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Pandemics are a growing health concern in the United States and abroad. But as global health specialists are ramping up efforts to prevent them, funding may be slipping away.

President Trump's proposed budget would eliminate the National Institutes of Health's Fogarty International Center, a key player in the fight against diseases worldwide.

According to a USA Today column by Michele Barry, Director of the Center for Innovation in Global Health and a Stanford Health Policy affiliate, and David Yach, a former cabinet director at the World Health Organization, Fogarty's global health research benefits the United States along with other countries. The center has produced insights into Alzheimer's research, is looking into the genetics of obesity and diabetes, and has started developing early warning systems for pandemics.

But its most important accomplishment, according to Barry and Yach, is training scientists in more than 100 low- and middle-income countries. These experts have emerged as leaders in their own countries and around the world.

Their contributions have not only improved health but have influenced the World Health Organization and leading global health donors.

Said Barry and Yach, "To eliminate the Fogarty Center now would undermine progress, erode trust in America’s leadership in global health, and increase the risk of a devastating and preventable epidemic in the U.S. Keeping Fogarty would preserve health, both of Americans and populations all over the world."

Read the full article.

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Professor Tetsuji Okazaki will present his research which examines the difference between the regime transition phase and consolidation phase, dividing government elites into the pre-Meiji-Restoration-born group and the post-Meiji-Restoration-born group. Using the newly constructed government elites’ data after the Meiji Restoration in Japan, his research shows that reformers’ strategies to recruit government elites and establish a new intra-elite hierarchy changed from the regime transition phase to its consolidation phase. Initially, in order to contend against the incumbent elites, reformers recruited talented activists from the non-elite strata and assigned them to higher-level positions based on their abilities. On achieving a transfer of power, however, reformers’ primary concern shifted to alleviating the dissatisfaction of the masses and the former elites. Therefore, while the barrier preventing access to the elite group keep lowering, which opened the way for non-elites to gain elite status, former elites are reintegrated into the elite group and the intra-elite hierarchy again comes to reflect the social stratum of the former regime.

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Tetsuji Okazaki is Professor of Economics at the University of Tokyo. He has been the President of International Economic History Association (IEHA) since 2015. His recent publications include “The expanding empire and spatial distribution of economic activities: The case of Japan’s colonization of Korea during the pre-war period” (with Kentaro Nakajima) forthcoming in Economic History Review, 2017, “Measuring the extent and implications of corporate political connections in prewar Japan” (with Michiru Sawada) forthcoming in Explorations in Economic History, 2017, and “Acquisitions, productivity, and profitability: Evidence from the Japanese cotton spinning industry” (with Serguey, Braguinsky, Atsushi Ohyama,and Chad Syverson) American Economic Review, 105(7): 2086-2119, 2015

Tetsuji Okazaki Professor of Economics, University of Tokyo
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Senior Research Scholar, Columbia University’s School for International and Public Affairs
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Jason Healey is a Senior Research Scholar and adjunct faculty at Columbia University’s School for International and Public Affairs specializing in cyber conflict, competition and cooperation. Prior to this, he was the founding director of the Cyber Statecraft Initiative of the Atlantic Council where he remains a Senior Fellow.  He is the author of dozens of published articles and the editor of the first history of conflict in cyberspace, A Fierce Domain: Cyber Conflict, 1986 to 2012.  A frequent speaker on these issues, he is rated as a “top-rated” speaker for the RSA Conference and won the inaugural “Best of Briefing Award” at Black Hat.

During his time in the White House, he was a director for cyber policy and helped advise the President and coordinate US efforts to secure US cyberspace and critical infrastructure.  He created the first cyber incident response team for Goldman Sachs and later oversaw the bank’s crisis management and business continuity in Hong Kong.  He has been vice chairman of the FS-ISAC (the information sharing and security organization for the finance sector) and started his career as a US Air Force intelligence officer with jobs at the Pentagon and National Security Agency.  Jason was a founding member (plankowner) of the first cyber command in the world, the Joint Task Force for Computer Network Defense, in 1998, where he was one of the early pioneers of cyber threat intelligence.

