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    Consequences of Armed Conflict in the Middle East and North

    Africa Region   ∗

    Scott Gates1,3, H̊avard Hegre1,2, Håvard Mokleiv Nygård1,2, and H̊avard Strand1

    1Centre for the Study of Civil War, (PRIO)2University of Oslo

    3Norwegian University of Science & Technology

    November 23, 2010

    ∗We thank the World Bank and the Norwegian Ministry of Foreign Affairs for support. We are grateful tothe WDR and MNA team at the World Bank as well as participants at the World Bank’s Cyprus consultationmeeting for valuable comments and inputs. We especially thank Colin Scott, Lene Lind, Phil Keefer and GaryMilante at the World Bank, as well as Simon Hug, Kaare Strøm and other participants at the CSCW WorkingGroup meeting and participants at the PRIO-World Bank MENA Workshop, especially Michael Alvarez, fortheir valuable comments. In addition we thank Siri Aas Rustad for assistance.

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    Executive Summary

    The consequences of violent conflict are profound and far reaching. Modern technologies

    of war gives armies the capacity to kill scores of people efficiently and brutally. But the

    consequences of war extend far beyond direct battlefield casualties. Although media at-

    tention usually stops soon after a ceasefire has been signed, this is when the most dramaticconsequences kick in. We examine three types of consequences: economic, political and

    health. A great deal of analysis has been carried out in the past decade on the the economic

    consequences of war. A central finding of this literature is that war, especially civil war, is

    a development issue. Conflict at once is both a consequence of lacking development, and

    a cause of it. This has the potential of locking countries in a conflict trap. For the Middle

    East and North Africa (MENA) region we also find traces of this economic conflict trap.

    Wars have a lingering effect on growth; conflict both pushes a country off its initial growth

    path, and slows it down long after the conflict has ended. The gravest consequences for the

    MENA region are not economic, but political. The political far outweighs the economic.

    Whereas many African countries are trapped in an economic conflict trap, many MENA

    countries find themselves in a  Political Conflict Trap.

    We argue that conflict in the MENA region increases human rights abuses, inhibits

    democratization and exacerbates social fragility. Furthermore, we find that for many of 

    the political consequences the effects of conflict are considerably more detrimental for

    MENA countries than for war-torn countries in other regions. A MENA country which

    experienced a durable war has a significantly higher probability of being in a situation

    where “murders, disappearance and torture are a common part of life”. The mechanism

    causing this is state securitization. War induces insecurity for leaders and this causes

    them to resort to political incarceration, brutal subjugation and torture. Moreover, the

    refreshing spray of a democratic wave has failed to reach the MENA region. The region’s

    authoritarian and semi-democratic regimes are, by global standards, remarkably stable

    and long-lived. Regimes with little or no constraints on the scope and authority of the

    executive seem to receive a significant war dividend. That is, unconstrained regimes which

    have experienced conflict endure much longer than those that have not. The pattern seen

    elsewhere in the world, where wars often act as catalyst for positive social change, is wholly

    absent in the MENA region.

    The MENA political conflict trap does not merely have consequences for politics.

    We also find marked effects of conflict on infant mortality, life expectancy and adequate

    access to water. Nonetheless, mortality is in turn exacerbated by political factors. We

    find for example that conflict increases infant mortality of a country by around 1 %.

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    In real terms this means that conflict causes an excess amount of infant deaths which

    is on par with direct battle deaths. For every person killed in fighting, an infant that

    would otherwise have survived dies as a consequence of that fighting. The main reason for

    these excess deaths is the deterioration of health infrastructure. The securitization effect

    we find for MENA countries, diverts resources away from building and rebuilding health

    infrastructure or adequate sewage and water systems, and this exacerbates mortality. The

    cause of increased mortality is not combat, but rather oppressive and inefficient regimes

    caught in a political conflict trap.

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    CONTENTS CONTENTS  

    Contents

    I Conflict in the MENA Region 7

    1 Introduction 7

    2 Conflict Trends in the MENA region, A General Overview 82.1 Trends in Number of Conflict and Battle Deaths . . . . . . . . . . . . . . . . . 82.2 Where are the Conflicts? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    3 How Conflict Affects the MENA Region Differently 12

    3.1 Summary of Results for MDG Goals for MENA and the World . . . . . . . . . 13

    II Development Consequences of Conflict 16

    4 Economic Consequences 16

    4.1 GDP Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

    5 Health and Mortality Consequences 21

    5.1 Battle Deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215.2 Surplus Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225.3 Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

    6 Political consequences 32

    6.1 Human Rights Abuses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326.2 Changes to Formal Political Institutions . . . . . . . . . . . . . . . . . . . . . . 366.3 Trends For the MENA Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406.4 Specific Regime-Type Consequence of Conflict . . . . . . . . . . . . . . . . . . . 416.5 Power-sharing Arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . 496.6 Gender Parity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 516.7 Social Fragility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

    III The Political Conflict Trap 56

    7 A Political Conflict Trap in the MENA Region 56

    7.1 MENA Exceptionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 597.2 Primary Commodities and Conflict . . . . . . . . . . . . . . . . . . . . . . . . . 59

    8 Policy Implications 61

    8.1 What Can Aid Donors Do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 628.2 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

    A Appendix 65

    A.1 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65A.2 Conflict Country Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67A.3 MDG indicators Used in the Analysis . . . . . . . . . . . . . . . . . . . . . . . 67A.4 Model Specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67A.5 Regression Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70A.6 Economic Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

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    LIST OF FIGURES LIST OF TABLES  

    List of Figures

    1 Trends in Number of Active Conflicts in the WORLD and MENA Region . . . 92 Trends in Number of Active Conflicts in the WORLD and MENA Region,

    Internal and International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Distribution of Conflict in MENA Region, 1980 . . . . . . . . . . . . . . . . . . 124 Distribution of Conflict in MENA Region, 1995 . . . . . . . . . . . . . . . . . . 125 Distribution of Conflict in MENA Region, 2004 . . . . . . . . . . . . . . . . . . 136 Distribution of Average GDP per Capita Rates 2007, by Conflict . . . . . . . . 177 Trends in GDP Level, All Countries, 1990–2008 . . . . . . . . . . . . . . . . . . 188 Trends in GDP Level, MENA, 1990–2008 . . . . . . . . . . . . . . . . . . . . . 199 The Effect of War on Economic Growth . . . . . . . . . . . . . . . . . . . . . . 2010 Trends in Number of Battle Deaths in the WORLD and MENA Region, 1946–

    2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2211 Distribution of Average Infant Mortality Rates 2007, by Conflict Category . . . 2412 Trends in Infant Mortality Rates, 1990–2008 . . . . . . . . . . . . . . . . . . . . 2513 Distribution of Average Life Expectancy Rates 2007, by Conflict Category . . . 2714 Distribution of Average Water Access Rates 2007, by Conflict Category . . . . 29

    15 Political Terror Scale by Conflict Categories . . . . . . . . . . . . . . . . . . . . 3316 Political Terror Scale by Post-Conflict Categories . . . . . . . . . . . . . . . . . 3517 Multidimensional Institutional Representation of Political Systems (MIRPS) . . 3818 Regime Type Trends for MENA . . . . . . . . . . . . . . . . . . . . . . . . . . 4019 Regime Type Trends for All Other Regions . . . . . . . . . . . . . . . . . . . . 4120 Executive Constraints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4521 Cost of Repression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4822 Distribution of Female Primary Education, Year 2000 . . . . . . . . . . . . . . 5223 Distribution of Female to Male Life Expectancy, Year 2000 . . . . . . . . . . . 53A-1 The Percentage of Population Suffering from Undernourishment, by Conflict

    Status and State Fragility in 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . 68

    A-2 GDP Growth, MENA Countries Only, 1990–2008 . . . . . . . . . . . . . . . . . 87

