Uncertain Times Ahead: Changing Principles
The world has undergone major drastic changes in the last two decades driven by several major factors, eg, explosion of human population and connectivity. Such changes seem further accelerated in recent years and it seems that our future becomes more uncertain and unpredictable. The Fukushima Nuclear Accident awakened us and led to creation of Independent Investigation Commission by the National Diet of Japan; The Commission Report revealed some of the fundamental issues of Japan’s nuclear policy. Meanwhile, multi-stakeholders’ engagement has become critical in various social affairs and in policy making domains within and across national boundaries, and has contributed in significant ways to affect the processes of addressing and impacting global agenda, such as climate change, food and water, energy, urbanization, biodiversity, human capital with shifting the balance of economy and power. In my view, the principles of our society may be changing quite fast heading somewhat differently from our conventional norm. The science community can and should contribute to these issues in nurturing future leaders, but in what way?
Kiyoshi Kurokawa is a graduate of University of Tokyo School of Medicine, trained in internal medicine and nephrology, in US 1969-84; Professor of Med, Dept Med ofUCLA Sch Med (79-84), Chair, Univ Tokyo Faculty of Med (89-96), Dean of Tokai Univ School of Med (96-02, President of Science Council of Japan (03-07), Science Advisor to Prime Minister (07-09), Board member of A*STAR (06-00), Bibliotheca Alexandria (04-08), Khalifa University (08- ), Okinawa Institute of Science and Tech (06- ), Global Science and Innovation Advisory Board of the Prime Minister of Malaysia (11-); President of Intl Soc Nephrology (97-99), Inst of Medicine of US Academies (92). Recently, chaired Fukushima Nuclear Accident Independent Investigation Commission by the National Diet of Japan (Dec 11-July 12). AAAS Scientific Freedom and Responsibility Award (2012), ‘100 Top Global Thinkers 2012” of Foreign Policy.
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Benin solar market garden project one of five most hopeful energy projects of 2012
Evaluating the Contribution of Weather to Maize and Wheat Yield Trends in 12 U.S. Counties
Evaluating the contribution of weather and its individual components to recent yield trends can be useful to predict the response of crop production to future climate change, but different modeling approaches can yield diverging results. We used two common approaches to evaluate the effect of weather trends on maize (Zea mays L.) and wheat (Triticum aestivum L.) production in 12 U.S. counties, and investigate sources of disparities between the two methods. We first used the Decision Support System for Agrotechnology Transfer (DSSAT) model from 1984 to 2008 to evaluate the contribution of weather changes to simulated yield trends in six counties for each crop, each county being located in one of the top 10 U.S. producing states for that crop. A parallel analysis was conducted by multiplying inter-annual weather sensitivity of county-level yields with observed weather trends to estimate weather contributions to empirical yield trends. Weather had a low (maize) to high (wheat) contribution to simulated yield trends, with rain having the largest effect. In contrast, weather and rain had lower contributions to empirical yield trends. Along with evidence from previous studies, this suggests that DSSAT may be too sensitive to water thus inflating the importance of rain. Moreover, the time period used to compute yield trends also had a large effect on the importance of weather and its individual components. Our results highlight the importance of using multiple computation approaches and different time periods when estimating weather-related yield trends.
Freshwater availability and water fetching distance affect child health in sub-Saharan Africa
Currently, more than two-thirds of the population in Africa must leave their home to fetch water for drinking and domestic use. The time burden of water fetching has been suggested to influence the volume of water collected by households as well as time spent on income generating activities and child care. However, little is known about the potential health benefits of reducing water fetching distances. Data from almost 200 000 Demographic and Health Surveys carried out in 26 countries were used to assess the relationship between household walk time to water source and child health outcomes. To estimate the causal effect of decreased water fetching time on health, geographic variation in freshwater availability was employed as an instrumental variable for one-way walk time to water source in a two-stage regression model. Time spent walking to a household’s main water source was found to be a significant determinant of under-five child health. A 15-min decrease in one-way walk time to water source is associated with a 41% average relative reduction in diarrhea prevalence, improved anthropometric indicators of child nutritional status, and a 11% relative reduction in under-five child mortality. These results suggest that reducing the time cost of fetching water should be a priority for water infrastructure investments in Africa.
Stephen P. Luby
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Prof. Stephen Luby studied philosophy and earned a Bachelor of Arts summa cum laude from Creighton University. He then earned his medical degree from the University of Texas Southwestern Medical School at Dallas and completed his residency in internal medicine at the University of Rochester-Strong Memorial Hospital. He studied epidemiology and preventive medicine at the Centers for Disease Control and Prevention.
