The gruesome theatrics of the Islamic State (IS) captivate the world’s attention, instilling fear in the public from Los Angeles to Paris to Beirut. Yet while arrests are made in Europe and airstrikes continue in Raqqa, Americans ignore developments on another worn-out battlefield: Afghanistan.

Afghanistan faces numerous crises in 2016 that could rock the country and threaten U.S. security investments. The United States still has 10,000 troops stationed in the country. It must take decisive action not to supply vast numbers of troops or massively increase spending, but instead abandon inadequate policies before something catastrophic occurs. These must be more than incremental policy changes that merely stave off disaster for the interim, as this would compound the seriousness of each crisis. After traveling to Afghanistan in October 2015, we have identified key security risks and steps the United States can take to forestall disaster.

In 2015, Taliban violence resulted in more Afghan civilian, police, and military casualties than in any year since U.S. and NATO forces began fighting in Afghanistan. More fighters, better weapons, and new tactics made the 2015 Taliban offensive their most effective yet, with a recent attack in Parwan province that killed six U.S. soldiers serving as a terrible reminder of this grim reality. Next year, the Taliban will aim to take provincial cities, pounce on Kandahar, and spread fear through spectacular attacks. A major Taliban offensive following this year’s fierce assault is almost certain. Indeed, as a recent Department of Defense report describes, the security situation in Afghanistan has grown more precarious over the last year.

The Afghan army has done its best to counter the Taliban assault. Afghan forces retook Kunduz and pushed back serious Taliban offensives in other cities, including Ghazni. While attrition is high due to soldiers overstaying leaves, desertion, and Taliban threats to soldiers’ families, recruitment of new forces has exceeded losses. Yet, strong ground forces cannot compensate for inadequate air support, modern intelligence capabilities, well-functioning logistics (to maintain vehicles and keep essential supplies available), and higher-order assistance for Afghanistan’s still-nascent security institutions. The United States must help fill these critical gaps while maintaining its promises to complete these critical, but unfinished, programs. The United States must also amend the very restrictive rules of engagement that currently limit air support capabilities, and restore intelligence assets that have been withdrawn. Stronger battlefield intelligence capabilities are essential, as we learned after the tragic bombing of the Médecins Sans Frontières (MSF) hospital in Kunduz. More effective air attacks and improved intelligence could seriously disrupt Taliban operations in Afghanistan.

But the Taliban is no longer the only threat to stability in Afghanistan. The influence of the Islamic State is growing, as it recruits more extremist Taliban members and brings in fighters from non-Afghan communities, including Uzbeks and Pakistanis. These IS-inspired groups challenge the new Taliban leader, Mullah Akhtar Mansour, who seeks to cement his leadership after the years-long deception over the death of his predecessor, Mullah Omar. The Taliban fragmentation and competition from IS, especially prominent in the provinces of Zabul and Nangarhar, have led to increased violence, including the recent beheadings of minority Hazaras. The renewed violence reduces already slim hopes for a negotiated peace in Afghanistan.

The United States and NATO must intensify actions against IS in Afghanistan. Like al Qaeda, the group must be a priority target for air and counter terrorist missions. Now is the time to destroy it. At a minimum, coalition forces must restrain the growth of this hostile force before it becomes a significantly larger threat.

Afghanistan is undertaking a unique experiment in elected government. Nearly 70 percent of the electorate voted in 2014, despite threats from the Taliban to kill or mutilate anyone who did so. However, the results were clouded by accusations of widespread fraud. After an extended political impasse, the United States brokered a peaceful settlement and a power-sharing agreement between the two contenders in the run off. The National Unity Government (NUG) was formed with Ashraf Ghani serving as president and his chief rival, Abdullah Abdullah, as chief executive officer.

Military solutions alone cannot solve all of the country’s woes, as the electorate’s participation and the elected officials’ ability to govern are as critical to a stable state as a strong security apparatus. Now, at a time when insurgent attacks need a strong response and the government needs to stop its internal wrangling and start delivering services to civilians, the NUG finds itself politically distracted. Ex-president Hamid Karzai and mujahedeen leaders continue to undermine the government in an attempt to spur its collapse. These attempts are little more than a naked power grab that, if successful, would usher in months of political paralysis while the victors squabble over the spoils of power. This would be disastrous, at a time when insurgent attacks need a strong response and the government needs to start delivering services. The United States and other coalition nations must voice strong opposition to all efforts to change the constitution through a Loya Jirga or the scheduling of early elections. Without first reforming the electoral system, another massively fraudulent election will surely follow. Quiet opposition will be taken as willingness to see the NUG undone.

Despite some positive developments, the Afghan government is losing popular support. More and more Afghans believe that the country is heading in the wrong direction. Thousands of Afghans are fleeing the country, and along with them goes the potential for economic growth. Crime and insecurity in the cities contribute to this brain and asset drain. Stakeholders in Afghanistan must demand governance improvements from the NUG – including opposition to vicious ethnic discrimination and power abuse, which the Taliban exploited in Kunduz – that the Afghan people crave. The government should focus on increasing effective anti-criminal and anti-corruption policing in the major cities, such as Kabul, Herat, and Jalalabad. This would require significant government action against some major power brokers. Additionally, a concerted foreign advisory effort with the police is needed to improve civilian security. These actions require vigorous U.S. and international backing.

Doubts are growing about the United States’ and NATO’s commitment to long-term support for Afghanistan. While President Barack Obama’s decision to retain major security hubs in Afghanistan was a step in the right direction, this progress was undercut by the planned force reductions at the end of 2016. In a worsening security environment, Afghans fear being abandoned by their international partners. To rebuild confidence, a U.S.-led NATO review of conditions on the ground and a demonstrated willingness to fill major gaps, such as air support, would counteract this sense of abandonment.

Not all is gloom. Unlike Karzai, who blamed the United States for most of Afghanistan’s problems and refused to move against massive corruption, Ghani remains committed to reform. There is progress in revenue collection, enforcement action against fraud in Kabul Bank, and some members of the new cabinet are making progress in less visible but important reforms like speeding business licensing and settling land titles. Unlike in Syria and Iraq, militias do not yet dominate either politics or the battlefield. Actions are still available to minimize the looming crises. But planning and decisions are needed now, not after the crises explode.

This piece was originally published by Foreign Policy. 

       

The Pakistani intelligence service is behind the recent attack on a major Indian air force base in Punjab using a terrorist group it created 15 years ago, according to well-informed press and other knowledgeable sources. The attack is designed to prevent any detente between India and Pakistan after Prime Minister Narendra Modi’s surprise Christmas Day visit to Pakistan.

The escalating violence between the two nuclear-weapons states, which have already fought four wars, threatens to get worse. The Pakistani intelligence service has the capability to launch more attacks with little notice, at some point prompting a vigorous Indian response.

On Dec. 31, a team of terrorists infiltrated across the Pakistani border into India. On Saturday they assaulted the Pathankot air base, one of India’s largest air force installations near the border. At least seven Indian soldiers were killed in the fighting, which lasted for days. On Sunday, the Indian Consulate in Mazar-e Sharif in northern Afghanistan was also attacked by gunmen.

Both attacks are the work of the Pakistani terror group Jaish e Muhammad, according to reliable press reports. JEM was created in 2000 by Mualana Masoud Azhar, a longtime Pakistani terrorist leader. Azhar was captured in India in 1994 after taking western hostages in Kashmir. In December 1999 a group of terrorists hijacked an Air India jet flying from Nepal to India and diverted it to Afghanistan. They demanded the release of Azhar and his colleagues in return for the passengers and crew.

And they got it, thanks to help from the Pakistani intelligence service ISI and al Qaeda leader Osama bin Laden, according to accounts of the hijacking based on the Indian officials who negotiated with the terrorists for the hostages’ freedom.

The Afghan Taliban assisted the hijackers once they got to Afghanistan. Once Azhar was traded for the hostages, the ISI took him on a public victory tour through Pakistan to raise money for the jihad against India, and he announced the formation of Jaish e Muhammad, or the Army of Muhammad, in early 2000. JEM received training and weapons from the ISI and worked closely with al Qaeda.

In December 2001, JEM terrorists working with terrorists from another ISI-backed group, Lashkar e Tayyiba (LET), attacked the Indian parliament building in New Delhi. That attack prompted India to mobilize its military, and a tense standoff went on for nine months. Only intense mediation by President Bush’s national security team averted war.

Azhar kept a low profile for several years after LET’s 2008 attack on Mumbai, but he reappeared publicly in 2014, giving fiery calls for more attacks on India and the United States. His group is technically illegal in Pakistan but enjoys the continuing patronage of the ISI.

The ISI is under the generals’ command and is composed of army officers, so the spies are controlled by the Pakistani army, which justifies its large budget and nuclear weapons program by citing the Indian menace. Any diminution in tensions with India might risk the army’s lock on its control of Pakistan’s national security policy. The army continues to distinguish between “good” terrorists like JEM and LET and “bad” terrorists like the Pakistani Taliban, despite decades of lectures from American leaders.

The army has long distrusted Prime Minister Nawaz Sharif, who has advocated a detente with India since the 1990s. An army coup in 1999 sent him into exile in Saudi Arabia for a decade. His warm embrace of Modi on Christmas Day in his home in Lahore undoubtedly angered the generals.

Modi’s visit was the first by an Indian prime minister in more than a decade. It was also Sharif’s birthday and the birthday of Pakistan’s founder, Muhammad Jinnah. Modi’s decision to visit and the warm family greeting Sharif extended set the stage for a planned resumption of formal diplomatic negotiations between the two countries scheduled for later this month.

So far New Delhi has not canceled the planned talks. Modi’s advisers are well aware of the double game the Pakistani army plays and the differences inside the Pakistani establishment. After four wars with Pakistan and a nuclear arms race, Indian experts understand the complexity of the dynamics inside Islamabad. The Indians have accepted Prime Minister Sharif’s public condemnation of the attack and promised to provide evidence of JEM’s role to his government, including cellphones captured in the attack.

Washington put JEM on the terrorist sanctions list years ago—but it continues to coddle the Pakistani army. Gen. Raheel Sharif, the army’s boss (and no relation to the prime minister) got a warm embrace from the Pentagon last fall—despite the ISI’s support for the Afghan Taliban’s offensive against the Kabul government and despite the Pakistani military’s backing of terror groups like JEM.

This piece was originally published by The Daily Beast.

       

2016 is shaping up to be a potentially critical year for Afghanistan. ISIS is rising there, the Taliban is gaining ground, the stability of the Afghan government is deteriorating by the day, and national elections are coming in October. The US, China, Pakistan, and the Afghan government are currently holding talks aimed at bringing the Taliban to the table to try negotiate an end to the war.

Of those countries, it's Pakistan that is the most significant. Pakistan has probably the most influence of anyone over whether those talks will succeed in getting the Taliban to agree to sit down and negotiate a peace agreement with the Afghan government. But there's a lot more going on with the peace talks that are perhaps the country's best or only remaining hope.

To understand how this works and why it matters, I spoke to Vanda Felbab-Brown, a senior fellow in the Center for 21st Century Security and Intelligence at the Brookings Institution and an expert on Afghanistan. What follows is a transcript of our conversation, lightly edited for clarity and length.

Jennifer Williams: Could you start by just explaining how Pakistan has been involved in the conflict between the Taliban and Afghanistan historically?

Vanda Felbab-Brown: That goes back to the creation of independent Pakistan, with issues having to do with the Pashtun minority in Pakistan, which is also the majority population of Afghanistan, and irredentist claims by Afghan Pashtun politicians, as well as the Cold War rivalry between the Soviet Union and the United States, who at different times supported either Pakistan or Afghanistan and played the two against each other.

Then you have the Taliban emerging in the 1990s, and Pakistan fully supports the Taliban: They help equip it, they provide intelligence, advisers, and during the Taliban era when they ruled country, Pakistan is one of only three countries that recognize the Taliban regime.

They continued supporting the Taliban throughout the past decade, and US-Pakistan relations became very fraught and complicated. It's never been easy. Pakistanis sometimes use the expression that the United States treats Pakistan like a condom: uses it when they need it then discards it when they are finished with it. It's a fairly common saying in Pakistan, especially in the military. So there is a sense of betrayal on the part of the United States, untrustworthiness, that it's an exploitative relationship on the part of the US toward Pakistan.

I should also say that Pakistan has long supported many Islamic extremist groups as part of its asymmetric policy toward India, and some of these groups have now mutated, or they slipped Pakistan's full control.

Even with respect to the Afghan Taliban, there is a lot of support from the Pakistani state intelligence services and military to the Afghan Taliban. At the same time, Pakistan has been under enormous US and international pressure to act against them, and so they will take the occasional action against the Afghan Taliban as well. But those actions are mostly seen as halfhearted, incomplete window dressing.

