Remembering Alexi Anatolyevich Navalny: The Russian opposition leader, lawyer, anticorruption activist, and political prisoner, Alexi Navalny died in the Arctic Wolf prison in Siberia approximately 1 year ago on February 16, 2024. He was designated a Prisoner of Conscience by Amnesty International and winner of the Sakharov Prize from the European Parliament for his work on human rights.—Robert Peter Gale, MD, PhD
Political Assassins and Poison
Poisoning of one’s political rivals has a long history. In 399 BC, an Athenian Court finding Socrates guilty of impiety and the corruption of youth ordered him to drink a fatal dose of hemlock. Jumping ahead a few centuries, in 1521, Juan Ponce de Leon was killed by an arrowhead dipped in the sap of the manchineel tree. In 2017, Kim Jong-Nam, half-brother of North Korean leader Kim Jong-Un, was assassinated by two women who walked up to him in the Kuala Lumpur airport and rubbed the nerve agent VX onto his face. And the list goes on.
Interestingly, a surprising proportion of poisonings involve Russians.
In 1959, Stepan Bandera, a Ukrainian nationalist, was assassinated by the Russian Secret Service (KGB), now the Federal Security Service (FSB), using a cyanide gas–emitting pistol.
In 2004, Ukrainian opposition leader and Russia critic Viktor Yushchenko fell ill during his campaign for President. Physical exam suggested dioxin poisoning. In 2006, in a case in which I was involved, former KGB agent and Kremlin critic Alexander Litvinenko died of radiation poisoning after taking tea containing polonium-210. A 2016 British inquiry ruled the murder was probably committed by the FSB.
In 2018, former Russian spy Sergei Skripal and his daughter Yulia were found unconscious on a park bench in Salisbury, England, having been poisoned with novichok, a weapons-grade anticholinesterase nerve agent developed by the Soviet military.
Political assassins used diverse poisons to eliminate political rivals including arsenic, tree bark, dioxin, ricin and novichok. Delivery routes were also creative: poisoned tea, cakes, gas-emitting pistols, and the like.
Alexei Navalny
In August 20, 2020, Russian political opposition leader Alexei Navalny was hospitalized in Tomsk after becoming acutely ill on a flight from Omsk to Moscow. Soon thereafter, he was transferred to Charité hospital in Berlin. The German Federal Defense and several laboratories associated with the Organization for the Prohibition of Chemical Weapons confirmed the present of a new novichok derivative in blood and urine samples.1,2
Of considerable interest was detecting the agent on skin, suggesting the exposure route was via clothing. Contaminated underwear is suspected as the most likely source. Details of Mr. Navalny’s hospitalization and recovery were reported in The Lancet.3
Fortunately, Mr. Navalny recovered but may have had long-term health sequelae. He voluntarily returned to Russia in early 2021 and was immediately imprisoned, ironically, for violating his parole while in the German hospital. ,He was later accused and convicted of several crimes including embezzlement and contempt of court, and sentenced to 9 years imprisonment. After stays in several Siberian prisons, he was transferred to the IK-3 special regime colony known as Polar Wolf.
On February 16, 2024, the Federal Penitentiary Service announced Mr. Navalny died at the prison. Sergey Naryshkin, head of the Russian Foreign Intelligence SVR-RF, said Mr. Navalny died of natural causes.
Readers will wonder why an article on nerve gas–wielding assassins is appearing in The ASCO Post. There’s a connection.
Chemical Warfare and Chemotherapy
During World War I, the Germans used chemical warfare including mustard gas. So did the British and French but only after the Germans. Chemical warfare was banned by the Geneva Protocol in 1925, but at the start of World War II, there was concern it might be reintroduced. To prepare, the U.S. Army secretly shipped a cargo of mustard gas bombs to Bari, Italy, aboard the SS John Harvey. In 1943, a German air raid sank the SS John Harvey releasing the bombs into the sea, injuring and killing more than 1,000 people. Dr. Stewart Alexander, an Army officer and expert in chemical warfare, was sent to investigate. In a secret document to the Army, Dr. Alexander reported that the injuries and deaths he observed resembled changes he had seen in rabbits injected with nitrogen mustard, especially severe bone marrow suppression. Presciently, he suggested the bombing released mustard gas, which killed rapidly dividing cells, especially lymphocytes, and might be useful to treat some cancers.
In 1942, Drs. Louis Goodman and Alfred Gilman at Yale developed a derivative of mustard gas, nitrogen mustard. Based on Dr. Alexander’s report (to which they were privy), they reasoned their agent could be used to treat lymphomas. In 1942, after successful experiments in mice, they collaborated with Dr. Gustaf Lindskog to treat a man with a non-Hodgkin lymphoma with mustine (mechlorethamine, HN2). There was a dramatic albeit transient response. In 1946, they reported data using mustard derivatives in lymphomas and other cancers.4
Ironically, the newest mustard derivative, bendamustine, was developed in Jena in the German Democratic Republic (GDR), now the same country (Federal Republic of Germany) where Alexey Navalny was treated for novichok poisoning.
Recently, the United States accused Russia of using chloropicrin, a chemical agent widely used during World War I, in the war in Ukraine. We await convincing evidence this is so.
Robert Peter Gale MD, PhD, DSc(hc), FACP, FRCP, FRCPI(hon), FRSM, is with the Centre for Haematology, Department of Immunology and Inflammation, Imperial College of Science, Technology and Medicine, London.
Disclosure: Dr. Gale reported having served in a leadership role for Neximmune, Ascentage Pharma Group, Antengene Biotech, StemRad Ltd, FFF Enterprises, and Nanexa AB; owns stock and has other ownership interests in Celgene; has received honoraria from BeiGene Pharma; and has received reimbursement for travel, accommodations, and expenses from Celgene.
References
- OPCW Issues Report on Technical Assistance Requested by Germany". Organisation for the Prohibition of Chemical Weapons. October 6, 2020. Archived from the original October 6, 2020. Retrieved May 2, 2024.
- FOI Confirms German Results on Novichok. Swedish Defence Research Agency. September 15, 2020. Archived from the original December 21, 2020. Retrieved May 2, 2024.
- Steindl D, Boehmerle W, Körner R, et al: Novichok nerve agent poisoning. Lancet 397:249-252, 2021.
- Goodman LS, Wintrobe MM, Dameshek W, et al: Nitrogen mustard therapy: Use of methyl-bis(beta-chloroethyl)amine hydrochloride and tris(beta-chloroethyl)amine hydrochloride for Hodgkin's (sic) disease, lymphosarcoma, leukemia and certain allied and miscellaneous disorders. JAMA 132:126-132, 1946.
Disclaimer: This commentary reflects the views of the author and may not necessarily reflect the views of The ASCO Post or ASCO.
