Amid uncertainty over the outcome of the six-party negotiations on North Korea's nuclear weapons development, public concern is likely to focus on whether Pyongyang will live up to commitments it made to dismantle its nuclear weapons programme (already questionable) and whether it will pursue long-range nuclear missiles that could destroy an American city or, more immediately, Seoul and Tokyo. But the latter concern is not the most effective nuclear threat North Korea or other potential adversaries could pose.

A nuclear threat to American cities, if implemented, would certainly provoke massive US retaliation. There are better options for opponents: credible, cheaper and more suited to the US capabilities that adversaries would face. Since the cold war, the top US military priority, as stated in congressional testimonies, has been to deploy the world's most effective power projection forces. These forces have been used in the Balkans, the Persian Gulf and central Asia. A power projection force operates in or near hostile territory. It must rely on superior training, tactics and equipment. Joint force training, mobile communication and control, soldiers capable of individual initiative and precision-guided munitions have been key to US success.

Any power projection force needs air bases and ports of debarkation and logistics centres for sustained operations. These facilities must be rented or conquered. Their number is limited - a handful in Iraq, and not many more in east Asia, seven or so in Japan, some bases in South Korea, and a few others. These facilities are highly vulnerable even to inaccurate nuclear missile attacks. They are "soft targets", not "hardened" against nuclear weapons.

North Korea, with a couple of dozen warheads mounted on its intermediate-range No Dong missiles, or its longer-range Taepo Dong missiles, could threaten all the US assets mentioned above and have weapons left to threaten Tokyo and Seoul.

The US could destroy those North Korean military and nuclear assets it could locate. North Korean forces could retreat into the mountains and position for a protracted ground war. But would the US then launch a massive attack against North Korea with the threat still hanging over Japanese and South Korean cities?

The Pentagon's Quadrennial Defense Review envisages a force structure better suited to counter-terrorism and control of the seas and the sky, rather than focused on fighting two land wars simultaneously. The nuclear threat to essential US force-projection assets largely counterbalances the advantage provided by US conventional forces, without necessarily consigning whole cities and industrial bases to destruction. That latter threat can still be held in reserve by our adversaries.

Should this threat mature, it would undercut the credibility of US security guarantees in east Asia that have been the hallmark of US strategy in the region for more than half a century. Japan, South Korea and Taiwan all depend heavily on these guarantees for their security. This credibility has dissuaded each government from acquiring its own nuclear force. Such restraint, in turn, has permitted China to proceed at a more measured pace in its own nuclear weapons development programmes.

If key political and defence officials in Tokyo, Seoul and Taipei no longer believed in US guarantees because of the vulnerability of US military assets in the region to a North Korean nuclear missile attack, the consequences for their own security and for US national strategy could be profound. Although circumstances are quite different in the Middle East-Persian Gulf region, similar consequences could materialise if Iran or another hostile country developed a comparable nuclear missile capability.

A great deal is at stake in constraining the missile and nuclear weapons capabilities of North Korea and other rogue states. The US thus must utilise all the resources at its disposal, working constructively with its allies and other interested parties, to deny these states the capabilities they almost surely seek to acquire. A more resilient forward defence and deterrent posture is essential to an effective American global strategy.

Despite a late start, Pakistan's information technology entrepreneurs and the government are hoping to make it big in the global marketplace for outsourcing of IT-enabled services. How have other countries succeeded and where does Pakistan stand?

Naween A. Mangi spoke from New York to Ron Hira, professor of public policy at the Rochester Institute of Technology, and Rafiq Dossani, senior research scholar at the Walter H. Shorenstein Asia-Pacific Research Center at Stanford University.

Software exports, call centres and medical transcription firms have become all the rage over the last three years. Young entrepreneurs are returning after years spent working at major tech firms in the US to start up their own ventures and the government is forecasting that IT will be the next big thing in Pakistan's economy.

So far, the numbers tell a less-than-compelling story. In 2004, although the software and IT enabled services business was worth $300 million, (including hardware the figure is $600 million), exports and outsourcing made up for just $33 million of that. By comparison, India logged $12.8 billion in software and services exports in 2004.

Still, the Pakistan Software Export Board, a federal body set up to promote outsourcing, forecasts that the business will grow by at least 45 per cent annually for the next five years. A lot of that growth will come from call centres and business process outsourcing which last year made up one-fourth of total exports. In the next ten years, the PSEB aims to be at the top of the class of tier two global IT companies.

