$500 Million Pledged to Fight Childhood Obesity

The Robert Wood Johnson Foundation plans to spend more than $500 million over the next five years to reverse the increase in childhood obesity. It is one of the largest public health initiatives ever tried by a private philanthropy.
“This is an epidemic that is going to cost the country in terms of morbidity and mortality and economically,” said Dr. Risa Lavizzo-Mourey, the foundation’s president and chief executive. “The younger generation is going to live sicker and die younger than their parents because of obesity.”
The foundation estimates that roughly 25 million children 17 and under are obese or overweight, nearly a third of the 74 million in that age group, according to Census Bureau data and a 2006 study published in The Journal of the American Medical Association.
Many of those children are poor and live in neighborhoods where outdoor play is unsafe and access to fresh fruits and vegetables is limited. “In many cases, the environment makes it almost impossible for them to choose healthy lifestyles,” Dr. Lavizzo-Mourey said. “We’re going to try to change that.”
The foundation plans to invest in programs to improve access to healthy food, encourage the development of safe play spaces, increase research to enhance understanding of obesity and prod governments into adopting policies to address the problem, among other things.
Philanthropy has long fueled improvements in health, from John D. Rockefeller, whose money produced a yellow fever vaccine, to Bill and Melinda Gates, who are underwriting new health technologies and vaccines to address a variety of global problems. (lack of gov. fund)
Several states have mandated changes in school menus, increased physical education requirements and begun reporting students’ body mass index scores to parents.

Shackles on the AIDS Program

An expert committee has found that the Bush administration’s ambitious program to combat AIDS abroad is off to a good start but warns that restrictions imposed by Congress or by the administration are hampering efforts to slow the spread of the epidemic. These inflexible barriers are often imposed for ideological, not health reasons.
The midcourse evaluation of the President’s Emergency Plan for AIDS Relief, or Pepfar, was delivered to Congress last week by a panel of experts assembled by the Institute of Medicine, a unit of the National Academy of Sciences. The program assists more than 120 countries in all, but concentrates its resources in 15 countries, mostly in Africa.
Programs to prevent the spread of H.I.V., the virus that causes AIDS, are perhaps the most important tool in that long-term fight. Yet Congress specified that only 20 percent of the money could be spent on prevention, and one-third of that had to be used to promote abstinence until marriage. More money has been spent in that area than on other prevention activities, including distribution of condoms and blocking mother-to-child transmission.
Another restriction that existed even before the creation of Pepfar (President's Emergency Plan For AIDS Relief) forbids the use of taxpayer money to give clean needles to injecting addicts, while a third requires that all antiretroviral medications be approved by the FDA, even those already approved by the WHO.
These restrictions needlessly hamper a program with great potential. Congress should eliminate them and let health professionals devise the most effective strategies.

Taking Aim at All Those Plastic Bags

By a 10-1 Board of Supervisors’ vote, San Francisco became the first major American city to ban the use of non-biodegradable plastic bags by supermarkets, drug stores and other large retailers.
The paper-or-plastic question has long been a vexing one. Paper bags, of course, are biodegradable and recyclable, and are made from trees, a renewable resource. But the production of paper bags generates significantly more air and water pollution; manufacturing and recycling them requires more energy than their plastic cousins do, according to the Environmental Protection Agency.
Paper bags also take up comparatively more space in landfills, where they are slow to degrade, like most everything in a landfill. A study for the American Forest and Paper Association estimated that about seven billion paper bags were used in the United States in 2003.
On the other hand, plastic bags made of polyethylene, which dominate the market, are non-biodegradable and are made from crude oil and natural gas, both nonrenewable resources. They can be recycled, but are mostly discarded.
The E.P.A. estimated that only 5.2 percent of the plastic bags and sacks in the municipal waste stream in 2005 were recycled, compared with 21 percent of paper bags and sacks. And there are also horror stories about animals swallowing them and starving to death.
Plastic bags have virtually taken over the grocery market since they were first put at check-out stands in 1977. Ninety percent of all grocery bags are now plastic, according to the Progressive Bag Alliance, an industry group of plastic bag manufacturers. Estimates of the number of plastic bags used around the world each year vary wildly — from 100 billion to as many as one trillion.
Whatever the number, it’s a lot. And that has made for a lot of plastic bag litter — which, the E.P.A. says, can take 1,000 years to decompose.
One reason for the abundance of plastic bags is economic. A standard plastic grocery bag costs about a penny to produce, according to the plastics industry, compared with 4 cents to 5 cents for a paper bag. Compostable plastic bags would cost from 8 cents to a dime, the industry says, although supporters of the San Francisco action say the cost would drop as more local governments require them.
Because of a tax, Ireland has cut the use of plastic bags by 90 percent, according to the Irish government.
Ikea, the Swedish home furnishings and accessories chain, has just begun charging customers 5 cents per plastic bag in the United States, which it donates to American Forests, a conservation group. On average, its United States stores have gone through about 70 million a year. In Britain, Ikea says, it has seen a 95 percent drop in plastic bag use since it began charging for them there last spring.
Yet another alternative is to sell consumers reusable bags.
“The paper versus plastics question takes us off the issue, which is consumption,” says Vincent Cobb, who offers reusable bags and containers on the Internet. He admits to using plastic bags, which he calls a “fantastic product,” but not as many as in the past.
“Getting into the habit of bringing your own shopping bag,” he says, “can slash this problem across the board.”

