Chris Hedges's Blog, page 467

Florence Death Toll Climbs to 37; Trump Visits Stricken Area

WILMINGTON, N.C.—The death toll from Hurricane Florence climbed to at least 37, including two women who drowned when a sheriff’s van taking them to a mental health facility was swept away by floodwaters, and North Carolina’s governor pleaded with thousands of evacuees not to return home just yet.

President Donald Trump, meanwhile, arrived in storm-ravaged North Carolina on Wednesday and helped volunteers at a church in the hard-hit coastal town of New Bern.

“How’s the house?” Trump was heard asking one person as he distributed plastic foam containers of food, including hot dogs, chips and fruit. “You take care of yourself.”

Wilmington, population 120,000, was still mostly an island surrounded by floodwaters, and people waited for hours Tuesday for handouts of food, water and tarps. Thousands of others around the state waited in shelters for the all-clear.

“I know it was hard to leave home, and it is even harder to wait and wonder whether you even have a home to go back to,” Gov. Roy Cooper said.

After submerging North Carolina with nearly 3 feet (1 meter) of rain, the storm dumped more than 6.5 inches (16.5 centimeters) of rain in the Northeast, where it caused flash flooding.

Cooper warned that the flooding is far from over and will get worse in places.

“I know for many people this feels like a nightmare that just won’t end,” he said.

Addressing roughly 10,000 people who remain in shelters and “countless more” staying elsewhere, Cooper urged them to stay put for now, particularly those from the hardest-hit coastal counties that include Wilmington, near where Florence blew ashore on Friday.

Roads remain treacherous, he said, and some are still being closed for the first time as rivers swelled by torrential rains inland drain toward the Atlantic.

At least 27 of the deaths happened in North Carolina.

In South Carolina, two women died on Tuesday evening when floodwaters from the Little Pee Dee River engulfed the van taking them to a mental health facility, authorities said.

The risk of environmental damage mounted, as human and animal waste was washed into the swirling floodwaters.

More than 5 million gallons (18 million liters) of partially treated sewage spilled into the Cape Fear River after power went out at a treatment plant, officials said, and the earthen dam of a pond holding hog waste was breached, spilling its contents. The flooding killed an estimated 3.4 million chickens and 5,500 hogs on farms.

In Wilmington on Tuesday, workers began handing out supplies using a system resembling a giant fast-food drive-thru: Drivers pulled up to a line of pallets, placed an order and left without having to get out. A woman blew a whistle each time drivers had to pull forward.

Todd Tremain needed tarps to cover up spots where Florence’s winds ripped shingles off his roof. Others got a case of bottled water or military MREs, or field rations. An olive-drab military forklift moved around huge pallets loaded with supplies.

Brandon Echavarrieta struggled to stay composed as he described life post-Florence: no power for days, rotted meat in the freezer, no water or food and just one bath in a week.

“It’s been pretty bad,” said Echavarrieta, 34, his voice breaking.

About 3,500 vehicles came through for supplies on the first day they were available, county officials said in a Facebook post.

Supplies have been brought into the city by big military trucks and helicopters.

At Fayetteville, about 100 miles (160 kilometers) inland, near the Army’s sprawling Fort Bragg, flooding from Cape Fear River got so bad that authorities closed a vehicle bridge after the water began touching girders supporting the span’s top deck.

Fayetteville Mayor Mitch Colvin said it was unclear if the bridge was threatened.

“We’ve never had it at those levels before, so we don’t really know what the impact will be just yet,” he said.

___

Waggoner reported from Raleigh, North Carolina. AP photographer Gerry Broome in Lumberton, North Carolina; Gary Robertson in Raleigh; Alex Derosier in Fayetteville, North Carolina; and Jay Reeves in Atlanta contributed to this report.

4 Ways to Build a Powerful Progressive Movement

Even in these dark times, I am confident that we can defeat Donald Trump and all he stands for. But it will require building a multiracial, middle- and working-class coalition dedicated to renewing our democracy and creating an economy that works for all, not just the privileged few. Here’s how:

First: At the heart of this coalition must be deep and abiding commitment to the democratic principles of political equality, equal opportunity and justice for all. These same ideals that animated many of us—both white and black Americans—to fight for civil rights and voting rights in the 1960s.

Second: Central to renewing our democracy is getting big money out of politics. For decades, the wealthy and corporations have flooded our political system with campaign contributions and lobbying dollars. In turn, Washington has rewritten the rules of the economy in their favor. This vicious cycle of money and politics funnels more and more wealth and power to those at the top.

Third: We have to ensure the economy works for all Americans, not just the wealthy and corporations. Since the 1980s, the wages and economic prospects of the typical American have gone nowhere. Nearly 80 percent now live paycheck to paycheck, and those paychecks have grown less secure.

Addressing these economic hardships requires a bold agenda: a basic income, a jobs guarantee, Medicare-for-All, access to free public colleges and universities, stronger unions, and worker representation on corporate boards.

Fourth and finally: Whether you voted for Bernie Sanders or Hillary Clinton or anybody else, we must put aside our differences. If we fail to do this, we are playing into the hands of those who seek to divide us. Trump and his enablers will continue to try to divide us, stoking racial divisions, stirring animosity, and breeding confusion and despair. We must not let them.

We have never been a perfect union. Our finest moments have always been when we sought to become more perfect than we had been. Together, we can do so again.

Black Patients Miss Out on Promising Cancer Drugs

This story was co-published with Stat.

It’s a promising new drug for multiple myeloma, one of the most savage blood cancers. Called Ninlaro, it can be taken as a pill, sparing patients painful injections or cumbersome IV treatments. In a video sponsored by the manufacturer, Takeda Pharmaceutical Co., one patient even hailed Ninlaro as “my savior.”

The U.S. Food and Drug Administration approved it in 2015 after patients in a clinical trial gained an average of six months without their cancer spreading. That trial, though, had a major shortcoming: its racial composition. One out of five people diagnosed with multiple myeloma in the U.S. is black, and African Americans are more than twice as likely as white Americans to be diagnosed with the blood cancer.

Yet of the 722 participants in the trial, only 13 — or 1.8 percent — were black.

The scarcity of black patients in Ninlaro’s testing left unanswered the vital question of whether the drug would work equally well for them. “Meaningful differences may exist” in how multiple myeloma affects black patients, what symptoms they experience and how they respond to medications, FDA scientists wrote in a 2017 journal article.

The racial disparity in the Ninlaro study isn’t unusual. Reflecting the reluctance of the FDA to force drugmakers to enroll more minority patients, and the failure of most manufacturers to do so voluntarily, stark under-representation of African Americans is widespread in clinical trials for cancer drugs, even when the type of cancer disproportionately affects them. A ProPublica analysis of data recently made public by the FDA found that in trials for 24 of the 31 cancer drugs approved since 2015, fewer than 5 percent of the patients were black. African-Americans make up 13.4 percent of the U.S. population.

Source: U.S. Food and Drug Administration; National Cancer Institute (Riley Wong for ProPublica)

As a result, desperately ill black patients who have exhausted other treatment options aren’t getting early access to experimental drugs that could extend their life spans or improve their quality of life. While unapproved treatments also carry a risk of setbacks or side effects, new cancer drugs have dramatically shifted outcomes for some patients.

Recently approved lung cancer treatments are “revolutionary,” said Dr. Karen Kelly, associate director for research at UC Davis Comprehensive Cancer Center. Even in the first phase of clinical testing, which is aimed at making sure a drug is safe, 20 percent of cancer patients now see their tumors shrink or disappear, up from 5 percent in the early 1990s, Kelly said.

Dr. Kashif Ali, research head at Maryland Oncology Hematology, has spent seven years recruiting patients for about 30 cancer and blood disease trials a year. He said he’s often seen minorities, including African Americans, miss out on trials because of financial hurdles, logistical challenges and their lingering distrust of the medical community due to a history of being victimized by medical experimentation.

“They’re potentially losing out on life-extending opportunities because it’s one more option they no longer have,” Ali said. “Especially when patients are in advanced stages of cancer, treatments are like stepping stones: When one stops working, you move on to the next.”

Not joining a trial can mean “you’ve lost life expectancy,” he said.

Pat Conley, a 72-year-old retired business analyst whose multiple myeloma relapsed last year, has never participated in a clinical trial. She was interested several times and didn’t meet the criteria. Now she’s eligible for one, but worries about the burden of regular hourlong trips from her Fayetteville, Georgia, home to the trial site in Atlanta, as well as the copays for medical tests. “They’ll want a new biopsy and Lordy, biopsies are not cheap,” she said.

Still, two drug regimens haven’t halted her cancer and she wants something positive to come from her illness. “If they don’t have African Americans to test it on, how will they know it’s going to work?” she asked. “If it doesn’t help me, it’ll help my children, it’ll help somebody else.”