He is on the Defense Science Board task force on cyber deterrence and is a frequent speaker at the main hacker and security conferences, including Black Hat, RSA, and DEF CON, for which he is also on the review board.  He is president of the Cyber Conflict Studies Association, and has been adjunct faculty at NSA’s National Cryptologic School, Georgetown University and Johns Hopkins School of Advanced International Studies. 

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When a state is “shamed” by outsiders for perceived injustices, it often proves counterproductive, resulting in worse behavior and civil rights violations, a Stanford researcher has found.

Rochelle Terman, a political scientist and postdoctoral fellow at Stanford’s Center for International Security and Cooperation (CISAC), recently spoke about how countries criticized by outsiders on issues like human rights typically respond -- and it's contrary to conventional wisdom. Terman has published findings, “The Relational Politics of Shame: Evidence from the Universal Periodic Review,” on this topic in the Review of International Organizations. She discussed her research in the interview below:

What does your research show about state "shaming"?

Shaming is a ubiquitous strategy to promote international human rights. A key contention in the literature on international norms is that transnational advocacy networks can pressure states into adopting international norms by shaming them – condemning violations and urging reform. The idea is that shaming undermines a state’s legitimacy, which then incentivizes elites into complying with international norms.

In contrast, my work shows that shaming can be counterproductive, encouraging leaders in the target state to persist or “double down” on violations. That is because shaming is seen as illegitimate foreign intervention that threatens a state’s sovereignty and independence.  When viewed in this light, leaders are rewarded for standing up to such pressure and defending the nation against perceived domination. Meanwhile, leaders who “give in” have their political legitimacy undermined at home. The result is that violations tend to persist or even exacerbate.

When and where does it work better to directly confront a country’s leadership about such injustices?

At least two factors moderate the effects of international shaming. The first is the degree to which the norm being promoted is shared between the “shamer” and the target. For instance, the West may shame Uganda or Nigeria for violating LGBT rights. But if Uganda and Nigeria do not accept the “LGBT rights” norm, and refuse to accept that homophobia constitutes bad behavior, then shaming will fail. In this case, it is more likely that shaming will be viewed as illegitimate meddling by foreign powers, and will be met with indignation and defiance.

Second, shaming is quintessentially a relational process. Insofar as it is successful, shaming persuades actors to voluntary change their behavior in order to maintain valued social relationships. In the absence of such relationship, shaming will fail. This is especially so when pressure emanates from a current or historical geopolitical adversary. In this later scenario, not only will shaming fail to work, it will likely provoke defensive hostility and defiance, having a counterproductive effect.

Combing these insights, we can say that shaming is most likely to work under two conditions: when the target is a strong ally, and the norm is shared.

What are some well-known cases where "shaming" backfired?

The main example I use in my forthcoming paper is on the infamous “anti-homosexuality bill” in Uganda. When Uganda introduced the legislation in 2009 (which in some versions applied capital punishment to offenders) it provoked harsh condemnation among its foreign allies, especially in the West. Western donor countries even suspended aid in attempt to push Yoweri Musaveni’s government to abandon the bill. According to conventional accounts, the onslaught of foreign shaming, coupled with the threat of aid cuts and other material sanctions, should have worked best in the Uganda case.

And yet what we saw was the opposite. The wave of international attention provoked an outraged and defiant reaction among the Ugandan population, turning the bill into a symbol of national sovereignty and self-determination in the face of abusive Western bullying. This reaction energized Ugandan elites to champion the bill in order to reap the political rewards at home. Indeed, the bill was the first to pass unanimously in the Ugandan legislature since the end of military rule in 1999. Museveni – who by all accounts preferred a more moderate solution to the crisis – was backed into a corner.

A Foreign Policy story quoted Ugandan journalist Andrew Mwenda as saying, “the mere fact that Obama threatened Museveni publicly is the very reason he chose to go ahead and sign the bill.” And Museveni did so in a particularly defiant fashion, “with the full witness of the international media to demonstrate Uganda’s independence in the face of Western pressure and provocation.”

Uganda anti-homosexuality law was finally quashed by its constitutional court, which ruled the act invalid because it was not passed with the required quorum. By dismissing the law on procedural grounds, Museveni – widely thought to have control over the court – was able to kill the legislation “without appearing to cave in to foreign pressure.” But by that time, defiance had already transformed Uganda’s normative order, entrenching homophobia into its national identity.

