It is nearly 30 years since Rudiger Dornbusch and Sebastian Edwards published a seminal book, The Macroeconomics of Populism. Their conclusion back then was that the economic policies of populist leaders were quintessentially irresponsible. These governments, blinded by an aim to address perceived social injustices, specialised in profligacy, unbothered by budget constraints or whether they might run out of foreign exchange.

Because of this disregard for basic economic logic, their policy experiments inevitably ended badly, with some combination of inflation, capital flight, recession and default. Salvador Allende’s Chile in the 1970s, or Alan García’s Peru in the 1980s, capture this story perfectly.

These days, the macroeconomics of populism looks different. Of course there are populist leaders out there whose policies follow, more or less, the playbook of the 1970s and 1980s. Donald Trump may prove to be one of those, with a late-cycle fiscal expansion that seemed to have no basis in economic reasoning; Recep Tayyip Erdogan, by some accounts, may be another.

But a much more interesting phenomenon is the apparent surge in populist leaders whose economic policies are remarkably disciplined.

Take Mexico’s president, Andrés Manuel López Obrador. When it comes to fiscal policy, it is odd indeed that this fiery critic of neoliberalism seems fully committed to austerity. His budget for 2019 targets a surplus before interest payments of 1 per cent of GDP, and on current plans he intends to increase that surplus next year to 1.3 per cent of GDP. He has upheld the autonomy of the central bank and, so far at least, his overall macroeconomic framework is anything but revolutionary.

Hungary’s prime minister Viktor Orban offers another example of conservative populism. Under his watch, budget deficits have been considerably lower than they had been previously, helping to push the stock of public debt down from 74 per cent of GDP in 2010, the year Orban took over, to 68 per cent last year.

This emphasis on the virtues of fiscal prudence is also visible in Poland, where Jaroslaw Kaczynski’s PiS has managed public finances with sufficient discipline in the past few years to push the debt/GDP ratio below 50 per cent last year, the first time this has happened since 2009.

The obvious question is: what has changed in the decades since Dornbusch and Edwards went into print?

One answer is that today’s populists tend to strive for national self-reliance, which encourages them to avoid building up any dependence on foreign capital. And since that goal is achieved by keeping a tight rein on macro policy, fiscal indiscipline is avoided in order to limit vulnerability to foreign influences.

Perhaps this is because the 'them', or the perceived enemy, for many of today’s populists tends to be outside the country rather than inside. Broadly speaking, it is the forces of globalisation — and global capital in particular — that are the problem for these leaders, and self-reliance is the only way to keep those forces at arm’s length. This helps to explain why, for example, Orban has been so keen to repay debt to Hungary’s external creditors. He has relied instead on selling bonds to Hungarian households to finance his deficits, even though the interest rates on those bonds are much higher than he would pay to foreign creditors. It also helps explain why the PiS in Poland has presided over a decline in foreign holdings of its domestic bonds. Foreign investors owned 40 per cent of Poland’s domestic government debt back in 2015, but only 26 per cent now.

In other words, among many of today’s populists there is a blurring of the distinction between populism and nationalism. And the nationalistic urge to keep the rest of the world off your back seems to dominate the populist urge to spend money. The perfect example of that instinct is Vladimir Putin: not necessarily a populist, but his administration has been emphatic about the need to keep public spending low and to build solid financial buffers. National self-reliance is an economic obsession for the Russian government, and provides a model for other countries who wish to insulate themselves from international finance.

One of the reasons why the macroeconomics of populism have changed in this way is the historical legacy of economic disaster. If you are a populist leader in a country where financial crisis is part of living memory — as it is in Mexico, Hungary and Russia, say — you might do well to err on the side of conservatism for fear of repeating the mistakes of your predecessors.

But another reason why populism looks different for countries like Poland, Hungary, Mexico and Russia has to do with mere luck. Hungary and Poland, in particular, enjoy the luck of geography: having been absorbed into the EU, they have received financial transfers from Brussels averaging some 3-4 per cent of GDP in the past few years, so that populism in these countries has been solidly underpinned by the terms of their EU membership. López Obrador is enjoying the inheritance of his predecessor’s sound macro policy, together with a buoyant US economy and low US interest rates. Russia has had the good fortune of oil exports to rely on.

The thing about luck is that it can run out. So maybe it’s not quite time yet to bury the old macroeconomics of populism. But for the time being, it seems true to say that many of today’s populists have an unexpectedly robust sense of economic discipline.

This article was originally published in the Financial Times.

For four decades, the rule of Iran’s Islamic Republic has rested on the pillars of redistributive social justice, foreign policy independence, Islam and a managed form of electoral legitimacy.  These pillars, each of equal importance, have served as guiding principles bolstering Iran’s domestic and foreign policy decisions.  Amid the latest round of protests to have gripped Iran, it is clear that these pillars are fracturing. 

On 15 November at midnight, the Iranian government, in a move supported by Supreme Leader Ali Khamenei, President Hassan Rouhani, Speaker of the Parliament Ali Larijani and Head of the Judiciary Ebrahim Raisi, announced a 200 per cent increase in fuel prices – a redistributive measure designed to provide cash transfers to the population.

In immediate reaction, Iranian citizens took to the streets to express their discontent with this policy move alongside mounting economic and political grievances.

What ensued over the subsequent days was an outbreak of protests through 100 Iranian cities, including at universities and bazaars, that was followed by a weeklong internet blackout and a brutal crackdown that has left at least 200 people dead and 7,000 arrested. Initially, public anger focused on the price increases but quickly targeted the political leadership, lack of government accountability, effective governance and corruption.

This wave of protests is the fourth in a two-decade period – 1999, 2009, 2017 and 2019 – for the Islamic Republic and comes at time when the Iranian government is under severe economic strain from Washington’s maximum pressure campaign. It is equally burdened by endemic factional politicking.

These protests are one of many reminders of the shattered social contract between state and society in Iran, which without repair will continue to resurface.

With internet connectivity resumed and news of the regime’s brutality spreading, conservatives and reformists are both trying to distance themselves from this internal crisis and reposition themselves in advance of the 2020 parliamentary elections.

Parliamentary elections for Iran’s 290-person legislature are expected to be held on 21 February. Amid concerns over public apathy and lower political participation, both reformists and conservatives are trying to develop strategies to maximize gains at their ballot box.

Even before these protests, voter turnout was anticipated to be lower than normal. Participation in the July 2019 Tehran municipality election was at a nadir of 9 per cent.  To prepare for this challenge, Iran’s parliament has lowered the vote threshold for a valid result from 25 to 20 per cent.

Elections in Iran, while by no means completely free and fair due to the vetting of candidates by the Guardian Council, have repeatedly been an important barometer of public support and participation. Electoral participation, which is traditionally higher than in most Western democracies, and compared to the lack of electoral opportunities in the Middle East, is heralded as a sign of public legitimacy. 

Voter participation is generally higher in presidential elections than in legislative ones.

For example, 73% voted in the 2017 presidential elections, 72% in 2013, 80% in the contested 2009 elections, and 59% in 2005 elections that brought Mahmood Ahmadinejad to office. Comparatively, in the 2016 parliamentary elections 62% voted, in 2012, 66%, in 2008, 47%, and in 2004, 51% participated.

Voter turnout in the 2008 parliamentary elections, reflective of public apathy, mounting international tensions over the nuclear programme, and Guardian Council vetting of reformist candidates, could be emblematic of what to expect next year. 

In the run up to the election, conservative groups are trying to capitalize on popular economic frustrations, disappointment with reformists, wider regional security concerns and tensions with the United States to rally voters. 

Reformists associated with the Rouhani government, who also supported the Iran nuclear agreement, have been severely weakened by the US maximum pressure campaign and the return of US sanctions.  They are also blamed for the current economic downturn and remain frustrated by their ability to affect change in a political system that affords more power to unelected figures.

Amidst this stalemate, Rouhani has continued to call for a national referendum to no avail, while reformist groups are debating how to position themselves – some even calling for greater accountability – so as not be tainted by the government crackdown. Leading reformist politicians such as Mohammad Khatami have called on reformists to stay united and avoid boycotting the elections. It remains to be seen how their strategy will develop after the protests.

Should the Guardian Council bar too many reformists from running, calls for a boycott could snowball and even incite new protests. Together with low turnout at the ballot box, the outcome of this election could further damage the regime’s already fragile electoral pillar and weaken its claims to legitimacy.

The view from the Gulf

Neil Quilliam

There has been no coordinated response among states of the GCC, but the messages have been universal, and surprisingly each one has welcomed US efforts to restart peace talks and praised this particular US administration for doing so. But in each case, the same set of issues and concerns has been highlighted, namely the status of Jerusalem, the situation of refugees and ultimately a simple absence of a revival contiguous Palestinian state.

While much has been made of younger Gulf generation’s apparent disconnect from the emotive issues around Palestinian statehood, the state of Jerusalem and the larger refugee issue, older leaders in the Gulf continue to pay them heed. And despite a desire to coordinate with Israel on matters of security, intelligence sharing and tech, they will not advance the relationship under the terms of the so-called ‘deal of the century’.

Put simply, the deal forces Palestinians to concede ground on all matters of importance. And should the Arab Gulf states sign up to it, they will be judged harshly by history for not only selling out Palestine for $50 billion, but also footing the bill. As such, they all feel compelled to hedge and pay salutary lip-service to US efforts but know quietly they will die on the vine and that the Arab Peace Initiative is the only viable framework for advancing talks.

Even younger leaders know that the greater risk will come from signing up to the deal rather than twitter wrath of the US president.

Kuwaiti Parliament Speaker Marzouq Al-Ghanim threw a copy in the bin, emphasizing that it ‘was born dead’ and ‘should be thrown in the dustbin of history’.