JW: So what role is Pakistan playing today? I know that they just had the four-party talks and that Pakistan has been insisting that these talks take place in Pakistan. Are they trying to speak for the Taliban?

VFB: I'm not sure that it's a fair characterization that they are speaking for the Taliban. Certainly the Afghan government, including in the latest talks, often insinuates or alleges that Pakistan speaks for the Taliban. But they clearly do not.

The relationship between the Taliban and Pakistan is hardly smooth and perfect. Many members of the Afghan Taliban deeply resent the level of Pakistani interference, even as the group has been supported by Pakistan. There is a lot of Afghan Pashtun nationalism also among the Taliban that deeply resents the influence and attempts at control by the Pakistani state.

Part of the key issue in the relationship is that although Pakistan supports the Afghan Taliban, and although it has historically supported other extremist groups, it does not have perfect control. And arguably, its control is diminishing. And so they posture, they do their double game. They want to appear strong, and so they posture that they have much greater control than they have, but at the same time they deny that they have any nefarious role.

In reality, they are playing both sides against the middle, and they often have much less capacity to control and rein in the extremist groups, including the Afghan Taliban, than many assume. The widespread criticism of Pakistan is one of its duplicity and its nefarious activity and its lack of willingness to act against the Afghan Taliban. Those are true, but they are also coupled with limits to their capacity. They are riding a tiger that they cannot control fully.

So they have been hosting these four-way talks that involve them, the US government, the Afghan government, and the Chinese government. The Afghan government is desperate to achieve some sort of negotiated deal with the Taliban. It feels under tremendous pressure, the military is taking a pounding from the Taliban, and the government lacks legitimacy.

The US has similar views on the notion that the way out of the predicament in Afghanistan is a negotiated deal. The Chinese also like the idea. They have their own influence in Pakistan. China would very much like to say that they finally achieved what the US failed to do over the past decade, that they will bring peace to Afghanistan, and that they will do it by enabling the negotiations.

Pakistan is responsive to China. Their relationship with China is much stronger than their relationship with the United States. They often tell the US that China is their old friend, that China is the country that hasn't betrayed them, unlike the United States. China has promised massive economic development in Pakistan at $40 billion. The Pakistanis often say to the US that the Pakistan-China relationship is "greater than the Himalayas and deeper than the ocean." Very flowery.

JW: What's the relationship like between the Afghan government and Pakistan today?

VFB: The crucial man there really is the Pakistani chief of the army staff Raheel Sharif; no relation to [Prime Minister] Nawaz Sharif. I think that there is sort of goodwill and motivation right now, even on the army staff — but that is juxtaposed with, again, the limits of control even the chief has. With almost clockwork regularity you have a round of negotiations in Pakistan or you have a meeting between Raheel Sharif and [Afghan President Ashraf] Ghani, and the next day a bomb goes off in Kabul and people die, or the Indian consulate is attacked.

All those ploys are meant to destroy any beginning of a more positive relationship and have been very effective in subverting the process. The same goes on between Pakistan and India. Meanwhile, Ghani is taking an enormously risky strategy with respect to the negotiations. It's vastly unpopular in Afghanistan, and many, many Afghans hate Pakistan and blame it for all of their troubles.

They use Pakistan as the explanation of everything that ever goes wrong in Afghanistan. And the Pakistanis are responsible for a lot, but there's much, much blame and responsibility that lies on Afghan politicians and Afghan people.

So Ghani's outreach and engagement with Pakistan is extremely unpopular. He's spending an extreme amount of political capital, and does not have support from his partner in the government, Abdullah Abdullah, and the northern Tajik factions that hate Pakistan with great vitriol. So the more Pakistan is unable to deliver things like the Haqqani network, reducing or stopping its attacks in Kabul, the more politically impossible for Ghani the process will be.

JW: So what does that mean in terms of the stability of Afghanistan's unity government?

VFB: The unity government is extremely strained. "Unity" it isn't. The Pakistani negotiation angle is just too big for the strain. It might be strategically important. It might be a very significant element in getting any negotiation going, but it's also extremely politically costly, and the longer it doesn't produce anything, the more politically costly and unsustainable it will be.

In October, there are supposed to be parliamentary elections and district elections in Afghanistan, and, more important, this loya jirga [a national assembly of Afghan elders]. And unless there is some sort of major breakthrough by the summer, a lot of the negotiations and political process with both the Taliban and Pakistan will be put on ice, because it will just be politically impossible in the context of the loya jirga and the elections.

So they really have until the summer to make some sort of breakthrough, and then you will have months of morass and extreme political instability in Afghanistan, but it will also not be conducive in any way to improving either the relationship with Pakistan or the negotiations.

JW: How does Pakistan fit into the rise of ISIS in Afghanistan? What's the relationship there? And how might this affect the peace negotiations?

VFB: The rise of ISIS-Khorasan is one of the most interesting developments. It complicates the negotiations for the Taliban. They oppose the negotiations, and they're a big problem for Mullah Mansour and those who want to negotiate. They enable defections, make them easy, and make them costly.

At the same time, it is interesting because ISIS does not have the same linkages to Pakistan that the Afghan Taliban had, even though ISIS includes many defectors from the Taliban. They quite specifically reject what they call the "yoke" that Pakistan has put on the Afghan Taliban, and they call the Afghan Taliban leadership traitors because of the close relationship with Pakistan.

Moreover, ISIS-Khorasan also has quite a few members of various Pakistani extremist groups like Lashkar-e Taiba and members of TTP [Tehrik-e Taliban Pakistan]. So there is also a lot of resentment and hostility toward Pakistan.

I think the rise of ISIS might make Pakistan be cooperative to some extent, but on the other hand, I think it will also reinforce in the mind of many Pakistan security controllers that it's important to cultivate the Afghan Taliban as friends against the bigger danger of ISIS.

JW: Now that ISIS-Khorasan has directly targeted Pakistan, the consulate in Jalalabad, do you think Pakistan will take action?

VFB: I think they'll take action against ISIS and groups like Tehrik-e Taliban. I don't think it will produce more resolve to go after the Afghan Taliban. That's my view. Others are hoping that they will finally accept the realities and really believe that they have to fight all of the insurgents, all of the terrorists, and that they cannot differentiate among them. I am not persuaded that that will, in fact, happen.

JW: So what does this all mean for the prospects for peace? Are you hopeful at all?

VFB: I think the peace negotiations are important, but I am skeptical that anything will happen quickly.

I think that if by summer the Taliban has been willing to join the negotiating table, that will be an important breakthrough, but nothing will be agreed. The summer will be very bloody, and then there will be the political [wrangling] associated with the loya jirga and the elections.

In my view, even if the Taliban comes to the negotiating table, we are looking at years of negotiations, and certainly no breakthrough before 2017 and likely much longer.

And so the question is whether we, the United States, are prepared to stand by with Afghanistan for that long and whether the Afghans will have the resolve. So it's really important that the military and the police fight as hard as they can, because the weaker they fight, the more they defect, the more intimidated they are, the more brain drain that flows from Afghanistan, the stronger the Taliban is viewed and the more intransigent they will be in the negotiations. Now the negotiations will be very much about the military battlefield as much as they will about what's happening at the table for a long time.

This interview was originally published by Vox.

       

Vanda Felbab-Brown writes that after more than a decade of struggles against al-Qaida and the Taliban, U.S. President Barack Obama hoped to extricate the United States from participating militarily in Afghanistan’s counterinsurgency. But as the end of his presidency approaches in the summer of 2016, Afghanistan again faces crisis. Very few trends in the country are going well. The U.S. drone killing of the Taliban leader Mullah Akhtar Mohammad Mansour in Baluchistan, Pakistan in May 2016 provides a fillip to the embattled Afghan government and may in the long-term result in fragmentation and internal withering of the Taliban. But that outcome is not guaranteed nor likely to materialize quickly. In fact, the Taliban swiftly announced Mawlawi Haibatullah Akhundzada, a deputy to Mullah Mansour, as its new leader to avoid the tensions and chaos that surrounded Mansour’s appointment.

The Taliban has mounted and sustained its toughest military campaign in years, and the war has become bloodier than ever. Despite the Taliban’s internal difficulties, its military energy shows no signs of fizzling out. The influence of the particularly vicious Haqqani network within the Taliban has grown. Moreover, the Islamic State established itself in Afghanistan in 2015, although it faces multiple strong countervailing forces.

Most ominously, Afghanistan’s political scene remains fractious and polarized. The National Unity Government of President Ashraf Ghani and his chief executive officer and rival Abdullah Abdullah (created in the wake of the highly contested presidential elections of 2014) has never really found its feet. Fundamental structural problems of the government remain unaddressed, and after two years in power the government may face its end as a result of a possible Loya Jirga assembly in the fall of 2016. Even if the Jirga does not meet, Afghanistan’s leadership will face potentially debilitating crises of legitimacy. Afghanistan’s elite has not taken any steps to heal the country’s deep and broad political wounds. Instead, the dominant mode of politics is to plot the demise of the government and focus on a parochial accumulation of one’s power at the expense of the country’s national interest, and even the very survival of the post-2001 order.

Struggling to deliver the promised improvements in government efficiency and reduction in corruption, President Ghani staked the two first years of his presidency on negotiations with the Taliban. In order to facilitate the negotiations, he reached out to Pakistan in a daring and politically costly gambit in the fall of 2014 and repeatedly since. The payoff so far has been limited and Ghani’s political space is shrinking. The death of Mullah Mansour is likely to complicate the process even more.

In the paper, Felbab-Brown discusses the evolving international support for Afghanistan; military developments in Afghanistan since the fall of 2014 and the intensity of the Taliban’s battlefield thrust; the Taliban’s internal cohesion, fragmentation and leadership successions; President Ghani’s outreach to Pakistan and the effort to negotiate with the Taliban; and Afghan political processes and trends.

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• Blood and faith in Afghanistan: A June 2016 update

       

       

       

       

       

       

The U.S. military will carry out a major modernization of its strategic nuclear forces in the 2020s.

It will cover all three legs of the strategic triad.

Much of the planned program makes sense. The long-range standoff (LRSO) — a new nuclear-armed cruise missile to outfit strategic bombers — does not.

The primary reason for the modernization program is that many US strategic weapons systems are aging out, and American policy is that, as long as there are nuclear weapons, the United States will maintain a safe, secure and robust nuclear deterrent.

The Ohio-class ballistic missile submarines will begin to hit the end of their service life in the late 2020s, and the Navy will need new submarines. Submarines and submarine-launched ballistic missiles (SLBMs) make up the most survivable leg of the triad, and they carry the bulk of deployed US strategic warheads.

The service life of the Minuteman III intercontinental ballistic missile (ICBM) runs out in 2030. The Air Force seeks a replacement ICBM. At a minimum, keeping an ICBM leg of the triad would require another life extension program for existing Minuteman III missiles.

As for the air-breathing leg of the triad, the Air Force wants to procure 80 to 100 B-21 bombers. Plans are shrouded in secrecy but reportedly will incorporate stealth features and advanced electronic warfare capabilities to allow the aircraft to penetrate contested air space. The Air Force is also modernizing the B61 nuclear gravity bomb for use on strategic bombers.

One can and should question the Pentagon’s desired numbers for these programs. That is especially the case given the projected costs of strategic modernization, which Pentagon officials openly admit they do not know how to fund.

It is not clear why the United States will need to replace 400 deployed ICBMs on a one-for-one basis, particularly as the Air Force several years ago was prepared to go down to 300. A force of 200-300 ICBMs would suffice and result in significant cost savings. Likewise, one can challenge the requirement for 12 new ballistic missile submarines, as opposed to nine or 10.

The biggest question, however, arises over the LRSO, with a projected cost of $20 billion to $30 billion. The Air Force originally developed nuclear-armed air-launched cruise missiles (ALCMs) in the 1970s because the B-52 — then the mainstay of the strategic bomber fleet — presented a big target for adversary radars. That would make it hard for the aircraft to penetrate air defenses. A B-52 armed with ALCMs could remain outside of radar range and release its cruise missiles.

The B-2, with its stealth features, was designed to restore a penetrating capability. The Air Force plans to use stealth and electronic warfare capabilities to give the B-21 a penetrating capability as well. If these bombers can defeat and penetrate air defenses, that makes the LRSO redundant. (Moreover, unlike in the 1970s, the Air Force today has very capable long-range conventionally armed cruise missiles that provide a standoff capability for bombers.)

If, on the other hand, the stealth of the B-21 will be compromised in the not-too-distant future, then one has to question the wisdom of spending $60 billion to $80 billion — and perhaps more — to procure the B-21. If we believe the B-21 would soon encounter problems penetrating air defenses, scrap that program. Buy instead modified Boeing 767s, a variant of which will serve as the Air Force’s new aerial tanker, and arm them with the LRSO.

The Air Force’s evident attachment to the B-21 suggests, however, that it believes that the aircraft will be able to defeat adversary air defenses for some time to come. That means that the LRSO would add little capability to the US strategic force mix.

