The Asia Health Policy Program at Stanford’s Shorenstein Asia-Pacific Research Center, 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 soliciting papers for the third annual workshop on the economics of ageing titled Financing Longevity: The Economics of Pensions, Health Insurance, Long-term Care and Disability Insurance held at Stanford from April 24-25, 2017, and for a related special issue of the Journal of the Economics of Ageing.

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 workshop is to explore the economics of ageing from the perspective of sustainable financing for longer lives. The workshop will bring together researchers to present recent empirical and theoretical research on the economics of ageing with special (yet not exclusive) foci on the following topics:

• Public and private roles in savings and retirement security
• Living and working in an Age of Longevity: Lessons for Finance
• Defined benefit, defined contribution, and innovations in design of pension programs
• Intergenerational and equity implications of different financing mechanisms for pensions and social insurance
• The impact of population aging on health insurance financing
• Economic incentives of long-term care insurance and disability insurance systems
• Precautionary savings and social protection system generosity
• Elderly cognitive function and financial planning
• Evaluation of policies aimed at increasing health and productivity of older adults
• Population ageing and financing economic growth
• Tax policies’ implications for capital deepening and investment in human capital
• The relationship between population age structure and capital market returns
• Evidence on policies designed to address disparities – gender, ethnic/racial, inter-regional, urban/rural – in old-age support
• The political economy of reforming pension systems as well as health, long-term care and disability insurance programs

Submission for the workshop

Interested authors are invited to submit a 1-page abstract by Sept. 30, 2016, to Karen Eggleston at karene@stanford.edu. The authors of accepted abstracts will be notified by Oct. 15, 2016, and completed draft papers will be expected by April 1, 2017.

Economy-class travel and accommodation costs for one author of each accepted paper will be covered by the organizers.

Invited authors are expected to submit their paper to the Journal of the Economics of Ageing. A selection of these papers will (assuming successful completion of the review process) be published in a special issue.

Submission to the special issue

Authors (also those interested who are not attending the workshop) are invited to submit papers for the special issue in the Journal of the Economics of Ageing by Aug. 1, 2017. Submissions should be made online. Please select article type “SI Financing Longevity.”

About the Next World Program

The Next World Program is a joint initiative of Harvard University’s Program on the Global Demography of Aging, the WDA Forum, Stanford’s Asia Health Policy Program, and Fudan University’s Working Group on Comparative Ageing Societies. These institutions organize an annual workshop and a special issue in the Journal of the Economics of Ageing on an important economic theme related to ageing societies.

More information can be found in the PDF below.

Studying the microorganisms that live in our gut is a relatively new field, one that has only really taken off in the last decade. In fact, it is estimated that half of the microbes that live in and around our GI track have yet to be discovered.

“This means there is a huge amount of this dark matter within us,” said Ami S. Bhatt, an assistant professor of medicine and genetics who runs the Bhatt Lab at the Stanford School of Medicine. The lab is devoted to exploiting disease vulnerabilities by cataloguing the human microbiome, the trillions of microbes living in and on our bodies.

“I think if we fast-forward to the impact of some these findings in 10 years, we’re going to learn that modifying the microbiota is a potent way to modulate health,” Bhatt said. “Humans are not only made up of human cells, but are a complex mixture of human cells and the microbes that live within us and among us — and these microorganisms are as critical to our well-being as we are to theirs.”

Bhatt, along with key collaborators at the University of Witwatersrand in Johannesburg, and the INDEPTH research consortium, now intends to take this research to Africa.

She is this year’s winner of the of the Rosenkranz Prize for Health Care Research in Developing Countries, awarded by Stanford Health Policy to promising young Stanford researchers who are investigating ways to improve health care in developing countries.

The $100,000 prize is targeted at Stanford’s emerging researchers who are dedicated to improving health care in poorer parts of the world, but may lack the financial resources.

Bhatt, MD, PhD, intends to take the prize money to execute the first multi-country microbiome research project focused on non-communicable disease risk in Africa. The project intends to explore the relationship between the gut microbiome composition and body mass index (BMI) in patients who are either severely malnourished or obese.

“As a rapidly developing continent with extremes of resource access, Africa is simultaneously faced with challenges relating to the extremes of metabolic status,” Bhatt wrote in her Rosenkranz project proposal. The Bay Area native, who is also the director of global oncology at Stanford, came to the School of Medicine in 2014 to focus on how changes in the microbiome are associated with cancer.

In this new project, Bhatt and members of her lab will team up with colleagues in Africa, first in South Africa, and then in Ghana, Burkina Faso, and Kenya. They will leverage the infrastructure already in place at the INDEPTH Network of researchers, using an existing cohort of 12,000 patients at within those four countries. The patients have already consented to be involved in DNA testing and have given blood and urine specimens.

Identifying alterations of the microbiome that are associated with severe malnutrition or obesity could pave the way for interventions that may mitigate the severity or prevalence of these disorders, Bhatt said.

