International Development

FSI researchers consider international development from a variety of angles. They analyze ideas such as how public action and good governance are cornerstones of economic prosperity in Mexico and how investments in high school education will improve China’s economy.

They are looking at novel technological interventions to improve rural livelihoods, like the development implications of solar power-generated crop growing in Northern Benin.

FSI academics also assess which political processes yield better access to public services, particularly in developing countries. With a focus on health care, researchers have studied the political incentives to embrace UNICEF’s child survival efforts and how a well-run anti-alcohol policy in Russia affected mortality rates.

FSI’s work on international development also includes training the next generation of leaders through pre- and post-doctoral fellowships as well as the Draper Hills Summer Fellows Program.

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ABSTRACT

Democracy promotion has been a longstanding goal of US foreign policy in the Middle East and elsewhere. President George W. Bush championed democracy promotion as a way to counter the ideology and extremism that led to the September 11, 2001 terror attacks against the United States. After Bush’s attempts ended in abject failure, President Barack Obama sought to repair relations with the Muslim world but also withdraw the US footprint in the Middle East. But Obama was forced to take a far more hands-on approach with the outbreak of the 2010-2011 uprisings known as the Arab Spring. President Donald Trump, who has displayed an almost allergic aversion to Obama’s policies, has openly embraced the region’s autocrats with little regard for their abuse of human rights or absence of attention to political or economic freedom. How the United States approaches the region matters – both for aspiring democrats and for those who wish to silence them. Despite the rise of Russia and China, the United States remains the sole superpower, with the loudest voice on the world stage. Thus, the shift from democracy promoter – albeit reluctantly at times – to authoritarian enabler has made the task of democratic political reform far more challenging for people across the Middle East. This discussion will examine the recent democracy promotion efforts of the United States, with a focus on the Obama and Trump years.

SPEAKER BIO

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Sarah Yerkes is a fellow in the Carnegie Endowment for International Peace’s Middle East Program, where her research focuses on Tunisia’s political, economic, and security developments as well as state-society relations in the Middle East and North Africa.  She has been a visiting fellow at the Brookings Institution and a Council on Foreign Relations international affairs fellow and has taught in the Security Studies Program at Georgetown University and at the Elliott School of International Affairs at the George Washington University. Yerkes is a former member of the State Department’s policy planning staff, where she focused on North Africa. Previously, she was a foreign affairs officer in the State’s Department’s Office of Israel and Palestinian affairs. Yerkes also served as a geopolitical research analyst for the U.S. military’s Joint Staff Strategic Plans and Policy Directorate (J5) at the Pentagon, advising the Joint Staff leadership on foreign policy and national security issues.

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The novel coronavirus (COVID-19) is a global public health disaster of almost biblical proportions. It is a once-in-a-century occurrence that threatens to destroy countless lives, ruin economies, and stress national and international institutions to their breaking point. And, even after the virus recedes, the geopolitical wreckage it leaves in its wake could be profound.

Many have understandably drawn comparisons to the influenza pandemic of 1918 and 1919. That pandemic, which began in the final months of World War I, may have infected 500 million people and killed 50 million people around the globe. As the grim toll of COVID-19 mounts, it remains to be seen if that comparison will prove apt in terms of the human cost.

But, if we want to understand the even darker direction in which the world may be headed, leaders and policymakers ought to pay more attention to the two decades after the influenza pandemic swept the globe. This period, often referred to as the interwar years, was characterized by rising nationalism and xenophobia, the grinding halt of globalization in favor of beggar-thy-neighbor policies, and the collapse of the world economy in the Great Depression. Revolution, civil war, and political instability rocked important nations. The world’s reigning liberal hegemon — Great Britain — struggled and other democracies buckled while rising authoritarian states sought to aggressively reshape the international order in accordance with their interests and values. Arms races, imperial competition, and territorial aggression ensued, culminating in World War II — the greatest calamity in modern times.

