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Video of A career in Economics...it's much more than you think

Marcella Alsan, an assistant professor of Medicine and CHP/PCOR core faculty member, shows how economics is a broader field than most people realize in this video produced by the American Economic Association (AEA).  Along with other top economists, she discusses the interdisciplinary nature of economics, specifically as it relates to global health.  Alsan states that "without understanding economic principals and economic forces, [there is] a real gaping hole in actually practicing medicine."  Understanding economics can help us to understand policy decisions and to tackle the broad problems of society.

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The deal has sparked a vigorous debate in Iran as well as in the United States. In a piece published in The Atlantic, FSI Director Michael McFaul and Abbas Milani – Stanford's director of Iranian Studies and an FSI affiliate – describe how the agreement has split Iranians into camps that could shape the country's future.

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Iranians celebrate on the streets following a nuclear deal with major powers, in Tehran July 14, 2015. | Reuters
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Drawing on twenty-four years of experience in government, Michael H. Armacost explores how the contours of the U.S. presidential election system influence the content and conduct of American foreign policy. He examines how the nomination battle impels candidates to express deference to the foreign policy DNA of their party and may force an incumbent to make wholesale policy adjustments to fend off an intra-party challenge for the nomination. He describes the way reelection campaigns can prod a chief executive to fix long-neglected problems, kick intractable policy dilemmas down the road, settle for modest course corrections, or scapegoat others for policies gone awry.

Armacost begins his book with the quest for the presidential nomination and then moves through the general election campaign, the ten-week transition period between Election Day and Inauguration Day, and the early months of a new administration. He notes that campaigns rarely illuminate the tough foreign policy choices that the leader of the nation must make, and he offers rare insight into the challenge of aligning the roles of an outgoing incumbent (who performs official duties despite ebbing power) and the incoming successor (who has no official role but possesses a fresh political mandate). He pays particular attention to the pressure for new presidents to act boldly abroad in the early months of his tenure, even before a national security team is in place, decision-making procedures are set, or policy priorities are firmly established. He concludes with an appraisal of the virtues and liabilities of the system, including suggestions for modestly adjusting some of its features while preserving its distinct character.

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Karl Eikenberry, a distinguished fellow at Stanford’s Freeman Spogli Institute for International Studies, will serve on the Commission on Language Learning at the American Academy of Arts and Sciences (AAAS). The new commission is part of a national effort to examine the state of American language education.

The commission will work with scholarly and professional organizations to gather research about the benefits of language instruction and to initiate a national conversation about language training and international education.

Eikenberry joins eight other commissioners, including: Martha Abbott, executive director of the American Council on the Teaching of Foreign Languages; Nicholas Dirks, chancellor of the University of California at Berkeley; and Diane Wood, chief judge, of the 7th U.S. Circuit Court of Appeals. The group is led by Paul LeClerc, director of Columbia University’s Global Center in Paris.

Eikenberry, who is also a member of the AAAS Commission on Humanities and Social Sciences, contributed to “The Heart of the Matter,” a 2013 report that aims to advance dialogue on the importance of humanities and social sciences for the future of the United States.

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Today’s landmark deal between six world powers and Iran, which would limit Iran’s nuclear program in exchange for lifting economic sanctions, was an important step toward stopping Iran from building a nuclear bomb.

However, the key challenge for the international community will be making sure Iran keeps its part of the bargain, according to Stanford experts.

“Both sides have made a series of compromises that will help Iran’s economy in exchange for constraining its nuclear capabilities – and that’s a deal worth making, in my view,” said Scott Sagan, the Caroline S.G. Munro professor of political science and senior fellow at the Center for International Security and Cooperation.

“Iran will still have a technical capability to develop nuclear weapons, given the technology and materials that they have, but under this deal it will both take them a much longer period of time and would require them to take actions that would be easily discerned by the International Atomic Energy Agency, so it constrains their break-out capabilities in important ways.”

