The world market in counterfeit pharmaceuticals is estimated to be worth some $75 billion annually. A couple million dollars worth of this trade can be attributed to the trade of botulinum neurotoxin (BoNT), an extremly potent toxin that, at very low doses, is commonly used in both cosmetic, e.g. BoTox, and therapeutic medical treatments. Because BoNT is the most potent toxin known to man, it is grouped with the world’s most lethal potential biological weapons agents, sharing “Select Agent” status with the pathogens that cause smallpox, anthrax and plague. This biowarfare potential puts the existence of illicit laboratories churning out the toxin and of shady distributors selling it worldwide through the Internet into a more disturbing light than most pharmaceutical fraud. This topic was addressed during a meeting Tuesday, November 9th at Global Green USA where Dr. Raymond Zilinskas, the director of the Chemical and Biological Weapons Nonproliferation Program at The James Martin Center for Nonproliferation Studies, presented some of his work on illicitly produced and/or distributed BoNT.
Dr. Zilinkas spoke about the various producers and end users for BoNT, which includes pharmaceutical grade BoNT sold to legitimate end users such as doctors, reagent grade BoNT which could be sold to both legitimate end users such as scientific researchers, or to dubious end users (e.g. the 2004 BoNT misuse incident in Flordia by Dr. McComb), and illicitly produced BoNT which is sold to dubious end users and possibly to terrorists. Dr. Zilinskas stressed that legitimate BoNT is sold in very low doses, such that it would take more than 20 bottles of BoTox to deliver a deadly dose of BoNT to an average individual. The issue is that concentrated BoNT has the potential to be very dangerous, and since BoNT production necessarily goes through a stage during which BoNT is at very high concentrations, all illicit producers have the potential to sell concentrated BoNT. In fact, Dr. Zilinskas mentioned that he has come across illicit companies offering to sell BoNT at any concentration.
With the wide availability of this dangerous toxin, some asked “… why has no one used BoNT in a terrorist attack since the terrorist group Aum Shinrikyo’s failed attempt in the early ’90s?” Dr. Zilinskas stated that due to some technical difficulties, guns and bombs are still the preferred method of mass destruction. But, the issue remains, what happens when BoNT is easier to acquire than guns or bombs? To address this, Dr. Zilinskas is interested in finding out who runs the illicit labs, from where, how many are there, are they independent or are they networked, and do they share a common distribution system? Once we know more about the labs, then proper agencies can begin to shut them down.
For more information on this topic, please read Dr. Zilinskas’ July 2010 article in Scientific American, “Fake Botox, Real Threat.” You can also listen to Diane Rehm’s show on the “Implications of a Global Black Market for Botox,” which features Marina Voronova-Abrams from Global Green USA.