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From the 1950s through the 1970s, the success of antibiotics and vaccines in controlling or eradicating infectious diseases (ID) worldwide resulted in decreased emphasis on development of ID therapeutics. The emergence in the past three decades of HIV, SARS, West Nile, avian flu, swine flu, Ebola, and the potential for bioterrorist attacks has reversed this trend and renewed interest in treatment and prophylaxis of ID. Unfortunately, because many diseases are prevalent primarily in developing nations (e.g., malaria, TB, Chagas), potential sales of bioterrorist pathogens are limited mainly to orders for government stockpiles (e.g., anthrax, smallpox, botulinum toxin), and the cost of anti-infective clinical trials is high, traditional large pharmaceutical companies have cut back R&D resources in this arena. To combat this investment shortfall, a new paradigm has emerged where public-private partnerships between the NIH, World Health Organization, private foundations, academia, and non-profits, are beginning to function like pharmaceutical companies to advance the development of promising ID drugs, even when there is little opportunity for profit. This talk will discuss the growing need for ID therapeutics, present some new models for discovering and developing them, and provide examples of public-private partnerships that have advanced therapeutics for specific infectious diseases.


About the speaker: Dr. Jon C. Mirsalis is Managing Director of the Biosciences Division and Executive Director of Preclinical Development at SRI International in Menlo Park, CA. Dr. Mirsalis is an internationally recognized expert in the development of drugs for infectious diseases. He manages two large programs for the National Institute of Allergy and Infectious Diseases (NIAID) for the development of promising therapeutics for the prevention and treatment of a broad range of infectious diseases including TB, malaria, influenza, polio, anthrax, plague, and Ebola. He has personally been involved in the development of over 50 therapeutics that have entered clinical trials and several have already reached the market. Before joining SRI in 1981, Dr. Mirsalis was a postdoctoral fellow at the Chemical Industry Institute of Toxicology, where he developed the in vivo-in vitro hepatocyte DNA repair assay, which is now widely used as a screen for potential carcinogens by government and industry. He is the author of over 140 publications and abstracts. Dr. Mirsalis received his B.S. degree in zoology/molecular biology from Kent State University, his M.S. degree in genetics from North Carolina State University, and holds Ph.D. degrees in toxicology and genetics from North Carolina State University. Dr. Mirsalis has an adjunct faculty appointment with the University of California-Santa Cruz, where he lectures regularly on genetic toxicology and carcinogenesis. He has recently served on the Board of Scientific Councilors for the National Toxicology Program, the Advisory Board for the Critical Path Institute, and is a past member of the FDA’s Over-the-Country Product Review Committee. Dr. Mirsalis has been certified by the American Board of Toxicology since 1983.

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Jon Mirsalis Managing Director, Biosciences Division Speaker SRI International
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Philanthropist and software giant Bill Gates spoke to a Stanford audience last week about the importance of foreign aid and product innovation in the fight against chronic hunger, poverty and disease in the developing world.

His message goes hand-in-hand with the ongoing work of researchers at Stanford’s Freeman Spogli Institute for International Studies. Much of that work is supported by FSI’s Global Underdevelopment Action Fund, which provides seed grants to help faculty members design research experiments and conduct fieldwork in some of the world’s poorest places.

Four FSI senior fellows – Larry Diamond, Jeremy Weinstein, Paul Wise and Walter Falcon – respond to some of the points made by Gates and share insight into their own research and ideas about how to advance and secure the most fragile nations.

Without first improving people’s health, Gates says it’s harder to build good governance and reliable infrastructure in a developing country. Is that the best way to prioritize when thinking about foreign aid?

Larry Diamond: I have immense admiration for what Bill Gates is doing to reduce childhood and maternal fatality and improve the quality of life in poor countries.  He is literally saving millions of lives.  But in two respects (at least), it's misguided to think that public health should come "before" improvements in governance.  

First, there is no reason why we need to choose, or why the two types of interventions should be in conflict.  People need vaccines against endemic and preventable diseases – and they need institutional reforms to strengthen societal resistance to corruption, a sociopolitical disease that drains society of the energy and resources to fight poverty, ignorance, and disease.  

