Search

You searched for: Content Type Working Paper Remove constraint Content Type: Working Paper Publishing Institution Atlantic Council Remove constraint Publishing Institution: Atlantic Council Political Geography America Remove constraint Political Geography: America
Number of results to display per page

Search Results

  • Author: Maxine Builder
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: Growing rates of antimicrobial resistance (AMR) pose a threat to public health that could undo many of the medical advances made over the last seventy years, eroding the global medical safety net and posing a significant threat to national security. Diseases once eliminated by a single course of antibiotics show drug resistance, often to several different classes of drugs. Some of the implications of increasing rates of AMR are intuitive, such as longer duration of illness, extended hospital stays, and higher rates of mortality. But other effects of a postantibiotics world are less obvious, such as the inability to perform life-saving operations or the ability for a simple scratch on the arm to kill. Humanity could soon find itself living in a reality in which communicable diseases such as tuberculosis, cholera, pneumonia, and other common infections cannot be controlled. This potentially catastrophic problem still can be abated, and the global health community, including the World Health Organization (WHO), has highlighted AMR as a priority in global health. But all sectors of the international community, not simply those in public health, need to take immediate steps to reverse the current trends and eliminate the systematic misuse of antimicrobial drugs, especially in livestock, and restore the pipeline of new antimicrobial drugs. The significant health and economic costs of AMR are difficult to quantify due to incomplete data that often underreports the extent of the problem, since there are no standard metrics or consensus on methodology to measure rates of AMR. But even the piecemeal statistics that exist paint a bleak picture. In a 2013 report, the US Centers for Disease Control and Prevention (CDC) reports at least two million Americans acquire serious infections to one or more strains of AMR bacteria annually, and at least 23,000 people die of these infections.1 A 2008 study estimated the excess direct costs to the US medical system attributable to AMR infections at $20 billion, with additional estimated productivity losses to be as high as $35 billion.2 With the increase in resistant infections and continuing rise in medical costs, the cost to the American medical system no doubt also has increased. This trend is not a uniquely American problem; it is truly global in scope. The European Union (EU) reports about 25,000 deaths annually due to drug-resistant bacteria, at an overall, combined cost of $2 billion in healthcare costs and productivity losses.3 There were over 14.7 million incidents of moderate-to-severe adverse reactions to antibiotics each year between 2001 and 2005 in China. Of these, 150,000 patients died annually.4 The most recent available data on China estimates that treatment of AMR infections during that same time period cost at least $477 million, with productivity losses of more than $55 million each year.5 A 2005 study of the United Kingdom (UK) found that the real annual gross domestic losses due to AMR were between 0.4 and 1.6 percent.6 Although slightly outdated, this estimate may be a useful guide in assessing the global impact of AMR, and given the trend of increasing resistance, it is likely that the impact will also increase accordingly. That said, it is prudent to repeat that the disparities in the quality of data reporting standards across China, the United States, the United Kingdom, and the European Union make it difficult to directly compare the severity of the impacts AMR has on each entity. The primary cause of AMR globally is antibiotic overuse and misuse, be it from doctors inappropriately prescribing antibiotics to treat viral infections or individuals seeking over-the-counter antibiotics for self-treatment. But another driver, less obvious than overuse in humans, is the use of antimicrobials in livestock, and the ratio of use in animals as compared to humans is astounding. In the United States, about 80 percent of all antibiotics are consumed in either agriculture or aquaculture. Generally, these drugs are administered to livestock as growth promoters and are medically unnecessary. Resistance in livestock quickly spreads to humans, and many community-acquired infections are the result of a contaminated food supply. Although most infections are acquired in the community, most deaths attributed to resistant infections occur in healthcare settings, and healthcare-acquired (or nosocomial) infections are another driver of AMR. At this point, AMR does not pose an immediate and direct threat to national security. Rather, this is a creeping global security crisis. If current trends continue, these drugs upon which the world relies will lose effectiveness. The gains made in fighting infectious diseases will be reversed, and a wide range of routine surgeries and easily treatable infections will become much more dangerous and deadly. This will cause the health of the world's working population to deteriorate, and the economic productivity and social cohesion of the globe to decline. At any time, a “black swan” event—triggered by an outbreak of drug-resistant tuberculosis, cholera, or pneumonia, for example—could prove catastrophic, endangering the fabric of societies and our globalized economy, forcing a stop to international trade and travel to prevent further spread. The issue of AMR is a tragedy of the commons in which individual incentives lead to the overuse and eventual destruction of a shared resource. International cooperation is required to walk back from this ledge and avoid a postantibiotics world, even though it is impossible to completely reverse the damage already done.
