Customs group to fight $200 bln bogus drug industry
(Reuters) – Counterfeit drugs have become a $200-billion-a-year industry and the 176-nation World Customs Organization (WCO) will sign a declaration later this month to fight the scourge, an official said on Thursday.
Fake or substandard versions of medicines are often hidden in cargoes sent on circuitous routes to mask their country of origin.
“We have more fakes than real drugs in the market,” said Christophe Zimmermann, the WCO’s anti-counterfeiting and piracy coordinator. “In 2007-2008 alone, it rose 596 percent.”
Pharmacies and back street merchants in Africa sell fake medicines at rock-bottom prices.
The World Trade Organization says fake anti-malaria drugs kill 100,000 Africans a year and the black market deprives governments of 2.5-5 percent of their revenue.
The Brussels-based WCO represents customs operations globally and has joined with former French president’s Jacques Chirac’s foundation to raise awareness at upper echelons to curtail the illicit industry.
Spurred by Chirac’s foundation, 176 national customs chiefs will sign a declaration on June 24 to ban the making and marketing of counterfeit drugs, Zimmermann told Reuters.
Fake medicines often contain the wrong or toxic ingredients and pose a growing health threat worldwide, especially in poor countries where drugs are sold to treat conditions such as malaria, tuberculosis and HIV.
“If these subjects are not dealt with and strong action not taken, they will be a source of conflict,” said Catherine Joubert, director general of the Fondation Chirac, adding that so far 30 groups had signed the declaration.
Getting the WCO’s 176 members on board will lend legitimacy to proposals to revamp obsolete legislation and improve coordination between enforcement agencies, Zimmermann said.
Western Europeans spend an estimated 10.5 billion euros ($14.3 billion) a year on illicitly sourced medicines, according to a Pfizer-sponsored survey published in February.
In a sign Europe is taking the issue seriously too, justice ministers on the Council of Europe are set to ratify a convention on counterfeit medicines in Istanbul this November.
Reference Link
http://www.reuters.com/article/idUSTRE6586DL20100610?feedType=nl&feedName=ushealth1100
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Thomson Reuters
Free drugs may help more get chlamydia treatment
(Reuters Health) – Vouchers for free medication might help the sexual partners of people being treated for chlamydia get treatment too, a new study says.
Treating partners is important, the researchers note, because patients who have been treated can get chlamydia again from a partner who has the infection. Going to a clinic and seeing a doctor is still the best option for those partners.
But the study’s authors say the vouchers are an option for people who might avoid clinics and never get treated to get the drugs they need without a prescription.
“Partners may not feel they have an STI (sexually transmitted infection),” Dr. Sharon Cameron, the lead author of the study and a gynecologist at the Dean Terrace Center in Edinburgh, Scotland told Reuters Health. Or, “they might be embarrassed to go to a clinic.” This system “gives individuals another option of where they would want to go be treated.”
Chlamydia is one of the most common STIs. In the U.S., around 1 percent of the population gets chlamydia every year. Young people age 15 to 24 are most at risk.
In the study, doctors gave out almost 600 vouchers to people diagnosed with chlamydia, most of them women. The vouchers allowed the sexual partners of those patients to go to a pharmacy and get a free dose of antibiotics used to treat the STI, which might otherwise cost around $20 if they didn’t have insurance. If they preferred, the partners could go to a clinic to be tested and treated there.
Forty percent of the vouchers were redeemed at a pharmacy, most within a few days. Four percent of partners chose to get treatment at one of the clinics tracked by the authors instead. The researchers don’t know whether the rest of the partners were treated by their primary care doctors or not at all.
Cameron said that these results are at least as good as what previous studies have shown for getting treatment to partners of people with chlamydia.
The voucher system is one way of getting medication in the hands of infected people quickly. Some states in the U.S. allow clinics to hand out extra antibiotics for patients to give to their sexual partners. But this isn’t allowed in the UK.
One worry is that giving people antibiotics without a doctor’s consult, either directly or through vouchers, could increase resistance to these drugs. The more antibiotics are used – and especially the more they are used for not enough time or at the wrong dose – the more likely that the infection will be able to fight off the drugs and become resistant to them. Resistant infections are more dangerous and costly to treat.
