Here's a fascinating take on the pros and cons of technological progress. Amazing story.
India's Skewed Sex RatioPuts GE Sales in Spotlight
By PETER WONACOTTApril 18, 2007; Page A1
INDERGARH, India -- General Electric Co. and other companies have sold so many ultrasound machines in India that tests are now available in small towns like this one. There's no drinking water here, electricity is infrequent and roads turn to mud after a March rain shower. A scan typically costs $8, or a week's wages.
GE has waded into India's market as the country grapples with a difficult social issue: the abortion of female fetuses by families who want boys. Campaigners against the practice and some government officials are linking the country's widely reported skewed sex ratio with the spread of ultrasound machines. That's putting GE, the market leader in India, under the spotlight. It faces legal hurdles, government scrutiny and thorny business problems in one of the world's fastest-growing economies.
Indian activists protest against female feticide in New Delhi last May.
"Ultrasound is the main reason why the sex ratio is coming down," says Kalpana Bhavre, who is in charge of women and child welfare for the Datia district government, which includes Indergarh. Having a daughter is often viewed as incurring a lifetime of debt for parents because of the dowry payment at marriage. Compared to that, the cost of an ultrasound "is nothing," she says.
For more than a decade, the Indian government has tried to stop ultrasound from being used as a tool to determine gender. The devices use sound waves to produce images of fetuses or internal organs for a range of diagnostic purposes. India has passed laws forbidding doctors from disclosing the sex of fetuses, required official registrations of clinics and stiffened punishments for offenders. Nevertheless, some estimate that hundreds of thousands of girl fetuses are aborted each year.
GE -- by far the largest seller of ultrasound machines here through a joint venture with Indian outsourcing giant Wipro Ltd. -- has introduced its own safeguards, even though that means forsaking sales. "We stress emphatically that the machines aren't to be used for sex determination," says V. Raja, chief executive of GE Healthcare South Asia. "This is not the root cause of female feticide in India."
But the efforts have failed to stop the problem, as a growing economy has made the scans affordable to more people. The skewed sex ratio is an example of how India's strong economy has, in unpredictable ways, exacerbated some nagging social problems, such as the traditional preference for boys. Now, some activists are accusing GE of not doing enough to prevent unlawful use of its machines to boost sales.
"There is a demand for a boy that's been completely exploited by multinationals," says Puneet Bedi, a New Delhi obstetrician. He says GE and others market the machines as an essential pregnancy tool although the scans often aren't necessary for mothers in low risk groups.
Earlier this month, prosecutors in the city of Hyderabad brought a criminal case against the GE venture with Wipro as well as Erbis Engineering Co., the medical-equipment distributor in India for Japan's Toshiba Corp. In the suits, the district government alleges that the companies knowingly supplied ultrasound machines to clinics that weren't registered with the government and were illegally performing sex-selection tests. The penalty is up to three months in prison and a fine of 1,000 rupees.
Both companies deny wrongdoing and say they comply with Indian laws. A GE spokesman said yesterday the company hadn't received court notification but its legal team would be looking into the charges.
Vivek Paul, who helped build the early ultrasound business in India, first as a senior executive at GE and then at Wipro, says blame should be pinned on unethical doctors, not the machine's suppliers. "If someone drives a car through a crowded market and kills people, do you blame the car maker?" says Mr. Paul, who was Wipro's chief executive before he left the company in 2005. Mr. Paul is now a managing director at private equity specialists TPG Inc., formerly known as Texas Pacific Group.
Critical Market
India has been a critical market to GE. Its outsourcing operations have helped the Fairfield, Conn., giant cut costs. The country also is a growing market for GE's heavy equipment and other products. The company won't disclose its ultrasound sales. But Wipro GE's overall sales in India, which includes ultrasounds and other diagnostic equipment, reached about $250 million last year, up from $30 million in 1995.
Annual ultrasound sales in India from all vendors reached $77 million in 2006, up about 10% from the year before, according to an estimate from consulting firm Frost & Sullivan, which describes GE as the clear market leader. Other vendors include Siemens AG, Philips Electronics NV and Mindray International Medical Ltd., a new Chinese entrant for India's price-sensitive customers.
India has long struggled with an inordinate number of male births, and female infanticide -- the killing of newborn baby girls -- remains a problem. The abortion of female fetuses is a more recent trend, but unless "urgent action is taken," it's poised to escalate as the use of ultrasound services expands, the United Nations Children's Fund said in a report this year. India's "alarming decline in the child sex ratio" is likely to exacerbate child marriage, trafficking of women for prostitution and other problems, the report said.
The latest official Indian census in 2001 showed a steep decline in the relative number of girls aged 0-6 years from 10 years earlier: 927 girls for every 1,000 boys compared with 945 in 1991. In much of northwest India, the number of girls has fallen below 900 for every 1,000 boys. In the northern state of Punjab, the figure is below 800.
Wider Gap
Only China today has a wider gender gap, with 832 girls born for every 1,000 boys among infants aged 0-4 years, according to Unicef. GE sells about three times as many ultrasound machines in China as in India. In January, the Chinese government pledged to improve the gender balance, including tighter monitoring of ultrasounds. Some experts predict China will be more effective than India in enforcing its rules, given its success at other population-control measures.
Boys in India are viewed as wealth earners during life and lighters of one's funeral pyre at death. India's National Family Health Survey, released in February, showed that 90% of parents with two sons didn't want any more children. Of those with two daughters, 38% wanted to try again. While there are restrictions on abortions in this Hindu-majority nation, the rules offer enough leeway for most women to get around them.
GE took the lead in selling ultrasounds in the early 1990s soon after it began manufacturing the devices in India. It tapped Wipro's extensive distribution and service network to deliver its products to about 80% of its customers. For more remote locations and lower-end machines, it used sales agents.
The company also teamed with banks to help doctors finance the purchase of their machines. GE now sells about 15 different models, ranging from machines costing $100,000 that offer sophisticated color images to basic black-and-white scanners that retail for about $7,500.
To boost sales, GE has targeted small-town doctors. The company has kept prices down by refurbishing old equipment and marketed laptop machines to doctors who traveled frequently, including to rural areas. GE also offered discounts to buyers inclined to boast about their new gadgets, according to a former GE employee.
"Strategically, we focused on those customers who had big mouths," said Manish Vora, who until 2006 sold ultrasounds in the western Indian state of Gujarat for the Wipro-GE joint venture.