If one were to argue for the redundant capability provided by the LRSO, the number of new ALCMs that the Pentagon proposes to purchase — 1,000 to 1,100 — is difficult to understand. Even allowing for extra cruise missiles for test purposes, the number seems excessively high.

In its 2010 annual report to Congress on implementation of the Strategic Offensive Arms Reduction Treaty (SORT), the State Department advised that, as of Dec. 31, 2009, the United States had 1,968 operationally deployed strategic nuclear warheads. That figure captured the actual number of nuclear warheads atop SLBMs and ICBMs plus the number of nuclear bombs and ALCMs at air bases for use by bombers.

On June 1, 2011, a State Department fact sheet showed the number of deployed US strategic warheads as 1,800 as of Feb. 5, 2011, when the New Strategic Arms Reduction Treaty (New START) went into force. A Dec. 1, 2011, fact sheet provided a more detailed breakdown of US strategic forces. It stated that, as of Sept. 1, 2011, the United States had 1,790 deployed strategic warheads and 125 deployed strategic bombers. Like SORT, New START counts each warhead on a deployed ballistic missile as a deployed warhead. But New START counts bomber weapons differently from SORT. New START attributes each deployed bomber as one warhead, regardless of the number that it can carry or the number of weapons that may be at bomber bases.

The 125 deployed bombers on Sept. 1, 2011, would have counted as 125 under New START’s deployed strategic warhead total. Reducing 1,790 by 125 yields 1,665 — the number of deployed warheads then on US SLBMs and ICBMs.

Comparing the SORT and New START numbers is a bit of an apples-and-oranges comparison, but it gives some idea of the number of bomber weapons at US strategic bomber bases. Unless there was a dramatic increase in the number of warheads on ICBMs and SLBMs between the end of 2009 and September 2011 — and there is no reason to think that there was — comparing SORT’s 1,968 figure (end of 2009) to the 1,665 deployed warheads on ICBMs and SLBMs (under New START counting rules in September 2011) suggests some 300 nuclear bombs and ALCMs were at bomber bases. The B-2s would have been armed with bombs, which indicates a maximum of 200-250 ALCMs. The Federation of American Scientists (FAS) also estimates that there are about 300 nuclear weapons at strategic bomber bases, of which 200 are nuclear-armed ALCMs. FAS believes an additional 375 ALCM airframes are held in reserve.

This comparison raises the question: Why would 1,000-1,100 ALCM airframes be needed to support a couple of hundred deployed ALCMs?

The United States should sensibly modernize its strategic deterrent, particularly in a time of tight defense budgets. The case for the LRSO is demonstrably weak, especially for the planned size of the program. The LRSO should be shelved.

This piece was originally published in Defense News.

      

The Pentagon is embarking on a modernization of U.S. strategic nuclear forces that will cost hundreds of billions of dollars. Much of it makes sense, as key elements of the strategic triad age out and require replacement. As long as nuclear weapons exist, the United States should maintain a robust triad. However, the long-range stand-off weapon (LRSO), a new nuclear-armed air-launched cruise missile, does not make sense.

The U.S. strategic triad consists of intercontinental ballistic missiles (ICBMs), submarine-launched ballistic missiles (SLBMs), and strategic bombers. This mix gives the Pentagon the ability to hold at risk things that a potential adversary values. The inherent ability to destroy those things provides the basis for deterrence.

ICBMs can hold at risk targets 6,000 miles away. As they are based on mobile ballistic missile submarines, SLBMs can reach targets anywhere on earth. The same is true for weapons carried by the B-2 and B-52 and, in the future, the B-21. With aerial refueling, U.S. strategic bombers have global reach.

So the question arises: What unique target set could the LRSO hold at risk that cannot be threatened by ICBMs, SLBMs, or gravity bombs delivered by stealthy strategic bombers? At a recent panel discussion on the LRSO, the best answer to this question was “certain things”—but the proponent could not articulate what those “things” were. That explains much of the questioning about the LRSO. No one seems able to offer a plausible explanation for what the LRSO could do that other strategic nuclear systems cannot.

The weapon’s justification often seems to boil down to: The Pentagon is replacing other strategic systems because they are old, so it should replace the old nuclear-armed air-launched cruise missile (ALCM) as well. Does that logic hold?

The Air Force developed nuclear-armed ALCMs in the 1970s because the B-52 presented a big target on radar screens. Concern grew that the B-52 could not penetrate Soviet air defenses. A B-52 armed with ALCMs could launch its missiles from well beyond the reach of those air defenses.

Today, however, the Air Force has the stealthy B-2 bomber. It is in the process of procuring 80 to 100 B-21 bombers, which reportedly will incorporate stealth and advanced electronic warfare capabilities. The Department of Energy is already well along in the program to modernize the B61 nuclear gravity bomb. The modernized bomb will be highly accurate and have a variable yield. B-2 and B-21 bombers that can penetrate advanced air defenses and deliver B61 bombs against targets make the LRSO redundant.

Some suggest the LRSO hedges against a compromise of the B-21’s stealth. If that argument has merit, Congress ought to reexamine the wisdom of spending $60 to $80 billion—or perhaps $100 billion—on the bomber. Converted KC-46s (military refueling variants of the Boeing 767) with LRSOs would offer a far cheaper option. The Pentagon, however, seems to believe the B-21 will be capable of defeating advanced air defenses.

That being so, the case for the LRSO is weak. It will cost taxpayers $20 to $30 billion. True, that is a relatively small cost compared to what the Pentagon will pay to replace the Ohio-class ballistic missile submarines or build the B-21. But it is not chump change.

Some LRSO proponents cite the relatively “small” cost to argue that the defense budget can afford it. Current Pentagon officials, however, say they have no idea how to pay for everything they want for strategic modernization. Given the rising cost of mandatory spending such as social security and Medicare, and the pressure to hold down the deficit, the budget problem will not become easier in the 2020s, when the “bow-wave” of strategic modernization spending arrives. The Air Force will likely find itself having to choose between B-21s, KC-46 tankers, F-35 fighters, and the LRSO. It also wants to buy a new ICBM then. It is hard to see how all of that will be affordable.

Funding the LRSO now contributes to a budget time-bomb that the current administration and Congress will leave to their successors. The LRSO seems a redundant weapon without a mission. Shelving the program would defuse part of that time-bomb.

       

       

Strong Growth and Changing Composition 

External financial flows to sub-Saharan Africa (defined as the sum of gross private capital flows, official development assistance (ODA), and remittances to the region) have not only grown rapidly since 1990, but their composition has also changed significantly. The volume of external flows to the region increased from $20 billion in 1990 to above $120 billion in 2012. Most of this increase in external flows to sub-Saharan Africa can be attributed to the increase in private capital flows and the growth of remittances, especially since 2005 (see Figure 1).

Figure 1. Sub-Saharan Africa: External Flows (1990-2012, in USD billions)

As also displayed in Figure 1, in 1990 the composition of external flows to sub-Saharan Africa was about 62 percent ODA, 31 percent gross inflows from the private sector, and about 7 percent remittances. However, by 2012, ODA accounted for about 22 percent of external flows to Africa, a share comparable to that of remittances (24 percent) and less than half the share of gross private capital flows (54 percent). Also notably, in 1990, FDI flows were greater than ODA flows in only two countries (Liberia and Nigeria) in sub-Saharan Africa excluding South Africa, but 22 years later, 17 countries received more FDI than ODA in 2012—suggesting that sub-Saharan African countries are increasingly becoming less aid dependent (see Figure 2).

Figure 2. Sub-Saharan Africa: Number of Countries Where FDI is Greater than ODA (1990-2012)

But to what extent have these changes in the scale and composition of external flows to sub-Saharan Africa equally benefited countries in the region? Did the rising tide lift all boats? Is aid really dying? Are all countries attracting private capital flows and benefiting from remittances to the same degree? Finally, how does external finance compare with domestic finance? 

The False Demise of ODA

A closer look at the data indicates that, clearly, ODA is not dead, though its role is changing. For instance, middle-income countries (MICs) are experiencing the sharpest decline in ODA as a share of total external flows to the region, while aid flows account for more than half of external flows in fragile as well as low-income countries (LICs) and resource-poor landlocked countries (see Figure 3 and Appendix).

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China has provided foreign assistance since the 1950s, and is now the largest developing country to provide aid outside of the Development Assistance Committee (DAC), a forum of the world’s major donor countries under the Organization for Economic Cooperation and Development (OECD). Like its foreign policy more broadly, Chinese foreign assistance has adhered to the “Five Principles of Peaceful Coexistence” and emphasized the virtue of national self-reliance. At the same time, it has served a strategic purpose alongside other foreign policy priorities.

A slow start but a steady increase

Compared to top DAC donor countries, the scale of China’s foreign assistance is still relatively small. According to some estimates and OECD International Development Statistics, China’s gross foreign aid in 2001 was extremely limited, amounting to only about 1.8 percent of the total contribution by DAC donors. However, since launching its “Go Global” strategy in 2005, China has deepened its financial engagement with the world, and its foreign aid totals have grown at an average rate of 21.8 percent annually. In 2013, China contributed about 3.9 percent to total global development assistance, which is 6.6 percent of the total contribution by DAC countries and over 26 percent of total U.S. foreign aid. 

Millions of USD (Current)

Gross foreign aid provided by China versus major DAC donors

And the lion’s share goes to: Africa

Africa is one of China’s most emphasized areas of strategic engagement. Particularly since the establishment of the Forum on China-Africa Cooperation (FOCAC) in 2000, the relationship between China and Africa has gotten closer and closer. In 2009, African countries received 47 percent of China’s total foreign assistance. Between 2000 and 2012, China funded 1,666 official assistance projects in 51 African countries (the four countries that don’t have diplomatic relations with China—Gambia, Swaziland, Burkina Faso, and São Tomé and Príncipe—were left out), which accounted for 69 percent of all Chinese public and private projects. Among the 1,666 official projects, 1,110 qualified as Official Development Assistance (ODA)—defined by the OECD as flows of concessional, official financing administered to promote the economic development and welfare of developing countries. The remaining 556 projects could be categorized, also according to the OECD, as Other Official Flow (OOF)—transactions by the state sector that are not “development-motivated” or concessional (such as export credits, official sector equity and portfolio investment, and debt reorganization). (Note: in terms of dollar amounts, not included in the statistics here, most Chinese lending to Africa and other parts of the developing world is not concessional and is therefore not foreign aid.)

Zeroing in on infrastructure

About 61 percent of Chinese concessional loans to Africa are used for infrastructure construction, and 16 percent are for industrial development. The three areas that receive the largest allocations of Chinese concessional loans are transport and storage; energy generation and supply; and industry, mining, and construction. A small portion of the remaining allocations go to health, general budget support, and education. 

Some have interpreted these trends to mean that China is making an effort to export domestic excess capacity in manufacturing and infrastructure, especially considering the uncertainties of China’s economic transition. But the motivations are broader than that. China’s “Africa Policy”—issued in December 2015, in Johannesburg—clearly expresses the Chinese government’s belief that infrastructure construction is a crucial channel for African development. This notion could be connected to the domestic Chinese experience of having benefited from the technological diffusion of foreign aid and foreign direct investment in the construction sector. Moreover, in practice, China’s more than 20 years of experience in implementing international contract projects, as well as advanced engineering technologies and relatively low labor costs, have proved to be a comparative advantage in Chinese foreign assistance. In addition, by prioritizing the principles of non-interference and mutual benefit, China is more comfortable providing infrastructure packages (e.g., turn-key projects) than many other countries. 

Doing assistance better

Legitimate concerns have been raised about China’s tendency to facilitate authoritarianism and corruption, as well that its assistance does not always trickle down to the poor. As such, the state-to-state Chinese approach to providing assistance should be reformed. Globalization scholar Faranak Miraftab indicates that on-the-ground partnerships between communities and the private sector—mediated by the public sector—could achieve synergies to overcome certain shortcomings, creating a win-win situation. With deeper involvement by domestic assistance providers, Chinese foreign assistance could touch more people’s lives by tackling both the short- and long-term needs of the most under-resourced parts of civil society. Domestic assistance providers should exploring public-private partnerships, which among other benefits could yield increased foreign assistance services. By focusing on its comparative advantage in contributing to infrastructure projects that benefit the general public while also facilitating participation from civil society, Chinese foreign assistance could bring more concrete benefits to more individuals. 

China has already begun tackling these and other weaknesses. Although infrastructure and industry still account for the largest share of total official projects in Africa, China has intentionally strengthened its official development finance efforts in areas related to civil society. Projects have surged in the areas of social infrastructure and services, developmental food aid and food security, support to non-governmental organizations, and women in development, to name a few. Moreover, following President Xi Jinping’s promise at the United Nations summit in September 2015, an initial $2 billion has been committed as a down payment toward the China South-South Cooperation and Assistance Fund. The funding is primarily designed to improve the livelihoods of residents of recipient countries and diversify domestic aid providers (e.g., NGOs) qualified to participate or initiate assistance projects in the least-developed countries. 

