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Stephen Stedman joined CISAC in 1997 as a senior research scholar, and was named a senior fellow at FSI and CISAC and professor of political science (by courtesy) in 2002. He served as the center's acting co-director in 2002-03. Stedman is the former director of Stanford's Ford Dorsey Program in International Policy Studies and is a director of 'Managing Global Insecurity,' a joint project with Stanford, New York University and the Brookings Institution. 

Stedman's research addresses the future of international organizations and institutions, an area of study inspired by his work at the United Nations. In 2003, he was recruited to serve as the research director of the U.N. High-Level Panel on Threats, Challenges and Change. The panel was created by then U.N. Secretary-General Kofi Annan to analyze global security threats and propose far-reaching reforms to the international system. Upon completion of the panel's report, A More Secure World: Our Shared Responsibility, Annan asked Stedman to remain at the U.N. as an assistant secretary-general to help gain worldwide support in implementing the panel's recommendations. Following the U.N. world leaders' summit in September 2005, during which more than 175 heads of state agreed upon a global security agenda developed from the panel's work, Stedman returned to CISAC.

Before coming to Stanford, Stedman was an associate professor of African studies at the Johns Hopkins University School of Advanced International Studies in Washington, D.C. In 1993, he was a Fulbright Senior Research Scholar at the University of the Western Cape in South Africa, where he studied the negotiations for a new constitution. He was an election observer in Angola in 1992 and in South Africa in 1994. He has served as a consultant to the United Nations on issues of peacekeeping in civil war, light weapons proliferation and conflict in Africa, and preventive diplomacy.

Stedman has taught courses on international conflict management, war in the 20th century, and the Rwandan genocide. In 2000, Scott Sagan and he founded the CISAC Interschool Honors Program in International Security Studies. From 1997 to 2003, Stedman and his wife, Corinne Thomas, were the resident fellows in Larkin House, the second largest all-frosh residence. Stedman received his PhD in political science from Stanford in 1988.

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Stephen Stedman is a Freeman Spogli senior fellow at the Center on Democracy, Development, and the Rule of Law and FSI, an affiliated faculty member at CISAC, and professor of political science (by courtesy) at Stanford University. 

In 2011-12 Professor Stedman served as the Director for the Global Commission on Elections, Democracy, and Security, a body of eminent persons tasked with developing recommendations on promoting and protecting the integrity of elections and international electoral assistance. The Commission is a joint project of the Kofi Annan Foundation and International IDEA, an intergovernmental organization that works on international democracy and electoral assistance. In 2003-04 Professor Stedman was Research Director of the United Nations High-level Panel on Threats, Challenges and Change and was a principal drafter of the Panel’s report, A More Secure World: Our Shared Responsibility. In 2005 he served as Assistant Secretary-General and Special Advisor to the Secretary- General of the United Nations, with responsibility for working with governments to adopt the Panel’s recommendations for strengthening collective security and for implementing changes within the United Nations Secretariat, including the creation of a Peacebuilding Support Office, a Counter Terrorism Task Force, and a Policy Committee to act as a cabinet to the Secretary-General.  His most recent book, with Bruce Jones and Carlos Pascual, is Power and Responsibility: Creating International Order in an Era of Transnational Threats (Washington DC: Brookings Institution, 2009).

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Paul Wise is a clinical professor of pediatrics and a CHP/PCOR core faculty member. His work focuses on children's health policy; health disparities by race, ethnicity and socioeconomic status; and the interaction of genetics and the environment as these factors influence child and maternal health.

Before coming to Stanford in July 2004, he was a professor of pediatrics at Boston University and vice-chief of Social Medicine and Health Inequalities at Brigham and Women's Hospital. He previously served as director of emergency and primary care services at the Children's Hospital of Boston, and as director of the Harvard Institute for Reproductive and Child Health at Harvard Medical School. He has also served as a special expert at the National Institutes of Health and as special assistant to the U.S. Surgeon General.

Wise has worked to improve healthcare practices and policies in developing countries. He is involved in child health projects in India, South Africa and Latin America, targeting diseases such as tuberculosis and AIDS. He currently chairs the steering committee of the NIH's Global Network for Maternal and Child Health Research, and he has served on many other boards and committees including the Physicians' Task Force on Hunger and the American Academy of Pediatrics' Consortium on Health Disparities. He has received honors from organizations including the American Public Health Association, the March of Dimes, and the New York Academy of Medicine.

He received a BA in Latin American studies from Cornell University, an MD from Cornell University and an MPH from the Harvard School of Public Health. He completed a residency in pediatrics at Children's Hospital Medical Center in Boston.

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Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

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After the peaceful mass uprising that toppled one of the world's oldest autocracies, it is now possible to imagine the emergence of a genuine democracy in Egypt-the most important country in the Arab world. The very possibility of it marks an historic turning point for the entire region. However, there is a long and often treacherous distance between the demise of an authoritarian regime and the rise of a democracy.

