J&J ordered to pay US$4.69b damages in talc cancer case

WASHINGTON: US pharmaceutical giant Johnson & Johnson was Thursday ordered to pay out US$4.69 billion, (RM18.95 billion) in damages in a lawsuit representing 22 women and their families who alleged a talc sold by the company contained asbestos and caused them to suffer cancer.

It is the latest twist in a matter that has seen several thousand lawsuits filed against J&J.

According to the victims’ lawyer, Mark Lanier, a jury composed of six men and six women in St Louis, Missouri, ruled in favour of the women after a six-week trial and eight hours of deliberation. The damages include US$550 million in compensation and over US$4.1 billion in punitive damages.

The plaintiffs said using the talc for personal hygiene had caused ovarian cancer.

“For over 40 years, Johnson & Johnson has covered up the evidence of asbestos in their products,” Lanier said in a statement.

“We hope this verdict will get the attention of the J&J board and that it will lead them to better inform the medical community and the public about the connection between asbestos, talc, and ovarian cancer,” he said, calling for talc to be pulled from the market.

J&J said it was “deeply disappointed in the verdict”.

In a statement, it described the trial as “a fundamentally unfair process that allowed plaintiffs to present a group of 22 women, most of whom had no connection to Missouri, in a single case all alleging that they developed ovarian cancer”.

“The result of the verdict, which awarded the exact same amounts to all plaintiffs irrespective of their individual facts, and differences in applicable law, reflects that the evidence in the case was simply overwhelmed by the prejudice of this type of proceeding”.

The company said its talc does not contain asbestos or cause ovarian cancer, and vowed it would “pursue all available appellate remedies”.

Several similar trials have already taken place, with a Los Angeles appeals court last October dismissing a US$417 million verdict against J&J, saying the complainant’s arguments were insufficient and vague. — AFP

Spanish researchers develop five-strain Ebola vaccine

MADRID: Spanish researchers are working on a vaccine against all five strains of the killer Ebola virus in what would be a world first, Madrid’s Oct 12 Hospital said Wednesday.

A prototype vaccine developed by pharmaceutical group Merck is already in use but acts only against the most virulent, “Zaire” strain.

Despite not having market approval, Merck’s rVSV-ZEBOV was administered to people in the Democratic Republic of Congo in May, with UN approval, in a bid to contain an outbreak of the same virus that killed more than 11,300 in three West African countries from 2013-2015, sparking international panic.

For several months, a team from the Oct 12 Hospital has been working with researchers at two other hospitals in the capital to examine and learn from blood samples taken from three people cured of Ebola in Spain.

Lead researcher Rafael Delgado told reporters the difficulty lay in the fact that the virus protects itself with proteins that act as a shield, and only exposes its vulnerable zones for short periods of time.

That makes it tough for the body’s immune system to fight the virus.

The three Spanish patients had produced “very effective” viral antibodies, though in a “small quantity” and only against the Zaire strain they were contaminated with.

Delgado, head of microbiology at the hospital, said researchers are aiming to reproduce these antibodies on a larger scale, and in a way that would make them efficient against all five virus strains.

US medical giant Johnson & Johnson is separately developing an experimental vaccine against two Ebola strains.

Delgado said researchers hope to get results from mouse experiments within a year.

The Ebola epidemic caused alarm in Spain in 2014 when a nursing assistant, Teresa Romero, became the first person infected outside Africa.

She caught the disease while tending to a Spanish missionary repatriated from Sierra Leone, who died in Spain in Sept that year. — AFP

West African states in joint fight against root crop ‘Ebola’

ABIDJAN: Researchers from half a dozen states in West Africa have joined together in a battle against what one expert calls a root crop “Ebola” — a viral disease that could wreck the region’s staple food and condemn millions to hunger.

Their enemy: cassava brown streak disease (CBSD), a virus that strikes cassava, also called manioc, which in some of the region’s countries is consumed by as many as 80% of the population.

The root-rotting disease was first discovered in Tanzania eight decades ago and is steadily moving westward.

“In outbreaks in central Africa, it has wiped out between 90% and 100% of cassava production — it’s now heading towards West Africa,” Justin Pita, in charge of the research programme, told AFP.

“It is a very big threat. It has to be taken very seriously”.

