New Draper Hills Summer Fellows come to Stanford to study linkages between democracy, development, and the rule of law

Rising leaders from a diverse group of nations in transition, including China, Russia, Ukraine, Syria, Iran, Iraq, Pakistan, Egypt, Kenya, Zimbabwe, Mozambique, and Nigeria arrived on campus on July 25 for a three-week seminar as Draper Hills Summer Fellows on Democracy and Development. Initiated by FSI's Center on Democracy, Development, and the Rule of Law (CDDRL) six years ago, the program has created a network of some 139 leaders from 62 transitioning countries.  This year's exceptional class of  23 fellows includes a deputy minister of Ukraine, current and former members of parliament (including a deputy speaker), leading attorneys and rule of law experts, civic activists, journalists, international development practitioners, and founders of non-governmental organizations (NGOs). (One fellow needed to withdraw because he was named to the Cabinet of the new Philippine president, Noynoy Aquino).

Draper Hills Summer Fellows are innovative, courageous, and committed leaders, who strive to improve governance, enhance civic participation, and invigorate development under very challenging circumstances"
- Larry Diamond"Draper Hills Summer Fellows are innovative, courageous, and committed leaders, who strive to improve governance, enhance civic participation, and invigorate development under very challenging circumstances," says CDDRL Director Larry Diamond. "This year's fellows are an inspiring group. They have come here to learn from us, but even more so from one another. And we will learn much from them, about the progress they are making and the obstacles they confront as they work to build democracy, improve government accountability, strengthen the rule of law, energize civil society, and enhance the institutional environment for broadly shared economic growth."

The three-week seminar is taught by an interdisciplinary team of leading Stanford faculty. In addition to Diamond, faculty include FSI Senior Fellow and CDDRL Deputy Director Kathryn Stoner; Stanford President Emeritus Gerhard Casper; FSI Deputy Director and political science Professor Stephen D. Krasner; Olivier Nomellini Senior Fellow Francis Fukuyama; professor of political science, philosophy, and law Joshua Cohen; professor of pediatrics and Stanford Health Policy core faculty Paul H. Wise; visiting associate professor Beth van Schaack; FSI Senior Fellow Helen Stacy; Walter P. Falcon, deputy director, Program on Food Security and the Environment; Erik Jensen, co-director of the Stanford Law School's Rule of Law Program; Avner Greif, professor of economics; Rick Aubry, lecturer in management, Stanford Graduate School of Business; and Nicholas Hope, director, Stanford Center on International Development.

Other leading experts who will engage the fellows include President of the National Endowment for Democracy Carl Gershman, United States Court of Appeals Judge Pamela Rymer, International Center on Nonviolent Conflict founding chair Peter Ackerman, Omidyar Network partner Matt Halprin, Conservation International's Olivier Langrand, executives of leading Silicon Valley companies, such as Google and Facebook, and media and nonprofit organizations in the Bay Area.  Michael McFaul, a Stanford political science professor and former CDDRL director, who now serves on the National Security Council as President Obama's chief advisor on Russia, will come to campus to teach a session on U.S. foreign policy in the Obama administration.

The demanding, but compelling curriculum will devote the first week of the seminar to defining the fundamentals of democracy, good governance, economic development, and the rule of law.  In the second week, faculty will turn to democratic and economic transitions and the feedback mechanisms between democracy, development, and a predictable rule of law. This week will include offerings on liberation technology, social entrepreneurship, and issues raised by development and the environment.  The third week will turn to the critical - and often controversial - role of international assistance to foster and support democracy, judicial reform, and economic development, including the proper role of foreign aid.

Our program helps to create a broader community of global activists and practitioners, intent on sharing experiences to bring positive change to some of the world's most troubled countries and regions"
- Kathryn Stoner-Weiss The fellows themselves also lead discussions, focused on the concrete challenges they face in their ongoing work in political and economic development. "Fellows come to realize that they are often engaged in solving similar problems - such as endemic corruption in different country contexts," says Kathryn Stoner-Weiss. "Our program helps to create a broader community of global activists and practitioners, intent on sharing experiences to bring positive change to some of the world's most troubled countries and regions."

The program has received generous gifts from donors William Draper III and Ingrid Hills.  Bill Draper made his gift in honor of his father, Maj. Gen. William H. Draper, Jr., a chief advisor to Gen. George Marshall and chief diplomatic administrator of the Marshall Plan in Germany, who confronted challenges comparable to those faced by Draper Hills Summer Fellows in building democracy, a market economy, and a rule of law, often in post-conflict conditions. Ingrid von Mangoldt Hills, made her gift in honor of her husband, Reuben Hills, president and chairman of Hills Bros. Coffee and a leading philanthropist. The Hills project they ran for 12 years improved the lives of inner city children and Ingrid saw in the Summer Fellows Program a promising opportunity to improve the lives of so many people in developing countries.

