Courtesy flickr user zmxncbv.com

The think tank 2020health has just released my report on UK vaccination policy. ‘Not immune: UK vaccination policy in a changing world‘ was written in response to the Conservative Party’s call for the UK’s Joint Committee on Vaccination and Immunisation (JCVI) to be merged with the National Institutes for Health and Clinical Excellence (NICE).  Drawing on interviews with senior vaccination policy-makers and an exhaustive review of the literature, the report concludes that while a merger would be more likely to harm rather than benefit the UK’s health, there is a strong case for more open and transparent immunisation policy-making.

The JCVI is currently quite a secretive body which conducts its meetings behind closed doors, only releasing minutes to the public a couple of months later. So far, this hasn’t caused any problems, but as the MMR vaccine scare and other health crises such as BSE and foot and mouth have shown, it’s impossible to predict what is around the corner, and if the JCVI should ever make a wrong decision (as its counterpart in the US recently did by introducing a dangerous rotavirus vaccine that subsequently had to be withdrawn), its secretive modus operandi will come under scrutiny. Trust is crucial for vaccine decision-making (unlike with the treatments for sick people that NICE evaluates, with immunisation parents are taking healthy children for jabs), but secrecy and trust are unlikely bedfellows. We therefore recommend that the JCVI open its meetings to the public and allow some public participation (which is likely to come as a shock to some JCVI committee members).

Another key message (there are quite a few recommendations but I’m afraid you’ll have to read the report for a full list) applies to both the JCVI and NICE. The cost-effectiveness of treatments and vaccines is a fundamental part of decisions on whether to introduce them into the National Health Service, but neither body has effectively made the case that cost-effectiveness is important. We therefore get regular outraged headlines in the Daily Mail and other boneheaded rags that decisions to reject drugs are based “purely on cost,” as if a health service with limited resources should take no account of expenditure.  NICE in particular should be more open about why it has to take account of cost-effectiveness, and about how this will benefit the nation’s health. Until then, it will continue to lose the media war, and its reputation will continue to take a battering.

The Sunday newspapers have lots of stories about how the man behind anti-war protest targeting British soldiers in Luton — Anjem Choudary –- has encouraged his extremist followers to stop spending their money on their families and divert it instead to Muslim soldiers waging jihad, or holy war. As the organization Mr. Choudary is affiliated with, Ahle Sunnah al-Jamah, is thought to have no more than a core of 30 to 40 people, the call is unlikely to change the bulk of remittances sent by, for example, British citizens of Pakistani origin to Pakistan.

But the call makes me come back to the issue of diaspora groups and the role they play in their “home” countries. For though Mr. Choudary’s appeal is unlikely to make much of a difference, I understand from speaking to British friends of Pakistani extraction that remittances are often sent not only to families but also for reconstruction projects in “home” villages and to political parties and movements.

In a study of party political funding, the Pakistani Institute of Legislative Development and Transparence suggested that most Pakistani political parties receive funding from abroad while many extremist groups, like Lashkar-e-Toiba, receive cash from abroad.

To varying degrees, this money — $673.50 million in December 2008 –- cannot help but encourage the centrifugal tendencies in Pakistani politics at a time when the government is facing a raging insurgency in its northern provinces and the secular Pakistan People’s Party and the big-landlord Muslim League are locked in an rancorous conflict, which may tear the country apart.

Development aid cannot make up the support from remittances to the political parties, as only a tiny proportion goes to democracy-promotion as opposed to poverty-alleviation. Out of the $278.60 million spent (pdf) by USAID in Pakistan in 2005, only $15 million were spent on governance and democracy-promotion (I’d show how much DfiD spends, if this information was not impossible to find on the department’s website). Even if more money was provided to this line item with liberal and civic-minded groups as the beneficiaries, their role in Pakistani society is limited or, in a sense, “co-opted” by the political parties.

The proactive way forward therefore seems to be to encourage a Pakistani diaspora network, which can fund liberal groups and centripetal projects in Pakistan, and rival the overseas money-collecting operation of the established political parties. Though some British government start-up cash ought to be offered, for such a network to any credibility among the diaspora and in Pakistan, it would have to be run by people of independent standing and funded in the main by non-governmental resources. But it would seem like an obvious project for many of the philanthropic organizations to back while I can think of numerous Britons (and other Europeans) of Pakistan extraction who could become powerful leaders of such a liberal project. Let us hope someone will step up to the plate and do for liberal causes what Anjem Choudary tries to do for the dark side.

