Emily Tuong-Vi Nguyen, a Stanford student studying human biology, writes about the Asia Health Policy Program’s international conference on diabetes

The Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center hosted the Net Value in Diabetes Management Workshop in March to discuss progress on an international research collaboration. Research teams from Hong Kong, Singapore, China, Taiwan, South Korea and the United States convened at the Stanford Center at Peking University (SCPKU) in Beijing to work on research that compares utilization and spending patterns on diabetes across different countries and to develop a method for measuring the net value of diabetes internationally, based on previous methods discussed in a Eggleston and Newhouse et al. 2009 study with Mayo Clinic Data for Type 2 diabetes.

The research teams from various Asian countries are attempting to calculate the net value of diabetes in those countries by observing the changes in diabetes value and spending. These calculations include monetizing the value of health benefits of new treatments and improvements in health, as well as avoided spending on treatments when prevention was effective, and associated mortality and probability of survival. Previous models used to measure diabetic values and risks, such as the United Kingdom Prospective Diabetes Study (UKPDS) risk engine that was created from U.K. data and populations, are not very relevant for Asian populations. The goal is to create separate risk models specifically suited for populations from Hong Kong, Singapore, China, Taiwan and South Korea.

During the workshop that spanned two days, the research teams had an opportunity to share updates on their individual projects and to discuss methods and ideas for future collaboration.

On the first day, each research team presented its work, describing data sets and explaining the risk models that were used or developed. Karen Eggleston, director of the Asia Health Policy Program, delivered introductory remarks and shared current progress by the Japan and Netherlands research teams on calculating value and risk for diabetes with data from the Netherlands and Japan. The data sets from those two countries were best estimated by the JJ Risk Engine for the Japan data and the UKPDS model for the Netherlands data.

Chao Quan of the University of Hong Kong presented the risk model used for Hong Kong populations. His work primarily looked at how the UKPDS risk engine predicted risk in Hong Kong populations as compared to a local Hong Kong risk engine and how to best calibrate the Hong Kong risk engine. His next step will be to monetize the value for improved survival in diabetes in Hong Kong. He offered to re-estimate the model using the risk factors available on others’ datasets so that the Hong Kong risk model could potentially be used by other teams as well.

Stefan Ma and Zheng Li Yau of the Ministry of Health of Singapore discussed the 5-year prediction model and statistical methods they used for all-cause mortality of Singaporean individuals with diabetes. Their work is based on Singapore’s extensive administrative and claims data as well as data provided by the national health surveys conducted every six years by the National Health Service of Singapore. The researchers plan to look into how their overall risk model compares with models for specific subpopulations, such as Chinese, Malay and Indian populations in Singapore.

Katherine Hastings from the Stanford University team, led by principal investigator Latha Palaniappan, presented preliminary ideas about measuring cardiovascular risk with the Atherosclerotic Cardiovascular Disease Risk Score in analyses of Stanford health system diabetic patients. The researchers are collaborating with a clinical bioinformatics team at Stanford to use machine learning to expedite the analysis.

Min Yu and Haibin Wu of the Zhejiang Center for Disease Control and Prevention shared results from their analysis of health data collected from community health centers for diabetes management, diabetes surveillance data, cause of death data and insurance claims data that showed relationships between different patient characteristics and insurance types. The researchers then estimated the annual cost of Type 2 diabetes and its complications in Tongxiang province, China.

Hai Fang and Huyang Zhang of Peking University worked with claims data of diabetic patients insured by the New Cooperative Medical Scheme in Beijing, and at the workshop, shared regression analyses on the relationship between outpatient visits and inpatient admissions.

Jianqun Dong of the People’s Republic of China Center for Disease Control and Prevention presented ongoing research about diabetes management in China, including preliminary results of a randomized control trial of diabetes self-management strategies.

Wankyo Chung of Seoul National University shared preliminary estimates of a risk model for mortality among diabetic patients in South Korea and discussed next steps for estimating net value of diabetes management using the detailed clinical and claims data available in South Korea.

On the second day, the workshop concluded with a videoconference between workshop participants in Beijing and collaborators at Stanford Graduate Business School, including Stanford professor Latha Palaniappan and Harvard visiting professor Joseph P. Newhouse, using the Highly Immersive Classroom.

The workshop was a good opportunity for the research teams to discuss preliminary models, to offer each other suggestions regarding research methods, and to discuss the future direction of the international collaboration on the net value of diabetes. All research teams are preparing comparative research papers that will be included in the working paper series of the Asia Health Policy Program. A follow-up event will be held at Stanford in November 2017 in recognition of World Diabetes Day.

