Wednesday, August 21, 2013

Why We Should Raise the Minimum Wage

  From the very start the minimum wage has been a politically contentious idea.  Republicans have always opposed the concept from the very start on Libertarian grounds that an employer should have the freedom to pay a worker anything he can if the worker will accept that wage.  Democrats take a more utilitarian view of the minimum wage, at least this Democrat does.  We tend to feel that a minimum wage that allows a worker to live above the poverty level provides the greatest good for the greatest number of people and is beneficial for the economic well being of our country.
   The minimum wage is a relatively recent development in history.  The first country to adopt it was New Zealand in 1894 and were enforced by compulsory arbitration.  In 1896 some states in Australia passed a minimum wage law for selected industries where the pay was considered to be too low.  After looking at their minimum wage laws on March 24, 1909 young Winston Churchill introduced the Trade Board Act and it went into effect in January, 1910.
   Even though Churchill was a conservative Tory his rational in support of a minimum wage was brilliant.  “It is a national evil that any class of Her Majesty’s subjects should receive less than a living wage in return for their utmost exertions … where you have what you call sweated trades, you have no organization, no parity of bargaining, the good employer is undercut by the bad and the bad by the worst.  The worker whose whole livelihood depends upon the industry, is undersold by the worker who only takes up the trade as a second string.  Where those conditions prevail you have not a condition of progress, but a condition of progressive degeneration.”
   Most of Europe either has a minimum wage or there are arbitration boards, unions and employer groups that work together to see that pay is not too low and to avoid strikes.
   It wasn’t until 1938 when Franklin Roosevelt and the Democrats enacted a national minimum wage law to help bring working families out of poverty so they would have money to spend to stimulate a destitute economy.  In the 1960’s as part of the Alliance for Progress many Latin American countries adopted minimum wage laws, however since they were too low they did little to move the working poor into the middle class.
   Ezra Klein published a graph on the internet that tracks labor’s share of income and corporate profits since 1970.  It clearly shows that labor’s share of the money has gone down slightly while corporate profits have soared.  Even though there was a sharp down in corporate profits during George W. Bush’s first term and the economy nearly collapsing late in his second term corporate profits have exceeded what labor makes for the first time.
   In President Obama’s 2013 State of the Union Address he said “We gather here knowing that there are millions of Americans whose hard work and dedication have not been rewarded.  Our economy is adding jobs - but too many people still can’t find full-time employment.”
   Yet, this situation seems fine to Republicans who complain about high unemployment but refuse to compromise with the President to pass a jobs bill.  George W. did sign an increase in the minimum wage, not out of conviction but out of political expediency.  He didn’t want his party to lose seats in the next election.
   Republicans trot out the same arguments every time we have this debate about the minimum wage.  Their first one is always that its going to cost jobs, as if they actually care about the working poor.  It might really cost a few low wage jobs temporarily but the figures tent to show that the improvement in business growth due to more people getting out of debt and having money to spend eventually creates more good paying jobs.  The minimum wage has been raised 17 times and 14 times in the following year GDP has grown.  Of those three times it didn’t  there were other contributing factors such as the Arab Oil Embargo.  Ignoring the strong correlation between higher wages for the working poor and economic growth Republicans never make this point.
   Another argument is that companies will move their operations overseas where labor is cheaper.  Yes, they have been doing that sort of outsourcing for a long time now and the result of those actions has been to hurt the quality of life here while exploiting people in others countries.  Republicans idealize corporations as the engines of employment, but when they choose the bottom line as their only goal their priorities become paying employees as little in possible in wages and benefits. There is nothing to admire in a company that doesn’t strive for the common good.  Fortunately this is not true of all corporations since many are run by human beings with a conscience.  Far too many companies pay no tax at all. We should find ways to penalize companies that try to game the system and limit the political power that gives them unfair and undeserved advantages.
   Their other argument against allowing an increase in the minimum wage is a rather specious one; in that it raises the cost of goods we buy.  This is the WalMart argument that low prices are great even when they drive people into poverty, where they have to live on food stamps and end up in the emergence room because they don’t have health insurance.  It’s the high cost of low prices.  Maybe I’m an old softy but I think paying just a little bit more is worth it if an American family can survive on a paycheck.
   Here are some reasons why a raise in the minimum wage is good.  People earning minimum wage have very little bargaining power to get a raise from their employer.  Out of simply fairness the government needs, from time to time, step in and adjust the minimum wage for inflation.
   We could reduce the number of people on food stamps, not by just cutting them off like Republicans want to do, but because many would no longer need them. Communities would be stronger and people would be less likely to resort to crime.  We have the highest incarceration rate in the world with 5% of the world’s population and we have 25% of the world’s prisoners.
   If you look at the states with no minimum wage you see a lot of poor southern red states like Alabama, Mississippi, Louisiana and South Carolina with no minimum wage and Georgia with the lowest at $5.15.  These are the states where poverty is severe and would benefit most.  About 28 million Americans would get a pay raise and improve their quality of life and that of their families.  Women and children would be the primary beneficiaries of a raise in the minimum wage.  With the gap between the top 1% and the bottom 80% continually widening we need to urgently address this problem or our social fabric will continue to disintegrate.  Raising the minimum wage is a good start, but America was much fairer and more equal when the top tax rates were much higher.  It is past time for our party to stand up and insist that we stop robbing the poor to give to the rich.
   If there is a California ballot initiative to raise the minimum wage, and there very likely will be, I will vote for it.

       Dave Silva

Tuesday, August 20, 2013

I've Got a Secret

I’ve got a secret
And you can’t tell
And if you don’t keep it
You’ll go straight to hell
Ships sunk by your loose lips
Will rise as ghosts from the water
And haunt your nightly dreams
As, of course, they oughter
‘Cause secrets it always seems
Are more dramatic
When made by a fanatic
And who are we to know
If your claims will blow
A ship or fantasy to bits
Or simply hide your bloody mitts

There have been so many cases of secrets in the news lately that I felt it was time to review the whole concept of secrets.  Why do we have them anyway?  We encode so much of our lives that we have passwords for entering passwords.  We have individuals keeping secrets.  We have nations protecting secrets and we have everything in between creating and protecting secrets.  Some secrets seem to be important while others seem to be self-serving protection from embarrassment.  Our national security is important.  If you remember My Lai from our excursion into Vietnam, however, that entire episode of depravity and brutal mass murder was classified Secret by The US Army.  Was it classified to prevent leaking tactical or strategic information to the enemy?  Hmm.  No.  It was classified because we were embarrassed by the criminal behavior of Lt. William “Rusty Calley” and the dozens of officers who attempted to cover up the incident.  Incidentally, if you would like to review the way we handled My Lai, read a copy of the Congressional Record of the testimony.  It is chilling for the phobic dismissal of the facts and the acceleration of the process to get past it rather than investigate. 