Poor Nations to Bear Brunt as World Warms

The world’s richest countries, which have contributed by far the most to the atmospheric changes linked to global warming, are already spending billions of dollars to limit their own risks from its worst consequences, like drought and rising seas.
In its fourth assessment of global warming, the Intergovernmental Panel on Climate Change used its strongest language yet in drawing a link between human activity and recent warming.
Do rich nations have an obligation to help poorer ones prepare for potential changes caused by global warming?
But despite longstanding treaty commitments to help poor countries deal with warming, these industrial powers are spending just tens of millions of dollars on ways to limit climate and coastal hazards in the world’s most vulnerable regions — most of them close to the equator and overwhelmingly poor.
Next Friday, a new report from the Intergovernmental Panel on Climate Change, a United Nations body that since 1990 has been assessing global warming, will underline this growing climate divide, according to scientists involved in writing it — with wealthy nations far from the equator not only experiencing fewer effects but also better able to withstand them.
Two-thirds of the atmospheric buildup of carbon dioxide, a heat-trapping greenhouse gas that can persist in the air for centuries, has come in nearly equal proportions from the United States and Western European countries.
In contrast, Africa accounts for less than 3 percent of the global emissions of carbon dioxide from fuel burning since 1900, yet its 840 million people face some of the biggest risks from drought and disrupted water supplies, according to new scientific assessments.
Scientists say it has become increasingly clear that worldwide precipitation is shifting away from the equator and toward the poles. That will nourish crops in warming regions like Canada and Siberia while parching countries — like Malawi in sub-Saharan Africa — which are already prone to drought.
Many other experts insist this is not an either-or situation. They say that cutting the vulnerability of poor regions needs much more attention, but add that unless emissions are curbed, there will be centuries of warming and rising seas that will threaten ecosystems, water supplies, and resources from the poles to the equator, harming rich and poor.
There are some hints that wealthier countries are beginning to shift their focus toward fostering adaptation to warming outside their own borders. Relief organizations including Oxfam and the International Red Cross, foreseeing a world of worsening climate-driven disasters, are turning some of their attention toward projects like expanding mangrove forests as a buffer against storm surges, planting trees on slopes to prevent landslides, or building shelters on high ground.
Some officials from the United States, Britain and Japan say foreign-aid spending can be directed at easing the risks from climate change.
Industrialized countries bound by the Kyoto Protocol, the climate pact rejected by the Bush administration, project that hundreds of millions of dollars will soon flow via that treaty into a climate adaptation fund.
The lack of climate aid persists even though nearly all the world’s industrialized nations, including the United States under the first President Bush, pledged to help when they signed the first global warming treaty, the Framework Convention on Climate Change, in 1992.
A $3 billion Global Environmental Facility fund maintained by contributions from developed countries has nearly $1 billion set aside for projects in poorer countries that limit emissions of greenhouse gases. But critics say those projects often do not have direct local benefits, and many are happening in the large fast-industrializing developing countries — not the poorest ones.
Technology also aids farmers in the north.
Robert O. Mendelsohn, an economist at Yale focused on climate, said that in the face of warming, it might be necessary to abandon the longstanding notion that all places might someday feed themselves. Poor regions reliant on unpredictable rainfall, he said, should be encouraged to shift people out of farming and into urban areas and import their food from northern countries.
Another option, experts say, is helping poor regions do a better job of forecasting weather. In parts of India, farmers still rely more on astrologers for monsoon predictions than government meteorologists.

