Campaign Against Sanctions on Iraq
OCCASIONAL BRIEFING #1: 17 MAY 1999
Written answer to Mr David Winnick (5 May, 1999)
The Campaign Against Sanctions on Iraq (CASI) is a registered society at the University of Cambridge. It is concerned about the humanitarian consequences of sanctions on Iraq. It does not support Saddam Hussein's regime and is not opposed to military sanctions on Iraq.
We analyse a written answer given on 5 May 1999 to a question on the humanitarian crisis in Iraq. The answer's remark that the export of food and medicine is allowed under sanctions is largely technically correct but fails to recognise the irrelevance of this permission in the absence of funds. Foundations cannot be found for the concerns that the answer expresses about the data on Iraq. The answer's claim about improvements under 'oil for food' contrasts sharply with UN statements that the "gravity of the humanitarian situation of the Iraqi people is indisputable and cannot be overstated". Its suggestion that the relatively worse situation in centre/south Iraq is entirely the fault of the Baghdad regime ignores factors such as the greater per capita quotas received under 'oil for food' by the north. Finally, the elements of the new British/Dutch proposal do not, prima facie, provide reason to believe that it will significantly ease the suffering of the Iraqi people.
This is the first CASI official Occasional Briefing. CASI has in the past prepared briefings for individual MPs and Lords at their request; we hope that by continuing this as part of an Occasional Briefing series we will bring some order to the loose briefings that we have written in the past.
While CASI may write Occasional Briefings on its own initiative we would prefer to do so at the request of MPs, Lords or members of the press as this increases the likelihood that the briefing is meeting an actual need. To this end contact details for CASI appear at the end of this document. We also welcome suggestions for improvement and suggestions as to others who might appreciate receiving these reports.
CONTEXT AND SOURCES
On 5 May 1999 a written answer was given to a question put by Mr David Winnick, Labour MP for Walsall North. We compare the claims made by this answer to statements found primarily in two UN documents. The first of these is S/1999/187 (22 February, 1999): Report of the Secretary-General pursuant to paragraph 6 of Security-Council Resolution 1210 (1998). This is the '90 day' report that the Secretary-General of the Security Council files at the mid-point of each 180 day phase of the 'oil for food' programme; the next '180 day' report is due later this month. The '90 day' report may be found on the internet at http://www.un.org/Depts/oip/reports/90day5.html.
Our second source is Annex II of S/1999/356 (30 March, 1999): Report of the second panel established pursuant to the note of the President of the Security Council of 30 January 1999 (S/1999/100), concerning the current humanitarian situation in Iraq. This is the report of the second panel established by the UN Security Council at the end of January (in S/1999/100) in response to the changes in the Iraqi situation prompted by the US/UK bombing of Iraq and the announcement by the Iraqi government that Unscom inspectors would not be allowed to return. The other two panels examined Iraqi disarmament and Kuwaiti claims. This is available on the internet at http://www.casi.org.uk/info/panelrep.html.
THE WRITTEN QUESTION
The question put by Mr Winnick asked:
the Secretary of State for Foreign and Commonwealth Affairs... what is the latest position on the provision of food and medicines in Iraq; what reports he has received on the number of children suffering in Iraq because of the lack of adequate medicines and other health supplies; and what plans he has to assist them. 
CLAIMS AND COMMENTS IN THE WRITTEN ANSWER
The following section titles reproduce the written answer in its entirety.
"The export of food and medicines to Iraq has never been prohibited under sanctions..."
UN Security Council Resolution 661, adopted on 6 August 1990 (four days after Iraq's invasion of Kuwait) imposed the sanctions regime on Iraq that has continued to date. Paragraph 3(c) prevented UN Member States from exporting to or assisting in export to Iraq or Kuwait, with the exception of "supplies intended strictly for medical purposes, and, in humanitarian circumstances, foodstuffs". Paragraph 4 applied the same restrictions to remittances of Iraqi assets held outside of Iraq. The resolution also established a Sanctions Committee to oversee the sanctions' functioning.
