Nagasaki University

Policy Proposal

for Support to Radiation Victims
in accordance with the Treaty
on the Prohibition of Nuclear
Weapons

April, 2022

Nagasaki University

Policy Proposal

for Support to Radiation Victims
in accordance with the Treaty
on the Prohibition of Nuclear
Weapons

April, 2022

Contents
Introduction

Nagasaki University and humanitarian disarmament …… P03

Policy Proposal Summary…………………………… P04
Policy Proposal

1. Provisions regulating support for radiation victims andtheir significance… ……………………………………… P06
2. Policy Proposal Content… ……………………………… P07

References… ……………………………………………… P17

Research Center for Nuclear Weapons Abolition,
Nagasaki University
Research Center for Nuclear Weapons Abolition, Nagasaki
University (RECNA) was established in 2012.
RECNA has been issuing policy recommendations basedon its research.

RECNA edits the “Journal for Peace andNuclear Disarmament”.

Atomic Bomb Disease InstituteAtomic Bomb Disease Institute (ABDI) was established in
1962 to develop treatment and research of long-term effectsof radiation on human, including A-Bomb survivors. With
our much experiences, we are also supporting victims ofradiation-related disasters worldwide including Fukushima.

02

I n troduc tion
Nagasaki University and humanitarian disarmament
The Treaty on the Prohibition of Nuclear Weapons (TPNW) legally entered into force inJanuary 2021. In contrast to traditional arms control treaties that merely reduce or prohibit
the use of weapons to address national security concerns, the TPNW views these issues froma humanitarian perspective. As such, its ultimate goals are to achieve a total ban of nuclear
weapons as inhumane weapons, and to provide support to people who have been exposed toradiation through the use and/or development of those weapons. With these aims, the TPNW
is rooted in the concept known as humanitarian disarmament.
However, we are still far from attaining a world in which all nuclear weapons are outlawed,
as countries possessing these weapons, as well as their allies, seem to have turned their backs
on the TPNW. Meanwhile, health hazards and anxieties persist due to radiation exposure,including that which occurs from nuclear testing and radioactive fallout. These unabatedproblems require urgent support from the humanitarian perspective. To demonstrateconcrete effectiveness in the early stages of a humanitarian disarmament treaty such as the
TPNW, it is essential to devise a system that can provide both physical and psychologicalsupport to individuals with radiation exposure, regardless of whether any harmful effects are
currently apparent.
Our institution, under the new educational system introduced through the National School
Establishment Law in 1949, employs its educational philosophies and research abilities
to actively work toward the creation of a world in which there is unity and peace. Thiswas precipitated by the enormous damage wrought by the atomic bombing of Nagasaki
in August 1945. A survey conducted by the A-bomb Material Preservation Committee ofNagasaki showed a devastating human toll, with 73,884 casualties and 74,909 wounded (asof December 1945)¹. Among these victims were nearly 1,000 students and faculty members
from the Nagasaki Medical College (the predecessor to Nagasaki University, which included
both the Specialized School of Medicine and the Specialized School of Pharmaceutics),
Nagasaki Normal School, and Nagasaki Higher Commercial School². In view of this historicalbackground of our institution and the central purpose of humanitarian disarmament framedby the TPNW, the Atomic Bomb Disease Institute at Nagasaki University and the ResearchCenter for Nuclear Weapons Abolition, Nagasaki University jointly drafted a proposal tosupport radiation victims, especially those who have potentially incurred damage fromradiation exposure following nuclear testing.
It would be greatly appreciated if this proposal provided practical reference and wasdeveloped to make a significant contribution to advancing the cause of supporting radiation
victims at the first Meeting of States Parties to the TPNW, scheduled to take place in Vienna
in 2022.