With no experience of democracy in recent decades, and no apparent government leadership that is committed to bringing it about, Egypt's transition faces more formidable challenges than the transitions that led to democracy in recent decades in countries like Spain, Greece, Argentina, Brazil, Chile, the Philippines, Poland, South Africa, Indonesia, and Ukraine. (Which isn't to say these were easy: We forget how difficult each of these transitions seemed at the time, and how fraught they were with dangers and uncertainties.) With an energized civil society and deep resources of youthful talent, creativity, and mobilizing skill, Egypt has a real chance to get to democracy in the next few years. But doing so will require a keen analysis of the numerous potential traps that could sandbag the process.

The first trap is the Machiavellian opaqueness of the aging generals who are now running the country. Beginning with the Defense Minister (and now junta leader) Mohamed Tantawi, until a few days ago a close ally of the deposed President Mubarak, Egypt's new military rulers cannot be trusted to structure the political process and emergent rules in a way that will favor genuine democracy. Their principal goal, it appears, is to preserve as much of the old order as possible-Mubarakism without Mubarak (the father or the son). This means another round of the old shell game of Arab regimes-what Daniel Brumberg has called "liberalized autocracy." The process of liberalization-which runs in cycles, and which countries like Morocco and Jordan have seen many iterations of-institutes just enough change in the rules and faces to give the appearance of movement toward democracy without any of the dangers (for the ruling elite). But the changes, imposed from above, stop well short of the sweeping institutional transformations that would open wide the political arena (and the functioning of government) while leveling the playing field.

In their initial "communiqués," Egypt's ruling generals show signs of treading down this duplicitous path. Their initial choices have evinced the seductive veneer of democratic change but the closure and control of authoritarian continuity. To begin with, there appears so far to be little consultation with democratic forces in determining the character and pace of transition. Despite opposition demands, emergency rule remains in place, and so do many political prisoners. The military's initial decisions have been unilateral and preemptory. We learn there will be a constitution drafted within two months, followed by a referendum. A respected retired judge will head the process. This will produce "amendments" to the now-suspended authoritarian constitution. But what will be the role for Egyptian opposition and civil society in this process? What will be the scope down the road to draft a completely new, more democratic and legitimate constitution with broad popular participation and support? Will the president to be elected later this year serve another imperial six-year term, or be a caretaker heading a neutral government until a new constitution can be adopted and fresh elections held? At this point, if anyone knows the answers to these questions, it is only the junta.

The military is talking about early presidential and legislative elections, within six months. What could be more democratic than that? But, in fact, after the fall of a longstanding autocracy, it typically takes a lot longer than six months to organize competitive, free, and fair elections. Think of the steps. A neutral and independent electoral administration must be established. This requires not just legal authorization but also new leadership, and recruitment, training, funding, and deployment of new staff and equipment. If Egypt's generals intend to have elections administered by the same Ministry of Interior that shamelessly rigged the vote for Mubarak and his ruling National Democratic Party (NDP), that will be a sure sign that they do not intend to deliver democracy-or are too incompetent and cavalier to care. Then, the next step must be to produce a new register of voters. Experts believe only a quarter of eligible Egyptians are registered to vote today. The exclusion was very useful to perpetuating autocracy but could be deadly for an emerging democracy. That will take months, money, and far-reaching organization to do even reasonably well.

It will be one thing to elect a new president and quite another to choose a new parliament in Egypt's transitional flux. The military now suggests the two elections can be held together within six months. But they will have very different logics and requirements. A presidential election will be much simpler. The old order will no doubt throw up a somewhat more palatable face, perhaps the former Foreign Minister Amr Moussa. The democratic opposition may well rally behind a single candidate (though the regime, no longer able to exclude a democratic alternative, will probably try to fragment the field with as many opposition candidates as possible). Still, voters will be faced with a few principal choices for national leadership, and it won't matter where people vote, so long as they are of voting age and only vote once. This kind of election can be done more roughly and quickly, tossing aside the voter register and just dipping every forefinger in indelible ink after it has marked a ballot for one presidential candidate or another. It will be important in this election-and every future one-to ensure transparency and citizen monitoring of the vote, as well as to have Egypt's judiciary oversee the balloting (as it did in previous elections until the judges got too good at it and Mubarak cut them out). But, otherwise, a presidential election won't be a complicated affair.

By contrast, new parliamentary elections present formidable challenges. First, Egyptians (and hopefully not just the military) must decide what electoral system will be used. This choice can invoke arcane debate, but it may be one of the most important that Egypt makes in pursuit of democracy. If the electoral rules are "majoritarian," in that they make it hard for small minorities to get elected, they will work to the disadvantage of not just small ideological tendencies but also the welter of new, emerging parties and political forces-many of them liberal and secular-that will just be taking shape and starting to test their strength. This will inflate the strength of the only two political forces that now have effective political organizations on the ground-the old ruling party and the Muslim Brotherhood (with a smattering of some of the other older opposition parties). If Egypt retains the current electoral system of two-member districts (with each voter getting two votes), these two established political forces could sweep most of the seats between them, marginalizing the moderates, polarizing the parliament and political system, and dooming democracy from the start. Creating a liberal center in democratic politics requires more than moral and technical support for these parties to function; it also requires rules that enable them to get traction.

