DOHA (Reuters) - Two years after flying in thousands of dairy cows to beat a trade embargo, Qatari milk producer Baladna has made its first exports.
Eric Knecht-JUNE 5, 2019 Qatar is the world’s top liquefied natural gas exporter but a net importer of nearly everything else. The small but wealthy country has been under a trade and transport boycott by Saudi Arabia and its allies since June 2017 that has forced it to retool an economy once heavily reliant on fellow Gulf states.
Saudi Arabia, the United Arab Emirates, Bahrain and Egypt accuse Qatar of supporting Islamist terrorist groups. Doha denies this and says the boycott, which closed its only land border and disrupted shipping routes, is an attempt to infringe on its sovereignty.
Baladna received its first cows a month after the boycott and set up a huge diary farm. It says it now supplies more than half of Qatar’s fresh milk and is exporting to Afghanistan, Yemen and Oman, and soon to Libya.
Soon after the boycott was imposed, Doha developed new trade routes to replace its former Gulf partners. In late 2017 it opened a $7.4 billion port designed to become a regional transport hub.
Government officials say Baladna’s rapid expansion shows the embargo has made Qatar’s economy stronger. Their goal is to encourage local producers.
In April, Baladna rolled out a line of fruit juices. In Qatar’s supermarkets, brands like Mazzraty, which opened the country’s largest poultry plant in January, sit beside “Qatar Farms” displays of local fruit and vegetables.
Vegetable output is up about 20% since mid-2017 to around 66,000 tonnes per year and is expected to increase by 20,000-40,000 tonnes next year as new farms come online, said Sheikh Faleh Bin Naser Al Thani, an agriculture official at the Ministry of Municipality and Environment.
Qatar is now self-sufficient in dairy and fresh poultry. Before 2017 it produced only about 20% and 10% percent of its needs in those sectors, respectively.
“Qatar after June 5, 2017 is not like Qatar before,” said Baladna communications director Saba al-Fadala, referring to the start of the boycott. “We now don’t want or need anyone.”
Workers pack vegetables harvested by Agrico, which has the country's biggest hydroponic farm, in Al-Khor, north of Doha, Qatar May 15, 2019. REUTERS/Naseem Zeitoon
Schoolchildren tour the milking parlours of Baladna’s farm, where 20,000 cows live in vast air-conditioned sheds. The visitors learn how flying in cows restored milk supplies that had been trucked in before Saudi Arabia closed the border.
TAKING A HIT
But other sectors of Qatar’s economy have suffered, with real estate and retail taking a hit. Shopping malls and hotels once filled with Saudi and UAE tourists at times appear nearly abandoned. Property prices fell sharply amid a supply glut in the run-up to Qatar hosting the World Cup 2022.
In March, Qatar Airways reported its second straight annual loss. Barred from the airspace of countries imposing the boycott, the state-owned carrier has had to re-route many flights, increasing their duration and cost.
At the same time, the boycott has forced Qatar to mount a public relations drive in the United States and Europe to counter claims by rivals that it finances terrorism.
It has also adopted a lower profile in the region after losing many of the bets it placed during the 2011 Arab Spring in Syria, Libya, and Egypt, where Qatar backed Islamist groups such as the Muslim Brotherhood.
But with a national population of just over 320,000 and a $320 billion sovereign fund, Qatar is well-placed to weather the embargo, diplomats and analysts say.
“If you are going to be subject to a blockade, then you better have a lot of money,” one banker told Reuters.
In the early months of the crisis, Qatar liquidated nearly $3 billion in U.S. treasury investments and drew down over $40 billion in foreign reserves to support its currency and banks.
The economy has since stabilised, growing 2.2% year-on-year in the third quarter of 2018. Qatar’s banks have been replenished by foreign deposits replacing much of the Saudi and Emirati money that left, and its stock market was the top performer in the Middle East last year.
Qatar’s goal of greater food self sufficiency has required launching agriculture on a commercial scale in one of the world’s harshest desert climates.
Nasser al-Khalaf, the managing director of Agrico, a produce grower and greenhouse manufacturer, says his business has boomed since he designed a system to keep fruit and vegetables cool enough to grow year-round.