But as experts and practitioners agree, Pakistan will need more than ambitious aims to meet that goal. Prof Ron Hira, whose new book Outsourcing America assesses the impact on the US job market, says the outsourcing industry is set for rapid growth in the next few years and if done right, developing countries like Pakistan could benefit from the boom.

Hira is an expert who has testified before the US Congress on the implications of outsourcing. "Pakistan isn't on the map yet," he says. "India dominates what most people think about [when it comes to outsourcing]."

Rafiq Dossani, an expert on outsourcing and a senior research scholar at Stanford University says there are several reasons for that. First, is the poor quality of infrastructure.

"When the Internet tanked recently, that created a really bad perception that the country has not thought through even the most rudimentary aspects," Dossani says. "Deregulation in this area is too limited." He says that while voice services have benefited from the deregulation, data services are still uncompetitive.

He says there are too many stumbling blocks since bandwidth is more expensive than in other countries. "The costs are outrageous at four or five times what they should be," he says.

Dossani identifies the thin segment of English speakers as a second hurdle in the way of a flourishing outsourcing industry in Pakistan. "Of the 30 per cent of the population that lives in urban Pakistan, one tenth speak English that's good enough to work at a call centre," he says. "And of those five million or so, only about one million are available to come into this field as the rest are working elsewhere."

Then, he says poor marketing also holds the industry back. "You just don't see the trade body [in Pakistan] working like India's Nasscom to project a positive image," he says. "The Pakistani diaspora has done well and there is a great need to better use that network."

He forecasts that the outsourcing business in Pakistan can be at least $1 billion in size but says this is only possible if alliances are formed with countries like India and China.

"The Philippines has done well by understanding that it cannot reach critical mass on its own and therefore forming alliances and pitching themselves as a second location to offset country risk," he says. Dossani also says Pakistan has the advantage of a highly skilled group of entrepreneurs which "is the reason why the tiny industry does exist."

Hira adds that since Pakistan entered into the industry late, playing catch up is an inevitable need. However, the sector can take advantage of the circumstances in other countries. "India has done a lot of things right," he says. "They have been successful at not just attracting foreign investment but also building their own companies and leveraging the large Indian diaspora," Hira says.

"India is also so talked about that people are comfortable doing business there. But since wages are rising, Pakistan can use that as an entry point." He says that while countries like India have accumulated critical mass and scale, others are distinguishing themselves in different ways.

Eastern European wages are slightly higher than Pakistan and companies in that region have specialized in near-shoring by targeting the European market. Russia, meantime, is aiming at the U.S. market in both services and manufacturing while the Philippines and Malaysia are targeting services.

"The question really is how you separate yourself from the pack," Hira says. "You can compete on price to a certain extent but you have to offer something more to distinguish yourself."

He says U.S. companies are now moving from pilot stage outsourcing to full deployment which indicates both the success of the pilot projects and the rapid growth that is likely to come in the outsourcing market for the next few years. "There will continue to be a backlash from U.S. workers, but by and large there has not been any real policy movement to restrict outsourcing so there is still a large opportunity," he says.

Hira admits that the extent to which a growing outsourcing industry ties into the broader economy in terms of job creation remains unclear but he says, other advantages emerge. "In India, for example, it remains unclear that they've been able to link the benefits [from outsourcing] back in, but the big benefit is that they have created world class management which can then move into other sectors."

Therefore, Hira recommends that Pakistan take a long-term vision not for the next three or five years but for the next two decades. "Right now you can try to pick up the low hanging fruit and absorb the excess demand but don't just think about attracting the individual company to come [to Pakistan]," he says. "Think about how this will fit into the larger set of skills for your country so that you can differentiate yourself much later down the road."

Afghanistan held its landmark legislative elections this Sunday. Almost exactly four years after 9/11, and the invasion that followed, Afghanistan will have, for the first time in its history, a democratically elected constitutional government. That is something remarkable, and cause to celebrate - but only in the way that one cheers hopefully during a tough game at halftime.

Everything we know about democracy promotion and post-conflict reconstruction tells us that Afghanistan is far from out of the woods. Even after significant international intervention, many failed states remain unstable, or relapse into conflict and chaos. Remember Haiti? The United States invaded in 1994 and oversaw reconstruction and elections in 1995 and 2000, as international forces slowly withdrew. By 2004, U.S. and United Nations Forces were dispatched to the troubled island again. Haiti is not an outlier. World Bank studies show that countries coming out of civil war are forty percent likely to return to war within five years. It took one horrific hurricane to turn New Orleans to chaos. Imagine the effects of 25 years of war.

