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Paul Wise is a clinical professor of pediatrics and a CHP/PCOR core faculty member. His work focuses on children's health policy; health disparities by race, ethnicity and socioeconomic status; and the interaction of genetics and the environment as these factors influence child and maternal health.

Before coming to Stanford in July 2004, he was a professor of pediatrics at Boston University and vice-chief of Social Medicine and Health Inequalities at Brigham and Women's Hospital. He previously served as director of emergency and primary care services at the Children's Hospital of Boston, and as director of the Harvard Institute for Reproductive and Child Health at Harvard Medical School. He has also served as a special expert at the National Institutes of Health and as special assistant to the U.S. Surgeon General.

Wise has worked to improve healthcare practices and policies in developing countries. He is involved in child health projects in India, South Africa and Latin America, targeting diseases such as tuberculosis and AIDS. He currently chairs the steering committee of the NIH's Global Network for Maternal and Child Health Research, and he has served on many other boards and committees including the Physicians' Task Force on Hunger and the American Academy of Pediatrics' Consortium on Health Disparities. He has received honors from organizations including the American Public Health Association, the March of Dimes, and the New York Academy of Medicine.

He received a BA in Latin American studies from Cornell University, an MD from Cornell University and an MPH from the Harvard School of Public Health. He completed a residency in pediatrics at Children's Hospital Medical Center in Boston.

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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
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Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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Paul H. Wise Richard E. Behrman Professor of Child Health and Society and CHP/PCOR Core Faculty Member Speaker CDDRL, CISAC Affiliated Faculty
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Conventional wisdom holds that the emigration of highly skilled workers depletes local human capital developing countries.  But when the very prospect of emigration induces people to invest more in their education, the effects might not be so negative.  We analyze a unique natural quasi-experiment in the Republic of Fiji Islands, where political shocks have provoked one of the largest recorded expoduses of skilled workers from a developing country.  We use rich census and administrative microdata to show that high rates of emigration by tertiary-educated Fiji Islanders not only raised investment in tertiary education in Fiji, but also raised the stock of tertiary-educated people in Fiji - net departures.

Michael Clemens is a senior fellow at the Center for Global Development where he leads the Migration and Development initiatiave.  His research focuses on the effects of international migration from and in developing countries.  Michael joined the Center after completing his Ph.D. in economics at Harvard.  His past writings have focused on the effects of foreign aid, determinants of capital flows and effects of tariff policy in the 19th century and the historical determinants of school system expansion.  Michael has served as a consultant for the World Bank, Bain & Co., the Environmental Defense Fund, and the United Nations Development Program.

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Michael Clemens Senior Fellow, The Center for Global Development Speaker
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Dr. Brian Chen's research has examined the tradeoffs between moral hazard and efficiencies in the integration of physician and non-physician medical services in the presence of asymmetric information. He has looked at a policy intervention in Taiwan that prohibited self-referrals of patients to physician-owned pharmacies unless the physician group integrated pharmacy services into the clinic by hiring an onsite pharmacist. He found that the policy reduced drug expenditures by close to thirty percent among physicians that did not have an onsite pharmacist. However, these physicians responded by increasing the overprovision of diagnostic services not covered by the policy, thereby reducing the effectiveness of the policy. Forty-five percent of the clinics that did not have an onsite pharmacist prior to the policy hired one subsequent to the implementation of the policy. Overall, after integration, the policy applied to only seventeen percent of clinics, and only reduced average discretionary expenditures by about two-point-five percent. Chen's research also shows that despite the reduction in drug utilization, patients treated at clinics without an onsite pharmacist did not have greater observable adverse health events than patients treated at integrated clinics. His results show that moral hazard costs of self-referral incentives are large, that the “safe harbor” exemption severely reduces the effectiveness of the policy, and that the exemption explains much of the recent integration of ancillary services into physician offices.

Dr. Brian Chen recently completed his Ph.D. in business administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.

