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1862. Substance Abuse Policy in Thailand: Current Challenges and Future Strategies
- Author:
- Darika Saingam
- Publication Date:
- 01-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Substance abuse has been an important social and public health problem in Thailand for decades. The National Household Survey on Substance and Alcohol Use in Thailand, which has been conducted six times, shows that substance abuse has steadily increased. Extrapolated country-wide in recent data, the estimated number of people who have used at least one addictive substance at some time in their lives was 2,964,444 or 5.8% of the total population aged 12 - 65 years. Kratom, Methamphetamine, methamphetamine hydrochloride crystal (ice), and cannabis were the most prevalent substances of abuse. Historical documentation and policy reports were used in this study. The objectives of this study were to complete a document review, determine the effectiveness of previous measures to control illegal substance abuse in Thailand, and consider options for the future. Controlling illegal substance abuse in the future and minimizing total harm requires a delicate balance of efforts to reduce the prevalence, quantity, and harmful effects of substances. Drug policy interventions should be continually evaluated for their effectiveness. The strategies relevant to drug policy, apart from primary prevention, are health services for chronic drug users, reform of criminal sanctions against drug addicts, and legalization of kratom.
- Topic:
- Health, Drugs, and Substance Abuse
- Political Geography:
- Asia and Thailand
1863. From Brain Drain to Brain Circulation and Linkage
- Author:
- Gi-Wook Shin and Rennie Moon
- Publication Date:
- 01-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- The development community has increased its focus on higher education over the past two decades, recognizing that education can contribute to building up a country’s capacity for participation in an increasingly knowledge-based world economy and accelerate economic growth. The value added by higher education to economies—job creation, innovation, enhanced entrepreneurship, and research, a core higher education activity—has been highlighted by an important body of literature. Yet experts remain concerned that investing in higher education in less-developed countries may lead to a “brain drain”--highly educated students and professionals permanently leaving their home countries. In the 2016 Kauffman report on international science, technology, engineering, and math (STEM) students in the United States, for instance, 48 percent among a randomly sampled survey of 2,322 foreign doctoral students in the United States wished to stay there after graduation, with only 12 percent wanting to leave and 40.5 percent being undecided. In fact, high percentages of foreign students in the United States with doctorates in science and engineering continue to stay in the United States, creating a brain drain problem for the sending countries. Because students tend to move from developing to developed countries to study, brain drain is more problematic for developing countries. In addition, given accelerated talent flows around the world and the increasing integration of less-developed countries into global value chains, the negative impact of brain drain could be further amplified. As demonstrated by the studies reviewed in this paper, the migration of high-skilled professionals from developing countries may indeed create brain drain for them, but at the same time can significantly enhance the social and economic development of their home countries, regardless of whether or not they decide to return home, thus complicating what used to be seen as a straightforward case of brain drain. From Brain Drain to Brain Circulation and Linkage examines how brain drain can contribute to development for the sending countries through brain circulation and linkage. It provides an overview of the conceptual framework to map out high-skilled labor flows, identifies empirical cases and policies in Asia that demonstrate high-skilled migrant professionals actually make significant contributions to their home countries (beyond monetary remittances), summarizes key social and economic enabling factors that are important in attracting and motivating migrant high-skilled professionals to return or engage with their home countries, and concludes with policy implications and suggestions for further research based on these findings.
- Topic:
- Development, Education, Higher Education, and Socioeconomics
- Political Geography:
- Global Focus
1864. Artificial Intelligence: The Algorithmic Revolution Driving the Next Industrial Transformation
- Author:
- Kenji E. Kushida
- Publication Date:
- 01-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Artificial Intelligence (AI) is rapidly becoming one of the underlying drivers of the next wave of industrial transformations. There is every reason to believe that we are on the cusp of a sea change in how human activities and decision-making are transformed by abundant computing power. This research note will provide the basis for understanding the conceptual building blocks and paradigmatic examples of how the development of AI is accelerating, and how its deployment will be transformative.
- Topic:
- Industrial Policy, Science and Technology, Entrepreneurship, and Artificial Intelligence
- Political Geography:
- Global Focus
1865. Abenomics and Japan's Entrepreneurship and Innovation: Is the Third Arrow Pointed in the Right Direction for Global Competition in the Digital Era of Silicon Valley?
- Author:
- Kenji E. Kushida
- Publication Date:
- 01-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Given that much of the global leadership in value creation over the past couple of decades has been driven by the Silicon Valley model – not only a geographic region but a distinct ecosystem of complementary characteristics – the basic question this paper asks is how far Japan’s Abenomics reforms are pushing Japan towards being able to compete in an era dominated by Silicon Valley firms. To answer this, the first section of this paper looks at content of the third arrow of Abenomics. The second section then distills the Silicon Valley ecosystem into its key characteristics, sorts each of these characteristics according to the underlying institutions to put forth a model, and briefly evaluates whether third arrow reforms move Japan closer to a Silicon Valley model of entrepreneurship and innovation.