Pharmaceutical companies contacted by ProPublica all said diversity in clinical trials is important to ensure that drugs meet patients’ needs. The issue “is not elevated high enough in the discussion on clinical studies,” said John Maraganore, chair of the industry group Biotechnology Innovation Organization. But he added that enrolling minorities is challenging, often for reasons beyond the manufacturer’s control, and that it would require a “public-private partnership, working with the FDA and NIH [National Institutes of Health].”

Black participation reached 10 percent in trials for only two of the 31 cancer drugs: the multiple myeloma drug Darzalex, where the figure was exactly 10 percent, and Yondelis, which treats two types of soft tissue cancer. Twelve percent of patients in the Yondelis trial were black, the highest proportion in the ProPublica study. Both drugs are made by Johnson & Johnson, which said it has an internal working group on trial diversity. The working group trains site leaders in best practices for diverse recruitment and seeks minority physicians to help run trials, since some patients prefer being treated by doctors of their own race.

Not enrolling in clinical trials is just one of many ways that African Americans trail white Americans in the quality of their health care. From diagnosis to death, they often experience inferior care and worse outcomes. Because some black Americans can’t afford the health insurance mandated under the Affordable Care Act, they remain less likely to have coverage than non-Hispanic white Americans. African Americans are 30 percent more likely than white Americans to die from heart disease. Black mothers are three to four times as likely as white mothers to die in pregnancy or childbirth, and black children are diagnosed with autism later than white children.

While the scarcity of African Americans stands out in ProPublica’s analysis, there appear to be gaps in participation of other minority groups as well. Asians were well represented in trials held in some foreign countries, but they made up only 1.7 percent of patients for drugs for which at least 70 percent of trials were conducted within the U.S. By comparison, about 6 percent of the U.S. population identifies as Asian. Almost two-thirds of the trials didn’t report any Native Americans or Alaska Natives, who together make up about 2 percent of the U.S. population. ProPublica’s analysis excluded Hispanics, because the FDA reports did not have a separate category for them until 2017 and do not distinguish between white and non-white Hispanics.

The very relationship of race to drug development is fraught with controversy. Race is primarily seen as a social concept, rather than as a product of measurable biological traits. Yet there’s growing evidence that, whether for environmental or genetic reasons, drugs may have different effects on different populations.

In 2014, the state of Hawaii sued Bristol-Myers Squibb Co. and Sanofi, the manufacturers of the blood thinner Plavix, accusing them of deceptive marketing for failing to disclose that the drug was less effective for some patients of East Asian or Pacific Islander descent. The drugmakers have denied allegations of misconduct and argue that genetic traits have not been proven to affect how well Plavix works. The case is pending. In the meantime, the FDA has added a warning to the label saying that Chinese patients are more likely to have a gene variation that renders the drug ineffective. Researchers at the University of California, San Francisco have found that a commonly used asthma medication, albuterol, doesn’t work as well for African-American and Puerto Rican children as it does for European American or Mexican children.

Inadequate minority representation in drug trials means that “we aren’t doing good science,” said Dr. Jonathan Jackson, founding director of the Community Access, Recruitment and Engagement Research Center at Massachusetts General Hospital in Boston. “If we aren’t doing good science and releasing these drugs out into the public, then we are at best being inefficient, at worst being irresponsible.”

The National Black Church Initiative, a coalition of 34,000 U.S. churches, urged the FDA in 2017 to mandate diversity in all clinical trials before approving a drug or device. “Simply put, the pharmaceutical community is not going to improve minority participation in clinical trials until the FDA compels them to do so via regulations,” it wrote to Commissioner Scott Gottlieb.

The FDA hasn’t done so. Although it noted in a 2013 report that a lack of diversity betrays a key ethical principle of medical research — equal justice for all — the agency has shied away from setting quotas or numerical guidelines for participation by race.

Instead, it has relied on persuasion. In its 2014 Action Plan, it said it aims to “share best practices,” to “support” industry efforts at improving diversity in clinical trials, and to “encourage” patients to participate in trials via social media, emails and blog posts.

“The FDA believes that enrollment should reflect the patients most likely to use a medical product,” spokeswoman Gloria Sanchez-Contreras said. The FDA “does not have the regulatory authority to require specific levels of minority representation in clinical trials,” although it may ask drugmakers for additional data, she said.

Dr. Rachel Sherman, the FDA’s principal deputy commissioner, said that she’s “not entirely satisfied” with minority enrollment but that clinical trials have become more diverse in other ways. Two decades ago, women and children were rarely included in drug studies. Now those groups are better represented and the FDA is working on including more minorities, she said.

Sherman added that the agency has to balance how much information it demands from drugmakers against the need to get a drug onto the market, where it will be broadly available for all patients.

“When it comes to clinical research in this country, there’s a credit card, and there’s a limit on the credit card,” she said. “If we spend on one thing, it won’t get spent on another. We have to be judicious in what we require and what we demand and what we encourage.”

Diversity has its trade-offs. Clinical trials already cost hundreds of millions of dollars, and drugmakers say that requiring participants to be racially representative would likely add more time and expense.

“If you have a significant delay in enrollment, that would delay the medication advancing to the whole patient population, hurting everybody including the black population,” said Maraganore, who is also CEO of drugmaker Alnylam Pharmaceuticals Inc.

To offset costs caused by these delays, manufacturers might reduce the number of drugs in development, depriving some patients of experimental treatments, or raise prices, which would translate into higher insurance premiums and make new drugs even less affordable for the uninsured. Maraganore favors improving diversity through patient education — “a carrot-based approach” — rather than government regulation.

Despite these short-term expenses, eliminating racial disparities in clinical trials would ultimately save costs through disease prevention and improved treatment, according to a 2015 analysis by researchers at the University of California, San Francisco. Without FDA pressure, though, manufacturers may be unlikely to increase efforts to recruit African Americans, especially if their sights are set on a worldwide market. They can use the same clinical trial data to gain approval in the European Union, or Japan.

Takeda, which is based in Tokyo, Japan, tested Ninlaro in the U.S., Japan and 24 other countries, including Australia, Austria, Denmark, New Zealand, Sweden and others with small black populations. “Clinical trials are reflective of the ethnicity distribution in the population where the study takes place,” Phil Rowlands, head of Takeda’s oncology unit, said in an email. “While we cannot control enrollment eligibility based on the strict clinical criteria, our recruitment efforts extend to diverse patient populations, including minorities.”

Asked why Takeda didn’t pick sites with higher black populations, Rowlands said that Takeda does not “select sites with ethnicity as an eligibility criteria unless specific risk factors require that.”

Income is another reason for sparse African-American representation. Clinical trials are largely a middle-class option. A 2015 study found that patients with an annual household income below $50,000 had 32 percent lower odds of participating in a trial than patients with income above that threshold. The median household income of African Americans in 2016 was $39,490, compared to $65,041 for non-Hispanic white Americans.

Patients who can’t afford to travel long distances to a trial, take time off work or find child care are at a disadvantage. They are usually reimbursed for travel and food costs, but drugmakers are careful not to pay too much because they do not want to appear to be enticing patients to join when it isn’t in their medical interests, said Laurie Halloran, founder and CEO of a consulting firm for the drug industry.

While the experimental drug used in a study is free, any approved treatments that are part of the trial typically need to be covered by a patient’s own insurance, according to Ali, the research director at Maryland Hematology Oncology.

He recalled one black patient who was eligible for a study that entailed taking an already approved drug in combination with a new treatment. The approved drug cost $10,000 a month and the patient’s insurance charged 20 percent as his copayment, Ali recalled. The patient decided that joining the trial would be too expensive. He instead underwent chemotherapy, which was cheaper, but he didn’t tolerate it well. The patient is now considering hospice, Ali said.

Criteria for admission to clinical trials have become more stringent over the years, Mass. General’s Jackson said, and patients of color are increasingly excluded. They are more likely than white people to have other conditions such as stroke, hypertension and diabetes, which could complicate research results. Trials often want to enroll “the healthiest sick people they can find” and preclude patients with other conditions. “The wall basically gets taller and taller,” he said.

Aredia Taylor didn’t qualify on other grounds. A former U.S. Department of Agriculture supervisor for food safety inspections, she was diagnosed with multiple myeloma in 2014 and has undergone a gamut of treatment including various chemotherapy drugs and a stem cell transplant.

While the transplant drove her cancer into remission, there is no cure for multiple myeloma, and she needs to take Revlimid — a standard treatment — daily to keep the cancer at bay. The drug has given her side effects that she describes as devastating to her daily life, including diarrhea, muscle spasms and an inability to concentrate. She said she wants to stop taking Revlimid and would be willing to try an experimental treatment.

