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John Seffrin, Ph. D., will be speaking on the issues of tobacco, with his experience as CEO of America Cancer Society, and as the immediate past president of the International Union Against Cancer in Geneva, Switzerland.

Medical School Office Building (MSOB)
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Stanford, CA 94305

John Seffrin CEO of America Cancer Society Speaker
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Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem. New choices for energy must be made carefully considering such effects as additional pressure on the world's forests through large-scale expansion of soybean and oil palm plantations, leading to forest clearing, biodiversity loss and disease emergence, expulsion of subsistence farmers, and potential increases in food prices and emissions of carbon dioxide to the atmosphere. Investigators must consider the full range of policy options, supported by more comprehensive, flexible, and transparent assessment methods.

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Holly Gibbs
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As we find ourselves at the start of the "biological century" with a wealth of potential benefits to public health, agriculture, and global economies, it is almost deliberately naive to think that the extraordinary growth in the life sciences might not be exploited for nefarious purposes. A report published in 2006 by an ad hoc committee of the National Academies of Science recognized that the breadth of biological threats is much broader than commonly appreciated and will continue to expand for the foreseeable future. The nature of these threats, and a set of potential approaches with which to mitigate these threats, will be reviewed.

David Relman, MD, is professor of medicine, and of microbiology and immunology at Stanford University. He is also chief, infectious diseases section, at the VA Palo Alto Health Care System in Palo Alto, California. His research is directed towards the characterization of the human indigenous microbial communities, with emphasis on understanding variation in diversity, succession, the effects of disturbance, and the role of these communities in health and disease.  This work brings together approaches from ecology, population biology, environmental microbiology, genomics and clinical medicine.  In addition, his research explores the classification structure of humans and non-human primates with systemic infectious diseases, based on patterns of genome-wide gene transcript abundance in blood and other tissues. The goals of this work are to recognize classes of pathogen and predict clinical outcome at early time points in the disease process, as well as to gain further insights into virulence. Past scientific achievements include the description of a novel approach for identifying previously-unknown pathogens, the identification of a number of new human microbial pathogens, including the agent of Whipple's disease, and some of the most extensive analyses to date of the human indigenous microbial ecosystem. See http://relman.stanford.edu

Among his other activities, Dr. Relman currently serves as Chair of the Board of Scientific Counselors of the National Institute of Dental and Craniofacial Research (NIH), Chair of the Institute of Medicine's Forum on Microbial Threats (U.S. National Academies of Science), member of the National Science Advisory Board for Biosecurity, and advises several U.S. Government departments and agencies on matters related to pathogen diversity, the future life sciences landscape, and the nature of present and future biological threats.  He co-chaired a three-year study at the National Academy of Sciences that produced a report entitled, "Globalization, Biosecurity, and the Future of the Life Sciences" (2006). He is a member of the American Academy of Microbiology. Dr. Relman received the Squibb Award of the IDSA in 2001, and was the recipient of both the NIH Director's Pioneer Award, and the Distinguished Clinical Scientist Award from the Doris Duke Charitable Foundation, in 2006.

Reuben W. Hills Conference Room

David Relman Professor of Medicine and of Microbiology and Immunology Speaker Stanford University
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The Asia Health Policy Program works with other researchers at Stanford and several countries of the Asia-Pacific to analyze prominent issues in population aging, child health, and control of infectious disease. Examples include comparative study of long-term care insurance and informal caregiving; collaborative study of health and healthcare access for children with special health needs; and a research project focusing on controlling tuberculosis and multi-drug resistant tuberculosis in Northeast Asia.

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Climate change, as an environmental hazard operating at the global scale, poses a unique and "involuntary exposure" to many societies, and therefore represents possibly the largest health inequity of our time. According to statistics from the World Health Organization (WHO), regions or populations already experiencing the most increase in diseases attributable to temperature rise in the past 30 years ironically contain those populations least responsible for causing greenhouse gas warming of the planet. Average global carbon emissions approximate one metric ton per year (tC/yr) per person. In 2004, United States per capita emissions neared 6 tC/yr (with Canada and Australia not far behind), and Japan and Western European countries range from 2 to 5 tC/yr per capita. Yet developing countries' per capita emissions approximate 0.6 tC/yr, and more than 50 countries are below 0.2 tC/yr (or 30-fold less than an average American). This imbalance between populations suffering from an increase in climate-sensitive diseases versus those nations producing greenhouse gases that cause global warming can be quantified using a "natural debt" index, which is the cumulative depleted CO2 emissions per capita. This is a better representation of the responsibility for current warming than a single year's emissions. By this measure, for example, the relative responsibilities of the U.S. in relation to those of India or China is nearly double that using an index of current emissions, although it does not greatly change the relationship between India and China. Rich countries like the U.S. have caused much more of today's warming than poor ones, which have not been emitting at significant levels for many years yet, no matter what current emissions indicate. Along with taking necessary measures to reduce the extent of global warming and the associated impacts, society also needs to pursue equitable solutions that first protect the most vulnerable population groups; be they defined by demographics, income, or location. For example, according to the WHO, 88% of the disease burden attributable to climate change afflicts children under age 5 (obviously an innocent and "nonconsenting" segment of the population), presenting another major axis of inequity. Not only is the health burden from climate change itself greatest among the world's poor, but some of the major mitigation approaches to reduce the degree of warming may produce negative side effects disproportionately among the poor, for example, competition for land from biofuels creating pressure on food prices. Of course, in today's globalized world, eventually all nations will share some risk, but underserved populations will suffer first and most strongly from climate change. Moreover, growing recognition that society faces a nonlinear and potentially irreversible threat has deep ethical implications about humanity's stewardship of the planet that affect both rich and poor.

