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  • Author: Maxine Builder
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: Growing rates of antimicrobial resistance (AMR) pose a threat to public health that could undo many of the medical advances made over the last seventy years, eroding the global medical safety net and posing a significant threat to national security. Diseases once eliminated by a single course of antibiotics show drug resistance, often to several different classes of drugs. Some of the implications of increasing rates of AMR are intuitive, such as longer duration of illness, extended hospital stays, and higher rates of mortality. But other effects of a postantibiotics world are less obvious, such as the inability to perform life-saving operations or the ability for a simple scratch on the arm to kill. Humanity could soon find itself living in a reality in which communicable diseases such as tuberculosis, cholera, pneumonia, and other common infections cannot be controlled. This potentially catastrophic problem still can be abated, and the global health community, including the World Health Organization (WHO), has highlighted AMR as a priority in global health. But all sectors of the international community, not simply those in public health, need to take immediate steps to reverse the current trends and eliminate the systematic misuse of antimicrobial drugs, especially in livestock, and restore the pipeline of new antimicrobial drugs. The significant health and economic costs of AMR are difficult to quantify due to incomplete data that often underreports the extent of the problem, since there are no standard metrics or consensus on methodology to measure rates of AMR. But even the piecemeal statistics that exist paint a bleak picture. In a 2013 report, the US Centers for Disease Control and Prevention (CDC) reports at least two million Americans acquire serious infections to one or more strains of AMR bacteria annually, and at least 23,000 people die of these infections.1 A 2008 study estimated the excess direct costs to the US medical system attributable to AMR infections at $20 billion, with additional estimated productivity losses to be as high as $35 billion.2 With the increase in resistant infections and continuing rise in medical costs, the cost to the American medical system no doubt also has increased. This trend is not a uniquely American problem; it is truly global in scope. The European Union (EU) reports about 25,000 deaths annually due to drug-resistant bacteria, at an overall, combined cost of $2 billion in healthcare costs and productivity losses.3 There were over 14.7 million incidents of moderate-to-severe adverse reactions to antibiotics each year between 2001 and 2005 in China. Of these, 150,000 patients died annually.4 The most recent available data on China estimates that treatment of AMR infections during that same time period cost at least $477 million, with productivity losses of more than $55 million each year.5 A 2005 study of the United Kingdom (UK) found that the real annual gross domestic losses due to AMR were between 0.4 and 1.6 percent.6 Although slightly outdated, this estimate may be a useful guide in assessing the global impact of AMR, and given the trend of increasing resistance, it is likely that the impact will also increase accordingly. That said, it is prudent to repeat that the disparities in the quality of data reporting standards across China, the United States, the United Kingdom, and the European Union make it difficult to directly compare the severity of the impacts AMR has on each entity. The primary cause of AMR globally is antibiotic overuse and misuse, be it from doctors inappropriately prescribing antibiotics to treat viral infections or individuals seeking over-the-counter antibiotics for self-treatment. But another driver, less obvious than overuse in humans, is the use of antimicrobials in livestock, and the ratio of use in animals as compared to humans is astounding. In the United States, about 80 percent of all antibiotics are consumed in either agriculture or aquaculture. Generally, these drugs are administered to livestock as growth promoters and are medically unnecessary. Resistance in livestock quickly spreads to humans, and many community-acquired infections are the result of a contaminated food supply. Although most infections are acquired in the community, most deaths attributed to resistant infections occur in healthcare settings, and healthcare-acquired (or nosocomial) infections are another driver of AMR. At this point, AMR does not pose an immediate and direct threat to national security. Rather, this is a creeping global security crisis. If current trends continue, these drugs upon which the world relies will lose effectiveness. The gains made in fighting infectious diseases will be reversed, and a wide range of routine surgeries and easily treatable infections will become much more dangerous and deadly. This will cause the health of the world's working population to deteriorate, and the economic productivity and social cohesion of the globe to decline. At any time, a “black swan” event—triggered by an outbreak of drug-resistant tuberculosis, cholera, or pneumonia, for example—could prove catastrophic, endangering the fabric of societies and our globalized economy, forcing a stop to international trade and travel to prevent further spread. The issue of AMR is a tragedy of the commons in which individual incentives lead to the overuse and eventual destruction of a shared resource. International cooperation is required to walk back from this ledge and avoid a postantibiotics world, even though it is impossible to completely reverse the damage already done.
