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Pharmaceutical policies are interlinked globally, yet deeply rooted in local culture. The newly published book Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific, edited by Karen Eggleston, examines how pharmaceuticals and their regulation play an important and often contentious role in the health systems of the Asia-Pacific.

In this colloquium, contributors to Prescribing Cultures discuss how the book analyzes pharmaceutical policy in China, Korea, Japan, Thailand, Taiwan, Australia, and India, focusing on two cross-cutting themes: differences in “prescribing cultures” and physician dispensing; and the challenge of balancing access to drugs with incentives for innovation.

As Michael Reich of Harvard University says in his Forward to Prescribing Cultures,

“The pharmaceutical sector…promises great benefits and also poses enormous risks.… Conflicts abound over public policies, industry strategies, payment mechanisms, professional associations, and dispensing practices—to name just a few of the regional controversies covered in this excellent book.

The tension between emphasizing innovation versus access -- a topic of hot debate on today’s global health policy agenda -- is examined in several chapters…

This book makes a special contribution to our understanding of the pharmaceutical sector in China… Globalization is galloping forward, with Chinese producers pushing the pace at breakneck speed. More and more, our safety depends on China’s ability to get its regulatory act together…”

The colloquium features presentations by Naoko Tomita (Keio University), Anita Wagner (Harvard University), and Karen Eggleston (Stanford FSI Shorenstein Asia-Pacific Research Center). They will give specific examples of how pharmaceutical policy serves as a window into the economic tradeoffs, political compromises, and historical trajectories that shape health systems, as well as how cultural legacies shape and are shaped by the forces of globalization.

Oksenberg Conference Room

Anita Wagner Speaker Harvard University
Naoko Tomita Speaker Keio University
Karen Eggleston Speaker Stanford University
Seminars
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The stated purpose of the Trade Act of 1974 was to promote free trade. Section 301 authorized the U.S. President to impose retaliatory trade sanctions if negotiations were unsuccessful in reducing unreasonable limits on trade. The Act was reinforced in 1984, became known as “Super 301”, and made annual assessment and retaliatory measures mandatory.

Because of trade imbalances, four emerging Asian countries gave the US firms access to cigarette markets: Japan (1987), Taiwan (1987), South Korea (1989) and Thailand (1990). These forced market opennings were called the “Second Opium War” by local protestors in these countries, challenging U.S. export of unwelcome and unhealthy products.

A sea change occurred in the decades that followed the cigarette market opening in Taiwan. Of particular interest are changes in areas marketing skills and market share; lower cigarette prices; paradoxical increased smuggling; increased youth consumption; evolution of the powerful tobacco industry lobby; and a sharp increase in tobacco-related cancer deaths. Accompanying the increased cigarette consumption, a special, unusual habit of chewing betel quid started and grew into a mainstream practice among adult males (nearly one out of four). Oral and esophageal cancer increased sharply soon after the market opened. At the same time, the patriotic protectionists, NGOs, and government galvanized an anti-smoking movement, which gradually transformed Taiwan's culture so that smoking in public is no longer socially acceptable. A new term, “de-normalization,” was coined about the favorable effect of market opening.

 The ironic outcome of Super 301 is that while the market was forced open solely by the US, in only ten years, US market share, once leading, shrunk to a distant fifth, after Japan, UK, Germany and domestic producers. The trade imbalance was little affected by the opening of the cigarette market.

Dr. Wen's colloquium continues the colloquium series on tobacco control in East Asia, sponsored by the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, in coordination with FSI’s Global Tobacco Prevention Research Initiative.

Philippines Conference Room

Chi Pang Wen Speaker National Health Research Institutes, Taiwan
Seminars
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Reckoning with the Past:  Truth, Justice and Reconciliation in Asia

Is it possible to come to terms with the violent past and foster reconciliation with former foes, what are the obstacles and how can they be overcome? These are some of the questions we are asking in the "Divided Memories and Reconciliation" project. This colloquia will bring several scholars to Stanford to discuss the ‘history problem' in a series of lectures analyzing the ways in which past conflict has or has not been addressed and resolved in contemporary Asia. Examining issues of memory and forgetting, guilt and innocence, apology and restitution from diverse social science perspectives, our speakers investigate the handling of the violent past both within and between countries in contexts ranging from international diplomacy to the broadcast media to mass education.

In November of 2008, the head of the Japanese air self defense force, General Tamogami Toshio, resigned in a swirl of controversy over an essay he wrote entitled "Was Japan An Aggressor Nation?" The essay argued that Japan's seizure of Korea and of northern China was a legal act and that it had pursued a moderate policy of modernization in its colonial rule of Korea, Taiwan and Manchuria, superior to the colonial rule of the Western imperial  powers. General Tamogami also argued, in his published essay, that Japan's war with the United States was a result of being "ensnared in a trap that was carefully laid by the United States to draw Japan into a war." What is the story behind this controversial incident? What does it mean when a senior Japanese military officer holds such views of the wartime past? What are the implications of this for Japan's security relations with its neighbors and the United States?

