“I am the first child of my parents. I have a small brother at home. If the first child were a son, my parents might be happy ... but I am a daughter. I complete all the household tasks, go to school, again do the household activities in the evening … my parents do not give value or recognition to me.”

Stanford Assistant Professor of Medicine Marcella Alsan often refers to this comment by a 15-year-old girl from Nepal when she talks about how the division of labor among men and women starts at a young age in the developing world.

“Anecdotally, girls must sacrifice their education to help out with domestic tasks, including taking care of children, a job that becomes more onerous if their younger siblings are ill,” said, Alsan, a core faculty member at the Center for Health Policy/Center for Primary Care and Outcomes Research (CHP/PCOR) within the Freeman Spogli Institute of International Studies, and the Department of Medicine.

More than 100 million girls worldwide fail to complete secondary school, despite research that shows a mother’s literacy is the most robust predictor of child survival. So Alsan is analyzing whether medical interventions in children under 5 tend to lead their older sisters back to school.

She is one of two winners of this year’s Rosenkranz Prize for Health Care Research in Developing Countries, awarded by CHP/PCOR to promising young Stanford researchers.

Her Stanford Department of Medicine colleague, Jason Andrews, is the other recipient of the $100,000 prize given to young Stanford researchers to investigate ways to improve access to health care in developing countries.

Andrews is looking at cheap, effective diagnostic tools for infectious diseases, while Alsan is researching how older girls in poorer countries are impacted by the health of their younger siblings.

“My proposed work lays the foundation for a more comprehensive understanding of how illness in households and early child health interventions impact a critical determinant of human development: an older girl’s education,” she said.

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Alsan, the only infectious-disease trained economist in the United States, said Stanford is the ideal place to carry out her interdisciplinary global health research.

“I am humbled and honored to receive this prize, since Dr. Rosenkranz has done so much for women’s health worldwide,” she said.

Alsan – an MD with a specialty in infectious disease who has a PhD in economics from Harvard – said she intends to estimate the impact that illnesses in under-5 children have on older girls’ schooling using econometric tools.

She will compile data from more than 100 Demographic and Health Surveys (DHS) covering nearly 4 million children living in low- and middle-income countries.

The surveys ask about episodes of diarrhea, pneumonia and fever in children under 5 and record data on literacy and school enrollment for every child in the household.

Alsan also intends to collaborate with partners in sub-Saharan Africa to study the gendered effect of household illness on time use, using culturally appropriate questionnaires.

Douglas K. Owens, a Stanford professor of medicine and director of CHP/PCOR, called Alsan’s work “groundbreaking.”

“Although training is critical, more importantly, her work to date shows a degree of innovation, creativity and rigor that led us to conclude she was likely to become one of the top investigators in her field worldwide,” he said.

Low-Cost Diagnostic Tools

Andrews, also an assistant professor of medicine, has been working on ways to bring low-cost diagnostic tools to impoverished communities that bear the brunt of disability and death from infectious disease.

“I began working in rural Nepal as an undergraduate student and as a medical student founded a nonprofit organization that provides free medical services in one of the most remote and impoverished parts of the country,” Andrews said. “As I became a primary physician, and then an infectious diseases specialist, one of the consistent and critical challenges I encountered in this setting was routine diagnosis of infectious disease.”

He said those routine diagnostics were typically hindered by lack of electricity, limited laboratory infrastructure and lack of trained lab personnel.

“In my experiences working throughout rural Nepal – and in India, South Africa, Brazil, Peru and Ethiopia – I found these challenges to be common across rural resource-limited settings,” said Andrews, who founded a nonprofit Nyaya Health – recently renamed Possible Health – which provides modern, low-cost healthcare to rural Nepal.

Andrews has been collaborating with engineers to develop an electricity-free, culture-based incubation and identification system for typhoid; low-cost portable microscopes to detect parasitic worm infections; and most recently an easy-to-use molecular diagnostic tool that does not require electricity.

“The motivation for these projects was not to develop fundamentally new diagnostic approaches, but rather to find simple, low-cost means to make established laboratory techniques affordable and accessible,” he said.

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“We then perform isothermal amplification heated by a reusable, solar-heated, phase-change material,” Andrews said, adding that the entire process is completed in less than 20 minutes and can be performed by anyone with minimal training.