In the United States, the interwar years also saw the emergence of the “America First” movement. Hundreds of thousands rallied to the cause of the America First Committee, pressing U.S. leaders to seek the false security of isolationism as the world burned around them. President Franklin Delano Roosevelt pushed back, arguing that rising global interdependence meant no nation — not even one as powerful and geographically distant as the United States — could wall itself off from growing dangers overseas. His warning proved prescient. The war eventually came to America’s shores in the form of the attack on Pearl Harbor.

Even before COVID-19, shadows of the interwar years were beginning to re-emerge. The virus, however, has brought these dynamics into sharper relief. And the pandemic seems likely to greatly amplify them as economic and political upheaval follows, great-power rivalry deepens, institutions meant to encourage international cooperation fail, and American leadership falters. In this respect, as Richard Haas notes, the COVID-19 pandemic and the aftershocks it will produce seem poised to “accelerate history,” returning the world to a much more dangerous time.

However, history is not destiny. While COVID-19 worsens or sets in motion events that may increasingly resemble this harrowing past, we are not fated to repeat it. Humans have agency. Our leaders have real choices. The United States remains the world’s most powerful democracy. It has a proud legacy of transformational leaps in human progress, including advances that have eradicated infectious diseases. It is still capable of taking urgent steps to ensure the health, prosperity, and security of millions of Americans while also leading the world to navigate this crisis and build something better in its aftermath. America can fight for a better future. Doing so effectively, however, requires understanding the full scope of the challenges it is likely to face.

Read the rest at War on the Rocks

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The novel coronavirus (COVID-19) is a global public health disaster of almost biblical proportions. It is a once-in-a-century occurrence that threatens to destroy countless lives, ruin economies, and stress national and international institutions to their breaking point. And, even after the virus recedes, the geopolitical wreckage it leaves in its wake could be profound.

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To support Stanford students working in the area of contemporary Asia, the Shorenstein Asia-Pacific Research Center is offering up to ten research assistant internships for summer 2020 and up to three predoctoral fellowships for the 2020-21 academic year. The Center will review applications starting April 15 and expects to fill the positions by April 30, 2020. 

Amid the fallout of the COVID-19 pandemic, students are facing summer internship cancelations and hiring freezes. They are left wondering about the long-term implications of the current crisis for their academic careers and their access to future jobs and valuable work experience.

At Shorenstein APARC, we want to do all we can to support Stanford students. That’s why we are announcing new internship and fellowship opportunities for current students working in the area of contemporary Asia: research assistant internships for the summer quarter of 2020 and predoctoral fellowships for the 2020-21 academic year.

The summer internships are all remote: research assistants will work as telecommuters. Regarding the predoctoral fellowships, we hope we can all have a normal 2020-21 academic year, in which case we expect the fellows to be in residence, but we will reassess the evolving COVID-19 situation closer to the appointment start dates and shift to flexible, online options as needed.

APARC will review applications for both opportunities on a rolling basis starting April 15, 2020. The Center will select up to ten research assistants and up to three predoctoral fellows by April 30, 2020.

Read on to learn more about these offerings and the application requirements, and follow the guidelines below to submit your candidacy.

Summer 2020 APARC Research Assistant Internships

Shorenstein APARC is seeking highly motivated and dedicated undergraduate and graduate students to join our team as paid research assistant interns for the summer quarter of 2020. Research assistants will work with assigned APARC faculty members on projects focused on contemporary Asia, studying varied issues related to the politics, economies, populations, security, foreign policies, and international relations of the countries of the Asia-Pacific region.

All positions will be for eight weeks starting late June or early July 2020. The hourly pay rate is $17 for undergraduate students, $25 for graduate students.

Research assistant positions are open to current Stanford students only. Undergraduate- and graduate-level students are eligible to apply.

Apply Now

  • Complete the application form and submit it along with these two (2) required attachments:
    • CV;
    • A cover letter (up to 1 page).
  • Arrange for a letter of recommendation from a faculty to be sent directly to APARC. Please note: the faculty members should email their letters directly to Kristen Lee at kllee@stanford.edu.

