Ending nuclear weapons, before they end us

This May, the World Health Assembly (WHA) will vote on re-establishing a mandate for the World Health Organization (WHO) to address the health consequences of nuclear weapons and war (1). Health professionals and their associations should urge their governments to support such a mandate and support the new UN comprehensive study on the effects of nuclear war. The first atomic bomb exploded in the New Mexico desert 80 years ago, in July 1945. Three weeks later, two relatively small (by today's standards), tactical-size nuclear weapons unleashed a cataclysm of radioactive incineration on Hiroshima and Nagasaki. By the end of 1945, about 213,000 people were dead (2). Tens of thousands more have died from late effects of the bombings.

This May, the World Health Assembly (WHA) will vote on re-establishing a mandate for the World Health Organization (WHO) to address the health consequences of nuclear weapons and war. Health professionals and their associations should urge their governments to support such a mandate and support the new UN comprehensive study on the effects of nuclear war.

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In January 2023, the Science and Security Board of the Bulletin of Atomic Scientists moved the hands of the Doomsday Clock forward to 90 s before midnight, reflecting the growing risk of nuclear war [1]. In August 2022, UN Secretary-General António Guterres warned that the world is now in ‘a time of nuclear danger not seen since the height of the Cold War’ [2]. The danger has been underlined by growing tensions between many nuclear-armed states [1, 3]. As editors of health and medical journals worldwide, we call on health professionals to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet, and we urge action to prevent it. Current nuclear arms control and non-proliferation efforts are inadequate to protect the world's population against the threat of nuclear war by design, error or miscalculation. The Treaty on the Non-Proliferation of Nuclear Weapons (NPT) commits each of the 190 participating nations to pursue negotiations in good faith on effective measures relating to the cessation of the nuclear arms race at an early date and to nuclear disarmament and on a treaty on general and complete disarmament under strict and effective international control [4]. Progress has been disappointingly slow, and the most recent NPT review conference in 2022 ended without an agreed statement [5]. Many examples of near disasters have exposed the risks of depending on nuclear deterrence for the indefinite future [6]. Modernisation of nuclear arsenals could increase risks: for example, hypersonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escalation. 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 two billion people at risk [7, 8]. 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 five to six billion people, threatening the survival of humanity [7, 8]. 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 has played a crucial role in efforts to reduce the risk of nuclear war and must continue to do so in the future [9]. In the 1980s, the efforts of health professionals, led by International Physicians for the Prevention of Nuclear War (IPPNW), helped to end the Cold War arms race by educating policy makers and the public on both sides of the Iron Curtain about the medical consequences of nuclear war. This was recognised when the 1985 Nobel Peace Prize was awarded to IPPNW [10] (http://www.ippnw.org). In 2007, IPPNW launched the International Campaign to Abolish Nuclear Weapons, which grew into a global civil society campaign with hundreds of partner organisations. A pathway to nuclear abolition was created with the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017, for which the International Campaign to Abolish Nuclear Weapons was awarded the 2017 Nobel Peace Prize. International medical organisations, including the International Committee of the Red Cross, IPPNW, the World Medical Association, the World Federation of Public Health Associations, and the International Council of Nurses, played key roles in the process leading up to the negotiations and in the negotiations themselves, presenting the scientific evidence on the catastrophic health and environmental consequences of nuclear weapons and nuclear war. They continued this important collaboration during the First Meeting of the States Parties to the Treaty on the Prohibition of Nuclear Weapons, which currently has 92 signatories, including 68 member states [11]. We now call on health professional associations to inform their members worldwide about the threat to human survival and to join with IPPNW to support efforts to reduce the near-term risks of nuclear war, including three immediate steps on the part of nuclear-armed states and their allies: first, adopt a no first-use policy [12]; second, take their nuclear weapons off hair-trigger alert; and, third, urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts. We further ask them to work towards a definitive end to the nuclear threat by supporting the urgent commencement of negotiations among the nuclear-armed states for a verifiable, time-bound agreement to eliminate their nuclear weapons in accordance with commitments in the NPT, opening the way for all nations to join the Treaty on the Prohibition of Nuclear Weapons. The danger is great and growing. The nuclear-armed states must eliminate their nuclear arsenals before they eliminate us. 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. The respective authors were paid by their employers. CZ's time was funded by International Physicians for the Prevention of Nuclear War. IH and AH developed the idea of the editorial and led drafting, along with CZ. All other coauthors contributed significantly to the editorial content.

