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Prevention

is l(ey. The United States musr recognize its vulnerability in a world where disease knows no borders. With twenty-five major international airports serving as accesspoints for millions of inbound passengers, anirnals, and cargo shipments each year, the possibility of exotic pathogens being introduced is a reality. But a little prevention goes a long way.

OY NJ A M E S W I L S O N ANINTRODUCTIB

TheFalland Riseof InfectiousDiseases

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D A V I DL . H E Y M A N N

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SilentThreat:Infectious Diseases andU.S.Biosecurity DUANEJ. GUBLER

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TheEconomics of Epidenrics M A U R E E NL E W I S

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Hazardous World: TheRealRiskof Bioterrorism

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Conflict&Security

J +s

Forest fromtheTrees: TheCostof Severing Defense Ties STEPHEN C. BALL Policymakers

-

consequences

j.ntent on punishment

must consider the unintended

of defense sanctions.

Eyeing theStorm A N I N T E R V I EW WI T HO E N N IC S .B L A I R The man at the helm of the U.S. Pacific command Asia.

addressesrecent events in

Summer/Fall

5e

WhyI Loveto LoveDonna TheUnitedStates, Summer: Cuba,andthePolitics of Culture D A M I A NF E R N A N D E Z

What does this disco queen have to do with U.S.-Cuban

relations?

ThePoliticsof Samba 67

B R U C EG I L M A N Behind

73

samba's sensuous beats is a political

rnessage.

Microfinance: A Changing Landscape for Development M A R I A O T E R OA N D M O N I C AB R A N D

Banking on the poor. How microfinance world.

is giving hope to rnany in the developing

International InternetGovernance: 0h Whata TangledWebWe CouldWeave

79

C A T H E R I NL E .MANN A look at the tensions and contradictions of multi- iurisdictional Internet regrrlation.

Terrorand Reform Colombia:Between M I G U E LC E B A L L O SA N D G E R A R DM A R T I N Strengthening

institutions:

the strateg'y for reducing

turrnoil

in Colombia.

Pockets of Flame:Communal Conflictin Indonesia

97

DINOPATTIDJALAL Rather than pushing blindly for democratization, Indonesia must first tackle the problem of communal strife. ro5

TheChinese Popular Weightof History: ReformMovement A N I N T E R V I EW WI T HW A N GD A N ATiananmen student leader reflects on the place of the r989 movement in Chinese history and the prospects for Chinese democracy.

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Georgetown Journal

of International

Affairs

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Science&Technology__ FromBangalore to Bulawayo: Connecting theLess-Developed World J E F F R ESYA C H S Theprivate sector must not underestimate its role in integrating technology with development.

Restoration of a Nation Margaret C. Lee reviews AIex Boraine's ACountry I|nmasked.

A Timefor Change:U.S.-JapanRelations Robert G. sutter reviews Gerald curtis's

NewPerspectiuesonU.s.-JapanRelations.

Business asUsualin the2lst Century Rebecca Johnson reviews HenrT Kissinger's

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DoesAmericaNeeda Foreign

B e y o n dt h e " D e a t h W a t c h t t J o D t EF O N S E C A An AIDS educator'sperspectiveon

the epidemic

in Malawi

L o w H u m o r i n H i g h P l a c e s D t E G oc . A S E N c t o Diplomacyis not all about being straightlaced,stern faced, and officious.

S u m m e r / F a l l2 o o r

International

EDITORS.IN.CHIEFMEREDITH CAMPANALE JA IAN CHONC

M A N A GI N G E D I T O R S M A R C A R E T _ R O S ET R E T T E R

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A S S O C I A T EE D I T O R S H E I D I A R O L A , M A R I A N N E B E N E T , JUANA BRACHET, PAUL CHEN, ANNE CHIORAZZT, PHILIPPE DE PONTET, CASSANDRA DOLL, NATHANIEL HELLER, ANTONIUS K U F F E R A T H , C H R I S T O P H E RM C I N T O S H , N I K H I L PATEL, LIAM PRlCE, JOHN RUDY, DAVID RUSSO, JONATHAN WEISS,MICHAEL YBARRA, DANIEL YEUNG

EDITORIALASSISTANTSMELISSACARDINAL, YUN-JO CHO, MEGAN FLEMMINC, LAN HOANC, BEN JOHNSON, SHEETAL KHERA, CAROLINE KWOK, XIN YINC MOK, ANNE MURRETT,JENNIE RAAB, ANCELA RODRICUEZ, HAE T]N SH]N. HUI MIEN TAN

DESIGNEDITOR REO MATSUZAKI G R A P H I CD E S I G N K A O R I A R A M A K I W E B O E S I G N E D W A R DY U T A K A S U M O T O

DESIGNSTAFF DIANA KELLER

B U S I I . I E S SM A N A G E R E L I Z A B E T H M C D O N A L D D I R E C T O RO F E X T E R N A L R E L A T I O N S A N N K R I S T I N K A R L S E N D I R E C T O RO F A D V E R T I S I N G C H E D A T E M S A H D I R E C T O RO F D I S T R I E U T I O N J U L I E S H A H D I R E C T O RO F M E D I A R E L A T I O N S M E C A N P O H O R Y L O LEGAL LIAISON ERIC O'MALLEY

A D V I S O R YE O A R D D A V I D A B S H I R E , S U S A N B E N N E T T , H . R , H . F E L T P En r

n O n n O r q y C R E C T A ,J O Y C E D A V I S ,

CARA DIMASSA, ROBERT L. CALLUCCI, LEE HAMILTON, PETER F. KROCH, MICHAEL MAZARR, FAREED ZAKARIA

U t { I V E R S I T YC O U N C I L A N T H O N Y A R E N D , R I C H A R D B R A H M , M I C H A E L E .

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Diseaseplays a central role in world history. From the Black Death, to the seventeenth-century srnallpox epidemic in the Americas, to the ongoing AIDS pandernic, disease has tipped power balances, ravagedeconomies, devastatedpolitical systems,and corroded social structures. Yet despite disease'simportance in world history, until recently the mainstream study of international affairs has devoted little tirne to exarnining its impact worldwide. With its focus on Internoglobal infectious diseases,this issue of the GeorgetownJournalof tionalAffairsspotlights this critical, but too often neglected, force in world affairs.

Disease, however, is only one of many transnational influences challenging the concept of state sovereignty in today's world. Damian Fernandez contends that culture, like disease, knows no national boundaries, prompting exchangesthat are beyond the control of even the most authoritarian states. Similarly, Catherine Mann argues that present state institutions are ill-equipped to address the concerns that accornpany the massive inforrnation flows of a wired world. AndJeffrey Sachs claims that the private sector, even rnore than the state, has a key role to play in development.

Yet those who contend that the traditional state is weakening in the face of unstoppable transnational forces represent rnerely one side of the debate. Several pieces in this issue maintain that statesremain crucial players on the world stage. Both Dennis Blair and Stephen Ball assertthat the United States, along with its allies, can help safeguard peace and stability in diverse regions of the globe. Likewise, Dino Patti Djalal highlights the irnportance of decisive state action in arresting the spread of communal violence that has accornpanied democratization and political liberalization in Indonesia.

Ignoring the rnany non-state influences and actors in today's world handicaps any attempt to comprehend the contemporary global system. Hastily relegating state influence in international politics to the dustbin of history is equally problematic. Only through consideration of both the state and non-state sources of problems and prospects now facing the world can academics and practitioners have an accurate grasp of contemporary global issues. We invite you to join the continuing struggle to better understand the ever-changing nature of international affairs.

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rutum G E O R G E T O W NJ O U R N A L O F I N T E R N A T I O N A LA F F A I R S

BIOALERT DISEASE

KNOWS

NO BORDERS

Imagine over twenty points of accessto a IS country. Through these points flow rnillions of people, AN INTRODUCTION BY anirnals, and cargo JAMES M. WILSON shiprnents each year.

Somewhere, a cryptic pathogen is carried through one of these points undetected. Over the following weeks, the characteristic pattern of an outbreak is recognized only after several people within the same city die of sirnilar syrnptorns. Public health officials eventually discover that the cryptic pathogen is a virus that attacks the brain and kills ro percent of the people it infects. They also make

The Falland Riseof

PnEvENTToN

KEY

InfectiousDiseases D A V I DL , H E Y M A N N

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Sil entThreat'Infectious Diseases and U.S. Biosecuri!

D U A N EJ . G U B L E R

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The Economics of Epidemics MAUREEN LEWIS

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HaTardousWorld' The Real Riskof Bioterrorism E R I CK . N O J I

Summer,/Fa2 lloor

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I N T R OD U C T I O N

the unfortunate discovery that the virus can be carried by native mosquitoes, infect local animals, and thus hide itself in the ecosystem. The epidemic abates but the virus is still there, hiding in the environment until conditions are favorable for it to re-emerge. During the following season more casesare identified.

The country now has a new infectious diseasewith which to contend-one that will cause significant rnorbidity and rnortality and require millions of taxpayer dollars for surveillance and control measures over subsequent years.

Is it possible to have a similar incident here in the United States? With twentyfive major international airports serving as accesspoints, the possibility of exotic pathogens being introduced is a reality.

Monitoring these points of entry for diseaseis a monstrous and nearly impossible task. In fact, the above "hypothetical" scenario actually took place in rggg.

Airport-based and national passive surveillance systerns in the United States proved ineffective in preventing the introduction of West Nile virus to New York City-where it infected fifty-six people and caused seven deaths-and its subsequent ecological establishment along the eastern seaboard. This was the first documented appearance of West Nile virus in the western hernisphere.

Indeed, the United States must repeatedly contend with exotic diseasessuch as dengr:.e,cholera, and rnalaria, and there is little question of the impact of HIV, an introduced pathogen, on lJ.S. society. In sorne cases these exotic diseases atternpt ecological establishment, creating the possibility of additional outbreaLs years later. As author David L. Heymann points out, now, more than ever, the United Statesis not an island.

The inability to control and contain an

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of International Affairs

infectious diseaseabroad can have direct implications for U.S. biosecurity.

Deliberate introduction of a pathogen through a terrorist attack raisesadditional concerns about the adequacy of U.S. surveillance and response systerns.Simulations and response exercises have repeatedly demonstrated the inadequacy of both of these systems. Recognition of these systems' failures can be a positive impetus for change.

In this Forum, leading infectious disease experts offer several articles that challenge the reader to consider the problem of transnational movernent of pathogens-either through "natural" or "intentional" mechanisms-and how this can affect U.S. national security.

David L. Heymann of the World Health Organization exarnines the threat that infectious diseases present to global security. He regards the problem as one that all nations must confront-and one addressed that cannot be successfully by any single country.

Duane J. Gubler of the U.S. Centers for Disease Control and Prevention offers two casestudies demonstrating why infectious diseasessurfacing in a country on the other side of the world are a direct threat to U.S. security. He reminds us that the patterns of global infectious diseasesare not static; transnational rnovement can. does. and will continue to occur, as will the challenge this presents for infectious disease surveillance and response in the United States.Gubler also suggests that while the United States should consider improvements in its own surveilLance and response capability, it should also consider assisting with surveilIance and response at the source-the origin countries. Control of infectious disease abroad can prevent extension of the problem to the United States.

w t L S o NB i o a l e r t It was once mainstream to view factors step in contending with infectious dissuch as war and poverty as the major easesis to acquire more knowledge of destabilizing forces on a society and its t h e s i t u a t i o n . S e c o n d , t h e U n i t e d economy. Yet infectious diseasecan also States must recognize that infectious be a potent disruptive factor. Maureen disease is not just the problem of the Lewis of the World Bank Group discuss- rest of the world, but of the United es the economic impact of AIDS to States as well. The point is not to argue demonstrate how an infectious disease whether a successfulbioterrorist attack may place major stressupon a national on U.S. soil is likely. Rather, it is to economy and the individuals struggling recognize that the problem of infecto earn an income within it. tious diseasesrequires a common soluFinally, Eric K. Noji of the U.S. Cention, not merely individual action by a ters for Disease Control and Prevention single country. It is time to consider presents the issue of biological terrorism the role of the United States in the and its more concrete implications for global solution: Will we seek preventive U.S. national security. The biggest frusmeasures within the international aretration in attempting to identif' a solution na or merely wait for the next introto the problem is accurately assessingthe d u c t i o n o f a n e x o t i c p a t h o g e n o r true threat: Can a mass-casualty event release of a bioweapon? occur through the successfuldeployment of a bioiogical agent in a U.S. city? How James M. Wilson wasa consultant with WHO and NASA likely is such an event? researching climatic triggering of Ebola hemorrhagic fever outbreaks. He is a pediatrician at Georgetown Univenity As in clinical rnedicine, prevention Hospital and a liaison to the the Infectious DiseasesWorking is key. For the United States, the first Group of the Clobal Disaster Information Network.

bummer/fall 2OOT t 5I

Bioalert

The Fall and Riseof

Inf ectious Diseases David L. Hevrnann

Just twenty years ago, wealthy nations could look on infectious diseaseswith the kind of smug indifference reserved for vanquished enemies. Srnallpox had been eradicated-was so surely gone, in fact, that vaccination stopped-and word was out that polio might become the next candidate for deliberate extinction. Malaria, tuberculosis (TB), and other mass killers frorn the past had retreated to distant shores. Plagues akin to diseases the Black Death were ancient history-infectious would never again sweep across continents, causing death and instability on such a massive scale. Of the threats that remained, vaccines protected against sorne of the worst, while potent antibiotics kept rnost others at bay. Arrned with the powerful tools of research, modern science had won the battle against infectious diseases.With these diseasesout of the way, research could now concentrate its considerable powers on the fight against cancer, heart disease, and other top priorities for the industrialized world.

But infectious diseases continued to thrive among the world's neglected and poorest in both industrialized and developing countries, and complacency proved to be an especially good mediurn for their progressive growth. Those twenty yearswitnessed the resurgence of malaria and TB, the spread ofcholera and yellow fever to new areas, a startling outbreak of

David L. Heymann, is Executive Director of the Communicable DiseasesCluster at the World Health Organizatron.

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plague, foodborne diseaseson the bilIion-dollar scale, and the advent of several lethal new diseaseswith no vaccines and no cure. Antibiotics began to fail, with replacements either much more costly or not even in sight. Multi-drug resistant strains of TB started appearing in U.S. hospitals, prisons, and homeless populations with a fatality rate of /o percent and an estirnated $r billion in healthcare and containment costs. Mosquitoes carrying the malaria parasite stowed away on jets, bringing rnalaria to people working or living near airports in temperate zones where it had long ago disappeared. West Nile fever emerged in NewYork City and then spread along the coast, costing almost $roo million to control. Altogether, over thirty new infectious diseasesappeared in the short span of three decades. Among them, AIDS-the new Black Death-moved swiftly frorn its spot on the horizon to engulf the globe. What went wrong?

Throughout history, human populations have experienced major epidemics of infectious diseases,often resulting in Iarge nurnbers of deaths, panic, disruption of trade, and political instability.

Before the advent of effective treatrnents and vaccines, conditions such as poverty, overcrowding, and poor sanitation provided fertile ground for diseasetransrnission. These disease-prornoting conditions rernain irnportant today, as evidenced by outbreals in crowded refugee carnps, epidernics following the breakdown in sanitation causedby natural disasters, and the persistently high levels of rnultiple infections seen in developing countries, where poverty and lack of sanitation are so often the norrn.

However, an explanation for the current emergence of so many new diseases, and the resurgence of so many others,

t8I

Georgetown Journal

of International

Affairs

must look beyond historical causes and consider some striking new trends.

These have to do with the way we inhabit the planet-how we produce our food, prescribe and use drugs, travel and trade, and interact with the environment and the infectious agents it hosts. One characteristic of infectious diseases is their potential for change and adaptation, and rnodern trends have amplified that potential considerably. Not only do infectious diseasestravel faster than ever before, but they also have been given novel opportunities to develop resistance to drugs, to jump the species barrier from animals to hurnans, and to infect our food.

Threats.or Jet-SetDisease these recent changes, one of the rnost important is the phenomenal increase in our mobility. Since rg$o, the number of international airline passengers has soared from two million a year to over r.4 billion. In medieval times, deadly plagues were transported from continent to continent by flea-infested rats sailing on ships. Today, infectious agents carried by passengers or insects fly by plane frorn one corner of the earth to another, all in a matter of hours. In the United Kingdom, nearly r,ooo new casesof rnalaria are irnported every year by passengers arriving from the tropics. In the United States, the nurnbers are even greater.

Deadly airborne diseasessuch as the pneurnonic plague, influenza, and TB can easily spread in crowded airport lounges, on a jumbo jet, or by passengers after their return home. In tjJl, over |o percent of passengerson board a grounded American airliner were infected with influenza by a fellow traveler. In 19JB, the polio virus was imported to Canada by unvaccinated

H E Y M A N NB I O A I C T I

travelers from Western Europe, resulting in an outbreak of eleven casesof the paralytic disease. In the early rggos, a flight attendant with active TB is believed to have infected up to twenty-three fellow crew members over the course of several flights. Most recently, Ebola-like symptorns in a Congolese wornan who arrived in Toronto after stopovers in Addis Ababa. Rome. and Newark created near hysteria in North America.

Not only are infected travelers a threat, but the disease vectors themselves may stow awayon flights. Mosquitoes carrying the malaria parasite can enter the passenger cabin before takeoff or during stopovers and survrve the trip in the luggage hold. As a result, rnalaria infections and deaths regrrlarly occur in Europe and North Arnerica following one-off bites from imported mosquitos near international airports. London, Paris, Brussels, Geneva, and Oslo have all reported recent casesof such airport malaria, as have cities in the United Statesand Canada.

Infectious diseasescan invade new territories in other waysaswell. In r9B$, the aggressive tiger mosquito, normally found in Asia, slipped unnoticed into the United States inside a shipment of water-logged used tires. Within two years, the rnosquitoes, capable of transmitting yellow fever, dengrre, and other diseases, had established themselves in seventeenstates.In Ig9I, a ship carrying contaminated water from Asia in its ballast tanls caused a cholera epidernic in Peru. The disease spread rapidly throughout South and Central America, causingsome II,OOO deaths.

Another side of our mobility is our incursion into new or unfamiliar ecological zones, sometimes for economic reasons, sometimes for adventure and fun.

When humans penetrate or modifr for-

merly unpopulated regions, they may come into close contact with unfamiliar anirnal reseryoirs or disease vectors against which they have no immunity.

Outbreaks of malaria, yellow fever, and leishmaniasis continue to be linked to workers who penetrate rainforests to cut trees. Recent importations ofyellow fever into Switzerland, the United States, and Germany have occurred after tourists, unaware of the need for vaccination, returned from excursions deep into the rainforests. In Septernber oflast year, the EcoChallenge sports event in the jungles and rivers of Malaysia, which drew over JOo athletes from twenty-nine U.S. states and twenty-six other countries, resulted in the irnportation of leptospirosis, an acute bacterial disease, to cities in three continents.

MadCowsand"Chicken Ebola."

An equally disturbing trend is the frequency with which diseases "previously confined to animals are making the evolutionary leap to hurnans. Again, exploitation of new ecological zones plays a role. Man-rnade changessuch as deforestation disrupt natural habitats and can force animals into closer contact with humans. Global warming and climate extrenes, whether involving excessive rainfall or drought, can likewise displace animal speciesand bring them into closer contact with human settlements. Over two-thirds of the emerging infections identified during the r99os are known to have originated in animals, both domesticated and wild. Sorne are believed to have emerged from animals living in tropical rainforests or elsewherein close proxirnity to humans, where rnicroorganisms have succeeded in crossing the speciesbarrier to humans. Though intensive research has failed to disclose the origins of Marburg

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T H E F A L L A N D R I S EO F I N F E C T I O U SD I S E A S E S

and Ebola outbreaks, both are thought to have animal sources somewhere in the transmission cycle.

Less exotic but all the more alarming are caseswhere diseasesof domesticated animals have made the leap to hurnans, with major implications for the food

tional trade, which has added food to the list of vehicles facilitating the rapid international spread of disease.Coupled with globalization, advances in food production technology have resulted in a food chain that is longer and rnore complex than ever before. Today, consumers

purchasiflg Today,consumers foods from the local. grocer risk e)cposureto pathogens native to relnote farts of the world. supply and huge costs for agriculture and trade. One dramatic example occurred in 1997 in Hong Kong, where an influenza virus previously found only in geeseand chickens caused infections and deaths in humans. Immediately dubbed "chicken Ebola" by the press, the outbreak resulted in the destruction of r.2 million birds. In rg99 an influenza virus previously confined to swine suddenly appeared in humans, raising the specter of the terrifyingly deadly Spanish Flu of rgr8, which some believe was caused by an avian virus that first crossed the species barrier to swine before jumping to humans. In rggg Malaysia also experienced the transmission of the newly identified Nipah virus from pigs to humans in an outbreak of viral encephalitis that caused panic in the country and among its neighbors.

Most notorious of all is the advent of spongiform encephalopat\, boaine or "mad cow disease," first detected in the United Kingdom in rg86. The disease,traced to cattie feed prepared from the carcassesof ruminants, has now been linked to a new and invariably fatal disease in humans, the variant C reutzfeldt-Jakob disease.

Such developments are made particularly ominous by the increase in interna-

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purchasing foods from the local grocer risk exposure to pathogens native to remote parts of the world. In this remarkable new environrnent, tracing the origin of all the ingredients in a meal has become virtually impossible, creating an enormous challenge for the control of foodborne diseases.

Blunt Weapons. Thefoodsupply is guilty on another count as wellr its contribution to the enorrnous problern of antirnicrobial drug resistance. Since the discovery of the growth-prornoting and disease-fighting capabilities of antibiotics, farmers, fish farmers, and livestock producers have used antimicrobials in everything frorn apples to aquaculture. Currently, only half of all antibiotics produced are intended for hurnan consumption. The other half are used to treat sick anirnals, prornote growth in livestock, and rid cultivated foodstuffs of various destructive organisms. Ongoing and often low-level dosing in the latter two uses results in the development of drug-resistant strains of bacteria in livestock. In several disturbing cases, rnultiresistant bacteria infecting hurnans have been directly linked to resistant organisms in animals.

HEYMANN BiOAICTI

A far more important cause of drug resistance is the widespread misuse of drugs prescribed for humans. This phenomenon is the rnost telling sign that we have failed to take the threat of infectious diseasesseriously. It suggeststhat we have rnishandled our potent and precious weapons for disease control, both by overusing them in industrialized nations and, paradoxicaliy, by misusing and underusing thern in the developing world.

The dramatic upsurge in the spread of drug-resistant microbes over the past decade is undermining today's efforts to control infectious diseases,As diseases once thought to be under control become increasingly resistant to available drugs, the specter of incurable infectious diseaseslooms large. In addition to requiring increased length of treatment with rnore expensive and, in sorne instances, more toxic antimicrobial drugs or drug combinations, resistant infections have seen a doubling of mortality rates. At the same tirne, fewer new antimicrobials reach the market, in part due to the high cost of new drug development. In fact, no new class of antibiotic has been rnarketed for hurnan use since the r96os.

From the first resistant organisms, the problem of antirnicrobial resistance has snowballed into a serious public health concern with economic, social, and political implications that are global in scope, crossing all environmental and ethnic boundaries. Multi-drug resistant TB is no longer confined to any one country or to people co-infected with HW, but has appeared in locations as diverse as Europe, Africa, Asia, and North Arnerica among healthcare workers and in the general population. Penicillin-resistant pneumococci are likewise

spreading rapidly, and resistant malaria is on the rise. A study publlshed earlier this year found that in nine U.S. and Canadian cities, 14 percent of those newly infected with HIV have acquired drugresistant strains of the virus.'

Although antimicrobial resistance affects industrialized and developing countries alile, its impact is far greater in deveLoping countries. The switch from norrnally less expensivefirst-line drugs to second- or third-Iine drugs involves a drarnatic escalation in the price of treatment. In sorne of the poorest countries, the cost of lengthy treatment and replacenent drugs means that some diseasesare too expensive to treat. In the case of TB, the ernergence of multi-drug resistant bacteria means that medications that once cost as little as $2o must now be replaced with drugs a hundred times more expensive. In fact, alrnost all organisrns that infect humans are at sorne stage of developing antimicrobial resistance, thus closing the window of opportunity to effectively treat the infections they cause.

SensationalCosts. Theresurgence of infectious diseasesimposes other costs as well. The response to an outbreak requires an immediate investigation followed by extensive containment activities, at times placing great financial demands on countries and calling to a halt routine measures for the prevention and control of other irnportant diseases.

Such costs can be greatly amplified by sensational media coverage, which can trigger unjustified fear arnong populations at negligible risk. The collective imagination is fuelled by media stories, such as those that have recently speculated about the origins of the Ebola virus or how West Nile virus entered North Arnerica, and by fear of intentional uses

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of infectious agents, such as smallpox and anthrax, in terrorism or war.

The economic costs of an outbreak with widespread and sensational reporting can be immense. Reports of the r99r cholera epidemic in Peru resulted in a loss of $77o tnillion in revenue, almost one-fifth of normal export earnings for the trade and tourism sectors.'?Sensational coverage of the rgg{. plague epidemic in Surat, India led to severe econornic lossesunofficially placed as high as $1./ billion.3 Hotel bookings in India fell by 20 to 6o percent immediately after the first media reports, and one airline reported losses of over $r million in the first week alone. In countries throughout the world, airports were closed to airplanes arriving from India and irnports of foodstuffs were blocked. The costs of mad cow disease in Europe will likewise be enorrnous.a Public panic over the safety of beef, which is now banned in school cafeterias in some countries, has recently prompted the European lJnion to introduce a series of draconian measuresthat will cost an estimated $2.8 billion in 2oor alone.

Asthe Stepped-Up Surveillance. world body responsible for leading and coordinating efforts to protect public health, the World Health Organization (WHO) performs a number of functions aimed at curbing the spread of infectious diseases, reducing deaths, and assisting countries in both routine diseasecontrol and reactions to outbreaks and epidemics. In this capacity, one of its jobs is to act as a watchdog, alerting health officials of any changes in the infectious diseasesituation, sounding the alarm when these changes threaten global health security, and ensuring the response necessaryfor containment.

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The WHO has recently stepped up its diseasesurveillance and reporting activities considerably. In 1997, the WHO facilitated the development of a powerful new Internet-based network that now scansthe world for rumors of outbreaks, investigateseach case, and verifies genuine outbreaks of international concern. Confirmed outbreaks are immediately announced on the WHO Web site, together with advice on any need to restrict travel or trade and on the containment rneasures introduced to stop their spread.

This new approach tackles a longstanding problem, the understandable reluctance of some countries to acknowledge outbreaks because of their rnajor negative impact on tourism and trade.

Too often, the result of this reluctance has been a call for international assistanceat a late stagewhen the outbreak is rnuch rnore it has spread difficult to control-when from a localized fire to a conflagration.

With the new system in place, countries are now beginning to recognize the considerable advantages of immediate reporting and prornpt assistancefrom the WHO and its partners. These advantages were vividly illustrated by the low fatality rate and quick containrnent of last year's Ebola outbreak in Uganda, where the outbreak was reported irnmediately after detection of the first suspected cases.In addition, clear inforrnation backed by the WHO's authority about the need for restrictions on travel or trade helps calm panic and gives countries another powerful incentive for prompt reporting. Had this system been in place in the early rg8os, AIDS might never have become a global epidemic on the scalewe seetoday.

A Clearand PresentDanger.

Though surveillance and reporting help

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contain outbreals and limit their international spread, the battle is far from won. Infectious diseases continue to rank as the world's biggest killer of children and young adults. They account for more than 13 million deaths a year and one in two deaths in developing countries. The majority of these deaths are causedby just a handful of illnesses'TB, malaria, AIDS, pneurnonia, diarrheal diseases,and measles.

Tuberculosis kilis r.g miilion people a year. Malaria kills over t million, rnost of thern children. Acute respiratory infections claim another f.g million lives. Diarrheal diseaseskill z million.

Ald measles, one of the most contagious diseasesknown to humans, kills around goo,ooo children in the developing world each year.

expectancy at birth has fallen frorn ]o to around $o years.5 InJanuary of last year, a special session of the United Nations Security Council took the unprecedented step of declaring that a disease-AlDS-poses a threat to global security. This pronouncement put the official seal on a blatant reality' A continent such as Africa faces a great impediment to survival when up to a quarter of its population is infected with a lethal and rapidlyspreadingvirus and when hordes ofuneducated and untended orphans are roaming the streets, hospitals are losing their doctors and nurses, schools are losing their teachers, and businesses cannot replace sick or dying employees.

With the cost of sufficient life-saving drugs exceeding the entire GDP in sev-

Infectious diseases continue to rank

as

the world's biggest killer of children and young adults.

But of all these diseasesclamoring for attention and help, it is AIDS-and espehas finally cially AIDS in Africa-that captured world attention and forced recognition of what an epidemic of this scale will mean for the future of our world. Since the beginning of the epidemic HIV has infected go million people, of whom 16 million have died. An estimated r.4 million children have HIV/AIDS. In Africa alone, 5,5oo people die from AIDS-related illnesses every day. In Zirnbabwe, 20 to 50 percent of pregnant women in some areas are infected with HIV and risk infecting their newborn children. In rnany countries, life expectancy and child surwival rates have plummeted. In Botswana, life

eral countries, world leaders in wealthy countries must address some difficult questions concerning patent protection for antiretroviral drugs and the rights of countries in the grip of the AIDS crisis to produce cheap copies of patented drugs or import them frorn elsewhere.

AIDS is one ominous problem arnong many caused by the upsurge of infectious diseases, the outburst of new diseases,and the return of old foes once considered defeated. Now rnore than ever, no country is an island. No country can forti$ itself against an invasion of infectious diseases either from its neighbors or from the remotest corners of the globe. Unlike the situation twenty years ago, we must accept that infec-

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tious diseasesare not under control and that a massive effort, as well as constant vigilance, will be needed to secure greater safety for the world's popula-

tions. The alarm bells sounded by these threats to global health security-a death serve as toll for so many millions-must a wake-up call for us all.

NO T E S r S. Little, "Is Transmitted Drug Resistance in HIV on the Rise?," BritishMedicolJournal 322 (zoor)' ro74-ro7 5. z World Health Organization, Week!Epidemiologicol R e c o r6d6 ( r g g g ) , 4 7 ; W o r l d H e a l t h O r g a n i z a t i o n , Bulletinof the World HealthOrgonizotion ]8.tt (zooo), r 3 6 z - r 3 6 3 ; a n d E . H a r r i s a n d N . K a d i r , A L o wC o s t Transferof BiomoleculorTechniques PCR: Approltriote Approoch ( N e w Y o r k , O x f o r d l J n i v e r s i t y P r e s s ,r 9 9 8 ) . ! C. Levy and K. Gage, "Plague in the United MedicineJanuary rggg: lnfectious States, r995-r9Jl," g.{.-63, and World Health Organization, Bulletin of the

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WorldH ealthOrganiqotion 7 B.rr (z ooo)' r 36o l3 62. , [ T . S a n c t o n . " L i f e W i t h o u t B e e f , " l . i m eM o g a z i n e 26 February 2oor. g World Health Organizarion, Remouing Obstacles to HealtlgDeulopment , World Health Organization Report o n I n f e c t i o u sD i s e a s ers9 9 9 . W H O / C D S / 9 9 . 1 ( a u a i l able upon request fi-om WHO/CDS Information Resource Centre) and Joint United Nations ProUpdote: gramme on AIDS (UNAfDS), NDS Epidemic D e c e m b2eor o o , U N A I D S / o o . 4 4 E - W H O / C D S / C S R / (available upon request from EDC/zooo.9 W H O / C D S I n f o r m a t i o n R e s o u r c eC e n t r e ) .

Bioalert

SilentThreat Infectious Diseases andU.S.Biosecuri!

Duane J. Gubler In the last thirty years there has been a dramatic global resurgence of infectious diseases. Some important diseaseswere recognized for the first time, including HIV/AIDS, hantavirus pulmonary syndrome, Ebola, Lyrne disease, and ehrlichiosis.

Equally important was the rising incidence of many old diseasesthat had been known for centuries but effectively controlled since the r96os, such as malaria, dengrre fever, yellow fever, plague, West Nile fever, cholera, and tuberculosis.

Helping drive this dramatic global increase in infectious disease epidernics is modern transportation, which has not only opened the United States to rnore trade and travelers, but also to exotic infectious diseases.More integrated with the world than ever before, the United States should pause to consider the implications this has for its biosecurity.

DuaneJ. Gubler of the Divi -

is Director

sion ofVector-Borne Infectious

Diseases at

the National for Infectious

Center Diseases,

Centers

for Disease

Control

and Preven-

tron.

Biting the Magic Bullet. Lookinsat the historyof infectious diseasesover the past fifty years helps to put the present situation into perspective. The twentieth century saw both triumphs and failures. The triumphs came mostly in the first seventyyears of the century and resulted from a high level of understanding of the ecology of infectious diseasesand a focus on diseaseprevention. The failures occurred when the medical establishment became complacent. Medicine came to

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rely too rnuch on the "quick fix" or "magic bullet" approach to diseasecontrol while concurrently de-emphasizing diseaseprevention.'

A major casualty of this "age of rnagic bullets" was preventive rnedicine. The shift in emphasis to curative medicine has resulted in a whole generation that has no

the Pacific. Plague was no longer a major public health problem, while antibiotics, vaccines, and other new wonder drugs effectively controlled most other important infectious diseases.These successes ushered in an era of complacency in the r97os that continued through the waning years of the twentieth century until today.

MediCine Came tO relytoo rnuchon the

"quickfix" or "rnagic bullei"_approa-chto disease co^ntrol while concurrently del ernphasizing diseaseprevention. concept of prevention; rrrany primary schools no longer even teach basic hygiene. Add to this the deterioration of public health systemsto the point where they are unequipped to deal with infectious diseasesin general, and in particular with vector-borne diseases-those that require a blood-sucking arthropod to transrnit disease between humans and other hosts-and we have a situation at the beginning of the twenty-first century that is highly perrnissive for epidemics.

For centuries, vector-borne diseases have been among the most important public health problerns. By the rg6os, a focus on breaking the transmission cycle at its weakestlink-the arthropod vectorhad effectively controlled many of these diseases.The successeswere significant.

Malaria had been eliminated in North America and Europe and effectively controlled in Asia, the Pacific Rim, and Central and South Arnerica, and progress in controlling the disease had also been made in Africa. Urban yellow fever epidemics had been effectively controlled in both Africa and the Americas, as had dengue fever in the Americas and

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This cornplacency, and the policy decisions that followed, set the stage for today's resurgence of epidernic infectious diseases.In the rgTos and r9Bos, limited resou.rces were redirected to rnore prorninent public health problems such as chronic diseases. At the sarne tirne, rnedical schools and other training institutions ernphasized curative rather than preventive medicine. Meanwhile, a revolution was occurring in biomedical research as major advanceswere rnade in rnolecular biology and tropical medicine. Most of the funds available for researchwere also spent on curative medicine and the development of high-technology solutions to health problems.

With decreasedfunding for field research on disease ecology-epidemiology and prevention, it became more difficult to attract bright young scientists into fields such as vector biology.

In 2oor, vector-borne diseaseslike malaria and dengue hemorrhagic fever are among the most serious public health problems in many countries where there are no properly-trained vector biologists in the ministries of health."

G U B L E RB | O A I C T I

Demographic and Societal ChangeS. In the past half-century

Changing agricultural practices, driven by population growth, have also contributed to the resurgence of infectious diseases. Many dams and agricultural irrigation systems built in the past fifty years were designed without consideration of their effect on infectious disease transmission. Deforestation has accelerated in developing countries as the need for rnore agricultural land has increased.

Sorne irnportant ernergent and resurgent vector-borne diseases associated with urbanization, deforestation, and changing agricultural practices in the past thirty years are listed in Thble r.a

there has also been unprecedented growth in the hurnan population. Projections indicate that the world's population will reach 8.3 billion by 2o2g and ro billion by 2ogo. This growth has largely occurred in developing countries and is the driving force behind rnany of the demographic and societal changes that have influenced the resurgence of infectious diseasesin the past thirtyyears.

Future prospects are not good. Projections suggestthat nearly 9$ percent of the world's population growth in the next twenty-five years will occur in developing countries. This Thble r. Influences on ernergent/resurgent growth will primarily take vector-borne diseises. place in urban centers-many ofwhich are in tropical areas U R B A N I Z A T I O N where vector- and waterDengue fever M a l ar i a rnost borne diseases occur fever Yellow frequently.3 ngunya C h i c k u Population pressure has Epidemic polyarthritis resulted in unplanned and West Nile Jever uncontrolled urbanization.

St, Louis encephalitis In the past few decades, L y m ed i s e a s e hundreds of rnillions of Ehrlichiosis Lym€disease people, mostly in developPlague ing countries, have rnoved to urban centers to seekbetMany societal changes that may be ter lives. Populations in cities have increased drarnatically during this time, indirectly linked to population growth have also had important influences on and it is projected that this trend will infectious For disease incidence. continue well throughout this century. instance, rnost of our consumer goods Much of the urban poor lives in inadeare packaged in non-biodegradable plasquate housing in areas with unreliable or nonexistent water, sewage,and solid tics and tins, which when discarded into waste rnanagernent systerns.These conthe environment collect rainwater and d i t i o n s a r e c o n d u c i v e t o i n c r e a s e d becorne ideal breeding sites for mosquirnosquito -borne, of toes. Also, as the number of automobiles transmission in the world increases, so does the nurnrodent-borne, water-borne, foodborne, and sexually transmitted dis- ber of used tires. These are difficult to eases,and lead to increased frequency dispose of and, alongwith other discarded iterns, rnake ideal larval habitats for of all kinds of epidemics.

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mosquitoes and harborages for rodents and other vermin.

Modern transportation has played a very important role in the resurgence of infectious diseases.In particular, the jet airplane has had a major influence on global demographics, providing the ideal mechanism for the movement of pathogens between population centers. A person can travel to almost any part of the globe in thirty-six to forty-eight hours, and if he happens to be infected by a pathogen before he leaves, he could potentially introduce that disease to his destination. The sarneapplies to animals.

With container shipping, organisms that act as vectors and reservoir hosts for pathogens are transported around the world. For example, in the past twenty years, four exotic mosquito species have been introduced and established in the United States;three of these are potential vectors of local diseases.According to the U.S. Department of Transportation, an estimated 6o million people from the United States traveled to a foreign destination in 2OOO, compared to an estirnated 20 million people in r983-an increase of 3oo percent.5 As the rnovement of people, animals, and commodities continues to increase, so will the movement of pathogens of all kinds.

TWO CaSgS. The global epidemic of HIV/AIDS is the best-known example of a newly-emergent disease and its impact on the world. Less well known are epidernics of vector-borne diseases that have been occurring with increasing frequency in recent years. In fact, a significant proportion of the major worldwide infectious disease epidemics in the past twenty years consisted of vector-borne diseases that had been major public health problems in the past. These

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include malaria, dengrre fever, yellow fever, and plague-diseases that were effectively controlled by the rg6os but that have recently resurged.o A casestudy of two diseaseswill illustrate the impact of infectious diseases on the United S t a t e sa n d t h e w o r l d .

The Plague in India. Theplague was likely introduced to India in the late r8OOs;between I$OO to 1925, it is estimated that 12 million people died as a result.TEffective prevention and control prograrns focused on reducing rat and flea populations. Ultimately, the use of antibiotics resulted in control of the plague by mid-century; the last-reported hurnan case of plagrre in India prior to 1994 was in rg66. Many public health officials had naively thought that the plagrre had been eliminated from the subcontinent. By Igg{,, there were few institutions in India that even had the laboratory capability to reliably diagnose the plagrre.

