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361. The Ending the HIV Epidemic in the U.S. Initiative: An Interim Assessment and Policy Recommendations

Author:
Jeffrey L. Sturchio, Mackenzie Burke, and Maclane Speer
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
The Ending the HIV Epidemic in the U.S. (EHE) initiative is a promising federal program launched by the U.S. Department of Health and Human Services (HHS) in February 2019 with the aim of reducing new HIV infections by 75 percent by 2025 and 90 percent by 2030 (from a baseline of more than 38,000 new diagnoses in 2017). While the EHE initiative set ambitious targets for ending the HIV epidemic in the United States in the context of a sound and sensible plan, it is at present off track. Now, three years in—at the midpoint of the first EHE phase, which has a target of reducing new HIV infections to 9,250 people or fewer by 2025—is an opportune moment to assess its status and the challenges it faces. After a review of progress to date, this report examines the collision between the logical plan behind the EHE initiative and the complicated patchwork of programs that provide HIV prevention, care, and treatment to the diverse communities affected across all EHE jurisdictions. The analysis is informed by several roundtable discussions convened by CSIS with the participation of a representative group of people living with HIV/AIDS (PLWHA), community advocates, physicians, service providers, researchers, and policymakers who are implementing the EHE initiative around the country. The report concludes with policy recommendations in four areas: (1) meet people where they are by building programs that are centered on the needs of populations directly affected by the HIV epidemic; (2) address flexibility in design and implementation; (3) improve data, metrics, and accountability; and (4) heighten political advocacy to ensure future funding of the EHE initiative. A strong theme that runs throughout the report is that lessons from the global HIV response—the importance of building interventions from the ground up, of engaging with affected communities, and of taking an integrated approach across a spectrum of biomedical, clinical, social, behavioral, economic, and political dimensions—can inform and strengthen the U.S. domestic response to HIV/AIDS.
Topic:
HIV/AIDS, Health, Medicine, and Epidemic
Political Geography:
North America and United States of America

362. Brazil: Five Phenomena and Three Scenarios

Author:
Lauri Tahtinen
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
Brazil heads into the second round of its general election on Sunday, October 30. This will include runoffs for the governorships in 12 of Brazil’s 26 states, including São Paulo, the most populous and wealthy state. However, most eyes are on the presidential race in which incumbent Jair Bolsonaro is seeking his second term in office and former president Luiz Inácio Lula da Silva is seeking his third. In the first round on Sunday, October 2, Lula received 48.4 percent of the vote and Bolsonaro received 43.2 percent. This analysis paints three scenarios for Brazil’s election. The baseline for these scenarios is Lula’s narrow win, and a narrow win for Lula remains the most plausible outcome. If the trends prevalent in September have accelerated through October, Bolsonaro could win narrowly. Conversely, if the trends of September decelerate or even reverse in October, Lula could win handsomely. Based on the first-round results, earlier runoffs, and simple election math, a major Bolsonaro victory is not a realistic outcome.
Topic:
Elections, Democracy, Leadership, Voting, and Partisanship
Political Geography:
Brazil and South America

363. Transforming Health Crises with Pandemic Therapies Image

Author:
Katherine E. Bliss and J. Stephen Morrison
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
The CSIS Commission on Strengthening America’s Health Security convened a working group on Covid-19 therapies in the fall of 2021 to develop policy recommendations aimed at strengthening U.S. leadership and global action to ensure development of, access to, and uptake of Covid-19 therapies worldwide. Drawing on insights gleaned through private meetings and roundtable discussions with pharmaceutical manufacturers, government officials, representatives of multilateral organizations, and nongovernmental organizations, and building on points raised in an interim report published in July 2022.
Topic:
Health, Pandemic, COVID-19, and Health Crisis
Political Geography:
Global Focus

364. Colombia’s Relationship with the PRC

Author:
Evan Ellis
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
From October 6 to 16, the author traveled throughout Colombia to speak with businesspeople, academics, and other professionals about the country’s security panorama, its commercial and other relationships with the People’s Republic of China (PRC), and prospects for evolving those relationships under the new government of Gustavo Petro. This white paper, the first of two on those interactions, addresses the country’s important and deepening relationship with the PRC and its companies. In recent years, Colombia’s political and security relationship with the PRC has been limited. This arguably reflects Bogotá’s perception that deepening political and security ties with the PRC might damage its close and important relationship with the United States. Nonetheless, despite perceptions that the PRC is more of a threat than an opportunity in the commercial arena, the presence of Chinese companies and their representatives in the country has expanded remarkably. Under the Petro government, all dimensions of Colombia’s relationship with the PRC, from political and security affairs to economic ones, are poised to expand and shift in ways that may cause unease in Washington.
Topic:
International Cooperation, Bilateral Relations, Hegemony, and Rivalry
Political Geography:
China, Asia, Colombia, and South America