(Then) Major Colin Powell went on to bigger and better things after his role in the “investigation.”  Perhaps the Peter Principle was on overdrive for Powell or perhaps he was rewarded for loyalty.  Surely he was not punished for spinning a massive massacre into a minor incident.  PFC Manning, on the other hand released some 700,000 classified documents and he can expect to spend the rest of his life in prison.  It was not a cover up and, even by generous description; many of those documents were sensitive to the security of these United States.  That is a violation of trust as well as a violation of law.  Richard Nixon pardoned Calley within a few weeks of his conviction by Court Martial at Fort Benning, Georgia.  Other participants in the massacre were never convicted and none were charged with the cover up.  I reveal this not to exonerate Manning who has “gender identification disorder,” but to illustrate the fragile construct of a secret.  Manning’s actions cost our government and our people dearly in terms of security.  Our security was never a question in the murder and cover up of My Lai.  Our national self-esteem was in question.  Wikileaks leader and accused rapist Julian Assange also takes pride in revealing secrets that put us in jeopardy, but revealing the truth merely verifies the secrets disclosed.  Similarly Edward Snowden revealed NSA secrets and then called himself a “whistleblower.”  The nature of secrets is such that proving they were critical verifies the secrets even while the methods for collecting information by the government can be deplored.  This destroys the fabric of trust both ways.

We have still other kinds of secrets that should be troubling to society.  A few months ago, the Hallowich family was offered $750,000 to remain silent on the impact of fracking on their home and family.  This will allow them to relocate under the court order that they cannot EVER reveal their specific health facts, etc., to anyone.  The order extends to their 6 and 7 year old children.  The court order for secrecy seems to exchange protection of one family for the jeopardy of all others.  The gag order by courts amounts to official support of secrecy under serious penalties by our court system in a way that cannot help the community at large.  In fact, even the investigation of fracking damage is specifically hindered by the practice of allowing energy companies to conduct fracking while calling their chemical compounds “proprietary.”  In other words, you cannot prove my fracking compounds are in your water because the court protects the secret as a commercial necessity.  “Trust me, your water may be on fire and you may suddenly become ill, since we began fracking operations, but we did not have anything to do with it.”   Now why would any commonwealth including the Commonwealth of PA disregard the common good for the commercial secrecy of solvents used in fracking?  This curious silence of the lambs is hardly scientific since it prohibits research and threatens the unaware.  I know.  “Corporations are people, my friend.”  (Presidential candidate Romney)  So we are merely protecting one person (the corporation) over other persons (the kind that eat, breathe and drink).  As an exception in Pennsylvania, physicians are allowed to know the contents of fracking fluids, but they are forbidden to inform patients.  Just so that you don’t get the impression that we know nothing of the fracking fluids, we know that water is essential to all of them.  In Barnhart, Texas that once had a common well for the town, there is no more water for consumers.  It is all used for fracking and the town has gone dry in the literal sense of the word.

I cannot leave the impression that fracking is the sole medical issue related to secrets.  Our laws protecting proprietary drug information also protect the corporation rather than the consumer.  One simple example relates to the products Prilosec and Nexium.  Both products are made by Zeneca, Inc., but in order to maintain a competitive edge in the antacid market, Zeneca conducted tests using 40 mg of Nexium versus 20 mg of Prilosec and advertised the superiority of its newer product to avoid the impact of generic imitators of Prilosec.  Shh.  It’s a secret to make money.  Unfortunately, there have been drugs like Vioxx that actually injured people before it was removed from the market.  The recall actually cost about $6 Billion mostly due to litigation, but the company (Merck) kept the test results secret.  Had Merck revealed that patients in the test suffered heart attacks instead of merely touting the value of Vioxx for arthritic pain, many injuries and deaths could have been avoided.  Yes, profit was the ultimate motive, but secrecy caused unnecessary pain and suffering.

We have other examples of secrecy being used to impede due process as when a corporation prohibits calling witnesses who could testify to the facts of a case or otherwise stifles open investigation.  Similarly, the military approach to sexual misconduct has been to keep all that information “inside the family,” rather than reveal the violations to the public.  Military commanders have long been evaluated by the number and severity of criminal convictions within their commands.  So, if a commander dismisses charges before they are fully investigated, there was no criminal activity, QED.  Let us reduce this to little misunderstandings or “he said, she said” kinds of inputs and there are no outputs.  Unfortunately for the military, sexual misconduct incidents have soared and secrecy simply does not work as a deterrent or a cure.  Look for outside review instead of command review as occurred for My Lai.

There have been significant abuses in the medical field.  Henrietta Lacks unknowingly, and without her permission, gave samples of her cancer, not for treatment but for research and profit.  Her cells have been bought and sold for billions of dollars while her family struggled with the basic expenses of life including healthcare.  The true purpose of their interest was not revealed to Henrietta, but was secret.  Unfortunately, Henrietta is dead and the secret earned her fame without compensation.   There have been secrets such as the results of testing the Chevrolet Corvair that allowed production and sale of an unsafe automobile.  The Corvair blew tires on nearly every test vehicle and sucked unhealthy amounts of carbon monoxide into the cabin.  The Ford Pinto had an unsafe gas tank that caused grisly injuries and death.  Those are harmful commercial secrets. Yet we see secrets used in our daily lives and often they are expected and harmless.  Priests hold confessions as secret.  Courts may hold certain items secret.  Diplomatic discussions are usually secret.  Medical records are usually secret.  Secrets can serve useful purposes when not used to hide unlawful or embarrassing information.  Our lives can be safer and more secure when secrets are handled properly.

There are many more secrets that you and I encounter in our daily living and dying, but there is one that only Congress would dare to create.  As of 25 July this year:  Today The Hill reported that Senators Max Baucus (D-Mont.) and Orrin Hatch (R-Utah), are working on a complete rewrite of the U.S. tax code, have assured their colleagues that any of their requests to preserve a loophole will be kept secret by the National Archives for 50 years. “Each submission will also be given its own ID number and be kept on password-protected servers, with printed versions kept in locked safes,” Until 2064.  Now let me think.  Why would any congressman be afraid that tax loopholes, if known, would damage our United States in any way?  Perhaps we know that the Congress is afraid that tax loopholes only protect the political and financial interests of congressmen and their special benefactors and that if we knew the truth during their lifetimes that their exalted elected positions would be at risk.

