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More than two decades have passed since the first case of HIV infection was detected in Cambodia in 1991. Cambodia is among the countries with the highest HIV prevalence in Asia and has been experiencing the most serious HIV/AIDS epidemic in the region. The epidemic is spread primarily through heterosexual transmission and revolves largely around the sex trade.

Since the beginning of the epidemic, the Royal Government of Cambodia has made a strong political commitment to the need for prevention of HIV transmission and care for people living with HIV/AIDS. It has received some technical and financial support from national and international agencies. Several prevention and intervention programs have been successfully implemented, and the WHO/UNAIDS recognized that the Cambodia’s HIV/AIDS epidemic appeared to have stabilized in 2002.

The estimated HIV prevalence in the general adult population declined to 0.5% in 2009, down from 1.2% in 2001. Among women visiting antenatal care clinics, the prevalence also declined from 2.1% in 1999 to 1.1% in 2006. There was also a gradual increase in the percentage of HIV-infected pregnant women who received antiretroviral therapy to reduce the risk of mother-to-child transmission, from 1.2% in 2003 to 11.2% in 2007, and finally to 32.3% in 2009.

Despite the decline of HIV prevalence in the general population, the prevalence remains high among high-risk groups such as commercial sex workers, men who have sex with men, and injection drug users. Furthermore, the so-called prevention-successful-country is also seeing the growing need for HIV/AIDS treatment and care.

This seminar will highlight the past and current features of Cambodia’s HIV/AIDS epidemic, lessons learned from prevention and care policies, and future challenges that Cambodia may face in the battles against HIV/AIDS.  

Dr. Siyan Yi joins the Walter H. Shorenstein Asia-Pacific Research Center during the 2011–12 academic year from the National Center of Global Health and Medicine and the University of Tokyo, Japan, where he jointly served as a research fellow and lecturer. He has also served as an adjunct faculty member at Cambodia’s School of Public Health, the National Institute of Public Health, and the School of International Studies at the Royal University of Phnom Penh.

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2011-12 Developing Asia Health Policy Fellow
YiSiyan_Profile.jpg MD, PhD

Dr. Siyan Yi joined the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) as a 2011-12 Developing Asia Health Policy Postdoctoral Fellow from the National Center of Global Health and Medicine and the University of Tokyo, Japan, where he jointly served as a research fellow and lecturer. He also served as an adjunct faculty member at Cambodia’s School of Public Health, the National Institute of Public Health, and the School of International Studies at the Royal University of Phnom Penh. He is currently an Associate Professor and UHS-SPH Integrated Research Programme Leader at NUS Saw Swee Hock School of Public Health (profile page here).

Yi’s research has centered largely on epidemiological methods. This has included, for example, work on surveys in Cambodia on adolescent risky sexual behaviors, substance abuse, and depression; a health promotion project in primary schools; sexual behaviors among people living with HIV/AIDS; and HIV risky behaviors among tuberculosis patients. Currently, he is involved in hospital- and community-based research projects in several developing countries as well as in Japan. He has published several papers in these research areas in international journals. His selected publications include:

  • Siyan Yi, Akiko Nanri, Kalpana Poudel, Daisuke Nonaka, Hori Ai, Tetsuya Mizoue. “Association between serum ferritin and depressive symptoms in Japanese municipal employees.” Psychiatry Research, 2011. 189: 368-372.
  • Siyan Yi, Daisuke Nonaka, Marino Nomoto, Jun Kobayashi, and Tetsuya Mizoue. “Predictors of the uptake of A (H1N1) influenza vaccine: Findings from a population-based longitudinal study in Tokyo.” PLoS One, 2011. 6: e18893.
  • Siyan Yi, Krishna C. Poudel, Junko Yasuoka, Paula H. Palmer, Songky Yi, and Masamine Jimba. “Risk vs. protective factors for substance use among adolescent students in Cambodia.” Journal of Substance Use, 2011. 16:14-26.
  • Siyan Yi, Krishna C. Poudel, Junko Yasuoka, Paula H. Palmer, Songky Yi, and Masamine Jimba. “Role of risk and protective factors for risky sexual behaviors among high school students in Cambodia.” BMC Public Health, 2010. 10: 477.
  • Siyan Yi, Krishna C. Poudel, Junko Yasuoka, Masao Ichikawa, Vutha Tan, and Masamine Jimba. “Influencing factors for seeking HIV voluntary counseling and testing among tuberculosis patients in Cambodia.” AIDS Care, 2009. 21: 529-534.

