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First Do No Harm - April 16

This webinar is co-hosted by the Asia Health Policy Program and the Korea Program at Shorenstein APARC

What are the underlying issues that have led to the physician-government stand-off impacting South Korea’s medical system? In this webinar, Korean health policy experts and medical students share their views on the breakdown of trust hampering resolution of the impasse. Medical interns and residents walked out over a month ago to protest the government’s announced plan of a substantial increase in the quota for medical school enrollment, to address Korea’s rapidly aging population and low doctor-population ratio. Medical trainees objected to the policy, alleging it would only exacerbate current problems and decrease quality. Military physicians have been called upon to help support the strained medical system. Some attempts at dialogue have failed to diffuse the tensions, with many senior physicians also tendering resignations in support of the junior doctors, albeit remaining at work. Join our webinar to better understand the genesis of the stand-off and potential longer-term impacts.

Soonman Kwon 041624

Soonman Kwon is Professor and Former Dean of the School of Public Health, Seoul National University (SNU) and has worked over 30 years on UHC, health finance and systems, and ageing and long-term care in Korea and LMICs. He is the founding director of the WHO Collaborating Centre for Health System and Financing, and was the Chief of the Health Sector Group in the Asian Development Bank (ADB). He was the president of the Korea Health Industry Development Institute (KHIDI), which is a R&D agency under the Ministry of Health and Welfare.

He received the Excellence in Education award of Seoul National University in 2020. He served as president of leading academic associations in Korea, including Health Economic Association, Society of Health Policy and Management, Association of Schools of Public Health, and Society of Gerontology. He is an associate editor (Asia Region Editor) of Health Policy (Elsevier) and International Journal of Health Economics and Management (Springer). He holds PhD from the Wharton School, University of Pennsylvania (1993) and taught at the University of Southern California School of Public Policy.

He has held visiting positions at the Harvard School of Public Health, London School of Economics, University of Toronto, University of Tokyo, Peking University, and University of Bremen. He has been a member of board or advisory committees of Health Systems Global (HSG), WHO Alliance for Health Policy and Systems Research, WHO Centre for Health and Development, Global Alliance for Vaccines and Immunization (GAVI), etc. He is a member of WHO TAG (Technical Advisory Group) on UHC and WHO TAG on Pricing Policies for Medicines. He has occasionally been a short-term consultant of WHO, World Bank, and GIZ for health system and financing in Algeria, Armenia, Barbados, Bhutan, Cambodia, China, Egypt, Ethiopia, Fiji, Georgia, Ghana, India, Indonesia, Kazakhstan, Kenya, Lao PDR, Malaysia, Maldives, Mongolia, Myanmar, Nepal, Oman, Pakistan, Philippines, South Africa, Sri Lanka, Tanzania, Uganda, Uzbekistan, and Vietnam.

Jing Li 041624

Jing Li is an Assistant Professor of Health Economics at the Comparative Health Outcomes, Policy and Economics (CHOICE) Institute at the University of Washington (UW) School of Pharmacy. A major focus of her research studies economic, social and behavioral factors related to decision-making of healthcare providers.

Her work has examined social preferences including altruism of medical students and practicing physicians in the U.S., and has linked these preferences to their career choice and medical practice behavior. Her publications have appeared in leading academic journals including Proceedings of the National Academy of Sciences, Journal of Health Economics, and JAMA Neurology.

Dr. Li was a faculty at Cornell University's Weill Medical College prior to joining UW. She received a PhD in Health Economics and MA in Economics from University of California, Berkeley, and an MA in International Comparative Education at Stanford University. 

Via Zoom Webinar

Soonman Kwon, Professor, Seoul National University
Jing Li, Assistant Professor of Health Economics, University of Washington
Representative of the Korean Medical Student Association, in dialogue with Stanford Medical School students
Seminars
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Flyer for the discussion "Rethinking US-Southeast Asia Relations" with headshots of speakers Cheng-Chwee Kuik and David Shambaugh.