Taylor, 58, said she saw pamphlets at her doctor’s office encouraging patients to ask about clinical trials, so she asked her oncologist, Dr. Larry Anderson at the University of Texas Southwestern Medical Center in Dallas, whether she should join a study. He told her that she “wasn’t a fit,” she said. Anderson told ProPublica that most trials are seeking patients with either newly diagnosed or relapsed multiple myeloma, and since Taylor is currently in remission, she wouldn’t be accepted.

Taylor was disappointed. Knowing that African Americans like herself are especially susceptible to multiple myeloma, she’d like to be a part of developing more effective treatments.

“I want to pay it forward and be a blessing to somebody else,” she said. “I want to be one of the people that they try to do a clinical trial for, so they find a way to a cure.”

Spurred by Congress, the FDA began in January 2015 to regularly publish a “Drug Trials Snapshot” for every new drug approved, delineating the demographic breakdown for clinical trial participants by sex, race and age subgroups. ProPublica’s analysis focused on participants in trials for the 31 cancer drugs approved since then, comparing their demographics with data from the National Cancer Institute on the incidence of various cancers by race.

Eighteen of those drugs targeted cancers that are at least as likely to afflict black Americans as white Americans. On average, only 4.1 percent of patients in those trials were black. Trials for four multiple myeloma drugs, including Ninlaro, averaged 5 percent black participation.

Source: U.S. Food and Drug Administration; National Cancer Institute (Riley Wong for ProPublica)

An FDA study over a longer time period corroborated ProPublica’s findings. In a 2017 article in the journal Blood co-authored by Richard Pazdur, the FDA’s cancer chief, the agency reported that black patients on average made up 4.5 percent of participants in trials for multiple myeloma drugs since 2003. Higher enrollment of minorities in myeloma trials would have “multiple benefits,” the FDA scientists noted. Not only would “underserved populations” gain access to new therapies, but additional data could help researchers identify subtypes of the blood cancer and develop targeted treatments.

A similar pattern emerges for treatments of non-small cell lung cancer. It occurs in 56 out of 100,000 black Americans, versus 49 out of 100,000 white Americans. Yet ProPublica found that in trials for two recently approved drugs for a type of non-small cell lung cancer driven by a mutation in what is known as the ALK gene, less than 2 percent of participants were black.

Those drugs, Takeda’s Alunbrig and Genentech’s Alecensa, are approved for patients whose lung cancer has spread to other parts of the body. In trials, both drugs were able to shrink tumors, including lesions in the brain. Patients taking Alecensa lived without the disease progressing for an average of 25.7 months, more than double the 10.4 months for patients on another treatment.

“We believe that we must consider differences across all populations to deliver on the promise of personalized health care,” said Meghan Cox, a Genentech spokeswoman, adding that the drugmaker is “continuing to study patient response to Alecensa across populations in the post-marketing setting.”

Source: U.S. Food and Drug Administration; National Cancer Institute (Riley Wong for ProPublica)

Similarly, prostate cancer affects 178 out of every 100,000 African Americans, more than for any other race in the U.S., compared to 106 out of every 100,000 white Americans. Black Americans are twice as likely as white Americans to die from prostate cancer.

Yet from 2009 to 2015, in seven trials conducted for five new prostate cancer therapies, only 3 percent of participants were black, according to a study conducted by Dr. Daniel Spratt, vice chair of research for the department of radiation oncology at the University of Michigan. More recently, 11 times as many white as black participants — or 66 percent compared to 6 percent — joined trials for Johnson & Johnson’s new prostate cancer treatment, Erleada.

The FDA approved Erleada in February after trials showed patients on the drug lived an average of two years longer without their cancer spreading into other organs than if they were taking a placebo. In a J&J press release, physicians hailed Erleada’s “impressive clinical benefits” for prostate cancer patients.

J&J is “confident in the efficacy and safety data that have supported the approval” of Erleada, J&J spokeswoman Satu Glawe said.

Source: U.S. Food and Drug Administration; National Cancer Institute (Riley Wong for ProPublica)

Like Genentech, J&J and Takeda said they track drugs after approval to see if any racial differences emerge. For example, after another J&J drug for prostate cancer, Zytiga, went on the market in 2011, the company ran a new study of 100 patients, 50 black and 50 white.

“We were aware of the low number of African American men” in the pre-approval drug studies of Zytiga, Glawe said. The post-marketing study was intended “to ensure the medication was also providing clinical benefit to these patients.” In fact, it showed that black men responded better than white men to the drug.

The FDA is able to look for signs that an approved drug isn’t helping a specific population through a surveillance system launched in 2016, called Sentinel, which provides access to medical claims and other data on 200 million Americans obtained from insurers and other health providers, Sherman, the FDA’s principal deputy commissioner, said.

Still, post-marketing surveillance doesn’t compensate for lack of diversity in clinical trials. Minorities still miss out on experimental treatments — and, if they take a drug once it’s approved, may suffer unanticipated side effects.

Leaving analysis of a drug’s effect on minorities until it’s already on the market is “a hubristic assumption, unnecessarily arrogant,” Jackson said. Drugs should “work for the individuals who are the most vulnerable,” he said. “That necessarily includes racial and ethnic minorities.”

Like African Americans, Native Americans rarely enroll in clinical trials. Among the drug trials analyzed by ProPublica, 64.5 percent did not report any Native American participants, even for types of cancer that Native Americans get at similar rates as other races. (It’s possible that some Native Americans were enrolled but lumped into a generic “other” category.)

Native Americans are at higher risk of colorectal cancer than white or Asian Americans. Yet the drugmaker Taiho Oncology didn’t report a single Native American among the 800 participants in its trials for the colorectal cancer treatment Lonsurf. Taiho didn’t respond to requests for comment.

Source: U.S. Food and Drug Administration; National Cancer Institute (Riley Wong for ProPublica)

To understand how a small minority group responds to a drug, researchers might have to enroll more patients than what would be a nationally representative sample. In a trial of 100 people, two Native American or Alaska Native patients would reflect those groups’ proportion of the U.S. population, but wouldn’t give doctors enough information about race-related impacts.

Dr. Linda Burhansstipanov, founder of the Native American Cancer Research Corporation, estimated that 85 percent of Native Americans want to participate in clinical trials when informed of the opportunity. She knows several Native American patients who drove three hours each way to participate in a trial, despite losing an entire day of work.

Still, trial protocols are rarely designed with minority communities in mind, Burhansstipanov said. It has long been rumored among Native Americans, she said, that a clinical trial in the 1990s required patients to take a medication upon rising in the morning. In many Native American tribes, the first thing people do when they wake up is greet the sun with morning prayers. For some tribes, prayers can take more than half an hour. Because of the delay, the tale goes, Native American patients were kicked out of the clinical trial for violating the protocol. “The story spread and became a barrier for people to take part in clinical trials,” she said.

In addition, the history of unscrupulous medical experimentation on minorities feeds wariness of clinical trials. Angela Marshall, an internal medicine doctor and board member of Black Women’s Health Imperative, said she sees a “lack of excitement among minority communities for clinical trials, coming from a mistrust of the medical community.”

Her black patients often cite the infamous Tuskegee study, conducted from 1932 to 1972 by the U.S. Public Health Service, in which researchers knowingly withheld treatment from African American sharecroppers with syphilis in order to study the progression of the disease. Some Native Americans are similarly suspicious of the medical community, Burhansstipanov said, because the Indian Health Service (a unit of the U.S. Department of Health and Human Services) sterilized thousands of Native American women in the 1970s without their consent.

“The medical community has to engage in some serious trust-building initiatives,” Marshall said.

That trust is what has helped to keep Thomas Goode alive. An African American diagnosed with multiple myeloma in 2005 when he was 34, Goode has endured three stem cell transplants. In between each transplant, he participated in clinical trials, where he gained access to drug cocktails that helped bridge him to the next procedure. He counted himself lucky that he lived close to Durham, North Carolina, which is a research hub, so he was able to see specialists and take part in trials.

“I never knew anything about clinical trials, but a lot of my trust and faith was in the doctor,” he said. “I said, ‘I trust you, doctor, whatever you say.’”

Now, Goode has gone six years without a relapse. “I’m in a good place right now,” he said, “But if I didn’t try a trial, who’s to say I would still be here?”

The Sinister Subtext of the Capitalist Manifesto

The original Capitalist Manifesto was a 1958 book by economist Louis O. Kelso and philosopher Mortimer J. Adler. In their view of a properly conducted democratic capitalist society, a sort of modern-day Homestead Act was envisioned, in which all Americans would participate in the “capitalist revolution” of growing stock portfolios. This would be possible because of great technologies (energy in the 1950s, AI now) that would allow all of us, in Aristotelian and Jeffersonian property-owning ways, to become ‘free’ to pursue the arts & sciences and to enjoy more leisure time. Today, this form of democratic capitalism could be realized through the Employee Stock Ownership Plan promoted by the “Just Third Way” movement.

