Food insecurity remains a critical issue across much of sub-Saharan Africa. In certain parts of the region, fish is sometimes the most accessible or affordable source of animal protein. Yet many wild fish stocks are threatened or in decline, and Africa is the only continent in which per capita fish supply is decreasing. To ward off future supply shortfalls, regional governments are investing in their aquaculture (fish farming) sectors using a variety of policy tools, including fish feed subsidies.

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Amy Zegart, one of the nation’s leading experts on national security, intelligence and foreign policy, has been appointed the next co-director of the Center for International Security and Cooperation.

Zegart, a CISAC faculty member and senior fellow at the Hoover Institution, will take up her new role July 1. She succeeds Mariano-Florentino Cuéllar, who was named director of the Freeman Spogli Institute for International Studies, CISAC’s parent organization.

“Amy Zegart is an award-winning scholar, an accomplished professional with public and private sector experience, and a trusted voice on national security and foreign policy,” said Cuéllar. “Her multi-disciplinary scholarship, diverse experiences, and commitment to getting it right will complement the Freeman Spogli Institute's growing focus on governance problems, and will make her a dynamic leader for CISAC as the center continues its vital work on international cooperation and security.”

Zegart, once named one of the 10 most influential experts in intelligence reform by the National Journal, said she intends to continue expanding the center’s focus on emerging security issues, such as cybersecurity, drones and challenges to governance while building on CISAC’s distinguished reputation in nuclear security.

“The international threat environment is changing faster and in more profound ways than anyone could have imagined 10 or 20 years ago,” said Zegart, who is also a professor of political economy (by courtesy) at the Stanford Graduate School of Business, where she co-teaches a course on managing political risk with former Secretary of State Condoleezza Rice.

“CISAC will continue to be at the forefront of addressing these new challenges with the same secret sauce it’s had since its founding in 1983: world class talent; a commitment to teaching the next generation; and a deep belief that bridging the natural and social sciences is vital to solving the world’s most dangerous problems,” she said.

 CISAC, more than any other institution, provided a scholarly environment that was intellectually challenging and personally supportive at the same time. That’s quite a rare cultural combination."

Zegart’s research examines the organization of American national security agencies and their effectiveness. She served on the Clinton administration's National Security Council staff and as a foreign policy adviser to the 2000 presidential campaign of George W. Bush. She has testified before the Senate Intelligence Committee, provided training to the Marine Corps, and advised officials on intelligence and homeland security matters. From 2009 to 2011 she served on the National Academies of Science Panel to Improve Intelligence Analysis. Her commentary has been featured on national television and radio shows and in The New York Times, Washington Post, and Los Angeles Times.

Zegart writes  regular commentary for Foreign Policy about national security issues. In this excerpt from one of those posts about the privatization of American intelligence and the growing businesses of political risk management, her approach accentuates her ability to bring complex issues to a general audience:

In the old days, the ‘free world’ and ‘Soviet bloc’ were two different universes. Not anymore. Now everything is connected. Sweden’s Ikea has stores in Russia. My CIA alarm clock was made in China. Unrest in Cairo can cause legging shortages in California. And communications happen everywhere. Wifi can be found in Bedouin tents, on the top of Mount Everest, and on buses in rural Rwanda. Kenyan fisherman may lack electricity, but they can check weather conditions and fish market prices on their cell phones. All of this connectedness means that political risks – civil strife, instability, insurgency, coups, weak legal standards, corruption – have more spillover effects. What happens in Vegas does not stay in Vegas.

Zegart recalls being fascinated with politics since she was a kid. She spent her childhood tracking election night tallies and writing her congressman. When she was 13, she followed on TV the late Chinese leader Deng Xiaoping’s historic visit to the United States in 1979 and was thrilled when he donned a cowboy hat at a Texas rodeo.

“I was enthralled,” Zegart said. “My mother, an antique dealer who can find anyone and anything, tracked down a local Taiwanese graduate student and convinced her to teach me Mandarin after school.”