We will consider only complete applications that include all the abovementioned supporting documents.  

2020-21 Shorenstein APARC Predoctoral Fellowships

APARC is inviting applications from current Stanford students for the 2020-21 Shorenstein APARC Predoctoral Fellowship. The fellowship supports predoctoral students working within a broad range of topics related to contemporary Asia. 

Up to three fellowships are available to Ph.D. candidates who have completed all fieldwork and are nearing the completion of their dissertation. The Center will give priority to candidates who are prepared to finish their degree by the end of the 2020-21 academic year.

Shorenstein APARC offers a stipend of $36,075 for the 2020-21 academic year, plus Stanford's Terminal Graduate Registration (TGR) fee for three quarters. We expect fellows to remain in residence at the Center throughout the year and to participate in Center activities.

Apply Now

  • Complete the application form and submit it along with these three (3) required attachments:
    • CV;
    • A cover letter including a brief description of your dissertation (up to 5 double-spaced pages);
    • A copy of your transcripts. Transcripts should cover all graduate work and include evidence of recently-completed work.
  • Arrange for two (2) letters of recommendation from members of your dissertation committee to be sent directly to Shorenstein APARC. Please note: the faculty/advisors should email their letters directly to Kristen Lee at kllee@stanford.edu.

We will consider only complete applications that include all the abovementioned supporting documents. 

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Speaker Bio:

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Kathryn Stoner is the Deputy Director at the Freeman Spogli Institute for International Studies at Stanford University and a Senior Fellow at the Center on Democracy, Development, and the Rule of Law, and the Center on International Security and Cooperation at FSI. She teaches in the Department of Political Science at Stanford, and in the Program on International Relations, as well as in the Ford Dorsey Master's in International Policy Program. Prior to coming to Stanford in 2004, she was on the faculty at Princeton University for nine years, jointly appointed to the Department of Politics and the Woodrow Wilson School for International and Public Affairs. At Princeton she received the Ralph O. Glendinning Preceptorship awarded to outstanding junior faculty. She also served as a Visiting Associate Professor of Political Science at Columbia University, and an Assistant Professor of Political Science at McGill University. She has held fellowships at Harvard University as well as the Woodrow Wilson Center in Washington, DC. 

In addition to many articles and book chapters on contemporary Russia, she is the author or co-editor of five books: "Transitions to Democracy: A Comparative Perspective," written and edited with Michael A. McFaul (Johns Hopkins 2013);  "Autocracy and Democracy in the Post-Communist World," co-edited with Valerie Bunce and Michael A. McFaul (Cambridge, 2010);  "Resisting the State: Reform and Retrenchment in Post-Soviet Russia" (Cambridge, 2006); "After the Collapse of Communism: Comparative Lessons of Transitions" (Cambridge, 2004), coedited with Michael McFaul; and "Local Heroes: The Political Economy of Russian Regional" Governance (Princeton, 1997). She is currently finishing a book project entitled "Russia Resurrected: Its Power and Purpose in a New Global Order" (Oxford University Press, forthcoming).

She received a BA (1988) and MA (1989) in Political Science from the University of Toronto, and a PhD in Government from Harvard University (1995). In 2016 she was awarded an honorary doctorate from Iliad State University, Tbilisi, Republic of Georgia. 

 

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Kathryn Stoner is the Mosbacher Director of the Center on Democracy, Development and the Rule of Law (CDDRL) and the Satre Family Senior Fellow at the Freeman Spogli Institute for International Studies (FSI). From 2017 to 2021, she served as FSI's Deputy Director. She is Professor of Political Science (by courtesy) at Stanford and teaches in the Department of Political Science, the Program on International Relations, and the Ford Dorsey Master's in International Policy Program. She is also a Senior Fellow (by courtesy) at the Hoover Institution.