(The following interview with CISAC's Siegfried Hecker appeared in the May 15 issue of the Bulletin of the Atomic Scientists.)

By Elisabeth Eaves

Siegfried Hecker has the rare distinction of being an American who has visited both North Korean and Russian nuclear facilities. An expert on plutonium science and a professor at Stanford University’s Center for International Security and Cooperation, Hecker is also a former director of the Los Alamos National Laboratory. Here he answers questions on Pyongyang’s nuclear capabilities, its most recent missile test, and what influence the new president of South Korea might have on the regional balance of power. He explains how North Korea developed its arsenal despite global opposition, and says there is no conceivable way the United States can destroy all North Korean nuclear weapons with military might.

BAS: Is North Korea currently capable of delivering any nuclear weapons any distance? How do you know?

SH: We know they have nuclear weapons that work because they have tested five nuclear devices over a period of 10 years. That test experience most likely enables them to miniaturize nuclear warheads to make them small and light enough to mount on missiles. They have also demonstrated over many years that they can launch relatively short-range missiles reliably. We have to assume they can mate the warheads and the missiles so as to reach targets anywhere in South Korea and Japan.

BAS: What does Pyongyang’s most recent missile test, which took place on Sunday, tell us about their capabilities and intentions?

SH: The missile experts are still analyzing the test as North Korea releases details and photos. However, they already agree that this missile outperformed any previous North Korean missile launch. It is reported to have traveled nearly 800 kilometers (497 miles) for 30 minutes (splashing down in the Sea of Japan south of the Russian border) and reached an altitude in excess of 2000 km (1243 miles). Since it was launched in a lofted trajectory, it may be able to travel at least 4,000 km (2486 miles) if launched on a standard trajectory. 

This would make it a real intermediate-range ballistic missile that puts Guam within range. But the more important objective of this test was to move North Korea closer to having an intercontinental ballistic missile (ICBM). 

BAS: What sequence of events might lead Kim Jong-un to launch a nuclear attack on one of its neighbors like South Korea or Japan? 

SH: I cannot imagine any circumstance that would lead Kim Jong-un to launch an unprovoked nuclear attack on anyone. However, we know so little about him and even less about the military that controls the country’s strategic rocket forces that we can’t rule out a miscalculation or a desperate response to a crisis. It is conceivable that they believe a small nuclear weapon could be used to de-escalate or terminate a conventional confrontation on their terms. 

BAS: How big is the largest nuclear bomb tested by North Korea, and can you give a sense of the level of damage such a bomb would cause? 

SH: The highest yield of the North Korean tests to date is in the range of 15 to 25 kilotons—an explosive power similar to the bombs that destroyed Hiroshima and Nagasaki, causing roughly 200,000 immediate fatalities and lingering radiological health effects for many survivors. If such a weapon were to be exploded over Seoul, it is possible that several hundred thousand people or more would perish. 

BAS: If Pyongyang were to attack South Korea or Japan, what would be the immediate and longer-term effects?

SH: The immediate effects would be horrific, the longer-term effects catastrophic. If several bombs exploded over South Korean or Japanese cities, there could be a million or more casualties. Beyond that, the cities would face massive evacuations and long-term building and grounds decontamination efforts. Dangerous radioactive clouds would drift over South Korea, Japan, China, or Russia, depending on the wind flow. An international order would be destroyed. 

BAS: How close is North Korea to being able to attack somewhere as far distant as the United States with a nuclear weapon? What technical leaps does it need to make to achieve that capability?

SH: I believe that North Korea does not yet have the capability to reach the US mainland with a nuclear-tipped missile. It has a very sparse and not very successful long-range rocket test history, although the missile test on Sunday brings it somewhat closer. Its solid-fueled rockets, which are of greatest concern because they can be launched quickly and from hidden locations, have failed regularly. It will need to miniaturize warheads to a much greater extent than it is currently likely capable of doing, and the warheads will have to survive the stresses at launch and the high temperatures and stresses during re-entry. At the current pace, North Korea may be able to make the technological progress required for a nuclear-tipped ICBM in five or so years. 

One corollary question that one must ask, however, is why would North Korea want to strike the US mainland? It is quite clear that it wants to threaten Washington with such a capability, but to launch would be suicidal, and I don’t believe the regime is suicidal. 

BAS: Besides being able to threaten the United States and its allies, what else could the Kim regime be trying to accomplish with its nuclear weapons?

