Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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Abstract
Improving the productivity of small farmers is essential for economic development in most poor countries.  Providing access to timely and relevant information could improve the opportunities available to farmers.  However, there are significant challenges related to literacy, infrastructure, access to technology and social, cultural, institutional and linguistic gaps between producers and consumers of knowledge.  The increased adoption of mobile phones is rapidly reducing the physical barriers of access.  Providing voice-based services via low-cost handsets could empower farmers to become producers as well as consumers of knowledge.  In this talk, I discuss several applications my students and I are developing to explore this potential.  Avaaj Otalo (Gujarati for "voice stoop") is the voice-based equivalent of an online discussion board. Farmers and agricultural experts call a toll-free line to ask questions, provide answers, and listen to each others questions, answers and experiences.  We conducted a six-month trial deployment of Avaaj Otalo with fifty farmers in Gujarat, India. Farmers found it useful to learn both from experts and other farmers, sharing advice on many topics - including the best time to sow fodder, recipes for organic pesticides, and homemade devices to scare away wild pigs at night. Digital ICS allows coffee cooperatives to monitor quality and organic certification requirements, and to be more responsive to farmers' needs.  Field inspectors use mobile phones to document growing conditions and record farmers questions and comments through a combination of text, audio and images.  In a six-month trial deployment, the system significantly reduced operational costs, saving the cooperative approximately $10,000 a year.  The cooperative also obtained richer feedback from its members, which can be used for targeting extension, improving decision-making and reaching out to consumers.  In both of these systems, voice provides not only an accessible interface to information, but a medium for aggregating and representing knowledge itself.  We found this approach more suitable for engaging communities more comfortable with oral forms of communication, for whom text and structured data represent significant barriers to expression.  Most importantly, we have found that rural communities have a deep desire to be "heard", and simply need the tools required to define and achieve "development" on their own terms.

Tapan Parikh's research focuses on the use of computing to support sustainable economic development across the World. I want to learn how to build appropriate, affordable information systems; systems that are accessible to end users, support learning and reinforce community efforts towards empowerment, economic development and sustainable use of natural resources. Some specific topics that I am interested in include human-computer interaction (HCI), mobile computing and information systems supporting microfinance, smallholder agriculture and global health

Summary of the Seminar
Tapan Parikh, of UC Berkeley School of Information, spoke about a number of projects that are using mobile phone based technology to give small businesses the information they need to improve productivity. He argued that voice technology has distinct advantages over text, because it overcomes challenges of illiteracy while responding to a strong need people feel to be heard. 

Information is key for economic development and empowerment. But information is worthless unless it is also useable (leads to decisions the business owner can actually take), trusted (comes from a source he respects) and relevant (speaks about the issues he is facing). For information to be really empowering, it must also be two way: there must be ways for individuals to create content themselves.

Tapan described three current projects he is involved in:

Hisaab: Microfinance groups in India often suffer from poor paper based record keeping, making it difficult for the group to track loans and repayments. The Hissab software was designed with an interface suitable for those who may be illiterate and/or new to computing. The use of voice commands and responses in the local language, Tamil, prevented the software from feeling remote and inaccessible and contributed to the success of this initiative. 

Avaaj Otalo: Agricultural extension workers provide advice to farmers on pests, new techniques etc to help improve yields. But often they have limited reach, visiting areas only rarely, or perhaps lacking the expertise to respond to all the problems they encounter. Avaaj Otalo is a system for farmers to access relevant and timely agricultural information over the phone. By dialing a phone number and navigating through simple audio prompts, farmers can record questions, respond to others, or access content published by agricultural experts and institutions. The service has been hugely popular, with farmers willing to spend time listening to large amounts of material to find what they want. The opportunity to be broadcast was a major attraction, reflecting the desire to be heard and to create media rather than be a passive consumer of it.

Digital ICS: Smallholders' compliance with organic, fair-trade and quality requirements is usually measured via paper based internal inspections. The data uncovered by these is vital but often lost. Digital ICS is a mobile phone based application that allows inspectors to fill out the survey digitally, enhance it with visual evidence (e.g. from camera phones) and upload it onto a web application. This is being piloted with coffee farmers in Mexico. A key finding from the work is that farmers want to know who ends up drinking their coffee, what they pay for it and what they think about it. Greater links between producers and consumers may therefore be another area for this project to investigate.  

