Pioneering HIV Researcher Mathilde Krim Remembered For Her Activism

Dr. Mathilde Krim at the World AIDS Day Symposium presented by the Foundation For AIDS Research and the Columbia University Mailman School of Public Health in 2002. Krim had a knack for helping people talk about HIV/AIDS rationally, colleagues say.

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With the death of biologist Mathilde Krim on Monday, at the age of 91 at her home in New York, the world lost a pioneering scientist, activist and fundraiser in AIDS research. She is being widely praised this week for her clarity, compassion and leadership.

Amid the panic, confusion and discrimination of the HIV epidemic’s earliest days, Krim stood out — using science and straight talk, in the 1980s and beyond, to dispel fear, stigma, and misinformation among politicians and the public.

“She has likely literally saved hundreds of thousands if not millions of lives because of what she did during the initial days and years of the epidemic,” says Corey Johnson, speaker of the New York City Council. “Every single one of us living with HIV today who are on medicines, where now we can live and thrive — it’s because of people like Dr.Mathilde Krim.”

Born in Italy in 1926, Krim received her doctorate in biology from the University of Geneva in Switzerland. She became a steadfast activist for human rights early on, lived in Israel for a time and moved to the United States in the late 50s.

She was studying viruses and cancer when the AIDS epidemic emerged in the early 1980s and was among the first scientists to raise funds for research to develop AIDS treatment, working with celebrities like actress Elizabeth Taylor and others. Krim was the founding chair of the American Foundation for AIDS Research (now called the Foundation for AIDS Research) and went on to raise millions of dollars to finance basic research, clinical trials of drugs and other treatments and AIDS awareness programs.

Mathilde Krim (left), shown here in 1992 with fellow amfAR board members Elizabeth Taylor and Dr. Mervyn F. Silverman, campaigned for needle exchange programs to stop the spread of HIV/AIDS among drug users, and promoted public campaigns that advocated safe sex practices, such as condom use.

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Colleagues say Krim had a knack for helping people talk about HIV/AIDS rationally.

“She did it in a very grandmotherly way but also in a very direct and honest way,” says Kevin Robert Frost, current CEO of the Foundation for AIDS Research. Krim facilitated much-needed public discussions of sex, drug use and homosexuality, Frost says.

“She was able to address all of those things and sweep aside the stigma and discrimination … in a way that I think very few people could have at the time,” he says.

While most lawmakers were silent, Frost says, discrimination against people with AIDS was rampant in housing, employment and even medical care. Krim fought for laws to ban such discrimination, campaigned for needle exchange programs to stop the spread of HIV/AIDS among drug users, and promoted public campaigns that advocated safe sex practices, such as condom use.

Long-time AIDS activist and author, Peter Staley, who was an early member of the Aids Coalition to Unleash Power (ACT UP), an international direct action advocacy group, calls Krim’s approach to public health groundbreaking.

“She recognized human nature for what it was — with all its faults and beautiful diversity — and she realized that using science and the traditional public health approach was the way to save lives,” says Staley. “You throw out the moralizing — the finger wagging — and you save lives. And she did this again and again and again, fighting HIV stigma and homophobia.”

Krim received 16 honorary doctorates; in 2000 President Bill Clinton presented her with the nation’s highest civilian honor — the Presidential Medal of Freedom.

Frost remembers Krim with a quote attributed to Albert Einstein that “a life lived for others is a life worthwhile.” Frost says he greatly mourns Krim’s passing, but it’s also a joy to remember somebody “who could devote themselves so completely to the people around them.”

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Even Dale Earnhardt Jr. Skids and Rams Tree In Snow Storm

Dale Earnhardt Jr. crashed into a tree minutes after helping another driver out of a snow-filled ditch.

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Former NASCAR superstar Dale Earnhardt Jr. found out even the best drivers may have to stay off the roads in a snow storm.

Wednesday morning after he helped pull another car out of ditch, his pickup skidded off the road and rammed into a tree.

On Twitter Earnhardt said he lost control of his car on a snow-covered road and warned other North Carolina drivers to avoid his fate.

