As the Soviet Union was dying in December 1991, a quiet collaboration between Russian and American scientists was being born. The Russians were bankrupt, the KGB was in disarray and nuclear scientist Siegfried S. Hecker – at the time director of the Los Alamos National Laboratory – was alarmed as tens of thousands of nuclear weapons and much of the more than 1,000 tons of fissile materials across the broken Soviet states stood poorly protected.

Thousands of Soviet scientists were suddenly in limbo and President George H.W. Bush worried some might turn to Iran or Iraq to sell their nuclear knowledge. Washington suddenly found itself more threatened by Russia’s weakness than its strengths. That recognition drove U.S. Senators Sam Nunn and Richard Lugar to launch cooperative threat reduction legislation, subsequently known as the Nunn-Lugar Cooperative Threat Reduction Act.

Secretary of Energy Admiral James Watkins echoed President Bush’s concern when he called a meeting in December 1991 with Hecker, today the co-director of Stanford’s Center for International Security and Cooperation (CISAC).

“I told him, I’ve been trying to get us together with the Russians for several years,” Hecker said. “Why don’t we go to their lab directors and say, `What’s it going to take to keep your guys home and from selling their knowledge someplace else?’”

Several weeks later, in February 1992, Hecker was on a tarmac in the once-secret Russian nuclear city of Sarov, shaking hands with Yuli Khariton. The Soviet physicist was the chief designer of Russia’s atomic bomb – their Robert Oppenheimer, creator of our nuclear bomb and first director of the Los Alamos laboratory in New Mexico.

Hecker would go on to make 44 trips to Russia in the name of nuclear nonproliferation and cooperation. His most recent was last month with CISAC researchers Peter Davis and Niko Milonopoulos and a dozen Americans scientists, to commemorate 20 years of laboratory-to-laboratory cooperation. They hosted a conference with their Russian counterparts in Sarov, the Russian version of Los Alamos 300 miles east of Moscow.

Some 100 Americans and Russians attended various legs of the conference, including the scientific directors of the three Russian nuclear weapons laboratories: Rady Ilkaev, Evgeny Avrorin and Yuri Barmakov. The American delegation included Jeffery Richardson, CISAC affiliate and former head of chemistry and proliferation prevention at Lawrence Livermore National Laboratory; James W. Toevs, former project leader for the Nuclear Cities Initiatives at Los Alamos; and K. David Nokes, former vice president of national security and arms control at Sandia National Laboratory. 

CISAC Co-director Siegfried Hecker and Rady Ilkaev, a scientific director within the Russian Federal Nuclear Center, swap gifts during their April 2012 conference in Sarov, Russia.

Hecker is determined to reignite the collaboration efforts, which have diminished dramatically in the last decade due to stark differences at the highest levels of our governments and because the Russian secret service agency has again tightened their grip on the nuclear complex.

“The 1990s were the heydays for us,” he said. “The scientists played a major role; we actually pushed the envelope on what we could do cooperatively. We worked well with the Russians.”

The U.S. Department of Energy supported and financed the joint efforts of the American and Russian nuclear laboratories to secure and safeguard Russian nuclear facilities and materials. They enlisted the help of civilian institutes to make urgent security upgrades at their nuclear facilities and the Americans brought the Russians to the U.S. nuclear sites – including the plutonium facility at Los Alamos – to let them see firsthand how Americans handled protection, control and accounting of nuclear material.

“The Sandia National Laboratories actually helped provide Kevlar blankets to protect Russian nuclear weapons while they were transporting them so that in case somebody shot at them, you didn’t get a mushroom cloud,” Hecker recalled.

Then, Russian President Vladimir Putin came to power for the first time in 2000 and the Federal Security Service – formerly the KGB – started tightening the screws. U.S. visas became difficult to obtain after the 9/11 terrorist attacks ratcheted up consular bureaucracy. Scientists on both sides began to feel less welcome at the labs and sites they had readily visited for a decade.

During his April trip, Hecker felt as if he were under house arrest in the worst security squeeze he’d seen in the 20 years of visiting Russia. He was followed by a security agent when he jogged, until the mud along the river became too deep for the agent’s shiny black shoes; Davis and Milonopoulos had their access denied at the last minute and were not allowed to enter Sarov to attend the three-day portion of the conference.

Many lab-to-lab cooperative agreements were allowed to expire by the Russian side in the last decade; even collaborations on fundamental research have been restricted and there is little nuclear power engineering cooperation. Worst of all, Hecker said, joint efforts to battle nuclear terrorism and compare means by which each side keeps its nuclear warheads safe and secure without nuclear testing are now virtually nonexistent.

