economist

Visting iraq’s latest grand shrine in what is said to be the world’s largest cemetery, in the holy city of Najaf, has become something of a pilgrimage for people from across the region wanting to salute two of Shia Islam’s modern heroes. One is Qassem Suleimani, the long-serving commander of the Quds force, the foreign arm of Iran’s Islamic Revolutionary Guard Corps (IRGC); the other is Abu Mahdi al-Muhandis, the commander of the beefiest umbrella group of Shia militias in Iraq, whose grave is at the shrine. (Suleimani is buried in southern Iran.) Both were killed three years ago in Baghdad by an American drone strike aimed at Suleimani, whose job was to protect and spread the Shia revolution across the region. Busloads of fellow Shias—from Lebanon and Bahrain as well as Iraq and Iran—come to the shrine to hail the pair for carving out a Shia domain that gave their sect, which caters for about 15% of Muslims across the world, a rare moment of triumph across the region. “Never again will we be the shoe-shiners and street-sweepers of the Middle East,” says a militiaman from Lebanon, referring to the centuries of domination by Sunni Muslims like those who still reign over Egypt, Saudi Arabia, Turkey and beyond. Were it not for America’s invasion of Iraq 20 years ago, the Shia resurgence might never have happened. Iran’s Islamic revolution in 1979 launched the project to elevate the region’s minority. But the dismantling of Saddam Hussein’s Sunni-led regime heralded its spread, replacing it with a government system that put Iraq’s Shia majority in charge. Uprisings in the Arab spring of 2011 shook the region’s Sunni order still more, creating power vacuums that Iran often sought to fill.Under Iran’s baton, Shia militiamen poured into Syria from as far afield as Afghanistan and Pakistan. In Lebanon a Shia political movement-cum-militia, Hizbullah, became the country’s dominant force. In Yemen a Shia revivalist militia under the Houthi banner swept into Sana’a, the capital. From north, south and east Shia militias launched their drones at Saudi Arabia, the bastion of Sunni Islam, striking its royal palaces in the capital, Riyadh, and briefly incapacitating half of the kingdom’s oil supply. In 2004 King Abdullah of Jordan lamented that a new “Shia crescent” was endangering the old Sunni world. Shia clerics trained in Iran’s religious capital, Qom, led Lebanon’s Hizbullah, much of Yemen, three of Iraq’s six main Shia parties, as well as Iran itself. Their main shrines in the Iraqi cities of Najaf and Karbala attract more pilgrims than Mecca in Saudi Arabia. They have routed the Sunni jihadists who created the caliphate that straddled eastern Syria and north-western Iraq. And they have gathered a vast arsenal, with an estimated 150,000 missiles pointing at Israel alone. Shia Iran has realised its age-old dream of reaching the Mediterranean by land and more recently air, through Iraq and Syria and on to Lebanon.But the Shia moment may have passed. Iran’s regime is in trouble, facing opposition on the street and from within its dithering, ageing ruling circle. Iraq is mired in corruption, periodic violence and misgovernment. Succession crises are brewing in both. “There’s a realisation that the Islamic order is reaching a dead end,” says Ali Taher, who runs Bayan Centre, a think-tank in Baghdad.One reason is that the clerics have been bad at managing economies. Incomes have plummeted, currencies have crashed and inflation has soared across the Shia crescent. Lebanon’s pound is the world’s worst-performing currency this year. The Syrian pound has fallen from 47 to the dollar before the Arab spring in 2011 to 7,550 this year. Iran’s economy has struggled since America walked away from a nuclear deal in 2018 that had eased sanctions in exchange for curbs on Iran’s uranium enrichment. Its currency has since slumped from about 45,000 rials per dollar to a low of about 580,000. (Before the revolution in 1979 a dollar would buy 70 rials.) From crescent to moonshineIraq should have bucked the trend. Alone among Shia states it retained its ties to the global economy under American tutelage. But its power-brokers squandered its oil wealth. Across the wider region Shia militia leaders have exploited the black economy, overseeing smuggling rings and the mass production of recreational drugs. Even in Lebanon, once the leading banking centre of the Middle East, Shia leaders have shared in the catastrophic mismanagement of the economy. Democracy in Iran, the self-proclaimed beacon of Shia governance, has shrivelled, even within the tight confines of clerical rule. Turnout in Iran’s election in 2021 was the lowest since 1979. In Iraq, among Shias, it has fallen from 80% after the fall of Saddam Hussein by more than half to perhaps 20% in 2021, when independent candidates topped the poll. In the southern districts of Beirut, Lebanon’s