AP IMPACT: Big Pharma cashes in on HGH abuse


A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.


The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.


But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.


From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.


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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


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Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.


The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.


Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.


Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.


Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.


Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.


Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.


HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.


Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.


Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.


The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.


On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.


Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.


Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.


While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.


Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition


Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.


"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.


And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.


First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.


Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.


FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.


Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.


Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.


These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.


The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.


A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.


For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)


These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.


"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."


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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.


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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh


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The AP National Investigative Team can be reached at investigate(at)ap.org


EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


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Time's Up: Sides Closing In on 'Fiscal Cliff' Deal













President Obama said an 11th-hour agreement to avert year-end tax hikes on 98 percent of Americans is "within sight" but not yet complete with just hours to go before the nation reaches the so-called fiscal cliff.


"There are still issues left to resolve but we're hopeful Congress can get it done," Obama said at a midday White House news conference. "But it's not done."


Congressional and White House negotiators have forged the contours of an agreement that would extend current tax rates for households making $450,000 or less; raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the Alternative Minimum Tax from hammering millions of middle-class workers, sources said.


The deal would also extend for one year unemployment insurance benefits set to expire Tuesday, and avert a steep cut to Medicare payments for doctors.


"There is an agreement to fix the tax problem; that is finalized," an aide to Senate Minority Leader Mitch McConnell told ABC News.


Both sides remained at odds over what to do about the other significant piece of the "fiscal cliff" -- the more than $1 trillion of automatic cuts to defense and domestic programs set to begin tomorrow.


The White House has proposed a three-month delay of the cuts to allow more time to hash out details for deficit reduction, while many Senate Democrats want a flat one-year delay. Republicans insist that some spending cuts should be implemented now as part of any deal.






Chip Somodevilla/Getty Images













"In order to get the sequester moved, you're going to have to have real, concrete spending cuts," Rep. Mike Rogers, R-Mich., said. "[Without that], I don't know how it passes the House."


Vice President Joe Biden and McConnell, R-Ky., have been locked in behind-the-scenes negotiations for much of the day, sources said, following several "good" conversations that stretched late into Sunday night.


If a deal is reached between Biden and McConnell, members in both chambers would still need to review it and vote on it later today. Passage is far from guaranteed.


"This is one Democrat that doesn't agree with that at all," Iowa Democratic Sen. Tom Harkin said of the tentative deal. "No deal is better than a bad deal, and this looks like a very bad deal the way this is shaping up."


"I don't see how you get something voted on today," Rogers said. "Even if they get a handshake deal today, you have to put the whole thing together and that's probably not going to happen before midnight. So it would make sense to roll into tomorrow to do that."


Failure of Congress to act on a tax measure by Tuesday morning would trigger income tax hikes on all Americans. The average family would pay an extra $3,446 in 2013 under the higher rates, according to the Tax Policy Center.


Regardless of the "cliff," virtually all workers are due to see less in their paychecks starting in January when the temporary 2 percent payroll tax cut will expire.


More than $1 trillion in automatic spending cuts to defense and domestic programs will also begin to take effect later this week unless Congress delays or replaces them.


"It is absolutely inexcusable that all of us find ourselves in this place at this time," Sen. Joe Manchin, D-W.Va., said Sunday night on the Senate floor.


"Something has gone terribly wrong when the biggest threat to our American economy is our American Congress," he said, echoing a frustration shared by many Americans.


Both sides say the cost of failure is high.


"If we are not able to reach an agreement, it will be dire," Sen. Jon Kyl, R-Ariz., said Sunday on ABC's "This Week." "Probably at least another million jobs lost, an unemployment rate over 9 percent, and putting us back into recession."



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C. Africa's pressured leader open to unity government






BANGUI: The president of the Central African Republic was on Sunday said to be ready to make important concessions to a rebel coalition that has easily pushed its way across the impoverished country and was within striking distance of the capital Bangui.

