In a May 14 lecture hosted by the Center on Democracy, Development and the Rule of Law, Francis Fukuyama, PhD -- professor of international political economy at Johns Hopkins University and renowned author of The End of History and the Last Man -- discussed the problem of weak, underdeveloped nation-states; the effectiveness of various approaches to strengthening such states; and the importance of culture, context and history in the task of state-building. His lecture, titled "State-building: A Framework for Thinking about the Transfer of Institutions to Developing Countries," drew a full room of attendees to the Bechtel Conference Center in Encina Hall

A former member of the RAND Corp. and the U.S. Department of State who has written widely on issues of democratization and international political economy, Fukuyama first presented a framework with which nation-states can be evaluated according to two key criteria: the strength of the state, and the scope of its functions. The first refers to a state's ability to enforce its own laws and policies; the second refers to how involved the state becomes in carrying out various societal functions, ranging from basic functions such as maintaining law and order and protecting public health, to more "activist" functions such as running industries and redistributing wealth.

Fukuyama asserted that from a development standpoint, nation-states should be strong but should carry out only the minimum necessary functions. He said that only one country he has studied -- New Zealand -- has effectively moved toward this ideal in recent years. He noted that many struggling, developing nations, such as Brazil, Mexico, Pakistan and Turkey, are overly ambitious in their scope -- attempting to run vast industries, for example -- but are weak and unable to carry out their policies because of factors like corruption. Other states that Fukuyama identified as "failed states," such as Haiti and Sierra Leone, are both limited in scope and weak, attempting to carry out only the most basic governmental functions and not doing it very well.

Fukuyama then discussed and evaluated various approaches to strengthening developing nations. He noted that in recent years much emphasis has been placed on encouraging such nations to reduce the scope of their functions, through deregulation and privatization, but said the effectiveness of this approach is now in question. A more effective approach, he said, is helping weak nation-states build their own strong institutions, such as political parties, public health networks and central banking.

Unfortunately, Fukuyama said, sometimes the efforts of outside organizations to strengthen a country's institutions only make things worse, because solutions are imposed from outside rather than developed from within. "Ideally, we would want a country's own public health system to handle that country's problems with AIDS or malaria," he said. "But when you flood the country with your organization's own doctors and nurses and infrastructure, what do the local doctors do? They quit their government posts to get on the payroll of your NGO." In a few months or years, when the organization withdraws its support, Fukuyama noted, the system collapses, because it was not built to be self-sustaining.

At the end of his talk, Fukuyama emphasized the importance of understanding local culture, context and history in the task of state building. For example, he said, those who run programs aiming to reduce the spread of HIV/AIDS in Africa should consider working with traditional faith healers, as they are an important part of the healthcare system in Africa.

Paul Farmer, MD, PhD, a physician, infectious disease expert and medical anthropologist who has dedicated his life to treating some of the world's poorest populations, spoke to an overflow crowd on April 8, 2004 at the Stanford Institute for International Studies. Farmer spoke in his capacity as the inaugural S.T. Lee Lecturer.

In his talk, titled "The Nexus of Health and Human Rights," Farmer spoke about the clinic he directs in Cange, Haiti. The clinic has become the center of a thriving community-based medical care system that is tackling Haiti's HIV problem head-on, demonstrating that complex medical treatments can be implemented successfully in poor, underdeveloped nations. Farmer, who has won several awards for his humanitarian work, also talked about promoting access to medical care as a basic human right.

The S.T. Lee Lectureship is named for Seng Tee Lee, a business executive and noted philanthropist. Mr. Lee endowed the lectureship in order to raise public understanding of the complex policy issues facing the global community today.