“These organisms are critical to our health in that they are in a delicate balance with one another and their human hosts,” she said. “Alterations in the microbiome are associated with various diseases — but have mostly been studied in Western populations. Unfortunately, little is known about the generalizability of these findings to low- and middle-income countries – where most of the world’s population lives.”

Bhatt said that as Africa rapidly continues to develop, the continent is simultaneous faced with challenges relating to extreme weight gain and loss. While the wealthy are facing obesity and its associated disease such as stroke, heart failure and diabetes, many people are still faced with issues related to food insecurity, hunger and malnutrition.

The research, she hopes, could lead to aggressive behavioral, dietary and lifestyle modifications targeted at maintaining healthy BMI in at-risk individuals.

Video by Ankur Bhatt

Grant Miller, an associate professor of medicine and core faculty member at Stanford Health Policy who chaired the Rosenkranz Prize committee this year, believes Bhatt’s research could eventually break new ground.

“The entire Rosenkranz Prize selection committee was highly impressed with Ami and the innovation of her project,” Miller said. “Ami’s work on the human microbiome in the extremes of nutritional status in developing countries — including its potential link to obesity, an emerging challenge in low income countries — is potentially path-breaking.”

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.

When the Soviet Union collapsed in 1991, the worry in the West was what would happen to that country’s thousands of nuclear weapons. Would “loose” nukes fall into the hands of terrorists, rogue states, criminals – and plunge the world into a nuclear nightmare?

Fortunately, scientists and technical experts in both the U.S. and the former Soviet Union rolled up their sleeves to manage and contain the nuclear problem in the dissolving Communist country.

One of the leaders in this relationship was Stanford engineering professor Siegfried Hecker, who served as a director of the Los Alamos National Laboratory before coming to Stanford as a senior fellow at the Center for International Security and Cooperation. He is a world-renowned expert in plutonium science, global threat reduction and nuclear security.

Hecker cited one 1992 meeting with Russian scientists in Moscow who were clearly concerned about the risks. In his new book, Doomed to Cooperate: How American and Russian scientists joined forces to avert some of the greatest post-Cold War nuclear dangers, Hecker quoted one Russian expert as saying, “We now need to be concerned about terrorism.”

Earning both scientific and political trust was a key, said Hecker, also a senior fellow at Stanford’s Freeman Spogli Institute for International Studies. The Russians were proud of their scientific accomplishments and highly competent in the nuclear business – and they sought to show this to the Americans scientists, who became very confident in their Russian counterparts’ technical capabilities as they learned more about their nuclear complex and toured the labs.

Economic collapse, political turmoil

But the nuclear experts faced an immense problem. The Soviets had about 39,000 nuclear weapons in their country and in Eastern Europe and about 1.5 million kilograms of plutonium and highly enriched uranium (the fuel for nuclear bombs), Hecker said. Consider that the bomb that the U.S. dropped on the Japanese city of Nagasaki in 1945 was only six kilograms of plutonium, he added. Meanwhile, the U.S. had about 25,000 nuclear weapons in the early 1990s.

Hecker and the rest of the Americans were deeply concerned about the one million-plus Russians who worked in nuclear facilities. Many faced severe financial pressure in an imploding society and thus constituted a huge potential security risk.

“The challenge that Russia faced with its economy collapsing was enormous,” he said in an interview.

The Russian scientists, Hecker said, were motivated to act responsibly because they realized the awful destruction that a single nuclear bomb could wreak. Hecker noted that one Russian scientist told him, “We arrived in the nuclear century all in one boat, and a movement by anyone will affect everyone.” Hecker noted, “Therefore, you know, we were doomed to work together to cooperate.”

All of this depended on the two governments involved easing nuclear tensions while allowing the scientists to collaborate. In short order, the scientists developed mutual respect and trust to address the loose nukes scenario.

The George H.W. Bush administration launched nuclear initiatives to put the Russian government at ease. For example, it took the nuclear weapons off U.S. Navy surface ships and some of its nuclear weapons off alert to allow the Russians to do the same. The U.S. Congress passed the Nunn-Lugar Cooperative Threat Reduction legislation, which helped fund some of the loose nuke containment efforts.

While those were positive measures, Hecker said, it was ultimately the cooperation among scientists, what they called lab-to-lab-cooperation, that allowed the two former superpower enemies to “get past the sensitivity barriers” and make “the world a safer place.”

Since the end of the Cold War, no significant nuclear event has occurred as a result of the dissolution of the Soviet Union and its nuclear complex, Hecker noted.

Lesson: cooperation counts

One lesson from it all, Hecker said, is that government policymakers need to understand that scientists and engineers can work together and make progress toward solving difficult, dangerous problems.

“We don’t want to lose the next generation from understanding what can actually be done by working together,” he said.  “So, we want to demonstrate to them, Look, this is what was done when the scientists were interested and enthusiastic and when the government gave us enough room to be able to do that.”

Hecker said this scientific cooperation extended to several thousand scientists and engineers at the Russian sites and at U.S. nuclear labs – primarily the three defense labs: Lawrence Livermore, Los Alamos, and Sandia national laboratories. Many technical exchanges and visits between scientists in Russia and the United States took place.