A much better-and fairer-alternative would be to elect the new parliament using some form of proportional representation, so that parties would win seats roughly in proportion to their vote shares. That way, new parties could begin to gain a foothold in the political process. Perhaps ironically, the best way to do this might be the way Iraq now does, by using the existing governorates (29 in Egypt) as multimember districts, and having each district then elect a share of seats equivalent to its share of the population. This would allow for very proportional results, with districts generally containing ten to 25 seats, while still enabling some accountability and candidate familiarity at the local level.

A truly democratic parliamentary election in Egypt cannot be pulled off in six months. In fact, it might require well over a year to prepare. But the alternative would be to rush to a vote with a flawed system that would leave Egypt's new democratic forces on the margins not just of legislating but of constitution-making as well.

How a new permanent constitution will be drafted-if it is even intended by the military-also remains a mystery at this point. The worst option would be to have a closed and hurried process dominated from above by the military. But that seems to be what the junta intends for the transitional period. Successful democratic transitions either use an expert but broadly representative constitutional drafting commission, and then a popular referendum to confirm the draft, or an elected constitutional assembly (often acting simultaneously as a parliament), possibly followed also by a popular referendum (as in Iraq). Some have used all of these methods combined. Experience of recent decades underscores the importance for future democratic legitimacy and stability of eliciting extensive public dialogue and broad popular participation in the constitution-making process, with adequate preparation and civic education and widespread media exposure, as in South Africa. A thorough, inclusive, and deliberate process of constitutional drafting and debate can also help to breed a more democratic culture at both the elite and mass levels. A rushed and closed process perpetuates authoritarian mentalities (and, often, authoritarian rules as well).

Prior to all of this is the most basic question of who writes the rules, the timetable, and the mode of transition. Egypt has now entered a classic transition game where the authoritarian regime and the democratic opposition have sharply different interests and little basis for cooperation and trust. As an institution, Egypt's military may not be hated the way Mubarak and his cronies were, but many of the generals were Mubarak's cronies. And the military's core interests are not freedom and democracy for the people, but preserving their own power, wealth, privilege, and impunity. The core lesson of numerous prior transitions is the need for a negotiated way out of this potentially fatal impasse. Democrats want democracy with no guarantees to autocrats. Autocrats want guarantees, with no real democracy.

There is an obvious generic compromise, and every successful negotiated transition-from Spain and Brazil to Poland, South Africa, and Indonesia-has settled on a version of it. The old order gets to hang on to most of its wealth and privilege, along with military autonomy at least for a time. Few, if any, henchmen of the old order are prosecuted for their past crimes, unless it is for the last, desperate excesses of a few diehards trying to hang on during the transition. Real accountability waits for a later day. Democrats get democracy. Autocrats (mostly) retain their wealth and influence, but they cannot bid for power unless they play the democratic game. The Yale political scientist Robert Dahl coined a term for this type of bargain. He called it "mutual security." From the Spanish transition on, the generic bargain became known as a political pact.

Only a negotiated pact between Egypt's surviving authoritarian regime and its emergent democratic forces can steer the transition through the current treacherous straits to calmer and freer waters. For that to happen, Egypt's disparate democratic forces must unify in a broad negotiating front that unites the "outside" opposition of the youthful movements with the "inside" opposition of the "wise persons" and established parties who have so far dominated, on an ad hoc basis, the discussions with the old order.

Opposition unity will give Egypt's democrats strategic leverage; if negotiations stall due to regime intransigence, then the unified opposition can more credibly threaten to turn out people by the millions again in protest. But, if negotiations move forward to ensure the essential conditions for a democratic transition-an end to emergency rule; freedom of organization, expression, and assembly; judicial independence; and new and fair electoral administration-then a unified opposition can guarantee social peace and political stability. Opposition coherence enables clear negotiating priorities to level the playing field and ensure a democratic transition. It will also give the old order a clear set of interlocutors who can credibly commit to deliver popular support behind a difficult compromise agreement. No condition is more important for a successful transition.

The role for the United States and other international actors is not to dictate terms for the transition or structures for the new political order. That is not our place, and Egyptians of every political stripe will resent it. But international actors should offer training to political parties and technical and financial assistance to the new civil society organizations and state institutions needed to make democracy work. For the United States., this will mean millions of dollars in new assistance for democracy in Egypt-but that is a trifle compared to the $68 billion we have invested in dictatorship (even if it was to buy peace). No less importantly, other democracies (including leaders of recent democratic transitions) can encourage Egypt's opposition groups to coalesce and share lessons of the strategies and choices that have led to democratic outcomes. And the Obama administration can make it clear to Egypt's military rulers that nothing less than a real transition to democracy-with broad consultation, serious negotiations, and a new climate of freedom-will return Egypt to stability and a lasting partnership with the United States.

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The central premise underlying Bussell's discussion this week is the reality that public service provision is often flawed in the developing world. Reforming public services entails significant efforts to increase the quality of public service, and there have been two important recent trends in this space: privatization and public-private partnerships and increased use of information and communication technologies (ICTs). The one-stop services model (which has been adopted globally in various forms, from Singapore's eCitizen Centre to Germany's Buergerbuero or "Citizen's Bureau"), exemplifies current trends.