In Uganda, 3,000 people died of hunger in the 1990s after the dreaded disease showed up, striking small farmers in particular.

“You can call it the Ebola of cassava,” said Pita.

The West African Virus Epidemiology (WAVE) project, a multi-million-dollar scheme funded by the Bill and Melinda Gates Foundation, aims to shield the region from the advancing peril.

Headquartered at Bingerville, on the edges of the Ivorian economic capital Abidjan, it gathers six countries from West Africa — Benin, Burkina Faso, Ghana, Ivory Coast, Nigeria and Togo — as well as the Democratic Republic of Congo.

Much is already known about CBSD — the virus is generally believed to be propagated by an insect called the Silverleaf whitefly, and also through cuttings taken from infected plants.

But there remain gaps in knowledge about West Africa’s specific vulnerabilities to the disease.

They include understanding the susceptibility of local strains of cassava to the virus, and identifying points in the cassava trade that can help a localised outbreak of CBSD swell into an epidemic.

The scheme will also look at initiatives to help boost yield — a key challenge in a region with surging population growth.

“The current average yield from cassava (in West Africa) is 10 to 12 tonnes per hectare, but it has the potential to reach 40 tonnes a hectare,” said Odile Attanasso, Benin’s minister of higher education and scientific research.

“In Asia, they have yields of 22 tonnes per hectare”.

‘Attieke is our husband’

The WAVE project hopes to go beyond the lab and test fields, though.

It also wants to harness the clout of community leaders and chiefs to spread CBSD awareness and promote better farming practices, such as confining and destroying crops in infested areas and banning the transport of manioc cuttings.

“We kings and traditional chiefs are the interfaces between the population and the government,” said Amon Tanoe, the ceremonial monarch of the coastal Grand-Bassam region in Ivory Coast.

Ivory Coast is a huge consumer of cassava — the starchy root is typically pulped and fermented and served in a side dish called attieke.

In Affery, a big cassava-growing region about 100km east of the economic capital Abidjan, makers of attieke said they were deeply worried about the threat of CBSD.

“Attieke is our husband,” said Nathalie Monet Apo, head of the association of attieke producers, emphasising how the cassava dish is intertwined with Ivorian life.

“If the disease shows up, it would be dramatic for our families and our community”.

“They have to find a cure for this disease — it’s thanks to growing cassava that I am able to provide an education for my four children,” said Blandine Yapo Sopi, eyeing a mound of harvested manioc that she hoped would bring in 450,000 CFA francs. — AFP

Candidate AIDS vaccine passes key early test

PARIS: The near 40-year quest for an AIDS vaccine received a hopeful boost Saturday when scientists announced that a trial drug triggered an immune response in humans and shielded monkeys from infection.

Shown to be safe in humans, the candidate vaccine has now advanced to the next phase of the pre-approval trial process and will be tested in 2,600 women in southern Africa to see whether it prevents HIV infection.

While the results so far have been encouraging, the research team and outside experts warn there are no guarantees it will actually work in the next trial phase dubbed HVTN705 or “Imbokodo” — the isiZulu word for “rock”.

“Although these data are promising, we need to remain cautious,” study leader Dan Barouch, a Harvard Medical School professor, told AFP.

Just because it protected two-thirds of monkeys in a lab trial doesn’t mean the drug will protect humans, “and thus we need to await the results of the … study before we know whether or not this vaccine will protect humans against HIV infection,” he said.

The results of the Imbokodo trial are expected in 2021/22.

“This is only the fifth HIV vaccine concept that will be tested for efficacy in humans in the 35+ year history of the global HIV epidemic,” added Barouch.

Only one so far, RV144, yielded some protection. RV144 was reported in 2009 to reduce the risk of HIV infection among 16,000 Thai volunteers by 31.2% — deemed insufficient for the drug to be pursued.

For the latest study, published in The Lancet medical journal, Barouch and a team tested the candidate drug on 393 healthy, HIV-free adults aged 18 to 50 in east Africa, South Africa, Thailand, and the United States.

The participants were randomly given one of seven vaccine combinations or a placebo “dummy” alternative. They received four shots each over 48 weeks.

Needed ‘badly’

The study used so-called “mosaic” vaccine combinations.

These combine pieces of different HIV virus types to elicit an immune response — when the body attacks intruder germs — against virus strains from different regions of the world.

