To examine the early development of humanitarian norm cascades, the author focuses on the processes that led to the adoption of the 1997 Mine Ban Treaty and the 2008 Convention on Cluster Munitions. Even though major military powers like the United States, Russia, and China opposed these initiatives, the latter set in motion quick norm cascades that brought about international legal norms stigmatizing land mines and cluster munitions. It is conventionally asserted that international norms emerge either due to great power backing or despite great power opposition, but the author argues that new norms can also take off because of great power opposition. When ngos and leading states actively foster normative change, a particular type of norm cascade is engineered—one generated by different mechanisms and starting earlier than postulated in the literature. Early norm cascading is driven not by emulation of peers and ngo naming and shaming of laggard states, but rather by leadership aspirations and naming and praising.

An estimated 110 million land mines scattered in 64 countries continue to terrorize people and destroy human lives long after wars and fighting have ceased. Despite efforts to clear these devices, their numbers continue to increase and their presence, constitutes a substantial threat to public health in the affected countries. Direct consequences include both the physical and emotional injuries from the impact, flying debris, and structural collapse associated with their detonation. Indirect consequences include increases in the incidence of waterborne diseases, diarrhea, malnutrition, infectious diseases, and spread of the human immunodeficiency virus associated with the increased use of blood. Those at highest risk of these latter consequences are mostly the disadvantaged poor, especially children. Psychiatric disorders, such as post-traumatic stress disorder, occur in those not directly injured as well as those physically wounded by the explosion.

Besides efforts to ban production, stockpiling and export of land mines, a comprehensive and integrated health program aimed at the prevention, treatment, and rehabilitation of those injured directly or indirectly by land mines is needed urgently. Strategies should include mine-awareness programs, enhanced transport of those directly injured, training the villagers in first aid, augmenting the capacity and quality of treatment facilities, improving the psychological support and treatment capabilities, development of rehabilitation programs, and the institution and enhancement of public-health programs directed at the indirect consequences associated with the presence of land mines.

Land mines constitute a major public-health problem in the world that must be addressed.