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.

On October 3-4, 2011, the Stanford University Program on Poverty and Governance at the Center on Democracy, Development, and the Rule of Law and the Center for International Security and Cooperation, in conjunction with the Center for Latin American Studies, the Stanford Law School, and the Bill Lane Center for the American West, hosted a conference to discuss the problem of violence, organized criminal activity, and governance. In particular, the conference focused on growing concerns about Mexican security. Participants examined the issue from a comparative perspective, drawing lessons from the experience of Afghanistan, Colombia, and other countries that have grappled with similar challenges.

Among other topics, the conference explored the root causes of the dramatic upswing in violence in Mexico in recent years, compared those problems to chronic violence and illicit activity in other countries, and considered potential solutions that could reduce the risk of violence in the future. The conference was held at Stanford University in the Bechtel Conference Center in Encina Hall. Participants included scholars and doctoral candidates from the United States, Mexico, Colombia, and Germany, representatives from the U.S. Departments of Justice and Treasury, and the Mexican Embassy.

Context of the Problem

Crime and violence pose a serious challenge to Mexico. According to one of the participants, between January 2007 and December 2010, official statistics confirm that approximately 40,000 homicides have occurred. The problem appears to be growing worse, with 2011 on pace to become the most violent year on record.

The rising violence in Mexico has resulted in a sharply heightened sense of fear among citizens, who now feel the presence of cartels in their every day lives. The use of extortion and kidnapping by cartels combined with a lack of trust in security forces terrorizes the population and makes them feel like they have no where to turn. Despite this fact, crime rates in Mexico remain lower than in other parts of Latin America. Venezuela, for example, has among the highest homicide rates in the world. Yet the pervasive infiltration of cartels into public life gives Mexicans a heightened sense of the severity of violent crime in their own country.

There are no simple answers explaining these developments. Some participants trace the violence back to the 1980s when the United States began working closely with the Colombian government to stem the flow of cocaine across the Caribbean, and to disrupt powerful Colombian criminal organizations. The scholars suggested that the crackdown on those illegal trafficking routes caused the drug trade to divert through Mexico on the way to markets in the United States. These trade routes strengthened Mexican drug trafficking organizations (DTOs), thereby altering the landscape and scale of illicit activity in the country.

Some participants also noted the importance of  attributing other factors to explain the growing violence in Mexico, citing four domestic factors. First, the efforts made by President Felipe Calderón of Mexico to crack down on drug-related violence after his inauguration in 2006; second, the fragmentation of Mexican cartels due to the capture or assassination of "kingpins" in the organizations; third, a diversification in the economic incentives of the DTOs; and fourth, the weak status of rule of law in Mexico.

These four explanations are by no means independent of each other, and the endogenous nature of these factors is exactly why it is so difficult to stop the increasing violence in Mexico. Indeed, examining these four factors a bit further makes it clear that they are closely linked. Following his inauguration, President Calderón made violence and drug trafficking top priorities. His strategy was to target and remove the cartel leadership, assuming that breaking the cartels up would make them easier to subdue. The effort had the opposite effect. Capturing and killing cartel kingpins created a power vacuum and splintered the cartels into many smaller, less organized, and more militant gangs. The smaller and less centralized gangs began fighting each other for control of routes and territory. Without centralized control, the groups also became less efficient as cocaine traffickers - a system that had previously thrived from economies of scale. As a result, they began diversifying their revenue streams. Extortion, human trafficking, money laundering, arms trading, and petty crime all became more economical relative to small-scale drug trafficking and dealing, which led the cartels to diversify further still. Though participants heavily debated the directionality of the link between this diversification and gang fractionalization, consensus emerged that dividing up the cartels led to increased violence in Mexico.

The persistent problems of the Mexican legal system have also exerted a huge impact on the ability of the Mexican government to subdue the violence. High rates of corruption within local police forces, due in part to low compensation, means that the police are unreliable as a means to enforce order in municipalities. This has prompted the government to deploy armed forces to try to restore order in some areas. Furthermore, the judicial system in Mexico is weak, with poor judges, a shortage of lawyers, and a backlog that makes due process nothing more than an idealized notion.