Just one problem. Apparently, in 1958, economists and philosophers were not able to foresee the unlimited greed of the relatively few people with the power to manipulate the strings of the capitalist state. They thought the newly productive post-war capitalists were being cheated by workers who depended on socialist strategies to even the score. But the opposite has happened. Average Americans have been cheated out of the gains from technological productivity. Just in the past ten years in our world of big business, over $30 trillion — nearly a third of our nation’s TOTAL current wealth — has gone to the richest 10% of Americans. Yet market-happy illusionists like the Wall Street Journal keep spouting nonsense about a healthy economy built on today’s capitalism.

The root of the problem is the condemnation of anything ‘social’ as un-American, which has helped modern-day capitalists to justify their belief in individual gain by any means. Wealthy conservatives know that social responsibility might take away some of their riches by providing opportunities and jobs and a decent standard of living for all Americans. In their minds, the poor have only themselves to blame for being poor, and for dying. But it is capitalism that is killing them. The Capitalist Manifesto has been twisted into an assault on poor people.

Politicians and Plutocrats Stand By as People Are Poisoned 

What is the capitalist incentive to clean the water in Flint, Michigan? Little money is to be made, so little effort is made to save lives. People are DYING because there’s no market for profit-making.

From a global perspective, the dangers of poisoning and death from pollution are magnified many times over. There were 1.5 billion people in 1900, there are 7.6 billion now, and 11 billion are anticipated by the year 2100. Scientists predict dangerous increases in respiratory and infectious diseases, malaria, meningitis, typhus, and cholera. And global food shortages. Instead of working in a cooperative manner to encourage self-sufficient small farms around the globe, industrial behemoths like Monsanto and DuPont are positioning themselves for a chemical assault on our food supplies.

Millions Are Without Health Care—for Many Americans That Means Death 

Over 30 million Americans are without health insurance in our business-driven, capitalist society. The American Journal of Public Health flatly states, “Numerous investigators have found an association between uninsurance and death…Our estimate for annual deaths attributable to uninsurance among working-age Americans is more than 140% larger than [the Institute of Medicine’s 2002 study].”

One of the most disturbing examples of individual disdain for society is the opioid epidemic. Purdue Pharmaceutical executives admitted to the felony charge of lying about their product’s addictive qualities, but no one went to jail. In a six-year period to follow, other Big Pharma dealers, including AmerisourceBergen and McKesson, distributed nearly a billion pills to West Virginia alone.

Social responsibility especially implies caring for our young people and the elderly. For the latter, see below. For young adults, one of every five deaths in 2016 involved opioid addiction. The great majority of heroin users started with prescription painkillers. But our social responsibility seems to dissipate under the cloud of individual-centered capitalism. Despite a doubling of opioid overdose deaths in six years, millions of people live in counties without a licensed provider of the drugs needed for treatment.

As social beings, we empathize with the opioid sufferers, but in a profit-driven world in which the victims rather than the predators are blamed for their own bitter misfortunes, the empathy is muted. Social consciousness would correct that. But that won’t happen as long as the media is promoting individual (human and corporate) gains over collective, cooperative efforts to restore our country to health.

Bankruptcies Are Surging, and So Are Suicides 

The percentage of elderly Americans filing for bankruptcy is three times what it was in 1991. Individualism over social consciousness is much to blame. A study by the Social Science Research Network found that the shift from employer and government pensions to individuals has increased risk while exacerbating stress. Meanwhile, much of the stress for working people comes from the 40-year stagnation in wages. “Deaths of despair” from drugs, alcohol and suicide are on the rise. For those who make up the poorest 60 percent of America, premature deaths are up 20 percent since the turn of the century, and the economic suicide rate has risen dramatically.

Life expectancy for the poorest classes in America is now equivalent to that of Sudan or Pakistan.

Yet business-minded conservatives are trying to make it harder for these most vulnerable of Americans to survive. Medicaid work requirements and drug testing are two of the proposed or implemented hardships reserved just for poor people.

The True Meaning of Socialism 

In the worst moments of the hurricanes that keep hitting American cities, members of government and business and military and especially the public abandon thoughts of personal gain and dedicate themselves to the needs of fellow human beings. People around the nation pitch in, through their labors and donations; neighbors and first responders rescue trapped victims; the Red Cross and other charitable organizations, including many local churches, deliver food and supplies and medicine; GoFundMe initiatives are set up; the business community donates their goods and services; government officials remain focused on the people they were elected to represent; even the military contributes with rescue helicopters. No one seems to care about the skin color or religion or politics of those in need.

It takes a tragedy to reveal the true meaning of socialism. It’s not government control, but rather people controlling their own lives through empathy and cooperation.

North Korea’s Kim Agrees to Dismantle Main Nuclear Site if U.S. Takes Steps Too

PYONGYANG, North Korea—The leaders of North and South Korea announced a wide range of agreements Wednesday which they said were a major step toward peace on the Korean Peninsula. But the premier pledge on denuclearization contained a big condition, with North Korean leader Kim Jong Un stating he’d permanently dismantle his main nuclear complex only if the United States takes unspecified corresponding measures.

Compared to the vague language of their two summits earlier this year, Kim and South Korean President Moon Jae-in agreed in their second day of meetings to an ambitious program meant to tackle soaring tensions last year that had many fearing war as the North tested a string of increasingly powerful weapons.

Kim promised to accept international inspectors to monitor the closing of a key missile test site and launch pad and to visit Seoul soon, and both leaders vowed to work together to try to host the Summer Olympics in 2032.

But while containing several tantalizing offers, their joint statement appeared to fall short of the major steps many in Washington have been looking for — such as a commitment by Kim to provide a list of North Korea’s nuclear facilities, a solid step-by-step timeline for closing them down, or an agreement to allow international inspectors to assess progress or discover violations.

It also was unclear what “corresponding steps” North Korea wants from the U.S. to dismantle its nuclear site.

The question is whether it will be enough for U.S. President Donald Trump to pick up where Moon has left off. Trump told reporters Wednesday that the outcome of the summit was “very good news” and that “we’re making tremendous progress” with North Korea. He didn’t indicate in his brief remarks whether the U.S. would be willing to take further steps to encourage North Korean action on denuclearization.

Declaring they had made a major step toward peace, Moon and Kim stood side by side as they announced their joint statement to a group of North and South Korean reporters after a closed-door meeting Wednesday morning. They took no questions.

“We have agreed to make the Korean Peninsula a land of peace that is free from nuclear weapons and nuclear threat,” Kim said at the guesthouse where Moon is staying. “The road to our future will not always be smooth and we may face challenges and trials we can’t anticipate. But we aren’t afraid of headwinds because our strength will grow as we overcome each trial based on the strength of our nation.”

Kim and Moon earlier smiled and chatted as they walked down a hallway and into a meeting room to finalize the joint statement, which also said that the leaders would push for a Korean Peninsula without nuclear weapons and to “eliminate all the danger of war.” Moon and Kim planned to visit a volcano sacred to the North on Thursday, the last day of Moon’s visit.

This week’s summit comes as Moon is under increasing pressure from Washington to find a path forward in efforts to get Kim to completely — and unilaterally — abandon his nuclear arsenal.

Trump has maintained that he and Kim have a solid relationship, and both leaders have expressed interest in a follow-up summit to their meeting in June in Singapore. North Korea has been demanding a declaration formally ending the Korean War, which was stopped in 1953 by a cease-fire, but neither leader mentioned it Wednesday as they read the joint statement.

In the meantime, however, Moon and Kim made concrete moves of their own to reduce tensions on their border.

According to a statement signed by the countries’ defense chiefs, the two Koreas agreed to establish buffer zones along their land and sea borders to reduce military tensions and prevent accidental clashes. They also agreed to withdraw 11 guard posts from the Demilitarized Zone by December and to establish a no-fly zone above the military demarcation line that bisects the two Koreas that will apply to planes, helicopters and drones.

Though not directly linked to security, the leaders’ announcement that they would seek a joint Summer Olympics was a significant move in terms of easing tensions and building trust. It also flows from the North’s decision to participate in the Pyeongchang Winter Games in February, which was regarded as a success for both sides.

Other agreements aimed at removing some longstanding irritants from their relations, such as allowing more contact between families divided by the Korean War. Moon also appeared to be making good on his proposals to help build up the North’s infrastructure and open cross-border rail links.

Unlike Trump’s initial tweets praising the summit, the news brought a quick and negative response from Republican Sen. Lindsey Graham, who tweeted that he was concerned the visit would undermine efforts by Secretary of State Mike Pompeo and U.N. Ambassador Nikki Haley to impose “maximum pressure” on the North.