After meeting with President Francois Bozize, African Union chief Thomas Boni Yayi said Bozize was ready to take part in talks to end the crisis, and that he would not run for president in 2016.

The talks "should lead to a national unity government", Boni Yayi said, adding that Bozize, who seized power in a 2003 coup and then won two elections, would not run for re-election in 2016 and would "respect constitutional provisions".

Opposition figures have criticised the president, whom they suspect wants to modify the constitution to enable a third term in office.

Rebels from a coalition known as Seleka, who took up arms December 10 near the Chad border and have met little resistance from government troops, on Sunday warned they could enter Bangui.

The rebels, now controlling five regional capitals in the centre and north of the country, faced no opposition as they entered the town of Sibut around 150 kilometres from Bangui on Saturday, a military official told AFP.

The country's armed forces had retreated to Damara, the last major town on the way to the capital, about 75 kilometres to the southwest.

Rebel spokesman Eric Massi on Sunday had said rebels would enter Bangui "if the situation demands it" but later said he had "taken note" of Bozize's pledges.

"A meeting shall be held with (Boni Yayi) to study in detail President Bozize's proposals and together create a plan to end the crisis," he told French radio.

With the rebels closing in, the Economic Community of Central African States (ECCAS), which has troops in the country, warned both sides Sunday that Damara must remain in government control.

"The ECCAS forces are on maximum alert, and the city of Damara is the line not to be crossed. We ask the FACA (government forces) and the rebels not to advance from their current positions and to give talks a chance," said Antonio Di Garcia, head of the regional bloc's mission, on national radio.

The rebels have been insisting on Bozize's departure.

"That issue must be discussed with the African Union," Massi told AFP. "President Bozize must recognise his military defeat on the ground ... and draw the necessary conclusions".

Officials on both sides said the rebels had also repelled army soldiers trying to recapture Bambari, a former military stronghold in the landlocked country, one of the world's poorest despite vast mineral wealth.

The coalition of three rebel movements in Seleka -- or the "alliance" in the Sango language -- launched their offensive claiming the government failed to meet the terms of peace pacts signed in 2007 and 2011, which include providing for disarmament, pay and social reintegration for insurgents.

Bozize on Sunday asked for a meeting with French President Francois Hollande, but calls for help from former colonial power France, as well as from the United States, have so far not been heeded.

France has a military presence of about 580 troops in the country, 180 of whom arrived overnight Saturday, the French defence ministry said.

This contingent is on hand to help protect and evacuate French and European nationals, should the need arise.

Hollande late Sunday urged all sides involved in the conflict to end hostilities, and welcomed efforts to find a negotiated solution to the crisis.

Neighbouring Chad, which helped Bozize with rebellions in 2010, has sent a contingent to the country, but those troops too have retreated from the rebel advance.

In Bangui, the population was fearful of a rebel attack and the uncertainty has caused a sharp spike in food prices. Authorities have imposed a night-time curfew, resulting in an eerie quiet in the usually noisy city.

In the town centre, businesses had hired guards armed with machetes to stand watch and prevent looting.

"I'm afraid of the rebels coming," said vegetable vendor Euphrasie Ngotanga in the city's huge Sambo market. "We're not going to sell our produce if there's no peace. And then how we will feed our children?"

The landlocked Central African Republic, with a population of about five million, is notorious for unrest including coups, army mutinies and rebellions.

- AFP/jc



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Don't take my daughter away from me, let her remain with me: Nirbhaya's mother

NEW DELHI: After nearly two weeks of watching their daughter fight a losing battle for her life, family members of the gang-rape victim had less than four hours to attend to VVIPs and arrange for her final rites.

They arrived at IGI Airport with her body at 3.30 am and by 7.30 am the last rites were completed.

Half-an-hour was spent meeting Prime Minister Manmohan Singh and Congress president Sonia Gandhi at the airport and another 30 minutes to rush the body home in a cavalcade of police vans.