“[North Carolina] stay off the roads today/tonight. 5 minutes after helping these folks I center punched a pine tree,” he wrote.

NC stay off the roads today/tonight. 5 minutes after helping these folks I center punched a pine tree. All good. Probably just needs a new alignment.

— Ralph Dale Earnhardt Jr. (@DaleJr) January 17, 2018

But fans need not worry about the hall of famer. “All good,” he said. “Probably just needs new alignment.”

A storm left a blanket of snow over North and South Carolina and Georgia. North Carolina Gov. Roy Cooper declared a state of emergency in advance of the storm. AccuWeather reported the snowstorm caused over 500 collisions in the state.

Earnhardt’s accident came a day after the former NASCAR star announced he’ll be covering the Super Bowl and Winter Olympics in Pyeongchang on NBC.

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DACA Troubles Could Put Spending Bill In Peril

President Trump, with House Speaker Paul Ryan of Wisconsin, Senate Majority Whip John Cornyn og Texas, and Senate Majority Leader Mitch McConnell of Kentucky, speaks to reporters after a recent retreat where GOP leaders made plans for 2018.

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Congressional leaders plan to vote later this week on a month-long spending bill but the ongoing fight over immigration threatens to derail the plan days before the Friday deadline to prevent a government shutdown.

Republican leaders say they are confident that Congress will vote this week to extend current spending levels until February 16 but Democrats and some far-right conservatives are threatening to block the legislation.

Democrats say they are unwilling to vote for a spending bill that does not provide a pathway to citizenship for the roughly 700,000 immigrants who are in the country illegally after being brought here as children. That group had been granted temporary status allowing them to remain in the U.S. without fear of deportation, and to work or attend college or graduate school, under the Deferred Action for Childhood Arrivals, or DACA, program created by the Obama administration. In September of last year, the Trump administration announced those protections would end in March 2017.

Now with a Jan. 19 deadline looming for continuing to fund the government, conservatives say they can’t support any spending bill that paves the way for a future immigration deal that could favor Democrats.

House Speaker Paul Ryan, R-Wis., told reporters Wednesday that a short-term spending measure will give negotiators more time to craft a bill that satisfies both sides and President Trump.

“I think the fact that we’re in earnest and negotiating in good faith with our four leaders on DACA speaks to the fact that we want to see a solution,” Ryan said. “We will not bring a DACA bill that the president doesn’t support. What point would it be to bring a bill through here that we won’t have signed into law by the president?”

The immigration talks ground nearly to a halt last week after Trump rejected a bipartisan solution proposed by Sens. Lindsey Graham, R-S.C. and Dick Durbin, D-Ill., during a profanity-laden meeting at the White House. That meeting effectively ended those bipartisan talks and a second group of negotiators has stepped in to attempt to craft a new deal.

Those talks have been lead by the second-ranking Republicans and Democrats in the House and the Senate. The talks have not yet produced a solution and leaders hope the a stop-gap spending bill will give them more time to reach a deal.

House leaders hope to vote on a spending bill on Thursday but a growing number of members of the conservative House Freedom Caucus say they may vote against the bill. Freedom Caucus Chairman Mark Meadows, R-N.C., told reporters Wednesday that conservatives aren’t sold on the direction of the immigration negotiations and would not say how many he expected would vote against the bill.

“My understand is leadership is going to put it on the floor regardless if they have votes or not,” Meadows said. “If that’s the case, I guess the day of reckoning will come tomorrow.”

Congressional leaders hope to avoid a serious confrontation over spending by pairing the stop-gap measure with a six-year extension of the popular State Children’s Health Insurance Program, known as CHIP. That program has broad bipartisan support and leaders hope lawmakers will vote for the measure to avoid voting against benefits for low-income children.

Senate Majority Leader Mitch McConnell, R-Ky., told reporters Wednesday that he hopes skeptical Democrats will support the spending bill to ensure that CHIP is extended.

“The Democrats in the Senate have been very consistent in clamoring for addressing the children’s health care program,” McConnell said. “They claim they don’t want to shut down the government, so it seems to me it would be a rather attractive package.”