Yi holds an MHSc (2007) and a PhD (2010) in international health sciences from the School of International Health at the University of Tokyo’s Graduate School of Medicine. He also earned an MD in general medicine from the University of Health Sciences, Cambodia (2001). Yi has won research awards, including: the Young Investigator Award from the Asia Pacific Academic Consortium for Public Health (2008), the Montreux Prize from the Swiss Association for Adolescent Health and the International Association for Adolescent Health (2009), and the Scientific Research Award from the University of Tokyo (2009).

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Siyan Yi 2011-12 Developing Asia Health Policy Fellow Speaker Stanford University
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North Korea’s agreement to curb its nuclear and weapons programs is welcome diplomatic news. But it stops far short of addressing the world’s concerns about the isolated and unstable dictatorship.

Stanford experts David Straub and Siegfried S. Hecker discuss Pyongyang’s deal with Washington that will allow nuclear inspectors into North Korea and deliver much-needed nutritional assistance to the impoverished country.

Straub is the associate director of the Korean Studies Program at the Freeman Spogli Institute for International Studies. He is a former State Department senior foreign service officer who worked for more than 12 years on Korean affairs. He travelled to North Korea in 2009 with former President Bill Clinton as part of a delegation to secure the release of two journalists from Current TV.

Hecker is co-director of the Center for International Security and Cooperation and a senior fellow at FSI. Hecker has visited North Korea four times since 2004. During his last trip in 2010, he was shown a new light-water reactor at the Yongbyon nuclear center and a uranium enrichment facility.

What are some of the key factors that led North Korea to agree to this deal?

Straub: This year marks the 100th anniversary of North Korean founder Kim Il Sung’s birth, which the entire country will be celebrating April 15. The government has also said that this is the target year for North Korea to become a “strong and prosperous country.” Kim Jong Un is a brand-new leader, and presumably he and his advisors want to show that he is capable of feeding his people and at least managing the relationship with the United States.

How do you assess the agreement? Where does the moratorium put relations between the U.S. and North Korea?

Hecker: The moratorium demonstrates that North Korea is once again interested in diplomacy with the United States. The fact that they are willing to halt the nuclear operations at Yongbyon, especially the uranium enrichment activities, is a big step in the right direction. I believe the U.S. now wants to achieve a permanent halt to all nuclear weapons activities in North Korea, then roll them back, and eventually achieve complete, verifiable denuclearization of the Korean Peninsula.

Straub: There is no perfect deal when it comes to North Korea, but overall I think it is worth giving this one a chance. It will probably slow down the pace of nuclear and missile development in North Korea. In addition, it will give us time to explore whether there is any prospect that the new leadership in North Korea may be willing to take a different, more positive approach toward the United States and South Korea than its predecessors.  If history is a guide, the likeliest outcome is that after a period of several months to a few years the six-party talks will again break down, after which North Korea will create a new crisis.

How hopeful are you that this will lead to the capping of North Korea's nuclear capabilities and perhaps even its ultimate denuclearization?

Hecker: My advice to our government since November 2010, when I was shown the Yongbyon centrifuge facility, was to take immediate action so that the nuclear situation does not get worse. I advocated three no’s: no more bombs, no better bombs and no exports. The current agreement will limit the number of bombs because the Yongbyon nuclear facilities will observe a moratorium. We are still not certain of what they can produce at an undisclosed site, but I believe it is limited. The nuclear testing and missile launch moratorium will constrain the sophistication of their nuclear weapons. Denuclearization is important, but it remains a more distant goal.

Why does the United States call this “important, but limited progress”?

Straub: It is significant, in part, because since North Korea threw out international nuclear inspectors in 2009 there has been no outside monitoring of what is going on at the Yongbyon facility. But most of the things North Korea has agreed to could be reversed at will. Apart from the nuclear tests, the suspension of North Korean nuclear activities applies only to Yongbyon. Dr. Hecker and other experts have concluded there is no way North Korea could have constructed its uranium enrichment facility at Yongbyon so soon after the departure of international inspectors if had not already had another facility elsewhere. The agreement also does not address a number of non-nuclear issues, such as North Korea’s military attacks on South Korea in 2010. For there eventually to be lasting progress on the Korean Peninsula—including a resolution of the nuclear issue—there will have to be great improvement in relations between North and South Korea.

