The Lancet 2005; 366:889
 http://www.thelancet.com
DOI:10.1016/S0140-6736(05)67306-0

Reed Elsevier and the international arms trade

Gene Feder a, Jon E Rohde b, Miguel San Sebastian c, Urban Janlert c, Masamine Jimba d, Enrico Materia e, Anna-Karin Hurtig c, Stephen Goldin f, Tom Stafford g, Berit Edvardsson h, Bjorn Hilt i, Stuart Parkinson j, Marion Birch k, Anna Jones l, Kathy Archibald m and John O Pastore n

Thomas Wakley founded The Lancet in 1823 as a beacon of medical knowledge and as a powerful ethical voice. “A lancet”, he announced, “can be an arched window to let in the light, or it can be a sharp surgical instrument to cut out the dross, and I intend to use it in both senses.”1 Wakley's successors have continued to challenge the political, social, and commercial forces that undermine medical values. In recent years, The Lancet has published groundbreaking work on the effect of conflict on public health, including a major 2004 study of civilian deaths in Iraq.2 Its work with the Peace Through Health programme at McMaster University, Hamilton, Ontario, Canada, is further evidence of the journal's leadership in this field.3

Today The Lancet finds itself connected to the profits of the global arms trade: a trade that inflicts physical and social harm in the poorest and least stable regions. Since 2003, The Lancet's owner and publisher, Reed Elsevier, has organised some of the world's largest arms fairs through its exhibition wing, Reed Exhibitions.

On Sept 13–16, 2005, Spearhead, a Reed Exhibition company, will stage the world's largest triservice (land, sea, and air) arms fair—Defence Systems and Equipment International (DSEi)—in London, UK. DSEi promotes arms sales ranging from warships to small arms (the cause of an estimated 500 000 fatalities annually) and cluster bombs.4 Military buyers from some of the world's most serious human-rights-abusing regimes, including Syria, Colombia, and Saudi Arabia, were invited to the last DSEi fair.5 There is a demonstrable lack of effective regulation at these events. For example, although organisers asked exhibitors in 2003 not to promote cluster munitions, journalists found cluster bombs openly on display.6

Professionals and practitioners who use Reed Elsevier's numerous medical and biomedical publications hold to principles that include, at their most basic, the maxim to “do no harm”. Reed Elsevier's involvement with the arms trade seems incompatible with this principle. It also contradicts Reed Elsevier's own subscription to the UN Global Compact, which aims to prevent conflicts and human rights abuse.7

As researchers, scientists, medical professionals, and campaigners concerned about the damaging effects of the arms trade on the health and wellbeing of many populations, we call on Reed Elsevier to end its international promotion of the arms trade. It is incompatible with The Lancet's guiding principles, Reed's subscription to the UN Global Compact, and the ethics of many of its contributors, readers, editors, and reviewers.
References

1. The Lancet. The Lancet— then and now
 http://www.thelancet.com/about
(accessed Aug 25, 2005).

2. Roberts L, Burnham G, Lafta R, Khudhairi J, Garfield R. Mortality before and after the 2003 invasion of Iraq: cluster sample survey. Lancet 2004; 364: 1857-1864. Abstract | Full Text | PDF (252 KB) | CrossRef

3. McMaster University. Peace Through Health
 http://www.humanities.mcmaster.ca/peace-health/
(accessed Aug 25, 2005).

4. International Action Network on Small Arms. Small arms are weapons of mass destruction
 http://www.iansa.org/documents/action/toolkit/wmd.pdf
(accessed Aug 25, 2005).

5. Campaign Against Arms Trade. Arms fairs: dealing in death
 http://www.caat.org.uk/armsfairs/dsei.shtml
(accessed Aug 25, 2005).

6. Norton-Taylor R. Welcome: this way for cluster bombs. The Guardian Sept 10 2003;.

7. Reed Elsevier. Corporate social responsibility. Reed Elsevier annual review and summary financial statements 2003
 http://www.reedelsevier.com/staging/ReviewReport/g1.htm...
(accessed Aug 25, 2005).
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Affiliations

a Barts and the London Queen Mary's School of Medicine and Dentistry, London, UK
b James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
c Umea International School of Public Health, Umea University, Sweden
d Department of International Community Health, University of Tokyo, Tokyo, Japan
e Agenzi di Sanita Pubblica, Rome, Italy
f Department of Public Health and Clinical Medicine, Umea University, Sweden
g Department of Psychology, Sheffield University, UK
h Umea University, Sweden
i On behalf of International Physicians for the Prevention of Nuclear War
j On behalf of Scientists for Global Responsibility
k on behalf of MedAct
l On behalf of the Campaign Against Arms Trade
m On behalf of Europeans for Medical Progress
n On behalf of Physicians for Social Responsibility

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Prof Gene Feder and colleagues claim in this week's issue that The Lancet finds “itself connected to the profits of the global arms trade”, a situation that, they say, is “incompatible with The Lancet's guiding principles”. During Sept 13–16, 2005, Spearhead Exhibitions—a part of Reed Elsevier, The Lancet's current publishers—is hosting one of the largest military exhibitions in the world, the Defence Systems and Equipment international (DSEi). The Lancet has a long record of drawing attention to the adverse health consequences of war and violence. We reject completely any perceived connection between the journal and the arms trade, no matter how tangential it might be. The Lancet is an entirely independent publication, editorially and financially. It is not subsidised by profits from any other part of Reed Elsevier.

