16 January 2001
Major General Van Hoof, Chairman of COMEDS
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
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.
- 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
- On the evidence available a causal link cannot
be identified between Depleted Uranium and the complaints
- 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.
- 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
- Each nation should correlate the collection of
morbidity data with known local health hazards in
COMEDS insists that any investigation and measurements
ought only to be undertaken where they are scientifically-validated.
- 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
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.
- 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
- 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
- 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.