While the Saudi official position towards the deal was one of qualified support, the Saudi press reported that King Salman had spoken with Palestinian Authority President Mahmoud Abbas, who has rejected the plan, to ‘stress to him the Kingdom's steadfast position vis-à-vis the Palestinian cause and the rights of the Palestinian people’. The king reportedly added: ‘The Kingdom stands alongside the Palestinian people and supports its choices and what[ever] will actualize its hopes and aspirations.’

Turki Al-Faisal, the former Saudi intelligence chief, described the deal’s idea of a Palestinian state as ‘a brutal conception’ and the deal itself as a ‘modern-day Frankenstein’. ‘For Palestine, it is definitely a step back,’ Al-Faisal said. ‘[The Trump administration has] given up the legitimate history and weight of the United Nations Security Council resolutions and adopted a unilateral path.’

The view from Europe

Reni Zhelyazkova

The initial EU response to President Trump’s ‘Peace to Prosperity’ plan was one of caution. An official statement soon after the announcement declared that the proposal needs to be studied and assessed but only a few days later the EU’s High Representative for Foreign Affairs, Josep Borrell, condemned the plan for being out of line with internationally agreed parameters.

Some member states like Luxembourg have expressed support for the foreign policy chief’s position. Ireland, historically a strong supporter of the Palestinian cause, and Sweden, the only country to recognize the Palestinian state after becoming an EU member, have responded negatively to the US proposal, expressing concern over mentions of Israeli annexation of Palestinian land and stating that it falls short from previous international agreements.

Other EU countries, however, have been much more guarded in their reactions. Responses from Germany and France have so far been lukewarm – on the one hand, welcoming US attempts at re-igniting peace talks between Israelis and Palestinians, and, on the other, warning that any future negotiations and agreements must be carried out in accordance with internationally established parameters and legal frameworks.

A strong voice of support for Trump’s proposal was that of Hungary, whose minister of foreign affairs and trade, Péter Szijjártó, commended White House adviser Jared Kushner on the plan during a meeting in Washington last week. Other EU countries are yet to respond publicly to the proposal but unity among all EU countries is far from certain.

The EU’s official position is that a two-state solution based on pre-1967 borders and in line with previous agreements and UN resolutions is the only viable option for lasting peace between Israelis and Palestinians.

However, Israeli foreign policy under Netanyahu has focused on strengthening bilateral relations with countries in eastern and central Europe. Cooperation with Romania, Bulgaria, Greece, Croatia, Cyprus, Czech Republic, Estonia, Latvia, Lithuania and most recently Slovakia and Hungary has improved in all areas – from security and trade to tourism and cultural exchanges.

Five of these countries, namely, the Czech Republic, Slovakia, Hungary, Romania and Bulgaria recognized the State of Palestine prior to joining the EU, but the rise of populist nationalism, concerns over migration and terrorism, and improving relations with the Trump administration in the US have contributed to an alignment in views between Israel and the right-leaning governments in southern and eastern Europe, as well as those in Italy and Austria.

Improved bilateral relations have translated into political acts of good will towards Israel with a number of EU countries expressing support for Israel in the United Nations and other international forums. Austria, Romania, Hungary and the Czech Republic defied official EU position and attended the US embassy opening in Jerusalem in May 2018.

In this sense, Israel’s strategy in eastern and central Europe can be seen as a deliberate effort to break up consensus within the EU, and, ideally, reverse the bloc’s position towards the Middle East conflict, but also towards Iran. 

At a time when the EU is managing Brexit, a complex internal agenda, including arguments over the EU budget, and with its relationship with the US strained over Iran, trade and other issues, it is unlikely that the bloc will contribute significant efforts to the Middle East Peace Process. It is even more difficult to see the EU coming up with its own proposal and even less likely that all member states will be able to agree on such an initiative given internal divisions. 

Under the EU Neighbourhood Policy, the European Joint Strategy in Support of Palestine for the period 2017-20 has focused on supporting the Palestinian Authority (PA) with institutional reform, economic development and service delivery. Progress, however, has been limited as the success of programming is dependent on Israeli policy towards the West Bank and Gaza. This has hardened under Netanyahu, who enjoys the full support of the current US administration and sees the EU as biased towards the Palestinians. 

Any plan that replaces the 2017-20 joint strategy will most likely be a continuation of the current approach which focuses on conflict management and supporting the already crumbling two-state solution by keeping the PA alive. 

Some room for cautious hope remains, as much depends on the outcome of the Israeli election on 2 March and the US presidential election in November. Changes in leadership could open up space for EU to actively support the reinvigoration of peace talks and regain its relevance as a mediator in the Middle East Peace Process.

As Lebanon strains to contain COVID-19, it is not clear which governmental public health policies apply to refugees. The government announced free testing for coronavirus in the public Rafiq Hariri University Hospital in Beirut but has not mentioned if refugees are eligible.

Lebanon’s coronavirus containment strategy is based on self-reporting and, given incidents of forced deportation and harassment of Syrian refugees from both the authorities and local communities, it is certainly less likely refugees would present themselves to the health authorities for fear of deportation.

Despite agreeing a Lebanon Crisis Response Plan with the UN for refugees, different ministries were left to implement it without coordination, just as Lebanese politicians from all sides started trying to rally popular support for ridding Lebanon from refugees - in particular from Syria, who Lebanese leaders say are causing a strain on the country’s already weak infrastructure.

This finger pointing is coupled with the leaders’ own complete disregard for the rampant corruption and lack of accountability within Lebanon’s political class, which contribute to the weakening of the country’s infrastructure.

For refugees who do find themselves back in Syria, there are different challenges according to which area they are in. In the north-east, the WHO and international NGOs (INGOs) negotiate with both Kurdish authorities as well as the government - each presenting its own hurdles.

Kurdish authorities in northeast Syria have closed the Semalka border with Iraqi Kurdistan, posing a serious dilemma for INGOs offering services in north-east Syria but concerned about their staff safety whose movement is now curtailed.

The government of Syria has stipulated all emergency response must go through its ministries. But this limits what the WHO can do in the country and gives Syrian authorities the ability to block ‘cross-line aid’ which goes from government-controlled to non-government areas.

Despite reports that doctors raised the alarm about suspected cases well before patient zero was confirmed, the government appears to be either covering up the actual extent of the spread of COVID-19 or failing to respond. Some limited testing kits have arrived but testing has barely started.

The WHO’s Syria plan is divided into three regions (north-west, north-east, and areas under government control). But concerns remain as to how workable such a decentralized plan is because of the government’s practices. In January, the UN Security Council did not renew the cross-border response resolution for the Yaroubiye border crossing between Syria and Iraq that the WHO was using to send medical supplies into north-east Syria.

Syrian authorities do not permit recently authorized ‘cross-line’ responders to engage with non-government authorities in areas outside regime control. This essentially voids the authorization to work cross-line as it is practically impossible to implement programs. The WHO has sought approval from the Syrian Ministry of Foreign Affairs to move medical supplies by land to north-east Syria.

While promising facilitation, the Ministry’s reply comes with conditions of seeking detailed approval for every shipment. When Eastern Ghouta was under siege, similar conditions led to certain supplies being removed from UN/ICRC convoys to Eastern Ghouta, and there is no guarantee this will not happen again.

Due to lack of capacity in north-east Syria, coronavirus tests conducted by the WHO there must be processed through the Central Public Health Laboratory in Damascus. Samples are transported twice a week from Qamishli to Damascus but no results were ever received from Damascus for those tests.

While the WHO is able to coordinate access to north-west Syria with the Turkish authorities, the prospective coronavirus testing capacity in the Idlib region is low – despite claims that thousands of kits are arriving, a lack of resource on the ground means potentially only 20 tests per day could be done in an area inhabited by an estimated three million people.

Following the recently announced ceasefire in the area, many internally displaced people are returning from the Turkish border to their homes in the north-west, but such mass movement increases the risk of coronavirus spreading. People also continue to move between Syria, Iraq, Turkey and Lebanon, posing a challenge to the WHO’s COVID-19 response in the Levant, as the WHO has distinct response plans for each country in the region and it is difficult to coordinate across these plans.

Challenges face refugees even if they head towards Europe due to the potential for conflation between migration control and coronavirus outbreak control. Aurelie Ponthieu, Coordinator for Forced Migration at Médecins Sans Frontières (MSF) says there is a risk some countries could use COVID-19 to impose draconian measures towards asylum seekers.

The crisis has also put a halt to search and rescue operations in the Mediterranean because European countries are not allowing boats carrying migrants to disembark under the pretext of limiting the spread of coronavirus. And for migrants who already made it - such as in Greece - they are now being put in collective quarantines in asylum centers, often with poor medical facilities.

Ponthieu also reports that migrants being quarantined on overcrowded navy ships docked in Greek ports, making social distancing impossible. And she is concerned the Greek authorities are imposing a curfew on asylum seekers but not on the local population.

UNHCR is stressing that people’s right of asylum must not be overruled by concerns about the spread of coronavirus, while local and international NGOs across the Levant are trying to coordinate their advocacy on lifting restrictions on freedom of movement for humanitarian workers and on other policies and practices by authorities in the region which are adversely affecting refugee and other vulnerable communities.

The international community must not lose sight of the impact of the crisis on refugees and migrants. It is not enough simply to supply humanitarian and medical assistance without paying attention to the policies and practices of the different authorities who have direct control over the fate of vulnerable communities.

The author would like to thank Aurelie Ponthieu and the two INGO field workers who all agreed to be interviewed to inform this analysis piece.

The event will be livestreamed on the MENA Programme Facebook page.

Climate and environmental issues have largely been marginalized in discussions about the Middle East and North Africa region and yet are critical to peace and security. In this webinar, experts will explore mounting pressures including those related to water (reduced, less reliable and more polluted sources), extreme temperatures, air pollution, land degradation and sea-level rise. Panelists will discuss the potential impact of worsening environmental conditions and what the region's governments can do to protect the health and livelihoods of their peoples.

