At a global workshop sponsored by the Advanced Systems & Concepts Office of the Defense Threat Research Agency within the U.S. Department of Defense, Professor Margaret Kosal described the "game-changing" nature of threats posed by synthetically manufactured smallpox viruses. Kosal delivered the keynote address at the "Over the Horizon Workshop on Synthetic Smallpox" which was held June 29, 2009 in Washington, D.C.

The threat of smallpox virus being deployed as a biological weapon has seemed remote since stock for the virus has been inaccessible to all but a handful of authorized personnel in the U.S. and Russia. However, current cutting-edge biotechnology has made de novo (from scratch) synthesis of smallpox, and potentially any virus, a 21st century possibility.

Kosal joined experts and representatives from U.S. government agencies and laboratories, the World Health Organization, Interpol, and the World Bank in an exploration of security threats from genetic manipulation of orthopox viruses and the research needed to anticipate them. Topics included the role for deterrence, current international and global security arrangements, the role of the U.S. government is guiding the discussion, and possible paths forward to close gaps in the current countermeasures.