World Medical Journal

The Growing Threat of Nuclear War and the Role of the Health Community

Ira Helfand, MD; Andy Haines, MD; Tilman Ruff, FRACP; Hans Kristensen; Patricia Lewis, PhD Zia Mian, PhD


January 03, 2017

In This Article

Editor's Note:
The following is an abridged version of an article previously published in World Health Journal in October 2016. This article was abridged by the original authors and is published here with permission.

The Growing Danger of Nuclear War

After the end of the Cold War, the intense military rivalry between the Soviet Union and the United States/North Atlantic Treaty Organization (NATO) was replaced by a much more cooperative relationship, and fears of war between the nuclear superpowers faded. Unfortunately, relations between Russia and the United States/NATO have deteriorated dramatically since then. In the Syrian and Ukrainian wars, the two have supported opposing sides, raising the possibility of open military conflict and fears that such conflict could escalate to nuclear war.

Speaking in January, when the Bulletin of the Atomic Scientists announced that its Doomsday Clock would remain at 3 minutes to midnight, former US Secretary of Defense William Perry stated, "The danger of a nuclear catastrophe today, in my judgment, is greater that it was during the Cold War...and yet our policies simply do not reflect those dangers."[1] His assessment was echoed 2 months later by Igor Ivanov, Russian Foreign Minister from 1998 to 2004. Speaking in Brussels on March 18, Ivanov warned that "The risk of confrontation with the use of nuclear weapons in Europe is higher than in the 1980s."[2]

The increased tensions between the United States and Russia have been matched by a similar escalation in the danger of nuclear war in South Asia. Since the nuclear weapon tests of May 1998 by India and then Pakistan, the two states have expanded many-fold their respective nuclear weapon and fissile material stockpiles. They have put in place command and control systems and doctrines that involve, in the case of Pakistan, first use of nuclear weapons in a conflict and, in the case of India, massive retaliatory strikes against population centers.[3,4,5]

North Korea has a track record of repeatedly threatening the use of nuclear weapons; for example, in March 2016, it warned it would make a "preemptive and offensive nuclear strike" in response to joint United States/South Korean military exercises.[6] It is capable of enriching uranium and producing weapons-grade plutonium and has deployed short- and medium-range ballistic missiles, as well as tested long-range missiles.[7]

While these growing tensions among nuclear-armed states could lead to the deliberate use of nuclear weapons, there is also the continuing danger that they could trigger the unintended or accidental use of these weapons. There have been at least five occasions since 1979 when either Washington or Moscow prepared to launch nuclear weapons in the mistaken belief that the other side had already launched a nuclear attack or was preparing to do so.[8]

In a June 2015 speech, retired Marine General James Cartwright, former head of the US Strategic Command, warned that it might be possible for terrorists to hack into Russian or American command and control systems and launch one or more nuclear missiles, a launch which would have a high probability of triggering a wider nuclear conflict. This danger is intensified by the continued US and Russian policy of maintaining their missiles on hair-trigger alert, fully prepared for use and simply awaiting an order to launch.[9]

The nuclear danger is amplified further by the extensive plans of all nine nuclear armed states to enhance their nuclear arsenals. There remain roughly 15,375 warheads today, of which 4200 are deployed with operational forces. Nearly 1800 warheads are on alert and ready for use on short notice.[10] Instead of moving decisively toward deep cuts of their nuclear arsenals and making plans for the eventual elimination of nuclear weapons, the nuclear-armed states are reaffirming the importance of nuclear weapons and are carrying out extensive and costly modernizations of their nuclear arsenals.


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