Second, good governance is a vital facilitator of improved public health.  When corruption is controlled, public resources are used efficiently and justly to build modern sanitation and transportation systems, and to train and operate modern health care systems.  With good, accountable governance, public health and life expectancy improve much more dramatically.  When corruption is endemic, life-saving vaccines, drugs, and treatments too often fall beyond the reach of poor people who cannot make under-the-table payments. 

Foreign aid has come under criticism for not being effective, and most countries have very small foreign aid budgets. How do you make the case that foreign aid is a worthy investment?

Jeremy M. Weinstein: While foreign aid may be a small part of most countries’ national budgets, global development assistance has increased markedly in the past 50 years. Between 2000 and 2010, global aid increased from $78 billion to nearly $130 billion – and the U.S. continues to be the world’s leading donor.

The challenge in the next decade will be to sustain high aid volumes given the economic challenges that now confront developed countries. I am confident that we can and will sustain these volumes for three reasons.

First, a strong core of leading voices in both parties recognizes that promoting development serves our national interest. In this interconnected world, our security and prosperity depend in important ways on the security and prosperity of those who live beyond our borders.

Second, providing assistance is a reflection of our values – it is these humanitarian motives that drove the unprecedented U.S. commitment to fighting HIV/AIDS during the Bush Administration.

Perhaps most importantly, especially in tight budget times, development agencies are learning a great deal about what works in foreign assistance, and are putting taxpayers’ dollars to better use to reduce poverty, fight disease, increase productivity, and strengthen governance – with increasing evidence to show for it.

Some of the most dire situations in the developing world are found in conflict zones. How can philanthropists and nongovernmental organizations best work in places with unstable governments and public health crises? Is there a role for larger groups like the Gates Foundation to play in war-torn areas?

Paul H. Wise: As a pediatrician, the central challenge is this: The majority of preventable child deaths in Sub-Saharan Africa and in much of the world occur in areas of political instability and poor governance. 

This means that if we are to make real progress in improving child health we must be able to enhance the provision of critical, highly efficacious health interventions in areas that are characterized by complex political environments – often where corruption, civil conflict, and poor public management are the rule. 

Currently, most of the major global health funders tend to avoid working in such areas, as they would rather invest their efforts and resources in supportive, well-functioning locations.  This is understandable. However, given where the preventable deaths are occurring, it is not acceptable. 

Our efforts are directed at creating new strategies capable of bringing essential services to unstable regions of the world.  This will require new collaborations between health professionals, global security experts, political scientists, and management specialists in order to craft integrated child health strategies that respect both the technical requirements of critical health services and the political and management innovations that will ensure that these life-saving interventions reach all children in need.

Gates says innovation is essential to improving agricultural production for small farmers in the poorest places. What is the most-needed invention or idea that needs to be put into place to fight global hunger?

Walter P. Falcon: No single innovation will end hunger, but widespread use of cell phone technology could help.

Most poor agricultural communities receive few benefits from agricultural extension services, many of which were decimated during earlier periods of structural reform. But small farmers often have cell phones or live in villages where phones are present.

My priority innovation is for a  $10 smart phone, to be complemented with a series of very specific applications designed for transferring knowledge about new agricultural technologies to particular regions.  Using the wiki-like potential of these applications, it would also be possible for farmers from different villages to teach each other, share critical local knowledge, and also interact with crop and livestock specialists.

Language and visual qualities of the applications would be key, and literacy problems would be constraining.  But the potential payoff seems enormous.

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Children play near a punctured water pipe in Nairobi's Kibera slums.
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Infectious diseases, especially those transmitted from person to person through the respiratory route, continue to pose a threat to the global community. Public health surveillance systems and the International Health Regulations are intended to facilitate the recognition of and rapid response to infectious diseases that pose the risk of developing into a pandemic, but the response to the 2009 H1N1 influenza pandemic illustrates the continuing challenges to implementing appropriate prevention and control measures. The response to the 2009 H1N1 influenza pandemic will be discussed and its implications examined.


Speaker biography:

Arthur Reingold, MD is Professor and Head of the Division of Epidemiology and Associate Dean for Research in the School of Public Health (SPH) at the University of California, Berkeley (UCB). He holds concurrent appointments in Medicine and in Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). He completed his BA and MD degrees at the University of Chicago and then completed a residency in internal medicine at Mt. Auburn Hospital in Cambridge, Massachusetts. He is board certified in internal medicine and holds a current medical license in California, but has devoted the last 25 years to the study and prevention of infectious diseases in the U.S and in developing countries throughout the world.

