Can international public health law help to prevent war?

Editor – The December 2002 issue invites debate on international law. As noted by Aginam (1), states generally comply with a law or a convention if they see it as being in their interests, however that may be interpreted. That the reverse is true is illustrated vividly by US positions on the Kyoto Accord, the International Court of Justice, and the use of a veto to block relaxation of patent laws to enable wider access to life-saving drugs in developing countries. Given the threat of war on Iraq, it is relevant to raise the parallel issue of military jurisprudence as another area affecting public health. After all, according to Taylor (2), the World Health Organization (WHO) is the only public international organization that brings together the institutional mandate, legal authority and public health expertise for the codification of treaties that principally address public health concerns. The prevention of war (the ultimate form of violence) is surely one of the most critical steps mankind can make to protect public health. After all, we were reminded only recently in the Bulletin that violence is a health issue (3). In fact, the deliberate degradation of public health infrastructures as a preferred strategy of modern warfare was well illustrated by the targeting of Baghdad's modern water supply and sanitation system by coalition forces during the Gulf War (4). This indirect form of biological warfare was not included in the 1972 Biological Weapons Convention, as it was mostly concerned with ''offensive biological warfare'' (e.g., ''weapons grade'' anthrax), and not the far more indiscriminate and destructive effects of waterborne diseases (4). Given that the vast majority of persons affected by such destruction are non-combatants, surely there is a need to revise this Convention in the interests of humanity and public health? The WHO Constitution itself makes no reference to the protection of health when threatened by war (6). While one principle is stated: ''The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest cooperation of individuals and States'', the converse is not declared. If stated, the converse would read: ''Peace and security are fundamental to the attainment of health of all peoples and are dependent upon the fullest cooperation of individuals and States''. Taylor & Bettcher (7) argue that not all global health problems call for a gearing up of international legal machinery, and that international …