Between 4.30 am and 6.30 am, the parents met their relatives at home and made arrangements for the last rites. The funeral procession of the braveheart was restricted to a distance as long as only five houses.

The mother of the 23-year-old woman fainted several times after the body was brought to their family home. "Meri bachchi ko mere paas rehne do, usey mujhse door mat karo (don't take my daughter away from me, let her remain with me)," cried out the distraught mother as the body of her young daughter was being taken to the crematorium.

The family was asked to rush to the crematorium in an ambulance after that and the relatives and neighbours were packed into two mini vans.

At 6.45 am, when the body reached the crematorium, it was dark. The pyre was prepared in torchlight and with the help of searchlights carried by the policemen.

The Congress MP from the area, Mahabal Mishra, and his supporters could be seen 'helping' the parents in arranging things for the last rites like the wood and even calling in the mourners, which included union minister of state for home affairs R P N Singh and chief minister Sheila Dikshit among others.

The funeral pyre was lit at 7.30 am by the victim's father. "I have lost everything I had. My daughter..," the bereaved father cried. The victim's younger brother was inconsolable.

State BJP president Vijender Gupta, Matiala councillor Rajesh Gehlot and BJP leader Jagdish Mukhi also paid a brief visit to the bereaved parents.

The crematorium was guarded by over 500 policemen, including BSF jawans. Almost all senior police officers from the area, including DCP, South, Chhaya Sharma, Joint CP, South-West, Vivek Gogia, and DCP airport J S Deswal, were present at the venue while the last rites were being performed.

"We did know that the deceased was the one we were hearing about on news channels. Her family had told everyone that she met with an accident. But now everyone knows thanks to heavy police deployment in the area and the visits by VVIPs. Last night, some policemen had come to the locality to put up barricades around 8 am and they also told us not to allow any mediaperson into the home for shooting videos," said a neighbour.

The police officers, who did not want to be named, justified the deployment, saying they did not want to take any chances as there were fears of some mischief-makers trying to incite violence.

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Kenya hospital imprisons new mothers with no money


NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.


Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.


Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.


"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."


"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."


The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.


Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.


"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.


She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.


A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.


"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.


Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.


One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.


Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.


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Associated Press reporter Tom Odula contributed to this report.


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President Suggests Small 'Cliff' Deal Likely


With less than two days remaining for Congress to reach a budget agreement that would avoid the so-called “fiscal cliff,” President Obama today suggested that a small deal remains the best hope to avoid the perilous package of spending cuts and tax increases.


In an interview aired this morning on NBC’s “Meet the Press” the president said if Republicans agreed to raising taxes on top income earners it should be enough to avoid the triggers that would execute the $607 billion measure. Economists agree that going over the cliff would likely put the country back in recession.


“If we have raised some revenue by the wealthy paying a little bit more, that would be sufficient to turn off what’s called the sequester, these automatic spending cuts, and that also would have a better outcome for our economy long-term,” he said.


Saying the “pressure is on Congress to produce,” the president did not specify what income level his party would deem acceptable as the cutoff for those who would see their tax rates remain at current levels. The president has called for expiration of the “Bush-era” tax cuts to affect household earnings over $250,000 since the campaign, but has reportedly floated a $400,000 figure in past negotiations. Speaker John Boehner once offered a $1 million cut-off in his failed “Plan B” proposal, which failed to garner enough support among the House Republicans.


“It’s been very hard for Speaker Boehner and Republican Leader McConnell  to accept the fact that taxes on the wealthiest Americans should go up a little bit as part of an overall deficit reduction package,” the president said.


Domestic programs would lose $55 billion in funding should sequestration pass, including $2 billion to Medicare and unemployment benefits. The Pentagon would take a $55 billion loss as well, or 9 percent of their budget.


Repeating remarks he made Friday after a meeting with congressional leaders, Obama said that should negotiations fail he has asked Senate Majority Leader Harry Reid, D-Nev., to introduce a stripped- down proposal to Congress for a straight up-or-down vote – if it isn’t blocked.


