Should increasing exports be part of the solution to Greater Cleveland's -- and the nation's -- economic doldrums? Can export growth make this recovery job-filled rather than jobless?

That's a counterintuitive proposition, but one that is gaining traction in Northeast Ohio. Cleveland, Youngstown and other metros often see themselves on the losing end of globalization, as manufacturing has moved abroad and trade barriers and currency manipulations impede the entry of U.S.-made goods into foreign markets.

But exports bring tremendous benefits to workers, companies and the nation as a whole. Exporting companies tend to be more innovative. They pay higher wages across all skill levels. And they are a response to a new global reality: 95 percent of the world's customers live outside the United States.

Any successful export strategy, including the one that the Obama administration is developing, must start with where U.S. exports come from. Our major metropolitan areas are the nation's export hubs. In 2008, they produced about 64 percent of U.S. exports, including more than 62 percent of manufactured goods and 75 percent of services.

Northeast Ohio's major metros are leaders in exports, oriented toward global consumers in a way that most American regions are not. Exports contribute more than 12 percent of the gross metropolitan product in Akron, 13 percent in Cleveland, and a jaw-dropping 18 percent in Youngstown, compared to a national metro average of 10.9 percent.

Exports are also a source of much-needed jobs in these metros. As of 2008 (the most recent year for which we have data) there were 110,000 export jobs in the Cleveland metro and about 30,000 each in greater Akron and Youngstown. Every $1 billion in exports from the average metropolitan area in 2008 supported 5,800 jobs.

To leverage the powerful export activity already occurring in Cleveland and elsewhere, the Obama administration should connect its macroeconomic vision for export growth with the metro reality where the doubling will mostly occur.

For example, the president's export advisory council should include state and local leaders, and revamp export guidance and support to meet the needs of small firms, which find it hard to enter new markets.

But Northeast Ohio metros have their own work to do. The rate of export growth between 2003 and 2008 in Cleveland and Akron is lackluster when compared to the large metro average. U.S. companies dominate the global market in service exports, and the nation actually has a generous service trade surplus, but service exports' share of overall output in Northeast Ohio metros is smaller than the large metro average, and growth in service exports is slower.

Most troubling, Cleveland and its neighbors are underperforming when it comes to innovation, which is a critical ingredient for future international success. Metros that are manufacturing-oriented or export-intensive (or both) tend to create patents at a rate of just over five patents per 1,000 workers. But Cleveland, Akron and Youngstown fall short, with 2.8, 4.5, and 1 patent per 1,000 workers, respectively.

Northeast Ohio must accelerate its efforts to increase the region's innovation and export capacity, through regional organizations such as NorTech and JumpStart. Just as the president set an export goal for the nation, Northeast Ohio should embrace the opportunity to set its own aggressive export goals. Business groups, the Fund for Our Economic Future, universities and regional economic development organizations have made a start but need to devote more resources and collaborate to achieve those goals.

The region can make this happen. Organizations like the Manufacturing and Advocacy and Growth Network (MAGNET) and its partners, with support from the Fund and chambers, are working directly with companies to increase manufacturing innovation in Northeast Ohio, with increasing exports one of their major emphases.

For too long, the debate over export policy has been the exclusive domain of macro policymakers in Washington and a narrow clique of trade constituencies. It is time to include a larger portion of the business sector and, just as importantly, the places like Northeast Ohio, where exporting companies can thrive.

       

       

       

       

Event Information

In the midst of a global economic downturn, the world’s climate change negotiators will descend on Copenhagen in December to craft a post-2012 climate regime. But with the timing and impacts of climate change still uncertain—not to mention the ongoing transitions brought about by globalization and the increased cost of capital investment due to weak financial markets—tensions across countries are evident. Policy-makers must now think creatively to realize their goal of revitalizing the global economy through low carbon growth models.

2009 Brookings Blum Roundtable: Related Materials
	Read the roundtable report - Climate Crisis, Credit Crisis: The Quest for Green Growth »  Read the conference policy briefs »  Download the participant list » (PDF) Download the scene setter » (PDF) Download the full roundtable agenda » (PDF)

In its sixth annual gathering, led by Kemal Derviş and co-chaired by Strobe Talbott and Richard C. Blum, the Brookings Blum Roundtable convened leaders from the climate change and global development communities from July 30 through August 1, 2009 to discuss and debate policy options to stimulate green, pro-poor growth. By examining the challenges and opportunities policymakers face, the roundtable forged sustainable solutions to solve the climate crisis in a way that revitalizes the global economy and lifts the lives of the poor.

Lunch Briefing: 

“Towards a Global Climate Agreement: Key Insights from Project Catalyst”

Keynote Sessions:

“A Blueprint for Transatlantic Climate Cooperation”

“Compounding Crises: How Can and How Are the Poor Protecting Themselves?”