Slideshow (12 Images)
In a polycarbon greenhouse, rows of ripening hydroponic tomatoes are cooled below 28 degrees Celsius as the temperature outside tops 40. Khalaf said the system allowed him to more than triple fruit and vegetable production to over 15 tonnes per day
Khalaf said his greenhouses are attracting investors looking at farming for the first time, drawn partly by increased subsidies for power, fertiliser and seeds since 2018.
“We never before saw businessmen investing in farms. They liked to invest in buildings and industry, anything but farms,” said Sheikh Faleh, the Qatari official.
Rabban Agriculture is one of the new entrants.
Owner Al Rabban Holding - with investments in property, transport and bottled water - is tapping initiatives like a 1 million riyal ($275,000) collateral-free loan from Qatar’s Development Bank to build a greenhouse farm, said deputy chairman Khalifa al-Rabban.
REFORMS AND OUTREACH
Qatari officials and diplomats said there was no sign of a let-up in the Gulf dispute, which has bolstered domestic support for 38-year-old ruler Emir Tamim bin Hamad Al Thani.
This has allowed him to accelerate reforms requested by Western allies that would have previously have faced local opposition, such as wider labour rights and a liberalised investment code for foreign ownership.
The reforms are intended to position Qatar as “like-minded with the Euro-U.S. community”, said a Western diplomat.
Doha pledged nearly $2 billion to expand Al-Udeid, the largest U.S. air base in the region. Qatar Petroleum aims to invest $20 billion in the United States, while the Qatar Investment Authority wants to expand its U.S. portfolio to $45 billion from $30 billion.
Nader Kabbani, director of research at Brookings Doha, said Qatar’s tone had changed from initially wanting to resolve the dispute to asserting it can go it alone.
Qatar can do that, said a Western diplomat, thanks to its gas wealth, World Cup exposure and international outreach efforts.
That was the claim from Conservative leadership hopeful Esther McVeyon Monday’s Victoria Derbyshire programme. So is she right?
What does her team say?
We asked Esther McVey’s office to show us the source for her claim that the UK is “one of the most generous countries in our support for disabled people”.
Her office declined to provide international comparisons to back it up, but a spokesperson told us: “we’re very happy for you to fact check and see where the UK ranks in the world for this”.
What does the government say?
We approached the Department for Work and Pensions, where Ms McVey was secretary of state until November.
A spokesperson told us “we spend £55 billion on benefits to support disabled people and those with health conditions — more than ever before”. That’s consistent with analysis from the independent Institute for Fiscal Studies (IFS), which found government spending on disability benefits rose by £5.9 billion in real terms between 2007 and 2017.
How does this compare internationally?
So UK spending on disability benefits has risen in the last decade. But that wasn’t Ms McVey’s claim: she was making a comparison with other countries.
Citing 2015 data from the OECD club of large economies, the DWP told us that “as a share of GDP, the UK’s public spending on disability and incapacity is higher than all other G7 countries bar Germany”. (The G7 group comprises Canada, France, Germany, Italy, Japan, the UK and the US.)
But when we look across the full range of OECD members, the picture’s more complicated.
The UK may be second among the G7, but we rank 24th out of 36 in the OECD as a whole.
Spending just under 1.9 per cent of GDP on “sickness, disability and occupational injury”, the UK is very slightly below the OECD average.
Breaking the figure down, the UK ranks 16th out of 36 for “benefits in kind” spending, which includes things like assisted vehicles or services for people with disabilities.
And when it comes to disability-related cash payments, like tax credits and Personal Independence Payments, the UK languishes near the bottom of the table in 27th place.
How many people are in need?
When we’re thinking about whether the UK’s disability benefits system is “generous”, we need to compare the total amount spent with the number of people who need help.
Frustratingly, we don’t have official figures on how much different countries spend on each person with a disability. But we do have some data that might put the UK system in context.
Stats compiled by the European Commission show that in 2012, the UK had had the third highest rate of disability in the European Economic Area, out of 27 countries where data was available.
Some 23 of those countries also show up on the OECD database. Among those, the UK ranks 19th in terms of disability spending as a proportion of GDP.
Putting these datasets together, it seems the UK has a relatively high rate of disability but spends relatively little on supporting disabled people compared to our European neighbours.
FactCheck verdict
Esther McVey said the UK is “one of the most generous countries in our support for disabled people”.
Her office couldn’t provide any evidence to back up the claim. But her former Whitehall home, the Department for Work and Pensions, pointed out that as a share of GDP, the UK’s public spending on disability and incapacity is higher than all other G7 countries bar Germany.
