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The 12th annual Draper Hills Summer Fellows Program gathered 25 democracy leaders from around the developing world for a three-week training program on democracy, good governance, and the rule of law reform. Selected from a large pool of applicants, the fellows have diverse backgrounds across sectors and geographies, working in civil society, public service, social enterprise, media and technology.

Fellows were instructed by an all-star roster of Stanford scholars and policy experts, including former U.S. Secretary of State Condoleezza Rice; FSI Director and former U.S. Ambassador to Russia Michael McFaul; CDDRL Mosbacher Director Francis Fukuyama and Larry Diamond, senior fellow at the Freeman Spogli Institute for International Studies. Fellows also met industry leaders such as Eric Schmidt of Google, democracy leaders such as Carl Gershman of the National Endowment for Democracy and others. During the program, they shared their personal stories about the struggle in their home countries, but also stories of their fight for justice, equality, and democracy, stories of optimism and endurance.

You can find some of their talks below and for more videos visit our YouTube channel


 

Kasha Nabagesera (Uganda)

The founding member of Uganda's LGBTI Movement

"I am the only founding member of Uganda's LGBTI movement who is still based in the country"

 

 

Kasha Nabagesera is the executive director of Kuchu Times Media Group, the first LGBTI media platform in Africa. She is known as the “founding mother” of the LGBTI movement in Uganda - where homosexuality is illegal - advocating for equal rights and the eradication of all forms of discrimination based on sexual orientation. Listen to her story about big losses and big wins, everyday dangers and hope.


Rafael Marques de Morais (Angola)

Investigative reporter, MakaAngola

"Why the government is after you when you are sleeping so much?"

Rafael Marques de Morais is an award-winning journalist and human rights activist in Angola, working to investigate corruption and abuse of power by the country’s ruling family. He founded Makaangola, a watchdog website dedicated to exposing corruption and human rights abuses in Angola. Find out why his son thinks that his father is harmless for the government.


Belabbes Benkredda (Algeria)

The founder of Munathara Initiative

"Debate is the central part of the democratic equation."

Belabbes Benkredda is an award-winning social innovator and the founder of the Munathara Initiative, the Arab world’s largest online and television debate forum highlighting voices of youth, women, and marginalized communities. Operating in 11 Arab countries, Munathara’s monthly prime-time TV debates are the only civil society-run, independent political talk program on Arabic television. Munathara Initiative organized over 650 workshops with more than 10 thousand participants from 12 countries. They have around 90 thousand of registered users. More importantly, Munathara Initiative provided safe public space for young women to voice their opinions and mark their presence in public, traditionally dominated by the middle-aged men.  

 

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This event has reached capacity. Please join us to watch the live-stream at this link. 

The symposium will focus on the key questions that impact health through the year 2020. How could the 2016 election affect health care in the U.S.? How will payment reform affect health systems, physicians and patients? Are the insurance exchanges viable? What challenges pose the biggest threat to global health? Experts from Stanford and beyond address these topics and more as they discuss the future of health policy.

 

Innovation, Discovery and Education from CHP/PCOR on Vimeo.

Agenda:  
 

  1:00PM - 1:15PMRegistration  
 
 
  1:15PM - 1:45PMOpening RemarksLloyd Minor  
Douglas Owens  
Laurence Baker  
 
  1:45PM - 2:15PMInternational HealthGrant Miller  
Eran Bendavid  
Marcella Alsan  
 
  2:15PM - 3:15PMKeynote: ACA at Five Years:  
Progress and Policy Opportunities
Bob Kocher  
Q&A with Laurence Baker  
 
  3:15PM - 3:30PMBreak  
 
 
  3:30PM - 4:15PMPayment ReformDavid Entwistle  
Chris Dawes  
Jay Bhattacharya  
Laurence Baker  
 
  4:15PM - 4:45PMPatient Safety and ValueDouglas Owens  
Kathryn McDonald  
David Chan  
 
  4:45PM - 5:30PMAmerican Health Policy:  
The Election and Beyond
Kate Bundorf  
David Studdert  
Michelle Mello  
Maria Polyakova  
 
  5:30PM - 5:40PMClosing RemarksLaurence Baker  
Douglas Owens  
 
  5:40PM - 7:00PMReception  
 
 

Featured Speakers:

 

Lloyd Minor, Dean, Stanford University School of Medicine

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Minor, MD, is a scientist, surgeon and academic leader. He is the Carl and Elizabeth Naumann Dean of the Stanford University School of Medicine, a position he has held since December 2012. Minor leads more than 1,500 faculty and 1,000 students at the oldest medical school in the West and has made precision health — the prevention of disease before it strikes — a hallmark of research, education and patient care at Stanford Medicine.