“Greening Business: Engaging the Private Sector in Climate Change Solutions”

Hal Harvey, ClimateWorks Foundation

Thomas Heller, Stanford Law School

Moderator: William Antholis, Brookings

John Podesta, Center for American Progress

Cem Özdemir, German Green Party

Moderator: Timothy Wirth, United Nations Foundation

Ernest Aryeetey, University of Ghana and Director, Africa Growth Initiative at Brookings

Helen Clark, United Nations Development Program

Raymond Offenheiser, Oxfam America

Moderator: Karen Kornbluh, Center for American Progress

Meg McDonald, Alcoa Foundation

Jane Nelson, Harvard Kennedy School of Government

Glenn Prickett, Conservation International

Mark Tercek, the Nature Conservancy

       

       

DC KIDS COUNT, housed at the nonprofit DC Action for Children, is the DC chapter of a nationwide network of local-level organizations aiming to provide a community-by-community picture of the conditions of children. The 26 year-old project is funded by the Annie E. Casey Foundation and its aim is to provide high-quality data and trend analysis as well as help local governments monitor budget and legislative decisions based on evidence of what works for children and families. As we pointed out in our recent papers and a blog, developing reliable and comprehensive data is a critical step to building effective community partnerships and producing outcomes that improve economic mobility and health in a neighborhood.

We discussed these issues with HyeSook Chung, Executive Director of DC Action for Children.

Q. Please summarize the history of the DC Kids Count project. What motivated it, and how it has evolved over the last years?

A. As part of the nationwide Kids Count network, each chapter tracks a number of indicators on child and family well-being through an online database called Kids Count Data Center. Each chapter also releases a yearly data book which summarizes the state of child well-being within their state or locality. When DC Action for Children became the host of DC Kids Count in 2012, I wanted to rethink the way we presented our data to move beyond the traditional print format into the exciting realm of visualizing data. This led to the beginning of our partnership with DataKind, a group of dedicated pro-bono data scientists who worked with us to create an interactive, web-based data tool that maps out indicators of child well-being across DC’s 39 neighborhood clusters.

We know that the neighborhood children grow up in, and the resources they have access to, plays a huge role in shaping children’s future opportunities. The maps we created with our Data Tool 2.0  reveal sharp disparities in DC neighborhoods: some DC neighborhoods are wealthy and have many assets, while others are characterized by high levels of poverty. The many challenges that come with high poverty neighborhoods include: poorer performing schools, more crime, and less access to libraries, parks, and healthy foods.  

Q. What type of indicators do you gather? How many years does the data cover? What level of granularity does the data have?

A. We track a variety of indicators of child well-being, including demographics, economic well-being, health and safety. The data is housed online in two places: The KIDS COUNT Data Center and our Data Tool 2.0. The Data Tool 2.0 maps the most recent available data at the neighborhood cluster, while the Data Center allows for a wider range of geographies (citywide and ward level) and different timeframes.  Many of the indicators have data from 1990 to the present.

Q. How do you measure the data tool’s impact on policy and legislation?

A. We have made it a priority to conduct internal evaluations to assess the utilization of the online tool, but we also believe that measuring the tool’s impact must go beyond traditional web analytics. We regularly use the Data Tool 2.0 in our work with city officials and direct service providers to offer an overview of the social context in the city’s different neighborhoods.     

In a city where the allocation of resources is often guided by personal relationships and old-school politics, it is important to show clearly whether budget decisions are aligned with the needs of our children. We believe that our Data Tool 2.0 project can bring much needed transparency to the allocation of the DC government budget and help achieve agreement.

Q. The DC Kids Count project is helping build data capacity across organizations, with the aim of creating a more “data-literate” city. Could you tell us about some of these initiatives? 

A. Businesses like Amazon and Netflix increasingly focus on finding “actionable” insights from their data. For them, “big data” analytics can help answer tough business questions. With the right platforms for analytics, they can increase efficiency or even improve operations and sales.

In a similar manner, we at DC Action for Children believe that big data opens up the opportunity for us to improve and reshape our strategy and decision making process to better align services with the needs of DC children in the same way Amazon or Netflix does with their customers.

For instance, we are offering the Child and Family Services Agency technical and data analysis support for their Healthy Families Thriving Communities Collaboratives, which are a citywide network of community-based organizations designed to embed family supports in their communities. Their mission is to strengthen and stabilize families and to prevent child abuse and neglect by offering services in the form of case management and support. We use KIDS COUNT data at the ward and neighborhood levels to highlight needs in the community and inform their planning. This encourages the Collaboratives’ staff to look at data differently—integrating it as a vital part of their program planning and strategy.

Q. What are some of the obstacles and challenges you face in integrating the data, and updating it?

A. Historically, our data analysis looked at more traditional indicators, such as program enrollment and the number of child welfare cases. But now we think we can use our access to big data to pull out patterns within our datasets and help guide the decisions of the city administrators. For example, if we are trying to prevent future child abuse cases, we can look at patterns analyzing family and child data in specific neighborhoods. We can use the type of predictive analysis practiced in the for-profit business to help us serve DC children more efficiently and effectively.

One of the most significant obstacles we face is ensuring that the indicators are up-to-date. This can be an issue with government agencies since some of them are slow in their release of new data.  Moreover, there is also no standard format across local agencies for how data is collected and released. Furthermore, data is often aggregated at different geographical units, like zip codes or census tracts. To get the data ready to upload to our Data Tool, we must recalculate the data into neighborhood clusters.  