DSEi takes place in association with the UK's Ministry of Defence. Over 1000 companies will exhibit their weapons and related systems at the arms fair in London's Docklands. In their promotional literature, our owners emphasise the “selling process” at DSEi, which is cited as a “key event for the total supply chain” of arms. At the last DSEi, held in 2003, this “selling process” included technologies such as cluster bombs, which are widely deplored by UN agencies and human rights organisations.

It would be grossly naive for The Lancet to argue that nations do not need responsible and well-managed defence industries as a means to protect themselves from security threats. Without security, health systems would be neither stable nor sustainable. But it would be equally naive to argue that the legality of a weapon somehow absolves a country, manufacturer, or even an exhibitions company from a judgment about the weapon's use, sale, or promotion.

More reasonably, one would expect the world's largest medical publisher to align its business values with the professional values of the majority of those it serves. Values of harm reduction and science-based decision-making are the core of public-health practice. Certain military technologies that Reed Elsevier has allowed to be showcased at DSEi are contrary to these values. In 2003, Reed Elsevier allowed INSYS, Israeli Military Industries, and Raytheon (all cluster bomb manufacturers) to exhibit at DSEi. The Campaign Against the Arms Trade estimates that there will be at least 15 cluster bomb producers at DSEi in 2005. Cluster bombs have high failure rates, creating de-facto minefields. Their effects do not discriminate between military targets and civilian populations. They are the worst kind of weapon.

The UN Mine Action Strategy specifically includes unexploded cluster bombs in its vision of a mine-free world. UNICEF reported that over 1000 children were injured by unexploded ordnance, including cluster bombs, after the Iraq war in 2003. Human Rights Watch has called for a moratorium on the use of cluster bombs until their civilian effects have been resolved. The Lancet has consistently opposed the use of cluster bombs. It will be incomprehensible to the journal's readers that our owners are engaged in a business that so clearly undermines not only principles of public-health practice, but also the policies of intergovernmental agencies.

Reed Elsevier's response is that the sale of military equipment is legal, government supported, and tightly regulated. However, The Lancet's collaborations in child survival and health-systems strengthening, for example, risk being tainted by Reed Elsevier's promotion of the “selling process” of arms. The arms industry draws vital investment away from the health budgets of low-income nations. In 2004, 59% of arms sales were to developing countries, at a total cost to their economies of US$22 billion.

Reed Elsevier has provided enormous material support to The Lancet during the past decade. It has never wavered in backing the journal's editorial independence, as proven by the publication of this leader comment. We cannot believe that Reed Elsevier wishes to jeopardise that commitment by its presence in a business that so self-evidently damages its reputation as a health-science publisher.

The Lancet's editors and the journal's International Advisory Board were unaware of Reed Elsevier's involvement with DSEi until a few weeks ago. We are deeply troubled by this connection to the arms trade. On behalf of our readers and contributors, we respectfully ask Reed Elsevier to divest itself of all business interests that threaten human, and especially civilian, health and well-being.

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The Lancet 2005; 366:889-890

DOI:10.1016/S0140-6736(05)67307-2
Reed Elsevier and the international arms trade – Reed Elsevier's reply

Stephen J Cowden (Reed Elsevier Group plc)

The views of distinguished medical practitioners and academics, such as Professor Gene Feder and his colleagues, are extremely important to us and require a response.

Reed Elsevier management and staff are passionate about what they do and take real pride in the contribution they make to the important industries which we serve, of which science, medicine, and education are directed to the advancement of human wellbeing. We are committed to the highest ethical standards in all our business activities, and to investment, innovation, and professionalism in the way in which we serve our customers and markets.

The defence industry is central to the preservation of freedom and national security. The sale of equipment and services for national defence is not only sanctioned and supported by the British and other leading governments around the world—the same governments which provide the largest single source of funding for scientific research—but is also enshrined in Article 51 of the United Nations Charter.

It is vital that trade shows serving this sector operate in as visible and tightly regulated an environment as possible. Reed Elsevier, through its Reed Exhibitions business (which manages more than 400 trade shows each year serving many different sectors) is well placed to work in conjunction with the UK Ministry of Defence to do this, and to ensure that the show adheres to the highest standards of scrutiny and compliance with the law. DSEi, like all our business activities, complies with the principles of the United Nations Global Compact, to which Reed Elsevier is a signatory.

All nations participating in DSEi are subject to the strictest rules and regulations about what they may exhibit and sell at the event. Any evidence that DSEi exhibitors had broken these rules would immediately be passed to the UK Department for Trade & Industry—in fact, failure to do so would be a criminal offence. Compliance checks take place before and throughout the exhibition. Should any exhibitor be found to be displaying or promoting prohibited items during DSEi, its stand would immediately be closed, its licence to exhibit would be rescinded, and the breach would be reported to the appropriate prosecuting authority.

The role of armed forces today often extends beyond the military to include disaster relief work, search and rescue and other humanitarian exercises in the civilian world. A large proportion of the equipment displayed at DSEi, such as air ambulances or equipment for fire control and firefighting, or for search, rescue, and survival are vital elements for life-saving activities.

In conclusion, it is our view that the defence industry is necessary for upholding national security for the preservation of democratic values and supporting the ever widening role played by the armed forces.