Nuclear War World Medical f) Journal WN\A
The Growing Threat ofNuclear War and the Role ofthe Health Community
The Growing Risk of Crimea, the European Leadership Net In this setting prominent leaders on both of Nuclear War work (ELN) documented a large irlcrcase sides have expressed alatm about rhe grow in inciderlts involving close c rlcounters ing danger of nudeat w~\r. After the end of the Cold W:.r the in between nuclear capable NATO :.nd Rus tense military rivalry between the Soviet sian military forces. A report issued by the Speaking in January, when the Bulletin of Uniofl and rhe United Stares/NATO was ELN concluded, .. ~n,ese events add up to the Atomic Scientisrs annouoced thar irs replaced by a much more cooperative re a highly d istutbiog picn1re of violations Doomsday C lock would temain at three hltionship, and fears of war between the of national airspace, emergency scrambles, minutes to midnight, former US Secre ~ nuclear superpowers faded. As recently narrowly avoided mid-air collisions, close tary of Defence William Perry stated, "'The as the 2014 US Quadrennial Defence encounters at sea, simulated attack runs danger of a nuclc::ar catastrophe toda)~ in Review, c01lAicr between rhe two fom1e r and orher dangerous actiOJlS happe11ing 011 my judgmenr is greater that it was duriog adversaries was not considered a realistic a regular basis over a very wide geographi the Cold War ... and yet O\lr policies sim· possibility [1]. cal area" [3]. Further, both sides ha~•e con ply do not reflect those dangers" [6]. His ducted large scale military exercises in Eu assessment was echoed two months later Unfortmlately, relations between Rus rope, leading rhe ELN toconclude, .. Russia by Igor l vanov, Russia1l Foreign Mi1\ist"er sia :md the US/NATO have deteriorated is preparing for a conAict with NATO, ~md !Tom 1998 to 2004. Speaking in Brussels dramatically since then. In the Syrian and NATO is preparing for a possible con on ~1arch 18, Ivanov warned that, "'The risk Ukrainian wars, the two have supported op frontation with Russia" [4]. 1he danger of confrontation with the use of nuclear posi11g sides, nlising the possibility of ope11 inhetent in this situation is magrlified by weapons in Europe is higher than in the military conflict and fears that S\lCh conflict the <.:\IJTCnt R\JSSian military d
86 Nuclear War World Medical Journal WN\A
from land, and from st.•bm:1rines at se-a.1l1ey In April 2016, at the conclosion of the No· and again in 1980 compt•te r errors in the ha\'C put in place command and control sys· clear Securiry Summit, the VVhite House US caused American radar systems to dis· rcms and doccrines that i1WOJ\'e, in the case Press secretary expressed concem abour, play, i r~ correct l y, incoming Soviet missiles of Pakistan, first t.•se of nt.•clear weapons in "the risk that a conventional conflict be· on their monitors. Tn September 1983, a conAict and, in the case of 1ndi:1, massive tween India and Pakist'Jn <.:oold escalate to Soviet military r:tdar incorrectly reported retaliatory strikes against population centres include the usc of nuclear weapons"' [18]. a NATO attack in progress. In November [8-10] . Should Pakistan use nudeat weapons of rhar year the Soviet leadership incor· agtlinst Indian conventional forces in such reedy concluded that a NATO mili"-ttY In May-July l999,the two countries fought a sit\Jation, l ndi:m nltclear doctrine calls for exercise was the cover for an :u.:tl• ~ll attack a war which apparently included mobiliza· massh·e retaliation directed at Pakistani cit· that was about to be launched. On Janu· tiOJ'l of nuclear weapons by Pakistan, mak ies and Pakistan has rhreate11ed ro respond ary 25, 1995, a full 5 years after the end ing it the most significant miliraty conAicr in kjnd. of the Cold War, Russia11 milirary radar benvecn two m~<.:lear :1rmed states [11). incorrectly identified a Norwegian Black They also went through a major military With Pakistan building ever closer mili· Brant XII rocket launched to study the crisis (December 2001 to June 2002) rrig mry and eCOilOmic ries ro Chi11a, a11d India aurora boreaJis as a Trident missile aimed gcred by an arrack 011 l11dia's parlia•nCilf by becoming a strategic parmet of the U11ired at Moscow. lslamist militants believed in lndi:1 to be States, s~•ch a fi.