This article covers the period from when China first reported the outbreak of COVID-19-source unknown-in Wuhan, Hubei on December 31, 2019 to the commencement of the 73rd session of the World Health Assembly (WHA) of the World Health Organization (WHO) in Geneva on May 18 and 19, 2020. It highlights how Taiwan's success in tackling the COVID-19 outbreak reinforced the Tsai Ing-wen government's quest for observer status in the WHA and defined its spirited campaign to be invited to the 73rd session of the WHA. The article analyzes the impact of the world approbation Taiwan received for containing the outbreak in cross-Strait relations, Taiwan-US ties and Taiwan's pragmatic diplomacy with reference to its campaign to secure the invitation. Analyzing the developments in these three thematic areas pertaining to Taiwan's WHA-WHO cause, it reiterates that universalist values and objectives in the present international order prove ineffectual in the face of power politics. Weaker political entities like Taiwan continue to be squeezed between favorable and unfavorable geopolitical situations. They rely heavily on a favorable geopolitical environment to be heard in the world without any guarantee of success. The Tsai government has succeeded in its bid for the WHA invitation insofar as its objective was to attract international attention towards its predicament vis-a-vis China and sensitize global opinion on the issue of Taiwan's entry into the WHA. However, Chinese power has prevailed and has not allowed any substantial diplomatic gains for Taiwan. As the ramifications of COVID-19-induced geopolitical developments for the world are yet to be fully revealed, Taiwan should prioritize the consolidation of the gains its pragmatic diplomacy has made in its relations with the US and beyond.

During the 2000 presidential election, in that time before the September 11th terrorist attacks, the stump speeches of George W. Bush and his Democratic opponent, Al Gore, focused on protecting Social Security, saving American education, expanding Medicare, raising or lowering taxes, and readying the military. If science was mentioned at all, it was usually in the context of missile defense, global warming, or Gore’s role in creating the internet. With the exception of the debate over stem-cell research, science remains a background topic in the current campaign. Democratic candidate John Kerry has occasionally highlighted US science policy and used it against President Bush, charging that the administration has put politics and ideology ahead of science. “Let scientists do science again,” a headline on the Kerry election website says.Bush has responded, primarily through his science adviser, John Marburger, by pointing to the 44% increase in federal R&D since fiscal year 2001 and the record $132 billion in the administration’s FY 2005 R&D budget. “Kerry ignores President Bush’s record science investments,” reads a headline on the Bush reelection website.Kerry answers by noting that most of the R&D money is going for weapons systems and defense spending related to the war in Iraq, not basic science programs. Marburger and other administration officials point to several R&D initiatives, including new nanotechnology centers, the Moon/Mars space initiative, and the program to develop hydrogen fuel technology. In an effort to get the candidates to specifically address questions of interest to the science community, Physics Today has continued a tradition begun in 1976; it asked Bush and Kerry nine questions covering a range of science topics. Their answers, sometimes direct and sometimes vague, show fundamental differences on several key issues.On missile defense, Bush says his request of $10 billion in FY 2005 for development and deployment of such a system fulfills a pledge he made to the American people. Kerry says we should not be “falsely comforted by an untested and unproven defense system.”On global warming, Kerry talks of both near- and long-term programs to deal with the problem. Bush promotes his “comprehensive climate change strategy.” The candidates also address a host of other issues ranging from space exploration to energy policy. During the 2000 presidential election, in that time before the September 11th terrorist attacks, the stump speeches of George W. Bush and his Democratic opponent, Al Gore, focused on protecting Social Security, saving American education, expanding Medicare, raising or lowering taxes, and readying the military. If science was mentioned at all, it was usually in the context of missile defense, global warming, or Gore’s role in creating the internet. With the exception of the debate over stem-cell research, science remains a background topic in the current campaign. Democratic candidate John Kerry has occasionally highlighted US science policy and used it against President Bush, charging that the administration has put politics and ideology ahead of science. “Let scientists do science again,” a headline on the Kerry election website says.Bush has responded, primarily through his science adviser, John Marburger, by pointing to the 44% increase in federal R&D since fiscal year 2001 and the record $132 billion in the administration’s FY 2005 R&D budget. “Kerry ignores President Bush’s record science investments,” reads a headline on the Bush reelection website.Kerry answers by noting that most of the R&D money is going for weapons systems and defense spending related