Prior to coming to Stanford in 2004, she was on the faculty at Princeton University for nine years, jointly appointed to the Department of Politics and the Princeton School for International and Public Affairs (formerly the Woodrow Wilson School). At Princeton, she received the Ralph O. Glendinning Preceptorship, awarded to outstanding junior faculty. She also served as a Visiting Associate Professor of Political Science at Columbia University and an Assistant Professor of Political Science at McGill University. She has held fellowships at Harvard University as well as the Woodrow Wilson Center in Washington, D.C. 

In addition to many articles and book chapters on contemporary Russia, she is the author or co-editor of six books: Transitions to Democracy: A Comparative Perspective, written and edited with Michael A. McFaul (Johns Hopkins 2013);  Autocracy and Democracy in the Post-Communist World, co-edited with Valerie Bunce and Michael A. McFaul (Cambridge, 2010);  Resisting the State: Reform and Retrenchment in Post-Soviet Russia (Cambridge, 2006); After the Collapse of Communism: Comparative Lessons of Transitions (Cambridge, 2004), coedited with Michael McFaul; and Local Heroes: The Political Economy of Russian Regional Governance (Princeton, 1997); and Russia Resurrected: Its Power and Purpose in a New Global Order (Oxford University Press, 2021).

She received a BA (1988) and MA (1989) in Political Science from the University of Toronto, and a PhD in Government from Harvard University (1995). In 2016, she was awarded an honorary doctorate from Ilia State University in Tbilisi, the Republic of Georgia.

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Stanford e-Japan is an online course that teaches Japanese high school students about U.S. society and culture and U.S.–Japan relations. The course introduces students to both U.S. and Japanese perspectives on many historical and contemporary issues. It is offered biannually by the Stanford Program on International and Cross-Cultural Education (SPICE). Stanford e-Japan is currently supported by the Yanai Tadashi Foundation. The Fall 2019 cohort was the ninth group of students to complete Stanford e-Japan.


In Summer 2020, three of the top students of the Fall 2019 Stanford e-Japan distance-learning course will be honored at an event at Stanford University. The three Stanford e-Japan Day honorees—Ayano Hirose (Okayama Sozan High School), Chisaki Sano (Gunma Kokusai Academy), and Natsumi Shindo (Keio Girls Senior High School)—will be recognized by Stanford e-Japan Instructor Meiko Kotani for their coursework and exceptional research essays that focused respectively on “Three Basic Ways to Promote Cross-Cultural Understanding in Japanese Education,” “U.S.–Japan Relations: Economic Interdependence Seen in 7-Eleven Operations,” and “The U.S.–Japan Security Alliance: Its Preservation and the Responsibilities of Both Countries.”

Yuta Myojo (Rikkyo Ikebukuro High School) received an Honorable Mention for his coursework and research paper on “How Could Japanese Society Achieve Increased Biculturalism: From the Aspects of Education Reform and Self-Awareness.”

In the Fall 2019 session of Stanford e-Japan, students from the following schools successfully completed the course: Aiko Gakuen (Ehime), Gunma Kokusai Academy (Gunma), Hiroshima High School (Hiroshima), Hiroshima Prefectural Hiroshima Junior/Senior High School (Hiroshima), Hitachi First Senior High School (Ibaraki), Ichikawa Junior and Senior High School (Chiba), Keio Girls Senior High School (Tokyo), Keio Senior High School (Kanagawa), Mita International High School (Tokyo), Nishiyamato Gakuen High School (Nara), Okayama Prefecture Asahi Senior High School (Okayama), Okayama Sozan High School (Okayama), Rikkyo Ikebukuro High School (Tokyo), Ritsumeikan Uji High School (Kyoto), Sendai Shirayuri Gakuen (Miyagi), Senior High School at Otsuka, University of Tsukuba (Tokyo), Senior High School at Kyoto University (Kyoto), Shibuya Kyouiku Gakuen Shibuya Senior High School (Tokyo), Shibuya Makuhari Senior High School (Chiba), Shirayuri Gakuen Senior High School (Tokyo), Takada High School (Mie), Takatsuki Senior High School (Osaka), Tokyo City University Senior High School (Tokyo), Waseda University Senior High School (Tokyo), Yokohama Science Frontier High School (Kanagawa), and Zushi Kaisei High School (Kanagawa).

