Here's a fact that tends to get lost in the pageantry of the American Revolution: smallpox killed more Continental soldiers than British muskets did. By the time Washington took command at Cambridge in 1775, the disease was already a strategic liability, ravaging the northern campaign into Canada, sweeping through Boston, and hollowing out companies at the worst possible moments. It was a slow, invisible attrition that individual courage couldn't stop.
The Decision
Variolation, or inoculation as it is known today, was the available solution in the Revolutionary era. Washington initially banned it. His reason was sound: a soldier undergoing the procedure was incapacitated for a month. If the British learned that large portions of the Continental Army were simultaneously laid low in quarantine, the military consequences could be catastrophic. Washington wrestled with the problem through the winter of 1776 into 1777. On February 6, 1777, he wrote to Dr. William Shippen Jr., director of the Army's medical department:
"Finding the smallpox to be spreading much and fearing that no precaution can prevent it from running thro' the whole of our Army, I have determined that the Troops shall be inoculated."
He ordered the procedure staggered across divisions in five-day intervals, commanded private homes and churches as isolation centers, and ran the whole operation under as much secrecy as the circumstances allowed.
The program worked. Smallpox rates among American forces dropped sharply. The Continental Army emerged with an immunity advantage that shaped the rest of the war.
What Washington's Campaign Really Was
Beneath the medical narrative, Washington's inoculation campaign was a biomanufacturing and logistics problem: produce a biological intervention, distribute it across a geographically dispersed force, administer it under adverse conditions, manage the resulting period of incapacitation, and do all of it in secret, under operational pressure, without adequate infrastructure. That's not just a medical question. It's a manufacturing and supply chain question, and it's exactly what three Manufacturing USA institutes exist to answer, permanently, at scale, with 250 years of additional science behind them.
NIIMBL: The Infrastructure Washington Didn't Have
The National Institute for Innovation in Manufacturing Biopharmaceuticals (NIIMBL), headquartered in Newark, Delaware, was built to accelerate what Washington's medics could only approximate: the innovation, standardization, and scale-up of biopharmaceutical manufacturing in the United States.
Pandemics made the stakes plain. When scientists demonstrated the effectiveness of new medical countermeasures in late 2020, the limiting factor was no longer the science; it was manufacturing infrastructure, supply chains, trained workforce, and regulatory pathways. NIIMBL helps ensure that next time we face a public health emergency, those are no longer bottlenecks. NIIMBL’s work spans scalability, efficiency, and safety of manufacturing processes for biomanufactured therapies. These efforts include the NIIMBL Preventive Medical Countermeasures (PMCM) Program, a collaborative initiative that unites industry members and federal partners to advance analytics and robust manufacturing approaches. By sharing knowledge and harmonizing practices, the program aims to accelerate the time-to-clinic and time-to-market for high quality preventive medical countermeasures. NIIMBL builds training manuals, protocols, and technology transfer frameworks that ensure a production process can move from one facility to the next without starting from scratch. The kind of interoperability Washington's medics needed and never had.
BioMADE: The Saltpeter Pamphlet, Updated
In 1775, the Continental Congress distributed a pamphlet telling citizens exactly how to turn stable runnings and slaughterhouse sweepings into potassium nitrate for gunpowder. It was an audacious act of industrial mobilization: here is the process, here are the materials around you, now scale it up.
BioMADE — the Bioindustrial Manufacturing and Design Ecosystem— is the institutional heir to that idea, powered by two and a half centuries of biological science. Its mission: build a domestic, end-to-end bioindustrial manufacturing ecosystem in which engineered microbes and biological processes produce chemicals, materials, and products at commercial scale, replacing petroleum-derived and foreign-sourced inputs with domestic biological alternatives.
In April 2026, BioMADE announced more than $21 million in joint funding across fourteen projects funded through the Department of War and the National Science Foundation. The portfolio includes a scalable microbial process for extracting lithium from produced water — the byproduct of oil and gas operations — which could help secure domestic supply of a mineral critical to EV batteries. Other projects are producing new bioplastics from methane gas, developing AI models to optimize protein production for wound healing and chemical defense, and creating point-of-need manufacturing capabilities for diagnostics and countermeasures.
To bridge the gap between laboratory and factory floor, BioMADE finalized a $132 million investment in 2025 — supported by the Department of War and the State of Minnesota — for a 122,000-square-foot demonstration facility in Minnesota featuring a 25,000-liter industrial fermenters. It's one of the first three sites in a national network – the others currently announced are in California and Iowa – designed to turn proven processes into actual production capacity.
BioFabUSA: Medicine at the Edge
BioFabUSA, based in Manchester, New Hampshire, is working at the frontier of what's biologically possible: scalable manufacture of engineered cells, tissues, and organs. Through its nationwide network, BioFabUSA is establishing the technologies, standards, workforce, and supply chains needed to make regenerative medicine manufacturing scalable, reproducible, and deployable where the need exists.
Washington's surgeons improvised amputations with whatever instruments they could find. Today, organizations within BioFabUSA's nationwide network are advancing technologies such as bioengineered blood products and ocular, bone, muscle, and nerve constructs to restore sight, form, and function following traumatic injury. BioFabUSA and its members have also developed manufacturing and preservation technologies to accelerate distribution and reduce the cost of products that historically required cold chain logistics and controlled laboratories. BioFabUSA is moving next-generation biomedical technologies to the point of need.
Washington inoculated soldiers in private homes and churches because that's where the soldiers were. The principle — effective biological intervention must be deployable where the need exists, not just where the infrastructure is — is exactly what BioFabUSA is encoding into the next generation of military medical capability.
Two hundred and fifty years later, the mission hasn't changed. We're still figuring out how to keep people alive in the field. We're just considerably better equipped to do it.
So, the next time someone tells you American manufacturing is a modern problem with a modern solution, you might gently remind them that we’ve been having this conversation since before we were even a country.
References:
- George Washington to William Shippen Jr., February 6, 1777. Founders Online,* National Archives. Washington's original order to inoculate the Continental Army.
- American Battlefield Trust. "Washington Inoculates an Army." A clear account of the decision, logistics, and military impact of the inoculation campaign.
- Federal Practitioner. "The Shot That Won the Revolutionary War." A peer-reviewed assessment of how variolation shaped the outcome of the war.