Tuesday, April 10, 2007

Challenge to Emissions Rule Is Set to Start

The fight over cars and carbon dioxide moves today from the Supreme Court to a federal courtroom in Burlington, Vt., in a case that automakers say could reshape vehicles sold on the East and West Coasts.
The industry is suing to block a 2004 California regulation on global warming from taking effect. The rule would require a 30 percent cut in emissions of greenhouse gases from cars and trucks sold in Vermont and New York, which follow California’s air quality rules, to be fully phased in by the 2016 model year.
In court filings, automakers have argued that regulating the emissions will increase pollution, cause more traffic deaths and lead domestic automakers to stop selling most of their passenger models in states that adopt such regulations.
The companies have disputed that global warming is a problem, even though they have acknowledged it in different forums as a serious problem. And they tried, mostly unsuccessfully, to close much of this case to the public.
“This is a huge issue to consumers, because it may well determine what vehicles are available for them to purchase,” said Gloria Bergquist, a spokeswoman for the Alliance of Automobile Manufacturers, which includes General Motors, Toyota and most other large automakers. “If it’s a big issue for consumers, it’s a big issue to us.”
Environmental groups and the offices of the attorneys general in Vermont and New York, which is a party to the case, say the automakers are overstating the complexity and hardship of such a regulation.
“It’s that sky-is-falling approach, but the sky didn’t fall with catalytic converters,” Attorney General William H. Sorrell of Vermont said, referring to the antipollution technology forced on the industry in the 1970s.
Last week, in a 5-to-4 decision in Massachusetts v. Environmental Protection Agency, the Supreme Court ruled that the agency has the authority to regulate heat-trapping gases in automobiles. The Bush administration has long opposed that.
Instead, more than 12 states, including California, Massachusetts, New York and Vermont, have already or are in the process of moving to regulate such emissions.
California has the authority to set air-quality rules, and Northeastern states have long chosen to follow those rules instead of Washington’s. The Supreme Court victory was important for the states, because the approval of the environmental agency is needed before California can regulate emissions involving global warming.
Automakers have sued to block the California regulation in federal courts in California, Rhode Island and Vermont, though just the Vermont case has gone forward. That case is scheduled to enter the trial phase today.
The battle has exposed fault lines among automakers. Two trade groups representing the major manufacturers are involved in the suit, one dominated by domestic producers and one by foreign.
They have clashed in their legal strategies, and just G.M. and DaimlerChrysler, two of the more outspoken companies opposing the new regulation, are directly listed as plaintiffs. The trade groups had initially sued separately but are now plaintiffs in a consolidated suit.
The main legal argument uniting the industry is their contention that states cannot regulate carbon dioxide emissions because that would be little different from regulating fuel economy, and Washington has the sole authority to set mileage standards. The recent Supreme Court ruling, however, appeared to undermine that argument.
The industry estimates that the new regulation would impose a 50 percent increase in fuel economy for passenger cars and small sport-utility vehicles but a more modest increase for large trucks, effectively making it harder for a company like G.M. to bring smaller vehicles like the Chevrolet Malibu into compliance than its Hummers.
An expert hired by automakers said, according to court filings, that DaimlerChrysler, Ford Motor and G.M. “will need largely to exit” from the passenger car and small truck markets.
Environmental groups say the industry is ignoring the potential effects of its move to bolster alternative fuels like ethanol, as well as the advent of hybrid electric technology and other technologies.
Automakers argued in a court filing in January that “defendants make unsubstantiated predictions that global climate change is having a number of alarming adverse effects.”
Michael J. Stanton, the president of the Association of International Automobile Manufacturers, a plaintiff group, said in an interview the position did not represent the views of the mostly Asian automakers who are his constituents, some of whom are trying to create “eco-friendly” reputations.
“We believe that there is enough information out there to address climate change and we know that cars — passenger cars and light trucks — contribute, and we want to be part of the solution,” Mr. Stanton said.
The regulation California adopted in 2004 was to begin taking effect with 2009 models and to be phased in over eight years. President Bush and Congress more recently discussed fuel economy rules that could potentially accomplish similar reductions for gases tied to global warming, though no firm plan is in place.
Among other points, the industry says more fuel efficient cars could be dangerous, because they will be cheaper to drive and lead people to drive more and potentially have more accidents.
“Everybody’s getting a good laugh out of the safety claim,” said David Bookbinder, a lawyer for the Sierra Club, which is a party to the case. “Detroit is saying it’s a bad idea for everybody to drive more.”

