Monday, March 21, 2016

Transplanting kidneys that are infected with hepatitis C (to uninfected patients) or HIV (to already infected patients) to ease the organ shortage

Two stories, one on Hep C kidneys to uninfected patients, another on HIV kidneys to patients already infected with HIV.

Here's the first story, on transplanting Hep C infected kidneys to patients who don't have the disease:

"Transplant surgeons at two US hospitals are about to do something long considered taboo: put kidneys from donors with hepatitis C into recipients without the infection.

In first-in-the-world clinical trials scheduled to launch later this spring, independent teams from the University of Pennsylvania and Johns Hopkins University will take kidneys from deceased carriers of the hep C virus, put them into patients with renal failure, and then give them a 12-week course of an antiviral therapy in the hopes that they will emerge infection-free.

If successful, the trials could enable hundreds of transplants each year for patients who might otherwise die waiting for a kidney.
"The idea behind the two upcoming trials is to take older patients who have long waits ahead and don’t have living donors, and allow them to jump the queue — if they’re willing to take on a bit more risk.

The risk of hep C infection is deemed manageable, and ethically acceptable, thanks to the latest wave of hep C medications, which offer cure rates of 95 percent and higher.

“For a 60-year-old diabetic who doesn’t have a living donor, who hasn’t been on the wait list very long, they’re miserable on dialysis, their mortality rate is high — that person might roll the dice on this and say, ‘You know what? These drugs work, and it’s worth it to me to get off dialysis sooner,’” said Dr. Heather Morris, a nephrologist at the Columbia University Medical Center.

“Initially, we’re targeting the population that has the highest mortality risk while waiting for a transplant,” explained Dr. Christine Durand, a transplant infectious disease specialist at Johns Hopkins. But if the technique proves safe and effective, she added, organs from hep C patients might one day join the regular organ pool.

“If it was me who needed a kidney,” Durand said, “I would sign up for this.”
"Both the Penn and Hopkins studies are backed by Merck, the drug company that makes Zepatier, the latest hep C agent to hit the market. The company is supplying its $54,500-per-patient medicine for free and providing additional financial support for staff and lab tests.
Here's the story about HIV kidneys:

Hahnemann to begin transplanting organs from HIV-positive donors

"The organs would be given only to patients who also are HIV-positive and have agreed to accept them. The transplants will be part of research that will carefully monitor both the transplant and the potentially deadly disease.

Johns Hopkins Hospital in Baltimore announced last month that it would be the first to offer HIV-positive organs to HIV-positive patients on its waiting list. The advantage of such transplants is that they might reduce waiting times for HIV-positive patients and also free up other organs for patients who don't have the immune-weakening virus.

The new approach was made possible by the HIV Organ Policy Equity (HOPE) Act of 2013. Before that, it was illegal to transplant organs from people with HIV. The ban was enacted when the blood-borne virus was considered a death sentence, but now that it is so much more manageable, people who are infected often die of something else.

The Philadelphia hospital has now received permission from the United Network for Organ Sharing (UNOS) to begin what are called HIV-positive to HIV-positive liver and kidney transplants. Doctors expect that most of the transplanted organs will be kidneys and that the first case will occur this year. The hospital currently has 45 HIV-positive patients either on its waiting list for kidneys or being evaluated for transplants."

Sunday, March 20, 2016

Rabbi (and kidney donor)i Shmuly Yanklowitz on Judaism and organ donation (video)

Rabbi (and kidney donor) Shmuly Yanklowitz speaks about organ donation, drawing on Jewish sources, in this 14 minute video:

HT: Max Bazerman 

Saturday, March 19, 2016

Stable marriage without the deferred acceptance algorithm

WuMoby Wulff & Morgenthaler

  • March 12, 2016

HT: James J. O'Donnell, MD.

Friday, March 18, 2016

Match Day for new doctors

Today is Match Day, when graduating medical students find out where they will do their residency.
Match Day!
Applicants: Medical school Match Day ceremonies at 12:00 p.m. ET. Learn where you matched in the R3 system and by email at 1:00 p.m. ET.
Programs: Match Results by Ranked Applicant and SOAP Results by Preferred Applicant reports available at 2:00 p.m. ET.
Advance Data Tables available on at 1:00 p.m. ET.

