A Nobel cause

In 1970, 15-year-old Tilman Ruff and friends from their just-formed school Amnesty International group walked into the Melbourne offices of the Greek Herald and urged the editor to report on the injustice of a young man imprisoned in Greece for writing a political slogan on a wall.

In 2017 in Oslo, 62-year-old Associate Professor Tilman Ruff AM sat with his wife, Charlotte, and son Kristian in the front row as the Nobel Peace Prize was presented to the International Campaign to Abolish Nuclear Weapons (ICAN), which he helped form.

His “heart was thumping with hope” that the award, and the landmark treaty banning nuclear weapons for which the group was being honoured, would help one day rid the world of this diabolical threat.

Back in the 1970s, the Greek youth was freed, a letter finally reaching Ruff from the boy’s father expressing in fractured English his heartfelt gratitude for such support from the other side of the world.

Young Ruff had learned that a determined and informed person can change the world.

He had also set in motion a destiny. Forty-seven years later, Ruff and his ICAN team became Nobel Laureates.

Such has been the remarkable career trajectory of a public health physician who had accepted, when still a teenager, the challenge issued by Albert Einstein when he proclaimed: “Those who have the privilege to know have the duty to act.”

That principle guided Ruff through his medical studies and student activism at Monash University, his decision to specialise in infectious diseases and public health, and continues still through his positions today as international medical adviser to the Australian Red Cross, and associate professor at the Nossal Institute for Global Health, University of Melbourne.

For some, the connection between public health and nuclear disarmament is not immediate, but Ruff makes it clear that the single-biggest threat to public health globally is nuclear weapons: “The key imperative for public health and infectious disease is prevention – it follows that this must be applied particularly to nuclear weapons."

“Modelling the consequences of even a limited exchange between two so-called small nuclear states shows two billion people would die from hunger and disease in the aftermath,” he says.

ICAN was awarded the 2017 Nobel Peace Prize for its evidence-based campaign to build diplomatic support for a Treaty on the Prohibition of Nuclear Weapons. The treaty was adopted by 122 United Nations member states on 7 July 2017 – a historic first step towards making nuclear weapons illegal under international law.

The lived experience

A key strategy used by Ruff and the ICAN group to build support for a treaty was to confront UN diplomats in New York with ‘lived human stories’. They presented Hiroshima descendants, survivors of US and French testing in the South Pacific, and Indigenous Australians still suffering the effects of British nuclear tests at Maralinga, South Australia.

“They have lived the realities of nuclear contamination and their voices were present at every key meeting. When they spoke you could hear a pin drop. The issue was no longer abstract,” he says.

Ruff’s appreciation for the value of the ‘lived experience’ also stems from his family’s background. His German parents and grandparents living in Templer Christian communities in Palestine were dispossessed by two world wars; exiled in Egypt after World War I, and then incarcerated in Palestine in World War II before being shipped to Australia and put behind barbed wire until 1947.

“My own family history is shaped by war’s needless destruction and long-term impacts. Perhaps not surprisingly I looked up to an older cousin who was active in the Monash Union of Students at the height of the anti-Vietnam War demonstrations. I was inspired by the courage and commitment of draft resisters.”

When Ruff also went to Monash – initially to study science before switching to medicine with encouragement from his medical-student girlfriend (and later wife, Charlotte, who also studied at Monash) – he formed an Amnesty International group there, too.

After graduating in 1980, he joined the International Physicians for the Prevention of Nuclear War founded by US cardiologist Dr Bernard Lown and his Soviet colleague, Dr Yevgeniy Chazov. Ruff was particularly inspired by Lown and also Australian paediatrician and anti-nuclear campaigner Helen Caldicott.

“It was they who articulated how the threat of nuclear war is the ultimate public health issue and a central ethical responsibility for physicians,” he says.

“Lown [who invented the defibrillator] had been researching sudden cardiac deaths, with Yevgeniy Chazov, when the pair came to the realisation – this being the height of the Cold War – that the greatest risk of sudden death was not cardiac arrest but nuclear weapons.”

Evidence makes the difference

Ruff says that through the physicians’ group (of which he is now the co-president) he saw the difference that organised, evidence-based advocacy could make – something powerfully illustrated a few years later when the evidence of climate scientists and physicians brought Ronald Reagan and Mikhail Gorbachev face-to-face to defuse the superpower nuclear stand-off. The US and Russian leaders had been shown, unequivocally, that a nuclear war would be terminal for humanity.

The climate researchers responsible for this détente were led by a Melbourne scientist, Dr Barrie Pittock, who became a mentor to Ruff as his own advocacy activity increased.

To this point, Ruff’s main drive had been professional, but in 1982 his first child, Ingrid, was born, adding an emotional impetus to what was by now becoming a lifelong quest “to eradicate the most acute existential threat that we all face”.

“Also, it’s not just the threat of these weapons being used,” he says. “There is not a human on the planet who today doesn’t have higher levels of strontium-90 and caesium in their bodies because of the atmospheric testing of nuclear bombs over the past 70 years. I was part of a global study looking at the health impacts of these tests, and even the most conservative assessments attribute millions of cancer-related deaths to the weapons tests.

“So the public health thread is clear, as is the primacy of prevention, because the risks will persist for as long as the weapons do.”

Looking ahead, Ruff is hopeful the treaty will come into force in 2019. Initially, it will fill a legal gap – this treaty effectively making the weapons illegal for the first time – and provide a rules-based structure for their elimination. There could be no greater legacy for a physician whose life and career has been so devoted to giving humanity a healthy future.

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WATCH: Dr Tilman Ruff's Monash Graduation speech - 11 December 2018