• When Israel Bombed AP’s Gaza Office

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    ***

    Wednesday was Nakba Day—the day commemorating the expulsion of 750,000 Palestinians with the creation of Israel, in 1948—but there was another anniversary worth remembering. The day a foreign country bombed the offices of a major U.S. press outlet, accusing it, without evidence, of harboring terrorists. And a significant portion of the US media spun the story to support the foreign country.

    On May 15, 2021, as part of its “Operation Guardian of the Walls” military campaign in Gaza, Israel bombed the Associated Press offices’ building, based on the still evidence-free claim that the AP headquarters “housed Hamas”. According to the Committee to Protect Journalists, the week prior, IDF bombed two other office buildings that “housed more than a dozen international and local media outlets.”



    Israeli Defense Forces (IDF) gave the tenants of the al-Jalaa Building in Gaza—which included AP, other news agencies including Al-Jazeera, and residential homes—a stern warning. IDF informed them they had one hour to evacuate their homes before the building would be bombed by Israeli missiles. Sixty minutes and three Israeli missiles later, the 12-story building was leveled to the ground.

    The IDF posted a short vague statement that provided no evidence for their claim the building was being used by terrorists but made sure to repeat the term “Hamas terror organization” four times, in just four sentences—five times if you count “Hamas military intelligence” in the headline.



    The AP’s CEO at the time, Gary Pruitt, said the news agency had been in the building for 15 years and “we have had no indication Hamas was in the building or active in the building.”

    So could Israel have been lying? Well, retired US Army colonel and former chief of staff to Secretary of State Colin Powell, Lawrence Wilkerson seems to think so.



    Let me let me preface these remarks with I never, never, ever believe Israeli figures. I’ve been in the government too long to know that the Israelis are patent liars in their intelligence community, in their propaganda community, certainly, and in their leadership. They are inveterate liars. Let me say that again. They are liars. So you can’t believe anything that comes out of Jerusalem. It’s all propaganda.

    The fact that Israel lied to the international press just one week prior about a fake ground invasion, to trick Hamas into giving up their positions, doesn’t help Israel’s case. On the contrary, it clearly shows that Israel puts military victory over truth, and has no respect for the press.



    Israeli military spokesman Lt. Col. Jonathan Conricus claimed that “Hamas used the building for a military intelligence office and weapons development” but “could not provide evidence” to back up the claims without “compromising” intelligence efforts.

    This “trust me I have the evidence” bullshit is reminiscent of the false narrative that fueled the 2003 Iraq War and the more recent Trump/Russia hoax. Such a pathetic cover story is enough to make most conservatives cringe but ultimately, many conservatives were tricked into celebrating anti-American terrorism—the bombing of civilian infrastructure that housed an American news outlet.

    A pro-Israel disinformation campaign, attempting to justify the bombing, began at the Washington Free Beacon before spreading across conservative media. The Republican-aligned Beacon has a history of lying and smear campaigns. It was founded by Bil Kristol, famous for helping the Bush admin lie America into the disastrous Iraq War. It went on to fund the Fusion GPS anti-Trump research that would later, under Democrat tutelage, hire Christopher Steele, a crucial source of the Trump/Russia investigation hoax, and more recently, the Beacon reported the Jewish girl “Stabbed in the Eye” hoax as fact.

    On the same day of the AP building bombing, the Beacon published an “exclusive” to defend IDF’s missile attack on the American press in Gaza. It cited two sources: (1) a Twitter post of Beacon contributor Noah Pollak, and (2) an old article published seven years prior in 2014 by Matti Friedman, a former AP reporter, and former IDF soldier.

    Pollack’s Twitter post cited an anonymous source he described as, “a well-placed friend in the IDF,” claiming that the AP office building “contained multiple Hamas operations & offices including weapons manufacturing and military intelligence,” adding that, “The building also housed an Islamic Jihad office. And AP’s local reporters knew about it.”



    “This info will come out soon,” he said.



    Yes, that’s right. He said, “This info will come out soon.” Over three years later now, “this info” supporting his claims still hasn’t come out.

    That alone is enough to completely discredit Pollak. But he’d already proven himself uncredible. He ran the Emergency Committee for Israel (ECI) (another “clown show” created by Kristol) which even the President of the Anti-Defanation League—not exactly an anti-Israel organization—called “misleading, distorted, inaccurate”. He was also caught leading an astroturfed pro-Israel counterprotest on a college campus. (Sounds familiar, doesn’t it?)

    Nevertheless, Pollak’s completely unsubstantiated claims were published immediately by the usual suspects—Fox News, Newsmax, New York Post, etc. The Republican party-aligned outlets also followed the Beacon’s lead, citing its second source, Friedman’s 2014 article.

    Like Pollak, Friedman also had a “well-placed friend” who “suggests there were indeed Hamas offices” in the AP building.




    Oh boy, another anonymous “friend”! Despite sounding so sure of his “intimately familiar with military decision-making” friend’s secret information, Friedman also wrote on Twitter that “Contrary to what I’ve seen attributed to me today, I didn’t write [in 2014] that Hamas operated out of the same building, and don’t know if that’s true”.




    The media citing Friedman typically omitted this. And I couldn’t help but notice that the media sharing his 2014 piece in The Atlantic accusing the AP of bias, and the piece itself failed to mention his own bias—his years of service in the IDF, and his “slightly rosier view of the IDF”, according to The Times of Israel.

    Now pause for just a moment to ponder how insane it is—even if all of Friedman’s disputed 2014 claims were true—to rely on an article written in 2014 by an IDF vet, who worked at AP in 2006-2011, to justify the IDF bombing Associated Press in 2021, for which the IDF itself provided no evidence to justify.

    This is the following 2014 excerpt that made the media rounds after the 2021 bombing:

    “The AP staff in Gaza City would witness a rocket launch right beside their office, endangering reporters and other civilians nearby—and the AP wouldn’t report it, not even in AP articles about Israeli claims that Hamas was launching rockets from residential areas. (This happened.) Hamas fighters would burst into the AP’s Gaza bureau and threaten the staff—and the AP wouldn’t report it. (This also happened.) Cameramen waiting outside Shifa Hospital in Gaza City would film the arrival of civilian casualties and then, at a signal from an official, turn off their cameras when wounded and dead fighters came in, helping Hamas maintain the illusion that only civilians were dying. (This too happened; the information comes from multiple sources with firsthand knowledge of these incidents.)”

    AP’s Director of Media Relations Paul Colford said Friedman’s story was “filled with distortions, half-truths and inaccuracies”, arguing that Israel challenged the AP with as many dangerous obstacles as Hamas and that AP covered both sides of the conflict.

    [Friedman’s] arguments have been filled with distortions, half-truths and inaccuracies…

    Like other media covering this story, we dealt with numerous obstacles, including Hamas intimidation, Israeli military censorship, anti-media incitement on both sides of the border, Hamas rocket fire and intense Israeli airstrikes that made it dangerous and difficult to get around Gaza during the fighting.

    Courageous AP staffers worked around the clock in Gaza, often at the risk of great personal harm. Intense Israeli airstrikes literally shook the high-rise building housing the AP’s office. Two AP employees were ultimately killed in Gaza, and a third critically wounded and maimed. Our body of work included images and stories about Hamas rocket fire from civilian areas, the suffering of the residents of southern Israel living under the threat of rocket, mortar and tunnel-based attacks, Hamas’ summary executions of suspected collaborators, the fears of Gazans to criticize the group, Hamas’ use of civilian areas for cover and the devastation wreaked on Gazan civilians by Israeli airstrikes and artillery attacks.

    Colford confirmed that armed militants entered AP’s offices in the early days of the 2008-2009 Gaza War to intimidate AP but said that AP did not give in to the intimidation.

    Regarding a few specific issues that Mr. Friedman has raised most recently:

    The AP published numerous photos and TV footage of rockets being launched from Gaza City. AP’s Josef Federman and Hamza Hendawi collaborated on an investigation into Hamas’ use of civilian areas for rocket launches, comparing maps obtained from Israeli military intelligence to facts on the ground.

    In the early days of the war, armed militants entered the AP’s offices in Gaza to complain about a photo showing the location of a specific rocket launch. The AP immediately contacted Hamas, which insisted the men did not represent the group. The photo was not withdrawn and the men were never heard from again. Subsequent videos similarly showed rocket launches from within the urban area. Such intimidation is common in trouble spots. The AP does not report many interactions with militias, armies, thugs or governments. These incidents are part of the challenge of getting out the news — and generally not themselves news.

    The Beacon’s “exclusive” was just the beginning. The “trust us we have secret evidence” disinformation campaign continued as the pro-Israel media eagerly forwarded another empty Israeli government claim, from a nameless “senior diplomatic source”, who told the Jerusalem Post of “smoking gun” evidence that Hamas was using the same Gaza building as AP.

    “We showed [the US] the smoking gun proving Hamas worked out of that building,” a senior diplomatic source said. “I understand they found the explanation satisfactory.”

    What evidence? Who exactly did they “show”? I guess we’ll never know!

    If there’s a satisfactory explanation for why IDF bombed an American news agency, you’d think Israel and the US might want to make that known. But they haven’t.

    Israeli Prime Minister Netanyahu repeated the claim of secret “smoking gun” evidence on CBS’s Face the Nation, saying, “We share with our American friends all that intelligence”.

    Hmmm. Netanyahu and U.S. Secretary of State Antony Blinken appear friendly…

    But no, Blinken said he “had not seen any evidence”.

    When asked the next day if he’d received any evidence, Blinken didn’t quite confirm receiving anything. He said, “Um…uh…it’s my understanding that uh, we’ve uh, uh received uh, some further information through, uh, uh intelligence channels.” The only thing he actually confirmed was that it’s “not something that [he] can comment on.”

    WAPO: Yesterday you said the US requested an explanation from Israel about its bombing of a high rise building containing U.S. and foreign media offices. Have you received anything? And what’s your assessment of that?

    BLINKEN: Um. We uh. Did uh. Seek uh. Further information from, uh, Israel on this question. Uh, it’s my understanding that uh, we’ve uh, uh received uh, some further information through, uh, uh intelligence channels. And that’s not something that, that I can comment on.



    Click here to watch the video

    The following month, in June 2021, Israel’s Channel 12 news reported that IDF Lieutenant-General Aviv Kohavi said that the AP’s journalists drank coffee with Hamas each morning in the building’s cafeteria, whether they knew it or not. The AP called the comments “patently false”, noting “there was not even a cafeteria in the building”. Israel’s Defense Minister Benny Gantz told AP that the IDF General was speaking figuratively. However, Gantz, like all the Israeli officials before him, offered AP no evidence to support IDF’s bombing of the news agencies.

    Gantz said Israel has shared its intelligence with the U.S. government. But he indicated that Israel has no intention of making the information public, saying it did not want to divulge its sources.

    As usual, the propaganda was not limited to conservative media. The Democrat Party-aligned television network CNN platformed IDF Spokesperson, Lt. Col. Jonathan Conricus. Asked, “Can you show us the evidence?” Cornicus replied, “That’s in process, and I’m sure that, in due time, that information will be presented.”

    It’s due time to come to grips with the reality that there is no evidence to justify the attack. Israel bombed an American news agency (with an American bomb), and the American government continues to cover for Israel and continues to fund continued death and destruction in Gaza.

    *

    Note to readers: Please click the share button above. Follow us on Instagram and Twitter and subscribe to our Telegram Channel. Feel free to repost and share widely Global Research articles.

    All images in this article are from the author
    When Israel Bombed AP’s Gaza Office All Global Research articles can be read in 51 languages by activating the Translate Website button below the author’s name (only available in desktop version). To receive Global Research’s Daily Newsletter (selected articles), click here. Click the share button above to email/forward this article to your friends and colleagues. Follow us on Instagram and Twitter and subscribe to our Telegram Channel. Feel free to repost and share widely Global Research articles. Global Research Wants to Hear From You! *** Wednesday was Nakba Day—the day commemorating the expulsion of 750,000 Palestinians with the creation of Israel, in 1948—but there was another anniversary worth remembering. The day a foreign country bombed the offices of a major U.S. press outlet, accusing it, without evidence, of harboring terrorists. And a significant portion of the US media spun the story to support the foreign country. On May 15, 2021, as part of its “Operation Guardian of the Walls” military campaign in Gaza, Israel bombed the Associated Press offices’ building, based on the still evidence-free claim that the AP headquarters “housed Hamas”. According to the Committee to Protect Journalists, the week prior, IDF bombed two other office buildings that “housed more than a dozen international and local media outlets.” Israeli Defense Forces (IDF) gave the tenants of the al-Jalaa Building in Gaza—which included AP, other news agencies including Al-Jazeera, and residential homes—a stern warning. IDF informed them they had one hour to evacuate their homes before the building would be bombed by Israeli missiles. Sixty minutes and three Israeli missiles later, the 12-story building was leveled to the ground. The IDF posted a short vague statement that provided no evidence for their claim the building was being used by terrorists but made sure to repeat the term “Hamas terror organization” four times, in just four sentences—five times if you count “Hamas military intelligence” in the headline. The AP’s CEO at the time, Gary Pruitt, said the news agency had been in the building for 15 years and “we have had no indication Hamas was in the building or active in the building.” So could Israel have been lying? Well, retired US Army colonel and former chief of staff to Secretary of State Colin Powell, Lawrence Wilkerson seems to think so. Let me let me preface these remarks with I never, never, ever believe Israeli figures. I’ve been in the government too long to know that the Israelis are patent liars in their intelligence community, in their propaganda community, certainly, and in their leadership. They are inveterate liars. Let me say that again. They are liars. So you can’t believe anything that comes out of Jerusalem. It’s all propaganda. The fact that Israel lied to the international press just one week prior about a fake ground invasion, to trick Hamas into giving up their positions, doesn’t help Israel’s case. On the contrary, it clearly shows that Israel puts military victory over truth, and has no respect for the press. Israeli military spokesman Lt. Col. Jonathan Conricus claimed that “Hamas used the building for a military intelligence office and weapons development” but “could not provide evidence” to back up the claims without “compromising” intelligence efforts. This “trust me I have the evidence” bullshit is reminiscent of the false narrative that fueled the 2003 Iraq War and the more recent Trump/Russia hoax. Such a pathetic cover story is enough to make most conservatives cringe but ultimately, many conservatives were tricked into celebrating anti-American terrorism—the bombing of civilian infrastructure that housed an American news outlet. A pro-Israel disinformation campaign, attempting to justify the bombing, began at the Washington Free Beacon before spreading across conservative media. The Republican-aligned Beacon has a history of lying and smear campaigns. It was founded by Bil Kristol, famous for helping the Bush admin lie America into the disastrous Iraq War. It went on to fund the Fusion GPS anti-Trump research that would later, under Democrat tutelage, hire Christopher Steele, a crucial source of the Trump/Russia investigation hoax, and more recently, the Beacon reported the Jewish girl “Stabbed in the Eye” hoax as fact. On the same day of the AP building bombing, the Beacon published an “exclusive” to defend IDF’s missile attack on the American press in Gaza. It cited two sources: (1) a Twitter post of Beacon contributor Noah Pollak, and (2) an old article published seven years prior in 2014 by Matti Friedman, a former AP reporter, and former IDF soldier. Pollack’s Twitter post cited an anonymous source he described as, “a well-placed friend in the IDF,” claiming that the AP office building “contained multiple Hamas operations & offices including weapons manufacturing and military intelligence,” adding that, “The building also housed an Islamic Jihad office. And AP’s local reporters knew about it.” “This info will come out soon,” he said. Yes, that’s right. He said, “This info will come out soon.” Over three years later now, “this info” supporting his claims still hasn’t come out. That alone is enough to completely discredit Pollak. But he’d already proven himself uncredible. He ran the Emergency Committee for Israel (ECI) (another “clown show” created by Kristol) which even the President of the Anti-Defanation League—not exactly an anti-Israel organization—called “misleading, distorted, inaccurate”. He was also caught leading an astroturfed pro-Israel counterprotest on a college campus. (Sounds familiar, doesn’t it?) Nevertheless, Pollak’s completely unsubstantiated claims were published immediately by the usual suspects—Fox News, Newsmax, New York Post, etc. The Republican party-aligned outlets also followed the Beacon’s lead, citing its second source, Friedman’s 2014 article. Like Pollak, Friedman also had a “well-placed friend” who “suggests there were indeed Hamas offices” in the AP building. Oh boy, another anonymous “friend”! Despite sounding so sure of his “intimately familiar with military decision-making” friend’s secret information, Friedman also wrote on Twitter that “Contrary to what I’ve seen attributed to me today, I didn’t write [in 2014] that Hamas operated out of the same building, and don’t know if that’s true”. The media citing Friedman typically omitted this. And I couldn’t help but notice that the media sharing his 2014 piece in The Atlantic accusing the AP of bias, and the piece itself failed to mention his own bias—his years of service in the IDF, and his “slightly rosier view of the IDF”, according to The Times of Israel. Now pause for just a moment to ponder how insane it is—even if all of Friedman’s disputed 2014 claims were true—to rely on an article written in 2014 by an IDF vet, who worked at AP in 2006-2011, to justify the IDF bombing Associated Press in 2021, for which the IDF itself provided no evidence to justify. This is the following 2014 excerpt that made the media rounds after the 2021 bombing: “The AP staff in Gaza City would witness a rocket launch right beside their office, endangering reporters and other civilians nearby—and the AP wouldn’t report it, not even in AP articles about Israeli claims that Hamas was launching rockets from residential areas. (This happened.) Hamas fighters would burst into the AP’s Gaza bureau and threaten the staff—and the AP wouldn’t report it. (This also happened.) Cameramen waiting outside Shifa Hospital in Gaza City would film the arrival of civilian casualties and then, at a signal from an official, turn off their cameras when wounded and dead fighters came in, helping Hamas maintain the illusion that only civilians were dying. (This too happened; the information comes from multiple sources with firsthand knowledge of these incidents.)” AP’s Director of Media Relations Paul Colford said Friedman’s story was “filled with distortions, half-truths and inaccuracies”, arguing that Israel challenged the AP with as many dangerous obstacles as Hamas and that AP covered both sides of the conflict. [Friedman’s] arguments have been filled with distortions, half-truths and inaccuracies… Like other media covering this story, we dealt with numerous obstacles, including Hamas intimidation, Israeli military censorship, anti-media incitement on both sides of the border, Hamas rocket fire and intense Israeli airstrikes that made it dangerous and difficult to get around Gaza during the fighting. Courageous AP staffers worked around the clock in Gaza, often at the risk of great personal harm. Intense Israeli airstrikes literally shook the high-rise building housing the AP’s office. Two AP employees were ultimately killed in Gaza, and a third critically wounded and maimed. Our body of work included images and stories about Hamas rocket fire from civilian areas, the suffering of the residents of southern Israel living under the threat of rocket, mortar and tunnel-based attacks, Hamas’ summary executions of suspected collaborators, the fears of Gazans to criticize the group, Hamas’ use of civilian areas for cover and the devastation wreaked on Gazan civilians by Israeli airstrikes and artillery attacks. Colford confirmed that armed militants entered AP’s offices in the early days of the 2008-2009 Gaza War to intimidate AP but said that AP did not give in to the intimidation. Regarding a few specific issues that Mr. Friedman has raised most recently: The AP published numerous photos and TV footage of rockets being launched from Gaza City. AP’s Josef Federman and Hamza Hendawi collaborated on an investigation into Hamas’ use of civilian areas for rocket launches, comparing maps obtained from Israeli military intelligence to facts on the ground. In the early days of the war, armed militants entered the AP’s offices in Gaza to complain about a photo showing the location of a specific rocket launch. The AP immediately contacted Hamas, which insisted the men did not represent the group. The photo was not withdrawn and the men were never heard from again. Subsequent videos similarly showed rocket launches from within the urban area. Such intimidation is common in trouble spots. The AP does not report many interactions with militias, armies, thugs or governments. These incidents are part of the challenge of getting out the news — and generally not themselves news. The Beacon’s “exclusive” was just the beginning. The “trust us we have secret evidence” disinformation campaign continued as the pro-Israel media eagerly forwarded another empty Israeli government claim, from a nameless “senior diplomatic source”, who told the Jerusalem Post of “smoking gun” evidence that Hamas was using the same Gaza building as AP. “We showed [the US] the smoking gun proving Hamas worked out of that building,” a senior diplomatic source said. “I understand they found the explanation satisfactory.” What evidence? Who exactly did they “show”? I guess we’ll never know! If there’s a satisfactory explanation for why IDF bombed an American news agency, you’d think Israel and the US might want to make that known. But they haven’t. Israeli Prime Minister Netanyahu repeated the claim of secret “smoking gun” evidence on CBS’s Face the Nation, saying, “We share with our American friends all that intelligence”. Hmmm. Netanyahu and U.S. Secretary of State Antony Blinken appear friendly… But no, Blinken said he “had not seen any evidence”. When asked the next day if he’d received any evidence, Blinken didn’t quite confirm receiving anything. He said, “Um…uh…it’s my understanding that uh, we’ve uh, uh received uh, some further information through, uh, uh intelligence channels.” The only thing he actually confirmed was that it’s “not something that [he] can comment on.” WAPO: Yesterday you said the US requested an explanation from Israel about its bombing of a high rise building containing U.S. and foreign media offices. Have you received anything? And what’s your assessment of that? BLINKEN: Um. We uh. Did uh. Seek uh. Further information from, uh, Israel on this question. Uh, it’s my understanding that uh, we’ve uh, uh received uh, some further information through, uh, uh intelligence channels. And that’s not something that, that I can comment on. Click here to watch the video The following month, in June 2021, Israel’s Channel 12 news reported that IDF Lieutenant-General Aviv Kohavi said that the AP’s journalists drank coffee with Hamas each morning in the building’s cafeteria, whether they knew it or not. The AP called the comments “patently false”, noting “there was not even a cafeteria in the building”. Israel’s Defense Minister Benny Gantz told AP that the IDF General was speaking figuratively. However, Gantz, like all the Israeli officials before him, offered AP no evidence to support IDF’s bombing of the news agencies. Gantz said Israel has shared its intelligence with the U.S. government. But he indicated that Israel has no intention of making the information public, saying it did not want to divulge its sources. As usual, the propaganda was not limited to conservative media. The Democrat Party-aligned television network CNN platformed IDF Spokesperson, Lt. Col. Jonathan Conricus. Asked, “Can you show us the evidence?” Cornicus replied, “That’s in process, and I’m sure that, in due time, that information will be presented.” It’s due time to come to grips with the reality that there is no evidence to justify the attack. Israel bombed an American news agency (with an American bomb), and the American government continues to cover for Israel and continues to fund continued death and destruction in Gaza. * Note to readers: Please click the share button above. Follow us on Instagram and Twitter and subscribe to our Telegram Channel. Feel free to repost and share widely Global Research articles. All images in this article are from the author
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  • Chronic Kidney Disease (CKD) is a long-term condition characterized by a gradual loss of kidney function over time. While there's no cure for CKD, management and treatment strategies aim to slow its progression, manage symptoms, and reduce complications. Here are some comprehensive strategies and approaches for managing CKD:

    Medical Management
    Blood Pressure Control:

    Use of antihypertensive medications such as ACE inhibitors or ARBs, which can also protect kidney function.
    Regular monitoring and maintaining blood pressure within target ranges.
    Blood Sugar Control (for Diabetic Patients):

    Tight control of blood glucose levels to prevent further kidney damage.
    Use of medications like SGLT2 inhibitors and GLP-1 receptor agonists that have renal benefits.
    Cholesterol Management:

    Use of statins or other lipid-lowering agents to reduce cardiovascular risk.
    Anemia Management:

    Use of erythropoiesis-stimulating agents (ESAs) and iron supplements to manage anemia commonly associated with CKD.
    Phosphate and Calcium Balance:

    Use of phosphate binders and vitamin D supplements to maintain bone health and prevent mineral and bone disorder in CKD.
    Lifestyle Modifications
    Dietary Adjustments:

    Low-sodium diet to help control blood pressure.
    Low-protein diet to reduce the kidneys' workload.
    Avoiding high-phosphorus foods to prevent mineral imbalance.
    Maintaining a healthy weight through balanced nutrition.
    Fluid Management:

    Proper hydration while avoiding overconsumption of fluids to prevent swelling and high blood pressure.
    Smoking Cessation:

    Quitting smoking to improve overall cardiovascular health and reduce further kidney damage.
    Regular Exercise:

    Engaging in moderate physical activity to improve cardiovascular health and maintain a healthy weight.

    Monitoring and Follow-Up
    Regular Check-Ups:

    Frequent monitoring of kidney function (e.g., serum creatinine, GFR) and other relevant parameters.
    Regular visits to a nephrologist for specialized care.
    Monitoring for Complications:

    Keeping an eye on signs of worsening kidney function or complications such as fluid overload, electrolyte imbalances, and heart disease.
    Advanced Treatments
    Dialysis:

    Hemodialysis or peritoneal dialysis for advanced CKD when the kidneys can no longer function adequately on their own.
    Kidney Transplant:

    Considering kidney transplantation as a long-term solution for end-stage renal disease (ESRD).
    Education and Support
    Patient Education:

    Providing information on CKD and its management to empower patients to take an active role in their care.
    Educating about the importance of medication adherence and lifestyle changes.
    Support Groups:

    Encouraging participation in support groups for emotional and psychological support.

    Preventive Measures
    Screening for At-Risk Populations:

    Regular screening for individuals with risk factors such as diabetes, hypertension, and family history of kidney disease.
    Early Detection and Intervention:

    Early identification of CKD through routine health checks to initiate timely management and prevent progression.
    Combining these approaches can help manage CKD effectively, improve quality of life, and delay the progression to more advanced stages of the disease. It is essential for patients to work closely with their healthcare providers to tailor a management plan specific to their individual needs and conditions.
    Click Here for More Information: https://tinyurl.com/bd42n8a7

    #kidneydisease #solution #kidneyfunction #CholesterolManagement #bloodsugarcontrol
    Chronic Kidney Disease (CKD) is a long-term condition characterized by a gradual loss of kidney function over time. While there's no cure for CKD, management and treatment strategies aim to slow its progression, manage symptoms, and reduce complications. Here are some comprehensive strategies and approaches for managing CKD: Medical Management Blood Pressure Control: Use of antihypertensive medications such as ACE inhibitors or ARBs, which can also protect kidney function. Regular monitoring and maintaining blood pressure within target ranges. Blood Sugar Control (for Diabetic Patients): Tight control of blood glucose levels to prevent further kidney damage. Use of medications like SGLT2 inhibitors and GLP-1 receptor agonists that have renal benefits. Cholesterol Management: Use of statins or other lipid-lowering agents to reduce cardiovascular risk. Anemia Management: Use of erythropoiesis-stimulating agents (ESAs) and iron supplements to manage anemia commonly associated with CKD. Phosphate and Calcium Balance: Use of phosphate binders and vitamin D supplements to maintain bone health and prevent mineral and bone disorder in CKD. Lifestyle Modifications Dietary Adjustments: Low-sodium diet to help control blood pressure. Low-protein diet to reduce the kidneys' workload. Avoiding high-phosphorus foods to prevent mineral imbalance. Maintaining a healthy weight through balanced nutrition. Fluid Management: Proper hydration while avoiding overconsumption of fluids to prevent swelling and high blood pressure. Smoking Cessation: Quitting smoking to improve overall cardiovascular health and reduce further kidney damage. Regular Exercise: Engaging in moderate physical activity to improve cardiovascular health and maintain a healthy weight. Monitoring and Follow-Up Regular Check-Ups: Frequent monitoring of kidney function (e.g., serum creatinine, GFR) and other relevant parameters. Regular visits to a nephrologist for specialized care. Monitoring for Complications: Keeping an eye on signs of worsening kidney function or complications such as fluid overload, electrolyte imbalances, and heart disease. Advanced Treatments Dialysis: Hemodialysis or peritoneal dialysis for advanced CKD when the kidneys can no longer function adequately on their own. Kidney Transplant: Considering kidney transplantation as a long-term solution for end-stage renal disease (ESRD). Education and Support Patient Education: Providing information on CKD and its management to empower patients to take an active role in their care. Educating about the importance of medication adherence and lifestyle changes. Support Groups: Encouraging participation in support groups for emotional and psychological support. Preventive Measures Screening for At-Risk Populations: Regular screening for individuals with risk factors such as diabetes, hypertension, and family history of kidney disease. Early Detection and Intervention: Early identification of CKD through routine health checks to initiate timely management and prevent progression. Combining these approaches can help manage CKD effectively, improve quality of life, and delay the progression to more advanced stages of the disease. It is essential for patients to work closely with their healthcare providers to tailor a management plan specific to their individual needs and conditions. Click Here for More Information: https://tinyurl.com/bd42n8a7 #kidneydisease #solution #kidneyfunction #CholesterolManagement #bloodsugarcontrol
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  • [Batching.ai x MARBLEX]
    The 2nd Weekly Collaboration

    https://wn.nr/3X5zhtc

    How to Participate

    ① Complete all the listed missions below.
    ② Submit your HAVAH wallet and Metamask wallet addresses for rewards.
    ③ The referral ranking will be based on the amount of entries you collected.

    Schedule

    1) Collaboration Period: April 24th ~ May 1st 07:00 AM (UTC)

    2) Winner Announcement: May 3rd
    [Batching.ai x MARBLEX] The 2nd Weekly Collaboration https://wn.nr/3X5zhtc How to Participate ① Complete all the listed missions below. ② Submit your HAVAH wallet and Metamask wallet addresses for rewards. ③ The referral ranking will be based on the amount of entries you collected. Schedule 1) Collaboration Period: April 24th ~ May 1st 07:00 AM (UTC) 2) Winner Announcement: May 3rd
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  • NEIN zur Legalisierung der Abtreibung – Menschenwürde verteidigen!