But Peter Carr, manager of the STD and HIV section at the Minnesota Department of Health, said the effect on resistance would not be significant. Resistance hasn’t been an issue for chlamydia like it has been for gonorrhea, and “the effect on overall antibiotic use would be small,” he told Reuters Health. “It would be a really tiny portion of the total antibiotics prescribed.”
Then there are the ethical issues of giving people treatment when a doctor hasn’t told them the drug’s side effects or their other options. An American Medical Association (AMA) report on the ethics of giving patients medication for their sexual partners said that the technique could be used as a back-up for times when doctors don’t think their patient’s partners will see a doctor.
“There are ethical trade-offs in what we do,” Dr. Mark Levine, the former chair of the AMA Council on Ethical and Judicial Affairs who was not involved in the study, told Reuters Health. “This is a means of getting treatment to more people than would be getting it using … the traditional doctor-patient relationship that requires an in-person visit.”
“The bottom line is if the partner’s not going to get anyway, it’s a way to make sure the partner does get treated,” said Carr, who was also not involved in the study. “We think it’s a valuable tool, and we need all the tools we can get for managing sexually transmitted infections in patients and their partners.”
Reference Link
http://www.reuters.com/article/idUSTRE6595K820100610?feedType=nl&feedName=ushealth1100
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Thomson Reuters
Youth League Fights AIDS With Soccer
Patrick Barth for The New York Times
MAWEWE, South Africa — Far from the World Cup, in this poor, rural village where there are no paved roads, no nets on the goals and no shoes for many of the players, Clement Nkala, 17, sat in a chair in his soccer uniform and held out his finger to be pricked for an H.I.V. test.
In a country where 5.7 million people are infected with the virus that causes AIDS — the most in the world — the problem is particularly acute here in the Nkomazi district of Mpumalanga Province, near South Africa’s eastern border with Swaziland and Mozambique.
Medical workers estimate that 65 percent of people between the ages of 18 and 34 in this area, slightly smaller in size than Rhode Island, carry H.I.V. and that 5,000 to 8,000 children under the age of 5 have been orphaned.
“I am thinking of my future,” Nkala said Saturday afternoon. “It is important to know your status.”
Sarah Kate Noftsinger seemed pleased and startled. A player volunteering to be tested in the open, with his friends playing nearby, would not have happened in this remote district 15 months ago, when she started a youth soccer league that has expanded to five villages and 2,500 boys on 160 teams in under-14 and under-17 divisions.
In this culture, parents seldom talk to their children about sex, medical workers said. Many are afraid to be tested for H.I.V., fearing that they might get their fingers pricked one day and die the next. Denial can be more comforting than the stress of knowing. Admission carries the risk of being shunned by a family, by an entire community. Nkala was a breakthrough.
“This is a big step,” said Noftsinger, 29, of Richmond, Va., who is director of sports and leadership for Triad Trust, a Boston-based charity that seeks to reduce AIDS-related deaths.
Subduing H.I.V. in this region of 500,000 people will not happen soon, it is universally agreed. But this is another fledgling attempt, by creating a sports league and educating players, to show that H.I.V. is preventable, that medicine is available for those who are infected and that there can be a big difference between living with H.I.V. and dying from AIDS.
“It’s a way to address something that nobody wants to talk about through a game that everybody loves,” Noftsinger said.
She is a small woman with the ebullient energy of a midfielder, which she was until the Women’s United Soccer Association folded in the United States in 2003.
She first came to this area to give a two-week clinic in December 2008. Five local advocates, in their mid-20s, pleaded with Noftsinger to help them start a sustainable league that could combine soccer and H.I.V. awareness and might prevent another generation from being lost.
Too often, said Zola Ndlovu, the league’s executive liaison, well-meaning Americans put on clinics then leave without training the locals to carry on in their absence.
“When they are gone, we are still dying,” Ndlovu said.
Flying home from that first trip, Noftsinger scribbled a business plan on a napkin. She felt the empathy of a survivor, having twice recovered from colon cancer and from a broken vertebra, sustained while heading a soccer ball.
