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To celebrate its May Release, the Stanford China Program hosted a virtual book launch event for Fateful Decisions: Choices That Will Shape China’s Future (Stanford University Press) on June 2nd. Joining co-authors Thomas Fingar (Shorenstein APARC Fellow, Stanford University) and Jean C. Oi (Director, Stanford China Program; William Haas Professor of Chinese Politics, Stanford University) were contributors Karen Eggleston (Senior Fellow at FSI; Director of the Asia Health Policy Program, Shorenstein APARC, Stanford University), Barry Naughton (Sokwanlok Chair of Chinese International Affairs, School of Global Policy and Strategy, UC San Diego), and Andrew Walder (Senior Fellow at FSI; Denise O'Leary and Kent Thiry Professor, Stanford University). As Fingar and Oi point out in their volume, despite China’s extraordinary growth over the past 40 years, the country’s future is uncertain. China has enjoyed optimal conditions for development since the 1980s, but new hurdles including an aging populace, the loss of comparative economic advantage, a politically entrenched elite, and a population with rising expectations will test the country’s leaders. With each focusing on a different facet of China’s challenges, the panelists gathered to share their expertise and provide the audience with a glimpse into what the future might hold for this important country.

Following an introduction from Professor Jean Oi, the program kicked off with Professor Barry Naughton of University of California, San Diego, who discussed his chapter entitled “Grand Steerage.” Professor Naughton argued that, as it plans for the future, China’s policymaking is becoming increasingly technology-focused, particularly in the realm of economic policy. Naughton further notes that China’s economy is becoming simultaneously more state-guided and more centered around technology. This decision is a gamble, though: China is investing heavily in high-tech industries, advancing massive, centrally steered projects like the Greater Bay Area initiative and the Xiong’an New District. If they are successful, says Naughton, this will indeed be an incredible success. But, if they are not, China’s losses will be major: “There’s not really a middle ground.”

After Professor Naughton was Professor Karen Eggleston, an expert on health policy in Asia. Professor Eggleston’s chapter, “Demographic and Healthcare Challenges,” deals with emerging obstacles for China’s healthcare system, including population aging and the problems that come with it, like chronic diseases and elder care. Although China’s healthcare system has improved dramatically in recent decades, it has done so unevenly, notes Eggleston: life expectancy has greatly increased, but with disparities according to income, region, and urban vs. rural status; universal healthcare is available, but the benefit level is low, effectively limiting the standard of care many can receive. The ratio of health spending to GDP is also increasing, yet it is still modest compared to high-income countries. The COVID-19 crisis has, of course, introduced even more challenges: Will China be able to distribute future vaccines equitably? Will this crisis negatively affect young people’s decisions to choose healthcare as a career? Will telemedicine, which has seen a surge under the pandemic, improve or exacerbate existing disparities? China faces a multitude of constraints and choices going forward if it hopes to meet its population’s healthcare needs.

The audience then had a chance to hear from co-editor Thomas Fingar, speaking on his chapter, “Sources and Shapers of China’s Foreign Policy.” Fingar noted three key takeaways from both his chapter and his talk: Firstly, China’s foreign policy is a fundamental part of its national policy. Secondly, the global political environment plays an important role in shaping both foreign and domestic policy which, thirdly, plays an important role in shaping foreign policy. The conditions that allowed China to flourish over the past 40 years, emphasized Fingar, are very different from those of the present. In the 1970s and 80s, China was able to take advantage of Cold War bipolarity, globalization was in its infancy, and “China was the only significant developing country willing to embark, at that time, on the export-led path of development.” In recent years, though, China’s behavior internationally has alienated other countries; there are many competitors pursuing its style of development; and its needs and aspirations have changed, requiring more raw materials and depending upon multi-national economic agreements. Fingar suggests two potential foreign policy options: China could continue with its wolf warrior diplomacy, which has “alienated essentially all China’s neighbors to some degree,” or it could return to a style more similar to that of the 1980s and 90s Reform and Opening era. It remains to be seen which style will win out.

Finally, Professor Andrew Walder concluded the program with his discussion of China’s political future at large. His chapter, “China’s National Trajectory,” follows China’s remarkable advancement in recent years and “tr[ies] to divine what a lower growth era will mean for China’s political future.” The last 40 years of rapid growth have generated support for China’s political system, more patriotism, the near eradication of democracy movements, and an elite unity not seen in the 1970s and 80s. However, low growth rates could mean a reversal for many of these trends, says Walder. While the aforementioned support for and stability of the Chinese government was maintained by ever-improving living standards and upward mobility, a low growth period (coupled with an aging population) means the government will no longer be able to rely on these trends for popular support. Rather, it will need to improve its provision of public services to address present-day challenges. Regardless, argues Walder, the low growth era will undoubtedly lead to “dynamic changes underneath the façade of stability of Chinese politics….”