to the war in Iraq, not basic science programs. Marburger and other administration officials point to several R&D initiatives, including new nanotechnology centers, the Moon/Mars space initiative, and the program to develop hydrogen fuel technology. In an effort to get the candidates to specifically address questions of interest to the science community, Physics Today has continued a tradition begun in 1976; it asked Bush and Kerry nine questions covering a range of science topics. Their answers, sometimes direct and sometimes vague, show fundamental differences on several key issues.On missile defense, Bush says his request of $10 billion in FY 2005 for development and deployment of such a system fulfills a pledge he made to the American people. Kerry says we should not be “falsely comforted by an untested and unproven defense system.”On global warming, Kerry talks of both near- and long-term programs to deal with the problem. Bush promotes his “comprehensive climate change strategy.” The candidates also address a host of other issues ranging from space exploration to energy policy. 1Section:ChooseTop of page1 <<BushKerry2BushKerry3BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerry Missile defense: The present administration is requesting more than $10 billion this year for development and deployment of a missile defense system. Many scientists say the system, given current and foreseeable technology, cannot be effective. What proof of effectiveness should be required before the system is fully deployed? Given the low-tech nature of terrorist attacks and the limited missile capabilities of North Korea and other hostile nations, does missile defense continue to be a wise investment? BushSection:ChooseTop of page1Bush <<Kerry2BushKerry3BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryOur policy is to develop and deploy, at the earliest possible date, a weapons system that would defend the United States homeland against nuclear attack, including ballistic missile defenses drawing on the best technologies available. Early in my administration, I called for the examination of the full range of available technologies and basing modes for missile defenses that could protect the United States, our deployed forces, and our friends and allies.The FY 2005 Defense Appropriations Act provides $10 billion that I requested for systems to defend against the threat from ballistic missiles. Later this year, the first components of America’s missile defense system will become operational, and we are on schedule for the next stages of the project. My administration will develop and deploy the technologies necessary to protect our people, fulfilling a pledge I made to the American people more than four years ago.KerrySection:ChooseTop of page1BushKerry <<2BushKerry3BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryA missile defense that works is a wise investment, but one that pours money into defenses at the expense of other immediate national security needs is not. And that’s what this administration has done. Missile defense should be one element of a comprehensive national security strategy. But a single-minded focus on this technology and the threat it is designed to meet ignores the very real danger of terrorism and our greatest danger—terrorists with weapons of mass destruction.John Edwards and I will be committed to developing a missile defense system that works, is fully tested, and geared to the threats we face. But I will refocus our efforts on preventing the spread of nuclear, biological, and chemical weapons and dramatically accelerating the security of nuclear weapons and material in Russia and around the world. We will not sit by, falsely comforted by an untested and unproven defense system, while these threats continue to fester.2Section:ChooseTop of page1BushKerry2 <<BushKerry3BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerry Climate change: Virtually all reputable research in recent years has reinforced the scientific conclusion that global warming is a real and growing crisis caused, at least in part, by the burning of fossil fuels. Do you accept that scientific consensus? Under what circumstances would you regulate carbon dioxide and other greenhouse gas emissions? BushSection:ChooseTop of page1BushKerry2Bush <<Kerry3BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryGlobal climate change is a serious long-term issue. In 2001, I asked the National Academy of Sciences (NAS) to provide the most up-to-date information about the science of climate change. The academy found that considerable uncertainty remains about the effect of natural fluctuations on climate and the future effects climate change will have on our environment.My administration is now well along in implementing a comprehensive climate change strategy to advance the science, expand the use of transformational energy and carbon sequestration technologies, and mitigate the growth of greenhouse gas emissions in the United States and in partnership with other nations. I created the new US Climate Change Science Program (CCSP) to refocus the federal government’s climate research programs, for which my 2005 budget seeks nearly $2 billion to fund research across the federal government. The NAS endorsed the CCSP strategic plan, noting that it “articulates a guiding vision, is appropriately ambitious, and is broad in scope.”I also committed the nation to a goal of reducing American