Note: This talk is also offered as an in-person seminar on April 5 at 12 p.m.

International procurement institutions have played an important role in drug supply. This paper studies price, delivery, and procurement lead time of drug supply for major infectious diseases (antiretrovirals, antimalarials, antituberculosis, and antibiotics) in 106 developing countries from 2007-2017 across four procurement institution types. We find that pooled procurement institutions lower prices: pooling internationally is most effective for small buyers and more concentrated markets, and pooling within-country is most effective for large buyers and less concentrated markets. Pooling can reduce delays, but at the cost of longer anticipated procurement lead times. Finally, pooled procurement is more effective for older-generation drugs, compared to intellectual property licensing institutions that focus on newer, patented drugs. We corroborate the findings using multiple identification strategies, including an instrumental variable strategy, the Altonji-Elder-Taber-Oster method, and reduced-form demand estimation. Our results suggest that the optimal mixture of procurement institutions depends on the trade-off between costs and urgency of need, with pooled international procurement institutions particularly valuable when countries can plan well ahead of time.

Coauthor: Nahim Bin Zahur (Queen’s University).

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Dr. Lucy Xiaolu Wang is a tenure-track Assistant Professor at University of Massachusetts Amherst, a Faculty Research Fellow at the Max Planck Institute for Innovation and Competition, Germany, and a Faculty Associate at the Canadian Centre for Health Economics. Her research focuses on the economics of innovation & digitization in health care markets (national and global), particularly in the biopharmaceutical and digital health industries. Dr. Wang earned her PhD in economics from Cornell University, her master’s degree in economics from Duke University, and her bachelor’s degree in applied economics (specialty: insurance) from Central University of Finance and Economics in Beijing, China. 

Talk Title: The Economics of Infertility—Evidence from Reproductive Medicine

Petra Persson is an Assistant Professor of Economics at Stanford’s Department of Economics. She is also a Faculty Research Fellow at the National Bureau of Economic Research, a Faculty Fellow at the Stanford Institute for Economic Policy Research and at the Stanford Center for International Development, and a Faculty Affiliate at the King Center on Global Development. Her research agenda centers on social insurance and family structure, and explores the interaction between government-provided insurance and intra-family insurance.

Natalia Serna is an economist with an interest in health economics and industrial organization. Her research agenda broadly examines the impact of government policies and insurance market structure on access to care through hospital networks, health outcomes, and health-care costs. Specifically, her research shows that health insurers engage in risk selection by providing narrow hospital networks for services that most patients tend to claim. Serna’s research shows that strong competition between private insurers is needed to achieve appropriate access to health services to avoid insurance monopolies. 

Fernando Alarid-Escudero, Ph.D., is an Assistant Professor of Health Policy at Stanford University School of Medicine. He obtained his Ph.D. in Health Decision Sciences from the University of Minnesota School of Public Health, and was an Assistant Professor at the Center for Research and Teaching in Economics (CIDE) Región Centro, Aguascalientes, Mexico, from 2018 to 2022, prior to coming to Stanford. His research focuses on developing statistical and decision-analytic models to identify optimal prevention, control, and treatment policies to address a wide range of public health problems and develops novel methods to quantify the value of future research.

About the Event: While rebels' electoral participation has become a focal point of scholarship on post-conflict development, the drivers and process of rebels' organizational transformation into political parties have remained elusive. Organizational theory provides a novel, yet critical, point of entry to understanding rebel-to-party transformation and the actors at the heart of it. I look inside rebels' wartime organizations and identify a set of subdivisions (in some groups) that mirror the key structures of political parties: governance wings, political-messaging wings, and social service wings. I argue that variation in rebels' wartime organizational structures gives rise to different party-building mechanisms with distinct prospects for success.  To test this theory, I use intra-organizational comparative process tracing of the Farabundo Martí National Liberation Front (FMLN) in El Salvador. Drawing on hundreds of archival documents, I create sub-organizational biographies and trace their evolution from inception to transformation.  This approach allows me to exploit systematic differences in the organizational structures of the FMLN's subgroups—while holding equal other key variables like ideology, prewar networks, and state context—to demonstrate how the construction of proto-party structures during wartime facilitates party-building at the war's end. 