For more insights on the modern obstacles China faces and what they mean for the country’s future, check out Fateful Decisions: Choices That Will Shape China's Future, available for purchase now.

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Karen Eggleston Examines China’s Looming Demographic Crisis, in Fateful Decisions

Karen Eggleston Examines China’s Looming Demographic Crisis, in Fateful Decisions
Quote from Thomas Fingar and Jean Oi from, "China's Challeges: Now It Gets Much Harder"
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Now It Gets Much Harder: Thomas Fingar and Jean Oi Discuss China’s Challenges in The Washington Quarterly

Now It Gets Much Harder: Thomas Fingar and Jean Oi Discuss China’s Challenges in The Washington Quarterly
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APARC is pleased to share that Stanford alumnae Shiran Victoria Shen and Lizhi Liu have won prestigious awards for best dissertation in their fields. Both Shen and Liu earned their doctoral degrees in Political Science in 2018 and worked with Jean Oi, director of the China Program at APARC, during their tenure as doctoral students.

Shen, who is currently an assistant professor at the University of Virginia, has won the 2020 Harold D. Lasswell Award for her dissertation The Political Pollution Cycle: An Inconvenient Truth and How To Break It. The award is given annually by the American Political Science Association for “the best doctoral dissertation in the field of public policy.” Using a wide array of data, techniques, and research designs, Shen’s work explains how environmental change influences and is shaped by politics and policy. It centers on the critical case of air pollution control policies and uses China as a natural experiment.

Liu, whose doctoral research focuses on the political economy of e-commerce in China, has won the 2020 Ronald H. Coase Best Dissertation Award from the Society for Institutional and Organizational Economics. Her study proposes that China has devised a novel solution, that is, institutional outsourcing, to the central question of how developing states build market-supporting institutions. She is currently an assistant professor in the McDonough School of Business and a faculty affiliate of the Department of Government at Georgetown University.

Congratulations, Shiran and Lizhi, on your excellent work and prestigious awards!

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Asia Health Policy Program Alum Wins Rothman Epidemiology Prize

Dr. Young Kyung Do, an expert in health policy and management at the Seoul National University College of Healthy Policy and the inaugural postdoctoral fellow in Asia health policy at APARC, has been awarded the 2020 prize for his outstanding publication in the journal Epidemiology last year.
Asia Health Policy Program Alum Wins Rothman Epidemiology Prize
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Shiran Shen (left) and Lizhi Liu (right)
Shiran Shen (left) and Lizhi Liu (right).
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Interdisciplinary environmental scholar Shiran Victoria Shen is the recipient of the Harold D. Lasswell Award and political economist Lizhi Liu is the recipient of the Ronald H. Coase Award in recognition of their outstanding doctoral dissertations.

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Weighing only a few pounds and standing only a foot or two tall, the mousedeer of Southeast Asia are the smallest hoofed mammals in the world. Small and agile, they avoid predators through camouflage and stealth, blending quietly into the forest foliage around them.

These tiny deer also provide the opening metaphor in The Deer and the Dragon: Southeast Asia and China in the 21st Century, the newest book of Donald Emmerson, a senior fellow emeritus at FSI and the director of APARC's Southeast Asia Program. Emmerson uses the imagery of the deer—small but strategic—in contrast with the dragon, a creature of might and strength, to illustrate the power dynamics between the countries of Southeast Asia and China.

[Listen to our conversation with Emmerson about the book and keep reading below. To stay connected with our scholars and their research, sign up for APARC newsletters.]

The ASEAN nations trail the PRC by enormous margins in geographic size, population, and GDP. Though ASEAN overtook the EU to become China’s main trading partner in Q1 of 2020, China’s economic capacity is easily quadruple that of all ASEAN’s member countries combined.  Southeast Asia is also one of the most diverse regions in the world, and these differences have proven a historic and ongoing challenge to ASEAN’s effectiveness as a political body. This has been particularly observable in the fractured responses to China’s increased presence in the South China Sea. But these factors do not mean Southeast Asia must always fall in line with the policy goals of Beijing. Like mousedeer, these smaller nations can draw on other strategies and strengths to push back against encroachments from PRC initiatives.

Agency is not a property of the strong alone. Weaker powers can be proactive, too, however limited and contingent their agency may be.
Donald K. Emmerson
Senior Fellow Emeritus at FSI and Director of the Southeast Asia Program

The fourteen chapters in The Deer and the Dragon aim to provide perspectives on how such strategies can be developed, as well as giving detailed context on the complexities of Southeast Asia-China relations and the impact these dynamics have both for the region and the global community. The contributors offer insights into the tensions between diversity and dependence in ASEAN-China investment and trade, discussions of the very divergent strategies nations such as Singapore and Indonesia have taken in their relations with China, and remarks on the political and developmental disparities nations such as Cambodia and Laos face in trying to balance their autonomy against China's influence and levy influence within ASEAN.

