Humanity faces an existential crossroads: by 2100, either a nuclear war or the deliberate misuse of artificial intelligence could bring about our end as we know it. That stark warning comes from a new global health risk assessment published in The Lancet, which identifies 17 major threats to human health and well-being over the next 75 years.
The list is broad, ranging from antimicrobial resistance and climate change to pandemics, income inequality, and chronic conditions like obesity and mental health disorders. But the two most catastrophic scenarios, according to the researchers, are nuclear conflict—with its cascading effects such as nuclear famine—and the malicious use of AI, which could include the development of bioweapons.
Measuring the unthinkable
The analysis was conducted by the Lancet Commission on 21st-century global threats to health, a panel of 37 experts spanning health, economics, security, and technology. They used a metric called disability-adjusted life years (DALYs) to compare the potential impact of each threat from 2025 to 2100 across 204 countries and territories, broken down by age, sex, and cause.
DALYs quantify the number of healthy years of life lost to a given threat. The researchers calculated both best-case and worst-case scenarios, showing how much difference decisive action—or inaction—could make. For context, the COVID-19 pandemic caused approximately 500 million DALYs. The 17 threats range from 1.02 billion to 23.1 billion DALYs, with obesity carrying the largest cumulative expected amenable burden.
The Commission's goal is not to create a simple ranking or set policy priorities, but to provide governments with the information and tools needed to prepare for these threats and take pre-emptive action. They stress that the findings are part of a dynamic process, to be updated as new evidence emerges.
Interconnected risks demand holistic action
While the experts note that “malicious use of AI, including bioweapons, and nuclear conflict with nuclear famine carry risks of extinction in the next 75 years,” they emphasize that all 17 threats are interconnected. They call for a “holistic action framework grounded in science, human rights, and solidarity.”
The Commission recommends that national governments invest in building “threat-ready health systems” to be better prepared for crises like the COVID-19 pandemic. They also urge more funding for “breakthrough solutions,” such as nuclear fusion and carbon removal technologies, which could radically alter climate outcomes, or the rapid vaccine development seen during the pandemic.
Regular monitoring and risk assessments are also proposed, with findings presented to international bodies like the G20 and the United Nations to heighten urgency and encourage collective action rather than isolated national efforts. The researchers argue that the current “competitive approach” of tackling major challenges one by one is undermining humanity's chances.
This warning comes as Europe grapples with its own security and technological challenges. The EU has been pushing for stronger counter-hybrid threat mechanisms, and recent reports highlight vulnerabilities in critical infrastructure, such as the Royal Navy's reliance on fire hoses against drones. Meanwhile, advances like nuclear clocks show the dual-use nature of technology.
The Commission's report is a call to action for governments worldwide, including those in Europe, to recognize the scale of these threats and work together to avert the worst-case scenarios. As the authors put it, the time to act is now—before the risks become crises.
