Public Health

On May 18-19, the Program on Poverty and Governance will host a two-day conference on the provision of public goods and good governance throughout the world. This conference, co-sponsored by the Center for Latin American Studies, will bring together an interdisciplinary group of economists, political scientists, policymakers, and public health researchers examining these questions. Public goods—goods and services such as education, healthcare, sanitation, potable water, and other benefits provided by the government—are intrinsically tied to issues of governance, which we broadly define as the exercise of political authority and the use of institutional resources to manage society’s problems and affairs. More specifically, factors such how political leaders get elected, the way in which government projects get funded, whether the community participates in decision-making, and the extent to which the distribution of government benefits is done through clientelistic networks, among others, play an important role in the quality and coverage of public goods that governments provide. Additionally, a critical question in large parts of the developing world relates to the role of international players and foreign aid in the provision of public goods –does external provision of public goods enable or hinder governmental capacity to deliver public services in poor communities? Through two days of presentations and panel discussions, the conference will explore how various facets of governance affect the provision of public goods and services throughout the world.

The conference will be held in Encina Hall at Stanford University May 18th and 19th, 2012. Guests are encouraged to RSVP by May 16th. Any questions may be addressed to the Program on Poverty and Governance program associate Elena Cryst.

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CISAC Conference Room

Dept. of Political Science
Encina Hall, Room 436
Stanford University,
Stanford, CA

(650) 724-5949
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Senior Fellow at the Freeman Spogli Institute for International Studies
Graham H. Stuart Professor of International Relations
Professor of Political Science
beatriz_magaloni_2024.jpg MA, PhD

Beatriz Magaloni Magaloni is the Graham Stuart Professor of International Relations at the Department of Political Science. Magaloni is also a Senior Fellow at the Freeman Spogli Institute, where she holds affiliations with the Center on Democracy, Development and the Rule of Law (CDDRL) and the Center for International Security and Cooperation (CISAC). She is also a Stanford’s King Center for Global Development faculty affiliate. Magaloni has taught at Stanford University for over two decades.

She leads the Poverty, Violence, and Governance Lab (Povgov). Founded by Magaloni in 2010, Povgov is one of Stanford University’s leading impact-driven knowledge production laboratories in the social sciences. Under her leadership, Povgov has innovated and advanced a host of cutting-edge research agendas to reduce violence and poverty and promote peace, security, and human rights.

Magaloni’s work has contributed to the study of authoritarian politics, poverty alleviation, indigenous governance, and, more recently, violence, crime, security institutions, and human rights. Her first book, Voting for Autocracy: Hegemonic Party Survival and its Demise in Mexico (Cambridge University Press, 2006) is widely recognized as a seminal study in the field of comparative politics. It received the 2007 Leon Epstein Award for the Best Book published in the previous two years in the area of political parties and organizations, as well as the Best Book Award from the American Political Science Association’s Comparative Democratization Section. Her second book The Politics of Poverty Relief: Strategies of Vote Buying and Social Policies in Mexico (with Alberto Diaz-Cayeros and Federico Estevez) (Cambridge University Press, 2016) explores how politics shapes poverty alleviation.

Magaloni’s work was published in leading journals, including the American Political Science Review, American Journal of Political Science, Criminology & Public Policy, World Development, Comparative Political Studies, Annual Review of Political Science, Cambridge Journal of Evidence-Based Policing, Latin American Research Review, and others.

Magaloni received wide international acclaim for identifying innovative solutions for salient societal problems through impact-driven research. In 2023, she was named winner of the world-renowned Stockholm Prize in Criminology, considered an equivalent of the Nobel Prize in the field of criminology. The award recognized her extensive research on crime, policing, and human rights in Mexico and Brazil. Magaloni’s research production in this area was also recognized by the American Political Science Association, which named her recipient of the 2021 Heinz I. Eulau Award for the best article published in the American Political Science Review, the leading journal in the discipline.

She received her Ph.D. in political science from Duke University and holds a law degree from the Instituto Tecnológico Autónomo de México.

Director, Poverty, Violence, and Governance Lab
Co-director, Democracy Action Lab
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Along with the speeches and ceremonies to mark the opening of the Stanford Center at Peking University, Stanford scholars from the Freeman Spogli Institute for International Studies are showcasing their work examining China’s promises, challenges and increasingly important role in the world.

