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Shorenstein APARC's annual report for the academic year 2022-23 is now available.

Learn about the research, publications, and events produced by the Center and its programs over the last academic year. Read the feature sections, which look at Shorenstein APARC's 40th-anniversary celebration and its conference series examining the shape of Asia in 2030; learn about the research our postdoctoral fellows engaged in; and catch up on the Center's policy work, education initiatives, publications, and policy outreach. Download your copy or read below:

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On October 18, as part of its autumn 2023 seminar series on APEC in advance of the organization's meeting in San Francisco in November, Shorenstein APARC and its Asia Health Policy Program (AHPP) presented the series' second event, Asia-Pacific Digital Health Innovation: Technology, Trust, and the Role of APEC. The featured panelists were Kiran Gopal Vaska, Director of the National Health Authority of India, and CK Cheruvettolil, the Senior Strategy Officer, Digital Health and Artificial Intelligence, at the Bill & Melinda Gates Foundation. Siyan Yi, the Director of the Integrated Research Program at the National University of Singapore and a former AHPP fellow, moderated the conversation.

While India is not an APEC member, Indian initiatives are examples of leveraging technology to better the health of the most vulnerable citizens in low- and middle-income countries (LMICs). Kiran Gopal Vaska gave an overview of the Ayushman Bharat Digital Mission (ABDM), India's latest health initiative that focuses on the interoperability of health records, services, and health claims. He stressed that ABDM was built on previous digital infrastructure, like Aadhaar, the national digital identity system, and Digilocker, a digital storage scheme for citizens' health and other records.

In ABDM, we do just three things: interoperability of health records, interoperability of services, and interoperability of health claims.
Kiran Gopal Vaska
Director of the National Health Authority of India

The approach India has taken is for the government to build the rails—the infrastructure of the system—and create a space where the private sector can develop applications integrated with that space through application programming interfaces (APIs), avoiding the siloing that can hamper the interoperability of data.

Regarding health data, privacy is a crucial concern at the patient level. ABDM addresses this concern through the use of a consent artifact. Individuals decide whether hospitals or other medical service providers have access to their data, and this access has levels of granularity: you can share specific portions of 7 different data types, like immunizations or prescriptions. You can limit that sharing to a particular period, like one day.

Also participating on the panel was CK Cheruvettolil, who discussed strategies by the Bill & Melinda Gates Foundation in leveraging the power of mobile phones to augment the work of Accredited Social Health Activists (ASHAs), the more than one million female frontline health workers in India. ASHAs can use mobile phone cameras, sensors, and streaming data to better care for low-birth-weight babies and other patients. 

If [software] is developed in isolation without understanding that social context, you would lose a huge portion of the population, you'd lose that effectiveness.
CK Cheruvettolil
Senior Strategy Officer, Digital Health and Artificial Intelligence, Bill & Melinda Gates Foundation

He explained the critical role of taking local context into account when developing software by using the example of pregnant Indian women in their third trimesters. The custom for Indian mothers, especially in rural areas, is for the child to be born in the maternal grandparents' home. If software were to store only the mother's address, healthcare workers in the grandparents' jurisdiction would not know that a pregnant woman in the critical third trimester would soon be giving birth at a local address.

Kiran Gopal Vaska noted that India had solved the technological issues, and now the task was to push for adoption. He emphasized that the technologies underlying India's digital health stack were created as public goods for the world, and for LMICs to support each other in advancing digital health technologies, the key was interoperability, "using standards that are accessible and acceptable worldwide."

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How South Koreans Feel About Telemedicine as an Alternative to In-Person Medical Consultations

A new study, co-authored by Asia Health Policy Director Karen Eggleston, investigated preferences for telemedicine services for chronic disease care in South Korea during the COVID-19 pandemic and found that preferences differed according to patient demographics.
How South Koreans Feel About Telemedicine as an Alternative to In-Person Medical Consultations
The Future of Health Policy: Reflections and Contributions from the Field
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Health Policy Scholars and Practitioners Examine the Future of the Field

