View Tilman Ruff 's Biography

Tilman Ruff is a public health and infectious diseases physician at the University of Melbourne. He was founding Australian and International Chair of the International Campaign to Abolish Nuclear Weapons (ICAN), which was awarded the Nobel Peace Prize in 2017.


Tilman Ruff

Editors' Note

In 2016-17, several artists involved in the Nuclear Futures Partnership Initiative made contributions to the growing campaign to abolish nuclear weapons, which gained focus through the UN Treaty on the Prohibition of Nuclear Weapons mandated for negotiation in December 2016, adopted in July 2017, and currently open for signature. The ban treaty was developed through the leadership of the International Campaign to Abolish Nuclear Weapons (ICAN), which won the Nobel Peace Prize in October 2017 -- the first to an organisation born in Australia. In this Postscript, ICAN co-founder Tilman Ruff reports and comments on the state of play with the Treaty and the campaign against nuclear weapons.

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Maralinga bomb image from the series Life Lifted into the Sky, used as a postcard by the International Campaign to Abolish Nuclear Weapons. Painting by Anangu artists Mima Smart and Rita Bryant.

Our existential predicament

We are all on borrowed time. The central question of our age is: will it be the end of nuclear weapons or the end of us? The Doomsday machine that proliferated during the Cold War remains, ticking, and the dangers of nuclear war have metastasised and grown. Nuclear-armed states not only are showing no seriousness about fulfilling their obligation to disarm; they are doing the opposite - all are investing massively in producing new nuclear weapons more likely to be used.

In part because of impatience and frustration with this continuing intolerable mortal danger, most of the world's governments in 2017 took a landmark step. They negotiated and adopted the UN Treaty on the Prohibition of Nuclear Weapons (UN General Assembly 2017), which for the first time comprehensively prohibits nuclear weapons in international law. It also provides the only currently defined path which all states can take to achieve the world free of nuclear weapons that our survival and planetary health demand.

The Treaty provides a historic moment of truth -- states that are serious about fulfilling their legal obligation to achieve nuclear disarmament will join. Those that do not, whatever they say, are exposed as not sincere and serious about disarmament.

In a time of great danger, a major tool towards ending the nuclear weapons era has been forged. Nuclear test survivors, Australian indigenous nuclear test survivors prominent among them, played a major role in the negotiation of the Treaty. And because of their presence and voice, and the humanitarian evidence-based nature of the Treaty, this is the first disarmament treaty to recognise the disproportionate impacts of nuclear weapons activities on women and girls, and on Indigenous peoples.

What nuclear war would mean

In the 1980s, after producing detailed reports on the effects of nuclear war on health and health services, the World Health Organisation (WHO) concluded that nuclear weapons constitute the greatest immediate threat to human health and welfare. They are the only weapons which loom as an acute existential threat to planetary health (World Health Assembly 1983). Every moment of every day that they exist, launch ready, they threaten everything we strive for and love, everything that matters, and the species with which we share our Earth. Everything that is made, built, lived and struggled for, everything our ancestors built and made, could become tragically irrelevant if we do not eradicate nuclear weapons before they are again used.

We are the first human generations in our long evolutionary history to face twin existential dangers of our own making -- ecosystem disruption particularly through rampant global warming, and nuclear weapons. The first is evolving and partly reversible; the second acute and largely irreversible.

The consequences of any use of nuclear weapons would be cataclysmic. If a war that began in the South China Sea or the Korean peninsula escalated, the warheads on Chinese ballistic missiles that would head for Australia would be up to 5 megatons, 5 million tons of TNT in explosive power. A single such warhead over a city would ignite hundreds of thousands of fires that would rapidly coalesce into a massive firestorm 45 kilometres across, releasing many hundreds of times more energy than the explosion itself (Ruff 2013).

In Melbourne, this area would extend to Springvale, Wantirna, Warrandyte, past Greenvale and to Point Cook; in which temperatures would exceed 800°C and every living thing would die. Such a weapon over Sydney would burn all the area between Mona Vale, Parramatta and Sutherland.

It is the unequivocal conclusion of WHO and the Red Cross and Red Crescent movement, the world's largest humanitarian organisation, among others, that no effective health and humanitarian response is possible to even a single nuclear detonation on an urban centre. The only cure is prevention.