Shigeru Kohno, President

Nagasaki University, National University Corporation

03

Policy Proposal Summary
The following agenda concerning the support for radiation victims should be discussed at thefirst Meeting of States Parties to the Treaty on the Prohibition of Nuclear Weapons (TPNW):
1. To devise a support system in time for the next meeting, two working groups will beestablished, including those tasked with (1) examining medical issues (health careworking group) and (2) solving institutional design and legal issues (institutional
support system working group).
2. The health care working group will specifically be tasked with the following:・List areas that are potentially damaged by nuclear testing and create and share adatabase providing an accurate picture of the current situation based on the results offield surveys
・Collect and share information related to support systems for radiation victims in various
countries, including Japan・Formulate international support criteria and guidelines for support policies
3. The institutional support system working group will specifically be tasked with thefollowing:・Establish a permanent coordination system that will facilitate participation between
States Parties, States not party, international organizations, and civil society
・Devise diverse fundraising strategies to secure the financial resources needed for victim
support
4. Both working groups will also be jointly tasked with the following:・Develop and adopt avenues for technical cooperation to implement national policies forvictim support
・Develop and run human resources training programs for victim support04

Treaty on the Prohibition of Nuclear Weapons

Health care working group

Database of exposure
information
Database of informationon the history ofradiation victim support
policies
Develop the support
criteria and guidelines

Mutualcooperation

Institutional Support system
working group

Coordinate international
cooperation
Raise and manage funds

Medical examination
system approach
Victim-centeredapproach
Local health caresystem-building approach

Medical and technicalcooperation forsupportDevelop and recruit
the required
personnel

Victim su p p o r t

05

Policy Proposal
1. Provisions regulating support for radiation victims andtheir significance

Article 6, Paragraph 1 of the TPNW asserts: “Each State Party shall, with respect toindividuals under its jurisdiction who are affected by the use or testing of nuclear weapons,in accordance with applicable international humanitarian and human rights law, adequately
provide age- and gender-sensitive assistance, without discrimination, including medicalcare, rehabilitation, and psychological support, as well as provide for their social andeconomic inclusion.” Such passages are often found in the international legal frameworks forhumanitarian and human rights issues. This provision follows the standard set by earlier
humanitarian disarmament treaties, such as the Convention on Cluster Munitions (CCM),
which unambiguously puts the primary responsibility on each State Party to support victims
under their jurisdiction.
However, the TPNW is distinct from other humanitarian treaties due to the provisions
contained in Article 7, Paragraph 4, which expects States Parties to also support victims of
nuclear explosions in areas that are not under their jurisdiction, given that they are capableof doing so³. By contrast, the CCM states that humanitarian assistance is achieved solely
through the promotion of international cooperation between States Parties; while it does
expressly instruct each able State Party to assist other States Parties in victim support⁴,
the TPNW clearly specifies that the target of assistance provision should be the “victims.”
This acknowledgment may pave the way for interpretations suggesting more direct roles
for States Parties (depending on the circumstances) in providing support to victims livingin areas under the jurisdiction of other countries. In this respect, the provisions containedin the TPNW more strongly emphasize the importance of providing relief to victims whencompared to traditional disarmament treaties and international humanitarian laws.
Moreover, Article 7, Paragraph 5 of the TPNW also mentions the roles of international
agencies (including the UN), regional organizations, non-governmental agencies, and Red
Cross organizations. Since it is not realistically feasible to recruit the direct involvement ofprivate citizens in dismantling and disposing of nuclear weapons, civil society traditionally06

plays a more limited role. Its contribution could include the promotion of nuclear
disarmament measures through awareness campaigns and other efforts to stimulate public
opinion. By contrast, a large number of disciplines may directly contribute to the support of
A-bomb survivors, thus providing civil society with an increasingly active role in the abolitionof nuclear weapons.
As stated in the preamble to the TPNW, there is a need to recognize the status of people
who have suffered injuries from nuclear explosions. It is only by promoting their relief
that we will be able to gain full awareness of the intolerable pain that is caused by nuclear
weapon usage and testing, as well as recognize both the unlawfulness and inhumanity of
those weapons. Moreover, the acknowledgment of these experiences may be a critical factor
in persuading the international community to recognize the importance of abolishing nuclear
weapons. In sum, the combined activism of civil society, nation states, and internationalorganizations is expected to raise international awareness about the importance of thehumanitarian aspect of the use or threat of use of nuclear weapons.

