The Alligator

In his press conference yesterday President Bush dismissed contentions that his administration was drawing unwarranted conclusions about Iran’s role in the Iraqi Civil War that he created as preposterous.  Gee- what would make any of us wonder if there might be something to question in any intelligence that this administration uses in making a case for war, increasing hostilities or putting more Americans in harms way?  Maybe the lead-up to the War in Iraq could be the culprit (ya think?)!

In the wake of the Iraq war, it has become clear that official intelligence analysis was not relied on in making even the most significant national security decisions, that intelligence was misused publicly to justify decisions already made, that damaging ill will developed between policymakers and intelligence officers, and that the intelligence community’s own work was politicized.

Public discussion of prewar intelligence on Iraq has focused on the errors made in assessing Saddam Hussein’s unconventional weapons programs. A commission chaired by Judge Laurence Silberman and former Senator Charles Robb usefully documented the intelligence community’s mistakes in a solid and comprehensive report released in March 2005. Corrections were indeed in order, and the intelligence community has begun to make them.

At the same time, an acrimonious and highly partisan debate broke out over whether the Bush administration manipulated and misused intelligence in making its case for war. The administration defended itself by pointing out that it was not alone in its view that Saddam had weapons of mass destruction (WMD) and active weapons programs, however mistaken that view may have been.In this regard, the Bush administration was quite right: its perception of Saddam’s weapons capacities was shared by the Clinton administration, congressional Democrats, and most other Western governments and intelligence services. But in making this defense, the White House also inadvertently pointed out the real problem: intelligence on Iraqi weapons programs did not drive its decision to go to war. A view broadly held in the United States and even more so overseas was that deterrence of Iraq was working, that Saddam was being kept “in his box,” and that the best way to deal with the weapons problem was through an aggressive inspections program to supplement the sanctions already in place. That the administration arrived at so different a policy solution indicates that its decision to topple Saddam was driven by other factors — namely, the desire to shake up the sclerotic power structures of the
Middle East and hasten the spread of more liberal politics and economics in the region. 

If the entire body of official intelligence analysis on Iraq had a policy implication, it was to avoid war — or, if war was going to be launched, to prepare for a messy aftermath. What is most remarkable about prewar U.S. intelligence on Iraq is not that it got things wrong and thereby misled policymakers; it is that it played so small a role in one of the most important U.S. policy decisions in recent decades. 

The proper relationship between intelligence gathering and policymaking sharply separates the two functions. The intelligence community collects information, evaluates its credibility, and combines it with other information to help make sense of situations abroad that could affect U.S. interests. Intelligence officers decide which topics should get their limited collection and analytic resources according to both their own judgments and the concerns of policymakers. Policymakers thus influence which topics intelligence agencies address but not the conclusions that they reach. The intelligence community, meanwhile, limits its judgments to what is happening or what might happen overseas, avoiding policy judgments about what the United States should do in response. 

In practice, this distinction is often blurred, especially because analytic projections may have policy implications even if they are not explicitly stated. But the distinction is still important. National security abounds with problems that are clearer than the solutions to them; the case of Iraq is hardly a unique example of how similar perceptions of a threat can lead people to recommend very different policy responses. Accordingly, it is critical that the intelligence community not advocate policy, especially not openly. If it does, it loses the most important basis for its credibility and its claims to objectivity. When intelligence analysts critique one another’s work, they use the phrase “policy prescriptive” as a pejorative, and rightly so. 

The Bush administration’s use of intelligence on Iraq did not just blur this distinction; it turned the entire model upside down. The administration used intelligence not to inform decision-making, but to justify a decision already made. It went to war without requesting — and evidently without being influenced by — any strategic-level intelligence assessments on any aspect of Iraq. (The military made extensive use of intelligence in its war planning, although much of it was of a more tactical nature.) Congress, not the administration, asked for the now-infamous October 2002 National Intelligence Estimate (NIE) on Iraq’s unconventional weapons programs, although few members of Congress actually read it. (According to several congressional aides responsible for safeguarding the classified material, no more than six senators and only a handful of House members got beyond the five-page executive summary.) 

