The World Health Organization (WHO) has updated its list of critical medicines that should be stockpiled for radiological and nuclear emergencies, along with policy advice for their appropriate management. These stockpiles include medicines that either prevent or reduce exposure to radiation, or treat injuries once exposure has occurred.

Key recommendations:

• The report provides policy advice for acquisition of drugs which can prevent or reduce radionuclides uptake or increase elimination of radionuclides from the human body.
• The report looks at the main elements required for developing, maintaining and managing the national stockpiles of specific medical supplies which will be required for radiological and nuclear emergencies.
• The report looks at the role of national health authorities in stockpile development as well as the role of WHO.
• This report includes a brief review of selected emerging technologies and drug formulations, including potential repurposing of products previously approved for other indications.
• The publication provides examples of practices in establishing and managing a national stockpile in selected countries, namely Argentina, Brazil, France, Germany, Japan, Republic of Korea, Russian Federation and USA.
• Typically, a national stockpile for all-hazards health emergencies would include generic supplies and materials used for any type of emergencies, such as personal protective equipment (PPE), trauma kits, fluids, antibiotics and painkillers.
• The publication lists only specific drugs for treating radiation exposure including:
  • Stable iodine, administered to prevent or reduce the exposure of the thyroid to radioactive iodine;
  • Chelating sand decorporating agents (Prussian blue, applied to remove radioactive caesium from the body and calcium- / zinc-DTPA used to treat internal contamination with transuranium radionuclides);
  • Cytokines used for mitigation of damage to the bone marrow, in case of acute radiation syndrome (ARS); and
  • Other medicines used to treat vomiting, diarrhoea and infections.
• Emerging treatments and countermeasures also discussed in the report give insight to the future medical countermeasures that could be used for managing patients overexposed to radiation.

Sources:

1. WHO News Release (January 27, 2023). Available from: https://worldhealthorganization.cmail19.com/t/d-e-ziiddjt-judivtyw-s/
2. National stockpiles for radiological and nuclear emergencies: policy advice (2023) https://www.who.int/publications/i/item/9789240067875