Stanford University

Alexandra Popke

0
CDDRL Honors Student, 2021-22
headshot_-_alexandra_julianna_popke.jpg

Major: International Relations
Minor: Art History, Spanish
Hometown: Euless, TX   
Thesis Advisor: Kathryn Stoner

Tentative Thesis Title: On the Road to Authoritarianism: China’s Belt and Road Initiative as an Explanation for Eastern European Democratic Decline

Future aspirations post-Stanford: I plan to obtain a JD/MBA with the intent of working at the intersection of business and law in the private sector.

A fun fact about yourself: I studied under a portrait artist in high school and competed nationally with my art!

Recent Advances in the Development of an Alternative Global Rare Earth Supply Chain

-

For spring quarter 2022, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

YouTube

 

                                                                                           

About the Event: With China's rapid rise and the reemergence of Russia as a major power, the global stage is set for multipolar competition for critical metals that support a variety of advanced technologies and provide the foundation for energy transitions, communication, and a reduction in greenhouse gas emissions. While the sources of rare earth elements (REEs) are slowly expanding, the REEs are finding accelerated demand in more applications, such as in electric vehicle batteries and permanent magnet motors. Consequently, many national initiatives are designed to respond to growing demand by discovering new ore deposits, finding substitute elements for specific applications, developing separation and extraction technologies, or recycling end-of-life (EOL) products. Despite these national initiatives, the current global REE supply chain is still highly imbalanced and tightly controlled by just a few countries. Such an imbalance of the critical metals supply chain poses a significant challenge to the energy transition and national security of many countries worldwide. With an in-depth analysis, this research offers insights into the current progress in developing an alternative REE supply chain and the possibilities of future strategic, technological, and economic international engagements.
 

About the Speaker: Dr. Gorakh Pawar is a visiting scholar at Stanford’s Center for International Security and Cooperation (CISAC). Dr. Pawar holds a doctorate in Mining Engineering and a Master of Science in Mechanical Engineering. Dr. Pawar is researching the global imbalanced critical material supply chain that poses a significant challenge to the energy transition and national security of many countries worldwide. Dr. Pawar is also a research scientist at the Idaho National Laboratory of the United States Department of Energy and a recipient of the Early Career Exceptional Achievement Award of Idaho National Laboratory. Dr. Pawar has spearheaded many projects resolving the fundamental scientific bottlenecks in advancing clean energy technologies.

Virtual to Public. Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. 

Gorakh Pawar
Seminars
Research Seminar Series

Foreign Policy in Hard Economic Times

-

For winter quarter 2022, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

                                                                                           

About the Event: Freddy Chen has developed a domestic political theory to explain the consequences of economic shocks for foreign policy. He argues that political leaders have incentives to improve their perceived competence by linking economic grievances to foreign countries. This linkage, in turn, increases public desire for more hawkish foreign policy. Nonetheless, leaders’ ability to make such connections depends on whether they can successfully manipulate information about the culpability for economic shocks. Therefore, the extent to which leaders can control the information environment determines whether an economic shock leads to more aggressive foreign policy. Survey experiments fielded on the American public and a unique sample of U.S. foreign policy analysts show that the information environment shapes elites’ expectations about leaders’ political behavior, public perceptions of leader competence, perceived culpability for the economic shock, and public preferences over foreign policy. Moreover, a cross-national analysis demonstrates that an economic shock tends to increase foreign policy hawkishness if the shock is more foreign-related or if the public has less access to a potential voice of the opposition. This article advances our understanding of the relationship between economic shocks, foreign policy, and public opinion as well as the interactions between domestic politics and international relations, with important implications for both political science research and policymakers.

About the Speaker: Frederick Chen is a Ph.D. Candidate in the Department of Political Science at the University of Wisconsin–Madison and currently a Pre-doctoral Fellow at the Center for International Security and Cooperation at Stanford University. His research focuses on how economics and security can interact to influence international relations, particularly through domestic political mechanisms. His work has appeared in the Journal of Politics and Conflict Management and Peace Science. He received the David A. Lake Award for best paper from the International Political Economy Society. He earned his M.A. in International Relations from Peking University (2016) and B.A. in International Politics from Tsinghua University (2013).

Virtual to Public. Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. 