He began his career as an infectious disease epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC), working there for eight years. While at CDC, he worked domestically on Toxic Shock Syndrome, Legionnaires’ disease, bacterial meningitis, fungal infections, and non-tuberculous mycobacterial infections and internationally on epidemic meningitis in West Africa and Nepal.

Since joining the faculty at UCB in 1987, he has worked on a variety of emerging and re-emerging infections in the U.S.; on acute rheumatic fever in New Zealand; and on AIDS, tuberculosis, malaria, and acute respiraatory infections in Brazil, Uganda, Ivory Coast, Zimbabwe, India and Indonesia. He has directed the National Institutes of Health (NIH) Fogarty AIDS International Training and Research Program at UCB/UCSF since its inception in 1988; co-directed (with Dr. Duc Vugia of the California Department of Health Services), the CDC-funded California Emerging Infections Program since its inception in 1994; and served as the Principal Investigator of the UCB Center for Infectious Disease Preparedness (CIDP) since its inception in 2002.

He also has ongoing research projects concerning malaria in Uganda; HIV/AIDS and related conditions in Brazil; and tuberculosis in India.  He regularly teaches courses on epidemiologic methods, outbreak investigation, and the application of epidemiologic methods in developing countries, among others. He also teaches annual short courses on similar topics in Hong Kong, Brazil, Switzerland, and other countries.

He has been elected to membership in the American Epidemiological Society; fellowship in the American Association for the Advancement of Science and the Infectious Diseases Society of America; and membership in the Institute of Medicine of the National Academy of Sciences. In Hong Kong, He has a close working relationship with Chinese University, particularly with its School of Public Health and its Centre for Emerging Infectious Diseases. Dr. Reingold gives short courses at the School of Public Health each year and he serves on the Advisory Board of the Centre for Emerging Infectious diseases.

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Arthur Reingold Professor of Epidemiology and Associate Dean of Research Speaker UC Berkeley School of Public Health
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Congratulations to Anand Habib, selected this weekend for a Rhodes Scholarship. Habib, 22, of Houston, Texas, is a 2011 graduate of Stanford, where he earned a bachelor's degree in biology, with honors in international security studies. He plans to pursue a master's degree in public policy and in medical anthropology at Oxford.

Habib is currently working on community health programs at St. Joseph's Clinic in Thomassique, Haiti, under a one-year global health fellowship awarded by Medical Missionaries. The nonprofit organization is a volunteer group of more than 200 doctors, nurses, dentists, and others who work to improve the health of the poorest of the poor in the United States and throughout the world.

In 2011, he won a Deans' Award for Academic Accomplishment which honors extraordinary undergraduate students for "exceptional, tangible" intellectual achievements. One of the professors who nominated him for the award described him as a "superb critical thinker" whose work is characterized by "creative genius" and "mature insights," adding that he "exemplifies exactly the kind of deeply informed, pragmatic and caring leadership that the world needs and Stanford enables."

As a Stanford student, Habib worked on behalf of politically and medically disenfranchised people in India, Mexico and Guatemala. On campus, he turned the Stanford tradition of the annual Dance Marathon into a vehicle dedicated to addressing the HIV/AIDS pandemic by engaging not only Stanford students but also local communities and corporations, raising more than $100,000. His exceptional work was recognized by his participation in the Clinton Global Initiative University Conference in April, 2011.

From Haiti, Habib discussed his current position, his plans in Oxford, and how his CISAC thesis relates to his work. 

What are you currently working on? 

I am currently working on a global health fellowship with an NGO that operates a clinic in Haiti's Central Plateau. As part of the fellowship I am helping to manage a number of community and public health projects including fortified salt (to counter iodine deficiency and filariasis), a point-of-use potable water system, a malnutrition intervention program, and a small system of community health committees and community health workers. For the past two months, I've taken on a number of administrative functions along with my co-fellow, who is also a recent college graduate. I started the fellowship shortly after graduation at the end of June 2011 and I am slated to be in Haiti until the end of June 2012.

What will you do at Oxford?