This event is part of the Southeast Asia Program's 25th Anniversary celebration on the theme "Reconsidering Southeast Asia: Issues and Prospects"

Two critiques still burden America’s relations with Southeast Asia: Southeast Asians tend to resent the American tendency to emphasize China while warning them against the "China threat” lest they succumb to the influence of Beijing. Americans, in turn, tend to object when Southeast Asians hedge their cooperation by tilting toward China while taking advantage of what the US can offer. Responding to American pressure, Southeast Asians warn Washington, “Don’t make us choose.” These and other concerns will be taken up by two analysts uniquely well-qualified to discuss them. 

Kuik Cheng Chwee - 040824

Cheng-Chwee Kuik is Professor of International Relations and Head of the Centre for Asian Studies at the Institute of Malaysian and International Studies in the National University of Malaysia and a nonresident Senior Fellow in the Foreign Policy Institute of the School of Advanced International Studies (SAIS) at Johns Hopkins University. 

David Shambaugh - 030824

David Shambaugh is the Gaston Sigur Professor of Asian Studies, Political Science, and International Affairs at George Washington University’s Elliott School of International Affairs, whose China Policy Program he founded and directs. 

Each scholar has written widely on the seminar’s topic. Recent examples include essays by Prof. Kuik—e.g., “Explaining Hedging: The Case of Malaysian Equidistance” (in process, 2024) and “Getting Hedging Right: A Small-State Perspective” (2021)—and the detailed report and recommendations of a Working Group on Southeast Asia led by Prof. Shambaugh, Prioritizing Southeast Asia in American China Policy (Asia Society, 2023), which followed his Where Great Powers Meet: America & China in Southeast Asia (2020). 

Lunch will be served.

Donald K. Emmerson
Don Emmerson, Director, Southeast Asia Program, Shorenstein Asia-Pacific Research Center, Freeman-Spogli Institute for International Affairs, Stanford University
Cheng-Chwee Kuik, Professor of International Relations, National University of Malaysia
David Shambaugh, 2023-24 Distinguished Visiting Fellow, Hoover Institution, Stanford University
Seminars
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Flyer for the seminar "Militarization Overlooked: Rethinking the Origins of Indonesia's New Order," with a portrait of speaker Dr. Norman Joshua.

In the conventional narrative, the genesis of Indonesia’s authoritarian military regime known as the “New Order” is often depicted as a sudden event catalyzed by the kidnapping and killing of six Army generals on September 30th-October 1, 1965. General Suharto, who avoided capture, seized the opportunity to establish a military autocracy that would endure for over three decades (1966-1998). Yet scholars have portrayed the 1950s favorably as a time when Indonesia experimented with liberal and constitutional democracy. By that implication, the New Order was an unforeseen anomaly. Joshua’s research challenges this view. He will argue that the 1950s in Indonesia were beset by underdevelopment, insecurity, disorder, and conflict, which promoted militarization that ultimately paved the way for the New Order’s ascendance. This militarizing process, he will show, offers fresh insight into an understudied period in Indonesian history and helps us better understand the origins of authoritarian military regimes worldwide.

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Joshua, Norman - 040924

Norman Joshua is a historian working on civil-military relations and authoritarianism in Southeast Asia.  Other topics covered in his publications include revolutionary politics, counterinsurgency, intelligence, and the political economy of petroleum in Indonesia. He obtained his M.A. and Ph.D. in history from Northwestern University in 2018 and 2023 respectively, where he was also an Arryman Scholar at the Northwestern Buffett Institute for Global Affairs from 2016 to 2023.

Lunch will be served

Donald K. Emmerson
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Shorenstein Postdoctoral Fellow on Contemporary Asia, 2023-2024
normanjoshua.jpeg Ph.D.

Norman Joshua was a Shorenstein Postdoctoral Fellow on Contemporary Asia for the 2023-24 academic year. He obtained his Ph.D. in History fom Northwestern University. His research interests revolve around the histories of authoritarianism, civil-military relations, and economic history in Southeast Asia and East Asia. He is particularly interested in the relationship between historical experiences and the emergence or consolidation of authoritarian governance.