The preamble to SCR 666 (13 September 1991) emphasised that "it is for the Security Council, alone or acting through the [sanctions] Committee, to determine whether humanitarian circumstances have arisen". It resolved to "keep the situation regarding foodstuffs in Iraq and Kuwait under constant review" (paragraph 1).
The next SCR mention of imports to Iraq occurred eight months later, in April 1991. SCR 687, which prolonged the sanctions on Iraq, appeared primarily concerned with detailing Iraqi obligations in the wake of the war. Its preamble noted "the necessity to meet urgently the humanitarian needs in Kuwait and Iraq". Section E outlined Iraqi financial obligations and decided to establish a compensation fund. Iraq would be allowed to make controlled oil sales to pay into the compensation fund; the humanitarian needs of Iraqis appear to be of secondary importance.
Paragraph 20 did decide that the import prohibitions outlined in SCR 661 "shall not apply to foodstuffs notified to the ... [Sanctions] Committee". This is not an explicit recognition that "humanitarian circumstances" had arisen but was taken as such.
Generally, then, medical imports have never been prohibited under sanctions and food imports have been permitted for most of the sanctions period. Three further qualifications bear mentioning.
First, before Iraq's expulsion from Kuwait an 'effective embargo' may have applied to medical supplies. Dr Eric Hoskins, winner of Canada's Pearson Prize for his work in releasing some Iraqi funds held in Canada, estimated that medical imports may have fallen to 3% of their usual levels during the bombing campaign. [Jean Dreze and Haris Gazdar (1992), "Hunger and Poverty in Iraq, 1991", World Development, 20(7) pp. 921-945]
Second, the right to purchase food and medicines is moot without the means to do so. As early as 1991 Dreze and Gazdar, then economists at the LSE, noted the similarity of food prices in Iraq and Jordan, suggesting a porous border. The collapse of Iraqi income, though, reduced Iraqis' ability to purchase food. The connection between purchasing power and famine is well known to Dreze, a co-author with Nobel Laureate Amartya Sen on famine.
Third, the Sanctions Committee (or 661 Committee), whose approval is necessary for imports to Iraq, is not required to make public the reasons for its decisions. Further, the five permanent members of the Security Council have the ability to veto import decisions. It is commonly held that the US and the UK have used their vetoes in this committee to prevent the import of materials that might not be considered "strictly for medical purposes" (e.g. gauze, syringes and anaesthetics). Given the lack of transparency in the 661 Committee CASI cannot verify such claims.
"...We are aware of claims that large numbers of children are dying every month. We have some concerns about the original sources of this information and the way the data have been interpreted..."
This claim has also been made previously. As we have yet to see a detailed treatment of the "concerns" we cannot respond directly to them. The cautionary remarks that we do make may be those referred to in the written answer.
Paragraph 10 of the UN humanitarian panel report noted that:
Data made available to the panel were considered generally reliable, as they were undersigned either by UN agencies or other credible sources. It was noted that the distribution of humanitarian supplies was being observed by hundreds of foreign humanitarian workers, with UN agencies and others having become increasingly apt at detecting distortions and exaggerations. Broadly speaking, the panel considered that the information it was provided with converged and formed a coherent picture.
This is relevant as this report contains the most recent child mortality estimates of which we are aware. These may be found in paragraph 18:
As mentioned by the UNFPA (UN Population Fund) the maternal mortality rate increased from 50/100,000 live births in 1989 to 117/100,000 live births in 1997. The under-five child mortality rate increased from 30.2/1,000 live births to 97.2/1,000 during the same period. Although figures for infant deaths are based on estimates that may involve a margin of error, the trend is one of sharp increases. The Population Division of the DESA [UN Department of Economic and Social Affairs] calculates that the infant mortality rate rose from 64/1,000 births in 1990 to 129/1,000 in 1995 (the latest Human Development Report sets the average infant mortality rate for Least Developed Countries at 109/1,000).