Q. What policy changes would help produce better data-sharing ecosystems? 

A. DC has in many ways demonstrated leadership in data sharing. The Office of the Chief Technology Officer works to make a large variety of datasets publicly available. We have also seen large investments over the years to create new data systems that track progress and service delivery for different agencies. But our city can do more to promote a data-sharing ecosystem. So can other cities.

While multiple agencies are adopting innovative data systems, the systems are often siloed and do not speak to each other. Moreover, since data is tracked differently across agencies, based on needs and requirements for reporting, it is difficult for agencies to share data both publicly and internally. It is also often difficult to get access to de-identified disaggregated data for richer analysis. We are glad that many agencies recognize the value of robust data collection, but more data transparency policies would give us a better understanding of the challenges that lie behind improving the wellbeing of children in the city.

Q. What are the next steps for the DC Kids Count project, and how do you expect it to grow over the next few years?

A. We just finished wrapping up some of the final work on our DataTool 2.0. In terms of next steps, we are working on a handbook that explains how we created our Data Tool so that other Kids Count chapters and organizations can replicate and adapt our tool.

We would also like to add local budget data to the asset maps to see if public investments align with the neighborhoods that need it the most. This would give us a more nuanced understanding of the geography of DC budget investments, including inequities in investments by geography and demographics.

Big data analytics has changed the way we focus our priorities and engage in business practices. I’m committed to this movement. I think that, through big data, we can also revolutionize the way we do policy.

***

In conclusion, DC Kids Count, housed at the nonprofit DC Action for Children, belongs to a larger, nationwide group of organizations helping to better coordinate regional development through data-driven decision making. By centralizing different government databases, and providing real-time, community level data, DC Kids Count can help local government entities allocate their resources more efficiently and creatively and help foster place-conscious strategies. The process behind compiling the data also illustrates many of the challenges—data sharing, interoperability of data systems, access to real-time data involved in building “data- sharing ecosystems.”

      

The Earned Income Tax Credit (EITC) is one of the federal government’s most effective antipoverty policies. In 2012 alone, it lifted about 6.5 million people out of poverty, including roughly 3.3 million children. Designed to incentivize work, the program has been hugely successful in boosting employment rates among poor single mothers. And these accomplishments have led to broad bipartisan support from figures such as Paul Ryan, Greg Mankiw, and Patty Murray.

However, the EITC still falls short of its potential, in large part because it offers little to no support to many of the workers who need it most. As such, it’s encouraging that President Obama chose to make expanding the EITC a priority in his fiscal year 2015 budget. Still, we think there’s opportunity for more robust reforms that further broaden the reach of this important program—at no additional cost to taxpayers.

The president’s plan takes some modest (but important) steps toward strengthening this make-work-pay policy. First, it would increase benefits to workers without children—a subgroup that has historically received very little help from the program. More specifically, the White House would double their maximum credit from about $500 to about $1,000, raise the income level at which their benefits are fully phased out from about $15,000 a year to about $18,000 a year, and loosen the age eligibility restrictions so as to include childless young adults between the ages of 21 and 25. The president also proposes making permanent the benefit expansions for married couples and families with three or more children that were temporarily enacted through the Recovery Act.

This piece is posted in full at the Spotlight on Poverty and Opportunity website »

      

The Earned Income Tax Credit (EITC) provides a refundable tax credit to lower-income working families. In 2011, the EITC reached 27.9 million tax filers at a total cost of $62.9 billion. Almost 20 percent of tax filers receive the EITC, and the average credit amount is $2,254 (IRS 2013). After expansions to the EITC in the late 1980s through the late 1990s—under Democrat and Republican administrations—the EITC now occupies a central place in the U.S. safety net. Based on the Census Bureau’s 2012 Supplemental Poverty Measure (SPM), the EITC keeps 6.5 million people, including 3.3 million children, out of poverty (Center on Budget and Policy Priorities [CBPP] 2014a). No other tax or transfer program prevents more children from living a life of poverty, and only Social Security keeps more people above poverty.

Since the EITC is only eligible to tax filers who work, the credit’s impact on poverty takes place through encouraging employment by ensuring greater pay after taxes. The empirical research shows that the tax credit translates into sizable and robust increases in employment (Eissa and Liebman 1996; Meyer and Rosenbaum 2000, 2001). Thus, the credit reduces poverty through two channels: the actual credit, and increases in family earnings. This dual feature gives the EITC a unique place in the U.S. safety net; in contrast, many other programs redistribute income while, at least to some degree, discouraging work. Importantly, transferring income while encouraging work makes the EITC an efficient and cost-effective policy for increasing the after-tax income of low-earning Americans. Yet a program of this size and impact could be more equitable in its reach. Under the current design of the EITC, childless earners and families with only one child, for instance, receive disproportionately lower refunds. 

In 2014, families with two children (three or more children) are eligible for a maximum credit of $5,460 ($6,143) compared to $3,305 for families with one child. Married couples, despite their larger family sizes, receive only modestly more-generous EITC benefits compared to single filers. Childless earners benefit little from the EITC, and have a maximum credit of only $496—less than 10 percent of the two-child credit. 

