AI extinction fears risk overshadowing preventable health threats

Anthony Butler

Apocalyptic fears bring with them a danger that more mundane challenges amenable to policy action will be downgraded

First published in Business Day

15 October 2026

Last month, a researcher called Jacob Coxon resigned from the artificial intelligence firm Anthropic, claiming that, “the people building AI earnestly believe that it could kill us all by the end of the decade.” The company’s Evan Hubinger added that the risk of human extinction within a decade is more than 10%.

The mechanisms bringing existential risk remain speculative, and analysts believe AI giants may favour mild regulation to protect them against insurgent competitors and shield them from massive product-liability exposure when their models enable costly cyberattacks. Nonetheless such warnings come alongside competing alarms about global nuclear war, asteroid collisions, novel pathogens, and synthetic mirror-image organisms bringing untreatable infections.

Such apocalyptic fears bring with them a danger that more mundane challenges amenable to policy action will be downgraded. For this reason, it is good news that the Lancet Commission on 21st Century Global Threats to Health has produced a new report categorizing and analysing dozens of global challenges.

The commission’s analysis builds on a baseline scenario that models future demographic shifts and economic trends to help understand how vulnerabilities will affect different populations.

It assesses “the number of years in good health that are lost due to sickness, disability or premature mortality”, a measure known as lost disability-adjusted life years (Dalys).

The report then categorizes global challenges into distinct tiers, ranging from “extinction potential” risks like nuclear conflict and the malicious use of AI to “major catastrophic” risks such as climate change, antimicrobial resistance, and obesity.

The “Dalys” approach captures well the potential impact of low probability risks as AI-engineered biological weapons, cascading disruptions in critical infrastructure, physical detonation of nuclear weapons, planetary agricultural collapse, and global nuclear famine. After all, if we are all dead, there will be no Dalys.

However, it also gives due weight to “major catastrophic threats” that cost fewer life years but are far more likely to occur. Climate change, for example, will bring direct health impacts from extreme heat, shifting patterns of infectious disease, floods, storms, and climate-fuelled air pollution. The study suggests action to contain global warming to 1.8C rather than allowing it to reach 4.4C could prevent almost two billion years of healthy life from being lost.

While headlines frequently focus on extinction-potential threats like nuclear war and AI annihilation, the study’s quantitative approach reveals that most preventable health loss over the next 70 years is likely to be caused by more everyday metabolic and social conditions.

Tobacco accounts for billions of lost DALYs as the dominant driver of chronic obstructive pulmonary disease, cardiovascular disease, and lung cancer. Smoking rates in low and middle income countries, moreover, continue to grow, and regulation continues to be circumvented.

High Systolic Blood Pressure is meanwhile the leading physiological driver of stroke, ischemic heart disease, and kidney failure. As with smoking, governments have scope to intervene more to limit its costs using well-understood and cheap interventions such as salt intake reduction and antihypertensive medication.

Worst of all is what the commission calls the “Obesity Cluster” of weight, poor diet, and low physical activity, which it describes as the single largest threat to global health. This cluster of pathologies fuels type 2 diabetes, cardiovascular diseases, chronic kidney disease, and cancers. It is driven by ultra-processed foods and sedentary lifestyles that governments can address through policy change.

The commission’s message is that fears about extinction-potential risks should not distract us from well-understood challenges that we are in a position to address using properly funded and “threat-ready” health systems, expanded prevention and preparedness, innovations such as new antibiotics, obesity therapeutics, and climate mitigation, and other tried and tested tools from conventional public policy armouries.

Butler teaches public policy at the University of Cape Town