Wallenberg Theater
Bldg 160

Tapan Parikh Assistant Professor Speaker University of California, Berkeley; affiliate in the Department of Computer Science at the University of Washington
Seminars
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We are very excited to announce the launch of Stanford's Center on Democracy, Development, and the Rule of Law's new Program on Human Rights and the McCoy Family Center for Ethics in Society's Human Rights Summer Fellowships for undergraduates.

2:00 - 2:10 Welcome by Larry Diamond, Director / Center on Democracy, Development, and the Rule of Law

2:10 - 3:45 "Program on Human Rights: Bridging Theory and Practice"
The Program on Human Rights provides a forum for the dozens of Stanford faculty who work in disciplines that engage or border on human rights (including law, philosophy, political science, education, human biology, public health, history and religious studies) and the more than 30 student-initiated human rights groups on campus.  Its work will be a unique intersection of social sciences scholarship that aims to shape public policy and practical implementation of human rights.  This panel showcases some important work being done by Stanford faculty on human rights.

  • Helen Stacy (Coordinator, Program on Human Rights / Law School) Chair
  • Jenny Martinez (Law School)
  • Terry Karl  (Professor, Political Science and Latin American Studies)
  • Ray Levitt (Civil and Environmental Engineering / Woods Institute for the Environment)
  • Jim Ferguson (Anthropology)

4:00 - 5:15 McCoy Family Center Undergraduate Human Rights Summer Fellowships
In the 2009-10 academic year, the McCoy Family Center is launching an Undergraduate Human Rights Fellowship Program that will allow 4 undergraduates to immerse themselves in a summer-long internship in a human rights organization. Come find out about the opportunities for doing human rights work and hear from students who have successfully worked on human rights projects.

  • Debra Satz (Director, Center for Ethics in Society / Philosophy) Chair

5:30 - 6:45  Keynote address - "Between the Concrete and the Clouds: Living Your Human Rights Principles"

  • Paul Wise (School of Medicine / Center for Health Policy)

Bechtel Conference Center

CDDRL
Stanford University
Encina Hall, C147
616 Jane Stanford Way
Stanford, CA 94305-6055

(650) 724-6448 (650) 723-1928
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Mosbacher Senior Fellow in Global Democracy at the Freeman Spogli Institute for International Studies
William L. Clayton Senior Fellow at the Hoover Institution
Professor, by courtesy, of Political Science and Sociology
diamond_encina_hall.png MA, PhD

Larry Diamond is the William L. Clayton Senior Fellow at the Hoover Institution, the Mosbacher Senior Fellow in Global Democracy at the Freeman Spogli Institute for International Studies (FSI), and a Bass University Fellow in Undergraduate Education at Stanford University. He is also professor by courtesy of Political Science and Sociology at Stanford, where he lectures and teaches courses on democracy (including an online course on EdX). At the Hoover Institution, he co-leads the Project on Taiwan in the Indo-Pacific Region and participates in the Project on the U.S., China, and the World. At FSI, he is among the core faculty of the Center on Democracy, Development and the Rule of Law, which he directed for six and a half years. He leads FSI’s Israel Studies Program and is a member of the Program on Arab Reform and Development. He also co-leads the Global Digital Policy Incubator, based at FSI’s Cyber Policy Center. He served for 32 years as founding co-editor of the Journal of Democracy.

Diamond’s research focuses on global trends affecting freedom and democracy and on U.S. and international policies to defend and advance democracy. His book, Ill Winds: Saving Democracy from Russian Rage, Chinese Ambition, and American Complacency, analyzes the challenges confronting liberal democracy in the United States and around the world at this potential “hinge in history,” and offers an agenda for strengthening and defending democracy at home and abroad.  A paperback edition with a new preface was released by Penguin in April 2020. His other books include: In Search of Democracy (2016), The Spirit of Democracy (2008), Developing Democracy: Toward Consolidation (1999), Promoting Democracy in the 1990s (1995), and Class, Ethnicity, and Democracy in Nigeria (1989). He has edited or coedited more than fifty books, including China’s Influence and American Interests (2019, with Orville Schell), Silicon Triangle: The United States, China, Taiwan the Global Semiconductor Security (2023, with James O. Ellis Jr. and Orville Schell), and The Troubling State of India’s Democracy (2024, with Sumit Ganguly and Dinsha Mistree).