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China's Harmonious Society colloquium series

co-sponsored by the Stanford China Program and the Center for East Asian Studies

Since 2006, the official doctrine of China's Communist Party calls for the creation of a "harmonious society" (HeXieSheHui). This policy, identified with the Hu Jintao leadership, acknowledges the new problems that have emerged as China continues its amazing economic growth. The economy is booming but so are tensions from rising inequality, environmental damage, health problems, diverse ethnicities, and attempts to break the "iron rice bowl." In this series of colloquia, leading authorities will discuss the causes of these tensions, their seriousness, and China's ability to solve these challenges.


Nancy Shulman's talk topic will be posted soon.

Nancy Shulman conducts laboratory and clinical research in the area of HIV therapeutics, with focus on antiretroviral resistance and treatment strategies of experienced patients, the impact of antiretroviral treatment on HIV co-receptor utilization, and HIV in China. she received her MD from Kansas University Medical School and holds a BA in biochemistry from University of Texas, Austin. She is a doctor specializing in internal medicine, pediatrics, and infectious diseases.

"Healthcare Coverage for 1.3 Billion: China's Odyssey"

Karen Eggleston

Media coverage as well as the academic literature give conflicting appraisals of China's reality: Is China's healthcare system on the verge of collapse? Why is healthcare so expensive and difficult to access in contemporary China? Have reforms 'marketizing' healthcare drastically undermined progress in assuring affordable access for all? Or do hospitals and other providers constitute a last bastion of state control and bureaucratized monopoly in the name of equal access? Chinese analysts and policy advisers have engaged in a sometimes acrimonious debate; some champion a government-led, National Health Service-like model, while others passionately argue that market forces should play a greater role. In this talk, Karen Eggleston will present a brief overview of China's health system reforms and current developments.

Karen Eggleston focuses her research on comparative healthcare systems during economic development and transition from central planning to market-based economies. Her interests include the impact of payment incentives on healthcare insurer and provider behavior; chronic disease management; and incentives surrounding health behaviors such as the spread of HIV/AIDS and tuberculosis, overuse of antibiotics, and smoking. She earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii.

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Stanford University
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Stanford, CA 94305-6055

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Senior Fellow at the Freeman Spogli Institute for International Studies
Center Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
Faculty Research Fellow of the National Bureau of Economic Research
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
karen-0320_cropprd.jpg PhD

Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.

Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.

Director, Asia Health Policy Program at the Walter H. Shorenstein Asia-Pacific Research Center
Stanford Health Policy Associate
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Karen Eggleston Shorenstein Asia-Pacific Research Center Fellow Speaker Stanford University
Nancy Shulman Assistant Professor of Medicine (Infectious Diseases) Speaker School of Medicine, Stanford University
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David L. Heymann, assistant director-general for communicable diseases and the director general's representative for polio eradication at the World Health Organization (WHO), has joined CISAC as a consulting professor.

Heymann has dedicated much of his career as a medical doctor to investigating and fighting the spread of infectious diseases and mobilizing global efforts to prevent pandemics.

"Dr. Heymann's expertise on threats to health security is a welcome addition to CISAC," Siegfried Hecker, CISAC co-director, said. "He is deeply knowledgeable about the most severe disease-related threats as well as how best to build cooperative international efforts to reduce these threats."

Prior to assuming his current position at WHO, Heymann served as executive director of WHO's Communicable Diseases Cluster, which includes programs on infectious and tropical diseases. In that position, he oversaw the response to Severe Accute Respiratory Syndrome (SARS) in 2003.

