Brett Carter is an Associate Professor in the Department of Political Science and International Relations at the University of Southern California, a Hoover Fellow at Stanford University's Hoover Institution, and a Faculty Affiliate at Stanford's Center on Democracy, Development and the Rule of Law. He received a Ph.D. from Harvard University, where he was a fellow at the Harvard Academy for International and Area Studies.
Carter studies politics in the world's autocracies. His first book, Propaganda in Autocracies: Institutions, Information, and the Politics of Belief (Cambridge University Press), draws on the largest archive of state propaganda ever assembled — encompassing over eight million newspaper articles in six languages from nearly 60 countries around the world — to show how political institutions shape the propaganda strategies of repressive governments. It received the William Riker Prize for the Best Book in Political Economy, the International Journal of Press/Politics Hazel Gaudet-Erskine Best Book Award, Honorable Mention for the Gregory Luebbert Award for the Best Book in Comparative Politics, and Honorable Mention for the APSA Democracy & Autocracy Section's Best Book Award.
His second book, in progress, shows how politics in Africa’s autocracies changed after the fall of the Berlin Wall and how a new era of geopolitical competition — marked by the rise of China and the resurgence of Russia — is changing them again.
Carter’s other work has appeared in the Journal of Politics, British Journal of Political Science, Perspectives on Politics, Journal of Conflict Resolution, Security Studies, China Quarterly, Journal of Democracy, and Foreign Affairs, among others. His work has been featured by The New York Times, The Economist, The National Interest, and NPR’s Radiolab.
Expected dramatic shifts of foreign policy by leading democracies, including the U.S. and U.K., would shake a future of liberal international order, which has underpinned the stability even after the end of the Cold War. Since Mr. Donald Trump was elected as the 45th President of the U.S., abovementioned discourse is heard everywhere in Europe and Asia today.
It is not clear, if American leadership and military presence would in fact retreat, how American allies behave and whether they can work together to sustain the order. Among others, Japan has been the exceptionally strong believer of such postwar American leadership. It is doubtful that all American allies and friends share same views, having their own historical context with the U.S. and own ideas on order and principles. Hence, naturally they shall differ in losing the confidence on the durability of American leadership.
A new order will be shaped by many factors, but American allies’ perspectives should not be overlooked. Hegemon’s own reluctance for ruling is surely significant. So is other great power’s revisionism, making use of such strategic opportunities. However, American allies has the potential to shape the fate of the order: if they succeed in acting collectively, it shall underpin the global governance for a while, and ensue the order transformation process in rather slow and peaceful pace.
If they fail, it shall not only accelerate the U.S. retrenchment, but invite an emergence of divisive and competitive order. Sahashi shares the findings from the international study project which he leads, and argues the difficulty for US allies to unite themselves and the potential order transformation in the long term.
Ryo Sahashi is Associate Professor of International Politics and Director, Faculty of Law, Kanagawa University, Yokohama, and is leading the newly-launched international joint study “Worldviews on the United States.” From 2014-2015, he served as Visiting Associate Professor, Shorenstein APARC, Stanford University.
She is the author of numerous books on a variety of subjects including the People’s Republic of China’s exchange rate system, Japan’s macroeconomic policy, IMF policy, and the European debt crisis. Her most recent book (translated title: Unwinding Super-Easy Monetary Policy), published in August 2016, is about the monetary policies of the BOJ, the European Central Bank, and the Federal Reserve System. She regularly appears on CNBC, Bloomberg, Reuters, BBC, and features in many Japanese TV programs and newspapers, commenting on the Japanese economy and monetary policy. URL: http://www.sayurishirai.jp
Her most recent book in English is Mission Incomplete: Reflating Japan’s Economy published by the Asian Development Bank Institute in February 2017. It is a complete analysis of BOJ’s unconventional monetary easing from the late 1990s to the present. Free Download is available at https://www.adb.org/publications/mission-incomplete-reflating-japan-economy.