Thanking the program's benefactors, Larry Diamond says, "The benefit to CDDRL faculty and researchers is incalculable, and we are deeply grateful for the vision and generosity of Bill Draper and Ingrid Hills." As he and Kathryn Stoner-Weiss state, "The Draper Hills Summer Fellows Program allows us to interact with a highly, talented group of emerging leaders in political and economic development from diverse countries and regions. They benefit from exposure to the faculty's cutting edge work, while we benefit from a cycle of feedback on whether these ideas work in the field."  Like CDDRL, which bridges academic theory and policy, the Draper Hills Summer Fellows Program, they note, "is an ideal marriage between democratic and development theory and practice."

For additional details on the program or to request permission to attend a session, please contact program coordinator Audrey McGowan, audrey.mcgowan@stanford.edu.

President Barack Obama announced his intent to appoint CISAC's Mariano-Florentino Cuéllar, an expert on federal regulatory policy, public safety, and international security, to the Council of the Administrative Conference of the United States (ACUS), an independent agency of the United States government charged with improving the efficiency and fairness of federal agencies.

Professor Cuéllar, who is both a CISAC faculty member and the Deane F. Johnson Faculty Scholar at Stanford Law School, recently returned from a leave of absence he took to serve as Special Assistant to the President for Justice and Regulatory Policy at the White House Domestic Policy Council. Among other issues, Cuéllar worked on improving food safety and public health policy, expanding support to state and local law enforcement, enhancing transparency in the regulatory process, and strengthening border coordination and immigrant integration. He negotiated key provisions of the Family Smoking Prevention and Tobacco Control Act and represented the Domestic Policy Council in the development of the first-ever Quadrennial Homeland Security Review. Earlier, Cuéllar co-chaired the Obama Transition's Immigration Policy Committee and served as a Treasury official in the Clinton Administration.

As part of the ACUS Council, Cuéllar will join leading lawyers such as former U.S. court of appeals judge Patricia Wald and former solicitor general Ted Olson in overseeing the work of ACUS and setting its priorities. With the appointment to the ACUS Council, Cuéllar will draw upon his scholarly expertise in how institutions manage complex regulatory challenges as well as his experience in government.

"At a time when our country faces such enormous challenges, it is especially important for agencies to safeguard the rights of the public, cut waste, and deliver value to the American people," said Cuéllar. "I am honored by this appointment and by the chance to work on these critical issues."

Established by statute in 1964, the Administrative Conference of the United States has played an important role in promoting improvements in the efficiency and fairness in the way federal agencies conduct regulatory programs. ACUS has been on hiatus for the past 14 years, but has been revived by Congress with support from a broad range of lawyers, scholars, and judges, including Supreme Court Justices Antonin Scalia and Stephen Breyer.

This Spring quarter, while our seminar series took a break, Terry Winograd and Joshua Cohen taught a new course at the Hasso Plattner Institute of Design (the d.school): Designing Liberation Technologies.

During this class, small interdisciplinary teams focus on a term-long design project, taking advantage of the design process structures and methods that have been developed in the d.school. This year's course developed as a collaboration between Stanford, the University of Nairobi and Nokia Africa Research Center.  The focus area was finding ICT solutions to the healthcare needs of people living in Kibera slum outside Nairobi.

Under the guidance of Jussi Impiö at Nokia and the Computer Science faculty, 27 students from the University of Nairobi Computer Science department conducted need finding studies at a number of health-related sites, including clinics, hospitals, community health workers, community leaders, and government offices. They read background materials, made observations, and talked with a wide variety of stakeholders. Their reports became the basis of the Stanford teams' initial understanding of users and needs. Communication with the group in Nairobi was also maintained throughout the course, using a Facebook group to facilitate discussions, as well as several teleconference sessions.

