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1. Starr Forum: The US and the World Under Trump: The First 100 Days

Author:
Juliette N. Kayyem and Kori Schake
Publication Date:
04-2025
Content Type:
Video
Institution:
MIT Center for International Studies
Abstract:
Starr Forum: The US and the World Under Trump: The First 100 Days: Wednesday, April 16th, 2025. Juliette Kayyem and Kori Schake analyzed President Trump’s first 100 days in office and what this means for our nation and the world. Speakers: Juliette Kayyem is the faculty chair of the Homeland Security and Security and Global Health Projects at Harvard University and the Harvard Kennedy School of Government. She also serves as a senior national security analyst for CNN where she has been described as CNN’s “go to” for disasters. A contributing writer to The Atlantic, Professor Kayyem has a weekly security segment on NPR’s Boston station WGBH. Her most recent book, "The Devil Never Sleeps: Learning to Live in an Age of Disasters," was described in a New Yorker profile as an “engagingly urgent blueprint for rethinking our approach to disaster preparedness and response.” She served as President Obama’s assistant secretary for intergovernmental affairs at the Department of Homeland Security. Kori Schake leads the foreign and defense policy team at the American Enterprise Institute. She is the author of "Safe Passage: the Transition from British to American Hegemony," and a contributing writer at the Atlantic, War on the Rocks, and Bloomberg. Before joining AEI, Dr. Schake was the deputy director-general of the International Institute for Strategic Studies in London. She has had a distinguished career in government, working at the US State Department, the US Department of Defense, and the National Security Council at the White House. She has also taught at Stanford, West Point, Johns Hopkins University’s School of Advanced International Studies, National Defense University, and the University of Maryland. She has written additional books, including "America vs the West: Can the Liberal World Order Be Preserved?" and is coeditor, along with former Secretary of Defense Jim Mattis, of “Warriors & Citizens: American Views of Our Military.” Moderator: Evan Lieberman is the Total Professor of Political Science and Contemporary Africa and the director of the MIT Center for International Studies. He conducts research on the political-economy of development, especially in sub-Saharan Africa. He studies the democratic politics of governing ethnically and racially diverse societies, including the challenges of public health, climate adaptation, and ensuring respect for human dignity. Lieberman is the author, most recently, of "Until We Have Won Our Liberty: South Africa after Apartheid."
Topic:
Security, Foreign Policy, Domestic Politics, Public Health, and Donald Trump
Political Geography:
North America and United States of America

2. Considering Returns on Federal Investment in the Negotiated “Maximum Fair Price” of Drugs Under the Inflation Reduction Act: an Analysis

Author:
Edward W. Zhou, Paula G. da Silva, Debbie Quijada, and Fred D. Ledley
Publication Date:
03-2024
Content Type:
Working Paper
Institution:
Institute for New Economic Thinking (INET)
Abstract:
The Inflation Reduction Act (IRA) of 2022 contained landmark provisions authorizing government to negotiate a “maximum fair price” for selected Medicare Part D drugs considering the manufacturer’s research and development costs, federal support for discovery and development, the extent to which the drugs address unmet medical needs, and other factors. This working paper describes federal investment in the discovery and development of the ten drugs selected for price negotiation in the first year of the IRA as well as the health value created through Medicare Part D spending on these drugs. We identified $11.7 billion in NIH funding for basic or applied research leading to approval of these drugs with median investment costs of $895.4 million/drug. This early public investment provided a median cost savings to industry of $1,485 million/drug, comparable to reported levels of investment by industry. From 2017-2021, Medicare Part D spent $126.4 billion (median $10.7 billion) for these products before rebates. Excluding two products for diabetes, Medicare Part D spending was $97.4 billion and the total health value created was 650,940 QALYs or $67.7 billion (WTP/QALY=$104K) representing a negative residual health value of -$29.7 billion (before rebates). We argue that a negotiated fair price should provide returns on both private and public investments in these products commensurate with the scale and risk of these investments, with the principal return on public sector investments being the residual health value (net price) accruing to those using the product. These empirical data provide a cost basis for negotiating a fair price that rewards early government investments in innovation and provides social value for the public.
Topic:
Economics, Health, Public Health, Pharmaceuticals, and Public Investment
Political Geography:
North America and United States of America

3. Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System

Author:
David Blumenthal, Evan D. Gumas, Arnav Shah, Munira Z. Gunja, and Reginald D. Williams II
Publication Date:
09-2024
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement. Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower. Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.
Topic:
Development, Public Health, Efficiency, and Healthcare System
Political Geography:
North America and United States of America