Here's an earlier WSJ story by a graduating doctor:
Match Day, the NFL Draft of Medicine
On March 18, thousands of budding doctors find out where they’ll be serving their residencies.
"As you can imagine, it is a day of high anxiety, celebration and disappointment. My classmates and I have spent the past year choosing specialties, filling out applications and interviewing with residency programs. This process has taken us to cities, hospitals and universities around the country. After years of study, we’re about to become physicians. Both our professional and personal lives hinge on the results of this algorithm.
The Match was introduced in 1952 to address many of the uncertainties of residency applications. Before, medical students had to seek residency spots by themselves. But this decentralized system was rife with coercion, favoritism and deceit. Residency programs would demand medical students accept offers before applicants could consider other options. Students and programs betrayed one another by reneging on commitments.
The Match provides structure to the process. Students apply for residency positions through a common application. Strict policies govern communication between programs and applicants, with public reporting of violations. Applicants and programs submit ranking preferences into a centralized system. The Match algorithm couples these rankings and establishes binding contracts for residency positions.
Last year saw record numbers, when nearly 35,000 applicants submitted ranking preferences for roughly 30,000 residency slots. Medical schools host ceremonies to celebrate the event. Researchers Alvin Roth and Lloyd Shapley even won the 2012 Nobel Prize in Economics for their work related to the Match."
Here's the NRMP page on why it takes 23 days from the time preferences are submitted to announce the match results

What Happens Between Rank Order List Deadline And Match Day?

Between the Rank Order List Certification Deadline and Match Day, the NRMP conducts a rigorous review of Match data, including:
  • Assessing and confirming the integrity of the data
  • Conducting a final verification of applicants’ credentials
  • Withdrawing applicants who are ineligible for the Match
  • Transferring the data from the R3 system to the matching algorithm module, rechecking the data, processing the algorithm, and transferring data back into the R3 system
  • Verifying the results of a Match and transferring the data into the NRMP databases
  • Verifying applicants’ credentials for Main Residency Match SOAP participation
  • Preparing 50,000 individual Match Week reports for Main Residency Match applicants, program directors, and medical schools
These steps, all completed in a few weeks, ensure the accuracy of Match results.
Here's a story on the SOAP scramble for unmatched students: 

Thursday, March 17, 2016

Transplants in Germany, further discussion of changing the transplant law, in Der Tagesspiegel

My op-ed in Der  Tagesspiegel yesterday on changing the German transplant law has drawn some prompt further comment in today's paper (as near as I can tell from Google Translate).

Here's the new commentary (English courtesy of GT):

Ärzte und Politiker für mehr Lebendspenden


[Organ transplant
physicians and politicians for more living donations German reservations "no longer fit into the time", criticizing physicians. The exchange between unacquainted pairs should be allowed.]

"The demand of the American Nobel Prize winner Alvin Roth, to facilitate in Germany living donation of organs and to amend the Transplantation Act accordingly, has met with doctors and politicians on consent.

The requirement that living donation - this question come kidney or parts of the liver - may come only from the direct family environment, are too strict, the economists had in Tagesspiegel criticizes. As in other European countries and the United States would also in Germany more distant relatives, friends or colleagues may donate writes Roth. In addition, an exchange between unacquainted pairs should be allowed (cross-donation, crossover Donation) at incompatible donor organs."

Here are my two earlier posts on the subject, with links to my earlier op-ed and the one by Axel Ockenfels and Thomas Gutmann

German organ transplant law should be amended or reinterpreted to allow kidney exchange: my op-ed in Der Tagesspiegel

During my recent visit to Germany, I spoke with a number of people about the fact that the German transplant law effectively outlaws kidney exchange.  I was invited to write an op-ed on the subject for the German newspaper Der Tagesspiegel, and it has just appeared:

Normally at this point I would use Google Translate to give a sense of the article, but in this case, since I wrote the op-ed in English, I can give you the original:

German organ transplant law should be amended or reinterpreted to allow kidney exchange
By Alvin E. Roth[i]
Kidney failure is epidemic around the world, and a shortage of organs for transplantation condemns many patients to dialysis, and early death. 

Most transplantable organs come from deceased donors, and there aren’t enough to fill the need. But because healthy people have two kidneys and can remain healthy with one, a healthy person can donate a kidney to a sick person.  A living-donor kidney works better than a deceased-donor kidney.
In the U.S. we now have around as many living donors as deceased donors (although we still have more deceased-donor transplants, since a deceased donor donates both kidneys).