One of the main reasons failing countries continue to fail is economic. Economic recovery after war provides one of the best measures of the likelihood of long-term stability. International assistance can play a key role in jump-starting the economy and paying for basic government services, but it can take a generation to return to pre-war standards of living. The problem is that donor countries tend to be most generous in the first few years of the crisis - when local capacity to do something with those funds is limited. And just when the government starts to get on its feet - usually around the four-year mark - the assistance dries up.

The Afghan economy has seen remarkable growth rates over the last four years, but that is only half good. There is a truly free market now in Afghanistan - free from the rule of law. Much of the growth has come from the booming opium trade and other smuggling operations. While a strong economy is necessary to rebuild state and society, a criminal economy will necessarily destroy them both.

Politically, Afghanistan is getting its first taste of real elections - but it is far from being a stable democracy. There were more than 5,000 candidates in the legislative elections this Sunday, violence was relatively low, and turnout decent - all signs that political participation is blossoming. But nobody knows who will run the new parliament, or how it will function. It has no building and no staff. The only other parliament in Afghanistan's history, from 1965 to 1973, is widely blamed for increasing the polarization that led to civil war there. Since armed warlords still dominate many parts of the country, they will undoubtedly be strongly represented in the new legislature. As we have seen in places like Liberia and Serbia, post-conflict elections can produce quite undemocratic leaders.

What does this mean for Afghanistan? First, it means that the next four years will be as important there as the last four. Afghanistan's leaders, elected and otherwise, must put the cause of their nation before their factional, ethnic and venal interests. For our part, the United States and its allies must continue to support Afghanistan, financially and militarily, until it gets out of the danger zone. That means the same level of support for at least another four years.

Second, it means we have to shift our mentality there from short term to long term. If the United States has one overarching goal, it must be to build a legitimate Afghan state that is strong enough to survive and competent enough to deliver results. The Afghan police and legal system remain in shambles. Afghanistan's school system was rated the worst in the world last year by the United Nations Development Program. More international support needs to go to education, training a capable Afghan government, and supporting the rule of law.

Finally, it means something a little more intangible: continued political attention. If Afghanistan falls off the policy agenda in Washington, London and Berlin, the dangers that lurk there will prosper. Lagging reconstruction is already creating support for the ongoing Taliban insurgency. An unchecked opium trade keeps warlord armies well fed.

On this anniversary, we must remember the true cause of those grim attacks four years ago: Bin Laden and Al Qaeda had free reign of a failed state in chaos. We may not be able to find bin Laden, but we know where Afghanistan is located.

The Stanford Institute for International Studies assembled a panel of experts last night to discuss the aftermath of last month's devastating South Asian tsunami and the future of the affected region.

The speakers highlighted the scope of the international relief effort and agreed that the focus of the assistance should be on aiding nations in regaining self-sufficiency. They argued that affected countries must take a proactive role in the rebuilding process.

"The key for us is to start the reconstruction efforts in ways that do not undermine the well-being of the population," said Lizanne McBride, the director of the nonprofit International Rescue Committee and expert on Indonesian humanitarian issues.

When it comes to rebuilding countries ravaged by disaster, "the tendency for countries like the U.S. is to do it ourselves, and what we need to do is help them do it themselves," McBride said.

Eric Weiss, assistant professor of surgery and international health expert, agreed.

"One of the main things is to help bring the local people back to self-reliance," he said.

"In a lot of relief, we send people to help people who can't help themselves, but there is little focus of promoting self-sufficiency. I think that is critical to addressing these crises."

The panelists also addressed the barriers impeding the relief effort, like the political instability of the region. "Before the wave hit, one had to question the administrative capacity of the provincial government [in Indonesia]," said international relations professor Donald Emmerson.

"The governor [in one affected area] isn't giving out aid and taking charge because he is currently in prison on corruption charges."

For years, the relationship between the United States and Indonesia has been icy, some panelists noted, a fact that may have long-term effects on a sustained

aid effort.

"For us, security, logistical access, and political access are key; without these we are crippled," McBride said. "The Indonesian military are providing us with security, and rebel groups have remained quiet, but as the region stabilizes-and it will stabilize-we will probably be increasingly denied access."

Religious differences may also play a factor in the outcome of relief efforts, Emmerson added.

"There are in fact Christian aid-givers in Indonesia who say that they are here to lead by example and not to evangelize the population, but the predominately

Muslim population seems to be skeptical," he said. "I think this may pose a problem."

The panelists also argued that it will be difficult to maintain a long-term relief effort as time passes.

