Nutrition
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Abstract
The scope and complexity of global health can be overwhelming, making it difficult to form an inspiring and unified vision for the future. Mired in this complexity, the international community defines success disease by disease‹without a clear picture of what fundamental reform would actually look like. If the aspiration of global health with justice is the right goal, then answering three simple questions may pierce the haze.

First, what would global health look like? That is, given optimal priority-setting, funding, and implementation, to what level of health should we aspire, and with what provision of health-related services? Posing these three elementary questions, of course, oversimplifies a field that is fraught with tensions and trade offs. But I want to imagine a more ideal future for world health, with bold proposals to get there. After thinking about these three basic questions, I turn to an idea for innovative global governance for health‹a Framework Convention on Global Health.

Second, what would global health with justice look like? Global health seeks to improve all the major indicators of health, such as infant and maternal mortality and longevity. Global health with justice, however, requires that we look beyond improved health outcomes for the population as a whole. Although overall population health is vitally important, justice requires a significant reduction in health disparities between the well-off and the poor. Societies that achieve high levels of health and longevity for most, while the poor and marginalized die young, do not comport with social justice.

Third, what would it take to achieve global health with justice? That is, once we clearly state the goal, and meaning, of global health with justice, what concrete steps are required to reach this ambitious objective? This raises fundamental challenges, intellectually and operationally, as the response cannot be limited to ever-greater resources, but must also involve improved governance‹at the country and international level and across multiple sectors.

Lawrence O. Gostin is University Professor, Georgetown University’s highest academic rank conferred by the University President. Prof. Gostin directs the O’Neill Institute for National and Global Health Law and was the Founding O’Neill Chair in Global Health Law. He served as Associate Dean for Research at Georgetown Law from 2004 to 2008. He is Professor of Medicine at Georgetown University, Professor of Public Health at the Johns Hopkins University, and Director of the Center for Law & the Public’s Health at Johns Hopkins and Georgetown Universities.

 Prof. Gostin holds a number of international academic professorial appointments: Visiting Professor (Faculty of Medical Sciences) and Research Fellow (Centre for Socio-Legal Studies) at the University of Oxford, United Kingdom; the Claude Leon Foundation Distinguished Scholar and Visiting Professor at the University of Witwatersrand, Johannesburg, South Africa; and the Miegunyah Distinguished Visiting Fellow and Founding Fellow of the Centre for Advanced Studies (Trinity College), University of Melbourne. Prof. Gostin serves as Secretary and a member of the Governing Board of Directors of the Consortium of Universities for Global Health.

Building 200 (History Corner)
Room 205
Stanford University

Lawrence O. Gostin O'Neill Professor in Global Health Law Speaker Georgetown University
Seminars
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**** PLEASE NOTE CHANGE OF SPEAKER***

Dr. Susan Kasedde currently serves as Senior Advisor and Team Leader on HIV and Adolescents for UNICEF based in New York since November 2009. In this role, she has contributed towards global level evidence generation, technical guidance development, advocacy, global partnership development, and technical assistance towards the global response towards HIV prevention, treatment and care in adolescents aged 10 - 19. Since 2011, on behalf of UNICEF, Susan has coordinated a series of efforts including documentation of global practices in the care of adolescents living with HIV; mathematical modeling with the Futures Institute to assess the impact and cost of scale up of proven high impact HIV prevention, treatment and care interventions within a holistic response, on new HIV infections and AIDS deaths in adolescents; and a systematic review with the London School of Hygiene and Tropical Medicine to confirm evidence on effective approaches for programming to reduce HIV infection, illness and death in adolescents. This work has contributed to stronger advocacy and technical guidelines for programming for adolescents, a group of children previously largely neglected. In 2013, the documentation on adolescents living with HIV was a major contribution to the new WHO guidelines on HIV testing and counseling and care in adolescents. The impact modeling and systematic review are among a series of key papers that will be released in a special supplement on HIV prevention, treatment and care in adolescents at the International AIDS Society Conference in Melbourne, Australia in 2014.

 

 Susan joined UNICEF having served since 2007 as Regional Adviser with the UNAIDS Regional Office for Eastern & Southern Africa. In that role, she was responsible for coordinating analytic work on the epidemic and response and modes of HIV transmission in several high HIV burden countries, working extensively with government teams and partners in the highest HIV burden countries in the world to use an incidence model to predict the next 1000 new HIV infections and assess alignment of national strategies with the national epidemic. Susan has over 18 years of experience working on adolescents sexual and reproductive health of which 16 of those have been focused on HIV in adolescents. Susan holds a doctorate in Epidemiology and Population Health from the London School of Hygiene & Tropical Medicine, a Masters degree in Public Health from Boston University and Bachelors degrees in Biomedical Science and French. Susan is a national of Uganda and speaks English and French.

