f Why Europe must end limbo for Afghans seeking asylum By www.chathamhouse.org Published On :: Thu, 14 Oct 2021 08:58:48 +0000 Why Europe must end limbo for Afghans seeking asylum Expert comment Anonymous (not verified) 14 October 2021 With a focus on evacuations from Afghanistan, the situation in Europe is often forgotten as thousands of asylum seekers continue to wait for their cases to be settled. Following the Taliban’s takeover of Afghanistan, European leaders shared messages to welcome those evacuated, but the reality of European responses to displacement in Afghanistan paints a more contentious picture. As of July 2021, 33,325 cases of Afghan asylum applicants were pending in Germany, in France 18,410 people were waiting on a decision, while in Greece the numbers were 13,660. Arguably, such numbers are manageable given European states’ size and their functioning asylum systems but, while 56 per cent of Afghans in Europe receive protection status, a large proportion is still in limbo in differing European countries’ asylum systems. Europe hosts fewer than ten per cent of the three million UN-registered displaced Afghans globally, as neighbouring countries carry the burden of Afghanistan’s forced displacement: Iran hosts almost one million Afghan refugees and Pakistan 1.5 million, and these numbers double when adding undocumented or Afghan passport holders. But despite these manageable numbers, national authorities in Europe often leave people waiting for months or even years to receive an asylum decision. Deportations to Afghanistan were halted only after the Taliban’s takeover of Kabul and even then there was resistance to this from certain European countries, while Austria suggested setting up ‘deportation centres’ in countries neighbouring Afghanistan. Europe remains a fortress The European Commission’s Draft Action Plan responding to the events in Afghanistan confirmed the willingness of the European Union (EU) to continue returns to non-European ‘third countries’. So Europe remains a fortress, despite pledging support for ‘the safe and orderly departure of foreign nationals and Afghans who wish to leave the country’. The wall by Greece at its border with Turkey and Poland’s treatment of Afghan asylum seekers trapped at its border with Belarus illustrate this hardline stance. The president of the European Council Charles Michel and EU Home Affairs Chief Ylva Johansson both confirm the priority is to secure European borders. This is further backed up by the European Council’s latest set of Conclusions on Afghanistan which focuses on security and ‘preventing illegal migration’ while avoiding reference to any domestic asylum efforts or the establishment of protection pathways for Afghans. Afghans in Europe need answers from European policymakers and, by strengthening domestic asylum responses alongside international humanitarian commitments, Europe’s actions would increasingly match its words. This disconnect is not new. At the national level, reports of illegal pushbacks on European land and sea borders alarmingly intensified in 2020 as authorities intercepted and sent migrants back to neighbouring countries without assessing asylum claims. At the EU level, development aid to countries such as Afghanistan has long been conditional on their governments’ adherence to the bloc’s migration objectives of preventing asylum seekers from reaching European borders and facilitating the repatriation of those refused asylum in Europe. But this latest displacement crisis from Afghanistan exposes clear inconsistencies in European approaches to asylum and humanitarianism. Migration remains a divisive issue in European politics, but European governments must act promptly to support Afghans already residing in their territories alongside establishing robust international commitments. Time for concrete action European countries should firstly improve the treatment of those Afghans currently in limbo within their respective asylum systems by expediting pending Afghan asylum applications and family reunification cases, re-examining rejected asylum applications, and facilitating integration. Secondly, national authorities should not return asylum seekers to Afghanistan or any third countries deemed ‘safe’. For Europe to coordinate evacuations from Afghanistan while simultaneously deporting asylum seekers undermines the international refugee regime and threaten Europe’s global credibility. Full Article
f The law as a tool for EU integration could be ending By www.chathamhouse.org Published On :: Fri, 15 Oct 2021 08:29:03 +0000 The law as a tool for EU integration could be ending Expert comment NCapeling 15 October 2021 Poland is not the only EU member state challenging the supremacy of European law, as historic change is happening in how European integration functions. The Polish Constitutional Tribunal’s ruling that several articles of the European treaties are incompatible with the Polish constitution is prompting much debate, especially in terms of both the similarities and differences between it and rulings by the German constitutional court which have also challenged the European Court of Justice (ECJ). Pro-Europeans are keen to draw a sharp distinction between the reasoning deployed by the two courts. They see the Polish court’s challenge as an exceptional case which the European Union (EU) cannot ‘tolerate’ because it would lead to the ‘demolition of the EU’s legal order from within’ and argue the EU must take a tough approach to Poland by re-asserting the supremacy of EU law. But this view misses a bigger long-term shift in the EU. Both the German and Polish cases illustrate some of the basic conflicts within the EU’s legal system for decades. What is being challenged increasingly openly – even since the UK left the EU – is the idea of the EU as a de facto federation in which non-majoritarian institutions such as the ECJ have final say about the quality of democracy in member states. ECJ’s quiet revolution Historically ‘integration through law’ was central to the European project and the ECJ was a key institution driving forward integration – usually benefiting from what Erik Stein called ‘benign neglect by the powers that be and the mass media’. Even when European integration in the form of treaties stalled in the 1960s and 1970s, ‘judicial integration’ through the ECJ continued, including its notable 1964 decision that EU law was supreme. According to the German court’s theory of ‘constitutional pluralism’, there is in effect a constant dialogue and accommodation between the national and EU level rather than a simple primacy of EU law over national law This self-empowerment of the ECJ – what another scholar of European constitutionalism Joseph Weiler calls ‘a quiet revolution’ – was possible because there was a ‘permissive consensus’ in member states which allowed judicial integration to continue largely unchallenged. But this has now changed as both politicians and national courts are more willing to challenge what they see as judicial overreach. There are important differences between the approach of the German and the Polish constitutional courts. The Law and Justice Party has politicized the Polish court, packing it with judges sympathetic to that party, whereas the German court is more independent. In addition, whereas the German court made qualified and subdued objections to measures taken in response to the euro crisis during the past decade and, in particular, the steps towards the mutualization of eurozone debt – but often backed down with ‘all bark and no bite’ as Christoph Schmid put it – the Polish court is driven by political considerations and has challenged the supremacy of EU law in a more direct and general way. However, the German court has made it clear it is the guardian of the German constitution and seeks to impose limits on the ECJ’s self-empowerment by arguing Europe is not a federation. According to the German court’s theory of ‘constitutional pluralism’, there is in effect a constant dialogue and accommodation between the national and EU level rather than a simple primacy of EU law over national law. The court sees itself as the ultimate arbiter of whether steps in European integration are consistent with the German constitution, and is likely to challenge any further steps in fiscal integration even if the ECJ deems them in accordance with the treaties – as it did with the European Central Bank’s quantitative easing programme. Supremacy of EU law is under pressure Right across Europe, courts and politicians are increasingly challenging the ECJ and questioning the supremacy of EU law. Michel Barnier called for France to regain ‘legal sovereignty’ and should no longer be subject to the judgments of the ECJ – an extraordinary demand from the EU Brexit negotiator who regularly lectured the UK about the sanctity of the EU’s legal order. The Polish challenge is part of a historic change in how European integration functions – or does not function Other possible French presidential candidates such as Valérie Pécresse and Eric Zemmour are also openly challenging the primacy of EU law. The UK, of course, is fighting its own battle with the EU about the ECJ’s role in the Northern Ireland Protocol. It was not the current Polish government but the people of France and the Netherlands who blocked the attempt at explicit constitutionalisation of the EU in a referendum just one year after the 2004 enlargement. Whereas the Constitutional Treaty ‘would have codified the doctrine of EU legal supremacy’, that provision was dropped from its successor the Lisbon Treaty, again indicating consensus on EU legal supremacy is not as strong as is often claimed. Full Article
f The West must face down Putin By www.chathamhouse.org Published On :: Tue, 01 Feb 2022 16:12:51 +0000 The West must face down Putin The World Today MVieira 1 February 2022 If Russia’s ambitions are not checked, the implications will be global, warns James Nixey After seven years of invasions, annexations, assassinations, abuses and now the current crisis in European security over the fate of Ukraine, one thing has been laid bare: the true nature of the Russian state. Moscow made its ambition clear in mid-December with the unprecedented and public issuing of ultimatums in the form of draft treaty proposals. Portrayed by Russia as an attempt to end Nato’s expansion eastwards, the Kremlin is in fact demanding that the United States and western institutions roll back their security guarantees to Eastern Europe. These are not two sides of the same coin if one believes and accepts the principles of the Helsinki Accords that the successor states to the Soviet Union are just as independent and sovereign as Russia. Russia’s demands laid bare equate to giving it a free hand in Eastern Europe. This should not be reduced to simplistic labels such as ‘territorial expansionism’ or a ‘return to the Soviet Union’, both of which can be picked at for a lack of accuracy. Russia has gone beyond being an awkward player at the negotiation table or a bully who can be dealt with further down the line But it is, in Russia’s own words, the most explicit statement yet of its long-standing desire to return to a former age, where great powers directed their respective spheres of influence – a yearning for a time of empire and a disregard for the flow of history. The intense diplomatic and media focus since then suggests there is a consensus that Russia has gone beyond being an awkward player at the negotiation table or a bully who can be dealt with further down the line. But this has not as yet led to the operational conclusion that Russia must be challenged and ultimately faced down, no matter how unpalatable. The logical response to the exposure of Russia’s true intentions would be an overhaul of western policy. Yet the West persists in its article of faith that dialogue with Russia will bring about a change in its behaviour – despite all evidence to the contrary. Western politicians have been anxious to avoid direct confrontation with Russia. But the Kremlin is likely to see this course of action as confirmation that it can proceed unchecked. When Moscow has chosen the path of conflict, efforts at dialogue rarely bring a peaceful resolution. When Moscow has chosen the path of conflict, efforts at dialogue rarely bring a peaceful resolution Russia is blessed with particularly talented negotiators. While it has its fair share of angry ultra-nationalists who are easily dismissed, it also has more subtle brains at official and unofficial levels with whom western politicians are eager to engage to claim morsels of intelligence or to show that the Kremlin is not beyond redemption. Sergei Lavrov, Russia’s foreign minister, is an intelligent and experienced man, who is adept at dismissing the protests of most of his western counterparts. In such circumstances, and with such a pressing need to avoid a war, dialogue must be tightly contained as it has the potential to lead to compromise in areas where there should be none. Russia’s ambitions for a land empire Eastern European states which were part of the Soviet Union or signatories to the Warsaw Pact are geographically closer to Russia and as a result more physically at risk. But their history and close relations with Moscow in the past have allowed them to acquire experience and expertise in dealing with their more powerful neighbour. They uphold principled stances on sovereign rights, which has led the Kremlin to brand the Baltic states, Ukraine and more recently Moldova as traitors. To the West, on the other hand, they can often be seen as awkward or getting in the way. While the sandwiched eastern states may have much to teach us about dealing with Russia, some central European countries have a closer relationship with Moscow. Serbia’s security services have recently been exposed as being under the influence of Russia’s own FSB, the Federal Security Service, successor to the KGB, and have colluded in repressing Moscow’s political opponents. At the same time, Viktor Orbán’s Hungary continues to defy the European Union with its repressions and is one of the few states that looks to Russia as a model. By failing to address the real nature of Russia’s demands, Europe is avoiding critical decisions What is at stake here is a basic grasp of the nature of relations between states in the 21st century. What Russia is insisting on is its right to a land empire which is entirely at odds with the principles of statehood that now govern Europe, and indeed much of the rest of the world. By failing to address the real nature of Russia’s demands, Europe is avoiding critical decisions that will affect its future security for generations to come. The implications of that avoidance do not only affect Europe – they are global in importance. Other powers, most notably China, will watch closely how the West responds to Russia and gauge its willingness to support allies, friends and partners against aggression. Any failure to respond firmly to Russia’s approach of demanding limits on the sovereignty of its neighbours, backed by the threat of military force, can only encourage similar strong-arm tactics elsewhere. It is notable that, from Chechnya to Syria, Russia has not yet suffered an unambiguous defeat when it has asserted its ambitions through military power. Facing down Russia will take skill, time, spine, money, grit and self-sacrifice Resolving the incompatibility between the way Russia sees itself and what the rest of Europe views as the acceptable limits of Russian power will be a long, painful process. Facing down Russia will take skill, time, spine, money, grit and self-sacrifice. Sanctions, for example, hurt those imposing them as well as the receiver. These are attributes in short supply in what Russia considers to be the weak, decadent West. Since such resources are unlikely to be found, the unappetizing future for relations is most likely to involve Russia continuing to chip away at European sovereignty while its own structural flaws further weaken it to the point of irrelevance, or to push it to take ever more extreme risks. Full Article
f Why a no-fly zone risks escalating the Ukraine conflict By www.chathamhouse.org Published On :: Sun, 13 Mar 2022 15:37:04 +0000 Why a no-fly zone risks escalating the Ukraine conflict Expert comment NCapeling 13 March 2022 The US rejection of Poland’s offer to send fighter jets as a boost to Ukraine’s air defence shows just how uneasy nations are about direct combat with Russia. The Pentagon’s decision to turn down the proposal by its fellow NATO member Poland to put Russian-made MiG-29 jets at its disposal demonstrates again how keen the US and allies are to avoid risking major confrontation with Russian forces. The US Department of Defense says the offer to locate jets at bases in Germany was ‘not tenable’ as this risks flying into contested airspace over Ukraine – a non-NATO member – raising ‘serious concerns for the entire NATO alliance’ and echoing the continuing rejection of calls to implement no-fly zones (NFZs) as a way of easing the devastation being faced by trapped Ukraine civilians. NFZs restrict any aircraft, including drones, from flying over a pre-defined region and can be used for both military and civilian purposes. But the implementation of NFZs is difficult to enforce and – most significantly – is unlikely to achieve the intended effect on the ground. In the long-term, under the terms of a ceasefire agreement, it may be possible to include a NFZ under a UN or joint OSCE-UN peace terms In conflict situations, they are usually implemented under the remit of United Nations (UN) peace support operations, requiring authorization under Article 42 of the UN Charter. This details that if all possible methods have proven ineffective in responding to a threat, countries ‘may take such action by air, or land forces as may be necessary to maintain or restore international peace and security’. Protection but with limitations NFZs provide both protection from attack and surveillance but do have limitations. They must be monitored and enforced which requires committing to fighter jet patrols with the explicit task of defending the area from the air by whatever means necessary. This could mean jets firing upon Russian planes and drones so, if NATO allies and partners were to enforce a NFZ, it would represent an escalation of measures which is a step that would most likely provoke an unpredictable Vladimir Putin into further escalation – in short, it is highly likely to be seen as an act of war. UK defence secretary Ben Wallace – among others – has repeatedly dispelled the idea, saying that enforcing NFZs would mean deploying ‘British fighter jets directly against Russian fighter jets’. In relation to moves such as the Polish jets, the Kremlin has warned that any countries offering airfields to Ukraine for attacks on Russia may be viewed as having entered the conflict. There have only been three past instances of military NFZs. In Bosnia, as part of Operation Deny Flight from 1993-1995, a NFZ was enforced as part of a strategy which also including the provision of close air support and approved air strikes. In Iraq, an NFZ endured for 12 years from 1991 and was succcesful in preventing Saddam Hussein from attacking Kurdish and Shia Muslim civilians. And in Libya in 2011, a NFZ was deployed to prevent the destruction of military infrastructure and the Libyan regime – although this quickly morphed into the provision of close air support. So it is unclear just how successful NFZs are at providing protection. In Iraq and Libya, NFZ cover protection was provided but neither Saddam Hussein or Colonel Gaddafi were able to effectively target victims through their ground forces whereas, in Bosnia, Slobodan Milosevic infamously used ground troops to slaughter 8,000 Bosnian men and boys at Srebrenica. Putin would still be able to continue to use both ground forces and artillery to assault Ukrainian cities with or without a NFZ – in fact, his sparse use of his Russian Aerospace Forces (VKS) has been one of the surprising features of the war so far. Under a NFZ, missile attacks could also continue, there is nothing in the record of no-fly zones to suggest the provision of safe areas for non-combatants would work. And NFZs have only been successful against vastly inferior forces such as in Iraq, Bosnia, and Libya. But Russia has an air force second only in size to the US and has a vast range of defences including the potent S-400 Triumf at its disposal. Not only would an NFZ be ineffective, it might also not be possible to enforce without risking significant losses to the peace operations force. It is due to a combination of these reasons that NFZs have not been used more in previous conflicts. The most recent consideration for a NFZ was in Syria but President Bashar al-Assad’s Syrian forces, protected by Russian air cover, could still have targeted their intended victims despite air policing so a NFZ was not used. If NATO allies and partners were to enforce a NFZ, it would represent an escalation of measures which is a step that would most likely provoke an unpredictable Vladimir Putin into further escalation In the long-term, under the terms of a ceasefire agreement, it may be possible to include a NFZ under a UN or joint OSCE-UN peace terms. However, the forces involved should exclude NATO allies and partners or any states with Russian alliances to avoid further conflict. This leaves few suitable countries with the capacity, willingness, and political stance to be called on. Two of the world’s most militarily capable states – China and India – abstained in the Uniting for Peace vote in the UN General Assembly (UNGA). Whether another willing state with the military capability – such as a Gulf state – could be considered acceptable to all sides remains to be tested. Notable successes with SAMs Many military commentators also note that currently Ukrainian forces are having notable success without jets, downing Russian aircraft using sophisticated surface-to-air missiles (SAMs) such as Stinger and Javelin, and NATO countries continue to supply those in their thousands. Full Article