SH: We need to look closely at how the North’s growing nuclear arsenal may change its domestic policies and foreign relations. Domestically, the nuclear arsenal may help justify the regime’s continued call for sacrifice by its citizens. But it may also provide a more solid foundation for the state’s security, allowing it to devote more resources to economic growth. Foreign visitors have reported that living conditions in Pyongyang have improved markedly in the past few years despite international sanctions. Kim Jong-un has officially promoted the dual policy of military and economic growth. 

Looking abroad, the regime’s nuclear arsenal could make it more aggressive in dealings with South Korea and the rest of the region. We have not seen a return to the North’s especially aggressive behavior of the late 1960s. Nevertheless, being one of fewer than 10 states in the world with nuclear weapons may change Pyongyang’s foreign policy toward its neighbors. And we don’t know how possessing a nuclear arsenal will affect the regime’s behavior in a crisis. 

BAS: Is it plausible that a US pre-emptive strike could destroy all North Korean nuclear weapons, fissile material, and nuclear production facilities? Why or why not?

SH: There is no conceivable way the United States could destroy all North Korean nuclear weapons. It is not possible to know where they all are. Even if a few could be located, it would be difficult to destroy them without causing them to detonate and create a mushroom cloud over the Korean peninsula. 

It is even less likely that the United States could locate and demolish all of the North’s nuclear materials. Missile launch sites could be destroyed, nuclear test tunnels could be bombed, production sites could be destroyed, and North Korean missiles could possibly be intercepted after launch. But North Korea is developing road-mobile and submarine-launched missiles, which cannot be located reliably. New test tunnels can be dug. And while we know North Korea has covert production facilities, we don’t know where they are. The US military may not be able to intercept missiles after launch. The bottom line is, military strikes could be used to set back the North Korean nuclear program but not to eliminate it.

Moreover, I believe the US and South Korean governments consider the consequences of any military intervention unacceptably high—in spite of the proclamation that “all options are on the table.” I believe the military option will only really be on the table if North Korea initiates military actions. 

BAS: There is talk that North Korea is about to conduct a sixth nuclear test. What do you make of these reports? Do you have any insight into what to expect?

SH: North Korea has ample technical reason to test again as it moves toward developing a credible nuclear-tipped ICBM. The test site appears to be ready. I believe the only thing that inhibits them from testing is the political fallout they would face—particularly from China and the new South Korean administration.

BAS: You recently estimated that North Korea has 20 to 25 nuclear weapons. How do we know?

SH: My estimate that it has sufficient plutonium and highly enriched uranium for 20 to 25 nuclear weapons is highly uncertain because we know so little about its uranium enrichment capacity. All estimates are to a large extent based on the observations my Stanford colleagues and I made during my last visit to Yongbyon in November 2010. To my knowledge, no outsiders have been in their nuclear complex since. So the only direct evidence we have is from that 30-minute tour and discussions with their experts at the centrifuge facility. The rest of the estimate is based on indirect evidence—that is, satellite imagery, and what North Korea chooses to publicize, combined with modeling of their capabilities and acquisitions. 

BAS: North Korea carried out its first nuclear test in 2006. How was it able to go from that widely condemned first test to today’s arsenal despite global opposition? 

SH: How they developed a threatening nuclear arsenal despite global opposition is a sad reflection on unwise US policies and the international community’s approach to preventing nuclear proliferation. Controlling the supply side of proliferation has been the predominant international mechanism for halting nuclear weapons development, but it failed terribly in the North Korean case. The international export system is leaky enough that a determined government can develop indigenous bomb-building capabilities over time. In North Korea, this process was exacerbated by the fact that once they built the Bomb, sanctions and isolation allowed them to build a whole arsenal instead of forcing them to give it up.

Insufficient attention has been paid to the demand side—that is, to why states want nuclear weapons and what can be done to influence the decision to acquire them. In the North Korean case, the Clinton administration greatly slowed North Korea’s drive to the Bomb with diplomacy. The Bush administration rejected diplomacy, but was unprepared for the consequences. It stood by while North Korea built a nuclear weapon. Subsequent attempts at diplomacy amounted to too little, too late. (This should serve as a lesson on the Iran nuclear agreement: if you kill a deal, you better be prepared for the consequences). The Obama administration was greeted with a North Korean nuclear test in 2009 and was never able or willing to pursue diplomacy effectively. It relied on two tactics, imposing sanctions and pressuring China, while North Korea continued to build its arsenal. Washington and Beijing never got on the same page on how to deal with Pyongyang. 

BAS: South Korea just elected a new president who takes a more conciliatory approach to North Korea than his predecessor. How might this affect the North’s nuclear activities?