 

 

Bob Kocher, a partner at the Silicon Valley venture capital firm, Venrock

Bob Kocher

Kocher, MD, is a partner at Venrock who focuses on healthcare IT and services investments and is a consulting professor at Stanford University School of Medicine. He served in the Obama Administration as special assistant to the president for health care and economic policy and was one of the key shapers of the Affordable Care Act.

 

 

 

David Entwistle, President and CEO, Stanford Health Care 

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Entwistle joined Stanford Health Care as its President and CEO in July, bringing extensive executive experience at leading academic medical centers. Most recently he served as CEO of the University of Utah Hospitals & Clinics, the only academic medical center in the Intermountain West region. While serving at UUHC, Entwistle received the Modern Healthcare “Up and Comers Award,” for significant contributions in health-care administration, management or policy.

 

Chris Dawes, President and CEO, Lucile Packard Children’s Hospital 

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Christopher G. Dawes became President and Chief Executive Officer of Lucile Packard Children’s Hospital Stanford in 1997 after five years of service as Chief Operating Officer. Under his guidance, the hospital, research center and regional medical network has been ranked as one of the best in the nation, as an industry leader in patient safety and innovation in providing a full complement of services for children and expectant mothers.

 

Panelists:  
 

Marcella Alsan, Assistant Professor of Medicine, Stanford University

Marcella Alsan’s research focuses on the relationship between health and socioeconomic disparities with a focus on infectious disease. Another vein of research focuses on the microfoundations of antibiotic overuse and resistance. She received a BA degree in cognitive neuroscience from Harvard University, a master’s degree in international public health from Harvard School of Public Health, a medical degree from Loyola University, and a PhD in economics from Harvard University. She is board-certified in both internal medicine and infectious disease. She trained at Brigham and Women’s Hospital,  completing the Hiatt Global Health Equity Residency Fellowship in internal medicine. She combined her PhD with an Infectious Disease Fellowship at Massachusetts General Hospital. She currently is an infectious disease specialist at the Department of Veterans Affairs, Palo Alto.

Laurence Baker, Chair of Health Research and Policy, Stanford University

Laurence Baker is an economist interested in the organization and economic performance of the U.S. health-care system, and his research has investigated a range of topics including financial incentives in health care, competition in health-care markets, health insurance and managed care and health-care technology adoption. Baker is a past recipient of the ASHE medal from ASHEcon and the Alice Hersch Award from AcademyHealth. He received his BA from Calvin College, and his MA and PhD in economics from Princeton University.

Eran Bendavid, Assistant Professor of Medicine, Stanford University

Eran Bendavid is an infectious diseases physician.  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.  Dr. Bendavid is also a disease modeler, and uses that skill to explore issues of resource allocation in low and middle-income countries with cost-effectiveness analyses. His recent research projects include an impact evaluation of the US assistance program for HIV in Africa, and an exploration of the association between drug prices, aid and health outcomes in countries heavily affected by HIV.

Jay Bhattacharya, Professor of Medicine, Stanford University

Jay Bhattacharya’s research focuses on the constraints that vulnerable populations face in making decisions that affect their health status, as well as the effects of government policies and programs designed to benefit vulnerable populations. He has published empirical economics and health services research on the elderly, adolescents, HIV/AIDS and managed care. Most recently, he has researched the regulation of the viatical-settlements market (a secondary life-insurance market that often targets HIV patients) and summer/winter differences in nutritional outcomes for low-income American families. He is also working on a project examining the labor-market conditions that help determine why some U.S. employers do not provide health insurance.

M. Kate Bundorf, Associate Professor of Medicine, Stanford University

M. Kate Bundorf is a Faculty Research Fellow at the National Bureau of Economic Research.  She received her M.B.A. and M.P.H. degrees from The University of California at Berkeley and her Ph.D. from The Wharton School. She was a Fulbright Lecturer and Visiting Professor at Fudan School of Public Health in Shanghai, China in 2009 and 2010.  Her research, which focuses on health insurance markets, has been published in leading economics and health policy journals and has received funding from the U.S. National Institutes of Health, the Agency for Health Care Research and Quality and the Robert Wood Johnson Foundation.  She received the 13th Annual Health Care Research Award from The National Institute for Health Care Management in 2007.