This is true but ignores some key points.
By the same measure of disability spending, the UK ranks 24th out of 36 among the OECD club of major world economies.
We don’t have any like-for-like figures on how much governments spend on each person with a disability. But OECD and European Commission figures suggest that the UK has one of the highest rates of disability in Europe, yet spends relatively little on supporting disabled people compared to our continental neighbours.
The most detailed simulation of a black hole yet has been unveiled. Source: Shutterstock
5 Jun 2019
SCIENTISTS on Thursday unveiled the most detailed simulation of a black hole yet, solving a mystery dating back more than four decades over how the star-devouring monsters consume matter.
Coming fresh on the heels of the first ever photo of one of the giant objects, which are scattered across the Universe, astrophysicists are now several steps closer to understanding how they form and develop.
A black hole is born when a large star collapses in on itself. Far from being a “hole”, they are instead incredibly dense objects with a gravitational pull so strong that nothing, not even light, may escape them.
As they suck in matter such as gas, dust and space debris, they form an accretion disk — a churning mass of super-accelerated particles that are among the brightest objects in the Universe — around them.
It is the accretion disk that can be seen as a blurry halo around the image of the black hole released in April from the Event Horizon Telescope.
But accretion disks are nearly always tilted at an angle to the orientation of the black hole, known as its equatorial plane.
In 1975, Nobel Prize-winning physicist John Bardeen and astrophysicist Jacobus Petterson theorised that a rotating black hole would cause the inner region of a tilted accretion disk to line up with the black hole’s equatorial plane.
But no model could ever work out how, precisely, that would happen. Until now.
A team of astrophysicists from Northwestern University, Oxford University, and the University of Amsterdam, used graphical processing units to crunch large sets of data and simulate how black holes interact with their accretion disks.
Crucially, their approach gave them the computing power to account for magnetic turbulence, which occurs when different particles churn at different speeds within the accretion disk.
It is precisely this electromagnetic effect that causes matter to fall to the centre of the black hole.
Alexander Tchekhovskoy, assistant professor of physics and astronomy at Northwestern’s Weinberg College of Arts and Sciences, likened matter accumulating near a black hole to throwing a dart towards the board at random.
“If you don’t really aim it will never hit the bullseye,” he said. “In the same way, when (matter) falls into the black hole it has some rotation but this rotation will have nothing generally to do with how the black hole rotates. The two rotations will not know anything about each other.”
Previous simulations manually predicted the additional friction their creators believed was needed to make matter move towards the black hole.
“Whereas now in our model, we don’t have to postulate this friction,” Tchekhovskoy told AFP. “We put in magnetic fields and these actually cause an instability that then causes friction and the disk falls in as a result.”
This might seem like a small detail but it directly affects how fast black holes spin and, consequently, what effect they have on the galaxies that surround them.
The simulation, which produces a disk with two jets of gas and magnetic fields protruding from the centre like fountains, shows the inner part of the accretion disk aligning perfectly with the black hole’s equator even as the outer part remains at an angle.
“Before now there was a worry that when you take into account all the complications that come with matter interacting with a black hole, such as magnetic fields, the turbulence in the disk, the swirling motions — those things might kill the alignment effect,” said Tchekhovskoy.
FILE PHOTO: A commuter walks along Waterloo Bridge, which is being blocked by climate change activists, during the Extinction Rebellion protest in London, Britain April 17, 2019. REUTERS/Hannah McKay/File Photo
LONDON (Reuters) - Companies are failing to disclose sufficient detail about how exposed they are to the potential risks of climate change, a global task force said in a report on Wednesday.
Many investors have called on companies to provide better communication on how climate change could impact their businesses, amid concerns that assets are being mispriced because the full scale of the risk is not being factored in.
“Given the speed at which changes are needed to limit the rise in the global average temperature — across a wide range of sectors — more companies need to consider the potential impact of climate change and disclose material findings,” the report said.
The Task Force on Climate-related Financial Disclosures (TCFD), set up by the G20’s Financial Stability Board, found in its report that climate related disclosure had improved since 2016 but only about a quarter of companies disclosed information aligned with more than five of the TCFD’s 11 recommendations.
The TCFD launched a voluntary framework in 2017 that calls on companies to provide climate-related financial disclosures in their public annual financial filings.