In looking at the broader conclusions of the book, Emmerson writes, "The future of Southeast Asia will greatly and probably decisively depend on what its individual states themselves either do or fail to do, [and] nothing can substitute for the creativity of Southeast Asian states in individual and joint pursuit of their own and their region’s security."

The volume is available through Stanford University Press and  Amazon.

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Fiery Cross Reef, Spratly Islands
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Strategy in the South China Sea

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In a new volume, Donald Emmerson explores how the ASEAN nations are navigating complex political and policy issues with China during a time when political cohesion within ASEAN is fractured and China is increasingly assertive in its goals.

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Stretching from China in the north to Indonesia in the south, the South China Sea – the third largest of the world’s 100-plus seas – possesses rich oil and natural gas reserves, constitutes a thriving fishing zone, and transits a vast amount of trade. It is also the center of disputes over issues of territorial sovereignty and maritime rights and interests involving China, Brunei, Indonesia, Malaysia, the Philippines, Taiwan, and Vietnam.

No Chinese behavior in Southeast Asia illustrates the “binary of strength over weakness more clearly than Beijing’s unilateral, adamant, and expansive assertion of full sovereignty over or proprietary rights in virtually all of the waters and land features in the South China Sea,” writes APARC’s Southeast Asia Program Director Donald K. Emmerson in his upcoming volume The Deer and the Dragon: Southeast Asia and China in the 21st Century. The fallout from COVID-19 and increased military activity in the region raise the risk of conflict between China and the United States, which has a strong interest in preventing China from controlling the disputed waterway.

Shorenstein APARC · Strategy in the South China Sea | Donald K. Emmerson

Against this background, the U.S. Embassy in Kuala Lumpur, Malaysia, hosted a virtual conversation with Emmerson, titled “Strategy in the South China Sea.” Held on May 12, 2020 (May 13 in Kuala Lumpur), the discussion drew attendees from across the United States and Southeast Asia. Emmerson's analysis focuses on issues such as the tactics China has used to advance its goal in the South China Sea; how the countries of Southeast Asia are reacting to the situation and whether they are pursuing defined strategies regarding the tensions in the region; and what an ASEAN strategy in the South China Sea might look like. Listen to his presentation above or on our SoundCloud channel.

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Fiery Cross Reef, Spratly Islands. | Loco Steve via Flickr, CC BY-SA 2.0.
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Donald K. Emmerson analyzes China’s tactics in the South China Sea and how the countries of Southeast Asia are reacting to the tensions in the disputed waterway.

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Cover of the book 'The Deer and the Dragon: Southeast Asia and China in the 21st Century"

Southeast Asia is arguably the most diverse region in the world. Accordingly, rather than addressing the exact same question, the contributors to this volume have — as experts on Southeast Asia-China relations — explored the matters they see as most important and most deserving of exploration and exposure. After the editor’s introduction, the chapters proceed in pairs. Each pair and a closing chapter cover a distinctive theme in Southeast Asia’s interactions with China.

Featured among the historical and economic contexts needed to understand the interactions are security and development as Chinese goals and how diversified beyond China Southeast Asia’s trading partners are. Southeast Asian and Chinese perceptions of each other are examined using survey research and by asking whether China views the region as its “strategic backyard.” Two actual or intended expansions are analyzed: expanded Chinese sovereignty over the South China Sea and Beijing’s interest in using “overseas Chinese” to expand its influence in the region. The chapters on strategies analyze the very different ways of approaching China preferred by Singapore and Indonesia. Rather than documenting the obvious inequalities of size and power between China on the one hand and Cambodia and Laos on the other, the essays on disparities show how relations with China interact with asymmetries inside these two states. Policy implications of differing distances are drawn in the pieces on how Southeast Asia’s proximity to China affects the prospect of Chinese regional dominance as compared with far-off America’s role and as seen through the lens of Beijing’s far-flung Maritime Silk Road. A final chapter on a seventh theme features a Myanmar analyst’s retrospection on myths and illusions that have arisen to cloud how that country’s relations with China are interpreted, with possible implications for understanding Sino-Southeast Asian dealings with China more broadly.

