The Public Health Implications of Resource Wars

Abstract

Competition for resources between or within nations is likely to become an increasingly common cause of armed conflict. Competition for petroleum is especially likely to trigger armed conflict because petroleum is a highly valuable resource whose supply is destined to contract.

Wars fought over petroleum and other resources can create public health concerns by causing morbidity and mortality, damaging societal infrastructure, diverting resources, uprooting people, and violating human rights.

Public health workers and the organizations with which they are affiliated can help prevent resource wars and minimize their consequences by (1) promoting renewable energy and conservation, (2) documenting the impact of past and potential future resource wars, (3) protecting the human rights of affected noncombatant civilian populations during armed conflict, and (4) developing and advocating for policies that promote peaceful dispute resolution.

War has enormous tragic impacts on people's lives and the environment. War accounts for more death and disability than many major diseases do. It destroys families, communities, and sometimes entire nations and cultures. It siphons human and financial resources away from health and other human services. It damages the infrastructure that supports the health of society, such as systems that provide safe food and water, electrical power, transportation, and communication. War violates human rights. It uproots people, forcing them to migrate to other countries or to become internally displaced persons within their own countries. It contributes to the spread of infectious disease. The mindset of war—which endorses the notion that violence is the best way to resolve conflicts or disputes—contributes to domestic violence, street crime, and many other kinds of violence throughout the world. War, and the preparation for war, contaminates and damages the environment and uses vast amounts of nonrenewable fuels and other resources. In sum, war damages not only the health of people but also the very fabric of society.¹

Wars today tend to be fought within nations (civil wars) instead of between nations. They are fought mainly with small arms and light weapons, and they usually involve attacks on civilians. In the past 20 years, since the end of the Cold War and withdrawal of US and Soviet military assistance to many less developed countries, military forces and armed groups in some countries have had to become more self-reliant, for example by engaging in illicit enterprises and exploiting local natural resources. As the International Committee of the Red Cross has demonstrated, insurgent groups frequently acquire weapons by trading resources (such as minerals) that are under their control, often illegally.² Such resources have come to be called “conflict minerals” or “conflict resources.” Also in the past 20 years, control over armed forces has become decentralized, with military power deriving from control of resources, arms, or drugs, or from the intensity of fear created in the local population.

The US government has recognized a clear link between illegal resource extraction and contemporary conflicts on the one hand and humanitarian disasters with resultant public health consequences on the other. The preamble to Section 1502 of the Wall Street Reform Act of 2010 states:

It is the sense of Congress that the exploitation and trade of conflict minerals originating in the Democratic Republic of the Congo is helping to finance conflict characterized by extreme levels of violence in the eastern Democratic Republic of the Congo, particularly sexual- and gender-based violence, and contributing to an emergency humanitarian situation therein.³

In an effort to combat this trade, the act requires US corporations to take appropriate measures to identify the source of minerals used in their products and to eliminate those deemed to be conflict minerals. The sale of diamonds to finance other military activities of this type has contributed to additional humanitarian disasters, prompting additional efforts to curb illicit trafficking.

Resource wars are violent conflicts that are largely driven by competition for control over vital or valuable natural materials, such as oil, water, land, timber, animals (or animal products), gold, silver, gems, and other key minerals. Resource wars can occur between states as (1) wars of conquest, in which a state or empire employs force to acquire resource-rich territories or colonies; (2) territorial disputes, in which 2 or more states fight over a border region or offshore territory with valuable resource deposits; or (3) access wars, in which a state fights to gain access to a critical resource deposit in another country. Resource wars can also occur within states, when groups fight for control over key sources of raw materials or over the allocation of the fees and royalties (or “rents”) obtained by governments from private entities that extract resources from areas owned or controlled by the state. A desire to gain control over a valuable resource supply or the wealth it generates is a dominant factor leading to war; however, conflicts over resources are usually driven by other factors as well, such as ethnic animosities and historical grievances.^4,5

In the current article, we examine what makes resource wars distinctive and an important issue for public health, and we outline ways in which public health workers and the organizations and professional associations with which they are affiliated can minimize the consequences of these wars and contribute to their prevention. Much of this article is focused on wars fought over petroleum; in a recent commentary we examined armed conflicts over water and what public health workers can do to address them.⁶

WHY RESOURCE WARS ARE RELEVANT TO PUBLIC HEALTH

We believe that resource wars are relevant to public health because of their profound consequences for public health and because public health workers have potential roles and responsibilities to minimize these consequences and to help prevent resource wars. Public health has been defined as what we, as a society, do collectively “to assure the conditions in which people can be healthy.”⁷ Resource wars threaten the conditions in which people can be healthy.