This webinar is part of the Chatham House MENA Programme's Online Event Series and will be held on the record.

Iraq is a country already in turmoil, suffering fallout from the major military escalation between the US and Iran, mass protests calling for an end to the post-2003 political system, and a violent government crackdown killing more than 600 and wounding almost 30,000 - all presided over by a fragmented political elite unable to agree upon a new prime minister following Adil abd al-Mehdi’s resignation back in November.

COVID-19 introduces yet another threat to the fragile political order, as the virus exposes Iraq’s ineffective public health system dismantled through decades of conflict, corruption and poor governance.

Iraqi doctors are making every effort to prepare for the worst-case scenario, but they do so with huge structural challenges. The Ministry of Health lacks enough ICU beds, human resources, ventilators, and personal protective equipment (PPE). Bogged down in bureaucracy, the ministry is struggling to process procurements of equipment and medications, and some doctors have made purchases themselves.

But individual efforts can only go so far as many Iraqi doctors are concerned the official numbers of confirmed COVID-19 cases do not reflect the complexity of the situation on the ground.

The ministry relies predominately upon patients self-presenting at designated public hospitals and has only just begun community-based testing in areas of suspected clusters. Reliance on self-presentation requires a level of trust between citizens and state institutions, which is at a historic low. This gap in trust – 17 years in the making – puts Iraq’s COVID-19 response particularly at risk.

Iraq’s myriad vulnerabilities

Certain social and political factors leave Iraq uniquely exposed to the coronavirus. The country’s vulnerability is tied directly to its social, religious and economic interconnections with Iran, an epicenter of the pandemic.

Exchanges between Iran and Iraq are concentrated in two regions, with strong cross-border links between Iraqi and Iranian Kurds in the north-east, and Iraqi and Iranian Shia pilgrims in the south. Cross-border circulation of religious pilgrims is particularly concerning, as they can result in mass ritual gatherings.

The high number of confirmed cases in the southern and northern peripheries of the country puts a spotlight on Iraq's failure in managing healthcare. The post-2003 government has failed to either rebuild a robust centralized healthcare system, or to pave the way for a federalized model.

Caught in an ambiguous middle between a centralized and federalized model, coordination across provinces and hospitals during the coronavirus crisis has neither reflected strong management from Baghdad nor robust ownership at the governorate level.

This problem is part of a wider challenge of managing centre-periphery relations and federalism, which since 2003 has not worked effectively. Baghdad has provided all 18 provinces with instructions on testing and treatment, but only a handful have enough resources to put them into practice. Advanced testing capacity is limited to the five provinces with WHO-approved centers, with the remaining 13 sending swabs to Baghdad.

But the greatest challenge to Iraq’s COVID-19 response is the dramatic deterioration of state-society relations. Studies reveal a profound societal distrust of Iraq’s public healthcare institutions, due to corruption and militarization of medical institutions. Numerous videos have recently circulated of families refusing to turn over sick members - particularly women - to medical teams visiting households with confirmed or suspected cases.

As medical anthropologist Omar Dewachi notes, the ‘moral economy of quarantine’ in Iraq is heavily shaped by a history of war and its impact on the relationship between people and the state. Although local and international media often interpret this reluctance to undergo quarantine as a matter of social or tribal norms, distrusting the state leads many families to refuse quarantine because they believe it resembles a form of arrest.

The management of coronavirus relies upon an overt convergence between medical institutions and security forces as the federal police collaborate with the Ministry of Health to impose curfews and enforce quarantine. This means that, troublingly, the same security establishment which violently cracked down on protesters and civil society activists is now the teeth behind Iraq’s COVID-19 response.

Without trust between society and the political class, civil society organizations and protest movements have directed their organizational structure towards awareness-raising across Iraq. Key religious authorities such as Grand Ayatollah Sistani have called for compliance to the curfew and mobilized charitable institutions.

However, such efforts will not be enough to make up for the lack of governance at the level of the state. In the short-term, Iraq’s medical professionals and institutions are in dire need of technical and financial support. In the long-term, COVID-19 is a lesson that Iraq’s once robust public healthcare system needs serious investment and reform.

COVID-19 may prove to be another catalyst challenging the ‘muddle through’ logic of the Iraqi political elite. International actors have largely been complicit in this logic, directing aid and technical support towards security forces and political allies in the interest of short-term stability, and neglecting institutions which Iraqis rely on for health, education, and well-being.

The response to the crisis requires cooperation and buy-in of a population neglected by 17 years of failed governance. This is a seminal event that may push the country to the brink, exposing and stirring underlying tensions in state-society relations.

This analysis was produced as part of the Iraq Initiative.

As new cases of COVID-19 continue to surge, countries around the world struggle to mitigate the public health and economic effects of the virus. It is becoming increasingly clear that an effective pandemic response requires a whole-of-government, whole-of-society approach. In the Arab world, where health systems are already strained by armed conflicts and displaced populations, a whole-of-society response to the pandemic is particularly critical as countries have become increasingly dependent on non-state actors, notably the private sector, for healthcare provision and any response that includes the state alone may not be sufficient to address the pandemic.

In a recent article, Fadi El-Jardali, argued that while the pandemic will have grave health and economic consequences for years to come, it brings with it a valuable opportunity to re-envision the role of state and non-state actors in strengthening health systems. The article addressed the need for increased collaboration between state and non-state actors, and the rethinking of existing cooperation models to provide quality healthcare services for all.  

In this webinar, part of the Chatham House project on the future of the state in the Middle East and North Africa, Dr El-Jardali will discuss how state and non-state actors can collaborate more effectively to address the shortcomings of national health care systems amidst the pandemic and beyond. The article’s author will share insights on the different capacities available in Arab societies that governments can draw upon to ensure that Universal Health Coverage, equity considerations and social justice are at the core of health systems.

You can express your interest in attending by following this link. You will receive a Zoom confirmation email should your registration be successful. Alternatively, you can watch the event live on the MENA Programme Facebook page.

 

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Efforts to address illegal logging and reduce the trade in illegal timber have borne fruit and prompted some positive reforms in producer countries, a new report from Chatham House has found. However, changes in the sector mean overall trade in illegal timber has not fallen in the last decade. 
  
EU and US policies designed to reduce demand for illegal timber have helped cut illegal imports to those markets. These reforms and the EU’s partnership agreements with producer countries have prompted improvements in forest governance and a fall in large-scale illegal timber production.

But growth of demand in emerging markets means that the progressive policies of so-called ‘sensitive markets’ are now less influential. China is now the world’s largest importer and consumer of wood-based products, as well as a key processing hub. India, South Korea, and Vietnam are also growing markets. The increasing role of small-scale producers, whose activities often fall outside legal frameworks, and a rapid increase in illegal forest conversion, also present new challenges. 
  
Alison Hoare: 'The EU and US have spearheaded some progressive and effective reforms. However, the changing scale and nature of the problem demands more coordinated international action. To stop further deforestation and associated carbon emissions, and to help achieve global objectives for sustainable development, the EU and US need to maintain their leadership while other countries - especially China, Japan, India and South Korea - need to step up their efforts to tackle illegal logging.'

The Chatham House report, which is based on the studies of 19 countries, which include key producers, consumers, or processors of timber, and is an update of a 2010 study found: 

Timber production

• More than 80 million m3 of timber was illegally produced in 2013 in the nine producer countries assessed, accounting for about one-third of their combined total production.
• An estimated 60% of this illegal timber is destined for these countries’ domestic markets.
• Small-scale producers are increasingly important – for example, in Cameroon, the DRC and Ghana, they account for an estimated 50, 90 and 70% respectively of annual timber production. The majority of this is illegal.
• For the nine producer countries, the area of forest under voluntary legality verification or sustainability certification schemes increased by nearly 80% between 2000 and 2013. 

Imports of illegal wood-based products 

• In most of the consumer and producer countries assessed, the volume of illegal imports of wood-based products fell during the period 2000–13. 
• The exceptions were China, and India and Vietnam where the volume of illegal imports more than doubled. 
• As a proportion of the whole, illegal imports declined for nearly all countries. 
• However, at the global level, the proportion of illegal timber imports remained steady at 10% - a result of the growth of the Chinese market. 

The EU and US 

• The volumes of illegal imports into the UK, France and the Netherlands nearly halved over the period 2000-13, from just under 4 million m3 to 2 million m3. 
• The volume of illegal imports into the US increased between 2000 and 2006, from around 5 to 9 million m3, and then declined to just under 6 million m3 in 2013. 
• In 2013, more than 60% of illegal imports of wood-based products to the UK and US came from China.

China

• The volume of illegal imports into China doubled between 2000 and 2013 from 17 to 33 million m3; but as a proportion of the whole illegal imports fell, from 26 to 17%.
•  The volume of exports of wood-based products (legal and illegal) from the nine producer countries to China nearly tripled, from 12 million m3 in 2000 to 34 million m3 in 2013.

The Chatham House report makes the following recommendations:

• The EU and US need to maintain and reinforce current efforts 
• Other countries need to take stronger action – China in particular, but also India, Japan and South Korea
• Strong international cooperation is needed to maintain & reinforce current efforts – the G20 could provide a forum to galvanise international action
• Producer countries need to focus on strengthening efforts to tackle corruption, improving legality within the small-scale sector, and reforming land-use governance 

     
Alison Hoare: 'Developing countries are losing significant amounts of potential revenue from illegal logging, which is also causing the loss and degradation of forests, depleting livelihoods, and contributing to social conflict and corruption. Tackling illegal logging and strengthening forest governance are essential for achieving critical climate and development goals. Having seen the progress that can be made, it’s imperative that governments agree to work together to rise to new challenges and promote a more sustainable forest sector for the benefit of all.'   

