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Strategic Epidemiology

Charles W. King

The recent outbreak of Ebola in a remote part of Congo prompted a rapid and comprehensive response from the World Health Organization (W.H.O.) including the first time in its seventy year history that its Director has traveled into the midst of an active hotzone. The response from the United States has been decidedly muted, unlike the previous outbreak in West Africa that began in 2013 where thousands of U.S. Army troops were deployed to construct field hospitals and support aid efforts. In the years since the West African outbreak the Trump Administration has requested Congress roll back funding that had been allocated for addressing Ebola and other virulent outbreaks. While costly, the expenditures by the United States between 2014 and 2016 to combat Ebola in West Africa, primarily through the Centers for Disease Control and Prevention (C.D.C.) and U.S. Agency for International Development (U.S.A.I.D.), represent an important strategic deployment of American resources to address a national interest.

Like food aid, medical aid to foreign countries, especially to address potential epidemics, is not solely altruistic. Infectious diseases like Ebola and Marburg are easiest to contain when populations of infected are localized. The the outbreaks of SARS and Avian Flu, which are much less lethal to humans than Ebola or Marburg, demonstrate how difficult fighting a disease that has penetrated the international travel network. If the United States was attempting to prevent Ebola or a similar disease from making it through American border posts, seaports, and airports it would be significantly more costly and dangerous than the billions spent in the West African campaign. American support for the fight against Ebola in West Africa between 2014 and 2016 was ultimately a single-digit billions line item in a trillions of dollar budget. A medical quarantine of the United States would not only be a major federal expense, but would have a significant effect on gross domestic product and economic growth.

The relatively contained outbreaks close to their origin are also important for the development of medical remedies and vaccines. The WHO is now deploying a vaccine for Ebola that was first tested in the last months of the West African outbreak in the thousands of doses in Congo. Without international funds for fighting in West Africa or Congo Merck, the pharmaceutical giant who developed the vaccine, would not have been able to incentivized to do so, which would hamstring future responses whether the outbreak was in the developed world or the undeveloped world.

It is also in the long term interest of the United States that the developing be stable and prosperous world. Stable developing states are markets for American goods and services. Unstable ones are sources of not only misery and death, but dangerous pressures on the United States and its allies, the Syrian Refugee crisis being only the largest and most recent example. Civil strife has been simmering in Congo and among its neighbors for decades, the return of major conflict at the same time as an outbreak could be orders of magnitude deadlier than the 2013-2016 Ebola outbreak in West Africa which killed approximately eleven thousand people. Epidemics cause their own refugee crises, but combined with flight from conflict such an outbreak could be un-containable by current measures. Policy-makers in the United States and Europe have a good case for supporting medical aid to the rest of the world, both in crises and in times of relative calm. They simply need to make it.

The Devil You Know: American Aid to Pakistan

Charles W. King

A month ago the Trump administration announced that it was cutting off financial assistance to Pakistan to the tune of $255 million. Relations between the United States and Pakistan have been strained for years due to an apparent unwillingness or inability on the part of the Pakistani government to address the presence of Afghan Taliban fighters using the semi-autonomous Federally Administrated Tribal Area (FATA) as a base of operations. The Trump administration has gone further, alleging that the Pakistani government attempted to deceive American officials in order to receive aid they never meant to use against the Taliban in Pakistan. This assessment is not without merit; in 2007 the Pakistani military negotiated a deal with Taliban forces in the FATA after two years of disastrous military operations against the combined forces of the Afghan Taliban and Tribal militias. This deal caused strain between the George W. Bush and Obama administrations and the Pakistani governments, and numerous member of Congress have been calling for a reassessment of American aid to Pakistan for years.

The ongoing situation in Pakistan raises the question as to whether or not there is value in giving foreign aid to a country that appears to be acting counter to American interests. This means asking what is going to happen to Pakistan without the American aid it has been receiving since the Cold War, and is that going to be more or less dangerous to the United States and its interests than the status quo? Pakistan’s Inter-Services Intelligence (ISI) is considered to be one of the best intelligence services in the world, punching well above its weight relative the security services of countries of similar size and development. This is due to the history and geopolitical situation that Pakistan has found itself in since independence in 1947. Tension with the also newly independent India began immediately, and in 1971 India defeated Pakistan in a war that resulted in the independence of Bangladesh. Relations with Pakistan’s other neighbors, Afghanistan and Iran, have also always been tense, prompting an outsized influence of the Pakistani military in domestic politics including coups in 1977 and 1999. Throughout the territory of Kashmir has been disputed between Pakistan and India, and concerned that the Pakistani military is unable to defeat the Indian military in a conventional conflict Pakistan developed nuclear weapons and cooperates with the Haqqani network of militants and groups who have conducted terrorist attacks in India. Surrounded by India, Afghanistan, China, and Iran and with instable domestic politics it is understandable why the Pakistani government and military consistently act to limit the risk of increased instability or existential danger.

