As the U.S. works toward getting more 11,000 Americans, diplomats and Afghan allies out of the country, what kind of Taliban should the U.S. expect to deal with in Afghanistan?  So far, there have been assurances from the Taliban that a new regime may not be as brutal as regimes past, but few who have worked with the Taliban believe the assurances.  How might the regime work with, or shelter groups like al-Qaeda, which is the reason why the U.S. entered into Afghanistan after 9/11.  And how might a massive-scale exodus of Afghans impact neighboring countries?

The Cipher Brief sat down with the former National Intelligence Manager for Iran at ODNI, Norman T. Roule to get his expert-level perspective.

Norman T. Roule, Former National Intelligence Manager for Iran, ODNI

Cipher Brief Expert Norm Roule served for 34-years in the Central Intelligence Agency, managing numerous programs relating to Iran and the Middle East. He served as the National Intelligence Manager for Iran (NIM-I) at the Office of the Director of National Intelligence from November 2008 until September 2017.  As NIM-I, he was the principal Intelligence Community (IC) official responsible for overseeing all aspects of national intelligence policy and activities related to Iran, to include IC engagement on Iran issues with senior policy makers in the National Security Council and the Department of State.

The Cipher Brief: How would you characterize the international community’s response to the Taliban victory in Afghanistan?

Roule:  Historians of the future will likely describe the response to the Taliban victory as a strange mix of apathy and confusion.

In terms of apathy, there is extraordinary irony in the fact that after spending so much blood and treasure to defeat Da’esh efforts to establish an extremist Islamic Republic in Syria and impose its oppression over Iraqis and Syrians, the international community failed to prevent the creation of an Islamic Republic in Afghanistan. Many of the arguments behind our involvement in Syria – from a refugee crisis to the need to deny international Islamic militants a home to birth new terror groups – apply to Afghanistan. Whether or not one supported this decision, it is hard to avoid thinking that this episode will embolden militants worldwide.

In terms of confusion, we seem to be unable to accept that no one can predict the course and pace of crowd dynamics that so quickly eroded Afghan resistance. We live in a world where people acknowledge their inability to predict who will win our presidential elections but insist the Intelligence Community can somehow predict the day events will occur in a denied environment. But such a worst-case possibility should have been part of the planning deck and resourced on the ground accordingly.

The Cipher Brief: How would you expect the international community to respond in the coming days?

Roule: Absent a Taliban attack, operations at the airport should proceed more smoothly as our response architecture grows. Beyond that, much depends on how the Taliban act in the coming weeks. The group is not a monolith. Their success was highly likely as much a surprise to them as anyone. As they define their path and choose their leaders, there will be internal debates, jockeying for power, and perhaps some violent infighting.

In terms of indicators of the regime’s direction, we may want to consider the following questions:

First and foremost, how will the Taliban respond to our ongoing evacuation? Thus far, they seem willing to let us leave untouched, probably believing that the sooner we get out, the easier it will be for them to take control. At the same time, international media coverage of the evacuation will impose a strategic embarrassment on Washington.

Second, to what extent have the Taliban changed? They certainly understand that diplomacy played a role in their victory. Some of their leaders have spent hundreds of hours with foreign diplomats and traveled to multiple foreign capitals. How will these leaders merge such experiences into governance with more insular colleagues? They are likely to talk initially about compromise regarding women’s rights and inclusion of opponents in the government, but this may well be another effort to buy time. The international community has few pressure points over the group. How this plays out will be a good indicator of how they plan to run the country.

Next, how will they handle the issue of al-Qaida and other terrorists? We cannot overlook the deep connections between the Taliban and al-Qaida. If they believe the international community will limit its response to demarches, press statements, and empty sanctions, many in the group will be inclined to allow al-Qaida to reorganize.

Last, I would look at the refugee issue. They are likely to welcome external aid and allow at least some humanitarian groups to remain in country. Doing so requires no political concessions, addresses a domestic headache, and provides an opportunity for corruption. Humanitarian groups also offer a lever the Taliban can use against the West, i.e., refrain from criticizing us, or we will block your humanitarian operations. The Houthis have done this with great effect in Yemen.


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The Cipher Brief: How do you think will China, Russia, and other adversaries will respond to the withdrawal? 

