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Karen Eggleston
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"The Role of the Private Sector in Health" was the topic of a full day symposium held July 11th at the Beijing International Convention Center. Convened one day before the World Congress of the International Health Economics Association, the private sector symposium attracted over a hundred participants from nations around the world. Aiming to foster dialogue between researchers interested in the private sector and policymakers, the event is one in a series with the long-term goal of promoting greater research interest and knowledge generation regarding the private sector to benefit health systems development. The program featured several scientific paper presentations and panels as well as keynote addresses by representatives from the Chinese Ministry of Health and the World Bank.

Karen Eggleston of the Asia Health Policy Program worked alongside several others on the organizing committee for this ongoing collaboration about the role of the private sector in health policy. Other committee members included Ruth Berg, PSP ONE, Abt Associates; Peter Berman, World Bank; Birger Forsberg, Karolinska Institutet; Gina Lagomarsino, Results for Development; Qingyue Meng, Shandong University; Dominic Montagu, University of California, San Francisco; Sara Bennett, Alliance for Health Systems and Policy Research; and Stefan Nachuk, Rockefeller Foundation.

Selected papers about the private health sector in Asia presented at the symposium will appear in the Asia Health Policy Program's working paper series on health and demographic change in the Asia-Pacific.

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CISAC is pleased to announce that 14 seniors have been selected to participate in its Undergraduate Honors Program in International Security Studies

The program provides an opportunity for eligible students focusing on international security subjects in any field to earn an honors certificate.

Students selected intern with a security-related organization, attend the program's honors college in Washington, D.C. in September, participate in a year-long core seminar on international security research, and produce an honors thesis with policy implications.

  • Bertram Ang
    Departments of Economics & Political Science
    Restructuring of the Military Mindset
  • Amir Badat
    Program in International Relations
    Nuclear Disarmament and the Nuclear Non-Proliferation Treaty
  • Daniel Cassman
    Departments of Political Science & Computer Science
    The Restart of Ended Civil Wars
  • Philippe de Koning
    Program in International Relations
    Minor in Economics
    The Influence of North Korea and China on Japanese Militarization
  • Daniel Leifer
    Department of Biology
    Rapid Mobilization of Health Care Workers in Times of Crisis
  • Ashley Lohmann
    Program in International Relations
    Tactical Change by Middle Eastern Terrorist Organizations, 1970-2004
  • Raffi Mardirosian
    Department of Economics & Public Policy Program
    The Adaptability of Terrorists and Rogue Nations to Financial Methods of Preventing WMD Proliferation and other Breaches of National Security
  • Ben Picozzi
    Department of Philosophy
    Minor in Classical Languages
    Norms and International Security with Respect to the Responsibility to Protect
  • Amir Ravandoust
    Department of Management Science & Engineering
    Minor in International Relations
    Nuclear Arab States: Is Proliferation Inevitable?
  • Sam Stone
    Department of Mathematics & Program in International Relations
    The Use of Energy Exports as a Foreign Policy Tool in the CIS and Eastern Europe
  • Gautam Thapar
    Department of Political Science
    Minor in Economics
    U.S. Aid to Pakistan
  • Son Ca Vu
    Department of Management Science & Engineering
    Minor in Political Science
    The A.Q. Khan Network: A Rogue Business Model
  • Georgia Wells
    Program in Human Biology
    Explaining the Radicalization of the Muslim Brotherhood in Egypt
  • Hao Yan
    Departments of Political Science & Economics
    China's Global Strategy

 

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Larry Diamond
Abbas Milani
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As the presidential electoral turmoil in Iran continues, pitting supporters of challenger Mir Hussein Moussavi against President Mahmoud Ahmadinejad, President Obama has gotten it right, Larry Diamond and Milani say, "by signaling America's support for peaceful protest, human rights, and the rule of law." More explicit language, or action, would only play into the hands of Iran's conservative elements. But the world has more than 100 other democracies, Diamond and Milani note, arguing "It is time that their voices were heard and their actions felt in Tehran."

Notices of the demise of Iran’s Green Revolution are premature. Without question, the tyrannical triumvirate — Ayotallah Ali Khamenei, President Mahmoud Ahmadinejad and the Revolutionary Guard — have dealt a crippling blow to the popular movement protesting their electoral coup of June 12.

Thousands of Iranians have been arrested and savagely tortured — from street protesters to election campaign organizers for Mir Hussein Moussavi, the likely victor in that contest. Many are now being forced to “confess” to having been agents of the United States or Britain.