Working in small teams, 20 Stanford students from a wide range of disciplines worked over 10 weeks to develop initial design concepts to respond to some of the needs that had been identified. Click on the title of each project to view their final presentations:

• mNote: an online archive for community health worker notes. This application empowers community health workers by preserving the flexibility and control they appreciate in their current paper notebooks, but adding digital knowledge management capabilities.
• M-MAJI ("mobile water"): an electronic information system that allows people to use their mobile phones to identify clean water sources in their community. The application seeks to decrease the time and money spent searching for water, improve water quality, and foster vendor accountability by providing a mechanism for user feedback.
• Babybank: a dedicated savings plan designed specifically for pregnant women in the slums of Nairobi. By leveraging a popular cell phone payment system, M-Pesa, the application aims to make savings easier, so that expecting mothers can afford the services that will keep themselves and their babies healthy.
• Mazanick: an application to provide support and advice to pregnant women via SMS, with the aim of helping motivate them to attend prenatal appointments.
• PillCheck (Kifaa cha Tenbe): a mobile application to help people in Kibera find information on the availability and pricing of malaria drugs quickly.
• PatientMap :a system to make the waiting process in clinics more transparent, and to increase patient trust in the medical system.

This summer, two follow up trips are planned, with Nairobi students due to spend several weeks at Stanford, while a number of students from the Stanford group will visit Nairobi to explore possibilities for developing their projects further. Building on the success and lessons learnt so far, the Designing Liberation Technologies course will be open to a new set of students next academic year. 

Advances in high-yield agriculture achieved during the so-called Green Revolution have not only helped feed the planet, but also have helped slow the pace of global warming by cutting the amount of biomass burned - and the resulting greenhouse gas emissions - when forests or grasslands are cleared for farming. Stanford researchers estimate those emissions have been trimmed by over half a trillion tons of carbon dioxide. The paper is being released this week in the Proceedings of the National Academy of Sciences.

Advances in high-yield agriculture over the latter part of the 20th century have prevented massive amounts of greenhouse gases from entering the atmosphere - the equivalent of 590 billion metric tons of carbon dioxide - according to a new study led by two Stanford Earth scientists.

The yield improvements reduced the need to convert forests to farmland, a process that typically involves burning of trees and other plants, which generates carbon dioxide and other greenhouse gases.

The researchers estimate that if not for increased yields, additional greenhouse gas emissions from clearing land for farming would have been equal to as much as a third of the world's total output of greenhouse gases since the dawn of the Industrial Revolution in 1850.

The researchers also calculated that for every dollar spent on agricultural research and development since 1961, emissions of the three principal greenhouse gases - methane, nitrous oxide and carbon dioxide - were reduced by the equivalent of about a quarter of a ton of carbon dioxide - a high rate of financial return compared to other approaches to reducing the gases.

"Our results dispel the notion that modern intensive agriculture is inherently worse for the environment than a more 'old-fashioned' way of doing things," said Jennifer Burney, lead author of a paper describing the study that will be published online by the Proceedings of the National Academy of Sciences.

Adding up the impact

The researchers calculated emissions of carbon dioxide, methane and nitrous oxide, converting the amounts of the latter two gases into the quantities of carbon dioxide that would have an equivalent impact on the atmosphere, to facilitate comparison of total greenhouse gas outputs.

Burney, a postdoctoral researcher with the Program on Food Security and the Environment at Stanford, said agriculture currently accounts for about 12 percent of human-caused greenhouse gas emissions. Although greenhouse gas emissions from the production and use of fertilizer have increased with agricultural intensification, those emissions are far outstripped by the emissions that would have been generated in converting additional forest and grassland to farmland.

"Every time forest or shrub land is cleared for farming, the carbon that was tied up in the biomass is released and rapidly makes its way into the atmosphere - usually by being burned," she said. "Yield intensification has lessened the pressure to clear land and reduced emissions by up to 13 billion tons of carbon dioxide a year."

"When we look at the costs of the research and development that went into these improvements, we find that funding agricultural research ranks among the cheapest ways to prevent greenhouse gas emissions," said Steven Davis, a co-author of the paper and a postdoctoral researcher at the Carnegie Institution at Stanford.

To evaluate the impact of yield intensification on climate change, the researchers compared actual agricultural production between 1961 and 2005 with hypothetical scenarios in which the world's increasing food needs were met by expanding the amount of farmland rather than by the boost in yields produced by the Green Revolution.

"Even without higher yields, population and food demand would likely have climbed to levels close to what they are today," said David Lobell, also a coauthor and assistant professor of environmental Earth system science at Stanford.

"Lower yields per acre would likely have meant more starvation and death, but the population would still have increased because of much higher birth rates," he said. "People tend to have more children when survival of those children is less certain."

Avoiding the need for more farmland

The researchers found that without the advances in high-yield agriculture, several billion additional acres of cropland would have been needed.