    List of Tables

    1 List of Armed Conflicts in the Middle East/North Africa Region, 1960–2008 . . 112 Summary of Results, Millenium Development Goals . . . . . . . . . . . . . . . 153 Millenium Development Goals, Population Affected, 2005 . . . . . . . . . . . . 154 Regime Stability by Region and Regime Type . . . . . . . . . . . . . . . . . . . 425 Regime Stability by Region and Regime Type for Conflict and Post-Conflict

    Countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 436 Durability of Three Different Levels of Executive Constraints by Conflict Status. 45

    7 Tabulation of Country Years by Conflict and Oil-producing Status for MENACountries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

    8 Tabulation of Countries by Conflict and Oil-producing Status . . . . . . . . . . 61A-1 Cross Section Analysis, Secondary Education Attainment . . . . . . . . . . . . 70A-2 Cross Section Analysis, Female Primary Education . . . . . . . . . . . . . . . 72A-3 Cross Section Analysis, Growth in GDP Capita . . . . . . . . . . . . . . . . . 73A-4 Cross Section Analysis, Infant Mortality Rates . . . . . . . . . . . . . . . . . . 74A-5 Cross Section Analysis, Life Expectancy . . . . . . . . . . . . . . . . . . . . . . 75A-6 Cross Section Analysis, Logged Infant Mortality . . . . . . . . . . . . . . . . . 76A-7 Cross Section Analysis, Female to Male Ratio . . . . . . . . . . . . . . . . . . 77

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    Background Paper: Consequences of Armed Conflict November 23, 2010

    A-8 Cross Section Analysis, Access to Water . . . . . . . . . . . . . . . . . . . . . . 78A-9 Effect of Conflict on Annual Growth in GDP per Capita (PPP, logged), 1960–

    2005, OLS with Panel-Corrected Standard Errors . . . . . . . . . . . . . . . . 79A-10 Fixed-Effects Analysis, Infant Mortality Rates, 1970–2005 . . . . . . . . . . . . 80A-11 Fixed-Effects Analysis, Life Expectancy, 1970–2005 . . . . . . . . . . . . . . . 81A-12 Fixed-Effects Analysis, Access to Water, 1990–2005 . . . . . . . . . . . . . . . 82

    A-13 Fixed-Effects Analysis, Parity in Primary School Enrollment, 1970–2005 . . . 83A-14 Fixed-Effects Analysis, Female to Male Life Expectancy, 1970–2005 . . . . . . 84A-15 Effect of Conflict on Riots, 1960–2006 . . . . . . . . . . . . . . . . . . . . . . . 85A-16 Effect of Conflict on Political Terror Scale, 1970–2005 . . . . . . . . . . . . . . 86

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    Background Paper: Consequences of Armed Conflict November 23, 2010

    Part I

    Conflict in the MENA Region

    1 Introduction

    War, especially civil war, is a development issue. War kills, but the consequences extend far

    beyond those killed or wounded. In addition to battlefield casualties, armed conflict leads

    to forced migration and the destruction of a societies’ infrastructure. Social, political, and

    economic institutions are indelibly harmed. The consequences of war for development are

    profound.

    As a region the Middle East and North Africa (MENA) face considerable risk of conflict.

    War, especially interstate and internationalized civil war, has ripped apart the region. This

    paper explores the impact of these wars on the region. The paper provides a statistical analysis

    of the consequences of conflict. More specifically, the effects of armed conflict on development

    are evaluated with respect to health and mortality; economic growth; the political institutions

    of a state; and human rights. This report also evaluates the direct and indirect mechanisms

    through which violent conflict degrades the quality of life.

    Not all consequences of conflict are measurable or have ever been measured. Indeed, many

    consequences of armed conflict are not incorporated in our analysis, such as the increased

    number of young males with war experience, accumulation of light weapons, erosion of trust,

    etc. Such problems of missing data and unmeasurable data make it especially difficult to assess

    systematically the consequences of conflict.1 We therefore focus primarily on the measurable

    consequences of war in terms of its effect on economic, health, and political indicators.

    These three dimensions, economic, health, and political, are interrelated. Political factors

    in the MENA region trump the others. In contrast to other regions of the world where an

    economic conflict trap is evident, in the MENA region this dynamic is as not evident. Conflict

    1To paraphrase Donald Rumsfeld missing data are ‘known unknowns’ and unmeasurable data are ‘unknownunknowns’. The problem of missingness is serious. Data collection in war-torn countries is problematic. Toaddress this problem we interpolate the data. We can only discuss and interpret unmeasurable phenomena.Statistical analysis is of course impossible.

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    Background Paper: Consequences of Armed Conflict November 23, 2010

    does affect economic growth, but nevertheless, in the MENA region the political consequences

    are so much stronger. We refer to these effects as the Political Conflict Trap.

    The consequences of war are profound and clearly evident. The quality of life is consistently

    downgraded by armed conflict. Given the extent of conflict in the MENA region, development

    policy needs to account for these effects. More particularly, the securitization of MENA

    states, which constitute a fundamental aspect of the political conflict trap, affects budgets,

    the implementation of health and economic policy, and the general policy environment.

    2 Conflict Trends in the MENA region, A General Overview

    2.1 Trends in Number of Conflict and Battle Deaths

    The trend in the incidence of armed conflict2 in the MENA region and globally from 1945 to

    2008 is shown in Figure 1. The figure shows a strong and fairly steady increase in the number

    of conflicts up until the early 1990s, and then a strong decline for the next 10 years. The

    increase in the 1970s and 1980s is probably a result of the Cold War era, during which the

    superpowers and their allies fought and supported a broad range of wars and minor conflicts.

    The decrease in the number of conflicts following the end of the Cold War did not come

    immediately, because of the political instability in a large number of countries as communist

    regimes were disbanded. Up until about 1993, the number of new armed conflicts exceeded

    the number terminated.

    Over the past five years the positive trend of the 1990s seems to have changed and we

    observe a noticeable increase in the number of conflicts in the world. The reasons for this

    increase are not clear. Possibly, the war on terror which has again led a superpower to both

    actively fight wars and to lend its support to other conflict actors constitute an important

    factor. Indeed, of the five major conflicts, i.e. conflicts that incurred more than 1000 battle

    deaths a year, that were ongoing in 2008, the US and her allies were involved in four.

    Looking at the trend for the Middle East and North Africa, we see a fairly similar picture3.

    2These data are taken from the PRIO-Uppsala Armed Conflict Database. An armed conflict is definedas a contested incompatibility involving at least 25 battle deaths per year and in which at least one of thebelligerents is a state. See Gleditsch et al. (2002). Also see Appendix A.1.1.

    3There is a widely held belief that the Gulf Cooperation Countries (GCC), i.e. Kuwait, Bahrain, SaudiArabia, Qatar, UAE and Oman, are substantially different from the other MENA countries and therefore thatyou can not compare across the two set. We have run all the analysis in this paper with a dummy markingGCC countries to see if we find statistically significant differences. Apart from female education we do not.

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    Background Paper: Consequences of Armed Conflict November 23, 2010

    The level of conflict was fairly moderate until the late 1970s. Some of the conflicts in this pe-

    riod were associated with decolonization, whereas other conflicts relate to issues of statehood,

    in particular the Palestinian conflict. During the 1980s and well into the 1990s, the incidence

    of conflict in the MENA region increased, with the Iran-Iraq war and the Algerian Civil War

    as the two most intense conflicts. While the second half of the 1990s has been more peaceful

    than the previous, the past decade has again witnessed more violence in the region.

    The trend in the MENA region is not dissimilar from that of the rest of the world. Sørli,

    Gleditsch and Strand (2005) reach a similar conclusion regarding the causes of conflict in

    this region. While the region is known for its particular religious configuration and strong

    dependence on oil, these variables do not explain more or less of conflict in this region than

    in others.