This suggests that American aid to Pakistan was never entirely about Pakistani cooperation in the War or Terror. Given the dangers, real and perceived, to the Pakistani state from within and without and Pakistan’s nuclear arsenal, it is understandable that the United States would seek to prevent the failure of the Pakistani state. It is truly an example of choosing the devil you know over the devil you don’t. When the Soviet Union collapsed in the early 1990s the world managed to survive the very real danger of loose nuclear weapons, it might not be so lucky if Pakistan collapsed. As distasteful as it may be to support a government with the human rights record and bellicose nature that Pakistan exhibits, preventing loose nuclear weapons from falling into the wrong hands might be a bargain at twice the price.

Guns vs. Butter: Humanitarian Crises in the Middle East

Charles W. King

As Saudi Arabia and its Arab allies prepare to seize the port of Hodeidah in Yemen, the World Health Organization and the United Nations are reporting a rising death toll from cholera. They forecast 150,000 new cases in the next month. A faction of the Hadi government has split off, without the southern leaders the government is in peril.

Across the Gulf of Aden Somalia is suffering from increasing drought. Al Shabaab is capitalizing on the inability of the government in Mogadishu to provide the humanitarian relief. Instead of barring aid organizations as they did in 2011, Al Shabaab is taking responsibility for providing food and water to Somalis where the Somali Federal Government cannot.

In Egypt the government of President Adbel Fattah el-Sisi has passed legislation requiring 47,000 local and 100 foreign non-governmental aid organizations to get approval from a new regulatory body. That body has not yet been established, aid organizations predict that it will be more of a roadblock than a regulator

On June 1st the Economist reported on Mohieddine Manfoush, a Syrian dairy farmer who provides dairy to Damascus and dry goods to cities besieged by government forces. Small entrepreneurs who could not afford to flee the Syrian conflict are filling the gaps left by those who could.

Meanwhile the United States is increasing its military support for Kurdish and Iraqi forces, both through military aid and the increasing deployment of American Special Forces and support troops, including artillery batteries. In a recent statement Emmanuel Macron, the recently elected President of France, pledged French intervention in the event of the use of chemical weapons in Syria. While the West is focusing on guns, many of the states and non-state actors in the Middle East are focused on butter.

Islamic State’s rapid growth was fueled not only by foreign fighters, but by its enthusiasm for replicating the functions of the state. As it expanded across Syria and Iraq Islamic State repaired infrastructure, instituted and enforced law, and sought to reinforce its claim to the Caliphate not only through religious dogma but by mimicking state institutions. The entrenchment of Hamas in Gaza and Hezbollah in Lebanon owe more to their willingness to provide governance and humanitarian relief than their military effectiveness.

The recognition that legitimacy derives not only from military force but also from the ability to protect and provide for the welfare of the people is not a recent innovation. The People’s Republic of China is acutely aware of how its declining economic growth may affect its legitimacy with the Chinese people. In the nineteenth century Germany and the Ottoman Empire instituted widespread reforms to strengthen state institutions and quiet domestic unrest. Providing health and prosperity engenders stability and suppot.

In Yemen cholera cases are rising and a longer conflict looms. Al Shabaab is positioning itself as a reliable source of governance and aid in rural Somalia. The el-Sisi government is increasing its control of aid organizations in Egypt. The government of Bashar al-Assad has recognized the need control over the flow of vital goods including food in the Syrian civil war. As these humanitarians crises in the Middle East worsen, the United States and the West remain fixated on killing jihadists and preventing the use of chemical weapons, and are providing guns and missiles to that end. Middle Eastern governments and insurgents alike have recognized the importance of providing milk, water, and wheat.

The Marshall Plan: Investing in America Abroad

Charles W. King

The success of The Marshall Plan rebuilding Europe after World War Two and correcting the mistakes of the Treaty of Versailles is one of the most well known facts about World War Two amongst the American. Named for George C. Marshall, the US Army Chief of Staff during the war and Secretary of State and Defense after the war, the Marshall Plan provided more than $13 billion (in 1940s dollars) to Western Europe to help rebuilding. This largess is contrasted with the punitive measures imposed on Germany after World War One.

The Treaty of Versailles required not only German admission of guilt for World War One but the acceptance of responsibility for not only their own war debt, but millions in reparations to the victorious Entente powers. The predominant historical narrative is that the burdens of the Treaty of Versailles led to the collapse of the Weimar Republic’s economy, the rise of Adolph Hitler, and World War Two, and that the Marshall Plan averted a repeat of this cycle. Contemporary historians and economists are skeptical of whether the Treaty of Versailles actually contributed to the hyperinflation that plagued Germany in the interwar period. This raises the question; if the Treaty of Versailles is not responsible for World War Two, then what was the purpose of the Marshall Plan?