During 2002–03, Diamond served as a consultant to the US Agency for International Development (USAID) and was a contributing author of its report, Foreign Aid in the National Interest. He has advised and lectured to universities and think tanks around the world, and to the World Bank, the United Nations, the State Department, and other organizations dealing with governance and development. During the first three months of 2004, Diamond served as a senior adviser on governance to the Coalition Provisional Authority in Baghdad. His 2005 book, Squandered Victory: The American Occupation and the Bungled Effort to Bring Democracy to Iraq, was one of the first books to critically analyze America's postwar engagement in Iraq.

Among Diamond’s other edited books are Democracy in Decline?; Democratization and Authoritarianism in the Arab World; Will China Democratize?; and Liberation Technology: Social Media and the Struggle for Democracy, all edited with Marc F. Plattner; and Politics and Culture in Contemporary Iran, with Abbas Milani. With Juan J. Linz and Seymour Martin Lipset, he edited the series, Democracy in Developing Countries, which helped to shape a new generation of comparative study of democratic development.

Download full-resolution headshot; photo credit: Rod Searcey.

Former Director of the Center on Democracy, Development and the Rule of Law
Faculty Chair, Jan Koum Israel Studies Program
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Larry Diamond Director, CDDRL Speaker
Helen Stacy Coordinator, Program on Human Rights Speaker CDDRL
Jenny Martinez Professor, Stanford Law School Speaker

Department of Political Science
Encina Hall
Stanford University
Stanford, CA 94305-6044

(650) 724-4166 (650) 724-2996
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Professor of Political Science
Gildred Professor of Latin American Studies
William and Gretchen Kimball University Fellow
Senior Research Scholar (by courtesty) of FSI/CDDRL
terrykarl.png MA, PhD

Professor Karl has published widely on comparative politics and international relations, with special emphasis on the politics of oil-exporting countries, transitions to democracy, problems of inequality, the global politics of human rights, and the resolution of civil wars. Her works on oil, human rights and democracy include The Paradox of Plenty: Oil Booms and Petro-States (University of California Press, 1998), honored as one of the two best books on Latin America by the Latin American Studies Association, the Bottom of the Barrel: Africa's Oil Boom and the Poor (2004 with Ian Gary), the forthcoming New and Old Oil Wars (with Mary Kaldor and Yahia Said), and the forthcoming Overcoming the Resource Curse (with Joseph Stiglitz, Jeffrey Sachs et al). She has also co-authored Limits of Competition (MIT Press, 1996), winner of the Twelve Stars Environmental Prize from the European Community. Karl has published extensively on comparative democratization, ending civil wars in Central America, and political economy. She has conducted field research throughout Latin America, West Africa and Eastern Europe. Her work has been translated into 15 languages.

Karl has a strong interest in U.S. foreign policy and has prepared expert testimony for the U.S. Congress, the Supreme Court, and the United Nations. She served as an advisor to chief U.N. peace negotiators in El Salvador and Guatemala and monitored elections for the United Nations. She accompanied numerous congressional delegations to Central America, lectured frequently before officials of the Department of State, Defense, and the Agency for International Development, and served as an adviser to the Chairman of the House Sub-Committee on Western Hemisphere Affairs of the United States Congress. Karl appears frequently in national and local media. Her most recent opinion piece was published in 25 countries.

Karl has been an expert witness in major human rights and war crimes trials in the United States that have set important legal precedents, most notably the first jury verdict in U.S. history against military commanders for murder and torture under the doctrine of command responsibility and the first jury verdict in U.S. history finding commanders responsible for "crimes against humanity" under the doctrine of command responsibility. In January 2006, her testimony formed the basis for a landmark victory for human rights on the statute of limitations issue. Her testimonies regarding political asylum have been presented to the U.S. Supreme Court and U.S. Circuit courts. She has written over 250 affidavits for political asylum, and she has prepared testimony for the U.S. Attorney General on the extension of temporary protected status for Salvadorans in the United States and the conditions of unaccompanied minors in U.S. custody. As a result of her human rights work, she received the Doctor of Humane Letters, honoris causa from the University of San Francisco in 2005.