The Shorenstein Asia-Pacific Research Center held a two-day workshop examining China’s relationships with its neighbors. The event draws on work being done by Thomas Fingar, FSI’s Oksenberg-Rohlen Distinguished Fellow, who is leading a new initiative to explore the nuances and complexity of China’s foreign relations and domestic issues.

Scott Rozelle, co-director of the Rural Education Action Project, planned a conference on Thursday exploring the impacts of technology on China’s health and education systems. For years, Rozelle has studied how basic medicine and better meals improve children’s performance in school. He’s lately been evaluating the best and most affordable ways to use new technology in rural Chinese schools.

On March 26 and 27, the Asia Health Policy Program will focus on the challenges China’s growing tobacco-control movement faces against a multibillion-dollar government-run industry. Anthropologist Matthew Kohrman, a specialist on tobacco in China, will lead the workshop examining the connections woven over the past 60 years between marketing and cigarette gifting, production and consumer demand, government policy and economic profit, and the other forces behind China’s smoking culture.

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As China's economy grows so does the prevalence of social inequality. In a YaleGlobal Online article, a team of Shorenstein APARC China experts says the country must invest more now in education and public health programs for its rural children or it will face major growth challenges in the near future.

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Karen Eggleston
Jean C. Oi
Scott Rozelle
Ang Sun
Xueguang Zhou
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More than two decades have passed since the first case of HIV infection was detected in Cambodia in 1991. Cambodia is among the countries with the highest HIV prevalence in Asia and has been experiencing the most serious HIV/AIDS epidemic in the region. The epidemic is spread primarily through heterosexual transmission and revolves largely around the sex trade.

Since the beginning of the epidemic, the Royal Government of Cambodia has made a strong political commitment to the need for prevention of HIV transmission and care for people living with HIV/AIDS. It has received some technical and financial support from national and international agencies. Several prevention and intervention programs have been successfully implemented, and the WHO/UNAIDS recognized that the Cambodia’s HIV/AIDS epidemic appeared to have stabilized in 2002.

The estimated HIV prevalence in the general adult population declined to 0.5% in 2009, down from 1.2% in 2001. Among women visiting antenatal care clinics, the prevalence also declined from 2.1% in 1999 to 1.1% in 2006. There was also a gradual increase in the percentage of HIV-infected pregnant women who received antiretroviral therapy to reduce the risk of mother-to-child transmission, from 1.2% in 2003 to 11.2% in 2007, and finally to 32.3% in 2009.

Despite the decline of HIV prevalence in the general population, the prevalence remains high among high-risk groups such as commercial sex workers, men who have sex with men, and injection drug users. Furthermore, the so-called prevention-successful-country is also seeing the growing need for HIV/AIDS treatment and care.

This seminar will highlight the past and current features of Cambodia’s HIV/AIDS epidemic, lessons learned from prevention and care policies, and future challenges that Cambodia may face in the battles against HIV/AIDS.  

Dr. Siyan Yi joins the Walter H. Shorenstein Asia-Pacific Research Center during the 2011–12 academic year from the National Center of Global Health and Medicine and the University of Tokyo, Japan, where he jointly served as a research fellow and lecturer. He has also served as an adjunct faculty member at Cambodia’s School of Public Health, the National Institute of Public Health, and the School of International Studies at the Royal University of Phnom Penh.

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Siyan Yi 2011-12 Developing Asia Health Policy Fellow Speaker Stanford University
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The life sciences have many examples of where research results and technologies can be used for good, but also for bad purposes. Because such scenarios are so common, it is critical to identify that research which is particularly bad and would be classified as dual use research of concern (DURC). Attributes that might result in a DURC designation include how immediate a threat it represents, the magnitude of the threat, the availability of safeguards to defend against its nefarious use and its relative risk to benefits ratio. Several policy forums have studied this problem and the National Science Advisory Board for Biosecurity (NSABB) is currently the official U.S. government advisory group for DURC policy. Recently, NSABB was asked to review two manuscripts that reported adaptation of the high-path avian influenza virus H5N1 to transmission in a mammalian model. This virus rarely infects humans but when it does, it has catastrophic consequences with ~60% mortality. The board weighed the risks and the benefits of the work and recommended that the papers not be published as written, but only in a highly redacted form that would prevent the rapid and direct replication of the work. NSABB also argued for a communication pause so that the consequences of these papers and this research focus be evaluated by a broad cross section of science, public health and society. The US government accepted these recommendations and the two journals (Science and Nature) have thus far not published the papers. Multiple additional forums are planned to discuss the issues and recommendations. The future for policy development in the area of pathogen research and DURC will be shaped by these recommendations and subsequent activities.