greenhouse gas intensity by 18% over the next 10 years, which would prevent more than 500 million tons of carbon emissions through 2012. To help achieve this goal, I created the Climate Vision program in 2003 to reduce the growth of greenhouse gas emissions by energy-intensive industrial sectors. Participants in the Climate Vision program account for between 40 and 45% of US greenhouse gas emissions. I have strongly supported over $4 billion in tax incentives for renewable and energy-efficient technologies, including wind and solar energy and hybrid and fuel-cell vehicles. Also, in April 2003, my administration raised the fuel economy standards for light trucks and SUVs [sport utility vehicles] for the first time since 1996, saving 3.6 billion gallons of gasoline. And in my 2003 State of the Union [address], I announced a $1.7 billion hydrogen fuel initiative to accelerate research that could lead to hydrogen-powered, no-emission vehicles within a generation.Additionally, my administration is participating in robust international partnerships to promote clean, renewable, commercially available fusion energy and to construct the $1 billion FutureGen project, which will test the latest technologies to generate electricity, produce hydrogen, and sequester greenhouse gas emissions from coal. KerrySection:ChooseTop of page1BushKerry2BushKerry <<3BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryI recognize the risk of climate change, and I have outlined a balanced set of programs that will have impact both in the near term and over the long term. My plan will also provide balanced support for technology that can increase the efficiency and cut greenhouse emissions in transportation systems, buildings, and industry that are attractive to consumers and US producers. Our programs will encourage the use of renewable fuels such as ethanol and renewable electric generation that produce little or no net greenhouse gases. I will expand the production tax credit for wind and biomass energy to cover the full array of renewable energy sources and increase Department of Energy (DOE) research into renewable energy sources and their applications. And I will propose an aggressive program of research, standards, and incentives to accelerate electric generation from renewable energy. Clean coal technology can play a critical role, given technology to cut carbon dioxide emissions.My plan would encourage energy efficiency with programs such as updated fuel efficiency standards, new tax incentives for automakers to build the new, more efficient automobiles of the future, and tax incentives for families to purchase more energy-efficient cars, trucks, and SUVs.3Section:ChooseTop of page1BushKerry2BushKerry3 <<BushKerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerry Science investment: There is concern in the science and economic communities that the US is losing its world leadership in the sciences, which they say bodes ill for future economic growth and global competitive-ness. To address that concern, should the US increase funding for basic science, and should the administration fully fund the 2001 bill, signed by the president, to double NSF’s budget? How would you reinvigorate science education for US-born students? What is the role of foreign scientists and students in the US scientific enterprise? BushSection:ChooseTop of page1BushKerry2BushKerry3Bush <<Kerry4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryIncluding my FY 2005 budget request, total federal R&D investment during the first term will have increased 44% to a record $132 billion in 2005. My FY 2005 budget request commits 13.5% of total discretionary outlays to R&D, the highest level in 37 years. In the context of the overall economy, federal R&D spending in the FY 2005 budget is the greatest share of GDP [gross domestic product] in over 10 years. Funding for basic research, the fuel for future technology development, is at an all-time high of $26.8 billion in FY 2005, a 26% increase over FY 2001. Funding for NSF during the four years of my administration has increased 30% over FY 2001 to $5.7 billion in FY 2005. NSF’s broad support for basic research, particularly at US academic institutions, provides not only a central source for discovery in many fields but also encourages and supports development of the next generation of scientists and engineers. Moreover, in fulfilling its mission, NSF has used its funding efficiently and effectively.As for the American scientific enterprise, it is important in this information and technological age that our students receive a first-rate science education, just as they receive quality instruction in reading, writing, and math. The federal government has no control over local curricula, and it is not my job to tell states and local boards of education what they should teach in the classroom. Nevertheless, the No Child Left Behind Act, one of my proudest legislative achievements this term, is improving our schools and, consequently, the teaching of science. NCLB requires, for the first time, assessments in science to give us better information about how our students are performing and how to improve instruction in science. I have also proposed creating the Presidential Math and Science Scholars Fund to provide $100 million in grants to low-income students who study math or science. This will ensure that America’s graduates have the training they need to compete for