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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Author Michael Schuman writes an opinion piece informed by Scott Rozelle's publication Past Successes and Future Challenges in Rural China's Human Capital 

"Many investors and economists continue to believe China’s rise to global economic greatness is inevitable. Modern history, however, tells us that graduating from emerging- to a developed-economy status is hardly automatic. An overly intrusive state, dependence on debt, feeble gains in productivity and poor resource allocation are all reasons to fear China might struggle with the transition like so many nations before it...'China must significantly raise its level of human capital if it wishes to attain high-income status. In the end, China can only be as competitive as its people.'"

 

Read the full story here. 

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Every summer, the Draper Hills Summer Fellows Program brings together international leaders who are pioneering new approaches to advance social and political change in some of the most challenging global contexts. The fellows spend three weeks living and taking classes on the Stanford campus, visiting Silicon Valley tech companies and building a network.

Representing business, government and the nonprofit sector, fellows are working on the frontlines of democratic change to combat the global rise of authoritarianism and populism. The Freeman Spogli Institute for International Studies spoke to five of the fellows about the impact of the Draper Hills program on their work and activism. These are their stories.

Shaili Chopra, India

shaili3 Shaili Chopra, founder of SheThePeopleTv. Photo: Alice Wenner
“I run a platform called SheThePeopleTv. It's a platform for women, and it aims to share news, opinions, data and statistics through a gendered lens. Women are a critical part of democracy — from where I come, in India, we have 600 million women. That's half of the country's population. I think they must also have half of the country’s voice, which they don't.

“I think a big plus of a program like Draper Hills is that when we are all working in the general construct of democracy, we have shared problems, and we also look for shared solutions. It's very empowering to be around people who understand these situations, or have found solutions or overcame them in their countries, or are going through similar problems. You can discuss them and get a sense of solidarity and a sense of empathy.”

Wiem Zarrouk, Tunisia

wiem1 Wiem Zarrouk, senior advisor to the Minister of Development, Investment and International Cooperation in Tunisia. Photo: Alice Wenner

“I’ve been working for the Tunisian government for three years as an advisor to the Minister of Development, Investment and International Cooperation. I am leading the government reforms to improve Tunisia's ranking in the World Bank Competitiveness Report - Doing Business.

“In Tunisia, we’ve set up most of our democratic institutions, and now we want to improve the business environment to attract more investment in local businesses. Eight years ago, the people went into the streets demanding more jobs. The challenge in Tunisia right now is economic, that’s why economic reforms are important to our government.

“I think the impact of the Draper Hills program will be immediate. I’ve learned a lot here about the link between development and democracies, so it really covers the scope of my work. And it's been great to learn about the theoretical side — the professors are really speaking about things that impact our daily work.” 


Ujwal Thapa, Nepal

ujwal1 Ujwal Thapa, president of the BibekSheel Nepali youth movement. Photo: Alice Wenner

“Bibeksheel Nepali is basically a political startup. It’s a youth-led movement, and we’re focused on changing the norms and mindsets of the culture in Nepal. We work a lot with citizens to instill the values of transparency, empathy and humility because we think democracy needs to be more emotional instead of just logical. I think liberal democracy needs to be understood more in the context of humanity. So it’s an experiment that we're doing in Nepal.

“When we started with the experiment, we decided not to focus only on the state, but thought about a few more components: one is our citizens, another is the society and the third is the government. Nepal recently came out of a violent civil war, and we just built a new constitution that is much more tolerant. Transparency is another value that we want to instill, because of the long isolationist and autocratic dictatorship that has existed in the past.

“Draper Hills is bringing all of these practitioners together who are experimental and innovative. And the world needs better collaboration from people who really believe in the ideals of the 21st century, which are liberal, democratic and more humanistic. That’s one of the strongest aspects of the Draper Hills program.”


N.S. Nappinai, India

nappinai1 N.S. Nappinai, senior practitioner in the Supreme Court of India and Bombay High Court. Photo: Alice Wenner

“I'm a lawyer — I specialize in cyber laws. My work throughout my career has been focused on ensuring responsible technology and the use of technology to fight crime. Two years ago I was appointed by the Supreme Court of India as Amicus Curiae on a matter related to protecting against the uploading of videos and images of gang rape and child pornography online.

