The world urgently needs to change course
MAY 5, 2023
The following Congress Declaration was published at the conclusion of IPPNW’s 23rd World Congress in Mombasa, Kenya, 27-29 April 2023.
We are honored to gather in Mombasa, one of Africa’s oldest and most historic cities, for the first IPPNW World Congress on the continent. As physicians, medical students, and health professionals committed to a peaceful and equitable world for all people, we join in solidarity with our African colleagues, who struggle on many fronts to erase the vestiges of colonialism, to end the post-colonial conflicts that have killed millions, and to advocate for policies that will provide health, true security, economic justice, and environmental protection not only for Africa but also for the world as a whole.
We regret, therefore, that Sudan’s hard-won progress toward democratically elected governance has faced a violent setback in just the past few weeks, and we endorse the calls of the African Union and other world leaders for an immediate ceasefire. At the same time, Sudan is embroiled in only one of dozens of ongoing armed conflicts in Africa that must come to an end. Civil society, here as elsewhere, plays an essential peace-making role, and we applaud our affiliates in the region for their efforts to bring peace and security to Sub-Saharan Africa over many years. We also thank them for hosting this 23rd World Congress and for the steadfast leadership they have provided to the federation as a whole.
The world in 2023 faces twin existential crises that have been exacerbated by a global pandemic from which we have yet to fully recover. We are at greater risk of nuclear war than at any time since the Cold War of the 1980s. And the accelerating pace of the climate crisis, driven by carbon emissions from the unchecked burning of fossil fuels, is bringing extreme weather events, agricultural disruption, rising sea levels, and vector-borne diseases to every corner of the world. The millions of deaths from Covid-19 over a two year-period not only tested the global capacity to deal with a public health emergency on such a vast scale, but also exposed the inequities in access to vaccines and treatments between wealthy and struggling nations. Unsurprisingly, the Doomsday Clock has recently been reset to 90 seconds before midnight, the closest it has ever been to global catastrophe.
The tragic invasion of Ukraine, now in its second year, has already claimed tens of thousands of Ukrainian and Russian lives, including more than 20,000 civilian casualties and several million displaced to other countries. The repercussions of the war for the world economy, including shortages of grain and other commodities, have been enormous. With more than 110 ongoing armed conflicts in the world today—more than 35 of them in Sub-Saharan Africa alone—we are reminded again that war and military actions are always unacceptable anywhere in the world.
Yet the severe global impacts of a war that has brought Russia into direct conflict with the US and NATO pale by comparison to what would happen if the nuclear threshold were crossed. Whether they are used in Ukraine, in South Asia where two nuclear-armed states, India and Pakistan, have fought four full-fledged wars, or during any other conflict, the use of nuclear weapons, for whatever reason, would almost certainly escalate into a nuclear war that would kill millions of people outright. Nuclear war would cause a climate disaster of another kind, plunging the world into a nuclear winter where agriculture would collapse and food scarcity would threaten billions of people with starvation, no matter how far removed they were from the conflict itself.
While nuclear war poses the most acute risk to the stable and hospitable climate we need, global heating from fossil fuel consumption is already increasing food and water insecurity, and has diminished the habitability of whole regions through sea level rise, extreme weather events, drought, flooding and intolerable heat. These rapid changes to the world’s climate are driving population displacement and increasing the prevalence of armed conflict. Each of these conflicts that involves a nuclear-armed state increases the risk of nuclear war, closing the circle of existential threats.
Nuclear power, which is an expensive, ineffective, and dangerous response to the climate crisis, also fuels nuclear proliferation by inextricably increasing fissile materials and the capacity to produce them. As we are seeing in Ukraine, nuclear power reactors are vulnerable military targets—essentially huge, pre-positioned radiological disasters-in-waiting. Misplaced investments in nuclear power, besides exacerbating this danger, delay the rapid scale-up of renewable energy, increased energy efficiency, and energy storage.
Military and nuclear weapons spending divert massive resources and create enormous opportunity costs that diminish and delay climate action and also steal resources from many other areas of human and environmental need, including health, shelter, and education. Militarization and armed conflict fuel tensions that diminish international cooperation in many areas, including climate action and disarmament.
We urgently need to change course if we are to avoid the catastrophic consequences of either a nuclear war or an environmental collapse. The diplomatic and political processes that produced the Treaty on the Prohibition of Nuclear Weapons (TPNW) showed the world that a well-organized group of non-nuclear-armed nations, armed instead with scientific evidence and medical expertise about nuclear weapons and nuclear war, and supported by an informed and energized civil society, could effectively make the case that possession of nuclear weapons is illegitimate and that nuclear deterrence is not only foolhardy, but also immoral.
African states paved the way for this humanitarian disarmament process when they adopted the Pelindaba Treaty, which entered into force in 2009, making Africa a nuclear-weapon-free zone. African states and civil society organizations, fully aware that they would suffer from the catastrophic consequences of a nuclear war anywhere in the world, especially the climate consequences, helped to drive the ban treaty process and the negotiations that produced the treaty text. We are proud to recall that in July 2015, an international team of IPPNW medical students, young doctors, and other activists climbed to the summit of Mt. Kilimanjaro, the world’s highest free-standing mountain, to raise awareness about the humanitarian and health effects of nuclear weapons and uranium mining in Africa.
The TPNW has already been signed by 33 African states, 15 of whom have joined as states parties. As we convene in Mombasa, we urge the Kenyan government to sign the Treaty and complete its ratification as soon as possible. All other states that have not yet joined the Treaty should do so and work actively to implement its prohibitions against nuclear weapons and other provisions, in order to hasten the day when they have been completely eliminated from the world’s arsenals.
As health professionals, we learned decades ago that there can be no medical response to a nuclear war. We are now learning that our capacity to respond effectively to extreme public health emergencies precipitated and multiplied by human-caused alterations to the world’s climate, is being severely tested. Moreover, those who are most vulnerable to the effects of the climate crisis are most often those without the resources to mitigate the harm. We see this in Africa and other parts of the post-colonial world, where access to technology, health care and basic services are inadequate at best, and where wealthy nations continue to exploit disadvantaged countries for resources, such as uranium for nuclear weapons.
Our responsibility is to prevent what we cannot cure. IPPNW rededicates itself at this 23rd World Congress, in Mombasa, Kenya, to a habitable world free from the threat of nuclear extinction and climate catastrophe.