David Chan, Assistant Professor of Medicine, Stanford University

David Chan is a physician and economist whose research focuses on productivity in US health care. His research draws on insights from labor and organizational economics. He is particularly interested in studying what drives physician behavior, how this explains differences in productivity in health care delivery, and what the implications are for the design of health care. He is the recipient of the 2014 NIH Director’s High-Risk, High-Reward Early Independence Award to study the optimal balance of information in health information technology for patient care. David Chan is also an investigator at the Department of Veterans Affairs and a Faculty Research Fellow at the National Bureau of Economic Research.

Kathryn M. McDonald, Executive Director of the Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University

Kathryn McDonald, MM, is the Executive Director of the Center for Health Policy (CHP) and Center for Primary Care and Outcomes Research (PCOR) and a senior scholar at the Centers. She is also Associate Director of the Stanford-UCSF Evidence-based Practice Center (under RAND). Her work focuses on measures and interventions to achieve evidence-based patient-centered healthcare quality and patient safety. Mrs. McDonald has served as a project director and principal investigator on a number of research projects at the Stanford School of Medicine, including the development and ongoing enhancement of the Quality and Patient Safety Indicators for the Agency for Healthcare Research and Quality. She has authored numerous peer reviewed articles and government reports, including several with wide enough followership to merit recent updates: Care Coordination Measures Atlas, Closing the Quality Gap, and Patient Safety Practices.

Michelle Mello, Professor of Law and of Health Research and Policy, Stanford University

Michelle Mello is Professor of Law at Stanford Law School and Professor of Health Research and Policy at Stanford University School of Medicine.  She conducts empirical research into issues at the intersection of law, ethics, and health policy.  She is the author of more than 150 articles and book chapters on the medical malpractice system, medical errors and patient safety, public health law, research ethics, the obesity epidemic, pharmaceuticals, and other topics. From 2000 to 2014, Dr. Mello was a professor at the Harvard School of Public Health, where she directed the School’s Program in Law and Public Health. In 2013-14 she completed a Lab Fellowship at Harvard University’s Edmond J. Safra Center for Ethics. Dr. Mello teaches courses in torts and public health law. She holds a J.D. from the Yale Law School, a Ph.D. in Health Policy and Administration from the University of North Carolina at Chapel Hill, an M.Phil. from Oxford University, where she was a Marshall Scholar, and a B.A. from Stanford University.  In 2013, she was elected to the National Academy of Medicine (formerly known as the Institute of Medicine).

Grant Miller, Associate Professor of Medicine, Stanford University

Grant Miller is Director of the Stanford Center for International Development, an Associate Professor of Medicine at the Stanford University School of Medicine, a Core Faculty Member at the Center for Health Policy/Primary Care and Outcomes Research, a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) and the Stanford Institute for Economic Policy Research (SIEPR), and a Research Associate at the National Bureau of Economic Research (NBER). His primary interests are health economics, development economics, and economic demography. As a health and development economist based at the Stanford Medical School, Dr. Miller’s overarching focus is research and teaching aimed at developing more effective health improvement strategies for developing countries. His agenda addresses three major interrelated themes. (1) First, what are the major causes of population health improvement around the world and over time? (2) Second, what are the behavioral underpinnings of the major determinants of population health improvement? (3) Third, how can programs and policies use these behavioral insights to improve population health more effectively?

Douglas K. Owens, Director of the Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University

Douglas K. Owens, MD, MS, is the Henry J. Kaiser, Jr., Professor at Stanford University, where he is a professor of medicine. He is director of the Center for Health Policy in the Freeman Spogli Institute for International Studies and director of the Center for Primary Care and Outcomes Research (PCOR) in the Department of Medicine. He is a general internist and associate director of the Center for Innovation to Implementation at the Veterans Affairs Palo Alto Health Care System. A past member of the U.S. Preventive Services Task Force, he has helped lead the development of national U.S. guidelines on screening for HIV, hepatitis C, hepatitis B, lung cancer, colorectal cancer, breast cancer, and use of aspirin and statins to prevent cardiovascular disease.

Maria Polyakova, Assistant Professor of Health Research and Policy, Stanford University

Maria Polyakova, PhD, is an Assistant Professor of Health Research and Policy at the Stanford University School of Medicine. Her research investigates questions surrounding the role of government in the design and financing of health insurance systems. She is especially interested in the relationships between public policies and individuals’ decision-making in health care and health insurance, as well as in the risk protection and re-distributive aspects of health insurance systems. She received a BA degree in Economics and Mathematics from Yale University and a PhD in Economics from MIT.