Roule: Chinese propagandists have aggressively exploited our evacuation from Afghanistan. Its media is already claiming that these events show Taiwan that “once war breaks out in the Straits, the island’s defense will collapse in hours, and the US military won’t come to respond.” China’s press has also reportedly announced that the U.S. will not stand by Hong Kong activists.

Beijing, Tehran, and their proxies will likely point to the withdrawal as evidence that the U.S. is a declining power, unwilling or incapable of defending its friends. It will be lost on no one that whereas the U.S. has abandoned Afghanistan, Russia, China, and Iran have not wavered in support of their – admittedly few and otherwise isolated – allies.

In a worse case, if our adversaries believe the withdrawal reflects a lack of national resolve, they may be tempted to test our will on other issues. In this case, a miscalculation could lead to a conventional war in another theater.

The Cipher Brief: What would you say to those who say that the withdrawal demonstrates that the U.S. will only focus on strategic interests?

Roule:  Certainly, this argument has an appeal. It is true that our strategic adversaries like nothing better than the U.S. expending resources and diplomatic energy in such areas as Afghanistan, in part because we are, in essence, protecting their interests for free. But it does beg two questions.

First, what will happen differently next year regarding China, Russia, efforts to combat climate change, and cyber actors, now that we are out of Afghanistan? Second, what exactly is a U.S. strategic interest that we would protect? Estonia? Bahrain? Taiwan?

This argument also glosses over how others respond to such a posture. If a country perceives itself outside the international community’s protection, it will likely accommodate an aggressor. Our next call for a coalition of the willing will likely meet with less enthusiasm.

U.S. influence depends on the respect shown to us in multiple arenas. The echoes of this localized respect become self-reinforcing. We should think about what happens to collective international security if these echoes are silenced.

Last, this argument inherently argues that values are strategic interests. Unless violence directly touches Americans, we will limit our response to diplomacy and public statements. Such protests are unlikely to stop those behind a future Srebrenica massacre or the Rwandan genocide. Indeed, one can make a case that such a response might even encourage such events.

The Cipher Brief: How can the U.S. now best demonstrate its national resolve?

Roule:  As the saying goes, the best way to demonstrate national resolve is to demonstrate national resolve. Fair or not, this episode will tar the Biden administration. It doesn’t help that some allies reportedly have complained that the U.S. did not sufficiently consult with them on its decision to withdraw. Public criticism of the withdrawal decision by some of our closest European partners is growing. Adversaries will now consider their action through the lens of Afghanistan, much as the post-Vietnam malaise encouraged Soviet aggression in the 1970s.

I am not saying that we can’t reverse this situation. The U.S. withdrawal from Lebanon in 1984 caused many to question U.S. resolve. Although it did signal an end to U.S. (and international) efforts to eradicate Hezbollah, Reagan’s actions in other arenas (to include Afghanistan) restored the image of U.S. national resolve. Difficult diplomacy and a demonstration of our willingness to use military power when needed lay ahead.


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The Cipher Brief: What does the return of the Taliban mean for al-Qaeda?

Roule:  There is little reason to believe the Taliban-Al-Qaida relationship will not resume, although al-Qaeda is a fragmented and a pale version of its original stature. Nonetheless, it is easy to imagine the delight of its remaining leadership and cadres. Elements in Iran will likely seek to return to Afghanistan, perhaps assuring Iran that in exchange for tolerance of periodic transit of Iranian territory, the group will use its influence with the Taliban to protect Iran’s interests. We should watch for any signs of a return to Afghanistan by Zawahiri’s deputy, Sayf al-Adel, who is currently in Iran with other members of the group’s leadership council.

But al-Qaeda is not the only actor on this stage. Its leader Ayman al-Zawahiri has not appeared for months and has far less influence than Osama Bin Laden. Afghanistan also hosts al-Qaeda in the Indian Subcontinent (AQIS), ISIS, and other groups. The Taliban have emptied Afghanistan’s prisons which held deeply committed and dangerous militants who may gravitate to whatever new militant leadership might arise. But a lethal threat to Americans is sure to appear. The only questions are its size, goals, and reach.

The Cipher Brief: What does the U.S. withdrawal mean for China and Russia?

Roule: Both countries have sought to undercut U.S. influence in Afghanistan. They will each be delighted with the rhetorical violence of our internal debate over the withdrawal. But they also enjoyed the stability our engagement provided in a country so close to their borders.