Daniel and Nancy Okimoto Conference Room

Daniel Sneider Speaker
Seminars
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Why did limited government and 'constitutionalism' (the rule of law, constitutional rules, and political representation) evolve in some societies but not others? Guided by history, this paper examines why this evolution reflects dependence on administrators to implement policy choices including those affecting them. Limited government and constitutionalism are manifestations of equilibria in which the administrators have the power to influence choices. The thesis that constitutionalism reflects an equilibrium among the powerful differs from the prevailing one, which asserts that it reflects gains to the weak from constraining the powerful. Analyzing the determinants and implications of administrative power reveals its impact on trajectories of economic development. Distinct administrative-power equilibria have different impacts on the security of the non-elite's property rights; intra-state and inter-state violence (e.g. civil wars and wars, respectively); policies; entry barriers to new technologies and economic sectors; the nature of political conflicts; and the means to resolve conflicts concerning political rights.

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Harvard University Press, in "Institutions and Economic Performance", Elhanan Helpman (ed.)
Authors
Avner Greif
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Asia’s economies have been hard hit by the current global financial crisis, despite in most cases enjoying strong macroeconomic fundamentals and stable financial systems.  Early hopes were that the region might be “decoupled” from the Western world’s financial woes and even able to lend the West a hand through high growth and the investment of large foreign exchange reserves.  But that optimism has been dashed by slumping exports, plunging commodity prices, and capital outflows.  The region’s most open, advanced and globally-integrated economies—Hong Kong, Singapore, and Taiwan—are already in severe recession, with Japan, Korea and Malaysia not far behind, and dramatic slowdowns are underway in China, India, Indonesia, Thailand and Vietnam.  What role did Asian countries play in the genesis of the global crisis, and why have they been so severely impacted?  How is their recovery likely to be shaped by market developments and institutional changes in the West, and in Asia itself in response to the crisis?  Will the region’s embrace of accelerated globalization and marketization following the 1997-98 Asian financial crisis now be retarded or reversed?

Linda Lim is a leading authority on Asian economies, Asian business, and the impacts of the current global financial crisis on Asia, and she has published widely on these topics. Her current research is on the ASEAN countries’ growing economic linkages with China.

Forthcoming in 2009 are Globalizing State, Disappearing Nation: The Impact of Foreign Participation in the Singapore Economy (with Lee Soo Ann) and Rethinking Singapore’s Economic Growth Model. She serves on the executive committees of the Center for Chinese Studies and the Center for International Business Education at the University of Michigan, where formerly she headed the Center for Southeast Asian Studies. Before coming to Michigan, she taught economic development and political economy at Swarthmore. A native of Singapore, she obtained her degrees in economics from Cambridge (BA), Yale (MA), and Michigan (PhD).

Philippines Conference Room

Linda Yuen-Ching Lim Professor of Strategy, Stephen M. Ross School of Business Speaker University of Michigan
Lectures
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As the new year begins, the administration of ROK President Lee Myung-bak faces an unusually complex and rapidly evolving regional security landscape as he seeks to craft a strategy that simultaneously deepens ties with the U.S., protects South Korean equities in North Korea, continues to reduce tensions with neighboring countries and promotes economic objectives in Northeast Asia (including eastern Siberia). What are his options, considerations and prospects for success?

The past year witnessed an accelerated pace and apparent deepening in substance of the nascent security ties between and among the nations of Northeast Asia. A veritable whirlwind of diplomatic activity featured “upgraded” dialogue and symbolic steps. Meanwhile, as token of warming relations and impetus for even closer regional cooperation, China, Japan and the ROK met trilaterally on an array of issues. Ambitious proposals – and cutthroat bargaining – attended competition for a stake in Russian energy resources and potential infrastructure projects in the conjunction of eastern Siberia, Korea and China. Through the year all involved parties – the ROK, China, Russia, Japan, and the U.S. – met in the Six-Party talks context. Each party, excepting North Korea, paid public obeisance to the goal of “transforming” the talks into a new regional security mechanism.

But the year 2009 dawns against the backdrop of uncertainties that cast a cloud over the promise suggested by these developments: the global economic and financial crisis; battered, untested or unpopular political leaderships; competing nationalisms – and national interests; and the import and implications of China’s “rise.”

Mr. Keyser retired from the U.S. Department of State in September 2004 after a 32-year career. He had been a member of the Senior Foreign Service since 1990, and held Washington-based ambassadorial-level assignments 1998-2004. Throughout his career he focused on U.S. policy toward East Asia, particularly China, Taiwan, Hong Kong, Japan and the Korean Peninsula. Fluent in Chinese and professionally conversant in Japanese, Russian and French, he served three tours at the American Embassy in Beijing, two tours at the American Embassy in Tokyo, and almost a dozen years in relevant domestic assignments. In the course of his career, Keyser logged extensive domestic and foreign experience in senior management operations, conflict resolution, intelligence operations and analysis, and law enforcement programs and operations.

Philippines Conference Room

Don Keyser Pantech Fellow, Shorenstein Asia Pacific Research Center, Stanford University Speaker
Seminars
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