“Some of the social media platforms had very good reporting mechanisms, whereas it was more hidden on other platforms. So we ensured that this issue was brought to the forefront so that people know that these are things that can be reported and some action can be taken. The whole idea was that as long as you identify such content at the earliest possible time, then you help the victim that much more.

“For me, balancing victims' rights with free speech is very important. This was a big dilemma that I faced, in terms of ‘How much of what I am doing is likely to stifle free speech?’ A lot of discussions at Draper Hills have helped formulate and structure my thoughts, and it's very nice to get the perspective from people from 26 other countries.”


Hinda Bouddane, Morocco

hinda1 Hinda Bouddane, the first vice president of the elected provincial council of the city of Fez. Photo: Alice Wenner

“I'm involved in women's empowerment and education for girls in Morocco. And especially for women in rural areas — they are less privileged, and many of them don't know their rights. So my fight through JA Worldwide and my activism is to empower these women and to raise awareness about their rights and the importance of education for girls.

“Education for girls is really important in fighting discrimination against women. Education empowers women to become financially independent, say no to violence, and to get engaged in the public sphere. Through that, women can be a part of the democratic process not only by voting, but also by taking part from within and running for office.

At Draper Hills, we're deepening our knowledge about topics like the rule of law, democracy and human rights, and hearing many different perspectives. And importantly, we are building a great network to connect many intelligent people from around the world, and we will work together to foster democratic values.”

 

 

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The 2019 Draper Hills Class of 2019 at the Freeman Spogli Institute for International Studies. Photo: Stanford Center on Democracy, Development and the Rule of Law
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David M. Lampton gave a talk titled “Chinese Power and Rail Connectivity in Southeast Asia” before the Stanford China Program audience on February 6th. He addressed three issues in particular: the scope of his research project, conducted in partnership with two co-authors based in Singapore and Malaysia; the long genesis of this railroad construction idea from Southeast Asia to China; and, third, the overarching question of whether China can effectively implement the gargantuan feat – technologically, financially, and politically. The high-and conventional-speed rail project will span seven Southeast Asian countries, plus China, Lampton highlighted.  This project is not only geographically forbidding, but the political terrain, and its socio-economic variety, is an even greater challenge.  Lampton’s talk comprised part of Stanford China Program’s 2019 Colloquia Series, “A New Cold War?: Sharp Power, Strategic Competition, and the Future of U.S.-China Relations.”

Lampton began by clarifying that the vision of rail connectivity through Southeast Asia into China is not the brainchild of either China’s leadership or Xi Jinping. This idea has a long history, he stated, beginning with the British and the French in the 19th century when they were occupying Burma and Indochina, respectively; and even during World War II when Japan further entertained building railroads from the Korean Peninsula to Singapore to advance their military ambitions. In contemporary times, ASEAN had articulated a plan in 1995 to develop a rail line from Singapore to Kunming city, P.R.C. In 2010, ASEAN again put forth a master connectivity plan for 2025 where railroad development comprised a prominent part. Only in the aftermath of these many plans and proposals did Xi Jinping, in 2013, officially announce China’s Belt and Road Initiative (BRI), an infrastructure initiative with a scope far greater than simply Southeast Asia. The idea of infrastructural connectivity in the region, in other words, has a long history that predates China entering the picture as a major actor. Only recently has China amassed the technological capacity and financial wherewithal to realize this enormous project, with economic, diplomatic, and strategic military implications.

Next he described the key role that Beijing’s industrial policy has played in the rapid development of China’s high-speed rail. From a nonexistent industry in 2001, China has built a sector that is now an international powerhouse in high-speed rail technology. As of 2014, China boasted four trunk lines, North and South; and four trunk lines, East and West, crisscrossing the P.R.C. China’s industrial policy has clearly delivered striking results (as well as some setbacks) not only with respect to high-speed rail but also in other industries.  In light of this, Lampton opined that China is not likely to yield to U.S. demands for major structural reforms in onoing trade talks with China. 

Lampton described the progress in high-speed and conventional-speed rail construction with partners in Southeast Asia (ASEAN) that the Chinese have made, with Laos and Thailand furthest along in implementation. Nonetheless, Beijing also has met with significant resistance due to the complicated political situation in various regions. Lampton described, for example, the drawn-out financial negotiations between Singapore and Malaysia with respect to the rail line connecting Singapore to Kuala Lumpur; and the jockeying among various heads of Malaysia’s federation of local states. The election of Mr. Mahathir in 2018 also put an at least temporary halt to the construction and planning of two rail projects for many reasons, including the corruption of the preceding regime of Najib in Kuala Lumpur. Although Lampton expressed overall confidence that the rail lines will get built to Kuala Lumpur and Bangkok, for example, in the not-too-distant future, the political complexities of the region and China’s ability to successfully navigate them are still open questions.

