WMD in Ukraine: a planetary near-death experience

The war in Ukraine is now in its fifth month and, while the brutal toll of military and civilian casualties continues to climb, the territorial lines have become increasingly static, with mostly incremental gains by Russian forces in Ukraine’s eastern Donbas region. We continue to learn of human rights violations, from intentional targeting of civilians and civilian infrastructure to deportation of Ukrainian civilians into Russia.

Despite the devastation that has taken place, fears persist about further catastrophe resulting from the Kremlin’s potential use of weapons of mass destruction (WMDs). As medical doctors with expertise in the effects of WMDs, we take these fears seriously.

The invasion of Ukraine is led by Russian military strategists trained during the Soviet era, when military doctrine identified settings where chemical, biological and nuclear weapons of mass destruction would meet strategic objectives. This deadly portfolio included 45,000 scientists working with adapted pathogens and biological toxins for use in airborne release, stand-off artillery or intercontinental ballistic missiles. Former bio-weaponeers have disclosed to our inspection teams that biological weapons were attractive to the Kremlin due to low cost, advantages in covert use and deniability. 

Russia’s active biological weapons R&D facilities — notably, its military biological research institute, Sergiyev Posad — remain both operational and off-limits to international weapons inspectors.

The grinding war in Eastern Ukraine is characterized by urban conflicts. These collapsed urban settings present huge logistical challenges to Russian ground forces. Russian military doctrine identifies these settings as ideal for the use of short-acting chemical weapons, as it did in support of Bashir al-Assad’s regime in Syria. From the standpoint of mass-casualty medical care, Ukrainian casualties resulting from the use of nerve or blister agents would be catastrophic. The medical care of blister, respiratory and nerve-agent casualties requires advanced medical facilities, novel therapeutics and uniquely skilled clinicians, all of which are in short supply right now in Ukraine.  

Our greatest hope, then, is prevention. The probability that Russia will use chemical weapons in Ukraine can be reduced by a layered strategy consisting of increased monitoring by the U.N.’s Organization for the Prevention of Chemical Weapons (OPCW) and by preemptive warnings from other nations that have ratified the chemical weapons convention. These signatory nations include two Russian allies, China and Belarus.

Beyond this, nuclear threats have been exchanged more than once since the beginning of the conflict. On Feb. 24, Russian President Vladimir Putin promised “consequences you have never faced in your history” to “anyone who tries to interfere with us,” and French Foreign Minister Jean-Yves Le Drian responded by saying Putin “must also understand that the Atlantic alliance is a nuclear alliance.” Many analysts interpret the Russian posture as reflecting a policy to “escalate to deescalate” — that the Russian military could use a tactical nuclear weapon to force negotiation if a conflict was not going well.

There are good reasons why tactical nuclear weapons have never been used, and why there was significant disinvestment from these weapons at the end of the Cold War.

Tactical nuclear weapons are defined by their short range and the idea that those would be used in a “battlefield” context, as compared to strategic nuclear weapons which are launched at an adversary’s population or military/industrial centers. However, the idea that these weapons are somehow more limited than strategic is a misunderstanding. Some tactical nuclear weapons in Russia’s arsenal have a yield less than a ton of TNT, but many have yields in the tens or even hundreds of kilotons, more powerful than the weapons that destroyed Hiroshima and Nagasaki. Using such weapons in a “battlefield” context would put one’s own military forces in harm’s way. And there is little basis to think that they would lead to negotiation rather than to further escalation to a broader nuclear exchange.

Nuclear weapons have the potential to turn an appalling situation into an apocalypse. A 2002 study showed that a large-scale nuclear attack by Russian forces on U.S. urban targets involving just 300 of their 1,500 strategic warheads would kill 75 million to 100 million people outright and destroy the economic infrastructure on which the rest of the population depends. A U.S. attack on Russia would have similar effects. Climate modeling shows that the burning of population centers would inject up to 150 million tons of soot into the upper atmosphere, dropping average global temperatures 18⁰ F and global precipitation by 60 percent, causing crop failures and famine on an unprecedented scale.

The continued existence of weapons of mass destruction is an unacceptable threat to global security and public health. Enormous progress has been made in nuclear disarmament in the past 40 years, with arsenals well below a quarter of their Cold War peak. Now, the Russian invasion of Ukraine and the resulting tensions between Russia and NATO may make progress in nuclear disarmament much more difficult. However, when this conflict reaches an end and a ceasefire or peace deal is signed, we must recognize that we have all survived a planetary near-death experience.

Ira Helfand, M.D., is a member of the International Steering Group, ICAN, the recipient of the 2017 Nobel Peace Prize. He is the immediate past president of the International Physicians for the Prevention of Nuclear War (IPPNW), the recipient of the 1985 Nobel Peace Prize; a co-founder and past president of Physicians for Social Responsibility, the U.S. affiliate of IPPNW Member, and a member of the steering committee of Back from the Brink.

Michael V. Callahan, M.D., DTM&H, MSPH, is an infectious disease and outbreak physician who served as medical director for the U.S chemical and biological weapons demilitarization program in Russia, 2001-2006, and is director for Clinical Translation, Vaccine and Immunotherapy Center, at Massachusetts General Hospital.

Joseph G. Hodgkin, M.D., is staff hospitalist at Massachusetts General Hospital and a member of Physicians for Social Responsibility.

Mark C. Poznansky, M.D., PhD., FIDSA, is director of the Vaccine and Immunotherapy Center (www.advancingcures.org), Massachusetts General Hospital, and professor of medicine at Harvard Medical School. He is co-founder of the Heal Ukraine Group (www.HealUkraineGroup.org).