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41. Gender Equity to Improve Immunization Services

Author:
Katherine E. Bliss and Alicia Carbaugh
Publication Date:
09-2022
Content Type:
Policy Brief
Institution:
Center for Strategic and International Studies
Abstract:
The Covid-19 pandemic has underscored the importance of a strong health workforce to outbreak response, as well as of vaccine delivery to prevent further outbreaks. Women and men providing care, transporting supplies, analyzing data, and delivering vaccines to patients and their families have all contributed to pandemic-related activities while maintaining a focus on routine health programs. Women comprise an estimated two-thirds of the formal health workforce worldwide—and a high percentage of the unpaid health workforce as well. Yet gender inequities, including those related to training, compensation, and professional advancement, limit opportunities for female health workers to perform their duties and develop professionally, with implications for quality of care and health outcomes. By prioritizing gender equity within their own health workforces; gathering data on gender dynamics within the immunization programs they support; and supporting initiatives to train, retain, and advance the careers of female immunization workers, donor governments—including the United States, working with bilateral and multilateral partners—can strengthen quality of care, improve global immunization coverage, and reinforce health security in the long run.
Topic:
Governance, Medicine, Equality, Immunization, and Gender
Political Geography:
Global Focus

42. It's Moving Time: Taiwanese Business Responds to Growing U.S.-China Tensions

Author:
Scott Kennedy
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
A new report by the CSIS Trustee Chair in Chinese Business and Economics interprets a formal survey of over 500 Taiwanese business executives, documenting their views about the evolving environment on the island and beyond. The Washington policy community is quite familiar with the views that U.S. and European companies hold toward China, but less clear are the views of Taiwanese companies that are central to the story of the world’s interaction with China. Their opinions have implications for Taiwan’s economic trajectory, cross-strait relations, global supply chains, and the effectiveness of U.S. policy in the region. The report documents that Taiwanese companies are highly concerned about their potential overdependence on the Chinese economy and the possibility of a military conflict. As a result, there is significant support for expanding trade and investment ties via regional arrangements and bilaterally with the United States, as well as for maintaining Taiwan’s technological edge through more spending on research and development and broadening restrictions for technology transfer to China. But perhaps the most noteworthy finding is that Taiwanese companies appear to be moving their businesses at record levels from Mainland China, but also from Taiwan. This report, by Trustee Chair Scott Kennedy, explains how the survey was carried out, then analyzes the sources of Taiwanese companies’ anxieties and the ways they are responding, and concludes by considering the policy implications for all parties involved. The report’s appendix provides a full summary of the original survey results.
Topic:
Security, Defense Policy, Territorial Disputes, Business, Conflict, and Rivalry
Political Geography:
China, Taiwan, Asia, North America, and United States of America

43. Reshoring Semiconductor Manufacturing: Addressing the Workforce Challenge

Author:
Sujai Shivakumar, Charles Wessner, and Thomas Howell
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
On August 9, 2022, President Biden signed the CHIPS and Science Act, sweeping legislation that seeks to strengthen the U.S. semiconductor supply chain, encourage investments in semiconductor manufacturing facilities in the United States, stimulate semiconductor research and development (R&D), and disincentivize U.S. investments in chip-making plants in China. Among other things, the legislation will provide $52.7 billion in federal outlays over five years for loans, loan guarantees, grants, and other financial support for domestic chip-making investments, as well as a 25 percent tax credit for semiconductor investments in the United States. Bolstered by this unprecedented level of federal support, six major chip makers are investing in new wafer fabrication facilities (“fabs”) in the United States: Intel, Samsung, TSMC, GlobalFoundries, Texas Instruments, and Micron Technology.
Topic:
Science and Technology, Manufacturing, Industrialization, and Semiconductors
Political Geography:
North America and United States of America

