Pre-sex HIV drug ‘no-brainer” for NHS

Published by:

A drug to dramatically cut the risk of HIV infection during sex would save the UK around £1bn over the next 80 years, say scientists.

The team at University College London says Prep, or pre-exposure prophylaxis, is a “no-brainer” for the NHS.

The study predicts that giving Prep to men who have sex with men would prevent one in four HIV cases.

NHS England is currently funding a trial of Prep in 10,000 patients, but does not offer the treatment routinely.

Prep is already available in Scotland. The health service in England fought against paying for Prep in the courts, but agreed to trialling it in selected clinics.

Media playback is unsupported on your device

Preventive pills

Prep disables HIV before it gets a stranglehold in the body and trials show it can cut the risk of being infected by up to 86%.

The financial analysis, published in the Lancet Infectious Diseases, looked at the cost-effectiveness of a national roll-out of Prep, focusing on the highest risk group – men who have sex with men.

It showed offering Prep would cost the NHS money initially as it paid for both Prep and lifelong care for people already infected with HIV.

It could take up to 40 years to become cost-effective, when savings from the falling number of new HIV cases equal the cost of Prep.

Eventually, after 80 years, the pills would deliver a saving of £1bn, say the researchers.

Dr Alison Rodger, part of the UCL team, told the BBC: “Not only is it a highly effective treatment, it will save money. It’s a no-brainer so it’s a good thing to do.”

The researchers’ mathematical model predicted:

  • In the first year Prep was available, 4,000 men would start taking it, rising to 40,000 within 15 years
  • Men would take Prep for 4.5 years on average
  • Men would take two pills before sex, followed by one-a-day until they had gone two days without condom-less sex
  • Men would average five pills a week

It is still cost-effective with a daily Prep pill, but it takes longer to become cost-effective. Both options are being investigated as part of the NHS England trial.

The other major unknown is the long-term cost of the drugs, which may fall as cheaper alternatives become available.

Dr Michael Brady, medical director at the Terrence Higgins Trust, said: “It is important that all who need Prep can access it, and evidence like this reinforces the need for Prep to be fully commissioned and given a long-term, sustainable home on the NHS in England.”

Dr Paul Revill, from the centre of health economics at the University of York, said the NHS needed to be “far sighted [and] invest now and reap long-term gains”.

He added: “With a combination of frequent HIV testing, immediate treatment, and Prep availability, there is now the prospect of bending the curve of new HIV infections downwards in a way that did not seem feasible just a few years ago.”

A spokesperson for NHS England said: “The Lancet study makes an important contribution to the growing evidence for cost effectiveness of PrEP, highlighting the factors which will determine this, such as price and duration on PrEP.”

Follow James on Twitter.

Six fishermen missing in capsize off Australian coast

Published by:

Six fishermen are missing after their trawler capsized and sank off the east coast of Australia.

A seventh man managed to survive being stranded for about 12 hours in waters near the Queensland town of Seventeen Seventy, according to authorities.

He survived by clinging to the boat’s hull before treading water until he was seen by a passing yacht, local media said.

Search teams have found debris but no trace of the missing men.

The 17m (55ft) commercial fishing trawler, Dianne, capsized at 19:30 local time on Monday (09:30 GMT) and sank about five hours later.

The Courier Mail newspaper named the rescued man as Ruben McDornan, and reported that he had heard crewmates trying to escape the vessel after it capsized.

Mr McDornan was saved on Tuesday morning after a yacht crew heard his cries for help.

“It was only through sheer luck that a passing couple on a yacht managed to hear the screams of the individual that was rescued,” said Queensland police Sgt Jeff Barnett, the search co-ordinator.

“If it had not been for that we still wouldn’t know.”

Police said they had not detected any emergency transmissions or beacons from the vessel.

Wet weather hindered the search on Tuesday. Search vessels, aircraft and local trawlers returned to the area on Wednesday.

French magazine accused of glorifying rock-star murderer

Published by:

A leading French music magazine has responded to criticism for making a rock star who killed his girlfriend its cover star.

Les Inrockuptibles placed Bertrand Cantat, who beat actress Marie Trintignant to death in 2003, on its front page last week.