“We ought to be working together, for heavens sake,” he said. “We’re not going to terrorize each other; we’ve got to keep the terrorists away from the rest of the world. We just have to get back to working together.”

CISAC researchers Peter Davis, left, and Niko Milonopoulous, right, with the U.S. Ambassador to Russia Michael McFaul at the ambassador's residence in Moscow in April 2012.

Their first step will be to compile the proceedings of the meetings with their Russian counterparts in Sarov, Nizhny Novgorod and Moscow. The document will be provided to the U.S. Department of Energy and policymakers in the Obama administration, as well as the three current U.S. nuclear lab directors, who are making their first joint visit to Russia in June. Hecker said his Russian counterparts are trying to coax Moscow into jumpstarting the collaboration efforts while wooing a new generation of nuclear scientists to the table.

Hecker, along with two former Russian nuclear weapons lab directors, is working on a book to document 20 years of nuclear collaboration between Russian and American nuclear scientists.

“The book is going to do a thorough job of looking at: What we did, why did it matter, what conditions made it possible and, then, what lessons were learned that might allow us to reestablish the relationship,” he said.

Hecker had another mission on his recent trip to Sarov. He wanted to reassure his Russian counterparts that their personal relationships truly mattered.

With the collapse of the Soviet Union in 1991, scientists in Russia, Ukraine, Kazakhstan and Belarus were confronted with a new reality: They went from lives of privilege to poverty. Programs launched by the U.S. Departments of State and Energy brought financial support to Russia’s closed nuclear cities, showed the Russian nuclear workers that they had a future in non-weapons research – and that someone cared about their well-being.

“One thing that came out, talk after talk during this trip, was how important the social relationships were between the scientists; how they are absolutely crucial,” Hecker said. Those little-known relationships – many of which became enduring friendships that celebrate marriages and grandchildren – led to significant steps in the U.S.-Russian nuclear threat reduction program.

President Ronald Reagan used one of his signature phrases, “Trust, but verify,” when he and Soviet General Secretary Mikhail Gorbachev signed the Intermediate-Range Nuclear Forces Treaty in 1987, eliminating nuclear and conventional ground-launched ballistic and cruise missiles with intermediate ranges. The phrase was taken from an old Russian proverb.

A year later, that proverb was put in effect with Hecker’s hand on the nuclear button at the Nevada test site for the Joint Verification Experiment.

“In August of ’88, the Soviets were at our test sites in Nevada and I was in the control room, essentially pushing the button to blow up one of our nuclear devices down hole, while the Russians had a cable that ran down the hole with which they were going to measure the magnitude of the nuclear explosion,” Hecker said. The following month, American scientists were in Russia to do the same.

“So I was sitting there in our control room, with the Russians right across the table from me,” he recalls. “That introduced us to the Russian nuclear scientists for the first time. You know what we said? These guys are just like us. They just want to do exactly the same thing for their country that we were doing for ours: keep their country safe and secure. And that started the process of working together.”

Today, the Russian proverb made famous by an American president could be turned on its head if the Russian-American nuclear collaboration is allowed to thrive: Verify through Trust.

The provision of public goods and services - education, healthcare, sanitation, potable water and other government benefits - are linked to issues of governance. The Program on Poverty and Governance at the Center on Democracy, Development and the Rule of Law (CDDRL) together with the Center for Latin American Studies will host a conference on May 18-19 at Stanford University to explore how governance impacts the provision of public goods and services throughout the world.

The conference will bring together an interdisciplinary group of economists, political scientists, policymakers, and public health researchers to present on-going research on the links between governance and public goods provisions. The conference will also focus on government corruption, electoral clientelism and the critical role of external actors in the provision and delivery of public goods.

According to Beatriz Magaloni, the director of the Program on Poverty and Governance at CDDRL, “A goal of the conference is to present pioneering research on the major issues facing public goods provision in developing economies and to explore a variety of institutional, political, and international factors that work to improve or hinder government capacity and accountability in service delivery.”

Conference speakers include: Stephen D. Krasner, professor of international relations and deputy director of the Freeman Spogli Institute at Stanford University, commenting on external actors and the provision of goods in areas of limited statehood; Stuti Khemani, senior economist at the World Bank, who will speak about information access and public health benefits; Miriam Goldman, visiting research scholar from Princeton University, who will examine corruption and electricity in India; Edward Miguel, director of the Center for Effective Global Action at UC Berkeley, who will present on institutional reform through minority participation; and James D. Fearon, professor of political science at Stanford University and CDDRL affiliated faculty, and David Laitin, professor of political science and Center for International Security and Cooperation (CISAC) affiliated faculty who will both serve as distinguished discussants.

