by Mark Weston | Mar 17, 2009 | Influence and networks, UK
Courtesy flickr user zmxncbv.com
The think tank 2020health has just released my report on UK vaccination policy. ‘Not immune: UK vaccination policy in a changing world‘ was written in response to the Conservative Party’s call for the UK’s Joint Committee on Vaccination and Immunisation (JCVI) to be merged with the National Institutes for Health and Clinical Excellence (NICE). Drawing on interviews with senior vaccination policy-makers and an exhaustive review of the literature, the report concludes that while a merger would be more likely to harm rather than benefit the UK’s health, there is a strong case for more open and transparent immunisation policy-making.
The JCVI is currently quite a secretive body which conducts its meetings behind closed doors, only releasing minutes to the public a couple of months later. So far, this hasn’t caused any problems, but as the MMR vaccine scare and other health crises such as BSE and foot and mouth have shown, it’s impossible to predict what is around the corner, and if the JCVI should ever make a wrong decision (as its counterpart in the US recently did by introducing a dangerous rotavirus vaccine that subsequently had to be withdrawn), its secretive modus operandi will come under scrutiny. Trust is crucial for vaccine decision-making (unlike with the treatments for sick people that NICE evaluates, with immunisation parents are taking healthy children for jabs), but secrecy and trust are unlikely bedfellows. We therefore recommend that the JCVI open its meetings to the public and allow some public participation (which is likely to come as a shock to some JCVI committee members).
Another key message (there are quite a few recommendations but I’m afraid you’ll have to read the report for a full list) applies to both the JCVI and NICE. The cost-effectiveness of treatments and vaccines is a fundamental part of decisions on whether to introduce them into the National Health Service, but neither body has effectively made the case that cost-effectiveness is important. We therefore get regular outraged headlines in the Daily Mail and other boneheaded rags that decisions to reject drugs are based “purely on cost,” as if a health service with limited resources should take no account of expenditure. NICE in particular should be more open about why it has to take account of cost-effectiveness, and about how this will benefit the nation’s health. Until then, it will continue to lose the media war, and its reputation will continue to take a battering.
by David Steven | Mar 16, 2009 | What we're watching
[youtube]http://www.youtube.com/watch?v=n8ZpaU0MNCo[/youtube]
by Daniel Korski | Mar 15, 2009 | Conflict and security, Cooperation and coherence
The Sunday newspapers have lots of stories about how the man behind anti-war protest targeting British soldiers in Luton — Anjem Choudary –- has encouraged his extremist followers to stop spending their money on their families and divert it instead to Muslim soldiers waging jihad, or holy war. As the organization Mr. Choudary is affiliated with, Ahle Sunnah al-Jamah, is thought to have no more than a core of 30 to 40 people, the call is unlikely to change the bulk of remittances sent by, for example, British citizens of Pakistani origin to Pakistan.
But the call makes me come back to the issue of diaspora groups and the role they play in their “home” countries. For though Mr. Choudary’s appeal is unlikely to make much of a difference, I understand from speaking to British friends of Pakistani extraction that remittances are often sent not only to families but also for reconstruction projects in “home” villages and to political parties and movements.
In a study of party political funding, the Pakistani Institute of Legislative Development and Transparence suggested that most Pakistani political parties receive funding from abroad while many extremist groups, like Lashkar-e-Toiba, receive cash from abroad.
To varying degrees, this money — $673.50 million in December 2008 –- cannot help but encourage the centrifugal tendencies in Pakistani politics at a time when the government is facing a raging insurgency in its northern provinces and the secular Pakistan People’s Party and the big-landlord Muslim League are locked in an rancorous conflict, which may tear the country apart.
Development aid cannot make up the support from remittances to the political parties, as only a tiny proportion goes to democracy-promotion as opposed to poverty-alleviation. Out of the $278.60 million spent (pdf) by USAID in Pakistan in 2005, only $15 million were spent on governance and democracy-promotion (I’d show how much DfiD spends, if this information was not impossible to find on the department’s website). Even if more money was provided to this line item with liberal and civic-minded groups as the beneficiaries, their role in Pakistani society is limited or, in a sense, “co-opted” by the political parties.