Learn more about the book and listen to a podcast conversation with Donald K. Emmerson >> 
 

Reviews

"The Deer and the Dragon offers a novel contribution to studies of China–Southeast Asia relations from a diverse set of voices, inviting the authors into an enriching conversation with one another. It also provides a welcome riposte to prevailing depictions of Southeast Asia as either powerless to challenge a rising China or as mere pawns in a great game between Beijing and Washington."
— Hunter Marston, Journal of Asian Security and International Affairs (Vol. 8, Issue 2, July 2021)

"In The Deer and the Dragon, Emmerson, one of the most eminent thinkers on Southeast Asia, has rallied an army of top regional experts to examine the nature, dynamics and implications of the power asymmetries between China and the countries of Southeast Asia.”
— Yun Sun, Contemporary Southeast Asia (vol. 42, no. 3, Dec 2020)


"[T]his rich compilation unearths multiple dimensions of China’s geo-economic and geo-strategic intentions in Southeast Asia, while speaking to the dynamics of power and agency [...] It will be invaluable for scholars of Southeast Asia looking to understand China’s past, future and present interactions with the region."
— Anna Buckley, Security Challenges (Vol. 16, no. 4, Dec. 2020)


"As China’s relations with most of its southern neighbors deteriorate, there is a crying need for a detailed, nuanced study to explain why. The Deer and the Dragon is the book we have been waiting for. Its diverse points of view, depth of research, and sophistication of analysis make the book essential reading."
— Nayan Chanda, Global Asia
 

“The authors of this commendably well-edited book are among the finest experts on China’s relations with Southeast Asia.  The result does justice both to the complex and multifaceted nature of China’s regional influence and to the diversity and increasing self-assertiveness of its southern neighbors, who are far from mere pawns in a game of chess between big powers.”
Richard Heydarian, author of The Indo-Pacific: Trump, China, and the New Struggle for Global Mastery

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Southeast Asia and China in the 21st Century

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Sponsored by the Stanford China Program and the Stanford Center at Peking University.

The ravages of COVID-19 are now global. But the pandemic first struck in China, and the nation suffered a 6.8% decline in its first-quarter GDP. China is also the first country to move towards a recovery, however, rolling out government measures, re-opening businesses, and re-starting its economy. In this key moment, the Stanford China Program, in collaboration with alumni members of the Stanford Graduate School of Business, surveyed senior executives in China as their companies reboot their operations. In this two-part program, we first unveil potential trends and key takeaways from the survey. In the second half, we host a panel of prominent CxOs from China who give their insights and experiences rebooting their businesses. What are short-term challenges that companies in China currently face? What are some long-term implications of COVID-19 for their operational model, supply chain strategies, technology, and business digitization? What might they also mean, if any, for global trade relations and the future of globalization?

Agenda (in Pacific Time)

5:00-5:30 PM   Survey Presentation: Key Takeaways
5:30-6:15 PM   China CxO Panel: Discussion
6:15-6:45 PM   Audience Q&A

Agenda (in China)

8:00-8:30 AM   Survey Presentation: Key Takeaways
8:30-9:15 AM   China CxO Panel: Discussion
9:15-9:45 AM   Audience Q&A

 

PANEL SPEAKERS

Portrait of Shiqi WangAlvin Shiqi Wang (王世琪) has served as CEO and President of 21Vianet Group, Inc. since February 2018. Currently, Mr. Wang serves as Vice President of TUS Digital Group, a subsidiary of TUS Holdings, and serves on the board of directors of Beijing CIC Technology Co., Ltd. and Guangzhou Tuwei Technology Co., Ltd. . Mr. Wang has nearly 20 years of experience in the telecommunications industry, working at various renowned international companies, including 11 years with Ericsson, focusing primarily on strategy development and execution, corporate management, and equity investments. Mr. Wang received a bachelor's degree from Tsinghua University and an MBA from Peking University-Vlerick MBA Programme (BiMBA).

 

Portrait of Xiang WangXiang Wang (王翔) is President and Acting CFO of Xiaomi Corporation, responsible for platform functions and for assisting the CEO with Group operations. Mr. Wang joined Xiaomi Corporation in July 2015 served as its Senior Vice President and President for International Business, responsible for global expansion, IP strategy, and strategic partner relationship management. Mr. Wang has more than 20 years of experience in the semiconductor and communications fields, with great vision and comprehensive understanding of next-generation wireless communications. He has played an integral role in shaping Xiaomi’s international business operations including with respect to its intellectual property compliance, management and strategy throughout the world. In 2016, Mr. Wang put together an international team of sales and marketing teams to expand into more markets outside of China. Within just 3 years, he led his teams into over 90 markets. As of Q3 2019, Xiaomi’s international revenue accounted for 48.7% of its total revenue. Today, Xiaomi is ranked among top 5 smartphone brands in over 40 markets. Mr. Wang previously served as the Senior Vice President of Qualcomm and President of Qualcomm Greater China, leading the company’s business and operations in Greater China. Prior to that role, he was Vice President of Qualcomm CDMA Technology, responsible for Qualcomm chipset business and customer service in China. Under his leadership, Qualcomm rapidly extended and strengthened its partnerships with increasing numbers of Chinese manufacturing customers. Before joining Qualcomm, Mr. Wang held key positions in sales and marketing at internationally leading companies, including Motorola and Lucent/Agere. Mr. Wang earned his BSEE from Beijing Polytechnic University.

