A new commission in the medical journal The Lancet warns that nuclear war and the malicious use of artificial intelligence could lead to human extinction by 2100. The report, published on 10 October, identifies 17 major threats to human health over the next 75 years, including cuts to international aid, the climate crisis and childhood malnutrition.
According to the experts, all the threats interact and must be tackled together, but there is "a realistic route to act" on each. The report stresses that the likelihood of nuclear conflict or malicious AI use, including AI-created bioweapons, remains low, but the consequences could be catastrophic. In a nuclear scenario, particles injected into the upper atmosphere would block sunlight and cause famine; in the AI case, the concern is biological weapons created with the technology.
To build the list, the commission modelled how many years of healthy life could be lost to illness, disability or early death from each threat, using a measure called disability-adjusted life years (DALYs). To make the list, threats had to cause a high number of lost healthy years and also have potential solutions.
The threats that weigh most
The report defines as "major catastrophic threats" those capable of causing more than one billion cumulative DALYs. These include climate breakdown, conventional conflict, high blood pressure, income inequality and low educational attainment. In higher-income regions, non-communicable diseases such as obesity and poor mental health dominate; in lower-income regions, health loss is driven by factors such as low educational attainment.
Action to limit warming to 2.6°C rather than letting it reach 4.4°C could prevent the loss of 1.89 billion years of healthy life, according to best- and worst-case scenarios modelled by the authors.
The aid cuts
The report also highlights international health aid. Several major donor nations, including the United States and the United Kingdom, have announced cuts over the past year. A collapse or steep reduction in those funds could cause up to 1.5 billion DALYs before 2100, nearly 70% of them in sub-Saharan Africa, the region that also bears the brunt of child malnutrition.
The 35-member commission will present its findings on Sunday at the World Health Summit in Berlin and will update its assessment every year with new data and emerging hazards. The authors urge leaders to act before the threats escalate into crises, investing in technological innovation and strengthening health systems.
"Three years ago we thought there were three big threats: conflict, climate and pandemics," said Professor Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington, the commission's co-chair. "There's a much larger number of threats we need to worry about, and governments need to dedicate money and staff to anticipation, prevention and preparation."

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