the best jobs of the 21st century.I also value the contributions that foreign scientists and students make to our nation’s scientific enterprise, while recognizing the importance of safeguarding our security. We will continue to welcome international students and scientists while implementing balanced measures to end abuses of the student visa system. My administration has already achieved several notable successes in reducing delays now being experienced by some visa seekers. We have increased security while speeding up the clearance process; approximately 1000 back-logged applications have already been cleared out.KerrySection:ChooseTop of page1BushKerry2BushKerry3BushKerry <<4BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryFor three years, the Bush administration has squandered America’s leadership in the world, putting politics before science and doing nothing to create jobs while our workers fall further behind. The administration has proposed cuts for scientific research and grossly distorted and politicized science on issues from mercury pollution to stem-cell research. This approach not only limits the research that our scientists are doing today, it undermines important discoveries of tomorrow and threatens America’s critical edge in innovation. I will reverse this course by restoring America’s scientific leadership, helping find new cures, moderating healthcare costs, and developing new technologies that will create good jobs. I will boost support for the physical sciences and engineering by increasing research investments in agencies such as NSF, the National Institutes of Health, DOE, NIST, and NASA. This funding will help with the broad areas of science and technology that will provide the foundations for economic growth and prosperity in the 21st century.4Section:ChooseTop of page1BushKerry2BushKerry3BushKerry4 <<BushKerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerry Nuclear weapons: Does the US need to develop a new class of nuclear weapons to deal with the changing threats of the 21st century? Is there any circumstance in which you would support the resumption of nuclear testing? BushSection:ChooseTop of page1BushKerry2BushKerry3BushKerry4Bush <<Kerry5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryThe Nuclear Posture Review, released by my administration in January 2002, noted that the nation’s nuclear infrastructure had atrophied since the end of the cold war and that the evolving security environment requires a flexible and responsive weapons complex infrastructure. To that end, my FY 2005 budget reflects an increase over the 2004 enacted level in the weapons activities account, which encompasses the stockpile stewardship programs. There is no current need for testing due to the sophistication of computer modeling and other new technologies, but we must maintain the capability to test in case such testing becomes necessary in the future to ensure the safety and reliability of our defensive arsenal. We have not identified any need for developing new nuclear weapons. KerrySection:ChooseTop of page1BushKerry2BushKerry3BushKerry4BushKerry <<5BushKerry6BushKerry7BushKerry8BushKerry9BushKerryNo, and a Kerry–Edwards administration will stop this administration’s program to develop a new class of nuclear weapons. This is a weapon we don’t need, and it undermines our ability to persuade other nations to forego development of these weapons.5Section:ChooseTop of page1BushKerry2BushKerry3BushKerry4BushKerry5 Nuclear There is serious concern many that could or a nuclear in a US Do you the US is doing to and control of nuclear weapons and material both in the US and BushSection:ChooseTop of administration in has more to and control nuclear weapons and material than US weapons and are and both the Department of Defense and are to make more My administration has increased funding to weapons and material in the Union and has by years the schedule the administration for security in We are with Russia to end the production of and to weapons for of weapons. the my administration the to or and material We have already weapons material from several our in its for nuclear weapons. To against we the international in a global effort to account and of sources that could be used in such We activities in over 40 on this as well as with international the Energy the the and the of Defense we have dramatically our ability to that could be a threat to us and to our friends and my administration the billion initiative to support and nuclear safety in the This of the international is to a more of nation’s highest must be preventing from to nuclear weapons and the material to make We must in a global partnership with other nations to prevent the spread of these weapons. the Bush administration’s have in the have the we need to advance our security. September they have not nearly to and on the while the nuclear from and North Korea have Our security requires an immediate change of I have proposed a comprehensive strategy to of weapons and including an of programs to all nuclear weapons and within the and at research in the within four production of new material for nuclear weapons by a global on production of new of nuclear weapons and by development of the new generation of nuclear accelerating in US and nuclear and reducing of in nuclear weapons programs in hostile including by with North Korea to ensure the and of its nuclear weapons program and a global