Building 200 (History Corner)
Room 205
Stanford University

Susan Kasedde Senior Advisor and Team Leader on HIV and Adolescents Speaker UNICEF
Seminars
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Africa (Proceedings of the National Academy of Sciences 2013): USAID and the UN's World Food Program have proposed strategies for allocating ready-to-use (therapeutic and supplementary) foods to children in developing countries. Analysis is needed to investigate whether there are better alternatives. We use a longitudinal data set of 5657 children from Bwamanda to construct a statistical model that tracks each child's height and weight  throughout the first five years of life. We embed this model into an optimization framework that chooses which individual children should receive food based on a child's sex, age, height and weight, to minimize the mean number of disability-adjusted life years per child subject to a budget constraint. Our proposed policy compares favorably to those proposed by the aid groups. Time permitting, we will also discuss a recent analysis of a nutrition program in Guatemala that quantifies the age dependence in the impact of supplementary food, and develops a food allocation policy that exploits this age dependence and reduces child stunting.

India: Motivated by India's nationwide biometric program for social inclusion, we analyze verification (i.e., one-to-one matching) in the case where we possess 12 similarity scores (for 10 fingerprints and two irises) between a resident's biometric images at enrollment and his biometric images during his first verification. At subsequent verifications, we allow individualized strategies based on these 12 scores: we acquire a subset of the 12 images, get new scores for this subset that quantify the similarity to the corresponding enrollment images, and use the likelihood ratio to decide whether a resident is genuine or an imposter. Compared to the policy currently used in India, our proposed policy provides a five-log (i.e., 100,000-fold) reduction in the false reject rate while only increasing the mean delay from 31 to 38 seconds.

A full speaker bio is available on CISAC's website. 

CISAC Conference Room

Graduate School of Business
Stanford University
Stanford, CA 94305-5015

(650) 724-1676 (650) 725-0468
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Jeffrey S. Skoll Professor of Management Science
CISAC Affiliated Faculty Member
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PhD

Lawrence Wein is the Jeffrey S. Skoll Professor of Management Science at the Graduate School of Business, Stanford University, and an affiliated faculty member at CISAC. After getting a PhD in Operations Research from Stanford University in 1988, he spent 14 years at the Sloan School of Management at MIT, where he was the DEC Leaders for Manufacturing Professor of Management Science. His research interests include mathematical models in operations management, medicine and biology.

Since 2001, he has analyzed a variety of homeland security problems. His homeland security work includes four papers in Proceedings of the National Academy of Sciences, on an emergency response to a smallpox attack, an emergency response to an anthrax attack, a biometric analysis of the US-VISIT Program, and an analysis of a bioterror attack on the milk supply. He has also published the Washington Post op-ed "Unready for Anthrax" (2003) and the New York Times op-ed "Got Toxic Milk?", and has written papers on port security, indoor remediation after an anthrax attack, and the detention and removal of illegal aliens.

For his homeland security research, Wein has received several awards from the International Federation of Operations Research and Management Science (INFORMS), including the Koopman Prize for the best paper in military operations research, the INFORMS Expository Writing Award, the INFORMS President’s Award for contributions to society, the Philip McCord Morse Lectureship, the Frederick W. Lanchester Prize for best research publication, and the George E. Kimball Medal. He was Editor-in-Chief of Operations Research from 2000 to 2005, and was elected to the National Academy of Engineering in 2009.   

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Lawrence Wein Jeffrey S. Skoll Professor of Management Science; CISAC Affiliated Faculty Member Speaker
Seminars

Urbanization and obesity-related chronic diseases are cited as threats to the future health of India's older citizens. With 50% of deaths in adult Indians currently due to chronic diseases, the relationship of urbanization and migration trends to obesity patterns have important population health implications for older Indians. The researchers constructed and calibrated a set of 21 microsimulation models of weight and height of Indian adults. The models separately represented current urban and rural populations of India's major states and were further stratified by sex.

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A tremendous amount of radioactive products were discharged as a result of the accident at the Fukushima nuclear power plant in March 2011, which resulted in radioactive contamination of the plant and surrounding areas. While geographical distribution of radioactive iodine, tellurium, and cesium in the surface soils was smoothly (but not always systematically) widespread all over the region, health risk information by the government, media, and other organizations is most likely to be given in terms of administrative boundaries (cf. prefectures, municipalities, etc.) and/or distance from the radiation source.