In the third installment of a series recognizing the 40th anniversary of Stanford’s Walter H. Shorenstein Asia-Pacific Research Center, the Asia Health Policy Program gathered alumni to reflect on their time at APARC and offer their assessments of some of the largest challenges facing healthcare practitioners.
Health Policy Scholars and Practitioners Examine the Future of the Field
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Kiran Gopal Vaska, CK Cheruvettolil, and Siyan Yi at the panel discussion on digitial health initiatives
(L to R) Kiran Gopal Vaska, CK Cheruvettolil, and Siyan Yi
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Shorenstein APARC continued its APEC seminar series with the second installment, Asia-Pacific Digital Health Innovation: Technology, Trust, and the Role of APEC, a panel discussion that focused on how India’s digital health strategy has evolved and its lessons for other countries creating their own.

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Flyer for Asia in 2030, APARC@40 Conference and Celebration with an image of Encina Hall facade

The culmination of a special event series celebrating Shorenstein APARC's 40th Anniversary, "Asia in 2030, APARC@40"

Join us in celebrating APARC's 40 years of research, education, and engagement. Recognizing the accomplishments of the past four decades and looking forward to the future, the two-day program will highlight multiple aspects of APARC’s core areas of expertise and examine key forces affecting Asia’s present and shaping its future.

1-1:30 p.m.

Opening Session

Opening Remarks

Gi-Wook Shin
Director of Shorenstein APARC and the Korea Program
William J. Perry Professor of Contemporary Korea
Professor of Sociology
Senior Fellow at the Freeman Spogli Institute for International Studies
Stanford University

Congratulatory Remarks

Kathryn Ann “Kam” Moler
Vice Provost and Dean of Research
Marvin Chodorow Professor
Professor of Applied Physics, Physics, and Energy Science Engineering
Stanford University

Condoleezza Rice
Tad and Dianne Taube Director of the Hoover Institution
Senior Fellow on Public Policy at the Hoover Institution
Denning Professor of Global Business and the Economy at the Stanford Graduate School of Business
Professor of Political Science
Senior Fellow at Freeman Spogli Institute for International Studies
Stanford University

Scott D. Sagan
Co-Director and Senior Fellow at the Center for International Security and Cooperation
Caroline S.G. Munro Professor of Political Science
Mimi and Peter Haas University Fellow in Undergraduate Education
Senior Fellow at the Freeman Spogli Institute for International Studies
Stanford University


1:30-2:45 p.m. 

The Future of Diplomacy

John Everard
Former Ambassador to Belarus, Uruguay, and North Korea for the United Kingdom
Coordinator of the UN Security Council’s Panel of Experts on North Korea
Former Pantech Fellow at Shorenstein APARC

Laura Stone
Former U.S. Deputy Assistant Secretary of State for India, Nepal, Sri Lanka, Bangladesh, Bhutan, and Maldives
Former Acting Deputy Assistant Secretary for China and Mongolia;
Former Director of the Office of Chinese and Mongolian Affairs
Former Director of Economic Policy Office in the Bureau of East Asia and Pacific Affairs
Visiting Scholar and Inaugural China Policy Fellow at Shorenstein APARC at Stanford University

Moderator

Michael Beeman
Former Assistant U.S. Trade Representative for Japan, Korea, and APEC at the Office of the U.S. Trade Representative
Visiting Scholar at Shorenstein APARC
Stanford University


2:45-3 p.m. ~ Coffee and Tea Break


3-4:15 p.m.

The Future of Asian Studies

Panelists

Donald K. Emmerson
Director of the Southeast Asia Program at Shorenstein APARC
Affiliated Faculty with the Center on Democracy, Development, and the Rule of Law
Affiliated Scholar with the Abbasi Program in Islamic Studies
Senior Fellow Emeritus at the Freeman Spogli Institute for International Studies
Stanford University

Thomas B. Gold
Professor of Sociology
University of California, Berkeley

Jisoo Kim
Korea Foundation Associate Professor of History, International Affairs, and East Asian Languages and Literatures
Director of the Institute for Korean Studies
Co-Director of the East Asia National Resource Center
The George Washington University

Moderator

Kiyoteru Tsutsui
Deputy Director of Shorenstein APARC
Director of the Japan Program
Henri H. and Tomoye Takahashi Professor and Senior Fellow in Japanese Studies
Professor of Sociology
Senior Fellow at the Freeman Spogli Institute for International Studies
Stanford University


4:15-4:30 p.m. ~ Coffee and Tea Break


4:30-6 p.m.