 

Before the war, on its own initiative, the intelligence community considered the principal challenges that any postinvasion authority in Iraq would be likely to face. It presented a picture of a political culture that would not provide fertile ground for democracy and foretold a long, difficult, and turbulent transition. It projected that a Marshall Plan-type effort would be required to restore the Iraqi economy, despite
Iraq’s abundant oil resources. It forecast that in a deeply divided Iraqi society, with Sunnis resentful over the loss of their dominant position and Shiites seeking power commensurate with their majority status, there was a significant chance that the groups would engage in violent conflict unless an occupying power prevented it. And it anticipated that a foreign occupying force would itself be the target of resentment and attacks — including by guerrilla warfare — unless it established security and put Iraq on the road to prosperity in the first few weeks or months after the fall of Saddam.

In addition, the intelligence community offered its assessment of the likely regional repercussions of ousting Saddam. It argued that any value Iraq might have as a democratic exemplar would be minimal and would depend on the stability of a new Iraqi government and the extent to which democracy in Iraq was seen as developing from within rather than being imposed by an outside power. More likely, war and occupation would boost political Islam and increase sympathy for terrorists’ objectives — and Iraq would become a magnet for extremists from elsewhere in the Middle East. 

The Bush administration deviated from the professional standard not only in using policy to drive intelligence, but also in aggressively using intelligence to win public support for its decision to go to war. This meant selectively adducing data — “cherry-picking” — rather than using the intelligence community’s own analytic judgments. In fact, key portions of the administration’s case explicitly rejected those judgments. In an August 2002 speech, for example, Vice President Dick Cheney observed that “intelligence is an uncertain business” and noted how intelligence analysts had underestimated how close Iraq had been to developing a nuclear weapon before the 1991 Persian Gulf War. His conclusion — at odds with that of the intelligence community — was that “many of us are convinced that Saddam will acquire nuclear weapons fairly soon.” 

In the upside-down relationship between intelligence and policy that prevailed in the case of Iraq, the administration selected pieces of raw intelligence to use in its public case for war, leaving the intelligence community to register varying degrees of private protest when such use started to go beyond what analysts deemed credible or reasonable. The best-known example was the assertion by President George W. Bush in his 2003 State of the Union address that Iraq was purchasing uranium ore in Africa. U.S. intelligence analysts had questioned the credibility of the report making this claim, had kept it out of their own unclassified products, and had advised the White House not to use it publicly. But the administration put the claim into the speech anyway, referring to it as information from British sources in order to make the point without explicitly vouching for the intelligence.

The reexamination of prewar public statements is a necessary part of understanding the process that led to the Iraq war. But a narrow focus on rhetorical details tends to overlook more fundamental problems in the intelligence-policy relationship. Any time policymakers, rather than intelligence agencies, take the lead in selecting which bits of raw intelligence to present, there is — regardless of the issue — a bias. The resulting public statements ostensibly reflect intelligence, but they do not reflect intelligence analysis, which is an essential part of determining what the pieces of raw reporting mean. The policymaker acts with an eye not to what is indicative of a larger pattern or underlying truth, but to what supports his case. 

Another problem is that on Iraq, the intelligence community was pulled over the line into policy advocacy — not so much by what it said as by its conspicuous role in the administration’s public case for war. This was especially true when the intelligence community was made highly visible (with the director of central intelligence literally in the camera frame) in an intelligence-laden presentation by Secretary of State Colin Powell to the UN Security Council a month before the war began. It was also true in the fall of 2002, when, at the administration’s behest, the intelligence community published a white paper on Iraq’s WMD programs — but without including any of the community’s judgments about the likelihood of those weapons’ being used. 

But the greatest discrepancy between the administration’s public statements and the intelligence community’s judgments concerned not WMD (there was indeed a broad consensus that such programs existed), but the relationship between Saddam and al Qaeda. The enormous attention devoted to this subject did not reflect any judgment by intelligence officials that there was or was likely to be anything like the “alliance” the administration said existed. The reason the connection got so much attention was that the administration wanted to hitch the Iraq expedition to the “war on terror” and the threat the American public feared most, thereby capitalizing on the country’s militant post-9/11 mood. 