- Topic:
- Digital Economy, Entrepreneurship, Innovation, Digitization, and Sillicon Valley
- Political Geography:
- North America and United States of America
1866. Organizing Old Age Pensions for India’s Informal Workers: A Case Study of a Sector-Driven Approach
- Author:
- M.R. Narayana
- Publication Date:
- 04-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- About 88 percent of India’s total labor force is composed of informal (officially labeled “unorganized”) workers. As many as 388 million such workers lack old age income security by way of a pension system. The Atal Pension Yojana (APY) is the latest contributory, national-level old age pension scheme for unorganized workers, with an entry age of 18–40 years. In other words, all current unorganized workers above the age of 40 are excluded. How could a national pension system viably guarantee equal pension benefits to all current unorganized workers? This paper considers how such a system might work by offering a case study of a non-contributory pension scheme for building and other construction workers in Karnataka State, India. The results indicate that this state-level pension scheme, fully funded by sector-specific receipts, is financially viable and sustainable with high levels of coverage and adequacy. The robustness of these results is shown via sensitivity analyses of discount rates, inflation rates, and growth rates of specific purpose tax collections. Additional analyses outline the scenarios under which pension benefits could be extended to all informal workers in the sector studied.
- Topic:
- Labor Issues, Work Culture, Unions, and Pension
- Political Geography:
- India and Asia
1867. Selective Mortality and the Long-term Effects of Early-life Exposure to Natural Disasters
- Author:
- Margaret Triyana and Xing Xia
- Publication Date:
- 04-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- We analyze the effects of early-life shocks with varying degrees of severity on mortality and human capital outcomes in the Philippines. We exploit variations in typhoon exposure and the introduction of a short-term post-disaster relief policy. Severe typhoons are associated with increased mortality and adverse long-term outcomes. Before the disaster relief policy, mortality from in utero exposure to severe typhoons was 10 percent, and survivors exhibited similar levels of human capital as the unaffected. Once implemented, the policy appears to have mitigated the mortality effect of severe typhoons, and survivors have lower human capital in the long term.
- Topic:
- Disaster Relief, Natural Disasters, Human Capital, and Mortality
- Political Geography:
- Philippines
1868. Dual Practice of Public Hospital Physicians in Vietnam
- Author:
- Ngan Do and Young Kyung Do
- Publication Date:
- 04-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon of so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physicians engage in private practice. It also examines the commitment of dual practitioners to the public sector. The analysis is based on a hospital-based survey of 483 physicians at 10 public hospitals in four provinces of Vietnam. Nearly half of the participants in the study sample reported themselves as dual practitioners. Various types of private practice were mentioned. Private practice at health facilities owned by the private sector was the most prevalent, followed by private practice delivered at health facilities owned by the dual practitioners themselves. Private practice inside public hospitals was also noted. Dual practitioners were likely to be senior and hold management positions inside their public hospitals. Substantial income differences were found between dual practitioners and those physicians practicing in only the public sector. The majority of dual practitioners, however, reported the willingness to give up private practice if certain conditions were met, such as a basic salary increase or non-pecuniary benefits. The main reasons dual practitioners gave for not leaving the public sector included a sense of public responsibility and opportunities to gain a broader professional network and more training. This study reiterates the significant challenges associated with dual practice, including its financial implications and possible effects on health care quality and access. The need for a high-quality workforce committed to the public sector is particularly critical, given the possibility of universal insurance coverage. Future research should address the need to improve data collection on physicians’ dual practice and incorporate the topic in policy debates on health reform.
- Topic:
- Health, Health Care Policy, Reform, and Hospitals
- Political Geography:
- Asia and Vietnam
1869. Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan
- Author:
- Jui-fen Rachel Lu and Karen Eggleston
- Publication Date:
- 04-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan’s National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer. Analyzing a unique dataset linking medical claims, cancer registry data and proxies for income between 2004 and 2015, we find that lower-income patients are more likely to be diagnosed with later stages of breast cancer, and this pattern renders NHI coverage of anti-HER2 therapy pro-poor even before full coverage of the diagnostic tests. Moreover, the expansion of NHI coverage—including the FISH diagnostic test and trastuzumab for early-stage breast cancer—strengthened the pro-poor distribution of genetic testing and target treatment, albeit only marginally. The extent of pharmaceutical company coverage of testing and its impact on patient access are topics of our ongoing research, contrasting breast cancer with colorectal cancer.
- Topic:
- Health, Health Care Policy, Economic Inequality, and Medicine
- Political Geography:
- Taiwan and Asia
1870. Taiwan's Place in the Evolving Security Environment of East Asia
- Author:
- Kharis Templeman
- Publication Date:
- 07-2018
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- In March 2018 the Taiwan Democracy and Security Project, a part of the U.S.-Asia Security Initiative at Stanford University’s Shorenstein Asia- Pacific Research Center, convened a workshop that examined Taiwan’s place in the evolving security environment of East Asia. Participants from the United States, Taiwan, and elsewhere in Asia were experts on a wide array of economic, diplomatic, and security topics. The discussions at the workshop were intended to place Taiwan’s security challenges in a broader regional context, to consider possible obstacles to and opportunities for greater multilateral cooperation on security issues, and to devise a set of recommendations for steps that Taiwan and its friends and partners could take to enhance regional security relationships.
- Topic:
- International Relations, Security, Military Strategy, and Democracy
- Political Geography:
- China, Taiwan, and Asia