The long-term damage to hibakusha health manifested itself in three phases: leukemia appeared as the first malignant disease as early as 1949, and continued for almost 15 years; many types of cancer developed during an intermediate phase; and we have seen a lifelong occurrence of cancers and leukemia (MDS) among hibakusha exposed to radiation as children.

Psychological damage, such as depression and post-traumatic stress disorder are also persisting. We don’t yet have firmly established medical evidence of the genetic transmission of radiation-induced damage, inducing malignant dis-eases and malformations, to the second generation hibakusha, despite some positive evidence for experimental animals such as mice and rats, including recent proof of gene abnormality transmission at the DNA level.

If such transmission of genetic abnormalities is found to be the case, the fourth phase will be the medical consequence of the bombings carried over to subsequent generations.

Thus, the human consequences of the bombings have not yet reached their full extent, and the total number of casualties cannot yet be calculated. Many people are still dying of radiation-induced malignant dis-eases. More than 100,000 hibakusha still live in both cities, in Tokyo, and in other parts of Japan and elsewhere. Their mean age is 83 years old.

Many hibakusha, even while they are continuing their battle with the radiation consequences, are simultaneously campaigning for the elimination of nuclear weapons. They cannot wait until the 100th anniversary of the bombings, by which time few if any will still be alive.

Hiroshima and Nagasaki have regenerated remarkably after sever-al decades, coincidentally with Japan’s economic recovery during the 1950-70s. Despite the resurrection of these two cities, however, we hibakusha still don’t see a world free of nuclear weapons. On the contrary the world has been divided into nuclear-weapon-possessing nations and their allies on the one hand, and nations promoting the prohibition of nuclear weapons, along with civil society, on the other. This divide is serious and will have to be addressed after the ratification of the Treaty on the Prohibition of Nuclear Weapons (TPNW). ICAN, which was awarded the 2017 Nobel Peace Prize for its work to help achieve the treaty, will face a new set of challenges once it enters into force.

As the COVID-19 pandemic has spread globally, and the number of deaths has multiplied rapidly, we have been compelled to seriously recognize the absolute necessity of confidence-building and cooperation among all nations, without exception. This situation is very similar to what we IPPNW physicians have faced since the foundation of our federation in 1980. Our founding co-presidents, Dr. Bernard Lown and Dr. Evgueni Chazov, then loudly said that the nuclear weapons and nuclear deterrence policy were a pandemic disease endangering world security.

Global warming and the climate cri-sis is another pandemic in our time. Facing these multiple global crises will require global cooperation and confidence-building. National ego-ism, to the contrary, is dangerous to all nations. We hibakusha have known this for 75 years, and it remains at the heart of our message as these pandemics come together!

As the only group of homo sapiens that has experienced the use of nuclear weapons in wartime, we hibakusha have engaged in a life-long movement to eliminate nuclear weapons. Political leaders, especially in the nuclear-armed states, must heed the wisdom and ethics of the hibakusha to save homo sapiens from possible extinction by nuclear winter and famine after a catastrophic nuclear war.

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