But living donation isn’t always possible, even when a willing donor is available, because a kidney must be well-matched to its recipient. Often the life-saving gift cannot be given, because the donor’s kidney is incompatible with the patient. (It is now sometimes possible to successfully transplant an incompatible kidney, but, like a deceased-donor kidney, this does not keep the patient as healthy for as long as would a compatible living-donor kidney.)

In the U.S., there is a way for incompatible patient-donor pairs to help each other, through what we call kidney exchange, or kidney paired-donation. In its simplest form, two incompatible patient-donor pairs are identified by their doctors such that each patient is compatible with the kidney of the other patient’s donor. Then four surgeries are performed, two nephrectomies and two transplants, so that each donor gives a kidney and each patient receives a compatible kidney. Kidney exchange has become a standard form of transplantation in the U.S., and has saved thousands of lives. (This is one of the “matching” markets I helped design, and wrote about in my recently translated book, Wer kriegt was - und warum?.)

Notice that no money changes hands in this paired donation. It is just an exchange of gifts between two patient-donor pairs, which allows each donor to save a life and see his intended recipient restored to good health.
Laws around the world prohibit buying a kidney for transplantation, because of fear that allowing organs to be sold would exploit the poor and vulnerable. (The single exception is Iran, which has a monetary market for kidneys.) But German transplant law  imposes a severe further restriction: a patient may receive a living-donor kidney only from a member of his or her immediate family. This means that, unless a judge intervenes, kidney exchanges are illegal in Germany. (This law also restricts the number of direct living donations in Germany compared to countries like the U.S., in which uncles, cousins, friends, colleagues, members of the same church, etc., are often living donors.)

I surmise that the reason for this strict limitation in German law is to remove any possibility that a kidney being transplanted has been purchased rather than freely given. But if when you want to give a kidney to your brother there is no suspicion that you are a paid organ-seller, you should remain above suspicion even if your kidney is incompatible with your brother. Kidney exchange allows you to give a kidney and save a life, and have your brother’s life saved. Kidney paired donation is a mutually beneficial exchange of life-saving gifts, not a commercial transaction.

The U.S. law that includes the prohibition on organ sales is the National Organ Transplant Act of 1984.  When American surgeons explored kidney exchange in the first decade of this century, it wasn’t initially clear what its legal status might be, but in 2007 Congress passed an amendment to the NOTA making kidney exchange explicitly legal.  Kidney exchange is legal elsewhere in Europe, and is well developed in the Netherlands and Britain. A similar amendment to the German law, or even instructions to judges that kidney exchanges should be allowed after being examined, could save the lives of many patients in Germany, without opening to door to commercial transactions in body parts.

[i] Alvin Roth, a professor of economics at Stanford University, shared the 2012 Nobel Prize in Economics for his work on market design. His recent book about markets has just appeared in German translation, Wer kriegt was - und warum?: Bildung, Jobs und Partnerwahl: Wie Märktefunktionieren

Wednesday, March 16, 2016

Slides from the American Society of Transplantation CEOT meetings

Many of the slides from the recent meeting of the American Society of Transplantation meeting in Phoenix are now available by clicking on the talk titles here:

Here is the session I spoke in

Session 4, Part 1:  Removing Disincentives and Exploring Controversies of Incentives
Co-Moderators: Robert S. Gaston, MD, FAST, University of Alabama at Birmingham, and
Larry B. Melton, MD, PhD, FAST, Dallas Nephrology Associates
11:00 am
World and Historical Perspectives
John Gill, MD, MS, FAST, The University of British Columbia
11:30 amUndue Incentives and Repugnant Transactions: One Economist’s Perspective
Alvin Roth, PhD, Stanford University
Nobel Laureate
12:00 pm
12:30 pmWhat is an Incentive and a Critical Appraisal of Possible Pilot Trials of Incentives in Organ Donation?
Robert S. Gaston, MD, FAST, University of Alabama at Birmingham and

Tuesday, March 15, 2016

Lloyd Shapley: obituaries, and memories

I've been asked to write a short "intellectual obituary" about Lloyd's work, which I'll try to do in the coming days.  In the meantime, here's a paragraph:

Lloyd Shapley was one of the founding giants of game theory. He shared the 2012 Nobel Prize in Economics for his seminal work with David Gale on stable matching, but he could have won a Nobel for any of a number of his papers that initiated whole literatures: he was one of the very first to formulate and study the core of a game, he and John Milnor initiated the study of games with a continuum of players (“Oceanic Games”), he invented the Shapley value, he and Martin Shubik showed how it could be useful in studying voting and political processes, and his paper on Stochastic Games initiated the study of Markov Decision Processes as well as Markov Games. 
Below, links to some obituaries:

The Economist: Matchmaker in heaven--Lloyd Shapley, a Nobel laureate in economics, has died

"One of Mr Shapley’s better-known achievements is the Gale-Shapley matching algorithm, which he devised after an old university friend (David Gale) asked for help to solve a problem. Given two groups of people, each with slightly different preferences, is there a way to match them in such a way that people aren’t constantly ditching their partner? After much head-scratching, Mr Gale suspected there was no solution, but could not prove it. As Mr Shapley told it, the solution took him the best part of an afternoon. "

UCLA: UCLA mourns the passing of Nobel laureate Lloyd Shapley, 92. Shapley, widely considered a father of game theory, was professor emeritus of economics and mathematics
"Shapley was widely considered one of the fathers of game theory. His research focused on both cooperative and non-cooperative game theory, in fields including stochastic games, strategic market games, assignment games, cooperative and non-cooperative market models, voting games and power indices, potential games, cost allocation and organization theory. His work included the development of the “Shapley value” and the “core.”

“Professor Shapley was one of the giants of game theory,” said UCLA Chancellor Gene Block. “His work in market design laid the foundation for advances in the matching of kidney donors with transplant recipients, in college admissions procedures, and in assignment of children to public schools. The entire UCLA community joins Professor Shapley’s family in mourning his passing.”

In their 1962 paper, “College admissions and the stability of marriage,” Shapley and mathematician/economist David Gale demonstrated how to match members of two groups — for example, men and women in a “marriage market” — in a way that is stable."

The NY Times: Lloyd S. Shapley, 92, Nobel Laureate and a Father of Game Theory, Is Dead

The Rand Corp. press release: Lloyd S. Shapley, Nobel Laureate in Economics, Dies at 92
"He was a research mathematician at RAND from 1948 to 1950 and from 1954 to 1981. He also taught “Game Theory and Applications” in the 1970s and early 1980s at what is now the Pardee RAND Graduate School, which awarded him an honorary degree in 2014."
The Associated Press obit: Nobel laureate Lloyd S. Shapley dies at 92 in Arizona

Here's a short video in which I was interviewed about my first meeting with Shapley:

I also wrote very briefly about that first meeting in the autobiographical essay I prepared for the Nobel:

"As I prepared to leave California for Illinois, I paid a visit to Lloyd Shapley at the Rand Corporation in Santa Monica to tell him about my work. I recall a pleasant visit, in which he correctly conjectured how the proof of my fixed point theorem worked, and (if I recall correctly) ended with him driving me to the airport in his station wagon. "

Monday, March 14, 2016

Promoting kidney exchange in Germany: Axel Ockenfels and Thomas Gutmann

In Germany, kidney exchange isn't legal (German law only permits a patient to receive an organ from a member of his immediate family). Here's an op-ed saying that should change, by Axel Ockenfels and Thomas Gutmann in the Sueddeutsche Zeitung:

Nierentausch in Zeiten des Mangels (kidney exchange in times of shortage)

Google translate makes it pretty clear.

Sunday, March 13, 2016

The market for photographs: "Man - 60 years and older"

Photographs for sale can be either of specific individuals or "stock photos" of generic images. Here's a picture of me that seems to be both, judging from the keywords the photographer or seller, Richard Kalvar at Magnum Photos, has assigned to it (such as "Man - 60 years and older"):

Keywords: Davos–International conference–American (nationality)–Davos
–Keedup QC–Man - 60 years and older–One Person–Portrait–Professor–ROTH Alvin

Saturday, March 12, 2016

Lloyd S. Shapley 1923- 2016

I turned on my phone after landing from Frankfurt, and found an email from Lloyd's son Peter Shapley, saying that Lloyd passed away in his sleep at around 12:45 AM today, March 12.

The world is the less...

Update: see some obituaries here-- Lloyd Shapley: obituaries, and memories

Cass Sunstein for Chair of the President's Council of Psychological Advisors

Cass R. Sunstein 

Harvard Law School

January 2016

Annual Review of Psychology, Vol. 67, pp. 713-737, 2016 


Findings in behavioral science, including psychology, have influenced policies and reforms in many nations. Choice architecture can affect outcomes even if material incentives are not involved. In some contexts, default rules, simplification, and social norms have had even larger effects than significant economic incentives. Psychological research is helping to inform initiatives in savings, finance, highway safety, consumer protection, energy, climate change, obesity, education, poverty, development, crime, corruption, health, and the environment. No nation has yet created a council of psychological advisers, but the role of behavioral research in policy domains is likely to grow in the coming years, especially in light of the mounting interest in promoting ease and simplification (“navigability”); in increasing effectiveness, economic growth, and competitiveness; and in providing low-cost, choice-preserving approaches.

