Day: November 5, 2021

Editor’s note: Here is a fast take on what the international community has been up to this past week, as seen from the United Nations perch.

Leaders talk global warming in Glasgow 

— World leaders met in Glasgow, Scotland, this week to try to halt global warming. But with some of the world’s biggest emitters like China and Russia skipping the conference, known as COP26, hopes dimmed that leaders will find a way to keep the world from warming more than the goal of 1.5 degrees Celsius this century.

Hope Eroding as COP26 Climate Pledges Fall Short

— Burning coal is the single biggest contributor to climate change. Phasing out its use between 2030 and 2040 is one of the United Nation’s most ambitious appeals. More than 40 countries made coal-related pledges on Thursday at COP26.

COP26: Britain Hails Global Deals to End Coal but Plans New Mine

— The world’s youth have the most at stake as the planet warms, and they have been vocal advocates for change. On Friday, they took center stage during Youth and Public Empowerment Day at COP26.

‘It’s Our Lives on the Line’, Young Marchers Tell UN Climate Talks 

War crimes committed in northern Ethiopia

— The conflict between the Ethiopian federal army and Tigrayan fighters in northern Ethiopia reached the one-year milestone this week. A report written by a joint investigative team from the United Nations and the Ethiopian Human Rights Commission was published Wednesday, saying all belligerents have committed atrocities during the year-long conflict.

UN Report Says Ethiopia’s War Marked by ‘Extreme Brutality’

— The U.S. special envoy for the Horn of Africa, Jeffery Feltman, traveled to Ethiopia on Thursday, as the internal armed conflict intensified. On Tuesday, the Ethiopian federal government declared a state of emergency, saying Tigrayan fighters were advancing toward the capital, Addis Ababa.

US Envoy to Visit Ethiopia After Government Declares State of Emergency

News in brief

World Food Program Executive Director David Beasley has for months been trying to attract the attention of some of the world’s richest men on Twitter, seeking $6 billion to assist 42 million people who are “marching toward starvation” due to conflict, climate change and COVID-19. On Monday, he finally caught the attention of the world’s richest man, Tesla founder Elon Musk.

Quote of note

“We are not drowning, we are fighting. This is our warrior cry to the world.”

— Samoan climate activist Brianna Fruean, 23, of her Pacific Island peers to world leaders at the opening of COP26 on Monday. 

What we are watching next week

An international conference on Libya will be held in Paris on November 12. Libya is set to hold elections on December 24, but concerns are growing that it may not be on track to carry out a free and fair election on time.

Did you know?

The 15 members of the U.N. Security Council take turns being council president for a month at a time. Rotation is in alphabetical order. Kenya was president in October, Mexico took over Monday for November, and Niger will finish out the year in December.

To mark their presidency, Mexico donated a new sculpture now on display at U.N. headquarters in New York City.

 
…

China now depends almost entirely on its own online content providers, as the number of big foreign companies in the market, such as Yahoo and LinkedIn, keeps dwindling, giving the government a boost in controlling the internet, analysts say.

On Monday the Silicon Valley internet service provider Yahoo closed all of its services in China, following LinkedIn’s pullout announcement in October and earlier blockages of Google content.

In an e-mailed statement, Yahoo cited an “increasingly challenging business and legal environment in China.” Many Yahoo services were largely blocked in China, where the email and search engine provider has operated since 1999.

“My first reaction was, I didn’t know Yahoo was still alive in China,” said Danny Levinson, Beijing-based head of technology at the seed investment firm Matoka Capital.

Domestic services flourish

Chinese netizens seldom use Yahoo or other major Silicon Valley internet services, especially for media and communications, as domestic rivals have flourished over the past two decades. The government can handily monitor local providers for what it considers subversive content by calling in company managers for discipline.

Chinese use China-based WeChat for the bulk of their daily communication, watch TikTok videos instead of YouTube and check China’s Baidu.com rather than Wikipedia. Alibaba, headquartered in Hangzhou, takes care of e-commerce, although foreign rivals can still get into China given their trade’s lack of political sensitivity.

“They had all the ingredients in place,” said Kaiser Kuo, a U.S.-based podcaster who has worked in Chinese tech. “You had a really large, very fast-growing market. There was a need for people to come in with services that were catered to Chinese language users and Chinese tastes. On top of that, it was so cutthroat that foreign internet companies just couldn’t compete very well.”