“If all else fails, if Republicans do in fact decide to block so that taxes on the middle class do in fact go up on January 1, then we’ll come back with a new Congress on January 4, and the first bill that will be introduced on the floor will be to cut taxes on middle-class families,” he said of the worst case scenario. “I don’t think the average person is going to say, ‘Gosh, you know, that’s a really partisan agenda.’”


The interview was taped Saturday while Reid and his GOP counterpart Sen. Mitch McConnell of Kentucky scrambled to their offices for a solution behind closed doors. Press staking out Capitol Hill reported little public activity from the leaders or their surrogates. If negotiations are successful, the lawmakers could introduce a bill for vote this afternoon.


Republican leaders bit back at the president’s remarks. In a written statement Speaker Boehner said casting blame was “ironic, as a recurring theme of our negotiations was his unwillingness to agree to anything that would require him to stand up to his own party. ”


“In an effort to get the president to agree to cut spending – which is the problem – I put revenues on the table last year, and I put them on the table again last month,” he wrote. “Republicans made every effort to reach the ‘balanced’ deficit agreement that the president promised the American people, while the president has continued to insist on a package skewed dramatically in favor of higher taxes that would destroy jobs.”


Senator McConnell’s office issued this response to the NBC appearance:


“While the President was taping those discordant remarks yesterday, Sen. McConnell was in the office working to bring Republicans and Democrats together on a solution. Discussions continue today.”


Regardless of outcome, talk of a comprehensive budget deal is gone and any bill would likely set up a series of smaller partisan roadblocks in the weeks and months to come. For example, if any hypothetical legislation managed to dodge tax increases for the middle class it may still not address the looming debt ceiling, which Treasury can avoid using accounting tricks for approximately two months.


A small deal may also not address the estate tax, another central point of the brinkmanship. Currently standing at 35 percent, Republicans want to leave that rate as-is after exempting the first $5 million in estate value. Meanwhile Democrats have called for a 45 percent tax after a $3.5 million exemption. Should negotiations fail, it would climb to 55 percent after a $1 million exemption after the New Year.


ABC’s Sunlen Miller and the Associated Press contributed to this report, which has been updated.

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Syria opposition leader rejects Moscow invitation


ALEPPO PROVINCE, Syria/BEIRUT (Reuters) - Syria's opposition leader has rejected an invitation from Russia for peace talks, dealing another blow to international hopes that diplomacy can be resurrected to end a 21-month civil war.


Russia, President Bashar al-Assad's main international protector, said on Friday it had sent an invitation for a visit to Moaz Alkhatib, whose six-week-old National Coalition opposition group has been recognized by most Western and Arab states as the legitimate voice of the Syrian people.


But in an interview on Al Jazeera television, Alkhatib said he had already ruled out such a trip and wanted an apology from Moscow for its support for Assad.


"We have clearly said we will not go to Moscow. We could meet in an Arab country if there was a clear agenda," he said.


"Now we also want an apology from (Russian Foreign Minister Sergei) Lavrov because all this time he said that the people will decide their destiny, without foreign intervention. Russia is intervening and meanwhile all these massacres of the Syrian people have happened, treated as if they were a picnic."


"If we don't represent the Syrian people, why do they invite us?" Alkhatib said. "And if we do represent the Syrian people why doesn't Russia respond and issue a clear condemnation of the barbarity of the regime and make a clear call for Assad to step down? This is the basic condition for any negotiations."


With the rebels advancing steadily over the second half of 2012, diplomats have been searching for months for signs that Moscow's willingness to protect Assad is faltering.


So far Russia has stuck to its position that rebels must negotiate with Assad's government, which has ruled since his father seized power in a coup 42 years ago.


"I think a realistic and detailed assessment of the situation inside Syria will prompt reasonable opposition members to seek ways to start a political dialogue," Lavrov said on Friday.


