• Is Trump really ready to negotiate with Iran?
    Trump’s exploratory outreach to Iran, presented as a clean slate, stands in stark contrast to the turbulence of his hawkish first term. Is this a sincere effort at diplomacy or a calculated salvo to throw his opponents off guard?

    Shivan Mahendrarajah

    In a surprising reversal, US President Donald Trump, who previously ordered the assassination of Iranian General Qassem Soleimani and unilaterally withdrew the US from the Joint Comprehensive Plan of Action (JCPOA), has signaled a willingness to reengage with Iran.

    His actions during his first term significantly destabilized West Asia, maximized tensions between Washington and Tehran – further entrenching a legacy of mistrust – ignited proxy conflicts, and complicated US relations with its allies. Yet, despite these past moves – or perhaps because of them –Trump now appears intent on resetting relations with Iran, signaling a fresh start with no threats or preconditions.

    This, together with his dismissal of US Special Envoy for Iran Brian Hook, an enforcer of “maximum pressure” sanctions, terminations of security clearances for anti-Iran policymakers who led him astray in his first term, and his appointment of Michael DiMino, a realist on Iran policy, are positive signs.

    Interpreting the signals

    Deciphering Trump’s latest overtures is no easy task, given his volatile nature, the conflicting array of signals coming from Washington, and the political storm surrounding his actions. The Tehran Times classifies the conflicting forces into two camps: “War Hawks” and “America First.” Trying to interpret Trump’s intent feels as uncertain as scapulimancy – reading omens in animal bones – amid the noise of his presidency.

    Some suspect the signals about negotiations, reported by an Israeli newspaper, may serve strategic goals far removed from diplomacy. For instance, they may be a stalling tactic for Israeli Prime Minister Benjamin Netanyahu’s government to negotiate prisoner releases or for an exhausted occupation army to regroup before any action against Iranian nuclear facilities.

    For all we know, Trump’s administration may plan to use the delay to cement critical appointments or prepare the US military to back Israeli operations.

    The US president’s many marital infidelities, bankruptcies, breaches of business agreements, and unilateral withdrawal from the JCPOA in 2018, make him, ipso facto, a faithless man and dubious negotiating partner. For Tehran to consider engagement, Trump must offer a genuine gesture of good faith, such as lifting sanctions on Iranian oil or reconnecting Iranian banks to SWIFT. While codifying sanctions relief through Congress would be ideal, it is highly unlikely.

    The Islamic Republic’s view

    Meanwhile, the administration of Iranian President Masoud Pezeshkian has made no secret of its openness to negotiations, with Reformist factions actively advocating for dialogue. Former foreign minister and current Vice-President for Strategic Affairs, Mohammad Javad Zarif, a favorite in Washington, recently appealed to Trump to restart nuclear talks.

    However, this eagerness only undermines Tehran’s bargaining position, as Trump’s predatory instincts are quick to exploit desperation. The Reformist approach in 2015, which handed former US president Barack Obama and Netanyahu extensive leverage without securing adequate benefits, serves as a bitter reminder of the risks.

    The firing of Brian Hook, too, is open to interpretation – as are the punitive measures against hawks John Bolton, Mike Pompeo, and 50 former senior intelligence and military officials, which can be explained away by the political adage, “reward your friends, punish your enemies.”

    Trump’s appointment of Michael DiMino as Deputy Assistant Secretary of Defense for Middle East caused excitement in America First circles, and hysteria in Israel First circles. DiMino has expressed rational views vis-à-vis West Asia. One of his main “heresies” is that the region does “not really” matter for US interests.

    Does the ‘Middle East’ matter?

    Even a cursory examination of DiMino’s observation reveals its truth. North America (US and Canada) has abundant oil and gas reserves for domestic consumption. The US does not need to import one drop of crude oil or one cubic millimeter of natural gas – if “green energy” and “climate change” restrictions are eliminated – hence, Trump’s pledge to “drill, baby, drill,” and abandon the Paris climate accords. The US is a net exporter of oil and gas. To illustrate, in the aftermath of the Biden Administration’s act of state terrorism against the Russian Federation on 26 September 2022, via the sabotage of the Nord Stream gas pipelines, the US began supplying the EU with liquefied natural gas (LNG,) accounting for 50 percent of Europe’s 2023 imports. West Asian oil and gas are not imperatives for North America.

    US military bases in West Asia exist principally to protect Israel. Bases in Incirlik and Izmir in Turkiye reflect NATO commitments. Qatar’s Al-Udayd base expanded in 2001; Al-Dhafra, UAE, was developed in 2002; the seaport in Bahrain in 2003, the air base in 2009; and Prince Sultan Air Base and smaller bases in Saudi Arabia were expanded.

    This expansion was for the “Global War on Terror” (GWOT) and to “contain” Iran. However, despite the end of GWOT in 2021, the bases still thrive. Kuwait lost about ten bases from its Iraq War peak, but around 14,000 US personnel remain at Camp Arifjan, Ali al-Salem Air Base, and four other bases. Illegal US occupation outposts in Syria and their unwelcome presence in Iraq exist solely to “contain” Iran.

    Who pays for these bases? Not Israel. Which country’s troops are in danger in Syria, Iraq, Qatar, Kuwait, Saudi Arabia, and UAE? Not Israel. Who benefits? Certainly not the US.

    Political and military factors that may influence Trump

    Iran’s recent demonstrations of military capability complicate any plans for military action. During Operations True Promise I and II, its ballistic missile program has proven capable of penetrating Israeli defenses, and its advanced air defense systems thwarted an October 2024 Israeli attack.

    While propaganda might suggest otherwise – that Israel “derided Iran’s missiles as ‘crude’ despite the fact that the projectiles penetrated Israel’s air defense en masse and struck sensitive targets” – Iran’s ability to mount a devastating response to aggression remains clear.

    DiMino was criticized for saying that Iran’s attack was “fairly moderate,” but former intelligence analyst Lee Slusher, concurs:

    “[T]hat Iran did not execute a wide-ranging, catastrophic assault was wrongly interpreted as a lack of ability instead of as a sign of restraint. Iran responded to Israel’s provocations by messaging that it did not want a wider war and, critically, by previewing some of its high-end offensive capabilities.”

    Simultaneously, Israel’s global reputation has suffered as Americans – both liberal and conservative – grow weary of US involvement in West Asia.

    Making America trustworthy again

    Public sentiment against foreign entanglements extends to the financial and military support for Ukraine and Israel, which many Americans view as burdens on US resources. Trump’s base, in particular, has little patience for the “forever wars” in the region.

    If Trump is serious about negotiating with Iran, he must first rebuild trust through unilateral concessions. For Tehran, this could include rolling back sanctions or reconnecting to global financial systems. Without such gestures, skepticism will persist on both sides.

    Ultimately, Trump may find that engaging in diplomacy, rather than another war, is the only viable path forward. Whether his actions will reflect this realization remains to be seen.

    If Trump listens to Americans and receives sound advice on Iran’s missile capabilities and air defenses, he will find it expedient to negotiate and avoid a war that the US will eventually lose in a long and costly conflict.

