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Infectious Diseases and National Security: Who will frame National Health Security Policy of Pakistan?

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Health plays an influential role in fostering economic growth and sustainable development. Because of its indirect impact on human development, better health boosts rates of economic growth and contributes to wealth creation. In the past decades, new healthcare challenges and emerging infectious disease outbreaks have drawn global attention particularly in developing countries like Pakistan. Traditionally, health and security occupied separate domains, but in recent years the imperative fusion between health and national security has been recognized by policymakers, security and defence analysts in both developed and developing countries. The last two or three decades have seen sharp rise in non-traditional threats to national security, such as infectious diseases. There are many lines of attack that infectious diseases can intimidate national security i.e. increased rates of morbidity and mortality, massive damage on public health and health infrastructure, political instability, and economic volatility.

Emerging and reemerging infectious diseases, and their pandemic potential, pose a challenge to national security in the 21st century that cannot be overlooked. Though, the historical threat to national security by epidemic diseases is not new; the threat has increased in recent past and is growing rapidly in Pakistan. Correspondingly, reemergence of mosquito-borne infections such as dengue, chikungunya, zika, and more virulent forms of malaria and new more severe forms of viral respiratory infections have evolved. Pakistan is one of several countries, which together bear 95% of the burden of infectious diseases, and the trend is on the rise. According to statistics, Pakistan had not been able to control the burden of communicable diseases like tuberculosis, malaria, dengue fever, typhoid, hepatitis, cholera and other infectious diseases. Malaria, dengue, polio, and tuberculosis, are among the top killers. Pakistan is ranked fifth on the list of high-burden TB countries, and worst of all; Pakistan is one of the three remaining countries where poliomyelitis, also called polio, is still endemic. An average of about one million lives claimed yearly by malaria (estimated 12% of the rural population is believed to carry malaria parasites in their blood) and anticipated mortality rate of 48 thousand deaths per year as a result of TB cases. Similarly, infectious diseases are the biggest killers of children in Pakistan, causing 60% of all child deaths under 5 years of age.

At present, Pakistan is facing multiple challenges in healthcare, which can be broken down into social issues, technical constraints, lack of trained human resources, infrastructure, effective legislation and policymaking, awareness and negligence. The structure and function of the current healthcare system in Pakistan is far below international standards and ranked at 122 out of 190 countries in terms of healthcare standards. Pakistan does not have an organized healthcare system; even health priorities are not properly defined by present government (except Health-card). There is no evidence of strong political will, and inter-ministerial and inter-departmental conflicts, corruption, awful governance, and lack of correspondence are rampant to cope with national health security issues.

Epidemiologically, the behavior of epidemic is usually compared to previous outbreaks. The reemergence of Dengue virus (year-to-date, thousands of dengue cases are reported and hundreds of deaths in last few months) along with the dispersion of infectious diseases geographically throughout Pakistan demonstrate that Ministry of Health (MoH) and Ministry of Defence (MoD) are not incorporated and interconnected to address the national health security issues. Likewise, research and development (R&D) for new tools and technologies to prevent, detect and respond to emerging disease threats and outbreaks have not been considered by authorities with growing need in the country. As seen with the Dengue and Chikungunya outbreaks, there is a shortage of appropriate diagnostic equipments and vaccines to manage the response and lack of regulatory framework for fast-tracking and surveillance technology, tools and techniques when rapid respond is indispensable.

To cut a long story short, health security has become a national priority in many countries, supported by loyal and devoted leadership. They are approaching health security in a holistic manner, including, social, technical, economic, diplomatic, military and intelligence-related aspects. On the contrary, the link between infectious diseases and national security is relatively a new concept in Pakistan. A new paradigm is needed that links infectious diseases to national security and recognize the broad effects of diseases on society. Response to infectious disease threats should be strategic priority of health and security agencies in Pakistan. Ministry of Defence needs to acknowledge its role in ensuring that the state’s population is fit and healthy since there are no signs that the Ministry of Defence is awakening to this responsibility. At a time when our conception of national security is evolving rapidly, we must look hard at uncertain and non-traditional threats, specifically. Today, Pakistan is facing a wide range of threats to national health security, including disease outbreaks and pandemics. As health threats are evolving, protecting Pakistan from 21st century health security threats need a clear strategic direction and teamwork between Ministry of Defence and Ministry of Health. Of course, with uncertainty and ambiguity, a large amount of work is needed to bring analytical clarity to the national health security paradigm.

Mirza A.A. Baig is CAS-TWAS President’s Fellow at University of Science and Technology of China (USTC). Biomedical Health Informatics Professional and Freelance Science Writer.

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Defense

Overcoming today’s challenges for tomorrow’s security

MD Staff

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In a world where technology such as artificial intelligence and robotics is evolving rapidly, defence organisations that are steeped in bureaucracy and decades-long procurement times are finding it more difficult to keep pace and ultimately keep their citizens safe.

An aging global population is making it harder for defence forces to ensure a supply of recruits. Meanwhile, global economic power is shifting towards China and India, and isolationist policies from superpowers such as the US and the UK are rewriting diplomatic conventions.

