Genetic mapping has led scientists to a better understanding of human disease and how to fight ailments like diabetes, mental illness and cancer.

But the information they have to work with is limited, drawing mostly from the DNA of people with European bloodlines. When it comes to figuring out how genetic disorders affect groups who don’t share that ancestry or have only trace amounts of it in their family histories, researchers are often at a loss.

Andres Moreno is changing that. Thanks to the $100,000 he is receiving as this year’s recipient of the George Rosenkranz Prize for Health Care Research in Developing Countries, the Stanford researcher will analyze the DNA of indigenous groups and cosmopolitan populations living in Mexico, South America and the Caribbean.

The data he gathers will lay the groundwork for scientists interested in knowing how genetic diseases take hold and manifest themselves among Latin Americans – one of the most underrepresented populations in the field of genetics.

“We can’t start talking about how to deliver personalized medicine in Latin America because we still have much to learn about their genetic makeup at the population level,” said Moreno, a research associate at School of Medicine’s genetics department.

“We need to draw the genetic map that will allow us to better understand the genetic basis of multiple conditions that lead to major health problems in Latin America,” he said.

Scientists have found numerous genetic variants linked to complex traits among people with European backgrounds, and that connection has allowed doctors to better treat and prevent diseases in that group.

But without a rich database built on the DNA of people whose family trees are rooted in Latin America, researchers have yet to find the genetic key to explain why descendants of region’s indigenous populations are predisposed to particular conditions.

Obesity, for example, is more prevalent in Mexico than in other parts of the world, Moreno said.

“We need to find population-specific gene variants that don’t exist anywhere else but locally,” he said. “Then we can maybe find the gene behind obesity there.”

Other conditions may be addressed by studying locally adapted populations, such as those living at high altitude in the Andes where pregnant women have a five-fold higher rate of maternal hypertension than the native population.

“We are trying to identify the genetic variants underlying the mechanisms for this protection, which may help to design preventive and therapeutic measures worldwide,” Moreno said.

Stanford’s Center for Health Policy, a center of the university’s Freeman Spogli Institute for International Studies, administers the Rosenkranz award that will fund Moreno’s work. The prize was created in 2007 to foster the research of a young Stanford scholar committed to improving health care in developing countries and reducing health disparities across the globe.

The first recipient was Eran Bendavid, an assistant professor of medicine and a CHP associate.

“We believe Andres’ work will deepen our understanding of the genetics of disease across populations, and we are delighted to recognize his important scientific contributions,” said Douglas Owens, director of the Center for Health Policy, the Henry J. Kaiser, Jr. Professor in the School of Medicine and an FSI senior fellow.

The Rosenkranz prize was established by the friends and family of Dr. George Rosenkranz, the scientist who helped first synthesize Cortizone in Mexico in 1951.

Rosenkranz, who lives in Menlo Park, also synthesized the active ingredient for the first oral birth control and served as a CEO of Syntex, a Mexican pharmaceutical company.

In addition to Owens, members of the award selection committee included: Donald Kennedy, president emeritus of Stanford; Rosamond Naylor, the William Wrigley Senior Fellow at FSI and Stanford’s Woods Institute for the Environment; Paul Yock, the Martha Meier Weiland Professor in the medical school; and Michele Barry, the medical school’s senior associate dean of global health and director of the Center for Innovation in Global Health.

Enrique Peña Nieto was elected Mexico's president promising to curb the drug-related violence that exploded during Felipe Calderon’s past six years in office. His victory means the Institutional Revolutionary Party, or PRI, will return to power after being defeated 12 years ago in the country’s first truly democratic election.

The PRI has a complicated history of corruption. But it also built a reputation for guaranteeing political stability and making the peace among Mexican post-revolutionary warlords during its 71 years as the country’s ruling party.

Associate professor of political science Beatriz Magaloni talks about what to expect from Peña Nieto, what his policies may mean for Mexican-U.S. relations, and how his government would likely allow drug cartels some freedom to operate in exchange for the promise of peace.

Magaloni is the director of the Program on Poverty and Governance at the Center on Democracy, Development, and the Rule of Law at Stanford’s Freeman Spogli Institute for International Studies.