It is this distortion of purpose that should get us angry enough to demand the truth and the elimination of secrets that enrich and empower the few highly placed people in our economic and political systems.  These are the people who are charged with our common good even while they instead serve themselves.

George Giacoppe
20 August 2013

The Ghost in your Genes

The Ghost in Your Genes is a 50-minute documentary produced by the BBC in 2006 ( It elucidates something astonishing about inheritance that counters what we have been taught in recent years—i.e. that our approximately 30,000 genes control everything about who we are. Instead, we learn that the lives of some of our forebears—what they ate, what they breathed, perhaps even what they saw—can directly affect us years later. In other words, though we get our genes directly from our parents and grandparents via sperm and egg, we are also affected by their experiences—which can determine which of our genes are expressed, and how. The latter is a short version of what is now called “epigenetics”—changes in the genome that do not involve structural changes or mutations in the genes themselves, but rather in how existing genes are expressed and at what level. As Dorothy Roberts explains in her excellent work, Fatal Invention, where she referred to The Ghost in Your Genes, “Scientists call each epigenetic change a mark, and the total set of epigenetic marks in an organism are the epigenome.” Most importantly, the “epigenome can be modified by the environment,” and those changes can last beyond a single life. Hence, not only what our grandparents were genetically, but even what they experienced can affect us many years later.

            This is (or was when it was discovered) truly paradigm-shifting stuff, because it means that the environment, the conditions that we all experience, can be passed on to our offspring and to their offspring. If we undergo certain kinds of stress—and scientists have already done research on the effects on unborn children of parents going through the horror of Nazi concentration camps, the collapse of the Twin Towers on 9/11, the effects of famines and pesticides—those stressors can affect our unborn heirs years later. We are not born with a blank slate of genes, protected from outside influence in their cozy DNA packets, as scientists once thought. We are also born with the experiences of generations that preceded us, experiences that can, and often do, leave their epigenetic marks. And if those who commit atrocities such as the bombings of Hiroshima and Nagasaki or the 400-year horror that was slavery and then Jim Crow and now mass incarceration in the allegedly free and equal United States of America—if they think that their evil is visited only upon those who directly experience it, then they must think again. For epigenetics is now telling us that the effects of evil (and good) actions are passed on to the generations.

            The Ghost in Your Genes starts out with the insight of a mild-mannered, and very appealing (he actually came near tears when explaining some of his discoveries) British geneticist named Marcus Pembrey, who noticed something strange in his work with children. He noticed that a rare genetic disorder, known to be caused by a deletion in a specific chromosome (#15), expressed itself differently depending on whether the gene came from the father or the mother. If the father passed the deletion on, the child was afflicted with Prada villi syndrome—a condition marked by severe overweight. If the mother passed it on, the child was afflicted with Angelman’s syndrome, a condition where children lack speech but seem exceptionally happy. Pembrey was shocked by this: the exact same genetic deletion resulted in two wildly different expressions in the human body. In the documentary, Pembrey says, “It was as if the genes knew where they came from.” This was unprecedented and altogether unexpected. Pembrey wrote up his results and published them, but received little response. Until one day he received an email from a researcher, Oluv Bygren, doing work in a remote town in Sweden near the Arctic Circle, which had the peculiarity that its archives recorded not only births and deaths, but also conditions in the lives of the people involved, particularly relating to the harvests. This was because being so remote, the harvests were critical: too little grain and there would be famine. Pembrey and Bygren subsequently were able to match the records of the recurring famines that occurred due to natural climate fluctuations with the deaths of inhabitants—specifically death from diabetes. To their great joy as scientists, they were able to plot the births during famines with records of death from diabetes, to find almost perfect matches over the years. In other words, if a woman gave birth during a famine year, her child would be more likely to later suffer from diabetes, and so would her grandchildren. The change in the expression of genes from an environmental event was passing on to subsequent generations. Prof. Michael Skinner, another researcher from the state of Washington, comments as follows:

What this means is: an environmental exposure that your grandmother had could cause a disease in you, even though you never were exposed to the toxin, and you will pass it on to your grandchildren. You are directly affected by the stress your grandmother experienced.

Again, this is astonishing stuff in light of the standard view of genetic inheritance, which says that genes pass untouched (except by mutation) from one generation to another; they are protected, essentially unaffected by our experience as individuals. But now, we must consider the contrary view that what we experience is, or can be passed on to not just one but several succeeding generations, to our biological heirs.

            Dr. Michael Pembrey calls this “genomic imprinting.” Genomic imprinting means that genes have a memory of where they came from—in the cases he first discovered, whether the gene deletion on chromosome #15 came from the mother or the father. This is one answer to the question sought by the researchers in the documentary: if the activity of genes is controlled by a switch, and if this switch controls the critical decision of whether a given gene is turned on or off—then what turns such genes on or off? To further answer this, the documentary shifts to a couple, the Mullins’, who after many years without a child turned to in vitro fertilization. It was successful and resulted in the birth of their first son, Keiran. But Keiran, even in the womb, showed signs that something was amiss: he displayed symptoms of something called Beckwith-Wiedemann syndrome. Such children tend to be very large, have protruding tongues, and have a tendency to develop cancerous tumors. It turned out that Keiran did have the syndrome, had several operations to fix some of the problems, and underwent recurring examinations for cancer. But the question was, what might have caused the disease? Another researcher named Wolf Reik came up with the answer, derived from his work with lab mice. Reik noticed that placing mouse embryos in a culture dish for a short time tended to affect the gene switch. He researched the records of babies with Beckwith Wiedemann’s and found the correlation: those who had been fertilized with IVF were 3 to 4 times more likely to have the syndrome. Something about altering the environment—having the embryo or the egg outside the womb—was causing an epigenetic change leading to the syndrome. Moreover, Reik found from experiments that mice with environmentally-altered gene switches also passed the condition on to several subsequent generations. Reik’s comment: “A simple environmental event could affect the way genes worked, and it could be passed on.”