    https://thecradle.co/articles/is-trump-really-ready-to-negotiate-with-iran
    Is Trump really ready to negotiate with Iran? Trump’s exploratory outreach to Iran, presented as a clean slate, stands in stark contrast to the turbulence of his hawkish first term. Is this a sincere effort at diplomacy or a calculated salvo to throw his opponents off guard? Shivan Mahendrarajah In a surprising reversal, US President Donald Trump, who previously ordered the assassination of Iranian General Qassem Soleimani and unilaterally withdrew the US from the Joint Comprehensive Plan of Action (JCPOA), has signaled a willingness to reengage with Iran. His actions during his first term significantly destabilized West Asia, maximized tensions between Washington and Tehran – further entrenching a legacy of mistrust – ignited proxy conflicts, and complicated US relations with its allies. Yet, despite these past moves – or perhaps because of them –Trump now appears intent on resetting relations with Iran, signaling a fresh start with no threats or preconditions. This, together with his dismissal of US Special Envoy for Iran Brian Hook, an enforcer of “maximum pressure” sanctions, terminations of security clearances for anti-Iran policymakers who led him astray in his first term, and his appointment of Michael DiMino, a realist on Iran policy, are positive signs. Interpreting the signals Deciphering Trump’s latest overtures is no easy task, given his volatile nature, the conflicting array of signals coming from Washington, and the political storm surrounding his actions. The Tehran Times classifies the conflicting forces into two camps: “War Hawks” and “America First.” Trying to interpret Trump’s intent feels as uncertain as scapulimancy – reading omens in animal bones – amid the noise of his presidency. Some suspect the signals about negotiations, reported by an Israeli newspaper, may serve strategic goals far removed from diplomacy. For instance, they may be a stalling tactic for Israeli Prime Minister Benjamin Netanyahu’s government to negotiate prisoner releases or for an exhausted occupation army to regroup before any action against Iranian nuclear facilities. For all we know, Trump’s administration may plan to use the delay to cement critical appointments or prepare the US military to back Israeli operations. The US president’s many marital infidelities, bankruptcies, breaches of business agreements, and unilateral withdrawal from the JCPOA in 2018, make him, ipso facto, a faithless man and dubious negotiating partner. For Tehran to consider engagement, Trump must offer a genuine gesture of good faith, such as lifting sanctions on Iranian oil or reconnecting Iranian banks to SWIFT. While codifying sanctions relief through Congress would be ideal, it is highly unlikely. The Islamic Republic’s view Meanwhile, the administration of Iranian President Masoud Pezeshkian has made no secret of its openness to negotiations, with Reformist factions actively advocating for dialogue. Former foreign minister and current Vice-President for Strategic Affairs, Mohammad Javad Zarif, a favorite in Washington, recently appealed to Trump to restart nuclear talks. However, this eagerness only undermines Tehran’s bargaining position, as Trump’s predatory instincts are quick to exploit desperation. The Reformist approach in 2015, which handed former US president Barack Obama and Netanyahu extensive leverage without securing adequate benefits, serves as a bitter reminder of the risks. The firing of Brian Hook, too, is open to interpretation – as are the punitive measures against hawks John Bolton, Mike Pompeo, and 50 former senior intelligence and military officials, which can be explained away by the political adage, “reward your friends, punish your enemies.” Trump’s appointment of Michael DiMino as Deputy Assistant Secretary of Defense for Middle East caused excitement in America First circles, and hysteria in Israel First circles. DiMino has expressed rational views vis-à-vis West Asia. One of his main “heresies” is that the region does “not really” matter for US interests. Does the ‘Middle East’ matter? Even a cursory examination of DiMino’s observation reveals its truth. North America (US and Canada) has abundant oil and gas reserves for domestic consumption. The US does not need to import one drop of crude oil or one cubic millimeter of natural gas – if “green energy” and “climate change” restrictions are eliminated – hence, Trump’s pledge to “drill, baby, drill,” and abandon the Paris climate accords. The US is a net exporter of oil and gas. To illustrate, in the aftermath of the Biden Administration’s act of state terrorism against the Russian Federation on 26 September 2022, via the sabotage of the Nord Stream gas pipelines, the US began supplying the EU with liquefied natural gas (LNG,) accounting for 50 percent of Europe’s 2023 imports. West Asian oil and gas are not imperatives for North America. US military bases in West Asia exist principally to protect Israel. Bases in Incirlik and Izmir in Turkiye reflect NATO commitments. Qatar’s Al-Udayd base expanded in 2001; Al-Dhafra, UAE, was developed in 2002; the seaport in Bahrain in 2003, the air base in 2009; and Prince Sultan Air Base and smaller bases in Saudi Arabia were expanded. This expansion was for the “Global War on Terror” (GWOT) and to “contain” Iran. However, despite the end of GWOT in 2021, the bases still thrive. Kuwait lost about ten bases from its Iraq War peak, but around 14,000 US personnel remain at Camp Arifjan, Ali al-Salem Air Base, and four other bases. Illegal US occupation outposts in Syria and their unwelcome presence in Iraq exist solely to “contain” Iran. Who pays for these bases? Not Israel. Which country’s troops are in danger in Syria, Iraq, Qatar, Kuwait, Saudi Arabia, and UAE? Not Israel. Who benefits? Certainly not the US. Political and military factors that may influence Trump Iran’s recent demonstrations of military capability complicate any plans for military action. During Operations True Promise I and II, its ballistic missile program has proven capable of penetrating Israeli defenses, and its advanced air defense systems thwarted an October 2024 Israeli attack. While propaganda might suggest otherwise – that Israel “derided Iran’s missiles as ‘crude’ despite the fact that the projectiles penetrated Israel’s air defense en masse and struck sensitive targets” – Iran’s ability to mount a devastating response to aggression remains clear. DiMino was criticized for saying that Iran’s attack was “fairly moderate,” but former intelligence analyst Lee Slusher, concurs: “[T]hat Iran did not execute a wide-ranging, catastrophic assault was wrongly interpreted as a lack of ability instead of as a sign of restraint. Iran responded to Israel’s provocations by messaging that it did not want a wider war and, critically, by previewing some of its high-end offensive capabilities.” Simultaneously, Israel’s global reputation has suffered as Americans – both liberal and conservative – grow weary of US involvement in West Asia. Making America trustworthy again Public sentiment against foreign entanglements extends to the financial and military support for Ukraine and Israel, which many Americans view as burdens on US resources. Trump’s base, in particular, has little patience for the “forever wars” in the region. If Trump is serious about negotiating with Iran, he must first rebuild trust through unilateral concessions. For Tehran, this could include rolling back sanctions or reconnecting to global financial systems. Without such gestures, skepticism will persist on both sides. Ultimately, Trump may find that engaging in diplomacy, rather than another war, is the only viable path forward. Whether his actions will reflect this realization remains to be seen. If Trump listens to Americans and receives sound advice on Iran’s missile capabilities and air defenses, he will find it expedient to negotiate and avoid a war that the US will eventually lose in a long and costly conflict. https://thecradle.co/articles/is-trump-really-ready-to-negotiate-with-iran
    THECRADLE.CO
    Is Trump really ready to negotiate with Iran?
    Trump’s exploratory outreach to Iran, presented as a clean slate, stands in stark contrast to the turbulence of his hawkish first term. Is this a sincere effort at diplomacy or a calculated salvo to throw his opponents off guard?
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  • Vitalflow is an all-new dietary supplement that seeks to help optimise the functional capacity of one's prostate gland, thus allowing users to obtain immediate relief from a whole host of urinary problems.

    VitalFlow is a characteristic enhancement for men that helps support prostate wellbeing. It is a day by day supplement that professes to furnish help to individuals battling with prostate augmentation. It is a quick and productive enhancement that decreases your prostate size to return to ordinary. This item offers enormous advantages as it looks to assist you with your BHP confusions by bringing down DHT levels in your body.

    This is a free audit of the Vital Flow regular enhancement. We will examine all the pertinent data about the item to help you settle on an educated choice about the item.

    Vitalflow is an all-new dietary supplement that seeks to help optimize the functional capacity of one’s prostate gland, thus allowing users to obtain immediate relief from a whole host of urinary problems. In terms of its composition, the manufacturer claims that each serving of this product comes replete with a special blend of ingredients that may help support healthy prostate function.

    Frequent bladder issues are quite common amongst older men, especially those who have crossed the age of 55. In this regard, studies have shown that incontinence, a condition where individuals have to go to the washroom at regular intervals, is becoming increasingly more prevalent amongst men these days (especially those living in developed nations). From a more technical standpoint, it should be noted that such problems usually arise as a direct result of poor prostate functioning.

    As per a research article published a couple of years back, it is estimated that every 1 man in 8 will be diagnosed with prostate cancer during his lifetime. Not only that, the condition is more likely to be witnessed in older men as well as in non-Hispanic Black men. Similar studies have also been released by other prominent health agencies including the WHO, Mayo clinic, etc

    VitalFlow supplements are known for their strong job in prostate augmentation in more established men. Here you will go through the essential stream survey to appropriately comprehend every little thing about it.

    A great deal of enhancements in the drug business guarantee to lessen irritation and tension on the prostate. These items need ordinary utilize so they give a legitimate benefit to the assistance of cancer prevention agents and supplements. Notwithstanding, numerous individuals grumble that the outcomes don't show up even after long haul use. Likewise, there are symptoms of utilizing the greater part of the items that are offered to determine prostate issues. This implies that we need an enhancement that just does not effectively settle prostate growth issues, yet in addition forestall incidental effects. VitalFlow for the prostate is one such enhancement that is known for its astounding outcomes and practically insignificant incidental effects.

    What is VitalFlow?

    VitalFlow is a characteristic enhancement that supports better prostate wellbeing. It is a dietary enhancement ok for customary utilization planned with natural and regular fixings. It diminishes the size of an extended prostate soothing you from its side effects. The prostate part is a fundamental piece of a man's body; it is liable for sustenance and semen insurance.

    The VitalFlow targets prostate amplification main driver, diminishing DHT levels present in the body. A great many men experience the ill effects of BPH entanglements consistently, and this enhancement will assist you with removing this issue from its very root without dreading any unfriendly incidental effects. VitalFlow professes to decrease all indications related with prostate expansion such that meds can't.

    The high level recipe of VitalFlow is made of 34 fixings, all extricated from the compelling force of nature. The makers of the enhancement have done broad examination on each fixing prior to adding it to the recipe. Every fixing has a pivotal task to carry out in assisting with BPH and the issues identified with it. Each fixing is included to the right extent to guarantee adequacy.

    What are the indications of Bad Prostate Health?

    A broadened prostate can prompt different issues, the most well-known being the wild inclination to pee. Here are a couple of manifestations of a broadened prostate.

    Successive Urination:

    In the event that you foster the inclination to pee much of the time, it very well may be a difficult situation. This may prompt the relentless and wild desire to visit the bathroom; it can influence your life differently.