44. What If . . . Alternatives to a Chinese Military Invasion of Taiwan Image

Author:
Benjamin Jensen, Riley McCabe, and Adrian Bogart
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
With the 20th Party Congress approaching and Xi Jinping seeking an unprecedented third term, it is important to explore the full range of actions Beijing could take to coerce Taiwan over the next 10 years. History provides a range of historical cases that suggest alternatives to a full-scale invasion. As part of its On Future War series, the CSIS International Security Program adapted six historical cases of coercion China could use to target Taiwan short of a costly amphibious invasion. The report looks back to look ahead, using the logic of historical cases ranging from the 1948 Berlin Airlift to the 1980s Tanker War in the Arabian Gulf to identify ways and means Beijing could use to compel Taiwan. The resulting range of scenarios point toward an urgent need to develop new escalation management frameworks supporting the new integrated deterrence strategy.
Topic:
Security, Defense Policy, Military Strategy, and Conflict
Political Geography:
China, Taiwan, and Asia

45. Choking off China’s Access to the Future of AI

Author:
Gregory Allen
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
On October 7, 2022, the Biden administration announced a new export controls policy on artificial intelligence (AI) and semiconductor technologies to China. These new controls—a genuine landmark in U.S.-China relations—provide the complete picture after a partial disclosure in early September generated confusion. For weeks the Biden administration has been receiving criticism in many quarters for a new round of semiconductor export control restrictions, first disclosed on September 1. The restrictions block leading U.S. AI computer chip designers, such as Nvidia and AMD, from selling their high-end chips for AI and supercomputing to China. The criticism typically goes like this: China’s domestic AI chip design companies could not win customers in China because their chip designs could not compete with Nvidia and AMD on performance. Chinese firms could not catch up to Nvidia and AMD on performance because they did not have enough customers to benefit from economies of scale and network effects. Because of the new export controls, revenues that formerly flowed to U.S. chip companies will now go to Chinese chip companies, offering a viable path to economies of scale and competitive performance. In the short term, this policy will significantly harm Chinese AI data center companies. However, blocking U.S. AI chip designers from selling their world-leading chips is actually good for China in the longer term because it will strengthen China’s domestic chip design ecosystem. While the reasoning in this criticism is sound, it does not imply that the Biden administration’s actions are self-defeating. Rather, it shows how the policy as disclosed in September was incomplete. A policy like this would not make sense if that is the only step the administration planned to take. Clearly something was missing, and industry experts have been waiting for the other shoe to drop ever since. On October 7, the other shoe dropped. The Biden administration announced a massive policy shift on semiconductor exports to China as well as revised rules for how the lists of restricted parties are managed. In recent decades, U.S. semiconductor policy has been primarily market driven and laissez faire. With the new policy, which comes on the heels of the CHIPS Act’s passage, the United States is firmly focused on retaining control over so-called “chokepoint” (or as it is sometimes translated from Chinese “stranglehold”) technologies in the global semiconductor technology supply chain. The most important chokepoints in the context of this discussion are AI chip designs, electronic design automation software, semiconductor manufacturing equipment, and equipment components. The Biden administration’s latest actions simultaneously exploit U.S. dominance across all four of these chokepoints. In doing so, these actions demonstrate an unprecedented degree of U.S. government intervention to not only preserve chokepoint control but also begin a new U.S. policy of actively strangling large segments of the Chinese technology industry—strangling with an intent to kill.
Topic:
Science and Technology, Hegemony, Artificial Intelligence, Rivalry, and Emerging Technology
Political Geography:
China, Asia, North America, and United States of America