            There is more to this splendidly informative documentary—including research on births to women pregnant during 9/11, indicating the affects of major stress on their offspring—so I recommend that anyone with even the slightest interest in the subject should watch it. What I would feel remiss in not mentioning, though, is one more episode, of lab research done by Dr. Michael Skinner of Washington. Skinner exposed pregnant rats to large doses of pesticides commonly used on our crops. Not unexpectedly, 85% of the exposed rats displayed symptoms of tumors, kidney damage, and immune dysfunction. What was unexpected was that after the third generation, the rats’ offspring showed the same degree of toxic effects: 85% of the third generation individuals were affected by tumors, kidney damage, and immune dysfunction! This was a new phenomenon in Skinner’s experience: an environmental toxin affecting not just the individual exposed, but extending its effects to several subsequent generations. The voice-over narrative made the point: “the exposure of a single animal to a toxin was causing a whole range of diseases in almost every individual of the following generations.”  And Skinner himself generalized as follows: “What your grandmother was exposed to when she was pregnant could cause a disease in you, even though you had no exposure, and you’re gonna’ pass it on to your grandchildren.”

            For Dorothy Roberts, and for us, these findings bear critical importance. What they mean is that the environment in which we live, and the stressors from that environment, can have direct and long-lasting effects on our bodies. Harvard biologist and public health expert Nancy Krieger has studied just this, and she calls it “embodiment:”

            “Embodiment to me refers to the many many, many different ways that we literally incorporate the world outside of us in us, in the expression of our biology….My focus is on how inequity becomes embodied and harms health.” (Roberts, p. 130)

Specifically, Krieger has studied the relationship between environmental stress and birth weight. In a 2004 study of 352 births, Krieger found that women reporting high levels of racial discrimination were almost five times (5X) more likely than those reporting no racial discrimination to deliver low-weight babies, and had three times (3X) the risk of preterm birth. In other words, stress leads to low birth weight, and low birth weight is often a predictor of such later-occurring maladies as diabetes, cardiovascular disease, and immune system dysfunction.  This is the key point that Dorothy Roberts emphasizes again and again: “Epigenetics may masquerade as genetic difference, but its biological effects stem from the environment, not mutations of the genetic code.” The new racism cloaked in the “objectivity” of science often, wittingly or not, takes part in this “masquerade.” Characteristics that have long been touted as an unalterable product of genetic difference—that is, the consequence of being born a certain race—are actually more often a product of the environment, which is to say, of society and the practices it dictates for the people it governs. It is a product of how people are treated—of what place they are allowed to occupy in a given society, of what access to that society’s goods they are allowed to have. And that treatment—particularly if it involves frequent humiliation and stress—affects not just them, but their offspring for generations and generations to come. When we reflect that even a single stressful event—such as 9/11—can affect generations of offspring, imagine what a lifetime or several lifetimes of stressors can do to a people’s epigenetic genome, to the way its genes are expressed.

            The good news, of course, is that environments can change. Societies can wake up to the burdens they are imposing on some classes of people. The only question is whether, and to what degree, a given society wishes to change, or if it wishes to perpetuate the epigenetic condemnation it imposes on its victims and their heirs in perpetuity. 

addendum, 8.16.13: A recent study at UCLA’s Cousins Center for Psychoneuroimmunology (see <> ) provides a fascinating gloss on the above discussion. Steven Cole and others, after many years studying the negative effects of stress on gene expression, studied the positive effects of happiness on gene expression (epigenetics). They studied two types of happiness: 1) eudaimonic well-being—the kind derived from having a deep sense of purpose and meaning in life; and 2) hedonic well-being—the kind that derives from self-gratification and pleasure. Though there is certainly overlap (both can be exhibited by people with strong social connections, and the presence of one can influence the other when people who “feel good” find more meaning in their lives), the differences when measured at the epigenetic level were striking. People with high levels of eudaimonic happiness displayed highly favorable gene expression in their immune cells: they had low levels of inflammatory gene expression, and powerful antiviral and antibody activity. People with high hedonic happiness, by contrast, had an opposite profile—one exhibiting high inflammation (the kind that can lead to cardiovascular and other diseases) and low antiviral and antibody gene expression. This despite the fact that, outwardly, eudaimonics and hedonics exhibited very little difference in their apparent emotional well-being.

            Professor Cole concludes that this study has important implications for the age-old question of what constitutes “the good life”: feeling good, or doing good. Though on the surface it appears that “feeling good” and “doing good” have the same effect on most people, at the level of health as measured by gene expression, they differ quite a bit. “Doing good” leads to a healthy immune system response, whereas “feeling good” can lead to the opposite. “Apparently,” says Cole, “the human genome is much more sensitive to different ways of achieving happiness than are conscious minds.” The genome may also provide a more “objective approach to moral philosophy rooted in the utility of health and the basic biology of human nature.”

            It is striking that this initial research displays a remarkable correlation with the wisdom traditions that have counseled human groups for millennia. As just one example, the Tibetan Buddhist teacher Matthieu Ricard, in his book on Happiness, advances a very simple and anti-modern formula. Happiness, he says, stems from serving others rather than from caring predominantly for oneself. Countless other spiritual teachers have said the same thing. Now, it appears, the heretofore inscrutable biology of the human genome seems to be supporting the same wisdom, this time from deep within the workings of the human body.

Lawrence DiStasi

Monday, August 12, 2013

The BiDil Scam

Of all the facts and figures in Dorothy Roberts’ book, Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century (New Press: 2011), the BiDil scam best gives the flavor of how this re-creation of race is being done. Targeting a serious health problem among African Americans—heart failure—the BiDil ‘inventors’ promoted a type of pill said to be specific for blacks. They thus not only tried to make a fortune on the misfortune of a downtrodden group, but also reinforced the idea that major illnesses are genetic—due to defective genes—rather than based in social and cultural deprivation. As Roberts argues tirelessly throughout the book, the current focus on genetic difference is just a new and more insidious way of establishing that racial differences, the concept of race itself, are real and biological rather than the product of societies that wish to justify their exploitation of some groups as biologically inferior.