    Difficult Discharge:

    Difficult sexual release are an early indication of awful prostate wellbeing. In case you're unexpectedly feeling a vibe of agony while delivering, there are chances that it very well may be an indication of Bad Prostate Health.

    Consuming Sensation While Urinating:

    On the off chance that you experience a consuming sensation while peeing, an extended prostate can be a deterrent. It is difficult to go pee through the developed prostate, which prompts a consuming inclination.

    Advantages of VitalFlow Prostate Supplement:

    This enhancement is liberated from incidental effects.

    Uses just the regular and most flawless type of fixings

    It lessens dribbling pee.

    It guarantees solid working prostate organs.

    It guarantees there is no consuming sensation during pee.

    Keeps from getting any type of urinary lot contamination, kidney stones, and kidney disappointments

    Lifts your sexual drive and charisma

    Further develops the bloodstream

    It further develops insusceptibility and guarantees you are liberated from prostate issues.

    The regular fixings support your energy levels and sexual cravings. You at this point don't need to be humiliated by low sexual cravings.

    Works on the nature of rest

    Because of the presence of fundamental nutrients, VitalFlow further develops vision.

    A rich wellspring of Antioxidants

    Lifts your emotional well-being

    How Does VitalFlow Act On The Body?

    In the primary occurrence, the enhancement disposes of dihydrotestosterone (DHT for short) and related specialists which are the fundamental driver of amiable amplification of the prostate, prostate malignant growth, and different states of prostatic organ. Then, at that point, Vital Flow standardizes testicular chemical creation, working on sexual execution and boosting sex drive. At last, the prostate supporting item improves the insusceptibility and anoxygenic movement with the goal that the creature can battle contaminations, irritation, malignancy cell development, etc.

    In the event that you need to find out about VitalFlow BPH, you should initially comprehend the explanations for the issue that causes BPH. The absolute most noticeable reasons incorporate the accompanying:

    Closing Thoughts

    The VitalFlow supplement is specifically designed for men struggling with Prostate enlargement. This supplement was formulated with 34 natural ingredients sourced from the best vendors and extracted in the purest form. Each ingredient is bottled together after running a lab test to ensure potency and quality checks.


    =>Check More details On The Official Website! : https://tinyurl.com/ybafhsmn

    #saveyourprostate #prostatehealth #dietarysupplement #prostateaugmentation #prostategland







    Vitalflow is an all-new dietary supplement that seeks to help optimise the functional capacity of one's prostate gland, thus allowing users to obtain immediate relief from a whole host of urinary problems. VitalFlow is a characteristic enhancement for men that helps support prostate wellbeing. It is a day by day supplement that professes to furnish help to individuals battling with prostate augmentation. It is a quick and productive enhancement that decreases your prostate size to return to ordinary. This item offers enormous advantages as it looks to assist you with your BHP confusions by bringing down DHT levels in your body. This is a free audit of the Vital Flow regular enhancement. We will examine all the pertinent data about the item to help you settle on an educated choice about the item. Vitalflow is an all-new dietary supplement that seeks to help optimize the functional capacity of one’s prostate gland, thus allowing users to obtain immediate relief from a whole host of urinary problems. In terms of its composition, the manufacturer claims that each serving of this product comes replete with a special blend of ingredients that may help support healthy prostate function. Frequent bladder issues are quite common amongst older men, especially those who have crossed the age of 55. In this regard, studies have shown that incontinence, a condition where individuals have to go to the washroom at regular intervals, is becoming increasingly more prevalent amongst men these days (especially those living in developed nations). From a more technical standpoint, it should be noted that such problems usually arise as a direct result of poor prostate functioning. As per a research article published a couple of years back, it is estimated that every 1 man in 8 will be diagnosed with prostate cancer during his lifetime. Not only that, the condition is more likely to be witnessed in older men as well as in non-Hispanic Black men. Similar studies have also been released by other prominent health agencies including the WHO, Mayo clinic, etc VitalFlow supplements are known for their strong job in prostate augmentation in more established men. Here you will go through the essential stream survey to appropriately comprehend every little thing about it. A great deal of enhancements in the drug business guarantee to lessen irritation and tension on the prostate. These items need ordinary utilize so they give a legitimate benefit to the assistance of cancer prevention agents and supplements. Notwithstanding, numerous individuals grumble that the outcomes don't show up even after long haul use. Likewise, there are symptoms of utilizing the greater part of the items that are offered to determine prostate issues. This implies that we need an enhancement that just does not effectively settle prostate growth issues, yet in addition forestall incidental effects. VitalFlow for the prostate is one such enhancement that is known for its astounding outcomes and practically insignificant incidental effects. What is VitalFlow? VitalFlow is a characteristic enhancement that supports better prostate wellbeing. It is a dietary enhancement ok for customary utilization planned with natural and regular fixings. It diminishes the size of an extended prostate soothing you from its side effects. The prostate part is a fundamental piece of a man's body; it is liable for sustenance and semen insurance. The VitalFlow targets prostate amplification main driver, diminishing DHT levels present in the body. A great many men experience the ill effects of BPH entanglements consistently, and this enhancement will assist you with removing this issue from its very root without dreading any unfriendly incidental effects. VitalFlow professes to decrease all indications related with prostate expansion such that meds can't. The high level recipe of VitalFlow is made of 34 fixings, all extricated from the compelling force of nature. The makers of the enhancement have done broad examination on each fixing prior to adding it to the recipe. Every fixing has a pivotal task to carry out in assisting with BPH and the issues identified with it. Each fixing is included to the right extent to guarantee adequacy. What are the indications of Bad Prostate Health? A broadened prostate can prompt different issues, the most well-known being the wild inclination to pee. Here are a couple of manifestations of a broadened prostate. Successive Urination: In the event that you foster the inclination to pee much of the time, it very well may be a difficult situation. This may prompt the relentless and wild desire to visit the bathroom; it can influence your life differently. Difficult Discharge: Difficult sexual release are an early indication of awful prostate wellbeing. In case you're unexpectedly feeling a vibe of agony while delivering, there are chances that it very well may be an indication of Bad Prostate Health. Consuming Sensation While Urinating: On the off chance that you experience a consuming sensation while peeing, an extended prostate can be a deterrent. It is difficult to go pee through the developed prostate, which prompts a consuming inclination. Advantages of VitalFlow Prostate Supplement: This enhancement is liberated from incidental effects. Uses just the regular and most flawless type of fixings It lessens dribbling pee. It guarantees solid working prostate organs. It guarantees there is no consuming sensation during pee. Keeps from getting any type of urinary lot contamination, kidney stones, and kidney disappointments Lifts your sexual drive and charisma Further develops the bloodstream It further develops insusceptibility and guarantees you are liberated from prostate issues. The regular fixings support your energy levels and sexual cravings. You at this point don't need to be humiliated by low sexual cravings. Works on the nature of rest Because of the presence of fundamental nutrients, VitalFlow further develops vision. A rich wellspring of Antioxidants Lifts your emotional well-being How Does VitalFlow Act On The Body? In the primary occurrence, the enhancement disposes of dihydrotestosterone (DHT for short) and related specialists which are the fundamental driver of amiable amplification of the prostate, prostate malignant growth, and different states of prostatic organ. Then, at that point, Vital Flow standardizes testicular chemical creation, working on sexual execution and boosting sex drive. At last, the prostate supporting item improves the insusceptibility and anoxygenic movement with the goal that the creature can battle contaminations, irritation, malignancy cell development, etc. In the event that you need to find out about VitalFlow BPH, you should initially comprehend the explanations for the issue that causes BPH. The absolute most noticeable reasons incorporate the accompanying: Closing Thoughts The VitalFlow supplement is specifically designed for men struggling with Prostate enlargement. This supplement was formulated with 34 natural ingredients sourced from the best vendors and extracted in the purest form. Each ingredient is bottled together after running a lab test to ensure potency and quality checks. =>Check More details On The Official Website! : https://tinyurl.com/ybafhsmn #saveyourprostate #prostatehealth #dietarysupplement #prostateaugmentation #prostategland
    0 Comments 0 Shares 9006 Views
  • The real reason Israel is assassinating Hamas and Hezbollah leaders, and why it won’t stop the resistance
    Israel’s assassination of Hamas and Hezbollah leaders doesn’t aim to weaken the resistance. Its real motive is to restore the image of military and intelligence superiority in the eyes of the Israeli public.

    Abdaljawad OmarJuly 31, 2024
    Iranian President Masoud Pezeshkian meets with Ismail Haniyeh, the Chairman of the Hamas Political Bureau, who traveled to Iran to participate in the swearing-in ceremony of the 14th term of the presidency, July 30, 2024. (Photo: Iranian Presidency Office/APA Images)
    Iranian President Masoud Pezeshkian meets with Ismail Haniyeh, the Chairman of the Hamas Political Bureau, who traveled to Iran to participate in the swearing-in ceremony of the 14th term of the presidency, July 30, 2024. (Photo: Iranian Presidency Office/APA Images)
    On the night of July 30, Israel escalated its military operations, targeting its adversaries across multiple fronts, including Lebanon, Iran, and Palestine. The Israeli government claimed a significant success with the assassination of a Hezbollah commander in the densely populated neighborhood of southern Beirut. Simultaneously, Israel launched a bold strike in the heart of Tehran, killing Ismail Haniyeh, the current politburo chief of Hamas.