46. Engines of Prosperity: The Promise of the Zones for Employment and Economic Development (ZEDEs) in Honduras Image

Author:
Ryan C. Berg and Matthew Carusi
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
Special economic zones (SEZs) are autonomous zones designed to facilitate free-trade operations. SEZs can be broken down into the following types of zones: free-trade zones, which are duty-free areas to warehouse and transit goods; enterprise zones, which provide tax benefits to underperforming industries; specialized zones, which include technology parks; and freeports—the largest type of economic zones, combining work and residential spaces. A 2008 World Bank report defined SEZs as having the following characteristics: a geographically secured area, a single management system, eligibility for benefits based on the location within the zone, and a separate customs area. Advocates of SEZs argue that they can improve a country’s economic standing by making it more competitive on the global stage. One way to achieve this goal is by improving a country’s infrastructure. Building out more extensive road networks or port systems is beneficial not only for businesses operating inside the SEZ, but also for the entire country’s future economic trajectory. Another argument in favor of SEZs is that they strengthen a country’s institutional framework. In developing countries, this narrative can be particularly relevant because weak institutions often constrain foreign investors from making large-scale commitments. SEZs attempt to fill this gap by increasing the efficiency of the regulatory frameworks, property rights, and investment flows. Since a wealth of SEZs are awarded a certain level of legal autonomy, establishing these unique governance structures can be arranged. SEZs offer similar advantages for streamlining efficiency in the labor market. Wages can be more flexible and the process of hiring and firing employees can become easier. Workers can further be attracted by the availability of better healthcare and education systems, as well as by the availability of internet or phone services. All these factors are crucial in attracting the best possible talent, both domestically and internationally, giving them reasons to set up operations inside an SEZ. The intended results of these characteristics are that GDP per capita within the SEZ would increase substantially and that surrounding areas would be able to reap these rewards. These are known as spillover effects, wherein new influxes of foreign and intellectual capital would spill over into the surrounding communities. However, the verdict on this subject is less clear. According to a 2017 World Bank study, the literature on SEZs does not confirm a clear link between achieving widespread spillovers and increasing regional employment levels. There is more evidence to support the claim that limited spillover effects exist in surrounding areas up to 50 kilometers outside the SEZ.
Topic:
Development, Economics, Employment, and Special Economic Zones
Political Geography:
Central America, North America, and Honduras

47. How Innovative Financing Models Can Support the Scaling of Supply Chain Innovations

Author:
Allie Dichiara and John Simon
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
Substantial progress has been made toward achieving Sustainable Development Goal (SDG) 3: Health and Well-Being for All. However, progress is plateauing as global health development funding decelerates, and much of the remaining gaps are among the hardest to address, especially for the most vulnerable and hardest-to-reach communities. A key element to reigniting progress toward SDG 3 is significantly improving the effectiveness of the current fragmented health commodity supply chain, through which billions in spending—approximately $6 billion in donor funds in 2015 and $50 billion in overall spending in 2017—flow each year to low- and lower-middle-income countries (LMICs). Fortunately, there is a growing number of innovative supply chain solutions available across sub-Saharan Africa that could have the potential to dramatically improve the underperforming status quo.
Topic:
Economics, Science and Technology, Innovation, and Supply Chains
Political Geography:
Africa

48. CCP Inc. in Greece: State Grid and China’s Role in the Greek Energy Sector

Author:
Briana Boland, Jude Blanchette, and Cory Combs
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
How did one of China’s core state-owned enterprises gain a foothold in Greece’s electricity sector? This case study examines the “CCP Inc.” ecosystem of Chinese officials, state-owned enterprises, policy banks, and private firms that helped State Grid Corporation of China (State Grid) and other Chinese companies gain a stake in the national electric grid and renewable energy projects in Greece. State Grid is the world’s largest utility company, pursuing an international strategy of expansion that both implements and informs Beijing’s policy goals for global energy infrastructure. By investigating how State Grid acquired a stake in Greece’s national power grid operator, the Chinese financing and energy sector business deals that followed State Grid’s investment, and the constraints that limited State Grid’s later efforts to expand its control over Greece’s electric grid, this case study offers insight to the role of state-owned enterprises in the global reach of China’s state capitalist system.
Topic:
Energy Policy, Finance, Electricity, and State-Owned Enterprises
Political Geography:
China and Asia