4. Insights into the U.S. Maternal Mortality Crisis: An International Comparison

Author:
Munira Z. Gunja, Evan D. Gumas, Relebohile Masitha, and Laurie Zephyrin
Publication Date:
06-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
The United States continues to have the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic. And within the U.S., the rate is by far the highest for Black women. Most of these deaths — over 80 percent — are likely preventable.1 With policies and systems in place to support women during the perinatal period, several high-income countries report virtually no maternal deaths. As policymakers and health care delivery system leaders in the U.S. seek ways to end the nation’s maternal mortality crisis, these countries may offer viable solutions. This brief updates an earlier Commonwealth Fund study of differences in maternal mortality, maternal care workforce composition, and access to postpartum care and social protections between the U.S. and other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.2 In this edition, we have also included data on Chile, Japan, and Korea — all high-income countries with universal health care systems. For our analysis, we used the most recently available data from the U.S. Centers for Disease Control and Prevention (CDC) and from the Organisation for Economic Co-operation and Development (OECD), of which the U.S. is a member. Where country-specific data are more than five years old, we note whether more recent published data from other sources are available for that country. Readers should be aware that because the methods we used to derive updated numbers from other sources may be different from methods the OECD uses, data points may not be comparable to the U.S. rates. For complete details on our methods, see “How We Conducted This Study.”
Topic:
Development, Inequality, Public Health, and Maternal Mortality
Political Geography:
United Kingdom, Canada, Norway, France, Germany, Australia, Switzerland, North America, Sweden, Netherlands, New Zealand, and United States of America

5. CTC Sentinel: July/August 2024 Issue

Author:
Devorah Margolin, Gina Vale, Kristina Hummel, Samuel Bowles, and Noah Tucker
Publication Date:
08-2024
Content Type:
Journal Article
Journal:
CTC Sentinel
Institution:
The Combating Terrorism Center at West Point
Abstract:
Ten years ago, in August 2014, the Islamic State began its genocidal campaign against the Yazidi community. In our cover article, Devorah Margolin and Gina Vale evaluate how the group’s gendered violence has manifested during and after its caliphate years. “Even without its caliphate,” they write, “the Islamic State’s gendered violence continues, as its supporters and ideology remain. Arguably, the lack of timely and appropriate responses has perpetuated this violence.” Our interview this month is with William Braniff, director of the Center for Prevention Programs and Partnerships at the Department of Homeland Security. In it, he describes his office’s efforts to utilize a public health-informed approach to preventing targeted violence and terrorism. Edward Lemon and Noah Tucker examine Central Asians’ prominent role in recent global terror plots and attacks. They argue that analysis should focus more on “the factors that led to mobilization to Syria and Iraq a decade ago and that have been exacerbated in recent years, especially in Tajikistan, including crackdowns on religion, corrupt ineffective governance, high levels of migration, and well-established terror networks that are holdovers from the peak of the Islamic State” as a way to understand this evolving threat area. When news reports appeared earlier this summer suggesting that the leader of the Islamic State in Somalia, Abdulqadir Mumin, may have quietly become the “worldwide leader” of the Islamic State last year and may have been killed in a recent U.S. airstrike, the news created far more questions than answers. Austin Doctor and Gina Ligon take a nuanced look at what the developments—if true—could mean for the group. Jessica Davis provides analysis of the Islamic State’s post-caliphate financial strategies. “The future of the Islamic State’s financial infrastructure,” she writes, “is networked, resilient, and adaptive.” This reality, she warns, portends “a grim future for efforts to combat the group’s international presence.” Finally, in June, the U.S. State Department designated the Nordic Resistance Movement, the largest neo-Nazi group in Sweden, as a Specially Designated Global Terrorist, only the second white nationalist organization on its terrorist list. Peter Smith outlines the development of the group and considers what the designation could mean for its future.
Topic:
Genocide, Migration, Terrorism, Women, Islamic State, Gender Based Violence, Public Health, Yazidis, and Neo-Nazis
Political Geography:
Europe, Central Asia, Middle East, Tajikistan, North America, Sweden, and United States of America

6. Korea Matters for America/America Matters for Korea (2023)

Author:
East-West Center
Publication Date:
04-2023
Content Type:
Special Report
Institution:
East-West Center
Abstract:
The 4th edition of Korea Matters for America/America Matters for Korea, part of the Asia Matters for America initiative, maps the trade, investment, employment, business, diplomacy, security, education, tourism, and people-to-people connections between the United States and South Korea at the national, state, and local levels. This publication and the AsiaMattersforAmerica.org website are resources for understanding the robust and dynamic US-Indo-Pacific relationship.
Topic:
International Relations, Climate Change, Economics, Education, Environment, Politics, Science and Technology, Governance, Population, Public Health, and Travel
Political Geography:
Asia, South Korea, North Korea, North America, and United States of America