He also described the competing world views regarding infrastructure construction and economic development. There are powerful constituents in China – now backed by Xi Jinping himself – who believe that infrastructure development drives growth: i.e., “if you want to get rich, build a road.” By contrast, the U.S. and entities such as the World Bank are more cautious, seeing all the negative social and environment extenalities such massive projects create. They also want to see greater assurances of projected returns from these infrastructure projects before devoting resources. Having said this, both multilateral financial and development institutions, and the United States Government, are gradually adopting a more supportive posture on large infrastructure projects, in part not wishing to abandon the commercial and strategic battlegrounds of the future to the PRC.

Lastly, Lampton debunked the notion that the BRI is a unified, top-down “plan.” Rather, he described it as Beijing’s “umbrella policy” that “creates a predisposition [among Chinese entities] to build infrastructure.” It incentivizes “entrepreneurial SOEs, provinces, localities, overseas Chinese . . . to push their pet projects . . . onto . . . the national largesse.” This being the case, Lampton described the BRI as a dynamic, chaotic and, sometimes, even a rapacious process for the transit countries. Yunnan Province, for example, started a rail line even before the central government had approved it; and Guangdong Province began developing its own special economic zone and port construction in Malacca all without central approval. As Lampton stated, the “BRI isn’t just about Xi Jinping and Beijing . . . . [I]t’s about local initative, and how Beijing can or cannot control or . . . under what circumstances, it chooses to control [its local actors].”

The recording and transcript are available below.  

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David M. Lampton, Oksenberg-Rohlen Fellow and Research Scholar at APARC, speaks at Stanford's China Program on February 6th, 2019.
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Singapore in Southeast Asia and Stanford University in the United States are focal points for discussions of AI and how it can be made to help—not hurt—human beings. In a piece written for RSIS Commentaries, Don Emmerson, Director of the Southeast Asia Program at APARC, uses a recent panel at Stanford to illustrate the difficulty and necessity of bringing both generalist and specialist perspectives to bear on the problem.


Singapore has been described as “a thriving hub for artificial intelligence.” In May 2019, Singapore’s Personal Data Protection Commission (PDPC) released the first edition of “A Proposed Model AI Governance Framework.”

That “accountability-based” document would “frame the discussions around harnessing AI in a responsible way” by “translat[ing] ethical principles into practical measures that can be implemented by organisations deploying AI solutions”. The guiding principles it proposes to operationalise are that AI systems should be “human-centric” and that decisions made by using them should be “explainable, transparent, and fair”….

Read the full article on RSiS Commentaries.

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LONDON, ENGLAND - AUGUST 04: A robot poses as Westfield prepare to host an interactive artificial intelligence storytelling event for kids at a pop-up indoor park on August 10 at Westfield London, August 4, 2016 in London, England. | Getty Images — Jeff Spicer / Stringer
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Naomi Funahashi
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Since joining SPICE in 2005, my annual calendar has revolved around not spring flowers, caterpillars dangling from trees, and falling leaves around the beautiful Stanford campus, but the schedule of the Reischauer Scholars Program (RSP), Stanford’s online course on Japan and U.S.–Japan relations for U.S. high school students. As the manager and instructor of the RSP, I have had the pleasure (and truly, the honor) of teaching this online course for 14 years. We accept applications beginning in August, outreach efforts ramp up in September and October, and new cohorts of talented U.S. high school students are selected every November. With January comes the updating of the syllabus with new readings, topics, and video lectures, and identifying and inviting guest speakers for the virtual classes. And the highlight of my year—every year—is on February 1, when the new cohort signs into our online learning platform ready to engage in this new community, connect over shared interests, learn from their differences, and to embark upon the RSP journey together.

It is now early June, and the 2019 Reischauer Scholars Program is, unbelievably, soon coming to an end. This year’s RSP journey has led us through explorations of tales of samurai, the modernization of Meiji Japan through the lens of filmmaker Ozu Yasujiro, comparative perspectives on colonial and wartime legacies through textbooks, and lessons on civil liberties as told by someone who was sent to a Japanese American internment camp with his family as a 9-year-old boy.