For more information about the Stanford e-Japan Program, please visit stanfordejapan.org.

To stay informed of news about Stanford e-Japan and SPICE’s other programs, join our email list and follow us on Facebook, Twitter, and Instagram.


SPICE offers separate online courses for U.S. high school students. For more information, please see the Reischauer Scholars Program (online course about Japan), Sejong Scholars Program (online course about Korea), and China Scholars Program (online course about China).


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Fall 2019 Stanford e-Japan honoree Ayano Hirose giving her final presentation at school. Courtesy of Ayano Hirose.
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The Stanford Center at Peking University (SCPKU), the Center on Democracy, Development and the Rule of Law (CDDRL), and the APARC China Program jointly hosted a workshop on China’s Belt and Road Initiative (BRI) in early March. The workshop, held on March 2 and 3, welcomed researchers from around the world with expertise in the Initiative. Unfortunately, because of the rapidly developing health emergency related to the coronavirus, participants from not only China, but also Japan, were prevented from attending. As described by Professor Jean Oi, founding director of SCPKU and the China Program, and Professor Francis Fukuyama, director of CDDRL and the Ford Dorsey Master's in International Policy, who co-chaired the workshop, the meeting aimed to provide a global perspective on the BRI, consolidate knowledge on this opaque topic, and determine the best method and resources for future research.  

The workshop began with presentations from several of the invited guests. Dr. Atif Ansar from the University of Oxford’s Saïd Business School kicked off the first day by describing not only the tremendous opportunity that the BRI presents to developing economies, but also the serious pitfalls that often accompany colossal infrastructure projects. Pointing out the poor returns on investment of mega infrastructure projects, Ansar examined the frequest cost and schedule overruns, random disasters, and environmental degradation that outweigh the minimal benefits that they generally yield. China’s own track record from domestic infrastructure projects does little to mitigate fear of these risks, Ansar claimed. In response, he urged professional management of BRI investments, institutional reforms, and intensified deployment of technology in BRI projects. Dr. Ansar was followed by Dr. Xue Gong of the S. Rajaratnam School of International Studies, Nanyang Technological University, Singapore. Dr. Gong’s analysis centered on the extent to which China’s geopolitical motivations influenced its outward foreign direct investments (OFDI). Although her research was still in the early stages, her empirical analysis of China’s OFDI inflows into fifty BRI recipient countries from 2007-2018 nevertheless revealed that geopolitical factors often outweigh economic factors when it comes to China’s OFDI destinations.

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Amit Bhandari of Gateway House: Indian Council on Global Relations presents his research at the Belt and Road Workshop.
Participants then heard presentations from Amit Bhandari of Gateway House: Indian Council on Global Relations and Professor Cheng-Chwee Kuik of the National University of Malaysia. Mr. Bhandari’s talk focused on Chinese investments in India’s six neighboring countries, which tend to center more on energy rather than connectivity projects. He first found that the investments are generally not economical for the host countries because they come with high costs and high interest rates. Secondly, he argued that these projects often lacked a clear economic rationale, appearing instead to embed a geopolitical logic not always friendly to India. Professor Kuik, by contrast, provided a counterexample in his analysis of BRI projects in Southeast Asia. He described how, in Southeast Asia, host countries’ reception of the BRI has varied substantially; and how various stakeholders, including states, sub-states and other entities, have used their leverage to shape outcomes more or less favorable to themselves. Kuik’s analysis injected complexity into the often black-and-white characterizations of the BRI. He highlighted the multidimensional dynamics that play out among local and state-level players in pursuit of their goals, and in the process of BRI implementation.