The issue of possible ties between Saddam and al Qaeda was especially prone to the selective use of raw intelligence to make a public case for war. In the shadowy world of international terrorism, almost anyone can be “linked” to almost anyone else if enough effort is made to find evidence of casual contacts, the mentioning of names in the same breath, or indications of common travels or experiences. Even the most minimal and circumstantial data can be adduced as evidence of a “relationship,” ignoring the important question of whether a given regime actually supports a given terrorist group and the fact that relationships can be competitive or distrustful rather than cooperative. 

In its report on prewar intelligence concerning Iraqi WMD, the Senate Select Committee on Intelligence said it found no evidence that analysts had altered or shaped their judgments in response to political pressure. The Silberman-Robb commission reached the same conclusion, although it conceded that analysts worked in an “environment” affected by “intense” policymaker interest. But the method of investigation used by the panels — essentially, asking analysts whether their arms had been twisted — would have caught only the crudest attempts at politicization. Such attempts are rare and, when they do occur (as with former Undersecretary of State John Bolton’s attempts to get the intelligence community to sign on to his judgments about Cuba and Syria), are almost always unsuccessful. Moreover, it is unlikely that analysts would ever acknowledge that their own judgments have been politicized, since that would be far more damning than admitting more mundane types of analytic error.

The actual politicization of intelligence occurs subtly and can take many forms. Context is all-important. Well before March 2003, intelligence analysts and their managers knew that the United States was heading for war with Iraq. It was clear that the Bush administration would frown on or ignore analysis that called into question a decision to go to war and welcome analysis that supported such a decision. Intelligence analysts — for whom attention, especially favorable attention, from policymakers is a measure of success — felt a strong wind consistently blowing in one direction. The desire to bend with such a wind is natural and strong, even if unconscious.

On the issue of Iraqi WMD, dozens of analysts throughout the intelligence community were making many judgments on many different issues based on fragmentary and ambiguous evidence. The differences between sound intelligence analysis (bearing in mind the gaps in information) and the flawed analysis that actually was produced had to do mainly with matters of caveat, nuance, and word choice. The opportunities for bias were numerous. It may not be possible to point to one key instance of such bending or to measure the cumulative effect of such pressure. But the effect was probably significant.

A clearer form of politicization is the inconsistent review of analysis: reports that conform to policy preferences have an easier time making it through the gauntlet of coordination and approval than ones that do not. (Every piece of intelligence analysis reflects not only the judgments of the analysts most directly involved in writing it, but also the concurrence of those who cover related topics and the review, editing, and remanding of it by several levels of supervisors, from branch chiefs to senior executives.) The Silberman-Robb commission noted such inconsistencies in the Iraq case but chalked it up to bad management. The commission failed to address exactly why managers were inconsistent: they wanted to avoid the unpleasantness of laying unwelcome analysis on a policymaker’s desk.

Another form of politicization with a similar cause is the sugar coating of what otherwise would be an unpalatable message. Even the mostly prescient analysis about the problems likely to be encountered in postwar Iraq included some observations that served as sugar, added in the hope that policymakers would not throw the report directly into the burn bag, but damaging the clarity of the analysis in the process.

But the principal way that the intelligence community’s work on Iraq was politicized concerned the specific questions to which the community devoted its energies. As any competent pollster can attest, how a question is framed helps determine the answer. In the case of Iraq, there was also the matter of sheer quantity of output — not just what the intelligence community said, but how many times it said it. On any given subject, the intelligence community faces what is in effect a field of rocks, and it lacks the resources to turn over every one to see what threats to national security may lurk underneath. In an unpoliticized environment, intelligence officers decide which rocks to turn over based on past patterns and their own judgments. But when policymakers repeatedly urge the intelligence community to turn over only certain rocks, the process becomes biased. The community responds by concentrating its resources on those rocks, eventually producing a body of reporting and analysis that, thanks to quantity and emphasis, leaves the impression that what lies under those same rocks is a bigger part of the problem than it really is.