capital, support for Hizbullah, which still dominates the area, is said to be dwindling.The declining popularity of Shia Islam is most noticeable in Iran. Mass protests used to erupt roughly once a decade. Since 2017 they have burst forth every few years and have spread from the main cities to provincial towns. They now embrace working-class Iranians, long considered the regime’s base, as well as students and the middle class. A recent poll suggested that more than 80% of Iranians approve of the current protests. As disaffection grows, many Shias are losing faith, not just in the ayatollahs’ ideology but in religion itself. Taqlid, the practice of strict obedience to the ayatollahs, is weakening. Women, in particular, want to shed religious dress codes and clerical patriarchy. Many are increasingly discarding the veil, once hailed by Ayatollah Ruhollah Khomeini, the regime’s founder, as “the flag” of the Islamic Republic. In Iraq, too, protesters have begun turning on the clerics whose fatwas endorsed the political system. “In the name of religion, we have been robbed by the thieves,” one banner recently declared. In some mosques in Baghdad’s middle-class neighbourhoods, clerics have abandoned their Friday sermons because they no longer draw crowds. Surveys suggest that, though most Iraqi Shias still respect their ayatollahs, they no longer obey them blindly, especially in matters of personal observance.Iran’s supreme leader, Ayatollah Ali Khamenei, is 83 and ailing. His succession is shrouded in doubt. None of the front-runners seems likely to revive the regime’s fortunes. Ebrahim Raisi, Iran’s turbaned president, is lampooned by fellow clerics for his lack of religious qualifications. Mr Khamenei’s son, Mojtaba, has sought them by teaching in Qom. But his nomination would smack of the dynastic rule that Iran’s revolution cast aside. The choice is limited because Mr Khamenei long ago silenced Muhammad Khatami, a former president who has called for a “fundamental transformation” of the system. Another former occupant of that post, Akbar Hashemi Rafsanjani, was hounded out before his death. Mir Hossein Mousavi, a former presidential candidate who spent 13 years under house arrest, recently called for a referendum on whether Iran should remain an Islamic republic.Some insiders suggest that the commander of the IRGC, Hossein Salami, may try to grab power if the clerics are unable to hold the country together. The corps might even offer a “new social contract”, speculates a political analyst in Tehran. The IRGC already dominates Iran’s armed forces, the parliament, the intelligence services and perhaps 40% of the economy, so a coup is far from unthinkable. “We’re living in suspended animation between one era and the next,” says a university lecturer.Should the IRGC seize the reins, says a government adviser, it would ditch the clerics’ isolationism and reach out to the West”. It could accommodate Iran’s prosperous business class and even its vocal diaspora that has long been at odds with the ayatollahs. The IRGC might even drop, or reduce, Iran’s support for its allies abroad, such as in Syria, Lebanon and Yemen. And it could build on Mr Khamenei’s recent decision to re-establish relations with the republic’s bitterest Sunni rival, Saudi Arabia.Long beards, long facesIraq is facing its own clerical succession crisis. This is less overtly political, because Iraq’s electoral system is not under the thumb of theocrats in the same way that Iran’s is. And Iraqi clerics tend to hold back from direct rule, preferring to nudge their candidates from the sidelines, though some, such as Moqtada al-Sadr, a populist cleric, have led from the front. Even so, politicians have generally sought the blessing of clerics such as Ali al-Sistani, Iraq’s 92-year-old chief ayatollah. When the Sunni jihadists of Islamic State were threatening to take over the whole country in 2013, Mr Sistani called all Shias to arms. But more recently he has withdrawn from the political scene, and no clear successor has emerged. “The age of the marja is ending,” says a Shia commentator, referring to the font of Shia religious authority. Mr Sadr may harbour ambitions to replace Mr Sistani as the leading light among Iraqi clerics, but an array of other Shia leaders are fiercely against him.In any case, since America assassinated Suleimani and Muhandis in 2020, Iran has struggled to stop its satellites from breaking away. “They’re asking why we should be agents of Iran,” says an analyst in Beirut close to Hizbullah’s leadership, when asked why Hizbullah had agreed to last year’s maritime deal with Israel mediated by America. President Bashar al-Assad of Syria is also doing his own thing. He has recently been welcomed with honours in the United Arab Emirates, visited Oman and received Egypt’s foreign minister. Despite its close affiliation to Iran, Iraq’s latest government may have nettled Iran’s rulers by becoming friendlier with Sunni-led states in the Gulf. Iran and Iraq still make a powerful pair of Shia states. But they are both in a mess. They and their allies in the region are beginning to hedge their bets. Across the Sunni world, King Abdullah’s striking phrase no longer feels so aptly fearful. ■