    Figure 1: Trends in Number of Active Conflicts in the WORLD and MENA Region

    Figure 2 shows the same trends broken down into two categories: internal (left panel)

    and international (right panel) conflicts. For the international category we group interstate

    wars and civil conflicts that involve intervention from international actors together. Civil

    conflict clearly is the dominant form of conflict. Proportionally the MENA region experiences

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    Background Paper: Consequences of Armed Conflict November 23, 2010

    Figure 2: Trends in Number of Active Conflicts in the WORLD and MENA Region, Internaland International

    a significant share of the globe’s international conflict.

    Table 1 lists the conflicts in the MENA region included in this analysis (Gleditsch et al.

    2002). The first column gives side a and the second column side b to the conflict. In intrastate

    conflict side a is the government, while side b is the rebel group. Columns three and four

    give the start and end year for the conflict, and the last column reports the intensity of the

    conflict with “Minor” implying between 25 and 999 battle related deaths in a year, and “War”

    implying more than 1000 battle deaths. For a conflict to be included at least one of the parties

    have to be the government of a state, with states defined according to the list provided by

    Gleditsch and Ward (1999).

    2.2 Where are the Conflicts?

    The maps in figures 3, 4 and 5 show the distribution of conflict for the MENA countries in

    1980, 1995 and 2004. The MENA countries are colored grey, and the conflict regions are

    marked with hatches. These maps show the geographic extent of conflicts in the region as

    snapshots taken from a single year in each decade. The maps also indicate where conflict

    occurred in neighboring countries outside the MENA region. The transnational aspects of 

    conflict are particularly relevant to MENA as several conflicts involve neighbors from other

    regions. These conflicts are particularly relevant for Djibouti, Iraq, and Iran.

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    Background Paper: Consequences of Armed Conflict November 23, 2010

        T   a    b    l   e    1   :    L    i   s   t   o    f    A   r   m   e    d    C   o   n    fl    i   c

       t   s    i   n   t    h   e    M    i    d    d    l   e    E   a   s   t    /    N   o   r   t    h    A    f   r    i   c   a    R   e   g    i   o   n ,

        1    9    6    0  –    2    0    0    8

        S    i    d   e    A

        S    i    d   e    B

        F

        i   r   s   t    Y   e   a   r

        L   a   s   t    Y   e   a   r

        H    i   g    h   e   s   t

        I   n   t   e   n   s    i   t   y

        A    l   g   e   r    i   a

        M   o   r   o   c   c   o

        1

        9    6    3

        1    9    6    3

        M    i   n   o   r

        T   a    k    fi   r   w   a    ’    l    H    i    j   r   a ,

        G    I    A ,

        A    I    S

     ,    A    Q    I    M

        1

        9    9    1

        2    0    0    8

        W   a   r

        L    i    b   y   a

        C    h   a    d

        1

        9    8    7

        1    9    8    7

        W   a   r

        D    j    i    b   o   u   t    i

        E   r    i   t   r   e   a

        2

        0    0    8

        2    0    0    8

        M    i   n   o   r

        F    R    U    D

        1

        9    9    1

        1    9    9    4

        M    i   n   o   r

        F    R    U    D  –    A    D

        1

        9    9    9

        1    9    9    9

        M    i   n   o   r

        E   g   y   p   t

       a    l  -    G   a   m   a    ’   a   a    l  -    I   s    l   a   m    i   y   y   a

        1

        9    9    3

        1    9    9    8

        M    i   n   o   r

        F   r   a   n   c   e

        F    L    N

        1

        9    6    0

        1    9    6    2

        W   a   r

        I   r   a   n

        A    P    C    O

        1

        9    7    9

        1    9    8    0

        M    i   n   o   r

        I   r   a   q

        1

        9    7    4

        1    9    8    8

        W   a   r

        J   o   n    d   u    l    l   a    h ,

        P    J    A    K

        2

        0    0    5

        2    0    0    8

        M    i   n   o   r

        K    D    P    I

        1

        9    6    6

        1    9    9    6

        W   a   r

        M    E    K

        1

        9    7    9

        2    0    0    1

        W   a   r

        I   r   a   q

        A    l  -    M   a    h    d    i    A   r   m   y ,    R    J    F ,

        A   n   s   a   r   a    l  -    I   s    l   a   m ,

        I    S    I

        2

        0    0    4

        2    0    0    8

        W   a   r

        A   u   s   t   r   a    l    i   a ,    U    K ,

        U    S    A

        2

        0    0    3

        2    0    0    3

        W   a   r

        K   u   w   a    i   t

        1

        9    9    0

        1    9    9    1

        W   a   r

        M    i    l    i   t   a   r   y    f   a   c   t    i   o   n    (    f   o   r   c   e   s   o    f    B

       r    i   g   a    d    i   e   r    A   r    i    f    ) ,

        N    C    R    C

        1

        9    6    3

        1    9    6    3

        W   a   r

        S    C    I    R    I

        1

        9    8    2

        1    9    9    6

        W   a   r

        K    D    P ,

        P    U    K ,

        K    D    P  -    Q    M

        1

        9    6    1

        1    9    9    6

        W   a   r

        I   s   r   a   e    l

        E   g   y   p   t ,    J   o   r    d   a   n ,

        S   y   r    i   a

        1

        9    6    7

        1    9    7    3

        W   a   r

        H   e   z    b   o    l    l   a    h

        1

        9    9    0

        2    0    0    6

        M    i   n   o   r

        P   a    l   e   s   t    i   n    i   a   n    i   n   s   u   r   g   e   n   t   s

        1

        9    6    0

        2    0    0    8

        M    i   n   o   r

        L   e    b   a   n   o   n

        L    A    A ,

        L    N    M ,

        A   m   a    l ,

        N    U    F ,    H

       o    b   e    i    k   a    f   a   c   t    i   o   n ,

        A   o   u   n    f   a   c   t    i   o   n    1

        9    7    5

        1    9    9    0

        W   a   r

        M   o   r   o   c   c   o

        M    i    l    i   t   a   r   y    f   a   c   t    i   o   n    (    f   o   r   c   e   s   o    f    M

       o    h   a   m   e    d    M   a    d    b   o   u    h    )

        1

        9    7    1

        1    9    7    1

        M    i   n   o   r

        P    O    L    I    S    A    R    I    O

        1

        9    7    5

        1    9    8    9

        M    i   n   o   r

        N   o   r   t    h    Y   e   m   e   n

        S   o   u   t    h    Y   e   m   e   n

        1

        9    7    2

        1    9    7    9

        M    i   n   o   r

        N   a   t    i   o   n   a    l    D   e   m   o   c   r   a   t    i   c    F   r   o   n   t

        1

        9    8    0

        1    9    8    2

        M    i   n   o   r

        R   o   y   a    l    i   s   t   s

        1

        9    6    2

        1    9    7    0

        W   a   r

        O   m   a   n

        P    F    L    O

        1

        9    7    2

        1    9    7    5

        M    i   n   o   r

        S   a   u    d    i    A   r   a    b    i   a

        J    S    M

        1

        9    7    9

        1    9    7    9

        M    i   n   o   r

        S   o   u   t    h    Y   e   m   e   n

        Y   e   m   e   n    i   t   e    S   o   c    i   a    l    i   s   t    P   a   r   t   y  -    I   s   m   a    i    l    f   a   c   t    i   o   n

        1

        9    8    6

        1    9    8    6

        W   a   r

        S   y   r    i   a

        M   u   s    l    i   m    B   r   o   t    h   e   r    h   o   o    d

        1

        9    7    9

        1    9    8    2

        W   a   r

        M    i    l    i   t   a   r   y    f   a   c   t    i   o   n    l   o   y   a    l   t   o    A   t   a   s   s    i   a   n    d    Z   e   a   y   e   n

        1

        9    6    6

        1    9    6    6

        M    i   n   o   r

        T   u   n    i   s    i   a

        F   r   a   n   c   e

        1

        9    6    1

        1    9    6    1

        W   a   r

        R    ´   e   s    i   s   t   a   n   c   e    A   r   m    ´   e   e    T   u   n    i   s    i   e   n   n   e

        1

        9    8    0

        1    9    8    0

        M    i   n   o   r

        Y   e   m   e   n

        D   e   m   o   c   r   a   t    i   c    R   e   p   u    b    l    i   c   o    f    Y   e   m   e   n

        1

        9    9    4

        1    9    9    4

        W   a   r

        U    K    (    S   o   u   t    h    Y   e   m   e   n    )

        F    L    O    S    Y

        1

        9    6    4

        1    9    6    7

        M    i   n   o   r

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    Figure 3: Distribution of Conflict in MENA Region, 1980

    Figure 4: Distribution of Conflict in MENA Region, 1995

    3 How Conflict Affects the MENA Region Differently

    Is the MENA region different from other regions in terms of the consequences of conflict?

