Promote health, not nuclear weapons: ethical duty of medical professionals

Despite ongoing tensions in various parts of the world, the year 2017 ended on a positive note. The Treaty Prohibiting Nuclear Weapons (TPNW) was passed by the UN General Assembly on July 7, 2017 (1), which will always be a red-letter day in history. It has raised many hopes for a future world without nuclear weapons and staved off the impending humanitarian catastrophe. Good health is a basic need of every individual. Therefore, each person yearns for a life free of violence and free of man-made catastrophes like the ones at Hiroshima and Nagasaki in 1945, which killed over two hundred thousand people and resulted in genetic mutations affecting generations thereafter. Unfortunately, instead of working for nuclear disarmament, the world moved towards an unending nuclear arms race, costing billions which could have been used for healing millions of people living in despair and sickness. This is why on December 10, 2017, Oslo, the capital of Norway, was filled with excitement when the Nobel Peace Prize for this year was bestowed upon the International Campaign to Abolish Nuclear Weapons (ICAN) (2). Large numbers of medical professionals from around the globe had gathered there to affirm their commitment to a healthy future through diversion of wasteful expenditure from the nuclear arms race towards universal health.

ICAN was set up at the initiative of International Physicians for the Prevention of Nuclear War (IPPNW) in 2007 with 468 partners and has been consistently working for a nuclear weapon free world. ICAN was officially launched in Vienna, Austria, in April 2007 during the Non-Proliferation Treaty preparatory committee meeting. As a result of continuous work since then, in the form of lobbying with governments in many countries and ICAN partners building public opinion in their respective countries, the UN General Assembly passed a resolution on July 7, 2017, by 122 votes in favour and only one against, declaring nuclear weapons illegal (1). This is indeed a big achievement which drew global attention and was recognised by the Nobel Peace Prize Committee by its award of the Nobel Peace Prize. The major thrust of ICAN’s work was the catastrophic humanitarian impact of nuclear weapons and the urgent need to prohibit and then abolish them (3).

While hundreds of millions of people across the globe go hungry, the nuclear-armed nations spend close to US$300 million (Rs.2000 crores) a day on their nuclear forces (4). The production, maintenance and modernisation of nuclear forces diverts vast public resources away from healthcare, education, climate change mitigation, disaster relief, development assistance and other vital services. Globally, annual expenditure on nuclear weapons is estimated at US$ 105 billion – or $ 12 million an hour (4). The World Bank forecast in 2002 (4) that an annual investment of just US$ 40–60 billion, or roughly half the amount currently spent on nuclear weapons, would be enough to meet the internationally agreed goals for poverty alleviation. Nuclear weapons spending in 2010 was more than twice the official development assistance provided to Africa and equal to the gross domestic product of Bangladesh, a nation of some 160 million people. The Office for Disarmament Affairs – the principal UN body responsible for advancing a nuclearweapon- free world – has an annual budget of $10 million, which is less than the amount spent on nuclear weapons every hour. As former UN Secretary General Ban Ki-Moon said:

“The world is over-armed and peace is under-funded …. The end of the cold war has led the world to expect a massive peace dividend. Yet, there are over 20,000 nuclear weapons around the world. Many of them are still on hair-trigger alert, threatening our own survival.” (5)

As per the latest report of Stockholm International Peace Research Institute (SIPRI) the annual global defense expenditure is 1699 billion USD (2.2 % of the global GDP). The US tops the defense spending at 611 billion USD. China’s defense expenditure is 215 billion USD, while India is the 5th largest military spender with an outlay of 55.9 billion USD (Rs.363350 crore) (6). India’s defense expenditure is 1.62 % of its GDP, while its central health budget is 0.26 of GDP, six times less than its arms budget. Pakistan’s budgetary allocation on arms is over 8 billion USD (7). With an economy that is worth 300 billion USD this takes Pakistan’s defence expenditure to 2.9% of its GDP (8).

These data clearly indicate the looming threat over mankind’s continued existence at a time when several parts of the world have serious conflict zones, many of them directly involving nuclear weapons states. Any use of nuclear weapons intentionally, or unintentionally would have extremely grave ramifications for the life system as a whole. Even without using these weapons, their production and maintenance costs are depriving millions of health, education and other basic needs. For countries like India and Pakistan, the situation is even graver as we are already among the most deprived regions in the world with poor human development and hunger indices. India, with a glorious past of promoting non-violence, should take the lead and convince other nuclear weapons-possessing countries to join the treaty prohibiting nuclear weapons and then make a concrete plan to abolish these weapons.

It is unfortunate that the nuclear weapon-possessing countries have not joined the treaty. It is high time that we come forward to build strong public opinion in these countries to work for health instead of mutually assured destruction. Doctors owe a special responsibility in this case as it is our ethical, professional and moral duty to prevent war and violence.