She would continue studying Chinese at Andover, majored in East Asian Studies at Harvard, and would win a Fulbright Scholarship to travel to China and study the 1989 Chinese democracy movement and Tiananmen Square tragedy. Zegart then earned her M.A. and Ph.D. in political science from Stanford and became a full professor of public policy at UCLA’s Luskin School of Public Affairs as well as a fellow at the Burkle Center for International Relations.

Zegart notes she’s been connected to CISAC for more than two decades. She first showed up at the center’s former Galvez House headquarters during her first quarter as a Stanford graduate student. She kept coming back even after she got her Ph.D.; both of her award-winning books were germinated in presentations she gave to CISAC seminars.

“CISAC, more than any other institution, provided a scholarly environment that was intellectually challenging and personally supportive at the same time,” Zegart said. “That’s quite a rare cultural combination.”

This academic year, she co-taught with Martha Crenshaw the popular CISAC-sponsored class International Security in a Changing World, which culminates in a U.N. Security Council simulation in which students debate a pressing global issue.

CISAC has a tradition of appointing co-directors – one from the social sciences and the other from the natural sciences – to advance the center’s interdisciplinary mission to conduct and promote cutting-edge research to make the world a safer place.

“Amy brings to CISAC a wealth of expertise in international security issues, a deep commitment to scholarship and a sincere desire to strengthen and expand the center’s activities and impact,” said David Relman, CISAC’s other co-director, a Stanford microbiologist and professor of infectious diseases, as well as expert on emerging biological threats. “We share an interest in emerging technologies and the effective international mechanisms that address 21st century challenges and threats.”

Zegart is the author of two award-winning books. Flawed by Design, which chronicles the development of the Central Intelligence Agency, Joint Chiefs of Staff, and National Security Council, won the highest national dissertation award in political science. Spying Blind, which examines why American intelligence agencies failed to adapt to the terrorist threat before 9/11, won the National Academy of Public Administration’s Brownlow Book Award. She has also published in International Security, Political Science Quarterly, and other leading academic journals. She serves on the editorial boards of Terrorism and Political Violence and Intelligence and National Security. Her most recent book is Eyes on Spies: Congress and the United States Intelligence Community.

Before her academic career, Zegart spent three years at McKinsey & Company advising Fortune 100 companies about strategy and organizational effectiveness.

She serves on the FBI Intelligence Analysts Association National Advisory Board and the Los Angeles Police Department’s Counter-terrorism and Community Police Advisory Board and is a lifetime member of the Council on Foreign Relations. 

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On March 18, Congolese militia leader Bosco Ntaganda surrendered himself unexpectedly to the U.S. Embassy in Kigali, Rwanda asking for transfer to the International Criminal Court (ICC) at The Hague, where he was wanted for allegedly committing crimes against humanity. The apprehension of ICC indictees was one of the main challenges raised during the Program on Human Right's (PHR) Sanela Diana Jenkins Human Rights Speaker Series last quarter. Ntaganda’s voluntary surrender provoked reflection on the lessons learned from the seminar’s evaluation of the ICC’s impact on international justice as it marked its first decade and exploration of its mandate moving forward.

Featuring lectures from international experts, academics, and activists, the seminar addressed many of the current challenges and future hopes of the ICC, including competing notions of justice and peace, budgetary constraints, and victims’ rights.

The series was led by PHR Director Helen Stacy and UCLA Law Professor Richard Steinberg, also a visiting scholar at Stanford's department of political science. They both kicked off the series by presenting the history and structure of the ICC and concluded with a discussion on its impact, commenting on how the ICC has helped shape the narrative on mass atrocities.

“Reflecting Diana Jenkins' personal commitment to restoring dignity, prosperity, justice and hope to those who most need it, the human rights speaker series aims to engage students on the most pressing human rights issues of our time,” said Stacy. “The International Criminal Court's 10th anniversary invites careful thought about its role so far, and its future. Our speakers brought an extensive range of opinions on the Court, but everyone agreed that the very existence of the Court has advanced the dialogue on international justice.”