First and foremost the Marshall Plan, along with the Cooperative for American Remittances to Europe (CARE), saved countless lives in Western Europe in the years after World War Two. Additionally, like many of the other post-war efforts by the United States and its Allies, the Marshall Plan was designed to create a post-war order that was good for the United States. As it transitioned from a war-time economy to a consumer one the United States would need markets for its goods. A struggling Europe or a Europe that had turned to communism would not be able or willing to purchase American consumer goods. Like many of the American aid programs that would follow in the twentieth century the Marshall Plan had requirements. States receiving aid had to lower interstate barriers to trade and other regulations. The Marshall Plan also facilitated economic growth through labor union participation, increased productivity, modern American business practices and above all capitalism.

Recognizing the purpose economic and political objectives of the Marshall Plan illuminates the fact that while bold and on a scale not seen before, it was not unprecedented. Economic growth through productivity and access to markets goes back to colonial resistance to British mercantilism and monopolies. Westward expansion and the acquisition of overseas territory at the end of the nineteenth century represent the second phase of this effort. The Marshall Plan was the third. It ushered in decades of active American foreign policy where aid was a political tool used to gain market access for the United States and to prevent foreign states from falling to communism by allowing them to participate in the economic growth experienced by the US and its trading partners. The Marshall Plan for all of its expense and obvious moral character was essential to preventing the collapse of the American economy and a return to the Great Depression after World War Two. George Marshall and President Truman recognized that for the United States to continue to prosper it needed to invest in the wider world.

The Arsenal of Democracy: A Tale of Four Arms Deals

Charles W. King

The United States is the world’s leading exporter of arms, more than the next two largest exporters, Italy and Germany, combined. The United State exported more than a billion dollars’ worth of small arms in 2013 according to the Small Arms Survey, a non-governmental organization supported by a group of western nations. The export of arms, from pistols and rifles to military aircraft and advanced technical systems represent not just an economic boon for the United States that incentivizes the continued growth of its arms industry, but a strategic asset for its foreign policy. Just as the United States controls the export of advanced technologies that it does not want its rivals or pariah states to possess (particularly nuclear and missile technology), it uses arms export agreements to bolster its allies and as an incentive.

The two most famous American arms export schemes are Franklin D. Roosevelt’s Lend-Lease program during World War Two and the Iran-Contra Scandal that rocked the administration of Ronal Reagan. Between 1941 and 1945 the United States exported $667 billion in 2017 dollars to its allies under Lend-Lease. Iran-Contra circumvented American law to fund the right-wing Contra rebels in Nicaragua with the proceeds of arms sales to the Islamic Republic of Iran, primarily missiles and also illegal. While these two programs differ greatly in scope, publicity, and legality they were both intended to provide material support to allies—long standing or of convenience—engaged in conflicts the outcome of which the respective administration felt it had a vested interest in. Today the supplying of arms to belligerents is highly controversial, and when doing so policy-makers must weigh the potential benefits of tipping the scale in a conflict, with the fallout, both domestic and diplomatic, of doing so.

Attempting to decide the winner in conflicts is not the only way that the United States uses arms exports to affect geopolitics. Bolstering the capabilities of allies and even competitors during peacetime can also be of strategic value. Sometimes it is possible to provide support with a direct American military presence, as the deployment of the US Army to West Germany did during the Cold War, and American AWACS Radar and Tanker planes did to the intervention in Libya in 2011. This is not always the case. In 1979 it would not have been possible to deploy American troops to the border between the Soviet Union and the People’s Republic of China. After recognizing the Sino-Soviet split American administrations sought to improve the People’s Liberation Army’s ability to fight their Soviet counter-parts, particularly against Soviet tanks. Even with the normalization of diplomatic relations between the US and China in 1979, this was a complicated task to accomplish. Eventually, the Carter Administration received the legislative approval it needed to let the PLA manufacture American designed anti-armor weapons in China under license, direct sales would have been politically impossible.

There is a third strategic use for arms exports that the US actively engages in; incentive and subsidy. The US government subsidizes the Iron Dome missile shield deployed in Israel, much of the money transferred to Israel as military aid comes right back to the United States as payments to US defense companies. This is not only good for the defense sector, but it encourages firms to perform research and development on certain kinds of technologies, like Iron Dome, that the US government wants to encourage but may not have a direct use for at the time.

The United States will remain the world largest exporter of arms for the foreseeable future. Arms sales are an important sector of the American economy. Arms export deals influence manufacturing and the development of advanced electronics and other technologies. They also provide considerable, if controversial, strategic options for American foreign policy. While picking winners may be the most obvious use, policy-makers should remember the utility of enhancing the capabilities of nations with similar interests during peacetime as a preventative measure.

Further Reading

Irene Pavesi, "Trade Update 2016: Transfers and Transparency," Small Arms Survey, (Geneva, Switzerland: Small Arms Survey, 2016).