With the world at an economic, strategic and technological inflection point, defence forces are under pressure to act now to embrace emerging technology and create flexible organsations, to ensure they don’t end up planning for a form of combat that no longer exists. That is the view of PwC’s Global Defence Advisory Board, in its inaugural white paper, which aims to guide governments through uncertainty and into taking bold action.

The paper, “Overcoming today’s challenges for tomorrow’s security,” has drawn expertise from the Global Government Defence Network, which spans 32 countries, and connects defence industry teams across PwC’s vast network of firms. It outlines key steps governments can take to plan effectively amid these changes.

“The future is more opaque than ever before for today’s defence planners,” says PwC Australia partner Terry Weber, Global Government Defence Network coordinator and the report’s lead author. “One breakthrough in AI technology, or a change in political cooperation within the European Union, could trigger a radical overhaul in a nation’s military plans. Yet, today’s major military platforms take longer to design, build, buy, integrate and deploy than ever before. Military equipment being built now, due to become operational in a decade’s time, and expected to serve decades into the future, may not be fit for purpose before it ever begins service,” Weber says.

The key opportunities

To achieve the level of maturity required to prepare for the future, defence organisations should focus their efforts through three mutually-reinforcing lenses: the organisation, its partnerships, and effective capability planning.

Mature organisations are those that build agile, adaptable and reflective defence organisations, adopt a more agile and efficient approach to procurement, and focus on strategic workforce planning, all while balancing the complexity of dealing with big organisations with competing interests and multiple stakeholders.

Mature partnerships involve building deep and trusted partnerships within industry, as well as building international relationships with organisations that share common needs that will help create the flexibility crucial to adapting to changing system requirements.

Mature capability planning involves avoiding a platform replacement approach; instead of new-for-old, decision makers should assess the technology’s use case first. It also includes adapting the supporting infrastructure to the changing force environment, many of which were implemented during or shortly after WWII and no longer applicable to today’s needs.

In order to seize the opportunities at hand, defence organisations need to take decisive actions to begin the change process now. To achieve that, senior leaders should:

1)    Assess their organisation’s maturity, and socialise these outside the organisation in order to establish the priorities for change.

2)    Engage with outside stakeholders. Seeking outside perspectives can help leaders look beyond their understanding and uncover new opportunities for improvement.

3)    Prioritise their reform agendas, to help drive meaningful change and form a foundation for lasting success.

4)    Drive the reform, achieving early wins that will allow stakeholders to see the benefit in continuing until a high level of maturity is reached consistently across the organisation.

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Is this the end of NATO-era?

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Money is a very powerful tool, which can easily ruin relations. Different views on money spending can ruin even good relations between countries in such huge and powerful organization as NATO. It should be noted that European defence spending will surpass $300 billion a year by 2021, according to new research from Jane’s by IHS Markit.

Defense expenditure is a highly sensitive topic in the region. U.S. President Donald Trump has repeatedly criticized NATO member countries in Europe for not respecting a rule that says 2% of GDP should be spent on defence.
At a NATO summit in 2017, Trump ramped up that pressure by noting the U.S. had allocated more cash to defense than all the other NATO countries combined.

The U.S., as the leader of the Alliance, keeps close eye on those of them who try to oppose the need to rapid increase on defence spending.
In particular, this month Germany displeased the U.S. by a conflict that erupted between Finance Minister Olaf Scholz of the Social Democrats (SPD) and Defense Minister Annegret Kramp-Karrenbauer, chair of Chancellor Angela Merkel’s Christian Democrats (CDU).

The finance minister insisted that an increase in the defense budget to 2 percent of gross domestic product, as NATO member states have pledged to do, not be anchored in the coalition government’s midterm assessment. The discord between the two apparently grew so heated that the Chancellery had to step in. President of France also shocked the NATO supporters when said about “the death of NATO brains”.
Judging by opinion polls, many residents of the European countries, including the Baltic States, consider military expenditures of this size unnecessary and dangerous.

The authorities of the Baltic States, in contrary, strive to increase defence spending. But the reason why the Baltic States support US requirements is their active cooperation with the U.S. The dependence on the U.S. is so high that they simply can not oppose U.S. initiatives. Though even 2 percent of gross domestic product on defence is a heavy burden for the Baltics’ economy.

Within the EU, the Baltic States and Poland are considered close U.S. partners and are doing everything to really benefit the United States, no matter how the EU looks at it. These are the main reasons why the Baltic countries support a requirement that they themselves are not able to fulfill.

Latvian journalist Māris Krautmanis in his article in Neatkarīgā Rīta Avīze discussing the adoption of the budget for next year, writes that there is no money for the promised salary increase for doctors and teachers. Krautmanis finds an explanation for why this is happening. “The tremendous sums from the state budget eat up defence spending so that NATO generals do not reproach that Latvia spends little. This is a taboo topic at all, it is not even discussed,” the author writes.

Another Latvian journalist Juris Lorencs writes in Latvijas Avīze about disturbing trends in world politics for Latvia and about what position should be taken in Latvia.
He writes about slogans which sound louder and louder: “Our home, our country comes first!” He thought they weaken both NATO and the EU. He also calls the U.S. unpredictable in its political behaviour.