Although public health is a societal function, it is a function performed mainly by public health workers in government agencies, academic institutions, nongovernmental organizations, and private-sector entities who work to assure the conditions in which people can be healthy. Although most public health workers do not address resource wars, some have the opportunity—and the responsibility—to help document the health consequences of resource wars, to raise awareness of these consequences, and to advocate for policies and programs for minimizing these consequences and for helping to prevent resource wars.

Public health has a responsibility to address the fundamental causes of disease and to prevent adverse health outcomes.⁸ War is a major cause of disease, disability, and death; thus, war is a major public health problem.^1,9 The Public Health Oath, which some public health students recite at orientation and graduation, includes the declaration:

I will work to ensure that people have the chance to live full and productive lives, free from avoidable disease and disability.¹⁰

Resource wars threaten people's ability to live full and productive lives; they also provide opportunities for public health workers to help prevent avoidable disease, disability, and death.

HISTORICAL CONTEXT

Competition for control over vital, valuable raw materials has been a source of violent conflict since prehistoric times.¹¹ Conflict over resources, such as gold, silver, spices, furs, timber, and slaves, was especially prominent and violent in the colonial wars and interimperial clashes that culminated in World War I. However, during World War II and the Cold War, conflict over resources was rarely a central issue. With the end of the Cold War, resource conflicts have again become prominent. Some of these wars, similar to those of the past, have involved efforts by the major powers to dominate sources of energy and safeguard the flow of oil, such as the interventions by the United States in the Persian Gulf area. Others have involved internal conflicts. For example, the ongoing conflict in the Democratic Republic of the Congo—perhaps the most lethal conflict of the post–Cold War era, with approximately 4 million people dead—has largely been fueled by competition for control of valuable mines in the eastern part of the country.¹² The fighting between northern and southern Sudan, another notably lethal conflict, has been driven in part by a struggle for control over valuable oil fields.¹³ The future of this struggle is unclear, given the recent separation of Sudan into 2 countries.

RESOURCE WARS ARE DISTINCTIVE

Resource wars have some distinctive features of relevance to public health:

1. They are often extremely intense because they frequently result from both ethnic animosities (or historical grievances) and disputes over distribution of or access to vital—and often commercially valuable—materials. This intensity may lead to the conflict having adverse consequences for human health and the environment that are more widespread and more serious than are those resulting from wars fought for other purposes.

2. They occur in remote, forbidding areas occupied largely by poor and indigenous people. Today, most oil production is concentrated in areas largely avoided by advanced cultures, such as deserts, tropical forests, steep mountainsides, and polar or near-polar regions. These areas, however, are often inhabited by indigenous peoples and those too poor to live elsewhere. Governments often allow the use of extractive practices in these areas—such as unsafe mining and environmentally insensitive oil extraction—that would not be permitted elsewhere. In the Niger Delta region of Nigeria, for example, lax government oversight of oil drilling has led to widespread contamination of local fields and fishing grounds, further harming the health and livelihoods of the already impoverished inhabitants, who have revolted against the oil companies and the federal government.¹⁴

3. The invasion of remote areas to secure access to fresh supplies of vital resources also threatens the modes of living of the few remaining indigenous peoples who still practice their traditional ways of life. Such invasions threaten not only indigenous peoples’ ability to survive as distinct cultures but also their physical and psychological health, as adaptive communal lifestyles give way to rootless urban or reservation life. This pattern is painfully evident in the history of Native Americans, Canadian First Nations peoples, and Australian Aborigines, all of whom have suffered from widespread alcoholism, depression, and inadequate health care after being driven from their ancestral lands. A similar pattern is being repeated today as oil and mining firms penetrate into the Amazonian heartland, central Africa, New Guinea, Borneo, the Arctic, and other areas previously exempted from large-scale development.¹⁵

4. Resource wars often target noncombatant civilians and violate their human rights through slavery, child labor, rape, kidnapping, and other inhumane practices that cause injury, illness, and death. Many recent wars in Africa, areas of South America, and Southeast Asia have been driven by warlords and rogue government officials trying to maintain or gain control over a valuable resource. Lacking funds or structural capacity to recruit and build professional armies, they typically force boys and young men into their ragtag militias, usually at gunpoint, paying them with drugs and the services of female sexual slaves kidnapped from nearby villages, while impressing poor men, women, and children to work in their mines (and paying them little, if anything).^16,17 This scenario is particularly evident in northeastern Congo, where the militia of the Democratic Forces for the Liberation of Rwanda employs a vast slave army to mine gold and coltan (columbite and tantalite, the source of the lightweight metals used in most cell phones and other handheld electronic devices).¹⁸ This militia and other similar groups also employ mass rape as a tactic of intimidation and coercion.^19,20 Aside from the physical harm and psychological trauma they cause, these tactics contribute to the spread of HIV/AIDS in Africa.