Frederick R. Chen CISAC
Seminars
Research Seminar Series

Invasions Are Not Contagious

Authors
Oriana Skylar Mastro
News Type
Commentary
Date
Paragraphs

This essay was originally published in Foreign Affairs magazine.

As Russian President Vladimir Putin intensifies his assault on Ukraine, a growing number of U.S. military and foreign policy analysts are voicing concern that China may be emboldened by Russia’s example and try to take Taiwan by force. “If Russia can grab chunks of Ukraine or install a puppet regime and withstand economic sanctions, that could embolden nationalists in China to look to Taiwan and think they could do the same,” Ian Johnson, a China expert at the Council on Foreign Relations, has argued. Representative Michael McCaul, Republican of Texas, made a similar argument in an interview last month, as did retired Army General Jack Keane, who said that Chinese President Xi Jinping sees “weakness in the West and how that can advantage him in terms of his national objectives as well.”

Xi is certainly watching events in Ukraine, but his calculus for whether to use force against Taiwan is shaped primarily by domestic factors, not foreign ones. As I have argued in Foreign Affairs, Chinese leaders are considering “armed reunification” with Taiwan more seriously than at any time in the last 50 years. But Xi will assert Chinese control over the island only if he is confident his military can conduct a successful amphibious invasion and if he believes the timing is right for his own career.

Sign up for our newsletters to receive in-depth analysis from our experts.


Shifts in the international environment would be important for Taiwan if they changed Xi’s thinking on either count. But the war in Ukraine has not. Xi’s views about U.S. power and resolve and about the likely international response to an invasion of Taiwan probably remain unchanged. If anything, China’s desire not to invite comparisons with Russia at a time when the world is united against Moscow will lengthen its timeline for taking control of Taiwan, not shorten it.

Too Big to Sanction?

The economic sanctions that the United States, Canada, and many European countries have imposed on Russia give China little reason for pause. To the contrary, these punitive measures simply confirm Beijing’s previous assessments of the possible economic repercussions of using force against Taiwan. Chinese leaders expect the economic costs of an invasion to be heavy but acceptable—partly because of how the international community has responded to Chinese provocations in the past and partly because Beijing’s foreign policy is designed to convince countries to stay out of China’s “internal” affairs, such as the status of Taiwan.

That is not to say the economic measures Washington and its allies have imposed on Russia in recent days are insignificant. The United States and European countries have blocked Russia’s access to most of its foreign currency reserves, making it impossible for Moscow to intervene to prop up its collapsing currency. They have frozen the assets of senior Russian officials, including Putin himself. And they have moved to exclude big Russian banks from SWIFT, the global financial messaging system.

China’s ability to retaliate against the West with economic sanctions of its own is much greater than Russia’s.
Oriana Skylar Mastro

But the United States and its allies could do more to punish Russia. They could bar all transactions with Russia, whether trade or financial. They could seize all Russian assets within their jurisdictions. Washington could announce secondary sanctions on anyone using U.S. dollars for any transaction with Russia. Most important, the United States could use these and other measures to prevent Russia from exporting oil and gas. Letting Russia continue to export oil and gas would be like letting China sell consumer electronics even after it had taken Taiwan by force.

If the United States and its allies have been cautious in their response to Russia, they are likely to be even more restrained when responding to China — and Beijing knows it. China’s ability to retaliate against the West with economic sanctions of its own is much greater than Russia’s. Singapore, which announced trade and banking restrictions against Moscow, trades about $2.5 billion worth of goods with Russia each year — but $57 billion worth of goods with China. China’s leaders likely do not fear U.S.-led economic sanctions in the event of a Taiwan takeover because they probably think that China’s own productive capacity, resources, and friendly partners will allow them to survive on their own, especially since China will soon be the world’s largest economy. They are probably right. China could absorb the types of sanctions being imposed on Russia. And given China’s ability to inflict pain on Western countries, any measures levied against Beijing would likely be softer than those imposed on Moscow.

Taiwan Is Not Ukraine

The Western military response to Russia’s invasion of Ukraine will have an even smaller impact than sanctions on China’s thinking about Taiwan. True, neither the United States nor NATO has deployed troops to fight on Ukraine’s behalf. And U.S. military assistance to Ukraine has been modest: late last month, President Joe Biden instructed the State Department to release up to an additional $350 million worth of weapons from U.S. stocks to Ukraine.

