Justifying jihad: US politics, propaganda and the Afghan mujahedeen

Hard-line anti-communists in the United States recognised the potential for the Soviet invasion of Afghanistan in 1979 to embroil their super-power rival in a ‘Vietnam-like quagmire.’ Their covert operation to arm the mujahedeen is well documented. This dissertation argues that propaganda and public diplomacy were powerful and essential instruments of this campaign. It examines the protagonists of this strategy, their policies, initiatives and programmes offering a comprehensive analysis heretofore absent. It stretches from the dying days of the Carter administration when Zbigniew Brzezinski saw the ‘opportunity’ presented by the invasion to the Soviet’s withdrawal in 1989. The aim of these information strategies was to damage Soviet credibility and enhance that of the US, considered under threat from growing ‘moral equivalence’ amongst international publics. The conflict could help the US regain strategic advantage in South Asia undermined by the ‘loss’ of Iran. The Reagan administration used it to justify the projection of US military might that it believed was eviscerated under Carter and emasculated by the lingering legacy of Vietnam. The research engages with source material from the Reagan Presidential Library, the United States Information Agency archives and the Library of Congress as well as a number of online archives. The material is multi-archival and multi-media including documentaries, booklets, press conferences, summit programmes and news-clips as well as national security policy documents and contemporaneous media commentary. It concludes that propaganda and public diplomacy were integral to the Reagan administration and other mujahedeen supporters’ determination to challenge the USSR. It finds that the conflict was used to justify military rearmament, further strategic aims and reassert US power. These Cold War machinations had a considerable impact on the course of the conflict and undermined efforts at resolution and reconciliation with profound implications for the future stability of Afghanistan and the world.

Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants

Background: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings: We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127·0 mm Hg (95% credible interval 125·7–128·3) in men and 122·3 mm Hg (121·0–123·6) in women; age-standardised mean diastolic blood pressure was 78·7 mm Hg (77·9–79·5) for men and 76·7 mm Hg (75·9–77·6) for women. Global age-standardised prevalence of raised blood pressure was 24·1% (21·4–27·1) in men and 20·1% (17·8–22·5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.