Tuesday, March 02, 2004

Human Health in the Spotlight

Arms Control as a Public Health Issue

One of the reasons I hailed Julie Gerberding as a hero is the fact that she has both an MD degree and an MPH.  As I was considering career choices in the early 1980's, i considered going for an MPH.  My thinking was that doctors help one person at a time, whereas public health professionals help many people at one time.  Dr. Gerberding went ahead and did both.

However, there are many ways to improve public health, and perhaps there is no better example than that of arms control experts. Every day, we read headlines about he Axis of Evil, uranium centrifuges, missile technology, ricin, anthrax, sarin, and so forth.  The problem with arms control as a profession is that, while you try to help improve the health of the entire planet, you never really know how successful you have been.  And, to a great extent, nobody else knows, or even cares. 

Yet, as we get closer to the Presidential election in the USA, it is increasingly important that we all pay close attention to the issue of arms control.  We have an opportunity to have a significant impact; not as doctors or public health wonks, nor as arms control experts; rather, we can have an impact on public health by making wise and informed choices in the voting booth.  Some presidential candidates may seek to sway voters by emphasizing the dangers of arms proliferation.  Indeed, there are few things with a public health impact greater than a nuclear weapon in the wrong hands.  Other candidates may seek to provide a balanced view of the arms control issues.  Such a balanced approach would acknowledge the dangers, but also acknowledge the opportunities.  The dangers are fairly obvious: nuclear weapons, dirty bombs, bioterrorism, chemical weapons, and advanced delivery systems.  The opportunities are much less obvious;  often, opportunities are anything but obvious.  It may take a certain degree of creativity and vision to see the opportunities amidst the dangers.   Danger is easy to compress into a sound bite.  Creativity takes, well, creativity to express. 

As we seek to become more informed about the arms control issues confronting our nation, many of us will turn to the Internet.  A few may stumble across this obscure site, The Corpus Callosum.  Therefore, I would like to take this opportunity to provide some information about arms control in the specific context of USA Election 2004. 

In all likelihood, we will have three candidates from which to choose.  The Republican candidate will be George W. Bush, barring some some of catastrophe.  The Democratic candidate probably will be John Kerry, but could be John Edwards.  (This is written one day before Super Tuesday.)  Ralph Nader will be a third candidate.  I will not give serious consideration to Mr. Nader.  Despite his virtues, he has no chance of winning. 

http://www.ecaar.org/The first thing to do here is to compile sources of information.  As it happens, someone else already has done a lot of work on this.  The Economists Allied for Arms Reduction  have a site with extensive information on the economics of war and some about the economics of terrorism.   Their overall philosophy seems to be encapsulated in the introduction to one of their articles:

Notes on the Economics of War and Empire by James Galbraith: The philosophical tradition of our discipline is broadly anti-war. This is not, as some suppose, because commerce is inherently a pursuit of the peace-loving. Quite to the contrary: Mercantilism was a doctrine of trade as war by other means. To the mercantilist, the accumulation of surplus served the same purposes as the privateer. 

But opposition to mercantilism was the hallmark of the modern economists, and in this light Wealth of Nations is a pro-peace tract. Smith identified the fund of labor as the source of wealth, partly in order to undermine the rationale for the pursuit of trade surpluses. Further, by making the distinction between productive and unproductive employments with soldiery counted among the latter, Smith placed expenditure on the military firmly among those types of spending to be kept as small as possible. He would have been a comfortable member of ECAAR.

Another resource is the page of links at http://carecon.org.uk/defence-links.html.  This is from the Applied Research in Economics Group, the parent organization of ECAAR.  One of their links will take the carefree link-clicker to the Arms Control Association website.  They style themselves to be "The Authoritative Source on Arms Control."  They claim to be nonpartisan.  I cannot verify this independently, but I did not see any obvious political bias.  The have an article by Alton Frye entitled: Election 2004: The National Security Context.  Frye's article states the obvious, as in this excerpt:

Like Reagan, Bush’s rhetoric is polarizing: it invigorates his fellow Republicans while infuriating Democrats.

