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Appropriate Use Criteria for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer After Definitive Primary Treatment




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Prospective Evaluation of 18F-DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer in an Academic Center: A Focus on Disease Localization and Changes in Management

18F-DCFPyL (2-(3-{1-carboxy-5-[(6-18F-fluoropyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) is a promising PET radiopharmaceutical targeting prostate-specific membrane antigen (PSMA). We present our experience with this single-academic-center prospective study evaluating the positivity rate of 18F-DCFPyL PET/CT in patients with biochemical recurrence (BCR) of prostate cancer (PC). Methods: We prospectively enrolled 72 men (52–91 y old; mean ± SD, 71.5 ± 7.2) with BCR after primary definitive treatment with prostatectomy (n = 42) or radiotherapy (n = 30). The presence of lesions compatible with PC was evaluated by 2 independent readers. Fifty-nine patients had scans concurrent with at least one other conventional scan: bone scanning (24), CT (21), MR (20), 18F-fluciclovine PET/CT (18), or 18F-NaF PET (14). Findings from 18F-DCFPyL PET/CT were compared with those from other modalities. Impact on patient management based on 18F-DCFPyL PET/CT was recorded from clinical chart review. Results: 18F-DCFPyL PET/CT had an overall positivity rate of 85%, which increased with higher prostate-specific antigen (PSA) levels (ng/mL): 50% (PSA < 0.5), 69% (0.5 ≤ PSA < 1), 100% (1 ≤ PSA < 2), 91% (2 ≤ PSA < 5), and 96% (PSA ≥ 5). 18F-DCFPyL PET detected more lesions than conventional imaging. For anatomic imaging, 20 of 41 (49%) CT or MRI scans had findings congruent with 18F-DCFPyL, whereas 18F-DCFPyL PET was positive in 17 of 41 (41%) cases with negative CT or MRI findings. For bone imaging, 26 of 38 (68%) bone or 18F-NaF PET scans were congruent with 18F-DCFPyL PET, whereas 18F-DCFPyL PET localized bone lesions in 8 of 38 (21%) patients with negative results on bone or 18F-NaF PET scans. In 8 of 18 (44%) patients, 18F-fluciclovine PET had located the same lesions as did 18F-DCFPyL PET, whereas 5 of 18 (28%) patients with negative 18F-fluciclovine findings had positive 18F-DCFPyL PET findings and 1 of 18 (6%) patients with negative 18F-DCFPyL findings had uptake in the prostate bed on 18F-fluciclovine PET. In the remaining 4 of 18 (22%) patients, 18F-DCFPyL and 18F-fluciclovine scans showed different lesions. Lastly, 43 of 72 (60%) patients had treatment changes after 18F-DCFPyL PET and, most noticeably, 17 of these patients (24% total) had lesion localization only on 18F-DCFPyL PET, despite negative results on conventional imaging. Conclusion: 18F-DCFPyL PET/CT is a promising diagnostic tool in the work-up of biochemically recurrent PC, given the high positivity rate as compared with Food and Drug Administration–approved currently available imaging modalities and its impact on clinical management in 60% of patients.




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Comparison of 3 Interpretation Criteria for 68Ga-PSMA11 PET Based on Inter- and Intrareader Agreement

PET using radiolabeled prostate-specific membrane antigen (PSMA) is now being more widely adopted as a valuable tool to evaluate patients with prostate cancer (PC). Recently, 3 different criteria for interpretation of PSMA PET were published: the European Association of Nuclear Medicine (EANM) criteria, the Prostate Cancer Molecular Imaging Standardized Evaluation criteria, and the PSMA Reporting and Data System. We compared these 3 criteria in terms of interreader, intrareader, and intercriteria agreement. Methods: Data from 104 patients prospectively enrolled in research protocols at our institution were retrospectively reviewed. The cohort consisted of 2 groups: 47 patients (mean age, 64.2 y old) who underwent Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBED-CC)] (68Ga-PSMA11) PET/MRI for initial staging of biopsy-proven intermediate- or high-risk PC, and 57 patients (mean age, 70.5 y old) who underwent 68Ga-PSMA11 PET/CT because of biochemically recurrent PC. Three nuclear medicine physicians independently evaluated all 68Ga-PSMA11 PET/MRI and PET/CT studies according to the 3 interpretation criteria. Two of them reevaluated all studies 6 mo later in the same manner and masked to the initial reading. The Gwet agreement coefficient was calculated to evaluate interreader, intrareader, and intercriteria agreement based on the following sites: local lesion (primary tumor or prostate bed after radical prostatectomy), lymph node metastases, and other metastases. Results: In the PET/MRI group, interreader, intrareader, and intercriteria agreement ranged from substantial to almost perfect for any site according to all 3 criteria. In the PET/CT group, interreader agreement ranged from substantial to almost perfect except for judgment of distant metastases based on the PSMA Reporting and Data System (Gwet agreement coefficient, 0.57; moderate agreement), in which the most frequent cause of disagreement was lung nodules. Intrareader agreement ranged from substantial to almost perfect for any site according to all 3 criteria. Intercriteria agreement for each site was also substantial to almost perfect. Conclusion: Although the 3 published criteria have good interreader and intrareader reproducibility in evaluating 68Ga-PSMA11 PET, there are some factors causing interreader disagreement. Further work is needed to address this issue.




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Head-to-Head Comparison of 68Ga-PSMA-11 with 18F-PSMA-1007 PET/CT in Staging Prostate Cancer Using Histopathology and Immunohistochemical Analysis as a Reference Standard

18F-PSMA-1007 is a novel prostate-specific membrane antigen (PSMA)–based radiopharmaceutical for imaging prostate cancer (PCa). The aim of this study was to compare the diagnostic accuracy of 18F-PSMA-1007 with 68Ga-PSMA-11 PET/CT in the same patients presenting with newly diagnosed intermediate- or high-risk PCa. Methods: Sixteen patients with intermediate- or high-risk PCa underwent 18F-PSMA-1007 and 68Ga-PSMA-11 PET/CT within 15 d. PET findings were compared between the 2 radiotracers and with reference-standard pathologic specimens obtained from radical prostatectomy. The Cohen -coefficient was used to assess the concordance between 18F-PSMA-1007 and 68Ga-PSMA-11 for detection of intraprostatic lesions. The McNemar test was used to assess agreement between intraprostatic PET/CT findings and histopathologic findings. Sensitivity, specificity, positive predictive value, and negative predictive value were reported for each radiotracer. SUVmax was measured for all lesions, and tumor-to-background activity was calculated. Areas under receiver-operating-characteristic curves were calculated for discriminating diseased from nondiseased prostate segments, and optimal SUV cutoffs were calculated using the Youden index for each radiotracer. Results: PSMA-avid lesions in the prostate were identified in all 16 patients with an almost perfect concordance between the 2 tracers ( ranged from 0.871 to 1). Aside from the dominant intraprostatic lesion, similarly detected by both radiotracers, a second less intense positive focus was detected in 4 patients only with 18F-PSMA-1007. Three of these secondary foci were confirmed as Gleason grade 3 lesions, whereas the fourth was shown on pathologic examination to represent chronic prostatitis. Conclusion: This pilot study showed that both 18F-PSMA-1007 and 68Ga-PSMA-11 identify all dominant prostatic lesions in patients with intermediate- or high-risk PCa at staging. 18F-PSMA-1007, however, may detect additional low-grade lesions of limited clinical relevance.




