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A clear and present danger

On this 70th anniversary of the bombings of Hiroshima and Nagasaki the world remembers the horrific effects and power of the atomic explosions. From the images imprinted in our mind of the mushroom clouds and victims of these weapons we have long recognized that they are incredibly dangerous. Recent scientific studies now show that these weapons are far more dangerous than we had previously realized. Beyond the radiation risks and immediate blast and fire effects of these weapons, the potential for global climatic change in the aftermath of nuclear war is now recognized as a much greater threat. 

We live with this nuclear threat every moment of every day as long as these weapons remain. This is the greatest eminent public health threat we face. A clear and present danger. 

As physicians we are charged with responding to the public health threats in our world. Yet in reality there is no adequate or reasonable response to the aftermath of a nuclear war. We now recognize that even a limited regional nuclear war using 100 Hiroshima size weapons, representing less than ½ of 1 percent of the global nuclear arsenals, would have a catastrophic global impact ultimately killing over 2 billion people from the resulting climatic change and famine that would follow. This represents almost 30 percent of the global population. Such an outcome could easily result from a war between India and Pakistan. 

The realization of this danger has moved the American Medical Association recently to step up and call for the U.S. and all national governments to work for a ban and elimination of nuclear weapons.  In addition they have called on all physicians to familiarize themselves with the public health consequences of nuclear war and to educate their patients, elected officials and general public to the medical and environmental consequences of nuclear war.  

Previously the largest NGO on the planet, the International Red Cross had passed a similar statement and set out a 4 year action plan for the total elimination and ban of nuclear weapons. 

These major statements are accompanied by hundreds of NGO’s around the world and 113 Nations who have signed the Humanitarian Pledge to abolished nuclear weapons by international convention just as every other weapon of mass destruction and indiscriminate killing has been banned.  

Yet on this anniversary of the Hiroshima bombing where do we find the U.S. body politic? Where are the leaders who would step forward with a voice and understanding of the risks we face as a planet? Who will express the need to abolish, not reduce these weapons? Not the U.S. unilaterally but collectively with Russia following the leadership that we must demonstrate.  

As the Republican candidates begin their debates you can rest assured that not one will have the courage to speak to the threat our planet faces and the need to rid the world of these weapons. Instead they will provide eloquent bluster about how we must remain strong, building our armed forces including nuclear weapons and delivery systems. Unfortunately, we have had no one from the Democratic party show any greater understanding even as we hear the rhetoric of a vision of a world without nuclear weapons.  

Thus we all remain hostage to nuclear threat that hangs over us every moment of every day as a consequence of the leadership void we face.  Ultimately luck remains our security policy, hoping that nuclear war does not happen by accident, cyberattack or intent.  

Every action that puts the brakes on the development and acquisition of nuclear weapons deserves our support.  The current Iran nuclear agreement is just such an agreement. We must support this diplomatic achievement by all of our nuclear allies and cold war adversaries demanding that our representatives do likewise. This agreement is based on the hard facts and science in the manufacture and procurement of nuclear weapons. It employs the highest level of scrutiny and oversight ever in the history of arms control.  Most who oppose it will not even have read or understood it. Even former Israeli military officials and heads of their defense think tank have spoken in favor of this agreement.  Who among our debaters will speak to this fact? The nuclear state of Israel will be safer with an Iran without nuclear weapons. Because ultimately in the Middle East and the world itself, there can be no individual security without collective security.  Israel is only as safe as its least secure neighbor. 

This is indeed an historic time. A time when we must choose our future path.  The choice is ours. If we continue down our current road many probability theorists and indeed military historians advise that ultimately nuclear war is a very real possibility. There is no guarantee that such a war would not be the end game of humanity. As with any public health threat from tuberculosis to polio and Ebola we must prevent what we cannot cure. Our greatest existential public health threat, the aftermath of nuclear war is no different. Prevention is the only response. This is our prescription for survival. 


Dodge is a family physician practicing full time in Ventura, California. He serves on the Los Angeles and National boards of Physicians for Social Responsibility (,  He also serves on the board of the Nuclear Age Peace Foundation ( and Citizens for Peaceful Resolutions ( He writes for PeaceVoice ( 



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