"The task for us is to hold attention to it," McBride said. "The hardest thing to do is to keep attention to the crisis after the cameras go away."

Donald Kennedy, University president emeritus and an environmental science and policy professor, agreed.

"Our political attention span about this sort of thing is notably short," he said. "The door won't be open for long."

This idea resonated with students in attendance as well.

"People seem to only want to do things that will make a quick impact," said freshman Aaron Berg. "There isn't a whole lot of popularity for groups or causes that pick a difficult task and try to stay with it until it is solved."

Political science professor Stephen Krasner, deputy director of the Stanford Institute for International Studies and moderator for the event, argued that this country still hasn't found an effective formula for providing humanitarian relief.

"We don't know how to do this," he said. "It isn't all about improving our political attention span. We just don't know how to do this."

Q. What is the history of the Journal of Korean Studies?

A. The Journal of Korean Studies was begun, I believe, in 1979 at the University of Washington by Professor James Palais, a preeminent Korean historian. The Journal of Japanese Studies appeared at the same time and both journals made tremendous contributions to their respective fields. The Journal of Korean Studies was unquestionably the top journal in the field of Korean studies. In fact, one of my first publications appeared in the Journal of Korean Studies. However, unlike the Journal of Japanese Studies, which has been published without interruption since its founding, publication of the Journal of Korean Studies was suspended in 1992 due to financial and administrative problems. So now we're reviving it at long last.

Q. Why did you feel it was important to revive the journal of korean studies and bring it to APARC?

A. First of all, there isn't really any top journal in the field at present, and Korean studies has grown enormously in the last ten years. As a result, there has been considerable demand for a good journal, especially among young scholars who want to publish their work. For Korean studies to continue to grow in the United States, it's vital for scholars to have a place to publish their research outcomes.

With respect to APARC serving as the home for the Journal of Korean Studies, we are still building up Korean studies at the Center, and at Stanford as a whole. I believe that having a premier journal in the program will more quickly place the program itself on the national map. It's also a great service to Korean studies in general. Many people-including very senior leaders in the field-really appreciate that we have put in the effort to bring back this important publication after such a long hiatus. And I'm so grateful to APARC for its financial, editorial, and administrative support in making the issue a reality. Chiho Sawada, postdoctoral research fellow in Korean studies at APARC, assisted me as associate editor and Victoria Tomkinson has done a wonderful job of editing the articles. We will celebrate the revival of the Journal of Korean Studies at the upcoming national meetings of the Association for Asian Studies.

Q. Where does the journal of korean studies fit into stanford's korean studies program?

A. Stanford's program began relatively late. This isn't to say that we haven't grown hugely, because the program has really taken off in the past three years. Yet there are other programs that have been up and running much longer, and therefore are more established. When I left the University of California, Los Angeles, which has the most well-established program in the nation, I wanted to create a unique Korean studies program at Stanford.

My vision for the Stanford Korean Studies Program can be summarized in two terms: social science and research. The research mission includes student training through research projects. Many students-both undergraduate and graduate-are involved in various research projects within the Korean Studies Program. Most other institutional programs focus on humanities and I don't intend to repeat what others elsewhere in the country and the world have already done. As I want to focus on social science, and research and publication, the Journal of Korean Studies will be a key component of that mission.

Q. Does the journal of korean studies have a particular focus within the field of korean studies?

A. Until now, the Journal of Korean Studies has predominantly published articles on history, literature, and culture, reflecting a general trend in the current field of Korean studies. Going forward, I'd like to publish more papers on social science. The revival issue doesn't reflect that goal and given the current concentration on humanities in the field, it won't be easy. Yet it's my hope that we'll tip the balance toward social sciences in subsequent issues and this is another way of making a contribution to the field as a whole.

Q. Publishing a major academic journal is a big job. What's the editorial procedure? What, for you as the co-editor [with john duncan, at the University of California, Los Angeles], is the most challenging part of putting the journal of korean studies together each year?

A. The number one challenge is getting good manuscripts. Last year, we received over twenty articles, but we accepted only one (and asked a few authors to revise and resubmit). Now that the journal is out, we expect more submissions in the months to come. My top priority is to control the quality of what we publish.

The second big challenge is finding good reviewers. The Journal of Korean Studies is, of course, a refereed journal. Usually we send each submitted manuscript to two people to read and evaluate, but the field of Korean studies is pretty small, and we can't go back to the same people all the time. Finding good readers will continue to be a vital but time-consuming part of the editorial process.