•ture Sollth As i ~m conAict backed by Pakistan, which included the two may quickly take on a global dimension In each of these situations preparations for countries movi11g a combined roral of over given the increasingly tense 11arure of the a countctsrrike were initiated a11d nuclcat half a million troops to their border [12]. g.-eat powet tivalry betwee11 Chi11a and the war was avened by minutes. The slow pace of 1ndi:m deployment and us [20]. inconclusive outcome of the stand· oA:.lcd The danger of this kind of mistake oc· India's army to begirl plarlning and train North Korea has a track record of repeatedly curring again is amplified by currerlt de· ing for a 1nore decisive and rapid con\'en threare11ing the use of nuclear weapo!lSi for fic iencies in Russia11 radar warning sys· tional Mrnck on Pakis"''" [13]. Pakisrnn e.xample, in l\1arch 2()16 it warned it wollld terns. Russia h:ts no sp:tce· b:tsed satellite began testing a short- range truck-mounted make a .. pre~emptive and ofiCnsh·e nuclear early warning systems to alert them to the mobile missile to deliver low-yield nuclear strike" in response to joint US-South Ko launch of nuclear-armed ballistic missiles weapons on the battlefield [14]. 1bis latter rean milir:tty exercises [2l}. l t is capable of from rhe ocean, so their waming time development has increased long-standing enriching uranillm ~nd prodt•dng weapons· could be as short ~s 10 to 15 minotes. The international concerns about the security grade plutonium and has deployed short only way for Russia to guarantee the abil· of nuclear weapons and fissile materials in and mcdium·range ballistic missiles as wcU ity to launch its forces before they arc de· Pakismn give1\ the latge-scale and frequent as resting long-range missiles [22]. srroyed by a pre-emptive atmck would be lslamist militant attacks on milit:ary targets to prc·dele!r-tte laonch ~uthori ty to field in the country and the ideological polariza commanders. Under these conditions, the tjon within the armed forces and broader Unintended Use of time pressure to make a launch decision society associated with the rise of hard-line N uclear Weapons could greatly increase the cha11ce ofan ac· lslamist political gro\lps over the past three cidenta l launch, especially if a computer decades [15]. While these growing tensions amongst nu error caused a false warning of attack dur clear armed states could lead to the deliber ing a crisis [24]. Recently, military lead· Potential triggers for anncd conflic-t be ate use of 1luclear weapons, there is also the ets have begun to warn of a rlew threat tween Pakist:tn and l ndia inclltde another <.:ontinlling danger th:tt they cot•ld trigger that might cause the onintended la\mc.:h major attack on India by Tsl:unist miJitant the lmintended or accidental liSe of these of nuc.:le~r weapons: cyberterrorism. In a groups like the one in ~1umbai ln Novem· weapons. June 2015 speech, retired Marine Gen. bet 2008 thar was linked to intellige•lce James Cartwright, former head of the agencies in Pakis"'" (16]. A second possible There h:tve been at least fi ve 87 Nuclear War World Medical t1 Journal WN\A wider n~aclear conflict. 1l1is danger is in· 8000 tcnsificd by the continued US and Rus 7300 7000 sia!\ policy of maintaining their mis...~:;iles on h:1ir trigger alert, f\ally prepared for use 6000 Retired and simply awaiting an order to hnmch • [25]. There is also extensive evidence that 5000 Stockpiled individuals with resp 88 Nuclear War World Medical Journal WN\A Table. Modernization Activities of the Nine N\•clear· armed S~ttes Russia France o replacing all 5ovietoera 55- 18, 55°19 and 55°25 intcrcon· o modernizing its 5SBN Beet with the new M51 5LBM that tinenr.