Tuesday, May 22, 2018
Opioids crisis - Rudy Giuliani won deal for OxyContin maker to continue sales of drug behind opioid deaths
By Chris McGreal
The US government secured a criminal conviction against Purdue Pharma in the mid-2000s but failed to curb sales of the drug after Giuliani reached a deal to avoid a bar on Purdue doing business.
The US government missed the opportunity to curb sales of the drug that kickstarted the opioid epidemic when it secured the only criminal conviction against the maker of OxyContin a decade ago.
Purdue Pharma hired Rudolph Giuliani, the former New York mayor and now Donald Trump’s lawyer, to head off a federal investigation in the mid-2000s into the company’s marketing of the powerful prescription painkiller at the centre of an epidemic estimated to have claimed at least 300,000 lives.
While Giuliani was not able to prevent the criminal conviction over Purdue’s fraudulent claims for OxyContin’s safety and effectiveness, he was able to reach a deal to avoid a bar on Purdue doing business with the federal government which would have killed a large part of the multibillion-dollar market for the drug.
The former New York mayor also secured an agreement that greatly restricted further prosecution of the pharmaceutical company and kept its senior executives out of prison.
The US attorney who led the investigation, John Brownlee, has defended the compromise but also expressed surprise that Purdue did not face stronger action from federal regulators and further criminal investigation given its central role in the rise of the epidemic.
Connecticut-based Purdue is now facing a wave of civil lawsuits as New York, Texas and five other states have joined a growing number actions against the company. But Brownlee was the first, and so far only, prosecutor to secure a criminal conviction against the drug maker.
Brownlee launched his investigation shortly after being appointed US attorney for the western district of Virginia as the region struggled with escalating overdoses and deaths from opioids in the early 2000s. When he looked at the source of the epidemic he found OxyContin, a drug several times more powerful than any other prescription painkiller on the market at the time.
Newborn deaths in Pakistan
Asad Ali
A GLOBAL assessment published by Unicef in February highlighted that a baby born in Pakistan is 50 times more likely to die in its first month than a baby born in Iceland, Japan or Singapore. One newborn out of every 22 in Pakistan dies within the first month, meaning 46 out of 1,000 newborn babies die within the first month of their life.
In contrast, India, which has similar sociocultural factors to those existing here, has a corresponding newborn mortality rate of 25 per 1,000 newborns. According to the report, Pakistan’s survival rate of newborns is ostensibly worse than many countries having compromised economies as well as weaker health infrastructure.
A critical factor responsible for the high newborn deaths is the poor state of maternal health and nutrition, especially during pregnancy. Pakistan’s stunting rate (ie children shorter than normal for that age) which is an indicator of chronic undernutrition, is one of the highest in the world. Girls who are malnourished as children grow up and become pregnant, not having received any dietary rehabilitation to correct this deficit.
This then leads to adverse consequences for the pregnant mother, newborn baby as well as a household’s overall well-being. Limited resources due to widespread poverty, combined with a lack of understanding that pregnant women need nutritious diets along with micronutrients leads to poor weight gain of pregnant women. Thus, malnourished women give birth to babies who are small and weak — increasing their likelihood of dying in the face of otherwise minor illnesses.
Interventions to reduce newborn deaths include those focusing on the nutritional health of girls and women.
The second key factor responsible for the high neonatal deaths is the poor provision of available obstetric care. Delivering in a health facility is generally considered safer as compared to delivering at home. However, according to the Pakistan Demographic and Health Survey (PDHS) of 2012-13, at least half of the births in our country are at home. Only 52pc of our births are assisted births, with the help of a skilled birth attendant, while the rest are not supervised by any trained person. The ability to care for the newborn is very limited in the home settings, with no access to immediate life-saving obstetrical procedures, otherwise provided at good health facilities. Examples of such critical services include obstetrical surgical interventions to safeguard both maternal and foetal lives as well as provision for subsequent neonatal resuscitation.
There are also major challenges within the healthcare facilities that provide obstetric care in Pakistan. Most of the private-sector obstetric facilities are concentrated in urban areas, and operate on a business model that prefers high volume of low-complexity cases. They do not invest adequately in the infrastructure and personnel to deal with labour complications and advanced neonatal care. In case of any last-minute complications related to the mother or the baby, they bank on referring the case to public-sector facilities. However, very few public-sector facilities are capable of dealing with these complicated cases, and those able to are overburdened by the magnitude and complexity of urgent cases coming their way, both from the private sector and failed attempts at assisted or otherwise unsupervised home-based deliveries.
