Medicine, conflict, and survival
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Security threats are a major concern for access to health care in many war-torn communities; however, there is little quantified data on actual access to care in rural communities during war. Kinderberg International e. ⋯ The number of patients declined in remote clinics while the number increased in central locations. This finding has an important practical implication: the monitoring of access to care should include remote clinics, otherwise it may potentially underestimate compromised access to health care due to security threats.
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Abolishing the threat of nuclear war requires the outlawing of nuclear weapons and dismantling current nuclear weapon stockpiles, but also depends on eliminating access to fissile material (nuclear weapon fuel). The near-universal use of weapons-grade, highly enriched uranium (HEU) to produce radiopharmaceuticals is a significant proliferation hazard. Health professionals have a strategic opportunity and obligation to progress the elimination of medically-related commerce in HEU, closing one of the most vulnerable pathways to the much-feared 'terrorist bomb'.
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In 2004, the United Kingdom Government withdrew free access to secondary healthcare for certain groups of overseas visitors, including those asylum seekers whose claims had failed but were still living legally in the UK. We argue, as others have previously, that the implementation of the 2004 National Health Service (Charges to Overseas Visitors) (Amendment) Regulations, represents a serious breach of the right to health as envisaged in international law. ⋯ We argue that this is not the role of healthcare and that doctors must not allow the denial of healthcare to be used as a tool of immigration policy. We also question the notion that these regulations make economic sense and suggest that they will have a detrimental effect upon public health.
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Climate change and nuclear war are currently the most dangerous challenges to human civilisation and survival. The effects of climate change are now sufficient to persuade many governments to take effective measures to reduce greenhouse gas emissions. Today there are about 27,000 nuclear warheads, many at least ten times more powerful than the Hiroshima and Nagasaki bombs, and a meaningful medical response to a nuclear attack is impossible. ⋯ The only effective preventive measure is the abolition of nuclear weapons. Steps towards this include: a Fissile Material Cut-off Treaty, for the nuclear weapon states to observe their obligations under the Nuclear Non-Proliferation Treaty, and for the Comprehensive Test Ban Treaty to enter into force. The ultimate need is for a Nuclear Weapons Convention; International Physicians for the Prevention of Nuclear War have launched an International Campaign to Abolish Nuclear weapons (ICAN) to promote a NWC.
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All the nuclear-weapon states are working to develop new nuclear-weapon systems and upgrade their existing ones. Although the US Congress has recently blocked further development of small nuclear weapons and earth-penetrating nuclear weapons, the United States is planning a range of new warheads under the Reliable Replacement Warhead programme, and renewing its nuclear weapons infrastructure. ⋯ The US has withdrawn from the Anti-Ballistic Missile Treaty and plans to install missile defence systems in Poland and the Czech Republic; Russia threatens to upgrade its nuclear countermeasures. The nuclear-weapon states should comply with their obligations under Article VI of the Non-Proliferation Treaty, as summarised in the 13-point plan agreed at the 2000 NPT Review Conference, and they should negotiate a Nuclear Weapons Convention.