About the speakers:

Dr. Paul Keim holds the E. Raymond and Ruth Cowden Endowed Chair in Microbiology at Northern Arizona University (NAU), where he is also a Regents Professor of Biology. In addition, he directs the Pathogen Genomics Division at The Translational Genomics Research Institute (TGen). Both institutions are based in Flagstaff, Arizona. His biological interests span many types of organisms and microbes, but revolve around genetic diversity and its organization in populations and species. This necessarily has involved systematic and phylogenetic analyses to understand how observable genetic diversity is based upon past evolutionary processes. Biodefense programs have capitalized upon his approach of using genomic analysis to understand bacterial pathogen populations for microbial forensics and molecular epidemiological analyses. His laboratory was heavily involved in analysis of evidentiary material from the 2001 anthrax-letter attacks. He has published extensively on the evolution and population genetics of Bacillus anthracis, Yersinia pestis, Francisella tularensis, Burkholderia pseudomallei, Burkholderia mallei, Brucella spp., and Coxiella burnetii. Recently, these same principles have been applied to other public health-related and clinically important pathogens such as S. aureus and E. coli. In all, he has published over 230 scientific or policy papers. Dr. Keim received his B.S. in Biology and Chemistry from Northern Arizona University in 1977 and his Ph.D. in Botany in 1981 from the University of Kansas. Dr. Keim has previously served on the editorial boards of Crop Science and Molecular Breeding; he currently serves on the editorial boards of Infection Genetics and Evolution, Investigative Genetics, and Biotechniques.

Dr. David Relman is a professor of medicine – infectious diseases, and of microbiology and immunology at Stanford. He joined CISAC as an affiliated faculty member in November 2011. He is also chief, Infectious Diseases Section, at the VA Palo Alto Health Care System. Among his other activities, Dr. Relman currently serves as Vice-President of the Infectious Diseases Society of America, Chair of the U.S. National Academies of Science Institute of Medicine's Forum on Microbial Threats, and member of the National Science Advisory Board for Biosecurity. He received a S.B. in biology from the Massachusetts Institute of Technology (1977) and an M.D. from Harvard Medical School Medicine (1982).

CISAC Conference Room

Paul Keim Acting Chair, National Science Advisory Board for Biosecurity, The Cowden Endowed Chair of Microbiology, Northern Arizona University and Director, Pathogen Genomics Division, Translational Genomics Research Institute Speaker

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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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David Relman Professor of Medicine-infectious diseases, Stanford Medical School and CISAC Affiliated Faculty Member Commentator
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Newly printed “no smoking” signs went up across China when the government rolled out a nationwide public indoor smoking ban in May 2011. A sticky gray layer of smoke residue now coats many signs, representing the challenges China’s growing tobacco-control movement faces against a multibillion-dollar government-run industry and deeply embedded social practices.

How has the cigarette become so integrated into the fabric of everyday life across the People’s Republic of China (PRC)?

To get to the heart of this question, historians, health policy specialists, sociologists, anthropologists, business scholars, and other experts met Mar. 26 and 27 in Beijing for a conference organized by Stanford’s Asia Health Policy Program. They examined connections intricately woven over the past 60 years between marketing and cigarette gifting, production and consumer demand, government policy and economic profit, and many other dimensions of China’s cigarette culture.

Anthropologist Matthew Kohrman, a specialist on tobacco in China, led the conference, which was held at the new Stanford Center at Peking University. In an interview, he spoke about the history of China’s cigarette industry, cigarettes and society, and the tobacco-control movement.

The early years

Tobacco first entered China through missionary contact in the 1600s, says Kohrman, but it was not until the early 20th century when cigarettes began gaining popularity. The first cigarette advertising was a “confused tapestry” of messages as marketers figured out what spoke to the public. “There were just as many images of neo-Confucian filial piety as there were of cosmopolitan ‘modern women,’” says Kohrman.

Through improved marketing and aggressive factory building, British American Tobacco and Nanyang Brothers, China’s two largest pre-war firms, helped increase the demand for cigarettes. The Sino-Japanese War (1937–1945) disrupted the cigarette supply, but their popularity had taken hold. Some cigarette firms shifted during the war to the relative safety of southwest China, where tobacco production has remained concentrated ever since.