In her research, which focuses primarily on the case of India, Bussell asks the following questions: why do or don't governments reform public service delivery? And when governments decide to implement reforms, why do they or don't they employ ICTs in these reforms?

The Indian strategy to public service reform has been to create stand-alone, one-stop citizen service centers. These centers are computerized and frequently have private-sector participation. Aside from these typical characteristics, there is significant state-level variation on several points, including timing of policy adoption, quantity and type of services, degree of automation, and ownership and management models.

Bussell discusses a variety of hypotheses that offer insight into the potential factors influencing the character of Indian reforms. First, she notes that politicians faced mixed electoral incentives for and against reforms. After all, there is evidence that eServices can improve service characteristics and reduce corruption. On the other hand, reforms may also reduce politicians' opportunities to amass funds to run for re-election. After all, bureaucratic discretion and opaque processes enable the siphoning of funds and bribe taking in service delivery. Politicians use "transfer authority" over bureaucrats to access bribes. More transparent services, due the implementation of reforms, threaten this access to bribes. At the same time, reform may also offer new opportunity for rents. Private partnerships to run centers entail new contracting processes. Larger-scale bribes may be available from ownership and management negotiation.

Based on these mixed direct and indirect incentives, Bussell predicts that reform will require expected net benefits to ruling politicians. States with higher petty corruption should implement policy reforms later. Meanwhile, states with higher grand corruption might lead to more partnerships with private sector.

So what factors actually explain variation in when different Indian states adopted reform? According to Bussell's research, the level of corruption was the most statistically significant variable affecting the timing of reform adoption. However, whether or not there was a coalition government in power was also significant. This means that an increase of 1 point out of 10 in the state's corruption level led to a 63% decrease in the chance of a reform being adopted in a given year. The quantity of services covered varied widely in the sample of states from less than 10 to more than 40 services. On average, moving from a state with below average corruption to a state with above average corruption causes a drop of 14 in the number of services covered.

In addition to examining the variation in reform adoption across Indian states, Bussell also looks at the consequences of reform. Despite reforms in the state of Karnataka, to give one example, demand for services continues to outstrip supply. Visitors to Nemmadi (privately-run computerized centers) were able to access services faster, while paying less money, making less visits, spending less time waiting at each visit, and seeing a reduction (on average) in the number of days before receiving the service. Despite quantitative improvements in average efficiency, however, perceived efficiency actually declined. Now, there is a 7-day minimum for service delivery and a 21-day maximum. Although average has declined as a consequence of these new requirements, it is now impossible to bribe officials in order to achieve service delivery in one day.

According to Bussell, these results bring up some interesting policy implications. First, it is important to consider the institutional incentives underlying the established model in order to ensure that reforms are effective. The incentives faced by both top politicians and street level officials must be taken into account. Second, it may be best to design policies that establish a strong, if narrow, initial model. After all, growing citizen demand affects electoral benefits and the calculations of politicians. Third, more research must be done regarding the various factors that influence policy outcomes. According to cases in South Africa and Brazil, there is some evidence that differences in electoral competition can affect policy outcomes. In South Africa, for instance, less electoral competition has led to less incentive to reform. More research will help to clarify the factors of importance in public service reform implementation.

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Two decades after the fall of Soviet-bloc dictatorships, popular movements for democracy are erupting in the last regional bastion of authoritarianism: the Arab world.

So far, only Tunisia's dictator, Zine el-Abidine Ben Ali, has been toppled, while Egypt's President Hosni Mubarak - who has ruled that ancient land longer than many pharaohs - announced Tuesday that he will step down in September. But other Arab autocrats are bound to go. From Algeria to Syria to Jordan, people are fed up with stagnation and injustice, and are mobilizing for democratic change.

So, what happens when the autocrat is gone? Will the end of despotism give way to chaos - as happened when Mobutu Sese Seko was toppled in 1997 after more than 30 years in power in Zaire? Will the military or some civilian strongman fill the void with a new autocracy - as occurred after the overthrow of Arab monarchs in Egypt and Iraq in the 1950s, and as has been the norm in most of the world until recently? Or can some of the Arab nations produce real democracy - as we saw in most of Eastern Europe and about half the states of sub-Saharan Africa? Regime transitions are uncertain affairs. But since the mid-1970s, more than 60 countries have found their way to democracy. Some have done so in circumstances of rapid upheaval that offer lessons for reformers in Tunisia, Egypt and other Arab countries today.

Unite the democratic opposition.

When a dictatorship is on the ropes, one thing that can rescue it is a divided opposition. That is why autocrats so frequently foster those divisions, secretly funding a proliferation of opposition parties. Even extremely corrupt rulers may generate significant electoral support - not the thumping majorities they claim, but enough to steal an election - when the opposition is splintered.

In the Philippines in 1986, Nicaragua in 1990 and Ukraine in 2004, the opposition united around the candidacies of Corazon Aquino, Violeta Chamorro and Viktor Yushchenko, respectively. Broad fronts such as these - as well as the Concertacion movement that swept Christian Democrat Patricio Aylwin to power in Chile in 1989 after the departure of Gen. Augusto Pinochet - often span deep personal and ideological differences. But the time for democratic forces to debate those matters is later, once the old order is defeated and democratic institutions have been established.

