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If Musharraf falls, and is replaced by an al Qaeda-sympathetic leader, we will have an instant war on our hands. It will be necessary for our military, probably by aircraft, to get in there and destroy every single thing that even hints of being part of their nuclear program. Hopefully, we are prepared for such a scenario. Because if we aren't, Israel's first, then New York.

If Musharraf falls, and is replaced by an al Qaeda-sympathetic leader, we will have an instant war on our hands.

This is exactly how I see it as well. There wouldn't be any time for diplomacy or the UN circle jerk. Immediate and bold action would be necessary. It could turn ugly very quickly. The important thing would be neutralizing the nukes. Whether that be through cruise missile or tactical nuke strikes at their known (or best know locations), massive bombing of same or SpecOps type snatch missions- something would definitely have to be done.

India might take matters into its own hands as well by simply employing a preemptive first strike to accomplish the same.

Yes, there was talk earlier about maybe a hundred warheads in Pakistan, plus delivery vehicles from North Korea and China. There was also talk back then of seizing control of the warheads if things got out of hand. We really wouldn't have much choice.