Political leaders are driven by a desire for power. They will tend to follow whatever is politically expedient in order to gain power. Right now, it is politically expedient only to make token efforts to try and prevent climate change, without making the electorate fore-go habits to which they have become accustomed.

But leaders are also driven by vanity, and have a powerful desire to be seen well by ‘posterity’ or the ‘history books’. Just look how long Tony Blair spent, while leaving office, in trying to explain his ‘legacy’, or at George W. Bush’s mea culpa last press conference.

This, it seems to me, is one way political leaders might be persuaded to take dramatic action now on climate change: scientists explain to them very clearly what will happen if the level of CO2 does not fall, they explain very clearly the huge loss of life this will cause,and the actions that need to be taken now if this situation is to be avoided.

And then you tell them that history will judge them. If you consider the infamy in which Adolf Hitler is now held: Hitler was responsible for the deaths of, how many, 40 million people?

That is, unfortunately, a drop in the ocean compared to how many will die in the coming decades if this generation of political leaders fail to do what is necessary.

The terrible suffering of World War II was, on the whole, confined to a generation. If the world warms by 4-6 degrees, the suffering will be felt by many generations, all of whom will look back to the beginning of the 21st century, when political leaders were clearly warned what was going to happen, and what was needed to be done to avoid it, and who failed to do what was necessary.

What this means is, it’s a terrible time to be a politician. Never has the chalice of power been so poisoned. On the one hand, you have to tell an electorate grown complacent with prosperity that they must radically alter their lifestyles and fore-go many activities they now take for granted. As a result, they may very well be voted out of office, or even laughed out of office, for doing do.

On the other hand, if they don’t do this, their names will be mud for decades, even centuries.

They will say ‘we didn’t know’ or ‘it wasn’t politically possible’ or ‘we didn’t have enough time’. But the history books will show that they were told what needed to be done, and they failed to act.

On the other hand, if they do act, if they finally recognise the gravity of the threat facing us, explain to the electorate what needs to be done, and begin leading their electorates through the necessary changes, they will win a place in the history books as great as Churchill, Gandhi, or Martin Luther King .

The line between historic hero or historic catastrophe is very thin right now, and it is not leaders’ response to the credit crunch which will decide their place in the eyes of posterity.

During the Cold War, when Western and Warsaw Pact tanks were facing each other, the idea of a “selling” NATO’s role to allied publics would have been ludicrous because everyone knew why it was important. Now, in the run-up to the Alliance’s 60th anniversary, NATO has realised how important it is to communicate its role and worth to publics in European and North America.

But doing so at a time when the only kind of security ordinary people think about is their job security is a real challenge. As my colleague Nick Witney has said: “Defense is no longer a business of manning the ramparts or preparing to resist invasion. It has to be about an attempt to project stability. It is a hard doctrine to get people to believe in.”

To help NATO communicate better, it has hired an executive from Coca-Cola to manage the way the alliance is seen around the world and launched a an internet-based service called NATO TV as well as a Media Operations Centre (called the “MOC”) with the sole task of improving communications about NATO’s Afghan mission. 

Next week, I will attend an internal NATO meeting to discuss ways to overcome NATO’s communications challenges. And this is where you come in. I’d like to solicit the help of you, the rarified group of people who make up the Global Dashboard readership.

For I’d like to tell the assembled defence communicators what security-tracking, information-seeking, well-informed people like yourselves think are the biggest communications challenges for NATO — and perhaps how to overcome  these.

So here are a couple of questions I’d love to get your in-put on, which I will duly pass on at the NATO meeting.

1. What are NATO’s greatest challenges now and over the next five years?
2. What are the most serious threats to your country’s national security and what role do you think NATO should play in addressing this?
3. What aspect of NATO’s communications do you think works well? 
4.  What do you think of NATO TV? How can it be improved?
5. If you were in charge of NATO communications, what would you do?

I look forward to hearing what you think.

Let’s today step out of the normal boundaries of analysis of our economic crisis and ask a radical question: What if the crisis of 2008 represents something much more fundamental than a deep recession? What if it’s telling us that the whole growth model we created over the last 50 years is simply unsustainable economically and ecologically and that 2008 was when we hit the wall — when Mother Nature and the market both said: “No more.”