Patents Over Patients

WE could make faster progress against cancer by changing the way drugs are developed. In the current system, if a promising compound can’t be patented, it is highly unlikely ever to make it to market — no matter how well it performs in the laboratory. The development of new cancer drugs is crippled as a result.
The reason for this problem is that bringing a new drug to market is extremely expensive. In 2001, the estimated cost was $802 million; today it is approximately $1 billion. To ensure a healthy return on such staggering investments, drug companies seek to formulate new drugs in a way that guarantees watertight patents. In the meantime, cancer patients miss out on treatments that may be highly effective and less expensive to boot.
In 2004, Johns Hopkins researchers discovered that an off-the-shelf compound called 3-bromopyruvate could arrest the growth of liver cancer in rats. The results were dramatic; moreover, the investigators estimated that the cost to treat patients would be around 70 cents per day. Yet, three years later, no major drug company has shown interest in developing this drug for human use.
Early this year, another readily available industrial chemical, dichloroacetate, was found by researchers at the University of Alberta to shrink tumors in laboratory animals by up to 75 percent. However, as a university news release explained, dichloroacetate is not patentable, and the lead researcher is concerned that it may be difficult to find funding from private investors to test the chemical. So the university is soliciting public donations to finance a clinical trial.
Potential anticancer drugs should be judged on their scientific merit, not on their patentability. One solution might be for the government to enlarge the FDA's “orphan drug” program, which subsidizes the development of drugs for rare diseases. The definition of orphan drug could be expanded to include unpatentable agents that are scorned as unprofitable by pharmaceutical companies.

Truth in College Lending

By rights, a student who calls a college financial aid office should reach one of the college’s aid officers. But that is often not the case, as a front-page article by Jonathan Glater of The Times pointed out last week. Many colleges route student calls to representatives of loan companies who pretend to work for the college but who actually have a vested interest in selling the costliest possible loans.
Colleges portray this as a harmless, cost-saving convenience that allows them to serve students without hiring more staff members. But it is part of a troubling — and possibly illegal — process that finds colleges steering students to “preferred lenders” in exchange for kickbacks based on volume.
Some financial aid officers argue that students are getting the best possible loan rates. That seems dubious, given that “preferred lender” agreements uncovered by prosecutors are based on the payments made to the colleges and make no mention of the interest rates the students will be charged. Deceptive packaging is also a problem. Some lenders name their loans after colleges and universities and use college mascots and logos on Internet sites and correspondence.

The Answer Is Inside

The great variety of cancers reflects the fundamental mechanism by which the disease arises: the different combinations of genetic variations that cause normal cells to grow excessively and behave badly. These cancer-causing mutations may be inherited or, more commonly, incurred after birth, and our ability to describe them offers entry to a world in which cancer can be better controlled. We already know a few hundred of the genes that are mutated in various cancers, and we are poised to discover virtually all of them through a new kind of “genome project” that is just beginning.
An obvious application of genetic knowledge about specific cancers is the development of drugs and antibodies that reverse the effects of the mutations in those cancers. Some success in this difficult endeavor has already been achieved — in the clinic, not just the laboratory. But new genetic knowledge can also be used to assess an individual’s inherited risk of developing certain kinds of cancer or to predict the likely behavior of any identified tumor.
Hereditary risks of developing cancer can now be determined by examining about 30 different genes that can cause changes associated with certain cancers. This information can be enormously beneficial by encouraging early screening or preventive surgery. But it can also create anxieties about genetic discrimination, upset families and raise disturbing questions about who should be tested and when. Most of the known mutations are so uncommon in the population and so expensive to find by DNA testing that it is not yet justified to examine people who aren’t from cancer-prone families.
Moreover, depending on the mutant gene, the risks that it will actually cause cancer can vary, from slightly above average to nearly 100 percent. And the absence of an inherited mutation, while reducing risk, does not preclude the cancer. In addition, there are doubtless more inherited variant genes to be discovered, especially variants that confer relatively weak risks of cancer. These features complicate genetic assessment of cancer risk, but I believe that the approach, on balance, can benefit affected individuals and public health.
These predictions will be especially important when tumors are found at very early stages. While not yet perfect, such tests are welcome harbingers of a more rational basis for making crucial decisions about treatment.

Being Nice to the Bacon, Before You Bring It Home

Thus was one meat consumer introduced to the culture of meat producers.
When Burger King announced last week that it would favor producers who treated their animals more humanely it was welcome news to animal welfare advocates. But it also served to remind the rest of us that if we are meat eaters, we are slaughterers, too. At least by proxy.
To farmers and ranchers who raise animals for food, the feeding, housing and killing of livestock is an unbroken continuum that delivers a product to people far removed from its production — city folk who work in advertising, or whatever it is that city people do.
Animals are for petting, not killing. Meat, unrelated, is for eating.
Beginning in the 1990s, animal welfare advocates like People for the Ethical Treatment of Animals (PETA) began virtually force-feeding the consuming public on certain realities of so-called factory farming.
For the sake of production efficiencies and a low-cost food supply, they explained, cows, pigs and poultry are often condemned to sunless, sometimes squalid lives, only to die with needless cruelty. These advocates led protests against the largest hamburger chains, beneficiaries of the factory system.
After initial resistance, in 2001 the chains agreed to some improvements. McDonald’s and Burger King imposed some guidelines for their meat and egg suppliers: extra water, wing-room and fresh air for egg-laying hens; mandatory electric-shock stunning of pigs and cattle before slaughter.
Retailers clearly see advantages in appealing to the demographic of kinder and gentler meat-eaters, according to Ron Paul, president of Technomic, a Chicago-based research and consulting firm for food suppliers. “There is a growing realization that the humane movement is a long-term movement,” he said. “It’s not going to go away.”
It might seem hypocritical to address the quality of life of a creature being raised exclusively to be killed for food. Mr. Waldau, who has degrees in law, religion and philosophy, said that the issue was not meat eating per se, but one’s responsibility for one’s choices as a consumer. Whether to eat the meat of animals treated abysmally during their lifetimes or to buy so-called blood diamonds or clothing made in sweatshops, become parallel questions, he said.