    In the following section we provide an overview of the effect of conflict on the Millennium12

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    Figure 5: Distribution of Conflict in MENA Region, 2004

    Development Goals. These goals are more or less universally accepted as  the  benchmarks for

    evaluating development. The following section juxtaposes the effect of war on MDGs in the

    World and in the MENA region. The overview shows that the consequences of conflict for

    development are less detrimental in the MENA region than in the world as a whole (excluding

    the OECD countries).

    This section is meant to place the MENA region in a global context. In the following

    sections we analyze the effect of conflict on economic, health and mortality and political

    factors for the MENA region on its own.

    3.1 Summary of Results for MDG Goals for MENA and the World

    In a series of statistical analyzes, we have investigated how conflict affects the achievement

    of the millennium development goals. These analyses are based on data for all countries in

    the world. For most indicators, the effect of conflict is likely to be independent of the region

    the country is located within. For our global assessment we also investigated the effect of a

    country having a fragile status on the the different Millennium development goals.

    We analyze the effect of conflict on seven of the millennium development goals. Table 2

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    lists these MDGs as well as the various indicators we analyze to gauge the effect of conflict

    on the attainment of the goals. As table 2 indicates, for the world as a whole, we find

    clear detrimental effects of conflict on undernourishment, poverty, life expectancy, GDP per

    capita, primary school enrollment, secondary school enrollment, gender ratio in primary school

    enrollment, gender ratios in life expectancy, infant mortality, under 5 year old mortality, and

    on access to water. The effect of conflict is unclear (small coefficient and large standard error)

    for the proportion having a health care professional attending a birth and access to sanitation.

    The effect of war on HIV is positive – meaning that war actually helps a country move towards

    achieving that MDG.

    For the MENA countries in contrast, the effect of conflict is detrimental for life expectancy,

    primary school enrollment gender ratios, infant mortality, and access to water. For some re-

    lationships in the MENA region, the effect of conflict is unclear (small coefficient and large

    standard error) – for undernourishment, primary school enrollment, secondary school enroll-

    ment, and under five year old mortality. We find no effect of war on poverty or access to

    sanitation.

    As discussed below, these effects are quite strong. Five years of sustained conflict with

    only a moderate amount of direct fatalities (on average) push 3–4% of the population into

    undernourishment. We also find conflicts to generate a surplus infant mortality at the same

    level as the direct deaths – for every soldier killed in battle, one infant dies that would otherwise

    have survived through the indirect effects of conflict.

    For some of the MDGs we do not find clear effects. This is partly due to incomplete

    data – the indicators we use for MDG1 and MDG4 are among those with best coverage. We

    find clearer effects of indicators that change relatively rapidly, such as GDP per capita or

    undernourishment. It is harder to identify clear causal effects of conflict for variables that

    change more slowly.

    Our analysis is fairly conservative, focusing exclusively on change within countries. This

    means that we cannot make much use of information for countries that have remained in

    conflict over the entire period for which we have data. There is no doubt whatsoever that

    fragile states and conflict countries are further from achieving the millennium development

    goals than countries without such problems.

    Table 3 compares the mean and median values across a series of indicators of the MDGs

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    Table 2: Summary of Results, Millenium Development Goals

    MDG Label Indicator Effect of Effect of  Conflict World Conflict MENA

    MDG 1 Ending Poverty Undernourishment Detrimental Uncleara

    MDG 1 and Hunger Poverty Headcount Detrimental No effectb

    MDG 1   Life expectancy   Detrimental Detrimentalc

    MDG 1   GDP per capita   Detrimental DetrimentalMDG 2 Universal Prim. Sch. Enrollment Detrimental UnclearMDG 2 E ducation Sec. Sch. Attainment Detrimental Unclear

    MDG 3 Gender Parity Primary School ratio Detrimental UnclearMDG 3 Life expectancy Unclear Unclear

    MDG 4 Child Mortality   Infant Mortality   Detrimental DetrimentalMDG 4 Under-5 Mortality Detrimental Unclear

    MDG 5 Maternal Mortality Birth Attendance Unclear Ambiguousd

    MDG 6 Combat HIV/AIDS Proportion HIV positive Positive No effect

    MDG 7 Environmental   Access to Water   Detrimental DetrimentalMDG 7 S ustainability Access to Sanitation Unclear No effect

    a Unclear denotes large Standard Errors (SE) and high Coeffecientb No effect denotes large SE and low coefficientsc Detrimental denotes low SE and a substantial negative effectd Ambiguous denotes that the statistical effect has more than one theoretical explanation

    Table 3: Millenium Development Goals, Population Affected, 2005

    MDG Label Indicator Developing Countries MENA countriMDG Label Indicator Median (Mean) Median (Mean

    MDG 1 Ending Poverty and Hunger Undernourishment 6% (12%) 5% (8%)

    MDG 1 GDP per capita (USD) 1452 (3578) 5119 (8727)MDG 2 Universal Education Primary Sch. Enrollment 91% (89%) 89% (86%)MDG 2 Sec. Sch. Attainment 71% (70%) 75% (69%)MDG 3 Gender Parity Female Primary Sch. 97% (95%) 97% (95%)

    Life Expectancy Ratio 1.06 (1.07) 1.05 (1.05)MDG 4 Child Mortality Infant Mortality per 1000 20 (32) 19 (26)MDG 4 Under-5 Mortality per 1000 25 (44) 25 (31)MDG 5 Maternal Mortality Birth Attendance 97% (82%) 98% (94%)MDG 6 Combat HIV/AIDS Proportion HIV positive 0.5 (2.4) 0.48 (.1)MDG 7 Environmental Access to Water 86% (80%) 96% (91%)MDG 7 Sustainability Access to Sanitation 65% (62%) 85% (81%)

    for MENA states and all the other developing countries.4

    4We have excluded from our analysis all countries labeled as industrialized in the first  World Development Report  (1977), except for South Africa. We redefine South Africa as a developing country. This list correspondswith the OECD member states).

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    Part II

    Development Consequences of Conflict

    4 Economic Consequences

    In this section we examine the economic consequences of conflict. There is a large literature

    on the economic conflict trap (Collier et al. 2003), which posits that underdevelopment is

    both a cause and a consequence of conflict. That is, economic underdevelopment increases

    the likelihood of conflict, and conflict exacerbates economic underdevelopment. For the world

    in general, in some respects nearly all the millennium development goals are affected by the

    destructiveness of armed conflict. Indeed, for Sub-Saharan Africa and South Asia we find

    quite dramatic effects of conflict on a number of development indicators. For the MENA

    region the effects are less dramatic. We find an effect of conflict on economic growth. But

    this effect is much less profound than for the world as a whole. This may be due to the size

    of the region, but it is more likely due to the point of departure for most MENA countries.

    The initial values for the MENA region are quite different from much of the developing world,

    which may go a long way in mitigating the effects of conflict. We find that given a reasonably

    high starting point in terms of development, the speed of recovery from conflict in economic

    terms can be quite impressive.