SH: In the end, the Korean peninsula nuclear crisis has to be resolved to the satisfaction of the Korean people. South Korean President Moon Jae-in favors diplomatic engagement with North Korea. I believe that at this point, it is imperative for Seoul and Washington to craft a unified strategy on North Korea and speak with one voice. That voice should reflect the new South Korean president’s views on finding a diplomatic resolution. I hope that the Trump administration will support President Moon, and that Pyongyang won’t pre-empt diplomacy with a nuclear or long-range missile test. 

BAS: If you were advising president Trump, what would you tell him to do in the next month regarding North Korea? In the next six months? The next year?

SH: In the next few weeks, after consultation with President Moon, President Trump should send an envoy to Pyongyang to tackle the most immediate danger—that is, to avoid a nuclear detonation on the Korean peninsula. There is a danger that overconfidence or miscalculation by Kim Jong-un, or an unpredictable reaction to a crisis, could result in a nuclear detonation. I also have serious concerns about a nuclear-weapon accident in North Korea, particularly if Pyongyang feels threatened and begins to deploy its nuclear arsenal. Moreover, in the case of upheaval or chaos in the North, who will control the weapons, and what will become of them? 

The next six months should be followed up with additional bilateral US-North Korea dialogue, with Washington separately keeping Seoul and Beijing informed. Washington should stress the seriousness of the situation, but also listen to the North’s concerns. 

These dialogues may then lay the foundation within the next year for a resumption of multilateral negotiations to halt, roll back, and eventually eliminate North Korea’s nuclear weapons. Talks could also lay the groundwork for normalizing relations between the North and its neighbors and the United States.

Follow CISAC at @StanfordCISAC and www.facebook.com/StanfordCISAC.

MEDIA CONTACTS:

Siegfried Hecker, Center for International Security and Cooperation: (650) 725-6468, shecker@stanford.edu

Clifton B. Parker, Center for International Security and Cooperation: (650) 725-6488, cbparker@stanford.edu

(Amy Zegart, co-director of the Center for International Security and Cooperation, wrote the following essay for The Atlantic.)

Today The Washington Post dropped the bombshell that President Trump had revealed classified information about the Islamic State to Russian Foreign Minister Sergei Lavrov and Russian ambassador Sergey Kislyak when the three of them met at the White House last week. You know a story is big when it gets as many concurrent visitors as the story about the infamous Access Hollywood video. There was no hiding near bushes in the dark this time to walk back the damage. Deputy National-Security Advisor Dina Powell declared the story “false,” and the administration also called out the big guns, with Secretary of State Rex Tillerson and National Security Advisor H.R. McMaster dutifully rushing into the breach to discuss the breach, using oh-so-carefully worded statements about how the president did not reveal “sources or methods” or any “military operations” that were not already known publicly.

So just how bad is the damage? On a scale of 1 to 10—and I’m just ball parking here—it’s about a billion. The story, which has since been confirmed by The Wall Street Journal, The New York Times, Reuters, Buzzfeed, and CNN, notes that the president could have jeopardized a critical source of intelligence on the Islamic State. Not America’s source. Somebody else’s. Presumably from an allied intelligence service who now knows that the American president cannot be trusted with sensitive information.

The type of information Trump cavalierly shared fell under a classification known as “code word,” according to the Post. There are three basic levels of classified information. Confidential information is defined as anything that could reasonably be expected to “cause damage” to American national security if shared without authorization. Secret information is one step up, considered to have the potential to cause “serious damage” if revealed. Top Secret information is a higher classification level still, comprising anything that could reasonably be expected to cause “exceptionally grave damage” to U.S. national security if revealed.

Code word is beyond Top Secret. It limits access to classified information to a much narrower pool of people to provide an extra layer of security. Many secrets are super-secrets—Harry Truman, as vice president, didn’t know about the Manhattan project. He learned of it only after Franklin Delano Roosevelt died and Truman was sworn in as president. Code word classification is so far off the scale, even fake spies rarely refer to it in the movies. Technically, the president can "declassify" anything he wants, so he did not violate any laws. But as Lawfare notes, if the president tweeted out the nuclear codes, he also wouldn't violate the law—but he would rightly be considered unfit for office.

Did Trump reveal intelligence crown jewels or just boast about the fact that he liked diamonds? According to the Post he revealed information about a purported ISIS plot involving laptops. It’s likely, however, that Tillerson, McMaster, the Postand the Times are ALL correct: The president did not reveal sources or methods or military operations. But that doesn’t matter much if he gave away information that will enable the Russians to identify the source or the methods. It looks like he did, since according to the Post’s account he talked about the content of a specific plot, the potential harm, and the location of the city in the Islamic State’s territory where the allied state’s intelligence service detected it. It was almost everything except the GPS coordinates. The denials by Tillerson and McMaster are a classic case of intelligence super-parsing—saying things that are technically and narrowly true but may not be accurate at all. No spin can hide the fact that the breach was deadly serious and reckless in the extreme.

