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.
Warfare was long synonymous with conditions preferred by germs—soldiers were packed into trenches without sanitation or clean water, exposed to the environment, and surrounded by vermin. Poor nutrition didn’t help, and penicillin wasn’t an option until the 1940s. During the Napoleonic wars, eight times more British soldiers died from pneumonia, typhoid, and dysentery than in battle. In the American Civil War, two-thirds of all deaths were due to pneumonia, diarrheal disease, and malaria.
