Prescribe generic drugs: MCI to doctors

MUMBAI: The Union government and regulatory bodies appear to be serious in ending the pharma-doctor nexus and curb unethical marketing practices. In its latest effort, the Medical Council of India has directed doctors, hospitals and medical colleges to prescribe generic medicines as far as possible. Generic medicines are more affordable versions of branded medicines sold by companies.

In its directive dated January 21 to the principals of medical colleges, director of hospitals and presidents of all state medical councils, the MCI has said that every physician should, as far as possible, prescribe drugs with generic names and ensure that there is a rational prescription and use of drugs. All doctors registered under the MCI act have been asked to comply with the directive.

Over the past couple of years, there have been a slew of efforts to curb unethical marketing practices followed by pharma companies, end the use of branded drugs and bring down the prices of medicines.

MCI chairman K K Talwar said, "The directive is a bid to educate the medical community, including doctors and make them aware about the increased availability of generic drugs and to make them more affordable as well. We need to instill confidence in people about the use of generic versions."

Though the government has opened the retail store, which market generic medicines, "Jan Aushadhi" in certain states, availability of quality generic medicines is a huge concern.

Doctors are of the view that the focus should be on the quality of the drugs prescribed. Says Dr Anoop Misra chairman of Delhi-based Fortis Centre of excellence for diabetes: "For the benefit of patients and to get the best possible results, highest quality drugs with best possible pharmacological properties should be used by all doctors. If the quality of generic drugs is up to high standards, doctors should prescribe generic medicines."

Industry experts, however, said the move may not benefit patients as it may not lead to a significant price reduction. Says Indian Pharmaceutical Alliance, secretary general D G Shah: "If the government is able to ensure the quality of generic medicines, then it will be beneficial. Patients do not know about the quality of medicines and will have to depend on chemists. It may lead to a chemist-pharma nexus from the much-discussed nexus between pharma companies and doctors".

Last year, in a bid to promote generic medicines, the health ministry ordered states to stop issuing licenses in brand names. The move has not benefitted patients much as companies continue to market the medicines in brand names. Also, concerned with increasing complaints of unethical marketing practices, the department of pharmaceuticals initiated an exercise to introduce a code of conduct for the pharma industry, which is yet to be finalized.

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Pictures: The Story Behind Sun Dogs, Penitent Ice, and More

Photograph by Art Wolfe, Getty Images

If you want the beauty of winter without having to brave the bone-chilling temperatures blasting much of the United States this week, snuggle into a soft blanket, grab a warm beverage, and curl up with some of these natural frozen wonders.

Nieve penitente, or penitent snow, are collections of spires that resemble robed monks—or penitents. They are flattened columns of snow wider at the base than at the tip and can range in height from 3 to 20 feet (1 to 6 meters). The picture above shows the phenomenon in central Chile. (See pictures of the patterns in snow and ice.)

Nieve penitente tend to form in shallow valleys where the snow is deep and the sun doesn't shine at too steep an angle, said Kenneth Libbrecht, a physicist at the California Institute of Technology in Pasadena who studies ice crystal formation.

As the snow melts, dirt gets mixed in with the runoff and collects in little pools here and there, he said. Since the dirt is darker in color than the surrounding snow, the dirty areas melt faster "and you end up digging these pits," explained Libbrecht.

"They tend to form at high altitude," he said. But other than that, no one really knows the exact conditions that are needed to form penitent snow.

"They're fairly strong," Libbrecht said. "People have found [the spires] difficult to hike through."

—Jane J. Lee

Published January 25, 2013

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Newtown Families March for Gun Control in DC

Jan 26, 2013 4:59pm

(YURI GRIPAS/AFP/Getty Images)

WASHINGTON, D.C. — Near-freezing temperatures didn’t stop several thousand gun-control activists from bearing their pickets today, carrying signs emblazoned with “Ban Assault Weapons Now” and the names of gun violence victims in a demonstration organized as a response to the mass shooting in Newtown, Conn. last month.