In order to achieve positive results, it is critical for the Chinese government to carry out detailed management initiatives to engage civil society: for example, establishing a complete system for information reporting and disclosure (actions have already been taken in several ministries and bureaus), publishing guidelines for the private sector to develop assistance services overseas, and improving coordination and accountability among ministries and within the Ministry of Commerce. Although challenges still remain, Chinese foreign assistance is moving in a positive direction without abandoning its defining characteristics. 

       

       

       

       

       

       

       

       

Event Information

From high-profile stabilization contexts like Afghanistan to global public health campaigns to a renewed focus on sustainable food security and the looming impacts of climate change, development effectiveness is a central and hotly debated issue. As traditional donors make progress in the international aid effectiveness dialogue, they must increasingly take into account the changing global development landscape and the slew of new actors, including emerging donors, multinational corporations, mega philanthropists, high-profile advocates, and a vocal and energized global public.

2010 Brookings Blum Roundtable: Related Materials
	Read the roundtable report - Aiding Development: Assistance Reform in the 21st Century »  Read the conference policy briefs »  Download the participant list » (PDF) Download the scene setter » (PDF) Download the full roundtable agenda » (PDF)

The seventh annual Brookings Blum Roundtable, led by Kemal Derviş and co-chaired by Richard C. Blum and Strobe Talbott, convened over 40 exceptional international thought leaders, entrepreneurs and practitioners to explore the relationship between efforts to promote aid effectiveness and the anticipated shape of the global development agenda over the next decade. The roundtable discussions provided an opportunity to look beyond questions of increased resources for anti-poverty services to the effectiveness of different approaches and to systemic issues associated with the delivery of development outcomes. The high-level group of participants explored opportunities for new commitment in engaging the private sector and multilateral actors, as well as the increasingly important role of climate assistance and operations in instable arenas. Over separate meal conversations, Dr. Donald Kaberuka, president of the African Development Bank, and Dr. Rajiv Shah, administrator of the U.S. Agency for International Development (USAID), reflected on the current and future roles of their organizations, and how they could each act on the suggestions put forward at the roundtable.

       

About 12,000 troops will parade through Tiananmen Square in Beijing tomorrow to celebrate the 70th anniversary of Japan’s surrender to the allies in World War II. China’s leadership is ostensibly using the anniversary as an opportunity, to use the Chinese phrasing, to celebrate “victory in the World Anti-fascist War and the Chinese people’s War of Resistance against Japanese Aggression.”

But really, the purpose is to display its modernized weaponry ahead of several key international visits by President Xi Jinping. For Western leaders, the parade has proven a diplomatic nightmare: The Chinese have pressured them to attend, but they realize that the event is aimed at celebrating the country’s new international assertiveness (and perhaps to sideline a rather bloody summer on the Chinese stock markets). 

Students pose with Chinese national flags and red stars in preparation for the parade on August 31, 2015. Photo credit: Reuters/China Daily.

It’s the present, stupid

Sixty-six years after the end of the war, the world has been learning how to deal with a new China—now a powerful country with a strong economy and an increasingly well-equipped military. China’s defense budget has seen a double-digit increase for the past 25 years, and the country now has J-15 fighter jets, Z-19 attack helicopters, and a truck-mounted version of the DF-41 intercontinental missile. There is little doubt the parade will be impressive both in precision and display. 

In spite of how the Chinese leadership spins it, the parade is not just about history—it’s also about the present and the future. China is using it as a moment to show off its strengths and assert a stronger role in the Asia-Pacific region (as tensions in the South China Sea remain high), if not the world.

The red carpet

One interesting sight will be the VIP box: Which heads of state will actually attend? Confirmed leaders include Russian President Vladimir Putin (who himself hosted Xi Jinping last May for a huge victory parade in Moscow); South African President Jacob Zuma; Venezuelan President Nicolas Maduro; Sudanese President Omar Hassan al-Bashir (who has an international arrest warrant against him); and—somewhat unexpectedly considering World War II sensitivities in the region—South Korean President Park Geun-hye. Park will attend ceremonies, but not the parade. North Korean leader Kim Jong Un will not be present, nor will Japanese Prime Minister Shinzo Abe. 

Fellow leading industrial nations countries don’t want to put Japan in a bind, but no one is willing to offend China. Hence, state leaders have responded to the standing Chinese invitation with an array of contortions. In the end, no Western leader will attend: President Barack Obama—who will be hosting Xi Jinping in the United States in a few weeks—will be represented by U.S. Ambassador to China Max Baucus. Unlike for the launch of the Asian Infrastructure Investment Bank (AIIB) earlier this year, Washington didn’t pressure other Western leaders to avoid Beijing. This wasn’t necessary, as those governments all had their own reasons for staying away. Even the German president—a largely ceremonial figure—has declined. So has his French counterpart François Hollande, who will travel to China in October to discuss climate issues; French Foreign Minister Laurent Fabius will attend instead. Italy will also be represented by its foreign minister. As for the United Kingdom, Prime Minister David Cameron chose to wait for the Chinese state visit to London in October to meet Xi in person. Britain is represented by a former Conservative cabinet minister, Kenneth Clarke. Even more surprising is the list of retired statesmen: former German Chancellor Gerhard Schroeder, who is known to have engaged with Russia’s Putin after leaving office in 2005, will be in there, like his friend and former U.K. counterpart Tony Blair. 

Aircraft perform during a rehearsal on August 23, 2015 for the September 3 military parade in Beijing. Photo credit: Reuters.

Enough troubles

The U.S.-China relationship is already complicated enough and needs no further upsets. While China flexes its muscles with a parade, America is in the middle of a presidential campaign during which candidates—such as Republican Wisconsin Governor Scott Walker, who recently called on President Obama to cancel Xi's visit—are openly criticizing China. For his part, Donald Trump claimed that “China would be in trouble” should he become president, adding: “The poor Chinese.” Although these kinds of comments cannot be taken too seriously, they will require even more diplomatic skills on the part of the current administration, and its successor, to fully restore fully the U.S.-China dialogue.

In these circumstances, it is no surprise that Washington has shown little interest in attending the Beijing events. Nor does the Obama administration want to be part of a demonstration of assertiveness weeks before a state visit to Washington by President Xi. History tells us that U.S.-China relations are going to get even more interesting than a parade.

       

       

       

       

       

       

       

       

Event Information

Register for the Event

On April 30, 2007, the Brookings Center on the United States and Europe held its fourth annual conference. As in previous years, the annual conference brought together scholars, officials, and policymakers from both sides of the Atlantic to examine the evolving roles of the United States and Europe in the global arena. Panel discussions covered some critical issues about Europe and the U.S.-Europe relationship: "The French Elections", "NATO and Afghanistan" and "Islam in Europe". Panelists included, among others, Lt. General Karl Eikenberry, Deputy Chairman of the NATO Military Committee; Ashraf Ghani, former Finance Minister of Afghanistan; Tufyal Choudhury of Durham University; Philip Gordon of the Brookings Institution; and Corine Lesnes from Le Monde.

8:30 a.m.		Continental breakfast available
8:50 a.m.		Welcome and Introduction Strobe Talbott, President, The Brookings Institution
9:00 - 10:30 a.m.		"The French Elections" Chair: Jim Hoagland, The Washington Post Panelists: Laurent Cohen-Tanugi, Skadden Arps; Notre Europe Corine Lesnes, Le Monde Philip Gordon, The Brookings Institution
10:30 - 10:45 p.m.		Break
10:45 a.m. - 12:15 p.m.		"NATO in Afghanistan" Chair: Carlos Pascual, The Brookings Institution Panelists: Lt. General Karl Eikenberry, Deputy Chairman of the NATO Military Committee Ashraf Ghani, former Finance Minister of Afghanistan Marvin Weinbaum, Middle East Institute
12:15 - 1:30 p.m.		Buffet Lunch (Saul/Zilkha)
1:30 - 3:00 p.m.		"Islam in Europe" Chair: Jeremy Shapiro, The Brookings Institution Panelists: Daniel Benjamin, The Brookings Institution Tufyal Choudhury, Durham University Jonathan Laurence, Boston College

The Center on the United States and Europe Annual Conference is made possible by the generous support of the German Marshall Fund of the United States

Transcript

• Transcript (.pdf)

Event Materials

• 20070430

       

       

       

       

       

       

       

Nearly eight years after a U.S.-led invasion toppled the Taliban regime, Afghanistan remains far from stable. As President Barack Obama considers alternatives to increasing the number of U.S. troops in Afghanistan, his administration’s new counternarcotics strategy meshes well with counterinsurgency and state-building efforts in the country. It is a welcome break from previous ineffective and counterproductive policies. The effectiveness of the policy with respect to counternarcotics, counterinsurgency and state-building, however, will depend on the operationalization of the strategy. The details are not yet clear, but the strategy potentially faces many pitfalls.

Efforts to bankrupt the Taliban through eradication are futile and counterproductive since they cement the bonds between the population and the Taliban. But interdiction is very unlikely to bankrupt the Taliban either. Security needs to come first before any counternarcotics policy has a chance of being effective. Counterinsurgent forces can prevail against the Taliban, without shutting down the Taliban drug income, by adopting an appropriate strategy that provides security and rule of law to the population and by sufficiently beefing up their own resources vis-à-vis the Taliban. Rural development is a long term and multifaceted effort. Simplistic strategies that focus simply on price ratios or try to raise risk through “seed-burn-seed” approaches are ineffective. Wheat replacement strategy as a core of the alternative livelihoods effort is singularly inappropriate for Afghanistan. Shortcuts do not lead to sustainable policies that also mitigate conflict and enhance state-building.

The Obama administration will need to reduce expectations for quick fixes and present realistic timelines to Congress, the U.S. public and the international community for how long rural development and other counternarcotics policies in Afghanistan will take to show meaningful and sustainable progress that advances human security of the Afghan people, mitigates conflict and enhance state building. Unless this is conveyed, there is a real danger that even a well-designed counternarcotics policy will be prematurely and unfortunately discarded as ineffective.

The New Strategy in Afghanistan’s Context

In summer 2009, the Obama administration unveiled the outlines of a new counternarcotics policy in Afghanistan. The new policy represents a courageous break with previous misguided efforts there and thirty years of U.S. counternarcotics policies around the world. Instead of emphasizing premature eradication of poppy crops, the new policy centers on increased interdiction and rural development. This approach strongly enhances the new counterinsurgency policy focus on providing security to the rural population, instead of being preoccupied with the numbers of incapacitated Taliban and al Qaeda.

In Afghanistan, somewhere between a third and a half of its GDP comes from poppy cultivation and processing and much of the rest from foreign aid, so the illicit poppy economy determines the economic survival of a large segment of the population. This is true not only of the farmers who cultivate opium poppy frequently in the absence of viable legal and illegal economic alternatives. But, as a result of micro- and macro-economic spillovers and the acute paucity of legal economic activity, much of the economic life in large cities is also underpinned by the poppy economy. After a quarter century of intense poppy cultivation, the opium poppy economy is deeply entrenched in the socio-economic fabric of the society. Islamic prohibitions against opiates notwithstanding, the poppy economy inevitably underlies Afghanistan’s political arrangements and power relations. Profits from taxing poppy cultivation and protecting smuggling rings bring substantial income to the Taliban. A recent CRS report (August 2009) estimates the income at $70-$100 million per year, which accounts for perhaps as much as half of Taliban income. But many other actors in Afghanistan profit from the opium poppy economy in a similar way: former warlords cum government officials; members of Afghanistan’s police; tribal chiefs; and independent traffickers.

Moreover, the Taliban and many others who protect the opium poppy economy from efforts to suppress it derive much more than financial profits. Crucially, they also obtain political capital from populations dependent on poppy cultivation. Such political capital is a critical determinant of the success and sustainability of the insurgency since public support or at least acceptance are crucial enablers of an insurgency. Indeed, as I detail in my forthcoming book, Shooting Up: Counterinsurgency and the War on Drugs, along with providing order that the Afghan government is systematically unable to provide and capitalizing on Ghilzai Pashtun sentiments of being marginalized, protection of the poppy fields is at the core of the Taliban support. By not targeting the farmers, the new counternarcotics strategy is thus synchronized with the counterinsurgency efforts because it can deprive the Taliban of a key source of support. Its overall design also promises to lay the necessary groundwork for substantial reductions in the size and impacts of the illicit economy in Afghanistan.

However, while appropriate in its overall conception, the new strategy has pitfalls. Specifically how to operationalize interdiction and rural development will to a great extent determine the effectiveness of the strategy—not only with respect to the narrow goal of narcotics suppression, but also with respect to counterinsurgency and state-building. While many of the details still remain to be developed, some of those that have trickled out give reasons for concern.

