BAN TREATY: A MEDICAL and PUBLIC HEALTH IMPERATIVE
Nuclear weapons are the most inhumane and indiscriminate weapons ever created. They violate international law, cause severe environmental damage, undermine national and global security, and divert vast public resources away from meeting human needs.
The risk of use of nuclear weapons is higher than ever - their prohibition and elimination is a medical and public health imperative.
INHUMANE, INDISCRIMINATE, ILLEGAL
The Treaty on the Prohibition of Nuclear Weapons (TPNW) is in force as of 22 January 2021.
The TPNW makes the development, possession and use of nuclear weapons illegal for states parties to the Treaty. It also includes positive obligations for assistance to victims of nuclear blasts and tests, and for remediation of the effects of blasts and tests on the environment.
The global campaign for a nuclear ban treaty was initiated in Australia by Medical Association for Prevention of War, representing medical and other health professionals throughout the country.
Based on compelling and irrefutable evidence, we concluded there could be no meaningful medical response to, or preparation for, nuclear war. The only ethical course of action is to work for prevention through the prohibition and elimination of nuclear weapons.
We launched the International Campaign to Abolish Nuclear Weapons (ICAN) in 2007. In 2017, the United Nations adopted the TPNW and ICAN was awarded the Nobel Peace Prize.
Medical and health professionals continue to play a vital role in advancing the evidence for prohibition and elimination, and universalising the TPNW.
The risk of use of nuclear weapons is higher than ever.
The only ethical course of action is to work for prevention, through the prohibition and elimination of nuclear weapons.
EVIDENCE FOR ACTION
The development, testing, and use of nuclear weapons causes harm.
TESTING
Studies of nuclear test workers and exposed nearby communities around the world consistently show adverse health effects, especially increased risks of cancer.
The total number of global cancer deaths as a result of atmospheric nuclear test explosions has been estimated at between 2 million and 2.4 million, even though these studies used radiation risk estimates that are now dated and likely underestimated the risk.
Britain conducted 12 nuclear test explosions in Australia between 1952 and 1957, and hundreds of minor trials of radioactive and toxic materials for bomb development up to 1963. These caused untold health problems for local Aboriginal people who were at the highest risk of radiation.
More than 16,000 Australian workers were also exposed. A key government-funded study belatedly followed these veterans over an 18-year period from 1982. Despite the difficulties of conducting a study decades later with incomplete data, it found they had 23% higher rates of cancer and 18% more deaths from cancers than the general population.
Our Pacific island neighbours also continue to suffer the devastating consequences of nuclear testing.
DETONATION
The blast wave, thermal wave, radiation and radioactive fallout generated by nuclear explosions have devastating short- and long-term effects on the human body, and health services are not equipped to alleviate these effects in any significant way (WHO, 1987).
The United Nations Institute for Disarmament Research (UNIDR) summarised the humanitarian effects of a single nuclear detonation in an urban area:
- Within the zone of blast, most people are killed or suffer horrific lifechanging injuries.
- Hospitals in the blast zone and fallout zones are rendered unusable. Surviving local hospitals are overwhelmed by large numbers of casualties with complex trauma.
- Humanitarian relief is rendered impossible by destruction of electricity, transport, clean water and communication infrastructure.
- Radioactive landscape provides a major hazard for relief efforts.
- Psychosocial challenges include widespread grief and confusion.
IONISING RADIATION
As well as creating hundreds of new radioactive elements that did not exist before, a nuclear explosion - and the operation of a nuclear reactor - both increase the total radioactivity from that of the starting material a million times or more.
Ionising radiation has significant effects on biology and human health, increasing cancer rates. New evidence points to these effects being greater than previously estimated. For example, an international study of over 308,000 radiation-monitored nuclear industry workers in France, the USA, and UK reported in 2015 strong evidence of positive associations between protracted low-dose radiation exposure and leukaemia.
In addition, radiation risk is not uniform across a population. It is highest in very young children and declines gradually with age. Infants are overall about four times as sensitive to radiation’s cancer-inducing effects as middle-aged adults.
Women are also disproportionally affected by ionising radiation.The UNIDR found that women are biologically more vulnerable to harmful health effects of ionising radiation than men, and that social effects of nuclear weapons are gendered.
