Lancet commission lists 17 threats to 2100, including nuclear war and malicious AI use

Extinction-level risks

The Lancet Commission on 21st Century Global Threats to Health, a newly established group of multidisciplinary experts convened by The Lancet, published its assessment on Sunday. The report places the malicious use of artificial intelligence and nuclear conflict at the top of a list of 17 threats to human health over the next 75 years, and says both carry risks of extinction by 2100. EL PAÍS reports that the commission includes 37 experts. The report says the likelihood of these events remains low, but that they could end humanity in two ways: a nuclear conflict that injects enough particles into the upper atmosphere to block sunlight and cause famine, or AI-created biological weapons. EL PAÍS reports that the authors put the AI pathways at up to 3% extinction risk, and that malicious AI and nuclear conflict are the only two threats the authors consider capable of extinction. An accompanying Lancet editorial warned about the consequences.

The scale of harm, should they be realised, would inflict an apocalypse on humanity.

How the list was built

The commission estimated how many years of healthy life could be lost to sickness, disability or early death from each threat, based on current trajectories. It measured those losses in disability-adjusted life years (DALYs). Threats had to be capable of causing a high number of lost healthy years and had to have potential solutions to be included. The Guardian reports that the other threats deemed catastrophic could each cause more than 1bn cumulative DALYs. The experts said all the threats interact, which means they must be addressed together, but they stressed that there is a 'realistic route to act' on each one. Commission co-chair Christopher Murray, who also directs the Institute for Health Metrics and Evaluation at the University of Washington, said:

Decisions made by leaders today will shape the health and wellbeing of the next generation

The full list of threats

Beyond the two extinction-level risks, the commission names air pollution, antimicrobial resistance, childhood malnutrition, climate breakdown, conventional conflict, declining overseas aid, high alcohol use, high blood pressure, income inequality, low educational attainment, naturally occurring pandemics, obesity, poor mental health, smoking and unhealthy ageing. EL PAÍS notes that the commission describes climate change as a threat multiplier, affecting health through floods, fires and changes in food supply as well as through direct temperature rise. The impact of a natural pandemic is uncertain and depends on how far it spreads and whether a cure can be developed. The report suggests that limiting global warming to 1.8 degrees Celsius could prevent the loss of 1.89 billion DALYs. It also suggests that if aid cuts by developed countries such as the United States and the United Kingdom continue, they could cost up to 1.5 billion DALYs by 2100.

Uncertainty and next steps

EL PAÍS reports that the authors acknowledge the uncertainty varies widely between threats. Smoking and malnutrition have clearer trajectories, while the long-term course of malicious AI use and nuclear war is not well documented by evidence. The authors also say the classification is not fixed and could change as circumstances shift or new data emerges. The commission frames the choices made now as decisive for future outcomes, and the Lancet editorial accompanying the report describes the stakes in the terms quoted above.