In a statement, it said its choice was “debatable”, and expressed “sincere regrets” to “those who felt hurt”.

France’s Elle magazine responded with a editorial tribute to Ms Trintignant.

Under the headline “In the name of Marie”, it said its words were for “all women victims of violence” carried out by men.

Cantat, who was released from prison in 2007, is trying to relaunch his music career with a new solo album.

Les Inrockuptibles said it had been covering Cantat since the 1980s and its history was built on his old band, Noir Desir. It justified its coverage by saying the article tackled controversial issues, such as “Did Cantat have the right to a public life after having killed Marie Trintignant with his fists?”

The magazine said it had received many complaints.

One Twitter user said Les Inrockuptibles “should apologise to the Trintignant family”.

The controversy coincided with the Harvey Weinstein scandal, which has seen the US producer accused of multiple assaults against women and which has also provoked a big reaction in France.

On Monday, Gender Equality Minister Marlène Schiappa set out plans for new laws to crack down on sexual violence.

She said a taskforce of politicians would work with police and magistrates to establish what sort of behaviour constituted sexual harassment.

“The idea is that society as a whole redefines what it is acceptable or not,” she told La Croix newspaper.

French Twitter users have also been using #balancetonporc, meaning “rat on your dirty old man”, to encourage women to name and shame their attackers.

First Lady Brigitte Macron has praised women for “breaking the silence”.

On Sunday, President Emmanuel Macron said that he would be stripping Harvey Weinstein of the prestigious Legion d’honneur award.

Elle magazine’s editorial retort also applauds the “courage” of the Hollywood figures who have spoken out against Harvey Weinstein in light of the recent allegations.

Les Inrockuptibles also noted the Weinstein allegations in its letter to readers, published on Tuesday, adding that it has always strived “to relay feminist ideas”.

“It was important for us to tell you that,” it said, signing off.

Media playback is unsupported on your device

‘Go to the dentist and get fined £100’

Published by:

Going to the dentist is something that many would want to avoid – but how about if you also faced a penalty fine?

More than 40,000 people a year in England are getting fines of £100 – from an automated system that dentists say is hitting the most vulnerable.

They warn that people such as dementia sufferers are unfairly getting caught up in a system meant to stop fraudsters from getting free treatment.

The NHS accepts there is a problem with errors and is promising changes.

The fines, about £4m per year, are being applied by a random screening process that checks on whether people going to the dentist are really eligible for free treatment.

But dentists say rising numbers of people with dementia, or those with learning difficulties, are being unfairly fined for something as simple as ticking a wrong box in confusing paperwork.

When these have been challenged, about 90% have been overturned as having been incorrectly applied.

The British Dental Association says the problem seems to be increasing and with an ageing population is only likely to get worse.


Why dentists are complaining

Charlotte Waite, a senior dentist working in Loughborough, Leicestershire, says this is a problem appearing on a “daily basis”.

“This has become a significant barrier to care. It can cause a lot of distress if people feel they are seen as fraudulent,” she says.

Mrs Waite, vice-chair of the British Dental Association’s England community dental services committee, is leading a campaign to stop a wave of fines for elderly and frail people, those with dementia or learning difficulties, who have made honest mistakes when filling in forms about free care.

She says even when patients are eligible for free treatment, an incorrect description of specific benefits or failure to renew documents can trigger a penalty fine, which rises to £150 if there is a delay in payment.

And she says because it typically affects vulnerable and often low-income families, there has been a lack of a “powerful advocate” to raise the issue.

Many such patients will be brought to the dentist by a carer, and Mrs Waite says they might not have the detailed information about types of benefit and exemption certificates.

She says this becomes a dilemma for dentists, whether to turn away patients or to treat them and then risk that they will face a fine.

Patients might turn up for the dentist and go away again without treatment because of confusion over benefits and entitlements and worries about being fined.

“I feel very strongly that clinical time should be spent on clinical work,” she says, rather then trying to navigate the benefits system.

“It’s an extreme waste of clinical time.

“We really need to sort this out now.”


What dentists say they’ve seen

  • “This patient has severe learning disabilities and cannot communicate verbally.

“They were fined twice over an 18-month period, due to the change in exemption and Mum accidently putting the wrong thing on the form.

