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41. Eritrea's Economy: Ideology and Opportunity

Author:
Seth Kaplan
Publication Date:
12-2016
Content Type:
Special Report
Institution:
Atlantic Council
Abstract:
Eritrea is often in the news for all the wrong reasons: its high rates of migration to Europe (it has sent more refugees to Europe in recent years than any other African nation), its conflicts with neighboring Ethiopia and Djibouti, and controversy over its mandatory and indefinite national service conscription program. Human rights activists, in particular, have long singled out the country for criticism, calling it “the North Korea of Africa.” The inappropriateness of that comparison is increasingly recognized—but misunderstandings about the nature of the Eritrean regime continue to abound.
Topic:
Migration and Refugee Crisis
Political Geography:
Africa, Europe, and Eritrea

42. Antimicrobial Resistance as an Emerging Threat to National Security

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, and Health Care Policy
Political Geography:
United States, China, United Kingdom, America, and Europe

43. A Transatlantic Approach for the Arab World: Stability through Inclusivity, Good Governance, and Prosperity

Author:
Amy Hawthorne, Frances G. Burwell, and Danya Greenfield
Publication Date:
01-2015
Content Type:
Policy Brief
Institution:
Atlantic Council
Abstract:
A new Atlantic Council report warns against the tendency of Europe and the United States to sideline political and economic reform in the Middle East while they pursue urgent security priorities in this turbulent region. Instead, the transatlantic partners should forge a shared strategy to encourage political systems that can protect Arab citizens' basic rights, provide security, deliver broad prosperity, and mitigate violent extremism.
Political Geography:
United States, Europe, and Middle East

44. Nordstream 2: Too Many Obstacles, Legal, Economic, and Political to be Delivered?

Author:
Alan Riley
Publication Date:
11-2015
Content Type:
Policy Brief
Institution:
Atlantic Council
Abstract:
Germany may be seeking to expedite the construction of Russia's Nordstream 2 pipeline by shielding the controversial project from tough the laws of the European Union (EU), according to a transcript of talks between Russian President Vladimir Putin and German Energy Minster Sigmar Gabriel, Atlantic Council Senior Fellow Alan Riley writes in "Nordstream 2: Too Many Obstacles, Legal, Economic, and Political to Be Delivered?".
Topic:
Energy Policy, International Law, International Trade and Finance, Natural Resources, and European Union
Political Geography:
Russia and Europe

45. The Transatlantic Trade and Investment Partnership: Big Opportunities for Small Business

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, and Europe

46. The Die Is Cast: Confronting Russian Aggression in Eastern Europe

Author:
Christopher Musselman
Publication Date:
12-2014
Content Type:
Policy Brief
Institution:
Atlantic Council
Abstract:
The Ukraine crisis demonstrates that European security can no longer be taken for granted and that NATO and the broader transatlantic community are struggling to address emerging security challenges. Whether Russia is classified revanchist, expanding its sphere of influence, or seeking to create regional hegemony, Putin's actions in both Crimea and eastern Ukraine are a stark reminder that the era of geopolitical competition in Europe is far from over. The transatlantic community must be ready to deal with similar challenges in the decades ahead.
Topic:
Conflict Resolution and Regional Cooperation
Political Geography:
Russia, Europe, and Ukraine

47. Completing Europe – From the North-South Corridor to Energy, Transportation, and Telecommunications Union

Author:
Atlantic Council and CEEP
Publication Date:
11-2014
Content Type:
Working Paper
Institution:
Atlantic Council
Abstract:
One of the greatest successes of our new century has been the progress made in unifying Europe. The accession of Central Europe's countries to the European Union (EU) has contributed to the end of division that wrought confrontations and conflicts. Yet this task is far from finished. Europe's economic woes, as well as new security challenges along the Union's eastern border add to the urgency of completing and consolidating the European integration project as part of our transatlantic vision of a Europe whole, free, and at peace.
Topic:
Economics, Energy Policy, Science and Technology, and Infrastructure
Political Geography:
Europe and Central Europe

48. Ten Ideas for Smarter NATO Missile Defense

Author:
Patrick O'Reilly
Publication Date:
01-2014
Content Type:
Policy Brief
Institution:
Atlantic Council
Abstract:
NATO leaders have cited missile defense as an example of applying the principles of the Smart Defense initiative endorsed at the 2012 NATO Summit to enhance collective defense at minimum cost. As ballistic missiles continue to proliferate and become more accessible to both state and nonstate actors, it is important to foster global partnerships to pursue NATO's missile defense mission and protect North American and European interests. NATO should consider opportunities to further apply the principles of Smart Defense now to reduce future costs of deterring and countering missile proliferation.
Topic:
Foreign Policy, Defense Policy, NATO, and Arms Control and Proliferation
Political Geography:
Europe, Middle East, Asia, and North America

49. NATO's Framework Nations: Capabilities for an Unpredictable World

Author:
Franklin D. Kramer
Publication Date:
04-2014
Content Type:
Policy Brief
Institution:
Atlantic Council
Abstract:
As the Ukraine crisis demonstrates, in an unpredictable world, military capabilities can be a critical factor. The longstanding goals of the United States and its NATO allies have been to create a Europe whole and free, and globally to support such goals through collective defense, crisis management, and cooperative security. Ukraine raises the issue of how best to accomplish those ends. As part of the Ukraine response, there have been and will continue to be diplomatic, economic, and energy efforts. However, one key element will be to create more effective integrated capabilities that will support NATO's military tasks, and thus the values and goals that NATO represents.
Topic:
NATO, Diplomacy, and Economics
Political Geography:
United States, Europe, Ukraine, and North America

50. Turkish-Iranian Rapprochement and the Future of European and Asian Energy

Author:
Pinar Dost-Niyego and Orhan Taner
Publication Date:
04-2014
Content Type:
Policy Brief
Institution:
Atlantic Council
Abstract:
The recent events in Ukraine have revived the question of European dependence on Russian natural gas. The security of Europe's natural gas supply has been a consistently important issue in Russian-European Union (EU) relations. Russia provided 34 percent of EU gas in 2012, and Russian policies can have a direct impact on EU supplies. After the West-Russian confrontation over Ukraine, a lot has been said about the 'US shale gas revolution' and the possibilities of the United States becoming an energy exporter for future European energy needs. Although US energy independence seems to promise new perspectives for future European energy security, as well as for the balance of power in the Middle East, this is not for this decade. We cannot expect that the European Union would be able to cut off all of its energy relations with Russia, but we can foresee–or at least agree–that the European Union should diversify its natural gas supplies.
Topic:
Security, Foreign Policy, Economics, and Energy Policy
Political Geography:
Russia, United States, Europe, Ukraine, Middle East, and Asia