Read the report >>

Seeing geo-strategic rivalry between the US and China as the sole variable in Asia-Pacific security risks becoming a self-fulfilling prophecy, according to a forthcoming Chatham House paper.            

As Xi Jinping’s visit to the US approaches, The Asia-Pacific Power Balance: Beyond the US–China Narrative, warns against deploying Cold War-type narratives that pit the two countries against each other. Such narratives not only misunderstand the complexity of the region and the growing influence of India, Japan and Indonesia, but also risk increasing the likelihood of conflict and of missing vital opportunities for future cooperation.                

The paper, by John Nilsson-Wright, Tim Summers and Xenia Wickett argues that by focusing too heavily on the US and China, policymakers risk narrowing the aperture through which they evaluate policy choices regarding major regional challenges. Some of the key findings include the following:

Military

• Despite rapidly rising defence spending across Asia, the relative importance of traditional military means is declining relative to instruments such as development assistance and cyber offence.
• The militaries of Japan and India are becoming – in very different ways – more versatile and potentially expanding their remits. In the future, there will be a larger number of more capable military powers in the region, including South Korea and Vietnam.
• Current perceptions that the main dynamic is China’s rising military capabilities outstripping others in the region, therefore, need to be tempered. India’s defence spending, for example, as a percentage of GDP has surpassed China’s for the past several decades.

Economics

• Although China has the world’s second-largest economy and – despite recent problems – is growing faster than most major economies, its growth rate is in secular decline. China has gone from near-constant double-digit growth over the past four decades to 7.4 per cent in 2014 and could dip below 7 per cent this year.
• Whilst India’s economy remains notably smaller than those of China, the US and Japan, it will surpass China’s growth rate this year and has a lot of potential.
• If the Trans-Pacific Partnership (TPP) is successfully negotiated, the potential for integration and growth between the United States, Japan and the other 10 TPP members may reduce their current trade dependence on China.

Demography

• The demography of Asia is another reason to look beyond the US-China nexus, as China faces the challenge of an aging society, while countries such as India have the advantage of a younger population and decades of demographic dividend ahead of them.
• Likewise populations across much of Southeast Asia, such as the Philippines and Indonesia are growing rapidly and expanding their middle classes. 

The risk of a serious cyber attack on civil nuclear infrastructure is growing, as facilities become ever more reliant on digital systems and make increasing use of commercial ‘off-the-shelf’ software, according to a major new report from Chatham House.

Cyber Security at Civil Nuclear Facilities: Understanding the Risks is the result of an 18-month study that draws on in-depth interviews with 30 leading industry practitioners based in more than eight countries. It found that the trend to digitization, when combined with a lack of executive-level awareness of the risks involved, means that nuclear plant personnel may not realize the full extent of their cyber vulnerability and are thus inadequately prepared to deal with potential attacks. 

Specific findings include:                

• The conventional belief that all nuclear facilities are ‘air gapped’ (isolated from the public internet) is a myth. The commercial benefits of internet connectivity mean that a number of nuclear facilities now have VPN connections installed, which facility operators are sometimes unaware of.
• Search engines can readily identify critical infrastructure components with such connections.
• Even where facilities are air gapped, this safeguard can be breached with nothing more than a flash drive.
• Supply chain vulnerabilities mean that equipment used at a nuclear facility risks compromise at any stage.
• A lack of training, combined with communication breakdowns between engineers and security personnel, means that nuclear plant personnel often lack an understanding of key cyber security procedures.
• Reactive rather than proactive approaches to cyber security contribute to the possibility that a nuclear facility might not know of a cyber attack until it is already substantially under way.

In the light of these risks, the report outlines a blend of policy and technical measures that will be required to counter the threats and meet the challenges. 

Recommendations include:

• Developing guidelines to measure cyber security risk in the nuclear industry, including an integrated risk assessment that takes both security and safety measures into account.
• Engaging in robust dialogue with engineers and contractors to raise awareness of the cyber security risk, including the dangers of setting up unauthorized internet connections.
• Implementing rules, where not already in place, to promote good IT hygiene in nuclear facilities (for example to forbid the use of personal devices) and enforcing rules where they do exist.
• Improving disclosure by encouraging anonymous information sharing and the establishment of industrial CERTs (Computer Emergency Response Team).
• Encouraging universal adoption of regulatory standards.

Revenues for pharmaceutical companies need to be 'delinked' from sales of antibiotics to avoid their over-use and avert a public health crisis, says a new report from the think-tank Chatham House.

Over-use of antibiotics is contributing to the growing resistance of potentially deadly bacteria to existing drugs, threatening a public health crisis in the near future. The report notes that, by 2050, failing to tackle antibiotic resistance could result in 10 million premature deaths per year.                                       

Novel antibiotics to combat resistant pathogens are thus desperately needed, but market incentives are exacerbating the problem. Towards a New Global Business Model for Antibiotics: Delinking Revenues from Sales states that,                                       

'The current business model requires high levels of antibiotic use in order to recover the costs of R&D. But mitigating the spread of resistance demands just the opposite: restrictions on the use of antibiotics.'

                                       

To tackle this catch-22 problem, the Centre on Global Health Security at Chatham House recommends the establishment of a global body to implement a radical new business model for the industry, which would encourage investment and promote global access to - and conservation of - antibiotics.      

The current business model has several perverse effects. As R&D is an inherently risky and costly endeavour, the industry is chronically under-investing in new treatments. Today, few large pharmaceutical companies retain active antibacterial drug discovery programmes. Re-stoking the industry's interest in antibiotics would be one of the primary roles of the new body.   

Secondly, the need to recover sunk cost under the current business model encourages both high prices and over-marketing of successful drugs, making potentially life-saving treatments unaffordable to many in developing countries, while simultaneously encouraging over-use in developed markets and increasing resistance.   

The new global body would address these challenges by ‘delinking’ pharmaceutical revenues from sales of antibiotics. It would do this by directly financing the research and development of new drugs, which it would then acquire at a price based on production costs rather than the recovery of R&D expenses. Acquisition could take the form of procurement contracts with companies, the purchase of full IP rights or other licensing mechanisms.                                       

This would enable it to promote global access to antibiotics while simultaneously restricting over-use. Conservation would be promoted through education, regulation and good clinical practice, with the report recommending that 'proven conservation methods such as antibiotic stewardship programmes… be incentivized and implemented immediately.'

Priorities for R&D financing would be based on a comprehensive assessment of  threats arising from resistance. Antibiotics would qualify for the highest level of financial incentives if they combat resistant pathogens posing a serious threat to human health.                                       

Finance for the new body would come from individual nation states, with the report noting that this could 'begin with a core group of countries with significant research activity and large antibiotic markets, (though) it is envisaged that all high income countries should make an appropriate financial contribution.'                                 

It is not yet clear exactly how much funding would be necessary to combat resistance, but with inaction expected to cost $100 trillion in cumulative economic damage, the report argues that 'an additional global investment of up to $3.5 billion a year (about 10 per cent of the current value of global sales of antibiotics) would be a bargain.'

In the week before governments assemble in Paris to agree a global climate deal, a new report from Chatham House shows that a worldwide shift to healthier diets could help close the gap between current emissions reduction plans and what is needed to prevent dangerous climate change.

Pledges from countries attending the 21st UNFCCC Conference of the Parties put the world on track for around 3 degrees of warming by 2100, leaving governments with much more still to do. Changing diets to healthy levels of meat consumption could generate a quarter of the remaining emission reductions needed to keep warming below the ‘danger level’ of 2 degrees Celsius – the main goal of the climate negotiations.

Changing Climate, Changing Diets: Pathways to Lower Meat Consumption by Laura Wellesley, Catherine Happer and Antony Froggatt argues that, ultimately, dietary change is fundamental to achieving the 2 degrees goal. The livestock sector is already responsible for 15 per cent of global greenhouse gas emissions. Unless strong demand growth for meat is curtailed, livestock sector emissions will increase to the point where dangerous climate change is unavoidable.

Dietary change would also have major health benefits. Global per capita meat consumption is already above healthy levels, and double the recommended amount in industrialized countries. Too much red and processed meat is associated with an increased risk of non-communicable diseases, in particular cancer, as found most recently by the World Health Organization.

'Reducing meat consumption is a real win-win for health and for the climate,' says report author Laura Wellesley. 'As governments look for strategies to close the Paris emissions gap quickly and cheaply, dietary change should be high on the list.'

However, the report finds that governments are ignoring the opportunity. Reducing meat consumption does not feature in a single national emissions reduction plan submitted in advance of the Paris meeting. Governments are afraid to interfere in lifestyle choices for fear of public backlash.

But new research undertaken for the report, including an innovative public survey in 12 countries and focus groups in Brazil, China, the United Kingdom, and the United States shows that government fears are exaggerated. Once aware of the link between meat and climate change, consumers accept the need for government action. Even unpopular interventions to make meat more expensive, for example through a carbon tax, would face diminishing resistance as publics come to understand the rationale behind intervention.

To build support for government action, the report recommends initiatives to raise public awareness of the climate and health impacts of excessive meat consumption. Governments should pursue comprehensive strategies to shift diets, including policies on labelling, public procurement, regulation and pricing.

'Raising awareness about the health and environmental impacts of meat is an important first step, but on its own it will not lead to significant behaviour change. Governments must do more to influence diets,' added Wellesley.

European leaders need to implement common European solutions to the refugee crisis. Only joint solutions can credibly and effectively reduce the growing human suffering and social and political turmoil.

The refugee crisis poses a serious challenge, both to the welfare of refugees and to European societies. In 2015, more than 1.5 million migrants crossed into the European Union. From Italy to Poland, and from Greece to Germany, countries face immense challenges in responding to requests for humanitarian aid, asylum, and integration. The associated integration challenges in housing, language, work and welfare are already formidable. Failing to manage them properly poses serious threats to social cohesion and political stability.