Walking in silence, the demonstrators trudged between Capitol Hill and the Washington Monument over a thin layer of melting snow. They were joined by politicians and some families of the Newtown victims.

March organizer Shannon Watts said the event was for the “families who lost the lights of their lives in Newtown, daughters and sons, wives and mothers, grandchildren, sisters and brothers gone in an unfathomable instant.”

“Let’s stand together and use our voices, use our votes to let legislators know that we won’t stand down until they enact common sense gun control laws that will keep our children out of the line of fire,” she told demonstrators.

Watts founded One Million Moms for Gun Control after the killing of 20 first graders and six adults at the Sandy Hook Elementary School in Newtown in December. In a profile with the New York Times, Watts said her 12-year-old son had suffered panic attacks after learning of last summer’s Aurora, Colo., theater shooting, leaving her at an impasse over how to talk to him about the latest tragedy.

Also among the speakers was a survivor of the 2007 Virginia Tech massacre, Collin Goddard.

“We need to challenge any politician who thinks it’s easier to ask an elementary school teacher to stand up to a gunman with an AR-15 than it is to ask them to stand up to a gun lobbyist with a checkbook,” he said.

The demonstration comes amid a push by progressive lawmakers to enact stricter gun control measures as a response to the trend of recent mass killings, although any hypothetical bill would likely face strong opposition in Congress.

Rep. Chris Van Hollen, D-Md., was among the demonstrators today.

“The idea that people need high-capacity magazines that can fire 30, 50, 100 rounds has no place in a civilized society,” he said. “Between the time we’re gathered here right now and this time of day tomorrow, across America, 282 Americans will have been shot.”

The congressman was quoting statistics compiled by the Brady Campaign to Stop Gun Violence.

INFOGRAPHIC: Guns by the Numbers

Last week President Obama proposed a sweeping overhaul of federal measures regulating gun ownership, including a universal background check system for sales, banning assault weapons,  and curbing the amount of ammunition available in weapon clips.

An ABC News/Washington Post poll released Thursday found 53 percent of Americans viewed Obama’s gun control plan favorably, 41 percent unfavorably. The division was visible today, as a handful of gun-rights advocates also turned out on the National Mall to protest what they believe would be infringements on their Second Amendment liberties.

ABC’s Joanne Fuchs contributed to this report.

SHOWS: Good Morning America World News

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Apple loses world's most valuable company crown

NEW YORK: Apple shares extended their losses Friday, ending a miserable week for the California tech giant as it surrendered its position as the world's biggest company based on market value.

Apple ended down 2.36 per cent at US$439.88, giving it a market capitalisation of $413 billion -- while oil giant ExxonMobil rose 0.36 per cent to US$91.68 with a market cap of US$418 billion, to edge into first place.

The shares of both firms zig-zagged during the session, with Apple at various points regaining the top spot before falling back.

Apple first overtook ExxonMobil in August 2011 as the most valuable company in the world based on the value of its stock.

A year later, Apple dethroned longtime rival Microsoft as the most valuable company in history based on the value of its stock at US$622 billion.

But the company took a bruising this week after Wednesday's gloomy forecast accompanying its record quarterly profit announcement prompted pessimism over the tech giant's slowing growth trajectory.

Apple's profit was US$13.1 billion on revenue of US$54.5 billion in the fiscal quarter that ended on December 29, with sales of iPhones and iPads setting quarterly highs.

But despite those figures, investors soured on Apple after it forecast that revenue for the current quarter would range from US$41-43 billion and that it would have a gross margin of 37.5 to 39.5 per cent, lower than expectations.

Analysts remained cautious about Apple, which had seen a meteoric rise last September to over US$700 a share but it has slid 37 per cent since then. The company shed some US$60 billion on Thursday and around US$10 billion more Friday.