Given the endorsement of these data by the panel they may represent the best available data. Recognising this, though, one might still express a few concerns.
First, the source of the UNFPA and DESA data is unclear from the report. Unicef's April 1998 "Situation Analysis of Children and Women in Iraq - 1997" is more informative. In section 188.8.131.52 they report that figures for "mortality reported in public hospitals for children under five years of age" has increased by "some 40,000 deaths yearly compared with 1989"; for those over five years the same method suggests that there is an excess of 50,000 deaths annually. Further, with "the substantial increase in mortality, under-registration of deaths is a growing problem. For infants, reporting a death would entail cancellation of the due ration for that child".
Second, figures based on deaths registered with the Iraqi Ministry of Health, such as Unicef's, may be distorted for political gain. We have yet to see concerns expressed about Iraqi mortality data by the UN agencies working with them.
Third, mortality data collection generally relies on verbal accounts of 'birth histories' by mothers to detail deaths occurring outside of hospitals. These are called 'direct techniques'. 'Indirect techniques' then perform statistical corrections on the data collected directly, as one might correct a census for under-representation of certain groups. As a result of possible mis-reporting and of the assumptions of the statistical corrections (e.g. that the population is 'stable', with constant birth and death rates and no net migration, an assumption unlikely to fit Iraq well) mortality rates may be unreliable.
Malnutrition rates, directly measurable, are therefore felt by some to be more reliable indicators of health. Paragraph 33 of the written answer's "most recent UN report on the implementation of 'oil for food'", the '90 day' report, reads
The extent of malnutrition is a critical factor in the health of the population. According to the nutrition status surveys conducted by UNICEF in collaboration with the Ministry of Health, the prevalence of general malnutrition in the centre/south has changed very little in the past two years. General malnutrition (weight for age) was found to occur in 14.1 per cent of infants in 1996, in 14.7 per cent of infants in late 1997 and 14.7 per cent of infants in the most recent survey of October 1998. General malnutrition among children under five in the centre/south was found to occur in 23.4 per cent of children in 1996, in 24.7 per cent of children in 1997 and in 22.8 per cent of children in the most recent survey of March 1998. While there has been no significant reduction in general malnutrition among infants or among children under five, previously rising prevalence rates have stabilized, albeit at an unacceptably high level.
The distinction drawn between the centre/south and the north of Iraq reflects the fact that northern Iraq has been effectively a UN protectorate, administered separately from Baghdad since 1991. We address this at greater length below.
Therefore, both the mortality data and the malnutrition data suggest that large numbers of Iraqis, including children, are at risk. Indeed, paragraph 49 of the Humanitarian Panel report reads:
The gravity of the humanitarian situation of the Iraqi people is indisputable and cannot be overstated. Irrespective of alleged attempts by the Iraq authorities to exaggerate the significance of certain facts for political propaganda purposes, the data from different sources as well as qualitative assessments of bona fide observers and sheer common sense analysis of economic variables converge and corroborate this evaluation.
"...According to the most recent UN report on the implementation of "oil for food", the UN humanitarian programme is making a real difference to the humanitarian situation in Iraq..."
This is not a strong claim: if Iraq were permitted no imports it would be worse off than it is now. Our UN texts suggest that, improvements under 'oil for food' notwithstanding, the humanitarian situation in Iraq is still in crisis.
As noted above, the '90 day' report found that malnutrition in the centre/south seemed to have stabilised, "albeit at an unacceptably high level" (paragraph 33) and had declined in the north (paragraph 66). Otherwise it gave little reason for optimism. Its final section, Observations and Conclusions, noted "the gravity of the humanitarian situation in Iraq and the limited scope of the humanitarian programme pursuant to Security Council resolution 986 (1995) ['oil for food']" (paragraph 97). Paragraph 100 observed that "various constraints are preventing the full implementation of the programme": "Indeed, the most serious issue facing the implementation of the programme at present is the growing shortfall in revenues required to implement the approved distribution plan" (paragraph 101); there was "little scope for optimism in regard to oil revenues in the immediate future" (paragraph 104).