We have seen this play before, not simply in Iran but in other tyrannies that suppressed mass movements for democratic change with massive violence and terror.

But Iran in 2009 is not China in 1989, Burma in 1990 or Belarus in 2006. The crisis in the Islamic Republic has exposed and widened massive cracks within the ruling elite. Such divisions are always a sign of an impending crackup of dictatorship.

Despite the rush to bury Iran’s reformist movement as another lost cause, Iran remains at a possible political tipping point. Democracies around the world have a duty — not simply to themselves, but to their strategic interests — to weigh in. They must not be deterred by threats to shun talks over Iran’s nuclear program.

President Obama has gotten it right by signaling America’s support for peaceful protest, human rights and the rule of law. More explicit language, not to mention action, would only play into the hands of the most cynical and vicious conservative elements in Iran. Moreover, with no diplomatic ties and all but no trade with Iran, there is little more the U.S. could do right now to pressure the regime.

But there are over 100 other democracies in the world. It is time that their voices were heard and their actions felt in Tehran.

Britain shares with the U.S. the handicap of a past history of negative interference in Iran. But Britain has diplomatic and economic ties to the regime, and breaking or suspending those will weaken Ayatollah Khamenei and his reactionary allies.

Moreover, Britain can have a unique kind of impact in Iran: For more than a century, Iranians have believed in the omnipotence of the “British hand” in the affairs of their country. Any indication that Britain is no longer willing to do business with the Islamic regime will hearten the Iranian people and undermine the regime’s aura of invincibility.

Germany, France and Italy are major trading partners with Iran. They have little history of colonial interference in Iranian affairs. Their decision to refuse to recognize the Ahmadinejad regime would have an immense effect. More compelling still would be a similar declaration from the entire Group of 8 at its impending summit.

The smaller and less powerful democracies can also have an impact. It would be preposterous for Iranian hardliners to attribute ulterior strategic motives to actions by the Scandinavian countries or the Netherlands, Ireland, Canada or Slovenia. If a coalition of such countries were to condemn the crackdown, call for a release of political prisoners and demand full respect for human rights — and back up these positions with a downgrading of diplomatic and trade ties — this would send a powerful message to both sides in Iran.

Many democracies around the world, including the above, have diplomatic ties with Iran. It is important that they maintain their embassies in Tehran. But they should now refuse to recognize the legitimacy of Ahmadinejad’s government.

The most powerful coalition of democracies in the world, the 27-member European Union, is now debating whether to withdraw their ambassadors from Tehran in protest over the detention of the British Embassy’s Iranian personnel.

The withdrawal of E.U. ambassadors would send a stunning message to the Iranian hardliners that coups and bloody suppression of peaceful protests carry a heavy price in international standing.

With the simple diplomatic act of denying legitimacy — something nearly all democratic forces in Iran are now asking of the world — the democracies of the world can give a needed boost to the forces of democratic change in Iran and earn the lasting gratitude of a movement that will eventually triumph.

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This year marks the 60th consecutive Current Strategy Forum at the Naval War College in Newport. The first was held on 9 May 1949 under the title "Round Table Talks," and offered an opportunity for the nation's public servants, scholars, and senior military officers to join the College faculty and students to discuss the future strategy of the United States. Over time this forum has expanded to include a cross section of America's civilian leadership to encourage a wide-ranging debate on national and international security. Each year the Secretary of the Navy hosts the Current Strategy Forum to provide an opportunity for an exchange of views among outstanding scholars and leaders from across industry, government and the military. Today, as the Navy continues to focus on its support for the wars in Iraq and Afghanistan it also must also look beyond the horizon.  The Navy must support our nation's national security objectives even as new challenges and threats emerge to threaten   the global system.  This year's forum will present the perspective of the nation's leading experts on how the Navy can both meet future challenges and identify opportunities to promote a more stable world with the theme:

» "Seizing Strategic Opportunities: Challenging the Paradigm"

Naval War College
Newport, RI

Freeman Spogli Institute for International Studies
Stanford University
Encina Hall, C-327
Stanford, CA 94305-6055

(650) 723-9149 (650) 723-6530
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Affiliated Scholar at The Center for International Security and Cooperation (CISAC)
tom_fingar_vert.jpg PhD

Thomas Fingar is an affiliate at the The Center for International Security and Cooperation (CISAC) in the Freeman Spogli Institute for International Studies at Stanford University. He was the inaugural Oksenberg-Rohlen Distinguished Fellow from 2010 through 2015 and the Payne Distinguished Lecturer at Stanford in 2009.

