S2-1_Satoshi Tashiro

Preparedness and activity
for a more peaceful and secure world
Satoshi Tashiro, MD, PhD
Regional Vice President (East Asia Pacific)
International Physicians for the Prevention of Nuclear War (IPPNW)
Research Institute for Radiation Biology and Medicine
Hiroshima University
World Medical Association’s Regional Expert Meeting in Pacific on the WMA Declaration of Helsinki
Theme: Pandemics and Health Emergency
Session 2: The DoH & Non-pandemic Health Emergencies
November 30, 2023 Tokyo
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Putin signals escalation as he puts
Russia’
s nuclear force on high alert
Deterrence order given asZelenskiy saysUkraine delegation will
meet Russian officialsat Belarusborder
Russia?
Ukraine war latest news:follow live updates
Vladimir Putin puts Russian nuclear forces on high alert – video
,
sels
00:48
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Vladim ir Putin has ordered his m ilitary to put Russia’
s nuclear deterrence
forces on high alert, in the latest signal from the Russian leader that he is
prepared to resort to the m ost extrem e level of brinkm anship is his effort to
achieve victory in Ukraine.
The US accused Putin of “totally unacceptable” escalation and m ade clear
that it w ould keep up its support of Ukraine and punitive m easures on
Russia. W ith the EU also announcing unprecedented new m easures against
M oscow, it w as clear that Putin’
s assault on Ukraine had failed to yield the
quick victories he had anticipated but had instead rallied a concerted
w estern response that w as potentially devastating for Russia’
s econom y.
The Ukrainian president, Volodym yr Zelenskiy, announced that a delegation
from Kyiv w ould m eet Russian officials w ithout preconditions on his
country’
s border w ith Belarus, but it w as far from clear Putin w as ready to
Search International edition
February 25, 2022
5:55 AM GMT+9
Last Updated 4 days ago
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Reuters
France says Putin needs
to understand NATO has
nuclear weapons
Europe
Netanyahu SuspendsIsraeli Minister
W ho Said Dropping a Nuclear Bomb
on Gaza Wasan Option
Theprime minister’
s swiftmoveappeared to reflecthis concerns
with his waning popularity among voters, and with international
criticism of Israel’
s attackson Gaza.
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Prime M inister Benjamin N etanyahu of I srael suspended a far-right minister, Amichay
Eliyahu, from his government on Sunday. Kenny H olston/The N ew York Tim es
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Nov. 4, 2023
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alksWithC
hinaAre
EssentialandLongO
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I llustration by Rebecca Chew/The N ew York Tim es
SUNDAY OPINION
• IPPNW is the only international medical organization dedicated to the abolition
of nuclear weapons.
• Founded by US and Russian physicians in 1980, IPPNW is credited with raising
public awareness about the devastating effects of nuclear weapons and with
persuading American and Soviet leaders that the Cold War nuclear arms race
was jeopardizing the survival of the entire world.
• IPPNW received the 1985 Nobel Peace Prize in recognition of this
accomplishment.
• Today IPPNW mobilizes doctors, medical students, and concerned citizens in
over 60 countries in the service of a broader war prevention mission.
What is IPPNW?
• Doctors have been expected to treat injured soldiers and civilians, and to help
restore societies to health at the conclusion of armed conflict. They have a
unique and profound understanding of both the immediate and the long term
consequences of war.
• In the 1960s, a group of concerned physicians studied and documented the
blast, heat, and radiation effects of nuclear weapons, and came to the
inescapable conclusion that a meaningful medical response to nuclear war is
impossible.
• The atomic destruction of Hiroshima and Nagasaki and the lifelong suffering of
the survivors-the result of only two, small, relatively primitive nuclear weapons-
had put the medical profession on notice that it must prevent what it would be
unable to cure.
• That doctors would advocate the abolition of nuclear weapons not only makes
sense, it is also seen by many as a professional responsibility.