In resource wars, military or insurgent forces sometimes target resources or related infrastructure over which these conflicts are fought, often with significant public health consequences. In the Persian Gulf War of 1990–1991, for example, retreating Iraqi military forces set fire to more than 600 oil wells in Kuwait; the fires burned for weeks, causing respiratory disorders and environmental damage.²¹ Many wars in which the control of oil or oil rents is a significant factor involve attacks on oil pipelines, refineries, and other infrastructure, often producing fires and oil spills that adversely affect civilian populations. The rebels in Colombia, for example, often sabotage the country's oil pipelines, causing oil spills that contaminate local water supplies.²²

FREQUENCY OF RESOURCE WARS WILL LIKELY INCREASE

Resource competition will likely be an increasingly common cause of armed conflict for several reasons²³:

1. The international supply of many vital materials—such as oil, certain minerals, and arable land—is dwindling or failing to grow significantly.

2. The demand for petroleum and other key natural resources will grow because population, urbanization, industrialization, and incomes are all increasing in many countries, which will cause competition for access to these resources to intensify.

3. Resource prices will rise, and so will rents obtained by governments that award the rights for the extraction of these resources. Incentives will increase for incumbent regimes to remain in power by any means necessary, including violent repression of opposition movements. Incentives will also increase for those out of power to use force to try to remove these regimes. (This phenomenon is known as the “resource curse.”²⁴)

4. Climate change will decrease the global supply of certain critical resources, especially water and arable land.²⁵

PETROLEUM WILL LIKELY BE AN INCREASING SOURCE OF CONFLICT

Competition for oil is likely to be a more frequent trigger for conflict for the following reasons:

1. Oil is an especially vital resource. Petroleum supplies approximately 37% of the world's primary energy supply, far more than do coal (27%) or natural gas (23%).²⁶ Oil is a critical source of fuel for transportation and farm machinery, enabling the mechanization of agriculture, which has facilitated a substantial increase in food production.²⁷ Oil is also a feedstock for many useful products, including plastics, paints, lubricants, pesticides, and many pharmaceuticals.

2. Global oil supplies will contract. Although there is debate over when the global production of crude petroleum will reach a peak and then subside, few doubt that such a reversal is likely in the not-too-distant future. The International Energy Agency, for example, predicted in 2008 that crude oil output from fields now in production or known to exist will reach a peak around 2012; the addition of “nonconventional oil” (such as Canadian oil sands, Venezuelan heavy oil, and shale oil) and the discovery of any new fields will compensate for some of the subsequent decline but cannot prevent an eventual contraction in net oil supply.²⁸ Many projects are under way to develop alternative transportation fuels, such as advanced biofuels and liquids derived from natural gas and coal, and to improve electric-powered vehicles. However, these projects are not likely to achieve commercial scale by the time oil becomes significantly less abundant—probably between 2015 and 2019—so competition for the remaining petroleum supply will become increasingly fierce.

3. Oil is a strategic resource. The procurement of a sufficient amount of oil to satisfy national requirements is widely considered a matter of “national security,” thus inviting state intervention. Oil is critical to the economies of the major industrial nations and is indispensable in modern, mechanized warfare. Except for a few nuclear-powered vessels, all weapons-delivery systems of the major military powers are fueled by petroleum, and many munitions are powered by petroleum-based propellants. Oil-fueled ships and planes, which are needed to convey troops and equipment to distant battle zones, constitute an essential ingredient of the “power projection” capabilities of any nation with regional or global defense commitments. For example, the US Department of Defense is the world's single largest consumer of oil; it used about 340 000 barrels daily in 2007.²⁹ US leaders have repeatedly stated that it is sometimes necessary to go to war to ensure access to overseas petroleum supplies, a precept enshrined in the Carter Doctrine of 1980.³⁰ This precept was invoked on several occasions to justify US involvement in overseas conflicts, most notably the Iran–Iraq War of 1980–1988 (when Iranian gunboats attacked Kuwaiti oil tankers), the Persian Gulf War of 1990–1991 (following Iraq's invasion of Kuwait),³⁰ and President George W. Bush's decision to invade Iraq in 2003.³¹ All of these wars had disastrous consequences for public health and the environment. As competition for access to oil intensifies, the United States and other countries will likely find reason to apply this logic again.