He goes on to make the following points, ones that are less obvious:

Nonetheless, many voters will find it essential, if difficult, to draw a scrupulous ledger of the assets and liabilities of Bush’s foreign policy record. There is much to be listed on the positive side of that ledger, and critics would do well to stipulate as much. Bush has taken the most advanced position of any president in supporting a two-state solution in the Israeli-Palestinian conflict. He has made multibillion-dollar commitments to the global effort to deal with HIV/AIDS, and his recasting of U.S. foreign assistance programs into the Millennium Challenge Account will, if funded, represent major improvements. He provided sober and determined leadership after September 11, earning wide admiration. With more agility than many expected, Bush shifted from a wary initial posture toward China as a strategic competitor to forge what knowledgeable observers describe as the best relationship the two countries have known since the Tiananmen Square crisis of the late 1980s. The president will able to tout these and other aspects of his foreign policy record as the 2004 race proceeds. It is on other issues that challenges will center... [bold emphasis mine]

Bush’s highlighting of the enhanced risks of proliferation in an age of terrorism is the baseline for his national security policy, a formulation that is both sound and politically astute.

Nevertheless, this central preoccupation has bred controversial initiatives. Disregarding domestic resistance and nearly universal international opposition, Bush moved methodically—some would say gratuitously—to terminate the 1972 Anti-Ballistic Missile Treaty in order to pursue an as yet unproved national missile defense system. Yet, he coupled the action with commitments for further reductions in strategic offensive nuclear forces. Those commitments were embodied in a new treaty with Russia, albeit one of limited duration and scope. The president opposed reconsideration of the Comprehensive Nuclear Test Ban Treaty but promised continued adherence to a testing moratorium. The latter policy, however, grew suspect with the administration’s plans to investigate new types of nuclear weapons and shorten the lead time for the possible resumption of testing, if deemed necessary for such hypothetical missions as deep-penetration bunker busters. Reflecting the administration’s skepticism of anything less than nearly perfect verification arrangements, the Bush team shied away from attempts to enhance inspection and enforcement provisions in the Biological Weapons Convention.

A serious difficulty in the administration’s approach—one sure to attract criticism in the coming election season—has been a tendency toward inflammatory language and provocative concepts. Read as a whole, the administration’s National Security Strategy offered many reasonable, forward-looking dispositions, including acknowledgement of a host of issues that can only be addressed through effective international collaboration. The entire document came under a cloud, however, because of its brief assertion of a doctrine of pre-emption and a determination that the United States should strive to maintain its military dominance more or less permanently. Those ideas were bound to elicit worry and condemnation in many quarters; they were hardly rallying cries for other states to join in efforts to manage the wider array of shared problems identified in the paper.

Mr. Frye goes on to discuss the problems with the doctrine of pre-emptive strikes, the unfortunate use of the word "crusade," and the controversial characterization of Iran, Iraq, and North Korea as "an Axis of Evil."  He credits Bush with the apparent increased openness of Iran to weapons inspectors, and the recent improvements in the
Libya's arms control efforts.   Personally, I suspect that negotiations with Libya have been going on for a long time, and there is more to the story than we know.  Still, one could argue that the invasion of Iraq was an impetus for the decommissioning of Libya's nuclear program.  Frye pronounces a "mixed verdict' on the Bush administration's efforts in North Korea.  His comments do not sound like an evenly  mixed verdict, however:

All in all, the president’s personalization of policy toward North Korea, reflected in his overt hostility toward Kim Jong Il, does not bespeak prudence in the face of danger. The menacing reality on the Korean peninsula makes hostages of Seoul’s millions of citizens and the thousands of U.S. forces deployed there. North Korea’s massive firepower along the 38th parallel constitutes an awesome conventional deterrent and denies the United States any acceptable military option to counter the North’s WMD activities. Great powers do not usually advertise their anxieties, but if the president’s approach is to be faulted, it is probably because it embodies too much loathing and not enough fear.

The remainder of the article summarizes Bush's weaknesses and goes on to say that the success of Bush's campaign for re-election may well depend upon the outcome of further developments in Iraq.  He refers to the Iraq war as bush's "greatest diplomatic feat -- and his greatest political and diplomatic failure."  His conclusion is interesting.   I will not cite it at great length, for fear of overstepping the boundary of "fair use."  Rather, I will summarize by reporting that Frye's expresses the opinion that Mr. Bush's re-election prospects will be dependent upon his ability to demonstrate progress on the task of establishing democracy and political stability in Iraq.
Nuclear facility in Algeria
Another arms control website is that of the Institute for Science and International Security.  This contains information regarding the problem of nuclear proliferation.  Most of the articles have to do with Iran, North Korea, and Iraq.  There is one article about the nuclear program in Algeria.  The article about Algeria is disturbing, because it highlights some of the limitations of IAEA inspections.  Many of the articles on the ISIS site were published originally in The Bulletin of the Atomic Scientists, another good source of information.  The authors of the Bulletin keep track of the nuclear proliferation, specifically, but they also pay attention to other weapons of mass destruction. 