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Cholecystokinin 2 Receptor Agonist 177Lu-PP-F11N for Radionuclide Therapy of Medullary Thyroid Carcinoma: Results of the Lumed Phase 0a Study

Treatment of patients with advanced medullary thyroid carcinoma (MTC) is still a challenge. For more than 2 decades, it has been known that the cholecystokinin 2 receptor is a promising target for the treatment of MTC with radiolabeled minigastrin analogs. Unfortunately, kidney toxicity has precluded their therapeutic application so far. In 6 consecutive patients, we evaluated with advanced 3-dimensional dosimetry whether improved minigastrin analog 177Lu-DOTA-(d-Glu)6-Ala-Tyr-Gly-Trp-Nle-Asp-PheNH2 (177Lu-PP-F11N) is a suitable agent for the treatment of MTC. Methods: Patients received 2 injections of about 1 GBq (~80 μg) of 177Lu-PP-F11N with and without a solution of succinylated gelatin (SG, a plasma expander used for nephroprotection) in a random crossover sequence to evaluate biodistribution, pharmacokinetics, and tumor and organ dosimetry. An electrocardiogram was obtained and blood count and blood chemistry were measured up to 12 wk after the administration of 177Lu-PP-F11N to assess safety. Results: In all patients, 177Lu-PP-F11N accumulation was visible in tumor tissue, stomach, and kidneys. Altogether, 13 tumors were eligible for dosimetry. The median absorbed doses for tumors, stomach, kidneys, and bone marrow were 0.88 (interquartile range [IQR]: 0.85–1.04), 0.42 (IQR: 0.25–1.01), 0.11 (IQR: 0.07–0.13), and 0.028 (IQR: 0.026–0.034) Gy/GBq, respectively. These doses resulted in median tumor-to-kidney dose ratios of 11.6 (IQR: 8.11–14.4) without SG and 13.0 (IQR: 10.2–18.6) with SG; these values were not significantly different (P = 1.0). The median tumor-to-stomach dose ratio was 3.34 (IQR: 1.14–4.70). Adverse reactions (mainly hypotension, flushing, and hypokalemia) were self-limiting and not higher than grade 1. Conclusion: 177Lu-PP-F11N accumulates specifically in MTC at a dose that is sufficient for a therapeutic approach. With a low kidney and bone marrow radiation dose, 177Lu-PP-F11N shows a promising biodistribution. The dose-limiting organ is most likely the stomach. Further clinical studies are necessary to evaluate the maximum tolerated dose and the efficacy of 177Lu-PP-F11N.




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Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

Posttreatment high-grade gliomas are usually monitored with contrast-enhanced MRI, but its diagnostic accuracy is limited as it cannot adequately distinguish between true tumor progression and treatment-related changes. According to recent Response Assessment in Neuro-Oncology recommendations, PET overcomes this limitation. However, it is currently unknown which tracer yields the best results. Therefore, a systematic review and metaanalysis were performed to compare the diagnostic accuracy of the different PET tracers in differentiating tumor progression from treatment-related changes in high-grade glioma patients. Methods: PubMed, Web of Science, and Embase were searched systematically. Study selection, data extraction, and quality assessment were performed independently by 2 authors. Metaanalysis was performed using a bivariate random-effects model when at least 5 studies were included. Results: The systematic review included 39 studies (11 tracers). 18F-FDG (12 studies, 171 lesions) showed a pooled sensitivity and specificity of 84% (95% confidence interval, 72%–92%) and 84% (95% confidence interval, 69%–93%), respectively. O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET) (7 studies, 172 lesions) demonstrated a sensitivity of 90% (95% confidence interval, 81%–95%) and specificity of 85% (95% confidence interval, 71%–93%). For S-11C-methyl)-l-methionine (11C-MET) (8 studies, 151 lesions), sensitivity was 93% (95% confidence interval, 80%–98%) and specificity was 82% (95% confidence interval, 68%–91%). The numbers of included studies for the other tracers were too low to combine, but sensitivity and specificity ranged between 93%–100% and 0%–100%, respectively, for 18F-FLT; 85%–100% and 72%–100%, respectively, for 3,4-dihydroxy-6-18F-fluoro-l-phenylalanine (18F-FDOPA); and 100% and 70%–88%, respectively, for 11C-choline. Conclusion: 18F-FET and 11C-MET, both amino-acid tracers, showed a comparably higher sensitivity than 18F-FDG in the differentiation between tumor progression and treatment-related changes in high-grade glioma patients. The evidence for other tracers is limited; thus, 18F-FET and 11C-MET are preferred when available. Our results support the incorporation of amino-acid PET tracers for the treatment evaluation of high-grade gliomas.




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SNMMI Leadership Update: To the SNMMI-TS: Congratulations on 50 Years of Dedicated Service to SNMMI and Your Patients




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Future Leaders of SNMMI and SNMMI-TS




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Fibrotic Encapsulation Is the Dominant Source of Continuous Glucose Monitor Delays

Continuous glucose monitor (CGM) readings are delayed relative to blood glucose, and this delay is usually attributed to the latency of interstitial glucose levels. However, CGM-independent data suggest rapid equilibration of interstitial glucose. This study sought to determine the loci of CGM delays. Electrical current was measured directly from CGM electrodes to define sensor kinetics in the absence of smoothing algorithms. CGMs were implanted in mice, and sensor versus blood glucose responses were measured after an intravenous glucose challenge. Dispersion of a fluorescent glucose analog (2-NBDG) into the CGM microenvironment was observed in vivo using intravital microscopy. Tissue deposited on the sensor and nonimplanted subcutaneous adipose tissue was then collected for histological analysis. The time to half-maximum CGM response in vitro was 35 ± 2 s. In vivo, CGMs took 24 ± 7 min to reach maximum current versus 2 ± 1 min to maximum blood glucose (P = 0.0017). 2-NBDG took 21 ± 7 min to reach maximum fluorescence at the sensor versus 6 ± 6 min in adipose tissue (P = 0.0011). Collagen content was closely correlated with 2-NBDG latency (R = 0.96, P = 0.0004). Diffusion of glucose into the tissue deposited on a CGM is substantially delayed relative to interstitial fluid. A CGM that resists fibrous encapsulation would better approximate real-time deviations in blood glucose.




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Evidence of Tissue Repair in Human Donor Pancreas After Prolonged Duration of Stay in Intensive Care

M2 macrophages play an important role in tissue repair and regeneration. They have also been found to modulate β-cell replication in mouse models of pancreatic injury and disease. We previously reported that β-cell replication is strongly increased in a subgroup of human organ donors characterized by prolonged duration of stay in an intensive care unit (ICU) and increased number of leukocytes in the pancreatic tissue. In the present study we investigated the relationship between duration of stay in the ICU, M2 macrophages, vascularization, and pancreatic cell replication. Pancreatic organs from 50 donors without diabetes with different durations of stay in the ICU were analyzed by immunostaining and digital image analysis. The number of CD68+CD206+ M2 macrophages increased three- to sixfold from ≥6 days’ duration of stay in the ICU onwards. This was accompanied by a threefold increased vascular density and a four- to ninefold increase in pancreatic cells positive for the replication marker Ki67. A strong correlation was observed between the number of M2 macrophages and β-cell replication. These results show that a prolonged duration of stay in the ICU is associated with an increased M2 macrophage number, increased vascular density, and an overall increase in replication of all pancreatic cell types. Our data show evidence of marked levels of tissue repair in the human donor pancreas.




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{beta}-Cell Stress Shapes CTL Immune Recognition of Preproinsulin Signal Peptide by Posttranscriptional Regulation of Endoplasmic Reticulum Aminopeptidase 1

The signal peptide of preproinsulin is a major source for HLA class I autoantigen epitopes implicated in CD8 T cell (CTL)–mediated β-cell destruction in type 1 diabetes (T1D). Among them, the 10-mer epitope located at the C-terminal end of the signal peptide was found to be the most prevalent in patients with recent-onset T1D. While the combined action of signal peptide peptidase and endoplasmic reticulum (ER) aminopeptidase 1 (ERAP1) is required for processing of the signal peptide, the mechanisms controlling signal peptide trimming and the contribution of the T1D inflammatory milieu on these mechanisms are unknown. Here, we show in human β-cells that ER stress regulates ERAP1 gene expression at posttranscriptional level via the IRE1α/miR-17-5p axis and demonstrate that inhibition of the IRE1α activity impairs processing of preproinsulin signal peptide antigen and its recognition by specific autoreactive CTLs during inflammation. These results underscore the impact of ER stress in the increased visibility of β-cells to the immune system and position the IRE1α/miR-17 pathway as a central component in β-cell destruction processes and as a potential target for the treatment of autoimmune T1D.




