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In a recent speech, Stanford professor Rosamond Naylor examined the wide range of challenges contributing to global food insecurity, which Naylor defined as a lack of plentiful, nutritious and affordable food. Naylor's lecture, titled "Feeding the World in the 21st Century," was part of the quarterly Earth Matters series sponsored by Stanford Continuing Studies and the Stanford School of Earth Sciences. Naylor, a professor of Environmental Earth System Science and director of the Center on Food Security and the Environment at Stanford, is also a professor (by courtesy) of Economics, and the William Wrigley Senior Fellow at the Freeman Spogli Institute for International Studies and the Stanford Woods Institute for the Environment.

"One billion people go to bed day in and day out with chronic hunger," said Naylor. The problem of food insecurity, she explained, goes far beyond food supply. "We produce enough calories, just with cereal crops alone, to feed everyone on the planet," she said. Rather, food insecurity arises from a complex and interactive set of factors including poverty, malnutrition, disease, conflict, poor governance and volatile prices. Food supply depends on limited natural resources including water and energy, and food accessibility depends on government policies about land rights, biofuels, and food subsidies. Often, said Naylor, food policies in one country can impact food security in other parts of the world. Solutions to global hunger must account for this complexity, and for the "evolving" nature of food security.

As an example of this evolution, Naylor pointed to the success of China and India in reducing hunger rates from 70 percent to 15 percent within a single generation. Economic growth was key, as was the "Green Revolution," a series of advances in plant breeding, irrigation and agricultural technology that led to a doubling of global cereal crop production between 1970 and 2010. But Naylor warned that the success of the Green Revolution can lead to complacency about present-day food security challenges. China, for example, sharply reduced hunger as it underwent rapid economic growth, but now faces what Naylor described as a "second food security challenge" of micronutrient deficiency. Anemia, which is caused by a lack of dietary iron and which Naylor said is common in many rural areas of China, can permanently damage children's cognitive development and school performance, and eventually impede a country’s economic growth.

Hunger knows no boundaries

Although hunger is more prevalent in the developing world, food insecurity knows no geographic boundaries, said Naylor. Every country, including wealthy economies like the United States, struggles with problems of food availability, access, and nutrition. "Rather than think of this as 'their problem' that we don't need to deal with, really it's our problem too," Naylor said.

She pointed out that one in five children in the United States is chronically hungry, and 50 million Americans receive government food assistance. Many more millions go to soup kitchens every night, she added. "We are in a precarious position with our own food security, with big implications for public health and educational attainment," Naylor said. A major paradox of the United States' food security challenge is that hunger increasingly coexists with obesity. For the poorest Americans, cheap food offers abundant calories but low nutritional value. To improve the health and food security of millions of Americans, "linking policy in a way that can enhance the incomes of the poorest is really important, and it's the hard part,” she said.” It's not easy to fix the inequality issue."

Success stories

When asked whether there were any "easy" decisions that the global community can agree to, Naylor responded, "What we need to do for a lot of these issues is pretty clear, but how we get after it is not always agreed upon." She added, "But I think we've seen quite a few success stories," including the growing research on climate resilient crops, new scientific tools such as plant genetics, improved modeling techniques for water and irrigation systems, and better knowledge about how to use fertilizer more efficiently. She also said that the growing body of agriculture-focused climate research was encouraging, and that Stanford is a leader on this front.

Naylor is the editor and co-author of The Evolving Sphere of Food Security, a new book from Oxford University Press. The book features a team of 19 faculty authors from 5 Stanford schools including Earth science, economics, law, engineering, medicine, political science, international relations, and biology. The all-Stanford lineup was intentional, Naylor said, because the university is committed to interdisciplinary research that addresses complex global issues like food security, and because "agriculture is incredibly dominated by policy, and Stanford has a long history of dealing with some of these policy elements. This is the glue that enables us to answer really challenging questions." 

 

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Brett Carter is an Associate Professor in the Department of Political Science and International Relations at the University of Southern California, a Hoover Fellow at Stanford University's Hoover Institution, and a Faculty Affiliate at Stanford's Center on Democracy, Development and the Rule of Law. He received a Ph.D. from Harvard University, where he was a fellow at the Harvard Academy for International and Area Studies.