“Mum was having a bad year and the patient had suffered a few health problems, and these fines were very upsetting and caused lots of anxiety.

“We did manage to get the fines turned around, but this took long periods of time and many phone calls and a letter. We were constantly up against a brick wall.”

  • “A vulnerable adult who has a valid certificate – which he brought in for us to see and the number was recorded correctly – was sent a fine for £100 saying he was claiming free treatment incorrectly.

“He contacted me in quite a panic and I had to reassure him and request that he brought in the paperwork to me to see, I completed the appeal form for him as he was entitled to claim free dental care.

“The appeal form that needed sending back was quite a complex letter, and I think our patient would have struggled to respond to it without help.

“I felt it was most unfair for him to have to go through that.”

  • “I had a patient whose parents didn’t realise her exemption certificate had expired, only to be fined.

“I phoned on her behalf, but they would not accept my word regarding the patient’s special needs and wanted a letter from the patient’s doctor.

“It took three weeks for the patient to get in to see the doctor as it wasn’t urgent. All I could get was a deferral in increasing the fine [for non-payment] while the patient waited for a letter from her doctor.”


What the NHS wants to do in response

The NHS Business Services Authority, which oversees the fining system, accepts there is a problem and is looking for a way to make improvements.

A spokeswoman says no-one wants vulnerable people to be unfairly fined or for dentists to waste valuable clinical time.

The checks have an important role in making sure free treatment isn’t being unfairly accessed by those who should pay.

The screening system compares what people have put on forms at the dentist against two databases of information about benefits and entitlements – and if these do not match, the fining system generates a penalty notice.

The most recent figures suggest almost 120,000 fines have been issued over the past three years.

But the British Dental Authority says when 30,000 of these fines were checked, almost 90% were overturned, suggesting the scale of the error in the system.

  • The NHS says it will run a national awareness-raising campaign, so people will have a much better understanding of who is entitled to free dental treatment
  • There are plans for simpler forms and clearer information, particularly for vulnerable patients

“We want to make sure that patients, particularly those who struggle with literacy, understand if they are entitled to receive free dental treatment or if they should pay,” says a NHS Business Services Authority spokeswoman.

“We recognise the importance of information and access to it for everyone.”

Rio Tinto charged with fraud by US authorities

Published by:

British-Australian mining giant Rio Tinto and two of its former executives have been charged with fraud in the US, accused of hiding losses by inflating the value of African coal assets.

It bought the Mozambique assets in 2011 for $3.7bn (£2.8bn) and sold them a few years later for $50m.

The mining company has said it will “vigorously defend” the charges.

The firm was also fined £27m by UK authorities for breaching disclosure rules over the African coal purchase.

Both the US and UK actions relate to the Mozambique investment made by the mining firm six years ago.

A lawsuit filed in the US accuses Rio Tinto, its former chief executive Thomas Albanese and ex-chief financial officer Guy Elliott of failing to follow accounting standards and company policies to accurately value and record the assets.

The US Securities and Exchange Commission argues that soon after the deal was completed, Rio Tinto learned that the projects would produce less coal, and of a lower quantity, than expected.

“Rio Tinto’s top executives allegedly breached their disclosure obligations and corporate duties by hiding from their board, auditor, and investors the crucial fact that a multi-billion dollar transaction was a failure,” SEC Enforcement Division co-director Stephanie Avakian said in a statement.

By making misleading claims the Anglo-Australian miner – one of the world’s largest – was able to raise $5.5bn from US investors, the SEC said.

Rio Tinto said it “intends to vigorously defend itself against these allegations”.

The firm added in a statement it believes the “SEC case is unwarranted and that, when all the facts are considered by the court, or if necessary by a jury, the SEC’s claims will be rejected.”

Largest ever UK fine

The miner separately reached a settlement with UK regulators for disclosure failures tied to the Mozambique investment.

It agreed to pay the Financial Conduct Authority £27 million to settle claims that it breached accounting rules in connection with the African coal assets.

The FCA said the fine is the largest ever imposed on a firm for a listing-rules breach.

