Before Sept. 11, smallpox had been conquered, plague was a chapter in medieval history and anthrax was a heavy-metal band.
In government, military and academic labs, a few scientists were studying these and other rare or Third World scourges that might be used in warfare or terror attacks.
But the big pharmaceutical companies were focused instead on diseases with bigger markets - such as HIV, influenza, meningitis, chicken pox or pneumonia.
So, when the terrorism of Sept. 11 put fear of bioterrorism on the front page, America opened its medicine chest to find that its defenses against the most likely bioterror agents were wanting.
Dr. Tara O'Toole of the Johns Hopkins Civilian Biodefense Studies Center told Congress that the United States had effective vaccines or drug treatment for just 12 of the 50 most serious pathogens thought to be likely bioweapon agents.
Developing and producing new vaccines to defend Americans against even the most likely bioterror agents could take a decade and hundreds of millions of dollars - each, experts say. It will not always be easy, or even desirable.
But there is now new momentum.
"There is, every day, more and more marshaling of resources and thoughts to try and become prepared," says Dr. Myron Levine, director of the University of Maryland Center for Vaccine Development.
Last year's federal budget included about $350 million in public health spending related to bioterrorism defense preparations. Democratic Sen. Edward M. Kennedy of Massachusetts and others have proposed spending more than $1.4 billion in the current year. The Bush administration has discussed an $800 million figure.
U.S. Health and Human Services Secretary Tommy G. Thompson has ordered the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration to join hands and work with private industry in the United States and abroad.
"He knows the urgency of it and is getting personally involved to make sure we don't have any insurmountable barriers," says Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.
Under normal circumstances, Levine says, the government labs, academia, biotech companies and drug makers constitute a vaccine research and development machine that is "by far the most productive in the world."