Why are doctors involved in a security issue?
tags: catastrophic humanitarian consequences, International Campaign to
Abolish Nuclear Weapons (ICAN), International Physicians for the
Prevention of Nuclear War, IPPNW, nuclear ban treaty, nuclear
disarmament, nuclear war, nuclear weapons, United Nations
Medical journals issue urgent call for
elimination of nuclear weapons
AUGUST 2, 2023
by IPPNW
[Editor’s note: More than 100 medical journals, including the Lancet, the British Medical Journal, the
New England Journal of Medicine, and JAMA have issued a joint call for urgent steps to decrease
the growing danger of nuclear war and to move rapidly to the elimination of nuclear weapons. At a
time of expanded fighting in Ukraine and increased tensions in Korea, leaders of the global health
community underscore that any use of nuclear weapons would be catastrophic for humanity.
The unprecedented call to action comes in the form of an editorial co-authored by the editors of 11 of
the leading medical and health journals, the World Association of Medical Editors, and leaders of the
International Physicians for the Prevention of Nuclear War (IPPNW). The editorial is being released
this week in conjunction with the start of the UN Nuclear Non-Proliferation Treaty (NPT) Preparatory
Committee Meeting and the 78th anniversary of the bombing of Hiroshima.]
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WELCOME TO THE IPPNW PEACE AND
HEALTH BLOG
A community of international physicians, medical students, and
policy experts writing about the medical consequences of nuclear
war, the abolition of nuclear weapons, the human dimensions of
armed violence, and global issues of peace, health, and security.
Opinions expressed by individual writers are their own
and do not necessarily reflect the organizational positions
of IPPNW.
Use the menus below to find articles by particular authors, by
News and opinion from the international medical movement to abolish nuclear weapons and to prevent war
Home About IPPNW The humanitarian impact of nuclear weapons (HINW)
• Any use of nuclear weapons would be catastrophic for humanity. Even a “limited” nuclear
war involving only 250 of the 13 000 nuclear weapons in the world could kill 120 million
people outright and cause global climate disruption leading to a nuclear famine, putting
2 billion people at risk.
• A large-scale nuclear war between the USA and Russia could kill 200 million people or
more in the near term, and potentially cause a global “nuclear winter” that could kill 5–6
billion people, threatening the survival of humanity.
• Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur
rapidly.
• The prevention of any use of nuclear weapons is therefore an urgent public health
priority and fundamental steps must also be taken to address the root cause of the
problem—by abolishing nuclear weapons.
• The health community played a decisive part during the Cold War and more recently in
the development of the Treaty on the Prohibition of Nuclear Weapons.
• We must take up this challenge again as an urgent priority, working with renewed energy
to reduce the risks of nuclear war and to eliminate nuclear weapons.
Atomic bombs
“Little boy” (Hiroshima)
Uranium 235, 15 kt
“Fat man” (Nagasaki)
Plutonium 239, 21 kt
海外では被爆し た広島の名前は知っ ていても 、 被爆
も ら える よ う 2 0 0 7 年に英語版、 2 0 1 7 年にフ ラ ンス
た。 被爆の実態を 世界に発信する ために活用し てい
N E W
日本語版 (改定版)
(定価 1 ,2 0 0 円 (税別))
英語版
(定価 1 ,5 0 0 円 (税別))
改訂版
I島の
おばあた
2025:80th anniversary
Acute Radiation Syndrome
た。 被爆の実態を 世界に発信する ために活用し ていただ
N E W
日本語版 (改定版)
(定価 1 ,2 0 0 円 (税別))
英語版
(定価 1 ,5 0 0 円 (税別)) (定価
書籍購入希望の方は日本支部事務局（ 広島県医師会内）
Research Institute for Radiation Biology and Medicine
Hiroshima University
Mission of RIRBM
Research on the science of treatment and prevention of disorders
caused by atomic bombs and other radiation, and its applications
Assume the use of nuclear weapons (1)
Hiroshima, 1 megaton, altitude 2,400 m
4Sv: 1.3km
0.01Sv
Large scale fire
Hiroshima, 16 kilotons, 600 m altitude
4Sv: 1.1 km
0.01Sv
Large scale fire
5 km 5 km
• If an atomic bomb of the same size as the previous one were dropped on the city of
Hiroshima, hundreds of thousands of people would be injured by radiation exposure.
• Of these, the number of exposed injured people who need to be triaged for radiation
exposure would be about 100,000-200,000.
• The results of radiation exposure dose estimation are needed within 1-2 weeks to
determine the treatment plan.