    4.1 GDP Growth

    Figure 65 shows the mean GDP per capita across countries that have not had conflict, those

    that are in conflict and those having recently experienced conflict. The figure shows that

    the difference between conflict and non-conflict countries is greater in the MENA region than

    globally. The bar for post-conflict countries shows that while these countries generally exhibit

    higher GDP per capita than conflict countries, they are significantly lower than the no-conflict

    5The median value in each group is given by the vertical line inside the box in the center of each box-whisker combination. The outer values of this box are the 25th and 75th percentiles. The whiskers representthe ‘adjacent values’ (Tukey 1977) – the upper adjacent value is the largest value smaller than  x75 +

    32

    (x75−x25).The dots represent extreme observations outside the adjacent values.

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    countries.

    Figure 6: Distribution of Average GDP per Capita Rates 2007, by Conflict

    These box-and-whisker diagrams provide an elegant way to visualize a variety of descriptive

    statistics. The main problem with them is that they are static. Figures 7 and 8, therefore,

    show the trends over time in GDP per capita across three groups of countries: A set that

    have not had conflict, A set consisting of countries in conflict and a third set consisting of 

    post-conflict countries. The first group consists of all countries that have not had any conflict

    in the period 1980–2008, labeled ”Not Conflict” in the figures. The second group is made up

    of the countries that had conflict in the period 1980–1990, but not in the period 1990–2008.

    These are labeled ”Post Conflict”. The final category consists of the countries that have had

    conflict in the period 1990–2008, which is labeled ”Conflict”. The rationale for using this

    classification rather than a yearly classification of actual conflict status is to maintain the

    focus on the consequence of conflict. If we used an exact classification of conflict category,

    the overall trend would be very dependent on particular countries jumping between categories

    rather than the overall average differences between the categories.   6

    Figure 7 shows all countries in the world. Figure 8 shows only the MENA country trends.

    6An alternative would be to use moving averages, but this would be more suitable for longer time series.Another alternative would be to use GDP growth as the Y-axis. We provide a illustration of this model inFigure A-2 along with a discussion of why this presentation is problematic.

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    Evident from Figures 7 and 8 is that while the general pattern is one of globally improving

    GDP per capita over time, there are significant differences between conflict-affected countries

    on the one hand and peaceful countries on the other. Conflict and post-conflict countries are

    developing at similar rates – they tend to be poor and remain poor. This is consistent with

    the Collier et al. (Collier et al. 2003) notion of an economic conflict trap. In the MENA

    sample, the post-conflict countries are actually slightly poorer than the countries in conflict,

    but this is due to the strong influence of Israel.

    Figure 7: Trends in GDP Level, All Countries, 1990–2008

    So far, we have examined the difference in averages between countries across the conflict

    categories statically and over time. In this we explicitly did not allow countries to move across

    categories. These graphs therefore can not shed any light on the consequences of conflict on

    a given country. To account for the individual country trends and idiosyncracies we ran a

    fixed effect regression analysis. Based on this model, we simulate the effect of thirteen years

    of war from 1974 to 1986 on a simulated average MENA country (a hypothetical composite

    defined from our analysis of the data). Figure 9 presents the estimated effect of war on GDP

    level over time. The red dots are the simulated average for a case with no conflict, and the

    blue line is the simulated average level for a case with a 1974–1986 war. The bars indicate the

    uncertainty of the conflict case estimates. The figure show a dramatic gap during the conflict.

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    Figure 8: Trends in GDP Level, MENA, 1990–2008

    Towards the end of the conflict and in the five first years after the conflict, the conflict case

    has a very strong period of growth. This is consistent with the findings of Collier and Hoeffler

    (1998) and more broadly with the Phoenix effect (Organski and Kugler 1980). After the war

    the gap closes considerably. There is a gap between the averages, but the uncertainty bars

    become quite large towards the end of the simulation.

    The same uncertainty is present in our conclusion. The economic consequence of a conflict

    is clearly negative during the conflict, but it is difficult to conclude that there is long-term

    economic consequence of conflict in a given country. On average, we believe conflict is only

    moderately harmful in the long run, but the effect for a single country is difficult to predict.

    What this tells us is that a post-conflict situation is quite open, and that it is a situation

    where international organizations have a very real chance of making a positive impact.

    Table A-9 shows the estimates from regressing the growth in gross domestic product on

    different conflict measures. The results confirm what could be seen in Figure 6, that conflict

    has a clear and detrimental effect on GDP per capita growth. We estimate an OLS model

    with panel-corrected standard errors, correcting for autocorrelation. The first column shows

    the estimates from regressing GDP growth on conflict with conflict and growth measures in

    the same year. The second column gives the results for a lagged measure of conflict making it

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    Figure 9: The Effect of War on Economic Growth

    possible to assess the impact of a conflict up until 10 years ago on GDP growth in any given

    year. Columns five and six correspond to one and two but for these we substituted a categorical

    conflict measure for a continuous measure of battle deaths. As model 1 shows, one year of 

    minor conflict reduces the growth in GDP of between 1% and 2%. If we switch from conflict

    to battle deaths the results remain largely the same. As for the lingering effect of conflict we

    find that a significant negative effect of a conflict that ended last year on growth this year.

    Although the results indicate that this negative effect continues for up to four years, these

    results are not statistically significant. We control for regional effects by including dummy

    variables for every region, using the OECD countries as the reference category. For the model

    with a battle deaths measure, column four, we find a significant negative effect for the MENA

    dummy. This means that the economic consequences of conflict (as measured across MDGs)

    are more severe in the MENA region than among the OECD countries, but less severe than

    in areas such as Sub-Saharan Africa or South Asia.

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    5 Health and Mortality Consequences

    We now turn to the consequences of conflict for health and mortality. More precisely, we

    analyze and estimate the effect of violent conflict on infant mortality rates, life expectancy

    and access to adequate sources of water. Access to water is considered a question of health

    since inadequate access to water increases the risk of outbreak and spreading of e.g. diarrhea-

    related diseases. In addition to these more indirect causes of conflict, we will also examine

    direct consequences of conflict on health through battle deaths. We will show that although

    battle deaths are the most visible effect of conflict, the big killers actually come in the wake

    of these direct deaths.

    In an influential article, Ghobarah, Huth and Russett (2003) argue that civil wars have

    a long term effect on civilian suffering. Analyzing the World Health Organization’s measure

    of so-called Disability Adjusted Life Years (DALYs) they argue that 8.01 million DALYs

    were lost in 1999 from civil wars during the period 1991–97. The authors build on these

    findings in a later article (Ghobarah, Huth and Russett 2004) and argue that the additional

    burden of death and disability caused by the lingering effects of civil wars, is nearly double

    the immediate and direct effect of these war. Civil wars, they argue, “directly effects all the

    major contributors to health: exposure to disease, medical care, public health interventions,

    and overall socio-economic conditions” (Ghobarah, Huth and Russett 2004, 871).

    The most comprehensive and recent study of the effects of conflict on health was carried

    out by Iqbal (2010). Following up on an earlier article, (Iqbal 2006), she argues that conflict

    results in a deterioration in public health, mainly because of the effect of conflict on both

    general infrastructure and health infrastructure. All of these authors are adopting, by and

    large, the line of argumentation first proposed by King and Murray (2001) on the need to

    focus on human security.

    5.1 Battle Deaths

    Figure 10 shows the trend in battle-related fatalities in the post-WWII period. It is worth

    noting that the peaks in the graph are modest relative to the number of fatalities experienced

    during the two world wars. Up until the mid 1970s the conflicts in East Asia completely

    dominate the picture. The Chinese Civil War, the Korean War, the Vietnamese War and

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    the Cambodian Civil War were dramatic events that overshadow all other conflicts in this

    period. However, after the Vietnamese invasion of Cambodia, East Asian contributions to the

    battle-related fatalities have been modest. The first Arab-Israeli war of 1948 is the first in a

    series of large wars in the MENA region. The Algerian war of independence is one of the most

    serious conflicts during the 1950s and accounts for a large share of the total battle-related

    fatalities during this decade. After 1980 the MENA region has contributed a major share of 

    global conflict fatalities. The war between Iran and Iraq (1980–88) is by far the most deadly of 

    these, but the later internal conflicts in Iraq also contribute significantly to the overall trend.