Misunderstanding of the role and amount of financing could lead to the NATO destruction on the inside. At least there are two reasons for the collapse of the NATO: the U.S. can stop its financing or European member states such as Germany and France will decide to quit the organization themselves in favor to strengthening defence in the framework of European Union. Let’s see… 

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As Kashmir simmers the IOR too stands as a potential Nuclear Flashpoint

M Waqas Jan

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This year has seen tensions between Nuclear armed Pakistan and India reach unprecedented levels with both countries flirting with a dangerous escalation spiral. February’s aerial engagement between the two countries’ air forces, sustained exchanges of small arms and artillery fire over the LOC, as well as the ongoing curfew and communications blackout (now in its 100th day) have all left many to contemplate the long-term consequences of these altercations on the stability and overall security of the entire South Asian region.

These include consequences leading to as far as the Indian Ocean Region, which despite being more than 1300kms away from the LOC remains witness to a series of dangerous developments, especially within context of the current scenario. For instance, India’s recently planned test of its K4 Submarine Launched Ballistic Missile (SLBM) represents a key part of India’s long-held desires of developing a robust second-strike capability. While the test itself is meant to signal a major tipping point within the overall strategic balance of the region, the worsening situation in Kashmir carries the risk of unnecessarily heightening tensions at a time when the regional situation is already quite complex. This is largely because the K4 with its purported range of 3500 kms is capable of targeting most of mainland China in addition to Pakistan from the relatively safer distance of India’s coastal waters. Its value as a strategic deterrent is evident from its planned deployment on India’s nascent fleet of nuclear-powered ballistic missile submarines (SSBNs). These include the INS Arihant and the recently commissioned INS Arighant for which the K4 has been designed to spec. With the Indian navy planning to induct even more SSBNS over the next decade, there are soon likely to be dozens of K4 missiles deployed on these subs, which themselves are likely to remain scattered across the IOR.

While the planned deployment of these missiles was to supposedly herald India’s coming of age as a major global power, the current context in which these actions are being taken presents a troubling scenario. Particularly keeping in mind the apparent shifts in India’s nuclear doctrinal and policy framework, the very thought of such nuclear weapons being readily deployed across the Indian Ocean represents a major cause for concern the world over. Unlike India’s land-based nuclear arsenal where its nuclear warheads are largely demated from the several delivery systems available to its military, India’s sea based nuclear arsenal is likely to be deployed at a much more heightened state of alert. As a result, it is also likely to be subject to an altered or more sophisticated command and control structure which in itself requires seamless communications not only between the Indian state and military but also within the many arms of the Indian military itself. Such integration is further conditional on India acquiring highly robust intelligence, surveillance and reconnaissance (ISR) capabilities that leave absolutely no margin for error considering the immense risks at stake in one of the world’s most volatile regions. Add to that the Indian government’s now institutionalized approach to nuclear brinkmanship and its steady revocation of its ‘No First Use’ policy, there exists a highly dangerous mix of hubris and recklessness where the entire human race risks being annihilated from even the smallest of missteps.

While some may argue that India is still quite a few years away from deploying a notable fleet of SSBNs armed with its K4 SLBMs, the nuclear weapons already deployed by the Indian Navy already pose quite serious challenges to regional stability. In addition to the K4 which is still under testing, India has equipped several of its surface and sub-surface platforms with a number of other nuclear capable missiles such as the Dhanush and the K-15 Sagarika SLMBs. Considering their relatively short ranges (the Dhanush has a target range of 350kms, while the K-15’s range is around 750-800 kms) these weapons are unlikely to be able provide an adequate second-strike deterrent. However, being mostly Pakistan specific, they still contribute immensely to converting the entire Indian Ocean Region to a nuclear flashpoint in addition to the LOC.

In fact, considering the direction in which India’s military thinking has evolved over the last decade, the IOR’s potential as a nuclear flashpoint is arguably even greater than that of the LOC. The sea’s vastness, lack of terrestrial boundaries and potential lack of collateral damage makes a nuclear detonation in the IOR all the more likely. This can range from a non-targeted nuclear detonation as a mere show of force to a tactical nuclear strike on a specific naval platform and its crew in a bid to achieve escalation dominance early on in a conflict. As has often been the case with Indian military thinking, such a scenario can arise from a gross overestimation of its capabilities. Derived from its conventional military superiority(which is already more manifest at sea), such conditions make for an attractive option for India to conduct a limited war against Pakistan at sea.

However, considering how both the Indian and Pakistani navies have opted to commingle conventional and nuclear weapons across a large section of their naval platforms, the risks of any conventional engagement escalating to the use of nuclear weapons remain unacceptably high. As such, even thinking that escalation from a small engagement or skirmish at sea can be managed by either side is downright illusory at best. Yet, based on the Indian state’s most recent actions and statements, whether the hubris coming out of India’s leaders extends to the manic delusions of a winnable nuclear war is unnervingly open to question.

One hopes that the world never has to contemplate, let alone face, the consequences of such an appalling possibility.

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