European countries have had sufficient time to analyse and assess the long-standing challenges which created the current crisis. Now it is time to act – not individually and at the expense of others, but jointly and in a spirit of European solidarity. This is why Vision Europe – a partnership between seven leading think tanks and foundations in Europe – will in 2016 focus its efforts on providing practical solutions to the current refugee crisis, and its root causes. We, the seven signatories, writing in an individual capacity, see an urgent need for a common European approach, to compliment local and national efforts.

At present, there is no consensus among member states on how to respond to the crisis, neither on the objectives to be achieved or the methods to be used.  But disagreements on substance must be overcome now. Building on current discussions, we propose a comprehensive agenda at the EU level, with five major dimensions.

First, it is important to control the EU’s external borders so that only refugees fleeing war and persecution, who have a legitimate right to seek asylum, can enter and potentially remain in the EU. The porous nature of the EU’s external borders has meant an unacceptable loss of control in the eyes of many EU citizens and has raised false hopes for irregular migrants trying to enter the Union. The control of the borders of the Schengen Area should be a collective effort of the EU and all Member States, coordinated by European Institutions with professional staff and with financial support provided to Member States at the EU’s periphery. Regaining control of the EU’s external borders is essential to preserve open internal borders.

Second, beyond implementing the already agreed upon relocation of 160,000 refugees from Greece and Italy, the EU should develop a system which distributes a much larger number of refugees across the Union, directly from the hotspots in the EU and the neighbouring counties such as Turkey, Jordan or Lebanon. Member States not willing to host refugees themselves could choose to make a primarily financial contribution to the system. A Migration Solidarity Fund should be created to manage this compensatory system. Turkey’s efforts to reduce the crossings in the Aegean Sea should be matched by a willingness among EU Member States to take in refugees in an orderly manner. The Conclusions from the European Council seem to move in the right direction in this regard.

The third measure should be to improve, standardize and speed up the processes to determine asylum applications. The sooner refugees know whether they can stay, the more energy can be invested in their integration into host countries’ societies and in family reunions. The sooner a decision is taken, the fairer and more feasible it is to send back those whose requests are refused in full respect of international law and human rights. And EU members cannot afford to have vastly different standards in granting asylum status.  Under international law, there can be no limit set on the number of those eligible to request asylum.

As a fourth measure, we recommend expanding efforts at the EU level to improve the living conditions of refugees staying in countries close to their countries of origin. Many refugees want to return to their homes as soon as the situation becomes safe again. They should not be driven to start the hazardous journey to the European Union only because of unbearable conditions in the countries where they are currently sheltering.

Last but not least, the EU and its Member States should work vigorously towards ending the violent conflicts that are the principal causes of the crisis. Europe must invest heavily in the Syria peace process, in particular. The EU must also raise the ambition and resources of its Neighbourhood Policy, with a focus on helping to stabilise the region and on improving the living conditions and economic opportunities in the Southern neighbourhood.

But action is also required at the national level, especially in the EU countries where significant numbers of refugees have received or are expected to receive asylum. The distribution of refugees across municipalities and regions should be fair and should come with adequate support and resources from the national level, emphasising education and language training. The recognition of professional competences and support to enter the labour market should be available at a very early stage. Within our societies, we need a dialogue between refugees and the host society. It should be made clear that respect for human rights, democratic values and cultural norms is indispensable for a prolonged stay in the respective European host country.

Coming from seven European countries, with different national policies and approaches to the refugee crisis, the foundations and think tanks of Vision Europe are working together to advance new ideas, to frame an informed debate and to emphasize the benefits of common European solutions to Europe-wide problems. Europe is strong enough to manage the migration challenges, but only if political leaders act now, act responsibly and use the resources at their disposal, including support for civil society working in this area. We must not leave the public space to populists and nationalists offering false promises. Only a European solution will be workable and sustainable.

 

Aart de Geus
Chairman and Chief Executive Officer, Bertelsmann Stiftung, Germany

Artur Santos Silva
President, Fundação Calouste Gulbenkian, Portugal

Guntram Wolff
Director, Bruegel, Belgium

Mikko Kosonen
President, Finnish Innovation Fund Sitra, Finland

Piero Gastaldo
Secretary General, Compagnia di San Paolo, Italy

Robin Niblett
Director, Chatham House, United Kingdom

Yves Bertoncini
Director, Jacques Delors Institute, France

The ‘Cavaliere’ of the Order of ‘Stella d’Italia’ is presented to individuals who have made a positive contribution to Italy’s reputation abroad and who have fostered positive relations and cooperation with other countries and their ties with Italy.

Founded in 1947 to recognize civilian and military expatriates or non-Italians who made an outstanding contribution to Italy’s post-war reconstruction, the focus of this honour has now shifted to acknowledge individuals who have made specific contributions to Italy’s image and relationships overseas.

Dr Subacchi’s research and work at Chatham House was praised for its quality and rigour and for encouraging international dialogue. Dr Subacchi’s influence through her books, articles and media appearances were also noted for the impact they created, in particular in the context of the wider platform and reputation of Chatham House. 

Accepting the award from Vincenzo Celeste, Dr Subacchi said: ‘I am very proud to accept this award. In particular I would like to thank my family, friends and colleagues for their support, friendship and mentoring and I am delighted to share this honour with them.’

The Academy was launched by Her Majesty the Queen in November 2014 to offer potential and established leaders from around the world the opportunity to spend ten months as Academy fellows and develop the tools needed to address the major policy challenges and critical issues facing the world today.

Academy fellows are drawn from government and the broader policy community, the private sector, media and civil society. During their time at the Academy, fellows deepen their understanding of critical issues, learn new skills, develop their networks and propose new ideas and solutions to complex policy challenges and opportunities.

Dr Leslie Vinjamuri, Dean, QEII Academy for Leadership in International Affairs says:

'Chatham House recognizes the need for inspirational and effective leadership in today’s complex and rapidly changing global environment. We remain absolutely committed to the mission of developing leadership skills and feel privileged to welcome the 2018-19 Academy Fellows. The Queen Elizabeth II Academy is uniquely well-positioned, drawing on the historical depth of expertise at Chatham House, our international and national networks, and the dynamism of London to develop skills, knowledge, and global insights that benefit emerging and accomplished leaders across diverse sectors in Europe, Africa, the Middle East, Asia and the Americas.'

Academy Fellows 2018/19

Rustam Anshba
Rustam’s research will explore the prospects for transforming the Georgian-Abkhaz conflict. He will be hosted by the Russia and Eurasia Programme. His fellowship is supported by the Robert Bosch Stiftung.

Rita Dayoub
Rita will analyse attacks against healthcare systems during conflicts in Syria and South Sudan. She will be hosted by the Centre on Global Health Security. Her fellowship is supported by the Asfari Foundation.

Isabel Dunstan
Isabel’s research will focus on digital literacy among women as a means to counter radicalization and intolerance in Indonesia. She will be hosted by the Asia-Pacific Programme. Her fellowship is supported by Mr Richard Hayden.

Sophia Ignatidou
Sophia will examine the political and security implications of Artificial Intelligence. She will be hosted by the International Security Department. Her fellowship is supported by the Stavros Niarchos Foundation.

Anna Korbut
Anna’s research will examine the current media landscape in Ukraine and its transformative potential. She will be hosted by the Russia and Eurasia Programme. Her fellowship is supported by the Robert Bosch Stiftung.

Damir Kurtagic
Damir will research the challenges and possibilities of private sector engagement in Sub-Saharan Africa. He will be hosted by the Africa Programme. His fellowship is supported by the Robert Bosch Stiftung.

Zaki Mehchy
Zaki will research the role and dynamics of non-state actors in Syria and their relationship with state institutions. He will be hosted by the Middle East and North Africa Programme. His fellowship is supported by the Asfari Foundation.

Anne Nyambane
Anne will examine the synergies and trade-offs involved in the implementation of the Sustainable Development Goals (SDGs). She will be hosted by the Energy, Environment and Resources Department. Her fellowship is supported by the Mo Ibrahim Foundation.

Masterclass
The Academy is also pleased to welcome three Masterclass participants from the European Bank for Reconstruction and Development.

For the past few months, users have been sharing their thoughts on our website on the future of democracy and the role of technology in it. Many have shared concerns about the effects of technological change:  

• Social media may be undermining the historic role of politicians to speak on behalf of their constituencies.
• Twitter favours brief writing and hence brief thinking, which may be leading to a deterioriation in democratic debates.
• The risk that the so-called 'echo chamber effect' undermines balanced and reasoned public debate.

But there have also been lots of ideas about how technology can help European democracies become more responsive and dynamic such as:

• The use of technology to better inform citizens and include civil society in decision-making.
• Sybil-proof identity verification for social network accounts operated by local municipalities.
• The development of non-profit personal data cooperatives as a response to the domination of Big Tech.

Now we want users help in shaping the final report. What do you think should be included?

We are opening up the report writing process and inviting you to take part and feed in your views. Work with us on a collaborative draft in Google Docs – comment, edit and get an insight into the black box of think tank research.

We’ll also be incorporating the most interesting submissions from the previous phase. If you'd like to make a submission, you can still do so here.

How To Join

To access the documents, you will need a Gmail account and to be registered as a user on demtech.chathamhouse.org. Each research question has its own working document, accessed via the Research Questions page.

The process is open to everyone. We look forward to working with you!

Join the project now

The Chatham House Prize is awarded to the person, persons or organization who is deemed to have made the most significant contribution to the improvement of international relations in the previous year. The presentation ceremony and panel discussion with the winners will be livestreamed on Wednesday.

The Blue Planet II series highlighted the damage caused by discarded plastics to the world’s oceans and marine wildlife. It is estimated that there are more than 150 million tonnes of plastic in the world’s oceans; resulting in the deaths of 1 million birds and 100,000 sea mammals each year. 