The roughly 1 billion Chinese who use the internet have spawned an industry with an operating revenue of about $155 billion in the first 11 months of 2019, up 22.4% over the same months of 2018, according to Caixin Globa, a Chinese economic news-focused website.

Chinese mass media have said the country aims to become technologically self-sufficient by 2030 and get around U.S. government bans on doing business with some of its flagship companies.

Chinese netizens contacted this week say they’re unfazed by Yahoo’s withdrawal. Many Chinese have never visited Yahoo’s homepage, one veteran Beijing internet user said.

Laws discourage foreign providers

China has monitored the internet for two decades, by blocking websites and filtering social feeds, to intercept anti-government material. Its latest effort, the Data Security Law, restricts outflows of sensitive data from China and requires internet operators to give their internal data to law enforcement agencies.

Getting around that law can be costly and upset users outside China who oppose censorship, some analysts say.

“If there was a platform that was willing to go into China and completely cede control to the Chinese government and regulators to manage that, I think there would be an opportunity to grow, but so far most companies have chosen not to,” said Zennon Kapron, director of the finance industry research firm Kapronasia.

China previously blocked Facebook, Google and most other global social media sites and search engines as well as flagship Western news websites. Foreign media content providers “haven’t been really there for a long time in force,” said Ma Rui, founder of the San Francisco-based consultancy Tech Buzz China.

Users in China can still access foreign internet content by using a virtual private network, but authorities search out and block overseas-based VPNs that are not authorized for specific companies doing business in China. The “efficacy” of VPNs to stop filtering or blocking of content has declined over the years, Levinson said.

Emailing can still take care of Chinese people’s overseas business matters, Ma said, while foreign companies active in China normally use WeChat. China, however, does not allow end-to-end encrypted e-mail or chats.

“The email gets through, but based on the originating DNS [domain name system], it might get blocked, and it might get filtered. So it’s not a 100 percent panacea, but for normal business communication it’ll be fine,” Levinson said.

China’s constitution affords its citizens freedom of speech and press, but authorities target web content that the government believes will expose state secrets or might endanger the country, according to the Council on Foreign Relations, a research group.
…

U.S. pharmaceutical company Pfizer announced Friday its new COVID-19 pill showed an 89% reduction in risk of COVID-19-related hospitalization or death in clinical trials and they plan to submit the drug to U.S. regulators for emergency use approval.

In a release Friday, Pfizer said the latest clinical trials of its pill, Paxlovid, featured a randomized, double-blind study of non-hospitalized adult patients with COVID-19 who are at high risk of progressing to severe illness. 

The company said interim analysis of the oral antiviral showed an 89% reduction in risk compared to a placebo in patients treated within three days of symptom onset. 

Pfizer said it has received an independent data monitoring committee recommendation to pause enrollment in the Phase 3 trial due to the overwhelming efficacy demonstrated in the latest results. 

The company plans to submit the data as part of its ongoing application to the FDA for Emergency Use Authorization as soon as possible. 

Pfizer is now the second drug manufacturer to develop an oral treatment for COVID-19. U.S. company Merck last month introduced its COVID-19 pill, which clinical studies showed to provide a 50% reduction in hospitalizations and deaths due to COVID-19. It has been submitted to the FDA, and the federal agency is scheduled to rule on it late this month. 

Currently, all COVID-19 treatments approved in the United States require injection or intravenous drip. Pills have the advantage of being distributed by pharmacies and taken at home. 

Britain’s Medicines and Healthcare products Regulatory Agency approved Merck’s pill, known as Molnupiravir, Thursday. The European Union’s drug regulator, the European Medicines Agency (EMA), said it would speed up its review of the Merck pill, and is prepared to give advice to individual EU member states so they can make the pill available for emergency use ahead of the EMA authorization. 

When Merck’s pill was submitted for approval last month, White House Coronavirus Response Coordinator Jeff Zients said the U.S. government had already arranged to buy 1.7 million doses of the pill, with an option to acquire more if needed.