All sessions will be held in the CISAC Conference room, 2^nd floor of Encina Hall Central, and are free and open to the public. To view the complete agenda and RSVP to the conference, please click here.

The government’s far-reaching health care foreign aid program has contributed to a significant decline in adult death rates in Africa, according to a new study by Stanford researchers. 

Between 2004 and 2008, the U.S. President’s Emergency Plan for AIDS Relief was associated with a reduction in the odds of death of nearly 20 percent in the countries where it operated. The researchers found that more than 740,000 lives were saved during this period in nine countries targeted by the program, known by its acronym, PEPFAR.

“We were surprised and impressed to find these mortality reductions,” said Eran Bendavid, an affiliate at Stanford Health Policy, part of the university’s Freeman Spogli Institute for International Studies.

“While many assume that foreign aid works, most evaluations of aid suggest it does not work or even causes harm,” said Bendavid, an assistant professor of medicine at Stanford’s School of Medicine. “Despite all the challenges to making aid work and to implementing HIV treatment in Africa, the benefits of PEPFAR were large and measurable across many African countries.”



The study is the first to show a decline in all causes of death related to the program. It appears in the May 16 issue of the Journal of the American Medical Association.

Bendavid is the lead author of the study. It was co-authored by Grant Miller and Jay Bhattacharya, who are both core faculty members of Stanford Health Policy and associate professors of medicine. The study was funded by the National Institutes of Health and the Dr. George Rosenkranz Prize for Health Care Research in Developing Countries.

PEPFAR began in 2003 under the Bush administration with a five-year, $15 billion investment in fighting AIDS around the world and a focus on treatment and prevention in 15 countries. It was reauthorized by Congress in 2008 and has expanded its reach to 31 countries.

To measure the impact of the program, Bendavid and his colleagues analyzed health and survival information for more than 1.5 million adults in 27 African countries, including nine countries where PEPFAR has focused its efforts. The researchers examined data available in the Demographic and Health Surveys, a USAID-funded project that involves a representative sampling of in-person interviews among women in which they discuss their health and the health of their family members. These surveys form the foundation of many health measurements in developing countries.

They found the odds of death from any cause among adults were 16 to 20 percent lower in the PEPFAR-targeted countries.

To bolster the results, the scientists did a separate analysis using specific data on PEPFAR programs in Rwanda and Tanzania. They compared regions of the two countries where PEPFAR’s investments led to widespread increases in the number and size of sites providing antiretroviral therapy, with areas where PEPFAR had fewer services available.



“We observed a similar reduction in mortality when exploring PEPFAR’s effects using a different lens,” Bendavid said.

In Tanzania, the odds of death were found to be 17 percent lower and in Rwanda 25 percent lower in the districts with greater support from PEPFAR.

Bendavid speculates that the program’s commitment to building an infrastructure that includes drug distribution systems, clinics, pharmacies, laboratories and testing facilities has been an important factor for its success.

“The scale of PEPFAR’s investment was unprecedented,” Bendavid said. “People working in PEPFAR’s focus countries describe working supply chains, stocked pharmacies and staffed clinics.”



Although the program was targeted to address HIV, these services could have benefitted patients with a variety of other health concerns. For example, one study found that some uninfected, pregnant women in Ethiopia, Rwanda and Tanzania chose to deliver their babies in facilities supported by PEPFAR, Bendavid said.

Some have argued that focusing resources on a specific disease, such as AIDS, may detract efforts from other diseases and activities, undermining some of the benefits of such programs. But the latest study does not support this argument. Rather, it suggests that PEPFAR helped prevent additional deaths from causes other than HIV/AIDS.

“Whether disease-specific programs like PEPFAR have synergies with other health improvement efforts – or instead undermine them, as some have worried – is really an open question,” Miller said. “There are reasons to think either scenario is possible, and more research is needed. We don’t find much evidence of PEPFAR undercutting other initiatives. If anything, we see hints of synergies.”



Bendavid said the program managed to accomplish the reduction in mortality in the face of enormous challenges – from persuading people to go for HIV testing and treatment to dealing with problems of drug shortages and drug resistance.

Historically, few other large-scale health initiatives have succeeded to such an extent. Smallpox, which was eradicated by 1979, is among the rare and more notable examples.

“PEPFAR’s success with HIV … may be considered the clearest demonstration of aid’s effectiveness in recent years,” the researchers concluded.