Oksenberg Panel: The Future of U.S.-China Relations

Introduction

Jean C. Oi
Director of the China Program at Shorenstein APARC
Lee Shau Kee Director of the Stanford Center at Peking University
William Haas Professor of Chinese Politics
Senior Fellow at the Freeman Spogli Institute for International Studies
Stanford University

Panelists

M. Taylor Fravel
Arthur and Ruth Sloan Professor of Political Science and Director, Security Studies Program
Massachusetts Institute of Technology

David Michael Lampton
Professor Emeritus and former Hyman Professor and Director of SAIS-China and China Studies, School of Advanced International Studies at John Hopkins University
Former Oksenberg-Rohlen Fellow at Shorenstein APARC

Oriana Skylar Mastro
Center Fellow at the Freeman Spogli Institute for International Studies
Stanford University

Moderator

Thomas Fingar
Former U.S. Department of State Assistant Secretary of the Bureau of Intelligence and Research, Deputy Assistant Secretary for Analysis, Director of the Office of Analysis for East Asia and the Pacific, and Chief of the China Division
Former Deputy Director of National Intelligence for Analysis and Chairman of the National Intelligence Council
Fellow at Shorenstein APARC
Stanford University
 

Conferences
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Book cover showing a robotic hand holding an older human hand.

Demographic transition, along with the economic and geopolitical re-emergence of Asia, are two of the largest forces shaping the twenty-first century, but little is known about the implications for innovation. The countries of East Asia have some of the oldest age structures on the planet: between now and 2050, the population that is age 65 and older will increase to more than one in four Chinese, and to more than one in three Japanese and Koreans. Other economies with younger populations, like India, face the challenge of fully harnessing the “demographic dividend” from large cohorts in the working ages.

This book delves into how such demographic changes shape the supply of innovation and the demand for specific kinds of innovation in the Asia-Pacific. Social scientists from Asia and the United States offer multidisciplinary perspectives from economics, demography, political science, sociology, and public policy; topics range from the macroeconomic effects of population age structure, to the microeconomics of technology and the labor force, to the broader implications for human well-being. Contributors analyze how demography shapes productivity and the labor supply of older workers, as well as explore the aging population as consumers of technologies and drivers of innovations to meet their own needs, as well as the political economy of spatial development, agglomeration economies, urban-rural contrasts, and differential geographies of aging.

Desk, examination, or review copies can be requested through Stanford University Press.

Table of contents and chapter 1, introduction
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Friction between machines and humans has existed since the beginning of the automated industry and machine-assisted work. It’s a trend that fuels the imaginations of pop culture and political debates alike as people voice worries about the roles increasingly sophisticated robots and technology are taking in society and workplaces.

But is this concern warranted? According to APARC’s Yong Suk Lee, the deputy director of the Korea Program and the SK Center Fellow at FSI, and Karen Eggleston, the deputy director of APARC and the director of the Asia Health Policy Program, perhaps not. A recent article published by the Stanford Institute for Human-Centered Artificial Intelligence (HAI) highlights Lee and Eggleston’s ongoing research into innovative uses of technology across industries, particularly in healthcare. Their findings indicate that the adoption of robotics ultimately does more to augment and adjust, rather than outrightly replace, the role of human labor in the workplace.

What will ultimately matter is whether there will be entirely new occupations, what economists call the ‘reinstatement effect.’ Simply saying that robots lead to permanent job reductions isn’t the end of the story.
Yong Suk Lee
Deputy Director of the Korea Program

[Subscribe to our newsletters to stay up-to-date with the latest from our researchers.]

Lee studies the impacts of AI and robotics across multiple industries, including manufacturing, retail banking, and nursing homes. A trend he sees across most sectors following the adoption of robotics or AI is a positive increase in productivity. This has impacts for both the short-term and long-term relationships between humans and their robot coworkers, or “co-bots.” While it is true that the introduction of automation and robots initially replaces a significant number of workers in sectors such as manufacturing, over time, that impact reverses and there are job gains in many cases.