f Ukraine exposes Europe’s double standards for refugees By www.chathamhouse.org Published On :: Wed, 30 Mar 2022 13:20:31 +0000 Ukraine exposes Europe’s double standards for refugees Expert comment NCapeling 30 March 2022 As European governments provide swift protection assurances to those fleeing Ukraine, non-European asylum-seekers continue to face violence at the EU’s borders. One month after Russia’s invasion of Ukraine, the European Union (EU) already faces its largest refugee crisis since World War Two, with more than ten million people having fled their homes – 6.5 million displaced within Ukraine and 3.9 million escaping to neighbouring countries. Acting quickly and decisively, European governments have opened borders and European citizens have opened their homes in an unprecedented showing of solidarity towards refugees. But, with all eyes on Ukraine, the Greek coastguard continues to illegally push back asylum-seekers crossing from Turkey while Spanish police forcefully repel those who dare to jump the fence in Melilla. The painful contrast exposes the double standards in the EU’s approach to refugees. With Europe’s grim history of restrictive asylum policies, it is wishful thinking that the warm welcome to Ukrainians will extend to all asylum-seekers. The EU solidarity to displaced Ukrainians illustrates the deeply politicized – and often discriminatory – nature of providing refugee protection. The waves of women and children leaving Ukraine prompted a surge of humanitarian action but they are also a chilling reality check of Europe’s double standards However, the hope is this turning point in European history can at least set an important precedent for treating refugees more humanely. Undoubtedly, EU solidarity towards people fleeing the horrors of Putin’s war is critically important and the initial response is positive in its efforts to meet immense humanitarian needs. Solidarity with Ukrainians The EU activation of the Temporary Protection Directive (TPD) is a significant step towards a more humane protection regime and fairer responsibility-sharing among member states. Without the need for the examination of individual applications, those fleeing Ukraine can access harmonized rights across the EU for three years – including residence, housing, medical assistance, and access to the labour market and education. The TPD is also a move away from the strict ‘Dublin’ rules which put the pressure of hosting refugees onto the countries of ‘first arrival’. Ironically, the fiercest opponents of intra-EU solidarity, such as Poland and Hungary, are the ones benefiting from this change now but, in the case of Ukraine, geographical proximity and shared histories must be considered when analysing Europe’s response. Eastern European and Baltic countries share a post-Soviet history and fear of Russian aggression, and Ukrainians already enjoyed 90 days of visa-free travel in the EU – with a large diaspora, many have established networks across Europe. But even considering these distinctive connections with Ukrainian displacement, the initial response still shows that European countries have both the political will and the capacity to host refugees. Unlike the usual – often media-fuelled – narratives of refugee ‘invasions’ into Europe, the waves of women and children leaving Ukraine prompted a surge of humanitarian action but they are also a chilling reality check of Europe’s double standards. The EU has used agreements with countries such as Turkey and Libya to prevent arrivals and outsource asylum responsibilities, while border violence, detention, and lengthy asylum procedures await the few asylum seekers who manage to enter Europe from the Middle East, Asia, and Africa. These ‘fortress Europe’ legacies have even undercut the humanitarian response in Ukraine, with reports of incidents of discrimination towards people of colour at the EU borders being condemned by the United Nations (UN) and the African Union (AU), the media facing allegations of racist reporting, and comments from Bulgarian PM Kiril Petkov providing a stark reminder of the islamophobia, racism, and history of colonization which still pervades European asylum policies. The unity shown over Ukraine can help reshape and refocus political efforts towards increased responsibility-sharing among EU member states – the perennial ‘hot potato’ of the EU asylum system Foreign policy also influences how EU leaders treat the right to asylum, as the geopolitics of Europe’s efforts to create a united front against Russian aggression is an undercurrent to the prompt European response to Ukrainians. But only a few months ago, non-European asylum-seekers trapped in freezing forests at the Poland-Belarus border were used as political pawns by Belarusian leader Aliaksandr Lukashenka and then dehumanised as a ‘hybrid attack’ by EU leaders. A turning point for asylum in Europe? Despite entrenched discriminatory precedents, it is worth looking ahead at this moment of reckoning. Although policy changes remain far off, the unity shown over Ukraine can help reshape and refocus political efforts towards increased responsibility-sharing among EU member states – the perennial ‘hot potato’ of the EU asylum system. Full Article
f War on Ukraine: Exploring the humanitarian response to the conflict By www.chathamhouse.org Published On :: Wed, 06 Apr 2022 08:42:16 +0000 War on Ukraine: Exploring the humanitarian response to the conflict 12 April 2022 — 12:00PM TO 1:00PM Anonymous (not verified) 6 April 2022 Online This event explores the implications of the humanitarian realities from Russia’s invasion of Ukraine, the largest ground campaign in Europe since World War Two. Reports from humanitarian organizations working in Ukraine are dire and reveal that a humanitarian disaster on an epic scale is unfolding. The United Nations (UN) and other organizations estimate 12 million of Ukraine’s population are in need of assistance, 4.1 million have been displaced to neighbouring countries, and 6.4 million have become internally displaced. Gillian Triggs, the assistant secretary-general and assistant high commissioner for protection at the UNHCR, joins other experts to discuss the humanitarian situation in Ukraine. The panel considers: What are the greatest needs in Ukraine now? How can aid agencies meet those needs? What are the short and long-term implications of the crisis for Ukraine and Europe? How do international organizations work with local NGOs to provide food, medical aid and shelter? This event is part of a regular series of events offering insight and analysis from experts and policymakers on how the war is affecting Ukraine, the region and the world. This event is part of Chatham House’s ongoing work on the future of conflict. Read the transcript Full Article
f New research on 21st-century conflict By www.chathamhouse.org Published On :: Mon, 11 Apr 2022 16:47:14 +0000 New research on 21st-century conflict 25 April 2022 — 5:00PM TO 6:00PM Anonymous (not verified) 11 April 2022 Online This International Affairs webinar shares research on US special operations, urban warfare, and digital activism in recent conflicts. Given the ongoing Russian invasion of Ukraine, and continuing conflicts in Myanmar, Yemen, and other countries, it is important to understand the changing nature of conflict in the 21st century. In this webinar, authors from the March 2022 issue of International Affairs share research on the transformation of Western special forces, the impact of army size in urban warfare, and the use of social media and online activism in war. The speakers in this event drew on the following research: US Special Forces transformation: post-Fordism and the limits of networked warfare (https://doi.org/10.1093/ia/iiab213) Urban insurgency in the twenty-first century: smaller militaries and increased conflict in cities (https://doi.org/10.1093/ia/iiac007) Diasporas as cyberwarriors: infopolitics, participatory warfare and the 2020 Karabakh war (https://doi.org/10.1093/ia/iiac015) International Affairs was started at Chatham House in 1922 to communicate research to members who could not attend in person. Over the past 100 years, it has transformed into a journal that publishes academically rigorous and policy-relevant research. It is published for Chatham House by Oxford University Press. Read the latest issue here. Full Article
f Africa and Europe: Cooperation on digital transitions and new technologies By www.chathamhouse.org Published On :: Thu, 12 May 2022 09:02:13 +0000 Africa and Europe: Cooperation on digital transitions and new technologies 26 May 2022 — 8:00AM TO 12:30PM Anonymous (not verified) 12 May 2022 Online The 11th Africa Day International Conference takes place under the auspices of the president of the Republic of Slovenia, HE Mr Borut Pahor, and within the framework of the Bled Strategic Forum. Slovenia’s annual high-level Africa event seeks to improve policy outcomes for citizens in Europe and Africa as a result of a mutual understanding and strengthened cooperation between the two regions. The event is co-hosted by the Ministry of Foreign Affairs of the Republic of Slovenia, the Chatham House Africa Programme and the European Commission. Expert discussions at this year’s edition will examine collaborative links between Africa and Europe in promoting responsible innovation and governance of emerging technologies, as well as the role of technology in shaping creative and cultural economies. The conference will be broadcast live on this website, on the Slovenian Ministry of Foreign Affairs website and on the Africa Programme Facebook page. 11th Africa Day International Conference Agenda (PDF) Full Article
f Culture notes: Populists of the world unite By www.chathamhouse.org Published On :: Wed, 25 May 2022 09:11:06 +0000 Culture notes: Populists of the world unite The World Today rsoppelsa.drupal 25 May 2022 America’s hard-right has successfully played a long game at home, and now it’s schmoozing Europe. We should be worried, says Catherine Fieschi The politics of advanced democracies is a rather Janus-faced affair these days. No sooner have we breathed a sigh of relief at the results of the French presidential election than a leaked United States Supreme Court document on Roe v Wade signals American abortion rights are under threat. Yes, Europe seems to be maintaining political unity in its support of Ukraine, and the US is lavishing eye-watering sums on it both in military and humanitarian aid. Yet one cannot help but feel that these might be short-lived spells of relief in the face of mounting storm clouds on the political horizon. Both at the domestic and international level, populist politics looks to be gathering pace still. On the domestic front, we should be cautious in our relief. In the French elections Emmanuel Macron was indeed re-elected, and comfortably so, but there is no denying the space occupied by populist politicians on the left and the right. In the first round, Marine Le Pen gained 23 per cent of the vote, left populist candidate Jean-Luc Mélenchon 22 per cent, and far-right candidate Éric Zemmour 7 per cent. Add to this a record low turnout, and the picture is one of a system in which mainstream politics has overall been rejected in favour of various populist options. The Hungarians weren’t so lucky, and Viktor Orbán’s capture of the media and quashing of the opposition over his years in power delivered solid victory. What should be cause for further concern is what is happening in the United States, as well as its potential impact on European politics. A quick flick through American politics today suggests dysfunctionalities of staggering magnitude and depth, and the full extent of the success of the right-wing Republican project, as confirmed by the intention to reverse Roe v Wade. Any reversal of Roe v Wade is a further step towards a drastic re-territorialization of American politics: into red states and blue states, into urban v rural, into places where taxes fund public education and public goods and where they won’t. It is also about a re-territorialization of institutional power away from the federal and into state institutions. The words of JD Vance, the Ohio Republican senatorial candidate – author of the rather good memoir Hillbilly Elegy – pander to an ‘American heartlands’ view of the United States’ role in the world. Asked about the fate of Ukraine, Vance simply replied that he ‘didn’t really care what happens to Ukraine one way or another’. On an even more basic level, we would do well to keep in mind that there were 440 anti-voter bills in 49 states at the end of 2021 and rising, calling into question citizens’ basic rights to vote. Republicans have pursued this agenda relentlessly. They have played a long game and invested in media, education and minor and not so minor projects – all of which have secured them a social and political base that is well-disposed towards the deep reversal of the American liberal global project and that of its allies across the world. The arrival of the Fox News-driven Conservative Political Action Conference in Hungary in May is deeply worrying And it is perhaps on this last point that we should be most alarmed. Between May 18-20, the Conservative Political Action Conference, an American conclave of the right, was held in Europe. Viktor Orbán gave the keynote speech, and other speakers included the Brazilian President Jair Bolsonaro’s son, Eduardo, and the president of Spain’s far-right party Vox, Santiago Abascal, as well as some well-known American Trumpian voices, including Trump himself. Marine Le Pen, whose earlier appearance at the conference had met with rapturous applause, chose not to cosy-up too closely to Orbán in the run-up to the French parliamentary elections in June but she sent her deputy. The export of the Fox News-driven conference from across the Atlantic is deeply worrying. Up until now populists have failed in their attempts at international alliances. At the European Union level their nationalism has always been in the way of their working together, and their groups tend to be short-lived or ineffective as a result. As for American attempts in Europe, the one led by Steve Bannon, the former White House adviser, in 2020 that aimed to create an Academy for the Judeo-Christian West ended as a damp squib – possibly not helped by his dismissal from the White House amid charges of defrauding donors. But something may be changing: the conference’s embrace of Orbán and an international smattering of ‘strongmen’ hailing from the hard-right, aligned with Putin and sup-ported by Trump and a media empire, suggests that we are entering a Trumpian-infused second act that in its triumphal revanchism is seeking to create an international right-wing populist, or even authoritarian front. This is about politics, media, but also money – something European populist parties have been short of. As Marine Le Pen explained to French voters, her party is so poor it had to borrow money from a Russian bank. As some have pointed out, the Russian aggression against Ukraine has complicated matters when it comes to Russian funding of disinformation to the West. Many routes have been shut down. But a new route between the US and Hungary as a platform to floss Europe with dirty money is a good replacement to the old Russian route. Full Article