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Brian Chen 2011 AHPP/CEAS Visiting Scholar Speaker Stanford University
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Professor Li Liang Dong of the Central Party School's Politics and Law Department advises directly senior officials in the Chinese Communist Party.  Professor Li received his doctorate from the Central Party School in Law.  His main research areas are:  democratic perspective, Western political thought, and political theory. 

Some of his key works include: "Contemporary Chinese Studies of Public Opinion" (Central Party School Press, 1996), "Mao Zedong and Chinese farmers" (China Farmers Press, 1993), "Contemporary Chinese Democracy Studies" (Contemporary World Press, 2001 edition) and "Third Wave and the Chinese Democracy" (Central Party School Press, 2001 edition).  He has published over 300 articiles.  Professor Li has hosted discussions on topics including "Public Discussion in China",  "Societal Transitions", and "Study of Political Stability".

Co-sponsored by The Center for Deliberative Democracy at Stanford University

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Li Liang Dong Professor, Department of Politics and Law Speaker Central Party School, Beijing, China
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Larry Diamond
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After the peaceful mass uprising that toppled one of the world's oldest autocracies, it is now possible to imagine the emergence of a genuine democracy in Egypt-the most important country in the Arab world. The very possibility of it marks an historic turning point for the entire region. However, there is a long and often treacherous distance between the demise of an authoritarian regime and the rise of a democracy.

With no experience of democracy in recent decades, and no apparent government leadership that is committed to bringing it about, Egypt's transition faces more formidable challenges than the transitions that led to democracy in recent decades in countries like Spain, Greece, Argentina, Brazil, Chile, the Philippines, Poland, South Africa, Indonesia, and Ukraine. (Which isn't to say these were easy: We forget how difficult each of these transitions seemed at the time, and how fraught they were with dangers and uncertainties.) With an energized civil society and deep resources of youthful talent, creativity, and mobilizing skill, Egypt has a real chance to get to democracy in the next few years. But doing so will require a keen analysis of the numerous potential traps that could sandbag the process.

The first trap is the Machiavellian opaqueness of the aging generals who are now running the country. Beginning with the Defense Minister (and now junta leader) Mohamed Tantawi, until a few days ago a close ally of the deposed President Mubarak, Egypt's new military rulers cannot be trusted to structure the political process and emergent rules in a way that will favor genuine democracy. Their principal goal, it appears, is to preserve as much of the old order as possible-Mubarakism without Mubarak (the father or the son). This means another round of the old shell game of Arab regimes-what Daniel Brumberg has called "liberalized autocracy." The process of liberalization-which runs in cycles, and which countries like Morocco and Jordan have seen many iterations of-institutes just enough change in the rules and faces to give the appearance of movement toward democracy without any of the dangers (for the ruling elite). But the changes, imposed from above, stop well short of the sweeping institutional transformations that would open wide the political arena (and the functioning of government) while leveling the playing field.

In their initial "communiqués," Egypt's ruling generals show signs of treading down this duplicitous path. Their initial choices have evinced the seductive veneer of democratic change but the closure and control of authoritarian continuity. To begin with, there appears so far to be little consultation with democratic forces in determining the character and pace of transition. Despite opposition demands, emergency rule remains in place, and so do many political prisoners. The military's initial decisions have been unilateral and preemptory. We learn there will be a constitution drafted within two months, followed by a referendum. A respected retired judge will head the process. This will produce "amendments" to the now-suspended authoritarian constitution. But what will be the role for Egyptian opposition and civil society in this process? What will be the scope down the road to draft a completely new, more democratic and legitimate constitution with broad popular participation and support? Will the president to be elected later this year serve another imperial six-year term, or be a caretaker heading a neutral government until a new constitution can be adopted and fresh elections held? At this point, if anyone knows the answers to these questions, it is only the junta.

