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CISAC Honors graduate awarded a Rhodes Scholarship

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Congratulations to Anand Habib, selected this weekend for a Rhodes Scholarship. Habib, 22, of Houston, Texas, is a 2011 graduate of Stanford, where he earned a bachelor's degree in biology, with honors in international security studies. He plans to pursue a master's degree in public policy and in medical anthropology at Oxford.

Habib is currently working on community health programs at St. Joseph's Clinic in Thomassique, Haiti, under a one-year global health fellowship awarded by Medical Missionaries. The nonprofit organization is a volunteer group of more than 200 doctors, nurses, dentists, and others who work to improve the health of the poorest of the poor in the United States and throughout the world.

In 2011, he won a Deans' Award for Academic Accomplishment which honors extraordinary undergraduate students for "exceptional, tangible" intellectual achievements. One of the professors who nominated him for the award described him as a "superb critical thinker" whose work is characterized by "creative genius" and "mature insights," adding that he "exemplifies exactly the kind of deeply informed, pragmatic and caring leadership that the world needs and Stanford enables."

As a Stanford student, Habib worked on behalf of politically and medically disenfranchised people in India, Mexico and Guatemala. On campus, he turned the Stanford tradition of the annual Dance Marathon into a vehicle dedicated to addressing the HIV/AIDS pandemic by engaging not only Stanford students but also local communities and corporations, raising more than $100,000. His exceptional work was recognized by his participation in the Clinton Global Initiative University Conference in April, 2011.

From Haiti, Habib discussed his current position, his plans in Oxford, and how his CISAC thesis relates to his work. 

What are you currently working on? 

I am currently working on a global health fellowship with an NGO that operates a clinic in Haiti's Central Plateau. As part of the fellowship I am helping to manage a number of community and public health projects including fortified salt (to counter iodine deficiency and filariasis), a point-of-use potable water system, a malnutrition intervention program, and a small system of community health committees and community health workers. For the past two months, I've taken on a number of administrative functions along with my co-fellow, who is also a recent college graduate. I started the fellowship shortly after graduation at the end of June 2011 and I am slated to be in Haiti until the end of June 2012.

What will you do at Oxford?

I proposed two one-year Masters programs: a masters in public policy from Oxford's new Blavatnik School of Government, and an M.Sc. in medical anthropology. As of now, I'm thinking of sticking with my proposed programs -- probably pursuing the medical anthropology degree first as it is a bit more theoretical. I think it would be better to have the more "academic" experience first before gaining the practical tools that an MPP will hopefully afford me. After a short send-off in Washington, D.C., at the end of September 2012, I will fly with the other American Rhodes Scholars-elect to Oxford the first week of October with term beginning shortly thereafter.

How does your work in the CISAC Honors program relate to what you are currently doing, your plans for Oxford, or what you'll be doing afterward? 

My honors thesis has allowed me to contextualize my experiences in Haiti in some fairly amazing ways. Two very persistent issues in Haiti are that of poor governance -- e.g. lack of strong regulatory structures, lack of government effectiveness, etc. -- and ineffective aid modalities, or the ways in which aid is delivered. My thesis was situated exactly at this nexus: how to deliver aid more effectively in order to improve governance. Ninety-nine percent of relief aid after the 2010 earthquake in Haiti was funneled to non-state organizations and only 12 percent of recovery aid went toward supporting government activities. In Haiti, I've witnessed how detrimental a patchwork system of NGO activity can be with little coordination between NGOs and little harmonization of NGO activities with government objectives. It becomes very frustrating at times, because, if my thesis is any indication, things need not be this way if both NGOs and states were engaged in collaborative partnerships -- along the lines of what Dr. Paul Farmer, deputy U.N. special envoy to Haiti, calls "accompaniment."

My initial interest in the topic of global health financing was spurred by work out of Oxford's Global Economic Governance Project. The director of the project, Dr. Ngaire Woods, was actually named the Dean of the Blavatnik School of Government through which the MPP is offered. I'd love to continue exploring the issues broached in my thesis at Oxford -- especially issues of aid effectiveness and sustainable systems of delivering development aid for health. In the future, I hope to become a physician-policymaker, helping to not only deliver care to individuals in difficult conditions around the world, but also in fostering more robust global health governance.

- Interview by Michael Freedman

 

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Japan’s Public Universal Health Insurance System Reform: Lessons for Achieving and Maintaining Universal Health Care Coverage

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The global health community has been aiming at ensuring health coverage for all. To achieve universal health care coverage, the German Social Health Insurance model is one solution. However, one major disadvantage of Social Health Insurance is the fragmented insurance plans, exemplified by 3,500 insurance plans in Japan’s public universal health insurance system. To improve the financial sustainability of Japan’s public universal health insurance, policy options include consolidating fragmented plans as already implemented in Germany and South Korea.