“While North Korea has stopped testing missiles and nuclear devices, they have NOT moved toward denuclearization,” he tweeted.

With the main business of the day complete, North Korea was expected to hold a huge mass games spectacle in the evening, with Moon as the special guest. Seoul said Moon would make a short speech.

North Korea had put the iconic games, which feature tens of thousands of performers dancing and flipping placards in unison to create giant mosaics and slogans, on a back burner for the past several years, but revived them for this month’s celebrations of its 70th founding anniversary. In a performance for the anniversary, a giant photo of Moon and Kim shaking hands at their first summit in April was projected onto one side of the stands in Pyongyang’s 150,000-seat May Day Stadium.

Kim has gone all out to make Moon’s visit a memorable one.

On Tuesday, the first day of the summit, he greeted Moon and his wife at Pyongyang’s airport and then rode into town with Moon in an open limousine through streets lined with crowds of North Koreans, who cheered and waved the flag of their country and a blue-and-white flag that symbolizes Korean unity.

At the start of their meeting, Kim thanked Moon for brokering the June summit with Trump.

“It’s not too much to say that it’s Moon’s efforts that arranged a historic North Korea-U.S. summit. Because of that, the regional political situation has been stabilized and more progress on North Korea-U.S. ties is expected,” Kim said, according to South Korean media pool reports and Moon’s office.

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Klug reported from Seoul. Associated Press writers Hyung-jin Kim and Kim Tong-hyung in Seoul contributed to this report.

How to Grow More Food While Slowing Down Climate Change

Two new studies have confirmed that farmers can win both ways, achieving a boost in harvests and helping to slow climate change.

One says that they can successfully farm with techniques that can help slow global warming and add to the store of carbon sequestered in the soils around the globe.

And a second study confirms that a range of tested and sustainable practices is already stepping up yields in small farms worldwide, while dramatically reducing greenhouse gas emissions, soil erosion and pesticide use.

Both studies address a planetary dilemma. Global agriculture is at serious risk from global warming and climate change driven by profligate fossil fuel combustion. But global agriculture – powered by greenhouse gas-emitting fossil fuels, ploughing, pesticides and herbicides – is also helping to drive global warming and climate change.

Massive changes needed

And while researchers have persistently argued that it should be possible both to feed the 9bn people expected by 2050, and to contain global warming to no more than 2°C by 2100, such advances can be achieved only by massive changes in diet and expectations. But both new studies focus on what is both practicable and possible right now.

US researchers report in the journal Science Advances that they have identified a range of well-established farming practices that – if adopted by everybody – could capture enough carbon from the atmosphere and store it in the world’s soils at a rate that could make a significant difference.

They suggest that simple approaches – cover crops, more thoughtful use of grazing animals, the planting of legumes on rangelands and so on – could, if coupled with dramatic reductions in carbon dioxide emissions, notionally add as much as 1.78 billion tonnes of carbon from the atmosphere to soils, lowering temperatures by 0.26°C. Since 1880, global average temperatures have already risen by about 1°C.

More tentatively, they suggest that if farmers added biochar – the residue of crops burned to make charcoal – to their soils, this could reduce global warming by as much as 0.46°C.

“I’m impressed by how far farmers across the world and especially in less developed countries have come in moving our food-production systems in a healthy direction”

Massive shifts to renewable energy worldwide would also be necessary: ever more carbon dioxide in the atmosphere would make changes in farming practices proportionately ever less effective. The bonus is that more carbon drawn down from the atmosphere and stored in the soil would pay off with healthier soils and better crop conditions.

“These are very commonly used approaches, though people don’t use them to sequester carbon – they are doing it for other reasons”, said Whendee Silver, an ecosystem ecologist at the University of California at Berkeley, and one of the authors.

“Any time you increase the organic content of soils, you are generally increasing the fertility, water-holding capacity, sustainability, decreasing erosion and increasing general resilience to climate change. Sequestering carbon is a side benefit.”

Costs lowered

In the same week, scientists from five nations reported in the journal Nature Sustainability that they could show that farming practices that show consideration for the global environment can and do deliver more food at lower costs.

Enthusiasts and environmentalists have been promoting “organic” or sustainable farming for decades. What the scientists call “sustainable intensification” is already employed in around a tenth of the world’s farmlands.

They looked at data and reports from 400 sustainable intensification initiatives – agroforestry is one example – used on either more than 10,000 farms or over 10,000 hectares of farmland. Altogether, their survey covered an estimated 163 million farms.

And their study showed that productivity went up, biodiversity and ecosystem services were conserved, yet costs were down.

Food for all

In West Africa, farmers were growing more cassava and maize. In Cuba, 100,000 farmers had stepped up yields by 150% while reducing pesticide use by 85%.

“Although we have a long way to go, I’m impressed by how far farmers across the world and especially in less developed countries have come in moving our food-production systems in a healthy direction,” said John Reganold, a soil scientist at Washington State University in the US, and one of the authors.

“Stronger government policies across the globe are now needed to support the greater adoption of sustainable intensification farming systems so that the United Nations Sustainable Development Goals endorsed by all members of the UN are met by 2030.

“This will help provide sufficient and nutritious food for all, while minimising environmental impact and enabling producers to earn a decent living.”

A Saudi-American War of Terror

It’s the war from hell, the savage one that Saudi Arabia and the United Arab Emirates, along with seven other Middle Eastern and North African states, have been waging in Yemen since March 2015, with fulsome support from the Pentagon and American weapons galore. It’s got everything. Dead children in the dozens, a never-ending air campaign that pays scant heed to civilians, famine, cholera, you name it. No wonder it’s facing mounting criticism in Congress and from human rights groups. Still, ever since President Donald Trump (like Barack Obama before him) embraced the Saudi-led coalition as this country’s righteous knight errant in the Middle East, the fight against impoverished Yemen’s Houthi rebels — who have, in turn, been typecast as Iran’s cats-paw — has only grown fiercer. Meanwhile, the al-Qaeda affiliate there continues to expand.

For years now, a relentless Saudi air campaign (quite literally fueled by the U.S. military) has hit endless civilian targets, using American smart bombs and missiles, without a peep of protest or complaint from Washington. Only a highly publicized, completely over-the-top slaughter recently forced the Pentagon to finally do a little mild finger wagging. On August 7th, an airstrike hit a school bus — with a laser-guided bomb made by Lockheed Martin — in northern Yemen, killing 51 people, 40 of them schoolchildren. Seventy-nine others were wounded, including 56 children. Soon after, a U.N. Security Council-appointed group of experts issued a report detailing numerous other egregious attacks on Yemeni civilians, including people attending weddings and funerals. Perhaps the worst among them killed 137 people and wounded 695 others at a funeral in Sana’a, Yemen’s capital, this April.

The attack on those schoolchildren and the U.N. report amplified a growing global outcry against the carnage in Yemen. In response, on August 28th, Secretary of Defense James Mattis let it be known that the Trump administration’s support for the Persian Gulf potentates’ military campaign should not be considered unreserved, that the Saudis and their allies must do “everything humanly possible to avoid any innocent loss of life.” Considering that they haven’t come close to meeting such a standard since the war started nearly five years ago and that the Trump administration clearly has no intention of reducing its support for the Saudis or their war, Mattis’s new yardstick amounted to a cruel joke — at the expense of Yemeni civilians.

The Statistics of Suffering

Some appalling numbers document the anguish Yemenis have endured. Saudi and Emirati warplanes officially have killed — and it’s considered a conservative estimate — 6,475 civilians and wounded more than 10,000 others since 2015. Targets struck have included farms, homes, marketplaces, hospitals, schools, and mosques, as well as ancient historic sites in Sana’a. And such incidents haven’t been one-off attacks. They have happened repeatedly.

By April 2018, the Saudi-led coalition had conducted 17,243 airstrikes across Yemen, hitting 386 farms, 212 schools, 183 markets, and 44 mosques. Such statistics make laughable the repeated claims of the Saudis and their allies that such “incidents” should be chalked up to understandable errors and that they take every reasonable precaution to protect innocents. Statisticscompiled by the independent Yemen Data Project make it clear that the Gulf monarchs don’t lie awake at night lamenting the deaths of Yemeni civilians.

Saudi Arabia and its partners have accused the Houthis, the rebels with whom they have been in such a deadly struggle, of also attacking Yemeni civilians, a charge Human Rights Watch has validated. Yet such a they-do-it-too defense hardly excuses the relentless bombing of non-military sites by a coalition that has overwhelming superiority in firepower. Houthi crimes pale by comparison.

