Paragraphs

We study two interventions in Beijing, China, that provide patients with information on antibiotic resistance via text message to discourage the overuse of antibiotics. The messages were sent once a month for five months. One intervention emphasizes the threat to the recipient’s own health and is found to have negligible effects. The other intervention, which highlights the overall threat to society, reduces antibiotics purchases by 17% in dosage without discouraging healthcare visits and other medicine purchases. The results demonstrate that prosocial messaging can have the potential to address public health issues that require collective action.

Keywords: Social-regarding message; Antibiotics; Field experiment

JEL codes: C93, D83, I12

Published: https://doi.org/10.1016/j.jdeveco.2023.103056

All Publications button
1
Publication Type
Working Papers
Publication Date
Subtitle

Asia Health Policy Program working paper # 66

Journal Publisher
Asia Health Policy Program working paper # 66
Authors
Jianan Yang
Authors
Noa Ronkin
News Type
News
Date
Paragraphs

We are pleased to share that Professor of Sociology Kiyoteru Tsutsui, the Henri H. and Tomoye Takahashi Professor and Senior Fellow in Japanese Studies at the Walter H. Shorenstein Asia-Pacific Research Center (APARC), has been honored by the Shinsho Taisho Award for his book, Human Rights and the State: The Power of Ideas and the Realities of International Politics (Iwanami Shinsho, 2022). The award recognizes the best titles in the category of Shinsho books — a popular Japanese format of paperback books on academic topics intended to reach a broader audience — published between December 2021 and November 2022. Tsutsui’s book has been ranked number 9 on the list of best new Shinsho titles out of over 1200 candidates.

The annual Shinsho Taisho Award is sponsored by Japanese publisher Chuokoron Shinsha. Award selections are made by experts with a deep knowledge of new releases, including scholars, booksellers, editors of new books from various companies, and newspaper reporters. The ranking of the top 20 honored titles, including detailed selection notes and reviews, are published in the March 2023 issue of Chuokoron magazine.

Tsutsui’s book explores the paradox underlying the global expansion of human rights, examines Japan’s engagement with human rights ideas and instruments, and assesses their impacts on domestic politics around the world. “This excellent book clarifies the principles of the international order by bringing ‘human rights power’ to the forefront, and makes constructive suggestions on the nature of Japan’s human rights diplomacy,” says one expert review.

For his book, Tsutsui was also recently honored as the recipient of the 2022 Ishibashi Tanzan Award and the 44th Suntory Prize for Arts and Sciences.

In an APARC interview about the book, Tsutsui, who is also director of APARC’s Japan Program, APARC’s deputy director, a senior fellow at the Freeman Spogli Institute for International Studies, and the co-director of the Center for Human Rights and International Justice, explains the tension inherent in the diffusion of global human rights, which is rooted in states’ embracing these universal rights although they are grounded in principles that constrain their sovereignty. Tsutsui believes that Japan has an opportunity to become a global leader in human rights. “The more inwardly oriented United States is creating a vacuum in promotion and protection of liberal values, especially with China’s influence surging, and Japan should carry the torch taking the mantle of human rights, democracy, and rule of law,” he argues.

Tsutsui’s research interests lie in political and comparative sociology, social movements, globalization, human rights, and Japanese society. His current projects examine issues including changing conceptions of nationhood and minority rights in national constitutions and in practice, populism and the future of democracy, the global expansion of corporate social responsibility, and Japan’s public diplomacy and perceptions of Japan in the world.

Read More

 People gather during a rally calling for an anti-discrimination legislation in Japan.
News

Most Japanese Support Same-Sex Marriage, New Public Opinion Survey Finds

The initial set of results of the Stanford Japan Barometer, a new periodic public opinion survey co-developed by Stanford sociologist Kiyoteru Tsutsui and Dartmouth College political scientist Charles Crabtree, indicate that most Japanese are in favor of recognizing same-sex unions and reveal how framing can influence the public attitude toward LGBTQ communities.
Most Japanese Support Same-Sex Marriage, New Public Opinion Survey Finds
Michael McFaul, Oriana Skylar Mastro, Ken Jimbo, Kiyoteru Tsutsui, Larry Diamond, and Francis Fukuyama speaking at the Yomiuri Conference, Tokyo.
News

Stanford Experts Explore the Roles of Taiwan and Ukraine in Countering Autocratic Challenges to Democracy

At the Yomiuri International Conference, Freeman Spogli Institute scholars Larry Diamond, Francis Fukuyama, Oriana Skylar Mastro, Michael McFaul, and Kiyoteru Tsutsui examined lessons from the war in Ukraine, the risks of a crisis over Taiwan, and the impacts of both geopolitical flashpoints for defending democracy and for a coordinated approach to deterrence in the Indo-Pacific.
Stanford Experts Explore the Roles of Taiwan and Ukraine in Countering Autocratic Challenges to Democracy
Kiyoteru Tsutsui and book, Human Rights and the State
News

Stanford Sociologist Kiyoteru Tsutsui Wins the 44th Suntory Prize for Arts and Sciences

The Suntory Foundation recognizes Tsutsui, the Henri H. and Tomoye Takahashi Professor and Senior Fellow in Japanese Studies at the Shorenstein Asia-Pacific Research Center, for his book 'Human Rights and the State.'
Stanford Sociologist Kiyoteru Tsutsui Wins the 44th Suntory Prize for Arts and Sciences
Hero Image
Shinsho Taisho Award logo and the cover of Kiyoteru Tsutsui's book, 'Human Rights and the State'
All News button
1
Subtitle

The Shinsho Taisho Award honors Tsutsui, the Henri H. and Tomoye Takahashi Professor and Senior Fellow in Japanese Studies at the Shorenstein Asia-Pacific Research Center, for his book 'Human Rights and the State,' listing it among the 10 best books of 2022 in Japan.