Professor Karl has been recognized for "exceptional teaching throughout her career," resulting in her appointment as the William R. and Gretchen Kimball University Fellowship. She has also won the Dean's Award for Excellence in Teaching (1989), the Allan V. Cox Medal for Faculty Excellence Fostering Undergraduate Research (1994), and the Walter J. Gores Award for Excellence in Graduate and Undergraduate Teaching (1997), the University's highest academic prize. Karl served as director of Stanford's Center for Latin American Studies from 1990-2001, was praised by the president of Stanford for elevating the Center for Latin American Studies to "unprecedented levels of intelligent, dynamic, cross-disciplinary activity and public service in literature, arts, social sciences, and professions." In 1997 she was awarded the Rio Branco Prize by the President of Brazil, Fernando Henrique Cardoso, in recognition for her service in fostering academic relations between the United States and Latin America.

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Terry L. Karl Professor, Political Science/Latin American Studies Speaker
Ray Levitt Professor, Civil and Environmental Engineering/Woods Institute for the Environment Speaker
Jim Ferguson Chair and Professor, Department of Anthropology Speaker

Department of Philosophy
Building 90, Room 102L
Stanford University
Stanford, CA 94305-2155

(650) 723-2133
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Marta Sutton Weeks Professor of Ethics in Society, Professor of Philosophy, and by courtesy, Political Science
debra_satz.jpg PhD

Debra Satz is the Marta Sutton Weeks Professor of Ethics in Society and Professor of Philosophy at Stanford University. Prior to coming to Stanford in 1988, Dr. Satz taught at Swarthmore College. She also held fellowships at the Princeton University Center for Human Values and the Stanford Humanities Center. In 2002, she was the Marshall Weinberg Distinguished Visiting Professor at the University of Michigan. 

Dr. Satz grew up in the Bronx and received her B.A. from the City College of New York. She received her PhD from MIT in 1987.

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Debra Satz Director, McCoy Family Center for Ethics in Society Speaker
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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
rsd15_081_0253a.jpg MD, MPH

Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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AHPP faculty affiliate, Matthew Kohrman, was interviewed by China Radio International (CRI) on August 13th, 2009 about tobacco control in China. As CRI reports, "tobacco control is always a difficult subject for law makers... Still, there appears to be a growing movement -- including in China -- to control tobacco sales."
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In April, China announced an ambitious health care reform plan that aims to provide universal access to basic care for all Chinese while enhancing population health initiatives, strengthening service delivery, improving risk pooling, and significantly increasing government funding for the health sector. China Radio International interviewed Karen Eggleston, Asia Health Policy Program Director, about China's health care reform for the radio program "People in the Know." The program, aired on August 21, can be heard online.
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Shorenstein APARC
Stanford University
Encina Hall, Room E-301
Stanford, CA 94305-6055

(650) 391-7164 (650) 723-6530
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AHPP Visiting Scholar, 2009-2010
wy-photo.jpg PhD

Dr. Yan Wang is a visiting scholar at Shorenstein Asia-Pacific Research Center for 2009-2010. Her research focuses on tobacco control, primary health care system, health education and health promotion, and health insurance. She is currently also the group manager of Division of Grass-Root Health Services, Shandong Provincial Health Department, P.R.China, and is in charge of urban community health services, health education and health promotion. She has an MA in public health from Shandong Medical University and PhD in Social Medicine and Health Management from Shandong University. Dr. Yan Wang has been an adjunct professor at Weifang Medical University since 2008. She also engaged in academic association and public organizations related to health affair.

Shorenstein APARC
Stanford University
Encina Hall, Room E-301
Stanford, CA 94305-6055

(650) 736-0771 (650) 723-6530
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2011 AHPP/CEAS Visiting Scholar
IMG_5703.JPG JD, PhD

Dr. Brian Chen is currently a visiting scholar with the Asia Health Policy Program and Center for East Asian Studies at Stanford University. He was recently Shorenstein Asia-Pacific Research Center's 2009-2010 postdoctoral fellow in Comparative Health Policy. As a visiting scholar, Dr. Chen will conduct collaborative research about health of the elderly and chronic disease in China.

