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Dr. Alejandro Toledo was democratically elected President of Peru from July 2001-July 2006.

He was born in a small and remote village in the Peruvian Andes, 12,000 feet above sea level. He is one of sixteen brothers and sisters from a family of extreme poverty. At the age of six, he worked as a street shoe shiner and simultaneously sold newspapers and lotteries to supplement the family income.

Thanks to an accidental access to education, Dr. Toledo was able to go from extreme poverty to the most prestigious academic centers of the world, later becoming one of the most prominent democratic leaders of Latin America. He is the first Peruvian president of indigenous descent to be democratically elected in five hundred years.

He received a BA from San Francisco University in Economics and Business Administration. From Stanford University, he received a MA in Economics of Human Resources, a MA in Economics, and a PhD in Economics of Human Resources.

This is the first lecture in a series of lectures Dr. Toledo will give. Lecture 2 is scheduled for April 10th and lecture 3 will be on May 14th.

Due to technical difficulties, we were unable to record this lecture. We apologize for the inconvenience.

Bechtel Conference Center

Alejandro Toledo Payne Distinguished Visiting Lecturer, CDDRL Visiting Scholar, and Former President of Peru Speaker
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Some rebel groups abuse noncombatant populations, while others exhibit restraint. Insurgent leaders in some countries transform local structures of government, while others simply extract resources for their own benefit. In some contexts, groups kill their victims selectively, while in other environments violence appears indiscriminate, even random. This book presents a theory that accounts for the different strategies pursued by rebel groups in civil war, explaining why patterns of insurgent violence vary so much across conflicts. It does so by examining the membership, structure, and behavior of four insurgent movements in Uganda, Mozambique, and Peru. Drawing on interviews with nearly 200 combatants and civilians who experienced violence firsthand, it shows that rebels' strategies depend in important ways on how difficult it is to launch a rebellion. The book thus demonstrates how characteristics of the environment in which rebellions emerge constrain rebel organization and shape the patterns of violence that civilians experience.

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Pamela Constable is the deputy foreign editor of The Washington Post. Previously she covered South Asia for The Washington Post for several years from April 1999, with extensive coverage of Afghanistan as well as both India and Pakistan.n She continues to visit and report from Afghanistan.

Before arriving in New Delhi in 1999, Constable worked for The Post from 1994 to 1998 covering immigration and Hispanic affairs in the Washington area, and reported from Honduras, El Salvador, Haiti and Cuba.

Prior to joining The Post, Constable worked for The Boston Globe as deputy Washington bureau chief and foreign policy reporter from June to September 1994. From 1983 until 1992, she was The Globe's roving foreign correspondent, Latin America correspondent and diplomatic correspondent. During this time she reported from Haiti, Chile, Peru, Argentina, Cuba, Colombia, El Salvador, Nicaragua, Mexico, South Korea, the Philippines, the Soviet Union and Brazil, as well as in Washington.

Her latest book is Fragments of Grace: My Search For Meaning in the Strife of South Asia. She is the co-author with Arturo Valenzuela of A Nation of Enemies: Chile Under Pinochet and has written articles for Foreign Affairs, Foreign Policy, Current History and other publications. She was awarded an Alicia Patterson Fellowship in 1990 and the Maria Moors Cabot Prize for coverage of Latin America in 1993. Constable is a member of the Council on Foreign Relations. She received a B.A. from Brown University.

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Pamela Constable The Washington Post Speaker
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Levitsky received his doctoral degree from UC-Berkeley. His areas of research include political parties and party change, informal institutions and organizations, and political regimes and regime change. His primary regional interest is Latin America, with a particular focus on Argentina and Peru. He is author of Transforming Labor-Based Parties in Latin America: Argentine Peronism in Comparative Perspective (Cambridge University Press, 2003). He is currently writing a book on the rise of competitive authoritarian regimes in Latin America, Africa, Asia, East-Central Europe, and the former Soviet Union during the post-Cold War era. He is also co-editing a book (with Gretchen Helmke) on informal institutions in Latin America.