    Wie bestellt so geliefert: Die von der lebensfeindlichen deutschen Regierung eingesetzte Kommission für eine Reform des Abtreibungsparagraphen 218 Strafgesetzbuch hat ihren Abschlussbericht vorgelegt, in dem erwartungsgemäß für eine weitgehende Legalisierung von Abtreibungen plädiert wird. Doch in ihrer Radikalität gehen die Vorschläge der Kommission noch weiter als von vielen befürchtet: Ungeborenen Kindern wird grundsätzlich die Menschenwürde und das Recht auf Leben abgesprochen. Wir müssen jetzt unsere Stimme für das Leben erheben, damit die Unmenschlichkeit und Barbarei nicht Gesetz wird!

    https://www.patriotpetition.org/2024/04/20/nein-zur-legalisierung-der-abtreibung-menschenwuerde-verteidigen/
    NEIN zur Legalisierung der Abtreibung – Menschenwürde verteidigen! Wie bestellt so geliefert: Die von der lebensfeindlichen deutschen Regierung eingesetzte Kommission für eine Reform des Abtreibungsparagraphen 218 Strafgesetzbuch hat ihren Abschlussbericht vorgelegt, in dem erwartungsgemäß für eine weitgehende Legalisierung von Abtreibungen plädiert wird. Doch in ihrer Radikalität gehen die Vorschläge der Kommission noch weiter als von vielen befürchtet: Ungeborenen Kindern wird grundsätzlich die Menschenwürde und das Recht auf Leben abgesprochen. Wir müssen jetzt unsere Stimme für das Leben erheben, damit die Unmenschlichkeit und Barbarei nicht Gesetz wird! https://www.patriotpetition.org/2024/04/20/nein-zur-legalisierung-der-abtreibung-menschenwuerde-verteidigen/
    WWW.PATRIOTPETITION.ORG
    NEIN zur Legalisierung der Abtreibung – Menschenwürde verteidigen!
    Die Empfehlungen der Kommission zur §218-Reform sind unannehmbar und ein beispielloser Angriff auf die Heiligkeit des Lebens. 2819 Unterzeichner
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  • Our most recent trip is now on our #YouTube channel-check it out. We find #snow, #ice, #rivers and even a self recovery! Like, subscribe and share please!!! #ARB #BigCountryCustoms #TRED

    Chilliwack Adventure - Farther, Deeper - March 2024 https://youtu.be/PgjexP3VujQ?si=df2-337pCUkjtTj1 via
    @YouTube
    Our most recent trip is now on our #YouTube channel-check it out. We find #snow, #ice, #rivers and even a self recovery! Like, subscribe and share please!!! #ARB #BigCountryCustoms #TRED Chilliwack Adventure - Farther, Deeper - March 2024 https://youtu.be/PgjexP3VujQ?si=df2-337pCUkjtTj1 via @YouTube
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  • PEI Mitarbeiter PACKT AUS! - Alle Risiken wurden BEWUSST ignoriert!!!
    Maximilian Pütz
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    PEI Mitarbeiter PACKT AUS! - Alle Risiken wurden BEWUSST ignoriert!!! Maximilian Pütz https://www.youtube.com/watch?v=WBfjZgNqpZE
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  • Pfizer partnering with Ido Bachelet on DNA nanorobots
    OUTRAGED HUMAN
    “No, no it’s not science fiction; it’s already happening,” said Ido Bachelet to a somewhat incredulous audience member








    https://www.youtube.com/watch?v=MzLTWU2EqP4 Ido Bachelet - Moonshot Thinking


    ... when they cause too much damage by mistake...

    or intentionally...


    5:12

    study your biology and activate targeted medication when necessary.


    5:36

    We also know how to remote-control these robots, using magnetic fields.

    5:40

    Furthermore, we can control them, as you saw in the clip, with a joystick,

    5:43

    directing them to a specific part of the body,

    5:46

    and then activating them with the push of a button.

    5:49

    We have also connected this joystick to the internet.

    5:51

    Our robots have a IP address,

    5:54

    so you can connect with them from afar and activate them online.



    6:01

    Imagine that in a couple of years,

    6:03

    your doctor will be able to sit at home with his smartphone,

    6:05

    and instead of playing "Candy Crush"

    6:08

    he will connect with the robots inside of you,

    6:11

    activate a certain medication and possibly even save you, just in time.

    AND IMAGINE THAT YOU WOULDN'T EVEN KNOW IT, YOU WOULDN'T BE TOLD ABOUT IT.

    AND THAT IN ORDER TO IMPLANT/INJECT IT, YOU WOULD BE TOLD THAT THERE IS A DREADFUL PANDEMIC, AND AT EVERY STEP YOU WOULD BE FORCED TO TAKE IT AS A NECESSARY "VACCINATION." AND A “PCR TEST”.

    BY YOUR GOVERNMENT, THE AIRLINES, THE EMPLOYER, THE WAITER AT THE RESTAURANT, THE FDA, THE EMA, THE WORLD HEALTH ORGANIZATION...

    AND YET IMAGINE THAT MANY PEOPLE WOULD DIE FROM IT, AND THEY WOULD BE YOUR RELATIVES AND FRIENDS.

    BUT YOU WOULD BE THE ONE WHO WOULD HAVE TO PROVE THAT IT WAS BECAUSE OF IT.

    IMAGINE BEING SURROUNDED BY CENSORSHIP, BEING RIDICULED, HAVING YOUR RIGHTS TO DO YOUR JOB, MOVE AROUND, OR EVEN SPEAK THE TRUTH AT ALL TAKEN AWAY FROM YOU....

    ISN’T THIS A BRIGHT FURTURE AND A FANTASTIC REALITY?

    ARE YOU AGAINST SCIENCE? AGAINST PROGRESS? AGAINST PREVENTING DISEASES?



    https://www.nextbigfuture.com/2015/05/pfizer-partnering-with-ido-bachelet-on.html

    Pfizer is cooperating with the DNA robot laboratory managed by Prof. Ido Bachelet at Bar-Ilan University. Bachelet has developed a method of producing innovative DNA molecules with characteristics that can be used to "program" them to reach specific locations in the body and carry out pre-programmed operations there in response to stimulation from the body. This cooperation was revealed in a lecture by Pfizer president of worldwide research and development (WRD), portfolio strategy and investment committee chairman, and executive VP Mikael Dolstein at the IATI Biomed Conference in Tel Aviv being concluded today.

    Research will focus on the possibility that the robots will deliver the medical proteins to designated tissue.

    Bachelet came to Bar-Ilan from the Massachusetts Institute of Technology (MIT) several years ago. At a Tedmed event held two years ago, he explained, "In order to make a nanometric robot, we first of all create a selected DNA sequence, and then fold it using a process called DNA origami. With this method, a person can give a command to a computer, which folds the DNA molecule as needed.

    "The result is that a DNA sequence can be made in the form of a clam, for example, and containing a drug. The DNA molecule, however, contains a code activated upon encountering certain materials in the body. For example, the clam can be designed to change its shape and release the drug only when it meets a cancer cell or the right tissue.

    "In addition, the molecules can receive signals from each other, and can theoretically change their shape according to signals from the body, and can be pre-programmed to attach themselves to one another. In the future, it will be possible to combine each such molecule with a miniature antenna. When the antenna receives an external signal, it will make a small change in the molecule that will make it open or close, and dissipate or connect itself to another molecule."



    In a brief talk, Bachelet said DNA nanobots will soon be tried in a critically ill leukemia patient. The patient, who has been given roughly six months to live, will receive an injection of DNA nanobots designed to interact with and destroy leukemia cells—while causing virtually zero collateral damage in healthy tissue.

    According to Bachelet, his team have successfully tested their method in cell cultures and animals and written two papers on the subject, one in Science and one in Nature.

    Contemporary cancer therapies involving invasive surgery and blasts of drugs can be as painful and damaging to the body as the disease itself. If Bachelet's approach proves successful in humans, and is backed by more research in the coming years, the team’s work could signal a transformational moment in cancer treatment.

    If this treatment works this will be a medical breakthrough and can be used for many other diseases by delivering drugs more effectively without causing side effects.

    2012 Video with answers from George Church, Ido Bachelet and Shawn Douglas on the medical DNA double helix clamshell nanobucket nanobot



    George Church indicates the smart DNA nanobot has applications beyond nanomedicine. Applications where there is any need for programmable and targeted release or interaction at the cellular or near molecular scale.

    2014 Geek Time Presentation from Ido Bachelet



    “AND THE LAST THING I AM GOING TO SCHOW YOU IS… PANDEMIC.

    SO, WE ARE REALLY CONCERNED ABOUT PANDEMICS… ESPECIALLY INFLUENZA PANDEMICS.

    SO THE BEST WAY TO AVOID PANDEMICS OR TO HANDLE PANDEMICS, IS SIMPLY TO KNOW WHERE THE VIRUS IS AND NOT TO BE THERE…

    IT SOUNDS STUPID, BUT IT IS ACTUALLY THE CASE…

    IF YOU COULD IDENTIFY WHERE THE VIRUS IS IN REAL TIME AND YOU CAN CONTAIN THAT AREA, YOU WOULD STOP THE PANDEMIC, YOU WOULD STOP THE DISEASE… OK?


    SO, WHAT WE DEVELOPED IS A SENSOR… COMPOSED OF CARBON NANOTUBES FUNCTIONALIZED WITH ALL KIND OF THINGS… THE SENSOR IS EXTREMELY SENSITIVE… WE’VE BUILT THIS APPLICATION… THEY SEND THEIR GPS COORDINATES TO OUR SERVER SO WE CAN SORT OF RECONSTRUCT A REAL MAP…

    I HOPE YOU ENJOYED THIS AND UNDESTOOND WHAT BIONICS IS ALL ABOUT…

    At the British Friends of Bar-Ilan University's event in Otto Uomo October 2014 Professor Ido Bachelet announced the beginning of the human treatment with nanomedicine. He indicates DNA nanobots can currently identify cells in humans with 12 different types of cancer tumors.

    A human patient with late stage leukemia will be given DNA nanobot treatment. Without the DNA nanobot treatment the patient would be expected to die in the summer of 2015. Based upon animal trials they expect to remove the cancer within one month.

    Within 1 or 2 years they hope to have spinal cord repair working in animals and then shortly thereafter in humans. This is working in tissue cultures.

    Previously Ido Bachelet and Shawn Douglas have published work on DNA nanobots in the journal Nature and other respected science publications.

    One Trillion 50 nanometer nanobots in a syringe will be injected into people to perform cellular surgery.

    The DNA nanobots have been tuned to not cause an immune response.
    They have been adjusted for different kinds of medical procedures. Procedures can be quick or ones that last many days.


    Medicine or treatment released based upon molecular sensing - Only targeted cells are treated

    Ido's daughter has a leg disease which requires frequent surgery. He is hoping his DNA nanobots will make the type of surgery she needs relatively trivial - a simple injection at a doctor's office.

    We can control powerful drugs that were already developed

    Effective drugs that were withdrawn from the market for excessive toxicity can be combined with DNA nanobots for effective delivery. The tiny molecular computers of the DNA nanobots can provide molecular selective control for powerful medicines that were already developed.

    Using DNA origami and molecular programming, they are reality. These nanobots can seek and kill cancer cells, mimic social insect behaviors, carry out logical operators like a computer in a living animal, and they can be controlled from an Xbox. Ido Bachelet from the bio-design lab at Bar Ilan University explains this technology and how it will change medicine in the near future.

    Ido Bachelet earned his Ph.D. from the Hebrew University in Jerusalem, and was a postdoctoral fellow at M.I.T. and Harvard University. He is currently an assistant professor in the Faculty of Life Sciences and the Nano-Center at Bar Ilan University, Israel, the founder of several biotech companies, and a composer of music for piano and molecules.


    Researchers have injected various kinds of DNA nanobots into cockroaches. Because the nanobots are labelled with fluorescent markers, the researchers can follow them and analyse how different robot combinations affect where substances are delivered. The team says the accuracy of delivery and control of the nanobots is equivalent to a computer system.

    This is the development of the vision of nanomedicine.
    This is the realization of the power of DNA nanotechnology.
    This is programmable dna nanotechnology.

    The DNA nanotechnology cannot perform atomically precise chemistry (yet), but having control of the DNA combined with advanced synthetic biology and control of proteins and nanoparticles is clearly developing into very interesting capabilities.

    "This is the first time that biological therapy has been able to match how a computer processor works," says co-author Ido Bachelet of the Institute of Nanotechnology and Advanced Materials at Bar Ilan University.

    The team says it should be possible to scale up the computing power in the cockroach to that of an 8-bit computer, equivalent to a Commodore 64 or Atari 800 from the 1980s. Goni-Moreno agrees that this is feasible. "The mechanism seems easy to scale up so the complexity of the computations will soon become higher," he says.

    An obvious benefit of this technology would be cancer treatments, because these must be cell-specific and current treatments are not well-targeted. But a treatment like this in mammals must overcome the immune response triggered when a foreign object enters the body.

    Bachelet is confident that the team can enhance the robots' stability so that they can survive in mammals. "There is no reason why preliminary trials on humans can't start within five years," he says

    Biological systems are collections of discrete molecular objects that move around and collide with each other. Cells carry out elaborate processes by precisely controlling these collisions, but developing artificial machines that can interface with and control such interactions remains a significant challenge. DNA is a natural substrate for computing and has been used to implement a diverse set of mathematical problems, logic circuits and robotics. The molecule also interfaces naturally with living systems, and different forms of DNA-based biocomputing have already been demonstrated. Here, we show that DNA origami can be used to fabricate nanoscale robots that are capable of dynamically interacting with each other in a living animal. The interactions generate logical outputs, which are relayed to switch molecular payloads on or off. As a proof of principle, we use the system to create architectures that emulate various logic gates (AND, OR, XOR, NAND, NOT, CNOT and a half adder). Following an ex vivo prototyping phase, we successfully used the DNA origami robots in living cockroaches (Blaberus discoidalis) to control a molecule that targets their cells.

    Nature Nanotechnology - Universal computing by DNA origami robots in a living animal


    44 pages of supplemental information

    Ido Bachelet's moonshot to use nanorobotics for surgery has the potential to change lives globally. But who is the man behind the moonshot?

    Ido graduated from the Hebrew University of Jerusalem with a PhD in pharmacology and experimental therapeutics. Afterwards he did two postdocs; one in engineering at MIT and one in synthetic biology in the lab of George Church at the Wyss Institute at Harvard.

    Now, his group at Bar-Ilan University designs and studies diverse technologies inspired by nature.

    They will deliver enzymes that break down cells via programmable nanoparticles.
    Delivering insulin to tell cells to grow and regenerate tissue at the desired location.
    Surgery would be performed by putting the programmable nanoparticles into saline and injecting them into the body to seek out remove bad cells and grow new cells and perform other medical work.


    Research group website is here.












    SOLVE FOR DISEASE X?

    https://en.globes.co.il/en/article-pfizer-to-collaborate-on-bar-ilan-dna-robots-1001036703


    Pfizer is cooperating with the DNA robot laboratory managed by Prof. Ido Bachelet at Bar-Ilan University. Bachelet has developed a method of producing innovative DNA molecules with characteristics that can be used to "program" them to reach specific locations in the body and carry out pre-programmed operations there in response to stimulation from the body. This cooperation was revealed in a lecture by Pfizer president of worldwide research and development (WRD), portfolio strategy and investment committee chairman, and executive VP Mikael Dolstein at the IATI Biomed Conference in Tel Aviv being concluded today.

    Bar-Ilan Research & Development Co. CEO Orli Tori said, "This is Pfizer's first cooperative venture with someone in Israeli higher education. The technology is fairly new for a drug company, but Pfizer has agreed to take up the challenge and support this technology, in the hope that it will make a contribution to the company at the proper time.

    "As in all of our research agreements, the company coming from the industry has the right to negotiate the acquisition of the technology at the end of the process." The financial volume of the deal was not disclosed, but most such agreements amount to several hundred thousand dollars at most. The medical sector in which cooperation will take place was also not disclosed,

    but it appears that research will focus on the possibility that the robots will deliver the medical proteins to designated tissue.

    Bachelet came to Bar-Ilan from the Massachusetts Institute of Technology (MIT) several years ago. At a Tedmed event held two years ago, he explained, "In order to make a nanometric robot, we first of all create a selected DNA sequence, and then fold it using a process called DNA origami. With this method, a person can give a command to a computer, which folds the DNA molecule as needed.

    "The result is that a DNA sequence can be made in the form of a clam, for example, and containing a drug. The DNA molecule, however, contains a code activated upon encountering certain materials in the body. For example, the clam can be designed to change its shape and release the drug only when it meets a cancer cell or the right tissue.

    "In addition, the molecules can receive signals from each other, and can theoretically change their shape according to signals from the body, and can be pre-programmed to attach themselves to one another. In the future, it will be possible to combine each such molecule with a miniature antenna.

    When the antenna receives an external signal, it will make a small change in the molecule that will make it open or close, and dissipate or connect itself to another molecule."

    Tori adds, "What is special about the robots is that they open and close according to signals from the surroundings, and that makes it possible to manage the disease. The robot exposes the drug to the target site according to biological signs within the body. For example were we to develop a product for diabetes, although that is not the purpose of this cooperation, it would be possible to develop a robot that would release insulin only when it sensed a rise in the blood sugar level."

    Published by Globes [online], Israel business news - www.globes-online.com - on May 14, 2015

    https://www.nextbigfuture.com/2015/03/ido-bachelet-dna-nanobots-summary-with.html

    Disadvantages

    1. Designing of nanorobot is very costly and complicated

    2. Stray field might be created from electrical systems which can trigger bioelectric based molecular recognition system in biology

    3. Electrical nanorobots remain vulnerable to electrical interference from other sources like radiofrequency or electric fields, electromagnetic pulse and stray fields from other in-vivo electronic devices.

    4. Nanorobots are difficult to design, and customize

    5. These are capable of molecular level destruction of human body thus it can cause terrible effect in terrorism field. Terrorist may make usage of nanorobots as a tool for torturing opponent community

    6. Other possible threat associated with nanorobots is privacy issue.

    As it dealt with designing of miniature form of devices, there are risks for snooping than that exist already.

    [https://web.archive.org/web/20200718043030/https://pharmascope.org/ijrps/article/download/2523/5031]

    [https://web.archive.org/web/20150911233849/http://www.nanosafe.org/home/liblocal/docs/Nanosafe%202014/Session%201/PL1%20-%20Fran%C3%A7ois%20TARDIF.pdf]

    NANOROBOTS:

    SOCIETAL CONCERNS: INDIVIDUAL FREEDOM, TRANSHUMANISM!!!

    http://immortality-roadmap.com/nanorisk.pdf










    http://jddtonline.info/index.php/jddt/article/download/891/533

    There are several drawbacks with this technology like toxicity, contamination. Sometime human body generates strong immune response against them.

    https://web.archive.org/web/20051218111931/http://teknologiskfremsyn.dk:80/download/58.pdf


    “Nanotubes can be highly toxic”

    Fifteen percent of the rats treated with carbon nanotubes suffocated to death within twenty-four hours due to clumping of the nanotubes that obstructed the bronchial passageways.








    Toxicity- the issue of toxicity of nanoparticles was raised as an area in which more research is needed, particularly in terms of whether the regulatory system is sufficient.






    And it's injected into people, soldiers, children, even infants…

    Thank you Zz for this link.



    Pfizer partnering with Ido Bachelet on DNA nano robots.

    “No, no it’s not science fiction; it’s already happening,” said Ido Bachelet to a somewhat incredulous audience member, displaying a test tube in which he says just one drop contains approximately 1,000 billiard robots.

    https://outraged.substack.com/p/pfizer-partnering-with-ido-bachelet?utm_source=cross-post&publication_id=1087020&post_id=143153580&utm_campaign=956088&isFreemail=true&r=1sq9d8&triedRedirect=true&utm_medium=email

    Follow @zeeemedia
    Website | X | Instagram | Rumble

    https://telegra.ph/Pfizer-partnering-with-Ido-Bachelet-on-DNA-nanorobots-04-03
    Pfizer partnering with Ido Bachelet on DNA nanorobots OUTRAGED HUMAN “No, no it’s not science fiction; it’s already happening,” said Ido Bachelet to a somewhat incredulous audience member https://www.youtube.com/watch?v=MzLTWU2EqP4 Ido Bachelet - Moonshot Thinking ... when they cause too much damage by mistake... or intentionally... 5:12 study your biology and activate targeted medication when necessary. 5:36 We also know how to remote-control these robots, using magnetic fields. 5:40 Furthermore, we can control them, as you saw in the clip, with a joystick, 5:43 directing them to a specific part of the body, 5:46 and then activating them with the push of a button. 5:49 We have also connected this joystick to the internet. 5:51 Our robots have a IP address, 5:54 so you can connect with them from afar and activate them online. 6:01 Imagine that in a couple of years, 6:03 your doctor will be able to sit at home with his smartphone, 6:05 and instead of playing "Candy Crush" 6:08 he will connect with the robots inside of you, 6:11 activate a certain medication and possibly even save you, just in time. AND IMAGINE THAT YOU WOULDN'T EVEN KNOW IT, YOU WOULDN'T BE TOLD ABOUT IT. AND THAT IN ORDER TO IMPLANT/INJECT IT, YOU WOULD BE TOLD THAT THERE IS A DREADFUL PANDEMIC, AND AT EVERY STEP YOU WOULD BE FORCED TO TAKE IT AS A NECESSARY "VACCINATION." AND A “PCR TEST”. BY YOUR GOVERNMENT, THE AIRLINES, THE EMPLOYER, THE WAITER AT THE RESTAURANT, THE FDA, THE EMA, THE WORLD HEALTH ORGANIZATION... AND YET IMAGINE THAT MANY PEOPLE WOULD DIE FROM IT, AND THEY WOULD BE YOUR RELATIVES AND FRIENDS. BUT YOU WOULD BE THE ONE WHO WOULD HAVE TO PROVE THAT IT WAS BECAUSE OF IT. IMAGINE BEING SURROUNDED BY CENSORSHIP, BEING RIDICULED, HAVING YOUR RIGHTS TO DO YOUR JOB, MOVE AROUND, OR EVEN SPEAK THE TRUTH AT ALL TAKEN AWAY FROM YOU.... ISN’T THIS A BRIGHT FURTURE AND A FANTASTIC REALITY? ARE YOU AGAINST SCIENCE? AGAINST PROGRESS? AGAINST PREVENTING DISEASES? https://www.nextbigfuture.com/2015/05/pfizer-partnering-with-ido-bachelet-on.html Pfizer is cooperating with the DNA robot laboratory managed by Prof. Ido Bachelet at Bar-Ilan University. Bachelet has developed a method of producing innovative DNA molecules with characteristics that can be used to "program" them to reach specific locations in the body and carry out pre-programmed operations there in response to stimulation from the body. This cooperation was revealed in a lecture by Pfizer president of worldwide research and development (WRD), portfolio strategy and investment committee chairman, and executive VP Mikael Dolstein at the IATI Biomed Conference in Tel Aviv being concluded today. Research will focus on the possibility that the robots will deliver the medical proteins to designated tissue. Bachelet came to Bar-Ilan from the Massachusetts Institute of Technology (MIT) several years ago. At a Tedmed event held two years ago, he explained, "In order to make a nanometric robot, we first of all create a selected DNA sequence, and then fold it using a process called DNA origami. With this method, a person can give a command to a computer, which folds the DNA molecule as needed. "The result is that a DNA sequence can be made in the form of a clam, for example, and containing a drug. The DNA molecule, however, contains a code activated upon encountering certain materials in the body. For example, the clam can be designed to change its shape and release the drug only when it meets a cancer cell or the right tissue. "In addition, the molecules can receive signals from each other, and can theoretically change their shape according to signals from the body, and can be pre-programmed to attach themselves to one another. In the future, it will be possible to combine each such molecule with a miniature antenna. When the antenna receives an external signal, it will make a small change in the molecule that will make it open or close, and dissipate or connect itself to another molecule." In a brief talk, Bachelet said DNA nanobots will soon be tried in a critically ill leukemia patient. The patient, who has been given roughly six months to live, will receive an injection of DNA nanobots designed to interact with and destroy leukemia cells—while causing virtually zero collateral damage in healthy tissue. According to Bachelet, his team have successfully tested their method in cell cultures and animals and written two papers on the subject, one in Science and one in Nature. Contemporary cancer therapies involving invasive surgery and blasts of drugs can be as painful and damaging to the body as the disease itself. If Bachelet's approach proves successful in humans, and is backed by more research in the coming years, the team’s work could signal a transformational moment in cancer treatment. If this treatment works this will be a medical breakthrough and can be used for many other diseases by delivering drugs more effectively without causing side effects. 2012 Video with answers from George Church, Ido Bachelet and Shawn Douglas on the medical DNA double helix clamshell nanobucket nanobot George Church indicates the smart DNA nanobot has applications beyond nanomedicine. Applications where there is any need for programmable and targeted release or interaction at the cellular or near molecular scale. 2014 Geek Time Presentation from Ido Bachelet “AND THE LAST THING I AM GOING TO SCHOW YOU IS… PANDEMIC. SO, WE ARE REALLY CONCERNED ABOUT PANDEMICS… ESPECIALLY INFLUENZA PANDEMICS. SO THE BEST WAY TO AVOID PANDEMICS OR TO HANDLE PANDEMICS, IS SIMPLY TO KNOW WHERE THE VIRUS IS AND NOT TO BE THERE… IT SOUNDS STUPID, BUT IT IS ACTUALLY THE CASE… IF YOU COULD IDENTIFY WHERE THE VIRUS IS IN REAL TIME AND YOU CAN CONTAIN THAT AREA, YOU WOULD STOP THE PANDEMIC, YOU WOULD STOP THE DISEASE… OK? SO, WHAT WE DEVELOPED IS A SENSOR… COMPOSED OF CARBON NANOTUBES FUNCTIONALIZED WITH ALL KIND OF THINGS… THE SENSOR IS EXTREMELY SENSITIVE… WE’VE BUILT THIS APPLICATION… THEY SEND THEIR GPS COORDINATES TO OUR SERVER SO WE CAN SORT OF RECONSTRUCT A REAL MAP… I HOPE YOU ENJOYED THIS AND UNDESTOOND WHAT BIONICS IS ALL ABOUT… At the British Friends of Bar-Ilan University's event in Otto Uomo October 2014 Professor Ido Bachelet announced the beginning of the human treatment with nanomedicine. He indicates DNA nanobots can currently identify cells in humans with 12 different types of cancer tumors. A human patient with late stage leukemia will be given DNA nanobot treatment. Without the DNA nanobot treatment the patient would be expected to die in the summer of 2015. Based upon animal trials they expect to remove the cancer within one month. Within 1 or 2 years they hope to have spinal cord repair working in animals and then shortly thereafter in humans. This is working in tissue cultures. Previously Ido Bachelet and Shawn Douglas have published work on DNA nanobots in the journal Nature and other respected science publications. One Trillion 50 nanometer nanobots in a syringe will be injected into people to perform cellular surgery. The DNA nanobots have been tuned to not cause an immune response. They have been adjusted for different kinds of medical procedures. Procedures can be quick or ones that last many days. Medicine or treatment released based upon molecular sensing - Only targeted cells are treated Ido's daughter has a leg disease which requires frequent surgery. He is hoping his DNA nanobots will make the type of surgery she needs relatively trivial - a simple injection at a doctor's office. We can control powerful drugs that were already developed Effective drugs that were withdrawn from the market for excessive toxicity can be combined with DNA nanobots for effective delivery. The tiny molecular computers of the DNA nanobots can provide molecular selective control for powerful medicines that were already developed. Using DNA origami and molecular programming, they are reality. These nanobots can seek and kill cancer cells, mimic social insect behaviors, carry out logical operators like a computer in a living animal, and they can be controlled from an Xbox. Ido Bachelet from the bio-design lab at Bar Ilan University explains this technology and how it will change medicine in the near future. Ido Bachelet earned his Ph.D. from the Hebrew University in Jerusalem, and was a postdoctoral fellow at M.I.T. and Harvard University. He is currently an assistant professor in the Faculty of Life Sciences and the Nano-Center at Bar Ilan University, Israel, the founder of several biotech companies, and a composer of music for piano and molecules. Researchers have injected various kinds of DNA nanobots into cockroaches. Because the nanobots are labelled with fluorescent markers, the researchers can follow them and analyse how different robot combinations affect where substances are delivered. The team says the accuracy of delivery and control of the nanobots is equivalent to a computer system. This is the development of the vision of nanomedicine. This is the realization of the power of DNA nanotechnology. This is programmable dna nanotechnology. The DNA nanotechnology cannot perform atomically precise chemistry (yet), but having control of the DNA combined with advanced synthetic biology and control of proteins and nanoparticles is clearly developing into very interesting capabilities. "This is the first time that biological therapy has been able to match how a computer processor works," says co-author Ido Bachelet of the Institute of Nanotechnology and Advanced Materials at Bar Ilan University. The team says it should be possible to scale up the computing power in the cockroach to that of an 8-bit computer, equivalent to a Commodore 64 or Atari 800 from the 1980s. Goni-Moreno agrees that this is feasible. "The mechanism seems easy to scale up so the complexity of the computations will soon become higher," he says. An obvious benefit of this technology would be cancer treatments, because these must be cell-specific and current treatments are not well-targeted. But a treatment like this in mammals must overcome the immune response triggered when a foreign object enters the body. Bachelet is confident that the team can enhance the robots' stability so that they can survive in mammals. "There is no reason why preliminary trials on humans can't start within five years," he says Biological systems are collections of discrete molecular objects that move around and collide with each other. Cells carry out elaborate processes by precisely controlling these collisions, but developing artificial machines that can interface with and control such interactions remains a significant challenge. DNA is a natural substrate for computing and has been used to implement a diverse set of mathematical problems, logic circuits and robotics. The molecule also interfaces naturally with living systems, and different forms of DNA-based biocomputing have already been demonstrated. Here, we show that DNA origami can be used to fabricate nanoscale robots that are capable of dynamically interacting with each other in a living animal. The interactions generate logical outputs, which are relayed to switch molecular payloads on or off. As a proof of principle, we use the system to create architectures that emulate various logic gates (AND, OR, XOR, NAND, NOT, CNOT and a half adder). Following an ex vivo prototyping phase, we successfully used the DNA origami robots in living cockroaches (Blaberus discoidalis) to control a molecule that targets their cells. Nature Nanotechnology - Universal computing by DNA origami robots in a living animal 44 pages of supplemental information Ido Bachelet's moonshot to use nanorobotics for surgery has the potential to change lives globally. But who is the man behind the moonshot? Ido graduated from the Hebrew University of Jerusalem with a PhD in pharmacology and experimental therapeutics. Afterwards he did two postdocs; one in engineering at MIT and one in synthetic biology in the lab of George Church at the Wyss Institute at Harvard. Now, his group at Bar-Ilan University designs and studies diverse technologies inspired by nature. They will deliver enzymes that break down cells via programmable nanoparticles. Delivering insulin to tell cells to grow and regenerate tissue at the desired location. Surgery would be performed by putting the programmable nanoparticles into saline and injecting them into the body to seek out remove bad cells and grow new cells and perform other medical work. Research group website is here. SOLVE FOR DISEASE X? https://en.globes.co.il/en/article-pfizer-to-collaborate-on-bar-ilan-dna-robots-1001036703 Pfizer is cooperating with the DNA robot laboratory managed by Prof. Ido Bachelet at Bar-Ilan University. Bachelet has developed a method of producing innovative DNA molecules with characteristics that can be used to "program" them to reach specific locations in the body and carry out pre-programmed operations there in response to stimulation from the body. This cooperation was revealed in a lecture by Pfizer president of worldwide research and development (WRD), portfolio strategy and investment committee chairman, and executive VP Mikael Dolstein at the IATI Biomed Conference in Tel Aviv being concluded today. Bar-Ilan Research & Development Co. CEO Orli Tori said, "This is Pfizer's first cooperative venture with someone in Israeli higher education. The technology is fairly new for a drug company, but Pfizer has agreed to take up the challenge and support this technology, in the hope that it will make a contribution to the company at the proper time. "As in all of our research agreements, the company coming from the industry has the right to negotiate the acquisition of the technology at the end of the process." The financial volume of the deal was not disclosed, but most such agreements amount to several hundred thousand dollars at most. The medical sector in which cooperation will take place was also not disclosed, but it appears that research will focus on the possibility that the robots will deliver the medical proteins to designated tissue. Bachelet came to Bar-Ilan from the Massachusetts Institute of Technology (MIT) several years ago. At a Tedmed event held two years ago, he explained, "In order to make a nanometric robot, we first of all create a selected DNA sequence, and then fold it using a process called DNA origami. With this method, a person can give a command to a computer, which folds the DNA molecule as needed. "The result is that a DNA sequence can be made in the form of a clam, for example, and containing a drug. The DNA molecule, however, contains a code activated upon encountering certain materials in the body. For example, the clam can be designed to change its shape and release the drug only when it meets a cancer cell or the right tissue. "In addition, the molecules can receive signals from each other, and can theoretically change their shape according to signals from the body, and can be pre-programmed to attach themselves to one another. In the future, it will be possible to combine each such molecule with a miniature antenna. When the antenna receives an external signal, it will make a small change in the molecule that will make it open or close, and dissipate or connect itself to another molecule." Tori adds, "What is special about the robots is that they open and close according to signals from the surroundings, and that makes it possible to manage the disease. The robot exposes the drug to the target site according to biological signs within the body. For example were we to develop a product for diabetes, although that is not the purpose of this cooperation, it would be possible to develop a robot that would release insulin only when it sensed a rise in the blood sugar level." Published by Globes [online], Israel business news - www.globes-online.com - on May 14, 2015 https://www.nextbigfuture.com/2015/03/ido-bachelet-dna-nanobots-summary-with.html Disadvantages 1. Designing of nanorobot is very costly and complicated 2. Stray field might be created from electrical systems which can trigger bioelectric based molecular recognition system in biology 3. Electrical nanorobots remain vulnerable to electrical interference from other sources like radiofrequency or electric fields, electromagnetic pulse and stray fields from other in-vivo electronic devices. 4. Nanorobots are difficult to design, and customize 5. These are capable of molecular level destruction of human body thus it can cause terrible effect in terrorism field. Terrorist may make usage of nanorobots as a tool for torturing opponent community 6. Other possible threat associated with nanorobots is privacy issue. As it dealt with designing of miniature form of devices, there are risks for snooping than that exist already. [https://web.archive.org/web/20200718043030/https://pharmascope.org/ijrps/article/download/2523/5031] [https://web.archive.org/web/20150911233849/http://www.nanosafe.org/home/liblocal/docs/Nanosafe%202014/Session%201/PL1%20-%20Fran%C3%A7ois%20TARDIF.pdf] NANOROBOTS: SOCIETAL CONCERNS: INDIVIDUAL FREEDOM, TRANSHUMANISM!!! http://immortality-roadmap.com/nanorisk.pdf http://jddtonline.info/index.php/jddt/article/download/891/533 There are several drawbacks with this technology like toxicity, contamination. Sometime human body generates strong immune response against them. https://web.archive.org/web/20051218111931/http://teknologiskfremsyn.dk:80/download/58.pdf “Nanotubes can be highly toxic” Fifteen percent of the rats treated with carbon nanotubes suffocated to death within twenty-four hours due to clumping of the nanotubes that obstructed the bronchial passageways. Toxicity- the issue of toxicity of nanoparticles was raised as an area in which more research is needed, particularly in terms of whether the regulatory system is sufficient. … And it's injected into people, soldiers, children, even infants… Thank you Zz for this link. Pfizer partnering with Ido Bachelet on DNA nano robots. “No, no it’s not science fiction; it’s already happening,” said Ido Bachelet to a somewhat incredulous audience member, displaying a test tube in which he says just one drop contains approximately 1,000 billiard robots. https://outraged.substack.com/p/pfizer-partnering-with-ido-bachelet?utm_source=cross-post&publication_id=1087020&post_id=143153580&utm_campaign=956088&isFreemail=true&r=1sq9d8&triedRedirect=true&utm_medium=email Follow @zeeemedia Website | X | Instagram | Rumble https://telegra.ph/Pfizer-partnering-with-Ido-Bachelet-on-DNA-nanorobots-04-03
    OUTRAGED.SUBSTACK.COM
    Pfizer partnering with Ido Bachelet on DNA nanorobots
    “No, no it’s not science fiction; it’s already happening,” said Ido Bachelet to a somewhat incredulous audience member Thanks for reading OUTRAGED’s Newsletter! Subscribe for free to receive new posts and support my work. https://www.youtube.com/watch?v=MzLTWU2EqP4
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  • Drinking Boiled Tap Water Reduces Human Intake of Nanoplastics and Microplastics
    Ana Maria Mihalcea, MD, PhD