Senate Minority Leader Charles E. Schumer, D-N.Y, told reporters that he wants to avoid a shutdown but many Democrats oppose the short-term spending bill.

“The revulsion towards that bill was broad and strong,” Schumer said. “Who called for the shutdown? Not a Democrat, but Donald Trump has repeatedly said, on tape, over and over again, what the country needs is a good shutdown.”

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Walmart Offers Product To Destroy Leftover Opioids, But Critics Say It's Unnecessary

On Wednesday Walmart began distributing a new solution to help customers dispose of leftover opioid prescriptions. But CDC says, just flush them down the toilet.

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Walmart is the latest national company joining in the fight to try to help curb America’s harrowing opioid epidemic, which now kills more people than breast cancer.

On Wednesday the chain rolled out a pharmacy product it says provides a safe way to get rid of extra prescription opioid drugs. It’s called DisposeRx and when mixed with warm water it turns any form of opioid drug — including powders, pills, tablets, capsules, liquids or patches — into a biodegradable gel that can’t be separated or converted back into a usable drug.

Walmart touted it as the first of its kind in a statement, and said the ingredients are FDA approved.

“The health and safety of our patients is a critical priority; that’s why we’re taking an active role in fighting our nation’s opioid issue – an issue that has affected so many families and communities across America,” Marybeth Hays, executive vice president of Consumables and Health and Wellness at Walmart U.S., said in the statement.

In 2016 more than 42,000 Americans died of an opioid overdose — including prescription opioids, heroin and fentanyl. That is more than any year on record and 40 percent of all overdose deaths involved a prescription.

Walmart explained patients filling new opioid prescriptions at any of its 4,700 pharmacies will receive a free DisposeRx packet starting immediately, while existing customers can ask for one at any time. Patients with chronic pain prescriptions will be offered packets every six months.

Republican Sen. John Boozman from Arkansas praised Walmart for helping “to keep unused prescription drugs out of the wrong hands.”

“About one-third of medications sold go unused. Too often, these dangerous narcotics remain unsecured where children, teens or visitors may have access,” he said in the statement Walmart released.

A CDC study found Arkansas’ prescription drugs are so ubiquitous there are enough pills on the black market that every single citizen — nearly 3 million in the state — could have a full bottle, reported Talk Business & Politics.

Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University, agrees that leftover pills do contribute to the spread of addiction but he says products like DisposeRx are unnecessary because the CDC already encourages anyone who’s at the end of a prescription opioid treatment to “flush them down the toilet.” No special ingredients necessary.

“The problem is the general public just doesn’t know that,” he said.

“Think about it,” he continued, “every time someone taking an opioid medication urinates or defecates, it gets into the water supply. So that’s not the real problem.”

Kolodny is also conducting a long-term study on the impact of numerous legislative and private company-led efforts to stem the epidemic. His conclusion on Walmart’s DisposeRx? “It’s nice that they’re trying but it will have little impact.”

The root of the explosion in the addiction crisis, he says, is rampant over-prescribing by doctors and dentists. Through his research, which is ongoing, Kolodny has found that policies limiting prescriptions are most effective, like the one imposed by CVS. In September the drug-store chain began limiting opioid painkillers to seven-day supplies for new patients.

But even that falls short of what is required, Kolodny said.

A better strategy is the one undertaken by the Vermont Department of Health. New rules established in April limit the quantity of a “morphine milligram equivalent” in prescriptions. They lay out specific dosages of drugs containing oxycodone, hydrocodone and acetaminophen-oxycodone (found in Percocet) that doctors should prescribe.

Kaiser Health Newsreported 22 states either adopted or toughened their prescription size limits in 2016.

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Psychic paid $3.5 million for exorcisms gets prison for evading U.S. taxes

BOSTON (Reuters) – A self-proclaimed psychic was sentenced on Wednesday to 26 months in prison after admitting that she tried to avoid paying taxes on over $3.5 million that she received from an elderly Massachusetts woman seeking to cleanse herself of demons.

