Propelled by the need to develop new and more productive avenues of communication among scholars and policy-makers based in Europe, North America, and the Middle East, in 2010 the Europe Center at Stanford University’s Freeman Spogli Institute for International Studies and the Van Leer Jerusalem Institute agreed to launch the multi-year collaborative project titled "Debating History, Democracy, Development, and Education in Conflicted Societies." Our joint initiative aims to promote research and policy projects with partners in Europe, the U.S., and the Middle East.

Viewed in an international context, with a focus on Europe and the Middle East, this collaborative project investigates how societies debate internally and attempt to reconcile differences of historical interpretation and political positions.  The first conference took place at the Van Leer Jerusalem Institute, and was dedicated to “Democracy in Adversity and Diversity” (May 18-19, 2011). Topics for the conference included democracy in comparative perspective, political reform, the notion and strategies of democracy promotion, regime transition, negotiating religion and democracy, immigration challenges, minorities and East-West relations, emergence or recovery of civil society, the role of non-governmental organizations in democratic societies, and human rights. 

The next conference, at Stanford University May 17-18, 2012 aims to deepen our understanding of the interplay between history and memory. Given the extensive discussion of memory and history across a variety of disciplines in recent decades, we would like to take stock of our current understanding of the concepts of memory and history as they affect society, politics and culture.  At the same time we wish to examine in what ways insights gained in the course of this cross-disciplinary and global discussion may be effective when considering the circumstances of the Middle East, especially the Israeli-Palestinian conflict. We are inviting new, innovative approaches to the study of memory and history as they affect different societies. We especially welcome contributions that engage the concepts of memory and history comparatively. Our goal is to advance beyond restating examples of conflicts between versions of history, and to seek new paths of research that may further the work in various cases, and also potentially offer guidance for engaging particular international and civil conflicts.

The questions that we seek to address at the conference include, among others:

• How do we understand the historians’ role and engagement in political and cultural conflicts about the past and present?
• What are the historians’ responsibilities in developing shared narratives about war, civil conflict, occupation, and genocide?
• How do we understand the relation between the work of professional historians and that of civic society organizations?
• How do we understand the roles and interplay of history and memory in efforts towards reconciliation?
• How should one think about the relative importance of historical commissions and truth commissions in “coming to terms with the past.”
• What is the relationship between the historian’s work on international and domestic conflict and that of judicial institutions?
• How do efforts in post-conflict situations to reach accurate assessments (“truth”) of the events meet the needs of healing social, ethnic, and/or religious wounds (“reconciliation”)?
• How do we understand the effectiveness, necessity, and/or legitimacy of remembering and forgetting in models of reconciliation?
• What are the consequences and meaning of actions of forgiveness, including the formal granting of amnesty? Do these actions conflict with the writing of history?

The conference committee consists of Norman Naimark (Core faculty member of The Europe Center at the Freeman Spogli Institute for International Studies and the Robert and Florence McDonnell Professor in East European Studies at Stanford), Yfaat Weiss (Director, The Franz Rosenzweig Minerva Research Center for German-Jewish Literature and Cultural History at Hebrew University of Jerusalem), Gabriel Motzkin (Director, The Van Leer Jerusalem Institute), and Amir Eshel (Director, The Europe Center and Edward Clark Crossett Professor of Humanistic Studies at Stanford).

The Europe Center invites the Stanford and area community to join us Friday, May 4th, for a roundtable discussion on the upcoming French elections.    (Sign-up here [link]).  Three analysts from different fields of expertise – Arthur Goldhammer, Laurent Cohen-Tanugi, and Jimia Boutouba – will discuss the election and its wider context.  The Europe Center is timing this public event  for the eve of round 2, with much to analyze from round 1, and policy options to consider for the impending winner.

Round 1 (April 22) results:

• François Hollande: 28.6%
• Nicolas Sarkozy 27.2%
• Marine Le Pen 17.9%
• Jean-Luc Melenchon 11.1%
• François Bayrou 9.1%
• Five other candidates 6.1%

Speculation during the two-week interim period between round 1 and 2 will focus on the leader of the far-right Front National – Marine Le Pen, who took her party to its highest vote tally in modern memory.  How will the two remaining candidates vie for these voters who were apparently preoccupied with a perceived threat from immigration, cultural dilution, and security?  Especially in the wake of the recent tragic violence in Toulouse, candidate Sarkozy courted such far-right voters, but candidate Hollande vociferously chastised the tactic as capitalizing on the tragedy.

Available opinion surveys note widespread disenchantment with incumbent President Nicolas Sarkozy, who has put his personal stamp on Euro-zone rescue and recovery and alliance with German Chancellor Angela Merkel, but who has failed to deliver such reform, stability, or growth in France.  President Sarkozy has also raised the profile of France and its international policy on the Afghan international peace-keeping force, as well as the Arab Spring and most recently international effort to enforce a cease fire in Syria.

French voters also express disappointment with Socialist candidate François Hollande, frequently labeling him and his party as vaguely center-right and having abandoned a clear commitment to the party’s traditional platform of equality and social justice.
Interest – and survey support – grew in the run-up to the first round of voting for the candidate Jean-Luc Mélenchon, who brings a background as a teacher and self-identified Trotskyite, to lead the party Front de Gauche – a loose coalition of ex-Communists, environmental left, and the rough equivalent of U.S. “99%” movement.  