Professor Curtis J. Milhaupt and Scholar-in-Residence Jeffrey Ball, both at Stanford Law School, followed with individual presentations on the role of State-Owned Enterprises (SOEs) in the BRI and the emissions impact of the BRI on climate change, respectively. Professor Milhaupt  characterized Chinese SOEs as both geopolitical and commercial actors, simultaneously charged with implementing Party policies and attaining corporate profits. Chinese SOEs are major undertakers of significant overseas BRI projects, acting not only as builders but also as investors, partners, and operators. This situation, Milhaupt asserted, carries significant risks for SOEs because these megaprojects often provide dismal returns, have high default rates, and can trigger political backlash in their localities. Milhaupt highlighted the importance of gathering firm-level data on businesses actually engaged in BRI projects to better infer geostrategic, financial, or other motivations. Jeffrey Ball turned the discussion to carbon emissions from BRI projects and presented preliminary findings from his four-country case studies. He concluded that, on aggregate, the emissions impact of the BRI is still “more brown than green.” Twenty-eight percent of global carbon emissions may be accounted for by BRI projects, Ball asserted, underscoring the importance of the BRI to the future of global climate change.

The day concluded with presentations by  Michael Bennon, Managing Director at the Stanford Global Projects Center, and Professor David M. Lampton, Oksenberg-Rohlen Fellow at the Freeman Spogli Institute for International Studies. Bennon first presented findings from two empirical case studies of BRI projects and then went on to describe how the BRI is now practically the “only game in town” for infrastructure funding for developing countries. Lengthy environmental review processes at Western multilateral banks have turned the World Bank, for example, from a lending bank into a “knowledge bank,” he argued. He also highlighted that, in general, economic returns on BRI projects for China are very poor, even though recipient countries may accrue macroeconomic benefits from these projects. Finally, Professor Lampton turned the discussion back to Southeast Asia, where China is currently undertaking massive cross-border high-speed rail projects through eight ASEAN countries. He described how each host country had varying capacity to negotiate against its giant neighbor, and how the sequential implementation of these cross-border rail projects also had varying impacts on the negotiating positions of these host countries. BRI played out differently in each country, in other words, eliciting different reactions, push-backs and negotiated terms.

The second day of the workshop was dedicated to working toward a collaborative approach to future BRI research. The group discussed the key gaps in the existing research, including how to know what China’s true intentions are, how to measure those intentions, who the main players and their interests in both China and the host countries are, and even what the BRI is, exactly. Some cautioned that high-profile projects may not be representative of the whole. Participants brainstormed about existing and future sources of data, and stressed the importance of diversifying studies and seeking empirical evidence.

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Participants in the Belt and Road Initiative Workshop at Stanford University, March 2-3, 2020.
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In the most sweeping reshuffle of his government since he took office last May, Ukrainian President Volodymyr Zelensky fired his Cabinet and appointed a new prime minister earlier this month. The announcement comes at a tricky time, as the government is considering several reform measures that are seen as important to winning much-needed investor confidence. In an email interview with WPR, Steven Pifer, a nonresident senior fellow at the Brookings Institution and former U.S. ambassador to Ukraine, discusses the factors behind Zelensky’s move and why the new Cabinet will need to work hard to prove it can bring about real change in Ukraine.

World Politics Review: Why has Zelensky chosen to reshuffle his government at this time?

Steven Pifer: Some analysts suggest Zelensky made the personnel change due to concern over his declining popularity. Elected with 73 percent of the vote last April, his approval rating has fallen to just under 50 percent—still high by Ukrainian standards. Overall, the new Cabinet ministers lack the reformist credentials of their predecessors, and the new prime minister, Denys Shmyhal, is a relative unknown. The change has given rise to concern that the country’s oligarchs, who continue to exercise outsized political influence, are reasserting their position after Zelensky’s initial pledges to rein them in.

That, combined with the inexplicable timing of the reshuffle, has rattled Ukrainian reformers and Western investors. Zelensky took office last year amid high hopes that his presidency could make a dramatic breakthrough and put Ukraine on a path of economic growth and reduced corruption. When I visited Kyiv in late October, Ukrainians I spoke with were cautiously optimistic about what Zelensky and his government could achieve. The Cabinet reshuffle moves the needle sharply in the direction of caution. Indeed, some analysts fear the president is not committed to real change, and that he will simply muddle through as president without making the breakthrough that Ukraine needs. He will have to work hard now to quash those concerns and meet the expectations of Ukrainian voters.