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Steve Levitsky Speaker Harvard University
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BACKGROUND: Cervical-cancer screening strategies that involve the use of conventional cytology and require multiple visits have been impractical in developing countries. METHODS: We used computer-based models to assess the cost-effectiveness of a variety of cervical-cancer screening strategies in India, Kenya, Peru, South Africa, and Thailand. Primary data were combined with data from the literature to estimate age-specific incidence and mortality rates for cancer and the effectiveness of screening for and treatment of precancerous lesions. We assessed the direct medical, time, and program-related costs of strategies that differed according to screening test, targeted age and frequency, and number of clinic visits required. Single-visit strategies involved the assumption that screening and treatment could be provided in the same day. Outcomes included the lifetime risk of cancer, years of life saved, lifetime costs, and cost-effectiveness ratios (cost per year of life saved). RESULTS: The most cost-effective strategies were those that required the fewest visits, resulting in improved follow-up testing and treatment. Screening women once in their lifetime, at the age of 35 years, with a one-visit or two-visit screening strategy involving visual inspection of the cervix with acetic acid or DNA testing for human papillomavirus (HPV) in cervical cell samples, reduced the lifetime risk of cancer by approximately 25 to 36 percent, and cost less than 500 dollars per year of life saved. Relative cancer risk declined by an additional 40 percent with two screenings (at 35 and 40 years of age), resulting in a cost per year of life saved that was less than each country's per capita gross domestic product--a very cost-effective result, according to the Commission on Macroeconomics and Health. CONCLUSIONS: Cervical-cancer screening strategies incorporating visual inspection of the cervix with acetic acid or DNA testing for HPV in one or two clinical visits are cost-effective alternatives to conventional three-visit cytology-based screening programs in resource-poor settings.

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New England Journal of Medicine
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Jeremy Goldhaber-Fiebert
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Which of the democratic checks and balances - opposition parties, the judiciary, a free press - is the most forceful? Peru has the full set of democratic institutions. In the 1990s, the secret-police chief Montesinos systematically undermined them all with bribes. We quantify the checks using the bribe prices. Montesinos paid television-channel owners about 100 times what he paid judges and politicians. One single television channel's bribe was five times larger than the total of the opposition politicians' bribes. By revealed preference, the strongest check on the government's power was the news media.

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Professor McMillan presents a paper co-authored by Pablo Zoido in which they descibe secret-police chief Vladimiro Montesinos Torres' effectiveness in undermining Peru's democratic institutions through bribery.

One single television channel's bribe was five times larger than the total of the opposition politicians' bribes. By revealed preference, the strongest check on the government's power was the news media.

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John McMillan Professor Graduate School of Business
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Helicobacter pylori (HP) infection can cause hypochlorhydria, a positive risk factor for Mycobacterium tuberculosis (MTB) infection. This study examined the association between HP and MTB infections among persons attending the Policlinico Peruano Japones Gastrointestinal Clinic in Lima, Peru. From 23 June 2000 to 18 August 2000, consenting 18-55 year olds who attended the clinic for gastric biopsy gave blood for HP serologic testing, underwent tuberculin skin testing (TST) and completed a social and medical history. Of 128 participating patients, 78 (61%) were TST positive for MTB, and 107 (84%) were infected with HP by serology. Of the patients who were HP positive, 67 (63%) developed positive TST reactions compared to 11 (52%) of 21 HP-seronegative subjects (OR 1.29; 95% CI 0.54-3.11; P = 0.6). There was no association after adjusting for covariates of H. pylori infection (OR 0.78; 95% CI 0.23-2.71; P = 0.7). However, study power was limited by high prevalence of the two infections.

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Epidemiology and Infection
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Julie Parsonnet
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%people1%, CESP Senior Fellow and Director of the Program on Energy and Sustainable Development is quoted in New York Times, September 6, 2003 article.

The United States needs natural gas. Developing countries many thousands of miles away are willing to supply it. This sleepy beachfront town and other communities along the Gulf of Mexico are likely to become the links between producers and consumers.

Altogether, energy companies are planning to spend more than $100 billion in the next decade to bring gas from developing countries to rich nations, according to PFC Energy, a Washington consulting firm. The only way to do it is to supercool the gas so that it condenses into a liquid, which is then compact enough to load onto tankers and send across oceans.