Both countries have developed relations with the Taliban. I believe each hosted a Taliban delegation in recent weeks. It shouldn’t be lost on us that neither country felt compelled to withdraw its personnel from Kabul. That’s a pretty good sign of their confidence in the relationship.

Outside of Afghanistan, each will use the withdrawal to increase their influence with Central Asian actors – including Turkey. Coordination on terrorism and narcotics issues will come most easily. For example, Uzbekistan will worry that the Taliban will renew support of the violent Islamic Movement of Uzbekistan, which has long maintained a presence in Afghanistan.

China’s concerns will be threefold. Beijing will use economic and diplomatic inducements to ensure that the Taliban do not encourage unrest among China’s oppressed Uighur population, let alone support the East Turkistan Islamic Movement or other Chinese militants in Xinjiang province. Next, Beijing will want to explore the Belt and Road access Afghanistan offers. Last, China will likely test whether it can achieve a commercially viable deal to mine Lithium and other minerals. In that mine operations require many years to develop and a vast amount of capital to construct, such arrangements are likely to be few given Afghanistan’s unpredictable political and security environment.

As for Russia, the U.S. withdrawal offers a chance for greater influence in Central Asia. We should watch for signs of new Russian military bases in the region. Moscow’s concern that Afghanistan will once more become a sanctuary for anti-Russian terrorists will also drive its relationship with the Taliban.

The Cipher Brief: What about Iran and Pakistan?

Roule: Iran has long maintained a relationship with Taliban elements. Reportedly, this involved sanctuary and provision of some weaponry. Tehran’s goals were to hedge its bets in Afghanistan, influence the enemies of the U.S., and protect the Shi’a of Afghanistan.

On the last point, Iran may have much work to do. Taliban personnel reportedly tore down Shi’a posters as they entered Kabul. Tehran must now contend with the consequences of refugees and the rise of warlords on its border.

The current head of Iran’s Qods Force, Esmail Qaani, has considerable experience on Afghan issues, and I expect he will play a prominent role in Iran’s response. We should watch to see how the Qods Force deploys its seasoned Afghan Fatemiyoun proxies from Syria.

Pakistan’s long-time relationship with the Taliban will give it more influence over the group than other countries. But Islamabad also will be on the receiving end of a flood of refugees, renewed militant terrorism in its loosely-controlled border areas, and Western pressure for its support of the Taliban. Ties to the Taliban may also complicate Islamabad’s relationship with India and China.

The Cipher Brief: What does this mean for the U.S. intelligence community?

Roule: The counterterrorism cadre of the US intelligence community and its partners have achieved extraordinary successes in the last years. But their work is now more complicated but no less urgent. For example, our withdrawal has reduced collection streams and potential access when the Afghanistan-based terrorist threat has only begun to grow. This challenge arrives as we shift counterterrorism resources from al-Qaeda to domestic extremists, cyber threats, and China.

The Cipher Brief: Any final comments?

Roule: If I may, I would like to close with a couple of brief comments.

First, we need to do everything we can to support personnel on the ground in Afghanistan. They – and their support teams at home – are trying to restore order in the middle of a hurricane. We are watching heroism at its best.

Next, the narrative of Afghanistan is unsurprisingly partisan. But politics shouldn’t obscure the truth. For more than twenty years, thousands of American and coalition partners volunteered to risk their lives in Afghanistan. We didn’t come to colonize. We didn’t steal Afghan resources. The operational goals were to bring Bin Laden to justice, destroy al-Qaeda, and prevent Afghanistan from becoming a haven for the group in the future. We also worked to transform Afghan society. The need for this last effort wasn’t apparent at the outset of our invasion. But it was likely unavoidable if we hoped to satisfy our values and enable Afghan society to confront its militant population. This effort represents the best of our values, and we owe all who served in this arena our most profound respect. Afghans who have participated in their country’s efforts during the past two decades will endure tremendous suffering. But they remain Afghanistan’s best hope and they deserve our support. Last, we need to end the fiction that Afghans didn’t fight for their country. Tens of thousands of Afghans were killed and wounded in the fight against al-Qaeda. Many involved in this fight are reportedly being sought door-to-door by the Taliban. Discounting their efforts may serve a political narrative, but it does them a terrible injustice.

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This piece was first published by RUSI in London.  The views do not represent those of RUSI.