We have created a system for growth that depended on our building more and more stores to sell more and more stuff made in more and more factories in China, powered by more and more coal that would cause more and more climate change but earn China more and more dollars to buy more and more U.S. T-bills so America would have more and more money to build more and more stores and sell more and more stuff that would employ more and more Chinese …

We can’t do this anymore.

That’s Tom Friedman, no less.  Another sign of the times: here’s Nick Stern in Copenhagen yesterday:

Do the politicians understand just how difficult it could be? Just how devastating 4, 5, 6 degrees centigrade would be? I think not yet. Looking back, the Stern review underestimated the risks and underestimated the damage from inaction.

Andrew Marshall is the 87  year old Director of the Office for Net Assessment. This is how Wired described him back in 2003:

Known as Yoda in defense circles, Marshall doesn’t need to shout to be heard. Named director of the Office of Net Assessment by Richard Nixon and reappointed by every president since, the DOD’s most elusive official has become one of its most influential.

According to Fred Kaplan who profiled Marshall in his book Daydream Believers the key to Marshall’s longevity and influence is that he has:

built a far-flung network of acolytes and loyalists: officers whose unconventional projects he had encouraged and helped to fund; analysts whose work he had sponsored and whose ideas he had helped form; and high-ranking officials, as well as committee chairmen on Capitol Hill, who simply valued having a man of ideas so high up in the Pentagon. (h/t TPM)

ONA is the Pentagon’s think tank and looks 20 to 30 years in the future. The NIC futures work pales into comparison. Now thanks to TPM we can get an insight into one of the most secretive and innovative units inside the Pentagon.

The studies’ authors are generally listed as individual academics or outside contractors like the Hudson Institute, a Washington think tank, government consulting giant Booz Allen Hamilton, or lesser-known firms like Scitor Corporation and IHS International.  The first thing you notice is how broad their remit is – there is literally nothing they haven’t looked into: Some of the studies  include:

September 2008
Rearmed Japan
Europe 2025: Mounting Security Challenges Amidst Declining Competitiveness

May 2008
Turkish-Iranian Relations: Fated Rivalry, Compelled Sympathy

August 2007
The Future Of Europe And Its Muslims: Four Scenarios

June 2007
The End of Religiously Motivated Warfare: Lessons From The Puritans And Beyond [Center for Strategic and Budgetary Assessments]

November 2000
Water As A Strategic Commodity In Asia

June 1996
China Contingencies And Scenarios: 2020

On Monday Gordon Brown announced the creation of a National Security Forum. The forum, which will be supported by the National Security Secretariat, is made up of twelve individuals  and what a super list it is:

Professor Michael Clarke CBE; Ex Deputy Assistant Commissioner Peter Clarke CBE; Sir Ronnie Flanagan GBE; Professor Julia King CBE; Sir David Manning KCMG; Sir David Pepper KCMG; Sir Michael Rake, Professor Ziauddin Sardar; Professor Amartya Sen; General Sir Rupert Smith KCB, DSO, OBE, QGM and Dame Juliet Wheldon DCB, QC

It must have been a real coup to get Amartya Sen to agree to sit on the forum. Likewise Peter Clarke and Sir Ronnie Flanagan between them have years of experience in policing and CT. Julia King , the materials engineer is a brilliant choice as is  Juliet Wheldon QC, Chair of the Human Rights Lawyers’ Association. For a dissenting voice I don’t think you could have chosen anyone better than  Ziauddin Sardar . Michael Rake may be the token industrialist (although Juliet Wheldon worked at Rolls Royce) but he also sits on a number of academic boards – notably The School of Oriental and African, the Judge Institute at the University of Cambridge , Chatham House and the Oxford University Centre for Corporate Reputation . These links will be very useful when the NSF looks to identify a further 100 or so specialists. Sir David Manning was our man in Washington and recently (I gather) advised Brown and his team on relations with the new US administration. Sir David Pepper was Director General of GCHQ and will be, I assume, making sure cyber security is taken more seriously in HMG and is made one, of a number of number one, priorities . General Sir Rupert Smith – experience in UN and NATO and author of ‘war among the people’ – who else would you want to discuss the most pressing issues of defence? (It will be interesting to know how he and Lord West get on in the coming months).

But – and it’s a pretty big but – what is the national security forum going to do that couldn’t be done by the system already? If I were a betting man I would suggest that a number of these men and women are currently advising HMG – so why the need to bring them all together under one Lord?And if the forum is meant to be a visible challenge function (as has been suggested) why not make it’s minutes etc public? Why go to all the bother of creating a national security forum if we never hear about its work again?

