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Editorials

Staring into the abyss: walking the nuclear tightrope in south Asia

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7155.363 (Published 08 August 1998) Cite this as: BMJ 1998;317:363

Sanctions can only make things worse for the people of India and Pakistan

  1. Zulfiqar Ahmed Bhutta, Professor of paediatrics and child health (zulfiqar.bhutta{at}aku.edu)
  1. The Aga Khan University, PO Box 3500, Karachi 74800, Pakistan

    Pokaran and Chagai, two remote wastelands in India and Pakistan, convulsed painfully under the impact of 11 nuclear explosions in May this year, as both countries overtly crossed the nuclear threshold. In the weeks that followed the widespread euphoria and irresponsible jingoism witnessed in the streets of Delhi and Islamabad has given way to introspection and the beginnings of a real debate on the implications of a nuclear arms race in the subcontinent.

    Although the genie of nuclear capability in both countries has been well and truly let out, it is imperative that India and Pakistan refrain from embarking on a nuclear weapons build up. It may already be too late to prevent such a build up, but there are several compelling reasons why such a programme in the subcontinent may not serve as a real deterrent to war but greatly enhance its risks and costs.

    The analogy with the nuclear stalemate between the United States and the Soviet Union is misguided, as neither India nor Pakistan possesses the technology or resources for the requisite safeguards and early warning systems that the United States and Soviet Union eventually established. Even if such fail safe systems were available, contiguous borders and missile delivery times of under 10 minutes, coupled with fragile democracies and volatile political systems, make the effectiveness of such systems highly questionable.

    Despite sophisticated systems of command and control, the cold war was fraught with numerous instances of near miss accidents, and a recent analysis suggests that the risk of accidental nuclear conflict may have actually increased since the breakup of the Soviet Union.1Despite claims of safety, significant radiation leakage has resulted from accidents involving nuclear weapons and production facilities in the West 2 3 and it is debatable if the fragile economies of India and Pakistan could sustain better weapons manufacturing, control, and monitoring systems. In the aftermath of the chemical disasters in Bhopal (India)and Seveso (Brazil) some have asserted that the sociopolitical turmoil and unstable economic structures make developing countries considerably more vulnerable to industrial accidents.4

    More importantly, the enormous costs of nuclear weapons must be weighed against the abysmal state of human development and health in south Asia. Both India and Pakistan have some of the highest rates for maternal and infant mortality in the world.5 Of every 1000 children born in these countries, at least 80 will not live to see their first birthday.6Between 20% and 33% of all newborn infants are of low birth weight,7 and the region boasts over half of all the malnourished children in the world.8 These horrifying health indicators, coupled with lack of basic facilities for health and education, make the diversion of scarce economic resources to weapons of mass destruction even more incongruous. Since the nuclear explosions India's defence budget has already been increased by 10% and Pakistan has imposed a 10% tax surcharge to meet increasing defence needs. These allocations have led to an unfortunate but predictable reduction in the existing meagre allocations to health and education.9

    Few among the unruly mobs celebrating in the streets of Delhi and Islamabad truly appreciate the horrors of nuclear war and the futility of available measures aimed at reducing the costs of nuclear conflict. The shocking calculations of the human costs of such an exchange, highlighted over 36 years ago,10not only still hold true, but are amplified severalfold by the growing sophistication of weapons design and burgeoning urban populations. In a hypothetical calculation of the impact of a 20 megaton ground burst nuclear device in Boston, USA, Ervin et al estimated that 2.1 million residents would perish and a further 0.5 million would be at risk of dying subsequently from major injuries.10With large urban populations living in highly inflammable and flimsy shanty towns, the casualty rates in comparable cities of India and Pakistan would inevitably be much higher. It is estimated that an exchange of much smaller (20 kilotons) nuclear devices between India and Pakistan would cause at least 1.2 million immediate deaths, with many more succumbing later from the effects of fall out and lack of medical facilities.11

    Neither side would be immune to the effects of even a limited nuclear exchange: a truly mutually assured destruction. The only way to ensure that such a conflict never occurs is by educating the populace and opinion leaders to the true horrors of nuclear conflict and the human costs of embarking on an expensive and futile programme of weapons building.

    In a subcontinent teetering on the brink of a nuclear abyss, a rapprochement between India and Pakistan can be achieved only by pragmatic confidence building measures12and by publicising the views of the many proponents of peace on both sides of the border. 13 14 It should dawn on politicians in both countries, asserting their right to rub shoulders with global nuclear superpowers, that true nuclear capability only comes with the necessary “nuclear responsibility,” a responsibility to their impoverished, destitute, and sick populations and to a world already made unsafe by stockpiles of nuclear, chemical, and biological weapons.

    Nor do the old nuclear powers hold any sort of moral high ground‐with their continued nuclear weapons programmes and a pitifully slow disarmament process. Surely some of the blame for recent events in south Asia lies at their doorstep. Given this failure of the leading nuclear powers to set an example by getting rid of their own nuclear arsenals, it is imperative that international sanctions against India and Pakistan do not add to the misery of millions of children and poor people in the subcontinent, who will undoubtedly bear the brunt of such measures

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