Based on what your 2010 visit to the Yongbyon nuclear facility, how much progress could they have made in terms of uranium enrichment?

Hecker: They told me they just brought up the centrifuge facility a week before we arrived in November 2010. They may have perfected the operations and produced some low enriched uranium feed material for the light-water reactor they are constructing (which is still at least a couple of years away from completion). It is also possible that they are still struggling to make the centrifuge facility work smoothly. It is very important to have the International Atomic Energy Agency inspectors get into the facility to see what progress has been made and to get a measure of how sophisticated their operations are. The North, in my opinion, still has only four to eight primitive plutonium bombs. I don’t believe they have the confidence to put a warhead small enough to fit on one of their missiles. We have little information on whether they have made highly enriched uranium or have tried to build a bomb fueled with highly enriched uranium.

What does this agreement say, if anything, about the new North Korean leadership?

Hecker: From what I know, this was pretty much the deal worked out the week before Kim Jong Il’s death. I think it’s a good sign; Kim Jong Un appears to be in control as indicated by the fact that he is able to offer up a similar deal even with his father gone.

Straub: This deal suggests that there is a great deal of continuity in North Korea’s leadership. The substance of this agreement is actually quite consistent with North Korean policies and priorities over the last 20 years. While there is no evidence to suggest that Kim Jong Un will adopt major new policies, there is always at least the possibility he might eventually.

The deal includes the provision of 240,000 metric tons of “nutritional assistance” to North Korea. What does the country’s food situation look like right now?

Straub: There is no doubt that many ordinary North Koreans are going hungry. The United States has termed this “nutritional assistance” to distinguish it from “food aid,” because officials are concerned that the provisions of bulk grain – especially rice – might be siphoned off by the North Korean elite. The U.S. government had said earlier that nutritional assistance would not involve bulk grain, and that it would be targeted toward especially vulnerable groups, such as lactating mothers, children, and the elderly.

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As the U.S. presidential election campaign moves into full bore, what role will foreign policy play in the national debate and the presidential election? Does foreign policy matter to voters or do international issues take a back seat to domestic concerns?  How does the election affect the conduct of foreign policy?

Here to shed light on the presidential election and U.S. foreign policy are three prominent commentators, with moderator Coit Blacker.

Michael H. Armacost is the Shorenstein Distinguished Fellow at FSI’s Walter H. Shorenstein Asia-Pacific Research Center, a position he has held since 2002. He is the former president of the Brookings Institution, former under secretary of state for political affairs and former U.S. ambassador to Japan and the Philippines. 

David Brady is deputy director and Davies Family Senior Fellow at the Hoover Institution. He is the Bowen and Janice Arthur McCoy Professor of Political Science and Leadership Values in Stanford's Graduate School of Business, a professor of political science in the School of Humanities and Sciences, and a senior fellow at the Freeman Spogli Institute and the Stanford Institute for Economic Policy Research. He is a specialist on U.S. national elections. 

David M. Kennedy is the Donald J. McLachlan Professor of History, Emeritus at Stanford and Faculty Co-Director of the Bill Lane Center for the American West. Most famously, Professor Kennedy won the 2000 Pulitzer Prize for History for his book  Freedom from Fear: The American People in Depression and War, 1929-1945 (1999). 

Moderator: Coit D. Blacker is director and senior fellow at the Freeman Spogli Institute for International Studies, the Olivier Nomellini Professor in International Studies in the School of Humanities and Sciences, and the Olivier Nomellini Family University Fellow in Undergraduate Education. During the first Clinton administration, Blacker served as special assistant to the president for National Security Affairs and senior director for Russian, Ukrainian, and Eurasian affairs at the National Security Council (NSC). 