Post-1949

After the founding of the PRC in 1949, the tobacco industry was nationalized and strong relationships between the central government and cigarette manufacturers in the provinces were formed. Cigarettes also began to be viewed as a part of everyday life. “Ration coupons for cigarettes were issued alongside grain, sugar, and bicycle coupons,” says Kohman. “The Maoist regime legitimized cigarettes as the right of every citizen."

During the Deng Xiaoping era (1978–1997), China’s cigarette industry really took off as manufacturers competed with one another for foreign currency to purchase cutting-edge European equipment and newer varieties of tobacco seed stock. Increased production and the return of full-scale advertising fueled greater consumer demand, and manufacturers began producing more and more varieties of cigarette. Vendors displayed glass cases filled with a colorful patchwork of cigarette packs bearing names like Panda, Double Happiness, and Red Pagoda.

The tobacco industry remained under government control as other industries privatized in the 1980s and 1990s. Party-state management of the cigarette became even more centralized in the early 1980s with the creation of the China Tobacco Monopoly Administration and its parallel external counterpart, the China Tobacco Corporation.

Since 1949, provincial protectionism has marked the cigarette market. It is now possible to purchase Beijing cigarettes in Kunming, Chengdu brands in Shanghai, and so on, but to distribute cigarettes in another province, a manufacturer must cut a deal with provincial government officials. Provincial administrations are loath to cut such deals because central government policy dictates that the portion of cigarette sales tax which does not go to the central government always is channeled to the finance bureau of the province of original production. China’s 2001 entry into the World Trade Organization opened the market ever so slightly to international brands like Marlboro and Kent, but domestic brands continue to dominate because of fierce protectionism.

...If it chooses to do so, China is in a position to lead and change the landscape in a very profound way.
-Matthew Kohrman, Professor of Anthropology, Stanford

A new era

In 2003, the World Health Organization established the first global health treaty, the Framework Convention on Tobacco Control (FCTC). Although the United States still has not yet ratified the FCTC, China signed the treaty in 2003 and ratified it in 2005. Kohrman says China’s tobacco industry giants fear competition from international cigarette brands more than they worry about tobacco-control measures related to the FCTC.

Nonetheless, the FCTC ushered in a new era of public health research about tobacco and has helped increase public awareness about the dangers of smoking. New restrictions have been imposed on print and television advertising for cigarettes, and international organizations, such as the Bloomberg Family Foundation, have begun funding anti-tobacco work in China.

A big challenge to tobacco-control campaigns, says Kohrman, is the sheer amount of money that tobacco companies have available for marketing. “In 2010, China’s tobacco industry posted profits in excess of U.S. $90 billion—that’s huge. Tobacco control research and advocacy now annually receive a few million dollars, and much of that is coming through outside funders, which have very specific projects in mind.”

China’s tobacco advertisers have adapted to the new restrictions that prevent them from openly promoting cigarettes in the media. They have instead moved to point-of-sale and soft-marketing tactics, including misinformation campaigns about the “dangers” of quitting smoking. “The actual expenditure on marketing probably hasn’t dropped very much,” says Kohrman.

Cigarettes and society

Strong marketing and the legitimization of cigarettes as a part of everyday life have led to the deep integration of cigarettes into Chinese society. While only 3 to 4 percent of women in China smoke, cigarettes are an important part of male identity and social mobility. The wide range of cigarette brands has led to the growth of high-end varieties favored by businessmen and politicians, with some brands costing as much as $50 a pack. The custom of cigarette gifting has existed in China for decades, and it is difficult for a young man to turn down a package of cigarettes from a senior colleague or supervisor.

There is also the fact that nicotine is highly addictive, and quitting is difficult in an environment where smoking cigarettes is socially sanctioned. Kohrman says, “When you take an incredibly addictive substance like nicotine and throw it into the mix of all of these norms and customs, it creates a pretty toxic brew.”

The future?

Tobacco control presents a formidable challenge in China, one that requires understanding the historical context and complex dimensions of the cigarette industry. “Cigarettes have been insinuated into so many aspects of daily life across China, and the market for this product has now become so closely enmeshed with matters of government finance and operations,” says Kohrman.

What happens in China could have implications for the entire world. “There’s a tobacco-induced human annihilation unfolding right now in almost every country and questions about how society and Big Tobacco are enmeshed, and how cigarette culture and government finance have become mutually supportive are pivotal,” says Kohrman. “Every country except Bhutan has legalized cigarette sales and is subject to many of the same general issues as China—only in China they’re on a much larger scale. But if it chooses to do so, China is in a position to lead and change the landscape in a very profound way.”   

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