Without discussing specific sales tactics, Mr. Raja, of GE Healthcare South Asia, acknowledges the company is "aggressive" in pursuing its goals. But he points out that ultrasound machines have broad benefits and make childbirth safer. As the machines become more available, women can avoid making long trips into cities where health care typically is more expensive, he says.
Indian authorities have tried to regulate sales. In 1994, the government outlawed sex selection and empowered Indian authorities to search clinics and seize anything that aided sex selection. Today any clinic that has an ultrasound machine must register with the local government and provide an affidavit that it won't conduct sex selection. To date, more than 30,000 ultrasound clinics have been registered in India.
GE has taken a number of steps to ensure customers comply with the law. It has educated its sales force about the regulatory regime, demanded its own affidavits from customers that they won't use the machines for sex selection, and followed up with periodic audits, say executives. They note that in 2004, the first full year it began implementing these new measures, GE's sales in India shrank by about 10% from the year before. The sales decline in the low-end segment, for black-and-white ultrasound machines, was especially sharp, executives say. Only last year did GE return to the sales level it had reached before the regulations were implemented, according to Mr. Raja.
Complying with Indian law is often tricky. GE can't tell if doctors sell machines to others who fail to register them. Different states interpret registration rules differently. GE also is under close scrutiny by activists battling the illegal abortion of female fetuses. Sabu George, a 48-year-old activist who holds degrees from Johns Hopkins and Cornell universities, crisscrosses the country to spot illegal clinics.
Criminal Case
The criminal case in Hyderabad against Wipro-GE, a company representative, three doctors and an ultrasound technician followed an inspection in 2005 that found one clinic couldn't produce proper registration and hadn't kept complete records for two years. A team of inspectors seized an ultrasound supplied by Wipro-GE. The inspection team's report said it suspected the clinic was using the machines for illegal sex determination.
The owner, Sarawathi Devi, acknowledged in an interview that her clinic, Rite Diagnostics, wasn't officially registered at the time of the 2005 inspection. She said the ultrasound machine was owned by a "free-lance" radiologist who had obtained proper documentation for the Wipro-GE machine, but wasn't there when the inspectors had arrived. She denied the clinic has conducted sex determination tests. Later in 2005, Dr. Devi's records show she registered the clinic with the government and bought a Wipro-GE machine, a sale the company confirms.
The court case was part of a wider dragnet spearheaded by Hyderabad's top civil servant, District Magistrate Arvind Kumar. During an audit last year, Mr. Kumar demanded paperwork for 389 local scan centers. Only 16% could furnish complete address information for its patients, making it almost impossible to track women to check if they had abortions following their scans. Mr. Kumar ordered the seizure of almost one-third of the ultrasound machines in the district due to registration and paperwork problems. A suit also was lodged against Erbis, the Toshiba dealer.
GE's Mr. Raja says that, in general, if there's any doubt about the customer's intent to comply with India's laws, it doesn't make the sale. "There is no winking or blinking," he says.
A Wipro-GE representative is scheduled to appear May 7 at the Hyderabad court. An Erbis spokesman said he was unaware of the case in Hyderabad. A court date for Erbis hasn't been set.
A visit to the clinic in Indergarh, a town surrounded by fields of tawny wheat, shows the challenges GE faces keeping tabs on its machines. Inside the clinic, a dozen women wrapped in saris awaited tests on GE's Logiq 100 ultrasound machine. The line snaked along wooden benches and down into a darkened basement. On the wall, scrawled in white paint, was the message: "We don't do sex selection."
Manish Gupta, a 34-year-old doctor, said he drives two hours each way every week to Indergarh from much larger Jhansi city, where there are dozens of competing ultrasound clinics. He said even when offered bribes he refuses to disclose the sex of the fetus. "I'm just against that," Dr. Gupta said.
But he is not complying with Indian law. Although the law requires that clinics display their registration certificate in a conspicuous place, Dr. Gupta's was nowhere to be seen. When Dr. George, the social activist, asked for the registration, he was shown a different document, an application. But the application was for a different clinic: the Sakshi X-ray center. Dr. Gupta said the proper document wasn't with him, adding: "I must have forgotten it at home."
Asked by The Wall Street Journal about the clinic, the local chief magistrate of Datia district called for Dr. Gupta's dossier later in the day. When a local official arrived, "Sakshi X-Ray center" had been crossed out on the application. In blue pen was written the correct name, "Sheetal Nagar," the part of Indergarh where the clinic is located.
It's not clear how Dr. Gupta procured the GE machine. Dr. Gupta said he bought it from a GE company representative, but he declined to show documents of ownership. GE says it doesn't comment on individual customers.
Like the rest of India, the Datia district government has taken a number of steps to try to boost the number of girls in the district. For girls of poor families, the local government provides a place to live, free school uniforms and books. When they enter ninth grade, the government buys bicycles for them. Yet the low ratio of girls born hasn't budged much over the past decade, according to Ms. Bhavre, the district government official.
Ultimately, says Mr. Raja, head of GE Healthcare in South Asia, it's the job of the government, not companies, to change the prevailing preference for boys. "What's really needed is a change in mindsets. A lot of education has to happen and the government has to do it," he says.
India's Ministry of Health, which is now pursuing 422 different cases against doctors accused of using ultrasounds for sex selection, agrees. "Mere legislation is not enough to deal with this problem," the ministry said in a statement. "The situation could change only when the daughters are not treated as a burden and the sons as assets."
-- Binny Sabharwal contributed to this article.
Wednesday, April 18, 2007
John Mack = Duke Sports Booster
Here's interesting news.
Vindicated Duke grad David Evans just landed a plum, six figure job as analyst at Morgan Stanley. Who's the head of Morgan Stanley? Duke grad and Iron Duke (e.g. sports booster) John Mack. Golly, that's peculiar.
Thoughts?
Thoughts?
"The rule of law is what I fight for. Men die for this. Don't stop."
This is a compelling, heartfelt piece by Lt. Commander Charles Swift, defense counsel in the Office of the Chief Defense Counsel in the Department of Defense (DoD) Office of Military Commissions. He is currently detailed to represent Salim Ahmed Hamdan, who is facing trial by Military Commission in Hamdan v. Rumsfeld. His piece begins:
It's time for some perspective, please. It's time to close Guantanamo Bay. Yes , I am the military officer who sued my commander in chief and the secretary of defense on behalf of a Guananamo Bay detainee named Salim Hamdan.