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Maternal Type 1 Diabetes Reduces Autoantigen-Responsive CD4+ T Cells in Offspring

Autoimmunity against pancreatic β-cell autoantigens is a characteristic of childhood type 1 diabetes (T1D). Autoimmunity usually appears in genetically susceptible children with the development of autoantibodies against (pro)insulin in early childhood. The offspring of mothers with T1D are protected from this process. The aim of this study was to determine whether the protection conferred by maternal T1D is associated with improved neonatal tolerance against (pro)insulin. Consistent with improved neonatal tolerance, the offspring of mothers with T1D had reduced cord blood CD4+ T-cell responses to proinsulin and insulin, a reduction in the inflammatory profile of their proinsulin-responsive CD4+ T cells, and improved regulation of CD4+ T cell responses to proinsulin at 9 months of age, as compared with offspring with a father or sibling with T1D. Maternal T1D was also associated with a modest reduction in CpG methylation of the INS gene in cord blood mononuclear cells from offspring with a susceptible INS genotype. Our findings support the concept that a maternal T1D environment improves neonatal immune tolerance against the autoantigen (pro)insulin.




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Artificial intelligence versus clinicians: systematic review of design, reporting standards, and claims of deep learning studies




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Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial




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Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study




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Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017




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Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study




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Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials




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Infectious diseases in children and adolescents in China: analysis of national surveillance data from 2008 to 2017




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Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal




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Use of electronic medical records in development and validation of risk prediction models of hospital readmission: systematic review




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Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden




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Prospective registration and reporting of trial number in randomised clinical trials: global cross sectional study of the adoption of ICMJE and Declaration of Helsinki recommendations




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Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study




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Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study




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Term complications and subsequent risk of preterm birth: registry based study




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Use of sodium-glucose co-transporter 2 inhibitors and risk of serious renal events: Scandinavian cohort study




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Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis




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Association between tax on sugar sweetened beverages and soft drink consumption in adults in Mexico: open cohort longitudinal analysis of Health Workers Cohort Study




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Use of genetic variation to separate the effects of early and later life adiposity on disease risk: mendelian randomisation study




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Prognosis of unrecognised myocardial infarction determined by electrocardiography or cardiac magnetic resonance imaging: systematic review and meta-analysis




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Conrad George and André Sheckleford | Incorrect layoff procedures can lead to future liability

OP-CONTRIBUTION: EMPLOYMENT CONTRACTS The COVID-19 pandemic is hitting businesses and the economy in a manner perhaps not seen since the Second World War. This, of course, has affected the ability of employers to pay their employees. The COVID-19...




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Starbucks operator Caribbean Coffee floats US$30m bond

Caribbean Coffee Traders Limited, CCTL, is moving ahead with plans for a US$30-million bond placement, the proceeds from which it will likely use to expand the Starbucks chain it operates in three regional markets. The initial franchise agreement...




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Playa to cut Jamaican room count 40% with sale of two Jewels

The sale of two Jewel properties will inject US$60 million into loss-making Playa Resorts while reducing the hotel rooms it operates in Jamaica by more 40 per cent. Playa announced the sale of Jewel Runaway Bay Beach Resort...




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BCIC offers partial refund on April premiums

 British Caribbean Insurance Company Limited, BCIC, will refund a portion of April’s premium to holders of its public passenger vehicle, PPV, and Diamond Max private motor insurance next week. The move, which is expected to cost BCIC...




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Why We Build Walls: 30 Years After the Fall of the Berlin Wall

8 November 2019

Robin Niblett

Director and Chief Executive, Chatham House

Gitika Bhardwaj

Editor, Communications & Publishing, Chatham House
Robin Niblett talks to Gitika Bhardwaj about the physical and psychological significance of border walls and their role in politics today.

GettyImages-1184642325.jpg

Part of the Berlin Wall still standing today. 9 November marks the 30th anniversary of the fall of the Berlin Wall that soon led to the collapse of the communist East German government. Photo: Getty Images.

This year marks the 30th anniversary of the fall of the Berlin Wall. The wall, which stood between 1961 to 1989, came to symbolize the ‘Iron Curtain’ – the ideological split between East and West – that existed across Europe and between the two superpowers, the US and the Soviet Union, and their allies, during the Cold War. How significant was the Berlin Wall during the Cold War – was it more important physically or psychologically?

The Berlin Wall was important physically, as well as psychologically, because Berlin was the only city that was divided physically by the Cold War between the Soviet Union and its allies in the Eastern Bloc and the West.

Given the disparity that quickly emerged between the two sides in economic wealth, freedom of expression and so on, the fear was that, without that wall, there would've been a unification of Berlin in a way that the Soviet side would have lost.

But it was also very important psychologically because it became the symbol of the division between two ideologies that saw each other as inimical to each other.

That meant that if you wanted to visualize the Cold War, and the separation between the capitalist, democratic system of the West and the communist, command-and-control system of the East, Berlin offered a place where you could physically walk from one world, through a checkpoint, into the other. The whole Cold War could be reduced to this one nexus point.

Because of its psychological as well as its physical significance, the fall of the Berlin Wall quickly became the symbol of the collapse of the communist ideology it had shielded.

Since the fall of the Berlin Wall, European countries have reportedly built over 1,000 kilometres of walls – the equivalent of more than six times the total length of the Berlin Wall – along their borders.

Why has Europe been building more walls and how effective have they been? Have they been used more as symbols to appeal to political bases, and if so, has it worked with voters?

The walls that have been built in Europe recently have been for a very specific reason. This was the huge influx of migrants and refugees to Europe in 2015, through what was called the ‘eastern Mediterranean’ or ‘western Balkan route’, from Turkey to Greece and on through the Balkans, Serbia and Hungary to northern Europe – in what was Europe's biggest migrant and refugee crisis since the Second World War.

What’s interesting is that for Viktor Orbán and the Hungarian government, which was on the frontline of the flow of migrants and refugees, building a wall was a way of reasserting its sovereignty. 

Like many other countries along the ‘migrant route’, they resented that the rules under which people could migrate into Europe were flouted by northern European governments which were willing to accept large numbers of migrants and refugees.

By accepting them, they kept attracting more, and so Orbán was worried that, at some point, Germany might say ‘We can’t take anymore’ and they’d be left in Hungary.

It’s important to remember that the communist states of central and eastern Europe were kept in aspic by the Soviet Union – they existed in a hermetically sealed environment without immigration. As a result, they didn’t experience the rise of multicultural societies of the sort that emerged in Britain, Belgium, France and Germany, where immigration persisted throughout the Cold War period.

The countries of central and eastern Europe were delighted that the Berlin Wall collapsed because it allowed them to unify with western Europe. They had been vassal states of the Soviet Union during the Cold War, and by joining the EU, they re-discovered personal freedom and re-gained national sovereignty. They thought they had become masters of their own future again.

But they suddenly found they were on the frontline of a new movement of people that wanted to get into the same world that they’d entered some 15 years earlier. And, as hundreds of thousands of migrants and refugees began arriving, they suddenly realised they were in a union that did not respect their sovereignty.

So, for them, putting up walls was a sovereign act against a European Union that didn’t seem to take their sovereignty seriously.

Has it worked? Definitely. The flow of migrants has been reduced drastically. This is partly because the EU paid Turkey to hold back the over three million migrants based there. But the walls also acted as a physical and psychological deterrent. 

It also worked politically. It allowed Viktor Orbán and other European parties that took the sovereigntist line to strengthen their appeal to voters – voters like to know that governments can do certain things like protecting them and their borders.

What is hypocritical, however, is that many of the governments in western Europe which criticized the Hungarian government for building its wall have actually been rather grateful that they did so as it slowed down the flow of migrants to their countries.

Then there’s the additional hypocrisy of the EU criticizing Donald Trump for building his wall with Mexico when Europeans are benefitting from theirs in Hungary.

