Nuclear Weapons and Neglected Diseases: The “Ten-Thousand-to-One Gap”

Together, the world’s eight acknowledged nuclear powers—the United States (US), Russia, United Kingdom (UK), France, China, India, Pakistan, and the Democratic People’s Republic of Korea (North Korea)—have amassed an arsenal of almost 30,000 nuclear weapons since 1945. In addition, Israel is believed to be a nuclear power while Iran (and possibly Syria as well) is also suspected of developing nuclear weapons. Despite the technological sophistication that has enabled the 11 nuclear weapons states to produce and deliver nuclear bombs, most of these nations simultaneously also suffer from high internal rates of poverty and endemic neglected diseases. They include high prevalence rates of neglected tropical diseases in India, China, Pakistan, Iran, and Syria, and related neglected infections of poverty in the US and Europe. Indeed, the 11 nuclear weapons states together account for up to one-half of the global disease burden from all neglected diseases. However, for a tiny fraction (less than 1/10,000) of the costs of producing and maintaining a nuclear arsenal the 11 nuclear powers could eliminate most of their neglected diseases and engage in joint neglected disease research and development efforts that help to reduce international tensions and promote world peace. Shown in Table 1 and Figure 1 are the 11 established and suspected global nuclear powers. Following the development and deployment of the atomic bomb by the US in 1945 (at an estimated cost of US$20 billion), Russia became the second nuclear power in 1949, and in every decade since then at least one new country has joined the nuclear club [1,2]. In addition three countries, South Africa, Argentina, and Brazil, began active nuclear weapons programs, but subsequently abandoned them by mutual treaty [1]. Today, only the first five nations to produce nuclear weapons,,the US, Russia, UK, France, and China, have signed the nuclear nonproliferation treaty [1]. The costs to maintain these nuclear arsenals are staggering. According to the Brookings Institution, which in 1998 published their US Nuclear Weapons Cost Study Project, the US alone spent $35 billion that year on nuclear weapons technology [2]. Further estimates indicate that the US may have spent more than $5.5 trillion in developing their nuclear arsenal, while France has invested approximately $1.5 trillion [3]. Although the data are unavailable, the costs for other nuclear weapon states are believed to be similar [3]. Therefore it is likely that the 11 nuclear weapons states together have invested at least $10 trillion on weapons production and maintenance. Despite this massive expenditure, each of the 11 nuclear weapons states, with the possible exception of the U.K., also suffers from high rates of neglected tropical diseases (and related neglected infections of poverty), defined as chronic and debilitating parasitic and other infectious diseases that occur in association with extreme poverty [4]. In addition to their health effects, the neglected tropical diseases also cause poverty through their ability to impair child physical and intellectual development, pregnancy outcomes, and worker productivity, while simultaneously promoting conflict and war through their agriculturally and socially destabilizing effects [4,5]. Although it is common to think of neglected diseases as confined to low-income countries in sub-Saharan Africa, Southeast Asia, and Latin America, as shown in Table 2 these infections also exhibit a high prevalence in middle-income countries such as China, India, Pakistan, North Korea, Iran, and Syria, as well as in selected areas of poverty found in the US, Russia, and Eastern Europe [6]. Indeed, with the possible exceptions of the UK, high neglected disease burdens are present in all of the nuclear weapons states, particularly the helminth infections, leishmaniasis and Chagas disease, toxoplasmosis, and trachoma.