f Reshaping NATO for an uncertain future By www.chathamhouse.org Published On :: Wed, 25 May 2022 10:31:53 +0000 Reshaping NATO for an uncertain future The World Today mhiggins.drupal 25 May 2022 A Chatham House expert panel outlines the challenges for delegates at the Madrid summit where the roadmap for the transatlantic alliance will be created This year had already been earmarked as pivotal for the shape and direction of European security even before Russia, a nuclear superpower, rolled its tanks into Ukraine. On the agenda at the NATO summit in Madrid in June is the Strategic Concept, which sets out the alliance’s direction and priorities for the next decade. There is much to discuss. From shared values to the state of the security environment, the Strategic Concept will have a direct impact on the global security landscape. Ten years ago, the world was a very different place. The United States had just withdrawn from its bloody war in Iraq and was still embroiled in Afghanistan fighting the Taliban. In China, Xi Jinping was poised to become the next president, while refugees escaping the vicious civil war in Syria were heading towards Europe. In Africa, Islamist activity in Mali was about to spread throughout the Sahel. Now, Russia’s illegal war in Ukraine rages on NATO’s doorstep, spurring the once neutral countries of Sweden and Finland to seek membership. How will Russia’s aggression towards Ukraine affect the western security agenda and what will be the shape of the new NATO that emerges from these talks? To help answer these questions, The World Today convened a panel of Chatham House experts to consider what the next 10 years holds for NATO. Here is what they said. Alice Billon-Galland We shouldn’t expect a revolution, but more an adaptation of reforms that have taken place at NATO for quite a long time, especially since the Wales summit in 2014. NATO allies will have to decide on the Russian threat perception and decide how they want to reinforce their deterrence and defence posture in the East, and how this affects their ability to maintain a 360-degree approach and to carry out the ambitious NATO 2030 agenda. Patricia Lewis We need to understand how deterrence works far better and we should have better metrics by now. Russia and NATO do not wish to engage in conventional warfare with each other, which suggests that Nato’s conventional deterrence is working. That said, Putin’s nuclear threats have not been within the framework of deterrence. But nuclear deterrence has not worked in the way strategists imagined since the end of the Cold War, and we need a much clearer hard look at these weapons once this is all over. Had we followed through on disarmament in the 1990s, Putin would have held very little sway today. Nuclear weapons and despots are not a good mix and with these weapons there are no small mistakes. We would be foolish to imagine that rationality will hold when it comes to nuclear decision-making. It is time to put arms control back on the agenda and strengthen our efforts to prevent nuclear proliferation. We need to put the elimination of these weapons back on the UN Security Council agenda. Andrew Dorman Finland and Sweden coming into NATO completely transforms the Baltic. It makes the deployment of reinforcements to the Baltic states an awful lot easier. From the Kremlin’s point of view, the last thing they want is another border with NATO. Russia is already overly committed and hasn’t got enough forces to deal with Ukraine. Its border with Finland is enormous. And NATO would be gaining two very robust, well-organized military forces. You are seeing a lot more NATO assets starting to look at the high north. Hans Kundnani I am actually slightly less worried about the Russian threat to NATO countries than I was before February 24. The war has demonstrated how weak the Russian military is, and so the idea that it might present a threat to Finland and Sweden seems less plausible than before. It is not even clear to me that Russia could do very much in other south-eastern European countries. It already seems pretty overstretched. This should make us more relaxed, rather than more worried, about threats to other countries and in particular to NATO countries or to Finland and Sweden. Leslie Vinjamuri Sweden and Finland moving forward with their requests for membership is a sign of success for the West, but it also raises important questions for the future of European security. The possibility that we lock in a division that might suit Europe and the United States now does not bode well for a Russia maybe 10 years out or with a different leader. Alice Billon-Galland We need to avoid mission creep, but we also need to avoid going back to a position where NATO only focuses on Russia and then set an agenda for 10 years based on that threat assessment alone. We will risk missing out on the next big challenge if we go back on something too specific. We risk being reactive, whereas the Strategic Concept is an exercise that should be proactive and provide a space for transatlantic partners to share broader common security concerns. Patricia Lewis NATO is open to all countries in the transatlantic area, and it is even possible that Russia could join in the future should they wish to apply. But it is important to remember that NATO is a political-military alliance, and its politics are fundamental to its cohesion, far more than that of any weapon system or a specific enemy. It will continue to address a wider range of threats as it has in, for example, Afghanistan and many of those will be directly related to the impacts of climate change. One thing to note, in light of Russia’s nuclear threats, is that NATO’s characterization of itself as a ‘nuclear alliance’ should be revised. NATO needs to be resilient to ebbs and flows of weapon systems and not become over-reliant on one system which has recently demonstrated severe negative impacts. Hans Kundnani During the Cold War, what held the alliance together was a shared perception of a threat from the Soviet Union – not a set of shared values. After all, there were authoritarian states in NATO. After the end of the Cold War that overwhelming sense of a shared threat from the Soviet Union disappeared and NATO tried to reinvent itself as a community alliance of democracies with shared values. But we now once again have authoritarian states in NATO. So it was really in danger of being pulled apart. The war in Ukraine has refocused NATO on its original, historic mission: collective security in relation to Russia. In that sense it has given NATO a lifeline. Creon Butler Shared values are still an awful lot stronger as an element of what ties NATO together now than they were in the past. I think you now have the threat perception coming back full force. But I still think you have that very strong element of values, indeed the extra countries that are coming in are very strong democratic countries. The interesting question is the out-of-area stuff – the Afghanistan-related stuff and counterterrorism more generally, and how important those threats remain. I guess there is an element to that which is a global kind of threat, counterterrorism, but there is also the out-of-area activity which obviously has been transformed following the withdrawal from Afghanistan. Alice Billon-Galland The crisis management mandate needs to be looked at again with some of the lessons learnt after Afghanistan and Libya, especially given what happened in Kabul, and all the discussion around cooperative security. The question is not only how do we work with partners and countries in the region, but how do we want to engage with China, for instance? How do we want to work on new technologies? How do we want to work with the European Union, with the United Nations? The alliance must decide what it wants to do versus what it wants to set aside and have other organizations do, while it refocuses on its core historic tasks. Andrew Dorman One of the sensitive, ongoing debates within NATO is whether it has a global role or whether it has a more transatlantic role. There are divisions within NATO about which is its focus. I think the answer, to a degree, is both. One of the real challenges for policymakers, particularly the Biden administration, is that they are going to be pushing for NATO to act as a global player. This is one of the dilemmas that NATO faces. It could spend all its time focused purely on the short term – that is Russia – and ignore China, and then suddenly need to think, ‘Oh heck’. What happens if , as a result of this, Russia is essentially dropped into the China camp and Putin becomes Xi Jinping’s poodle? That is a real dilemma, and why I think the US is going to focus on a global NATO. Leslie Vinjamuri NATO may have a role to play in Washington’s China strategy. But it won’t be the most important institution. The Biden administration is relying on multiple frameworks for engaging in the Indo-Pacific. For example, the Quad – a partnership between the US, Japan, India and Australia – is designed to secure India’s participation. Pulling India into the region where it has economic power, influence, military and security capabilities and can move the needle. It is both an intelligent and pragmatic strategy to have a number of groupings, a patchwork of overlapping partnerships, including existing alliances. That seems right to me. Patricia Lewis It is unlikely that the US would want to create a global NATO. The US and its allies in other regions may wish to model future alliances on NATO, that have strong relationships with it in areas such as political coherence, interoperability, and joint training and exercises and such. But political decision-making would be better suited to sit within specific regional contexts. Washington has formal alliances in the Indo-Pacific region that commit the US to, for example, the defence of Australia through the Anzus security treaty, as well as Japan. As Washington increases its focus on the Pacific, the existing political-military relationships in the region could become more coherent. We might see a version of a Pacific-Asia Treaty Organization emerge – a Pato. All this depends on how China uses its power and how perspectives in the region evolve. Creon Butler I am not sure it is a problem that NATO does not have a specific focus on dealing with the China threat. It potentially has a role in dealing with those things that are seen by the membership as common threats. Which clearly is Russia now but has added terrorism in the past and may well include other things. China is not a common threat in the way that Russia is perceived to be. Of course, something could happen, not least something with Taiwan, which would change that, but that is not where NATO is at present. Alice Billon-Galland I think we should really avoid a false dichotomy between ‘NATO should do only Russia’ and ‘NATO should do everything’ because there are lots of activities in the middle where the alliance can bring some added value – and that is exactly what we should be discussing. The issue around China and NATO is being completely overblown. We need to be very clear that the purpose of NATO is to defend the Euro-Atlantic space, but that may include keeping an eye on ‘when China comes to us’, as NATO Secretary-General Jens Stoltenberg often says. Hans Kundnani None of the regional partners in Asia that you need to deal with the China challenge are in NATO – and can’t be – so it is just the wrong vehicle to deal with the Indo-Pacific. But there is also a bit of a tension here between Indo-Pacific and Euro-Atlantic. People in Asia also look at the different threat perceptions in completely different ways than we do in Europe. There are a number of reasons why people in India do not support the war in the Ukraine, but one of them is that they see China, not Russia, as the real threat. Andrew Dorman I think so much of the debate we have had so far is about political NATO as supposed to military NATO. One of its key roles is how military forces operate, engage and conduct operations, plan operations through deterrents and so forth. NATO as the template of the West does work. That is why it is in the interest of the US to keep this going. It is one of the ways of making sure, for example, the US Pacific fleet remains compatible with the US Atlantic fleet by forcing them to operate the same system, which is the NATO system. It is one of the things the American forces learnt out of Afghanistan and Iraq. There is a NATO way which is a global footprint. NATO’s role within the African Union is as a template for peacekeeping operations. You have got the likes of Australia and South Korea and Japan very much integrated into NATO. It doesn’t have to be a formal political NATO, but it does strike me to be in the interest of the West to have them reach forces capable of operating with one another. Patricia Lewis One of the most interesting developments in the past year has been the creation of Aukus, the security pact between Australia, Britain and the United States. That grew out of the Five Eyes intelligence partnership which led to the need to develop new, interoperable equipment such as nuclear-powered submarines. We will have to see how it develops, but maybe it could be the start of a PATO in the region. Creon Butler In the current situation, we have a crucial partnership between NATO and the EU over Russia, in terms of the long-term future they hold out for Ukraine, but also with the G7 because that is the place to organize the financial support for Ukraine and the economic and financial sanctions against Russia. They are different memberships but the combination of the EU, G7 and NATO is an absolutely crucial alliance of different alliances, with different memberships serving different purposes but having an overall impact that can potentially be very effective. Leslie Vinjamuri We work with the institutions that we have, but not always with a clear recognition of their limitations. We are facing a dark moment for the UN Security Council, with one of its founder members blatantly violating the UN’s most important norm. Yet many people in the rest of the world say, ‘Yes, but in 2003, the United States violated Iraq’s sovereignty …’ Where the West sees moral clarity, and so condemns Russia’s invasion of Ukraine, there is an assumption by much of the rest of the world of moral equivalence between these two invasions. Working through the UN Security Council is going to be difficult for some time. This means that states are probably going to find different strategies for working around, rather than through, the Security Council. Full Article
f How Oslo adds a touch of style to the UN By www.chathamhouse.org Published On :: Wed, 25 May 2022 13:06:24 +0000 How Oslo adds a touch of style to the UN The World Today rsoppelsa.drupal 25 May 2022 Seventy years ago, Norway paid for the interior of ‘the most important room in the world’. Now it’s rediscovering the soft power of its design heritage The view from the roof terrace of Oslo’s newest museum takes in the deep blue fjord and harbour but also the recently opened Munch Museum, whose tilting tower leans over the white iceberg of the opera house. All are emblematic of the transformation of Norway’s capital, one of Europe’s fastest growing cities, into a cultural destination. The £500 million National Museum, which opens on June 11, is another statement building in a city which has tended to value modesty over self-promotion. Locals may call it ‘the bunker’ but Denise Hagströmer, a senior curator who compiled its design galleries, believes the museum’s monumental scale and the range of its displays mark a change in Norway’s idea of itself: ‘The country that in the past was thought of as the “little brother” of Scandinavia is now speaking with a completely different voice.’ When Norway paid for the interior of the Security Council Chamber 70 years ago, it had yet to discover the oil that would make the country rich Norway, with a population of only 5.5 million people, has a history of excelling when it comes to using cultural soft power as a tool of foreign policy, says Hagströmer. One of the exhibits in the design galleries is the blue and gold wallpaper used in the United Nations Security Council Chamber in New York, dubbed ‘the most important room in the world’. In here, the Security Council imposes sanctions, dispatches peacekeeping missions and authorizes the use of force. — Norwegian textile artist Else Poulsson designed the Security Council chamber’s wallpaper (Photo: Ivan Brodey) Designed by Else Poulsson, the Norwegian textile artist, its motifs represent faith, hope and love, reflecting the aspirations of the UN. Norway’s decision to pay for the interior of the Security Council Chamber 70 years ago came at a time when the country was recovering from Nazi occupation, while the oil that would make it rich had yet to be discovered. Trygve Lie, the first UN Secretary-General, a Norwegian Labour politician, is said to have played a central role in pushing the project, intended to show the effectiveness of design as a cultural ambassador. ‘Norway elevated its position on the world stage and achieved an oversized presence at the UN for such a small country,’ says Sarah Lichtman, a design historian from the Parsons School of Design in New York. Even though it doesn’t have a permanent seat on the Security Council, Norway embedded its identity in the room through the legacy of the architecture and interior design, she adds. The world we abandoned cannot be erased just like that, but one can build a bridge over the adversity and from that journey to a new society Per Krohg, the artist who created the Security Council mural While other Scandinavian architects in the UN complex went for the fashionable modernist look in the Trusteeship and Economic and Social Council chambers, Norwegian Arnstein Arneberg opted for a more classic, even conservative style. In a letter to the Norwegian Foreign Ministry, he wrote: ‘This interior must represent Norway in a worthy manner.’ As well as Poulsson, Arneberg hired his fellow countryman Per Krohg to paint a giant mural. Krohg, who had been a prisoner of the Nazis in the Second Word War, turned his commission into an altarpiece to peace. ‘The world we abandoned cannot be erased just like that, but one can build a bridge over the adversity and from that journey to a new society,’ he said of his mural, which measures five metres by nine metres. The connection between design and politics is explored further in the new Oslo museum’s design galleries and in a separate exhibition, Scandinavian Design & the United States, which show how Nordic objects were charged with democratic values in the post-war period. ‘Design plays an important role in the Cold War battles that are not just about bombs and missiles but also about lifestyle and ideology,’ says the Swedish writer, Sara Kristoffersson. — Norway’s recently redesigned passports (Photo: Catharino Caprino) Scandinavian design is rooted in egalitarian ideals of social democracy. Ornate decoration that valued one object above another was replaced with clean forms, craftsmanship and natural materials such as leather, wood and wool, says Astrid Skjerven, a professor at the department of product design at Oslo Metropolitan University. Shortly after the Security Council chamber was completed, Norwegian designers participated with Danes, Swedes and Finns in the Design in Scandinavia exhibition that was hugely popular in America in the mid-1950s. The Norwegians, who were the least known internationally, had the most to gain from the three-year tour, with stores in Manhattan showcasing their designs. First Lady Jacqueline Kennedy and Emperor Hirohito of Japan each bought pieces by the Norwegian designer Torbjørn Afdal. Norway’s neighbours capitalized on the international demand for Scandi style by supporting their furniture makers with state funding, promotional campaigns abroad and a national design strategy. Yet despite creating prize-winning, mid-century pieces, Norway ended up as ‘the underdog of Nordic design’, according to Morten Hippe, a Norwegian industrial designer, who in 2016 started a company, Eikund, to reproduce furniture from the golden era of Norwegian design. The market in Norway for these goods was tiny, and the discovery of oil in 1969 meant many craftsmen moved to more lucrative jobs. Across the Atlantic, Norwegian soft power had made its mark in the halls of the UN. By 2006, the Security Council Chamber and the rest of the UN complex needed renovating. The permanent members stipulated that restoration work must preserve the chamber in its original form. They also insisted on having the room duplicated in their temporary space elsewhere in the UN building, with a smaller photographic reproduction of the Krohg mural. The painting had become integral to the function of the room, argues Lichtman – ‘like Picasso’s Guernica or one of those paintings with a moralizing tale that reminds the people in the room of the horrors of war’. Norway gave $5 million to the restoration, which was finished in 2013. — Norway’s mission to the UN evokes the country’s landscapes and showcases its designers (Photo: Laura Guerrero Almeida) Recently, Norwegian diplomats also realized that design could be used more broadly to communicate values and ideas. A new, minimalist passport was issued in 2020 which reflects Norway’s reputation for design excellence. When the country’s joint consulate and UN mission in New York had to move location, it was an opportunity to create an open-plan office that reflected the non-hierarchical structure of most private and public bodies back home. The corner office, with the best views, has a communal table that everyone can use. The room’s design has echoes of a wooden cabin, the typical weekend bolt hole for many Norwegians. Carpets resemble a forest floor, birdsong plays in the bathrooms and futuristic ‘Extreme’ chairs designed by Terje Ekstrom are framed by views of Manhattan. Consul General Heidi Olufsen says visitors to the offices are taken aback when they find a little slice of Norwegian life. Olufsen’s official residence is sparer and more elegant. The mid-century dining table and chairs designed by Fredrik Kayser are from Eikund and the bright velvet Bollo chairs by Andreas Engesvik, seen by many as the country’s top furniture designer. Olufsen wants the decor to make guests ‘feel they are in the modern Norway of 2022’, she says, with more to offer than just mountains and fjords. Yet Olufsen admits there is still a way to go: ‘We still have more to do to boost our self-confidence and demand more space for Norwegian design.’ Full Article
