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  • Author: Masanori Akiyama, Ryozo Nagai
  • Publication Date: 03-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: As Japan faces rapid aging, a declining birthrate, widening income disparity, expanding fiscal debt, and remarkable hikes in health care costs, the sustainability of its health care system is at stake. Despite the need to allocate limited medical resources optimally, Japan lacks a common platform for sharing medical data, ideally over the Internet. The potential benefits of health information technology, or health IT, are not well known among patients, practitioners, or policymakers. Electronic patient records are not available from one hospital to another and are isolated from the Internet due to privacy concerns. Clinical practitioners have no remote access to patients' information when away from a particular hospital or clinic. Unique medical data, stored individually in each hospital or clinic, is vulnerable to accidents and natural disasters. The Tohoku disaster demonstrated the absence of a reliable backup for health data, the challenge of data management during an emergency, and the dangers of prescribing drugs with insufficient access to medical records.
  • Topic: Demographics, Health, Science and Technology
  • Political Geography: Japan, Israel
  • Author: Katherine E. Bliss
  • Publication Date: 03-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: In 1985, four years after the U.S. Centers for Disease Control and Prevention (CDC) published a notice in the Morbidity and Mortality Weekly Report regarding unusual clusters of disease in young, otherwise healthy, gay men in California and New York, more than 2,000 scientists from around the world assembled at the World Congress Center in Atlanta to exchange research and compare notes on what had come to be known as Acquired Immune Deficiency Syndrome, or AIDS. There have been 18 international AIDS conferences since that initial gathering, in locales ranging from Amsterdam and Florence to Durban and Mexico City. These conferences, which have been organized since 1988 by the International AIDS Society, have evolved from modest- sized meetings of scientists and researchers to multitrack, week-long conventions attracting more than 20,000 delegates, including heads of state, celebrities, philanthropists, researchers, activists, and people living with the human immunodeficiency virus (HIV) and AIDS.
  • Topic: HIV/AIDS, Health, International Cooperation, Infectious Diseases
  • Political Geography: United States
  • Author: Huasheng Zhao
  • Publication Date: 03-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: China holds clear, coherent, but relatively low-profile positions on Afghanistan. While staying largely with the mainstream of the international community on the issue of Afghanistan, China maintains an independent policy that reflects the peculiarities of Chinese interests, concerns, and priorities in Afghanistan. China has multiple interests in Afghanistan; however, domestic concerns about the security and stability of the largely Muslim region of Xinjiang overwhelm all others. China maintains normal and good relations with the Afghan government, takes active part in the country's economic rebuilding, and provides Afghanistan financial aid and other assistance. China supports the international community in its efforts in Afghanistan, but stays away from direct military involvement. China refrains from criticizing America's involvement in the war in Afghan- istan, but it doubts the war's efficacy, and China refuses to join the American Northern Distribu- tion Network (NDN) to Afghanistan. China dislikes the Taliban because of its close relations with the “East Turkistan” organization—a Uyghur separatist group—but China deals with the Taliban cautiously, trying to avoid direct conflict. China favors an Afghanistan governed by Afghans and hopes that the “Kabul process”—the transition to greater Afghan responsibility and ownership in both security and civilian areas—will have a successful end. At the same time, China also prepares for unexpected outcomes.
  • Topic: Development, Economics
  • Political Geography: Afghanistan, United States, China, Asia
  • Author: Jeffrey Mankoff
  • Publication Date: 03-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Situated astride one of the world's key strategic crossroads, the “Big Caucasus” is increasingly a region in flux. The August 2008 war among Georgia, Russia, and the separatist regions of South Ossetia and Abkhazia emphasized the fragility of the territorial status quo that took hold in the years immediately following the collapse of the USSR, but which has failed to establish legitimacy among either local populations or the international community. The 2008 war solidified the de facto separation between the Georgian state and its breakaway provinces and put Georgia's NATO accession on indefinite hold—but did not resolve the underlying problems of sovereignty and security that led to the conflict. Similar problems abound across the Big Caucasus. An increasingly authoritarian Azeri government has staked much of its legitimacy on regaining Nagorno-Karabakh. While talks between Baku and Yerevan have made little progress, an arms buildup in the region continues, raising fears of renewed conflict. Meanwhile, Russia's North Caucasus smolders. A nationalist insurgency that began in Chechnya in the early 1990s has spread to neighboring regions and taken on a harder jihadist edge, raising concerns about a possible al Qaeda presence and creating a direct threat to Western interests.