EXPERT PERSPECTIVE –The international community is coming under increasing pressure to recognise the Taliban and to unfreeze Afghan funds held by the IMF or to risk a humanitarian crisis over the winter and a resurgence of international terrorism.

As Afghanistan heads deeper into winter the desperate need is to avoid a humanitarian crisis. The World Food Programme has launched an appeal to feed up to 23 million people and Médecins sans Frontières have followed suit in the healthcare field. Fortunately, the distribution mechanisms are in place inside Afghanistan; what is needed is for the international community to ensure that UN humanitarian programmes are fully funded. This will require Western capitals to get over the shock of their recent defeat. It goes without saying that hunger and health should not be used as instruments of political leverage.

Meanwhile, it is becoming ever more apparent that the Taliban do not have the skills to administer a country which is far more complex than the Afghanistan of 1996 – when they began their previous and disastrous spell in office. They will need international assistance to stabilise the economy, get people back to work and, in time, continue the gradual infrastructure improvements which have been underway since 2002. China will doubtless be willing to assist in some areas but Beijing has already made clear that it is adopting a cautious, gradualist approach. However, there are emerging indications that the Taliban’s intransigent views are beginning to relax; such as their approval of the polio vaccination scheme and their willingness to work with UN humanitarian agencies.

The Taliban will also need outside help in defeating the threat from the Islamic State’s Khorasan Province (ISK). Already the Taliban are finding it difficult to counter similar asymmetric tactics which they used so successfully against Western forces. This is likely one of the subjects which CIA Director William Burns discussed with the Taliban during his visit on 24 August and where there is a mutual interest.

What can the international community (not just the West) realistically expect from the Taliban, following the militant group’s stunning victory? Maximalist demands will inevitably get short shrift.


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First, the Taliban should form a more inclusive government. According to multiple sources, the Taliban were intending to form such an administration had Ashraf Ghani not fled the country on 15 August. I am sceptical that this was ever their intention but former president Hamid Karzai and former reconciliation chief Abdullah Abdullah may have remained in Kabul on this understanding and Fatima Gailani, a former negotiator, insists this was the Taliban’s intention.

An inclusive government would need to include women and non-Taliban representatives from the Hazara, Uzbek and Tajik communities. It need not comprise the failed politicians and bloodstained warlords of the past, least of all Gulbuddin Hekmatyar and Abdul Rashid Dostum. It is surely time for a new generation of more technocratic Afghans to become involved in government. Some may be persuaded to return from abroad but they will need assurances for their safety.

Second, the international community should insist on female education at all levels be restored and for women to play a fuller role in society. The Taliban will baulk at this but they only need to look at Pakistan where women play an important role in an avowedly Islamic, if not Islamist, society.

Third, all neighbouring countries, as well as the wider world, want Afghanistan to commit to removing all terrorist bases and terrorists from its soil; not just ISK and Al-Qa’ida but also the Eastern Turkistan Islamic Movement, the Pakistani Taliban (TTP), anti-Iranian and anti-Indian groups, and Central Asian militant movements including the Islamic Movement of Uzbekistan.

Fourth, the Taliban should commit to allow people to join their families in exile if they wish and also cease the continuing search for and punishment of those Afghans who served the Afghan government and Western allies since 2001.


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In an ideal world there would also be a fifth request: to remove Haqqani network members from the Taliban administration. However, that pass was sold when the US negotiator Zalmay Khalilzad engaged with the Haqqanis in Doha – another result of that calamitous dialogue. Furthermore, the current reality is that the Haqqanis control both Kabul and its airport and Sirajuddin Haqqani holds the key position of interior minister.

Instead, the Haqqanis need to be persuaded to prevent Al-Qa’ida regrouping in Afghanistan. Sirajuddin’s father was close to Osama bin Laden and the group retains its Al-Qa’ida connections. Pakistan is already using the Haqqanis to bring the TTP to the negotiating table. It remains to be seen how successful this will be. It is doubtful that the Haqqanis would be willing to take military action against a group from a similar area in the tribal borderlands. However, the Haqqanis could be useful as intermediaries, if not as enforcers.