While this online course has always approached the study of Japan and U.S.–Japan relations with an intense academic rigor befitting Stanford University, I also wanted to offer students access to the personal stories of practitioners who play an active role in Japanese society and the U.S.–Japan relationship that we study. One of the wonderful aspects of teaching online is that for our weekly virtual classroom sessions—where all students meet synchronously using Zoom video conferencing software—we are able to welcome guest speakers to join us from anywhere in the world.

As we explored the U.S.–Japan security relationship this year and the controversies surrounding the presence of U.S. military bases in Okinawa, for example, students met with an Okinawan native who works on the U.S. Air Force Base in Kadena. Learning about how her experiences and perspectives inform her own efforts to enhance U.S.–Japan relations gave the students new insight into the impact of international policy upon individuals and the communities in which they live.

For our module on U.S.–Japan diplomacy we were joined by the Principal Officer of the U.S. Consulate in Sapporo, Rachel Brunette-Chen, who talked about how her interests in connecting the U.S. and Japan have informed her career in the U.S. State Department. RSP students often cite international relations and diplomacy as two high-interest fields for their future undergraduate studies and career aspirations, so they made the most of this opportunity to ask thoughtful questions about careers in Foreign Service. Given the diverse career tracks available in the State Department, students were inspired to learn that they could take their multidisciplinary interests and apply them in an international context for years to come.

As we grappled with the various challenges facing modern Japanese society during the last few weeks of class—including students mired in a test-centric system, the demographic realities of an aging population and declining birth rates, pervasive issues of gender inequality, and minority rights, among others—it was important to gain an understanding of how these issues are being addressed and experienced by real people. Our final guest speaker for the 2019 RSP, a Japanese American entrepreneur and educator living and working in Tokyo, shared his first-hand perspectives on the state of entrepreneurship and innovation in contemporary Japan.

Perhaps the most memorable of the online video conferencing sessions this year were the two joint virtual classes with the students of the Stanford e-Japan Program. Stanford e-Japan is an online course that engages Japanese high school students in the study of U.S. society and U.S.–Japan relations, and is comprised of students from across Japan. The rich, open discussions and friendly international camaraderie fostered during these joint sessions are always a delight to observe. I know that many of my RSP students—and many of the Stanford e-Japan students, as well—will treasure these experiences and relationships for years to come.

In our virtual class on diplomacy, one student asked, “How can we, as high school students, make a real impact on the U.S.–Japan relationship?” “By taking the initiative to be active participants in courses like the Reischauer Scholars Program,” replied Ms. Brunette-Chen, “you are already on your way. In sharing what you learn about Japan, you are also raising awareness about the importance of the U.S.–Japan relationship among your peers and school communities.” Indeed, these 2019 Reischauer Scholars are already on their way. As the spring flowers, dangling caterpillars, and fall leaves continue to come and go in the years ahead, I am eager to see the different ways in which their impact upon U.S.–Japan relations will continue to take shape. Who knows? Perhaps a few will return to the RSP years from now—this time not as students, but as guest speakers who coach and inspire the Reischauer Scholars of the future.


To be notified when the next Reischauer Scholars Program application period opens, join our email list or follow us on Facebook and Twitter.

The Reischauer Scholars Program is one of several online courses for high school students offered by SPICE, Stanford University, including the China Scholars Program, the Sejong Scholars Program (on Korea), and the Stanford e-Japan Program.


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Student honorees of the 2018 Reischauer Scholars Program with Consul General Tomochika Uyama and RSP Instructor Naomi Funahashi. | Rylan Sekiguchi
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Early Childhood Development Takes Center Stage in China: Questions & Answer with Scott Rozelle and James Heckman

 

【编者按】2018年11月17日,詹姆斯·赫克曼(James J. Heckman)教授在西安召开的“2018年儿童早期发展国际论坛”上发表主旨演讲,出席会议的有来自世界各地和中国各地的政要和顶尖学者。赫克曼教授就儿童早期发展(ECD)质量对生活在贫困和富裕社区的婴幼儿的重要性进行了广泛和深入的概述。他在演讲中阐明儿童早期发展质量对一个人的童年及其终生的健康、经济和社会性结果都有重大影响。高质量的儿童早期发展项目对整个社会的影响也是巨大的。他特别强调了儿童早期发展的经济学意义,认为政府投资弱势儿童的早期发展,其社会回报率非常高。赫克曼教授借鉴了世界各地的研究成果,包括他自己以及美国和其他发达国家的其他学者的研究成果。

