While many of us here in the US wake up concerned about political, economic, and military unrest at home and abroad, billions still wake up with more basic, human security concerns, opened FSE director Rosamond L. Naylor in a plenary connecting climate, energy, food, water, and health.

Are we going to have enough to eat today? How am I going to feed my family or care for family members struggling with HIV/AIDS and other infectious diesease? Is there enough water to drink, bathe, and still water my crops?

Naylor emphasized the need to bring these human security issues back into the forefront of our global conscious. While these are 'humanitarian needs at the core', they are also related to national and international security.

"When people are desperate enough, and we've seen this particularly with the food price spike in recent years, they take to the streets, and sometimes when they take to the streets they realize they are disgruntled about a number of things in addition to food prices," said Naylor.

The Arab Spring and wave of rebellions throughout the Middle East last year demonstrate the connections between food security, unmet basic needs, and national security. It has been a chaotic time for world food markets, said Naylor.

Naylor's global statistics are discouraging. Over a billion people still suffer from chronic hunger and malnutrition, 1/5 don't have physical access to water, and roughly 1.6 billion are facing economic water constraints (do not have the economic resources to access available water). Food and water insecurity are exacerbating the incidence and transmission of infectious disease.

At a time when investment is sorely needed, the Hill has been making dramatic cutbacks in foreign assistance and foreign investment is falling short. Efforts made by the private sector, philanthropy, and civil society, while valuable, remain siloed. Opportunties are being missed by not addressing the interrelated nature of food and health issues.

Despite this dire outlook, Naylor offered solutions to help us rethink our development strategy.

1. Invest in more diversified and nutritious crops that have more climate adaptation potential.
2. Consider new irrigation strategies, particularly in areas like Africa where 96% of the continent is still not irrigated. Not large dams, but small, distributed irrigation systems that rely on solar and wind.
3. Integrate food and health programs and the way we think about domestic and productive water uses.

Naylor was joined on the panel by Jeff Seabright (Vice President, The Coca-Cola Company), Daniel Gerstein (Deputy Under Secretary for Science and Technology, U.S. Department of Homeland Security), and Geoff Dabelko (Woodrow Wilson International Center for Scholars). The panel was moderated by Frank Sesno (George Washington University and Planet Forward). Video of the plenary can be found below:

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Since the Taif agreement of 1989, which helped end the civil war, half of Parliament has been reserved for Christians, the other half for Muslims, with each half distributed among 11 of Lebanon’s 18 officially recognized sects (Maronite, Greek Orthodox, Protestant, Sunni, Shiite, Druze, Alawite, etc). Each of Parliament’s (pdf) 128 seats is sect-specific: only members of that sect can run for it. (Voters, however, can cast their ballot for every seat in their district regardless of their own religious affiliation.) The president must be a Maronite, the prime minister a Sunni and the speaker of Parliament a Shiite. Hundreds of bureaucratic appointments are also subject to sectarian apportionment under the Constitution.

The imposition of religious representativeness in politics is a scourge. In the best of circumstances, it is vulnerable to the demagoguery of religious leaders; in the worst, it breeds civil violence and paralyzes the government. But others fear that a more open system would not provide the guarantees of power-sharing among religious minorities that the current model entails.

In recent months, the focus of these long-standing divergences has centered on the intricacies of Lebanon’s electoral law. The next parliamentary elections are less than a year and a half away, and a loose coalition of civil society groups, independent politicians and Lebanon’s president – the former army general Michel Suleiman — has recently proposed implementing a system of proportional representation to replace the current majoritarian, or “winner-take-all,” model.

Under the existing system, a fledgling party with a small but dedicated following stands no chance of getting its candidates elected in a district where a more established party holds sway. Under proportional representation — in which seats are allocated in keeping with the share of votes collected — a small party could win some seats with a minority of votes. In addition to ensuring multiparty representation in each district, proportional representation would empower lesser-known independent candidates. Over time the newcomers could coalesce to form a bulwark against the traditional political mainstream and advance a more liberal agenda.

