Strategy of the IPPNW in the 21st Century
and our expectations for the Japanese anti-nuclear movement.

Dr. Mary-Wynne Ashford

Twenty years ago, in the dark times of the Cold War, a handful of doctors challenged orthodox beliefs about the enemy and founded an organisation of doctors determined to prevent nuclear war. From its beginning, IPPNW focused on the fact that there could be no meaningful medical response to a nuclear war, that prevention is the only rational course.

We are not a group of activists who happen to be doctors; we are doctors first, committed to easing suffering and death. We bring that commitment to the global stage in our attempt to prevent the ultimate suffering and death of nuclear war . The tools of our work are research, education and advocacy, and our unique contribution is that we bring the skills, expertise and ethics of medicine to the work of preventing war. We are non-partisan and neutral with regard to conflicts but we will not be silent in the face of evil. We recognise that nuclear war cannot be prevented without preventing conventional war.

We know that in more than half the world, doctors face the immediacy of other issues such as inadequate nutrition, polluted water, disease and poverty, and that nuclear war seems a distant problem. At the same time, we know that the effects of a nuclear war would not spare the South. In 1993 the mandate of IPPNW was expanded to read "IPPNW seeks to prevent all wars, to promote non-violent conflict resolution, and to minimise the effects of war and preparations for war on health, development, and the environment."

IPPNW was founded by two world-renowned cardiologists: Dr. Bernard Lown of the United States, and Dr. Evgenie Chazov of the USSR. These charismatic leaders touched doctors all over the world and inspired more than 200,000 to join in the work to educate the public and world leaders about the looming threat to the survival of our planet. In the early 1980's, IPPNW held World Congresses in cities on both sides of the Iron Curtain, and seized the attention of cameras the world over. In 1985, IPPNW won the Nobel Peace Prize for its work bringing together doctors from the US and the USSR to prevent nuclear war. In 1989 the IPPNW World Congress was held in Hiroshima. We are still haunted by the images of Hiroshima: The Atomic Bomb Museum; the shadows on the paving stones where once a human being stood in the light of a fire brighter than the sun, and disappeared; and the voices of the hibakusha telling of an unimaginable nightmare.

With the fall of the Berlin Wall and the collapse of the Soviet Union, the vast majority of the public heaved a huge sigh of relief and went on with other things. Peace groups folded as many social activists turned their attention to other urgent social issues such as human rights, and the deterioration of the environment. After 1991, membership in IPPNW and its affiliates dropped significantly, and public events dealing with nuclear weapons were rare.

Committed activist doctors in IPPNW recognised that disarmament was not, in fact, advancing. We intensified our efforts at the UN, and continued to publish research documents exposing, among other things, the health effects of militarism, including plutonium production, low level radiation, the threat of nuclear war by accident or terrorist attack, the effects of a bomb on Bombay, and the continuing devastation caused by anti-personnel landmines.

IPPNW has been part of several major successes on the path to disarmament. Let me remind you of them briefly because they illustrate the increasing power of civil society to bring about change in the international sphere. In 1987 a handful of activists (doctors and lawyers) in New Zealand were considering whether nuclear weapons were illegal under international law. They reasoned that if dumdum bullets were illegal then nuclear weapons surely must be. A lawyer commented that their ideas made little difference, unless the World Court made a statement that nuclear weapons were illegal. The problem was that only a nation state or a UN agency, not ordinary people, could ask the opinion of the Court. The group then decided to campaign to get a nation to take the question forward at the UN General Assembly.

In 1988 a New Zealand doctor brought this project to IPPNW for support. I recall the meeting where we voted unanimously to support the World Court Project although many of us thought it was a crazy idea that would never go anywhere. It turned out to be a brilliant idea that circled the globe. Over the next few years, 3 million people all over the world signed declarations that it was their conscientious belief that nuclear weapons were abhorrent and should be banned, and they requested the World Court to give an advisory opinion about their legality.

At the UN General Assembly, the Non-aligned Movement proposed the resolution, and delegates voted overwhelmingly in favour of asking for an advisory opinion from the Court. Fourteen months later, in 1996, the Court gave its opinion that in general, the threat or use of nuclear weapons is not legal under international law, and perhaps more importantly, that Article VI of the Preamble to the NPT is a legally binding obligation of the nuclear weapons states to proceed to full and complete disarmament. This marked the first time that civil society had succeeded in moving the General Assembly to an action. The importance of the advisory opinion was very evident at the NPT Review last May, where many countries cited the opinion in their submissions.