David M. Studdert, Professor of Medicine and of Law, Stanford University

David M. Studdert is a leading expert in the fields of health law and empirical legal research. His scholarship explores how the legal system influences the health and well-being of populations. A prolific scholar, he has authored more than 150 articles and book chapters, and his work appears frequently in leading international medical, law and health policy publications. Professor Studdert has received the Alice S. Hersh New Investigator Award from AcademyHealth, the leading organization for health services and health policy research in the United States. He was awarded a Federation Fellowship (2006) and a Laureate Fellowship (2011) by the Australian Research Council. He holds a law degree from University of Melbourne and a doctoral degree in health policy and public health from the Harvard School of Public Health.

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The availability of accurate and reliable information on the location of impoverished zones is surprisingly lacking for much of the world. Applying machine learning to satellite images could identify impoverished regions in Africa.

One of the biggest challenges in providing relief to people living in poverty is locating them. The availability of accurate and reliable information on the location of impoverished zones is surprisingly lacking for much of the world, particularly on the African continent. Aid groups and other international organizations often fill in the gaps with door-to-door surveys, but these can be expensive and time-consuming to conduct.

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In the current issue of Science, Stanford researchers propose an accurate way to identify poverty in areas previously void of valuable survey information. The researchers used machine learning – the science of designing computer algorithms that learn from data – to extract information about poverty from high-resolution satellite imagery. In this case, the researchers built on earlier machine learning methods to find impoverished areas across five African countries.

“We have a limited number of surveys conducted in scattered villages across the African continent, but otherwise we have very little local-level information on poverty,” said study coauthor Marshall Burke, an assistant professor of Earth system science at Stanford and a fellow at the Center on Food Security and the Environment. “At the same time, we collect all sorts of other data in these areas – like satellite imagery – constantly.”

The researchers sought to understand whether high-resolution satellite imagery – an unconventional but readily available data source – could inform estimates of where impoverished people live. The difficulty was that while standard machine learning approaches work best when they can access vast amounts of data, in this case there was little data on poverty to start with.

“There are few places in the world where we can tell the computer with certainty whether the people living there are rich or poor,” said study lead author Neal Jean, a doctoral student in computer science at Stanford’s School of Engineering. “This makes it hard to extract useful information from the huge amount of daytime satellite imagery that’s available.”

Because areas that are brighter at night are usually more developed, the solution involved combining high-resolution daytime imagery with images of the Earth at night. The researchers used the “nightlight” data to identify features in the higher-resolution daytime imagery that are correlated with economic development.

“Without being told what to look for, our machine learning algorithm learned to pick out of the imagery many things that are easily recognizable to humans – things like roads, urban areas and farmland,” said Jean. The researchers then used these features from the daytime imagery to predict village-level wealth, as measured in the available survey data.

They found that this method did a surprisingly good job predicting the distribution of poverty, outperforming existing approaches. These improved poverty maps could help aid organizations and policymakers distribute funds more efficiently and enact and evaluate policies more effectively.

“Our paper demonstrates the power of machine learning in this context,” said study co-author Stefano Ermon, assistant professor of computer science and a fellow by courtesy at the Stanford Woods Institute of the Environment. “And since it’s cheap and scalable – requiring only satellite images – it could be used to map poverty around the world in a very low-cost way.” 

Co-authors of the study, titled “Combining satellite imagery and machine learning to predict poverty,” include Michael Xie from Stanford's Department of Computer Science and David Lobell and W. Matthew Davis from Stanford's School of Earth, Energy and Environmental Sciences and the Center on Food Security and the Environment. For more information, visit the research group's website at: http://sustain.stanford.edu/

 

CONTACTS: 

Neal Jean, School of Engineering: nealjean@stanford.edu, (937) 286-6857

Marshall Burke, School of Earth, Energy and Environmental Sciences: mburke@stanford.edu, (650) 721-2203

Michelle Horton, Center on Food Security and the Environment: mjhorton@stanford.edu, (650) 498-4129

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A key concern weighing heavily on those attending this week’s global conference on AIDS is the diminishing donor support to fight the communicable disease, which has claimed an estimated 35 million lives since the beginning of the epidemic.

“That’s on everybody’s mind now — how to continue facing the epidemic with the shrinking resources,” said Eran Bendavid, a core faculty member at Stanford Health Policy and assistant professor at Stanford Medicine attending the conference in Durban, South Africa.

Donor government funding to support HIV efforts in low- and middle-income countries fell for the first time in 2015, decreasing from $8.6 billion in 2014 to $7.5 billion last year, according to a new report by the Kaiser Family Foundation and UNAIDS.

Funding for HIV treatment declined for 13 of 14 major donor governments, with the U.S. continuing to provide more donor funding for HIV than any other country or organization.

“There’s a sense of panic about how we’re going to fill the shortfall in funding,” Bendavid said. “All the major donors are here, PEPFAR, the Global Fund, and everyone is saying `We need more to continue the fight.’