The vaccine “induced robust (high levels of) immune responses in humans,” said Barouch.

The tests also showed the vaccine was safe. Five participants reported side-effects such as stomach pain and diarrhoea, dizziness, or back pain.

In a separate study, the same vaccine offered complete protection from infection in two-thirds of 72 trial monkeys each given six injections with an HIV-like virus.

“I cannot emphasise how badly we need to have a vaccine … to get rid of HIV in the next generation altogether,” said Francois Venter of the University of the Witwatersrand Reproductive Health and HIV Institute in South Africa.

Approached for comment on the study, which he was not involved in, Venter urged caution.

“We have been here before, with promising candidate vaccines that haven’t panned out,” he told AFP.

“This one is novel in many ways so it is exciting, but we have a long way to go.”

Could be ‘phenomenal’

Jean-Daniel Lelievre of France’s Vaccine Research Institute said the vaccine was likely not the “definitive” version but may represent “a phenomenal advance”.

An estimated 37 million people live with HIV/AIDS, according to the World Health Organization.

There are about 1.8 million new infections and a million deaths every year.

Almost 80 million people are estimated to have been infected since the virus was first diagnosed in the early 1980s.

About 35 million have died.

A vaccine has proven elusive as the human immunodeficiency virus (HIV) mutates easily and can hide away in cells, evading the immune system, only to reemerge and spread years later.

For now, people infected with HIV rely on lifelong virus-suppressing anti-retroviral treatment (ART) to stay healthy.

Condoms are still at the frontline of efforts to prevent infection — mainly through sex and blood contact — though more and more people use ART as prophylaxis.

The latest results come ahead of the International Aids Conference to be held in Amsterdam from July 23 to 27. — AFP

China’s organ transplant system feted despite transparency doubts

MADRID: Just a few years ago, China was persona non grata in the transplantation world over its use of organs from executed inmates, some of them prisoners of conscience.

But at the Transplantation Society’s annual congress in Madrid this week, the tables turned as 150 Chinese experts took part — an unprecedented number — and one-time critics endorsed the country’s organ donation system despite allegations it is far from transparent.

“That couldn’t happen just a few years ago,” said Francis Delmonico, a high-profile US transplant surgeon and former president of the society.

The transplant society used to ban Chinese experts in the field from giving presentations at annual conferences, he told reporters at a press conference organised by the Chinese embassy in Madrid.

“The fact that there are so many Chinese professionals here reporting their experience is a very important testimony of the evolution of China,” Delmonico added.

China banned the use of executed prisoners’ organs in 2015 and has set up a nationwide voluntary donation system instead.

But there are fears the practice goes on, with prisoners being reclassified as voluntary donors to get around the rules.

Huang Jiefu, the man in charge of overhauling China’s transplant system, strongly denies this and says there is zero tolerance now.

He nevertheless admitted at a conference last year at the Vatican that organ transplants from prisoners may still be taking place.

“China is a big country with a 1.3 billion population so I am sure, definitely, there is some violation of the law,” he said.

How many transplants?

There are currently 178 hospitals for organ transplants in China.

Last year China completed more than 16,000 transplants, ranking it second in the world behind the United States, according to an official statement handed out at the press conference.

But in a report that examined transplant hospitals’ bed counts, bed utilisation rates, revenue, state funding and more, the China Organ Harvest Research Centre, which has long scrutinised the issue, claimed there are thousands more being performed.

China initiated its voluntary organ donation system in 2010 and rolled it out nationwide in 2013.

“Official accounts indicate that the percentage of organs sourced from donations jumped from 23% in 2013 to 80% in 2014, with voluntary donations officially becoming the sole official organ source in 2015,” the centre said in a report.

“It is not plausible that such a complete transition in this system could have taken place in just one or two years”.

Apart from mistrust of authorities, many Chinese believe they will be reincarnated after death and feel the need to keep a complete body, making them reluctant to donate an organ.

This raises the question of where the organs would come from.

In its report, the China Organ Harvest Research Centre alleges that organs are not just harvested from executed inmates but also from living prisoners of conscience.

It alleges these include practitioners of the banned Falungong spiritual movement and people from the Uighur ethnic minority, which China has cracked down on.

However, there is no firm evidence this is happening.

