Joseph Wong

Re-Making the Developmental State in Taiwan: The Challenges of Biotechnology

Taiwan has embarked on a new post-industrial or post-manufacturing industrial trajectory, targeting specifically biotechnology and the bio-business sector. Technological innovation has become the key imperative in Taiwan’s continued economic transformation. This transition invites a rethinking of the East Asian developmental state model and in particular the state’s role in leading knowledge-intensive industrial development. The article first offers a framework of analysis for the post-industrial developmental state, followed by an overview of the emerging biotechnology sector in Taiwan. The bulk of the article examines different political, economic and social challenges faced by the developmentally oriented state. The concluding section discusses how the interventionist state has begun to adapt in post-industrial and democratic Taiwan.

Canada's neglected tropical disease research network: who's in the core-who's on the periphery?

Background This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canadas neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding. Methodology Multiple methods were used to conduct this study, including: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level “core-periphery” network analysis to measure and map the structure of Canadas NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canadas NTD network (“k-core measure”) and the quantity and quality of research produced. Principal Findings Over the past sixty years (1950–2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network. Conclusion/Significance The publication specialties, composition, and position of NTD researchers within Canadas NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the NTD research they generate; there is opportunity to leverage existing research collaborations and help advance regions and NTD areas that are currently under-developed.

Achieving universal health coverage

There is global consensus on the goals of universal health coverage (UHC), which has been defined as “all people receiving quality health services that meet their needs without exposing them to financial hardship in paying for them.”1 Yet despite this consensus, it remains unclear how the global health community can achieve universal coverage. The obvious answer is to ensure that health services reach those who need them. The complicated real-world challenge, however, is actually delivering services to reach those most in need and more specifically to those who are hardest to reach. Without a focus on reach, resources will be wasted and the number of preventable deaths and treatable illnesses will remain high. Until now, the main constraint in achieving UHC has been understood in terms of lack of ability to pay for health services. The barrier to universal health, many argue, is the un-affordability of health services for the world’s very poor.1 Hence, conventional wisdom prescribes the reduction of financial barriers – such as the removal of user fees – to achieve UHC.2 This is not the wrong prescription; it is an important one and without a reduction of such financial barriers, UHC is impossible. But it is a prescription that only addresses one obstacle. As the global health community moves beyond the financial model of health access, it has begun to consider and address additional barriers to health care, such as geographical distance, cultural differences, gender norms, citizenship, social determinants and so on.1 Innovative methods are needed so that health services reach beyond and around these barriers. After all, a very poor villager in the rural hinterland of India is more likely to be unhealthy not just because she cannot afford health care, but also because many health services do not reach her. But to be reached requires one to be visible in the first place. If the goal of UHC is to reach vulnerable populations who are otherwise left out, then all people need to be visible. Many people in high-income countries take visibility for granted. Most pay taxes; have an official identification; a registered birth; a street address. They can be reached by health services because they are visible. This is not the reality for many people in low- and middle-income countries, particularly those who are very poor or marginalized. For instance, how is it possible to deliver an immunization programme in a slum where no one has an address and thousands are constantly on the move? Anthropologist Arjun Appadurai, in his work on slums in Mumbai, laments that in India “a host of local, state-level and federal entities exist with a mandate to rehabilitate or ameliorate slum life. But none of them knows exactly who the slum dwellers are, where they live, or how they are to be identified.”3 The problem of invisibility, especially among the world’s poor, is not easily overcome. Most poor workers in low- and middle-income countries are employed informally, irregularly or casually and as a result are fiscally invisible;4 hundreds of millions live in slums – illegal settlements without official addresses;5 stateless peoples such as the Roma in Europe and the “hill peoples” in Asia are excluded from the health care benefits of citizenship.6 Until recently, nearly half of India’s population had no formal identification; in China, the household registration system means that hundreds of millions of migrant workers are ineligible for social benefits;7 in Israel, unrecognized Bedouin villages are literally off the official map. According to the United Nations Children’s Fund (UNICEF), an estimated 230 million births are unregistered worldwide, most of whom are born into poor households and are therefore likely to be excluded from health services.8 To address the problem of reach requires methods that actively connect the provision of health services to people who are otherwise invisible and thus unreachable. There are successful examples, including Brazil’s conditional cash transfer programme – Bolsa Familia – implemented in 2003. Close to 14 million families identified as being in the bottom income quintile have been enrolled in the program. Bolsa Familia provides a direct cash transfer to poor families, on the condition that their children attend school, are immunized and have regular medical check-ups. In tandem with Brazil’s Programa Saude da Familia, these conditional cash transfers have had a positive effect on child health, including a significant decrease in under-5 mortality rates.9 The programme has been very successful in reaching poor families, with around 75% of cash transfers reaching the intended beneficiaries. (In other Latin American countries, similar programs transfer only 35–50% of resources to the intended people).10 The programme has had a positive health impact among the poor because it has effectively reached the poor. There are several reasons why the Bolsa Familia programme has been so successful in extending its reach. First, it is a targeted programme, explicitly mandated to reach the very poor. Second, it is very precise in its targeting. A Brazilian official once remarked that “if all the resources spent on social policies in Brazil were dropped from a helicopter, they would have a better chance of reaching the poor than they have now.”11 The Bolsa Familia programme addresses such imprecision by implementing a sophisticated census exercise, constructing poverty maps and a unified registry and employing technical solutions for monitoring within municipalities. The programme was helped by the existing work card system, near universal birth registration rates and a mandatory voting law, meaning all voting-age citizens are registered. Third, the program, while funded by the federal government, is administered locally, along with the Programa Saude da Familia, in over 5000 municipalities. The administration is closer to the ground, where local agents possess better local knowledge. Local administration apparently reduces corruption – a frequent problem in the delivery of social services – and allows for more flexible implementation.10 Reaching the unreached is expensive, as the World Health Organization has recently acknowledged.1 The Bolsa Familia programme relies on costly interventions, including establishing and maintaining the unified registry; implementing the card technology used to transfer and access funds; installing cashpoint machines, especially in difficult-to-reach places; providing incentives to continue to identify inclusion and exclusion errors in enrolment and expending resources to ensure that the required conditions (school attendance and medical care) are being met. The political and economic tension is to reconcile expanding coverage of existing health services with ensuring that services are targeted to the hardest-to-reach people. When it comes to precise targeting, there are few economies of scale to be realized, as the marginal cost of reaching each additional person or family increases for those that are hardest-to-reach. Extending reach, therefore, is not just a technical problem to be solved but also a political problem of resource redistribution. First, stakeholders in government, nongovernmental organization and health providers should use empirical methods to evaluate the marginal cost of extending reach. This will help decision-makers devise ways to mitigate some of the costs, improve understanding of what services to include and where efficiencies can be gained. Second, programme planners and politicians must highlight the benefits – such as economic productivity and poverty reduction – of costly but ultimately effective policies. Third, because reach involves designing means and methods that connect people to health services, local innovation and adaptation are critical. The success of the Bolsa Familia programme can be attributed in part to the tremendous flexibility and innovation capacity that municipalities have to reach families in their jurisdictions. Local innovation is not about big fixes, but small and effective adaptations.12 Finally, greater investment in information and identification systems is needed. The unified registry in Brazil, the unique identification programme in India, birth registration in South Africa – if implemented effectively, can make poor and vulnerable people more visible. Having such infrastructure in place means the state and other providers can deliver other important services. The allocation of national development resources and international development assistance should support health service delivery to people who are hard to reach.

