Lancet: Nuclear War and Malicious AI Threaten Human Extinction by 2100

Humans face the risk of extinction by 2100 due to the misuse of artificial intelligence (AI) and nuclear war, according to the latest global risk assessment from The Lancet Commission on 21st Century Global Threats to Health. The two threats top a list of 17 major dangers to human health over the next 75 years, which also include aid cuts by wealthy countries, the climate crisis, and child malnutrition.

The newly formed commission stresses that all threats are interconnected, so they must be addressed simultaneously. Nevertheless, the experts believe there is a "realistic path to action" on each risk. "The decisions made by leaders today will shape the health and well-being of future generations," said Prof Christopher Murray, co-chair of the commission and Director of the Institute for Health Metrics and Evaluation, University of Washington.

To compile the list, the commission modeled how many healthy life years could be lost to illness, disability, or premature death from each threat under current trajectories—a metric known as disability-adjusted life years (DALYs). "The use of malicious AI, including biological weapons, and nuclear conflict with nuclear famine carry the risk of extinction within the next 75 years," the report states. Although the probability is low, the impact could end human civilization through particles that block sunlight and trigger famine, or AI-made biological weapons. An editorial in The Lancet accompanying the report warns, "The scale of the damage, if realized, would spell doom for humanity."

Other threats that could cause more than 1 billion cumulative DALYs—and are categorized as "major catastrophic threats"—include air pollution, antimicrobial resistance, child malnutrition, and climate damage, as well as conventional conflict, declining foreign aid, high alcohol consumption, high blood pressure, income inequality, low education levels, natural pandemics, obesity, poor mental health, smoking, and unhealthy aging. To make the list, a threat must not only have the potential to cause large losses of healthy life years but also have possible solutions.

"We didn't start from the standpoint of 'oh, we want to scare you'. We started from the premise that if you are a policymaker today, whether at the global multilateral or national level, these are the potential threats you will face, and this is the scale of impact you could change if you act," said Ibrahim Abubakar, a commission member and professor of infectious disease epidemiology at UCL.

The report also modeled best- and worst-case scenarios for each threat. Action to limit global warming to around 1.8°C, rather than letting it reach 4.4°C, could prevent 1.89 billion healthy life years lost. In high-income regions, non-communicable diseases such as obesity and poor mental health are the dominant threats, while in low-income regions, health losses are driven by issues such as low education levels.

Many major donor countries, including the US and the UK, have announced massive cuts to aid spending over the past year. The commission found that the potential collapse or sharp reduction of international health aid could cause up to 1.5 billion DALYs before 2100, with nearly 70% of them occurring in Sub-Saharan Africa. The region also bears the heaviest burden of child malnutrition.

The commission, made up of 35 experts, will present its findings on Sunday at the World Health Summit in Berlin, Germany. Their assessment will be updated annually to re-evaluate the 17 identified threats, incorporating new data and emerging dangers. The authors urge leaders to address risks before they escalate into crises, including through investment in technological innovation and strengthening health systems.

"We started this process three years ago, thinking there were three major threats: conflict, climate, and pandemic," Murray said. "It turns out there are more threats we need to worry about, and governments really need to allocate funds and staff to the task of anticipating, preventing, and preparing for this more diverse set of threats."

For Indonesia, these findings serve as a reminder that reliance on international health aid and vulnerability to climate impacts and pandemics could worsen losses of healthy life years. Investment in resilient health systems, AI oversight, and diplomacy to prevent nuclear conflict is becoming increasingly urgent. Without real action, the projected loss of billions of healthy life years is not a fictional scenario, but a measurable warning.