2. Policy Proposal Content(1) The first meeting of states parties and future challenges
While the TPNW outlines the main goals and directions for policies aimed at victim
support, it does not provide detailed or concrete advice on the contents of those policies,
nor does it discuss their implementation. In this respect, the TPNW provisions on victim
support follow a pattern highly similar to those found in the CCM and the Convention on
the Prohibition of the Use, Stockpiling, Production, and Transfer of Anti-Personnel Minesand on their Destruction (also known as the Anti-Personnel Mine Ban Treaty, or simply
the MBT). Looking at the status of obligation fulfillments under the CCM and the MBT, thebasic frameworks and strategies for developing victim support policies have historically been
discussed and formulated during Meetings of States Parties. Similarly, for the TPNW, it isextremely important to determine whether and how the first Meeting of States Parties canconcretely contribute to the establishment of a support system. Based on this understanding,
it is crucial to aim for a consensus on the following points:① Establish the framework for an international support system
From the perspective of realizing a support program that is congruent with the basic
goals and directions provided in the treaty, the mission entrusted to the first Meetingof States Parties is crucial. However, some problems have recently arisen. Not only has
the meeting been postponed due to the spread of COVID-19, the sessions have also been07

shortened; meanwhile, the active participation of States Parties is under question due tosuch constraints. Given these circumstances, it is unlikely that the discussions will resultin substantial progress or a comprehensive policy for victim support. Upon convening,
the first Meeting of States Parties should therefore begin with the aim of creating aframework for an international support system that will be tasked with selecting priority
issues that emerge during the session and formulating work plans. Thereafter, the official
Meeting of States Parties, in which States not party to the TPNW may participate as
observers, will be held only every two years, as provided in Article 8, Paragraph 2. In
sum, the first Meeting of States Parties should immediately work to create the framework
for an international support system, thus facilitating actual discussions and future strategic
implementation.
② Promote actual discussions by establishing international cooperation working groups
Even within the limited timeframe dictated by the meeting conditions, this initiative
would be a major step toward the concrete development of victim support policies.
However, many other issues should also be addressed at the meeting. If we reflect on
the actual state of affairs, the first Meeting of States Parties to the TPNW is only an
entry point to the discussion. The support system framework suggested above highlights
the need to establish working groups that can draft concrete proposals for subsequentdiscussion. As reflected by current needs, two working groups should be established,including a health care working group, which will examine medical issues (e.g., how
to provide adequate medical support based on the status of damage by collecting andanalyzing necessary scientific data), and an institutional support system working group,
which will tackle institutional design and legal issues related to the implementation ofinternational victim support policies. These working groups should comprise members
from a variety of countries and organizations, including States Parties, States not party(participating as observers), experts in relevant fields, and NGOs.
(2) Tasks that should be entrusted to the health care working group① List areas that are considered to be affected by nuclear testing, provide a clear pictureof the current situation, and share the collected information
Field studies on nuclear victims after the atomic bombings of Hiroshima and Nagasaki
and nuclear reactor accidents at Chernobyl and Fukushima taught us that it is criticallyimportant to evaluate exposure doses in survivors. In this respect, the result of an
epidemiological survey conducted on A-bomb survivors in Hiroshima and Nagasaki canstill be regarded as the scientific gold standard for modern investigations into radiation