•l ballistic missiles (ICBMs) by the early· 2020s with will soon receive a new warhe~1d. difiCrcnt versions of the SS-27 and a new .. hc.-avy~ silo-based • anning its bomber force with ALCMs. ICBM. • replacing Mirage 2000N aircraft with the Rafale which will • building eight new baUistic missile submarines (SSBNs) be armed with a new ALCI\1. with the new 55-N-32 (B,davn) missile to replace eight opo United Kingdom crational Soviet-era Delta-class SSBNs and their missiles. • dcvdoping a r\cw SSBN class m replace rhe curte11r Van o upgmding its old Tuol60 (Bklckj:.ck) and T uo95MS (Bear) guard-class S5BNs which will carry the life oextended Trio bombers so they can continue to operate until a new bomber dc1n II 05 with a new guidance system. c;an repl:tce them sometime in the 2020s. • eqtaipping ct.•rrent SLB1'vls with enhanced warheads. o graduaUy replacing the old A5· 15 air-launched cruise mis· sile (ALCM) with a new ALCM known as the Kh-102. (>akis-tan • modernizing some of its non-strategic nuclear forces, re o deploying new and longer-range 5hahecn· III ballistic miso placing the old 55·21 short-range ballistic missile (SRBM) siles, Ra'ad ALCI\1s, Babur grom\d-launched cruise mis \\;th the 55o26 (lskander), replacing the old 55-No21 siles, and de\rcloping a nuclear SLCM. se:.ol:nmched land· :.tt<•ck cruise missile (SLCM) with the • dcployi11g a tactical nuclear weapor), the 60-kilomcter 55oN•30A (Kalibr), and replacing the old 5u-24 (Fencer) NASR missile. fighter-bomber with the 5u· 34 (Fullback). • increasing production of fissile matetial for additional war heads. U1t ited States o building a new Aeet of 12 5SBNs to replace the current 14 India SSBNs. The new submarines will catty an impro\'ed vetsiOI\ • deploying and developing longer- range ballistic missiles of the Trident II 05 sea· l:mnched ballistic missile (SLBM) that ta1\ mrgec all of Pakisra11 and China, including several with 11ew guidance system and enhar)ced warheads. new versions of the Agni missile family. modemi~ 89 Nuclear War World Medical t1 Journal WN\A ofl ndi:t and Pakistan actuaUy contain more <.-onsttmption, and would not begin tO offset in South Asi:t, the glob:tl cl.imate effects than 220 nuclear warheads.) The direct ef the shortfall over a full decade [38). Fur would be far worse. A war involving only fects in South Asia are cara.srmphic. Some thermore, there are curret\tly 795 millior\ the strategic weapotlS that will still be de 20 million people would die in the first people who are alre:.tdy ttndernourishcd at ployed when New START is 1\•Uy imple week from the direct effects of the explo ~ b:tseline [39). There are also some 300 mil mented would pot some 150 million tons sions, fire and local radiation [32]. lion people who enjoy adequate nutrition of soot in the upper atmosphere, and drop today, bur live in countries highly depen· temperatures around the world by ~C . lt\ The global consequences-global climate dent on food imports which would probably the interior regions of North America and disnaption and rest.Jitant fit m in e ~would be not be :tv:tihtble :ts grain exporting CO\Intries Ettrasia, temper:ttt.tres \VO\.IId faJI by 25 to far more devastating. The fires caused by suspended exports to feed their own people. 30"C. These conditions would persist for these nuclear weapoos would loft 6.5 mil In addiriot\, there are 11early a billion people more than a decade. Ternpetaturcs Or\ Earth liOI'l tons ofsoor into the upper atmosphere. in China with incom~s of S5 a day or less ha\'e nor beetl rhar cold since the last ice The impact of this SOOt has been e.xamined who are adequately fed today, but who h:lVe age. ln the temper:.1te regions of the North· by three teams of cHmatc scientists using shared little in China's growing prosperity ern Hemisphere, the temperature would faH three differe1U climate 1nodels a1\d mak over the last several decades. All of these below freezing for some portion of