Q. What topics do you plan to cover in future issues?

A. My plan is to publish one general issue per year that covers a broad spectrum of topics in Korean studies, much like our revival issue. And, beginning this summer, I'm going to hold an annual one-week summer workshop, a small gathering here at Stanford. I'll pick a specific topic or theme and then through open competition select five or six scholars who have a draft paper on the topic. I will bring them to Stanford for one week and work with a senior scholar to lead the workshop. I plan to publish the papers that come out of that workshop as a special issue of the Journal of Korean Studies. The workshop we are organizing for summer 2005 will address the globalization of Korea. Professor Michael Robinson of Indiana University (who previously collaborated with me on Colonial Modernity in Korea) will lead the workshop. Thus, starting in 2006, the Journal of Korean Studies will publish one general and one special issue each year.

Q. Any highlights from this inaugural issue?

A. All of the articles in this inaugural issue have been carefully selected and are very strong in their quality. I'm particularly pleased that the articles range across so many subjects, from Michael Kim's piece on vernacular fiction and popular reading, to Robert Buswell's study of the significance of Sugi's collation notes on the Korean Buddhist canon, to Jin-Kyung Lee's article about feminist literature in 1950s South Korea. In addition to these, there are two other research articles, and a number of reviews of recent books in the field.

Q. How can people get copies of the journal of korean studies?

A. Subscriptions to the Journal of Korean Studies are being handled by Rowman & Littlefield Publishers, located in Maryland. They, too, have been wonderfully supportive and involved in getting the Journal of Korean Studies off the ground. Those wishing to subscribe to the Journal can find more information on the .

For nearly two decades, most major developing countries have struggled to introduce market forces in their electric power systems. In every case, that effort has proceeded more slowly than reformers hoped and the outcomes have been hybrids that are far from the efficiency and organization of the "ideal" textbook model for a marketbased power system.

At the same time, growing concern about global climate change has put the spotlight on the need to build an international regulatory regime that includes strong incentives for key developing countries to control their emissions of greenhouse gases. In most of these countries, the power sector is a large source of emissions that, with effort, could be controlled.

The United Nations Framework Convention on Climate Change and the Kyoto Protocol included mechanisms that would reward developing nations that cut emissions, but so far the performance of these mechanisms has fallen far short of their potential.

Beginning in 2002, the Program on Energy and Sustainable Development (PESD) at the Stanford Institute for International Studies (SIIS) and the Indian Institute of Management in Ahmedabad (IIMA) have conducted a set of studies to examine the intersection of these two crucial challenges for the organization of energy infrastructures in the developing world. This research, funded by the U.S. Agency for International Development, examined power-market reforms and greenhouse-gas emissions in two key states in India. At the same time PESD was conducting a comprehensive study of electricity-market reforms in five developing countries (Brazil, China, India, Mexico, and South Africa) as well as detailed analyses of the greenhouse-gas emissions from three provinces in China in conjunction with other research partners.

PESD and IIMA presented their findings at a workshop on January 27-28, 2005, at Stanford University. The workshop brought together scholars studying the organization of the electric-power sector and other infrastructures in developing countries with energy policy makers, technologists, and those studying the effectiveness of international legal regimes, with the aim of not only focusing on new theories that are emerging to explain the organization of the power sector and the design of meaningful international institutions, but also identifying practical implications for investors, regulators, and policymakers.

The workshop offered diagnoses of what has gone wrong and what opportunities have nonetheless emerged. It focused on practical solutions and a look at the prospects for different technologies to meet the growing demand for power while minimizing the ecological footprint of power generation.

One of the key conclusions of the research and the workshop, as discussed by David Victor, director of PESD, is that electricity markets in the developing world have not progressed inexorably and consistently from a state-owned model to an open market-based model. Rather, much as the experience of the past ten years in the United States has demonstrated, reform of electric-power systems has proceeded differentially between parts of the industry and between jurisdictional units, with some segments of the power generation, transmission, and distribution systems still dominated by the state and some segments now fully responsive to signals from the market.

This hybrid condition-with portions of the electricity enterprise deregulated and other portions still fully regulated-has proven to be virtually universal and quite durable as well. For the most part, it also has proven beneficial to the overall operation of the system as well as to climate mitigation due to the fact that introduction of market forces to parts of the system tends to have a spillover effect, helping to improve efficiency in parts of the system that remain under state control.