Surgery was required in 2006 to repair the vertebra and a ruptured disk. A year and a half of lethargy followed, she said, as she healed. She quit taking classes at business school and left her job as an assistant coach for Stanford’s women’s soccer team. The idea of a league in South Africa shifted a stalled Noftsinger back into overdrive. She buzzes about now, carrying three cellphones, writing notes on her hand. Even her name has been compressed from Sarah Kate to Skate.
“Fast forward always, in Charlie Chaplin mode,” said Themba Mahakane, the league’s financial director.
For six weeks at a time, Noftsinger travels here as executive director of the league’s umbrella organization, Triad Nkomazi Rush. She believes the league will survive only if it can be maintained by local leaders. Scheduling, finances, marketing and medical education are administered by a local seven-member executive committee. Her approach is to offer advice but not to take control.
In three years, Noftsinger hopes to make herself obsolete. She envisions the league continuing with full-time jobs for local administrators, coaches and medical workers in an area with an unemployment rate estimated at 60 to 90 percent.
Once a week, players receive instruction about topics like H.I.V., domestic violence and self-confidence. Instruction is provided by medical workers and by an improvisational drama troupe that uses plays, songs, dance and poetry to address social situations encountered in daily life.
Teams with perfect attendance receive uniforms provided by Rush, an American youth soccer organization. To keep the uniforms, players must continue attending the classes. A few girls from a nearby village called Block B have begun taking health lessons and have asked to join a team.
The ultimate goal is to have each player tested for H.I.V. every 90 days, using a fingerprint-based system that keeps the results confidential.
“Triad Nkomazi Rush is trying to make people see that a person with H.I.V. is not the enemy,” said Paul Makofane, the deputy director for sports advancement in Mpumalanga Province. “And they are transferring skills, so we won’t have to rely on the mother programs from the United States. We can run our own.”
Almost everyone in this area has a relative or friend infected with the virus. The mother, father and brother of Nomsa Shabangu, the league’s director of medical education, have all tested positive, she said. Among migrant farm workers, who frequently change sexual partners, she said, the infection rate may be 80 or 90 percent.
Ignorance about sex and disease is rampant. From village to village, myths persist that men can be cured of H.I.V. by having sex with an infant less than 2 years old, or with a virgin, or even with a goat or a dog, Shabangu said. She had her own misunderstandings, giving birth at 16.
“I was not aware that I could get pregnant and have a baby from sexual activity,” Shabangu, 26, said. “Our parents taught us that you go and buy a baby from the hospital or they fall from airplanes. It’s important that we start telling the truth about these things.”
Some H.I.V. transmission results from desperate poverty in Nkomazi villages, where the most thriving business can be the local mortuary, Noftsinger said.
A woman might trade sexual favors to buy a few extra minutes for her cellphone, so she can keep in contact with her relatives, or for help paying the grocery bill so she can feed an extended family decimated by AIDS.
“What do you do when you have to put food on the table for your brothers and sisters because your parents have died?” Noftsinger said.
The nascent league has faced inevitable advances and retreats. On Sunday, in the nearby village of Kamhlushwa, a championship tournament was completed before a monthlong break for winter and the World Cup. Trophies and medals were awarded. But the under-14 title game was suspended for more than an hour as opposing coaches tried to resolve a dispute over a red-card ejection.
By the time the match concluded, the sun had set. Noftsinger piled one of the teams in her pickup so the children would not have to walk more than a mile home in the dark.
“I think I got five more gray hairs today,” she said.
Some days are more heartening, like Saturday, when 14 players in Mawewe agreed to be tested for H.I.V. Nkala stuck out his finger and a drop of blood was placed in a cartridge that resembled a home pregnancy kit.
A few minutes later, the test came back negative. Nkala said he wanted to become sexually active. Through the soccer league, he said, “I know how to protect myself.”
It was important that the players took the test voluntarily instead of being pushed, said Clifford Ndlovu, the league’s marketing director.
“It shows they trust us,” he said.