08

exposure and its health effects; in particular, this is because researchers estimatedradiation dose amounts in survivors with considerable accuracy based on both the
distance from the hypocenter of the explosion and shielding conditions at that time. The
fact that can be inferred from these findings is that most A-bomb radiation exposure wasexternally incurred at the time of the explosion⁵. By contrast, it is more difficult to assessinternally incurred exposure from radioactive fallout caused by nuclear accidents, such as
those at Chernobyl and Fukushima⁶. Because of this, estimated doses based on location
and age at the time of the accident (exposure) were used as indexes in place of individual
exposure doses.
In addition to nuclear test sites in the surrounding areas of states with such weapons,other areas that are considered to have incurred radiation exposure from nuclear testing
include the Semipalatinsk test site (and surrounding areas) in the Republic of Kazakhstan(former Soviet Union), the Marshall Islands (and surrounding areas), where the UnitedStates conducted tests, certain locations in Australia, where the United Kingdom
conducted tests, and both Polynesia (and surrounding areas) and Algeria, where France
conducted tests. Since the majority of the radiation exposure observed around nuclear
test sites has been through radioactive fallout entering the body, there is a higher risk ofinternal exposure (as in the case of nuclear reactor accidents) than external exposure; thisis a major concern, especially for residents of the surrounding areas.
In all nuclear testing areas, it is difficult to measure radioactive nuclides and exposure
doses once a certain amount of time has elapsed since the exposure episode. Regardless,major efforts should be concentrated on developing an estimation system that is linked toindividual exposure doses. Despite the difficulties confronted therein, the establishment ofsuch a system may also be necessary for designing the aforementioned support system.
The following preliminary arrangements must be made first: (a) list areas with individuals
who have incurred radiation exposure and provide a clear picture of the current situation(this should include dose surveys, pollution status, and a health survey of residents); (b)continuously collect and store relevant data and biological materials, which are needed
to objectively assess the health effects of nuclear radiation exposure; and (c) enter all
information gathered through the above procedures into a database that is shared (undercertain conditions) with the concerned countries, international organizations, support
groups, and experts.
② Conduct case studies on relief policies for A-bomb survivors in Japan, support policies
for individuals exposed to radiation in countries with nuclear test sites, and share thecollected information

09

In a country such as Japan, which has experienced the effects of nuclear radiation
through the atomic bombings of Hiroshima and Nagasaki, there are three main pathways
for supporting survivors: developing and implementing a medical examination system,
enhancing social welfare, and providing medical assistance. Table 1 below outlines somespecific measures. In accordance with and to the extent provided by the applicablelaw, survivors of the atomic bombings at Hiroshima and Nagasaki may receive medical
examinations regardless of their nationality and residency status; in other words, thisapplies both to Japanese nationals and individuals who live abroad, given that they visit
Japan for services⁷. It should be noted that the Japanese support system for A-bomb
survivors is not compensatory, as it is designed to provide relief through medical care.
Table 1. Main support measures provided by the Atomic Bomb Survivors Support Law(1994)
Medical examinations are provided twice yearly at no cost to the recipient.

Medical Examinations

Additional examinations can be arranged upon request (up to twice eachyear); transportation expenses are reimbursed on such occasions.
If a survivor suffers an injury that is certified as caused by exposure to
A-bomb radiation (a certified disease), then their medical expenses are

Medical Benefits

covered by public funds. As a general rule, medical expenses incurred at
designated medical institutions for the treatment of common diseases andinjuries are also covered by public funds.

Special Medical Allowance
Special Allowance

This is granted to individuals who require treatment for A-bomb certified
diseases.
This is granted to individuals with A-bomb certified diseases who do not
require continual treatment.
This is granted to A-bomb survivors who are suffering from disabilities

Health Care Allowanceassociated with at least one of the 11 types of disease listed by thegovernment as potentially related to A-bomb radiation exposure.

Health Allowance
Nursing Care Allowance
Atomic Bomb Microcephaly
Allowance

This is granted to A-bomb survivors (including those exposed in utero)located within a radius of 2 km from the hypocenter of the explosion.
This is granted to A-bomb survivors who require nursing care due toinjuries caused by A-bomb radiation exposure.
This is granted to patients who have been diagnosed with microcephalycaused by A-bomb radiation exposure.
This is granted in cases of death among A-bomb survivors, provided

Funeral Expenses

that the cause is clearly related to injuries caused by A-bomb radiation
exposure.

※ A-bomb survivors can only apply for one of the following allowances: Special Medical Allowance, Special
Allowance, or Health Care Allowance and Health Allowance.