    Morphology and composition of incrustants in different conditions. (a) Scanning electron microscopic (SEM) images of bare-polystyrene (PS, 1 μm, 1 mg L–1) and incrustant coprecipitates formed in tap water at different temperatures (180 mg L–1 of CaCO3, 40 mL, 25–100 oC); (b) SEM images of bare-PS (1 μm, 1 mg L–1) and incrustant coprecipitates in different water hardness upon boiling (60–300 mg L–1 of CaCO3, 100 oC); (c) SEM images of bare-PS and incrustant coprecipitates in different PS concentrations (1 μm, 0–5 mg L–1) upon boiling of tap water (180 mg L–1 of CaCO3, 100 oC); and (d) SEM images and (e) X-ray diffraction patterns of bare-, carboxyl-, and amino-PS and incrustant coprecipitates upon boiling of tap water (1 and 0.1 μm, 1 mg L–1, 180 mg L–1 of CaCO3, 100 oC).

    ____________________________________________________________________________

    This is a hopeful article explaining the methodology to decontaminate drinking water. This is very important because we do know that all bottled water is contaminated. You can read that study here:

    Study Shows A Quarter Million Nanoparticle Polymers Per Liter In Water Bottles - Same Polymers Found As In Moderna Patent For Covid 19 Shots, Morgellons Filaments, Blood & Rubbery Clots

    The abstract states:

    Tap water nano/microplastics (NMPs) escaping from centralized water treatment systems are of increasing global concern, because they pose potential health risk to humans via water consumption. Drinking boiled water, an ancient tradition in some Asian countries, is supposedly beneficial for human health, as boiling can remove some chemicals and most biological substances. However, it remains unclear whether boiling is effective in removing NMPs in tap water. Herein we present evidence that polystyrene, polyethylene, and polypropylene NMPs can coprecipitate with calcium carbonate (CaCO3) incrustants in tap water upon boiling. Boiling hard water (>120 mg L–1 of CaCO3) can remove at least 80% of polystyrene, polyethylene, and polypropylene NMPs size between 0.1 and 150 μm. Elevated temperatures promote CaCO3 nucleation on NMPs, resulting in the encapsulation and aggregation of NMPs within CaCO3 incrustants. This simple boiling-water strategy can “decontaminate” NMPs from household tap water and has the potential for harmlessly alleviating human intake of NMPs through water consumption.


    Here is the ACS article:

    Drinking Boiled Tap Water Reduces Human Intake of Nanoplastics and Microplastics

    Here is the sciencedaily write up:

    Want fewer microplastics in your tap water? Try boiling it first

    Contamination of water supplies with nano- and microplastics (NMPs), which can be as small as one thousandth of a millimeter in diameter or as large as 5 millimeters, has become increasingly common. The effects of these particles on human health are still under investigation, though current studies suggest that ingesting them could affect the gut microbiome. Some advanced drinking water filtration systems capture NMPs, but simple, inexpensive methods are needed to substantially help reduce human plastic consumption. So, Zhanjun Li, Eddy Zeng and colleagues wanted to see whether boiling could be an effective method to help remove NMPs from both hard and soft tap water.

    The researchers collected samples of hard tap water from Guangzhou, China, and spiked them with different amounts of NMPs. Samples were boiled for five minutes and allowed to cool. Then, the team measured the free-floating plastic content. Boiling hard water, which is rich in minerals, will naturally form a chalky substance known as limescale, or calcium carbonate (CaCO3). Results from these experiments indicated that as the water temperature increased, CaCO3 formed incrustants, or crystalline structures, which encapsulated the plastic particles. Zeng says that over time, these incrustants would build up like typical limescale, at which point they could be scrubbed away to remove the NMPs. He suggests any remaining incrustants floating in the water could be removed by pouring it through a simple filter such as a coffee filter.

    In the tests, the encapsulation effect was more pronounced in harder water -- in a sample containing 300 milligrams of CaCO3 per liter of water, up to 90% of free-floating MNPs were removed after boiling. However, even in soft water samples (less than 60 milligrams CaCO3 per liter), boiling still removed around 25% of NMPs. The researchers say that this work could provide a simple, yet effective, method to reduce NMP consumption.

    From the paper supplemental information

    Results. Boiling hard water can remove most PS, PE, and PP MPs, and PS, PE, and PP MPs precipitation efficiencies were 95 ± 4%, 81 ± 3%, and 90 ± 3%, respectively, at 100 oC. Increasing temperature accelerated the formation of incrustants on spherical, fragmented, and fibrous MP surfaces. MPs continued to be encapsulated by newly formed incrustants (Figure S2) and finally precipitated under gravity, confirming that spherical PS, fragmented PE, and fibrous PP MPs are able to coprecipitate with incrustants in tap water upon boiling. In concluding, the results with NPs in the main text were also applicable to MPs.

    Here are the polymer plastics found in drinking water throughout the world:



    Thank you to Karen Kingston, who brought this article to my attention.

    https://anamihalceamdphd.substack.com/p/drinking-boiled-tap-water-reduces

    https://telegra.ph/Drinking-Boiled-Tap-Water-Reduces-Human-Intake-of-Nanoplastics-and-Microplastics-04-02
    Drinking Boiled Tap Water Reduces Human Intake of Nanoplastics and Microplastics Ana Maria Mihalcea, MD, PhD Morphology and composition of incrustants in different conditions. (a) Scanning electron microscopic (SEM) images of bare-polystyrene (PS, 1 μm, 1 mg L–1) and incrustant coprecipitates formed in tap water at different temperatures (180 mg L–1 of CaCO3, 40 mL, 25–100 oC); (b) SEM images of bare-PS (1 μm, 1 mg L–1) and incrustant coprecipitates in different water hardness upon boiling (60–300 mg L–1 of CaCO3, 100 oC); (c) SEM images of bare-PS and incrustant coprecipitates in different PS concentrations (1 μm, 0–5 mg L–1) upon boiling of tap water (180 mg L–1 of CaCO3, 100 oC); and (d) SEM images and (e) X-ray diffraction patterns of bare-, carboxyl-, and amino-PS and incrustant coprecipitates upon boiling of tap water (1 and 0.1 μm, 1 mg L–1, 180 mg L–1 of CaCO3, 100 oC). ____________________________________________________________________________ This is a hopeful article explaining the methodology to decontaminate drinking water. This is very important because we do know that all bottled water is contaminated. You can read that study here: Study Shows A Quarter Million Nanoparticle Polymers Per Liter In Water Bottles - Same Polymers Found As In Moderna Patent For Covid 19 Shots, Morgellons Filaments, Blood & Rubbery Clots The abstract states: Tap water nano/microplastics (NMPs) escaping from centralized water treatment systems are of increasing global concern, because they pose potential health risk to humans via water consumption. Drinking boiled water, an ancient tradition in some Asian countries, is supposedly beneficial for human health, as boiling can remove some chemicals and most biological substances. However, it remains unclear whether boiling is effective in removing NMPs in tap water. Herein we present evidence that polystyrene, polyethylene, and polypropylene NMPs can coprecipitate with calcium carbonate (CaCO3) incrustants in tap water upon boiling. Boiling hard water (>120 mg L–1 of CaCO3) can remove at least 80% of polystyrene, polyethylene, and polypropylene NMPs size between 0.1 and 150 μm. Elevated temperatures promote CaCO3 nucleation on NMPs, resulting in the encapsulation and aggregation of NMPs within CaCO3 incrustants. This simple boiling-water strategy can “decontaminate” NMPs from household tap water and has the potential for harmlessly alleviating human intake of NMPs through water consumption. Here is the ACS article: Drinking Boiled Tap Water Reduces Human Intake of Nanoplastics and Microplastics Here is the sciencedaily write up: Want fewer microplastics in your tap water? Try boiling it first Contamination of water supplies with nano- and microplastics (NMPs), which can be as small as one thousandth of a millimeter in diameter or as large as 5 millimeters, has become increasingly common. The effects of these particles on human health are still under investigation, though current studies suggest that ingesting them could affect the gut microbiome. Some advanced drinking water filtration systems capture NMPs, but simple, inexpensive methods are needed to substantially help reduce human plastic consumption. So, Zhanjun Li, Eddy Zeng and colleagues wanted to see whether boiling could be an effective method to help remove NMPs from both hard and soft tap water. The researchers collected samples of hard tap water from Guangzhou, China, and spiked them with different amounts of NMPs. Samples were boiled for five minutes and allowed to cool. Then, the team measured the free-floating plastic content. Boiling hard water, which is rich in minerals, will naturally form a chalky substance known as limescale, or calcium carbonate (CaCO3). Results from these experiments indicated that as the water temperature increased, CaCO3 formed incrustants, or crystalline structures, which encapsulated the plastic particles. Zeng says that over time, these incrustants would build up like typical limescale, at which point they could be scrubbed away to remove the NMPs. He suggests any remaining incrustants floating in the water could be removed by pouring it through a simple filter such as a coffee filter. In the tests, the encapsulation effect was more pronounced in harder water -- in a sample containing 300 milligrams of CaCO3 per liter of water, up to 90% of free-floating MNPs were removed after boiling. However, even in soft water samples (less than 60 milligrams CaCO3 per liter), boiling still removed around 25% of NMPs. The researchers say that this work could provide a simple, yet effective, method to reduce NMP consumption. From the paper supplemental information Results. Boiling hard water can remove most PS, PE, and PP MPs, and PS, PE, and PP MPs precipitation efficiencies were 95 ± 4%, 81 ± 3%, and 90 ± 3%, respectively, at 100 oC. Increasing temperature accelerated the formation of incrustants on spherical, fragmented, and fibrous MP surfaces. MPs continued to be encapsulated by newly formed incrustants (Figure S2) and finally precipitated under gravity, confirming that spherical PS, fragmented PE, and fibrous PP MPs are able to coprecipitate with incrustants in tap water upon boiling. In concluding, the results with NPs in the main text were also applicable to MPs. Here are the polymer plastics found in drinking water throughout the world: Thank you to Karen Kingston, who brought this article to my attention. https://anamihalceamdphd.substack.com/p/drinking-boiled-tap-water-reduces https://telegra.ph/Drinking-Boiled-Tap-Water-Reduces-Human-Intake-of-Nanoplastics-and-Microplastics-04-02
    ANAMIHALCEAMDPHD.SUBSTACK.COM
    Drinking Boiled Tap Water Reduces Human Intake of Nanoplastics and Microplastics
    Morphology and composition of incrustants in different conditions. (a) Scanning electron microscopic (SEM) images of bare-polystyrene (PS, 1 μm, 1 mg L–1) and incrustant coprecipitates formed in tap water at different temperatures (180 mg L–1 of CaCO3, 40 mL, 25–100 oC); (b) SEM images of bare-PS (1 μm, 1 mg L–1) and incrustant coprecipitates in different water hardness upon boiling (60–300 mg L–1 of CaCO3, 100 oC); (c) SEM images of bare-PS and incrustant coprecipitates in different PS concentrations (1 μm, 0–5 mg L–1) upon boiling of tap water (180 mg L–1 of CaCO3, 100 oC); and (d) SEM images and (e) X-ray diffraction patterns of bare-, carboxyl-, and amino-PS and incrustant coprecipitates upon boiling of tap water (1 and 0.1 μm, 1 mg L–1, 180 mg L–1 of CaCO3, 100 oC).
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  • Fresh testimonies of Israeli army-perpetrated robberies, looting around Al-Shifa Medical Complex
    Fresh testimonies of Israeli army-perpetrated robberies, looting around Al-Shifa Medical Complex
    Palestinian Territory – Israel’s army has committed numerous thefts and robberies of Palestinian residents’ property, among other crimes that continue for the second consecutive week in the vicinity of Gaza City’s Al-Shifa Medical Complex.

    The Israeli army has been conducting a massive military assault on Al-Shifa Medical Complex and the surrounding areas, in the west of Gaza City, since 18 March. During this operation, Israel’s army has committed a number of crimes, including extrajudicial executions, murder, physical liquidations, and arbitrary arrests. Additionally, fresh testimonies have surfaced, exposing the involvement of Israeli forces in stealing cash and valuable property from Palestinian homes after forcibly evacuating their owners.

    Israel’s army condones and occasionally even encourages its members to steal money and property from Palestinian homes and residents in the Gaza Strip, and does not hold the perpetrators accountable for these violations, since they are frequently carried out without official documentation.

    The Israeli army has been caught stealing gold jewelry and cash from homes it has raided and from people it drove into the southern Gaza Valley. After forcing the owners of these houses out of their homes, Israeli soldiers took everything they owned, including their personal belongings.

    Euro-Med Monitor has previously documented systematic thefts since the Israeli army began carrying out ground military operations inside the Gaza Strip on 27 October 2023. These operations have become systematically practised, as evidenced by the frequent storming of residential areas, the raiding of homes, and the launching of random arrest campaigns.

    As part of an Israeli strategy centred on collective retaliation and the dehumanisation and decimation of the Palestinian populace, soldiers have set fire to, bombed, and destroyed many of the homes in the Strip after looting and robbing them first.

    “When the Israeli army stormed the house where we were staying in western Gaza, they searched the entire place,” a doctor called Yahya Khalil Deeb Al-Kayyali, 59, told Euro-Med Monitor. “They found jewelry and gold belonging to my son’s bride, as well as gold belonging to other women from the Al-Ifranji family. Along with other personal belongings, we also had bags containing deposits totaling more than $100,000 [USD].” Al-Kayyali stated that the total value of all of these belongings was more than $200,000 USD, explaining that the Israeli soldiers broke laptops apart with their feet and “took everything away”: “The soldiers stopped my wife when she attempted to take the bags. I informed the officer that there was a sizable quantity of cash.” The officer laughed and said the cash would be distributed among the soldiers.

    “I told them that we were civilians,” Al-Kayyali continued. “I spoke to them in English. They asked the males to take off all their clothes completely, so we got naked except for our boxers. We were led to the restroom and held there. They took my 30-year-old son, Amer, to a neighbouring room and subjected him to severe interrogation and torture.

    “I was hearing him screaming, as they asked him for information. He told them that he had recently come from Germany and knew nothing. They then put me through an interrogation and made death threats. I was verbally abused amid very cold weather.

    “Then, while I was still undressed, a soldier asked me to go down to the Bseiso family’s house and call them. He said that he would shoot me if I [tried to run away]. I approached [the Bseiso family] and instructed them to raise their hands. The soldier was standing on the balcony when they went out.

    “There was a blind man and a disabled man with them,” added Al-Kayyali. “But the soldier insisted on taking off their clothes and asked me to bring them home. They took the women to another place in the house before using them as a human shield during an exchange of fire with gunmen.”

    Social media videos of Israeli soldiers boasting about stealing cash and valuables are circulating online, along with footage showing them purposefully damaging civilian houses in the Gaza Strip by setting them on fire or writing racist or Zionist slogans on the walls.

    Euro-Med Human Rights Monitor calls for a comprehensive and impartial international investigation into the grave violations and war crimes being committed by the Israeli army against the people of the Gaza Strip and their property. The international community must act swiftly to ensure legal accountability.


    Fresh testimonies of Israeli army-perpetrated robberies, looting around Al-Shifa Medical Complex

    Euro-Med Monitor
    https://euromedmonitor.org/en/article/6253
    Fresh testimonies of Israeli army-perpetrated robberies, looting around Al-Shifa Medical Complex Fresh testimonies of Israeli army-perpetrated robberies, looting around Al-Shifa Medical Complex Palestinian Territory – Israel’s army has committed numerous thefts and robberies of Palestinian residents’ property, among other crimes that continue for the second consecutive week in the vicinity of Gaza City’s Al-Shifa Medical Complex. The Israeli army has been conducting a massive military assault on Al-Shifa Medical Complex and the surrounding areas, in the west of Gaza City, since 18 March. During this operation, Israel’s army has committed a number of crimes, including extrajudicial executions, murder, physical liquidations, and arbitrary arrests. Additionally, fresh testimonies have surfaced, exposing the involvement of Israeli forces in stealing cash and valuable property from Palestinian homes after forcibly evacuating their owners. Israel’s army condones and occasionally even encourages its members to steal money and property from Palestinian homes and residents in the Gaza Strip, and does not hold the perpetrators accountable for these violations, since they are frequently carried out without official documentation. The Israeli army has been caught stealing gold jewelry and cash from homes it has raided and from people it drove into the southern Gaza Valley. After forcing the owners of these houses out of their homes, Israeli soldiers took everything they owned, including their personal belongings. Euro-Med Monitor has previously documented systematic thefts since the Israeli army began carrying out ground military operations inside the Gaza Strip on 27 October 2023. These operations have become systematically practised, as evidenced by the frequent storming of residential areas, the raiding of homes, and the launching of random arrest campaigns. As part of an Israeli strategy centred on collective retaliation and the dehumanisation and decimation of the Palestinian populace, soldiers have set fire to, bombed, and destroyed many of the homes in the Strip after looting and robbing them first. “When the Israeli army stormed the house where we were staying in western Gaza, they searched the entire place,” a doctor called Yahya Khalil Deeb Al-Kayyali, 59, told Euro-Med Monitor. “They found jewelry and gold belonging to my son’s bride, as well as gold belonging to other women from the Al-Ifranji family. Along with other personal belongings, we also had bags containing deposits totaling more than $100,000 [USD].” Al-Kayyali stated that the total value of all of these belongings was more than $200,000 USD, explaining that the Israeli soldiers broke laptops apart with their feet and “took everything away”: “The soldiers stopped my wife when she attempted to take the bags. I informed the officer that there was a sizable quantity of cash.” The officer laughed and said the cash would be distributed among the soldiers. “I told them that we were civilians,” Al-Kayyali continued. “I spoke to them in English. They asked the males to take off all their clothes completely, so we got naked except for our boxers. We were led to the restroom and held there. They took my 30-year-old son, Amer, to a neighbouring room and subjected him to severe interrogation and torture. “I was hearing him screaming, as they asked him for information. He told them that he had recently come from Germany and knew nothing. They then put me through an interrogation and made death threats. I was verbally abused amid very cold weather. “Then, while I was still undressed, a soldier asked me to go down to the Bseiso family’s house and call them. He said that he would shoot me if I [tried to run away]. I approached [the Bseiso family] and instructed them to raise their hands. The soldier was standing on the balcony when they went out. “There was a blind man and a disabled man with them,” added Al-Kayyali. “But the soldier insisted on taking off their clothes and asked me to bring them home. They took the women to another place in the house before using them as a human shield during an exchange of fire with gunmen.” Social media videos of Israeli soldiers boasting about stealing cash and valuables are circulating online, along with footage showing them purposefully damaging civilian houses in the Gaza Strip by setting them on fire or writing racist or Zionist slogans on the walls. Euro-Med Human Rights Monitor calls for a comprehensive and impartial international investigation into the grave violations and war crimes being committed by the Israeli army against the people of the Gaza Strip and their property. The international community must act swiftly to ensure legal accountability. Fresh testimonies of Israeli army-perpetrated robberies, looting around Al-Shifa Medical Complex Euro-Med Monitor https://euromedmonitor.org/en/article/6253
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  • The WHO Pandemic Agreement: A Guide
    By David Bell, Thi Thuy Van Dinh March 22, 2024 Government, Society 30 minute read
    The World Health Organization (WHO) and its 194 Member States have been engaged for over two years in the development of two ‘instruments’ or agreements with the intent of radically changing the way pandemics and other health emergencies are managed.

    One, consisting of draft amendments to the existing International health Regulations (IHR), seeks to change the current IHR non-binding recommendations into requirements or binding recommendations, by having countries “undertake” to implement those given by the WHO in future declared health emergencies. It covers all ‘public health emergencies of international concern’ (PHEIC), with a single person, the WHO Director-General (DG) determining what a PHEIC is, where it extends, and when it ends. It specifies mandated vaccines, border closures, and other directives understood as lockdowns among the requirements the DG can impose. It is discussed further elsewhere and still under negotiation in Geneva.

    A second document, previously known as the (draft) Pandemic Treaty, then Pandemic Accord, and more recently the Pandemic Agreement, seeks to specify governance, supply chains, and various other interventions aimed at preventing, preparing for, and responding to, pandemics (pandemic prevention, preparedness and response – PPPR). It is currently being negotiated by the Intergovernmental Negotiating Body (INB).

    Both texts will be subject to a vote at the May 2024 World Health Assembly (WHA) in Geneva, Switzerland. These votes are intended, by those promoting these projects, to bring governance of future multi-country healthcare emergencies (or threats thereof) under the WHO umbrella.

    The latest version of the draft Pandemic Agreement (here forth the ‘Agreement’) was released on 7th March 2024. However, it is still being negotiated by various committees comprising representatives of Member States and other interested entities. It has been through multiple iterations over two years, and looks like it. With the teeth of the pandemic response proposals in the IHR, the Agreement looks increasingly irrelevant, or at least unsure of its purpose, picking up bits and pieces in a half-hearted way that the IHR amendments do not, or cannot, include. However, as discussed below, it is far from irrelevant.

    Historical Perspective

    These aim to increase the centralization of decision-making within the WHO as the “directing and coordinating authority.” This terminology comes from the WHO’s 1946 Constitution, developed in the aftermath of the Second World War as the world faced the outcomes of European fascism and the similar approaches widely imposed through colonialist regimes. The WHO would support emerging countries, with rapidly expanding and poorly resourced populations struggling under high disease burdens, and coordinate some areas of international support as these sovereign countries requested it. The emphasis of action was on coordinating rather than directing.

    In the 80 years prior to the WHO’s existence, international public health had grown within a more directive mindset, with a series of meetings by colonial and slave-owning powers from 1851 to manage pandemics, culminating in the inauguration of the Office Internationale d’Hygiene Publique in Paris in 1907, and later the League of Nations Health Office. World powers imposed health dictates on those less powerful, in other parts of the world and increasingly on their own population through the eugenics movement and similar approaches. Public health would direct, for the greater good, as a tool of those who wish to direct the lives of others.

    The WHO, governed by the WHA, was to be very different. Newly independent States and their former colonial masters were ostensibly on an equal footing within the WHA (one country – one vote), and the WHO’s work overall was to be an example of how human rights could dominate the way society works. The model for international public health, as exemplified in the Declaration of Alma Ata in 1978, was to be horizontal rather than vertical, with communities and countries in the driving seat.

    With the evolution of the WHO in recent decades from a core funding model (countries give money, the WHO decides under the WHA guidance how to spend it) to a model based on specified funding (funders, both public and increasingly private, instruct the WHO on how to spend it), the WHO has inevitably changed to become a public-private partnership required to serve the interests of funders rather than populations.

    As most funding comes from a few countries with major Pharma industrial bases, or private investors and corporations in the same industry, the WHO has been required to emphasize the use of pharmaceuticals and downplay evidence and knowledge where these clash (if it wants to keep all its staff funded). It is helpful to view the draft Agreement, and the IHR amendments, in this context.

    Why May 2024?

    The WHO, together with the World Bank, G20, and other institutions have been emphasizing the urgency of putting the new pandemic instruments in place earnestly, before the ‘next pandemic.’ This is based on claims that the world was unprepared for Covid-19, and that the economic and health harm would be somehow avoidable if we had these agreements in place.

    They emphasize, contrary to evidence that Covid-19 virus (SARS-CoV-2) origins involve laboratory manipulation, that the main threats we face are natural, and that these are increasing exponentially and present an “existential” threat to humanity. The data on which the WHO, the World Bank, and G20 base these claims demonstrates the contrary, with reported natural outbreaks having increased as detection technologies have developed, but reducing in mortality rate, and in numbers, over the past 10 to 20 years..

    A paper cited by the World Bank to justify urgency and quoted as suggesting a 3x increase in risk in the coming decade actually suggests that a Covid-19-like event would occur roughly every 129 years, and a Spanish-flu repetition every 292 to 877 years. Such predictions are unable to take into account the rapidly changing nature of medicine and improved sanitation and nutrition (most deaths from Spanish flu would not have occurred if modern antibiotics had been available), and so may still overestimate risk. Similarly, the WHO’s own priority disease list for new outbreaks only includes two diseases of proven natural origin that have over 1,000 historical deaths attributed to them. It is well demonstrated that the risk and expected burden of pandemics is misrepresented by major international agencies in current discussions.

    The urgency for May 2024 is clearly therefore inadequately supported, firstly because neither the WHO nor others have demonstrated how the harms accrued through Covid-19 would be reduced through the measures proposed, and secondly because the burden and risk is misrepresented. In this context, the state of the Agreement is clearly not where it should be as a draft international legally binding agreement intended to impose considerable financial and other obligations on States and populations.

    This is particularly problematic as the proposed expenditure; the proposed budget is over $31 billion per year, with over $10 billion more on other One Health activities. Much of this will have to be diverted from addressing other diseases burdens that impose far greater burden. This trade-off, essential to understand in public health policy development, has not yet been clearly addressed by the WHO.

    The WHO DG stated recently that the WHO does not want the power to impose vaccine mandates or lockdowns on anyone, and does not want this. This begs the question of why either of the current WHO pandemic instruments is being proposed, both as legally binding documents. The current IHR (2005) already sets out such approaches as recommendations the DG can make, and there is nothing non-mandatory that countries cannot do now without pushing new treaty-like mechanisms through a vote in Geneva.

    Based on the DG’s claims, they are essentially redundant, and what new non-mandatory clauses they contain, as set out below, are certainly not urgent. Clauses that are mandatory (Member States “shall”) must be considered within national decision-making contexts and appear against the WHO’s stated intent.