Andrews will enroll 250 patients with suspected cases of cholera in Nepal, using the new diagnostic tools and adapting as many local supplies as possible.

Andrews also intends to establish and curate a website to gather open-source ideas and evidence on diagnostic techniques for use in the developing world.

“Stanford is one of the world’s greatest hubs for innovation and information sharing as pertains to science and technology and is an ideal home for this venture,” he said.

In the current scientific climate, most National Institutes of Health grants go to established researchers. The Rosenkranz Prize aims to stimulate the work of Stanford’s bright young stars – researchers who have the desire to improve health care in the developing world, but lack the resources.

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.

“As in past years, the competition was extremely tough,” said Grant Miller, a senior fellow at the Freeman Spogli Institute and associate professor of medicine who chaired the prize committee this year.

“It’s exciting to see all of the truly innovative global health research being done by junior scholars at Stanford,” he said. “Both Jason and Marcella really exemplify this – and the legacy of George Rosenkranz.”

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A research team led by FSE director Rosamond Naylor has won a $400,000 multi-year grant to study how to create sustainable palm oil supply chains that promote economic growth and environmental sustainability in Indonesia and West Africa. 

Palm oil has become one of the world’s fastest growing and most valuable agricultural commodities. Global production of palm oil doubled in both volume and area each decade between 1970 and 2010, and is expected to double again by 2025. The windfall profits from this rapid expansion have come at a cost of tropical deforestation, biodiversity loss and rising greenhouse gas emissions, and in many cases the economic benefits have bypassed local smallholder farmers. 

Naylor and her team of Stanford faculty, scholars and students will undertake the three-year project with funding from the Stanford Global Development and Poverty Initiative (GDP), launched in Spring 2014. GDP aims to transform Stanford’s capacity to speak to the challenges of poverty and development. This year, GDP awarded more than $2 million to 13 faculty research teams from across the university. 

The new project marks the first venture that connects Stanford’s expertise in sustainability with the Graduate School of Business’ experience in value chain innovations. The team will conduct an evaluation of value chain opportunities for sustainable palm oil production, build corporate partnerships to improve smallholder incomes, and engage in policy advising. 

GDP is a joint initiative of the Stanford Institute for Innovation in Developing Economies (SEED) and the Freeman Spogli Institute for International Studies (FSI). SEED is housed within the Stanford Graduate School of Business. 

Rosamond Naylor is William Wrigley Professor of Earth System Science and Senior Fellow at the Stanford Woods Institute for the Environment and at FSI.

Bad weather in sub-Saharan Africa increases the spread of HIV, according to a study published in the June 2015 issue of the Economic Journal, co-authored by Stanford professor and FSE fellow Marshall Burke.

When the rains fail, farmers in rural areas often see their incomes fall dramatically and will try to make up for it however they can, including through sex work. Analysing data on more than 200,000 individuals across 19 African countries, the research team finds that by changing sexual behaviour, a year of very low rainfall can increase local infection rates by more than 10%.

The results have important policy implications for fighting the spread of the epidemic, as co-author Erick Gong of Middlebury College notes:

‘Existing approaches to stopping the spread of HIV – such as promoting condom use and the use of anti-retrovirals – remain critically important. But our results suggest that other policy approaches could be very useful too – in particular, approaches that provide safety nets to rural households when the weather turns bad.’

Policies and investments seemingly unrelated to HIV – such as the promotion of rural insurance or household savings schemes, or the development of drought-tolerant crops – might have surprising benefits in slowing the HIV epidemic. Co-author Kelly Jones of the International Food Policy Research Institute says:

‘The HIV/AIDS epidemic remains one of the world’s greatest health challenges, with over a million new infections per year in Africa alone. Our results expand the menu of options for addressing the epidemic, and highlight some surprising options that are not at the forefront of people’s minds.’

The research sheds valuable light on why HIV continues to spread in Africa. Previous studies have documented in limited settings that poor women often alter their sexual behaviour in response to an income shortfall. But until now, there has been little evidence that this response is big enough to affect the trajectory of the HIV epidemic.

To fill this gap, the researchers combined data on the HIV status of thousands of people across sub-Saharan Africa with data on the recent rainfall history in each individual’s location.