7. Japan Matters for America/America Matters for Japan (2023)

Author:
East-West Center
Publication Date:
02-2023
Content Type:
Special Report
Institution:
East-West Center
Abstract:
The 4th edition of Japan Matters for America/America Matters for Japan, part of the Asia Matters for America initiative, maps the trade, investment, employment, business, diplomacy, security, education, tourism, and people-to-people connections between the United States and Japan at the national, state, and local levels. This publication and the AsiaMattersforAmerica.org website are resources for understanding the robust and dynamic US-Indo-Pacific relationship.
Topic:
International Relations, Climate Change, Economics, Education, Politics, Science and Technology, Governance, Population, Public Health, and Travel
Political Geography:
Japan, Asia, North America, and United States of America

8. HIV, the Legacy of America’s Response, and Lessons for Future Outbreaks

Author:
Alisha Smith-Arthur
Publication Date:
11-2023
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
As I stood in line (safety distanced) to receive a COVID test before returning home to the US after a trip to Cote d’Ivoire in 2022, I was able to see and reflect upon the enduring legacy of the American public health diplomacy effort to fight the global pandemic of HIV. The testing site had the unmistakable dual-flag PEPFAR (The President’s Emergency Plan for AIDS Relief, announced by George W. Bush in 2003) logo outside, indicating that the testing equipment (and likely the training for the personnel inside) came via a PEPFAR project. I’ve seen similar stamps on rural labs and remote health posts across the countries I’ve worked in (as well as on the airport welcome signs of many a friendly health worker who has readily included me in their work), and it always serves to remind me of the common goals we are working towards in these health diplomacy projects.
Topic:
HIV/AIDS, Diplomacy, Public Health, and COVID-19
Political Geography:
Africa, North America, and United States of America

9. Overworked and Undervalued: Unmasking Primary Care Physicians’ Dissatisfaction in 10 High-Income Countries

Author:
Evan D. Gumas, Munira Z. Gunja, Arnav Shah, and Reginald D. Williams II
Publication Date:
08-2023
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
In many countries, including the United States, primary care physicians are reaching a breaking point.1 In 2021, an estimated 117,000 physicians in the U.S. left the workforce for reasons like retirement, burnout, and pandemic-related stressors.2 During the COVID-19 pandemic, primary care physicians around the world saw a dramatic fall in in-person visits in favor of telehealth, accompanied in some countries by decreases in revenue.3 The Commonwealth Fund also found that most primary care physicians experienced increases in their workload because of more time spent processing insurance payments, getting patients medications or treatments because of coverage restrictions, and reporting clinical or quality of care data to external entities. This has contributed to increased stress, emotional distress, demoralization, and burnout.4 This brief explores primary care physician work satisfaction in the first year of the pandemic — 2020 to 2021 — drawing from the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians. (See “How We Conducted This Survey” for more details.) Understanding how primary care physicians feel about their everyday work is crucial to improving their patients’ quality of care and to reversing the steady stream of professionals exiting the primary health care workforce. Across 10 high-income countries, including the U.S., we compare primary care physicians’ time spent with patients, number of patients seen, and job satisfaction.
Topic:
Health Care Policy, Public Health, Primary Care, and Dissatisfaction
Political Geography:
North America, Global Focus, and United States of America

10. Behavioral Responses to Supply‐​Side Drug Policy during the Opioid Epidemic

Author:
Simone Balestra, Heige Liebert, and Nicole Maestas
Publication Date:
12-2022
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
In the last 20 years, the use of prescription opioids has grown dramatically in the United States. Since 1999, the number of opioid prescriptions increased by 300 percent, surpassing 255 million prescriptions in 2012 (81.3 prescriptions per 100 people) before declining to 153 million prescriptions by 2019 (46.7 per 100 people). Opioids may be an effective analgesic for acute pain, but they are also associated with high risks of addiction and overdose. Death rates from opioid poisoning tripled between 2000 and 2014, contributing to a stunning reversal in 1999 of the long‐​running decline in midlife mortality. The increase in overdose deaths was initially driven by prescription opioid poisonings, but the more recent surge in deaths has been attributed to illicit opioids such as heroin and fentanyl.
Topic:
Economy, Drugs, Public Health, and Opioid Crisis
Political Geography:
North America and United States of America