Trump and Kim share a common desire for development.

At first glance U.S. President Donald Trump and North Korean leader Kim Jong Un seem like an unlikely pair. A few years back they were calling each other “Rocket Man” and a “dotard,” and tension between the United States and North Korea was escalating rapidly in 2017. But in a few days they are slated to meet for the second time, and according to Trump they had “fallen in love” not long after their first encounter. What could have created such intimate bond between the two? The common interest that brings the two together is the desire for development — economic development in the case of Kim and property development in the case of Trump.

Read the full article on The Diplomat.

This post was originally published on Axios.

Where it stands: Trump and Kim each face immense pressure, both international and domestic, to make progress.

• Trump needs to earn political trust back in Washington to continue negotiating with North Korea. His strategy so far has been to convince Kim that North Korea’s denuclearization would bring the country a “bright future.”
• At the same time, Trump must address Kim’s concerns about whether any agreement reached with his administration will withstand the Democrat-controlled House and survive the post-Trump era.

Between the lines: Successful diplomacy sometimes entails purposeful ambiguities, and the ambiguities of the first Trump-Kim summit might indeed have been strategic. At this critical juncture, however, a failure on Trump’s and Kim’s part to commit to defined objectives could hurt the bilateral relationship.

The bottom line: Trump and Kim need support more than ever to advance their diplomatic endeavors. While spectators have good reason to be skeptical, and one can only be cautiously hopeful with North Korea, a return to confrontation or "strategic patience" is in no one’s interest.

Gi-Wook Shin is the William J. Perry Professor of Contemporary Korea and director of the Walter H. Shorenstein Asia-Pacific Research Center at Stanford University.

Opioids overdoses now kill more Americans than car accidents or guns, with more than 350,000 Americans having succumbed to the painkillers since 2000.

“The opioid misuse and overdose crisis touches everyone in the United States,” Health and Human Services Secretary Alex Azar said in this recent report. “The effects of the opioid crisis are cumulative and costly for our society — an estimated $504 billion a year in 2015 — placing burdens on families, workplaces, the health care system, states, and communities.”

Now, new research led by Stanford shows that not only have opioid-related deaths jumped fourfold in the last 20 years, but that those most affected by the epidemic, and where they live, has also shifted dramatically. In fact, the District of Columbia has had the fastest rate of increase in mortality from opioids, more than tripling every year since 2013.

“Although opioid-related mortality has been stereotyped as a rural, low-income phenomenon concentrated among Appalachian or midwestern states, it has spread rapidly, particularly among the eastern states,” writes Mathew V. Kiang, ScD, a research fellow at the Center for Population Health Sciences at the Stanford University School of Medicine, in an original investigation published in JAMA Network Open.

The study found the highest rates of opioid-related deaths and more rapid increases in mortality were observed in eight states: Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire and Ohio. Two states, Florida and Pennsylvania, had opioid-related mortality rates that were doubling every two years — and tripling in Washington, D.C.

Kiang and his co-authors, including Stanford Health Policy’s Sanjay Basu, MD, PhD,an assistant professor of medicine at Stanford Medicine, used data from the National Center for Health Statistics and corresponding population estimates from the U.S. Census. The other authors are Jarvis Chen, ScD, at the Harvard T.H. Chan School of Public Health, and Monica Alexander, PhD, in the Department of Sociology at the University of Toronto.

“It seems there has been a vast increase in synthetic opioid deaths in the eastern states and especially in the District of Columbia because illicit drugs are often tainted with fentanyl or other synthetic opioids,” Kiang said in an interview.  “People aren’t aware their drugs are laced and more potent than they expected — putting them at higher risk of overdose.”

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Synthetic opioid deaths now outnumber heroin deaths in these eastern states, which suggests fentanyl has spread to other illegal drugs and is no longer limited to heroin.

“The identification and characterization of opioid `hot spots’ — in terms of both high mortality rates and increasing trends in mortality — may allow for better-targeted policies that address the current state of the epidemic and the needs of the population,” the authors write.

