The results show that the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19. Study participants with chronic conditions faced significant challenges in managing their symptoms during the pandemic. They experienced a loss of income and difficulties in accessing healthcare or medications, with the resulting delayed and foregone care leading to uncertain longer-term effects. For a nontrivial portion of participants, these factors are associated with the worsening of diabetes symptoms. The threat is twofold among people living in rural populations with limited access, availability, and affordability of healthcare services.

A Global Health Priority

The unintended adverse consequences of the COVID-19 pandemic on chronic disease care may also further aggravate inequality in health outcomes. “If the trend continues and no immediate actions are taken to mitigate pandemic impacts,” Eggleston and her colleagues caution, then “the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal (SDG) target 3.4 to reduce premature mortality from non-communicable diseases by a third relative to 2015 levels and to promote mental health and wellbeing.”

Addressing the pandemic’s unintended negative social and economic impacts on chronic disease care is a global health priority, determine the researchers. They propose several measures to help provide timely care for people with chronic conditions in resource-constrained settings. These include implementing innovations in healthcare delivery models to improve the adoption of healthy lifestyle changes and self-management of chronic disease and mild COVID-19 symptoms, increasing investment in interventions to provide social and economic support to disadvantaged populations, and strengthening primary healthcare infrastructure and support of healthcare providers.

The study was supported in part by funding from Shorenstein APARC’s faculty research award, Stanford King Center for Global Development, and a seed grant from the Stanford Center for Asian Health Research and Education.

My summer internship experience at the Asia Society Policy Institute (ASPI) was remote due to the pandemic. It was nonetheless a memorable experience as I got to explore cybersecurity issues around Southeast Asia. ASPI is a think-tank under the umbrella of the Asia Society family, which aims to explain the diversity of Asia to the United States and the complexity of the United States to Asia. It heightens understanding between the two regions and tackles major policy challenges confronting the Asia-Pacific in security, prosperity, and sustainability by providing solution-oriented recommendations and ideas for such challenges.

At Asia Society Policy Institute (ASPI), I delved into policies and developments around the data privacy issue in Malaysia, Indonesia, Vietnam, Thailand, and Singapore. I learned how these countries bring up policies and collaborate bilaterally, regionally, and globally to tackle problems around cybersecurity. My summer internship experience also enriched my knowledge and understanding of the world.

Working at ASPI

The internship started in June 2021, around the end of the spring quarter, and continued through the end of summer. There were a total of four interns in the Washington D.C. office. I mainly worked with a small team of three - Elina, my supervisor, Chris, my co-intern, and I - which focused on cybersecurity issues.

My supervisor, Elina Noor, an inspiring expert in cyberspace, especially in the Southeast Asia region, led the team with great insights and leadership. Along with my co-intern, Chris, we spent the entire three months working on a project that studies Ethical Artificial Intelligence (AI) and Data for Inclusive Development in Southeast Asia. The project itself is expected to continue for a year, and we were in the early stages of the project. 

As a security research intern, I collected data and assisted the research. Additionally, I focused on building-up fundamental understanding of the project - determining the stages of development each country is in, how they respond to the global trend and issues, and what criteria need to be included in analyzing the different characteristics of each country, considering both the local context and the global trend. In the next nine months, the project will survey countries’ positions on these issues, assess the importance and impact of the topic, and highlight the significance of engaging in international developments. I am excited for the final product to come forth, a collaborative work of all people involved in this project.

Other responsibilities also came along the way. I had the opportunity to find the correlation between the South China Sea dispute and cyber incidents between the countries claiming sovereignty over the region. These incidents are ambiguous to identify, and the attribution is not always clear. It was also challenging to make a data set from scratch as it was a whole new experience. However, I managed to conclude that cyber incidents spiked around the time of the major disputes around the South China Sea. No secret that the Global Economy class taught by Professor Aturupane from Fall 2020-21 helped me make sense of the data set and read graphs!

The interns in the New York and Washington D.C. office took turns doing daily press scans, following up with news from the Northeast to the Middle East. It was amazing to learn how Asia, as one big continent, held such a diverse set of news and events occurring each day. I also accumulated lists of people in congress, embassies, and the government to share the op-eds from ASPI. Most of these administrative works were done as a team effort, and I met a larger ASPI family through the experience.

Ending My Internship

Working at ASPI was a rewarding way to spend my summer. I owe special thanks to Elina and Chris, who were incredibly supportive and made me feel like I was making a significant contribution to the institution. I was also rewarded with knowledge and insights into new topics in Asia and its relations with the world, mainly focusing on the U.S. It provided great insight into the developments of cybersecurity issues and data privacy around Southeast Asian countries. It was a fantastic opportunity to apply what I learned at Stanford to real-world policy problems. I thoroughly enjoyed my internship this summer and feel ready to embark on new challenges that will come forth in my career path.

Vice President Kamala Harris traveled to Hanoi on Tuesday, August 24, as part of a high-stakes visit to Southeast Asia this week that aims to bolster economic and security ties with U.S. partners in Singapore and Vietnam. Ms. Harris is the first U.S. Vice President to visit Vietnam.

Vietnamese online newspaper VnExpress spoke with APARC Southeast Asia Program Director Donald K. Emmerson about the significance of Harris’ visit. The following is an expanded version of the interview.  

VnExpress: What does the visit mean to the United States, to Vietnam, and to the U.S.-Vietnam relationship?

Emmerson: U.S.-Vietnam relations have steadily and markedly improved in recent years, especially in the security realm. A case in point is the recent visit of the U.S. secretary of defense. The first-ever visit to Hanoi by a sitting American vice-president, Kamala Harris, is meant to further strengthen U.S.-Vietnam relations. Their importance will be underscored by Kamala Harris’s status in the U.S. government, second only to President Biden’s. Their scope will be advanced by the prominence of nonmilitary topics on her agenda.