Other recommendations include disclosing metrics companies use to set internal climate targets and describing processes for managing climate-related risks.
The task force published its second status report on Wednesday, showing 785 companies and organizations, with a combined market capitalization of more than $9.2 trillion, had committed to supporting the TCFD framework, a more than 50% increase from the first status report published in September.
Companies supporting the framework include insurance groups AXA and Aviva, oil majors Royal Dutch Shell and Total and mining companies Anglo American and BHP.
Climate scientists said last year that keeping the Earth’s temperature rise to 1.5 degrees Celsius, a level that would stave off the worst effects of climate change, required rapid changes in the way people used energy, eat, lived and traveled.
But Wednesday’s report said there was only a 3 percent increase from 2016 to 2018 in the number of firms disclosing information on the resilience of their strategies, taking into consideration different climate-related scenarios, including a 2 degree scenario or lower.
The Paris climate agreement, adopted by almost 200 nations in 2015, set a long-term goal to limit global warming to “well below” a rise of 2 degrees Celsius above pre-industrial times while “pursuing efforts” for the tougher goal of 1.5 degrees.
More than 200 of the world’s largest listed companies have forecast that climate change could cost them a combined total of almost $1 trillion, a report by charity group Carbon Disclosure Project showed this week.
Experts say region is losing the battle to stop the biggest animal disease outbreak the planet has ever faced Vietnamese health officials spray disinfectant on a dead pig in Hanoi before burying it in a quarantined pit to stop the spread of African swine fever. Photograph: Manan Vatsyayana/AFP/Getty Images
Hannah Ellis-Petersen in Bangkok- South-east Asia is battling to contain the spread of highly contagious African swine fever, known as “pig Ebola”, which has already led to the culling of millions of pigs in China and Vietnam. African swine fever, which is harmless to humans but fatal to pigs, was discovered in China in August, where it has caused havoc, leading to more than 1.2m pigs being culled. China is home to almost half of the world’s pigs and the news sent the global price of pork soaring.
There is no vaccination for African swine fever, which causes pigs to internally haemorrhage until they die, so the only option to contain the disease is to kill any contaminated animals. Some estimates say that in Chinaup to 200m animals may eventually be slaughtered. The virus can last for several weeks on anything from clothes to vehicles, allowing for it to easily travel long distances.
It has spread like wildfire across Asia, causing growing devastation to the pig farmers of Vietnam and Cambodia and putting Thailand, Asia’s second-biggest pork producer, on “red alert”. Cases have increased in Mongolia, North Korea and Hong Kong in recent weeks, while South Korea is blood testing pigs at the border.
The UN Food and Agriculture organisation (UNFAO) and regional experts fear that Myanmar, Philippines and Laos will be next because they are all highly susceptible to an outbreak, due to the struggle to control the movement of pigs and pig products across porous borders.This is the biggest animal disease outbreak we’ve ever had on the planet
“This is the biggest animal disease outbreak we’ve ever had on the planet,” said Dirk Pfeiffer, a veterinary epidemiologist at City University of Hong Kong and expert on African swine fever. “It makes the foot and mouth disease and BSE outbreaks pale in comparison to the damage that is being done. And we have no way to stop it from spreading.”
Health officials lower a pig carcass into an isolated quarantined pit in Hanoi. Photograph: Manan Vatsyayana/AFP/Getty Images
Currently the battle to contain the disease is being lost. “There are concerns that the disease will continue to spread across the countries in south-east Asia,” said Dr Wantanee Kalpravidh, regional manager for UNFAO, who said they believed the swine fever cases being reported by governments in the region were “underestimates”.
Wantanee said problems included the lack of compensation for pig farmers in south-east Asia whose herds were culled, giving them little reason to report a disease outbreak, and fears that banning movement of pigs and pork across borders would only create a “black market which would be impossible to control”.
The implications of the outbreak are already being felt beyond Asia. Global pork prices have risen by almost 40%, and long term it is likely to lead to more pork imports from Europe and America to meet demand, which will also push up global meat prices. Market analyst Rabobank said global pork supplies could fall by 8%.
In Vietnam, the first swine fever case was detected in January this year in northern Vietnam, not far from the border with China. Last week, agriculture minister Nguyen Xuan Cuong confirmed the virus had now spread to 48 of the country’s 63 provinces. The country has now culled about 2m pigs, or 6% of the country’s herd, a figure that is expected to rise steeply.
