By Thalif Deen
UNITED NATIONS (IDN) — The rising nuclear threats over the Russian invasion of Ukraine—and the growing tensions in the Korean Peninsula triggered by a nuclear-armed North Korea—have prompted the Geneva-based World Health Organization (WHO) to update its list of medicines that should be stockpiled for radiological and nuclear emergencies along with policy advice for their appropriate management. [2023-01-29]
In a report released on January 27, the WHO says these stockpiles include medicines that either prevent or reduce exposure to radiation or treat injuries once exposure has occurred.
"In radiation emergencies, people may be exposed to radiation at doses ranging from negligible to life-threatening. Governments need to make treatments available for those in need—fast," said Dr Maria Neira, WHO Acting Assistant Director-General a.i, Healthier Populations Division.
"It is essential that governments are prepared to protect the health of populations and respond immediately to emergencies. This includes having ready supplies of lifesaving medicines that will reduce risks and treat injuries from radiation."
The Russian invasion of Ukraine, which reaches its first anniversary on February 24, resulted in threats by several Russian officials, including Foreign Minister Sergey Lavrov, of a possible use of nuclear weapons.
A Russian news agency last year cited Lavrov’s dire warning: If a third world war (WWIII) breaks out, it would involve nuclear weapons—and be destructive.
Meanwhile, former Ukrainian Prime Minister Oleksiy Honcharuk repeated similar fears speculating that the Russian invasion could be the start of a third world war.
In March last year, UN Secretary-General António Guterres warned that further escalation of the war, whether by accident or design, threatens all of humanity.
Raising the alert of Russian nuclear forces is a bone-chilling development, he noted.
"The prospect of nuclear conflict, once unthinkable, is now back within the realm of possibility. The security and safety of nuclear facilities must also be preserved," he said.
"It's time to stop the horror unleashed on the people of Ukraine and get on the path of diplomacy and peace. I have been in close contact with a number of countries—including China, France, Germany, India, Israel and Turkey—on mediation efforts to bring an end to this war."
But so far, all such efforts have failed—with possible use of tactical nuclear weapons looming over the horizon.
Meanwhile, the current WHO publication supersedes the 2007 WHO report on the development of national stockpiles for radiation emergencies and includes updated information on the stockpile formulary based on the developments in radiation emergency medicine in the last decade.
It also provides policy advice for the acquisition of drugs that can prevent or reduce radionuclide uptake or increase the elimination of radionuclides from the human body.
"It looks at the main elements required for developing, maintaining and managing the national stockpiles of specific medical supplies which will be required for radiological and nuclear emergencies," the WHO said.
The UN agency says the report looks at the role of national health authorities in stockpile development as well as the role of WHO.
"As the leading international organization in public health with both the authority and responsibility to assist in health emergencies, WHO provides advice and guidance to countries on public health preparedness and response to radiation emergencies, including stockpile development."
In health emergencies WHO may assist in procuring or sharing medical supplies among countries.
The report also includes a brief review of selected emerging technologies and drug formulations, including the potential repurposing of products previously approved for other indications.
Finally, the publication provides examples of practices in establishing and managing a national stockpile in selected countries, including Argentina, Brazil, France, Germany, Japan, the Republic of Korea, the Russian Federation and USA.
"This updated critical medicines list will be a vital preparedness and readiness tool for our partners to identify, procure, stockpile and deliver effective countermeasures in a timely fashion to those at risk or exposed in these events," said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme.
Typically, a national stockpile for all-hazards health emergencies would include generic supplies and materials used for any type of emergencies, such as personal protective equipment (PPE), trauma kits, fluids, antibiotics and painkillers.
The WHO publication includes only specific drugs which are known and licensed today to prevent or treat human over-exposure to radiation, according to the agency.
The WHO also warns that radiological and nuclear emergencies may result in exposure to radiation doses high enough to lead to severe health consequences or even death.
"It is therefore extremely important that governments respond rapidly to such threats. Many countries, however, still lack the essential elements of preparedness for radiation emergencies," according to annual reporting to the WHO Secretariat.
Potential scenarios considered in the publication include radiological or nuclear emergencies at nuclear power plants, medical or research facilities, or accidents during the transport of radioactive materials, as well as intentional uses of radioactive materials with malicious intent.
The publication focuses on pharmaceuticals for treating radiation exposure and addresses the governance and management of such a stockpile. A typical radiation emergency stockpile will include the following medicines:
Stable iodine administered to prevent or reduce the exposure of the thyroid to radioactive iodine;
Chelating sand de-corporating agents (Prussian blue, applied to remove radioactive caesium from the body and calcium- / zinc-DTPA used to treat internal contamination with transuranium radionuclides);
Cytokines used for mitigation of damage to the bone marrow, in case of acute radiation syndrome (ARS); and
Other medicines used to treat vomiting, diarrhoea and infections.
WHO says its global expert network, REMPAN (Radiation Emergency Medical Preparedness and Assistance Network), is an important asset of the Organization for implementing its work on providing technical guidance and tools for response, delivering activities for building capacity through education and training, and on promoting international cooperation and information-sharing between the members of the network and the professional community in the field of radiation emergency medicine.
WHO is a member of ICARNE, the Inter-Agency Committee on Radiological and Nuclear Emergencies, which provides the coordination mechanism between 20 international organizations with relevant mandates.
Members of IACRNE develop, maintain and co-sponsor the Joint Radiation Emergency Management Plan of the International Organizations (JPlan 2017).
The J-Plan describes a common understanding of each organization’s roles in making preparedness arrangements and during a response and recovery. [IDN-InDepthNews – 29 January 2023]
Image: Nuclear Power Plant in Cattenom. CC BY-SA 3.0