Dr Robin Niblett, director of Chatham House said: ‘Plastic pollution is one of the gravest challenges facing the world’s oceans, and undoubtedly an international issue. Sir David and the BBC Studios Natural History Unit played an instrumental role in helping to put this issue at the forefront of the public agenda. Blue Planet II spurred a passionate global response and generated clear behavioural and policy change.’

This year the G20 agreed on an international framework to address marine plastic litter, acknowledging the increasing urgency of the issue and the need for an international solution. This follows action from the UK government, including a plan to ban common plastic items and investment in global research.

See full award citation

Read more about Chatham House's research work in this area

Other nominees

Dr Niblett thanked Chatham House members for voting and acknowledged the outstanding achievements of the 2019 nominees:

Abiy Ahmed, prime minister of Ethiopia, nominated for his efforts to transform civic leadership and promote plural politics, free speech and peace in Ethiopia 

Katrín Jakobsdóttir, prime minister of Iceland, nominated for her commitment to gender equality and women’s financial inclusion in Iceland 

Event

The Prize was presented to Sir David and Julian Hector by Her Majesty The Queen at Chatham House on Wednesday 20 November.

Watch video from the event

For more information please contact

Chatham House Press Office
pressoffice@chathamhouse.org
+44 (0)207 957 5739

BBC Studios Natural History Unit Communications Manager
Lynn.li@bbc.co.uk
+44 (0) 7513 137893

About the Chatham House Prize

The Chatham House Prize is voted for by Chatham House members, following nominations from the institute’s staff. The award is presented on behalf of the institute's patron, Her Majesty the Queen, representing the non-partisan and authoritative character of the Prize.

The Chatham House Prize was launched in 2005. Previous recipients of the Prize include the Committee to Protect Journalists, Colombian president Juan Manuel Santos, president of Ghana John Kufuor, Médecins Sans Frontières and Melinda Gates, co-founder of the Bill and Melinda Gates Foundation.

Chatham House is a world-leading policy institute based in London. Our mission is to help governments and societies build a sustainably secure, prosperous and just world. We engage governments, the private sector, civil society and our members in open debate and private discussions about the most significant developments in international affairs.  Our research and policy ideas involve rigorous analysis of critical global, regional and country-specific challenges and opportunities.

About BBC Studios Natural History Unit 

BBC Studios Natural History Unit produces the world’s most iconic natural history programmes, such as Blue Planet II and Planet Earth II, which have been watched by more than a billion people globally. Ranging from technically challenging live shows and super-landmarks to long-running series and children’s content, The Natural History Unit programmes include Dynasties, Blue Planet Live, Springwatch, Animal Babies: First Year On Earth, Andy’s Dinosaur Adventures as well as the currently on air Seven Worlds, One Planet presented by Sir David Attenborough and third-party commissions for Discovery, Apple, Quibi, National Geographic and BBC America. 

The Natural History Unit is part of BBC Studios, a subsidiary of the BBC, which develops, produces and distributes bold, British content, making over 2,500 hours of content each year, operating in 22 markets globally and generating revenue of around £1.4bn. In the year to March 2019, it returned £243m to the BBC Group, complementing the BBC’s licence fee and enhancing programmes for UK audiences.

In an open podcast recorded following the event, Robin Niblett discussed the state of the transatlantic relationship with International New York Times London Bureau Chief Steven Erlanger, former UK defence secretary Liam Fox and former Foreign Affairs Committee chair Mike Gapes.

The roundtable was held under the Chatham House Rule.

 

While revelations about the activities of the NSA and GCHQ confirmed the depth of cooperation between the US and the UK over intelligence, the debate over the UK’s membership of the EU and difficulties in coordinating a response to the Syria crisis have raised tensions between policy-makers in Washington and London. With the two countries now facing an array of shared international challenges – not least in Ukraine, Afghanistan and Iraq – this roundtable will examine the current state of the transatlantic relationship.

The NATO Summit, held in September 2014 in Newport, Wales, was a waypoint in the larger strategic vision for NATO over the coming decade. As the alliance continues to confront challenges on its eastern and southern frontiers, it must find ways to adapt its strategy for more effective responses, while also staying ahead of emerging threats and risks. 

The event will bring together senior representatives from a number of the NATO member states, NATO partners and external experts from industry, the media and the think-tank and academic communities, to examine what NATO member states have done thus far to move the deliverables forward, and how to most effectively work together in continuing to do so. 

Attendance at this event is by invitation only.

This is the second of two workshops held in collaboration with SWP-Berlin; the first took place at Chatham House in October 2014.

Summary

• Chatham House brought together European, Asian and American policy-makers and experts over the course of a two-day scenario workshop in November 2015. The participants were asked to take part in a structured role-playing exercise imagining a potential near-future conflict between China and Japan over disputed islands.
• The findings of the workshop, and the actions of participants in the simulation, suggested significant differences between how the United States and Europe prioritize their interests in the Asia-Pacific. In particular, the perception was that the European Union and its member states consider challenges from their ‘near abroad’ as more tangible than those emanating from Asia, and that they focus on commercial opportunities in the region. In contrast, US foreign policy in the Asia-Pacific is seen as emphasizing strategic and geopolitical challenges.
• In terms of military capabilities, Europeans view themselves as having few assets to bring to bear in Asia. European, American and Asian observers are largely unaware of French and British military capabilities in or near the region.
• Beyond the military, Europe’s other tools of leverage – diplomatic, development, economic and other soft-power instruments – are also ignored. Europeans are often unaware of the activities of their own governments in the region. This is equally true in reverse – Japan’s engagement vis-à-vis European interests (such as with respect to Russia or Syria) is little recognized by Europeans.
• European nations prefer to engage unilaterally with Asia on trade and multilaterally, through the EU, on security and geopolitical issues. However, no ideal forum for multilateral coordination exists (given the fact that the EU is not a member of most Asian regional organizations).
• The US’s greater engagement in Asia reflects the fact that the US, unlike its European counterparts, is a Pacific nation. But it can also be explained by greater domestic public support for such engagement. This reflects the presence of significant numbers of US troops in Asia and the relatively high proportion of ethnic Asians in the US compared with the EU.

Summary

• The United States and the European Union are deeply integrated economically in terms of movement of goods, services and capital across the Atlantic, but this is not matched by the mobility of labour. Freer movement of high-skilled workers across the Atlantic has a potentially critical role to play in maintaining and strengthening the bilateral economic relationship.
• Both the US and EU seek to attract high-skilled labour through the use of temporary visa programmes. Various routes are available for highly skilled workers from the EU to temporarily work in the US (for instance, through the H-1B visa for foreign nationals in ‘specialty occupations’, as well as other visa categories for treaty traders and investors, intra-company transferees, and international students seeking work authorization in the US before or after graduation). The main ways for highly skilled workers from the US to temporarily work in EU member states are through EU-wide schemes that apply in 25 out of the 28 member states (for holders of EU Blue Cards or intra-company transferees); or via member states’ parallel national schemes.
• The experiences of US and EU employers and workers under the US H-1B programme and the EU’s Blue Card scheme differ greatly. The EU Blue Card scheme avoids many of the drawbacks of the H-1B visa. It does not have an annual cap on the number of visas issued. It also grants greater autonomy to the worker by not requiring the employer to sponsor long-term residence, by providing greater flexibility to switch employment, and by having a longer grace period for visa-holders to find new employment after dismissal.
• The US visa system hampers America’s economic growth. Restrictive policies such as an annual limit on the number of H-1B visas issued, and the associated uncertainty for employees and employers, hinder the ability of US companies to expand and innovate. The complex and costly visa application process is a particular burden for small and medium-sized enterprises. Problems around the timely availability of visas frustrate investors both from the US and from abroad (including from the EU). European firms face difficulties in acquiring visas for intra-company transferees, and not all EU member states have access to the treaty trader and treaty investor visa categories. At times, this impedes foreign direct investment and restricts US job creation. In addition, current policies hinder the economy’s retention of EU and other graduates of US universities. This is of particular concern given that skilled graduates have a critical role to play in addressing the US’s growing shortage of workers in the science, technology, engineering and mathematics (STEM) fields.
• Given the comparability of US and EU wages and labour markets, US concerns about foreign workers ‘stealing’ their jobs or depressing wages generally do not apply to EU citizens. On the contrary, a more open immigration policy for high-skilled workers – in particular for EU citizens – would benefit the US economy.
• Efforts to reform visa systems for high-skilled labour are under way in both the US and EU. In order to facilitate the movement of highly skilled workers across the Atlantic, this research paper recommends (1) creating a special visa for highly skilled EU citizens to work temporarily in the US; (2) extending the availability of treaty trader and investor visas to all EU member states; and (3) increasing efforts to eliminate fraud and abuse in the H-1B system. These measures could potentially help to create more investment, jobs and economic growth in the US.

Megan Greene will join us for a discussion on the prospect of future economic and political uncertainty on both sides of the Atlantic.

The first year of Donald Trump’s presidency and the ongoing saga of Brexit negotiations underscore the amount of uncertainty about the economic future on both sides of the Atlantic.

Despite that, business and consumer confidence in the US and continental Europe have soared. Are we still stuck in secular stagnation, or are we breaking out of the low growth, low inflation, low rate environment we’ve been in for years?

What opportunities and risks are posed by this year’s elections in France and Germany, the upcoming elections in Italy, and the mid-term elections in the US?

This event is part of the US and Americas Programme ongoing series on Transatlantic Perspectives on Common Economic Challenges. This series examines some of the principal global challenges that we face today and potentially differing perspectives from across Europe and the US.

Attendance at this event is by invitation only.