What I sought was simply that the president, just like the soldiers, sailors, and marines under his command, be required to comply with the Uniform Code of Military Justice and the Geneva Conventions. Because I believe that resorting to secret prisons, coercive interrogations, and the abandonment of the rule of law is not the way to keep our country safe from a handful of fanatics. Last summer, with the help of my civilian co-counsel, Professor Neal Katyal, and the law firm of Perkins Coie, I won the case in the Supreme Court of the United States. The problem is that the victory, as big as it was, was disdained by the administration, which has attempted to defy the Supreme Court and the rule of law by building Guantanamo up in the wake of the decision, instead of down. That needs to change.
Why did I sue my chain of command?
Before I go any further, let me introduce myself. I am from a small town in western North Carolina called Franklin. I have been in the Navy since I entered the United States Naval Academy in the summer of 1980. Before going to law school, I spent seven years serving as a surface-warfare officer in the greatest navy the world has ever known. After law school, I returned to active duty in the Navy as a member of the Judge Advocate General's Corps. That means that I am both a uniformed officer in the United States Navy and a licensed and practicing attorney. This May I will retire from active service. Serving in the United States armed forces as both a combat officer and a lawyer is the greatest privilege I will ever have, because of both who we are and what we defend. And part of who we are and what we defend are the Geneva Conventions.
I say that not just because I am Hamdan's lawyer; I say that because it is what I was taught from plebe summer on. General John Vessey, who retired after serving as chairman of the joint chiefs of staff under President Reagan, summed up those teachings better than I ever could in a recent letter to Senator John McCain. In the letter, he quoted General George Marshall:
"The United States abides by the laws of war. Its Armed Forces, in dealing with all other peoples, are expected to comply with the laws of war, in the spirit and the letter. In waging war, we do not terrorize helpless non-combatants, if it is within our power to avoid so doing. Wanton killing, torture, cruelty, or the working of unusual hardship on enemy prisoners or populations is not justified under any circumstance. Likewise respect for the reign of law, as that term is understood in the United States, is expected to follow the flag wherever it goes...."
It does not matter that Al Qaeda does all of the terrible things that General Marshall enumerated and more. It is not about them. It is about us.
">Link
It's time for some perspective, please. It's time to close Guantanamo Bay. Yes , I am the military officer who sued my commander in chief and the secretary of defense on behalf of a Guananamo Bay detainee named Salim Hamdan.
What I sought was simply that the president, just like the soldiers, sailors, and marines under his command, be required to comply with the Uniform Code of Military Justice and the Geneva Conventions. Because I believe that resorting to secret prisons, coercive interrogations, and the abandonment of the rule of law is not the way to keep our country safe from a handful of fanatics. Last summer, with the help of my civilian co-counsel, Professor Neal Katyal, and the law firm of Perkins Coie, I won the case in the Supreme Court of the United States. The problem is that the victory, as big as it was, was disdained by the administration, which has attempted to defy the Supreme Court and the rule of law by building Guantanamo up in the wake of the decision, instead of down. That needs to change.
Why did I sue my chain of command?
Before I go any further, let me introduce myself. I am from a small town in western North Carolina called Franklin. I have been in the Navy since I entered the United States Naval Academy in the summer of 1980. Before going to law school, I spent seven years serving as a surface-warfare officer in the greatest navy the world has ever known. After law school, I returned to active duty in the Navy as a member of the Judge Advocate General's Corps. That means that I am both a uniformed officer in the United States Navy and a licensed and practicing attorney. This May I will retire from active service. Serving in the United States armed forces as both a combat officer and a lawyer is the greatest privilege I will ever have, because of both who we are and what we defend. And part of who we are and what we defend are the Geneva Conventions.
I say that not just because I am Hamdan's lawyer; I say that because it is what I was taught from plebe summer on. General John Vessey, who retired after serving as chairman of the joint chiefs of staff under President Reagan, summed up those teachings better than I ever could in a recent letter to Senator John McCain. In the letter, he quoted General George Marshall:
"The United States abides by the laws of war. Its Armed Forces, in dealing with all other peoples, are expected to comply with the laws of war, in the spirit and the letter. In waging war, we do not terrorize helpless non-combatants, if it is within our power to avoid so doing. Wanton killing, torture, cruelty, or the working of unusual hardship on enemy prisoners or populations is not justified under any circumstance. Likewise respect for the reign of law, as that term is understood in the United States, is expected to follow the flag wherever it goes...."
It does not matter that Al Qaeda does all of the terrible things that General Marshall enumerated and more. It is not about them. It is about us.
">Link
Supreme Court Backs Ban on Abortion
WASHINGTON (AP) - The Supreme Court upheld the nationwide ban on a controversial abortion procedure Wednesday, handing abortion opponents the long- awaited victory they expected from a more conservative bench.
The 5-4 ruling said the Partial Birth Abortion Ban Act that Congress passed and President Bush signed into law in 2003 does not violate a woman's constitutional right to an abortion.
">Link
The 5-4 ruling said the Partial Birth Abortion Ban Act that Congress passed and President Bush signed into law in 2003 does not violate a woman's constitutional right to an abortion.
">Link
Tuesday, April 17, 2007
Obama Links Virginia Tech to Imus' "Verbal Violence"
Below is a link to the 23-minute .mp3 file of Obama on the state of violence in the U.S. You will hear him connect the violence at Virginia Tech to the "verbal violence" of Don Imus.
You should really listen to him.
http://www.wispolitics.com/1006/20070416obama.mp3
You should really listen to him.
http://www.wispolitics.com/1006/20070416obama.mp3
Virgina Tech Officials Defend Response to Deadliest Shooting Rampage in American History
Virginia Tech President Charles W. Steger described his reaction to the killings as horror, disbelief, and profound sorrow. But even as administrators expressed grief, they faced questions about whether the university could have done more to prevent the bloodshed. Virginia Tech police responded to the first shooting (at the dormitory) minutes after it occurred.
But university Police Chief Wendell Flinchum says administrators saw no reason at that point to lock down the rest of the campus because they thought the dormitory shooting was an isolated incident, a domestic dispute that posed no danger to the rest of the student body.
"We had information from witnesses and the evidence at the scene that led us to believe the shooter was no longer in the building and more than likely off campus," Flinchum said. "We were acting on information we had at the time. We secured the building. We secured the crime scene. You can second guess all day. We acted on the best information we had at the time."
Thoughts?
But university Police Chief Wendell Flinchum says administrators saw no reason at that point to lock down the rest of the campus because they thought the dormitory shooting was an isolated incident, a domestic dispute that posed no danger to the rest of the student body.