As catastrophic as the effects of blast, flash burns, fires and radiation would be, we now know that it is the climatic impacts of nuclear war that would exact the greatest toll. Even a relatively small-scale regional nuclear war would have severe global consequences. For example, a nuclear war between India and Pakistan involving 100 Hiroshima-size bombs, less than half of their current nuclear arsenals, targeted on cities, would loft more than 5 million tons of dark sooty smoke high into the stratosphere, where it would rapidly circle the globe and persist for decades, precipitously cooling, darkening and drying climate worldwide (Mills 2015). These effects alone would decimate agriculture, putting billions of people's lives at risk from starvation (Helfand 2013). The heated and lofted smoke would destroy stratospheric ozone, increasing ultraviolet flux around the world to unprecedented levels (Mills 2015). Disease epidemics and further conflict would inevitably accompany such severe and widespread famine (Helfand 2013).

One hundred Hiroshima size weapons represents less than 0.5% of the global nuclear arsenal, and less than 0.1% of its explosive yield.

The warheads on a single US or Russian ballistic missile submarine could cause such global climate catastrophe and nuclear famine several times over. The 1800 nuclear weapons currently on high alert would produce temperatures typical of ice ages, and use of strategic Russian and US weapons would risk human extinction. Willingness, capacity and plans to execute nuclear war, the reality behind policies of nuclear deterrence, are blind to these facts.

This evidence is plain that nuclear weapons cannot keep anyone secure but rather jeopardise everything and everyone. They are in reality global suicide bombs.

The growing danger of nuclear war

The dangers of nuclear war are growing. Combinations of technical malfunction and human error have brought us repeatedly within a hair's breadth of nuclear war, on at least five occasions. The first use of nuclear weapons has been threatened repeatedly, by the US alone on at least 25 occasions (Ellsberg 2017). Cyberwarfare creates new risks, not limited to governments. Even the computers of the US National Security Agency were hacked in 2017 (Shane 2017). Over the past eight years, as climate disruption starts to bite, the number of armed conflicts worldwide is increasing (UN 2018).

Disarmament is stalled; there are not even talks about talks. Rather than disarming, as they are legally obligated to do, all the nine nuclear-armed states are investing massively, over US$105 billion annually (Blair 2011), not just in retaining nuclear weapons for the indefinite future, but in modernising their weapons to make them more accurate, more usable. In recent years, we have seen frighteningly irresponsible escalation and brinkmanship in explicit threats to use nuclear weapons, not only from so-called leaders in North Korea and the United States, but also from Russia's President Putin, UK Prime Minister May, and leaders in India and Pakistan. These threats have been accompanied by increasingly provocative and hazardous exercises, deployments and policies for early and first use of nuclear weapons (Helfand 2016).

The welcome step away from escalating vitriolic and explicit nuclear threats between North Korea and the US in mid-2018 is still fragile and yet to be anchored in any durable agreement. If the Kim-Trump summit process falters, there is a real likelihood that the drums of war will rapidly grow louder in Washington; raising the danger that a failed summit process could be even more hazardous for all of us than no such process.

The Bulletin of the Atomic Scientists, with 15 Nobel laureates on its Board of Sponsors, has since 1947 provided authoritative annual assessments of our proximity to an existential chasm. This year for the first time since 1953, when both the US and USSR in rapid succession tested hydrogen bombs, they moved the hands of the Doomsday Clock forward to 2 minutes to midnight, as close as they have ever been (Mecklin 2018).

The US walking away from the landmark Iran nuclear deal bodes ill. This agreement is successfully delivering the most stringent, verified constraints ever negotiated on any nation's nuclear program. Meanwhile, the toxic effects of those demanding others disarm while expanding their own nuclear arsenals deepens.

If nuclear weapons are used again in a world with multiple nuclear-armed states, we will be in uncharted waters. All nuclear-armed states have the capacity to use their weapons first, and all except China have policies to do so. With 1800 nuclear weapons worldwide on hair-trigger alert ready to be launched within minutes (Kristensen 2018), plans to launch nuclear weapons quickly in response to warning of an attack, and war plans to use nuclear weapons before they are destroyed by an incoming attack, use of nuclear weapons by a state is highly likely to rapidly escalate.