Both Human Rights Watch (HRW) and Amnesty International say they have been unable to verify the claims.

“While the Chinese government subjects Falungong practitioners and Uighurs to harsh treatment, including the use of torture and imprisonment, so far there is a lack of convincing evidence that they are being executed for their organs,” HRW China researcher Maya Wang told AFP.

Both groups, however, say the organ donation system’s lack of transparency makes it impossible to assess whether reforms have been successful.

Transplantation tourism?

There are also concerns foreigners are travelling to China to get a quick transplant.

Last year, a South Korean television team went to a hospital in Tianjin, a city near Beijing, where journalists spoke to foreign patients who had been told their transplant could take place within weeks.

Huang told reporters in Madrid this practice was now illegal except as “humanitarian aid” and would be punished.

“China used to be the hotspot for organ transplantation tourism,” he acknowledged.

But he said that had since changed, adding that more than 60 doctors had been “punished by law”. — AFP

Creating blood donation awareness

KUALA LUMPUR: Lee Hishammuddin Allen and Gledhill (LHAG) jointly organized a blood donation drive in collaboration with the National Blood Centre (PDN) at the law firm’s office last week.

The donation drive received very encouraging support from its employees, and has received over 13 litres of blood from 34 donors.

The President of LHAG Sports & Recreation Committee, Ashley Lee thanked the donors saying, “The blood donation drive is part of the firm’s efforts in playing a role to give back to the society. It is an annual fixture on the firm’s corporate social responsibility calendar.”

Ashley also added that they have seen an increase in participation this year, which is an encouraging sign for blood donation awareness amongst their employees.

‘Slow but sure’ progress toward less toxic tools to fight cancer

BALTIMORE: John Ryan is just one of the miracles to emerge from the Johns Hopkins cancer unit in Baltimore. An immunotherapy treatment — highly effective in a minority of patients — saved his life after a lung cancer diagnosis.

The retired military nuclear reactor specialist will celebrate his 74th birthday in July, and his battle with cancer illustrates the promises and failures of immunotherapy, a burgeoning field in which the pharmaceutical industry is investing heavily.

Ryan has been able to attend the graduations of three of his children and will take part in the wedding of one of his daughters this summer — even though doctors expected he had just 18 months to live in June 2013.

“That’s exciting stuff to be around for,” he said.

But he knows of plenty people who have not been so lucky.

“In five years, I have lost a lot of dear friends”.

Immunotherapy is one of two major categories of drugs against cancer. The best-known is chemotherapy, which has been used for decades and aims to kill tumours but is so toxic that it also attacks healthy cells, leading to major side effects like weakness, pain, diarrhoea, nausea and hair and weight loss.

Ryan went through all that in 2013, and his tumour persisted.

Exhausted by chemo and wracked with pain, Ryan was accepted into a last-ditch clinical trial using nivolumab (brand name Opdivo) in late 2013.

The drug was delivered intravenously at the hospital, at first every two weeks, then once a month.

His tumour rapidly disappeared, and 104 injections later, the main side effect has been itching.

Recently, a mysterious mass appeared in his right lung. It was treated with radiation.

“They shot me with chemo, it almost killed me. And now I have been sucking up immunotherapy, and it’s been good. My quality of life has been great,” said Ryan.

Relatively few patients

Immunotherapy trains the body’s natural defences — immune cells, also known as T-cells — to detect and kill cancer cells, which otherwise can adapt and hide.

Some experts are cautious, having been disappointed numerous times by other newfangled approaches to fighting cancer.

But many consider immunotherapy as a turning point. More than 30 immunotherapy drugs are in development, and 800 clinical trials are underway, according to Otis Brawley, medical director of the American Cancer Society.

Ryan’s oncologist, Julie Brahmer, said she now starts about a third of her lung cancer patients on immunotherapy first, not chemo.

It helps that the Baltimore facility has numerous clinical trials underway, far more than the average US hospital.

Doctors are intrigued by the unusually long remissions seen in a small number of patients like Ryan. These success stories make up about 10 to 15% of patients, said William Nelson, director of the Sidney Kimmel Comprehensive Cancer Centre at Johns Hopkins.

Normal remissions typically last a year and a half to two years.

Chemotherapy and radiation are still the most dominant tools.