The humanitarian panel report is even less optimistic about the extent to which 'oil for food' can meet Iraq's humanitarian needs. It did report that the "adoption of the 'oil for food' programme has played an important role in averting major food shortages in Iraq and to a considerable extent has helped to alleviate the health situation, especially in the North" (paragraph 29). The Observations and Recommendation section of the report made clear that a belief that 'oil for food' had improved matters is not equivalent to a belief that 'oil for food' is capable of meeting Iraq's humanitarian needs. Paragraphs 45 and 46 read:
... At the same time, it is the panel's view that, under current conditions the humanitarian outlook will remain bleak and become more serious with time. Even if not all suffering in Iraq can be imputed to external factors, especially sanctions, the Iraqi people would not be undergoing such deprivations in the absence of the prolonged measures imposed by the Security Council and the effects of war.
Due to a substantial shortfall in revenue for the implementation of approved distribution plans, the "oil for food" humanitarian programme established by the Security Council has not been able to achieve fully its objectives. But even if all humanitarian supplies were provided in a timely manner, the humanitarian programme implemented pursuant to resolution 986 (1995) can admittedly only meet but a small fraction of the priority needs of the Iraqi people. Regardless of the improvements that might be brought about in the implementation of the current humanitarian programme - in terms of approval procedures, better performance by the Iraqi Government, or funding levels - the magnitude of the humanitarian needs is such that they cannot be met within the context of the parameters set forth in resolution 986 (1995) and succeeding resolutions, in particular resolution 1153 (1998) ['enhanced oil for food']. Nor was the programme intended to meet all the needs of the Iraqi people.
It concluded with the words:
In presenting the above recommendations to the Security Council, the panel reiterates its understanding that the humanitarian situation in Iraq will continue to be a dire one in the absence of a sustained revival of the Iraqi economy, which in turn cannot be achieved solely through remedial humanitarian efforts.
This gloomy prediction has just been echoed by the International Committee of the Red Cross. According to Agence France Presse
"After eight years of economic sanctions, the ICRC is increasingly concerned by the steady deterioration of living conditions," the ICRC's representative in Iraq, Michel Minnig, said in a statement.... "...it is the ICRC opinion that humanitarian action alone can not be a substitute for the country's needs," he warned. [AFP, Red Cross warns of deteriorating living conditions in Iraq, 8 May 1999]
On top of this, the drought currently afflicting the Middle East may be the worst in Iraq for 50 years, possibly reducing its staple crop production by 75%. [Associated Press, 19 April 1999]
"...It made clear that in the north, where the UN is responsible for distribution, there were very few if any shortages of essential drugs, and malnutrition was decreasing..."
The "few if any shortages of essential drugs" wording is taken verbatim from paragraph 63 of the '90 day' report; no reference to drugs appears in the humanitarian panel report. Both reports addressed the differential performance of centre/south Iraq and north Iraq.
The '90 day' report follows mention of decreasing malnutrition in the north by noting that the "fact that the per capita value of inputs in the north significantly exceeds that in the centre/south provides one explanation for the increasing difference between them" (paragraph 67). Later it noted that "$111 million had not been transferred from the 13 per cent [northern] account to the 53 per cent [centre/south] account" (paragraph 105), further reducing the funds available for purchases by the centre/south. The centre/south undertakes bulk purchases of food and medicines on behalf of the north, which is then expected to reimburse the centre/south.