On the Lam by the Thousands, Pursued by the Dozens

THE math isn’t pretty. As of February, there were an estimated 636,000 “fugitive aliens” in the United States — foreigners who have ignored orders to leave the country. They may have entered illegally and been caught (about 60 percent of all fugitives), or they may have visited legally but then overstayed their visas or committed crimes.
Washington (the 27th-largest city) has deputized a force of about 318 officers in the Department of Homeland Security to track and apprehend the fugitives — a backlog of roughly 2,000 fugitives per officer.
Last year, officials ended their practice of “catch and release,” in which only about a third of alleged immigration violators caught were detained, for lack of housing. Most of those released did not show up for court dates and became fugitives. Now, Mr. Torres said, virtually all are detained.

Florida Girls Lift Weights, and Gold Medals

From New York Times

No other state has officially adopted weightlifting for girls, as the Florida High School Athletic Association did in 1997, a sign that the perception endures of weightlifting as a sport for he-men and the occasional bodybuilding queen who slathers her preternaturally bulging biceps with baby oil.

“I find it very surprising,” said Jackie Metcalf, the weightlifting coach at Sarasota High School. “because it’s a great way to get girls involved for gender equity. You don’t have to be a skilled athlete to do this.”

The presence on many teams of cheerleaders — who become better jumpers and fliers after lifting — has helped remove the stigma from the sport, several girls said. Many wear bows in their hair at competitions, and at a recent meet, one wore pearls with her singlet. They share weight rooms with boys who admiringly call them “beast.” T-shirts emblazoned with “Silly Boys, Weights Are For Girls” and the like are de rigueur.

Extracurricular club programs for girls have sprung up around the country since women’s weightlifting became an Olympic sport in 2000. But Florida, with 170 high school teams that have produced two Olympians and several dozen world team members, has “set the gold standard” for the sport, said Rodger DeGarmo, director of high performance and coaching for USA Weightlifting in Colorado Springs, the governing body that oversees Olympic lifting.

“I think it’s awesome for this group of girls because there’s so many times you have to be tall, slender,” said Judy Miller, Jessica’s foster mother. “With this, you can be any size.”

Some chugged bottles of honey before they lifted — the sugar high helps, they said — while others sat silently in a corner of the gym, summoning their strength. They ranged from 93.6 pounds to 379.1, from featherweight cheerleaders to hulking softball players and even girls who never before dabbled in sports.

“It doesn’t matter how much you lift,” said Jessica, a senior at Booker High School in Sarasota, after collecting her gold medal. “It just matters that you’re trying to make yourself better.”

Some coaches have to recruit aggressively to build a team, correcting misperceptions along the way.

“A lot of girls think if you do it you’re going to get all beefy,” said Alexa DeCristofaro, a senior at New Smyrna Beach High School who won first place in the 199-pound weight class. “Well, you really don’t. If you do it, you get toned, which is different from getting totally muscular.”

In the decade since high schools here began offering girls’ weightlifting, certain towns — Port Orange (near Daytona Beach), Port Charlotte (near Sarasota), Fort Walton Beach (near Pensacola) — have become known for their girl weightlifters. Tom Bennett, a coach at Spruce Creek High, said one of his former lifters won a slot at the Olympic Training Center in Colorado Springs and others are bent on joining her.

“The girls are very, very competitive — in some cases more than the boys,” said Mr. Bennett, whose team of 30 girls has won every state weightlifting championship since they began in 2004.

The sport is far more popular in North Florida than in Miami-Dade, Broward and Palm Beach Counties, possibly because South Florida has more wealth and its young athletes gravitate toward “upper class” sports like tennis and golf, Mr. Bennett said. Altha, a speck of a town in the Panhandle, sent six girls to this year’s state finals, while Miami sent none.

Mr. Bennett’s team practices at least 12 hours a week. Like other coaches around the state, he recruits from the school softball, soccer, cheerleading and basketball teams, with the promise that weightlifting will improve athletic performance in general.

“It definitely makes them faster, more explosive, more flexible, stronger,” said Richard Lansky, a member of the board of USA Weightlifting who runs an extracurricular club in Sarasota.