 
…

Activists will take over the UN climate summit in Scotland on Friday, capping off a week of dizzying government speeches and pledges with a student march, youth-led presentations, and a giant iceberg shipped from Greenland to Glasgow’s River Clyde to dramatize the plight of the Arctic.

UK organizers decided to hand the day over to civic groups in an acknowledgement of how young campaigners like Vanessa Nakate of Uganda and Greta Thunberg of Sweden have raised public understanding of climate change, and a nod to their stance that today’s youth must live with consequences of state decisions.

“We’re expecting lots of people to come and join us in the streets and not only youth but also adults supporting youth, and adults that want climate action,” said Isabelle Axelsson, 20, an activist with Thunberg’s climate movement Fridays For Future, which is organizing the march.

The COP26 talks in Glasgow aimed to secure enough national promises to cut greenhouse gas emissions – mainly from fossil fuels – to keep the rise in the average global temperature to 1.5 degrees Celsius. Crossing that threshold could trigger a cascading climate crisis, scientists say.

The COP26 summit has so far yielded deals to phase out coal, reduce deforestation and curb methane, but a clear picture has yet to emerge on what these voluntary initiatives would add up to in terms of moderating temperature rises.

The head of the International Energy Agency, Fatih Birol, said on Thursday that emissions cut pledges made so far – if all implemented – could potentially hold warming to 1.8 C. But some U.N. negotiators said that assessment was too rosy.

Former U.S. Vice President Al Gore and UK COP26 President Alok Sharma will sit down Friday with civil society leaders to discuss the progress made so far and what remains to be done over the next week of negotiations.

Professor Gail Whiteman, founder of the climate activist group Arctic Basecamp, said she hoped to bring a sense of urgency to discussions on Friday by using an iceberg as a giant prop.

She said her group had the iceberg shipped from Greenland via Iceland to the east coast of England, and then onward on a truck to the River Clyde.

“Studies are showing that if we lose the snow and ice in the Arctic we will amplify global warming by 25 to 40%,” she said. “We felt that negotiators here had to actually come face to face with the Arctic, so we brought the iceberg.”
…

Seats are once again packed at professional baseball games in South Korea. Just as in pre-pandemic times, fans can drink beer and eat fried chicken. They can clap their hands, stomp their feet, and wave inflatable noisemakers to support their team.

What they are not allowed to do, though, at least not yet, is shout or sing fight songs, a key feature of Korean baseball crowds.

“If you shout a lot, the virus will leak through your mask,” Prime Minister Kim Boo-kyum pleaded with fans on a radio show this week, after crowds were seen as being too vocally supportive of their teams during tense playoff games.

It is a microcosm of how life is going in South Korea: basically, things are returning to normal, but they are not quite there yet.

Although South Korea never locked down during the coronavirus pandemic, it was never fully open either, especially as the country has battled a fourth wave of infections since July.

However, starting this week, the government rolled out the first step of its “living with COVID-19” plan. Bigger crowds can now gather in Seoul. Restaurants and cafes, including those that serve alcohol, are no longer subject to a nighttime curfew. Sports fans have returned to stadiums and arenas.

Barring setbacks, South Korea will phase out all social distancing rules by the end of February, two years after the country experienced one of the world’s first COVID-19 outbreaks.

South Korea’s COVID-19 approach has unquestionably been a success so far. It is one of very few countries to avoid both mass lockdowns and mass deaths.

Now, after outperforming its global peers at nearly every stage of the pandemic, South Korea hopes it can demonstrate how to live with COVID-19.

A cautious opening

For starters, few in South Korea are declaring victory. That is in contrast to countries such as the United States and Britain, where leaders announced independence from the virus and quickly eased social distancing, only to see the delta variant sweep through their populations, killing tens of thousands more in each country.

“The goal here is to set up a system where the government can relax the restrictions, but at the same time has criteria for moving back,” said Jerome Kim, director-general of the International Vaccine Institute in Seoul.

There are good reasons for caution. Although over 75% of South Koreans are vaccinated, the number of daily confirmed COVID-19 cases has not fallen since the fourth wave began.

“We do, I think at this point, have a realization that the vaccines are doing what they’re supposed to do, which is preventing severe disease, hospitalization, and death. But they don’t necessarily prevent infection,” Kim said.

Officials have repeatedly warned the opening up could be reversed. And they say some precautions, such as mandatory facemasks, may be around for the foreseeable future.