What do we know about Enrique Peña Nieto? Who is he?

His campaign slogan was “Because you know me.” But the paradox is that nobody knows him at all. He’s been the governor of Mexico State for six years, but he doesn’t have a particularly good or impressive record. There hasn’t been a lot of scrutiny of his performance, and people perceive him as a product of the media. He’s married to a soap opera star, and he’s known for his good looks – but also his shallowness. He was asked to list three books that have influenced him, and he had a lot of trouble answering the question.

Peña Nieto is the new face of an old party. What did the PRI accomplish in its 71 years of power?

Mexico had a social revolution in 1910. After the revolution there was continuous violence for almost two decades, and the PRI was created to put an end to the violence by bringing together all the post-revolutionary warlords into one single organization. The idea was they would stop killing each other and as long as they joined this organization, they would be guaranteed a piece of the pie.

The party did tame violence in Mexico, and that’s a big accomplishment. The party also has a history of social reform. They organized massive land redistribution, expanded welfare benefits to workers and oversaw moderate economic growth.

But the PRI was so successful in monopolizing power that they became increasingly corrupt. In the end, the corruption wound up destroying Mexico’s development. By the time of the PRI loss in 2000, we had more than 20 years of economic catastrophe. There was huge inflation, devaluation, unemployment, and a lot of corruption that was exceedingly destructive.

What does corruption in Mexico look like today, and how can it be addressed?

The relationships among cartels, police and politicians are very complicated throughout the country. Mexico has 31 states and one federal district. There are more than 2,400 municipalities, each with its own police force. There are also state and federal police. There are about 15 cartels, and as many as 10 different gangs operating in many of the larger cities. So in each region, you never know who the police are really working for.

The drug trade is so profitable that there are huge incentives for vast sectors of Mexican society to participate. You have to offer people opportunities and chances to make money outside of the drug market. You have to give civil society groups the room they need to grow and influence communities. Tijuana has been successful in turning things around. There was a big push to engage entrepreneurs and make them understand it was up to them to reclaim the city. They helped support the arts and culture. And, most importantly, they gave young people opportunities.

There have been at least 50,000 drug-related killings during Calderon’s term. Why has it been such a bloody six years?

This is a big debate. Some people blame Calderon’s policy of attacking the cartels, which they say forced them to strike back with more force. They say that if he didn’t do that, Mexico wouldn’t be as violent as it is now. Implicit in that critique is that Mexico shouldn’t have done anything about the drug problem. This is the argument that PRI is capitalizing on now – this notion that things were better off when we did nothing.

The other argument from Calderon and his supporters is that criminal organizations were already out of control when he took office. He said cartels were the de facto power holders in vast areas of the territory throughout Mexico, and the government had to do something about it to regain control.

How will the drug war shift?

Peña Nieto says he’s going to control the violence more than fight the cartels. So that’s implying that you have to let the cartels operate. Wars are ended with either a pact or a victory. There can be no victory as long as the drug market is as lucrative as it is. So you need a pact that says as long as the cartels don’t kill or kidnap or do violence, they can operate. But the problem with that is they will continue to be extremely powerful and in control of state institutions. It is very hard to draw the line between that kind of pact and absolute state corruption. I fear it’s hard to reach that pact without acknowledging that Mexico will never have rule of law.

It is clear that we cannot continue with the violence as it is. That’s the biggest thing that needs to be addressed. People are suffering so much. Crimes are not being solved. There is no real sense of justice.

As Mexico’s neighbor and the largest consumer of drugs moving out of Mexico, what role does the United States need to play in reducing the violence?

Much of the problem is about the demand for drugs in the U.S. That’s the source. But people aren’t going to stop consuming drugs. So you need to do something about the legal nature of drugs. Making all drug use and trafficking into an illegal activity is what’s fueling a lot of the violence. So if you legalize drugs – that doesn’t mean you sell them as freely as you sell alcohol, but you can sell them under legal regulation – I think violence will be reduced. And if the United States doesn’t become more engaged and rethink its policies, the violence is going to eventually come across its borders.