 

Read the rest at World Politics Review

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On Wednesday night, U.S.-led coalition forces based out of Camp Taji north of Baghdad came under intense rocket fire. The attack killed three coalition personnel, two American and one British. It also injured nearly a dozen more personnel.

While rocket fire on U.S. military bases in Iraq is not new, this attack is the first time U.S. personnel have been killed by suspected Iranian-backed Iraqi groups since the United States killed Iranian Gen. Qasem Soleimani in early January. The attack is likely to anger the Trump administration, which has pursued an aggressive strategy against Iran. It also catches the White House in the middle of another ballooning international crisis — the coronavirus pandemic.

Why did this attack happen now? And will this incident spark more hostilities in the Middle East?
 

 

Read the rest at The Washington Post

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Abstract:

Do programmatic policies always yield electoral rewards? A growing body of research attributes the adoption of programmatic policies in African states to increased electoral competition. However, these works seldom explore how the specifics of policy implementation condition voters’ electoral responses to programmatic policies over time, or changes in electoral effects throughout policy cycles. We analyze the electoral effects of both the promise and implementation of a programmatic policy designed to increase secondary school enrollment in Tanzania over three election cycles. We find that the incumbent party benefited from a campaign promise to increase access to secondary schooling, but incurred an electoral penalty following implementation of the policy. We do not find any significant electoral effects by the third electoral cycle. Our findings illuminate temporal dynamics of policy feedback, the conditional electoral effects of programmatic policies, and the need for more studies of entire policy cycles over multiple electoral periods.

 

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Dr. Ken Opalo is an Assistant Professor at Georgetown University’s School of Foreign Service. His research interests include the political economy of development, legislative politics, and electoral accountability in African states. Ken’s current research projects include studies of political reform in Ethiopia, the politics of education sector reform in Tanzania, and electoral accountability under devolved government in Kenya. His works have been published in Governance, the British Journal of Political Science, the Journal of Democracy, and the Journal of Eastern African Studies. His first book, titled Legislative Development in Africa: Politics and Post-Colonial Legacies (Cambridge University Press, 2019) explores the historical roots of contemporary variation in legislative institutionalization and strength in Africa. Ken earned his BA from Yale University and PhD from Stanford University.

 

Ken Opalo Assistant Professor at Georgetown University’s School of Foreign Service
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Taiwan is only 81 miles off the coast of mainland China and was expected to be hard hit by the coronavirus, due to its proximity and the number of flights between the island nation and its massive neighbor to the west.

Yet it has so far managed to prevent the coronavirus from heavily impacting its 23 million citizens, despite hundreds of thousands of them working and residing in China.

According to the Johns Hopkins Coronavirus COVID-19 Global Cases map, as of Tuesday there were only 42 cases and one death in Taiwan, far behind China, with more than 80,000 cases and more than 2,900 deaths. The country also lags far behind its other Asian neighbors and ranks 17th in the world for the number of global cases. As of this writing, South Korea was second, with 5,186 cases; followed by Iran with 2,336 and Italy with 2,036 people infected with the virus.

The United States currently stands at 107 known cases and six deaths.

The viral outbreak in China occurred just before the Lunar New Year, during which time millions of Chinese and Taiwanese were expected to travel for the holidays.

So what steps did Taiwan take to protect its people? And could those steps be replicated here at home?

Stanford Health Policy’s Jason Wang, MD, PhD, an associate professor of pediatrics at Stanford Medicine who also has a PhD in policy analysis, credits his native Taiwan with using new technology and a robust pandemic prevention plan put into place at the 2003 SARS outbreak.

“The Taiwan government established the National Health Command Center (NHCC) after SARS and it’s become part of a disaster management center that focuses on large-outbreak responses and acts as the operational command point for direct communications,” said Wang, a pediatrician and the director of the Center for Policy, Outcomes, and Prevention at Stanford. The NHCC also established the Central Epidemic Command Center, which was activated in early January.