Predictably, most major parties have conspired to protect the status quo; they want to maintain their primacy within it. The Future Movement, the main Sunni party, worries that the Sunni allies of its Shiite archrival, Hezbollah, might encroach on its turf. Walid Jumblatt, the country’s main Druze leader, fears that he would lose votes to other Druze figures with small-time followings in his traditional stronghold, the Chouf mountains.

In a rare show of unity, the leaders of Lebanon’s main Christian parties have come together to oppose the president’s draft law. The proposed law would combine Lebanon’s small electoral districts into fewer and larger ones, which is necessary for proportional representation to work effectively. (Imagine an election between 10 different parties in a 10-seat district: if each party wins 10 percent of the overall vote, each one gets its own seat. In a two-seat district, only the top two lists win seats.) But an electoral map with  larger districts also means  larger constituencies, which in turn means that substantial numbers of Christian candidates could be voted in on the lists of non-Christian parties (like the Future Movement and Hezbollah). And that would erode the influence of the traditional Christian political elite.

And so the Christian political establishment has offered a radical counter-proposal: a law that would institute proportional representation but also require citizens to vote only for members of their own sect (Sunnis would elect Sunnis; Greek Orthodox, Greek Orthodox, etc.)

One of the many problems with this idea is that it would generate considerable inequalities of suffrage between Christians and Muslims. As is, Christians already have greater voting power than Muslims because they still occupy half of Parliament even though they now represent less than half of Lebanon’s population. Under the new proposal, this disparity in representation would be further exacerbated.

Worse is the vision of Lebanon’s political future at the heart of the Christian plan. The president’s proposal envisages a country whose citizens vote for candidates on the basis of party affiliation and political platform, not sect. The Christians’ counter-proposal imagines Lebanon as a collection of 18 insular religious communities jealously nominating their own nobility and eyeing one another with suspicion. The first model is a bold step toward dismantling political sectarianism; the second is an enormous step backward, toward greater divisiveness.

Because of its inexpediency, a substantive revision of the electoral law in time for the 2013 elections seems unlikely — despite the fact that a solid majority of Lebanese say they would prefer proportional representation to the current system. Yet if Lebanon is ever to establish a new social contract — one based on true citizenship rather than begrudging coexistence — it will need to change its electoral arithmetic.

Riding around on the back of a motorcycle in 2009, Jeremy Menchik snapped photos of hundreds of Indonesian campaign posters. That number has now grown to over 5000 images, which Menchik and Colm Fox have painstakingly coded and analyzed to better understand the politics of identity in Indonesia. The initial results of their research reveal similarities between the United States and Indonesia, and shed light on the transitional democracies of the Arab Spring.

Menchik is a 2011–12 Shorenstein Fellow at Stanford University, and will take up a position as an assistant professor in international relations at Boston University in 2013.

Fox is a doctoral student at the George Washington University’s Department of Political Science.

How important is political identity in Indonesia? Why?

Indonesia is the largest Muslim-majority country in the world, and one of the most diverse. But what we found was that rather than being unique, Indonesian politicians behave remarkably similar to American politicians in using a variety of regional, religious, and ethnic identity symbols to court voters.

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What is an important factor in determining a candidate’s use of identity symbols?

What we found is that the election rules matter, a lot. Candidates are far more likely to use religious and ethnic symbols in a plurality (“winner-take-all”) system like the United States than in a proportional representation system (PR) like Indonesia. This is an important finding, because tinkering with election rules is one of the tools that international relations practitioners can use to reduce ethnic and sectarian violence. And what we are saying is that it works. Changing election rules can change the types and levels of identities that are politicized. And that is an important lesson for conflict resolution.

What are some of the most surprising results to come out of your research?

The first is how badly the dominant explanations for identity politics—modernization theory and secularization theory—fared when they were tested on a large dataset. We are at an interesting juncture in time, where our theories of religion and politics have not caught up with the way the world works.