effort to prevent from the necessary to build nuclear weapons. international efforts to by and and as well as improving the security a presidential to prevent nuclear terrorism who will focus on a effort to all nuclear weapons and around the world and prevent a nuclear terrorist of Energy than of and have not in a comprehensive US energy policy. years into the future, what do you the US energy should How would you the US in that BushSection:ChooseTop of and energy is critical to America’s and homeland security. We will be more and more we are on foreign sources of energy. The of a comprehensive and balanced national energy policy has been one of my During my first in I proposed a national energy policy that would our energy production and systems, reduce our on foreign promote efficiency and increase domestic production from all of energy including renewable energy and continue to our economy and create new jobs. We will continue to with on the energy to the administration has nearly all of the more than in the comprehensive national energy policy that not as increasing reliability R&D to help prevent and the to its of million to provide energy security in case of of have proposed an program of research, and standards that would increase the efficiency of energy use and use of new energy sources that can ensure a and while reducing the risk of climate change. The program would be supported in by a billion energy security and from federal and gas the in by I have to around the and a of that can meet US needs both in the term and for in the Given the long time required to over energy investments such as of and trucks, industrial and we must a broad set of new technologies as as possible we have any of US energy use in the near term, many of the most control systems, and other technologies to improve the energy of buildings, and industrial that the US to reduce its on from the and I will set for fuels such as I will support research and incentives that will dramatically increase use of from wind and other renewable And I will encourage development of technology and nuclear generation with high standards for stewardship and of Nuclear recent by that nuclear is the best energy source to meet the US while protecting the renewable energy can be deployed on a Do you increasing the use of nuclear If what would you do with the BushSection:ChooseTop of support the further development of nuclear technologies as a clean, and to meet this nation’s future energy Nuclear for of our This which no pollution or greenhouse gas can play an expanding role in our energy future while the we with energy national energy policy several to encourage increased use of nuclear and to the that through the Nuclear my administration is with industry to the for an of a new US nuclear within the next years. through the the United States is with around the to develop a next generation of more and more nuclear that can also produce hydrogen and my administration has made a to the nuclear and the of a long-term at We are ahead with the of a to the Nuclear at the end of this administration is also committed to and in new technologies that will change the we generate I committed the United States to the international fusion energy as in is a important to test the of nuclear fusion as a source of and the of a nearly source of energy the that long-term of Nuclear can play an role in energy while reducing the risk of climate key such as nuclear nuclear and security must be John Edwards and I will ensure safety and science We George Bush’s plan to over the of a Kerry–Edwards administration will on science. John Edwards and I do not support as a nuclear and will that nuclear and transportation only on the of science and that to and the John Edwards and I will George Bush and to from a for an NAS study to is the as to long-term and or some other technology. an international to scientific for nuclear and nuclear from terrorist John Edwards and I will improve and security at nuclear In we will nuclear to to improve including measures to reduce to the an of National National Nuclear the national weapons continue to be with security spending and What would you to improve at the Does the current plan of the to the risk of the in the of the war on BushSection:ChooseTop of national are doing to deal with the threats of the 21st are a in our efforts to improve homeland are the source of technological and are helping the war on With their at the highest level in years, National National and National are also on the edge of defense research, protecting the nation’s infrastructure from terrorist attacks, and developing a that the of a nuclear This is we billion on weapons research and production in FY 2004 and I for billion for We must and security My administration has made effort to improve the the weapons do and one of efforts is that in all areas of central to the war on we can use our more and focus on his or of national play a critical role in our nuclear weapons stockpile and that our nation’s nuclear weapons are and The national also have an important role in preventing the spread of weapons of mass and in science for our nation’s have a of our nation’s but this record has been by and security at the has been John Edwards and I are committed to and and restoring the at these critical national of is being to the long-term of to the and Many scientists the will money from science How do you the importance of science