Prospects and progress towards eradicating nuclear weapons

Eradicating nuclear weapons has been urgent and unfinished business since the very first resolution of the United Nations General Assembly on 24 January 1946 called for the elimination of nuclear weapons from national armaments. International law requires nuclear disarmament, to which all states are ostensibly committed.

We have made substantial progress in controlling other kinds of indiscriminate and inhumane weapons. Treaties which prohibit and provide for the elimination of biological and chemical weapons, landmines and cluster munitions have dramatically reduced the production, stockpiling, financing, deployment and use of these weapons. In each case, the approach which has proven effective is to establish that these weapons can only have indiscriminate, unacceptable consequences; and codify their rejection in an international treaty that applies the same legal standard for all states. This then provides the basis and motivation for the weapons' progressive elimination. This approach can be summarised as stigmatise -- prohibit -- eliminate.

In 2005, distinguished Malaysian obstetrician Datuk Dr Ron McCoy, despairing that nuclear disarmament was moribund, and inspired by the success of the International Campaign to Ban Landmines, proposed we apply these lessons to nuclear weapons by establishing a new International Campaign to Abolish Nuclear Weapons - ICAN. A few of us in Melbourne involved with the Medical Association for Prevention of War (MAPW), were struck by Ron's idea, and began to plan and build ICAN. They included Dimity Hawkins and Torquay GP Dr Bill Williams, who died way too young in 2016 and is sorely missed.

ICAN was conceived as a global campaign coalition of diverse organisations, working for a treaty to prohibit and eliminate nuclear weapons, based on the unacceptable catastrophic consequences of any use of these weapons. We needed to engage young and old around the world with horror, humour, hope and humanity. We needed to mobilise citizens, and also work with governments. MAPW and International Physicians for the Prevention of Nuclear War (IPPNW) initially hosted and nurtured the campaign. The wider Kantor family in Victoria believed in us enough to generously provide funds to enable us to start and grow a global campaign.

In 2010, the International Committee of the Red Cross kicked off an energised focus on nuclear disarmament as an urgent humanitarian imperative, in what became known as the Humanitarian Initiative. Through landmark intergovernmental conferences in Norway, Mexico and Austria in 2013 and 14, the first ever focused on the humanitarian impact of nuclear weapons, evidence about the consequences and dangers of nuclear weapons was authoritatively updated and widely accepted (Europe Integration and Foreign Affairs Federal Ministry 2014). ICAN established its credibility as the lead civil society partner for each of the governments hosting these conferences.

A clear strategy emerged, crystallised in a UN Working Group in 2016 charged by the General Assembly with identifying the best next steps the world could take to progress long moribund nuclear disarmament (UN General Assembly 2016). While states that do not own nuclear weapons cannot eliminate them, they could break the logjam in disarmament by filling the legal gap that saw nuclear weapons as the only weapons of mass destruction not explicitly prohibited in international law, if they used a forum which could not be blocked by nuclear-armed and nuclear-dependent states (Ruff 2018a).

In December 2016, the UN General Assembly voted more than three to one to mandate negotiations for a new treaty prohibiting nuclear weapons, leading towards their elimination. These negotiations in New York resulted in the adoption, on 7 July 2017, by a vote of 122 to 1, of the historic Treaty on the Prohibition of Nuclear Weapons. This treaty provides a categorical and comprehensive prohibition of everything to do with nuclear weapons. It complements existing treaties, and provides pathways for all states to join, whether they currently possess nuclear weapons, had them in the past, have them deployed on their territory, or like Australia, assist in military preparations for their use. The treaty thus provides a pathway -- the only currently defined pathway -- for all states to fulfil their obligation to achieve and sustain a world free of nuclear weapons. All governments should take that path.

The ferocity of the opposition of some nuclear-armed states, and the divestments from companies making nuclear weapons that we have already seen on the part of some of the world's largest financial institutions, demonstrate that this treaty matters. Since its adoption, the world's largest sovereign wealth fund, the Norwegian Pension Fund with over USD 1 trillion; Europe's largest pension fund -- Holland-based ABP; Deutsche Bank; and Belgian bank KBC; have divested from makers of nuclear weapons on humanitarian grounds.