I proposed two one-year Masters programs: a masters in public policy from Oxford's new Blavatnik School of Government, and an M.Sc. in medical anthropology. As of now, I'm thinking of sticking with my proposed programs -- probably pursuing the medical anthropology degree first as it is a bit more theoretical. I think it would be better to have the more "academic" experience first before gaining the practical tools that an MPP will hopefully afford me. After a short send-off in Washington, D.C., at the end of September 2012, I will fly with the other American Rhodes Scholars-elect to Oxford the first week of October with term beginning shortly thereafter.

How does your work in the CISAC Honors program relate to what you are currently doing, your plans for Oxford, or what you'll be doing afterward? 

My honors thesis has allowed me to contextualize my experiences in Haiti in some fairly amazing ways. Two very persistent issues in Haiti are that of poor governance -- e.g. lack of strong regulatory structures, lack of government effectiveness, etc. -- and ineffective aid modalities, or the ways in which aid is delivered. My thesis was situated exactly at this nexus: how to deliver aid more effectively in order to improve governance. Ninety-nine percent of relief aid after the 2010 earthquake in Haiti was funneled to non-state organizations and only 12 percent of recovery aid went toward supporting government activities. In Haiti, I've witnessed how detrimental a patchwork system of NGO activity can be with little coordination between NGOs and little harmonization of NGO activities with government objectives. It becomes very frustrating at times, because, if my thesis is any indication, things need not be this way if both NGOs and states were engaged in collaborative partnerships -- along the lines of what Dr. Paul Farmer, deputy U.N. special envoy to Haiti, calls "accompaniment."

My initial interest in the topic of global health financing was spurred by work out of Oxford's Global Economic Governance Project. The director of the project, Dr. Ngaire Woods, was actually named the Dean of the Blavatnik School of Government through which the MPP is offered. I'd love to continue exploring the issues broached in my thesis at Oxford -- especially issues of aid effectiveness and sustainable systems of delivering development aid for health. In the future, I hope to become a physician-policymaker, helping to not only deliver care to individuals in difficult conditions around the world, but also in fostering more robust global health governance.

- Interview by Michael Freedman

 

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The Center for International Security and Cooperation is pleased to announce the selection of 13 rising seniors for participation in its Undergraduate Honors Program in International Security Studies. 

The program provides an opportunity for eligible students focusing on international security subjects in any field to earn an honors certificate.

Students selected intern with a security-related organization, attend the program's honors college in Washington, D.C. in September, participate in a year-long core seminar on international security research, and produce an honors thesis with policy implications.

 

Joshua Alvarez

International Relations, Minor in Economics

Identity and Security: Turkey's Grand Strategy in the Middle East

 

Keshia Bonner

International Relations, Minor in Economics

United States Policy Towards Hamas and Hezbollah as State Actors

 

Stephen Craig

Political Science

Security Issues and Domestic Constraints on European Integration

 

Noura Elfarra

Political Science

How does Regime Change and Revolution Affect the Secret Police?

 

Alison Epstein

International Relations

British and American Intelligence Cooperation: the Iraq Inquiry and the New Face of the Special Relationship

 

Peter Hong

Political Science

Recalibrating and Resolving Deficiencies in Multinational Nuclear Fuel Cycle Initiatives

 

Mohammad Islam

Electrical Engineering, Minor in International Relations

Domestic Terrorism Prevention Strategies in the US and UK

 

Suraya Omar

Materials Science and Engineering

North Korea's Ambitions for a Light Water Reactor

 

Clay Ramel

Science, Technology & Society – Energy Engineering Concentration

National Security Dimensions of Developing an Energy Secure United States 

 

Nick Rosellini

International Relations, Minor in Economics & Modern Languages

The NATO Strategic Concept: Evolution of a Nuclear Posture 1957-2010

 

Ram Sachs

Earth Systems, Minor in Modern Languages

Environmental Dimensions of Security - Yemen and Violent Extremism

 

Jeffrey Sweet

Materials Science and Engineering

The Effect of Public Perceptions of Diseases such as HIV, H1N1, SARS, and Anthrax on the Effectiveness of Controlling Epidemics

 

Reagan Thompson

International Relations, Minor in Chinese

The Chinese Influence in Africa: Case Studies of Ghana and Angola


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Anand Habib

Ten undergraduates recently received the 2011 Deans' Award for Academic Accomplishment, which honors extraordinary undergraduate students for "exceptional, tangible" intellectual achievements. Among them: CISAC honors student Anand Habib, a senior majoring in biology with honors in international security studies. He is completing an honors thesis focusing on health governance.