[[{"fid":"219719","view_mode":"crop_870xauto","fields":{"format":"crop_870xauto","field_file_image_description[und][0][value]":"","field_file_image_alt_text[und][0][value]":"","field_file_image_title_text[und][0][value]":"Final plenary session at the United Nations Office in Vienna, Austria. Photo credit: U.S. State Department","field_credit[und][0][value]":"","field_caption[und][0][value]":"","field_related_image_aspect[und][0][value]":"","thumbnails":"crop_870xauto","pp_lightbox":false,"pp_description":false},"type":"media","attributes":{"title":"Final plenary session at the United Nations Office in Vienna, Austria. Photo credit: U.S. State Department","width":"870","style":"width: 400px; height: 266px; float: right; margin-left: 15px","class":"media-element file-crop-870xauto"}}]]The U.S.-led negotiations also included fellow United Nations Security Council members Britain, China, France, and Russia, as well as Germany – a group known collectively as as the "P5+1."

Sig Hecker, former Los Alamos National Laboratory director and senior fellow at Stanford’s Center for International Security and Cooperation, said the nuclear deal was “hard-won and is better than any other reasonably achievable alternative.”

“Iran agreed to considerably greater restrictions on its program than what I thought was possible before the Joint Plan of Action was signed in November 2013,” said Hecker.

Abbas Milani, director of Iranian studies at Stanford and an affiliate at the Center for Democracy Development and the Rule of Law, called it the “least bad deal” for both Iran and the international community.

“Nobody gets everything they want,” Milani said. “Every side gets some of what they want.”

Under the deal, Iran would be allowed to continue to enrich uranium for peaceful purposes in its energy and health industries.

But it would have to reduce the number of its centrifuges from 19,000 to 6,000, and cut its stockpile of low enriched uranium down from more than 20 thousand pounds to about 660 pounds.

“Reducing that stockpile actually lengthens the breakout time more than any other measure,” said Hecker.

These limits were designed to increase the “breakout time” it would take for Iran to produce enough fissile material to make a nuclear weapon from the current two to three months, to one year over a period of the next 10 years.

The agreement still faces a series of political hurdles before it gets implemented, and will face tough scrutiny from a Republican-controlled U.S. Congress, as well as the parliaments of European countries that were parties to the talks.

“I think it’s going to be hard for the U.S. Congress and [European] parliaments to kill the deal and be perceived as the ones who would rather have a war than give diplomacy a chance,” said Thomas Fingar, distinguished fellow at the Freeman Spogli Institute for International Studies.

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“The key is going to be the effectiveness of the verification procedures and IAEA access,” Fingar said.

“There’s an element of trust, but a far more important part is the rigorous verification protocols.”

As soon as the IAEA confirms that Iran is abiding by the terms of the agreement, economic sanctions can be lifted.

Sagan warned that the international community should not be surprised if Iran pushed the limits of the agreement, and should be ready to reimpose economic sanctions if Iran violated the deal.

“We should anticipate that Iranian opponents to the agreement will try to stretch it and do things that are potential violations and that we have to call them on that, and not treat every problem that we see as unexpected,” said Sagan.

“We should anticipate such problems and be ready, if necessary, to reimpose sanctions. Having the ability to reimpose sanctions is the best way to deter the Iranians from engaging in such violations.”

But Hecker said the international community should focus on incentivizing Iran.

“The best hope is to make the civilian nuclear path so appealing – and then successful – that Tehran will not want to risk the political and economic consequences of that success by pursuing the bomb option,” he said.

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The negotiations were a diplomatic balancing act, with serious consequences for both sides of the negotiations if they failed to reach an agreement.

Iran faced the threat of military action if it continued to press forward with its nuclear program.

While Russia and China had both signaled that they were likely to abandon the sanctions regime if talks fell apart.

One of the key challenges to reaching an agreement was “finding a language that would allow both parties to declare victory”, according to Milani.

“Iran has clearly made some very substantive concessions, but Iran has also been allowed to keep enough of its infrastructure so that it can declare at least partial victory for the domestic political audience."

Now the scramble is on in Tehran to claim credit for the deal.

Reformists, led by current Iranian President Hassan Rouhani and former president Akbar Hashemi Rafsanjani, hope it will strengthen their hand as they head into the next election.

On the other side of the political spectrum, conservatives believe it could give them the edge in the battle to succeed Ayatollah Ali Khamenei as Iran’s Supreme Leader.

“They understand that whoever gets the credit for this will be in a much better position to determine the future leadership and future direction of Iran’s foreign policy,” said Milani.

It’s too early to tell what impact the agreement might have on Iran’s foreign policy, which is often at odds with U.S. interests in hot spots like Iraq, Syria, Yemen and Afghanistan. But Sagan said today’s deal was an important step in making sure that future conflicts with Iran don’t go nuclear.