This presentation has two major goals. One is to evaluate the optimal health insurance size in consolidating 3,500 insurance plans in Japan through a simulation analysis using the best available micro data in Japan. The other goal is to discuss the global policy implications based on the experiences of Japan's public universal health insurance.

Dr. Byung-Kwang Yoo is an associate professor in health policy in the Department of Public Health Sciences at the UC Davis School of Medicine. Yoo’s unique career includes clinical medicine (MD) in Japan and research experience as a health services researcher/health economist in the United States. He obtained an MS in health policy and management from Harvard University, and a PhD in health policy and management (concentration on health economics) from Johns Hopkins University. Yoo used to work as a research associate at the Center for Health Policy at Stanford University, as a health economist at the Centers for Disease Control and Prevention in Atlanta, and as an assistant professor in the Division of Health Policy at the University of Rochester School of Medicine in New York State. He has published his work in leading journals such as Lancet, Health Economics, Health Services Research, the American Journal of Public Health, and the American Journal of Preventive Medicine.

Philippines Conference Room

Byung Kwang Yoo Associate Professor in Health Policy in the Department of Public Health Sciences, School of Medicine Speaker UC Davis
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David Relman

CISAC
Stanford University
Encina Hall, E209
Stanford, CA 94305-6165

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Senior Fellow at the Freeman Spogli Institute for International Studies
Thomas C. and Joan M. Merigan Professor
Professor of Medicine
Professor of Microbiology and Immunology
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David A. Relman, M.D., is the Thomas C. and Joan M. Merigan Professor in the Departments of Medicine, and of Microbiology and Immunology at Stanford University, and Chief of Infectious Diseases at the Veterans Affairs Palo Alto Health Care System in Palo Alto, California. He is also Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford, and served as science co-director at the Center for International Security and Cooperation at Stanford from 2013-2017. He is currently director of a new Biosecurity Initiative at FSI.

Relman was an early pioneer in the modern study of the human indigenous microbiota. Most recently, his work has focused on human microbial community assembly, and community stability and resilience in the face of disturbance. Ecological theory and predictions are tested in clinical studies with multiple approaches for characterizing the human microbiome. Previous work included the development of molecular methods for identifying novel microbial pathogens, and the subsequent identification of several historically important microbial disease agents. One of his papers was selected as “one of the 50 most important publications of the past century” by the American Society for Microbiology.

Dr. Relman received an S.B. (Biology) from MIT, M.D. from Harvard Medical School, and joined the faculty at Stanford in 1994. He served as vice-chair of the NAS Committee that reviewed the science performed as part of the FBI investigation of the 2001 Anthrax Letters, as a member of the National Science Advisory Board on Biosecurity, and as President of the Infectious Diseases Society of America. He is currently a member of the Intelligence Community Studies Board and the Committee on Science, Technology and the Law, both at the National Academies of Science. He has received an NIH Pioneer Award, an NIH Transformative Research Award, and was elected a member of the National Academy of Medicine in 2011.

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Eric Lambin

473 Via Ortega
Y2E2 room 371
Stanford, CA 94305-4205

(650) 724-9825
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George and Setsuko Ishiyama Provostial Professor
Senior Fellow, Stanford Woods Institute for the Environment
FSE Affiliated Faculty
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Dr. Lambin's research is in the area of human-environment interactions in land systems. He develops integrated approaches to study land use change by linking remote sensing and socio-economic data. This includes research to better detect subtle land changes based on time series of Earth observation satellites at multiple scales. He aims at better modeling causes and impacts of deforestation, dryland degradation, agricultural intensification, and conflicts between wildlife and agriculture around natural reserves. He also studies responses by rural communities to environmental changes. He focuses on land use transitions - i.e., the shift from deforestation (or land degradation) to reforestation (or land sparing for nature) that is taking place in some forest countries or drylands. This research identifies the conditions for a sustainable land use by rural communities. He also conducts projects on the impact of land change on vector-borne disease, through integrated analyzes of interactions between people, vectors, animal hosts and land. His research is mostly focused on tropical regions.

Human Rights of Indigenous Peoples in Latin America

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The Program on Human Rights and the Center for Latin American Studies are pleased to host the Conference "Human Rights of Indigenous Peoples in Latin America".