But Russia would have to invade a NATO ally without provoking a U.S. military response for Chinese leaders to seriously question Washington’s commitment to defending Taiwan. Biden has made clear from the beginning of the crisis that his administration will never send troops to Ukraine—a stark contrast with his rhetoric on Taiwan. Just last week, Biden stated unequivocally that the United States would defend Taiwan in the event of a Chinese attack. As a show of support, he also sent to the island a delegation of former U.S. officials led by Mike Mullen, a former chairman of the Joint Chiefs of Staff.

Chinese planners largely assume the United States would intervene militarily on behalf of Taiwan.
Oriana Skylar Mastro

In any case, Chinese planners largely assume the United States would intervene militarily on behalf of Taiwan. What some of them question is whether the United States could amass enough forces fast enough to blunt a Chinese assault on the island. Ironically, if the United States had launched a military operation in response to Russia’s invasion of Ukraine, Chinese leaders would have had further reason to question Washington’s ability to thwart a Chinese assault on Taiwan. The United States does not have the resources to fight the Russians in Europe and prepare adequately for a great-power war in Asia.  

Of course, these facts have not prevented China from trying to manipulate the narrative to undermine Taiwan’s resolve. Chinese state media has been flush with stories about how the United States did not come to Ukraine’s aid and therefore won’t come to Taiwan’s either. Like much of what appears on Chinese state media, however, these stories reflect what Chinese leaders want the world to believe—not what they believe themselves.

Not the Right Time

Chinese leaders are without a doubt considering an attack on Taiwan, but now is not the right time. China’s military is still honing the capabilities it would need to take and hold the island. And Xi is unlikely to take a dangerous gamble on Taiwan before the next Party Congress in late 2022, when he is widely expected to secure a third term as general secretary of the Chinese Communist Party. Xi is also working hard to lessen China’s technological dependence on the West, thus minimizing the impact on any further decoupling after a possible war. For all these reasons, an assault on Taiwan before 2025 is unlikely.

If anything, the crisis in Ukraine creates an additional incentive for China to wait. Beijing does not want the world to equate the two scenarios. From China’s perspective, Ukraine is an independent country engaged in a border dispute with Russia. Taiwan, by contrast, “has always been an inalienable part of China’s territory,” as China’s ambassador to the Association of Southeast Asian Nations, Deng Xijun, put it late last month. In other words, linking the two issues would undermine China’s claim to the island.

China also understands that moving against Taiwan now would solidify fears in the West of an axis of autocrats. The United States may not have the resolve to fight a protracted war to defend Taiwan. But suddenly faced with a need to defend freedom and democracy against an authoritarian alliance, Washington could muster a greater military response and convince its allies to do the same. Partly for this reason, China has desperately tried to maintain some semblance of neutrality during the Ukrainian crisis.

Russia’s invasion of Ukraine has certainly changed aspects of the international order. It has rallied European countries against Russia, prompted Germany to increase defense spending, and even convinced historically neutral countries such as Finland, Sweden, and Switzerland to take a stance against Moscow. From China’s perspective, however, nothing Russia or its adversaries have done meaningfully alters the calculus on Taiwan. 

Headshot of Oriana Skylar Mastro

Oriana Skylar Mastro

Center Fellow at the Freeman Spogli Institute for International Studies

Deterrence and Defense Across the Taiwan Strait

Learn more about Oriana Skylar Mastro's research project analyzing the political and strategic dynamics underpinning deterrence in the region.
Explore research project page

Read More

Army Reserve members during practice
Commentary

Ukraine Is a Distraction from Taiwan

Getting bogged down in Europe will impede the U.S.’s ability to compete with China in the Pacific.
Ukraine Is a Distraction from Taiwan
President Xi and Kim Jong Un meet on a TV screen
Commentary

North Korea Is Becoming an Asset for China

Pyongyang’s Missiles Could Fracture America’s Alliances
North Korea Is Becoming an Asset for China
Chinese military propaganda depicting the Second Taiwan Strait Crisis of 1958.
News

Reassessing China’s Capabilities and Goals for Strategic Competition

On the World Class podcast, Oriana Skylar Mastro argues that in order to set effective policy toward China, the United States needs to better understand how and why China is projecting power.
Reassessing China’s Capabilities and Goals for Strategic Competition
Hero Image
All News button
1
Subtitle

Russia’s War in Ukraine Doesn’t Presage a Chinese Assault on Taiwan

Russia, Ukraine and NATO: The View from Paris

-

 All CISAC events are scheduled using the Pacific Time Zone. 
 