A wide array of positions were offered by the speakers, representing the nonprofit, academic and policymaking arenas. Citing some of the limitations facing the ICC, Human Rights Watch’s Director of International Justice Program Richard Dicker made a compelling case for the Court, highlighting the role of civil society in promoting the adoption of the Rome Statute - the treaty that established the ICC - by its 122 current signatories.

William Pace, convener of the Coalition for the International Criminal Court described the Rome Statute as “among the greatest advancements ever in international human rights law.”

Stanford political science Professor James Fearon questioned whether the Court can be effective in deterring mass atrocities while relying on states parties to turn over suspects without a police force of its own. He argued that the Court may in fact limit the liability of human rights abusers because it gives them a choice of whether (or not) to turn themselves over to the ICC for trial. This could potentially contribute to prolonged civil conflict if governments’ hands are tied in offering backdoor deals in exchange for an end to the conflict.

Many speakers proposed modifications to the current ICC structure and suggested the following measures to enhance the work of the Court:

  • Cherif Bassiouni, who led the drafting committee to launch the ICC, emphasized the need for the Court to appoint well-trained judges;
  • David Scheffer, former U.S. Ambassador at Large for War Crimes Issues, highlighted the tremendous diplomatic challenge of not having instruments of arrest or enforcement under ICC control and limited to pressuring states parties to follow through on their obligation to detain indictees of the Court;
  • Carla Ferstman, director of REDRESS, a human rights organization that helps torture survivors obtain justice and reparations, focused on the challenges presented by the ICC's distance from the home countries of those on trial and how victims might have a more significant role in the justice process.

Recognizing the ICC’s inevitable growing pains, Shamila Batohi, a senior legal advisor to the Office of the Prosecutor, offered a hopeful conclusion to the series, reminding students of the Court’s commitment to protecting the rights of the more than 2.3 billion people represented by the statute’s 122 states parties and ending impunity for war crimes, genocide and crimes against humanity.

“Over the course of these nine weeks, students, faculty, and our guest speakers collaborated to develop a range of policies that could potentially improve the ICC system,” said Richard Steinberg. “Though the colloquium took place here on the Stanford campus, the broader collaboration engaged 19,000 users in a fruitful discussion via an online forum.”

Following each lecture, Dr. Diane Steinberg led a dinner discussion for interested students to distill the speaker’s main points into a thought-provoking question to be debated by a global audience on the Human Rights & International Criminal Law Online Forum. Stanford students joined forum participants from around the world to discuss vital questions, such as: “How should the relationship between the International Criminal Court and the United Nations Security Council be changed, if at all, to advance international justice?” and “Assuming that the ICC chooses to retain victim participation in its processes, how can victims’ representation at the ICC be improved and victims’ rights be protected?”

The seminar left students with these provocative questions – and many more – to ponder while tracking the Ntaganda case and the future trial of Uhuru Kenyatta, Kenya’s newly elected president wanted by the ICC for crimes against humanity following the 2007 presidential elections.

Stay tuned for more information on the 2014 Sanela Diana Jenkins Speakers Series, which will focus on the right to health and healthcare delivery.

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Without a Fight is a feature length documentary film that explores how soccer can facilitate social change in Kibera, one of Africa’s largest slums.

When: Thursday, April 11th at 6pm

Where: Branner Lounge, Stanford University

RSVP: Join the event on Facebook

Dinner Provided from DARBAR Indian Restaurant

· Introduction by Sarina Beges, CDDRL Program Manager

· Post-screening Q&A with CFK-Kenya Executive Director Hillary Omala and Producer Beth-Ann Kutchma

About the Film

Footage of violent clashes fueled by polarizing national presidential elections is intertwined with profiles of youth from different religious and ethnic backgrounds as they navigate daily life and prepare for the final championship soccer game of the season. The film provides a glimpse often a very positive one into an Africa few have seen. It attempts to break stereotypes associated with people who live in extreme poverty while depicting sports as a tool that could be used to prevent violence among at-risk youth. The film made its World Premiere at the 11 MM Festival in Berlin, Germany in March 2012 and its North American Premiere at the Full Frame Documentary Festival in Durham, NC in April 2012. The soccer league is run by the international development organization,Carolina for Kibera. Watch the Film’s Trailer.

