Not many people go into farming to get rich. Low commodity prices, high operational costs and limited profit opportunities cloud the outlook. William Wrigley Professor and FSE Founding Director ROSAMOND NAYLOR gave a keynote presentation on the path toward a more profitable future at an agricultural symposium hosted by the Federal Reserve Bank of Kansas City. See slides from Naylor’s presentation here.

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Brett McGurk, the former Special Presidential Envoy for the Global Coalition to Counter ISIL, has had a busy summer. Between working on a new book contract, travelling to international security conferences on two continents and prepping for his upcoming class — “Presidential Decision-Making in Wartime” — which will be taught this fall at Stanford, the Payne Distinguished Lecturer at the Center for International Security and Cooperation sat down with the Freeman Spogli Institute to reflect on what he’s learned about Middle Eastern politics this summer.

FSI: You recently attended a number of conferences focused on international security. Tell us a little about where you’ve been and the conferences you participated in.

Sure. I was recently at a conference in Beijing sponsored by the Carnegie Foundation for International Peace that focused on China in the Middle East. This was a good opportunity to reconnect with former officials and experts on China and also to discuss with Chinese officials and academics how Beijing views its emerging role in the Middle East region. This is an important topic, and we intend to develop it further here at Stanford FSI through a combination program with CISAC and the Shorenstein Asia-Pacific Research Center. I recently published an article in the Atlantic on some of the themes from Beijing.

I also attended the Oslo Forum in Norway, which brings together top diplomats from around the world engaged in mediating the most difficult conflicts. UN envoys from Syria and Libya, for example, participate, as do leaders working on Yemen and other seemingly intractable crises. The main takeaway from that important conference was that there is a window of opportunity right now for active U.S. diplomacy to help de-escalate what are in effect proxy wars between regional powers. Libya is increasingly a conflict between long-time U.S. allies, with Turkey and Qatar on one side and UAE and Egypt on the other side. Yemen is a humanitarian catastrophe and UN mediation has opened the door to ceasefires and a path for winding down the war, which some of our key allies now support. 

Iran and extremists like al Qaeda and ISIS take advantage of proxy wars and vacuums – so it’s in our interests both from a humanitarian, geostrategic, and national security perspective to use diplomacy and other tools to end these conflicts. That was the focus of the Norway meetings.

In spectacular #Oslo today for the 2019 #OsloForum. Look forward to reconnecting with former counterparts and friends from around the globe, many trying largely on their own to mediate some of the world’s most intractable conflicts. @NorwayMFA pic.twitter.com/0DmTY7swW6

— Brett McGurk (@brett_mcgurk) June 18, 2019

To what extent did the U.S. participate in the Oslo Forum?

I was struck that the United States was largely absent. There were no U.S. officials at the Forum, for the first time as I can recall, and total lack of clarity on U.S. goals and objectives. On Syria, the top UN Envoy, Geir Pederson, attended as did a number of parties to the Syrian conflict, including from the Syrian Democratic Forces, which played a key role in defeating ISIS. 

There is some hope that Syria is approaching a stage for a meaningful political settlement; I’ve expressed some skepticism on that, again, due largely to questionable U.S. intent and commitment and the facts on the ground and in the region, which leave Washington with few good options. The sooner we acknowledge that reality the better because the situation can still get much worse. My recent article in Foreign Affairs delves into those issues in some detail.

You were at the Herzliya Conference in Israel. Did Iran’s nuclear program dominate the agenda? What else was top of mind for the conference organizers, presenters, and people in attendance?

Yes, I attended the annual security conference sponsored by Israel’s Institute for Policy and Strategy. It’s become a go-to event for assessing the direction of Middle East politics and Israeli policies in a difficult part of the world. I used to attend as a sitting official and it was great to be there as a private citizen.

Flying from San Francisco to Tel Aviv for the annual @HerzliyaConf which has become a go-to event for thinkers and practitioners on the Middle East. Look forward to reconnecting with former colleagues and new friends. @FSIStanford @CarnegieMEC pic.twitter.com/0se7WvGCG1

— Brett McGurk (@brett_mcgurk) June 28, 2019

Much of the focus this year, of course, was on Iran – but also on the internal situation inside Israel, President Donald Trump’s much-delayed Middle East peace plan, and the rift I mentioned earlier between Egypt, Saudi Arabia, and UAE on one side, with Turkey and Qatar on the other side. 