One policy option for countries reliant on natural resources is to share part of the revenues directly with citizens, an idea known as oil to cash. Technological innovation, such as biometric identification and mobile money, now allow direct payments to people on a massive scale. Additional changes in the global marketplace, experiments in India and Kenya, and shifting political views of cash transfers have all affected the potential of cash to boost governance.
Whether it’s WikiLeaks and CIA documents or nuclear thieves, the danger from insiders in high-security organizations is escalating in our Internet age.
But many threats from within go unrecognized or misunderstood, according to Stanford professor Scott Sagan, who co-edited a new book Insider Threats with Matthew Bunn, a professor of practice at Harvard University. Their work analyzes the challenges that high-security organizations face in protecting themselves from employees who might betray them. Sagan, a core faculty member in Stanford's Center for International Security and Cooperation, and Bunn recently participated in an online discussion of the book’s key arguments. They will hold a talk and book signing at 3:30 p.m. on May 16 in the CISAC Central Conference Room.
Sagan and Bunn wrote, “Perhaps the most striking lesson we learned in working with scholars and officials who have dealt with this problem was the sheer scale of the red flags – from explicit statements of support for Osama bin Laden to behavior leading other staff to fear for their lives – that organizations are able to ignore.”
They found that organizations tend to have biases that cause them to downplay insider threats. In particular, organizations with high-security needs face significant risks from trusted employees with access to sensitive information, facilities, and materials.
The researchers highlight "worst practices" from these past mistakes, suggesting lessons and insights that could improve the security situations at many workplaces. Amy Zegart, co-director of CISAC, has a chapter in Insider Threats that provides a detailed account of the organizational dysfunction that allowed Nidal Hasan to carry out his massacre at Fort Hood.
Other chapters include the following topics and authors:
Another chapter examines the potential terrorist use of nuclear insiders, offering new data that shows that jihadist writings and postings contain only a modest emphasis on possible nuclear plots, and essentially no mention of the possibility of using nuclear insiders. However, the authors warn this is no reason for complacency – insiders have been largely responsible for past nuclear theft incidents.
MEDIA CONTACTS
Scott Sagan, Center for International Security and Cooperation: (650) 725-2715, ssagan@stanford.edu
Clifton B. Parker, Center for International Security and Cooperation: (650) 725-6488, cbparker@stanford.edu
The Center for International Security and Cooperation is educating the next generation of thought leaders and policy makers in international security. Toward this, fellows produce policy-relevant research on topics they are studying. One way they connect research with the policy arena is through journal articles, op-eds and essays. Three recent publications by CISAC pre- and post-doctoral fellows on the subject of nuclear risks include:
• Sayuri Romei’s op-ed The Hidden Costs of our Nuclear World appeared March 10 in the Monkey Cage blog that's published by the Washignton Post. Her research with Japanese people who have survived radioactive exposure in World War II and Fukushima suggests that they long endure discrimination and shame, as well as a government and society relecutant to come to grips with the human effects. "For a long time after the Hiroshima and Nagasaki bombings, Japanese citizens had no clear and reliable information on the health effects of the bomb. That opacity continues in the secretive and contradictory way information is coming out about the Fukushima nuclear accident," she wrote.
• Jooeun Kim’s op-ed ‘Actions speak louder than words’: Rhetoric and nuclear policy realities’ was published in the Freeman Spogli Institute's Medium site on March 7. She explored why it is so important for the U.S. to be viewed by its Asian allies as a dependable nuclear and military power that can help them during a crisis. She notes that "the greater the number of nuclear states, the higher the risk of nuclear war by miscalculation or accident." She concludes that if the Trump administration provides support to allies when they are in need, the president's "rhetoric from the campaign trail can be forgotten amid the policy realities of the international order."