Heart failure affects millions of Americans each year when the heart muscle, weakened by a heart attack, high blood pressure or infection, no longer pumps a sufficient supply of blood. Patients become weak, short of breath, and most die within five years of diagnosis. A cardiologist named Jay Cohn around 1970 hypothesized that vasodilators—drugs that relax blood vessels—might help as a treatment. The prevailing vasodilator, sodium nitroprusside, had to be administered by injection. Cohn came up with the idea of combining two generic vasodilators, Hydralazine and Isosorbide nitrate, into a single pill that could be taken orally. By helping the body make more nitrous oxide, the vasodilator combination would widen arteries and let more blood flow through. The key, though, is that no new drug was involved here. Cohn simply combined two already-available generics into a single pill, and patented them as a new drug for a new purpose. When he and other cardiologists ran a trial on 642 black and white patients, they found that the combination pill did lower the death rate. This was great news for Cohn initially. But then a new trial was conducted, this time comparing the effectiveness of the H-I combined pill with an “angiotensin-converting enzyme (ACE) inhibitor called enalapril.”  The study found that enalapril was even more effective than H-I at lowering the death rate, and these ACE inhibitors subsequently became the preferred treatment for heart failure.

Cohn at this point had no useful drug to peddle, but he wasn’t discouraged; after all, the era of making millions on a patented drug was in full swing. So Cohn filed a patent in 1989 for his combined H-I pill, not mentioning race, and then became partners with a biotech firm, Medco, to whom he licensed the property rights. In 1996, Medco applied to the FDA for a New Drug Application for the drug it christened BiDil, also never mentioning its efficacy or lack thereof for any particular race. Long story short, the FDA refused to approve the new drug, finding that the case for BiDil was not convincing. At this point, Medco gave up and returned the rights to Cohn, who was now in a bind. He had only 10 years left on his patent and he needed something to give it new life. Then he had another eureka moment: he decided to patent BiDil—which he had previously patented without regard to race—as a therapy specifically for African Americans. He and one of his researchers named Carson returned to the original data, broke down the statistics by race, and published the new results in the Journal of Cardiac Failure claiming that, based on their retrospective analysis of the original trial, “the H-I combination appears to be particularly effective in prolonging survival in black patients.” They also claimed that enalapril worked especially well with whites, and concluded that “therapy for heart failure might appropriately be racially tailored” (Roberts, p. 170).

Despite the clear problems with the small size of the test sample and the real possibility that other factors might have contributed to the different outcomes for whites and blacks, Cohn kept pushing, and in 1999 relicensed his intellectual property rights to yet another pharmaceutical company called NitroMed. The new patent submitted by Cohn and Carson stated that “the present invention provides methods for treating and preventing mortality associated with heart failure in an African American patient.” One of the great benefits of the new patent was that where his original patent was due to expire in 2007, the new one gave Cohn another 13 years, till 2020, of control over his drug. This was not because he had invented a new drug, but rather had reinvented “an existing therapy as race-specific.”

Cohn and NitroMed then went to the FDA to get approval for BiDil as a drug specifically for African Americans. The FDA said that if the applicants could prove in a specific trial that the drug worked specifically for African American patients, they might approve it. NitroMed and its CEO, Michael Loberg set out to raise the money for a drug trial, promising millions in revenues the very first year blacks started using the pill. Rather quickly, $34 million in financing showed up, with investors and even banks salivating at the prospect of such a bonanza. Thus, the African American Heart Failure Trial (A-HeFT) began in 2001. The trial included about 1000 African American men only (no whites or other groups) supplied mainly by the Association of Black Cardiologists, who were enthusiastic. Half the subjects received BiDil in addition to standard heart failure medicine, while half got only the standard therapies. The results were so positive for BiDil that the trial was stopped ahead of schedule; BiDil increased survival by as much as 43 percent. Loberg and NitroMed were ecstatic, releasing a report claiming that 750,000 diagnosed African Americans with heart failure (900,000 expected by decade’s end) would be using the drug for a projected income of nearly $1 billion.

BiDil’s chances were improved for FDA approval by the lobbying of many African American groups who saw the chance to finally have therapies, equal to white therapies, designed for black Americans. Even the Congressional Black Caucus urged approval. But the FDA was concerned about the lack of any real scientific evidence to support the claim that the drug worked specifically for blacks. Nor was there any control group of white or other groups for comparison to back up the claim. The FDA also said there was little precedent for designating a drug for any particular racial group: drugs tested on mostly whites were not designated “white drugs.” But with the chair of the FDA approval committee arguing in its favor, the FDA finally approved NitroMed’s application for BiDil, even without scientific much less genetic proof about why it worked for blacks. They were satisfied by the claim that there is an unknown physiological mechanism that explains how BiDil works, and race, blackness (specifically blacks self-identifying as African American), was perhaps a proxy or signal for that unknown factor—probably genes. Cohn and Carson in their patent application speculated along these lines, writing that “blacks, particularly with a hypertensive history, may have a greater deficiency of nitric oxide generation that is restored” (177) by their drug. In 2005, the FDA even claimed that its approval of BiDil was an important step towards the long-desired “promise of personalized medicine.”

In the end, however, even with FDA approval, BiDil failed; so did NitroMed, and so did Jay Cohn’s dream of making a fortune. Roberts says this by way of an initial explanation:

NitroMed did not make money from a drug that was developed to treat heart failure in black patients. It made money by converting a drug for heart failure into a drug for African Americans based on unsubstantiated claims about racial difference. (p. 185)
Here is how it broke down: even with the encouragement of the NAACP and the African American Cardiologist’s Association, only a mere 1% of those 750,000 black heart-failure patients bought prescriptions for BiDil. Part of it had to do with the price. BiDil pills were priced at $1.80 per pill, with a recommended dose of 6 pills daily. That would be $10.80 per day, or nearly $4,000 per year. That adds up to 4 to 7 times the price for the generic drugs of which it is made, so the insurance companies refused to pay the approximately $3,000 extra per year for BiDil compared to the identical two generics. So did Medicare part D and Medicaid. And they were right. BiDil was not a new drug; it was just a clever combination of two drugs already available in generic form! It was a drug that had not originally been targeted to black people or white people or any specific group. Only when the original FDA application failed did the ‘clever’ cardiologist named Jay Cohn come up with a new ploy: market it specifically to black people; and then show how it works; and then massage the marketing to appeal to the sense among African Americans that no one cares about their specific health problems; and Eureka, you’re a billionaire.