Meanwhile, the wider Taliban, usually referred to as the ‘Kandaharis’, are increasingly exasperated by the entryist Haqqanis. Although they have worked together, there was never much love lost between the two. The Kandaharis have always distrusted the Haqqanis’ proximity to the Pakistani military. Since the Taliban takeover of Afghanistan, Mullah Abdul-Ghani Baradar, whose willingness to negotiate with the Kabul government in 2008 and 2010 earned him eight years in a Pakistani prison, has been sidelined. There will doubtless be a reckoning

A lasting regret of the US’s careless withdrawal is that Washington did not conclude a broader settlement for Afghanistan involving China, Iran, Russia, India and the Central Asian Republics. From now on it is essential to include all the neighbours in the discussion of recognition and the conditions required. But first the Afghans must be helped to survive the winter.

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Controversial psychologist and author Jordan Peterson claimed Western countries had no “moral right” to force developing nations to reduce pollution output, noting instead that improving their economies was key.

During an appearance on the BBC’s ‘Question Time’ show on Thursday, the Canadian professor noted that the focus of climate change policies should be on incentivizing the development of cheap energy in poorer polluter countries.

“The best long term solution is to try to make developing countries as rich as possible, and the best way to do that is not control their pollution output, but to help them develop the cheapest energy they can possibly manage as fast as they possibly can,” Peterson said.

The debate saw UK undersecretary for employment Mims Davies suggest that measures taken to tackle climate change should not come at the “expense of developing countries.” But Peterson countered that it “absolutely, 100% will be [at their expense].”

I don’t think we have any moral right in the West at all to do that.

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FILE PHOTO: Jordan Peterson speaking with attendees at the 2018 Student Action Summit hosted by Turning Point USA in West Palm Beach, Florida, December 20, 2018 © Flickr / Gage Skidmore
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He also criticized the recent COP26 climate change conference for failing to explore ideas on how best to improve national economies in the developing world, noting that he saw “very little of that sort of idea” coming out of the UN summit.

In the final hours of the two-week conference, China and India had intervened to soften the wording around the use of coal in the Glasgow Pact. The two countries demanded a change in the final text of the agreement that called for coal to be phased out, revising this to “phasing down unabated coal.”

The move prompted COP26 president and UK minister Alok Sharma to declare that China and India would have to “justify” their actions to countries that were more vulnerable to global warming effects. However, officials in both Beijing and New Delhi have countered that the criticism was unfair.

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The EU Commission has released draft legislation aimed at tackling the destruction of woodland by introducing import restrictions on products not certified as ‘deforestation-free’.

The draft proposal, which the commission hopes will become binding rules for all member states, seeks to limit the import of beef, cocoa, coffee, palm, soy, and wood if it is not proven “deforestation-free.”

Outlining the legislation, the EU commissioner for climate action policy, Virginijus Sinkevicius, called it a “ground-breaking” proposal that will help fight “illegal deforestation” and “deforestation driven by agricultural expansion.”

The bill comes after nations at the COP26 summit agreed to work to end deforestation by 2030. It would impose two criteria on imports, requiring items to have been produced in accordance with the origin country’s laws, and not on land that has been deforested or degraded since the start of 2021.

It is not clear when the rules would come into effect; legislative proposals by the commission have to be debated and considered by both the EU Parliament and the Council of the EU before they are passed. The implementation of measures could potentially impact the EU’s trade relations with countries like Brazil, where clearing of the Amazon rainforest hit a new record in October.

During the recent COP26 climate summit, 110 world leaders – whose countries contain around 85% of the world’s woodland – committed to ending and reversing deforestation by 2030, pledging around £14 billion ($18.84 billion) of public and private funds towards the goal.

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CIPHER BRIEF EXPERT PERSPECTIVE 

Cipher Brief Expert Tim Willasey-Wilsey served for over 27 years in the British Foreign and Commonwealth Office. He is now Visiting Professor of War Studies at King’s College, London.

Older Americans have Saigon 1975 and the helicopters from the Embassy roof seared into their memories. A previous generation of Britons was haunted by the image of General Percival surrendering vast numbers of troops and equipment in Singapore to the Japanese in 1942. How Kabul falls to the Taliban could have important practical and symbolic significance.

The announcement that the United States is sending 3,000 troops to Kabul alongside 600 British troops to manage the evacuation of their civilians and those Afghans who provided assistance, is a remarkably late response to a rapidly deteriorating situation. Unless carried out in the next 48 hours, it will also be risky. Taliban infiltrators are already inside Kabul and the forces which captured Ghazni and Kandahar on 12th August will be heading towards the capital on their Honda 125cc motorbikes.