“Hopefully those disagreements will be played out without the shadow of nuclear weapons hanging over the future, and that’s a good thing.”

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U.S. Secretary of State John Kerry speaks with Hossein Fereydoun, the brother of Iranian President Hassan Rouhani, and Iranian Foreign Minister Javad Zarif before announcing a historic nuclear agreement to reporters in Vienna, Austria. | U.S. State Department
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Beth Duff-Brown
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Foreign aid to the public health sectors of developing countries often appears to be allocated backwards: The global burden of non-communicable diseases such as diabetes or heart disease is enormous – yet they receive little health aid. 

By comparison, the global burden of HIV is much smaller, yet it receives more health aid than any other single disease.

So will a wholesale reversal in health aid priorities improve global health? The answer, according to a new study by Stanford researchers, is that if the goal is to maximize the health benefits from each donor dollar, health aid is actually allocated pretty well.

Still, reallocating foreign aid to step up the fight against malaria and TB could lead to greater overall health improvements in developing nations. And it could be done without spending more money, the researchers have found.

Eran Bendavid, an assistant professor in the Department of Medicine and a core faculty member at the Center for Health Policy and Center for Primary Care and Outcomes Research, and three Stanford research assistants write in the July issue of Health Affairs that more health aid is going to disease categories with more cost-effective interventions.

"What we found, somewhat to our surprise, is that in nearly all countries, more aid was flowing to finance priorities with more cost-effective options,” Bendavid said in an interview. “That is partly because more aid was flowing to the treatment and prevention of infectious diseases such as HIV and malaria, and their management can be relatively inexpensive, even if the burden of these diseases is lower than that of non-communicable diseases.”

Bendavid, an infectious disease physician, added: “Conversely, even though the burden of non-communicable diseases is high and growing, addressing these chronic conditions such as diabetes and heart disease is, broadly, more costly than the unfinished infectious disease agenda.”

The authors also show that just because health aid is broadly allocated toward better cost-effectiveness does not mean that it cannot be better allocated.

The biggest gains would come from taking some of the foreign aid earmarked for HIV or maternal, newborn or child health, and putting it toward programs to treat malaria and tuberculosis, they write.

The Stanford research team reviewed the literature for cost-effectiveness of interventions targeting five disease categories: HIV, malaria, tuberculosis, non-communicable disease and maternal, newborn and child health.

What they found was that aid from wealthy nations to developing ones might be allocated efficiently, but that the money is not always spent in the best interest of curbing the communicable diseases that would improve the overall health of a nation.

It is crucial, therefore, to further study the consequences of realignment of donor funds.

Public health aid is critical to most developing countries. Development assistance from high-income countries to public health sectors of low- and middle-income countries amounts to nearly 40 percent of public health spending in countries with a per capita GDP of less than $2,000.

The researchers focused on 20 countries that received the greatest total amount of aid between 2008 and 2011, a period of historically unprecedented growth in health aid. Development assistance has since flattened, however, so the authors believe it’s increasingly important to consider best value when investing limited resources.

The 20 countries studied ­– from Afghanistan to Zambia – received $58 billion out of the total $103.2 billion in recorded health aid disbursements to 170 countries between 2001 and 2011.

“Over the period of 2001-2011, a greater amount of disbursements flowed to HIV programs than any other disease category,” the authors write. “On average, interventions addressing malaria and had the lowest incremental cost-effectiveness ratio (ICER), which indicates that malaria interventions could yield greater health improvements from each dollar compared with the interventions having a higher ICER.”

The authors analyzed the data and determined that the alignment improves if up to 61 percent of HIV aid is reallocated for TB control and up to 80 percent is reallocated for malaria control.

“Our evidence suggests that the greatest improvements in the efficiency of global health dollars could result from reallocating funds to malaria and TB control programs,” the authors write.

“This study shows, for the first time, that the current allocation of health aid is generally aligned with the cost-effectiveness of targeted interventions. Contrary to common views that advocate for reprioritization toward non-communicable diseases, our data suggest that the alignment could best be improved by focusing on malaria and TB, especially where addressing those diseases is highly cost effective.”

The other authors of the study are Andrew Duong and Gillian Raikes, both research assistants in the Program of Human Biology; and Charlotte Sagan, a RA in the School of Medicine.