In 2009, PEPFAR was folded into a new Global Health Initiative that calls for a broader agenda, with some resources redistributed to other programs, such as maternal and child health.

Its budget, which rose dramatically in the early years, has remained relatively flat or declined slightly since then. It peaked at $6.8 billion in fiscal year 2010, then declined to $6.7 billion and $6.6 billion in fiscal years 2011 and 2012, respectively, according to figures from the Kaiser Family Foundation. The Obama administration’s budget request for the 2013 fiscal year is $6.4 billion.

While the program appears to have had an impact within a few years of its implementation, Bendavid noted that reduced investments in fighting AIDS, both through PEPFAR and other international aid programs, could have implications for the future of the epidemic.

“We are transforming the face of the epidemic but funding shortfalls will change the road ahead,” he said.



Ruthann Richter is Director of Media Relations for the Stanford School of Medicine.

Adrian Bonifacio, a second generation Filipino-American from Chicago, is one of the recipients of the Program on Human Rights and the McCoy Family Center for Ethics in Society's 2012 Human Rights Fellowship.  The Program on Human Rights at the Center on Democracy, Development, and the Rule of Law together with the McCoy Family Center for Ethics in Society offer four annual summer fellowships in human rights open to Stanford undergraduates interested in working for organizations, government agencies, NGOs or international organizations that promote or defend human rights.

This summer, Bonifacio will work with the Asian Pacific Mission for Migrants, a non-governmental organization based in Hong Kong that promotes and defends the rights of migrant workers, a majority of whom are Filipino. Filipino immigrants in Hong Kong work predominately as domestic workers. The situation of Filipino diasporas is very complex with more than 10% of the Filipino population abroad, and over 4,000 Filipinos leaving the country every day.

Passionate about Filipino and Filipino-American issues relating to human rights such as migration, exploitation, and servitude, Stanford undergraduate Bonifacio has joined Filipino groups such as Stanford’s Pilipino American Student Union (PASU) and Anakbayan Silicon Valley, a youth organization based in Santa Clara County. He is currently pursuing a major in international relations with a minor in economics as well as co-term masters degree in sociology.

In the 1970s, Filipino dictator Ferdinand Marcos began the Labor Export Policy (LEP), a deliberate policy to send Filipino workers abroad. “This became a vicious cycle, the Philippines tried to achieve economic development based on remittances but because it sends both high skill and low skill workers abroad, and because the remittances they send are not usually put towards investment and long term development, there is not much progress happening in the country," explained Bonifacio. "Every president since Marcos has continued to promote the LEP in the name of national development.”

Last summer, Bonifacio worked for HURIGHTS OSAKA, a human rights non-profit organization, where he conducted research related to Filipino migrants in Japan to understand the link between human rights and remittances. “Although it was difficult integrating with the community in such a limited timeframe, a lot of different opportunities presented themselves—celebrating Philippine Independence Day, cooking Filipino food for events, even performing traditional dances," said Bonifacio. "My supervisor at work and all the migrants I have come to know made my transition into life in Japan, as well as my research, much easier.”

Japan and agencies in the Philippines that facilitate labor migration are notorious for abusing “entertainment visas” which allowed young women to be trafficked into Japan. Many Filipino women were promised jobs in high-end hotels as singers or dancers, but upon arrival in Japan, were trafficked into bars, with some entering prostitution rings and red light districts... Starting in the mid-1980s, many Japanese men in rural areas began to “import” Filipino women as mail-order brides, to solve the demographic problem of low birth rates caused largely by women moving out to cities to pursue professional careers.

Although the mail-order bride phenomenon has died down and Japan has since abolished the entertainment visa in 2006, there are still cases of abuse and human trafficking. Moreover, Filipino men have a history of working in construction, often as day laborers with insecure sources of income and housing. According to Bonifacio, “It is hard to determine the proportion of remittances that come from exploitation, but if you look at general trends and the types of employment Filipinos have all over the world—for example as “entertainers” in Japan or domestic workers in Hong Kong, Saudi Arabia, and even the United States—one could say that remittances and exploitation are closely connected.”

In preparation for his fellowship in Hong Kong Bonifacio says, “I was humbled by what I saw in Japan. I think that one of the best things one can do to educate oneself - and something that does not always happen in a classroom - is to understand the community we want to serve. We need to learn about the issues these communities face before considering fighting for change.”

Students interested in applying to the human rights fellowship for the summer of 2013 should contact Nadejda Marques to learn about the selection process and deadline for submission.