Carter studies politics in the world's autocracies. His first book, Propaganda in Autocracies: Institutions, Information, and the Politics of Belief (Cambridge University Press), draws on the largest archive of state propaganda ever assembled — encompassing over eight million newspaper articles in six languages from nearly 60 countries around the world — to show how political institutions shape the propaganda strategies of repressive governments. It received the William Riker Prize for the Best Book in Political Economy, the International Journal of Press/Politics Hazel Gaudet-Erskine Best Book Award, Honorable Mention for the Gregory Luebbert Award for the Best Book in Comparative Politics, and Honorable Mention for the APSA Democracy & Autocracy Section's Best Book Award.

His second book, in progress, shows how politics in Africa’s autocracies changed after the fall of the Berlin Wall and how a new era of geopolitical competition — marked by the rise of China and the resurgence of Russia — is changing them again.

Carter’s other work has appeared in the Journal of Politics, British Journal of Political Science, Perspectives on Politics, Journal of Conflict Resolution, Security Studies, China Quarterly, Journal of Democracy, and Foreign Affairs, among others. His work has been featured by The New York Times, The Economist, The National Interest, and NPR’s Radiolab.

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Join Global Development and Poverty Initiative (GDP) for a stimulating discussion on the opportunities, obstacles, and unforeseen events encountered while conducting field research in the developing world.

The panelists will share stories of challenges and successes from their own experiences and will offer insights on conducting effective research in the field.

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Jennifer (“Jenna”) Davis is a Professor in the Department of Civil and Environmental Engineering and the Higgins-Magid Senior Fellow at the Woods Institute for the Environment, both of Stanford University. She also heads the Stanford Program on Water, Health & Development. Professor Davis’ research and teaching is focused at the interface of engineered water supply and sanitation systems and their users, particularly in developing countries. She has conducted field research in more than 20 countries, including most recently Zambia, Bangladesh, and Uganda.

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Katherine Casey Panelist

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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.

 

Director of Research, Stanford Center for Innovation in Global Health
Affiliated faculty at the Center on Democracy, Development and the Rule of Law
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About the Topic: Foreign aid for health in low- and middle-income countries has increased five-fold over the past 25 years. Between 2005 and 2010, health aid made up more than 30% of all health spending in low-income countries.  Global health is also an increasingly important component of U.S. foreign aid, rising steadily from under 4% of all U.S. non-military aid in 1990 to 22.7% in 2011. There is growing evidence for the role of health aid in improving health among recipient countries, but is that it? In this talk I will address the arguments for and against health as a focus of aid efforts and present initial evidence on the role of health aid on human capital and economic development.

 

About the Speaker: Eran Bendavid is an infectious diseases physician and an Assistant Professor of Medicine in the Division of General Medical Disciplines and a Stanford Health Policy affiliate. His research interests involve understanding the relationship between policies and health outcomes in developing countries. He explores how decisions about foreign assistance for health are made, and how those decisions affect the health of those whom assistance aims to serve.

He received a B.A. in chemistry and philosophy from Dartmouth College, and an M.D. from Harvard Medical School. He completed his residency in internal medicine and fellowship in infectious diseases at Stanford.

 


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Eran Bendavid Assistant Professor of Medicine Speaker Stanford University
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Military interventions have traditionally been a source of controversy in the United States. But America’s appetite for the dispatch of armed forces has been diminished greatly by factors that have primarily emerged in the 21st century. These include, most painfully, the protracted campaigns in Afghanistan and Iraq that have made US political and military leaders more cautious about waging wars to end tyranny or internal disorder in foreign lands.

Debates on military intervention are complicated by the network of political, security and economic interests that must be balanced when contemplating this option. In this IISS commentary, Karl Eikenberry, the William J. Perry Fellow in International Security at CISAC, talks about how four factors have heavily influence the current calculus.

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Foreign aid for health care is directly linked to an increase in life expectancy and a decrease in child mortality in developing countries, according to a new study by Stanford researchers.

The researchers examined both public and private health-aid programs between 1974 and 2010 in 140 countries and found that, contrary to common perceptions about the waste and ineffectiveness of aid, these health-aid grants led to significant health improvements with lasting effects over time.

Countries receiving more health aid witnessed a more rapid rise in life expectancy and saw measurably larger declines in mortality among children under the age of 5 than countries that received less health aid, said Eran Bendavid, MD, an assistant professor in Stanford Medical School's Division of General Medical Disciplines and lead author of the study. If these trends continue, he said, an increase in health aid of just 4 percent, or $1 billion, could have major implications for child mortality.

“If health aid continues to be as effective as it has been, we estimate there will be 364,800 fewer deaths in children under 5,” he said. “We are talking about $1 billion, which is a relatively small commitment for developed countries.”

The study was published online April 21 in JAMA Internal Medicine. The study’s co-author, Jay Bhattacharya, MD, PhD, is an associate professor of medicine.