Egypt is fortunate - it has an obvious alternative leader, Mohamed ElBaradei, whom disparate opposition elements seem to be rallying around. Whether the next presidential election is held on schedule in September or moved up, ElBaradei, or anyone like him leading a broad opposition front, will probably win a resounding victory over anyone connected to Mubarak's National Democratic Party.

Make sure the old order really is gone.

The exit of a long-ruling strongman, such as Ben Ali, does not necessarily mean the end of a regime. Fallen dictators often leave behind robust political and security machines. No autocrat in modern times met a more immediate fate than Romania's Nicolae Ceausescu, who was executed by a firing squad of his own soldiers in 1989 just three days after a popular revolution forced him to flee the capital. Yet his successor, Ion Iliescu, was a corrupt former communist who obstructed political reform. Most of the former Soviet states, such as Georgia and Kazakhstan, had similar experiences.

Countries are much more likely to get to democracy quickly if they identify and embrace political leaders who are untainted by the old order and are ready to roll it back.

But also come to an understanding with the old order.

Victorious democrats won't be able to completely excise the pillars of the authoritarian order. Instead, for their country to turn toward democracy, those pillars must be neutralized or co-opted. This old order may descend into violence when, as in Iraq, broad classes of elites are stigmatized and ousted from their positions. In a successful bargain, most old-regime elites retain their freedom, assets and often their jobs but accept the new rules of the democratic game.

Unless the military collapses in defeat, as it did in Greece in 1974 and in Argentina after the Falklands War, it must be persuaded to at least tolerate a new democratic order. In the short run, that means guaranteeing the military significant autonomy, as well as immunity from prosecution for its crimes. Over time, civilian democratic control of the military can be extended incrementally, as was done masterfully in Brazil in the 1980s and in Chile during the 1990s. But if the professional military feels threatened and demeaned from the start, the transition is in trouble.

The same principle applies to surviving elements of the state security apparatus, the bureaucracy and the ruling party. In South Africa, for example, old-regime elements received amnesty for their human rights abuses in exchange for fully disclosing what they had done. In this and other successful transitions, top officials were replaced, but most state bureaucrats kept their jobs.

Rewrite the rules.

A new democratic government needs a new constitution, but it can't be drawn up too hastily. Meanwhile, some key provisions can be altered expeditiously, either by legislation, interim executive fiat or national consensus.

In Spain, the path to democratization was opened by the Law for Political Reform, adopted by the parliament within a year of dictator Francisco Franco's death in 1975. Poland adopted a package of amendments in 1992, only after it had elected a new parliament and a new president, Lech Walesa; a new constitution followed in 1997. South Africa enacted an interim constitution to govern the country while it undertook an ambitious constitution-writing process with wide popular consultation - which is the ideal arrangement.

An urgent priority, though, is to rewrite the rules so that free and fair elections are possible. This must happen before democratic elections can be held in Egypt and Tunisia. In transitions toward democracy, there is a strong case for including as many political players as possible. This requires some form of proportional representation to ensure that emerging small parties can have a stake in the new order, while minimizing the organizational advantage of the former ruling party. In the 2005 elections in Iraq, proportional representation ensured a seat at the table for smaller minority and liberal parties that could never have won a plurality in individual districts.

Isolate the extremes.

That said, not everyone can or should be brought into the new democratic order. Prosecuting particularly venal members of a former ruling family, such as those tied to the Philippines' Ferdinand Marcos, Indonesia's fallen strongman Suharto or now Tunisia's Ben Ali, can be part of a larger reconciliation strategy. But the circle of punishment must be drawn narrowly. It may even help the transition to drive a wedge between a few old-regime cronies and the bulk of the establishment, many of whom may harbor grievances against "the family."

A transitional government should aim for inclusion, and should test the democratic commitment of dubious players rather than inadvertently induce them to become violent opponents. However, groups that refuse to renounce violence as a means of obtaining power, or that reject the legitimacy of democracy, have no place in the new order. That provision was part of the wisdom of the postwar German constitution.

Transitions are full of opportunists, charlatans and erstwhile autocrats who enter the new political field with no commitment to democracy. Every democratic transition that has endured - from Spain and Portugal to Chile, South Africa and now hopefully Indonesia - has tread this path.

Fragile democracies become stable when people who once had no use for democracy embrace it as the only game in town.

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After nearly 30 years on the throne, Egypt's modern-day pharaoh, Hosni Mubarak, will soon follow in the footsteps of Tunisia's dictator, Ben Ali. The only question is not whether he will leave the presidency of Egypt, or even when, but how. In the face of persistent and growing mass protests-and a newfound sense of civic empowerment on the part of Egypt's long demoralized youthful masses-it is difficult to imagine Mubarak surviving in office for more than another week to ten days. The only question is whether he will see the inevitable and do one last service to his country-leave office gracefully-or whether he will have to be pushed out by the military or a deepening climate of chaos on the streets.

Egypt is very far from being "ready" institutionally or civically for democracy, but it is perched at an interesting point that could make a transition to democracy feasible. 

