Nuclear weapons proliferation, medicine's supreme challenge.

Nuclear proliferation, because of its ability to threaten human survival, is fast coming to overshadow all other global issues.1-7 When the renowned explorer Jacques-Yves Cousteau addressed the UN General Assembly in 1976 he observed that atomic power had "reshaped what we may fear, what we may dream, how we live and how we may die." He was emphasising as many before him had done that since August 1945, when the 14-kiloton uranium bomb Little Boy was unloaded over Hiroshima reputedly killing 100 000 people and destroying 60 000 buildings, a totally different world had come into being. The nuclear Pandora's box was now unlocked, and as a result mankind had acquired for himself an altogether novel potential for self-destruction. Since 1945 the earth's nuclear arsenals have expanded enormously. They are now believed to contain 60 000 weapons, both strategic and tactical, and to possess more than one million times the power of the Hiroshima bomb.8 9 Both superpowers have an overkill capacity that can only be described as daunting. Thus in the early 1970s it was estimated that the USA had enough strategic weapons to destroy 50 times over every Soviet city with a population of 100 000, while the USSR had the ability to raze American cities of comparable size 20 times over.1 In the SALT II Agreement of Vienna 1979 strategic force numbers were to be allowed to build up to the following totals in the mid-1980sl' 01 (J Erckson, personal communication). In the case of the USA the total number of launchers (1054 inter-continental ballistic missiles, 656 submarine-launched ballistic missiles, and 390 bombers) would be 2100: total warheads would be 9854 and total megatonnage 3178-5. When the Trident I submarine-launched ballistic missile, short-range attack missiles, and air-launched cruise missiles were added, totals would be 2180 launchers, 736 SLBMs, 13 904 warheads, and 3332-5 megatons. On the Soviet side the assumption was of a build-up to SALT II levels with the addition of the Backfire (TU-22M) bomber, and at the Vienna meeting Leonid Brezhnev confirmed that the production of this bomber would not exceed 30 a year. For the USSR the intercontinental ballistic missile total was to be 1328, submarine-launched ballistic missiles 1003 (955 covered by the SALT Agreement), the launcher total 2438, warheads 8294, and the megatonnage 10 111. Weapons are constantly being improved, modified, and upgraded. The USA is currently concentrating on its interconti-nental ballistic missile …