Ending nuclear weapons before they end us: current challenges and paths to avoiding a public health catastrophe.

The United Nations Treaty on the Prohibition of Nuclear Weapons (TPNW)-an important planetary health good-entered into legal force in January 2021. Evidence of the consequences of nuclear war, particularly the global climatic and nutritional effects of the abrupt ice age conditions from even a relatively small regional nuclear war, indicates that these are more severe than previously thought. None of the nine nuclear-armed states is disarming; instead, all invest enormously in new and more hazardous nuclear weapons.

Australia's contribution to global immunisation.

Objective: To review Australian contributions to global immunisation.

Approach: We summarise Australian scientific and program contributions to vaccines and global immunisation, describe key developments and strengths in Australia's national immunisation program, and outline how both of these can link with Australia's increasing international development budget to build Australia's future contribution to global immunisation.

Conclusions: Australian contributions to vaccines and immunisation have been substantial, and Australia offers a range of good practices in its domestic and development approaches.

Antibody persistence six years after two doses of combined hepatitis A and B vaccine.

Persistent immunity to hepatitis A and hepatitis B antibodies six years after vaccination of adolescents (aged 12-15 years) with a combined hepatitis A and B (HAB) vaccine following a 0, 6 month or a 0, 12 month schedule was assessed. Yearly (Year-2-6) serum samples were tested for anti-HAV and anti-HBs using EIA. Subjects with anti-HBs concentrations <10 mIU/mL (14/23) at Year-5 or Year-6, received an additional HBV vaccine dose approximately 12 months after Year-6.

Priorities and challenges for hepatitis B control in the Philippines and the importance of a vaccine dose at birth.

The Philippines annual birth cohort of over 2 million is the second largest in the Western Pacific Region; 44% of births occur outside health facilities. With third dose infant hepatitis B (HB) vaccine coverage of 43% in 2006, erratic vaccine supply, and lack of policies or processes for universal HB vaccine birth dose delivery, a substantial burden of preventable chronic HB infection continues to occur. Funding, policy, technical and immunization delivery developments now make substantial progress in HB control in the Philippines possible.

Booster vaccination of toddlers with reduced antigen content diphtheria -- tetanus -- acellular pertussis vaccine.

Immunogenicity and reactogenicity of DTPa and reduced antigen dTpa booster vaccines were compared to a hepatitis A control vaccine in DTPa-primed toddlers aged 18 - 20 months. Post-booster, all DTPa and dTpa recipients were seroprotected against diphtheria and tetanus, and > or = 93.3% had a booster response to pertussis.

Proliferation dangers associated with nuclear medicine: getting weapons-grade uranium out of radiopharmaceutical production.

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'.

Implementing the birth dose of hepatitis B vaccine in rural Indonesia.

Reaching mothers and their newborn infants around the time of birth with adequate health services has long been a difficult problem in developing countries. In parallel, similar problems have arisen in attempting to deliver hepatitis B (HepB) vaccine to infants born at home in many countries where mother-to-infant transmission is common. It is logical, and supported by experience in Indonesia, to find a combined solution for both problems.

Biological agents as weapons 2: anthrax and plague.

Although most naturally occurring infections with anthrax and plague are cutaneous, both organisms are most likely to be deliberately disseminated in aerosolised form, resulting in severe pulmonary illness. Mortality from both would be high and rapid in the absence of early and effective treatment, making swift and effective liaison between alert clinicians and public health authorities crucial to an effective response. Differentiating features include mediastinal widening (anthrax) and haemoptysis (plague).

Biological agents as weapons 1: smallpox and botulism.

1. Early recognition by clinicians of illnesses suggesting a biological attack is integral to the public health response. 2.