Does this 'doubling down' effect vary in domestic or international contexts?

Probably. States with a significant populist contingent, for instance, are especially hostile to international pressure, especially when it emanates from a historical adversary, like a former colonial power. Ironically, democracies may also be more susceptible to defiance, because elites are more beholden to their constituents, and thus are less able to “give in” to foreign pressure without undermining their own political power. 

The international context matters a great deal as well. States are more likely to resist certain norms if they have allies who feel the same way. For instance, we see significant polarization around LGBT rights at the international level, with most states in Africa and the Muslim world voting against resolutions that push LGBT rights forward. South Africa – originally a pioneer for LGBT rights – has changed its position following criticism from its regional neighbors. 

Does elite reaction drive this response to state "shaming?"

To be quite honest, this is a question I’m still exploring and I don’t have a very clear answer. My hunch at the moment is no. The “defiant” reaction occurs mainly at the level of public audiences, which then incentives elites to violate norms for political gain.  These audiences can be at either the domestic or international level. For instance, if domestic constituents are indignant by foreign shaming, elites are incentivized to “double down,” or at least remain silent, lest they undermine their own political legitimacy.

That said, elites can also strategize and manipulate these expected public reactions for their own political purposes. For instance, if Vladimir Putin knows that the Russian public will grow indignant following Western shaming, he might strategically promote a law that he knows will provoke such a reaction in order to benefit from the ensuing conflict. This is what likely occurred with Russia’s “anti-gay propaganda” law, which (unsurprisingly) provoked harsh condemnation from the West and probably bolstered Putin’s domestic popularity.

Any other important points to highlight?

One important point I’d like to highlight is the long-term effects of defiance. In an effort to resist international pressure, states take action that, in the long term, work to internalize oppositional norms in their national identity. In this way, shaming actually produces deviance, not the other way around.

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

MEDIA CONTACTS:

Rochelle Terman, Center for International Security and Cooperation: (650) 721-1378, rterman@stanford.edu,

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

 
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Protestors march to the United Nations building during International Human Rights Day in 2012 in New York City. Activists then called for immediate action by the UN and world governments to pressure China to loosen its control over Tibet -- a form of "state shaming," as examined by CISAC fellow Rochelle Terman in her research. | Steve Platt/Getty Images
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Expected dramatic shifts of foreign policy by leading democracies, including the U.S. and U.K., would shake a future of liberal international order, which has underpinned the stability even after the end of the Cold War. Since Mr. Donald Trump was elected as the 45th President of the U.S., abovementioned discourse is heard everywhere in Europe and Asia today.

It is not clear, if American leadership and military presence would in fact retreat, how American allies behave and whether they can work together to sustain the order. Among others, Japan has been the exceptionally strong believer of such postwar American leadership. It is doubtful that all American allies and friends share same views, having their own historical context with the U.S. and own ideas on order and principles. Hence, naturally they shall differ in losing the confidence on the durability of American leadership.

A new order will be shaped by many factors, but American allies’ perspectives should not be overlooked. Hegemon’s own reluctance for ruling is surely significant. So is other great power’s revisionism, making use of such strategic opportunities. However, American allies has the potential to shape the fate of the order: if they succeed in acting collectively, it shall underpin the global governance for a while, and ensue the order transformation process in rather slow and peaceful pace. 

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If they fail, it shall not only accelerate the U.S. retrenchment, but invite an emergence of divisive and competitive order. Sahashi shares the findings from the international study project which he leads, and argues the difficulty for US allies to unite themselves and the potential order transformation in the long term.

Ryo Sahashi is Associate Professor of International Politics and Director, Faculty of Law, Kanagawa University, Yokohama, and is leading the newly-launched international joint study “Worldviews on the United States.” From 2014-2015, he served as Visiting Associate Professor, Shorenstein APARC, Stanford University.

 

Ryo Sahashi Associate Professor, Kanagawa University
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Co-sponsored by the Center on Democracy, Development, and the Rule of Law and the Southeast Asia Program
 
The Philippines is typically characterized as a weak, even patrimonial, state in which powerful oligarchs and political families dominate politics and policymaking.  By implication, the elite should be able to easily suppress reform and the state should be unwilling or incapable of carrying out reforms.   Yet some efforts to achieve socioeconomic and governance reform have succeeded.  How and why is this the case?  And what does this suggest about the changing nature of the Philippine state?