But in recent years, a series of clinical trials have shaken up the cancer world, showing it was possible to better treat and even cure some of the most difficult forms of cancer without resorting to the most toxic techniques.

Personalized treatments

A spectacular example concerns prostate cancer.

Researchers have found that recommendations of regular screening had the opposite effect of what was intended: too many tumours that would never have spread were being treated in operations.

Regarding breast cancer, a major study published in early June at the American Society of Clinical Oncology conference showed that for tens of thousands of women, surgery and hormone therapy were enough to keep cancer away. Chemotherapy was being given unnecessarily, they found, in a finding that surprised the cancer community.

Meantime, genetic analyses are becoming ever more common for tumours, allowing more precise and rapid treatments for patients.

Johns Hopkins has a genomic lab specially designed to help doctors personalize patient treatments, rather than basing treatment simply on the location of a tumour.

“At this point, we have better and better tools to say, ‘Yes, he needs to be treated, you don’t,'” said Nelson.

Some cancers, including brain cancer, remain on the margin of these new treatments.

But for leukaemia, breast, lung, cervical, colon and rectal cancer, as well as the serious skin cancer is known as melanoma, immunotherapy and other personalized treatments are making progress “slowly but surely,” said Nelson.

For oncologist Julie Brahmer’s part, she hopes that one day, metastatic cancers — those that can spread to points distant from the site of origin — will be treated like a “chronic disease,” rather than a death sentence.

John Ryan has a simpler objective in mind.

“My goal is to die of something other than lung cancer,” he said. — AFP

Courts and DNA help Chile mothers search for ‘stolen babies’

SANTIAGO: Prosecutors are revisiting one of the darkest chapters of Chilean history, when under the Pinochet dictatorship hundreds and possibly thousands of babies were stolen from their mothers and given away just after being born.

On July 9, 1977, Margarita Escobar gave birth to a baby girl at Santiago’s Paula Jaraquemade hospital. She saw her daughter for only a few moments before staff took her away.

Four decades, Escobar hasn’t given up on meeting the grown woman her daughter may have become, buoyed by the prosecutors’ push for the truth about Chile’s stolen babies, and under-the-table adoptions.

She told AFP hospital staff kept her sedated back then. “Every time I woke up I asked about her again, until a midwife told me, ‘you’re baby was stillborn'”.

She wasn’t allowed to see the body. “Nobody even gave me a document. They sent me home. I don’t know how I got there. I was totally doped”.

Fast forward almost 10 years, to February 1985, and Maria Orellana gave birth in the same hospital to a boy she named Cristian.

“I heard that he was a boy, then they gave me an injection and that was the last I knew about it,” she told AFP.

Like other mothers, she was told her baby had died and, as it would be “too cruel” for her to see the body, the hospital took care of the burial. “Keep the memory that you had of your little boy,” she recalls being told.

Like Escobar, Oreland was given no documentation “There is nothing. It is as if I had never even been in that hospital,” she recalls now, determined like thousands of other mothers to find a child she never held.

The path of justice

Tasked with helping thousands of mothers in the same situation, Chile’s Special Judge for Human Rights Mario Carroza has been investigating the kidnappings since January. Most occurred during the dictatorship of Augusto Pinochet (1973-1990) but others have been reported as recently as 2000.

Carroza has ruled out the state using child stealing as a means of repression, a tool commonly used by the military dictatorship in Argentina. Instead, he says the ultimate goal was financial gain, making Chile’s situation more reminiscent of Spain.

The first trial in a case of “stolen babies” under Francisco Franco’s 1939-75 regime has just begun. The practise in Spain continued there long afterward for monetary gain.

“We have not established a link with a policy of state repression. It appears more like a kind of illicit association, an organization set up to make money from illegal adoptions,” said Pablo Rivera, a lawyer of the National Institute for Human Rights, who has filed complaints on behalf of the mothers.

At the heart of the scheme was a network of social workers, nuns, doctors and municipal officials who identified mothers in vulnerable situations.

“In general, the cases are related to low income mothers who gave birth to a boy or a girl and were later deceived by hospital officials that they were dead or sick,” Rivera said.

A law, which remained in force until 1988, facilitated the scheme. It allowed the destruction of all records of biological families after adoption, Karen Alfaro, a historian at Austral University, told AFP.