Then there’s the impact on America’s unnamed ally, whom the Post reported was already nervous about sharing such sensitive intelligence with the United States. It is difficult to penetrate the Islamic State, and there is a major risk that this breach will close down a vital source. It’s an even bigger deal in the big picture, potentially jeopardizing intelligence cooperation with other U.S. allies around the world. Trump already raised intelligence eyebrows when he turned his Mar-a-Lago dining area into an impromptu Situation Room after the North Koreans decided to launch a ballistic missile. The president and his aides used the lights on cell phones to illuminate field reports, in full view of resort dinner guests snapping photos. If you’re known as someone who cannot keep a secret, the world’s secret-keepers are not going to tell you much.

“Can you believe the world we live in today?” President Trump said, according to one official in the two Sergeis meeting. “Isn’t it crazy?”

Yes, Mr. President. It’s crazy.

Fellows will arrive at Stanford in July to begin the three-week academic training program taught by Stanford faculty, policymakers and thought-leaders in the technology sector.

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Stanford's Center on Democracy, Development, and the Rule of Law is proud to announce the 2017 class of Draper Hills Summer Fellows, which is composed of 28 leaders – selected from among hundreds of applications – advancing democratic development in some of the most challenging corners of the world.

In Bahrain, Burma, Rwanda and Sudan our fellows are working on peace-building initiatives to create more tolerant and inclusive societies. Judges and lawyers are holding government and criminals accountable and reforming the rule of law in Argentina, Guatemala and the Philippines. Gender rights activists are creating new tools and programs to protect the safety and freedom of women and girls in India, Kuwait and Papua New Guinea.

In Egypt, Morocco, Pakistan, Serbia and Ukraine, our fellows are serving inside the government as members of Parliament and senior civil servants to advance reform and new policy agendas. Business leaders in Jordan and India launched initiatives to support more inclusive economic growth and social development.

CDDRL is excited to launch another powerful network of leaders determined to advance change in their communities. They will emerge with new tools, frameworks and connections to enhance their work and deepen their impact on democratic reform.

The 2017 class will mark the 13th cohort of the Draper Hills Summer Fellows Program and the fellows will join the Omidyar Network Leadership Forum, an alumni community of over 300 alumni in 75 countries worldwide.

When one thinks of the casualties of war, it is easy to imagine severed limbs, bullet holes, shrapnel, perhaps even sarin gas or Agent Orange. But in a recent Daedalus essay, Paul Wise argues that the most damaging health impacts of war are often indirect. Losing access to food supplies, medication and electricity can kill more people than battle itself. In this video by the American Academy of Arts and Sciences, Wise, a professor of pediatrics and Stanford Health Policy core faculty member, explains how fatal the indirect costs of war can be.

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While the United States has no peers in conventional military power, it is especially vulnerable – as a free and democratic society – to cyber misinformation campaigns, a Stanford scholar says.

Herbert Lin, a senior research scholar for cyberpolicy and security at Stanford’s Center for International Security and Cooperation (CISAC), is the co-author of a new draft working paper that spells out the perilous risks facing democratic, wired-up countries around the world.

America’s adversaries are seeking “asymmetric” methods for social disruption, rather than direct military conflict, Lin said.

“Cyber warfare is one asymmetric counter to Western (and especially U.S.) military advantages that depend on the use of cyberspace,” wrote Lin and his co-author Jackie Kerr, a research fellow at the Lawrence Livermore National Laboratory.

This new type of cyber aggression is aimed at winning – and confusing – hearts and minds, the very control centers of human existence, Lin said.

As a result, “information/influence warfare and manipulation,” or IIWAM as Lin describes it, poses profound implications for Western democracies, even though much of it may not be illegal under international law. This approach is based on the deliberate use of information by one party on an adversary to confuse, mislead, and ultimately to influence the choices and decisions that the adversary makes.

A recent example in point would be the 2016 Russian hacking of the U.S. presidential election and the surge of so-called “fake news.”

Lin points out that while misinformation campaigns are not new, the technology to spread it far and wide globally is. He noted that the patron saint of distorting reality for war-like purposes is Sun Tzu, who wrote that, “The supreme art of war is to subdue the enemy without fighting.”

While traditional cyber attacks typically hit hard targets like computer systems, cyber “influence” campaigns are conducted over longer periods of time and rely on soft power – propaganda, persuasion, culture, social forces, confusion and deception, Lin said. 