First, the naming of a Vice-President, after the office sat vacant throughout Mubarak's presidency, leaves open the possibility of an orderly transitional succession. Should the savvy former intelligence chief, Omar Suleiman, read his country's mood shrewdly and decide to preside over a free and fair contest for the presidential election six months hence, he could go down as a hero in Egyptian history, negating the central role he played in a now widely reviled regime. Parallels to the now valued transitional role played by Indonesia's Vice President, Habibie, after the fall of Suharto in 1998 come to mind. However, as the public mood shifts toward demand for a thorough house-cleaning, it is possible that nothing less than a broad-based interim government will satisfy popular demands for change.

Second, in contrast to Tunisia, there is an obvious democratic alternative to Mubarak (or Suleiman, or any other regime stalwart): the Nobel-prize-winning former IAEA head, Mohamed ElBaradei.  As a political novice who has lived outside Egypt for most of the last few decades, ElBaradei is far from an ideal founding president of a new democracy (but then, few countries in a situation of regime turmoil, or even after a carefully planned transition, wind up with a leader of the vision and political skill of Nelson Mandela). Yet ElBaradei has a number of assets, including a keen understanding of the international environment, wide international contacts, experience in running a large organization, a personal history that is untainted by association with the repression and corruption of the Mubarak era, and the apparent ability to unite disparate elements of the opposition, religious and secular, behind his candidacy.

Beyond ElBaradei, the emergence of a broad opposition effort (including ElBaradei and former opposition presidential candidate Ayman Nour) to negotiate the terms of a transition and a new national unity government also augur hopefully for the near-term future.

If a reasonably free and fair contest for the presidency could be organized on schedule in September 2011, there is little doubt that the long-ruling NDP would be dealt a crushing defeat.  To ensure that, however, would not only require institutional changes to allow a fully open and free presidential contest, but also to ensure a fresh registration of voters and neutral administration of the electoral process. These changes would need to be implemented fairly quickly to enable a credible and reasonably fair process as soon as September. The first such change will need to be a constitutional amendment to remove the condition that requires a party to have 5 percent of the seats in parliament in order to field a presidential candidate. 

If the September election timetable can be adhered to, the democratic election of a new president of Egypt would be the beginning, not the end, of a democratic transition in Egypt.  The parliament will need to be completely reelected, as the elections of late 2010 were even more farcical and outrageously rigged than previous ones. As a result, the ruling NDP won 81 percent of the seats, and no opposition party won more than a small sliver of seats in an election that at least three-quarters of eligible voters (and probably many more) boycotted. 

A new democratically elected president would thus need to preside over a far-reaching transitional process, which would require the rewriting of the constitution; the reform and renewal of the electoral system, the judiciary, and other government institutions, especially the police; and the training and empowerment of democratic political parties, mass media, and civil society organizations, which have been heavily constrained during the Mubarak era. Egyptians might want to consider the next presidential term as a deliberately transitional and power-sharing government, under a relatively spare interim constitution, while a democratic process of dialogue and deliberation drafted a new permanent constitution. South Africa could serve as a model here; a newly elected democratic parliament could also serve as a Constituent Assembly to draft a new constitution with wide popular participation and consultation.

Forging the rules and institutional arrangements of a transitional period will not be easy. Political stability will require a broadly inclusive process of negotiations that brings all key political stakeholders to the table, and that forges a political pact that ensures the loyalty of the army and security apparatus while gradually renewing its officer ranks and establishing civilian democratic control. No doubt there will be calls for retrospective justice to investigate the many abuses of human rights during the Mubarak era, but the historical experience of other transitions suggest that this task should be addressed with caution and deliberation, in a way that does not drive the surviving elements of the old regime into a posture of resistance and sabotage.

The challenge for the U.S. is to align itself squarely behind Egypt's aspirations for democracy without being so public, clumsy and abrupt in abandoning Mubarak that we provoke an anti-American backlash from among other regional allies. But if we have to choose between rulers and their people, it is time we started choosing the people. We need to quickly develop a strategy and commit new resources to assist Egyptian political parties, non-governmental organizations, civic education groups, and independent media to help them prepare the country for a period of protracted and unprecedented democratic change.

Egypt is entering the end of an era. The exit from power of Hosni Mubarak under pressure of volcanic popular protests will have wide repercussions throughout the Arab world. It will accelerate the momentum of democratic change in the region, and open the possibility of electoral democracy emerging in the Arab world's largest and most influential country. If Mubarak can be induced to exit peacefully and soon, and the way can be paved to a free and credible presidential election in September, the authoritarian exceptionalism of the Arab world may begin drawing to an end.

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Today's world abounds in international courts, laws, and tribunals, yet war is becoming more brutal, more transnational, with mounting civilian casualties. Helen Stacy, FSI senior fellow and Stanford scholar in international and comparative law, notes that "civilians, often women and children, who played no role in the conflict – these are the people who suffer first, last, and in the middle." Stacy recently moderated a panel on Civilians in War Zones, that included Richard Goldstone, former justice of the Constitutional Court of South Africa, history Professor James Campbell, and Peter Berkowitz, senior fellow at the Hoover Institution, as part of this year's Ethics and War series.
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Larry Diamond
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The toppling of a brutal, corrupt, and long-ruling dictator, Zine el Abidine ben Ali, is an extraordinary achievement for the diverse elements of Tunisian society who came out into the streets in recent weeks to demand change. Ben Ali's startling fall is another reminder of how suddenly political change can come in authoritarian regimes that substitute force, fear, and fraud for legitimacy. Such regimes may appear stable for very long periods of time, but when the people lose their fear and the army refuses to fire on the people, they can unravel very quickly.