Despite accelerating economic growth in India over the last thirty years, India’s structural transformation remains stunted, said economist Hans Binswanger-Mkhize at a May 10 FSE symposium on global food policy and food security. Unlike China, urban migration and labor absorption have been slower than expected, especially in the typically labor-intensive manufacturing sector. Formal sector jobs are few and declining as a share of employment, and agricultural employment (and growth) remains low.

The rural non-farm sector has been left to pick up the slack, and has emerged as the largest source of new jobs in the Indian economy. This will likely remain so over the next few decades given that two-thirds of India’s growing population is projected to live in rural areas. Add to the equation the need to increase crop yields by 50 percent under changing climate conditions and it becomes apparent that improving rural incomes and supporting agricultural growth is essential to decreasing poverty and unemployment in India now and in the future.

“The importance of India's rural non-farm sector shows us that structural transformation does not follow a recipe,” said commentator Marianne Banziger, a senior scientist at the International Maize and Wheat Improvement Center (CIMMYT) in Mexico.

While non-farm jobs offer significantly higher wages than farm labor, most jobs are informal and/or insecure (i.e., no health benefits, unemployment insurance or pensions). These jobs go mostly to men 18-26 years old who have some education, while the illiterate and women struggle to transition into this sector. Retail trade and transport, construction, and services (internet and phone booths, maintenance and repair of motor vehicles, and hotels and restaurants) are growing especially fast, partly due to urban-rural spillovers, but manufacturing is still only 20 percent of non-farm jobs.

“For rural households, non-farm employment is not distress employment, but a profitable diversification strategy,” said Binswanger-Mkhize. “At the same time, it has selectively absorbed young males into wage employment, decreased the number of farmers, and increasingly concentrated women in agriculture, contributing to a progressive feminization of agriculture.” 

As a result, farms on average have declined in both land and household size, and have moved toward the production of higher-valued goods and a modern model of part-time farming. This transformation concerned Banziger.

“Will the urban and land-less poor be held hostage by part-time farmers?” she asked.

Banziger projects in the next 20 years food and energy price inflation will likely exceed the income growth of the urban poor. Food price increases will push net consumers, who spend a third of their income on food staples, back into poverty.

“For food prices to remain constant, farmers yield gains will have to increase by 50 percent on essentially the same land area, with less water, nutrients, energy, labor and as climate changes,” said Banziger. "The more we delay investments, the steeper the challenge.”

Fortunately, small farmers are now better equipped to respond to these challenges, but are still limited by scale. Precision irrigation and fertilization technology coupled with remote sensing and cell phone technology enable better yield predictions that affect nutrient application. Better farm-level nutrient management increases farmer income and nutrient use efficiency.

For an optimistic Indian future to be realized government policy must support ways in which households increase their incomes, said Binswanger-Mkhize. A positive outcome for rural areas depends on continued urban spillovers, and on better agriculture and rural development policies, institutions, and programs.

Productivity growth needs to be sustained at very high levels. This requires more responsive, accountable, and better-financed research systems, more diversification of agriculture, and larger, better financed, and more accountable agricultural extension system. India currently employs one-seventh the number of extension workers as China.

"Rapid policy and institutional change will be required to overcome poor performance of many government programs," said Binswanger-Mkhize. "Current subsidies to fertilizer, electricity, water, and support to crop prices are already large, but are an inefficient means to transfer income to farmers."

Direct payments may be a more efficient way of supporting income growth. This is beginning to happen with fertilizers, but should be extended to electricity and food subsidies, said Binswanger-Mkhize.

“Maybe the people who have been disadvantaged in the past are the core for future change. With appropriate support, smallholder farmers can become the engines for agricultural productivity growth and transform India's growing economy,” concluded Banziger. 

As the Soviet Union was dying in December 1991, a quiet collaboration between Russian and American scientists was being born. The Russians were bankrupt, the KGB was in disarray and nuclear scientist Siegfried S. Hecker – at the time director of the Los Alamos National Laboratory – was alarmed as tens of thousands of nuclear weapons and much of the more than 1,000 tons of fissile materials across the broken Soviet states stood poorly protected.

