“Do not let the nuclear armed states lead us down the path to death.”

EDITOR'S INTRODUCTION: Dr. Ira Helfand delivered a compelling statement on behalf of International Physicians for the Prevention of Nuclear War (IPPNW) at the Third Preparatory Committee for the 2026 Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) at the United Nations Headquarters in New York City, 30 April 2025. He concluded the statement with a call to action: "The world is at a crossroads.  We have before us the choice of life or death.  Do not let the nuclear armed states lead us down the path to death." 

Having worked in emergency medicine, Dr. Helfand knows that there will not be enough - if any at all - emergency rooms, let alone burn unit beds, should even a "limited" nuclear war break out. The (initial) survivors will be on their own, and they will envy the dead! It is not a matter of if, but when, humanity suffers what will be the final war, so long as countries continue to brandish nuclear weapons. The U.S. is building up its nuclear arsenal once again, setting the (wrong) example for other countries, rather than leading the way to a world without the threat of nuclear war. 

Will we choose life... or death???

This statement was originally published on April 30, 2025 at the IPPNW Peace & Health Blog. Dr. Helfand is an IPPNW Board Member.

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Distinguished delegates, esteemed colleagues, and honored guests,

Dr. Ira Helfand delivering IPPNW’s statement to the 2025 NPT Preparatory Committee

Thank you for the opportunity to speak with you today. I am not a diplomat. I am an Emergency Room doctor who has spent the last 50 years speaking with patients and their families. So let me talk to you now as I would to the family of a critically ill patient.

Because that is the situation we face. The world, for which we are collectively responsible, is in terrible danger. Nine countries, five of them parties to this Treaty, have chosen to build arsenals of nuclear weapons that effectively hold all of humanity, including their own citizens, hostage. They want these weapons because they make them strong and allow them to bully the rest of the world. They justify these weapons with the illusion that they offer security. That is a dangerous lie. These weapons are the greatest threat to our survival and pose an existential threat to civilization.

Like the chronic smoker who lives in denial about the risk of developing lung cancer, we have largely convinced ourselves that nuclear war will never happen. The truth is, we are closer to a nuclear war today than we have ever been and, yet, we go about our daily life as though this sword of Damocles were not hanging over us.

Studies show that a large-scale nuclear war between the United States and Russia, who together possess nearly 90% of the world’s nuclear weapons, would end life as we know it. Most of this city, including this very building we are sitting in, would be vaporized and 12 to 15 million people would simply disappear. Across both countries, an estimated 200-300 million people would be killed in the first half hour. Survivors would be left in a radioactive waste field with no electric grid, no internet, no cell phones, no health care, no food distribution system, no banking system, and no system for maintaining law and order. In the following months, most of those who initially survived would die—from radiation poisoning, epidemic disease, exposure, and starvation.  

But this is only part of the story. The impacts of this war would ripple far beyond the borders of the US and Russia. The enormous fires that consumed the cities of Russia and America would loft millions of tons of soot into the upper atmosphere, blocking out the sun and causing global temperatures to plummet by an average of 10 degrees C. In the interior regions of North America and Eurasia temperatures would drop 25 to 30 degrees C. We have not seen temperatures that cold since the last Ice Age. 

Under these conditions, ecosystems that have evolved since the end of that Ice Age will collapse; food production will stop and, according to a landmark study published in 2022, 6 billion people, three quarters of humanity, will starve in the first two years. The study stopped at 2 years. The famine would not, and we do not know what the ultimate death toll will be. That same study showed that a much smaller-scale war, such as one between India and Pakistan, will cause enough climate disruption to trigger a famine that will kill a quarter of humanity—2 billion people globally in the first 2 years.

The nuclear powers assure us that this will never happen — that deterrence will prevent nuclear weapons from ever being used. They push this myth even as they threaten to use these very weapons.

But the truth is that nuclear weapons do not possess some magical power that guarantees they will never be used. In fact, there have been numerous incidents throughout the nuclear weapons era when we have come within minutes of the holocaust I have just described. We have not survived because deterrence works, because our leaders have been all wise, our military policies and doctrines sound and our technology perfect. We have survived, to use the words of former US Defense Secretary Robert McNamara, because, “We lucked out…It was luck that prevented nuclear war.”

Five of the nine nuclear powers have a binding obligation under Article VI of this Treaty to engage in good faith negotiations for the elimination of nuclear weapons. Yet they have ignored this obligation for nearly 6 decades. The US and Russia have actually gone further by abandoning every nuclear arms control agreement except for New START, and that will expire next February. These failures, taken together with the destabilizing and deadly wars in Ukraine and Gaza, are causing some non-nuclear parties to the NPT to seek access to nuclear weapons. 

When 121 non nuclear nations came together to uphold Article VI and negotiated the Treaty on the Prohibition of Nuclear Weapons (TPNW), the nuclear armed states chose not to join that historic effort but to boycott the negotiations and do everything they could to undermine the new Treaty using the bizarre claim, straight out of 1984’s Ministry of Truth, that the TPNW “undermined” the NPT. This review conference needs to call out their horrific failure to honor their Article VI obligations. The N-9 should address any concerns with the TPNW by meaningfully engaging with States Parties and joining the Treaty’s official proceedings. 