Indigenous peoples around the world have often been dispossessed of their land, leading to ongoing conflict over control and usage of land and resources. Indigenous peoples in Latin America are no exception; they are among the most disadvantaged and vulnerable peoples in the region. Indigenous peoples in Latin America rank highest on underdevelopment indicators such as incarceration, illiteracy, unemployment, poverty and disease. They face discrimination in schools and are exploited in the workplace. Their sacred lands and artifacts are plundered from them. In many Latin American countries, indigenous peoples are not even permitted to study their own language.

The Stanford Spring conference “Human Rights of Indigenous Peoples in Latin America,” brings scholars from all disciplines to examine the common trends, actors, challenges and changes among indigenous populations in Latin America and the Caribbean.

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Bechtel Conference Center

Alejandro Toledo President of Peru from 2001 to 2006 Keynote Speaker
Eliane Karp-Toledo Anthropologist, Economist and former First Lady of Peru (2001 to 2006) Keynote Speaker
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CDDRL Conferences
Indigenous Peoples Rights

Lee M. Sanders

Encina Commons Room 210,
615 Crothers Way,
Stanford, CA 94305-6006

(650) 723-1919
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Professor, Pediatrics
Professor, Health Policy
Professor, Epidemiology & Population Health (by courtesy)
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Dr. Lee Sanders is a general pediatrician and Professor of Pediatrics at the Stanford University School of Medicine, where he is Chief of the Division of General Pediatrics. He holds a joint appointment in the Center for Health Policy in the Freeman Spogli Institute for International Studies, where he is a co-director of the Center for Policy, Outcomes and Prevention (CPOP).

An author of numerous peer-reviewed articles addressing child health disparities, Dr. Sanders is a nationally recognized scholar in the fields of health literacy and child chronic-illness care.  Dr. Sanders was named a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar for his leadership on the role of maternal health literacy and English-language proficiency in addressing child health disparities.  Aiming to make the US health system more navigable for the one in 4 families with limited health literacy, he has served as an advisor to the Institute of Medicine, the Centers for Disease Control and Prevention, the Food and Drug Administration, the American Academy of Pediatrics, the Academic Pediatric Association, and the American Cancer Society.  Dr. Sanders leads a multi-disciplinary CPOP research team that provides analytic guidance to national and state policies affecting children with complex chronic illness – with a focus on the special health-system requirements that arise from the unique epidemiology, care-use patterns, and health-care costs for this population.  He leads another CPOP/PCOR-based research team that applies family-centered approaches to new technologies that aim to improve care coordination for children with medical complexity.    Dr. Sanders is also principal investigator on two NIH-funded studies that address health literacy in the pediatric context: one aims to assess the efficacy of a low-literacy, early-childhood intervention designed to prevent early childhood obesity; the other aims to provide the FDA with guidance on improved labeling of pediatric liquid medication.  Research settings for this work include state and regional health departments, primary-care and subspecialty-care clinics, community-health centers, WIC offices, federally subsidized child-care centers, and family advocacy centers.

Dr. Sanders received a BA in History and Science from Harvard University, an MD from Stanford University, and a MPH from the University of California, Berkeley.  Between 2006 and 2011, Dr. Sanders served as Medical Director of Children’s Medical Services South Florida, a Florida state agency that coordinates care for more than 10,000 low-income children with special health care needs.  He was also Medical Director for Reach Out and Read Florida, a pediatric-clinic-based program that provides books and early-literacy promotion to more than 200,000 underserved children.  At the University of Miami, Dr. Sanders directed the Jay Weiss Center for Social Medicine and Health Equity, which fosters a scholarly community committed to addressing global health inequities through community-based participatory research.  At Stanford University, Dr. Sanders served as co-medical director of the Family Advocacy Program, which provides free legal assistance to help address social determinants of child health.

Fluent in Spanish, Dr. Sanders is co-director of the Complex Primary Care Clinic at Stanford Children’s Health, which provides multi-disciplinary team care for children with complex chronic conditions.  Dr. Sanders is also the father of two daughters, aged 11 and 14 years, who make sure he practices talking less and listening more.

Co-Director, Center for Policy, Outcomes & Prevention (CPOP)
Chief, Division of General Pediatrics, School of Medicine
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Mechanisms of Antibiotic Resistance and the Impact of Drug Resistance on the Development and Use of Antibiotics

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Antibiotics have represented the primary line of defense for treating bacterial infections since 1935 when the first sulfur-containing compounds were introduced. Many antibiotic compounds are produced naturally by microorganisms while some more recently developed antibiotics are chemically designed based on a knowledge of susceptible biochemical pathways or physiological processes in pathogenic bacteria. Ciprofloxacin (“cipro”), a synthetic broad-spectrum antibiotic, functions by interfering with DNA replication.