Norman’s dissertation and book project, “Fashioning Authoritarianism: Militarization in Indonesia, 1930-1965,” asks why and how the Indonesian military intervened in non-military affairs before the rise of the New Order regime (1965-1998). Using newly obtained legal and military sources based in Indonesia and the Netherlands, the project argues that the military gradually intervened in the state and society through the deployment of particular policies that were shaped by emergency powers and counterinsurgency theory, which in turn ultimately justified their continuous participation in non-military affairs.

His research highlights the role of social insecurity, legal discourses, and military ideology in studying authoritarianism, while also emphasizing the significance of understanding how durable military regimes legitimize their rule through non-coercive means.

Norman’s other works study revolutionary politics, counterinsurgency, military professionalism, intelligence history, and the political economy of petroleum in Indonesia. His first monograph, Pesindo, Pemuda Sosialis Indonesia 1945-1950 (2015, in Indonesian) examines the politics of youth groups in early revolutionary Indonesia (1945-1949).

At APARC, Norman developed his dissertation into a book manuscript that transcends the boundaries of his initial study. By broadening the scope of his research, he aims to trace the historical and social contexts upon which military authoritarian regimes legitimize their rule through non-coercive mechanisms, thereby enriching our understanding of the long-term effects of colonialism, war, and revolution on societal norms, values, power structures, and institutions

Date Label
Norman Joshua, Shorenstein Postdoctoral Fellow on Contemporary Asia, 2023-2024, APARC, Stanford University
Seminars
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An Indian woman stands on a hill of coal, wielding a sledgehammer above her head. Next to her is the text "Shorenstein APARC Working Paper," with the organization logo.

Highlights

  • The sustainability narrative has become central to 21st-century development policy, but it resonates primarily with the population of the developed economies. The same narrative appears elitist for the remaining 84 percent of the global population focused on meeting daily needs.
  • The paradox of sustainability arises from placing equally high expectations on both developed and developing economies to achieve sustainable development. While developed countries are responsible for the vast majority of historical carbon emissions, developing countries attempting to modernize and feed themselves are under pressure to curb emissions and pursue low-carbon development trajectories.
  • An examination of the degree of electrification in developing countries demonstrates the difficulty of attaining carbon neutrality by 2050. Many developing economies, like Indonesia and India, are electrified only to around 1,000 kWh per capita, far below a “modern” level of electrification at 6,000 kWh per capita. At current levels of capacity building, most Southeast Asian countries will require more than 26 years to reach this level of electrification, with Indonesia requiring 121 years.
  • There are challenges facing the energy equation both on the demand and supply sides. The long-term demand for fossil fuels is not likely to decline, whereas, on the supply side, there are technological and economic challenges. Southeast Asian countries will need more than $1.8 trillion to build out renewable power generation capabilities — a Herculean task given their lack of robust fiscal spaces, low monetary supply availabilities, and limited ability to attract foreign direct investment.
  • To advance carbon neutrality for all, developed economies must increase their investment in clean energy opportunities in developing economies, channeling for this purpose the $100 trillion of liquidity funds they have generated under long periods of prosperity.
  • Southeast Asian countries, on their part, should focus on investing more in education to improve their economic performance and better inform citizens about the unintended consequences of detrimental environmental practices. They should also prioritize advancing a more robust political culture conducive to a stronger alignment between talent and power, thus encouraging capacity and institutional building as well as better prospects for meaningful regional and global collaboration.


Summary

This paper analyzes the paradox of sustainability that stems from the high expectations placed upon developed and developing nations' environmental and economic progress. Focusing on the coal-powered electricity sector, which has underpinned most of the world’s electrification, the author examines the time it took for Western European countries and the United States of America to modernize and the time it will take for developing economies, like those in Southeast Asia and India, to modernize while pursuing a quest for sustainable development. The author also proposes potential solutions, including renewable energy and multilateralism, to mitigate the challenges of achieving modernization and sustainability through greater collaboration among countries. The focus is on how developing countries must concentrate on increasing their renewable energy production capability. The paper does not address other elements of the sustainability narrative, such as reducing pre-existing carbon emissions, environmental protection, poverty, and hunger; responsible consumerism; or the circular economy.