Some express concern that Apple has lost its edge in innovation since the death of Steve Jobs, and is losing ground to rivals such as Samsung, which leads the mobile phone market, and to others using Google's Android operating system.

Jinho Cho at Mirae Asset Securities said Apple will likely increase carrier subsidies in 2013 and launch "an entry-level iPhone" to compete better in emerging markets.

"These moves by Apple should lead to stiffer competition for greater carrier subsidies among smartphone makers, thus driving down handset industry-wide operating margins," the analyst said.

Colin Gillis at BGC Financial said Apple is facing new challenges.

"While we are incrementally more positive on the stock, we also mention that competition is increasing for the company," he said in a research note.

"We see competitors are using price as a lever to get traction in the market. Apple may also run into difficulty posting both the volumes and maintaining its prices over the next several quarters."

- AFP/jc

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Backroom dilemma on rape law report

KOLKATA: She is one of the 15 young lawyers who worked tirelessly behind the scenes - analyzing and interpreting legal provisions that could be used to nail rapists and impose the maximum possible penalty on them.

Shwetasree Majumdar cherishes the experience with the JS Verma Commission report to help strengthen rape laws in the country. The 33-year-old Kolkata girl, now based in Bangalore, says she got passionately involved in framing the report as soon as she got a call from commission member Gopal Subramanium.

The National Law School graduate, who runs an intellectual property law firm, said working on the report took a lot from her emotionally and was one of the biggest challenges she has faced.

"It was very personal. Here was a chance to be part of a real, tangible comprehensive and legitimate exercise to bring change - it was imperative that the report be academically sound, just, fair and legally defensible. And when the civil society narratives started pouring in, many of which shaped how individual provisions in the law were ultimately crafted, it was hard to remain neutral and non-judgmental," she said.

"I felt shock, outrage and anger and every time I heard a narrative of systematic violence on women, children and the poor and I worked a little bit harder. I can say that I have not been this motivated and driven about any task in a very long time. I put my work, my family - everything on hold over these last few days," said Shwetasree, who worked for a fortnight on the report.

It was back to her law school days, burning the midnight oil and reading large volumes on comparative jurisprudence. "The high profile nature of the task meant we were under tremendous pressure. We were operating under strict rules of confidentiality and keeping our deliberations and work secret. We were also conscious that we could not let emotions cloud our sense of reason and approach each issue in a logical and balanced manner - not easy, given the recent events," said Shwetasree.

But in the end she was disappointed that the decision to turn down death penalty was all that got highlighted while none bothered to focus on the rationale for it. The team of lawyers and commission members did a good job, believes Shwetasree who worked on criminal law amendments, medical and psychiatric protocols.

"Taking a moral stand either way on the death penalty was the toughest challenge. On the one hand there was this overwhelming public outcry in its favour and on the other, there was voluminous literature and opinion on why it was not a deterrent. Whatever you chose you alienated someone and surely, as we expected, the rationale behind the decision was ignored," she said.

Personally, she isn't in favour of death penalty for rape since she doesn't believe that there is a link between death sentence and deterrence. A quick, effective and hard hitting punishment is far more important, she feels.

"Even if it could have a marginal deterrent effect, the effect could be felt only if you had high rates of execution, that were mandatory as well as being speedily enforced, which is fraught with its own problems. Also, in reality, although it is possible to award the death penalty for murder in 'rarest of rare' cases in India we are well aware that such cases are few and far between," she argued.

Shwetasree studied at St Teresa's Secondary School in Kidderpore before moving to Bangalore to study law. A regular visitor to Kolkata - her parents still live in their ancestral house in New Alipore - the lawyer said she was worried that free-thinking individuals were being suppressed by "misogynistic politicos" in the liberal city.

"When I first moved to Delhi and would listen wide-eyed to friends talking about the North Indian obsession with male children and was met with surprise whenever I said I was an only child and a girl, I felt proud. Some of my best friends from school were also only children and girls and not being boys was inconsequential," she said.

