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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. Election 2024 in Pakistan - A Catalyst for Strengthening Global Health Security Partnerships

Author:
Saeed Ahmad
Publication Date:
07-2024
Content Type:
Special Report
Institution:
East-West Center
Abstract:
Dr. Saeed Ahmad, a Public Health Coordinator with Pakistan’s Ministry of National Health Services, "explores the impact of Pakistan’s 2024 electoral outcomes on health policy formulation, resource allocation, and continued partnership and engagement with the United States on global health security and sustainable development."
Topic:
Security, Development, Elections, Partnerships, and Public Health
Political Geography:
Pakistan, South Asia, and United States of America

3. 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

4. Do Abortion Bans Affect Reproductive and Infant Health? Evidence from Texas’s 2021 Ban and its Impact on Health Disparities

Author:
Raymond Caraher
Publication Date:
07-2024
Content Type:
Working Paper
Institution:
Political Economy Research Institute (PERI), University of Massachusetts Amherst
Abstract:
The overturning of Roe v. Wade led to a wave of abortion bans in state legislatures across the United States. This emergence of a restrictive reproductive health policy environment has the potential to affect a wide range of reproductive health outcomes. This paper uses Texas’s 2021 6- week ban on abortion as a case study to examine the causal effect of an abortion ban on reproductive health outcomes, specifically abortion rates, fertility rates, and infant health outcomes. It examines how these effects may be heterogeneous by group, especially focusing on how the effects of abortion bans on reproductive health may be concentrated in those who are already facing disparities in reproductive health outcomes such as Black women. Using a difference-in-differences strategy, the analysis finds that the ban decreased abortion rates by over 40 percent, and increased fertility rates by about 4 percent, with the largest increases for Black non-Hispanic women and for counties far from a state with less restrictive abortion laws. This paper then constructs a measure of unmet reproductive health needs after an abortion ban, and finds that the unmet needs after the Texas 6-week ban are largest in counties with higher proportions of Black non-Hispanic residents, as well as counties which are furthest away from states which did not ban abortion after the Dobbs decision. The analysis then examines the effect of the ban on infant health outcomes, specifically focusing on heterogeneity in the effect of the ban on birth weight and infant mortality. This paper finds that the ban led to increases in the probability of an infant being born with very low birth weight of about 7 percent, with Black non-Hispanic infants experiencing the largest increases in the likelihood of very low birth weight. Additionally, the analysis finds significant increases in the infant mortality rate of about 6 percent after the abortion ban, again with Black non-Hispanic infants experiencing the largest increases in mortality. Further, the ban increased infant mortality rates more in counties which are further away from states which did not ban abortion after the Dobbs decision. The results suggest that the effects of abortion bans tend to be especially concentrated in marginalized populations, as well as those who are least able to shift their fertility options away from in-state abortions after a ban. The analysis shows that the trend towards an increasing number abortion bans will further exacerbate disparities in reproductive health outcomes.
Topic:
Public Health, Reproductive Health, and Abortion
Political Geography:
Texas and United States of America

5. Health Care for Women: How the U.S. Compares Internationally

Author:
Munira Z. Gunja, Relebohile Masitha, and Laurie Zephyrin
Publication Date:
08-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Recently released federal data once again show the United States with by far the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic.1 Racial disparities are also extreme: Black women in the U.S. are nearly three times more likely to die from pregnancy-related complications than white women are. But maternal deaths and complications may be an indicator of the nation’s wider failures with respect to women’s health and health care. Compared to women in other high-income countries, American women have long had worse access to the health care they need. While the U.S. spends more on health care than other countries do, surveys regularly find that Americans avoid seeking care because of costs at the highest rates, even as the U.S. continues to lead in the prevalence of chronic disease.2 At the same time, limited access to primary care and inadequate coordination of health services are likely factors in the nation’s poor performance when it comes to the prevention, diagnosis, and management of diseases.3 In this brief, we compare selected measures of health care access and outcomes for women in high-income countries. We drew upon data from four sources: the Commonwealth Fund’s 2023 International Health Policy Survey of Australia, Canada, France, Germany, the Netherlands, New Zealand, Switzerland, the United Kingdom, and the United States, which allowed us to analyze responses by race and ethnicity;4 the Centers for Disease Control and Prevention National Vital Statistics System; the Organisation for Economic Co-operation and Development (OECD); and the Institute for Health Metrics and Evaluation Global Burden of Disease. The latter two data sets permitted us to show results on selected measures for five additional countries — Chile, Japan, Korea, Norway, and Sweden. (See “How We Conducted This Survey” for more details.)
Topic:
Women, Public Health, Healthcare System, and Life Expectancy
Political Geography:
United Kingdom, Canada, France, Germany, Australia, and United States of America

6. 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

7. 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

8. Hospital Global Budgeting: Lessons from Maryland and Selected Nations

Author:
Bob Atlas
Publication Date:
06-2024
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
Issue: Maryland has utilized hospital global budgeting for a decade, but the approach is rarely used elsewhere in this country. The Centers for Medicare and Medicaid Services now hopes to test global budgeting in more states to help scale up this form of cost containment. Goals: Examine the ways Maryland, Canada, the Netherlands, New Zealand, and Norway employ hospital global budgeting and the lessons they offer to those hoping to see wider adoption in the United States. Methods: Analysis of the various health systems and expert interviews. Key Findings and Conclusion: Maryland and the four selected countries vary significantly in their approaches to hospital global budgeting. With its previous experience using price controls and current global budgeting approach, Maryland has succeeded in holding hospital spending growth steady for nearly a decade. While Norway combines fixed and variable payments to support global budgeting, the Netherlands and Canada’s province of Ontario are moving away from global budgeting in favor of other approaches. Meanwhile, New Zealand has added multiyear rolling forecasts and budgets to support its own model. Future approaches in the U.S. could prove more effective by factoring in the complexities, conflicting incentives, and potential unintended consequences of global budgeting.
Topic:
Public Health, Healthcare System, and Budgeting
Political Geography:
Canada, Maryland, Netherlands, New Zealand, and United States of America

9. 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

10. 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