In January, 2023, the Science and
Security Board of the Bulletin of the Atomic Scientists moved the hands of the Doomsday Clock forward to 90s before midnight, reflec- ting the growing risk of nuclear war (1). In August, 2022, the UN Secretary-General, Ant- ónio Guterres, warned that the world is now in “a time of nuclear danger not seen since the height of the Cold War” (2). The danger has been underlined by growing tensions between many nuclear armed states (1,3). As editors of health and medical journals worldwide, we call on health professionals to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet, and urge action to prevent it. Current nuclear arms control and nonproliferation efforts are inadequate to protect the world’s population against the threat of nuclear war by design, error, or miscalcula- tion. The Treaty on the Non-Proliferation of Nuclear Weapons (NPT) commits each of the 190 participating nations ”to pursue negotia- tions in good faith on effective measures rela- ting to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarma- ment under strict and effective international control” (4). Progress has been disappointingly slow and the most recent NPT review conference in 2022 ended without an agreed statement (5). There are many examples of near disasters that have exposed the risks of depending on nuclear deterrence for the inde- finite future (6). Modernisation of nuclear ars- enals could increase risks, for example, hyper- sonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escal- nation.
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Reducing the risks of nuclear war—the role of health professionals