Sadly, the Australian government was the most active among those claiming protection from other's nuclear weapons, in its opposition to and undermining of the processes that led to the treaty. When it was adopted, Foreign Minister Julie Bishop quickly stated that Australia would not join the treaty. Despite Australia's claim to support disarmament, the UN and international law, these were the first multilateral disarmament negotiations ever boycotted by Australia, and this is the first weapons prohibition treaty which Australia has repudiated.

The reason is the fundamental inconsistency between being serious about nuclear disarmament, while claiming that (US) nuclear weapons are essential to Australia's security and prosperity, and assisting in preparations for their possible use, including on our behalf. This position is deeply immoral and makes Australia part of the problem rather than the solution to the most acute existential danger our world faces. We have work to do to bring our governments on the right side of history.

On 6 October 2017, the Norwegian Nobel committee announced it's awarding of the Nobel Peace Prize for 2017 to ICAN "for its work to draw attention to the catastrophic humanitarian consequences of any use of nuclear weapons and for its ground-breaking efforts to achieve a treaty-based prohibition of such weapons" (The Norwegian Nobel Committee 2017). This provided needed attention to this urgent danger, and to the historic importance of the ban treaty. It gives great encouragement to the many thousands of people and governments who work for the end of nuclear weapons; and it opens doors like nothing else. It is also a tribute to what a few people with a vision, a plan, and persistence can achieve.

The importance of memory; the power of story

Scientific including health evidence, and effective evidence-based advocacy, played a key role in getting the ban, and now in using the treaty to advance elimination. This evidence directly underpins and is reflected in this treaty.

Nuclear weapons and the cataclysmic harm they cause can be difficult to grasp, hard to think about, painful to confront. Numbing and denial are very common responses to the horror embedded in nuclear weapons. Yet eradicating this horror requires facing it. Two aspects of humanitarian evidence were key in the treaty process. First, uniting voices around the scientific evidence to communicate it clearly and with authority. In particular, the leading global federations of health professionals - the World Medical Association, the International Council of Nurses, the World Federation of Public Health Associations - joined with IPPNW in op-eds and submissions and presentations to the negotiating and preceding conferences, laying out with united voice the urgent planetary health imperative to prohibit and eliminate nuclear weapons (Ruff 2018b).

The second key approach was combining authoritative evidence with the power of human stories, of lived human experience. From late 2014, Indigenous nuclear test survivors Aunty Sue Coleman-Haseldine or Karina Lester, along with Japanese hibakusha and survivors of nuclear testing in other places, were present and heard at every key international step towards the negotiation and adoption of the ban treaty. When they spoke, you could hear a pin drop. They touched hearts. In the formal procedures, day after day in the bowels of the UN, the survivors reminded diplomats why they were there, why their work mattered. Why nuclear weapons are not some abstract great power chess game, but an intolerable lived daily reality of indiscriminate, transgenerational contamination, suffering, loss and displacement. Why diplomats should park parochial issues and seize the historic opportunity in the time-limited mandate afforded them by the General Assembly.

Ambassador Elayne Whyte Gómez, president of the negotiating conference, has described how important the strength of the humanitarian evidence was in achieving the treaty; and also how looking into the eyes of the survivors each day motivated diplomats with a sense that they must not fail. Thus key contributions to the Humanitarian Initiative for nuclear disarmament and the historic Treaty on the Prohibition of Nuclear Weapons were made by evidence of the catastrophic impacts of nuclear weapons, together with the testimony and advocacy of survivors of nuclear use and testing.

Of course many of the efforts of survivors and communities affected by nuclear testing focus on recognition for having been put in harms way; seeking accountability; compensation; adequate care for ill-health, loss and displacement; and monitoring and where feasible remediation of contaminated lands. The demands of surviving, as well as seeking some justice, are challenge enough. But they have gone much further, in their deep conviction that no-one anywhere should ever again have to suffer as they have. Their important role as compelling witnesses and advocates for the eradication of nuclear weapons deserves praise and our deep gratitude.

One important aspect of the treaty is that it builds on the humanitarian and human rights-based norms developed in the landmine and cluster munitions ban treaties, providing for needs-based assistance to victims, and feasible clean-up of contaminated environments as obligations of states that join. This is the first treaty related to nuclear weapons that addresses these matters. It calls on states joining it to assist people affected by the use or testing of nuclear weapons, without discrimination, including medical care, rehabilitation and psychological support, as well as for their social and economic inclusion. Clearly much of the harm caused by nuclear weapons cannot be undone in the way traumatic injuries can be treated, and discrete munitions can be removed, but these provisions should help ensure that the ongoing needs of survivors, and for environmental monitoring and where feasible clean-up, are not ignored or forgotten. The responsibility of states that have used or tested nuclear weapons draws specific mention in the treaty.