            Fortunately, BiDil and NitroMed crashed and burned. People of color were not so dumb after all; rather, they were suspicious from the get go. But it makes one wonder: how many other “miracle” drugs have been hatched and marketed the same way? In a pill-crazy culture like the United States, one would have to guess “a lot” (just think of all the statins taken by Americans desperate to reduce their cholesterol).  Sadly, though, the underlying problem exhaustively chronicled by Roberts is sure to recur. Race-based pharmaceuticals—what have been called pharmacogenics or pharmacoethnicity—are sure to return again and again. It’s as old as snake oil: there’s gold in them thar hills. And cardiologists—I know, having consulted them for some time now—and pharmaceutical companies are among the nation’s most avid and mercenary prospectors.

Lawrence DiStasi

Thursday, August 08, 2013

Boys and their Toys

Today is the anniversary of one of the blackest days in American, and world history: on August 6, 1945, President Harry Truman’s order to drop the newly-built Atomic Bomb on Japan was carried out. The city of Hiroshima was leveled, along with tens of thousands of human beings vaporized immediately, and more tens of thousands in the weeks, months and years to come. What’s important to note about this—and the story is told in chilling detail in The Untold History of the United States, by Oliver Stone and Peter Kuznick (2012)—is not simply the overwhelming devastation of a Japanese city, nor the radiation of thousands of human beings, nor the countless deformed births that resulted, but the pre- and post-history of that traumatic event. Because dropping that bomb and the one three days later that similarly destroyed Nagasaki, were completely unnecessary. The Japanese were already an utterly defeated nation. But the United States and its novice president, Harry S. Truman, were determined to force “unconditional surrender” from the Japanese—knowing, in fact, that the Japanese could not agree to such terms because it would mean deposing their god-like Emperor. The U.S. military knew this too, and several of its leaders—Secretary of War Henry Stimson, Secretary of the Navy James Forrestal, assistant Secretary of War John McCloy, and most generals—urged President Truman to change the surrender terms so Japan could agree to them. Also militating against using the A-bomb was the relentless firebombing of major Japanese cities starting on March 9 & 10, 1945 under the direction of General Curtis “Iron Ass” LeMay. On those dates, LeMay sent
“334 planes to attack Tokyo with incendiary bombs consisting of napalm, thermite, white phosphorus, and other inflammables. The bombs destroyed 16 square miles, killing perhaps 100,000 people and injuring close to a million…caused canals to boil, metal to melt, and people to burst into flames spontaneously. The victims, LeMay reported, were “scorched and boiled and baked to death.” (p. 157)
Nor was this all. The firebombing of Japan’s essentially ‘paper cities’ spread rapidly to over 100 sites, to the extent that in August there were no major cities left for the A-Bombs to hit. That’s why the obscure cities of Hiroshima and Nagasaki (originally Kokura was selected, but poor visibility there led to a switch to Nagasaki) were chosen.
In any event, President Truman, influenced by his hawkish secretary of state, James Byrnes, ignored his military, ignored the letter from 150 scientists at Oak Ridge where the bomb had been developed pleading with him not to drop it, and ordered the now infamous bombs to be delivered. Stone and Kuznick point out another key precursor to Truman’s decision. The once obscure and diffident haberdasher was at the Potsdam Conference in July when he received word of the successful testing of a usable nuclear weapon. Truman immediately saw the super weapon as a way to get the Japanese to unconditionally surrender without the Soviet Union’s help, and without their sharing in the spoils. More important, he said “it gave him an entirely new feeling of confidence.” Stone and Kuznick quote Winston Churchill, also at the conference, about this: “When he [Truman] got to the meeting after having read this report he was a changed man. He told the Russians just where they got on and off and generally bossed the whole meeting.” Assistant War Secretary John McCloy added that Churchill was as “stiffened” by the awesome new power as the President: “After getting Groves’ report, they went to the next meeting like little boys with a big red apple secreted on their persons” (p. 163. Emphasis added).
“Little boys with a big red apple.” If this seems to be stretching a metaphor, consider how President Truman, aboard the USS Augusta returning from Potsdam, reacted when he learned of the vaporizing of Hiroshima: “he jumped up and exclaimed, ‘This is the greatest thing in history’” (p. 171). Stone and Kuznick add that shortly thereafter Truman asserted that “announcing the news of Hiroshima was the ‘happiest’ announcement he had ever made.” This is really a key to much that would come later, for the possession of first atomic, then hydrogen bombs, weapons of mass destruction used against human beings only twice in history—by the United States of America—became an instrument of coercion in the hands of “little boys.” It became essentially—and the Soviet Union saw this right away, saw that they, even more than the Japanese, were the target of the bomb—a weapon for atomic blackmail. For the United States was signaling that this new devastating weapon could, and would be used against anyone, especially the Soviets, who threatened U.S. interests. As to its usefulness against Japan—forcing their immediate surrender to save American lives—Japanese leaders, according to Stone and Kuznick, attributed greater impact to the invasion by the Soviet Union on August 9, for it dashed their hopes that the Soviets would somehow save them from utter destruction. This is because, according to General Torashiro Kawabe, it took time for the Japanese to realize how horrible the destruction of Hiroshima had been, whereas the shock of the Soviet invasion hit immediately. As to the Japanese Emperor, the United States actually allowed him to remain as a hope for some postwar stability—so Truman’s insistence on unconditional surrender, and the alleged need for the Bomb to compel it, had been rendered moot.
Harry Truman wasted no time using ‘atomic blackmail’ against the Soviet Union. When the Soviets refused to leave Iran in 1946, Truman made it plain that if they didn’t withdraw, he would have no compunction about using atomic weapons. The Soviets withdrew. Then, in response to a plan for an international Atomic Development Authority, meant to prevent any nation from using atomic weapons or power against others (the plan was developed by Dean Acheson, David Lilienthal, and Robert Oppenheimer), Truman, through Bernard Baruch, insisted on loading the original plan with inspections so intrusive that the Soviets would have no choice but to reject them; which they did. Truman immediately ordered more atomic tests, this time at Bikini atoll in the Pacific. Harold Ickes, longtime Secretary of the Interior under Roosevelt, called it “diplomacy by intimidation.” By 1948, with the mad bomber Curtis LeMay now in charge of the Strategic Air Command (SAC), the United States was embarked on a course designed to fight the Soviet Union within seconds. Saying “We are at war now!” LeMay planned to deliver the entire U.S. stockpile of atomic weapons at once, overwhelming the Russians with 133 bombs on 70 cities, killing 2.7 million people. Partly because war by atomic weapon was cheaper than war with millions of conventional forces, Truman went along.
It wasn’t long before General Douglas MacArthur, in December of 1950, was requesting the authority to use atomic bombs against the North Koreans and their allies, the Chinese. He figured he could use four bombs on invading forces and four more for “critical concentrations of enemy air power.” He also figured that dropping a mere 30 to 50 A-bombs “across the neck of Manchuria” would create a “belt of radioactive cobalt” that would win the war in 10 days. Lloyd Bentsen of Texas (later a Vice Presidential candidate) advised President Truman to warn North Korea to pull their troops back from the 38th parallel in one week or risk being A-bombed. Though President Truman fired MacArthur, his replacement, General Matthew Ridgeway also asked for 38 atomic bombs in 1951 for use in the Korean War. The truce ended that threat, but the pattern was plain. Atomic blackmail had come of age. When Dwight Eisenhower became president, he talked ‘atoms for peace’ but made it plain that massive nuclear retaliation in the event of any perceived threat had become the foundation of U.S. “defense”. From about 1,000 nukes when Ike became president in 1952, the U.S. arsenal grew to over 22,000 nuclear bombs, including the far more lethal H-bomb, when he left office eight years later. Indeed, in response to a proposal by Russian premier Nikita Krushchev, after launching Sputnik into space, to establish a peaceful space competition as a way of ending the Cold War (“Our satellites are…waiting for the American and other satellites to join them and to form a commonwealth of satellites…[it] would be much better than competition in the race to manufacture lethal weapons..”), President Eisenhower said:
“Our nation has…enough power in its strategic retaliatory forces to bring near annihilation to the war-making capabilities of any other country…In numbers, our stock of nuclear weapons is so large and so rapidly growing that…we are well ahead of the Soviets…both in quantity and quality. We intend to stay ahead.” (p. 277)
This brings us back to the “big toys for little boys in a pissing contest” metaphor. Stone and Kuznick point to a conversation between a Rand Corp. analyst named Loftus, and General James Walsh, then head of SAC intelligence. Loftus was questioning the Strategic Air Command’s Emergency War Plan that targeted Russian cities and their human populations, 2500 targets in all. In reply Walsh said this:
“Goddamit, Loftus, there’s only one way to attack the Russians, and that’s to hit them hard with everything we have and”—he shouted, pounding his fist on the enormous Bible on the table—“knock their balls off!” (p. 257, emphasis added.)
This was apparently conventional thinking at SAC. During the Kennedy administration, SAC’s commander was Thomas Power. Another RAND thinker named William Kauffman was briefing Power about the need to avoid targeting civilians. Power’s response:
“Why do you want us to restrain ourselves? Restraint! Why are you so concerned with saving their lives? The whole idea is to kill the bastards!” He added: “Look. At the end of the war, if there are two Americans and one Russian, we win!” (p. 303).
Sadly, it was not just the generals who thought about nuclear weapons in terms of male genitalia. President John Kennedy also felt he had to persuade the Soviets and their Premier, Krushchev, of his manhood. Fortunately, during the 1963 Cuban Missile Crisis, his head prevailed, at least in public, over his gonads. In spite of the insistence of his generals, including the madman LeMay, that the United States “ought to just go in there today and knock ‘em off!”, JFK managed to forge a deal with Krushchev: Russia would remove its missiles from Cuba, and the U.S. would remove its corresponding missiles targeting Russia from Turkey. Krushchev agreed and did remove the Russian missiles, but the United States never completed its end of the bargain. No matter. The unthinkable—mass nuclear annihilation from ICBMs hitting both Russian and American cities—had been avoided. But what did the peace-making John Fitzgerald Kennedy say in private about the outcome? He said that he had “cut [Krushchev’s] balls off.”
            There is more about this in the words and thoughts of future U.S. presidents, and no doubt more still in the unknown counsels of the leaders of other countries. Regardless of the numbers, the point is the same: we are in the hands of so-called leaders who often find themselves in dire crises that could result in the useless deaths of millions of human beings, but whose amygdala-driven thinking often reverts to primal, boyish responses appropriate to their school playgrounds. Only that these overgrown boys now command very big toys indeed. And we, the vulnerable masses of humans hoping that wisdom will prevail, are in a position comparable to the one that occurs to the blinded Gloucester in King Lear:
            As flies to wanton boys are we to th’ gods
            They kill us for their sport