"We had information from witnesses and the evidence at the scene that led us to believe the shooter was no longer in the building and more than likely off campus," Flinchum said. "We were acting on information we had at the time. We secured the building. We secured the crime scene. You can second guess all day. We acted on the best information we had at the time."
Thoughts?
Monday, April 16, 2007
Controversial Vaccine?
This is just the kind of story I love. It takes a current controversy in the news -- the new cerival cancer vaccine -- and spins it on its head. Since the vaccine was introduced last summer, there's been a ideoligical tug of war between public health officials who wants all girls age 12 to get the vaccine. Some states are considering making the vaccine mandatory, like other vaccines. But conservatives and many parents hate the idea, saying providing a vaccine that reduces a consequences (albeit a possibly deadly one) of a sexually-transmitted disease may promote premarital sex. Now, enter this story, which makes things even more complicated.
I've pasted it here because the Journal's is a paid site.
Dan
Viral Marketing: Questions on Efficacy Cloud a Cancer Vaccine --- Merck Predicts Big Fall In Cervical Lesions, But Data Are Complex
By John Carreyrou
2451 words
16 April 2007
The Wall Street Journal
A1
English
(Copyright (c) 2007, Dow Jones & Company, Inc.)
When Merck & Co. introduced its new vaccine against cervical cancer last June, it gave it one of the biggest pushes any new medicine has received. The company lobbied dozens of states to make the vaccine mandatory for 11- and 12-year-old girls. It aired TV ads featuring young girls skipping rope while reciting the slogan, "I want to be one less" woman to battle the disease.
The campaign scored some big victories. The Centers for Disease Control and Prevention declared all women age 11 to 26 should get the vaccine, called Gardasil. Texas and Virginia passed mandatory-vaccination laws for girls entering the sixth grade. Even after Merck halted its lobbying in February amid criticism, an organization backed by the company continues to push for similar laws, and about 20 states are considering them. The vaccine costs $360 for a three-shot regimen.
But behind the scenes, Gardasil has been dogged by uncertainty about how effective it really is. Merck won approval for the vaccine based on research that showed it protected against two strains of the human papillomavirus, known as HPV 16 and 18, that are thought to cause 70% of cervical-cancer cases. The Food and Drug Administration didn't ask its panel of experts advising on Gardasil to rule on whether the vaccine specifically prevented the cancer itself. In clinical trials, 361 of 8,817 women who received at least one shot of Gardasil went on to develop precancerous lesions on their cervixes within three years of vaccination, just 14% fewer than in a placebo control group.
Scott Emerson, a professor of biostatistics at the University of Washington who sat on the FDA advisory committee, says he's not persuaded the vaccine is worth the billions of dollars likely to be spent on it in coming years. "I do believe that Gardasil protects against HPV 16 and 18, but the effect it will have on cervical-cancer rates in this country is another question entirely," says Dr. Emerson. "There is a leap of faith involved."
Merck says the 14% figure is misleading because more than a quarter of the women in the study were already infected with HPV before receiving the vaccine, blunting its effect. Gardasil isn't designed to treat those with pre-existing infection. The company prefers to point to a subset of 4,616 trial participants who were mostly free of HPV when they were vaccinated. Only 52 of these women went on to develop precancerous lesions on their cervixes over the next three years, 46% fewer than among the placebo group. Merck says this smaller group of women is the one most representative of the 11- and 12-year-old girls for whom Texas and Virginia have required vaccination.
Safety is another issue. Merck tested the vaccine in only a few hundred 11- and 12-year-old girls. Some doctors consider that number too small to declare the vaccine safe for preteen girls, given the big changes their bodies undergo.
In its approval letter, the FDA ordered Merck to follow "a sufficient number of children 11-12 years of age" in a large postmarketing study to further establish the vaccine's safety. That study won't be completed until 2009. Norman Baylor, the director of the Office of Vaccines Research and Review at the FDA, says it's common for the agency to recommend postmarketing studies for vaccines, and the FDA considers Gardasil safe.
The company says it complied with the FDA's request that the clinical trials include more than 3,000 9- to 17-year-olds. It adds that it didn't test Gardasil more widely on girls because it wanted to focus on sexually active women to demonstrate the vaccine's efficacy. So far, Merck has distributed more than four million doses of the vaccine in the U.S., and the CDC says adverse events have been mostly minor and within the normal range.
Eliav Barr, the head of Merck's HPV vaccine program, says Gardasil is a "lifesaving" vaccine and its widespread adoption will result in "a substantial decline in the rate of cervical cancer." Dr. Barr says Merck provided "an extremely strong dossier" on Gardasil that both the FDA and the CDC have deemed satisfactory.
Merck has a lot riding on Gardasil. It faces patent expirations on other best sellers and legal costs related to Vioxx, the withdrawn painkiller linked to heart attacks and strokes. Some analysts believe Gardasil's annual sales could reach $2 billion or more by 2010.
Work on a cervical-cancer vaccine goes back nearly two decades, after scientists discovered that HPV infection can trigger lesions of the cervix that eventually turn into cancer. In the early-to-mid-1990s, Merck licensed patents held by the National Cancer Institute and CSL Ltd. of Australia, and began work on commercializing the vaccine.
From the start, Merck faced a challenge in winning acceptance of the vaccine as a universal necessity for American women. Though common in developing nations, cervical cancer is a relatively rare disease in the U.S., accounting for about 0.7% of cancer diagnoses and deaths each year. Women already have a highly effective method of prevention: visiting a gynecologist for regular Pap tests. The low-tech exam has contributed to an 80% reduction in cervical-cancer deaths in the U.S. over the past 50 years.
Human studies of the present version of the vaccine, which also targets two HPV strains that cause genital warts, began in 2000. The vaccine was administered to more than 20,000 women. It is delivered in three injections over six months. Merck submitted Gardasil to the FDA for approval in 2005.
A meeting of the FDA advisory panel that reviewed Gardasil in May 2006 gave the first hint of Merck's troubles in persuading doctors of Gardasil's real-world efficacy. In its presentation, Merck stressed the vaccine's nearly 100% effectiveness in blocking infection by HPV 16 and 18 and in preventing precancerous lesions caused by those two strains. But a document prepared for the committee by an FDA reviewer noted the vaccine's limited overall efficacy against precancerous lesions in the broader group of nearly 9,000 trial participants.