“But, in my mind,” Bendavid continued, “the conversation that is mostly missing is the one between the organizations on the front lines and the national ministries of health and finance. See what they can do to get domestic resources to fill the gap.”

PEPFAR — the President’s Emergency Plan for AIDS Release — is the U.S. government initiative to help those suffering from HIV/AIDS.

Bendavid, an infectious disease physician, joins 18,000 global leaders, researchers, activists and front-line health workers attending the conference July 18-22.

The U.N. General Assembly last month pledged to end the AIDS epidemic by 2030. But more than half of the nearly 37 million people around the world infected with HIV still have no access to the antiretroviral therapy that is saving so many lives.

U.S. Secretary-General Ban Ki-moon said on the opening day of AIDS2016 that when the conference was last held in Durban 16 years ago, less than 1 percent of all people living with HIV in developing countries had access to treatment.

“Today, the world has proven that when we come together, we can transform lives,” Ban said, noting that of the 36.7 million people living with HIV today, about 46 percent of infected adults have access to antiretroviral treatment.

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“In addition, medicines are more effective and less toxic, technology allows diagnosis in 20 minutes or less, generic medicines reduced the cost of treatment to just a dollar a day and great international finance has been made available,” Ban said.

Still, the secretary-general warned, “the gains are inadequate — and fragile,” when you consider that more than half of all people living with HIV still lack access to treatment.

Bendavid, who spoke by telephone from Durban, gave a symposium at the conference on Tuesday that summarizes his research and provides his conclusions on the most effective approaches to use donor resources.

He said the while the global burden of noncommunicable diseases, such as heart disease and cancer, is greater than HIV, malaria, or TB, the interventions available to combat infectious diseases are more cost-effective. 

“Basically, the resource constraints are forcing us to think carefully about what to invest in, and we want to invest in what works,” Bendavid said, adding that donor funding typically goes straight to the disease rather than the local health system infrastructure.

“The scarce donor resources should not be directed towards interventions that are either inefficacious or costly,” he argued. “The opportunity cost of investing in costly or ineffective interventions is very high when you consider the millions who could benefit from inexpensive, simple interventions such as bed nets and drugs for TB.”

He conceded that he typically gets push back on this line of reasoning.

“But when you’re talking about what you can do with very limited resources, investing in noncommunicable diseases, in my mind, jeopardizes the premise of donor funding: There are many people who would be happy to shut down PEPFAR and the Global Fund if they were shown to be ineffective.”

He published a paper earlier this year that found the U.S. government has invested $1.4 billion in HIV prevention programs that promote sexual abstinence and marital fidelity. But there is no evidence that the programs have been effective at changing sexual behavior and reducing HIV Risk.

Bendavid said his presentation at the symposium was received with a mix of understanding and concern.

“People mentioned that funding health systems could have averted Ebola, and that the fight against HIV needs to address health systems,” he said. “I agree, but also think governments should step up and help fill some of those gaps.”

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21st International AIDS Conference (AIDS 2016), Durban, South Africa
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The Asia Health Policy Program at Stanford’s Shorenstein Asia-Pacific Research Center, in collaboration with scholars from Stanford Health Policy's Center on Demography and Economics of Health and Aging, the Stanford Institute for Economic Policy Research, and the Next World Program, is soliciting papers for the third annual workshop on the economics of ageing titled Financing Longevity: The Economics of Pensions, Health Insurance, Long-term Care and Disability Insurance held at Stanford from April 24-25, 2017, and for a related special issue of the Journal of the Economics of Ageing.

The triumph of longevity can pose a challenge to the fiscal integrity of public and private pension systems and other social support programs disproportionately used by older adults. High-income countries offer lessons – frequently cautionary tales – for low- and middle-income countries about how to design social protection programs to be sustainable in the face of population ageing. Technological change and income inequality interact with population ageing to threaten the sustainability and perceived fairness of conventional financing for many social programs. Promoting longer working lives and savings for retirement are obvious policy priorities; but in many cases the fiscal challenges are even more acute for other social programs, such as insurance systems for medical care, long-term care, and disability. Reform of entitlement programs is also often politically difficult, further highlighting how important it is for developing countries putting in place comprehensive social security systems to take account of the macroeconomic implications of population ageing.