Tom Heller, SIIS senior fellow, noted that the negotiations leading up to the

development of the Kyoto Protocol and subsequent discussions and experience have

demonstrated that the burden-sharing metaphor-expecting developing nations to

make a proportional investment and effort in reducing greenhouse-gas emissions-

will not be successful. Rather, as gross and per capita energy consumption increases in developing nations, which is occurring especially rapidly in China and India, policies and mechanisms that facilitate investment in efficient and clean energy production, transmission, and end-use infrastructures will need to be developed and rolled out.

The Kyoto Protocol provided a Clean Development Mechanism (CDM) to encourage such investment. However, the conclusion reached by practitioners developing such projects in China is that CDM is an inefficient and insufficient mechanism for fostering the magnitude of development projects that will be required to help mitigate the environmental effects of energy growth in the developing nations.

Two problems with CDM were raised at the workshop. First, the bureaucratic hurdles facing developers of CDM projects are daunting. To date no such project has received certification. Second, the Kyoto Protocol's current round of reductions targets expires in 2012, and uncertainty regarding the likely direction and form of future U.S. and European initiatives provides a disincentive to investment in CDM projects.

Alberto Chiappa, managing director of Energy Systems International, noted the good news is that in spite of these difficulties, investors are finding opportunities to develop projects to provide cleaner sources of energy and improve end-use energy efficiency. Professor P.R. Shukla of IIMA pointed out that there is a great need to align development and climate concerns if future mechanisms for climate mitigation in the developing world are to be successful.

Douglas Ogden, program officer at the Energy Foundation, noted that China has made a firm commitment to greatly increase the market share of electricity from renewable sources to 5 percent by 2010 and 20 percent by 2020 and in 2008 will adopt an automobile fuel-economy standard 20 percent more efficient than U.S. CAFE standards. Also, both China and India are engaged in developing natural gas markets in sectors traditionally dominated by coal.

Mario Pereira, director of Power Systems Research, discussed Brazil's current efforts to develop economical and efficient electricity supply through biomass-specifically ethanol derived from sugarcane bagasse. The ethanol industry was originally developed as a reaction to the oil shocks of the 1970s. Although the majority of electricity in Brazil is provided by hydroelectric projects, sugarcane ethanol has some important advantages. First, the sugarcane fields are geographically close to major centers of demand, and second, sugarcane thrives during drier periods of the year when hydroelectric production declines. The experience in Brazil thus demonstrates that renewables can provide an economically attractive source of energy for developing nations.

Looking toward the future, PESD has several projects under way pertaining to the

intersection of electricity-market reforms and global climate change. The program is expanding its research on power-market reforms through a set of case studies on independent power producer projects in ten developing nations and is also initiating a set of studies examining the introduction of natural gas to regions in India and China.

Much work remains to be done before the interface between electricity-market reform and global climate change is well understood. As energy markets in the developing world expand, addressing this question will become more and more important if we are to stabilize atmospheric levels of greenhouse gases.

China has a large and growing elderly population, but to be old in China-particularly in the countryside-is to be vulnerable. In the country's rural areas there are few clinics and hospitals, and health insurance is virtually nonexistent. Compared with elderly Chinese living in urban areas, those in rural areas have a shorter life expectancy and a poorer quality of life.

Further, little academic research has focused on the health needs and health status of China's elderly. It is with the goal of addressing this deficit that Pengqian Fang, a trainee with CHP/PCOR's China-U.S. Health and Aging Research Fellowship, recently returned to China from Stanford. Fang is seeking to document the health disparities between China's rural and urban elderly population, and to use his findings to propose healthcare assistance programs for the elderly in rural areas of China.

Fang spent a year at Stanford studying health-services research concepts and methods and developing his research project.

In the project, which Fang refined with guidance from CHP/PCOR faculty, Fang will conduct a detailed survey of the health status, health needs, and healthcare utilization of elderly people in rural and urban areas of China, through in-home interviews in three Chinese provinces with different geographic and socioeconomic characteristics: Guizhou (in southwest China), Hubei (in central China), and Guangdong (in the southeast).

He will conduct the project in collaboration with the health departments of the

three provinces, and with support from Tongji Medical College in Wuhan, where he

is director and associate professor of healthcare management.

Fang's study will be among the first of its kind in China. Such research is needed, Fang explained, because China's elderly population (of whom 70 percent reside in rural areas) is growing steadily, and in the coming years its members will require medical services at increasing rates. According to the country's 2000 census, China has 132 million people over age 65, making up more than 10 percent of the population; the over-80 population, which numbers 10 million people, is increasing by 5.4 percent a year; and about 20 percent of all elderly people in the world live in China.