Effects of Previous Eradication-Centered Policy

During the 2008-09 growing season, the area of cultivation in Afghanistan fell by 22% to 123,000 hectares and opium production fell by 10 percent to 6,900 metric tons (mt). Much of this decline in cultivation was driven by market forces largely unrelated to policy: After several years of massive overproduction in Afghanistan that surpassed the estimated global market for opiates by almost three times, opium prices were bound to decline. Even at 6,900 mt, production still remains twice as high as world demand, leading to speculation that someone somewhere is stockpiling opiates.

More significant, the persistence of high production betrays the ineffectiveness of simplistic policies, such as premature forced eradication before alternative livelihoods are in place, which since 2004 (until the new Obama strategy) was the core of the counternarcotics policy in Afghanistan. Policies that fail to address the complex and multiple structural drivers of cultivation and ignore the security and economic needs of the populations dependent on poppy cultivation generate vastly counterproductive effects with respect to not only counternarcotics efforts, but also counterinsurgency, stabilization and state building.

The eastern Afghan province of Nangarhar provides a telling example. For decades, Nangarhar has been one of the dominant sources of opium poppy. But over the past two years, as a result of governor Gul Agha Shirzai’s suppression efforts—including bans on cultivation, forced eradication, imprisonment of violators and claims that NATO would bomb the houses of those who cultivate poppy or keep opium—cultivation declined to very low numbers. This has been hailed as a major success to be emulated throughout Afghanistan.

In fact, the economic and security consequences were highly undesirable. The ban greatly impoverished many, causing household incomes to fall 90% for many and driving many into debt. As legal economic alternatives failed to materialize, many coped by resorting to crime, such as kidnapping and robberies. Others sought employment in the poppy fields of Helmand, yet others migrated to Pakistan where they frequently ended up recruited by the Taliban. The population became deeply alienated from the government, resorting to strikes and attacks on government forces. Districts that were economically hit especially severely, such as Khogiani, Achin and Shinwar, have become no-go zones for the Afghan government and NGOs. Although those tribal areas have historically been opposed to the Taliban, the Taliban mobilization there has taken off to an unprecedented degree. The populations began allowing the Taliban to cross over from Pakistan, and U.S. military personnel operating in that region indicate that intelligence provision to Afghan forces and NATO has almost dried up. Tribal elders who supported the ban became discredited, and the collapse of their legitimacy is providing an opportunity for the Taliban to insert itself into the decision-making structures of those areas. And all such previous bans in the province, including in 2005, turned out to be unsustainable in the absence of legal economic alternatives. Thus, after the 2005 ban, for example, poppy cultivation inevitably swung back.

The Ingredients of Success

Security
The prerequisite for success with respect to narcotics is security, i.e. sustained state control of territory. Without it, Afghanistan cannot be stabilized and the state strengthened; nor can counternarcotics policies be effective. Whether one adopts iron-fisted eradication or sustainable rural development as the core of a counternarcotics policy, security is essential. Without security first, counternarcotics efforts have not yet succeeded anywhere. Suppression without alternative livelihoods in place requires firm control of the entire territory to prevent illicit crop displacement and harsh suppression of the population dependent on illicit crops. Apart from being problematic with respect to human rights, this harsh approach is also very costly politically. Rural development requires security, otherwise investment will not come in, the population will not make risky long-term investments in legal crops and structural drivers of cultivation will not be effectively addressed. Development under a hail of bullets simply does not work, and in the context of insecurity, illicit economies persist and dominate.

Nor have counternarcotics policies, such as eradication or interdiction, succeeded in bankrupting or severely weakening any belligerent groups profiting from drugs anywhere in the world. Not in China, Thailand, Burma, Peru, Lebanon or even Colombia. Instead, they cement the bonds between marginalized populations dependent on illicit crops and belligerents plus severely reduce human intelligence flows to the counterinsurgent forces.

But counterinsurgent forces can prevail against insurgents and terrorists without stopping or reducing the terrorists’ drug-based financial inflows—either by increasing their own forces and resources vis-à-vis the belligerents or by adopting a smarter strategy that is either militarily more effective or wins the hearts and minds. This was the case in China, Thailand, Burma, and Peru where counterinsurgents succeeded without eradication. Evidence that counterinsurgent forces can prevail without bankrupting the belligerents through eradication also holds in the case of Colombia where the FARC has been weakened militarily not because of the aerial spraying of coca fields, but in spite of it. Today, more coca is grown there than at the beginning of Plan Colombia; but as a result of U.S. resources and training, Colombian forces were capable of greatly weakening the FARC even though forced eradication virtually eliminated human intelligence from the population to the government.

Interdiction with the Right Focus
The broad focus of the new counternarcotics strategy on interdiction is well placed, but interdiction’s effectiveness will depend on its objectives and execution. Just like eradication, interdiction will not succeed in bankrupting the Taliban. The Taliban has many other sources of income, including donations from Pakistan and the Middle East, taxation of legal economic activity, smuggling with legal goods, wildlife and illicit logging. In fact, it rebuilt itself in Pakistan between 2002 and 2004 without access to the poppy economy. Overall, drug interdiction has a very poor record in substantially curtailing belligerents’ income, with only a few successes registered in, for example, highly localized settings in Colombia and Peru.

Instead, the objective of the policy should be to reduce the coercive and corrupting power of organized crime groups. But achieving that requires a well-designed policy and a great deal of intelligence. Previous interdiction efforts in Afghanistan have in fact had the opposite effect: they eliminated small traders and consolidated the power of big traffickers, giving rise to the vertical integration of the industry. They also strengthened the bonds between some traffickers and the Taliban (although many traffickers continue to operate independently or are linked to the government).

Large-scale interdiction that targets entire networks and seeks to eliminate local demand for opium from local traders, which some are arguing for, is extraordinarily resource-intensive given the structure of the Afghan opium industry. Prioritization will need to be given to devoting scarce resources to drug interdiction or directly to counterinsurgency. The odds of success are not high. But even if such an interdiction strategy did succeed in shutting down local demand, the policy would become counterproductive since in local settings its effects would approximate the effects of eradication, thus once again alienating the population. Such large-scale interdiction is thus not currently appropriate for Afghanistan.

But even the NATO-led selective interdiction of targeting designated Taliban-linked traffickers (the United States has identified fifty such traffickers) is not free from pitfalls. First, selective interdiction can actually provide opportunities for the Taliban to directly take over the trafficking role or strengthen the alliance between the remaining traffickers and the Taliban, thus achieving the opposite of what it aims for. In fact, interdiction measures in Peru and Colombia frequently resulted in tightening the belligerents-traffickers nexus and belligerents’ takeover of trafficking.

Second, uncalibrated interdiction can provoke intense turf wars among the remaining traffickers, thus intensifying violence in the country and muddling the battlefield picture by introducing a new form of conflict. Mexico provides a vivid example of such an undesirable outcome. In the Afghan tribal context, such turf wars can easily become tribal or ethnic warfare.

Third, such selective interdiction can also send the message that the best way to be a trafficker is to be a member of the Afghan government, thus perpetuating a sense of impunity and corruption and undermining long-term state building and legitimacy.

Finally, the effectiveness of interdiction is to a great extent dependent on the quality of rule of law in Afghanistan plus the capacity and quality of the justice and corrections systems, all of which are woefully lacking in Afghanistan and are deeply corrupt.

Comprehensive Rural Development
Rural development appropriately lies at the core of the new strategy because, despite the enormous challenges, it has the best chance to effectively and sustainably strengthen the Afghan state and reduce the narcotics economy. But for rural development to do that, it needs to be conceived as broad-based social and economic development that focuses on improvements in human capital—including health care and education—and addresses all of the structural drivers of opium poppy cultivation. In Afghanistan, these drivers include insecurity; lack of physical infrastructure (such as roads), electrification and irrigations systems; lack of microcredit; lack of processing facilities; and the absence of value-added chains and assured markets. They also include lack of land titles and, increasingly, the fact that land rent by sharecroppers has become dependent on opium poppy cultivation as land concentration has increased over the past eight years. Poppy cultivation and harvesting are also very labor-intensive, thus offering employment opportunities unparalleled in the context of Afghanistan’s economy.

The price-profitability of poppy in comparison to other crops is only one of the drivers and frequently not the most important one. Without other structural drivers being addressed, farmers will not switch to licit crops even if they fetch more money than the illicit ones. By the same token, however, farmers are frequently willing to sacrifice some profit and forgo illicit crop cultivation as long as the licit alternatives bring them sufficient income and address all of the structural drivers, including the insecurity to which farmers are exposed in illicit economies.

Unfortunately, the wheat distribution program that was the core of rural development in Afghanistan last year (and that is slated to be its key component this year) is likely to be woefully ineffective for several reasons. First, in 2008, the program was based solely on an unusually high price ratio of wheat to poppy, driven by poppy overproduction and a global shortage of wheat. However, this price ratio is unlikely to hold; Afghanistan’s wheat prices are dictated anyway by surrounding markets, such as Pakistan and Kazakhstan. Second, the program did nothing to address the structural drivers. In fact, it had counterproductive effects because the free distribution of wheat undermined local markets in seeds. Afghan farmers can obtain seeds; their challenge lies in how to obtain profit afterwards. Thus, some sold the wheat seed instead of cultivating it. Third, those who actually cultivated wheat frequently did so not for profit, but for subsistence to minimize costs of buying cereals on the market. In fact, because of land distribution issues, many Afghan farmers do not have access to enough land to cover even their subsistence needs with wheat monocropping. A key lesson from alternative development over the past thirty years is that monocropping substitution strategies are particularly ineffective. Fourth, if all of current poppy farmers switched to wheat cultivation, Afghanistan would experience a great increase in unemployment since wheat cultivation employs 88% less labor than poppy cultivation and harvesting do.

Instead of wheat, rural development in Afghanistan needs to emphasize diversified high-value, high-labor-intensive crops, such as fruits, vegetables and specialty items like saffron. Generating lasting off-farm income opportunities will also be important, but even more challenging than jump-starting legal agromarkets.

After eight years of underresourcing and neglecting agriculture development, the new counternarcotics policy’s focus on the farm is appropriate. But the new strategy needs to take care not to throw away the baby with the bath water. The effort still needs to include developing value-added chains and assured internal and external markets plus enabling sustained access to them. Once again, thirty years of history of alternative livelihoods show that without value-added chains and accessible markets even productive legal farms become unsustainable and farmers revert back to illicit crops.

Finally, rural development requires time. Perhaps in no country in the world since Mao wiped out poppy cultivation in China in the 1950s did counternarcotics efforts face such enormous challenges as they do in Afghanistan—in terms of the scale of the illicit economy, its centrality to the overall economy of the country and hence its vast marco- and micro-economic and political effects, the underdevelopment of the country and its human capital and the paucity of viable economic alternatives. Even under much more auspicious circumstances along all the above dimensions, counternarcotics rural development in Thailand took thirty years.

Conclusion

Clearly, there is a need to quickly bring some economic, social and rule of law improvements to the lives of the Afghan people. Without such quick, visible and sustainable change, it will become impossible to rebuild the confidence of the Afghan people in the future, harness their remaining aspirations and to persuade them that the central state with support of the international community is preferable to the Taliban or local warlord- or tribal-based fiefdoms. But there is an equal need to urge strategic patience in the United States—both for counterinsurgency and for counternarcotics.

Eradication can be a part of the mix of counternarcotics policies, but should only be adopted in areas that are free of violent conflict and where sufficient legal economic alternatives are available to the population. Interdiction needs to focus on reducing the coercive and corrupting power of crime groups. Before interdiction measures are undertaken, an analysis of second and third- order effects needs to be conducted. It needs to be carefully calibrated with the strength of law enforcement in Afghanistan to avoid provoking dangerous turf wars, ethnic violence and cementing the relationship between the Taliban and the traffickers. It also needs to target top traffickers linked to the Afghan government. Interdiction needs to encompass building the justice and corrections system in Afghanistan and broad rule of law efforts. Rural development needs to address all structural drivers of poppy cultivation. It needs to focus not only on the farm, but also on value-added chains and assured markets. It needs to emphasize diversified high-value, high-labor intensive crops, and not center on wheat.

Evaluations of counternarcotics policies need to back away from simplistic and inappropriate measures, such as the numbers of hectares eradicated or traffickers caught. Instead, the measures need to encompass the complexity of the issue, including, size of areas cultivated with licit as well as illicit crops, human development indexes, levels of education, the number of resource-poor farmers dependent on illicit crops for basic subsistence or vulnerable to poverty-driven participation in illicit economies, food security, availability of legal microcredit, prevalence of land titles and accessibility of land, infrastructure density and cost of infrastructure use (such as road tolls), availability of non-belligerent dispute resolution and arbitrage mechanisms, quality of property rights, prevalence of value-added chains, and accessibility of markets. The United States and its allies must reduce public expectations for quick fixes and dedicate increased resources to rural development for a long time. Although U.S. forces do not need to stay in Afghanistan for decades, economic development will take that long.

