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For Gates, global health should drive foreign policy

Gates Foundation-funded research is putting war deaths three times higher than conventional ways of counting them. In turn, good data might drive good international politics.
<i>Closing In, Kwajalein Atoll</i> (1944). (Official U.S. Army Signal Corps Photograph, National Park Service, <a href='http://www.nps.gov/amme/index.htm' target='_blank'>American Memorial Park</a>, Mariana Islands, Saipan).

Closing In, Kwajalein Atoll (1944). (Official U.S. Army Signal Corps Photograph, National Park Service, American Memorial Park, Mariana Islands, Saipan). None

With the end of the Cold War, the number, intensity, and lethality of wars were believed to be in decline [PDF]. However, new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington challenges the idea that war deaths are falling. The IHME paper claims war deaths are three times higher than previously thought and not decreasing. Beneath the surface, the debate shows an increasingly prominent and well-funded global health community flexing its muscle in the foreign policy arena.

The IHME was founded a little more than a year ago with a 10-year, $105 million grant from the Bill & Melinda Gates Foundation. The institute is tasked with evaluating a multitude of health programs worldwide as well as developing an overall report card on global health by 2010. IHME represents the Gates Foundation's hard-nosed drive for evidence-based policies and accountability, sussing out what works, identifying the causes of death — and what or who is to blame.

Lead author of the IHME study, Ziad Obermeyer, told Crosscut that previous estimates of war deaths "fit with an increasingly common view in the academic and political communities that technological innovations (‘smart' bombs, precision warfare, etc.) and strategic priorities in recent years have dramatically reduced the number of civilian war deaths ... " Obermeyer noted: "If civilian deaths can essentially be ignored in the political calculus, war becomes a less difficult and more defensible option."

The common view has been that battle deaths were in decline. War deaths, by definition, exceed battle deaths because wars also kill by disease or starvation, for example. Data on all war-related deaths have been scant. IHME's estimates are hotly disputed because the number and trend of deaths are highly sensitive to assumptions in their model. Changing the treatment of data from Georgia, for instance, dramatically swings the estimate of war deaths and also whether the trend has been up or down over the last half century.

Oddly, the debate over war deaths is not between hawks and doves. The view that Obermeyer and colleagues seek to revise largely derives from the aptly-named Peace Research Institute, Oslo, Norway. The deeper question is: Whose voice should be authoritative on foreign policy? From a global health perspective, the present keepers of the world order have made a hash of it: Just count all the dead and dying. The Gates Foundation believes a more intelligent approach is possible — and necessary.

Early in their foundation's work, the Gateses discovered a "failure of collective action" among developed nations and international bodies leading to, for example, underfunded vaccination programs and vaccine research. More recently, in a speech to the Council on Foreign Relations in June, Melinda Gates elaborated: "Bill and I have come to recognize that poor people cannot get adequate food, and education, and health care because they cannot express their needs in ways that matter to markets or that motivate governments." In words dense with ramification, she concluded: "Only the non-profit sector has the primary mission of serving the people who've been left out."

Global health advocates emphasize a borderless world and policies focused on health orchestrated by non-profits, as against the prevailing system centered on nations and national security. The people, policies, and basic paradigms all differ, at times starkly. However, because these problems are so complex, the Gateses once wrote, "government has to be involved in solving them." In turn, "that means we need to get these issues on the political agenda."

Recently, it's been more clear how they propose to change the international agenda. In 2003, the Gates Foundation funded a new Global Health and Foreign Policy Fellow at the Council on Foreign Relations. Publisher of Foreign Affairs, the Council arguably wields more influence on foreign policy than any other private body. The first Gates fellow, Pulitzer prize-winning journalist Laurie Garrett, authored "HIV and National Security: Where Are the Links?" [PDF] in 2005, arguing that AIDS epidemics — eventually — jeopardized security in nations suffering from them while other countries faced a possible threat of terrorists arising from the resulting, destabilized regimes. in such a way, global health policy and foreign and defense policies are tied together.


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Comments:

Posted Fri, Aug 22, 9:56 a.m. Inappropriate

Sins of the Father...: Too bad his Pop's 'inheiratance' to his son will be his legacy of Abramoff style corruption and monopoly 'like' abuses of power.....

-Douglas Tooley

Posted Fri, Aug 22, 10:29 a.m. Inappropriate

One dollar at a time: Maybe the Gates Foundation can do specific outreach and give a dollar or two to George Hussein Obama, newly revealed half-brother of Barack. Perhaps all forms of charity should be performance audited and war death related efforts would be a good place to start.

animalal

Posted Fri, Aug 22, 5:09 p.m. Inappropriate

Institute for Health Metrics and Evaluation Study Deeply Flawed: This article correctly points out that political scientists have shown that 'the number, intensity, and lethality of wars' have declined since the end of the Cold War. It goes on to note that 'new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington challenges the idea that war deaths are falling.'

In fact nothing in the IHME's deeply flawed research paper published in the British Medical Journal disproves any of the findings from the International Peace Research Institute, Oslo or Uppsala University's Conflict Data Program.

The authors make quite unwarranted claims about trends in worldwide wartime fatality on the basis of a sample of just 13 countries--approximately one tenth of the countries involved in armed conflicts in the period covered by the WHO surveys that they cite.

Their discussion of fatality trends fails to compare like with like with respect to the time periods that the two sets of estimates cover. This alone invalidates the authors' confident assertion that there has been no decline in war deaths even for the small sample of countries they investigate.

They fail point out that the conflict fatality dataset they criticize measures a much narrower category of fatalities than their 'war death' category used in the WHO surveys. Again a failure to compare like with like that invalidates the comparison they make and one that seriously undermines their conclusions.

Their assumption that there is a 'consistent relationship' between the WHO fatality estimates and those of the conflict research dataset they criticize is demonstrably untrue.

They focus on the WHO-derived survey data that supports their contention that the conflict research dataset undercounts war deaths, but ignore the conflict research data that counts significant numbers of fatalities that the WHO surveys miss completely.

The provenance of the some of their fatality figures is wholly unclear.


Andrew Mack
Director
Human Security Report Project
School for International Studies
Simon Fraser University
Suite 2400
515 West Hastings St.
Vancouver
BC V6B 5K3
Tel: 604 803 3548
Email: amack@sfu.ca

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