Monday, April 09, 2007

A Call for Manners in the World of Nasty Blogs

Is it too late to bring civility to the Web?
The conversational free-for-all on the Internet known as the blogosphere can be a prickly and unpleasant place. Now, a few high-profile figures in high-tech are proposing a blogger code of conduct to clean up the quality of online discourse.
Last week, Tim O’Reilly, a conference promoter and book publisher who is credited with coining the term Web 2.0, began working with Jimmy Wales, creator of the communal online encyclopedia Wikipedia, to create a set of guidelines to shape online discussion and debate.
Chief among the recommendations is that bloggers consider banning anonymous comments left by visitors to their pages and be able to delete threatening or libelous comments without facing cries of censorship.
A recent outbreak of antagonism among several prominent bloggers “gives us an opportunity to change the level of expectations that people have about what’s acceptable online,” said Mr. O’Reilly, who posted the preliminary recommendations last week on his company blog (radar.oreilly.com). Mr. Wales then put the proposed guidelines on his company’s site (blogging.wikia.com), and is now soliciting comments in the hope of creating consensus around what constitutes civil behavior online.
Mr. O’Reilly and Mr. Wales talk about creating several sets of guidelines for conduct and seals of approval represented by logos. For example, anonymous writing might be acceptable in one set; in another, it would be discouraged. Under a third set of guidelines, bloggers would pledge to get a second source for any gossip or breaking news they write about.
Bloggers could then pick a set of principles and post the corresponding badge on their page, to indicate to readers what kind of behavior and dialogue they will engage in and tolerate. The whole system would be voluntary, relying on the community to police itself.
The code of conduct already has some early supporters, including David Weinberger, a well-known blogger (hyperorg.com/blogger) and a fellow at the Berkman Center for Internet and Society at Harvard Law School. “The aim of the code is not to homogenize the Web, but to make clearer the informal rules that are already in place anyway,” he said.

But as with every other electrically charged topic on the Web, finding common ground will be a serious challenge. Some online writers wonder how anyone could persuade even a fraction of the millions of bloggers to embrace one set of standards. Others say that the code smacks of restrictions on free speech.
Mr. Wales and Mr. O’Reilly were inspired to act after a firestorm erupted late last month in the insular community of dedicated technology bloggers. In an online shouting match that was widely reported, Kathy Sierra, a high-tech book author from Boulder County, Colo., and a friend of Mr. O’Reilly, reported getting death threats that stemmed in part from a dispute over whether it was acceptable to delete the impolitic comments left by visitors to someone’s personal Web site.
Menacing behavior is certainly not unique to the Internet. But since the Web offers the option of anonymity with no accountability, online conversations are often more prone to decay into ugliness than those in other media.
Nowadays, those conversations often take place on blogs. At last count, there were 70 million of them, with more than 1.4 million entries being added daily, according to Technorati, a blog-indexing company. For the last decade, these Web journals have offered writers a way to amplify their voices and engage with friends and readers.
But the same factors that make those unfiltered conversations so compelling, and impossible to replicate in the offline world, also allow them to spin out of control.
Women are not the only targets of nastiness. For the last four years, Richard Silverstein has advocated for Israeli-Palestinian peace on a blog (richardsilverstein.com) that he maintains from Seattle.
People who disagree with his politics frequently leave harassing comments on his site. But the situation reached a new low last month, when an anonymous opponent started a blog in Mr. Silverstein’s name that included photos of Mr. Silverstein in a pornographic context.
One public bid to improve the quality of dialogue on the Web came more than a year ago when Mena Trott, a co-founder of the blogging software company Six Apart, proposed elevating civility on the Internet in a speech she gave at a French blog conference. At the event, organizers had placed a large screen on the stage showing instant electronic responses to the speeches from audience members and those who were listening in online.
“Any community that does not make it clear what they are doing, why they are doing it, and who is welcome to join the conversation is at risk of finding it difficult to help guide the conversation later,” said Lisa Stone, who created the guidelines and the BlogHer network in 2006 with Elisa Camahort and Jory Des Jardins.
A subtext of both sets of rules is that bloggers are responsible for everything that appears on their own pages, including comments left by visitors. They say that bloggers should also have the right to delete such comments if they find them profane or abusive.
That may sound obvious, but many Internet veterans believe that blogs are part of a larger public sphere, and that deleting a visitor’s comment amounts to an assault on their right to free speech. It is too early to gauge support for the proposal, but some online commentators are resisting.
Mr. O’Reilly said the guidelines were not about censorship. “That is one of the mistakes a lot of people make — believing that uncensored speech is the most free, when in fact, managed civil dialogue is actually the freer speech,” he said. “Free speech is enhanced by civility.”