“The impact of robots often evolves over time from replacing human workers to augmenting them,” Lee explains, “and productivity gains [can] create opportunities for existing and new occupations.” This happens in a variety of ways. In some cases, the use of robotics and automation in one area frees up time, labor, and resources to employ more people in other, higher-skilled areas. In another situation, increases in productivity brought on by automation allow for greater company growth than would not have been possible otherwise. This, in turn, spurs the need to expand the workforce.

Alternatively, supplementing the labor of a small workforce with robotics and AI can also spread limited resources much farther. Lee and Eggleston’s studies of the impacts of robots on nursing home care in Japan repeatedly show that the use of robots positively increases the quality of service that oftentimes-understaffed care facilities can provide to the elderly and infirm. This can range from monitoring the physical condition of patients and reliably delivering medications to providing mental and emotional support to elderly residents through the use of robotic humanoid companions. Such innovative use of tech fills critical gaps that a human-only workforce would struggle to meet in a staffing shortage like Japan faces.

Looking to the future, Lee shares this perspective: “When the automobile was invented, we suddenly had a new demand for drivers. Now we’ll have to see if [automation] creates demand for other new occupations.” It’s an area of innovation and research he, Dr. Eggleston, and other Stanford researchers will be closely watching with their human eyes in the years to come.

Read the original article by Stanford HAI here >>

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Q&As

Robots May Be the Right Prescription for Struggling Nursing Homes

Karen Eggleston and Yong Suk Lee speak to the Oliver Wyman Forum on how robotics and advancing technologies are helping staff in Japanese nursing homes provide better and safer care to their patients.
Robots May Be the Right Prescription for Struggling Nursing Homes
Cover image of the book "Healthy Aging in Asia", showing a smiling elderly Chinese woman with a cane standing in a small village.
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New Book Highlights Policy Initiatives and Economic Research on Healthy Longevity Across Asia

Asia health policy expert Karen Eggleston’s new volume, ‘Healthy Aging in Asia,’ examines how diverse Asian economies – from Singapore and Hong Kong to Japan, India, and China – are preparing for older population age structures and transforming health systems to support patients who will live with chronic disease for decades.
New Book Highlights Policy Initiatives and Economic Research on Healthy Longevity Across Asia
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Call for Stanford Student Applications: APARC Hiring 2020-21 Research Assistants

To support Stanford students working in the area of contemporary Asia, the Shorenstein Asia-Pacific Center is offering research assistant positions for the fall, winter, and spring quarters of the 2020-21 academic year.
Call for Stanford Student Applications: APARC Hiring 2020-21 Research Assistants
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A man with interacts with 'Emiew,' a humanoid robot made by Hitachi.
Koichi Kamoshida, Getty Images
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Yong Suk Lee and Karen Eggleston’s ongoing research into the impact of robotics and AI in different industries indicates that integrating tech into labor markets adjusts, but doesn’t replace, the long-term roles of humans and robots.

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A new book published by the Shorenstein Asia-Pacific Research Center (APARC) explores the future of China’s urbanization. Addressing the complex challenges facing Chinese cities will require updated institutions and unparalleled innovation, researchers say.

China’s growth in cities has been unprecedented over the past decade, and the urbanization policies the government put in place, while achieving notable successes, continue to face systemic obstacles that challenge the effectiveness of central and local governments. How the government will resolve the complex sets of conflicting interests will considerably shape Chinese society and politics for decades.
 
That is the premise of a new book co-edited by Karen Eggleston, senior fellow in Stanford’s Freeman Spogli Institute for International Studies; Jean C. Oi, the William Haas Professor in Chinese Politics; and Yiming Wang, deputy director general and senior research fellow at the State Council Development and Research Center.
 
In the book Challenges in the Process of China’s Urbanization, eleven chapters authored by 21 authors feature urbanization challenges ranging from property rights and affordable housing to food security and the environment.

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“Urbanization is not merely a process of financial engineering or rational decision-making, but a complicated ‘dance’ of power and politics,” the editors write in the introductory chapter.
 