Friday, March 11, 2016

German press coverage

One of the themes that has struck a chord with the German press during my visit is that refugee resettlement is a matching problem:

Handelsblatt „Die Flüchtlingskrise ist ein Matching-Problem“ ("The refugee crisis is a matching problem")

Die Welt "Staaten sollten Gebote für Flüchtlinge abgeben"
From google translate:
From because of cooler economist - Alvin Roth has indeed studied hard subjects with mathematics and computer science. But he loves not only the numbers, but also the people. It shows the same. He greeted with a winning smile, leaving a to an exciting conversation about refugees and donor kidneys, financial markets and future presidents.
The World: Some economists want to apply to the distribution of refugees in Europe your design markets. Is this a good idea?
Alvin Roth: Essentially, yes. The distribution of refugees is a so-called matching market - on the right pairing it depends, in this case of people and place. The people themselves have preferences where they want to live. At the same time they should be able to be easily integrated into the economy. For that we should allow an orderly exchange of information. According Dublin procedure an applicant must his application but ask in the country where he first arrived. This does not add up.

Lit.Cologne photo:

Who Gets What and Why in Frankfurt, at the German National Library

I'll be speaking about Who Gets What and Why in Frankfurt today at the German National Library:

Einladung zur Veranstaltung mit Alvin E. Roth am 11.03.2016

(Markets Work: Nobel Laureate Alvin E. Roth in an interview with Malte Lehming about his book "Who gets what and why"?)
CoverWas verbindet Organspende, Parkplatzsuche, den Kauf eines Hauses und die Suche nach einem Ausbildungsplatz? Vermeintlich nichts. Dann aber stellt man fest, dass wir es bei all diesen Dingen mit Märkten zu tun haben, die in vielfältiger Weise in unser Leben eingreifen. Es handelt sich um Märkte, die nicht unbedingt oder unmittelbar mit Geld zu beeinflussen sind.
Alvin E. Roth, der Miterfinder des »Market Designs« und Nobelpreisträger für Wirtschaft des Jahres 2012, widmet sich in seinem neuesten Buch den Märkten, die sich, statt über Preise, über den Abgleich von Interessen und das optimale Verbinden von Wünschen zur Zufriedenheit aller regeln lassen. Im Gespräch mit Malte Lehming geht er dabei unterschiedlichsten Fragestellungen des Alltags nach: Wie finden Eltern die richtige Schule für ihr Kind? Wie findet man den richtigen Arbeitgeber? Wie finden Nierenkranke den richtigen Organspender? Dabei geht es nicht allein um die Frage, nach welchen Regeln und Gesetzen diese Märkte funktionieren, sondern auch darum, wie wir lernen können, sie zu unseren Gunsten zu beeinflussen.
Zu dieser Veranstaltung in englischer Sprache laden wir Sie und Ihre Begleitung herzlich ein. Der Eintritt ist frei. Wir freuen uns auf Sie!
Veranstaltung in Kürze
Freitag, 11. März 2016, 19 Uhr
Deutsche Nationalbibliothek
Adickesallee 1, 60322 Frankfurt

How markets work: Nobel Prize winner Alvin E. Roth in conversation with Malte Lehming about his book "Who gets what – and why" // Book presentation and interview (in English) // German National Library in Frankfurt am Main // Friday, 11 March 2016, 19:00

Buchcover des Buches "Wer kriegt was und warum?" von Alvin E. Roth
In his new book Alvin E. Roth, contributor to the "market design" theory and 2012 Economics Nobel Prize winner, examines the types of markets which are regulated by the balancing of interests, by the optimised and mutually satisfying marrying of different wishes, and not by price. In an interview with Malte Lehming (Der Tagesspiegel) he explores everyday issues such as: How can parents find the right school for their child? What is the best way of finding the right employer? How can kidney patients find the right donor? Alvin Roth explains the rules and laws which govern these markets, but also shows how we can learn to influence them for our own benefit.
Organised in cooperation with the Siedler Verlag, the Consulate General of the United States Frankfurt, Goethe University of Frankfurt and Hessische Landeszentrale für politische Bildung
Free admission. Registration:

Thursday, March 10, 2016

NY Times report on incompatible kidney transplants

The New York Times has an article about a recent paper in the New England Journal of Medicine which reports that an incompatible kidney, transplanted after desensitization of the patient,  is now better than no transplant or a long wait to receive a deceased donor kidney. For the time being there seems to be no dispute that compatible kidneys are better if you can get them (so I don't anticipate that this will reduce the demand for kidney exchange).  This is part of a series of studies that make clear that a living donor kidney is generally more beneficial than a deceased donor kidney, and that long waits for transplants harm patients, particularly once they are on dialysis.

Here's the NY Times story: New Procedure Allows Kidney Transplants From Any Donor

Who Gets What and Why in Cologne: Wer kriegt was?

Today I speak in Cologne...

Nobel laureate Alvin E. Roth asks: Who Gets What – and Why?

Are you one of those people who believe that the word “market” only applies to large share deals? In Who Gets What – and Why, Alvin E. Roth, who won the Nobel Memorial Prize in Economic Sciences for his work on game theory, shows us that market rules also apply when looking for a job or a school, or matching organ donors. Using specific examples, he explains how markets determine our lives – and how we can learn to use them to our advantage. Host: Nicole Bastian

 7:00pm  Börsensaal der IHK zu Köln, Unter Sachsenhausen 10-26, 50667 Köln


Schwarzweiß Porträt von Alvin E. Roth

Schwarzweiß Porträt von Nicole Bastian
©Pablo Castagnola / Handelsblatt

Wednesday, March 9, 2016

Who Gets What and Why at the European School of Management and Technology (ESMT), in Berlin.

I'm in Berlin to speak about Who Gets What and Why...

Wednesday, March 09, 2016, 07:00 pm

Who Gets What and Why: The New Economics of Matchmaking and Market Design


In his lecture, Alvin E. Roth shines a light on the everyday world of matching markets in diverse areas such as organ donation, public school choice programs, college admissions, employment, and online dating. Unlike commodity markets such as stocks and bonds, where price alone determines who gets what, in a matching market you are not free to choose but must also be chosen. Roth is in the forefront of the “market design” school, which aims to solve problems plaguing matching markets that are not “thick” enough (lacking sufficient participants) or suffer from “congestion” (an overwhelming range of options). As an example, he points out that over 100,000 people in the U.S. are waiting for kidney transplants, yet only about 11,000 non-directed kidneys become available each year. Using market design principles, Roth helped design the New England Program for Kidney Exchange. As another example, he examines the college application process, a vicious cycle in which, as students apply to more colleges, acceptance rates go down. After reading Roth’s book, readers may or may not make better matches, but they will better understand how matching markets work.
Moderated by Christoph von Marschall, Managing Editor, Der Tagesspiegel
In cooperation with Siedler Verlag and the European School of Management and Technology (ESMT).
Who Gets What and Why: The New Economics of Matchmaking and Market Design will be released
in March 2016 by Siedler Verlag as Wer kriegt was und warum? Bildung, Jobs und Partnerwahl: Wie Märkte funktionieren.
The lecture will take place at the European School of Management and Technology (ESMT), Schloßplatz 1, 10178 Berlin.

See also  ESMT Open Lecture und Buchpräsentation mit Wirtschaftsexperte und Nobelpreisträger Alvin E. Roth

Tuesday, March 8, 2016

James Hathaway: Plan for, rather than simply react to, refugee movements

Mitu Gulati points me to this piece by James Hathaway:
A global solution to a global refugee crisis
JAMES C. HATHAWAY 29 February 2016

His summary:

 How should we proceed?
A team of lawyers, social scientists, non-governmental activists, and governmental and intergovernmental officials, drawn from all parts of the world, worked for five years to conceive the model for a new approach to implementing the Refugee Convention. We reached consensus on a number of core principles.

1. Reform must address the circumstances of all states, not just the powerful few.

Most refugee “reform” efforts in recent years have been designed and controlled by powerful states—for example, Australia and the EU. There has been no effort to share out fairly in a binding way the much greater burdens and responsibilities of the less developed world, even at the level of financial contributions or guaranteed resettlement opportunities. This condemns poorer states and the 80% of refugees who live in them to mercurial and normally inadequate support—leading often to failure to respect refugee rights. It is also decidedly short-sighted in that the absence of meaningful protection options nearer to home is a significant driver of efforts to find extra-regional asylum, often playing into the strategies of smugglers and traffickers.

