The World Health Organization (WHO) today updated its list of medicines that should be stockpiled for radiological and nuclear emergencies, along with policy advice for their appropriate management. These stocks include drugs that prevent or reduce radiation exposure, or treat injuries once exposure has occurred.
“In the event of a radiological emergency, people can be exposed to doses ranging from negligible to life-threatening. Governments must make treatments available to those who need them – quickly,” said Dr Maria Neira, WHO Acting Assistant Director-General, Healthier Populations Division. “It is essential that governments are ready to protect people’s health and respond immediately to emergencies. This includes having stocks of life-saving drugs on hand that will reduce risk and treat radiation injuries.
- This publication replaces the 2007 WHO report on the development of national stockpiles for radiological emergencies. It includes updated information on the stock form based on developments in radiation emergency medicine over the past decade.
- It provides strategic advice for the acquisition of drugs that can prevent or reduce the absorption of radionuclides or increase the elimination of radionuclides from the human body.
- It examines the main elements necessary for the development, maintenance and management of national stocks of specific medical supplies that will be needed for radiological and nuclear emergencies.
- The report examines the role of national health authorities in stockpile development as well as the role of WHO. As the primary international public health organization with both authority and responsibility to assist in health emergencies, WHO provides advice and guidance to countries on public health preparedness and response radiological emergencies, including stockpiling. In the event of a health emergency, WHO can help buy or share medical supplies between countries.
- This report includes a brief review of selected emerging technologies and drug formulations, including the potential repurposing of previously approved products for other indications.
- Finally, the publication provides examples of national stockpile establishment and management practices in selected countries, namely Argentina, Brazil, France, Germany, Japan, Republic of Korea, Federation of Russia and the United States.
“This updated list of critical medicines will be a vital preparedness and readiness tool for our partners to identify, procure, stock and deliver effective countermeasures in a timely manner to those at risk or exposed during of 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 equipment used for any type of emergency, such as personal protective equipment (PPE), trauma kits, fluids, antibiotics and painkillers. This publication includes only specific drugs that are known and approved today to prevent or treat human overexposure to radiation.
Radiological and nuclear emergencies can result in exposure to radiation doses high enough to cause serious health consequences or even death. It is therefore extremely important that governments react quickly to such threats. However, many countries still lack the essential elements of preparedness for radiological emergencies, according to annual reports 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 material, as well as intentional uses of radioactive material for malicious purposes.
Components of a pharmaceutical stock for radiological emergencies
This publication focuses on pharmaceuticals for the treatment of radiation exposure and discusses the governance and management of such a stockpile. A typical radiation emergency stock will include the following drugs:
- Stable iodine, administered to prevent or reduce exposure of the thyroid to radioactive iodine;
- Chelating sand decorporating agents (Prussian blue, applied to remove radioactive cesium from the body and calcium-/zinc-DTPA used to treat internal contamination with transuranic radionuclides);
- Cytokines used to mitigate bone marrow damage, in acute radiation syndrome (ARS); and
- Other medicines used to treat vomiting, diarrhea and infections.
Emerging treatments and countermeasures also discussed in the report provide insight into future medical countermeasures that could be used to manage radiation overexposure patients. In particular, studies identifying new cellular and molecular pathways and new ways to deliver drugs can be exploited for new treatments and products for use in a radiation emergency.
Emergency preparedness, response and recovery saves lives
The coordination of local, national and international responses is essential for a harmonized response to radiological emergencies. As the agency responsible for guiding health care interventions globally, WHO provides guidance and ensures access to medicines and health services for countries that develop national preparedness capacity. and response to radiological emergencies.
The WHO Global Network of Experts, REMPAN
WHO’s global network of experts, the Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), is an important asset of the Organization in implementing its work of providing technical guidance and tools for intervention, carrying out capacity building activities through education and training, and promoting cooperation and information sharing between network members and the professional community in the field of radiation emergency medicine.
WHO is a member of ICARNE, the Interagency Committee on Radiological and Nuclear Emergencies, which provides the coordination mechanism among 20 international organizations with relevant mandates. IACRNE members develop, maintain and co-sponsor the International Organizations Joint Radiation Emergency Management Plan (JPlan 2017). The JPlan describes a common understanding of the roles of each organization in making preparedness arrangements and during response and recovery.