"The Kolkata I lived in was safe, it respected its women and Bengali women were known for their spirit and for being free thinkers. They still are. But what has changed is the environment in which they live in now. I hang my head in shame every time I read a misogynistic remark from a politician or any other person in a position of influence in Bengal. This is not the city I knew. And it disturbs me deeply," the lawyer sighed.

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Pictures: Inside the Lives of Albinos in Tanzania

Photograph by Jacquelyn Martin, AP

Being an albino can be a death sentence in Tanzania. Since 2006, 71 people with no pigment in their skin, hair, or eyes have been killed there. Another 29 have been attacked.

The genetic condition is believed to have been born in this East African nation. Today, 1 in every 1,400 Tanzanians has it (the world average is 1 in 20,000). Nevertheless, misinformation abounds. Some locals believe albinos are ghosts that can’t die. Others think they were born into cursed families. And—most chillingly—witch doctors want to hack off  their limbs to put in magic potions promising prosperity and healing. A complete albino “set”—ears, tongue, nose, genitals, all four limbs—can sell for $75,000.

As a result, many of Tanzania’s 17,000 albinos have been hidden away by the government. In this image, Bestida Salvatory is reunited with her 17-year-old daughter, Angel, at the Kabanga Protectorate Center. Angel, who has skin cancer, was forced to flee their home four years ago, after Angel’s own father led a group of men to attack her. Here Angel also visits her one-year-old half-brother, Ezekiel.

Published January 25, 2013

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Apple Drops Manufacturer Using Underage Workers

Apple has stopped doing business with a Chinese manufacturer after a report said it had employed 74 underage workers. According to Apple's Supplier Responsibility Report, which was released by the company Thursday, Guangdong Real Faith Pingzhou Electronics was employing workers under the age of 16.

"Our auditors were dismayed to discover 74 cases of workers under age 16 — a core violation of our Code of Conduct. As a result, we terminated our business relationship with PZ," the company says in the report.

Apple has now lost its spot as the most valuable publicly traded company, one year after it first firmly overtook ExxonMobil. Even though it announced a record number of iPhone and iPad sales in its last quarter earnings, its stock price has fallen over 12 percent.

Apple says it is working hard to improve labor conditions at the factories of its Chinese contractors. It said it also discovered that one of the region's labor agencies had conspired with the manufacturer, providing children to them and helping forge age-verification documents. Apple said in its report that it alerted the provincial government, which fined the agency and suspended its business license.

Apple To Start Making Some Mac Computers in America in 2013

"The children were returned to their families, and PZ was required to pay expenses to facilitate their successful return," Apple says in the report.

In an interview with Bloomberg, Apple's Senior Vice President of Operations, Jeff Williams, said child labor was being used more than companies care to admit. "Most companies, they either don't report on it at all, or they say they look for it and found none, or they obscure the data in some way," Williams told Bloomberg. "If they're not finding it, they're not looking hard enough."

ABC News' Bill Weir visited the factory of Apple's Foxconn supplier last year and did not see any underage workers. "But while we looked hard for the kind of underage and maimed workers we've read so much about, we mostly found people who face their days through soul-crushing boredom and deep fatigue," Weir wrote about his visit.

PHOTOS: Inside Apple's Factories in China

In the 37-page Supplier Responsibility Progress Report, which can be viewed here, Apple said there had been a 72 percent increase in facility audits. According to the report, Apple achieved an average of 92 percent compliance with the goal, for now, of a maximum 60-hour work week.

Apple vowed last year to improve working conditions at its manufacturing facilities in China, vowing to work specifically on reducing working hours for Chinese workers. In March 2012, the Fair Labor Association released a report on the poor conditions at Apple's Foxconn supplier. The organization gave a long list of recommendations to Apple and Foxconn, and both Apple and Foxconn agreed to follow them.

