Democracy and Digital Authoritarianism: An Assessment of the EU’s External Engagement in the Promotion and Protection of Internet Freedom. College of Europe EU Diplomacy Paper 01/2020

The past decade has seen a gradual global increase in digital authoritarianism. Internet shutdowns, online censorship, mass surveillance and violations of privacy rights have all become more frequent in parts of the world where citizens are not guaranteed sufficient digital rights. The task of defending, promoting and protecting internet freedom is becoming increasingly relevant for the European Union (EU) − for internal digital and cybersecurity policies as well as for the EU’s external promotion of democracy and human rights. Whilst much has been written about the various internal policies which establish and protect internet freedom within the European Union and its member states, the EU’s external engagement in this field remains critically under-researched. To what extent does the EU engage externally in the promotion and protection of internet freedom? This paper answers this question by covering a wide variety of policy fields including human rights and democracy promotion, digital policy, enlargement and neighbourhood policy, development cooperation and trade policy. Whereas the EU faces a limited opportunity to shape global norms with regard to internet freedom or to change the course of digitally authoritarian states, it has demonstrated several strengths which deserve not to be overlooked. These include, for example, the externalisation of internal data protection and policies and the provision of direct support and protection for civil society. Despite facing significant obstacles, the promotion and protection of internet freedom has become an important area of the EU’s external action which is only set to become more relevant in the coming years

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

If not now, when? Climate disaster and the Green vote following the 2021 Germany floods

Can first-hand experience of a climate-related natural disaster make citizens more likely to vote in favour of progressive climate politics? Leveraging the rare occurrence of a large-scale disaster just two months before a federal election, we use a difference-in-differences design to study the short-term electoral effects of the devastating 2021 Germany floods on voter support for Germany’s major environmentalist party, the Green Party. Compared to other German voters, those living in areas affected by the floods were marginally (0.4–1.6 percentage points) more likely to vote for the Greens. The largest increases in Green vote share are observed in municipalities which were directly exposed to flooding. Contrary to expectation, we tend to find larger increases in Green Party support in the less severely affected areas. Despite substantial increases in turnout in affected areas, we find that the observed increase in vote share for the Greens was rather driven by a persuasion effect on voters who previously supported other parties. In the absence of evidence that the floods led to an increase in voters’ issue prioritisation of climate change, our results highlight the limited possibility for major natural disasters to induce increased localised support for Green parties