Dr. Emerson, the University of Washington professor, expressed concern that Merck wasn't putting enough emphasis on the question of whether the vaccine prevented cervical cancer. "It's almost the treating the symptom but not the disease sort of idea," he said, according to a transcript of the meeting.
Merck pointed to the confounding factors behind the lower efficacy rates, including the problem of women who came into the trial already infected. In an interview, Merck's Dr. Barr says Gardasil's true efficacy will become more apparent with time, particularly in the group that includes women with a pre-existing infection.
While Merck often states that Gardasil prevents infection with viruses that account for 70% of cervical-cancer cases, Dr. Barr concedes that the vaccine is less than 70% effective against precancerous lesions. Merck says this is because the HPV strains not covered by Gardasil cause disproportionately more precancerous lesions that don't end up turning into cancer.
Efficacy against lesions is a significant issue because after a Pap test, doctors generally remove any lesions that reach a certain grade of seriousness, even though some might not turn into cancer. The surgery involves cutting out part of the cervix and can cost several hundred to several thousand dollars. Dr. Barr predicts Gardasil will eventually be shown to prevent nearly 60% of precancerous lesions that doctors would want to remove among women who were free of HPV infection when they were vaccinated.
Ultimately Gardasil received the panel's unanimous approval, and the FDA approved the vaccine in June 2006. The agency reasoned that waiting for more data would prevent some women who needed the vaccine from getting it.
With the FDA's approval, Merck faced a new challenge: persuading the public to take its vaccine. It got a quick boost from the CDC, which issued guidance in late June recommending that all girls receive the vaccine at age 11 or 12. The CDC said women age 13 to 26 should also get the vaccine. Gardasil was also endorsed by the American Academy of Pediatrics.
Merck crafted its advertising and public relations to avoid some of the less-favorable numbers surrounding Gardasil. The TV commercial says the vaccine "may help protect you" from HPV strains "that may cause 70% of cervical cancer." The company doesn't often discuss the lower efficacy against precancerous lesions or in populations where some women are already infected. The "one less" slogan avoids the question of how many lives will be saved.
Some Gardasil supporters funded by Merck are less careful about qualifying their claims. At the FDA advisory committee hearing, Martha Nolan, vice president of a women's health group that receives funds from Merck, said that by approving Gardasil, the agency had "the opportunity to eradicate this terrible disease."
After the FDA approval, a group of female state legislators called Women in Government started a campaign to get states to mandate vaccinations. The group receives money from Merck but won't say how much. Many of the pending bills would allow parents to keep their children out of the vaccination program, but only after submitting proof that they have received information about cervical cancer and the vaccine.
In early January, Women in Government held a conference for some 60 state legislators in Marco Island, Fla., paying for their airfare and hotel rooms. One of the speakers was Christine Baze, a pop singer and cervical-cancer survivor. As she performed songs on the piano, Ms. Baze told the story of her battle with the disease and said she wished a vaccine had been available to her. Ms. Baze says Women in Government paid her a $2,500 fee and covered her travel and lodging. She says she didn't receive any money from Merck for the appearance, but the company has paid her $7,500 to speak at three other events.
Marilyn Canavan, a representative in the Maine assembly who attended the conference, says she was bothered by the large number of drug-industry lobbyists she saw. A list of conference participants shows that 30 pharmaceutical-industry representatives were present -- one for every two state legislators. Merck had two representatives there. Ms. Canavan has since resigned her post as Women in Government's director in Maine over concerns that the group's agenda is being dictated by drug companies. Susan Crosby, Women in Government's president, says those concerns are unfounded.
Other state lawmakers came away from the conference inspired. Upon returning home, Jessica Sibley Upshaw, a representative in the Mississippi assembly, drafted a bill that would make vaccination a school requirement. "For me, it's a common-sense thing to do if we can eradicate a disease," she says. Ms. Upshaw's bill has since died, but she plans to reintroduce it.
In February, Texas Gov. Rick Perry bypassed the state legislature and issued an executive order mandating that all girls entering the sixth grade be vaccinated as of September 2008. One of Merck's lobbyists in Texas is Mike Toomey, Gov. Perry's former chief of staff, and Merck contributed $6,000 to the governor's re-election campaign. Mr. Toomey didn't return calls and emails seeking comment. A spokeswoman for the governor says he acted to protect the public's health, not because of the contribution or the lobbying of his former aide.
Gov. Perry's order sparked an uproar. Among the opponents are religious conservatives who say receiving the vaccine conflicts with their message of abstinence. Other opponents say Gardasil isn't worth the cost, which includes $360 for the vaccine and up to several hundred dollars more for three doctors' appointments to get the shots. The money would be better spent, these people say, in pushing Pap tests for women who aren't getting them now.
John Schiller, one of the National Cancer Institute scientists whose vaccine work was licensed by Merck, believes Gardasil is an important advance that should receive wide use, but he has mixed feelings about the way the company has promoted it. He hopes it won't divert public-health dollars away from regular Pap screening, which he says remains the most important weapon against cervical cancer. Merck "is a heavy-handed company," Dr. Schiller says. "When they do something, they spare no energy. It's the Merck way or the highway."
Merck says cost-effectiveness studies suggest the vaccine could deliver its life-saving benefits at a reasonable cost, in part by reducing the need for frequent Pap tests. Most of these studies have been funded by Merck and GlaxoSmithKline PLC, maker of another HPV vaccine, Cervarix. Glaxo applied for FDA approval of Cervarix last month.
One skeptic is Diane Harper, a longtime HPV researcher and professor at Dartmouth Medical School, who was involved in Gardasil's clinical trials and has received speaker and consulting fees from Merck and Glaxo. She says as many as 10% of 11- and 12-year-old girls may already have HPV, either from sexual activity, sexual abuse or transmission through nonsexual skin-to-skin contact. That could reduce the vaccine's efficacy, she says.
Dr. Harper also suspects the vaccine may require booster shots after 10 years. Merck says it's not sure how long the vaccine's protection will last and is monitoring women over the long term to find out.
The American Cancer Society, while agreeing with the CDC that girls should be vaccinated, said in January there is "insufficient evidence" that women age 19 to 26 will benefit from the vaccine because many have already been exposed to HPV.
Worried about the backlash that emerged in February in Texas and other states, Merck shifted into damage control. Richard Haupt, Merck's executive director of medical affairs, placed calls to respected figures in the vaccine field, including Jon Abramson, the chairman of the CDC's advisory committee on immunization practices, and Joseph Bocchini, chairman of the committee on infectious diseases at the American Academy of Pediatrics. Both men and others told Dr. Haupt they supported the vaccine, but it was too early and counterproductive to push for school requirements.