Habib sees his work as an intentional synthesis of scholarship and larger social commitments. He has lived this out in many ways at Stanford, including working on behalf of politically and medically disenfranchised people in India, Mexico and Guatemala. On campus, he has turned the Stanford tradition of the annual Dance Marathon into a vehicle dedicated to addressing the HIV/AIDS pandemic by engaging not only Stanford students but also local communities and corporations, raising more than $100,000. His exceptional work was recognized by his participation in the Clinton Global Initiative University Conference in April.

English Associate Professor Michele Elam described Habib as a "superb critical thinker" whose work is characterized by "creative genius" and "mature insights." She holds him up as a model for others, saying that "he exemplifies exactly the kind of deeply informed, pragmatic and caring leadership that the world needs and Stanford enables."

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Professor Wein received his PhD in Operations Research from Stanford in 1988 and has taught core MBA courses in operations management throughout his entire career, both at MIT's Sloan School of Management from 1988 to 2002 and, since 2002, at Stanford's Graduate School of Business, where he is currently Paul  E. Holden Professor of Management Science. He has also been a Senior Fellow (by courtesy) at FSI since 2003.

Since 2001, Wein has analyzed a variety of homeland security problems. His homeland security work includes four papers in the Proceedings of the National Academy of Sciences: one on an emergency response to a smallpox attack,  a second on an emergency response to an anthrax attack, a third presenting a biometric analysis of the US-VISIT Program, and a fourth analyzing a bioterror attack on the milk supply. He has also published the Washington Post op-ed "Unready for Anthrax" (2003) and the New York Times op-ed "Got Toxic Milk?" (2005) and has written papers on port security, indoor remediation after an anthrax attack, and the detention and removal of illegal aliens.  He was also Editor-in-Chief of Operations Research from 2000 to 2005. Wein has won several awards, including the 1993 Erlang Prize for the outstanding applied probabilist under 35 years of age and the 2002 Koopman Prize for the best paper in military operations research.

Rebecca Slayton Affiliated Faculty at CISAC, and Lecturer in Science, Technology, and Society Commentator

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Lawrence Wein is the Jeffrey S. Skoll Professor of Management Science at the Graduate School of Business, Stanford University, and an affiliated faculty member at CISAC. After getting a PhD in Operations Research from Stanford University in 1988, he spent 14 years at the Sloan School of Management at MIT, where he was the DEC Leaders for Manufacturing Professor of Management Science. His research interests include mathematical models in operations management, medicine and biology.

Since 2001, he has analyzed a variety of homeland security problems. His homeland security work includes four papers in Proceedings of the National Academy of Sciences, on an emergency response to a smallpox attack, an emergency response to an anthrax attack, a biometric analysis of the US-VISIT Program, and an analysis of a bioterror attack on the milk supply. He has also published the Washington Post op-ed "Unready for Anthrax" (2003) and the New York Times op-ed "Got Toxic Milk?", and has written papers on port security, indoor remediation after an anthrax attack, and the detention and removal of illegal aliens.

For his homeland security research, Wein has received several awards from the International Federation of Operations Research and Management Science (INFORMS), including the Koopman Prize for the best paper in military operations research, the INFORMS Expository Writing Award, the INFORMS President’s Award for contributions to society, the Philip McCord Morse Lectureship, the Frederick W. Lanchester Prize for best research publication, and the George E. Kimball Medal. He was Editor-in-Chief of Operations Research from 2000 to 2005, and was elected to the National Academy of Engineering in 2009.   

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Lawrence M. Wein Professor of Management Science, Stanford Graduate School of Business; Senior Fellow (by courtesy), Freeman Spogli Institute for International Studies Speaker
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In this op-ed, CISAC's Richard Rhodes argues that public health, a discipline that organizes science-based systems of surveillance and prevention, has been primarily responsible for controlling the effects of infectious disease. A similar campaign around public safety could help end the existential threat posed by nuclear weapons. Such a push would help create unity in common security and a fundamental transformation in relationships between nations, Rhodes argues.

Today, at the other end of the long trek down the glacier of the Cold War, the nuclear threat has seemingly calved off and fallen into the sea. In 2007, the Pew Research Center's Global Attitudes Project found that 12 countries rated the growing gap between rich and poor as the greatest danger to the world. HIV/AIDS led the list (or tied) in 16 countries, religious and ethnic hatred in another 12. Pollution was identified as the greatest menace in 19 countries, while substantial majorities in 25 countries thought global warming was a "very serious" problem. Only nine countries considered the spread of nuclear weapons to be the greatest danger to the world.