365. A Seismic Shift: The New U.S. Semiconductor Export Controls and the Implications for U.S. Firms, Allies, and the Innovation Ecosystem

Author:
Sujai Shivakumar, Charles Wessner, and Thomas Howell
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
On October 7, 2022, the Department of Commerce’s Bureau of Industry and Security (BIS) announced sweeping revisions to its export controls, which are aimed at restricting China’s ability to obtain certain high-end semiconductor devices with potential military applications, develop and maintain supercomputers, and manufacture advanced semiconductor devices. This announcement, the most expansive export control action in decades, represents a fundamental shift in the traditional strategy underlying the U.S. and allied export control regime. As National Security Advisor Jake Sullivan put it , until now, “we previously maintained a ‘sliding scale’ approach that said we need to stay only a couple of generations ahead. That is not the strategic environment we are in today. Given the foundational nature of certain technologies, such as advanced logic and memory chips, we must maintain as large of a lead as possible.” In effect, the new measures are intended to dramatically slow, if not freeze Chinese developmental capability.
Topic:
Science and Technology, Innovation, Rivalry, and Semiconductors
Political Geography:
China, Asia, North America, and United States of America

366. Baltic Conflict: Russia’s Goal to Distract NATO?

Author:
Courtney Stiles Herdt and Matthew "BINCS" Zublic
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
The Baltics are a key strategic region where the North Atlantic Treaty Organization (NATO) and Russian military and economic interests overlap. Sabotage of the Nordstream 2 pipeline, regardless of who executed the attack, has signaled that conflict in the region is no longer left of bang. Gray zone operations are underway, and the United States, NATO, and their partners need to be ready to act in unity against an increasingly hostile Russia that is now trying to distract attention from its military shortcomings in Ukraine. In this effort, Russia’s playbook will test the limits and try to exploit the seams of the alliance. An exacting response is needed to deny Russia control and ensure full conflict is avoided. The NATO summit in Vilnius will be critical to strengthening resolve and a path forward to a combined strategy to deter further Russian aggression.
Topic:
Security, Defense Policy, NATO, International Cooperation, and Military Strategy
Political Geography:
Russia, Europe, North America, and Baltic States

367. CCP Inc. in Portugal: China's Investments in Financial Services and the Reach of the Chinese Communist Party in the Private Sector

Author:
Andrew Polk
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
This “CCP Inc.” case study explores how an ecosystem of Chinese party-state actors enabled a range of state-owned and private Chinese companies to embed themselves in Portugal’s financial system, creating a foothold to widen China’s financial presence within the country and beyond. The report specifically focuses on Fosun International Limited, a subsidiary of the Chinese conglomerate Fosun Group, which became a key source of foreign direct investment in Portugal through strategic acquisitions that opened market access for Chinese firms. Fosun’s investments in Portugal provide insight into the Chinese Communist Party’s activism in shaping the business environment for private sector players, as the company’s international strategy faced the challenge of balancing alignment with state goals against a regulatory crackdown on private sector outbound spending.
Topic:
Finance, Investment, Private Sector, and International Competition
Political Geography:
China and Asia