For years, this process was too costly to compete with relatively cheap domestic supplies of natural gas and with imports from Canada. But those supplies are tightening just as the demand for clean-burning gas is soaring. That has led to the most severe gas shortage in the last 25 years and caused domestic gas prices to double this year.

The gap between domestic supply and total demand is forecast to grow significantly over the next 20 years. That has made liquefied natural gas competitive, if only companies can find places that are willing to accept having L.N.G. terminals built nearby. "We've entered the gas age, and there's no turning back if we want a firm supply of a strategically crucial fuel," said Michael S. Smith, an investor who controls Freeport LNG, a Houston company that plans to build a receiving terminal on Quintana Island.

Mr. Smith and his partners, Cheniere Energy and Contango Oil and Gas, both of Houston, expect to begin construction of the terminal early next year on this tiny island about 70 miles south of Houston. The $400 million operation will be able to receive ships full of liquefied natural gas, warming the gas and piping it to a nearby plant owned by the Dow Chemical Company.

Quintana Island's attraction lies not only in its proximity to a plant that uses natural gas as a raw material but also in its location near the center of the nation's energy industry. That, it is hoped, will make political resistance to such projects tepid compared with the safety, aesthetic and environmental concerns in places like Northern California and Massachusetts.

Despite such concerns and worries that large, potentially explosive gas terminals could become terrorist targets, energy companies are eager to import liquefied natural gas. It is a shift that could avoid gas shortages forecast for the future, but could also increase the nation's dependence on foreign energy supplies.

"Just as we're debating the need to diversify our oil supplies, we're faced with an array of challenges to secure reliable and politically stable sources of gas," said David G. Victor, director of the Program on Energy and Sustainable Development at Stanford University.

More than a dozen projects like the one here are seeking approval from regulators in North America, including several on the Gulf Coast and in the northern Mexican state of Baja California.

The United States is already the world's largest natural gas producer, and domestic production is expected to increase to 28.5 trillion cubic feet in 2020 from 19.1 trillion cubic feet in 2000, according to the Energy Information Administration. Still, demand is expected to far outstrip production, growing to 33.8 trillion cubic feet by 2020 from 22.8 trillion cubic feet in 2000.

The gas to close that gap - more than five trillion cubic feet, a 40 percent increase in 20 years - will have to come largely from outside the United States.

Almost all of America's imported natural gas currently comes by pipeline from Canada. But a growing market for gas within Canada and rapidly depleting Canadian wells are expected to weaken that country's ability to increase exports. Mexico, though believed to have large untapped gas reserves, is mired in nationalist debate over making it easier for foreign financiers and companies to explore for gas.

As a result, Mexico, a power in crude oil, is a growing importer of natural gas - and an attractive base for liquefied natural gas receiving terminals, which cost as much as $700 million to build. The Organization for Economic Cooperation and Development recently forecast that the percentage of North America's gas from imports would climb to 26 percent by 2030 from just 1 percent today.

Those imports will come mostly from developing nations like Equatorial Guinea, a former Spanish colony in West Africa where Marathon Oil of Houston plans to build an L.N.G. plant able to serve gas fields throughout the Gulf of Guinea.

Ambitious ventures are also under way in other West African countries, including Angola and Nigeria, where energy companies were recently burning gas escaping from oil drilling operations because there was no ready market for it. In the Middle East, small countries like Oman, a sultanate on the Strait of Hormuz, and Qatar, are emerging as important gas powers.

In South America, Trinidad and Tobago has become an early leader in exporting liquefied natural gas, although companies in Bolivia and Peru have had difficulties advancing efforts to export L.N.G. to California. Producers in Indonesia, Malaysia and Russia could step in to supply the West Coast, pushing the Andean countries to the margins of the business.

In some ways, the scramble for natural gas projects resembles the heady early days of the oil industry a century ago. Then, British, Dutch and American investors raced around the world to stake out interests in remote oil fields in the Middle East, Central Asia and the archipelagoes of the Java Sea.

Some regions are considered more promising than others. Industry executives point out that just three countries  Iran, Qatar and Russia  hold more than half of the world's natural gas reserves, inevitably focusing attention on the delicate interplay between politics and commerce in these places.

Russia, with the largest proven reserves, plans to start exporting liquefied natural gas in 2007 with deliveries to Japan. Iran, while off limits to American companies because of trade restrictions by the United States, has attracted Japanese, French, British, Indian and South Korean concerns interested in mounting gas ventures.