There was also an open question and significant discussion over whether current U.S. policies are worsening tensions in the region. Much of that will depend on whether the core White House assumption driving its Iran policy is correct. That assumption holds that maximum pressure against Iran will force Iran back to the negotiating table that Trump himself left and result in a better nuclear deal and more responsible Iranian behavior in the region. If that assumption is false, and Iran reacts to unilateral American pressure by forging stronger ties with China and Russia, restarting its illicit nuclear activities, and increasing its malign behavior in the region – then U.S. policy may have precisely the opposite effect than its stated intent. That would require Trump to either double down on pressure, to include military pressure, or back down from what is now a zero-sum bargaining position. 

For more on Brett McGurk’s policy recommendations on Iranian nuclear ambitions, read his Op-Ed in Bloomberg News.

On stated U.S. intent, there was also quite a bit of discussion about U.S. objectives, given that Trump says one thing and his national security team says something else, often within the same 24-hour time span.  This uncertainty, I would argue, is breeding more instability, not less.

There was an interesting “war game” conducted at the Herziliya Conference, which simulated direct negotiations between U.S. and Iranian officials. The game ended without producing an agreement. What do you make of that?

I participated in that war game. Having confronted the Iranians from the shadows and in direct face-to-face negotiations, I would say this simulation was fairly accurate and its findings important. My first conclusion was that it’s highly unlikely the Iranians are going to return to the table under the current circumstances and without some up-front concession (such as reinstating some waivers to allow limited export of oil) by the Trump administration.  Nobody likes that answer, but it’s a realistic assessment of Iranian decision-making and important if the U.S. objective is truly – as Trump says – to get back to the negotiating table for a better nuclear deal. 

I read recently that the Emir of Qatar, who visited Trump in the Oval Office in mid-July, told the president the same thing.  So even our close friends in the region have this assessment. It means, if you want to get back to the negotiating table, then you need to create a pretext with some up-front steps, to be taken both from Washington and from Tehran.  A creative package, for example, might offer some limited sanctions relief and also demand release of Americans held in Iranian prisons. Absent something like that, relying on pressure alone, there are unlikely to be any talks.

How did the simulated negotiations between the U.S. and Iran unfold?

Presuming you get to the stage of talks, which was the focus of the simulation, the position of the two sides are irreconcilable. Iran was willing to consider some amendments to the Joint Comprehensive Plan of Action – but from the U.S. side, that was insufficient. We demanded, as Secretary of State Mike Pompeo has demanded, a total abandonment of Iran’s enrichment program, defunding proxy militias throughout the region, cabining the ballistic missile program, and other measures. The talks totally broke down after a number of rounds, and risks of a conflict increased significantly. It’s better to have no talks than ill-prepared talks where the U.S. is not even clear on what it’s hoping to achieve or has demands that are known non-starters.

The only silver lining was that if the goal is a strengthened nuclear deal that truly blocks Iran’s path to a weapon in perpetuity, while allowing a civilian program, then it’s achievable. Trump has said that’s the goal. If so, there is a path. But that’s a far more limited goal than what has been discussed by his national security team. The more ambitious objectives are unlikely to be met, and without a realistic objective, the talks themselves are unlikely to get off the ground.

A more comprehensive approach for Iran: 1) Naval coalition to protect shipping; 2) On-ramp to strengthen nuke deal; 3) Diplomacy to de-escalate proxy wars; 4) Treat Iranian people as allies (end travel ban); 5) Keep focus on ISIS: don't leave Iraq/Syria. https://t.co/BBNVtbLEhn

— Brett McGurk (@brett_mcgurk) June 26, 2019

Have you participated in “war games” like this one before?

I don’t like the phrase “war game” because it suggests something trite like a game or reenactment; in fact, simulations like this are among the best tools we have to predict the future and prepare for contingencies in foreign policy. Even with all the tools and information available to a policy-maker at the most senior level, humans can’t predict the future. Well-run simulations alert you to policy adjustments that may be necessary. We used them quite a bit during the campaign to defeat ISIS and to good effect. A famous war game, SIGMA II, run out of the Pentagon in 1965 predicted perfectly what would happen if the U.S. pursued its graduated pressure campaign against North Vietnam – a quagmire that sucked in multiple U.S. divisions.