Sally Ann Johnson, 41, was sentenced by U.S. District Judge Denise Casper in Boston, who said the evidence suggested the psychic took advantage of the Martha’s Vineyard resident as the woman began to suffer from dementia.

“There is a strong inference of fraud here,” Casper said.

She ordered Johnson to repay the woman nearly $3.57 million she received from 2007 to 2014 and to pay $725,912 in restitution to the U.S. government for the taxes she avoided paying.

Johnson, who never passed the second grade and calls herself a Romani “spiritual consultant,” pleaded guilty in October to trying to impede the administration of tax laws. In court, she apologized for that conduct.

But Johnson denied that she took advantage of anyone. Her attorneys called the elderly woman intelligent if not eccentric and fully competent when she employed Johnson.

“I am not somebody who would do wrong to anybody,” Johnson said.

Court papers refer to the woman only as “V.P.” and say she attended Radcliffe College and Harvard University, was independently wealthy and was more than 70 years old in 2007. She is a resident of Martha’s Vineyard, a favorite vacation spot for the rich and famous.

“She is someone who descends from great wealth and power,” Paul Petruzzi, one of Johnson’s lawyers, said in court.

Prosecutors said that Johnson, who has lived in Florida and also goes by Angela Johnson, has operated a small collection of businesses that offer psychic or spiritual services.

Prosecutors contended Johnson employed techniques commonly used by fraudulent fortune-tellers who prey on vulnerable and incapacitated people and cultivated a sense of dependence in the elderly woman.

The unnamed woman was already prone to believe in the presence of evil spirits, prosecutors said. They said that as her dementia advanced, the woman attributed her symptoms to demonic possession, which she hoped Johnson could alleviate.

To evade the Internal Revenue Service’s scrutiny, Johnson used an alias, directed the woman to wire payments to three different bank accounts and withdrew large sums of cash to conceal the money’s source, prosecutors said.

She also accrued charges on a credit card held in the elderly woman’s name, spending $20,000 on entertainment and jewelry alone, prosecutors said.

Reporting by Nate Raymond in Boston; Editing by Lisa Shumaker

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U.K. Lawmakers Want To Battle Waste With A 'Latte Levy' On Disposable Cups

A grande Cafe Nero, large Costa Coffee and venti-sized Starbucks to-go cups sold in London. The U.K. Parliament is considering a tax on disposable cups in an effort to cut down on waste.

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Lawmakers in the United Kingdom are debating a new tax on disposable cups in an effort to cut down on waste.

While the so-called “latte levy” is controversial, the goal is to replicate the success of Britain’s tax on plastic bags; their use has declined by 80 percent since the tax was introduced in 2015. Proponents of the tax say it would encourage people to carry around their own reusable cups rather than use disposable ones, which in their current form are difficult to recycle.

Simon Ellin, chief executive of The Recycling Association, tells Here & Now’s Jeremy Hobson that the law is designed to shift consumer behavior towards the cheaper, more environmentally friendly option, though he admits the proposal does have its limitations.

“Human nature says if it’s going to cost you more, then you would take the cheaper option and that would be for you to bring your own mug,” he says. “I’m probably as guilty as anybody when I’m catching a train or on the road, I probably would always have a [disposable] coffee cup with me.” But the point of the tax, he says, is “changing the way that the general public [perceives] waste and recycling.”

The British Parliament issued a report earlier this month proposing a 34-cent (25-pence) tax, which would amount to about 10 percent on every cup sold. By comparison, the British tax on plastic bags is 7 cents (5 pence) per bag.

According to the report, 2.5 billion disposable cups are tossed out each year in Britain alone, and that number is expected to rise given the growth of coffee shops in the U.K. in recent years. (There are more than four times as many coffee shops today as there were in 2000.)

Disposable cups have a plastic lining that makes them waterproof, which means they cannot be processed by most recycling facilities, the report notes. As a result, most of them end up in landfills or are incinerated.