Words and images

How does it work? Lin explains:

“Victory is achieved by A when A succeeds changing B’s political goals so that they are aligned with those of A.  But such alignment is not the result of B’s 'capitulation' or B’s loss of the ability to resist – on the contrary, B (the losing side) is openly willing.”  That is, such victory shares the focus on subverting the opponent’s will, though not on destroying his military forces.

The ammunition in these cyberspace battles are “words and images,” the kind that persuade, inform, mislead, and deceive so that the adversary cannot respond militarily. In the example of a “fake news” story, they often take place below legal thresholds of “use of force” or “armed attack,” and at least in an international legal sense, do not trigger a military response.

The target is the “adversary’s perceptions,” which reside in the “cognitive dimension of the information environment.” In other words, such cyber warfare focuses on “damaging knowledge, truth, and confidence, rather than physical or digital artifacts,” according to Lin. It is the “brain-space.”

Additionally, IIWAM injects fear, anger, anxiety, uncertainty, and doubt into the adversary’s decision making processes, he added.  Success is defined as altering such perceptions so the target makes choices favoring the aggressor.

“Sowing chaos and confusion is thus essentially operational preparation of the information battlefield – shaping actions that make the information environment more favorable for actual operations should they become necessary,” the researchers wrote.

These cyber manipulations often prey upon cognitive and emotional biases present in the psychological and mental makeup of human beings, Lin said. 

For example, media channels such as Fox News play to “confirmation bias” for individuals with a right-of-center orientation, and similarly for MSNBC for those with a left-of-center, orientation, he wrote. Confirmation bias is the tendency to interpret new evidence as confirmation of one's existing beliefs or theories.

Countering misinformation

“Naming and shaming” is probably ineffective against many nation states conducting cyber disinformation campaigns, Lin said. And the idea that a government like the U.S. can quickly respond to misinformation created in the private sphere is unlikely to be effective as well.

What, then, might work? Lin suggests new tactics are needed, as no existing approach seems adequate. For example, Facebook is deploying a new protocol for its users to flag questionable news sites.  Google has banned fake news web sites from using its online advertising service. Twitter, YouTube, and Facebook shut down accounts that they determine are promoting terrorist content.  He noted that a recent Facebook letter from CEO Mark Zuckerberg states that, “Our approach will focus less on banning misinformation and more on surfacing additional perspectives and information, including that fact checkers dispute an item's accuracy.”

But such measures are unlikely to stem the “rising tide of misinformation conveyed” through cyber warfare, Lin said, because they mostly require users to do additional mental work.  

Wired world riskier

Today’s Internet-driven Western world offers countless opportunities for cyber influence mischief, Lin wrote.

“Democracy has rested on an underlying foundation of an enlightened, informed populace engaging in rational debate and argument to sort out truth from fiction and half-truth in an attempt to produce the best possible policy and political outcomes,” Lin wrote.

Cyber manipulators have exploited an arguable gap between ideals and reality in democratic systems – “rendered it much more questionable” – through the tremendous reach and speed of misinformation, he said. Many countries cannot deal with the onslaught of such focused efforts. This serves to make the democratic process look weak and unstable in the eyes of its citizens. The same dynamic does not apply equally around the world.

“Cyber weapons pose a greater threat to nations that are more advanced users of information technology than to less-developed nations,” Lin wrote.

He said that less developed or authoritarian countries do not have much Internet infrastructure or that wield control over expression – North Korea is an example.

MEDIA CONTACTS

Herbert Lin, Center for International Security and Cooperation: (650) 497-8600, herbert.s.lin@stanford.edu

Clifton B. Parker, Center for International Security and Cooperation: (650) 725-0224, cbparker@stanford.edu

Anna Péczeli, a Stanton Nuclear Security Fellow at CISAC, wrote the following op-ed for the Bulletin of the Atomic Scientists:

What does the future hold for the US nuclear posture under President Trump? The last Nuclear Posture Review occurred in April 2009, when a 12-month review process was conducted to translate President Obama’s vision into a comprehensive nuclear strategy for the next five to 10 years. The review addressed several major areas: the role of nuclear forces, policy requirements, and objectives to maintain a safe, reliable, and credible deterrence posture; the relationship between deterrence policy, targeting strategy, and arms control objectives; the role of missile defense and conventional forces in determining the role and size of the nuclear arsenal; the size and composition of delivery capabilities; the nuclear weapons complex; and finally the necessary number of active and inactive nuclear weapons stockpiles to meet the requirements of national and military strategies.