4. Oil is an especially valuable resource. Oil is the single most lucrative item in international trade, generating approximately $1 trillion in sales in 2007.^32,33 Oil is often the most important source of wealth in poor and middle-income countries that produce oil; it is thus a powerful attraction for those who seek to enrich themselves by controlling the collection and allocation of resource rents in their countries. In Nigeria, for example, oil has accounted for approximately 95% of the country's total export revenue³⁴; in Sudan, it has accounted for 70%.³⁵ As the supply of oil contracts relative to demand, prices will rise, enhancing the lure of controlling petroleum rents, not only in major oil-producing countries such as Libya, Nigeria, and Saudi Arabia, but also in minor ones like Chad and Equatorial Guinea. In those countries, oil rents provide a fortune for the dictators (and their cronies) who control them, but almost all other people live in abject poverty.³⁶ Under these conditions, conflicts sparked by discontent over the inequitable distribution of oil revenues are likely to become more widespread, with profound adverse consequences for public health.

5. Ownership of many valuable oil fields is disputed. As once-prolific reservoirs in relatively easily accessible areas on land and in shallow coastal waters are exhausted, the major oil producers are relying increasingly on deposits in offshore areas, border regions, the Arctic, and other long-neglected areas. Although these deposits offer new sources of oil, many are located in areas that are contested by 2 or more countries or by ethnic groups that seek to break away from a larger state and form their own ethnic homeland. Some of the most promising new sources of oil and gas in the South China Sea, for example, are located in areas claimed by China, Malaysia, the Philippines, Taiwan, and Vietnam.⁴ These overlapping claims have, on occasion, led to violent confrontations among these countries. In June 2011, for example, Vietnam conducted live-fire exercises in the area after a Chinese vessel snagged a seismic device being towed by a Vietnamese survey ship in waters claimed by Vietnam.³⁷ Likewise, a dispute between China and Japan over a contested natural gas field in the East China Sea has led to provocative military behavior by both countries.^38,39 Territorial disputes revolving around the pursuit of oil have also provoked periodic violence or naval clashes in the Caspian Sea, in the Persian Gulf, and on the Iran–Iraq border. Conflict has also arisen when populations inhabiting an oil-producing area, such as the inhabitants of Angola's Cabinda province, have attempted to separate from the larger country in which they are incorporated and form their own oil-financed nation, provoking a clash with government forces.⁴⁰

HOW PUBLIC HEALTH WORKERS CAN ADDRESS THESE PROBLEMS

Public health workers, working mainly through the government agencies, academic institutions, nongovernmental organizations, and professional associations with which they are affiliated, can help prevent and minimize the health consequences of petroleum wars and other resource wars in the following ways.

Documenting Health Consequences

Public health workers can use epidemiological and statistical methods to document the health consequences of past and potential future petroleum wars and other resource wars. They can follow the example of epidemiologists who have performed studies on the human consequences of the war in Iraq⁴¹ and in the Democratic Republic of Congo⁴² and have communicated their results to help protect civilian noncombatants. They can follow the example of the International Physicians for the Prevention of Nuclear War and its national chapters, such as the US organization Physicians for Social Responsibility, which have projected the human consequences of a nuclear attack.

Raising Awareness

Public health workers can widely disseminate information on the adverse health consequences of petroleum wars and other resource wars in many ways: they can write journal articles and make presentations at scientific meetings; they can write op-ed commentaries, letters to the editor, and blogs on the issue; and they can write to and meet with elected officials and other policymakers to draw attention to the issue and inform them of ways to address the problem.

Advocating for Policies and Programs

Public health workers can advocate for policies and programs to help protect noncombatant civilian populations during armed conflict. They can use their moral authority to help ensure the safety and security of noncombatant civilians, including internally displaced persons and refugees, and they can help ensure that the basic needs of these populations are met. They can promote the neutrality of medical and public health workers, and they can communicate about human rights violations when they occur to help prevent them from recurring.

Public health workers can also work to reduce demand for petroleum by promoting conservation measures and by promoting the development of renewable or sustainable alternatives, such as wind, solar energy, and biofuels.⁴³ By promoting renewable energy sources, public health workers can help to reduce air pollution and generation of greenhouse gases that contribute to climate change. By promoting substantially reduced consumption of petroleum, they can help the United States reduce its need to import oil from Africa and the Middle East, making it unnecessary to employ military force to ensure US access to oil-supply regions in accordance with the Carter Doctrine. They can help prevent petroleum wars and other resource wars by promoting nonviolent resolution of conflicts through negotiation, mediation, adjudication, and third-party diplomacy. Public health workers can support activities that are aimed at halting trade in conflict minerals, such as the Enough Project.⁴⁴ And public health workers can help establish a culture of peace.⁴⁵

CONCLUSIONS

Declining reserves of petroleum and other resources, population growth, increasing industrialization and modernization of societies, and other factors are increasing the likelihood of petroleum wars and other resource wars. Public health workers can help document the health consequences of resource wars, raise awareness about these consequences, and advocate for policies and programs for minimizing these consequences and for helping to prevent resource wars.