South Koreans seem receptive. According to a recent poll by Seoul National University, about 49% of South Koreans have mixed feelings about the loosened restrictions. Twenty-seven percent think it will be impossible to ever stop wearing masks, according to a survey by Gallup Korea.

Getting public support

Unlike many countries, South Korea has seen almost no domestic backlash to its pandemic approach.

Businesses largely complied with mandatory curfews. There has been no successful anti-vaccine movement. Virtually everyone wears masks, even when running alone outside on empty paths.

That public buy-in has been at the heart of South Korea’s COVID-19 success, according to public health experts. Not only has it given authorities more anti-pandemic tools, those tools are less coercive and more precise.

For instance, no vaccine mandates have been necessary; about 90% of adults have received the COVID-19 vaccine. Mass lockdowns, too, are unheard of; during the pandemic it has always been possible to go shopping or eat at a restaurant.

Perhaps the most invasive tool is South Korea’s system of contact tracing.

Using cellphone, credit card, and other personal data, authorities can quickly determine where those infected with COVID-19 have gone and who they may have contacted.

The contact tracing only became possible after South Korea’s National Assembly loosened privacy laws following a public outcry over the government’s handling of a deadly 2015 outbreak of Middle East respiratory syndrome, or MERS.

“I think there are a number of choices that people here have made in order to have freedom, which is really what it is,” Kim said.

Moving ahead

As South Korea makes the transition toward living with the virus, it will continue to use many of those same tools, which have become a part of daily life.

Customers at every restaurant in Seoul are required to check in either via their phones or on a sign-up sheet at the counter. Temperature checks remain at the entrance of almost every business. Soon, electronic vaccine passes will be required to enter sporting events, concerts, and other large venues.

Some health experts caution that new standards may be necessary for defining COVID-19 success, though.

While many news outlets continue to focus on the number of confirmed daily cases, it will soon be important to pay attention to more meaningful measurements, such as the number of intensive care unit beds available or the number of serious illnesses.

“Even if there are 10,000 confirmed cases, it will still be more important to know the number of serious cases or what the fatality rate is,” said Chun Eun-mi, a respiratory disease specialist at Ewha Womans University Medical Center in Seoul.

Experts also warn inconsistencies may need to be addressed as authorities figure out the best path to follow.

During a previous round of social distancing, many South Korean newspapers mocked the strangely specific guidelines for Seoul fitness centers, which were prohibited from playing music with a tempo higher than 120 beats per minute. Joggers were also prevented from running faster than 6 kph on the treadmill.

More recently, Korean baseball fans are the ones questioning the rules against cheering. Why are they allowed to attend baseball games, they ask, but remain forbidden to vocally support their team?

South Korean officials insist that cheering may be allowed during future rounds of opening up.

For now, South Korea’s prime minister asked fans, “please reduce your shouts by just a little.”

Lee Juhyun contributed to this report.

 
…

The “end of coal” is in sight, according to Britain — the host of the COP26 climate summit — after dozens of countries pledged to stop using coal and end the financing of fossil fuels. But as Henry Ridgwell reports from the Glasgow summit, weaning economies off coal won’t be easy — even for Britain itself.

Camera: Henry Ridgwell
…

Congressional Democrats this week proposed an addition to U.S. President Joe Biden’s climate and social spending legislation that would allow Medicare, the federal government’s health care program for older Americans, to negotiate with drugmakers over the cost of certain prescription medications.

U.S. consumers pay higher prices for prescription medications than almost any of their peers in the developed world, a fact that generations of politicians and advocates have struggled in vain to change. If passed, the proposal working its way through Congress would make a dent, though a relatively small one, in that long-standing problem.

The plan being discussed would give Medicare officials the ability to negotiate pricing on a sliver of the thousands of prescription medications on the market in the United States, beginning with about 10 drugs and capped at 20. Liberal members of Congress at first had hoped to grant Medicare authority to negotiate the prices of up to 250 costly drugs every year.

Though small, the number of drugs that would be covered by the proposal represents a disproportionate amount of the annual “spend” on drugs by Medicare patients.

