From fragmentation to integration: building a globally harmonised biodosimetry framework for radiological emergency...

Escalating geopolitical instability and the persistent risk of radiological or nuclear incidents highlight an urgent need for resilient global radiation emergency preparedness. In such crises, rapid and reliable biological dose assessment is indispensable for triage, therapeutic stratification, and long-term health surveillance. While the dicentric chromosome assay remains the gold standard for biodosimetry, its labour-intensive nature, limited throughput, and variability in implementation constrain large-scale responsiveness. Emerging approaches, including DNA-DSB repair foci analysis and G₀-phase premature chromosome condensation combined with fluorescencein situhybridisation, offer promising acceleration, yet lack universally harmonised validation frameworks. Despite the existence of regional and international initiatives, global biodosimetry capacity remains fragmented, with heterogeneous protocols, uneven infrastructure, and limited interconnectivity. This commentary contends that isolated excellence is insufficient in the face of potential mass-casualty scenarios that transcend national boundaries. We propose the establishment of a formally integrated global biodosimetry consortium anchored in coordinated interlaboratory comparisons, standardised protocols aligned with IAEA and ISO guidance, shared digital platforms, and sustained training programmes. Modelling suggests that coordinated activation of existing laboratories could increase triage capacity by orders of magnitude compared to isolated national responses. A globally harmonised biodosimetry framework is not merely a technical aspiration; it is a strategic imperative. Integration will enhance scientific rigour, operational scalability, and collective resilience against radiological emergencies of unprecedented scale.