After two decades of rampant violence and political dysfunction, Iraq is at last showing signs of recovery. Most of the concrete blast walls that sliced up cities have come down. Baghdad, the capital, is reviving, towered over by a new central bank. The road to the airport, once dubbed the world’s most dangerous because of the snipers along the way, is lined with private universities and housing estates. “Before, we had to clear roads of landmines,” says the head of a paramilitary engineering unit. “Now we clear people’s sewage.” Though politics is still messy and corrupt, with parliament and government subject to bitter horse-trading between parties in hock to sectarian militias, a measure of representative democracy has been achieved. The Shia majority, suppressed under the vicious Sunni-led dictatorship of Saddam Hussein, is sitting pretty, its leaders content to reap the rewards of power and patronage. The application of religious laws has softened. Unveiled women again walk the streets. A main reason for this return to relative normality is that violence has largely abated. Last year about 60 people were killed every month, according to Iraq Body Count, a British-based monitor, whereas at the height of the sectarian civil war in the years that followed the American invasion of 2003, the toll often exceeded a hundred a day, with suicide-bombings sometimes killing whole crowds in markets. The last big bomb in Baghdad was over a year ago.Yet the trauma of the past two decades cannot easily be wiped away. At least 270,000 Iraqis, more than half of them civilians, perished violently in that period, as well as 8,000-plus American service people and contractors, according to a monitoring project at Brown University in America. Mosul, the country’s third city and heart of the Sunni north, was ruined as the central government recaptured it from the Sunni jihadists whose caliphate oversaw a reign of terror over much of the north and west in 2014-17. Many of Iraq’s ancient minorities, notably the Christians, have been chased abroad or into the Kurds’ autonomous haven in the north. Under the caliphate thousands of Yazidis, adherents of a sect in northern Iraq that draws from elements of Christianity and Islam, suffered what nearly amounted to genocide.Only the Kurds can claim a more or less unbroken period of progress and calm as a result of the American invasion. Protected initially by American force and by their own militias, their autonomous region has been far less affected by the violence that shattered the rest of the country. Their government in Erbil continued to function while the rest of Iraq fell into bloodshed and chaos. But the Kurds’ bid for complete independence looks unlikely to succeed; in 2017 forces under the aegis of the government in Baghdad recaptured a chunk of territory the Kurds had occupied, including the oilfields of Kirkuk. Ordinary Iraqis have yet to benefit from the oil wealth of the country, the world’s fifth-biggest producer. Some 25% of the population have incomes below the national poverty line, the government says. This is because billions of dollars from oil revenues have been lost to corruption, leaving public services overwhelmed even as Iraq’s population has soared, from 27m in 2003 to 44m at last guess. A third of young Iraqis have no jobs. Schools are dilapidated. Electricity is as patchy as it was after America invaded. The failures of Iraq’s government are making the democracy promised by America look increasingly threadbare. Elections are held on time but are manipulated by militia bosses. Turnout has steadily declined. Freedom of speech, a big bonus of Saddam Hussein’s removal, is declining. Journalists who criticise the militias may be killed. Protesters who take to the streets are liable to be met with guns. Yet the younger generation, for whom the American invasion is a distant memory, has not given up hope. In late 2019 mass protests unseated a prime minister and called for better services and an end to corruption. The protesters were brutally repressed. But their thirst for a decent government and a decent society cannot be denied for ever. ■

