The recent discovery of at least 50 dead migrants aboard a boat off the shores of Libya sparked a discussion on KQED Radio’s “forum with Michael Krasny" about the escalating crisis (Thurs., Aug. 27, 2015). Cécile Alduy, Stanford associate professor of French literature and affiliated faculty at The Europe Center was one of those asked to weigh in on Europe’s migration policy struggle.

Also joining the discussion was Gregory Maniatis, senior European Policy Fellow at the Migration Policy Institute and Tom Nuttall, Charlemagne columnist for The Economist.

Visit KQED Radio's Forum web article “More Migrants Found Dead as Hundreds of Thousands Flee to Europe” to download a recording of this interview.

Video of A career in Economics...it's much more than you think

Marcella Alsan, an assistant professor of Medicine and CHP/PCOR core faculty member, shows how economics is a broader field than most people realize in this video produced by the American Economic Association (AEA).  Along with other top economists, she discusses the interdisciplinary nature of economics, specifically as it relates to global health.  Alsan states that "without understanding economic principals and economic forces, [there is] a real gaping hole in actually practicing medicine."  Understanding economics can help us to understand policy decisions and to tackle the broad problems of society.

The deal has sparked a vigorous debate in Iran as well as in the United States. In a piece published in The Atlantic, FSI Director Michael McFaul and Abbas Milani – Stanford's director of Iranian Studies and an FSI affiliate – describe how the agreement has split Iranians into camps that could shape the country's future.

Karl Eikenberry, a distinguished fellow at Stanford’s Freeman Spogli Institute for International Studies, will serve on the Commission on Language Learning at the American Academy of Arts and Sciences (AAAS). The new commission is part of a national effort to examine the state of American language education.

The commission will work with scholarly and professional organizations to gather research about the benefits of language instruction and to initiate a national conversation about language training and international education.

Eikenberry joins eight other commissioners, including: Martha Abbott, executive director of the American Council on the Teaching of Foreign Languages; Nicholas Dirks, chancellor of the University of California at Berkeley; and Diane Wood, chief judge, of the 7^th U.S. Circuit Court of Appeals. The group is led by Paul LeClerc, director of Columbia University’s Global Center in Paris.

Eikenberry, who is also a member of the AAAS Commission on Humanities and Social Sciences, contributed to “The Heart of the Matter,” a 2013 report that aims to advance dialogue on the importance of humanities and social sciences for the future of the United States.

Today’s landmark deal between six world powers and Iran, which would limit Iran’s nuclear program in exchange for lifting economic sanctions, was an important step toward stopping Iran from building a nuclear bomb.

However, the key challenge for the international community will be making sure Iran keeps its part of the bargain, according to Stanford experts.

“Both sides have made a series of compromises that will help Iran’s economy in exchange for constraining its nuclear capabilities – and that’s a deal worth making, in my view,” said Scott Sagan, the Caroline S.G. Munro professor of political science and senior fellow at the Center for International Security and Cooperation.

“Iran will still have a technical capability to develop nuclear weapons, given the technology and materials that they have, but under this deal it will both take them a much longer period of time and would require them to take actions that would be easily discerned by the International Atomic Energy Agency, so it constrains their break-out capabilities in important ways.”

[[{"fid":"219719","view_mode":"crop_870xauto","fields":{"format":"crop_870xauto","field_file_image_description[und][0][value]":"","field_file_image_alt_text[und][0][value]":"","field_file_image_title_text[und][0][value]":"Final plenary session at the United Nations Office in Vienna, Austria. Photo credit: U.S. State Department","field_credit[und][0][value]":"","field_caption[und][0][value]":"","field_related_image_aspect[und][0][value]":"","thumbnails":"crop_870xauto","pp_lightbox":false,"pp_description":false},"type":"media","attributes":{"title":"Final plenary session at the United Nations Office in Vienna, Austria. Photo credit: U.S. State Department","width":"870","style":"width: 400px; height: 266px; float: right; margin-left: 15px","class":"media-element file-crop-870xauto"}}]]The U.S.-led negotiations also included fellow United Nations Security Council members Britain, China, France, and Russia, as well as Germany – a group known collectively as as the "P5+1."

Sig Hecker, former Los Alamos National Laboratory director and senior fellow at Stanford’s Center for International Security and Cooperation, said the nuclear deal was “hard-won and is better than any other reasonably achievable alternative.”