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While antibiotics are necessary and crucial for treating bacterial infections, their misuse over time has contributed to a rather alarming rate of antibiotic resistance, including the development of multidrug-resistance bacteria or “super bugs.” Misuse manifests throughout all corners of public and private life; from the doctor’s office when prescribed to treat viruses; to industrial agriculture, where they are used in abundance to prevent disease in livestock. New data from the World Health Organization (WHO) and U.S. Centers for Disease Control and Prevention (CDC) confirm that rising overuse of antibiotics has already become a major public health threat worldwide.

As drug resistance increases, we will see a number of dangerous and far-reaching consequences. First, common infections like STDs, pneumonia, and “staph” infections will become increasingly difficult to treat, and in extreme cases these infections may require hospitalization or treatment with expensive and toxic second-line therapies. In fact, recent estimates suggest that every year more than 23,000 people die due to drug-resistant infections in the U.S., and many more suffer from complications caused by resistant pathogens. Further, infections will be harder to control. Health care providers are increasingly encountering highly resistant infections not only in hospitals – where such infections can easily spread between vulnerable patients – but also in outpatient care settings.

Fundamental Approaches to Slowing Resistance

Incentivize appropriate use of antibiotics. Many patients and providers underestimate the risks of using antibiotics when they are not warranted, in part because these drugs often have rapid beneficial effects for those who truly need them.  In many parts of the world the perception that antibiotics carry few risks has been bolstered by their low costs and availability without a prescription or contact with a trained health care provider. Education efforts, stewardship programs, and the development of new clinical guidelines have shown some success in limiting antibiotic use, but these fixes are limited in scope and generally not perceived as cost-effective or sustainable. Broader efforts to incentivize appropriate use, coupled with economic incentives, may be more effective in changing the culture of antibiotic use. These options might include physician or hospital report cards that help impact patient provider selection, or bonuses based on standardized performance measures that can be used to report on success of promoting appropriate use.  While these might create additional costs, they would likely help control rates of drug resistant infections and outweigh the costs of treating them.

Reinvigorate the drug development pipeline with novel antibiotics. There has not been a new class of antibiotics discovered in almost three decades, and companies have largely left the infectious disease space for more stable and lucrative product lines, such as cancer and chronic disease. Antibiotics have historically been inexpensive and are typically used only for short periods of time, creating limited opportunities for return on investment. In addition, unlike cancer or heart disease treatments, antibiotics lose effectiveness over time, making them unattractive for investment. Once they are on the market, the push to limit use of certain antibiotics to the most severe infections can further constrict an already weak market.

Late last year, H.R. 3742, the Antibiotic Development to Advance Patient Treatment (ADAPT) Act of 2013, was introduced and referred to the House Energy and Commerce Subcommittee on Health. If enacted, the ADAPT Act would create a streamlined development pathway to expedite the approval of antibiotics that treat limited patient populations with serious unmet medical needs. This could potentially reduce costs and development time for companies, thereby encouraging investment in this space. Regulators have indicated that they would also welcome the opportunity to evaluate benefits and risk for a more selective patient subpopulation if they could be confident the product would be used appropriately. The bill has received a great deal of support and would help address a critical public health need.

Advance new economic incentives to remedy market failure. Innovative changes to pharmaceutical regulation, research and development (R&D), and reimbursement are necessary to alleviate the market failure for antibacterial drugs. A major challenge, particularly within a fee-for-service or volume-based reimbursement system, is providing economic incentives that promote investment in drug development without encouraging overuse.  A number of public and private stakeholders, including the Engelberg Center for Health Care Reform and Chatham House’s Centre on Global Health Security Working Group on Antimicrobial Resistance, are exploring alternative reimbursement mechanisms that  “de-link” revenue from the volume of antibiotics sold. Such a mechanism, combined with further measures to stimulate innovation, could create a stable incentive structure to support R&D.

Improve tracking and monitoring of resistance in the outpatient setting. There is increasing concern about much less rigorous surveillance capabilities in the outpatient setting, where drug-resistant infections are also on the rise. Policymakers should consider new incentives for providers and insurers to encourage a coordinated approach for tracking inpatient and outpatient resistance data. The ADAPT Act, mentioned above, also seeks to enhance monitoring of antibiotic utilization and resistance patterns. Health insurance companies can leverage resistance-related data linked to health care claims, while providers can capture lab results in electronic health records. Ultimately, this data could be linked to health and economic outcomes at the state, federal, and international levels, and provide a more comprehensive population-based understanding of the impact and spread of resistance. Current examples include the Food and Drug Administration’s (FDA) Sentinel Initiative and the Patient-Centered Outcomes Research Institute’s PCORnet initiative. 

Antibiotic resistance is an urgent and persistent threat. As such, patients and providers will continue to require new antibiotics as older drugs are forced into retirement by resistant pathogens. Stewardship efforts will remain critical in the absence of game-changing therapies that parry resistance mechanisms. Lastly, a coordinated surveillance approach that involves diverse stakeholder groups is needed to understand the health and economic consequences of drug resistance, and to inform antibiotic development and stewardship efforts.

       

Antimicrobial resistance is one of the most significant threats to public health globally. It will worsen in the coming decades without concerted efforts to spur the development of new antibiotics, while ensuring the appropriate use of existing antibiotics. Antimicrobial therapy is essential for treating and preventing bacterial infections, some of which can be life-threatening and acquired as a result of
critical medical interventions, including surgery, chemotherapy and dialysis. However, the international rise in antimicrobial resistance has weakened our antibiotic armamentarium and multi-resistant bacteria now cause over 150,000 deaths annually in hospitals around the world (WHO, 2013). Unfortunately, the evolution of drug-resistant pathogens is unavoidable due to random genetic changes in the pathogens that can render antibiotics ineffective. While antibiotic therapy can succeed in killing susceptible pathogens, it also inadvertently selects for organisms that are resistant. Because each exposure to antibiotics contributes to this process, efforts to restrict antibiotic usage only slow the development of resistance. Ultimately, innovative antimicrobial drugs with diverse mechanisms of action will be needed to treat emerging resistant pathogens.

Combating resistance

Inappropriate use of antibiotics contributes significantly to the acceleration of resistance. Needlessly exposing patients to antibiotics (for example, for viral or mild infections likely to resolve on their own), the use of overly broad-spectrum antibiotics and suboptimal doses of appropriate therapy hasten the evolution of resistant pathogens. While affordable, rapid and accurate point-of-care diagnostics are essential for determining appropriate therapy for many bacterial diseases, routine clinical use will be limited if the tests are too expensive or not accessible during routine clinical encounters. In the absence of a clear diagnostic result, many health care providers prescribe empiric broadspectrum therapy without knowing exactly what they are treating. Although inappropriate use is widespread in many parts of the world, where antibiotics are available without a prescription or oversight by a health care provider or stewardship team, overuse abounds even where antibiotic prescribing is more tightly regulated.

Studies conducted in the USA indicate that around 258 million courses of antibiotics are dispensed annually for outpatient use (Hicks, 2013) and up to 75 per cent of ambulatory antibiotic prescriptions are for the treatment of common respiratory infections, which may or may not be bacterial in origin (McCaig,1995). Recent evidence suggests that over half of these prescriptions are not medically indicated. For example, 60 per cent of US adults with a sore throat receive an antibiotic prescription after visiting a primary care practice or emergency department, despite the fact that only ten per cent require treatment with antibiotics. This is particularly troubling given the availability of rapid tests that can detect Group A Streptococcus, the bacteria responsible for the ten per cent of cases that require antibiotic treatment.

The overuse of antibiotics has been driven largely by their low cost and clinical effectiveness, which has led many patients to view them as cure-alls with few risks. This perception is reinforced by the fact that antibiotics are curative in nature and used for short durations. However, the clinical effectiveness of these drugs decreases over time, as resistance naturally increases, and this process is accelerated with inappropriate use. Moreover, there are numerous consequences associated with the use of antibiotics, including over 140,000 emergency department visits yearly in the USA for adverse incidents (mostly allergic reactions; CDC, 2013a). In addition, antibiotics can eliminate protective bacteria in the gut,
leaving patients vulnerable to infection with Clostridium difficile, which causes diarrhoeal illness that results in 14,000 deaths every year in the USA (CDC, 2013b). It is estimated that antimicrobial resistance costs the US health care system over US$20 billion annually in excess care and an additional $35 billion in lost productivity (Roberts et al., 2009).

The inappropriate use of antimicrobial drugs is particularly concerning because highly resistant pathogens can easily cross national borders and rapidly spread around the globe. In recent years, strains of highly drug-resistant tuberculosis, carbapenem-resistant Enterobacteriaceae and other resistant pathogens have spread outside their countries of origin within several years of their detection. Because resistant bacteria are unlikely to stay isolated, stewardship efforts must be improved globally and international attention is needed to improve surveillance of emerging pathogens and resistance patterns.

A major challenge for clinicians and regulators will be to find stewardship interventions that can be scaled-up and involve multiple stakeholders, including providers, drug manufacturers, health care purchasers (insurers), governments and patients themselves. Such interventions should include practical and costeffective educational programmes targeted towards providers and patients that shift expectations for antibiotic prescriptions to a mutual understanding of the benefits and risks of these drugs.

Educational programmes alone, however, will not be sufficient to lower prescribing rates to recommended levels. Pushing down the inappropriate use of antibiotics also warrants stronger mechanisms that leverage the critical relationships between the stakeholders. For example, health care purchasers can play an important role by using financial disincentives to align prescribing habits with clinical guidelines that are developed by infectious disease specialists in the private and public sectors. This type of approach has the potential to be effective because it includes multiple stakeholders that share responsibility for the appropriate use of antibiotics and, ultimately, patient care.

Key obstacles to antibiotic development

The continual natural selection for resistant pathogens despite efforts to limit antibiotic use underscores the need for new antibiotics with novel mechanisms of action. To date, antimicrobial drug innovation and development have not kept pace with resistance. The number of approved new molecular entities (NME) to treat systemic infections has been steadily declining for decades (see Figure 1). Some infections are not susceptible to any antibiotic and in some cases the only effective drugs may cause serious side effects, or be contra-indicated due to a patient’s allergies or comorbidities (e.g. renal failure). There is significant unmet medical need for therapies that treat serious and life-threatening bacterial diseases caused by resistant pathogens, as well as some less serious infections where there are few treatment alternatives available (e.g. gonorrhoea).

Antibiotic development for these areas of unmet medical need has been sidelined by a number of scientific, regulatory and economic obstacles. While the costs and complexity of any clinical trial necessary for approval by drug regulators can be substantial, in part due to the large study samples needed to demonstrate safety and efficacy, the infectious disease space faces a number of unique clinical challenges. Patients with serious drug-resistant infections may be in need of urgent antibiotic therapy, which can preclude efficient consent and timely trial enrolment procedures; prior therapy can also confound treatment effects if the patient is later enrolled in a trial for an experimental drug. In addition, many patients with these pathogens are likely to have a history of longterm exposure to the health care setting and may have significant comorbidities that render them less likely to meet inclusion criteria for clinical trials.

Emerging infections for which there are few or no treatment options also tend to be relatively rare. This makes it difficult to conduct adequate and well-controlled trials, which typically enrol large numbers of patients. However, clinical drug development can take many years and waiting until such infections are more common is not feasible. Another issue is that it may also not be possible to conclusively identify the pathogen and its susceptibility at the point of enrolment due to the lack of rapid diagnostic technologies. Ultimately, uncertainty about the aetiology of an infection may necessitate trials with larger numbers of patients in order to achieve sufficient statistical power, further compounding the challenge of enrolling seriously ill infectious disease patients in the first place.

The need to conduct large trials involving acutely ill patients that are difficult to identify can make antibiotic development prohibitively expensive for drug developers, especially given that antibiotics are relatively inexpensive and offer limited opportunities to generate returns. Unlike treatments for chronic diseases, antibiotic therapy tends to last no longer than a few weeks, and these drugs lose efficacy over time as resistance develops, leading to diminishing returns. The decline in antimicrobial drug innovation is largely due to these economic obstacles, which have led developers to seek more durable and profitable markets (e.g. cancer or chronic disease) in recent decades. There are only a handful of companies currently in the market and the development pipeline is very thin. Changes to research infrastructure, drug reimbursement and regulation are all potentially needed to revitalise antibiotic innovation.