The research suggests the opioid epidemic has evolved as three intertwined, but distinct waves, based on the types of opioids associated with mortality:

1. The first wave of opioid-related deaths was associated with prescription painkillers from the 1990s until about 2010.
2. From 2010 until the present, the second wave was associated with a large increase in heroin-related deaths.
3. And in the third and current wave, which began around 2013, the rapid increase is associated with illicitly manufactured synthetic opioids, such as tramadol and fentanyl.

“The evolution has also seen a wider range of populations being affected, with the spread of the epidemic from rural to urban areas and considerable increases in opioid-related mortality observed in the black population,” they write.

The Centers for Disease Control and Prevention reports that African-Americans experienced the largest increase in opioid overdose deaths among any racial group from 2016 to 2017, with a 26 percent surge.

“The identification and characterization of opioid ‘hot spots’ — in terms of both high mortality rates and increasing trends in mortality — may allow for better-targeted policies that address the current state of the epidemic and the needs of the population,” the researchers write.

States are trying to combat the epidemic by enacting policies, such as restricting the supply of prescription drugs and expanding treatment and access to the overdose-reversing drug naloxone.

“Treating opioid use as a disorder should be our top priority to curb the problem,” said Kiang. “Similarly, we have the ability that counteract the effects of an overdose — these life-saving drugs should be easily accessible and widely available.”

This piece originally appeared at Brookings.

The Trump administration has finished off the 1987 Intermediate-range Nuclear Forces (INF) Treaty, a treaty mortally wounded by Russia’s deployment of a banned intermediate-range missile. That leaves the 2010 New Strategic Arms Reduction Treaty (New START) as the sole agreement limiting U.S. and Russian nuclear forces.

New START has less than two years to run. At the February 15-16 Munich Security Conference, a senior Russian official reiterated Moscow’s readiness to extend the treaty. The administration, however, continues its odd reluctance to take up that offer. House Democrats should use their power of the purse on the issue.

WHY EXTENSION MAKES SENSE

Signed in 2010, New START limits the United States and Russia each to no more than 700 strategic ballistic missiles and bombers, and no more than 1,550 deployed strategic warheads. Those limits took full effect in February 2018. Both sides have complied, although technical questions have arisen. Russian officials question the way in which the U.S. military converted some launchers so that they would not count.

By its terms, New START runs until February 5, 2021. It can be extended for up to five years by simple agreement between the U.S. and Russian presidents.

When asked about extension in 2017, administration officials said they would wait to complete the nuclear posture review and to see if the Russians met the New START limits. Both of those boxes were checked more than a year ago. Administration officials now say they are studying extension but see no need to rush.

New START extension is in the U.S. interest.

First, extension would constrain Russian strategic nuclear forces until 2026. It makes little sense to let the treaty lapse in 2021, when Russia has hot production lines churning out new missiles, submarines, and bombers.

Second, New START extension would not impact U.S. strategic modernization plans. They are sized to fit within New START’s limits. Moreover, the United States will not start producing significant numbers of replacement missiles, submarines, and bombers until the second half of the 2020s.

Third, extension would continue the flow of information that the sides share with each other about their strategic forces. That comes from data exchanges, notifications, on-site inspections and other verification measures, all of which end if New START lapses. Making up for that loss of information would require a costly investment in new national technical means such as reconnaissance satellites.

WHY WE SHOULD WORRY

Extension should be a no-brainer. However, in a White House that operates on its own facts and at times with an indecipherable logic, extension is not a given.

President Trump does not seem to understand much about nuclear arms control. During his first telephone conversation with President Putin, Trump reportedly dismissed New START as a bad deal done by his predecessor. He has taken delight in undoing the accomplishments of President Obama (witness the Iran nuclear accord).