 

演讲结束后,他与会议组织团队进行了座谈,回答了关于他的研究以及其他科学家和社会科学家近期研究的一些基本问题。问答阶段的总目标是总结儿童早期发展对国家发展的重要性以及决策者在这一进程中的作用。在可能的情况下,赫克曼教授尝试从国际文献中为中国案例提供经验与启示。与詹姆斯·赫克曼教授的问答,由罗斯高(Scott Rozelle)教授主要负责。问答后附有对“赫克曼曲线”的简要述评。

 

Read the full story here.

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Fighting to End Hunger at Home & Abroad:  Ambassador Ertharin Cousin shares her journey & lessons learned

A Conversation in Global Health with Ertharin Cousin

FSI Payne Distinguished Lecturer | Former Executive Director of the World Food Programme | TIME's 100 Most Influential People

RSVP for conversation & lunch: www.tinyurl.com/CIGHErtharinCousin (please arrive at 11:45 am for lunch)

Professor Ertharin Cousin has been fighting to end global hunger for decades. As executive director of the World Food Programme from 2012 until 2017, she led the world’s largest humanitarian organization with 14,000 staff serving 80 million vulnerable people across 75 countries. As the US ambassador to the UN Agencies for Food and Agriculture, she served as the US representative for all food, agriculture, and nutrition related issues.

Prior to her global work, Cousin lead the domestic fight to end hunger. As chief operating officer at America’s Second Harvest (now Feeding America), she oversaw operations for a confederation of 200 food banks across America that served more than 50,000,000 meals per year.

Stanford School of Medicine Senior Communications Strategist Paul Costello will interview Professor Cousin about her experiences, unique pathway, and the way forward for ending the global hunger crisis.

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Li Ka Shing Room 320 

Seminars

Please join Larry Diamond, Senior fellow at the Freeman Spogli Institute for International Affairs and the Hoover Institution for the launch of his latest book, "Ill Winds: Saving Democracy from Russian Rage, Chinese Ambition, and American Complacency."

 

Featuring a Panel Conversation with:

 

Zin Mar Aung

Burmese MP and political activist

 

Vladimir Kara-Murza

Russian journalist and anti-corruption crusader

 

Cara McCormick

CEO, Chamberlain Project, Co-founder/Co-leader of The

Committee for Ranked Choice Voting in Maine

 

*Reception to follow

Bechtel Conference Center

Encina Hall

616 Serra Mall

Stanford, CA 94305

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We are proud to announce our next year's cohort of CDDRL Honors Program students! We selected a diverse group of undergraduate majors for the program who will be writing their senior theses on a subject touching upon DDRL with a global impact. Students will work to complete their thesis under the guidance and consultation of CDDRL faculty, but may have a primary thesis advisor from their own department. Upon fulfilling individual department course requirements and completing the honors program, the student will graduate in his/her major with a certificate of honors in Democracy, Development, and Rule of Law. 

Read their bios here.

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U.S. government aid for treating children and adults with HIV and malaria in developing countries has done more than expand access to lifesaving interventions: It has changed how people around the world view the United States, according to a new study by researchers at the School of Medicine.

Compared with other types of foreign aid, investing in health is uniquely associated with a better opinion of the United States, improving its “soft power” and standing in the world, the study said.  

Favorability ratings of the United States increased in proportion to health aid from 2002 to 2016 and rose sharply after the implementation of the President’s Emergency Plan for AIDS Relief in 2003 and the launch of the President’s Malaria Initiative in 2005, the researchers report.

Their findings were published this week in the American Journal of Public Health. The lead author is postdoctoral scholar Aleksandra Jakubowski, PhD, MPH. The senior author is Eran Bendavid, MD, associate professor of medicine and a core faculty member at Stanford Health Policy.

“Using data on aid and opinions of the United States, we found that investments in health offer a unique opportunity to promote the perceptions of the United States abroad, in addition to disease burden relief,” the authors wrote. “Our study provides new evidence to support the notion that health diplomacy is a net win for the United States and recipient countries alike.”