Two years before the fall of the Berlin Wall, former US president Ronald Reagan challenged Soviet leader Mikhail Gorbachev to ‘tear down this wall’ declaring ‘across Europe this wall will fall. For it cannot withstand [freedom].’

32 years later, building a wall along the US–Mexico border has become a cornerstone of the current US administration under Donald Trump who has pledged to build a ‘big beautiful wall’. How does this reflect the political evolution of the US and what effect does that have across the rest of the world?

President Reagan talked about tearing down the Berlin Wall as a symbol of the Cold War. He knew that the fall of the wall would undermine the Soviet Union. 

President Trump is way beyond the Cold War. Building a new wall is his response to the growing sense of economic dislocation that segments of America, like Britain and other parts of Europe and the developed world, have experienced on the back of the rise of globalization, which was partly the result of the end of the Cold War but also the rise of China.

The spread of globalization, the declining earning power of many workers in the West, advances in technology which have taken away many high-earning jobs, the eight years of austerity after the global financial crisis – these are all factors driving Trump’s thinking. 

Have inflows of Mexican immigrants or immigrants through the Mexico border been the principal driver of economic insecurity?  No.  What you’ve got is Trump promising to build a wall as a symbol of his administration’s determination to protect Americans.

So I’d say the US–Mexico wall is another symbolic – or psychological – wall. Trump’s wall is supposedly about stopping illegal immigration but there are still plenty of ways to come through the border posts. It’s principally an exercise in political theatre.

Construction site for a secondary border fence, following the length of the current primary border fence, separating the US and Mexico in San Diego. Photo: Getty Images.

From the Great Wall of China to Hadrian’s Wall, walls and fences of all sorts have been used throughout history for defence and security, but not all of them have been physical.

So-called ‘maritime walls’, as well as ‘virtual walls’, are also increasingly being enforced which, today, includes border forces patrolling seas and oceans, such as in the Mediterranean Sea or off the coasts of Australia, and border control systems controlling the movement of people. Politically how do these types of barriers compare to physical ones?

You could argue that the Mediterranean Sea, and the European border forces operating within it, still act as a physical wall because they constitute a physical obstacle to migrants being able to move from the South across the Mediterranean Sea into Europe. 

So I don’t see this maritime wall being much different to the physical walls that have been built to try to stop migrants – just like any other border patrol, the Italian navy is preventing NGO vessels carrying migrants, who have been stranded at sea from docking at Italian ports. 

In this sense, you could argue that the Mediterranean Sea is a larger version of the Rio Grande between the US and Mexico which also incorporates physical barriers along its shores.

I think the more interesting walls that are being built today are virtual walls such as regulatory walls to trade, or with the internet, new barriers are being built to digital communication which affect your capacity to access information. 

In the end, all these walls are manifestations of national sovereignty through which a government demonstrates it can ‘protect’ its citizens – whether they are successful in this objective or not.

The border between Ireland and Northern Ireland, and the presence of enforcement mechanisms along the border, has become a key issue in the Brexit negotiations. How much of the debate over this is about the symbolism of the border against its economic implications?

The Irish border carries great symbolic importance because it reflects the reality of the separation of two sovereign states.

On the island of Ireland, the British and Irish governments have wanted to minimize this reality to the greatest extent possible. They even went as far as removing all types of barriers as part of the Good Friday Agreement.

This is the same sort of fiction the European Union created when it removed any physical manifestations of the existence of borders between those member states in its Schengen agreement on borderless travel.

By removing physical manifestations of the border, the UK was able to reduce some of the popular support for Irish unification as well as support for the IRA’s campaign of violence and terrorism to try to force the same outcome. 

Brexit has thrown a huge spanner into this arrangement. If Brexit is going to mean the entire UK not being in the EU’s customs union then some sort of border would need to be reinstated.

The British government proposed to do all the checks behind the border somewhere. The EU’s view was, ‘Well, that’s nice for you to say, but this border will become the EU’s only land border with the UK, and you cannot guarantee that people won’t be able to smuggle things through.’

On the other hand, recreating a border of some sort, whether physical or not, would reignite the differentiation between the two nations – running counter to the spirit of the Good Friday Agreement.

The only solution available to Prime Minister Boris Johnson has been to put the border down the Irish Sea.  While this means that Northern Ireland will no longer be an obstacle to the UK signing new, post-Brexit, free trade agreements with other countries, it has betrayed the Conservative Party’s unionist allies, for whom it’s essential that the UK’s borders include and not exclude them. 

By the end of the Cold War there were just 15 walls and fences along borders around the world, but today, there are at least 70. How effective, do you think, building barriers are as a political and military strategy to defence and security issues given their financial – and human – cost?

Physical barriers can be an effective form of protection – or imprisonment. 

The separation wall between Israel and the Palestinian territories has reduced the level of terrorist violence being perpetrated in Israel, but the cost has been the impoverishment of many Palestinians, and is another nail in the coffin of a two-state solution.

Yet many Israelis are saying that, maybe, being entirely separate is the best way to achieve peace between the two sides.

However, the walls around the Gaza Strip have not prevented, for various reasons, the Hamas government from developing rockets and firing them into Israel.   

You could argue that the border between China and North Korea, which is severely patrolled, has been a tool of continued political control protecting the Kim Jong-un regime from collapse – as has its virtual border preventing internet penetration.

Similarly, the virtual border the Chinese government has created around its own internet, the ‘great firewall’, has been very effective both economically – allowing Chinese internet platforms to develop without the threat of competition – and also as a form of political control that helps the Chinese Communist Party retain its monopoly on power. 

So walls in all of their shapes and forms can work. They are like sanctions – sanctions are easy to impose but difficult to remove. Walls are easy to build but they’re difficult to break down. 

But my view would be that they still only work temporarily. In the end, walls serve their particular purpose for a particular period, like the Berlin Wall, they end up outliving their purpose.

You have to be alive to the fact that, whether that purpose was a good or bad purpose, there will be a moment when walls end up protecting the interests of an ever-narrower number of people inside the wall, while they cease serving, if they ever did, the interests of the growing number on both sides. 

It’s ironic that the fall of the Berlin Wall in November 1989 was not the main marker of the end of the Cold War. It began earlier that year, with the intensification of people protesting in Poland, Hungary and Czechoslovakia.

Once Hungarian troops dismantled the fence separating them from Austria in May 1989, thousands of Hungarian citizens simply walked out of their country, because by then, the wall between the East and West only existed in their minds.

Then, once East Germans also realized that Mikhail Gorbachev and the Soviet regime had lost its willingness to defend the Berlin Wall, it collapsed. 

So it is interesting that we’re marking the end of the Cold War with this anniversary of the fall of the Berlin Wall, which of course, did divide two halves of one country, making its fall all the more poignant and powerful. But the end of the Cold War really began with the fall of the invisible wall in people’s minds.




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How Can the EU Learn the Language of Power?

3 December 2019

Vassilis Ntousas

Stavros Niarchos Foundation Academy Fellow, Europe Programme
The new EU foreign policy chief, Josep Borrell, has an eye-catching declaration of intent. But what does it mean in practice?

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High Representative of the Union for Foreign Policy and Security Policy Josep Borrell answers the questions of members of the European Parliament in Brussels in October. Photo: Getty Images.

The new European Commission has finally started its work this week. In a world increasingly defined by great power competition and deprived of the certainties of a strong transatlantic partnership, this might well be the first commission where foreign and security policy issues will be equally important to internal EU ones.

Amid an escalating Sino-American rivalry, there is a growing realization in Brussels that something has to change in the way the EU thinks and acts internationally.

Charting a more successful path forward will not be easy. Josep Borrell, the EU’s new high representative for foreign affairs and security policy, during his confirmation hearing, offered a hint as to what might be needed to get there: ‘The EU has to learn to use the language of power.”’

What might this mean in practice?

Four issues illustrate some of the key dilemmas ahead for the EU and its new executive.

Hard power

The most revealing of these concerns hard power.