Clearly, changes are afoot. On January 27, 2017, President Trump issued a presidential memorandum that mandated “a new Nuclear Posture Review to ensure that the United States nuclear deterrent is modern, robust, flexible, resilient, ready, and appropriately tailored to deter 21st-century threats and reassure our allies.” 

Looking ahead, the new administration should conduct this review through a broad, inter-agency process, involving the State and Energy departments, and allies as well. This approach offers several valuable benefits by broadening the focus from deterrence to non-proliferation, reassurance, and nuclear security.

The main role of the Nuclear Posture Review, or NPR, is to assess the threat environment, outline nuclear deterrence policy and strategy for the next 5 to 10 years, and align the country’s nuclear forces accordingly. Since the end of the Cold War, each administration has conducted its own NPR, but the process and the scope of the reviews were different in all three cases. 

The first NPR was conducted by the Clinton administration in 1994, and even though important senior positions have still not been appointed by the Trump White House, Trump's mandate suggests that their review might use it as a template for 2017. It was a bottom-up review, initiated by the Department of Defense, mostly focusing on a set of force structure decisions—such as the right size and composition of US nuclear forces, including the size of the reserve or so-called “ hedge” force. That review lasted for 10 months, and the Pentagon was in charge of the entire process, mainly focusing on deterrence requirements. 

In contrast, the 2001 NPR of the Bush administration was mandated by Congress, and it addressed a broader set of issues, including all components of the deterrence mix—nuclear and non-nuclear offensive strike systems, active and passive defenses, and the defense infrastructure. The Defense Department took the lead in this case just as before, but this time the Energy Department and the White House were also engaged in the process. As a result, the Bush NPR’s force structure requirements—how to size and sustain the country’s forces—were driven by four factors: assuring allies, deterring aggressors, dissuading competitors, and defeating enemies. 

The Obama administration’s 2010 NPR was also mandated by Congress, but the Defense Department was specifically tasked to conduct an inter-agency review. Besides the unprecedented level of such cooperation, a bipartisan Congressional commission also laid out a number of recommendations for the review process, many of which became part of the final text of the Obama review. Officials from State, Energy, and the Joint Chiefs of Staff were involved, as well as US allies who were regularly briefed during the different stages of the review. 

In the final phase of the 2010 NPR, the White House leadership made the decisions on the actual content of the nuclear posture. While the Clinton and the Bush reviews were largely conducted behind the scenes and only short briefing materials were published on the outcome, the Obama administration released an unprecedentedly long report on its nuclear posture review. 

These cases offer two models for a review process: It can be conducted by a small group of people in the most highly classified manner, or it can be a larger, relatively transparent inter-agency process. In the former approach, the final decisions are typically presented to the secretary of defense, the president, Congress, and allies. The problem is that this tends to be a one-sided approach, putting the main focus on deterrence and modernizations. 

Though it is effective and fast, the implementation of a Nuclear Posture Review requires all stakeholders to be on board with the new strategy. One of the most painful lessons of the Bush review was that because the White House and Defense failed to explain their new approach to the public, the military, and Congress, there was effectively a loss of leadership—which made procurement extremely difficult and caused major problems in the implementation of their strategy. 

On the other hand, involving all stakeholders and providing a balanced approach to nuclear strategy would support the goals of not just deterrence, but those of reassurance, non-proliferation, and nuclear security as well. Due to the involvement of the State Department, the 2010 NPR, for example, emphasized a number of policies which supported non-proliferation objectives and strengthened US negotiating positions at global arms control forums. One of these policies was the “negative security assurance,” which stated that the United States would not use or threaten to use nuclear weapons against non-nuclear weapon states that are party to the NPT and in compliance with their nuclear nonproliferation obligations. 

The other policy that was advocated by senior State Department officials was the so called sole-purpose posture—which means that nuclear weapons only serve to deter or respond to a nuclear attack, and they no longer play a role in non-nuclear scenarios. Although the sole purpose posture was eventually dropped and it was set only as a long-term objective, the Obama administration still reduced the role of nuclear weapons with the new negative security assurance, and it signaled its intent to continue this process with the promise of sole purpose. These steps supported US leadership at the 2010 Nuclear Non-Proliferation Treaty Review Conference and they contributed to the adoption of a consensual final document at the conference. 

This broader scope strengthens inter-agency cooperation, and ensures that all the departments that are affected by the NPR are on board with the strategy, which eases the implementation of the decisions. Besides, it also strengthens alliance relations by regular consultations. The Trump administration’s mandate did not include a specific timeline or format; consequently it will be mainly the responsibility of Defense Secretary James Mattis to decide on the framework. Though the presidential memorandum did not require an inter-agency process, it would be wise to conduct one.