f Polish-British Belvedere Forum 2022 By www.chathamhouse.org Published On :: Mon, 13 Jun 2022 10:27:13 +0000 Polish-British Belvedere Forum 2022 7 July 2022 TO 8 July 2022 — 12:00PM TO 4:00PM Anonymous (not verified) 13 June 2022 Chatham House and Online The Belvedere Forum is a leading annual British and Polish dialogue that seeks to strengthen the extensive social, economic and political partnership between the two countries. Please note this event has reached full in-person capacity. You are welcome to join virtually via the Zoom link: https://chathamhouse.zoom.us/webinar/register/WN_QFwXsXb0RoSt-1ywkuPjfQ The video on this page is of the opening remarks from the Belvedere Forum, with addresses from Sir Robin Niblett KCMG, Dr Sławomir Dębski, Prof Zdzisław Krasnodębski, Sir Malcolm Rifkind KCMG QC, Ambassador Anna Clunes CMG OBE, Lord (Tariq) Ahmad of Wimbledon, Min Marcin Przydacz, and Ambassador Piotr Wilczek. This and other session videos are available to watch on the Belvedere Forum 2022 playlist on YouTube. Photos by Mateusz Jozwiak, Zuzanna Nowak/PISM. The Belvedere Forum is a leading annual British and Polish bilateral dialogue bringing together a diverse group of actors from civil society, politics, business, academia and NGOs. It seeks to strengthen and deepen the extensive partnership between the two countries by exploring political, economic, social and cultural issues through debate and discussion. The forum is an annual event alternating between the UK and Poland. Originally created in 2017 by the governments of the UK and Poland, the forum is now jointly organized by Chatham House and the Polish Institute of International Affairs (PISM) in Warsaw. The forum brings together a diverse group of actors to debate and discuss not only current British-Polish relations, but also the British and Polish responses to key European and global challenges. Agenda - Polish-British Belvedere Forum 2022 (PDF) Full Article
f NATO must now transform old missions into new strategy By www.chathamhouse.org Published On :: Tue, 21 Jun 2022 10:29:06 +0000 NATO must now transform old missions into new strategy Expert comment NCapeling 21 June 2022 As the war in Ukraine becomes prolonged and unpredictable, risks for the transatlantic alliance will increase, as will the global shockwaves of the conflict. As a revitalized NATO alliance deals with a crisis that has major economic and humanitarian as well as military dimensions, the need for it to develop both a European and a global containment strategy grows ever more urgent. Bolstering NATO’s defences so as to provide the capability to repel any form of Russian attack on land, at sea, in the air, or through space and cyberspace is a key aspect of this strategy as, in recent weeks, more combat forces able to defend territory have taken the form of additional troops, ships, and aircraft reinforcing the Baltic states and the Black Sea coastlines of Poland and Romania. Ten allies have so far contributed to this effort, placing 40,000 troops under direct NATO command. Those sceptical about the future of the transatlantic security relationship have been confounded by the major role the US has played in this effort, sending parts of the 82nd Airborne Division and 3rd Armoured Division to Poland, and redeploying US Stryker brigades from Germany and Italy to the Baltic states and Romania. Although many other allies have sent useful assets – such as French and UK aircraft to Romania or German and Netherlands Patriot batteries to Slovakia – the US contribution still surpasses all European efforts put together. The US now has 100,000 troops in Europe, the most it has deployed there since the mid-1990s. Transitioning from temporary to permanent deployment NATO has also mobilized its high-readiness Reaction Force for the first time and aims to establish four new multinational battalions in the Black Sea region – with France offering to lead the one in Romania, Italy in Bulgaria, and the Czech Republic in Slovakia. Most of these deployments are on a temporary basis, but the receiving allies would understandably like them to stay longer and for NATO to commit to permanent stationed forces. The decision of Germany to increase its defence spending to two per cent of GDP and to devote €100 billion to modernizing the Bundeswehr makes it technically possible for NATO to move to a Cold War-style forward, armoured defence Although this would oblige the alliance to break formally from the pledge it made to Moscow in 1997 not to station substantial combat forces or nuclear weapons or build military infrastructure on the territory of its new member states in eastern Europe, this was a political undertaking linked to circumstances prevailing at the time. Given Russia’s behaviour, there is no reason why NATO should not now abandon it. There is also a question over whether NATO could also repeal the NATO-Russia Founding Act and the NATO-Russia Council, or simply leave them in suspension for a future, more cooperative, and less bellicose Russian regime. Beyond showing the flag along its eastern flank, NATO does face longer-term issues which need to be clarified in its new Strategic Concept. First is whether to abandon its current strategy of reinforcement and military mobility across Europe – known as the Enhanced Forward Presence in the NATO jargon – in favour of the deployment of heavy armoured brigades or even divisions in fixed positions close to borders. This will be expensive in the long-run and deprive allies of the flexibility they have enjoyed since the end of the Cold War to use their forces as and where they wish – from deployments in the Sahel or Afghanistan to fighting forest fires or building emergency hospitals for COVID-19 patients at home. The only exception is when they have put forces on rotation into the NATO high readiness forces or the European Union (EU) Battle Groups. Germany’s commitment gives NATO more options The decision of Germany to increase its defence spending to two per cent of GDP and to devote €100 billion to modernizing the Bundeswehr makes it technically possible for NATO to move to a Cold War-style forward, armoured defence. But it is unclear how quickly Berlin could raise its new divisions given its problems with procurement and government/industry relations in the defence sector. It may make more sense for Germany not to launch new acquisition programmes but to buy existing off-the-shelf capabilities – as it has recently done with its decision to buy 35 US F35 aircraft – which other European countries are also acquiring, offering economies of scale and cheaper operating and maintenance costs. But if Germany abandons ambitious defence projects with France – which prefers a ‘buy European’ approach – such as the Future European Air Combat System, the relationship with France will become strained and French plans for EU self-reliance in the military field put at risk. As a country averse to war fighting and narrow military approaches to security, it is uncertain how much of the conventional defence burden in NATO Germany would be willing to take on, so this could be the opportunity to create more integrated European units with France, the Benelux, Poland, and Italy, even with the post-Brexit UK. In reinforcing the alliance’s eastern flank, allies have sent forces to wherever they like and largely under national command, but this would not work in a real war The UK has doubled the size of its forces in Estonia and sent 1,000 troops to Poland, as well as devoting a substantial portion of its army, navy, and airforce to regular NATO exercises in the Baltic region. London was also the first ally to grant Sweden and Finland a temporary security guarantee pending full integration into the alliance. NATO will likely settle on a compromise, increasing the size of its battalions on its eastern flank – turning them into battle groups – but giving each one a larger reserve force which will remain in Germany or other European allied countries. A NATO strategic plan is now needed The other issue for NATO is to develop a single theatre-wide strategic plan managed by the Supreme Allied Commander, Europe (SACEUR) and the NATO command structure. In reinforcing the alliance’s eastern flank, allies have sent forces to wherever they like and largely under national command, but this would not work in a real war. One thing NATO has done well in this crisis is its political messaging. As Russia has become more threatening and reckless, it has been essential for NATO to be consistent and predictable NATO must revise its exercises to prepare and train for the new threat level, ensuring its forward deployed forces are fully integrated with local forces and the police and border guards to anticipate and respond to any Russian hybrid war tactics. It also needs to step up its joint planning and interoperability with Sweden and Finland and bring their territories into its standing defence plans. One thing NATO has done well in this crisis is its political messaging. As Russia has become more threatening and reckless, it has been essential for NATO to be consistent and predictable. Re-affirming its core defensive purpose, calmly rejecting Putin’s nuclear posturing, and refusing to put NATO forces in Ukraine may be frustrating for some but it is vital not to play into Putin’s playbook regarding an ‘aggressive NATO’ or give him the sense he is being pushed into a corner. However, NATO strategic ambiguity can be useful when considering how to respond to a Russian escalation in Ukraine itself, such as using chemical weapons. The key questions for NATO are: What should be the balance between permanently deployed and rotational forces in NATO’s new posture? What should be the balance of US/Canadian and European forces in this posture? How can the capability development programmes under EU Strategic Autonomy (such as PESCO and the European Defence Fund) be geared to support the European role and responsibility in the alliance? Air and missile defence would seem to be priorities given Russia’s reliance on long range strikes. How can the EU’s Strategic Compass, NATO’s next Strategic Concept and the third NATO-EU Joint Declaration be harmonized to bring the two institutions more closely together in responding to Russian hybrid operations and influence campaigns, and in assisting both Ukraine and others such as Georgia and Moldova? What should be the balance between forces for collective defence with heavy armour and directed artillery fire, and those for expeditionary missions beyond Europe such as counterterrorism, stabilization and peacekeeping? NATO is revived and refocused Although the Russian invasion of Ukraine is a catastrophe for Ukraine and Europe more generally, the multilateral system has discovered a new energy and sense of purpose as NATO has been revived and refocused on its core mission. The EU and the US have pulled together with daily coordination of their policies and actions, and the EU is also facing up to its geo-political role, as recognizing the EU aspirations of Ukraine, Moldova, and Georgia as well as the countries of the western Balkans shows its responsibility for the security and economic integration of the whole of Europe. Full Article
f Russia's war: How will it shape the region's future? By www.chathamhouse.org Published On :: Wed, 17 Aug 2022 08:27:13 +0000 Russia's war: How will it shape the region's future? 1 December 2022 — 9:00AM TO 6:00PM Anonymous (not verified) 17 August 2022 Chatham House and Online This conference takes a deep-dive into the implications of the war for the wider region. You will receive an email in advance of the conference with further details on accessing the event. The video on this page is of the opening session only. To view all the session videos, please visit the conference playlist on YouTube. How will Russia’s war shape the region’s future? Russia’s latest invasion of Ukraine is on such a scale that it will have a seismic effect on all the countries that once formed the Soviet empire. Vladimir Putin’s decisions have accelerated trends across the region leading to unintended consequences. Now it is more crucial than ever – not only for those concerned with the region’s economic and democratic development, but for all those with a stake in the future security of Europe. For some states, this will mean a faster break from the legacy of the USSR and from Russia’s ‘Geopathological embrace‘ while, for others, maybe even a fresh start at democracy and good governance. In isolated cases, the war will conceivably hasten assimilation with Russia. But the two principal combatants, Ukraine and Russia, will diverge even further. Ukraine, though fighting for its survival now, will at least get the opportunity to ‘build back better’ if it achieves some form of victory. Whatever the course of the war, however, Russia’s aspirations to be a global power again are doomed as it is gradually deglobalized from Western structures. This conference analyses: How Russia’s war will affect the broader regional economy and whether this will hasten Vladimir Putin’s exit What to hope for, what to fear and the key trends that will dominate the region going forward. Unique expertise in an independent forum on what’s at stake for Europe. Full Article
f Gorbachev's complex legacy is beyond the popular belief By www.chathamhouse.org Published On :: Sat, 03 Sep 2022 09:45:59 +0000 Gorbachev's complex legacy is beyond the popular belief Expert comment NCapeling 3 September 2022 The last major figure with a decisive Cold War role, Mikhail Gorbachev was not as bad as Putin’s Russia portrays him, but also not as heroic as the West thinks. Arguably the worst year of the Cold War since the Cuban Missile Crisis was 1983, with three major incidents which escalated East-West tensions – and any one of them could have led to a full-scale war. The first was the Korean Airline KAL007 being shot down by an SU15 fighter aircraft for straying into Soviet airspace, killing all 269 passengers and crew. Then came the identification of signals from Soviet satellites as being incoming US intercontinental ballistic missiles – Colonel Stanislav Petrov, going against all protocols, thankfully decided to report them as a false alarm before he could be sure. The third was perhaps the most dangerous, being the misinterpretation of a live-fire NATO exercise which was believed by some in both East Germany and Russia to be a front for an imminent attack. The greatest disappointment in Gorbachev’s legacy was he completely believed the USSR could be reformed and still survive as an entity while others, such as Boris Yeltsin and Ronald Reagan, understood it had to be dismantled All three incidents occurred in the few months following the infamous March 1983 ‘Star Wars’ speech by US president Ronald Reagan, in which he talked about nuclear arms control and laid out the US case for a ballistic missile defence programme. At that time Mikhail Sergeyevich Gorbachev was the youngest serving member of the USSR Politburo, known to be a favourite of Soviet leader Yuri Andropov, and it is highly likely he had been aware of these close calls and was part of discussions within Kremlin decision-making circles. A changemaker both inside and outside the USSR Following the deaths of Andropov in 1984 and his replacement Konstantin Chernenko in 1985, Gorbachev’s appointment as general secretary of the Communist Party saw him immediately begin to change the Soviet Union from within – and also change relationships with the major Western powers, especially the US, Germany, and the UK. His policies of glasnost (openness) and perestroika (restructuring) were primarily aimed at internal reforms but translated into a major reset of international relations and international security. During his six years as leader, Gorbachev initiated many arms control negotiations which resulted in treaties and increased both the transparency and the confidence between the USSR and the US. These included the 1986 Stockholm Accord which emanated from the Helsinki Process and allowed for the observation and inspection of large-scale military exercises, the 1985 resumption of the Strategic Arms Reduction Talks which lead to START I, and the 1987 INF Treaty in which the USSR ‘out-yessed’ the US – the most open and transparent disarmament treaty in terms of notification and verification measures ever agreed. There was also a reciprocal moratorium on nuclear weapons tests starting from 1985 – which laid the groundwork for the 1996 CTBT – the 1991 Chemical Weapons Convention, and the 1990 Conventional Forces in Europe (CFE) Treaty. The most dramatic moment of all was when Gorbachev and Reagan met at a summit in Reykjavik and came close to deciding to eliminate nuclear weapons – but the initiative failed to reach agreement, mainly because Reagan could not drop his commitment to ballistic missile defences and Gorbachev could not accept the offer of joint development. Nonetheless, all these nuclear arms control treaties led the way for their descendants which have kept nuclear weapons in check ever since and are still in place in the form of the New START agreement. During his six years as leader, Gorbachev initiated many arms control negotiations which resulted in treaties and increased both the transparency and the confidence between the USSR and the US But despite these outstanding achievements, Gorbachev had blind spots – such as enabling rather than destroying the USSR bioweapons programme, unlike the US which had dismantled its own bioweapons offensive capability by 1973. And it is now known that, despite negotiating the Chemical Weapons Convention, Russia withheld information on new chemical weapons agents – Novichoks – which have since been used to lethal effect by Russia in Salisbury and against figures opposing the current regime. His misguided faith in a Soviet future Gorbachev was markedly different to his predecessors as secretary general. He was neither as decrepit nor as hardline, and he understood from the outset that the Soviet Union was, by the 1980s, finally dying. Using the intellectual abilities of Aleksandr Yakovlev, he forced through the reforms which simultaneously captured the imagination of the free world and liberated his countrymen and women. But although he built solid relationships – even friendships – with the world’s major heads of state and improved the USSR’s human rights, releasing dissidents such as Andrei Sakharov, but many – especially Ukrainian dissidents – continued to languish in camps. The greatest disappointment in Gorbachev’s legacy was he completely believed the USSR could be reformed and still survive as an entity while others, such as Boris Yeltsin and Ronald Reagan, understood it had to be dismantled. This shortcoming is especially uncomfortable as today’s Russia continues to insist it has a given right to control other former Soviet states, to the extent it is willing to destroy them if they do not concede. Full Article