The legacy of nuclear tests stretches over geological time; and much of their lingering hazard, from both radioactive and chemical toxicity, remains insidiously invisible, and their victims unnamed and unrecognised.

So the role of story and art in keeping alive the memory and knowledge of what happened at Monte Bello, Emu Field and Maralinga is crucial, and in spreading awareness of what occurred and its consequences. Making the story go far in time and distance, across generations, borders and cultures; linking with other survivors of nuclear weapons use and testing; making the invisible visible.

Nuclear weapons and the danger of their use, as long as they exist, will not go away through denial or inattention. They will be eradicated by the love and labours and working together of many, to protect all that matters and that we love on this good Earth. Memory, story and voice are crucial in overcoming denial and acquiescence; aligning head and heart. Making your story our story.

We have no time to lose. There can only be one answer to the question: will it be the end of nuclear weapons or the end of us? All of us have a role in ensuring the answer.

Works cited

Blair, Bruce, and Matthew Brown. 2011. World spending on nuclear weapons surpasses $1 trillion per decade. Global Zero Technical Report, June 2011.

Ellsberg, Daniel. 2017. The Doomsday Machine. Confessions of a Nuclear War Planner. New York, USA: Bloomsbury.

Europe Integration and Foreign Affairs Federal Ministry, Republic of Austria. 2014. Report and Summary of Findings of the Conference, Vienna Conference on the Humanitarian Impacts of Nuclear Weapons, 9 Dec 2014.

Helfand, Ira. 2013. Nuclear Famine: Two Billion People at Risk. Boston: International Physicians for the Preven­tion of Nuclear War.

Helfand, Ira, Andy Haines, Tilman Ruff, Hans Kristensen, Patricia Lewis and Zia Mian. 2016. The growing threat of nuclear war and the role of the health community. World Medical Journal, 62(3), 86-94.

Kristensen, Hans and Robert S Norris. 2018. Status of World Nuclear Forces. Federation of American Scientists.

Mecklin, John. (ed.). 2018. It is now two minutes to midnight. 2018 Doomsday Clock Statement, Science and Security Board, Bulletin of the Atomic Scientists.

Mills, Michael J, Owen B Toon, Julia Lee-Taylor and Alan Robock. 2015. Multi-decadal global cooling and unprecedented ozone loss following a regional nuclear conflict. Earth's Future, 2, 161--76.

Ruff, Tilman A. The health consequences of nuclear explosions. 2013. In: Fihn, Beatrice. (ed). Unspeakable suffering -- the humanitarian impact of nuclear weapons. Reaching Critical Will, Women's International League for Peace and Freedom, Geneva/New York: 14-27.

Ruff, Tilman. 2018a. Negotiating the UN treaty on the prohibition of nuclear weapons and the role of ICAN. Global Change, Peace and Security, published online 30 Apr 2018, DOI:10.1080/14781158.2018.1465908.

Ruff, Tilman A. 2018b. The treaty on the prohibition of nuclear weapons: a planetary health good of the highest order. (The Federation's Pages -- World Federation of Public Health Associations). J Public Health Policy, online 9 May 2018

Shane, Scott, Nicole Perlroth and David E Sanger. Security breach and spilled secrets have shaken the N.S.A. to its core. 2017. New York Times. November 12.

The Norwegian Nobel Committee. 2017. The Nobel Peace Prize for 2017. Oslo: The Norwegian Nobel Committee.

UN General Assembly. 2016. Report of the Open-ended Working Group taking forward multilateral nuclear disarmament negotiations. Geneva: United Nations.

UN General Assembly. 2017. Treaty on the Prohibition of Nuclear Weapons. A/CONF.229/2017/8. 

United Nations and World Bank. 2018. Pathways for Peace. Inclusive Approaches to Preventing Violent Conflict. Washington DC, USA: World Bank.

World Health Assembly. 1983. The role of physicians and other health workers in the preservation of peace as the most significant factor for the attainment of health for all. WHA36.28. Geneva: WHO.