A second example of IPPNW collaborating in a powerful action by civil society is the International Campaign to Ban Landmines. One of the first meetings of this campaign took place in a convent in London England in 1992. Some fifty representatives of NGO's met for three days to learn the facts about landmines, the injuries they caused and the legal instruments that might be used to ban them. The level of expertise and strategizing was exceptionally sophisticated, and the campaign moved swiftly to capture media and government attention. In the next year the campaign was greatly facilitated by e-mail communications. As you are aware, once Canadian Foreign Minister, Lloyd Axworthy, took up the issue and Princess Diana became an advocate for the treaty, the process was fast-tracked. Canada brought together like-minded states to write a treaty which was signed in 1997. In this case, civil society laid the groundwork and worked in partnership with government. NGO's continue with monitoring the signatory countries and working for mine clearance and treatment of victims.

As horrific as modern conventional warfare has become, nuclear arsenals remain the greatest threat to public health because no other weapons could eliminate most life on earth in an afternoon. There are still more than 30,000 nuclear weapons in the world, and, despite the end of the Cold War, nearly 5000 are kept on high alert between Russia and the United States. This absurd and dangerous situation receives little notice in the press and, consequently, little protest from the public.

The problems on our agenda are complex and difficult ｷ de-alerting, irreversible steps in decommissioning, verification, controls and disposal of fissile materials, links with nuclear energy… But one problem dwarfs the others: The US wants nuclear weapons. If the US were to disarm, the other Nuclear Weapons States would follow. If the US does not, no one else will. The US blocks every avenue to real progress in real time. And with National Missile Defence it is on a course to escalate the arms race, and in the next stages, to move the race to outer space. I am referring to the mission statement of the US Space Command with its explicit goal of domination of the world from outer space. I recommend exploring the web site of the USSC. No wonder China is so deeply concerned about Preventing an Arms Race in Outer Space. (PAROS).

The development of the US National Missile Defence Program will reverse the progress made in decades of disarmament agreements by undermining the ABM Treaty and by stimulating a new nuclear arms race. While the NPT Review was in progress, the United States was embarrassed by the release by the Bulletin of the Atomic Scientist of documents showing that the US was trying to convince Russia to permit modifications to the ABM Treaty that would allow the missile defence program. The Americans told the Russians not to worry about NMD because with 2000-2500 nuclear weapons they would be able to overwhelm the American missile defence scheme. The US told Russia that both countries would have nuclear weapons for the foreseeable future. In other words, the US was saying one thing at the NPT Review and doing another in its negotiations with Russia. China indicated that if the US went ahead with NMD, China would have to respond by increasing its arsenal.

The world is at a fork in the road. If we allow the US missile defence system, we cannot achieve the elimination of nuclear weapons. Either we go in the direction of de-alerting and eliminating nuclear weapons, or we go in the direction of missile defence and a new arms race. We cannot go both ways.

Russian President, Vladimir Putin, put it this way in his letter to the IPPNW Congress:
"The characteristic feature of the current situation of which the international community is getting increasingly aware, is the following. Either we will be able to save and enhance by joint effort everything we achieved in non-proliferation and reduction of nuclear weapons, or the entire system of the international and bilateral agreements developed in past years in this field will be threatened. Particularly important will be the outcome of the debate over the ABM Treaty triggered by the US intention to create a national missile defence."

The US stands alone in its plan for missile defence, against both its enemies and its allies. This situation presents a unique opportunity for the entire NGO community, to work WITH our governments, supported by international law, to oppose the development of this scheme. Missile defence is based on a world view that only domination by force can guarantee security. This world view has given way in most countries to the view that common security is ensured by strengthening international law and co-operation with other nations. It is time for the US to join this new way of thinking.

What forces sustain the American passion for nuclear weapons?

the power and prestige accorded nuclear weapons states. We saw this demonstrated when we visited India in Feb. 1999 and met with Prime Minister Vajpayee and Minister of Defence, George Fernandes. They told us that India has been calling for the abolition of nuclear weapons for decades but that they have been ignored and dismissed. Now that they have tested nuclear weapons, everything has changed. They are treated with respect, and their opinions are sought.

The personal power accorded to the men who can push the button and destroy our civilisations is something we can scarcely imagine.
The military-industrial lobby is even more powerful than the tobacco lobby.
The only force that I can imagine that is strong enough to overcome the policy lock is the force of an aroused public.
US civil society could change US policy or change its leaders.

Interestingly, US public opinion polls show that 87% of Americans favour nuclear disarmament. In Canada, 92% want our government to take the lead in abolishing nuclear weapons, the same way that we did in the campaign to ban landmines.

What is needed is not to convince the public, but to elicit an expression of public opinion that would affect elections. Public opinion is influenced by who speaks and who is listening. A survey in the US last year revealed that when Americans were asked who they trust to give them information, they responded that they trust (in order), the military, Public Broadcasting System, and National Public Radio. As a retired senior military officer, Admiral Eugene Carrol is an extremely powerful spokesman for nuclear abolition and his Centre for Defence Information provides invaluable documentation of defence information. General Lee Butler, retired head of Strategic Command, is another impressive voice for the abolition of nuclear weapons. Other celebrated allies in the movement include author Jonathan Schell and actors Michael Douglas, Pearse Brosnan and Sylvester Stallone. But the volume must be turned up if these voices are to be heard on the streets.

