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31. Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Author:
Bilal Siddiqi, Maarten Voors, Johannes Haushofer, Oeindrila Dube, and Darin Christensen
Publication Date:
03-2020
Content Type:
Working Paper
Institution:
Empirical Studies of Conflict Project (ESOC)
Abstract:
Developing countries are characterized by high rates of mortality and morbidity. A potential contributing factor is the low utilization of health systems, stemming from the low perceived quality of care delivered by health personnel. This factor may be especially critical during crises, when individuals choose whether to cooperate with response efforts and frontline health personnel. We experimentally examine efforts aimed at improving health worker performance in the context of the 2014–15 West African Ebola crisis. Roughly two years before the outbreak in Sierra Leone, we randomly assigned two accountability interventions to government-run health clinics — one focused on community monitoring and the other gave status awards to clinic staff. We find that over the medium run, prior to the Ebola crisis, both interventions led to improvements in utilization of clinics and patient satisfaction with the health system. In addition, child health outcomes improved substantially in the catchment areas of community monitoring clinics. During the crisis, the interventions also led to higher reported Ebola cases, as well as lower mortality from Ebola—particularly in areas with community monitoring clinics. We explore three potential mechanisms: the interventions (1) increased the likelihood that patients reported Ebola symptoms and sought care; (2) unintentionally increased Ebola incidence; or (3) improved surveillance efforts. We find evidence consistent with the first: by building trust and confidence in health workers, and improving the perceived quality of care provided by clinics prior to the outbreak, the interventions encouraged patients to report and receive treatment. Our results suggest that accountability interventions not only have the power to improve health systems during normal times, but can additionally make health systems resilient to crises that may emerge over the longer run.
Topic:
Health, Infectious Diseases, Health Care Policy, Mortality, Public Health, and Pandemic
Political Geography:
West Africa and Sierra Leone

32. India’s Strategic Intent and Military Partnerships in the Indian Ocean Region

Author:
Gaurav Sharma and Marc Finaud
Publication Date:
05-2020
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
Due to the importance India attaches to potential threats to its maritime security, its diplomacy has increasingly focused on the Indian Ocean region (IOR) and it has increased cooperation with Indian Ocean states. In the last five years, India has also established security partnerships with major IOR strategic stakeholders such as France and the United States. India has increasingly invested in providing military training, weapons support and disaster relief assistance to “like-minded” states in the IOR. Due to the potential risks of escalation to nuclear-weapons use should conflict occur with other countries in the region such as China and Pakistan, it would be in India’s interests to promote more confidence and
Topic:
Security, Diplomacy, Nuclear Weapons, Military Affairs, and Missile Defense
Political Geography:
Pakistan, China, South Asia, India, and Indian Ocean

33. Perspectives on the future of Idlib

Author:
Kirill Semenov
Publication Date:
04-2020
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
The situation in Idlib poses a challenge to the Assad government. Damascus has neither the forces nor the means to resolve the problem. Moreover, any operation conducted against the Syrian moderate opposition and the radical alliance “Hayat Tahrir al-Sham” (HTS) concentrated in this region could be significantly problematic for the government. Turkey seeks to establish a protectorate or security zone in Idlib to accommodate those fleeing regime-held areas and prevent a new refugees flow into Turkey. The gains achieved by the Turkish operation in Idlib by the establishment of the security zone has potentially been lost as a result of the subsequent Russian backed Syrian government offensive, which has created a problem for Turkey with hundreds of thousands heading toward the Turkish border and threatening to exasperate what is already a costly refugee problem for Ankara. In order for Turkey to address issues in Idlib, including IDPs and economic problems, it first needs to deal with the HTS, ideally finding a way to dissolve the group. This could potentially be an area of cooperation for Moscow and Ankara. This may be necessary to prevent a deterioration in the security situation and long-term destabilisation of the area.
Topic:
Security, Refugees, Economy, Political stability, Displacement, Syrian War, Hay'at Tahrir al-Sham (HTS), and Transition
Political Geography:
Russia, Turkey, Middle East, Syria, and Idlib