Participants also presented evidence that additional factors could have exacerbated the violence. Among them: the global recession, which has reduced economic opportunities, and democratization in the 1990s. But in general, participants concluded that the evidence that either of these factors affected the overall crime situation in Mexico was weak relative to the other factors discussed.

The overall consensus was that any policy initiative made to control violence in Mexico invariably must address the weak rule of law institutions, the economic incentives of the cartels, and the exploding intra- and inter-cartel violence. Successful strategies, moreover, must approach these topics differently than how they have been addressed thus far.

Lessons and Proposals

What can be done to rein in the rising violence? Participants examined a number of successful anti-gang and anti-drug policies in other countries for potential answers. For instance, the Unidades de Polícia Pacificadora (Pacifying Police Units or UPP) program in Rio de Janeiro, which started in 2008, consists of proximity policing, gaining the trust of and working with favela populations, and directly engaging with and helping favela children and youth. The program's main goal is to keep organized crime out of favelas, which have been their hideout for decades. The program helped restore law and order, participants said, because of the high effectiveness of proximity policing in high-risk communities, which combined policing with social and public services to increase legitimacy of the program. This dual security approach-using specialized forces during conflict and then proximity policing to maintain daily safety and security in the slums-has been highly successful at maintaining order and controlling police corruption in Rio.

In Colombia, because the violence of a few decades ago seemed to be more a result of a weak state than the presence of drugs, the situation improved when the state's capacity increased. Nevertheless, part of the solution found in the city of Medellín, where the local cartel proved too strong to destroy, was to allow one cartel to have a monopoly. Yet while this trade-off worked in the short-term, once the Medellín Cartel kingpin was captured and extradited with the help of U.S. military aid, violence started to increase again.

U.S. military aid to Colombia also had a drawback as some of the funding was leaked to paramilitary activities. Conference participants said one lesson from this experience is that it is important to invest more in drug interdiction than in eradication, because eradication programs increase the price of drugs, thereby improving trafficking incentives. The most important implication of this is that squeezing the traffickers will only cause them to re-route, not stop. When squeezed out of Colombia and the Caribbean, they re-routed through Mexico. If this occurs in Mexico, traffickers will most likely move into Central America. The issue of drug trafficking cannot be resolved if policymakers ignore Central American republics.

Several other proposals received attention during the conference. Among them was the suggestion that Mexican policy emulate aspects of the Colombian model by concentrating all efforts toward destroying the single-most violent cartel until it is entirely eliminated, and then progressing on to the next largest and so forth. Theoretically, doing so would systematically destroy the cartels while minimizing their fragmentation.

Participants also suggested that authorities focus on targeting extortion, kidnapping, and other non-drug related economically incentivized crimes committed by the gangs, which could help limit their ability to fragment and diversify. This approach could benefit from careful analysis of efforts to implement community policing strategies that some participants believe to have yielded results in the United States and Brazil. A third proposal with serious implications is to reform the judicial and penal system in Mexico to ensure that incarcerated "narcos" cannot continue operating from within Mexican prisons.

Finally, much discussion was given to the best way to address the demand-side of drug trafficking. While legalizing drugs in the United States was seen as highly unlikely option with very unclear potential results, a participant proposed that policymakers encourage the expansion of rigorous drug treatment programs, such as Hawaii's highly successful Opportunity Probation with Enforcement program. It requires convicted drug offenders on probation to undergo randomized drug tests one to seven times a week, with automatic incarceration for anyone who tests positive or is found to be in violation of their parole.

Conclusion

Daunting problems remain in understanding crime and governance in Latin America. But this conference, among other things, helped highlight areas where further research on drug trafficking, organized crime, violence, and issues of citizen security are still needed. There were also several highly actionable proposals put forth based on programs that have been implemented in other countries in the Western Hemisphere. These initiatives hold promise for helping Mexico deal with its own situation. This conference should serve as a launch pad to encourage and develop research and communication in this area with policy implications for the near future.