    Common sense would suggest that the Agreement, and the accompanying IHR amendments, be properly thought through before Member States commit. The WHO has already abandoned the legal requirement for a 4-month review time for the IHR amendments (Article 55.2 IHR), which are also still under negotiation just 2 months before the WHA deadline. The Agreement should also have at least such a period for States to properly consider whether to agree – treaties normally take many years to develop and negotiate and no valid arguments have been put forward as to why these should be different.

    The Covid-19 response resulted in an unprecedented transfer of wealth from those of lower income to the very wealthy few, completely contrary to the way in which the WHO was intended to affect human society. A considerable portion of these pandemic profits went to current sponsors of the WHO, and these same corporate entities and investors are set to further benefit from the new pandemic agreements. As written, the Pandemic Agreement risks entrenching such centralization and profit-taking, and the accompanying unprecedented restrictions on human rights and freedoms, as a public health norm.

    To continue with a clearly flawed agreement simply because of a previously set deadline, when no clear population benefit is articulated and no true urgency demonstrated, would therefore be a major step backward in international public health. Basic principles of proportionality, human agency, and community empowerment, essential for health and human rights outcomes, are missing or paid lip-service. The WHO clearly wishes to increase its funding and show it is ‘doing something,’ but must first articulate why the voluntary provisions of the current IHR are insufficient. It is hoped that by systematically reviewing some key clauses of the agreement here, it will become clear why a rethink of the whole approach is necessary. The full text is found below.

    The commentary below concentrates on selected draft provisions of the latest publicly available version of the draft agreement that seem to be unclear or potentially problematic. Much of the remaining text is essentially pointless as it reiterates vague intentions to be found in other documents or activities which countries normally undertake in the course of running health services, and have no place in a focused legally-binding international agreement.

    REVISED Draft of the negotiating text of the WHO Pandemic Agreement. 7th March, 2024

    Preamble

    Recognizing that the World Health Organization…is the directing and coordinating authority on international health work.

    This is inconsistent with a recent statement by the WHO DG that the WHO has no interest or intent to direct country health responses. To reiterate it here suggests that the DG is not representing the true position regarding the Agreement. “Directing authority” is however in line with the proposed IHR Amendments (and the WHO’s Constitution), under which countries will “undertake” ahead of time to follow the DG’s recommendations (which thereby become instructions). As the HR amendments make clear, this is intended to apply even to a perceived threat rather than actual harm.

    Recalling the constitution of the World Health Organization…highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.

    This statement recalls fundamental understandings of public health, and is of importance here as it raises the question of why the WHO did not strongly condemn prolonged school closures, workplace closures, and other impoverishing policies during the Covid-19 response. In 2019, WHO made clear that these dangers should prevent actions we now call ‘lockdowns’ from being imposed.

    Deeply concerned by the gross inequities at national and international levels that hindered timely and equitable access to medical and other Covid-19 pandemic-related products, and the serious shortcomings in pandemic preparedness.

    In terms of health equity (as distinct from commodity of ‘vaccine’ equity), inequity in the Covid-19 response was not in failing to provide a vaccine against former variants to immune, young people in low-income countries who were at far higher risk from endemic diseases, but in the disproportionate harm to them of uniformly-imposed NPIs that reduced current and future income and basic healthcare, as was noted by the WHO in 2019 Pandemic Influenza recommendations. The failure of the text to recognize this suggests that lessons from Covid-19 have not informed this draft Agreement. The WHO has not yet demonstrated how pandemic ‘preparedness,’ in the terms they use below, would have reduced impact, given that there is poor correlation between strictness or speed of response and eventual outcomes.

    Reiterating the need to work towards…an equitable approach to mitigate the risk that pandemics exacerbate existing inequities in access to health services,

    As above – in the past century, the issue of inequity has been most pronounced in pandemic response, rather than the impact of the virus itself (excluding the physiological variation in risk). Most recorded deaths from acute pandemics, since the Spanish flu, were during Covid-19, in which the virus hit mainly sick elderly, but response impacted working-age adults and children heavily and will continue to have effect, due to increased poverty and debt; reduced education and child marriage, in future generations.

    These have disproportionately affected lower-income people, and particularly women. The lack of recognition of this in this document, though they are recognized by the World Bank and UN agencies elsewhere, must raise real questions on whether this Agreement has been thoroughly thought through, and the process of development been sufficiently inclusive and objective.

    Chapter I. Introduction

    Article 1. Use of terms

    (i) “pathogen with pandemic potential” means any pathogen that has been identified to infect a human and that is: novel (not yet characterized) or known (including a variant of a known pathogen), potentially highly transmissible and/or highly virulent with the potential to cause a public health emergency of international concern.

    This provides a very wide scope to alter provisions. Any pathogen that can infect humans and is potentially highly transmissible or virulent, though yet uncharacterized means virtually any coronavirus, influenza virus, or a plethora of other relatively common pathogen groups. The IHR Amendments intend that the DG alone can make this call, over the advice of others, as occurred with monkeypox in 2022.

    (j) “persons in vulnerable situations” means individuals, groups or communities with a disproportionate increased risk of infection, severity, disease or mortality.

    This is a good definition – in Covid-19 context, would mean the sick elderly, and so is relevant to targeting a response.

    “Universal health coverage” means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.

    While the general UHC concept is good, it is time a sensible (rather than patently silly) definition was adopted. Society cannot afford the full range of possible interventions and remedies for all, and clearly there is a scale of cost vs benefit that prioritizes certain ones over others. Sensible definitions make action more likely, and inaction harder to justify. One could argue that none should have the full range until all have good basic care, but clearly the earth will not support ‘the full range’ for 8 billion people.

    Article 2. Objective

    This Agreement is specifically for pandemics (a poorly defined term but essentially a pathogen that spreads rapidly across national borders). In contrast, the IHR amendments accompanying it are broader in scope – for any public health emergencies of international concern.

    Article 3. Principles

    2. the sovereign right of States to adopt, legislate and implement legislation

    The amendments to the IHR require States to undertake to follow WHO instructions ahead of time, before such instruction and context are known. These two documents must be understood, as noted later in the Agreement draft, as complementary.

    3. equity as the goal and outcome of pandemic prevention, preparedness and response, ensuring the absence of unfair, avoidable or remediable differences among groups of people.

    This definition of equity here needs clarification. In the pandemic context, the WHO emphasized commodity (vaccine) equity during the Covid-19 response. Elimination of differences implied equal access to Covid-19 vaccines in countries with large aging, obese highly vulnerable populations (e.g. the USA or Italy), and those with young populations at minimal risk and with far more pressing health priorities (e.g. Niger or Uganda).

    Alternatively, but equally damaging, equal access to different age groups within a country when the risk-benefit ratio is clearly greatly different. This promotes worse health outcomes by diverting resources from where they are most useful, as it ignores heterogeneity of risk. Again, an adult approach is required in international agreements, rather than feel-good sentences, if they are going to have a positive impact.

    5. …a more equitable and better prepared world to prevent, respond to and recover from pandemics

    As with ‘3’ above, this raises a fundamental problem: What if health equity demands that some populations divert resources to childhood nutrition and endemic diseases rather than the latest pandemic, as these are likely of far higher burden to many younger but lower-income populations? This would not be equity in the definition implied here, but would clearly lead to better and more equal health outcomes.

    The WHO must decide whether it is about uniform action, or minimizing poor health, as these are clearly very different. They are the difference between the WHO’s commodity equity, and true health equity.

    Chapter II. The world together equitably: achieving equity in, for and through pandemic prevention, preparedness and response

    Equity in health should imply a reasonably equal chance of overcoming or avoiding preventable sickness. The vast majority of sickness and death is due to either non-communicable diseases often related to lifestyle, such as obesity and type 2 diabetes mellitus, undernutrition in childhood, and endemic infectious diseases such as tuberculosis, malaria, and HIV/AIDS. Achieving health equity would primarily mean addressing these.

    In this chapter of the draft Pandemic Agreement, equity is used to imply equal access to specific health commodities, particularly vaccines, for intermittent health emergencies, although these exert a small fraction of the burden of other diseases. It is, specifically, commodity-equity, and not geared to equalizing overall health burden but to enabling centrally-coordinated homogenous responses to unusual events.

    Article 4. Pandemic prevention and surveillance

    2. The Parties shall undertake to cooperate:

    (b) in support of…initiatives aimed at preventing pandemics, in particular those that improve surveillance, early warning and risk assessment; .…and identify settings and activities presenting a risk of emergence and re-emergence of pathogens with pandemic potential.

    (c-h) [Paragraphs on water and sanitation, infection control, strengthening of biosafety, surveillance and prevention of vector-born diseases, and addressing antimicrobial resistance.]

    The WHO intends the Agreement to have force under international law. Therefore, countries are undertaking to put themselves under force of international law in regards to complying with the agreement’s stipulations.

    The provisions under this long article mostly cover general health stuff that countries try to do anyway. The difference will be that countries will be assessed on progress. Assessment can be fine if in context, less fine if it consists of entitled ‘experts’ from wealthy countries with little local knowledge or context. Perhaps such compliance is best left to national authorities, who are more in use with local needs and priorities. The justification for the international bureaucracy being built to support this, while fun for those involved, is unclear and will divert resources from actual health work.

    6. The Conference of the Parties may adopt, as necessary, guidelines, recommendations and standards, including in relation to pandemic prevention capacities, to support the implementation of this Article.

    Here and later, the COP is invoked as a vehicle to decide on what will actually be done. The rules are explained later (Articles 21-23). While allowing more time is sensible, it begs the question of why it is not better to wait and discuss what is needed in the current INB process, before committing to a legally-binding agreement. This current article says nothing not already covered by the IHR2005 or other ongoing programs.

    Article 5. One Health approach to pandemic prevention, preparedness and response

    Nothing specific or new in this article. It seems redundant (it is advocating a holistic approach mentioned elsewhere) and so presumably is just to get the term ‘One Health’ into the agreement. (One could ask, why bother?)

    Some mainstream definitions of One Health (e.g. Lancet) consider that it means non-human species are on a par with humans in terms of rights and importance. If this is meant here, clearly most Member States would disagree. So we may assume that it is just words to keep someone happy (a little childish in an international document, but the term ‘One Health’ has been trending, like ‘equity,’ as if the concept of holistic approaches to public health were new).

    Article 6. Preparedness, health system resilience and recovery

    2. Each Party commits…[to] :

    (a) routine and essential health services during pandemics with a focus on primary health care, routine immunization and mental health care, and with particular attention to persons in vulnerable situations

    (b) developing, strengthening and maintaining health infrastructure

    (c) developing post-pandemic health system recovery strategies

    (d) developing, strengthening and maintaining: health information systems

    This is good, and (a) seems to require avoidance of lockdowns (which inevitably cause the harms listed). Unfortunately other WHO documents lead one to assume this is not the intent…It does appear therefore that this is simply another list of fairly non-specific feel-good measures that have no useful place in a new legally-binding agreement, and which most countries are already undertaking.

    (e) promoting the use of social and behavioural sciences, risk communication and community engagement for pandemic prevention, preparedness and response.

    This requires clarification, as the use of behavioral science during the Covid-19 response involved deliberate inducement of fear to promote behaviors that people would not otherwise follow (e.g. Spi-B). It is essential here that the document clarifies how behavioral science should be used ethically in healthcare. Otherwise, this is also a quite meaningless provision.

    Article 7. Health and care workforce

    This long Article discusses health workforce, training, retention, non-discrimination, stigma, bias, adequate remuneration, and other standard provisions for workplaces. It is unclear why it is included in a legally binding pandemic agreement, except for:

    4. [The Parties]…shall invest in establishing, sustaining, coordinating and mobilizing a skilled and trained multidisciplinary global public health emergency workforce…Parties having established emergency health teams should inform WHO thereof and make best efforts to respond to requests for deployment…

    Emergency health teams established (within capacity etc.) – are something countries already do, when they have capacity. There is no reason to have this as a legally-binding instrument, and clearly no urgency to do so.

    Article 8. Preparedness monitoring and functional reviews

    1. The Parties shall, building on existing and relevant tools, develop and implement an inclusive, transparent, effective and efficient pandemic prevention, preparedness and response monitoring and evaluation system.

    2. Each Party shall assess, every five years, with technical support from the WHO Secretariat upon request, the functioning and readiness of, and gaps in, its pandemic prevention, preparedness and response capacity, based on the relevant tools and guidelines developed by WHO in partnership with relevant organizations at international, regional and sub-regional levels.

    Note that this is being required of countries that are already struggling to implement monitoring systems for major endemic diseases, including tuberculosis, malaria, HIV, and nutritional deficiencies. They will be legally bound to divert resources to pandemic prevention. While there is some overlap, it will inevitably divert resources from currently underfunded programs for diseases of far higher local burdens, and so (not theoretically, but inevitably) raise mortality. Poor countries are being required to put resources into problems deemed significant by richer countries.

    Article 9. Research and development

    Various general provisions about undertaking background research that countries are generally doing anyway, but with an ’emerging disease’ slant. Again, the INB fails to justify why this diversion of resources from researching greater disease burdens should occur in all countries (why not just those with excess resources?).

    Article 10. Sustainable and geographically diversified production

    Mostly non-binding but suggested cooperation on making pandemic-related products available, including support for manufacturing in “inter-pandemic times” (a fascinating rendering of ‘normal’), when they would only be viable through subsidies. Much of this is probably unimplementable, as it would not be practical to maintain facilities in most or all countries on stand-by for rare events, at cost of resources otherwise useful for other priorities. The desire to increase production in ‘developing’ countries will face major barriers and costs in terms of maintaining quality of production, particularly as many products will have limited use outside of rare outbreak situations.

    Article 11. Transfer of technology and know-how

    This article, always problematic for large pharmaceutical corporations sponsoring much WHO outbreak activities, is now watered down to weak requirements to ‘consider,’ promote,’ provide, within capabilities’ etc.

    Article 12. Access and benefit sharing

    This Article is intended to establish the WHO Pathogen Access and Benefit-Sharing System (PABS System). PABS is intended to “ensure rapid, systematic and timely access to biological materials of pathogens with pandemic potential and the genetic sequence data.” This system is of potential high relevance and needs to be interpreted in the context that SARS-CoV-2, the pathogen causing the recent Covid-19 outbreak, was highly likely to have escaped from a laboratory. PABS is intended to expand the laboratory storage, transport, and handling of such viruses, under the oversight of the WHO, an organization outside of national jurisdiction with no significant direct experience in handling biological materials.

    3. When a Party has access to a pathogen [it shall]:

    (a) share with WHO any pathogen sequence information as soon as it is available to the Party;

    (b) as soon as biological materials are available to the Party, provide the materials to one or more laboratories and/or biorepositories participating in WHO-coordinated laboratory networks (CLNs),

    Subsequent clauses state that benefits will be shared, and seek to prevent recipient laboratories from patenting materials received from other countries. This has been a major concern of low-and middle-income countries previously, who perceive that institutions in wealthy countries patent and benefit from materials derived from less-wealthy populations. It remains to be seen whether provisions here will be sufficient to address this.

    The article then becomes yet more concerning:

    6. WHO shall conclude legally binding standard PABS contracts with manufacturers to provide the following, taking into account the size, nature and capacities of the manufacturer:

    (a) annual monetary contributions to support the PABS System and relevant capacities in countries; the determination of the annual amount, use, and approach for monitoring and accountability, shall be finalized by the Parties;

    (b) real-time contributions of relevant diagnostics, therapeutics or vaccines produced by the manufacturer, 10% free of charge and 10% at not-for-profit prices during public health emergencies of international concern or pandemics, …

    It is clearly intended that the WHO becomes directly involved in setting up legally binding manufacturing contracts, despite the WHO being outside of national jurisdictional oversight, within the territories of Member States. The PABS system, and therefore its staff and dependent entities, are also to be supported in part by funds from the manufacturers whom they are supposed to be managing. The income of the organization will be dependent on maintaining positive relationships with these private entities in a similar way in which many national regulatory agencies are dependent upon funds from pharmaceutical companies whom their staff ostensibly regulate. In this case, the regulator will be even further removed from public oversight.

    The clause on 10% (why 10?) products being free of charge, and similar at cost, while ensuring lower-priced commodities irrespective of actual need (the outbreak may be confined to wealthy countries). The same entity, the WHO, will determine whether the triggering emergency exists, determine the response, and manage the contracts to provide the commodities, without direct jurisdictional oversight regarding the potential for corruption or conflict of interest. It is a remarkable system to suggest, irrespective of political or regulatory environment.

    8. The Parties shall cooperate…public financing of research and development, prepurchase agreements, or regulatory procedures, to encourage and facilitate as many manufacturers as possible to enter into standard PABS contracts as early as possible.

    The article envisions that public funding will be used to build the process, ensuring essentially no-risk private profit.

    10. To support operationalization of the PABS System, WHO shall…make such contracts public, while respecting commercial confidentiality.

    The public may know whom contracts are made with, but not all details of the contracts. There will therefore be no independent oversight of the clauses agreed between the WHO, a body outside of national jurisdiction and dependent of commercial companies for funding some of its work and salaries, and these same companies, on ‘needs’ that the WHO itself will have sole authority, under the proposed amendments to the IHR, to determine.

    The Article further states that the WHO shall use its own product regulatory system (prequalification) and Emergency Use Listing Procedure to open and stimulate markets for the manufacturers of these products.

    It is doubtful that any national government could make such an overall agreement, yet in May 2024 they will be voting to provide this to what is essentially a foreign, and partly privately financed, entity.

    Article 13. Supply chain and logistics

    The WHO will become convenor of a ‘Global Supply Chain and Logistics Network’ for commercially-produced products, to be supplied under WHO contracts when and where the WHO determines, whilst also having the role of ensuring safety of such products.

    Having mutual support coordinated between countries is good. Having this run by an organization that is significantly funded directly by those gaining from the sale of these same commodities seems reckless and counterintuitive. Few countries would allow this (or at least plan for it).

    For this to occur safely, the WHO would logically have to forgo all private investment, and greatly restrict national specified funding contributions. Otherwise, the conflicts of interest involved would destroy confidence in the system. There is no suggestion of such divestment from the WHO, but rather, as in Article 12, private sector dependency, directly tied to contracts, will increase.

    Article 13bis: National procurement- and distribution-related provisions

    While suffering the same (perhaps unavoidable) issues regarding commercial confidentiality, this alternate Article 13 seems far more appropriate, keeping commercial issues under national jurisdiction and avoiding the obvious conflict of interests that underpin funding for WHO activities and staffing.

    Article 14. Regulatory systems strengthening

    This entire Article reflects initiatives and programs already in place. Nothing here appears likely to add to current effort.

    Article 15. Liability and compensation management

    1. Each Party shall consider developing, as necessary and in accordance with applicable law, national strategies for managing liability in its territory related to pandemic vaccines…no-fault compensation mechanisms…

    2. The Parties…shall develop recommendations for the establishment and implementation of national, regional and/or global no-fault compensation mechanisms and strategies for managing liability during pandemic emergencies, including with regard to individuals that are in a humanitarian setting or vulnerable situations.

    This is quite remarkable, but also reflects some national legislation, in removing any fault or liability specifically from vaccine manufacturers, for harms done in pushing out vaccines to the public. During the Covid-19 response, genetic therapeutics being developed by BioNtech and Moderna were reclassified as vaccines, on the basis that an immune response is stimulated after they have modified intracellular biochemical pathways as a medicine normally does.

    This enabled specific trials normally required for carcinogenicity and teratogenicity to be bypassed, despite raised fetal abnormality rates in animal trials. It will enable the CEPI 100-day vaccine program, supported with private funding to support private mRNA vaccine manufacturers, to proceed without any risk to the manufacturer should there be subsequent public harm.

    Together with an earlier provision on public funding of research and manufacturing readiness, and the removal of former wording requiring intellectual property sharing in Article 11, this ensures vaccine manufacturers and their investors make profit in effective absence of risk.

    These entities are currently heavily invested in support for WHO, and were strongly aligned with the introduction of newly restrictive outbreak responses that emphasized and sometimes mandated their products during the Covid-19 outbreak.

    Article 16. International collaboration and cooperation

    A somewhat pointless article. It suggests that countries cooperate with each other and the WHO to implement the other agreements in the Agreement.

    Article 17. Whole-of-government and whole-of-society approaches

    A list of essentially motherhood provisions related to planning for a pandemic. However, countries will legally be required to maintain a ‘national coordination multisectoral body’ for PPPR. This will essentially be an added burden on budgets, and inevitably divert further resources from other priorities. Perhaps just strengthening current infectious disease and nutritional programs would be more impactful. (Nowhere in this Agreement is nutrition discussed (essential for resilience to pathogens) and minimal wording is included on sanitation and clean water (other major reasons for reduction in infectious disease mortality over past centuries).

    However, the ‘community ownership’ wording is interesting (“empower and enable community ownership of, and contribution to, community readiness for and resilience [for PPPR]”), as this directly contradicts much of the rest of the Agreement, including the centralization of control under the Conference of Parties, requirements for countries to allocate resources to pandemic preparedness over other community priorities, and the idea of inspecting and assessing adherence to the centralized requirements of the Agreement. Either much of the rest of the Agreement is redundant, or this wording is purely for appearance and not to be followed (and therefore should be removed).

    Article 18. Communication and public awareness

    1. Each Party shall promote timely access to credible and evidence-based information …with the aim of countering and addressing misinformation or disinformation…

    2. The Parties shall, as appropriate, promote and/or conduct research and inform policies on factors that hinder or strengthen adherence to public health and social measures in a pandemic, as well as trust in science and public health institutions and agencies.

    The key word is as appropriate, given that many agencies, including the WHO, have overseen or aided policies during the Covid-19 response that have greatly increased poverty, child marriage, teenage pregnancy, and education loss.

    As the WHO has been shown to be significantly misrepresenting pandemic risk in the process of advocating for this Agreement and related instruments, its own communications would also fall outside the provision here related to evidence-based information, and fall within normal understandings of misinformation. It could not therefore be an arbiter of correctness of information here, so the Article is not implementable. Rewritten to recommend accurate evidence-based information being promoted, it would make good sense, but this is not an issue requiring a legally binding international agreement.

    Article 19. Implementation and support

    3. The WHO Secretariat…organize the technical and financial assistance necessary to address such gaps and needs in implementing the commitments agreed upon under the Pandemic Agreement and the International Health Regulations (2005).

    As the WHO is dependent on donor support, its ability to address gaps in funding within Member States is clearly not something it can guarantee. The purpose of this article is unclear, repeating in paragraphs 1 and 2 the earlier intent for countries to generally support each other.

    Article 20. Sustainable financing

    1. The Parties commit to working together…In this regard, each Party, within the means and resources at its disposal, shall:

    (a) prioritize and maintain or increase, as necessary, domestic funding for pandemic prevention, preparedness and response, without undermining other domestic public health priorities including for: (i) strengthening and sustaining capacities for the prevention, preparedness and response to health emergencies and pandemics, in particular the core capacities of the International Health Regulations (2005);…

    This is silly wording, as countries obviously have to prioritize within budgets, so that moving funds to one area means removing from another. The essence of public health policy is weighing and making such decisions; this reality seems to be ignored here through wishful thinking. (a) is clearly redundant, as the IHR (2005) already exists and countries have agreed to support it.

    3. A Coordinating Financial Mechanism (the “Mechanism”) is hereby established to support the implementation of both the WHO Pandemic Agreement and the International Health Regulations (2005)

    This will be in parallel to the Pandemic Fund recently commenced by the World Bank – an issue not lost on INB delegates and so likely to change here in the final version. It will also be additive to the Global Fund to fight AIDS, tuberculosis, and malaria, and other health financing mechanisms, and so require another parallel international bureaucracy, presumably based in Geneva.

    It is intended to have its own capacity to “conduct relevant analyses on needs and gaps, in addition to tracking cooperation efforts,” so it will not be a small undertaking.

    Chapter III. Institutional and final provisions

    Article 21. Conference of the Parties

    1. A Conference of the Parties is hereby established.

    2. The Conference of the Parties shall keep under regular review, every three years, the implementation of the WHO Pandemic Agreement and take the decisions necessary to promote its effective implementation.

    This sets up the governing body to oversee this Agreement (another body requiring a secretariat and support). It is intended to meet within a year of the Agreement coming into force, and then set its own rules on meeting thereafter. It is likely that many provisions outlined in this draft of the Agreement will be deferred to the COP for further discussion.

    Articles 22 – 37

    These articles cover the functioning of the Conference of Parties (COP) and various administrative issues.

    Of note, ‘block votes’ will be allowed from regional bodies (e.g. the EU).

    The WHO will provide the secretariat.

    Under Article 24 is noted:

    3. Nothing in the WHO Pandemic Agreement shall be interpreted as providing the Secretariat of the World Health Organization, including the WHO Director-General, any authority to direct, order, alter or otherwise prescribe the domestic laws or policies of any Party, or to mandate or otherwise impose any requirements that Parties take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures, or implement lockdowns.

    These provisions are explicitly stated in the proposed amendments to the IHR, to be considered alongside this agreement. Article 26 notes that the IHR is to be interpreted as compatible, thereby confirming that the IHR provisions including border closures and limits on freedom of movement, mandated vaccination, and other lockdown measures are not negated by this statement.

    As Article 26 states: “The Parties recognize that the WHO Pandemic Agreement and the International Health Regulations should be interpreted so as to be compatible.”

    Some would consider this subterfuge – The Director-General recently labeled as liars those who claimed the Agreement included these powers, whilst failing to acknowledge the accompanying IHR amendments. The WHO could do better in avoiding misleading messaging, especially when this involves denigration of the public.

    Article 32 (Withdrawal) requires that, once adopted, Parties cannot withdraw for a total of 3 years (giving notice after a minimum of 2 years). Financial obligations undertaken under the agreement continue beyond that time.

    Finally, the Agreement will come into force, assuming a two-thirds majority in the WHA is achieved (Article 19, WHO Constitution), 30 days after the fortieth country has ratified it.

    Further reading:

    WHO Pandemic Agreement Intergovernmental Negotiating Board website:

    https://inb.who.int/

    International Health Regulations Working Group website:

    https://apps.who.int/gb/wgihr/index.html

    On background to the WHO texts:

    Amendments to WHO’s International Health Regulations: An Annotated Guide
    An Unofficial Q&A on International Health Regulations
    On urgency and burden of pandemics:

    https://essl.leeds.ac.uk/downloads/download/228/rational-policy-over-panic

    Disease X and Davos: This is Not the Way to Evaluate and Formulate Public Health Policy
    Before Preparing for Pandemics, We Need Better Evidence of Risk
    Revised Draft of the negotiating text of the WHO Pandemic Agreement:

    Published under a Creative Commons Attribution 4.0 International License
    For reprints, please set the canonical link back to the original Brownstone Institute Article and Author.

    Authors

    David Bell
    David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. He is a former medical officer and scientist at the World Health Organization (WHO), Programme Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, WA, USA.

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    Thi Thuy Van Dinh
    Dr. Thi Thuy Van Dinh (LLM, PhD) worked on international law in the United Nations Office on Drugs and Crime and the Office of the High Commissioner for Human Rights. Subsequently, she managed multilateral organization partnerships for Intellectual Ventures Global Good Fund and led environmental health technology development efforts for low-resource settings.