34. Operation Peace Spring: Objectives, Current Situation and its Future

Author:
Serhat Erkmen
Publication Date:
04-2020
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
The Peace Spring Operation (PSO), launched on 9 October 2019, was Turkey’s military/diplomatic/political offensive against the People's Defence Units (YPG) in Syria and beyond and was triggered by key dynamics in the country. The first was the redeployment of US troops in the northeast of Syria; second was the expansion of Russia’s area of influence towards the east of the Euphrates; third was the launch of a new phase of the Assad government’s operation in Idlib; forth was a re-evaluation of YPG’s patron-client relationship with the United States and the European Union. Turkey sought to prevent the formation of a Kurdish state and to address the Syrian refugee issue. While Turkey was able to achieve some strategic gains via the PSO, many challenges remain which prevent Ankara from achieving all its objectives. This paper argues that PSO should be analysed in the context of Turkey’s two former operations in Syria, Euphrates Shield Operation (ESO) and Olive Branch Operation (OBO).
Topic:
Military Intervention, Conflict, Syrian War, Transition, and YPG
Political Geography:
Russia, Turkey, Middle East, Syria, and United States of America

35. ISIS after the US repositioning in the Northeast of Syria: camps, women and children, and leadership revival

Author:
Jean-Pierre Keller
Publication Date:
04-2020
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
Since the fall of Baghuz city in North East of Syria in March 2019, thousands of women, children and former IS fighters have been imprisoned in either camps or prisons. Following the Turkish military operation in October 2019, the security conditions have deteriorated, resulting in fewer guards as well as more instability and vulnerability for all those imprisoned. The worsening living conditions, the absence of adequate medical care and lack of access to education endanger the future of the children imprisoned in the camp. Moreover, the influence of the Muhajirats remains constant as a means for the spreading of propaganda inside and outside the camps.
Topic:
Security, Human Rights, Children, Women, Islamic State, and Transition
Political Geography:
Turkey, Middle East, Syria, and United States of America

36. The Prospective and Limitations of the Syrian Constitutional Committee

Author:
Sinan Hatahet
Publication Date:
02-2020
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
The Syrian Constitutional Committee, a UN-authorised constituent assembly, was established to reconcile the Syrian government and the Syrian opposition, in the context of the peace process, by adopting a new constitution for Syria. While it enjoys a measure of international legitimacy, it may be a mechanism to override the terms of UN Security Council’s resolutions 22541 in favour of establishing the Astana talks as the only regulator of the political process. The committee has encountered several challenges. First is the divergence of expectations between the opposition and the Syrian government; second, the lack of a clear time frame for its deliberations; third, the Syrian government’s insistence on imposing its anti-terrorism vision; finally, the lack of international commitment to its outcome, mainly from the US and its partners. This brief examines the positions of both the Syrian government and the opposition and their expectations from the constitutional process as well as the impact of the Turkish offensive in the north east of the country on the process.
Topic:
Constitution, Syrian War, Negotiation, and Transition
Political Geography:
Middle East, United Nations, and Syria

37. Russian views on the Constitutional Committee and the political process in Syria

Author:
Nikolay Sukhov
Publication Date:
01-2020
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
The Russian leadership believes that the Constitutional Committee (CC) is a key factor in a political settlement in Syria. Russia hopes that the West, primarily the EU, adhering to the principle of “no reconstruction without a political transition”1, would regard the launch of the CC as the beginning of this political process and increase humanitarian aid to Syrians living in government- controlled territory. Russia's position on the constitution issue differs from that of the Syrian government. However, glimmer of hope could come from events in northeast Syria2, which has strengthened position of the opposition in the CC. Yet, neither Russia, nor Syria, are ready to recognise this reality. The Russian leadership is not likely to promote rapprochement between the Syrian government and the opposition on reform issues, as Russia perceives these to be the internal affairs of Syria. In Russia, it is perceived that the constitutional, and later, the political process based on the new constitution, could facilitate the return of refugees. The next step after the adoption of the new constitution should be legislative reform, which would bring Syrian legislation into line with the constitution. The topic of legislative reform in Syria could become bargaining tool for Europe in negotiations with Russia. If Europe wishes to stabilise the situation in Syria and the Middle East, it should first participate in reconstruction efforts by reviving the economy, and thereby Syrian civil society. This would be an indirect stimulation of political reforms. In this case, European leaders need to develop a long-term strategy aimed at improving Syrian society, preventing radical ideas, terrorism and possible new waves of migration to Europe. Russia could contribute to the implementation of European initiatives as the interests of Russia and Europe to stabilise Syria and the region coincide.
Topic:
Constitution, Syrian War, Negotiation, and Peace
Political Geography:
Russia, Middle East, and Syria