And when it comes to the destruction of civilian lives and livelihoods, believe it or not, that may be the least of it. Take the naval blockade of the country by Saudi Arabia and the United Arab Emirates that cut the number of ships docking in the Houthi-controlled port of Hodeida from 129 between January and August 2014 to 21 in the same months of 2017. The result: far less food and medicine entered the country, creating a disaster for Yemenis.

That country, the Arab world’s poorest, has long relied on imports for a staggering 85% of its food, fuel, and medicine, so when prices soared, famine spread, while hunger and malnutrition skyrocketed. Nearly 18 millionYemenis now rely on emergency food aid to survive: that’s an unbelievable 80% of the population. According to the World Bank, “8.4 million more are on the brink of famine.” In December 2017, following a barrage of bad publicity, the Saudi-Emirati blockade was eased marginally, but it had already set in motion a spiral of death.

The blockade also contributed to a cholera epidemic, which the shortage of medicines only exacerbated. According to a World Health Organization report, between April 2017 and July 2018, there were more than 1.1 million cholera cases there. At least 2,310 people died from the disease, most of them children. It is believed to be the worst cholera outbreak since statistics began to be compiled in 1949. At 800,000 cases between 2010 and 2017, Haiti held the previous record, one that the Yemenis surpassed within half a year of the first cases appearing. The prime contributors to the epidemic: drinking water contaminated by rotting garbage (uncollected because of the war), devastated sewage systems, and water filtration plants that stopped running due to lack of fuel — all the result of the horrendous bombing campaign.

Wartime economic blockades starve and sicken civilians and soldiers alike and so amount to a war crime. The Saudi-Emirati claim that the blockade’s sole purpose is to stanch the flow of Iranian arms to the Houthis is nonsense, nor can it be considered a legitimate act of self-defense, even though it was instituted after the Houthis fired ballistic missiles at the airport in the Saudi capital and the residence of that country’s monarch. (Both were shot down by Saudi air defenses and were clear responses to coalition airstrikes on Houthi-held territory that killed 136 civilians.) By the standards of international humanitarian law or simply common sense, choking off Yemen’s imports was a disproportionate response, and clairvoyance wasn’t required to foresee the calamitous consequences to follow.

True to form, President Trump’s U.N. ambassador, Nikki Haley, echoed Saudi charges that the Houthi missiles were Iranian-supplied Qiam-1s and condemned that country’s interference in Yemen. Given the scale of destruction by a foreign coalition using armaments and technical assistance provided by the United States (and Britain), her comments, in less grim circumstances, would have been laughable.

Those American-supplied weapons have included cluster munitions, which pose a particular hazard to civilians because, when dropped from a plane, their devastating bomblets often disperse over enormous areas. (Such bombs are banned under a 2008 treaty signed by 120 countries that neither Riyadh nor Washington has joined.) In May 2016, the Obama White House confirmed that it had stopped sending such weapons to Saudi Arabia, which then continued to use Brazilian-made variants. However, other American arms have continued to flow to Saudi Arabia, while its warplanes rely on U.S. Air Force tankers for mid-air refueling (88 million pounds of fuel as of this January according to a Central Command spokeswoman), while the Saudi military has received regular intelligence information and targeting advice from the Pentagon since the war began. And with the advent of Donald Trump, such military involvement has only deepened: U.S. Special Operations forces are now on the Saudi-Yemen border, helping to find and attack Houthi redoubts.

In June 2018, ignoring U.S. opposition, the Saudi coalition heightened the risk to Yemeni civilians yet more by launching an offensive (“Golden Victory”) to capture the port of Hodeida. (So much for the Pentagon’s standard claim that supporting the war gives the U.S. influence over how it is waged and so limits civilian casualties.) Saudi and Emirati airpower and warships supported Emirati and Sudanese troops on the ground joined by allied Yemeni militias. The advance, however, quickly stalled in the face of Houthi resistance, though only after at least 50,000 families had fled Hodeida and basic services for the remaining 350,000 were disrupted, creating fears of a new outbreak of cholera.

The Roots of War

Yemen’s progression to its present state of perdition began as the Arab Spring’s gales swept through the Middle East in 2011, uprooting or shaking regimes from Tunisia to Syria. Street demonstrations grew against Yemen’s strongman, Ali Abdullah Saleh, and only gathered strength as he attempted to quell them. In response, he allied ever more strongly with Saudi Arabia and the United States, alienating the Houthis, whose main bastion, the governate of Saada, abuts the Saudi border. Adherents of Zaydi Islam, the Houthis played a pivotal role in creating a political movement, Ansar Allah, in 1992 to assert the interests of their community against the country’s Sunni majority. In an effort to undercut them, the Saudis have long promoted radical Sunni religious leaders in Yemen’s north, while intermittently raiding Houthi territories.

As a Houthi rebellion began, Saleh tried to make himself an even more indispensable ally of Washington in its post-9/11 anti-terrorist campaigns, notably against al-Qaeda in the Arabian Peninsula (AQAP), a growing local franchise of al-Qaeda. For good measure, he joined the Saudis in painting the Houthis little more than tools of an Iran that Washington and Riyadh both loathed. When those powers nonetheless came to see the Yemeni autocrat as a political liability, they helped oust him and transfer power to his deputy, Abdu Rabbu Mansour Hadi. Such moves failed to calm the waters, as the country started to disintegrate and Saudi-U.S. efforts to consolidate the transition from Saleh to Hadi unraveled.

Meanwhile, regular American drone strikes against AQAP angered many Yemenis. In their eyes, not only did the attacks violate Yemen’s sovereignty, they intermittently killed civilians. Hadi’s praise for the drone campaign only discredited him further. AQAP’s power continued to grow, resentment in southern Yemen rose, and criminal gangs and warlords began to operate with impunity in its cities, highlighting the Hadi government’s ineffectuality. Neoliberal economic reforms only further enriched a clutch of families that had long controlled much of Yemen’s wealth, while the economic plight of most Yemenis worsened radically. The unemployment rate was nearly 14% in 2017 (and exceeded 25% for young people), while the poverty rate rose precipitously, as did inflation.

It was a formula for disaster and when Hadi proposed a plan to create a federal system for Yemen, the Houthis were infuriated. New boundaries would, among other things, have cut their homeland off from the Red Sea coast. So they gave up on his government and girded for battle. Soon, their forces were advancing southward. In September 2014, they captured the capital, Sana’a, and proclaimed a new national government. The following March, they occupied Aden in southern Yemen and Hadi, whose government had moved there, promptly fled across the border to Riyadh. The first Saudi airstrikes against Sana’a were launched in March 2015 and Yemen’s descent to hell began.

The American Role

The commonplace rendition of the war in Yemen pits a U.S.-backed Saudi coalition against the Houthis, cast as agents of Iran and evidence of its increasing influence in the Middle East. Combatting terrorism and countering Iran became the basis for Washington’s support of the Saudi-led war. Predictably, as this cartoonish portrayal of a complicated civil war gained ground in the mainstream American media and among Beltway pundits (as well, of course, as in the Pentagon and White House), inconvenient facts were shunted aside.

Still, all these years and all those dead later, it’s worth considering some of those facts. There are, for instance, significant differences between the Houthis’ Zaydi variant of Shia Islam and the Twelver Shiism dominant in Iran — and some similarities between Zaydis and Sunnis — which makes the ubiquitous claims about a Iran-Houthi faith-based pact shaky. Moreover, Iran did not jump into the fray during the violent 2004-2010 clashes between Saleh and the Houthis and did not have longstanding ties to them either. In addition, contrary to the prevailing view in Washington, Iran is unlikely to be their main source of weaponry and support. Sheer distance and the Saudi coalition’s naval blockade have made it next to impossible for Iran to supply arms to the Houthis in the volume alleged. Besides, having pillaged various military bases during their march toward Aden, the Houthis do not lack for weaponry. Iran’s influence in Yemen has undoubtedly increased since 2015, but reducing the intricacies of that country’s internal crisis to Iranian meddling and a Tehran-led Shiite bloc expanding from Syria to the Arabian Peninsula amounts to, at best, a massive oversimplification.

The obsession of Trump and his key advisers with Iran (a remarkable number of them are Iranophobes) and The Donald’s obsession with plugging American arms makers and hawking their wares helps explain their embrace of the House of Saud and continuing support for its never-ending assault on Yemen. (Jared Kushner’s bromance with Saudi Crown Prince Mohammad bin Salman undoubtedly played a part as well.) None of that, however, explains the full-scale American backing for the Saudi-led intervention there in the Obama years. Even as his administration denounced Bashar al-Assad’s slaughter of Syrian civilians, his officials seemed unmoved by the suffering war was inflicting on Yemenis. In fact, the Obama administration offered $115 billion worth of weaponry to Riyadh, including a $1.15 billion package finalized in August 2016, when the scale of Yemen’s catastrophe was already all too obvious.