So these simulations are important. I hope the administration is conducting them on Iran, though I tend to doubt they are, at least not at the highest levels. Sound foreign policy depends on setting clear and achievable objectives, marshaling the resources for achieving them, and regularly testing assumptions to make adjustments as circumstances warrant.

I recently published an essay in Foreign Affairs on the misalignment of ends and means with respect to Trump’s foreign policies in Syria, Venezuela, and Iran. That’s generally a recipe for either a failed policy or unintended consequences that box presidents into decisions they don’t want to make: either double down on resources or ratchet back objectives.

Did you have a chance to reconnect with old friends from your many years as a U.S. diplomat in the Middle East?

I did, and I also caught up with a number of former colleagues still serving in the Trump administration. They are a dedicated group and doing all they can under difficult circumstances. I could not hide my enthusiasm for being out of Washington and out here at Stanford. Stanford is just an incredible place to think deeply and differently about the issues now confronting our nation and the world.

You start teaching in the Ford Dorsey Master’s in International Policy program in the fall quarter.  Can you tell us a bit about your course?

Sure. In the fall I will teach “Presidential Decision-Making in Wartime.” It’s a course about how the most consequential decisions – war and peace – are made in reality, particularly since 9/11. We will dive into the essential laws of strategy such as setting clear objectives, aligning ends, ways, and means, and what happens when those essential laws are ignored. I hope it will give students the tools to ask the right questions if they are ever in the Situation Room with a chance to influence the course of history for the better. 

Most debacles have this same basic flaw of ignoring what I call the iron law of strategy and alignment of ends, ways, and means. Even for students not heading towards a national security career, the tools and elements of strategic thinking are broadly applicable. 
 

The 3rd Forum on Regulatory Science and Biomedical Innovations was successfully held on June 7-8^th, 2019, at the Stanford Center at Peking University.

Initiated and organized by the Stanford Center for Innovative Study Design. The focus of this year’s forum is on the Real-World Evidence in Biomedical Product Development and Regulatory Science. About 150 international and Chinese scholars and researchers, US and Chinese regulators, and pharma/biotech leaders attended the event.

Over the last decade, significant strides have been made in medical research, which leads to great improvement in human health. With increasing availability of real-world data (RWD), such as electronic health and medical records and mobile health data, and rapidly evolving analytic techniques to generate real-world evidence (RWE) from the RWD, there are vast research interests in academia, industry, and regulatory agencies on how to use the RWE to inform regulatory decision and to assess the potential benefits and/or risks of medical products. On May 8, 2019, the US FDA published the draft guidance for industry on “Submitting Documents Using Real-World Data and Real-World Evidence to FDA for Drugs and Biologics.” On May 29, 2019, the Chinese National Medical Product Administration (NMPA) published their call for comments on the draft guidance on “Basic Considerations for Using Real-World Evidence to Support Drug Development.” Our forum was timely organized to discuss the challenges and research opportunities on the topic.

Three keynote speakers were invited, representing academia, government, and industry. Our first keynote speaker was Professor Ping-yan Chen, Chair of the Department of Biostatistics, Southern Medical University, Guangzhou, China. Professor Chen chaired development committee of tri-parties (Chinese academia, industry, and NMPA) for the Chinese draft of the guidance on RWE published on May 29, 2019. Professor Chen provided unique perspectives of their committee work and explained the considerations recommended in the guidance document. The second keynote speaker, Dr. Jing Chen, was from the Chinese NMPA on the evaluation of generic medications in China. The 3^rd keynote speaker was Dr. Donald Yin, Vice President and Head of Economic and Data Science at Merck. He shared with us the examples and insights on the use of real-world data and evidence in the pharmaceutical industry.

Two invited panel discussions on “The Challenges and Opportunities for Using RWE in Medical Produce Development and Regulatory Oversights” and “Statistical Evidence on Regulatory Decisions” were also well received.