f Russian imperial mindset must change for real victory By www.chathamhouse.org Published On :: Thu, 08 Dec 2022 09:47:14 +0000 Russian imperial mindset must change for real victory Expert comment NCapeling 8 December 2022 The attitude of Russia’s elite – and wider population – to the states which used to constitute the USSR needs to change in order to solve the Russia challenge. Although the reverberations of Russia’s invasion of Ukraine clearly stretch around the globe, the strongest shocks are – and will continue to be – felt by those countries Moscow used to directly rule. These countries struggle to shrug off a Soviet legacy as, to varying degrees – linguistically, technologically, culturally, and politically – they bear psychological and physical scars of Russia’s colonial past and its present mentality. It does not help that these countries lack an appropriate collective descriptor. Over the years there has been ‘Newly Independent States’ – hardly appropriate after 31 years – the now-defunct ‘Commonwealth of Independent States’, the ‘post-Soviet space’ and ‘Former Soviet Union’ which both reference the past, and simply ‘Eurasia’ which is hardly appropriate for either Ukraine or Turkmenistan. Some of these former ‘colonies’ are as badly governed and as sinister – albeit not as lethal beyond their borders – as Russia itself. Others, most notably the Baltic states, are modern, liberal, affluent societies, but Moscow’s shadow still looms. There is a strong mindset in most of Russia’s citizens that, because that it used to rule these other countries, it either still has privileged rights over them or they are not real countries at all – but instead historical aberrations to be extinguished. What is past is gone As historian Timothy Snyder has noted, whatever the wrongs of Putin’s ‘history-based’ assertions about the ‘return of historic lands’, all historical claims are bunkum anyway. If the past brings validity, almost no land border on earth would be beyond dispute. It is agreements which count, and Russia signed away the other successor states in 1991. There is a strong mindset in most of Russia’s citizens that, because that it used to rule these other countries, it either still has privileged rights over them or they are not real countries at all The Russia and Eurasia programme at Chatham House has, for the last 31 years, always taken as a starting position that these countries are as sovereign as any other. This of course this means they can choose to be in Russia’s embrace if they wish. But none do because Russia is insufficiently attractive. Some have better relationships with Moscow than others – mainly the more autocratic ones – but no former slave goes back to their master willingly. At the recent Chatham House conference Russia’s war: How will it shape the region’s future? (note the avoidance of a specific descriptor), the overwhelming consensus was that Russia must lose, that Ukraine must be reconstructed and planning for that must start now, and that the regional economy is convulsing. But another key view was that, in Russia, rent seeking and buying loyalty are likely to lead to the separation of the Russian people and the regime, especially as the population ages and young men being sent to die at the front. Putin may still be popular in some places in Russia, but not in others – although popularity can rise and fall fast in Russia. However, few at the conference foresaw the disintegration of Russia any time soon. With continued skill, determination, and more weaponry, Ukraine may well vanquish Russia on the battlefield, and this remains a necessary pre-requisite for European security. But even a Ukraine victory will not erase malign intent. Getting Russians to look upon their neighbours as equals requires widescale self-reassessment in a post-Putin Russia The Russian imperial itch is so deeply embedded, it must be excised not just from Russian capability but from the intention and mindset of elites and in the popular imagination. That is hard to achieve when so many believe in it as fervently as a religion – even the Russian Orthodox Church invokes a messianism in Russia’s imperial ‘rights’. The wider region is suffering Getting Russians to look upon their neighbours as equals requires widescale self-reassessment in a post-Putin Russia. But, for now, the wider region will surely be looking to simply neuter Russia’s destructive capacities. Full Article
f Culture notes: Will the EU find its voice at last? By www.chathamhouse.org Published On :: Mon, 30 Jan 2023 13:09:06 +0000 Culture notes: Will the EU find its voice at last? The World Today mhiggins.drupal 30 January 2023 Russia’s invasion of Ukraine has galvanized the bloc, but doubt remains about how it can capitalize on this moment, writes Catherine Fieschi. Despite its reticence to believe that Russia would attack Ukraine, once Vladimir Putin’s tanks rolled across the Donbas, the European Union finally grasped the momentous nature of the events unfolding on its eastern flank. The immediate reaction of Europe’s member states was one of unity, resolve and uncharacteristically rapid decision-making, at least on sanctions and energy policy. That they would need to act in concert across a concatenation of crises that would be either triggered (energy), worsened (inflation) or heightened (geopolitical instability) by Putin’s move was obvious. And so, Europe’s collective narrative of this past year slid into place, and it goes something like this: We gave Russia the benefit of every doubt, including after their invasion of Crimea when we still tried to bring them back to the negotiating table, but Putin has made the fundamental choice of turning away from democracy and the rule of law. Europe had long been in need of an arc to follow Now, the narrative goes on, we have to treat them as enemies and give ourselves the means to become resilient in the face of aggression as Ukraine is all that stands – both symbolically and geographically – between us and the chaos of a Europe-wide war. Like any good narrative, it is anchored in previous trials and exploits. Having learnt from its failure to coordinate action during the eurozone crisis and then the migration crisis, Europe was keen to make the most of its resilience in the face of the Covid pandemic in the form of the joint vaccine purchases and a massive recovery plan. The Russian invasion of Ukraine is an added – albeit dramatic and costly – opportunity to pursue further collective action and discover the next chapter of its shared purpose, as a political and perhaps even a defence alliance. Europe had long been in need of an arc to follow. In the aftermath of the Second World War, peace and prosperity seemed enough. But the new multipolar world that emerged from the ashes of the Cold War and then 9/11 were more difficult to navigate for a largely commercial and regulatory alliance. Could the EU, then, ever find its political voice? David vs Goliath While Brexit and Covid created rallying points, the shock and tragedy of the invasion delivered everything the EU needed in narrative terms: a David and Goliath story, with the opportunity to feature on Team David in European terms while allying with the United States, and a ‘band of brothers’ element to shore up a union bruised by the defection of a key but troubled member. Above all, the appearance of an arch-villain in the form of Vladimir Putin put Europe back into the familiar and mythical territory of the 1940s and then the Cold War. When on May 28, 2016, Putin seated himself on the throne of the Byzantine emperors in Mount Athos’ Protaton Church in Greece in a scene truly worthy of Game of Thrones, the writing should have been on the wall. That day he explicitly laid out his aim to appoint himself as the new Eastern emperor who would fight the decadence of the West. ‘Today,’ Putin told the world, ‘we restore the values of patriotism, historical memory and traditional culture.’ Later, he cited Ukraine as the biggest unfinished mission of his years in power. That Europe – and Germany in particular – had taken so long to decipher Putin’s dark designs only adds to the narrative’s epic quality, positioning Europe as a victim of its own good faith and open heart. Cracks in the narrative But the narrative is not free from cracks. The Baltic states would argue that they had long warned of Putin’s nefarious intentions; and Poland has always been convinced of the threat posed by its neighbour. Full Article
f In conversation with Edi Rama, prime minister of Albania By www.chathamhouse.org Published On :: Mon, 13 Mar 2023 17:22:14 +0000 In conversation with Edi Rama, prime minister of Albania 23 March 2023 — 5:30PM TO 6:30PM Anonymous (not verified) 13 March 2023 Chatham House and Online From migration to Russia and China, how is Albania responding to the geopolitical challenges of today? In late 2022, the UK government made a pointed remark that many of the illegal migrants attempting to get into the country were from Albania. In response, Albania prime minister Edi Rama replied that targeting Albanians as the cause of Britain’s crime and border problems ‘makes for easy rhetoric but ignores hard fact’. This nuanced response demonstrated the challenges and complexities that Albania faces, the same as many other countries. As well as being embroiled in the major challenge of international migration, Albania has suffered from a serious cyber-attack in July 2022 from Iran. Government networks were compromised for a month with Tirana removing the Iranian embassy in the capital. Then there is the ongoing threat from Russia and China. Nestled in the already volatile Balkans, Albania has been at the heart of international affairs in recent months. Prime Minister Rama speaks at Chatham House to discuss: How is Albania responding to Russian aggression and what is its stance on Ukraine? Where does Tirana believe China poses the most serious threat? How can countries in Europe best respond to illegal migration and better control the flow of people? How is the region of the Western Balkans effected by the war in Ukraine and how can it contribute to the security challenges posed by the war? As with all member events, questions from the audience drive the conversation. Full Article
f How Russia’s war affects politics in southeast Europe By www.chathamhouse.org Published On :: Fri, 24 Mar 2023 11:42:13 +0000 How Russia’s war affects politics in southeast Europe 4 April 2023 — 11:00AM TO 12:00PM Anonymous (not verified) 24 March 2023 Online This event will discuss how the war on Ukraine has affected southeastern Europe. This event will discuss how the war on Ukraine has affected southeastern Europe. How have the governments and publics responded to the war? The panel will discuss Russia’s goals and leverage in the region, including the impact of its disinformation campaigns. Are the governments reassessing their foreign policy options? The granting of EU candidate status to Ukraine and Moldova has brought attention to the stalled accession process in the Western Balkans. What lessons from the Western Balkans can be applied in Ukraine and Moldova? Have new linkages emerged between the two regions? Full Article
f Eurovision, war and the geopolitics of pop By www.chathamhouse.org Published On :: Tue, 28 Mar 2023 15:46:39 +0000 Eurovision, war and the geopolitics of pop The World Today mhiggins.drupal 28 March 2023 Europe’s great song competition may strive for continental harmony, but bitter conflicts and voting blocs often drag it off key, writes Saskia Postema. In May, the city that spawned the Beatles will add another notch to its cultural belt as Liverpool hosts the Eurovision Song Contest. The pop competition has been celebrating extravagance, dramatic acts and lots of glitter since 1956. It is expressly designed to be non-political, with performers barred from promoting political interests, yet it exists for a specific political purpose – to promote European unity. The organizer, the European Broadcasting Union (EBU), has certainly succeeded in part with its mission. While Europe Day on May 9 comes and goes without much fanfare, Eurovision is an eagerly anticipated fixture on the cultural calendar. Cultural diplomacy While some may dismiss it as simply an extravagant party, there is more to it than that: it is a form of cultural diplomacy. Beyond artistry, acts are expected to bring their cultural identity to the stage as they bid for douze points, Eurovision’s highest score, from national juries. Like any popular forum, it reflects popular opinion. So, when war threatens the European harmony Eurovision is meant to exude, politics inevitably manifests itself. This was evident last year. Following Russia’s invasion of Ukraine in February, Eurovision’s organizers reiterated their apolitical stance stating both countries would be allowed to participate. But when various countries threatened to withdraw if Russia was allowed to compete, the EBU changed its tune and broke off ties with Russian broadcasting agencies indefinitely. As reluctant as it was to act in this capacity, the organization still inadvertently highlighted its role as a political gatekeeper and confirmed Eurovision does function as a political arena. The first ‘nul points’ awarded to the UK in 2003 was seen as a backlash against the Iraq war Unsurprisingly, all eyes were on the Ukrainian entry that year. Kalush Orchestra’s Stefania, presenting a blend of traditional Ukrainian folk music with hip hop beats, went on to win the contest resoundingly. And while the winning nation normally hosts next year’s competition, due to the war this honour passed to the runner-up, the United Kingdom. Britain, coincidentally, has been one of the most visible supporters of Kyiv’s war efforts. Boris Johnson, the former prime minister, was among the first leaders to visit Kyiv after the Russian invasion. Last year’s second place ended a long spate of poor results for the UK in the competition. The first year it scored nul points was 2003 when the UK entry was Cry Baby by the duo Jemini. The result was seen widely as a backlash against Britain’s entry into the Iraq war earlier that year. In the intervening years it has been placed last twice and received nul points again in 2021 when the entry was Embers sung by James Newman. With last year’s second place for Sam Ryder’s Space Man, the UK redeemed itself and will get to host Eurovision in Liverpool, a city twinned with Odesa since 1957. It is not the first time that Russia’s geopolitical relations have led to Eurovision controversy. In 2008, following the Russo-Georgian war, Russia recognized the self-proclaimed independence of South Ossetia and Abkhazia which had broken away from Georgia. Despite Russian objections, Ukraine’s 2016 entry about Stalin’s deportation of Crimean Tatars was permitted – and won As a result, Georgia initially refused to take part in the 2009 Eurovision as it was to be held in Moscow. It changed its mind, however, submitting a song by Stefane and 3G called We Don’t Wanna Put In. The submission was rejected by the EBU, which said it contained obvious references to the Russian leader, something Georgia denied. In 2015, Ukraine withdrew from Eurovision following the Russian annexation of Crimea. The following year the EBU was faced with a similar problem when Ukraine submitted a song, 1944,sung by Jamala, which told the story of her great-grandmother who lived through the mass deportation of Crimean Tatars in the Soviet Union under Josef Stalin. This time the EBU allowed the entry, despite the Russian Duma calling for its rejection. The song went on to win. " class="video-embed-field-lazy"> — A year after Russia annexed Crimea, Ukraine’s triumphant 2016 Eurovision entry, ‘1944’ by Jamala, touched on the mass deportation of Crimean Tatars in the Soviet Union. Country-level voting behaviour, in general, can reveal interesting trends, starting with neighbourly support. Geographical voting blocs are a reality – whether it is Belgium and the Netherlands awarding each other points, the former Soviet Bloc countries showing preference for one another, or the Nordic states exchanging highest scores. In 2004 hosts Turkey refused to screen a map of the Republic of Cyprus Similarly, voting trends might be indicative of large diaspora communities living in a particular country. They can also provide insights into political trends. Amid rising tensions between Armenia and Azerbaijan in 2009, police reportedly questioned all 43 Azerbaijan judges who had voted for Armenia, resulting in a fine from the EBU. On the flipside, when Istanbul hosted the 2004 contest, it marked the first time that Turkey and Cyprus recognized each other through voting despite ongoing tensions, although Turkey still refused to screen a map of the Republic of Cyprus, which it does not recognize, when that country’s votes were announced as is custom. Participation means recognition Indeed, participation means recognition for countries. It shows kinship to the European continent, particularly attractive in the early 2000s during the initial waves of accession to the European Union by Eastern Bloc countries. Participation also offers individual recognition for the acts, whose mere involvement may promote diversity and inclusion. Having achieved a cult following from the LGBT community, Eurovision has become a platform for the promotion of human rights as well, exemplified by Austria’s 2014 winner Rise Like a Phoenix by Conchita Wurst, a moustachioed drag performer in a ball gown. " class="video-embed-field-lazy"> — The drag performer Conchita Wurst won Eurovision for Austria in 2014 with ‘Rise Like a Phoenix’. Eurovision acts as a gauge for cultural trends across the continent. As a result, it simply cannot be apolitical, not when countries such as Hungary withdraw from the competition calling Eurovision ‘too gay’. Interestingly, when China censored Ireland’s 2018 entry because it included two men dancing together, the EBU chose not to break ties. Full Article