Unfortunately, the demise of a dictator does not guarantee the rise of a democracy in its place.  Historically, most authoritarian regimes have given way to a new (and often only slightly reconstituted) autocracy. This has been the principle pattern not only in the successor states to the Soviet Union, but in much of Africa since independence, and in numerous states in Asia and Latin America historically as well. In the Middle East, the odds against a successful democratic transition are particularly long, since there have hardly been any (outside Turkey and Israel) since the end of colonial rule. In Iran in 1979, a popular uprising against a long-serving dictator led not to democracy but rather to an even more odious and murderous form of oppression.

 If Tunisia is to defy the odds, it will need a significant period of time to reform the corrupt rules and institutions of the authoritarian regime and create an open, pluralistic society and party system that is capable of structuring democratic competition. Even if elections for a successor government are pushed out to six months, rather than sixty days, it is highly unlikely that this will provide sufficient time to create even a minimally fair and functional democratic playing field. 

Think of the many components of a democratic election, and Tunisia today is far from having them in place. After decades of fixed and phony elections, Tunisia needs a complete overhaul of its electoral machinery: a new and impartial electoral administration, a new electoral register, and perhaps as well a new electoral system. An energetic program of civic education should help Tunisians understand not only the mechanics of a democratic electoral process but also the underlying norms, rights, and responsibilities of democratic citizenship. This is a long process, but from Poland to Chile to South Africa, civil society organizations have shown that much can be accomplished to lay the foundations for popular democratic awareness and capacity if the models, materials, and resources are made available, and if there is a decent interval of time and political space to do the work. Doing this work-and enabling political parties and candidates to convey their messages-also requires a new and more pluralistic media environment. State control of the electronic and print media must be radically refashioned.  Privately owned media must be allowed to form and function, and critics of the old order must be allowed to enter the arena of ownership.

An effective democratic election requires not just freedom of opposition parties to organize, but time, resources, and training for them to form-or reform-and develop some ability to perform the essential functions of modern parties:  to establish what they stand for, to develop programmatic agendas, to elect leaders and recruit candidates, to forge ties with constituencies, and to survey public opinion and respond with appropriate messages. Trade unions, business chambers, and other civic groups need time as well to purge themselves of corrupting ties to the old order, or form anew, cultivate their natural constituencies, and build an authentic civil society.  Independent think tanks and public opinion surveys can also help to structure and enrich an emergent democratic process, but they as well need time and resources to function effectively.

Free and fair elections-especially in a context where they have never taken place before-also require extensive preparations for domestic monitoring and international observation, so that fraud can be detected and deterred, honest mistakes can be exposed and corrected, and public confidence can be generated in the new procedures.

Many of these tasks are ongoing after a successful transition to democracy, and setting too ambitious an agenda for reform could risk waiting indefinitely and squandering the opportunity for democratic change. But one of the most common reasons for failed transitions is a rush to early national elections and a failure to prepare the ground adequately for a fair and meaningful contest. Two common consequences of hurried elections are chaos or renewed autocracy, as some portions of the old order rally behind a new figure or old party and win by hook or crook. 

Unfortunately, there are also risks in waiting too long. Democratic energy in society can dissipate.  If (putative) democratic forces enter into a broad-based transitional government, as is now happening in Tunisia, they risk being corrupted or tainted with the stench of the old order if they hang around for too long, sharing some authority and stature but no real power. A prolonged transitional period can also give authoritarian forces time to regroup, purge the worst elements, present cosmetic changes, divide and confuse the opposition, and return to power under the guise of a pseudo-democracy. That is why it is important that opposition figures in Tunisia insist on a serious program of institutional and possibly constitutional reform during the transitional period, with extensive public dialogue and broad popular participation, so that interim rule is not a stagnant pause but rather a dynamic historical moment that engages and mobilizes public opinion for real democratic change. The risks of delay could also be reduced if a non-partisan, technocratic figure, not associated with the Ben Ali's political machine, could be tapped to lead the interim government, and if the political opposition could unify to negotiate strong conditions for the period of interim rule, including basic freedoms, an end to censorship, and removal of Ben Ali loyalists from the cabinet.

There is an important role for international actors at this seminal moment in Tunisian history. Like peoples throughout the Middle East and other post-colonial spaces, Tunisians are understandably wary of foreign intervention. After a quarter-century of lavish Western (especially French) aid and political comfort to Ben Ali, Tunisians will no doubt cast a suspicious eye on grants, statements and actions that purport to now, suddenly, want to build democracy in Tunisia. But Tunisians may welcome limited and specific steps if they are transparent and taken in careful consultation with diverse elements of Tunisia's civil society and historic opposition. 