The two governments have agreed to call their relations “comprehensive.” By attending to economic and social cooperation as well as security matters, the visit will better illustrate that inclusive label. It is even possible that the United States and Vietnam could, in the not too distant future, upgrade their relationship by calling it not only “comprehensive” but “strategic” as well.

VnExpress: In Hanoi, Harris will launch the U.S. Centers for Disease Control and Prevention regional office in Southeast Asia. Why did the United States choose Vietnam for the CDC regional office? And what is your assessment of the Vietnam-U.S. medical cooperation, particularly during the COVID-19 pandemic?

Emmerson: In the realm of health, Vietnam offers a record of achievement and challenge. Based on official statistics, Vietnam appears to have countered the virus more effectively than most Asian countries. Yet it still needs to deal more thoroughly with the consumption of wildlife sold in wet markets where future viruses can bridge the gap from animals to people. COVID-19, which began in neighboring China, has killed nearly 4.5 million people worldwide and worsened the lives of almost everyone on the planet. A regional office of the US Centers for Disease Control and Prevention in Vietnam could reduce the threat of future pandemics while helping to strengthen health systems and policies throughout Southeast Asia.  

VnExpress: What do you think about Vietnam's role in the region and in the world?

Emmerson: Nearly five decades have passed since the end of Vietnam’s successful “Resistance War against America” in 1975 and the failure of China’s invasion of Vietnam in 1979. The challenge for Vietnam going forward will be to maintain the resilience and autonomy that it has earned at such a high cost in lost lives. Kamala Harris’s visit can contribute to that goal. If and as inter-state peace continues to prevail in East Asia, one can also hope that Vietnam’s leaders will feel less threatened and thus possibly less obliged to curtail the rights and freedoms of their own people.  

As for Vietnam’s role in the region (and, indirectly, the world), one priority could be for Hanoi to coordinate its policies on the South China Sea with those of other Southeast Asian claimant states and possibly with other states who use the sea and also oppose China’s campaign to control its waters.

1. Can you give us an overview of your research and the topics you’re investigating?

My research addresses the following question: Why are some authoritarian regimes more responsive to social unrest than others? While it might seem counterintuitive to think of authoritarian regimes in this light, repression and responsiveness often occur in tandem under authoritarian rule. Centered on a comparison between Vietnam and China, I document the steps that each has taken to address social discontent fueled by pervasive government seizures of rural land. In response to societal input between 2003 and 2017, Vietnam enacted comprehensive and programmatic reforms to reduce the permissible scope for government land expropriation whereas those enacted by China were relatively marginal and piecemeal. At the subnational level, this difference has had important implications for land rights and the security of villagers in both countries. In summary, despite their many similarities, the manner and degree of their responsiveness have varied. My research then traces the historical origins that undergird the political development and institutional character of Vietnam and China’s divergent responsiveness to social unrest. 

2. How did you first become interested in these topics?

My interest in the repressive-responsive character of authoritarian regimes stems from my preoccupation with questions of political legitimacy, societal resistance, and institutional dynamics in authoritarian contexts. One particular experience that stoked my interest was my visit to Wukan, Guangdong in 2016. Wukan was once hailed as an emblematic case of grassroots democracy and accommodation by the Chinese state, when villagers’ outcries against the local government’s seizure of their land resulted in the re-election of the village committee in 2012. Yet, when I visited in 2016, villagers expressed that nothing had changed, and that “everything that could be done has already been done.” This experience led me to question what responsiveness means in authoritarian contexts.

3. During the last year, the world has changed significantly because of the pandemic and fluctuating politics in many nations. Have these changing global situations given you any new insights into your research?

The pandemic has underscored the need for a nuanced and contextual understanding of democracies and non-democracies. For instance, the variation in state responses to COVID-19 suggests that there is no clear correlation between responsiveness or the effectiveness of government responses to COVID-19 and regime types. Consider Vietnam’s proactive approach and success at containing the pandemic as opposed to the US. Other recent developments such as the crackdowns on pro-democracy protests in Thailand and mass protests against the recent military coup in Myanmar showcase how quickly state responsiveness to social demands can erode, even in multi-party states.

4. What has your experience as one of our Shorenstein Fellows been like during this unusual period of time when we haven’t physically been together at APARC?

My fellowship has been remote, and I have therefore needed to be much more proactive to stay as engaged as possible. I have consulted with my mentor often over Zoom, and reached out to other scholars for their feedback and advice on my research. I have also especially appreciated the chance to participate in the China Social Science Workshop, where I've shared my work and learned from other presenters. Other postdoctoral fellows at APARC and I have also gotten together virtually to exchange stories and to share our experiences from this unusual year.  

5. What are some of the things you've done during this past year to give yourself a break from work and have some fun?

Due to the pandemic, I have been living back home to Austin, Texas, since March of last year. The last time that I was home for this long must have been after I graduated from college. So, for the first time in a long time, I've planted tomatoes, eggplants, and sunflowers in our garden, and I've really enjoyed watching them bloom and ripen. With everything growing, it feels like I've spent most of my break in our backyard defending our flowers, fruits, and vegetables from squirrels and bunnies! But luckily I also have our two dogs, Wishie and Sushi, to help me!

6. As the state of the pandemic changes and things in academia and our communities, what are some things you are looking forward to both professionally and personally?

I'm certainly looking forward to having conferences in person again! I'm also still not sure when it will be possible and safe for me to visit Asia again, especially Vietnam and China, but I have missed these places. I'm also learning Khmer this summer, and I'm excited to eventually visit Cambodia to pursue my research there.