every ing the conservative assumptiorl rhar only people, arourld rwo bi lliotl, would be ar risk day for at least rwo years [43]. Under rhcsc 5 million tons of soot :uc injected into the tmder the potential f:.tm ine conditions that conditions food prodoction would stop and atmosphere [33-35). Each model shows would result from this limited, regional nu the vast majority of the human race would signific:uu dtops in average surf."tce temper clear war [ 40]. Large scale war betweer\ the starve. ature a11d average prec.ipirarion across the US ar\d Russia would be fat worse. lr1 early globe with the effects lasting fo r more th:tn 2016, Rttssia and the US were estimated to a decade. The most sophisticated and recent possess 7300 and 6970 nuclear warheads rc Efforts to Eliminate tnodel shows the most pei"Sistem declines it\ specth·ely, 93% of the global roral of 15,375. Nuclear Weapons remperantre at\d precipiration, which have Under rhe provisioi\S of the New START not yet returned to baseline after 26 years, treaty, each of these cotmtries will retain Understanding of the unprecedented ex· as long as the model was run. \,Yhile the some 1550 strategic (long range) nuclear istential threat posed by nuclear weapons fuel density of modern cities varies, there warheads when the Treaty is fuHy imple was widely recognized in the very first is nothir\g specific to lndiaff'akisrarl about merued in 2018. Most of these weapons resolution of the U1\ited Natiot\S General such a sccmtrio. Nude:.tr we:.tpons :are ex· are 10 to 50 times more powerf'-1 1 than the Assembly in January 1946, calling for the tremcly efficient at igniting. over large areas, bombs which destroyed Hiroshima [41). A elimination of atomic weapons [44]. The simultaneous fires which rapidly coalesce 2002 study showed that if just 300 of the preamble of the 1970 nuclear Non-Prolif and inject large volumes ofsoot and smoke weapons in the Russian atserul hit utbar\ eration T rcary (N PT) oper1s: "'Coosider· into the stratosphere. targets in the US, 75 to 100 miUion people ing the devastation that wottld be visited would die in the first half hour from the upon all mankind by a nuclear war and the This climate disruption would in turn have firestorms and explosjons [42). This attack consequent need to make every effort to profout\dly negative impact Orl food pro· would also destroy m.ost of the infra.'it:ruc· avert the danger ofsuch a war .. ."[45]. Yet duction. The maize crop in the US, the tt.•rc - the electric ga-id, internet, b:tnking for most of the P'.tst 71 years, the sh:tred world's largest producer, would decline and public health systems, food distribution interests of humanity, based on the real an average of 12% over a full decade [36). network - needed to suppon the rest of the consequences of any usc of nuclear weap In China, the world's largest producer of populatiOt\, most of whom would succurnb Orls, have beerl sidelined by the perceived grain, middle season rice wOttld dedine to exposure, starvation and epidemic disease interests of the 9 governments that pos· by I 7% over a full decade, maize by 16%, in the months followlng. A US counterat· sess and threaten ttse of nttcle:.tr weapons, and winter wheat, by a truly catastrophic tack would be expected to cause the same which have dictated the pace and extent 31% (37] . level ofdestruction in Russia, and if NATO of t\uclear anns conttol and disarmamem. were involved in the conflict, Ctmada and However, the obligation tO pttrstte effective Under <.1.1rrent conditions, adequ:tte human mttch of Ettrope would face similar des true· measures towards nttclear disarmament is nutrition cannot be sustained in the face of tion. a shared responsibility of all 190 NPT sig declines of food productiOt\ of this rnagni· t\atoty stares, at\d the lruernational Court tl.1 de. Tot:tl world gnin reserves in Ja_n~t ary These direct effects arc only part of the ofjustice in its 1996 Advisory Opinion on 2016 amounted to only 84 days of global story, however. As is true for a limited war nttclear weapons ttnanimotasly roled that 90 Nuclear War World Medical ~ Journal WN\A there e.xists an obligation not only to ptar· governmental meetings dedicated to the a treaty. 