Reference Link
http://www.nytimes.com/2010/06/11/sports/soccer/11aids.html?th=&emc=th&pagewanted=all
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The New York Times Company
Prune and Grow
Sixteen months ago, Congress passed a stimulus package that will end up costing each average taxpayer $7,798. Economists were divided then about whether this spending was worth it, and they are just as divided now.
The president’s economists ran the numbers through their model and predicted that the stimulus package would create or save at least three million jobs. John F. Cogan and John B. Taylor of Stanford and Tobias Cwik and Volker Wieland of the Goethe-University of Frankfurt argue that the White House methodology is archaic. Their model suggests the stimulus will create about a half-million jobs.
Edward L. Glaeser of Harvard compared the change in employment in each state to the amount of stimulus money it has received. He found a slight relationship between stimulus dollars and job creation, but none at all if you set aside three states: Alaska and the Dakotas.
Over all, most economists seem to think the stimulus was a good idea, but there’s a general acknowledgment that we know relatively little about the relationship between fiscal policy and job creation. We are left, as Glaeser put it on The Times’s Economix blog, “wading in ignorance.”
If the economists are divided about what just happened, the rest of the world is not divided about what should come next. Voters, business leaders and political leaders do not seem to think that the stimulus was such a smashing success that we should do it again, even with today’s high unemployment.
They seem to see the fiscal floodgates wide open and that the private sector still only created a measly 41,000 jobs last month. That doesn’t inspire confidence. Furthermore, they understand something that is hard to quantify: Deficit spending in the middle of a debt crisis has different psychological effects than deficit spending at other times.
In times like these, deficit spending to pump up the economy doesn’t make consumers feel more confident; it makes them feel more insecure because they see a political system out of control. Deficit spending doesn’t induce small businesspeople to hire and expand. It scares them because they conclude the growth isn’t real and they know big tax increases are on the horizon. It doesn’t make political leaders feel better either. Lacking faith that they can wisely cut the debt in some magically virtuous future, they see their nations careening to fiscal ruin.
So we are exiting a period of fiscal stimulus and entering a period of fiscal consolidation. Last year, the finance ministers of the G-20 were all for pumping up economic activity. This year, they called on their members to reduce debt. In this country, deficits are now the top concern.
Some theorists will tell you that if governments shift their emphasis to deficit cutting, they risk sending the world back into recession. There are some reasons to think this is so, but events tell a more complicated story.
Alberto Alesina of Harvard has surveyed the history of debt reduction. He’s found that, in many cases, large and decisive deficit reduction policies were followed by increases in growth, not recessions. Countries that reduced debt viewed the future with more confidence. The political leaders who ordered the painful cuts were often returned to office. As Alesina put it in a recent paper, “in several episodes, spending cuts adopted to reduce deficits have been associated with economic expansions rather than recessions.”
This was true in Europe and the U.S. in the 1990s, and in many other cases before. In a separate study, Italian economists Francesco Giavazzi and Marco Pagano looked at the way Ireland and Denmark sharply cut debt in the 1980s. Once again, lower deficits led to higher growth.
So the challenge for the U.S. in the years ahead is to consolidate intelligently. That means reducing deficits while at the same time making the welfare state more efficient, boosting innovation in areas like energy, and spending more money on growth-enhancing sectors like infrastructure.
That’s a tough balancing act.
The biggest task will be to reduce middle-class entitlement spending. Alesina found that spending cuts are a more effective way to stabilize debt than tax increases, though we’ll need both.
The second biggest task is to consolidate while addressing another problem: labor market polarization. According to a Hamilton Project/Center for American Progress study by David Autor, high-skill sectors saw no net loss of jobs during the recession. Middle-skill sectors like sales saw an 8 percent employment decline. Blue-collar jobs fell by 16 percent.
In other words, the recession exacerbated the inequalities we’ve been seeing for decades. Somehow government has to cut total spending while directing more money to address the trends that threaten to hollow out the middle class.
During the period of consolidation, in other words, the government will have to spend less, but target better. That will require enormous dexterity and intelligence from a political system that has recently shown neither.
Reference Link
http://www.nytimes.com/2010/06/11/opinion/11brooks.html?th&emc=th
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The New York Times Company
Goodness Apple 
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