Thousands of Soviet scientists were suddenly in limbo and President George H.W. Bush worried some might turn to Iran or Iraq to sell their nuclear knowledge. Washington suddenly found itself more threatened by Russia’s weakness than its strengths. That recognition drove U.S. Senators Sam Nunn and Richard Lugar to launch cooperative threat reduction legislation, subsequently known as the Nunn-Lugar Cooperative Threat Reduction Act.

Secretary of Energy Admiral James Watkins echoed President Bush’s concern when he called a meeting in December 1991 with Hecker, today the co-director of Stanford’s Center for International Security and Cooperation (CISAC).

“I told him, I’ve been trying to get us together with the Russians for several years,” Hecker said. “Why don’t we go to their lab directors and say, `What’s it going to take to keep your guys home and from selling their knowledge someplace else?’”

Several weeks later, in February 1992, Hecker was on a tarmac in the once-secret Russian nuclear city of Sarov, shaking hands with Yuli Khariton. The Soviet physicist was the chief designer of Russia’s atomic bomb – their Robert Oppenheimer, creator of our nuclear bomb and first director of the Los Alamos laboratory in New Mexico.

Hecker would go on to make 44 trips to Russia in the name of nuclear nonproliferation and cooperation. His most recent was last month with CISAC researchers Peter Davis and Niko Milonopoulos and a dozen Americans scientists, to commemorate 20 years of laboratory-to-laboratory cooperation. They hosted a conference with their Russian counterparts in Sarov, the Russian version of Los Alamos 300 miles east of Moscow.

Some 100 Americans and Russians attended various legs of the conference, including the scientific directors of the three Russian nuclear weapons laboratories: Rady Ilkaev, Evgeny Avrorin and Yuri Barmakov. The American delegation included Jeffery Richardson, CISAC affiliate and former head of chemistry and proliferation prevention at Lawrence Livermore National Laboratory; James W. Toevs, former project leader for the Nuclear Cities Initiatives at Los Alamos; and K. David Nokes, former vice president of national security and arms control at Sandia National Laboratory. 

CISAC Co-director Siegfried Hecker and Rady Ilkaev, a scientific director within the Russian Federal Nuclear Center, swap gifts during their April 2012 conference in Sarov, Russia.

Hecker is determined to reignite the collaboration efforts, which have diminished dramatically in the last decade due to stark differences at the highest levels of our governments and because the Russian secret service agency has again tightened their grip on the nuclear complex.

“The 1990s were the heydays for us,” he said. “The scientists played a major role; we actually pushed the envelope on what we could do cooperatively. We worked well with the Russians.”

The U.S. Department of Energy supported and financed the joint efforts of the American and Russian nuclear laboratories to secure and safeguard Russian nuclear facilities and materials. They enlisted the help of civilian institutes to make urgent security upgrades at their nuclear facilities and the Americans brought the Russians to the U.S. nuclear sites – including the plutonium facility at Los Alamos – to let them see firsthand how Americans handled protection, control and accounting of nuclear material.

“The Sandia National Laboratories actually helped provide Kevlar blankets to protect Russian nuclear weapons while they were transporting them so that in case somebody shot at them, you didn’t get a mushroom cloud,” Hecker recalled.

Then, Russian President Vladimir Putin came to power for the first time in 2000 and the Federal Security Service – formerly the KGB – started tightening the screws. U.S. visas became difficult to obtain after the 9/11 terrorist attacks ratcheted up consular bureaucracy. Scientists on both sides began to feel less welcome at the labs and sites they had readily visited for a decade.

During his April trip, Hecker felt as if he were under house arrest in the worst security squeeze he’d seen in the 20 years of visiting Russia. He was followed by a security agent when he jogged, until the mud along the river became too deep for the agent’s shiny black shoes; Davis and Milonopoulos had their access denied at the last minute and were not allowed to enter Sarov to attend the three-day portion of the conference.

Many lab-to-lab cooperative agreements were allowed to expire by the Russian side in the last decade; even collaborations on fundamental research have been restricted and there is little nuclear power engineering cooperation. Worst of all, Hecker said, joint efforts to battle nuclear terrorism and compare means by which each side keeps its nuclear warheads safe and secure without nuclear testing are now virtually nonexistent.

“We ought to be working together, for heavens sake,” he said. “We’re not going to terrorize each other; we’ve got to keep the terrorists away from the rest of the world. We just have to get back to working together.”