Bendavid and Bhattacharya are core faculty members at Stanford’s Center for Health Policy and Center for Primary Care and Outcomes Research at the university's Freeman Spogli Institute for International Studies.

Does it work?

Bendavid noted that there is much debate around foreign aid. Critics question whether it’s used effectively and reaches its intended recipients. They often argue that it discourages local development and displaces domestic resources that might otherwise be devoted to health. So the researchers devised a statistical tool to address the basic unanswered question: Do investments in health really lead to health improvements?

Bendavid said there are many reasons to suspect the answer would be no, though the findings proved just the contrary, with health-related aid leading to direct, beneficial outcomes.

“I think for many people, that will be surprising,” he said. “But for me, it fits with other evidence of the incredible success of public health promotion in developing countries.” In a previous study, for instance, he found that hundreds of thousands of lives were saved through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, in which the U.S. government invested billions of dollars in antiretroviral treatment and other AIDS-related prevention and treatment initiatives.

In the latest study, the two investigators used data from the Creditor Reporting System of the Organization for Economic Cooperation and Development, the world’s most extensive source of information on foreign aid. While aid programs for health grew during the 36-year study period, the largest period of growth occurred between 2000 and 2010, they found.

Stepped-up investments

It was during this decade that many governments and private groups stepped up their investments in health, including PEPFAR; the World Bank; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Gates Foundation; and the GAVI Alliance, among others, he said.

As a result, while health aid in 1990 accounted for 4 percent of total foreign aid, it now amounts to 15 percent of all aid, he said. And it’s become an important part of health budgets in recipient countries, accounting for 25-30 percent of all health-care spending in low-income countries, Bendavid said.

The researchers found that these funds were used effectively, largely because of the targeting of aid to disease priorities where improved technologies — such as new vaccines, insecticide-treated bed nets for malarial prevention and antiretroviral drugs for HIV — could make a real difference.

They observed the greatest health impacts between 2000 and 2010, when donor investments were at their peak. During the decade, under-5 child mortality declined from a mean of 109.2 to 72.4 deaths per 1,000, or 36.8 fewer deaths among those children in the countries that received the most health aid, the researchers found (a 34 percent reduction). In the countries receiving the least, under-5 mortality fell from 31.6 to 23.2 deaths per 1,000, or 8.4 fewer deaths per 1,000 live births (a 26 percent reduction), the researchers reported.

Life expectancy increases

During that period, life-expectancy figures also grew faster in countries with a greater infusion of health aid, Bendavid said. Life expectancy rose from 57.5 to 62.3 — an increase of 4.8 years — among the countries receiving the most aid. Among the countries receiving the least health aid, life expectancy increased by 2.7 years, from 69.8 to 72.5 years.

Bendavid said previous experience has shown that, on average, life expectancy has increased by nearly one year every four years in developed countries. But health-aid programs literally cut in half the time it took to reach this goal in developing countries. “In that same four-year span, they increased life expectancy by two years, rather than one year,” he said.

He said the results are not surprising if one considers some of the new health technologies made available to developing nations as a result of foreign aid. Childhood vaccines, including those for diphtheria, tetanus, polio and measles, have all but wiped out what used to be among the top killers of young children in the developing world. Health aid directed to providing insecticide-treated malarial bed nets also has been credited in recent studies with reducing malarial deaths among young children, he noted.

Among both adults and children, aid that has expanded the availability of antiretroviral drugs in the developing world has had a major impact on reducing deaths and improving overall life expectancies, he said. For instance, in a study published in 2012, Bendavid and colleagues found that PEPFAR’s health aid resulted in more than 740,000 lives saved between 2004 and 2008 in nine countries.

The researchers also found that the benefits of aid have a lasting effect: The telltale signs of aid’s relationship to reducing under-5 mortality were detectable for three years following the distribution of aid. The correlation between health aid and longer life expectancy overall was detectable for five years after the aid was distributed.

With aid commitments flattening amid the economic downturn, Bendavid said donors will have to be that much smarter in how they invest future dollars, focusing on the most cost-effective interventions and technologies.

“To date, there has been little consideration of how to use development aid in the most cost-effective manner,” he said. “That will have to change now that the funding level has reached a plateau.”

The study was funded by the George Rosenkranz Fellowship for Health Policy Research in Developing Countries and by the National Institutes of Health (grant K01AI084582).

Information about Stanford’s Department of Medicine, which also supported the work, is available at http://medicine.stanford.edu.