While these two factors are critically important, they still do not explain why Pakistan’s newborn mortality rate would be higher than any of the other countries listed in the top 10 of Unicef’s list. Especially puzzling is the fact that this report comes at a time when other indicators like rates of institutional delivery, skilled birth attendance and Caesarean section have progressively improved, particularly in Punjab and KP as shown by recent provincial health surveys. Unicef estimates seem to be based largely on the findings and trends of both the 2006 and 2012-13 PDHS, and there are some fundamental differences in these two surveys with how a baby’s death has been defined and classified. We clearly need more robust data to make better-informed estimates of the number and causes of newborn deaths, ideally with district-level specificity.
There are probably additional factors in Pakistan that need scientific exploration such as cousin marriages which increases the risk of genetic disorders in subsequent generations. According to the 2012-13 PDHS, half of all marriages in Pakistan occur between first cousins. The burden of genetic disorders due to cousin marriages and its impact on the overall newborn and maternal mortality burden is currently unknown in Pakistan.
Moving forward, it seems that other than conducting research regularly, interventions most likely to reduce newborn deaths in Pakistan include those focusing both on the general and nutritional health of girls and women. It is important that this be done across the board to make certain that no female child is left behind. This can be done by ensuring that during her infancy a female child is not malnourished, during adolescence every girl is provided adequate nutritional resources for herself as well as to cope with the added requirements of pregnancy so that she gets adequate diet for two, and after childbirth so she is able to provide adequate nutrition and immunity to the newborn via breast milk. All deliveries should be in the presence of a skilled birth attendant. The health facilities need to be upgraded, with networks and services being brought closer to the people, rather than expecting people to bring the delivering woman in obstructed labour or a sick newborn all the way to the tertiary care public sector facilities of large urban areas.
Prevention, prompt diagnosis and correct treatment of illnesses in newborns are equally important, and must be given due importance in parallel to efforts focusing on women’s health. Although the government bears the primary responsibility for public health, the developmental sector, the academic institutions and civil society also need to prioritise this issue of women and girls health. Ignoring girl and women’s health any further literally threatens the future of our very nation.
Shoot the messenger: Pakistan authorities disrupt newspaper distribution after report on Sharif's 26/11 comments
The action led by Pakistan's military began after the newspaper published the interview of Nawaz Sharif.
Pakistan’s oldest newspaper, Dawn, is facing the heat after publishing an interview of ousted PM Nawaz Sharif in which he all but accepted that Pakistani ‘non-state actors’ were involved in the 26/11 Mumbai attacks.
Reporters Without Borders (RSF), an international body keeping track of the state of independent journalism, claimed that distribution of Dawn was being disrupted in much of the country since the publication of the interview.
The interview which appeared on May 12 has reportedly displeased Pakistan military. RSF says that the blocking began on May 15. The distribution of the English daily is “disrupted in most of Baluchistan province, in many cities in Sindh province and in all military cantonments,” it said.
Apparently, the Press Council of Pakistan has also notified Dawn’s editor that the newspaper breached the ethical code of practice by publishing content that "may bring into contempt Pakistan or its people or tends to undermine its sovereignty or integrity as an independent country".
RSF, in a statement, said, “The unwarranted blocking of the distribution of one of the main independent newspapers has yet again shown that the military is determined to maintain their grip on access to news and information in Pakistan.”
“It is clear that the military high command does not want to allow a democratic debate in the months preceding a general election. We call on the authorities to stop interfering in the dissemination of independent media and to restore distribution of Dawn throughout Pakistan.”
Nawaz Sharif, in the interview, had questioned Pakistan’s inability to complete the trial against 26/11 attack mastermind. “Militant organisations are active. Call them non-state actors, should we allow them to cross the border and kill 150 people in Mumbai? Explain it to me. Why can’t we complete the trial?” he had said.
The comment was lapped up by Indian media as an acceptance of Pakistani role in the terrorist attack. In Pakistan, his comment was criticised by all quarters. PM Shahid Khaqan Abbasi accused the Indian media of giving the issue “a different hue”.
Dawn was founded by Muhammad Ali Jinnah in 1941 in New Delhi. Though it started as the mouthpiece of Muslim League, after the division of British India, it became the leading voice in English Language journalism in Pakistan.
#MeToo - Pakistan confronts its Me Too movement — and backlash
Naila Inayat
A handful of Pakistani women recently went public to accuse famous actor and musician Ali Zafar of sexually harassing and abusing them. Their announcement grabbed headlines, prompted outrage and sparked the Me Too movement in conservative Pakistan.
The women’s remarkable statements — followed by similar claims in politics and business sectors — are a sea change in this highly traditional Islamic country where female honor killings, child brides and polygamy are commonplace. In Pakistan, women receive only a portion of an inheritance that males get.
"I think in any society it is difficult for women to come forward,” said Nighat Dad, director of the Digital Rights Foundation and an activist for women's rights. “The Me Too movement has organically come with women coming forward against powerful men, be it Ali Zafar or a CEO of a tech start-up, to finally hold men accountable for their behavior.”