f Independent Thinking: Sweden, Finland, and NATO By www.chathamhouse.org Published On :: Fri, 31 Mar 2023 09:24:17 +0000 Independent Thinking: Sweden, Finland, and NATO Audio NCapeling 31 March 2023 Episode 21 of our weekly podcast examines the latest developments relating to Sweden and Finland’s proposed accession to NATO. The Hungarian parliament has finally ratified Finland’s membership to the NATO alliance, two weeks after President Erdogan in Turkey gave his seal of approval following a meeting with the Finnish president. Sweden however remains trapped in limbo, with both Turkey and Hungary delaying Stockholm’s membership and Erdogan in particular asking for more concessions. The panel discusses why Turkey and Hungary took issue with Sweden and Finland, what the strategic situation in the Baltic looks like now with only Finland joining NATO, and the challenges facing Sweden amid its fraught ties with President Erdogan. We also look ahead to Turkey’s presidential election in May as recent opinion polls point to a neck-and-neck race, with some polls even showing President Erdogan falling behind the opposition. The panel examines what the sentiment is like in Turkey ahead of the election, and how the world would respond if there was a change in power in Ankara for the first time in 20 years. Joining Bronwen Maddox on the podcast this week is Henri Vanhanen, research fellow with the Finnish Institute of International Affairs, and Galip Dalay, associate fellow with our Middle East and North Africa programme. About Independent Thinking A weekly podcast hosted by Chatham House director Bronwen Maddox, in conversation with leading policymakers, journalists, and Chatham House experts providing insight on the latest international issues. Full Article
f Africa and Europe: Climate security for the future By www.chathamhouse.org Published On :: Fri, 31 Mar 2023 10:37:14 +0000 Africa and Europe: Climate security for the future 20 April 2023 TO 21 April 2023 — 7:30AM TO 12:00PM Anonymous (not verified) 31 March 2023 Slovenia and Online The 12th Africa Day International Conference hosted in Slovenia offers a platform for interregional exchange and policy cooperation between African and European countries on climate security. The 12th Africa Day International Conference offers a platform for inter-regional exchange and cooperation to further contribute to progress on climate security. The 12th Africa Day International Conference is hosted by the Ministry of Foreign and European Affairs of the Republic of Slovenia, in collaboration with the European Commission and the Chatham House Africa Programme. This high-level annual event seeks to improve policy outcomes for citizens in Europe and Africa on the basis of mutual understanding and cooperation between the two regions, while strengthening bilateral relations between Slovenia and African countries. Climate change poses one of the most serious threats to global security. No individual country or region can face it alone; strong regional and international partnerships are crucial. Analysing risk and taking action can help towards achieving a number of SDGs and a more secure and sustainable future. Addressing climate security is essential for the well-being and future stability of nations and societies around the world, and for the global community as a whole. This conference will offer a platform for interregional exchange and cooperation on the topic of climate security policy. It will bring together decision-makers and experts from Europe, Africa and across the globe to identify the key challenges and policy priorities in addressing climate security. The conference will be broadcast live on the Slovenian Ministry of Foreign Affairs webpage, and on the Africa Programme Facebook page. Full Article
f Virtual breakfast: The state of the EU in 2023 By www.chathamhouse.org Published On :: Wed, 05 Apr 2023 10:52:14 +0000 Virtual breakfast: The state of the EU in 2023 3 May 2023 — 8:30AM TO 9:30AM Anonymous (not verified) 5 April 2023 Online In this breakfast discussion, we will explore the current state of play in the EU with one the most prominent experts on European politics. While the European Union has come together in its response to the invasion of Ukraine, significant divisions remain on other issues. East-West tensions remain high and troublesome German-French relations are hampering the bloc’s traditional engine of integration. Furthermore, the EU is pushing through legislation at breakneck speed, including in its attempts to kickstart green industrial policy with its responses to the American Inflation Reduction Act. At the same time, the main players within the EU continue to disagree on what the bloc’s fiscal rules should look like. What are the implications of the recent wave of protests in France against President Macron’s pension reforms? What is the outlook of EU-UK relations following the successful completion of the Windsor Framework? Where are the fiscal rules likely to land and when will they be back in place? Are we seeing the emergence of a new Central and Eastern European power bloc within the EU? In short, despite having avoided an energy crisis over the winter, the EU continues to face significant challenges. In this breakfast event, we will explore the current state of play in the EU with one of the most prominent experts on European politics. Full Article
f [68Ga]Ga-PSMA-11 PET/CT-Positive Hepatic Inflammatory Pseudotumor: Possible PSMA-Avid Pitfall in Nuclear Imaging By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Full Article
f Ultrashort Oncologic Whole-Body [18F]FDG Patlak Imaging Using LAFOV PET By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Methods to shorten [18F]FDG Patlak PET imaging procedures ranging from 65–90 to 20–30 min after injection, using a population-averaged input function (PIF) scaled to patient-specific image-derived input function (IDIF) values, were recently evaluated. The aim of the present study was to explore the feasibility of ultrashort 10-min [18F]FDG Patlak imaging at 55–65 min after injection using a PIF combined with direct Patlak reconstructions to provide reliable quantitative accuracy of lung tumor uptake, compared with a full-duration 65-min acquisition using an IDIF. Methods: Patients underwent a 65-min dynamic PET acquisition on a long-axial-field-of-view (LAFOV) Biograph Vision Quadra PET/CT scanner. Subsequently, direct Patlak reconstructions and image-based (with reconstructed dynamic images) Patlak analyses were performed using both the IDIF (time to relative kinetic equilibrium between blood and tissue concentration (t*) = 30 min) and a scaled PIF at 30–60 min after injection. Next, direct Patlak reconstructions were performed on the system console using only the last 10 min of the acquisition, that is, from 55 to 65 min after injection, and a scaled PIF using maximum crystal ring difference settings of both 85 and 322. Tumor lesion and healthy-tissue uptake was quantified and compared between the differently obtained parametric images to assess quantitative accuracy. Results: Good agreement was obtained between direct- and image-based Patlak analyses using the IDIF (t* = 30 min) and scaled PIF at 30–60 min after injection, performed using the different approaches, with no more than 8.8% deviation in tumor influx rate value (Ki) (mean difference ranging from –0.0022 to 0.0018 mL/[min x g]). When direct Patlak reconstruction was performed on the system console, excellent agreement was found between the use of a scaled PIF at 30–60 min after injection versus 55–65 min after injection, with 2.4% deviation in tumor Ki (median difference, –0.0018 mL/[min x g]; range, –0.0047 to 0.0036 mL/[min x g]). For different maximum crystal ring difference settings using the scan time interval of 55–65 min after injection, only a 0.5% difference (median difference, 0.0000 mL/[min x g]; range, –0.0004 to 0.0013 mL/[min x g]) in tumor Ki was found. Conclusion: Ultrashort whole-body [18F]FDG Patlak imaging is feasible on an LAFOV Biograph Vision Quadra PET/CT system without loss of quantitative accuracy to assess lung tumor uptake compared with a full-duration 65-min acquisition. The ultrashort 10-min direct Patlak reconstruction with PIF allows for its implementation in clinical practice. Full Article
f Improving 18F-FDG PET Quantification Through a Spatial Normalization Method By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Quantification of 18F-FDG PET images is useful for accurate diagnosis and evaluation of various brain diseases, including brain tumors, epilepsy, dementia, and Parkinson disease. However, accurate quantification of 18F-FDG PET images requires matched 3-dimensional T1 MRI scans of the same individuals to provide detailed information on brain anatomy. In this paper, we propose a transfer learning approach to adapt a pretrained deep neural network model from amyloid PET to spatially normalize 18F-FDG PET images without the need for 3-dimensional MRI. Methods: The proposed method is based on a deep learning model for automatic spatial normalization of 18F-FDG brain PET images, which was developed by fine-tuning a pretrained model for amyloid PET using only 103 18F-FDG PET and MR images. After training, the algorithm was tested on 65 internal and 78 external test sets. All T1 MR images with a 1-mm isotropic voxel size were processed with FreeSurfer software to provide cortical segmentation maps used to extract a ground-truth regional SUV ratio using cerebellar gray matter as a reference region. These values were compared with those from spatial normalization-based quantification methods using the proposed method and statistical parametric mapping software. Results: The proposed method showed superior spatial normalization compared with statistical parametric mapping, as evidenced by increased normalized mutual information and better size and shape matching in PET images. Quantitative evaluation revealed a consistently higher SUV ratio correlation and intraclass correlation coefficients for the proposed method across various brain regions in both internal and external datasets. The remarkably good correlation and intraclass correlation coefficient values of the proposed method for the external dataset are noteworthy, considering the dataset’s different ethnic distribution and the use of different PET scanners and image reconstruction algorithms. Conclusion: This study successfully applied transfer learning to a deep neural network for 18F-FDG PET spatial normalization, demonstrating its resource efficiency and improved performance. This highlights the efficacy of transfer learning, which requires a smaller number of datasets than does the original network training, thus increasing the potential for broader use of deep learning–based brain PET spatial normalization techniques for various clinical and research radiotracers. Full Article
f C-X-C Motif Chemokine Receptor 4-Directed Scintigraphy Using [99mTc]Tc-Pentixatec in Primary Aldosteronism: A Proof-of-Concept Study By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 C-X-C motif chemokine receptor 4 (CXCR4)–directed imaging has gained clinical interest in aiding clinical diagnostics in primary aldosteronism (PA). We retrospectively evaluated the feasibility of CXCR4-directed scintigraphy using the novel CXCR-4 ligand [99mTc]Tc-pentixatec in patients with PA. Methods: Six patients (mean age ± SD, 49 ± 15 y) underwent CXCR4-directed scintigraphy (including planar imaging and SPECT/CT) 30, 120, and 240 min after injection of 435 ± 50 MBq of [99mTc]Tc-pentixatec. Adrenal CXCR4 expression was analyzed by calculating lesion-to-contralateral ratios (LCRs). Imaging results were correlated to clinical information. Histopathology and clinical follow-up served as the standard of reference. Results: Three subjects showed lateralization of adrenal tracer accumulation, with a mean maximum lesion-to-contralateral ratio of 1.65 (range, 1.52–1.70), which correlated with morphologic findings on CT. One individual underwent adrenalectomy and presented with complete biochemical and clinical remission at follow-up. Histopathologic workup confirmed unilateral aldosterone-producing adenoma. Conclusion: [99mTc]Tc-pentixatec scintigraphy with SPECT in patients with PA is feasible and might offer a valuable alternative to CXCR4-directed imaging with [68Ga]Ga-pentixafor PET. Full Article
f Design, Synthesis, and Preclinical Evaluation of a High-Affinity 18F-Labeled Radioligand for Myocardial Growth Hormone Secretagogue Receptor Before and After Myocardial Infarction By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 The peptide hormone ghrelin is produced in cardiomyocytes and acts through the myocardial growth hormone secretagogue receptor (GHSR) to promote cardiomyocyte survival. Administration of ghrelin may have therapeutic effects on post–myocardial infarction (MI) outcomes. Therefore, there is a need to develop molecular imaging probes that can track the dynamics of GHSR in health and disease to better predict the effectiveness of ghrelin-based therapeutics. We designed a high-affinity GHSR ligand labeled with 18F for imaging by PET and characterized its in vivo properties in a canine model of MI. Methods: We rationally designed and radiolabeled with 18F a quinazolinone derivative ([18F]LCE470) with subnanomolar binding affinity to GHSR. We determined the sensitivity and in vivo and ex vivo specificity of [18F]LCE470 in a canine model of surgically induced MI using PET/MRI, which allowed for anatomic localization of tracer uptake and simultaneous determination of global cardiac function. Uptake of [18F]LCE470 was determined by time–activity curve and SUV analysis in 3 regions of the left ventricle—area of infarct, territory served by the left circumflex coronary artery, and remote myocardium—over a period of 1.5 y. Changes in cardiac perfusion were tracked by [13N]NH3 PET. Results: The receptor binding affinity of LCE470 was measured at 0.33 nM, the highest known receptor binding affinity for a radiolabeled GHSR ligand. In vivo blocking studies in healthy hounds and ex vivo blocking studies in myocardial tissue showed the specificity of [18F]LCE470, and sensitivity was demonstrated by a positive correlation between tracer uptake and GHSR abundance. Post-MI changes in [18F]LCE470 uptake occurred independently of perfusion tracer distributions and changes in global cardiac function. We found that the regional distribution of [18F]LCE470 within the left ventricle diverged significantly within 1 d after MI and remained that way throughout the 1.5-y duration of the study. Conclusion: [18F]LCE470 is a high-affinity PET tracer that can detect changes in the regional distribution of myocardial GHSR after MI. In vivo PET molecular imaging of the global dynamics of GHSR may lead to improved GHSR-based therapeutics in the treatment of post-MI remodeling. Full Article
f Molecular Imaging of p53 in Mouse Models of Cancer Using a Radiolabeled Antibody TAT Conjugate with SPECT By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Mutations of p53 protein occur in over half of all cancers, with profound effects on tumor biology. We present the first—to our knowledge—method for noninvasive visualization of p53 in tumor tissue in vivo, using SPECT, in 3 different models of cancer. Methods: Anti-p53 monoclonal antibodies were conjugated to the cell-penetrating transactivator of transcription (TAT) peptide and a metal ion chelator and then radiolabeled with 111In to allow SPECT imaging. 111In-anti-p53-TAT conjugates were retained longer in cells overexpressing p53-specific than non–p53-specific 111In-mIgG (mouse IgG from murine plasma)-TAT controls, but not in null p53 cells. Results: In vivo SPECT imaging showed enhanced uptake of 111In-anti-p53-TAT, versus 111In-mIgG-TAT, in high-expression p53R175H and medium-expression wild-type p53 but not in null p53 tumor xenografts. The results were confirmed in mice bearing genetically engineered KPC mouse–derived pancreatic ductal adenocarcinoma tumors. Imaging with 111In-anti-p53-TAT was possible in KPC mice bearing spontaneous p53R172H pancreatic ductal adenocarcinoma tumors. Conclusion: We demonstrate the feasibility of noninvasive in vivo molecular imaging of p53 in tumor tissue using a radiolabeled TAT-modified monoclonal antibody. Full Article
f The Emission of Internal Conversion Electrons Rather Than Auger Electrons Increased the Nucleus-Absorbed Dose for 161Tb Compared with 177Lu with a Higher Dose Response for [161Tb]Tb-DOTA-LM3 Than for [161Tb]Tb-DOTATATE By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Preclinical data have shown that 161Tb-labeled peptides targeting the somatostatin receptor are therapeutically more effective for peptide receptor radionuclide therapy than are their 177Lu-labeled counterparts. To further substantiate this enhanced therapeutic effect, we performed cellular dosimetry to quantify the absorbed dose to the cell nucleus and compared dose–response curves to evaluate differences in relative biological effectiveness in vitro. Methods: CA20948 cell survival was assessed after treatment with [161Tb]Tb- and [177Lu]Lu-DOTATATE (agonist) and with [161Tb]Tb- and [177Lu]Lu-DOTA-LM3 (antagonist) via a clonogenic assay. Cell binding, internalization, and dissociation assays were performed up to 7 d to acquire time-integrated activity coefficients. Separate S values for each type of particle emission (Auger/internal conversion [IC] electrons and β– particles) were computed via Monte Carlo simulations, while considering spheric cells. Once the absorbed dose to the cell nucleus was calculated, survival curves were fitted to the appropriate linear or linear-quadratic model and corresponding relative biological effectiveness was evaluated. Results: Although the radiopeptide uptake was independent of the radionuclide, [161Tb]Tb-DOTATATE and [161Tb]Tb-DOTA-LM3 delivered a 3.6 and 3.8 times higher dose to the nucleus, respectively, than their 177Lu-labeled counterparts on saturated receptor binding. This increased nucleus-absorbed dose was mainly due to the additional emission of IC and not Auger electrons by 161Tb. When activity concentrations were considered, both [161Tb]Tb-DOTATATE and [161Tb]Tb-DOTA-LM3 showed a lower survival fraction than did labeling with 177Lu. When the absorbed dose to the nucleus was considered, no significant difference could be observed between the dose–response curves for [161Tb]Tb- and [177Lu]Lu-DOTATATE. [161Tb]Tb-DOTA-LM3 showed a linear-quadratic dose response, whereas [161Tb]Tb-DOTATATE showed only a linear dose response within the observed dose range, suggesting additional cell membrane damage by Auger electrons. Conclusion: The IC, rather than Auger, electrons emitted by 161Tb resulted in a higher absorbed dose to the cell nucleus and lower clonogenic survival for [161Tb]Tb-DOTATATE and [161Tb]Tb-DOTA-LM3 than for the 177Lu-labeled analogs. In contrast, [161Tb]Tb-DOTATATE showed no higher dose response than [177Lu]Lu-DOTATATE, whereas for [161Tb]Tb-DOTA-LM3 an additional quadratic response was observed. Because of this quadratic response, potentially caused by cell membrane damage, [161Tb]Tb-DOTA-LM3 is a more effective radiopeptide than [161Tb]Tb-DOTATATE for labeling with 161Tb. Full Article
