02474589

I assumed that the problem with multi-resistant pathogens was that the patient may not live long enough to try all antibiotics.

Which doesn't mean that terrorists actually have the good judgment to recognize potential consequences, but e.g. your typical Islamic extremist would consider wiping out the Middle East to be undesirable.

The zealots are usually foot soldiers for states or quasi-states, or groups aspiring to control/creation of states, and most of those groups are similarly rational to states. A random Hamas footsoldier, especially with assurances that his family will then be cared for, may commit a suicide attack, just as a soldier of a name might engage in kamikaze attacks, of in military missions that involve a practical certainty of personal death. But neither the leadership not the groups as units are prone to deliberate self-destruction to maximize damage to enemies.

At that point, I suspect aggressive deterrence will be the only viable option.

More likely, warfare biological or not is going to become even more rare and even less accepted.

If we keep up the forces that brought us peace, UN, EU, NATO, international trade, amongst many other forces, we're more likely to a world without war.

They all spread memetically rather then biologically. In a way that is a bigger problem because it means effective eradication is virtually impossible, because even if the practice is eliminated, it has “spores” in human cultural record which are both difficult to eliminate and difficult (arguably impossible) to avoid adverse side effects when eliminating.

It's a weapon so dangerous to use that only the insane would even develop it in the first place.

There is no real way someone could set off a biological bomb and promise it won't make its way back to their own people. If it is infectious enough to wipe out the enemy completely, it is enough to spread to your home country. I think some of this is because a biological bomb would almost need to be something that can be carried through the air. There are probably some that could dust an area requiring direct contact, but if the folks have good hygeine, it'll be less of a threat. Contaminating drinking water is harder still - and again, you have to get through hygiene and all available filtration and sanitation systems that the enemy could be using.

You could infect animals, but animals being what they are they are likely to infect folks that aren't the enemy, including your own ground troops if you have any. Things that need direct contact with bodily fluids are even harder to use directly, and you are just as likely to kill slews of medical personell as you are the folks actually warring. Any accidents kill your own people first.

In any case, the outcome and international response will likely be similar to using nuclear warheads on a people. It might work, but you are going to kill lots of innocent people as well with something that keeps on killing long after the initial sickness due to the infectious nature of the thing.

Additionally, I highly doubt they'd mistake a biological for a traditional bomb: Any smart country with a scientific section would be looking at the components of bomb residue. If a biological agent is included, I think there is a chance of finding it and developing a cure before the kiling happened if it doesn't happen in a short timeframe.

Now, this is just for diseases. Poisons (biological or synthetic) and other sorts of chemical weapons are probably easier to control these things, and international response seems to be unfortunately slow on this depending on where in the world it is happening.

The interesting thing is that many of those targets are also conventionally attackable yet don't seem to be even considered. Firebombing farms isn't the norm although it is technically an option to weaken them.

For instance terrorists could cause a lot of disruption and casualties just by sabotaging train tracks or shooting substations yet they they target people directly instead. It seems almost memetic that they avoid the 'boring' options even when they lack other motivations. Al-Qaeda doesn't plan on annexing the US in even their wildest dreams so they would have no reason to care about damage to an asset - it is even cheap and uses highly available tools locally. Yet they never even attempted it. The closest thing was considering bringing a plane into a nuclear powerplant until they did the math and realized that it wouldn't cause a meltdown, radiation leakage, or even loss of power - it would cause cosmetic damage.