On Feb. 20, Merck announced that it was suspending its lobbying push, but Women in Government continues to lobby for school requirements. Virginia's mandate became law two weeks ago.
I've pasted it here because the Journal's is a paid site.
Dan
Viral Marketing: Questions on Efficacy Cloud a Cancer Vaccine --- Merck Predicts Big Fall In Cervical Lesions, But Data Are Complex
By John Carreyrou
2451 words
16 April 2007
The Wall Street Journal
A1
English
(Copyright (c) 2007, Dow Jones & Company, Inc.)
When Merck & Co. introduced its new vaccine against cervical cancer last June, it gave it one of the biggest pushes any new medicine has received. The company lobbied dozens of states to make the vaccine mandatory for 11- and 12-year-old girls. It aired TV ads featuring young girls skipping rope while reciting the slogan, "I want to be one less" woman to battle the disease.
The campaign scored some big victories. The Centers for Disease Control and Prevention declared all women age 11 to 26 should get the vaccine, called Gardasil. Texas and Virginia passed mandatory-vaccination laws for girls entering the sixth grade. Even after Merck halted its lobbying in February amid criticism, an organization backed by the company continues to push for similar laws, and about 20 states are considering them. The vaccine costs $360 for a three-shot regimen.
But behind the scenes, Gardasil has been dogged by uncertainty about how effective it really is. Merck won approval for the vaccine based on research that showed it protected against two strains of the human papillomavirus, known as HPV 16 and 18, that are thought to cause 70% of cervical-cancer cases. The Food and Drug Administration didn't ask its panel of experts advising on Gardasil to rule on whether the vaccine specifically prevented the cancer itself. In clinical trials, 361 of 8,817 women who received at least one shot of Gardasil went on to develop precancerous lesions on their cervixes within three years of vaccination, just 14% fewer than in a placebo control group.
Scott Emerson, a professor of biostatistics at the University of Washington who sat on the FDA advisory committee, says he's not persuaded the vaccine is worth the billions of dollars likely to be spent on it in coming years. "I do believe that Gardasil protects against HPV 16 and 18, but the effect it will have on cervical-cancer rates in this country is another question entirely," says Dr. Emerson. "There is a leap of faith involved."
Merck says the 14% figure is misleading because more than a quarter of the women in the study were already infected with HPV before receiving the vaccine, blunting its effect. Gardasil isn't designed to treat those with pre-existing infection. The company prefers to point to a subset of 4,616 trial participants who were mostly free of HPV when they were vaccinated. Only 52 of these women went on to develop precancerous lesions on their cervixes over the next three years, 46% fewer than among the placebo group. Merck says this smaller group of women is the one most representative of the 11- and 12-year-old girls for whom Texas and Virginia have required vaccination.
Safety is another issue. Merck tested the vaccine in only a few hundred 11- and 12-year-old girls. Some doctors consider that number too small to declare the vaccine safe for preteen girls, given the big changes their bodies undergo.
In its approval letter, the FDA ordered Merck to follow "a sufficient number of children 11-12 years of age" in a large postmarketing study to further establish the vaccine's safety. That study won't be completed until 2009. Norman Baylor, the director of the Office of Vaccines Research and Review at the FDA, says it's common for the agency to recommend postmarketing studies for vaccines, and the FDA considers Gardasil safe.
The company says it complied with the FDA's request that the clinical trials include more than 3,000 9- to 17-year-olds. It adds that it didn't test Gardasil more widely on girls because it wanted to focus on sexually active women to demonstrate the vaccine's efficacy. So far, Merck has distributed more than four million doses of the vaccine in the U.S., and the CDC says adverse events have been mostly minor and within the normal range.
Eliav Barr, the head of Merck's HPV vaccine program, says Gardasil is a "lifesaving" vaccine and its widespread adoption will result in "a substantial decline in the rate of cervical cancer." Dr. Barr says Merck provided "an extremely strong dossier" on Gardasil that both the FDA and the CDC have deemed satisfactory.
Merck has a lot riding on Gardasil. It faces patent expirations on other best sellers and legal costs related to Vioxx, the withdrawn painkiller linked to heart attacks and strokes. Some analysts believe Gardasil's annual sales could reach $2 billion or more by 2010.
Work on a cervical-cancer vaccine goes back nearly two decades, after scientists discovered that HPV infection can trigger lesions of the cervix that eventually turn into cancer. In the early-to-mid-1990s, Merck licensed patents held by the National Cancer Institute and CSL Ltd. of Australia, and began work on commercializing the vaccine.
From the start, Merck faced a challenge in winning acceptance of the vaccine as a universal necessity for American women. Though common in developing nations, cervical cancer is a relatively rare disease in the U.S., accounting for about 0.7% of cancer diagnoses and deaths each year. Women already have a highly effective method of prevention: visiting a gynecologist for regular Pap tests. The low-tech exam has contributed to an 80% reduction in cervical-cancer deaths in the U.S. over the past 50 years.
Human studies of the present version of the vaccine, which also targets two HPV strains that cause genital warts, began in 2000. The vaccine was administered to more than 20,000 women. It is delivered in three injections over six months. Merck submitted Gardasil to the FDA for approval in 2005.
A meeting of the FDA advisory panel that reviewed Gardasil in May 2006 gave the first hint of Merck's troubles in persuading doctors of Gardasil's real-world efficacy. In its presentation, Merck stressed the vaccine's nearly 100% effectiveness in blocking infection by HPV 16 and 18 and in preventing precancerous lesions caused by those two strains. But a document prepared for the committee by an FDA reviewer noted the vaccine's limited overall efficacy against precancerous lesions in the broader group of nearly 9,000 trial participants.
Dr. Emerson, the University of Washington professor, expressed concern that Merck wasn't putting enough emphasis on the question of whether the vaccine prevented cervical cancer. "It's almost the treating the symptom but not the disease sort of idea," he said, according to a transcript of the meeting.
Merck pointed to the confounding factors behind the lower efficacy rates, including the problem of women who came into the trial already infected. In an interview, Merck's Dr. Barr says Gardasil's true efficacy will become more apparent with time, particularly in the group that includes women with a pre-existing infection.
