Medact is an organisation of health professionals challenging social and environmental barriers world-wide. Thus it draws attention to the global health impacts of violent conflict, poverty and environmental degradation and, with others, acts to eradicate them. It is the UK affiliate of the International Physicians for the Prevention of Nuclear War which won the Nobel Peace Prize in 1985.

  Medact has always taken the view that the effects of nuclear weapons are so catastrophic that their use could never be justified, however dire the circumstances. This view is supported by the British Medical Association's Board of Science and Education's report (1983) which concluded, among the other items, that "The NHS could not deal with the casualties that might be expected following the detonation of a single one megaton weapon over the UK". In addition, the British Medical Association passed a motion, in 1998, condemning the development, testing, production, deployment, threat and use of nuclear weapons "as a world-wide threat to public health". Furthermore, the International Court of Justice stated its view, in its decision in 1996, that the use, and threat to use, nuclear weapons would, in practice, be illegal under international law. The court did not feel able to pronounce on the legality of nuclear weapons used "in an extreme circumstance of self-defence".

  Since the end of the Cold War, the threat of deliberate hostility between East and West involving the use of nuclear weapons appears to have receded, although whether this will remain so in the future is unknown. On the other hand, so long as the nuclear weapon countries continue to regard them as "a necessary element of our security", as stated in the Strategic Defence Review (SDR), it is understandable that other countries may take the same view as, indeed, India and Pakistan have done. Such an attitude totally undermines the spirit of the Non-Proliferation Treaty (NPT).

  As well as the risk of nuclear war, there is the threat of the manufacture, or theft, of nuclear devices by terrorist groups, which was the subject of a seminar sponsored by Medact at the House of Commons in 1996.

  In addition, there is the ever-present risk of accidental nuclear war which was the subject of a study published in 1998 in the prestigious New England Journal of Medicine (being forwarded by surface mail). The methodology was to review the recent literature on the status of nuclear arsenals and the risk of nuclear war. The authors drew attention to the fact that the US and Russian nuclear weapons systems remained on high alert which fact, combined with the ageing of Russian technical systems, they felt increased the risk of an accidental nuclear attack threatening a public health disaster of unprecedented scale. Thus a conservative estimate of the casualties arising from an accidental intermediate-sized launch of weapons from a single Russian submarine was 6,838,000 deaths from firestorms in eight US cities and the probable exposure of millions of other people to potentially lethal radiation from fallout. The authors concluded that the risk of an accidental nuclear attack had increased in recent years and that there was an urgent need for an agreement to remove all nuclear missiles from high-level alert status and eliminate the capability of a rapid, accidental launch. In this respect, we believe that UK nuclear missiles are kept on moderate-alert, which should also be reconsidered with a view to reducing the status still further.

  However such a measure does not remove the risks associated with possession of nuclear weapons. As a further immediate step, we strongly urge those nuclear weapons nations not already so committed, which includes the UK, to adopt a no first-use policy. Although we are aware that this conflicts with current UK deterrence doctrine, we would argue that it is an essential prerequisite to fulfilling the wish, mentioned in the SDR, to see "a safer world in which there is no place for nuclear weapons". Furthermore, if such a policy could be rapidly implemented, the likelihood of a successful outcome of the review of the NPT in May of this year would be increased.

  Ultimately, however, the only sure safeguard is the elimination of nuclear weapons world-wide. We feel a Nuclear Weapons Convention, comparable to those on biological and chemical weapons, is essential and remind the Committee of the model Nuclear Weapons Convention drafted by a group of non-governmental organisations and originally submitted to the United Nations as a discussion paper by Costa Rica in 1997. Since then it has been revised and reissued in the document "Security and Survival—the Case for a Nuclear Weapons Convention".

  In adopting a policy of eliminating nuclear weapons, governments would, in fact, be responding to the will of the people in those countries where this has been sought. Thus polls carried out in the USA, UK, Germany and Canada have indicated that a large majority of the population would support negotiations on a treaty to eliminate nuclear weapons.

  We would be happy to supply copies of any of the documents mentioned to the Committee.