The US must have extracted undertakings from the Taliban negotiators in Qatar not to launch their full assault on Kabul until the evacuations are complete, but elements of doubt remain. Previous Taliban assurances have proved worthless, and it is doubtful that individual Taliban commanders would wish to hold back while some of Ashraf Ghani’s ministers, senior army officers, judges and officials are spirited away to a life of exile.

It is hard not to be impressed by the speed and élan of the Taliban’s recent successes; taking 13 of Afghanistan’s 34 regional capitals in almost as many days. It is reminiscent of the extraordinary progress which the Japanese made down the Malaya Peninsula in 1942 with Singapore as the ultimate prize.

The Taliban’s success has not happened by chance. It is clearly the fruit of preparation and planning. Above all, they have learnt from the experience of 1994 to 1996 when they eventually took Kabul but failed to capture the north, thereby allowing space for the Northern Alliance parties to survive and then reassert themselves following the 9/11 terrorist attacks.

This time, the Taliban have focussed first on border posts with neighbouring countries (thereby denying the government vital supply routes and customs revenues) before taking outlying regional capitals and leaving Kabul (which is never easy to capture) until last. Above all, they have concentrated on the north where many rural Afghans are disenchanted with the Kabul government and regional warlords. The north is no longer the solid bastion of anti-Taliban sentiment it was in the 1990s.


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Taliban progress in the north has snuffed out any chance that the old Northern Alliance could be reborn out of the eventual collapse of the Ashraf Ghani government. Whereas in 1996, Ahmed Shah Massoud, its brilliant military leader, was able to abandon Kabul and beat a tactical retreat up the Panjshir Valley, that option barely exists today. Not only is Massoud dead but his former adherents are no longer guerrilla fighters but members of a stratified Afghan army which has struggled to perform without US air support.

The Taliban have also ruthlessly exploited the weak negotiating stance of the United States and its chief negotiator Zalmay Khalilzad. Whereas some of the Taliban team in Doha, such as Mullah Barader, may indeed have been ‘moderates’ there was never any doubt that the Taliban movement wanted to see the total defeat of the Kabul government and the expulsion of Western forces. Pakistan too, may have occasionally considered some form of negotiated deal but ultimately the only sure way of keeping Indian influence out of Afghanistan (it believes) is a Taliban government.

The Afghan army (and in particular its impressive Special Forces) will now be assembling in Kabul and should be able to repel initial attempts to overrun the city. Certainly, Gulbuddin Hekmatyar found it impossible to take Kabul in 1992 and 1993 even with help from Pakistan, which, in frustration, switched support to the newly-created Taliban movement in late 1994.

But from 1992 to 1996 there were frequent deliveries of supplies to Massoud and his Northern Alliance defenders from Russia, Iran, and India. In 2021, the position is very different. Russia has already decided to “back the winner” and believes it has extracted promises from the Taliban not to export Islamism northwards into the Central Asian Republics (CARs). Iran too has channels to the Taliban and will be watching carefully for any return to the Taliban’s persecution of the Shia Hazaras. And India has already made contact with the Taliban in Doha in the hope that the Taliban in power will prevent Kashmiri militant groups from setting up bases there.

The likelihood therefore is that Kabul will fall to the Taliban quite quickly. If the Americans and British do manage to insert their evacuation forces soon, they should be able to complete the operation successfully, although there are likely to be heart-rending scenes at the airport as crowds of refugees are turned away at gunpoint from departing aircraft. Regional powers, particularly Pakistan, will try and persuade the Taliban to hold back from intervening, conscious that a bloodbath in Kabul would be a disastrous start to the Taliban’s second spell in government. Ironically, however, the evacuation would almost certainly lead to the collapse of the Kabul government as senior officials are forced to decide whether to take the last aircraft out or face almost certain torture and death at the hands of the victors. It is doubtful whether any Western countries will choose to retain their embassies in Kabul. For President Biden, the memory of Benghazi will be too raw.

What is certain is that there will be new iconic images to rival those of Saigon and Singapore.


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Hospitals in the Netherlands have begun delaying certain operations to free-up ICU beds during a record wave of Covid-19 infections, while an infectious diseases researcher has warned of an impending ‘Code Black’ in the sector.

