Defense, Diplomacy and Development: A Gordian Knot?

CSIS issued an interesting report a year ago which I just finished reading this morning called "Integrating 21st Century Development and Security Assistance; Final Report of the Task Force on Nontraditional Security Assistance." The report can be downloaded here: http://www.csis.org/index.php?option=com_csis_pubs&task=view&id=4236. I liked the thoughtful writing and thought that the report provided insight into the diplomacy-defense-development nexus which is quite a Gordian Knot for practitioners and for the various involved agencies. I will write more about this report later, since it caused me to more clearly consider the legitimacy of the NGO claims against DoD--and in my mind pointed out why DoD may be somewhat unresponsive as a bureaucracy to those claims. But that controversial post is for the future.

I was also reading a report from October 2008 called "Health System Reconstruction: Can it Contribute to State-Building?" The report was commissioned by the Health and Fragile States Network and can be downloaded here: http://www.healthandfragilestates.org/. In it, the authors investigate, with a clarity that I have not see before, the argument that development of health systems creates a more resilient state. They define "resilient state" by these characteristics: a state with organizational and institutional capacity (to make and enforce policies, ensure the implementation of state-sponsored programmes, etc.); with legitimacy; with political processes to manage expectations (the compact between state and its citizens); and with access to resources. I think defining these characteristics further clarifies the argument heard over and over again that "health diplomacy" is probably a good thing for the U.S. to do, especially in the context of the Global War on Terror, since it builds legitimacy of foreign governments. The authors of the report conclude that this argument, that building health systems in fragile states will legitimize the state (and the successor argument that we should therefore assist with health system development because legitimizing states will mitigate development of terror networks and reduce potential for attacks against the U.S.) is unsubstantiated at this point. I'm not surprised.

Further, I actually wonder if building health systems in fragile states (whether being done by the U.S. government, U.S. military or NGOs or all three) might be a stimulus for Islamic terrorist groups? I know, this is heresy, but my general train of thought is this: Islamist terrorists are waging a war that is based on profound and inarguable religious beliefs. They believe the West is wrong, generally put. We (the West, or America) come in to their communities and try to assist their opponent governments, which are very weak, with building health systems so that the government may be responsive to its divided people. The first problem with this scenario in my mind is that not everyone all around the world expects their government to provide health care services or systems (so that others -- like NGOs -- can deliver the care). So trying to get a government to establish a system might not be enabling the Citizen-State relationship that we in the West prefer to see. In other words, our actions are never going to produce the results we hope to see. In fact,we might actually be disrupting the expected governance structures which might be based less on central state governments or on governments at all, but be based on 'war lords' or local strong men. Could it be that we sometimes are stimulating further disruption by our "good deeds"?

Assuming that we feel it somehow a basic and shared human value (Condoleeza Rice has said something to this effect) that all people should get health care everywhere and that by extension, we should try to work toward that end, we must act with caution since apparently there is no recognizably effective method of acting. The Western world often feels that it has a moral imperative to assist with saving lives where ever and whenever it can. But does that life saved cause another life lost elsewhere?

I am not a proponent of endless navel-gazing while these important issues are pondered by wise men with long beards. But I am a proponent for action which is documented and which can therefore be considered and assessed with some clarity for 'course correction' in further actions. The Health and Fragile States Network report should send a chill through the Gordian Knot of U.S. diplomacy, development and defense communities which are now engaged in trying to be more effective, as evidenced by the CSIS report. But it probably won't.