Britain’s Military to Permit Former Captives to Sell Stories

Two days after they were paraded as heroes with a story to tell, some of the 15 British sailors and marines captured and released by Iran seemed Sunday to have decided they have a story to sell.
In a highly unusual decision, Britain’s Ministry of Defense — normally tight-lipped, to say the least — acknowledged Saturday that it had agreed to permit them to offer their experiences for sale to newspapers and television stations.

Such transactions are common enough among civilians, some of whom have traded the rights to their stories for considerable sums of money. But the notion of active military service members making a profit from their exploits — particularly when thousands of others serving in Iraq and Afghanistan face daily peril and sometimes death — has reinforced the criticism of the 15 Britons’ seemingly pliant behavior toward the Iranians holding them.
Our armed forces are, I think, the most respected institution in the country pretty much, and they deserve to be after the job they have done in very difficult circumstances in Iraq and in Afghanistan,” William Hague, the opposition Conservative spokesman on foreign affairs, said in a television interview.
But if, whenever people have been in a difficult situation, they are going to be allowed to sell their story quickly after that, then I think we are going to lose steadily that dignity and respect for our armed forces.
Six of the 15 former captives spoke at a news conference on Friday, recounting moments when some of them thought they were about to be executed as they faced psychological pressure to make public “confessions” on state-run Iranian television that they had unlawfully strayed into Iranian territorial waters.
The Ministry of Defense’s decision to allow them to tell the stories of solitary confinement and blindfolding to the public seemed intended to offset criticism in newspapers here that the sailors and marines had succumbed too easily and too quickly to Iranian pressure. The critics said their behavior contrasted markedly with that of service personnel in earlier eras, when captured service members were under orders to provide their captors with only limited information.
“It seems reasonable to at least wonder whatever happened to divulging one’s name, rank and number,” the columnist Marina Hyde wrote in The Guardian.
Opposition even came from the possibly unexpected quarter of Max Clifford, one of Britain’s leading publicists, who, as a well-known agent on behalf of people selling their stories, has done as much as anyone to put the word checkbook into checkbook journalism.
This is purely a propaganda exercise,” Mr. Clifford told The Press Association news agency. “In the past troops were always stopped from talking about what had gone on.”
“They can control it, and they do control it when it suits them,” he said, referring to the Ministry of Defense. “It didn’t suit them in this particular case.”
The Ministry of Defense said in a statement on Sunday that the sale of stories would strengthen its control over what the released sailors and marines had to say.
It was clear that the stories they had to tell were likely to have emerged via family and friends, regardless of any decision the navy took,” the statement said.
By allowing them to sell their stories, by contrast, the statement said, the navy and the Ministry of Defense would have “sight of what they were going to say as well as providing proper media support to the sailors and marines in the same way as would have been the case in more ordinary circumstances.
Mr. Clifford estimated that the sales could earn about $500,000, with the biggest amount likely to be paid to Leading Seaman Faye Turney, the only woman among the captives, who was said by Iranian television to have written letters home criticizing British and American policy.
Mr. Clifford said he had been approached by three or four of the service members about selling their stories.
In some ways, the unfolding saga of the 15 — captured on March 23 in the Persian Gulf — has become a parable for modern Britain in a time when warfare has become intertwined with the battle of perceptions and versions played out on 24-hour television news channels.
During the captivity, British, American and other broadcasters picked up and retransmitted Iranian video of the captives seeming to deny Britain’s official insistence that they were captured while performing a legal search in Iraqi waters.
The released hostages are behaving like reality TV stars,” Col. Bob Stewart, a former commander of United Nations forces in Bosnia, told The Sunday Times of London. “I am appalled that the Ministry of Defense is encouraging them to profit in this way.
There is an element, too, of the class distinctions that still stratify some parts of British society. “No one complains if a general writes his memoirs,” said Flight Lt. John Nichol, who was captured and tortured during the Persian Gulf war of 1991. “But there is snobbery about a junior rank telling their story.”
The most poignant criticism came from the relatives of the 140 British service members who have died in Iraq since the invasion in March 2003 and of the 52 who have died in Afghanistan since 2001.
“This is wrong and I don’t think it should be allowed,” Rose Gentle, the mother of a 19-year-old soldier killed in Basra in 2004, said of the decision to allow the sailors and marines to sell their stories.
One of the former captives, at least, had a different view on the sale of stories. “I am not interested in making money out of this,” said Lt. Felix Carman of the navy, the highest-ranking of the 15 captives, who spoke at length during Friday’s news conference. “My main aim is to tell the story.
There’s some people who might be making money, but that’s an individual’s decision, that’s very private, but that’s not something that myself or many of the others will do,” he said.