In August, the FLA said that that Foxconn had completed 280 action items on time or ahead of schedule. By July 1, 2013, Foxconn has promised to reduce workers' hours to 49 hours per week and stabilize pay -- though the limit is rarely enforced because workers often want to work overtime and make ends meet.

Apple announced in December that it would begin to make some of its Mac computers in America in 2013.

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OPM plans to shake up charity program raise concerns about reduced donations

The Office of Personnel Management wants to shake up the Combined Federal Campaign (CFC), the charitable-giving system for federal employees, but in the process the agency could risk losing donors and reducing contributions.

One rule under review by the Obama administration would “eliminate the use of cash, check and money order contributions. Instead, all donations will be required to be made through electronic means.”

This could “streamline the operations,” as proposed rules from OPM suggest, but whether it also would “increase the effectiveness of the program to ensure its continued growth and success” is questionable.

The reason: In 2011, the last year for which OPM data are available, just 22 percent of the money pledged was donated electronically. Moreover, 88.4 percent of the donors did not make electronic contributions.

So, a move to electronic-only donations would seem to put CFC at risk of losing a majority of its donors. The proposal worries executives of some charitable organizations, even as they welcome other sections of the plan.

Federal employees contribute through the CFC to various charities. Donations exceeded $272 million in 2011. That’s a lot of money, but it represents a drop of almost $10 million from 2009, the high point.

An OPM spokeswoman said the agency does not comment on rules under review. In the 53-page document that contains the proposed regulations, however, OPM Director John Berry wrote:

“These proposed changes will introduce efficiencies and cost savings into the CFC by leveraging technology that was not widely available just a few years ago. They will make the CFC more efficient, more transparent, more accountable and more relevant to Federal, Postal and military service personnel who want to make the biggest impact with their donations.”

Scott Jackson, chief executive of Global Impact, said electronic giving can save $14 a pledge, by reducing processing costs.

“That’s very, very powerful,” he added. How the change to electronic-only contributions might effect donations presents “important issues to work through,” he said. Global Impact administers the overseas campaign of the CFC.

Those issues leave Stephen M. Delfin “highly concerned.” He is president and chief executive of America’s Charities, a group that works with CFC organizations. Delfin said he is worried that the rules, previously reported by the Federal Times, could result in lower donations.

“You have to be careful,” he said. “Technology is not a panacea.”

Marshall Strauss, chief executive of the Workplace Giving Alliance, a consortium of CFC federations, agreed. Although he thinks “electronic donations are an excellent addition to the campaign,” he said he worries that relying solely on that “may dramatically reduce the number of people giving and the overall receipts of the campaign. Many thousands of people prefer to give by check or even cash, and we would hope the government would preserve these options.”

In addition to electronic-only giving, Delfin and others have concerns about a proposal to eliminate 184 local CFC committees in favor of fewer and larger regional panels.

This would require “a reduced number of Federal personnel for oversight purposes,” according to the plan.

But it also would diminish the sense of community that charitable leaders say is crucial in motivating individuals to give.

Dumping the local committees will shrink the “person-to-person feeling of the campaign, which is very, very important,” said Kalman Stein, president and CEO of EarthShare, which was recently selected to administer the Combined Federal Campaign of the National Capital Area.

Stein said that he doesn’t think OPM understands “how critical that local component is” and that he is “very concerned the campaign will decline precipitously” if the Local Federal Coordinating Committees are eliminated.

“Our history shows that more consolidation leads to less donations,” said Stein, who, along with Strauss, was a member of the CFC-50 Commission. The commission, formed in 2011 to mark CFC’s 50th anniversary, issued a report last year. A number of its recommendations were incorporated into OPM’s proposals.

But Stein said consolidating the local committees into regional ones would go “way beyond the commission’s recommendations.”

The commission said its 24 recommendations were designed to further encourage a “history of giving” by federal employees, who have “set the standard for workplace giving to charitable organizations.”

But the recent decrease in donations “is a cause for concern,” the report said.

Now there is concern that parts of the OPM plan could make the situation worse.