When Lesedi was growing up in Johannesburg, South Africa’s commercial capital, her family was so poor that she used a cloth filled with sand as a makeshift sanitary product. That changed when, at the age of 14 (which is below the legal age of consent), she began having sex with a man nearly 15 years older who gave her rides to school and bought her toiletries. The boyfriends who followed in her teenage years and early twenties were increasingly generous. “If I were to date you, you had to make sure that you’re working first,” says Lesedi (whose name we have changed). “Love alone can’t give me food.” One married man paid for her apartment and outfits, and gave her money to support her family. She got everything she wanted, says Lesedi, until she found out that she was infected with HIV. Relationships between adolescent girls or young women and older men are a big cause of new HIV infections globally. Eastern and southern Africa have about a tenth of the world’s population, yet accounted for nearly half of the world’s 1.5m new HIV cases in 2021. And young women (aged 15-24) are disproportionately affected, with infection rates more than three times higher than in their male peers (see chart). Like Lesedi, many of these girls and women have become infected while dating a succession of older men. A few years later many pass it on when they meet someone closer to their own age with whom they wish to settle down. “This is when HIV is transmitted to this young man, who then becomes the older man,“ says Linda-Gail Bekker of the Desmond Tutu HIV Centre at the University of Cape Town. “So you have the vicious HIV cycle.”Breaking this cycle is one of the biggest challenges in public health. Efforts to change the behaviour of young women and older men are seldom successful. Instead, the solution may be pharmacological, in the form of pre-exposure prophylactic (PrEP) drugs that healthy people take to avoid contracting HIV. New and highly effective PrEP regimens for women are becoming available or are in late-stage development. If they become widely used by girls and women having sex with older men, Africa’s HIV epidemic will take a sharp turn down. Explaining the age gapRelationships with sugar daddies (which wonks prefer to call “transactional sexual relationships”) are different from sex work. Some women talk about being romanced by older men and getting emotional support from them that they might not get from men their own age. Girls in South Africa often start having sex at the age of 14 or 15 when, puberty-wise, they are more sexually mature than their male peers, says Dr Bekker. Some start relationships with slightly older men as part of discovering their sexuality, flattered that they are so attractive to them. Research in South Africa has found that the man is usually five to eight years older, though there are also cases like Lesedi’s, with a man a generation older. Attitudes to men in such relationships are encapsulated in what many young Africans call their older male partners: “blessers”. Some women boast on social media about their gifts (using #blessed). Having a blesser provides social status as well as trendy clothes, expensive smartphones and other goodies that their parents cannot afford to buy for them, says Joyce Wamoyi of the National Institute for Medical Research in Tanzania. Such gifts are common among university students. In the poorer countryside, by contrast, men provide money for necessities such as food and clothing. Younger men struggle to compete for the attention of young women because they tend to earn less money than older men. Yet their male elders are much more likely to have HIV, simply because they have been having sex for longer and with more partners in societies with high rates of HIV. Men in their 20s—often the first partners of adolescent girls—are less likely to know they are infected and, therefore, to take antiretroviral drugs (ARVs), which would make them less likely to pass the virus on through sex. A study conducted in 2016 in KwaZulu-Natal, a province in South Africa with a high prevalence of HIV, found that the sexual partners of women younger than 25 were, on average, 8.7 years older. The partners of women who were 25-40 were only a year older. Clusters of related infections identified through HIV genotyping led the researchers to conclude that younger women got infected by older men and. Then as they got older, they infected men of their own age.Various programmes aiming to change this have mostly failed. Charities have tried giving poor adolescent girls small amounts of cash to meet their basic needs. But once they have food on the table as a result of such handouts, says Dr Wamoyi, they aspire to have more, such as nicer clothes; and once they have that, they want more expensive things such as a smartphone. A cash grant programme may give them the equivalent of $10 or $20 every three months. “An older man can give you $20 on the spot,” she says.A more promising idea is to prevent girls and young women from becoming infected, ideally using methods which do not require them to persuade a man to wear a condom (which is difficult). Among these are three PrEP methods that have become available in recent years: a vaginal ring, a daily pill and an injection every