Dr. Albright's dosage of sanctions doesn't really work

                 By Richard Foster
                 of the Journal Sentinel

                 It's not every day that a secretary of state writes - or has any reason to write - an article for a learned
                 scientific journal. But Madeleine K. Albright's name appears under an article in a recent issue of "Annals
                 of Internal Medicine," published twice a month by the American College of Physicians and the American
                 Society of Internal Medicine.

                 Standing alongside offerings with such high-domed titles as "Prevalence of and Risk Factors for Hepatic
                 Steatosis in Northern Italy," Albright offers a vigorous but unconvincing defense of economic sanctions,
                 notably those directed at Iraq and Cuba. Elsewhere in the magazine appear articles critical of these
                 embargoes.

                 Why is a medical journal publishing articles about economic sanctions, anyhow? Aren't the editors going
                 beyond their professional expertise when they venture into the domain of foreign affairs?

                 In fact, Albright's article has a legitimate place in the pages of a medical journal. At the busy intersection
                 of diplomacy and public health, the vehicles of policy-makers often collide with those of doctors.
                 Specifically, sanctions have a place in medical discussions (and in medical journals) because embargoes
                 against rogue countries often erode the health of people who live in them.

                 According to Albright, "the case for continued sanctions as a means of pressure against Saddam Hussein
                 is overwhelming. There is no greater enemy to public health in Iraq than he."

                 She makes similar remarks about Fidel Castro's Cuba: "There would be no better route to greater
                 prosperity and improved public health in Cuba than a government that was accountable to its people."

                 In essence, Albright is saying that if the people of Iraq and Cuba are in a pickle, it is because Hussein
                 and Castro put them there. Blame these dictators for the shortages, the poverty and the disease, not us.
                 This is buck-passing masquerading as rational analysis.

                 It is obvious - and thus hardly worth saying - that Iraq and Cuba would be better off with more
                 enlightened and humane leaders. Hussein is a particularly detestable character because he has made the
                 sparse goods in his country available only to those who support him. Thus, he has transformed the
                 embargo into an instrument of repression, which seems to me to be another reason to end it.

                 But to say, as Albright says, that Hussein and Castro are to blame for their countries' plight is to say only
                 part of the truth. It says nothing about this country's role - the role of the sanctions - in the misery that
                 Iraqis and Cubans suffer. It ignores our complicity, however unintended, in the misery of people who
                 already suffer under the lash of dictatorial rule.

                 Albright points out that food and medicine are exempt from the sanctions against Iraq and Cuba, but she
                 knows very well this is a phony argument. An embargo is intended to cripple the economy of a target
                 country, and to the extent that it makes people poor, it erodes their ability to buy food and medicine,
                 however available they may be in theory. The wealthy and powerful, of course, can buy what they want;
                 it's just ordinary citizens, especially the poor, who are hit.

                 The shortage of medical care is much more serious in Iraq than in Cuba. Castro is a ruthless dictator, but
                 unlike many dictators (notably Hussein) he has always devoted a huge share of his country's resources to
                 basic medical care and basic education.

                 The embargo of Cuba has been in place since 1961, which is a long time for any government policy to
                 remain intact. It has completely failed to achieve its intended goal, which is to weaken Castro and
                 promote democracy in Cuba. The sanctions against Iraq were imposed in 1991, and they, too, have
                 failed. In fact, it is likely that Hussein is stronger now than he was when the embargo was first imposed.

                 Over the years, international support for the Cuba blockade has disappeared, so that the United States
                 now stands virtually alone in maintaining it. There is every indication that the same erosion will make a
                 mockery of the Iraqi blockade; already, support for it is weakening in the United Nations, even in those
                 Arab countries that would be Iraq's most immediate victims. Increasingly, they are isolating the U.S., not
                 its adversaries.

                 These embargoes are creating misery, not democracy; they are weakening the health of ordinary people,
                 not the iron grip of those who rule them. It's no wonder that doctors have cause to oppose them. They
                 are not just bad economic policy; they are public health menaces.

                 Richard Foster is an editorial writer and columnist for the Milwaukee Journal Sentinel. He can be
                 reached at rfoster@onwis.com
 

                                    Appeared in the Milwaukee Journal Sentinel on Jan. 23, 2000.