(Report of the Expert Group on Assumptions of Damage from Nuclear Weapons Attacks, 2007)
Dead: 66,000
Injuries: 205,000
Dead: 372,000
Injuries: 460,000
Tokyo Station, 500 tons (North Korea, 2006)
Explosion in the air
Tokyo, 16 kilotons, airborne explosion
３度熱傷
(Nukemap)
Dead: 55,900
Injuries: 205,260
Dead: 5,260
Injuries: 19,960
5 Sv
Burn, 3rd deg.
Assume the use of nuclear weapons (2)
Diagnosis and treatment
• Memories of Dr. Michihiko Hachiya,
Director of Hiroshima Post Hospital
• English translation published in 1955
as “Hiroshima Diary”
• Dr. Michihiko Hachiya was exposed to
the atomic bombing, but was involved
in the treatment and management of
the hospital.
• Importance of securing medical
facilities (Triage Center)
• Lack of supplies (logistics)
• Difficulty in diagnosis and treatment of
unknown A-bomb diseases
Hiroshima Diary
Preparing for Radiation Disaster
Ensuring social safety
-Securing water, food, transportation, and distribution
-Detection of radioactive materials
Establishment of medical system
-Disaster medical system for radiation exposure injuries/illnesses
-Cooperation with disaster medical team (DMAT)
Medical development
-Development of diagnostic and therapeutic methods
Diagnosis
Dosimetory
Therapeutics
development
Regenerative
Medicine
Development
Hematopoietic disorders: cytokines, etc.
Skin disorders: anti-inflammatory agents, etc.
Gastrointestinal disorders: Antioxidants, etc.
Hematopoietic disorders: hematopoietic stem cells
Skin disorders: mesenchymal stem cells
Others : iPS cells
Biological dosimetry
Chromosome analysis, white blood cell count, etc.
Bioassay
Physical dosimetry
Basic
research
Translational
research
Clinical
research
Applicable to radiation exposure accident response
and management of medical radiation exposure, etc.
Medical Development
in Response to Nuclear Threats
Stockpile Governance and Management
1
Resource Commitment and Management
• Substantial initial cost
– Purchase of pharmaceuticals, supplies, equipment
– Other cost
• Sustainable finance and human resources
– Replenishment after use and stockpile rotation
– Maintenance of facilities and expertise
• Reliable and sustainable sources of supplies
– Purchase agreement, assistance during an emergency, contingency plans
(From Dr. Zhanat Carr, WHO)
The challenges in medical development
for radiation injuries
• Rareness of the condition:
Radiation injuries are rare, making it difficult to recruit a large patient population for clinical
trials. This rarity limits the ability to conduct the extensive research and trials needed to
develop effective treatments.
• Rapid Response Requirement:
• In the event of a radiation disaster, there is a need for immediate and effective treatment
strategies to handle the large number of potential victims, which is a significant challenge
given the current state of research and preparedness.
• Late effects:
• The late effects of radiation exposure can take years to manifest, making it difficult to
evaluate potential treatments and understand the progression of the injury.
• Lack of public awareness:
• General public awareness about radiation injuries might be low, which can impact funding
and support for research in this area.
• Addressing these challenges requires a multi-disciplinary approach, combining research,
ethical considerations, and practical application in emergency situations.
WMA
WHO
IPPNW
government
academia
military
IAEA
• Relationship between civilian and military
medical systems:
• International collaboration:
Some more challenges
in medical development for radiation injuries
Ethical concerns
• Research on Radiation Effects and Treatment:
– To improve guidelines for the conduct of research into the health effects
of radiation exposure and the development of treatments for radiation
sickness. This includes establishing ethical standards for such research,
particularly in emergency or high-risk scenarios.
• Disaster Preparedness and Response Research:
– Expand the scope of the Declaration to include ethical considerations for
medical research in disaster response, particularly in the context of large
scale nuclear incidents. This would include the development of guidelines
for rapid and ethical decision-making in crisis situations.
• International Collaboration and Data Sharing:
– Strengthen clauses related to international collaboration in medical
research, emphasizing the need for global cooperation in the context of
nuclear threats. This would include sharing data and research findings to
rapidly advance understanding and treatment options.
ご静聴、ありがとうございました。
Thank you!
ktashiro@hiroshima-u.ac.jp
To protect people from nuclear weapon