After twelve years at Stanford’s Center on Democracy, Development, and the Rule of Law, the Taiwan Democracy Project will be returning to its original home at the Walter H. Shorenstein Asia-Pacific Research Center (APARC) this fall. During its tenure at CDDRL, the Taiwan Democracy Project was led by FSI Senior Fellow Larry Diamond, who expanded the research agenda to examine the political, social and regional dynamics confronting democracy in Taiwan. A particular focus for the Program was cross-Strait relations and the increasing threats from regional neighbors. 

The Taiwan Democracy Project hosted an annual conference on Taiwan democracy at Stanford bringing together Taiwanese scholars and experts, as well a very active speaker series that ran through the course of the academic year. Several publications also emerged from the program, most recently, Taiwan's Democracy Challenged: The Chen Shui-bian Years, edited by Yun-han Chu, Larry Diamond and Kharis Templeman, which provides a sweeping account of Taiwan’s democratic performance from 2000-2008.

Other edited books of the project compared political trajectories in Taiwan and mainland China, and assessed the policy and institutional challenges confronting the maturing democracies of Taiwan and Korea. A fourth book, assessing the recently concluded presidency of Ma Ying-jeou, is now in preparation. The program also hosted a fellowship program for senior public administrators in the Taiwan government who spent an academic quarter in residence at CDDRL. An undergraduate student fellowship allowed Stanford students to spend a summer in Taiwan to examine different dimensions of its democratic transition. 

"We are very proud of what we were able to accomplish during these last twelve years," said Larry Diamond at the conclusion of CDDRL's hosting of the project. "Taiwan is one of the most vibrant and successful democracies of the Third Wave of global democratization, and what we have learned has significant implications not only for Taiwan's democratic future, but for the possible - and I believe eventual - emergence of democracy on the mainland as well. We are especially grateful to our partners at the Taipei Economic and Cultural Office in San Francisco, which has provided generous support while always respecting the core principle of academic freedom."

In returning to APARC, the Taiwan Democracy Project’s focus will shift to examine the challenges of democracy and security and will be renamed the Taiwan Democracy and Security Project under the leadership of Karl Eikenberry, the Oksenberg-Rohlen Fellow and the director of the U.S.-Asia Security Initiative at APARC. Kharis Templeman, who has been at CDDRL for over four years managing the project, will continue in this capacity as the project's director at APARC. 

South Korean President Moon Jae-in and U.S. President Donald Trump recently held a summit in Washington, their first face-to-face meeting in a time of heightened tensions on the Korean Peninsula. Experts from the Shorenstein Asia-Pacific Research Center offered insights in a series of publications and press interviews.

In advance of the summit, William J. Perry Fellow Kathleen Stephens spoke on Bloomberg television about the challenges facing the United States and South Korea, and how those challenges would be prioritized during the bilateral meeting.

Moon would be bringing the message that the U.S.-South Korea alliance is a “strong one and that he remains committed to it,” and that, “only by working transparently and closely together” could the two countries address areas of concern, Stephens said.

“Only when Washington and Seoul are able to talk very frankly to each other and come up with a coordinated plan do we have any chance of making some progress on North Korea,” she added.

Stephens joined the program from Seoul, where a group of Shorenstein APARC faculty and fellows participated in a public seminar and the Korea-U.S. West Coast Strategic Forum, a biannual conference that seeks to foster dialogue about issues affecting the Korean Peninsula and the U.S.-South Korea alliance.

The seminar, held in conjunction with The Sejong Institute, received press coverage; such articles can be read on the Voice of America website (in Korean) and Sisa Journal website (in Korean).

In an analysis piece for Tokyo Business Today, Associate Director for Research Daniel Sneider assessed the outcomes of the summit between Moon and Trump, suggesting that their meeting was satisfactory – without signs of major discord.

“For the most part, this display of calculated pragmatism worked well. There was no visible daylight between the two leaders over how to handle the North and THAAD totally disappeared from the summit talk, at least in public and in the joint statement issued by the two governments.”

The summit, however, may prove to be a “temporary gain,” Sneider added. “Beneath the smiles, there was plenty of evidence of the gaps, and even the tensions, that exist between a progressive government in Seoul, one that echoes the views of its ideological predecessors of a decade ago, and a nationalist, conservative regime in Washington.”

Read the piece in English and Japanese.

Days after the summit, North Korea test-launched an intercontinental ballistic missile (ICBM), which the United States and South Korea followed by hosting joint military exercises.

Stephens spoke on WBUR radio about the ICBM test launch and the initial reactions of the Trump administration.