This paper estimates the effect of such health risk information rather than the actual health risks of radiation on land and other prices in different locations. We find that the prefecture and municipality border effects – but not the distance effect from the nuclear power plant – are significantly related to a reduction in land and other prices after the accident. This shows that people responded to health risk information based on administrative boundaries rather than the actual health risk of radiation after the disaster. Although health risk information based on prefecture and municipality boundaries has an obvious advantage of distilling large and complex risk information into a simple one, the government, media, and other organizations need to recognize and carefully examine the potential of misclassifying non-contaminated areas into contaminated prefectures. Doing so will avoid unintentional consequences to the region’s economy.

Hiroaki Matsuura is currently Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies, University of Oxford and a Junior Research Fellow of St. Antony’s College. His main interests are health economics and demography, with a special interest in the relation between laws and population health. Hiroaki received his B.A. in Economics from Keio University, M.A. in Social Science from the University of Chicago, M.S. in Project Management from Northwestern University’s McCormick School of Engineering and Applied Science, and Sc.D. in Global Health and Population (Economics track) from Harvard University’s School of Public Health. In the past, he was affiliated with Institute of Quantitative Social Sciences, Human Rights in Development, and Takemi Program in International Health at Harvard University. He also worked as a research assistant at the National Bureau of Economic Research. His doctoral dissertation research explores a right to health or to health care in national constitutions of 157 countries and state constitutions of the 50 U.S. states and estimates the impact of introducing (or removing) a right to health or to health care into national and state constitutions on health system and population health outcomes. His most recent article, “The Right to Health in Japan: Challenges of a Super Aging Society and Implication from Its 2011 Public Health Emergency” (with Eriko Sase) will be appeared on “Advancing the Human Right to Health”, edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, Oxford University Press, 2013. 

Daniel and Nancy Okimoto Conference Room

Hiroaki Matsuura Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies Speaker University of Oxford
Seminars
Paragraphs

This study uses a randomized controlled trial of a school-based anemia reduction program in rural China to examine how increased school emphasis on health promotion affects academic performance. Although education and health promotion are complementary functions of schools, they do compete for finite school resources. We compare the effects of a traditional program that provided only information about anemia and subsidies to an otherwise identical program that included performance incentives for school principals based on school-level anemia prevalence. By the end of the trial, exam scores among students who were anemic at baseline improved under both versions of the program, but scores among students in the incentive group who were healthy at baseline fell relative to healthy students in the control group. Results suggest that performance incentives to improve student health increase the impact of school-based programs on student health outcomes, but may also lead to reallocation of school resources.

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Journal Articles
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Economics of Education Review
Authors
Sean Sylvia
Renfu Luo
Linxiu Zhang
Yaojiang Shi
Alexis Medina
Alexis Medina
Scott Rozelle
Scott Rozelle
Paragraphs

Distributed irrigation systems are those in which the water access (via pump or human power), distribution (via furrow, watering can, sprinkler, drip lines, etc.), and use all occur at or near the same location. Distributed systems are typically privately owned and managed by individuals or groups, in contrast to centralized irrigation systems, which tend to be publicly operated and involve large water extractions and distribution over significant distances for use by scores of farmers. Here we draw on a growing body of evidence on smallholder farmers, distributed irrigation systems, and land and water resource availability across sub-Saharan Africa (SSA) to show how investments in distributed smallholder irrigation technologies might be used to (i) use the water sources of SSA more productively, (ii) improve nutritional outcomes and rural development throughout SSA, and (iii) narrow the income disparities that permit widespread hunger to persist despite aggregate economic advancement.

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Journal Articles
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Proceedings of the National Academy of Sciences
Authors
Jennifer Burney
Jennifer Burney
Rosamond L. Naylor
Rosamond Naylor
Sandra L. Postel
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There is little evidence showing whether health information transmitted via text messages can change health and educational outcomes. We conducted a randomized field experiment involving 900 primary students in rural China to study whether a health education campaign conducted via text message could affect caregiver knowledge or student outcomes. When caregivers received both weekly health messages and monthly quiz questions (testing retention of the information conveyed in the weekly messages), caregiver knowledge improved and students experienced gains in both health and academic performance. When caregivers received weekly health messages only, there was no impact on caregiver knowledge or student outcomes.

 

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Journal Articles
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World Development
Authors
Di Mo
Renfu Luo
Chengfang Liu
Huiping Zhang
Linxiu Zhang
Alexis Medina
Alexis Medina
Scott Rozelle
Scott Rozelle
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