APPENDIX 4
Memorandum submitted by the British Medical
Association (BMA)
The British Medical Association welcomes the
International Development Committee's inquiry on the future of
sanctions. We note that the inquiry will include in its scope
the humanitarian/developmental impact of sanctions and the effectiveness
of humanitarian exemptions, and the potential for "smart
sanctions" to improve the effectiveness of sanctions and
to reduce unintended side-effects.
The BMA, along with many other national medical
associations, is particularly concerned about the potential impact
of economic sanctions on the health of citizens and on the ability
of health professionals to deliver health care. We are anxious
to ensure that agreed exemptions for medicines, medical supplies
and basic food stuffs are respected and also applied in such a
way that those who most need the food and medicines have access
to them. Children who are denied essential nutrients may suffer
permanent health damage—in particular the impairment of
brain development. Shortages of vaccines may also have a devastating
effect on populations, with children and the elderly particularly
vulnerable. Other factors connected with the breakdown of infrastructure
will also have an adverse effect on public health—we are
told, for example, that there are particular problems with the
sanitation system in Iraq at the moment.
In November 1997, the World Medical Association
(WMA) adopted a resolution urging national medical associations
to ensure that governments employing economic sanctions against
other states respect the agreed exemptions for medicines, medical
supplies and basic food items. I attach a copy of the full text
of this resolution. The 1998 BMA Annual Representative Meeting
endorsed the resolution and has instructed the Association to
campaign against embargoes which damage health. This issue, among
many others, will be covered in our forthcoming publication on
the medical profession and human rights.
Following the adoption of the 1997 WMA resolution,
we corresponded with the Foreign and Commonwealth Office and received
assurances of the government's commitment to enforcing exemptions
for medicines and food. An official pointed out that Iraq was
the only country where comprehensive economic sanctions were enforced
and that UN sanction packages were increasingly targeted to hit
the regime rather than the people. We are fully aware that the
circumstances applying to Iraq are particularly complex, but we
continue to receive reports from our members and others about
the dire effects on the Iraqi population of the sanctions. During
Human Rights Week in December 1998, we posed the following questions
in a letter to the Foreign Secretary:
1. What steps is the Government taking to
gather information about the impact on the health of populations
of countries currently subject to UN and other economic embargoes?
2. What measures are being taken to ensure
that the exemptions for basic food stuffs and medicines are respected?
3. What, if any, mechanisms are in place
to ensure that essential food and medical supplies reach those
who need them most?
The reply which we received from the Minister
of State at the Foreign and Commonwealth Office referred to the
work of UN Multidisciplinary Observation Units (MDOUs) in monitoring
the implementation and impact of the Oil for Food programme and
also referred to the involvement of the World Health Organisation,
which was planning a drug use survey at a national level to track
prescription practices. He also stated, however, that the limitations
placed by the government of Iraq on the implementation and monitoring
of the UN's humanitarian effort in Iraq had been a factor in delaying
progress in some areas such as health infrastructure.
We should like to urge the International Development
Committee in its inquiry to focus on the extent to which economic
sanctions affect human health, whether directly or indirectly,
and we should be delighted if the Committee were to focus in particular
on monitoring mechanisms, perhaps using the three questions which
we posed during Human Rights Week 1998. We note that the Committee
will consider the sanctions policies of the United Kingdom, United
Nations, European Union and other regional and multilateral organisations.
We would urge its members also to consider, if possible, the impact
of other international sanctions—such as those applied against
Cuba—and internal sanctions applied by governments against
sections of their own populations, for example those applied by
the Sri Lankan Government against the Tamil population.
The British Medical Association would be delighted
to offer the Committee any further help or advice and looks forward
very much to seeing the outcome of the Committee's inquiry.
Dr Ian G Bogle
Chairman of Council, British Medical Association
22 April 1999
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