1his recommendation was taken sue in good faith, but to bring to a conclu· humanitarian impacts of nuclear weapons. forward in a resolution co-sponsored by 57 sion, negoriario1\S leading 10 flucleat disar 1here was no significa11t disagreemem at srares [58) and adopted by the UNGA FiNt on:unent [46]. these conferences regarding the cxten· Committee on 27 October 2016, with 123 sive expert evidence presented, leading to S"-ltCS voting yes, 38 (predominantly nucle The contemporary 'Humanitarian In.itiath·c' the conclusions 1) that any usc of nuclear ar-armed and nuclear-allied) voting no, and on nuclear weapons bega1l with Jntcma weap 'K" .( CO), L\_[S 91 Nuclear War World Medical t1 Journal W/'1/\A ing a test b:tn was signed by 9000 scientists the detonation ofa single meg:1ton weapon In 2007, IPPNW fo 92 Nuclear War World Medical ~ Journal WN\A Russia :md the \Vest in 2014. Eumpea.n Leader· 2016, htt)>:l/thebullc:tin.org/nudc:ar•b:mlcs· 2nd maitt produc1ion in the Midwest United ship Network, November 20 I.a. $()~t th-a..s.ia9415 (rKCU..~ i\'by 5 2016). State$. Climatic Chang~; 2013; 116: 373-87. 4. Fre-ar T, Kearns I, Kulesa L. 1\e-paring for the 20. Mian Z. lUmana M . As.ian War Machines, doi: 10.1007/d0S84-QI2-0518-I. \>VonJt: An: Russi;an ~nd NATO Milit:u')' Exer C ritical Asi:m Studies 201.a; 46(2):345-60. 37. Xir& [... Robod: A, Mills M, Stenke A. H c.lf.-tnd. cises Making Wu in Europe Mort Likdy? Eu 21 . http://edit ion ,cnn . .:om/201 6/03/06/asia/ tkcadal reduction of Chinese agrtculture after a ropean Leadership Nc=rwork, August 2015. nonh· kortt· prc:empti,·c- nuclear-strikc:· thte:u/ regional nuclear war. E:1nh's Future 2015; 3:37- 5. Sokov N. \Vhy Russia calls a limited nuclear (acmscd Ap,il18. 20 16). 48, doi:IO.I002/2014EF'000283. strike ·de·csc:al:uion'". BAS 1.l M:a«h 2014. 22. hnp://www.mi.orgllc:arnlcoumrics/nonh· ko• 38. http://www.usda.gov/occ/commndit)'/wasdc/ http:/lthebullctin.<>rglwllr-ru!.Si:a-calls-limitcd re:V(acce$$edAprill8.20 16). l:uest.pdf(rKceue '\<." '( CO), L '-.j'S 93 Nuclear War World Medical t1 Journal WN\A \VMking towards the d imin:nion of nuckar re:.chingcritic:.lwill.c>rg/ imagc:s/documents./ wma.ncrlen/30public:.ttonsl10policies/n7/ (ac· wC<~pons. Ccnev.~: ICRC. 2011. http://www. Disoumament-fora/1com/ 1com16/rcsolutions/ ces.scd May9.2016). icrc.orglcnglrcsourcc!lldocumenu/rcsolution/ !At.pdf(•=ssed Ocmbc• 30, 201(>). 75. UN General Assembly. The health and humani· coun<:il-del~tt$-tUOl uti<:>n- 1 -20l 1 .htm (.-c 59.Conventi 94 ISSN zz;6-o;8o or f) WM.A Official Journal ofThe World Medical Association, Inc. Nr. 3, October zor6 vol. 62 Contents Currently the Earth is a Planet ofPiastics ...... 81 Interview with Sir Michael Marmot, President of the World Medical Association ...... 82 Migration ofDoctors and WorkingT ime Arrangements from an International Perspective ...... 83 Women in Migration: Beyond Statistics ...... 84 The Growing Threat ofNuclear War and the Role ofthe Health Community ...... 86 WMA Calls on Governments to Ban and Eliminate Nuclear Weapons ...... 95 The Value of Resiliency Training in Postgraduate Medical Education ...... 95 The Role ofPhysicians Fighting Children Trafficking and Illegal Adoptions: the Use of Genetic Identification ...... 96 Why Should the World Medical Association not Change its Policy towards Euth.anasia.? ...... 99 Voluntary Euthanasia and Physician-assisted Suicide: Should the WMA Drop its . . } 0 pposttion...... 103 One Health and Antimicrobial Resistance ...... 108 Global Development ofMedical Science and Publication Opportunities and Challenges ...... 112 Southeast European Medical Forum ...... 114 Paul Cibrie: Defending the Medical Profession in the Age ofInternationalization ...... 117 Introduction to work at COP22 ...... 119