A Global Health Imperative

Why Nuclear Disarmament Is an Urgent Medical Necessity

Any use of nuclear weapons would have catastrophic humanitarian consequences. Tilman Ruff, a medical doctor and chair of the International Campaign to Abolish Nuclear Weapons, argues that nuclear disarmament is a public health imperative of the highest order.

Effects of Nuclear Weapons


A nuclear explosion creates an enormous shockwave that reaches speeds of many hundreds of kilometres an hour. The blast kills people close to ground zero, and causes lung injuries, ear damage and internal bleeding further away. People sustain injuries from collapsing buildings and flying objects.


Thermal radiation from the explosion is so intense that almost everything close to ground zero is vaporized. The extreme heat causes severe burns, and ignites fires over a very large area, which coalesce into a firestorm. Even people in underground shelters die due to the heat, lack of oxygen, and carbon monoxide/dioxide poisoning.


Unlike conventional weapons, nuclear weapons kill and wound through radiation. This damage is caused by gamma and neutron radiation in the initial blast, as well as beta, alpha and gamma radiation in the radioactive fallout. Radiation can result in cancers many years after the explosion, and genetic damage can be passed from generation to generation.


ICAN: Are nuclear weapons a global public health hazard?

Tilman Ruff (TR): Nuclear weapons are the biggest threat to global health. The world’s peak health body, the World Health Organization (WHO), undertook detailed studies in the 1980s of the health dangers posed by nuclear weapons. In response to these authoritative reports, the World Health Assembly, made up of health ministers from every country, concluded that nuclear weapons constitute the greatest immediate threat to the health and welfare of humankind.

Since then, new evidence has emerged that the effects of nuclear explosions would be even worse than was then realized. Like rampant global warming, but on a timescale that could be ferociously acute, nuclear weapons could end human civilization, perhaps even human survival.

ICAN: Would any medical response be possible after a nuclear attack?

TR: The relatively “small” nuclear weapon (by today’s standards) detonated over Hiroshima in 1945 killed or injured 90 per cent of the physicians and nurses, and only three out of 45 hospitals in the city were able to provide even the most meager care in the absence of services, supplies and staff. Most of the injured suffered combinations of burns, blast trauma and radiation injury – difficult and demanding to treat even in optimal circumstances.

WHO concluded that it was obvious that no health service in any area of the world would be capable of dealing adequately with the hundreds of thousands or millions of severely injured people from even a single nuclear weapon detonated on a city. Most injured people would suffer terrible agony without so much as relief for their pain. The International Committee of the Red Cross recently confirmed that there is no capacity anywhere worldwide to provide effective emergency assistance to the victims of even one nuclear explosion. WHO concluded that the only feasible approach to treatment of the health effects of nuclear weapons is prevention of their use.

ICAN: What are the environmental effects of nuclear weapons?

TR: At the review conference of the nuclear Non-Proliferation Treaty in 2010, almost all the world’s governments agreed that any use of nuclear weapons would cause catastrophic humanitarian consequences. Radioactive fallout would spread indiscriminately across borders and cause ongoing harm and genetic damage to current and future generations.

Scientists have shown that cooling, darkening and drying of the climate worldwide would persist for over a decade following a regional nuclear war using less than one half of 1 per cent of the world’s nuclear weapons. Such a conflict could unfold between India and Pakistan, in the Middle East involving Israel, or on the Korean Peninsula, but the effects would be felt worldwide.

Global food production even in lands distant from the conflict would plummet over successive years, global disease epidemics would follow, and starvation on a scale never seen before can be expected to claim not only the most vulnerable – the close to one billion people already persistently hungry – but others too.

ICAN: Why should banks be concerned about nuclear weapons?

TR: Use of nuclear weapons anywhere would have major repercussions for social and commercial activities of all kinds around the world. A nuclear war would be very bad for business. Because people everywhere share a completely globalized vulnerability to the consequences of nuclear weapons being used anywhere, and because of the profound existential danger that nuclear weapons pose to current and future generations, all people, organizations and sectors have a stake in ensuring – and responsibility to ensure – that nuclear weapons are banned before they are ever again used.

This requires their elimination – a vital step to achieving this is ending the manufacture of nuclear weapons. And even if nuclear weapons are never used, their production, testing and deployment involve ongoing costs of the order of US$100 billion annually. Re-direction of such vast resources towards vital social and environmental goals such as eradicating poverty, improving health and education, rollout of benign, renewable energy systems, and environmental protection, would greatly enhance human security, equity and social and economic stability.

Curbing investment in nuclear weapons would directly help end their production, stigmatize these most inhumane of all weapons, show leadership, and encourage others. Banks and financial institutions which make clear that they will not invest in nuclear weapons demonstrate vision and leadership, win public support, do their staff proud, and deliver on their social responsibility and sustainability obligations. A world freed from nuclear weapons is good for everyone – the business case to do the right thing and help to bring it about is compelling.

For more information, visit www.ippnw.org.

A 100-Kiloton Nuclear Bomb

3-km radius

A radioactive fireball hotter than the sun and with the force of 100,000 tonnes of dynamite kills all.

5-km radius

The vast majority of people die quickly from blast injuries, asphyxiation and radiation sickness.

10-km radius

About half die from trauma and burns. Many succumb soon after to fires and radiation sickness.

80-km radius

Radioactive fallout spreads. Over time, many thousands will die from cancers and radiation sickness.

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