 

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Portrait of Simon Yang
Simon Yang (杨士宁) is the CEO of Yangtze Memory Technologies Co., Ltd. (YMTC), who brings YMTC to a new height in 3D NAND industry. As an experienced executive in the semiconductor industry for over 30 years, Dr. Yang served as the CEO of XMC, COO/CTO of SMIC, and CTO/SVP of Chartered Semiconductor (Now GlobalFoundries), in charge of fab operation and technical R&D. Before that, he was in the Portland Technology Development sector of Intel for more than 10 years, in which he led a series of technical R&D projects. Dr. Yang obtained a Bachelor’s Degree from Shanghai University of Science & Technology, and a Master’s Degree and a Doctoral Degree from Rensselaer Polytechnic Institute.

 

Portrait of Zhiqiang (ZZ) ZhangZhiqiang (ZZ) Zhang (张志强) is President of ABB in China since October 2018. He has extensive management experience and a deep understanding of the Chinese market, developed during his career at several large global companies over the past three decades. He joined ABB from Sandvik where he was Asia- Pacific Regional Holding Officer and President of Sandvik China, and Member of Sandvik Group Executive Committee. Prior to that, he held leadership positions at several other companies, including Nokia Siemens Networks, where he was President of the Greater China Region, and Siemens VDO Automotive, China, where he was President and CEO. Mr. Zhang is Non-Executive Board member of Georg Fischer AG (Switzerland) and Daetwyler Holding AG (Switzerland). He holds a bachelor’s degree in electronic engineering from Beijing Jiaotong University, China, and a master’s degree in business administration from the Smith School of Business at Queen’s University in Canada.

 

 

SURVEY PRESENTERS

Jean C. OiJean C. Oi is the William Haas Professor of Chinese Politics in the Department of Political Science and a senior fellow in the Freeman Spogli Institute for International Studies at Stanford University. She directs the China Program at the Walter H. Shorenstein Asia-Pacific Research Center and is the Lee Shau Kee Director of the Stanford Center at Peking University. Professor Oi has published extensively on China’s reforms. Recent books include Zouping Revisited: Adaptive Governance in a Chinese County, coedited with Steven Goldstein (Stanford University Press, 2018), and Challenges in the Process of China’s Urbanization, coedited with Karen Eggleston and Yiming Wang (2017). Current research is on fiscal reform and local government debt, continuing SOE reforms, and the Belt and Road Initiative.

 

Photo of Christopher ThomasChristopher Thomas was most recently a partner with McKinsey & Company. He served as co-Managing Partner for the Firm’s Global Digital Strategy service line as well as its Global IoT service line; and as the leader of its Asia Semiconductor Practice. Prior to McKinsey, Mr. Thomas spent ten years at Intel. He was the General Manager of Intel China, with joint ownership for the region’s $5 billion-plus P&L. In this role, he grew revenues by more than 50% and oversaw China’s successful elevation from a sales unit to an independent regional P&L business reporting directly into headquarters. Mr. Thomas began his career as a private equity investor at The Blackstone Group in New York City. He is currently a Visiting Professor at Tsinghua University, China’s leading educational institution. He received an MBA from Stanford Business School, where he was an Arjay Miller scholar; a Master of Arts in Political Science from Stanford University; and a Bachelor of Science in Economics, summa cum laude, from the Wharton School.

 

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Portrait of Xander Wu
Xander Wu (吴雪) oversees industry development and builds partnerships with the world’s top cloud computing companies for China Mobile International (USA). He helps clients expand their global footprint and advises companies on best practices for digital transformation. Mr. Wu has 13 years' experience in the global 4G and 5G industry, with a track record of achieving a number of the world’s first milestones in 5G and several de-facto standards for 4G and data networks. Mr. Wu graduated from Stanford Graduate School of Business, where he researched digital transformation and advised startups in the energy sector. He serves as a mentor at several incubators such as Plug and Play, helping startups find the right product/market fit and tailor go-to-market strategy.