Costly Contraceptives

For almost 20 years, college health centers have been able to purchase contraceptives at nominal prices. This was not a tax-funded subsidy. It was a financial incentive that gave drug manufacturers an exemption from Medicaid pricing rules so they could sell contraceptives and other products to certain charitable groups, like the college clinics, at an extreme discount. In response to concerns that drug companies were abusing this privilege, language was sewn into legislation in 2005 to close a loophole. It also inadvertently slashed this important benefit for clinics and their patients.
On some college campuses, the price of brand-name contraceptives has risen from the neighborhood of $5 per month to $40 or even $50. Switching to a generic is an option in some cases, but it can still entail a 300 percent price increase. Generics often run at about $15 per month. Newer contraceptives, like the NuvaRing, which contains a very low hormone dose and does not require a daily action that is easily forgotten, are not yet available generically. Many students are priced out of the market.
The spike in price affects more than just consumers of contraceptive devices and pills. College and university health clinics sold these products for a small profit — buying them at, say, $3 and selling them at $5. Even on a small campus, these dollars add up quickly. The money was an important part of health center operating budgets, paying for classes and even subsidizing more expensive medications.
The Centers for Medicare and Medicaid Services could reapply these exemptions with the stroke of a pen. If they do not, Congress should restore this much-needed benefit.

Sunday, April 08, 2007

WASHINGTON, April 7 — Senior members of Congress from both parties are working feverishly on legislation that could give consumers access to lower-cost copies of biotechnology drugs that now cost tens or hundreds of thousands of dollars a year.

Prospects for the legislation have increased since Democrats took control of Congress this year. Consumer groups, employers and insurers are lobbying for the bill, which they see as a way to hold down health costs.

The proposal faces formidable scientific and political obstacles. Brand-name pharmaceutical companies contend that biotechnology products, made from cells and living organisms, are so complex that a copy will never be identical to the original and therefore cannot be certified as safe without testing in humans.

Biotech medicines are the fastest-growing category of health spending, with sales of $40 billion last year, up 20 percent from 2005, according to IMS Health, a market research company. More than 400 biotech products are in the pipeline, for more than 100 diseases, including cancer, AIDS, diabetes and Alzheimer’s.

Conventional drugs are synthesized by putting atoms together from basic chemicals and are often in pill form.

Biotech drugs, also known as biologic products, are typically proteins made by modifying the DNA of bacteria, yeast or mammal cells, and they are often given by injection or infusion.

Supporters of the legislation received an unexpected boost when the chief medical officer of the Food and Drug Administration, Dr. Janet Woodcock, told Congress last month that the agency had the expertise and experience to decide what types of human and laboratory tests were needed to ensure that copies of a biotechnology drug worked as well as the original.

Brand-name drug manufacturers have urged Congress to require human trials before allowing the sale of any products billed as comparable or equivalent to biotechnology medicines already on the market.

But Dr. Woodcock said: “Where trials are not needed, it is of questionable ethics to repeat them. The use of human subjects for trials that are not needed is not desirable.”

Many biotech drugs are effective but expensive. Avastin, a cancer treatment made by Genentech, can cost $4,400 to $8,800 a month, with a maximum cost of $55,000 a year for people who qualify for the company’s patient assistance program.

Cerezyme, a drug made by Genzyme for Gaucher disease, costs $200,000 a year. Enbrel, made by Amgen for rheumatoid arthritis and psoriasis, costs an average of $16,000 a year.