The report also points out that many people mistakenly think coffee cups are recycled when they are disposed of in recycling bins. As The New York Times notes:

“A 2011 consumer survey cited by the lawmakers found that eight in 10 consumers were laboring under the misconception that disposable cups were being recycled, and that most consumers tried to discard their cups in recycling bins. The report found that fewer than one cup in 400, or 0.25 percent, gets recycled.”

Right now, Britain is home to just two facilities capable of recycling disposable cups by stripping the plastic from the paper, Ellin says. He says many to-go cups contain drink residue that makes them difficult to recycle.

“Just because you design a recyclable coffee cup doesn’t necessarily mean that it will be recycled,” he says.

And if drink residue in a disposable cup spills over onto other containers in a recycling bin, it can make them harder to recycle, too, Ellin says.

Earlier this month, Starbucks said it would experiment with a 5-pence paper cup charge in 25 London stores starting in February. The company already offers a discount for customers who use reusable cups, as do other coffee chains.

And McDonald’s recently announced it will produce all of its packaging from recycled or sustainable materials by 2025.

“One of the things we’re looking at is cups,” says Francesca DeBiase, the fast-food giant’s chief sustainability officer. “There’s been a lot of work in the industry related to cups and finding a cup for cold drinks that lasts as long as our customers may want to keep their cup in their car throughout the day. That’s been a challenge for us.”

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Aetna Agrees To Pay $17 Million In HIV Privacy Breach

Ronda Goldfein, attorney and executive director of the AIDS Law Project of Pennsylvania, holds an envelope that revealed a person’s HIV status through the clear window.

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Aetna settled a lawsuit for $17 million Wednesday over a data breach that happened in the summer of 2017. The privacy of as many as 12,000 people insured by Aetna was compromised in a very low-tech way: the fact that they had been taking HIV drugs was revealed through the clear window of the envelope.

“Through our outreach efforts, immediate relief program and this settlement we have worked to address the potential impact to members following this unfortunate incident,” Aetna wrote in a statement. “In addition, we are implementing measures designed to ensure something like this does not happen again as part of our commitment to best practices in protecting sensitive health information.”

In an ironic twist, the letters were sent in response to a settlement over previous privacy violation concerns. Aetna had required members to obtain HIV medications through mail-order pharmacies. The affected people had taken medication to treat HIV or to lower the risk of becoming infected with the virus, an approach called PrEP, or pre-exposure prophylaxis.

Lawsuits filed in 2014 and 2015 alleged that policy was discriminatory, that it prevented patients taking HIV medicine from receiving in-person counseling from a pharmacist, and that it jeopardized members’ privacy.

Aetna settled with the individual plaintiffs, changed its policy to allow members to fill HIV prescriptions in person at retail pharmacies and, in turn, sent out notification letters to anyone who had filled prescriptions for HIV medications.

It was those letters that contained a large envelope window that exposed that sensitive HIV information.

“I was shocked,” said Sam, who distinctly recalls the day he received the notice in August. (NPR agreed not to use his full name because of worries about how going public with his status might affect his work.) The letter came to his mailbox in an apartment complex in New Jersey. He wasn’t directly involved in the lawsuit but says the letter hit a level of vulnerability he had never felt before.

“I haven’t disclosed my HIV status to my parents,” he said. “Let’s say that letter had gotten forwarded to their house and someone happened to open the mail. Those were the types of things going through my mind.”

Sam, 36, is a civil rights attorney. He was diagnosed with HIV four years ago,

While the stigma surrounding HIV may be less severe than it used to be and treatments have most certainly improved, Ronda Goldfein, director of the AIDS Law Project of Pennsylvania, says the reality is that serious discrimination still exists. That means protecting patient confidentiality is critical in ensuring people feel safe getting care.

As hundreds of calls from people who received the Aetna letter started coming into her office and others around the country, she learned of even more harrowing and devastating experiences. She says she heard from one man who had homophobic slurs painted on his door when neighbors saw the letter. Others had to move out of their neighborhoods. For one woman, whose status became known in her tight-knit immigrant community, “she stopped being able to function, she stopped being able to go to work, and she lost her job,” Golfein said.