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The increasing resistance to antimicrobial drugs is a growing public health concern, particularly in low- and middle-income countries that require high out-of-pocket payments for prescription drugs.

“Understanding the drivers of antibiotic resistance in low- to middle-income countries is important for wealthier nations because antibiotic-resistant pathogens, similar to other communicable diseases, do not respect national boundaries,” said Marcella Alsan, MD, PhD, MPH, the lead author of the study, which was published July 9 in The Lancet Infectious Disease.

Alsan is an assistant professor of medicine at Stanford, an investigator at the Veterans Affairs Palo Alto Health Care System and a core faculty member at the Center for Health Policy/Center for Primary Care and Outcomes Research.

“Out-of-pocket health expenditures are a major source of health-care financing in the developing world,” said Jay Bhattacharya, MD, PhD, senior author of the study and a professor of medicine, a senior fellow at the Freeman Spogli Institute for International Studies and another core faculty member at CHP/PCOR.

 

Read the full article here.

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Yom Nob, a lab technician at Ta Sanh Health Center, Cambodia sends a text message to a new drug resistance alert system. The WHO and its partners use the alert system to map and track drug resistant cases of malaria. | The Gates Foundation
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The United Nations has thus far fulfilled its charter to prevent a third world war, but with 60 million refugees, continued bloodshed with unresolved civil conflicts and terrorism spreading like cancer, the world's leading peacekeeping organization must spearhead global action, U.N. Secretary-General Ban Ki-moon said Friday at Stanford on the 70th anniversary of the international organization.

Ban, the U.N.'s eighth secretary-general, did not rest on any laurels during his speech at a public event sponsored by the Walter H. Shorenstein Asia-Pacific Research Center (APARC). "I humbly accept criticism that the U.N. is not doing enough," he said. 

However, the situation could have been worse if not for the United Nations, he continued. "Without peacekeepers, or without the U.N.'s continued humanitarian assistance and advocacy of human rights, I'm afraid to tell you that this world would have been poorer, more dangerous and even bloodier without the United Nations."

Ban's visit to Stanford – his second to the university in less than three years – was part of a trip to the Bay Area to commemorate the signing of the U.N. charter. In 1945, representatives from 50 nations gathered in San Francisco to create the United Nations – an international organization aimed at saving future generations from the "scourge of war."

Today, the United Nations has grown to 193 member nations. Its challenges – from climate change and poverty to civil wars and terrorism – have never been greater, Ban said.

"This is a critical year; 2015 is a year of global action," he said. "The U.N. cannot do it alone. We need strong solidarity among government, business communities and civil societies, from each and every citizen."

The fact that so many young people around the globe are drawn to violent narratives is worrisome, Ban said. "Violent terrorism is spreading like cancer around the world."

The rise in terrorist activities stems from "a failure of leadership," he said. That's why the United Nations needs to develop a comprehensive plan of action to address extremism, he maintained.

The U.N.'s 70th anniversary coincidentally fell on a momentous day of tragedy and celebration around the world. Dozens were killed when terrorists launched horrific attacks across three continents – in France, Tunisia and Kuwait – fueling anger, sadness and fear of more violence.

But in the United States, celebrations rang out in response to a landmark U.S. Supreme Court ruling that legalizes same-sex marriages nationwide.

Ban, who has long advocated for equality and last year pushed the United Nations to recognize same-sex marriages of its staff, drew a round of applause when he heralded the court ruling as "a great step forward for human rights."

The June 26 event was 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

May Wong is a freelance writer for the Stanford News Service.

Coverage and related multimedia links:

Remarks at Stanford University by Ban Ki-moon (U.N. News Centre, 6/26/15)

Photos of Ban Ki-moon at Stanford University (U.N. Photo, 6/26/15)

At Stanford University, Ban says U.N. ready to build a better future for all (U.N. News Centre, 6/27/2015)

U.N. Secretary-General Ban Ki-moon welcomes growing engagement of India, China (NDTV, 6/27/2015)

U.N. Secretary-General Ban Ki-moon speaks at Stanford, celebrates U.N.'s 70th anniversary (Stanford Daily, 6/29/15)

Hoover archival photographs featured at lecture delivered by U.N. Secretary-General Ban Ki-moon (Hoover Institution, 6/29/2015)

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Ban Ki-moon, the eighth secretary-general of the United Nations, urged the audience to see 2015 as a year of global action. | UN/Mark Garten
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