This presentation will examine the dynamics and outcomes of three extended efforts at social, economic and governance reform in the Philippines:  1) agrarian reform; 2) liberalization of the telecommunications sector and 3) fiscal and budget reforms.

Theory and practice will be bridged in an examination of interlinked factors including the autonomy and capacity of the state, the limits on reform imposed by elite-dominated democracy, and the conditions and strategies that have enabled some reforms to succeed.
Particular questions to be addressed will include:
·       What are the political and institutional barriers to reform in the Philippines?  How have these changed over time?
·       How have these barriers been overcome in the cases of “successful” reform?  What does “successful” mean?  
·       How have attempts at reform strengthened or weakened the state?
·       Looking forward, will the typically partial or incremental character of reform result in transformational change, or deflect it?

David Timberman is a political analyst and development practitioner with 30 years of experience analyzing and addressing political, governance and conflict-related challenges, principally in Southeast and South Asia.  As a Visiting Scholar at Stanford/APARC he is working on a book on the contemporary Philippine political economy.  During 2015-2016 he was a Visiting Professor of Political Science at De La Salle University in Manila. He has lived and worked in the Philippines, Indonesia and Singapore, including experiencing first-hand the democratic transitions in the Philippines (1986-1988) and Indonesia (1998-2001). He has written extensively on political and governance issues in the Philippines and has edited or co-edited multi-author volumes on the Philippines, Cambodia, and economic policy reform in Southeast Asia.

David G. Timberman 2016-2017 Lee Kong Chian NUS-Stanford Fellow on Contemporary Southeast Asia
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Dr. Sayuri SHIRAI is currently a professor of Keio University and is also a visiting scholar at the Asian Development Bank Institute. She was a Member of the Policy Board of the Bank of Japan (BOJ) from April 2011 to March 2016, who is responsible for making policy decisions. She also taught at Sciences Po in Paris in 2007–2008 and was an economist at the International Monetary Fund (IMF) from 1993 to 1998.

She is the author of numerous books on a variety of subjects including the People’s Republic of China’s exchange rate system, Japan’s macroeconomic policy, IMF policy, and the European debt crisis. Her most recent book (translated title: Unwinding Super-Easy Monetary Policy), published in August 2016, is about the monetary policies of the BOJ, the European Central Bank, and the Federal Reserve System. She regularly appears on CNBC, Bloomberg, Reuters, BBC, and features in many Japanese TV programs and newspapers, commenting on the Japanese economy and monetary policy. URL: http://www.sayurishirai.jp

Her most recent book in English is Mission Incomplete: Reflating Japan’s Economy published by the Asian Development Bank Institute in February 2017. It is a complete analysis of BOJ’s unconventional monetary easing from the late 1990s to the present. Free Download is available at https://www.adb.org/publications/mission-incomplete-reflating-japan-economy.

Sayuri Shirai Professor at Keio University and Visiting Scholar at Asian Development Bank Institute
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Speakers:  

Stefan Ma & Zheng Li Yau (Ministry of Health, Singapore)

Chao Quan (University of Hong Kong)

Wankyo Chung (Seoul National University)

Karen Eggleston & Katherine Hastings (Stanford University)

Hai Fang (Peking University)

Min Yu & Haibin Wu (Zhejiang CDC)

Jianqun Dong (China CDC)

As the demographic and epidemiological transitions continue to unfold into the second and third decades of the 21st century, health systems face the challenge of how best to promote healthy ageing, including reducing the complications associated with complex chronic diseases like diabetes. About 80% of people with diabetes live in low-to-middle income countries, with the largest increase in absolute numbers in East and South Asia.

This colloquium showcases research from an international collaboration studying “value for money” in controlling chronic disease, focusing on the case of diabetes. Presenters from ministries of health and distinguished universities throughout East Asia will provide brief summaries of the policy challenges their health systems face and how we are together assessing net value of diabetes management in the diverse institutional contexts of Beijing, Zhejiang, Hong Kong, Taiwan, Singapore, Japan, Korea, the US, and the Netherlands. 