For a union so addicted to the US security guarantee, and so used to the softer approaches of exercising its influence, this was always going to be a difficult discussion. The recent disagreement between Germany and France over the future of NATO gave a taste of how fraught and complex this discussion can be.

Underpinning it are three fundamental questions. If the EU has to enhance its capacity to defend its interests with military power, how (and how quickly) is it to move ahead, how much additional responsibility will that mean and to what degree will this responsibility need to be shouldered autonomously, potentially distancing itself from NATO or Washington? Moving forward with this agenda while balancing the competing interests of member states and preserving the fragile progress already achieved with initiatives such as PESCO will not be easy.

Discussion and debate among member states should not be discouraged, but the new commission has a role to play in ensuring that such discussion is constructive. Distracting talks about an EU army or a nuclear ‘Eurodeterrent’ should be shelved, with the focus as much as possible on acquiring tangible capabilities, getting the defence architecture right, ensuring operational readiness and spending defence budgets smartly.

How to use power

Great powers have traditionally been able to cooperate in certain areas while competing in others. Given their wide reach, powers like the US have generally not allowed disagreement on one issue to interfere with the ability to work together on others.

If the EU aspires to be a more assertive global player, it will need to grow comfortable with this compartmentalization. For example, if Brussels wants to stand up to Beijing regarding human rights, the South China Sea or issues of acquisition of European infrastructure, this should not mean that cooperation on areas such as peacekeeping, arms control or climate change needs to be blocked.

Footing the bill

Ursula von der Leyen, the new commission president, has announced that she wants an increase of 30% for external action in the 2021–27 Multi-annual Financial Framework (the EU budget). But with the Brexit budget gap looming, and little appetite to increase contributions or reduce the funds allocated to costly schemes, like the Common Agricultural Policy, compromises will have to be made for this to happen.

This will be one of the first key tests for the new commission. Power costs money, not just gestures, and therefore specific commitments already made under the Juncker mandate regarding the European Defence Fund or the new Neighbourhood, Development and International Cooperation Instrument need to be guaranteed, if not expanded.

Internal politics

None of these steps are possible if the internal workings of the EU become too dysfunctional. A stronger stance internationally would make the sometime incoherence of internal EU management more of a liability to the bloc’s credibility. For example, how can the EU advocate for the rule of law beyond its borders while some of its own member states violate the same principles? 

And there remains the perpetual question of how much more power member states are willing to cede – if any – to deliver faster and more efficient decision-making. If the bloc’s reflexes – often slow, consensual and risk averse – are out of place with the role of a modern great power, how does the commission envision introducing decision-making mechanisms, like qualified majority voting, in foreign and security policy matters?

Borrell’s résumé shows his extensive experience in handling critical policy dossiers. He is also expected to travel less than his predecessor, being mindful of the even heavier institutional work ahead, not least in working with a more politically fragmented European Council and a more politicized European Parliament.

Ultimately, learning the language of power might mean that the EU finally deals with the basics of international affairs as a coherent and cohesive actor, rather than as an occasional ensemble. This endeavour clearly lacks a fixed path or destination. But the new commission seems to be mindful that the EU will have to find new ways to use power as the world changes around it. In doing so, it should keep in mind that the language of power is best articulated not with words, but with actions.




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Don’t Be Afraid of Political Fragmentation

16 December 2019

Pepijn Bergsen

Research Fellow, Europe Programme
If managed correctly, splintering and more volatile political systems – so-called ‘Dutchification’ – need not be a ticket to political and policy paralysis.

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Voters cast their vote as part of the Dutch general elections on March 15, 2017 at a polling station in a mill in Oisterwijk. Photo by ROB ENGELAAR/AFP via Getty Images.

In recent decades, political party systems across Europe have fragmented and electoral volatility has increased. The number of parties represented in parliaments across the continent has grown and the formerly dominant mainstream parties have seen their support base collapse, forcing parties into often uncomfortable and unstable coalitions.

From the United Kingdom to Germany, politicians and commentators talk of such scenarios in often apocalyptic terms and associate it with political instability and policy paralysis.

They shouldn’t. Instead they should focus their energy on making these increasingly competitive political markets work.

The Netherlands is frequently held up as a prime example of this process, which is therefore sometimes referred to as ‘Dutchification’. Its highly proportional political system has created the opportunity for new parties and specific interest groups to win parliamentary representation, ranging from an animal rights party and a party catering specifically to the interests of the elderly.

This has been accompanied by increased electoral volatility. In the 1970s, less than 15% of seats in the Dutch parliament would change party at any election, but in the last election in 2017, this was just over a quarter. The system also created space for the relatively early rise of populist far-right parties, though it was not the cause of their rise.

Nevertheless, despite the regularly difficult coalition politics, it remains one of the most well-governed countries in the world.

A short history of fragmentation

Looking at the effective number of parties represented in parliaments, the number of parties, corrected for their size, provides a good measure of the extent of fragmentation. In the Netherlands this steadily increased from around four in the 1980s to over eight following the election in 2017. Even the populist far-right vote has fragmented, with two parties partly competing for the same electorate. In other countries it has been a more recent phenomenon. Spain remained a de facto two-party system until the financial crisis. Dissatisfaction with both mainstream parties has seen challenger parties on both the left and the right attract significant support, making it harder to form stable coalitions. Political fragmentation decreased slightly in Italy in recent years, but that was from a high base as it shot up in the early 1990s when the post-war political settlement crumbled.

German politics, long a hallmark of stability, is struggling with the decrease in support for the parties that dominated its political scene in the post-war period. The Christian Democrats and Social Democrats only barely managed to win a majority together in the election in 2017, at 53.4% of the vote compared with the 81.3% achieved 30 years earlier. The latest polls suggest they would only get to 40% together if an election were held today.

A similar trend is visible within the European Parliament. Whereas the two largest groups in the European Parliament, the Christian Democrats and the Social Democrats, together won 66% of the vote in the election in 1999, they did not even manage to win a majority together in 2019, taking just 39.5% of the vote.

No crisis of democracy

If electoral volatility and political fragmentation does indeed constitute some sort of crisis of democracy, we should expect to see voters become unhappy about how their national democracy functions. Largely, the opposite seems to be the case.

In the Netherlands, satisfaction with its democracy went up at the same time as Dutchification did its work. Similar trends are visible in other highly fragmented European political systems, often those with very proportional systems. Despite regular minority governments, satisfaction with democracy is above 90% in Denmark and at 80% in Sweden, according to the latest Eurobarometer data.

In comparison, it stood at 52% in the United Kingdom and 53% in France, where the electoral system has, at least on the surface, prevented the kind of fragmentation supposedly plaguing proportional systems.

Satisfaction with democracy seems to be affected by a number of factors. This includes the state of the economy, particularly in countries that were hit the hardest by the global financial and euro zone crises. Nevertheless, the data suggests that, even if we can’t say that Dutchification by definition leads to more satisfaction with democracy, it is clearly not associated with falling faith in the system.

A competitive political market

Dutchification should be seen as accompanying a more competitive political marketplace. A more emancipated, demanding and politically engaged electorate than in the post-war decades is willing to shop around instead of merely vote according to socioeconomic class or other dividing lines, such as religious ones. The fragmented parliaments that emerge as a result provide better representation of different groups within European societies.

This makes life harder for Europe’s political parties and politicians, as they juggle large coalitions, or changing coalitions under minority governments, but provides voters with more choice and democratic renewal. If handled correctly this would also allow more responsiveness to shifts in public opinion.

Such democratic creative destruction in competitive political markets is to be celebrated in a well-functioning democracy. Just as companies prefer to operate in an oligopoly, political parties prefer the stability of limited political competition. But wishing for this kind of stability comes perilously close to preferring stability over proper representation.

Worrying about Dutchification risks confusing a crisis of the traditional mainstream parties with a crisis of democracy. For some countries, particularly those like the Netherlands and Denmark which have longer histories of consensus-based politics and coalition building, this is an easier adjustment. But this should not be an excuse to not attempt to make politics work better as they were forced to go through, arguably still ongoing, adjustment processes too.