The elderly in China's rural areas face particular challenges in getting high-quality, affordable healthcare services, Fang explained. There are few clinics and hospitals in rural areas, and there is no government-sponsored health coverage for the elderly (like the United States' Medicare program) anywhere in China. All of these factors put China's rural elderly in a vulnerable position, especially those with disabilities or serious illnesses.

"This research will show the disparities that exist, and it will encourage a dialogue about policies to help rural elderly people in China," Fang said.

Fang plans to conduct his survey in the first half of 2005, analyze the data in the summer and fall, and return to Stanford in November 2005 to present the results. In each of the three provinces studied, the research team will recruit 500 households and will conduct interviews with all individuals age 65 and over who reside there, for an estimated final sample of 2,500 people.

The respondents will be asked for a variety of information, including their income and education, insurance status, health status, daily activities, social activity, mental health, utilization of healthcare services, and accessibility and affordability of medical care. The researchers will also interview community healthcare workers-including physicians, nurses, and administrative staff-to seek information on the health needs of the elderly and the barriers they and their healthcare providers face.

The China-U.S. Health and Aging Research Fellowship, administered jointly by

CHP/PCOR and the China Health Economics Institute (Beijing), aims to improve

healthcare quality and efficiency in China through an exchange program in which

selected Chinese health services researchers come to Stanford to study for six months to a year, and then return to China to conduct an original research project. The fellowship is funded by the National Institutes of Health's Fogarty International Center.

"I have learned very much from Stanford and this program," Fang said. "The classes I attended have given me very useful ideas." He noted that since health services research is still a young field in China-about ten years old-"we learn a lot from the United States, like how to ask the research question, how to get a grant, how to design a study."

One aspect of Stanford that particularly impressed Fang was its emphasis on interdisciplinary collaboration.

"This is a very good feature-the close relationship between different fields," he said. "In my country we are more focused on one narrow field."

Fang said he is interested in establishing research collaborations between Stanford and Tongji Medical College-an idea that he and CHP/PCOR's leadership will be exploring in the coming months.

There is much to admire about the U.S. healthcare system's emphasis on innovation and technology, Fang said. Still, he said, "I don't hope for China to follow the U.S. health system," with its heavy reliance on free-market principles. For one thing, "medicine here is very costly." He cited a personal example of how he fractured his arm in a minor bicycle accident, and how his emergency room visit for the injury, along with a follow-up physician appointment, cost more than $1,000. "I was surprised it cost so much," he said.

A review of the fellowship program conducted by officials at the China Health Economics Institute last fall concluded that it has been successful and valuable. Leaders at the institute said the trainees' Stanford experience has enhanced their intellectual abilities, their knowledge of research methodology, their leadership capacity, and their ability to collaborate internationally.

For over five years the war in Chechnya has occupied a central and neuralgic place in Vladimir Putin's political agenda. In unleashing a renewed military campaign in September 1999-abrogating the cease-fire agreement that had terminated the earlier 1994-1996 war launched by then president Boris Yeltsin-President Putin sought to win American and Western acquiescence in, if not support for, Russia's military campaign by framing the conflict as a war on international terrorism.

However, far from extinguishing the conflict, or confining it within the territory of Chechnya, these policies have contributed to the spread of violence and instability far beyond the borders of the Chechen republic. Instead of pursuing strategies that would address the larger socioeconomic crisis of the predominantly Muslim regions of the Northern Caucasus, marginalize extremists, and win broad support from the population of the region, the brutality of Russian military forces and their local allies in the war in Chechnya and the repressive actions of the security services in neighboring republics have fanned the flames of hostility to Moscow and created conditions for the spread of radical Islamist ideologies and the recruitment of new adherents across the Northern Caucasus.

President Putin has treated the problems facing Russia as a product of state "weakness" and has called for strengthening Russia's unity and state power in response. Ostensibly in order to better combat terrorism, he has introduced a series of measures aimed at strengthening Russia's political unity and executive power at the expense of political pluralism, freedom of information, and civil society development. But by weakening or undermining Russia's fragile and weakly developed system of institutional checks and balances on central power, and reducing the transparency and accountability of official behavior, these policies may well be exacerbating rather than mitigating the challenges facing Russia today.

What began as a secular conflict over the political status of Chechnya has progressively been transformed into a wider struggle involving more radical fighters from other Muslim republics with an avowedly Islamist agenda that now threatens to destabilize the broader region of the Northern Caucasus. The past few years have also seen a rising tide of terrorist actions directed against local authorities and security services in other republics of the Northern Caucasus as well as against the Russian government and population more broadly, including terrorist acts aimed at targets in the city of Moscow itself.