We might hope that a charismatic president might be able to led the US in a different direction, but I recall that when (then) Senator Albert Gore spoke to the IPPNW Congress in Moscow in 1989 he told us that he favoured nuclear disarmament, and that our task was to provide the public support that would force him to vote for it. As the bumper sticker says, "If the people will lead the leaders will follow." It seems more likely that a charismatic leader outside government might influence public opinion. Gandhi, Martin Luther King Jr., Nelson Mandela were not in government when they mobilised their people. But we cannot wait for another Gandhi.

People are influenced by their friends, those they admire, and especially by television. Marketers tell us that it is simple to change public opinion if you can present the right message at the right time, over and over and over again. Such a strategy costs money. Disarmament activists are thin on the ground, but we have many successes, powerful allies and wide networks. Now we need the rich and famous. Especially rich and famous media moguls.

Last May I attended a dinner of Physicians for Social Responsibility in the US. They awarded Ted Turner of CNN "Citizen of the Year" for his work on the environment. In his acceptance speech he said that he had thought the nuclear weapons issue was over ten years ago, and that he had turned his attention to the environment. But now he would have to put millions into getting rid of nuclear weapons. He was on his way to Moscow to meet with President Putin. They were friends from the Goodwill games that Turner sponsored in St. Petersburg.

Let me speak for a moment about the role of Non-governmental organisations in the elimination of nuclear weapons. Since 1992 when NGO's were first invited to take part in Preparatory meetings for the Conference on Environment and development, more and more UN Conferences have been opened to NGO participation. The disarmament meetings, however, continue to limit access and input from NGO's. On the other hand, NGO briefing documents are highly valued by government delegations and NGO presentations are now incorporated into the agenda of some conferences. Our IPPNW books are in great demand at UN Conferences.

NGO knowledge is deep and the networks are broad. In terms of nuclear disarmament, academics, analysts and NGO's have developed tremendous legal and technical expertise over several decades

The NonProliferation Treaty Review in May produced a final document that gives an unequivocal commitment to the elimination of nuclear weapons. The enormous power of the Nuclear 5 states was countered by the determination of a handful of states known as the New Agenda Coalition - Mexico, Egypt and South Africa, Sweden, New Zealand, and Ireland. Of these, Egypt was a tenacious leader in holding the N-5 to their obligation to full and complete nuclear disarmament. These successes mean that our efforts toward the abolition of nuclear weapons are backed by international law, and now by the agreement by 187 countries including the nuclear weapons states. India, Pakistan and Israel must now be brought into this agreement.

Japan has recently prepared a draft statement for the First Committee of the UN, entitled "A Path to the total elimination of nuclear weapons". The language of this draft repeats the final document of the NPT Review, calling for the full implementation of START II; the "principle of irreversibility;" transparency; and reduction of non-strategic (tactical) arms. A notable addition is that it calls for the entry into force of the Comprehensive Test Ban Treaty before 2003. The statement, however, falls short on the concept of universality of nuclear disarmament. While it does refer to the "unequivocal undertaking" by the Nuclear Weapons States, there is no mention of a final legally-binding document; there is a lack of any practical steps beyond the interim steps outlined in the NPT document; and there is nothing explicit about the Nuclear Weapons States other than the US and Russia. If Japan, as the only country to have experienced the effects of atomic bombs could, instead, support the New Agenda Coalition, it would provide enormous moral leadership.

Every year since 1996, Malaysia has introduced a resolution entitled "Follow-up to the advisory opinion of the International Court of Justice on the Legality of the Threat or Use of Nuclear Weapons". The resolution underlines the unanimous conclusion of the ICJ that there exists an obligation to pursue in good faith and bring to a conclusion negotiations leading to nuclear disarmament in all its aspects under strict and effective international control, and calls on States to fulfil that obligation by commencing negotiations leading to the conclusion of a nuclear weapons convention. On this resolution, Japanese support would provide much needed leadership..

In his introductory speech at the NPT Review, UN Secretary General Kofi Annan proposed a conference on Reducing Nuclear Dangers. Such a conference, held outside the NPT, could include India, Pakistan and Israel. This proposal must be taken up by a nation willing to host the conference, and would benefit from the strong support of the NGO community, particularly from IPPNW.