Crews push to contain California fires, search for bodies

Published by:

SANTA ROSA, Calif. (Reuters) – Crews fought their way across rugged, steep terrain on Tuesday in a push to gain full control of the deadliest wildfires in California history, as search-and-rescue teams picked through an ashy moonscape of destroyed homes looking for victims.

Though a dozen major blazes were still burning across the region, where 5,700 homes and businesses, some of them wineries, have been gutted, fire officials said they were gaining confidence they had finally gained the upper hand against the flames.

“There are still some concerns that if the west winds come up or we get some erratic winds they could push our lines, but as of right now we’re looking pretty good,” Steve Crawford, a fire operations chief, told reporters at a briefing in Sonoma County in the heart of California’s celebrated wine country.

At the same time, teams of searchers were moving house to house through neighborhoods where little was left standing, picking through ash and rubble to recover the bodies of those who did not make it out in time.

Already 41 people have been confirmed killed in the fires, which erupted last week and were driven by dry, hot winds into Northern California communities, giving residents little or no chance to escape.

Law enforcement officials said 63 people remained missing or unaccounted for in Sonoma and Napa counties.

Most of the over 1,900 people listed in missing-persons reports have turned up safe, including evacuees who failed to alert authorities after fleeing their homes, but authorities still fear they may find more charred bodies as they move into previously inaccessible areas.

Tens of thousands of people remained displaced. Many would return to find nothing left, leaving them to hastily make alternative plans for shelter.

DEADLIEST FIRE ON RECORD

Kevin Klotter, who owns Valley Quail Vineyard in Mendocino County, said his home and two barns were burned to the ground on his 6.5-acre (2.63-hectare) property, but that he had managed to harvest 22 tons of grapes before the fire fame.

“Miraculously, the vineyard survived,” Klotter said, adding that his insurance company was paying for his family to stay in a motel in nearby Ukiah.

An airplane drops fire retardant while battling the Wilson Fire near Mount Wilson in the Angeles National Forest in Los Angeles, California, U.S. October 17, 2017. REUTERS/Mario Anzuoni

As for the long term, he said, he and his wife Bree would buy a recreational vehicle to live in while they rebuild at estimated cost of $700,000.

Fire officials said investigators were working to determine the cause of each blaze.

Light winds on Tuesday helped a small army of 11,000 firefighters gain more control of the flames, which have blackened more than 245,000 acres (86,200 hectares), an area more than five times the size of Washington, D.C.

The Tubbs fire near the community of Calistoga was 82 percent contained as of Tuesday afternoon and the Atlas fire to the southeast was 77 percent contained, according to the California Department of Forestry and Fire Protection (Cal Fire), the state’s firefighting agency.

Slideshow (24 Images)

The Nuns Fire, located in Sonoma County and now the state’s largest blaze, was 68 percent contained.

Fire officials, employing more than 960 fire engines, 30 air tankers and 73 helicopters, hoped the blazes would be fully contained by Friday.

Rain was also forecast for later in the week, bringing relief from dry conditions, although fire officials said that a storm could also stir up unfavorable winds.

Sutter Santa Rosa Regional Hospital, which had to evacuate last week, reopened on Tuesday morning, the Sonoma Sheriff’s Department said.

The wildfires are California’s deadliest on record, surpassing the Griffith Park fire of 1933 in Los Angeles, which had 29 deaths.

About 30 vintners sustained some fire damage to wine-making facilities, vineyards, tasting rooms or other assets, according to the industry group Napa Valley Vintners.

About 90 percent of Napa’s grape harvest had been picked and escaped exposure to smoke that could have tainted the fruit.

Still, the toll taken on the region has thrown the wine industry into disarray. The group’s spokeswoman, Patsy McGaughy, said the 2017 Napa vintage would likely be smaller than previously expected.

Reporting by Jim Christie in Santa Rosa, Brendan O’Brien in Milwaukee, Chris Kenning in Chicago and Dan Whitcomb in Los Angeles; writing by Dan Whitcomb; editing by Jonathan Oatis, Peter Cooney and G Crosse

China’s President Xi says will continue years-long war on smog

Published by:

BEIJING (Reuters) – China will keep up its years-long battle against smog to ensure “blue skies” and promote a “revolution” in clean energy, President Xi Jinping said on Wednesday at the opening ceremony of a key Communist Party congress.