From the dramatic seizure of some 800 hostages in a Moscow theater in October

2002, in which 129 hostages died from the effects of a lethal gas used by Russian security services in a bungled rescue operation, to the September 2004 horrific siege of an elementary school in Beslan, Southern Ossetia, in which over 300 civilians died-over half of them children-these episodes have not only challenged the official assertions that the war could be confined to Chechnya alone but have dramatized the inability of the Russian government to adequately protect the security of its population.

The inept and chaotic handling of many of these terrorist attacks has brought into stark relief the poor performance of the security services, the incompetence of local officials, serious intelligence failures, and above all widespread official corruption. In the Beslan episode, to take just one example, the siege was carried out by some thirty-two terrorists, of several different nationalities, who were apparently able to bribe their way across a series of checkpoints to enter the republic and to utilize weapons and explosives stored on the site beforehand. The local authorities and the federal security services proved incapable of coordinating their actions to control the situation, and the Moscow-appointed president of the republic proved completely inept. Indeed, the most courageous and effective actor was Ruslan Aushev, the former president of Ingushetia, a figure removed from power by Moscow for resisting pressure for more coercive policies.

The Putin government has used these events to justify a series of measures which

are ostensibly intended to more effectively combat terrorism but which appear to

have little relation to the real terrorist threat. First, it has refused to seek a political solution to the conflict in Chechnya and has deliberately sought to undermine possible negotiations or international mediation and to delegitimize potential negotiating partners by demonizing a broad array of Chechen political figures within the country and abroad as "terrorists."

Conflating Chechen resistance with international terrorism, President Putin has explicitly refused to distinguish between more moderate figures and extremists and has exaggerated their ties to international terrorist organizations like Al Qaeda.

Domestically, the Russian government has used security concerns to justify ever greater restrictions on freedom of information, on civil rights, and on the role of nongovernmental organizations, particularly those engaged in the defense of human rights. The military and the organs of law enforcement have been given an ever freer hand, rarely if ever held accountable for their abusive behavior and atrocities against civilians.

Refugee camps in the neighboring republic of Ingushetia were closed and the international non-governmental organizations providing medical care and humanitarian assistance to refugees there were compelled to depart. The mass media have largely lost their independence and editors and journalists have been dismissed or attacked for expressing critical views.

A whole series of measures aimed at further centralization of political power and the strengthening of the executive branch have eroded the already fragile elements of federalism and separation of powers in the Russian political system. The autonomy and political influence of regions and republics has been sharply reduced. Parliament, now dominated by a single pro-presidential party, no longer acts as an independent check on executive power, and liberal political parties and their leaders have been marginalized. Most recently, the popular election of regional governors was abolished in favor of their appointment by Moscow, and a discussion is now under way of bringing even local government under tighter central control by eliminating the election of mayors as well.

Moreover, a high proportion of President Putin's appointees to key positions in

the regions are drawn from the military and security services, selected for their presumed loyalty to the president but often lacking political skills or understanding of local conditions. But the substitution of appointed for elected officials does not necessarily guarantee either loyalty or competence.

In the absence of a competitive party system in which political parties help create a web of ties between the central government and local populations, Putin's centralizing measures could well widen the chasm between state and society.

This growing emphasis on centralization, unity, repression, and secrecy is arguably exacerbating rather than mitigating the problems and making state power even more dysfunctional. In Chechnya and in the broader Caucasus region the brutality as well as the corruption of Russian military and security forces and their local allies-and their extensive reliance on torture, mass roundups, indiscriminate executions, disappearances of civilians, and simple extortion-has embittered many toward Moscow and made it increasingly difficult to win "hearts and minds" and build popular support. Indeed, the lack of transparency, and the difficulty of holding Russian officials accountable for abusive behavior, has led unprecedented numbers of Russian citizens frustrated by the unresponsiveness of their own government to seek redress at the European Court of Human Rights in Strasbourg.

Lacking a positive agenda for ameliorating socioeconomic conditions in the Northern Caucasus, the expanding operations of security forces across the Northern Caucasus, the closure of mosques, and the wave of often indiscriminate arrests have served to drive Islam underground and facilitated the spread of extremist ideologies. Without a coherent and sustained program of economic development that would create employment, housing, and education and offer alternative opportunities to an impoverished and alienated population, particularly young males, and absent a serious effort to eliminate corruption, these trends are likely to worsen.

Russia under Putin is facing a somber future.