The AIDS Law Project of Pennsylvania and the Legal Action Center initially issued a demand letter in late August that the insurer stop the mailings. The company responded, setting up a relief fund for affected people and apologizing. “This type of mistake is unacceptable, and we are undertaking a full review of our processes to ensure something like this never happens again,” the health insurer said.

Goldfein and others soon learned that the mailing was more widespread than first thought: up to 12,000 people had received it. Her agency, the Legal Action Center and Berger & Montague, P.C. filed a lawsuit and sought class-action status.

Aetna “carelessly, recklessly, negligently, and impermissibly revealed HIV-related information of their current and former insureds to their family, friends, roommates, landlords, neighbors, mail carriers and complete strangers,” the lawsuit states. “In the course of sending out the agreed notices, however, Aetna again failed to recognize the dangers associated with sending information about HIV medications through the mail.”

The privacy breach as outlined in the proposed settlement was twofold: Aetna released the names of 13,480 people to its legal counsel and a vendor without proper authorization. Of those, 11,875 got the letter that revealed they were taking HIV medication.

The proposed settlement is awaiting approval in federal court, but in it Aetna has agreed to pay$17,161,200 and set up new “best practices” to prevent something like this from happening again.

As part of the payout, the law firms are setting aside at least $12 million for payments of at least $500 to the estimated 11,875 people who may have received a letter exposing that information, acknowledging that “the harm was in the status begin disclosed,” according to Goldfein. Plus, people won’t have to file additional paperwork and go through more mailings pertaining to their HIV medications.

A fund will be set up for those who experienced additional financial or emotional distress. Individuals will be able to claim up to $20,000. The rest of the money will go toward legal fees and costs.

In a review of past privacy settlements, Goldfein believes the Aetna settlement marks the largest per person payout for any kind data breach. Either way, “that’s a big settlement,” according to William McGeveran, a specialist in privacy law and data breaches at the University of Minnesota.

“It’s a much bigger settlement than ordinary identity theft scenarios where an online database has been breached and the main injury people are claiming is that they might be victims of identity theft and maybe have their financial information compromised,” he said.

The amount may be unusual, but McGeveran also says low-level breaches like this aren’t. Companies may be so focused on IT security that they overlook other ways that privacy can be breached.

“They’re more common than people realize,” McGeveran said. “There’s so much attention to cybersecurity, and rightly so, but a lot of medical privacy concerns are much more analog than that. They’re about things being overheard, they’re about paper records and in this case it’s about a paper mailing.”

For Goldfein, reaching a settlement in just four and a half months was a relief to her client and others and underscores that medical privacy is a right for everyone.

“It was important for us to send a clear message to people with HIV that your medical information is important, that it will be protected, that we will take quick action to make sure that it is protected,” she said.

Beyond the payout itself, she hopes the suit helps change the culture of companies when it comes to the attention paid to medical privacy, and the rights of people with HIV in particular. In order to highlight that, they used “Andrew Beckett” as the pseudonym for the original plaintiff in the case, a Pennsylvania man from Bucks County.

It’s a nod to the Tom Hanks character in the 1993 film Philadelphia. He was fired after his law firm found out he had HIV—this “Beckett” is taking PrEP.

“HIV still has a negative stigma associated with it, and I am pleased that this encouraging agreement with Aetna shows that HIV-related information warrants special care,” Beckett said in statement.

This story is part of a reporting partnership with NPR, WHYY and Kaiser Health News.

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U.K. Now Has A Minister For Loneliness

U.K. Minister for Sport and Civil Society Tracey Crouch talks to a woman during a visit to Norwich, England, in 2015. Crouch has been selected to be the U.K. Minister for Loneliness.

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The U.K. has appointed a Minister of Loneliness to tackle what Prime Minister Theresa May calls a “sad reality of modern life” for many U.K. citizens.

May announced the position today, appointing current Minister for Sport and Civil Society Tracey Crouch.

“I want to confront this challenge for our society and for all of us to take action to address the loneliness endured by the elderly, by carers, by those who have lost loved ones – people who have no one to talk to or share their thoughts and experiences with,” said May.