• Anna Péczeli’s journal article Russia, NATO and the INF Treaty was featured in the Strategic Studies Quarterly on Feb. 28. She noted that Russia’s leadership must understand that continued noncompliance with the Intermediate-Range Nuclear Forces Treaty will yield no political or military gains for them – a message that must be communicated to the Kremlin by the U.S. government. She wrote, "The INF treaty, long a cornerstone of European security, is in acute danger of collapse since the United States and Russia are operating on the basis of different, indeed contrasting, logic."
CISAC has had 399 fellows since its founding more than 30 years ago. They conduct research, write about their findings, and spur informed public discussions about policy. To learn how to apply to the CISAC fellowship program, click here.
Agenda
4:15pm: Doors open
4:30pm-5:30pm: Talk and Discussion
5:30pm-6:00pm: Networking
1265 Welch Road, Room 245
Stanford, CA 94305-5479
Dr. Hernandez-Boussard is an Associate Professor in Medicine (Biomedical Informatics), Surgery, and Biomedical Data Science at the Stanford University School of Medicine. Dr. Hernandez-Boussard's background and expertise is in the field of computational biology, with concentration on accountability measures, population health, and health policy. A key focus of her research is the application of novel methods and tools to large clinical datasets for hypothesis generation, comparative effectiveness research, and the evaluation of quality healthcare delivery.
Non-communicable diseases such as heart and respiratory disease, cancer, obesity and diabetes are now responsible for some two-thirds of premature deaths around the world. And most of those are in low- and middle-income countries.
The United Nations has estimated that on top of the social and psychological burdens of chronic disease, the cumulative loss to the global economy could reach $47 trillion by 2030 if things remain status quo.
“That was a big whopper of a number and got a lot of attention, and that was good because it raised awareness,” said Rachel Nugent, vice president for global non-communicable diseases (NDCs) at the research institute RTI International.
“It’s an issue that is driven by a lot of different factors, “ she said. “And understanding how the larger social and economic factors affect NDCs, at a policy level, very little progress has been made — there’s been very little collaboration.”
Nugent was addressing the fourth annual Global Health Economics Colloquium at University of California San Francisco, with health experts, policymakers, students and researchers from Stanford, Berkeley and UCSF who gather every year to take a deep dive into the economics of a global health issue. More than 200 experts from 10 universities and public health departments attended the conference.
The daylong gathering focused on recent developments in the economics of NDCs, looking at case studies from around the world, and new guidelines for cost-effectiveness analysis and the role of economics in reducing health inequality.
“The donors are not convinced that there are cost-effective things that we can do in these countries; a lot of them are very skeptical that this is affecting the poor,” said Nugent, a member of the World Health Organization’s expert advisory panel on the management of NCDs.
In India, for example, much of the population still defecates outdoors, contaminating water sources and agricultural products, which can lead to malnutrition and physical and cognitive disorders. Many donors would rather see funds go to building latrines as they can see tangible results; NDC prevention is a long-term slog.
“But I don’t think we should necessarily think of NDCs as either-or,” said Nugent. “I think that integration of services and programming is very much at the forefront of what is the right way to go.”
Cost-effectiveness Analyses
Nugent’s research has shown five cost-effective interventions would avert more than 5 million premature deaths from NCDs by 2030, or a reduction of 28.5 percent in projected mortality from chronic disease around the world. And the average benefit-cost ratio is 9:1, at a global cost of $8.5 billion a year.
The interventions are raising the price of tobacco products by 125 percent through taxation; providing aspirin to 75 percent of those suffering from acute myocardial infarction; reducing salt intake by 30 percent; reducing the prevalence of high blood pressure with low-cost hypertension medication; and providing preventive drug therapy to 70 percent of those at high risk of heart disease.
Gillian Sanders-Schmidler, a professor of medicine at Duke University Medical Center and former assistant professor of medicine at Stanford Health Policy’s Center for Primary Care and Outcomes Research, addressed the colloquium about recommendations of the Second Panel on Cost-Effectiveness in Health and Medicine.
“There is a continued emphasis on transparency and comparability across analyses,” said Sanders-Schmidler. “And of course the big changes are that we’re now asking for a second reference case and using an ‘impact inventory’ table to clarify the scope of the findings.”