  • Topic: Development, Political Economy, Sovereignty
  • Political Geography: Russia, United States, Iran, Turkey, Moscow
  • Author: David J. Berteau, Guy Ben-Ari, Gregory Sanders, Priscilla Hermann, David Morrow
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: This report examines the budgetary trends and trends in contract spending in the Department of State (DoS) and the U.S. Agency for International Development (USAID). The report is divided into six sections, including the introduction and an appendix. Unless Otherwise noted, all dollar figures are in constant 2010 dollars and all years are fiscal years.
  • Topic: Development, Government, Foreign Aid
  • Political Geography: United States
  • Author: Anthony H. Cordesman
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The US may not face peer threats in the near to mid term, but it faces a wide variety of lesser threats that make maintaining effective military forces, foreign aid, and other national security programs a vital national security interest. The US does need to reshape its national security planning and strategy to do a far better job of allocating resources to meet these threats. It needs to abandon theoretical and conceptual exercises in strategy that do not focus on detailed force plans, manpower plans, procurement plans, and budgets; and use its resources more wisely. The US still dominates world military spending, but it must recognize that maintaining the US economy is a vital national security interest in a world where the growth and development of other nations and regions means that the relative share the US has in the global economy will decline steadily over time, even under the best circumstances. At the same time, US dependence on the security and stability of the global economy will continue to grow indefinitely in the future. Talk of any form of “independence,” including freedom from energy imports, is a dangerous myth. The US cannot maintain and grow its economy without strong military forces and effective diplomatic and aid efforts. US military and national security spending already places a far lower burden on the US economy than during the peaceful periods of the Cold War, and existing spending plans will lower that burden in the future. National security spending is now averaging between 4% and 5% of the GDP -- in spite of the fact the US has been fighting two wars in Iraq and Afghanistan -- versus 6 - 7% during the Cold War.
  • Topic: Security, Defense Policy, Economics, Government
  • Political Geography: Afghanistan, Middle East
  • Author: Robert D. Lamb, Liora Danan, Joy Aoun, Sadika Hameed, Kathryn Mixon, Denise St. Peter
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The top headlines of the past year have made increasingly clear to U.S. government officials the central—but complicated—roles that religion plays in many of the most strategically important engagements of the United States.
  • Topic: Political Violence, Peace Studies, Religion
  • Political Geography: Pakistan, Afghanistan, United States, South Asia, India
  • Author: Richard Jackson, Neil Howe, Tobias Peter
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: As the world's societies age, governments and businesses are trying to look ahead and anticipate the needs of tomorrow's growing elderly populations. Nowhere is this more difficult to do than in emerging East Asia.
  • Topic: Demographics, Economics, Health
  • Political Geography: Israel, East Asia
  • Author: S. Amer Latif
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Over the past decade, the United States and India have built the foundations of a partnership that has the potential to be one of the more consequential relationships of the twenty-first century. Since President Bill Clinton's visit to India in 2000, the two countries have forged a relationship that is now defined by five pillars of cooperation that include strategic issues, energy and climate change, education and development, economics and trade, and science and technology. It is a wide-ranging partnership that holds the promise of collaboration on issues that are not only important to these two countries, but to many other countries as well.