The objective of the workshop is to explore the economics of ageing from the perspective of sustainable financing for longer lives. The workshop will bring together researchers to present recent empirical and theoretical research on the economics of ageing with special (yet not exclusive) foci on the following topics:

  • Public and private roles in savings and retirement security
  • Living and working in an Age of Longevity: Lessons for Finance
  • Defined benefit, defined contribution, and innovations in design of pension programs
  • Intergenerational and equity implications of different financing mechanisms for pensions and social insurance
  • The impact of population aging on health insurance financing
  • Economic incentives of long-term care insurance and disability insurance systems
  • Precautionary savings and social protection system generosity
  • Elderly cognitive function and financial planning
  • Evaluation of policies aimed at increasing health and productivity of older adults
  • Population ageing and financing economic growth
  • Tax policies’ implications for capital deepening and investment in human capital
  • The relationship between population age structure and capital market returns
  • Evidence on policies designed to address disparities – gender, ethnic/racial, inter-regional, urban/rural – in old-age support
  • The political economy of reforming pension systems as well as health, long-term care and disability insurance programs

 

Submission for the workshop

Interested authors are invited to submit a 1-page abstract by Sept. 30, 2016, to Karen Eggleston at karene@stanford.edu. The authors of accepted abstracts will be notified by Oct. 15, 2016, and completed draft papers will be expected by April 1, 2017.

Economy-class travel and accommodation costs for one author of each accepted paper will be covered by the organizers.

Invited authors are expected to submit their paper to the Journal of the Economics of Ageing. A selection of these papers will (assuming successful completion of the review process) be published in a special issue.

 

Submission to the special issue

Authors (also those interested who are not attending the workshop) are invited to submit papers for the special issue in the Journal of the Economics of Ageing by Aug. 1, 2017. Submissions should be made online. Please select article type “SI Financing Longevity.”

 

About the Next World Program

The Next World Program is a joint initiative of Harvard University’s Program on the Global Demography of Aging, the WDA Forum, Stanford’s Asia Health Policy Program, and Fudan University’s Working Group on Comparative Ageing Societies. These institutions organize an annual workshop and a special issue in the Journal of the Economics of Ageing on an important economic theme related to ageing societies.

 

More information can be found in the PDF below.


 

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Studying the microorganisms that live in our gut is a relatively new field, one that has only really taken off in the last decade. In fact, it is estimated that half of the microbes that live in and around our GI track have yet to be discovered.

“This means there is a huge amount of this dark matter within us,” said Ami S. Bhatt, an assistant professor of medicine and genetics who runs the Bhatt Lab at the Stanford School of Medicine. The lab is devoted to exploiting disease vulnerabilities by cataloguing the human microbiome, the trillions of microbes living in and on our bodies.

“I think if we fast-forward to the impact of some these findings in 10 years, we’re going to learn that modifying the microbiota is a potent way to modulate health,” Bhatt said. “Humans are not only made up of human cells, but are a complex mixture of human cells and the microbes that live within us and among us — and these microorganisms are as critical to our well-being as we are to theirs.”

Bhatt, along with key collaborators at the University of Witwatersrand in Johannesburg, and the INDEPTH research consortium, now intends to take this research to Africa.

She is this year’s winner of the of the Rosenkranz Prize for Health Care Research in Developing Countries, awarded by Stanford Health Policy to promising young Stanford researchers who are investigating ways to improve health care in developing countries.

The $100,000 prize is targeted at Stanford’s emerging researchers who are dedicated to improving health care in poorer parts of the world, but may lack the financial resources.

Bhatt, MD, PhD, intends to take the prize money to execute the first multi-country microbiome research project focused on non-communicable disease risk in Africa. The project intends to explore the relationship between the gut microbiome composition and body mass index (BMI) in patients who are either severely malnourished or obese.

“As a rapidly developing continent with extremes of resource access, Africa is simultaneously faced with challenges relating to the extremes of metabolic status,” Bhatt wrote in her Rosenkranz project proposal. The Bay Area native, who is also the director of global oncology at Stanford, came to the School of Medicine in 2014 to focus on how changes in the microbiome are associated with cancer.

In this new project, Bhatt and members of her lab will team up with colleagues in Africa, first in South Africa, and then in Ghana, Burkina Faso, and Kenya. They will leverage the infrastructure already in place at the INDEPTH Network of researchers, using an existing cohort of 12,000 patients at within those four countries. The patients have already consented to be involved in DNA testing and have given blood and urine specimens.

Identifying alterations of the microbiome that are associated with severe malnutrition or obesity could pave the way for interventions that may mitigate the severity or prevalence of these disorders, Bhatt said.

“These organisms are critical to our health in that they are in a delicate balance with one another and their human hosts,” she said. “Alterations in the microbiome are associated with various diseases — but have mostly been studied in Western populations. Unfortunately, little is known about the generalizability of these findings to low- and middle-income countries – where most of the world’s population lives.”