Paragraph 44 of the humanitarian panel's report was more detailed:
The North of Iraq is clearly doing better than the Center/South for a variety of reasons. The per capita allocation of funds under the 986 programme is higher, distribution of food and medicine through UN agencies is comparatively more efficient than distribution by the Government, and the Northern border is more permeable to embargoed commodities than the rest of the country. At the same time, it is noted that the number of internally displaced persons in need of assistance in the North remains high, at approximately 500,000, compared with 80,000 in the Center/South. Although the historic vulnerability of the North, as recognized in paragraph 8 (b) of resolution 986 (1995) would seem to justify the special attention it receives, it is a matter of concern that the situation in the Center/South is, in general terms, comparatively worse - a circumstance which most UN agencies felt should not be overlooked. It was also noted, in this context, that the territorial integrity and sovereignty of Iraq has been consistently upheld by Security Council resolutions.
The permeability of the northern border refers to the smuggling engaged in, primarily by Kurds, across the Turkish border.
"...In the centre and south, however, the Iraqi Government refuses to engage constructively in the programme. They refuse to make efforts to prioritise properly what is purchased for the programme, to target it towards the most vulnerable, or to improve the poor distribution system..."
More specifically, the '90 day' report noted that:
The second item is explained at greater length (paragraph 31):
The delays in distributing medical supplies, resulting in accumulations in warehouses, are due in part to the lack of modern managerial tools, poor working conditions within the warehouses and the lack of transport for moving the supplies to health centres. They are also due, in part, to the rigid hierarchy in the Ministry of Health administration which makes it difficult for functionaries to approve deliveries without approval of superiors, and this takes time. A variety of sources, including WHO, suggest that stockpiling seems to have increased following September 1998, when tensions mounted, and superiors may have deliberately withheld supplies in anticipation of emergency needs.
The humanitarian panel report commented directly on the question of Iraqi cooperation with 'oil for food' (paragraph 37):
While there is agreement that the Government could do more to make the "oil for food" programme work in a better and more timely fashion, it was not clear to what extent the problems encountered could be attributed to deliberate action or inaction on the part of the Iraqi Government. It is generally recognized that certain sectors such as electricity work smoothly while drug supplies suffer from delays in distribution. But mismanagement, funding shortages (absence of the so called "cash component") and a general lack of motivation might also explain such delays. While food and medicine had been explicitly exempted by Security Council resolution 661, controls imposed by resolution 986 had, at times, created obstacles to their timely supply.
The "cash component" bears explanation. In centre/south Iraq the government is not given cash under oil for food. As a result it is constrained in its ability to, for example, hire a lorry to make a delivery if it does not have one available at the time. This is not the case in the north.
The "lack of motivation" may derive from the perceived design of 'oil for food'. When its predecessor was first proposed in 1991 (SCR 706 and 712) the value of oil sales considered were less than the minimum sum consistent with Iraq's basic needs, as estimated by the Secretary-General in S/23006 (4 September 1991). Further, when oil sales were first mentioned in SCR 687 it was in the context of providing Iraq with revenues to pay reparations; Iraq's humanitarian needs were given a second place. Therefore, while not apparently primarily concerned with Iraq's need 'oil for food' has been used by the US and the UK as an example of their generosity. Iraq did not accept 'oil for food' in 1991. By 1995 Iraq's attempts to rebuild its agricultural sector had failed and the humanitarian situation had deteriorated; it was in this context that the present 'oil for food' programme was accepted.
The written answer has therefore criticised the Iraqi government for failing to "engage constructively" with a programme that is perceived to be a poisoned chalice, one that the humanitarian panel report has predicted will merely continue a 'dire' situation. This criticism is even more amazing given that Hans von Sponeck, the UN Humanitarian Coordinator in Iraq, has claimed that the ongoing US/UK "airstrikes were affecting the UN's humanitarian programme in Iraq". [BBC News Online, Monday, May 3, 1999, "Iraq says two killed in air attack"]
When the panel report comes to make recommendations for improvement only one page is devoted to recommendations to the government of Iraq. These mostly appeal to refer to administrative efficiency ("do its utmost to ensure the timely distribution of humanitarian goods", "address effectively the needs of vulnerable groups", "refine their list of priorities", etc.) with three comments more obviously directed to co-operation: "allow freer access to UN agencies ... to restricted areas and sections of populations", "ensure that those involuntarily displaced receive adequate humanitarian assistance, without having to demonstrate that they have resided for six months in their places of temporary residence" and "extend full cooperation to the mine clearing programme in the North" (paragraph 57)).