Ruthann Richter is the director of media relations at the Stanford School of Medicine.

 

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n Afghan child receives polio vaccination drops during an anti-polio campaign in Kabul March 24, 2014.
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Zack Bonzell came to Stanford with a strong interest in human biology and political science. Last summer, the undergraduate had the chance to fuse his interests while doing field research with faculty at the university’s Freeman Spogli Institute for International Studies (FSI). 

During a two-week internship, he travelled to Guatemala with FSI senior fellows Paul Wise, Beatriz Magaloni, Alberto Díaz-Cayeros and Scott Rozelle to learn about the country’s rural health care system by shadowing doctors and interviewing mothers in an impoverished area about the issues leading to the area’s high rates of child malnutrition.

“That experience was an ideal way to blend my interests and gave me a better idea of how to craft my course of study at Stanford,” said Bonzell, who is now a junior. “One of the things that really struck me was when Paul Wise said the health outcomes we were seeing are the result of extreme material deprivation. These people are sick because they are poor. That gave me more of an interest in political economy.”

Students conduct interviews about nutrition with REAP in China. Photo Credit: Matt Boswell

FSI is now expanding its educational opportunities for students, like Bonzell, who want to do research on global issues in Asia, Latin America, Europe and Africa.

The Stanford Global Student Fellows program (SGSF) is being funded in large part through a $1.25 million anonymous gift that will help grow existing programs and create new offerings for graduates and undergraduates.

“This program deepens FSI’s commitment to its mission of educating the next generation of leaders in international affairs,” said FSI Director Mariano-Florentino Cuéllar. “It also offers outstanding opportunities for Stanford students to work closely with the leading thinkers on global policy issues.”

The program, which is part of FSI’s efforts to expand student opportunities, will build on the institute’s undergraduate mentorship programs that allow students to work on faculty research projects each quarter. Those positions will now be available during the summer. Some of the positions will be connected to projects in FSI’s new International Policy Implementation Lab, an initiative that gives students a close-up view of how academics and policy influencers can address some of the world’s thorniest issues.

PoliSci 114S students work together in a UN conflict simulation. Photo Credit: Rod Searcey

Building on FSI’s experience placing students in research opportunities, the program will create and expand summer field research internships. The two- to six-week internships this summer will give undergraduates the opportunity to work with FSI senior fellows in China, Guatemala, India and Mexico who study global health, conflict resolution, governance and poverty reduction.  In coming years, the program will likely include additional fieldwork projects in Rwanda, Tanzania and Brazil. The SGSF program covers all travel expenses for students and provides students with an opportunity to work closely with a faculty member and a team of other students on an ongoing research project addressing real-world problems in a specific region. 

“What makes FSI such an incredible institution is that it attracts faculty who have very pragmatic interests,” Bonzell said. “It seeks to wed academic work with a more direct impact, and there’s a lot of potential for more students to think along similar lines.”

The Stanford Global Student Fellows will also allow FSI to work closely with its partners, including the Program in International Relations, the Haas Center for Public Service, and Stanford in Government to provide opportunities for graduate and undergraduate students. 

Mexican Ambassador Eduardo Medina Mora and Jorge Olarte, '13, speaking with students at the US-Mex FoCUS event. Photo Credit: Rod Searcey

One of the program’s new initiatives geared toward undergraduates is the Global Policy Summer Fellowships. The fellowships help secure placement and a $6,000 stipend for students interested in interning at international policy and international affairs organizations. This summer,The Europe Center at FSI is placing students at the Center for European Policy Studies and Bruegel, two Brussels-based think tanks. Future positions will be created with six offerings abroad and two based in the United States.including the Program in International Relations, the Haas Center for Public Service, and Stanford in Government to provide opportunities for graduate and undergraduate students. 

The Stanford Global Student Fellows program will also commit $400,000 to create a Mentored Global Research Fellowship that will provide research opportunities for students to conduct their own overseas research under the close mentorship of a faculty member. The program will award stipends of $6,000 for summer undergraduate projects and $9,000 for summer graduate projects, and $1,500 for smaller projects executed during the school year.

Thomas Hendee '13 chatting with children in rural Guatemala. Photo Credit: Maria Contreras

The faculty advisory committee overseeing the development and implementation of these new programs includes Scott Rozelle, the Helen F. Farnsworth Senior Fellow and the co-director of FSI’s Rural Education Action ProgramStephen Stedman, a senior fellow at FSI and the deputy director of CDDRL; and Lisa Blaydes, assistant professor of political science.