-
A stethoscope lying over bills of foreign money with text "the future of health policy"

The third installment in a special event series on the occasion of Shorenstein APARC's 40th Anniversary, "Asia in 2030, APARC@40"

Hosted by APARC's Asia Health Policy Program

The Asia Health Policy Program (AHPP) aims to help empower health systems and policymakers in the Asia-Pacific region to improve their proactive, evidence-based responses to population health problems. This webinar brings together former postdoctoral fellows and visiting scholars from the program to explore their contributions to guiding healthcare providers and policy audiences toward a better understanding of health and demographic issues and the delivery of disease management and other health services. In celebrating the 40th anniversary of the Shorenstein Asia-Pacific Research Center, these scholars and practitioners will also share their reflections on how the center and the program have shaped their research and professional careers.

Speakers

Image
Brian Chen

Brian Chen, JD, PhD. Dr. Chen is an associate professor at the Arnold School of Public Health, University of South Carolina. He brings with him a global perspective on health and well-being, having lived and worked in health-related industries in Taiwan, Japan, and France. Using the tools of economic analysis, his research focuses on the organization and delivery of health care as well as the social determinants of health in Asia and the United States. A particular focus of his work is on the impact of laws and economic incentives on healthcare treatment decisions. His doctoral dissertation, published in the Journal of Public Economics, explored how Taiwan’s separating policy that mandated the separation of diagnosing from drug dispending affected physician prescribing behavior, and whether such changes had an impact on observable health outcomes.

Dr. Chen continues to work on economics- and health law-related research, investigating the impact of opioid regulations on prescribing behavior and subsequent health consequences. His new project aims to understand how the introduction of a novel class of therapeutics may have affected the undertreatment of osteoporosis, an important question in aging societies in Asia, the United States, and around the world.

Dr. Chen received his BA summa cum laude in Linguistics with Computer Science from Harvard College (1992), JD from Stanford Law School (1997), and his PhD in Business Administration from the University of California at Berkeley (2009). He was a postdoctoral fellow at the Walter H. Shorenstein Asia-Pacific Research Center at Stanford from 2009 to 2011.

Image
Wasin Laohavinij

Wasin Laohavinij, MD. Wasin Laohavinij is a medical doctor with an interest in quality improvement and program evaluation. He was a visiting scholar at the Asia Health Policy Program, Walter H. Shorenstein Asia Pacific Research Center, Stanford University in the United States in the Autumn of 2019.

Currently, He is a preventive medicine physician concentrating on non-communicable diseases and serves as a Chief of Data Management and Cost Evaluating Center, at King Chulalongkorn Memorial Hospital, Thailand. His work focuses on reducing healthcare costs while maintaining the quality-of-care patients receive. Furthermore, he is also interested in evaluating the efficacy and cost-effectiveness of health interventions.

Image
Phyu Phyu Thin Zaw

Phyu Phyu Thin Zaw, MBBS, MPP, PhD. Phyu Phyu Thin Zaw, who is a Burmese national, is a medical doctor, epidemiologist, and health systems researcher currently working as a Lecturer in the School of Public Health at the Li Ka Shing Faculty of Medicine, University of Hong Kong. She is also a member of the Steering Committee of the Science in Exile initiative, which brings together at-risk, displaced, and refugee scientists along with like-minded organizations who work together to strengthen systems that support, protect and integrate such affected scientists.

Phyu Phyu’s research interests are equity, health and education policies, Southeast Asia health systems and policies, sexual and reproductive health, gender equality, poverty eradication, and human rights issues. Thin Zaw is also a public health and policy consultant giving technical advice to think tanks and non-governmental organizations.

Image
Margaret Triyana

Margaret Triyana, PhD. Dr Triyana is a Senior Economist at the World Bank's Office of the Chief Economist, South Asia Region. Her main research area examines human capital formation over the life cycle, with an emphasis on how policies and environmental factors affect different dimensions of human capital in low and middle-income countries. She also examines the distributional impacts of both environmental risks and policies.

Image
Siyan Li

Siyan Yi, MD, MHSc, PhD. Dr. Yi is a medical doctor and an infectious disease epidemiologist by training. He received his PhD from the School of International Health of the University of Tokyo in Japan in 2010. He was a postdoctoral fellow at the Asia Health Policy Program, Walter H. Shorenstein Asia Pacific Research Center, Stanford University from 2011-2012. He is an Assistant Professor and Director of the Integrated Research Program at Saw Swee Hock School of Public Health, National University of Singapore. He also serves as Director of KHANA Center for Population Health Research in Cambodia and Adjunct Associate Professor at Touro University California, the United States. His implementation research program focuses on developing and evaluating community-based innovative interventions for improving access to prevention, treatment, and care services for HIV/AIDS, tuberculosis, sexual and reproductive health, and maternal and child health among vulnerable and marginalized populations in Southeast Asia.

Karen Eggleston
Karen Eggleston

Online via Zoom Webinar

Brian Chen Associate Professor, Health Services Policy and Management, Arnold School of Public Health, University of South Carolina
Wasin Laohavinij Chief of Data Management and Cost Evaluating Center and Physician, King Chulalongkorn Memorial Hospital, Thailand
Phyu Phyu Thin Zaw Lecturer, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong
Margaret Triyana Senior Economist, World Bank, South Asia Region
Siyan Yi Assistant Professor and Director of the USH-SSHSPH Integrated Research Program at Saw Swee Hock School of Public Health, National University of Singapore
Seminars
-
Contesting Sharia Law and Moral Enforcement in Aceh, Indonesia: A Contextual Approach