In Augrrst r994, an outbreak of plague occurred among rats in Maharashtra in western India. There were no hurnan casesor deaths reported, and this incident was not reported to the World Health Organization. In Septernber rgg{., an outbreak of a highly fatal disease of unlnown etiology occurred in Surat, Gujarat, about lOO kilometers north of Mumbai (formerly Bombay). The afflicted were primarily adult males who exhibited fever and non-specific signs and symptoms followed by pulrnonary hemorrhage and often death.8 The Indian medical community had not seen a disease like this before. Samples from patients were sent to New Delhi for laborator/ diagnosis; the results were equivocal, causing confusion and uncertainty.

Although several infectious agents were

G U B L E RB i O A l C T t

suspected, based on clinical and pathologic observations, it was concluded that this was an outbreak of pneumonic plagrre. When the suspected etiology was announced, the human-to-human transmission and the potential for explosive epidemics of pneumonic plagrre caused panic. In the first two weeks of October an estimated 5oo,ooo people

tries wanting to develop diagnostic capacity, including India. It also sent two teams of scientists to India to help set up laboratories and investigate the epidemic.

Finally, the CDC developed educational materials that were transmitted electronically to public health officials around the globe. In the United States, the CDC established intensified airport surveil-

have Four exotic mOsquitospecies been introduced and establishedin the United States in the past twenty years; three of these are potential vectors of local diseases. fled the city of Surat, going prirnarily to other urban centers in India where the principal international airports were located. Within days, secondary cases were reported in cities such as New Delhi, Murnbai, Chennai, and Kolkata, and an international public health emergency was initiated as thousands of people boarded airplanes in India and flew to all corners ofthe globe.

The lack of a definitive laboratory diagnosis, the uncertainty and confusion, and the subsequent panic that occurred in India created sirnilar confusion and uncertainty in countries around the world. Some countries terminated all transport (sea and air) communications with India. Others drastically curtailed airplane flights in and out of the country as thousands of visitors cancelled their visits to India. Most countries with direct or indirect air connections to India implemented intensified surveillance for plague. The Centers for Disease Control and Prevention (CDC) in the United States provided diagnostic reagents and laboratory test protocols to many coun-

lance for suspected plagrre cases at all major ports of entry. International health regrrlations, which were implemented for the first time in several decades, required airplanes to call ahead to report any suspected illness among passengers on a flight. U.S. Public Health Service quarantine officers met airplanes with such passengers and all such reports were investigated before passengerswere allowed to deplane. Passengerswith suspected plague were quarantined for observation. In all, the CDC investigated thirteen such patients, none of whorn had plagrre infections.e In the end, plagrre was confirmed as the etiology of the cases in Surat, but there were relatively few patients. The Indian epidemic was primarily one of panic, not plague. Lack of laboratory diagnostic and epidemiologic capacity led to confusion, lack of confidence, and ultimately panic. The government of India estimates that the incident cost the country $2 billion; other estimates accounting for lost tourism and commerce were as high as $3 billion.'" Coun-

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tries around the world, including the United States, experienced economic lossesfrom this epidemic as well; however, no good estimates of their extent exist. It is clear that this epidemic, which should have been a relatively unimportant local public health event, cost the global econolny several billion U.S. dollars. Had India possessedadequate laboratory diagnostic and epiderniologic capacity, and had effective international surveillance for infectious diseasesbeen in place to provide governrnents with accurate and reliable information rather than inflammatory mass media reports, these costs could have been prevented.

The West N ile Virus. In lateAug'st 1999 a cluster of eight cases of viral encephalitis were reported in a section of northern Qreens, New York City. AII patients had signs and symptorns consistent with viral encephalitis. Seven of the eight patients also experienced severe muscle weakness,however, which alerted New York City health officials that these casesrnight be unusual. Initial laboratory diagnostic tests were positive for flavivirus infection, and the serology, combined with the clinical and epidemiological data, suggested infection by St. Louis encephalitis virus, a flavivirus which is the enzootic-epidernic in animals-in United States. Based on these results, intensified surveillance and mosquito control rneasrrreswere initiated immediately. By the third week of September, viruses had been isolated from both birds and mosquitoes and were identified not as St. Louis encephalitis but as the closely-related West Nile (WN) virns, an exotic African disease.

WN virus was first isolated in the West Nile Province of Uganda in rgg] in a person with febrile illness. IJntil recent-

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ly, its known geographic distribution included Africa, the Middle East, and West Asia; epidemics of WN virus were uncommon and when they did occur were primarily mild." In the past six years, however, increased epidemic activity has been noted in Africa, the Middle East, Europe, and for the first time in history, the United States.

The New York City epidernic was detected by an alert infectious disease physician who reported sorne unusual casesof neurologic illness in Queens to the city health department." By this time, however, the outbreak had already peaked. Retrospective and prospective surveillance showed that the earliest onset of illness identified was on August 2 and the lateston Septernber22, 1999. Of sixry-tuo total casesin the New York City area, fifty-nine were hospitalized with encephalitis, rneningitis, or both. There were seven deaths-a casefatality rate of rr percent. The severe neurologic disease and deaths occr.rred prirnarily in elderly persons over the age of fifty.'3 Concurrent with the human epidemic, but unknown to public health authorities, an epizootic was also occurring in birds and horses. It was determined retrospectively that bird die-offs, primarily amongArnerican crows, had been occr.rrring in New York City since early July, and that an outbreak in horses occurred in the Riverhead area of Long Island in August and September. Investigation revealed that both epizootics were caused

by WN virrs.'{ The natural life cycle of WN virus involves transrnission to birds by mosquitoes. This virus was not normally known to kill birds, so it was not until the virus was isolated from the brain of sick birds that the connection was rnade to the hurnan epidernic.'5 Epizootic WN virus activity in birds was ultimate-

G U E L E RB | O A I C T I

ly detected in New York, New Jersey, Connecticut, and Maryland in rggg.'b Although this was a relatively small outbreak in terrns of human cases and deaths, it becarne a major media event primarily because it involved an exotic virus and occurred in New York City.

The New York City Health Department responded appropriately and initiated rnosquito suweillance and control as soon asWN was identified as a mosquitoborne virus. Very quickly the city established an effective outreach progran to educate the public about the diseaseand how to protect oneself frorn rnosquito bites to reduce the risk of infection.'7 It purchased and distributed insect repellent and advised people on how to control mosquitoes that rnight be breeding on their property. The Department also contracted with a private mosquito control company to spray insecticides for adult rnosquito control.

In November, after transrnission had stopped, the CDC and the U.S. Department of Agriculture brought together both national and international experts to review the data from the epidemic and draft guidelines for surveillance, prevention, and control. Recommendations frorn that rneeting included monitoring for possible overwintering in mosquitoes (a process by which the virus lies dorrnant in the species, only to potentially emerge later on), implernenting early spring surveillance in the bird populations, executing early spring control of Culexspecies mosquitoes that might carry the virus through the winter and amplifr it in the spring, and developing a more effective national surveillance plan for WN and ot}er related arboviruses (viruses transmitted chiefly by art}ropods).'u These recommendations were irnplemented and WN virus was isolated from

overwintering Culer pipiens mosquitoes collected in New York City in January and February 2ooo. New York City treated over I$O,OOO storm drains with insecticide to kill larval mosquitoes in the spring of Zooo. Additionally, dead bird surveillance was initiated in twenty-two Iocal and state health departments along the east and Gulf coasts of the United States-areas where the potential for WN virus activity was projected based on known bird rnigration patterns.

The surveillance, prevention, and control plan was successful. Spring transmission to birds was detected in May 2ooo, although retrospectively laboratory investigation identified a WN-positive bird as early as April rst.

Widespread epizootic WN virus activity was detected before the first hurnan cases occurred. That year, the virus was detected in birds in twelve states and the District of Colombia.'s In 2OOO, only twenty-one laboratory-positive hurnan cases were documented despite the intensified surveillance and widespread epizootic activity in the northeastern parts of the country.

It is likely that the early spring larval rnosquito control, the continued adult rnosquito control, and the public outreach prograrns to reduce risk of human infection played a major role in preventing illness.

It is not known how WN virus was introduced into the United States. Possibilities include infected persons, birds, or rnosquitoes traveling frorn an area where recent epizootic activity has been documented, such as the Middle East.

Another possibility is purposeful introduction by terrorists.'a While it is not known for sure which of these was the mechanism, all available evidence suggests that this was a natural introduction -

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which major epidemics, whether local or global, usually begin. In today's era of modern transportation, pathogens move freely between cities, countries, and regions. The result has been the globalization of infectious diseases. The organisms that cause disease know no national boundaries, and if one of these agents is introduced into an area that is conducive to transmission, an epidemic or epizootic can occur. The WN virus is a classic exarnple of this phenornenon; the virus was introduced into an area where the bird (and hurnan) populations were susceptible to infection and where there were cornpetent rnosquito vectors that could effectively transmit the million total) for 2oor. The bulk of this virus locally. With the increased movernoney was passed on to state and local ment of people, animals, and comrnodities between countries and regions health departments in order to irnprove of the world, this scenario will occur surveillance, prevention, and control in more and more frequently. the spring and surnrner of 2oor.

The United States,like all other counThe United States's experience with WN virus during rggg and 2ooo suggests tries, is at risk of suffering epidemics caused by the introduction of exotic that the virus has becorne established in this country and will continue to expand pathogens. The hundreds of dengue fever and malaria casesthat are irnported its geographic range in the years to This resulted first each year are evidence of the regrrlarity epidemic that come.'o frorn an epizootic demonstrates once with which this occurs."' The plagrre and again the easewith which exotic pathogens WN virus epidemics illustrate that the United States is at increased risk as the can spread to new geographic locations in today's era of modern transportation and global economy and modern transportation continually shrink the world to a the increased movement of humans, animals, and cornrnodities. It also underglobal village. Although the economic scores the inadequacy of state and local irnpact of globalization can be great, the public health impact can be devastating. public health infrastructures in dealing There are important lessons to be with epidernic vector-borne diseases."' learned from the experience of the past thirty years. First, it is unlikely that we United States? Theslobalresur- will eradicate many infectious diseases gence of infectious diseasesclearly has a from this planet; they are here to stay and we must develop effective, sustaingreater impact on areas in the developable prevention and control programs ing world where public health infrastructure is lacking. These are the areas to reduce human morbidity and mortality. Second, we should not become where pathogens are maintained and in most likely by a person who was infected in the Middle East, got on an airplane, and traveled to Queens, NewYork, where he was bitten by local mosquitoes that became infected in turn and triggered a local transmission rycle in birds.

There is no good estimate of the economic irnpact of WN virus on the United States. New York State estimated that the rggg epidemic cost it in excessof $3o million. The CDC provided several rnillion dollars through cooperative agreements to state and local health departments in 2ooo, but this was only a very srnall proportion of the total arnount of money spent by local jurisdictions. Congress has provided an additional $zo million ($25

What CouldHappento the

Izzl

GeorgetownJournal

of International

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G U B L E RB I O A I C T I

complacent after a few successes.We must learn from the experience of the rglos that infectious diseaseswill return in epidemic form when resources are redirected and prevention programs terminated. Third, we should not place all of our research emphasis on hightechnology, "quick fix" solutions. There are sorne diseasesthat will not be effectively controlled in this manner; thus the emphasis should be placed on sustainable surveillance, prevention, and control prograrns. Lastly, because

infectious diseases know no national boundaries, we must develop and international implement effective and collaboration in these cooperation programs. Only by knowing what is happening to our neighbors can we predict what will happen to us. Fortunately, effective prevention and control of epidernic infectious diseases can be achieved by building global public health infrastructure, and by developing international surveillance and inforrnation exchange prograrns.

NOTES r DJ.

Gubler, "Prevention and Control

ofTrop-

ical Diseases in the 2rst Century: Back to the Field," Presidential address presented at the 49th annual meeting of the American Society of Tropical Medicine and Hygiene, 3I October 2OOo. A Cuide z World Resources Institute, WorldResources, to the Clobol Enuironment' The Urbon Enuironment1996-tgg7 (Oxford IJniversity Press: Washington, D.C., 1996).

Diseases 3 DJ. Gubler, "Resurgent Vector-borne as a Global Health Problem,"

EmerginglnfectiousDrseues {

(r998),442-5o.

2ooo sta{. U.S. Department of tansportation tistics.

Diseases as a $ Gubler, "Resurgent Vector-borne Global Health Problem" 4+2-50.

6 K.L. Gage, "Plague," Toplg &Wkon's Microbiolog and Miuobial Infections,Volume 3, eds. WJ. Hausler and lJniversity Press, M. Sussman (New York, Oxford

r998). / V. Ramalingaswami, "The Plague Outbreaks of India, 199{.-A Prologue," Current Science7t (t996),

( B o c a R a t o n , C R C P r e s s ,1 9 8 9 ) , 5 9 - 8 8 . r2 D.S. Asnis, R. Conetta, A.A. Teixeira, et al., "The West Nile Mrus Outbreak of 1999 in New York, The Flushing Hospital Experience," ClinicolInfectiow Diseoses 30(2ooo). 4ry-8. r J D . N a s h , F . M o s t a s h a r i ,A . F i n e , e t a l . , " O u t break of the West Nile Mrus, New York City Area, Medicine rgg!," "Meuf4/ondJournolof !{{ (zoor), 18o7r814. r 4 .R . S . L a n c i o t t i , J . T . R o e h r i g ,V . D e u b e l , e t a l - , "Origin of the West Nile Virus Responsible for an Outbreak of Encephalitis in the Northeastern IJnited S t a t e s ," S c i e n c2e8 6 ( 1 9 9 9 ) , 2 3 3 3 - 7 .

1 5 K . E . S t e e l e ,M J . L i n n , R J . S c h o e p p , e t a l . , "Pathologyof FatalWestNile Mrus Infections in Native and Exotic Birds during the 1999 Outbreak in New York City," VeterinogPotholog 37 (zooo), 208-24. t 6 D J . G u b l e r , G . L . C a m p b e l l , R . S . N a s c i ,e t a l . , "West Nile Mrus in the United States' Guidelines for Detection, Prevention, and Control," VirolImmunolog

, 69-75. r 3 . 4( z o o o ) +

l8r-8o6.

8 C.L. Fritz, D.T. Dennis,M.A. Tipple, et al.,

Nile Mral

"Surveillance

r$$$:

States during for Control

for

Pneumonic

an International of Imported

Plague in the United Emergency,

Emerging

A Model

Diseases," Emerging

Diseues2 (January- March r99 6), 3o- 36.

I nfectious Plogue-lndio r!!.1': 9 World Health Organizarion, (Geneva, WHO, -Economicloss ry97). 4. roJ.T.Jacob,

"Can Plagues Be Predicted?," lcncet

3 5 4 ( 1 9 9 9 )2: o o o . ''West lI

C.G.

Hayes,

r/ A. Fine and M. Lay'ton, "Lessons from the West Encephalitis

Implicatons

Outbreak

in New York

City,

for

Bioterrorism Preparedness," Clinical InfectiousDreorer32 (Z oor)' 277 -82. t8 Cubler. et al. 469-75.

'West Nile 19 A.A. Martin and DJ. Gubler,

Encephalitis, An emerging Disease in States. " Cliniccl1nfectiou:D iseose s (z oor).

the United

zo Gubler. et al.469-75. and Fine, et"al.277-82. eral.469-75 Diseases as a 22 Gubler, "ResurgentVector-borne Global Health Problem" ++2-50.

2r Gubler,

Nile

Epidemiolog and Ecolog, Volume

Fever," The Arbouiruses' V,

ed. T.P.

Monath

Summer/Falleoor IZ3J

Bioalert

Maureen Lewis Infectious and parasitic diseaseshave alwaysbeen part of man's existence. Only occasionally, however, does a single infectious agent transform societies and their economies with devastating results. Where infectious diseasehas swept through communities, countries, or continents and causedsharp increasesin diseaseincidence and high mortality, it has been due to a set of unique circumstances that enhanced the risks of infection.

Such epidemics have only rarely had significant national and international econornic impacts, although diseasehas played an irnportant role in destabilizing rulers and tipping the balance in cornbat.' Nevertheless, the influence of disease on econornic growth and well-being is an issue of increasing importance as new and virulent diseasesemerge and spread quickly across the globe, exposing the world to a whole new classof illnesses.

Increasingly, infectious diseasesare taking on the characteristics of "public goods"-affecting society at large and therefore requiring broad public intervention. Such pervasive effects have implications for economic and political stability. Profound epidernics hinder economic growth, which in turn determines government revenues and expenditures.

At the same time, losses at the household and community levels reduce income earning capacity and lead to greater reliance on the governrrrent for support just when government capacity is waning. This is what is occurring with AIDS in Africa and elsewhere.

Maureen Lewis is Sector Human

Manager

Economics

in Europe

and the Central Region Bank

for

Development Asian

at the World

in Washington,

D.C.

Summer/l.all 2OOI

t25l

T H E E C O N O M I C SO F E P I D E M I C S

Epidemicsand Economics: savings due

to loss of income and the

MgaSUfement. M"ururingthe eco- costs of treatment. In time, reductions in nomic impact of epidemics poses problems since health and economic development are intertwined. Lower levels of growth (or incorne as measured by GDP) are associatedwith worse health, and viceversa. Moreover, economic agents-individuals, households, firms, and governments-react to adverse health circumstances, making the impact hard to capture since adaptations occur constantly at all levels. To surmount these rneasurement problerns, Ainsworth and Over have divided the impact of illness into three stages:initial shock in the face of ill health or death; initiation of coping strategiesby economic actors as a response; and, finally, net outcornes on well-being that are adjusted according to the successof coping strategiesand represent the irnpact of an epidernic on the national econorny."

Their approach highlights a key point: Assessingthe economic irnpact of diseases requires measuring the effects of ill health and death at the microeconomic levelhouseholds and firrns-as well as their aggregation to the rnacroeconornic levelthe nationaleconomy.

Knowledge of the microeconomic impact of an infectious disease assists economists in understanding the disease's incidence and distributional impact within the economy. Epidemics can lead to rising rnortality of the heads of households. The most important consequence of this is a reduction in labor productivity. Illness of household heads leads to direct lossesof income and output-for example, in agriculture-that also hamper the productivity of other household labor, as time and energy are redirected to care for the primary breadwinner. The second-round response to disease-related shocks is reductions in

I Z6]

Georgetown Journal of International Affairs

savings lead to "disinvestments" in human capital, notably the education of children, and to the loss of productive assets,including land or housing.

Macroeconornic analysis captures the irnplications for both the sectors most cornmonly affected-such as health, education, agliculture, and social welfareand the overall economy. Such analysis presents difficulties, however. Since the macroeconomic level represents a cornplex interaction of individuals, households, firrns, and sectors,it becomes difficult to ferret out individual effects.

Indeed, poorly designed macroeconornic analysiscan generate distorted, inaccurate results. For exarnple, in caseswhere disease prevalence leads to dramatic decreases in population while GDP remains constant (possibly from lags in reporting), there will seem to be a rise in GDP per capita. Hence, selecting and applying appropriate rneasurement tools becomes critical to capturing the true economic impacts of disease.

In the aggregate, macroeconomic indicators measure growth in the factors of production, Iand, labor, and technology. Slower growth in any of these will retard overall economic output as measured by GDP. Common economic models used to predict impacts of disease on national production include dernographic projections that extrapolate from past trends to predict the course of the epidemic, and behavioral rnodels that predict the economic growth implications of diseasesand their intermediate effects on the economy.

AIDS,the UltimateEpidemic.

AIDS poses a distinct set of challenges. At the end of 2ooo, 36 million people were

L E W t sB i o a l e r t living with AIDS, of which g.J rnillion had been newly infected that year. Since the onset of the epidemic, almost 22 rnflion people have died, four-fifths of thern adults, reversing the gains in life expectancy in sorne developing countries back to the level of the rg$os.3 From an economic perspective,the concentration of victirns within the economically-active population (ages fifteen to forty-five) leads to dissolution of families, impoverishrnent of households, and low returns to investments in education.

sis, and data quality of each study. Implications at the household level differ from those at the macroeconomic level.

Considerable controversy surrounds the macroeconomic impact of the AIDS epidemic, partly because the evidence on the extent of effects varies and partly because data are uneven. Alternative assumptions concerning the pathways of effect, the timing and availability of data for ernpirical analyses, and alternative measures of irnpact lead to different conclusions.

AI DS iS ravaging Africa-in bothhurnan I

and econornlc terms.

The sharp rise in AIDS incidence is a worldwide phenornenon. Africa is the region rnost seriously affected, suffering the most rapid growth in AIDS over the past decade. Indeed, the ten countries with the highest prevalence of AIDS in the world are all African, with Botswana topping the list. By the end of 1999, they exhibited an adult prevalence rate of over a third of the economically-active population. Sorne developing countries, notably BraziI and Thailand, have aggressively addressed AIDS through effective prevention strategies, the only certain and affordable means of stemming the epidemic.a Yet throughout Africa as a whole there are few prospects for widespread treatrnent to prolong life given the prohibitively high costs. AIDS is ravaging Africa-in both human and economic terms.

For example, using a sarnple of fiftyone countries, Bloom and Mahal find no association between AIDS prevalence and levels of econornic growth. They likewise suggestthat the bubonic plagr.rehad little effect on European econornies in the fourteenth century, using real changes in wage levels as a proxy for income shifts.s On the other hand, Over predicts a reduction in per capita income of between o and ro percent for thirty subSaharan African countries.6 This larger impact derives from the assumption that the infection is concentrated in higherincorne individuals, whose illness would therefore disproportionately affect the level of per-capita income, and that a significant proportion of healthcare treatment is financed through reduced individual savings.

CountrT-level statistical analyses for Malawi, Tanzania, and SouthAfrica suggest a loss in GDP per capita between o and ro percent depending on assumptions made regarding the direction of the epidernic, the public costs of AIDS

CanAIDSInfecttheEconomy?

Conclusions on the economic impact of AIDS are mixed, being highly dependent on the assumptions, level of analy-

S u m m e r , / F a lzl o o r

[27)

T H E E C O N O M I C SO F E P I D E M I C S

treatment, and the effects of the epidemic on labor productivity.T But because developing countries hit hardest

by AIDS often face already high levels of unemployment, the effects of AIDS on employment levels and productivitywhen taken in the aggregate-can be hard

of average per capita income, which for the poor implies a significant mortgaging of future earnings.s InAfrican countries, where hospitalization is typically free, AIDS patients often represent over half of all bed occupancy and consume close to /g percent ofpublic budgets.

atrents I I I fAfrican In tl f lUdf l U AILIb p countries...

U U I I I f l t r ) . . . ArDS ^o..rrpu,

often represent orten represent over over nalr half or all bed of au Decl,occupan

cy

and con^surneclose to 7 5 percent of public

budgets.

to discern. Excess labor already exists; replacements are readily available.

Macroeconornic analysis, then, discounts shifts in labor productivity, which have a larger effect on households than they do on econornies as a whole.

Data gaps in behavioral responses of households and sectors, both public and private, complicate the economic modeling of responsesto the AIDS epidemic. Aggregate economic projections suffer frorn uneven information and measurement, but those frorn the studies above represent the best estimates for a handful of countries. The more specific and detailed the modeling, the greater the projected lossesin GDP per capita. As the epidemic ages,the quality and breadth of data make measurements more accurate.

Sectoral effects are more directly measurable. Take healthcare systems: Evidence from a sample ofAfrican countries suggests that the average total cost of AIDS treatment ranges from a low of $z9o in Thnzania to a high of $938 in Kenya, and projections estimate that this will continue to climb. Within households, such expenditures claim multiples

tZ8I

Georgetom

Journal

of International

Affairs

Analysis of the economic impact of AIDS at the firm level has received scant attention, though it is extremely relevant.

One study analyzed the irnpact of AIDS on Thailand's long haul trucking industry, showing the risks faced by individuals and the implications for th'e industry.e Thai enterprises in the formal sector finance rnedical care. sick leave. and death-related costs for employees, and bear the costs of both reduced output during disabiliry and of replacement and training when employees terrninate ernployrnent. The more skilled the worker, the more costly the replacement.

Recent studies in Africa indicate that prevalence arnong workers ranged between one-quarter and one-third.

Costs to employers come from low productivity, worker attrition, and training new workers. As a result, private companies must expend resources on launching prevention efforts to inform employees of what constitutes risky behavior and of rneans to avoid infection.

On the household level, the epidemic's economic impact emerges more clearly. Across countries the epidemic has led to greater inequality, because

LEWIS

mcome, which for nificant mortgaging 1 Mrican countries, 1 is typically free, represent over half and consume close ic budgets.

tients :cupancy ,ublic

onomic impact of I has received scant extremely relevant. he impact of AIDS lUI trucking indus­ faced by individuals for the industry.9 the formal sector e, sick leave, and )r employees, and th reduced output )f replacement and )loyees terminate re skilled the workthe replacement. frica indicate that workers ranged r and one-third. ,me from low pro­ tion, and training .lIt, private compa­ urces on launching lform employees of , behavior and of )n.

level, the epidem­ ct emerges more ries the epidemic nequality, because

infection rates vary within countries and across families. Those families whose breadwinners become infected will grow more impoverished not just from loss of income through reduced employment, declining remittances, and lower labor productivity, but also from the cost of treatment and the diversion of time among household members to nursing the sick and mourning the victim. lo Sex workers bear a disproportionate brunt of the AIDS epidemic in all countries, rein­ forcing the co ncentration of infection in lower income groups. As information has emerged regarding prevention, the better educated, who also tend to be the better off, have altered their behavior, leading to a more concentrated impact among lower income groups.

The economic impacts on survivors in these households can be extensive. The most important effects include shifting consumption toward lower-cost foods­ for example, cassava rather than maize­ raising the risk of malnutrition for both children and adults; allowing land to lay fallow due to lack of labor to manage its productive use; moving from cash to subsistence crops; selling productive assets to finance both consumption and healthcare; and reducing investments in human capital such as schooling. For example, in the Kagera region of Tanza­ nia, where AIDS accounts for over half of all deaths, farm incomes declined by over 25 percent during the 1990s due to the disease, leading to reduced food security.

In poor households, spending on food declined by almost one-third and food consumption by 25 percent in the six months following the death of a parent.

Similar findings emerge from various research programs in Zambia."

Compounding these effects, the poor face fewer and more costly coping

Bioalert

options due to a combination of limited access to resources, greater discrimina­ tion' decreased ability to cushion disas­ ter, and inaccessibility to formal institu­ tions like disability or health insurance.

Extended families appear to substitute for formal safety nets, although evidence from Tanzania's Kagera Region indicates that the poorest families are more likely to take out formal loans requiring collat­ eral and interest, while better-off fami­ lies rely on private, generally costless transfers from friends and relatives. 13 Widows face limited economic options. Often, land ownership laws prevent women from inheriting land. In some Mrican countries, women must resort to prostitution and bootlegging to survive, instigating a vicious cycle of infection."} A particularly tragic conse­ quence of the epidemic, particularly in Africa, is the increasing number of orphans. By the end of 1999, 121 million Mrican children were orphaned due to AIDS, as were over 200 million children elsewhere in the world. While a humani­ tarian disaster, the lack of parental income and care has alarming conse­ quences for the next generation, which will lack education and parental guid­ ance. This will pose serious economic challenges for the future.

I.

Economic Anti-Virus. The evidence on the economic impact of AIDS is mixed. At the household level, labor shortages jeopardize the well- being of the family, but at the sectoral and national levels, the excess labor in the overall econ­ omy leads to projections of uncertain impacts. Over time, where the epidemic is not stemmed, the devastation is likely to reverberate throughout the economy.

The sheer number of orphans in coun­ tries already struggling to maintain posi­ Summer/Fall2001 [29]

T H E E C O N O M I C SO F E P I D E M I C S

tive economic growth will create a drag on the econorny. Statewelfare investments to ensure the survival of orphans and the elderly become essential where the economically-active population that supports and caresfor both groups is lost to AIDS. Nonetheless, these demands divert governrlent expenditures away from investments in education, roads, water supply, and other factors that foster econornic activity toward consumption, thereby undermining the foundations of economic growth. Econornic rnodels capture these phenomena imperfectly, but the consequencesare realSternming the AIDS epidemic and others like it confounds public health experts and governments alike. The "invisible,"

dence through aggressiveefforts among commercial sexworkers. In Brazil, transgression of international property rights of drug patents---rvhatever its legal flawshas allowed affordable treatrnent, and public service rnessagesinforrn the public of sensible means of prevention, such as condorn use. In all cases,policies have had to go beyond traditional efforts to convince government and non-government bodies alike of the need to take aggressive action. Those countries that have been successfulhave faced the challenge and altered their approach to the diseaseand its control.

The role of the governrnent in identifying, measuring, and addressing the problerns of rising infectious disease behavioral-based nature of AIDS, its easy incidence is key. Though the public transmission through international health systemrepresentsthe front line of migration, the lag between infection and intervention, diseaseslike AIDS cannot the onset of symptorns, the enorrnous cost be effectively addressed through it alone. of treatment, and the social costs that Moreover, becausethe impacts of disease linger after death make AIDS a global haz- are felt increasingly beyond the health ard. Becauseit affects not only health, but sector, the responsibility for repelling also overall economic well-being, AIDS is a n d r e s p o n d i n g t o e p i d e m i c s n o w no longer the purview of health experts extends beyond the public health system alone, but is a national challenge that to include the private sector, the judiciarequires rnultiple levels of decision-rnakry, and welfare agencies. Indeed, private ing to ensure national consensus on an companies in Africa are investing heaviappropriate response. Only national ly in AIDS inforrnation and counseling. policies addressing prevention, disabillty, The need for comprehensive strategies healthcare access, tradeoffs between and a strong political stance requires investment and consumption, and intercentral governments, along with parliaventions to control the epidernic can conrnents and local governments, to be strain this affliction. active in the effort to squash diseaseslike Potential models already exist. ThaiAIDS. Without such commitment, sociland successfully reduced AIDS inciety worldwide is at risk.

N O T ES t William

H. McNeill,

(NewYork, PlaguesondPeoples

Doubleday, r998).

2 Martha Ainsworth and Mead Over, "The Economic Impact of Aids, Shocks, Responses and Outcomes," World Bank Technical Working Paper No. I (Washington, 1.C., r99z).

3 UNAIDS,

I g o]

NDS Epideni Updote: Decemberlooo,

Georgetown.lournal of International Affairs

Joint United Nations Programme on HIV/AIDS (Geneva,UNAIDSAVHO. zooo).

4 Tina Rosenberg, "How to Solve the World's AIDS Crisis, Look at Brazil," TheNeuYorkTimes Masoline Z BJ a n u a r y2 o O t , s e c t i o n6 . g David E. Bloom and Ajay S. Mahal, "AIDS, Flu, and the Black Death' Impacts on Economic Growth

LEw ts Bioalert and Well-being ," The Economisof HN and AIDS' The Caseof Southand SoutfrEastAsia, eds. David Bloom and Peter Godwin (New Delhi, Oxford University Press, rgg/).

6 Mead Over,

"The

Macroeconomic

Impact

Aids in Sub-Saharan Africa," World Bank Working Paper (Washington, D.C., rggz).

of

Reseatch

7 John T. Cuddington and John D. Hancock, "The Macroeconomic Impact of AIDS in Malawi, a Dualistic, Labour Surplus Economy," Journal of Africon E c o n o m i e4 s.r (I995), r-28; John T. Cuddington, "Modeling

the Economic

Effect of AIDS, with an 'lhe World Bonk EconomicReuiew

Application to Tanzania."

7.2 (May rggJ); and Channing Arndt Lewis, "The Macro Implications of

Anna

Economic

Welfare in Peasant Agriculture:

ies from

Tibaijuka.

Kajumulo

and

Case Stud-

Kagabiro Mllage, Kagera Region, tnzania," (1997), 963-g75; and K. C. S. Pandat, and L. M. Nath, "lmpact of

W o r l d D e t e l o p m e n2f 5 . 6 Anand,

HIV/AIDS on the National Polig47 (1999), r95-2o5.

Heolti

Tibaijuka,

Peasant Agriculture:

Case Studies from

lage, Kagera Region.

Thnzania";

andJe{fi'ey D.

AIDS

Southeast Asia:

Kagabiro Ml-

and UNAIDS,

HIV/AIDS

in

of India,"

and Over. "AIDS and African Devel"AIDS and Economic Welfare in

tt Ainsworth opment";

Economy

EpidemicUpdote:Decenber2ooo.

12 Myo Thant, "The Economic

in

"AIDS

opment";

Equity

,41DS

Implications of Considerations,"

South Africa:

A Preliminary Assessment," SouthAl'ricsn (December 2OOO). l o u r n o lo f E c o n o m i c6s8 . 5 8 Martha Ainsworth and Mead Over, "AIDS and African Development," The World Bqnk ReseorchObseruer 9.2 (1994)' 2o3-40.

EconomiclmplicotionsofAIDSinAsio, eds. David E. Bloom andJoyce V. Lyons (De'lhi: United Nations Development Programme, 1993). S.. also Bloom and Glied, "W}o is Bearing the Cost of the AIDS Epi-

9 Patrick Giraud, "The Economic Impact of AIDS at the Sectoral Level, Developing an Assessment Methodology and Applying it to Thailand's Transport Sector, " EconomicImplicationsof AI D S in Asio, eds. David E.

and

and Joyce V. Lyons (Delhi, Development Programme, rggJ)Bloom

ro David E. Bloom

United

Nations

demic

in Asia?";

Economic

Systems and

is

Research

tems and Livelihoods

in Rural Africa,

ence and Lessons from

Some Experi-

Uganda, Tlnzania and Zamb i a , " J o u r n c lo J ' l n t e r n a t i o nD o le u e l o p m e n7t. r ( I g g 5 ) , I 6 3 I76i Ainsworth and Over, "AIDS and African Devel

in

Rural

on

Social

Farming

Africa,

Case Studies from

Some

Kagabiro

Region, Thnzania"; and Pandav, and Nath, "lmpact of H|V/AIDS

holds

Sys-

et al.. "The

HIV/AIDS

Kagera

and Economic

on Farming

Livelihoods

in Peasant Agriculture:

Bearing the Cost of the AIDS Epidemic in Asia?" EconomiclmplicotiorcofAIDSinlsic, eds. David E. Bloom and Joyce V. Lyons (Delhi' United Nations Development Programme, rgg!);Tony Barnett et al., "The Social Impact of HIV/AIDS

of

Experience and Lessons from Uganda, Tlnzania and "AIDS and Economic Welfare Zambia"; Tibaijuka, Mllage,

and Sherry G'lied, "Wlro

Tony Barnett

Impact

Anand, on

the

National Economy of India." r3

Mattias Lundberg, Mead Over, and Phare "Sources of Financial Assistance for House-

Mujinja,

Suffering

an

Working

Adult

Paper

Deatli," 2gO8

World Bank (Washington,

Economic

Welfare

No.

D . C . .z o o o ) . r{, Tibaijuka,

"AIDS

PeasantAgriculture:

and

in

Case Studies from Kagabiro Ml-

lage, Kagera Region, Tanzania."

Summer/Fall zooT

[ 3I ]

Bioalert

--

Hazardous World TheRealRiskof Bioterrorism Eric K. Noji Despite their current notoriety, biological weapons are not new. Two of the earliest reported r.rsesoccurred in the sixth century B. C. when the Assyrians poisoned enemy wells with rye ergot and Solon used the purgative herb hellebore during the arrny siege of Krissa. In r!{6, plague broke out in the trtar as it sieged Kaffa in the Crimea. The attackers hurled the corpses of those who died over the city walls, and the plagr-re epidemic that followed forced the defenders of the city to surrender. Some infected people who left Kaffa may have started the Black Death pandernic that spread throughout Europe and killed one-third of the population. Indeed, the destructive power of biological weapons has long been known. \tt biological weapons have not always been understood.

Biological weapons differ fundamentally from other weapons of mass destruction and therefore require a unique response.

Whereas nuclear and chemical weapons cause imrnediate casualties,biological agents require hours, days, or even weeks of incubation before they causefatalities. This delay gives such agents special advantagesas terrorist weapons.' Barring an announcement by the perpetrators of the attack or a fortuitous discovery, a biological attack could only become known hours, days, or even weeLs after its execution, when victirns begin to appear in doctors' offices and hospital emergency

Eric K. Noji is Associate

Director

of the Bioterrorism Preparedness Response

the National for

and

Program

lnfectious

at

Center Diseases,

Centers for Disease Control

and Preven-

tron.

S u m m e r / F a lzl o o r [ 3 3 ]

H A Z A R D O U SW O R L D

rooms.2 Sufficiently subtle biological terrorist attacks might even go unrecognized for longer periods.

Many of the pathogens potentially used as agents of bioterrorism initially cause symptoms that are very sirnilar to cornrnon illnesses such as the flu, making the detection of biological attack extremely difficult. Early in an epidemic, it is difficult even for seasonedclinicians to distinguish between patients with the common cold or allergic sinusitis and those in the early phasesof pneurnonic plague.3 Once news of the epidemic reaches the public, the resulting rush to hospitals and rnedical facilities by thousands of the "worried well" is likely to be a major patient managernent disaster in itself.

Moreover, although conventional military users of bioweapons do not desire high contagiousness because it could an epidemic that might produce boomerang on the attacking forces, terrorists may consider contagiousnessan asset. Contagious agents can spread disease far beyond the population initially exposed in the attack, arnplifring destruction with minirnal effort. For exarnple, the two- to three-day incubation period penis)is long enough to for plagrre f1[ersinia allow victims of an attack to travel by air between virtually any two cities in the world before seriously becoming illespecially if the organisms were released in the departure area of a rnajor international airport or train station.

The unique qualities of biological weapons underscore a key point: Preparing for bioterrorisrn requires improving the recognition and inforrnation-sharing mechanisms of existing public health surveillance systemswithin the United States and overseas. Domestically, physicians and other healthcare workers must be given the training needed to recognize or at

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least suspect unusual diseases.The ability to check these suspicions rapidly at the local, state, regional, and national levels rnust be available. Within the U.S. governrnent, coordination arnong public health, law enforcement, and intelligence agencies should be strengthened.a Internationally, the United Statesshould work with foreign governrnental, rnultilateral, and non-governmental organizations to improve global surveillance for suspicious outbreals. In this context, responsibility for national security extends throughout society-frorn prirnary care physicians and pathologists at local hospitals and clinics, to state and national health laboratories and officials, to overseas public health surveillance networks. 5

MorePlayers.

MoreTechnology, Before exarnining the problerns of responding to bioterrorisrn and the irnportance of irnproving public health surveillance systerns, a discussion of the spread of biological weapons is helpful.

The hurnan and technical resources needed to develop biological weapons programs are proliferating throughout the world. While it may still be true that rnost developing countries lack the rnicrobiological capacity to develop biological warfare agents, eight or rnore developing nations have been irnplicated in developing offensive biological warfare Russian capabilities.o A prorninent defector has alleged that Russian scientists have used genetic engineering to produce antibiotic-resistant strains of a number of disease organisrns.T Some of this research has been published in open literature and therefore is available to other nations seeking to develop biological weapons capacities.InJanuary rggB, Iraq reportedly sent approximately one dozen scientists to Libya to help develop

NoJtBioalert a biological warfare complex near tipoli that was disguised as a medical facility.8 In a report issuedin November rgg/, thenSecretary of Defense William Cohen singled out Libya, Iraq, Iran, and Syria as countries "aggressivelyseeking" nuclear, biological, and chemical weapons.e Tlke Iraq's program, for example. Fermenters found in the Al Hakan plant in Iraq hadvolume capacitiesof r,$oo liters.

Organic solutions produced in these ferrnenters can achieve concentrations of roo,ooo lethal doses per milliliter with approximately one billion spores of anthrax per milliliter-a weapon of mass lethality. Iraq has subsequently admitted to the United Nations Security Council Obserwer Mission (UNSCOM) that it was able to produce about B,ooo liters of concentrated anthrax solution; UNSCOM suspects that Iraq actually made ten times this amount.