38. A Review of Sierra Leone’s Mines and Minerals Act

Author:
Tehtena Mebratu-Tsegaye, Perrine Toledano, and Sophie Thomashusen
Publication Date:
03-2020
Content Type:
Working Paper
Institution:
Columbia Center on Sustainable Investment
Abstract:
With the support of Oxfam, the Columbia Center on Sustainable Investment reviewed select provisions in the Mines and Minerals Act 2009 and corresponding policy statements from the Minerals Policy 2018 to provide recommendations for how to best align the anticipated new mining law with international best practice. The 2009 law was reviewed with a focus on the following topics: • Fiscal regime; • Climate change; • Access to and use of land; • Community consultations and participation; • Human rights; and • Community development agreements.
Topic:
Climate Change, Human Rights, Natural Resources, Mining, Land, Sustainability, and Community
Political Geography:
Africa, West Africa, and Sierra Leone

39. Algeria’s Borderlands: A Country Unto Themselves

Author:
Dalia Ghanem
Publication Date:
05-2020
Content Type:
Working Paper
Institution:
Carnegie Endowment for International Peace
Abstract:
Smuggling goods across the border between Algeria and Tunisia has created a parallel economy for marginalized border populations. Law enforcement and smugglers alike must navigate these gray zones in state authority. In Algeria, state formation remains an evolving process, as evidenced by the situation in the country’s northeastern border regions. With Algerian officials in these areas permitting smuggling of petrol and certain other commodities over the border with Tunisia and smugglers weeding out security threats even as they go about their illicit trade, the two ostensibly adversarial parties complement each other. This unusual relationship furthers the intrusion of the state into citizens’ livelihoods even as it manipulates state authority.
Topic:
Law Enforcement, Economy, Borders, Trade, and Smuggling
Political Geography:
Algeria, North Africa, and Tunisia

40. Europe Needs a Regional Strategy on Iran

Author:
Cornelius Adebahr
Publication Date:
05-2020
Content Type:
Working Paper
Institution:
Carnegie Endowment for International Peace
Abstract:
The rift between Europe and the United States over Iran is deepening. To regain leverage, the Europeans should engage all eight Gulf states in talks about regional security and nonproliferation. The rift between Europe and the United States over Iran is deepening. Two years of U.S. maximum pressure on Tehran have not yielded the results Washington had hoped for, while the Europeans have failed to put up enough resistance for their transatlantic partner to change course. Worse, the U.S. policy threatens to destabilize the broader Persian Gulf, with direct consequences for Europe. To get ahead of the curve and regain leverage, the European Union (EU), its member states, and the United Kingdom have to look beyond their relations with the Islamic Republic and address wider regional security challenges. The United States’ incipient retreat as a security guarantor and Russia’s increased interest in the region make it necessary for Europe to engage beyond its borders. Despite being barely alive, the 2015 international nuclear deal with Iran offers a good starting point. The Europeans should regionalize some of the agreement’s basic provisions to include the nuclear newcomers on the Arab side of the Gulf. Doing so would advance a nonproliferation agenda that is aimed not at a single country but at the region’s broader interests. Similarly, the Europeans should engage Iran, Iraq, and the six Arab nations of the Gulf Cooperation Council in talks about regional security. Rather than suggesting an all-encompassing security framework, for which the time is not yet ripe, they should pursue a step-by-step approach aimed at codifying internationally recognized principles at the regional level.
Topic:
Security, Nuclear Weapons, Treaties and Agreements, and Nonproliferation
Political Geography:
Europe, Iran, Middle East, and United States of America