The response was very different among nuclear and national security experts when Indiana Republican Sen. Richard Lugar surveyed PDF them in 2005. This group of 85 experts judged that the possibility of a WMD attack against a city or other target somewhere in the world is real and increasing over time. The median estimate of the risk of a nuclear attack somewhere in the world by 2010 was 10 percent. The risk of an attack by 2015 doubled to 20 percent median. There was strong, though not universal, agreement that a nuclear attack is more likely to be carried out by a terrorist organization than by a government. The group was split 45 to 55 percent on whether terrorists were more likely to obtain an intact working nuclear weapon or manufacture one after obtaining weapon-grade nuclear material.

"The proliferation of weapons of mass destruction is not just a security problem," Lugar wrote in the report's introduction. "It is the economic dilemma and the moral challenge of the current age. On September 11, 2001, the world witnessed the destructive potential of international terrorism. But the September 11 attacks do not come close to approximating the destruction that would be unleashed by a nuclear weapon. Weapons of mass destruction have made it possible for a small nation, or even a sub-national group, to kill as many innocent people in a day as national armies killed in months of fighting during World War II.

"The bottom line is this," Lugar concluded: "For the foreseeable future, the United States and other nations will face an existential threat from the intersection of terrorism and weapons of mass destruction."

It's paradoxical that a diminished threat of a superpower nuclear exchange should somehow have resulted in a world where the danger of at least a single nuclear explosion in a major city has increased (and that city is as likely, or likelier, to be Moscow as it is to be Washington or New York). We tend to think that a terrorist nuclear attack would lead us to drive for the elimination of nuclear weapons. I think the opposite case is at least equally likely: A terrorist nuclear attack would almost certainly be followed by a retaliatory nuclear strike on whatever country we believed to be sheltering the perpetrators. That response would surely initiate a new round of nuclear armament and rearmament in the name of deterrence, however illogical. Think of how much 9/11 frightened us; think of how desperate our leaders were to prevent any further such attacks; think of the fact that we invaded and occupied a country, Iraq, that had nothing to do with those attacks in the name of sending a message.

Richard Butler, the former chairman of the Canberra Commission on the Elimination of Nuclear Weapons and the last chairman of UNSCOM, often makes the point that the problem with nuclear weapons is nuclear weapons. People don't always understand what he means. He means that it is the weapons themselves that are the problem, not the values of the entities that control them. U.S. nuclear weapons are just as potentially dangerous to the world as, say, North Korean nuclear weapons. More, I would say, since we have greater numbers of them and have not hesitated to brandish them--even to use them--when we thought it in our interest to do so.

That the problem with nuclear weapons is nuclear weapons may seem counterintuitive, but two centuries ago governments began to think that way about disease, with untold benefits to humanity as a result. Epidemic disease had been conceived in normative terms, as an act of God for which states bore no responsibility. The change that came when disease began to be conceived as a phenomenon of nature without a metaphysical superstructure, a public health problem, a problem for government and a measure of government's success, was revolutionary. More lives were saved, and spared, with public health measures in the twentieth century in the United States alone than were lost throughout the world in all of the twentieth century's wars.

As my Scottish friend Gil Elliot wrote in his seminal book Twentieth Century Book of the Dead, "[These lives] are not saved by accident or goodwill. Human life is daily deliberately protected from nature by accepted practices of hygiene and medical care, by the control of living conditions and the guidance of human relationships. Mortality statistics are constantly examined to see if the causes of death reveal any areas needing special attention. Because of the success of these practices, the area of public death has, in advanced societies, been taken over by man-made death--once an insignificant or 'merged' part of the spectrum, now almost the whole.

"When politicians, in tones of grave wonder, characterize our age as one of vast effort in saving human life, and enormous vigor in destroying it, they seem to feel they are indicating some mysterious paradox of the human spirit. There is no paradox and no mystery. The difference is that one area of public death has been tackled and secured by the forces of reason; the other has not. The pioneers of public health did not change nature, or men, but adjusted the active relationship of men to certain aspects of nature so that the relationship became one of watchful and healthy respect. In doing so they had to contend with and struggle against the suspicious opposition of those who believed that to interfere with nature was sinful, and even that disease and plague were the result of something sinful in the nature of man himself."