That is to say nothing of the nonstate-basedthreat. Biological and chernical agents are now demonstrably within the technical expertise of non-state groups, and even primitive and inefficient versions of these weapons could wreak economic or psychological devastation. The Aum Shinrikyo cult, for example, was a multinational tenorist group intent on the development and deployment of an array of weapons of mass destruction. Aum Shinrikyo's release of sarin nerve agent in the T"ky" subway systernin Igg$, not to mention the group's attempts to attack T"ky" using anthrax and botulism, indicates that large-scale terrorist attacks on civilian populations using weapons of mass destruction are no longer in the realm of fantasy. At least, the Tokyo attacls represent the crossing of a grim thresholdresulting in the weakening of longstanding taboos on attacking civilians

and positing an increased likelihood of analogous attacks in the futur-e.

Lax oversight of former Soviet technologies has exacerbatedthe problem of proliferation. As the United States and its allies learned frorn high-level Soviet and Russian defectors in the early rggOs, the USSR took advantageof loopholes in the rg/2 Biological Weapons Treaty and scientific advancesin genetic research to rnodernize its existing offensive biological weapons program.'o This included the development of genetically-engineered pathogens and other bacteria and viruses useful as strategic bioweapons. In rgl!, Soviet leader Leonid Brezhnev signed a decree creating Biopreparat.

This was an ostensibly civilian operation that recruited the best and briehtest p h y s i c i a n sa n d s c i e n t i s t so f a g e n e i t i o . , and became the heart of a burgeoning Soviet bioweapons program.

At its peak, Biopreparat ernployed over Jo,ooo people. There was also a rnilitary program of at least rS,OOo people and an agricultural prograrn employing IO,OOO people that concentrated on producing pathogens that targeted crops and animals. The production capacityof Biopreparat facilities was measured in the hundreds and thousands of tons of pathogens annually. Since the collapse of the Soviet Union, security and accounting oversight of materials produced under Biopreparat programs have degenerated. Moreover, many Biopreparat employees lost their jobs, and Biopreparat material and expertise from forrner employees are now reportedly for s a l et o t h e h i g h e s tb i d d e r .

Biological terrorism is not new, yet since the end of the Cold War concern about this threat has escalated."During the Cold War, the Soviet Union po."J the greatest biological threat to the Unit-

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ed States; that threat seerned most likely to be manifested in overt war. however. than in acts of terrorism. Additionally, rogue states had less freedom to launch bioterrorist attacks in a bipolar world because of alliance restrictions. With the collapse of the Soviet LJnion, the threat of overt war no longer seems likely. Yet the accornpanying collapse of the Cold War alliance network also means that there are fewer restraints on rogue states that wish to engage in bioterrorism. The current overwhelrning conventional military superiority of the United States means that biological weapons, used in unconventional warfare, rnight now be seen by conventionally weaker nations as a way to bridge the power gap.

Problemsof Responsâ‚Ź.

There isa substantial extant level of naturallyoccurring infectious diseasein the United Statesthat can mask sufficiently subtle and dispersed bioterrorisrn. From the point of view of improving bioterrorism surveillance, it is irnportant to recognize the practical difficulty of discerning the difference between spontaneous outbreals of infectious diseaseand deliberate acts of terrorism. Given this fact, effective surveillance for biological terrorism requires effective surveillance for general infectious diseases.

Incubation delay endows biological agents with advantages as terrorist weapons that nuclear or chernical weapons lack. The possibility of uncontrollable contagion (in the caseof agents such as smallpox, for example), and the fear that this sparls, provides perpetrators with a distinct terror advantage.

These characteristics of biological agents highlight the importance of public health surveillance strategies for incidents of bioterrorism-an approach that

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is inapplicable to cases of chemical or nuclear attacls. Therefore, it is crucial to understand the threats posed by biological weapons and to address them in a very different way.

Barring a terrorist annor.rncement or the interruption of an attack already underway, traditional "first responders" (fire, .esc..e, police, and paramedics) or quick-response teams with specialized equipment and training will not initially recognize a biological attack. No annou.ncements accornpanied the biological terrorist attacks conducted by followers of Baghwan Shree Rajneesh, who poisoned several salad bars in Oregon with salrnonella bacteria in r9B{, and those attempted by rnembers of Aum Shinrikyo in the early tggOs.'" These attacks also rernained unrecognized while in progress.

Recognition of and response to a bio logical attack, whether domestic or abroad, will depend on the sensitivity and connectivity of the existing public health system. "Sensitivity" refers to the likelihood that a physician or healthcare worker will recognize a given manifestation of a diseaseasbeing out of the ordinary. "Connectivity" refers to how quickly and accurately information about a case passes vertically frorn the clinical level up to state, national, and international authorities, as well as horizontally within these levels.

A survey ofthe possible scaleofterrorist attacks and the extent to which these have proven or may prove difficult to distingrrish from outbreals of infectious diseasesrnakes it clear that improvements to surveillance systemsfor biological terrorism must build directly upon existing public health surveillance systems.'3 The most dramatic biological threat is a major terrorist attack against an urban

NoJr Bioalert center that employs an efficient mechanism for the dispersal of the biological agent. The destructive effects of this form of blological attack could be similar to a chemical or nuclear one. In 1993, the Congressional Office of Technology Assessmentestimated that roo kilograms of aerosolized (confined to respirable particles in the one to five micron size

preparing for chemical or nuclear attacks. Most incidents of biological terrorism will bypass the quick-response hazardous material teams that are critical in coping with attacls using explosive, chemical, or radioactive rnaterials. The diseaseagents likely to be used as terrorist weapons may incubate for hours, days, or even weeks before victims feel any

Thefe iS a substantialextantlevelof naturally-occurring infectious diseasein the United Statesthat datr,mask sufficiently subtle and dispersed bioterrorism. .a.rge) anthrax spores dispensed by an airplane upwind of a rnajor city could kill hundreds of thousands to rnillions of people.'a In another scenario, the dispersion ofan anthrax aerosol from a boat sailing upwind frorn New York City could result in over 4oo,ooo deaths.'5 Although no such rnajor biological attack has succeeded yet, the last decade has seen the releaseof sarin nerve agent in the Tokyo metro systernby the Aum Shinrikyo religious cult in 1995. This act killed eleven people and injured over $,ooo, more than Joo of whom required hospitalization. Moreover, Aurn Shinri\o attempted biological attacls on Tokyo as well as nearby U.S. naval installations at least nine times. Although the failure of Aum Shinrikyo's attacks suggests that acquiring and weaponizing an effective biological agent remains challenging, the attempts themselves indicate that largescale attacls on large urban populations are distinct possibilities.

Preparing for biological terrorism actually has more in common with confronting emerging diseases than with

symptoms. Sufficiently hidden or dispersed terrorist attacks may initially be indistinguishable from naturally occurring infections or outbreaks. This emphasizes the importance of training physicians and other healthcare workers to determine rapidly that an unusual infection is involved.

In the event of a biological attack, public health surveillance is critical to rninimizing deaths and casualties as well as economic costs. A recent study examined the expected deaths and economic impact for scenarios involving three different biological agents [Bacillusanthracis, Brucella melitensis,and -Froncrsella tularensis] released as aerosols in a terrorist attack on a major city.'b According to the study, the tirne required for effective intervention varies with each agent.

First, consider the case of anthrax.

The study found that intervention (defined as 9o percent effective administration of antibiotics and vaccinations) within one day after the attack could keep deaths below TO,OOO; in contrast, if intervention occurred five or more days

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later, the toll could rise to over 30,OOO. Moreover, early intervention could save $r5 billion to $zo billion. At the other extreme in incubation timescales is the case of brucellosis, where intervention within the first two weels after the attack would only reduce deaths by about roo as compared with over 5oo if intervention takes place two months later.

Effective intervention would be possible only if farnily physicians and emergency departrnent personnel recognized the nature of the disease outbreak as early as possible and if these concerns were effectively passed to state and national authorities for rapid diagnosis and response.'7 These sarne public health capabilities are required to detect more subtle attacks as well. One can envision terrorists introducing a disease into the United States in such a way that no easily recognizable outbreak occurs or that the outbreak is not noticed until the epidemic is well underway. Such a rnasked attack, followed by a credible terrorist announcernent, could spark a reaction far out of proportion to the deaths that actually result.

of State and Territorial Epidemiologists (CSTE) to develop and maintain a list of national reportable diseases. Individual state requirements for reportable diseasestypically parallel this list.

Through the National Notifiable DiseasesSurweillance System (NNDSS), states voluntarily report weekly to the CDC on the incidence of some fifty diseases.These diseasesinclude several of potential interest to bioterrorists, such as anthrax, botulism, brucellosis, and the plague. Reporting is rnandatory for a small number of diseases requiring quarantine, such as smallpox, infectious tuberculosis, and viral hemorrhagic fevers. The CDC regularly analyzes the data it receives frorn the states and reports summary statistics in its Morbidilt andMoftahlt Week! Report.LJnfortunately, one result of this system is that outbreaks of diseasesnot on the national reportable disease list rnay rernain undetected until an outbreak is well under'way.

A second type of national diseasesurveillance by the CDC involves the use of "sentinel" hospitals.'eIn this case, there is no attempt to gather comprehensive national data. Rather, the National Infection Surveillance Nosocornial (NNIS) system gathers data voluntarily provided by 163 hospitals. (Nosocornial

to BioterCurrentResponses f0f lSm. In the United States, surveillance for infectious diseasesis largely a passiveprocess, focusing on reporting of actual cases rather than prevention.'8 Each state has its own requirernents for physicians, hospitals, and other healthcare providers to report specific diseases.

Physicians or laboratories are supposed to notiS local or state health departments if a patient is diagnosed with a diseasedefined as reportable by the state government. At the national level, the Centers for Disease Control and Prevention (CDC) collaborateswith professional organizations such as the Council

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infections are infections acquired while a patient is hospitalized.) Incidence of infections in the participating hospitals may be used to estirnate the national incidence of nosocornial infections. In addition to the NNDSS and the NNIS systern, the CDC also engages in pilot projects with certain states, key U.S. cities, and individual "sentinel" physicians to gather data on the incidence and characteristics of other diseasesor diseaseoutbreaks.to

NoJt Bioalert

ImprovingSurveillance.

Surveil-nounced lance efforts are complicated because of the complexity of the task. As pathogens may have long incubation periods, no nation can protect itself by simply screening travelers at its borders. Nor can a country such as the United States hope to inspect more than a small fraction of the food it irnports daily. Yet the United States can strengthen its chances of catching biological terrorisrn by improving surveillance before such an incident occurs.

As agricultural markets becorne increasingly global, the potential vulnerability of nations to foodborne natural or intentional disease will continue to increase. Nevertheless, screening and quarantine efforts at ports of entry and inspection of food imports are an important component of public health surveillance.In r99$, the Committee on International Science, Engineering, and Technology of the Clinton adrninistration's National Science and Technology Council called for the strengthening of screening and quarantine efforts at ports of entry into the United States. With respect to food safety, the Clinton administration issued the National Food Safety Initiative, which included improved surveillance coverage for imported foods as well as for domestic produce, seafood, and livestock. These initiatives should irnprove surveillance for both natural and deliberate epidernic outbreaks in food sources.

Further improving domestic surveillance requires improving sensitivity and connectivity in the flow of information from physicians to national health authorities. An announced biological attack, or one discovered while underway, will require first responders who have appropriate training. lJnan-

biological attacls must first be recognized by pathologists, physicians, nurses, infection control staff, and other healthcare personnel in family practices, clinics, and hospitals. It is important, therefore, that these rnedical professionals have knowledge of the clinical presentations of lii<ely bioterrorist agents. The best way to ensure that busy physicians improve their expertise in this area is to require relevant training as part of medical school curricula and certification exarninations, as well as to offer appropriate training to practicing physicians.

The first step in improving sensitivity for incidents of biological terrorism is for the federal governrnent to rnake a long-term, sustained commitment to training the nation's physicians, nurses, infectious disease specialists, pathologists, and other first responders.

Next, regional centers of public health laboratory sciences rnust be able to perform rapid diagnoses of clinical sarnples from within their geographic areas. These regional centers must have the trained personnel and diagnostic tools necessaryto accomplish this mission, and connections to both local and national institutions rnust be assured.

This high-volume rapid diagnostics capability differs from the traditional expertise of national reference laboratories. New regional centers of laboratory excellence should build directly on the best state public health laboratories in order to minimize additional expense.

The president's budget requests to Congressfrorn fiscal years Ig99 to 2OOI also ask for additional funding to improve the ability of public health centers to recognize and share information on outbreaks of suspicious diseases.These policies, if successfullyimplernented at local and state health departrnent levels,

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should improve both sensitivity to detect epidemics and connectivity between all rnajor levels of the U.S. public healthcare system.

Emergency planners also need to devote more attention to developing rapid diagnostics appropriate to this sort of laboratory setting. For erample, state or regional laboratories will need diagnostics and appropriate reagents that are capable of thousands of sequential assays.Such diagnostics would not have to be hand-held or necessarily employ cutting-edge technologies, but they would need to be robust and reliable. A related requirernent, also with resource implications, is to maintain cadres of individuals at laboratories throughout the United States with expertise in the diseasesand biological agents likely to be ernployed by terrorists. Presently the CDC has the only laboratory in the world that serves as a WHO reference Iaboratory for plague.

ed. The first is enhanced collection of information regarding general, naturally-recurring diseaseswith the intention of recognizing outbreals as they occur.

The second involves a directed expert field and laboratory response to the outbreak of a specific, new epidemic. The latter category falls under surveillance provided that the response includes an investigation whose goal is to identify the nature, extent, and origin of a disease outbreak. Investigation of new outbreals, especially those deemed suspicious, and the identification of the responsible organism or strain are critical, but these capabilities are dependent upon a general epidemiological surveillance systern operating in the background that is able to detect outbreaks as soon as they occur.

While egregious attacls or accidents in biological warfare programs may be difficult to miss, the ability to deter potential violators of the rg/2 United Nations -Weapons Biological and Toxin Conven(BWC) tion would be enhanced by having the most sensitive public health surveillance network possible. This means having the ability to detect subtle outbreaks or to identi$' more obvious out* breaks in their earliest stages. From a national security perspective, such a network provides the best opportunity to stop an outbreak of infectious disease before it reaches the United States.

Establishing an international bioterrorisrn surveillance system rneans improving the existing international network for the detection of infectious diseases.Currently there are too many geographic holes in the international disease surveillance system. Yet there is cause for growing optimism. The WHO has established a program whose mission and mandate is to strengthen national and international capacities in the surveillance

InternationalCooperation.

Surveillance for disease outbreals overseasalso needs improvement. The surest way to prevent virulent non-endemic diseasesfrom reachingArnerica's shores, not to mention to alleviate hurnan suffering, is to detect and stop outbreals quickly while they are still abroad. Trained healthcare workers and epidemiologists, regional laboratories with reliable diagnostic equipment, good communications, and the ability to rapidly send in teams of experts to investigate reports of outbreals will help spot both emerging diseasesaswell as outbreals resulting from the use, testing, or accidental release of biological warfare agents.

There are two broad and interrelated categories into which international surveillance for bioterrorism may be divid-

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r.ro,lrBioalert and control of communicable diseases, primarily in the developing world.'' The WHO now publishes in both print and format electronic the bilingual English/Fre nch Week! Epidemiological Record and the electronic DiseweOutbreakNews.

The WHO is also compiling a searchable database of WHO collaborating centers worldwide. Along with the World Banl and the Joint UN Programme on HIV/AIDS (UNAIDS), the WHO is also connecting the collaborating centers elec-

oratories and institutions around the world. WHO Collaborating Centers carry out specific activities on behalf of the WHO such as providing information on disease distribution as well as conducting laboratory diagnoses and training in the host nation or region. Host governments agree to allow the centers to report directly to the WHO without first going through the government. lJnfortunately, there are large regions of the world where these centers are absent or rare, including

.Cqrrentlythere are t9q rnanygeographic holes in the international diseas6 surveillance systern. tronically."' Sirnultaneously, the Program Monitor Emerging Diseases to (ProMED), an international non-governmental group of infectious disease experts, has established an electronic reporting system open to unconfirrned reports of diseaseoutbreals.'3 This system parallels the more strongly filtered WHO O utbreak Veif cation List.

The United States has also been crafting an individual response to the global problem. In 1996, then-Vice President Gore announced the Clinton administration's new policy for responding to emerging global infectious diseases. Under that policy, President Clinton directed the U.S. government to "work with other nations and international organizations to establish a global infectious disease surveillance and response system, based on regional hubs and linked by modern communications technologies. " One such global system is comprised of WHO Collaborating Centers, which form a network of over two hundred lab-

Eastern Europe, much of Saharan and sub-Saharan Africa, Central America, and Southeast Asia. These areas need new regional networks to help fill these gaps.

Another element of the global biosecurity monitoring systembeing strengthened by the WHO provides a model for public health reporting that does not require explicit bioterrorism surveillance. The International Health Regulations (IHR) are the only components of international public health legislation that require mandatory reporting of infectious diseases.Yet reporting is currently limited to cholera, the plague, and yellow fever. To transform the IHR into a global alert system, the WHO is broadening their scope to include many diseasesand syndromes for which they currently make no provision.

The IHR require initial notification of the appearance of certain syndromes, which will then be followed by reporting of specific diseasesonce clinics and laboratories establish the diagnosis. Reporting suspicious syndromes, however,

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allows rnedical interventions and studies to commence even before a laboratory diagnosis is made. From the point of view of those concerned with incidents of biological terrorism, reports of syndromes may help to identify incidents of bioterrorism at an early stage. This method of reporting could provide regional networks with a way to participate defacto in surveillance relevant to biological agents without having to do so explicitly.

Another forrn of international cooperation provides a powerful deterrent for would-be developers and users ofbiological weapons. The same molecular biological technologies that facilitate the engineering of irnproved biological agents provide international surveillance experts with a way to track biological weapons. Genetic fingerprinting provides scientists with a way to identify the biological "signatures" of particular strains of organisrns through biochemical or molecular biological analyses of those strains. This technology may enable scientists to track the source of even a secret biological release. Greater transparency, including the exchange of strains of organisms held in the national laboratories of individual nations, could facilitate tracking. Moreover, development of a DNA-sequence database for different strains of organisrns, especially those associated with bioweapons programs, would aid in investigation of domestic or international outbreaks.

Biological signature tracking and attribution could become a powerful tool for identifring when an outbreak is intentional and who its perpetrator might be.

The threat of biological terrorism, and potential early ambigu.ities between natural outbreaks and intentional or accidental releases of biological agents, demands that closer ties between law

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enforcement, intelligence, and public health officials be established. For example, public health officials would benefit from domestic and international intelligence reports of a probable biological threat and concern over the potential use of a particular biological agent. Conversely, law enforcement and intelligence agencies could benefit from being informed regularly about what outbreaks are being seen in public health surveillance (domestic and overseas) and how these events are being resolved.

Despite its potential benefits, international cooperation is currently hampered by conflicting dernands on public health organizations. On the one hand exists international public health organizations' desire for transparency and scientific analysis; on the other are restrictions imposed by law enforcement or intelligence gathering requirements. Consider, for example, an institution such as a hospital or university that experiences a diseaseoutbreak. Personnel and adrninistrators rnay talk freely to scientists pursuing a public health investigation, but rnay be much less forthcoming if they perceive investigators as surrogates for law enforcement agencies,who could pursue possible prosecutions or litigation.

Internationally, the situation is even rnore delicate. After the 1995 plague outbreak in Surat, for example, the Indian news weekly The Wek explicitly accused the United States of being responsible for the outbreak and identified by name four members of the CDC field team who had arrived in India to study it. The CDC's desire to send epidemiologists was described as suspicious.

U.S. agenciesconducting epidemiological or other public health activities, be they civilian or military, will understandably be reluctant to risk cornpro-

NoJrBioalert mising their credibility and their ability to detect and respond to diseasesoverseasby appearing to have ties with intelligence gathering or covert activities.

On the other hand, the United States rnust prepare itself to respond effectively to biological attacls should they occur.

This necessitates improving existing domestic diseasesurveillance systernsthat focus on natural epidemics aswell asglobist attacls using biological weapons have al cooperation in surveillance and inforbeen carried out or atternpted at virtually mation-sharing to allow for the timely every scale,from individual assassinations detection of, and response to, biological to indiscrirninate attacls meant to harm attacks. Enhancing the ability to respond thousands. While apocalyptic urban successfully to bioterrorisrn also means attacks have fortunately not succeeded, grr.i^g emergency serwices and laboratothey have been attempted by at least one ries the training and equipment necessary terrorist group. This puts biological to contend with a biological attack. attackswell within the realm of possibility.

Even if a major biological terrorist Prudent national security policy attack never occurs, the investment in requires that the United States prepare strengthening the U.S. public health for biological terrorist attacks. On one infrastructure will work, on a daily basis, hand, this means stepping up prevention to benefit the health and welfare of all efforts in order to pre-ernpt a possible citizens. An appropriate national securibioterrorist attack. Such action calls for ty response to the threat of biological terincreased intelligence, counter-terrorrorism is similar to that necessary to ist, and deterrence activities as well as cornbat the threat of emerging infectious international efforts to check the devel- diseases.By preparing for acts ofbioteropment, spread, and use of biological rorisrn, the United Stateswill be ready to weapons. IJnfortunately, pre-ernption face the loorning danger of epidemic rnust be accornpanied by the understandoutbreaks. Public health and national ing that no preventive measures are security rnerge in the realm of emerging absolutely foolproof. diseasesand biological terrorisrn.

TheRealmof Possibility. r".'-".-

N O T ES r Department of Defense, Proliferotion,Threot and Xesporoe(Washington D.C.: Dept. of Defense, 2OOr). z E. Eitzen, J. Pavlin, and T. Cieslak, et al., eds., Medical Manogementof BiologicolCasualtiesHondbook Jrd. edi tion (Frederick, MD, US Army Medical Research Institute for Infectious

Diseases, 2oor).

3 D.R. Franz, P.B. Jahrling, and M. Friedlander, et al., "Clinical Recognition and Management of Patients Exposed to Biological Warfare Agents," Journol of the American Med[col Associotion 278.5

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GggT):

Response 4 Advisory Panel to Assess Domestic Capabilities for Terrorism Involving Weapons of Mass Destruction ("Gilmore" Report), TowardNotionol Strote g for CombotingTerorism,Second Annual Report President and The Congress, (Washington, Government Printing O1fice, 2ooo). g A.S. Khan, S. Morse, and S. Lillibridge, lic-health

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in

t h e U S A , " T h e L a n c3e5t 6 . 9 2 3 6 ( z o o o ) , r r T g - 8 2 .

6 R. Zilinskas, "Terrorism and Biological Weapons, Inevitable Alliance?" Per$ectiues in Biolog and Medicine, Z4 (J990), 44-72. ] K. Alibek and S. Handelman, Bioho4rd'TheChilling TrueStog of theLargenCouerlBiologcolWoponsProgromin the World-Toldfom the Insideblt the Mon Who Rsn /t (New York' Random House, rggg).

8 T . M a n g o l d a n d J . G o l d b e r g , P l a g u e W oA r eT' r u e Storyof Biolo$colI4lct'ore(New York, St. Martin's Press, r999). of 9 R. Zajtchuk and R.F. Bellamy, eds., Textbook Militag Medicine: MedicalAspects of Chemicol ond Biologicol War/ore (Washington, D.C., Office of the Surgeon General, Borden Institute, Walter Reed Army Medical Center, rgg/). ro Mangold and Goldberg, PlagueWors.

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t2 TJ. Torok et al., "A large Community Outbreak of Salmonellosis causedby Intentional Contamination of Restaurant Salad Bars," /ou rnalof theAmericonMedicolAsociation 2lB (r997), g8 g- g 5. t 3 J . E . M c D a d e a n d D . F r a n z , " B i o t e r r o r i s m a sa Public Health Threat," Emerging InfectiousDiseoses { (r998),493-4 r{, Office of Technology Assessment,"Proliferation of Weapons of Mass Destruction: Assessingthe Risks," Ol-,4-ISC-jjg (Washington, D.C., US Government Printing Office, I993). r5 R.H. Kupperman and D.M. Smith, "Coping with Biological Terrorism," BiologicolWeaporc: Waponsof t h eF u t u r ee, d . B . R o b e r t s ( W a s h i n g t o n ,D . C . ; C e n t e r f o r S t r a t e g i ca n d I n t e r n a t i o n a l S t u d i e s , 1 9 9 3 ) ; M J .

Powers, "Deterring Terrorism with CBRN Weapons, Developing a Conceptual Framework," Occasionol Poper "lfo.2 (Washington, D.C.: Center for Biological and Chemical (CBACI), 2oor); and A.H. Cordesman, Defending America'Red$ningtheConceptual Borders of Homeland Delroe (Washington, D.C., Center for Strategic and

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Studies, zooo). et al., "The Economic

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Intewention Programs Justifiable?"

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Osterholm

andJ.

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and Post-attack EmergingInfectious

Schwartz, LiuingTerrore,

What Amer[ca Needsto Knou to Suruiue the Coming Biotetorisl Catutrophe(New York, Delacorte Press, Zoob). r8 Institute

of Medicine,

Emergnglnfectiorc'Microbial

Threotsto Health in the United Stctes(Washington,

D.C.:

National Academy of Sciences, rgg2). r9 Centers

for Disease Control

and Prevention,

AddresingEmergingInfectiou DiseoseThreats:A Preuntion Strateg for the United Stdtes(Atlanta, CDC, zooo).

2 o I nstitute o f M edicine, EmergingI nfections.

(WHO), 2r World Health Organization Communicoble DisesseCluster Annual Report (Geneva, Organization,

World

Health

2OOO).

CommunicableDiseaseClusler Annual Reporl.

22 WHO, 2! "Fast Tracking Epidemic L o n c e t! ! , 8 ( 1 9 9 6 ) ' 1 5 9 9 .

Information,"

The

0onflict&securlty

TheCostof Seuering Defense Ties Stephen C. Ball Since the late I$$Os, sanctions have come under increasing scrutiny. Punitive policies meant to compel change, sanctions are being labeled ineffective and indiscriminately harrnful to populations that are vulnerable and not responsible for the behavior that instigated the sanction. Yet sanctions continue to be the policy of choice when dealing with recalcitrant or rogue states.

Much of the research and writing on international sanctions has focused on economic sanctions, overlooking the case of defense sanctions. Defense sanctions are those policies that affect-that is, limit, deny, restrict, sever, or prohibit-military- and defense-oriented education, training and operational exercises,weapons and equipment procurement, and all other rnilitary-to-military contact with a targer counrry.

In the caseof a military coup in a foreign state, the United Statesis obliged by law to impose full defense sanctions as well as to halt economic assistance.In most other circumstances, the policy is not legally predetermined. When a state's military exceeds accepted boundaries of conduct, for instance, by securing political influence through force or turning combat power against its citizens to preserve power, part of the policy remedy has frequently been to enact defense sanctions. In some cases,sanctions were held out as a deterrent to steer countries

S t e p h e nC . B a l l is a Colonel

in the

U . S .A r m y , U . S .

Army

Senior

Senice

College Fellow, and U.S. Defense Attachddesignate to Vietnam.

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away from nuclear development. Policymakers within the United States governrnent have turned to defense sanctions with the hope that by cutting off communications, aid, equipment, training, and recognition, the country and its military will changetheir behavior.

On the surface, sanctions seemed the appropriate policy prescription for countries whose rnilitaries behaved in a rnanner that put U.S. interests at risk or that was inconsistent with U.S. policy mandates. Severing defense ties with recalcitrant regirnes, however, has also had the effect of severing contact with a weak state's rnost powerful institution fledgling reform and jeopardizing rnovements within the state. It has not resulted in an irnproved or safer security environrnent. In the late r98os and r99os, U.S. -imposed sanctions resulted in a rise in prorninence of destabilizing influences in the target countries, for instance, heightened Islamic fundarnentalism or cultivation of closer relations with China, Iraq, or North Korea. They have also helped create, or at least failed to arrest, the formation of failed or near-failed states, thus jeopardizing security in severalregions.

A look at Asian states that have been targets of U.S. defense sanctions-Burrna, Carnbodia, China, India, Indonesia, Laos, North Korea, Pakistan, and Vietnam-reveals that one policy does not fit all. Severing ties has not been an impetus for regime change, rnilitary reform, human rights improvernent, or increased domestic or regional stability.

An analysis of two sanctioned countries revealsthat the universal policy rernedy of severing defense ties not only has been unsuccessful on the surface, but also has exacerbated the very conditions that justified the sanctions in the first place.

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Sanctions as a Policy0ption.

Branded "the Sanctions Decade," the r99Os were characterized by a dramatic rise in the use of sanctions. Between r9r4 and r99o, countries around the world imposed econornic sanctions in tt6 case s . ' B e t w e e nr g g 2 a n d r 9 9 6 , t h e U n i t e d States imposed sanctions sixty-one times on a total of thirty-five countries, for reasons ranging from state-sponsored human rights violations and religious persecution, to proliferation of rnissiles and nuclear weapons, to state sponsored terrorism." It is estirnated that the United Stateshas approximately seventy sanctions of various types currently in effect.

There are four primary reasons for the dramatic increase in sanctions since r99O. First, many statespreviously held in check, if only loosely, by the bipolar Cold War international systernnow feel a growing sense of unaccountability. Policymakers perceive sanctions to be a way of reining in these states.Second, without the overarching Cold War strategy of -Western rnaintaining Eastern or bloc solidarity, the necessity of policyrnakers to overlook bad or reprehensible internal state behavior is rnoot. Third, in a few notable instances sanctions have been effective, as evidenced by the role they played in South Africa's abandonment of apartheid in rgg2. Finally, sanctions offer policymakers a way to take action against a regime without comrnitting rnilitary forces.

TwO CaSeS. Indonesia and Pakistan have enjoyed long and cornprehensive relationships with the United States.

They have also been subject to several U.S. defense sanctions regimes. Partial defense sanctions were enacted against Indonesia after reports that the Indonesian military participated in vio-

BALLConflict&Security Pakistan's history since independence has been more tumultuous. Since rg{f , Pakistan has fought three wars with India, experienced six constitutional arrangernents, and developed close, but separate, political-military associationswith China and the United States.

Former Deputy Chief of Mission for the U.S. Embassy in Islarnabad John Holzrnan characterizes the U.S. -Pakistan relationship as "a mutually exploitative affair." Recognizing the irnportance of a Thehis- friendly, or at least non-adversarial, PakThe Roadto Sanctions. istan, the United States cultivated this tory of U.S. involvement with Indonesia relationship while carefully avoiding and Pakistan stretchesback to their earliest days of independence. Through the entanglement in the India-Pakistan policy of containment, the United States rivalry. The U.S.-Pakistan relationship supported the young armed forces of was viewed as very useful to U.S. policy in South Asia and the Middle East, toward these developing countries in the hope of China, and, particularly during the Cold extinguishing cornrnunist rnovements 'War, in containing the spread of corncropping up in post-colonial Southeast rnunism. For Pakistan, the "partnership" and South Asia. The fight against cornrnunisrn remained the foundation of was a means to stronger defense and deterrent against India.

U.S. policy in these regions for much of The U.S.-Indonesia and U.S.-Pakthe three decadesfollowingWorldWar II. As the Vietnarn War carne to a close, istan relationships developed fissureswith the end of the Cold War. Concerning the United States becarne the primary aid provider to the Indonesian armed Indonesia, human rights violations by the Indonesian rnilitary, culminating with the f o r c e s , i n c r e a s i n ga i d f r o m $ 5 . 8 m i l l i o n i n 1 9 6 9 t o $ i B m i l l i o n i n r $ / o . B y horrendous and violent period after the rg16, Arnerican military aid had risen Augrrst 1999 sovereignty referendum in East Timor, introduced tension into the to rnore than $4o million annually.' relationship. Defense sanctions were The payoffs frorn this relationship of irnposed on September 9, 1999. aid, training, and assistancewere beginIn Pakistan, with containment no ning to be noticed in the early rggos. for longer an issue, nonproliferation Former Assistant Secretary of State assurned the forefront of the U.S. agenthe East Asia and Pacific Bureau Winda. In rg89, as stipulated by the Pressler ston Lord noted that in the areas of peaceful settlement of disputes in the Amendment to the Foreign Assistance region, arrns control, and free trade, Act, defense sanctions were imposed folIowing then-president George Bush's Indonesia's acceptedposition of leaderdeclaration that he could not verifr that ship within Southeast Asia and its prolJ.S. stance established it as a "positive Pakistan was not engaged in a nuclear weapons program. Following Pakistan's force for promoting regional and globnuclear tests on May Z8 and 3o, 1998, al goals that are in the u.S. interest."a lent clashesbetween East Timorese separatist groups and pro-Indonesia groups in r99r. Such sanctions were again enacted after the Indonesian military was determined to have supported atrocities in East Tirnor after the Augrrst r999 sovereignty referendum. Defense sanctions were imposed on Pakistan in rggo due to its nuclear developrnent program and were increased following the 199B nuclear tests.

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the United States tightened prohibitions on the sale or transfer of weapons and spare parts to Pakistan and trade with any other country where U.S. -licensed components were involved. After the October 1999 coup by Chief of Army Staff General Pervais Musharraf, the United Statesimposed further sanctions, adding more restrictions on military-to-military contact to the nuclear-based defense sanctions still in effect.

Exacerbating Instability. s",.tions have done little to improve conditions in Indonesia and Pakistan. In fact, the state of security has dramatically worsened. Governance in both states is increasingly ineffective. Both countries have suffered intense internal political upheavals and experienced violent social chaos resulting in countless deaths. Economic recovery has stalled and conditions indicate that further recession is underway. The spillover effects of turmoil in these failing states continue to be felt in

fractured. The resulting breakdown in military discipline and effectiveness has created much instability in the country.

As a result, the military has not been able, or in some casesis not inclined, to restore order in the face of rising separatist, et-hnic, and sectarian violence. In some instances, members of the military have even contributed to the violence or failed to take rudimentary steps to stem the breakdown of order. The continuation of this situation fuels further sectarian violence and militant separatism by undermining trust inJakarta's ability to provide security and stability to local regions.

The inability of the security forces to restore order has contributed to increasirg separatist sentiment, and with Abdurrahman Wahid's ouster from the presidency, the future of the Indonesian government is uncertain. Forces posturing to fill the potential political vacuum include the Axis Group, a Muslim-based political coalition that calls for Shariah law. As one analysisboldly states, "If that

t'Balkanizationttof Indonesiaisnota remote possibility.

Asian markets, in reduced productivity of natural resources, and, in Indonesia's case, in more unstable transit routes through important sea lanes of communication (SLOCs). In fact, a "Balkanization" of Indonesia is not a remote possibility, and an increase in militant Islamic activism is evident in both countries.

Meanwhile, the governments in both countries remain unable to contribute actively to reform and recovery.

Coupled with the social, political, and economic upheavals in Indonesia, defense sanctions have left the militarv

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happens, Indonesia will certainly break up. Provinces where Christianity is strong-East Nusatenggara, Maluku, and North Sulawesi-have hinted that they would declare independence if Shariah Iaw is adopted."5 In Pakistan, sanctions have similarly contributed to political instability by fostering a dangerous rise in religious extremism. Since the imposition of sanctions on Pakistan, extremist and sectarian gr.oups have begun to operate freely and openly in the country.6 Despite Musharraf s harsh words early in his tenure aimed

aaLL Conflict&Security at rnilitant Islamic groups, the occurrence and scale of Muslim extremist violence have increased. Not only does the rise of religious extremism and militancy impede reform in Pakistan, but it also threatens the security of its volatile surrounding region. Commenting on the troubling effects of the increase in Islamic militancy in Pakistan, a recent Center for Strategic and International Studies paper notes that the violence and the government's inability to effectively deal with it "have rnade Pakistan a source of instability that radiates outward to its neighbors."T One effect of this breakdown in stability is the exacerbation of the long-standing IndiaPakistan dispute in Kashmir.

Defense sanctions have also contributed to shifting the focus of Pakistan's defense strategy toward an increasing reliance on nuclear weapons. Former U.S. Ambassador to Pakistan Robert Oakley argues that sanctions have "clearly led to an acceleration of lPakistan's] nuclear efforts, aswell a shift from strategic reliance upon sophisticated U.S. aircraft to acquisition of Chinese and North Korean ballistic missiles capable of carrying the nuclear warheads. [Additionally,l cancellation of IMET [International Military Exchange and Trainingl and most other military education and training for Pakistan has aggravatedanti-U.S., Islamic and nationalistic attitudes amongst its officer corps and reduced incentives for restraint in military-supported, anti-Indian activities in Kashmir and elsewhere."u Sanctions have only exacerbatedthe arms race and the potential for instability in the region.

Additionally, defense sanctions have prornpted Indonesia and Pakistan to forge closer relationships with potential U.S. adversaries and states of concern. Largely because of the effect the lack of accessto

U.S. training, arms, and assistancehas had on military readiness, Jakarta and Islamabad are increasingly forced to look to other sources for military assistance.

Indonesia is considering buying armarnents frorn Poland and Russia, while Pakistan remains dependent upon China for rnilitary aid and technology. Pakistan has also established a missile-related technology transfer relationship with North Korea that is likely to continue barring U.S. intervention.e At the same tirne, Pakistan's uncornfortably close relationship with the Thliban government in Afghanistan has drawn criticism from both Russia and the United States.

Minimizing U.S. Leverage.

Another problem of defense sanctions is the over-emphasis on singrrlar issues. In the casesof Indonesia and Pakistan, lJ.S. interests go far beyond hurnan rights and Indonesia is a rnajor proliferation. source of energy for countries in East Asia, and it sits astride the Molucca and Sunda Straits, the major SLOCs between Europe, the Middle East, and East Asia.

Indonesia's size and geographic location also make it central to security and stability in Southeast Asia. Pakistan provides a crucial gatewayto Central Asia, is located near the entrance of the Persian Gulf, and is key to peace and stability in South Asia.'" By hinging military contact on single issues, defense sanctions impede Washington's ability to influence these countries in order to protect and promote U.S. interests.

Pakistan's strategic value to the United Stateschanged in rg88, when its role as a "frontline state" lost relevancy after the Soviet withdrawal from Afghanistan.

Non-proliferation becarne the sole focus of the U.S.-Pakistan relationship.

IJnfortunately, the United States has

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too many interests at stake in South Asia-from accessto energy in the Persian Gulf and Central Asia to the need allow a relato control terrorism-to tionship to be dominated by any one issue. By concentrating exclusively on non-proliferation, is Washington ignoring Islarnabad's irnportance in other areas of U.S. inrerest.

Amidst Pakistan's crumbling civil and political structures, the rnilitary is the only national institution that remains largely intact. By severing contact with the

U.S. policy towards Indonesia. In a country where the military rernains a central political force, defense sanctions are drastically discounting the U.S. ability to affect the situation. With defense sanctions in place, the United States has effectively extinguished its capability to encourage the Indonesian military to and institutional support political reforrn, refrain frorn politically-rnotivated violence, and develop more peaceful waysto maintain order.

The one-dirnensional nature of U.S.

and SanCtiOnShave prornptedIndonesia Pakistan to forge clo^serrelationsbips with potential adversarresand statesof cbncern. rnilitary, the United States has handicapped its ability to communicate with, and influence, a major power broker in the Pakistani political systern. Thus, by dirninishing Washington's contact with the rnilitary, defense sanctions in Pakistan are threatening the capacity to advance and protect U.S. interests in South Asia and its environs.

Similarly, the United Stateshas tied its relationship with Indonesia to one narrow issue. Though the U.S.-Indonesia relationship was founded on the broad area of containment, in the post-Cold War era the relationship has come to be defined by human rights. Fueled by knowledge of atrocities committed by the Indonesian military, U.S. policy in Indonesia has corne to be dorninated by outrage over military conduct. As a result, political, economic, and defense interests have become secondary.