SEMINAR RECORDING

YouTube

 

About the Event: Europe's attention has been transfixed for more than two months by the Russian military build-up near Ukraine, efforts to coordinate a trans-Atlantic response, and contacts with Russia and Ukraine.  France has been closely involved in shaping the West's policy and diplomacy, and President Macron in February visited both Moscow and Kyiv.  Sylvie Kauffmann, editorial director, leader writer and columnist for Le Monde, will discuss how the crisis has been viewed in Paris and the French government's policy response.

 

About the Speaker: Sylvie Kauffmann is Editorial Director, Leader Writer and Columnist for Le Monde, writing a weekly column on global affairs. Her opinions on European and international politics have also appeared in the New York Times. Previously, she was the first female Editor-in-Chief of Le Monde, including during the Wikileaks collaboration with El País, the Guardian and the New York Times. She has reported from Asia, Eastern Europe and the United States, where she wrote a prize-winning series of articles about life in America following the 9/11 attacks. Kauffmann graduated from the Institut d’Études Poltiques Aix-en-Provence and the faculty of law at the University of Provence Aix-Marseille.

Virtual only.

Sylvie Kauffmann
Seminars
European Security Initiative

Ukraine Is a Distraction from Taiwan

Authors
Oriana Skylar Mastro
Elbridge Colby
News Type
Commentary
Date
Paragraphs

This commentary was originally published by The Wall Street Journal.

A Russian invasion of Ukraine would be the most consequential use of military force in Europe since World War II and could put Moscow in a position to threaten U.S. allies in Europe. Many in the American foreign-policy establishment argue that the appropriate U.S. response to any such invasion is a major American troop deployment to the Continent. This would be a grave mistake.

The U.S. can no longer afford to spread its military across the world. The reason is simple: an increasingly aggressive China, the most powerful state to rise in the international system since the U.S. itself. By some measures, China’s economy is now the world’s largest. And it has built a military to match its economic heft. Twenty-five years ago, the Chinese military was backward and obsolete. But extraordinary increases in Beijing’s defense budget over more than two decades, and top political leaders’ razor-sharp focus, have transformed the People’s Liberation Army into one of the strongest militaries the world has ever seen.

Sign up for APARC newsletters to receive our experts' commentary and analysis.

China’s new military is capable not only of territorial defense but of projecting power. Besides boasting the largest navy in the world by ship count, China enjoys some capabilities, like certain types of hypersonic weapons, that even the U.S. hasn’t developed.

Most urgently, China poses an increasingly imminent threat to Taiwan. Xi Jinping has made clear that his platform of “national rejuvenation” can’t be successful until Taiwan unifies with the mainland—whether it wants to or not. The PLA is growing more confident in its ability to conquer Taiwan even if the U.S. intervenes. Given China’s military and economic strength, China’s leaders reasonably doubt that the U.S. or anyone else would mount a meaningful response to an invasion of Taiwan. To give a sense of his resolve, Mr. Xi warned that any “foreign forces” standing in China’s way would have “their heads . . . bashed bloody against a Great Wall of steel forged by over 1.4 billion Chinese people.”

If Taiwan falls into Chinese hands, the U.S. will find it harder to defend critical allies like Japan and the Philippines, while China will be able to project its naval, air and other forces close to the U.S. and its territories

The U.S. must defend Taiwan to retain its credibility as the leader of a coalition for a free and open Indo-Pacific. From a military perspective, Taiwan is a vital link in the first island chain of the Western Pacific. If Taiwan falls into Chinese hands, the U.S. will find it harder to defend critical allies like Japan and the Philippines, while China will be able to project its naval, air and other forces close to the U.S. and its territories. Taiwan is also an economic dynamo, the ninth-largest U.S. trading partner of goods with a near-monopoly on the most advanced semiconductor technology—to which the U.S. would most certainly lose access after a war.