National Security Advisor Bolton shows disdain for arms control and has criticized New START. One of its faults, according to Mr. Bolton: It provides for equal limits on the United States and Russia. He felt the treaty should allow the U.S. military to have more. (U.S. diplomats would have had an interesting time trying to negotiate that.) Asked about New START extension, Mr. Bolton notes two alternatives: renegotiation and a new treaty modeled on the 2002 Strategic Offensive Reductions Treaty (SORT).

Renegotiation would allow U.S. officials to try to improve New START, perhaps with more intrusive verification measures, or even broadening the agreement to cover non-strategic nuclear weapons. Moscow, however, would seek changes as well, such as constraints on missile defenses—anathema to Washington.

Renegotiation would prove difficult, take considerable time, and have at best uncertain prospects for success. A wiser course would extend New START and then seek a renegotiation or a new follow-on treaty.

As for SORT, negotiated by Mr. Bolton, it limited deployed warheads only. Mr. Putin accepted that in 2002, but Russian officials have long since made clear that limits should apply to warheads and delivery vehicles, as they do in New START.

SORT, moreover, was “sort of” arms control. Lacking agreed definitions, counting rules or monitoring measures, it was unverifiable. In doing their own counts on the honor system, the U.S. and Russian militaries may not have even counted the same things.

Neither Secretary of State Pompeo nor Acting Secretary of Defense Patrick Shanahan has shown interest in championing New START. The uniformed military leadership argued the treaty’s value in the past, but Chairman of the Joint Chiefs Joseph Dunford recently has hedged.

While ratification of a treaty requires consent from two-thirds of the Senate, the president alone can decide to leave a treaty. The Trump administration did not consult with either Congress or allies on withdrawal before Trump announced his intention to pull out of the treaty last October.

HOUSE DEMOCRATS TO THE RESCUE?

While the Trump administration shows little interest in arms control, it does want funding to modernize U.S. strategic forces. Democrats should recognize that and force the White House’s hand.

The U.S. strategic triad is aging. Ballistic missile submarines are the leg of the triad most in need of urgent replacement. They should be funded. Replacing intercontinental ballistic missiles (ICBMs) or building the B-21 bomber, however, are less urgent needs. As they work on the appropriations for the 2020 defense budget, House Democrats should make clear to the White House and the Pentagon that money for ICBM modernization or the B-21 would need to be paired with extension of New START. That will get attention.

Retaining a strategic triad makes sense (though the need for 400 deployed ICBMs is debatable). Retaining New START makes sense as well. House Democrats should simply insist on a trade.

Stanford e-Japan is an online course that teaches Japanese high school students about American society and culture and U.S.–Japan relations. The course introduces students to both American and Japanese perspectives on many historical and contemporary issues. It is offered biannually by the Stanford Program on International and Cross-Cultural Education (SPICE). The Fall 2018 cohort was the seventh group of students to complete Stanford e-Japan.

In August 2019, three of the top students of the Fall 2018 Stanford e-Japan distance-learning course will be honored at an event at Stanford University. The three Stanford e-Japan Day honorees—Sakura Hayakawa (Katoh Gakuen Gyoshu Senior High School), Ryotaro Homma (Kaisei Senior High School), and Taiki Yamamoto (Ritsumeikan Uji Senior High School)—will be recognized for their coursework and exceptional research essays that focused respectively on “Importance of Youth Political Participation and Citizenship Education,” “The Abolition of the Electoral College: A Synthesis of the Positive Aspects,” and “The U.S.-Japan Alliance: Is a New Framework Necessary?”

Mayu Fujinami (Keio Girls Senior High School) and Tatsuya Sugiyama (Saitama Prefectural Urawa High School) received Honorable Mentions for their research papers on “The Importance of Paternity Leave for Gender Equality” and “Design Thinking: Lessons from the U.S.,” respectively.

Applications for the next session of Stanford e-Japan (Spring 2019) are currently being accepted through February 24, 2019. More information is available at stanfordejapan.org.

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