The military is talking about early presidential and legislative elections, within six months. What could be more democratic than that? But, in fact, after the fall of a longstanding autocracy, it typically takes a lot longer than six months to organize competitive, free, and fair elections. Think of the steps. A neutral and independent electoral administration must be established. This requires not just legal authorization but also new leadership, and recruitment, training, funding, and deployment of new staff and equipment. If Egypt's generals intend to have elections administered by the same Ministry of Interior that shamelessly rigged the vote for Mubarak and his ruling National Democratic Party (NDP), that will be a sure sign that they do not intend to deliver democracy-or are too incompetent and cavalier to care. Then, the next step must be to produce a new register of voters. Experts believe only a quarter of eligible Egyptians are registered to vote today. The exclusion was very useful to perpetuating autocracy but could be deadly for an emerging democracy. That will take months, money, and far-reaching organization to do even reasonably well.

It will be one thing to elect a new president and quite another to choose a new parliament in Egypt's transitional flux. The military now suggests the two elections can be held together within six months. But they will have very different logics and requirements. A presidential election will be much simpler. The old order will no doubt throw up a somewhat more palatable face, perhaps the former Foreign Minister Amr Moussa. The democratic opposition may well rally behind a single candidate (though the regime, no longer able to exclude a democratic alternative, will probably try to fragment the field with as many opposition candidates as possible). Still, voters will be faced with a few principal choices for national leadership, and it won't matter where people vote, so long as they are of voting age and only vote once. This kind of election can be done more roughly and quickly, tossing aside the voter register and just dipping every forefinger in indelible ink after it has marked a ballot for one presidential candidate or another. It will be important in this election-and every future one-to ensure transparency and citizen monitoring of the vote, as well as to have Egypt's judiciary oversee the balloting (as it did in previous elections until the judges got too good at it and Mubarak cut them out). But, otherwise, a presidential election won't be a complicated affair.

By contrast, new parliamentary elections present formidable challenges. First, Egyptians (and hopefully not just the military) must decide what electoral system will be used. This choice can invoke arcane debate, but it may be one of the most important that Egypt makes in pursuit of democracy. If the electoral rules are "majoritarian," in that they make it hard for small minorities to get elected, they will work to the disadvantage of not just small ideological tendencies but also the welter of new, emerging parties and political forces-many of them liberal and secular-that will just be taking shape and starting to test their strength. This will inflate the strength of the only two political forces that now have effective political organizations on the ground-the old ruling party and the Muslim Brotherhood (with a smattering of some of the other older opposition parties). If Egypt retains the current electoral system of two-member districts (with each voter getting two votes), these two established political forces could sweep most of the seats between them, marginalizing the moderates, polarizing the parliament and political system, and dooming democracy from the start. Creating a liberal center in democratic politics requires more than moral and technical support for these parties to function; it also requires rules that enable them to get traction.

A much better-and fairer-alternative would be to elect the new parliament using some form of proportional representation, so that parties would win seats roughly in proportion to their vote shares. That way, new parties could begin to gain a foothold in the political process. Perhaps ironically, the best way to do this might be the way Iraq now does, by using the existing governorates (29 in Egypt) as multimember districts, and having each district then elect a share of seats equivalent to its share of the population. This would allow for very proportional results, with districts generally containing ten to 25 seats, while still enabling some accountability and candidate familiarity at the local level.

A truly democratic parliamentary election in Egypt cannot be pulled off in six months. In fact, it might require well over a year to prepare. But the alternative would be to rush to a vote with a flawed system that would leave Egypt's new democratic forces on the margins not just of legislating but of constitution-making as well.

How a new permanent constitution will be drafted-if it is even intended by the military-also remains a mystery at this point. The worst option would be to have a closed and hurried process dominated from above by the military. But that seems to be what the junta intends for the transitional period. Successful democratic transitions either use an expert but broadly representative constitutional drafting commission, and then a popular referendum to confirm the draft, or an elected constitutional assembly (often acting simultaneously as a parliament), possibly followed also by a popular referendum (as in Iraq). Some have used all of these methods combined. Experience of recent decades underscores the importance for future democratic legitimacy and stability of eliciting extensive public dialogue and broad popular participation in the constitution-making process, with adequate preparation and civic education and widespread media exposure, as in South Africa. A thorough, inclusive, and deliberate process of constitutional drafting and debate can also help to breed a more democratic culture at both the elite and mass levels. A rushed and closed process perpetuates authoritarian mentalities (and, often, authoritarian rules as well).