Prominent proposals seek to mitigate these inequalities. President Obama’s fiscal year 2015 budget includes an expansion of the childless EITC, a concept outlined by John Karl Scholz in 2007 in a proposal for The Hamilton Project. Notably, MDRC is currently evaluating Paycheck Plus, a pilot program for an expanded EITC for workers without dependent children, for the New York City Center for Economic Opportunity (MDRC 2014). The recent Hamilton Project proposal for a secondary-earner tax credit addresses the so-called EITC penalty for married couples (Kearney and Turner 2013). And the more generous EITC credit for three or more children was recently enacted as part of the American Recovery and Reinvestment Act of 2009, and is currently scheduled to sunset in 2017. 

Considering this broad set of EITC reforms, and recognizing the demonstrated effectiveness of the program as an antipoverty program with numerous benefits, this policy memo proposes an expansion for the largest group of  EITC recipients: families with one child. In particular, I propose to expand the one-child schedule to be on par with the two-child schedule, in equivalence scale-adjusted terms. An equivalence scale captures the cost of living for a household of a given size (and demographic composition) relative to the cost of living for a reference household of a single adult, and is a standard component in defining poverty thresholds. The proposal expands the maximum credit for one-child families to $4,641, from $3,305 under current law, an increase of about 40 percent. The expansion will lead to a roughly $1,000 increase in after-tax income for taxpayers in the bottom 40 percent of the income distribution receiving the higher credit. As this paper outlines, the expansion is justified on equity and efficiency grounds. This expansion is anchored in the equity principle in that the generosity of the credit should be proportional to the needs of families of differing sizes; I use the equivalence scale implicit in the poverty thresholds of the Census SPM as a guide for household needs. This proposal is also supported by efficiency principles given the EITC’s demonstrated success at raising labor supply among single mothers. 

The target population for the proposal is low-income working families with children. Implementing this proposal requires legislative action by the federal government; it is important to note that altering the EITC schedule requires a simple amendment to the tax code, and not a massive overhaul of our nation’s tax system. The revenue cost of the proposal derives from additional federal costs of the EITC, less the additional payroll and ordinary federal income taxes. The private benefits include increases in after-tax income and reductions in poverty. The proposal would also generate social benefits through the spillover effects that the increase in income plays in improving health and children’s cognitive skills (Dahl and Lochner 2012; Evans and Garthwaite 2014; Hoynes, Miller, and Simon forthcoming).

Downloads

• Building on the Success of the Earned Income Tax Credit - Full Text

      

We are kicking off the new Millions Learning video series with a spotlight on Teach For All, one of the 14 case studies examined in the Millions Learning report. Teach For All is an international network of local, independent partner country organizations dedicated to improving educational opportunities for children and youth around the globe. From China to Bulgaria to Peru to Ghana, each partner organization recruits and trains recent top-performing graduates and professionals to teach in their country’s underserved communities for two years, with the ultimate goal of developing a cadre of education leaders, both inside and outside of the classroom.

In this video, Wendy Kopp, CEO and co-founder of Teach For All, discusses Teach For All’s unique approach to building a pipeline of future “learning leaders and champions” and the role that a supportive policy environment plays in enabling this process. Kopp then explains how Teach For All grew from the original Teach For America and Teach First in the United Kingdom to an international network of 40 partner countries, sharing her own lessons learned along the way.

To learn more about Millions Learning, please visit our interactive report, Millions Learning: Scaling up quality education in developing countries, and/or visit our webpage.

Video

• Getting millions to learn: Interview with Wendy Kopp of Teach For All

       

“We are not buildings artists; we are buildings leaders in society.” 

These stirring words of Juliano Mer Khamis, the charismatic founder of The Freedom Theatre (TFT) in Jenin refugee camp in Palestine, are coming true, despite his assassination five years ago. 

Against all odds, The Freedom Theatre, a beacon of creativity, discipline, and vision located in the heart of Jenin refugee camp, recently celebrated its tenth anniversary. Known for its fierce fighters and its conservatism, Jenin refugee camp, where over 16,000 live on one square kilometer, increasingly is known as well for its art. 

Juliano Mer Khamis returned to Jenin during the second Intifada to find his mother’s Stone Theatre (Arna’s Children tells her story) reduced - like so much of the camp—to rubble by Israeli tanks, and many of his mother’s student actors killed. In 2005 he joined forces with Jonatan Stanczak, currently Managing Director of TFT and Zakaria Zbeidi, a “Stone Theatre child” turned head of the Al-Aqsa brigades in Jenin, who later renounced militancy for cultural resistance. Together they rebuilt a theater in the camp, which evolved into The Freedom Theatre. 

Mer Khamis urged his acting students to wage a cultural intifada, warning that the occupation of the mind was more dangerous than the occupation of the body. Unlike many charismatic leaders, Mer Khamis developed an institution, not a cult of personality (even though he was adored). Following Juliano’s untimely and unsolved murder in 2011 — he was shot sitting in his car just outside the theater, with his infant son in his lap - the devastated theater soldiered on, a living testament to the powerful impact of his teaching and vision.

“When Juliano died he gave us the strength to continue and he showed us the strength we had in ourselves, so we kept going,”

Ahmad Matahen, age 24, a typical “child of The Freedom Theatre”, explained to me. Matahen joined in 2006; first as an actor, then as Juliano encouraged him to discover and exploit his individual talents, he moved into technology, engineering and stage design. He now studies stage design in Bethlehem, with the support of TFT, where he hopes eventually to work.