    Figure 10: Trends in Number of Battle Deaths in the WORLD and MENA Region, 1946–2008

    5.2 Surplus Mortality

    5.2.1 Infant Mortality

    Figure 11 provides an initial and somewhat crude look at the effect of conflict on infant

    morality. The figure shows the mean logged infant mortality, measured as the number of 

    infants per 1000 who die before reaching one year of age, in the year 2008 across conflict and

    region. Clearly the non-conflict countries perform much better in terms of infant mortality

    than conflict-affected countries. This holds for both the world and for the MENA region,

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    many more infant deaths than the later. Given that the Middle East has a high proportion

    of interstate wars, as discussed above, and that these wars tend to be characterized more

    by bombardment and shelling than guerilla raids, it is actually not surprising that we find

    a greater effect of conflict on infant mortality for the MENA subset of countries than for

    the world average. It should be noted here that different kinds of warfare will differ in their

    effect on various health indicator. HIV/AIDS rates in contrast to infant mortality rates might

    be more affected by guerilla warfare than by more conventional warfare. As Iqbal and Zorn

    (2010, 152) argue, guerrilla warfare is characterized by “substantial interaction between rebel

    combatants and civilians, with the result that such conflicts’ direct effects on HIV transmission

    will be substantial as well”.

    Figure 11: Distribution of Average Infant Mortality Rates 2007, by Conflict Category

    These direct deaths, however, are only a part of the surplus deaths caused by conflict.

    Although it is hard to measure the exact ratio, most probably a greater number of infant

    deaths occur due to the indirect effects of conflict. These indirect effects range from disruption

    of health infrastructure, which obviously affect an infants chance of surviving, to increased

    spread of diseases. As discussed below in relation to access to water epidemiological research

    argues that disease, and especially diarrhea, has a greater effect on mortality rates than direct

    battle deaths (Degomme and Guha-Sapir 2010). Degomme and Guha-Sapir (2010, 297) study

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    Figure 12: Trends in Infant Mortality Rates, 1990–2008

    Darfur and argue that “more than 80% of excess deaths were not a result of [the] violence.

    (...) but the main cause of mortality during the stabilization period were diseases such as

    diarrhoea”. Such excess deaths are the result of an increased spread of disease, which in turn

    drive up infant mortality rates. The increased spread may be caused by the inability of states

    to provide health services for their population during war time, or to conditions in e.g. refugee

    camps that increases the transmission of disease. By and large people do not die battle-related

    deaths after the point at which a cease-fire is decleared7. Excess deaths due to the spread

    of disease and the disintegration of health infrastructure, on the other hand, leads to higher

    mortality rates for years after the violent conflict has ended.

    Conflict, however, does not only effect the infant morality rate, it also effects changes in

    these rates. We examine this by looking at the effect of conflict on the trajectory of im-

    provement or worsening of infant mortality rates. The results of that analysis is found in the

    appendix, A-10. The results clearly show that conflict does not only have a detrimental effect

    on crude rates, it also affects the rate of improvement. Although we do not find significant

    results for minor conflict, i.e. less than 1000 battle related deaths, for ma jor wars we find a

    7This of course is not completely true. Deaths due to e.g. land-mines and unexploded ordinance often killpeople long after a a truth have been declared. Such deaths are of course battle-related deaths.

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    decrease, however, is not due to adult deaths, but rather due to mortality among infants and

    younger people. An infant dying before the reaching one year of age, will of course suppress

    the mean life expectancy for the population more than an adult dying at age 50. Decreased

    life expectancy is caused, by and large, by heightened infant mortality.

    Figure 13: Distribution of Average Life Expectancy Rates 2007, by Conflict Category

    5.2.3 Access to Water

    A person is perceived to have adequate access to water if she has reasonable access to at

    least 20 liters of water a day from a source within one kilometer of her household. Figure 14

    shows the percentage of people with adequate access to water across our conflict categories.

    As the the graph reveals, access to water is not more of a problem in the MENA region than

    in the rest of the world (excluding OECD), but it nevertheless remains a significant problem.

    The figure also shows that reduced access to water as a consequence of conflict is not merely

    a result of fighting. If access to water declined during conflict because of military fighting.

    That is if the fighting make traveling safely to sources of water impossible. Then conflict

    should not have a lingering effect on this measure. The problem, in essence, would cease to

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    be a problem the day a cease-fire was called.8 In such a case, post-conflict countries should

    not perform worse than non-conflict countries on this measure. Nonetheless, they do. The

    effect of conflict, therefore, goes beyond this issue of physical separation. Access to water is

    also closely related to the the two previous mortality measures we analyzed. As noted above

    diarrhea is one of the biggest killers in the wake of conflict. The spread of this disease is

    closely related to the availability of adequate drinking water.

    For our analysis we estimate two sets of regressions, the results can be found in the

    appendix, see table A-12. The results show that one year of minor conflict decrease the

    population with adequate access to water with close to 0.9 percentage points. In an average

    MENA country close to 10 % of the population lacks adequate access to water. After five

    years of conflict 14.54 % of the population would not have adequate access to water. In a

    MENA country with average population this corresponds to adding a little over 51.000 people

    to the segment of the population without adequate access to water according to our estimates.

    Clearly that is a substantial effect of conflict.

    We argued above that the detrimental effect of conflict on access to water is not just due

    to fighting decreasing the mobility of a country’s population. To better analyze that claim we

    estimate our regression analysis with a lagged conflict measure. The substantial effect of the

    lagged conflict measure seems to confirm this claim. We also find a significant effect of conflict

    on the rate of change in access to water rates. This corresponds with the previous indicators.

    Conflict affects a state’s ability to provide adequate water supplies for its population even after

    the conflict has ended, and this accounts for the detrimental effect of conflict on improvement

    in access rates. This decrease in water accessibility can occur through the destruction of 

    infrastructure, especially pipes and pumping stations.

    Such infrastructure destruction would set the country back on this indicator, but it ac-

    counts poorly for the long term damage we see through the analyzes of the improvement gap.

    Infrastructure after all is relatively easy to rebuild, and after large scale conflicts international

    funds are often amassed to help with precisely such types of rebuilding. Our finding that

    conflict has an enduring effect on access to water must consequently be accounted for through

    other causes as well. One potential mechanism relates to the political conflict trap. During

    conflict government funds are shifted from “butter to guns”, and the weak institutions that

    8That might be an overstatement. Once again land-mines and unexploded ordinance can take huge deathtolls after fighting has stopped

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    Figure 14: Distribution of Average Water Access Rates 2007, by Conflict Category

    we argue often result from conflict in the MENA region may be unable to shift focus back to

    “butter” and thus rebuild critical infrastructure in an adequate way. The authors of the 2009

    Arab Human Development Report also argue that there is a connection between conflict and

    access to water, but they stress instead the lack of cooperation on “water usage and man-

    agements” which they argue is “heavily affected by prevailing political tension and ongoing

    conflicts” (United Nations Development Programme, Regional Bureau for Arab States 2009).

    They point, thus, to a possible additional mechanism to ones we have discussed.

    5.3 Mechanisms

    How does conflict cause a deterioration in health and mortality? What are the specific mecha-

    nisms? In an influential article, Ghobarah, Huth and Russett (2003) argue that civil wars have

    a long term effect on civilian suffering. Analyzing the World Health Organization’s measure

    of so-called Disability Adjusted Life Years (DALYs) they argue that 8.01 million DALYs were

    lost in the year 1999 from civil wars that occurred during the period 1991–97. In Ghobarah,

    Huth and Russett (2004), they argue that the additional burden of death and disability caused

    by the lingering effects of civil wars, is nearly double the immediate and direct effect of these

    war. Civil wars, they argue, “directly effects all the major contributors to health: exposure

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    to disease, medical care, public health interventions, and overall socio-economic conditions”

    (Ghobarah, Huth and Russett 2004, 871). Iqbal (2010) indicate in a comprehensive empirical

    study that a considerable amount of differences between countries indeed can be attributed

    to conflict over and beyond factors that explain both variables.