The Biden administration this month ordered more than 6,000 additional U.S. troops deployed to Eastern Europe, with many more potentially on the way. These deployments would involve major additional uncounted commitments of air, space, naval and logistics forces needed to enable and protect them. These are precisely the kinds of forces needed to defend Taiwan. The critical assets—munitions, top-end aviation, submarines, and intelligence, surveillance and reconnaissance capabilities—that are needed to fight Russia or China are in short supply. For example, stealthy heavy bombers are the crown jewel of U.S. military power, but there are only 20 in the entire Air Force.

The U.S. has no hope of competing with China and ensuring Taiwan’s defense if it is distracted elsewhere. It is a delusion that the U.S. can, as Pentagon press secretary John Kirby said recently, “walk and chew gum at the same time” with respect to Russia and China. Sending more resources to Europe is the definition of getting distracted. Rather than increasing forces in Europe, the U.S. should be moving toward reductions.

To be blunt: Taiwan is more important than Ukraine. America’s European allies are in a better position to take on Russia than America’s Asian allies are to deal with China.

There is a viable alternative for Europe’s defense: The Europeans themselves can step up and do more for themselves, especially with regard to conventional arms. This is well within Europe’s capacity, as the combined economic power of the NATO states dwarfs that of Russia. NATO allies spend far more on their militaries than Russia. To aid its European allies, the U.S. can provide various forms of support, including lethal weapons, while continuing to remain committed to NATO’s defense, albeit in a more constrained fashion, by providing high-end and fungible military capabilities. The U.S. can also continue to extend its nuclear deterrent to NATO.

The U.S. should remain committed to NATO’s defense but husband its critical resources for the primary fight in Asia, and Taiwan in particular. Denying China the ability to dominate Asia is more important than anything that happens in Europe. To be blunt: Taiwan is more important than Ukraine. America’s European allies are in a better position to take on Russia than America’s Asian allies are to deal with China. The Chinese can’t be allowed to think that America’s distraction in Ukraine provides them with a window of opportunity to invade Taiwan. The U.S. needs to act accordingly, crisis or not.

Ms. Mastro is a center fellow at the Shorenstein Asia-Pacific Research Center, part of Stanford’s Freeman Spogli Institute for International Studies, and a nonresident senior fellow at the American Enterprise Institute. Mr. Colby is a principal at the Marathon Initiative and author of “The Strategy of Denial: American Defense in an Age of Great Power Conflict.”

Headshot of Oriana Skylar Mastro

Oriana Skylar Mastro

Center Fellow at the Freeman Spogli Institute for International Studies
Full Biography

Read More

President Xi and Kim Jong Un meet on a TV screen
Commentary

North Korea Is Becoming an Asset for China

Pyongyang’s Missiles Could Fracture America’s Alliances
North Korea Is Becoming an Asset for China
Chinese military propaganda depicting the Second Taiwan Strait Crisis of 1958.
News

Reassessing China’s Capabilities and Goals for Strategic Competition

On the World Class podcast, Oriana Skylar Mastro argues that in order to set effective policy toward China, the United States needs to better understand how and why China is projecting power.
Reassessing China’s Capabilities and Goals for Strategic Competition
Taiwan Wall
Commentary

Would the United States Come to Taiwan's Defense?

On CNN's GPS with Fareed Zakaria, APARC Center Fellow Oriana Skylar Mastro shares insights about China's aspirations to take Taiwan by force and the United States' role, should a forceful reunification come to pass.
Would the United States Come to Taiwan's Defense?
Hero Image
All News button
1
Subtitle

Getting bogged down in Europe will impede the U.S.’s ability to compete with China in the Pacific.

Mother Nature, Bioweapons and Lab Accidents: Guarding Against the Next Global Biological Catastrophe

-

For winter quarter 2022, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

YouTube

                                                                                           


About the Event: With the devastating loss of life, economic disruption, and political instability it has wrought, COVID-19 has revealed that national governments and the international community are woefully unprepared to respond to pandemics—underscoring the world’s vulnerability to future catastrophic biological threats that could meet or exceed the severe consequences of the current pandemic. To effectively guard against future biological risks, leaders should take a longer-term view and recognize that, while naturally occurring pandemics remain a threat, the next global catastrophe could result from a laboratory accident or the deliberate misuse of bioscience and biotechnology.   This talk will provide a high-level overview of the broader biothreat landscape and outline actions that national leaders and the international community should take with a view to preventing catastrophic biological events—specifically by constraining capabilities and shaping the intent of powerful actors who may wish to exploit the tools of modern bioscience to cause harm. This talk will outline two priority NTI initiatives to strengthen international capabilities to prevent catastrophic biological events. We are working to develop and launch the International Biosecurity and Biosafety Initiative for Science (IBBIS), a new international organization that will focus on preventing the deliberate abuse or accidental misuse of bioscience and biotechnology by strengthening international biosecurity norms and developing innovative, practical tools to reduce risks throughout the research and development life cycle. NTI is also working to develop the concept of a new Joint Assessment Mechanism to strengthen UN-system capabilities to investigate high-consequence biological events of unknown origin. The ability to rapidly discern the source of emerging pandemics is critical to mitigating their effects in real time and protecting against future risks.
 