Increased use and mis-use of antibiotics has led to increased numbers of pathogenic bacteria that are resistant to one or more antibiotics. Some resistant microbes possess mechanisms that allow continued growth in the presence of multiple antibiotics. These multiply drug-resistant pathogenic bacteria may also possess pathogenic properties that result in significantly more severe disease than their drug-sensitive cousins. Medical misuse of antibiotics – prescribing antibiotics for viral infections, failure of patients to complete treatment with the full regiment of antibiotics, or application of antibiotics based on inaccurate or incomplete tests can lead to selection of antibiotic resistant bacteria that can then cause infections that cannot be treated with the antibiotic(s) to which they are resistant. Multiple drug resistance can quickly reduce or eliminate all antibiotic-based treatment options. Infections caused by antibiotic resistant bacteria are very difficult to treat and can sometimes lead to death of the patient.

Antibiotic resistance can also result from selection based on exposure to antibiotics present in the environment. More than 70% of the antibiotics sold in the U.S. are used as supplements to animal feed. The intestinal bacteria in the animals provided with such feed often show resistance to the antibiotics in the feed and, in some documented cases, have transferred this resistance to pathogenic microbes with which they share the environment.

A brief of history of antibiotic use and the medical and public policy factors that are, in part, responsible for increased antibiotic resistance in pathogenic microbes and for a decrease in the development of new antibiotics will be presented. An introduction to new directions that are being taken to develop a next generation of antibiotic compounds will also be provided.

Speaker Biography:

Paul Jackson received his Bachelor's of Science degree from the University of Washington in Cellular Biology and his Ph.D. from the University of Utah in Molecular Biology. He became a CISAC Visiting Scholar in September 2011. He was previously a CISAC affiliate.

For the past 18 years he has been studying bacterial pathogens, first working to develop DNA-based methods of detecting these microbes and their remnants in environmental and laboratory samples, then developing methods to differentiate among different strains of the same pathogenic species. Research interests include the study of different methods of interrogating biological samples for detection and characterization of content, and development of bioforensic tools that provide detailed information about biothreat isolates including full interrogation of samples for strain content and other genetic traits.

Methods he developed have been applied to forensic analysis of samples and aid in identifying the source of disease outbreaks. He contributed to analysis of the Bacillus anthracis present in the 2001 Amerithrax letters and conducted detailed analyses of human tissue samples preserved from the 1979 Sverdlovsk anthrax outbreak, providing evidence that was inconsistent with Soviet government claims of a natural anthrax outbreak.

His current work continues to focus on development of assays that rapidly detect specific signatures including antibiotic resistance in threat agents and other pathogens. More recent activities include identification and characterization of new antimicrobial compounds that are based on the pathogens' own genes and the products they encode. These include development of such materials as therapeutic antimicrobials, their application to remediate high value contaminated sites and materials, and their use to destroy large cultures and preparations of different bacterial threat agents. Efforts to address issues of antibiotic resistance and treatment of resistant organisms have recently been expanded to look at non-threat agent pathogens that cause problematic nosocomial or community-acquired infections of particular interest to the military.

Paul spent 24 years as a Technical Staff Member at Los Alamos National Laboratory where he was heavily involved in development of the biological threat reduction efforts there. He was appointed a Laboratory Fellow at Los Alamos in recognition of his efforts. He moved to Lawrence Livermore National Laboratory in 2005 where he is presently Senior Scientist in the Global Security and Physical and Life Sciences Directorates. In addition to his work at the National Laboratories, he has served on the FBI's Scientific Working Group for Microbial Forensics, on NIH study sections and review panels, and continues to serve on steering and oversight committees for other federal agencies.

Reuben W. Hills Conference Room

Paul J. Jackson Visiting Scholar Speaker CISAC
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Controlling Drug-Resistant Tuberculosis in North Korea and China: An Agenda for a New Foreign Policy

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Rates of tuberculosis, a disease that thrives on poverty, malnutrition and interrupted medical care, are now among the highest in the world in the Democratic People's Republic of Korea (DPRK, North Korea), elevating the risk of an epidemic of drug-resistant strains and a spread into China. This project represents a unique historical opportunity to examine the relationship between food security, malnutrition and the epidemiology of tuberculosis in a present-day famine.

Walter P. Falcon Lounge

Gary K. Schoolnik professor of medicine/infectious diseases, of microbiology and immunology; FSI senior fellow Speaker
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