Even though most African states have signed and ratified the Framework Convention on Tobacco Control (FCTC), a global treaty to limit tobacco use, African states have been slow to pass and implement tobacco control policies like regulations on sales, smoke-free environments and taxes. This article examines how the ineffectiveness of local tobacco-control advocacy contributes to this suboptimal outcome. It asserts that the disconnect between the global tobacco-control advocacy network and local advocates shapes this ineffectiveness. With funding and direction predominately from the Bloomberg Initiative, local advocates emulate the funders' goal of achieving quick, measurable policy results. Their reliance on the network drives African advocates to strive to pass legislation, even in difficult political climates, and to remake their agendas when funders change their priorities. They also emulate the network's focus on evidence-based arguments that stress epidemiological data and biomedical interventions, even when this issue frame does not resonate with policy-makers. Financial dependence can draw local advocates into expectations about patronage politics, undermine their ability to make principled arguments, and lead them to downplay the ways that their home country's socioeconomic and cultural contexts affect tobacco use and control. Based on key informant interviews with African advocates, media analysis and the case-studies of Ghana and Tanzania, the article broadens the study of philanthropy in global health, it adds an African perspective to the literature on global health advocacy, and it deepens knowledge on power dynamics between external funders and local actors in the realms of health and development.

Air pollution has been classified as a cancer-causing agent with evidence showing an increased risk of lung cancer associated with increasing levels of exposure to outdoor air pollution and particulate matter.

Air pollution is also known to increase risks for other diseases, especially respiratory and heart diseases, and studies show that levels of exposure to air pollution have increased significantly in some parts of the world - mostly in rapidly industrializing countries with large populations.

In coordination with London Global Cancer Week partner organizations, this event outlines the evidence linking air pollution and cancer rates in London and other major cities.

Panellists provide a 360° picture of the impact of the rising incidence of cancer across the world, the challenges the cancer pandemic poses to the implementation of universal health coverage and the existing UK contribution to strengthening capacity in cancer management and research in developing countries.

The leaked record of the five meetings of the UK–US Trade & Investment Working Group held in 2017–18 has led to a controversy in the UK election campaign around the claim that ‘the NHS is up for sale’.

But a careful reading of the leaked documents reveals how remarkably little concerns the NHS – in five meetings over 16 months, the NHS is mentioned just four times. The patent regime and how it affects medicines is discussed in more depth but largely in terms of the participants trying to understand each other’s systems and perspectives. For the most part, the discussions were overwhelmingly about everything else a trade deal would cover other than healthcare – matters such as subsidies, rules of origin and customs facilitation.

But this does not mean there will be no impact on Britain’s health service. There are three main concerns about the possible implications of a US–UK trade deal after Brexit – a negotiation that will of course only take place if the UK remains outside the EU customs union and single market and also does not reach a trade agreement with the EU that proves incompatible with US negotiating objectives.

One concern is that the US aim of securing ‘full market access for US products’, expressed in the US negotiating objectives, will affect the ability of NICE (The National Institute for Health and Care Excellence) to prevent the NHS from procuring products that are deemed too expensive in relation to their benefits. It could also affect the ability of the NHS to negotiate with companies to secure price reductions as, for instance, happened recently with Orkambi, a cystic fibrosis drug.

A peculiarity of the main US government healthcare programme (Medicare) is that it has historically not negotiated drug prices, although there are several bills now before Congress aiming to change that. US refusal to negotiate or control prices is one reason that US drug prices are the highest in the world.  

A second concern is that the US objective of securing ‘intellectual property rights that reflect a standard of protection similar to that found in US law’ will result in longer patent terms and other forms of exclusivity that will increase the prices the NHS will have to pay for drugs.

However, it is not immediately apparent that UK standards are significantly different from those in the US – the institutional arrangements differ but the levels of protection offered are broadly comparable. Recent publicity about a potential extra NHS medicine bill of £27 billion resulting from a trade deal is based on the NHS having to pay US prices on all drugs – which seems an unlikely outcome unless the UK contingent are extraordinarily bad negotiators.

Nevertheless, in an analysis section (marked for internal distribution only), the UK lead negotiator noted: ‘The impact of some patent issues raised on NHS access to generic drugs (i.e. cheaper drugs) will be a key consideration going forward.’

A third concern is that the US objective of providing ‘fair and open conditions for services trade’ and other US negotiating objectives will oblige the UK to open up the NHS to American healthcare companies.

This is where it gets complicated. At one point in a discussion on state-owned enterprises (SOEs) the US asked if the UK had concerns about their ‘health insurance system’ (presumably a reference to the NHS). The UK response was that it ‘wouldn’t want to discuss particular health care entities at this time, you’ll be aware of certain statements saying we need to protect our needs; this would be something to discuss further down the line…’

On this exchange the UK lead negotiator commented:  ‘We do not currently believe the US has a major offensive interest in this space – not through the SOE chapter at least. Our response dealt with this for now, but we will need to be able to go into more detail about the functioning of the NHS and our views on whether or not it is engaged in commercial activities…’

On the face of it, these documents provide no basis for saying the NHS would be for sale – whatever that means exactly. The talks were simply an exploratory investigation between officials on both sides in advance of possible negotiations.

But it is a fact that US positions in free trade agreements are heavily influenced by corporate interests. Their participation in framing agreements is institutionalized in the US system and the pharmaceutical and healthcare industries in the US spend, by a large margin, more on lobbying the government than any other sector does. Moreover, President Donald Trump has long complained about ‘the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country’.

It is when (and if) the actual negotiations on a trade deal get under way that the real test will come as the political profile and temperature is raised on both sides of the Atlantic.

As the COVID-19 crisis roars on, so have debates about China’s role in it. Based on what is known, it is clear that some Chinese officials made a major error in late December and early January, when they tried to prevent disclosures of the coronavirus outbreak in Wuhan, even silencing healthcare workers who tried to sound the alarm.

China’s leaders will have to live with these mistakes, even if they succeed in resolving the crisis and adopting adequate measures to prevent a future outbreak. What is less clear is why other countries think it is in their interest to keep referring to China’s initial errors, rather than working toward solutions.

For many governments, naming and shaming China appears to be a ploy to divert attention from their own lack of preparedness. Equally concerning is the growing criticism of the World Health Organization (WHO), not least by Donald Trump who has attacked the organization - and threatens to withdraw US funding - for supposedly failing to hold the Chinese government to account.

Unhelpful and dangerous

At a time when the top global priority should be to organize a comprehensive coordinated response to the dual health and economic crises unleashed by the coronavirus, this blame game is not just unhelpful but dangerous.

Globally and at the country level, we all desperately need to do everything possible to accelerate the development of a safe and effective vaccine, while in the meantime stepping up collective efforts to deploy the diagnostic and therapeutic tools necessary to keep the health crisis under control.

Given there is no other global health organization with the capacity to confront the pandemic, the WHO will remain at the center of the response, whether certain political leaders like it or not.

Having dealt with the WHO to a modest degree during my time as chairman of the UK’s independent Review on Antimicrobial Resistance (AMR), I can say that it is similar to most large, bureaucratic international organizations.

Like the International Monetary Fund (IMF), the World Bank, and the United Nations, it is not especially dynamic or inclined to think outside the box. But rather than sniping at these organizations from the sidelines, we should be working to improve them.

In the current crisis, we all should be doing everything we can to help both the WHO and the IMF to play an effective, leading role in the global response. As I have argued before, the IMF should expand the scope of its annual Article IV assessments to include national public-health systems, given that these are critical determinants in a country’s ability to prevent or at least manage a crisis like the one we are now experiencing.

I have even raised this idea with IMF officials themselves, only to be told that such reporting falls outside their remit because they lack the relevant expertise. That answer was not good enough then, and it definitely isn’t good enough now.

If the IMF lacks the expertise to assess public health systems, it should acquire it. As the COVID-19 crisis makes abundantly clear, there is no useful distinction to be made between health and finance. The two policy domains are deeply interconnected, and should be treated as such.

In thinking about an international response to today’s health and economic emergency, the obvious analogy is the 2008 global financial crisis which started with an unsustainable US housing bubble, fed by foreign savings owing to the lack of domestic savings in the United States.

When the bubble finally burst, many other countries sustained more harm than the US did, just as the COVID-19 pandemic has hit some countries much harder than it hit China.

And yet not many countries around the world sought to single out the US for presiding over a massively destructive housing bubble, even though the scars from that previous crisis are still visible. On the contrary, many welcomed the US economy’s return to sustained growth in recent years, because a strong US economy benefits the rest of the world.

So, rather than applying a double standard and fixating on China’s undoubtedly large errors, we would do better to consider what China can teach us. Specifically, we should be focused on better understanding the technologies and diagnostic techniques that China used to keep its - apparent - death toll so low compared to other countries, and to restart parts of its economy within weeks of the height of the outbreak.

And for our own sakes, we also should be considering what policies China could adopt to put itself back on a path toward 6% annual growth, because the Chinese economy inevitably will play a significant role in the global recovery.

If China’s post-pandemic growth model makes good on its leaders’ efforts in recent years to boost domestic consumption and imports from the rest of the world, we will all be better off.

This article was originally published in Project Syndicate

The coronavirus pandemic continues to claim lives around the world. As countries grapple with how best to tackle the virus, and the reverberations the pandemic is sending through their societies and economies, scientific understanding of how the COVID-19 virus is behaving and what measures might best combat it continues to advance.

Join us for the sixth in a weekly series of interactive webinars on the coronavirus with Professor David Heymann and special guest, Johan Giesecke, helping us to understand the facts and make sense of the latest developments in the global crisis. What strategy has Sweden embraced and why? Can a herd immunity strategy work in the fight against COVID-19? How insightful is it to compare different nations’ approaches and what does the degree of variation reveal?

Professor Heymann is a world-leading authority on infectious disease outbreaks. He led the World Health Organization’s response to SARS and has been advising the organization on its response to the coronavirus. 

Professor Giesecke is professor emeritus of Infectious Disease Epidemiology at the Karolinska Institute Medical University in Stockholm. He was state epidemiologist for Sweden from 1995 to 2005 and the first chief scientist of the European Centre for Disease Prevention and Control (ECDC) from 2005 to 2014.