Instead of investing in futile attempts to get back to how things were in the old days, or hoping this will somehow magically happen, political leaders and parties across Europe need to reassess how they deal with the new reality of Dutchification.




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Britain’s Soft Power Potential: In Conversation with Penny Mordaunt

Members Event

5 February 2020 - 6:00pm to 7:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Penny Mordaunt MP, Member of Parliament for Portsmouth North; Secretary of State for Defence (2019); Secretary of State for International Development (2017-2019)

Chair: Thomas Raines, Director, Europe Programme, Chatham House

Drawing on her experience as secretary of state for defence and secretary of state for international development, Penny Mordaunt discusses how soft power can protect, promote and project Britain’s international interests and foreign policy agenda.

Often defined as the capacity to influence others without coercion or force, soft power differs from traditional military capabilities in favour of more subtle forms of influence rooted in values, culture and civic institutions.

Consistently upholding democratic values and human rights can contribute to a nation’s soft power as much as its cultural icons and legacies.  However, utilising soft power – the power of attractiveness – is not straightforward: the government is only part of a broad mix of institutions and actors with a role to play.

Can the UK develop a long term approach that brings together all of the components of its soft power for a common purpose?

What are the key sources of Britain’s soft power? How has Brexit affected perceptions of Britain internationally? And with the UK’s departure from the European Union now confirmed, how should we think about its soft power in the future?

Members Events Team




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Deepening Economic Ties? The Future of Africa-UK Trade and Investment

Corporate Members Event

25 February 2020 - 6:00pm to 7:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Raj Kulasingam, Senior Counsel, Dentons

Megan McDonald, Head of Investment Banking (International), Standard Bank Group

Chair: Dr Alex Vines OBE, Managing Director, Ethics, Risk & Resilience; Director, Africa Programme, Chatham House

Theresa May’s announcement in 2018 on the UK’s ambition to become the G7’s largest investor in Africa by 2022 has been followed by similar stated ambitions at the recent UK-Africa Investment Summit, which saw the attendance of 16 African heads of states. Such ambitions mirror overtures from various international players including a call for a ‘comprehensive strategy for Africa’ by the EU in 2019. While the UK’s recent expansion of its diplomatic networks in Africa and the signing of the Economic Partnership Agreement with the Southern African Customs Union and Mozambique appear promising, there are significant challenges to deepening partnerships including visa restrictions and complex business environments.
 
At this event, the panellists will assess the future of trade and investment relations between the UK and Africa. Amid a proliferation of new trading partners including Asia’s emerging economies, Russia and the Gulf states, what are the points of change and continuity in the long-standing relationship between Africa and the UK? And what are the challenges and opportunities facing governments and businesses in Africa and the UK in efforts to build long-lasting economic ties?
 
This event will be followed by a drinks reception.

This event is open to Chatham House Corporate Members and corporate contacts of Chatham House's Africa Programme only.

Not a member? Find out moreFor further information on the different types of Chatham House events, visit Our Events Explained.

 

 

Members Events Team




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The Future of Democracy in Europe: Technology and the Evolution of Representation

3 March 2020

To the extent that perceptions of a crisis in liberal democracy in Europe can be confirmed, this paper investigates the nature of the problem and its causes, and asks what part, if any, digital technology plays in it.

Hans Kundnani

Senior Research Fellow, Europe Programme

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A woman writes a note on the Savita Halappanavar mural in Dublin on 26 May 2018, following a referendum on the 36th amendment to Ireland’s constitution. The referendum result was overwhelmingly in favour of removing the country’s previous near-universal ban on abortion. Photo: Getty Images.

Summary

  • There is a widespread sense that liberal democracy is in crisis, but little consensus exists on the specific nature and causes of the crisis. In particular, there are three prisms through which the crisis is usually seen: the rise of ‘populism’, ‘democratic deconsolidation’, and a ‘hollowing out’ of democracy. Each reflects normative assumptions about democracy.
  • The exact role of digital technology in the crisis is disputed. Despite the widely held perception that social media is undermining democracy, the evidence for this is limited. Over the longer term, the further development of digital technology could undermine the fundamental preconditions for democracy – though the pace and breadth of technological change make predictions about its future impact difficult.
  • Democracy functions in different ways in different European countries, with political systems on the continent ranging from ‘majoritarian democracies’ such as the UK to ‘consensual democracies’ such as Belgium and Switzerland. However, no type seems to be immune from the crisis. The political systems of EU member states also interact in diverse ways with the EU’s own structure, which is problematic for representative democracy as conventionally understood, but difficult to reform.
  • Political parties, central to the model of representative democracy that emerged in the late 18th century, have long seemed to be in decline. Recently there have been some signs of a reversal of this trend, with the emergence of parties that have used digital technology in innovative ways to reconnect with citizens. Traditional parties can learn from these new ‘digital parties’.
  • Recent years have also seen a proliferation of experiments in direct and deliberative democracy. There is a need for more experimentation in these alternative forms of democracy, and for further evaluation of how they can be integrated into the existing institutions and processes of representative democracy at the local, regional, national and EU levels.
  • We should not think of democracy in a static way – that is, as a system that can be perfected once and for all and then simply maintained and defended against threats. Democracy has continually evolved and now needs to evolve further. The solution to the crisis will not be to attempt to limit democracy in response to pressure from ‘populism’ but to deepen it further as part of a ‘democratization of democracy’.




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Webinar: Challenges to Democracy: What is the Future of Democracy in Europe?

Members Event Webinar

30 March 2020 - 6:00pm to 7:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Dr Catherine Howe, Director, Democracy Society

Hans Kundnani, Senior Research Fellow, Europe Programme, Chatham House

Chair: Thomas Raines, Director, Europe Programme, Chatham House

PLEASE NOTE: THIS EVENT HAS BEEN CANCELLED.

There is a widespread sense that liberal democracy is in crisis but little consensus about how to understand it. While some attribute this crisis to the rise of populist figures, movements and parties, others see populism as a response to a deeper hollowing out of democracy during the last several decades. Some blame the development of digital technology – in particular the emergence of social media – while others argue that the correlation between the development of digital technology and the perceived corrosion of democracy is exaggerated or that it has facilitated greater participation in politics from traditionally under-represented demographics in a way that was not previously possible.

Launching the Chatham House research paper The Future of Democracy in Europe, this panel will discuss how liberal democracy is evolving against the background of social and technological change. What are the challenges to liberal democracy in Europe? How should we understand the impact of technology on how democracy in Europe functions? Given the plurality of democratic structures and institutions across the continent, how can democracy in Europe be reinvigorated? And what role can citizens' assemblies and referendums play in making democracy more responsive to citizens?

This event is open to Chatham House Members only. Not a member? Find out more.

For further information on the different types of Chatham House events, visit Our Events Explained.




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Webinar: European Union – The Economic and Political Implications of COVID-19

Corporate Members Event Webinar

26 March 2020 - 5:00pm to 5:45pm

Online

Event participants

Colin Ellis, Chief Credit Officer, Head of UK, Moody’s Investors Service
Susi Dennison, Director, Europe Power Programme, European Council of Foreign Relations
Shahin Vallée, Senior Fellow, German Council of Foreign Relations (DGAP)
Pepijn Bergsen, Research Fellow, Europe Programme, Chatham House

Chair: Hans Kundnani, Senior Research Fellow, Europe Programme, Chatham House


 

In the past few weeks, European Union member states have implemented measures such as social distancing, school and border closures and the cancellation of major cultural and sporting events in an effort to curb the spread of COVID-19. Such measures are expected to have significant economic and political consequences, threatening near or total collapse of certain sectors. Moreover, the management of the health and economic crises within the EU architecture has exposed tensions and impasses in the extent to which the EU is willing to collaborate to mitigate pressures on fellow member states.

The panellists will examine the European Union's response to a series of cascading crises and the likely impact of the pandemic on individual member states. Can the EU prevent an economic hit from developing into a financial crisis? Are the steps taken by the European Central Bank to protect the euro enough? And are member states expected to manage the crisis as best they can or will there be a united effort to mitigate some of the damage caused?  