About the Speaker: Sherry Zaks is a visiting scholar at the Center for International Security and Cooperation as well as an assistant professor of Comparative Politics and Methodology at the University of Southern California. Her substantive work examines the conditions under which rebel groups are able to transform into political parties in the aftermath of civil wars. She draws on organizational sociology to develop a comprehensive model of militant groups and trace how wartime structures either facilitate or inhibit rebel-to-party transformations. On the methods side, Sherry’s work focuses on conceptualization, measurement, and process tracing. 

 All CISAC events are scheduled using the Pacific Time Zone.

About the Event: Debates on cohesion in the world’s most powerful alliance have largely overlooked NATO’s complex constellation of internal politics - instead overly focusing on US influence. While the US undoubtedly retains it outsized role in NATO, security scholarship offers few clues as to how or why Russia’s full-scale 2022 invasion of Ukraine has affected NATO cohesion. Policymakers and pundits were quick to predict a long-lasting “NATO revival”, however, the aftermath has been a mixed bag: achievements (e.g. Swedish accession, augmented force posture) and setbacks (e.g. EU-NATO coordination on Ukraine, Russia-PRC responses, etc.). In this study, I argue that observed variation in NATO cohesion can best be explained by policymakers’ repeated use of internal, sticky narratives about other Allies’, which limit the number of issue areas on which formal agreements can occur. Even when Allies’ interests align, such pre-determined labeling of some Allies as spoilers and others as champions on specific issues constrains Allies’ outreach to one another. To test this narrative-focused argument, I conduct a discourse analysis of high-level, formally-agreed NATO documents (e.g. Strategic Concept, Communiqués and other NATO Summit “deliverables”), which are the products of months of intense negotiations, and leaders’ public statements immediately preceding and following the invasion. I also draw on interview evidence from several officials who were part of negotiations during this period. The study advances security scholarship by offering a new argument for why NATO cohesion has changed in the ways that it has, offers an explanation for observed disunity and updates negotiations literatures to stress the power of outgoing knowledge on coalition politics. The study’s empirical evidence also reveals that policymakers’ national narratives can both increase or decrease cohesion, depending on these narratives – even when the narratives themselves mischaracterize Allies’ actual bargaining space. The research advances existing security studies that find that individuals – and not just states – can play critical roles in alliance decision-making.

About the Speaker: Prof. Heidi Hardt is an Associate Professor of Political Science at the University of California, Irvine. As a 2021-2022 Council on Foreign Relations International Affairs TIRS fellow, she served the State Department (NATO Desk), a senator and congresswoman. She has authored articles, chapters and two books: NATO’s Lessons in Crisis: Institutional Memory in International Organization (Oxford, 2018) and Time to React: The Efficiency of International Organizations in Crisis Response (Oxford, 2014). Hardt examines transatlantic and European security, NATO, multilateral military operations, climate security, organizational change, learning, gender and elite decision-making. The NSF, Fulbright, NATO and Carnegie have funded her research.

 All CISAC events are scheduled using the Pacific Time Zone.

About the Event: When and why do terrorist groups attack outside their local conflict ecosystems? In the last decade, the number of terrorist groups carrying out violence across international borders has increased. Many explanations of transnational terrorism focus on state-level factors that make some countries more attractive bases or targets for transnational attacks than others. However, state-centric explanations fail to consider the organizational characteristics of the groups carrying out this violence. Transnational terrorism demands significant resources, strength, and coordination as well as intent. At what point in a group’s campaign is it motivated and capable of carrying out attacks abroad? Why are some groups more likely to transition to transnational violence? In this paper, we study the conditions under which terrorist groups move from conducting attacks in their home country to carrying out violence across state borders. We employ data from the Mapping Militants Project to analyze which organizational traits are associated with this choice. Our findings emphasize the importance of group-level attributes in understanding broader patterns of terrorism and consider the implications for counterterrorism policies.

About the Speakers: 

Martha Crenshaw is a senior fellow emerita at the FSI Center for International Security and Cooperation (CISAC) and a professor of political science by courtesy, emerita, at Stanford University. She taught in the Department of Government at Wesleyan University from 1974 to 2007. She has published extensively on the subject of terrorism. In 2011, Routledge published Explaining Terrorism, a collection of her previously published work. A book co-authored with Gary LaFree titled Countering Terrorism was published by the Brookings Institution Press in 2017. She is the founder and a Principal Investigator on the Mapping Militants Project, which traces the evolution of violent militant or extremist organizations across several different conflict theatres.