The book is one of two publications that emerged from a conference in May 2014 at the Stanford Center at Peking University, that was part of a joint five-year research initiative between the Shorenstein Asia-Pacific Research Center and the National Development and Reform Commission (NDRC) – a government agency in China that formulates and implements strategies of national economic and social development.  
 
Wang, who was the deputy chief of staff at the NDRC and executive director of its Institute of Macroeconomic Research, facilitated ongoing scholarly exchanges, including workshops and conferences as well as joint fieldwork in China. At one point, the NDRC came to the Bay Area to interview local government officials about urbanization and affordable housing policies.  
 
Eggleston and Oi responded to a few questions about the book.
 
What patterns are shaping urbanization in China?
Oi: A primary pattern shaping China’s urbanization is the movement of people from rural areas to megacities – Beijing, Shanghai and elsewhere.  There also is movement from poorer to richer areas within the countryside. Rural to urban migration has been taking place in China since the 1970s, but the difference now is that the government is encouraging it. The Chinese government has an officially sanctioned program that is advocating migration. A second pattern shaping China’s urbanization is administrative redistricting. Redistricting is a government-led process that changes the administrative makeup of a municipality. For example, areas originally designated as ‘rural’ can be redistricted to qualify as ‘urban.’ Additionally, smaller cities can become larger by absorbing surrounding areas. Counties can also be combined into districts.
 
Why are cities and counties pursuing redistricting?
Oi: One of the main factors driving redistricting in China is the perks and power that are linked to the size of an administrative unit. Government officials in charge of smaller cities or counties have incentives to become larger. The larger the municipality, the more power and resources the municipality has. Smaller cities that become larger cities gain resources; yet on the other hand, counties that become part of a district lose certain local-level rights. Municipalities are essentially competing with each other. The book dives into the incentive structures at play and other political economy issues embedded in the urbanization process.
 
What kind of disciplinary approaches are undertaken in the book?
Eggleston: One of the book’s strengths is its array of disciplinary approaches. Drawn primarily from the social sciences, the book includes theoretical and empirical analyses of evidence gathered from case studies and fieldwork. 
 
Oi: The book is a true collaboration of scholars from the United States and China. About half of the chapter authors are officials from the National Development and Reform Commission (NDRC), including our co-editor, Yiming Wang, who was NDRC deputy-secretary when we did the work for the volume. Each chapter attempts to offer a balanced perspective of the policy implications of China’s urbanization experience at both national and local levels.

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Karen Eggleston, FSI senior fellow and director of the Asia Health Policy Program, speaks on a panel about demographic change and health at the conference, "Challenges in Process of Urbanization: China in Comparative Perspective," Stanford Center at Peking University, May 2014.


What do you hope the book will achieve?

Oi: The book offers an analysis of the intricacies of and potential solutions to problems related to the process of China’s urbanization. We hope the book taken as a whole gives a sense of the magnitude of these problems, why there are no easy solutions, as well as what will be needed to address them going forward.  Some of the solutions are not just about money. 
 
Eggleston: The book aims to sketch an interesting picture of the varied aspects of China’s urbanization. Each chapter looks at a select issue, for example, land financing, spatial growth and housing security, and sets it in the broader context of urbanization. We purposely decided not to cover everything that falls under the banner of urbanization. Most of the topics could very well be made into a whole book alone. We hope the book will enliven conversation amongst scholars, policy influencers and China and urbanization enthusiasts.
 

What do “people-centered” solutions to urbanization challenges in China include?

Eggleston: “People-centered” is the term used in China’s official urbanization plan, the New National Urbanization Plan, published in 2014. We defined the term “people-centered” to include what makes life in urban areas attractive. “People-centered” urbanization emphasizes well-being and the factors that lead to a good livelihood, including access to public goods. For example, from a health perspective, cities around the world were historically less healthy locations to live in during the industrial revolution, before basic knowledge of how to control infectious disease with clean water and other population health measures. Now, cities can be healthier places to live in compared to rural areas. The Chinese government has a successful record of building basic infrastructure, but faces many challenges in harnessing the requisite resources to innovate and truly achieve people-centered development.