f Theranostic GPA33-Pretargeted Radioimmunotherapy of Human Colorectal Carcinoma with a Bivalent 177Lu-Labeled Radiohapten By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Radiolabeled small-molecule DOTA-haptens can be combined with antitumor/anti-DOTA bispecific antibodies (BsAbs) for pretargeted radioimmunotherapy (PRIT). For optimized delivery of the theranostic - and β-emitting isotope 177Lu with DOTA-based PRIT (DOTA-PRIT), bivalent Gemini (DOTA-Bn-thiourea-PEG4-thiourea-Bn-DOTA, aka (3,6,9,12-tetraoxatetradecane-1,14-diyl)bis(DOTA-benzyl thiourea)) was developed. Methods: Gemini was synthesized by linking 2 S-2-(4-isothiocyanatobenzyl)-DOTA molecules together via a 1,14-diamino-PEG4 linker. [177Lu]Lu-Gemini was prepared with no-carrier-added 177LuCl3 to a molar-specific activity of 123 GBq/μmol and radiochemical purity of more than 99%. The specificity of BsAb-177Lu-Gemini was verified in vitro. Subsequently, we evaluated biodistribution and whole-body clearance for [177Lu]Lu-Gemini and, for comparison, our gold-standard monovalent [177Lu]Lu-S-2-(4-aminobenzyl)-DOTA ([177Lu]Lu-DOTA-Bn) in naïve (tumor-free) athymic nude mice. For our proof-of-concept system, a 3-step pretargeting approach was performed with an established DOTA-PRIT regimen (anti-GPA33/anti-DOTA IgG-scFv BsAb, a clearing agent, and [177Lu]Lu-Gemini) in mouse models. Results: Initial in vivo studies showed that [177Lu]Lu-Gemini behaved similarly to [177Lu]Lu-DOTA-Bn, with almost identical blood and whole-body clearance kinetics, as well as biodistribution and mouse kidney dosimetry. Pretargeting [177Lu]Lu-Gemini to GPA33-expressing SW1222 human colorectal xenografts was highly effective, leading to absorbed doses of [177Lu]Lu-Gemini for blood, tumor, liver, spleen, and kidneys of 3.99, 455, 6.93, 5.36, and 14.0 cGy/MBq, respectively. Tumor–to–normal tissue absorbed-dose ratios (i.e., therapeutic indices [TIs]) for the blood and kidneys were 114 and 33, respectively. In addition, we demonstrate that the use of bivalent [177Lu]Lu-Gemini in DOTA-PRIT leads to improved TIs and augmented [177Lu]Lu-Gemini tumor uptake and retention in comparison to monovalent [177Lu]Lu-DOTA-Bn. Finally, we established efficacy in SW1222 tumor-bearing mice, demonstrating that a single injection of anti-GPA33 DOTA-PRIT with 44 MBq (1.2 mCi) of [177Lu]Lu-Gemini (estimated tumor-absorbed dose, 200 Gy) induced complete responses in 5 of 5 animals and a histologic cure in 2 of 5 (40%) animals. Moreover, a significant increase in survival compared with nontreated controls was noted (maximum tolerated dose not reached). Conclusion: We have developed a bivalent DOTA-radiohapten, [177Lu]Lu-Gemini, that showed improved radiopharmacology for DOTA-PRIT application. The use of bivalent [177Lu]Lu-Gemini in DOTA-PRIT, as opposed to monovalent [177Lu]Lu-DOTA-Bn, allows curative treatments with considerably less administered 177Lu activity while still achieving high TIs for both the blood (>100) and the kidneys (>30). Full Article
f Preclinical Evaluation of 177Lu-OncoFAP-23, a Multivalent FAP-Targeted Radiopharmaceutical Therapeutic for Solid Tumors By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Fibroblast activation protein (FAP) is abundantly expressed in the stroma of most human solid tumors. Clinical-stage radiolabeled FAP ligands are increasingly used as tools for the detection of various cancer lesions. To unleash the full therapeutic potential of FAP-targeting agents, ligands need to remain at the tumor site for several days after administration. We recently described the discovery of OncoFAP, a high-affinity small organic ligand of FAP with a rapid accumulation in tumors and low uptake in healthy tissues in cancer patients. Trimerization of OncoFAP provided a derivative (named TriOncoFAP, or OncoFAP-23) with improved FAP affinity. In this work, we evaluated the tissue biodistribution profile and the therapeutic performance of OncoFAP-23 in tumor-bearing mice. Methods: OncoFAP-23 was radiolabeled with the theranostic radionuclide 177Lu. Preclinical experiments were conducted on mice bearing SK-RC-52.hFAP (BALB/c nude mice) or CT-26.hFAP (BALB/c mice) tumors. 177Lu-OncoFAP and 177Lu-FAP-2286 were included in the biodistribution study as controls. Toxicologic evaluation was performed on Wistar rats and CD1 mice by injecting high doses of OncoFAP-23 or its cold-labeled counterpart, respectively. Results: 177Lu-OncoFAP-23 emerged for its best-in-class biodistribution profile, high and prolonged tumor uptake (i.e., ~16 percentage injected dose/g at 96 h), and low accumulation in healthy organs, which correlates well with its potent single-agent anticancer activity at low levels of administered radioactivity. Combination treatment with the tumor-targeted interleukin 2 (L19-IL2, a clinical-stage immunocytokine) further expands the therapeutic window of 177Lu-OncoFAP-23 by potentiating its in vivo antitumor activity. Proteomics studies revealed a potent tumor-directed immune response on treatment with the combination. OncoFAP-23 and natLu-OncoFAP-23 exhibited a favorable toxicologic profile, without showing any side effects or signs of toxicity. Conclusion: OncoFAP-23 presents enhanced tumor uptake and tumor retention and low accumulation in healthy organs, findings that correspond to a strongly improved in vivo antitumor efficacy. The data presented in this work support the clinical development of 177Lu-OncoFAP-23 for the treatment of FAP-positive solid tumors. Full Article
f [68Ga]Ga-RAYZ-8009: A Glypican-3-Targeted Diagnostic Radiopharmaceutical for Hepatocellular Carcinoma Molecular Imaging--A First-in-Human Case Series By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 To date, the imaging and diagnosis of hepatocellular carcinoma (HCC) rely on CT/MRI, which have well-known limitations. Glypican-3 (GPC3) is a cell surface receptor highly expressed by HCC but not by normal or cirrhotic liver tissue. Here we report initial clinical results of GPC3-targeted PET imaging with [68Ga]Ga-DOTA-RYZ-GPC3 (RAYZ-8009), a peptide-based GPC3 ligand in patients with known or suspected HCC. Methods: [68Ga]Ga-RAYZ-8009 was obtained after labeling the peptide precursor with 68Ga from a 68Ge/68Ga generator and heating at 90°C for 10 min followed by sterile filtration. After administration of [68Ga]Ga-RAYZ-8009, a dynamic or static PET/CT scan was acquired between 45 min and 4 h after administration. Radiotracer uptake was measured by SUVs for the following tissues: suspected or actual HCC or hepatoblastoma lesions, non–tumor-bearing liver, renal cortex, blood pool in the left ventricle, and gastric fundus. Additionally, tumor–to–healthy-liver ratios (TLRs) were calculated. Results: Twenty-four patients (5 patients in the dynamic protocol; 19 patients in the static protocol) were scanned. No adverse events occurred. Two patients had no lesion detected and did not have HCC during follow-up. In total, 50 lesions were detected and analyzed. The mean SUVmax of these lesions was 19.6 (range, 2.7–95.3), and the mean SUVmean was 10.1 (range, 1.0–49.2) at approximately 60 min after administration. Uptake in non–tumor-bearing liver and blood pool rapidly decreased over time and became negligible 45 min after administration (mean SUVmean, <1.6), with a continuous decline to 4 h after administration (mean SUVmean, 1.0). The opposite was observed for HCC lesions, for which SUVs and TLRs continuously increased for up to 4 h after administration. In individual lesion analysis, TLR was the highest between 60 and 120 min after administration. Uptake in the gastric fundus gradually increased for up to 45 min (to an SUVmax of 31.3) and decreased gradually afterward. Conclusion: [68Ga]Ga-RAYZ-8009 is safe and allows for high-contrast imaging of GPC3-positive HCC, with rapid clearance from most normal organs. Thereby, [68Ga]Ga-RAYZ-8009 is promising for HCC diagnosis and staging. Further research is warranted. Full Article
f Dual Somatostatin Receptor/18F-FDG PET/CT Imaging in Patients with Well-Differentiated, Grade 2 and 3 Gastroenteropancreatic Neuroendocrine Tumors By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Our purpose was to prospectively assess the distribution of NETPET scores in well-differentiated (WD) grade 2 and 3 gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) and to determine the impact of the NETPET score on clinical management. Methods: This single-arm, institutional ethics review board–approved prospective study included 40 patients with histologically proven WD GEP NETs. 68Ga-DOTATATE PET and 18F-FDG PET were performed within 21 d of each other. NETPET scores were evaluated qualitatively by 2 reviewers, with up to 10 marker lesions selected for each patient. The quantitative parameters that were evaluated included marker lesion SUVmax for each tracer; 18F-FDG/68Ga-DOTATATE SUVmax ratios; functional tumor volume (FTV) and metabolic tumor volume (MTV) on 68Ga-DOTATATE and 18F-FDG PET, respectively; and FTV/MTV ratios. The treatment plan before and after 18F-FDG PET was recorded. Results: There were 22 men and 18 women (mean age, 60.8 y) with grade 2 (n = 24) or grade 3 (n = 16) tumors and a mean Ki-67 index of 16.1%. NETPET scores of P0, P1, P2A, P2B, P3B, P4B, and P5 were documented in 2 (5%), 5 (12.5%), 5 (12.5%) 20 (50%), 2 (5%), 4 (10%), and 2 (5%) patients, respectively. No association was found between the SUVmax of target lesions on 68Ga-DOTATATE and the SUVmax of target lesions on 18F-FDG PET (P = 0.505). 18F-FDG/68Ga-DOTATATE SUVmax ratios were significantly lower for patients with low (P1–P2) primary NETPET scores than for those with high (P3–P5) primary NETPET scores (mean ± SD, 0.20 ± 0.13 and 1.68 ± 1.44, respectively; P < 0.001). MTV on 18F-FDG PET was significantly lower for low primary NETPET scores than for high ones (mean ± SD, 464 ± 601 cm3 and 66 ± 114 cm3, respectively; P = 0.005). A change in the type of management was observed in 42.5% of patients after 18F-FDG PET, with the most common being a change from systemic therapy to peptide receptor radionuclide therapy and from debulking surgery to systemic therapy. Conclusion: There was a heterogeneous distribution of NETPET scores in patients with WD grade 2 and 3 GEP NETs, with more than 1 in 5 patients having a high NETPET score and a frequent change in management after 18F-FDG PET. Quantitative parameters including 18F-FDG/68Ga-DOTATATE SUVmax ratios in target lesions and FTV/MTV ratios can discriminate between patients with high and low NETPET scores. Full Article
f Quantitative SPECT/CT Metrics in Early Prediction of [177Lu]Lu-DOTATATE Treatment Response in Gastroenteropancreatic Neuroendocrine Tumor Patients By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Our objective is to explore quantitative imaging markers for early prediction of treatment response in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) undergoing [177Lu]Lu-DOTATATE therapy. By doing so, we aim to enable timely switching to more effective therapies in order to prevent time-resource waste and minimize toxicities. Methods: Patients diagnosed with unresectable or metastatic, progressive, well-differentiated, receptor-positive GEP-NETs who received 4 sessions of [177Lu]Lu-DOTATATE were retrospectively selected. Using SPECT/CT images taken at the end of treatment sessions, we counted all visible tumors and measured their largest diameters to calculate the tumor burden score (TBS). Up to 4 target lesions were selected and semiautomatically segmented. Target lesion peak counts and spleen peak counts were measured, and normalized peak counts were calculated. Changes in TBS (TBS) and changes in normalized peak count (nPC) throughout treatment sessions in relation to the first treatment session were calculated. Treatment responses were evaluated using third-month CT and were binarized as progressive disease (PD) or non-PD. Results: Twenty-seven patients were included (7 PD, 20 non-PD). Significant differences were observed in TBSsecond-first, TBSthird-first, and TBSfourth-first (where second-first, third-first, and fourth-first denote scan number between the second and first, third and first, and fourth and first [177Lu]Lu-DOTATATE treatment cycles), respectively) between the PD and non-PD groups (median, 0.043 vs. –0.049, 0.08 vs. –0.116, and 0.109 vs. –0.123 [P = 0.023, P = 0.002, and P < 0.001], respectively). nPCsecond-first showed significant group differences (mean, –0.107 vs. –0.282; P = 0.033); nPCthird-first and nPCfourth-first did not reach statistical significance (mean, –0.122 vs. –0.312 and –0.183 vs. –0.405 [P = 0.117 and 0.067], respectively). At the optimal threshold, TBSfourth-first exhibited an area under the curve (AUC) of 0.957, achieving 100% sensitivity and 80% specificity. TBSsecond-first and TBSthird-first reached AUCs of 0.793 and 0.893, sensitivities of 71.4%, and specificities of 85% and 95%, respectively. nPCsecond-first, nPCthird-first, and nPCfourth-first showed AUCs of 0.764, 0.693, and 0.679; sensitivities of 71.4%, 71.4%, and 100%; and specificities of 75%, 70%, and 35%, respectively. Conclusion: TBS and nPC can predict [177Lu]Lu-DOTATATE response by the second treatment session. Full Article
f Composite Prediction Score to Interpret Bone Focal Uptake in Hormone-Sensitive Prostate Cancer Patients Imaged with [18F]PSMA-1007 PET/CT By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Unspecific bone uptake (UBU) related to [18F]PSMA-1007 PET/CT imaging represents a clinical challenge. We aimed to assess whether a combination of clinical, biochemical, and imaging parameters could predict skeletal metastases in patients with [18F]PSMA-1007 bone focal uptake, aiding in result interpretation. Methods: We retrospectively analyzed [18F]PSMA-1007 PET/CT performed in hormone-sensitive prostate cancer (PCa) patients at 3 tertiary-level cancer centers. A fourth center was involved in performing an external validation. For each, a volume of interest was drawn using a threshold method to extract SUVmax, SUVmean, PSMA tumor volume, and total lesion PSMA. The same volume of interest was applied to CT images to calculate the mean Hounsfield units (HUmean) and maximum Hounsfield units. Clinical and laboratory data were collected from electronic medical records. A composite reference standard, including follow-up histopathology, biochemistry, and imaging data, was used to distinguish between PCa bone metastases and UBU. PET readers with less (n = 2) or more (n = 2) experience, masked to the reference standard, were asked to visually rate a subset of focal bone uptake (n = 178) as PCa metastases or not. Results: In total, 448 bone [18F]PSMA-1007 focal uptake specimens were identified in 267 PCa patients. Of the 448 uptake samples, 188 (41.9%) corresponded to PCa metastases. Ongoing androgen deprivation therapy at PET/CT (P < 0.001) with determination of SUVmax (P < 0.001) and HUmean (P < 0.001) independently predicted bone metastases. A composite prediction score, the bone uptake metastatic probability (BUMP) score, achieving an area under the receiver-operating-characteristic curve (AUC) of 0.87, was validated through a 10-fold internal and external validation (n = 89 bone uptake, 51% metastatic; AUC, 0.92). The BUMP score’s AUC was significantly higher than that of HUmean (AUC, 0.62) and remained high among lesions with HUmean in the first tertile (AUC, 0.80). A decision-curve analysis showed a higher net benefit with the score. Compared with the visual assessment, the BUMP score provided added value in terms of specificity in less-experienced PET readers (88% vs. 54%, P < 0.001). Conclusion: The BUMP score accurately distinguished UBU from bone metastases in PCa patients with [18F]PSMA-1007 focal bone uptake at PET imaging, offering additional value compared with the simple assessment of the osteoblastic CT correlate. Its use could help clinicians interpret imaging results, particularly those with less experience, potentially reducing the risk of patient overstaging. Full Article
f Clinical Factors That Influence Repeat 68Ga-PSMA-11 PET/CT Scan Positivity in Patients with Recurrent Prostate Cancer Under Observation After a Negative 68Ga-PSMA-11 PET/CT Scan: A Single-Center Retrospective Study By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 This analysis aimed to identify clinical factors associated with positivity on repeat 68Ga-PSMA-11 PET/CT after a negative scan in patients with recurrent prostate cancer (PCa) under observation. Methods: This single-center, retrospective analysis included patients who underwent at least 2 68Ga-PSMA-11 PET/CT scans (PET1 and PET2) at UCLA between October 2016 and June 2021 for recurrent PCa with negative PET1 and no PCa-related treatments between the 2 scans. Using Prostate Cancer Molecular Imaging Standardized Evaluation criteria to define negative and positive scans, the final cohort was divided into PET2-negative (PET2-Neg) and PET2-positive (PET2-Pos). The same PET1 was used twice in the more than 2 PET cases with inclusion criteria fulfilled. Patient characteristics and clinical parameters were compared between the 2 cohorts using Mann–Whitney U test and Fisher exact test. Areas under the curve (AUCs) of the receiver operating characteristic and the Youden index were computed to determine the discrimination ability of statistically significant factors and specific cut points that maximized sensitivity and specificity, respectively. Results: The final analysis included 83 sets of 2 PET/CT scans from 70 patients. Thirty-nine of 83 (47%) sets were PET2-Neg, and 44 of 83 (53%) sets were PET2-Pos. Prostate-specific antigen (PSA) increased from PET1 to PET2 for all 83 (100%) sets of scans. Median PSA at PET1 was 0.4 ng/mL (interquartile range, 0.2–1.0) and at PET2 was 1.6 ng/mL (interquartile range, 0.9–3.8). We found higher serum PSA at PET2 (median, 1.8 vs. 1.1 ng/mL; P = 0.015), absolute PSA difference (median, 1.4 vs. 0.7 ng/mL; P = 0.006), percentage of PSA change (median, +270.4% vs. +150.0%: P = 0.031), and median PSA velocity (0.044 vs. 0.017 ng/mL/wk, P = 0.002) and shorter PSA doubling time (DT; median, 5.1 vs. 8.3 mo; P = 0.006) in the PET2-Pos cohort than in the PET2-Neg cohort. Receiver operating characteristic curves showed cutoffs for PSA at PET2 of 4.80 ng/mL (sensitivity, 34%; specificity, 92%; AUC, 0.66), absolute PSA difference of 0.95 ng/mL (sensitivity, 62%; specificity, 71%; AUC, 0.68), percentage of PSA change of a positive 289.50% (sensitivity, 48%; specificity, 82%; AUC, 0.64), PSA velocity of 0.033 ng/mL/wk (sensitivity, 57%; specificity, 80%; AUC, 0.70), and PSA DT of 7.91 mo (sensitivity, 71%; specificity, 62%; AUC, 0.67). Conclusion: Patients with recurrent PCa under observation after a negative 68Ga-PSMA-11 PET/CT scan with markedly elevated serum PSA levels and shorter PSA DT are more likely to have positive findings on repeat 68Ga-PSMA-11 PET/CT. Full Article