Branner Lounge, Stanford University

Sarina Beges CDDRL Program Manager Speaker
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Sarina A. Beges
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Africa is witnessing a period of impressive economic transformation. Small business growth and technological innovation are bridging the development divide and lifting many out of poverty. Foreign investment has been pouring into the continent, viewed by analysts as one of the few remaining emerging market economies. Google's Eric Schmidt recently traveled to Africa on a technology tour citing Kenya's impressive gains in the ICT sector.

But the headlines and statistics fail to account for the large number left behind in the continent's race to develop. Social problems continue to plague African societies and threaten to reignite tensions, stalling long-term progress.

To address these challenges, grassroots leaders are working across Africa to introduce new models and practices to give voice and representation to marginalized groups, many of which include: women, children, and rural populations.

Referred to as "social entrepreneurs" these individuals work in partnership with local communities to use non-conventional approaches and innovative designs to address development challenges. Unlike traditional business entrepreneurs, their goal is not financial profit but societal gain.

In an effort to harness the collective expertise of these global change-makers, Stanford University's Program on Social Entrepreneurship was launched in 2011 to bring practitioners inside the classroom and on campus.

In April, three social entrepreneurs working to advance social, economic, and political change in Africa will spend the spring quarter in residency at the Center on Democracy, Development, and the Rule of Law.

Turning justice on its head

After emerging from a decade-long civil war, Sierra Leone has been cited as a successful model of post-conflict development and stability. However, the formal justice system has continued to exclude large numbers of the country's rural population who continue to seek customary legal systems of representation. Recognizing this problem, Simeon Koroma co-founded Timap (which translates to "Stand Up" in the national Krio language) for Justice in 2003 to combine the best of both systems.

Through a network of highly trained paralegals and mediators located in 19 offices across Sierra Leone, Timap for Justice is helping clients navigate both systems to seek justice and address community-level concerns. To date, Timap for Justice has represented over 20,000 clients who are often the victims of human rights abuses at the hands of multinational corporations. Their innovative grassroots justice model together with Koroma's efforts to grow the organization has led Timap for Justice to be recognized on a national and regional level.

Transforming ripples into waves

Gemma Bulos - a California native - did not know the impact water would have on her life until she witnessed the world water crisis first-hand while traveling the world on a global peace campaign. A self described "accidental social entrepreneur," Bulos learned by actively listening to the needs of the local community and learning from their experiences. She co-founded A Single Drop for Safe Water in the Philippines to empower local communities to plan, implement, and manage community-driven water and sanitation solutions.

Recognizing the important role women play in the success of water projects, Bulos started her second entrepreneurial venture - the Global Women's Water Initiative (GWWI) - to work with rural women in East Africa to build simple water and sanitation technologies. Tailoring each project to the community's needs, GWWI equips women with the technical skills to build rainwater harvesting tanks, water treatment technologies, and toilets. All projects are constructed using locally appropriate and affordable technologies. Trainings have helped to spur micro-enterprise development, and have provided over 15,000 people with clean water and sanitation solutions.

Putting children's rights first

Malawi made international headlines as the destination for pop singer Madonna's adoption of two young children, but the country has made little progress in protecting the rights of their youngest citizens. Maxwell Matewere founded the organization, Eye of the Child, to advocate for children who are victims of forced marriage, child labor, abuse, and sexual exploitation.

Matewere's innovative model uses litigation, public and policy advocacy, and training of community organizations to lead national campaigns against child abuse. Since 2010, the organization has provided free legal aid to 47 cases of forced marriages, 13 cases of arranged marriages, and rescued 21 children from early marriages.

Through his work leading Eye of the Child, Matewere has challenged powerful actors in business and government to advocate for new practices and legislation to protect the interests and well-being of young children. In recognition of his work, Matewere was appointed as Malawi's special law commissioner to develop a national policy for anti-human trafficking and adoption.

