Securing Health: Lessons from Nation-Building Missions

We define nation-building as efforts carried out after major combat to underpin a transition to peace and democracy. Nationbuilding involves the deployment of military forces, as well as comprehensive efforts to rebuild the health, security, economic, political, and other sectors. The research we conducted focused on one aspect of nation-building-efforts to rebuild the public health and health care delivery systems after major combat. We looked at seven cases- Germany, Japan, Somalia, Haiti, Kosovo, Afghanistan, and Iraq. These are some of the most important cases since World War II in which international institutions, non-governmental organizations (NGOs), and countries such as the United States have taken part in efforts to rebuild the health sector. These missions also have important health components. To date, a significant amount of academic and policy-relevant work has been devoted to efforts to rebuild such areas as police and military forces. Little comprehensive work has examined efforts to rebuild public health and health care delivery systems, however. The work that has been done on health tends to focus on immediate humanitarian and relief efforts rather than long-term health reconstruction. The goal of our research was to fill this void.

America’s Role in Nation-Building: From Germany to Iraq

The post-World War II occupations of Germany and Japan set standards for postconflict nation-building that have not since been matched. Only in recent years has the United States has felt the need to participate in similar transformations, but it is now facing one of the most challenging prospects since the 1940s: Iraq. The authors review seven case studies – Germany, Japan, Somalia, Haiti, Bosnia, Kosovo, and Afghanistan – and seek lessons about what worked well and what did not. Then, they examine the Iraq situation in light of these lessons. Success in Iraq will require an extensive commitment of financial, military, and political resources for a long time. The United States cannot afford to contemplate early exit strategies and cannot afford to leave the job half completed.