Lawrence DiStasi

Wednesday, August 07, 2013

Fake Peace, Fake Process

With the Israeli military again in the headlines, having once more attacked a country, Syria, without a shred of provocation, it is perhaps useful to go over the so-called ‘peace process’ that Israel and the United States keep bringing up to cover their crimes. We are told again and again that Israel is willing to talk peace, but “can’t find a real partner for talks”—i.e. one that will grant Israel’s “right to exist.” We are told repeatedly that the Obama administration wants to be an “honest broker for peace” between Israelis and Palestinians, but can’t find partners willing to make necessary compromises. And so, where Presidents Carter and Clinton and others were able to make apparent progress, neither Obama nor Bush nor Reagan have been able to advance the process, though all have made reassuring sounds about their intention to broker a peace that will result in a Palestinian state.

            Rashid Khalidi’s latest book, Brokers of Deceit: How the U.S. Has Undermined Peace in the Middle East, puts all this in perspective. For what Khalidi—a professor of modern Arab studies at Columbia—shows us is that far from being impartial brokers working to reach a just peace, successive administrations in Washington could more accurately be described as ‘Israel’s Lawyers.’  They have been so openly partisan, so eager to please their Israeli clients, so craven in their obedience to whatever Israeli leaders have dictated to them as terms, that they have undermined rather than advanced the cause of peace. Moreover, while many Americans who have thought about the problem posit that it is the Israel lobby and groups like AIPAC that drive America’s middle East policy, Khalidi points out that American strategic interests in the middle East, particularly with respect to Arab oil-producing despotisms, are the policy drivers because the U.S. pays little or no price for its bias in favor of Israel. Though the Arab public rages about this American favoritism, the monarchies that rule places like Saudi Arabia and Jordan and Bahrain, keep their people so suppressed that Washington can safely ignore the people themselves. As we saw when Hamas won, openly and democratically, the right to represent the Palestinians, the thing Washington fears most is Arab democracy. Despots who keep their people controlled suit America just fine.