Opportunities to streamline innovative antibiotic development

In the USA, several proposals have been made to expedite the development and regulatory review of antibiotics while ensuring that safety and efficacy requirements are met. In 2012, the US President’s Council of Advisors on Science and Technology recommended that the US Food and Drug Administration (FDA) create a ‘special medical use’ (SMU) designation for the review of drugs for subpopulations of patients with unmet medical need. Drug sponsors would be required to demonstrate that clinical trials in a larger patient population would need much more time to complete or not be feasible. A drug approved under the SMU designation could be studied in subgroups of patients that are critically ill, as opposed to the broader population, under the condition that the drug’s indication would be limited to the narrow study population. The SMU designation was discussed at an expert workshop convened by the Brookings Institution in August 2013. Many participants at the meeting agreed that there is a pressing need to develop novel antibiotics and that such a limited-use pathway could support the appropriate use of newly approved drugs.

The Infectious Diseases Society of America developed a related drug development pathway called the Limited Population Antibacterial Drug (LPAD) approval mechanism. The LPAD approach calls for smaller, faster and less costly clinical trials to study antibiotics that treat resistant bacteria that cause serious infections. Both the SMU and LPAD approaches would allow drug developers to demonstrate product safety and efficacy in smaller patient subpopulations and provide regulatory clarity about acceptable benefit–risk profiles for antibiotics that treat serious bacterial diseases. The US House of Representatives is currently considering a bill¹ that incorporates these concepts.

A recent proposal from the drug manufacturer industry for streamlined antibiotic development is to establish a tiered regulatory framework to assess narrow-spectrum antibiotics (e.g. active versus a specific bacterial genus and species or a group of related bacteria) that target resistant pathogens that pose the greatest threat to public health (Rex, 2013: pp. 269–275). This is termed a ‘pathogen-focused’ approach because the level of clinical evidence required for approval would be correlated with the threat level and feasibility of studying a specific pathogen or group of pathogens. The pathogen-focused approach was also highlighted at a recent workshop at the Brookings Institution (Brookings Institution, 2014). Some experts felt that the approach is promising but emphasised that each pathogen and experimental drug is unique and that it could be challenging to place them in a particular tier of a regulatory framework. Given that pathogen-focused drugs would likely be marketed internationally, it will be important for drug sponsors to have regular interactions and multiple levels of discussion with regulators to find areas of agreement that would facilitate the approval of these drugs.

Antibiotics with very narrow indications could potentially support stewardship as well by limiting use to the most seriously ill patients. Safe use of these drugs would likely depend on diagnostics, significant provider education, labelling about the benefits and risks of the product, and the scope of clinical evidence behind its approval. Because these antibiotics would be used in a very limited manner, changes would potentially need to be made to how they are priced and reimbursed to ensure that companies are still able to generate returns on their investment. That said, a more focused drug development programme with regulatory clarity could greatly increase their odds of success and, combined with appropriate pricing and safe use provisions, could succeed in incentivising antimicrobial drug development for emerging infections.

Endnote
1 H.R. 3742 – Antibiotic Development to Advance Patient Treatment (ADAPT) Act of 2013.

References
Barnett, M. L. and Linder, J. A., 2014. ‘Antibiotic prescribing to adults with sore throat in the United States, 1997–2010’. JAMA Internal Medicine, 174(1), pp. 138–140.

Brookings Institution, 2013. Special Medical Use: Limited Use for Drugs Developed in an Expedited Manner to Meet an UnmetMedical Need. Brookings Institution. Available at: www.brookings.edu/events/2013/08/01-special-medical-use

Brookings Institution, 2014. Modernizing Antibacterial Drug Development and Promoting Stewardship. Available at: www.brookings.edu/events/2014/02/07-modernizing-antibacterialdrug-development [Accessed 11 March 2014].

CDC, 2013a. Antibiotic resistance threats in the United States,2013 [PDF] CDC. Available at: www.cdc.gov/drugresistance/threatreport-2013/pdf/ar-threats-2013-508.pdf#page=25 [Accessed 16 January 2014].

CDC, 2013b. Clostridium difficile. Antibiotic resistance threats in the United States, 2013 [PDF] CDC. Available at: www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf#page=50 [Accessed 16 January 2014].

Hicks, L. A. et al., 2013. ‘US Outpatient Antibiotic Prescribing, 2010’. New England Journal of Medicine, 368(15), pp. 1461–1463.
Infectious Disease Society of America, 2012.

Limited Population Antibacterial Drug (LPAD) Approval Mechanism. Available at: www.idsociety.org/uploadedFiles/IDSA/News_and_Publications/IDSA_News_Releases/2012/LPAD%20one%20pager.pdf [Accessed 5 March 2014].

Infectious Disease Society of America, 2012. Limited Population Antibacterial Drug (LPAD) Approval Mechanism [PDF] Infectious
Disease Society of America. Available at: www.idsociety.org/uploadedFiles/IDSA/News_and_Publications/IDSA_News_Releases/2012/LPAD%20one%20pager.pdf  [Accessed 18 January 2013].

Kumarasamy, K. K., Toleman, M. A., Walsh, T. R. et al.,2010. ‘Emergence of a new antibiotic resistance mechanism in India,
Pakistan, and the UK: A molecular, biological, and epidemiological study’. Lancet Infectious Diseases, 10(9), pp. 597–602.

McCaig, L. F. and Hughes, J. M., 1995. ‘Trends in antimicrobial drug prescribing among office-based physicians in the United
States’. Journal of the American Medical Association, 273(3), pp. 214–219.

President’s Council of Advisors on Science and Technology, 2012. Report to the President on Propelling Innovation in Drug
Discovery, Development and Evaluation. Available at:www.whitehouse.gov/sites/default/files/microsites/ostp/pcast-fdafinal.pdf    [Accessed 5 March 2014].

Rex, J. H. et al., 2013. ‘A comprehensive regulatory framework to address the unmet need for new antibacterial treatments’. Lancet Infectious Diseases, 13(3), pp. 269–275.

Roberts, R. R., Hota, B., Ahmad, I. et al., 2009. ‘Hospital and societal costs of antimicrobial – Resistant infections in a Chicago
teaching hospital: Implications for antibiotic stewardship’. Clinical Infectious Diseases, 49(8), pp. 1175–1184.

WHO (World Health Organization), 2010. Fact Sheet: Rational Use of Medicines [webpage] WHO. Available at:
www.who.int/mediacentre/factsheets/fs338/en [Accessed 28 February 2014].

WHO (World Health Organization), 2013. Antimicrobial Drug Resistance [PDF] WHO. Available at: http://apps.who.int/gb/ebwha/pdf_files/EB134/B134_37-en.pdf [Accessed 6 March 2014].

WHO (World Health Organization), 2013. Notified MDR-TB cases (number per 100,000 population), 2005–12. WHO. Available at:
https://extranet.who.int/sree/Reports?op=vs&path=/WHO_HQ_Reports/G2/PROD/EXT/MDRTB_Indicators_map [Accessed 28 February 2014].

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• Antibiotics Stewardship and Innovation

       

After years of warnings from the public health community about the growing threat of antibiotic resistance, yesterday the White House announced a national strategy to combat the growing problem of antibiotic resistance within the U.S. and abroad. The administration’s commitment represents an important step forward, as antibiotic-resistant infections are responsible for 23,000 deaths annually, and cost over $50 billion in excess health spending and lost productivity.  The administration’s National Strategy on Combating Antibiotic-Resistant Bacteria includes incentives for developing new drugs, more rigorous stewardship of existing drugs, and better surveillance of antibiotic use and the pathogens that are resistant to them.  President Obama also issued an Executive Order that establishes an interagency Task Force and a non-governmental Presidential Advisory Council that will focus on broad-based strategies for slowing the emergence and spread of resistant infections. 

While antibiotics are crucial for treating bacterial infections, their misuse over time has contributed to a rather alarming rate of antibiotic resistance, including the development of multidrug-resistance bacteria or “super bugs.” Misuse manifests throughout all corners of public and private life; from the doctor’s office when prescribed to treat viruses; to industrial agriculture, where they are used in abundance to promote growth in livestock. New data from the World Health Organization (WHO) and U.S. Centers for Disease Control and Prevention (CDC) confirm that rising overuse of antibiotics has already become a major public health threat worldwide.

The administration’s announcement included a report from the President’s Council of Advisors on Science and Technology (PCAST) titled “Combatting Antibiotic Resistance,” which includes recommendations developed by a range of experts to help control antibiotic resistance. In addition, they outline a $20 million prize to reward the development of a new rapid, point-of-care diagnostic test. Such tests help health care providers choose the right antibiotics for their patients and streamline drug development by making it easier to identify and treat patients in clinical trials.  

The Need for Financial Incentives and Better Reimbursement

A highlight of the PCAST report is its recommendations on economic incentives to bring drug manufacturers back into the antibiotics market. Innovative changes to pharmaceutical regulation and research and development (R&D) will be welcomed by many in the health care community, but financial incentives and better reimbursement are necessary to alleviate the market failure for antibacterial drugs. A major challenge, particularly within a fee-for-service or volume-based reimbursement system is providing economic incentives that promote investment in drug development without encouraging overuse.

A number of public and private stakeholders, including the Engelberg Center for Health Care Reform and Chatham House’s Centre on Global Health Security Working Group on Antimicrobial Resistance, are exploring alternative reimbursement mechanisms that “de-link” revenue from the volume of antibiotics sold. Such a mechanism, combined with further measures to stimulate innovation, could create a stable incentive structure to support R&D. Further, legislative proposals under consideration by Congress to reinvigorate the antibiotic pipeline, including the Antibiotic Development to Advance Patient Treatment (ADAPT) Act of 2013, could complement the White House’s efforts and help turn the tide on antibiotic resistance. Spurring the development of new antibiotics is critical because resistance will continue to develop even if health care providers and health systems can find ways to prevent the misuse of these drugs.

       

For more than a decade, government assistance to Afghanistan, Iraq, and Pakistan (the so-called AIP countries) has dominated United States aid efforts. And as the examples below illustrate, American institutions and mindsets found it extraordinarily difficult to adjust to aid in unsafe places. Cameron Munter draws on his experience as the head of the Provincial Reconstruction Team (PRT) in Mosul, Iraq in 2006 and as ambassador of the United States to Pakistan in Islamabad in 2011, with a description of U.S. reconstruction and state-building from which we may find lessons to consider in the future.

In 2006, when he went to Mosul as the first leader of the first PRT, the American civilian and military authorities in Baghdad painfully learned that the post-conflict situation would not correct itself. The undergrowth of our own bureaucratic structure prevented us from gaining a sophisticated understanding of our surroundings. Members of the PRT came and left after a few months, without passing on their hard-obtained knowledge. Local authorities quickly realized that the PRT had neither the money nor the firepower of the brigade commanders. And most of all, the guiding principles in place were still the creation of a kind of constitutional framework where political leaders, police, courts, businesspeople, and citizens would have institutions familiar to Americans, institutions that would work as we knew how to make them work.

Munter arrived in Pakistan at a time of great hope for U.S.-Pakistani relations. In 2011, in a series of meetings with the U.S. deputy secretary of state for resources and the head of USAID, Kerry-Lugar-Berman priorities took center stage: education, energy efficiency, job creation, special projects in the tribal areas, and public health. It is one thing to define a task and quite another to apply it to the specific context of a country in which security considerations prevent most USAID workers from even laying eyes on their projects. Overall, it seems the United States was much better at measuring its commitment to a prosperous, democratic Pakistan at peace with its neighbors by counting how much it spent and how fast rather than creating the proper relationship with those on the ground with whom it might have partnered.

Under these circumstances, what are lessons learned? When security is shaky, assistance is difficult. It may be that in situations like the AIP countries, we only have the capacity to engage in humanitarian aid and immediate reconstruction. If that is so, then the whole question of engagement in dangerous places is reopened: In a military setting, with military tasks, and thus a military system of organization, can civilian assistance succeed? Money spent is the way we measure commitment in such a setting, and that doesn’t bring the results we need.

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• Imagining assistance: Tales from the American aid experience in Iraq in 2006 and Pakistan in 2011

      

       

Overview

Increasing educational attainment is likely to reduce conflict risk, especially in countries like Pakistan that have very low levels of primary and secondary school enrollment. Education quality, relevance and content also have a role to play in mitigating violence. Education reform must therefore be a higher priority for all stakeholders interested in a more peaceful and stable Pakistan. Debate within the country about education reform should not be left only to education policymakers and experts, but ought to figure front and center in national dialogues about how to foster security. The price of ignoring Pakistan’s education challenges is simply too great in a country where half the population is under the age of 17.

There has been much debate concerning the roots of militancy in Pakistan, and multiple factors clearly come into play. One risk factor that has attracted much attention both inside Pakistan and abroad is the dismal state of the national education sector. Despite recent progress, current school attainment and literacy levels remain strikingly low, as does education spending. The Pakistani education sector, like much of the country’s public infrastructure, has been in decline over recent decades. The question of how limited access to quality education may contribute to militancy in Pakistan is more salient now than ever, given the rising national and international security implications of continued violence.

