January 16, 2001
What is COMEDS?
COMEDS is the senior military medical advisory committee of the NATO. It is composed of the Surgeons General of each NATO nation, the Medical advisors of the Strategic Commands and the Medical Staff Officer of the International Military Staff.
Why did we meet yesterday?
COMEDS held an extraordinary meeting yesterday to discuss the health concerns aired among the military personnel and veterans of member nations in recent months.
COMEDS takes these health concerns seriously. Obviously, it is our duty as medical officers is to ensure that each of our service members receive the medical care to which they are entitled, no matter what the cause of their problems. As an organisation, COMEDS is dedicated to ensure that our service personnel do not face unnecessary health risks during operations and the meeting of yesterday was held to address whether or not such health risks are causing medical problems following the operations in the Balkans.
Accordingly, we first exchanged all the available information on the actual health concerns among our military personnel, on the collected data about illness reports, on local risk assessments and on preventive measures that have been taken by the different nations.
After analysis of the available data and of the available peer reviewed medical scientific literature, a common NATO medical policy for the handling of the actual situation was discussed. Conclusions were drawn and recommendations were put forward to the Military Committee.
A. From available data, COMEDS believes that:
- Based on the presented national preliminary data on death and disease and on the number of personnel deployed in theater, we cannot identify any increase in disease or mortality in soldiers who have deployed to the Balkans as compared to those soldiers who have not deployed.
- On the evidence available a causal link cannot be identified between Depleted Uranium and the complaints or pathologies.
- Based on the available peer reviewed medical scientific studies, from both governmental and independent sources, any danger related to Depleted Uranium exposure is known to be quantity-dependent, and so far there is no evidence of possible exposure beyond the save levels. Available peer reviewed medical scientific studies show no links between natural uranium or depleted uranium exposure and cancer.
- However, there are a number of military personnel reporting symptoms. While these symptoms are not linked to Depleted Uranium exposure, these should warrant further peer reviewed scientific studies.
B. The following common NATO medical policy for the handling of the actual situation has been agreed upon:
- Each nation should analyse its military personnel crude mortality rates, and age-specific mortality rates. These rates should be calculated separately for the deployed and for non-Balkan deployed military personnel and should be compared. A comparison with the general population should also be made.
- Each nation should analyze the overall and/or specific rate of malignancies occurrence within its Balkan veterans, and compare it to their national matched statistics.
- Each nation should correlate the collection of morbidity data with known local health hazards in theater.
COMEDS insists that any investigation and measurements ought only to be undertaken where they are scientifically-validated.
C. COMEDS also made proposals for the future.
Within NATO, in the past, the military medical support was a pure national responsibility. With the increase in multinational deployments, common principles and policies specific for the medical support were and are still being developed. Common agreements and policies form the basis of NATO working procedures as each nation's own legislative framework may determine which measures will be additionally implemented for its own deployed personnel.
A workgroup for Military Preventive Medicine will develop a coherent strategy, process and standardized procedures that will enable known and future health hazards to be identified and addressed.
D. The conclusions of COMEDS were the following :
- COMEDS recognizes the imperative to listen to the health concerns of the military personnel.
- These health concerns and problems are best served by scientific, peer-reviewed analysis including independent studies.
- Based on such peer-reviewed medical scientific data and on the available national information, a link between Depleted Uranium and the reported cancers cannot be established.
- Although presently there is no indication of any atypical illness, linked to the Balkans, the timely investigation of all reports of an increased incidence of symptoms or pathologies is necessary. Again this ought to be performed in an open, scientific, and peer-reviewed manner.
- It is in the interest of the veterans, the military and medical communities and the local populations, that health risks related to the operational environment be approached by Medical Services from a multinational perspective in a transparent and independent manner.
- COMEDS will fully support the work of the ad hoc committee of Depleted Uranium established by the NAC.
- The issue of the health concerns will be discussed with our partner medical community at the COMEDS plenary and PfP meeting in May.
- COMEDS will meet again to discuss this issue as more information becomes available.