    After ten months of slowly but steadily losing the escalation dominance it had maintained for decades, Israel is now attempting to reclaim the initiative and reestablish the upper hand by targeting both Beirut and Tehran in under 24 hours.

    Israel’s actions are not merely about projecting strength; they are also designed to increase pressure on the axis of resistance. The strategic objective here is to fracture the unity of this coalition by leveraging its military capabilities to flirt with the prospect of an all-out war — an outcome that neither Israel nor Hezbollah, and by extension Iran, truly desire. This calculated brinkmanship aims to unsettle the adversaries, forcing them to reconsider their unified stance and possibly leading to concessions in Israel’s favor.

    Israel is banking on the notion that fear of further escalation will push Hezbollah and Iran to exert pressure on Hamas to meet some of Israel’s demands during ceasefire negotiations. Additionally, Israel anticipates that any real escalation — particularly one provoked by its targeted actions — would compel the United States and its allies to offer military and diplomatic support. While Washington may not actively seek a major conflict, Israel is confident that the U.S. will not hesitate to come to its aid if the situation escalates. In other words, Israel is pursuing a policy of entanglement and in doing so is taking calculated risks, knowing that if things go awry, the American military will rush to its defense in another war in the Middle East.

    For some time now, Israel has been gauging the reactions of its adversaries, particularly noting the subdued Palestinian response to its proclamations that it had successfully assassinated Hamas’s military commander in Gaza, Muhammad al-Deif. This observation has led Israeli strategic planners to conclude that while a diplomatic deal remains a priority, such targeted assassinations are unlikely to derail these efforts.

    Additionally, Israel’s calculations suggest that although Hezbollah and Iran might view incursions into Beirut or Tehran as significant escalations requiring a response, both actors are likely to avoid triggering an all-out conflict that could lead to open warfare. This belief underscores Israel’s confidence in its ability to carry out targeted actions without provoking a broader regional conflict.

    These maneuvers would likely have taken place regardless of the incident in Majdal Shams. The current operations and series of escalations are occurring at a moment when Israel stands to benefit strategically, even if it ultimately signs an agreement. By accumulating tactical successes, Israel aims to reassert its escalation dominance in its ongoing conflicts with adversaries. This approach reflects a calculated effort to strengthen its negotiating position while ensuring it maintains a decisive upper hand in any potential confrontation. It also seeks to showcase its resilience and will to fight even though the war has dragged on for months on end, with signs of fractures within Israeli society and the loss of trust in the military. This has most recently culminated in mutinous and insurrectionary riots outside the notorious prison of Sde Teiman protesting the detainment of nine Israeli soldiers accused of gang-raping a Palestinian prisoner.

    Israel’s history and policy of assassinating Palestinian leaders

    The notion of assassination is deeply embedded in the history of the Arab region, with the term itself originating from the region. During the 11th to 13th centuries, amid the turmoil of the Crusades, the Nizari Ismailis — commonly known as the “Hashashin” — employed assassination as a strategic tool to eliminate leaders who opposed their cause. Yet, the significance of assassination in the region extends far beyond mere etymology. This region, long subjected to colonial encroachment and artificially induced disunity, has become a theater where the conventional rules of war can be suspended. In this context, political actors who do not align with Western hegemonic interests are often rendered exceptions, making their leaders legitimate targets in ways that violate rules and norms upheld elsewhere.

    Israel has refined the practice of targeted assassinations, often coupled with the arrest of key leaders, to eliminate influential political and military figures. This strategy is not merely about neutralizing immediate threats; it is also about shaping the composition and character of the resistance it faces in the region.
    In the past century, Israel has refined the practice of targeted assassinations, often coupled with the arrest of key leaders, to eliminate influential political and military figures. This strategy is not merely about neutralizing immediate threats; it is also about shaping the composition and character of the resistance it faces in the region. Through these lethal interventions, Israel seeks to cultivate a leadership class within Palestine and the broader Arab world that aligns more closely U.S. and Israeli interests, thereby manipulating the dynamics of resistance against its policies of land appropriation, ethnic cleansing, and colonization.

    These tactics have proven effective in removing key Palestinian leaders at critical junctures of the struggle. For instance, during the pre-Oslo years, the assassinations of pivotal figures such as Yasser Arafat’s second and third in command — Abu Iyad (Salah Khalaf) and Abu Jihad (Khalil al-Wazir) — cleared the way for the emergence of a more pliant leadership, which now has been ultimately epitomized by Mahmoud Abbas.

    During the Second Intifada, Israel arrested popualr Fatah leader Marwan Barghouti and PFLP General Secretary Ahmad Saadat. It also possibly poisoned Yasser Arafat, and it assassinated the PFLP’s military commander, Abu Ali Mustafa, along with key figures within Hamas such as Abdul Aziz Rantisi and Hamas’s founder, Ahmad Yassin, ensuring that no real opposition to the entrenchment of Palestine’s own comprador class could gain dominance in Palestinian politics. Through such operations, Israel sought to remold the consciousness of the very leadership class that opposed it. After all, if Palestinians, Arabs, or their leaders give up on the cause, then there would be no cause to speak of. New leaders would not only fear for their lives but would also be more amenable to Israeli goals and objectives.

    This policy has served Israel well in the past but has also created unintended consequences.
    This policy has served Israel well in the past but has also created unintended consequences. Today, Palestinian disunity is not within a specific coalition or political group; it is disunity marked by a pragmatic comprador class ruling the West Bank, while more homogenous resistance groups operate from places like Gaza. While the PLO once incorporated various currents, like the stance of Mahmoud Abbas, into its organizational fabric, the current disposition of resistance groups contains fewer disagreements about its strategies vis-à-vis Israel. What differences do exist among the resistance are largely tactical or tied to choices of alliance systems. In other words, assassinating Ismail Haniyeh does not automatically lead to more compliant leadership emerging in his place, because the movement from which Haniyeh descends remains united around the framework of resistance.

    Moreover, Israel’s rejectionism and refusal to accommodate figures like Mahmoud Abbas, or to grant Palestinians even a bantustan state, have shaped Palestinian consciousness in a way that reinforces the belief that only resistance can bring about strategic shifts. This attitude has been bolstered by the fact that negotiations are futile with an Israeli society that is both arrogant and supremacist, epitomized recently by the riots in the Sde Teiman protests for the right to rape Palestinian prisoners.

    The declining efficacy of Israeli assassinations

    Israel’s fear of peace, coupled with its insistence on maintaining dominance through force and the ironic presence of figures like Mahmoud Abbas, who, by enabling Israel’s colonization in the West Bank without resistance, have led Palestinians and Palestinian resistance groups to dismiss any serious approach towards negotiated solutions. These dynamics have deepened the conviction that meaningful change cannot be achieved through dialogue with a state that continues to prioritize force and hegemony over genuine peace efforts.

    Moreover, Palestinians have both reframed their resistance and institutionalized its organizational structures. The character of these organizations has evolved, becoming less dependent on a cult of personality or deep emotional ties with individual leaders, and more focused on organizational roles and operational efficacy. Gone are the days when resistance groups would collapse into disarray following the loss of a key figure.

    Today, Palestinian and Lebanese resistance movements have adapted to the reality that the assassination of a prominent leader may cause a tactical setback, but it does not lead to the disintegration of their operations. In fact, in many instances, these groups have demonstrated resilience, using such incidents as a catalyst for the further consolidation and strengthening of their organizational frameworks. This shift reflects a maturing of the resistance movements, where the focus is on sustainability and continuity rather than on the influence of individual leaders or specific clientelist networks bent on building influence within a specific political formation.

    So, beyond the immediate tactical impact, what do these assassinations achieve? In some cases, they can backfire, as seen with the assassination of Hezbollah leader Abbas Musawi, which paved the way for the rise of Hasan Nasrallah. In other instances, these actions may even facilitate the emergence of more innovative and adaptable commanders who can take on key positions. By removing one leader, Israel may inadvertently create space for another often more formidable leader to emerge. One only needs to look at the development of both Hamas and Hezbollah in the wake of various assassinations at various historical stages to realize that these operations lost much of their power.

    These assassinations reinforce the bond between political-military organizations and the broader society within which they are enmeshed. . . Instead of weakening their opponents, such tactics can unintentionally solidify unity and resolve.
    These assassinations reinforce the bond between political-military organizations and the broader society within which they are enmeshed, making it much harder for any real schism to develop. Instead of weakening their opponents, such tactics can unintentionally solidify unity and resolve, bridging the gap between militant factions and the larger population. The killing of Hamas leaders such as Ismail Haniyeh, who left Gaza, loosens internal dissent.