Improving the notoriously toxic air across the northern regions of the world’s second-largest economy has been a cornerstone of Beijing’s economic and social policy in recent years.

China has ordered factories to cut output in a bid to enforce bigger emission cuts in coming months and avoid a repeat of the near-record levels of choking smog that enveloped key northern areas at the start of the year.

In the long term, it has also launched a series of measures to curb the use of coal, the nation’s favorite fuel, and boost use of renewable power, like wind and solar.

The government will also take measures to improve rural areas by restoring soil and waterways, Xi added, as China moves to modernize its vast agricultural sector.

Reporting by Christian Shepherd and Stella Qiu; Writing by Josephine Mason; Editing by Paul Tait and Clarence Fernandez

Portugal’s government faces no-confidence vote over forest fires

Published by:

LISBON (Reuters) – A Portuguese opposition party launched a motion of no-confidence in the Socialist government on Tuesday over its failure to prevent the loss of human lives in this week’s lethal wildfires, the second such disaster in four months.

Hundreds of fires have raged across northern and central Portugal since Sunday after the driest summer in nearly 90 years, killing at least 41 people and overwhelming fire-fighting and rescue services.

The fires were dying down on Tuesday under the first real rain since June, when an even deadlier forest blaze – Portugal’s worst disaster in living memory – killed 64 people.

The no-confidence motion proposed by the small center-right CDS-PP party is largely symbolic as the minority Socialist government is backed in parliament by two left-wing parties. They have only to abstain for such a vote to fail.

But it comes amid growing public criticism of Socialist Prime Minister Antonio Costa’s government over the perceived slowness of its response to the disaster. The government has so far enjoyed strong approval ratings due to an improving economy.

“There has been a grave failure to fulfil the most basic duty of the state – to protect the lives of the people,” CDS-PP leader Assuncao Cristas told reporters in proposing the no-confidence vote.

Her criticism was amply echoed in Portuguese media and on social networks.

A date for the vote of no-confidence can only be set after Cristas has formally submitted the motion to parliament.

A woman walks through the burnt forest in Vila Nova, near Vouzela, Portugal October 17, 2017. REUTERS/Pedro Nunes

THREE DAYS OF MOURNING

The government, which says the fires are due to an extraordinary spell of unusually dry weather, has declared three days of public mourning starting on Tuesday.

Slideshow (15 Images)

A report on the June fire pointed to failures in response times by emergency services and poor coordination by firefighters, in addition to a breakdown of communications networks used by the civil protection agency.

Costa, who visited the affected areas on Tuesday, said in a televised address to the nation on Monday that he would not sack his interior minister, but he promised reforms, adding: “Nothing will stay the same after this year.”

The parliamentary head of the center-right opposition Social Democrats, Hugo Soares, said on Tuesday that Costa’s statement was an “insult to the intelligence” of the Portuguese people and that he had to take political responsibility for the fires.

The latest blazes have brought the total area burned in Portugal this year to 350,000 hectares, the worst since 2003, making the country by far the worst hit by fires this year in the European Union.

In neighboring Spain, a much larger country which has also suffered fires in the past few days, only 88,000 hectares have burnt this year, EU data show.

The fires at the weekend also destroyed one of Portugal’s oldest pine forests, whose trees were used to make the ships that carried Portuguese explorers around the globe during their voyages of discovery in the 15th and 16th centuries.

Reporting by Axel Bugge and Andrei Khalip; Editing by Gareth Jones

Deforestation drops for first time in three years in Brazil’s Amazon

Published by:

BRASILIA (Reuters) – Deforestation in Brazil’s Amazon fell 16 percent in the year to July 2017 compared to the same period a year prior, the first decline in three years, the country’s environment minister said on Tuesday.

Reasons for the decline included stepped-up enforcement and refinements in real-time monitoring that allow for rapid response to deforestation, Minister Jose Sarney Filho told a news conference at the presidential palace in the capital, Brasilia.

However, Paulo Barreto, a senior researcher for non-profit Amazon institute Imazon, said economic recession in Brazil and a drop in livestock prices were likely the major cause for the decline. The cattle industry is a major contributor to deforestation.