The proactive way forward therefore seems to be to encourage a Pakistani diaspora network, which can fund liberal groups and centripetal projects in Pakistan, and rival the overseas money-collecting operation of the established political parties. Though some British government start-up cash ought to be offered, for such a network to any credibility among the diaspora and in Pakistan, it would have to be run by people of independent standing and funded in the main by non-governmental resources. But it would seem like an obvious project for many of the philanthropic organizations to back while I can think of numerous Britons (and other Europeans) of Pakistan extraction who could become powerful leaders of such a liberal project. Let us hope someone will step up to the plate and do for liberal causes what Anjem Choudary tries to do for the dark side.
by Jules Evans | Mar 14, 2009 | Climate and resource scarcity
Political leaders are driven by a desire for power. They will tend to follow whatever is politically expedient in order to gain power. Right now, it is politically expedient only to make token efforts to try and prevent climate change, without making the electorate fore-go habits to which they have become accustomed.
But leaders are also driven by vanity, and have a powerful desire to be seen well by ‘posterity’ or the ‘history books’. Just look how long Tony Blair spent, while leaving office, in trying to explain his ‘legacy’, or at George W. Bush’s mea culpa last press conference.
This, it seems to me, is one way political leaders might be persuaded to take dramatic action now on climate change: scientists explain to them very clearly what will happen if the level of CO2 does not fall, they explain very clearly the huge loss of life this will cause,and the actions that need to be taken now if this situation is to be avoided.
And then you tell them that history will judge them. If you consider the infamy in which Adolf Hitler is now held: Hitler was responsible for the deaths of, how many, 40 million people?
That is, unfortunately, a drop in the ocean compared to how many will die in the coming decades if this generation of political leaders fail to do what is necessary.
The terrible suffering of World War II was, on the whole, confined to a generation. If the world warms by 4-6 degrees, the suffering will be felt by many generations, all of whom will look back to the beginning of the 21st century, when political leaders were clearly warned what was going to happen, and what was needed to be done to avoid it, and who failed to do what was necessary.
What this means is, it’s a terrible time to be a politician. Never has the chalice of power been so poisoned. On the one hand, you have to tell an electorate grown complacent with prosperity that they must radically alter their lifestyles and fore-go many activities they now take for granted. As a result, they may very well be voted out of office, or even laughed out of office, for doing do.
On the other hand, if they don’t do this, their names will be mud for decades, even centuries.
They will say ‘we didn’t know’ or ‘it wasn’t politically possible’ or ‘we didn’t have enough time’. But the history books will show that they were told what needed to be done, and they failed to act.
On the other hand, if they do act, if they finally recognise the gravity of the threat facing us, explain to the electorate what needs to be done, and begin leading their electorates through the necessary changes, they will win a place in the history books as great as Churchill, Gandhi, or Martin Luther King .
The line between historic hero or historic catastrophe is very thin right now, and it is not leaders’ response to the credit crunch which will decide their place in the eyes of posterity.
by Daniel Korski | Mar 13, 2009 | Conflict and security, Cooperation and coherence
During the Cold War, when Western and Warsaw Pact tanks were facing each other, the idea of a “selling” NATO’s role to allied publics would have been ludicrous because everyone knew why it was important. Now, in the run-up to the Alliance’s 60th anniversary, NATO has realised how important it is to communicate its role and worth to publics in European and North America.
But doing so at a time when the only kind of security ordinary people think about is their job security is a real challenge. As my colleague Nick Witney has said: “Defense is no longer a business of manning the ramparts or preparing to resist invasion. It has to be about an attempt to project stability. It is a hard doctrine to get people to believe in.”
To help NATO communicate better, it has hired an executive from Coca-Cola to manage the way the alliance is seen around the world and launched a an internet-based service called NATO TV as well as a Media Operations Centre (called the “MOC”) with the sole task of improving communications about NATO’s Afghan mission.
Next week, I will attend an internal NATO meeting to discuss ways to overcome NATO’s communications challenges. And this is where you come in. I’d like to solicit the help of you, the rarified group of people who make up the Global Dashboard readership.
For I’d like to tell the assembled defence communicators what security-tracking, information-seeking, well-informed people like yourselves think are the biggest communications challenges for NATO — and perhaps how to overcome these.
So here are a couple of questions I’d love to get your in-put on, which I will duly pass on at the NATO meeting.
- What are NATO’s greatest challenges now and over the next five years?
- What are the most serious threats to your country’s national security and what role do you think NATO should play in addressing this?
- What aspect of NATO’s communications do you think works well?
- What do you think of NATO TV? How can it be improved?
- If you were in charge of NATO communications, what would you do?
I look forward to hearing what you think.