    The real reason for Israel’s current policy of assassinations serves more as a mechanism to galvanize its own society rather than genuinely altering the political or military stance of its adversaries. The efficacy of such tactics in destabilizing Israel’s enemies has severely diminished, revealing a shift in the purpose of these operations. Instead of crippling opposition forces, these targeted killings now function primarily as a tool for internal cohesion, rallying Israeli national sentiment, and showing Israel’s intelligence and operational capabilities. It also permits Israel to claim that it gained the upper hand in the moves to dominate the escalation ladder with its adversaries.

    The real reason for Israel’s current policy of assassinations serves more as a mechanism to galvanize its own society rather than genuinely altering the political or military stance of its adversaries.
    Ultimately, these acts are displays of tactical prowess designed to enshrine the supremacy of Israeli power, largely aimed at impressing Israelis themselves at a time when Israelis feel that their army and intelligence apparatus failed them. When Israel talks about a “loss of deterrence,” it is not so much concerned with how its enemies perceive it but rather with how it perceives itself. The rhetoric of deterrence is less about external threats and more about maintaining an internal narrative of strength and invincibility, ensuring that the image of Israeli power remains intact in the collective psyche of its own society.


    https://mondoweiss.net/2024/07/the-real-reason-israel-is-assassinating-hamas-and-hezbollah-leaders-and-why-it-wont-stop-the-resistance/
    The real reason Israel is assassinating Hamas and Hezbollah leaders, and why it won’t stop the resistance Israel’s assassination of Hamas and Hezbollah leaders doesn’t aim to weaken the resistance. Its real motive is to restore the image of military and intelligence superiority in the eyes of the Israeli public. Abdaljawad OmarJuly 31, 2024 Iranian President Masoud Pezeshkian meets with Ismail Haniyeh, the Chairman of the Hamas Political Bureau, who traveled to Iran to participate in the swearing-in ceremony of the 14th term of the presidency, July 30, 2024. (Photo: Iranian Presidency Office/APA Images) Iranian President Masoud Pezeshkian meets with Ismail Haniyeh, the Chairman of the Hamas Political Bureau, who traveled to Iran to participate in the swearing-in ceremony of the 14th term of the presidency, July 30, 2024. (Photo: Iranian Presidency Office/APA Images) On the night of July 30, Israel escalated its military operations, targeting its adversaries across multiple fronts, including Lebanon, Iran, and Palestine. The Israeli government claimed a significant success with the assassination of a Hezbollah commander in the densely populated neighborhood of southern Beirut. Simultaneously, Israel launched a bold strike in the heart of Tehran, killing Ismail Haniyeh, the current politburo chief of Hamas. After ten months of slowly but steadily losing the escalation dominance it had maintained for decades, Israel is now attempting to reclaim the initiative and reestablish the upper hand by targeting both Beirut and Tehran in under 24 hours. Israel’s actions are not merely about projecting strength; they are also designed to increase pressure on the axis of resistance. The strategic objective here is to fracture the unity of this coalition by leveraging its military capabilities to flirt with the prospect of an all-out war — an outcome that neither Israel nor Hezbollah, and by extension Iran, truly desire. This calculated brinkmanship aims to unsettle the adversaries, forcing them to reconsider their unified stance and possibly leading to concessions in Israel’s favor. Israel is banking on the notion that fear of further escalation will push Hezbollah and Iran to exert pressure on Hamas to meet some of Israel’s demands during ceasefire negotiations. Additionally, Israel anticipates that any real escalation — particularly one provoked by its targeted actions — would compel the United States and its allies to offer military and diplomatic support. While Washington may not actively seek a major conflict, Israel is confident that the U.S. will not hesitate to come to its aid if the situation escalates. In other words, Israel is pursuing a policy of entanglement and in doing so is taking calculated risks, knowing that if things go awry, the American military will rush to its defense in another war in the Middle East. For some time now, Israel has been gauging the reactions of its adversaries, particularly noting the subdued Palestinian response to its proclamations that it had successfully assassinated Hamas’s military commander in Gaza, Muhammad al-Deif. This observation has led Israeli strategic planners to conclude that while a diplomatic deal remains a priority, such targeted assassinations are unlikely to derail these efforts. Additionally, Israel’s calculations suggest that although Hezbollah and Iran might view incursions into Beirut or Tehran as significant escalations requiring a response, both actors are likely to avoid triggering an all-out conflict that could lead to open warfare. This belief underscores Israel’s confidence in its ability to carry out targeted actions without provoking a broader regional conflict. These maneuvers would likely have taken place regardless of the incident in Majdal Shams. The current operations and series of escalations are occurring at a moment when Israel stands to benefit strategically, even if it ultimately signs an agreement. By accumulating tactical successes, Israel aims to reassert its escalation dominance in its ongoing conflicts with adversaries. This approach reflects a calculated effort to strengthen its negotiating position while ensuring it maintains a decisive upper hand in any potential confrontation. It also seeks to showcase its resilience and will to fight even though the war has dragged on for months on end, with signs of fractures within Israeli society and the loss of trust in the military. This has most recently culminated in mutinous and insurrectionary riots outside the notorious prison of Sde Teiman protesting the detainment of nine Israeli soldiers accused of gang-raping a Palestinian prisoner. Israel’s history and policy of assassinating Palestinian leaders The notion of assassination is deeply embedded in the history of the Arab region, with the term itself originating from the region. During the 11th to 13th centuries, amid the turmoil of the Crusades, the Nizari Ismailis — commonly known as the “Hashashin” — employed assassination as a strategic tool to eliminate leaders who opposed their cause. Yet, the significance of assassination in the region extends far beyond mere etymology. This region, long subjected to colonial encroachment and artificially induced disunity, has become a theater where the conventional rules of war can be suspended. In this context, political actors who do not align with Western hegemonic interests are often rendered exceptions, making their leaders legitimate targets in ways that violate rules and norms upheld elsewhere. Israel has refined the practice of targeted assassinations, often coupled with the arrest of key leaders, to eliminate influential political and military figures. This strategy is not merely about neutralizing immediate threats; it is also about shaping the composition and character of the resistance it faces in the region. In the past century, Israel has refined the practice of targeted assassinations, often coupled with the arrest of key leaders, to eliminate influential political and military figures. This strategy is not merely about neutralizing immediate threats; it is also about shaping the composition and character of the resistance it faces in the region. Through these lethal interventions, Israel seeks to cultivate a leadership class within Palestine and the broader Arab world that aligns more closely U.S. and Israeli interests, thereby manipulating the dynamics of resistance against its policies of land appropriation, ethnic cleansing, and colonization. These tactics have proven effective in removing key Palestinian leaders at critical junctures of the struggle. For instance, during the pre-Oslo years, the assassinations of pivotal figures such as Yasser Arafat’s second and third in command — Abu Iyad (Salah Khalaf) and Abu Jihad (Khalil al-Wazir) — cleared the way for the emergence of a more pliant leadership, which now has been ultimately epitomized by Mahmoud Abbas. During the Second Intifada, Israel arrested popualr Fatah leader Marwan Barghouti and PFLP General Secretary Ahmad Saadat. It also possibly poisoned Yasser Arafat, and it assassinated the PFLP’s military commander, Abu Ali Mustafa, along with key figures within Hamas such as Abdul Aziz Rantisi and Hamas’s founder, Ahmad Yassin, ensuring that no real opposition to the entrenchment of Palestine’s own comprador class could gain dominance in Palestinian politics. Through such operations, Israel sought to remold the consciousness of the very leadership class that opposed it. After all, if Palestinians, Arabs, or their leaders give up on the cause, then there would be no cause to speak of. New leaders would not only fear for their lives but would also be more amenable to Israeli goals and objectives. This policy has served Israel well in the past but has also created unintended consequences. This policy has served Israel well in the past but has also created unintended consequences. Today, Palestinian disunity is not within a specific coalition or political group; it is disunity marked by a pragmatic comprador class ruling the West Bank, while more homogenous resistance groups operate from places like Gaza. While the PLO once incorporated various currents, like the stance of Mahmoud Abbas, into its organizational fabric, the current disposition of resistance groups contains fewer disagreements about its strategies vis-à-vis Israel. What differences do exist among the resistance are largely tactical or tied to choices of alliance systems. In other words, assassinating Ismail Haniyeh does not automatically lead to more compliant leadership emerging in his place, because the movement from which Haniyeh descends remains united around the framework of resistance. Moreover, Israel’s rejectionism and refusal to accommodate figures like Mahmoud Abbas, or to grant Palestinians even a bantustan state, have shaped Palestinian consciousness in a way that reinforces the belief that only resistance can bring about strategic shifts. This attitude has been bolstered by the fact that negotiations are futile with an Israeli society that is both arrogant and supremacist, epitomized recently by the riots in the Sde Teiman protests for the right to rape Palestinian prisoners. The declining efficacy of Israeli assassinations Israel’s fear of peace, coupled with its insistence on maintaining dominance through force and the ironic presence of figures like Mahmoud Abbas, who, by enabling Israel’s colonization in the West Bank without resistance, have led Palestinians and Palestinian resistance groups to dismiss any serious approach towards negotiated solutions. These dynamics have deepened the conviction that meaningful change cannot be achieved through dialogue with a state that continues to prioritize force and hegemony over genuine peace efforts. Moreover, Palestinians have both reframed their resistance and institutionalized its organizational structures. The character of these organizations has evolved, becoming less dependent on a cult of personality or deep emotional ties with individual leaders, and more focused on organizational roles and operational efficacy. Gone are the days when resistance groups would collapse into disarray following the loss of a key figure. Today, Palestinian and Lebanese resistance movements have adapted to the reality that the assassination of a prominent leader may cause a tactical setback, but it does not lead to the disintegration of their operations. In fact, in many instances, these groups have demonstrated resilience, using such incidents as a catalyst for the further consolidation and strengthening of their organizational frameworks. This shift reflects a maturing of the resistance movements, where the focus is on sustainability and continuity rather than on the influence of individual leaders or specific clientelist networks bent on building influence within a specific political formation. So, beyond the immediate tactical impact, what do these assassinations achieve? In some cases, they can backfire, as seen with the assassination of Hezbollah leader Abbas Musawi, which paved the way for the rise of Hasan Nasrallah. In other instances, these actions may even facilitate the emergence of more innovative and adaptable commanders who can take on key positions. By removing one leader, Israel may inadvertently create space for another often more formidable leader to emerge. One only needs to look at the development of both Hamas and Hezbollah in the wake of various assassinations at various historical stages to realize that these operations lost much of their power. These assassinations reinforce the bond between political-military organizations and the broader society within which they are enmeshed. . . Instead of weakening their opponents, such tactics can unintentionally solidify unity and resolve. These assassinations reinforce the bond between political-military organizations and the broader society within which they are enmeshed, making it much harder for any real schism to develop. Instead of weakening their opponents, such tactics can unintentionally solidify unity and resolve, bridging the gap between militant factions and the larger population. The killing of Hamas leaders such as Ismail Haniyeh, who left Gaza, loosens internal dissent. The real reason for Israel’s current policy of assassinations serves more as a mechanism to galvanize its own society rather than genuinely altering the political or military stance of its adversaries. The efficacy of such tactics in destabilizing Israel’s enemies has severely diminished, revealing a shift in the purpose of these operations. Instead of crippling opposition forces, these targeted killings now function primarily as a tool for internal cohesion, rallying Israeli national sentiment, and showing Israel’s intelligence and operational capabilities. It also permits Israel to claim that it gained the upper hand in the moves to dominate the escalation ladder with its adversaries. The real reason for Israel’s current policy of assassinations serves more as a mechanism to galvanize its own society rather than genuinely altering the political or military stance of its adversaries. Ultimately, these acts are displays of tactical prowess designed to enshrine the supremacy of Israeli power, largely aimed at impressing Israelis themselves at a time when Israelis feel that their army and intelligence apparatus failed them. When Israel talks about a “loss of deterrence,” it is not so much concerned with how its enemies perceive it but rather with how it perceives itself. The rhetoric of deterrence is less about external threats and more about maintaining an internal narrative of strength and invincibility, ensuring that the image of Israeli power remains intact in the collective psyche of its own society. https://mondoweiss.net/2024/07/the-real-reason-israel-is-assassinating-hamas-and-hezbollah-leaders-and-why-it-wont-stop-the-resistance/
    MONDOWEISS.NET
    The real reason Israel is assassinating Hamas and Hezbollah leaders, and why it won’t stop the resistance
    Israel’s assassination of Hamas and Hezbollah leaders doesn’t aim to weaken the resistance. Its real motive is to restore the image of military and intelligence superiority in the eyes of the Israeli public.
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  • Comirnaty, liability, and how the HHS Conspiracy lies, cheats and steals from the public to hide vaccine injuries and useful treatments
    Dear readers, this is a "mistake" substack. My real site is merylnass.substack.com. Nothing more will be added to this site. Please subscribe at the other site.