368. A World in Crisis: The “Winter Wars” of 2022–2023

Author:
Anthony H. Cordesman and Paul Cormarie
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
t is obvious that the world now faces a wide range of potential wars and crises. What is far less obvious is the level of confrontation between the U.S. and its strategic partners with both Russia and China, the rising levels of other types of violence that are emerging on a global level, how serious these wars and crises can become, and what kind of future could eventually emerge out of so many different crises, confrontations and conflicts, and trends. These issues are addressed in depth in a new analysis by the Emeritus Chair in Strategy at the CSIS entitled A World in Crisis: The “Winter Wars” of 2022–2023. This analysis explores the risk on the basis that war does not have to mean actual military conflict. Here, it is important to note that avoiding or minimizing combat is scarcely peace. As Sun Tzu pointed out in the Art of War well over 2,000 years ago, “war” does not have to involve the use of military force or any form of actual combat. His statement that “the supreme art of war is to subdue the enemy without fighting” applies to every form of major military confrontation and gray area warfare between opposing powers. It recognizes that it is all too easy to predict dire outcomes from the War in Ukraine, the current arms races with Russia and China, and growing levels of violence and confrontation between other states. There is still a case, however, for examining the broader impact of the war, the growing intensity of the arms races with Russia and China, and the current overall patterns of global conflict as the world enters the winter of 2022-2023. It is already clear that this will be a deeply troubled winter in many areas of the globe, that the level of confrontation between major powers has risen sharply, that they do seek to subdue the enemy without fighting, and their rivalry has become the equivalent of political and economic warfare. It is equally clear that the wide range of lower-level conflicts between other powers, their civil wars, and the abuses many governments commit against their own citizens are also intensifying, although many of these conflicts have been going on in some form for years or even decades. In far too many cases, the world is not moving toward peace. It is moving towards repression and war. Accordingly, this analysis argues that the world already faces a series of possible and ongoing “Winter Wars” in 2022-2023 that may not escalate to open military conflict but that are wars at the political and economic level and in competition to build-up more lethal military forces both for deterrence and to exert political leverage. It also shows that these “Wars” already pose serious risks and could escalate sharply and in unpredictable ways for at least the next five to ten years.
Topic:
Security, Military Strategy, Rivalry, and Competition
Political Geography:
Russia, China, Europe, Asia, North America, and United States of America

369. Galvanising the Ship of the Indian State: An Agenda for Research and Dialogue

Author:
Saurabh Kumar
Publication Date:
09-2022
Content Type:
Special Report
Institution:
India International Centre (IIC)
Abstract:
Three major tipping points affecting the future of the country vitally kick into play at about the same time, no more than a few decades from now: • reversal of the (currently favourable) youthful demography of the country (by 2055 or so); • danger of calamitous climate change globally beginning to affect the Indian subcontinent harshly; • likely disruptive impact of mainstreaming of Artificial Intelligence (AI) on the socio-economic order (and therefore on political stability) as a result of robots surpassing human capabilities and replacing all human labour in repetitive and routine tasks. The prospect of large sections of society finding themselves free of want (basic survival needs) but idle, and therefore terribly distraught, in other words— an ‘unknown unknown’ that would beat the classical recipe for breeding a fair crop of devil’s workshops hands down. Especially so in conjunction with maturing and convergence of other fourth generation technologies (digital, nano, bio and machine learning) and increasing fusion of cyber and physical spaces. This essay, a strategic take on the overall Indian situation, is premised on the reading that the latter two of these mega challenges (which can, without exaggeration, be characterised as existential ones) cannot be addressed adequately in ‘business as usual’ (BAU) mode within the ambit of the existing organisational structures of over a century inherited by the Indian Republic from the colonial State. The likely sweeping, 360-degree impact of these overarching trends makes for urgent review of the machinery and mechanisms of the Indian State in a pragmatic, strategic mindset aimed at bracing up for the new challenges.
Topic:
Climate Change, Government, Research, State, and Dialogue
Political Geography:
South Asia and India

370. Implications of the European Union’s Digital Regulations on U.S. and EU Economic and Strategic Interests

Author:
Kati Suominen
Publication Date:
11-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
In recent months, the European Union has adopted several sweeping digital regulations, such as the Digital Services Act (DSA) and Digital Markets Act (DMA), while proposing a number of new measures—including the Data Act, the Artificial Intelligence Act, and the Media Freedom Act. These regulations will shape, likely quite dramatically, the environment for doing digital business in Europe and beyond. They will have profound implications on the leading U.S. digital service providers designated by the European Union as “gatekeepers”—large digital services providers that are expected to adhere to regulatory requirements—as well as these companies’ hundreds of millions of transatlantic European business and individual customers. By impacting primarily U.S. companies instead of Asian or European ones, Europe’s digital policies will also shape U.S. and European global strategic and national security interests. This study will assess the potential implications of new and proposed EU digital acts on U.S. digital service providers, on their customers in Europe and the United States, and on the EU and U.S. economies and exports.
Topic:
European Union, Regulation, Regionalism, Strategic Interests, and Digitalization
Political Geography:
Europe, North America, and United States of America