Under the title “Political Contestation and New Social Forces in the Middle East and North Africa,” the Program on Arab Reform and Democracy convened its 2018 annual conference on April 27 and 28 at Stanford University. Bringing together a diverse group of scholars from across several disciplines, the conference examined how dynamics of governance and modes of political participation have evolved in recent years in light of the resurgence of authoritarian trends throughout the region.

Delivering the opening remarks of the conference, Freeman Spogli Institute (FSI) and Hoover Institution Senior Fellow Larry Diamond reflected on the state of struggle for political change in the Middle East and North Africa (MENA) region. In a panel titled “Youth, Culture, and Expressions of Resistance,” FSI Scholar Ayca Alemdaroglu discussed strategies the Turkish state has pursued to preempt and contain dissent among youth. Adel Iskandar, Assistant Professor of Communications at Simon Fraser University, explained the various ways through which Egyptian youth employ social media to express political dissent. Yasemin Ipek, Assistant Professor of Global Affairs at George Mason University, unpacked the phenomenon of “entrepreneurial activism” among Lebanese youth and discussed its role in cross-sectarian mobilization.

The conference’s second panel, tilted “Situating Gender in the Law and the Economy,” featured Texas Christian University Historian Hanan Hammad, who assessed the achievements of the movement to fight gender-based violence in Egypt. Focusing on Gulf Cooperation Council states, Alessandra Gonzales, a Visiting Postdoctoral Fellow at the Stanford Institute for Economic Policy Research, analyzed the differences in female executive hiring practices across local and foreign firms. Stanford University Political Scientist and FSI Senior Fellow Lisa Blaydes presented findings from her research on women’s attitudes toward Female Genital Mutilation (FGM) in Egypt.

Speaking on a panel titled “Social Movements and Visions for Change,” Free University of Berlin Scholar Dina El-Sharnouby discussed the 2011 revolutionary movement in Egypt and the visions for social change it espouses in the contemporary moment. Oklahoma City University Political Scientist Mohamed Daadaoui analyzed the Moroccan regime’s strategies of control following the Arab Uprisings and their impact on various opposition actors. Nora Doaiji, a PhD Student in History at Harvard University, shared findings from her research examining the challenges confronting the women’s movement in Saudi Arabia.

The fourth panel of the conference, “The Economy, the State, and New Social Actors,” featured George Washington University Associate Professor of Geography Mona Atia, who presented on territorial restructuring and the politics governing poverty in Morocco. Amr Adly, an Assistant Professor of Political Science at the American University in Cairo, analyzed the relationship between the state and big business in Egypt after the 2013 military coup. Rice University Professor of Economics Mahmoud El-Gamal shared findings from his research on the economic determinants of democratization and de-democratization trends in Egypt during the past decade.

The final panel focused on the international and regional dimensions of the struggle for political change in the Arab world, and featured Hicham Alaoui, a Research Fellow at Harvard University’s Weatherhead Center for International Affairs, Georgetown University Political Scientist Daniel Brumberg, and Nancy Okail, the Executive Director of the Tahrir Institute for Middle East Policy.

The conference included a special session featuring former fellows of the American Middle Eastern Network at Stanford (AMENDS), an organization dedicated to promoting understanding around the Middle East, and supporting young leaders working to ignite concrete social and economic development in the region. AMENDS affiliates from five different MENA countries shared with the Stanford community their experiences in working toward social change in their respective countries.

How can we make sense of the tragedy in Syria? Northwestern University political scientist Wendy Pearlman has conducted open-ended interviews with more than 300 displaced Syrians across the Middle East and Europe from 2012 to 2017. She has brought together these personal stories in the acclaimed new book, We Crossed a Bridge and It Trembled: Voices from Syria (HarperCollins 2017). In a talk dated February 7, 2018, Pearlman shared a selection of voices from the book, along with her own commentary and analysis, to explain the origins and evolution of the Syrian conflict, as well as what it has been like for the ordinary people who have lived its unfolding. Co-hosted by the Program on Arab Reform and Democracy and the Abbasi Program in Islamic Studies, the talk offered a humanistic interpretation of the current conflict in Syria and how it has transformed those who have experienced it. The video of the talk is available through the link below.

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In Beijing’s bustling Chaoyang District stands a multi-story building known as the Gonghe Senior Apartments: a 400-bed nursing home for middle-income seniors who are disabled or suffer from dementia. Why is Gonghe unique and why is it worth considering? Because Gonghe is a public-private partnership (PPP), a collaborative organizational structure supported by the District Civil Affairs Bureau Welfare Division that donated the land and building and the nonprofit Yuecheng Senior Living that operates the facility. And because PPPs like Gonghe might just be the right model to address the challenges surrounding elderly care in China as well as in other nations that face a looming burden of population aging.