    Meryl Nass
    If you receive or use a product that is under an Emergency Use Authorization (EUA), and are injured, you cannot sue the manufacturer, whose liability has been waived by the government. The only possible way to obtain benefits is to apply to the Countermeasures Injury Compensation Program (CICP). This waiver, and the CICP program apply to all EUA products: vaccines, drugs, masks, ventilators, COVID tests, monoclonal antibodies.

    When a vaccine is fully licensed, if it has not been placed on the childhood vaccine schedule, you can sue the manufacturer for an injury. A minority of vaccines fall into this category, such as typhoid and cholera vaccines.

    There is a second US government program that waives manufacturer liability for those vaccines that have been placed on the childhood schedule. It is called the Vaccine Injury Compensation Program (VICP), and it was established in 1986. All vaccines that CDC recommends for children or pregnant women (and the vast majority of vaccines administered in the US) fall into this category. Both the CICP and VICP programs are administered under the Health Resources and Services Agency (HRSA), a subagency of HHS.

    On August 23, 2021, FDA gave Comirnaty a license for people aged 16 and up. And on August 30, 2021, the CDC Advisory Committee on Immunization Practices voted unanimously to put Comirnaty on the childhood schedule, and the CDC Director, Rochelle Walensky, concurred. The USG was able to do this because the vaccine had been licensed for 16-17 year olds, who are still children.

    But before Comirnaty can enter the VICP program and gain its liability shield, there must be a 75 cent excise tax imposed on each dose. This money is what supports the VICP awards for injuries. There must also be a notice in the Federal Register. Perhaps surprisingly, neither an excise tax nor a Federal Register notice has been issued for Comirnaty.

    I confirmed this by checking whether Cominarty had been formally added to the childhood schedule, and according to the HRSA, which manages both compensation programs, it has not.

    So, if you actually received the licensed Comirnaty vaccine, correctly labeled as the brand-name product, and not the EUA Pfizer-BioNTech vaccine being fobbed off as licensed product, and you were injured, you would be free to sue the manufacturer for your injury.

    But it seems there is no licensed Comirnaty vaccine anywhere to be found in the US. Pfizer wrote, "Pfizer does not plan to produce any product with these new [Comirnaty National Drug Codes] and labels over the next few months while EUA authorized product is still available and being made available for U.S. distribution."

    So, if there is no licensed product being administered, and the EUA vaccine is shielded from liability under the CICP, there is no need to finish moving the product into the VICP, yet. The CICP offers stronger liability protection than does the VICP, and its maximum benefit, about $375,000, is a small fraction of the maximal VICP payout. Furthermore, moving the vaccine into the VICP when there isn't any vaccine to be found might create legal risks for the FDA and HHS.

    FDA issued a license for Comirnaty in order to enable vaccine mandates, which are illegal for EUA products, since EUA products are by legal definition experimental. (I have cited the EUA laws in earlier blog posts.) Yet FDA knew no licensed vaccine would be offered. This was a crime, a "bait and switch" on the American public. I wrote extensively about it the week of August 23, and in an article in The Defender coauthored with Robert F. Kennedy, Jr. on August 24.

    If you received the Pfizer-BioNTech vaccine under Emergency Use Authorization, or received the Moderna (whose branded product, “Spikevax” was licensed on Jan. 31, 2022 but is also unavailable ) or J and J vaccine, you can't sue anyone. You have the right to beg HRSA for compensation for lost wages and unpaid medical bills, period. So far, HRSA and the Countermeasures Injury Compensation Program it administers have not paid out one dime for the approximately one million injuries and 20,000 deaths reported to VAERS for any COVID vaccine, nor a cent for any unreported injuries. In fact, they have not paid out a plug nickel for any injuries due to monoclonal antibodies, remdesivir, other COVID drugs, ventilators, tests, masks etc. that are all being used (a.k.a. shielded) for COVID under the EUA program.

    Look at the Countermeasures Injury Compensation Program list of all the payments the CICP has made since it was founded. They have paid out a total of 29 claims since 2010. Over 6,000 (almost all related to COVID products) remain to be adjudicated. Note that the word "alleged" is used for both the countermeasure and the injury for which HRSA provided compensation. Even after HRSA provided benefits, HRSA has not admitted that an injury occurred nor that a countermeasure had caused it.

    Table 2. CICP Claims Compensated (Fiscal Years 2010 – 2022) As of November 1, 2021

    “This table displays the alleged countermeasure, alleged injury and amount of compensation paid for each compensated CICP claim filed between Fiscal Years 2010 through 2022.”

    Total amount paid to all CICP claimants since 2010: $6,076,087.47

    DHHS-HRSA have not admitted that a single injury was caused by a COVID vaccine, or for that matter by any COVID product used under an emergency use authorization.

    Similarly, CDC says it has not linked a single death to a COVID vaccine--not even when a recipient walked into the vaccination center but got carried out to the morgue.

    HRSA, FDA, CDC and NIH are all agencies within the federal Department of Health and Human Services. They have all gotten their stories straight. They know nothing and they are just following orders. This article will provide you with examples of how each of these 4 so-called public health agencies helped hide the truth, instead spreading identical false narratives. It made no difference which party was in power. Heil HHS!