In recent years, opposition to the war in Congress has been on the rise, with Senator Bernie Sanders and Representative Ro Khanna playing prominent roles in mobilizing it. But such congressional critics had no effect on Obama’s war policy and are unlikely to sway Trump’s. They face formidable barriers. The mainstream narrative on the war remains powerful, while the Gulf monarchies continue to buy vast quantities of American weaponry. And don’t forget the impressive, money-is-no-object Saudi-Emirati lobbying operation in Washington.

That, then, is the context for the Pentagon’s gentle warning about the limits of U.S. support for the bombing campaign in Yemen and Secretary of State Mike Pompeo’s subsequent certification, as required by Congress, that the Saudis and Emiratis were taking perfectly credible action to lower civilian casualties — without which the U.S. military could not continue refueling their planes. (Mattis “endorsed and fully supported” Pompeo’s statement.)  As the fifth anniversary of this appalling war approaches, American-made arms and logistical aid remain essential to it.  Consider President Trump’s much-ballyhooed arms sales to the Saudis, even if they don’t total $100 billion (as he claimed): Why then would the Saudi and Emirati monarchs worry that the White House might actually do something like cutting off those lucrative sales or terminating the back-end support for their bombing campaign?

One thing is obvious: U.S. policy in Yemen won’t achieve its declared goals of defeating terrorism and rolling back Iran. After all, its drone strikes began there in 2002 under George W. Bush. Under Obama, as in Pakistan and in Afghanistan, drones became Washington’s anti-terrorist weapon of choice. There were 154 drone strikes in Yemen during the Obama years according to the most reliable high-end estimates, and civilian casualties ranged between 83 and 101. Under Trump they soared quickly, from 21 in 2016 to 131 in 2017.

The reliance on drone attacks has bolstered al-Qaeda’s narrative that the American war on terror amounts to a war on Muslims, whose lives are deemed expendable. And so many years later, in the chaos of Yemen, the group’s power and reach is only growing. The U.S.-backed, Saudi-led intervention is also likely to prove not just self-defeating but self-prophetic. It seems to be cementing an alliance between Iran and the Houthis who, though they have been pushed out of Aden, still control a big chunk of Yemen. Meanwhile, in a move that could make the war even deadlier, the Emiratis appear to be striking out on their own, supporting secession in southern Yemen. There’s not much to show on the anti-terrorism front either. Indeed, the Saudi coalition’s airstrikes and U.S. drone attacks may be moving Yemenis, enraged by the destruction of their homes and livelihoods and the deaths of loved ones, toward AQAP. In short, a war on terror has turned into a war of and for terror.

In Yemen, the United States backs a grim military intervention for which — unless you are a weapons company — it is hard to find any justification, practical or moral. Unfortunately, it is even harder to imagine President Trump or the Pentagon reaching such a conclusion and changing course.

Storm Flooding Kills 3.4 Million Chickens and Turkeys

About 3.4 million chickens and turkeys and 5,500 hogs have been killed in flooding from Florence as rising North Carolina rivers swamped dozens of farm buildings where the animals were being raised for market, according to state officials.

The N.C. Department of Agriculture issued the livestock mortality totals Tuesday, as major flooding is continuing after the slow-moving storm’s drenching rains. Sixteen North Carolina rivers were at major flood stage Tuesday, with an additional three forecasted to peak by Thursday.

The Department of Environmental Quality said the earthen dam at one hog lagoon in Duplin County had breached, spilling its contents. Another 25 of the pits containing animal feces and urine have either suffered structural damage, had wastewater levels go over their tops from heavy rains or had been swamped by floodwaters. Large mounds of manure are also typically stored at poultry farms.

North Carolina is among the top states in the nation in producing pork and poultry, with about 9 million hogs at any given time and 819 million chickens and 34 million turkeys raised each year.

The N.C. Pork Council, an industry trade group, said the livestock losses from the storm should be taken in the context.

“Our farmers took extraordinary measures in advance of this storm, including moving thousands of animals out of harm’s way as the hurricane approached,” the group said in a statement issued Tuesday. “We believe deeply in our commitment to provide care for our animals amid these incredibly challenging circumstances.”

The industry lost about 2,800 hogs during flooding from Hurricane Matthew in 2016.

Sanderson Farms, a major poultry producer in the state, said it lost about 1.7 million chickens after flooding at more than 60 of the independent farms that supply its poultry processing plants. The company said its facilities suffered no major damage, but supply disruptions and flooded roadways had caused shutdowns at some plants.

In addition, about 30 farms near Lumberton have been isolated by flood waters, hampering the delivery of feed to animals. The lack of food could cause additional birds to die if access isn’t restored quickly, the company said.

Smithfield Foods, the world’s largest pork producer, said its plants also suffered no significant damage and are operating at limited capacity. The company said it would ramp up production as roads become passable.

An environmental threat is also posed by human waste as low-lying municipal sewage plants flood. On Sunday, the Cape Fear Public Utility Authority reported that more than 5 million gallons of partially treated sewage had spilled into the Cape Fear River after power failed at its treatment plant.

The Environmental Protection Agency said Monday that 16 community water treatment facilities in North Carolina are unable to supply drinking water and that seven publicly owned sewage treatment works are non-operational due to the flooding.

Duke Energy is continuing cleanup operations Tuesday following a weekend breach at a coal ash landfill at its L.V. Sutton Power Station near Wilmington.

Duke spokeswoman Paige Sheehan said a full assessment of how much ash escaped from the waterlogged landfill is ongoing. The company initially estimated Saturday that about 2,000 cubic yards (1,530 cubic meters) of ash were displaced, enough to fill about 180 dump trucks.

The coal-fired Sutton plant was retired in 2013 and replaced with a new facility that burns natural gas. The company has been excavating millions of tons of leftover ash from old pits there and removing the waste to a new lined landfill constructed on the property. The gray ash left behind when coal is burned contains toxic heavy metals, including arsenic, lead and mercury.

Photos from the site provided to AP by Cape Fear River Watch, an environmental advocacy group, show cascades of gray-colored water spilling from at least two breaches at the landfill and flowing toward Sutton Lake, the plant’s former cooling pond which is now used for public recreation, including fishing and boating.

Sutton Lake drains into the Cape Fear River. Sheehan said Duke’s assessment is that there was minimal chance any contaminants from the spill had reached the river.

At a different power plant near Goldsboro, three old coal ash dumps capped with soil were inundated by the Neuse River. Duke said they had no indication those dumps at the H.F. Lee Power Plant were leaking ash into the river.

Duke’s handling of ash waste has faced intense scrutiny since a drainage pipe collapsed under a waste pit at an old plant in Eden in 2014, triggering a massive spill that coated 70 miles (110 kilometers) of the Dan River in gray sludge. The utility later agreed to plead guilty to nine Clean Water Act violations and pay $102 million in fines and restitution for illegally discharging pollution from ash dumps at five North Carolina power plants. It plans to close all its ash dumps by 2029.

In South Carolina, workers with electricity provider Santee Cooper erected a temporary dike in hopes of preventing flooding of an old coal ash dump at the demolished Grainger Generating Station near Conway. The dump is adjacent to the Waccamaw River, which is expected to crest at nearly 20 feet (6 meters) this weekend. That’s nine feet above flood stage and would set a new record height.

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Follow Associated Press investigative reporter Michael Biesecker at twitter.com/mbieseck

The U.S. Causes Refugee Crises. Now It’s Slashing Refugee Admissions.

Secretary of State Mike Pompeo announced Monday that the Trump administration would slash refugee admissions to 30,000 in 2019, down from 45,000 in 2018 and from 85,000 in fiscal 2016. Refugees come in numbers to the US when there is a crisis in their own country.

At the same time, US policies toward refugees in the past have often been political and not just humanitarian, and there is a strong instrumental streak in the admissions patterns. In other words, Washington has often asked what we get out of letting refugees in, and not just what we can do for them.

Nowadays, there is a special, separate program for bringing in Iraqis who helped US troops as translators or in other capacities, and the Pentagon is worried that Trump is not letting in enough of them. If the word gets out in Iraq that the US military will use you and then leave you and your family twisting in the wind when ISIL comes after you, then no one will be willing to serve as interpreter or fixer for the some 6,000 US troops still in that country.

So you could argue that the US has a responsibility to Iraqi refugees, since Bush invaded their country on flimsy pretexts and turned the society upside down. The resultant war, occupation and guerrilla push-back were such that some 1.5 million refugees were created internally, and 2.5 million were pushed abroad.

That is 4 million Iraqis who would never have had to leave their homes if the US had not invaded and occupied them and provoked the rise of al-Qaeda in Mesopotamia and then the Islamic State of Iraq.

Likewise, the US bears some responsibility for all the civilians displaced in eastern Syria as a result of its war there on ISIL in alliance with Kurdish fighters of the YPG guerilla group.

