Stanford University

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.

Delivering Justice to the Poor: Evidence from a Field Experiment in Liberia

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Abstract: 

CDDRL post-doctoral fellow Bilal Siddiqi will address the question of whether progressive, statutory legal reform can meaningfully affect the lives of the poor, using observational and experimental evidence from Liberia in a new study co-authored with Justin Sandefur at the Center for Global Development. The authors develop a simple model of forum choice and test it using new survey data on over 4,500 legal disputes taken to a range of customary and formal legal institutions in rural Liberia. Their results suggest that the poor would benefit most from access to low-cost, remedial justice that incorporates the progressive features of the formal law. They then present the results of a randomized controlled trial of a legal empowerment intervention in Liberia providing pro bono mediation and advocacy services, using community paralegals trained in the formal law. The authors find strong and robust impacts on justice outcomes, as well as significant downstream welfare benefits—including increases in household and child food security of 0.24 and 0.38 standard deviations, respectively. They interpret these results as preliminary evidence that there are large socioeconomic gains to be had from improving access to justice, not by bringing the rural poor into the formal domain of magistrates’ courts, government offices, and police stations, but by bringing the formal law into the organizational forms of the custom through third-party mediation and advocacy.

About the Speaker: 

Bilal Siddiqi is a postdoctoral scholar affiliated with the Empirical Studies of Conflict project (esoc.princeton.edu). His research focuses on micro-institutions, formal and informal legal systems, peace-building and state accountability in post-conflict settings. He is currently involved in several field experiments in Sierra Leone and Liberia, including a randomized controlled trial of two non-financial incentive mechanisms in Sierra Leone’s public health sector; experimental evaluations of community-based paralegal programs in Liberia and Sierra Leone; and a randomized controlled trial of a community reconciliation program in Sierra Leone. 

Bilal received his Ph.D. and M.Phil. in economics from Oxford University, where he studied as a Rhodes Scholar. Prior to Stanford, he was based at the Institute for International Economic Studies (IIES) at Stockholm as a Marie Curie / AMID Scholar; and has also spent time at the Center for Global Development in Washington, DC, where he worked on aid effectiveness in global health. He holds a B.Sc. (Hons) from the Lahore University of Management Sciences in Lahore, Pakistan.

 

Encina Ground Floor Conference Room

Bilal Siddiqi

Encina Hall
616 Serra Street
Stanford, CA 94305-6055

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Minerva Postdoctoral Fellow (ESOC Project)
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Bilal Siddiqi is a postdoctoral scholar affiliated with the Empirical Studies of Conflict project (esoc.princeton.edu). His research focuses on micro-institutions, formal and informal legal systems, peace-building and state accountability in post-conflict settings. He is currently involved in several field experiments in Sierra Leone and Liberia, including a randomized controlled trial of two non-financial incentive mechanisms in Sierra Leone’s public health sector; experimental evaluations of community-based paralegal programs in Liberia and Sierra Leone; and a randomized controlled trial of a community reconciliation program in Sierra Leone.

Bilal received his Ph.D. and M.Phil. in economics from Oxford University, where he studied as a Rhodes Scholar. Prior to Stanford, he was based at the Institute for International Economic Studies (IIES) at Stockholm as a Marie Curie / AMID Scholar; and has also spent time at the Center for Global Development in Washington, DC, where he worked on aid effectiveness in global health. He holds a B.Sc. (Hons) from the Lahore University of Management Sciences in Lahore, Pakistan.

Bilal Siddiqi Post-doctoral fellow Speaker CDDRL
Seminars

Can Liberation Technology Save Lives? Addressing State Failure in the Provision of Public Goods

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Abstract:
This discussion will focus on the potential utility of innovative technology to address the governance obstacles to the provision of critical public services.  Using the challenge of maternal and child mortality reduction as an illustrative example, this discussion will outline the role political forces and governance failures play in shaping the public infrastructure of service provision and opportunities for reform.  Of special focus will be the potential role of technology to create and address these opportunities.  While there are numerous efforts underway to use new technologies to enhance the breadth and efficiency of health services in low-income settings, this discussion will focus on how these technologies could be “liberating” by being designed and used to address the political determinants of inadequate public service commitments and capacity. 

Dr. Paul Wise is the Richard E. Behrman Professor of Child Health and Society, Professor of Pediatrics at Stanford University School of Medicine, and Senior Fellow in the Freeman-Spogli Institute for International Studies at Stanford University.  He is Director of the Center for Policy, Outcomes and Prevention and a core faculty of the Centers for Health Policy and Primary Care Outcomes Research, at Stanford University.  Dr. Wise has served as Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health, a member of the Secretary of the Department of Health and Human Service’s Advisory Committee on Genetics, Health and Society and currently serves on the National Advisory Council of the National Institute for Child Health and Human Development, NIH.  Dr. Wise’s research focuses on U.S and international child health policy, particularly the provision of technical innovation in resource-poor areas of
the world. 

