Smallpox: the Fight to Eradicate a Global Scourge is a thorough treatment of the debate about whether or not to eliminate the last known stocks of variola. Koplow's writing is lucid and accessible, and he is good about delineating purely speculative evidence from more substantial evidence.
His book is thorough. The first six chapters either cover general background about the disease or lay the groundwork for arguments forwarded in the final three chapters. This includes general background on the history of the eradication effort, the biology of viruses and the history and authority of the WHO. Koplow also gives background to orient the reader for arguments laid out in chapters 7-9. He discusses environmental law, especially as it relates to biodiversity and endangered species legislation to prepare for later questions about whether the virus should be protected on environmental or moral grounds. Because some of the most important arguments about whether or not to eliminate the variola stocks relate to national security concerns, he discusses biological weapons (BW)—international agreements on BW use, previous instances of BW use, perceived threats in post 9-11 world.
At times Koplow is overly thorough. Although he admirably wishes to give the reader a strong understanding of the history of environmental legislation, most of this background is not pertinent to smallpox. He readily admits this, writing: “In sum, the law of environmental protection...is not directly relevant to the question of extermination of the variola virus” (136). His treatment of bioweapons is a little better, but he fails in many places to relate his examples back to the question at hand. For instance, Koplow mentions the anthrax scare multiple times, but only to convince the reader that BW is a real threat. He could have drawn more specific and useful connections to smallpox by, for instance, discussing relevant epidemiological differences between anthrax and smallpox, or whether one disease is more weaponizable than the other, or whether one is easier to identify and diagnose.
On the good hand, Koplow's insistence on covering issues that don't directly relate to smallpox leads us to think about issues in broader or more interesting terms. In spite of the fact that environmental law is largely irrelevant, it was interesting to consider the smallpox extermination debate in terms of endangered species protection. More than anything, such considerations shed more light on our feelings about endangered species than on smallpox. For instance: “Why do we extend special recognition to big creatures and not small?”
Finally, a minor flaw in the last three chapters was Koplow's tendency to show his hand while supposedly giving even-handed accounts of the extermination debate. It is clear, for instance, that he believes elimination would be hubristic when he portrays the side in favor of extermination as saying that humans “play God all of the time” (195). Nevertheless, the critical reader will be able to discern Koplow's biases and can still learn a lot from this book.