 

Via Zoom Webinar.
Register at: https://bit.ly/2U2r30q

Alvin Shiqi Wang (王世琪) <br>CEO, President of 21Vianet Group, Inc.<br><br>
Xiang Wang (王翔) <br>President of Xiaomi Corporation<br><br>
Simon Yang (杨士宁) <br>CEO of Yangtze Memory Technologies Co., Ltd. (YMTC)<br><br>
Zhiqiang (ZZ) Zhang (张志强) <br>President, ABB (China)<br><br>
Jean C. Oi <br>Director of Shorenstein APARC China Program; William Haas Professor of Chinese Politics, Stanford University<br><br>
Christopher Thomas <br>Visiting Professor, Tsinghua University<br><br>
Xander Wu (吴雪) <br>China Mobile International (USA)<br><br>
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On May 15, 2020, the King Center on Global Development held a virtual panel discussion with the Shorenstein APARC on the economic impact of COVID-19 in China. As China lifts its lockdown and U.S. cases of COVID-19 ramp up, three APARC faculty members — Karen Eggleston, Scott Rozelle, and Xueguang Zhou — joined the King Center’s China Program Director Hongbin Li to analyze the Chinese government’s initial response to the coronavirus outbreak and how the virus has impacted urban and rural employment in China’s health care sectors. Watch the panel discussion:

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Michael McFaul, Xueguang Zhou, Karen Eggleston, Gi-Wook Shin, Don Emmerson, and Yong Suk Lee
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FSI Hosts APARC Panel on COVID-19 Impacts in Asia

Scholars from each of APARC's programs offer insights on policy responses to COVID-19 throughout Asia.
FSI Hosts APARC Panel on COVID-19 Impacts in Asia
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Stories in a Time of Pandemic: APARC Alumni Share Their Experiences

We've asked some of our former scholars how COVID-19 is changing life in the many places around the world they call home.
Stories in a Time of Pandemic: APARC Alumni Share Their Experiences
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Karen Eggleston, Scott Rozelle, and Xueguang Zhou join the King Center on Global Development’s Hongbin Li to examine how COVID-19 has impacted urban and rural employment in China’s health care sectors.

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Noa Ronkin
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What are the Chinese government’s objectives for the development of its healthcare system? How do these ambitions affect its interaction with U.S. and other foreign healthcare markets? And what policy recommendations should lawmakers consider regarding the development of China's healthcare system and its implications for U.S. national interests? These are some of the questions that APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston discussed in her testimony before the U.S.-China Economic and Security Review Commission on May 7, 2020.

Watch Eggleston’s testimony (start time 23:25]

Read Eggleston's complete testimony
Download pdf

[To receive more stories like this in your inbox sign up for APARC’s newsletters]

Chaired by Dr. Robin Cleveland, the commission’s hearing, “China’s Evolving Healthcare Ecosystem: Challenges and Opportunities,” focused on China's domestic healthcare infrastructure and its use of technology in the light of the COVID-19 pandemic. The commission listened as Eggleston reviewed the strides China has made in its national health reforms and highlighted the many challenges its health system now faces. “It is in the interest of Americans and Chinese to have a strong, resilient healthcare system in China,” she said. “The United States should reemphasize scientific, evidence-based health policy and regulation, and encourage China to do so as well.”

The commission’s mandate is to investigate and submit to Congress an annual report on the national security implications of the bilateral trade and economic relationship between the United States and China and to provide recommendations to Congress for legislative action.

Ambitious Goals, Complex Challenges

Reforms over the past two decades, noted Eggleston, have brought China’s health system closer to a level of reliability and accessibility commensurate with the country’s dramatic economic growth. The government has already achieved its goal of providing universal health coverage and has made significant progress in many of the areas outlined in its “Healthy China 2030” blueprint, including tackling health disparities between regional and urban/rural population subgroups and building a more comprehensive and higher quality health service delivery system.

Still, China faces many daunting challenges, from dealing with COVID-19 and its aftermath to other urgent and lingering needs, such as tackling its looming demographic crisis and promoting healthy aging, addressing patient-provider tensions and trust, and changing provider payment to promote “value” rather than volume. If China is to make its investments in universal health coverage and rapid medical spending growth sustainable, said Eggleston, then it must build an infrastructure that increases health system efficiency, strengthens primary care, reforms provider payment system, and protects the most vulnerable from illness-induced poverty.

Constructive policies in support of health system improvements in both the United States and China could strengthen the global capacity to control future pandemics and avoid the devastating social and economic effects of future outbreaks on the scale of COVID-19.
Karen Eggleston

Technology and COVID-19 Response

Like other countries, China’s government and private sector have utilized various technologies in response to the COVID-19 crisis, such as telemedicine, “internet-plus” healthcare, and contact tracing applications, and are deploying digital and biotechnologies in efforts focused on epidemic mentoring and on treatment and vaccine development. Eggleston noted that the response to COVID-19 “will leave an indelible mark on health policies for decades to come,” not only in terms of technology adoption but also organizational innovation. One would hope to see future prioritization in resource allocation and renewed investment in the diagnosis and treatment of health system weaknesses, she added.

Recommendations for Congress

In all our policies and interactions, Eggleston concluded her testimony, we should remember that China is large and diverse, that local government agencies are those that make many important decisions in health policies as in other policies, and that the “Chinese people” are not synonymous with any given leader. “Avoid politicizing the COVID-19 pandemic and other health and humanitarian issues,” she noted. “In other geopolitical considerations in bilateral US-China relations, uphold U.S. interests while encouraging the PRC to be active as a globally responsible stakeholder.”

