Secretaries Rice & Albright anchor joint event with the Carnegie Endowment

At FSI in May 2016, Washington DC met Silicon Valley and the results were enlightening.

On May 11 and 12, FSI director Michael McFaul welcomed the Carnegie Endowment for International Peace to Stanford for a series of in-depth discussions on technology and international affairs. Anchored by appearances from Carnegie president William Burns, LinkedIn CEO Reid Hoffman, and former secretaries of state Condoleezza Rice and Madeleine Albright, the inaugural Carnegie Forum on Technology, Innovation and International Affairs offered a close examination of the intersection of geopolitics and technology.

The invitation-only event opened with a fireside chat between Burns and Hoffman, covering questions from China’s digital future to European privacy concerns with U.S. trends in between. Despite waves of nationalism and violent extremism worldwide, Burns struck a note of long-term optimism about the ways in which technology affects individuals’ and nations’ relationships to one another.

On the second day, a lineup of regional and subject-matter experts from Stanford, Carnegie and beyond addressed longstanding concerns in the Middle East, new challenges in Asia, and the myriad opportunities for both connection and conflict offered by rapid technological advances. “We tend to have just one narrative for the Middle East, and that is crisis and conflict,” said venture capitalist Christopher Schroeder, who moderated a discussion among Carnegie and FSI senior scholars on the region. “But I would submit that something else is happening too. Last December I went to a gathering of 5,000 entrepreneurs – the type of event that you would all recognize here in Silicon Valley – but it was in Cairo.”

It was a familiar theme throughout the day, from a forward-looking panel on the growth of Asian economies to a comparison of privacy and cybersecurity issues around the world. Moderated by World Affairs Council CEO Jane Wales, the final panel on “Disrupting International Affairs” featured Carnegie visiting scholar James Rothkopf and Matthew Stepka, the former VP of Google Special Projects.

In an off-the-record keynote conversation, Rice, Albright and Burns discussed the foreign policy highlights of their own tenures and offered candid thoughts on today’s challenges. “In many ways, the digital age poses similar challenges to the nuclear age,” said Burns. “Scholars at Carnegie and at Stanford made profound contributions to the international response to nuclear proliferation. The challenges of the 21^st century require the same focus and discipline, the same commitment to understanding divergent international perspectives, and working toward shared solutions.”

Could out of pocket drug costs be responsible for pandemics? In this Public Health Perspectives article, Marcella Alsan discusses how copayments for antibiotics can cause people in poor areas to turn to unregulated markets.

On May 26, 2016, researchers at the Walter Reed National Military Medical Center reported the first case of what they called a “truly pan-drug resistant bacteria.” By now, the story has been well-covered in the media: a month earlier, a 49 year old woman walked into a clinic in Pennsylvania with what seemed to be a urinary tract infection. But tests revealed something far scarier—both for her and public health officials. The strain of E. Coli that infiltrated her body has a gene that makes it bulletproof to colistin, the so-called last resort antibiotic.

Most have pinned the blame for the impending doom of a “post-antibiotic world” on the overuse of antibiotics and a lack of new ones in the development pipeline. But there’s another superbug incubator that hasn’t gotten the attention it deserves: poverty.

Last month at the IMF meeting in Washington, D.C., UK Chancellor George Osborne warned about the potentially devastating human and economic cost of antimicrobial resistance. He called for “the world’s governments and industry leaders to work together in radical new ways.” But Gerry Bloom, a physician and economist at the Institute for Development Studies, argued that any measures to stop overuse and concoct new drugs must be “complemented by investments in measures to ensure universal access to effective antibiotic treatment of common infections.”

“In many countries, poor people obtain these drugs in unregulated markets,” Bloom said. “They often take a partial course and the products may be sub-standard. This increases the risk of resistance.”

For at least fifteen years, we’ve known about these socioeconomic origins of antimicrobial resistance. Other studies have revealed problems with mislabeled or expired or counterfeit drugs. But the clearest link between poverty and the rise of antimicrobial resistance is that poor people may not see a qualified health care provider or complete a course of quality antibiotics. Instead, they might turn to unregulated markets for substandard drugs.

But why do people resort to unregulated markets or take drugs that aren’t that great if they are available? Marcella Alsan, an assistant professor of medicine at the Stanford School of Medicine who studies the relationship between socioeconomic disparities and infectious diseases, led a study that answered this question. In last October’s Lancet Infectious Diseases, Alsan and her colleagues showed that it might have a lot to do with requiring copayments in the public sector. To show this, they analyzed the WHO’s 2014 Antibacterial Resistance Global Surveillance report with an eye toward the usual suspects, such as antibiotic consumption and antibiotic-flooded livestock.

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Alliances serve an important purpose in international relations, but the attention given by each country to each other is rarely equal. This kind of asymmetry is apparent in the U.S.-South Korea alliance; however, South Korea as the weaker ally can work to garner greater attention from the United States by leveraging the news media, according to Stanford professor Gi-Wook Shin and Yonsei University professor Rennie Moon.

Their co-authored editorial can be viewed on the AIIA blog. More on the subject can be found in an extended journal article by Shin, Moon and Hilary Izatt in the Australian Journal of International Affairs, and the Stanford University Press book One Alliance, Two Lenses: U.S.-Korea Relations in a New Era.

If provoked, many Americans might well back nuclear attacks on foes like Iran and al Qaeda, according to new collaborative research from CISAC senior fellow Scott Sagan and Dartmouth professor Benjamin Valentino.

You can read more about their latest public opinion polling data, and its implications for the debate surrounding President Obama's upcoming visit to Hiroshima, in a column they co-authored for the Wall Street Journal.

The Wall Street Journal reports on REAP's project to transition family planning workers to a new role - early childhood development experts that give China's rural children a headstart in life. To read the original article, click here.

For 30 years, Yu Huajian visited villages in rural China to remind couples to have just one child, to abide by the law and help the economy. He also pursued violators of the much-hated policy and oversaw abortions.

Since the one-child policy was abandoned in October, Mr. Yu and some of the half a million other family-planning workers have knocked on rural doors with a different message: How to play with children, read to them and raise them with better skills.

The shift was abrupt, but Mr. Yu said he has always done what he and leaders thought was best for the country.

"I think we should focus now on education," he said. "It's more meaningful."

China's leaders say that the one-child policy, which was ended amid a growing demographic imbalance, improved livelihoods. But for rural Chinese, the gap between them and urban dwellers widened sharply during the country's decades of explosive growth.

Today, their annual per capita disposable income is around $1,750, compared with $4,770 for their urban counterparts. High-school graduation rates for rural students are about 3%, compared with 63% for those in cities, according to China's Ministry of Education and the Asian Development Bank.

That gap has come into focus as China's government tries to shift the economy toward services and away from low-skilled manufacturing.

"This is China's ticking time bomb," said Shi Yaojiang, an economics professor at Shaanxi Normal University who is working with the government on the early-childhood project.

"The roads have all been paved, the buildings all constructed," said Mr. Shi. "We now need a labor supply that's up to standard."

The new early-childhood initiative has been rolled out in 15 provinces, districts and cities, according to the National Health and Family Planning Commission.

Cai Jianhua, the director of program training at the commission, is urging China's senior leaders to reorient the commission toward early-childhood development and expand funding to build early educational centers.