Gita Wirjawan

Gita Wirjawan

Visiting Scholar
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A Critique of the Modern World's Approach to Sustainable Development

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Gita Wirjawan
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Human Rights Foundation's College Freedom Forum speaker on stage

The registration form for this event is closed. If you wish to attend, please proceed to the event check-in table in front of the Bechtel Conference Center, Encina Hall.

The College Freedom Forum connects university students with world-renowned activists working to promote democracy and human rights in authoritarian regimes. During this event, students will gain exposure to some of today’s most pressing human rights issues, resources to enhance their academic endeavors, and connections for professional growth.

Programming will focus on human rights, democratic movements, and activism in countries ruled by authoritarian regimes in the Asia-Pacific region. Speakers will shed light on some of the region’s most pressing human rights issues, from the Chinese Communist Party’s repression of the Uyghur people to Kim Jong-un’s totalitarian regime in North Korea to crackdowns on free speech in Vietnam, among others. Activists will convene to share their personal stories and highlight what the international community can do to stand in solidarity with their causes.

Confirmed Speakers:

  • Jewher Ilham, Uyghur advocate and daughter of imprisoned scholar Ilham Tohti
  • Mai Khoi, Vietnamese pop star and political activist
  • Eunhee Park, North Korean defector
  • Lobsang Sangay, Former Prime Minister of the Central Tibetan Administration’s government-in-exile

 

We will also have a panel discussion with Stanford faculty on authoritarian repression in the Asia-Pacific region and the responses of civil society and pro-democracy movements.

At a catered reception following the event, students will have the opportunity to meet and talk with the speakers.

This event is hosted by the Human Rights Foundation, and co-sponsored with Stanford's Shorenstein Asia-Pacific Research Center at the Freeman Spogli Institute for International Studies, and the Center for Human Rights and International Justice.

Symposiums
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Flyer for AHPP event: Navigating Trade-Offs of Technological Innovation in Healthcare

Co-sponsored by Peking University's Institute for Global Health and Development and the Asia Health Policy Program

This event delves into the complex landscape of technological advancements in healthcare, focusing on the critical balance between embracing innovative tools and managing their implications for provider skills and patient outcomes. It presents two pivotal papers that collectively shed light on the nuanced trade-offs inherent in the adoption of new technologies like robotic surgery. The first paper utilizes a Roy model to articulate the coexistence of new and incumbent technologies, emphasizing the trade-offs between different quality dimensions and productivity. The second paper examines the adoption of surgical robots in England's healthcare system. It offers an insightful analysis of how such technologies can bridge the skill gap among healthcare providers, potentially leading to more equitable patient outcomes. The study underscores a significant variance in the benefits of robotic surgery based on the surgeon's expertise, highlighting an uneven landscape of technology utilization. Through these discussions, the event aims to navigate the intricate interplay between technological innovation, healthcare provider skill enhancement, and the ultimate goal of improved patient care.

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Breg 20240312

Nathaniel Breg earned his PhD at Carnegie Mellon University and his BA at Tufts University. His interest in health care providers intersects with questions from labor economics and industrial organization. Nate's current research investigates how providers respond to incentives, how they decide to adopt new technology, and how health care services affect local economies and local health. He is a 2020-2021 recipient of the Fellowship in Digital Health from CMU's Center for Machine Learning and Health. He previously worked at RTI International on evaluations of government health care initiatives, prospective payment systems, and health care delivery quality measures.

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Tafti 20240312

Elena Ashtari Tafti is an applied microeconomist working on topics at the intersection of innovation, health, and personnel economics. In September 2023, she joined the Ludwig Maximilian University of Munich as an Assistant Professor in Economics. Elena holds a PhD in Economics from University College London and is a Scholar at the Institute of Fiscal Studies (IFS) and the Centre for Microdata Methods and Practice (CeMMAP).

 

Jianan Yang, Assistant Professor of Economics, Institute for Global Health and Development, Peking University

Via Zoom Webinar

Nathaniel Breg, Postdoctoral Scholar, Stanford University; and the U.S. Veterans Health Administration
Elena Ashtari Tafti, Assistant Professor, Ludwig Maximillian University
Seminars
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Flyer for the talk "Procurement Institutions and Essential Drug Supply in Low- and Middle-Income Countries" with headshot of speaker  Lucy Xiaolu Wang.