While Merck often states that Gardasil prevents infection with viruses that account for 70% of cervical-cancer cases, Dr. Barr concedes that the vaccine is less than 70% effective against precancerous lesions. Merck says this is because the HPV strains not covered by Gardasil cause disproportionately more precancerous lesions that don't end up turning into cancer.
Efficacy against lesions is a significant issue because after a Pap test, doctors generally remove any lesions that reach a certain grade of seriousness, even though some might not turn into cancer. The surgery involves cutting out part of the cervix and can cost several hundred to several thousand dollars. Dr. Barr predicts Gardasil will eventually be shown to prevent nearly 60% of precancerous lesions that doctors would want to remove among women who were free of HPV infection when they were vaccinated.
Ultimately Gardasil received the panel's unanimous approval, and the FDA approved the vaccine in June 2006. The agency reasoned that waiting for more data would prevent some women who needed the vaccine from getting it.
With the FDA's approval, Merck faced a new challenge: persuading the public to take its vaccine. It got a quick boost from the CDC, which issued guidance in late June recommending that all girls receive the vaccine at age 11 or 12. The CDC said women age 13 to 26 should also get the vaccine. Gardasil was also endorsed by the American Academy of Pediatrics.
Merck crafted its advertising and public relations to avoid some of the less-favorable numbers surrounding Gardasil. The TV commercial says the vaccine "may help protect you" from HPV strains "that may cause 70% of cervical cancer." The company doesn't often discuss the lower efficacy against precancerous lesions or in populations where some women are already infected. The "one less" slogan avoids the question of how many lives will be saved.
Some Gardasil supporters funded by Merck are less careful about qualifying their claims. At the FDA advisory committee hearing, Martha Nolan, vice president of a women's health group that receives funds from Merck, said that by approving Gardasil, the agency had "the opportunity to eradicate this terrible disease."
After the FDA approval, a group of female state legislators called Women in Government started a campaign to get states to mandate vaccinations. The group receives money from Merck but won't say how much. Many of the pending bills would allow parents to keep their children out of the vaccination program, but only after submitting proof that they have received information about cervical cancer and the vaccine.
In early January, Women in Government held a conference for some 60 state legislators in Marco Island, Fla., paying for their airfare and hotel rooms. One of the speakers was Christine Baze, a pop singer and cervical-cancer survivor. As she performed songs on the piano, Ms. Baze told the story of her battle with the disease and said she wished a vaccine had been available to her. Ms. Baze says Women in Government paid her a $2,500 fee and covered her travel and lodging. She says she didn't receive any money from Merck for the appearance, but the company has paid her $7,500 to speak at three other events.
Marilyn Canavan, a representative in the Maine assembly who attended the conference, says she was bothered by the large number of drug-industry lobbyists she saw. A list of conference participants shows that 30 pharmaceutical-industry representatives were present -- one for every two state legislators. Merck had two representatives there. Ms. Canavan has since resigned her post as Women in Government's director in Maine over concerns that the group's agenda is being dictated by drug companies. Susan Crosby, Women in Government's president, says those concerns are unfounded.
Other state lawmakers came away from the conference inspired. Upon returning home, Jessica Sibley Upshaw, a representative in the Mississippi assembly, drafted a bill that would make vaccination a school requirement. "For me, it's a common-sense thing to do if we can eradicate a disease," she says. Ms. Upshaw's bill has since died, but she plans to reintroduce it.
In February, Texas Gov. Rick Perry bypassed the state legislature and issued an executive order mandating that all girls entering the sixth grade be vaccinated as of September 2008. One of Merck's lobbyists in Texas is Mike Toomey, Gov. Perry's former chief of staff, and Merck contributed $6,000 to the governor's re-election campaign. Mr. Toomey didn't return calls and emails seeking comment. A spokeswoman for the governor says he acted to protect the public's health, not because of the contribution or the lobbying of his former aide.
Gov. Perry's order sparked an uproar. Among the opponents are religious conservatives who say receiving the vaccine conflicts with their message of abstinence. Other opponents say Gardasil isn't worth the cost, which includes $360 for the vaccine and up to several hundred dollars more for three doctors' appointments to get the shots. The money would be better spent, these people say, in pushing Pap tests for women who aren't getting them now.
John Schiller, one of the National Cancer Institute scientists whose vaccine work was licensed by Merck, believes Gardasil is an important advance that should receive wide use, but he has mixed feelings about the way the company has promoted it. He hopes it won't divert public-health dollars away from regular Pap screening, which he says remains the most important weapon against cervical cancer. Merck "is a heavy-handed company," Dr. Schiller says. "When they do something, they spare no energy. It's the Merck way or the highway."
Merck says cost-effectiveness studies suggest the vaccine could deliver its life-saving benefits at a reasonable cost, in part by reducing the need for frequent Pap tests. Most of these studies have been funded by Merck and GlaxoSmithKline PLC, maker of another HPV vaccine, Cervarix. Glaxo applied for FDA approval of Cervarix last month.
One skeptic is Diane Harper, a longtime HPV researcher and professor at Dartmouth Medical School, who was involved in Gardasil's clinical trials and has received speaker and consulting fees from Merck and Glaxo. She says as many as 10% of 11- and 12-year-old girls may already have HPV, either from sexual activity, sexual abuse or transmission through nonsexual skin-to-skin contact. That could reduce the vaccine's efficacy, she says.
Dr. Harper also suspects the vaccine may require booster shots after 10 years. Merck says it's not sure how long the vaccine's protection will last and is monitoring women over the long term to find out.
The American Cancer Society, while agreeing with the CDC that girls should be vaccinated, said in January there is "insufficient evidence" that women age 19 to 26 will benefit from the vaccine because many have already been exposed to HPV.
Worried about the backlash that emerged in February in Texas and other states, Merck shifted into damage control. Richard Haupt, Merck's executive director of medical affairs, placed calls to respected figures in the vaccine field, including Jon Abramson, the chairman of the CDC's advisory committee on immunization practices, and Joseph Bocchini, chairman of the committee on infectious diseases at the American Academy of Pediatrics. Both men and others told Dr. Haupt they supported the vaccine, but it was too early and counterproductive to push for school requirements.
On Feb. 20, Merck announced that it was suspending its lobbying push, but Women in Government continues to lobby for school requirements. Virginia's mandate became law two weeks ago.
Sunday, April 15, 2007
Ghetto to Goldman Sachs? Does Income Inequality Matter?
In his latest column on Yahoo finance, Charles Wheelan ("The Naked Economist") discusses a really interesting idea about income equality.