10Compensatory and medical support systems have also been established for radiation
victims living in areas around nuclear test sites. In Kazakhstan, compensation is paid
based on both the distance from the test site and the number of years of residence, with
supplemental pensions or wages and annual paid and maternity leave provided to radiation
victims through the Semipalatinsk Nuclear Victim Civil Protection Act. As for health care,
medical examinations are mandatorily provided to individuals who have been affected by
nuclear testing. However, Kazakhstan operates a free healthcare system, in which caseit does not grant medical benefits for treatment services⁸. In the Marshall Islands, healthcare is provided to individuals with injuries from nuclear tests under Section 177 of theCompact of Free Association Act, as signed by both the republic island state and theUnited States government⁹. Moreover, the Nuclear Claims Tribunal has assessed relevant
damages and calculated compensation amounts for victims. However, this is accomplishedthrough a trust fund established by the United States government, which has denied
additional compensation; under this arrangement, affected individuals may have problems
receiving appropriate amounts10.
As discussed above, each system is constructed against a specific background, reflecting
the local environment, relevant modes of exposure, and practical conditions. Thus, it is not
feasible to simply apply any of these systems to another area. However, these cases canoften be used as reference points by considering their various similarities and differences.
For this reason, it is highly important to promote information sharing based on data fromcase studies aimed at supporting policies in countries, including Japan, where individuals
have incurred radiation exposure from nuclear testing. While the tasks listed in Section① are essential for gaining a clear picture of the actual medical conditions required todevelop a support system, those listed in Section② (i.e., case studies and information

sharing) are essential for understanding the respective institutional conditions.
③ Develop international criteria and guidelines for victim support
There is a need to establish goals and criteria for victim support policies as well as tocreate implementation guidelines and schedules that can be used in international settings.
These elements should be developed based on data from case studies conducted in various
countries (including Japan) and the results of basic surveys in designated areas. In doingso, (a) due care should be taken (depending on the actual conditions in designated countries
and areas) not to impose excessive burdens on States Parties that have committed toproviding victim support; meanwhile, (b) vigilant efforts should be made to ensure that
effective, efficient, fair, and balanced guidelines allow victims to receive adequate support
as quickly as possible.

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④ Select a support approach
There are three main ways for the development of victim support policies, namely,
the medical examination system approach, the victim-centered approach, and the local
healthcare system-building approach.
The medical examination system approach would be designed based on Japan’s
experience of supporting A-bomb survivors11. Since it is well-known that malignancies are
long-term side effects of radiation exposure, it is necessary to establish and implementa system of regular medical examinations aimed at the early diagnosis of cancer inindividuals whose exposure is thought to have exceeded a certain dose.
The victim-centered approach entails providing support based on both the actual
conditions that occur due to certain doses of radiation exposure, and the presence ofany radiation-induced diseases. In its consideration of the relationship between various
exposure doses and diseases, this approach aims to establish exposure dose standards
for specific diseases in order to determine the appropriate amount of support for eachradiation victim.
The local healthcare system-building approach promotes specific interventions indesignated areas where past exposure conditions have not adequately been ascertained.
For example, this approach has been employed to support A-bomb survivors of Nagasaki
in designated areas who suffer from mental illness. In such cases, it is necessary to
determine appropriate support levels and content based on the designated area and local
conditions.
Victim support policies that are based on international criteria and guidelines must
employ approaches that are suitable for the characteristics of each country and area inwhich interventions are required. Depending on the case, this may entail either a single
or multiple approach(es). These factors are of crucial importance when developing support
criteria and implementation guidelines.
(3) Tasks that should be entrusted to the institutional support system working group① Quickly develop an international cooperation system
The World Health Organization (WHO) recently established the Radiation Emergency
Medical Preparedness and Assistance Network (REMPAN), which is designed to help
international health experts share information and advice on diagnosing and treating
patients who have been exposed to radiation from nuclear disasters and workplace
radiation incidents. Similarly, the International Commission on Radiological Protection(ICRP) has established guidelines for the protection of individuals living in long-term
contamination areas (due to nuclear accidents or after radiation emergency situations), as