Elliot goes on to compare what he calls "public death," meaning biological death, death from disease, to man-made death: "[I do not wish] to claim mystical authority for the comparison I have made between two kinds of public death--that which results from disease and that which we call man-made. The irreducible virtue of the analogy is that the problem of man-made death, like that of disease, can be tackled only by reason. It contains the same elements as the problem of disease--the need to locate the sources of the pest, to devise preventive measures, and to maintain systematic vigilance in their execution. But it is a much wider problem, and for obvious reasons cannot be dealt with by scientific methods to the same extent as can disease."

To advance the cause of public health it was necessary to depoliticize disease, to remove it from the realm of value and install it in the realm of fact. Today we have advanced to the point where international cooperation toward the prevention, control, and even elimination of disease is possible among nations that hardly cooperate with each other in any other way. No one any longer considers disease a political issue, except to the extent that its control measures a nation's quality of life, and only modern primitives consider it a judgment of God.

In 1999, for the first time in human history, infectious diseases no longer ranked first among causes of death worldwide. Public health, a discipline which organizes science-based systems of surveillance and prevention, was primarily responsible for that millennial change in human mortality. One-half of all the increases in life expectancy in recorded history occurred within the twentieth century. Most of the worldwide increase was accomplished in the first half of the century, and it was almost entirely the result of public health measures directed to primary prevention. Better nutrition, sewage treatment, water purification, the pasteurization of milk, and the immunization of children extended human life--not surgeons cutting or doctors dispensing pills.

Public health is medicine's greatest success story and a powerful model for a parallel discipline, which I propose to call public safety.

Where nuclear weapons--the largest-scale instruments of man-made death--are concerned, the elements of that discipline of public safety have already begun to assemble themselves: materials control and accounting, cooperative threat reduction, security guarantees, agreements and treaties, surveillance and inspection, sanctions, forceful disarming if all else fails.

Reducing and finally eliminating the world's increasingly vestigial nuclear arsenals may be delayed by extremists of the right or the left, as progress was stalled during the George W. Bush administration by rigid Manichaean ideologues who imagined that there might be good nuclear powers and evil nuclear powers and sought to disarm only those they considered evil. Nuclear weapons operate beyond good and evil. They destroy without discrimination or mercy: Whether one lives or dies in their operation is entirely a question of distance from ground zero. In Elliot's eloquent words, they create nations of the dead, and collectively have the capacity to create a world of the dead. But as Niels Bohr, the great Danish physicist and philosopher, was the first to realize, the complement of that utter destructiveness must then be unity in common security, just as it was with smallpox, a fundamental transformation in relationships between nations, nondiscrimination in unity not on the dark side but by the light of day.

Violence originates in vulnerability brutalized: It is vulnerability's corruption, but also its revenge. "Perhaps everything terrible," the poet Rainer Maria Rilke once wrote, "is in its deepest being something helpless that wants help from us." As we extend our commitment to common security, as we work to master man-made death, we will need to recognize that terrible helplessness and relieve it--in others, but also in ourselves.

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In early 2007, CSIS launched an expert task force to examine the growing involvement of the Department of Defense as a direct provider of “non-traditional” security assistance, concentrated in counterterrorism, capacity building, stabilization and reconstruction, and humanitarian relief. The task force set out to shed light on what drives this trend, including the new global threat environment; assess what was happening at the same time in the diplomatic and developmental realms; evaluate DOD performance in conducting its expanded missions; and consider the impact of the Pentagon’s enlarged role on broader U.S. national security, foreign policy and development interests. From the outset, the task force sought to generate concrete, practical recommendations to Congress and the White House on reforms and legislation that will create a better and more sustainable balance between military and civilian tools.