“Iran agreed to considerably greater restrictions on its program than what I thought was possible before the Joint Plan of Action was signed in November 2013,” said Hecker.

Abbas Milani, director of Iranian studies at Stanford and an affiliate at the Center for Democracy Development and the Rule of Law, called it the “least bad deal” for both Iran and the international community.

“Nobody gets everything they want,” Milani said. “Every side gets some of what they want.”

Under the deal, Iran would be allowed to continue to enrich uranium for peaceful purposes in its energy and health industries.

But it would have to reduce the number of its centrifuges from 19,000 to 6,000, and cut its stockpile of low enriched uranium down from more than 20 thousand pounds to about 660 pounds.

“Reducing that stockpile actually lengthens the breakout time more than any other measure,” said Hecker.

These limits were designed to increase the “breakout time” it would take for Iran to produce enough fissile material to make a nuclear weapon from the current two to three months, to one year over a period of the next 10 years.

The agreement still faces a series of political hurdles before it gets implemented, and will face tough scrutiny from a Republican-controlled U.S. Congress, as well as the parliaments of European countries that were parties to the talks.

“I think it’s going to be hard for the U.S. Congress and [European] parliaments to kill the deal and be perceived as the ones who would rather have a war than give diplomacy a chance,” said Thomas Fingar, distinguished fellow at the Freeman Spogli Institute for International Studies.

[[{"fid":"219720","view_mode":"crop_870xauto","fields":{"format":"crop_870xauto","field_file_image_description[und][0][value]":"","field_file_image_alt_text[und][0][value]":"","field_file_image_title_text[und][0][value]":"The Iranian delegation attend the final plenary session in Vienna, Austria. Photo credit: U.S. State Department","field_credit[und][0][value]":"","field_caption[und][0][value]":"","field_related_image_aspect[und][0][value]":"","thumbnails":"crop_870xauto","pp_lightbox":false,"pp_description":false},"type":"media","attributes":{"title":"The Iranian delegation attend the final plenary session in Vienna, Austria. Photo credit: U.S. State Department","width":"870","style":"width: 400px; height: 268px; float: right; margin-left: 15px","class":"media-element file-crop-870xauto"}}]]If the deal survives the inevitable political challenges, inspectors from the International Atomic Energy Agency will be responsible for confirming that Iran is living up to its obligations.

“The key is going to be the effectiveness of the verification procedures and IAEA access,” Fingar said.

“There’s an element of trust, but a far more important part is the rigorous verification protocols.”

As soon as the IAEA confirms that Iran is abiding by the terms of the agreement, economic sanctions can be lifted.

Sagan warned that the international community should not be surprised if Iran pushed the limits of the agreement, and should be ready to reimpose economic sanctions if Iran violated the deal.

“We should anticipate that Iranian opponents to the agreement will try to stretch it and do things that are potential violations and that we have to call them on that, and not treat every problem that we see as unexpected,” said Sagan.

“We should anticipate such problems and be ready, if necessary, to reimpose sanctions. Having the ability to reimpose sanctions is the best way to deter the Iranians from engaging in such violations.”

But Hecker said the international community should focus on incentivizing Iran.

“The best hope is to make the civilian nuclear path so appealing – and then successful – that Tehran will not want to risk the political and economic consequences of that success by pursuing the bomb option,” he said.

Image

Iran faced the threat of military action if it continued to press forward with its nuclear program.

While Russia and China had both signaled that they were likely to abandon the sanctions regime if talks fell apart.

One of the key challenges to reaching an agreement was “finding a language that would allow both parties to declare victory”, according to Milani.

“Iran has clearly made some very substantive concessions, but Iran has also been allowed to keep enough of its infrastructure so that it can declare at least partial victory for the domestic political audience."

Now the scramble is on in Tehran to claim credit for the deal.

Reformists, led by current Iranian President Hassan Rouhani and former president Akbar Hashemi Rafsanjani, hope it will strengthen their hand as they head into the next election.

On the other side of the political spectrum, conservatives believe it could give them the edge in the battle to succeed Ayatollah Ali Khamenei as Iran’s Supreme Leader.

“They understand that whoever gets the credit for this will be in a much better position to determine the future leadership and future direction of Iran’s foreign policy,” said Milani.