“The world and Vietnam have never faced such an extremely dangerous, difficult, complicated and expensive epidemic as this,” Cuong said in a statement last month.
The economic and social impact is likely to be huge for Vietnam. Pork accounts for 75% of all meat consumed in the country and it is an industry worth 94tn dong (£32m). Overall, the agriculture sector in Vietnam employs almost 50% of the workforce, with pork farming a significant part of that.
Speaking in parliament, Cuong urged consumers and businesses to stockpile pork ahead of likely shortages towards the end of the year. The government has also mobilised police and military to help contain the outbreak but has stopped short of declaring it a national emergency.
In Cambodia, around 2400 pigs have died or been culled due to the disease in the past two months, while in Hong Kong two separate cases led to there being no fresh pork in the country for a week.
White disinfectant powder is sprinkled on the soil around a pig farm in northern China’s Hebei province. Photograph: Sam McNeil/AP
But Pfeiffer was not optimistic Thailand – which has more than 2m pigs – could resist the pandemic spreading from neighbouring Vietnam and Cambodia, or China, for much longer, saying it could probably enter “through pork products brought in illegally from Vietnam and China, even if just by tourists or truck drivers”.
“The virus survives so well and there are so many people travelling particularly between China and Thailand, it’s hard to see how it could be contained for much longer,” he added.
fizer’s arthritis drug appeared to reduce the risk of getting Alzheimer’s disease. The Washington Post’s Chris Rowland explains why Pfizer did not pursue it.(Luis Velarde/The Washington Post)
A team of researchers inside Pfizer made a startling find in 2015: The company’s blockbuster rheumatoid arthritis therapy Enbrel, a powerful anti-inflammatory drug, appeared to reduce the risk of Alzheimer’s disease by 64 percent.
The results were from an analysis of hundreds of thousands of insurance claims. Verifying that the drug would actually have that effect in people would require a costly clinical trial — and after several years of internal discussion, Pfizer opted against further investigation and chose not to make the data public, the company confirmed.
Researchers in the company’s division of inflammation and immunology urged Pfizer to conduct a clinical trial on thousands of patients, which they estimated would cost $80 million, to see if the signal contained in the data was real, according to an internal company document obtained by The Washington Post.
“Enbrel could potentially safely prevent, treat and slow progression of Alzheimer’s disease,’’ said the document, a PowerPoint slide show that was prepared for review by an internal Pfizer committee in February 2018.
The company told The Post that it decided during its three years of internal reviews that Enbrel did not show promise for Alzheimer’s prevention because the drug does not directly reach brain tissue. It deemed the likelihood of a successful clinical trial to be low. A synopsis of its statistical findings prepared for outside publication, it says, did not meet its “rigorous scientific standards.’’
Pharma companies have raised prices for new drugs and commonly used medications, prompting many patients to order medications across the border.(Luis Velarde/The Washington Post)
Science was the sole determining factor against moving forward, company spokesman Ed Harnaga said.
Likewise, Pfizer said it opted against publication of its data because of its doubts about the results. It said publishing the information might have led outside scientists down an invalid pathway.
Pfizer’s deliberations, which previously have not been disclosed, offer a rare window into the frustrating search for Alzheimer’s treatments inside one of the world’s largest drug companies. Despite billions spent on research, Alzheimer’s remains a stubbornly prevalent disease with no effective prevention or treatment.
Some outside scientists disagree with Pfizer’s assessment that studying Enbrel’s potential in Alzheimer’s prevention is a scientific dead end. Rather, they say, it could hold important clues to combating the disease and slowing cognitive decline in its earliest stages.
Despite promising preliminary data in an internal analysis, Pfizer opted against conducting a clinical trial to see if its drug Enbrel could prevent Alzheimer's disease. (Spencer Platt/Getty Images)
Pfizer did share the data privately with at least one prominent scientist, but outside researchers contacted by The Post believe Pfizer also should at least have published its data, making the findings broadly available to researchers.
“Of course they should. Why not?’’ said Rudolph E. Tanzi, a leading Alzheimer’s researcher and professor at Harvard Medical School and Massachusetts General Hospital.