“And Taiwan rapidly produced and implemented a list of at least 124 action items in the past five weeks to protect public health,” Wang said. “The policies and actions go beyond border control because they recognized that that wasn’t enough.”

Wang outlines the measures Taiwan took in the last six weeks in an article published Tuesday in the Journal of the American Medical Association.

“Given the continual spread of COVID-19 around the world, understanding the action items that were implemented quickly in Taiwan, and the effectiveness of these actions in preventing a large-scale epidemic, may be instructive for other countries,” Wang and his co-authors wrote.

Within the last five weeks, Wang said, the Taiwan epidemic command center rapidly implemented those 124 action items, including border control from the air and sea, case identification using new data and technology, quarantine of suspicious cases, educating the public while fighting misinformation, negotiating with other countries — and formulating policies for schools and businesses to follow.

Big Data Analytics

The authors note that Taiwan integrated its national health insurance database with its immigration and customs database to begin the creation of big data for analytics. That allowed them case identification by generating real-time alerts during a clinical visit based on travel history and clinical symptoms.

Taipei also used Quick Response (QR) code scanning and online reporting of travel history and health symptoms to classify travelers’ infectious risks based on flight origin and travel history in the last 14 days. People who had not traveled to high-risk areas were sent a health declaration border pass via SMS for faster immigration clearance; those who had traveled to high-risk areas were quarantined at home and tracked through their mobile phones to ensure that they stayed home during the incubation period.

The country also instituted a toll-free hotline for citizens to report suspicious symptoms in themselves or others. As the disease progressed, the government called on major cities to establish their own hotlines so that the main hotline would not become jammed.

Some might say that because Taiwan is such a small country — about 19 times smaller than Texas — it is easier to mobilize during emergencies. Yet Taiwan is particularly challenged by its proximity to China and the fact that 850,000 of its citizens reside on the mainland; another 400,000 work there. Taiwan had 2.71 million visitors from China last year.

So when the WHO was notified on Dec. 31, 2019, of a pneumonia of unknown cause in Wuhan, China, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane.

As early as Jan. 5, notification was expanded to include any individual who had traveled to Wuhan in the past 14 days and had a fever or symptoms of upper respiratory tract infection at the point of entry. Suspected cases were screened for 26 viruses, including SARS and MERS. Passengers displaying symptoms were quarantined at home and assessed whether medical attention at a hospital was necessary.

What the U.S. Could Learn

One of Wang’s co-authors, Robert H. Brook, M.D., ScD., of the David Geffen School of Medicine at the University of California, Los Angeles, said Washington could learn a great deal from Taiwan’s so-far successful management of the virus.

“In Taiwan, diverse political parties were willing to work together to produce an immediate response to the danger,” said Brook, also of the nonprofit RAND Corporation. “Transparency was critical and frequent communication to the public from a trusted official was paramount to reducing public panic.”

The other co-author of their study is Chun Y. Ng, MBA, MPH, of The New School for Leadership in Health Care, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.

Brook said Taiwan got out ahead of the epidemic by setting up a physical command center to facilitate rapid communications. The command center set the price of masks and used government funds and military personnel to increase mask production. By Jan. 20, the Taiwan CDC announced that it had a stockpile of 44 million surgical masks, 1.9 million N95 masks and 1,100 negative pressure isolation rooms.

“In a country as complex as the United States,” Brook said, “there needs to be a sharing of intelligence on a real-time basis among states and the federal government so that action is not delayed by going through formal channels.”

Please contact Beth Duff-Brown for media requests. 

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LOS ANGELES, CALIFORNIA - FEBRUARY 28: A flight crew from China Airlines, wearing protective masks, stand in the international terminal after arriving on a flight from Taipei at Los Angeles International Airport (LAX) on February 28, 2020 in Los Angeles, California. The World Health Organization (WHO) has raised the global coronavirus risk level to 'very high'. | Photo by Mario Tama/Getty Images
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