RSVP required. To register, please email Lisa Lee (llee888@stanford.edu) or call Sanjiu Zhang (86-10-62744163). 

International Comparison of Net Value in Diabetes Management
Download pdf

Stanford Center at Peking University

Lee Jung Sen Building, Peking University

Beijing, China

 

Panel Discussions
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Abstract:

One policy option for countries reliant on natural resources is to share part of the revenues directly with citizens, an idea known as oil to cash. Technological innovation, such as biometric identification and mobile money, now allow direct payments to people on a massive scale. Additional changes in the global marketplace, experiments in India and Kenya, and shifting political views of cash transfers have all affected the potential of cash to boost governance.

 

Speaker Bio:

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Todd Moss is senior fellow at the Center for Global Development in Washington DC and nonresident scholar at the Center for Energy Studies at Rice University’s Baker Institute. A former Deputy Assistant Secretary of State, Moss is the author of Oil to Cash: Fighting the Resource Curse with Cash Transfers and The Golden Hour, a diplomatic thriller set in West Africa.

Todd Moss Senior fellow at the Center for Global Development in Washington DC
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The Asia Health Policy Program at Stanford’s Shorenstein Asia-Pacific Research Center (APARC), in collaboration with scholars from Stanford Health Policy's Center on Demography and Economics of Health and Aging, the Stanford Institute for Economic Policy Research, and the Next World Program, is holding its third annual conference on the economics of ageing. The conference is one of several activities planned in 2017 to mark the 10th anniversary of the Asia Health Policy Program.

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

The objective of the conference is to explore the economics of ageing from the perspective of sustainable financing for longer lives. The conference will bring together researchers to present recent empirical and theoretical research on a range of topics in this area.

The first full day of the conference – April 24 – is open to the public. The lunchtime keynote speech on the second day of the conference – April 25 – is also open to the public; the remaining portions of that day are reserved for panelists only to encourage candid conversation in a closed-door setting.

Conference Agenda

April 24

7:45                             Breakfast

8:25                             Welcome         Gi-Wook Shin, Stanford University

                                                           Karen Eggleston, Stanford University

 

Session I: Long-term Care and Intergenerational Support

Chair: Gopi Shah Goda, Stanford University

8:30 – 9:30                   “Housing Assets and Access to Long Term Care Services and Supports: Evidence from the Housing Bubble Burst”

                                                            Richard Frank, Harvard University

                                                            Discussant: Tom Davidoff, University of British Columbia

9:30 – 10:30               “The Demand for Long-Term Care Insurance in Canada”

                                                            Pierre-Carl Michaud, HEC Montréal and RAND

                                                            Discussant: Chris Tonetti, Stanford Graduate School of Business

10:30 – 10:45              Coffee break

10:45 – 11:45             “The Price of the East Asian Miracle: Generational Cultural Shift and Elderly Suicide”

                                                            Hyejin Ku, University College London

                                                            Discussant: Hongbin Li, Tsinghua University and Stanford University

Session II:

Co-Chairs: John Shoven and Karen Eggleston, Stanford University

11:45 – 13:45              Lunch

Keynote panel: "The policy challenges of financing longevity: Perspectives from Japan and the US"

Hirotaka Unami, Senior Director for Policy Planning and Research, Minister's Secretariat, Ministry of Finance, Japan

Olivia S. Mitchell, International Foundation of Employee Benefit Plans Professor, as well as Professor of Insurance/Risk Management and Business Economics/Policy, Wharton School, University of Pennsylvania

Session III: Financial Planning and Health

Chair: David Canning, Harvard University

14:00 – 15:00              “Cognitive Decline and Household Financial Outcomes at Older Ages”

                                                            Marco Angrisani, University of Southern California

                                                            Discussant: Kathleen McGarry, UCLA

15:00 – 15:15              Break

15:15 – 16:15             “From Compression to Expansion of Morbidity: Upcoming Challenges for Health Care and Long Term Care in China”

                                                            Bei Lu, University of New South Wales

                        Discussant: Wang Feng, Fudan University and UC Irvine

16:40                           Closing

 

Apri1 25

11:45 – 13:00              Lunch

                                    Policy challenges of financing longevity: Perspectives from Singapore

Kelvin Bryan Tan, Ministry of Health, Singapore

 

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