Compared to 2010, the security environment has dramatically deteriorated: renewed tensions between NATO and Russia since the annexation of Crimea, China’s building of military bases in what had previously been international waters, significant military modernization efforts by both these states, and North Korea’s increasingly bellicose nuclear threats. All of these developments have created a serious deterrence and security challenge for the United States and its allies. Only a broader approach can address all relevant threats and create the necessary internal consensus for the funding and creation of a modern, robust, flexible, resilient, ready, and appropriately tailored nuclear arsenal.

"What is behind democracy’s seeming decline? What is fuelling the widespread appeal of authoritarianism? Is liberal democracy simply a politics of prosperity, but ill-suited for times of crisis and parsimony? By privileging individual choice and minimizing civic virtue, is liberal democracy simply a victim of its own ‘success’?" For ABCRadio, Larry Diamond, Senior Fellow at CDDRL/FSI discusses the dangers of authoritarianism. Listen here. 

Event Recap: First Minister of Scotland, Nicola Sturgeon, Visits Stanford

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In her April visit to Stanford University, Nicola Sturgeon, First Minister of Scotland and leader of the Scottish National Party (SNP), spoke to over 300 members of the Stanford community about Scotland's place in the world. An additional 4475 people viewed the talk remotely via live stream. With many Scottish voters choosing to remain a part of the United Kingdom in order to ensure continued membership in the European Union, Sturgeon argued that the June 2016 Brexit vote posed a "fundamental question for Scotland" and that the Scottish populace had a right to decide whether to pursue independence in order to continue to be a part of the European Union. Furthermore, Sturgeon argued that Scottish priorities of inclusivity, equality, openness, fairness, climate protection, and economic prosperity are at odds with a decision to prioritize "immigration curbs above all else." She contrasted the 2014 independence referendum with the 2016 Brexit vote: "[The independence referendum] was a debate that had a high level of understanding about the issues at stake. The EU referendum by contrast had none of that. The information that people had was reduced to a lie on the side of double decker bus." Adding, however, "I fervently hope for the independence of my country. I wouldn't want it to be won on the basis of a campaign that was as dishonest as the EU referendum campaign." Sturgeon stated that she is "fairly certain" that there will be a second referendum on Scottish independence.

Voted into the Scottish Parliament in 1999, Nicola Sturgeon became the First Minister of Scotland in 2014 and is the first female to hold the position. She led her party to success in the Westminster and Holyrood elections, with the SNP becoming the first party in Scotland to secure a third term in government. Following the Brexit vote in the United Kingdom, the First Minister has been a leading voice arguing for a continuing relationship between Scotland and the European Union and an open and welcoming approach to immigration. She was ranked as the 50th most powerful woman in the world in 2016 and 2nd in the United Kingdom by Forbes magazine.

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In her dissertation, Playing to the Point: Weimar-Era Agitprop and the Aesthetics of Progressive Popular Performance, Jessi examines political street theater. Throughout the dissertation, she first focuses on Weimar-era "agitprop" and then uses the findings from the first part to rethink standard assumptions about contemporary forms of activist street theater.

Funded by The Europe Center, Jessi spent August and September 2016 in Berlin, Germany conducting archival and site-specific research for her dissertation. While in Germany, Jessi's research centered on the agitprop troupes of Weimar-era Germany. Agitprop was a popular form of live entertainment that was generally both created and performed by amateur artists from Germany’s working classes. Today, the texts are generally unavailable in published form and are primarily available in the Agit-Prop-Sammlung at the Akademie der Künste Archiv in Berlin. Moreover, as Jessi learned from the head of the archive’s Performing Arts division, with the exception of a single volume from 1961, little of the material has been referred to in academic work. Jessi notes that the materials in this collection are extraordinarily diverse, and have allowed her to begin to reconstruct aspects of this fascinating theatrical tradition that have largely escaped the attention of performance scholars. An important part of this research focuses on the Bildsprache, or iconography, developed by agitprop troupes throughout the 1920s. Jessi argues that contrary to popular thought, the “heavy-handedness” and simplicity of these performances paradoxically helped to constitute a space for critical reflection, dialogue, and dissensus among spectators and performers alike.

Jessi has been awarded a DAAD Research Grant and will therefore be returning to Berlin for the 2017-2018 academic year. During that time she will conduct additional archival research and will embark upon an ethnographic exploration of contemporary performances. At this time, Jessi intends to return to Stanford for the 2018-2019 academic year in order to complete and defend her dissertation.

Please visit our website for more information about our Graduate Student Grant program.