Efforts to change the corrupt behavior of the military through the penalties of defense sanctions now form the core of

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policies toward Indonesia and Pakistan has made bilateral relations strategically weak. Since the end of the Cold War, viewing the relationships through the lensesof human rights and nonproliferation has established "single points of failure" for both relationships. By basing relations exclusively on progress on restrictive single issues, Washington is ignoring the importance of bilateral relations with Indonesia and Pakistan to other areasof U.S. interest. In "pivotal states" such as Indonesia and Pakistan, defense sanctions have damaged the states and the region and put U.S. interests at risk.

Missing fortheTrees. theForest The cost of defense sanctions is high. In Indonesia and Pakistan, defense sanctions have uniquely hurt reform. Continued U.S. isolation of the military in both states has not brought about improvements in the areas that initially prompted the imposition of sanctions. Defense sanctions have neither empowered other state

BALLConflict&Security institutions nor have they been a catalyst for fundamental military reform. The net result of defense sanctions has been to weaken the institutions of the armed forces, leaving internal law and order unattended to such an extent that progress in political, economic, and other civilmilitary reform has essentiallyhalted."

Instead, domestic political instability and the weakening of civil-political institutions continue, militancy and extrernism are on the rise, and countries are looking more to rogue statesand potential U.S. adversariesfor assistance.In the case of Pakistan, defense sanctions designed to stem the country's nascent nuclear and ballistic missile programs have likely encouraged Islarnabad's dependence on such defense technologies. In Indonesia, military sanctions are not helping to rein in the political instability that may provoke destabilizing refugee flows and continues to depress investor confidence."

Sanctions have dirninished U.S. influence in Indonesia and Pakistan overall.

In the long terrn, certainty that either regirne will support U.S. requests to participate in responses to regional crises (for instance. in the UN-led coalition a g a i n s tl r a q i n t g g r a n d i n E a s tT i m o r ) i s decreasing. The impact of influence is hard to rneasure. However, an excellent exarnple of the importance of U.S. influence on the militaries of countries like Indonesia and Pakistan was witnessed during the destabilizing Pakistani troop movements in Kashrnir in June rggg.

The unique accessof the forrner Cornmander-in-Chief of the U.S. Central

Comrnand, General Anthony Zinni, to Pakistan's leadership and his timely diplornacy led to disengagement of Pakistan's military from the Line of Control (LOC) and de-escalation of hostilities between India and Pakistan in Kashmir.

It is doubtful whether the United States will be able to exert such effective pressure in the future.

The task for U.S. policymakers is to view defense relationships through the lens of maintaining and nurturing strategic interests. In stateswhere the military plays an irnportant, if not primary, role, accessingand influencing the military is important for meeting U.S. strategic interests. In these situations, the enactrnent of defense sanctions cripples Washington's ability to bring its influence to bear. In caseswhere countries or their militaries have gone astray, one policy does not necessariiyfit ali.

If the intent of sanctions is to compel change, then their record is checkered at best. In developing stateswhere the military is prominent, severing ties has not been an impetus for regime change, military reform, hurnan rights irnprovement, or increased stability in the state or region. In fact, considering the situations in Indonesia and Pakistan,the policy rernedy of severing defense ties has not only been unsuccessful on the surface but has also accelerated already declining conditions, leaving these states in circumstances far worse than those prior to the enactment of sanctions. In being so quick to impose defense sanctions over narrow issues,U.S. policy is jeopardizing broader, long-term interests.

NOTES t Robert P. O'Quinn, nomic

Sanctions,"

"A lJser's Guide to Ecotr26, (Washing-

Back1rounderNo.

ton, D.C.' Heritage Foundation. a5Junel997) z O'Quinn

5.

r.

The Arml and Politiu in Indonesia Crouch, 3 Harold (Ithaca, Co.tel'l University Press, 1978) 338.

4 Winston Lord, fusistant Secretary of State, "U.S. Relations with Indonesia." Testimonv before

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the Senate Foreign Relations Sub-Committee Asian and PacificAffairs, tenber rgg6. g Kanis Dursin,

Washington,

D.C.,

on East r8 Sep-

es," Taking Chorge, A Biportban Report to the PresidentElect on ForeignPolig and National Securi!, eds. Frank C arlucci, Robert and Zalmay Khalilzad (Santa Monica, Cali-

Hunter, 'Vahid's

Enemies Plot an Islam-

fornia,

RAND

ro Richard

ic State," Asia Tines to March 2oor.

6 Stephen P. Cohen, "Pakistan's Fear of Failure,"

committee

The'AsionWoll Street Journol 23 October

International

2ooo.

November

Corporation,

N. Haass, Testimony

2ooo) 85. before the Sub-

on Asia and the Pacific, Committee on Relations, U.S. House of Representa-

"Pak/ Melissa Iqbal and Teresita C. Schaffer, istan, the Middle East, and Central Asia," Soull lsio Monitor Number 3o (Washington, D.C., Center for

tives, 3 March I999.

Ir Cohen, "Pakistan's Fear ofFailure." r2 Angel Rabasa, "Presening Stability

Strategic and International Studies, I February 2oor).

8 Robert B. Oakley, "Defense Diplomacy," paper

Democracy

for the zftst Annual

Robert Hunter, and Zalmay eds. Frank Carlucci, Khalilzad (Santa Monica, California, RAND Corpo-

International

Institute for Strate-

gic Studies Conference, September rggg. g AshleyJ. Tellis, "South Asia' U.S. Policy Choic-

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in

and

Toking Charge, A Bipartison

Indonesia,"

Reportto the PresidentE[ed on ForeignPolig ond Notional Securp,

ration, November

2ooo)

92.

Conflict& Security

A d m i r a lD e n n i sC . B l a i ro n in s e c u r i t ya n d c o o p e r a t i o n Asia From conflict in the Korean Peninsula, the Thiwan Strait, and Kashmir to political and social collapse in Indonesia, Asia hosts some of the world's most volatile flashpoints. At the sarne time, Asia is home to some of the world's most important economies-Japan, China, the Republic of Korea, Thiwan, and increasingly, India. At the proverbial "sharp end" of promoting stability and preserving U.S. interests in Asia is the United States Pacific Command (PACOM) in Hawaii, headed by Admiral Dennis C. Blair.

Recent months have not been smooth forAdmiral Blair and PACOM. The command has been at the center of several storms. These range from the accidental sinking of aJapanese trawler by a U.S. nuclear attack subrnarine in February, to a mid-air collision between U.S. and Chinese military aircraft in April, to mounting pressure in Okinawa against the U.S. military presence on the island. In the midst of these challenges, Admiral Blair, ever the picture of calm, spoke to the Joumal about his vision for advancing peace, security, and cooperation in Asia.

D e n n i sC . B l a i r is an admiral

in the

U.S. NarT and Commander-in-Chief the United

of

States

Pacific Command.

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'What GJIr: do you see as the greatest security challenge in the Asia-Pacific region, and what role do you think the United States has to play in addressing this issue?

I think disputes rernaining from BLATRT former wars, the emergence and growing influence of certain countries in the region, and communal violence and transnational crime form the web of threats and concerns the United States and other countries deal with in the region. Underlying that, if the United Statesand the Asia-Pacific countries treat them as opportunities to work together, manage thern, isolate the points of contact, and emphasize points of cooperation, we can develop a really new way forward for Asia. If we allow the threats to divide us-through arms races, balanceof-power politics, suspicious ways of Asia, I think, risks thinking-then a very dangerous place. becoming Glrr: In previous statementsand articles, you mentioned the need to createsecurity communities and enrich bilateralisrn to respond to the above situation. Critics seethis as detrimental to long-terrn U.S. involvement in the region. How would you speak to these concerns?

BLAIR:I would fundamentally disagree.I think an Asia-Pacific community that has a security structure built on bilateral and multilateral activities and norms of conduct, as well as bilateral security treaties with a strong set of interactions that involve information technology, business, academic exchanges, and travel, is in fact a much rnore favorable Asia for the United States than we have ever had.

The United States is not seeking to control or dominate Asia. I think the United

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States is seeking to participate in a secure and peacefully developing Asia. To me, all the concepts for regional cooperation are consistent with lJ.S. interests and are better suited to the Asia of the future than some of the rnodels of the past, such as Cold War rivalries and strictly bilateral approaches. So I think this is a different age of policy for us, but one that is better.

G J I A : ' W h e n y o u t a l k o f s u c c e s s f u cl o o p eration, one of the examples you often cite is that of ASEAN [Association of S o u t h e a s tA s i a n N a t i o n s ] . H o w e v e r , t h e countries of ASEAN are facing a host of dornestic problems and have many differences among themselves. What steps do you think ASEAN and the United Statesneed to take to deal with this situation, because so far ASEAN seerns rather ineffective in dealine with regional issues?

BLArR: It depends on the time scale that you are looking at. It also is worth looking at bad things that did not happen, as well as the good things that did not happen quite as quickly as ASEAN members would have wanted. No ASEAN rnernber has fought against another member since its founding; neither have subsequent rnernbers once they joined. I have talked to military leaders in ASEAN and I have asked about particular potential flashpoints in the region, whether they are Malaysian-Singaporean disputes over airspaceor water, or Thai-Burmese disputes over narcotics, or Indonesian-MalaysianPhilippine piracy and immigration flows across their borders. What I inevitably hear from Southeast Asian countries is, "We'll work it out. " Nobody is a pushover, but they want to "work it out." That ASEAN attitude, I think, counts for a lot, whether or not you think it can go further

T N T E R V TCEoW n f l i c t &S e c u r i t y in terms of preventive measures. We all I solving the problem. So I think the secuknow that the region has had a hard time l rity community approach contributes to with the Asian financial crisis and huge an atrnosphere for peaceful resolution in social change in Indonesia. These are big Thiwan, although I agree with you that just setbacls to ASEAN. I am not one who to take such an approach and put it right thinlsASEAN is a failure by any means. It on top of Thiwan is a stretch. spawned the ARF IASEAN Regional Forum], the ASEAN-Plus-Three, and so GJ I A: Further concerning the Taiwan on. I think these are useful forurns that issue, during your trip to China in rnidcan be applied to specific problerns. I March, Beijing essentially rebuffed the think people-like the visionaries who atternDt to link a decreasein the number

What I inevitably h"u.frornSoutheast

Asian colrntries is, "We'll work it out." Nobodyt is a pushover, but they want to "work it out. " founded ASEAN-would like to see more progress, but I arn not completely discouraged by any means. cJIA: \Mhen you say that ASEAN has the attitude that it can work things out and its mechanisrns can work across different issues,how does this apply to the issue of Thiwan? Is it possible to apply the security community approach to the problern of Thiwan, especiallygiven the fact that China seesthe matter as strictly internal and consciously tries to exclude Thiwan from any international grouping?

BLAr R: I thinl it is hard to apply a multilateral approach directly to the Thiwan issue, but what is important is a regional attitude and dependable expectations of peaceful change. If that is the prevailing ethic and attitude in the region, then it seems to me that we can solve even tough problems like Thiwan, Kashmir, and Korea. Those problems tend to dominate relationships, unless there is sorne sort of environrnent or countervailing tendency with an emphasis on cooperation and

of missiles facing Thiwan with a less robust IJ.S. arrns sale package to Taipei.

In light of Beijing's intransigence over its arrns build up vis-d-vis Thiwan, how do you think the United States should balance its cornrnitrnent to help Thiwan rneet its defense needs yet avoid provoking the PRC? BLAr R: As I said to the Chinese when I was in Beijing, I do not want to specify a year, date, nurnber of missiles, or specific rnetric to thern, but over time, China's missile buildup will threaten the sufficient defense of Thiwan. So there is some tirne to work on a restrained approach that will lead to a peaceful development, but China cannot simply continue to add rnore and more missiles every year. It is an internal Chinese rnatter, but one that is going to run right up against U.S. obligations to provide Thiwan with a sufficient defense. That is not good for either side. cJ IAr Events following from the mid-air collision between a U.S. surveillanceair-

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craft and a Chinese fighter plane over the South China Sea suggest a stronger view of the United States within the People's Republic of China, especially among members of the People's Liberation Army [PIA]. What sto,rtd the U.S. military in Asia do in light of the situation?

B L A r R :I b e l i e v e t h a t t h e p a r t i c i p a t i o n o f the PLA in sorne of the cooperative, multilateral approaches, which the United States also cooperates in and sometimes sponsors, is one very important step. It puts us on the ground where we are working on common problems as professionals from different countries that have an interest in making progress. It expands our relationship from a one-dimensional focus, and those sorts of activities are very irnportant to working out a peaceful way forward in the region.

GJIA: How do you think the United States should deal with domestic issues with broader regional implications? I am thinking especially of Indonesia, where domestic cohesion-a sovereignty matter-can adversely affect the region as a whole.

BLAr R: I think the rnilitary aspectsof those situations are something in which the United Statesdoes not have much of a role to play; so in the short term, it is not something in which I thinl my command can play a role. I believe in keeping in contact with those in t}e Indonesian Armed Forces who share the goals of turning the TNI l%ntoroNosiono/Indonesit*the Indonesian NationalArmed Forces] more toward external threats, toward internal reform, and toward a more professional force.

Our effort should be to support, and that is the best contribution we can make.

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e,rrr: Officers in the TNI have asked for the resumption of U.S. military aid to help them play a more constructive role in their country. The TNI has a very negative record in human rights, yet at the same time it is central to Indonesia's identity and unity. In light of this, do you still see a very limited U.S. role in dealinswith the TNI? 'We BLArR; are limited by legislation restricting many aspects of our military relationship until the TNI assigns accountabiliry for the actions in East Timor in the surnrner of 1999 and solves the problem of East Timorese refugees in West Tirnor. The TNI has to rnake good on those matters before we can really renew anything even close to the forrner relationship that we had, so those are important things. crrn: With regard to North Korea, the current administration seems rnuch more cautious than its predecessor. Do you agreewith this approach? Does it also mean that the Perry Process is dead?

BLAIR: The new adrninistration is reviewing policy towards North Korea.

The irnportant components of the Perry policy-consultations with the Republic of Korea and Japan, keeping a strong military posture for deterrenceare there. Then the whole area of arrangernents to keep North Korea from threatening its neighbors is being re-examined. I think the fundamental pieces of the Perry Processwill be continued. cJrA: Right now-W-ashington is facing a Iot of problems in the U.S.-Japan security pact. How can the U.S. military help repair the current rawness in relations?

T N T E R V TCEoW nflict&Security BLArR:I think the important thing is the continued realization on both sides that our alliance is not an alliance of the past that was dealing with a single threat, but an alliance of the future that can be used for addressing big problerns in the region and the world. W-e are talking about the

two largest economies in the world, the two countries that contribute over half the international aid in the world. Japan and the United States and their alliance can solve future regional problems, and we are in the process of working that out now, because it is new territory.

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0ulture&Soclety

TheUnitedStates, Cuba,andthe Politics of Culture Darnian J. Fernandez I will never forget that on my first visit to Cuba in rg/g one of the initial questions a Cuban asked me was if I liked Donna Summer. It was the height of disco fever-of course I liked Donna, who didn't? At the tirne, I did not realize that the disco queen had a role in U.S. -Cuban relations. In fact, embracing Donna Summer-or any other icon of U.S. pop culture in I$/$-was not merely a rnatter of musical taste, but a political act as well. To the beat of Donna Summer, and through culture in general, individuals could forge bonds that governments on both sides of the Florida Straits shunned. In rgg2, during another trip to the island, it becarne clear to me once again that culture was succeeding where governments had failed. Cuba was then experiencing its deepest economic crisis since the r9$g revolution, and, as a result, life for Cubans was very hard. Nevertheless, Madonna, another U.S. pop diva, captured the imagination and adrniration of Cubans. Cuban radio and television stations played the Material Girl's material even if the U.S.-Cuban relationship-like the theoretical standing of dialectical materialism itself--was in dire straits.

The power of culture to break through political walls, in the process revealing stark ironies, surprised me.

The Cubans I have met during rny trips to the island have wanted to share with U.S. citizens not only musical tastebut all

Damian J. Fernandez is Associate Professor Chair

and

of the Department

of International

Relations

at Florida

International

University.

He is the

author

of Cubo on d the Politia o/Possion (University of Texas Press, zooo) co-editor

and the

of Cubo, the Elusiae

N at ion : Reinterpretotio ns of N ationol ldenti! (U.ire rs ity of Florida

Press, 2ooo).

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things cultural, from Levis to Elvis, from the principles of capitalist economics to postmodernism. From this vantagepoint, Cuba's "isolation" appears more myth than reality. At least at the level of pop culture, Cubans are integrated into the global stage,if not into the global market.

A significant arena of cultural commonality exists that can lay the functional foundation for further political rapprochement between Washington and Havana. Such an approach is fickle at best, however. In the cultural arena, common ground can be as easilylost as found, depending on who is in power to dictate policies and what lies below the surface of the cultural connection. In the expanding area of U.S.-Cuban cultural exchanges-a subdivision of the "people-to-people" policy inaugurated in rgg2-tensions and contradictions exist that reveal the possibilities aswell asthe lirnits of cultural relations in the rnidst of political divorce.

cornmon citizens. Only the daring or ardent sympathizers of the revolution traveled to Cuba. In the late rg)os, under the presidency ofJimmy Carter, the situation changed. After a group of CubanAmericans visited the island, tens of thousands of emigrds found the doors to the island relatively open and were able to reestablish their bonds with loved ones who had stayed behind. Returning exiles brought with thern rnore than suitcases full of goodies; they also carried cultural baggage that had a remarkable irnpact on Cuban society, convincing Cubans of the tremendous opportunities that U.S. society offered. This belief found its most dramatic expression in the Mariel exodus of r98o, when more than r2$,ooo Cubans used a brief relaxation of emigration restrictions to leave the island.

In rgg2, the Toricelli Law (Cuban

Dernocracy Act) inaugurated a twotrack policy that encouraged people-topeople contacts but continued to exert econornic and political pressure on the Cuban g'overnment. The law rnarked a cultural transnationalism is part and normative change in U.S. policy by parcel of processes at work in today's f a c i l i t a t i n g c u l t u r a l a n d a c a d e m i c world, cultural ties between Cuba and exchanges with, as well as relaxing travel the United Statesdate back centuries. In restrictions to, Cuba. The United the sixteenth century, Spanish expediStates's new logic was to take a soft tions to Florida sailed from Cuba. stance on the Cuban people while Nineteenth-century Cuban nationalmaintaining a hard line toward Fidel ism was forged as much in Havana as in Castro's government. The law was a Key West, Thmpa, and New York. In the compromise that addressed the confirst half of the twentieth century, cerns of two contending sides in the Cuban music was the rage of dance halls debate over Cuba policy' those who throughout North and South America favored normalization, and those who and Europe. Just as U.S. culture sold in advocated isolation. The ability to craft Cuba, Cuban culture sold in the Unita modusuiaendiin what has been a polared Statesand around the globe. ized issue is noteworthy, even if neither After the breakdown of U.S.-Cuban side was totally appeased. On the one relations in the early r96os and the estab- hand, traditional supporters of the stalishment of the embargo in rg62, culturtus quo vis-a-vis Cuba in the CubanaI contacts with Cuba were off limits to A m e r i c a n c o m m u n i t y e n d o r s e d t h e

U.S.-Cuban CulturalRelations in HistoricPerspective. while

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F E R N A N DcEuzl t u r e &s o c i e t y Toricelli Law becauseTrack II (the sec- Cuban educational programs under tion of the legislation that established Track II aimed to corrode socialist ideolpeople-to-people contacts) was porogy and subvert the Cuban government.

Pope John Paul II's visit to Cuba in trayed as a backdoor way of underrnining the Castro regirne-a logic that, as r99B helped convince-Washington of the explained below, did not escapeCuban wisdorn of expanding cultural exchanges with the island. The Pope called for policymakers. On the other hand, proponents of normalization saw the law as Cuba to open to the world, and for the a step in the right direction. world to open to Cuba. In January The Toricelli Lawwas a watershed since 1999, President Clinton announced it codified what seemsto be the current, if the U.S. government's decision to facilitate cultural engagernent with Cuba. tentative, consensus on U.S. policy toward the island, relaxing the ernbargo The new provisions allowed for greater piecemeal while not abandoning sanc- flexibility in securing licenses to travel tions wholesale. The legislation also res- and the relaxation of restrictions on remittances from Cuban-Americans to onates with the Bush administration's relatives on the island. current professed support for "smart Today, two pillars sustain U.S. policy sanctions"-sanctions that punish governments, not peoples. While the Toricelli toward Cuba' facilitating people-toLaw's Track II legislation facilitated people contacts while upholding the greater social fluidity between the island longstanding embargo. People-to-peoand the United States,the Helms-Burton ple contacts have resulted in a rnyriad Act passedin i996 seemed to put an end of institutionally-organized cultural to exchanges. Helms-Burton was passed exchanges as well as hundreds of thouin response to the Cuban military's sands of family visits which have lead to downing of two civilian aircraft in interpersonal, cultural, and affective encounnational waters off the Cuban coast. ters. The official exchanges cover a wide range of activities: painters who travel to Helms-Burton tightened the ernbargo on the Cuban governrnent and expanded exhibit their work, authors who read from their latest novels, professors who possible sanctions on countries, companies, and individuals who engagedwith it. attend conferences to present papers and The year rgg6 rnarked a downturn in collaborate on research projects, and cultural engagement not only due to performers who stagetheir works.

The growth in the nurnber of instituWashington's actions, but to Havana's as well. The Cuban government tightened tions that have established programs with control over academic and cultural travel Cuba since r99g-over 2Oo in the Unitto the United States. In an infamous ed States-and individuals who have travspeech, Rairl Castro, the Minister of the eled there legally-close to 2oo,ooo frorn the United States, including Armed Forces (and Fidel's brother), condemned what he called "fifth columCuban-Alnericans-underscores the nists" inside the country's cultural and grassroots support in both nations for educational establishment who had built these types of linkages. It is particularly relationships with foreign academics, revealing that these exchangeshave multiplied despite governmental obstacles. particularly Cubanists in the United Rar1l argued U.S.Yet States.

Castro that this fast pace may be curtailed by fur-

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groups within a rigid political system and a failing economy.

At the same time, the Cuban government rernains aware of the inherent dangers of cultural exchanges. Artists and intellectuals, especially younger ones, form the group in Cuban society that has come closest to overtly challenging the Heart,Soul,andMone!.cultur- Cuban government. Nowhere is the impact of the exchangesas dramatic as in al exchanges carve out a new space of Miami. Although, publicly, a majority of cornrnonality and encounter that is outCuban-Arnericans continue to support side the traditional realm of bilateral In U.S.-Cuban case the crethe ernbargo as a rnatter of principle, they politics. the also retain close bonds of kinship with ation of such a space has enabled both Cubans on the island. As a consequence, countries to normalize one dimension of Cuban cultural activity from the island is their relationship, even if most other readily found in Miarni-the rnusic of /c aspects remain firmly grounded in anachronistic Cold War logic. tlmbo, the latest short stories of Antonio a Jos6 Ponte, cutting-edge art installaCultural flows are by definition two-way affair. Cuban culture has tions, and the most gripping of docufound a market in the United States rnentaries. because it sells well. The U.S. entertainment industry appropriates "prodWhile people-to-people engagernent and ucts"-whether they are songs, novels, or the bilateral cultural activities that are movies-frorn the world over and markets thern successfully at home and subsumed under this policy have considis erable benefits, the policy rests on a cenabroad. Capitalism takeswhat alleged"authentic," ly nationally in this case tral contradiction and on several questionable premises. It also leads to misinCuban, and internationalizes it. The "BuenaVistaSocialCiub phenomenon" is a terpretation of the nature of the relationship between art and politics in general, result of this process. Cuba is particularly susceptible to such cultural exports and in the Cuban casespecifically.

A host of argrrrnents have been articsince it has had a rich cultural tradition, especially in music, both before and ulated in favor of the cultural exchanges.

Advocates (I ar.ro.rg them) contend that after the revolution of 1959. repreexchangesin the arts, education, sports, While cultural exchanges rnay and religion serye as confidence-buildsent a temporary brain drain for Cuba, ing measures that could translate into rnore importantly they are a source of further collaboration in key areas such foreign exchange. The rnusic industry milas drug trafficking and immigration alone is reported to generate $ro lion a year for Cuba, while remittances control, if not to full-fledged normalization. Cultural exchanges have the from exiles are calculated at $8oo mlllion. Moreover, cultural programs clear potential to become a positive abroad also constitute a mechanism that force for change within Cuban political and economic life. provides flexibility to certain favored conther governmentally-imposed straints. Since last year, for example, the Cuban government has been attempting to further limit accessof Cuban cultural agents, particularly scholars, to conferences and other exchange venues, particularly in the United States.

Possibilities and Constraints.

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F E R N A N DcEuzl t u r e & s O c i e t y The experience of former totalitarian and authoritarian regimes demonstrates that cultural influences may easea state's stranglehold on society. The covert political effects of rnusic, art, and education can help slowly erode a dictatorship's authority. The same phenomenon is occurring in Cuba.

The policy of perrnitting cultural exchanges also distinguishes between peoples and governrnents, a logic which both Havana and Washington endorse.

This soft, long-term approach is a positive step toward conflict resolution, especially in the advent of a future democratic transition in Cuba. Developing forms of cultural engagement can help in the long term by fostering the Cuban peo-

This grassroots diplomacy is expected to have a liberalizing impact in an otherwise totalitarian political system.

People-to-people contacts, and their cultural component, are expected to contribute to the development of Cuban civil society by providing greater room for autonomy from the state. While never fully articulated, this contribution is a centerpiece of the policy's logic. Current policy can assistthe proto-civil society on the island in a number of ways, since it: (r) may prornpt a demonstration effect by showing the benefits of alternative forms of governan..; (z) has economic repercussions in terrns of helping fund rnicro-enterprises, self-help initiatives, and the informal econorny outside state

Culturalexchanges carveoutanewspace of comrnonality and encounter that is outside the traditional realrn of bilateral politics. ple's goodwill and attempting to replace rnutual rnisperceptions with a better understanding of both societies. Some advocatesregard this as a cautious process of rapprochement that could eventually lead to normal diplomatic relations.

The current policy "democratizes" U.S. policymaking in two distinct ways.

On the one hand, it responds to U.S. citizens' values in terms of freedom of travel (even if severe restrictions are still in place and licensesare required) and thus echoes the domestic majority's perspective that isolating Cuba is inappropriate in the post-Cold War world. On the other hand, people-to-people contacts turn those U.S. citizens who are allowed to travel into indirect instruments of U.S. policy, as they become envoys of U.S. culture (and economic and political ideals).

control; (3) makes the task of government's surveillance more arduous as the influx complicates procedures; (4)

the Cuban apparatus of visitors facilitates the channeling of assistance to hurnan rights groups; (5) underscores the position of those within the Cuban governrnent who support improved relations with the United States (the sarne individuals who are most likely to endorse a space for civil society on the isla.d); (6) redefines the relationship between the state and society by providing greater autonomy for creative agents even if they work within state- controlled institutions; and (7) ettubles the rise of epistemic communities, that is, networks of individuals in the same profession who use a similar vocabulary even if they speak a different langrrage.

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The impact of cultural exchanges on civil society development is neither immediate nor automaticr rather, it is a long-term project that in considerable measure depends on the structure of opportunity for autonomous collective action in the country. Sectors of the comrnunity partly Cuban-Arnerican oppose cultural programs because they do not see the possibility of civil society formation within state-controlled arenas. Their endorsement of people-to-

on society. In Cuba though, they are also political in a literal sense, as the government makes direct decisions about who is funded or allowed to sing, play, publish, dance, or exhibit. It is therefore a pitfall to perceive Cuba as a normal country where artists are free to engage in their activities. Although the Cuban government has supported the arts, beneficiaries paid the price of accepting limits on their freedorn of artistic expression. If we find that the

isa The seductivepowerof u.S.cutture threat to Cuban authorities. people contacts is therefore limited to support for bona-fide NGOs such as churches and dissident groups.

U.S. culture carries U.S. values, and since it is attractive it can convert others into "believgls"-q1 so the argument goes. Capitalism's popular culture and U.S. political values are indeed quite rnagnetic to many throughout the world.

Cuba is no exception. The seductive power of U.S. culture is a threat to Cuban authorities. They believe that capitalist culture may undermine socialist values of egalitarianisrn and, more importantly, erode the elite's control over political and economic life.

separation of cult,rre frorn politics is a necessaryfiction for current U.S. policy, let us fully acknowledge this finding and all its consequences.

Second, ignoring the political dimension of Cuban culture also obscures orrr perception of Cuban artists' civil liberties and human rights. The people-to-people approach neglects that the Cuban governrnent-and the U.S. government, but not based on a political litrnus test of the applicants for travel licensesdecides who is allowed to travel. In practice, therefore, "people-to-people" really rneans "people-to-governmentto -people."

Finally, the current policy may also be counterproductive because it tends to shroud traveling to Cuba in an aura of rornantic prohibition.

Moreover, by focusing exclusively on cultural exchanges, the old tendency of exoticizing and sexualiring Cuba-which is cornmonly portrayed by seductively dancing blacks or mulattos-is reinforced. This is a clichd irnage that edits out the less-than-gleeful aspectsof Cuban social life.

Pitfallsand Misconceptions.

While notions that culture builds bridges and music serves as a universal langrrage are easily assurned, they can also be misguided and possibly counterproductive. First, they dismiss the intensely political relationship between the government, society, and the arts.

The arts are always political in a broader sense,as they interpret and cornment

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F E R N A N DcEuZl t u r e &s o c i e t y

in How Cool is Cool? Participants U.S. -Cuban cultural programs, including U.S. performers and celebrities, at tirnes seem rather naive. They go with good intentions but little knowledge. As a consequence, they do not notice the serious and real restrictions of freedom in Cuban society. Contrary to what the Cuban government clairns and what some readily believe, the United States and the embargo are not responsible for the constraints on civil liberties in Cuba. To praise the Cuban government for its cultural efforts, as Harry Belafonte recently did, without recognizing the pervasive limitations on the freedorn of writers, artists, filrnmakers, intellectuals, and rnost Cubans generally, is counterproductive. The sarne applies to those who say, or, as in Bonnie Raitt's case, sing, that Cuba is "waytoo cool." Cuba rnaybe "cool," but calling a dictatorship "cool" really isn't.

A rninority that engages in artistic and educational prograrns rnay be willing to accept restrictions on human rights in Cuba that it is unwilling to accept in the United States. Yet even cultural relativisrn has its limits. Artists traveling to Cuba should acknowledge the Cuban people's right to choose their own form of government.

A Way 0ut? There is a way to reconcile the tensions inherent in cultural engagement and political divorce. If the United States adopts a policy that is broader in scope and internally consistent, the logical faults of the current situation will be reduced and the benefits increased. I propose a policy with four key characteristicsit needs to be long-term, multilateral, normalizing, and opportunistic.

Long-term suggests that the means and ends of the policy should look well

beyond Fidel Castro in an effort to safeguard the United States'sfuture interests on the island. This assumes that Cuba will undergo significant political change only post-Fidel. The United States must therefore position itself in ways that wiII help assistthe transition and safeguard its interests-promoting peace, stability, controlled migration, drug interdiction, and democracy, among others.

Multilateralisrn refers to a policy that engages other countries and aligns the United States with its closest allies.

While this would entail the revision of it would enable the Helms-Burton, United Statesto rnore consistently draw its allies to its side in related Cuban issues, for instance, in hurnan rights votes in the United Nations. It would also have the added benefit of defusing the U.S.-Cuba confrontation. The United States would downplay the the Cuban bilateral conflict-which has used for its own purgovernrnent poses-by crafting a rnultilateral consensus that rnight increase pressure on the Cuban governrnent.

Third, this policy would entail the normalization of bilateral diplomatic conduct. This would provide the United States with the tools to take Cuba to task for violating fundarnental norms that the United States and its neighbors endorse and that the Cuban people themselves value.

Finally, an opportunistic policy would give the United States the flexibility to respond to changes on the island as soon as they occur. Under the provisions of Helms-Burton, however, the president has little room to maneuver.

People-to-people contacts and cultural exchanges with Cuba rnake an important contribution to normalizing the United States's relationship with the

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government and the people of Cuba.

These programs, coupled with travel to the island of U.S. citizens at large, and Cuban-Arnericans in particular, have had, and will continue to have, positive

and at times unexpected outcomes. Yet current policy imposes unnecessarylimitations, and in so doing does not serve the long-terrn interests of the United States as well as it should.

PREPARE FORYOURCAREERIN INTERNATIONALAFFAIRSAT THE

BN,{TW CnNTER FoRGpnnnAN ANDEUNOPEAN STUUES . /-\

at Lreorgetown s EDMUND

A. WALSH SCHOOL OF FOREIGN SERVICE

The BMW CnNrnn FoR GERMAN AND EuRoprRN Sruotes fearures an intensive, interdisciplinaryprogram of instruction in German and European affairs.It is designedto prepare students for professionalcareersin international business,government, or nongovernmentalorganizations,as well as for academiccareers.The Center offers a two-year professionaldegree,the MASTERoF ARTS IN GERMANAND EUROPEANSTUDIES.It also offersstudentsthe opportunity to pursuea Pn.D. simultaneouslyin one of the participating academicfields: Economics,German, Government (emphasison International Relationsor ComparativePolitics)and History. For more information about the Center and the School of ForeignService,visit our websiteat www.georgetown.edu/sfs/cges.

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The Politicsof Samha Bruce Gilrnan Samba, which was cr\ .ted in its present form in the rgros, yet whose roots reach back much farther and tie Brazil to the African continent, has played an integral part in Brazil's conceptualization as a nation. Originally despised by Brazil's elite, sarnba's messageof racial integration was eventually used by both progressive reformers and authoritarian dictators.

Despite sarnba's image abroad as a catalyst for racial miscegenation, its political message never took hold in Brazilian society. Today, samba continues to be as rnuch a source of social integration as a prisrn of Brazil's racial fractures.

BruceGilman, Music

Editor

magazine, master's

for BroTll

received

music

from

fornia

Institute

Arts.

his

degree in the Caliof the

He is the recipi-

ent of three government

grants that have

allowed research

him

to

traditional

music in China, and Brazil. reach him e-mail:

You

India, can

through

his

cuica@inter-

world. net.

HiStOfiCal ROOIS. It is probable that the word "samba" originated in Angola, where the Kimbundu word sembadesignated a circle dance sirnilar in choreography to the westAfrican batuquethat Bantu slaves brought to Brazil. While the exact nurnber of blacls entering Brazil during its period of slaveryis unknown, it is comrnonly estimated that at least eighteen rnillion Africans were "imported" between r$38 and r8zB. The primary center from which the Portuguese disseminated slavesinto the Brazilian interior was Salvador, Bahia. It was the second largest city in the Portuguese Empire after Lisbon, and famous for its sensuality and decadence expressedin its beautiful colonial mansions and gold-filled churches. In Bahia, African culture took root to such an extent that today many African traditions are better preserved there than any-

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where else in the New World. Samba's rhythm is rooted in the rich musical heritage that Africans took with thern in their forced migration to Brazil.

Although samba's rhythm is of African origin, its melody, harmony, form, and instrumentation are influenced by European traditions. The licentious /undu dance, derived from the rhphrn of the batuque, became increasingly popular in Brazil in the late eighteenth century. At the same tirne, the flute, guitar, and caoaquinho, which initially accornpanied the modinha,the Brazilian way of playing the lyric song style of the Portuguese elite, would come to play an important role in samba. Brazilian poet and priest Dorningo Caldas Barbosa (r74o-r8oo), whose rnotherwas a slavefromAngola andwhose father was a Portugrrese businessman, broke with the tradition of the court style by substituting guitar for the harpsichord and introducing risqu6 ly'rics in the most aristocratic salons of Lisbon. While Barbosa was indignantly criticized for his sensuous poetrl, erudite Portuguese composers soon began producing their own modinhas. Both the lundu and the modinha crossed the boundaries between popular and elite, yet gained acceptanceat the Lisbon royal court in an early instance of the fusion ofAfrican and Iberian styles.

Brazil's African-inspired rnusical traditions also rnerged with other nonPortuguese, European styles. In the mid-r84os, French traveling musical theater companies introduced the polka to Brazil. As the lundu fused with the polka, it turned into the maxixe,a Brazilianized version of the polka. The maxixe became the first genuinely Brazilian dance and decisively influenced the creation of samba as a specific genre, eventually finding acceptance among the elite of Rio deJaneiro.

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Sambaand the Politicsof

RacialMarginalization.

During

Brazil's belleepoque,the fashionable elite aspired to Europeanize Brazil and put an end to the African aspects of Brazilian culture. Having recently gained its independence, Brazil was searching for an identity, and it turned to the European discourse of the time for an example.

Light-skinned Brazilians became ever rnore concerned about how they appeared in the eyes of European contemporaries, and a sense of inferiority induced them to conceal their regional customs and African influences. In stylish salons and caf6s, and at literary lectures, any reference to "things native" flagged the speaker's poor taste. The rnodinha and folk varieties of religious observance were disregarded because they did not fit European values of rnodernity and had gone out of style. In sophisticated circles throughout Brazil, European culinary tastes were held in high esteem, and regional foods were considered gauche. The daughters ofthe rich played with china dolls frorn France that idealized the French female as the image of elegance.

Similarly, African musical traditions were marginalized at the expense of European musical styles. By the r8/os, Republican propagandists were attempting to prohibit samba on the pretext that folkloric dances shamed Brazil's national image. Instead, people of "cultivated tastes" preferred Italian opera, the form of rnusic most representative of European elegance. Concerts given by famous European violinists were events of great social prestige. While the elite frequented dances where the waltz, polka, schottische, and the Arnerican quadrille were fashionable, the rnaxixe was considered a "black vulgarity. "

cTLMAN Culture & Society Racial marginalization was also fostered by the growing conviction among nineteenth-century intellectuals that true Brazilian nationhood required ethnic homogeneity. Influential scientists regarded people of mixed race as indolent, undisciplined, and shortsighted.

They argued that Brazil's racial composition did not exernplifr cultural richness or vitality, but rather constituted a singular case of extreme miscegenation; consequently, the person of rnixed race evolved into a symbol of Brazilian back-

heritage into a cornmon Brazilian blend.

Declining fortunes in the tobacco and cocoa plantations in Bahia state, the r87r Law of the Free Womb which freed all children born to slaves, the abolition of slavery in 1888, and the proclamation of the Brazilian Republic in rBBg brought many slavesand former slavesto Rio de Janeiro. As they migrated southward they brought along cultural baggage that included a whole complex of forrns, values, and social rituals expressive of an African and Afro-Brazilian way of life.

By the I87 0S, Rep.uplican propagand,isrs

were atternptrng to prohrbrt sanrbaon the pretext l\", folElori^cdances sharned Brazil's natlonal

lrrrage.

wardness. Blacks were seen as a major factor contributing to Brazil's inferiority because they would never be able to absorb, and could only imitate, "Aryan" culture. Racial mixing thus furnished an explanation for the defects and weaknessesof Brazilian society and became a central issue in Brazil's conceptualization as a nation.

Most Brazilians beiieved that national homogeneity could be achieved through assimilation and miscegenation, but only if this guaranteed evolutionary superiority through a general "whitening" of the population. Thus, the most welcorned immigrants were southwestern Europeans who rnixed readily with the rest of the Brazilian population; Africans were never considered among possible candidates for immigration.

Economic and political changes in the Iate nineteenth century undermined these attempts at slowly fusing the African

These included percussion jams and dances. In the absence ofpopular venues for entertainrnent, newcomers to Rio sought support and consolation at farnily parties with music, dancing, and even religious devotion.

The horne of Hilaria de Almeida, "Tia Ciata," was a gathering point for the musical talent that had rnigrated frorn Northern Brazil. At Tia Ciata's parties, there was dancing in the sitting room, samba at the back of the house, and batuque in the yard. Singing melodies with popular lyrics, her grrests would dance in a circle, clapping to the accompanirnent of grritars, cavaquinhos, and percussion. Among the enthusiastic and talented rnusicians who frequented Tia Ciata's parties was a group of outstanding instrumentalists-Josd Barbosa Machado da Silva, "Sinh6, " Joio 'Joio Guedes, Baiana," Ernesto da dos Santos, "Donga," and Alfredo da Rocha

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"Pixinguinha."