 

 

Wallenberg Theater

Paul H. Wise

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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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Liberation Technology Seminar Series

The Folly of Technological Solutionism

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Abstract
He will preview some of the main arguments about the temptations of "solutionism" from his upcoming book "To Save Everything, Click Here." Now that everything is smart, hackable and trackable, it is very common to see big technology companies (as well as ordinary tech enthusiasts and geeks) embark on ambitious projects to "solve all of the world's problems." Obesity, climate change, dishonesty and hypocrisy in politcs, high crime rate: Silicon Valley can do it all. But where does this solutionist quest lead? What are the things that ought to be left "dumb" and "unhackable"? How do we learn to appreciate the imperfection - of both our lives and our social institutions - in a world, where it can be easily eliminated? Do we even have to appreciate it? 
 
 Evgeny Morozov is the author of The Net Delusion: The Dark Side of Internet Freedom. In 2010-2012 he was a visiting scholar at Stanford University's Liberation Technology program and a Schwartz fellow at the New America Foundation. In 2009-2010 he was a fellow at Georgetown University and in 2008-2009 he was a fellow at the Open Society Foundations (where he also sat on the board of the Information Program between 2008 and 2012).  Between 2006 and 2008 he was Director of New Media at Transitions Online.  Morozov has written for The New York Times, The Economist, The Wall Street Journal, The New Republic, Financial Times, London Review of Books, Times Literary Supplement, and other publications. His monthly Slate column is syndicaetd in El Pais, Corriere della Sera, Frankfurter Allgemeine Zeitung, Folha de S.Paulo and several other newspapers. 

Wallenberg Theater

Evgeny Morozov Author and former Stanford Visiting Scholar Speaker
Seminars
Liberation Technology Seminar Series

Stephen P. Luby

Y2E2
473 Via Ortega
Stanford, CA 94305

(650) 723-4129 (650) 725-3402
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Faculty Lead, Center for Human and Planetary Health
Professor of Medicine (Infectious Diseases)
Professor of Epidemiology & Population Health (by courtesy)
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Woods Institute for the Environment
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
steve_luby_2023-2_vert.jpg MD

Prof. Stephen Luby studied philosophy and earned a Bachelor of Arts summa cum laude from Creighton University. He then earned his medical degree from the University of Texas Southwestern Medical School at Dallas and completed his residency in internal medicine at the University of Rochester-Strong Memorial Hospital. He studied epidemiology and preventive medicine at the Centers for Disease Control and Prevention.

Prof. Luby's former positions include leading the Epidemiology Unit of the Community Health Sciences Department at the Aga Khan University in Karachi, Pakistan, for five years and working as a Medical Epidemiologist in the Foodborne and Diarrheal Diseases Branch of the U.S. Centers for Disease Control and Prevention (CDC) exploring causes and prevention of diarrheal disease in settings where diarrhea is a leading cause of childhood death.  Immediately prior to joining the Stanford faculty, Prof. Luby served for eight years at the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), where he directed the Centre for Communicable Diseases. He was also the Country Director for CDC in Bangladesh.

During his over 25 years of public health work in low-income countries, Prof. Luby frequently encountered political and governance difficulties undermining efforts to improve public health. His work within the Center on Democracy, Development, and the Rule of Law (CDDRL) connects him with a community of scholars who provide ideas and approaches to understand and address these critical barriers.

 

Director of Research, Stanford Center for Innovation in Global Health
Affiliated faculty at the Center on Democracy, Development and the Rule of Law
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Managing the Risk of Pandemic Influenza Amidst Weak Government Institutions

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Abstract:
 
Bangladesh is one of the highest risk settings for emergence of new strains of influenza. Some of these strains could infect humans and spread globally causing widespread human mortality. The government of Bangladesh has made genuine efforts to reduce this risk, but these efforts are constrained by the limited capacity of government institutions to affect the situations and behaviors that generate this ongoing risk.
 
Speaker Bio:

Dr. Luby comes to us from the International Center for Diarrheal Diseases and Research, Bangladesh (ICDDR, B) after serving as the research director there for the past eight years in a shared position with CDC.  Prior to this position, he taught at the Aga Khan University in Pakistan. He will be leading our research efforts within CIGH and we are looking forward to his start in September 2012.

