Two Billion At Risk: The Threat of Limited Nuclear War

As physicians we spend our professional lives applying scientific facts to the health and well being of our patients. When it comes to public health threats like TB, polio, cholera, AIDS and others where there is no cure, our aim is to prevent what we cannot cure. It is our professional, ethical and moral obligation to educate and speak out on these issues.

That said, the greatest imminent existential threat to human survival is potential of global nuclear war. We have long known that the consequences of large scale nuclear war could effectively end human existence on the planet. Yet there are more than 17,000 nuclear warheads in the world today with over 95% controlled by the U.S. and Russia. The international community is intent on preventing Iran from developing even a single nuclear weapon. And while appropriate to stop the spread of nuclear weapons, there is precious little effort being spent on the much larger and more critical problem of these arsenals.

Despite the Cold War mentality of the U.S. and Russia with their combined arsenals and a reliance on shear luck that a nuclear war is not started by accident, intent or cyber attack, we now know that the planet is threatened by a limited regional nuclear war which is a much more real possibility.

A report released Tuesday by the Nobel Laureate International Physicians for the Prevention of Nuclear War and its US counterpart Physicians for Social Responsibility documents in fact the humanitarian consequences of such a limited nuclear war. Positing a conflict in South Asia between India and Pakistan, involving just 100 Hiroshima sized bombs-- less than 0.5% of the world's nuclear arsenal-- would put two billion people's health and wellbeing at risk. The local effects would be devastating. More than 20 million people would be dead in a week from the explosions, firestorms and immediate radiation effects. But the global consequences would be far worse.

The firestorms caused by this war would loft 5 million tons of soot high into the atmosphere, blocking out sunlight and dropping temperatures across the planet. This climate disruption would cause a sharp, worldwide decline in food production. There would be a 12% decline in US corn production and a 15% decline in Chinese rice production, both lasting for a full decade. A staggering 31% decline in Chinese winter wheat production would also last for 10 years.

The resulting global famine would put at risk 870 million people in the developing world who are already malnourished today, and 300 million people living in countries dependent on food imports. In addition, the huge shortfalls in Chinese food production would threaten another 1.3 billion people within China. At the very least there would be a decade of social and economic chaos in the largest country in the world, home to the world's second largest and most dynamic economy and a large nuclear arsenal of its own.

A nuclear war of comparable size anywhere in the world would produce the same global impact. By way of comparison, each US Trident submarine commonly carries 96 warheads each of which is ten to thirty times more powerful than the weapons used in the South Asia scenario. That means that a single submarine can cause the devastation of a nuclear famine many times over. The US has 14 of these submarines, plus land based missiles and a fleet of strategic bombers. The Russian arsenal has the same incredible overkill capacity. Two decades after the Cold War, nuclear weapons are ill suited to meet modern threats and cost hundreds of billions of dollars to maintain.

Fueled in part by a growing understanding of these humanitarian consequences of nuclear war, there is today a growing global movement to prevent such a catastrophe. In 2011, the International Red Cross and Red Crescent movement called for its national societies to educate the public about these humanitarian consequences and called for the abolition of nuclear weapons. Seventeen nations issued a Joint Statement in May 2012 on the Humanitarian Impact of Nuclear Weapons that called for their total elimination. By this fall the number rose to 125 nations.

The international community should continue to take practical steps to prevent additional countries from acquiring nuclear weapons. But, this effort to prevent proliferation must be matched by real progress to eliminate the far greater danger posed by the vast arsenals that already exist.

Simply put, the only way to eliminate the threat of nuclear war or risk of an accidental launch or mishap is to eliminate nuclear weapons. This past year the majority of the world's nations attended a two-day conference in Oslo on the humanitarian consequences of nuclear war. The United States and the other major nuclear powers boycotted this meeting. There will be an important follow up meeting in Mexico in February. It is time for us to lead the nuclear weapons states by example in attending this meeting and by embracing the call to eliminate nuclear weapons.

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