Informing theory with practice

During the spring quarter, the three social entrepreneurs will participate in an undergraduate course (IR142) examining how social entrepreneurs advance democracy, development, and justice. Taught by Kathleen Kelly Janus, a lecturer at Stanford, the course will combine academic theory with the social entrepreneurs practical experience to present a more inclusive model of social change. Students will also be encouraged to partner with social entrepreneurs on service learning projects.

Social entrepreneurs will engage the broader Stanford community through a series of speaking roles on campus during the academic quarter. They will also have the time and space to pursue their own research initiatives, contemplate the next steps on their journey as social change leaders, and document their own models of social change.

CDDRL's Program on Social Entrepreneurship was founded in 2011 by Kavita Ramdas, the former head of the Global Fund for Women and the current representative of the Ford Foundation in India. The program is now led by Faculty Director Deborah L. Rhode, a professor of law at Stanford Law School and affiliate faculty member at CDDRL.

This spring marks the third cycle of the program, which has welcomed previous social entrepreneurs from Bosnia-Herzegovina, Malaysia, Palestine, South Africa, and the San Francisco Bay Area, who together work on critical problems of democracy, development, and social justice in their communities.

For more information on the program, please visit: pse.stanford.edu.

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Beth Duff-Brown
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Carnegie Corporation of New York, the foundation that promotes “real and permanent good in this world,” has awarded a $1 million grant to CISAC to fund research and training on international peace and security projects over the next two years. 

Specific areas of focus include research on strengthening communities in Afghanistan through collaborative civilian-military operations, several projects on improving nuclear security, and a study of community policing interventions to increase public safety and stability in rural Kenya. 

“The breadth and extent of Carnegie’s support will be crucial in advancing CISAC’s research and teaching to help build a safer world,” said CISAC Co-Director Mariano-Florentino Cuéllar

As part of a project funded in part by the Carnegie Grant, former Secretary of Defense William J. Perry, the Michael and Barbara Berberian Professor (emeritus) at FSI and the School of Engineering and a CISAC faculty member, and Siegfried S. Hecker – former CISAC co-director and professor (research) in the Department of Management Science and Engineering – will travel, consult and write on issues of nuclear security in Russia and China. Their goal is to increase technical cooperation between national nuclear laboratories in the United States and Russia. They will also pursue Track II dialogue with Pakistan to promote stability in South Asia.  

“It is crucial to promote cooperation with Russia and China on nuclear issues, both in terms of superpower relations and preventing nuclear proliferation and terrorism around the world,” Hecker said. “Bill Perry and I will continue to use our broad network of contacts to promote common approaches to reducing global nuclear risks.” 

Also in the area of nuclear security, Lynn Eden, CISAC senior research scholar and associate director for research, will take a hard look at the conflicting U.S. nuclear weapons strategy and policy for her project, “Vanishing Death: What do we do when we plan to fight a nuclear war?” Eden will focus on nuclear war planning and draw out the implications for future nuclear policies, including achieving a world free of nuclear weapons. She intends to publish her research with the goal of better informing the American public about the paradoxes and contradictions of U.S. nuclear weapons policy. 

“A historically informed public will be in a far better position to democratically participate in nuclear weapons policy debates, including questions of reducing the role and size of global nuclear weapons arsenals,” Eden said. 

The Carnegie grant also will enable CISAC senior research scholar Joseph Felter, a retired U.S. Army colonel, to assess and compare the effectiveness of counterinsurgency strategies and operations in the Philippines and Afghanistan. The former director of the Combating Terrorism Center at West Point and commander of the International Security Assistance Force’s Counterinsurgency Advisory and Assistance Team in Afghanistan, Felter has reported to the nation’s senior military officers and intends to generate a number of policy scenarios to be incorporated by the military. 

“CISAC brings scientists and engineers together with social scientists, government officials, military officers, and business leaders to collaboratively analyze some of the world’s most pressing security problems,” said Carnegie Corporation’s Patricia Moore Nicholas, project manager of the International Program.  “The original thinking and proposed solutions that emerge from these collaborations will help address a series of enduring and emerging challenges.” 