  • Topic: Defense Policy, Arms Control and Proliferation, International Trade and Finance
  • Political Geography: United States, South Asia, India
  • Author: Anthony H. Cordesman, Alexander Wilner
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Iran's potential acquisition of nuclear weapons or other weapons of mass destruction, and Iran's future ability to arm its missiles and aircraft with such weapons, pose s critical risk s that shape every aspect of US, Arab, Israeli and other military competition with Iran . In the near term, they could trigger a major confrontation or war in the Gulf. In the mid to long - term, they could trigger a nuclear arms race in the region, coupled to the search for missile defenses and an accelerated arms race to improve conventional, asymmetric, and proxy forces as well.
  • Topic: Defense Policy, Arms Control and Proliferation, Nuclear Weapons
  • Political Geography: Iran, Middle East
  • Author: Janet Fleischman
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The dual global epidemics of HIV/AIDS and gender - based violence (GBV) exert a destructive and disproportionate impact on women and girls, especially in high HIV - prevalence countries in Africa. Yet despite bipartisan political consensus on the intersection between HIV and GBV, efforts to address this area have not attracted the attention or resources necessary to drive the program innovation that could demonstrate progress. However, new momentum is now being brought to this agenda with the U.S. President ' s Emergency Plan for AIDS Relief ' s (PEPFAR) GBV initiative. Although still early in implementation and facing many challenges, the GBV initiative has the potential to yield important lessons about synergies and cost - effectiveness in reducing GBV and HIV, with clear implications for U.S. global health investments.
  • Topic: Gender Issues, Globalization, Health
  • Political Geography: United States
  • Author: Anthony H. Cordesman, Sam Khazai
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Iraq is in an ongoing struggle to establish a new national identity, and one that can bridge across the deep sectarian divisions between its Shi'ite s and Sunnis and the ethnic division s between its Arabs and its Kurds and other minorities. At the same time, it must build a new structure of governance, economic, and social order after a period of dictatorship, war, sanctions, occupation and civil conflict that began in 1979 and has continued ever since. It must cope with a steadily growing population, and diversify an economy that is so dependent on petroleum exports that they provide some 95% of its government revenues. This struggle can still end in a new round of serious civil conflict and even in the division of the country. At the same time, Iraq does have great potential and its political divisions and ongoing low - level violence do not mean it cannot succeed in establishing stability, security, and a better life for its people.
  • Topic: Democratization, Peace Studies, War, Counterinsurgency, Self Determination
  • Political Geography: Iraq, Middle East, Arabia
  • Author: Mariam Mufti
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The importance of studying the rise of Islamic radicalism in Afghanistan and Pakistan cannot be overemphasized. First, both Afghanistan and Pakistan have experienced serious threats from radical Islamic groups. In Afghanistan, coalition forces led by the United States were successful in overthrowing the Taliban regime after the terrorist attacks of 9/11, but since then there has been a resurgence in violence that is being perpetrated by a combination of the Taliban who have regrouped, the Haqqani Network (HQN) and Hizb-e-Islami (HiG). Foreign groups such as al Qaeda are also implicated in the violence. In Pakistan, most of the militant activity has occurred in the frontier region between Afghanistan and Pakistan, known as the FATA. But other parts of Pakistan, especially Punjab, have also been subject to bomb attacks. These attacks have not only targeted Pakistanis but also foreigners, including U.S. government facilities.
  • Topic: Political Violence, Islam, Religion, Armed Struggle, Counterinsurgency
  • Political Geography: Pakistan, Afghanistan
  • Author: Daniel F. Runde, Amasia Zargarian
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Justifying traditional U.S. assistance to middle-income countries is an increasingly difficult proposition, and refocusing limited U.S. government development resources away from middle-income countries offers an efficient way to identify savings in the foreign assistance budget. This is not the first time that the U.S. government has faced such questions, and it can draw upon past transitions—not all successful—for a variety of valuable lessons for repurposing the United States' relationship with middle-income countries.