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During last year’s Arab Spring, the ideal of democracy was celebrated throughout the world. How might your research shed light on understanding the complexities of these transitioning democracies?

Well this research has clear implications for the Arab Spring, particularly for understanding the future of Egypt. Just because religious parties like the Muslim Brotherhood or the Salafist Nour party come into office does not mean that democracy is doomed, or that religious minorities are going to suffer. As long as secular Muslims, Christians, liberals, and other groups have a stake in elections, we are likely to see cross-ethnic and cross-religious coalitions emerge. This is a very good thing. One obvious difference, however, is that we did not see a lot of overt military participation in politics in Indonesia after 1999. The military was largely absent. And that is one way that Egypt is very different from Indonesia. If there is a big threat to democracy in Egypt, it is not coming from the politicization of identity—it is coming from the suppression of the people's voice by the military.

One year after the Arab Spring, American public diplomacy is still facing the now-established conundrum of linking words and actions. The rise of Islamist political parties as the new leaders in the Arab world is the latest challenge for U.S. public diplomacy, but it is also an opportunity.

Since the attacks of September 11, the United States has been matching its military activity in the Middle East with outreach to Muslim and Arab communities. By and large, this outreach has not been successful. As several public diplomacy experts have been arguing for a number of years now, the limited impact of this outreach is due to the negative perception of U.S. foreign policy towards the Middle East by citizens in the region. When actions and words do not match, words are perceived with a hefty dose of suspicion.

When the Egyptian revolution began on January 25, 2011, U.S. foreign policy took some time to catch up with sentiment on the Egyptian street. To make matters worse, the “Made in USA” tear gas canisters that protesters in Tahrir Square angrily displayed to the cameras of the international media were a further reminder of the United States’ cozy relationship with the Mubarak regime.

Since then, the U.S. has improved its words and actions by declaring both rhetorical and policy support for the Arab world’s revolutionaries (albeit in varying degrees), and as a result, public opinion about the U.S. in the region has improved. The 2011 Arab Public Opinion Pollshows a significant increase in favorability towards the U.S., compared with the 2010 poll, from 10% to 26%. The U.S. must continue to enhance this record.

Back in 2006, after much hype by the U.S. about the importance of free and fair elections in Palestine, the U.S. backtracked when Hamas swept the Palestinian Legislative Council elections in Gaza,withdrawing aid and boycotting the elected Gaza government. As Islamist parties sweep free and fair elections in one country after another in the region—starting with Tunisia, then Egypt—it is fairly safe to declare that in the immediate aftermath of the Arab Spring, the Arab world will be led by Islamists. So far, the U.S. has not repeated the mistake of 2006 with Hamas’ election in Gaza, accepting the results of the elections as democratic and as representing the will of the people.

But this is not enough. Of course, the United States currently has an easier task, since none of the groups that have been elected to-date in the Arab region are on the U.S.’s “terrorist” list. However, merely accepting election results will not cause a significant change in the perception of the U.S. on the Arab street.

The U.S. recognizes the current period as one of opportunity: it is the time to reinvigorate U.S. assistance with civil society, economic aid, and cultural outreach in the Arab world. But the most important “action” of all remains how foreign policy will play out. The Islamist groups that have assumed leadership positions in Tunisia and Egypt, namely Ennahda and the Muslim Brotherhood, have one very old dream: to be recognized as statesmen nationally and internationally. If U.S. foreign policy in this new era is going to be successful, it must be based on treating those leaders as such.

This is not just important on the traditional diplomatic level; it is also important for the success of U.S. public diplomacy. The Islamist leaders now assuming positions as Prime Ministers or House Speakers (and who knows, perhaps also presidents in the near future) reached power through having been elected by their constituents. The U.S. cannot reach out to those constituents while treating their leaders differently. In the past, U.S. public diplomacy towards Egypt appeared insincere because the U.S. attempted to engage the Egyptian people while taking a soft stance towards the Mubarak regime, which had been jailing, harassing, and—as in the case of Khaled Said—killing those same people.

