U.S. pledges extra $320 million for bird flu fight

By Alastair Sharp

SHARM EL SHEIKH, Egypt (Reuters) - The United States pledged an additional $320 million to the global fight against bird flu and warned on Saturday against complacency in combating the virus, which could mutate and cause a deadly pandemic.

The figure brings to $949 million Washington's total pledges to fight avian influenza, which has killed 245 people in Asia, Africa, and Europe since late 2003. Countless birds have been culled.

"The United States is pledging an additional $320 million in international assistance for avian and pandemic influenza," said Paula Dobriansky, Under Secretary of State for Democracy and Global Affairs.

At the opening of a ministerial conference in Egypt, Dobriansky echoed comments from Egyptian ministers and heads of international organizations in warning of "flu fatigue."

"(There is) a growing feeling that the threat of an influenza pandemic has somehow diminished and that scarce resources could be better used elsewhere in the field of public health, in other words flu fatigue," she said.

Official pledges will be made at the end of the conference on Sunday, but the European Commission has indicated it will not promise additional money, saying half of the funds already allocated had not yet been spent.

"We are going to be at this for another year or two with the current commitments that we have," said James Moran, the head of Commission's external relations unit.

Moran said some 140 million euros ($176.2 million) would be available for research into bird flu and other infectious diseases in 2009.

"This is quite a substantial amount of funding but we can't say right now what proportion of it will be spent outside of the EU," he said.

Next year the conference will be held in Vietnam.

European Union member states and the European Commission have previously given a total of 413 million euros toward global efforts to combat avian influenza.

Of the additional U.S. funds, $94 million will go to international organizations for capacity building and pandemic preparation, while $86 million is allocated for bilateral programs, $57 million is for research and $83 million will go into a contingency fund.

The World Bank estimates that a global pandemic resulting from the mutation of bird flu could cost $3 trillion and result in a nearly 5 percent drop in world gross domestic product.

It has said that more than 70 million people could die worldwide in a severe pandemic.

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I See the Failure of the Health-Care System Every Day

By Dena Rifkin, MD

For the past three weeks, each issue of The New England Journal of Medicine has featured viewpoints on the pressing health-care policy issues facing the next administration. These topics (in case you haven’t heard) include health insurance and rising health-care costs, and how to balance them economically, ethically, and politically.

I see the insanity of the current “system” pretty much every day.

For instance: the patient crippled by diabetes at age 60, unable to hold a job, and therefore out of luck when it comes to health insurance—too young for Medicare, slightly too wealthy for Medicaid. The older man with lengthy illnesses who’s “used up” his eligibility for rehabilitation and is forced to pay out of pocket. The transplant patient trying to figure out how to pay for the medications that keep the transplant working. Medicare would pay tens of thousands of dollars for dialysis, should her kidney fail—but it won’t cough up the hundreds of dollars to cover medications that will prevent that from happening in the first place.

These people face unfathomable financial stress in the midst of significant illness.

I’ve asked patients to come to the emergency room because of disturbing symptoms or lab-test results, only to have them tell me that they fear a denial letter and the ensuing insurance fight, should the ER evaluation reveal that nothing is wrong.

I also see patients like those highlighted in this week’s New York Times health section—people deciding not to take some or all of their medications because of the cost. Sure, some of those people will do OK. There are well-documented problems with polypharmacy (when too many medications actually create health problems), particularly in older adults. And not every person at risk for a disease (heart disease and stroke, for instance) will actually get it without being treated.

But many who skimp on their meds to save money will pay the price later, when uncontrolled high blood pressure leads to a stroke, or undertreated diabetes leads to vision loss or heart disease.

It used to be said disparagingly of Britain’s national health system that it ought to be called the “national sickness system.” Well, that’s what we’ve got here in the United States: a sick system. Without extending coverage beyond the employed, the impoverished, and those at the extremes of age, there will be no cure. Massachusetts has made a tremendous step in this direction. The rest of the nation should watch and learn.

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Wanna get your hands on an all-electric Mini?

500 to be leased next year, but only in 3 states and at $850 a month

Each Mini E will have a large electric plug logo on the roof and its serial number showing on the side front panel.

BMW is jumping into — OK it's actually more like testing — the market for all-electric vehicles with its Mini brand, announcing a pilot project to lease 500 completely electric Minis in California, New Jersey and New York.

"By introducing the Mini E, the BMW Group is underscoring the resolve with which it works towards reducing energy consumption and emissions in road traffic," the company said in a statement ahead of the car's debut at the Los Angeles Auto Show on Nov. 19-20.

The specs aren't bad: a lithium-ion battery range of 150 miles, a top speed of 95 mph and 0-60 mph in 8.5 seconds.

But there are some downsides. The car will initially be available only as a two-seater because the battery takes up the space that had been a back seat.

And then there's the lease itself: $850 a month. That does include all technical maintenance and the cars themselves will be quite the fashion statement — each decked out with a huge yellow electric plug logo on the roof and a serial number on their front fenders.

Of course, the cost of charging the Mini E will be minimal — pennies per gallon.

The vehicles can be recharged overnight at any standard power outlet. BMW will also install a high-speed "wallbox" charger at a customer's garage that can recharge the battery pack in just 2.5 hours.

BMW also touted the Mini E's ability to decelerate with less braking and while charging the battery.

"As soon as the driver releases the gas pedal, the electric motor acts as a generator," it stated. "This results in braking force, and the power recovered from the kinetic energy is fed back to the battery ... In city traffic, some 75 percent of all deceleration can be done without the brakes. Making substantial use of this energy recuperation feature extends the car's range by up to 20 percent."

BMW didn't promise to mass produce the Mini E specifically but did state that it "aims to start series production of all-electric vehicles over the medium term."

Other major carmakers are also moving towards all-electric vehicles or plug-in hybrids, and several startups, especially California-based Tesla, are trying to carve niches.

BMW, for its part, urged potential Mini E customers to be part of its "pioneering mission."

"Customers will join forces with BMW Group experts to assist in the project's scientific evaluation," the company stated. Aiming to monitor driver behavior and car performance, "Mini E engineers accord high importance to staying in touch with the drivers on a regular basis."

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