 

"In trying to reach a public goal like low-income housing, the Chinese government is trying to set up an incentive system so that the goal can be reached not just with taxpayer money but also by bringing in the private sector to build housing in a way that includes affordable units and doesn’t lead to segregation."  

     — Karen Eggleston; FSI senior fellow, Asia Health Policy Program director

 
An issue highlighted in the book is China’s household registration system. Why is it an issue and what is being done to address it?
Oi: Because China’s urbanization has been so rapid, institutions have not yet fully caught-up. There is a disjuncture between the institutions that exist and those that are actually necessary. One pressing example is the household registration system. Citizens who live in rural areas have a different kind of residency status than citizens in urban areas. Everyone has rights, but rights differ depending on where primary residence was originally listed. A Chinese citizen is only able to enjoy all of his or her rights where he or she is registered. So migrants tend to lose out as soon as they move away from their home locality. However, the central government has started to make changes to this system. For example, children of migrants now have access to public services such as primary education. Some localities have begun to implement a points-based system wherein families accumulate points over time and, after reaching a certain level, become eligible for citizenship in that place of residence.
 
Can you describe the state of housing in Chinese cities?
Eggleston: Affordable housing is a key issue of urbanization across the world, not just in China. So, the glass is half-full or half-empty depending on how you look at it. China has been remarkably successful in avoiding the development of large urban slums common in lower income countries with rapid urbanization. That said, problems associated with housing are not going to go away quickly. The macro nature of China’s population amplifies the problem, and coincides with a dramatic increase in housing prices. Continued government investment in affordable housing will help address scarcity, and could help tackle interrelated problems such as assisted living for the elderly population in China.
 
Oi: The central government began to offer affordable housing in 2007 with the intention of providing housing for the neediest portion of the population. In theory, it works, but in reality, it has faults. Supply and demand sometimes isn’t in sync. For example, quotas were used as a way to decide the location of its affordable housing, but some cities found that housing units remain unused. The local government builds a number of affordable housing units but then discovers no one wants them because commercial housing is less expensive or factories provide dormitory space. Part of this mismatch in supply and demand is rooted in the issue of resident permits. In most cases, the neediest portion of the population is typically migrants but they are not eligible for affordable housing in the cities where there is most need for low cost housing such as Beijing or Shanghai. As a result, migrants often live in inadequate housing in city centers – small, windowless spaces with many people living together in one room. 
 
One of the chapters in the book focuses on food security. As Chinese migrants continue to move from rural to urban areas, are fears of declining food security founded?
Eggleston: Food security is an important issue. In the book, one chapter written by 9 co-authors applies rigorous methods to understand whether urbanization threatens food security in China. They found that fear of declining food security is mostly overblown. Continued government investment in agricultural production such as irrigation systems can help address those fears, and help enable sustainable food production.

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Jean Oi, FSI senior fellow and director of the China Program, (Center), and Xueguang Zhou, FSI senior fellow and professor of sociology, (Left of Center), take a tour of housing developments during fieldwork with the National Development and Reform Commission in August 2012. Oi is speaking with one of the village leaders about a "new rural community" concept developed in a housing development in Chengdu, where this photo was taken.


Another chapter in the book references pollution. Beijing has faced unprecedented levels of air pollution lately. Does it coincide with urbanization?

Eggleston: Although issues of pollution and “green growth” merit separate book-length treatment and are not central to this book, pollution illustrates the broader issue of concentrations of industry and people living in one area. Everyone has to share public space. Both a migrant and someone working at the top levels of government in Beijing breathe the same air. Things that are less visible like water quality are avoidable by some of the population, but air pollution is not, and therefore, quickly reveals how hard it is for the government to efficiently fix a problem. Policies to mitigate pollution often take awhile to have an effect, and in the mean time, people begin to doubt government accountability. Local governments have made strides within the past few years in revising evaluation structures so that officials are incentivized to react to public problems like air pollution. Historically, an official’s performance was based largely if not solely on GDP growth of his or her municipality, but it has since expanded to include other factors such as health insurance enrollment.
 