    These agencies can't find a doggone problem in the 20 or so databases they are spending many $millions of your money to "study."

    Want to know the biggest conspiracy in the US right now? It is the HHS.

    FDA and CDC each have their own large sets of databases, about a dozen apiece, most of which they pay industry to access. They share management of the VAERS database, by statute. Why don't they share their other databases, since the taxpayer has already paid for them? One reason is that this gives them a reason to spend more loot, and to point fingers at each other when things aren't going well.

    FDA has access to a bunch of electronic databases it has termed the "BEST" Initiative, and it published a plan to use them to study heart attacks, pulmonary embolism, thrombocytopenia, etc. after COVID vaccinations back in July. Where are the results, FDA? What are you waiting for? (According to CDC, "More than 459 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through November 29, 2021."). It seems clear that we aren't going to be informed of FDA's findings until everyone possible has been vaccinated, at which point the results will be irrelevant.

    In October 2020, FDA's head of epidemiology and biostatistics, Steve Anderson, told us there were even more databases that would be studied. Here is what he promised would be studied:


    And here is a more recent FDA list of the databases FDA claims it is using to assess COVID vaccine safety, in addition to VAERS, which FDA and CDC jointly share:


    There was another system FDA promised to use to evaluate vaccine safety: PRISM. But we have heard nothing from PRISM regarding COVID vaccines, or anything else, lately. PRISM has disappeared.


    The Center for Biologics' Office of Biostatistics and Epidemiology currently has 11 fulltime staff and 4 vacancies. Did the honest analysts leave? The other eleven seem to be sitting on their hands. Myocarditis is the most obvious COVID vaccine-associated severe adverse event. It usually happens within 4 days of the second shot. It is most common in young males. It has been reported many thousands of times to VAERS. Understanding it ought to be a slam dunk.

    On August 23, 2021, FDA had the temerity to write to BioNTech that its [FDA's] capabilities were inadequate to assess myocarditis, so BioNTech would have to do it for them. Here is what FDA wrote about its inability to use VAERS and its many other databases to assess the myocarditis risk:

    As noted above, the FDA acknowledges that “We have determined that an analysis of spontaneous post-marketing adverse events reported under section 505(k)(1) of the FDCA [in other words, analyzing VAERS--Nass] will not be sufficient to assess known serious risks of myocarditis and pericarditis and identify an unexpected serious risk of subclinical myocarditis.

    Furthermore, the pharmacovigilance system that FDA is required to maintain under section 505(k)(3) of the FDCA [in other words, FDA's many other databases that cost the taxpayer $zillions are also inadequate--Nass] is not sufficient to assess these serious risks.”

    NOT SUFFICIENT???? Is this a joke? All this data, plus software, plus a team of analysts, and FDA says it can't assess the risk of myocarditis, despite identifying thousands of cases?

    Unsaid, but implied, is that if FDA is incapable of understanding thousands of reported cases of myocarditis, it cannot or will not study the other serious adverse events that have been reported in conjunction with COVID vaccines.

    VAERS has operated for 30 years, collecting reports of vaccine adverse events. It averaged under 100 cases of myocarditis reported yearly until this year. Through November, CDC reports it received 1949 reports of myocarditis and pericarditis, just in those under 30. CDC didn't say what the total number of reports for all ages was.

    Somehow, FDA and CDC don't seem at all perturbed that the acknowledged reporting rate of myocarditis is over 20 times the average during the past 30 years. Why not?

    CDC has been even more shady in its analyses of safety as FDA, if that is even possible. Below, Nancy Messonier, then head of Immunizations and Respiratory Diseases at CDC, presented this list of databases that CDC would be using in the evaluation of COVID vaccine safety, on December 10, 2020. Apart from the V-safe database (which they stopped talking about last January, after it revealed that 1-3% of vaccine recipients required a doctor visit to deal with side effects), the Vaccine Safety Datalink (VSD) (which somehow can't find any problems, not even myocarditis) and the VAERS database, all the other databases CDC promised to study have been MIA.


    NIH, whose job has never been to issue treatment guidelines, but instead to perform and fund research, suddenly took over the treatment guidelines for COVID early in 2020. It formed a committee of internal and eternal "experts" to make up the guidelines. How were they chosen? That is not clear, but what is clear is that 16 of these so-called experts had current or recent financial entanglements with Gilead, the maker of remdesivir. NIH and the US Army also owned pieces of remdesivir. A number of the experts had financial dealings with Merck. While NIH is the single biggest funder of medical research in the world, I cannot recall seeing a single study it funded on the safety of COVID vaccines. Yet somehow vaccines are its number one recommendation.

    It is not clear whether the NIH's guidelines committee is functional. The NIH has been sued to learn whether a vote was even taken by the committee regarding its ivermectin guidelines, which fly in the face of the evidence on ivermectin. And no one has answered the big question: how was NIH somehow authorized to issue treatment guidelines in the first place?

    Here is what has obviously occurred. All these agencies were told they had to keep quiet on vaccine problems (and perhaps problems of other COVID treatments), and they had to fiddle with their data or their analytic methods, or both, to get the required results. And there was to be NO BAD NEWS, no matter what. And no good news regarding generic treatments.

    As we have seen, the so-called scientists and physicians working as bureaucrats in these agencies all caved, sucked it up, did the dirty work, kept their jobs, and betrayed their oaths and the trust of the people of the USA and the world.

    Here is one example of their gross perfidy:
    Rochelle Walensky, MD, MPH

    @CDCDirector

    #COVID19 vaccines are safe for children 5-11. They have undergone the most comprehensive & intense safety monitoring system in U.S. history. To date, no serious safety concerns have been identified. Vaccination is the best way to protect children from COVID-19. Dec. 10

    Yet here is what her own agency found 6 months ago:


    And in Hong Kong, health authorities found one case of myocarditis in every 2700 boys aged 12-17 after their second shot. Apparently CDC Director Walensky thinks that is safe. Is she really a doctor?

    It is important to call out the criminals. I hope everyone knows HHS gave the CDC Director's husband's company a $5 million dollar contract in taxpayer money, with options for $12 million more, presumably if she behaves herself... at our expense.