According to government figures, more than 9 million people in the U.K. “always or often feel lonely,” and “around 200,000 older people have not had a conversation with a friend or relative in more than a month.”

An increasing body of research has found that feelings of social isolation can have profound health effects; according to a government commission, loneliness is as bad for people’s health as smoking 15 cigarettes daily.

“Loneliness can be triggered by a life event, such as a bereavement or becoming a parent, with certain groups, such as young people and carers, particularly at risk,” said Crouch.

A commission on loneliness, which was set up by former Member of Parliament Jo Cox before she was murdered, had called for a minister to be appointed to spearhead the government’s strategy. Cox was 41 years old when she was killed by a white supremacist in 2016, in the lead up to the U.K.’s vote to leave the European Union.

“This is an issue that Jo cared passionately about and we will honour her memory by tackling it, helping the millions of people across the UK who suffer from loneliness,” May said.

The government says it has started developing a “cross-government strategy on loneliness in England” and is working to come up with the Office of National Statistics on ways to measure loneliness.

“One of the awful things about losing Jo is knowing how much difference she would have made in the world,” said Cox’s husband Brendan in a tweet. “When the kids wake up this morning I’m going to tell them how – even though she’s not here – she’s still making the world a better place.”

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A 'Fraught Time' For Press Freedom In The Philippines

College students protest to defend press freedom in Manila on Wednesday, after the government cracked down on Rappler, an independent online news site.

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Philippine President Rodrigo Duterte does not like the press. Stung by critical media reporting, he has in the past months called some of the country’s largest media organizations “bullshit,” “garbage,” “son of a bitch.” Journalists, he said, have no shame. They are corrupt fabulists and hypocrites who “pretend to be the moral torch of the country.”

But Duterte does not just get mad; he gets even. This week, the Philippine Securities and Exchange Commission revoked the corporate registration of Rappler, an online media startup that has reported aggressively on Duterte’s troll army and police abuses in the government’s war on drugs. If the order is confirmed by an appeals court, the company may have to shut down.

Philippine President Rodrigo Duterte, shown here on Dec. 20 at a ceremony marking the anniversary of the military, became president as the Philippine media were losing prestige and market power.

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Threatening as this crackdown is, it’s only one arm of a pincer-like assault on the press. Duterte is drawing from the Modern Autocrat’s Field Guide to Information Control. The aim is complete encirclement so as to drown out critical and independent voices. Like Vladimir Putin, Turkey’s Recip Tayyip Erdogan and Hungary’s Viktor Orban, he has launched a two-pronged attack.

One prong is media muzzling through government regulation. In Russia, Turkey and Hungary, autocratic leaders have shut down critical news outlets or transferred their ownership to friendly proprietors. In all these countries, government regulators have hounded recalcitrant media owners with spurious allegations like tax evasion and failure to obtain licenses.

More insidiously, populist leaders have tried to de-legitimize independent and critical media by ridiculing their editorial standards and their claims to a moral high ground. The press, said Dutere, “throw[s] garbage at us … [but] How about you? Are you also clean?”

Demonization by government — something President Trump also deploys against media outlets he dislikes — is just one tactic. The other is letting loose an army of trolls, bloggers on the state’s payroll, propagandists and paid hacks who ensure the strongman’s attacks against the press are amplified in newspaper columns and on the airwaves, on social media and fake news sites.

In 1972, when Ferdinand Marcos declared martial law, he closed down all newspapers and broadcast stations and hauled dozens of journalists to jail. When the presses and broadcast networks reopened, they were all owned by Marcos kin and cronies and were censored by the presidential palace. The flow of information was strictly controlled: There were only three daily newspapers and a limited number of TV and radio stations.

Employees of Rappler, an online news outfit known for its critical reporting on Philippine President Rodrigo Duterte, continued to work in their office in Manila on Tuesday. The Philippine Securities and Exchange Commission revoked Rappler’s corporate registration this week.

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Duterte is an admirer of Marcos, but he is using a 21st century playbook for media control. The strategy is no longer restricting information flows, but flooding the information space with disinformation and propaganda while also attacking legitimate purveyors of the news.