In addition, there were six invited scientific sessions on topics from the use of historical control data in confirmative trials, challenges in regulatory evaluation of generic drugs, diagnosis test and prediction models, Use of RWE for regulatory decisions, big data and artificial intelligence in precision health, and from the real work data to real world evidence.

Several feedbacks commented that this was the highest quality academic event in recent years.

The event was co-sponsored by the Stanford Center at Peking University and Peking University Health Science Center. The event was funded in part by mProbe and Merck.

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The SCPKU summer workshop, "Chinese Corporations: A Case Study Workshop" led by Prof. Andrew Walder (Stanford) and Prof. Zheng Lu (Tsinghua) convened in Beijing on June 17^th,  2019. A diverse student body from Stanford, Tsinghua, and Peking University meet three times each week for three weeks to do research on major Chinese corporations.

The 18 student participants in the workshop have their majors in social sciences, management, history, and engineering. Each Stanford student is paired with one Chinese-speaking partner to conduct in-depth case study on two major Chinese companies of their selection.

Each group selects two corporations, one state owned or controlled, the other private or of mixed ownership. Teams investigate the company's founding and history of expansion, including any restructuring, privatization, and listing on domestic or international stock exchanges. Of particular interest are the company’s structure of ownership and control, along with its business strategies. The comparison across state and nonstate owned corporations helps to understand the transformation of the country’s economy over the past 30 years and the inner workings of the Chinese model of development.

Selected Chinese corporations in study include: Huawei and Xiaomi (in telecom equipment and electronics); Greenland Holdings and China Vanke (in real estate); Tencent and JD (in social media and e-commerce); China Merchants Group and Cosco (in finance and shipping); Tsingdao Haier and the Midea Group (in appliances).  Course information can be found here.

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PKUHSC (Peking University Health Science Center) delegation, headed by Prof. Zhan Qimin, Executive Vice President of Peking University and President of Peking University Health Science Center, visited Stanford on May 9, 2019.

Prof. Oi, director of SCPKU (Stanford Center at Peking University) hosted the event for the delegation joined by interested Stanford faculty and researchers.

SCPKU was founded in 2012 with a landmark building on PKU campus.  Over 1000 programs and events have been convened at SCPKU, Stanford has had 78 projects in 40 different departments with some components involving research or training in China, and 3,187 different Chinese co-authors have collaborated on publications with Stanford authors.

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SCPKU has fellows across campus, with the greatest number of faculty from the School of Medicine.  SCPKU will expand Stanford’s role in global education and research and enable all faculty to do research in China.

The PKUHSC delegation presented an overview of PKU Health Science Center, which gave exposure to the Stanford participants for matching their own work with the resources that PKU offered.

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A roundtable introduction/discussion followed Prof Oi’s talk between the members of the delegation and Stanford participants.  Both sides were interested in exploring further partnership in global health, life science, public health and emergency medicine.

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The delegation had a meeting with Dean of the School of Medicine, Lloyd Minor (5^th from right); Mijiza Sanchez (4^th from right), associate Dean, office of Medical Student Affairs.

The delegation also met with Prof. Mark Cullen (4^th from right), Director, Center for Population Health Sciences, Senior Associate Vice Provost for Research, Professor of Medicine, and discussed medical research and population health sciences.

Both sides agreed that a lot more could be done via the SCPKU platform in further exchange and exploration to formulate meaningful collaboration projects.

Stanford participants:   Jean Oi, director of SCPKU; Ann Hsing, research professor of medicine and a co-leader of the Population Sciences Program; Bruce Ling, professor of surgery; Hua Shan, professor of pathology; Jianghong Rao, professor of radiology; Karen Eggleston, senior fellow at FSI; Mathew Strehlow, professor of emergency medicine; Yang Hu, professor of Ophthalmology and Ying Lu, professor of biomedical data science.   PKU delegation members:  Qimin Zhan, executive vice president and president of Peking University Health Science Center; Weimin Wang, vice president of education; Ning Zhang, vice president of research; Jie Qiao, president, Peking University Third Hospital and director of National Clinical Research Center; Xiaojun Huang, director, institute of hematology; Qiudan Sun, director, office of International Cooperation of Peking University Health Science Center.