Bhatt said that as Africa rapidly continues to develop, the continent is simultaneous faced with challenges relating to extreme weight gain and loss. While the wealthy are facing obesity and its associated disease such as stroke, heart failure and diabetes, many people are still faced with issues related to food insecurity, hunger and malnutrition.

The research, she hopes, could lead to aggressive behavioral, dietary and lifestyle modifications targeted at maintaining healthy BMI in at-risk individuals.

Video by Ankur Bhatt

Grant Miller, an associate professor of medicine and core faculty member at Stanford Health Policy who chaired the Rosenkranz Prize committee this year, believes Bhatt’s research could eventually break new ground.

“The entire Rosenkranz Prize selection committee was highly impressed with Ami and the innovation of her project,” Miller said. “Ami’s work on the human microbiome in the extremes of nutritional status in developing countries — including its potential link to obesity, an emerging challenge in low income countries — is potentially path-breaking.”

The award’s namesake, George Rosenkranz, first synthesized cortisone in 1951, and later progestin, the active ingredient in oral birth control pills. He went on to establish the Mexican National Institute for Genomic Medicine, and his family created the Rosenkranz Prize in 2009.

The award embodies Dr. Rosenkranz’s belief that young scientists hold the curiosity and drive necessary to find alternative solutions to longstanding health-care dilemmas.

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Ami S. Bhatt with Ricky Rosenkranz (Stanford '85, son of George Rosenkranz) celebrate her winning the 2016 Rosenkranz Prize for emerging research in the developing world. The prize will help Bhatt launch a microbiome research project in Africa.
Nicole Feldman
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This five day intensive program for a select group of mid- and high-level African government officials and business leaders is designed to address how government can encourage and enable the private sector to play a larger, more constructive role as a force for economic growth and development. A driving principle of this LAD-Strathmore program is that policy reform is not like engineering or other technical fields that have discrete skills and clear, optimal solutions. Instead, successful reformers must be politically aware and weigh a broad range of factors that influence policy outcomes. For example, they must have a solid grasp of country-specific economic, financial, political and cultural realities. Most importantly, they must have a sense of how to set priorities, sequence actions and build coalitions. This program is designed to provide participants with an analytical framework to build these leadership abilities and operate effectively under adverse conditions. 

Nairobi, Kenya

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Larry Diamond
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In the July/August edition of Foreign Affairs, Larry Diamond takes stock of the global democratic recession, and urges the next president to make democracy promotion a pillar of his or her foreign policy agenda. 


Click here to read the full article. 

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Turkey's Prime Minister Recep Tayyip Erdogan addresses members of parliament from his ruling AK Party (AKP) during a meeting at the Turkish parliament in Ankara on June 11, 2013.
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Stanford’s Center on Democracy, Development and the Rule of Law congratulates its undergraduate honors class for completing their original research and undergraduate theses. They graduated from Stanford University on June 12 with honors in their respective disciplines.

Graduates include Vehbi “Deger” Turan, who was awarded the Firestone Medal for his thesis entitled “Augmenting Citizen Participation in Governance through Natural Language Processing.” Turan’s project employed existing literature on democratic participation, case studies and an original algorithm in order to devise a means by which government agencies can evaluate public comments received via the Internet on political issues.

The Firestone Medal for Excellence in Undergraduate Research recognizes Stanford's top ten percent of honors theses in social science, science and engineering among the graduating senior class.

Turan decided to explore this topic shortly after joining the Fisher Family CDDRL Honors Program.

According to the program’s Director Stephen Stedman, “After listening to a research seminar at our Center, Deger believed that he could develop an aggregation tool to help policy makers understand such immense data.”

Francis Fukuyama, the Mosbacher Director of CDDRL also noted, “Deger is perhaps the best example to date of why interschool honors programs are valuable. He is a computer science major who came to us expressing an interest in using his background in artificial intelligence to help solve critical public policy problems.” Fukuyama together with Associate Professor of Political Science Justin Grimmer advised Turan on his honor’s thesis.

Turan will be starting a new position at Atomic Labs’ Zenreach start-up after graduation.

The CDDRL Award for Outstanding Thesis was given to Rehan Adamjee whose thesis explored the different factors at play in choosing between healthcare providers in a rural area of Pakistan.

Adamjee and Turan are just two members of a the 2016 cohort of 11 honors students, many of whom traveled to foreign countries to collect original data, conduct interviews and research their thesis topics. Their topics range from timely case studies on the use of social media as a tool of empowerment to a glimpse at the effects of regional politics on healthcare reform in Post-Soviet Russia.

The 2016 class joins 76 graduates from CDDRL’s honors program since its launch in 2007.