The funding for the project in Kenya will allow James D. Fearon, the Theodore and Frances Geballe Professor in the School of Humanities and Sciences and a CISAC affiliated faculty member to study the security sectors in Kenya, and then to use this research as a basis for developing effective strategies for peace building in other states in transition.

 

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Larry Diamond
Larry Diamond
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This book originated in a conference on "Liberation Technology in Authoritarian Regimes" held at Stanford University in Oct. 2010. 

The revolutions sweeping the Middle East provide dramatic evidence of the role that technology plays in mobilizing citizen protest and upending seemingly invulnerable authoritarian regimes. A grainy cell phone video of a Tunisian street vendor’s self-immolation helped spark the massive protests that toppled longtime ruler Zine El Abidine Ben Ali, and Egypt’s "Facebook revolution" forced the ruling regime out of power and into exile.

While such "liberation technology" has been instrumental in freeing Egypt and Tunisia, other cases—such as China and Iran—demonstrate that it can be deployed just as effectively by authoritarian regimes seeking to control the Internet, stifle protest, and target dissenters. This two-sided dynamic has set off an intense technological race between "netizens" demanding freedom and authoritarians determined to retain their grip on power.

Liberation Technology brings together cutting-edge scholarship from scholars and practitioners at the forefront of this burgeoning field of study. An introductory section defines the debate with a foundational piece on liberation technology and is then followed by essays discussing the popular dichotomy of "liberation" versus "control" with regard to the Internet and the sociopolitical dimensions of such controls. Additional chapters delve into the cases of individual countries: China, Egypt, Iran, and Tunisia.

This book also includes in-depth analysis of specific technologies such as Ushahidi—a platform developed to document human-rights abuses in the wake of Kenya’s 2007 elections—and alkasir—a tool that has been used widely throughout the Middle East to circumvent cyber-censorship.

Liberation Technology will prove an essential resource for all students seeking to understand the intersection of information and communications technology and the global struggle for democracy.

Contributors: Walid Al-Saqaf, Daniel Calingaert, Ronald Deibert, Larry Diamond, Elham Gheytanchi, Philip N. Howard, Muzammil M. Hussain, Rebecca MacKinnon, Patrick Meier, Evgeny Morozov, Xiao Qiang, Rafal Rohozinski, Mehdi Yahyanejad

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Context  The effect of global health initiatives on population health is uncertain. Between 2003 and 2008, the US President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative ever devoted to a single disease, operated intensively in 12 African focus countries. The initiative's effect on all-cause adult mortality is unknown.

Objective  To determine whether PEPFAR was associated with relative changes in adult mortality in the countries and districts where it operated most intensively.

Design, Setting, and Participants  Using person-level data from the Demographic and Health Surveys, we conducted cross-country and within-country analyses of adult mortality (annual probability of death per 1000 adults between 15 and 59 years old) and PEPFAR's activities. Across countries, we compared adult mortality in 9 African focus countries (Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, Tanzania, Uganda, and Zambia) with 18 African nonfocus countries from 1998 to 2008. We performed subnational analyses using information on PEPFAR's programmatic intensity in Tanzania and Rwanda. We employed difference-in-difference analyses with fixed effects for countries and years as well as personal and time-varying area characteristics.

Main Outcome Measure  Adult all-cause mortality.

Results  We analyzed information on 1 538 612 adults, including 60 303 deaths, from 41 surveys in 27 countries, 9 of them focus countries. In 2003, age-adjusted adult mortality was 8.3 per 1000 adults in the focus countries (95% CI, 8.0-8.6) and 8.5 per 1000 adults (95% CI, 8.3-8.7) in the nonfocus countries. In 2008, mortality was 4.1 per 1000 (95% CI, 3.6-4.6) in the focus countries and 6.9 per 1000 (95% CI, 6.3-7.5) in the nonfocus countries. The adjusted odds ratio of mortality among adults living in focus countries compared with nonfocus countries between 2004 and 2008 was 0.84 (95% CI, 0.72-0.99; P = .03). Within Tanzania and Rwanda, the adjusted odds ratio of mortality for adults living in districts where PEPFAR operated more intensively was 0.83 (95% CI, 0.72-0.97; P = .02) and 0.75 (95% CI, 0.56-0.99; P = .04), respectively, compared with districts where it operated less intensively.