Before joining WHO, Heymann worked for 13 years as a medical epidemiologist in sub-Saharan Africa, on assignment with the U.S. Centers for Disease Control. While there, he participated in investigating both the first outbreak of Ebola, in Yambuku (then Zaire) in 1976, and the second outbreak, in Tandala, in 1977. He directed the international response to the Ebola outbreak in Kikwit in 1995. Heymann also spent two years as a medical officer in the WHO smallpox eradication program in India prior to 1976.

Heymann spent two weeks in residence at Stanford last spring, co-hosted by CISAC and FSI, during which he delivered a a talk in FSI's Payne Lecture series. In the lecture, titled "Infectious Diseases across Borders: Public Health Security in the 21st Century," he discussed the collective responsibility to defend public health. He surveyed WHO's efforts to fight emerging and re-emerging infectious disease on every continent.

Among those efforts is a global network of scientists who monitor and collect viruses, sending samples to four WHO collaborating centers for analysis and tracking. This network detected the novel virus H5N1, known as avian flu, in 1997, a disease WHO continues to track closely.

Currently, Heymann said, the H5N1 virus is in the third of six phases in WHO's pandemic alert system, meaning that there have been cases of human infection but "no, or very infrequent, human-to-human spread."

Heymann emphasized, "It is important to prevent the disease at the source." At the same time, WHO is working to "provide universal access to vaccines," which, while not eliminating the disease, "will prevent sickness," he said.

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UNAFF, which is now completing its first decade, was originally conceived to celebrate the 50th anniversary of the signing of the Universal Declaration of Human Rights. It was created with the help of members of the Stanford Film Society and United Nations Association Midpeninsula Chapter, a grassroots, community-based, nonprofit organization. The 10th UNAFF will be held from October 24-28, 2007 at Stanford University with screenings in San Francisco on October 17 and 18, East Palo Alto on October 19 and San Jose on October 21. The theme for this year is "CAMERA AS WITNESS."

UNAFF celebrates the power of films dealing with human rights, environmental survival, women's issues, protection of refugees, homelessness, racism, disease control, universal education, war and peace. Documentaries often elicit a very personal, emotional response that encourages dialogue and action by humanizing global and local problems. To further this goal, UNAFF hosts academics and filmmakers from around the world to discuss the topics in the films with the audience, groups and individuals who are often separated by geography, ethnicity and economic constraints.

Over three hundred sixty submissions from all over the world have been carefully reviewed for the tenth annual UNAFF. The jury has selected 32 films to be presented at this year's festival. The documentaries selected showcase topics from Afghanistan, Bolivia, Canada, Chile, China, Croatia, Cuba, France, Haiti, Kenya, Kosovo, Iceland, India, Iran, Iraq, Ireland, Iran, Israel, Italy, Lesotho, Macedonia, Mongolia, Nigeria, Norway, Palestine, Peru, Romania, Russia, Saudi Arabia, Serbia, Spain, Sudan, Uganda, the UK, Ukraine, the US, Vietnam and Zambia.

Cubberley Auditorium (October 24)
Annenberg Auditorium (October 25-28)

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WASHINGTON, May 24 (IPS) - This year the Association of Southeast Asian Nations celebrates its 40th birthday, and it has big plans. After four decades of being largely a political and security alliance, ASEAN is accelerating its plans for economic integration.

ASEAN leaders are so eager to pull together into an economic community that they recently decided to move the goalposts. The economic benchmarks originally planned for 2020 have been moved up to 2015.

"The mission of this economic community is to develop a single market that is competitive, equitably developed, and well integrated in the global economy," says Worapot Manupipatpong, principal economist and director of the office of the Secretary-General in the ASEAN Secretariat. He was speaking last week at an Asian Voices seminar in Washington, DC, sponsored by the Sasakawa Peace Foundation.

The single market of 2015 would encompass all ten members of ASEAN: Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar (Burma), Philippines, Singapore, Thailand, and Vietnam. According to the projections of the ASEAN Secretariat, the single market will be accomplished by removing all barriers to the free flow of goods, services, capital, and skilled labor. Rules and regulations will be simplified and harmonised. Member countries will benefit from improved economies of scale. Common investment projects, such as a highway network and the Singapore--Kunming rail link, will facilitate greater trade.

Although there will not be a single currency like the European Union's euro, the ASEAN countries will nevertheless aim for greater currency cooperation.

"ASEAN's process of economic integration was market-driven," says Soedradjad Djiwandono former governor of Bank Indonesia, and it was influenced by the "Washington consensus" favoring increased liberalisation. "It is a very different framework from the closed regionalism of the Latin American model," he continues. With multilateral talks on trade liberalisation stalled, efforts have largely shifted to bilateral negotiations. "There has been a proliferation of bilateral agreements that developed countries use as a way to push a program for liberalising different sectors," Djiwandono concludes.