J. Stephen Morrison joined CSIS in early 2000. He directs the CSIS Africa Program, the CSIS Task Force on HIV/AIDS (begun in 2001) and most recently co-directed a CSIS Task Force on non-traditional U.S. security assistance. In his role as director of the Africa Program, he has conducted studies on the United States’ rising energy stakes in Africa, counter-terrorism, the stand-up of the U.S. Africa Command, and implications for U.S. foreign policy. In 2005–2006, he was co-director of the Council on Foreign Relations Independent Task Force on Africa, ‘Beyond Humanitarianism: A Strategic U.S. Approach Toward Africa.’ Immediately prior to that, he was executive secretary of the Africa Policy Advisory Panel, commissioned by the U.S. Congress and overseen by then–Secretary of State Colin Powell. From 2005 up to the present, he has directed multi-phase work on China’s expansive engagement in Africa. His work on HIV/AIDS and related global health issues has involved multiple missions to China, Russia, India, Vietnam and Africa, and most recently, a series of focused studies on the President’s Emergency Plan for AIDS Relief. He publishes widely, testifies often before Congress, and is a frequent commentator in major media on U.S. foreign policy, Africa, foreign assistance, and global public health. From 1996 through early 2000, Morrison served on the secretary of state’s policy planning staff, where he was responsible for African affairs and global foreign assistance issues. From 1993 to 1995, he conceptualized and launched USAID’s Office of Transition Initiatives, which operates in countries emerging from protracted internal conflict and misrule. From 1992 until mid-1993, he was the U.S. democracy and governance adviser in Ethiopia and Eritrea. In the period 1987 to 1991, he was senior staff member of the House Foreign Affairs Subcommittee on Africa. Morrison holds a Ph.D. in political science from the University of Wisconsin, has been an adjunct professor at the Johns Hopkins School of Advanced International Studies since 1994, and is a graduate magna cum laude of Yale College. He is a member of the Council on Foreign Relations and the International Institute for Strategic Studies.

CISAC Conference Room

J. Stephen Morrison Executive Director Speaker HIV/AIDS Task Force and Director, Africa Program, Center for Strategic & International Studies
Seminars
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This presentation provides an overview of the history of US satellite-based reconnaissance as has been publicly revealed by the US Government to date. Extrapolating from there, it will transition to the evolutionary and revolutionary role that commercial satellite imagery is now playing on the international stage in proving a heretofore-unimaginable basis for greater global transparency and the way it has helped, and will continue to help, to detect and monitor undeclared unconventional weapons related facilities and activities. In addition, new geospatial tools, which draw heavily upon commercial satellite imagery as well as augmenting it, have also become available over the internet. Among those Geospatial tools, "Digital Virtual Globes" (i.e., Google Earth, Virtual Earth, etc.) not only provide a much improved mapping capability over previously used simple plan-view line drawings used by various international inspection organizations such as the IAEA, but the offer much improved visualization of known and inspected sites. Such digital globes also provide a new, essentially free means to conduct broad area baseline search for possible "clandestine" sites...either allege through open source leads; identified on internet blogs and wiki layers with input from a "free" cadre of global browsers and/or by knowledgeable local citizens that can include ground photos and maps; or by other initiatives based on existing country program knowledge. The digital globes also provide highly accurate terrain mapping for better overall geospatial context and allow detailed 3-D perspectives of all sites or areas of interest. 3-D modeling software, when used in conjunction with these digital globes can significantly enhance individual building characterization and visualization (including interiors), allowing for better international inspector training through pre-inspection walk-arounds or fly-around, and perhaps better IAEA safeguard decision making. In sum, these new geospatial visualization aids are ideal for international inspector training and orientation, as well as site characterization, monitoring and verification. But perhaps just as significantly, these new geospatial tools also now make it possible for anyone to conduct his or her own satellite-based reconnaissance for any application from the comfort of home, at a wi-fi enabled coffee shop, or even on the beach at a tropical island resort.

Frank Pabian is a Senior Nonproliferation Infrastructure Analyst at Los Alamos National Laboratory who has over 35 years experience in the nuclear nonproliferation field including six years with the Office of Imagery Analysis and 18 years with Lawrence Livermore National Laboratory's "Z" Division. Frank also served as a Chief Inspector for the IAEA during UN inspections in Iraq from 1996-1998 focusing on "Capable Sites." In December 2002, Frank served as one of the first US nuclear inspectors back in Iraq with UN/IAEA. While at Los Alamos, Frank has developed and presented commercial satellite imagery based briefings on foreign clandestine nuclear facilities to the International Nuclear Suppliers Group, the IAEA, NATO, and the Foreign Ministries of China and India on behalf of the NNSA and STATE.

Reuben W. Hills Conference Room

Frank Pabian Speaker Los Alamos National Laboratory
Seminars
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