For Alfaro, the practise was “also part of the Pinochet dictatorship’s ideological struggle, a type of social violence inflicted on the poorest”.

DNA testing

According to official figures, 26,611 adoptions were registered in Chile between 1973 and 1987, but no register exists for how many children went to families abroad.

Carroza has determined that at least 2,021 children were adopted in Sweden between 1971 and 1992. Thousands more went to Germany, France, Italy, Spain, Holland, Switzerland, the United States, Uruguay and Peru. Each adoption was worth between 3,000 and 5,000 dollars.

Without supporting documents, many mothers have maintained a painful silence for decades. But as the first cases were made public and search groups were formed on the internet, they realized thousands of women shared their experience.

One of these groups, the “Sons and Mothers of Silence,” has 3,000 members on Facebook, children seeking their biological parents, and mothers grasping for any clue that could lead them to the baby who was snatched from them.

“What we need is for the files, the hospital files, to be opened. For this to be done publicly so that people who are outside Chile realize that they could have been adopted illegally,” says Marisol Rodriguez, spokesperson for the group.

In three years, the group has achieved almost 90 mother-and-child reunions.

The best way is through DNA testing, which despite the cost, many mothers undertake so their information is put into international gene banks.

“What I want to know is what happened to my daughter and if my daughter is looking for me,” Josefina Sandoval told AFP after undergoing a DNA test.

In theory, the daughter snatched from her at birth on June 24, 1980, should have just turned 38 years old.

“We are looking for her and with this we will find her.” — AFP

‘High-performing’ cyberdoc puts British GPs on defensive

LONDON: A medical chatbot said to perform as well as or even better than human doctors has sparked a war of words in Britain, in a clash over how much the cash-strapped public health service should rely on artificial intelligence.

AI company Babylon, which is already working with the National Health Service (NHS) claimed its chatbot scored higher marks than real live doctors in “robust tests”.

The British firm said it quizzed the AI using sample questions for trainee exams set by Britain’s Royal College of General Practitioners (RCGP), the professional body for family doctors.

The programmed chatbot, a key feature of Babylon’s “GP at Hand” app, scored 81% when sitting the test for the first time, while the average pass mark over the past five years for doctors was 72%, according to the company.

Its founder Ali Parsa, who presented the findings in London earlier this week, hailed the results as “a landmark”.

“(They) take humanity a significant step closer to achieving a world where no one is denied safe and accurate health advice,” he said in a statement.

Andrew Goddard, an NHS doctor and president of the Royal College of Physicians (RCP), which represents 34,000 doctors across the globe and hosted the Babylon event unveiling the findings, told the audience that Artificial Intelligence was “the future”.

“How quickly we’ll get there I will wait and see — medicine needs to get engaged with it,” he said.

But ahead of the London showcase, the RCGP issued a stern rebuke of the company’s claims.

“No app or algorithm will be able to do what a GP does,” said its vice-chair Martin Marshall.

“Computers are computers, and GPs are highly-trained medical professionals: the two can’t be compared and the former may support but will never replace the latter.”

The organisation went on to question the sample questions used by Babylon in its testing.

In response, the company called the RCGP “completely off the mark” and accused it of “misunderstanding” facts.

Mobasher Butt, Babylon’s medical director, said the RCGP was “shoring up an outmoded and financially self-interested status quo which solely works to the benefit of a limited number of partner GPs”.

Cutting costs

Babylon says it is on a mission “to put an accessible and affordable health service in the hands of every person on earth”.

It launched an app for patients in Britain’s NHS in parts of London last Sept that has more than 50,000 users.

The company also has more than 2 million members in its healthcare service in the east African nation of Rwanda.

It plans further rollouts around the world, and is collaborating with tech giants Samsung and Tencent to expand its app offerings.

“I believe that we are on the threshold of being able to do with healthcare what Google, for instance, did with information,” Parsa said.

Noting two-thirds of healthcare costs within the NHS go on salaries, he called on the medical community to welcome AI.

“As long as we don’t tackle our complete reliance on human beings to deliver healthcare, we are not going to be able to do so affordably.”

But the RCGP said Babylon’s “GP at Hand” app was “cherry-picking” patients, “leaving traditional GP services to deal with the most complex patients”.

“The way it is being used risks undermining and damaging traditional general practice services,” it added. — AFP