Biotech treatments for multiple sclerosis range in price from $16,000 to $25,000 a year. “Many patients are denied access to these important drugs because even the co-payments can reach thousands of dollars a year,” said Arney Rosenblat, a spokeswoman for the National Multiple Sclerosis Society.

Consumers save billions of dollars a year by using low-cost generic versions of conventional drugs, which are approved by the government under a 1984 law.

One author of the 1984 law, Representative Henry A. Waxman, Democrat of California, is pushing a bill that would authorize the Food and Drug Administration to approve safe, lower-cost versions of biotechnology drugs.

Senators Charles E. Schumer and Hillary Rodham Clinton of New York, both Democrats, have introduced an identical bill, with support from several Republicans, including Senators Susan Collins of Maine and David Vitter of Louisiana.

The chief lobby for makers of biotech drugs, the Biotechnology Industry Organization, strongly opposes the bill, saying it would endanger patients and kill incentives for research and innovation.

The debate over biotech drugs is filled with paradoxes. Brand-name drug companies, which have for years criticized the regulation of drug prices in Europe, now point to Europe’s strict regulation of “follow-on biologics” as a possible model for the United States. Democrats, who have often criticized the F.D.A. as lax in enforcing drug safety laws, now say they trust the agency to decide whether copies of biotech drugs are safe and effective, without the full range of tests required for new products.

The Widening College Loan Scandal

Congress needs to address the college loan scandal that has unfolded since New York’s attorney general, Andrew Cuomo, began to investigate the troubling — and possibly illegal — payments to universities that steer students to so-called preferred lending companies. These kickbacks are part of a wider pattern of shady dealing that, we now find out, reaches into the federal government as well.
The Times reported last week that a senior official at the Department of Education who helped oversee the federal student loan program held shares of the parent company of the student loan company Student Loan Xpress. That came one day after financial aid officials at three universities that listed Student Loan Xpress as a preferred lender — Columbia University, The University of Texas at Austin and the University of Southern California — were found to have sold shares in the company. The official at Columbia, who earned more than $100,000 on the sale, bought his shares for about $1 each and sold them for about $10.
These cases show what lenders will do to win a slice of the business — last year students took out $85 billion in loans — and the all-too-frequent willingness of universities to go along. Financial aid officers are offered gifts and trips, and universities are offered hundreds of thousands of dollars in payments, if they place a company on their list of preferred lenders that most students use when looking for loans. Universities have also been offered large payments to switch from the government’s student loan program to private lenders whose huge profits are based in part on government subsidies.
This program is clearly in need of serious and immediate reform. For starters, Congress needs to make it illegal for colleges and universities to accept anything of value from lenders. It should also require universities to choose preferred lenders through an open process that guarantees the best rates and treatment for student borrowers.

Hot and Cold

Last week began with a Supreme Court decision declaring that the federal government had the authority to regulate greenhouse gas emissions and all but ordering the Bush administration to do so. It ended with a report from the Intergovernmental Panel on Climate Change — the world’s authoritative voice on global warming — warning that failure to contain these emissions will have disastrous environmental effects, especially in poorer countries, which are least able to defend themselves and their people against the consequences of climate change.
One would hope that these events would shake President Bush out of his state of denial and add his authority to the chorus of governors, legislators and business leaders calling for an aggressive regulatory and technological response to the dangers of global warming. They haven’t. When asked about the Supreme Court decision, the president said he thought he was already doing enough.
He argued further that there was little point in the United States’ doing any more unless other polluters like China acted as well. That ignores the reality that no developing country is going to move unless the United States — which produces one-fourth of the world’s emissions with only 5 percent of its population — takes the lead.
The report from the intergovernmental panel was the second of three due this year. The first concluded with “90 percent certainty” that humans had caused the rise in atmospheric temperatures over the last half-century. The most recent focused on the consequences, few of them positive.
The northern latitudes will have longer growing seasons. But elsewhere climate change will lead to more severe storms, the flooding of tropical islands and coastlines inhabited by hundreds of millions of people, the likely extinction of at least one-fourth of the world’s species and, in poorer countries in Asia and Africa, drought and hunger.
Some of these changes have begun. “We’re no longer arm-waving with models,” said Martin Parry, the co-chairman of the team that wrote the report. But the report also makes clear that while emissions already accumulated in the atmosphere make some damage inevitable, the worst can be avoided if the world’s nations take swift action to stabilize and then reverse emissions.
What must be avoided, the report said, is a rise of 3 to 5 degrees Fahrenheit, the point at which truly devastating effects will begin to kick in. But such a rise is almost inevitable over the next century if the world continues to do business as usual.
The panel’s next paper will discuss alternatives to business as usual. These policies will almost certainly require a major shift in the way energy is produced and used, as well as massive investments in new technologies. They will also be expensive. But what the world’s scientists are telling us, with increasing confidence, is that the costs of doing nothing will be far greater than the costs of acting now.