“It would benefit the scientific community to have that data out there,’’ said Keenan Walker, an assistant professor of medicine at Johns Hopkins who is studying how inflammation contributes to Alzheimer’s. “Whether it was positive data or negative data, it gives us more information to make better informed decisions.’’
Internal discussions about possible new uses of drugs are common in pharmaceutical companies. In this case, Pfizer’s deliberations show how decisions made by industry executives — who are ultimately accountable to shareholders — can have an impact well beyond corporate board rooms.
As its Enbrel deliberations ended early last year, Pfizer was getting out of Alzheimer’s research. It announced in January 2018 that it would be shutting down its neurology division, where Alzheimer’s treatments were explored, and laying off 300 employees.
Meanwhile, Enbrel has reached the end of its patent life. Profits are dwindling as generic competition emerges, diminishing financial incentives for further research into Enbrel and other drugs in its class.
“I’m frustrated myself really by the whole thing,’’ said Clive Holmes, a professor of biological psychiatry at the University of Southampton in Great Britain who has received past support from Pfizer for Enbrel research in Alzheimer’s, a separate 2015 trial in 41 patients that proved inconclusive.
He said Pfizer and other companies do not want to invest heavily in further research only to have their markets undermined by generic competition.
“Someone can pop up and say, ‘Look, I’ve got a me-too drug here,’ ’’ Holmes said, referring to the advent of generic versions of Enbrel. “I think that is what this is all about.’’
Enbrel's 'life cycle'
The broader market forces that critics say discouraged Pfizer from investing in Alzheimer’s clinical trials are rooted in Enbrel’s “life cycle,’’ the 20-year period of patent exclusivity when a brand manufacturer reaps monopoly profits from a drug. By industry standards, Enbrel, an injectable biologic drug, is relatively old, with FDA approval for rheumatoid arthritis in 1998. It also has been approved to treat psoriasis.
Pfizer got rights to market it internationally when it acquired drugmaker Wyeth in 2009. But Enbrel, which earned Pfizer $2.1 billion in 2018, now faces generic competition.
Drug companies often are criticized for extending the patent life of a drug — and winning new profits — by merely tweaking a drug’s molecule or changing the method of delivery into the body. But it is a “heavy lift’’ for a company to win regulatory approval to use a drug for a completely different disease, said Robert I. Field, a professor of law and health care management at Drexel University.
“Our patent laws do not provide the appropriate incentives,’’ Field said. Drug therapy for early Alzheimer’s “would be a godsend for American patients, so we should be doing everything we can as a country to encourage development of treatments. It’s frustrating that there may be a missed opportunity.’’
As Enbrel’s life cycle winds down, Pfizer has introduced a new rheumatoid arthritis drug, Xeljanz, that works differently from Enbrel. Pfizer is putting its marketing muscle behind the new treatment.
While Enbrel revenue is shrinking, Xeljanz revenue is growing. The Xeljanz patent expires in 2025 in the United States and 2028 in Europe, according to Pfizer’s public disclosures. The drug is on track to make Pfizer billions more each year for the foreseeable future.
Wagering money on a clinical trial of Enbrel for an entirely different disease, especially when Pfizer had doubts about the validity of its internal analysis, made little business sense, said a former Pfizer executive who was aware of the internal debate and spoke on the condition of anonymity to discuss internal Pfizer matters.
“It probably was high risk, very costly, very long term drug development that was off-strategy,’’ the former executive said.
Another former executive, who also spoke on the condition of anonymity to discuss Pfizer operations, said Pfizer offered virtually no explanation internally for opting against further investigation in early 2018, when the internal debate ended.
“I think the financial case is they won’t be making any money off of it,’’ the second former executive said.
'Impeding research'
Drug companies frequently have been pilloried for not fully disclosing negative side effects of their drugs. What happens when the opposite is the case? What obligation does a company have to spread potentially beneficial information about a drug, especially when the benefits in question could improve the outlook for treating Alzheimer’s, a disease that afflicts at least 500,000 new patients per year?
A medical ethics expert argued that Pfizer has a responsibility to publicize positive findings, although it is not as strong as an imperative to disclose negative findings.
“Having acquired the knowledge, refusing to disclose it to those who might act upon it hides a potential benefit, and thereby wrongs and probably harms those at risk of developing Alzheimer’s by impeding research,’’ said Bobbie Farsides, professor of clinical and biomedical ethics at Brighton and Sussex Medical School in the United Kingdom.