As an applied economist, Chen’s research focuses on the impact of incentives in health care organizations on provider and patient behavior. For his dissertation, Chen empirically examined how vertical integration and prohibition against self-referrals affected physician prescribing behavior. His job market paper was selected for presentation at the American Law and Economics Association’s Annual Meeting, the Academy of Management, the Canadian Law and Economics Association, the Conference on Empirical Legal Studies, and the First Annual Conference on Empirical Health Law and Policy at Georgetown Law Center in 2009.  The paper was also nominated for best paper based on a dissertation at the Academy of Management.

Chen comes to the Shorenstein Asia-Pacific Research Center not only with a multidisciplinary law and economics background, but also with an international perspective from having lived and worked in Taiwan, Japan, and France. He has a particularly intimate knowledge of the Taiwanese health care system from his experience as an assistant to the hospital administrator at a medical college in Taiwan.

During his past residence as a postdoctoral fellow with the Asia Health Policy Program, Chen conducted empirical research on cost containment policies in Taiwan and Japan and how those policies impacted provider behavior. His work also contributed to the program’s research activities on comparative health systems and health service delivery in the Asia-Pacific, a theme that encompasses the historical evolution of health policies; the role of the private sector and public-private partnerships; payment incentives and their impact on patients and providers; organizational innovation, contracting, and soft budget constraints; and chronic disease management and service coordination for aging populations.

Dr. Brian Chen recently completed his Ph.D. in Business Administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.

117 Encina Commons
Stanford, CA 94305

(650) 804-5398
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oddvar_kaarboe.jpg PhD

Currently Dr. Kaarboe is working as an associate professor in economics at Department of Economics, University of Bergen, Norway. He also serves as the research director of the research group Health Economics Bergen (HEB).

Dr. Kaarboe's research has mainly been focused on developing and implementing financing models in the health care sector. This includes i) theoretical work, ii) developing remuneration models at the nation level, and iii) developing and implementing remuneration models at the regional level in Norway. He has also been involved in a WHO-project on implementing decentralization in health care. Recently Dr. Kaarboe was the Principal Investigator (PI) for a project on evaluation of a Norwegian hospital reform. This reform concerns a major change in the governance structure of the hospital sector in Norway. Currently Dr. Kaarboe is the PI of a project on prioritization in the hospital sector. The main purpose of the project is to develop a surveillance system to monitor prioritization of hospital patients. One part of the project includes a comparative analysis of prioritization practices in Norway and Scotland. He is also involved in a project about the relationship between social capital and health.

The health economics group in Bergen is one of the larger health research groups in Europe. The research group is based within economics and business administration but emphasizes multidisciplinary research cooperation with medicine, health care institutions and other social sciences. It has a broad international (European) network. Well known health economics like Professors Andrew Jones, (York), Carol Propper (Imperial College/Bristol University), John Cairns (London School of Hygiene and Tropical Medicine), Matt Sutton (University of Manchester), Sherman Folland (Oakland University) and Maarten Lindeboom (Vrije University) are all affiliated with the health group.

Adjunct Affiliate at the Center for Health Policy and the Department of Health Policy
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PrescribingCultures front cover

Pharmaceutical policies are interlinked globally and at the same time deeply rooted in local culture. Prescribing Cultures examines how pharmaceuticals and their regulation play an important and often contentious role in the health systems of the Asia-Pacific.

The first section of this timely book analyzes pharmaceutical policy in China, Korea, Japan, Thailand, Taiwan, Australia, and India. The second section focuses on two cross-cutting themes: differences in "prescribing cultures" and physician dispensing; and the challenge of balancing access to drugs with incentives for innovation.

The book's contributors discuss important issues for U.S. policy. These include such hot-button topics as drug imports from Asia, regulation of global supply chains to assure drug safety and quality, new legislation to encourage development of drugs for neglected diseases, and the impact that decisions about pricing, regulation, and bilateral trade agreements have on access to medicines at home and abroad. In Prescribing Cultures, pharmaceutical policy reveals the economic trade-offs, political compromises, and historical trajectories that shape health systems.

Prescribing Cultures also illustrates how cultural legacies shape and are shaped by the forces of globalization, and thus will be of interest to students and scholars well beyond the confines of health policy.

Desk, examination, or review copies can be requested through Stanford University Press. 

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Karen Eggleston
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