  • Topic: International Relations, Development, International Trade and Finance, Foreign Aid
  • Political Geography: United States
  • Author: Anthony H. Cordesman, Alexander Wilner
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The most threatening form of US and Iranian competition takes place in the military and security arena. The areas where this competition now gets primary attention are the nuclear and missile arena, and Iranian threats to “close the Gulf.” US and Iranian tensions over Iran's nuclear program have grown steadily over the years. They now threaten to reach the crisis point as Iran produces highly enriched uranium and develops all of the technology necessary to produce nuclear weapons, and as US, European, and UN sanctions become steadily stronger.
  • Topic: Conflict Prevention, Security, Foreign Policy, Defense Policy, Arms Control and Proliferation, Nuclear Weapons, Oil, Weapons of Mass Destruction
  • Political Geography: United States, Europe, Iran, Middle East, United Nations
  • Author: Anthony H. Cordesman, Nicholas S. Yarosh
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The US and China face a critical need to improve their understanding of how each nation is developing its military power and how to avoid forms of military competition that could lead to rising tension or conflict between the two states.
  • Topic: Defense Policy, Arms Control and Proliferation, Bilateral Relations
  • Political Geography: United States, China, Israel
  • Author: Janet Fleischman
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Each day, nearly 800 women die around the world from complications in pregnancy or childbirth. That's one woman losing her life, every 100 seconds, every day. And while, from 1990 to 2010, global maternal mortality rates declined by roughly 47%, from about 546,000 to 287,000, the regional disparities are enormous: 85% of all maternal deaths occur in sub-Saharan Africa and South Asia—and more than half of these occur in sub-Saharan Africa. These deaths are largely preventable with interventions and training to address complications such as hemorrhage, infection, and obstructed labor, and more broadly with increased access to reproductive health services.
  • Topic: Foreign Policy, Health, International Affairs, Foreign Aid, Health Care Policy
  • Political Geography: Africa, United States, South Asia
  • Author: Anthony H. Cordesman
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The key issue in evaluating the prospects for a successful Transition in Afghanistan is not whether a successful transition in Afghanistan is possible, it is rather whether some form of meaningful transition is probable — a very different thing. The answer is a modest form of strategic success is still possible, but that it is too soon to know whether it is probable and there are many areas where the current level of planning, analysis, and action combined to sharply reduce the chances for success.
  • Topic: Conflict Resolution, Security, Defense Policy, War, Counterinsurgency, Fragile/Failed State
  • Political Geography: Afghanistan
  • Author: Michael Johnson
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Corruption in the Philippines diverts, delays, and distorts economic development, undermines the quality and credibility of democracy, and reduces the quality of life. That is so not just because of its extent but also because it comes in particularly disruptive and intractable forms. Philippine corruption is an example of the Oligarch-and-Clan syndrome—one found in countries offering significant and expanding political and economic opportunities in a setting of very weak institutions, but a pattern shaped by historical, cultural, and geographical influences specific to the country. Oligarch-and-Clan corruption is particularly disruptive, in development terms. Because of institutional weaknesses and the power of corrupt oligarchs and their followings, it often faces ineffective opposition. More than other syndromes it is closely linked to violence, and sharply limits the state's ability to perform such basic functions as revenue collection, maintenance of institutional foundations for the economy, law enforcement, conflict resolution, and dealing with security threats.
  • Topic: Political Violence, Corruption, Democratization, Development, Economics
  • Political Geography: Israel, Philippines
  • Author: Pieter Fourie
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: When the Group of Eight (G-8) industrialized countries decided at their 2001 meeting in Genoa to establish the Global Fund to Fight AIDS, Tuberculosis, and Malaria to increase international funding for interventions against the three diseases, the United States was a leading supporter. The fund was a public-private partnership set up in 2002 with formal status as a foundation under Swiss law. In the fund's first two years, the United States accounted for nearly half the total amount pledged and challenged other donors to increase their contributions. By 2008 the Global Fund had committed $15.6 billion to AIDS activities in 140 country.
  • Topic: Foreign Policy, Government, Health, Health Care Policy
  • Political Geography: United States, South Africa