Another health-care ethics specialist cautioned that the demand for drug company disclosure should remain focused on information collected during clinical trials.
“I do think you have to draw some limits, and say that not every piece of information they have in their files has to be disclosed with others,’’ said Marc A. Rodwin, a law professor at Suffolk University Law School in Boston.
Pfizer markets Enbrel outside North America. Another drug company, Amgen, which holds rights to market Enbrel in the United States and Canada, says it knew of the Pfizer data and similarly decided the findings held little promise. Amgen said market factors played no role in its deliberations.
“Unfortunately, our exploratory work did not yield results strong enough to warrant further studies,’’ Amgen said.
Analyzing insurance claims
Sometimes doctors prescribe drugs for uses that have not been approved by the Food and Drug Administration. But none of the experts interviewed for this story said such “off-label’’ use of Enbrel would be appropriate for Alzheimer’s, because of the very limited nature of the data thus far. Nor, they said, do they believe such prescribing is happening to any significant extent.
The role of brain inflammation in Alzheimer’s recently has been getting closer attention among academics after the failure of multiple experimental drugs that targeted the buildup of plaques on brain tissue. In 2016, researchers from Dartmouth and Harvard universities published a study of insurance claims data — similar to Pfizer’s internal findings — that showed a potential benefit of Enbrel. Enbrel “shows promise as a potential treatment’’ for Alzheimer’s, the study found.
Pfizer’s analysis about potential Enbrel benefits in the brain sprang from the company’s division of immunology and inflammation, based in a large Pfizer office complex in Collegeville, Pa.
Statisticians in 2015 analyzed real world data, hundreds of thousands of medical insurance claims involving people with rheumatoid arthritis and other inflammatory diseases, according to the Pfizer PowerPoint obtained by The Post.
They divided those anonymous patients into two equal groups of 127,000 each, one of patients with an Alzheimer’s diagnosis and one of patients without. Then they checked for Enbrel treatment. There were more people, 302, treated with Enbrel in the group without Alzheimer’s diagnosis. In the group with Alzheimer’s, 110 had been treated with Enbrel.
The numbers may seem small, but they were mirrored in the same proportion when the researchers checked insurance claims information from another database. The Pfizer team also produced closely similar numbers for Humira, a drug marketed by AbbVie that works like Enbrel. The positive results also showed up when checked for “memory loss’’ and “mild cognitive impairment,’’ indicating Enbrel may have benefit for treating the earliest stages of Alzheimer’s.
A clinical trial to prove the hypothesis would take four years and involve 3,000 to 4,000 patients, according to the Pfizer document that recommended a trial. The document said Pfizer would gain a positive public relations “halo effect’’ by investigating an Alzheimer’s treatment.
Enbrel reduces inflammation by targeting a specific protein called TNF-a. The Pfizer claims data analysis added to a growing body of evidence that broadly targeting TNF-a in the body has the potential to prevent Alzheimer’s, said Holmes, the professor of biological psychiatry at the University of Southampton.
Holmes is among the few researchers who has gained access to the Pfizer data; he won the company’s permission to use it in a grant application for a small clinical trial he is undertaking in England.
“If it’s true in reality, if you did it in a clinical trial setting, it’s massive — it would be huge,’’ Holmes said. “That’s why it’s so exciting.’’
One reason for caution: another class of anti-inflammatory therapies, called non-steroidal anti-inflammatory drugs (NSAIDS), showed no effect against mild-to-moderate Alzheimer’s in several clinical trials a decade ago. Still, a long-term follow-up of one of those trials indicated a benefit if NSAID use began when the brain was still normal, suggesting the timing of therapy could be key.
Pfizer said it also was skeptical because Enbrel has only a limited effect on the brain. The Enbrel molecule is too large to pass through the “blood-brain barrier’’ and directly target TNF-a in brain tissue, the company said.
Yet Alzheimer’s researchers believe inflammation outside the brain — called peripheral inflammation — influences inflammation within the brain.
“There is a lot of evidence suggesting that peripheral or systemic inflammation may be a driver of Alzheimer’s disease,’’ said Walker, the Johns Hopkins researcher. It is a fair hypothesis that fighting inflammation outside the brain with Enbrel will have a similar effect inside the brain, he said.
“I don’t believe Enbrel would need to cross the blood brain barrier to modulate the inflammatory/immune response within the brain,’’ Walker said.