I would also hazard a guess that the brace of Sir Davids, plus Sir Ronnie and Peter Clarke are all HMG pass holders and DV’d as well – which on the plus side means they can see classified intelligence but on the downside may mean they are too close to the machinations of Government to provide a broader/ independent perspective. This is why I wonder if the NSF is really an admission of failure by the Government that it’s own processes and structures don’t work – and instead of tackling the systemic issues inside HMG it has created an external body to challenge ideas and assumptions outside. I raise this point now as I am wondering whether it is of value – financially speaking – to make the NSF an NDPB in 2010 – when these men and women are already working with and sometimes for the British Government (I don’t believe the new team which will come into force in 24 months will be very different to those involved now).

Finally, Spy Blog make a good point when they ask why there is no pandemic disease, biotech or financial market, or cyber security expertise in the forum. If the NSF is there to provide advice it would seem sensible to have such experts on future risks involved…

In Small Wars Journal, Sergeant Michael Hanson laments the weight of the equipment that a US marine carries to keep himself safe. 40 pounds of body armour, plus a pack that can weight twice as much again (at a total of 120 pounds or 54 kilos, that’s like lugging Jennifer Lopez around wherever you go).

The consequences are predictable:

This weight limits their speed, mobility, range, stamina, agility and all around fighting capability. They can’t go out far and they can’t stay out long with all of this gear. It is simply too much. Combat patrols are typically four hours, and even that short amount of time is exhausting. Our Marines are being consistently outrun and outmaneuvered by an enemy with an AK, an extra magazine and a pair of running shoes.

Sergent Hansen believe that the flight to security  (“all the best equipment for our soldiers”) – ends up making soldiers less secure. You’ll find a similar sentiment in General Petraeus’s admirably concise counterinsurgency guidelines. Walk, is one of his directives. You can’t commute to this fight, is another.

But where does this leave civilian agencies? I doubt there is a single British or American embassy in the world that hasn’t seen dramatically increased security since 9/11. Many now resemble prisons.

Aid agencies, meanwhile, operate from fortified compounds in a growing number of countries, while the Iraq operations of some international NGOs are said to have hidden their use of armed guards from their own head offices. Both struggle against the prospect of an ‘armed humanitarianism.’

Petraeus calls on soldiers to live among the people, deepening their cultural understanding and ability to navigate informal networks, through prolonged and regular face-to-face contact. Diplomats, of course, need to do the same.

He advises them to “understand how local systems are supposed to work – including governance, basic services, maintenance of infrastructure, and the economy-and how they really work.” That’s the mission of development workers.

I am not trying to make a glib point here. Soldiers have the means to defend themselves (and to prevent the kidnaps that, once amplified by the media, can be strategic game changers). Diplomats and aid workers do not.

But how can civilian agencies deepen engagement with populations, while responding to growing insecurity? And what will they do if they find that – like the overloaded marine – security measures are eroding their ability to do their job?

White Band Action, the website of the Global Call to Action against Poverty, has some goodies to dish out: it’s got 50 places for bloggers at the G20 London Summit, and 20 of them are going to be handed out on the basis of readers’ nominations.

Now, I’m prepared to admit that recent posts of ours may not have been entirely aligned with Britain’s NGO community: David’s been cruelly taunting climate NGOs for being missing in action as Copenhagen beckons, Richard is running a recruitment drive for Nepal’s Maoist rebels, and I’ve been trashing 0.7 and suggesting that the pre-G20 Put People First march is an exercise in utter pointlessness (no, they still don’t have a policy platform).

But on the plus side, as regular readers will know, we’re all incorrigible summit nerds here at Global Dashboard – so we can promise you reams of top notch coverage if you nominate us for a place at the summit.  And if you’re a fellow blogger: sure we’re open to a bit of vote-trading! This is the EU, after all; there are certain standards to observe…

Nobuo Tanaka, the executive director of the International Energy Agency, is quoted in the FT this morning as saying that “it would be in the interests of producers and consumers if oil stayed at its present level of about $45″.

This strikes me as a bit odd.  A whole range of senior oil industry figures has been warning that with prices having fallen off a cliff since last summer’s peak of $147, investment in new production capacity has fallen sharply as well – setting the stage for a potential supply crunch as soon as the world begins to emerge from the downturn and demand starts to pick up.