Read an overview of the medical evidence and the impact of the TPNW in the New England Journal of Medicine.
Initially there is an intense flash of light which can blind those who are looking towards it. Then follows a blast wave, causing tornado-force winds, collapse of buildings, and flying glass and other debris for up to tens of kilometres from the epicentre. The winds and intense heat would lead to firestorms which can also occur for many kilometres from the epicentre. At Hiroshima, ground temperatures reached 11,000 degrees F. Burning debris spreads the fires even further, the hazards being augmented by broken gas lines and fallen power cables. Dust and smoke would choke the city.
For the victims – children, women and men – the injuries include any combination of burns, multiple fractures, blast injuries, rupture of internal organs, chest trauma, head injuries, and haemorrhage. Many would be trapped under building rubble. Underground shelters would probably be death traps as the firestorms consume all available oxygen. Health services tend to be located centrally in cities and many, probably most, would be destroyed.
Those that did survive the attack would be totally overwhelmed. Any physicians and first responders who are not themselves victims would be unable to work in the totally devastated, radioactively contaminated wastelands that would extend for kilometres beyond ground zero. Health care depends on adequate communications, transport, electricity, sewerage and the other infrastructure that modern cities have. There is likely to be little water or even pain relief for most of the survivors, let alone meaningful medical assistance.
After a variable period – hours, days or weeks, depending on the size of the dose – there is the onset of radiation sickness, the symptoms including bleeding, bruising, nausea, vomiting, diarrhoea, mouth and other gastrointestinal ulceration, fatigue, and loss of hair. Loss of white blood cells leads to the onset of fever and life-threatening infections. In the longer-term, radiation in the form of ‘fallout’ will occur downwind of a nuclear explosion. The fallout may then be inhaled by people and animals or ingested through contaminated food and water …
In addition, epidemics of infectious disease and greatly increased potential for further war and civil conflict would follow. [W]hat’s at stake [would be] unprecedented in human history.
Testimony to the International People's Tribunal on the Nuclear Powers
WORKING FOR PREVENTION
Medical and other health professionals around the world have championed action to prevent the harms of nuclear testing and detonation.
Medical Association for Prevention of War and International Physicians for the Prevention of Nuclear War launched the International Campaign for the Abolition of Nuclear Weapons in Australia in 2007, seeking to create a treaty-based prohibition of the only weapons of mass destruction yet to be eliminated.
Worldwide, medical, health and humanitarian federations and institutions have accepted the evidence on nuclear weapons, and endorsed the Treaty on the Prohibition of Nuclear Weapons (TPNW).
WORLD MEDICAL ASSOCIATION
The WMA has recognised the duty of physicians to advocate for the elimination of nuclear weapons, and endorses the TPNW. Read the WMA statement on elimination.
INternational COUNCIL of Nurses
The ICN, representing nurse and midwife federations worldwide, has called for the elimination of nuclear weapons based on the evidence of their devastating effects on human and planetary health. Read the ICN's joint statement.
World Federation of Public Health Associations
The WFPHA has been a powerful force for the TPNW, recognising that advocacy for the elimination of nuclear weapons is consistent with the Global Charter for the Public’s Health—protection, prevention and promotion. Read more on the WFPH and nuclear abolition.
The duties and responsibilities of the medical profession [are] to preserve and safeguard the health of the patient and to dedicate itself to the service of humanity.
Therefore... to achieve a world free of nuclear weapons is a necessity.
World Medical Association
Nuclear weapons constitute the most acute existential threat to human and planetary health, and there is an urgent public health imperative to prohibit and eliminate them as the only way to effectively prevent their otherwise inevitable use.
World Federation of Public Health Associations
resources
TPNW
- What does entry into force of the TPNW mean for Australia? Read ICAN Australia's briefing paper.
- What is the global significance of the entry into force of the TPNW?
- Which countries have signed or ratified the TPNW?
- How does the TPNW interact with other nuclear weapons treaties or agreements? Read the analysis.
divestment
- If you have money in an Australian superannuation fund, you may be investing in companies involved in the production of nuclear weapons. Learn more about our Quit Nukes campaign.