George W. Bush
The White House
1600 Pennsylvania Ave.
Washington, DC 20510

Dear President Bush:

As the Co-Presidents of International Physicians for the Prevention of Nuclear War (IPPNW), which was awarded the 1985 Nobel Peace Prize for raising global awareness of the medical and environmental consequences of nuclear war, we wish to express our deep concern that the recently completed Nuclear Posture Review represents a repudiation of US disarmament commitments under the Nuclear Non-Proliferation Treaty (NPT), and thus will undermine decades of efforts to prevent the spread-and eventual use-of nuclear arms.

The Los Angeles Times reports that the NPR names seven countries-five of which are non-nuclear states-as targets of US nuclear weapons and that the US plans to develop small, tactical nuclear weapons for use in a variety of battlefield contingencies. If accurately described, this targeting policy will make the use of nuclear weapons more, rather than less, likely and must be retracted. Such a policy is also in violation of international law according to the 1996 advisory opinion of the International Court of Justice.

US nuclear policy as we now understand it places the world in greater jeopardy of nuclear war than at any time since the height of the Cold War. By asserting a central role for nuclear weapons well into the middle of this century, the NPR removes all incentive for the existing nuclear weapon states to disarm. Countries that joined the NPT on the condition that the nuclear weapon states, including the US, would honor their disarmament obligations under Article VI, might well reconsider their own “nuclear postures.”

The reductions in strategic nuclear weapons that have been announced as a key element of the NPR would be welcome as an important step toward US disarmament obligations were it not for the apparent decision to retain most of them in an inactive “responsive” force, ready to be re-deployed on short notice. This shift in the operational status of US warheads does not equate to a reduction in the size of the arsenal in any legitimate sense and, in any case, is too easily reversible.

Moreover, we cannot avoid the conclusion, from what has been published about the NPR, that the US intends to resume nuclear testing as soon as new warhead designs emerge from the DOE weapons labs, so that a new generation of nuclear weapons can be added to the arsenal even as older ones are removed. If the US “modernizes” its nuclear arsenal, other countries will do the same. A resumption of nuclear testing in the US will inevitably lead to a global breakdown of the decade-long moratorium on testing, which has been one of the most promising developments in the global campaign to prevent further nuclear proliferation.

Your administration has already declared its intention to withdraw from the ABM Treaty in order to develop and deploy an enormously expensive system that cannot protect against the most likely means of nuclear weapons delivery by terrorists or by countries that might acquire a small number of nuclear weapons with hostile intent against the US. Missile defenses will provoke other nuclear weapons states to counter what they see as a threat to their own security by building more nuclear weapons rather than by honoring their treaty commitments.

Finally, the NPR underscores a dangerous trend in US strategic policy in which the distinctions between nuclear and non-nuclear “missions”-and even nuclear and non-nuclear weapons- become blurred. Giving officers in the field a nuclear “capability” to destroy an underground bunker, for example, increases the likelihood that the nuclear threshold will be crossed by military decision makers who would come to think of nuclear weapons as just one option among many. This must never be allowed to happen.

As physicians concerned with the prevention of nuclear war, our objections to US nuclear policy as articulated in the NPR take on a heightened sense of urgency given the expansion of US military activity around the world, enormous increases in military spending that cannot be justified by legitimate concerns over terrorism, and a disturbing trend toward unilateral decision making. Rather than leading the way toward a world in which our common security is assured, as much as possible, by the norms and structures of international law and by policies that address and alleviate the root causes of conflict, the United States is needlessly endangering not only American lives, but the lives of people throughout the world who, unless this policy is reversed, must continue to live under the shadow of weapons of mass destruction for generations to come.

IPPNW and its affiliates joined the world in condemning the terrorist attacks against the US on September 11, and we mourned the loss of innocent life. We were gratified to see the huge reservoir of sympathy for the victims of those attacks, for their families, and for the rescue workers who lost their lives in the attempt to save the lives of others. We are terribly saddened, therefore, at the prospect that the US could squander the good will of the international community by adopting what amounts to a permanent state of war in which nuclear threats play an ever more intricate part.

There is another way. The US and the other nuclear weapon states can negotiate a verifiable and enforceable Nuclear Weapons Convention that would release the world from its perpetual state of nuclear terror. As the world’s wealthiest nation, the US is also in a unique position-and has a unique responsibility-to lead the nations of the world in efforts to alleviate the conditions that give rise to terrorism and to global conflict.

On behalf of our affiliates, comprising medical associations in 65 countries, we urge you to abandon the course set out in the Nuclear Posture Review, to honor the US commitment to eliminate its nuclear weapons, and to join the international community in productive, collaborative efforts to resolve conflicts without resort to war.

Mary-Wynne Ashford, MD – Co-President, Canada
Abraham Behar, MD – Co-President, France
Sergei Grachev, MD – Co-President, Russia