  • Topic: Health, National Security, Infectious Diseases, Health Care Policy
  • Political Geography: United States, China, United Kingdom, America, Europe
  • Author: Garrett Workman
  • Publication Date: 11-2014
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: With Transatlantic Trade and Investment Partnership (TTIP) negotiations underway, there is an increasing focus on the prospective economic benefits and potential policy changes resulting from an ambitious agreement. While modernizing trade rules will benefit businesses of all sizes on both sides of the Atlantic, TTIP will be especially critical for small and medium-sized enterprises (SMEs) that often struggle with the numerous administrative, legal, and regulatory barriers to exporting that slow down trade and hinder innovation. Given their limited financial and human resources, small businesses stand to gain exponentially from a transatlantic agreement that streamlines regulatory and customs processes.
  • Political Geography: United States, America, Europe
  • Author: Jason Healey, Klara Tothova Jordan, John C. Mallery, Nathaniel V. V. Youd
  • Publication Date: 11-2014
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: Confidence-building measures (CBMs) are an instrument of international politics, negotiated by and applied between states to strengthen international peace and security by reducing and eliminating the causes of mistrust, fear, misunderstanding, and miscalculations that states have about the military activities of other states.
  • Political Geography: Russia, China, America
  • Author: Isabelle Francois
  • Publication Date: 09-2013
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: The past twenty years have been marked by a series of setbacks and disappointments in the US-European-Russian dialogue, despite regular attempts to develop a strategic partnership. In this cyclical relationship, 2012 was a low point in Western relations with Russia, from the calculated absence of President Vladimir Putin at the NATO summit in Chicago to the Russian ban on American adoptions of Russian orphans, and the US reaction to the Sergei Magnitsky case. The year 2013 could have been the beginning of an upswing in the trilateral dialogue. In April, US Secretary of State John Kerry and Russian Foreign Minister Sergey Lavrov met on the margins of the G8 foreign ministers' gathering in London. At the same time, US National Security Advisor Tom Donilon called on Putin in Moscow, where he hand-delivered a letter from President Barack Obama detailing potential areas of cooperation. A series of meetings between Russian and American officials throughout the summer saw a new diplomatic push to reframe the US–Russia relationship in the run-up to the Group of Eight meeting in June and the G20 meeting in September 2013. However, the Edward Snowden affair and Obama's subsequent decision to cancel the planned September meeting with Putin in light of insufficient progress on bilateral issues point to a pause in the relationship.
  • Topic: International Relations, Economics
  • Political Geography: Russia, United States, America, Europe
  • Author: Richard L. Lawson, Mihaela Carstei, Blythe Lyons, John Lyman
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: A substantive dialogue has emerged in the United States under the rubric of “the energy and water nexus,” representing the deepening understanding of the circular relationship between water and energy. Both are essential building blocks of US economic and physical security, and interface with efforts to improve health and prosperity. On a national level, the criticality of this relationship to economic and public prosperity is often ignored, as energy and water impacts are largely specific to a watershed or a local surface water source. Simply put, energy security and the availability of water are both critical elements of US national security. Furthermore, ensuring adequate water supplies underpins the production of energy resources, which remains a major driver of the US economy.
  • Topic: Economics, Energy Policy, Human Rights, Water
  • Political Geography: America
  • Author: Ross Wilson, Damon Wilson
  • Publication Date: 11-2010
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: An arc of potential disorder and instability increasingly looms over Central Asia. This year's political turmoil and ethnic violence in Kyrgyzstan illustrated the difficulties and dangers before the region –and that American interests confront there. Much of Central Asia is not succeeding economically or politically. Parts of it face the prospect of indigenous extremist violence and/or could become new safe havens for transnational threats emanating from Afghanistan. U.S. strategies that for years aimed to support the sovereignty, independence, territorial integrity and success of the new Central Asian states have come to be dominated by the exigencies of the Afghan war and an increasingly unproductive conversation on human rights and democracy. As a result, those strategies are failing, and U.S. policy is being marginalized.
  • Topic: Foreign Policy, Diplomacy
  • Political Geography: United States, America, Central Asia
  • Publication Date: 01-2008
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: The National Committee on American Foreign Policy was founded in 1974 by Professor Hans J. Morgenthau and others. It is a nonprofit activist organization dedicated to the resolution of conflicts that threaten US interests. Toward that end, the National Committee identifies, articulates, and helps advance American foreign policy interests from a nonpartisan perspective within the framework of political realism. Believing that an informed public is vital to a democratic society, the National Committee offers educational programs that address security challenges facing the United States and publishes a variety of publications, including its bimonthly journal, American Foreign Policy Interests.
  • Topic: Foreign Policy, Democratization, Diplomacy
  • Political Geography: United States, America