The Amazon, the world’s largest tropical rainforest, soaks up vast amounts of carbon and is seen as vital to the fight against climate change.

PRODES satellite data, which serves as the official government benchmark, showed 6,624 square kilometers (2,558 square miles) of forest were destroyed between August 2016 and July 2017, compared to 7,893 square kilometers in 2015/2016.

The rate remains well above the 4,571 square kilometers deforested in 2012, which was the low since records began in 2004/2005.

A man’s foot is seen covered in sawdust after he cut down a tree in a forest near the municipality of Itaituba, Brazil August 7, 2017. Picture taken August 7, 2017. REUTERS/Nacho Doce

“Surveillance and control help, but it is not a solution. We will only end deforestation when we value the standing forest,” Sarney said.

“But we are reaching the limit. If we do not fulfill international agreements, especially for payment for environmental services, it will be very difficult to maintain the fall in deforestation,” he said, referencing a system of payments to landowners in exchange for maintaining forest on their property.

Slideshow (2 Images)

Environmentalists said the fall was important but it was too soon to celebrate.

Deforestation needs to fall much further in order for Brazil to meet its climate change targets, said Alfredo Sirkis, general coordinator for the Brazil Forum for Climate Change.

Deforestation must fall to an annual loss of no more than 4,000 square kilometers by 2020 to meet a climate change target known as a nationally appropriate mitigation action (NAMA), a concept adopted in connection with the 2009 Copenhagen Accord, said Sirkis, a former politician and co-founder of Brazil’s green party.

“At least we can say the curve has inverted, but there’s lots of stuff to do, and we have to try harder,” Sirkis said.

Reporting by Jake Spring, Additional reporting by Anthony Boadle, Lisandra Paraguassu and Leonardo Goy, Editing by Rosalba O’Brien

Bloody spectacle: Indonesian villages pit wild boars against dogs

Published by:

CIKAWAO, Indonesia (Reuters) – A gory fight to the death between snarling dogs and captured wild boars.

Gathered around a bamboo-walled arena, Indonesians in this remote part of Java island seem eager to watch the blood-curdling contests, known locally as ‘adu bagong’ (boar fighting). (Click reut.rs/2ynD5bl for a picture essay of these dog and boar fights)

Not surprisingly, animal rights activists are up in arms against the regular spectacle, which began in the 1960s when wild pig numbers in this area in West Java soared and they were hunted to protect crops.

Participants told Reuters the fights were a way to preserve a tradition of hunting in the area. There’s also a cash prize of up to $2,000 for the winning dog.

“It used to be very simple, not like now when the dogs are trained,” said Nur Hadi, head of Hiparu, a group of hunting dog enthusiasts that takes part in the fights.

“From there it’s been handed down and has even become part of tradition and culture,” Hadi told Reuters.

He defends the practice against criticism from animal rights groups, who say it should be banned.

A dog and wild boar fight during a contest, known locally as ‘adu bagong’ (boar fighting), in Cikawao village of Majalaya, West Java province, Indonesia, September 24, 2017. REUTERS/Beawiharta SEARCH “BOAR FIGHT” FOR THIS STORY. SEARCH “WIDER IMAGE” FOR ALL STORIES.

“It is a criminal act against animals,” said Indonesian animal rights activist Marison Guciano.

“The government and NGOs should go to the field to stop this event and educate the people that dog fighting is not right.”

Slideshow (25 Images)

The fights take place in a 15-by-30 meter (50 ft by 100 ft) arena surrounded by a bamboo fence to protect spectators, and only end when one of the animals is injured.

Participants say the contests test the agility and hunting abilities of the dogs. If a boar survives a fight, once healed it will be returned to the arena to fight another day. If not, it will be butchered and sold for meat.

Dog breeder Agus Badud says the tradition also gives people a source of income.

“I take part in this contest to increase the selling price and economic value of my dogs, and it would be useless for me as a breeder if I did not participate in a contest like this,” Badud said in his house where he keeps 40 dogs.

Dog owners pay anywhere from 200,000 rupiah to 2 million rupiah ($15 to $150) to enter the fights, depending on the size of their dog.

Reporting by Tommy Ardiansyah and Johan Purnomo; Writing by Fergus Jensen; Editing by Shri Navaratnam