They must come together, agree to a detailed timetable to eliminate their nuclear arsenals, adhere to the TPNW’s provisions, and join the Treaty at the earliest possible date. 

The world is at a crossroads.  We have before us the choice of life or death.  Do not let the nuclear armed states lead us down the path to death.

“Historic” U.N. Vote for Nuclear Weapons Ban

EDITOR'S NOTE: The United Nations General Assembly voted yesterday to move forward to negotiate a total ban on nuclear weapons. This is a historic vote, and is the beginning of a global effort to finally move past the archaic stonewalling of the nuclear-armed nations that has made a sham of treaty obligations (e.g., the Treaty on the Non-Proliferation of Nuclear Weapons). The following news release from the Institute for Public Accuracy contains an analysis of the vote by Ira Helfand, past president of Physicians for Social Responsibility and current co-president of International Physicians for the Prevention of Nuclear War. Time to move forward!!!

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AP reports: “United Nations member states voted overwhelmingly on Thursday to approve a resolution calling for negotiations on a treaty that would outlaw nuclear weapons, despite strong opposition from nuclear-armed nations and their allies.

“The vote in the U.N. disarmament and international security committee saw 123 nations voting in favor of the resolution, 38 opposing and 16 abstaining.

“The resolution was sponsored by Austria, Brazil, Ireland, Mexico, Nigeria and South Africa.

“The United States, Russia, Israel, France and the United Kingdom were among the countries voting against the measure.

“The resolution now goes to a full General Assembly vote sometime in December.”

IRA HELFAND, MD, @IPPNW
    Helfand is past president of Physicians for Social Responsibility and is currently co-president of that group’s global federation, the International Physicians for the Prevention of Nuclear War, recipient of the 1985 Nobel Peace Prize.

Helfand said today: “In an historic move the United Nations First Committee voted Thursday to convene a conference next March to negotiate a new treaty to ban the possession of nuclear weapons. The vote is a huge step forward in the campaign to rid the world of nuclear weapons launched several years ago by non-nuclear weapons states and civil society from across the globe.

“Dismayed by the failure of the nuclear weapons states to honor their obligation under Article VI of the Non-Proliferation Treaty which requires them to pursue good faith negotiations for the elimination of their nuclear arsenals, and moved by the growing danger of nuclear war, more than 120 nations gathered in Oslo in March of 2013 to review the latest scientific data about the catastrophic consequences that will result from the use of nuclear weapons. The conference shifted the focus of international discussion about nuclear war from abstract consideration of nuclear strategy to an evaluation of the medical data about what will actually happen if these weapons are used. It was boycotted by all of the major nuclear powers, the U.S., Russia, UK, China and France, the five permanent members of the U.N. Security Council, or P5.

“Further meetings in Nayarit, Mexico and Vienna followed in 2014 and culminated in a pledge by the Austrian government to ‘close the gap’ in international law that does yet specifically outlaw the possession of these weapons. More than 140 countries ultimately associated themselves with the pledge which was fiercely opposed by the United States and the other nuclear weapons states, and in the fall of 2015 the U.N. General Assembly voted to establish an Open Ended Working Group which met in Geneva earlier this year and recommended the negotiations approved Thursday.

“The United States, which led the opposition, had hoped to limit the ‘Yes’ vote to less than one hundred, but failed badly. The final vote was 123 For, 38 Against and 16 Abstentions. The ‘No’ votes came from the nuclear weapons states, and U.S. allies in NATO, plus Japan, South Korea and Australia, which have treaty ties to the U.S., and consider themselves to be under the protection of the ‘U.S. nuclear umbrella.’

How the nations voted

“But four nuclear weapons states broke ranks, with China, India and Pakistan abstaining, and North Korea voting in favor of the treaty negotiations. In addition, the Netherlands defied intense pressure from the rest of NATO and abstained, as did Finland, which is not a member of NATO but has close ties with the alliance. Japan which voted with the U.S. against the treaty has indicated that it will, nonetheless, participate in the negotiations when they begin in March.

“The U.S, and the other nuclear weapons states will probably try to block final approval of the treaty conference by the General Assembly later this fall, but, following Thursday’s vote, it appears overwhelmingly likely that negotiations will begin in March, and that they will involve a significant majority of U.N. member states, even if the nuclear states continue their boycott.

“The successful completion of a new treaty will not of itself eliminate nuclear weapons. But it will put powerful new pressure on the nuclear weapons states who clearly do not want to uphold their obligations under the Non-Proliferation Treaty even as they insist that the non-nuclear weapons states meet theirs.

“We have come perilously close to nuclear war on multiple occasions during the last 70 years, and we have been incredibly lucky. U.S. nuclear policy cannot continue to be the hope that we will remain lucky in the future. We need to join and lead the growing movement to abolish nuclear weapons and work to bring the other nuclear weapons states into a binding agreement that sets out the detailed time line for eliminating these weapons and the detailed verification and enforcement mechanisms to make sure they are eliminated.

“This will not be an easy task, but we really have no choice. If we don’t get rid of these weapons, someday, perhaps sooner rather than later, they will be used and they will destroy human civilization. The decision is ours.”