Four pages of recommendations are directed to the Security Council. Central to these are suggestions aimed at increasing Iraq's revenues, such as permission for foreign investment and joint ventures.
"...We are determined to do what we can to improve all aspects of the humanitarian situation. Together with the Netherlands, the UK has tabled a draft Security Council resolution which attempts to translate the work of the three UN Iraq panels into action. On the humanitarian side, our draft resolution brings together a whole range of measures including lifting the ceiling on Iraqi oil exports under "oil for food", streamlining Sanctions Committee approval procedures, allowing local procurement and the payment of local costs, and commissioning expert advice on how to increase Iraq's oil production. These measures should make significant improvements to the humanitarian situation in Iraq..."
The recent US/UK bombings of Iraq, and the subsequent apparent death of Unscom, have given rise to the perception that the existing Iraq policy needed revising and to a flurry of new proposals. A French proposal would lift non-military sanctions and maintain a strict weapons inspection regime. An American proposal and the British/Dutch proposal were both put forward afterwards.
Given the magnitude of the humanitarian crisis facing Iraq estimates of the British/Dutch proposal's expected effect should be demanded for it to be seriously regarded as an attempt to alleviate the situation. While this briefing is unable to perform a proper scenario analysis it can comment on some of the components of the British/Dutch proposal.
Both the US proposal and the humanitarian panel report also recommended lifting the ceiling on Iraqi oil sales; the humanitarian panel noted that this would not, on its own, lead to any extra revenue for Iraq, which is unable to even meet its current ceiling. Streamlining the Sanctions Committee approval procedures and allowing local procurement may both increase the efficiency of the 'oil for food' programme. The value of expert advice on increasing Iraqi oil production is unclear: the Secretary-General is already advised by a team of oil experts and the humanitarian panel report has already recommended both joint ventures and foreign investment.
As none of the proposal's elements seem likely to significantly increase Iraqi revenue it seems improbable therefore that the British-Dutch proposal is capable of addressing the fundamental shortcomings in 'oil for food' noted by the humanitarian panel. This may not be surprising. This government's statements about its concern for the Iraqi people notwithstanding the UK and the US are viewed as the permanent members of the Security Council most hostile to Iraq. While certainly the most hostile to its government, their alleged blocking and delaying genuine humanitarian contracts in the Sanctions Committee suggest that this hostility is not well focused. Possibly with this record in mind Sarah Graham-Brown, author of Sanctioning Saddam and Christian Aid researcher, has claimed that the British/Dutch proposal should be seen as a political rather than a humanitarian proposal. [Council for Arms Control panel discussion, "The Ethics of Sanctions on Iraq", 19 April 1999, King's College, London]
The components, then, of the British/Dutch proposal seem unlikely to help significantly the Iraqi people and there is reason to believe that this is intentional. Those "determined to... improve all aspects of the humanitarian situation" in Iraq would therefore be advised to demand more detailed analyses of expected results of this proposal before supporting it.
TITLES IN THE CASI OCCASIONAL BRIEFING SERIES
1. Written answer to Mr David Winnick (5 May, 1999). 17 May, 1999.
This briefing has been prepared by Colin Rowat [out of date contact details removed].
The CASI website is at http://www.casi.org.uk
CASI can be reached by email at email@example.com, by telephone on 0845 330 4520 or by post at Campaign Against Sanctions on Iraq, c/o CUSU, 11-12 Trumpington Street, Cambridge CB2 1QA, UK. [contact details updated April 2002]. It is happy to accept small donations to support the distribution of these briefings.