In the four years since a State Council think tank, the Development Research Center, bluntly declared the failure of three decades of healthcare reform, China has placed a high political priority on designing, building and financing a modern, equitable health delivery system that serves every last one of its 1.3 billion people. As publisher of practice-building trade magazines for medical specialists in China and India, Jeffrey Parker has developed unique and valuable perspectives on what's wrong with China's healthcare system -- and how Indian practitioners are able to deliver results despite a per-capita GDP that is roughly half of China's. Through an unprecedented China-India training exchange, Mr. Parker has begun testing whether Indian models of self-financed grassroots medical startup practices can help doctors shake free of China’s Stalinist paralysis without having to wait for sweeping programmatic reforms that are always on the horizon, but seem never to come. What's more, would such grassroots empowerment models not create unprecedented opportunities for participation by international investors who up to now have been largely marginalized in China's healthcare development?

In this lunchtime colloquium, Mr. Parker reviews his experiences in China and India over the past six years and looks at several exciting recent developments in China. These include:

• An ambitious rural reimbursement scheme that already has begun to complete a nationwide healthcare safety net. The program is creating a vast pool of funds to finance rural medical services, but how will Beijing populate the countryside with sustainable grassroots practices?
• The first domestic healthcare IPO, by which Aier Ophthalmology raised some $50 million as one of 28 debut listings in the Shenzhen's new "ChiNext" Growth Enterprise Market. New wind in the sails of healthcare privatization?
• Licensing reforms that have begun delinking doctors' certification from their "work unit" hospitals under trials in Beijing and Yunnan, removing a vexing obstacle to hands-on surgical training of young practitioners. Will the breaking of senior doctors' "skills monopoly" create opportunities for private-sector training programs that will shake up China's Soviet-style residency programs?

Jeffrey Parker has lived in Greater China since 1990, first as a journalist and since 2003 as a publisher. His transition from chronicler of China's historic rise to active proponent of its economic development gives him a unique perspective on the opportunities still opening up in China -- and the challenges facing anyone keen to participate. With a twin B.A. in Asian Studies and Geography from U.C. Santa Barbara and Masters training in Journalism from Columbia University, Parker trimmed his sails for a China career from an early age. After early editorial jobs in New York and Washington, D.C., he was dispatched to Beijing by United Press International as senior correspondent in 1990. During the next 10 years with UPI and then Reuters, he covered a wide range of political, economic and social stories from postings in Hong Kong, Taiwan and the Peoples Republic. In his final two years at Reuters, Parker got his first taste of media development, launching local-language multimedia news and video feeds in China, Japan, Korea, India and Southeast Asia. Since 2003, Parker has built up a family of world-class doctors' magazines serving more than 50,000 specialists in China and India from the Shanghai base of ILX Media Group, where he is editorial director, chief operating officer, a corporate director and investor. Among his objectives is to help foster a badly needed transformation of medical practice across China by inspiring grassroots doctors to deliver high-quality, cost-effective services in rural and less-developed communities left behind by government health care.

Bethany Lacina is a Hewlett Pre-Doctoral Fellow at CDDRL and a PhD candidate in the Stanford Department of Political Science.  She is also affiliated with the Centre for the Study of Civil War at the International Peace Research Institute, Oslo.  Next fall, she will begin an assistant professorship at the University of Rochester.

Mobile phones are transforming lives in low-income countries faster than ever imagined.  The effect is particularly dramatic in rural areas of sub-Saharan Africa, where mobile phones have often represented the first modern infrastructure of any kind.  The iconic image of cell phones in Africa is the market woman, surrounding by her goods while making calls to potential clients in the capital city.  Equally common are the slogans of mobile phone companies promising a better life for those who use it. 

Yet do these images and slogans reflect the reality of what cell phones can do?  Cell phones are being adopted by the rural and urban poor at a surprising rate, far exceeding cell phone companies' projections. An emerging body of research suggests that mobile phones are improving households' access to information and reducing costs, thereby making markets more efficient and increasing incomes.  These impacts have occurred without NGOs or donor investments - but as a positive externality from the IT sector.

Governments, donors and NGOs have noticed the potential of information technology in achieving development goals in a variety of sectors, including agriculture, education, health, financial services and governance.  Mobile phones can greatly facilitate the effectiveness of development programs, but are needed in partnership with the private sector. And while cell phone coverage reaches over 60% of the population in most African countries, other constraints to cell phone adoption - namely pricing and handset cost - should be addressed.

Jenny Aker has worked extensively in Central, North and West Africa for the past ten years for NGOs, international organizations and universities. Her research uses field work and field experiments to better understand field-driven development problems, primarily by teaming up with NGOs and program implementers in an effort to link research with policy and implementation.

Jenny is currently involved in three main areas of research. The first assesses the impact of information technology (mobile phones) on development outcomes, namely farmers’ and traders’ welfare, market performance, labor outcomes, literacy rates and early warning systems. Based upon her previous work in Niger, she is collaborating with Catholic Relief Services in Niger on Project ABC (Alphabétisation de Base par Cellulaire), which uses cell phones as a learning tool to allow literacy participants to read and write in their local languages via SMS. The project takes a rigorous impact evaluation approach, assessing the impact of cell phones on literacy rates and farmers’ marketing behavior. Her second area of research involves assessing the impact of climate change on farmer-herder conflicts in the Sahel, with a particular focus on Mali. Her third area of research evaluates the impact of specific development interventions -- including food aid distributions, local purchases, and cash vouchers – on producers’ welfare and market performance in the Sahel.

In September 2009, Jenny joined Tufts University as an Assistant Professor in the Economics Department and Fletcher School of Law and Diplomacy.