f Optimizing the Therapeutic Index of sdAb-Based Radiopharmaceuticals Using Pretargeting By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Single-domain antibodies (sdAbs) demonstrate favorable pharmacokinetic profiles for molecular imaging applications. However, their renal excretion and retention are obstacles for applications in targeted radionuclide therapy (TRT). Methods: Using a click-chemistry–based pretargeting approach, we aimed to reduce kidney retention of a fibroblast activation protein α (FAP)–targeted sdAb, 4AH29, for 177Lu-TRT. Key pretargeting parameters (sdAb-injected mass and lag time) were optimized in healthy mice and U87MG (FAP+) xenografts. A TRT study in a pancreatic ductal adenocarcinoma (PDAC) patient-derived xenograft (PDX) model was performed as a pilot study for sdAb-based pretargeting applications. Results: Modification of 4AH29 with trans-cyclooctene (TCO) moieties did not modify the sdAb pharmacokinetic profile. A 200-µg injected mass of 4AH29-TCO and an 8-h lag time for the injection of [177Lu]Lu-DOTA-PEG7-tetrazine resulted in the highest kidney therapeutic index (2.0 ± 0.4), which was 5-fold higher than that of [177Lu]Lu-DOTA-4AH29 (0.4 ± 0.1). FAP expression in the tumor microenvironment was validated in a PDAC PDX model with both immunohistochemistry and PET/CT imaging. Mice treated with the pretargeting high-activity approach (4AH29-TCO + [177Lu]Lu-DOTA-PEG7-tetrazine; 3 x 88 MBq, 1 injection per week for 3 wk) demonstrated prolonged survival compared with the vehicle control and conventionally treated ([177Lu]Lu-DOTA-4AH29; 3 x 37 MBq, 1 injection per week for 3 wk) mice. Mesangial expansion was reported in 7 of 10 mice in the conventional cohort, suggesting treatment-related kidney morphologic changes, but was not observed in the pretargeting cohort. Conclusion: This study validates pretargeting to mitigate sdAbs’ kidney retention with no observation of morphologic changes on therapy regimen at early time points. Clinical translation of click-chemistry–based pre-TRT is warranted on the basis of its ability to alleviate toxicities related to biovectors’ intrinsic pharmacokinetic profiles. The absence of representative animal models with extensive stroma and high FAP expression on cancer-associated fibroblasts led to a low mean tumor-absorbed dose even with high injected activity and consequently to modest survival benefit in this PDAC PDX. Full Article
f Evaluating the Utility of 18F-FDG PET/CT in Cancer of Unknown Primary By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Cancer of unknown primary (CUP) represents a heterogeneous group of metastatic tumors for which standardized diagnostic work-up fails to identify the primary site. We aimed to describe the Peter MacCallum Cancer Centre experience with 18F-FDG PET/CT in extracervical CUP with respect to detection of a primary site and its impact on management. A secondary aim was to compare overall survival (OS) in patients with and without a detected primary site. Methods: CUP patients treated between 2014 and 2020 were identified from medical oncology clinics and 18F-FDG PET/CT records. Information collated from electronic medical records included the suspected primary site and treatment details before and after 18F-FDG PET/CT. Clinicopathologic details and genomic analysis were used to determine the clinically suspected primary site and compared against 2 independent masked reads of 18F-FDG PET/CT images by nuclear medicine specialists to determine sensitivity, specificity, accuracy, and the rate of detection of the primary site. Results: We identified 147 patients, 65% of whom had undergone molecular profiling. The median age at diagnosis was 61 y (range, 20–84 y), and the median follow-up time was 74 mo (range, 26–83 mo). Eighty-two percent were classified as having an unfavorable CUP subtype as per international guidelines.18F-FDG PET/CT demonstrated a primary site detection rate of 41%, resulted in a change in management in 22%, and identified previously occult disease sites in 37%. Median OS was 16.8 mo for all patients and 104.7 and 12.1 mo for favorable and unfavorable CUP subtypes, respectively (P < 0.0001). Median OS in CUP patients when using 18F-FDG PET/CT, clinicopathologic, and genomic information was 19.8 and 8.5 mo when a primary site was detected and not detected, respectively (P = 0.016). Multivariable analysis of survival adjusted for age and sex remained significant for identification of a potential primary site (P < 0.001), a favorable CUP (P < 0.001), and an Eastern Cooperative Oncology Group status of 1 or less (P < 0.001). Conclusion: 18F-FDG PET/CT plays a complementary role in CUP diagnostic work-up and was able to determine the likely primary site in 41% of cases. OS is improved with primary site identification, demonstrating the value of access to diagnostic 18F-FDG PET/CT for CUP patients. Full Article
f Predicting Pathologic Complete Response in Locally Advanced Rectal Cancer with [68Ga]Ga-FAPI-04 PET, [18F]FDG PET, and Contrast-Enhanced MRI: Lesion-to-Lesion Comparison with Pathology By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Neoadjuvant therapy in patients with locally advanced rectal cancer (LARC) has achieved good pathologic complete response (pCR) rates, potentially eliminating the need for surgical intervention. This study investigated preoperative methods for predicting pCR after neoadjuvant short-course radiotherapy (SCRT) combined with immunochemotherapy. Methods: Treatment-naïve patients with histologically confirmed LARC were enrolled from February 2023 to July 2023. Before surgery, the patients received neoadjuvant SCRT followed by 2 cycles of capecitabine and oxaliplatin plus camrelizumab. 68Ga-labeled fibroblast activation protein inhibitor ([68Ga]Ga-FAPI-04) PET/MRI, [18F]FDG PET/CT, and contrast-enhanced MRI were performed before treatment initiation and before surgery in each patient. PET and MRI features and the size and number of lesions were also collected from each scan. Each parameter’s sensitivity, specificity, and diagnostic cutoff were derived via receiver-operating-characteristic curve analysis. Results: Twenty eligible patients (13 men, 7 women; mean age, 60.2 y) were enrolled and completed the entire trial, and all patients had proficient mismatch repair or microsatellite-stable LARC. A postoperative pCR was achieved in 9 patients (45.0%). In the visual evaluation, both [68Ga]Ga-FAPI-04 PET/MRI and [18F]FDG PET/CT were limited to forecasting pCR. Contrast-enhanced MRI had a low sensitivity of 55.56% to predict pCR. In the quantitative evaluation, [68Ga]Ga-FAPI-04 change in SULpeak percentage, where SULpeak is SUVpeak standardized by lean body mass, had the largest area under the curve (0.929) with high specificity (sensitivity, 77.78%; specificity, 100.0%; cutoff, 63.92%). Conclusion: [68Ga]Ga-FAPI-04 PET/MRI is a promising imaging modality for predicting pCR after SCRT combined with immunochemotherapy. The SULpeak decrease exceeding 63.92% may provide valuable guidance in selecting patients who can forgo surgery after neoadjuvant therapy. Full Article
f Whole-Body HER2 Heterogeneity Identified on HER2 PET in HER2-Negative, -Low, and -Positive Metastatic Breast Cancer By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Understanding which patients with human epidermal growth factor receptor 2 (HER2)–negative or –low metastatic breast cancer (MBC) benefit from HER2-targeted strategies is urgently needed. We assessed the whole-body heterogeneity of HER2 expression on 89Zr-trastuzumab PET (HER2 PET) and the diagnostic performance of HER2 PET in a large series of patients, including HER2-negative and -low MBC. Methods: In the IMPACT-MBC study, patients with newly diagnosed and nonrapidly progressive MBC of all subtypes were included. Metastasis HER2 status was determined by immunohistochemistry and in situ hybridization.89Zr-trastuzumab uptake was quantified as SUVmax and SUVmean. HER2 immunohistochemistry was related to the quantitative 89Zr-trastuzumab uptake of all metastases and corresponding biopsied metastasis, uptake heterogeneity, and qualitative scan evaluation. A prediction algorithm for HER2 immunohistochemistry positivity based on uptake was developed. Results: In 200 patients, 89Zr-trastuzumab uptake was quantified in 5,163 metastases, including 186 biopsied metastases. With increasing HER2 immunohistochemistry status, uptake was higher (geometric mean SUVmax of 7.0, 7.6, 7.3, and 17.4 for a HER2 immunohistochemistry score of 0, 1, 2, or 3+, respectively; P < 0.001). High uptake exceeding 14.6 (90th percentile) was observed in one third of patients with a HER2-negative or -low metastasis biopsy. The algorithm performed best when lesion site and size were incorporated (area under the curve, 0.86; 95% CI, 0.79–0.93). Conclusion: HER2 PET had good diagnostic performance in MBC, showing considerable whole-body HER2 heterogeneity and uptake above background in HER2-negative and -low MBC. This provides novel insights into HER2-negative and -low MBC compared with standard HER2 immunohistochemistry on a single biopsy. Full Article
f Diagnostic Accuracy of [18F]FDG PET/MRI in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Metaanalysis By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 This study evaluates the diagnostic utility of PET/MRI for primary, locoregional, and nodal head and neck squamous cell carcinoma (HNSCC) through systematic review and metaanalysis. Methods: A systematic search was conducted using PubMed and Scopus to identify studies on the diagnostic accuracy of PET/MRI for HNSCC. The search included specific terms and excluded nonhybrid PET/MRI studies, and those with a sample size of fewer than 10 patients were excluded. Results: In total, 15 studies encompassing 638 patients were found addressing the diagnostic test accuracy for PET/MRI within the chosen subject domain. Squamous cell carcinoma of the nasopharynx was the most observed HNSCC subtype (n = 198). The metaanalysis included 12 studies, with pooled sensitivity and specificity values of 93% and 95% per patient for primary disease evaluation, 93% and 96% for locoregional evaluation, and 89% and 98% per lesion for nodal disease detection, respectively. An examination of a subset of studies comparing PET/MRI against PET/CT or MRI alone for evaluating nodal and locoregional HNSCC found that PET/MRI may offer slightly higher accuracy than other modalities. However, this difference was not statistically significant. Conclusion: PET/MRI has excellent potential for identifying primary, locoregional, and nodal HNSCC. Full Article
f Development of 18F-Fluoromisonidazole Hypoxia PET/CT Diagnostic Interpretation Criteria and Validation of Interreader Reliability, Reproducibility, and Performance By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Tumor hypoxia, an integral biomarker to guide radiotherapy, can be imaged with 18F-fluoromisonidazole (18F-FMISO) hypoxia PET. One major obstacle to its broader application is the lack of standardized interpretation criteria. We sought to develop and validate practical interpretation criteria and a dedicated training protocol for nuclear medicine physicians to interpret 18F-FMISO hypoxia PET. Methods: We randomly selected 123 patients with human papillomavirus–positive oropharyngeal cancer enrolled in a phase II trial who underwent 123 18F-FDG PET/CT and 134 18F-FMISO PET/CT scans. Four independent nuclear medicine physicians with no 18F-FMISO experience read the scans. Interpretation by a fifth nuclear medicine physician with over 2 decades of 18F-FMISO experience was the reference standard. Performance was evaluated after initial instruction and subsequent dedicated training. Scans were considered positive for hypoxia by visual assessment if 18F-FMISO uptake was greater than floor-of-mouth uptake. Additionally, SUVmax was determined to evaluate whether quantitative assessment using tumor-to-background ratios could be helpful to define hypoxia positivity. Results: Visual assessment produced a mean sensitivity and specificity of 77.3% and 80.9%, with fair interreader agreement ( = 0.34), after initial instruction. After dedicated training, mean sensitivity and specificity improved to 97.6% and 86.9%, with almost perfect agreement ( = 0.86). Quantitative assessment with an estimated best SUVmax ratio threshold of more than 1.2 to define hypoxia positivity produced a mean sensitivity and specificity of 56.8% and 95.9%, respectively, with substantial interreader agreement ( = 0.66), after initial instruction. After dedicated training, mean sensitivity improved to 89.6% whereas mean specificity remained high at 95.3%, with near-perfect interreader agreement ( = 0.86). Conclusion: Nuclear medicine physicians without 18F-FMISO hypoxia PET reading experience demonstrate much improved interreader agreement with dedicated training using specific interpretation criteria. Full Article
f Association Between CA 15-3 and 18F-FDG PET/CT Findings in Recurrent Breast Cancer Patients at a Tertiary Referral Hospital in Kenya By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 The tumor marker cancer antigen 15-3 (CA 15-3) is that most commonly used to monitor metastatic breast cancer during active therapy and surveillance for disease recurrence after treatment. The association of CA 15-3 and 18F-FDG PET/CT findings can be considered complementary, since any significant rise may indicate the presence of disease and imaging is able to map the tumor sites. Although current guidelines do not recommend the routine performance of CA 15-3 in asymptomatic patients being followed up after definitive breast cancer treatment, most oncologists perform serial assessment of the tumor markers as part of routine follow-up of patients. The aim of this study was to evaluate the correlation between CA 15-3 levels and 18F-FDG PET/CT scan findings in patients with recurrent breast cancer. Methods: This was a cross-sectional study with data collected retrospectively. Patients being evaluated for breast cancer recurrence with 18F-FDG PET/CT imaging and CA 15-3 level were included. Evaluation of the association between CA 15-3 levels and 18F-FDG PET/CT scan findings was then done. Results: In total, 154 cases were included in this study; 62 patients had recurrence (positive) on the 18F-FDG PET/CT scans, whereas 92 patients had normal (negative) findings on follow-up 18F-FDG PET/CT scans. There was an association between CA 15-3 levels and the presence or absence of recurrence on 18F-FDG PET/CT scans, with 84.4% (27/32) of patients who had elevated CA 15-3 levels having disease recurrence on 18F-FDG PET/CT and 84.4% (27/32) of patients who had elevated CA 15-3 levels having disease recurrence on 18F-FDG PET/CT as well as a correlation with the burden of metastases. Most patients with disease recurrence on 18F-FDG PET/CT, however, had normal CA 15-3 levels. Conclusion: Higher CA 15-3 levels correlate with breast cancer recurrence on 18F-FDG PET/CT as well as with burden of metastasis. Notably, CA 15-3 levels within the reference range do not exclude breast cancer disease recurrence since more than half of patients with recurrence had normal CA 15-3 levels. 18F-FDG PET/CT should therefore be considered in patients with suspected breast cancer recurrence but normal CA 15-3 levels. Full Article
f 1,090 Publications and 5 Years Later: Is FAP-Targeted Theranostics Really Happening? By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Full Article
f Nuclear Imaging of Bispecific Antibodies on the Rise By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Bispecific antibodies (bsAbs) are engineered to target 2 different epitopes simultaneously. About 75% of the 16 clinically approved bsAbs have entered the clinic internationally since 2022. Hence, research on biomedical imaging of various radiolabeled bsAb scaffolds may serve to improve patient selection for bsAb therapy. Here, we provide a comprehensive overview of recent advances in radiolabeled bsAbs for imaging via PET or SPECT. We compare direct targeting and pretargeting approaches in preclinical and clinical studies in oncologic research. Furthermore, we show preclinical applications of imaging bsAbs in neurodegenerative diseases. Finally, we offer perspectives on the future directions of imaging bsAbs based on their challenges and opportunities. Full Article
f The Rise of Molecular Image-Guided Robotic Surgery By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Following early acceptance by urologists, the use of surgical robotic platforms is rapidly spreading to other surgical fields. This empowerment of surgical perception via robotic advances occurs in parallel to developments in intraoperative molecular imaging. Convergence of these efforts creates a logical incentive to advance the decades-old image-guided robotics paradigm. This yields new radioguided surgery strategies set to optimally exploit the symbiosis between the growing clinical translation of robotics and molecular imaging. These strategies intend to advance surgical precision by increasing dexterity and optimizing surgical decision-making. In this state-of-the-art review, topic-related developments in chemistry (tracer development) and engineering (medical device development) are discussed, and future scientific robotic growth markets for molecular imaging are presented. Full Article
f Navigating the Future of Prostate Cancer Care: AI-Driven Imaging and Theranostics Through the Lens of RELAINCE By jnm.snmjournals.org Published On :: 2024-10-01T04:08:08-07:00 Full Article
f EU-Turkey Customs Union: Lessons for Brexit By www.chathamhouse.org Published On :: Mon, 05 Mar 2018 12:30:00 +0000 EU-Turkey Customs Union: Lessons for Brexit 15 March 2018 — 11:00AM TO 12:00PM Anonymous (not verified) 5 March 2018 Chatham House, London Turkey and the EU are preparing to open negotiations to modernize their 22 year old customs union and expand its scope beyond goods to include services, public procurement and a more liberal regime for agriculture. At the same time, the UK is debating whether to seek a customs union with the EU to facilitate a frictionless flow of goods and to prevent a hard border with Ireland. The speaker will discuss Turkey’s customs union modernization agenda and share his insights on the lessons for the UK’s future relationship with the EU.Attendance at this event is by invitation only. Full Article
f Can Cyprus Be Reunified? By www.chathamhouse.org Published On :: Fri, 29 Jun 2018 10:55:02 +0000 Can Cyprus Be Reunified? 18 July 2018 — 12:30PM TO 1:30PM Anonymous (not verified) 29 June 2018 Chatham House | 10 St James's Square | London | SW1Y 4LE The latest round of Cyprus peace negotiations to resolve the Cypriot issue broke down in Crans-Montana, Switzerland in July 2017. The speaker will offer the Turkish Cypriot perspective on future developments to reunifying the divided island.THIS EVENT IS NOW FULL AND REGISTRATION HAS CLOSED. Full Article