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    https://brownstone.org/articles/the-who-pandemic-agreement-a-guide/

    https://www.minds.com/donshafi911/blog/the-who-pandemic-agreement-a-guide-1621719398509187077
    The WHO Pandemic Agreement: A Guide By David Bell, Thi Thuy Van Dinh March 22, 2024 Government, Society 30 minute read The World Health Organization (WHO) and its 194 Member States have been engaged for over two years in the development of two ‘instruments’ or agreements with the intent of radically changing the way pandemics and other health emergencies are managed. One, consisting of draft amendments to the existing International health Regulations (IHR), seeks to change the current IHR non-binding recommendations into requirements or binding recommendations, by having countries “undertake” to implement those given by the WHO in future declared health emergencies. It covers all ‘public health emergencies of international concern’ (PHEIC), with a single person, the WHO Director-General (DG) determining what a PHEIC is, where it extends, and when it ends. It specifies mandated vaccines, border closures, and other directives understood as lockdowns among the requirements the DG can impose. It is discussed further elsewhere and still under negotiation in Geneva. A second document, previously known as the (draft) Pandemic Treaty, then Pandemic Accord, and more recently the Pandemic Agreement, seeks to specify governance, supply chains, and various other interventions aimed at preventing, preparing for, and responding to, pandemics (pandemic prevention, preparedness and response – PPPR). It is currently being negotiated by the Intergovernmental Negotiating Body (INB). Both texts will be subject to a vote at the May 2024 World Health Assembly (WHA) in Geneva, Switzerland. These votes are intended, by those promoting these projects, to bring governance of future multi-country healthcare emergencies (or threats thereof) under the WHO umbrella. The latest version of the draft Pandemic Agreement (here forth the ‘Agreement’) was released on 7th March 2024. However, it is still being negotiated by various committees comprising representatives of Member States and other interested entities. It has been through multiple iterations over two years, and looks like it. With the teeth of the pandemic response proposals in the IHR, the Agreement looks increasingly irrelevant, or at least unsure of its purpose, picking up bits and pieces in a half-hearted way that the IHR amendments do not, or cannot, include. However, as discussed below, it is far from irrelevant. Historical Perspective These aim to increase the centralization of decision-making within the WHO as the “directing and coordinating authority.” This terminology comes from the WHO’s 1946 Constitution, developed in the aftermath of the Second World War as the world faced the outcomes of European fascism and the similar approaches widely imposed through colonialist regimes. The WHO would support emerging countries, with rapidly expanding and poorly resourced populations struggling under high disease burdens, and coordinate some areas of international support as these sovereign countries requested it. The emphasis of action was on coordinating rather than directing. In the 80 years prior to the WHO’s existence, international public health had grown within a more directive mindset, with a series of meetings by colonial and slave-owning powers from 1851 to manage pandemics, culminating in the inauguration of the Office Internationale d’Hygiene Publique in Paris in 1907, and later the League of Nations Health Office. World powers imposed health dictates on those less powerful, in other parts of the world and increasingly on their own population through the eugenics movement and similar approaches. Public health would direct, for the greater good, as a tool of those who wish to direct the lives of others. The WHO, governed by the WHA, was to be very different. Newly independent States and their former colonial masters were ostensibly on an equal footing within the WHA (one country – one vote), and the WHO’s work overall was to be an example of how human rights could dominate the way society works. The model for international public health, as exemplified in the Declaration of Alma Ata in 1978, was to be horizontal rather than vertical, with communities and countries in the driving seat. With the evolution of the WHO in recent decades from a core funding model (countries give money, the WHO decides under the WHA guidance how to spend it) to a model based on specified funding (funders, both public and increasingly private, instruct the WHO on how to spend it), the WHO has inevitably changed to become a public-private partnership required to serve the interests of funders rather than populations. As most funding comes from a few countries with major Pharma industrial bases, or private investors and corporations in the same industry, the WHO has been required to emphasize the use of pharmaceuticals and downplay evidence and knowledge where these clash (if it wants to keep all its staff funded). It is helpful to view the draft Agreement, and the IHR amendments, in this context. Why May 2024? The WHO, together with the World Bank, G20, and other institutions have been emphasizing the urgency of putting the new pandemic instruments in place earnestly, before the ‘next pandemic.’ This is based on claims that the world was unprepared for Covid-19, and that the economic and health harm would be somehow avoidable if we had these agreements in place. They emphasize, contrary to evidence that Covid-19 virus (SARS-CoV-2) origins involve laboratory manipulation, that the main threats we face are natural, and that these are increasing exponentially and present an “existential” threat to humanity. The data on which the WHO, the World Bank, and G20 base these claims demonstrates the contrary, with reported natural outbreaks having increased as detection technologies have developed, but reducing in mortality rate, and in numbers, over the past 10 to 20 years.. A paper cited by the World Bank to justify urgency and quoted as suggesting a 3x increase in risk in the coming decade actually suggests that a Covid-19-like event would occur roughly every 129 years, and a Spanish-flu repetition every 292 to 877 years. Such predictions are unable to take into account the rapidly changing nature of medicine and improved sanitation and nutrition (most deaths from Spanish flu would not have occurred if modern antibiotics had been available), and so may still overestimate risk. Similarly, the WHO’s own priority disease list for new outbreaks only includes two diseases of proven natural origin that have over 1,000 historical deaths attributed to them. It is well demonstrated that the risk and expected burden of pandemics is misrepresented by major international agencies in current discussions. The urgency for May 2024 is clearly therefore inadequately supported, firstly because neither the WHO nor others have demonstrated how the harms accrued through Covid-19 would be reduced through the measures proposed, and secondly because the burden and risk is misrepresented. In this context, the state of the Agreement is clearly not where it should be as a draft international legally binding agreement intended to impose considerable financial and other obligations on States and populations. This is particularly problematic as the proposed expenditure; the proposed budget is over $31 billion per year, with over $10 billion more on other One Health activities. Much of this will have to be diverted from addressing other diseases burdens that impose far greater burden. This trade-off, essential to understand in public health policy development, has not yet been clearly addressed by the WHO. The WHO DG stated recently that the WHO does not want the power to impose vaccine mandates or lockdowns on anyone, and does not want this. This begs the question of why either of the current WHO pandemic instruments is being proposed, both as legally binding documents. The current IHR (2005) already sets out such approaches as recommendations the DG can make, and there is nothing non-mandatory that countries cannot do now without pushing new treaty-like mechanisms through a vote in Geneva. Based on the DG’s claims, they are essentially redundant, and what new non-mandatory clauses they contain, as set out below, are certainly not urgent. Clauses that are mandatory (Member States “shall”) must be considered within national decision-making contexts and appear against the WHO’s stated intent. Common sense would suggest that the Agreement, and the accompanying IHR amendments, be properly thought through before Member States commit. The WHO has already abandoned the legal requirement for a 4-month review time for the IHR amendments (Article 55.2 IHR), which are also still under negotiation just 2 months before the WHA deadline. The Agreement should also have at least such a period for States to properly consider whether to agree – treaties normally take many years to develop and negotiate and no valid arguments have been put forward as to why these should be different. The Covid-19 response resulted in an unprecedented transfer of wealth from those of lower income to the very wealthy few, completely contrary to the way in which the WHO was intended to affect human society. A considerable portion of these pandemic profits went to current sponsors of the WHO, and these same corporate entities and investors are set to further benefit from the new pandemic agreements. As written, the Pandemic Agreement risks entrenching such centralization and profit-taking, and the accompanying unprecedented restrictions on human rights and freedoms, as a public health norm. To continue with a clearly flawed agreement simply because of a previously set deadline, when no clear population benefit is articulated and no true urgency demonstrated, would therefore be a major step backward in international public health. Basic principles of proportionality, human agency, and community empowerment, essential for health and human rights outcomes, are missing or paid lip-service. The WHO clearly wishes to increase its funding and show it is ‘doing something,’ but must first articulate why the voluntary provisions of the current IHR are insufficient. It is hoped that by systematically reviewing some key clauses of the agreement here, it will become clear why a rethink of the whole approach is necessary. The full text is found below. The commentary below concentrates on selected draft provisions of the latest publicly available version of the draft agreement that seem to be unclear or potentially problematic. Much of the remaining text is essentially pointless as it reiterates vague intentions to be found in other documents or activities which countries normally undertake in the course of running health services, and have no place in a focused legally-binding international agreement. REVISED Draft of the negotiating text of the WHO Pandemic Agreement. 7th March, 2024 Preamble Recognizing that the World Health Organization…is the directing and coordinating authority on international health work. This is inconsistent with a recent statement by the WHO DG that the WHO has no interest or intent to direct country health responses. To reiterate it here suggests that the DG is not representing the true position regarding the Agreement. “Directing authority” is however in line with the proposed IHR Amendments (and the WHO’s Constitution), under which countries will “undertake” ahead of time to follow the DG’s recommendations (which thereby become instructions). As the HR amendments make clear, this is intended to apply even to a perceived threat rather than actual harm. Recalling the constitution of the World Health Organization…highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. This statement recalls fundamental understandings of public health, and is of importance here as it raises the question of why the WHO did not strongly condemn prolonged school closures, workplace closures, and other impoverishing policies during the Covid-19 response. In 2019, WHO made clear that these dangers should prevent actions we now call ‘lockdowns’ from being imposed. Deeply concerned by the gross inequities at national and international levels that hindered timely and equitable access to medical and other Covid-19 pandemic-related products, and the serious shortcomings in pandemic preparedness. In terms of health equity (as distinct from commodity of ‘vaccine’ equity), inequity in the Covid-19 response was not in failing to provide a vaccine against former variants to immune, young people in low-income countries who were at far higher risk from endemic diseases, but in the disproportionate harm to them of uniformly-imposed NPIs that reduced current and future income and basic healthcare, as was noted by the WHO in 2019 Pandemic Influenza recommendations. The failure of the text to recognize this suggests that lessons from Covid-19 have not informed this draft Agreement. The WHO has not yet demonstrated how pandemic ‘preparedness,’ in the terms they use below, would have reduced impact, given that there is poor correlation between strictness or speed of response and eventual outcomes. Reiterating the need to work towards…an equitable approach to mitigate the risk that pandemics exacerbate existing inequities in access to health services, As above – in the past century, the issue of inequity has been most pronounced in pandemic response, rather than the impact of the virus itself (excluding the physiological variation in risk). Most recorded deaths from acute pandemics, since the Spanish flu, were during Covid-19, in which the virus hit mainly sick elderly, but response impacted working-age adults and children heavily and will continue to have effect, due to increased poverty and debt; reduced education and child marriage, in future generations. These have disproportionately affected lower-income people, and particularly women. The lack of recognition of this in this document, though they are recognized by the World Bank and UN agencies elsewhere, must raise real questions on whether this Agreement has been thoroughly thought through, and the process of development been sufficiently inclusive and objective. Chapter I. Introduction Article 1. Use of terms (i) “pathogen with pandemic potential” means any pathogen that has been identified to infect a human and that is: novel (not yet characterized) or known (including a variant of a known pathogen), potentially highly transmissible and/or highly virulent with the potential to cause a public health emergency of international concern. This provides a very wide scope to alter provisions. Any pathogen that can infect humans and is potentially highly transmissible or virulent, though yet uncharacterized means virtually any coronavirus, influenza virus, or a plethora of other relatively common pathogen groups. The IHR Amendments intend that the DG alone can make this call, over the advice of others, as occurred with monkeypox in 2022. (j) “persons in vulnerable situations” means individuals, groups or communities with a disproportionate increased risk of infection, severity, disease or mortality. This is a good definition – in Covid-19 context, would mean the sick elderly, and so is relevant to targeting a response. “Universal health coverage” means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. While the general UHC concept is good, it is time a sensible (rather than patently silly) definition was adopted. Society cannot afford the full range of possible interventions and remedies for all, and clearly there is a scale of cost vs benefit that prioritizes certain ones over others. Sensible definitions make action more likely, and inaction harder to justify. One could argue that none should have the full range until all have good basic care, but clearly the earth will not support ‘the full range’ for 8 billion people. Article 2. Objective This Agreement is specifically for pandemics (a poorly defined term but essentially a pathogen that spreads rapidly across national borders). In contrast, the IHR amendments accompanying it are broader in scope – for any public health emergencies of international concern. Article 3. Principles 2. the sovereign right of States to adopt, legislate and implement legislation The amendments to the IHR require States to undertake to follow WHO instructions ahead of time, before such instruction and context are known. These two documents must be understood, as noted later in the Agreement draft, as complementary. 3. equity as the goal and outcome of pandemic prevention, preparedness and response, ensuring the absence of unfair, avoidable or remediable differences among groups of people. This definition of equity here needs clarification. In the pandemic context, the WHO emphasized commodity (vaccine) equity during the Covid-19 response. Elimination of differences implied equal access to Covid-19 vaccines in countries with large aging, obese highly vulnerable populations (e.g. the USA or Italy), and those with young populations at minimal risk and with far more pressing health priorities (e.g. Niger or Uganda). Alternatively, but equally damaging, equal access to different age groups within a country when the risk-benefit ratio is clearly greatly different. This promotes worse health outcomes by diverting resources from where they are most useful, as it ignores heterogeneity of risk. Again, an adult approach is required in international agreements, rather than feel-good sentences, if they are going to have a positive impact. 5. …a more equitable and better prepared world to prevent, respond to and recover from pandemics As with ‘3’ above, this raises a fundamental problem: What if health equity demands that some populations divert resources to childhood nutrition and endemic diseases rather than the latest pandemic, as these are likely of far higher burden to many younger but lower-income populations? This would not be equity in the definition implied here, but would clearly lead to better and more equal health outcomes. The WHO must decide whether it is about uniform action, or minimizing poor health, as these are clearly very different. They are the difference between the WHO’s commodity equity, and true health equity. Chapter II. The world together equitably: achieving equity in, for and through pandemic prevention, preparedness and response Equity in health should imply a reasonably equal chance of overcoming or avoiding preventable sickness. The vast majority of sickness and death is due to either non-communicable diseases often related to lifestyle, such as obesity and type 2 diabetes mellitus, undernutrition in childhood, and endemic infectious diseases such as tuberculosis, malaria, and HIV/AIDS. Achieving health equity would primarily mean addressing these. In this chapter of the draft Pandemic Agreement, equity is used to imply equal access to specific health commodities, particularly vaccines, for intermittent health emergencies, although these exert a small fraction of the burden of other diseases. It is, specifically, commodity-equity, and not geared to equalizing overall health burden but to enabling centrally-coordinated homogenous responses to unusual events. Article 4. Pandemic prevention and surveillance 2. The Parties shall undertake to cooperate: (b) in support of…initiatives aimed at preventing pandemics, in particular those that improve surveillance, early warning and risk assessment; .…and identify settings and activities presenting a risk of emergence and re-emergence of pathogens with pandemic potential. (c-h) [Paragraphs on water and sanitation, infection control, strengthening of biosafety, surveillance and prevention of vector-born diseases, and addressing antimicrobial resistance.] The WHO intends the Agreement to have force under international law. Therefore, countries are undertaking to put themselves under force of international law in regards to complying with the agreement’s stipulations. The provisions under this long article mostly cover general health stuff that countries try to do anyway. The difference will be that countries will be assessed on progress. Assessment can be fine if in context, less fine if it consists of entitled ‘experts’ from wealthy countries with little local knowledge or context. Perhaps such compliance is best left to national authorities, who are more in use with local needs and priorities. The justification for the international bureaucracy being built to support this, while fun for those involved, is unclear and will divert resources from actual health work. 6. The Conference of the Parties may adopt, as necessary, guidelines, recommendations and standards, including in relation to pandemic prevention capacities, to support the implementation of this Article. Here and later, the COP is invoked as a vehicle to decide on what will actually be done. The rules are explained later (Articles 21-23). While allowing more time is sensible, it begs the question of why it is not better to wait and discuss what is needed in the current INB process, before committing to a legally-binding agreement. This current article says nothing not already covered by the IHR2005 or other ongoing programs. Article 5. One Health approach to pandemic prevention, preparedness and response Nothing specific or new in this article. It seems redundant (it is advocating a holistic approach mentioned elsewhere) and so presumably is just to get the term ‘One Health’ into the agreement. (One could ask, why bother?) Some mainstream definitions of One Health (e.g. Lancet) consider that it means non-human species are on a par with humans in terms of rights and importance. If this is meant here, clearly most Member States would disagree. So we may assume that it is just words to keep someone happy (a little childish in an international document, but the term ‘One Health’ has been trending, like ‘equity,’ as if the concept of holistic approaches to public health were new). Article 6. Preparedness, health system resilience and recovery 2. Each Party commits…[to] : (a) routine and essential health services during pandemics with a focus on primary health care, routine immunization and mental health care, and with particular attention to persons in vulnerable situations (b) developing, strengthening and maintaining health infrastructure (c) developing post-pandemic health system recovery strategies (d) developing, strengthening and maintaining: health information systems This is good, and (a) seems to require avoidance of lockdowns (which inevitably cause the harms listed). Unfortunately other WHO documents lead one to assume this is not the intent…It does appear therefore that this is simply another list of fairly non-specific feel-good measures that have no useful place in a new legally-binding agreement, and which most countries are already undertaking. (e) promoting the use of social and behavioural sciences, risk communication and community engagement for pandemic prevention, preparedness and response. This requires clarification, as the use of behavioral science during the Covid-19 response involved deliberate inducement of fear to promote behaviors that people would not otherwise follow (e.g. Spi-B). It is essential here that the document clarifies how behavioral science should be used ethically in healthcare. Otherwise, this is also a quite meaningless provision. Article 7. Health and care workforce This long Article discusses health workforce, training, retention, non-discrimination, stigma, bias, adequate remuneration, and other standard provisions for workplaces. It is unclear why it is included in a legally binding pandemic agreement, except for: 4. [The Parties]…shall invest in establishing, sustaining, coordinating and mobilizing a skilled and trained multidisciplinary global public health emergency workforce…Parties having established emergency health teams should inform WHO thereof and make best efforts to respond to requests for deployment… Emergency health teams established (within capacity etc.) – are something countries already do, when they have capacity. There is no reason to have this as a legally-binding instrument, and clearly no urgency to do so. Article 8. Preparedness monitoring and functional reviews 1. The Parties shall, building on existing and relevant tools, develop and implement an inclusive, transparent, effective and efficient pandemic prevention, preparedness and response monitoring and evaluation system. 2. Each Party shall assess, every five years, with technical support from the WHO Secretariat upon request, the functioning and readiness of, and gaps in, its pandemic prevention, preparedness and response capacity, based on the relevant tools and guidelines developed by WHO in partnership with relevant organizations at international, regional and sub-regional levels. Note that this is being required of countries that are already struggling to implement monitoring systems for major endemic diseases, including tuberculosis, malaria, HIV, and nutritional deficiencies. They will be legally bound to divert resources to pandemic prevention. While there is some overlap, it will inevitably divert resources from currently underfunded programs for diseases of far higher local burdens, and so (not theoretically, but inevitably) raise mortality. Poor countries are being required to put resources into problems deemed significant by richer countries. Article 9. Research and development Various general provisions about undertaking background research that countries are generally doing anyway, but with an ’emerging disease’ slant. Again, the INB fails to justify why this diversion of resources from researching greater disease burdens should occur in all countries (why not just those with excess resources?). Article 10. Sustainable and geographically diversified production Mostly non-binding but suggested cooperation on making pandemic-related products available, including support for manufacturing in “inter-pandemic times” (a fascinating rendering of ‘normal’), when they would only be viable through subsidies. Much of this is probably unimplementable, as it would not be practical to maintain facilities in most or all countries on stand-by for rare events, at cost of resources otherwise useful for other priorities. The desire to increase production in ‘developing’ countries will face major barriers and costs in terms of maintaining quality of production, particularly as many products will have limited use outside of rare outbreak situations. Article 11. Transfer of technology and know-how This article, always problematic for large pharmaceutical corporations sponsoring much WHO outbreak activities, is now watered down to weak requirements to ‘consider,’ promote,’ provide, within capabilities’ etc. Article 12. Access and benefit sharing This Article is intended to establish the WHO Pathogen Access and Benefit-Sharing System (PABS System). PABS is intended to “ensure rapid, systematic and timely access to biological materials of pathogens with pandemic potential and the genetic sequence data.” This system is of potential high relevance and needs to be interpreted in the context that SARS-CoV-2, the pathogen causing the recent Covid-19 outbreak, was highly likely to have escaped from a laboratory. PABS is intended to expand the laboratory storage, transport, and handling of such viruses, under the oversight of the WHO, an organization outside of national jurisdiction with no significant direct experience in handling biological materials. 3. When a Party has access to a pathogen [it shall]: (a) share with WHO any pathogen sequence information as soon as it is available to the Party; (b) as soon as biological materials are available to the Party, provide the materials to one or more laboratories and/or biorepositories participating in WHO-coordinated laboratory networks (CLNs), Subsequent clauses state that benefits will be shared, and seek to prevent recipient laboratories from patenting materials received from other countries. This has been a major concern of low-and middle-income countries previously, who perceive that institutions in wealthy countries patent and benefit from materials derived from less-wealthy populations. It remains to be seen whether provisions here will be sufficient to address this. The article then becomes yet more concerning: 6. WHO shall conclude legally binding standard PABS contracts with manufacturers to provide the following, taking into account the size, nature and capacities of the manufacturer: (a) annual monetary contributions to support the PABS System and relevant capacities in countries; the determination of the annual amount, use, and approach for monitoring and accountability, shall be finalized by the Parties; (b) real-time contributions of relevant diagnostics, therapeutics or vaccines produced by the manufacturer, 10% free of charge and 10% at not-for-profit prices during public health emergencies of international concern or pandemics, … It is clearly intended that the WHO becomes directly involved in setting up legally binding manufacturing contracts, despite the WHO being outside of national jurisdictional oversight, within the territories of Member States. The PABS system, and therefore its staff and dependent entities, are also to be supported in part by funds from the manufacturers whom they are supposed to be managing. The income of the organization will be dependent on maintaining positive relationships with these private entities in a similar way in which many national regulatory agencies are dependent upon funds from pharmaceutical companies whom their staff ostensibly regulate. In this case, the regulator will be even further removed from public oversight. The clause on 10% (why 10?) products being free of charge, and similar at cost, while ensuring lower-priced commodities irrespective of actual need (the outbreak may be confined to wealthy countries). The same entity, the WHO, will determine whether the triggering emergency exists, determine the response, and manage the contracts to provide the commodities, without direct jurisdictional oversight regarding the potential for corruption or conflict of interest. It is a remarkable system to suggest, irrespective of political or regulatory environment. 8. The Parties shall cooperate…public financing of research and development, prepurchase agreements, or regulatory procedures, to encourage and facilitate as many manufacturers as possible to enter into standard PABS contracts as early as possible. The article envisions that public funding will be used to build the process, ensuring essentially no-risk private profit. 10. To support operationalization of the PABS System, WHO shall…make such contracts public, while respecting commercial confidentiality. The public may know whom contracts are made with, but not all details of the contracts. There will therefore be no independent oversight of the clauses agreed between the WHO, a body outside of national jurisdiction and dependent of commercial companies for funding some of its work and salaries, and these same companies, on ‘needs’ that the WHO itself will have sole authority, under the proposed amendments to the IHR, to determine. The Article further states that the WHO shall use its own product regulatory system (prequalification) and Emergency Use Listing Procedure to open and stimulate markets for the manufacturers of these products. It is doubtful that any national government could make such an overall agreement, yet in May 2024 they will be voting to provide this to what is essentially a foreign, and partly privately financed, entity. Article 13. Supply chain and logistics The WHO will become convenor of a ‘Global Supply Chain and Logistics Network’ for commercially-produced products, to be supplied under WHO contracts when and where the WHO determines, whilst also having the role of ensuring safety of such products. Having mutual support coordinated between countries is good. Having this run by an organization that is significantly funded directly by those gaining from the sale of these same commodities seems reckless and counterintuitive. Few countries would allow this (or at least plan for it). For this to occur safely, the WHO would logically have to forgo all private investment, and greatly restrict national specified funding contributions. Otherwise, the conflicts of interest involved would destroy confidence in the system. There is no suggestion of such divestment from the WHO, but rather, as in Article 12, private sector dependency, directly tied to contracts, will increase. Article 13bis: National procurement- and distribution-related provisions While suffering the same (perhaps unavoidable) issues regarding commercial confidentiality, this alternate Article 13 seems far more appropriate, keeping commercial issues under national jurisdiction and avoiding the obvious conflict of interests that underpin funding for WHO activities and staffing. Article 14. Regulatory systems strengthening This entire Article reflects initiatives and programs already in place. Nothing here appears likely to add to current effort. Article 15. Liability and compensation management 1. Each Party shall consider developing, as necessary and in accordance with applicable law, national strategies for managing liability in its territory related to pandemic vaccines…no-fault compensation mechanisms… 2. The Parties…shall develop recommendations for the establishment and implementation of national, regional and/or global no-fault compensation mechanisms and strategies for managing liability during pandemic emergencies, including with regard to individuals that are in a humanitarian setting or vulnerable situations. This is quite remarkable, but also reflects some national legislation, in removing any fault or liability specifically from vaccine manufacturers, for harms done in pushing out vaccines to the public. During the Covid-19 response, genetic therapeutics being developed by BioNtech and Moderna were reclassified as vaccines, on the basis that an immune response is stimulated after they have modified intracellular biochemical pathways as a medicine normally does. This enabled specific trials normally required for carcinogenicity and teratogenicity to be bypassed, despite raised fetal abnormality rates in animal trials. It will enable the CEPI 100-day vaccine program, supported with private funding to support private mRNA vaccine manufacturers, to proceed without any risk to the manufacturer should there be subsequent public harm. Together with an earlier provision on public funding of research and manufacturing readiness, and the removal of former wording requiring intellectual property sharing in Article 11, this ensures vaccine manufacturers and their investors make profit in effective absence of risk. These entities are currently heavily invested in support for WHO, and were strongly aligned with the introduction of newly restrictive outbreak responses that emphasized and sometimes mandated their products during the Covid-19 outbreak. Article 16. International collaboration and cooperation A somewhat pointless article. It suggests that countries cooperate with each other and the WHO to implement the other agreements in the Agreement. Article 17. Whole-of-government and whole-of-society approaches A list of essentially motherhood provisions related to planning for a pandemic. However, countries will legally be required to maintain a ‘national coordination multisectoral body’ for PPPR. This will essentially be an added burden on budgets, and inevitably divert further resources from other priorities. Perhaps just strengthening current infectious disease and nutritional programs would be more impactful. (Nowhere in this Agreement is nutrition discussed (essential for resilience to pathogens) and minimal wording is included on sanitation and clean water (other major reasons for reduction in infectious disease mortality over past centuries). However, the ‘community ownership’ wording is interesting (“empower and enable community ownership of, and contribution to, community readiness for and resilience [for PPPR]”), as this directly contradicts much of the rest of the Agreement, including the centralization of control under the Conference of Parties, requirements for countries to allocate resources to pandemic preparedness over other community priorities, and the idea of inspecting and assessing adherence to the centralized requirements of the Agreement. Either much of the rest of the Agreement is redundant, or this wording is purely for appearance and not to be followed (and therefore should be removed). Article 18. Communication and public awareness 1. Each Party shall promote timely access to credible and evidence-based information …with the aim of countering and addressing misinformation or disinformation… 2. The Parties shall, as appropriate, promote and/or conduct research and inform policies on factors that hinder or strengthen adherence to public health and social measures in a pandemic, as well as trust in science and public health institutions and agencies. The key word is as appropriate, given that many agencies, including the WHO, have overseen or aided policies during the Covid-19 response that have greatly increased poverty, child marriage, teenage pregnancy, and education loss. As the WHO has been shown to be significantly misrepresenting pandemic risk in the process of advocating for this Agreement and related instruments, its own communications would also fall outside the provision here related to evidence-based information, and fall within normal understandings of misinformation. It could not therefore be an arbiter of correctness of information here, so the Article is not implementable. Rewritten to recommend accurate evidence-based information being promoted, it would make good sense, but this is not an issue requiring a legally binding international agreement. Article 19. Implementation and support 3. The WHO Secretariat…organize the technical and financial assistance necessary to address such gaps and needs in implementing the commitments agreed upon under the Pandemic Agreement and the International Health Regulations (2005). As the WHO is dependent on donor support, its ability to address gaps in funding within Member States is clearly not something it can guarantee. The purpose of this article is unclear, repeating in paragraphs 1 and 2 the earlier intent for countries to generally support each other. Article 20. Sustainable financing 1. The Parties commit to working together…In this regard, each Party, within the means and resources at its disposal, shall: (a) prioritize and maintain or increase, as necessary, domestic funding for pandemic prevention, preparedness and response, without undermining other domestic public health priorities including for: (i) strengthening and sustaining capacities for the prevention, preparedness and response to health emergencies and pandemics, in particular the core capacities of the International Health Regulations (2005);… This is silly wording, as countries obviously have to prioritize within budgets, so that moving funds to one area means removing from another. The essence of public health policy is weighing and making such decisions; this reality seems to be ignored here through wishful thinking. (a) is clearly redundant, as the IHR (2005) already exists and countries have agreed to support it. 3. A Coordinating Financial Mechanism (the “Mechanism”) is hereby established to support the implementation of both the WHO Pandemic Agreement and the International Health Regulations (2005) This will be in parallel to the Pandemic Fund recently commenced by the World Bank – an issue not lost on INB delegates and so likely to change here in the final version. It will also be additive to the Global Fund to fight AIDS, tuberculosis, and malaria, and other health financing mechanisms, and so require another parallel international bureaucracy, presumably based in Geneva. It is intended to have its own capacity to “conduct relevant analyses on needs and gaps, in addition to tracking cooperation efforts,” so it will not be a small undertaking. Chapter III. Institutional and final provisions Article 21. Conference of the Parties 1. A Conference of the Parties is hereby established. 2. The Conference of the Parties shall keep under regular review, every three years, the implementation of the WHO Pandemic Agreement and take the decisions necessary to promote its effective implementation. This sets up the governing body to oversee this Agreement (another body requiring a secretariat and support). It is intended to meet within a year of the Agreement coming into force, and then set its own rules on meeting thereafter. It is likely that many provisions outlined in this draft of the Agreement will be deferred to the COP for further discussion. Articles 22 – 37 These articles cover the functioning of the Conference of Parties (COP) and various administrative issues. Of note, ‘block votes’ will be allowed from regional bodies (e.g. the EU). The WHO will provide the secretariat. Under Article 24 is noted: 3. Nothing in the WHO Pandemic Agreement shall be interpreted as providing the Secretariat of the World Health Organization, including the WHO Director-General, any authority to direct, order, alter or otherwise prescribe the domestic laws or policies of any Party, or to mandate or otherwise impose any requirements that Parties take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures, or implement lockdowns. These provisions are explicitly stated in the proposed amendments to the IHR, to be considered alongside this agreement. Article 26 notes that the IHR is to be interpreted as compatible, thereby confirming that the IHR provisions including border closures and limits on freedom of movement, mandated vaccination, and other lockdown measures are not negated by this statement. As Article 26 states: “The Parties recognize that the WHO Pandemic Agreement and the International Health Regulations should be interpreted so as to be compatible.” Some would consider this subterfuge – The Director-General recently labeled as liars those who claimed the Agreement included these powers, whilst failing to acknowledge the accompanying IHR amendments. The WHO could do better in avoiding misleading messaging, especially when this involves denigration of the public. Article 32 (Withdrawal) requires that, once adopted, Parties cannot withdraw for a total of 3 years (giving notice after a minimum of 2 years). Financial obligations undertaken under the agreement continue beyond that time. Finally, the Agreement will come into force, assuming a two-thirds majority in the WHA is achieved (Article 19, WHO Constitution), 30 days after the fortieth country has ratified it. Further reading: WHO Pandemic Agreement Intergovernmental Negotiating Board website: https://inb.who.int/ International Health Regulations Working Group website: https://apps.who.int/gb/wgihr/index.html On background to the WHO texts: Amendments to WHO’s International Health Regulations: An Annotated Guide An Unofficial Q&A on International Health Regulations On urgency and burden of pandemics: https://essl.leeds.ac.uk/downloads/download/228/rational-policy-over-panic Disease X and Davos: This is Not the Way to Evaluate and Formulate Public Health Policy Before Preparing for Pandemics, We Need Better Evidence of Risk Revised Draft of the negotiating text of the WHO Pandemic Agreement: Published under a Creative Commons Attribution 4.0 International License For reprints, please set the canonical link back to the original Brownstone Institute Article and Author. Authors David Bell David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. He is a former medical officer and scientist at the World Health Organization (WHO), Programme Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, WA, USA. View all posts Thi Thuy Van Dinh Dr. Thi Thuy Van Dinh (LLM, PhD) worked on international law in the United Nations Office on Drugs and Crime and the Office of the High Commissioner for Human Rights. Subsequently, she managed multilateral organization partnerships for Intellectual Ventures Global Good Fund and led environmental health technology development efforts for low-resource settings. View all posts Your financial backing of Brownstone Institute goes to support writers, lawyers, scientists, economists, and other people of courage who have been professionally purged and displaced during the upheaval of our times. You can help get the truth out through their ongoing work. https://brownstone.org/articles/the-who-pandemic-agreement-a-guide/ https://www.minds.com/donshafi911/blog/the-who-pandemic-agreement-a-guide-1621719398509187077
    BROWNSTONE.ORG
    The WHO Pandemic Agreement: A Guide ⋆ Brownstone Institute
    The commentary below concentrates on selected draft provisions of the latest publicly available version of the draft agreement that seem to be unclear or potentially problematic.
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  • Why Does the WHO Make False Claims Regarding Proposals to Seize States’ Sovereignty?
    By David Bell, Thi Thuy Van Dinh December 11, 2023 Government, Law, Public Health 15 minute read
    The Director General (DG) of the World Health Organization (WHO) states:

    No country will cede any sovereignty to WHO,

    referring to the WHO’s new pandemic agreement and proposed amendments to the International Health Regulations (IHR), currently being negotiated. His statements are clear and unequivocal, and wholly inconsistent with the texts he is referring to.

    A rational examination of the texts in question shows that:

    The documents propose a transfer of decision-making power to the WHO regarding basic aspects of societal function, which countries undertake to enact.
    The WHO DG will have sole authority to decide when and where they are applied.
    The proposals are intended to be binding under international law.
    Continued claims that sovereignty is not lost, echoed by politicians and media, therefore raise important questions concerning motivations, competence, and ethics.