What did not happen this year was to have an “alternative” candidates from what are seen as the edges of ideological spectrum can win enough votes to edge out Sarkozy or Hollande and survive to the second round – as happened in 2002 when Jean-Marie Le Pen (father of Marine) out-placed the Socialist Lionel Jospin, to make it to the second round, and effectively compel center-left Socialists to hand the election to Jacques Chirac.
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The French presidential election is organized to accommodate two rounds.  The first round took place Sunday, April 22.  Because no candidate won more than fifty percent of the vote, there will be a run-off election of the top two candidates, on Sunday, May 6.
Basic facts of the structure of the French Presidential election are at:
http://www.heraldtribune.com/article/20120420/API/1204200768?p=1&tc=pg

Latest blog entry by Arthur Goldhammer: http://artgoldhammer.blogspot.com/

Opinion poll results from the leading agency Ipsos Public Affairs are updated frequently at: http://www.ipsos.fr/presidentielle-2012/index.php

A once-a-day pill to help prevent HIV infection could significantly reduce the spread of AIDS, but only makes economic sense if used in select, high-risk groups, Stanford researchers conclude in a new study.

The researchers looked at the cost-effectiveness of the combination drug tenofovir-emtricitabine, which was found in a landmark 2010 trial to reduce an individual’s risk of HIV infection by 44 percent when taken daily. Patients who were particularly faithful about taking the drug reduced their risk to an even greater extent – by 73 percent.

The results generated so much interest that the Stanford researchers decided to see if it would be cost-effective to prescribe the pill daily in large populations, a prevention technique known as pre-exposure prophylaxis, or PrEP.

They created an economic model focused on gay men, as they account for more than half of the estimated 56,000 new infections annually in the United States, according to the Centers for Disease Control and Prevention.

“Promoting PrEP to all men who have sex with men could be prohibitively expensive,” said Jessie Juusola, a PhD candidate in management science and engineering in the School of Engineering and first author of the study. “Adopting it for men who have sex with men at high risk of acquiring HIV, however, is an investment with good value that does not break the bank.”

For instance, using the pill in the general population of gay men would cost $495 billion over 20 years, compared to $85 billion when targeted to those at particularly high risk, the researchers found. The study will be published in the April 17 issue of the Annals of Internal Medicine.

Senior author Eran Bendavid, an affiliate of Stanford Health Policy at the Freeman Spogli Institute, said the results are a departure from a previous study. Earlier research found PrEP was not cost-effective when compared with other commonly accepted prevention programs.

The new Stanford study differs in a few important respects, taking into consideration the decline in transmission rates over time as more individuals take the pill. The Stanford team also assumed individuals would stop taking PrEP after 20 years, not stay on the drug for life, as the previous study had assumed.

The pill combination, marketed under the brand name Truvada, is widely used for treating HIV infection. But it wasn’t until a landmark trial, published in the New England Journal of Medicine in November 2010, that individuals and their doctors began to seriously consider using the drug as a preventive therapy. The drug’s maker, Foster City, Calif.-based Gilead Sciences Inc., has filed a supplemental new drug application to market it for prevention purposes.

The CDC issued interim guidelines on the drug’s use in January 2011, suggesting that if practitioners prescribe it as a preventive measure, they regularly monitor patients for side effects and counsel them about adherence, condom use and other methods to reduce their risk of infection.

In developing their model, the Stanford researchers took into account the cost of the drug – about $26 a day, or almost $10,000 a year – as well as the expenses for physician visits, periodic monitoring of kidney function affected by the drug, and regular testing for HIV and sexually transmitted diseases.

“We’re talking about giving uninfected people a drug that has some toxicities, so it’s crucial to have them monitored regularly,” said Bendavid, who is an assistant professor of medicine in Stanford’s School of Medicine.

Without PrEP, the researchers calculated there would be more than 490,000 new infections among gay men in the United States in the next 20 years. If just 20 percent of these men took the pill daily, there would be nearly 63,000 fewer infections.

However, the costs are substantial. Use of the drug by 20 percent of gay men would cost $98 billion over 20 years; if every man in this group took PrEP for 20 years, the costs would be a staggering $495 billion.

Given these figures, the researchers looked at the option of giving PrEP only to men who are at high risk – those who have five or more sexual partners in a year. If just 20 percent of these high-risk individuals took the drug, 41,000 new infections would be prevented over 20 years at a cost of about $16.6 billion.

At less than $50,000 per quality-adjusted life year gained (a measure of how long people live and their quality of life), that strategy represents relatively good value, according to Juusola.

“However, even though it provides good value, it is still very expensive,” she said. “In the current health care climate, PrEP’s costs may become prohibitive, especially given the other competing priorities for HIV resources, such as providing treatment for infected individuals.”

She said the costs could be significantly reduced if the pill is found to be effective when used intermittently, rather than on a daily basis. Current trials are examining the effectiveness of the drug when used less often.

Other co-authors are Margaret L. Brandeau, the Coleman F. Fung Professor of Engineering, and Douglas K. Owens, the Henry J. Kaiser, Jr. Professor at Stanford and senior investigator at the Veterans Affairs Palo Alto Health Care System. Owens also is director of Stanford’s Center for Health Policy and Center for Primary Care and Outcomes Research.

The study was funded by the National Institutes of Health and the Department of Veterans Affairs and supported by Stanford’s departments of Medicine and Management Science and Engineering.