2. Plan for, rather than simply react to, refugee movements.

The international refugee system should commit itself to pre-determined burden (financial) sharing and responsibility (human) sharing quotas. Such factors as prior contributions to refugee protection, per capita GDP, and arable land provide sensible starting points for the allocation of shares of the financial and human dimensions of protection. But, as the recent abortive effort to come up with such shares ex post by the European Union makes clear, the insurance-based logic of standing allocations can only be accomplished in advance of any particular refugee movement.

3. Embrace common but differentiated state responsibility.  

There need be no necessary connection between the place where a refugee arrives and the state in which protection for duration of risk will occur, thus undercutting the logic of disguised economic migration via the refugee procedure. And rather than asking all states to take on the same protection roles, we should harness the ability and willingness of different states to assist in different ways. The core of the renewed protection regime should be common but differentiated responsibility, meaning that beyond the common duty to provide first asylum, states could assume a range of protection roles within their responsibility-sharing quota (protection for duration of risk; exceptional immediate permanent integration; residual resettlement)—though all states would be required to make contributions to both (financial) burden-sharing and (human) responsibility-sharing, with no trade-offs between the two.

4. Shift away from national, and towards international, administration of refugee protection.

We advocate a revitalized UNHCR to administer quotas, with authority to allocate funds and refugees based on respect for legal norms; and encouragement of a shift to common international refugee status determination system and group prima facie assessment to reduce processing costs, thereby freeing up funds for real and dependable support to front-line receiving countries—including start-up funds for economic development that links refugees to their host communities, and which facilitate their eventual return home. Our economists suggest that reallocation of the funds now spent on domestic asylum systems would more than suffice to fund this system. And since as described below positive refugee status recognition would have no domestic immigration consequence for the state in which status assessment occurs, this savings could be realized without engaging sovereignty concerns.

5. Protection for duration of risk, not necessarily permanent immigration.

We should be clear that this is a system for which migration is the means to protection, not an end in and of itself. Managed entry regimes should be promoted where feasible, though the right of refugees to arrive wherever they can reach without penalization for unlawful presence must be respected (thus undercutting the market for smugglers and traffickers). Some refugees—such as unaccompanied minors and victims of severe trauma—will require immediate permanent integration, though others should instead be granted rights-regarding protection for duration of risk. Creative development assistance linking refugees to host communities would increase the prospects for local integration, and many refugees will eventually feel able to return home. But for those still without access to either of these solutions at 5-7 years after arrival, residual resettlement would be guaranteed to those still at risk, enabling them to remake their lives with a guarantee of durable rights—in stark contrast to the present norm of often indefinite uncertainty.
If we are serious about avoiding continuing humanitarian tragedy—not just in Europe but throughout the world—then the present atomized and haphazard approach to refugee protection must end. The moment has come not to renegotiate the Refugee Convention, but rather at long last to operationalize that treaty in a way that works dependably, and fairly.

Monday, March 7, 2016

First paired kidney exchange transplant done in Singapore

Here's the story from the Straits Times, about a short non-directed donor chain:  First paired kidney exchange transplant done in Singapore

"Ms Siti was put on dialysis while waiting for a donor, but time was running out. It was then that doctors put forth a novel proposal, known as a paired kidney exchange transplant.  Under this arrangement, a good Samaritan would donate his or her kidney to Ms Siti. In exchange, Madam Rafidah would give one of her own kidneys to someone on the national waiting list.

"While this procedure has been approved since 2009, it has never been carried out due to the lack of a donor who is both willing and medically fit.
"Every year, said Professor A Vathsala, who is co-director of the National University Centre for Organ Transplantation at the National University Hospital, only two or three healthy people come forward to donate their kidneys. And of these, only one would be assessed as medically fit.

"On the other hand, the average person on the national waiting list for a new kidney would have to wait nearly a decade for a new organ."