Saturday, April 07, 2007

Breast Cancer Screening

The often confusing issue of screening for breast cancer just got more confusing. First, a major medical group disputed the need for regular mammograms for all women ages 40 to 49, as is currently recommended. Then a widely used computer system that was supposed to make mammograms more accurate was judged to make them less accurate. And guidelines just issued by the American Cancer Society recommend annual M.R.I. scans in addition to mammograms — for all women at especially high risk of developing breast cancer, starting at age 30.

Nothing in the new material shakes the long-standing recommendation that all women age 50 or older should get regular mammograms. Women in their 40s, however, will need to weigh the pros and cons carefully. Most expert groups believe they should get mammograms every year or two. But clinical guidelines issued by the American College of Physicians take a more discriminating approach.

The guidelines acknowledge that regular mammograms for women in their 40s can reduce the risk of dying from breast cancer by a modest amount: for every 10,000 women screened, six might avoid death from breast cancer. But a very high percentage of the women screened, the college warns, will get false positive results that lead to unnecessary biopsies, increased costs and risk of injury. There is also a tiny risk that radiation from the screening might itself cause cancer. In the end, women deeply worried about breast cancer will want to get screened, while those who judge — with the help of their doctors — that they are at low risk may prefer to wait.

The latest verdicts on two advanced technologies were mixed. One new study found that M.R.I. scans could find tumors that mammograms had missed in a small percentage of women. The downside is that the costly scans are so sensitive they pick up lots of suspicious but harmless growths.

Another new study found that a costly computerized system to help radiologists read mammograms was no better at finding cancer than traditional mammography and led to many more false alarms that required needless biopsies. The computerized systems are used in some 30 percent of all mammography centers, where they are driving up costs for no clear medical benefit. Government and private insurers may need to reconsider whether the systems are worth covering.

The non-aligned movement

The quality of aid matters as much as the quantity
MAIMONIDES, a 12th-century rabbi and philosopher, argued that it is better to give anonymously, like the sages who secretly placed coins under the doors of the poor, than to flaunt your generosity. Better still, he said, to pool your charity—by contributing to a tzedakah box, for example—so that neither the poor nor their benefactor know the other's identity.
The club of 22 governments who dominate foreign aid would not rate very highly by the Torah's reckoning. This week they met in Paris to measure progress on two big commitments made in 2005. In July of that year, those world leaders who gathered for the G8 summit in Gleneagles in Scotland promised to increase aid to $130 billion, and double aid to Africa, by 2010.
But giving freely only gets you past the lowest rank of benefactors in Maimonides' scheme. An earlier pledge, made in Paris four months before, would have impressed him more. Donors promised to be more self-effacing in their charity, to “harmonise” their efforts with other benefactors, and “align” them with the priorities of governments they were trying to help.
Sadly, progress on both pledges is weak.
Such uncertainties should worry a prudent African finance minister. Can he count on seeing some of the extra $25 billion the continent is promised by 2010? Of the G8 leaders who signed that pledge, half have already departed, two are on their way out, and the remaining pair will be gone before 2010. Even if donors meet the target, the aid may arrive in a sudden and unmanageable rush a year or two before the deadline.
Only about 65% of aid actually arrives on schedule, according to the OECD. Finance ministers must cope with shortfalls and windfalls. Zambia was due to receive $930m in 2005, but ended up with just $696m. Vietnam which was expecting about $400m, got roughly $2 billion.
Because the aid they receive is such a capricious, volatile commodity, governments dare not make full use of it. They could hire legions of extra teachers, clinicians and civil servants, but only if they are prepared to fire them when the aid spigot is closed. They could put AIDS-sufferers on anti-retroviral therapies, but only if they are willing to discontinue treatment once the money stops. Not surprisingly, some governments choose to hoard aid rather than spend it. In 2001-03, Ghana received an extra $1.3 billion of aid; $1.2 billion collected in the vaults of its central bank.
Aid is also poorly co-ordinated. A trio of researchers compared donors with a gaggle of crop-growers, spraying water hither and thither, leaving some plants parched, others deluged. After the Indian Ocean tsunami, according to a report in El Pais, an Acehnese girl developed measles symptoms thanks to three identical jabs from different aid agencies.
Where donors and governments do see eye to eye, there may be little need for aid agencies at all. The British government, for example, could simply write a cheque to its Tanzanian counterpart. Some donors do just this, bankrolling governments they trust, and letting them manage the money themselves. About £1.2 billion ($2.4 billion) of British aid will top up government budgets in this way next fiscal year.
Other donors are less enthusiastic. They may want to trumpet their good deeds, or have real or imagined doubts about the recipient's book-keeping and budgeting. Even countries with “moderately strong” exchequers were not always trusted to audit their aid money, the OECD notes. “The very countries that helped us reform our systems, then don't use our systems,” complains Paul Lupunga, a senior Zambian official.
The Paris declaration says that donors must be accountable to beneficiaries. For now, most prefer to please their voters.