This webinar will address the complexities and the unexpected outcomes of enforcing Sharia—Islamic law—through the machinery of inefficient statecraft in the Indonesian province of Aceh, which is located on the periphery of the world’s largest archipelagic nation. Of Indonesia’s 38 provinces, Aceh is the only one that has been granted the official right to implement Islamic law. Sharia promises to provide comprehensive guidance in all aspects of life.  Local authorities in Aceh have used the scope and force of the law to prohibit expression and criminalize conduct deemed to deviate from “Islamic ideals.” Movies, concerts, New Year’s Eve celebrations, punk and other “alternative” lifestyles were outlawed and seen as signs of calamity, moral disorder, and social disease. Yet the Sharia state’s efforts to limit the “acceptable” range of ways of being Muslim in Aceh are not impervious to opposition. Various forms of resistance to the everyday workings of state Sharia institutions have occurred. In the provincial capital, Banda Aceh, for example, several youth groups have creatively confronted government efforts to discipline them and control their space despite facing continuous harassment from Muslim hardliners and the Sharia Police. Beyond reviewing these conditions, Professor Idria’s analysis of the state enforcement of Islamic law on the periphery of a large country’s rapidly changing society will explore and explain how the implementation of Sharia in Aceh has both influenced and been shaped by broader contexts, political, economic, social, and cultural in character.

Image
Reza Idria 030223

Reza Idria is an Assistant Professor of Social Anthropology in the Ar-Raniry State Islamic University in Banda Aceh, Indonesia, where he chairs the Aceh Association of Oral Tradition.  He also serves in various scholarly and journalistic capacities and as a researcher in the International Center for Aceh and Indian Ocean Studies. His writings have appeared in journals and books and he has given talks and presented papers in Asia, Europe, and the United States.  His post-graduate degrees are from Leiden University (Islamic Studies, MA 2010) and Harvard (Social Anthropology, MA 2016 and PhD 2020)

Donald K. Emmerson

Via Zoom webinar http://bit.ly/3YtY7hd

0
Visiting Scholar at APARC, 2022-23
Lee Kong Chian NUS-Stanford Fellow on Contemporary Southeast Asia, 2022-23
idria_700x700.jpg Ph.D

Reza Idria joined the Walter H. Shorenstein Asia-Pacific Research Center (APARC) as Visiting Scholar and 2022-23 Lee Kong Chian NUS-Stanford Fellow on Contemporary Southeast Asia for the winter and spring quarter of 2023. Idria currently serves as Assistant Professor at the Universitas Islam Negeri Ar-Raniry, Banda Aceh, Indonesia. While at APARC, he conducted research on the wide range of social and political responses that have emerged with the state implementation of Sharia (Islamic Law) in Indonesia.

Date Label
Reza Idria 2022-23 Lee Kong Chian NUS-Stanford Fellow on Contemporary Southeast Asia
Seminars
-
Event poster for Beyond ASEAN? Geopolitics, External Rivals, Internal Differences, and The State of Southeast Asia 2023

The Association of Southeast Asian Nations (ASEAN) deserves credit for sustaining peaceful and consensual multilateral cooperation in a diverse and historically divided region.  Accordingly, in principle if not always in practice, outside powers have supported the regional centrality of ASEAN.  But what does that centrality mean and can it survive current challenges?  While still recovering from the impact of the COVID-19 pandemic, Southeast Asia faces the destabilizing consequences of intense US-China tensions, Russia’s war in Ukraine, and global economic uncertainty.  Nor has ASEAN responded effectively to the ongoing domestic repression by the junta in Myanmar, one of the grouping’s own member countries.  Are there steps that ASEAN’s 2023 chair, Indonesia, could take to help meet these challenges?  Should minilateral options be considered?  In the context of addressing these and related topics, Sharon Seah will share pertinent findings from a just-published regional survey of Southeast Asian opinion influencers, The State of Southeast Asia 2023.

Image
Sharon Sheah 022723

Sharon Seah, in addition to her work for ISEAS-Yusof Ishak’s ASEAN Studies Centre, coordinates the Institute’s Climate Change in Southeast Asia Programme.  Her earlier service has included 15 years in Singapore’s Ministry of Foreign Affairs and its National Environment Agency.  Among her research interests are ASEAN, multilateralism, climate change, and the rule of law.  Her publications include, as co-editor, Building a New Legal Order for the Oceans (2019) and 50 Years of ASEAN and Singapore (2017). She has also served as the lead author of ISEAS-Yusof Ishak’s survey reports, The State of Southeast Asia and The Southeast Asia Climate Outlook.  She holds a Master in Public and International Law from the University of Melbourne (2018

Donald K. Emmerson

Via Zoom webinar http://bit.ly/3RXaVdB

Sharon Seah Senior Fellow and Coordinator, ASEAN Studies Centre, ISEAS-Yusof Ishak Institute
Seminars
-
Distressed flags of China, South Korea, and the United States

The intensifying strategic competition between the United States and China has put substantial pressure on South Korea concerning several strategic issues. The U.S.-China rivalry is only likely to continue with the upcoming American presidential election in 2024.

As the South Korean government has recently tilted toward the United States, China wants South Korea to take a more balanced approach in its policies between the two countries. China is also expressing concern on matters of interest to it, such as the THAAD deployment, supply chain reset, and issues of the Taiwan Strait and the regional status of Xinjiang.

As Ambassador Jung-Seung Shin will argue, South Korean foreign policies should be based on its national interests and reflect its identity and the values its people share. Therefore, according to Shin, South Korea should not only make efforts to further strengthen the KORUS alliance for the peace and stability of the Korean Peninsula and the region, but to properly manage its relations with China.

Featured Speaker

Ambassador Shin

Ambassador Jung-Seung Shin joins the Freeman Spogli Institute for International Studies (FSI) and the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) as Visiting Scholar and Payne Distinguished Fellow for the 2023 winter quarter. He previously served as Ambassador for the Republic of Korea to the People's Republic of China from 2008 to 2010, and currently serves as Chair Professor at the East Asia Institute at Dongseo University. While at Stanford, he will be conducting research on the strategic relationships between Korea, China, and the United States.