Viana Filho, They blended all contemporary musical styles with an instinctive freedom; rather than being a mechanical aggregate of distinct musical characteristics, their work created an original and independent phenomenon that modified the cultural panorama of Brazil.

One of the collective creations that emerged out of Tia Ciata's home was a tune called "Pelo Telefone" ("On the Telephone"). Both the theme and the melody originated in the Brazilian Northeast. The song tells a story of stolen love and a telephone conversation with the chief of police, and incorporates the characteristic rhythrnic divisions of rnaxixe. The telephone, an advanced means of communication, is also symbolic of modern tirnes. While this song ernployed characteristics of the maxixe, these were fused with new elernents-creating what is arguably the first sarnba.

On November 6, rg16, Donga registered his intellectual property rights to "Pelo Telefone" with the National Library in fuo de Janeiro as a Carnaval samba. Rather than intending to attribute authorship to himself, he registered it with the intention of establishing samba as a unique genre. "Pelo Telefone" was transformed into a huge Carnaval hit in r9r7, was recorded by Banda de Odeon for Casa Edison, and triggered countless imitations. Whiie it was possibly not the first samba ever recorded, "Pelo Telefone" allowed samba to acquire commercial value as a distinct genre.

Despite subsequent disputes over author rights, samba eventually took its place alongside marchaas a preferred style of Carnaval music in Rio and eventually throughout the rest of Brazil.

In the first decade or so after the debut of "Pelo Telefone," municipal

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authorities tried to crack down on samba. It was restricted to shantytowns and publicly perceived as a socially inferior type of musical expression cultivated by rascals and vagrants. The police, in their efforts to maintain public order, prohibited not only samba groups from parading downtown, but banned the actual instruments of samba as well.

Samba was forced to conceal itself in condombl| (an Afro-Brazilian religion), which was then considered slightly more acceptable. It would take the edict of a federal administration to halt the persecution of neighborhood samba groups and to officially recognize their parades.

Sambaasthe Modelfor a New Brazil. After the fed.eralgovernment lent its support to samba,Brazilian folklore began to win growing acceptance beyond its traditional shantytown constituenry. The increasing assertiveness arnong Brazil's black and mulatto populations, news of the growing appreciation of black art in Europe, and the Harlem Renaissance in the United States, all turned Brazilian folklore stylish. The upper class of Rio de Janeiro and Sao Paulo began to cultivate a taste for the exotic, and Brazilian music was enriched by the interchange of elite and popular tastes. At the same tirne, the views of anthropologist Gilberto Freyre, and Getrllio Vargas, Brazil's new populist president, provided the country with fresh perspectives on racial mixing. Both Freyre and Vargas highlighted the significant contributions that blacks had made to national culture and rejected older notions that only cultural "whitening" could help Brazil evolve into a modern nation-state.

Freyre successfully challenged traditional views by arguing against the racial

c t L M A NC u l t u r e & S o c i e t y pessimism and Europhile reasoning that dominated the late nineteenth and early twentieth centuries. Instead, he promoted the idea of a Brazilian mestizo identity in which racial mixing was seen as a positive cultural process rather than a degenerative influence. Freyre believed that music, more than any other artistic form, was the chief expression of Brazil's national spirit. He was convinced that "the most Brazilian of arts" had the potential to break down barriers of race and classand could serve as a channel of communication for diverse groups in Brazilian society.

Vargas provided the political counterpart to Freyre's views. Ever since Brazil's coffee oligarchy had gained statepower in the wake of the rBBg proclamation of the Republic, it continuously expressed its preference for European, rather than African imrnigration (slavery having been abolished in rB8B). Only after Vargas became president in rgJo did the oli-

men Miranda's Baiana clothing was, for instance, selected as Brazil's typical costume. Given Rio de Janeiro's prominence in this composite, samba schools and carnaval parades were supported by the state and quickly established themselvesall over Brazil. Vargas also ordered that radio programming include popular music, and arranged for srnall rural towns to have public radio loudspeakers.

Radio broadcasts, in turn, acquired a rnass audience, and broadcasts from Rio becarne the most popular programs.

Samba significantly benefited frorn the political efforts to create a homogeneous national culture. While certain types of music suggested different racial or class origins, samba dissipated social antagonisms and helped uniS a society that varied in its origins, appearance, and waysof Iiving and thinking.

Samba's triumph over the airwaves allowed it to penetrate all sectors of Brazilian society. Growing international interest in Carnaval as a

rrrorethanany Freyre believedthat rnusic, other artistic fo1m, was the chief expression of Brazil's national spirit. garchy lose its grip on power. Vargas made racial mixing a semi-official doctrine. The rg!{ constitution stipulated that "the entrance of irnrnigrants into the national territory will be subject to the restrictions necessaryto guarantee ethnic integration," "ethnic integration" being the official euphemism for racial mixing.

Under Vargas's authoritarian umbrella, a new model of national identity was fabricated in which distinct cultural elernents were selected from the alreadyexisting regional models and recombined to form an official national culture. Car-

cultural phenomenon also ensured that samba would play a central role in forging a new image of the Brazilian nation both at home and abroad.

FromPolitics to PopCulture.

Despite samba's popularity across aII sectors of Brazilian society, its rnessageof racial integration never completely took hold. Since the beginning of the nineteenth century, Brazilian elites opposed the participation of blacls in Carnaval.

In response, a nucleus of black resistance developed which still remains alive today.

Summer/l.all 2OOT tTrl

Buslness &Flnance Microfinance: Changing

Landscape for Development Maria Otero and Monica Brand Microfinance is the provision of financial serwicesto lowincorne and very poor self-ernployed people. A developrnent approach that provides srnall loans at cost-of-lending interest rates, rnicrofinance is a financially viable and socially ernpowering way to fight poverty. Its power lies in the fact that it is based on human self-initiative, the one assetfound even in the rnost disadvantaged pockets of society. Informal microenterprises-fruit stands, shoe repair shops, small-scale clothing manufacturers-account for 6o percent of ernployrnent in sorne developing countries.'

Instead of redistributing existing wealth, microfinance creates new wealth-right where poverty exists. It derives its power from some of the rnost resourceful and resilient people in the world, the working poor. taditionally, a microentrepreneur in Latin America will pay one dollar in interest daily for every ten dollars borrowed frorn rnoneylenders to buy the knickknacks to sell in a kiosk, the feed to fatten chickens, or the yarn to sew sweaters. Microfinance institutions (MFIs) replace moneylenders by offering financial services to the working poor in a more client-friendly manner. MFIs charge less than the informal moneylenders and invest the proceeds in expanding serwicesto a larger nurnber of people, increasing their impact and financial viability. The results are impressive.

MariaOtero is President

and

of ACCION tional,

CEO

Interna-

a non-profit

organization

that pro-

vides financing

to the

working

poor

America

and Africa.

in Latin

MonicaBrand is Senior Director the Research Development

of

and Depart-

ment of ACCION International.

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MICROFINANCE

Many MFIs boast a repayment rate of better than g8 percent.

Since its inception in the 197os, microfinance has evolved in astounding ways,incorporating into its practice social and economic development concepts as well as principles that underlie financial and commercial markets. This combina-

to alleviate poverty at the client level.

Indisputably, microfinance, at its core, combats poverty. In the main, urban clients of MFIs are poor city-dwellers housed in overcrowded slums or squatter settlements, lacking accessto basic services such as healthcare, electricity, and running water. These individuals

rateof .Many.MFIs bOast a repayment better than g8 percent.

tion has led to the creation of a growing number of sustainable and profitable MFIs around the developing world. As microfinance continues to evolve as a development strategy, it will be successful only if it is able to strike the right balance between the two frameworks that underlie its practice: development and finance.

The answer to the capital needs of marginal populations is based on innovative efforts centered on three intersections between microfinance and developrnent: reaching the poor, building institutions, and deepening the financial system's reach. All three characteristics must be present for microfinance institutions to achieve both their development and financiai goals. Without them, the combined strength of rnicrofinance and development will evaporate and microfinance will become either a set of highly profitable financial institutions that have abandoned their market or a systernof insignificant donor-dependent and localized credit programs. Keeping the collective eyes of microfinance professionals on these intersection points is the primary challenge of this field today.

Reaching the Poor. The first intersection is microfinance's obiective

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lack education and other skills that are e s s e n t i a lt o e n t e r t h e m a i n s t r e a m e c o n omy. Many of them are women, poorly trained and playing dual roles of provider and caregiver. These poor people are more exposed to the threats of bad sanitation, and diseasethan the rest of the population. When disaster strikes in the form of inflation, floods, earthquakes, or other outside forces, they are the most vulnerable.

Rural clients are landless or landedpoor. Their land is often unproductive or lies outside irrigated areas. Many farrn in arid zones or on steep, hilly slopes, lands that are ecologically vulnerable.

Opportunities for off-farm employment are few and must be self-generated. Many of the rural poor rnix various earning activities to generate the cash they need to survive. They live in large households.

Their children are especially susceptible to diseaseand often suffer from malnutrition. Many depend on their children for work and rnust weigh the opportunity cost of sending children to school, as an investment for the future, against the present benefits of keeping them at work.

Microfinance enables poor people who start their own small businesses to create capital, protect the capital they have, deal

o r E R o& B R A N DB U S i n e S SF&i n a n C e with risk, and avoid the destruction of capital. It attempts to build assetsand create wealth among people who lack both.

For the very poor, microfinance becomes a liquidity tool that helps smooth their consumption patterns and reduce their Ievel of nrlnerability.'

At a more subtle but no less important level, increasing material capital strengthens a poor person's sense of dignity and contributes to ernpowering hirn or her to be a productive participant in the economy and society. With a source of income, a person can provide for the family, improve the household's accessto basic needs, and plan for the future.

When these conditions are present, a person who is part of the marginalized sector of the society becomes better equipped to be an active citizen.

they become a transitory means of reaching the poor and lose their punch as a cornponent of a broader developnent strategy. Moreover, only by becoming financially self-sufficient and ultimately profitable will these institutions be able to continue accessing private capital markets-the only source large enough to address a problem as immense and endemic as world poverty.

This rnajor link between finance and development begins to unravel unless rnicrofinance institutions attain selfsufficiency in their operations.

In order to strengthen institutional viability, many prograrns, such as ACCION International, work with affiliate MFIs to implernent innovative strategies that both increase the efficiency of their internal operations and address the unique nature of their tarBuildingInstitutioflS.Thesecondget rnicroenterprise markets through point of intersection between microfinew product developrnent. Arnong the nance and development occurs at the innovations that MFIs have developed institutional level. Microfinance proto maximize efficiency are cost manposes to create private, sustainable, and agement schemes, re-engineering perrnanent institutions that specialize in efforts, and creative uses of technology delivering financial serwicesto the poor. such as srnart cards, credit scoring, and Against a broader development backhandheld computers. drop, these institutions become a means On the client side, MFIs have develto an end, not an end in and of themoped an ar ray of new products, includselves.They constitute part of the unating solidarity groups based on "social" tained and long-sought-after vehicles c o l l a t e r a l f o r t h o s e m i c r o e n t r e p r e needed to incorporate the poorer sec- neurs that are asset-poor and thus lack tors into the economy. They put capital traditional forms of grrarantees; indiin the hands of those who otherwise vidual loans for those clients whose would not have it to employ immediatebusinesses have grown or who need ly in productive ways, and they enable more tailored credit terms; and lines of people with few assetsto save. credit for those whose cash needs flucIt is for this reason that institutional tuate and who have demonstrated the sustainability becomes so crucial to capacity to manage this variability. Such microfinance. If microfinance instituinitiatives seek to create financial institions are not financially solid, able to tutions for the poor that become true cover their costs, and capable ofdeliverintermediaries between the informal ing financial services over the long term, sector and the conventional economy.

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Linkto the Financial System.microloans The final intersection between microfinance and development occurs when a microfinance institution becornes a regulated institution that is part of a country's financial system. This connection is made possible by the recognition in the last decade that healthy financial systerns are an important piece of the development puzzle and that financial sector improvement and reform should be a priority in all developing countries.

When MFIs become part of the financial system they can accesscapital markets to fund their lending portfolios, allowing them to dramatically increase the number of poor people they reach. They can also capture savings, providing another important financial service to the poor, and access these deposits as another source of lending funds.

In Bolivia, a microfinance institution, BancoSol, has successfullytapped international capital markets to expand its funding sources. In the first two years of BancoSol's operations, hea',y reliance on the interbank market made it particularly vulnerable, given its status as a new institution focused on a segment long considered unbankable. Support provided by the ACCION Latin Arnerica Bridge Fund was key to the bank's funding, as was the purchase of certificates of deposit by BancoSol's shareholders and others.

Created in t984, ACCION International's Latin Arnerica Bridge Fund is a guarantee fund that helps rneet its affiliates' growing dernand for capital to fund their microloan portfolios. The first of its kind, the Bridge Fund is capitalized by donations and private deposits. The Fund issues letters of credit that allow ACCION affiliate MFIs to borrow directly from local banks, dramatically increasing their pool of capital for

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and effectively linking microenterprise with the formal banking sector. The Latin America Bridge Fund is currently capitalized at over $6 million and pays a range of interest rates to its lenders. In 2OOr, the Bridge Fund has received approval to extend new letters of credit totaling $3.5 million to some of the larger, faster-growing MFIs to support portfolio growth.

By inserting thernselvesinto the financial systerns of their country, these microfinance institutions drarnatically deepen the reach of financial systemsto populations previously excluded from banls and other financial institutions.

One essential means of alleviating poverty is the creation of a broader, rnore inclusive financial systern that does not restrict the allocation of capital to a tiny group of elite but instead integrates the poor as a market segment and reallocates resources from other sectors.

Deepening the reach of the financial systerns is, in relative terrns, a recent achievernent for microfinance. It is rnade possible only after creating financiallyviable institutions.

Only after it was demonstrated that MFIs could manage risk effectively and would not becorne a systemic risk did their incorporation into financial systemsbecome possible.

Reality:Challenges Facedby MFIS. With profits comes competition. Microfinance's successhas attracted new players that are dramatically changing its landscape. Clients have become more discriminating now that they have choices, deserting institutions that do not respond to their needs. The resulting downward pressure on prices and the scrarnble to enhance product offerings has put severe pressure on institutions that were born in donor-driven.

orERo& BRANDBusiness&Finance environrnents. As a monopoly-like result, it is estimated that of the many thousands of MFIs currently in operation, only about 2oo will survive in a financially sustainable way-without continued donor subsidy.

The factors that have differentiated the strong institutions from the more vulnerable are well docurnented and widely understood. One of the most critical success factors is strong leadership, characterized by a balanced focus on sustainability and outreach and an ability to empower and motivate rniddle managernent to rnake decisions. Good governance, characterized by transparency, accountability,

advancement in the field. However, even strong institutions are facing new challenges that will determine whether they can continue increasing their outreach and link to the financial systems.

MFIs must confront these new challenges in order to push forward the frontier of microfinance. The first challenge for MFIs is to develop a deeper understanding of their market so that they can survive when cornpetition hits. MFIs must differentiate the needs and preferences of distinct market segments and tailor products accordingly. Yet understanding alone is insufficient given the ferocity of competition in sorne markets

hasattracted new M iCrOfinanCgtSSuCCeSS players that are drarnatically changing its IanoscaPe. and rigorous adherence to stated objectives, is a natural corollary to this factor.

Another critical element is robust credit technology, which is based on logical, efficient processes and a welldesigned management inforrnation system well tailored to the needs of the target rnarket. This latter point highlights how important it is for MFIs to have a strong understanding of the market and differentiate themselvesfrom the competition.

Tlken together, these last two factors will help ensure strong portfolio quality, which is crucial to institutional longevity.

Institutions that have been able to attain these goals have been able to attract capital from more conventional sources and reduce their dependency on donors. Thus, because of innovative investment vehicles like the Bridge Fund, accessto capital is no longer the principal impedirnent to continued

like Bolivia and Nicaragua. Thus, MFIs must dedicate resources to the development of new products that sirnultaneously respond to clients' needs while helping to generate new revemres.

Innovation is needed as much on the supply side of the equation as the demand side, as efficiency has taken on a new importance in today's competitive microfinance market. In addition to the competitive pressure on prices, the desire to extend their reach to more destitute clients has increased the urgency among MFIs to cut costs. Thus, from a poverty perspective, one of the benefits of increased competition is that the cost of credit has come down dramatically for the clients. However, for the MFIs, the pace of these price wars has outstripped their ability to improve efficiency, leaving institutions struggling to cover their costs.

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This new irnpetus to dramatically improve efficiency has prompted two responses among MFIs' re-engineering and the use of technology. Re-engineering involves the often radical redesign of business processesto improve efficiency, product quality, revenue generation, and customer service. In the U.S. financial sector, re-engineering involving consolidating, streamlining, and automating lending operations was critical for banls faced with deregrrlation and an onslaught of competition in order to prevent further erosion of profit margins.

A core component of re-engineering in corporate Arnerica was the application of technology to automate, integrate, and redesign business processes to improve efficiency, custorner serwice,and product quality. Similarly, many MFIs are applying both old and new technologies to better utilize scarce resources. Some of the newer experimental technologies include the use of PaIm Pilots to create "paperless"microloan processingsystems and credit scoring to patially automate the decision-making process. For exam-

ple, building on the extensive databases of a few of its more established affiliates, is developing a pilot credit ACCION scoring systern to develop automated decision trees to facilitate loan decisions.

The ability of microfinance institutions to maintain the double bottom line of increased outreach and financial sustainability has allowed them to connect the inforrnal economy to conventional markets. By strengthening the intersection between poverty reduction, institution building, and accessto commercial markets, MFIs have the capacity to create structural changes in how capital is made available to people previously excluded from the financial rnainstream. Microfinance addressesthe seemingly intractable problem of creating the infrastructure to reallocate resources and to create wealth among poorer sectors. Its strength and sustainability depend on the systems themselves. Most importantly, however, rnicrofinance's successlies in the perseverance and entrepreneurial spirit of the working poor whose businessesfuel their countries' economies.3

NOTES r International

Labor

Organization,

"Empleo

Protecci6n

y

"Microfinance,

Risk Management

and Poverty," pre-

Social en el Sector Informa'l' El Empleo en el Sector ]nformal - Retos y Programa Futuro," Comisi6n de Empleo y Politica Social (ESP) (Gine-

paredfor

bra, ILO, March zooo) 2, < w.ilo.org>.

especial'ly when they face personal emergencies

2 These findings are emerging from the work conducted by Jennefer Sebstad and Monique Cohen,

3 This article is based on a piece by Maria Otero published inloumolofMiuofnance,Vol. r, no. r, fallrg99.

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theWorldBonk'sWorldDeuelopmentReporl2oooon

Poae!, lggg.

Data from four countries demonstrates that finance for the poor seryes to reduce their risk,

Law&Ethics

WebWeCouldWeaue Oh Wat a Tangled Catherine L. Mann The Internet marketplace is global, technologically dynamic, information rich, and network driven. Policyrnaking, however, tends to be nation bounded, rule oriented, and issuespecific. There are two areas where meshing dornestic and crossborder policies presents challenges. First is balancing the value of personal information collected by firms against the individual's desire for limits and confidentiality. Equally challenging is balancing the creator's intellectual property rights with promoting the dispersion of technology to encourage innovation that will benefit society. How policyrnakers respond to these issuesin their own and in their overlapping jurisdictions will rnaterially affect the extent to which individuals, firms, and countries will benefit from the qlobal

Catherine L. Mann is a senior Institute tional

fellow at the for Interna

Economics.

Pre-

viously she held several at the Federal

positions

Resewe Board ernors,

of Gov-

was a senior

economist

on the Pres-

ident's Council

of Economic Advisors ('9I'9:), and was a Ford Foundation

Fellow.

Internet rnarketplace.

Many policymakers have been cautious in formulating new initiatives just for the Internet, and indeed, the basic Internet policy issues of data privacy and intellectual property rights are not new. However, because the Internet heavily involves cross-border activity and because it is technologically dynamic, it tends to exacerbate issues germane to domestic

Copyright

2oor.

Institute for International

Economics

Summer/balt2OOI [7ql

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policy, highlight differences in national approaches toward policy, and strain international agreements.

In the area of personal information, some nations, such as the United States, lean toward a rnarket-oriented approach that favors creating incentives for technological solutions. Other policymakers, such as those of the European lJnion, lean toward directives or mandated solutions that prornote a harrnonized approach across the EU. Reconciling these two different courses is a key challenge.

In the area of intellectual property, general principles have been agreed upon by the'World Intellectual Property Organization (WIPO), but irnplementing them in an Internet environrnent has proven to be problematic.

Signatories to the Trade Related Intellectual Property Rights (TRIPs) agreement in the World Tiade Organization (WTO) agreed to global standards, yet these might not be appropriate for the Internet age either.

Policyrnakers rnust ensure that they meet the dernands of the majority of their constituents, yet also allow for minority preferences within the nation.

On an international level, the rnere relief of negotiating a multilateral agreement should not excuse leaving in place policies that stifle innovation and perhaps exacerbate the digital divide.

The outcorrre of an overly-rigid and internaapproach-domestically be a tangled web of tionally-could inconsistent and conflicting rules for governing the Internet. A preferable alternative strategy would place a greater burden on technology and the will of policymakers to allow innovation to meet the varied needs within and across national borders.

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Balancing Economic Benefits and PrivacyConcerllS.Networked inforrnation technologies, and increasingly information itself, are driving the benefits of the Internet marketplace. For example, when all members of a global supply chain can follow the whole process, operating efficiency increases, throughput quickens, and all mernbers of the supply chain benefit. A person using the Internet can tailor the inforrnation that appears in her newspaper, and firms can meet detailed product preferences, thus saving time and targeting specific demands more effectively. When inforrnation frorn both buyers and sellers appearson a business-to-business(BzB) auction site or exchange, better pricing of products (for example, office supplies), superior usage of equipment (for example in trucking), and quicker elimination of excess(say of past-season fashion clothing) become possible. The opportunities for global electronic comrnerce created by inforrnation technology increase the value of information and the ease of obtaining valuable content.

However, with this much information the potential for rnisuse also arises.

There is a tension between collectors few firms that of information-the aggregate information-and providers numerous individof information-the ual business or consumer users. Agg"agators such as DoubleClick highly value the collection of information because they can dissect, combine, and either use or sell the information to produce better-tailored products and rnore efficient processes. As a result, these firms from will want to collect information everyone and will tend to ignore individual users' desires for less collection of personal data. Under these circurnstances, concerned individuals face an

MANNLaw& Ethics undesirable choice: Use the Internet, but be fearful that the inforrnation collected may be used inappropriately, or don't use the Internet, and lose the benefits of this new medium for information and business activity.

What is the role of policy intervention in balancing the demand of individuals to control and protect their personal information against the desires of those who want it to create new products and serwices?There are two broad strategies.

Policyrnakers can rnandate a specific standard that all firms must follow for how data are collected and used. For example, the EU Privacy Directive rnandates a specific standard for the treatment of most personal data of EIJ residents.

Alternatively, policymakers can prornote incentives so that the rnarket innovates and improves the range of choices on whether and how data are collected, compiled, and cross-referenced. The U.S. approach, with minimal legislation that addresses only financial, medical, and children's information, is an exarnple of a more market-oriented strategy.

In an economic sense, is there a winner between the mandate and rnarket approaches to balancing the benefits of and concerns about the use of data? In economics, the Theory of the Second Best suggeststhat the rnarket solution and the mandate solution cannot be ranked.

In neither casewill the needs of all individuals be met, nor can we be sure that society's well-being is rnaximized.

On the one hand, because there are rnanyusers and fewaggregators, the rnarket approach is likely to yield an incomplete set of "information-use" policies.

As a result, the privacy preferences of each unique user may not be rnet. What are the consequences? Consider a business example. Suppose a firrn worries so

much about revealing strategic business information by participating in a BZB marketplace that it refuses to participate; the benefits from having such an exchange would be reduced by having fewer players. More generally, the value of the Internet derives from its participants, and increases exponentially with the nurnber of users. When fear of participating prevents its use, the benefits of the Internet to both individuals and society are exponentially reduced.

On the other hand, the mandate solution is a sort of "one-size-fits-all" policy that assumes that each person or business has the same preference over revealing information.

Because people and businesses are not all alike in their attitudes toward privacy, some specific preferences will not be met. In this case, those left out probably would be willing to disclose rnore information to get rnore tailored products and services.

Consequently, with a mandate policy sorne buyers and sellers won't bother to log on. As in the caseabove, the value of the Internet is reduced exponentially by the lower level of participation.

One cannot really tell which policy approach will result in the greater number of unhappy users, and this is why one cannot rank the alternative policies in terrns of their impact on efficiency or society'swell-being. So what is the difference between the two approaches?

Under the market approach, firms continue to face incentives to try to satisfy specific and heterogeneous privacy demands, particularly if those demands are effectively cornmunicated to the inforrnation aggregators and are backed by enforcement. The incentives come from the very network benefits (translated into potential profits) that are being lost if the privacy options are insufficient

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and users defect. By contrast, under the mandate approach, the private sector has fewer incentives to innovate to resolve market imperfections since there are common rules for all to follow, and the enforcement issue remai ns.

Beyond the theory of these alternatives and how they might work within the domestic rnarketplace is the important issue of overlapping governrnent jurisdictions. One exarnple of an interoperable strategy for two different approaches to privacy protection is the March r{, 2ooo "safe-harbor" agreernent between the United States and the European Union. Under the agreement, U.S. firms receiving personal data from the EU can subscribe to self-regulatory organizations such as the Better Business Bureau's BBBOnline, thereby making a commitment to follow the EU rules for data on EU individuals. The firrns could be subject to legal action by the U.S. Federal Tiade Cornrnission if they do not abide by their commitment.

Does "safe harbor" truly represent an interoperable approach? It would appear to ensure continuity of U.S.-EU crossborder data flows, but this solvesonly part of the problem. Countries not party to the safe-harbor ag:reement wonder what will happen to their firms. Must they follow the EU Privacy Directive? Can they enter the U.S. safe harbor? Do they need to carve out their own agreement? If so, with whom? The possibility exists that cross-border data flows could be fragrnented, or routed around some countries and through other countries, with the potential for great lossesof efficiency and global network benefits. More importantly, the safe-harbor arrangement between the United States and the EU does not yield new privacy options for users, which is the true crux of the matter.

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In such a technologically dynamic environrnent, retaining the incentive for private sector innovation is crucial. The market-oriented approach and cutting-edge technology offer the greatest potential to come up with innovative solutions to meet the greatest variety of dernands. Innovations such as Anonymizer and Pretty Good Privacy (PGP) come frorn individual firms. The Platforrn for Privacy Preferences (PgP) is the outcome of an industry group discussion and could becorne a standard feature on Internet browsers.

Yet the combination of market incentives and technological prowess rnay not be enough. Policymakers in the United States must push harder to get firrns to respond to demands, including calls for privacy products that are easyto use, One rnethod is to threaten what might happen if privacy dernands are ignored and opportunities to irnprove informationuse policies are squandered. For example, the plethora of privacy legislation put before Congress in 2oor threatens the rnarket-oriented approach and could yield rnandated standards. U.S. policyrnakers need to state their objectives and outline their threats more clearly if the private sector is to respond appropriately.

Balancing CreatorRightsand InnovationPromotion.The architects of intellectual property law must strike a balance between protecting property that is expensive to produce but easy to replicate and allowing its replication in order to promote competition and further innovation from existing knowledge. Accordingly, an analysis of intellectual property (IP) issuesin the Internet environment must proceed along severalfronts at once. To balance the rights of innovators and users at a point in time, IP law needs to

MANNLaw& Ethics address how to extend protection to materials created and transmitted over the Internet. To balance the rights of incumbents against the objective of promoting innovation for societal benefits, IP law needs to address the scope and duration of protection for IP materials. Finally, beca..se the Internet and innovation know no borders, international cooperation is essential.

How has the Internet changed the nature of the balance between users and creators of information? First, inforrnation is an increasingly important

entrants. It would be especially unfortunate if latecomers-in developing countries, in rural or poorer areas in industrial countries, or arnong srnaller businesses-face IP barriers that rnake it too difficult for them to use global technologies and tailor them to local needs.

The issue of IP for transmitted materials was the first to be addressed by national and international bodies. In December rg96, under the auspices of WIPO, nations outlined the principles of strong IP protection on the Internet, negotiating the WIPO Copyright teaty

It WOUIdhe unfortunateif latecomers...face IP barriers that rnake it too difficult to use global technologies and tailor thern to local needs] cornponent of the product or serwice, and information, by itself, is "nonrival"-that is, rny consurnption of it does not lirnit yours. Aggregations of inforrnation, such as databases,have value beyond just the individual data points. Second, the digital medium of the Internet rneans that "copying" is easy and perfect. All this adds up to the need for strong IP protection, not only to preserve the value to the innovator but also to ensure the integrity of the copy.

Having said this, the ability of innovators to build freely onto existing software was key to the exceedingly rapid growth of the Internet. Going forward, global policy needs to consider the balance between incurnbents and new entrants, particularly as this may impact the so-called "digital divide." Excessively strong IP protection could favor incurnbents, keeping out innovative new firrns and participants and exacerbating the divide between early adopters and later

and the V|IPO Perforrnances and Phonograrns teaty. However, key elements regarding the irnplernentation of these agreements were not addressed, including third-party liability, application of the "fair use" doctrine, and how to treat devicesthat defeat copyright protection. The Internet has heightened disagreernents in these areas.

For exarnple, with respect to thirdparty liability, eBay.com has become involved in policing its auctions for software. Yet how far should its responsibility extend? Is it okay to resell shrink-wrapped software but not downloaded software? Concerning fair use, a furor has developed between software companies on one hand and libraries and educational institutions on the other over the terms of the Uniforrn Computer Information Transaction (UCITA), Act which re-wrote the Uniform Commercial Code to cover computer information.

While few states

S u m m e r , / F azl o l or

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have ratified UCITA, the issue of what represents "fair use" when copying only takes a couple of mouse clicks is unresolved. In terms of devices that defeat copyright protection, several cases are pending concerning the legal responsibilities of Internet sites that offer DeCSS, a rneans to decode and copy DVD format entertainment.

Even though technologies that enable perfect copying raise the potential for infringernent, they can also produce rnany potential benefits. The ability to make perfect and authentic copies of radiological images, databases used for medical research. and serni-

growth of an operating system that could challenge Microsoft Windows. Or consider what might happen if suits against Napster spill over to affect the MP3 music format and exchange to force significant changes and restrictions.

Whereas artists and record companies with previous copyrights desire their music to be protected and royalties to be paid, some new artists want to use this type of music format and exchange to build an audience directly and cheaply, without having to pay for an agent.

In the same vein, fundamental questions concerning patent rights for software need to be addressed. Thken

In this faSt-paCed u'd technologically dynamic environrrrent, policyrnakers inust'avoid pi'edetermining how the private sector should act. conductor chip designs are only a few of the useful applications of this technology. Therefore, policy concerning IP protection should primarily focus on authentication and encryption of copyright- protected works.

IP protection cannot be just about limiting use. The presence of network externalities rneans that information increases in value the more people have accessto it, use it, and augment it (consider an auction site, for exarnple). IP protection that limits the ability of firms to create interoperable software will constrain the development and therefore the value of the whole network, as well as potentially reduce competition among existing firms and applications. Innovation could suffer.

Consider, for exarnple, if Linux software writers were forced to copyright their product. This would limit the

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together, recent court decisions, U.S. legislation, and new policies by both the U.S. Patent Office and the European Patent Convention are expanding eligible subject matter. For example, business-method software is now the fastestgrowing category of new patents. In particular, developers of basic e-commerce software, looking to apply to their innovations the same patent protection afforded Amazon.com's OneClick feature and Priceline.com's reverse auction method, are likely to be among the plethora of new patent applicants. Such patents could undercut innovation in Internet business methods to the detriment of the development of electronic commerce as well as later-stage adopters.

Business-method patents also expose the jurisdictional tensions concerning the duration of protection between

unruru Law&Ethics national approaches and commitments under international agreements (TRIPs in the WTO). Specifically, international patent protection extends twenty years but allows reverse engineering of software. Neither of these stipulations rnake sensefor business-method software. On the one hand, reverse engineering allows new entrants to build on and augrnent existing platforms, which can yield the tailored approaches that benefit different classesofusers and also enhance network benefits by ensuring the interoperability on which those benefits depend.

On the other hand, such reverse engineering scuttles the very protection that is being granted to the developer of the business-rnethod software.'With respect to duration, while nearly everyone agrees that a life of twenty years is too long for patents covering business-method software, this is the policy that was negotiated in the international forum. Individual countries have little incentive to change domestic laws and certainly no ability to change the length of patents agreed to in international jurisdictions.

For policyrnakers, there are two real issues:deciding what to protect and how to protect it. Of the two, the formerwithin countries' borders, let alone across them-is the greater challenge, and the way to accomplish it is not clear.

Nevertheless, if policymakers could agree on what should be protected, the private sector could invest in the technological solutions to cornply. But without any agreement on what to protect, there is no rnandate or incentive to c r e a t es u c h s o l u t i o n s .

Moreto GetMore.p""Demand sonal and strategic business information and intellectual property and innovation are issues where conflicts can develop

between individuals and information aggregating firms, the global marketplace and and domestic policy jurisdiction, current profits to producers and future value to society. What should policyrnakers do? Ignore the individual and allow the information aggregator to rule the relationship? Ignore the global rnarketplace and impose national regulations a n d m a n d a t e s ?B e t o n c u r r e n t i n n o v a tors to the detriment of the next generation? Policymakers rnust carefully consider their approach.

In this fast-paced and technologically dynamic environrnent, policyrnakers must avoid predetermining how the private sector should act. The key is to create incentives for the private sector to help rnanage the differences between individuals and society and the problerns of cross-border jurisdictional overlap. Because the private sector reaps the rewards frorn network benefits as well as frorn niche markets, it will seek interoperable approaches to solve the problems of spillovers and jurisdictional overlap.

In terrns of cross-border privacy solutions, market-oriented policymakers such as those of the United States must press harder on firrns to enable easier P3P-type solutions, while rnandatestrategy policyrnakers such as those of the EU must allow this platform to serve their residents. In terms of IP protection, policyrnakers need to be sure that protection and cornpetition are balanced. The one-size-fits-all approach of the TRIPs is not appropriate, but neither is the broad extension of protection of the business-method patent.

Policymakers have the ability to set spefor the mancific objectives-including agement of information.' Imposing rules and mandates, however, runs the risk of

Summer/llall 2OOI

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locking in sub-optimal solutions and creating a tangled web of inconsistent and conflicting rules to govern the Internet.

Instead, polirymakers must ensure that domestic and international policy creates

an environment conducive to technological innovation and absorption. Clearly, this will not solve all the problems of the Internet marketplace, but it is a prerequisite for solving many of them.

CERES offers a two-year program of gtaduate study leading to the degtee of Master of Arts in Russian and East European Srudies. Our curricularprograms serve students planning further graduate study and those seekingprofessional training. Students may concentrate in history; governmentl economicsl social, ethnic and regional issues; or literature and culture. A majority of out students currently receive financial aid through University scholarships and FLAS fellowships. CERES is a Tide VI National Resource Center for Russian and East European Studies.

For more information about CERES, Iinancial aid, or about our joint degree programs (M.A./Ph.D. professional), please contact:

Laurie Beans,AssociateDirector CERES . Box 571031 GeorgetownUniversity Washington,DC 20057-1031 phone: (202) 687-6080 fax: (202) 687-5829 E-mail: guceres@georgetown.edu Visit our web site ar WWV.GEORGETOWN.EDU/SFS/CERES

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of International

Affairs

and M.A./

Law& Ethics

Colomhia: Between

TerrorandReform

Miguel Ceballos and Gerard Martin Frorn the I97Os to the early Iggos, Colombia's domestic security situation grew rapidly out of control. This owes much to the cornbined inflnence of rising levels of violence led by organized crime, guerrilla groups, and paramilitary organizations, against the backdrop of weak instruments of law and order and high Ievels of impunity. What most fail to recognize, however, is that since I99I, Colornbia has been able to reduce its national homicide rate by a significant 2/ percent.' This reduction is even more impressive because it has occurred amidst steep economic recession and unsuccessful peace negotiations with the Revolutionary Armed Forces of Colombia (FARC) and the National Liberation Army (ELN) guerrilla groups. The observed reduction in homicide rates not only contradicts the widespread view that the situation in Colombia is merely getting worse, but also provides some hope for the future.'

Yet despite irnprovements since 199r, Colombia's most vioIent year to date, homicide rates in Colombia continue to compare poorly with those of all other countries in the region, as does the brutality and tenor associated with violence in Colombia. Colornbia has nevertheless made prog'ress in the past ten years.Abetter understanding of the factors behind the observed decline in homicides will help in the formulation of

M i g u e lC e b a l l o s is Director Colombia the Center Anerican

of the Program

of

for latin Studies at

Georgetown

University,

Gerard Martin is Research Director the Colombia

for

Program.

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[8 7 ]

4 IA C O L ON B

appropriate policies to fight crime and violence in Colombia. This requires assessingthe dornestic security crisis both in its historical context and in light of past and current efforts in Colornbia to reduce and prevent violence and crirne.

Colombia's current dornestic security crisis is embedded in a tradition of violence. Historically, the state has never managed to assert exclusive authority over all its territory or rnonopolize the recourse to violence force.3 This incomplete rnonopoly on violence explains, at least in part, why violence and crirne since rgl/ have been able to spread so fast and proven so difficult to bring under control.a As the crisis is deeply rooted in institutional failure, an effective solution will include strengthening the perforrnance and legitirnacy of core public institutions, especially ones involved in the administration and provision of law and order.

Roots of Violencâ&#x201A;Ź.corornbia suffered an early rnajor breakdown of dornestic order during the I94Os and rg$os in the wake of a civil war between Liberals and Conservatives. During this period, better known as La Volencia,an estimated 2oo,ooo people lost their Iives. Ia Volenciaended in rg$B when the two parties agreed to a ceasefireand a farreaching administrative and political power-sharing agreement that lasted for the next 16 years-a period known as the National Front. The National Front was installed through a referendum that was widely backed by large parts of Colornbian society. The bi-partisan formulamuch more open and flexible than is generally argrred-proved a well-adapted solution to bring at least the partisan component of the violence under controI.5 During the National Front's

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regime, the annual homicide rate decreased significantly and stabilized at about 2$ per rOO,Ooo individuals.

Since the power-sharing agreernent seemed to be sufficient in bringing homicide rates down and restoring public order, after modest initial reforms, subsequent National Front governments came to neglect the need to strengthen law enforcement agencies and the judiciary.

During the r96os and r97os, homicide rates rernained sornewhat higher than those observed in neighboring countries and reflected a wide range of problems, particularly small guerrilla insurgencies, common crime, post-Violenciopolitical vendettas, local death squads, and rural frontier violence.

What these problems had in cornrnon was poor institutional performance, expressed in terms of high levels of irnpunity as well as inefficient and often corrupt law enforcernent agencies. Low priority for institution-building was even rnore problematic since Colornbia was at the same time rapidly and dramatically transforrning. Its population grew from about 12 rnillion in I95I to an estimated 42 million today. At the same tirne, the urban population increased frorn $/ percent of the total population in I95I to about 74 pe.cetrt currently.

Agriculture now contributes less than r$ percent to GDP-about the sarne as manufacturing, but less than the financial or public sectors.