Victims of sexual abuse and harassment have long suffered in silence in Pakistan, where shame is placed on the woman and not the perpetrator. Most women never report the incidents, but those who do come forward often face shame or questions about their morality.
Pakistani pop singer Meesha Shafi, who accused Zafar of sexually harassing her on multiple occasions, is challenging that tradition.
“Today I am breaking this culture of silence and I hope that by doing that I am setting an example for young women in my country to do the same,” Shafi wrote on Twitter last month. “We only have our voices and the time has come to use them.”
Zafar denied the claims and demanded that Shafi delete the allegation online and issue an apology, or he would file a $9 million defamation suit against her.
“I am deeply aware and in support of the global Me Too movement and what it stands for,” Zafar said in a statement. “I am the father of a young girl and a young boy, a husband to a wife and a son to a mother. I have nothing to hide. Silence is absolutely not an option.”
Shafi has refused to take down her tweets. Her attorney denied she defamed Zafar. Days after the public dispute erupted, more women came forward against Zafar, who has been compared to Hollywood producer and accused abuser Harvey Weinstein in the Pakistani news media. Leena Ghani, a makeup artist based in London, said Zafar had repeatedly “crossed boundaries” with her. “His behavior displays a clear lack of respect for women,” Ghani said on Twitter. “Inappropriate contact, groping, sexual comments should not fall in the gray area between humor and indecency.” Humna Raza, a blogger from Lahore, accused Zafar of groping her when she asked to take a selfie with him. Another woman, Noor Sehar, a Karachi marketing executive, accused Zafar of sexual misconduct at a party. Such allegations are not isolated. Khalid Bajwa, chief executive of local music streaming company Patari, stepped down from his post last month following sexual harassment allegations. While many have supported the Pakistani singer for bravely speaking out, others questioned Shafi's accusations.
“I just don’t see any truth in these allegations,” said film actress Resham, who uses a single name for her career. “Ali cannot do such a thing. How can he harass a woman and she doesn’t slap him back, hit him with a shoe, push him away or complain to his wife?”
Shafi also has been shamed on social media after she went public. "The backlash that Meesha has faced, the misogynistic attitudes that she has had to confront also sends women a message that there is still a cost to coming forward,” said Dad, the women's rights activist. Others defended her.
“Meesha is a superstar who is really successful and earns as much as the male stars in this country,” said actor and model Iffat Omar in an Instagram post. “So why would she do this if she was not hurt? Many people are claiming that she is doing this for fame or money. She already has more than enough of both.”
Still, many women are afraid to come forward because of possible repercussions.
For example, lawmaker Ayesha Gulali of the mainstream Pakistan Tehreek-e-Insafpolitical party, recently accused her party’s leader, Imran Khan, of sending her lewd text messages. She was hit with backlash both online and from her party. Party leaders tried but failed to kick her out of the party and expel her from Parliament.
Also, broadcast journalists Tanzeela Mazhar and Yashfeen Jamal pursued a sexual harassment case against the director of current affairs at Pakistan Television, Agha Masood Shorish, they stirred up a storm of criticism before he was eventually fired. “When I raised my voice, people responded with (degrading) comments about women, our character and personal lives,” Mazhar said.
Still, Shafi encouraged other women to come forward with this answer on Twitter: “It’s only scary till you say it!”
Load-shedding triggers protest across the district Badin
The residents of the different parts of city including Seerani road, Ward no: 05, Shahi Bazar, Shah Latif road, Bilawal Park, Post office area, Army sugar Mills road Badin, Kachhi Mohla, Gujrati Mohla, Kazia Canal, Khatti Mohla and others areasled the protests for immediate supply of power and minimize the load-shedding during the holy month of Ramzan.
Enraged people haling of different areas city led by Ayaz Rahimon, Nadeem Abbasi, Rizwan Zaur, Ram Chand, Ghulam Sarwar Shaikh, Nazir Udhejo, Ali Akbar Udhejo, Dhani Bux, Ahsan Memon and others gathered at outside of Badin Press Club on Monday and shouted slogans against the federal and provincial governments for their people negligence policy and failing to take any action against WAPDA officials.
The protesters alleged the politicians of district and HESCO officials of not taking measures to address the issue. On the others hand, Govt of Sindh has announced heat-stroke for the week long span of time and advised to the people to avoid going out of the shelters from dawn to dusk amid to protect them from upsets of heat-stroke.
The people of Badin facing extreme heat and load-shedding and dearth of the water adding that unannounced load-shedding had made their lives miserable. The regretted that HESCO officials did not even bother to attend phone calls of the citizens let to resolve the complaints.
Adding the protesters demanded the water and power ministry to take immediate notice of the situation and bring an end of unscheduled load-shedding and stressed that government to take strict action against those officers who do not pay heed to the complaints of the citizens.
http://www.thesindhtimes.com/sindh/05/load-shedding-triggers-protest-across-district-badin/
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