Air pressure

America's Supreme Court rules on the environment
THROUGHOUT George Bush’s presidency, the federal government has refused to countenance any regulation of the greenhouse gases that cause global warming. Whenever the subject comes up, officials tend to mumble about uncertainties. But on Monday April 2nd, in its most important environmental decision for many years, the Supreme Court at last settled one of the biggest outstanding questions: whether the government has the authority to curb emissions in the first place.
The court ruled, by the slenderest of margins, that the Clean Air Act—a law from the 1960s designed to combat smog and acid rain-gives the Environmental Protection Agency (EPA) the power to regulate carbon dioxide, the main greenhouse gas. It also said the EPA would need an excuse grounded in the original law if it decided not to use this power. It dismissed the justifications the EPA had provided for inaction—that emissions from American cars were insignificant in the grand scheme of things and that unilateral action by America would undermine efforts to achieve international consensus on global warming—as inadequate. Strictly speaking, the decision applies only to emissions from vehicles, but another, similar case involving coal-fired power plants is pending in a lower court. The EPA says it is now examining the ruling.
It might examine it for some time, of course. Any regulations it comes up with in response might still defer action into the distant future, since the law allows the EPA to delay implementation until appropriate technology can be acquired at a reasonable cost. Even if it proceeds quite swiftly, a new president and Congress with globe-cooling ideas of their own will be in place long before any new rules come into effect.
That suits the environmental lobby just fine. They hope the ruling will spur Congress to address global warming with proper legislation. After all, it makes little sense for such an important issue to be tackled tangentially through a 40-year-old law. At the very least, they can use the ruling to rally the faithful and shame climate-change sceptics in next year’s elections. And if 2009 sees the inauguration of a greener president, he or she will now have the power to dictate stricter fuel efficiency, in the form of lower CO2 emissions, without reference to Congress. If the lawsuit involving power plants goes the same way, the new president will be able to enforce across-the-board cuts in emissions by fiat. As Barbara Boxer, an environmentally-minded senator from California, stated gleefully, “This decision puts the wind at our back.”
That is true of California in particular. In 2002, the state assembly passed a law regulating emissions of CO2 from vehicles, based on a provision of the Clean Air Act that allows California to adopt stricter pollution standards than the federal government (other states can then choose to follow the Californian standards if they wish). Carmakers have challenged the law, in part on the ground that CO2 was not an air pollutant—a notion the Supreme Court has now comprehensively quashed.
California still needs a waiver from the EPA in order to enforce its own emissions standards. The EPA will presumably hesitate to withhold its permission after its setback in court. But it might argue that California does not face the “compelling and extraordinary conditions” the law requires before stricter standards can be imposed. That would prompt another protracted legal battle. On the one hand, global warming is, as its name suggests, a global problem. On the other, a big share of California’s water supply is threatened by decreasing snowfalls in the Sierra Nevada mountains-a change attributed to global warming.
The car industry, at any rate, seems rattled by the ruling. Its trade group quickly declared that the issue of global warming is best handled by at the federal level by Congress. Thanks to the Supreme Court, that now seems more likely.