That was immediately dismissed by the opposition: "The coalition is ready for political talks with anyone ... but it will not negotiate with the Assad regime," spokesman Walid al-Bunni told Reuters. "Everything can happen after the Assad regime and all its foundations have gone. After that we can sit down with all Syrians to set out the future."


BRAHIMI TO MOSCOW


Russia says it is behind the efforts of U.N. mediator Lakhdar Brahimi, fresh from a five-day trip to Damascus where he met Assad. Brahimi, due in Moscow for talks on Saturday, is touting a months-old peace plan for a transitional government.


That U.N. plan was long seen as a dead letter, foundering from the outset over the question of whether the transitional body would include Assad or his allies. Brahimi's predecessor, Kofi Annan, quit in frustration shortly after negotiating it.


But with rebels having seized control of large sections of the country in recent months, Russia and the United States have been working with Brahimi to resurrect the plan as the only internationally recognized diplomatic negotiating track.


Russia's Middle East envoy, Deputy Foreign Minister Mikhail Bogdanov, who announced the invitation to Alkhatib, said further talks were scheduled between the "three B's" - himself, Brahimi and U.S. Undersecretary of State William Burns.


Speaking in Damascus on Thursday, Brahimi called for a transitional government with "all the powers of the state", a phrase interpreted by the opposition as potentially signaling tolerance of Assad remaining in some ceremonial role.


But such a plan is anathema to the surging rebels, who now believe they can drive Assad out with a military victory, despite long being outgunned by his forces.


"We do not agree at all with Brahimi's initiative. We do not agree with anything Brahimi says," Colonel Abdel-Jabbar Oqaidi, who heads the rebels' military council in Aleppo province, told reporters at his headquarters there.


Oqaidi said the rebels want Assad and his allies tried in Syria for crimes. Assad himself says he will stay on and fight to the death if necessary.


In the rebel-held town of Kafranbel, demonstrators held up cartoons showing Brahimi speaking to a news conference with toilet bowls in front of him, in place of microphones. Banners denounced the U.N. envoy with obscenities in English.


DIPLOMATS IMPOTENT


Diplomacy has largely been irrelevant to the conflict so far, with Western states ruling out military intervention like the NATO bombing that helped topple Libya's Muammar Gaddafi last year, and Russia and China blocking U.N. action against Assad.


Meanwhile, the fighting has grown fiercer and more sectarian, with rebels mainly from the Sunni Muslim majority battling Assad's government and allied militia dominated by his Alawite sect, an offshoot of Shi'ite Islam.


Still, Western diplomats have repeatedly touted signs of a change in policy from Russia, which they hope could prove decisive, much as Moscow's withdrawal of support for Serbian leader Slobodan Milosevic heralded his downfall a decade ago.


Bogdanov said earlier this month that Assad's forces were losing ground and rebels might win the war, but Russia has since rowed back, with Lavrov last week reiterating Moscow's position that neither side could win through force.


Still, some Moscow-based analysts see the Kremlin coming to accept it must adapt to the possibility of rebel victory.


"As the situation changes on the battlefield, more incentives emerge for seeking a way to stop the military action and move to a phase of political regulation," said Dmitry Trenin, director of the Carnegie Moscow Center.


Meanwhile, on the ground the bloodshed that has killed some 44,000 people continues unabated. According to the pro-opposition Syrian Observatory for Human Rights, a monitoring group based in Britain, 150 people were killed on Thursday, a typical toll as fighting has escalated in recent months.


Government war planes bombarded the town of Assal al-Ward in the Qalamoun district of Damascus province for the first time, killing one person and wounding dozens, the observatory said.


In Aleppo, Syria's northern commercial hub, clashes took place between rebel fighters and army forces around an air force intelligence building in the Zahra quarter, a neighborhood that has been surrounded by rebels for weeks.