That is what happened when the Bush administration repeatedly called on the intelligence community to uncover more material that would contribute to the case for war. The Bush team approached the community again and again and pushed it to look harder at the supposed Saddam-al Qaeda relationship - calling on analysts not only to turn over additional Iraqi rocks, but also to turn over ones already examined and to scratch the dirt to see if there might be something there after all. The result was an intelligence output that — because the question being investigated was never put in context — obscured rather than enhanced understanding of al Qaeda’s actual sources of strength and support.

This process represented a radical departure from the textbook model of the relationship between intelligence and policy, in which an intelligence service responds to policymaker interest in certain subjects(such as “security threats from Iraq” or “al Qaeda’s supporters”) and explores them in whatever direction the evidence leads. The process did not involve intelligence work designed to find dangers not yet discovered or to inform decisions not yet made. Instead, it involved research to find evidence in support of a specific line of argument — that Saddam was cooperating with al Qaeda — which in turn was being used to justify a specific policy decision.

So Mr. Bush- it isn’t preposterous for us to question your administration’s use of intelligence.  Your administration has politicized intelligence in ways that no other President would have imagined.  Even if the intelligence about Iran is correct- aren’t you just the little boy who cried wolf once to often.  Fool me once- shame on you.  Fool me twice – shame on me! 

There are a number of changes that have come with the passage of the Ryan White HIV/AIDS Treatment Modernization Act of 2006.  .  The structure of the legislation has not been altered.   Title I is the funding that goes directly to urban areas – eligible metropolitan areas (EMAs).  Title I awards are based on both formula funding, based on the prevalence of HIV in the jurisdictions, and a “supplemental” award which is based on scores received on the grant application..  Title II is funding that goes to the states and territories.   The “base” award of Title II operates nearly identically to what was outlined for Title I.  In addition to this “base” award is additional funding for the AIDS Drug Assistance Program (ADAP).  Some states add their own funds to ADAP.  This causes the program to be very different in each state in terms of formulary and eligibility requirements.  Titles I and II have “hold harmless” provisions.  “Hold harmless” is in place to ensure that any formula changes that may negatively impact a jurisdiction do not happen suddenly and cause such a large cut that it could easily destabilize the jurisdiction’s system of care.  Instead decreases occur gradually with a cap on the percentage a jurisdiction can lose each year.  Title III directly funds community health clinics.  Title IV directly funds programs for women family and children.  There are also sections of the bill that establish dental reimbursement programs (mostly dental schools); the Minority AIDS Initiative (MAI) funding for Title I and II jurisdictions specifically targeting communities of color; and demonstration projects known as Special Projects of National Significance (SPNS).

1.  Sunset of legislation:  Most importantly is that this bill is authorized for only 3 years (as opposed to the past – which was 5 years) and even more significantly- this bill sunsets on September 30, 2009.  This was a deal made in the Senate to thwart some of the problems that were holding up the passage of this bill.  So everything is on the table and there is no bill that will provide the same sort of framework we had in the 1996, 2000 and 2006 reauthorizations.  Senator Kennedy’s staff is already beginning to have conversations with key organizations in the HIV/AIDS community to begin an assessment of how best to craft a new bill to be responsive to the current realities of the epidemic.  This may open up an opportunity to bring employment issues into a new piece of HIV/AIDS funding legislation. 