It’s too early to tell what impact the agreement might have on Iran’s foreign policy, which is often at odds with U.S. interests in hot spots like Iraq, Syria, Yemen and Afghanistan. But Sagan said today’s deal was an important step in making sure that future conflicts with Iran don’t go nuclear.

“Hopefully those disagreements will be played out without the shadow of nuclear weapons hanging over the future, and that’s a good thing.”

Foreign aid to the public health sectors of developing countries often appears to be allocated backwards: The global burden of non-communicable diseases such as diabetes or heart disease is enormous – yet they receive little health aid. 

By comparison, the global burden of HIV is much smaller, yet it receives more health aid than any other single disease.

So will a wholesale reversal in health aid priorities improve global health? The answer, according to a new study by Stanford researchers, is that if the goal is to maximize the health benefits from each donor dollar, health aid is actually allocated pretty well.

Still, reallocating foreign aid to step up the fight against malaria and TB could lead to greater overall health improvements in developing nations. And it could be done without spending more money, the researchers have found.

Eran Bendavid, an assistant professor in the Department of Medicine and a core faculty member at the Center for Health Policy and Center for Primary Care and Outcomes Research, and three Stanford research assistants write in the July issue of Health Affairs that more health aid is going to disease categories with more cost-effective interventions.

"What we found, somewhat to our surprise, is that in nearly all countries, more aid was flowing to finance priorities with more cost-effective options,” Bendavid said in an interview. “That is partly because more aid was flowing to the treatment and prevention of infectious diseases such as HIV and malaria, and their management can be relatively inexpensive, even if the burden of these diseases is lower than that of non-communicable diseases.”

Bendavid, an infectious disease physician, added: “Conversely, even though the burden of non-communicable diseases is high and growing, addressing these chronic conditions such as diabetes and heart disease is, broadly, more costly than the unfinished infectious disease agenda.”

The authors also show that just because health aid is broadly allocated toward better cost-effectiveness does not mean that it cannot be better allocated.

The biggest gains would come from taking some of the foreign aid earmarked for HIV or maternal, newborn or child health, and putting it toward programs to treat malaria and tuberculosis, they write.

The Stanford research team reviewed the literature for cost-effectiveness of interventions targeting five disease categories: HIV, malaria, tuberculosis, non-communicable disease and maternal, newborn and child health.

What they found was that aid from wealthy nations to developing ones might be allocated efficiently, but that the money is not always spent in the best interest of curbing the communicable diseases that would improve the overall health of a nation.

It is crucial, therefore, to further study the consequences of realignment of donor funds.

Public health aid is critical to most developing countries. Development assistance from high-income countries to public health sectors of low- and middle-income countries amounts to nearly 40 percent of public health spending in countries with a per capita GDP of less than $2,000.

The researchers focused on 20 countries that received the greatest total amount of aid between 2008 and 2011, a period of historically unprecedented growth in health aid. Development assistance has since flattened, however, so the authors believe it’s increasingly important to consider best value when investing limited resources.

The 20 countries studied ­– from Afghanistan to Zambia – received $58 billion out of the total $103.2 billion in recorded health aid disbursements to 170 countries between 2001 and 2011.

“Over the period of 2001-2011, a greater amount of disbursements flowed to HIV programs than any other disease category,” the authors write. “On average, interventions addressing malaria and had the lowest incremental cost-effectiveness ratio (ICER), which indicates that malaria interventions could yield greater health improvements from each dollar compared with the interventions having a higher ICER.”

The authors analyzed the data and determined that the alignment improves if up to 61 percent of HIV aid is reallocated for TB control and up to 80 percent is reallocated for malaria control.

“Our evidence suggests that the greatest improvements in the efficiency of global health dollars could result from reallocating funds to malaria and TB control programs,” the authors write.

“This study shows, for the first time, that the current allocation of health aid is generally aligned with the cost-effectiveness of targeted interventions. Contrary to common views that advocate for reprioritization toward non-communicable diseases, our data suggest that the alignment could best be improved by focusing on malaria and TB, especially where addressing those diseases is highly cost effective.”

The other authors of the study are Andrew Duong and Gillian Raikes, both research assistants in the Program of Human Biology; and Charlotte Sagan, a RA in the School of Medicine.