The Fisher Family CDDRL Honors Program trains Stanford students from diverse majors to write theses with global policy implications on a subject related to democracy, development and the rule of law. Students attend a class on research methods the spring quarter of their junior year. During their senior year, in tandem with the CDDRL research community and their faculty advisor, students conduct both local and international research in order to write their theses. Students travel to Washington, DC for the annual honors college to meet policymakers and members of the development community to enrich their thesis topics.

A list of our graduating students along with links to all their theses can be found below.

 

NAMEMAJORTHESIS

Rehan Adamjee

Economics; Public Policy

Advisor: Jayanta Bhattacharya

Anna Blue

International Relations

Advisor: Alberto Diaz Cayeros

Sarah Johnson

Economics

Advisor: Lisa Blaydes

Shang-Ch’uan Li

Materials, Science and Engineering

Advice and Consent: Increase in Malaysian Judges Appointed from the Practicing Bar after the Passage of the Judicial Appointments Commission Act 2009

Advisors: Erik Jensen, Justin Grimmer

Hannah Meropol

Political Science

Advisor: Lisa Blaydes

Jelani Munroe

Economics; Public Policy

Advisor: Pete Klenow

Hannah Potter

International Relations

Advisor: Stephen Stedman

Tebello Qhotsokoane

Public Policy

Advisor: Marcel Fafchamps

Hadley Reid

Human Biology

Advisor: Grant Miller

Paul Shields

International Relations; Slavic Language & Literature

Advisor: Kathryn Stoner

Deger Turan

Computer Science

Advisors: Francis Fukuyama, Justin Grimmer

 

Meet our Class of 2017 

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The graduating class of 2015-2016 CDDRL senior honors students take a group photo with CDDRL Mosbacher Director Francis Fukuyama and the Fisher Family CDDRL Honors Program Director Stephen Stedman. From left to right: Didi Kuo (CDDRL honors program mentor); Jelani Munroe; Stephen Stedman; Tebello Qhotsokoane; Paul Shields; Shang-Ch’uan Li; Hannah Potter; Hadley Reid; Vehbi Deger Turan; Sarah Johnson; Hannah Meropol; Rehan Adamjee; Anna Blue
Alice Kada
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Could out of pocket drug costs be responsible for pandemics? In this Public Health Perspectives article, Marcella Alsan discusses how copayments for antibiotics can cause people in poor areas to turn to unregulated markets.

On May 26, 2016, researchers at the Walter Reed National Military Medical Center reported the first case of what they called a “truly pan-drug resistant bacteria.” By now, the story has been well-covered in the media: a month earlier, a 49 year old woman walked into a clinic in Pennsylvania with what seemed to be a urinary tract infection. But tests revealed something far scarier—both for her and public health officials. The strain of E. Coli that infiltrated her body has a gene that makes it bulletproof to colistin, the so-called last resort antibiotic.

Most have pinned the blame for the impending doom of a “post-antibiotic world” on the overuse of antibiotics and a lack of new ones in the development pipeline. But there’s another superbug incubator that hasn’t gotten the attention it deserves: poverty.

Last month at the IMF meeting in Washington, D.C., UK Chancellor George Osborne warned about the potentially devastating human and economic cost of antimicrobial resistance. He called for “the world’s governments and industry leaders to work together in radical new ways.” But Gerry Bloom, a physician and economist at the Institute for Development Studies, argued that any measures to stop overuse and concoct new drugs must be “complemented by investments in measures to ensure universal access to effective antibiotic treatment of common infections.”

“In many countries, poor people obtain these drugs in unregulated markets,” Bloom said. “They often take a partial course and the products may be sub-standard. This increases the risk of resistance.”

For at least fifteen years, we’ve known about these socioeconomic origins of antimicrobial resistance. Other studies have revealed problems with mislabeled or expired or counterfeit drugs. But the clearest link between poverty and the rise of antimicrobial resistance is that poor people may not see a qualified health care provider or complete a course of quality antibiotics. Instead, they might turn to unregulated markets for substandard drugs.

But why do people resort to unregulated markets or take drugs that aren’t that great if they are available? Marcella Alsan, an assistant professor of medicine at the Stanford School of Medicine who studies the relationship between socioeconomic disparities and infectious diseases, led a study that answered this question. In last October’s Lancet Infectious Diseases, Alsan and her colleagues showed that it might have a lot to do with requiring copayments in the public sector. To show this, they analyzed the WHO’s 2014 Antibacterial Resistance Global Surveillance report with an eye toward the usual suspects, such as antibiotic consumption and antibiotic-flooded livestock.

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