12

well as guidelines aimed at protecting people and the environment from radiation following
large-scale nuclear accidents. However, there is currently no international cooperation
system for supporting the victims of radiation exposure due to nuclear testing or the useof nuclear weapons. In this regard, the implementation of a support system for nuclear
explosion victims should take advantage of the vast experience accumulated by the WHO
and ICRP, which must be leveraged through widespread international cooperation. Thisis critical, as many States Parties would be burdened by the requirement to provide
victim support in the absence of effective international cooperation. In fact, this may also
undermine the benefits gained from the ratification of the TPNW altogether. As such,it is extremely important to undertake the development of an international cooperation
system for victim support at the earliest possible stage. This will not only facilitate thefulfillment of obligations assumed under the TPNW; it will also contribute to the smooth
implementation of support policies for radiation victims around the world, including those
who may be exposed to future nuclear disasters.
② Establish a permanent coordination mechanism (possibly a secretariat) for theparticipation of States Parties, States not party, international organizations, and private
sectors
The TPNW does not mention a specific system for supporting radiation victims.
However, the establishment of an effective and efficient international cooperation systemfor victim support requires a clear understanding of what each country that implements
relevant policies will need. Moreover, this will ensure appropriate coordination between
those countries and donors that can supply the necessary resources. Considering that
Meetings of States Parties are only held once every two years, it is not realistic or efficient
to expect that such coordination will be achieved solely through those events. Along withthe problem of inefficiency, there are also concerns that individual negotiations between
potential donors and States Parties may lead to biased aid provisions, thus preventing
victims with higher assistance needs from receiving prioritized support.
To recruit a wide range of donors and appropriately allocate assistance measures, itis therefore advisable to establish a permanent coordination mechanism to ensure that
States Parties, States not party, international organizations, and private sectors canactively participate in victim support policies. While it is certainly difficult to establish a
new international organization from scratch, the MBT set a relevant precedent by having
the Switzerland-based NGO Geneva International Center for Humanitarian Demining(GICHD) play a significant role in the implementation of its provisions, even though it was
not formally established as a secretariat under the treaty. The first step toward fulfilling13the obligations of the TPNW is to promote the coordination of international cooperation
activities between various countries, international organizations, and private sectors. Thishighlights the urgent need to establish an organization such as the GICHD, which can,thus, enforce appropriate and adequate support provisions.
③ Raise funds from a wide range of investors and pool the economic resources needed to
implement victim support policies
Under the terms of the treaty, any costs related to the implementation of victim support
policies should be borne, in the first place, by the countries that provide assistance.
However, a large number of States Parties to the TPNW are developing countries, thus
making it impractical (and inadvisable) to impose heavy burdens on their public finances.
We should also avoid situations in which potential States Parties hold back from ratifying
the treaty for financial reasons. In other words, while the implementation of victim support
policies requires both technical and financial cooperation, there are currently no specificfundraising plans for this purpose. To cope with this state of affairs, 1) contributions should
be sought from a wide range of donors, including not only States Parties, but also relevantinternational organizations, States not party, and private sources; and 2) any collected
funds should be temporarily pooled while the design and establishment of a system forpromoting the efficient management and utilization of financial resources is urgently
undertaken. As an example, the WHO broadly funded the supply of COVID-19 vaccines
to developing countries, and the ensuing vaccination campaigns, using donations collected
not only from governments, but also from international organizations, private foundations,and business enterprises. Similar approaches should also be applied to the TPNW. In doingso, important issues such as how to manage collected funds and who will be responsible
for managing them should be quickly addressed through follow-up discussions within theframework of the newly established international cooperation system.
(4) Ensure medical technology support and develop health care personnel① Medical technology cooperation for the domestic implementation of victim support
policies
It is important to establish an international cooperation system among relevant parties
that can provide support at the requisite medical, technological and institutional levels,
thus delivering prompt assistance to victims residing in all affected States Parties. In
concrete terms, it is necessary to forge close cooperation among highly skilled professionals
who can provide the medical support needed to gain a firm grasp of the realities ofradiation exposure and to better understand the types of medical examinations that will