Thus, during the r98os, in the double context of a fast-growing illegal drug economy and hardening guerrilla groups, crime and violence rapidly increased without major institutional resistanceor reaction. In the cities, this trend expressed itself through the proIiferation of urban militias controlled by gr.rerrilla groups and hit squads financed

CEEALLO& S MARTINLAW&EthiCS

by the drug cartels. These gangs mainsociety organizations, were executed by tained large degreesof autonomy, Iendhitmen employed by drug cartels, guering their serwicesto all kinds of agents rilla groups, and paramilitary gangs. and objectives. A significant portion of As for the political dimensions of the homicides over the last twenty years crisis, it is important to stresstwo points. occurred in urban areas. Whole city First, the domestic security situation was areas were transformed into ganglands derailed after the National Front colwith extremely vicious turf wars. In rurlapsed (tg7 D in the context of a widening al and frontier areas, guerrilla groups of the political arena. This transition was rapidly increased their military strength characterized by many third parties and territorial influence, forcefully obtaining political representation on the aligning social organizations while local, regional, and national levels in installing brutal racketeering schemes addition to internal fragrnentation of traon agriculture, commerce, and transditional political parties. Consequently, portation. These efforts to gain territoduring the post-National Front period rial control often resulted in violent the country was faced with even more limconfrontations with other guerrilla ited government capacity to formulate (autodefensas), groups, arrned vigilantes coherent policies to confront rnajor social hit squads controlled by drug lords, problems lile crirne and violence. pararnilitary groups, and, to a lesser While there were reforms of the crimidegree, government forces. nal justice sector in r97r and r98/, these

Trying tO explain theColornbian crisisin purely political terrns is a dead-end road.

Illegal resources frorn the drug economy infiltrated the entire social and political framework. Violent intimidation and bribery undermined the state's capacity to react and thus its legitimacy. Illegal drug money also became an easy source of political campaign finance on the local, regional, and national levels.

Terrorist actions of organized crirne and armed groups weakened the judicial institutions even further, or simply-and literally-blew thern away. Police posts in rural areaswere assaulted, and many had to be evacuated,Ieaving about 2oo of the roSo Colornbian municipalities without police stations. Judges and justice ministers, as well as hundreds of mayors, city council members, and members of civil

reforms were inadequate in addressing the seriousness of corruption and growing intimidation by armed groups and organized crime. The cornplexity and brutality of the violence itself further undermined institutional capacities.b Rather than a consequence of supposed shortcomings of the National Front regime, the new violence and crime wave seemsto be, at Ieast in part, a result of the lack of capacity of posf-National Front governments to seriously confront new challenges. This includes professionalizing institutions, fighting crime, preventing political and administrative corruption, and creating forms of regrrlation appropriate for a rapidly modernizing and urbanizing society.

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coLor\4BrA

Second, trying to explain the Colombian crisis in purely political terms is a dead-end road. The booming drug business and its fueling of violence is more of an autonomous factor than a political one. The decision of g"uerrilla groups to adopt a revolutionary agenda and celebrate violence and terror as legitimate means to obtain their goals has to do with strategies of individual actors and not regirne characteristics.

Given Colombia's constitutional democracy, non-authoritarian regirne, free elections, and free press, there is no clear political dimension to this conflict. Nor is there rnuch reason to believe that poverty, inequality, and political exclusion should produce stronger forms of violence in Colombia than they tend to produce in other Latin Arnerican countries-which sometirnes have more serious social problems than Colombia.T The current violence is rooted in an institutional crisis rather than a regime crisis, and the country confronts an explosive mix oforganized crirne and terrorism rather than political violence per se.

Second, Colombia maintained democracy and extraordinary regime stabilitywhatever the institutional limitations might have been. The absence of military or authoritarian regimes in Colombia also contributed to low visibility of the crisis. Only toward the end of the r98os, when violence reached unprecedented Ievels, characterized by car bombings, assassinations, kidnappings, and massacres, did the costs of the crisis start to become widely visible.

Third, the international community was late to react to the situation in Colombia-and not only in political circles. Academia and NGOs have traditionally been rnore interested in outspoken political forms of violence, including ethnic and minority struggles, and failed and rogrre state issues. These themes are not easily applied to the typical Colornbian case. In the rggos, the serious threat posed by armed groups and organized violence was finally acknowledged as a rnajor obstacle for developrnent and political stability.'

Even if efforts to curb the wave of crirne and violence came late and were often incoherent or inadequate, it would Reformsand Disillusions.

The be incorrect to conclude that the current seriousness and particularities of crisis is the result of a lack of governrnent Colombia's security crisis went largely initiatives. Peace negotiations and instiunrecognized both domestically and tutional reform have been underway abroad until the late rg8os. There are since the rg8os and have changed the three main reasons why this may have character of the crisis aswell as the strateoccurred. First, Colornbia was a relagies of its main protagonists. tively stable country in various respects Peace negotiations with the guerrilla until recently. The national econorny groups started during the government of continued to perforrn well. Colombia Belisario Betancourt (1982-86). They did not experience a debt crisis, hyperwere more inspired by presidential inflation, or a "lost decade," unlike goodwill than by a coherent negotiation many countries in the region. Increased strategy, at least on the governmental violence did not seem to translate, at side. The guerrilla groups, including least in the beginning, into an obstacle FARC, declared a cease-fire in exchange to socio-econornic development. for quasi-conditional amnesties and the

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c E B A L L o& s MARTTN Law&Ethics release of hundreds of their imprisoned members. Those who were released were provided with governlnent pensions and financial aid to study or make a professional start. However, the guerrilla groups-inspired by the victorious armed struggle in Nicaragrra-never seriously intended to give up their arms, even if they repeatedly told the country otherwise. While formally participating in

total of 4,ooo members, demobilized and disarmed one after another at the end of the r98os and early rggos.

Among these were M-r9, Quintin Lame (formed by members of Indian communities but co-opted by FARC), and the EPL (formed by a Maoist group that split from the Communist Party, which traditionally supported FARC). Their members were reincorporated as common cit-

It WOUId be in.orrect to conclud.ethat the current crisis is the result of a lack of government initiatives. peace negotiations, qhe guerrillas secretly decided to increase ranks and strengthen military capacity by capturing new resources-particularly through (including widespread extortion kidnapping) and increased rent-seeking in profitable sectors such as oil, agriculture, and narcotics.

Betancourt's peace efforts went up in flarnes in Novernber r98$ when the M-rg (arguably the only Colombian guerrilla group ever to mobilize any popular political sympathy) assarrlted the National Palace of Justice in the heart of Bogota, taking goo people hostage, including nearly the entire High Court of Justice.

The army stormed the Palace and fierce flghting ensued. The drama left about roo dead, including almost all of M-rg and eleven supreme court justices, as well as a scorched PalaceofJustice.

The unfortunate outcome of Betancourt's attempts did not prevent subseVirgilio Barco quent presidents (r986-9o) and Cesar Gaviria (rggo-g+) from continuing negotiations with the guerrilla groups. To general surprise, eight guerrilla groups, with a combined

izens in Colombian society. Several of the forrner guerrilla groups transformed into legal political parties, cornpeting in local, departrnental, and national elections-and not alwayswithout success.

The most evident political result of the peace process was the writing of a new constitution in I99I. A Constitutional Assernbly was formed through general elections-albeit with a high rate of abstention-and a third of the seatswere obtained by Alianza Democratica M-19, the political party formed by the dernobilized M-r9. Representatives of all other demobilized and disarmed guerrilla groups also obtained seatsthrough election or by special presidential decree.

The new constitution defined conditions for political and institutional rnodernization, such as strengthened political, financial, and administrative decentralization and a deepening of democracy.

The process was inspired by domestic factors, the general regional trend toward decentralization, democratization, and institutional reform, and wider issues such as economic globalization. It also built on processes already underway in

S u m m e r / F a lzl o o r

[9rJ

C O L O MB I A

Colombia such as political decentralization, especially the introduction in rg86 of elections for mayors instead of nomination by the national government.

At the same time, international aid and pressure, mainly from the United States, helped Colombian police and intelligence agencies develop more efficient strategies to fight organized crime.

For Colombia, this meant open confrontation with extremely violent crime syndicates, especially the drug cartels.

The cartels-accustorned to irnposing their own terms of negotiation-replied with terror campaigns using car bornbings, rnassacres, and assassinations of judges, lawyers, and police officers. The cost in terrns of human losses and traurna was enormous, but the crackdown led to the relatively successful break-up of important drug cartels, particularly in (rggr-gg) Medellin and Cali (rgg+-g5).At the sarnetirne, the police underfunded, discorps-traditionally organized, and affected by corruptionunderwent major reforms and significantly irnproved its performance and public irnage.

The CurrentSituation.Therggr constitution outlines the conditions for political reform and institutional modernization, and a variety of rneasureshave been implemented even if other changes have yet to take place. Nevertheless, FARC and ELN have continued their armed struggle, despite the Pastrana administration's generous scope for peace negotiations. The illegal drug econorny continues to prosper, and paramilitary organizations have become major protagonists in the conflict.

The ro-year-old "new" constitution thus seems to have been less effective in its effort to bring peace, at least in the

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short term, than the r9$8 referendum that installed the National Front. This is in part due to the different underpinnings of lo Volenciaand the current spate of violence. La Violenciahad a much stronger political dirnension, while the current violence is comprised of a variety of components, such as organized crirne, illegal arrned groups, urban gangs, and terrorism. Still, r99r is something of a watershed, The homicide rate has decreased since then, and Colombia has started to take firmer control of its institutions. Consequently, the character of the conflict and the strategies of its rnain protagonists have once again changed.

For FARC and ELN, the discrepancy between their rnilitary potential and the weakness of their political and social support has only increased during the rggos.s FARC continues to argue that peace is not a viable alternative given the assassinatio.rs(itr the late rg8os and early rggos) of hundreds of members of social and political organizations who were sympathetic to FARC and the Communist Party by paramilitary organizations, competing guerrilla groups, or unknown agents. But the argument has proven hard to sell now that eight other grrerrilla groups have de facto dropped their arms and reintegrated into Colombian society. The assassination, mainly by FARC, of hundreds of demobilized grrerrilla fighters during the first part of the rggos (largely of EPL), dealt an additional blow to what sympathy remained for the radical left and the armed struggle.

More recently, brutal assaults on hamlets and villages, kidnappings, rnassacres, and other acts of terror have exasperatedlocal populations. To a certain extent, these conditions have pre-

c E B A L L o&s M A R T T LNa w & E t h i c s pared the terrain for the rise of paramilitary forces. Tensions inside the guerrilla groups and continued violent confrontation for territorial influence between FARC and ELN are constant problems aswell. Since r994, more than r,5oo guerrillas have individually deserted ranks and reintegrated into society through a government-sponsored reinsertion prograrn.'o To rnaintain their ranks, the guerrillas often resort to forced recruitrnent and the enlistrnent of juveniles. Opinion polls reveal the immense unpopularity of the guerrilla movement. Some have argued that the guerrillas' political weakness, involvernent in organized crirne, and rnassive human rights violations are the main obstaclesfor a negotiated peace."

As for the paramilitaries, they have rapidly augrnented their ranks and territorial influence since rgg$. They have expelled FARC and ELN frorn strategic areas and broken guerilla networks in areas such as lJraba and Magdalena Medio through terror tactics including torture and rnassacres.These paramilireflect tary groups opportunistic alliances among drug traffickers and local political and econornic elite seeking private protection and "clean" areas free of grrerrillas. In areas where paramilitaries have wiped out the guerrillas, support for them is sornetirnes firrnly estabIished-though seldom by free choice.

Extrerne brutality rapidly diminishes the political pretensions of both the pararnilitaries and the guerrillas.

The historically under-equipped, and poorly-educated poorly-trained, Colornbian army has been accused of corruption, hurnan rights violations, and different forms of support for the paramilitaries. With U.S. and European training and support (largely as a result

of Plan Colombla), the Colombian army has entered a process ofprofessionalization and has intensified operations against pararnilitary organizations.

In areaswhere guerrillas and paramilitaries fight for control of the crirne market-both its territory and resources-and forcefully align the population, polarization can become so intense that a dimension of civil war seerns to be present.

Civilians are obliged by armed groups to align with one side or the other, lacking any real choice' pledge support, leave, or be killed. Despite these kinds of situations, the Colombian conflict does not seem to be evolving into a civil war, nor does it deserve to qualiS as such. There are too many actors, too many local theaters of conflict, and too many components of organized crirne. On the n a t i o n a l l e v e l, p u b l i c o p i n i o n i s n o t divided into two camps, nor is there any significant popular support for a guerrilla, paramilitary, or openly military solution to the conflict.

Organized crime groups, including networks of drug-trafficking organizations, are the only real beneficiaries of the mayhem. After the breakup of the Iarger cartels-which led to significant decreasesin the hornicide rates in cities like Medellin-drug barons have rnoved to rnediurn-sized cities and more isolated rural areas of the country. They rnaintain rnuch lower profiles with less obvious use of violence, which has enabled thern to operate with greater effectiveness and impunity.

While narcotics are one of the rnost irnportant financial resources for armed g:roups, illegal drugs are far from the only resource that fuels the conflicts. Armed groups can operate without the drug business by further strengthening t-heir racketeering practices on multinationals and

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While narcoticsare oneof thernosr

important financial resourcesfor arrned groups, illegal drygg are far frorn the only ieso.irce thit fuels"theconflicts. entrepreneurs involved in the exploitation of oil, coal, gold, ernerald, and coal mines, cattle, bananas, and even coffee.

Over the last year, EARC has violently and successfully contested traditional ELN influence in the lawless, oil-rich eastern area of Arauca. This seems to reflect a FARC strategy to neutralize losses frorn decreasing incomes from the drug economy due to increased counternarcotics operations in southwestern Colornbia.

Armed groups can also strengthen their racketeering of municipal adrninistrations through intimidation, kidnapping, and murder of elected mayors and city council members, as has been the case over the last few years.

Bringingthe State BackIn. Colombians are convinced that the overall cost of the drug trade-in terms of violence, corruption, and organized crime-outweighs its economic benefits.

The priority for Colombians, however, is not fighting the narcotics economy per se, but further reducing acts of violence and terror such as homicides, kidnappings, car bombings, assaultson villages, illegal roadblocks, and so forth.

These occurrences represent the main sor.rrceof daily trauma and brutalization of life for Colombians.

Analyzing the policies that contributed to the observed decrease in homicides since I99I can contribute to a better understanding of how to proceed in order to bring Colombia's domestic secu-

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rity crisis further under control, while fully acknowledging the lirnits and difficulties imposed by continuing guerrilla and paramilitary warfare. Cities like Cali (population Z million), Medellin (Z.Z rnillion) and Bogota (5.5 millio.r) have introduced, since the early Iggos, rather similar programs of urban violence reduction. These efforts have cornbined strategiesof law enforcement, risk reduction, and public information carnpaigns.

Bogota-which reduced its hornicide rate frorn Bo per roo,ooo individuals in 1993, to 35 per Ioo,ooo in 2ooo-is now a significantly less violent city than Caracas or Sao Paulo in terrns of the rnurder rate, though kidnapping rates are still significantly higher in Bogota.

In Colombia, the highest homicide rates are now found in the municipalities that are under pressure by illegal arrned organizations." About $o percent of the rnost violent municipalities (in terms of homicide rates) are those with guerrilla presence; /o percent, those with heavy narco-trafficking; and about 6$ percent, those with a strong paramilitary presence.'3 Many of these rnunicipalities have no police posts anymore, since grrerrillas assaulted thern repeatedly. In other words, violence is most intense in areaswith a strong presence of armed groups and low institutional density. Massacres and international human rights violations are also concentrated in these "lawless" areas.

There is increasing consensus in

CEBALLO& S M A R T I NL A W & E t h i C S

Colornbia that solutions for the cunent crisis can only be obtained through a long-terrn process of institutional strengthening, and that only irnproved institutional performance can guarantee sustainable peace and security, social development, and the deepening of dernocracy. The need for institutional reform in the political, economic, and judicial areas is also expressed in a recent report by a group of internationally renowned specialists on these topics, coordinated by the Colombian think tanl Fedesarrollo.'a In the context of a wider strategy of "bringing the state back in," priority should be given to strengthening law enforcernent agencies and the judiciary

sector at thelocalleuel,particularly in medium-sized cities, which account for about 12g of Colombia's roBo municipalities, including

thirty with more than Ioo, ooo inhabitants. Relatively sustainable results can be expected here. New efforts should profit frorn lessons already learned in larger cities such as Bogota, Cali, and Medellin.'5 Judiciary control over violence and crime is in line with strong dernands by Colombian citizens for increased security and lower levels of crime and violence. It is also the only sustainable strategy in the long terrn. Strengthening institutions and deepening democracy must go hand-in-hand.

NO T E S r Other

crime indicators,

such as robbery,

also decreased, but kidnappings

have

have increased since

r 9 95 .

2 The Colonbia's

Council

on Foreign Relations describes "worsening crisis, " but does not provide

ciencias.2OOI).

Montenegro and Carlos Esteban / Armando P o s a d a . L c V i o l e n c i ae n C o l o m b i o . ( B o g o t a ' E d i t o r i a l Alfaomega-Cambio, 8 The World

May 2oor).

Bank, Colom6ic- Country AssktanceStrot-

homicide rates or any other crime data to sustain the argument. See "U.S. Interests and Objectives in

eg ProgresReport t999, CAS Progress Report Number (Washington, D.C., rg8o5 November r99g).

In

Colombia,

general, the homicide

A

Commentary,"

Relations Working

Paper

Council of Foreign (Washington. D.C.,

neglected indicator

rate continues to be a widely

in country

2Oorr.

by international

of Molence in 3 Gerard Martin, "The Tradition Colombia, Material and Synbolic Aspects," Meaningsof

Bank and the Inter-American

Violence,A Cros- Culturol Penpecfiue, eds. G. Aijmer and J. (Oxford' Berg Publishers, 2oor) r6r-r92.

in

institutions,

analyses performed including

the World

Development

Abbink

c o n s t i t u t e a b o u t g . { -p e r c e n t o f C o l o m b i a ' s

{. Since t977, the homicide rate increased from 28 per IoO,OOO people to 86 per IOO,Ooo people

have less than

in IggI-Colombia's 2ooo,

The rate for the first quarter of 2oor

ro fl Pcis, 6 May zoor. rr Daniel Pecaut, Cuerro contralo Sociedad(Bogota:

people.

is estimated at

area, but

and a J percent of the population density of less than two persons per square mile.

most violent year to date. As of

it has decreased to 62 per roo,ooo

Bank.

$ Cuerrilla presence is increasingly concentrated the nine eastern lowland departments, which

E s p a s aE d i t o r e s , 2 o o t ) .

5 8 p e r T O O , O O Op e o p l e . ! The Liberal and Conservative parties had par-

homicide

to have the highest rates. The three largest cities alone (Bogo-

ity in all appointed

ta, Cali,

and Medellin)

and elected offices, except the

r2 The largest cities continue

presidency. The presidency alternated between the

total national homicides

two parties, but elections took place anong

the national population.

dates of the corresponding

candi-

party.

6 For an excellent assessment of the crisis in the Colombian Justice Administration, see EI Coleidoscopio de loslusticiasen Colombia, eds. Boaventura de Sousa Santos and Mauricio Garcia Mllegas (Bogota: Col-

account for and contain

!$ percent of 2! percent of

13 Fabio Sanchez and Jairo Nunez Mendez, "Determinantes del Crimen Violento en un pais altamente

violento:

el caso Colombia."

Crimen-yConJlicto,eds. Astrid de

Bogota:

Universidad

Martinez

Ortiz

Nacional

de

Economio(Santa Fe Colombia,

S u m m e r / F a l l2 o o r

Ig 5 ]

COLOM BIA

r99r/293. r{,

For

background

papers

to

the

report,

see

<http,//w.fedesarrollo.org>. rg

Malcolm

Colombia:

Deas,

"Violence

Lessons from

Government

the Last Decade," Background Bank, St. Anthony's

Reduction

in

Policies over

paper for The World

College, Oxford,

rggg; Joanne

Klevens, "Evaluations of Interventions to Prevent or Reduce Violence in Bogota." unpublished paper, Bogota, rgg8; Gerard Martin, "Crime andMolence i n C a l i , C o l o m b i a , a D i a g n o s i sa n d P o l i c y P r o p o s i tions," Backgroundpaper for the World Bank's City Development Strategy for Cali (World Bank, Washington D.C., 2ooo).

MesrnR oF ScrnNcErN FoBnrcN SnnvrcE The MSFS Programis a two-yearprogramof i n t e r d i s c i p l i n acr oy u r s e w o rikn i n t e r n a t i o n a l affairs. includedevelopment, security, Concentrations business-government relations,fi nanceand commerce,foreignpolicy,and self-designed c o n c e n t r a t i o ni n s c l u d i n gr e g i o n asl t u d i e s .

W i t h i ns i x w e e k so f g r a d u a t i o n9,1 %o f t h e C l a s s of 2001was employed.

Joint degreeprogramswith Georgetown's Businessand Law schools,and with the Economics, History,and PublicPolicydepartmentsa , r ea l s oa v a i l a b l e .

M S F SA d m i s s i o n s G e o r g e t o w nU n i v e r s i t y , W a s h i n g t oDn. ,C .

Tel: (202)687-6716Fax:(202)687-5115

t96 ]

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Journal

of International

Affairs

Studentstypicallycompletetwo to four internships.

Polltics&Diplomac Pocketsof Flame CommunalConJlictin Indonesia

Dino Patti Djalal Increasing cornrnunal violence has accompanied Indonesia's transition to democracy. Since the fall of Suharto in r998 and the UN-organized referendun on independence in East Timor in August 1999, the intensity of separatist 'West Papua provinces has increased conflicts in Aceh and significantly. Community leaders on the island of Riau have threatened to forrn a separate state ifJakarta refuses to grant the province a rnajority share of oil revenues. Ethnic violence is tearing Maluku, long renowned as a bastion of religious tolerance, apart. In Borneo, the local Dayaks and the transrnigrant Madurese are engaging in violent clashes.

Additionally, minor ethnic confrontations that commonly play on religious differences have sprung up in Lombok, Flores, Medan, Larnpung, Jambi, South Sulawesi, Central Sulawesi, West Kalirnantan, Aru Island, and Sumbawa. Last Christmas, in an obvious attempt to provoke religious conflict, bombs were detonated in churches around the country, allegedly by an Islamic terrorist group. Communal violence in sorne regions has claimed thousands of human lives, brought about widespread population displacement, resulted in material destruction, contributed to econornic breakdown, and hampered Indonesia's democratization

Dino Patti Djalal is Head of the Political Department at the Embassy of Indonesia in Washington, D.C. The views expressed here are strictly personal.

Process.

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To better understand the limits of democratization in ameliorating communal differences in Indonesia, it is irnportant to note several significant features of Indonesia's separatist and ethnic conflicts. First, they are occurring simultaneously in many parts of the country. This is problematic for the government, which has limited numbers of police and military personnel to cover a vast, discontiguous archipelago of some r3,ooo islands. Members of the police often express frustration at the fact that they sirnply cannot predict from which part of the country the next outburst of violence will corne.

Second, no single cause explains the conflicts and why they are on the rise.

Explanations include expressions of a relatively young Indonesian nationalisrn, economic dissatisfaction, interelite power play, human rights grievances, transmigration, historical animosity, and land-ownership disputes.

Because each conflict situation is different, no single solution is applicable acrossthe board.

Finally, communal violence has imposed significant human, economic, and social costs on Indonesia. It is estimated that over r million Indonesians have become "internally displaced persons" (IDPs) dne to these conflicts. The conflict in Maluku alone has claimed approximately {,ooo lives and displaced sorne {OO,OOO people. To escapeDayak attacks, more than 6o,ooo Madurese fled frorn Sarnbas,West Borneo in 1999, and more recently some JO,OOO more Madurese fled from Sampit, East Borneo. InWest Tirnor, over IOO,OOO East Timorese refugees are still awaiting resettlement and repatriation.

Historyof CommuIndonesia's nal COnfl iCt. Communally-based regional rebellions are nothing new in rnodern Indonesian history. Shortly after the forrnal transfer of sovereignty from the Netherlands in 1949, the young Indonesian Republic experienced the emergence of several ethnically-based rebel rnovernents. In the Moluccas there was an attempt to estab-

region?l.ebeuions Communally-based are nothing new in rnodern Indonesian history.

in violence Third, communal Indonesia entails both horizontal and vertical conflicts. Horizontal conflicts are between different ethnic groups, while vertical conflicts involve a particular ethnic group and the state. In horizontal conflicts, the authority and integrity of the state is not questioned. Alternatively, vertical conflicts come in the form of challenges to the legitimacy of state rule over a particular area which is often the casewith separatist movements.

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lish the Republic of South Maluku. In Aceh, Daud Beureu'eh led a movement to create a separate Islamic Acehnese state. In Java, the group Darul Islam launched an armed insurrection to change the province into an Islarnic state. These rebellions were all variants of vertical conflicts between the peripheries and the central government. They were also similar in that their leaders all resorted to violence to advance their goals.

D J A L A LP o l i t i c s &D i p l o m a c y For the most part, these early communal uprisings were short-lived. Although some contact and networking occurred arnong the rebels, a lack of transportation and comrnunication facilities prevented these different rebel groups from establishing effective networls and political cooperation. All-out military operations byJakarta, coupled with the lack of proper organization and broad grassroots support, soon doomed these rnovernents to failure. Moreover, the rebelIions usually collapsed with the capture of the rebel leaders. The Republic of South Maluku crumbled after the capture of members of the South Maluku government, including its leader Soumokil.

The Darul Islarn revolt carne to an end not long after the arrest of its leader, Kartosuwiryo, in April rg62.

Apart from military solutions, former President Sukarno (1945-1966) also pursued a cornbination of political rneasures by offering political concessions, co-opting rebel leaders, promising local autonomy, granting amnesty, reorganizing regional governments, and redrawing provincial boundaries.

Maluku was restored as a province in rggJ, and Central Surnatra was divided into the three provinces ofJarnbi, Riau, and West Sumatra. In Aceh, the government made a separate peace with followers of Daud Beureu'eh, and the region, previously part of North Sumatra province, was rnade a "province and special area." Sukarno similarly divided Sulawesi into the four separate provinces of North, Central, South, and Southeast Sulawesi in 196{.

Like his predecessor, President Suharto (1967-1998) also used military means to quell regional uprisings. However, his handling of ethnic conflicts differed from that ofPresident Sukarno in at least

two ways. First, Suharto opposed tinkering with political-territorial status as a way to address local grievances. When he took over in rg6J, Indonesia consistedof twenty-six provinces. He maintained this territorial arrangement, only adding East Tirnor in 1916, until he resigned in May 1998. Indeed, in the mid-r99os Suharto was in favor of retracting the "special area" status accorded to Aceh, Yogyakarta, and Jakarta and making these areas regular provinces.

In addition, Suharto used his extensive control over the media and communications, the military, and the education system to silence dissent and promote a sense of Indonesian national identity.

Suharto also used political symbolismsuch as allegiance to the rg{$ Constitution and the state ideology, Pancasila-to promote national conformity.' Even though Suharto was able to keep ethnic rebellions largely in check throughout much of his ru1e, horizontal ethnic violence began to surface, particularly in the Moluccas, in his last days in power.

DemocraticTransitionand Communal Conflict. The rnost important developrnent in Indonesia in recent years is the country's transition to democracy. Ostensibly, Indonesia is now the world's third largest democrary, after India and the United States. President BJ. Habibie, who succeeded Suharto in May 1998, launched a series of political reforrns that scrapped oppressive laws and restored freedom of speech and association. The number of political parties, previously confined to only three, mushroomed to forty-eight. InJune rggg, the country held its first free elections since rg$$. Over rOO million voters participated, and a vocal national parliament, the DPR, is now in place.

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III-pfepafed fOf a hi.qhly-contested election in Iggg, a nurnber of politi'cal parties took a carnpaign shortcut by appealin$ to cornrnunal sentrrnents.

Indonesia's democratic transition has had several consequences for the rnanagement of communal divisions. Rural cornmunities throughout the vast Indonesian archipelago, which contain some 65 percent of the total population, are becoming re-politicized. President Suharto had effectively de-politicized the countryside, banning political activities except during brief election carnpaign periods every four years. As a result, political parties-old and new-must now try to win over rural areas to secure seats in the $oo-member DPR. There is no question that Indonesia's democratic stability will depend greatly on the ability of political parties to effectively establish grassroots rural support for constructive political purposes.

Ill-prepared for a highly-contested election in rggg, a number of political parties took a campaign shortcut by appealing to comrnunal sentirnents.

Fortunately, despite minor skirmishes, the 1999 elections were generally peaceful. However, if the trend in rural Indonesian politics of ernphasizing communal differences to win votes continues, the country rnay see the rise of ethnic dernagogues and rnob rule.

Under such circumstances, ethnic violence rnay accompany-and mar-the process of democratization and political iiberalizationin Indonesia.

Islam is increasingly becorning a political force in Indonesia's process of democratic transition. Suharto's politi-

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cal order did much to curtail Islam's political influence on the national arena. Suharto managed to persuade the country's biggest Islamic organizations-Nahdatul Ulama with 3o rnillion followers and Muhamrnadiyah with 2o rnillion members-to stay out of "practical politics." During the rggg elections, however. numerous Islamic political parties carne to the fore. Nahdatul Ulama became the basis for the formation of a new political party, the National Awakening Party (PKB), while Muhammadiyah's leader Amin Rais formed the National Mandate Party (PAN). Scores of srnaller political parIslarnic platforms ties with also emerged. In fact, Abdurrahman'Wahid became president after gaining the majority vote in the People's Consultative Assembly (MPR) through a coalition of Islamic political parties. The rise of Islam as a political force will likely be a Iong-term feature of Indonesian politics. Although, how it will mix with ethnic politics remains to be seen.

The good news is that the Islamic parties who won the Parliamentary seats in the 1999 elections are moderates and embrace religious tolerance. Concommitantly, however, a nurnber of Islamic groups-some rnore militant and less tolerant-have surfaced in Indonesia's society. The rise of political Islam is of particular significance in areas where religious difference is a major factor in politics. For example, the Laskar Jihad

DJALALPolitics&Diplomacy Isiamic militia fromJava has taken part in communal conflicts between Muslim and Christian communities in Maluku. At a recent meeting in May 2OOI, certain leaders of Nahdatul Ulama threatened to incite the province of EastJava to secede from Indonesia if the MPR impeached President Wahid.

Equally pertinent to Indonesia's ability to deal with ethnic conflicts is the inadvertent irnpact of democratization and political liberalization on military effectiveness. The Indonesian rnilitary (TNI) today does not have the leverage that it did in dealing with ethnic conflicts during the Sukarno and Suharto years.

Recent political reforms have separated the police and the military, which were previously part of a common armed forces structure, with the police focusing on law and order, including issues of internal unrest. Unfortunately, the police lack experience and training in dealing with the heavily-arrned insurrection in Aceh and the intense communal violence in places like Sampit or Ambon.

On the other hand, the military, eager to reform its battered image, is reluctant to act unless called to do so by the police or by the political leadership. One highranking general in the TNI recently stated that flawed procedures for engaging the military to quell cornmunal violence are causing confusion and even delay in effectively dealing with this situation.

There is also the danger that the both the military and the police are overextended. The 2/o,ooo army, +7,ooo navy, 23,ooo air force, and tgo,ooo police personnel are insufficient to deal with the many security problems that plague Indonesia. Military leaders also complain that they are unable to react swiftly to cornmunal violence, particularly in the outer islands, due to the

ongoing U.S. military embargo that deprives the TNI of spare parts for aircraft, ships, and other means of transportation (altho.tgh, spareparts for Crgo Hercules have been made available through commercial sales). In casesof intense communal conflict, such as in Maluku and Borneo, the ability to conduct speedy, forceful, and sustained intervention is crucial to separate the warring communities and prevent the spread of rriolence to other areas.

The hectic agenda for dernocratic reform also means that ethnic conflicts, especially in remote areas, often do not get the attention they deserve. In times of constitutional battles and power struggles, for exarnple, politicians vying for their surwivaltend to be preoccupied with events inJakarta. At other times, ethnic conflicts become the subject of partisan political quarrels. Such situations distract the government in Jakarta and detract frorn its capacity to deal with communal violence across the Indonesian archipelago in a sustained, coherent, and consistent manner.

Finally, there is the issue of political and economic decentralization, a process that began under former President BJ. Habibie. At the heart of decentralization is enhancing the role of provinces, regencies, and municipal districts in national politics by granting greater power and autonomy to local governments." Although there are those who expect decentralization to dampen local grievances, others warn that this process could exacerbatecommunal differences by creating disparate levels of socio-economic growth between resource-rich and resource-poor areas.

The process of decentralization, if mismanaged, can create new sou.rcesof tension within Indonesia.

Summer/Fallzoor Iror]

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T

POCKETS OF FLAME

Dealing with Communal Conflict.

To contend effectively with communal conflict, a number of steps must be tak­ en. Tn the case of horizontal conflicts, making resources available to support timely and effective responses to com­ munal confrontations across the Indonesian archipelago is essential.

Ameliorating conflicts between Chris­ tians and Muslims in Maluku or between Dayaks and Madurese in Borneo requires swift law enforcement measures to end violence, augmented by efficient com­ munity re-building efforts. Lawenforce­ ment forces have to act quickly to contain the situation and ensure that violence does not escalate. In particular, there needs to be quick separation of the war­ ring groups and containment of the con­ flict to ensure that it does not spread to other areas. The longer it takes the gov­ ernment to react, the greater the casual­ ties and damage caused by communal violence. Mter conditions have stabi­ lized, there also needs to be efficient implementation of community rebuild­ ing efforts, reconciliation, humanitarian assistance, and refugee repatriation.

Vertical confhcts between an ethnic group and the state, such as in Aceh and West Irian, usually require substantial investment in finding formalized politi­ cal solutions. This necessitates negotia­ tions between the Jakarta government and separatist groups to find a peaceful, negotiated political settlement. In most cases, this solution will take the form of self-government schemes, such as the establishment of "special areas" or "autonomous areas." In the case of Aceh, for example, Foreign Minister AIwi Shi­ hab has stated that the Acehnese "can have everything under the sun short of independence." The government is now trying to draft an autonomy law designed

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specifically for Aceh, which would be dif­ ferent from a national autonomy law. A draft autonomy law designed specifically for West Irian is also in the works. In both cases, the main challenge is to come up with self-government arrangements that can gain the consent of the local populations. Since both Aceh and West Irian are rich in natural resources, an attractive resources-sharing scheme will be critical to the credibility of any auton­ omy plan for these provinces.

The nationalism that has emerged alongside democratization and political liberalization is also a crucial factor behind the shaping ofJakarta's response to ethnic separatism. Accompanying the recent intensification of communal conflict is the rise of nationalist senti­ ment stemming from a growing sense of insecurity about Indonesia's national integrity. The concept of national terri­ tory is critical to Indonesia's sense of nationalism, and Indonesians tend to zealously guard the status quo. The cur­ rent consensus among most Indone­ sians is that the territory of the Indone­ sian Republic as originally laid out by the founding fathers--namely the region covered by the former Nether­ lands East Indies-must be kept intact at all costs. The political parties that make up the DPR are in agreement on this issue, and Indonesian politicians will long remember that B.J. Habibie lost the preSidency in 1999 chiefly because he lost East Timor. Hence, Jakarta's solutions to ethnic separatism must take place within the context of a united Indonesia. This means that Jakarta has to rule out an East Timor-style referen­ dum in Aceh and West Irian.

The role of international assistance in Indonesia's vertical and horizontal con­ flicts is also limited. In the case of East

Timor, because tionally disputec ernment was will ation of UN S Annan in its nel to find a politic. as there is wide situations in Ac domestic issues, tion does not see the few cases in 1 tance comes int, government has Geneva-based NI Center, which ac mediator) to est. logue with dem Movement (GM to an agreemen pause in fightinl ment and the CJ dement remains Meanwhile, th eign peacekeep forces" in horizo Maluku or Borne further complic unnecessarily dr into a conflict ir reason for invol being, the Indo; been content to community sUPF facilitate peacefu: vide humanitaria

Democratic predicament rai efficacy of demo liberalization in violence within democracy in Ir fill Samuel Hur diction that the cy to a wide-ran

DJALALPolitics&Diplomacy Timor, because its status was internationally disputed, the Indonesian government was willing to accept the mediation of UN Secretary-General Kofi Annan in its negotiations with Portugal to find a political settlement. However, as there is wide understanding that the situations in Aceh and West Irian are domestic issues, international rnediation does not seem likely. Aceh is one of the few casesin which third-party assistance comes into play. Since rggg the government has accepted the help of a Geneva-basedNGO, the Henry Dunant Center, which acts as a facilitator (not a mediator) to establish contact and dialogue with elements of the Free Aceh Movement (GAM). Subsequent talks led to an agreement on a hurnanitarian pause in flghting between the governrnent and the GAM, but a political settlement remains elusive.

Meanwhile, the introduction of foreign peacekeepers or "rnonitoring

eties can lead to the rise ofpolitical leaders and movements that appeal to indigenous nationalist, religious and often anti--Western sentiments that increase the likelihood of conflict."3 Through Indonesia's experience, it is clear that democracy does not necessarily end ethnic conflicts, in the same way that democracy does not end corruption, poverty, and human rights violations. Although Indonesia's ethnic conflicts are still politically rnanageable, they will take time to settle, and democracy has little active role to play in these processes.The threat of national disintegration, while real, does not seem to be a serious possibility, at least for now.

Despite the regrrlarity of ethnic conflicts in Indonesia, it is erroneous to conclude that the country is on the point of disintegration. In fact, the majority of Indonesia's 2oo million population resides peacefully in areas not devastated by communal violence. forces" in horizontal conflicts such as in Perhaps the real source of concern is Maluku or Borneo is unrealistic and may that the cumulative impact of communal further cornplicate the situation by violence leads not necessarilyto Indoneunnecessarily drawing outside parties sia's disintegration, but to political and into a conflict in which they have little social decay. Ethnic conflicts damage reason for involvement, For the time Indonesia's longstanding policy of rnulbeing, the Indonesian government has ticulturalism as ernbodied in the nationbeen content to have the international al rnotto "Unity in Diversity." Commucornrnunity support its national unity, nal conflicts detract from the capacity of facilitate peaceful negotiations, and prothe body politic to move on with the vide hu manitarian assistance. consolidation of democracy consolidation by retarding the growth of civil sociDemocratic Decay?Indonesia's ety. Communal violence is also detripredicament raises questions about the mental to democratic developrnent efficacy of democratization and political because it encourages political extremliberalization in coping with communal ism and leaves little room for tolerance. violence within borders. The advent of This signals the breakdown of the ability democracy in Indonesia appears to fulof democratic institutions to peacefully fill Samuel Huntington's ominous prechannel and settle grievances. Such diction that the "expansion of democraproblems can prove lethal to a fragile cy to a wide-range of non-western socisociety in the rnidst of transformation.

Sunner/Fall zoor

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P O C K E T SO F F L A M E

The longer these ethnic and religious conflicts continue, the more Indonesia's democracy, security, prosperity, and unity will suffer. Ultimately, rather than pushing blindly for democratization, it

is critical to first tackle the evils of communal strife in order to establish an environment conducive to building a stable foundation for long-Iasting political reform and change in Indonesia.

NOTES t Pancasila is a concept first described by President Sulqrno in a speech inJune r${,$' It is composed of five principles: Nationalism, Humanism or InternationalSocial Justice, and ism, Representative Government,

13 March 2oor.

All organizations in Indonesia have been required to adopt Pancasila as their guiding ideology. in 2 Ryaas Rasyid, "The policy of decentralization Indonesia," paper presented at a (Jnited States-Indone-

U n i v e r s i t y P r e s s ,2 o o o ) : 1 2 .

4 Robert Cooper, "Integration and Disintegration," Clobolizotion,Pouer, and Democrag, eds. Marc Plattner and Alexander Smol"r (Baltimo.e' TheJohns Hopkins Uni-

sia Society (USINDO)

versity Press, 2ooo):

Monotheism.