CISAC Conference Room

Stephen P. Luby

Y2E2
473 Via Ortega
Stanford, CA 94305

(650) 723-4129 (650) 725-3402
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Faculty Lead, Center for Human and Planetary Health
Professor of Medicine (Infectious Diseases)
Professor of Epidemiology & Population Health (by courtesy)
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Woods Institute for the Environment
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
steve_luby_2023-2_vert.jpg MD

Prof. Stephen Luby studied philosophy and earned a Bachelor of Arts summa cum laude from Creighton University. He then earned his medical degree from the University of Texas Southwestern Medical School at Dallas and completed his residency in internal medicine at the University of Rochester-Strong Memorial Hospital. He studied epidemiology and preventive medicine at the Centers for Disease Control and Prevention.

Prof. Luby's former positions include leading the Epidemiology Unit of the Community Health Sciences Department at the Aga Khan University in Karachi, Pakistan, for five years and working as a Medical Epidemiologist in the Foodborne and Diarrheal Diseases Branch of the U.S. Centers for Disease Control and Prevention (CDC) exploring causes and prevention of diarrheal disease in settings where diarrhea is a leading cause of childhood death.  Immediately prior to joining the Stanford faculty, Prof. Luby served for eight years at the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), where he directed the Centre for Communicable Diseases. He was also the Country Director for CDC in Bangladesh.

During his over 25 years of public health work in low-income countries, Prof. Luby frequently encountered political and governance difficulties undermining efforts to improve public health. His work within the Center on Democracy, Development, and the Rule of Law (CDDRL) connects him with a community of scholars who provide ideas and approaches to understand and address these critical barriers.

 

Director of Research, Stanford Center for Innovation in Global Health
Affiliated faculty at the Center on Democracy, Development and the Rule of Law
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Stephen P. Luby Senior Fellow, FSI and the Woods Institute; CDDRL Affiliated Faculty; Research Deputy Director, Center for Innovation in Global Health; Professor of Medicine, Infectious Diseases Speaker
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The United Nations and a World in Transition

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United Nations Secretary-General Ban Ki-moon presented a free public talk at Stanford on Thursday, Jan. 17.

Ban, who is the eighth secretary-general of the UN, will speak about the UN's role in creating opportunities out of the challenges posed by today's rapidly transitioning world.

"Times of transition are times of profound opportunity," he recently said during his acceptance speech for the Seoul Peace Prize. "The decisions we make in this period will have an impact for generations to come.”

Ban's initiatives as UN secretary-general have focused on promoting sustainable development; empowering women; supporting countries in crisis or instability; generating new momentum on disarmament, arms control, and nonproliferation; and strengthening the UN. Among his many activities as secretary-general, he has successfully raised major pledges and financing packages for aid and crisis response, established the agency UN Women, and introduced new measures to promote UN transparency and efficiency.

Ban was born in the Republic of Korea in 1944, and he served for 37 years with the ROK Foreign Ministry, in roles including that of minister of foreign affairs and trade, foreign policy adviser to the president, and chief national security adviser to the president. He took office as UN secretary-general in January 2007, and was re-elected for a second term by the UN General Assembly in June 2011. Ban will serve as secretary-general until December 2016.

The Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) and the Freeman Spogli Institute for International Studies are co-sponsoring the event. Ban's talk, part of the Asia-Pacific Leaders Forum, will kick off a series of activities commemorating Shorenstein APARC's thirtieth anniversary.

Founded in 2005, Shorenstein APARC's Asia-Pacific Leaders Forum regularly convenes senior leaders from across Asia and the Pacific to exchange ideas on current political, economic, and social dynamics in the region.

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Dinkelspiel Auditorium
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Ban Ki-moon Secretary-General of the United Nations Speaker
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Stanford researchers show a better way to curb TB where the disease is rampant

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Those who live and die behind prison walls don’t usually get much public attention. Incarceration is, after all, meant to remove criminals from society. But contagious and potentially deadly diseases can’t be locked and left in a penitentiary, especially when infected inmates are eventually released.

The problem of prisoners and ex-convicts transmitting diseases to the general population is especially bad in the countries of the former Soviet Union, where rates of tuberculosis and drug-resistant strains of TB are among the world’s highest.

But Stanford researchers have identified solutions that could help curb tuberculosis in Russia, Latvia, Tajikistan and the 12 other countries in the region. Led by Jeremy Goldhaber-Fiebert, an assistant professor of medicine, the team has shown that a genetic TB and drug resistance screening tool called GeneXpert is more cost effective and better at reducing the spread of the disease than other methods currently recommended by the World Health Organization. Their findings were published online Nov. 27 in PLoS Medicine.

“Tuberculosis doesn’t stop at any border or any locked gate,” said Goldhaber-Fiebert, who is also a faculty member at Stanford Health Policy, a research center at the university’s Freeman Spogli Institute for International Studies.