Discussant

Ambassador Shin

Oriana Skylar Mastro is a Center Fellow at Stanford University’s Freeman Spogli Institute for International Studies, where her research focuses on Chinese military and security policy, Asia-Pacific security issues, war termination, nuclear dynamics, and coercive diplomacy. She is also a Non-Resident Senior Fellow at the American Enterprise Institute and continues to serve in the United States Air Force Reserve, for which she works as a strategic planner at INDOPACOM.

She has published widely, including in International Security, Foreign Affairs, the New York Times, International Studies Review, Journal of Strategic Studies, The Washington Quarterly, Survival, and Asian Security. Her book, The Costs of Conversation: Obstacles to Peace Talks in Wartime, (Cornell University Press, 2019), won the 2020 American Political Science Association International Security Section Best Book by an Untenured Faculty Member.

Moderator

Gi-Wook Shin

Gi-Wook Shin is the director of the Walter H. Shorenstein Asia-Pacific Research Center; the William J. Perry Professor of Contemporary Korea; the founding director of the Korea Program; a senior fellow of the Freeman Spogli Institute for International Studies; and a professor of sociology, all at Stanford University. As a historical-comparative and political sociologist, his research has concentrated on social movements, nationalism, development, and international relations. 

Shin is the author/editor of more than twenty books and numerous articles. His recent books include South Korea's Democracy in Crisis (2022); The North Korean Conundrum: Balancing Human Rights and Nuclear Security (2021); Demographics and Innovation in the Asia-Pacific (2021); and Shifting Gears in Innovation Policy from Asia (2020). His new research initiative examines potential benefits of talent flows in the Asia-Pacific region, where countries, cities, and corporations have competed with one another to enhance their stock of "brain power" by drawing on the skills of both their own citizens and those of foreigners.

This event is part of the Frank E. and Arthur W. Payne Lecture Series. 

The Payne Lectureship is named for Frank E. Payne and Arthur W. Payne, brothers who gained an appreciation for global problems through their international business operations. Their descendants endowed the annual lecture series at the Freeman Spogli Institute for International Studies to raise public understanding of the complex policy issues facing the global community today and to increase support for informed international cooperation.

The Payne Distinguished Lecturer is chosen for his or her international reputation as a leader, with an emphasis on visionary thinking, a broad, practical grasp of a given field, and the capacity to clearly articulate an important perspective on the global community and its challenges.

Gi-Wook Shin
Gi-Wook Shin

In-Person at Philippines Conference Room, Encina Hall 3rd Floor
616 Jane Stanford Way, Stanford Campus

Ambassador Jung-Seung Shin

Stanford CISAC
Stanford University
Encina Hall
Stanford,  CA  94305-6055

0
Center Fellow at the Freeman Spogli Institute for International Studies
Courtesy Assistant Professor of Political Science
Faculty Affiliate at the Walter H. Shorenstein Asia-Pacific Research Center
OrianaSkylarMastro_2023_Headshot.jpg PhD

Oriana Skylar Mastro is a Center Fellow at the Freeman Spogli Institute for International Studies and Courtesy Assistant Professor of Political Science at Stanford University, where her research focuses on Chinese military and security policy, Asia-Pacific security issues, war termination, and coercive diplomacy. She is also a nonresident scholar at the Carnegie Endowment for International Peace and a member of the Council on Foreign Relations. She was previously an assistant professor of security studies at Georgetown University. Mastro continues to serve in the United States Air Force Reserve, for which she currently works at the Pentagon as Deputy Director of Reserve Global China Strategy. For her contributions to U.S. strategy in Asia, she won the Individual Reservist of the Year Award in 2016 and 2022 (FGO).

She has published widely, including in International Security, Security Studies, Foreign Affairs, the Journal of Strategic Studies, The Washington Quarterly, the Economist, and the New York Times. Her most recent book, Upstart: How China Became a Great Power (Oxford University Press, 2024), evaluates China’s approach to competition. Her book, The Costs of Conversation: Obstacles to Peace Talks in Wartime (Cornell University Press, 2019), won the 2020 American Political Science Association International Security Section Best Book by an Untenured Faculty Member.

She holds a B.A. in East Asian Studies from Stanford University and an M.A. and Ph.D. in Politics from Princeton University.

Her publications and commentary can be found at orianaskylarmastro.com and on Twitter @osmastro.

Selected Multimedia

CV
Date Label
Oriana Skylar Mastro
Lectures
-
Event Flyer for "Global Health Economics, China, and the Science of Healthcare Delivery in the Digital Age' with photo of Sean Sylvia

Co-sponsored by Peking University Institute for Global Health and Development, and the Asia Health Policy Program

Digitization in healthcare coupled with advances in artificial intelligence and other so-called "4th Industrial Revolution" technologies are enabling a radical shift in how healthcare is delivered. Few places are attempting to integrate these into healthcare as rapidly as China. This talk will discuss China's comparative advantage in healthcare digitization and lay out a research agenda for the economics of digital health. While these technologies bring potential to improve access to high- quality care and lower costs, unintended consequences and effects on healthcare markets are underexplored. Evidence on these issues is needed to inform policy and better harness these technologies for population health. Specific applications will be drawn from ongoing research in China and elsewhere.

Image
Sylvia, Sean 021623

Sean Sylvia is an Assistant Professor of health economics at UNC. His primary research interest is in the delivery of healthcare in China and other middle-income countries. Working with multidisciplinary teams of collaborators, he conducts large-scale population-based surveys and randomized trials to develop and test new approaches to provide healthcare to the poor and marginalized. His recent work focuses on the use of information technology to expand access to quality healthcare.