Iro 4 ]

conference, Washington,

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D.C',

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"Culture, Power, and ! Samuel Huntington, Clobahzption,Power,and Demotog, eds. Marc Democracy," Plattner and Alexander Smolar (Baltimore: TheJohns Hophns

JL

Politics& Diplomacy

EIOl|

of History The ChinesePopular Reform Movement

The thought of democratic reforrn in China invokes hghly emotional images-from the mass of students in Tiananmen Square to one man standing up to a column of tanls in a Beijing street. The tradition of modern Chinese political reform movements, however, goes back more than a century to the SelfStrengthening Movernent of the r88os. These reform movements have provided inspiration for some of the most important events in recent Chinese history, frorn the rgrr Revolution to the May Fourth Movement and the Communist victory in 1949.

Most recent in the line of public demands for reform in China is the 1989 Tiananmen Movement. Also known as the June Fourth Movement, it is comprised of a series of protests in Beijing's Tiananmen Square and elsewhere in urban China. Largely led by university students dernanding government efficiency, an end to corruption, and democracy, the movement began in late April r9B9 and lasted until its violent suppression by authorities onJune 4, r989.

One afternoon in late winter, Wang Dan, one of the most prominent student leaders of the Tiananmen Movement, sat oumalof IntemationalAffairs.Wang down to speak with the GeorgetownJ Dan shared with us his feelings about his experiences and political change in modern Chinese history, aswell as his aspirations for democracy and reform in China.

Tiananmen student leaderWang Danputsthe struggle for democracy in historical perspective.

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W E I G H TO F H I S T O R Y

GJ r A: In the collection of the poems you wrote in prison, lv! SolitagJourngintheCold (Wo /gi Hanlengrttong Duxing), and in l4la4g Dan'sPrisonMemoirs(WangDan Tu fltong Hu!ilu), you display little bitterness about your imprisonment. How did you overcome the feelings of resentment most associatewith such exneriences? wANG: I feel that I exist within a larger process ofsocial change. In this process, some people must pay a price for reform.

It is not because I was unlucky that I was incarcerated. I do not feel that imorisonment was something targeted at me personally; rather, facing persecution for pursuing reform is a natural part of historical change. If I were not imprisoned, it would definitely have been someone else-if not someone else then it would have been me. In a sense, I deserved to be in prison. My selectedvocation is to push for change in China. With this choice comes a necessaryprice.

GJIA: As you were growing up, who most influenced your thoughts and beliefs? wANG: The greatest influence on my thinking essentially came from both rny parents, but primarily from my rnother.

They are both graduates of Beijing University and were influenced by the free flow of thought and intellectual discourse at the lJniversity. In bringing this experience horne, they affected rny beliefs about democracy. As I grew older, some of rny professors at Beijing University also played a formative role in my thinking-people like the famous liberal intellectual, Fang Lizhi. errr, Many great historical figures have emerged from the history of Chinese popular reform movements, from the

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Hundred Day Reform, the May Fourth Movement in I9I9, and even the Democracy Wall Movement in 1979. Is there anyone arnong such figrrres that you find particularly adrnirable or influential in formulating your own beliefs about democratic reforrn? w A N G :I n t h e c o u r s e o f h i s t o r y , I f i n d rnany of my esteerned predecessors highly adrnirable and I respect all of them greatly. All of them, in their collective and individual struggles for reform weigh heavily on rny beliefs.

Hence, I find it extremely difficult to separate any one person from this group ofgreat people.

GJ I A: In saying that you have to pay a personal price on behalf of society for social reform, you echo the words and thoughts of nineteenth-century reformer Tan Sitong. Does he have any influence on your own effort to seek reforrn in China? w A N G :I n c h o o s i n g n o t t o f l e e t h e c o u n try after the failure to reform the Qing (Ch'ing) dynasty in the r89os, Tan Sitong provides a model to many people involved in the Tiananmen incident.

There exist people in the Tiananmen Movement who choose to follow consciously in Thn Sitong's footsteps. By remaining in China, this group chooses to share its fate with the country and its people. This includes myself. c,lt a: The processof economic reform in China is bringing substantial benefits to the common people. What can democracy offer to the average person that the current reforms cannot? wANG: Most fundamentally, a person in society needs liberty and respect as a

T N T E R V t EPW O l i t i C SD &iplomaCy human being. A totalitarian system cannot offer either. Democratic reform can provide people the liberty and respect they deserve. Additionally, a dernocratic polity can bring a multitude of other benefits which foster social and personal development-but most irnportant is still liberty and respect.

GJIA: But democratic development often results in instability. How can democratic reform in China provide and guarantee the stability that safegrrardsthe interests of the cornrnon people? wANG: I feel that it is impossible for a totalitarian system to be transformed into a dernocracy completely without sorne kind of instability. We cannot be too idealistic in pursuing reforrn and expect a completely stable process of change. In sorne countries undergoing such change, such as Taiwan, there is the rise of social and political instability. I feel these are necessary symptoms of transforrnation.

If we compare systems,I feel that there will come a point where people will choose change and its accompanying volatility rather than continuing to live under a totalitarian system. You can take Russiaasan example. Despite severalelections and the presence of great instability, the people have not returned the Cornmunist Party to power. Evidently the people prefer to have sorne unsteadiness in their society than to revert to totalitarian rule. From the choice of the people, it is clear that some instability is an essential price that they are willing to pay.

instability is necessary for political change. How do you then propose reform while still attendins to the needs of the people? werG: The only way to achieve stable political reform is if the ruling authority-currently the Chinese Communist reform. If the government-initiates basic social trend is to support reform, but the governrnent resists, then there will be more political volatility. This is unavoidable. In comparison, the relatively stable transition to democrary in Thiwan is because the Kuornintang authorities accepted and adapted to social changes and did not use violence to resist political reform. Therefore, whether political change is stable really depends on the rulers of a country. el r n: Then do you think that recent government promotion of village elections in China is a positive developrnent?

w A N G :I a c c e p t t h a t v i l l a g e e l e c t i o n s a r e a step in the right direction. Mllage elections have no negative implications.

On the other hand, I arn highty skeptical as to whether the village elections we witness today can bring about real democratic change. The governrnent should bring elections to the cities and towns as well. This will give ordinary people experience with democracy and elections. Why has the governrnent Iirnited elections strictly to the villages?

I am highly suspicious of the true motivations behind the government's implementation of village elections. I do not think that the governrnent realGrte: Over the past I$O years, the search ly wants to forward democratic reform for reform has led China to experience and change in China. However, I admit much political upheaval, greatly harming that having village elections is better the Chinese people. Yet you say that than not having them.

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cJIA: Ifyou see change from the top as essential to stable political change, then what direction do you think political reform should take in China todav?

I

wANG:I think there has to be coordination between the top and bottom, but the top should initiate the changes. The more enlightened individuals in the leadership should begin to push for reform. However, without pressure from the bottom, it will be almost impossible for enlightened rnembers within the government to advocate reforrn. Hence, political change in China will most likely emerge as public pressure forces the top Ieadership in the government to begin changing from within. The process of political change requires both the top and bottom levelsof sociew to act.

GJ r A: How can the democratic reformers encourage enlightened members of the leadership to begin reforrn? wANG: There are two main factors behind getting reform started frorn within the government. First, I think popular pressure will build to a flashpoint where any small issue will become a big one for society and incite social unrest. At that time, the governrnent will have to reconsider its policies. It then depends on whether social pressure can coalesce into a powerful, coherent force to push the governing authorities to irnplernent reform. This is what we members of the opposition need to encourage-the fostering of social and public pressure to bring about change in China. cJrAr With economic reform in China, the focus of common citizens appears to be on attaining prosperity. Are they will-

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ing to sacrifice their newly found wealth for democratic reform? wnHe: With China's econornic development, conflicts of interest are becoming an important feature of our time. The process of redistributing national wealth has compromised many popular interests. However, this increases the desire of the people for political reforrn. It has been more than ten years since the June Fourth incident, but you can still see the people's determination for reform. The degree to which people are dernanding reform is increasing. c J I A: You have traveled widely after being exiled frorn China and visited, arnong other places, Taiwan and Hong Kong.

What lessons do you think the democratic movement in China can learn frorn the experiences of other atternpts to bring about political change? wAilG: The rnost instructive case is Thiwan. The current ruling party in Thiwan, the Democratic Progressive Party, developed first as a democratic movement.

Taiwan has a cultural background that is similar to Mainland China. Dernocracy in Thiwan presents a starting point for political change in China. It is possible to look at the road to democracy in Thiwan and develop options and lessonsfor China that we can absorb.

The successof democrary in Thiwanthe actual peaceful transfer of powerprovides encouragement to the Mainland. People on the Mainland will look at Taiwan and think, "If this can happen in Thiwan, it should be able to happen on the Mainland too."

The other case is Hong Kong. Hong Kong retains its freedom of the press.

The ability of the press to write freely has

T N T E R V TPEoW l i t i c s &D i p l o m a c y a great impact on political thinking on the Mainland, particularly the neighboring southern coastal region of China. This area is now the most politically active area in China. Clearly, the free press in nearby Hong Kong benefits the Mainland.

wrHe : The rise of selfish, opportunistic politicians is unavoidable. As long as there is politics, as long as there is human interaction, such problerns are inescapable. However, the ability of a democracy to self-correct is the best rneans to balance against the selfish arnbitions of such people.

Grtr: Many people claim that the Thiwaneseexperience is not applicable to the Mainland. Thiwan exhibits many differences, least of all in terms of scale and population size, but also in terrns of its political systemand history. Do you think this is true?

GJrA:At the same tirne, history contains rnany examples of political movements that began as democratic, but resulted eventually in authoritarianism. In pushing for democratic change, how can China avoid such an outcome?

wANG: No two rnandarin oranges are exactly alike. If even rnandarin oranges cannot be completely alike, then it is not possible for two countries to be exactly alike. The existence of physical differences, however, does not mean that experiences are not similar. From rny observation, the experiences of Taiwan and China are very similar.

Although disparities exist in terrns of territorial and population size, I feel that the two sides have much more in common than not. Both have the same cultural background, the same kind of totalitarian rule-the Kuomintang and Communist Party are ruling parties of one nature-and the same kind of social opposition from intellectuals and the population. Similarities vastly outweigh differences. China can learn much frorn Thiwan's experience.

wn He : There are two answers to this question. The first rests on the political systern. There are constant irnprovements in democratic systernsof governance. There are rnany examples of such experiences and lessons that I arn sure are evident to everyone. It is possible then to learn from these examples and avoid the rise of authoritarianism. Secondly, there needs to be a reconstruction of political culture.

Changes to the concepts of national identity and senseof self are necessaryin China. Such a result is possible through education and the spread of democratic ideals that aim to change political culture and thinking in order to reject anyone who tries to manipulate the systemfor personal ambition.

Respectively, these two approaches provide short-term and longterrn solutions to avoiding the rise of authoritarianism frorn political change.

GJ I A: In many cases where countries ernbarked on attempts to bring about dernocrary, such as in Africa, Asia, and Latin America, politicians have tried to manipulate popular outcry and demands for selfish personal gain. How can China avoid such a situation?

ella' With respect to political culture, however, many observers say that the Chinese people cannot live under an open system, that Chinese society requires sorne forrn of patriarchal authority for order and development.

How do you respond to such statements?

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wnre , Such an argurnent has no empirical basis. We observe in Thiwan the acceptance of all kinds of opinions and political parties. There is such accommodation in Thiwan that I saw students go to classwearing uniforms of the Chinese People's Liberation Army. As long as a good system is established, there can be peaceful accommodation of vastly different views. On the Mainland, only

Gong movement falls within this greater historical pattern?

WANG:These movements all relate to a larger social reality. Falun Gong is a signal that there are substantial contradictions and conflicts in contemporary Chinese society. Falun Gong is only one representation of such developments. The prominence and influence that Falun Gong has

Thefe ngedS tO be a reconstruction of political ^nationalculture. Ch-angesto the concepts of identity and sJnse of self are necessary. the realization of a dernocratic system can bring about the ernergence of a political culture that is accomrnodating and willing to accept differences. olrr: There is criticism that the movement to dernocracy in Taiwan has resulted in political, social, and economic uncertainty that has harmed average citizens. Are such features unavoidable in the develooment of a democratic polity? wrle : They represent a stage in such development that is inevitable. People need to give the new government time.

After some tirne, a democratic systemwill necessarily make an adjustment towards greater stability. c J I A: News of the Falun Gong movement and its repression by the Chinese government has recently abounded. In Chinese history, the rise of quasi-religious sects, such as the Thiping Rebellion and the White Lotus Sect, represents the rnoral bankruptcy and weakness of the central government. Do you think that the Falun

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today stems from the dysfunctional methods the Chinese Communists are using to suppress the movement. In reality, the Falun Gong phenornenon is not something that has only developed in the past year or two-it has existed for rnany years.

The rise of Falun Gong is the result of the authorities not knowing how to deal with new problems, contradictions, and conflicts of interest in better ways.

GJ I A: In suppressing Falun Gong aswell as the short-lived China Dernocratic Party and the Tiananmen Movernent, the Chinese governrnent shows an unwillingness to accept pressuresfor social change. How can the democratic movement in China overcome such an obstacle? wANG:I do not think that this is a problem of the dernocratic movement. It is a problem of the government, and is the real danger in China today. The rulers simply do not know how to respond to a rapidly changing social environment.

They do not know how to face the current situation in new ways. The government only knows how to use old oppressive

TNTERVTE PW O l i t i C SD &iplomacy methods to address new social pressures.

It is up to the government to solve this issue. The democratic rnovement can do nothing in this respect.

Gltn: You mentioned earlier that you hope reform comes frorn the top. If it is not possible to cornmunicate to the government how it should change, how is top-down reform possible? How can the democratic rnovement encourage the government to change? wnHc, There are two courses that the democratic movernent can adopt to help bring about reform within the government. First, we need to maintain pressure for change and hope that the rnore enlightened rnembers of the governrnent have the opportunity to raise their voices.

Second, the dernocratic opposition movement needs to have its own views and proposals for political change that are peaceful, open, and enlightened.

In particular, the opposition rnovernent needs foresight in considering and discussing China's future development. It needs to present a different set of goals for the country. Only with a set of objectives that is different frorn the Cornrnunist Party can the people truly have a choice.

I believe the ultimate goal of dernocracy is to provide freedom for the people.

The most irnportant freedom in China is allowing the cornmon people to enjoy political liberty. With only the Chinese Communist Party, there is no freedorn to choose. The rnain airn of the democratic movement should be to provide freedom of choice, to give the people a set of different options. Only then can ordinary people have the opportunity to choose.

Hopefully, both the opposition movement and enlightened members of gov-

ernment will have the same vision for political change, allowing the two sides to come together. I hope the democratic opposition movement can achieve these two objectives. cJrA: How do you propose to achieve these goals without unleashing another political upheaval upon the Chinese people and being accused of collusion with a corrupt regirne? w n r G : T h e d e m o c r a t i co p p o s i t i o n m o v e ment needs come together and produce constructive plans for change and for addressing social problems. This means that we need to corne up with concrete proposals and political platforms. We must show that we are very different from the government. This is essential to establishing a strong opposition movement and, I believe, more useful than inciting the public to revolt, riot, or demonstrate. Nonetheless, we must recognize that the choice ultirnately rests with the people whether they choose the Communist Party or the opposition.

GJIA: How then does the dernocratic opposition movement intend to bring its message to the people? After all, the Kuomintang ascendance in the IgZOs and the Chinese Cornmunist rise to power both highlight the importance of organized, mass popular movements. wANG: The Communist Party claims that they are the vanguard of the proletariat; they lead and organize the people. The members of the democratic movernent are merely trying to further the rights of the people through our individual pursuit of rights. We are an example for the people, an experiment for the people to see and learn from.

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WEIGHT OF HISTORY

We are not saying that we should orga­ nize the people and lead a revolution.

As leaders of the democratic move­ ment, we are seeking our own rights, doing what we think should be done, seeking our personal freedom, saying what we want to say. We are showing the people what can be done. We are not forcing them to follow us.

Over the next two years, the Chinese Communist Party and government will

G J I A:

the enlightened faction and new leaders in government, but they were ultimately and severely disappointed. How is the current situation any different? How can you avoid a similar outcome?

WAN G: I think the situation is not much different. Although I have hope and look optimistically toward the government and leadership, I accept that changes may not occur. There is always hope and there is always disappointment. This is a recur-

We are an

example for the people, an experiment for the people to see and learn from. experience a generational change in lead­ ership. What effect do you think this event will have on democratic reform in China?

In principle, the change in gener­ ational leadership should bring hope.

However, it is not enough to simply hope that generational change will bring about significant steps towards reforming the political system. Actually, the leadership change offers both the international community and Chinese society a chance to push the government towards reform.

If substantial pressure for change exists, it will provide the new generation of lead­ ers with an environment conducive to reform and will bring about change. Per­ sonally, I look at the next generation of Chinese leaders with a definite amount of hope and optimism.

WANG:

During the Hundred Days Reform, reformers such as Kang Youwei and Liang Qichao also placed great hope in

GJ I A:

Sciel

ring historical pattern. Personally, if! am disappointed, I will not feel too sur­ prised. Nonetheless, I cannot stop hop­ ing because of the possibility of failure and disappointment. This is history.

Many have asked you what obstacles the democratic movement in China faces. On the contrary, we are curious to know what you see as conducive to the emergence of democracy in contempo­ rary China.

G J I A:

WAN G: I think the answer rests in the existence of human nature. All people desire freedom and the ability to pursue their dreams. A totalitarian system wants to suppress freedom. This pre­ sents a basic social contradiction. This conflict of interest is beneficial to the democratic movement. Everyone wants freedom, including people in the Com­ munist Party. The overall situation is to our advantage.

t------"---I.J~I...L

...

,

Connecting th

Jeffrey Sad

The idea of inform ment is something tal linkage. I belie, nologies are absolu information techn< ment, will not find without help from, Thinking about· lenges are, two cor· connectivity. These achieve economic 1 and communicati implies, are critical mation to bear on : of the world, which vide information t<

Editor's Note: The text 0 frey Sachs at a conference University on March 12. 2' The GeorgetownJournolofTnt allowi ng it to print this art bringing efficiency. innova through the linking of corF

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Sclence&hchnolog

ConnectingtheLess- Deuelop ed Worl d Jeffrey Sachs The idea of information technology playing a role in development is sornething like a fish in water; it is a pretty fundamental linkage. I believe information and communications technologies are absolutely vital instruments for development. But information technology, and the benefits it brings to development, will not find its way to the poorest regions of the world without help from outside nations.

Thinking about what developrnent is and what its real challenges are, two core elements corne to mind: knowledge and connectivity. These are central to any society's aspirations to achieve economic growth on a sustained basis. Information and communications (IC) technologies, as their name implies, are critical in two dimensions. First, they bring information to bear on local conditions and allow isolated regions of the world, which are often the poorest of the poor, to provide information to the rest of the world. Second, IC tech-

Jeffrey Sachs is Director vard Center national

of the Harfor Inter-

Development

and Galen L. Stone Professor of International

Trade

at Har-

vard University.

Note: The text ofthis article wm adapted frorn an address by professor.fefSachs at a conference co-sponsored by DevelopmentEx.com urd G"o.g.,l* frey University on March 12, 2ool.

Editor's

TheCeorgetounlournaloflnternotronolr4foinwould like to thank DevelopmentEx.com lbr allowing it to print this article. DevelopmentEx.com is an independent marketplace bringing efficiency, innowtion, and transparency to the global development industrJ through the linking ofcorporations,

consultants, NGOs,

and donor aEencies.

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nologies enable communities to connect to the rest of the world in virtually every sphere of social actiyity. This includes commerce, of course, but also education, health, culture, and many other dirnensions of social life.

I think we have in our hands the opportunity to take a big step forward in development-one that has not been availablebefore. At this juncture, however, I am not sure the digital divide is getting any narrower. I am not sure that we are really making the bridges over this vast grrlf that we need to make.

Some of this divide will take care of itself. We have to understand that commercial activity is going to be successfulin and of itself in making inforrnation flow and connecting parts of the world that otherwise would be unconnected. An example of this is in southern India, where a revolution is at hand. There, the three headline capitals of southern Bangalore, and India-Hyderabad, Chennai-are each competing for the title of "Silicon Valley" of the region.

But, I can also tell you frorn severalweels of driving through the srnallest villages in southern India that information technology by itself is already reaching into the most remote hamlets. In virtually every village there is a banner over the road for lessonsinJava or in some other programming language that I am too out-of-date to even know about.

So what is making India go forward? It is an important question. Clearly, India is primed in a few important ways. First, a very wise investment was made forty years ago-a kind that we have stopped making in many regions, unfortunately. That investment entailed helping India build very sophisticated leadership in technology with the creation of the Indian Institutes of Technology, the IITs, which are

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now the champions of the information technology (IT) revolution in India.

These are actually the champions of the American IT revolution as well, because so many Indian entrepreneurs are leaders of the IT industry in the United States.

Those IITs were built before it became conventional wisdom that developing countries should only have primary education but not necessarily tertiary education. Countries cannot get by focusing just on basic literacy. Building great centers of learning has huge long-terrn social returns. In India, this was accomplished by inviting foreign institutions and investors to team up with severalcenters of excellence throughout the country. Those centers of excellence have now produced leading faculty and experts in IT software and hardware, and these people are now spearheading a brilliant spread of IC technologies. That's one good piece of news.

Second, another of India's advantages from the point of view of IT is that it is a very crowded place. Why is this advantageous? Becausehaving about Boo people per square kilorneter rneans that it's efficient for the private sector to lay down fiber-optic cables all over the country, even in very remote areas.When firrns get to those remote areas, they are then able to use locally-designed technologies that take that connectivity to the last milethrough a local wireless loop, for exarnple, that is well-designed for Indian ecological conditions such as hot temperatures. Due to these locally designed technologies, high connectivity is spreading throughout India.

A third factor, related to the second, is that India is becoming increasingly connected to the world. Innovations such as a submarine cable running from Singapore to Chennai, which is opening up

sAcHS Science&Technology tremendous amounts of bandwidth for southern India, are making it possible to dramatically expand the coverage of information technology at very low cost.

India is a place where the IC industry is going to take-off with a little bit of nudging and one major piece of public policy: getting out of the way. In rgg8, India finally broke the state telecom monopoly that was holding up the rapid spread oftechnology by keeping connectivity in the hands of a single inefficient state enterprise. By increasingly getting out of the way-and in this year's budget by providing some very positive investment incentives-India is spurring tremendous private-sector development.

The problem with the digital divide, however, is that India's special circumstances are not replicated throughout the world. Actually, the fourth condition that is very helpful for India is that Indians happen to speak some of the rnost beautiful English in the world.

This language capacity has been phenomenally helpful in enabling India to take the lead in software development and in the kind of long-distance data services for which India has become famous. Data transcription, data processing services, long-distance consultancies, and so forth dot the horizon of the major IT centers of Hyderabad, Chennai, and Bangalore.

If the whole world's situation were like that of India, we would stand here marveling at the rate at which the digital divide would take care of itself. But first, recognize that this miracle isn't even extending to the north of India. Nor is it yet extending to much of the world that urgently needs this technology and what it can bring. There are many parts of the world, I believe, where these technologies will prove to be commercially viable in a

relatively short period of time. This will not happen, however, without a period of pump-priming to prove economic viability, create platforms, and establish the modalities and the uses of these technologies that will enable them to become commercially viable in the longer term.

Let me turn to the caseof sub-Saharan Africa. At the risk of making profound and unfair generalizations about a continent that has forty-nine countries south of the Sahara and 2o percent of the world's landmass, I will refer to it as a homogenous entity, which it hardly is. What one can say about sub-Saharan Africa is that there the divide is not being conquered in the same way that it's being conquered in India. In general, sub-Saharan Africa does not have local centers of excellence that allow for the kind of Iocal adaptation of technology that has proven to be so irnportant in the Indian context. Sub-Saharan Africa does not have the population density in urban or rural areas that makes it feasible right now for private sector firrns to lay fiber-optic cables. lJntil now, though I hope it is imminently changing and that my remarks may even be a little out of date, Africa connects to the world only through satellite, in effect because the submarine cables that will be vital for high-bandwidth, low-cost data exchange have not yet been laid. The Africa One project, a privately-financed project whose goal is to lay a fiber-optic loop around the African continent, can make a profound difference in the future.

My understanding is that the Africa One project is still slated for completion at the end of 2oor. Until that happens, however, Africa is connected to the world primarily through costly satellite transmission, and that rneans very low bandwidth, high subscription rates, and the lile.

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Af riGang0vefnmentShave yetto d.o what the Indian governrnent has unifor^ly finally done-gotten out oflhe way of the private sector.

I

In addition, African governments have yet to do uniformly what the Indian government has finally done-gotten out of the way of the private sector. There is still far too much state rnonopolization of telecomrnunications companies, too much corruption, and too much use of the telecoms as state cash cows that finance local political parties or other even less savory propositions. This has proved to be yet another obstacle.

Yet if one thinks about a part of the world that needs to bridge this divide urgently, it is certainly the African continent, particularly the sub-Saharan African region. How can this be done? I have a few thoughts that I hope will prompt deliberation.

For a drarnatic and sustainable expansion of IC technology to occur, there is really no substitute for long-term commercial viability. This is a technology that will work if it can pay for itself. I believe this is extrernely likely to happen, even in the poorer settings of the world, if we look at a five- to ten-year horizon. Why is that? I think we are going to find that there is such a multiplicity of uses for these technologies that viability will be achieved because they will serve purposes in education, health, commerce, agriculture, data transcription, and job creation, to name a few areas.

The problern is that in order to achieve viability a stable infrastructure need to be in and multifunctionality place. In investment terms, this is the

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typical chicken-and-egg problem. Multifunctionality cannot be developed until the infrastructure is there, but the private sector is very unlikely to finance the infrastructure itselfjust because an optimistic grly from some university in New England saysso. So, we are a little stuck.

The logic of the situation says that we ought to be promoting very rapid developrnent of the bandwidth and connectivity because of all of the purposes that this technology can support. Yet we are finding that it is not being rolled out in most of Africa and in many other remote and very poor parts of the world. Hence the divide continues to widen.

In t-he numerous digital divide conferences that I have attended there has been a Iot of discussion of the potential sources of this divide, but remarkably few specific projects to overcome it have actually been designed and carried out. Practical steps should now be undertaken to close the divide, because the general scale, scope, and nature of this problern are well understood. I propose a combination of high-level decision-making along with some pilot projects supported largely by U.S. industry to prove the worth and viability of IC technology in a number of settings. High-level decisions are required to ensure adequate high-bandwidth connectivity in all parts of the world. Africa One is vital for Africa's future economic development. It is a matter of high public poliry concern to ensure that projects like it go forward. We

sAcHSScience&Technology should understand that until that project is completed, our hopes for high-bandwidth, rnultifunctional applications are going to be ideas but not realities.

A second crucially needed action is the creation, through deregulation, of a business environment that will allow the private sector to invest large amounts of capital in these countries. This mainly means telecommunications deregulation. I have yet to see a casefor doing that slowly. I am a very impatient person to begin with, so I generally think all reforrn should be done this rnorning. But on telecoms, I really would commend the Singapore approach.

Normally a very cautious country, Singapore did its big bang and just said, "Okay, this sector is open for business," and then gave fifty-seven licenses in the first day of mass deregrrlation. It did not say, "We'll do one company here," and, "we'll license two there," and so forth. In my opinion, gradualism in a sector like telecom is a reflection of payoffs,corruption, or rentseeking rather than real economic logic.

Thus, high-level decisions are needed to guarantee the bandwidth in international connectivity and accessfor investrnent through deregrrlation. Within that context, what is needed on the ground are real projects in difficult areas in developing countries. The urban coastal sites around the world will take care of thernselves. Dar-es-Salaam, Abidjan, Accra, and Dakar will all have Internet connectivity almost no matter what we do and probably on a pretty good basis within the next few years. What worries me are the more remote, irnpoverished regions where so many of the poor people of the world live.

I believe we need to think through some verl practical projects. Yes, projects can make a difference becausewe can offer

ideas about how to get schools online, how to construct better education platforms, and so forth. I would look for applications that have high social returns, that are urgently needed, and that are technologically feasible. My favorite of favorites right now is to get the public health systernsof Africa online and connected with the proper inforrnation technology platform as an instrument for a rnassive attack against the critical diseases that are ravaging the continent.

Frorn a technical point of view, this is a proposition that needs public and private support from the U.S. government and U.S. industry. I know that it is an extremely high and rising priority among the African leadership.

By establishing prograrns like this, in which technologies are introduced for sorne very specific but extremely important purposes, we will also find, as one does in poor villages that get connected to the world, that at the end of the day, the terminal at the primary health center is going to turn into the local kiosk for e-commerce. It is going to be the place where farrners get the weather report and local businessesget the timing of ships, and will soon enough becorne sornething that local schools use as a platform for education.

There is little doubt that information and cornmunications technologies can have a profoundly positive irnpact on the lives of the world's poorest people. But technology will not necessarily take care of itself in those regions. Developed countries, through well-designed and highly targeted projects, can ensure that investment finds its way to the regions of the world that need it most. With such investments, the digital divide will become an outdated label.

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Restoration of a Nation

rains came, the shackswould slide down into the slimyJukskei.

Reuiew b7Margaret C. Lee The J,OOO residents scheduled for removal protested when the police and Arrx BonarNr. A CountryUnmaskedt Insid.e security guards arrived. Teargas, stun SouthAfrica'sTruthand Reconciliation Commis- glenades, and rubber bullets were used sion. New York, Oxford University to contain the resistance. The shacks P r e s s 2, o o o , 4 4 8 p p . $ 3 o . o o . were destroyed and the people who Iived along the river were loaded into trucks It seemed like a normal day in Alexanand literally dumped on vacant land that lacked shelter, proper sanitation, and dra Township, SorrthAfrica (Alex) until the tlucks, police, and security guards electricity. The South African Human appeared and began forcibly rernoving Rights Commission accusedthe govern3,OoO residents that lived along the ment of violating the Alex residents' banks of theJukskei River. At the point human rights to dignity and self-respect. at which the river passed through Alex, One would be forgiven for thinking it was so filthy that it was deemed a that the forced removals in Alex took health hazard to t h e r e s i d e n t s . place under the brutal and repressive Nonetheless, this area in densely-popuapartheid regime, under which over J.g lated Alex was home to the poorest of million people were forcibly rernoved t h e p o o r , s o m e o f w h o m h a d c o n s t r u c t - from their homes. However', the Alex ed their homes-shacls made of cardremoval took place in February 2}or, board and corrugated iron-on top of u n d e r t h e l e a d e r s h i p o f t h e p o s t graves.The settlement was located on an apartheid African National Congress incline, which meant that when the (ANC)-led government. Ironically, it

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LEE

was the ANC that led the movement in the early I99Os to develop a human rights culture in South Africa and restore dignity to the victims of apartheid. ln A Countg Unmasked, InsideSouthAfrica's Truth and ReconctliationCommission,Alex Boraine tells a fascinating story of the effort to develop a human rights culture in post-apartheid South Africa. The first step in creating such a culture was to put in place a mechanisrn that would allow victirns as well as perpetrators to tell their stories. This was the Tiuth and Reconciliation Commission (TRC) of South Africa. As deputy chairperson of the TRC, Boraine provides an invaluable insider's perspective on the origins and functions of the Commission.

The TRC originated from the decision of the African National Congress (ANC) to investigate allegations of human rights violations made against the organization. Such violations allegedly occurred in ANC training camps in Thnzania and other parts of southern Africa.

The Motsuenyane Commission confirrned that human rights violations had occurred. In accepting this reality, the ANC National Executive Comrnittee e s t a b l i s h e da t r u t h c o m m i s s i o n i n p o s t apartheid South Africa to investigate all human rights violations since Ig4B. It was envisaged that uncovering the truth would allow the beginning of a process of healing and reconciliation.

The TRC was actually a cornpromise between those who wanted a Nurernbergs$le trial to prosecute apartheid-era perpetrators and those who were opposed to such a trial. Though the TRC wasto investigate all hurnan rights violations, it was clear frorn the beginning that, morally, there was a difference between those who used force to maintain the apartheid system and those who used force to oppose it.

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The TRC consisted of seventeen cornmissioners appointed by President Nelson Mandela. The selection of the cornmissioners followed public hearings and the recomrnendation of twenty-five final candidates by a selection cornmittee.

Mandela appointed Bishop Desmond Tutu as Chairperson and Boraine as Deputy Chairperson. The TRC established six objectives: to return victims their civil and hurnan rights; to restore the moral order; to record the truth; to grant arnnesty to those who qualified; to create a culture of human rights and respect for the rule of law; and to prevent the violation of human rights from ever happening again.

The South African TRC was unique among other truth commissionsin two major respects. First, blanket amnestywas rejected. Instead, perpetrators of apartheid-era crirnes would have to apply for arnnesty, which could only be granted for political actions that were fully disclosed. Second, the focus of the TRC was to be on apartheid-era victims who were to tell their stories with the purpose of regaining human dignity.

Three rnain TRC comrnittees were established, the Hurnan Rights Violation Cornrnittee, the Arnnesty Comrnittee, and the Reparation and Rehabilitation Cornrnittee. In particular, gross hurnan rights violations that occurred between March r, 1960 and December $, rg93 were to be examined. The latter date was subsequentlyextended to May IO, 1994.

The Human Rights Violation Committee was given the task of identifring those who had experienced gross human rights violations, verifring the facts surrounding the violations, and then allowing many of the victims to publicly tell their stories. As Boraine indicates, this was a mamrnoth task. It was heart-

Books

BOfaine iS COffeCt i.t speculatins thathe will receive considerable crilicism foi devoting an entire chapl"J to all.egations against "the Mother of the Nation. " wrenching to read the unirnaginable stories of rnurder and torture. One particularly horrific torture technique was called "the helicopter"; it "involved suspending the victim upside down from a wooden stick and beating and kicking him in the process, often until he was unconscious." (p. ro3) The chapter devoted to allegations of hurnan rights violations cornrnitted by Winnie Madikizela-Mandela (the forrner wife of Nelson Mandela) and the socalled "Mandela Unified Football Club" is one of the most controversial parts of the book. Boraine is correct in speculating that he will receive considerable criticism for devoting an entire chapter to allegations against "the Mother of the Nation." The stories told by the victims in this chapter are no less horrific than those told in other chapters. Yet by revealing in such detail the allegations against Madikizela-Mandela, there is an irnplicit suggestion that the human rights violations committed by those fighting against the apartheid regirne can be placed on the same level as those comrnitted on behalf of the apartheid state.

As a reflection of the difficulty of distinguishing between human rights violators, the ANC, under the leadership of current South African President Thabo Mbeki, vehemently rejected the TRC's r99B findings that the organization had committed gross violations of hurnan rights both during its liberation struggle and after its unbannine.

The ANC

unsuccessfully took the TRC to court to seekan injunction against the publication of the Commission's findings. Boraine points to the inherent contradiction between the ANC's insistence that a truth commission be established and its desire to muzzle the commission's findings.

The Amnesty Cornrnittee was given the gargantuan task of determining if the perpetrators of apartheid-era human rights violations should be granted amnesty. It was during the arnnesty trials that families were finally able to learn about the fate of loved ones who had been victirns. Boraine does an excellent job of portraying the devastating psychological effect that the often violent confessions had on the country. Over B,ooo arnnesty applications were filed, but only a small percentage of applicants were actually granted amnesty. Now, SouthAfrica must decide if it is going to prosecute those for whorn arnnestywas denied.

One of the unfortunate outcomes of the arnnesty arrangement was that rnany were not held accountable for their role in apartheid crimes. Former apartheidera presidents P. W. Botha and F. W. de Klerk escaped responsibility for wrongdoings comrnitted under their regimes.

This raises fundamental questions about the ability of an apartheid-era legal system to adrninister justice in the postapartheid era. lJnfortunately, Borraine does not explore this issue.

The third major committee, Reparations and Rehabilitation, was given the

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task of determining the type of reparaflourish. In fact, volumes have been writtions that should be given to recognized ten about the role of the United States, victims of apartheid. As Boraine discuss- Israel, France, Germany, and Britain, es, one of the most evident weaknessesof a m o n g o t h e r s , i n s u p p o r t i n g t h e the TRC's mandate was the restrictions apartheid regime. A special TRC comirnposed on what was defined as a gross mittee should have been established to human rights violation. Given their strinuncover the truth about this cornplicity. gency, only I/,OOO apartheid-era victims Without this history, the "true" story of are eligible for reparations instead of the South Africa's past cannot be written. millions that were and continue to be vicDespite this weakness, Boraine's book apartheid. tims of is a must-read for those who want a betCritics have argrred that one of the ter understanding of the TRC's efforts weaknessesof the TRC process is that to provide justice to the victims of reparations have not been forthcorning. apartheid. Now that South Africa has In response, Boraine states that many begun to come to terms with its past, it is members of the Commission, including time to take seriously the challenge of himself, felt strongly that they were restoring dignity to victims of apartheid unable to quantify reparations until they and developing a culture of human had heard from the victims. Hence, while rights. The forced removals in Alex is making clear the limited rneans of the evidence that gross violations of hurnan state and the Cornmission, the TRC rights continue to this day. It is past tirne often askedvictims what they expected in for South Africa to restore dignity to cornpensation. Knowing the injustice victims of apartheid-era human rights inflicted on the majority of the populaviolations. tion as a result of apartheid, it was perMargaret C. Lee it a Research Associate in the African haps irresponsible of the commissioners Studies Program at Georgetown University. not to prioritize funding for reparations if they were serious about restoring human dignity to victims of apartheid.

The South African governrnent has not a l l o c a t e dt h e 3 b i l l i o n r a n d ( - $ 3 6 0 m i l lion) requested by the Reparations and Rehabilitation Comrnittee. This is a Reuieu b7Robert G. Sutter small arnount cornpared to the over 43 billion rand (-$5,22o million) allocated by the government for buying arms.

Gnnaro Cunrrs. New Per$ectiues on U.S.Telling stories alone will not restore peo- Japan Relations.Tokyo, Japan Center for ple's dignity. Self-worth and dignity also International Exchange, 2OOO, 3O2 pp. flow from having basic amenities and $ z 5 . o o . employment, which could be facilitated International observers are worried through reparations.

A glaring weaknessof the book is that aboutJapan's continued economic stagBoraine fails to mention the role that the nation, with apparent paralysis among West played in allowing the apartheid Japanese political leaders compounding regime not only to continue, but also to the problem. Some see the possibility of

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S U T T ER

task of determining the type of reparaflourish. In fact, volumes have been writtions that should be given to recognized ten about the role of the United States, victims of apartheid. As Boraine discuss- Israel, France, Germany, and Britain, es, one of the most evident weaknessesof a m o n g o t h e r s , i n s u p p o r t i n g t h e the TRC's mandate was the restrictions apartheid regime. A special TRC comirnposed on what was defined as a gross mittee should have been established to human rights violation. Given their strinuncover the truth about this cornplicity. gency, only I/,OOO apartheid-era victims Without this history, the "true" story of are eligible for reparations instead of the South Africa's past cannot be written. millions that were and continue to be vicDespite this weakness, Boraine's book apartheid. tims of is a must-read for those who want a betCritics have argrred that one of the ter understanding of the TRC's efforts weaknessesof the TRC process is that to provide justice to the victims of reparations have not been forthcorning. apartheid. Now that South Africa has In response, Boraine states that many begun to come to terms with its past, it is members of the Commission, including time to take seriously the challenge of himself, felt strongly that they were restoring dignity to victims of apartheid unable to quantify reparations until they and developing a culture of human had heard from the victims. Hence, while rights. The forced removals in Alex is making clear the limited rneans of the evidence that gross violations of hurnan state and the Cornmission, the TRC rights continue to this day. It is past tirne often askedvictims what they expected in for South Africa to restore dignity to cornpensation. Knowing the injustice victims of apartheid-era human rights inflicted on the majority of the populaviolations. tion as a result of apartheid, it was perMargaret C. Lee it a Research Associate in the African haps irresponsible of the commissioners Studies Program at Georgetown University. not to prioritize funding for reparations if they were serious about restoring human dignity to victims of apartheid.

