Due to the stock for the smallpox virus being inaccessible to all but a handful of authorized personnel in the US and Russia, the threat of smallpox as a biological weapon has seemed remote. However, current cutting-edge biotechnology has made the de novo (from scratch) synthesis of smallpox and potentially any virus a possibility that requires further research.

Professor Margaret Kosal joined a team of experts at an invitation-only workshop in June entitled, Over the Horizon Synthetic Smallpox: Now What? The workshop was sponsored by ASCO, the Advanced Systems & Concepts Office of the Defense Threat Research Agency, and included representatives from US government agencies and laboratories, the World Health Organization, Interpol, and the World Bank.

Topics considered included the role for deterrence, current international and global security arrangements, the role of the US government is guiding the discussion, and possible paths forward to close gaps in the current countermeasures.

Professor Kosal delivered the keynote address, Deterrence, Policy, and Strategic Security Implications of Synthetic Smallpox, at the "Over the Horizon Workshop on Synthetic Smallpox" discussing the potential strategic implications of the genetic manipulation or de novo synthesis of orthopox viruses as a "game-changer" for national and international security.