From 2005 through 2008, he served as the first deputy director of national intelligence for analysis and, concurrently, as chairman of the National Intelligence Council. Fingar served previously as assistant secretary of the State Department’s Bureau of Intelligence and Research (2000-01 and 2004-05), principal deputy assistant secretary (2001-03), deputy assistant secretary for analysis (1994-2000), director of the Office of Analysis for East Asia and the Pacific (1989-94), and chief of the China Division (1986-89). Between 1975 and 1986 he held a number of positions at Stanford University, including senior research associate in the Center for International Security and Arms Control.

Fingar is a graduate of Cornell University (A.B. in Government and History, 1968), and Stanford University (M.A., 1969 and Ph.D., 1977 both in political science). His most recent books are From Mandate to Blueprint: Lessons from Intelligence Reform (Stanford University Press, 2021), Reducing Uncertainty: Intelligence Analysis and National Security (Stanford University Press, 2011), The New Great Game: China and South and Central Asia in the Era of Reform, editor (Stanford University Press, 2016), Uneasy Partnerships: China and Japan, the Koreas, and Russia in the Era of Reform (Stanford, 2017), and Fateful Decisions: Choices that will Shape China’s Future, co-edited with Jean Oi (Stanford, 2020). His most recent article is, "The Role of Intelligence in Countering Illicit Nuclear-Related Procurement,” in Matthew Bunn, Martin B. Malin, William C. Potter, and Leonard S Spector, eds., Preventing Black Market Trade in Nuclear Technology (Cambridge, 2018)."

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Philip Taubman
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Now that President Obama has set a promising arms reduction agenda with President Dmitri Medvedev of Russia, he faces the greater challenge of getting his own government and the American nuclear weapons establishment to support his audacious plan to make deep weapons cuts, Philip Taubman writes in the New York Times.

As President Obama will soon discover, erasing the nuclear weapons legacy of the cold war is like running the Snake River rapids in Wyoming — the first moments in the tranquil upstream waters offer little hint of the vortex ahead. Now that Mr. Obama has set a promising arms reduction agenda with President Dmitri A. Medvedev of Russia, he faces the greater challenge of getting his own government and the American nuclear weapons establishment to support his audacious plan to make deep weapons cuts and ultimately eliminate nuclear weapons.

So far, Mr. Obama has effectively coupled an overarching vision of getting to a world without nuclear weapons, outlined in a speech in Prague earlier this year, with concrete first steps like the one-quarter reduction in operational strategic nuclear weapons promised in Moscow this week. Given his short time in office, and the looming December expiration of the treaty with Russia covering strategic nuclear arms reductions, the new limits are a good, realistic start. It is especially important to extend the monitoring and verification provisions of the expiring arms accord.

But the overall Obama approach involves a balancing act that requires him to move boldly while reassuring opponents that he is not endangering our security. Put simply, he has to maintain a potent nuclear arsenal while slashing it.

Mr. Obama might consider Ronald Reagan’s experience when he tried to set a similar course. The nuclear weapons crowd practically disowned Reagan when he proposed abolishing nuclear weapons during his 1986 summit meeting with Mikhail Gorbachev in Reykjavik, Iceland. After the meeting, when Reagan asked his generals to explore the ramifications of possibly sharply cutting warheads and eliminating nuclear-tipped ballistic missiles, they politely but firmly told their commander in chief it was a terrible idea.

Mr. Obama’s moment of truth with his generals is coming later this year when the Pentagon completes its periodic Nuclear Posture Review. This, in the Pentagon’s words, “will establish U.S. nuclear deterrence policy, strategy and force posture for the next 5 to 10 years.” So it will be the American nuclear weapons bible for the remainder of Mr. Obama’s presidency, one term or two.

President Obama must make sure it reflects his thinking. That will not be automatic, because the nuclear weapons complex — the array of Pentagon and Energy Department agencies involved in nuclear operations, including the armed services and the weapons labs — harbors considerable doubt about his plans. The same goes for the wider world of defense strategists. There is resistance in Congress, too.

The view in these quarters is that the weapons cuts Mr. Obama envisions — deeper than the modest goals set in Moscow this week — would dangerously undermine the power of America’s arsenal to deter attacks against the United States and its allies. Sentiment also favors building a new generation of warheads, a step Mr. Obama has rejected.

