The more a country depends on aid, the more distorted are its incentives to manage its own development in sustainably beneficial ways. Cambodia, a post-conflict state that cannot refuse aid, is rife with trial-and-error donor experiments and their unintended results, including bad governance—a major impediment to rational economic growth. Massive intervention by the UN in the early 1990s did help to end the Cambodian civil war and to prepare for more representative rule. Yet the country’s social indicators, the integrity of its political institutions, and its ability to manage its own development soon deteriorated. Based on a comparison of how more and less aid-dependent sectors have performed, Prof. Ear will highlight the complicity of foreign assistance in helping to degrade Cambodia’s political economy. Copies of his just-published book, Aid Dependence in Cambodia, will be available for sale. The book intertwines events in 1990s and 2000s Cambodia with the story of his own family’s life (and death) under the Khmer Rouge, escape to Vietnam in 1976, asylum in France in 1978, and immigration to America in 1985.

Comparative, policy-oriented research aimed at improving health care and the overall quality of life across the Asia-Pacific region is at the heart of AHPP’s mission and activities. As a research program within a world-class university, focusing exclusively on comparative health policy in Asia, it is unique. AHPP aims to provide evidence for addressing key health policy challenges in the Asia-Pacific, from links between poverty and ill health, to improving “value for money” and defining appropriate government and market roles in health systems. The program brings researchers to Stanford for on-site collaboration, and creates opportunities for Stanford students to conduct research in and about Asia.

The study of comparative health policy at the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) dates back almost a quarter century, with its roots in the Comparative Health Care Policy Research Project inaugurated in 1990. Starting with pioneering research on health economics in Japan, the program has expanded since then to encompass research on health policy and demographic change throughout the region, albeit with a continuing focus on East Asia in comparative perspective.

Collaborative initiatives and global researchers

AHPP’s leading-edge research involves experts on both sides of the Pacific. Among its current core research initiatives, AHPP is investigating the economic and social implications of Asia’s unprecedented demographic change, especially population aging and gender imbalance in China, as well as examining the determinants of health and health disparities among Asian populations.

AHPP is also analyzing evidence on health service delivery and financing in the Asia-Pacific region, such as the impact of expanding insurance coverage, reforming provider payment incentives, and contracting with the private sector. In addition, the program is conducting a comparative analysis of the historical development of health care institutions — like physician drug dispensing and recent reforms to separate prescribing from dispensing. AHPP also sponsors collaborative initiatives to address critical global health issues, including tobacco control, promotion of child health, and control of infectious diseases.

Preparing future health care policy experts

The program is dedicated to training the next generation of health policy experts: undergraduate and graduate students gain crucial research experience by their involvement in AHPP’s research initiatives, as well as invaluable mentoring for their own projects. A postdoctoral fellowship was initiated in 2008, followed three years later by a fellowship for young health policy experts from low-income countries of Asia.

In addition to numerous peer-reviewed journal articles, recent AHPP publications include Aging Asia: The Economic and Social Implications of Rapid Demographic Change in China, Japan, and South Korea and Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific. AHPP also runs its own working paper series that is open to scholars and health policy experts around the world.

Annual workshops and engaging seminars

Each year, AHPP assembles some of the world’s greatest health policy minds at Stanford to examine focused topics at conferences and workshops, resulting in special issues of journals, edited volumes, and ongoing collaborative research. In this thirtieth anniversary year of Shorenstein APARC, director Karen Eggleston organized a conference on “Economic Aspects of Population Aging in China and India,” co-sponsored by several related research programs at Harvard University.

In addition, AHPP organizes numerous public seminars throughout the academic year. Recent topics have included the battle against HIV/AIDS in Cambodia; immunizations and child health in Bangladesh; population aging in Japan; Vietnam’s health policy challenges; tobacco control in China; air pollution in South Asia; private health insurance in South Korea; and many other important health policy-related issues.

For several decades, Southeast Asia’s tracts of dense, old-growth rainforest have served as fertile ground for lumber, and much land has been converted to agriculture. Now, palm oil plantations are being planted where forests once stood.

In 2011, Indonesia, one of the region’s most prosperous countries, instituted a two-year moratorium on clearing new areas of forest, which is set to expire this May and has been criticized as having several loopholes. Other countries, including Cambodia and Myanmar, are losing forests rapidly.

