Aiming for Prevention: International Initiatives

Aiming For Prevention logoConference Report

1st Biennial Meeting of States on the UN Programme of Action on Small Arms (UNPoA) and Light Weapons
New York City
July 11, 2003

IOn July 11, 2003, IPPNW and the World Health Organization co-sponsored a panel entitled “Public Health Dimensions of Small Arms Violence: Impacts, Meaningful Interventions, and the Programme of Action.” The panel, attended by approximately 40 public health experts, medical students, and members of NGOs affiliated with the International Action Network on Small Arms (IANSA), was a side event in conjunction with the “1st Biennial Meeting of States to Consider the Implementation of the Programme of Action on Small Arms and Light Weapons,” held at the United Nations in New York from July 7-11.

The Panel was convened to examine the contribution of public health professionals to understanding the effects of small arms violence on individuals and communities and to explore public health interventions that can effectively preventing small arms violence. The focal point was the Programme of Action on Small Arms adopted at the conclusion of the Conference on the Illicit Trade of Small Arms and Light Weapons in All its Aspects in July 2001. The Programme of Action includes calls to combat the small arms trade simultaneously from both a supply and demand perspective, and to develop and support action-oriented research.

IPPNW, through its “Aiming for Prevention” campaign, and WHO, primarily through the work of its Department of Injuries and Violence Prevention, share a common interest in bringing together the medical research and medical advocacy agendas that are key to the prevention of small arms violence. The goal is to reduce, as far as humanly possible, the deaths, injuries, and social disruption inflicted by small arms and light weapons, and to do so by supporting policies and practices that are based firmly on a well documented public health analysis.

The following panelists addressed these issues from both global and national perspectives:

Wendy Cukier, Professor of Justice Studies at Ryerson University and Coordinator of the Small Arms and Firearms Education and Research Network (SAFER-Net), served as the panel moderator.

Summary of Presentations

Camilla Waszink

States have focused attention on the parts of the Programme of Action that deal with curbing the supply of weapons. Yet the Programme also recognizes other dimensions to the problem, including "security, conflict prevention and resolution, crime prevention, humanitarian, health and development aspects." The problem must be tackled from both a supply and demand perspective. From the ICRC's perspective, strictly controlling the production, transfers and availability of weapons is vital to ensure that weapons do not end up where they are likely to be used to violate international humanitarian law. But understanding demand, too, is crucial if the aim is to reduce small arms violence. Until we better understand what motivates the choices that people make in using small arms, it is hard to know what to say or do to influence people's behavior.

Our objective is to identify which preventive measures are likely to be most effective. This is where public health methodology is particularly useful. Extensive action-oriented research will be required to assess and understand the complex factors that drive the demand and misuse of small arms and light weapons. Working with communities to understand the specific factors that give rise to small arms violence in the local context, to assess community needs and develop applicable solutions is essential. It is necessary not only to quantify deaths and injuries caused by arms violence, but also to identify the circumstances surrounding those incidents. Epidemiological surveillance deals with the "who, what, when, where and how" of an incident. One also needs to ask "why?" Only by asking why can one determine effective ways to influence and change behavior.

Therefore, a public health approach will need to be complemented by other disciplines, including, for example, sociology, psychology, anthropology, and ethnography, in order to examine the different aspects that play a role in small arms violence. A range of sectors with relevant expertise, including health, development, the humanitarian sector, law enforcement, criminology, military, and legal experts can and probably must contribute in order to develop applicable responses that can reduce the problem in a comprehensive manner.

Balkrishna Kurvey

As a large country with more than one billion people, the main reason for the accumulation of small arms is poverty. There are three areas where small arms and light weapons are particularly problematic: Jammu/Kashmir, where more than 60,000 people have been killed in the past 15 years; northeast India, where an armed insurgency is fueled by weapons from China, Afghanistan, and Romania; and the central Indian state of Bihar, where rich people buy AK-47s as status symbols and a Maoist faction wants to change the government through violent means. The traffic in small arms is also connected to the traffic in drugs, especially from Afghanistan.

Educating doctors and medical students about the socioeconomic effects of small arms is an important public health intervention in India, because physicians are still respected and have the capacity to influence public opinion and the views of policy makers. IIPDEP has conducted a series of small arms seminars for junior doctors and medical students throughout Central India and other parts of the country, empowering them to engage in political advocacy in support of the Programme of Action.

Simon Bokongo Kawaya

The quest for tribal hegemony in the Great Lakes region of Africa fuels many of the current conflicts. The war in the Democratic Republic of Congo (DRC), which has continued for five years now, has a number of aspects: armies from other countries are fighting over their own agendas in DRC; there are various civil wars; local militias are fighting against rebel groups and other armies; there are ethnic wars not necessarily related to any of the other conflicts. These armed conflicts are often quite difficult to sort out from one another, and in none of them does there appear to be any understanding of or respect for international humanitarian law or the Geneva Conventions.

These wars are being fought with both legally and illegally obtained weapons. There are many civilian casualties because all of the parties to these conflicts use every kind of available weapon in the middle of large, densely populated cities as well as the countryside. Many of these weapons are a legacy of Mobutu, who used the national wealth to arm his regime instead of investing in the health and security of the 50 million inhabitants of the DRC.

There were few hospitals in the DRC to begin with, and those have been largely destroyed by war. During periods of intense fighting as many as 1,000 injured people can flood hospitals with no more than 100 beds. IPPNW has been working with the UN, WHO, and NGOs in the region to stop the war and deal with the casualties. The top three public health priorities in the DRC are preventing more violence; minimizing the effects of war-related injuries; and gathering medical resources.

David Meddings

WHO is optimistic about the Programme of Action and the process around it. The Progamme recognizes the determination to reduce human suffering as a concern and theme for UN member States, which moves the discussion beyond traditional arms control and disarmament debates and squarely into the public heallth arena.

Nevertheless, the complexity of the issue, as illustrated by the two previous speakers, requires a diverse set of approaches. The World Report on Violence and Health, published by WHO in 2002, is a groundbreaking document in this regard. The Report is a compilation and synthesis of what we currently know about all forms of violence, from child abuse to armed conflict. For example, the same number of people die each year from armed violence as die from tuberculosis.

The Report proposes an ecological model of violence prevention, exploring the effectiveness of preventive measures at each of four levels: individuals; relationships; communities; and society as a whole. There is a recognition that norms and practices accepted within each of the broader areas reinforces behaviors at other levels.

The perception of insecurity and violence in one’s community is a principal driver of the demand for small arms and light weapons. Violence prevention programs implemented in Brazil (Viva Rio) and Mozambique have shown promising results, but evaluation based on accurate data is essential if we are to credibly assess the evidence for their true effectiveness.