Conclusions  Between 2004 and 2008, all-cause adult mortality declined more in PEPFAR focus countries relative to nonfocus countries. It was not possible to determine whether PEPFAR was associated with mortality effects separate from reductions in HIV-specific deaths.

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Eran Bendavid
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Nadejda Marques
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On October 30, the Program on Human Rights (PHR) at Stanford's Center on Democracy, Development and the Rule of Law (CDDRL) held a day-long conference to examine health and human rights. The conference was held to discuss how a rights-based approach to health services can impact the delivery of effective health interventions and advance other socio-economic and cultural rights in developing regions. The conference titled, “Why We Should Care: Health and Human Rights” was divided into five panels with presenters from diverse backgrounds and professions including lawyers, doctors, public health experts, students and activists.

The Program:

The conference started with a welcoming address by Helen Stacy, director of the Program on Human Rights. CDDRL Director Larry Diamond introduced the keynote speaker Paul H. Wise, professor of child health and society and pediatrics at Stanford University’s School of Medicine, and director of the Center for Policy, Outcomes and Prevention. Wise's opening remarks began on a somber note, “The language of rights means very little to a child stillborn, an infant dying in pain from pneumonia or a child desiccated by famine.” In his address, Wise emphasized the need for an aligned and integrated rights-based approach that does not undermine effective and efficient medical interventions. “We need to fill the gap between the worlds of child health and child rights so that our programs and policies are both effective and just,” he stressed.

Following the keynote address, the conference presenters shared their work according to a geographic or thematic focus. The first panel brought together three generations of speakers from Stanford - a faculty member, a pre-doctoral fellow and a recent graduate - in a unique opportunity to share ideas and discuss possibilities of health work in Africa. Rebecca Walker, clinical instructor in emergency medicine at Stanford School of Medicine, presented her impressions and reactions on Mindy Roseman’s study of forced sterilization in Namibia. Roseman, academic director of the Human Rights Program and lecturer on law at Harvard Law School, was unable to attend due to flight complications after hurricane Sandy hit the East Coast.

Eric Kramon, 2011-2012 pre-doctoral fellow at CDDRL, spoke about the political sources of ethnic inequality in health outcomes in Africa.  Kramon’s work in Kenya illustrated how politics plays a determinant role in ethnic inequalities and consequently in access to health and health outcomes. Jeffrey Tran, a 2011 Stanford graduate in human biology, described the vision behind the launch of the Project of Emergency First Aid Responder in Western Cape Province, South Africa that he helped implement. Tran explained, “Individuals and communities are an integral part of the solution and we work with the communities to develop first aid training programs that are taught and eventually run by community members.”

Panel two was dedicated to the health impact of drones in Pakistan and in Gaza. Based on research by the Stanford International Clinic on Human Rights and Conflict Negotiation in Pakistan, Professor James Cavallaro and Stanford law school student Omar Shakir, explained that drones are not only responsible for deaths of civilians but also constitute a constant disturbance to social life and mental health of ordinary people, including their relations with children and the elderly. Drones impact other rights as well - such as the right to education - as children are prevented from attending schools for fear of drone strikes. Rajaie S. Batniji, resident physician in internal medicine at Stanford and a CDDRL affiliate, explained the clinical diagnosis of traumatic disorders that result from constant surveillance and insecurity. He cited the work of Jonathan Mann in defining dignity and the devastating effects on physical, mental, and social well-being when these senses are violated. Batniji explained that populations in Gaza are prevented from living life with dignity and respect because they live under constant threat to their security and intrusion into their homes and communications.

