Today is the centenary of the end of the most devastating humanitarian catastrophe the world had hitherto ever seen, in which at least 20 million people were killed and over 21 million wounded. The notorious global influenza epidemic which was encouraged by wartime and post-war conditions lasted into 1919 and killed 50 to 100 million people.

We, as health professionals in Medact, join our colleagues in IPPNW in warning humankind of the risk of a humanitarian catastrophe on an even greater scale. This is because the US Administration plans to abrogate the Intermediate-Range Nuclear Forces (INF) treaty. The political restraint currently holding the signatories to the treaty would be reversed and the hard-earned benefits replaced by a resurgent nuclear arms race making a full-scale nuclear conflict much more likely. Widespread urban destruction would result in vast environmental contamination, billions of fatalities and billions of casualties for whom medical aid would be unavailable. Survivors – if any – would die in vast numbers over the following years, from famine brought on by massive crop failures due to the nuclear detonations throwing millions of tons of soot and dust into the atmosphere worldwide and blocking sunlight. As a result, humankind could become extinct.

Today’s successors to the INF treaty (signed by the US and the USSR in 1987) continue to hold the vast majority of the world’s nuclear arsenal. The treaty was intended to reduce the risk of nuclear war in Europe and, in the succeeding decades, successfully eliminated land-based US and Soviet/Russian nuclear and conventional short- and medium-range missiles. A significant easing of international tension followed and was sustained through the early years of the Russian Federation which inherited the Soviet nuclear system. Although more recently each party has strategically tested the political efficacy of the treaty, it has continued to be an essential factor in retarding nuclear proliferation – until the US stated, on 20th October 2018, its intent to abrogate it.

A safer world would come about if each party to the INF treaty strived for an effective well-planned process to eliminate the provocative desire to possess nuclear weapons. We need a STRONGER bilateral INF, not its abrogation. Such would bring honour to its co-signatories and encourage other nuclear-weapon-possessing States to meaningful disarmament. Mechanisms to achieve this are available via the Nuclear Non-Proliferation Treaty of 1968 and the 2017 Treaty on the Prohibition of Nuclear Weapons.