The Bulletin's famous Doomsday Clock currently stands at seven minutes to midnight.  This is sort of like the Dept. of Homeland Security's terrorism alert level.  The good news is that they have not advanced the clock since February 27, 2002.  The bad news is that the clock now stands at the same place it was in 1955.  Their press release on the topic basically summarizes their current concerns about arms control:

February 27, 2002: Today, the Board of Directors of the Bulletin of the Atomic Scientists moves the minute hand of the “Doomsday Clock,” the symbol of nuclear danger, from nine to seven minutes to midnight, the same setting at which the clock debuted 55 years ago. Since the end of the Cold War in 1991, this is the third time the hand has moved forward.

We move the hands taking into account both negative and positive developments. The negative developments include too little progress on global nuclear disarmament; growing concerns about the security of nuclear weapons materials worldwide; the continuing U.S. preference for unilateral action rather than cooperative international diplomacy; U.S. abandonment of the Anti-Ballistic Missile (ABM) Treaty and U.S. efforts to thwart the enactment of international agreements designed to constrain proliferation of nuclear, chemical, and biological weapons; the crisis between India and Pakistan; terrorist efforts to acquire and use nuclear and biological weapons; and the growing inequality between rich and poor around the world that increases the potential for violence and war. If it were not for the positive changes highlighted later in this statement, the hands of the clock might have moved closer still.

In the interest of fairness, they criticize the Clinton administration as well as both Bush administrations:

...since 1991, successive U.S. and Russian administrations have failed to push for either a full inventory of weapons and materials, or for measures to confirm their destruction.

Of interest to US voters in 2004, they do cite some specific concerns about Bush 43, and about global economic policy in general:

The U.S. administration’s decision to withdraw from the ABM Treaty is a matter of great concern. The administration’s rationale—that the treaty is a relic that endangers U.S. security interests—is disingenuous. Regrettably, the United States was unwilling to consider any compromise that would have preserved the basic framework of the treaty, and therefore blocked pursuit of a compromise that would have allowed additional testing but maintained some limits on defenses. Abandoning the treaty will have serious repercussions for years to come...

...Yet the U.S. administration has abandoned negotiations with that country [North Korea], and in his State of the Union message, President George W. Bush lumped all three countries together as an “axis of evil,” warning that, “The United States of America will not permit the world’s most dangerous regimes to threaten us with the world’s most destructive weapons.” The preference implicit in this statement for preemptive force over diplomacy, and for unilateral action rather than international cooperation, is likely to complicate efforts to defeat terrorism and strengthen global security....

...When resetting the clock we have often noted that the growing disparities between rich and poor increase the potential for violence and war. Poverty and repression breed anger and desperation. Charismatic leaders with easy answers prey on the dispossessed and disaffected, channeling their anger into dangerous and destructive activities. The global community must recognize these facts and do much more to address them. The success of the war on terrorism depends not only on disrupting and destroying terrorist organizations, but also on eradicating the conditions that give rise to terror.

This last comment, the one about the "growing disparity between rich and poor," is not a direct criticism of Bush, because they are referring to the increase gap between the wealthiest countries and the poorest countries.  One could argue, though, that the corresponding gap within the US population carries with it parallel risks. 

Seeking appropriate balance in their presentation, the authors of the Bulletin mention some positive developments attributable to the current US policies:

U.S. funding and technical assistance continues to make significant and cost-effective contributions to international security by working to ensure that Russian nuclear weapons are dismantled, and that nuclear materials and nuclear expertise do not leave Russia...

...President Bush’s announcement in November 2001 that U.S. “operationally deployed strategic warheads” would be reduced to between 1,700 to 2,200 by 2012—an intention reaffirmed in the administration’s Nuclear Posture Review in January—is positive news.

The authors conclude with some statements regarding the most desirable goals to be sought by the USA in future arms control efforts.  They call for reduction of US and Russian nuclear warheads to 1,000 each.  They call for an end to the practice of keeping some nuclear weapons on high alert status.  They also call for greater funding for control of fissile material in Russia.  Among their concluding recommendations, they call for advancement of a
Fissile Material Cut-off Treaty.  This is something that Bush has mentioned, but does not seem to have pursued.  As I pointed out in an earlier post, this would require that the US go back to the UN and seek international cooperation.  I would suggest that this become an issue in the upcoming election, especially since Mr. Bush already has put the issue on the table for discussion. 

Since it is getting late, and I don't want to increase my insulin resistance, C-reactive protein, and leptin by depriving myself of sleep, I will research and report upon the Democratic candidates' arms control policies tomorrow, or whenever I have the time...