49. Modernizing Ukraine’s Transport and Logistics Infrastructure

Author:
Romina Bandura, Janina Staguhn, and Benjamin Jensen
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
Russia’s ongoing war in Ukraine is yielding devastating human and material costs. But with the destruction comes a rare opportunity to modernize Ukraine’s economy by building state-of-the-art infrastructure. Rebuilding hospitals, schools, and housing will be critical to bringing refugees back, while constructing new roads and rail networks alongside ports and airfields could catalyze the economic reconstruction and link the growth of small and medium-sized enterprises (SMEs) to global supply chains and markets. Infrastructure investments can achieve a rare combination of political and economic objectives, connecting Ukraine to Europe while helping its large industrial base and educated workforce reach global markets. In other words, rebuilding the transportation and logistics infrastructure in Ukraine provides an opportunity for democratic leaders to realize the vision of the Group of Seven (G7) Partnership for Global Infrastructure and Investment (PGII). A successful reconstruction would include a Ukraine that is connected to and firmly embedded in the Euro-Atlantic community. Ukraine has a large industrial base, with a well-educated and skilled population that has the potential to build a highly competitive manufacturing sector to complement the European Union. However, to unlock this potential, Ukraine needs to build quality transport and logistics infrastructure (i.e., civilian airports, roads, bridges, ports, and railways) connected to the West. Over the next 10 years, the transport and logistics infrastructure sector will require significant financing, prioritization, and coordination among the Ukrainian government and international actors (bilateral partners, multilateral institutions, and the private sector). Foreign direct investment (FDI), including through long-term public-private partnership and concession contracts financed by the private sector, will also be critical for funding large-scale projects and providing know-how so there is a world-class infrastructure base in Ukraine. International donors and foreign investors need to assess how to best support Ukraine’s future economic and trade recovery, specifically regarding its transport and logistics infrastructure. Ukraine can also be the country where the PGII conducts its first project, testing its capabilities and providing a demonstration for other investors.
Topic:
Infrastructure, Modernization, Transportation, and Logistics
Political Geography:
Europe and Ukraine

50. The Ending the HIV Epidemic in the U.S. Initiative: An Interim Assessment and Policy Recommendations

Author:
Jeffrey L. Sturchio, Mackenzie Burke, and Maclane Speer
Publication Date:
10-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
The Ending the HIV Epidemic in the U.S. (EHE) initiative is a promising federal program launched by the U.S. Department of Health and Human Services (HHS) in February 2019 with the aim of reducing new HIV infections by 75 percent by 2025 and 90 percent by 2030 (from a baseline of more than 38,000 new diagnoses in 2017). While the EHE initiative set ambitious targets for ending the HIV epidemic in the United States in the context of a sound and sensible plan, it is at present off track. Now, three years in—at the midpoint of the first EHE phase, which has a target of reducing new HIV infections to 9,250 people or fewer by 2025—is an opportune moment to assess its status and the challenges it faces. After a review of progress to date, this report examines the collision between the logical plan behind the EHE initiative and the complicated patchwork of programs that provide HIV prevention, care, and treatment to the diverse communities affected across all EHE jurisdictions. The analysis is informed by several roundtable discussions convened by CSIS with the participation of a representative group of people living with HIV/AIDS (PLWHA), community advocates, physicians, service providers, researchers, and policymakers who are implementing the EHE initiative around the country. The report concludes with policy recommendations in four areas: (1) meet people where they are by building programs that are centered on the needs of populations directly affected by the HIV epidemic; (2) address flexibility in design and implementation; (3) improve data, metrics, and accountability; and (4) heighten political advocacy to ensure future funding of the EHE initiative. A strong theme that runs throughout the report is that lessons from the global HIV response—the importance of building interventions from the ground up, of engaging with affected communities, and of taking an integrated approach across a spectrum of biomedical, clinical, social, behavioral, economic, and political dimensions—can inform and strengthen the U.S. domestic response to HIV/AIDS.
Topic:
HIV/AIDS, Health, Medicine, and Epidemic
Political Geography:
North America and United States of America