Fortunately, Tunisia has many liberal and democratic figures in business, intellectual, cultural, and civic life who understand what liberal democracy is and would like to see it emerge in Tunisia. And it has other distinct advantages. It is a relatively small country in size and population, which makes some of the tasks of institution building and promotion of democratic norms a bit easier. Educational levels are relatively high, and there is a significant infrastructure of a middle class society. The security forces seem to be divided, and it appears the army refused to fire on peaceful protestors-a very positive precedent. Without blood on its hands from the recent violence, the army is better poised than other elements of state security to guarantee a process of democratic change, if its leadership comes down in favor of it (for whatever reason). And in contrast to Algeria, Egypt, or Jordan, Islamists do not seem to have strong public support. Thus, it is difficult for the forces of the ancien regime to manipulate public fears of radical Islam (or of disorder that the old elites themselves covertly generate) in order to discredit liberalism as naïve and ride back to power. 

It is vital that Europe and the United States not fall again for the specter of disorder or an Islamist surge, but rather insist on genuine democratic reforms, and tie future aid and geopolitical support to this. The US and EU should hold forth the prospect of Tunisia achieving a special and potentially transformative status in economic relations if it negotiates the path to become the first Arab democracy of this era. At the same time, they should threaten to institute targeted travel and financial sanctions against diehard defenders of the old order who frustrate or sabotage a democratic transition, or who use violence against peaceful demonstrators.  These kinds of prospective inducements, positive and negative, can help to tip the balance in the calculations of a lot of elites from outside the Ben Ali "family" but who were part of the Ben Ali regime and must now be wondering where their own interests lie. To complement the necessary private messages, the US ambassador (and others representing democracies in Tunis) should stand up publicly for democratic reforms, embrace democratic reformers, support new democratic initiatives with small grants, and warn old regime elites against repression.

In the coming weeks and months, American and European democracy foundations and aid organizations, along with the United Nations and its political assistance programs in the UNDP, can do a lot-transparently, and in consultation with Tunisian society-to train and support the emerging infrastructure of democracy in the state administration, political parties, and civil society. The funding required to make a difference is not large in absolute terms, and it should be a priority. Time is of the essence, and more flexible instruments, like USAID's Office of Transition Initiatives, should be tapped to activate assistance quickly.        

History-and the grim realities of pervasive authoritarianism in what is known in the political science discipline as a "bad neighborhood"-do not justify a high degree of optimism about the prospects for democracy in Tunisia. Yet the third wave of global democratization is replete with instances of successful democratization in even more unlikely circumstances. The speed with which the Tunisian protests mushroomed in a few weeks from a lone act of self-sacrifice to a national uprising, and the intensity with which this uprising has resonated in nearby countries, shows the pent-up demand for democratic change in the Arab world. If that demand can be directed toward pursuit of concrete institutional reform, with timely international support, the Jasmine Revolution could surprise again, by giving birth to the first Arab democracy of our time.

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Objective: The World Health Organization (WHO) recently changed its first-line antiretroviral treatment guidelines in resource-limited settings. The cost-effectiveness of the new guidelines is unknown.

Design: Comparative effectiveness and cost-effectiveness analysis using a model of HIV disease progression and treatment.

Methods: Using a simulation of HIV disease and treatment in South Africa, we compared the life expectancy, quality-adjusted life expectancy, lifetime costs, and cost-effectiveness of five initial regimens. Four are currently recommended by the WHO: tenofovir/lamivudine/efavirenz; tenofovir/lamivudine/nevirapine; zidovudine/lamivudine/efavirenz; and zidovudine/lamivudine/nevirapine. The fifth is the most common regimen in current use: stavudine/lamivudine/nevirapine. Virologic suppression and toxicities determine regimen effectiveness and cost-effectiveness.

Results: Choice of first-line regimen is associated with a difference of nearly 12 months of quality-adjusted life expectancy, from 135.2 months (tenofovir/lamivudine/efavirenz) to 123.7 months (stavudine/lamivudine/nevirapine). Stavudine/lamivudine/nevirapine is more costly and less effective than zidovudine/lamivudine/nevirapine. Initiating treatment with a regimen containing tenofovir/lamivudine/nevirapine is associated with an incremental cost-effectiveness ratio of $1045 per quality-adjusted life year compared with zidovudine/lamivudine/nevirapine. Using tenofovir/lamivudine/efavirenz was associated with the highest survival, fewest opportunistic diseases, lowest rate of regimen substitution, and an incremental cost-effectiveness ratio of $5949 per quality-adjusted life year gained compared with tenofovir/lamivudine/nevirapine. Zidovudine/lamivudine/efavirenz was more costly and less effective than tenofovir/lamivudine/nevirapine. Results were sensitive to the rates of toxicities and the disutility associated with each toxicity.

Conclusion: Among the options recommended by WHO, we estimate only three should be considered under normal circumstances. Choice among those depends on available resources and willingness to pay. Stavudine/lamivudine/nevirapine is associated with the poorest quality-adjusted survival and higher costs than zidovudine/lamivudine/nevirapine.

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AIDS (Official Journal of the International AIDS Society)
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Eran Bendavid
Douglas K. Owens
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