The international arms trade and its impact on health

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Abstract
The second world war brought the world to an apogee of mass murder, with widespread killing of military personnel and civilians; the indiscriminate aerial bombing of cities such as London, Dresden, and Tokyo; and the detonation of single bombs over Hiroshima and Nagasaki. These nuclear bombs caused some 200000 deaths immediately and hundreds of thousands of injuries, many resulting in death in succeeding months and in permanent physical or psychological disabilities.1 2 3 Over the 50 years since the end of that war, nuclear weapons and the even more destructive thermonuclear weapons developed in the 1950s4 5 have not been used in war, although there have been threats to do so by some nations possessing them. Among the other “weapons of mass destruction,” chemical weapons have been rarely used, and biological weapons, although stockpiles existed and their use has been alleged, were probably not used at all.6 On the other hand, so called “conventional weapons” have, since 1945, directly caused the deaths of more than 30 million people. During this period the percentage of direct war deaths among civilians has increased steadily (fig 1), and in recent years approximately nine times as many civilians as military personnel have been killed by weapons during war.** Many millions more civilians have died from war related hunger and disease as their crops were destroyed or they were forced to flee their homes to become part of the world's growing number of refugees inside or outside their countries. Fig 1 Civilian deaths as percentage of all deaths in war (source: Unicef) Virtually all the wars since 1945 have been fought in Third World countries, often as surrogate wars between the United States and the former Soviet Union. More recently civil wars, often based on historic ethnic enmities, opposition to oppressive governments, or arising …