For the first time in the Arab world’s history, there is a real opportunity for the U.S. to match its words and actions towards the region, and to have foreign policy become the basis upon which to formulate a truly engaging public diplomacy.

As incomes rise around the world, health experts expect a more troubling figure to increase as well: the number of diabetics in developing countries.

In China and India – two of the world’s most populous nations with fast-paced economies – the prevalence of diabetes is expected to double by 2025. Between 15 and 20 percent of their adult population will develop the disease as household budgets increase, diets change to include more calories and new health problems emerge.

But China, India and other developing countries are not fully prepared to deal with the rising trend of diabetes. And a growing number of diabetics aren’t getting the care they need to prevent serious complications, Stanford researchers say.

Even with insurance, many diabetics don’t have essential medications that could help them manage their conditions. In many cases, people are spending a great deal of their household incomes to pay for their treatment, said Jeremy Goldhaber-Fiebert, an assistant professor of medicine who led the research team.

“Public and private health insurance programs aren’t providing sufficient protection for diabetics in many developing countries,” said Goldhaber-Fiebert, a faculty member at Stanford Health Policy at the university’s Freeman Spogli Institute for International Studies. “People with insurance aren’t doing markedly better than those who don’t have it. Health insurance and health systems need to be re-oriented to better address chronic diseases like diabetes.”

Findings from the study are online and will be published in the Jan. 24 edition of Diabetes Care, the journal of the American Diabetes Association. The journal article was co-authored by Jay Bhattacharya, an associate professor of medicine and Stanford Health Policy faculty member; and Crystal Smith-Spangler, an instructor at Stanford’s Department of Medicine and an investigator at the Palo Alto VA Health Care System.

Failure to adequately manage diabetes will lead to more severe health problems like blindness, heart disease and kidney failure. It also harms the otherwise healthy, Goldhaber-Fiebert said.

Diabetes often strikes people at an age when they’re taking care of children and elderly parents. To sideline these primary caretakers as dependants will lead to a heavy burden for communities and create an obstacle for economic growth, he added.

Using responses to a global survey conducted by the World Health Organization in 2002 and 2003, Goldhaber-Fiebert and his colleagues examined data from 35 low- and middle-income countries in Asia, Latin America, Africa and Eastern Europe to determine whether diabetics with insurance were more likely to have medication than those without insurance.

They also wanted to know whether insured diabetics have a lower risk of “catastrophic medical spending,” a term the researchers define as spending more than 25 percent of a household income on medical care.

“Surprisingly, diabetics with insurance were no more likely to have the medications they need than uninsured diabetics,” Goldhaber-Fiebert said. “They were also no less likely to suffer catastrophic medical spending.”

There are many reasons why health insurance may not protect diabetics in developing countries against high out-of-pocket spending. In some cases, there’s a lack of sufficient medication – such as insulin – that regulate glucose levels. Without those drugs, there’s a greater risk of complications that often lead to more hospitalizations and more expenses.

In other cases, co-payments and deductibles are too high. Sometimes, drugs and medical services to prevent diabetes complications are not covered. And doctors and hospitals don’t always accept insurance.

“Better policies are needed to provide sufficient protection and care for diabetics in the developing world,” Goldhaber-Fiebert said.

Without medications to manage diabetes and prevent secondary complications, the condition will worsen and the burden of catastrophic spending will increase, he said.

“It’s important to get ahead of the curve and prepare so there’s an infrastructure in place to deal with these health and cost issues,” he said.

While preventing diabetes in the first place would be ideal, programs and policies must be established to care for the many cases that will surely continue to exist.

“There isn’t a single country that’s managed to entirely arrest or reverse the trend of diabetes,” he said. “Programs that focus on primary prevention are extremely important, but the reality is that the developing world faces hundreds of millions of diabetes cases that are unlikely to all be prevented.”