Infrastructure spending has been a driver of China’s economic growth. Has China’s rush to build quickly come at the expense of safety?
Oi: Economic growth is intimately tied to the process of China’s urbanization. Growth of cities has been driven by the ambitions of local officials who want to see their municipalities expand. But the question remains over how they’re going to finance rising needs for and costs of public goods. Each municipality receives funding from the central government and it’s based on the quantity of citizens – a number that excludes migrants. Any migrant is then – administratively speaking – a burden on the system. Municipalities have to determine how they’re going to fund public goods. This is where fiscal politics comes in. China’s fiscal system is really the most important institution in need of reform. Each chapter of the book touches upon the issue of public funding in some way.
 
Eggleston: China is generally known for its investment in infrastructure projects, but the goal of rapid growth can seemingly clash with a concern for safety. One of the main themes of the book is to think carefully about the incentives that govern the process. I think that theme certainly rings true with regard to infrastructure and safety. Put simply: if officials and contractors do not have incentive to prioritize safety, then safety problems are going to arise. The Chinese government efforts to develop and improve specific regulatory structures should continue, as several authors point out in different chapters of the book.

 

"Economic growth is intimately tied to the process of China’s urbanization. Growth of cities has been driven by the ambitions of local officials who want to see their municipalities expand. But the question remains over how they’re going to finance rising needs for and costs of public goods."  

     — Jean C. Oi; Stanford professor of political science, China Program director

 
How can a balance be struck between public and private sector led projects that address urbanization challenges?
Oi: The Chinese government is increasingly looking to establish public-private partnerships as a way to deal with urbanization challenges. Affordable housing is one area that could experiment further with the public-private model. Instead of going to local governments, the central government is now talking directly with housing developers. They say to the developers “we’ll give you permission to develop a housing estate, but within that housing estate, you’re going to have to set aside ‘X’ number of units for affordable housing.” Depending on the city, this approach has had mixed effects. Some high-end housing developers don’t want to include affordable housing because the price per unit could drop as a result.
 
Eggleston: It’s critical to think about public-private partnerships in the context of urbanization-related policy goals. I think we’re bound to see them grow. The government has an opportunity to harness the innovation of the private sector through such partnerships.
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A man pushes his bicycle past a construction site in the Central Business District in Beijing, China.
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On April 3, 2014, Karen Eggleston provided testimony before the U.S-China Economic and Security Review Commission at the "Hearing on China’s Healthcare Sector, Drug Safety, and the U.S.-China Trade in Medical Products."

Some of the questions addressed included:

  • How has the nature of disease in China changed in recent decades? What kind of burden might it place on China's future development?
  • If providers are "inducing" demand by overprescribing drugs, it this a public health crisis in the making?
  • Can you outline the pros and cons of market reform in China's healthcare sector? What might be the proper role of the state of improving healthcare delivery?
  • Kan bing nan, kan bing gui (inaccessible and unaffordable healthcare) is one of the top concerns of ordinary Chinese. Which groups are most affected? Is this a global problem, what lessons can we learn from China?
  • The pharmaceuticals industry features in China's Medium and Long-term Plan for Science and Technology (2006-2020), as well as in more recent measures to promote indigenous innovation and industrial upgrading. Is it fair to say that the Chinese government is prioritizing domestic pharmaceutical companies, which foster economic growth, over the welfare of patients?
  • What were major successes and failures of the 2009 healthcare reforms [in China]? How have those reforms been supplemented by more recent measures (e.g. last November's Third Plenum)?
  • What aspects of China's healthcare reform should the U.S. government and U.S. companies pay most attention to?
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How do countries in the vast and diverse Asia-Pacific region differ in “prescribing cultures”? How do health systems in the region balance access to pharmaceuticals with incentives for innovation? How do the forces of globalization shape, and in turn are shaped by, cultural legacies about health and health care? These are the key questions addressed by the new Asia Health Policy Program book, Prescribing Cultures and Pharmaceutical Policy in the Asia Pacific.

AHPP held a book launch event September 23rd with three authors of the book detailing how pharmaceutical policies are interlinked globally and at the same time deeply rooted in local culture. 

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