second month. Convincing women at risk of HIV to use them can, however, be a challenge.The vaginal ring, an insertable silicone device that releases an ARV drug and must be replaced every month, can reduce the risk of HIV infection by as much as 50%. But “it’s not going to be everybody’s cup of tea,” admits Dr Bekker. The daily PrEP pill, which contains a combination of ARV drugs, has been available in Africa for several years. But it has been tricky to pinpoint how effective it is because even in clinical trials too few women used it consistently. Some studies estimate that, if used properly, these pills can reduce the risk of HIV infection by as much as 90%. But it is hard to take the medication discreetly at work or school and tricky to hide from a parent or a boyfriend. Women worry about stigma if people think they are taking the pills because they have HIV. And many people, particularly youngsters, are not very good at remembering to take medication every day, says Dr Bekker. “They have enthusiasm, they get started, but then the persistence falls off quite rapidly,” she says. Some also choose to take their pills only around the time they have sex. A study of 427 girls and young women in Africa published in 2019 found that a year after starting this type of prophylaxis only 9% had levels of the drug in their blood that suggested they were still taking it regularly. The most promising option is an injectable form of PrEP. This contains a long-acting form of cabotegravir, which stops an important stage in the replication of HIV in host cells. It is delivered as an injection, initially once a month and then every two months, and was included in the World Health Organisation guidelines on HIV prevention last year. In clinical trials with women in Africa, it was nearly 90% more effective than oral PrEP. Regulators in Zimbabwe and South Africa approved it late last year; other African countries are expected to follow. Injectable contraceptives are already the most popular type of birth control in Africa, so women in the region may take to injectable PrEP more easily than the vaginal ring or the pills. And more convenient versions of it are in clinical trials. Lenocaprivir, which is injected every six months, is in late-stage trials. Unlike cabotegravir, which is an intramuscular jab, lenocaprivir is a subcutaneous injection. This means it can be administered by community health workers, rather than nurses, or even self-administered. Its timing will also align with the most popular injectable contraceptives, which are taken every three months. Women going to a family-planning clinic could get their HIV shot, too, “and nobody would ever know about it,” says Nina Russell of the Bill and Melinda Gates Foundation, a charity.The impact could be large. Modelling published earlier this year in the Lancet found that the introduction of injectable cabotegravir in sub-Saharan African could almost double uptake of PrEP to 46% of those who need it, from about 28% if it were not introduced. The authors reckon that this would avert 29% of new HIV infections over 20 years and bring cases within a whisker of the HIV-elimination threshold of one new infection per 1,000 people.Much will depend on the cost of injectable PrEP. The Lancet study estimates that cabotegravir would be cost-effective at about $60 for a year’s supply, which is about the same as the cost of oral PrEP. Viiv, the company that makes the drug, says it will offer it at a non-profit price to public programmes in sub-Saharan Africa until a generic version is available, though it has yet to reveal the price (it charges $22,000 for it in America). It has signed a deal with the Medicines Patent Pool, a UN-backed organisation that promotes the production of generic versions of patented drugs for poor countries. But setting up production in a low-cost factory, perhaps in India or Africa, will take time. Meanwhile, African countries will need aid organisations to help pay for the new drug. It may be a while before long-acting PrEP drugs are widely available in Africa. But they are coming. And with them, eventually, the hope of ending the HIV epidemic on the continent. ■

Beersheva, a sleepy town in the Negev desert, is 100km south but a world away from Tel Aviv. Last year two-thirds of the town voted for parties of the far-right and religious coalition led by Binyamin (“Bibi”) Netanyahu, now the prime minister. Yet on March 11th some 10,000 Beershevans felt angry enough to protest against the government’s plans to weaken Israel’s Supreme Court. “This is a Bibi-ist town,” says Zipi Stolero, a retired civil servant who has lived there for 65 years. “But people are marching because they feel…freedom is at risk.” That the demonstrations have spread to Beersheva shows how widespread discontent with the government has become. Listen to this story. Enjoy more audio and podcasts on