He is asking the important question about whether income inequality matters. To be clear, he is not referring to the need of helping people out of poverty, but instead whether the SIZE of the income gap matters once most people have basic necessities (i.e. a TV in every pot). The main question is: "If we succeed in raising the incomes of the poor, does it matter if incomes at the top are rising even faster, making us a more unequal society overall?".
Many economist argue that income inequality can be seen as an economic incentive for people on the lower end to "reach" up. Some argue that this inequality motivates risk, hard work, and innovation.
But does it? If not, is there a better way to distribute income?
The really interesting idea from the article centers around two points.
First, if the socioeconomic ladder is broken, there may not be a way for inner city kids to advance up the socioeconomic curve. Can they go from the ghetto to Goldman Sachs? Of course we have some instances of people from lower economic classes reaching wall street (or some other highly paid position), but how often does this happen? How much of a collective impact do these few instances have on people's motivation? It is possible that these citizens may look at our growing income inequality as a permanent structure and are unconvinced they can follow. It is also quite possible that they may decide to be more revolutionary and attempt their own economic structure.
Economic research may indicate this. Robert Putnam, professor of political science at Harvard, established links between social capital and economic inequality. Two of his studies (Putnam, Leonardi, and Nanetti 1993, Putnam 2000) established these links in both the United States and Italy.
"Community and equality are mutually reinforcing… Social capital and economic inequality moved in tandem through most of the twentieth century. In terms of the distribution of wealth and income, America in the 1950s and 1960s was more egalitarian than it had been in more than a century… [T]hose same decades were also the high point of social connectedness and civic engagement. Record highs in equality and social capital coincided. Conversely, the last third of the twentieth century was a time of growing inequality and eroding social capital… The timing of the two trends is striking: somewhere around 1965-70 America reversed course and started becoming both less just economically and less well connected socially and politically"
Secondly, Wheelan points out that relative wealth may be more important to our sense of well being than absolute wealth. Cornell economist Robert Frank found that a majority of Americans would prefer to earn $100,000 while everyone else earns $85,000, rather than earning $110,000 while everyone else earns $200,000.
So......what does this mean? This may question whether income inequality is acceptable as long as the pie gets larger and everyone moves up the scale.
To be fair, this is a very debatable point. However, it could be possible that a country (e.g. the U.S.) could be collectively better off if (depending on one's definition of well being) we had a smaller, more evenly divided pie.
http://finance.yahoo.com/expert/article/economist/19750
He is asking the important question about whether income inequality matters. To be clear, he is not referring to the need of helping people out of poverty, but instead whether the SIZE of the income gap matters once most people have basic necessities (i.e. a TV in every pot). The main question is: "If we succeed in raising the incomes of the poor, does it matter if incomes at the top are rising even faster, making us a more unequal society overall?".
Many economist argue that income inequality can be seen as an economic incentive for people on the lower end to "reach" up. Some argue that this inequality motivates risk, hard work, and innovation.
But does it? If not, is there a better way to distribute income?
The really interesting idea from the article centers around two points.
First, if the socioeconomic ladder is broken, there may not be a way for inner city kids to advance up the socioeconomic curve. Can they go from the ghetto to Goldman Sachs? Of course we have some instances of people from lower economic classes reaching wall street (or some other highly paid position), but how often does this happen? How much of a collective impact do these few instances have on people's motivation? It is possible that these citizens may look at our growing income inequality as a permanent structure and are unconvinced they can follow. It is also quite possible that they may decide to be more revolutionary and attempt their own economic structure.
Economic research may indicate this. Robert Putnam, professor of political science at Harvard, established links between social capital and economic inequality. Two of his studies (Putnam, Leonardi, and Nanetti 1993, Putnam 2000) established these links in both the United States and Italy.
"Community and equality are mutually reinforcing… Social capital and economic inequality moved in tandem through most of the twentieth century. In terms of the distribution of wealth and income, America in the 1950s and 1960s was more egalitarian than it had been in more than a century… [T]hose same decades were also the high point of social connectedness and civic engagement. Record highs in equality and social capital coincided. Conversely, the last third of the twentieth century was a time of growing inequality and eroding social capital… The timing of the two trends is striking: somewhere around 1965-70 America reversed course and started becoming both less just economically and less well connected socially and politically"
Secondly, Wheelan points out that relative wealth may be more important to our sense of well being than absolute wealth. Cornell economist Robert Frank found that a majority of Americans would prefer to earn $100,000 while everyone else earns $85,000, rather than earning $110,000 while everyone else earns $200,000.
So......what does this mean? This may question whether income inequality is acceptable as long as the pie gets larger and everyone moves up the scale.
To be fair, this is a very debatable point. However, it could be possible that a country (e.g. the U.S.) could be collectively better off if (depending on one's definition of well being) we had a smaller, more evenly divided pie.
http://finance.yahoo.com/expert/article/economist/19750
Paulson Praises Wolfowitz as Bank Chief Clings to Job
April 14 (Bloomberg) -- U.S. Treasury Secretary Henry Paulson praised Paul Wolfowitz, the World Bank president who is battling to save his job after the group's board chastised him and staff called for his resignation.
``I have a very high regard for Paul Wolfowitz,'' Paulson told a news conference yesterday after hosting a meeting in Washington of Group of Seven finance officials. He described Wolfowitz as a ``very dedicated public servant.''
http://news.yahoo.com/s/bloomberg/20070414/pl_bloomberg/aupndxy5gaei_1
``I have a very high regard for Paul Wolfowitz,'' Paulson told a news conference yesterday after hosting a meeting in Washington of Group of Seven finance officials. He described Wolfowitz as a ``very dedicated public servant.''
http://news.yahoo.com/s/bloomberg/20070414/pl_bloomberg/aupndxy5gaei_1
That Night At Duke - Newsweek
They spent a year accused of kidnapping, assault and rape. Now, though, the three Duke lacrosse players were told they were 'innocent.' The inside story of the infamous evening.
April 23, 2007 issue
http://www.msnbc.msn.com/id/18110003/site/newsweek/
April 23, 2007 issue
http://www.msnbc.msn.com/id/18110003/site/newsweek/
Are mobile phones wiping out our bees?
Are mobile phones wiping out our bees? Scientists claim radiation from handsets are to blame for mysterious 'colony collapse' of bees
http://news.independent.co.uk/environment/wildlife/article2449968.ece
http://news.independent.co.uk/environment/wildlife/article2449968.ece
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