This event is part of a fortnightly series of 'Business in Focus' webinars reflecting on the impact of COVID-19 on areas of particular professional interest for our corporate members.

Not a corporate member? Find out more.

 




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Coronavirus and the Future of Democracy in Europe

31 March 2020

Hans Kundnani

Senior Research Fellow, Europe Programme
The pandemic raises difficult questions about whether liberal democracies can adequately protect their citizens.

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Police officers wearing protective face masks patrol during coronavirus lockdown enforcement in Wroclaw, Poland. Photo by Bartek Sadowski/Bloomberg via Getty Images.

It is less than a month since we published our research paper on the future of democracy in Europe. But it feels like we now live in a different world. The coronavirus has already killed thousands of people in Europe, led to an unprecedented economic crisis and transformed daily life – and in the process raised difficult new questions about democracy.

The essence of our argument in the paper was that democracy in Europe should be deepened. But now there is a much more basic question about whether democracies can protect their citizens from the pandemic.

There has already been much discussion about whether authoritarian states will emerge stronger from this crisis than democracies. In particular, although the virus originated in China and the government initially seemed to struggle to deal with it, it was able to largely contain the outbreak in Hubei and deploy vast resources from the rest of the country to deal with it.

Come through the worst

China may have come through the worst of the health crisis – though a second wave of infections as restrictions are lifted is possible – and there have already been three times as many deaths in Italy, and twice as many in Spain, as in China (although there is increasing doubt about the accuracy of China’s figures).

However, it is not only authoritarian states that seem so far to have coped relatively well with the virus. In fact, some East Asian democracies appear to have done even better than China. At the time of writing South Korea, with a population of 51.5 million, has had only 144 death rates so far. Taiwan, with a population of nearly 24 million, has had only two deaths.

So rather than thinking in terms of the relative performance of authoritarian states and democracies, perhaps instead we should be asking what we in Europe can learn from East Asian democracies.

It is not yet clear why East Asian democracies were able to respond so effectively, especially as they did not all follow exactly the same approach. Whereas some quickly imposed restrictions on travel (for example, Taiwan suspended flights from China and then prohibited the entry of people from China and other affected countries) and quarantines, others used extensive testing and contact tracing, often making use of personal data collected from citizens.

Whatever the exact strategy they used, though, they did all act quickly and decisively – and the collective memory of the SARS outbreak in 2003 and other recent epidemics seems to have played a role in this. For example, following the SARS outbreak, Taiwan created a central epidemic command center. Europe, meanwhile, was hardly affected by SARS – and we seem to have assumed the coronavirus would be the same (although that does not quite explain why we were still so slow to react in February even after it was clear that the virus had spread to Italy).

However, while the relative success of East Asian democracies may have something to do with this recent experience of epidemics, it may also have something to do with the kind of democracies they are. It may be a simple matter of competence – the bureaucracy in Taiwan and South Korea may function better, and in particular in a more coordinated way, than in many European countries.

But it may also be more than that. In particular, it could be that East Asian democracies have a kind of 'authoritarian residue' that has helped in the initial response to this crisis. South Korea and Taiwan are certainly vibrant democracies – but they are also relatively new democracies compared to many in Europe. As a result, citizens may have a different relationship with the state and be more willing to accept sudden restrictions of freedoms, in particular on movement, and the use of personal data – at least in a crisis.

In that sense, the pandemic may be a challenge not to democracy as such but to liberal democracy in particular – in other words, a system of popular sovereignty together with guaranteed basic rights, such as including freedom of association and expression and checks and balances on executive power. There may now be difficult trade-offs to be made between those basic rights and security – and, after the experience of coronavirus, many citizens may choose security.

This brings us back to the issues we discussed in our research paper. Even before the coronavirus hit, there was already much discussion of a crisis of liberal democracy. In particular, there has been a debate about whether liberalism and democracy, which had long been assumed to go together, were becoming decoupled.

In particular, ‘illiberal democracies’ seemed to be emerging in many places including Europe (although, as we discuss in the paper, some analysts argue that the term is incoherent). This model of ‘illiberal democracy’ – in other words, one in which elections continue to be held but some individual rights are curtailed – may emerge stronger from this new crisis.

It is striking that Singapore – also seen as responding successfully to coronavirus – was seen as a paradigmatic ‘illiberal democracy’ long before Hungarian Prime Minister Viktor Orbán embraced the idea. In particular, there is little real opposition to the People’s Action Party, which has been in power since 1959.

Since this new crisis began, Orbán has gone further in suspending rights in Hungary. On March 11, he declared a state of emergency – as many other European countries have also done. But he has now gone further by passing legislation that allows him to govern by decree indefinitely and make it illegal to spread misinformation that undermines the government’s response to the pandemic. Clearly, this is a further decisive step in the deconsolidation of liberal democracy in Hungary.

So far, though, much of the discussion, particularly in the foreign policy world, has focused mainly on how to change popular perceptions that liberal democracies are failing in this crisis. For example, High Representative Josep Borrell, the European Union’s foreign minister, wrote last week of a 'battle of narratives'.

But this misses the point. It is not a matter of spinning the European model, but of taking seriously the substantial questions raised by the coronavirus about the ability of liberal democracies to adequately protect their citizens.




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Virtual Breakfast: Europe in the Age of COVID-19: Priorities and Debates

Invitation Only Research Event

6 May 2020 - 9:00am to 10:00am

Event participants

Duncan Robinson, Charlemagne Columnist; Brussels Bureau Chief, the Economist
Chair: Pepijn Bergsen, Research Fellow, Europe Programme, Chatham House

The new European Commission had a bold new agenda when it began its work in December 2019, with climate change, digital transformation and strengthening European democracy among its priorities. Less than six months later, the European continent is in the midst of the worst crisis since the second World War and business as usual has been taken over by crisis management.

Has COVID-19 monopolized the agenda in Brussels? What priorities are still on the table and what debates have fallen victim to the coronavirus? Is the current crisis reigniting and exacerbating existing faultlines in the EU or creating new ones?

Reflecting on his first four months as the Economist’s Charlemagne columnist, the speaker will share what decision-making in Brussels looks like during a pandemic and what debates are dominating conversations in the EU capital today.

Event attributes

Chatham House Rule

Alina Lyadova

Europe Programme Coordinator




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The multilevel identity politics of the 2019 Eurovision Song Contest

7 May 2020 , Volume 96, Number 3

Galia Press-Barnathan and Naama Lutz

This article uses the 2019 Eurovision Song Contest (ESC) that took place in Tel Aviv to explore how cultural mega-events serve both as political arenas and as tools for identity construction, negotiation and contestation. These processes of identity politics are all conducted across national–subnational–international–transnational levels. The hosting of mega-events fleshes out these multiple processes in a very strong manner. We first discuss the politics of hosting mega-events in general. We then examine the identity politics associated more specifically with the Eurovision Song Contest, before examining in depth the complex forms of identity politics emerging around the competition following the 2018 Israeli victory. We suggest that it is important to study together the multiple processes—domestic, international and transnational—of identity politics that take place around the competition, as they interact with each other. Consequently, we follow the various stakeholders involved at these different levels and their interactions. We examine the internal identity negotiation process in Israel surrounding the event, the critical actors debating how to use the stage to challenge the liberal, western, ‘normal’ identity Israel hoped to project in the contest and how other stakeholders (participating states, national broadcasting agencies, participating artists) reacted to them, and finally we examine the behaviour of the institution in charge, the European Broadcasting Union, and national governments. We contribute to the study of mega-events as fields of contestation, to the understanding of the complex, multilevel nature of national identity construction, negotiation and contestation in the current era, and more broadly to the role that popular culture plays in this context.




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Delivering Sustainable Food and Land Use Systems: The Role of International Trade

20 September 2019

This paper explores a set of core trade-related issues affecting the food and land use system, and proposes constructive ways forward in reconfiguring the global trading system towards delivering a more sustainable and healthy diet for all.