Prof. Luby's former positions include leading the Epidemiology Unit of the Community Health Sciences Department at the Aga Khan University in Karachi, Pakistan, for five years and working as a Medical Epidemiologist in the Foodborne and Diarrheal Diseases Branch of the U.S. Centers for Disease Control and Prevention (CDC) exploring causes and prevention of diarrheal disease in settings where diarrhea is a leading cause of childhood death. Immediately prior to joining the Stanford faculty, Prof. Luby served for eight years at the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), where he directed the Centre for Communicable Diseases. He was also the Country Director for CDC in Bangladesh.
During his over 25 years of public health work in low-income countries, Prof. Luby frequently encountered political and governance difficulties undermining efforts to improve public health. His work within the Center on Democracy, Development, and the Rule of Law (CDDRL) connects him with a community of scholars who provide ideas and approaches to understand and address these critical barriers.
The United Nations and a World in Transition
United Nations Secretary-General Ban Ki-moon presented a free public talk at Stanford on Thursday, Jan. 17.
Ban, who is the eighth secretary-general of the UN, will speak about the UN's role in creating opportunities out of the challenges posed by today's rapidly transitioning world.
"Times of transition are times of profound opportunity," he recently said during his acceptance speech for the Seoul Peace Prize. "The decisions we make in this period will have an impact for generations to come.”
Ban's initiatives as UN secretary-general have focused on promoting sustainable development; empowering women; supporting countries in crisis or instability; generating new momentum on disarmament, arms control, and nonproliferation; and strengthening the UN. Among his many activities as secretary-general, he has successfully raised major pledges and financing packages for aid and crisis response, established the agency UN Women, and introduced new measures to promote UN transparency and efficiency.
Ban was born in the Republic of Korea in 1944, and he served for 37 years with the ROK Foreign Ministry, in roles including that of minister of foreign affairs and trade, foreign policy adviser to the president, and chief national security adviser to the president. He took office as UN secretary-general in January 2007, and was re-elected for a second term by the UN General Assembly in June 2011. Ban will serve as secretary-general until December 2016.
The Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) and the Freeman Spogli Institute for International Studies are co-sponsoring the event. Ban's talk, part of the Asia-Pacific Leaders Forum, will kick off a series of activities commemorating Shorenstein APARC's thirtieth anniversary.
Founded in 2005, Shorenstein APARC's Asia-Pacific Leaders Forum regularly convenes senior leaders from across Asia and the Pacific to exchange ideas on current political, economic, and social dynamics in the region.
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Conference proposes meaningful ways to advance health rights
On October 30, the Program on Human Rights (PHR) at Stanford's Center on Democracy, Development and the Rule of Law (CDDRL) held a day-long conference to examine health and human rights. The conference was held to discuss how a rights-based approach to health services can impact the delivery of effective health interventions and advance other socio-economic and cultural rights in developing regions. The conference titled, “Why We Should Care: Health and Human Rights” was divided into five panels with presenters from diverse backgrounds and professions including lawyers, doctors, public health experts, students and activists.
The Program:
The conference started with a welcoming address by Helen Stacy, director of the Program on Human Rights. CDDRL Director Larry Diamond introduced the keynote speaker Paul H. Wise, professor of child health and society and pediatrics at Stanford University’s School of Medicine, and director of the Center for Policy, Outcomes and Prevention. Wise's opening remarks began on a somber note, “The language of rights means very little to a child stillborn, an infant dying in pain from pneumonia or a child desiccated by famine.” In his address, Wise emphasized the need for an aligned and integrated rights-based approach that does not undermine effective and efficient medical interventions. “We need to fill the gap between the worlds of child health and child rights so that our programs and policies are both effective and just,” he stressed.
Following the keynote address, the conference presenters shared their work according to a geographic or thematic focus. The first panel brought together three generations of speakers from Stanford - a faculty member, a pre-doctoral fellow and a recent graduate - in a unique opportunity to share ideas and discuss possibilities of health work in Africa. Rebecca Walker, clinical instructor in emergency medicine at Stanford School of Medicine, presented her impressions and reactions on Mindy Roseman’s study of forced sterilization in Namibia. Roseman, academic director of the Human Rights Program and lecturer on law at Harvard Law School, was unable to attend due to flight complications after hurricane Sandy hit the East Coast.
Eric Kramon, 2011-2012 pre-doctoral fellow at CDDRL, spoke about the political sources of ethnic inequality in health outcomes in Africa. Kramon’s work in Kenya illustrated how politics plays a determinant role in ethnic inequalities and consequently in access to health and health outcomes. Jeffrey Tran, a 2011 Stanford graduate in human biology, described the vision behind the launch of the Project of Emergency First Aid Responder in Western Cape Province, South Africa that he helped implement. Tran explained, “Individuals and communities are an integral part of the solution and we work with the communities to develop first aid training programs that are taught and eventually run by community members.”