    There are a number of good reasons to think that conflicts do have a causal effect. Gho-

    barah, Huth and Russett (2003, 191–192) suggest a useful theoretical framework for analyzing

    the effect of conflict and fragility on the development outcomes summarized in the MDGs.

    Noting that “health conditions are shaped by the interplay of exposure to conditions that cre-

    ate varying risks of death and disease for different groups in society and the ability of groups

    in society to gain access to health care and receive the full range of benefits produced by the

    health-care system”, they first list four sources of differences in health outcomes:

    1. The extent to which populations are exposed to conditions that increase the risk of 

    death, disease, and disability

    2. The financial and human resources available for addressing the public health needs of 

    populations

    3. The level of resources actually allocated to public health needs by the private and public

    sectors

    4. The degree to which resources actually allocated to public health are efficiently utilized

    Civil wars directly expose populations to conditions that increase mortality and disability,

    point 1 above. The most obvious source is of course battle deaths. Mortality increases and

    life expectancy decreases through deaths incurred as a direct consequence of fighting. The

    effect of this mechanism on aggregate life expectancy and mortality levels depend on the

    technology of war utilized by the warring parties. Conflict characterized by low-scale guerilla

    warfare will produce much fewer battle deaths than conflict in which artillery shelling and

    aerial bombardment is used. By and large, however, the indirect effects of conflict are likely

    to be much greater than the direct effects. This is not only true for intra-state wars. “For

    instance the influenza-epidemic that spread in 1918 and 1919 killed more people than the

    deaths resulted directly from military activity in World War I (...) some of the causes of the

    magnitude that epidemic reached included the mass movement of armed forces, the conditions

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    in which soldiers lived in the trenches, and the effects of mustard gas and fumes generated by

    some weapons” (Iqbal 2010, 40). Civil wars also often displace large populations, and their

    temporary accommodation often expose them to new risk factors. As noted by Ghobarah,

    Huth and Russett (2003, 192), “epidemic diseases – tuberculosis, measles, pneumonia, cholera,

    typhoid, paratyphoid, and dysentery – are likely to emerge from crowding, bad water, and poor

    sanitation in camps, while malnutrition and stress compromise people’s immune systems”.

    Even without displacement, conflict may destroy pre-existing local health facilities as well

    as blocking access to proximate facilities because of the risks involved in traveling through con-

    flict zones. This is particularly true for infant and under-five mortality as well as birth-related

    maternal mortality. Epidemiological research shows that disease, and especially diarrhea, has

    a greater effect on mortality rates than direct battle deaths. Degomme and Guha-Sapir (2010,

    297) study Darfur and argue that “more than 80% of excess deaths were not a result of [the]

    violence. (...) but the main cause of mortality during the stabilization period were diseases

    such as diarrhoea”. Such excess deaths are the result of an increased spread of disease, which

    in turn drive up infant mortality rates. The increased spread may be caused by the inability

    of states to provide health services for their population during war time, or to conditions in

    e.g. refugee camps that increases the transmission of disease. Ghobarah, Huth and Russett

    (2003, 192) further note that violence often escalates in the aftermath of war, adding to the

    mortality and disability rates.

    Civil wars also affect the second and third points above. Military expenditures invariable

    increase during war and local economies may be disrupted. The effect is to reduce health

    spending. In cases where distinct population groups are perceived as the opposition, the

    government will often be tempted to cut off public spending in their territory at the same

    time as the military contest is likely to be most intense in the opposition’s home region.

    Finally, conflict reduces the efficiency of the public health resources that are allocated.

    Again in the words of Ghobarah, Huth and Russett (2003, 193), “ wartime destruction and

    disruption of the transportation infrastructure (roads, bridges, railroad systems; communica-

    tions and electricity) weakens the ability to distribute clean water, food, medicine, and relief 

    supplies, both to refugees and to others who stay in place.” Medical personnel tend to leave

    conflict zones if they can, leaving the poorest and most immobile behind. Ghobarah et al.

    note, military forces often deliberately target health facilities and transportation infrastruc-

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    ture to weaken the opposition.

    6 Political consequences

    Armed conflict is defined as the organized use of violence over political issues, and we should

    therefore expect the political consequences of conflict to be significant. In this section we will

    not focus on the policies of conflict as such, but on the consequences of conflict. We show that

    conflict has consequences for the broader institutional framework that constitute the political

    system and for the real policies that politicians produce within this framework. We show that

    this in turn has important consequences for development and long-term peace, which we label

    a political conflict trap.

    The most immediate political consequence of armed conflict is that large parts of society

    become securitized. Policies usually deemed unacceptable by the public can be implemented

    with reference to the security of the state. Freedom of speech can be effectively limited through

    associating certain political stances with “the terrorists”.

    Securitization can lead to political and social exclusion, which in turn is highly destabi-

    lizing. Several regimes in the MENA regions have attempted to combine authoritarian rule

    while maintaining an open and inclusive political strategy. When this inclusive strategy fails,

    the only way to voice opposition is through riots and violence. Suppressing popular revolts is

    very costly, and further securitized the political climate. In the end, these half-way attempts

    at opening up have often led to further suppression or return to armed conflict.

    6.1 Human Rights Abuses

    Arendt (1970) argue that a strong autocrat does not have to violently suppress its citizens.

    Both government and opposition know what the outcome of a challenge will be. The Moscow

    show trials are a prime example of how an autocracy can keep its population under tightcontrol with a modest and inexpensive use of force. Dissent will be more likely to occur in

    weaker regimes, where opposition groups doubt the regime’s ability to maintain control. It is

    in this setting we expect the most thorough and visible human rights abuses.

    Most research on the prevalence of human rights abuses (see Davenport (2007a ) for a

    good review) find that the presence of a threat to the regime increases the risk that the

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    regime will engage in repressive policies (designed to address perceived threats to the regime).

    Armed conflict, by definition, threatens the regime. In a securitized environment we tend

    to see flagrant violations of human rights - torture, disappearances, political incarcerations,

    discrimination, and brutal subjugation.

    While underdevelopment in itself can be seen as a human rights violation, we focus here

    on the more traditional definition of human rights as civil and political rights. Some countries

    have developed economically under repressive regimes. However, the literature on this subject

    point out that human rights abuses are associated with poor development (Barro 1997; Isham,

    Kaufmann and Pritchett 1997). The World Bank has subsequently in concert with major

    donor countries highlighted human rights abuses as a developmental issue (Palacio 2006).

    We measure a state’s human rights situation through the Political Terror Scale (PTS)

    (Gibney, Cornett and Wood 2008). The measure is a five-point scale with 1 indicating a

    country under secure rule of law, 3 indicating extensive political imprisonment, political exe-

    cutions and little or no due process, and 5 indicating that the leaders of the country place no

    limits on the means or thoroughness with which they pursue personal or ideological goals 9.

    These data are based on reports by Amnesty International and the U.S State Department.

    Figure 15: Political Terror Scale by Conflict Categories

    Figure 15 describes the probability of each of the five Political Terror Scale indicators

    under four different conflict scenarios, separated by whether the conflict is intense (war) or

    9See the Political Terror Scale web site: http://www.politicalterrorscale.org/ptsdata.php

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    less violent (Minor conflict) and whether the conflict erupted recently (New) or not (Durable).

    The unit in Figure 15 is country-year observations, and the size of the bars are based on

    predictions from a regression based simulation using Clarify (King, Tomz and Wittenberg

    2000). The regression results used in this simulation is described in Table A-16.10

    The results enforce the point made above. A MENA country with a durable war is more

    than 80% likely to be in the least favorable category, with large-scale human right violations,

    and more than 95% likely to be in the worst two. Human rights violations becomes more

    severe as a war continues, but even in the first year, a country with an internal war is 80%

    likely to be in either the worst or the second worst category.