Nick Butler, for example, suggested in December that a price band of $50-$75 a barrel is needed to ensure that sufficient new investment comes on stream to meet demand (which the IEA projects will rise from 85m barrels a day in 2007 to 106m mb/d by 2030). Total CEO Christophe de Margerie, meanwhile, said in October last year that if the oil price fell to $60 a barrel and stayed there, “a lot of [new] projects would be delayed”.

Strangest of all, it’s less than a month since Nobuo Tanaka himself was briefing heavily about the risks of a future supply crunch resulting from under-investment, and stressing that he expected demand to rise by about 1 mb/d from next year onwards.

So what’s going on?

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Yesterday, I put some words into Barack Obama’s mouth – re-jigging JFK’s famous ‘man on the moon’ speech as a call for an immediate peak to global emissions.

Setting a goal that emissions should never rise again, is something I have argued we should do now, rather than hoping we’ll simply be braver or more desperate in five or ten years’ time.

Originally, I suggested this should be a major plank for civil society campaigning – and I still think it should be. But governments can play too. Let’s look at the policy from vantage point of the Obama administration. (more…)

I’ve been visiting Pakistan on and off for a couple of years now – and each time things have got much, much worse (see this bleak assessment from 12 months ago).

Now the country has been plunged into further crisis. The Mumbai attacks put new pressure on its fractious relationship with India. The shootings in Lahore have severed its sporting links with the rest of the world.

These are calculated attempts to isolate and destabilize the country – attacks that have been planned by people who understand how to probe a culture’s weak points, and are skilled in the art of systems disruption.

They have consistently achieving outcomes disproportionate to the resources invested. But have we – the West I mean – done the same?

Here’s six questions I’d like to have the answer to. They all relate to the the country’s army, which is a dominant force in Pakistan’s politics and economics – and is an institution that has iconic status, even though it is losing legitimacy and respect.

Today, the Pakistan army finds itself in a strikingly similar position to that of the US military in Iraq before the surge. It is fighting a series of interlinked insurgencies. And it is losing badly – mostly because it’s fighting the wrong war.

So:

1. How much money are the UK and US channeling to the Pakistan military?
2. What proportion strengthens Pakistan’s ability to fight 20th century wars?
3. And what proportion is directed at counter-insurgency and 4th generation warfare?
4. Has a systematic and concerted attempt been made to pass the lessons learned in Iraq onto Pakistani senior and mid-level officers?
5. If so, is there evidence that strategy is switching from targeting militants to protecting Pakistan’s people (perhaps the fundamental COIN tenet).
6. And given that all modern armies boast about their commitment to outcomes (or effects based operations), what outcome has the UK and US’s vast post-911 investment in the Pakistan military delivered? 

The Economist has a piece on its website today bemoaning the effect of the credit crunch on aid flows:

It is unclear how aid flows are responding to the slowdown but the most recent data (which predate the crisis) hardly encourages hopes of a substantial expansion. Aid from OECD countries fell between 2006 and 2007, partly because of an exceptionally high level of debt relief in 2006. Disregarding this one-off effect, aid only crept up by 2% in 2007. And as a new report from the OECD points out, a 1970 United Nations target for aid of 0.7% of rich-country GDP remains a distant dream. Only Sweden, Norway, Denmark, Luxembourg and the Netherlands have reached this target. The average contribution is 0.45% of GDP.

And this sum was calculated before donor countries were hit by an economic crisis that has shifted priorities dramatically. Moreover, the size of the overall pot in rich countries will shrink as economies contract. Maintaining current levels of aid implies the unlikely earmarking of an even greater share of GDP.

Ah, the target of giving 0.7% of GNI to development assistance: bow your heads in reverence.  But hang on a minute.  Why are we all paying so much attention to a target that’s (a) not based on any assessment of how much money is needed to achieve any defined set of objectives, and (b) nearly forty years old?

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Now that President Bashir of Sudan has been indicted by the ICC, we can safely assume that a whole lot of speculative punditry is coming our way.  But few will have the sheer logical power of the analysis emerging from the camp of libertarian crazy man economist  Lyndon LaRouche, whose staff have drawn a compelling set of links between the indictment, a potential collapse of U.S. foreign policy, the ensuing collapse of civilization… and the need to dismantle the British Empire.  A policy goal that I must admit I thought was pretty much in the bag, but what would I know?