The application deadline for all summer programs is Feb. 28, 2015. The deadline to apply for academic quarterly programs is the end of the first week of each quarter, beginning in the fall of 2014. 

For more information, students should contact Elena Cryst at ecryst@stanford.edu and watch for postings on FSI’s student program Facebook page. Students can also sign up for the program’s distribution and announcement list.

 

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There is no consensus in the policy or academic worlds about what kind of interventions are most effective in promoting governance in badly governed polities.   The three major approaches to understanding state development — modernization theory, institutional capacity, and rational choice institutionalism suggest very different approaches.   While modernization theory is most expansive about the possibilities for external action, its record over time is the most problematic.   Rational choice institutionalism, in contrast, suggests that in rent-seeking exclusive orders the opportunities for external actors are limited.  Rational choice institutionalism, however, does not provide a clear mapping of mixed order polities, ones in which the interests of political elites are torn between open access and rent-seeking.
 
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Stephen Krasner is the Graham H. Stuart Professor of International Relations, the Senior Associate Dean for the Social Sciences, School of Humanities & Sciences, and the deputy director of FSI. A former director of CDDRL, Krasner is also an FSI senior fellow, and a fellow of the Hoover Institution. From February 2005 to April 2007 he served as the Director of Policy Planning at the US State Department. While at the State Department, Krasner was a driving force behind foreign assistance reform designed to more effectively target American foreign aid. He was also involved in activities related to the promotion of good governance and democratic institutions around the world.

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Senior Fellow at the Freeman Spogli Institute for International Studies, Emeritus
Graham H. Stuart Professor of International Relations
Senior Fellow at the Hoover Institution, Emeritus
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Stephen Krasner is the Graham H. Stuart Professor of International Relations. A former director of CDDRL, Krasner is also an FSI senior fellow, and a fellow of the Hoover Institution.

From February 2005 to April 2007 he served as the Director of Policy Planning at the US State Department. While at the State Department, Krasner was a driving force behind foreign assistance reform designed to more effectively target American foreign aid. He was also involved in activities related to the promotion of good governance and democratic institutions around the world.

At CDDRL, Krasner was the coordinator of the Program on Sovereignty. His work has dealt primarily with sovereignty, American foreign policy, and the political determinants of international economic relations. Before coming to Stanford in 1981 he taught at Harvard University and UCLA. At Stanford, he was chair of the political science department from 1984 to 1991, and he served as the editor of International Organization from 1986 to 1992.

He has been a fellow at the Center for Advanced Studies in the Behavioral Sciences (1987-88) and at the Wissenschaftskolleg zu Berlin (2000-2001). In 2002 he served as director for governance and development at the National Security Council. He is a fellow of the American Academy of Arts and Sciences and a member of the Council on Foreign Relations.

His major publications include Defending the National Interest: Raw Materials Investment and American Foreign Policy (1978), Structural Conflict: The Third World Against Global Liberalism (1985), Sovereignty: Organized Hypocrisy (1999), and How to Make Love to a Despot (2020). Publications he has edited include International Regimes (1983), Exploration and Contestation in the Study of World Politics (co-editor, 1999),  Problematic Sovereignty: Contested Rules and Political Possibilities (2001), and Power, the State, and Sovereignty: Essays on International Relations (2009). He received a BA in history from Cornell University, an MA in international affairs from Columbia University and a PhD in political science from Harvard.

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It is almost too obvious to state, but access to public services and the nature of governance varies hugely within countries, regions and cities. Nevertheless, most work on the “quality of government”, rule of law, corruption, etc. focuses on between-country comparisons. After providing some evidence that within-country variation belies any notion of a national “quality of government”, I lay out a framework for explaining why outcomes vary so much across localities within countries. I explore the usefulness of the framework by providing evidence from three ongoing projects. The first relies on surveys designed to examine the role of slum-level social and political networks in conditioning access to basic public services in Udaipur, India. The second project relies on four post-civil war settings to understand why authorities target some localities with electrification projects but not others.  The third project involves a field experiment embedded in an aid program that compares alternative means of improving accountability in Ghana’s district governments. I will conclude with some reflections on the costs and benefits of working with donors on governance programming.

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Erik Wibbels is an Associate Professor of Political Science at Duke University. His research focuses on development, decentralized governance and other areas of political economy. He has also spent considerable time working with USAID's Center of Excellence on Democracy, Human Rights and Governance in an effort to improve the quality of aid programs aimed at decentralized governance and service provision.

 

 

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Erik Wibbels Associate Professor of Political Science Speaker Duke University
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