The South African governrnent has not a l l o c a t e dt h e 3 b i l l i o n r a n d ( - $ 3 6 0 m i l lion) requested by the Reparations and Rehabilitation Comrnittee. This is a Reuieu b7Robert G. Sutter small arnount cornpared to the over 43 billion rand (-$5,22o million) allocated by the government for buying arms.

Gnnaro Cunrrs. New Per$ectiues on U.S.Telling stories alone will not restore peo- Japan Relations.Tokyo, Japan Center for ple's dignity. Self-worth and dignity also International Exchange, 2OOO, 3O2 pp. flow from having basic amenities and $ z 5 . o o . employment, which could be facilitated International observers are worried through reparations.

A glaring weaknessof the book is that aboutJapan's continued economic stagBoraine fails to mention the role that the nation, with apparent paralysis among West played in allowing the apartheid Japanese political leaders compounding regime not only to continue, but also to the problem. Some see the possibility of

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Books a serious economic crisis or downturn inJapan over the next few years that will have dire implications for the region, the global economy, and the United States. Meanwhile, the U.S. -Japan security alliance enjoys strong and broad support on both sides of the Pacific. Nonetheless, regional dynamics, notably nascent d6tente on the Korean peninsula and the rise of Chinese power, together with domestic Japanese sensitivities over lJ.S. bases and intrusive rnilitary activities, suggest a need for alliance adjustments and change. U.S.-Japanese political cooperation also remains strong, but increasingly weak governments and fragmented national politics in Japan make it less likely that the United States andJapan can easilywork out new cooperative rneasures regarding sensitive economic, security, and political issues.

The nine chapters in "Alero Per$ectiues on U.S.-JapanRelations provide useful insights and perspectiveson rnany of the irnportant econornic, security, and political issuescurrently facing decision-makers in T"ky" and W-ashington. They discuss the reasons for the decline in Japan's econornic power, the impact of economic globalization on Japan-U.S. ties, and changing power relationships and other challenges facing the security relationship.

The contributors to the book are mainly political scientists with strong reputations in the field of U.S.-Japan relations who were brought together by the Japan Center for International Exchange in r99B and 1999 to discuss and critique the now-publlshed articles.

Most of the authors focus on fairly specific aspects or issues regarding the developrnent of the rnultifaceted U.S.Japan relationship. Gerald Curtis of Columbia lJniversity leads off the vol-

ume with an intrigrring historical essay, arguing that two issues-managing relations with China and bilateral U.S.Japan trade relations-have been the main sources of tension in that relationship and in rnany respects illustrate important general features of U.S. policy toward Japan, culminating with the 'Japan passing" phenomenon of the Clinton administration.

Five of the articles deal with economic relations. Robert Bullock of Cornell University takes issue with the prevailing pessirnisrn over the problems and prospects of market opening in Japan.

He highlights significant changes in economic forces affecting Japan that, if cornbined with targeted pressure from the United States and elsewhere, could lead to significant market opening in certain sectors. Bullock buttresses his argurnent with excellent docurnentation and detailed casestudies.

Sirnilarly well-researched is the article by Jennifer HoIt Dwyer of the City I-Jniversity of New York, who takes on the often contentious U.S.-Japan relations over financial markets. She concludesthat globalization injects tension into U.S.-Japan relations in this area, but that the two powers can be expected to continue to cooperate broadly as globalization binds the two econornies more closely together.

In reviewing Japan's reaction to international economic pressure since the rg/os, KatoJunko of the lJniversity of Tokyo argues that good econornic perforrnance in the past made it easier for Japan to appear to accommodate outside demands, but recent poor economic performance means that Japan will have less latitude to meet outside pressures and that outside powers will also expect less ofJapan in this regard.

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Rounding out the treatment of economic issues,Kojo Yoshiko, also of the University of Tokyo, explains the dynamics of Japanese decision-making regarding adjustments in Japan's baiance of payments since the r97os.

Robert Uriu of the lJniversity of California, Irvine, builds on his experience on the staff of the Clinton adrninistration to demonstrate the influence of the ideas of the revisionist school of U.S.Japan relations on American trade policy at that time.

Masayuki of Japan's Thdokoro National Defense Academy examines in detail the mutual images seen in U.S. and Japanese news media, concluding that negative images shown over tirne undermine close political relations. He calls for strong public diplornacy on both sides of the Pacific. tnaka Akihiko of the University of Tokyo cornprehensively describes the "difficult international context" of U.S. -Japan relations in the r99os before concluding that the overall context prornpts the two allies to focus largely on cooperation rather than divergence.

Michael Green of the Council on Foreign Relations assessesfive key areas of U.S.-Japan alliance relations and concludes that growing realisrn in Japanese security thinking and fluidity inJapanese politics mean that Japan is likely to take more steps independent of the alliance relationship, even asbroadJapanese support for the alliance remains strong.

This book provides important insights about where U.S.-Japan relations currently stand. A few authors, notably Michael Green in his discussion of security ties, give a clear and comprehensive senseof what to exPect in important policy areas. In the end, however, it is up to the reader to integrate what the different

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strands developed in the volume mean for the changing nature, problems, and prospects of the U.S.-Japan relationship in the 2lst century.

Robell G, Suttel is the National IntelligenceOfficer for East Asia at the National Intelligence Council, Office of the Director of Central Intellieence.

inthe Business asUsual 2lst Century Reuiew fl RebeccaJohnson HnNnv KrssrNcnn. DoesAmerica Needa Foreign

Polig? Towarda Diplomagfor the 21stCentury.

NewYork, Simon & Schuster, 2oor, 296 PP. $3o.oo.

In his new book DoesAmericaNeeda Foretgn Polig? Towarda Diplomagfor the 21stCentury, former Secretary of State and National Security Adviser Henry Kissinger grapples with the question of how the United States should approach the challenges of an increasingly globalized world.

Kissinger is concerned with the erosion of the Westphalian state systern and the possibility that challenging the order that has prevailed internationally since 1648 could create an international system prone to instability and violence.

The ernerging trend of interventions in the narne of protecting individual hurnan rights and the growing dominance of international legal rules that constrain state action in new ways have enabled conflicts of a sort reminiscent of the Crusades. Kissinger promises a sober and level-headed analysis of the contemporary world to determine how the United States should respond to these changes.

JOHNSON

Rounding out the treatment of economic issues,Kojo Yoshiko, also of the University of Tokyo, explains the dynamics of Japanese decision-making regarding adjustments in Japan's baiance of payments since the r97os.

Robert Uriu of the lJniversity of California, Irvine, builds on his experience on the staff of the Clinton adrninistration to demonstrate the influence of the ideas of the revisionist school of U.S.Japan relations on American trade policy at that time.

Masayuki of Japan's Thdokoro National Defense Academy examines in detail the mutual images seen in U.S. and Japanese news media, concluding that negative images shown over tirne undermine close political relations. He calls for strong public diplornacy on both sides of the Pacific. tnaka Akihiko of the University of Tokyo cornprehensively describes the "difficult international context" of U.S. -Japan relations in the r99os before concluding that the overall context prornpts the two allies to focus largely on cooperation rather than divergence.

Michael Green of the Council on Foreign Relations assessesfive key areas of U.S.-Japan alliance relations and concludes that growing realisrn in Japanese security thinking and fluidity inJapanese politics mean that Japan is likely to take more steps independent of the alliance relationship, even asbroadJapanese support for the alliance remains strong.

This book provides important insights about where U.S.-Japan relations currently stand. A few authors, notably Michael Green in his discussion of security ties, give a clear and comprehensive senseof what to exPect in important policy areas. In the end, however, it is up to the reader to integrate what the different

ItZ +)

Georgetown Journal

of lnternational

Affairs

strands developed in the volume mean for the changing nature, problems, and prospects of the U.S.-Japan relationship in the 2lst century.

Robell G, Suttel is the National IntelligenceOfficer for East Asia at the National Intelligence Council, Office of the Director of Central Intellieence.

inthe Business asUsual 2lst Century Reuiew fl RebeccaJohnson HnNnv KrssrNcnn. DoesAmerica Needa Foreign

Polig? Towarda Diplomagfor the 21stCentury.

NewYork, Simon & Schuster, 2oor, 296 PP. $3o.oo.

In his new book DoesAmericaNeeda Foretgn Polig? Towarda Diplomagfor the 21stCentury, former Secretary of State and National Security Adviser Henry Kissinger grapples with the question of how the United States should approach the challenges of an increasingly globalized world.

Kissinger is concerned with the erosion of the Westphalian state systern and the possibility that challenging the order that has prevailed internationally since 1648 could create an international system prone to instability and violence.

The ernerging trend of interventions in the narne of protecting individual hurnan rights and the growing dominance of international legal rules that constrain state action in new ways have enabled conflicts of a sort reminiscent of the Crusades. Kissinger promises a sober and level-headed analysis of the contemporary world to determine how the United States should respond to these changes.

Books Leaders in Washington over the past eight years failed to realize these dangers, idealistically swept up as they were with the heady promise of instant rnessaging Kissinger, however, and NASDAQ. wastesno opportunity to fault the Clinton administration for squandering what could have been a decadespent positioning the United States to capitalize on the next half-century.

With the Republicans finally back in the White House, Kissinger's book should serve as precisely the guide that Democrats lacked for answering critical grand strategy questions. What world would the United States construct if it had complete discretion? What world would the United States be willing to accept, as it lacks absolute control over international events? What world is

IJnfortunately for the consewative establishment, Kissinger does nothing of the sort. While his book is interesting in its sometimes colorful interpretations of events over the past century and laudable for its truly global scope, Kissinger at best offers some short-range policy recommendations, roughly half of which are already being undertaken by the new Bush administration at the tirne of the book's publication.

This book is less a strategic text for "diplomacy for the 2rst century" as promised by the title than it is a quick shopping list for a one-term Republican president. Kissinger really answers the question, "What actions can U.S. leaders take to rnost quickly reverse the trends their predecessors established over the past decade?" Those trends are

ThiS bOOlt iS 1... a strategictext for "d,iplornacy for the 2rst centr-rry"?qit i5 a qui& shopping list for a one-terrn Republican pr^esident. utterly unacceptable? Is the world headed in a direction it could acceptor one it must reject? What options are availableto bring the world closer to the forrner than the latter, and what obstacles will the United States face in the process? not These questions are mine, Kissinger's, but they are critical for engaging in the type of strategic planning that Kissinger argues is long overdue in the United States. In answering them, Kissinger could once again prove his central place in the United States'sconservative foreign policy establishment and the United States could develop the tools it needs to begin reasserting support for traditional power politics predicated on an international system ofstates.

engaging Russia as an important strategic partner, developing the international expectation that states will not violate the essential hurnan rights of their citizens (and that if they do, othe r s t a t e sn e e d n o t r e m a i n m u t e ) . a n d using unparalleled U.S. power and wealth to support the expression of its fundamental values where they are threatened around the world. One can debate the merits of these trends, but Kissinger fails to offer anything to stand in their place other than the same realpolttikhe has endorsed for the past thirty years, which is only questionably capable of responding to a world more complex and dangerous than at any other time in history.

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To illustrate his points, Kissinger outlines the major issues confronting four regions of the world and offers his observations regarding various policies the United States has adopted over the past century, bluntly criticizing the Wilsonian responsesof the past eight years. He also offers his suggestions as to how the United States should respond to particular conternporary issues. For example, he advocatesabrogating the ABM treaty since the threat of a Russian buildup of offensivenuclear weaponsis low (and the threat for a nuclear attack on U.S. soil is great), accepting India as a nuclear power, and sustaining a constructive relationship with China through geopolitical dialogue.

Kissinger sees a world divided into geographic spheres whose political characteristics parallel different historical periods in the evolution of European history. Europe and the Western Hernisphere lend thernselvesto relations based on idealist beliefs, Asia is characterized by nineteenth-century balance of power politics, and the Middle East is analogous to seventeenth-century Europe. Africa is the one region that does not follow the trajectory of European development; Kissinger labels the continent's problems His book is divided to reflect suigeneris. these geographic and teleological divisions. Kissinger presents each chapter in the form of a quick review of the region's history with longer treatments of current issues facing specific states and suggestions for U.S. policy.

I cornrnend Kissinger for undertaking such a comprehensive project; it is important and seldom done. But spots of DoesAmericaNeed a ForeignPolig? read more like Benjamin Barber's Jihad as.

McWorld than a serious discussion of U.S. grand strategy. This is because in places Kissinger is long on emotional supposi-

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tion and short on hard facts. It is truly ironic that the man who is argrrably the world's most prominent spokesrnan for realisrn relies on unsubstantiated assumptions about the "backward" nationalisrn that supposedly grips the Balkans, Africa, and the Middle East.

It would be ternpting to recornmend this book as a prirner for those unfamiliar with twentieth century foreign policy.

Kissinger does an adrnirable job of covering important conflicts around the world since World War II. lJnfortunately, however, he rather selectively omits some important events from the Cold IMar period such as Grenada, Panama, and Iran-Contra and offers highly disputable interpretations of other events.As someone who studies the Balkans closely I find his portrayal of U.S. and NAIO actions in Bosnia and Kosovo shameful.

When writing a book of the purported reach of Kissinger's, it is always difficult to deal with editors who want books that are easily consumed by the public. However, keeping the book brief while including historical overviews from each important country or region irnpedes his ability to give each region the treatment it warrants. The chapter on Asia is the largest at sixty-three pages, but can one really deal with historical and contemporary strategic policy of all of Latin Arnerica in twenty-six pages? What is the implication of addressing the entire African continent in nine?

Although one can disagree with Kissinger's views of the world and the role of the United Statesin it, his years in various Republican administrations have provided hirn with some truly useful insights to guide U.S. foreign poliry. At one point, Kissinger calls for leaders to overcome the Cold War political bifurcation of idealism versus realism. He also

Books points to the finitude of U.S. resources and calls for U.S. leaders to make some hard choices to prioritize foreign policy goals. This is an action that is long overdue in the debates and conduct of foreign policy, and a challenge so large that it could well take a name as large as Henry Kissinger to carry it out effectively.

(Jnfortunately, throughout the book Kissinger fails to question outdated ways of conceptualizing foreign policy. His d i s c u s s i o no f c o n t e m p o r a r y i n t e r n a t i o n al politics, full of snide jabs at the foreign policies of this century's Democratic presidents, is yet another attempt to vindicate realism and a foreign policy based on a narrow definition of national interests in a rapidly changing world that increasingly refuses to comply with his vision of international politics.

Kissinger uses his regional chapters to launch his critique of what is commonly labeled the "idealist" or "Wilsonian" school of foreign policy. His first objection is to the rnessianic zeal with which Dernocrats seek to hasten the corruption of the Westphalian system. By promoting international institutions that are able to sanction sovereign states that violate human rights, Wilsonians foster an international system that glorifies the individual to the detriment of the state and therefore emboldens ethnic conflicts and wars for independence.

Kissinger seems to think that if the States stopped promoting United human rights abroad, separatist groups would simply never think to rise up against repressive regimes or demand their independence. Yet Kissinger's opposition goes further. Not only does the United States's adoption of a language of human rights incite individuals to demand their freedom from oppressive states, it draws the United States

into the business of defending those rights, with troops if necessary. But Kissinger overstatesthe likelihood of a defense of hurnan rights resorting to military force and understates the willingness of the American people to support such actions if it does.

This last point illustrates Kissinger's second objection to Wilsonian foreign policy. In his conclusion, Kissinger writes, "...[T]he United Stateswill drain its psychological and material resources if it does not learn to distinguish between what it must do, what it would like to do, and what is beyond its capacities." It is with some regret that the reader reaches the end of the book only to find that Kissinger offers no answersto these questions. One may disagree with a defense for a strictly realist grand strategy in the twenty-first century, but one would certainly like to see that defense first.

Such a defense would require another task Kissinger fails to take up, sornewhat ironically given the title of the book-a clear discussion and articulation of his understanding of what constitutes U.S. national interests today. Without erplicitly defining what they are, he characterizes national interests in very traditional security terms, though when discussing Africa he allows that the United Stateshas a rnoral obligation to organize a multilateral effort in the region, which is only vaguely mentioned and not explained.

However, Kissinger is unwavering in his belief that the United States must take every precaution to ensure the preservation and strengthening of the norrn of state sovereignty internationally.

Does the United States need a new strategy to guide its foreign policy? Yes, and that strategyshould be based on precisely the value traditional realpolitikadherents spurn-a belief in the unalienable

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rights of the individual. Kissinger may need to find geographic pockets of the world still dominated by the balance of power to justify business as usual, but he forgets a key observation he himself makes-the United States is the world's undisputed power and is in the position to shape the trajectory of international politics. It is neither the responsibility of the United States nor in its interest to rnake everystateon the planet look and act

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just lile itself. Yet it is the obligation of the United Statesto do what it can to promote and defend its values. The United Statesmust not rnerely extol those values; it must live by them. And that rneans moving past the narrow self-interest and power politics espoused by Kissinger.

Rebecca J, Johnson, a Ph.D. candidatein the Government Department at Georgetown fJniversity, is currently writing her dissertation on conflict resolution in the Balkans.

View frnm lhp Grnund

_

Beyond the "DeathWatch" Jodie Fonseca I hear it everywhere, from the elementary school children who declare, "O.ly people withAIDS go to the anti-AIDS club," to the teenage boys who complain of AIDS when they have a simple upset stornach. Levity in the face of a diseasethat has no cure and no vaccine always surprises me at first. But then I thinl about it. Adisease that has no cure and no vaccine. An epidemic that has one face in the industrialized world and an entirely different face in sub-Saharan Africa. A rnodern-day plague that hits us where we are least inclined to talk about it-our se* lives.

What possible reaction to this diseaseis there other than to be flippant or pretend it is a joke?

Thirteen-year-old Malani Gondwe, a student at the elementary school where I work as an AIDS educator and curriculum developer, has an answer: Tieat AIDS not with casual negligence but fatalisrn and dread. "You are a killer, " he writes in a poem he hopes to submit to a local newspaper for World AIDS Day. "Do you want to wipe out the whole world?"

Dismayed by the tone of his poem, I ask him to try writing somethingwith a more positive message.I give him a one-week deadline, but by the end of the week he hasn't written anything.

"It's impossible, " he says."There's nothing positive to say."

As a Crisis Corps Volunteer working in the small southern African country of Malawi, I cannot blame Malani for feeling this way about an epidemic whose effects he has already seen several times in his brief life. However. I can blame two

Jodie Fonseca is a Crisis unteer

Vol -

Corps

in Malawi

focuses on AIDS cation.

In I997 she

graduated Tulane a B.A.

who edu -

from

University

with

in English and

Political Science. This fall she will attend the Fletcher School of Law and Diplomacy Tufts

at

University.

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world-that decades of government anti-AIDS camgives Malawians little reward focused frightening Malawians for their endless efforts at subsistence. on paigns into changing their behavior, the relentCombine this with a nearly non-existent less focus in the local and international medical infrastructure in which triplemedia on sickness and death, and the cocktail drug therapy is the stuff of legend, and you are left with what the counserrnonizing of religious and other try has now: an out-of-control epidemic. groups who clairn that only the irnmoral But you have heard all this before. If are at risk for HIV. There has been so much negativity for so long that it seems you read any of the rnajor Western news journals, you may believe that there are to come as second nature.

If yOU f ead any of the rnaior \!-esrernnews iournals, you rnay believe that there are only fhree kinds of pebple in sub-Saharan Africi: dead, dying, oi orphaned.

Malani's negative attitude might be something he picked up from his teachers. When asked to come up with a title for a new AIDS education textbook, they Chewa decided on a well-known proverb. tanslated into its closest English equivalent, it means "knowledge is power." Literally translated, however, it has a darker tenor-"ignorance is death."

When it cornes to AIDS, it may well be true that what you do not know will hurt you. But such pessirnistic rnessages clearly have not been effective. This tactic has only succeeded in generating more cynicism, and has not inspired a change in unsafe sexual behavior of the average person here-rnuch less anywhere else in the world. Malawi's HfV infection rate continues to climb; tens of thousands of children are orphaned; and funerals consurne rnore time than any other social function.

Take the overwhelrning indifference with which the rest of the world views the epidemic. To this indifference, add an economy-one of the poorest in the

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only three kinds of people in sub-Saharan Africa, dead, dying, or orphaned.

The rnost popular-and, judging by the meager amounts of assistancetrickling in frorn the developed world, the least effective-way to drum up support for the sick and suffering in the developing 'l-he w o r l d s e e m st o b e t o p e d d l e m i s e r y .

Economist labeled Africa "The Hopeless Continent." The Clinton adrninistration, couching the epidemic in the vocabulary of clear and present danger, called AIDS in Africa a threat to U.S. national security. In its New Year's edition, Nea.rsu.reek portrayed the continent a s a f r e s h l y d u g g r a v ec o n s u m i n g i t s c i t izens. Focusing alrnost exclusively on Post sickness and hardship, a Washington article confronted readers with photographs of emaciated AIDS patients and dismal, poorly-staffed hospitals.

The title of the article? "Death W-atch."

And while there have been some exceptions to this ominous reporting on the epidemic-commentaries from the VilIogeVoiceand Harvard economist Jeffrey

ViewfromtheGround Sachs come to mind-they are few and far between.

If the average Malawian's attitude towards AIDS is one of negativity, the world's is no better. The media has already told you all you need to know about the macabre aspectsof the disease.

Africans are getting sick in frightening numbers. You did not need to hear it from me, because you have heard it too many times before. Africans are dying.

It is time to begin reporting fairly on the situation, because people on this continent are living too. In just three years in Malawi, I have seen signs of what Peter Piot, in his preface to the I99g UNNDS Reporton theGlobolHIV/NDS Epidemic, called "forward-looking strategies to fight the epidemic." On all fronts, frorn the national to the interpersonal, Malawians are taking stock of their situation. Beyond sirnply taking stock, they are also taking action.

The government's response, though hampered by lack of funding and proper medical facilities, has also been cause for optimism. Arnbitious in scope, "National Response to Malawi's HMAIDS for 2ooo-2oo4" outlines strategies for modifring unsafe cultural practices, reaching young people before they become sexually active, and promoting reproductive rights for women and girls. This national framework also includes provisions for alleviating the suffering and isolation of people living with HIV/AIDS and for the tens of thousands of orphans left behind by adult AIDS deaths. The outpouring of creative effort to curb the spread of the virus from nearly all sectors of the government has been impressive. Countries in the developed world would do well to observe and learn a few lessons about the power of collaboration in tackling a

problem many in the rest of the world perceive as insurmountable.

Empowering the public to take control of its own health is an important new element of Malawi's NationalAIDS Control Programme. Voluntary counseling and testing have moved from being taboo to becorne nearly universally-accepted practices at hospitals and clinics. Tbsting centers in urban areassee as many as 2OO patients per day, a remarkable number given that most centers are little more than converted two-bedroorn houses with only a handful of staff, and that the mention of HIV/AIDS has traditionally sent people scurrying in the opposite direction. Why learn your HfV status when life after the blood test will be exactly the same as life before it? This indifference has slowly eroded to the point that thousands of Malawians are confronting their fears about the disease and queuing up at free testing centers.

In Malawi, using a condom has historically been just as unthinkable as getting an HfV test. Yet, in another sign of changing viewpoints, protected sex has been the focus of severalhighlyvisible government-sponsored billboards around Malawi's larger towns. The rnessagethat "real men use condorns" is one that urgently needs to reach the thousands of men and women rnaking up the young, sexually-active urban elite.

From state-financed radio shows to conferences, there are dozens more examples of the initiative the Malawian governrnent has shown in attempting to lower the rate of new HfV infections and improve the lives of those already infected.

Although the government's efforts have been admirable, they have fallen short on many fronts. This stems mainly from the fact that the average Malawian lives in a village far removed from urban centers

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and rarely interacts with government institutions. Smaller- scale organizations lil<e local medical centers, youth groups, churches, schools, sports teams, and cultural troupes attempt to bridge this gap.

They have begun to play an important role in sharing facts about HIV/AIDS with their members and surrounding communities. Acting as open forums for people to come together and discusstopics such as the best course of action for preventing the spread of HIV among the youth or the vicissitudes of AlDS-related illnesses, these gatherings at churches, schools, and community halls have gone a long way toward de-rnystifiing and destigrnatizing the disease.

Yet the most heartening signs of change are not on the level of these local groups. They are not even on the level of nationwide mobilization the of resources. It is among individuals that I have seen the rnost willingness to measure the situation and make the behavioral changes needed to avoid HfV infection.

In the words of Howard Majarnanda, a primary school teacher in Lilongwe, Malawians should not "say one thing and do another" when it comes to fighting the epidernic. His way of following his own advice is to teach students about the proper use of condoms, a once-forbidden topic that has gained acceptance in Malawian schools. But Majamanda's crusade does not stop there: He uses condoms himself and doesn't hesitate to admit it. He is also forthcoming about engaging in extramarital sex, despite the fact that he is a married man with a twoyear-old daughter. Casual extramarital sex is viewed as the birthright of men in Malawi. However, this view is gradually being altered, along with other local cultural practices that carry a high risk for HIV transmissiorr..

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In urban areas where infection rates may be higher than !o percent, the system of combining HMAIDS awareness with advocacy for gender equality has shown signs of success.Women are now more aware of their rights after the death of their husbands, and many no longer submit to the practice of being passedon as the new wife of the deceased man's brother. Chiefs and other cornrnunity Ieaders in villages and suburban townships are discouraging initiation rites designed to give adolescent girls the "practice" they need to please their husbands later in life.

Shifts in cultural norms are benefiting others in society besides wornen. The elders of some tribes are phasing out the use of one razor to circumcise several rnales during initiation ceremonies.

Also, many traditional healers have received training in reducing the risk of HfV transrnission during patients' visits.

This gradual progression-from virtuaI silence on the issue, to more and more open discussion, to a subtle shift not only in words but also in behavior-has been one of the most heartening signs of change in the country. Like Majamanda, many Malawians are movingbeyond simply getting the facts out about HMAIDS. They're beginning to say one thing and do it, too. Frorn teachers who openly advocate condorn-use to maize farmers who are finally adrnitting that their friends and relatives are dying of AIDS, people are taking active steps to confront the epidemic. One very inspiring sign that Malawi is determined to fight the virus is the number of school children pledging to take responsibility for growing up as part of the so-called "AIDSFree Generation."

Given this trend, at first I was disappointed to hear fifteen-year-old Doreen

ViewfromtheGround Banda, a tenth grade student in one of istry's rnessage goes. Focus instead on the regions of the country hit hardest by what you have to live for.

AIDS deaths, clairn that she did not need If Malawians are taking responsibility to learn how to use condoms. Then she for their personal sexual behavior, they told me her reason. are also beginning to realize the futility of "I am going to refuse to have sex until pointing fingers outside the country for I'm married," she declared. She then the origins of their own epidemic. When went on to list all the motivations she I first came to the country in rggf, I had for taking precautions with her own heard stories of how South Africans, life' school, friends, family, career. Z i m b a b w e a n s , M o z a m b i c a n s , E u r o Measuring the level of determination in peans, or Americans were responsible for her words, I have every reason to believe planting the first seedsof today's soaring that she will accomplish her goal of HIV infection rate in Malawi. Some high abstinence until marriage. Doreen is school students even went so far as to not the only voice of responsibility invent a new name for AIDS, "Arnerican among her generation. Though the Ideas for Discouraging Sex." But lately I response is far from universal, increas- have heard a different story. Malawians ing numbers of secondary school stuseern to have realized that blarning othdents are delaying sexual intercourse or ers-frorn citizens of neighboring couninsisting on safer sex. tries to the prostitutes in their horne vilThis growing awareness and willinglage-does not help solve the problern of nessto act extends to younger children as HIV infection in the here and now. well. Prirnary school students are overOnani Mughogho, an HIV/AIDS coming their inhibitions to ask-and counselor and educator in Lilongwe, put even sornetimes demand-to learn about it best at a recent educational workshop' "If a poisonous snake comes into your sexuality, pregnancy, and condoms.

These issues have becorne so cornrnonkitchen and you know its venorn is deadIy, do you sit back and wonder where it place that chants such as "we alwayspractice safe sex, and you should too" can came frorn?" he asked his audience. A often be heard from cheerleaders on the chorus of "no's" resounded. "You do not sidelines at weekend soccer matches. hesitate before you kilI it, because ifyou Innovative attitudes arnong Malawian hesitate it will kill you." youth are being matched by one of their Most have taken this rnessageto heart. representative agencies in the governThey no longer try to blame others, clairn ment: the Ministry of Education. Rec- ignorance, or argue that AIDS only ognizing that novel tactics are required affects those who deserve it. Malawians to combat the spread of HIV among the have started to change their minds about young, the Ministry has developed a new the disease; they have begrrn to see it as a philosophy: teaching children how to problem that involves all and therefore live rather than how not to die. A forthmust be solved by all. coming HMAIDS and life-skills curWhat then should be done about the riculum will focus on the message that Western media, with its tendency to senHIV is a virus that kills. but that anvone sationalize the epidemic and demean the can avoid it by taking a few precautionary millions suffering on distant continents? steps. Stop focusing on dying, the MinPerhaps, lile Malani Gondwe, the media

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needs to be given a new mandate: to seek people into changing their behavior lands out the positive and the negative in equal somewhere in the middle, harnessing the measure. To shift the focus onAfrica away two extrernes of fear and indifference. frorn raging epidemics, corrupt leaders, The world media ought to embrace the bankrupt economies, and expensive civil same philosophy. AIDS is not a joke, but it does not need to take on the dimenwars. To allow readers in developed counAfricans sions of a modern-day plague-ubiquito consider on equal tries terms-as people who live, work, sleep, tous, out of control, inevitable.

As for the articles focusing on the socialize, grow up, grow old, have sex, cook, and farm. If we are to believe what tragedy of AIDS in Africa, believe what we read in Newsweek, disease, war, and you read. The situation is grim. But look beyond the oversimplifications the world's famine are the only features of the African landscape. By focusing on these negatives, rnedia has handed you. Look past the "death watch," and you will soon see that however, the media ignores the cornplexity and resilience of the Continent's peothere is a hurnan face to this epidemicple. The emerging alternative to scaring and it is not alwaysin tears.

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A Lnnk Bank

Diego C. Asencio There are two cornrnon irnages of a Foreign Service officer.

One is that of a dour, serious bureaucrat, constantly rushing frorn one stressful, high-powered engagernent to the next.

The other is the picture of a suave, alwaysimpeccably dressed individual, srnooth-talking his or her way from one highsociety function to another. As I was assembling rnaterial, papers, memories, and ideas for my mernoirs, however, it struck me that neither caricature captures the full experience of working in the diplomatic corps.

As in any other field, serwing as a diplomat involves hard work, but it also has its rewarding and more entertaining moments. In retrospect, I find three particular incidents to be not only hurnorous, but representative of the environrnent in which a Foreign Service officer operates. I hope that these events will help provide a different perspective on the seemingly mysterious life and work of a foreign policy professional.

DiegoC, Asencio spent thirty-one in the Foreign He is former Ambassador

years Senice.

U.S. to Colom

bia and Brazil

and for-

mer Assistant

Secretary

of State for Consular Affairs.

He is now

Executive

Director

the U.S.-Spain

cil. As Ambassador Colombia, napped

of

Counto

he was kid-

along with oth-

er diplomats

by the M-

I9, a terrorist

organi-

zation,

and held for

sixty-one

days.

Tempers Tempering WASHINGTON, D.C., 1965 One of the most difficult, pressure prone, and incidentally most powerful jobs in the Foreign Service is that of a special assistant to an assistant secretary of state. This was precisely the position in which I found myself when I served with Assistant Secretary of State for Inter-American Affairs/Coor-

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dinator of the Alliance for Progress,Jack Vaughn, from 196{ to 1967. My work provided me with a marvelous window on the making of history but was by no rneans an easytask.

It was a rainy Washington evening in r965-the equivalent of Snoopy's "It was a dark and stormy night." The phone rang and Secretary of State Dean Rusk said to rny boss, Assistant Secretary 'Jack, Vaughn, Bobby wants to go to

invite the senator and his staff to the State Department's Bureau of InterAmerican Affairs for one final briefing.

The all-star cast for the briefing included the assistant secretary, his deputies, and the country directors of areas on the senator's itinerary. I could hardly contain my exciternent as I ushered the senator and his people into the conference room where the group awaited. As the senator and his group entered the

AS thg SenatOl andhis .qroupentered. the

roorrr and sat down at one end of the table, I could not help but-notice the State Department staff brooding on the opposite end.

Latin America. Please set it up for him and give him whatever he needs." Both the assistant secretary and I knew he was referring to the junior senator frorn New York, Robert Kennedy. The next morning, I was at the senator's door ready to put our resources at his disposal.

This began a period of constant visits to Capitol HiIl. As your typical young, ambitious, starry-eyed political officer, I was delighted at this turn of events. I saw this as an opportunity and a careerenhancing move. I was the immediate State Department contact for someone who might be president of the United States one day. On each trip, I brought piles of briefing books, proposed schedules, policy papers, biographies, and other foreign policy data to help the senator and his staff prepare for what was to become an epic visit.

I orchestrated the paper flow and a parade of departmental experts on a range of subjects to the senator's office, and decided, as a piece de resistance, to

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roorn and sat down at one end of the table, I could not help but notice the State Department staff brooding on the opposite end.

Disaster struck. Assistant Secretary Vaughn started the proceedings by politely asking, "Senator, before we begin is there any particular question you would like us to answer?" Senator Kennedy replied, "Yes, perhaps you can tell rne why our Latin American Poliry is up. " Assistant SecretaryVaughn, so f-d a red-headed ex-boxer with a fiery temper, neverthelesscoolly replied, "We have the same policy now that we had under your brother." Visibly irritated, the senator responded, "You do not have the same policy now that we had under PresidentKennedy." Vaughn bristled and said, "W'e have the same f-ing policy that we had under your brother."

The senator stood up and started towards the door. I quickly ran after him, desperately trying to douse the flames. The Senator turned to me,

A LookBack stared hard, and said, "I'm gonna get that guy." One of his staffers brushed me aside, saying, "That goes for you too, you SOB. " "There goesmy career down the tubes," I thought. But I would not have time to seek alternative positions for myself-a soon-to-be jobless junior diplomat-as Vaughn was leaving on a trip of his own with rne in his entourage.

We were high over the Andes when Deputy Assistant Secretary Bob Sayre called me on the plane. He read aloud the front-page headline story from TheWashinglonPost.Itcontained an acid description of the senator's exchange with Vaughn.

With a chuckle Sayre said, "TellJack that President Lyndon Johnson, who had been conternplating firing him, was so delighted with the story and his defense of the administration's Latin Arnerica policy 'Kennedy in the face of the Legend' that he has decided to keep him on."

Secretary Kissinger was giving a policy speechbefore a combined U.S. -VenezueIan blue-ribbon audience in the auditoriurn of a hotel. I went to Kissinger's suite, where he asked rne to wait while he finished dressing, saying that he would read the communiqud on his way to the auditorium. He walked out of his dressing room at a fast pace, took the communiqu6 from my hands, and proceeded with rne to a waiting elevator. He read the material as the elevator descended and continued reading as we walked across the lobby to the auditorium. At the door, he turned to me and in his inirnitable Teutonic accent said, "I want the last paragraph first and the first paragraph last."

He then walked into the auditorium to great applause, while I stood transfixed trying to figure out what to do, watching the doors close in my face.

I sent a bellboy to find the Venezuelan foreign rninister, Escobar Salorn, who was looking forward to the secretary's speech and was unhappy at the VENEZUEIA, CARACAS, 19)6 interruption.

His response was, It was a delicate moment in Caracas. "Absolutely not. We took great pains in The Venezuelan government was in the getting it just right. I want it the way it process of nationalizing the petroleum is." He turned on his heels and strode industry. The U.S. Embassy was heavily back into the auditorium, the doors involved in ensuring that American oil closing once again in my face. companies got a fair shake, while avoidMeanwhile, the press attach6, looking ing confrontations and preserving U.S. disheveled, carne running across the lobn a t i o n a l i n t e r e s t s . A t t h i s t i m e l y by, waving his arrns. He informed rne that rnornent, Secretary of State Henry he had about one hundred journalists Kissinger announced that he was cornafter him, clamoring for the text of the ing for a three-day visit. As the deputy communiqud, which we had promised to chief of mission, I worked laboriously release that hour. Just then, I spotted with the Venezuelan Foreign Ministry Ambassador Harry Shlaudemann rnaking on the joint communiqud traditionally his way to the auditoriurn. I rushed forissued at the conclusion of such visits. ward and tackled hirn with our problem.

After an entire week of very careful At the last mornent, we came to a decinegotiations and crafting, we finalized sion. We resolved that the Spanish version the document within only hours of the would have the first paragraph first and secretary'sarrival. that the English version would have the

Miscommunicating Communiqu6s

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last paragraph first. Nobody noticed the difference-so rnuch for the value ofjoint communiqu6s!

Years later when I was ambassador to Brazil, I had Dr. Kissinger, who was then a private citizen, as rny guest. When I inforrned him of what I had done, he responded in mock outrage, with a twinkle in his eyes, "You defied an order of the secretary of state!"

this type, there is a draft of a letter on its way to President Carter's desk denying the story." President Peres informed me that he could not back down, having issued the order. He suggestedthat I go down to the beach where no one would find rne and have dinner. "By all means," he said, "don't go home."

Back in rny car, I received a telephone call from the embassy duty officer, who inforrned rne that the letter from President Carter was coming over our comCARACAS,VENEZUEIA, tg77 munications equipment. I dashed back to After Arnbassador Shlaudemann left the ernbassyand was relieved to read an Caracas to becorne assistant secretary of absolute denial of the NewTorklimesstory state for inter-American affairs, Ambasin a friendly letter to President Peres, sador Viron "Pete" Vuky, u distinguished signed by President Carter. I called Minveteran of diplomatic wars, took his place. ister Arria, who asked me to proceed One of our most interesting crises arose imrnediately to the presidential palace, frorn a Neufork li'mesarticle that said that and that he would handle everything else. the volatile and charisrnatic Venezuelan AmbassadorVaky picked me up and we president Carlos Andres Peres had been sheepishly entered the presidential palace near midnight in the face of a full media on the CIA payroll when he was fighting the Cuban insurgency in Venezuela as blow-out, with television carneras,rnicrorninister of the interior. phones, and flash bulbs everywhere. The Late one afternoon I received a telepress corps followed us into the presicall from minister inforphone the of dent's office, where we found President mation, Diego Arria, who asked me to Peres, flanked by Foreign Minister Escostop by his horne for a drink. As I walked bar Salom, looking stern with his arrns into his library, he handed rne the telecrossed.ArnbassadorVaky and I sat amidst phone and President Peres'svoice greetthe explosion of flash bulbs and the full ed rne. "I havejust instructed the Foreign blast of the television lights.

Minister to expel both the overt and The arnbassador handed the letter to covert political sections ofyour ernbassy. President Peres, who made a great show The Foreign Minister is looking for you of opening the envelope and carefully at this very moment." scanning the letter. He then looked at the "Mr. I protested, saying, President, if rnedia with a radiant srnile. After a few rnoments of picture-taking, he asked his you do that, it will take years to get U.S.Venezuelan relations back on an even aides and the reporters to clear the roorn. keel. I was informed this afternoon that Once the press left, he handed the letter contrary to our usual policy, which is to the foreign minister and said, "Read it neither to confirm nor deny stories of to me; I can't read English."

Blameit onthePress

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