  • Topic: Health, National Security, Infectious Diseases, Health Care Policy
  • Political Geography: United States, China, United Kingdom, America, Europe
  • Author: David J. Berteau, Gregory Sanders, T.J. Cipoletti, Meaghan Doherty, Abby Fanlo
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The European defense market, though impacted by lethargic economic growth and painful fiscal austerity measures, continues to be a driver in global defense. Five of the fifteen biggest military spenders worldwide in 2013 were European countries, and Europe remains a major market for international arms production and sales. Surges in military spending by Russia, China, and various Middle Eastern countries in recent years has augmented the defense landscape, especially as European countries in aggregate continue to spend less on defense and the United States embarks on a series of deep-striking budget cuts. This report analyzes overall trends in defense spending, troop numbers, collaboration, and the European defense and security industrial base across 37 countries. To remain consistent with previous reports, this briefing utilizes functional NATO categories (Equipment, Personnel, Operations and Maintenance, Infrastructure, and Research and Development) and reports figures in constant 2013 euros unless otherwise noted. Many of the trends identified within the 2012 CSIS European Defense Trends report continued into 2013, namely reductions in topline defense spending, further cuts to R spending, and steadily declining troop numbers. Though total European defense spending decreased from 2001-2013, with an accelerated decline between 2008 and 2010, select countries increased spending2 between 2011 and 2013. Collaboration among European countries has decreased in the R category; however, it has increased in the equipment category – indicating increased investment in collaborative procurement. Defense expenditure as a percentage of total government expenditure has decreased across Europe from 2001-2013 with the exceptions of Albania and Estonia. An updated CSIS European Security, Defense, and Space (ESDS) Index is included within this report and exhibits a shift in geographic revenue origin for leading European defense firms away from North America and Europe and towards other major markets between 2008 and 2013. Finally, a brief analysis of Russian defense spending is included in the final section of this report in order to comprehend more fully the size and scope of the European defense market within the global framework. In 2013, Russia replaced the United Kingdom as the third largest global defense spender, devoting 11.2 percent of total government expenditures to defense. This briefing report concludes with summarized observations concerning trends in European defense from 2001 to 2013. CSIS will continue to follow and evaluate themes in European defense, which will appear in subsequent briefings.
  • Topic: Security, Defense Policy, Military Affairs, Budget
  • Political Geography: Russia, China, United Kingdom, America, Europe
  • Author: Heather Grabbe, Stefan Lehne
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Carnegie Endowment for International Peace
  • Abstract: The European Union's dwindling democratic legitimacy is an acute political challenge. Trust in EU institutions is declining even in countries where the union once had high levels of support. Populist parties are rising and turning against the EU. To restore its legitimacy, the EU needs to respond to public apathy and anger with emotional intelligence and to offer solutions that feel relevant to people outside the Brussels bubble.
  • Political Geography: Europe
  • Author: Marie-Claire Aoun
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Istituto Affari Internazionali
  • Abstract: European energy security challenges have changed dramatically in the past 20 years. On the one hand, the current tensions between Russia and the EU are undermining their historical partnership on energy; on the other, deep transformations in the energy landscape at the global level, triggered by technological advances and major geo-political transformations, are leading the EU to rethink its energy security strategy. The aim of this paper is to discuss European energy security in a changing global context and to analyse the tools and policies implemented to strengthen it. The role of potential future vectors of energy cooperation between the EU and its Mediterranean neighbours is also examined.
  • Political Geography: Europe
  • Author: Maria Giulia Amadio Viceré
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Istituto Affari Internazionali
  • Abstract: Because of the intergovernmental nature of EU foreign policy, the role of the European Commission in EU external action is often considered minimal or residual. Providing a systematic review of the case of Kosovo, this paper demonstrates that it is possible to identify different degrees of integration in EU foreign policy. It does so by investigating under which conditions Member States delegate foreign policy competences to the Commission. In the case of Kosovo, integration in EU foreign policy has been conditioned by the level of control Member States have chosen exercise on or delegate to supranational institutions.
  • Political Geography: Europe
  • Publication Date: 02-2015
  • Content Type: Working Paper
  • Institution: Carnegie Endowment for International Peace
  • Abstract: Foreign ministers have lost influence in recent decades, and prime ministers have emerged as the central foreign policy actors. Mirroring this development, the European Council, which convenes the European Union's (EU) heads of state and government, has become the top decisionmaker on EU foreign policy. But the European Council's approach to external affairs lacks coherence, continuity, and ambition. The Brussels leadership team that took over in late 2014 should significantly upgrade the European Council's role in this area and, through that body, energize the EU's other foreign policy institutions.