Panel two was dedicated to the health impact of drones in Pakistan and in Gaza. Based on research by the Stanford International Clinic on Human Rights and Conflict Negotiation in Pakistan, Professor James Cavallaro and Stanford law school student Omar Shakir, explained that drones are not only responsible for deaths of civilians but also constitute a constant disturbance to social life and mental health of ordinary people, including their relations with children and the elderly. Drones impact other rights as well - such as the right to education - as children are prevented from attending schools for fear of drone strikes. Rajaie S. Batniji, resident physician in internal medicine at Stanford and a CDDRL affiliate, explained the clinical diagnosis of traumatic disorders that result from constant surveillance and insecurity. He cited the work of Jonathan Mann in defining dignity and the devastating effects on physical, mental, and social well-being when these senses are violated. Batniji explained that populations in Gaza are prevented from living life with dignity and respect because they live under constant threat to their security and intrusion into their homes and communications.
Vivek Srinivasan, manager of the Program on Liberation Technology at CDDRL, presented his experience on the Right to Food Campaign in India. He believes that this campaign has led to the mobilization for rights and the provision of services. “Not all demands are confrontational. Communities begin demanding something that is perceived as small in scope but have ramifications that extend to other rights such as the right to education, the right to housing and the right to work.” According to Srinivasan, the Right to Food Campaign in India has had a tremendous impact in putting hunger on the policy agenda. Suchi Pande, an activist-researcher who worked on the Right to Information Campaign in India for over seven years and was the secretary for the National Campaign for People’s Right to Information from 2006 to 2008, supported Srinivasan’s argument of strong correlation in achievements and right-based mobilization. However, Pande pointed out that despite successes in the Right to Food Campaign, other economic and social rights including the right to health in India continues to be a non-issue for politicians and the government. She is optimistic and believes that rural public hearings, the role of the right to information and its supporting mechanisms will facilitate access to public health in rural India.
In panel four, Sarah MacCarthy showed results that suggest that counseling and testing services for HIV-positive pregnant women remain limited, insufficient or lacking in quality in Salvador, Brazil. “While Brazil’s HIV/AIDS program has been internationally acclaimed, national practice still fails to meet national and global guidelines,” she explained. Calling attention to the regional discrepancies in the HIV/AIDS policy and program implementation in Brazil, Nadejda Marques, manager of the Program on Human Rights at CDDRL,, expressed concerns about the implementation of an HIV/AIDS program in a context of limited resources. “In Angola, counseling and voluntary testing units for HIV/AIDS don’t have drinking water or sanitary conditions to receive patients. They lack basic equipment for testing and data collection, there is a generalized shortage of doctors, and health care providers have no specific training on HIV/AIDS.” Despite this alarming situation, Marques explained that advocating for the rights of persons living with HIV/AIDS in Angola has put in evidence the failure of a heath system unable to provide even the most basic services to its population and has enabled mobilization in a context where human rights are routinely violated.
Ami Laws, adjunct associate professor of medicine at Stanford, described how a physician can provide services in collaboration with the judicial system to advance human rights. Laws is an expert witness on cases of torture survivors that require asylum status in the U.S. and has worked mainly with victims of torture in the Punjab region in India. Everaldo Lamprea, a JSD candidate at Stanford Law School and an assistant professor at Los Andes Law School in Bogotá, Colombia, spoke about his recent comparative study on health litigation in low and middle-income countries. The escalation of right-to-health litigation in these countries can have unexpected and harmful consequences to healthcare reforms and the enforceability of the right to health. In part, this is because significant financial resources are allocated to the litigation processes and not to the health system. In addition, while litigation can highlight gaps that exist in the health system that need regulation, countries have been very slow to adapt and adjust to these signals.
Next Steps:
A number of key ideas, questions and insights emerged from the conference including:
. How to identify an effective intervention that will also mobilize communities to advocate for its implementation?
. How to provide services to the more vulnerable populations without alienating a contingent that has access to basic health care services?
. What instruments can be used to share best practices among national healthcare systems?
. How do global priorities adapt to contexts of limited financial resources and human capital?
. How can punctual achievements in rights that guarantee access to health be expanded for the achievement of other social, economic and cultural rights?
The Program on Human Rights at CDDRL will continue to pursue a research agenda examining health and human rights following the conference and announced that it will be the thematic focus of the Sanela Diana Jenkins Speakers Series in 2014. The PHR is also actively seeking support for research projects that include a right to health component at the core of its academic investigation for the 2012-2013 academic year.