“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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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

Rigorous inspections, no cheating and continued talking can help generate a successful U.S.-Iranian nuclear deal, Stanford faculty experts say.

But the United States and the world community need to convince Iran it has more to lose than to gain from building a nuclear bomb, according to Siegfried Hecker, a research professor in the Department of Management Science and Engineering and a senior fellow at the Freeman Spogli Institute for International Studies.

On April 2, the United States, Iran and five other world powers agreed on "key parameters" for resolving a long-standing dispute over Iran's nuclear program. Aimed at curbing Iran's nuclear program in exchange for lifting of financial sanctions, the broad agreement charts the course for a possible final, detailed agreement by June 30.

Hecker said that even though Iran has already put in place all the requisite technical capabilities to build the bomb, it has not yet decided to exercise the option to build one.

The problem, he said, is that it takes rather small quantities of bomb fuel, highly enriched uranium or plutonium, to build a bomb, whereas commercial nuclear power production requires huge amounts of uranium and large enrichment capacity.

"In other words, even a small production capacity is useful for bombs, whereas large capacities are required for electricity. Hence, it is all but impossible to prevent Iran from reconstituting the capabilities to build the bomb should it decide to break the agreement," he wrote in an article for the Bulletin of Atomic Scientists.

Hecker said it is important is to have Iran agree to an "intrusive inspection and verification regime" so the international community can respond quickly should Iran "break out" with a nuclear weapon.

"Breakout time" measures the amount of time to build a nuclear weapon – the United States wants a year, while some say Iran is within a few months. It has been a key sticking point between Western and Iranian negotiators.

"There are lessons to be learned from what happened in North Korea – it 'broke out' in 2003, and the U.S. and international community did not respond adequately. Consequently, North Korea not only has the bomb today, but a rapidly growing nuclear arsenal," said Hecker, who recently wrote about the North Korean situation.

Hecker is an expert in plutonium science, global threat reduction and nuclear security who served as the director of the Los Alamos National Laboratory, where the first atomic bomb was created in 1945.

From a purely economic and technical standpoint, he said there is no need for Iran to have any enrichment capability or to build the type of reactor they chose for medical isotope production in their Arak facility.

"The enrichment services are readily available to Iran in the international market. However, insisting on zero enrichment or no centrifuges shatters Iran's pride and questions why the regime has spent billions of dollars pursuing what is really not needed to have civilian nuclear energy," he said.

The key objective for the next few years, he said, should the deal be formalized, is to convince Iran that it has "more to gain from keeping its end of the bargain than it would lose by exercising its hedge."

Inspections critical

Allen Weiner, director of the Stanford Program in International and Comparative Law and a senior lecturer at Stanford Law School, said the robustness of the inspection process and whether Iran decides to cheat are two big factors.

"If we stop and think about where we are starting from, it certainly seems that the agreed arrangement can't hurt. Without the agreement, if Iran concludes that it wishes to build nuclear weapons, it is doubtful that international actions can stop that," he said.

Weiner points out that Iran has weathered sanctions for nearly a decade and has continued to move closer to "breakout" capability. "Given that backdrop, the framework arrangement has the potential to help," he said.

If Iran's nuclear program spurs similar ones among its neighbors, the outlook is dire, said Weiner, a former U.S. State Department lawyer.

"A Middle East region with multiple nuclear-armed states would be a very dangerous place. The risk of nuclear confrontation would grow under such circumstances," he said, noting the especially acute tensions now between Shiite states like Iran and Sunni ones like Saudi Arabia and Egypt.

Weiner noted, "The greatest danger if multiple states in the region acquire nuclear weapons may be miscalculations or mistakes leading to the use of a nuclear weapon."

The length of the breakout period for Iran between a decision to build nuclear weapons and its ability to actually assemble such a weapon is seen as critical, according to Weiner: "That window presumably provides time for the international community to develop a response."

As for sticking points, for the United States the acceptance of the basic idea that Iran would retain a uranium enrichment capability was difficult, "although it was a pill the U.S. swallowed early in the negotiations," Weiner said.

Once the United States had agreed to this, it had to accept the risk of Iranian breakout, which makes the ultimate deal dependent on Iran's good faith, he said.

"It creates the grave fear that even if the agreement works, we are merely kicking the Iranian nuclear crisis down the road for 10 years," due to the time limits under the arrangement on the restrictions on the number of centrifuges that Iran may operate to enrich uranium, Weiner said.

For Iran, it was difficult to accept the reality that not all sanctions would be immediately lifted, he added. The country says it is only trying to exercise its rights to operate a peaceful civilian nuclear power program.

"Iran feels that it has accepted both substantive restrictions on its nuclear program and an intensive inspection regime that do not apply to other Nuclear Nonproliferation Treaty states, and that it should not continue to be singled out for sanctions, even partial ones, in order to earn the trust of the international community," he said.

Finally, the road ahead will be exceedingly difficult due to internal politics in both countries. Abbas Milani, the director of Iranian studies at Stanford and co-director of the Iran Democracy Project at the Hoover Institution, offers this perspective:

"While the people of Iran are rejoicing at what they think is a new beginning, and while Iranian President Hassan Rouhani and his men are congratulating Iran for its 'victory,' the conservative press has been blasting the agreement as defeatist and accusing the U.S. of publishing a faulty version of the agreement. In short, it is a happy moment, but a final resolution is yet to come."