Four years ago Zulfiqar Ahmed Bhutta, a professor of paediatrics from Karachi, argued in the BMJ about the dangers of Pakistan and India crossing the nuclear threshold by testing nuclear weapons (1998;317:363). Then he argued that India and Pakistan had volatile political systems and none of the safeguards that the first nuclear powers, America and the Soviet Union, had built up to prevent them using their weapons. Earlier this year Bhutta joined forces with Samiran Nundy, a surgeon from New Dehli, to warn of the particular risks of nuclear conflict in the subcontinent (2002;324:356). This week (p 1405) Bhutta …