Jianan Yang
Sean Sylvia Assistant Professor of Health Economics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
Seminars
-
Gita Wirjawan

In November-December 2022 Indonesia hosted two international events, the Group of Twenty Summit (G20) and the Bali Democracy Forum (BDF).  Being in the country then, Gita Wirjawan gained impressions of the G20 and attended the BDF.  At both gatherings, he noted, concerns were expressed over the rise of autocracy, the growth of populism, and their effects on state integrity and performance, including an inability to recruit and select national leaders based on their actual talent—proven merit—above other considerations.  This tendency is increasingly common, Wirjawan will argue, in developed as well as developing countries.

A vital requisite for the economic and democratic success of open economies, in Southeast Asia as elsewhere, is trust.  International transfers of capital are like flows of water driven by gravity.  The power of that attraction depends on the extent to which the receiving country is perceived as trustworthy.  For liberal democracy to thrive in Southeast Asia, the region needs good governance by talented and trusted leaders who can ensure that appropriate rules are enforced and that the benefits of economic growth accrue to all layers of society.  Wirjawan’s recommendations in that context will include a priority on widely available quality education.

Image
Photo of Gita Wirjawan

Gita Wirjawan is an Indonesian entrepreneur and educator.  Having established a successful investment business in Indonesia, the Ancora Group, he created the Ancora Foundation.  The foundation has endowed scholarships for Indonesians to attend Stanford and other high-ranked universities around the world and has funded the training of teachers at hundreds of Indonesian kindergartens serving underprivileged children.  Wirjawan’s public service has included positions as Indonesia’s minister of trade, chairman of its Investment Coordinating Board, and chair of a 159-nation WTO ministerial conference in 2012 that focused on easing global trade barriers.  He led his country’s national badminton association in 2012-16 when Indonesia won four gold medals in the sport at world championships including the Olympics.  As an educator, he advises Indonesia’s School of Government and Public Policy (SGPP) and Yale’s School of Management, among other institutions.  At SGPP he hosts a public-policy podcast called endgame, to which an estimated 471,000 people subscribe and which has recently carried several interviews with Stanford faculty.  His degrees are from the Harvard Kennedy School (MPA), Baylor University (MBA), and the University of Texas at Austin (BSc). 

 

 

Donald K. Emmerson

Via zoom

Gita Wirjawan 2022-23 Visiting Scholar, APARC
Seminars
-
AHPP flyer for Feb 2, 2023 webinar with portrait of speaker Daniel Bennett

Co-sponsored by Peking University Institute for Global Health and Development, and the Asia Health Policy Program

Depression is the most common mental disorder and is more prevalent among people who live in poverty. Emerging economic literature studies the ways that depression may affect economic decision-making and contribute to intergenerational poverty. Dr. Bennett will describe recent developments in the literature and discuss his recent study of the socioeconomic impacts of depression treatment among underpriviledged adults in Karnataka, India.

Image
Bennet 020223

Daniel Bennett is an economist at the Center for Economic and Social Research and the Department of Economics at the University of Southern California. He studies economic development and global health in Africa and South Asia. Recent work examines the relationship between poverty and poor mental health, as well as the indirect consequences of the HIV/AIDS epidemic in Sub-Saharan Africa. Other work considers sanitation and hygiene behavior and the organization of pharmaceutical markets. Dr. Bennett collects primary data and uses both experimental and quasi-experimental methods. He received his Ph.D. in 2008 from Brown University.

Jianan Yang

Via Zoom Webinar

Daniel Bennett Associate Professor (Research) of Economics, University of Southern California.
Seminars
Authors
News Type
Q&As
Date
Paragraphs

This article originally appeared in the Korean daily newspaper Munhwa Ilbo on January 2, 2023. It was translated from Korean by Raymond Ha.

In an exclusive interview for the Munhwa Ilbo, Stanford University professors Gi-Wook Shin and Francis Fukuyama had a conversation on a wide range of topics including the war in Ukraine, U.S.-China competition, and North Korea policy.

The world faces a crisis of political leadership as each country pursues its own interests. Fukuyama stressed the importance of robust international institutions, instead of relying solely on great leaders. He pointed to NATO and the U.S.-Korea alliance as examples of institutions that uphold the liberal international order. In terms of the U.S.-China competition, he said without hesitation that “a democracy like Korea…has to make the decision that it is going to be on the side of democracy.” Fukuyama also noted that in the event of an armed confrontation over Taiwan, Korea would almost certainly be pulled in, given the significant U.S. military presence there. He was skeptical about prospects for progress over North Korea, pointing to the long history of failed negotiations and the lack of viable alternatives. “Not every problem has a solution,” he said.

Gi-Wook Shin, who led the interview, observed that the global decline of democracy appears to have hit a turning point, “although it’s too early to say if there will be a rapid recovery…or a more gradual shift.” As for the state of democracy in the United States, he said, “We will have to wait and see what happens in the 2024 presidential election.” Even though Trump’s political influence may be weaker, he observed, “pro-Trump forces are still part of the system.” In terms of Korea’s foreign policy, Shin emphasized that Seoul “should take [the Taiwan] problem much more seriously.” A crisis in the Taiwan Strait “could become the biggest challenge for the Yoon administration’s foreign policy, not North Korea,” and domestic polarization over China policy is one issue that could threaten to “become extremely controversial.”

The interview was held in-person for one hour at Stanford on December 8, 2022, with a follow-up interview held over the phone on December 27.  


[Gi-Wook Shin] Let’s start by looking back on 2022. How would you summarize this year?