Note: This talk is also offered as a virtual webinar on April 4 at 6 p.m.

International procurement institutions have played an important role in drug supply. This paper studies price, delivery, and procurement lead time of drug supply for major infectious diseases (antiretrovirals, antimalarials, antituberculosis, and antibiotics) in 106 developing countries from 2007-2017 across four procurement institution types. We find that pooled procurement institutions lower prices: pooling internationally is most effective for small buyers and more concentrated markets, and pooling within-country is most effective for large buyers and less concentrated markets. Pooling can reduce delays, but at the cost of longer anticipated procurement lead times. Finally, pooled procurement is more effective for older-generation drugs, compared to intellectual property licensing institutions that focus on newer, patented drugs. We corroborate the findings using multiple identification strategies, including an instrumental variable strategy, the Altonji-Elder-Taber-Oster method, and reduced-form demand estimation. Our results suggest that the optimal mixture of procurement institutions depends on the trade-off between costs and urgency of need, with pooled international procurement institutions particularly valuable when countries can plan well ahead of time.

Coauthor: Nahim Bin Zahur (Queen’s University).

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Lucy Xiaolu Wang 040424

Dr. Lucy Xiaolu Wang is a tenure-track Assistant Professor at University of Massachusetts Amherst, a Faculty Research Fellow at the Max Planck Institute for Innovation and Competition, Germany, and a Faculty Associate at the Canadian Centre for Health Economics. Her research focuses on the economics of innovation & digitization in health care markets (national and global), particularly in the biopharmaceutical and digital health industries. Dr. Wang earned her PhD in economics from Cornell University, her master’s degree in economics from Duke University, and her bachelor’s degree in applied economics (specialty: insurance) from Central University of Finance and Economics in Beijing, China. 

Karen Eggleston
Karen Eggleston, Director of the Stanford Asia Health Policy Program
Lucy Xiaolu Wang, University of Massachusetts Amherst; Max Planck Institute for Innovation and Competition; Canadian Centre for Health Economics
Seminars
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Planet Earth in outer space with network connection and sunlight.

Highlights

  • Competition among the great powers is hindering the ability of multilateral cooperation to solve acute problems. The last true, successful multilateral agreement was probably the WTO's Uruguay Round in 1994.
  • The emergence of the COVID-19 pandemic illustrated the failure of a multilateral response.
  • "Minilateral" groups, like the Quad (Australia, India, Japan, and the United States) have received much attention recently, but they are not suited to global crises that require rapid action.
  • "Task Force Diplomacy," an approach that grew out of the pandemic, can be a useful approach for novel, acute global crises
  • Some features of Task Force Diplomacy include an urgent, concrete goal; 1–2 countries willing to take the lead; voluntary membership that is economically and regionally diverse; the inclusion of multilateral organizations when appropriate; senior official engagement in the effort; and the division of the problem into smaller pieces that each partner can tackle.


Summary

In an era of increasing great power competition between China, the United States, and Russia, multilateral cooperation to solve global problems has become measurably more difficult. Slow multilateral responses are particularly problematic in the face of acute problems requiring a strong, immediate response, as the failure of a comprehensive response to the recent global COVID-19 pandemic demonstrated. The evolving “minilateral” structures can aid in a response but are not flexible or comprehensive enough to coordinate a global response to many problems. Ad hoc voluntary coalitions of willing and capable states and organizations—“Task Forces”—sprang up to lead the COVID-19 response. This “Task Force Diplomacy” model proved to be a viable supplement to existing multilateral, minilateral, and bilateral groupings.  

Based on personal observations working on global cooperation aimed at addressing the COVID-19 pandemic, as well as a lifetime working on global and regional challenges, this is a first-cut effort to reflect on lessons learned that others can take as a starting point to move forward and embellish as we deal with mechanisms to address new fast-moving challenges in an evolving world characterized by great power competition. The intention is not to reinvent the international structure — indeed, the default response to global problems should remain multilateral, comprehensive cooperation — but rather to present a systemization of ways to deal with serious acute problems in which multilateral responses prove inadequate.