Kaitlyn Robinson is an Assistant Professor of Political Science at Rice University. She received her Ph.D. in Political Science from Stanford University in 2022, and she was an America in the World Consortium Postdoctoral Fellow at Duke University from 2022-2023. Her research seeks to explain how violent non-state actors organize, build relationships with foreign states, and carry out violence in armed conflict. In this work, she draws on original datasets, fieldwork interviews, and archival materials. She is a Principal Investigator on the Mapping Militants Project, which traces the evolution of violent militant or extremist organizations across several different conflict theatres.

 All CISAC events are scheduled using the Pacific Time Zone.

About the Event: The Missiles on Our Land investigates the human and environmental risks associated with the U.S. Air Force plans to replace its current fleet of land-based intercontinental ballistic missiles and maintain it well into the 2080s. It is the result of a two-year collaboration led by the Princeton University’s Program on Science & Global Security together with Nuclear Princeton, a group of Japanese and Native American researchers, and Columbia University’s School of Journalism, and published in partnership with Scientific American. This project combines state-of-the-art simulations of the consequences of nuclear war with ethnography and journalism, including narrative storytelling, podcasting, photography and cinematography to shed light on the consequences of the most significant nuclear weapon build-up since the end of the Cold War. This project aims to provide information that everyone in the United States and especially the communities living closest to the missile fields need to know so that they can understand and be part of the discussion as to the full extent of the risks associated with deploying new missiles for the next 60 years or more.

About the Speaker: Sébastien Philippe is a Research Scholar with Princeton University’s Program on Science and Global Security, part of the School of Public and International Affairs where he holds a continuous appointment. His research includes nuclear non-proliferation, arms control, disarmament, and justice issues. He is the co-author of Toxique (French University Press, 2021), an investigation into the radiological and environmental impact of French nuclear tests in the Pacific, which was a Finalist for the 2021 Albert Londres Prize (the French equivalent of the Pulitzer) and won a 2022 Sigma Award for best data journalism in the world, among other accolades. Philippe received his PhD in Mechanical and Aerospace Engineering from Princeton, was a Stanton Nuclear Security Postdoctoral fellow at the Harvard Kennedy School, and has served as a nuclear weapon system safety engineer in France's Ministry of Armed Forces.

 All CISAC events are scheduled using the Pacific Time Zone.

About the Event: The future of technology is unknown. In some cases, however, the military accepts exceptional expectations about future technology. What technology hype is accepted? And why does the military accept some exceptional expectations but dismiss similar hype about other kinds of emerging technology? Paradoxically, despite discourse about “revolution” and “disruption,” I argue that the hype audiences accept depends on their established identities and interests. They choose to embrace technology hype so long as the imagined change is familiar. Unfamiliar change is rejected. To test my argument, I posit that the U.S. military’s established identities and interests favor offense over defense, and kinetic over non-kinetic capabilities. I then compare the military’s response to discourse about the Cyber Revolution versus the Revolution in Military Affairs (RMA). The latter was familiar; the former was not. I find that the armed services were more willing to act on hype about the RMA. The military’s conservative bias is well documented in scholarship about bureaucratic politics and technological innovation. What makes the contrast between the RMA and Cyber Revolution so remarkable is how persistent that bias can be—even when the military thinks about revolutionary change and the future of war.

About the Speaker: Frank L. Smith III is a Professor and Director of the Cyber & Innovation Policy Institute at the U.S. Naval War College. His interdisciplinary research and teaching examine how ideas about technology—especially bad ideas—influence national security and international relations. His current research examines international cooperation on military science, cyber wargames, and the impact of technology hype. Previous scholarship includes his book, American Biodefense, as well as articles published in Security Studies, Social Studies of Science, Security Dialogue, Health Security, Asian Security, and The Lancet. His policy work includes helping draft the 2023 National Defense Science and Technology Strategy. He has a PhD in political science and a BS in biological chemistry, both from the University of Chicago. 

 All CISAC events are scheduled using the Pacific Time Zone.