About the Speaker: Dr. Jaime M. Yassif is Senior Director and Lead Scientist for Global Biological Policy and Programs at NTI, where her work focuses on strengthening governance of dual-use bioscience and reducing global catastrophic biological risks. Yassif previously served as a Program Officer at Open Philanthropy, where she led the Biosecurity and Pandemic Preparedness initiative. In this role, she managed approximately $40 million in biosecurity grants, which rebuilt the field and supported work in several key areas, including developing new biosecurity programming at leading think tanks, establishing the Global Health Security Index, and initiating new biosecurity work in China and India. Prior to this, Yassif served as a science and technology policy advisor at the U.S. Department of Defense and worked on the Global Health Security Agenda at the U.S. Department of Health and Human Services.

Virtual to Public. Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. 

Jaime Yassif NTI
Seminars
Research Seminar Series

Russia, Ukraine and NATO: The View from London

-

 All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

YouTube
 

                      

About the Event: The Russian military continues to mass forces near Ukraine, while the Kremlin says that the United States and NATO have addressed its secondary concerns but have ignored its key demands, such as that the Alliance foreswear further enlargement. Britain has played a critical role in NATO deliberations on how to respond to Moscow proposals and actions, and the British military is sending additional forces to bolster the Alliance's eastern flank. Sir Roderic Lyne, a former British ambassador to Russia and former foreign policy advisor to the prime minister, will describe how the crisis is viewed in London, the motivations driving Russian actions, and how the West should respond.

 

About the Speaker: Roderic Lyne served in the UK's Diplomatic Service for 34 years, including three postings to Moscow between 1972 and 2004, and was the last Head of the Soviet Department in the Foreign Office. In the mid-1990s he was the adviser to the Prime Minister on foreign affairs, security and Northern Ireland. Since retiring as Ambassador to the Russian Federation in 2004 he has visited Russia about fifty times as a business consultant and lecturer, and has written extensively on the subject. His most recent article was "Putin's Gamble: Must It End Up As Lose/Lose", published by Chatham House in late January. From 2009 to 2016 Roderic Lyne served on the UK's Inquiry into the Iraq conflict of 2003.

Virtual only.

Sir Roderic Lyne
Seminars
European Security Initiative

COVID-19 Disproportionately Affected Marginalized and Rural Populations in Asia, New Study Shows

Authors
Noa Ronkin
News Type
News
Date
Paragraphs

As the COVID-19 pandemic remains a crucial global public health threat, pandemic control measures such as lockdowns and mobility restrictions continue to disrupt the provision of health services, leading to reduced healthcare use. Indeed, evidence shows the pandemic has emerged as a particular challenge for people with chronic conditions such as diabetes and hypertension. Yet there is limited data comparing the pandemic’s impact on access to care and the severity of chronic disease symptoms at the population level across Asia.

Now a new collaborative study, published by the Asia Pacific Journal of Public Health, addresses this limitation. The study co-authors, including APARC’s Asia Health Policy Program Director and FSI Senior Fellow Karen Eggleston, offer the first report comparing the impacts of the COVID-19 pandemic and its associated mobility restrictions on people with chronic conditions at different stages of socio-demographic and economic transitions in five Asian regions — India, China, Hong Kong, Korea, and Vietnam.

The findings show that the pandemic has disproportionately disrupted healthcare access and worsened diabetes symptoms among marginalized and rural populations in Asia. Moreover, the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19, with the resulting delayed and foregone care leading to uncertain longer-term effects.