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 A Cooperation Model for the Era of Great Power Competition

Authors
Laura Stone
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Flyer for the talk "Procurement Institutions and Essential Drug Supply in Low- and Middle-Income Countries" with headshot of speaker  Lucy Xiaolu Wang.

Note: This talk is also offered as an in-person seminar on April 5 at 12 p.m.

International procurement institutions have played an important role in drug supply. This paper studies price, delivery, and procurement lead time of drug supply for major infectious diseases (antiretrovirals, antimalarials, antituberculosis, and antibiotics) in 106 developing countries from 2007-2017 across four procurement institution types. We find that pooled procurement institutions lower prices: pooling internationally is most effective for small buyers and more concentrated markets, and pooling within-country is most effective for large buyers and less concentrated markets. Pooling can reduce delays, but at the cost of longer anticipated procurement lead times. Finally, pooled procurement is more effective for older-generation drugs, compared to intellectual property licensing institutions that focus on newer, patented drugs. We corroborate the findings using multiple identification strategies, including an instrumental variable strategy, the Altonji-Elder-Taber-Oster method, and reduced-form demand estimation. Our results suggest that the optimal mixture of procurement institutions depends on the trade-off between costs and urgency of need, with pooled international procurement institutions particularly valuable when countries can plan well ahead of time.

Coauthor: Nahim Bin Zahur (Queen’s University).

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Lucy Xiaolu Wang 040424

Dr. Lucy Xiaolu Wang is a tenure-track Assistant Professor at University of Massachusetts Amherst, a Faculty Research Fellow at the Max Planck Institute for Innovation and Competition, Germany, and a Faculty Associate at the Canadian Centre for Health Economics. Her research focuses on the economics of innovation & digitization in health care markets (national and global), particularly in the biopharmaceutical and digital health industries. Dr. Wang earned her PhD in economics from Cornell University, her master’s degree in economics from Duke University, and her bachelor’s degree in applied economics (specialty: insurance) from Central University of Finance and Economics in Beijing, China. 

Karen Eggleston
Karen Eggleston, Director of the Stanford Asia Health Policy Program

Online via Zoom Webinar

Lucy Xiaolu Wang, University of Massachusetts Amherst; Max Planck Institute for Innovation and Competition; Canadian Centre for Health Economics
Seminars
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(Machine) Learning About Sudden Cardiac Death

Co-sponsored by Peking University's Institute for Global Health and Development and the Asia Health Policy Program

Every year, hundreds of thousands of people suffer sudden cardiac death. What makes these deaths so tragic is that many of them are preventable, with an implanted cardioverter defibrillator (ICD) — if only we could know who was at high risk before they died. Using a massive new dataset of electrocardiograms (ECGs) linked to death certificates, we predict sudden cardiac death far better than current methods, both in a hold-out set of Swedish patients and in a completely independent dataset from Taiwan. We also show that high-risk patients — and only high-risk patients — who receive ICDs have significantly lower mortality. Finally, we create a generative model of the ECG waveform to tie what the model is ‘seeing’ back to underlying cardiac electrophysiology.

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Obermeyer Z - 20240221

Ziad Obermeyer's research uses machine learning to help doctors make better decisions and help researchers make new discoveries — by ‘seeing’ the world the way algorithms do. His work on algorithmic racial bias has impacted how many organizations build and use algorithms, and how lawmakers and regulators hold AI accountable. He is a co-founder of Nightingale Open Science and Dandelion Health, a Chan Zuckerberg Biohub Investigator, and a faculty research fellow at the National Bureau of Economic Research. He was named one of the 100 most influential people in AI by TIME magazine. Previously, he was an assistant professor at Harvard Medical School and continues to practice emergency medicine in underserved communities.

Jianan Yang, Assistant Professor of Economics, Institute for Global Health and Development, Peking University

Online via Zoom Webinar

Ziad Obermeyer, Associate Professor, Blue Cross of California Distinguished Professor, UC Berkeley
Seminars
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