Prior to all of this is the most basic question of who writes the rules, the timetable, and the mode of transition. Egypt has now entered a classic transition game where the authoritarian regime and the democratic opposition have sharply different interests and little basis for cooperation and trust. As an institution, Egypt's military may not be hated the way Mubarak and his cronies were, but many of the generals were Mubarak's cronies. And the military's core interests are not freedom and democracy for the people, but preserving their own power, wealth, privilege, and impunity. The core lesson of numerous prior transitions is the need for a negotiated way out of this potentially fatal impasse. Democrats want democracy with no guarantees to autocrats. Autocrats want guarantees, with no real democracy.

There is an obvious generic compromise, and every successful negotiated transition-from Spain and Brazil to Poland, South Africa, and Indonesia-has settled on a version of it. The old order gets to hang on to most of its wealth and privilege, along with military autonomy at least for a time. Few, if any, henchmen of the old order are prosecuted for their past crimes, unless it is for the last, desperate excesses of a few diehards trying to hang on during the transition. Real accountability waits for a later day. Democrats get democracy. Autocrats (mostly) retain their wealth and influence, but they cannot bid for power unless they play the democratic game. The Yale political scientist Robert Dahl coined a term for this type of bargain. He called it "mutual security." From the Spanish transition on, the generic bargain became known as a political pact.

Only a negotiated pact between Egypt's surviving authoritarian regime and its emergent democratic forces can steer the transition through the current treacherous straits to calmer and freer waters. For that to happen, Egypt's disparate democratic forces must unify in a broad negotiating front that unites the "outside" opposition of the youthful movements with the "inside" opposition of the "wise persons" and established parties who have so far dominated, on an ad hoc basis, the discussions with the old order.

Opposition unity will give Egypt's democrats strategic leverage; if negotiations stall due to regime intransigence, then the unified opposition can more credibly threaten to turn out people by the millions again in protest. But, if negotiations move forward to ensure the essential conditions for a democratic transition-an end to emergency rule; freedom of organization, expression, and assembly; judicial independence; and new and fair electoral administration-then a unified opposition can guarantee social peace and political stability. Opposition coherence enables clear negotiating priorities to level the playing field and ensure a democratic transition. It will also give the old order a clear set of interlocutors who can credibly commit to deliver popular support behind a difficult compromise agreement. No condition is more important for a successful transition.

The role for the United States and other international actors is not to dictate terms for the transition or structures for the new political order. That is not our place, and Egyptians of every political stripe will resent it. But international actors should offer training to political parties and technical and financial assistance to the new civil society organizations and state institutions needed to make democracy work. For the United States., this will mean millions of dollars in new assistance for democracy in Egypt-but that is a trifle compared to the $68 billion we have invested in dictatorship (even if it was to buy peace). No less importantly, other democracies (including leaders of recent democratic transitions) can encourage Egypt's opposition groups to coalesce and share lessons of the strategies and choices that have led to democratic outcomes. And the Obama administration can make it clear to Egypt's military rulers that nothing less than a real transition to democracy-with broad consultation, serious negotiations, and a new climate of freedom-will return Egypt to stability and a lasting partnership with the United States.

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Stanford University’s Center on Democracy, Development, and the Rule of Law in partnership with the Canadian Foreign Affairs and International Trade department are hosting a symposium, Addressing the Accountability Gap in Statebuilding: The Case of Afghanistan, on February 25, 2011. The distinguished Ashraf Ghani, former Afghan Minister of Finance and 2009 Presidential Candidate, will be delivering the keynote address. This event will bring together practitioners, experts, and diplomats from Afghanistan and beyond, to share experiences and explore options to improve the contemporary practice of state-building. This conference and keynote address is open to the public.
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