Bernice Lee OBE

Research Director; Executive Director, Hoffmann Centre for Sustainable Resource Economy

Christophe Bellmann

Associate Fellow, Hoffmann Centre for Sustainable Resource Economy, Chatham House

Jonathan Hepburn

Senior Policy Advisor, International Institute for Sustainable Development

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Aerial view of containers sitting stacked at Qingdao Port in the Shandong province of China. Photo by Han Jiajun/Visual China Group via Getty Images.
  • Meeting future global food security requirements is not just about quantity; it is also about meeting growing needs in a way that safeguards human as well as planetary health. But national priorities and policies often remain out of sync with aspirations for more sustainable and healthy food systems.
  • International trade and trade policies play an ambiguous role in the current food system. With 80 per cent of the world’s population depending on imports to meet at least part of their food and nutritional requirements, trade has a unique function in offsetting imbalances between supply and demand. However, in the absence of effective regulatory frameworks or pricing frameworks that internalize environmental, social or health costs, trade can exacerbate and globalize challenges associated with food production and land use trends such as deforestation, land degradation, greenhouse gas emissions, biodiversity loss and the shift to unhealthy diets.
  • Over the last two decades, trade in agricultural products (excluding intra-EU flows) has more than tripled in value, to reach $1.33 trillion. The geography of global food trade flows has also shifted, primarily towards South–South trade, which now accounts for roughly a quarter of total agricultural trade flows. The nature of global trade has changed drastically, with traditional exports such as wheat and coffee growing slowly at around 2 per cent per year, while products such as palm oil, fruit juice, soft drinks and other processed products have grown at 8 per cent or more annually.
  • This overall increase in trade in agricultural products raises questions about the growing utilization of resources, such as water or soil nutrients, that are embedded in those products through production and processing. Trade itself also causes negative environmental impacts, starting with greenhouse gas emissions associated with transport and storage. If the environmental cost associated with production and trade is not reflected in the final price of goods, trade may accelerate the depletion of resources or their unsustainable use.
  • It is critical to ensure that trade policy options pursued by producing and consuming countries alike will support a transition to more sustainable and healthier food and land use systems. The first step in addressing trade-related food systems challenges must involve rebuilding trust among policy actors. There is a need for new spaces for informal dialogue among actors, and ‘soft’ governance mechanisms that can help rebuild consensus on the best ways forward. Meeting these challenges also requires an appreciation of the complex interactions between sectoral policies (e.g. on water, land, food, etc.) and their multiple interfaces with trade policies. 
  • Conditioning the use of subsidies on their sustainability and/or health impacts encourages the delivery of essential public goods in ways that are consistent with sustainability and health goals. A first step therefore is the removal of perverse incentives (e.g. subsidies encouraging the overuse of fertilizers or pesticides or the overproduction of certain commodities, as well as certain biofuels subsidies) and replacing them with market-correcting subsidies.
  • Trade facilitation measures for fruits and vegetables that are aimed at easing transit at the border, by cutting unnecessary bureaucracy and reducing waiting times, can improve their availability, reduce costs and improve food quality and safety for consumers. Similarly, measures aimed at improving sustainable cold storage and upgrading value chains can support better diets and consumption by increasing the availability of fresh produce on markets, especially in developing countries.
  • A global food stamps programme developed through the G20 and facilitated by the UN’s food agencies could address purchasing power imbalances and tackle malnutrition in developing countries. If carefully designed, such ‘safety net’ schemes can not only contribute to improving calorific intakes but also help deliver more balanced and healthier diets. Careful attention must be given to how such a scheme would work in practice, building on experience to date with similar initiatives.
  • Integrating the notion of sustainable food and inputs trade in the post-2020 global biodiversity framework can help to deliver more sustainable and healthier food and land use systems. This could be achieved by likeminded countries introducing a set of goals or targets aimed at mitigating the role of trade in placing indirect pressure on biodiversity, and to encourage trade in biodiversity-based products including natural ingredients produced ethically and following sustainability principles and criteria.
  • An SDG-oriented agenda for agricultural trade is needed. It could be formed by countries seeking to remove perverse incentives, guaranteeing a safe harbour for market-correcting measures, clarifying existing rules and establishing plurilateral negotiations among subsets of the WTO membership, or sectoral approaches, to address specific challenges.
  • Greenhouse gas emissions resulting from trade need to be addressed. Governments could seek to achieve this through ensuring the carbon neutrality of existing and new trade deals, either by connecting carbon markets among contracting parties or by developing joint initiatives to tax international maritime and air transport emissions.




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Sino-Russian Gas Cooperation: Power of Siberia I and II and Implications for Global LNG Supplies

Invitation Only Research Event

27 November 2019 - 8:30am to 9:30am

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Professor Keun-Wook Paik, Associate Fellow, Energy, Environment and Resources Department, Chatham House
Chair: John Lough, Associate Fellow, Russia and Eurasia Programme, Chatham House

In a new event in the Sustainable Transitions series, the speaker will present an update of Sino-Russian gas cooperation.

To give a comprehensive account of their impact on global liquefied natural gas (LNG) supplies, he will discuss the following points:

  • Gas is scheduled to start flowing from the Power of Siberia I (POS) on 2 December 2019. But what is the background of development of POS 1 and what is its current status and prospects? 
  • What are the chances of exporting gas through the proposed Altai pipeline? Why is the Mongolia export route so significant? And how will it affect the Central Asian Republics and in particular Turkmenistan’s gas export to China? 
  • What are the implications of both POS I and Altai gas via Mongolia route in the context of global LNG supply?
  • What are the prospects for multilateral pipeline gas cooperation in northeast Asia?
  • What are the implications for other Arctic onshore LNG supply, in particular, for Novatek's Yamal LNG and Arctic LNG 1 and 2 to China on top of POS 1 and Altai gas?

Attendance at this event is by invitation only.

Event attributes

Chatham House Rule

Chloé Prendleloup




of

COP26 Diplomatic Briefing Series: Outcomes of COP25 and What It Means for 2020

Invitation Only Research Event

22 January 2020 - 4:30pm to 6:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

HE Raffaele Trombetta, Italian Ambassador to the UK, Co-Host, COP 26
Archie Young, UK Lead Climate Negotiator, Cabinet Office 
Peter Betts, Associate Fellow, Energy, Environment and Resources Department, Chatham House
Chair: Professor Tim Benton, Research Director, Energy, Environment and Resources, Chatham House  

The UK will host the 26th Conference of the Parties (COP26) in November 2020 in Glasgow. In the run up, Chatham House is organizing a monthly briefing series targeted to:

  • The diplomatic service based in London, in particular, staff of the London embassies who are reporting on climate change issues.
  • Senior UK government civil servants, officials and politicians engaged in climate change.
  • Academics, experts, business representatives and NGOs.

The first briefing in the series focuses on the results from COP25 held in Madrid in December 2019 and what this means for 2020.

This briefings series offer an opportunity to discuss, in an informal setting, the most pressing and complex climate issues of the day with UK and international government officials and experts.

Johanna Tilkanen

Project Manager, Energy, Environment and Resources Department

Event attributes

Chatham House Rule




of

Seventh Meeting of the New Petroleum Producers Discussion Group

Research Event

11 November 2019 - 9:00am to 15 November 2019 - 6:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

The seventh annual meeting of the New Petroleum Producers Discussion Group brings together people from the group's member countries. The meeting includes an international discussion, a national seminar and a range of policy-relevant courses which have been specially tailored to the priorities of the group. This year’s international discussion focused on ‘Building Capacity and Institutions’.

The New Petroleum Producers Discussion Group was first established in 2012 and provides a unique forum which brings together governments from over 30 new and prospective oil and gas producers to share their ideas and experiences. The group is jointly coordinated by Chatham House, the Commonwealth Secretariat, and the Natural Resource Governance Institute (NRGI).

This event was hosted by the Ministry of Energy of Uganda.