“Drug-resistant TB is rampant in prisons,” he said. “When infected prisoners get out, they are thought to drive the TB epidemic in the general population. We are looking to find better ways to deal with that.”

About 400,000 cases of TB were diagnosed last year in the 15 former Soviet Union states – 40 times the number reported in the United States. Nearly 80,000 of the sick had drug-resistant TB. According to several studies, the prevalence of TB among the region’s prisoners is 10 times greater than that of the general population.

The WHO suggests three ways to screen for TB in prisons: relying on inmates to report symptoms, actively interviewing prisoners about their health, and administering chest X-rays. The organization doesn’t recommend one method over another, and currently, prisoners in the former Soviet Union are screened annually with miniature chest X-rays.

While X-rays can show whether a lung looks healthy, they don’t always catch TB. And when they do, they cannot differentiate between a TB that can be cured with standard medications and its drug-resistant cousins that require more expensive and extensive treatments.

That’s where GeneXpert has an upper hand.

Since it was introduced in 2005, the diagnostic has been hailed as a potentially powerful tool that can help to cut TB and drug-resistance rates by more accurately diagnosing people and getting them treated. With just a small sample of mucous analyzed by a machine, the GeneXpert system can instantly detect TB and its drug-resistant genetic mutations, well suited to mass screening within the prison systems of the former Soviet Union.

But the GeneXpert test is more expensive than alternative screening methods. And while it promises to be more effective, its impact on total costs had not been quantified in the former Soviet Union region until Goldhaber-Fiebert and his colleagues began their work nearly three years ago.

By developing computer models of the former Soviet Union’s prison populations, the team predicted that using GeneXpert can cut the prevalence of TB among inmates by about 20 percent within four years – provided the screening is combined with standard regimens of drug treatment for infected patients and for those with drug-resistant TB.

“For this to make sense, you need to have the right drugs to cure those individuals you identify,” Goldhaber-Fiebert said.

The additional cost of screening with GeneXpert averages to $71 per prisoner compared to the next best alternative approach, he said.

When compared to the decreases in illness and increases in survival, and factoring the financial and societal costs of TB in the broader population, the method makes good economic sense, he said.

“There is a large, direct value to using this technology for screening in prison settings, and there are potentially substantial secondary benefits to the general population of the former Soviet Union and to the world,” Goldhaber-Fiebert said.

Douglas K. Owens, a professor of medicine who is one of the paper’s co-authors and director of Stanford Health Policy, said the findings could give governments and medical experts the evidence they need to change the way they tackle TB.

“This is the kind of work we hope will inform policymaking about TB control,” Owens said. “We’ve shown there’s a more effective approach for trying to catch TB in prisons, and that means a better chance for preventing the disease from spreading.”

Co-authors on the PLoS Medicine paper also include former Stanford medical student Daniel Winetsky and current Stanford doctoral student in Management Science and Engineering, Diana Negoescu.

The researchers collaborated with the AIDS Foundation East-West. Funding for the study came from Äids Fonds, the International Research & Exchanges Board, the Department of Veterans Affairs, the National Institutes of Health, and Stanford.

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Russian prisoners with tuberculosis take their medicine. The problem of prisoners and ex-convicts transmitting diseases is especially bad in the countries of the former Soviet Union, where TB rates are among the world’s highest.
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Global Health Diplomacy in North Korea: the Stanford Tuberculosis Project in the Democratic Peoples Republic of Korea

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About the topic: Stanford University, in collaboration with humanitarian NGOs, WHO, the Global Fund and the North Korean Ministry of Public Health have undertaken to develop that country's first National Tuberculosis Reference Laboratory. North Korea is estimated to have the highest tuberculosis rate outside sub-Saharan Africa and is believed to have a mounting epidemic of patients infected with drug-resistant strains. This presentation will focus on the nature of the TB epidemic in North Korea, the role of this laboratory in addressing this epidemic, challenges to the laboratory's development in this isolated country and possible "dual use" concerns about the importation of equipment and expertise intended for the diagnosis and treatment of TB patients.

 

About the speaker: Gary Schoolnik is Professor of Medicine, Microbiology and Immunology, Attending Physician in Internal Medicine and Infectious Diseases at Stanford Hospital, Associate Director of the Institute for Immunology, Transplantation and Infection and Associate Dean, School of Medicine. His research laboratory studies tuberculosis and cholera using molecular, genetic and genomic methods to understand how these microbes cause disease and how that understanding might lead to improved preventive, diagnostic and treatment strategies.

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Gary Schoolnik Professor, Medicine (Infectious Diseases); Professor, Microbiology and Immunology; Senior Fellow, Institute for the Environment Speaker
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