What a different future than Matahen might have had, if Mer Khamis had not invited in this street youth who had mocked the theater, and expressed his anger and frustration by throwing rocks at Israeli tanks. Matahen described the common attitude in Jenin:

“When you go to the camp and ask people what they want, they say they want to die. They have no jobs, no hope.”

When asked what he missed most after Juliano’s death, Matahen said “hugs”, something no one besides Juliano gave him. As a teenager, Ahmad, like so many of his contemporaries, saw his friends killed by the invading/occupying Israelis. Considered against the backdrop of trauma that pervades the camp, hugs are no small thing. They form the foundation for the self-confidence and sense of purpose that Matahen has gained from The Freedom Theatre.

High school dropout Ameer Abu Alrob defied his family and left his village to live and work at The Freedom Theatre. He traveled to India last year with a TFT group that also included two female acting students, for a ground-breaking, three-month Palestinian-Indian collaboration and tour with Janam Theater. Ameer and half of the other Palestinian student actors had never previously traveled outside Palestine, much less flown in a plane.

Through his experiences Ameer is not only broadening the horizons of his family and village, but, importantly, also introducing them to their own history through The Freedom Theatre productions such as The Siege. (One of the reasons Ameer dropped out was that school taught him nothing about his own environment and history).

Performed to date in Palestine and Great Britain, The Siege brings to life on stage the incident in 2002 during the second Intifada when armed Palestinian fighters along with some two hundred Palestinian civilians escaped the onslaught of Israeli gunfire and tanks by taking refuge in Bethlehem’s renowned Church of the Nativity. The trapped Palestinians - without food, water, or medical supplies - struggled to remain “steadfast”. After thirty-nine days, they surrendered, responding to the plea of a young mother whose baby’s life was at risk because the siege prevented her taking the infant to the hospital.

This decision, which reflected the fighters’ firm belief that the goal of their struggle was to help the Palestinian people, cost the insurgents dearly. In a European-brokered deal, they were exiled immediately upon exiting the Church — some to Europe and some to Gaza — with no hope of return (even though the European exile was supposed to last one year).

Nabil Al-Raee, The Freedom Theatre’s artistic director, explained that he wanted to re-open this important incident to present the Palestinian side, absent in the media. “This is the first time that we speak about these freedom fighters and tell their stories.” One and a half years of research, with travel to Europe and skype conversations with Gaza to interview those in exile, including personal friends of Al-Raee’s, were distilled into a visually stunning and dramatically taut production.

“The lesson of The Siege was putting weapons down,” 

according to one of the actors, Faisal Abu Alhayjaa, referring to the essential humanity of the Palestinian fighters, who would not harm a sick child for the sake of their cause.

This powerful message apparently was lost on New York’s acclaimed Public Theater which cancelled the production scheduled for this May. This alarming trend of performances cancelled/censored (take your pick) for political reasons will be examined at a conference at Georgetown University this June, where Al-Raee will speak.

Undeterred, The Freedom Theatre and its resolute supporters currently are seeking other American venues for The Siege. While some may see Palestinians on stage with machine guns, others, including sold-out audiences during The Siege‘s recent British tour, see, in the words of the Guardian review, “an unexpectedly compelling theatrical experience with a rough and ready energy, and in the very act of its telling, speaks for the voiceless and forgotten”.

In the tinderbox that is Israel-Palestine, The Freedom Theatre defies its seemingly hopeless environment, and is making a tangible difference in Jenin camp and beyond. Another child of the Theatre, an actor in The Siege and in the forthcoming feature film The Idol, Ahmed Al Rokh, described the change.

“We can feel the difference in the camp. Our audience is growing because the kids who first came now have families, and bring them. Now they understand that the theatre works for us and with us.”

In contrast to the situation in the developed world, where art is often considered discretionary, Faisal Abu Alhayjaa described art and culture in Palestine as “essential like water and bread”. Inspiring as it is, The Freedom Theatre’s story is not unique. The Palestinian Performing Arts Network (PPAN) includes many ensembles and organizations striving for dignity and agency through art.

Abu Alhayjaa sees the education and empowerment that comes through working in the arts generally, and The Freedom Theatre specifically, as vital to Palestine’s future.

“If there will be a liberation for Palestine, it will come with a generation that knows what they want, and that knows to think critically.”

That generation is being trained at The Freedom Theatre.

This piece was originally published by The Huffington Post.

       

Event Information

The Sentinel System is a state of the art active surveillance system relying on a distributed data network to rapidly scale analysis of health care data collected from over 178 million patients nationwide. Sentinel is an important safety surveillance tool used by the U.S. Food and Drug Administration (FDA), and its underlying distributed data infrastructure is increasingly being recognized to have the potential to support the needs of diverse stakeholders including other public health agencies, health systems, regulated industry, and the clinical research enterprise. Despite Sentinel’s importance in safety surveillance, patients are largely unaware of Sentinel’s public health mission and commitment to protecting patient privacy. Therefore, it is both timely and critical to identify opportunities to raise awareness and build trust for Sentinel safety surveillance among patients, consumers, and the general public.