exploration What is the funding between the BushSection:ChooseTop of I announced my for the future of America’s space exploration this will the of both and science will as to the and other vehicles continue to their and of to we have systems on and around a system and one on its to the for cannot be by the most or the most We need to and and for And only are of to the by space we our on the we are developing a new exploration to our This will be by and its first no than will to the as as and no than and use it as a for the We will with to the and for future will with the goal of and there for of Edwards and I will continue America’s long tradition of leadership in and space exploration as of a program to broad for this will not to programs such as the Bush administration’s Program that from in the with no or will in new programs to set by scientific in and other Our administration will on the of the scientific to the most for research and the most for these the of or are most to the 2004 American of

Strengthening the BTWC: The role of the Biological and Toxin Weapons Convention in combating natural and deliberate disease outbreaks

The International Council of Nurses is in a unique position to represent nurses at the World Health Organization, and its task has never been more urgent than this year. Amid the global COVID‐19 pandemic, the death rates of nurses and other health care workers are truly shocking, with around 115 000 deaths. However, many countries do not collect statistics on health and care workers’ deaths and infections from COVID‐19, so the full extent of this awful situation is not known.At this year's World Health Assembly, the body that sets the World Health Organization's agenda for the following year, the International Council of Nurses’ 50‐strong delegation voiced the concerns of nurses and ensured that the views and advice of nurses were heard by the World Health Organization's 194 member states’ delegates. Here, the International Council of Nurses’ Chief Executive Officer Howard Catton describes how the Council is influencing health and care policy worldwide. He urges nurses everywhere to hold their politicians to account.

The World Health Organization (WHO) is a global organization that nowadays has integrated gender issues into its policy, programmes and budget. How then is the state of affairs in the area of gender equity at the ultimate governing bodies of the modern WHO? This study aims to assess the representation of women and men and their promotion within the supreme decision-making bodies of the WHO during the year 2000. Information sources used are the official and confirmed protocols of the 53rd World Health Assembly (WHA) in 2000 and of the two Executive Board (EB) meetings of the corresponding year. A descriptive quantitative content analysis approach is used exclusively. The present study demonstrates strikingly skewed gender distribution, with men substantially at an advantage numerically in the prominent positions at the WHA 2000. Additionally, men also hold an advantage in terms of being promoted to leading positions within the bodies examined, notably all upgraded chairs of the EB during 2000. However, the formerly male-dominated supervisory positions of the WHO are, these days, challenged by women having been elected at the very top of the WHO. The present study stresses the need to elaborate a qualitative research design to advance the understanding of the social construction of gender in supreme governing positions of the modern WHO.

Reducing the risks of nuclear war to humanity

A terrible itchiness is the first symptom of guinea-worm disease or dracunculiasis. Next, explains Adama Guindo, a village chief in eastern Mali, an agonizing blister appears on an ankle or foot. You don't see the worm to begin with, he says. When the creature's head emerges several days later, the pain is unbearable. Nausea, vomiting, diarrhoea and dizziness follow. You can't work or sleep, and if you can walk at all--it's with a crutch, he says. Extracting the worm takes on average between 30 and 60 days, as it must be done manually, by making an incision and twisting the worm slowing out around a stick. Secondary infection from the wound can lead to tetanus, permanent disability or septicaemia, which can be fatal. Guindo's home village of Tele, at the foot of the Bandiagara escarpment, a sandstone massif close to the border with Burkina Faso, is one of thousands of communities in Mali that were once ravaged by guinea-worm disease. We had guinea worm so badly here that women from other villages were frightened of marrying our men, recalls Ata Lougue. Only 30 years ago, a large proportion of the population was stricken with this debilitating disease and the granaries were empty, says Professor Ogobara Doumbo, a parasitologist at the University of Mali, who grew up in the area. [ILLUSTRATION OMITTED] Today guinea-worm disease stands on the brink of eradication--the goal is to wipe it out globally by December 2015--a year from now. Although the eradication goal was revised after an earlier goal to stop human transmission of the disease globally by 2009 was missed, few public health campaigns have made such rapid progress. In the mid-1980s, 3.5 million new cases were estimated to occur annually, but in 2013, as a result of the intensive efforts to halt transmission, only 148 cases were reported--a reduction of more than 99% since 1989--and the disease has