14

be required. The same type of support is needed to establish a system for improving
the administration of medical insurance. In this respect, it is advisable to cooperate withinternational organizations that hold high credentials in relevant fields (e.g., the WHO andthe United Nations Development Programme [UNDP]) while ensuring bilateral cooperation,
consultancy provisions, and on-site guidance from higher learning institutions that featuretechnical and specialized backgrounds (e.g., universities and research institutes). To
effectively promote this type of cooperation, it is preferable to utilize the coordination
mechanism described in Section② of (3)12. It is also advisable to establish a worldwide

roster from which qualified personnel can be secured to provide consulting services for
medical technology support.
② Develop the health care personnel needed for victim support
While prompt and direct provisions are essential for sustainably supporting radiation
victims, it is even more critical to improve radiation-related education and develop
qualified personnel in the affected areas. Whatever type of support approach is adopted,
the personnel who carry out interventions must be recruited from the countries in which
the victims reside. Training programs should be launched as soon as possible, as it takes
considerable time to develop qualified personnel. To accomplish this goal, some key
issues must be addressed quickly, including the development of curricula, institutions,and organizations that can provide qualified training, as well as the establishment of an
ideal fellowship system. In this regard, Nagasaki University has already collaborated with
Fukushima Medical University to establish the Disaster and Radiation Medical Sciences
Joint Master’s Program, which aims to develop qualified specialists in Japan and abroad.
Moreover, both institutions have collaborated with North-Western State Medical University
in the Russian Federation (which experienced the Chernobyl accident) to establish adouble degree program aimed at developing global human resources in relevant fields.
In the future, similar programs should be created to enable the development of required
human resources not only in countries that are affected by nuclear testing, but also inStates Parties at large. This will ensure that any specialized knowledge gained from these
programs can be applied to manage exposure cases resulting from weapons usage andnuclear disasters alike.

15

This policy proposal was primarily authored by Satoshi Hirose, who is affiliated with the
Research Center for Nuclear Weapons Abolition (RECNA), Nagasaki University. Assistance
was provided by Fumihiko Yoshida, who is also affiliated with RECNA, as well as Yasushi
Miyazaki and Noboru Takamura, both of whom are affiliated with the Atomic Bomb Disease
Institute, Nagasaki University.

1

http://city.nagasaki.ajisai-call.jp/faq/show/3705?site_domain=default Accessed December 16, 2021

2

The casualties were specifically distributed as follows: 302 faculty members and 596 students from theNagasaki Medical College, 54 students from the Nagasaki Normal School, and one faculty member and 26
students from the Nagasaki Higher Commercial School.

3

The exact wording is: “Each State Party in a position to do so shall provide assistance for the victims of theuse or testing of nuclear weapons or other nuclear explosive devices.”

4CCM, Article 6, International cooperation and assistance:		“1. In fulfilling its obligations under this Convention, each State Party has the right to seek and receive
assistance.

		

2. Each State Party in a position to do so shall provide technical, material and financial assistance to State
Parties affected by cluster munitions, aimed at the implementation of the obligations of this Convention. Suchassistance may be provided, inter alia, through the United Nations system, international, regional or nationalorganizations or institutions, non-governmental organizations or institutions, or on a bilateral basis” (Emphasis
added by the author). There is no mention about individual victims as recipients of international support.

5

External exposure occurs when all or parts of the body are exposed to radiation from external sources.

6Internal exposure occurs when the source of radiation is inside the body (e.g., through intake of radioactive
material). This is, typically, the result of ingesting or inhaling radioactive materials from the air, food, or drink.
Radiation exposure derived from diagnostic or therapeutic procedures can also be detected in the blood cells.