The U.S. government should encourage China and its scientists and firms to work collaboratively with multilateral efforts to prevent and control future pandemics, she argued. Specific recommended actions include supporting efforts to strengthen primary care and population health interventions with proven cost-effectiveness; sharing experiences with regional, community-based efforts to address the social determinants of health and promote multisector policies for healthy aging; encouraging public-private collaborative governance arrangements to strengthen the health sector in China; promoting transparent peer review of research and international collaboration between Chinese and American scientists, medical educators, health systems researchers, and technology developers; and collaborating with Chinese counterparts to address regional issues of population health importance, such as health problems in the DPRK and integration of public health priorities into China’s Belt and Road Initiative.

Read Eggleston's complete testimony >> 

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FSI Hosts APARC Panel on COVID-19 Impacts in Asia

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Asia health policy expert Karen Eggleston provides testimony for a U.S.-China Economic and Security Review Commission hearing on China's domestic healthcare infrastructure and the use of technology in its healthcare system amid COVID-19.

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To celebrate its May release, contributors Karen Eggleston, Barry Naughton, and Andrew Walder will join editors Thomas Fingar and Jean Oi for a panel discussion of their volume Fateful Decisions: Choices That Will Shape China’s Future (Stanford University Press).  China has enjoyed an extraordinary run of rapid growth and development over the last 40 years.  Yet, as Fingar and Oi point out, China’s future is hardly set in stone.  Sustained economic growth, social welfare and stability will depend upon tough policy decisions confronting Beijing’s leaders today in what is a watershed moment.  Casting doubt on Beijing’s aversion to major reforms and its return to certain Mao-era policy tools, Oi and Fingar argue that China’s challenges are not only complex, but high-stakes – challenges that have become even more daunting in the aftermath of COVID-19.  As China battles the difficulties caused by an aging population, the loss of comparative economic advantage, a politically entrenched elite, and a population with rising expectations, today’s policy decisions will weigh heavily on its future. Topics explored in the volume include China's healthcare challenges in a slowing economy, its global ambitions and track record, economic aims and realities, the country’s mounting governance pressures, and more. 

 

Fateful Decisions is available for purchase here.

 

Fore more information on Fateful Decisions, check out these articles:

Karen Eggleston Examines China’s Looming Demographic Crisis, in Fateful Decisions

Now It Gets Much Harder: Thomas Fingar and Jean Oi Discuss China’s Challenges in The Washington Quarterly

China’s Challenges: Now It Gets Much Harder

 

Portrait of Karen EgglestonKaren Eggleston is a senior fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University, director of the Stanford Asia Health Policy Program, and deputy director of the Walter H. Shorenstein Asia-Pacific Research Center at FSI. She is also a fellow with the Stanford Center for Innovation in Global Health and a faculty research fellow of the National Bureau of Economic Research (NBER). Eggleston earned her PhD in public policy from Harvard University, studied in China for two years, and was a Fulbright scholar in South Korea. Her research focuses on comparative health systems and health reform in Asia, especially China; government and market roles in the health sector; supply-side incentives; healthcare productivity; and economic aspects of demographic change.

 

Portrait of Thomas FingarThomas Fingar is a Shorenstein Distinguished Fellow in the Shorenstein Asia-Pacific Research Center at Stanford University. From May 2005 through December 2008, he served as the first deputy director of national intelligence for analysis and, concurrently, as chairman of the National Intelligence Council. Previous positions include assistant secretary of state for Intelligence and Research (2000-2001, 2004–2005), principal deputy assistant secretary (2001–2003), deputy assistant secretary for analysis (1994–2000), director of the Office of Analysis for East Asia and the Pacific, and chief of the China Division. Fingar is a graduate of Cornell University (AB in government and history) and Stanford University (MA and PhD, both in political science). His most recent books are Uneasy Partnerships: China’s Engagement with Japan, the Koreas, and Russia in the Era of Reform (editor) (Stanford University Press, 2017); The New Great Game: China’s Relations with South and Central Asia in the Era of Reform (editor) (Stanford University Press, 2016); and Reducing Uncertainty: Intelligence Analysis and National Security (Stanford University Press, 2011).

 

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Photo of Barry Naughton
Barry Naughton is the So Kwanlok Professor at the School of Global Policy and Strategy, University of California–San Diego. Naughton’s work on the Chinese economy focuses on market transition; industry and technology; foreign trade; and political economy. His first book, Growing Out of the Plan, won the Ohira Prize in 1996, and a new edition of his popular survey and textbook, The Chinese Economy: Adaptation and Growth, appeared in 2018. Naughton did his dissertation research in China in 1982 and received his PhD in economics from Yale University.