Comparing emissions in the theoretical scenarios with real-world emissions from 1961 to 2005, the researchers estimated that the actual improvements in crop yields probably kept greenhouse gas emissions equivalent to at least 317 billion tons of carbon dioxide out of the atmosphere, and perhaps as much as 590 billion tons.

Without the emission reductions from yield improvements, the total amount of greenhouse gas pumped into the atmosphere over the preceding 155 years would have been between 18 and 34 percent greater than it has been, they said.

To calculate how much money was spent on research for each ton of avoided emissions, the researchers calculated the total amount of agricultural research funding related to yield improvements since 1961 through 2005. That produced a price between approximately $4 and $7.50 for each ton of carbon dioxide that was not emitted.

"The size and cost-effectiveness of this carbon reduction is striking when compared with proposed mitigation options in other sectors," said Lobell. "For example, strategies proposed to reduce emissions related to construction would cut emissions by a little less than half the amount that we estimate has been achieved by yield improvements and would cost close to $20 per ton."

The authors also note that raising yields alone won't guarantee lower emissions from land use change.

"It has been shown in several contexts that yield gains alone do not necessarily stop expansion of cropland," Lobell said. "That suggests that intensification must be coupled with conservation and development efforts.

"In certain cases, when yields go up in an area, it increases the profitability of farming there and gives people more incentive to expand their farm. But in general, high yields keep prices low, which reduces the incentive to expand."

The researchers concluded that improvement of crop yields should be prominent among a portfolio of strategies to reduce global greenhouse gases emissions.

"The striking thing is that all of these climate benefits were not the explicit intention of historical investments in agriculture. This was simply a side benefit of efforts to feed the world," Burney noted. "If climate policy intentionally rewarded these kinds of efforts, that could make an even bigger difference. The question going forward is how climate policy might be designed to achieve that."

David Lobell is a Center Fellow at the Freeman Spogli Institute for International Studies and at the Woods Institute for the Environment. The Program on Food Security and the Environment is a joint project of the Woods Institute and the Freeman Spogli Institute. The Precourt Institute for Energy and FSE provided funding for Jennifer Burney's research on agriculture and energy.

U.S. Ambassador to the United Nations and former FSI Advisory Board member Susan Rice '86 urged Stanford's graduating class to fight global poverty, conflict, and repression, saying "These massive disparities erode our common security and corrode our common humanity." Conflict-ridden states not only cause suffering for their people, she noted. "Poor and fragile states can incubate threats that spread far beyond borders -- terrorism, pandemic disease, nuclear proliferation, criminal networks" and more. "In our interconnected world," she said, " a threat to development anywhere is a threat to security everywhere."

When Susan Rice graduated from Stanford in 1986, the Soviet Union was a formidable foe, China barely registered on the global economic scene and the first computer laptops – weighing in at 12 pounds each – were just hitting the market.

And if someone had told her that she'd serve in the Cabinet of the country's first black president as ambassador to the United Nations, "I would've asked them what they were smoking."

But in her remarks delivered during Stanford University's 119th Commencement on Sunday, Rice put the advances of the past 24 years in perspective. She called the fight against global poverty "not only one of the great moral challenges of all time, but also one of the great national security challenges of our time."

"The planet is still divided by fundamental inequalities," she said. "Some of us live in peace, freedom and comfort while billions are condemned to conflict, poverty and repression. These massive disparities erode our common security and corrode our common humanity."

While she did not discuss any specifics of her role as the country's ambassador to the United Nations or the organization's recent move to impose a fourth round of sanctions on Iran, Rice did talk about the link between poverty and security.

"When a country is wracked by war or weakened by want, its people suffer first. But poor and fragile states can incubate threats that spread far beyond borders – terrorism, pandemic disease, nuclear proliferation, criminal networks, climate change, genocide and more. In our interconnected age, a threat to development anywhere is a threat to security everywhere."
-Ambassador Susan Rice

Rice's address marked a very public return to Stanford. She graduated with a bachelor's in history from the university as a junior Phi Beta Kappa and Truman Scholar in 1986.

She was confirmed as ambassador to the United Nations in 2009 after being nominated by President Obama. It was a job that followed her role as Obama's senior adviser for national security affairs during his presidential campaign in 2007 and 2008. Before that, she served as the country's assistant secretary of state for African affairs and as a special assistant to President Clinton. She was also a senior director for African affairs at the National Security Council.

During a trip to a displaced persons camp in war-torn Angola in 1995, Rice saw firsthand the global poverty she talked about on Sunday. Of all the people she saw in the camp, she said one of her most striking memories is the smile she received from a malnourished little boy when she gave him her baseball cap.

But she's haunted by thoughts of what may have happened to him.