Dialogues with Decision Makers

For the last three years, IPPNW has sent annual delegations to decision makers in the nuclear weapons states. These delegations continue to build on the early strategy of IPPNW to meet with key leaders. In his book, Perestroika, Mikhail Gorbachev wrote:

"The International Physicians for the Prevention of Nuclear War has come to exercise a tremendous influence on world opinion in quite a short period of time... I had met Professor Lown before, but this time, after their congress in Moscow, I met all the leaders of the movement. It is impossible to ignore what these people are saying. What they are doing commands great respect. For what they say and what they do is prompted by accurate knowledge and a passionate desire to warn humanity about the danger looming over it. In the light of their arguments and the strictly scientific data which they possess, there seems to be no room left for politicking. And no serious politician has the right to disregard their conclusions."

IPPNW leaders have met with senior government members in the UK, France, Russia, the US, and India. In fact, in India we have met with the President, the Prime Minister and the Minister of Defence. Perhaps you are also aware that two delegations from IPPNW have gone to the DPRK (North Korea) to meet with colleagues and to take humanitarian aid and medical materials and literature. Dr. Ken Yokoro of JPPNW has carefully laid the groundwork for these meetings and I was pleased to join Dr. Yokoro, Dr. Ian Maddocks of Australia and Dr. John Pastore of the US on the last mission. I hope that in the light of the signs that North Korea is opening to the outside world, that IPPNW doctors will organise exchanges to provide some of the equipment , books and journals they need so desperately. Such an initiative would help to build bridges and perhaps offer some stability in the transformation of North Korean society.

This month President Kim Dai Jung of South Korea has been awarded the Nobel Peace Prize for his work toward the re-unification of North and South Korea. This is a time when we can foresee the likely outcome of the initiatives being taken by Kim Jong-il to open North Korea to the rest of the world. If events follow the pattern that we saw in Eastern Europe, it is likely that Kim Jong-il will be toppled in the relatively near future. How can we prepare now for the reintegration of a very deprived population similar in many ways to the East Germans at the time of the fall of the Berlin Wall? What can we do to try to ensure a bloodless revolution in power? In order to avoid a flood of refugees, we need to begin to build the bridges and prepare groundwork that will help the people restructure their society quickly after a change in government. We have enough case studies of countries that have overthrown their Marxist Leninist leaders that we should be able to predict the challenges and act to minimise upheaval.

War on Public Health

The changes in warfare in the past century have resulted in increasing the proportion of civilian deaths, until civilians now make up 95% of the deaths in war. Recent changes in military strategy from targeting populations to targeting infrastructure have been described as "war on public health". In the case of Iraq and Serbia, sanctions have prevented reconstruction and restoration of the basic needs of a modern society. The significance of this change has raised little outcry because when the bombing stops the media withdraw and the impression is left that the war somehow spared the innocent. The insidious effects of destroying the water supply, sewage system, agriculture, food distribution, electricity, fuel systems and the economic base for an entire country are not obvious until starvation and disease create a humanitarian crisis that cannot be ignored. In fact, far from sparing the innocent, this deliberate strategy disproportionately kills the very young, the very old and the very weak. IPPNW must take this issue to the public as an inhuman violation of all standards of civilised behaviour and demand that civilians not be held hostage to the dictators they are powerless to remove.

One further issue has slipped from the agenda of social action. It is the issue of militarism and the environment. In 1992, the UN Conference on Environment and Development inadvertently sparked a downturn in the level of collaboration between activists working on environment and those working on disarmament. President George Bush prevented the topic of militarism and the environment from being on the official agenda of UNCED. The NGO Forum focused to a large extent on the issue s that were on the table, and gradually, the importance of the environmental destruction wrought by the world's military forces seems almost to have disappeared from the agendas of environmental conferences. This loss is of grave concern, because of the level of devastation caused by world-wide military activities. Okinawa is one of many places where a foreign military base brings environmental and social destruction. IPPNW must restore it associations with related environmental researchers and activists and rebuild the synergy of collaborative work on these issues.

IPPNW today has strong affiliates acting on a wide range of issues. We have developed effective e-mail communications that allow us to make decisions rapidly with full participation of our federation. We have a highly effective central office, and a presence at the UN through the new New York office. We are key participants in the Hague Agenda for Peace and the Middle Powers Initiative. We are developing new joint programs with PSR/USA that will bring the influence of an international organisation to support the work of our American affiliate. We have a growing student movement and an important relationship with the International Federation of Medical Students Associations.

The next two years will define the world's direction concerning nuclear weapons. We must also work to shine a spotlight on the bloody civil wars in Africa and elsewhere that kill and maim countless thousands, and ruthlessly destroy the prospects for democracy and economic stability.

Viktor Frankl wrote" Auschwitz showed what man is capable of, and Hiroshima showed what is at stake."

Our work is daunting in its scope, but we have many allies and many successes behind us. For twenty years we have worked together with great respect for the strengths and creativity that come with diversity. Our friendships have overcome disagreements, financial difficulties, and vast distances. Our commitment to our shared ideals gives us the will and the power to change the world.

End