Out of concern for climate change, international initiatives such as Reduced Emissions from Deforestation and forest Degradation (REDD+) have aimed to promote conservation and sustainable development in countries with significant forest cover. But these efforts do not always support local needs, and can inadvertently have negative impacts.

Tim Forsyth, a Lee Kong Chian NUS-Stanford Distinguished Fellow, speaks about the gap between conservation efforts and economic and social development in Southeast Asia. He is visiting Stanford this quarter from the London School of Economics and Political Science where he is a reader in environment and development at the Department of International Development.

What major types of forest management do we see across Southeast Asia today?

A number of countries have put laws in place to restrict illegal logging, and have established national park areas. These are usually old-growth rainforests that restrict logging and agriculture. The problem with national parks is that they put so many restrictions on land use that the vulnerable populations living around them either suffer or are forced to cut other trees. I have spent some years working in poorer villages in Indonesia and Thailand on the edge of protected forests, and usually conservation policies avoid the fact that people need to get livelihoods somehow. Government policy should acknowledge how these people are vulnerable to changes in crop prices and the availability of land, or else these people might be forced into breaking the rules of national parks.

There is also production forest, which usually includes forest plantations. These can include softwoods such as pine, or hardwoods such as teak — and increasingly oil palm for food and biofuels. Forest plantations are attractive to governments and businesses because they earn money and can provide timber for construction and exports. Sometimes, plantations also gain carbon credits, although this is not a lot of money so far. In terms of conservation, destroying old-growth forest and replacing it with a monoculture plantation is not good for biodiversity. It also does not benefit those local people who want to harvest forest products or use part of the land for agriculture.

Finally, there are community forests that are supposed to be places where people can grow food, live, and have forest cover. The definition of “community forest,” however, varies from place to place. In Thailand, for example, the way the government defines it is not very different from a conservation area, and consequently there is not much space for agriculture. The Philippines, on the other hand, is more decentralized and local people can shape the nature of the forest landscape more. Corruption, however, is a problem.

Is there an ideal model that successfully supports sustainable development? How does your research approach this issue?

There has been much progress in collaborations that involve willing governments, international advisors, and local actors — often in accordance with an international agreement such as the Convention on Biological Diversity. These collaborations are more useful than a single actor working alone, and they acknowledge a wider range of objectives.

A new initiative is Reducing Emissions from Deforestation and forest Degradation (REDD+). This is meant to encourage governments to slow down deforestation by rewarding them financially through carbon credits. But REDD+ has a number of challenges. The main problem is that the value of the credits is so low at the moment. REDD+ also overemphasizes forest cover, rather than forest quality. This means that if a satellite image of a country shows a lot of forest cover, that is good according to REDD+. But this gives no indication as to the biodiversity or the diversity of livelihoods inside a forest. It is a green light to all of the people who want fast-growing tree plantations, which makes them money and supplies them with wood for construction. In addition, it keeps a government happy because it supplies their country with timber and tax revenue, but this is not necessarily what you would call sustainable development.

There are elements of good models in different places, and it really depends on one’s viewpoint. Nepal offers a good example of community forestry because, in principle, it aims to engage local people more effectively and equally, and so can combine local development with the protection of national forests. From a development perspective, some forms of conservation can hurt poorer people and actually undermine conservation efforts. Therefore, in my work, I try to promote policy that acknowledges the needs of the more vulnerable populations. My research tries to make climate change policy more relevant to development processes in Southeast Asia. In my current project, I am seeing how policy recommendations about forests can be reshaped and reinterpreted locally in developing countries in order to address local interests. My goal is to understand how expert knowledge about climate change can be governed more effectively in order to enhance both development and conservation in Asia with better outcomes for everybody.

What can people do in their everyday lives to help combat climate change?

The practical problem of dealing with forest destruction and climate change in Southeast Asia is also a function of social and economic trends. As countries become more prosperous, more and more people live in megacities, drive cars, live in air-conditioned apartments, and frequent shopping malls.

A couple of years ago in Bangkok, I took lots of photographs of t-shirts printed with global warming messages and of people carrying reusable bags. When I was there recently, all of these things had disappeared. In other words, there is a tendency for people to think of conservation efforts as a fashion trend.

I do not think that any city in Asia is doing enough. We have to start planning cities in ways that use fewer greenhouse gases, and also to encourage people to realize that they can be real agents of change. At the moment, many urban citizens believe they can implement climate change policy by managing rural and forested landscapes. Instead, they need to realize the problems of these approaches, and to see what they can do themselves.