been confined to four countries: Chad, Ethiopia, Mali and South Sudan. This year, the pattern has been similar. From January to September, 101 cases have been reported, with 11 of those in Chad, two in Ethiopia, 19 in Mali and 69 in South Sudan. So far, the World Health Organization (WHO) has certified 197 countries, areas and territories, including 185 WHO Member States, as being free of the disease. Efforts to wipe out guinea-worm disease date back to the years after smallpox was declared the first disease to be eradicated in 1979. In May 1981, the Interagency Steering Committee for Cooperative Action for the International Drinking Water Supply and Sanitation Decade (1981-1990) proposed the eradication of guinea-worm disease as an indicator of success for the 10-year clean water campaign. In the same year, WHO's decision-making body, the World Health Assembly (WHA), adopted resolution WHA 34.25 reinforcing the idea that the International Drinking Water Supply and Sanitation Decade presented an opportunity to wipe out the disease. As a result, WHO and the United States Centers for Disease Control and Prevention developed a strategy and a set of technical guidelines for a global eradication campaign. To give it a final push in 2011, the WHA called on the countries where the disease was still endemic to step up efforts to stop transmission and strengthen nation-wide surveillance to achieve their goal. Although the disease is still endemic in Mali, some parts of the country have been transformed by the global eradication campaign. In Tele, children stood giggling shyly when asked about the disease that once ravaged their parents' communities. They are too young to know what guinea worm is, says Lougue, explaining that it has been years since anyone in Tele contracted the disease. In those days, people blamed sorcerers for poisoning their wells--they knew that people got infected from drinking water, but did not know how, she says. A key part of efforts to eradicate the disease has been educating people in the communities affected on how the disease is transmitted. …

The World Health Organization (WHO) Framework Convention on Tobacco Control originated in 1993 with a decision by Ruth Roemer and Allyn Taylor to apply to tobacco control Taylor's idea that the WHO should utilize its constitutional authority to develop international conventions to advance global health. In 1995, Taylor and Ruth Roemer proposed various options to WHO, recommending the framework convention-protocol approach conceptualized by Taylor. Despite initial resistance by some WHO officials, this approach gained wide acceptance. In 1996, the World Health Assembly voted to proceed with its development. Negotiations by WHO member states led the World Health Assembly in May 2003 to adopt by consensus the WHO Framework Convention on Tobacco Control-the first international treaty adopted under WHO auspices. The treaty formally entered into force for state parties on February 27, 2005.

BackgroundA new resolution on mental, neurological and substance use disorders was adopted in January 2012 by the World Health Organization (WHO) Executive Board. The resolution urges WHO and Member States to collaborate in the development of a comprehensive mental health action plan, to be submitted for discussion and approval to the WHO World Health Assembly. This commentary aims at rising awareness on the risk that this resolution may not fulfil its potential.DiscussionLack of political awareness and visibility of the resolution is a first major issue. Theoretically, Member States should be aware of the resolution and support its implementation at their respective national level, but in practice political commitment may not be high enough, and technical and financial resources made available may be limited. A second challenge is that the resolution suggests to work with Member States and technical agencies to promote academic exchange through which to contribute to policy-making in mental health. It is not straightforward, however, how such a statement may be effectively translated into action. A third key methodological aspect is how scientific evidence and factors other than scientific evidence will be handled. This seems particularly relevant in the field of mental health, where value-based decisions together with resource and feasibility considerations may be unavoidable.SummaryWe argue that WHO and Member States should work together to increase the visibility of the resolution, ensuring that Ministries of Health and other relevant components of the health systems are aware of the resolution and its implications. As the resolution urges for academic exchange, WHO should develop a plan for an explicit, inclusive and open call for support and collaboration, so that partners willing to contribute are not kept out from the process. The production of an action plan for mental disorders should be based on scientifically sound methodology. Such a methodology should be transparently described, for example in a WHO process document, to make it clear how individual-level recommendations and policy-level guidance are developed. WHO should establish and maintain an open forum of experts, scientists, health officials and user groups worldwide to interact and agree on values, preferences, feasibility, acceptability, implementability, equity and economic issues that should inform the action plan.

Cancer and palliative care in Africa.