    There is a significant difference between full war, as seen in Algeria, Iraq or Lebanon, and

    less violent conflicts, as seen in Iran. A country in a durable minor conflict has a very high

    probability of being in category 4, but a small probability of being in the worst category. This

    is even more apparent early in a minor conflict, where we see more than 70% probability of 

    scoring a 3 or lower score on the Political Terror Scale.

    Globally conflict countries have a political terror scale one point above that of no conflict

    countries. That might not sound like much. The difference, however, between a score of 2 and

    3 on the political terror scale, is the difference between “a limited amount of imprisonment

    (...) However, few persons are affected, torture and beatings are exceptional” and “extensive

    political imprisonment”.

    Severe violence begets securitization which in turn begets serious human rights abuses.

    Minor conflict, in contrast, results in far less securitized environment, and results in limited

    human rights abuses. The threat of terrorism exacerbates this causal relationship. Minor

    conflicts, involving terrorist attacks on civilians, can produce severe securitized environments,

    particularly in the MENA region. The mere threat of terror often results in human rights

    abuses.

    6.1.1 Human Rights Violations in Post-Conflict Countries

    When we move from the conflict to the post-conflict context, we observe a significant im-

    provement in human rights practices. We see no long-term effect from minor conflicts, but

    civil wars seem to have an effect beyond their termination. The securitization of the political

    10We use five annual lags of the political terror variable, which should be sufficient to guard against theplausible hypothesis of reversed causality.

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    environment persists. This effect is partly contingent on political institutions, as post-conflict

    autocracies are somewhat more oppressive than the regions semi-democracies. Figure 16 de-

    scribes the post-conflict probabilities for each PTS category. Again, the darker colors are the

    better categories.

    Figure 16: Political Terror Scale by Post-Conflict Categories

    The gradual improvement of human rights in post-conflict situations can be due to the

    effect Arendt pointed out. After years of large-scale repression, dissidents lose their strength

    and are subdued, which in turn reduces the need for suppression.   11

    11However, we cannot dismiss a competing methodological explanation that countries with good governanceare less likely to fall back into conflict and thereby producing a biased sample for the more durable post-conflictsocieties. We thank Alex Kremer for his helpful comments on this topic

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    A disturbing finding is that most post-conflict MENA countries, regardless of regime

    type, have a troublesome human rights record. The most prevalent situation is category 3 or

    extensive political imprisonments, murders and habeas corpus violations, which is what both

    Amnesty International and the US State Department describe as the situation in Lebanon in

    2008.

    Our analysis shows that after 6 years the post-conflict situation approaches the pre-war

    situation, in which the two most disturbing levels of the PTS are seldom seen. Large-scale

    human rights violations in the MENA region are in other words a conflict and immediate

    post-conflict phenomenon.

    Comparing the two different political systems, we see that post-conflict autocracies are

    more likely to implement the worst human right violations. Although the difference in per-

    centage points remains rather small, a clear majority of the worst post-conflict human rights

    regimes are autocracies. Why is this so? We will use the following sections to outline an

    explanation.

    6.2 Changes to Formal Political Institutions

    We will briefly define a number of central terms, then give an overview of the trends in the

    region, discuss the underlying mechanisms that we see connecting conflict to the current state

    of affairs and assess what we believe are the core challenges ahead.

    6.2.1 What Institutions?

    Nobel laureate Douglass North (1990) defines institutions as the rule of the game in society,

    or the set of formal and informal rules that together constrains individuals and their actions.

    These can be unwritten social norms or more formal laws. At the far end of this spectrum we

    find the formal political institutions from which political power arises. There are three core

    issues that together decide the formation and distribution of formal political power:

    1. How did the president, prime minister, monarch, etc. become the chief political executive

    officer of his or her country? Is this office reserved for a single person, filled through

    competition within a small elite, or is it open to anyone?

    2. To what extent did the process involve the general public in a meaningful way? Many

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    dictators hold elections, and they often get an impressive part of the vote, but the

    election is a scam. Participation becomes meaningful when politicians are sensitive to

    how the public choose to participate (Strøm 1992).

    3. How far can the executive branch execute its authority before it is checked by some

    other, formal institution? The separation of powers into three branches of government

    is a prerequisite for a system of checks and balances. Independent judicial systems,

    constitutional review by an elected assembly and federalism are the most common ways

    of limiting the power of an executive. The effect of these checks and balances are a more

    transparent political system and safeguards against abuse of power.

    Eckstein (1973) label these three dimensions of formal institutions for recruitment, partici-

    pation, and executive constraint. A regime which has an open form of recruitment, large-scale

    effective participation and significant limits on the executive power is labeled a democracy,

    whereas an autocracy has closed recruitment channels, no popular participation and no limits

    to the executive power.

    Huntington (1991), among others, argue that there is a qualitative difference between

    democracies and non-democracies, and that this qualitative difference is more important than

    any other aspect: Is the government elected or not? Przeworski et al. (2000) take the issue

    one step further and defines democracies as countries where governments lose elections. While

    such dichotomous definitions have their strengths, such as clarity and parsimony, they do not

    pay sufficient attention to the heterogeneity of the non-democracies. The non-democratic

    regimes comes in many different forms and shapes, and it is important to separate between

    them, particularly for the MENA region.

    6.2.2 A Multidimensional Representation of Political Systems

    We label the regimes that are neither autocracies nor democracies as Semi-democracies. While

    they are often analyzed as a consistent category, they are anything but that. Apartheid South

    Africa is institutionally very different from Kenya. Morocco is different from Algeria. Yemen

    is different from Iran. Figure 17 illustrates how Gates et al. (2006) conceptualize the variation

    among different regimes. In the upper right corner all three dimensions are aligned towards

    distributing political power between the branches of government, and the voters. In the lower

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    left corner, political power is concentrated among a small group of people.

    Saudi Arabia is an good example of a regime in the lower left corner. Political power sits

    in the hands of a very small group of people, which is self-recruiting. Israel is in the other end

    of the cube, with a very competitive political system where power is distributed among several

    institutions and where all citizens have a say in popular election. However, if one would count

    the about 4.1 million palestinians as a disenfranchised part of the electorate, Israel would slide

    downwards along the upper right edge of the cube.

    Figure 17: Multidimensional Institutional Representation of Political Systems (MIRPS)

    The question of stability is clearly dependent on regime type. Both democracies and

    autocracies are institutionally consistent. That is, the different institutions work towards the

    same end, whether it is the separation of power or the opposite. Gurr (1974) and Gates

    et al. (2006) show how instability arises from a situation in which different institutions pull

    in different directions. The most unstable situation is a system with highly contested election

    but no independent review of the executive branch between elections. These systems are

    typically found in Sub-Saharan Africa.

    As an example, Iran’s elections gave people a chance to voice an alternative to the current

    political platform. With no constitutional mechanism to address the religious foundation of 

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    the Islamic Republic, popular discontent is by default illegal and the system’s ugliest side

    showed itself. The pre-election screening of candidates by the Council of Guardians means

    that Executive Recruitment in Iran is a mix between competition and designation. The

    electorate can choose between different candidates, but not freely so. The presence of an

    elected parliament provides some minimum levels of constraints, but the real constraint lies

    with the President and the religious Council of Experts. In sum this puts Iran anno 2000

    somewhere close to the middle of the left side of the cube. Over the last decade, several

    changes have been made to concentrate power in the Wali Faqih and the Presidency, and in

    light of the very disputed elections in 2009, Iran has moved downwards into the Autocratic

    corner.

    Algeria represents a very different form of semidemocracy. The 2004 re-election of Boute-

    flika was recognized as free and fair by the international society. Yet, it is an open question

    how free and fair the election would have been if the winner was deemed unacceptable by the

    military. The 2007 legislative elections were a setback in comparison, as low confidence in

    the electorate led to a dismal turnout of 35%, and the 2009 presidential elections re-elected

    Bouteflika for a third time with mo