The Trump administration, however, has proposed a 23% cut in foreign aid in its 2020 budget, including large reductions to programs that fight AIDS and malaria overseas.

The Stanford researchers believe their study is the first to add heft to the argument that U.S. health aid boosts the “soft power” that wins the hearts and minds of foreign friends and foes.

“Our study shows that investing in health aid improves our nation’s standing abroad, which could have important downstream diplomatic benefits to the United States,” Jakubowskisaid. “Investments in health aid help the United States accumulate soft power. Allowing the U.S. reputation to falter would be contrary to our own interests.” 

A Policy Debate

Many politicians and economists consider spending U.S. tax dollars on foreign aid as an ineffective, and possibly harmful, enterprise that goes unappreciated and leads to accusations of American meddling in other countries’ national affairs.

The U.S. government, for the past 15 years, has contributed more foreign health aid than any other country, significantly reducing disease burden, increasing life expectancy and improving employment in recipient countries, the authors wrote. Still, this generosity has historically constituted less than 1% of the U.S. gross domestic product.

“Our results suggest that the dollars invested in health aid offer good value for money,” the researchers wrote. “That is, the relatively low investment in health aid (in terms of GDP) has provided the United States with large returns in the form of improved public perceptions, which may advance the U.S. government’s ability to negotiate international policies that are aligned with American priorities and preferences.”

The researchers used 258 Global Attitudes Surveys, based on interviews with more than 260,000 respondents, conducted by the Pew Research Center in 45 low- to middle-income countries between 2002 and 2016.

Their analysis focused on the health sector, which includes several large programs for infectious disease control, but also support for nutrition, child health and reproductive health programs. They compared health aid to other major areas of U.S. investment: governance, infrastructure, humanitarian aid and military aid. They also constructed a database of news stories that mentioned the President’s Emergency Plan for AIDS Relief or the President’s Malaria Initiative by crawling through the online archives of the top three newspapers by circulation in each of the 45 countries.

They found that the probability of populations holding a very favorable opinion of the United States was 19 percentage points higher in the countries where and years when U.S. donations for health care were highest, compared with countries where and years when health aid donations were lowest. Using another metric, the researchers found that every additional $100 million in health aid was associated with a nearly 6 percentage-point increase in the probability of respondents indicating they had a “very favorable” opinion of the United States. 

In contrast, the researchers found, aid for governance, infrastructure, humanitarian and military purposes was not associated with a better opinion of the United States.

Bendavid, an infectious diseases physician and core faculty member of Stanford Health Policy, said that when he set out to conduct this research, he believed it would result “in a resounding thud” — that the “soft power” of health aid would have no impact on public opinion.

“For me, the notion that this program — hatched and headquartered in D.C. — would have impacts among millions in Nairobi and Dakar, seemed farfetched,” Bendavid said. “I was incredulous until all the pieces were in place.”

The ‘America First’ Agenda

The Trump administration’s “America First” agenda is calling for significant cuts to global health aid, particularly to the highly successful AIDS relief program, which was established by President George W. Bush. The administration’s budget, released in March, proposed a $860 million cut to the program; the President’s Malaria Initiative is facing a $331 million reduction in federal funding. That’s a decline of 18% and 44%, respectively.

The U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria would also decline by 17%, or $225 million, according to the Kaiser Family Foundation.

Yet beyond the reputational damage to the United States, such cuts could be a major setback to improving health outcomes in developing countries, the researchers said. After all, HIV knows no borders, and having more resilient health care systems is instrumental when facing public health crises, such as the Ebola outbreak in the Democratic Republic of Congo, Jakubowski said.

“The most direct impact of cutting the United States’ health aid allocations is the potential to undermine or reverse the progress that has been enabled by U.S. aid in curbing mortality and the spread of disease,” Bendavid said. “However, this study suggests there are also repercussions to the United States: the relationships the U.S. has built with recipient nations could also be undermined.”            

Other Stanford co-authors are Steven Asch, MD, MPH, professor of medicine, and former graduate student Don Mai.

Stanford’s Department of Medicine supported the work.

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HARBEL, LIBERIA—Workers unload medical supplies to fight the Ebola epidemic from a USAID cargo flight on August 24, 2014 in Harbel, Liberia. | Photo by John Moore/Getty Images
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