Vivek Srinivasan, manager of the Program on Liberation Technology at CDDRL, presented his experience on the Right to Food Campaign in India. He believes that this campaign has led to the mobilization for rights and the provision of services. “Not all demands are confrontational. Communities begin demanding something that is perceived as small in scope but have ramifications that extend to other rights such as the right to education, the right to housing and the right to work.” According to Srinivasan, the Right to Food Campaign in India has had a tremendous impact in putting hunger on the policy agenda. Suchi Pande, an activist-researcher who worked on the Right to Information Campaign in India for over seven years and was the secretary for the National Campaign for People’s Right to Information from 2006 to 2008, supported Srinivasan’s argument of strong correlation in achievements and right-based mobilization. However, Pande pointed out that despite successes in the Right to Food Campaign, other economic and social rights including the right to health in India continues to be a non-issue for politicians and the government. She is optimistic and believes that rural public hearings, the role of the right to information and its supporting mechanisms will facilitate access to public health in rural India.

In panel four, Sarah MacCarthy showed results that suggest that counseling and testing services for HIV-positive pregnant women remain limited, insufficient or lacking in quality in Salvador, Brazil. “While Brazil’s HIV/AIDS program has been internationally acclaimed, national practice still fails to meet national and global guidelines,” she explained. Calling attention to the regional discrepancies in the HIV/AIDS policy and program implementation in Brazil, Nadejda Marques, manager of the Program on Human Rights at CDDRL,, expressed concerns about the implementation of an HIV/AIDS program in a context of limited resources. “In Angola, counseling and voluntary testing units for HIV/AIDS don’t have drinking water or sanitary conditions to receive patients. They lack basic equipment for testing and data collection, there is a generalized shortage of doctors, and health care providers have no specific training on HIV/AIDS.” Despite this alarming situation, Marques explained that advocating for the rights of persons living with HIV/AIDS in Angola has put in evidence the failure of a heath system unable to provide even the most basic services to its population and has enabled mobilization in a context where human rights are routinely violated.

Ami Laws, adjunct associate professor of medicine at Stanford, described how a physician can provide services in collaboration with the judicial system to advance human rights. Laws is an expert witness on cases of torture survivors that require asylum status in the U.S. and has worked mainly with victims of torture in the Punjab region in India. Everaldo Lamprea, a JSD candidate at Stanford Law School and an assistant professor at Los Andes Law School in Bogotá, Colombia, spoke about his recent comparative study on health litigation in low and middle-income countries. The escalation of right-to-health litigation in these countries can have unexpected and harmful consequences to healthcare reforms and the enforceability of the right to health. In part, this is because significant financial resources are allocated to the litigation processes and not to the health system. In addition, while litigation can highlight gaps that exist in the health system that need regulation, countries have been very slow to adapt and adjust to these signals.

Next Steps:

A number of key ideas, questions and insights emerged from the conference including:

. How to identify an effective intervention that will also mobilize communities to advocate for its implementation?

. How to provide services to the more vulnerable populations without alienating a contingent that has access to basic health care services?

. What instruments can be used to share best practices among national healthcare systems?

. How do global priorities adapt to contexts of limited financial resources and human capital?

. How can punctual achievements in rights that guarantee access to health be expanded for the achievement of other social, economic and cultural rights?

The Program on Human Rights at CDDRL will continue to pursue a research agenda examining health and human rights following the conference and announced that it will be the thematic focus of the Sanela Diana Jenkins Speakers Series in 2014. The PHR is also actively seeking support for research projects that include a right to health component at the core of its academic investigation for the 2012-2013 academic year.

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Stanford Woods Institute for the Environment
473 Via Ortega
Stanford, CA 94305-4020

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Research Associate
Lecturer
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MS, PhD

Amy Pickering is a research associate and lecturer at Stanford University. She received a BS in biological engineering at Cornell University, a MS in environmental engineering from the University of California, Berkeley and a PhD in interdisciplinary environment and resources at Stanford University. Her current research interests include understanding the relationship between water access, food security, sanitation and infectious disease in rural communities in Kenya, Bangladesh, and Mali.

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