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Coit D. Blacker director and senior fellow, FSI, the Olivier Nomellini Professor in International Studies and Olivier Nomellini Family University Fellow in Undergraduate Education Moderator
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Former Shorenstein APARC Fellow
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Michael Armacost (April 15, 1937 – March 8, 2025) was a Shorenstein APARC Fellow at the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) from 2002 through 2021. In the interval between 1995 and 2002, Armacost served as president of Washington, D.C.'s Brookings Institution, the nation's oldest think tank and a leader in research on politics, government, international affairs, economics, and public policy. Previously, during his twenty-four-year government career, Armacost served, among other positions, as undersecretary of state for political affairs and as ambassador to Japan and the Philippines.

Armacost began his career in academia, as a professor of government at Pomona College. In 1969, he was awarded a White House Fellowship and was assigned to the Secretary and Deputy Secretary of State. Following a stint on the State Department's policy planning and coordination staff, he became a special assistant to the U.S. ambassador in Tokyo from 1972 to 74, his first foreign diplomatic post. Thereafter, he held senior Asian affairs and international security posts in the State Department, the Defense Department, and the National Security Council. From 1982 to 1984, he served as U.S. ambassador to the Philippines and was a key force in helping the country undergo a nonviolent transition to democracy. In 1989, President George Bush tapped him to become ambassador to Japan, considered one of the most important and sensitive U.S. diplomatic posts abroad.

Armacost authored four books, including, Friends or Rivals? The Insider's Account of U.S.–Japan Relations (1996), which draws on his tenure as ambassador, and Ballots, Bullets, and Bargains: American Foreign Policy and Presidential Elections (2015). He also co-edited, with Daniel Okimoto, the Future of America's Alliances in Northeast Asia, published in 2004 by Shorenstein APARC. Armacost served on numerous corporate and nonprofit boards, including TRW, AFLAC, Applied Materials, USEC, Inc., Cargill, Inc., and Carleton College, and he currently chairs the board of The Asia Foundation.  

A native of Ohio, Armacost graduated from Carleton College and earned his master's and doctorate degrees in public law and government from Columbia University. He received the President's Distinguished Service Award, the Defense Department's Distinguished Civilian Service Award, the Secretary of State's Distinguished Services Award, and the Japanese government’s Grand Cordon of the Order of the Rising Sun.

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Michael H. Armacost Shorenstein Distinguished Fellow at FSI’s Walter H. Shorenstein Asia-Pacific Research Center Speaker
David Brady deputy director and Davies Family Senior Fellow at the Hoover Institution Speaker
David Kennedy Donald J. McLachlan Professor of History Emeritus at Stanford and Faculty Co-Director of the Bill Lane Center for the American West Speaker
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Life expectancy at aged 65 is remarkably similar in the three Chinese cities of Hong Kong, Shanghai, and Taipei, even though the cities differ in levels of socioeconomic development, health systems, and other factors. Edward Jow-Ching Tu will discuss research that aims to understand this phenomenon. Despite unprecedented increases in life expectancy and attainment of similar current levels of life expectancy, the cities differ in the contributions of changes in major causes of death to the improvements in life expectancy among the elderly. Tu and colleagues have explored several possible determinants of these different patterns and trends in the three cities, including socioeconomic development, health service delivery systems, cause-of-death classification systems, and competing risks from cardiovascular disease and other diseases. Their analysis suggests that the effect of equity of health service delivery has become more important over time.

Edward Jow-Ching Tu is a senior lecturer of demography in the Division of Social Science at Hong Kong University of Science and Technology. His work is focused on the impact of fertility, mortality, and migration on socio-economic changes in East Asia countries with special emphasis on nations experiencing a transition from planned economy to market economy; on causes and impacts of mortality changes and health transition on aging societies; and on the causes of lowest-low fertility in many East Asia countries. He has several active research projects ongoing in China, Japan, Taiwan, Hong Kong, and Singapore. He holds graduate degress from West Virginia University, the University of Pennsylvania, and the University of Tennessee (Knoxville). Tu has worked extensively in Asia, and has served as an adjunct professor and taught in many universities in China, including Peking University, Peoples University, Nankai Univerity, and Fudan University. He had served as a senior research scientist at the New York State Health Department and as a research fellow (full professor) at the Institute for Social Sciences and Philosophy at Academia Sinica. Tu has also taught at the State University of New York in Albany.

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Edward Jow-Ching Tu Senior Lecturer of Demography at the Division of Social Science Speaker Hong Kong University of Science and Technology
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