The country set a daily national record for new Covid infections on Thursday, registering around 23,600 cases. It was the third day in a row of the figure topping 20,000.

To make more staff available for Covid wards, a number of operations, including those for cancer and heart patients, are being canceled from this week on, Dutch healthcare officials have said. Fewer than 200 beds remained available in Dutch ICUs as of Thursday, while Friday figures show almost half (47.8%) of occupied ICU beds were being used by Covid patients.

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FILE PHOTO. A woman wearing a protective mask walks past a store in Amsterdam, Netherlands.
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“These are cancer patients that should actually be operated-on within six weeks of diagnosis, and that won’t be met in all cases. It’s also heart patients,” said a spokesperson for the National Coordination Center for Patient Distribution (LCPS).

Meanwhile, new calculations by an infectious disease modeller at Wageningen University & Research suggest that a so-called ‘Code Black’ in hospitals is looming. The emergency designation means that patient safety is at risk and, if declared, would mean many people with life-threatening illnesses cannot go to the ICU, while doctors have to prioritize who to treat.

According to recent estimates from the Dutch Healthcare Authority (NZa), up to 200,000 operations were not performed as a result of urgently needed Covid care since the start of the pandemic. On Thursday, the NZa revealed that almost a quarter of operating rooms across the country are not currently in use due to a combination of Covid patient pressures and rising staff absences due to illness.

It is not yet clear what impact the delayed care will have on public health. In December 2020, the Dutch National Institute for Public Health and the Environment (RIVM) calculated that an estimated 34,000 to 50,000 ‘healthy life years’ had been lost due to the first Covid-19 wave alone.

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Clinics in the Austrian region of Salzburg have set up a special assessment team tasked with identifying Covid patients who have a higher chance of survival; the rest may soon have to take a back seat.

Amid a dramatic spike in Covid cases, medical personnel warn they may soon have to make the heart-wrenching choice of which patients get life-saving treatment and which ones will have to wait, Austrian media report. Intensive care units in the Salzburg region are packed, with the number of patients treated there setting a new grim record on Tuesday, reaching 33. The region ranks amid Austria’s hardest-hit, logging more than 1,500 new infections per 100,000 residents in a week. In an emotional plea for help to the local government, the head of Salzburg’s hospitals warned that soon clinics would likely not be able to guarantee the existing level of standards in terms of medical treatment. A representative for the city clinics likened the situation to “running into a wall.

The region’s governor, Wilfried Haslauer, announced on Tuesday that some of the Covid patients whose condition was no longer life-threatening would be transferred from hospitals to rehabilitation centers to make room for more serious cases.

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FILE PHOTO.GRAZ, AUSTRIA. © AFP /CREDITERWIN SCHERIAU
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In neighboring Upper Austria, the situation is no better, with the number of deaths in intensive care units surpassing figures seen in all the previous Covid waves. Speaking to Austria’s Der Standard paper on condition of anonymity, healthcare workers there said they had free beds “because the infected are dying.

For the time being, the creation of a so-called ‘triage team’ in Salzburg hospitals is being described as a “precautionary measure.” The panel is made up of six people: one legal expert and five providers from various medical disciplines. If push comes to shove, they will be deciding which patients stand a chance and which treatments have little prospect of success.

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This piece by General Joseph Votel (Ret.) and Lt. Gen. Michael K. Nagata (Ret.) and was first published by our friends at the Middle East Institute.


Lt. Gen. (ret.) Michael K. Nagata is a distinguished senior fellow on national security at MEI. He retired from the U.S. Army in 2019 after 38 years of active duty, with 34 years in US Special Operations. His final position was director of strategy for the National Counterterrorism Center from 2016 to 2019.

Gen. (ret.) Joseph L. Votel is a distinguished senior fellow on national security at MEI. He retired as a four-star general in the U.S. Army after a nearly 40-year career, during which he held a variety of commands in positions of leadership, including most recently as commander of CENTCOM from March 2016 to March 2019. 


OPINION – The United States and Pakistan have had a complex and often disappointing “love-hate” relationship since 1947 — one severely tested during the 20-year U.S.-led intervention in Afghanistan. We believe the time has come for serious policy consideration of whether and how both nations can achieve a more strategically beneficial and sustainable post-intervention relationship between the American and Pakistani governments and their populations.