    The intent of the texts is a transfer of decision-making currently vested in Nations and individuals to the WHO, when its DG decides that there is a threat of a significant disease outbreak or other health emergency likely to cross multiple national borders. It is unusual for Nations to undertake to follow external entities regarding the basic rights and healthcare of their citizens, more so when this has major economic and geopolitical implications.

    The question of whether sovereignty is indeed being transferred, and the legal status of such an agreement, is therefore of vital importance, particularly to the legislators of democratic States. They have an absolute duty to be sure of their ground. We systematically examine that ground here.

    The Proposed IHR Amendments and Sovereignty in Health Decision-Making

    Amending the 2005 IHR may be a straightforward way to quickly deploy and enforce “new normal” health control measures. The current text applies to virtually the entire global population, counting 196 States Parties including all 194 WHO Member States. Approval may or may not require a formal vote of the World Health Assembly (WHA), as the recent 2022 amendment was adopted through consensus. If the same approval mechanism is to be used in May 2024, many countries and the public may remain unaware of the broad scope of the new text and its implications to national and individual sovereignty.

    The IHR are a set of recommendations under a treaty process that has force under international law. They seek to provide the WHO with some moral authority to coordinate and lead responses when an international health emergency, such as pandemic, occurs. Most are non-binding, and these contain very specific examples of measures that the WHO can recommend, including (Article 18):

    require medical examinations;
    review proof of vaccination or other prophylaxis;
    require vaccination or other prophylaxis;
    place suspect persons under public health observation;
    implement quarantine or other health measures for suspect persons;
    implement isolation and treatment where necessary of affected persons;
    implement tracing of contacts of suspect or affected persons;
    refuse entry of suspect and affected persons;
    refuse entry of unaffected persons to affected areas; and
    implement exit screening and/or restrictions on persons from affected areas.
    These measures, when implemented together, are generally referred to since early 2020 as ‘lockdowns’ and ‘mandates.’ ‘Lockdown’ was previously a term reserved for people incarcerated as criminals, as it removes basic universally accepted human rights and such measures were considered by the WHO to be detrimental to public health. However, since 2020 it has become the default standard for public health authorities to manage epidemics, despite its contradictions to multiple stipulations of the Universal Declaration of Human Rights (UDHR):

    Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind including no arbitrary detention (Article 9).
    No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence (Article 12).
    Everyone has the right to freedom of movement and residence within the borders of each state, and Everyone has the right to leave any country, including his own, and to return to his country (Article 13).
    Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers (Article 19).
    Everyone has the right to freedom of peaceful assembly and association (Article 20).
    The will of the people shall be the basis of the authority of government (Article 21).
    Everyone has the right to work (Article 23).
    Everyone has the right to education (Article 26).
    Everyone is entitled to a social and international order in which the rights and freedoms set forth in this Declaration can be fully realized (Article 28).
    Nothing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein (Article 30).
    These UDHR stipulations are the basis of the modern concept of individual sovereignty, and the relationship between authorities and their populations. Considered the highest codification of the rights and freedoms of individuals in the 20th century, they may soon be dismantled behind closed doors in a meeting room in Geneva.

    The proposed amendments will change the “recommendations” of the current document to requirements through three mechanisms on

    Removing the term ‘non-binding’ (Article 1),
    Inserting the phrase that Member States will “undertake to follow WHO’s recommendations” and recognize WHO, not as an organization under the control of countries, but as the “coordinating authority” (New Article 13A).
    States Parties recognize WHO as the guidance and coordinating authority of international public health response during public health Emergency of International Concern and undertake to follow WHO’s recommendations in their international public health response.

    As Article 18 makes clear above, these include multiple actions directly restricting individual liberty. If transfer of decision-making power (sovereignty) is not intended here, then the current status of the IHR as ‘recommendations’ could remain and countries would not be undertaking to follow the WHO’s requirements.

    States Parties undertake to enact what previously were merely recommendations, without delay, including requirements of WHO regarding non-State entities under their jurisdiction (Article 42):
    Health measures taken pursuant to these Regulations, including the recommendations made under Articles 15 and 16, shall be initiated and completed without delay by all State Parties and applied in a transparent, equitable and non-discriminatory manner. State Parties shall also take measures to ensure Non-State Actors operating in their respective territories comply with such measures.

    Articles 15 and 16 mentioned here allow the WHO to require a State to provide resources “health products, technologies, and know-how,” and to allow the WHO to deploy personnel into the country (i.e., have control over entry across national borders for those they choose). They also repeat the requirement for the country to require the implementation of medical countermeasures (e.g., testing, vaccines, quarantine) on their population where WHO demands it.

    Of note, the proposed Article 1 amendment (removing ‘non-binding’) is actually redundant if New Article 13A and/or the changes in Article 42 remain. This can (and likely will) be removed from the final text, giving an appearance of compromise without changing the transfer of sovereignty.

    All of the public health measures in Article 18, and additional ones such as limiting freedom of speech to reduce public exposure to alternative viewpoints (Annex 1, New 5 (e); “…counter misinformation and disinformation”) clash directly with the UDHR. Although freedom of speech is currently the exclusive purview of national authorities and its restriction is generally seen as negative and abusive, United Nations institutions, including the WHO, have been advocating for censoring unofficial views in order to protect what they call “information integrity.”

    It seems outrageous from a human rights perspective that the amendments will enable the WHO to dictate countries to require individual medical examinations and vaccinations whenever it declares a pandemic. While the Nuremberg Code and Declaration of Helsinki refer specifically to human experimentation (e.g. clinical trials of vaccines) and the Universal Declaration on Bioethics and Human Rights also to the provider-patient relationship, they can reasonably be extended to public health measures that impose restrictions or changes to human behavior, and specifically to any measures requiring injection, medication, or medical examination which involve a direct provider-person interaction.

    If vaccines or drugs are still under trial or not fully tested, then the issue of being the subject of an experiment is also real. There is a clear intent to employ the CEPI ‘100 day’ vaccine program, which by definition cannot complete meaningful safety or efficacy trials within that time span.

    Forced examination or medication, outside of a situation where the recipient is clearly not mentally competent to comply or reject when provided with information, is unethical. Requiring compliance in order to access what are considered basic human rights under the UDHR would constitute coercion. If this does not fit the WHO’s definition of infringement on individual sovereignty, and on national sovereignty, then the DG and his supporters need to publicly explain what definition they are using.

    The Proposed WHO Pandemic Agreement as a Tool to Manage Transfer of Sovereignty

    The proposed pandemic agreement will set humanity in a new era strangely organized around pandemics: pre-pandemic, pandemic, and inter-pandemic. A new governance structure under WHO auspices will oversee the IHR amendments and related initiatives. It will rely on new funding requirements, including the WHO’s ability to demand additional funding and materials from countries and to run a supply network to support its work in health emergencies (Article 12):

    In the event of a pandemic, real-time access by WHO to a minimum of 20% (10% as a donation and 10% at affordable prices to WHO) of the production of safe, efficacious and effective pandemic-related products for distribution based on public health risks and needs, with the understanding that each Party that has manufacturing facilities that produce pandemic-related products in its jurisdiction shall take all necessary steps to facilitate the export of such pandemic-related products, in accordance with timetables to be agreed between WHO and manufacturers.

    And Article 20 (1):

    …provide support and assistance to other Parties, upon request, to facilitate the containment of spill-over at the source.

    The entire structure will be financed by a new funding stream separate from current WHO funding – an additional requirement on taxpayers over current national commitments (Article 20 (2)). The funding will also include an endowment of voluntary contributions of “all relevant sectors that benefit from international work to strengthen pandemic preparation, preparedness and response” and donations from philanthropic organizations (Article 20 (2)b).

    Currently, countries decide on foreign aid on the basis of national priorities, apart from limited funding that they have agreed to allocate to organizations such as WHO under existing obligations or treaties. The proposed agreement is remarkable not just in greatly increasing the amount countries must give as treaty requirements, but in setting up a parallel funding structure disconnected from other disease priorities (quite the opposite of previous ideas on integration in health financing). It also gives power to an external group, not directly accountable, to demand or acquire further resources whenever it deems necessary.

    In a further encroachment into what is normally within the legal jurisdiction of Nation States, the agreement will require countries to establish (Article 15) “…, no-fault vaccine injury compensation mechanism(s),…”, consecrating effective immunity for pharmaceutical companies for harm to citizens resulting from use of products that the WHO recommends under an emergency use authorization, or indeed requires countries to mandate onto their citizens.

    As is becoming increasingly acceptable for those in power, ratifying countries will agree to limit the right of their public to voice opposition to the WHO’s measures and claims regarding such an emergency (Article 18):

    …and combat false, misleading, misinformation or disinformation, including through effective international collaboration and cooperation…

    As we have seen during the Covid-19 response, the definition of misleading information can be dependent on political or commercial expediency, including factual information on vaccine efficacy and safety and orthodox immunology that could impair the sale of health commodities. This is why open democracies put such emphasis on defending free speech, even at the risk of sometimes being misleading. In signing on to this agreement, governments will be agreeing to abrogate that principle regarding their own citizens when instructed by the WHO.

    The scope of this proposed agreement (and the IHR amendments) is broader than pandemics, greatly expanding the scope under which a transfer of decision-making powers can be demanded. Other environmental threats to health, such as changes in climate, can be declared emergencies at the DG’s discretion, if broad definitions of ‘One Health’ are adopted as recommended.

    It is difficult to think of another international instrument where such powers over national resources are passed to an unelected external organization, and it is even more challenging to envision how this is seen as anything other than a loss of sovereignty. The only justification for this claim would appear to be if the draft agreement is to be signed on the basis of deceit – that there is no intention to treat it other than as an irrelevant piece of paper or something that should only apply to less powerful States (i.e. a colonialist tool).

    Will the IHR Amendments and the Proposed Pandemic Agreement be Legally Binding?

    Both texts are intended to be legally binding. The IHR already has such status, so the impact of the proposed changes on the need for new acceptance by countries are complicated national jurisdictional issues. There is a current mechanism for rejection of new amendments. However, unless a high number of countries will actively voice their oppositions and rejections, the adoption of the current published version dated February 2023 will likely lead to a future shadowed by the permanent risks of the WHO’s lockdown and lockstep dictates.

    The proposed pandemic agreement is also clearly intended to be legally binding. WHO discusses this issue on the website of the International Negotiating Body (INB) that is working on the text. The same legally binding intent is specifically stated by the G20 Bali Leaders Declaration in 2022:

    We support the work of the Intergovernmental Negotiating Body (INB) that will draft and negotiate a legally binding instrument that should contain both legally binding and non-legally binding elements to strengthen pandemic PPR…,

    repeated in the 2023 G20 New Delhi Leaders Declaration:

    …an ambitious, legally binding WHO convention, agreement or other international instruments on pandemic PPR (WHO CA+) by May 2024,

    and by the Council of the European Union:

    A convention, agreement or other international instrument is legally binding under international Law. An agreement on pandemic prevention, preparedness and response adopted under the World Health Organization (WHO) would enable countries around the globe to strengthen national, regional and global capacities and resilience to future pandemics.

    The IHR already has standing under international law.

    While seeking such status, WHO officials who previously described the proposed agreement as a ‘treaty” are now insisting neither instrument impacts sovereignty. The implication that it is States’ representatives at the WHA that will agree to the transfer, rather than the WHO, is a nuance irrelevant to its claims regarding their subsequent effect.

    The WHO’s position raises a real question of whether its leadership is truly ignorant of what is proposed, or is actively seeking to mislead countries and the public in order to increase the probability of acceptance. The latest version dated 30 October 2023 requires 40 ratifications for the future agreement to enter into force, after a two-thirds vote in favor within the WHA. Opposition by a considerable number of countries will therefore be needed to derail this project. As it is backed by powerful governments and institutions, financial mechanisms including IMF and World Bank instruments and bilateral aids are likely to make opposition from lower-income countries difficult to sustain.

    The Implications of Ignoring the Issue of Sovereignty

    The relevant question regarding these two WHO instruments should really be not whether sovereignty is threatened, but why any sovereignty would be forfeited by democratic States to an organization that is (i) significantly privately funded and bound to obey the dictates of corporations and self-proclaimed philanthropists and (ii) jointly governed by Member States, half of which don’t even claim to be open representative democracies.

    If it is indeed true that sovereignty is being knowingly forfeited by governments without the knowledge and consent of their peoples, and based on false claims from governments and the WHO, then the implications are extremely serious. It would imply that leaders were working directly against their peoples’ or national interest, and in support of external interests. Most countries have specific fundamental laws dealing with such practice. So, it is really important for those defending these projects to either explain their definitions of sovereignty and democratic process, or explicitly seek informed public consent.

    The other question to be asked is why public health authorities and media are repeating the WHO’s assurances of the benign nature of the pandemic instruments. It asserts that claims of reduced sovereignty are ‘misinformation’ or ‘disinformation,’ which they assert elsewhere are major killers of humankind. While such claims are somewhat ludicrous and appear intended to denigrate dissenters, the WHO is clearly guilty of that which it claims is such a crime. If its leadership cannot demonstrate how its claims regarding these pandemic instruments are not deliberately misleading, its leadership would appear ethically compelled to resign.

    The Need for Clarification

    The WHO lists three major pandemics in the past century – influenza outbreaks in the late 1950s and 1960s, and the Covid-19 pandemic. The first two killed less than die each year today from tuberculosis, whilst the reported deaths from Covid-19 never reached the level of cancer or cardiovascular disease and remained almost irrelevant in low-income countries compared to endemic infectious diseases including tuberculosis, malaria, and HIV/AIDs.

    No other non-influenza outbreak recorded by the WHO that fits the definition of a pandemic (e.g., rapid spread across international borders for a limited time of a pathogen not normally causing significant harm) has caused greater mortality in total than a few days of tuberculosis (about 4,000/day) or more life-years lost than a few days of malaria (about 1,500 children under 5 years old every day).

    So, if it is indeed the case that our authorities and their supporters within the public health community consider that powers currently vested within national jurisdictions should be given over to external bodies on the basis of this level of recorded harm, it would be best to have a public conversation as to whether this is sufficient basis for abandoning democratic ideals in favor of a more fascist or otherwise authoritarian approach. We are, after all, talking about restricting basic human rights essential for a democracy to function.

    Published under a Creative Commons Attribution 4.0 International License
    For reprints, please set the canonical link back to the original Brownstone Institute Article and Author.

    Authors

    David Bell
    David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. He is a former medical officer and scientist at the World Health Organization (WHO), Programme Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, WA, USA.

    View all posts
    Thi Thuy Van Dinh
    Dr. Thi Thuy Van Dinh (LLM, PhD) worked on international law in the United Nations Office on Drugs and Crime and the Office of the High Commissioner for Human Rights. Subsequently, she managed multilateral organization partnerships for Intellectual Ventures Global Good Fund and led environmental health technology development efforts for low-resource settings.

    View all posts
    Your financial backing of Brownstone Institute goes to support writers, lawyers, scientists, economists, and other people of courage who have been professionally purged and displaced during the upheaval of our times. You can help get the truth out through their ongoing work.

    https://brownstone.org/articles/why-does-the-who-make-false-claims-regarding-proposals-to-seize-states-sovereignty/
    Why Does the WHO Make False Claims Regarding Proposals to Seize States’ Sovereignty? By David Bell, Thi Thuy Van Dinh December 11, 2023 Government, Law, Public Health 15 minute read The Director General (DG) of the World Health Organization (WHO) states: No country will cede any sovereignty to WHO, referring to the WHO’s new pandemic agreement and proposed amendments to the International Health Regulations (IHR), currently being negotiated. His statements are clear and unequivocal, and wholly inconsistent with the texts he is referring to. A rational examination of the texts in question shows that: The documents propose a transfer of decision-making power to the WHO regarding basic aspects of societal function, which countries undertake to enact. The WHO DG will have sole authority to decide when and where they are applied. The proposals are intended to be binding under international law. Continued claims that sovereignty is not lost, echoed by politicians and media, therefore raise important questions concerning motivations, competence, and ethics. The intent of the texts is a transfer of decision-making currently vested in Nations and individuals to the WHO, when its DG decides that there is a threat of a significant disease outbreak or other health emergency likely to cross multiple national borders. It is unusual for Nations to undertake to follow external entities regarding the basic rights and healthcare of their citizens, more so when this has major economic and geopolitical implications. The question of whether sovereignty is indeed being transferred, and the legal status of such an agreement, is therefore of vital importance, particularly to the legislators of democratic States. They have an absolute duty to be sure of their ground. We systematically examine that ground here. The Proposed IHR Amendments and Sovereignty in Health Decision-Making Amending the 2005 IHR may be a straightforward way to quickly deploy and enforce “new normal” health control measures. The current text applies to virtually the entire global population, counting 196 States Parties including all 194 WHO Member States. Approval may or may not require a formal vote of the World Health Assembly (WHA), as the recent 2022 amendment was adopted through consensus. If the same approval mechanism is to be used in May 2024, many countries and the public may remain unaware of the broad scope of the new text and its implications to national and individual sovereignty. The IHR are a set of recommendations under a treaty process that has force under international law. They seek to provide the WHO with some moral authority to coordinate and lead responses when an international health emergency, such as pandemic, occurs. Most are non-binding, and these contain very specific examples of measures that the WHO can recommend, including (Article 18): require medical examinations; review proof of vaccination or other prophylaxis; require vaccination or other prophylaxis; place suspect persons under public health observation; implement quarantine or other health measures for suspect persons; implement isolation and treatment where necessary of affected persons; implement tracing of contacts of suspect or affected persons; refuse entry of suspect and affected persons; refuse entry of unaffected persons to affected areas; and implement exit screening and/or restrictions on persons from affected areas. These measures, when implemented together, are generally referred to since early 2020 as ‘lockdowns’ and ‘mandates.’ ‘Lockdown’ was previously a term reserved for people incarcerated as criminals, as it removes basic universally accepted human rights and such measures were considered by the WHO to be detrimental to public health. However, since 2020 it has become the default standard for public health authorities to manage epidemics, despite its contradictions to multiple stipulations of the Universal Declaration of Human Rights (UDHR): Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind including no arbitrary detention (Article 9). No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence (Article 12). Everyone has the right to freedom of movement and residence within the borders of each state, and Everyone has the right to leave any country, including his own, and to return to his country (Article 13). Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers (Article 19). Everyone has the right to freedom of peaceful assembly and association (Article 20). The will of the people shall be the basis of the authority of government (Article 21). Everyone has the right to work (Article 23). Everyone has the right to education (Article 26). Everyone is entitled to a social and international order in which the rights and freedoms set forth in this Declaration can be fully realized (Article 28). Nothing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein (Article 30). These UDHR stipulations are the basis of the modern concept of individual sovereignty, and the relationship between authorities and their populations. Considered the highest codification of the rights and freedoms of individuals in the 20th century, they may soon be dismantled behind closed doors in a meeting room in Geneva. The proposed amendments will change the “recommendations” of the current document to requirements through three mechanisms on Removing the term ‘non-binding’ (Article 1), Inserting the phrase that Member States will “undertake to follow WHO’s recommendations” and recognize WHO, not as an organization under the control of countries, but as the “coordinating authority” (New Article 13A). States Parties recognize WHO as the guidance and coordinating authority of international public health response during public health Emergency of International Concern and undertake to follow WHO’s recommendations in their international public health response. As Article 18 makes clear above, these include multiple actions directly restricting individual liberty. If transfer of decision-making power (sovereignty) is not intended here, then the current status of the IHR as ‘recommendations’ could remain and countries would not be undertaking to follow the WHO’s requirements. States Parties undertake to enact what previously were merely recommendations, without delay, including requirements of WHO regarding non-State entities under their jurisdiction (Article 42): Health measures taken pursuant to these Regulations, including the recommendations made under Articles 15 and 16, shall be initiated and completed without delay by all State Parties and applied in a transparent, equitable and non-discriminatory manner. State Parties shall also take measures to ensure Non-State Actors operating in their respective territories comply with such measures. Articles 15 and 16 mentioned here allow the WHO to require a State to provide resources “health products, technologies, and know-how,” and to allow the WHO to deploy personnel into the country (i.e., have control over entry across national borders for those they choose). They also repeat the requirement for the country to require the implementation of medical countermeasures (e.g., testing, vaccines, quarantine) on their population where WHO demands it. Of note, the proposed Article 1 amendment (removing ‘non-binding’) is actually redundant if New Article 13A and/or the changes in Article 42 remain. This can (and likely will) be removed from the final text, giving an appearance of compromise without changing the transfer of sovereignty. All of the public health measures in Article 18, and additional ones such as limiting freedom of speech to reduce public exposure to alternative viewpoints (Annex 1, New 5 (e); “…counter misinformation and disinformation”) clash directly with the UDHR. Although freedom of speech is currently the exclusive purview of national authorities and its restriction is generally seen as negative and abusive, United Nations institutions, including the WHO, have been advocating for censoring unofficial views in order to protect what they call “information integrity.” It seems outrageous from a human rights perspective that the amendments will enable the WHO to dictate countries to require individual medical examinations and vaccinations whenever it declares a pandemic. While the Nuremberg Code and Declaration of Helsinki refer specifically to human experimentation (e.g. clinical trials of vaccines) and the Universal Declaration on Bioethics and Human Rights also to the provider-patient relationship, they can reasonably be extended to public health measures that impose restrictions or changes to human behavior, and specifically to any measures requiring injection, medication, or medical examination which involve a direct provider-person interaction. If vaccines or drugs are still under trial or not fully tested, then the issue of being the subject of an experiment is also real. There is a clear intent to employ the CEPI ‘100 day’ vaccine program, which by definition cannot complete meaningful safety or efficacy trials within that time span. Forced examination or medication, outside of a situation where the recipient is clearly not mentally competent to comply or reject when provided with information, is unethical. Requiring compliance in order to access what are considered basic human rights under the UDHR would constitute coercion. If this does not fit the WHO’s definition of infringement on individual sovereignty, and on national sovereignty, then the DG and his supporters need to publicly explain what definition they are using. The Proposed WHO Pandemic Agreement as a Tool to Manage Transfer of Sovereignty The proposed pandemic agreement will set humanity in a new era strangely organized around pandemics: pre-pandemic, pandemic, and inter-pandemic. A new governance structure under WHO auspices will oversee the IHR amendments and related initiatives. It will rely on new funding requirements, including the WHO’s ability to demand additional funding and materials from countries and to run a supply network to support its work in health emergencies (Article 12): In the event of a pandemic, real-time access by WHO to a minimum of 20% (10% as a donation and 10% at affordable prices to WHO) of the production of safe, efficacious and effective pandemic-related products for distribution based on public health risks and needs, with the understanding that each Party that has manufacturing facilities that produce pandemic-related products in its jurisdiction shall take all necessary steps to facilitate the export of such pandemic-related products, in accordance with timetables to be agreed between WHO and manufacturers. And Article 20 (1): …provide support and assistance to other Parties, upon request, to facilitate the containment of spill-over at the source. The entire structure will be financed by a new funding stream separate from current WHO funding – an additional requirement on taxpayers over current national commitments (Article 20 (2)). The funding will also include an endowment of voluntary contributions of “all relevant sectors that benefit from international work to strengthen pandemic preparation, preparedness and response” and donations from philanthropic organizations (Article 20 (2)b). Currently, countries decide on foreign aid on the basis of national priorities, apart from limited funding that they have agreed to allocate to organizations such as WHO under existing obligations or treaties. The proposed agreement is remarkable not just in greatly increasing the amount countries must give as treaty requirements, but in setting up a parallel funding structure disconnected from other disease priorities (quite the opposite of previous ideas on integration in health financing). It also gives power to an external group, not directly accountable, to demand or acquire further resources whenever it deems necessary. In a further encroachment into what is normally within the legal jurisdiction of Nation States, the agreement will require countries to establish (Article 15) “…, no-fault vaccine injury compensation mechanism(s),…”, consecrating effective immunity for pharmaceutical companies for harm to citizens resulting from use of products that the WHO recommends under an emergency use authorization, or indeed requires countries to mandate onto their citizens. As is becoming increasingly acceptable for those in power, ratifying countries will agree to limit the right of their public to voice opposition to the WHO’s measures and claims regarding such an emergency (Article 18): …and combat false, misleading, misinformation or disinformation, including through effective international collaboration and cooperation… As we have seen during the Covid-19 response, the definition of misleading information can be dependent on political or commercial expediency, including factual information on vaccine efficacy and safety and orthodox immunology that could impair the sale of health commodities. This is why open democracies put such emphasis on defending free speech, even at the risk of sometimes being misleading. In signing on to this agreement, governments will be agreeing to abrogate that principle regarding their own citizens when instructed by the WHO. The scope of this proposed agreement (and the IHR amendments) is broader than pandemics, greatly expanding the scope under which a transfer of decision-making powers can be demanded. Other environmental threats to health, such as changes in climate, can be declared emergencies at the DG’s discretion, if broad definitions of ‘One Health’ are adopted as recommended. It is difficult to think of another international instrument where such powers over national resources are passed to an unelected external organization, and it is even more challenging to envision how this is seen as anything other than a loss of sovereignty. The only justification for this claim would appear to be if the draft agreement is to be signed on the basis of deceit – that there is no intention to treat it other than as an irrelevant piece of paper or something that should only apply to less powerful States (i.e. a colonialist tool). Will the IHR Amendments and the Proposed Pandemic Agreement be Legally Binding? Both texts are intended to be legally binding. The IHR already has such status, so the impact of the proposed changes on the need for new acceptance by countries are complicated national jurisdictional issues. There is a current mechanism for rejection of new amendments. However, unless a high number of countries will actively voice their oppositions and rejections, the adoption of the current published version dated February 2023 will likely lead to a future shadowed by the permanent risks of the WHO’s lockdown and lockstep dictates. The proposed pandemic agreement is also clearly intended to be legally binding. WHO discusses this issue on the website of the International Negotiating Body (INB) that is working on the text. The same legally binding intent is specifically stated by the G20 Bali Leaders Declaration in 2022: We support the work of the Intergovernmental Negotiating Body (INB) that will draft and negotiate a legally binding instrument that should contain both legally binding and non-legally binding elements to strengthen pandemic PPR…, repeated in the 2023 G20 New Delhi Leaders Declaration: …an ambitious, legally binding WHO convention, agreement or other international instruments on pandemic PPR (WHO CA+) by May 2024, and by the Council of the European Union: A convention, agreement or other international instrument is legally binding under international Law. An agreement on pandemic prevention, preparedness and response adopted under the World Health Organization (WHO) would enable countries around the globe to strengthen national, regional and global capacities and resilience to future pandemics. The IHR already has standing under international law. While seeking such status, WHO officials who previously described the proposed agreement as a ‘treaty” are now insisting neither instrument impacts sovereignty. The implication that it is States’ representatives at the WHA that will agree to the transfer, rather than the WHO, is a nuance irrelevant to its claims regarding their subsequent effect. The WHO’s position raises a real question of whether its leadership is truly ignorant of what is proposed, or is actively seeking to mislead countries and the public in order to increase the probability of acceptance. The latest version dated 30 October 2023 requires 40 ratifications for the future agreement to enter into force, after a two-thirds vote in favor within the WHA. Opposition by a considerable number of countries will therefore be needed to derail this project. As it is backed by powerful governments and institutions, financial mechanisms including IMF and World Bank instruments and bilateral aids are likely to make opposition from lower-income countries difficult to sustain. The Implications of Ignoring the Issue of Sovereignty The relevant question regarding these two WHO instruments should really be not whether sovereignty is threatened, but why any sovereignty would be forfeited by democratic States to an organization that is (i) significantly privately funded and bound to obey the dictates of corporations and self-proclaimed philanthropists and (ii) jointly governed by Member States, half of which don’t even claim to be open representative democracies. If it is indeed true that sovereignty is being knowingly forfeited by governments without the knowledge and consent of their peoples, and based on false claims from governments and the WHO, then the implications are extremely serious. It would imply that leaders were working directly against their peoples’ or national interest, and in support of external interests. Most countries have specific fundamental laws dealing with such practice. So, it is really important for those defending these projects to either explain their definitions of sovereignty and democratic process, or explicitly seek informed public consent. The other question to be asked is why public health authorities and media are repeating the WHO’s assurances of the benign nature of the pandemic instruments. It asserts that claims of reduced sovereignty are ‘misinformation’ or ‘disinformation,’ which they assert elsewhere are major killers of humankind. While such claims are somewhat ludicrous and appear intended to denigrate dissenters, the WHO is clearly guilty of that which it claims is such a crime. If its leadership cannot demonstrate how its claims regarding these pandemic instruments are not deliberately misleading, its leadership would appear ethically compelled to resign. The Need for Clarification The WHO lists three major pandemics in the past century – influenza outbreaks in the late 1950s and 1960s, and the Covid-19 pandemic. The first two killed less than die each year today from tuberculosis, whilst the reported deaths from Covid-19 never reached the level of cancer or cardiovascular disease and remained almost irrelevant in low-income countries compared to endemic infectious diseases including tuberculosis, malaria, and HIV/AIDs. No other non-influenza outbreak recorded by the WHO that fits the definition of a pandemic (e.g., rapid spread across international borders for a limited time of a pathogen not normally causing significant harm) has caused greater mortality in total than a few days of tuberculosis (about 4,000/day) or more life-years lost than a few days of malaria (about 1,500 children under 5 years old every day). So, if it is indeed the case that our authorities and their supporters within the public health community consider that powers currently vested within national jurisdictions should be given over to external bodies on the basis of this level of recorded harm, it would be best to have a public conversation as to whether this is sufficient basis for abandoning democratic ideals in favor of a more fascist or otherwise authoritarian approach. We are, after all, talking about restricting basic human rights essential for a democracy to function. Published under a Creative Commons Attribution 4.0 International License For reprints, please set the canonical link back to the original Brownstone Institute Article and Author. Authors David Bell David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. He is a former medical officer and scientist at the World Health Organization (WHO), Programme Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, WA, USA. View all posts Thi Thuy Van Dinh Dr. Thi Thuy Van Dinh (LLM, PhD) worked on international law in the United Nations Office on Drugs and Crime and the Office of the High Commissioner for Human Rights. Subsequently, she managed multilateral organization partnerships for Intellectual Ventures Global Good Fund and led environmental health technology development efforts for low-resource settings. View all posts Your financial backing of Brownstone Institute goes to support writers, lawyers, scientists, economists, and other people of courage who have been professionally purged and displaced during the upheaval of our times. You can help get the truth out through their ongoing work. https://brownstone.org/articles/why-does-the-who-make-false-claims-regarding-proposals-to-seize-states-sovereignty/
    BROWNSTONE.ORG
    Why Does the WHO Make False Claims Regarding Proposals to Seize States’ Sovereignty? ⋆ Brownstone Institute
    If it is indeed the case that our authorities and their supporters within the public health community consider that powers currently vested within national jurisdictions should be given over to external bodies on the basis of this level of recorded harm, it would be best to have a public conversation as to whether this is sufficient basis for abandoning democratic ideals in favor of a more fascist or otherwise authoritarian approach.
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  • ENDLICH! RKI Mitarbeiterin packt aus! Wir MÜSSEN tun was sie uns sagen!!!
    Maximilian Pütz
    31.3.2024
    https://www.youtube.com/watch?v=NVzVvcX0Tv0
    ENDLICH! RKI Mitarbeiterin packt aus! Wir MÜSSEN tun was sie uns sagen!!! Maximilian Pütz 31.3.2024 https://www.youtube.com/watch?v=NVzVvcX0Tv0
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  • ‘No, dear. I will never leave Gaza.’
    I tried to convince my parents to leave Gaza, but my father’s resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly. The weight of our conversation lingered long after we said our goodbyes.

