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The very existence of the world as we know is being directly threatened by three pressing issues, according to a new report. Nuclear war was chief among them, followed by disease and climate change. They each and collectively pose a risk “where an adverse outcome would either annihilate Earth-originating intelligent life or permanently and drastically curtail its potential,” the report on existential risks concluded.

The apocalyptic report, published Friday by The Future of Humanity Institute, was finalized after its authors interviewed some of the world’s foremost experts on the topics. They deduced that the future of the earth was in jeopardy if nothing was done to combat or prevent a possible nuclear war.

While strides were being made in the effort to reverse climate change and to slow global pandemics, a biosecurity expert and one of the study’s authors told Phys.org that the same was not necessarily true for nuclear war.

“A recent survey of the views of national technical experts on biological weapons highlighted a dire need for broader and more sustained international focus on identifying and managing the research most readily applied to causing deliberate harm,” said Piers Millett of the Future of Humanity Institute.

Given their history of aggressions toward one another, especially as of late, India and Pakistan were logically the most likely countries with nuclear weapons to engage in nuclear war against one another, according to the report. “However, given the relatively modest size of their arsenals, the risk of human extinction is plausibly greater from a conflict between the United States and Russia,” the report continued. “Tensions between these countries have increased in recent years and it seems unreasonable to rule out the possibility of them rising further in the future.”

Aside from those four countries, five others possess nuclear weapons: China, Israel, France, North Korea and the United Kingdom. Russia has the most nuclear warheads with about 7,300, with the U.S. closely trailing at about 6,970, according to NBC News. Following those two countries, the drop-off was significant, as France was the next-nearest country with about 300 nuclear warheads.

Former Soviet Union leader Mikhail Gorbachev recently said the current global arms race “looks as if the world is preparing for war,” but a column in Forbes last month suggested that modernizing the U.S. military could actually stave off a nuclear war.

Even still, the lingering threat of nuclear war will likely not be eliminated anytime soon.

“International cooperation on global risks is more important than ever,” the report’s lead author, Sebastian Farquhar, told Phys.org. “Disease, climate change, and nuclear winter don’t respect national borders.”