Other coverage:
First living paired kidney exchange in Singapore performed at NUH (news broadcast with a video.)
Posted 29 Feb 2016 15:50

Sunday, March 6, 2016

Saturday, March 5, 2016

Penn celebrates differential privacy (and an application to anti-terrorism surveillance)

Briefly on Penn's front web page, here's the story.
Balancing Privacy and Security in Network Analysis

Something about the pictures caught my eye:

(L to R) Steven Wu, Michael Kearns, Aaron Roth, and Grigory Yaroslavtsev

Unified enrolment in Oakland

The NY Times has an article about controversies in Oakland public schools, including about the prospect of instituting a unified enrollment system that would give parents one application form for both district and charter schools:
Oakland District at Heart of Drive to Transform Urban Schools

"Mr. Wilson says that a single application form, where parents rank their choices among all schools and students are assigned through a computer algorithm, will reduce the ability of well-connected parents to place their children in the most desirable schools and force charters to be more open about how they admit students. Similar systems have been put in place in Washington and New Orleans and are being considered in Boston."

Friday, March 4, 2016

NYC High School Match Day

If you are a NYC 8th grader, or have one in your family, this is a big day. Good luck!

Chalkbeat has the story (with links to their earlier coverage of high school admissions):
On high school match day, a Chalkbeat guide to high school admissions debates
By Stephanie Snyder

"Most of New York City’s eighth-graders will find out what high school they were matched with on Friday — which means it’s going to be a day of stress, celebration, and a few tears.

"Students have been waiting for the last three months to hear where they would be placed after navigating the city’s complicated choice-based high school system. In December, nearly 75,000 teenagers finished that process, often sifting through a 649-page directory to find and rank their top picks."

Thursday, March 3, 2016

Sri Lanka Destroys Illegal Elephant Tusks

 The NY Times has the story: Sri Lanka Destroys Illegal Elephant Tusks

"A group of saffron-robed monks chanted as officials crushed more than 300 elephant tusks in a seaside ceremony on Tuesday, as the new government of President Maithripala Sirisena sought to differentiate itself from its predecessor by sending a powerful message of intolerance for elephant poaching.

Sri Lanka is the first South Asian nation to publicly destroy ivory obtained through elephant poaching and the 16th country in the world to destroy confiscated elephant tusks so that they cannot be traded in the black market.

The previous Sri Lankan government, led by Mahinda Rajapaksa, had planned to distribute the tusks to Buddhist temples around the island, including the Sacred Temple of the Tooth, the country’s most revered. That spurred an outcry from Sri Lankan environmentalists and international wildlife agencies, who argued that the ivory would later be traded."

Wednesday, March 2, 2016

Signaling English language proficiency with video interviews

Colleges are increasingly availing themselves of video and internet technology to assess language skills of foreign applicants: see e.g. this story in the WaPo:
Amid fraud fears, colleges vet China applicants with video

I'm an advisor to one of the companies they mention, Initial View.

"One service provider, InitialView, was launched in Beijing in 2009 by an American couple. While many colleges have interviewed students themselves on the Internet, the company offers verification of student identities. InitialView conducts interviews in 14 cities across China and has begun operating in other countries. "

Here's an earlier, related NYT story: Chinese Students and U.S. Universities Connect Through a Third Party

Tuesday, March 1, 2016

First Uterus Transplant in the U.S., at the Cleveland Clinic

Uterus transplants were pioneered in Sweden, where surrogacy is illegal. But there is also demand in the U.S.

The NY Times has the story: First Uterus Transplant in U.S. Bolsters Pregnancy Hopes of Many

"The procedure’s purpose is to enable women born without a uterus, or who had theirs removed, to become pregnant and give birth. The patient will have to wait a year before trying to become pregnant, letting her heal and giving doctors time to adjust the doses of medication she needs to prevent organ rejection.

Then she will need in vitro fertilization to become pregnant. Before the transplant, the patient had eggs removed surgically, fertilized with her husband’s sperm and frozen. The embryos will be transferred into her uterus.

The transplant will be temporary: The uterus will be removed after the recipient has had one or two babies, so she can stop taking anti-rejection drugs.

The Cleveland hospital’s ethics panel has given it permission to perform the procedure 10 times, as an experiment. Officials will then decide whether to continue, and whether to offer the operation as a standard procedure. The clinic is still screening women who may be candidates for the operation.

The leader of the surgical team is Dr. Andreas G. Tzakis, who has performed 4,000 to 5,000 transplants of kidneys, livers and other abdominal organs. To prepare for uterus transplants, he traveled to Sweden and worked with doctors at the University of Gothenburg, the only ones in the world to have performed the procedure successfully so far. Nine women have had the operation in Sweden, with the transplants taken from living donors. At least four recipients have had babies, who were born healthy though premature.

About 50,000 women in the United States are thought to be candidates for transplanted uteruses."