[Francis Fukuyama] I think 2022 was a very good year, where we may have bottomed out in this global move away from democracy and toward authoritarian government. The year really started out in February with the Russian invasion of Ukraine, which looked very, very threatening. China was on a roll. It looked like they were beating everybody in terms of COVID policy. Then, by the end of the year, the Russians got completely bogged down. China experienced mass protests, and there were protests also in Iran. In America’s elections on November 8, all the pro-Trump forces failed to make gains and, in fact, lost almost everywhere. I think that maybe we will look back on 2022 as the year when this democratic recession that has been going on for over 15 years finally bottomed out.

[GWS] I agree, although it’s too early to say if there will be a rapid recovery toward democracy or a more gradual shift. In the United States, we will have to wait and see what happens in the 2024 presidential election. Former President Trump may be weaker politically, but pro-Trump forces are still part of the system. As for the Ukraine war, many people thought Russia would win quite easily, but now it looks like they are struggling. It’s a big question, of course, but how do you think the war will be remembered in history?

[FF] I think that it is going to be remembered as one of the biggest strategic mistakes made by a great-power leader in a very long time. I think that the mistake is directly due to the nature of the political system. You remember that Vladimir Putin was sitting at the end of this 25-foot table with his defense minister because he was so afraid of COVID. He was extremely isolated during the whole pandemic, and he had already isolated himself in a political system where he doesn’t face checks and balances. That kind of decision-making system makes you prone to make even bigger mistakes, because you don’t have other people to test your ideas against. He was completely uninformed about the degree to which Ukraine had developed a separate national identity and that the Ukrainian people were willing to fight for it. He didn’t have any idea how incompetent his own army was. If he had been in a more democratic country that required him to share power with other people, I don’t think he could have made that kind of mistake.

 

The most important thing is the breakdown of the Chinese economic model. For the past decade, the Chinese model has been to pump a huge amount of money into the real estate sector. That model is collapsing. The other big problem is that they don’t have economic growth anymore.
Francis Fukuyama

[GWS] Putin is struggling, as you said. There are a lot of problems in China, but Xi Jinping secured a third term. Authoritarian leaders elsewhere still hold power. By contrast, I don’t think President Biden has shown powerful leadership at home or globally. I don’t see any strong political leaders in the U.K., France, or Germany either.

[FF] I think that although Xi Jinping may succeed in stabilizing the situation in China with the protests over COVID in the short run, he is in a lot of trouble. He was creating all this social instability with the zero-COVID policy. Now that they’ve started to relax it, I think the number of cases and deaths is going to go up very dramatically, but I don’t think they’ve got much of a choice. I think this has probably damaged the people’s sense of Xi’s authority and legitimacy, and I’m not sure he can recover from that.

The most important thing is the breakdown of the Chinese economic model. For the past decade, the Chinese model has been to pump a huge amount of money into the real estate sector. That model is collapsing. The other big problem is that they don’t have economic growth anymore. Some economists think that they’re actually in a recession, with negative growth. This is like what Japan went through in the 1990s. So much of the Chinese government’s legitimacy has been based on having extremely high growth rates, and that period is over. I don’t see how they get it back, and they certainly won’t by inserting the state into every economic decision and controlling their high-tech sector. Their population is shrinking now. I’m not sure that Xi Jinping, in the longer run, is actually going to look like a very effective leader.

[GWS] But in the short term, say the next three to five years, won’t authoritarian leaders be powerful in comparison? Just as “America First” shows, some say there is a crisis of political leadership among Western democracies, including the United States, the United Kingdom, France, and Germany.

[FF] I think that apart from President Zelenskyy in Ukraine, we don’t see any really inspiring leaders in Germany or France or the United States. On the other hand, the nice thing about democracy is that it’s an institutional system for managing change. Biden has turned 80, and Trump himself is in his upper 70s. The leadership in Congress and the Democratic Party are all elderly, but they’re all about to change. In the next election cycle, there is going to be a whole new generation of people that are up-and-coming. I don’t think you need a charismatic leader with great vision, necessarily, to run any of the countries you mentioned.

[GWS] Another question is if the United States can provide global leadership. When Trump was defeated, there was a strong expectation for the Biden administration to restore global order and to do much better than its predecessor. I’m not sure whether that’s happening.

[FF] Again, I think that’s why you want to have international institutions rather than being dependent simply on leaders. This gives an institutional basis for continuity in policy. There are all of these alliance structures, like NATO. People thought that NATO was obsolete and was going to go away. It has actually proved to be very durable. The United States has security ties with Korea and Japan that also are quite old, but they’re still durable. It’s interesting that the authoritarian countries have not been able to create anything comparable to that set of alliances. There is the Shanghai Cooperation Organization (SCO), but all the Central Asian states don’t want to be part of this China-Russia dominated organization. We can’t just depend on great leadership.

Korea should proactively participate in upholding and creating an international order that facilitates a resurgence of democracy. Korea has not really played this role before, but with the 10th largest economy in the world, it is now in a position to play a positive role.
Gi-Wook Shin

[GWS] To add on to that, I think Korea should proactively participate in upholding and creating an international order that facilitates a resurgence of democracy. Korea has not really played this role before, but with the 10th largest economy in the world, it is now in a position to play a positive role.

[FF] There is a set of values that underpin America’s alliances, both in Asia and Europe. Throughout the whole Cold War, the Soviet Union never actually invaded a Western democracy, but that’s what Russia did. NATO has suddenly become very relevant once more. I think that both in Korea and Japan, there is also recognition of a comparable challenge from an authoritarian China. Unless all democracies work together and show solidarity with one another, they could be picked off by these two authoritarian powers.

[GWS] There is a lot of debate about whether China is going to invade Taiwan or not. I have a two-part question. First, could the situation in Ukraine reduce the possibility of China invading Taiwan? Second, if China still invades nevertheless, what should Korea do? This is a difficult question for Korea. It cannot say no to the United States as a military ally, but at the same time, it cannot antagonize China. I think this is the most difficult question for Korea at the moment.