"I had to leave that camp," she said. "And when I did, I left that little boy in hell. I like to think, and I sure hope, that kid is OK. But he could well have become one of the 9  million children under the age of 5 who die each year from preventable and treatable afflictions."

And that boy, she said, should be a symbol to Stanford's graduates of the challenges that face them and the good they can do in the world.

"That little boy's future is tied to ours," she said. "Our security is ultimately linked to his well-being. So we must shape the world he deserves."

Rice's weighty remarks still left room for graduation levity. And the student procession – known as the Wacky Walk – showcased much of it.

The graduates hit the field of Stanford Stadium with balloons and signs thanking mom and dad. They were dressed as Egyptian kings and Vikings, wizards and butterflies. Some wore bathing suits and flowing togas. Others covered up with costumes paying homage to the pop culture past of Pac-Man, as well as more timeless pursuits like dominoes and poker.

It was a final blast of carefree fun for college students about to contend with an uncertain job market.

"We have everything we need on campus," said Tyler Porras, a graduating biology major who took to the field with a bolo tie and black cowboy hat. "Now it's off to the real world where you need to find a job."

The ceremony marked the award of 1,722 bachelor's degrees, 2,100 master's degrees and 980 doctoral degrees.

Departmental honors were awarded to 365 seniors, and 272 graduated with university distinction. Another 74 graduated with multiple majors and 33 received dual bachelor's degrees. There were 110 graduates receiving both bachelor's and master's degrees.

Among international students, there were 102 undergraduates from 45 countries other than the United States, and 955 graduate students from 75 foreign countries.

"As you leave Stanford, I hope you carry a deep appreciation of the values and traditions that are everlasting, as well as a willingness to be bold and to approach challenges with a fresh perspective," Stanford President John Hennessy told the graduates.

The day also gave parents a time to beam and brag.

"These kids have the potential to contribute so much to the world," said Tim Roake, whose daughter, Caitlin Roake, is graduating as a biology major and is planning to join the Peace Corps.

Roake and his wife, Kathleen Gutierrez, had front-row seats in the stadium bleachers next to Dave and Lori Gaskin. Their son, Greg, has been dating Caitlin Roake since their freshman year.

"The last four years for Greg have been such an enriching experience from an academic perspective but also on a personal level," Lori Gaskin said. "I attribute that not only to the university but the wonderful people he's met and the relationships he's made."

 

A new AHPP working paper contributes to an important debate in law and health policy

Malpractice liability, along with medical technology and payment system distortions, regularly figures among the most-cited reasons for escalating health-care spending in the United States. On the one hand, Harvard economist Amitabh Chandra conservatively estimates that upwards of $60 billion, or 3 percent of total health care costs ($1.8 trillion), is spent annually as a result of direct litigation and indi­rect defensive medicine costs. On the other hand, tort reform advocates place the figure at $200 billion by extrapolating, to the entire U.S. population, the results of research conducted by Stanford professor Dan Kessler and Mark McClellan. Their 1996 study shows that tort reforms reduced provider liability costs for Medicare heart patients by 5 to 9 percent.

 

At the heart of these debates is the following question. Does medical malpractice liability achieve its dual goal of compensating victims of medical injuries and deterring medical errors, or does it merely encourage wasteful defensive medicine without improving patient health? Despite considerable empiri­cal research, there is little evidence that malpractice litigation deters medical negligence. The evidence is much stronger—though still hotly debated—that malpractice fears actually encourage physicians to engage in defensive medicine.

 

The newest release in the Asia health Policy Program working paper series, AHPP working paper #13 by Brian Chen, explores whether malpractice pressures affect physician behavior, patient health, and health care costs in Asia. Studying physicians’ response to legal changes in Taiwan, he finds that greater malpractice liability may, under certain circumstances, prompt physicians to perform more services without necessarily improving patient health.

 

Dr. Chen investigates how physicians’ test-ordering behavior and propensity to perform cesarean sections were affected first by a series of court rulings in Taiwan that increased physicians’ liability risks, and then by a subsequent amendment to the law that reversed the courts’ rulings. He finds that physicians faced with higher malpractice pressure increased laboratory tests as expected but unexpectedly reduced cesarean sections. The reduction in cesarean deliveries may be due to the fact that liability risks were more closely aligned with physicians’ standard of care after the court rulings. After the law was amended to negate the court decisions, physicians reversed their previous behavior, reducing laboratory tests and increasing cesarean deliveries. This pattern of behavior strongly suggests that physicians in Taiwan practice defensive medicine.