 [Sign up for APARC newsletters to receive the latest research by our scholars]

Unintended Adverse Consequences

Routine screening, risk factor control, and continuity of care for non-communicable diseases are a global challenge. The COVID-19 pandemic has exacerbated the challenge even further. Existing reports show the pandemic has particularly adverse impacts on essential prevention and treatment services for people with chronic conditions. These reductions in health services arose from pandemic-associated factors such as mobility restrictions, lack of public transport, and lack of health workforce.

Eggleston and a group of colleagues set out to provide evidence on how the pandemic has impacted chronic disease care in diverse settings across Asia during COVID-19-related lockdowns. Using standardized questionnaires, the researchers surveyed 5672 participants aged 55.9 to 69.3 years with chronic conditions in India, China, Hong Kong, Korea, and Vietnam. The researchers collected data on participants’ demographic and socio-economic status, comorbidities, access to healthcare, employment status, difficulty in accessing medicines due to financial and nonfinancial (COVID-19 related) reasons, treatment satisfaction, and severity of their chronic condition symptoms.

If no immediate actions are taken to mitigate pandemic impacts, the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal target 3.4 to reduce premature mortality from non-communicable diseases […] and to promote mental health and wellbeing.
Karen Eggleston et al.

The results show that the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19. Study participants with chronic conditions faced significant challenges in managing their symptoms during the pandemic. They experienced a loss of income and difficulties in accessing healthcare or medications, with the resulting delayed and foregone care leading to uncertain longer-term effects. For a nontrivial portion of participants, these factors are associated with the worsening of diabetes symptoms. The threat is twofold among people living in rural populations with limited access, availability, and affordability of healthcare services.

A Global Health Priority

The unintended adverse consequences of the COVID-19 pandemic on chronic disease care may also further aggravate inequality in health outcomes. “If the trend continues and no immediate actions are taken to mitigate pandemic impacts,” Eggleston and her colleagues caution, then “the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal (SDG) target 3.4 to reduce premature mortality from non-communicable diseases by a third relative to 2015 levels and to promote mental health and wellbeing.”

Addressing the pandemic’s unintended negative social and economic impacts on chronic disease care is a global health priority, determine the researchers. They propose several measures to help provide timely care for people with chronic conditions in resource-constrained settings. These include implementing innovations in healthcare delivery models to improve the adoption of healthy lifestyle changes and self-management of chronic disease and mild COVID-19 symptoms, increasing investment in interventions to provide social and economic support to disadvantaged populations, and strengthening primary healthcare infrastructure and support of healthcare providers.

The study was supported in part by funding from Shorenstein APARC’s faculty research award, Stanford King Center for Global Development, and a seed grant from the Stanford Center for Asian Health Research and Education.

Read More

A woman at a desk in a village medical clinic in China.
News

Strengthening the Frontline: How Primary Health Care Improves Net Value in Chronic Disease Management

Empirical evidence by Karen Eggleston and colleagues suggests that better primary health care management of chronic disease in rural China can reduce spending while contributing to better health.
Strengthening the Frontline: How Primary Health Care Improves Net Value in Chronic Disease Management
Closeup on hands holding a glucometer
News

A New Validated Tool Helps Predict Lifetime Health Outcomes for Prediabetes and Type 2 Diabetes in Chinese Populations

A research team including APARC's Karen Eggleston developed a new simulation model that supports the economic evaluation of policy guidelines and clinical treatment pathways to tackle diabetes and prediabetes among Chinese and East Asian populations, for whom existing models may not be applicable.
A New Validated Tool Helps Predict Lifetime Health Outcomes for Prediabetes and Type 2 Diabetes in Chinese Populations
money
News

Bargaining Behind Closed Doors: Why China’s Local Government Debt Is Not a Local Problem

New research in 'The China Journal' by APARC’s Jean Oi and colleagues suggests that the roots of China’s massive local government debt problem lie in secretive financing institutions offered as quid pro quo to localities to sustain their incentive for local state-led growth after 1994
Bargaining Behind Closed Doors: Why China’s Local Government Debt Is Not a Local Problem
Hero Image
covid_vietnam_barricade_gettyimages-1235178941.jpg
All News button
1
Subtitle

In the first report of its kind comparing the impacts of the pandemic on people with chronic conditions in five Asian regions, researchers including APARC’s Karen Eggleston document how the pandemic’s broad social and economic consequences negatively affected population health well beyond those directly suffering from COVID-19.

Subscribe to Northeast Asia