On June 23, the Center for Health Policy at Brookings, in collaboration with the FDA, hosted an expert workshop to discuss opportunities to raise awareness of the Sentinel System through improved communication to patients and consumers. Participants, including Sentinel Data Partners, patient focused organizations (e.g., consumer advocacy groups), experts in patient privacy, ethics, and health literacy, and representatives from the FDA explored possible opportunities where each stakeholder might be uniquely positioned to engage with patients, and how these communications could be designed and delivered effectively. Discussions from this workshop resulted in recommendations including a set of guiding principles, potential tools, and strategies to improve awareness of the Sentinel System, but more broadly, safety surveillance activities led by the FDA.

Event Materials

• Sentinel Engagement_Discussion Guide
• Engagement_Agenda
• Engagement_Participant List
• Engagement_Speaker BioSketches
• Engagement_Meeting Summary

       

Event Information

Under the Food and Drug Administration Amendments Act (FDAAA) of 2007, the FDA has the authority to require pharmaceutical manufacturers to develop Risk Evaluation and Mitigation Strategies (REMS) for drugs or biologics that carry serious potential or known risks. Since that time, the REMS program has become an important tool in ensuring that riskier drugs are used safely, and it has allowed FDA to facilitate access to a host of drugs that may not otherwise have been approved. However, concerns have arisen regarding the effects of REMS programs on patient access to products, as well as the undue burden that the requirements place on the health care system. In response to these concerns, FDA has initiated reform efforts aimed at improving the standardization, assessment, and integration of REMS within the health care system. As part of this broader initiative, the agency is pursuing four priority projects, one of which focuses on improving provider-patient benefit-risk counseling for drugs that have a REMS attached.

Under a cooperative agreement with FDA, the Center for Health Policy at Brookings held an expert workshop on July 24 titled, “Risk Evaluation and Mitigation Strategies (REMS): Building a Framework for Effective Patient Counseling on Medication Risks and Benefits”. This workshop was the first in a series of convening activities that will seek input from stakeholders across academia, industry, health systems, and patient advocacy groups, among others. Through these activities, Brookings and FDA will further develop and refine an evidence-based framework of best practices and principles that can be used to inform the development and effective use of REMS tools and processes.

Event Materials

• REMS_PBRC_Meeting_Agenda
• REMS BR Speaker Bios
• REMS BenefitRisk Meeting Summary
• REMS BenefitRisk communication white paper

       

       

       

       

Following U.S. troop withdrawal in 2014, Afghanistan faces an uncertain future. Its fate could be compromised or even commanded by war lords, terrorists or corrupt government officials. Fellow Vanda Felbab-Brown spent time on the ground observing events and talking to a mix of Afghans from high ranking officials to village elders, to merchants to the person on the street. In this four-part video series based on her book, “Aspiration and Ambivalence: Strategies and Realities of Counterinsurgency and State-Building in Afghanistan,” Felbab-Brown offers analysis on an Afghanistan in flux.

Video

• Vanda Felbab-Brown: Counterinsurgency and State-Building in Afghanistan after 2014
• Vanda Felbab-Brown: The Afghan People Simply Want to Live and Thrive
• Vanda Felbab-Brown: Pakistan Plays a Significant Role in Afghanistan's Future
• Vanda Felbab-Brown: The Choices the U.S. Makes Will Largely Determine Afghanistan's Future

       

       

In a new paper, William Galston and Elaine Kamarck argue that the laws and rules that shape corporate and investor behavior today must be changed. They argue that Wall Street today is trapped in an incentive system that results in delivering quarterly profits and earnings at the expense of long-term investment.

As Galston and Kamarck see it, there’s nothing wrong with paying investors handsome returns, and a vibrant stock market is something to strive for. But when the very few can move stock prices in the short term and simultaneously reap handsome rewards for themselves, not their companies, and when this cycle becomes standard operating procedure, crowding out investments that boost productivity and wage increases that boost consumption, the long-term consequences for the economy are debilitating.

Galston and Kamarck argue that a set of incentives has evolved that favors short-term gains over long-term growth. These damaging incentives include:

• The proliferation of stock buybacks and dividends
• The increase in non-cash compensation
• The fixation on quarterly earnings
• The rise of activist Investors

These micro-incentives are so powerful that once they became pervasive in the private sector, they have broad effects, Galston and Kamarck write. Taken together, they have contributed significantly to economy-wide problems such as: (1) Rising inequality, (2) A shrinking middle class, (3) An increasing wedge between productivity & compensation, (4) Less business investment, and (5) Excessive financialization of the U.S. economy.

So what should be done? Galston and Kamarck propose reining in both share repurchases and the use of stock awards and options to compensate managers as well as refocusing corporate reporting on the long term. To this end, these scholars recommend the following policy steps:

• Repeal SEC Rule 10-B-18 and the 25% exemption
• Improve corporate disclosure practices
• Strengthen sustainability standards in 10-K reporting
• Toughen executive compensation rules
• Reform the taxation of executive compensation

Galston and Kamarck state that the American economy would work better if public corporations behaved more like private and family-held firms—if they made long-term investments, retained and trained their workers, grew organically, and offered reasonable but not excessive compensation to their top managers, based on long-term performance rather than quarterly earnings. To make these significant changes happen, the incentives that shape the decisions of CEOs and board of directors must be restructured. Reining in stock buybacks, reducing short-term equity gains from compensation packages, and shifting managers’ focus toward long-term objectives, Galston and Kamarck argue, will help address the most significant challenges facing America’s workers and corporations.  