 

Jean C. OiJean C. Oi is the William Haas Professor of Chinese Politics in the Department of Political Science and a senior fellow in the Freeman Spogli Institute for International Studies at Stanford University. She directs the China Program at the Walter H. Shorenstein Asia-Pacific Research Center and is the Lee Shau Kee Director of the Stanford Center at Peking University. Oi has published extensively on China’s reforms. Recent books include Zouping Revisited: Adaptive Governance in a Chinese County, coedited with Steven Goldstein (Stanford University Press, 2018), and Challenges in the Process of China’s Urbanization, coedited with Karen Eggleston and Yiming Wang (2017). Current research is on fiscal reform and local government debt, continuing SOE reforms, and the Belt and Road Initiative.

 

Portrait of Andrew WalderAndrew G. Walder is the Denise O’Leary and Kent Thiry Professor of Sociology in the School of Humanities and Sciences, and a senior fellow in the Freeman Spogli Institute for International Studies at Stanford University. A political sociologist, Walder has long specialized in the study of contemporary Chinese society and political economy. After receiving his PhD at the University of Michigan, he taught at Columbia, Harvard, and the Hong Kong University of Science and Technology. At Stanford he has served as chair of the Department of Sociology, director of the Asia-Pacific Research Center, and director of the Division of International, Comparative, and Area Studies in the School of Humanities and Sciences. His most recent books are Fractured Rebellion: The Beijing Red Guard Movement (2009), China under Mao: A Revolution Derailed (2015), and Agents of Disorder: Inside China’s Cultural Revolution (2019).

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Karen Eggleston <br> Senior Fellow at FSI; Director of the Asia Health Policy Program, Shorenstein APARC, Stanford University <br><br>
Thomas Fingar <br> Shorenstein APARC Fellow, Stanford University <br><br>
Barry Naughton <br> Sokwanlok Chair of Chinese International Affairs, School of Global Policy and Strategy, UC San Diego <br><br>
Jean C. Oi <br> Director, Stanford China Program; William Haas Professor of Chinese Politics, Stanford University <br><br>
Andrew Walder <br> Senior Fellow at FSI; Denise O'Leary and Kent Thiry Professor, Stanford University <br><br>
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U.S.-China relations had deteriorated long before the coronavirus outbreak. Over the last decade, many observers have concluded that China’s actions in the foreign policy arena have become more assertive, ambitious, and worrisome to the U.S.-led international order. APARC Fellow Thomas Fingar, however, argues that China’s foreign policy has changed far less than its rhetoric and the characterization of many commentators suggest. “I don’t think China is eager to displace the United States,” he says in our recent video Q&A.

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Fingar considers how the difficult choices facing the Chinese leadership – now exacerbated by the coronavirus pandemic – are poised to determine the future course of the country’s international behavior and what successful management of the relationship with China requires. “The requirement for them and us,” he emphasizes, “is to figure out how to transform the international order into something more sustainable, and the tragedy of the last three years is that we have surrendered much of the leadership role and a great deal of the confidence others have in the wisdom of the United State.” Watch:

These issues are the focus of Fingar’s chapter, “Sources and Shapers of China’s Foreign Policy,” in the new volume Fateful Decisions: Choices that Will Shape China’s Future, now out from Stanford University Press. Coedited by Fingar and APARC’s China Program Director Jean Oi, this volume is part of APARC’s monograph series with SUP.

Fingar argues that China’s foreign policy and international behavior are key components of Beijing’s overall objectives to maximize opportunities for economic growth and modernization. As economic growth slows and Beijing finds it increasingly difficult to meet its domestic challenges, incentives to continue to work with and within the U.S.-led international order remain compelling. In Fingar’s view, the realities of interdependence and the perceived need to maintain high rates of growth and ambitious developmental targets constrain Beijing to maintain more-or-less the same foreign policy practices it has followed since the dawn of the Reform and Opening era.

However, China’s decision to pursue its interests by working within the U.S.-led international order does not mean that it would remain a largely passive participant coerced (in Beijing’s view) to abide by rules and institutions that would restrain Beijing’s freedom of action, says Fingar. Beijing expects China to play a more influential role in shaping the global order, but it does not (yet) aspire to lead it.

This is the fourth installment in a series leading up to the publication of the volume Fateful Decisions. Explore the previous parts in the series via the links below.

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Quote from Thomas Fingar and Jean Oi from, "China's Challeges: Now It Gets Much Harder"
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Now It Gets Much Harder: Thomas Fingar and Jean Oi Discuss China’s Challenges in The Washington Quarterly

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In a video Q&A, Fingar discusses the challenges for the U.S.-China relationship and the principles that shape China’s foreign policy and international behavior.

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