On 10 January 2020, Chinese scientists released the sequence of the COVID-19 genome on the internet. This provided the starting gun for scientists around the world to start developing vaccines or therapies. With at least 80 different vaccines in development, many governments are pinning their hopes on a quick solution. However, there are many hurdles to overcome. 

Vaccine development

Firstly, vaccine development is normally a very long process to ensure vaccines are safe and effective before they are used. 

Safety is not a given: a recent dengue vaccine caused heightened disease in vaccinated children when they later were exposed to dengue, while Respiratory Syncytial Virus vaccine caused the same problem. Nor is effectiveness a given. Candidate vaccines that use novel techniques where minute fragments of the viruses’ genetic code are either injected directly into humans or incorporated into a vaccine (as is being pursued, or could be pursued for COVID-19) have higher risks of failure simply because they haven’t worked before. For some vaccines, we know what levels of immunity post-vaccination are likely to be protective. This is not the case for coronavirus. 

Clinical trials will have to be done for efficacy. This is not optional – regulators will need to know extensive testing has taken place before licencing any vaccine. Even if animal tests are done in parallel with early human tests, the remainder of the process is still lengthy. 

There is also great interest in the use of passive immunization, whereby antibodies to SARS-CoV-2 (collected from people who have recovered from infection or laboratory-created) are given to people who are currently ill. Antivirals may prove to be a quicker route than vaccine development, as the testing requirements would be shorter, manufacturing may be easier and only ill people would need to be treated, as opposed to all at-risk individuals being vaccinated.

Vaccine manufacturing

Developers, especially small biotechs, will have to make partnerships with large vaccine manufacturers in order to bring products to market. One notorious bottleneck in vaccine development is getting from proof-of-principle to commercial development: about 95 per cent of vaccines fail at this step. Another bottleneck is at the end of production. The final stages of vaccine production involve detailed testing to ensure that the vaccine meets the necessary criteria and there are always constraints on access to the technologies necessary to finalize the product. Only large vaccine manufacturers have these capacities. There is a graveyard of failed vaccine candidates that have not managed to pass through this development and manufacturing process.

Another consideration is adverse or unintended consequences. Highly specialized scientists may have to defer their work on other new vaccines to work on COVID-19 products and production of existing products may have to be set aside, raising the possibility of shortages of other essential vaccines. 

Cost is another challenge. Vaccines for industrialized markets can be very lucrative for pharmaceutical companies, but many countries have price caps on vaccines. Important lessons have been learned from the 2009 H1N1 flu pandemic when industrialized countries took all the vaccines first. Supplies were made available to lower-income countries at a lower price but this was much later in the evolution of the pandemic. For the recent Ebola outbreaks, vaccines were made available at low or no cost. 

Geopolitics may also play a role. Should countries that manufacture a vaccine share it widely with other countries or prioritize their own populations first? It has been reported that President Trump attempted to purchase CureVac, a German company with a candidate vaccine.  There are certainly precedents for countries prioritizing their own populations. With H1N1 flu in 2009, the Australian Government required a vaccine company to meet the needs of the Australian population first. 

Vaccine distribution

Global leadership and a coordinated and coherent response will be needed to ensure that any vaccine is distributed equitably. There have been recent calls for a G20 on health, but existing global bodies such as the Coalition for Epidemic Preparedness Innovations (CEPI) and GAVI are working on vaccines and worldwide access to them. Any new bodies should seek to boost funding for these entities so they can ensure products reach the most disadvantaged. 

While countries that cannot afford vaccines may be priced out of markets, access for poor, vulnerable or marginalized peoples, whether in developed or developing countries, is of concern. Developing countries are at particular risk from the impacts of COVID-19. People living in conflict-affected and fragile states – whether they are refugees or asylum seekers, internally displaced or stateless, or in detention facilities – are at especially high risk of devastating impacts. 

Mature economies will also face challenges. Equitable access to COVID-19 vaccine will be challenging where inequalities and unequal access to essential services have been compromised within some political systems. 

The need for global leadership 

There is an urgent need for international coordination on COVID-19 vaccines. While the WHO provides technical support and UNICEF acts as a procurement agency, responding to coronavirus needs clarity of global leadership that arches over national interests and is capable of mobilizing resources at a time when economies are facing painful recessions. We see vaccines as a salvation but remain ill-equipped to accelerate their development.

While everyone hopes for rapid availability of safe, effective and affordable vaccines that will be produced in sufficient quantities to meet everyone’s needs, realistically, we face huge hurdles. 

When the H1N1 influenza pandemic struck in 2009, some industrialized countries were well prepared. Many countries’ preparedness plans had focused on preparing for an influenza pandemic and based on earlier alerts over the H5N1 ‘bird flu’ virus, countries had made advanced purchase or ‘sleeping’ contracts for vaccine supplies that could be activated as soon as a pandemic was declared. Countries without contracts scrambled to get supplies after those that already had contracts received their vaccine.

Following the 2009 pandemic, the European Union (EU) developed plans for joint-purchase vaccine contracts that any member state could join, guaranteeing the same price per dose for everyone. In 2009, low-income countries were unable to get the vaccine until manufacturers agreed to let 10 per cent of their production go to the World Health Organization (WHO).

The situation for COVID-19 could be even worse. No country had a sleeping contract in place for a COVID-19 vaccine since nobody had anticipated that the next pandemic would be a coronavirus, not an influenza virus. With around 80 candidate vaccines reported to be in development, choosing the right one will be like playing roulette.

These candidates will be whittled down as some will fail at an early stage of development and others will not get to scale-up for manufacturing. All of the world’s major vaccine pharmaceutical companies have said that they will divert resources to manufacture COVID-19 vaccines and, as long as they choose the right candidate for production, they have the expertise and the capacity to produce in huge quantities.

From roulette to a horse race

Our game now changes from roulette to a horse race, as the probability of winning is a matter of odds not a random chance. Countries are now able to try to make contracts alone or in purchasing consortia with other states, and with one of the major companies or with multiple companies. This would be like betting on one of the favourites.

For example, it has been reported that Oxford University has made an agreement with pharmaceutical company AstraZeneca, with a possibility of 100 million doses being available by the end of 2020. If the vaccine works and those doses materialize, and are all available for the UK, then the UK population requirements will be met in full, and the challenge becomes vaccinating everyone as quickly as possible.

Even if half of the doses were reserved for the UK, all those in high-risk or occupational groups could be vaccinated rapidly. However, as each major manufacturer accepts more contracts, the quantity that each country will get diminishes and the time to vaccinate the at-risk population gets longer.

At this point, it is not known how manufacturers will respond to requests for vaccine and how they will apportion supplies between different markets. You could bet on an outsider. You study the field and select a biotech that has potential with a good production development programme and a tie-in with a smaller-scale production facility.

If other countries do not try to get contracts, you will get your vaccine as fast as manufacturing can be scaled up; but because it is a small manufacturer, your supplies may take a long time. And outsiders do not often win races. You can of course, depending on your resources, cover several runners and try to make multiple contracts. However, you take on the risk that some will fail, and you may have compromised your eventual supply.

On April 24, the WHO co-hosted a meeting with the president of France, the president of the European Commission and the Bill & Melinda Gates Foundation. It brought together heads of state and industry leaders who committed to ‘work towards equitable global access based on an unprecedented level of partnership’. They agreed ‘to create a strong unified voice, to build on past experience and to be accountable to the world, to communities and to one another’ for vaccines, testing materials and treatments.

They did not, however, say how this will be achieved and the absence of the United States was notable. The EU and its partners are hosting an international pledging conference on May 4 that aims to raise €7.5 billion in initial funding to kick-start global cooperation on vaccines. Co-hosts will be France, Germany, Italy, the United Kingdom, Norway and Saudi Arabia and the priorities will be ‘Test, Treat and Prevent’, with the latter dedicated to vaccines.

Despite these expressions of altruism, every government will face the tension between wanting to protect their own populations as quickly as possible and knowing that this will disadvantage poorer countries, where health services are even less able to cope. It will not be a vote winner to offer a share in available vaccine to less-privileged countries.

The factories for the biggest vaccine manufacturers are in Europe, the US and India. Will European manufacturers be obliged by the EU to restrict sales first to European countries? Will the US invoke its Defense Production Act and block vaccine exports until there are stocks enough for every American? And will vaccine only be available in India for those who can afford it?

The lessons on vaccine availability from the 2009 influenza pandemic are clear: vaccine was not shared on anything like an equitable basis. It remains to be seen if we will do any better in 2020.

As countries grapple with how best to tackle the COVID-19 pandemic and the reverberations it is sending through their societies and economies, scientific understanding of how the virus is behaving, and what measures might best combat it, continues to advance. This briefing will focus on the progress towards and prospects for a coronavirus vaccine, exploring the scientific considerations, the production, distribution and allocation challenges as well as the access politics.

Join us for the eighth in a weekly series of interactive webinars on the coronavirus with Professor David Heymann and special guest, Professor David Salisbury, helping us to understand the facts and make sense of the latest developments in the global crisis. With 80 candidate vaccines reported to be in development, how will scientists and governments select the 'right' one? What should be the role of global leadership and international coordination in the development and distribution of a new vaccine? And can equitable access be ensured across the globe?

Professor Heymann is a world-leading authority on infectious disease outbreaks. He led the World Health Organization’s response to SARS and has been advising the organization on its response to the coronavirus.

Professor Salisbury was director of immunization at the UK Department of Health from 2007 to 2013. He was responsible for the national immunization programme and led the introduction of many new vaccines. He previously chaired the WHO’s Strategic Advisory Group of Experts on Immunization and served as co-chair of the Pandemic Influenza group of the G7 Global Health Security Initiative.

This event will be livestreamed.