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Over the past few years, higher education has been a frequent casualty of the violent conflicts sweeping the Middle East. Campuses have been bombed in Syria, Gaza and now Yemen; occupied or closed in Libya and Iraq; and been the subject of severe police crackdowns across the region. What institutional measures can both regional entities and international bodies take to protect institutions of higher learning in the Arab world? Beyond this, how can strategies of protection be incorporated into programs of reconstruction and development for this much-maligned sector?

Read "Houses of wisdom matter: The responsibility to protect and rebuild higher education in the Arab world"

Sultan Barakat and Sansom Milton, in a new Brookings Doha Center Policy Briefing, contend that higher education is often an unrecognized casualty of these conflicts, with priority given to more pressing humanitarian needs. They assert that the protection and rebuilding of such institutions across the Middle East forms a crucial response to present concerns, helping to shelter and develop strategically vital youth populations. Crucially, they hold that an action plan for higher education in the Arab world cannot end at rebuilding shattered classrooms or rescuing individual scholars.

Ultimately, Barakat and Milton argue for a regional approach to defending and advancing higher education, as a key tool to combat violent extremism, address economic challenges, and encourage social stability. A strategy of “building back better” would allow higher education to serve as an engine for regional revitalization, living up to the historical example set by the region’s centuries-old institutions of higher learning.

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Event Information

For Cubans, “D17”—December 17, 2014—changed everything. On that day, the United States and Cuba announced that the two countries would renew diplomatic relations nearly 60 years after Fidel Castro came to power. For both countries, a new transformation has begun—but this time, it is the promise of Cuba’s insertion in the globalized economy and the crumbling U.S. embargo that is catalyzing change on the island.

On May 31, the Brookings Book Club hosted Nonresident Senior Fellow Richard E. Feinberg and NPR Correspondent Tom Gjelten for a discussion of Feinberg’s new book, “Open for Business: Building the New Cuban Economy” (Brookings Institution Press, 2016). The discussion focused on the factors that guided this monumental decision: international diplomacy; changes already underway in Cuba; successful Cuban entrepreneurs and foreign investments; and scenarios for Cuba’s future development path.

Three young Cuban leaders, including two whose vignettes appear in the book, “Open for Business,” joined the discussion and shared their personal experiences with the economic realities in Cuba today, as well as the opportunities created by the shift in Cuban-American relations.

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• Open for business: Building the new Cuban economy

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• Open for business: Building the new Cuban economy

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• Transcript (.pdf)

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• 20160531_cuba_economy_transcript

       

On April 2, 2011, Ethiopia embarked upon the construction of what is expected to be the biggest hydroelectric power plant in Africa.  Called the Grand Ethiopian Renaissance Dam (GERD), it will be located on the Blue Nile, 40 kilometers (25 miles) from the border with the Republic of Sudan and will have the capacity to produce 6,000 megawatts of electricity.  The GERD, once completed and made operational, is expected to ameliorate chronic domestic energy shortages, help the country’s households (especially those located in the rural areas) switch to cleaner forms of energy and allow the government to earn foreign exchange through the exportation of electricity to other countries in the region.  Although authorities in Addis Ababa believe that the dam will contribute  significantly to economic growth and development—not just in Ethiopia, but also in neighboring countries, such as Sudan—its construction has been very controversial.  The major controversies revolve around Ethiopia’s decision to fund the building of the dam from its own sources and the potential impacts of the dam on downstream countries, especially Egypt.  

Ethiopia opted to source funds for the construction of the GERD through selling bonds to citizens at home and abroad.  Government employees have been encouraged to devote as much as one or two months of their salaries to the purchasing of the GERD bonds.  Most public workers in Ethiopia earn relatively low wages and face a significantly high cost of living.  Hence, they are not likely to be able to sacrifice that much of their salaries to invest in this national project.  Nevertheless, many of them have been observed purchasing the GERD bonds, primarily because of pressure from the government and the belief that participation in this national project is a show of one’s patriotism.

The government of Ethiopia has also encouraged the private sector to invest in the GERD project.  Specifically, private domestic banks and other business enterprises are expected to purchase millions of Birr worth of these bonds.  The government also hopes that Ethiopians in the diaspora will contribute significantly to this massive effort to develop the country’s hydroelectric power resources.  However, many Ethiopians in the diaspora have not been willing to invest in the GERD project, citing pervasive corruption in the public sector and dictatorial government policies as reasons why they would not commit the resources necessary to move the project forward.  Additionally, Ethiopians living outside the country have argued that the present government in Addis Ababa continues to impede the country’s transition to democracy by making it virtually impossible for opposition parties to operate, using draconian laws (e.g., anti-terrorism laws) to silence legitimate protests and generally denying citizens the right to express themselves.  For these reasons, many of them have refused to invest in the GERD project.  Finally, Ethiopia’s traditional development partners, including such international organizations as the World Bank and the International Monetary Fund, appear to be unwilling to lend the country the necessary funds for the construction of the dam given the controversies surrounding the dam and their policies on the building of megadams.