[FF] This is a difficult question for the United States because it’s not clear that Congress or the American people actually want to go to war with China in order to save Taiwan. I think if you ask them a polling question stated like that, probably a majority would say, “No, we’re not going to send our troops to die.” But I think it’s likely that the United States will get dragged into such a conflict one way or the other. Among other things, the Chinese would probably have to preempt some of the American forces that are in the theater. American military personnel will get killed as the Chinese attack unfolds, and I think there will be a lot of political pressure to help Taiwan.

[GWS] How much can the United States be involved? Some in Korea are skeptical that Washington will step in.

[FF] This is really the problem. During the Cold War, we had a good idea of what a war would like look like if it actually happened. The military planning was very concretely designed against certain types of escalation. With China, we don’t have a clear set of expectations for what escalation would look like. It could just start with a Chinese invasion. It could start with a blockade. It could start with something in the South China Sea. It could actually start on the Korean Peninsula, with North Korea doing something. If it happens, it’s going to be much more devastating than the war in Ukraine. So much of global production comes out of Asia, and there’s a strong incentive not to let things get out of hand. Whether we have the wisdom to do that is not clear. I also think that people’s expectations and opinions will change once the conflict begins. The moment people see cities being bombed, they will change their minds.

Francis Fukuyama conversing in Gi-Wook Shin's office at Stanford University.
Francis Fukuyama. | Kim Namseok/Munhwa Ilbo

[GWS] I also think that a conflict over Taiwan would affect the American people more directly than what is happening in Ukraine. What’s your view on how seriously Korea should be taking this possibility?

[FF] It is likely enough that it is absolutely important for everyone to take it seriously and plan against it. What you want to do is deter China from taking any military action against Taiwan. They’re not going to be deterred unless they see that there’s a response on the other side that is going to raise the cost for them. That’s not going to happen unless people take the scenarios seriously and start thinking about concrete ways that they could help Taiwan or stymie any kind of Chinese attack. I think it is very important for Korea to think this through and think about ways they could support Taiwan and be part of a larger alliance that can push back against China.

[GWS] I keep telling my friends and colleagues in Korea that they should take this problem much more seriously. Taiwan could become the biggest challenge for the Yoon administration’s foreign policy, not North Korea. China policy has become an extremely divisive partisan issue in South Korea, and it could tear the country apart. What advice would you have for President Yoon?

[FF] There’s two things. First is the rhetorical position. Korea should make its position clear in advance that it would oppose Chinese military action and would support the United States, for example. Korea is going to get dragged into this because so much U.S. military equipment is in Korea, and that is going to be moved in closer to the theater. I think making that position clear in advance is important.

The other thing that’s been very clear from the Ukraine war is that democracies are not prepared for an extended conflict. Everybody is running out of ammunition in Europe and the United States is running low on certain types of ammunition. The Ukrainians have used so much of it just in the 10 months they have been fighting. I think that any high-intensity conflict in East Asia is also going to be very costly in terms of supplies. South Korea is in a better position than other countries because it has been preparing for a North Korean attack for decades. Everybody needs to be prepared for an extended conflict. It may not be over in 48 hours.

[GWS] Koreans are quite nervously watching the ongoing escalation of tensions between the United States and China. In the past, the paradigm was “United States for security, China for the economy” (an-mi-gyeong-joong). Now, security and the economy are linked together. The Yoon government is promoting the strengthening of the alliance with the United States, but South Korea faces the fundamental problem of how to position itself as U.S.-China tensions escalate. Do you have any wisdom for Korea?

[FF] I don’t know if it’s wisdom, but I think Korea needs to take a clearer position. Under the previous government, there was a belief that Korea could somehow be halfway between China and the United States. That’s just not a tenable position. The tension between the United States and China has really been driven by China ever since 2013, when Xi Jinping took power. China has become a much more severe dictatorship internally, and it has become much more aggressive externally. You see the influence of the Belt and Road Initiative and the militarization of the South China Sea. In the last 10 or 15 years, China has been picking fights with India, Japan, Korea, and all of Southeast Asia over territorial issues. They built the size of their military much more rapidly than any other great power in that period of time. As a result, the United States and other countries have simply reacted to this. I think that a democracy like Korea cannot pretend that it is somehow in between the United States and China. It has to make the decision that it is going to be on the side of democracy.

[GWS] I agree that an-mi-gyeong-joong is now obsolete, but I think that South Korea must be more sophisticated in its response. As they say, the devil is in the details. On the economy, Seoul can actively work with Washington on areas closely related to security, but it can still partner with Beijing on sectors that are not. There can be a fine-tuned policy.

I now want to ask about North Korea and U.S. policy. I have been saying that the Biden administration policy is one of “strategic neglect,” not the “strategic patience” of the Obama administration. Kim Jong-un keeps testing missiles and provoking, and South Koreans are puzzled by the lack of response from Washington. Why is that? Is it because all the attention is on Ukraine and China?

[FF] Not every problem has a solution, and I don’t think this problem has a solution. You could use diplomacy. You could use military force. You could use deterrence. There are a limited number of possible approaches, and I think none of them are going to work. There has been a long history of negotiation. That has not worked. I think confrontation is not going to work. I think preemption is certainly not going to work. I just don’t think there’s a good solution, so we’ve ended up with trying to ignore the problem by default. Part of the reason North Korea is launching all of these missiles is that they want people to pay attention to them. Ignoring the problem is not much of a solution either, but it’s not as if there is a better solution.

[GWS] I agree with you that for many people in government, North Korea has been a hot potato. You don’t want to touch it because there is no clear solution, and it won’t help your career. But if we just ignore the problem, then five years later it’s going to be worse. What kind of North Korea are we going to face in five or ten years?

[FF] Everybody has been hoping that something would happen internally. It’s fine to think that, but it’s also not taking place. That said, Kim Jong-un is obese and unhealthy. Who knows what might happen?