    Ghada HaniaMarch 30, 2024
    A Palestinian man sits near the damage to a building after an overnight Israeli air raid in Rafah, southern Gaza, March 29, 2024. (Photo: Ahmed Ibrahim/APA Images)
    A Palestinian man sits near the damage to a building after an overnight Israeli air raid in Rafah, southern Gaza, March 29, 2024. (Photo: Ahmed Ibrahim/APA Images)
    I sip my coffee, pondering whether my mother has enough coffee stocked at home. Recognizing the importance of this question, especially during the sacred month of Ramadan when she typically begins her fast with a sip of coffee, a ritual I have mirrored, I resolve to call her via WhatsApp.

    Dialing her number, I encounter the frustration of a phone call that fails to connect, indicating a lack of internet service. Undeterred, I make my way to the nearby supermarket, where I top up my phone with 60 RM, the maximum allowed per charge. With experience guiding me, I opt for three charges, estimating that 180 units should afford me about a 35-minute conversation.

    Each call to my mother serves as a conduit for updates on her well-being, my father’s health, and the overall status of our extended family, all residing together in one apartment.

    During Ramadan, these conversations delve into her preparations for breaking the fast. Perhaps this time, she’s managed to procure budget-friendly alternatives from the market, steering away from the monotony of canned meals like beans, hummus, or tuna, and perhaps opting for cherished dishes like chicken maqloubeh or mloukhiyyeh, beloved by both herself and our family.

    As the phone finally rings after multiple attempts, I eagerly await my mother’s answer. When she finally picks up on the fifth try, I greet her affectionately, “Hello, my love. How are you?”

    “I am fine, my dear Ghadoosh,” she responds, using her term of endearment for me.

    I ask about her third-day iftar meal, to which she replies, “Today, we’re preparing beans with lemon and tomato, served alongside saj bread.”

    “You know we’ve finished building a clay oven on the roof of the house, and we use it to bake bread.”

    “Oh, that sounds good, Mom. Bon appétit,” I replied, understanding how monotonous it can be to eat the same meal for more than 100 days.

    Concerned about her health, especially given her diagnosis of irritable bowel syndrome (IBS), I ask about her condition. She acknowledges her discomfort, expressing gratitude for the doctor’s recommendations to avoid certain foods. Unfortunately, everything the doctor recommended is either unavailable or too expensive to afford.

    As our conversation progresses, the familiar sound of her voice brings comfort, even amidst the backdrop of challenges we face. Every time we talk, there’s a quiet sadness that hangs in the air, partly because of the miles between us and the heavy load of worries we both carry.

    “All praises to Allah,” my mother began, her voice tinged with discomfort. “I have persistent abdominal pain, but it’s bearable. It will pass,” she reassured me.

    Responding like a concerned physician, I rushed to advise her, “Mom, please pay careful attention to your diet and hydration during Ramadan. Make sure you drink plenty of water and consume nourishing foods like dates, while avoiding anything that exacerbates your discomfort. Choose light, healthy meals like thyme and cheese with bread, and incorporate olive oil. If canned foods like hummus, beans, or chickpeas make you feel tired or worsen your symptoms, refrain from eating them. Your well-being is paramount, so take care of yourself, my love. Remember to say bismillah before each meal, and trust in Allah for strength and healing.”

    “Okay, my love. Don’t worry,” she responded, her tone conveying gratitude for my concern.

    “How is your husband and his family?” she inquired. “How is your mother-in-law? Please convey my regards to them, and I hope we can meet soon once the war ends, Allah willing, if we are still alive on that day.”

    “Oh, mom, please don’t say that. May all negativity fade away. May Allah safeguard you and bring us all together again.”

    My husband’s family and I are unable to communicate with each other within Gaza due to poor connectivity. Therefore, when I speak to my husband’s relatives, I extend greetings from my family, and when I converse with my own family, I convey greetings from my husband’s family.

    “How are my sisters, mom? Have you been in touch with Sara? Did you manage to visit Mona?” I asked anxiously.

    “Sara is still in Gaza with her kids, husband, and his family. They’re facing immense struggles to find food and water. I’ve only managed to contact her once during these difficult months. Sadly, the call was abruptly cut off, and I couldn’t even say goodbye,” my mom explained with a heavy heart.

    “Mona and her family are living in a tent in Khan Younis. The conditions are harsh — when it rains, the tent floods, and when it stops, the sand’s smell makes them sick,” she continued.

    “We’ve had limited contact with your sisters, Ghada. Last week, we were able to confirm Sara’s well-being through one of your father’s cousins in Gaza. However, you know there’s a famine in the north. May Allah ease their hardships,” my mom said tearfully.

    After composing herself, she added, “Mona visited us briefly yesterday. Thankfully, she and her kids are doing okay. Don’t worry, dear.”

    “Don’t cry, mom. Let’s pray. It’s our most powerful tool. May Allah alleviate their suffering, guide us all, and bring an end to this war. May the situation improve,” I reassured her.

    The wail of an ambulance interrupted our conversation. My mother’s voice, usually composed, now shook with emotion as she recounted the struggles since being forcibly displaced from Gaza City to Rafah. Reflecting on our decision to settle in Rafah in my uncle’s home due to the lack of available housing, she expressed her sorrow, “If we had a home in Gaza, we would never have left, Ghada. They’ve destroyed everything in Gaza: the trees, the stones, the streets. There’s nothing left, my dear. The city has transformed; you wouldn’t recognize it.”

    “Inshallah everything will improve, mom. We’ll rebuild the city again,” I said optimistically.

    She replied softly, “Inshallah, dear.”

    I broached the topic of leaving Gaza for Malaysia, but his resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly, revealing a depth of sentiment I hadn’t fully grasped before.
    I seized the opportunity to speak to my father, eagerly greeting him, “Hello, Dad. How are you?”

    His warm voice comforted me, assuring me, “Everything is good, dear. Don’t worry. We’re in good spirits, and as long as we have each other, we’ll be fine.”

    “How much is the fish per kilo?” I asked. My father has always had a deep love for fish, enjoying it day after day before the war.

    He replied with sadness, “The price for a kilo of sardines is around 130 shekels. That’s the cheapest rate in the market. Prices have increased tenfold.”

    Despite his assurances, I couldn’t shake the heavy burden weighing on my heart. “May Allah protect you, dear Baba,” I said, my voice trembling with emotion. “I know it’s not easy, but please stay steadfast. Your strength gives me hope.”

    I broached the topic of leaving Gaza for Malaysia, but his resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly, revealing a depth of sentiment I hadn’t fully grasped before.

    “We’ve purchased tents in case the situation deteriorates further. We’ll relocate to Nuseirat refugee camp or Deir al-Balah,” he added.

    The weight of our conversation lingered long after we said our goodbyes. Despite my efforts to offer comfort, I couldn’t shake the sense of helplessness that settled over me, leaving me feeling powerless to ease their suffering.

    https://mondoweiss.net/2024/03/no-dear-i-will-never-leave-gaza/
    ‘No, dear. I will never leave Gaza.’ I tried to convince my parents to leave Gaza, but my father’s resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly. The weight of our conversation lingered long after we said our goodbyes. Ghada HaniaMarch 30, 2024 A Palestinian man sits near the damage to a building after an overnight Israeli air raid in Rafah, southern Gaza, March 29, 2024. (Photo: Ahmed Ibrahim/APA Images) A Palestinian man sits near the damage to a building after an overnight Israeli air raid in Rafah, southern Gaza, March 29, 2024. (Photo: Ahmed Ibrahim/APA Images) I sip my coffee, pondering whether my mother has enough coffee stocked at home. Recognizing the importance of this question, especially during the sacred month of Ramadan when she typically begins her fast with a sip of coffee, a ritual I have mirrored, I resolve to call her via WhatsApp. Dialing her number, I encounter the frustration of a phone call that fails to connect, indicating a lack of internet service. Undeterred, I make my way to the nearby supermarket, where I top up my phone with 60 RM, the maximum allowed per charge. With experience guiding me, I opt for three charges, estimating that 180 units should afford me about a 35-minute conversation. Each call to my mother serves as a conduit for updates on her well-being, my father’s health, and the overall status of our extended family, all residing together in one apartment. During Ramadan, these conversations delve into her preparations for breaking the fast. Perhaps this time, she’s managed to procure budget-friendly alternatives from the market, steering away from the monotony of canned meals like beans, hummus, or tuna, and perhaps opting for cherished dishes like chicken maqloubeh or mloukhiyyeh, beloved by both herself and our family. As the phone finally rings after multiple attempts, I eagerly await my mother’s answer. When she finally picks up on the fifth try, I greet her affectionately, “Hello, my love. How are you?” “I am fine, my dear Ghadoosh,” she responds, using her term of endearment for me. I ask about her third-day iftar meal, to which she replies, “Today, we’re preparing beans with lemon and tomato, served alongside saj bread.” “You know we’ve finished building a clay oven on the roof of the house, and we use it to bake bread.” “Oh, that sounds good, Mom. Bon appétit,” I replied, understanding how monotonous it can be to eat the same meal for more than 100 days. Concerned about her health, especially given her diagnosis of irritable bowel syndrome (IBS), I ask about her condition. She acknowledges her discomfort, expressing gratitude for the doctor’s recommendations to avoid certain foods. Unfortunately, everything the doctor recommended is either unavailable or too expensive to afford. As our conversation progresses, the familiar sound of her voice brings comfort, even amidst the backdrop of challenges we face. Every time we talk, there’s a quiet sadness that hangs in the air, partly because of the miles between us and the heavy load of worries we both carry. “All praises to Allah,” my mother began, her voice tinged with discomfort. “I have persistent abdominal pain, but it’s bearable. It will pass,” she reassured me. Responding like a concerned physician, I rushed to advise her, “Mom, please pay careful attention to your diet and hydration during Ramadan. Make sure you drink plenty of water and consume nourishing foods like dates, while avoiding anything that exacerbates your discomfort. Choose light, healthy meals like thyme and cheese with bread, and incorporate olive oil. If canned foods like hummus, beans, or chickpeas make you feel tired or worsen your symptoms, refrain from eating them. Your well-being is paramount, so take care of yourself, my love. Remember to say bismillah before each meal, and trust in Allah for strength and healing.” “Okay, my love. Don’t worry,” she responded, her tone conveying gratitude for my concern. “How is your husband and his family?” she inquired. “How is your mother-in-law? Please convey my regards to them, and I hope we can meet soon once the war ends, Allah willing, if we are still alive on that day.” “Oh, mom, please don’t say that. May all negativity fade away. May Allah safeguard you and bring us all together again.” My husband’s family and I are unable to communicate with each other within Gaza due to poor connectivity. Therefore, when I speak to my husband’s relatives, I extend greetings from my family, and when I converse with my own family, I convey greetings from my husband’s family. “How are my sisters, mom? Have you been in touch with Sara? Did you manage to visit Mona?” I asked anxiously. “Sara is still in Gaza with her kids, husband, and his family. They’re facing immense struggles to find food and water. I’ve only managed to contact her once during these difficult months. Sadly, the call was abruptly cut off, and I couldn’t even say goodbye,” my mom explained with a heavy heart. “Mona and her family are living in a tent in Khan Younis. The conditions are harsh — when it rains, the tent floods, and when it stops, the sand’s smell makes them sick,” she continued. “We’ve had limited contact with your sisters, Ghada. Last week, we were able to confirm Sara’s well-being through one of your father’s cousins in Gaza. However, you know there’s a famine in the north. May Allah ease their hardships,” my mom said tearfully. After composing herself, she added, “Mona visited us briefly yesterday. Thankfully, she and her kids are doing okay. Don’t worry, dear.” “Don’t cry, mom. Let’s pray. It’s our most powerful tool. May Allah alleviate their suffering, guide us all, and bring an end to this war. May the situation improve,” I reassured her. The wail of an ambulance interrupted our conversation. My mother’s voice, usually composed, now shook with emotion as she recounted the struggles since being forcibly displaced from Gaza City to Rafah. Reflecting on our decision to settle in Rafah in my uncle’s home due to the lack of available housing, she expressed her sorrow, “If we had a home in Gaza, we would never have left, Ghada. They’ve destroyed everything in Gaza: the trees, the stones, the streets. There’s nothing left, my dear. The city has transformed; you wouldn’t recognize it.” “Inshallah everything will improve, mom. We’ll rebuild the city again,” I said optimistically. She replied softly, “Inshallah, dear.” I broached the topic of leaving Gaza for Malaysia, but his resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly, revealing a depth of sentiment I hadn’t fully grasped before. I seized the opportunity to speak to my father, eagerly greeting him, “Hello, Dad. How are you?” His warm voice comforted me, assuring me, “Everything is good, dear. Don’t worry. We’re in good spirits, and as long as we have each other, we’ll be fine.” “How much is the fish per kilo?” I asked. My father has always had a deep love for fish, enjoying it day after day before the war. He replied with sadness, “The price for a kilo of sardines is around 130 shekels. That’s the cheapest rate in the market. Prices have increased tenfold.” Despite his assurances, I couldn’t shake the heavy burden weighing on my heart. “May Allah protect you, dear Baba,” I said, my voice trembling with emotion. “I know it’s not easy, but please stay steadfast. Your strength gives me hope.” I broached the topic of leaving Gaza for Malaysia, but his resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly, revealing a depth of sentiment I hadn’t fully grasped before. “We’ve purchased tents in case the situation deteriorates further. We’ll relocate to Nuseirat refugee camp or Deir al-Balah,” he added. The weight of our conversation lingered long after we said our goodbyes. Despite my efforts to offer comfort, I couldn’t shake the sense of helplessness that settled over me, leaving me feeling powerless to ease their suffering. https://mondoweiss.net/2024/03/no-dear-i-will-never-leave-gaza/
    MONDOWEISS.NET
    ‘No, dear. I will never leave Gaza.’
    I tried to convince my parents to leave Gaza, but my father’s resolute refusal caught me off guard. “No, dear. I will never leave Gaza,” he stated firmly. The weight of our conversation lingered long after we said our goodbyes.
    0 Comments 0 Shares 17423 Views
  • Meta Refuses to Answer Questions on Gaza Censorship, Say Sens. Warren and Sanders
    Sam BiddleMarch 26 2024, 8:00 a.m.
    WASHINGTON, DC - MARCH 03: Sen. Elizabeth Warren (D-MA) questions U.S. Federal Reserve Chair Jerome Powell as he testifies at a Senate Banking, Housing, and Urban Affairs Committee hearing on the Fed's "Semiannual Monetary Policy Report to the Congress," on Capitol Hill on March 3, 2022 in Washington, DC. (Photo by Tom Williams-Pool/Getty Images)
    Citing the company’s “failure to provide answers to important questions,” Sens. Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt., are pressing Meta, which owns Facebook and Instagram, to respond to reports of disproportionate censorship around the Israeli war on Gaza.

    “Meta insists that there’s been no discrimination against Palestinian-related content on their platforms, but at the same time, is refusing to provide us with any evidence or data to support that claim,” Warren told The Intercept. “If its ad-hoc changes and removal of millions of posts didn’t discriminate against Palestinian-related content, then what’s Meta hiding?”

    In a letter to Meta CEO Mark Zuckerberg sent last December, first reported by The Intercept, Warren presented the company with dozens of specific questions about the company’s Gaza-related content moderation efforts. Warren asked about the exact numbers of posts about the war, broken down by Hebrew or Arabic, that have been deleted or otherwise suppressed.

    The letter was written following widespread reporting in The Intercept and other outlets that detailed how posts on Meta platforms that are sympathetic to Palestinians, or merely depicting the destruction in Gaza, are routinely removed or hidden without explanation.

    A month later, Meta replied to Warren’s office with a six-page letter, obtained by The Intercept, that provided an overview of its moderation response to the war but little in the way of specifics or new information.

    Most Read

    “Meta’s lack of investment to safeguard its users significantly exacerbates the political situation in Palestine and perpetuates tech harms on fundamental rights in Palestine and other global majority countries, all while evading meaningful legal accountability,” Mona Shtaya, nonresident fellow at the Tahrir Institute for Middle East Policy, told The Intercept. “The time has come for Meta, among other tech giants, to publicly disclose detailed measures and investments aimed at safeguarding individuals amidst the ongoing genocide, and to be more responsive to experts and civil society.”

    Meta’s reply disclosed some censorship: “In the nine days following October 7, we removed or marked as disturbing more than 2,200,000 pieces of content in Hebrew and Arabic for violating our policies.” The company declined, however, to provide a breakdown of deletions by language or market, making it impossible to tell whether that figure reflects discriminatory moderation practices.

    Much of Meta’s letter is a rehash of an update it provided through its public relations portal at the war’s onset, some of it verbatim.

    Now, a second letter from Warren to Meta, joined this time by Sanders, says this isn’t enough. “Meta’s response, dated January 29, 2024, did not provide any of the requested information necessary to understand Meta’s treatment of Arabic language or Palestine-related content versus other forms of content,” the senators wrote.

    Both senators are asking Meta to again answer Warren’s specific questions about the extent to which Arabic and Hebrew posts about the war have been treated differently, how often censored posts are reinstated, Meta’s use of automated machine learning-based censorship tools, and more.

    Accusations of systemic moderation bias against Palestinians have been borne out by research from rights groups.

    “Since October 7, Human Rights Watch has documented over 1,000 cases of unjustified takedowns and other suppression of content on Instagram and Facebook related to Palestine and Palestinians, including about human rights abuses,” Human Rights Watch said in a late December report. “The censorship of content related to Palestine on Instagram and Facebook is systemic, global, and a product of the company’s failure to meet its human rights due diligence responsibilities.”


    Related

    Meta Considering Increased Censorship of the Word “Zionist”

    A February report by AccessNow said Meta “suspended or restricted the accounts of Palestinian journalists and activists both in and outside of Gaza, and arbitrarily deleted a considerable amount of content, including documentation of atrocities and human rights abuses.”

    A third-party audit commissioned by Meta itself previously concluded it had given the short shrift to Palestinian rights during a May 2021 flare-up of violence between Israel and Hamas, the militant group that controls the Gaza Strip. “Meta’s actions in May 2021 appear to have had an adverse human rights impact … on the rights of Palestinian users to freedom of expression, freedom of assembly, political participation, and non-discrimination, and therefore on the ability of Palestinians to share information and insights about their experiences as they occurred,” said the auditor’s report.

    In response to this audit, Meta pledged an array of reforms, which free expression and digital rights advocates say have yet to produce a material improvement.

    In its December report, Human Rights Watch noted, “More than two years after committing to publishing data around government requests for taking down content that is not necessarily illegal, Meta has failed to increase transparency in this area.”

    Update: March 26, 2024, 1:11 p.m. ET
    This story has been updated to include a statement received after publication from Mona Shtaya, a nonresident fellow at the Tahrir Institute for Middle East Policy.

    https://theintercept.com/2024/03/26/meta-gaza-censorship-warren-sanders/
    Meta Refuses to Answer Questions on Gaza Censorship, Say Sens. Warren and Sanders Sam BiddleMarch 26 2024, 8:00 a.m. WASHINGTON, DC - MARCH 03: Sen. Elizabeth Warren (D-MA) questions U.S. Federal Reserve Chair Jerome Powell as he testifies at a Senate Banking, Housing, and Urban Affairs Committee hearing on the Fed's "Semiannual Monetary Policy Report to the Congress," on Capitol Hill on March 3, 2022 in Washington, DC. (Photo by Tom Williams-Pool/Getty Images) Citing the company’s “failure to provide answers to important questions,” Sens. Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt., are pressing Meta, which owns Facebook and Instagram, to respond to reports of disproportionate censorship around the Israeli war on Gaza. “Meta insists that there’s been no discrimination against Palestinian-related content on their platforms, but at the same time, is refusing to provide us with any evidence or data to support that claim,” Warren told The Intercept. “If its ad-hoc changes and removal of millions of posts didn’t discriminate against Palestinian-related content, then what’s Meta hiding?” In a letter to Meta CEO Mark Zuckerberg sent last December, first reported by The Intercept, Warren presented the company with dozens of specific questions about the company’s Gaza-related content moderation efforts. Warren asked about the exact numbers of posts about the war, broken down by Hebrew or Arabic, that have been deleted or otherwise suppressed. The letter was written following widespread reporting in The Intercept and other outlets that detailed how posts on Meta platforms that are sympathetic to Palestinians, or merely depicting the destruction in Gaza, are routinely removed or hidden without explanation. A month later, Meta replied to Warren’s office with a six-page letter, obtained by The Intercept, that provided an overview of its moderation response to the war but little in the way of specifics or new information. Most Read “Meta’s lack of investment to safeguard its users significantly exacerbates the political situation in Palestine and perpetuates tech harms on fundamental rights in Palestine and other global majority countries, all while evading meaningful legal accountability,” Mona Shtaya, nonresident fellow at the Tahrir Institute for Middle East Policy, told The Intercept. “The time has come for Meta, among other tech giants, to publicly disclose detailed measures and investments aimed at safeguarding individuals amidst the ongoing genocide, and to be more responsive to experts and civil society.” Meta’s reply disclosed some censorship: “In the nine days following October 7, we removed or marked as disturbing more than 2,200,000 pieces of content in Hebrew and Arabic for violating our policies.” The company declined, however, to provide a breakdown of deletions by language or market, making it impossible to tell whether that figure reflects discriminatory moderation practices. Much of Meta’s letter is a rehash of an update it provided through its public relations portal at the war’s onset, some of it verbatim. Now, a second letter from Warren to Meta, joined this time by Sanders, says this isn’t enough. “Meta’s response, dated January 29, 2024, did not provide any of the requested information necessary to understand Meta’s treatment of Arabic language or Palestine-related content versus other forms of content,” the senators wrote. Both senators are asking Meta to again answer Warren’s specific questions about the extent to which Arabic and Hebrew posts about the war have been treated differently, how often censored posts are reinstated, Meta’s use of automated machine learning-based censorship tools, and more. Accusations of systemic moderation bias against Palestinians have been borne out by research from rights groups. “Since October 7, Human Rights Watch has documented over 1,000 cases of unjustified takedowns and other suppression of content on Instagram and Facebook related to Palestine and Palestinians, including about human rights abuses,” Human Rights Watch said in a late December report. “The censorship of content related to Palestine on Instagram and Facebook is systemic, global, and a product of the company’s failure to meet its human rights due diligence responsibilities.” Related Meta Considering Increased Censorship of the Word “Zionist” A February report by AccessNow said Meta “suspended or restricted the accounts of Palestinian journalists and activists both in and outside of Gaza, and arbitrarily deleted a considerable amount of content, including documentation of atrocities and human rights abuses.” A third-party audit commissioned by Meta itself previously concluded it had given the short shrift to Palestinian rights during a May 2021 flare-up of violence between Israel and Hamas, the militant group that controls the Gaza Strip. “Meta’s actions in May 2021 appear to have had an adverse human rights impact … on the rights of Palestinian users to freedom of expression, freedom of assembly, political participation, and non-discrimination, and therefore on the ability of Palestinians to share information and insights about their experiences as they occurred,” said the auditor’s report. In response to this audit, Meta pledged an array of reforms, which free expression and digital rights advocates say have yet to produce a material improvement. In its December report, Human Rights Watch noted, “More than two years after committing to publishing data around government requests for taking down content that is not necessarily illegal, Meta has failed to increase transparency in this area.” Update: March 26, 2024, 1:11 p.m. ET This story has been updated to include a statement received after publication from Mona Shtaya, a nonresident fellow at the Tahrir Institute for Middle East Policy. https://theintercept.com/2024/03/26/meta-gaza-censorship-warren-sanders/
    THEINTERCEPT.COM
    Meta Refuses to Answer Questions on Gaza Censorship, Say Sens. Warren and Sanders
    Facebook and Instagram’s parent company Meta dodged questions from Elizabeth Warren and Bernie Sanders about censorship of posts about Gaza.
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  • The Silent Shame of Health Institutions
    J.R. Bruning
    For how much longer will health policy ignore multimorbidity, that looming, giant elephant in the room, that propagates and amplifies suffering? For how much longer will the ‘trend’ of increasing diagnoses of multiple health conditions, at younger and younger ages be rendered down by government agencies to better and more efficient services, screening modalities, and drug choices?

    Multimorbidity, the presence of many chronic conditions, is the silent shame of health policy.

    All too often chronic conditions overlap and accumulate. From cancer, to diabetes, to digestive system diseases, to high blood pressure, to skin conditions in cascades of suffering. Heartbreakingly, these conditions commonly overlap with mental illnesses or disorders. It’s increasingly common for people to be diagnosed with multiple mental conditions, such as having anxiety and depression, or anxiety and schizophrenia.

    Calls for equity tend to revolve around medical treatment, even as absurdities and injustices accrue.

    Multimorbidity occurs a decade earlier in socioeconomically deprived communities. Doctors are diagnosing multimorbidity at younger and younger ages.

    Treatment regimens for people with multiple conditions necessarily entail a polypharmacy approach – the prescribing of multiple medications. One condition may require multiple medications. Thus, with multimorbidity comes increased risk of adverse outcomes and polyiatrogenesis – ‘medical harm caused by medical treatments on multiple fronts simultaneously and in conjunction with one another.’

    Side effects, whether short-term or patients’ concerns about long-term harm, are the main reason for non-adherence to prescribed medications.

    So ‘equity’ which only implies drug treatment doesn’t involve equity at all.

    Poor diets may be foundational to the Western world’s health crisis. But are governments considering this?

    The antinomies are piling up.

    We are amid a global epidemic of metabolic syndrome. Insulin resistance, obesity, elevated triglyceride levels and low levels of high-density lipoprotein cholesterol, and elevated blood pressure haunt the people queuing up to see doctors.

    Research, from individual cases to clinical trials, consistently show that diets containing high levels of ultra-processed foods and carbohydrates amplify inflammation, oxidative stress, and insulin resistance. What researchers and scientists are also identifying, at the cellular level, in clinical and medical practice, and at the global level – is that insulin resistance, inflammation, oxidative stress, and nutrient deficiencies from poor diets not only drive metabolic illness, but mental illnesses, compounding suffering.

    There is also ample evidence that the metabolic and mental health epidemic that is driving years lost due to disease, reducing productivity, and creating mayhem in personal lives – may be preventable and reversible.

    Doctors generally recognise that poor diets are a problem. Ultra-processed foods are strongly associated with adult and childhood ill health. Ultra-processed foods are

    ‘formulations of ingredients, mostly of exclusive industrial use, typically created by series of industrial techniques and processes (hence ‘ultra-processed’).’

    In the USA young people under age 19 consume on average 67% of their diet, while adults consume around 60% of their diet in ultra-processed food. Ultra-processed food contributes 60% of UK children’s calories; 42% of Australian children’s calories and over half the dietary calories for children and adolescents in Canada. In New Zealand in 2009-2010, ultra-processed foods contributed to the 45% (12 months), 42% (24 months), and 51% (60 months) of energy intake to the diets of children.

    All too frequently, doctors are diagnosing both metabolic and mental illnesses.

    What may be predictable is that a person is likely to develop insulin resistance, inflammation, oxidative stress, and nutrient deficiencies from chronic exposure to ultra-processed food. How this will manifest in a disease or syndrome condition is reflective of a human equivalent of quantum entanglement.

    Cascades, feedback loops, and other interdependencies often leave doctors and patients bouncing from one condition to another, and managing medicine side effects and drug-drug relationships as they go.

    In New Zealand it is more common to have multiple conditions than a single condition. The costs of having two NCDs simultaneously is typically superadditive and ‘more so for younger adults.’

    This information is outside the ‘work programme’ of the top echelons in the Ministry of Health:

    Official Information Act (OIA) requests confirm that the Ministries’ Directors General who are responsible for setting policy and long-term strategy aren’t considering these issues. The problem of multimorbidity and the overlapping, entangled relationship with ultra-processed food is outside of the scope of the work programme of the top directorates in our health agency.

    New Zealand’s Ministry of Health’s top deputy directors general might be earning a quarter of a million dollars each, but they are ignorant of the relationship of dietary nutrition and mental health. Nor are they seemingly aware of the extent of multimorbidity and the overlap between metabolic and mental illnesses.

    Neither the Public Health Agency Deputy Director-General – Dr Andrew Old, nor the Deputy Director-General Evidence, Research and Innovation, Dean Rutherford, nor the Deputy Director-General of Strategy Policy and Legislation, Maree Roberts, nor the Clinical, Community and Mental Health Deputy Director-General Robyn Shearer have been briefed on these relationships.

    If they’re not being briefed, policy won’t be developed to address dietary nutrition. Diet will be lower-order.

    The OIA request revealed that New Zealand’s Ministry of Health ‘does not widely use the metabolic syndrome classification.’ When I asked ‘How do you classify, or what term do you use to classify the cluster of symptoms characterised by central obesity, dyslipidemia, hypertension, and insulin resistance?’, they responded:

    ‘The conditions referred to are considered either on their own or as part of a broader cardiovascular disease risk calculation.’

    This is interesting. What if governments should be calculating insulin resistance first, in order to then calculate a broader cardiovascular risk? What if insulin resistance, inflammation, and oxidative stress are appearing at younger and younger ages, and ultra-processed food is the major driver?

    Pre-diabetes and Type 2 diabetes are driven by too much blood glucose. Type 1 diabetics can’t make insulin, while Type 2 diabetics can’t make enough to compensate for their dietary intake of carbohydrates. One of insulin’s (many) jobs is to tuck away that blood glucose into cells (as fat) but when there are too many dietary carbohydrates pumping up blood glucose, the body can’t keep up. New Zealand practitioners use the HbA1c blood test, which measures the average blood glucose level over the past 2-3 months. In New Zealand, doctors diagnose pre-diabetes if HbA1c levels are 41-49 nmol/mol, and diabetes at levels of 50 nmol/mol and above.