Egypt has registered its opposition to the construction of the GERD.  In fact, before he was ousted, former Egyptian president Mohamed Morsi made it known to authorities in Addis Ababa that Egypt would not support the project.  The Egyptians, as they have done before, have invoked the Anglo-Egyptian Treaty of 1929, which granted Egypt veto power over all construction projects on the Nile River and its tributaries.  According to Cairo, then, Ethiopia was supposed to obtain permission from Egypt before embarking on the GERD project.

In May 2010, five upstream riparian states (Ethiopia, Kenya, Uganda, Rwanda and Tanzania) signed the Nile Basin Cooperative Framework Agreement (CFA), which, they argue, would provide the mechanism for the equitable and fair use of Nile River waters.  On June 13, 2013, the Ethiopian Parliament ratified the CFA and incorporated it into domestic law.  The other four signatories have not yet ratified the treaty but plan to do so eventually.  Egypt and Sudan, however, have refused to sign the CFA and continue to argue that the 1929 Anglo-Egyptian Treaty, as well as the 1959 bilateral agreement between Egypt and Sudan, represent the only legal mechanisms for Nile River governance.  Recently, however, the government of Sudan has indicated its support for the GERD, and South Sudan, which gained its independence from Khartoum on July 9, 2011, does not oppose the project either.

Significant increases in population in Egypt, the need for the country to expand its irrigated agricultural base, as well as other industrial needs have significantly increased the country’s demand for water.  Unfortunately for Egyptians, the only viable source of water in the country is the Nile River.  Thus, Egyptians, as made clear by their leaders, are not willing to relinquish even one drop of water.  The country’s bitter opposition to the GERD stems from the fact that it will reduce the flow of water into the Nile River and force Egyptians to live with less water than now.  Egyptian leaders are not willing to accept the assertion made by the Ethiopian government that the construction of the dam will not significantly reduce the flow of water from the Blue Nile into Egypt.  Thus, Cairo has hinted that it would employ all means available to stop the construction of the GERD.

The site of the GERD was identified during geological surveys conducted between 1956 and 1964 by the United States Bureau of Reclamation.  Although studies determining the feasibility of a dam on the Blue Nile were completed almost half a century ago, previous Ethiopian governments did not make any attempt to build such a structure on the Blue Nile.  This inaction may have been due to Egypt’s ability to lobby the international donor community and prevent it from providing Addis Ababa with the necessary financial resources to complete the project, Ethiopia’s chronic internal political instability, or Egypt’s military strength and its strong ties with neighboring Sudan (the latter shares the same interests as Egypt regarding the waters of the Nile River).  In fact, the 1929 Anglo-Egyptian Treaty and the 1959 bilateral agreement between Sudan and Egypt granted both countries complete control of all the waters of the Nile River.

Since the ouster of Hosni Mubarak, Egypt has been weakened significantly, politically, economically and militarily.  The struggle between the military and civil society for control of the government has been a major distraction to the Egyptian military, and it is unlikely that it can effectively face a relatively strong and more assertive Ethiopian military.  Hence, it appears that this might be the most opportune time for Ethiopia to initiate such a construction project.  Perhaps more important is the fact that virtually all of the upstream riparian states are no longer willing to allow both Egypt and Sudan to continue to monopolize the waters of the Nile River.  In addition, Ethiopia is relatively at peace and maintains good relations with its neighbors, particularly the Republic of Sudan, which would be critical in any successful attack on Ethiopia by Egypt.  Of course, Addis Ababa has also invoked and relied on the Cooperative Framework Agreement which, besides Ethiopia, has been signed by four other upstream riparian States—the CFA favors the equitable and fair use of the waters of the Nile River.  Authorities in Addis Ababa believe that the GERD will contribute to such fair and equitable use; after all, the Blue Nile (which is located in Ethiopia) provides 86 percent of the water that flows into the Nile River.  Up to this point, Ethiopia has made virtually no use of that water, allowing Egypt and Sudan alone to dictate its usage.

Critics of the GERD, including some Ethiopians within and outside the country, argue that Addis Ababa initiated the building of the dam just to divert public attention away from internal political tensions associated with lack of religious freedom, human rights violations, suppression of the press, and the economic and political polarization that has become pervasive throughout the country during the last several decades. 

Given the economic significance of the Blue Nile for the source country (Ethiopia) and downstream countries (Egypt and Sudan), it is critical that these countries engage in constructive dialogue to find a mutually beneficial solution for the project.  Such negotiations should take into consideration the fact that the status quo, characterized by Egyptian monopolization of the waters of the Nile River and the exclusion of Ethiopia from exploiting its own water resources for its development, cannot be maintained.  Thus, the construction of the GERD should be taken as a given and the three countries—Egypt, Sudan and Ethiopia—should find ways to maximize the benefits of the dam and minimize its negative impacts on the downstream countries.  As part of that negotiation, both Egypt and Sudan should abandon their opposition to the CFA, sign it and encourage their legislatures to ratify it.  The Nile River and its tributaries should be considered common property belonging to all Nile River Basin communities and should be managed from that perspective.