Because years of low rainfall can lead to much lower incomes in these locations, particularly in rural areas where people depend more heavily on agriculture for their livelihoods, variation in rainfall provides a way to study how changes in local economic conditions affect infection rates. Co-author Marshall Burke comments:

‘We were surprised by how strong the relationship is between recent rainfall fluctuations and local infection rates. As expected, the relationship is much stronger in rural areas, and particularly for women who report working in agriculture. These are the people who really suffer when the rains fail, and who are forced to turn to more desperate measures to make ends meet.’

Notes for editors: ‘Income Shocks and HIV in Africa’ by Marshall Burke, Erick Gong and Kelly Jones is published in the June 2015 issue of the Economic Journal.

Marshall Burke is an assistant professor of Earth System Science at Stanford University. Erick Gong is an assistant professor of economics at Middlebury College. Kelly Jones is a research fellow at the International Food Policy Research Institute (IFPRI).

For further information: contact Marshall Burke on +1-650-736-8571 (email: mburke@stanford.edu); Erick Gong on +1-802-443-5553 (email: egong@middlebury.edu); Kelly Jones on +1-202-862-4641 (email: k.jones@cgiar.org); or Romesh Vaitilingam on +44-7768-661095 (email: romesh@vaitilingam.com; Twitter: @econromesh).

Ban Ki-moon, the eighth secretary-general of the United Nations, will deliver a public speech at Stanford University on Friday, June 26.

Ban’s visit will highlight the 70^th anniversary of the founding of the U.N., part of a larger trip to the Bay Area to commemorate the San Francisco Conference, where the charter establishing the U.N. was signed in 1945. After his speech, he will participate in a question and answer session with Ambassador Kathleen Stephens, the U.S. ambassador to the Republic of Korea (2008-11).

The Stanford event will take place at 3 p.m. RSVP is required by June 24; seating is first come, first served. Media must pre-register by 9 a.m. on June 25.

It is Ban’s second visit to Stanford in under three years. In Jan. 2013, he delivered a speech to mark the occasion of the Walter H. Shorenstein Asia-Pacific Research Center (APARC)’s thirtieth anniversary.

“I believe we face a unique opportunity,” Ban said in Dinkelspiel Auditorium. “Because the changes we face are so profound – the decisions we make will have a deeper and more lasting impact than perhaps any other set of decisions in recent decades.”

Calling on students to be ‘global citizens,’ he spoke about the ongoing crisis in Syria, the mandate to act on climate change, and the need for a sustainable peace worldwide.

“Growing up, the U.N. was a beacon of hope for me and my country,” he said. “I urge you to harness that same spirit and make a difference.”

Ban was born in the Republic of Korea in 1944. As a youth, more than fifty years ago, Ban visited California during his first trip to the United States with a Red Cross, saying “my trip here opened my eyes to the world.” He has since held a 37-year career in public service in the Ministry of Foreign Affairs, including the role of minister of foreign affairs and trade, foreign policy advisor and chief national security advisor to the president.

“It’s truly our pleasure to host Secretary-General Ban Ki-moon on the seventieth anniversary of the U.N.,” said Gi-Wook Shin, a Stanford professor and director of Shorenstein APARC. “The U.N. has had a profound impact on the shaping of global order in the postwar era. And Ban’s leadership has steered the organization toward the world’s most pressing aims.”

Ban is reaching the end of his term as secretary-general. He assumed office in Jan. 2007 and was reelected for a second term in June 2011. Over his tenure, Ban has led a major push toward peace and non-proliferation activities, youth, women’s rights and the environment. He has urged leaders of China, Japan and South Korea to work harder on reconciliation over the wartime past to ensure long-term stability in the region.

The June 26 event, which can be followed at #UNatStanford, is co-sponsored by Shorenstein APARC and the Freeman Spogli Institute for International Studies at Stanford University; with promotional co-sponsors Asia Society, Asia Foundation and the World Affairs Council of Northern California.

CONTACT: Event inquires may be directed to Debbie Warren, dawarren@stanford.edu or (650) 723-8387; Media inquires may be directed to Lisa Griswold, lisagris@stanford.edu or (650) 736-0656