A study by the Kaiser Family Foundation released this year determined that the 10 top-selling drugs covered under Medicare Part D accounted for 16% of net total spending in 2019. The top 50 drugs — representing just 8.5% of all drugs covered under the program — accounted for 80% of spending.

The top 10 drugs, according to the Kaiser Family Foundation include “three cancer medications, four diabetes medications, two anticoagulants and one rheumatoid arthritis treatment.”

Confusing system 

Unlike many countries outside the U.S., where the government is able to negotiate drug prices and bring down the cost for a single national health care system, the landscape in the U.S. is highly fragmented. Most Americans with health insurance are covered by policies issued by for-profit companies in the private sector.

Americans 65 years and older are eligible for Medicare, which takes the place of a private insurer, but with some critical differences. For many years, Medicare did not offer prescription drug coverage, forcing Medicare patients to pay for medications out of pocket or seek third-party insurance coverage for their medications.

In 2003, Congress created Medicare Part D, under which private insurers offered medication coverage that met minimum requirements established by the federal government. While that program reduced costs for many seniors, cost-sharing provisions and design flaws mean that many recipients continue to face financially crippling bills for medication. A key reason is that each insurance provider must negotiate prices with drug companies individually, rather than using the bargaining power of the entire Medicare population to insist on lower costs.

‘Subsidizing R&D for the world’ 

For years, advocates for change have pointed out that drug companies set prices in the U.S. far above those in other countries in which they sell the same drugs. A study by the Rand Corporation this year comparing the U.S. with 32 other countries found that drugs cost on average 256% more in the U.S.

“American consumers are subsidizing the R&D for the world,” said Lovisa Gustafsson, vice president of the Controlling Health Care Costs program at the Commonwealth Fund, a think tank in Washington, D.C.

Compounding the problem is that Americans also shoulder a much greater share of the cost for their prescription medications.

“Patients in the U.S. face far higher cost-sharing than in a lot of other countries. So, just because they have insurance doesn’t mean that patients can actually afford the drugs that they need currently,” Gustafsson said. “There’s survey after survey showing that 20% to 25% of Americans can’t afford the drugs they’re prescribed by their physician, or split pills, or don’t get the prescription filled, because they just can’t afford it. And that’s even when they have insurance.”

Putting a lid on costs

An important element of the proposal before Congress is that it would place an annual cap of $2,000 on the co-payments that Medicare patients can be charged for their medications.

The prospect of a cap on out-of-pocket costs was well-received by many calling for reforms, such as AARP, a large advocacy group for older Americans.

“There’s no greater issue affecting the pocketbooks of seniors on Medicare than the ever-increasing costs of prescription drugs,” AARP CEO Jo Ann Jenkins said in a statement. “For decades, seniors have been at the mercy of Big Pharma. Allowing Medicare to finally negotiate drug prices is a big win for seniors. Preventing prices from rising faster than inflation and adding a hard out-of-pocket cap to Part D will provide real relief for seniors with the highest drug costs.”

Drug firms unhappy

PhRMA, a powerful trade group representing the pharmaceuticals industry, reacted unhappily to news of the proposal.

“If passed, it will upend the same innovative ecosystem that brought us lifesaving vaccines and therapies to combat COVID-19,” PhRMA President and CEO Stephen J. Ubl said in a statement. “Under the guise of ‘negotiation,’ it gives the government the power to dictate how much a medicine is worth and leaves many patients facing a future with less access to medicines and fewer new treatments.”

“While we’re pleased to see changes to Medicare that cap what seniors pay out of pocket for prescription drugs, the proposal lets insurers and middlemen like pharmacy benefit managers off the hook when it comes to lowering costs for patients at the pharmacy counter,” Ubl continued. “It threatens innovation and makes a broken health care system even worse.”

Industry claims exaggerated?

Numerous supporters of allowing the government to negotiate on drug prices claim that the industry’s insistence that it will stymie innovation is exaggerated.

One piece of evidence they point to is a study released by the Congressional Budget Office in August. The CBO created a model in which pharmaceutical companies were faced with the following scenario: A policy is put in place that reduces the return on their most profitable drugs by 15% to 25%.

The agency estimated that the impact would be a reduction of the number of new drugs coming onto the market by only one-half of 1% over the first 10 years of the new policy. That would increase to as much as an 8% reduction in the first three decades of the program.
…