2: Core Medical Services: The bill now has language that requires Title I, II and III grantees to spend 75% of their award on core medical services.  These services are defined as outpatient and ambulatory health services; medications; pharmaceutical assistance; oral health care; early intervention services; health insurance premium and cost sharing assistance for low-income individuals; home health care; medical nutrition therapy; hospice services; home and community based health services; mental health services; substance abuse outpatient care; and medical case management, including treatment adherence services.  Significantly – housing and in-patient substance use are excluded from core service funding.  The use of the term “medical case management, including treatment adherence services” was a concern to advocates because this could be interpreted conservatively to exclude peer based case management.  However there have been assurances that the bill’s report language will clearly include peer-based case management. The 75% core services requirement  can be waived if there is no ADAP waiting list and core medical services are otherwise available to all those identified and eligible.  Advocates are concerned that applying for a waiver could jeopardize Title I and II jurisdictions’ ability to effectively write a grant application for the supplemental/competitive award that is part of Title I and Title II grant process and based on demonstrated need of the applicant.

3:  Change in formula/supplemental funding:  In the past the division of monies available for Titles I and II was split 50-50 between formula funding and the competitive application supplemental.  This bill changes that split to 66% formula based and 33% available for supplemental.  Hold harmless monies for eligible jurisdictions are taken out of the 33% supplemental pot and the remainder is available for distribution among all jurisdictions through the general competitive/ supplemental grant.

4: Requirement for ADAP Formulary:  ADAP has never had a formulary requirement imposed on the states.  There will now be a requirement for a formulary core HIV drugs and drugs for HIV related symptoms to be established by the Secretary of HHS and imposed on the states.  This may require some states to increase their commitment of state funds for ADAP and this may have consequences for state funds available for other HIV specific programs in those states.

5:  HIV data use for funding:  Currently “formula” funding is determined by an obtuse formula that results in “estimated living AIDS cases” however the 2000 bill did require HIV case data to be used by FY 2007. The new legislation affirms current law (switch to HIV cases by FY 2007). The bill specifies that formula funding will use living HIV/AIDS cases from names-based reporting states only, after being reported to and confirmed by the CDC. A second “track” of states and Title I EMAs that do not have mature names-based HIV reporting or certified names-based HIV cases with the CDC, but use code-based systems, will have their code-based HIV cases used for funding distribution purposes after an adjustment that will reduce the count by 5%.

6: Change in structure of Title I:  Title I is now divided into 2 subparts Subpart 1 = EMAs (eligibility redefined)Subpart 2 = TGAs, a new program for “transitional grant areas.” This incudes some metropolitan areas previously eligible as Title I EMAs, “grandfathered” EMAs, and some areas previously eligible as Title II Emerging Community funding.  Planning Councils are not mandatory for TGAs (unless TGA was an EMA in FY2006).

7: New Title I Jurisdictions:  There are currently 51 EMAs  that receive Title I funding.  There has been a redefinition of Title I eligibility which has added 5 new EMAs to the existing 51.  These are-
Baton Rouge LA, Charlotte-Gastonia-Rock Hill NC/SC, Nashville TN,  Indianapolis IN and Memphis TN/AR/MS.  If appropriations for 2007 are not increased for Title I (which is unlikely) there will be more jurisdictions that must share the already inadequate funding for Title I.  Current jurisdictions that no longer fall into the Title I definition (e.g. Santa Rosa CA) will not be eliminated during the term of this 3-year bill but will drop off at that time (of course there will be no legislation based on the current configuration at that time due to it’s sunset in 2009).  8: Miscellaneous other funding changes:  There are a number of other funding issues in the new bill that will have an impact.  The current formula for Title II funding for states that have Title I EMAs is changed that will give more weight to areas outside of EMAs.

 There is a provision that extends hold harmless protection for Title I EMAs throughout the term of this legislation.

Title II no longer has a separate hold harmless for ADAP funding and Title II base. 

There are new restrictions for the use of unspent funds for carryover between fiscal years.

Appropriations increases and amounts are specified in this legislation as opposed to the previous language which stated “such sums as may be necessary”.

There are a host of other changes to the legislation, but these are the 7 points that I have outlined here are, in my opinion, the most significant and will have the most impact on funding for HIV/AIDS services . 

Currently Ryan White grantees and advocates are addressing issues and concerns about implementing these changes with HRSA – such as the timeline for altering allocations to be compliant with the 75% core services provision since grant applications and allocation decisions were made for FY 2007 before this legislation was signed into law.