The faddeev equations and franck-condon models for chemical reactions

Abstract The Faddeev decomposition of the scattering wavefunction is shown to be a useful starting point for the development of Franck-Condon type models of chemical reactions. A simple model based on this approach is shown to yield excellent results for collinear H + C 2 → HCl + H.

A thin printed metasurface for microwave refraction

This paper presents a novel thin metasurface for microwave refraction. The metasurface is based on the new concept of establishing orthogonal electric and magnetic currents (Huygens sources) on a surface thus physically implementing the equivalence principle. Such thin Huygens Metasurfaces can be used for refraction, focusing and general beam shaping. Here we discuss the design procedure and experimental validation of such a metasurface for 1D refraction. In contrast to previous work, the proposed metasurface does not require stacked layers, but it comprises collocated electric and magnetic dipoles printed on a single panel. This can be represented in one layer of lattice cells, and its behavior described using transmission-line theory. This makes it electrically thin and readily scalable to millimeter-wave frequencies and beyond.

Democratization and the Left Comparing East Asia and Latin America

This article examines how democratic transition has shaped leftist politics in Taiwan, South Korea, Brazil, and Chile. On one hand, the new left has positioned itself differently in the two regions, specifically in terms of when the left emerged (or reemerged) onto the political scene and how it has organized politically. On the other hand, new left forces in both regions have moderated their political tactics and ideological demands. This article contends that the new left has had to adapt to new political contexts. Divergence in new left politics can be explained by variations in the pacing of democratic reform, the institutional basis of democratic breakthrough, and salient cleavage structures. Yet the imperatives of democratic competition—irrespective of the specific mode of transition—have compelled the new left in both regions to similarly moderate their political tactics and transformative demands.