CISAC researchers Peter Davis, left, and Niko Milonopoulous, right, with the U.S. Ambassador to Russia Michael McFaul at the ambassador's residence in Moscow in April 2012.

Their first step will be to compile the proceedings of the meetings with their Russian counterparts in Sarov, Nizhny Novgorod and Moscow. The document will be provided to the U.S. Department of Energy and policymakers in the Obama administration, as well as the three current U.S. nuclear lab directors, who are making their first joint visit to Russia in June. Hecker said his Russian counterparts are trying to coax Moscow into jumpstarting the collaboration efforts while wooing a new generation of nuclear scientists to the table.

Hecker, along with two former Russian nuclear weapons lab directors, is working on a book to document 20 years of nuclear collaboration between Russian and American nuclear scientists.

“The book is going to do a thorough job of looking at: What we did, why did it matter, what conditions made it possible and, then, what lessons were learned that might allow us to reestablish the relationship,” he said.

Hecker had another mission on his recent trip to Sarov. He wanted to reassure his Russian counterparts that their personal relationships truly mattered.

With the collapse of the Soviet Union in 1991, scientists in Russia, Ukraine, Kazakhstan and Belarus were confronted with a new reality: They went from lives of privilege to poverty. Programs launched by the U.S. Departments of State and Energy brought financial support to Russia’s closed nuclear cities, showed the Russian nuclear workers that they had a future in non-weapons research – and that someone cared about their well-being.

“One thing that came out, talk after talk during this trip, was how important the social relationships were between the scientists; how they are absolutely crucial,” Hecker said. Those little-known relationships – many of which became enduring friendships that celebrate marriages and grandchildren – led to significant steps in the U.S.-Russian nuclear threat reduction program.

President Ronald Reagan used one of his signature phrases, “Trust, but verify,” when he and Soviet General Secretary Mikhail Gorbachev signed the Intermediate-Range Nuclear Forces Treaty in 1987, eliminating nuclear and conventional ground-launched ballistic and cruise missiles with intermediate ranges. The phrase was taken from an old Russian proverb.

A year later, that proverb was put in effect with Hecker’s hand on the nuclear button at the Nevada test site for the Joint Verification Experiment.

“In August of ’88, the Soviets were at our test sites in Nevada and I was in the control room, essentially pushing the button to blow up one of our nuclear devices down hole, while the Russians had a cable that ran down the hole with which they were going to measure the magnitude of the nuclear explosion,” Hecker said. The following month, American scientists were in Russia to do the same.

“So I was sitting there in our control room, with the Russians right across the table from me,” he recalls. “That introduced us to the Russian nuclear scientists for the first time. You know what we said? These guys are just like us. They just want to do exactly the same thing for their country that we were doing for ours: keep their country safe and secure. And that started the process of working together.”

Today, the Russian proverb made famous by an American president could be turned on its head if the Russian-American nuclear collaboration is allowed to thrive: Verify through Trust.

Young Stanford researchers focusing on improving health care access in developing countries are eligible for the Dr. George Rosenkranz Prize.

The $100,000 award is given to a non-tenured professor, post-doctoral student or research associate during a two-year period. The deadline to apply is May 11. The recipient will be announced in early June

Rosenkranz, who helped first synthesize Cortisone in 1951 and went on to synthesize progestin  – the active ingredient for the first oral birth control – dedicated his career to improving health care access around the world. Born in Hungary in 1916, the chemist started his career in Mexico and helped establish the Mexican National Institute for Genomic Medicine. He lives with his wife in Menlo Park.

The award is being funded by the Rosenkranz family and administered by Stanford Health Policy, a center within the Freeman Spogli Institute for International Studies and the Center for Primary Care and Outcomes Research. It also is designed to give its recipients access to a network that will help them develop their careers.

Eran Bendavid, a SHP affiliate and Stanford Medical School instructor, received the first award in 2010 to support his analysis of whether money going to HIV and malaria programs in sub-Saharan Africa has improved the overall health of children and their mothers.

More application information is available at http://healthpolicy.stanford.edu/fellowships/rosenkranz_prize.