There are important differences, however, between past oil booms and the current interest in natural gas. For one thing, studies show the world will be swimming in natural gas supplies while oil reserves are expected to dwindle in the decades ahead. Just one area in Qatar, a monarchy near Saudi Arabia with fewer than a million people, is thought to have enough gas to supply the United States for 40 years, according to a study by Deutsche Bank.

The natural gas industry has to overcome several obstacles before evolving into a vibrant global market. Even with ample supplies there is no market for trading liquefied natural gas, as there is for crude oil. Instead, producers and customers sign long-term contracts, sometimes resulting in significant price differences from one year to the next or from one country to another.

One reason the natural gas market has remained fragmented is because the fuel is difficult and expensive to extract and transport. But these costs are declining, adding to the appeal of gas projects. Lord Browne, the chief executive of BP, said the cost of developing gas liquefaction plants had halved since the 1980's, while shipping costs had also fallen.

Shipbuilders are seeking to meet demand for tankers, with the global gas fleet expected to grow to 193 ships by 2006 from 136 in 2002, according to LNG One World, a gas- shipping information service operated by Drewry International of Britain and Nissho Iwai of Japan.

Natural gas is still not considered as crucial as oil for overall energy security since oil's main use is for transportation and there is no short-term alternative. Natural gas has a variety of important industrial uses, like serving as a raw material for fertilizer and generating electricity.

Still, the growth in demand for liquefied natural gas in the United States is expected to outstrip other parts of the world. It is likely to grow 35 percent in the next five years, compared with 20 percent in other North Atlantic countries and 12 percent worldwide, according to Deutsche Bank. Hence the rush to proceed with projects that supply liquefied natural gas to the United States.

"The world could be consuming more gas than oil by 2025," Philip Watts, the chairman of the Royal Dutch/Shell Group, the large British-Dutch energy company, said in a recent address to industry executives in Tokyo. "We must be prepared for growing geopolitical turbulence and volatility in an increasingly interdependent world."

The United States has only five terminals capable of receiving L.N.G., including one in Puerto Rico. Almost 20 are on the drawing board, but opposition to the terminals has already prevented the start of work on several of them. Earlier this year, for instance, Shell and Bechtel Enterprises shelved a plan to build a terminal about 30 miles north of San Francisco because of stiff public opposition.

California remains perhaps the most difficult place in the country to gain approval for gas-receiving terminals. This has encouraged imaginative proposals like one last month from BHP Billiton, Australia's largest energy company, for a $600 million floating terminal 20 miles off the coast of Oxnard in the southern part of the state. It remains to be seen whether any of the California projects will be built.

An air of resignation hangs over even the critics of the plan to build the terminal on Quintana, which is scheduled to start operating by 2007. Officials from Freeport LNG have told residents that they expect to make more than $1 million a year in tax payments to the city, a substantial sum for a community of 40 homes that is the smallest municipality in Texas.

At the Jetties, a restaurant on the island's edge overlooking the brown water of the Gulf of Mexico, the walls are plastered with warnings of the perceived dangers of receiving tankers full of potentially combustible gas from far-flung parts of the world. But the restaurant's employees seem to believe that the terminal will be built, inevitably changing the island's easygoing atmosphere.

"People come out here to drink beer on the beach and look at the birds and the gulf," said Dana Difatta, a cook at the restaurant. "Imagine what they'll think when they're staring at some huge vats holding natural gas. Will they be horrified or relieved?"

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In its relations with Peru, the United States has historically placed greatest emphasis on fighting the war on drugs. As Sendero Luminoso, The Shining Path, led an insurgency against the Peruvian government in the 1980s and 1990s, the United States provided ample support against the terrorists located in the jungle, especially those participating in the drug trade. But Peru's victory over terrorism then was due more to improved police intelligence and increased public investment, rather than success in the war on drugs. Now, in the midst of economic troubles and a difficult transition back to democracy in Peru, the Shining Path has made a resurgence. The United States again faces a choice about how to proceed - to continue focusing on the war on drugs or to provide sustained levels of investment in Peru's economy and political institutions, thereby turning this war on terror into a war on poverty.

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