The independent panel of non-government scientists and scholars, which also included Stanford Health Policy’s Douglas K. Owens, focused on new ways to deliver health care effectively, yet with a focus on efficiency, as health care spending in the United States has reached 18 percent of GDP, much greater than the global average of 10 percent.
The first panel that convened in 1996 recommended that all cost-effectiveness analyses of health interventions include a reference case that uses standard methodological practices to improve comparability and quality. The second panel, which published its findings in September, now recommends that in addition to the societal perspective recommended by the original panel, that CEAs include a second reference case that looks at the health-care sector impact of an intervention. Additional guidance was given on what to include in the societal perspective reference case.
The panel wrote in its JAMA “special communication” that these societal reference cases should include medical costs “borne by third-party payers and paid out-of-pocket by patients, time costs of patients in seeking and receiving care, time costs of informal (unpaid) caregivers, transportation costs, effects on future productivity and consumption, and other costs and effects outside the health-care sector.”
They found most countries, including the United States, give greater weight to clinical evidence in their cost-effectiveness analyses. The panel now recommends an “impact inventory” that helps analysts and end-users of cost effectiveness analyses look at the impact of interventions beyond the formal health-care sector.
“We’re trying to ask people to be explicit,” said Owens, director of the Center of Primary Care and Outcomes Research and Center for Health Policy at Stanford.
“We want them to look at how to value outcomes in a societal perspective, not just the health-care sector, to look at all these other sectors such as productivity consumption, criminal justice, education, housing and the environment,” he said.
Case Studies
Several case studies presented at the colloquium indicated that policy changes, government intervention and social factors are key to preventing obesity and diabetes and other NCDs.
Kristine Madsen, an associate professor of public health at UC Berkeley who focuses on childhood obesity, spoke about the nation’s first “soda tax” on sugar-sweetened beverages, which was implemented in Berkeley in March 2015.
The city has seen a 21 percent decline in the drinking of soda and other sugary drinks in low-income neighborhoods after the city levied a penny-per-ounce tax on sodas and sugary drinks. At the same time, according to a study in the American Journal of Public Health, neighboring San Francisco — where a similar soda-tax measure was defeated — and Oakland saw a 4 percent increase in the purchase of sweetened beverages.
“This decline of 21 percent in Berkeley represents the largest public health impact in an intervention that I have ever seen,” said Madsen.
Sergio Bautista of the Mexico National Institute of Public Health and UC Berkeley, said that Mexico’s sugary drinks tax implemented in January 2014 is expected to lead to a 10 percent reduction in sugary drinks consumption and prevent an estimated 189,300 cases of diabetes in a country famed for its sugary bottled cola.
William Dow, a professor of health policy management at UC Berkeley, shared his research on Costa Rica, where on average people live longer than Americans, despite the several times higher income and 10 times higher health expenditures in the United States.
Costa Rican men have a life expectancy of 77 and the women typically live until age 82; in Americans the numbers are 76 and 81, respectively. Obesity is low among Costa Rican men and few of their women smoke. Lung cancer mortality in the United States is four times higher among men and six times higher among women.
“It’s remarkable in so many ways,” Dow said, noting that deaths in the Central American country are due predominantly to infectious disease. “Does Costa Rica have any unique effective programs to emulate, or is there something going on upstream driving those health outcomes?”
He believes Costa Rica’s national health insurance and excellent access to primary care for nearly all its people are key. Having this guaranteed lifetime access to health care also reduces the stress and depression that can so badly harm physical health.
“And I would argue that probably diet is one of the most important things going on here,” said Dow, noting their diets are healthy.
Costa Ricans eat mostly unprocessed foods such as rice and black beans, corn tortilla, yam and squash, with little meat and plenty of fresh fruit.
“They also have the highest remaining life expectancy at age 80 of any country in the world, he said. “What we have learned in Costa Rica would be helpful in many other countries.”