(Additional reporting by Omar Fahmy in Cairo, Dominic Evans in Beirut and Steve Gutterman and Alissa de Carbonnel in Moscow; Writing by Peter Graff; Editing by Giles Elgood)



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China sets date for 12th National People's Congress






BEIJING: China has fixed March 5, 2013, as the date it will convene a key legislative session, state media reported Friday, with new Communist Party chief Xi Jingping set to become president during the two-week meeting.

The date for the start of the first annual session of the 12th National People's Congress (NPC) was approved at an NPC Standing Committee meeting Friday, the official Xinhua news agency reported.

The announcement comes after the Communist Party in November chose current Vice President Xi to take over the reins of the ruling party from current President Hu Jintao.

That was the first step in China's highly choreographed once-a-decade leadership transition that sees the party change leaders first, with state positions, including president, premier and other key posts, filled at the NPC several months later.

Xi is set to be formally selected as president during the NPC session, while Li Keqiang, another top party official, is slated to become premier, replacing Wen Jiabao, the positions's current occupant.

Xinhua said the legislative session would last about two weeks and would also deal with other important matters including approving a draft plan on national economic and social development for next year.

The announcement of the start of the next NPC comes after November's party congress, which had been expected some time in October, was delayed amid an internal party scandal involving disgraced politician Bo Xilai.

Bo, the former party boss in the central mega-city of Chongqing, was once seen as a candidate for promotion to the party's top echelons but was brought down by murder allegations against his wife that came to light after his police chief sought refuge in a US consulate.

Gu Kailai, Bo's wife, was later given a suspended death sentence -- a judgment commonly commuted to a life sentence -- for fatally poisoning British businessman Neil Heywood.

Bo has been formally expelled from the party and is in custody awaiting trial for alleged corruption and abuse of power.

The months-long controversy exposed deep divisions in the party's top leadership ahead of the sensitive power transition, as Bo had influential patrons and a following among left-leaning members.

-AFP/ac



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After weapons, Army jawans’ combat kit now set for a major upgrade

NEW DELHI: Along with new assault rifles and other weaponry in the pipeline, the Army jawans are now getting set for a complete makeover in their clothing and personal kits to boost their operational efficiency.

From new backpacks and ammunition pouches to sneakers and improved mosquito nets, Army chief General Bikram Singh has initiated or cleared several such acquisition projects. Till now, only the around five lakh or so infantry soldiers were entitled to get "improved combat kits" (ICKs) but the approved plan is to issue it to the entire 11-lakh strong Army. "Composed of new small and large backpacks, ammunition pouches, belts, water bottles and the like, the ICKs will also be issued to the other arms over the next five years. Each ICK costs around Rs 4,900," said an officer.

Similarly, the Army will soon float a new tender to acquire eight lakh Reebok or Adidas-like sneakers to replace the thin brown canvas PT shoes currently issued to soldiers. Despite attempts to upgrade the PT shoes to proper "sports shoes" over the last several years, the project was stuck in bureaucratic red-tape till now, as reported by TOI earlier.

"The technical specifications for the sneakers, made of a mix of leather and synthetic mesh, have been finalised after trials. Each such sneaker will cost around Rs 900-1,100," he said. The vintage-pattern canvas PT shoes, incidentally, have been in service for over 50 years without any improvement in quality. The Army also wants to introduce specially-designed combat boots for soldiers that will be more durable, flexible and light-weight than the existing heavy boots.

The Army has also decided to issue cloth, manufactured by ordnance factories, and an Rs 225 allowance to get it stitched as per their size and shape to soldiers to bring homogeneity in uniforms. Jawans will also get new "long-lasting insecticidal nets" instead of the old mosquito nets they have been making do with till now.

"Soldiers will also be issued multi-purpose ponchos to replace the rain capes/rain coats they have at present. The quality of blankets, much lighter and with more fine-grade wool, is also been improved," he added.

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Kenya hospital imprisons new mothers with no money


NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.


Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.


Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.


"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."


"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."


The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.


Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.


"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.


She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.


A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.


"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.


Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.


One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.


Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.


___


Associated Press reporter Tom Odula contributed to this report.


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