Sixty-three years ago this month, the United States was the first (and only—so far) nation to use nuclear weapons, detonating two warheads in the cities of Hiroshima and Nagasaki, Japan. Tens of thousands of people were killed instantly. By the end of 1945, more than 200,000 more were dead from radiation-related ailments.

This somber anniversary provides an opportunity to assess the range of nuclear threats bedeviling international relations and threatening the future. The moment is even more salient given the recent military probe of Georgia into its breakaway province of South Ossetia, the Russian military’s apparent overreaction, and the Bush administration’s subsequent rhetorical bluster threatening to reignite the Cold War, as well as ongoing U.S. attempts to establish antimissile deployments in Poland and the Czech Republic, a development provoking concern and defensiveness in Russia.

There is some good news. In a dramatic display, North Korea destroyed a cooling tower at its Yongbyon nuclear complex on June 28. Closer to home, the U.S. Congress refused to fund the administration’s demand for a new nuclear weapon system, the Reliable Replacement Warhead, which would have upgraded most of the U.S.’s current nuclear warheads. (The existing warheads will remain frighteningly effective for many years, according to a preponderance of scientists and military theorists.)

Now the bad news. We face a stalled disarmament process, tens of billions of dollars that the U.S. is still pumping into a vast nuclear weapons complex, and the horrifying possibility of nuclear terrorism.

In 2002, George W. Bush and his Russian counterpart, now former president Vladimir Putin, agreed to sharp reductions in nuclear stockpiles by 2012. (Even under this agreement, however, the “decommissioned” weapons could be easily and quickly re-commissioned.) More than half the allotted time has passed, yet this key post-Cold War priority has faltered.

Furthermore, the Bush administration has decreased funding directed toward the critically important goal of securing “loose nukes” in Russia to keep them from the hands of terrorists.

The 1970 Treaty on the Non-Proliferation of Nuclear Weapons (NPT) established the framework under which nuclear weapon states, included the U.S., committed to disarm. Nonnuclear signers of the treaty pledged not to develop a nuclear weapons capability in exchange for assistance in acquiring peaceful nuclear technology. The NPT’s delicate balance has now been overturned: Israel, North Korea, Pakistan, and India have all built nuclear weapons stockpiles outside the treaty. They have pointed—accurately—to the implicit double standard of the original five nuclear weapons states, “led” by the U.S., which have failed to take any meaningful steps toward their own disarmament.

At the same time, the U.S. is irresponsibly inconsistent with other countries. The Bush administration has given India a special path to nuclear legitimacy despite its development of nuclear weapons outside of international law. India is close to accepting a deal giving it access to nuclear fuel and technology for power plants, in exchange for opening only part of its nuclear fuel cycle to inspections.

The U.S. at the same time threatens to attack Iran for thinking nuclear thoughts. The most recent National Intelligence Estimate, in fall 2007, found that Iran ceased pursuit of nuclear weapons in 2003, while continuing to attempt mastery over uranium enrichment, maintaining that its current program is for peaceful energy uses, as permitted under the NPT. The Bush administration continues to use an “all options are on the table” threat—code for “nuclear weapons could be used in military strikes”—against Iran, which, all parties agree, has no nuclear weapons. The Bush White House is the first U.S. administration in history to threaten the use of nuclear weapons against nonnuclear nations, a startling and parlous policy.

The International Atomic Energy Agency asserts that 20-30 countries have the intent or capability to pursue new nuclear weapons programs. And large quantities of highly enriched uranium and plutonium remain scattered at poorly secured sites throughout the world.

Despite calls for disarmament from a cadre of converted Cold Warriors, the Department of Energy is asking for an estimated $150 billion to develop a new generation of nuclear weapons and a more “responsive” production network. This proposal builds on the Bush administration’s quiet surge in nuclear weapons spending: Adjusting for inflation, U.S. spending on nuclear weapons has increased by more than 13 percent since 2001 and is now one-third more than the Cold War average.

The Bulletin of the Atomic Scientists has been measuring the danger posed by nuclear weapons since 1947. In January 2007, it moved the clock from seven minutes to nuclear midnight to five minutes to nuclear midnight, due to “the perils of 27,000 nuclear weapons—2,000 of them ready to launch within minutes.”

In his campaign stump speech, Illinois Sen. Barack Obama warns that nuclear terrorism is one of the gravest threats facing the United States today, highlighting his work on this overlooked issue. During the election season—and in the first months of a new presidential administration and Congress—citizens have an opportunity to insist that nuclear weapons materials from the Cold War be locked down, that nuclear stockpiles be reduced, and that we turn back the clock with real progress toward nonproliferation.

Steve Daniels, MD, is the Santa Barbara chair of Physicians for Social Responsibility.