Keep health at the center of public discussions on nuclear risk

In response to growing geopolitical tensions, editors of more than 100 international journals have jointly published an editorial today urging health professionals to keep health at the centre of public discussions on nuclear risk.

The editorial appears across leading global publications, including The BMJ, The Lancet, the Medical Journal of Australia, the East African Medical Journal, the National Medical Journal of India and International Nursing Review.

In 2025, the nuclear armed states - China, France, India, Israel, North Korea, Pakistan, Russia, the United Kingdom, and the United States - spent just under $119bn, or $3768 per second, on their nuclear arsenals, an increase of 19% from the previous year, explain the authors.

And with over 12,000 nuclear warheads worldwide and 30% of the population living in 33 megacities, models show that even a “small” nuclear war using just 2-3% of existing weapons could trigger global starvation and the collapse of modern civilization.

In response, the United Nations General Assembly initiated a comprehensive review of current knowledge about the consequences of nuclear war, which is due in 2027, and the World Health Organization will update its studies on the public health effects of nuclear war by 2029.

These initiatives represent the first major international reassessments of the effects of nuclear war by these bodies in nearly 40 years, note the authors.

Work on top level international nuclear treaties has also intensified, they say, notably the Treaty on the Prohibition of Nuclear Weapons (TPNW), to which 75 countries have become legally bound to it, and a further 26 have signed it.

However, they point out that, ahead of its first review conference at the end of 2026, none of the nine nuclear-armed states have signed or ratified it, despite rising pressure.

The principal argument for nuclear weapons is that they prevent nuclear war through deterrence, but the authors argue that this security “remains fragile, asymmetric, dependent on the permanent threat of catastrophe, and blind to the needs of non-nuclear states.”

Insights from psychology and neuroscience also suggest that decisions about nuclear weapons are not rational, while emerging AI and drone technologies, misinformation and disinformation further heighten risk.

“We need a verifiable, deadline driven agreement to eliminate all nuclear weapons,” write the authors. To safeguard human survival, they say it is essential that the health sector continues to demand that every country, including nuclear armed states, join the TPNW.