Russia’s invasion of Ukraine: We need a non-militarised response


Medact members have called for a non-militarised response to Russia’s aggression in Ukraine, rejecting calls for increased UK military spending.

Responding to an article in the BMJ by Martin McKee which said that we “cannot call for more money to prevent threats from microorganisms but criticise spending to protect against actions by hostile states“, members of Medact’s Arms & Militarisation Group joined the call for a ceasefire in Ukraine, but also called for a new non-militarised paradigm of security, as well as a reduction in arms sales and investment in health, education and social welfare. You can read their letters in full below.

We need a new non-militarised security paradigm in response to wars

Dear Editor

We note with concern that in the article published 2 March 2022 entitled ‘Russia invades Ukraine again: how can the health community respond?’ Professor Martin McKee supports an increase in defence spending.

We write on behalf of the Nuclear Weapons Group of Medact which is the UK affiliate of International Physicians for the Prevention Nuclear War (IPPNW), winners of the Nobel Peace Prize in 1985. It is also an affiliate of the International Campaign to Abolish Nuclear Weapons (ICAN), winner of the Nobel Peace Prize in 2017.

We admire the work of Professor McKee to draw attention to the public health implications of the war in Ukraine and we agree with his analysis of public health ramifications regarding Ukraine, Covid 19, polio, mental health and agricultural disruptions. We strongly endorse his call for an immediate ceasefire.

We, however, respectfully disagree with his following point:

‘The end of the cold war brought a financial dividend as defence budgets were cut. However, it is now clear that in many cases this went too far, and, as in Germany, spending is likely to rise substantially. We cannot call for more money to prevent threats from microorganisms but criticise spending to protect against actions by hostile states.’

We are concerned that such increased military spending could all too easily escalate. A new cold war or potentially worse situations involving further wars could lead to scenarios involving nuclear weapon use. And nuclear weapon use is never acceptable and must be avoided.

The major threats to our security involve global issues, such as the climate crisis and lack of pandemic vaccine justice. Addressing them in a meaningful fashion requires diverting money away from arms budgets to climate change mitigation and health budgets. While declaring a ‘climate emergency’ the UK government spending on carbon reduction is less than half the increase in military spending in the recent Integrated Strategic Defence and Security Review. And ‘European NATO members already spend almost 5 times as much as Russia on their militaries’.

The UK is already the second largest arms dealer in the world and arms manufacturers and dealers view this war, and all wars, as huge opportunities for vast profit. The only real winner in the war is and will be the arms companies.

It is so very important to offer a public health perspective about the war – and Professor McKee’s voice is valued and respected. We, however, found it disappointing that he did not mention the greatest potential public health risk of the war: the possible escalation to the use of nuclear weapons. As in other cases in medicine we must prevent what we cannot cure, and the use of nuclear weapons is the most pressing example of that.

There is no possible way to have a meaningful medical response to the use of even one nuclear bomb as the Journal of Public Health published in 2020 made clear. A limited war risks famine killing 2 billion people. A likely escalation to full nuclear war risks the end of our civilisation. A needed ceasefire now, yes, and real negotiations. However also needed now is recognition that for most countries, nuclear weapons already are illegal under international humanitarian law and pressure should now be put on the UK government to attend the meeting of nuclear ban treaty states’ parties in Vienna in June.

As the World Health Organisation has stated, nuclear weapons pose the greatest immediate threat to human health and welfare. They are primed to unleash a final epidemic for which there could be no effective treatment. These warnings have been echoed by the Bulletin of the Atomic Scientists, the International Campaign to Abolish Nuclear Weapons (ICAN) and the International Committee of the Red Cross. We need a new non-militarised paradigm of security.

Yours sincerely,

Michael Orgel, MD

01 April 2022
Michael G Orgel
NHS Medical Doctor (retired from clinical practice)
Medact Nuclear Weapons Group

Re: Russia invades Ukraine again: how can the health community respond?Health professionals and military expenditure

Dear Editor,

I agree with the authors re the threat to public health from the Russian invasion of Ukraine. However, I cannot agree with the suggestion that as health professionals, we should support an increase in military expenditure. Global military expenditure was estimated as $1981 billion in 2020 by the Stockholm Institute of Peace Research, an increase of 2.6% from 2019 [1]. That is equivalent to $250 for every individual on the planet. The UK increased its military expenditure by 2.9% in 2020 and is planning to renew Trident (nuclear weapons) at an estimated cost of £200 billion. Nuclear weapons have rightly been declared illegal by the UN. After armed conflict, small arms remain in the community and result in significant mortality and morbidity, especially on children and young people [2]. At present, over half a million small arms are produced each year [2].

We need an immediate ceasefire in the Ukraine, but also in the Yemen and other areas of armed conflict.

As health professionals, we should support the call for a global peace dividend, whereby ALL member states reduce military expenditure [1]. This call by world leaders and more than 50 Nobel laureates is more important than ever. Unfortunately, politicians throughout the world will use the war in the Ukraine as a justification for producing more weapons on a planet that already has over 100 million AK-47 assault rifles [2]. As health professionals, we should call for a reduction in arms sales and investment in health, education and social welfare.


  1. Choonara I. Global peace dividend and child health.BMJ Paediatrics Open 2022;6:e001442. doi: 10.1136/bmjpo-2022-001442
  2. Feinstein A, Choonara I. Arms sales and child health. BMJ Paediatr Open. 2020;4:e000809. Published 2020 Sep 9. doi:10.1136/bmjpo-2020-000809

24 March 2022
Imti Choonara
Retired paediatrician
University of Nottingham
Dept of Child Health, Derby Medical School,University of Nottingham