“If [President Trump’s] agenda is to take stronger defensive measures against North Korea, I think he will find strong partners in Japan and South Korea,” she said, noting that other measures, such as diplomacy and economic sanctions, have also been used to affect pressure on the regime.

Responding to a question about China’s relationship with North Korea, Stephens said Beijing has not exhausted all possible tools in its efforts to persuade Pyongyang to slow or abandon its nuclear and missile activities. This is because China fears a collapse of the regime and “takes a long view” in its calculus, she said.

This news item has been updated.

Colonel Patrick Winstead, the 2016-17 FSI senior military fellow at Shorenstein APARC, writes about the second annual orientation at U.S. Pacific Command headquarters

The mission of the Department of Defense (DoD) in the Indo-Asia-Pacific region recently became a bit clearer for 22 faculty and military fellows from Stanford, the Massachusetts Institute of Technology, the Naval Postgraduate School and the Daniel K. Inouye Asia-Pacific Center for Security Studies (APCSS). The U.S.-Asia Security Initiative at the Shorenstein Asia-Pacific Research Center (APARC) in the Freeman Spogli Institute (FSI) organized a group of faculty and fellows for a two-day orientation of United States Pacific Command (USPACOM) and its component military organizations in and around Honolulu, Hawaii, April 13-14, 2017. The purpose of the orientation was to provide researchers with a comprehensive understanding of how America’s armed forces both develop and implement U.S. national security strategy, doctrine and policy throughout Asia.

The trip began with a visit to the headquarters of USPACOM at Camp H.M. Smith. After receiving briefings about USPACOM's mission and operations, the group engaged in roundtable discussions with General Terrence O’Shaughnessy (Commander, U.S. Pacific Air Forces); Major General Kevin B. Schneider (Chief of Staff, USPACOM); Rear Admiral Mark Montgomery (Director for Operations, USPACOM); Major General Steven Rudd (Director for Strategic Planning and Policy, USPACOM); as well as other key joint directors and members of the command staff. The faculty and fellows provided short presentations on the situation in the South China Sea, U.S.-Philippine relations and cyber warfare to an audience of mid-grade military officers and civilian personnel assigned to USPACOM.

In addition to meeting with the leadership of USPACOM, the group was also afforded the opportunity to interact with personnel from the four separate component commands. Deputy Commanding General of U.S. Army Pacific, Major General Charlie Flynn, provided a command briefing at the U.S. Army Pacific headquarters at Fort Shafter. The briefing stimulated a wide-ranging discussion about Army initiatives and activities in support of USPACOM’s mission in the Indo-Asia-Pacific region. At Marine Corps Base Hawaii at Kaneohe Bay, under the guidance of trainers, the visitors took part in a hands-on experience operating Humvee simulators in a virtual-reality convoy setting and firing simulated weapons that Marines typically employ in combat operations. The first day of the trip ended with a working dinner at the historic Nimitz House with the Commander of the U.S. Pacific Fleet, Admiral Scott Swift, where the conversation ranged from Chinese military modernization to evolving U.S. naval doctrine.

Those themes carried into the second day, when the group met for several hours with faculty at APCSS for plenary presentations and multiple breakout sessions to facilitate in-depth dialogue on select topics including the threats posed by nuclear weapons on the Korean Peninsula and in South Asia. The day continued with a tour of the U.S.S Hopper, an Arleigh-Burke class guided missile destroyer, based at Pearl Harbor, Hawaii. Once onboard, the ship’s captain, Lieutenant Commander J.D. Gainey, provided briefings on Hopper’s mission and operational capabilities. In addition, the group spoke with members of the ship’s crew. The experience allowed the faculty and fellows to interact informally with sailors who serve in the Asia-Pacific theatre and to candidly discuss issues of concern. The second day of the orientation ended with a visit to the headquarters of U.S. Pacific Air Forces and a dialogue with O’Shaughnessy and his staff about the unique security challenges of the Indo-Asia-Pacific region, such as tyranny of distance, limited support bases and multiple emerging threats, and how those challenges impact the Air Force and the entire U.S. military’s preparations for contingencies in the region.

Overall, the orientation provided a unique opportunity to engage directly with high-level leaders of USPACOM and to learn first-hand about the challenges faced by those who serve in the armed forces. The orientation also provided a forum to discuss the United States’ national security interests in the region and its efforts to maintain peace and stability in the Indo-Asia-Pacific and to help maintain a rules-based, liberal democratic order.