As we consider a new policy, the U.S. military withdrawal from Afghanistan after two decades of leading the international coalition is almost complete. Early indications are that Afghanistan is increasingly likely to descend into significant instability and possibly serious fracture, which will have unwelcome consequences for the Afghan people and all of Afghanistan’s neighbors. It is already clear that international terrorist groups like al-Qaeda and Islamic State-Khorasan Province will continue to enjoy and probably grow their safe havens.

Whatever U.S. strategic concerns may be about the future of Afghanistan, the course and direction of Pakistan’s strategic choices in coming years will also matter to the United States. There are a variety of reasons for this.

First, Pakistan is a nuclear weapon state. Decades of investments in nuclear weapons by Pakistan and India, compounded by unrelenting and mutual historical, religious, cultural, and political antagonism between them, make this one of the world’s most dangerous flashpoints.

Second, all of the countries Pakistan borders are consequential for the U.S. Pakistan also has significant religious, cultural, and economic ties to other Muslim states such as Turkey and Saudi Arabia. In an era of “great power competition,” while Pakistan may not be one of the principal players, its network of relationships can be of strategic benefit to any of the great powers now involved, including the U.S. and China.

Third, despite its significant political and economic difficulties, Pakistan has a growing technology sector. Its youthful population and worldwide diaspora of Pakistani doctors, scientists, academics, and other professionals have become an increasingly important part of the global community.


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As long-time veterans of South Asia, both of us understand the sources of “weariness and wariness” that U.S. policymakers, in both Democratic and Republican administrations, often associate with strategic discussions of Pakistan. We have both seen the U.S. government’s reluctance toward undertaking any kind of strategic interaction or rapprochement with Pakistan because of previous disappointments or perceived betrayals. Understanding the enormous complexities of Pakistan’s relationships, influence, and strategic choices in the South Asia milieu can be intellectually challenging and draining.

Yet, we have both concluded that the only thing harder than establishing a functional and mutually beneficial relationship with Pakistan is living without one. Given unstable borders, a nuclear standoff with India, the continued presence of terrorist organizations, and the high potential for all of this to further disrupt our interests, there is no better alternative.

Among those areas that we believe worth exploring with the Pakistanis are these:

First, the possibility of planning, along with other like-minded international actors (both state and non-state), to manage the consequences of significant political instability and human suffering emerging from Afghanistan, including the possibility of substantial refugee flight into Pakistan. Indeed, the Pakistanis have long and miserable memories of the surge of Afghan refugees after the Kabul government collapsed in the 1990s and have consistently expressed deep concerns about a possible repeat resulting from the U.S. withdrawal now nearing its completion.

Second, the possibility of counterterrorism cooperation against any terrorist threat that emerges from Afghanistan and prevents it from sowing further instability across the region. We do not consider it likely that Pakistan will allow any positioning of U.S. intelligence or counterterrorism elements within its borders. Still, there may be other ways (e.g., working groups, forums, or exchanges) to foster better cooperation if a threat emerges from Afghanistan that is of concern to our mutual interests.

Third, the possibility of enlisting Pakistan cooperation, and that of India, toward some type of partial de-escalation of tensions along their common border and, with it, even a slight amelioration of the nuclear weapons threat. It is instructive to recall that, before 9/11, Pakistani President Pervez Musharraf and Indian Prime Minister Atal Bihari Vajpayee initiated a dialogue about the de-escalation of tensions that included the highly emotional issue of Kashmir. However, talks broke down without significant agreement. While we recognize this is an extraordinarily complex and fraught issue for the U.S. to embrace, given all of its other strategic challenges, the specter of a potential nuclear conflict in South Asia should at a minimum prompt us to ask ourselves, “why not at least try?” Indeed, U.S. antagonists such as China would probably take a dim view of such efforts, and we believe that might be a reason for doing so rather than a reason to flinch from it.


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We have long heard U.S. policy and operational practitioners cite phrases such as “never underestimate the Pakistanis’ ability to disappoint us.” But, unfortunately, most American policymakers do not understand how often we have heard the Pakistanis say the same thing about Americans. Thus, both sides have longstanding “neuralgias” about the other. As we end our Afghan campaign, now is the time to move beyond our neuralgias and carefully weigh the strategic costs of whether trying to somehow partner with Pakistan is more, or less, than the cost of failing to do so. We believe, in the long run, it is likely to be less costly.

The views expressed in this piece are those of the authors.

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