This was a core message shared by Alan Trager, founder and president of the PPP Initiative Ltd., who spoke at a special workshop organized by Shorenstein APARC’s Asia Health Policy Program (AHPP). Focused on PPPs in health and long-term care in China, the workshop was part of a two-day convening related to the Innovation for Healthy Aging project, a collaborative research project led by APARC Deputy Director and AHPP Director Karen Eggleston that identifies and analyzes productive public-private partnerships advancing healthy aging solutions in East Asia and other regions.

The Innovation for Healthy Aging project is driven by the imperative to respond to a world that is aging rapidly. This demographic transition, reminded Trager at the opening of his talk, is a defining issue of our time, as aging is a multisectoral issue that increases the demand for health care, long-term care, and a large number of other social services. The aging challenge is exacerbated by its convergence with the rising prevalence of non-communicable diseases (NCDs), also known as chronic diseases. For while NCDs affect all age groups, they account for the highest burden among the elderly.

China: Ground Zero for Global Aging

Alan Trager discusses health and long-term care in China in the GSB's Highly Immersive Classroom (Photo: Noa Ronkin)

The need to advance healthy aging and NCD prevention is a matter of grave concern in China, whose older population is larger than in any other country. Moreover, the aging challenge in China is interwoven with unique social trends. In particular, filial piety—which, for thousands of years, has been a fundamental family value and a mainstay of health and elder care—is under pressure, as young people strive to balance the demands of careers, fewer children per family, and migrating to cities for school and work, without affordable housing or long-term care financing support for their parents and other elderly relatives, who often stay in rural areas.

China’s health system is yet to adapt to the shift in the disease burden and health care needs driven by the aging population. Its existing health insurance programs are insufficient for outpatient management and care of chronic conditions, and as Trager emphasized, there is a lack of investment in training geriatric medicine professionals and incorporating geriatric principles into clinical practice.

How can China meet the high demand for elder care, increase workforce capacity, and promote healthy aging?

The answer, claims Trager, lies in developing multisector, integrated solutions to the challenges posed by population aging. While system-level efforts, such as building the social protection system and sustaining universal health coverage, continue to be led by the government, PPPs can play a major role in capacity building to ensure the sustainability of such systems through the advancement of technology, human resources, and innovation. Trager shared PPP Initiative Ltd.’s recent efforts to develop PPP solutions for aging populations in China and elsewhere. The workshop was held on October 10 at the Stanford GSB’s Highly Immersive Classroom, which is equipped with advanced video conferencing technology that allows participants in Palo Alto and at the Stanford Center at Peking University to collaborate in real-time. Experts from Beijing joined the discussion and followed Trager’s presentation with comments on how to move from awareness to action.

Private Efforts, Public Value

From left to right: John Donahue, Karen Eggleston, Richard Zeckhauser. (Photo: Thom Holme)

Public-private collaborations—or rather collaborative governance–in China as well as in the United States is the subject of an upcoming volume co-authored by Eggleston with Harvard scholars Richard Zeckhauser and John Donahue. Both Zeckhauser and Donahue joined Eggleston the following day, October 11, at an AHPP-hosted seminar to discuss this upcoming publication, titled Private Roles for Public Goals in China and the United States: Contracting, Collaboration, and Delegation.

Eggleston, Donahue, and Zeckhauser define collaborative governance as private engagement in public tasks on terms of shared discretion, where each partner bears responsibilities for certain areas. Their upcoming book explores public-private collaborations in China and the United States, two countries where public needs require solutions that far outstrip the capacities of their governments alone. Beyond considering merely health and elderly care, the book features research into public and private roles in the governance of multiple other sectors, including education, transport infrastructure, affordable housing, social services, and civil society.

At the seminar, the three scholars reviewed different models of private efforts providing public value, outlined the justifications for collaborative governance, and explained some of the conditions that make such collaborative partnerships productive and valuable. They emphasized the need to account for the unique contexts in China and the United States and to steer clear of one-size-fits-all solutions.

Imperative for the Young Generation

One thing, they all agree, applies to both countries: government collaboration with private entities is inevitable if China and the United States are to achieve their articulated goals and meet rapidly increasing demand for high-end public services.

This sentiment echoed a claim Trager made the preceding day: a tidal wave of noncommunicable diseases in an aging world is approaching us quickly and governments cannot handle it alone. Young people must care about advancing creative solutions to this pressing problem because they will be the ones who will pay for the consequences if we get it wrong.