Previous columns by Joe Davidson are available at wapo.st/JoeDavidson.

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Cooling-off Day for Punggol East by-election

SINGPORE: Friday is Cooling-off Day for the Punggol East by-election, which has seen nine days of vigorous campaigning by the four candidates contending in the polls.

The Elections Department has reminded political parties and candidates that Friday has been set aside for voters to reflect rationally on various issues raised during the campaigning before they go to the polls on Saturday.

The four candidates Channel NewsAsia spoke to say they intend to spend their time with their family, friends, and supporters after a gruelling election campaign that took form in walkabouts, morning visits to train stations to catch office-goers, as well as public and online rallies.

Campaigning is not allowed on Cooling-off Day. Election advertising cannot be published or displayed on Cooling-off Day as well.

Exceptions include reports in newspapers as well as on radio and television which relate to election matters.

Also allowed are approved posters and banners lawfully displayed before the start of Cooling-off Day. Other election advertising, such as internet election advertising lawfully displayed or published before the start of Cooling-off Day, is also allowed. Candidates can also continue to wear a replica of the symbol allotted to them.

Candidates and supporters have been advised to refrain from attending public events on Cooling-off Day and Polling Day. However they can attend religious ceremonies or worship services, or functions in the course of work or employment, but must be mindful of the rule prohibiting campaigning and election advertising.

On Saturday, some 31,600 voters from Punggol East SMC will go to the polls to elect their Parliamentary representative.

The by-election is being contested by four political parties.

Dr Koh Poh Koon from the People's Action Party, Mr Kenneth Jeyaretnam from the Reform Party, Mr Desmond Lim Bak Chuan from the Singapore Democratic Alliance and Ms Lee Li Lian from the Workers' Party.

This is Singapore's second by-election in eight months after the May 2012 Hougang by-election.

The Cooling-off Day provision in the Parliamentary Elections Act is now in force for the fourth time, after the 2011 General and Presidential Elections and the 2012 Hougang by-election.

- CNA/jc

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South India worst hit by diabetes

NEW DELHI: Diabetes and hypertension, traditionally seen as a rich man's disease, has made its way to the slums. Health ministry's fresh data shows one out of every four persons living in the urban slums of Chennai suffer from diabetes — which is three times higher than the national average of about 7%.

In the slums of Bangalore the prevalence rate of diabetes was reported to be 14.77%, followed by 13.37% in Ahmedabad. Delhi had among the lowest rates of 5.02%.

"The results of Chennai are shocking. I have asked the state health officials concerned to indentify all positive cases and refer them to the nearest centre for treatment," said Dr Jagdish Prasad, the Director General of Health Services ( DGHS).

He said the union health ministry started targeted screening in urban slums in June 2011. "So far we have screened about 10 lakh people in Delhi, Bangalore, Chennai, Ahmedabad and Assam," said Prasad.

Medical experts say poor eating habits and sedentary lifestyle is the main reason for the rise in diabetes among the urban poor. "It is a false belief that only those eating burgers and pizzas can get obese and develop diabetes. High consumption of fried items such as kachori, samosa and gulab jamun can also led to the onset of diabetes," said Dr H P S Sachdev, senior consultant pediatrics at Sitaram Institute of Science and Research.

Sachdev said people living in urban slums generally did less physical activity than their rural counterparts.

Simply put, diabetes is a condition in which the body has trouble turning food into energy. All bodies break down digested food into a sugar called glucose, their main source of fuel. In a healthy person, the hormone insulin helps glucose enter the cells. But in a diabetic, the pancreas fails to produce enough insulin, or the body does not properly use it. Cells starve while glucose builds up in the blood.

There are two predominant types of diabetes. In Type 1, the immune system destroys the cells in the pancreas that make insulin. In Type 2, which accounts for an estimated 90% to 95% of all cases, either the body's cells are not sufficiently receptive to insulin or the pancreas makes too little of it, or both.

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