Criteria to assess potential reverse innovations: opportunities for shared learning between high- and low-income countries.

BackgroundLow- and middle-income countries (LMICs) are developing novel approaches to healthcare that may be relevant to high-income countries (HICs). These include products, services, organizational processes, or policies that improve access, cost, or efficiency of healthcare. However, given the challenge of replication, it is difficult to identify innovations that could be successfully adapted to high-income settings. We present a set of criteria for evaluating the potential impact of LMIC innovations in HIC settings.MethodsAn initial framework was drafted based on a literature review, and revised iteratively by applying it to LMIC examples from the Center for Health Market Innovations (CHMI) program database. The resulting criteria were then reviewed using a modified Delphi process by the Reverse Innovation Working Group, consisting of 31 experts in medicine, engineering, management and political science, as well as representatives from industry and government, all with an expressed interest in reverse innovation.ResultsThe resulting 8 criteria are divided into two steps with a simple scoring system. First, innovations are assessed according to their success within the LMIC context according to metrics of improving accessibility, cost-effectiveness, scalability, and overall effectiveness. Next, they are scored for their potential for spread to HICs, according to their ability to address an HIC healthcare challenge, compatibility with infrastructure and regulatory requirements, degree of novelty, and degree of current collaboration with HICs. We use examples to illustrate where programs which appear initially promising may be unlikely to succeed in a HIC setting due to feasibility concerns.ConclusionsThis study presents a framework for identifying reverse innovations that may be useful to policymakers and funding agencies interested in identifying novel approaches to addressing cost and access to care in HICs. We solicited expert feedback and consensus on an empirically-derived set of criteria to create a practical tool for funders that can be used directly and tested prospectively using current databases of LMIC programs.

A Simple, Minimally Invasive Method for Creation of the Superior Palpebral Fold in Asians With the Modified Continuous Buried Tarsal Stitch: A Joint Assessment From Toronto, Ontario, Canada, and Chengdu, China

A simple, minimally invasive stitch method to construct the superior palpebral fold in Asian upper eyelids is described. With the use of a clear 6-0 monofilament polypropylene suture and a continuous stitch and by securing multiple consecutive transcutaneous intratarsal fixations, we were able to produce a consistent, natural result with high success rates and no noticeable scarring in 1648 cases over a 9-year period at 2 surgical centers in Toronto, Ontario, Canada, and Chengdu, China.

Innovating for the global south : towards an inclusive innovation agenda

Introduction: Re-Thinking Innovation - Joseph Wong (University of Toronto, Munk School of Global Affairs, Innovation) and Dilip Soman (University of Toronto, Rotman School of Management, Marketing) Chapter 1: Poverty Invisibility and Innovation - Joseph Wong Chapter 2: Behaviourally Informed Innovation - Dilip Soman Chapter 3: Appropriate Technologies for the Global South - Yu-Ling Cheng (University of Toronto, Chemical Engineering and Applied Chemistry) and Beverly Bradley (University of Toronto, Centre for Global Engineering) Chapter 4: Globalization of Biopharmaceutical Innovation: Implications for Poor Market Diseases - Rahim Rezaie (University of Toronto, Munk School of Global Affairs, Research Fellow) Chapter 5: Embedded Innovation in Health - Anita M. McGahan (University of Toronto, Rotman School of Management, Associate Dean of Research), Rahim Rezaie and Donald C. Cole (University of Toronto, Associate Professor) Chapter 6: Scaling Up: The Case of Nutritional Interventions in the Global South - Ashley Aimone Phillips (Registered Dietitian), Nandita Perumal, Carmen Ho (University of Toronto, Doctoral Fellow, Political Science), and Stanley Zlotkin (University of Toronto, Hospital for Sick Children, Paediatrics, Public Health Sciences and Nutritional Sciences) Chapter 7: New Models for Financing Innovative Technologies and Entrepreneurial Organizations in the Global South - Murray R. Metcalfe (University of Toronto, Centre for Global Engineering, Globalization) Chapter 8: Innovation and Foreign Policy - Janice Gross Stein (University of Toronto, Political Science) Conclusion: Inclusive Innovation - Will Mitchell (University of Toronto, Rotman School of Management, Strategic Management), Anita M. McGahan Glossary About the Contributor

Multiple scattering theory. III. Reactive scattering in first order

Abstract A study of all first order multiple scattering theory contributions to reactive scattering in a model F + HD → FD + H reaction at thermal energies is presented. The results clearly show the overwhelming dominance, for scattering in both the forward and backward direction, of the knockout-pickup mechanism over the Born term. In addition, system properties influencing the magnitude of the knockout-pickup mechanism in general are discussed.