            To make his point, Khalidi focuses on three “peace episodes” of recent years: the Camp David Accords of 1978 and their aftermath; the Madrid-Washington negotiations of 1991-93 leading to the Oslo Accords; and Obama’s efforts since his election. All three have, of course, failed to bring peace or result in a Palestinian state. Indeed, Khalidi points out in meticulous detail that the chief aim of Israeli leaders has always been to prevent the formation of a Palestinian state. Even acknowledging that there is a Palestinian people has been written out of agreements like those President Carter was forced to sign at Camp David. In a January 22, 1978 side letter to Menachem Begin five days after the Accords were signed, Carter agreed that,

            wherever the expressions “Palestinians” or “Palestinian people” occurred in the text, they “are being and will be construed and understood by you as ‘Palestinian Arabs.’” This was a term of art among those Israelis who denied that the Palestinians were a people. (6)

Khalidi explains that this denial of Palestinians as a people goes all the way back to the Balfour Declaration of 1917 (the foundational document allowing for Jews to have a homeland in Palestine) “which never mentioned the Palestinians by name.” The same kind of linguistic sleight of hand was already incorporated into the Camp David Accords which establish a “Self Governing Authority” for the inhabitants of the West Bank and Gaza, giving them “full autonomy” over themselves, but not over the land. The land, that is, was to “remain under full Israeli control.” This was consistent with the Israeli, and especially the right-wing Likud Party’s concept of Eretz Israel, which said that “The right of the Jewish people to the Land of Israel is eternal.”

            Understanding this basic principle—at first hidden in the secret Carter letter—is crucial to understanding all the so-called peace efforts that follow. For if there is no Palestinian people (Prime Minister Golda Meir specifically stated, in 1969, that “There was no such thing as Palestinians….It was not as though there was a Palestinian people in Palestine considering itself as a Palestinian people and we came and threw them out and took their country away from them. They did not exist.” 9), then talk of a Palestinian state is arrant nonsense, a smokescreen. This is why the representative of the Palestinian people, the PLO, with Yasser Arafat as its leader, was completely excluded from the Camp David talks. A people that is not a people cannot even be thought of as having a government, and besides, the PLO were terrorists (until, that is, it became convenient for the U.S. and Israel to consider the Palestinian authority the sole representative of the Palestinians, instead of Hamas, which has now become the “terrorists.”) Then, to make things even clearer, Khalidi cites a 1982 CIA memo (Reagan was now president) that went as follows:

            “Begin asserts that the C[amp] D[avid] A[ccords] rule out the emergence of a Palestinian state. In Begin’s view, the agreements ‘guarantee that under no condition’ can a Palestinian state be created. In practice Begin effectively rules out any exercise of Palestinian self-determination except one that continues Israel’s preeminent position in the West Bank.” (19)

Khalidi comments that this was not only the position of Prime Minister Menachem Begin, but “the enduring position of every Israeli government since.” So, while there has been an almost endless procession of American “negotiators” seeking to find a peace agreement between Israel and Palestine resulting in a secure state for each, this has all been a ruse, a way to drag out so-called peace talks endlessly, endlessly giving Palestinians and the world the illusion that a Palestinian state was right around the corner (as soon as knotty little problems like “facts on the ground” could be ironed out). In reality,

            the Palestinians would be restricted to talking about and eventually living under the extremely low ceiling of Begin’s scheme for “autonomy” for the people, but not the land, all the while continuing to suffer under a regime of continued occupation. (37)

That 45-year occupation, by the way, illegal under international law, and allowing the Israelis to arrest and imprison and assassinate Palestinians with impunity, establish “facts on the ground” such as hundreds of illegal settlements that split the alleged territory of future Palestine into impossible “bantustans,” and undermine the now-acceptable PLO government by leaving no doubt who is in charge, continues, illegally, to this day.

            Skipping the Oslo Accords of 1993, which, according to Khalidi, only made things worse for Palestinians, we come to Barack Obama. Initially thought to offer the Palestinians their best hope for peace and a state for themselves, Obama has instead become more and more subservient to the demands of Israeli prime ministers and their American proxies. Most importantly, he has accepted the “central element of Israeli’s self-presentation: that the state of Israel and the Israeli people, indeed the entire Jewish people, are in a state of perpetual existential danger”(74). In this regard, yet a new rhetorical term has been added to emphasize this “existential threat”: “lawfare.” The term means what it sounds like: Israel’s enemies using the law, mainly international law, to conduct war against Israel by calling attention to Israeli violations of International Law! To rabid supporters of Israel, this is an illegitimate tactic, comparable to the related tactic of “delegitimization” of Israel (which points out that the blockade of the Gaza Strip, or the use of phosphorus shells against civilians, or detention without trial, or Israel’s occupation of the Palestinian territories, are in fact illegal according to International Law.) There are several pro-Israeli websites that monitor such “illegitimate” legal tactics against ‘existentially-threatened’ Israel. No matter. Israel has never had anything to worry about from Obama, or his emissaries like ex-senator George Mitchell (whom Israeli supporters called “biased” due to his Lebanese descent). Mitchell’s mission was quickly sabotaged by Dennis Ross, Obama’s special assistant for the Middle East. Ross undermined Mitchell at every opportunity, finally triumphing over him by offering Israeli Prime Minister Netanyahu outrageous guarantees (F-35 jets, a US veto of a planned UN Security Council resolution on Palestinian statehood if it came up, and long term security guarantees in case of an overall peace settlement) in return for a 3-month settlement freeze. But even the U.S.’s added promise never to ask for such a freeze on illegal settlements again didn’t work: Netanyahu haughtily refused.

            The Mitchell effort essentially ended U.S. peace attempts. All that is left is an Israel that dictates U.S. policy whenever it wishes to, and receives in return absurd validations of its every crime and violation of international law—including its recent unprovoked bombing of Syria. The response has become almost pro-forma: ‘Israel has a right to defend itself.’ Against what? Against whom? Against any perceived threat that it defines as a threat, regardless of the evidence?

            As of now, in other words, there is no Palestinian peace process, just as there has never been a “Palestinian people” as far as Israel is concerned. And with the excision and destruction of the names (the 1992 proposal stated that the peace talks deal only with the people, not the territories, referring to both as “the Arab inhabitants of Judea, Samaria, and the Gaza District), comes the excision and destruction of the people themselves. That is essentially what the United States has brokered with its so-called “peace process:” the slow destruction of a people and their culture, the slow expropriation of their land and property and any hope they might ever have entertained for justice. And all of it has taken place in broad daylight, in full view of the entire international community that makes comforting noises about peace and justice and the right of self-determination.

Lawrence DiStasi