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Emily Tuong-Vi Nguyen, a Stanford student studying human biology, writes about the Asia Health Policy Program’s international conference on diabetes

The Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center hosted the Net Value in Diabetes Management Workshop in March to discuss progress on an international research collaboration. Research teams from Hong Kong, Singapore, China, Taiwan, South Korea and the United States convened at the Stanford Center at Peking University (SCPKU) in Beijing to work on research that compares utilization and spending patterns on diabetes across different countries and to develop a method for measuring the net value of diabetes internationally, based on previous methods discussed in a Eggleston and Newhouse et al. 2009 study with Mayo Clinic Data for Type 2 diabetes.

The research teams from various Asian countries are attempting to calculate the net value of diabetes in those countries by observing the changes in diabetes value and spending. These calculations include monetizing the value of health benefits of new treatments and improvements in health, as well as avoided spending on treatments when prevention was effective, and associated mortality and probability of survival. Previous models used to measure diabetic values and risks, such as the United Kingdom Prospective Diabetes Study (UKPDS) risk engine that was created from U.K. data and populations, are not very relevant for Asian populations. The goal is to create separate risk models specifically suited for populations from Hong Kong, Singapore, China, Taiwan and South Korea.

During the workshop that spanned two days, the research teams had an opportunity to share updates on their individual projects and to discuss methods and ideas for future collaboration.

On the first day, each research team presented its work, describing data sets and explaining the risk models that were used or developed. Karen Eggleston, director of the Asia Health Policy Program, delivered introductory remarks and shared current progress by the Japan and Netherlands research teams on calculating value and risk for diabetes with data from the Netherlands and Japan. The data sets from those two countries were best estimated by the JJ Risk Engine for the Japan data and the UKPDS model for the Netherlands data.

Chao Quan of the University of Hong Kong presented the risk model used for Hong Kong populations. His work primarily looked at how the UKPDS risk engine predicted risk in Hong Kong populations as compared to a local Hong Kong risk engine and how to best calibrate the Hong Kong risk engine. His next step will be to monetize the value for improved survival in diabetes in Hong Kong. He offered to re-estimate the model using the risk factors available on others’ datasets so that the Hong Kong risk model could potentially be used by other teams as well.

Stefan Ma and Zheng Li Yau of the Ministry of Health of Singapore discussed the 5-year prediction model and statistical methods they used for all-cause mortality of Singaporean individuals with diabetes. Their work is based on Singapore’s extensive administrative and claims data as well as data provided by the national health surveys conducted every six years by the National Health Service of Singapore. The researchers plan to look into how their overall risk model compares with models for specific subpopulations, such as Chinese, Malay and Indian populations in Singapore.

Katherine Hastings from the Stanford University team, led by principal investigator Latha Palaniappan, presented preliminary ideas about measuring cardiovascular risk with the Atherosclerotic Cardiovascular Disease Risk Score in analyses of Stanford health system diabetic patients. The researchers are collaborating with a clinical bioinformatics team at Stanford to use machine learning to expedite the analysis.

Min Yu and Haibin Wu of the Zhejiang Center for Disease Control and Prevention shared results from their analysis of health data collected from community health centers for diabetes management, diabetes surveillance data, cause of death data and insurance claims data that showed relationships between different patient characteristics and insurance types. The researchers then estimated the annual cost of Type 2 diabetes and its complications in Tongxiang province, China.

Hai Fang and Huyang Zhang of Peking University worked with claims data of diabetic patients insured by the New Cooperative Medical Scheme in Beijing, and at the workshop, shared regression analyses on the relationship between outpatient visits and inpatient admissions.

Jianqun Dong of the People’s Republic of China Center for Disease Control and Prevention presented ongoing research about diabetes management in China, including preliminary results of a randomized control trial of diabetes self-management strategies.

Wankyo Chung of Seoul National University shared preliminary estimates of a risk model for mortality among diabetic patients in South Korea and discussed next steps for estimating net value of diabetes management using the detailed clinical and claims data available in South Korea.

On the second day, the workshop concluded with a videoconference between workshop participants in Beijing and collaborators at Stanford Graduate Business School, including Stanford professor Latha Palaniappan and Harvard visiting professor Joseph P. Newhouse, using the Highly Immersive Classroom.

The workshop was a good opportunity for the research teams to discuss preliminary models, to offer each other suggestions regarding research methods, and to discuss the future direction of the international collaboration on the net value of diabetes. All research teams are preparing comparative research papers that will be included in the working paper series of the Asia Health Policy Program. A follow-up event will be held at Stanford in November 2017 in recognition of World Diabetes Day.