Last year, the president launched blistering assaults against two news organizations that reported allegations he had stashed millions in secret bank accounts. As he turned up the heat, the owners of the Philippine Daily Inquirer, the country’s second largest newspaper, announced they would sell the daily to a businessman chummy with the president. Duterte also tightened the screws on the top television network, ABS-CBN, threatening to block the renewal of its franchise and to sue its owners for failing to air campaign ads that he said he had already paid for.

Rappler was investigated supposedly because it violated the ban on foreign media ownership. The pioneering startup issued $1 million in securities, called Philippine depository receipts, to the Omidyar Network, the philanthropic arm of eBay founder Pierre Omidyar.

Other companies, including a giant telecommunications firm and two broadcast networks, have similar arrangements with foreign investors. But only Rappler’s registration has been revoked — tellingly, six months after Duterte accused the news site of being U.S.-owned.

During the Marcos era, Filipino journalists and citizens used innovative ways to skirt censorship. There was a robust underground press and above-ground media used allegory and allusion to evade restrictions.

The new media landscape requires new strategies for ensuring that genuine news evades encirclement by poisoned information. More cautious news outlets have taken the path of self-preservation through self-censorship. Rappler, for one, has said it will not stand down, and it has the support of major journalist groups in the Philippines and overseas. In the past, journalists, with the support of outraged citizens, have successfully resisted gagging.

But the Philippine press has never been weaker. Media influence and market power soared after Marcos fell in a 1986 popular uprising. There was a hunger for news and uncensored information and crusading journalists and newspapers were feted for their role in the democracy movement. Before long, powerful families bought newspapers and broadcast networks, using their media clout to advance their interests. Sensationalism ruled in a crowded and competitive media market.

Like elsewhere, technology has disrupted the media business in the Philippines: Revenues have fallen, and audiences have moved online, gravitating toward Facebook, which has become the de facto news source for most Filipinos.

Duterte became president as the media were losing prestige and market power. He attacked the press where it was most vulnerable: His tirades against sensationalist journalists and elitist media owners resonated among many Filipinos.

This is a fraught time for the Philippine press. In the past, journalists and citizens have stood together to defend the right to know. They may do so again, but they need a clear vision, an ark that will see them through the Duterte era’s deluge of disinformation.

Sheila S. Coronel (@sheilacoronel) is Director of the Toni Stabile Center for Investigative Journalism and Dean of Academic Affairs at the Columbia University Graduate School of Journalism. She co-founded the Philippine Center for Investigative Journalism.

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Brandi Carlile On World Cafe

  • “Every Time I Hear That Song”
  • “The Joke”
  • “The Mother”

Brace your abs for an emotional gut-punch. Brandi Carlile is here with bandmates and co-writers Tim and Phil Hanseroth. Together, they have a new album called By the Way, I Forgive You. It was recorded at Nashville’s legendary RCA Studio A, produced by Dave Cobb and Shooter Jennings. And it’s filled with emotionally stirring songs — some that are massive and some that are stripped bare.

In the first category, there’s a song called “The Joke,” born out of a request by Dave Cobb. He challenged Carlile to write a song that went floor to ceiling the way her epic ballad “The Story” did ten years ago. Carlile responded, along with Phil and Tim, by writing an opus with strings, a really big build and the kind of high note that only Carlile can hit.

Then there’s the acoustic guitar-based “The Mother,” which doesn’t go for the high notes or big swells but instead pulls deep on the ol’ heartstrings. The song is about Carlile’s daughter Evangeline. In this session, hear Carlile’s performance of both of those songs live, and our conversation about the tenth anniversary of her breakout album The Story. She celebrated that anniversary by assembling an A-list roster that includes Dolly Parton and Adele to cover the entire album for the benefit of War Child UK. Oh yeah: Barack Obama participated too.

Carlile, Tim and Phil (along with drummer Chris Powell and a full band with a string section) performed in front of a live audience here at the World Cafe. They started us off with “Every Time I Hear That Song.” Hear it all in the player above.

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