    Type 2 diabetes management guidelines recommend that sugar intake should be reduced, while people should aim for consistent carbohydrates across the day. The New Zealand government does not recommend paleo or low-carbohydrate diets.

    If you have diabetes you are twice as likely to have heart disease or a stroke, and at a younger age. Prediabetes, which apparently 20% of Kiwis have, is also high-risk due to, as the Ministry of Health states: ‘increased risk of macrovascular complications and early death.’

    The question might become – should we be looking at insulin levels, to more sensitively gauge risk at an early stage?

    Without more sensitive screens at younger ages these opportunities to repivot to avoid chronic disease are likely to be missed. Currently, Ministry of Health policies are unlikely to justify the funding of tests for insulin resistance by using three simple blood tests: fasting insulin, fasting lipids (cholesterol and triglycerides), and fasting glucose – to estimate where children, young people, and adults stand on the insulin resistance spectrum when other diagnoses pop up.

    Yet insulin plays a powerful role in brain health.

    Insulin supports neurotransmitter function and brain energy, directly impacting mood and behaviours. Insulin resistance might arrive before mental illness. Harvard-based psychiatrist Chris Palmer recounts in the book Brain Energy, a large 15,000-participant study of young people from age 0-24:

    ‘Children who had persistently high insulin levels (a sign of insulin resistance) beginning at age nine were five times more likely to be at risk for psychosis, meaning they were showing at least some worrisome signs, and they were three times for likely to already be diagnosed with bipolar disorder or schizophrenia by the time they turned twenty-four. This study clearly demonstrated that insulin resistance comes first, then psychosis.’

    Psychiatrist Georgia Ede suggests that high blood glucose and high insulin levels act like a ‘deadly one-two punch’ for the brain, triggering waves of inflammation and oxidative stress. The blood-brain barrier becomes increasingly resistant to chronic high insulin levels. Even though the body might have higher blood insulin, the same may not be true for the brain. As Ede maintains, ‘cells deprived of adequate insulin ‘sputter and struggle to maintain normal operations.’

    Looking at the relationship between brain health and high blood glucose and high insulin simply might not be on the programme for strategists looking at long-term planning.

    Nor are Directors General in a position to assess the role of food addiction. Ultra-processed food has addictive qualities designed into the product formulations. Food addiction is increasingly recognised as pervasive and difficult to manage as any substance addiction.

    But how many children and young people have insulin resistance and are showing markers for inflammation and oxidative stress – in the body and in the brain? To what extent do young people have both insulin resistance and depression resistance or ADHD or bipolar disorder?

    This kind of thinking is completely outside the work programme. But insulin levels, inflammation, and oxidative stress may not only be driving chronic illness – but driving the global mental health tsunami.

    Metabolic disorders are involved in complex pathways and feedback loops across body systems, and doctors learn this at medical school. Patterns and relationships between hormones, the brain, the gastrointestinal system, kidneys, and liver; as well as problems with joints and bone health, autoimmunity, nerves, and sensory conditions evolve from and revolve around metabolic health.

    Nutrition and diet are downplayed in medical school. What doctors don’t learn so much – the cognitive dissonance that they must accept throughout their training – is that metabolic health is commonly (except for some instances) shaped by the quality of dietary nutrition. The aetiology of a given condition can be very different, while the evidence that common chronic and mental illnesses are accompanied by oxidative stress, inflammation, and insulin resistance are primarily driven by diet – is growing stronger and stronger.

    But without recognising the overlapping relationships, policy to support healthy diets will remain limp.

    What we witness are notions of equity that support pharmaceutical delivery – not health delivery.

    What also inevitably happens is that ‘equity’ focuses on medical treatment. When the Ministry of Health prefers to atomise the different conditions or associate them with heart disease – they become single conditions to treat with single drugs. They’re lots of small problems, not one big problem, and insulin resistance is downplayed.

    But just as insulin resistance, inflammation, and oxidative stress send cascading impacts across body systems, systemic ignorance sends cascading effects across government departments tasked with ‘improving, promoting, and protecting health.’

    It’s an injustice. The literature solidly points to lower socio-economic status driving much poorer diets and increased exposures to ultra-processed food, but the treatments exclusively involve drugs and therapy.

    Briefings to Incoming Ministers with the election of new Governments show how ignorance cascades across responsible authorities.

    Health New Zealand, Te Whatu Ora’s November 2023 Briefing to the new government outlined the agency’s obligations. However, the ‘health’ targets are medical, and the agency’s focus is on infrastructure, staff, and servicing. The promotion of health, and health equity, which can only be addressed by addressing the determinants of health, is not addressed.

    The Māori Health Authority and Health New Zealand Joint Briefing to the Incoming Minister for Mental Health does not address the role of diet and nutrition as a driver of mental illness and disorder in New Zealand. The issue of multimorbidity, the related problem of commensurate metabolic illness, and diet as a driver is outside scope. When the Briefing states that it is important to address the ‘social, cultural, environmental and economic determinants of mental health,’ without any sound policy footing, real movement to address diet will not happen, or will only happen ad hoc.

    The Mental Health and Wellbeing Commission, Te Hiringa Mahara’s November 2023 Briefing to Incoming Ministers that went to the Ministers for Health and Mental Health might use the term ‘well-being’ over 120 times – but was silent on the related and overlapping drivers of mental illness which include metabolic or multimorbidity, nutrition, or diet.

    Five years earlier, He Ara Ora, New Zealand’s 2018 Mental Health and Addiction enquiry had recognised that tāngata whaiora, people seeking wellness, or service users, also tend to have multiple health conditions. The enquiry recommended that a whole of government approach to well-being, prevention, and social determinants was required. Vague nods were made to diet and nutrition, but this was not sufficiently emphasised as to be a priority.

    He Ara Ora was followed by 2020 Long-term pathway to mental well-being viewed nutrition as being one of a range of factors. No policy framework strategically prioritised diet, nutrition, and healthy food. No governmental obligation or commitment was built into policy to improve access to healthy food or nutrition education.

    Understanding the science, the relationships, and the drivers of the global epidemic, is ‘outside the work programmes’ of New Zealand’s Ministry of Health and outside the scope of all the related authorities. There is an extraordinary amount of data in the scientific literature, so many case studies, cohort studies, and clinical trials. Popular books are being written, however government agencies remain ignorant.

    In the meantime, doctors must deal with the suffering in front of them without an adequate toolkit.

    Doctors and pharmacists are faced with a Hobson’s choice of managing multiple chronic conditions and complex drug cocktails, in patients at younger and younger ages. Ultimately, they are treating a patient whom they recognise will only become sicker, cost the health system more, and suffer more.

    Currently there is little support for New Zealand medical doctors (known as general practitioners, or GPs) in changing practices and recommendations to support non-pharmaceutical drug treatment approaches. Their medical education does not equip them to recognise the extent to which multiple co-existing conditions may be alleviated or reversed. Doctors are paid to prescribe, to inject, and to screen, not to ameliorate or reverse disease and lessen prescribing. The prescribing of nutrients is discouraged and as doctors do not have nutritional training, they hesitate to prescribe nutrients.

    Many do not want to risk going outside treatment guidelines. Recent surges in protocols and guidelines for medical doctors reduce flexibility and narrow treatment choices for doctors. If they were to be reported to the Medical Council of New Zealand, they would risk losing their medical license. They would then be unable to practice.

    Inevitably, without Ministry of Health leadership, medical doctors in New Zealand are unlikely to voluntarily prescribe non-drug modalities such as nutritional options to any meaningful extent, for fear of being reported.

    Yet some doctors are proactive, such as Dr Glen Davies in Taupo, New Zealand. Some doctors are in a better ‘place’ to work to alleviate and reverse long-term conditions. They may be later in their career, with 10-20 years of research into metabolism, dietary nutrition, and patient care, and motivated to guide a patient through a personal care regime which might alleviate or reverse a patient’s suffering.

    Barriers include resourcing. Doctors aren’t paid for reversing disease and taking patients off medications.

    Doctors witness daily the hopelessness felt by their patients in dealing with chronic conditions in their short 15-minute consultations, and the vigilance required for dealing with adverse drug effects. Drug non-compliance is associated with adverse effects suffered by patients. Yet without wrap-around support changing treatments, even if it has potential to alleviate multiple conditions, to reduce symptoms, lower prescribing and therefore lessen side effects, is just too uncertain.

    They saw what happened to disobedient doctors during Covid-19.

    Given such context, what are we to do?

    Have open public discussions about doctor-patient relationships and trust. Inform and overlay such conversations by drawing attention to the foundational Hippocratic Oath made by doctors, to first do no harm.

    Questions can be asked. If patients were to understand that diet may be an underlying driver of multiple conditions, and a change in diet and improvement in micronutrient status might alleviate suffering – would patients be more likely to change?

    Economically, if wrap-around services were provided in clinics to support dietary change, would less harm occur to patients from worsening conditions that accompany many diseases (such as Type 2 diabetes) and the ever-present problem of drug side-effects? Would education and wrap-around services in early childhood and youth delay or prevent the onset of multimorbid diagnoses?

    Is it more ethical to give young people a choice of treatment? Could doctors prescribe dietary changes and multinutrients and support change with wrap-around support when children and young people are first diagnosed with a mental health condition – from the clinic, to school, to after school? If that doesn’t work, then prescribe pharmaceutical drugs.

    Should children and young people be educated to appreciate the extent to which their consumption of ultra-processed food likely drives their metabolic and mental health conditions? Not just in a blithe ‘eat healthy’ fashion that patently avoids discussing addiction. Through deeper policy mechanisms, including cooking classes and nutritional biology by the implementation of nourishing, low-carbohydrate cooked school lunches.

    With officials uninformed, it’s easy to see why funding for Green Prescriptions that would support dietary changes have sputtered out. It’s easy to understand why neither the Ministry of Health nor Pharmac have proactively sourced multi-nutrient treatments that improve resilience to stress and trauma for low-income young people. Why there’s no discussion on a lower side-effect risk for multinutrient treatments. Why are there no policies in the education curriculum diving into the relationship between ultra-processed food and mental and physical health? It’s not in the work programme.

    There’s another surfacing dilemma.

    Currently, if doctors tell their patients that there is very good evidence that their disease or syndrome could be reversed, and this information is not held as factual information by New Zealand’s Ministry of Health – do doctors risk being accused of spreading misinformation?

    Government agencies have pivoted in the past 5 years to focus intensively on the problem of dis- and misinformation. New Zealand’s disinformation project states that

    Disinformation is false or modified information knowingly and deliberately shared to cause harm or achieve a broader aim.
    Misinformation is information that is false or misleading, though not created or shared with the direct intention of causing harm.
    Unfortunately, as we see, there is no division inside the Ministry of Health that reviews the latest evidence in the scientific literature, to ensure that policy decisions correctly reflect the latest evidence.

    There is no scientific agency outside the Ministry of Health that has flexibility and the capacity to undertake autonomous, long-term monitoring and research in nutrition, diet, and health. There is no independent, autonomous, public health research facility with sufficient long-term funding to translate dietary and nutritional evidence into policy, particularly if it contradicted current policy positions.

    Despite excellent research being undertaken, it is highly controlled, ad hoc, and frequently short-term. Problematically, there is no resourcing for those scientists to meaningfully feedback that information to either the Ministry of Health or to Members of Parliament and government Ministers.

    Dietary guidelines can become locked in, and contradictions can fail to be chewed over. Without the capacity to address errors, information can become outdated and misleading. Government agencies and elected members – from local councils all the way up to government Ministers, are dependent on being informed by the Ministry of Health, when it comes to government policy.

    When it comes to complex health conditions, and alleviating and reversing metabolic or mental illness, based on different patient capacity – from socio-economic, to cultural, to social, and taking into account capacity for change, what is sound, evidence-based information and what is misinformation?

    In the impasse, who can we trust?

    Published under a Creative Commons Attribution 4.0 International License
    For reprints, please set the canonical link back to the original Brownstone Institute Article and Author.

    Author

    J.R. Bruning is a consultant sociologist (B.Bus.Agribusiness; MA Sociology) based in New Zealand. Her work explores governance cultures, policy and the production of scientific and technical knowledge. Her Master’s thesis explored the ways science policy creates barriers to funding, stymying scientists’ efforts to explore upstream drivers of harm. Bruning is a trustee of Physicians & Scientists for Global Responsibility (PSGR.org.nz). Papers and writing can be found at TalkingRisk.NZ and at JRBruning.Substack.com and at Talking Risk on Rumble.

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    https://brownstone.org/articles/the-silent-shame-of-health-institutions/
    The Silent Shame of Health Institutions J.R. Bruning For how much longer will health policy ignore multimorbidity, that looming, giant elephant in the room, that propagates and amplifies suffering? For how much longer will the ‘trend’ of increasing diagnoses of multiple health conditions, at younger and younger ages be rendered down by government agencies to better and more efficient services, screening modalities, and drug choices? Multimorbidity, the presence of many chronic conditions, is the silent shame of health policy. All too often chronic conditions overlap and accumulate. From cancer, to diabetes, to digestive system diseases, to high blood pressure, to skin conditions in cascades of suffering. Heartbreakingly, these conditions commonly overlap with mental illnesses or disorders. It’s increasingly common for people to be diagnosed with multiple mental conditions, such as having anxiety and depression, or anxiety and schizophrenia. Calls for equity tend to revolve around medical treatment, even as absurdities and injustices accrue. Multimorbidity occurs a decade earlier in socioeconomically deprived communities. Doctors are diagnosing multimorbidity at younger and younger ages. Treatment regimens for people with multiple conditions necessarily entail a polypharmacy approach – the prescribing of multiple medications. One condition may require multiple medications. Thus, with multimorbidity comes increased risk of adverse outcomes and polyiatrogenesis – ‘medical harm caused by medical treatments on multiple fronts simultaneously and in conjunction with one another.’ Side effects, whether short-term or patients’ concerns about long-term harm, are the main reason for non-adherence to prescribed medications. So ‘equity’ which only implies drug treatment doesn’t involve equity at all. Poor diets may be foundational to the Western world’s health crisis. But are governments considering this? The antinomies are piling up. We are amid a global epidemic of metabolic syndrome. Insulin resistance, obesity, elevated triglyceride levels and low levels of high-density lipoprotein cholesterol, and elevated blood pressure haunt the people queuing up to see doctors. Research, from individual cases to clinical trials, consistently show that diets containing high levels of ultra-processed foods and carbohydrates amplify inflammation, oxidative stress, and insulin resistance. What researchers and scientists are also identifying, at the cellular level, in clinical and medical practice, and at the global level – is that insulin resistance, inflammation, oxidative stress, and nutrient deficiencies from poor diets not only drive metabolic illness, but mental illnesses, compounding suffering. There is also ample evidence that the metabolic and mental health epidemic that is driving years lost due to disease, reducing productivity, and creating mayhem in personal lives – may be preventable and reversible. Doctors generally recognise that poor diets are a problem. Ultra-processed foods are strongly associated with adult and childhood ill health. Ultra-processed foods are ‘formulations of ingredients, mostly of exclusive industrial use, typically created by series of industrial techniques and processes (hence ‘ultra-processed’).’ In the USA young people under age 19 consume on average 67% of their diet, while adults consume around 60% of their diet in ultra-processed food. Ultra-processed food contributes 60% of UK children’s calories; 42% of Australian children’s calories and over half the dietary calories for children and adolescents in Canada. In New Zealand in 2009-2010, ultra-processed foods contributed to the 45% (12 months), 42% (24 months), and 51% (60 months) of energy intake to the diets of children. All too frequently, doctors are diagnosing both metabolic and mental illnesses. What may be predictable is that a person is likely to develop insulin resistance, inflammation, oxidative stress, and nutrient deficiencies from chronic exposure to ultra-processed food. How this will manifest in a disease or syndrome condition is reflective of a human equivalent of quantum entanglement. Cascades, feedback loops, and other interdependencies often leave doctors and patients bouncing from one condition to another, and managing medicine side effects and drug-drug relationships as they go. In New Zealand it is more common to have multiple conditions than a single condition. The costs of having two NCDs simultaneously is typically superadditive and ‘more so for younger adults.’ This information is outside the ‘work programme’ of the top echelons in the Ministry of Health: Official Information Act (OIA) requests confirm that the Ministries’ Directors General who are responsible for setting policy and long-term strategy aren’t considering these issues. The problem of multimorbidity and the overlapping, entangled relationship with ultra-processed food is outside of the scope of the work programme of the top directorates in our health agency. New Zealand’s Ministry of Health’s top deputy directors general might be earning a quarter of a million dollars each, but they are ignorant of the relationship of dietary nutrition and mental health. Nor are they seemingly aware of the extent of multimorbidity and the overlap between metabolic and mental illnesses. Neither the Public Health Agency Deputy Director-General – Dr Andrew Old, nor the Deputy Director-General Evidence, Research and Innovation, Dean Rutherford, nor the Deputy Director-General of Strategy Policy and Legislation, Maree Roberts, nor the Clinical, Community and Mental Health Deputy Director-General Robyn Shearer have been briefed on these relationships. If they’re not being briefed, policy won’t be developed to address dietary nutrition. Diet will be lower-order. The OIA request revealed that New Zealand’s Ministry of Health ‘does not widely use the metabolic syndrome classification.’ When I asked ‘How do you classify, or what term do you use to classify the cluster of symptoms characterised by central obesity, dyslipidemia, hypertension, and insulin resistance?’, they responded: ‘The conditions referred to are considered either on their own or as part of a broader cardiovascular disease risk calculation.’ This is interesting. What if governments should be calculating insulin resistance first, in order to then calculate a broader cardiovascular risk? What if insulin resistance, inflammation, and oxidative stress are appearing at younger and younger ages, and ultra-processed food is the major driver? Pre-diabetes and Type 2 diabetes are driven by too much blood glucose. Type 1 diabetics can’t make insulin, while Type 2 diabetics can’t make enough to compensate for their dietary intake of carbohydrates. One of insulin’s (many) jobs is to tuck away that blood glucose into cells (as fat) but when there are too many dietary carbohydrates pumping up blood glucose, the body can’t keep up. New Zealand practitioners use the HbA1c blood test, which measures the average blood glucose level over the past 2-3 months. In New Zealand, doctors diagnose pre-diabetes if HbA1c levels are 41-49 nmol/mol, and diabetes at levels of 50 nmol/mol and above. Type 2 diabetes management guidelines recommend that sugar intake should be reduced, while people should aim for consistent carbohydrates across the day. The New Zealand government does not recommend paleo or low-carbohydrate diets. If you have diabetes you are twice as likely to have heart disease or a stroke, and at a younger age. Prediabetes, which apparently 20% of Kiwis have, is also high-risk due to, as the Ministry of Health states: ‘increased risk of macrovascular complications and early death.’ The question might become – should we be looking at insulin levels, to more sensitively gauge risk at an early stage? Without more sensitive screens at younger ages these opportunities to repivot to avoid chronic disease are likely to be missed. Currently, Ministry of Health policies are unlikely to justify the funding of tests for insulin resistance by using three simple blood tests: fasting insulin, fasting lipids (cholesterol and triglycerides), and fasting glucose – to estimate where children, young people, and adults stand on the insulin resistance spectrum when other diagnoses pop up. Yet insulin plays a powerful role in brain health. Insulin supports neurotransmitter function and brain energy, directly impacting mood and behaviours. Insulin resistance might arrive before mental illness. Harvard-based psychiatrist Chris Palmer recounts in the book Brain Energy, a large 15,000-participant study of young people from age 0-24: ‘Children who had persistently high insulin levels (a sign of insulin resistance) beginning at age nine were five times more likely to be at risk for psychosis, meaning they were showing at least some worrisome signs, and they were three times for likely to already be diagnosed with bipolar disorder or schizophrenia by the time they turned twenty-four. This study clearly demonstrated that insulin resistance comes first, then psychosis.’ Psychiatrist Georgia Ede suggests that high blood glucose and high insulin levels act like a ‘deadly one-two punch’ for the brain, triggering waves of inflammation and oxidative stress. The blood-brain barrier becomes increasingly resistant to chronic high insulin levels. Even though the body might have higher blood insulin, the same may not be true for the brain. As Ede maintains, ‘cells deprived of adequate insulin ‘sputter and struggle to maintain normal operations.’ Looking at the relationship between brain health and high blood glucose and high insulin simply might not be on the programme for strategists looking at long-term planning. Nor are Directors General in a position to assess the role of food addiction. Ultra-processed food has addictive qualities designed into the product formulations. Food addiction is increasingly recognised as pervasive and difficult to manage as any substance addiction. But how many children and young people have insulin resistance and are showing markers for inflammation and oxidative stress – in the body and in the brain? To what extent do young people have both insulin resistance and depression resistance or ADHD or bipolar disorder? This kind of thinking is completely outside the work programme. But insulin levels, inflammation, and oxidative stress may not only be driving chronic illness – but driving the global mental health tsunami. Metabolic disorders are involved in complex pathways and feedback loops across body systems, and doctors learn this at medical school. Patterns and relationships between hormones, the brain, the gastrointestinal system, kidneys, and liver; as well as problems with joints and bone health, autoimmunity, nerves, and sensory conditions evolve from and revolve around metabolic health. Nutrition and diet are downplayed in medical school. What doctors don’t learn so much – the cognitive dissonance that they must accept throughout their training – is that metabolic health is commonly (except for some instances) shaped by the quality of dietary nutrition. The aetiology of a given condition can be very different, while the evidence that common chronic and mental illnesses are accompanied by oxidative stress, inflammation, and insulin resistance are primarily driven by diet – is growing stronger and stronger. But without recognising the overlapping relationships, policy to support healthy diets will remain limp. What we witness are notions of equity that support pharmaceutical delivery – not health delivery. What also inevitably happens is that ‘equity’ focuses on medical treatment. When the Ministry of Health prefers to atomise the different conditions or associate them with heart disease – they become single conditions to treat with single drugs. They’re lots of small problems, not one big problem, and insulin resistance is downplayed. But just as insulin resistance, inflammation, and oxidative stress send cascading impacts across body systems, systemic ignorance sends cascading effects across government departments tasked with ‘improving, promoting, and protecting health.’ It’s an injustice. The literature solidly points to lower socio-economic status driving much poorer diets and increased exposures to ultra-processed food, but the treatments exclusively involve drugs and therapy. Briefings to Incoming Ministers with the election of new Governments show how ignorance cascades across responsible authorities. Health New Zealand, Te Whatu Ora’s November 2023 Briefing to the new government outlined the agency’s obligations. However, the ‘health’ targets are medical, and the agency’s focus is on infrastructure, staff, and servicing. The promotion of health, and health equity, which can only be addressed by addressing the determinants of health, is not addressed. The Māori Health Authority and Health New Zealand Joint Briefing to the Incoming Minister for Mental Health does not address the role of diet and nutrition as a driver of mental illness and disorder in New Zealand. The issue of multimorbidity, the related problem of commensurate metabolic illness, and diet as a driver is outside scope. When the Briefing states that it is important to address the ‘social, cultural, environmental and economic determinants of mental health,’ without any sound policy footing, real movement to address diet will not happen, or will only happen ad hoc. The Mental Health and Wellbeing Commission, Te Hiringa Mahara’s November 2023 Briefing to Incoming Ministers that went to the Ministers for Health and Mental Health might use the term ‘well-being’ over 120 times – but was silent on the related and overlapping drivers of mental illness which include metabolic or multimorbidity, nutrition, or diet. Five years earlier, He Ara Ora, New Zealand’s 2018 Mental Health and Addiction enquiry had recognised that tāngata whaiora, people seeking wellness, or service users, also tend to have multiple health conditions. The enquiry recommended that a whole of government approach to well-being, prevention, and social determinants was required. Vague nods were made to diet and nutrition, but this was not sufficiently emphasised as to be a priority. He Ara Ora was followed by 2020 Long-term pathway to mental well-being viewed nutrition as being one of a range of factors. No policy framework strategically prioritised diet, nutrition, and healthy food. No governmental obligation or commitment was built into policy to improve access to healthy food or nutrition education. Understanding the science, the relationships, and the drivers of the global epidemic, is ‘outside the work programmes’ of New Zealand’s Ministry of Health and outside the scope of all the related authorities. There is an extraordinary amount of data in the scientific literature, so many case studies, cohort studies, and clinical trials. Popular books are being written, however government agencies remain ignorant. In the meantime, doctors must deal with the suffering in front of them without an adequate toolkit. Doctors and pharmacists are faced with a Hobson’s choice of managing multiple chronic conditions and complex drug cocktails, in patients at younger and younger ages. Ultimately, they are treating a patient whom they recognise will only become sicker, cost the health system more, and suffer more. Currently there is little support for New Zealand medical doctors (known as general practitioners, or GPs) in changing practices and recommendations to support non-pharmaceutical drug treatment approaches. Their medical education does not equip them to recognise the extent to which multiple co-existing conditions may be alleviated or reversed. Doctors are paid to prescribe, to inject, and to screen, not to ameliorate or reverse disease and lessen prescribing. The prescribing of nutrients is discouraged and as doctors do not have nutritional training, they hesitate to prescribe nutrients. Many do not want to risk going outside treatment guidelines. Recent surges in protocols and guidelines for medical doctors reduce flexibility and narrow treatment choices for doctors. If they were to be reported to the Medical Council of New Zealand, they would risk losing their medical license. They would then be unable to practice. Inevitably, without Ministry of Health leadership, medical doctors in New Zealand are unlikely to voluntarily prescribe non-drug modalities such as nutritional options to any meaningful extent, for fear of being reported. Yet some doctors are proactive, such as Dr Glen Davies in Taupo, New Zealand. Some doctors are in a better ‘place’ to work to alleviate and reverse long-term conditions. They may be later in their career, with 10-20 years of research into metabolism, dietary nutrition, and patient care, and motivated to guide a patient through a personal care regime which might alleviate or reverse a patient’s suffering. Barriers include resourcing. Doctors aren’t paid for reversing disease and taking patients off medications. Doctors witness daily the hopelessness felt by their patients in dealing with chronic conditions in their short 15-minute consultations, and the vigilance required for dealing with adverse drug effects. Drug non-compliance is associated with adverse effects suffered by patients. Yet without wrap-around support changing treatments, even if it has potential to alleviate multiple conditions, to reduce symptoms, lower prescribing and therefore lessen side effects, is just too uncertain. They saw what happened to disobedient doctors during Covid-19. Given such context, what are we to do? Have open public discussions about doctor-patient relationships and trust. Inform and overlay such conversations by drawing attention to the foundational Hippocratic Oath made by doctors, to first do no harm. Questions can be asked. If patients were to understand that diet may be an underlying driver of multiple conditions, and a change in diet and improvement in micronutrient status might alleviate suffering – would patients be more likely to change? Economically, if wrap-around services were provided in clinics to support dietary change, would less harm occur to patients from worsening conditions that accompany many diseases (such as Type 2 diabetes) and the ever-present problem of drug side-effects? Would education and wrap-around services in early childhood and youth delay or prevent the onset of multimorbid diagnoses? Is it more ethical to give young people a choice of treatment? Could doctors prescribe dietary changes and multinutrients and support change with wrap-around support when children and young people are first diagnosed with a mental health condition – from the clinic, to school, to after school? If that doesn’t work, then prescribe pharmaceutical drugs. Should children and young people be educated to appreciate the extent to which their consumption of ultra-processed food likely drives their metabolic and mental health conditions? Not just in a blithe ‘eat healthy’ fashion that patently avoids discussing addiction. Through deeper policy mechanisms, including cooking classes and nutritional biology by the implementation of nourishing, low-carbohydrate cooked school lunches. With officials uninformed, it’s easy to see why funding for Green Prescriptions that would support dietary changes have sputtered out. It’s easy to understand why neither the Ministry of Health nor Pharmac have proactively sourced multi-nutrient treatments that improve resilience to stress and trauma for low-income young people. Why there’s no discussion on a lower side-effect risk for multinutrient treatments. Why are there no policies in the education curriculum diving into the relationship between ultra-processed food and mental and physical health? It’s not in the work programme. There’s another surfacing dilemma. Currently, if doctors tell their patients that there is very good evidence that their disease or syndrome could be reversed, and this information is not held as factual information by New Zealand’s Ministry of Health – do doctors risk being accused of spreading misinformation? Government agencies have pivoted in the past 5 years to focus intensively on the problem of dis- and misinformation. New Zealand’s disinformation project states that Disinformation is false or modified information knowingly and deliberately shared to cause harm or achieve a broader aim. Misinformation is information that is false or misleading, though not created or shared with the direct intention of causing harm. Unfortunately, as we see, there is no division inside the Ministry of Health that reviews the latest evidence in the scientific literature, to ensure that policy decisions correctly reflect the latest evidence. There is no scientific agency outside the Ministry of Health that has flexibility and the capacity to undertake autonomous, long-term monitoring and research in nutrition, diet, and health. There is no independent, autonomous, public health research facility with sufficient long-term funding to translate dietary and nutritional evidence into policy, particularly if it contradicted current policy positions. Despite excellent research being undertaken, it is highly controlled, ad hoc, and frequently short-term. Problematically, there is no resourcing for those scientists to meaningfully feedback that information to either the Ministry of Health or to Members of Parliament and government Ministers. Dietary guidelines can become locked in, and contradictions can fail to be chewed over. Without the capacity to address errors, information can become outdated and misleading. Government agencies and elected members – from local councils all the way up to government Ministers, are dependent on being informed by the Ministry of Health, when it comes to government policy. When it comes to complex health conditions, and alleviating and reversing metabolic or mental illness, based on different patient capacity – from socio-economic, to cultural, to social, and taking into account capacity for change, what is sound, evidence-based information and what is misinformation? In the impasse, who can we trust? Published under a Creative Commons Attribution 4.0 International License For reprints, please set the canonical link back to the original Brownstone Institute Article and Author. Author J.R. Bruning is a consultant sociologist (B.Bus.Agribusiness; MA Sociology) based in New Zealand. Her work explores governance cultures, policy and the production of scientific and technical knowledge. Her Master’s thesis explored the ways science policy creates barriers to funding, stymying scientists’ efforts to explore upstream drivers of harm. Bruning is a trustee of Physicians & Scientists for Global Responsibility (PSGR.org.nz). Papers and writing can be found at TalkingRisk.NZ and at JRBruning.Substack.com and at Talking Risk on Rumble. View all posts Your financial backing of Brownstone Institute goes to support writers, lawyers, scientists, economists, and other people of courage who have been professionally purged and displaced during the upheaval of our times. You can help get the truth out through their ongoing work. https://brownstone.org/articles/the-silent-shame-of-health-institutions/
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    The Silent Shame of Health Institutions ⋆ Brownstone Institute
    There is no scientific agency outside the Ministry of Health that has flexibility and the capacity to undertake autonomous, long-term monitoring and research in nutrition, diet and health.
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