“There is increasing evidence that peripheral inflammation can influence brain function,’’ said rheumatologist Christopher Edwards, of the University of Southampton in Britain.
“It’s important that that’s published, and in the public domain,’’ Edward added of the Pfizer data. “It needs to be out there.’’
Correction: An earlier version of this story misstated the location of the Brighton and Sussex Medical School.
Over the past decade, smoking has become marginalised and stigmatised.
From the smoking ban in 2007 to the introduction of plain packaging a decade later, everything has been done to discourage people from taking up the habit.
And there are signs sugar is heading the same way.
Sugary drinks are already taxed - and now a leading think tank has even suggested sweets, snacks and sugary drinks should be wrapped in plain packaging to make them less appealing, given the excess consumption of the sweet stuff.
The call has been made by the Institute for Public Policy Research (IPPR) in a new report.
IPPR director Tom Kibasi believes it could make a real difference.
"Plain packaging would help us all to make better choices and reduce the hassle of pester power for busy parents," he said.
He wants to see it adopted alongside a range of other measures, including a ban on junk food advertising.
That is something that has already been looked at by ministers.
But would plain packaging be a step too far?
Industry against the move
Industry has been quick to object, with trade body the Food and Drink Federation arguing that branding is a "fundamental commercial freedom" and "critical to competition".
The same sort of arguments were put forward by the tobacco industry, but successive governments have still increasingly shown an appetite to get tough.
Interestingly, the government has not ruled the idea of plain packaging for sugar products entirely.
Instead, the Department of Health and Social Care is saying it is waiting to hear what England's chief medical officer, Prof Dame Sally Davies, has to say.
Why? There is a recognition that bold moves are needed if the ambition to halve the child obesity rate by 2030 is to be achieved.
Dame Sally has been asked to review the steps that are being taken to ensure no stone is left unturned.
And she is said to be open to the idea of plain packaging, which of course would be an even more radical step.
But what is clear from the last decade is that the unlikely can soon become likely.
During the early noughties, health campaigners and academic bodies were pushing and pushing for a ban on smoking in public places to be introduced.
Time after time, the government poured cold water on the move.
But then things slowly began to change once Patricia Hewitt became health secretary, paving the way for even more radical measures.
The approach seems to be working - smoking rates have fallen by a third in just over 10 years.
Some of the credit is clearly because of the growth of vaping as an alternative.
But tough public health tactics have no doubt played some part.
Evidence from Australia - the first nation to introduce plain packaging for tobacco products - suggests a quarter of the subsequent reduction in smoking rates could be attributed to the move.
As the debate rages about obesity, expect to hear much more about the merits of radical action on sugar.
Families of the disappeared in Vavuniya held a protest on Saturday outside the office of the Ilankai Thamil Arasu Katchi (ITAK) in Jaffna, demanding action over enforced disappearances.
Marking ten years since the end of the armed conflict when families handed over their now missing partners and children to Sri Lankan security forces, families condemned ITAK representatives for their failure to resolve the issue and accused them of not showing sufficient interest.
The ITAK is the largest constituent party of the Tamil National Alliance (TNA).
Qatar is the world’s top liquefied natural gas exporter but a net importer of nearly everything else. The small but wealthy country has been under a trade and transport boycott by Saudi Arabia and its allies since June 2017 that has forced it to retool an economy once heavily reliant on fellow Gulf states.
In a polycarbon greenhouse, rows of ripening hydroponic tomatoes are cooled below 28 degrees Celsius as the temperature outside tops 40. Khalaf said the system allowed him to more than triple fruit and vegetable production to over 15 tonnes per day
Breaking the figure down, the UK ranks 16th out of 36 for “benefits in kind” spending, which includes things like assisted vehicles or services for people with disabilities.
Some 23 of those countries also show up on the OECD database. Among those, the UK ranks 19th in terms of disability spending as a proportion of GDP.
Putting these datasets together, it seems the UK has a relatively high rate of disability but spends relatively little on supporting disabled people compared to our European neighbours.
Health officials lower a pig carcass into an isolated quarantined pit in Hanoi. Photograph: Manan Vatsyayana/AFP/Getty Images
White disinfectant powder is sprinkled on the soil around a pig farm in northern China’s Hebei province. Photograph: Sam McNeil/AP