We've had four elections now where [Trump] was playing a major role in the Republican Party. In three of those elections, he really hurt his own party. He can stir up a third of the electorate that loves him, but it’s never enough to win an election, especially in a swing state.
Francis Fukuyama

[GWS] Let’s now turn to domestic politics here in the United States. I think many Americans were relieved by what happened in the midterm elections last month. Trump’s influence was much more limited than what people thought. But he’s still there, and he’s likely to run again. I think he is still a strong candidate for the Republicans.

[FF] He declared his candidacy, but I think that he is declining very rapidly in influence. We have had four elections now where he was playing a major role in the Republican Party. In three of those elections, he really hurt his own party. He can stir up a third of the electorate that loves him, but it’s never enough to win an election, especially in a swing state. I think he’s gotten crazier in recent months. He is doing so many self-destructive things, having dinner with neo-Nazis and repeating all these conspiracy theories. These are things that no rational candidate would do. The Republicans are going to want somebody that can actually beat the Democrats, and I don’t think it’s going to be him.

[GWS] You don’t expect a rematch between Biden and Trump in 2024?

[FF] This gets into a technical issue, but the Republican primaries are mostly winner-take-all primaries. Any candidate that can get 30% of the vote is likely to be nominated. If you have a Republican field that has several people competing, they may split the alternative vote and Trump may end up winning. I think he still has a good chance of being the Republican nominee. If you’re a Democrat, that’s not the worst thing in the world. It is probably easier to run against Trump than a more normal Republican candidate.

[GWS] Two years is still a long time in politics. You said that Trump is likely to be nominated. Would Biden also run again?

[FF] I think that Biden is going to run again. Part of the problem is in the Democratic Party. It’s not clear who the successor would be. There are a lot of potential new-generation politicians, but I don’t think any of them has enough presence and attention that they can clearly take over the mantle to run as the Democratic candidate. If there is a rematch, I think Biden will win.

[GWS] Now to South Korea. Last June, I did some interviews advocating a parliamentary system, and they received good attention. There is still a lot of hesitancy among Koreans, though. I think there are a few reasons. The first is that we need a strong presidential system to deal with North Korea. There’s no stability if the prime minister keeps changing. Second is that it may drive politicians closer to big business (chaebol) because there’s less direct accountability. What would you suggest for South Korea in terms of institutional reform?

[FF] There are several possibilities even short of a parliamentary system. You can coordinate the presidential and parliamentary terms. It’s still the case that the president has a five-year term, but the legislature is on an even-year term. If you want to have strong government, you need a president that has majority support in the legislature. If they get elected simultaneously on a regular basis, you’re more likely to see strong leadership emerge. In a presidential system, the legislature itself is a check against the president. If you don’t have a strong majority in the legislature, you can’t do anything.

[GWS] That is what is happening right now in Korea.

[FF] In a parliamentary system like the British one, if you have a majority in parliament, you can do what you want. I think the presumption that somehow a presidential system is inevitably stronger than a parliamentary system is not historically correct.

[GWS] Is a parliamentary system maybe one solution to political polarization?

[FF] Sometimes a parliamentary system will have that effect, but the kind of plurality voting system that we have in the United States and in Britain tends to promote polarization. To the extent that you make it possible for third parties to run, that’s probably a better system. If you have more parties and it becomes harder to get a majority in the legislature, that forces coalitions and some degree of power sharing.

Francis Fukuyama 2022

Francis Fukuyama

Olivier Nomellini Senior Fellow at the Freeman Spogli Institute for International Studies, Director of the Ford Dorsey Master’s in International Policy, and Professor by Courtesy, Department of Political Science
Full Biography
Gi-Wook Shin

Gi-Wook Shin

Senior Fellow at the Freeman Spogli Institute for International Studies, Professor of Sociology, William J. Perry Professor of Contemporary Korea, Director of the Shorenstein Asia-Pacific Research Center, and Director of the Korea Program
Full Biography

Read More

Yoon Suk-yeol speaks during a press conference
Commentary

In Troubled Waters: South Korea’s Democracy in Crisis

Just as the United States experienced a crisis of democracy under the Trump administration, South Korea underwent a democratic recession during President Moon Jae-in’s time in office. The consequences of this decline have been evident throughout the election and the subsequent presidential transition.
In Troubled Waters: South Korea’s Democracy in Crisis
South Korean soldiers participate in a river crossing exercise with U.S. soldiers.
News

Striking the Right Balance: What South Korea Can Do to Enhance Deterrence in the Taiwan Strait

Despite obstacles and risks, there are good reasons why South Korea should want to increase deterrence against China. In a new article, Center Fellow Oriana Skylar Mastro and co-author Sungmin Cho chart an optimal strategy for Seoul to navigate the U.S.-China rivalry and support efforts to defend Taiwan.
Striking the Right Balance: What South Korea Can Do to Enhance Deterrence in the Taiwan Strait
Ukrainian President Volodymyr Zelensky addresses the South Korean parliament via video link.
Commentary

In the Wake of Russia’s Invasion of Ukraine, Korea Should Join Its Peers in Defending the Liberal International Order

It is difficult to anticipate how the geopolitical storm set off by Russia’s invasion of Ukraine may develop. What is certain is that the international order will not be the same, and this change will have significant repercussions for South Korea.
In the Wake of Russia’s Invasion of Ukraine, Korea Should Join Its Peers in Defending the Liberal International Order
Hero Image
Gi-Wook Shin and Francis Fukuyama at Encina Hall, Stanford, in conversation.
Gi-Wook Shin (L) and Francis Fukuyama.
Kim Namseok/ Munhwa Ilbo
All News button
1
Subtitle

A Conversation with Francis Fukuyama on the Challenges of a Changing Global Order

Date Label
Subscribe to Asia-Pacific