He recalled visiting some of the nuclear sites in Russian cities shrouded by mystery. “These cities were so secret, they didn’t even appear on Soviet maps.”

Change of threat

When the Soviet Union collapsed, the nature of the nuclear threat changed, Hecker said. The threat before was one of mutual annihilation, but now the threat changed to what would happen if nuclear assets were lost, stolen or somehow evaded the control of the government.

“From an American perspective we referred to these as the ‘four loose nuclear dangers,'” he said.

This included securing the loose nukes in the Soviet Union and Eastern Europe; preventing nuclear materials or bomb fuel from getting into the wrong hands; the human element involving the people who worked in the Soviet nuclear complex; and finally, the “loose exports” problem of someone trying to sell nuclear materials or technical components to overseas groups like terrorists or rogue nations.

For Hecker, this is not just an American story. It is about a selfless reconciliation with a longtime enemy for the greater global good, a relationship not corrupted by ideological or nationalistic differences, but one reflective of mutual interests of the highest order.

“The primary reason,” he said, “why we didn’t have a nuclear catastrophe was the Russian nuclear workers and the Russian nuclear officials. Their dedication, their professionalism, their patriotism for their country was so strong that it carried them through these times in the 1990s when they often didn’t get paid for six months at a time … The nuclear complex did its job through the most trying times. And it was a time when the U.S. government took crucial conciliatory measures with the new Russian Federation and gave us scientists the support to help make the world a safer place.”

FSI SENIOR FELLOWS FRANCIS FUKUYAMA & LARRY DIAMOND DISCUSS DEMOCRACY IN THE JULY/AUGUST ISSUE OF FOREIGN AFFAIRS

Larry Diamond and Francis Fukuyama, senior fellows at the Freeman Spogli Institute, have both written essays in the July/August 2016 issue of Foreign Affairs. Follow the links below to read the full articles without a subscription block:

Diamond, who is also the former director of the Center for Democracy, Development and the Rule of Law (CDDRL), takes stock of the global democratic recession and urges the next president to make democracy promotion a pillar of his or her foreign policy agenda in his article "Democracy in Decline."

In "American Political Decay or Renewal?" Fukuyama, the Olivier Nomellini Senior Fellow at FSI and the Mosbacher Director of CDDRL, analyzes the rising tide of populism as represented by the current candidates for the US Presidential elections.

In the July/August edition of Foreign Affairs, Larry Diamond takes stock of the global democratic recession, and urges the next president to make democracy promotion a pillar of his or her foreign policy agenda. 

Click here to read the full article. 

Stanford’s Center on Democracy, Development and the Rule of Law congratulates its undergraduate honors class for completing their original research and undergraduate theses. They graduated from Stanford University on June 12 with honors in their respective disciplines.

Graduates include Vehbi “Deger” Turan, who was awarded the Firestone Medal for his thesis entitled “Augmenting Citizen Participation in Governance through Natural Language Processing.” Turan’s project employed existing literature on democratic participation, case studies and an original algorithm in order to devise a means by which government agencies can evaluate public comments received via the Internet on political issues.

The Firestone Medal for Excellence in Undergraduate Research recognizes Stanford's top ten percent of honors theses in social science, science and engineering among the graduating senior class.

Turan decided to explore this topic shortly after joining the Fisher Family CDDRL Honors Program.

According to the program’s Director Stephen Stedman, “After listening to a research seminar at our Center, Deger believed that he could develop an aggregation tool to help policy makers understand such immense data.”

Francis Fukuyama, the Mosbacher Director of CDDRL also noted, “Deger is perhaps the best example to date of why interschool honors programs are valuable. He is a computer science major who came to us expressing an interest in using his background in artificial intelligence to help solve critical public policy problems.” Fukuyama together with Associate Professor of Political Science Justin Grimmer advised Turan on his honor’s thesis.

Turan will be starting a new position at Atomic Labs’ Zenreach start-up after graduation.

The CDDRL Award for Outstanding Thesis was given to Rehan Adamjee whose thesis explored the different factors at play in choosing between healthcare providers in a rural area of Pakistan.

Adamjee and Turan are just two members of a the 2016 cohort of 11 honors students, many of whom traveled to foreign countries to collect original data, conduct interviews and research their thesis topics. Their topics range from timely case studies on the use of social media as a tool of empowerment to a glimpse at the effects of regional politics on healthcare reform in Post-Soviet Russia.

The 2016 class joins 76 graduates from CDDRL’s honors program since its launch in 2007.

The Fisher Family CDDRL Honors Program trains Stanford students from diverse majors to write theses with global policy implications on a subject related to democracy, development and the rule of law. Students attend a class on research methods the spring quarter of their junior year. During their senior year, in tandem with the CDDRL research community and their faculty advisor, students conduct both local and international research in order to write their theses. Students travel to Washington, DC for the annual honors college to meet policymakers and members of the development community to enrich their thesis topics.

A list of our graduating students along with links to all their theses can be found below.

Meet our Class of 2017