The second half of 2009 witnessed not only the Pakistani government stepping up action against insurgents but also the release of a new Pakistan National Education Policy that aspires to far-reaching and important reforms, including a commitment to increase investment in education—from 2 to 7 percent of gross domestic product. Hundreds of millions of dollars in international education aid have been newly pledged by donor countries. This renewed emphasis on education represents a substantial opportunity to seek to improve security in Pakistan and potentially also globally over the medium to long term. Policymakers both inside and outside Pakistan should give careful consideration to whether and how education investments can promote peace and stability, taking into account what we now know about the state of the education sector and the roots of militancy.

This report takes a fresh look at the connection between schools, including but not limited to Pakistan’s religious seminaries, known as “madrasas,” and the rising militancy across the country. Poor school performance across Pakistan would seem an obvious area of inquiry as a risk factor for conflict. Yet to date, the focus has been almost exclusively on madrasas and their role in the mounting violence. Outside Pakistan, relatively little attention has been given to whether and how the education sector as a whole may be fueling violence, over and above the role of the minority of militant madrasas.

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INTRODUCTION

In recent years, there has been a resurgence of interest in the issue of inequality. Part of this resurgence can be traced to new evidence of persistent and widening wealth gaps. Average incomes may be converging globally as a result of high growth in emerging markets, stronger growth in many poor countries, and slow growth in rich countries. However, the evidence also shows that within countries a parallel process of income divergence, marginalization and rising inequality is also taking place. Put differently, the rising tide of global prosperity is not lifting all boats.

Much of the international debate on inequality focuses on the distribution of income across and within countries. Other dimensions of inequality have received less attention. This is unfortunate. Amartya Sen has described development as “a process of expanding the real freedoms that people enjoy” by building human capabilities or their capacity to lead the kind of life they value. Income is a means to that end but it is a limited indicator of well-being. Moreover, a person’s income reflects not just personal choice but also their opportunities for improving health, literacy, political participation and other areas. Education is one of the most basic building blocks for the “real freedoms” that Sen describes. People denied the chance to develop their potential through education face diminished prospects and more limited opportunities in areas ranging from health and nutrition, to employment, and participation in political processes. In other words, disparities in education are powerfully connected to wider disparities, including international and intra-country income inequalities. This is why education has been identified as one of the most critical factors in breaking down the disadvantages and social inequalities that are limiting progress toward the United Nations’ Millennium Development Goals (MDGs)—development targets adopted by the international community for 2015.

Understanding patterns of educational inequality is critical at many levels. Ethical considerations are of paramount importance. Most people would accept that children’s educational achievements should not be dictated by the wealth of their parents, their gender, their race or their ethnicity. Disparities in educational opportunities are not just inequalities in a technical sense, they are also fundamental in equities—they are unjust and unfair. In an influential paper, John Roemer differentiated between inequalities that reflect factors such as luck, effort and reasonable reward, and those attributable to circumstances that limit opportunity (Roemer 1988).1 While the dividing line may often be blurred, that distinction has an intuitive appeal. Most people have a high level of aversion to the restrictions on what people—especially children—are able to achieve as a result of disparities and inherited disadvantages that limit access to education, nutrition or health care (Wagstaff, 2002). There is a wide body of opinion across political science, philosophy and economics that equal opportunity—as distinct from equality of outcomes—is a benchmark of egalitarian social justice. The theories of distributive justice associated with thinkers such as Amartya Sen, John Rawls, Ronald Dworkin and John Roemer argue, admittedly from very different perspectives, that public policy should aim at equalizing opportunity to counteract disadvantages associated with exogenous circumstances over which individuals or social groups have no control. Given the role of education as a potential leveler of opportunity, it is a national focal point for redistributive social justice.

Considerations of economic efficiency reinforce the ethical case for equalizing educational opportunities. Education is a powerful driver of productivity, economic growth, and innovation. Econometric modeling for both rich and poor countries suggests that an increase in learning achievement (as measured by test score data) of one standard deviation is associated on average with an increase in the long-run growth rate of around 2 percent per capita annually (Hanushek and Wößmann, 2010; Hanushek, 2009; Hanushek and Wößmann, 2008). Such evidence points to the critical role of education and learning in developing a skilled workforce. Countries in which large sections of the population are denied a quality education because of factors linked to potential wealth, gender, ethnicity, language and other markers for disadvantage are not just limiting a fundamental human right. They are also wasting a productive resource and undermining or weakening the human capital of the economy.

International development commitments provide another rationale for equalizing educational opportunities. This is for two reasons. First, the commitments envisage education for all and achievement of universal primary education by 2015. Second, there is mounting evidence that inequality is acting as a brake on progress toward the 2015 goals. Since around 2005, the rate of decline in the out-of-school population has slowed dramatically. Based on current trends, there may be more children out of school in 2015 than there were in 2009. Caution has to be exercised in interpreting short-run trends, especially given the weakness of data. However, the past three editions of the UNESCO Education for All Global Monitoring Report (GMR) have highlighted the role of inequality in contributing to the slowdown with governments struggling to reach populations that face deeply entrenched disadvantages (UNESCO, 2008, 2010, 2011). Therefore, picking up the pace toward the 2015 goals requires a strengthened focus on equity and strategies that target the most marginalized groups and regions of the world (Sumner and Tiwari, 2010; UN-DESA, 2009; UNESCO, 2010). It should be added that disparities in education relate not just to access, but also to learning achievement levels.

Accelerated progress in education would generate wider benefits for the MDGs. Most of the world’s poorest countries are off-track for the 2015 MDG target of halving income poverty and a long way from reaching the targets on child survival, maternal health and nutrition. Changing this picture will require policy interventions at many levels. However, there is overwhelming evidence showing that education—especially of young girls and women—can act as a potent catalyst for change. On one estimate, if all of sub-Saharan Africa’s mothers attained at least some secondary education, there would be 1.8 million fewer child deaths in the region each year. Thus while education may lack the “quick fix” appeal of vaccinations, it can powerfully reinforce health policy interventions.

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Ghana attained middle-income status after rebasing its National Accounts, pushing per capita gross domestic product (GDP) of the country above $1,000 in 2007. After recovering from economic recession in 1984 on account of the Bretton Woods sponsored economic reform introduced at that time, Ghana’s growth has been remarkably strong, with its lowest economic growth of 3.3 percent recorded in 1994. The country’s growth rate reached its peak of 15 percent in 2011 on the back of the commencement of commercial production of oil, making it one of the fastest growing economies globally during that year. This has translated into increased per capita income, which reached a high of about $1,900 in 2013.

The concern, however, has been the ability of the country to sustain this growth momentum given the level and quality of education and skills, and, more importantly, the failure of this strong growth performance to be translated into the creation of productive and decent jobs, improved incomes and livelihoods. The structure of the economy remains highly informal, with a shift in the country’s national output composition from agriculture to low-value service activities in the informal sector. The commencement of commercial production of oil raised the share of the industrial sector in national output. However, the continuous decline in manufacturing value added undermines Ghana’s economic transformation effort to promote high and secure incomes and improve the livelihoods of the people.

Structural change towards higher value added sectors, and upgrading of technologies in existing sectors, is expected to allow for better conditions of work, better jobs, and higher wages. But the low level and quality of human resources not only diverts the economy from its structural transformation path of development but also makes it difficult for the benefits of growth to be spread through the creation of gainful and productive employment. Thus, productive structural economic transformation hinges on the level and quality of education and labor skills. A highly skilled, innovative and knowledgeable workforce constitutes a key ingredient in the process of structural economic transformation, and as productive sectors apply more complex production technologies and research and development activities increase the demand for education and skills. However, the observed weak human capital base does not provide a strong foundation for structural economic transformation of Ghana.

Ghana’s employment growth lags behind economic growth, with an estimated employment elasticity of output of 0.47, suggesting that every 1 percent of annual economic growth yields 0.47 percent growth of total employment.

There is also widespread concern about the quality of the country’s growth in terms of employment and inequality, as well as general improvement in the livelihood of the people (see Alagidede et al. 2013; Aryeetey et al. 2014; Baah-Boateng 2013). A key indicator for measuring the extent to which macroeconomic growth results in gains in the welfare of the citizenry is the quality of jobs that the economy generates. Ghana’s employment growth lags behind economic growth, with an estimated employment elasticity of output of 0.47 (see Baah-Boateng 2013), suggesting that every 1 percent of annual economic growth yields 0.47 percent growth of total employment. Besides the slow rate of job creation is the dominance of vulnerable employment and the working poverty rate in the labor market. In 2010, 7 out of 10 jobs were estimated to be vulnerable while only 1 out of 5 jobs could be considered as productive jobs that meet the standard of decent work (Baah-Boateng and Ewusi 2013). Workers in vulnerable employment tend to lack formal work arrangements as well as elements associated with decent employment such as adequate social security and recourse to effective social dialogue mechanisms (Sparreboom and Baah-Boateng 2011). The working poverty rate remains a challenge with one out of every five persons employed belonging to poor households.

The article seeks to provide an analytical assessment of Ghana’s economic growth as one of Africa’s growth giants over a period of more than two decades and the implication for labour market and livelihood outcomes. Growth of labor productivity at the national and sectoral level is examined, as well as the sectoral contribution to aggregate productivity growth. The article also analyses the effect of growth on employment and the employment-poverty linkage in terms of elasticity within the growth-employment-poverty nexus in Ghana. It also delves into a discussion of the constraints on growth and productive employment from both demand and supply perspectives, and identifies skills gaps and the opportunities offered in the country, which has experienced strong growth performance. The article has five sections, with an overview of Ghana’s economic growth performance in Section 2, after this introductory section. This is followed by an overview of the developments in the labor market, specifically in the area of employment, unemployment, poverty, and inequality in Ghana in Section 3. The growth-employment-poverty linkage analysis is carried out in Section 4 followed by a discussion of constraints to growth and employment generation in Section 5. Section 6 provides a summary and conclusion, with some policy suggestions for the future.

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President Obama is right to keep at it in Afghanistan, argues a new policy brief by Michael O’Hanlon, senior fellow and director of research for the Brookings Foreign Policy program.

Some have criticized the president’s decision to maintain a significant troop presence there (5,500 troops), instead of following through on the planned military withdrawal. But Afghanistan remains very important to American security, O’Hanlon contends, and the situation in the country is far from hopeless in spite of recent setbacks. We should reinvigorate American efforts in Afghanistan, he argues—not returning to levels seen in previous years, but ramping up somewhat from our current posture.

O’Hanlon calls Obama’s resolve in Afghanistan commendable, but writes that he and his administration are still making mistakes on U.S. policy toward the war-torn country. He advises that Washington make two specific changes to its military strategy in Afghanistan:

1. Allow U.S. and NATO airpower to target the Islamic State and the Taliban (currently, they can only fight those groups if directly attacked). The narrow rules of engagement constraining foreign forces were intended to push Afghan armed forces to defend their territory themselves. While a worthy goal, O’Hanlon says, these rules often prevent us from attacking ISIS (though the targeting strategy towards the group may be changing) as well as the Taliban. They also impose unrealistically high demands on Afghan forces and make too fine a distinction between an array of aligned extremist groups operating in the country.
2. Expand U.S. force presence from the current 5,500 troops to around 12,000 for a few years. In O’Hanlon’s opinion, our current numbers are not enough to work with fielded Afghan forces, and skimping on ground forces has contributed to security challenges in places like Helmand, for instance, which experienced new setbacks in 2015. More broadly, leaders in Washington and Brussels should stress the value of a long-term NATO-Afghanistan partnership, rather than emphasizing an exit strategy. This will signal Western resolve to the Taliban and other groups. While the next commander in chief should set the United States on a gradual path toward downsizing American troops in Afghanistan, he believes it would be a mistake for Obama to do so in the short term.

The long haul

O’Hanlon also argues that the United States needs to take a longer-term perspective on key political and economic issues in Afghanistan. On the economic front, there seems to be little thinking about an agricultural development plan for Afghanistan, associated infrastructure support, and land reform, among other challenges. On the political front, conversations often tend to focus on shorter-term issues like organizing parliamentary elections, reforming the Independent Election Commission, or modifying the current power-sharing arrangement. In the process, conversations about foundational political strategy focusing on Afghan institutions and the health of its democracy get short-changed. The parliament is in need of reforms, for instance, as is the political party system (which should encourage Afghans to group around ideas and policy platforms, rather than tribes and patronage networks).

O’Hanlon concludes that the situation in Afghanistan today, while fraught, is understandable given the Taliban’s resilience and NATO’s gradual withdrawal of 125,000 troops. We should not be despondent, he writes—rather, we should identify specific strategies that can help improve the situation. At the end of the day, Afghans must make the big decisions about the future of their country. But as long as the United States and its partners are still providing tremendous resources—and as long as security threats emanating from South Asia continue to threaten the United States—leaders in Washington should use their influence wisely.