7

Moreover, the governments of both Nagasaki Prefecture and Nagasaki City have cooperated with the Republicof Korea National Red Cross to continually provide medical examinations and health counseling to A-bomb
survivors residing in South Korea since the experimental project was undertaken in 2004, though which is nota part of implementation of the Atomic Bomb Survivors Support Law .

8

Seiichiro Takemine, Noriyuki Kawano, Talgat Muldagaliyev, Kazbek Apsalikov, “Outline of the Law on Social
Protection of Citizens who Suffered from Nuclear Tests in Semipalatinsk Conducted by the Former Soviet
Union,” Hiroshima Peace Science No. 37, Institute for Peace Science Hiroshima University, pp. 76-81.

9Compact of Free Association Act of 1985, Section 177		“(a) The Government of the United States accepts the responsibility for compensation owing to citizens of
the Marshall Islands or the Federated States of Micronesia for loss or damage to property and person of
the citizens of the Marshall Islands, the Federated States of Micronesia or resulting from the nuclear testing
program which the Government of the United States conducted in the Northern Marshall Islands between
June 30, 1946, and August 18, 1958.”

10

https://mh.usembassy.gov/the-legacy-of-u-s-nuclear-testing-and-radiation-exposure-in-the-marshall-islands/
Accessed December 16, 2021

11

There is not yet a final verdict on the role and significance of medical examinations or interventions for alarge number of residents who were exposed to low radiation doses in the aftermath of the Fukushima Daiichi
Nuclear Power Plant accident in Japan. However, some experts believe that such doses may not necessarily
warrant regular checkups, especially cancer screenings. Moreover, there is no international consensus on thedefinition of “low radiation dose,” although international organizations, including the United Nations ScientificCommittee on the Effects of Atomic Radiation (UNSCEAR) and International Commission on RadiologicalProtection (ICRP), often define low exposure doses as those less than 100 mSv. In one instance, a 2010
report from UNSCEAR defined low radiation doses as those less than 200 mSv.

12

Please see p. 11

16

References
Treaty on the Prohibition of Nuclear Weapons (excerpts)
Preamble(omitted) Mindful of the unacceptable suffering of and harm caused to the victims of
the use of nuclear weapons (hibakusha), as well as of those affected by the testingof nuclear weapons, (omitted)
Article 6Victim assistance and environmental remediation
1. Each State Party shall, with respect to individuals under its jurisdiction who are affectedby the use or testing of nuclear weapons, in accordance with applicable international
humanitarian and human rights law, adequately provide age- and gender-sensitive
assistance, without discrimination, including medical care, rehabilitation and psychologicalsupport, as well as provide for their social and economic inclusion.
2. Each State Party, with respect to areas under its jurisdiction or control contaminatedas a result of activities related to the testing or use of nuclear weapons or othernuclear explosive devices, shall take necessary and appropriate measures toward theenvironmental remediation of areas so contaminated.
3. The obligations under paragraphs 1 and 2 above shall be without prejudice to the duties
and obligations of any other States under international law or bilateral agreements.
Article 7
International cooperation and assistance
1. Each State Party shall cooperate with other States Parties to facilitate the implementationof this Treaty.
2. In fulfilling its obligations under this Treaty, each State Party shall have the right to seek
and receive assistance, where feasible, from other States Parties.
3. Each State Party in a position to do so shall provide technical, material and financial
assistance to States Parties affected by nuclear weapons use or testing, to further the
implementation of this Treaty.
4. Each State Party in a position to do so shall provide assistance for the victims of the use or
testing of nuclear weapons or other nuclear explosive devices.
5. Assistance under this Article may be provided, inter alia, through the United Nations
system, international, regional or national organizations or institutions, non-governmentalorganizations or institutions, the International Committee of the Red Cross, theInternational Federation of Red Cross and Red Crescent Societies, or national Red Cross
and Red Crescent Societies, or on a bilateral basis.
6. Without prejudice to any other duty or obligation that it may have under internationallaw, a State Party that has used or tested nuclear weapons or any other nuclear explosive
devices shall have a responsibility to provide adequate assistance to affected States Parties,
for the purpose of victim assistance and environmental remediation.

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