  • Political Geography: Europe
  • Author: Karen del Biondo
  • Publication Date: 02-2015
  • Content Type: Working Paper
  • Institution: Kolleg-Forschergruppe "The Transformative Power of Europe"
  • Abstract: The Joint Africa-EU Strategy (JAES), which was adopted in 2007, aimed to break with the traditional do¬nor-recipient relationship between the EU and Africa and to develop a true partnership. The concept of partnership has been central in EU-Africa relations ever since the Lomé Agreement (1975), but many have argued that it has been eroded by conditionalities and the end of special trade preferences. Ideally, a partnership is characterized by shared values, equality and trust, but are these principles reflected in the JAES? This study investigates this question by focusing on the thematic partnerships on peace and security and democratic governance and human rights. The paper argues that, despite the power asymmetries between the EU and Africa, the JAES has been characterized by equality in decision-making and by African ownership in capacity-building. However, while the JAES may objectively be based on shared values, the EU and the AU have often differed on how to apply those values in concrete situations, more particularly on the question which type of intervention is acceptable (conditionality, military intervention, etc.). Moreover, the analysis identifies a general feeling of mistrust amongst both parties in the partnership.
  • Topic: Security, Human Rights, Governance
  • Political Geography: Africa, Europe
  • Author: Angela Pennisi di Floristella
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Kolleg-Forschergruppe "The Transformative Power of Europe"
  • Abstract: Why, following the EU's first attempts at advancing community cooperation in civil protection and the creation of the EU civil protection mechanism, has ASEAN undertaken new initiatives, such as the adoption of a legally binding accord, AADMER and a formal institution, the AHA Center, largely comparable to the institutional innovations endorsed by the EU, in the same issue area? Can these developments be interpreted simply as the result of independent decision-making by ASEAN or are they at least a partial outcome of a transfer process? The aim of this study is to contribute to the emerging debate on European influence in Southeast Asia, taking into account how processes of policy and institutional transfer may lead ASEAN's region builders to learn from the EU's experience. Specifically, by discussing the case of disaster management, which has remained largely unexplored by comparative IR literature, this study argues that independent problem solving does not offer an adequate explanation of ASEAN's developments. Conversely, lesson drawing and emulation are suggested as the two most relevant underlying mechanisms which can explain the gradual and selective adoption of an EU-like model of disaster cooperation.
  • Political Geography: Europe, Asia
  • Author: Zheng Liansheng
  • Publication Date: 03-2015
  • Content Type: Working Paper
  • Institution: Centre for International Governance Innovation
  • Abstract: The shadow banking system was defined in 2007 by Paul McCulley, the managing director of Pacific Investment Management Company, but it began to receive significant attention in the immediate aftermath of the GFC. Since the beginning of the financial crisis in 2008, the regulatory agencies of different countries, international organizations and think tanks have all carried out in-depth research into shadow banking and have released a series of results. Regulatory reforms have also addressed shadow banking, the most important of which is the US Dodd-Frank Act of 2010, which aims to restrain the expansion and risk taking of shadow banking in the United States. The United Kingdom and the European Union have also adopted reforms and built up a supervisory system to track the risks of the shadow banking system.
  • Topic: Financial Crisis
  • Political Geography: United States, China, United Kingdom, Europe
  • Author: David Omand
  • Publication Date: 03-2015
  • Content Type: Working Paper
  • Institution: Centre for International Governance Innovation
  • Abstract: This paper describes the nature of digital intelligence and provides context for the material published as a result of the actions of National Security Agency (NSA) contractor Edward Snowden. Digital intelligence is presented as enabled by the opportunities of global communications and private sector innovation and as growing in response to changing demands from government and law enforcement, in part mediated through legal, parliamentary and executive regulation. A common set of organizational and ethical norms based on human rights considerations are suggested to govern such modern intelligence activity (both domestic and external) using a three-layer model of security activity on the Internet: securing the use of the Internet for everyday economic and social life; the activity of law enforcement — both nationally and through international agreements — attempting to manage criminal threats exploiting the Internet; and the work of secret intelligence and security agencies using the Internet to gain information on their targets, including in support of law enforcement.
  • Topic: Security, Economics, Government
  • Political Geography: Europe