If the White House does not assert itself, the Nuclear Posture Review could easily spin off in unhelpful directions. The review that was produced when Bill Clinton was president in 1994 offered a rehash of cold war policies. The one that was done when George W. Bush took office in 2001 was more unconventional, but was quickly overshadowed by the terror attacks of Sept. 11, 2001, and the war in Iraq.

To serve Mr. Obama’s interests, the new review should lay the groundwork for pronounced cuts in weapons and shape America’s nuclear stockpile to fit a world in which threats are more likely to come from states like North Korea and Iran than from a heavily armed power like Russia.

After the review, the next big test for Mr. Obama will likely be Senate consideration of the Comprehensive Test Ban Treaty. He has pledged to resubmit this 1996 United Nations treaty, which was flatly rejected by the Senate in 1999.

To get the two-thirds majority needed for its approval, Mr. Obama will need to hold his fellow Democrats in line — far from a sure thing — and also pick up some Republican support. Two influential Republican senators — John McCain and Richard Lugar — are pivotal. Both voted against the treaty in 1999.

Opponents wrongly argue that the treaty is unverifiable. That might have been the case a decade ago, but technological advances make monitoring of even small underground nuclear tests possible today. Critics also say a permanent ban on testing — the United States has honored a moratorium since 1992 — would eventually cripple the nation’s ability to maintain reliable warheads. So far, most weapons experts would say, that has not proven to be true and should not be for many years.

Few presidential moments are more glittering than the announcement of arms reduction accords in the Kremlin’s gilded halls. For Mr. Obama, that was the easy part.

 

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CDDRL Deputy Director Kathryn Stoner commented on NPR's The World on key issues as U.S. President Barack Obama meets in Moscow with Russian President Dmitri Medvedev and Prime Minister Vladimir Putin as part of a broad U.S. effort to re-set U.S. Russian relations. Noting that the U.S. president had no choice but to meet with Putin, who still holds significant power, Stoner-Weiss pointed to a number of gains, including bilateral agreement to reduce nuclear warheads, cooperate on the war in Afghanistan, and address the risks posed by North Korea's and Iran's nuclear programs.
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Pharmaceutical policies are interlinked globally, yet deeply rooted in local culture. The newly published book Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific, edited by Karen Eggleston, examines how pharmaceuticals and their regulation play an important and often contentious role in the health systems of the Asia-Pacific.

In this colloquium, contributors to Prescribing Cultures discuss how the book analyzes pharmaceutical policy in China, Korea, Japan, Thailand, Taiwan, Australia, and India, focusing on two cross-cutting themes: differences in “prescribing cultures” and physician dispensing; and the challenge of balancing access to drugs with incentives for innovation.

As Michael Reich of Harvard University says in his Forward to Prescribing Cultures,

“The pharmaceutical sector…promises great benefits and also poses enormous risks.… Conflicts abound over public policies, industry strategies, payment mechanisms, professional associations, and dispensing practices—to name just a few of the regional controversies covered in this excellent book.

The tension between emphasizing innovation versus access -- a topic of hot debate on today’s global health policy agenda -- is examined in several chapters…

This book makes a special contribution to our understanding of the pharmaceutical sector in China… Globalization is galloping forward, with Chinese producers pushing the pace at breakneck speed. More and more, our safety depends on China’s ability to get its regulatory act together…”

The colloquium features presentations by Naoko Tomita (Keio University), Anita Wagner (Harvard University), and Karen Eggleston (Stanford FSI Shorenstein Asia-Pacific Research Center). They will give specific examples of how pharmaceutical policy serves as a window into the economic tradeoffs, political compromises, and historical trajectories that shape health systems, as well as how cultural legacies shape and are shaped by the forces of globalization.

Oksenberg Conference Room

Anita Wagner Speaker Harvard University
Naoko Tomita Speaker Keio University

Shorenstein APARC
Stanford University
Encina Hall E301
Stanford, CA 94305-6055

(650) 723-9072 (650) 723-6530
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Senior Fellow at the Freeman Spogli Institute for International Studies
Center Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
Faculty Research Fellow of the National Bureau of Economic Research
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
karen-0320_cropprd.jpg PhD

Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.

Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.

Director, Asia Health Policy Program at the Walter H. Shorenstein Asia-Pacific Research Center
Stanford Health Policy Associate
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Center on Food Security and the Environment, Stanford University
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Rosamond L. Naylor
David S. Battisti
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