    https://meryl.substack.com/p/how-4-hhs-agencies-conspire-to-lie


    https://donshafi911sars-cov-2.blogspot.com/2024/07/comirnaty-liability-and-how-hhs.html
    Comirnaty, liability, and how the HHS Conspiracy lies, cheats and steals from the public to hide vaccine injuries and useful treatments Dear readers, this is a "mistake" substack. My real site is merylnass.substack.com. Nothing more will be added to this site. Please subscribe at the other site. Meryl Nass If you receive or use a product that is under an Emergency Use Authorization (EUA), and are injured, you cannot sue the manufacturer, whose liability has been waived by the government. The only possible way to obtain benefits is to apply to the Countermeasures Injury Compensation Program (CICP). This waiver, and the CICP program apply to all EUA products: vaccines, drugs, masks, ventilators, COVID tests, monoclonal antibodies. When a vaccine is fully licensed, if it has not been placed on the childhood vaccine schedule, you can sue the manufacturer for an injury. A minority of vaccines fall into this category, such as typhoid and cholera vaccines. There is a second US government program that waives manufacturer liability for those vaccines that have been placed on the childhood schedule. It is called the Vaccine Injury Compensation Program (VICP), and it was established in 1986. All vaccines that CDC recommends for children or pregnant women (and the vast majority of vaccines administered in the US) fall into this category. Both the CICP and VICP programs are administered under the Health Resources and Services Agency (HRSA), a subagency of HHS. On August 23, 2021, FDA gave Comirnaty a license for people aged 16 and up. And on August 30, 2021, the CDC Advisory Committee on Immunization Practices voted unanimously to put Comirnaty on the childhood schedule, and the CDC Director, Rochelle Walensky, concurred. The USG was able to do this because the vaccine had been licensed for 16-17 year olds, who are still children. But before Comirnaty can enter the VICP program and gain its liability shield, there must be a 75 cent excise tax imposed on each dose. This money is what supports the VICP awards for injuries. There must also be a notice in the Federal Register. Perhaps surprisingly, neither an excise tax nor a Federal Register notice has been issued for Comirnaty. I confirmed this by checking whether Cominarty had been formally added to the childhood schedule, and according to the HRSA, which manages both compensation programs, it has not. So, if you actually received the licensed Comirnaty vaccine, correctly labeled as the brand-name product, and not the EUA Pfizer-BioNTech vaccine being fobbed off as licensed product, and you were injured, you would be free to sue the manufacturer for your injury. But it seems there is no licensed Comirnaty vaccine anywhere to be found in the US. Pfizer wrote, "Pfizer does not plan to produce any product with these new [Comirnaty National Drug Codes] and labels over the next few months while EUA authorized product is still available and being made available for U.S. distribution." So, if there is no licensed product being administered, and the EUA vaccine is shielded from liability under the CICP, there is no need to finish moving the product into the VICP, yet. The CICP offers stronger liability protection than does the VICP, and its maximum benefit, about $375,000, is a small fraction of the maximal VICP payout. Furthermore, moving the vaccine into the VICP when there isn't any vaccine to be found might create legal risks for the FDA and HHS. FDA issued a license for Comirnaty in order to enable vaccine mandates, which are illegal for EUA products, since EUA products are by legal definition experimental. (I have cited the EUA laws in earlier blog posts.) Yet FDA knew no licensed vaccine would be offered. This was a crime, a "bait and switch" on the American public. I wrote extensively about it the week of August 23, and in an article in The Defender coauthored with Robert F. Kennedy, Jr. on August 24. If you received the Pfizer-BioNTech vaccine under Emergency Use Authorization, or received the Moderna (whose branded product, “Spikevax” was licensed on Jan. 31, 2022 but is also unavailable ) or J and J vaccine, you can't sue anyone. You have the right to beg HRSA for compensation for lost wages and unpaid medical bills, period. So far, HRSA and the Countermeasures Injury Compensation Program it administers have not paid out one dime for the approximately one million injuries and 20,000 deaths reported to VAERS for any COVID vaccine, nor a cent for any unreported injuries. In fact, they have not paid out a plug nickel for any injuries due to monoclonal antibodies, remdesivir, other COVID drugs, ventilators, tests, masks etc. that are all being used (a.k.a. shielded) for COVID under the EUA program. Look at the Countermeasures Injury Compensation Program list of all the payments the CICP has made since it was founded. They have paid out a total of 29 claims since 2010. Over 6,000 (almost all related to COVID products) remain to be adjudicated. Note that the word "alleged" is used for both the countermeasure and the injury for which HRSA provided compensation. Even after HRSA provided benefits, HRSA has not admitted that an injury occurred nor that a countermeasure had caused it. Table 2. CICP Claims Compensated (Fiscal Years 2010 – 2022) As of November 1, 2021 “This table displays the alleged countermeasure, alleged injury and amount of compensation paid for each compensated CICP claim filed between Fiscal Years 2010 through 2022.” Total amount paid to all CICP claimants since 2010: $6,076,087.47 DHHS-HRSA have not admitted that a single injury was caused by a COVID vaccine, or for that matter by any COVID product used under an emergency use authorization. Similarly, CDC says it has not linked a single death to a COVID vaccine--not even when a recipient walked into the vaccination center but got carried out to the morgue. HRSA, FDA, CDC and NIH are all agencies within the federal Department of Health and Human Services. They have all gotten their stories straight. They know nothing and they are just following orders. This article will provide you with examples of how each of these 4 so-called public health agencies helped hide the truth, instead spreading identical false narratives. It made no difference which party was in power. Heil HHS! These agencies can't find a doggone problem in the 20 or so databases they are spending many $millions of your money to "study." Want to know the biggest conspiracy in the US right now? It is the HHS. FDA and CDC each have their own large sets of databases, about a dozen apiece, most of which they pay industry to access. They share management of the VAERS database, by statute. Why don't they share their other databases, since the taxpayer has already paid for them? One reason is that this gives them a reason to spend more loot, and to point fingers at each other when things aren't going well. FDA has access to a bunch of electronic databases it has termed the "BEST" Initiative, and it published a plan to use them to study heart attacks, pulmonary embolism, thrombocytopenia, etc. after COVID vaccinations back in July. Where are the results, FDA? What are you waiting for? (According to CDC, "More than 459 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through November 29, 2021."). It seems clear that we aren't going to be informed of FDA's findings until everyone possible has been vaccinated, at which point the results will be irrelevant. In October 2020, FDA's head of epidemiology and biostatistics, Steve Anderson, told us there were even more databases that would be studied. Here is what he promised would be studied: And here is a more recent FDA list of the databases FDA claims it is using to assess COVID vaccine safety, in addition to VAERS, which FDA and CDC jointly share: There was another system FDA promised to use to evaluate vaccine safety: PRISM. But we have heard nothing from PRISM regarding COVID vaccines, or anything else, lately. PRISM has disappeared. The Center for Biologics' Office of Biostatistics and Epidemiology currently has 11 fulltime staff and 4 vacancies. Did the honest analysts leave? The other eleven seem to be sitting on their hands. Myocarditis is the most obvious COVID vaccine-associated severe adverse event. It usually happens within 4 days of the second shot. It is most common in young males. It has been reported many thousands of times to VAERS. Understanding it ought to be a slam dunk. On August 23, 2021, FDA had the temerity to write to BioNTech that its [FDA's] capabilities were inadequate to assess myocarditis, so BioNTech would have to do it for them. Here is what FDA wrote about its inability to use VAERS and its many other databases to assess the myocarditis risk: As noted above, the FDA acknowledges that “We have determined that an analysis of spontaneous post-marketing adverse events reported under section 505(k)(1) of the FDCA [in other words, analyzing VAERS--Nass] will not be sufficient to assess known serious risks of myocarditis and pericarditis and identify an unexpected serious risk of subclinical myocarditis. Furthermore, the pharmacovigilance system that FDA is required to maintain under section 505(k)(3) of the FDCA [in other words, FDA's many other databases that cost the taxpayer $zillions are also inadequate--Nass] is not sufficient to assess these serious risks.” NOT SUFFICIENT???? Is this a joke? All this data, plus software, plus a team of analysts, and FDA says it can't assess the risk of myocarditis, despite identifying thousands of cases? Unsaid, but implied, is that if FDA is incapable of understanding thousands of reported cases of myocarditis, it cannot or will not study the other serious adverse events that have been reported in conjunction with COVID vaccines. VAERS has operated for 30 years, collecting reports of vaccine adverse events. It averaged under 100 cases of myocarditis reported yearly until this year. Through November, CDC reports it received 1949 reports of myocarditis and pericarditis, just in those under 30. CDC didn't say what the total number of reports for all ages was. Somehow, FDA and CDC don't seem at all perturbed that the acknowledged reporting rate of myocarditis is over 20 times the average during the past 30 years. Why not? CDC has been even more shady in its analyses of safety as FDA, if that is even possible. Below, Nancy Messonier, then head of Immunizations and Respiratory Diseases at CDC, presented this list of databases that CDC would be using in the evaluation of COVID vaccine safety, on December 10, 2020. Apart from the V-safe database (which they stopped talking about last January, after it revealed that 1-3% of vaccine recipients required a doctor visit to deal with side effects), the Vaccine Safety Datalink (VSD) (which somehow can't find any problems, not even myocarditis) and the VAERS database, all the other databases CDC promised to study have been MIA. NIH, whose job has never been to issue treatment guidelines, but instead to perform and fund research, suddenly took over the treatment guidelines for COVID early in 2020. It formed a committee of internal and eternal "experts" to make up the guidelines. How were they chosen? That is not clear, but what is clear is that 16 of these so-called experts had current or recent financial entanglements with Gilead, the maker of remdesivir. NIH and the US Army also owned pieces of remdesivir. A number of the experts had financial dealings with Merck. While NIH is the single biggest funder of medical research in the world, I cannot recall seeing a single study it funded on the safety of COVID vaccines. Yet somehow vaccines are its number one recommendation. It is not clear whether the NIH's guidelines committee is functional. The NIH has been sued to learn whether a vote was even taken by the committee regarding its ivermectin guidelines, which fly in the face of the evidence on ivermectin. And no one has answered the big question: how was NIH somehow authorized to issue treatment guidelines in the first place? Here is what has obviously occurred. All these agencies were told they had to keep quiet on vaccine problems (and perhaps problems of other COVID treatments), and they had to fiddle with their data or their analytic methods, or both, to get the required results. And there was to be NO BAD NEWS, no matter what. And no good news regarding generic treatments. As we have seen, the so-called scientists and physicians working as bureaucrats in these agencies all caved, sucked it up, did the dirty work, kept their jobs, and betrayed their oaths and the trust of the people of the USA and the world. Here is one example of their gross perfidy: Rochelle Walensky, MD, MPH @CDCDirector #COVID19 vaccines are safe for children 5-11. They have undergone the most comprehensive & intense safety monitoring system in U.S. history. To date, no serious safety concerns have been identified. Vaccination is the best way to protect children from COVID-19. Dec. 10 Yet here is what her own agency found 6 months ago: And in Hong Kong, health authorities found one case of myocarditis in every 2700 boys aged 12-17 after their second shot. Apparently CDC Director Walensky thinks that is safe. Is she really a doctor? It is important to call out the criminals. I hope everyone knows HHS gave the CDC Director's husband's company a $5 million dollar contract in taxpayer money, with options for $12 million more, presumably if she behaves herself... at our expense. https://meryl.substack.com/p/how-4-hhs-agencies-conspire-to-lie https://donshafi911sars-cov-2.blogspot.com/2024/07/comirnaty-liability-and-how-hhs.html
    MERYL.SUBSTACK.COM
    Comirnaty, liability, and how the HHS Conspiracy lies, cheats and steals from the public to hide vaccine injuries and useful treatments
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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. 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    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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