So far, ASEAN points to increased trade within the ten-member community as an early sign of success. But, overall trade share -- 25 percent -- pales in comparison to the 46 percent share of the North American Free Trade Agreement countries or the 68 percent share of EU countries. And with intra-ASEAN foreign direct investment rather low -- only 6 percent in 2005 -- financial integration lags behind trade integration.

The ASEAN approach differs in several key respects from the EU model, which originated in a 1951 coal and steel agreement among six European nations. ASEAN's origins, in contrast, have been primarily political and security-oriented, observes Donald Emmerson, director of the South-east Asia Forum at the Shorenstein Asia-Pacific Research Center at Stanford. "The success attributed to ASEAN is that it presided over an inter-state peace ever since it was formed. There's never been a war fought between ASEAN members."

Also distinguishing ASEAN from EU is the latter's institutionalisation. "ASEAN is radically different," Emmerson continues. "The much discussed ASEAN way is consultation, not even voting, since if they vote, someone will lose. Sometimes the consultation goes on without result. Sometimes decisions are reduced to the lowest common denominator. It also means that rhetoric predominates." This consultative process will be tested in November, when ASEAN leaders gather to adopt a charter, something that the EU has so far failed to accomplish.

Another difference with Europe is the enormous economic disparities among the ASEAN members, with Singapore and Brunei among the richest countries in the world and Laos among the poorest. These economic disparities are reproduced within the countries as well.

Worapot Manupipatpong points to two ASEAN initiatives for closing the gap. There is help for small and medium-sized enterprises. And the Initiative for ASEAN Integration,"basically provides technical assistance to Cambodia, Laos, and Myanmar so that they can catch up with the rest of the ASEAN members," he says. "Attention will be paid to where these countries can participate in the regional networks, what comparative advantage they have, and how to enhance their capacities to participate in the regional development and supply chain."

Then there are ASEAN's efforts to address "public bads," according to Soedradjad Djiwandono. "When there is a tsunami or a pandemic," he argues, "the worst victims are the marginalised or the poor. Addressing that kind of issue has some positive impact on reducing inequality."

"The gap between the early joiners and the later joiners will continue to be substantial because ASEAN has always been more of a forum and less of a problem-solving organisation," observes Karl Jackson, director of the Asian Studies Program at the School for Advanced International Studies at Johns Hopkins University. "As a result one would expect that these gaps would be closed only as individual countries increase their rates of growth." He attributes the inequality within countries to the middle stage of growth experienced by almost all societies: "Inequality increases before the state becomes strong enough to redivide some of the pie and take care of the gross inequalities caused by rapid economic growth."

ASEAN is banking on financial and trade liberalisation increasing the overall regional pie. On paper it is an ambitious project. But "the low hanging fruit have been plucked," says Donald Emmerson. Tariffs on the "easy commodities" have already been reduced to less than 5 percent. But non-tariff barriers to trade remain, and member countries are very protective of certain sectors.

Also tempering the region's optimism is the memory of the Asian financial crisis. The crisis began in Thailand in 1997 and spread rapidly to other countries in the region. One school of thinking holds that capital mobility -- "hot money" -- either caused or considerably aggravated the crisis. Since the ASEAN integration promises greater capital mobility, will the region be at greater risk of another such crisis?

"One consequence of the economic dynamism of the Asia-Pacific region," notes Donald Emmerson, "is that the accumulation of vast foreign exchange reserves -- obviously in China, but in other countries too -- more than anything else represents an asset that can be brought into the equation as a stabilising factor in the event of a financial crisis." Also, he continues, as a result of the ASEAN plus Three network, which adds China, South Korea, and Japan to the mix, the 13 countries have "made serious headway toward establishing currency swap arrangements that would come into play in an emergency on the scale of an Asian financial crisis."

Karl Jackson also looks to currency reforms as a hedge against future crisis. The Thai baht and the Indonesian rupiah are now unpegged currencies. "You will not have a situation in which the central bank of Thailand loses 34 billion US dollars defending the baht," Jackson argues. "Instead, the baht will appreciate or depreciate according to market forces."

But Jackson still remains cautious about the future. He points to the large number of non-performing loans in the Chinese banking sector. Also, there is "this anomaly of the U.S. absorbing two-thirds of the savings coming out of Asia, plugging it mostly into consumption rather than direct investment," he observes. "Eventually there has to be some kind of readjustment. The real value of the dollar must fall." (END/2007)

Reprinted by permission from IPS Asia-Pacific.

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