How cynical the US follow-up has been is illustrated by an experience I had. In summer of 2008 I went to Jordan and did some research on the condition of Iraqi refugees there. I was told by someone who should know that the Bush administration was afraid that the Iraqi refugees there might riot, putting GOP standard-bearer McCain in jeopardy, and therefore was finally going to let Iraqi refugees come to the US in large numbers (Bush let in 13,775 in 2008, compared to less than two thousand the previous year). But this was done in large part to keep from embarrassing McCain.

The political character of US refugee admittances stretches back into the mists of time. In the 1970s, the US let in a lot of refugees from South Vietnam, in part to reward families that had supported the US war there and in part because the “boat people” crisis that developed when Vietnamese fled to southeast Asian countries that put them in camps.

In 1980 the Mariel boatlift and other routes brought 125,000 Cubans to the United States, and letting Cubans into the US was an attempt to undermine the Communist Castro government that the Kennedy administration had tried and failed to overthrow.

Through the 1980s, extra slots were awarded for Soviet refugees, as part of the Cold War with the Soviet Union.

Pewresearch.org.

After President Bill Clinton intervened to save the Kosovars from ethnic cleansing or severe repression at the hands of Serb nationalists, the US let in refugees from Kosovo to show solidarity with them.

So Pompeo in adopting this curtailed immigration program is hurting the US, not just the immigrants. Not letting immigrants from Iraq signals that we won’t reward interpreters and other helpers of the US war effort. It discourages Iraqis from proffering their help even now. The US in the old days deployed refugee policy to create allies. Trump doesn’t have that prospect, of friendship and support.

 

Koreas to Form Joint Military Committee

PYONGYANG, North Korea — The Latest on the summit between North Korean leader Kim Jong Un and South Korean President Moon Jae-in (all times local):

12:30 p.m.

South Korean President Moon Jae-in says the Koreas have agreed to establish a joint military committee to evaluate how to reduce tensions and maintain communication to defuse crises and prevent accidental clashes.

Moon said Wednesday the plans for the committee are part of a commitment to remove “any threat that could cause war” on the Korean Peninsula. He was speaking following the Pyongyang summit with North Korean leader Kim Jong Un.

Moon’s government has been stressing the importance of reducing the conventional military threat between the Korea to prevent accidental clashes that can escalate into a nuclear conflict.

The Koreas first agreed to form a joint military committee in 1991, but the plans weren’t carried out due to turbulent relations between the rivals.

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12:20 p.m.

A Joint statement says the two Koreas have agreed to seek to obtain the rights to co-host the 2032 Summer Olympics.

The statement was released by Seoul on Wednesday after a Pyongyang summit between South Korean President Moon Jae-in and North Korean leader Kim Jong Un.

It says the two leaders also agreed to cooperate in major sports events such as the 2020 Summer Olympics. It didn’t elaborate.

It says the two leaders have also agreed on a Pyongyang art troupe visiting Seoul for performances in October.

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12:10 p.m.

A joint statement released by Seoul shows North Korean leader Kim Jong Un has promised to visit Seoul “in the near future.”

South Korean President Moon Jae-in is in Pyongyang this week for a summit with Kim.

South Korean media pool footage show Moon told reporters Wednesday that Kim could visit Seoul this year.

If realized, he would be the first North Korean leader to visit Seoul since the peninsula was divided into North and South at the end of World War II in 1945.

Kim’s late father, Kim Jong Il, had promised reciprocal visits when South Korean leaders visited him in Pyongyang in 2000 and 2007. But his Seoul trip wasn’t realized before his 2011 death.

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12 noon

South Korean President Moon Jae-in says North Korean leader Kim Jong Un has agreed to permanently dismantle a missile engine test site and a launch pad in the presence of international experts in what he described as a specific step toward denuclearization.

Moon also said on Wednesday that the North agreed to take further steps such as permanently dismantling its main Nyongbyon nuclear complex if the United States takes corresponding measures.

Moon and Kim spoke at a news conference after signing a joint statement following their second day of summit talks in Pyongyang.

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11:25 a.m.

The leaders of the two Koreas have signed a joint statement after their summit talks, but no details of what it said were released.

South Korean media pool footage shows South Korean President Moon Jae-in and North Korean leader Kim Jong Un signing the documents in Pyongyang on Wednesday.

The leaders posed for photos while displaying the documents.

Seoul says the two Koreans leaders are to jointly announce the results of their summit later Wednesday.

The defense chiefs of the two Koreas also signed their agreements that Seoul says are about reducing military tensions along the border.

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10:15 p.m.

North Korean leader Kim Jong Un and South Korean President Moon Jae-in have started their second day of summit talks in Pyongyang over the nuclear standoff and other inter-Korean issues.

Moon and Kim on Wednesday were seen talking as they stepped into a meeting room at Pyongyang’s Paekhwawon State Guesthouse.

They were accompanied by their wives and top government officials, including Moon’s national security adviser Chung Eui-yong and Kim’s sister, Kim Yo Jong, who is seen as Kim’s closest confident and possibly the second-most powerful figure in his ruling regime.

Moon and Kim were expected to release a joint statement later on Wednesday.

North Korea’s state media says there was an “in-depth exchange of opinions on various issues” between the leaders during their first talks on Tuesday.

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9:30 a.m.

South Korea says President Moon Jae-in will attend a performance of North Korea’s iconic mass games following his second day of summit talks with North Korean leader Kim Jong Un in Pyongyang.

Moon’s spokesman Yoon Young-chan said Wednesday he couldn’t confirm whether Kim will also attend the evening performance at Pyongyang’s May Day Stadium of tens of thousands of people working in unison.

Yoon says the performance of “The Glorious Country” will draw about 150,000 spectators.

Yoon says the Korean leaders will likely announce a joint statement following their summit talks earlier on Wednesday but will probably not take questions from reporters.

North Korea first staged its mass games in 2002, when Kim’s father, Kim Jong Il, was the country’s leader. They continued almost without interruption on an annual basis until 2014, when they were not held at all.

The North brought back the mass games during its lavish celebrations for the 70th anniversary of its state founding earlier this month.

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6:45 p.m.

North Korean leader Kim Jong Un says his June summit with U.S. President Donald Trump has stabilized the regional security situation.

South Korean media pool reports say Kim made the comment during a meeting with South Korean President Moon Jae-in.

The reports say Kim thanked Moon for brokering his summit with Trump in Singapore.

The leaders of the two Koreas had their first in-depth talks in Pyongyang on Tuesday. The talks are to continue Wednesday and Moon is expected to return to Seoul on Thursday.

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4:30 p.m.

The leaders of the two Koreas have begun their summit talks on denuclearization of the Korean Peninsula and other issues.

South Korean President Moon Jae-in flew to Pyongyang, North Korea’s capital, on Tuesday for his third summit of the year with North Korean leader Kim Jong Un.

Moon’s office says the talks with Kim began at a ruling Workers’ Party building in Pyongyang.

It says two senior officials from both countries are also attending the meeting with the leaders.

Moon and Kim are to meet again on Wednesday.

Moon’s office says the summit will focus on how to achieve denuclearization, reduce military tensions between the Koreas and promote ties.

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2:15 p.m.

Britain’s top diplomat says it’s time for North Korea to take concrete actions toward eliminating its nuclear weapons.

Foreign Secretary Jeremy Hunt said Tuesday in Tokyo that dialogue has helped improve the atmosphere “but we need to see actions now.”

He spoke as South Korean President Moon Jae-in was visiting Pyongyang to meet North Korean leader Kim Jong Un to try to revitalize the North’s denuclearization talks with the United States.

Hunt told The Associated Press that Britain is ready to relax economic sanctions on North Korea when there is concrete evidence of a change from the North Korean side.

He is in Japan to hold “strategic dialogue” talks with Japanese Foreign Minister Taro Kono.

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1:20 p.m.

North Korean leader Kim Jong Un and South Korean President Moon Jae-in are holding a car parade along Pyongyang streets.

The recorded South Korean media pool footage showed the two leaders aboard a convertible black limousine smiling and waving their hands as residents, many wearing colorful traditional handbook dresses, chanted and waved plastic flowers.

A convoy of sedans and motorcycles were the only other cars on the neatly manicured route.

Moon arrived Tuesday morning for a three-day visit. They’re holding their third summit and will attempt to improve ties and resolve a standoff in nuclear disarmament talks.

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11:30 a.m.

North Korean leader Kim Jong Un and South Korean President Moon Jae-in have arrived at a guesthouse in Pyongyang where they are expected to have talks over lunch.

Kim and Moon arrived at the Paekhwawon State Guesthouse in a black Mercedes convertible and were seen talking and adjusting their hair before stepping out of the backseat.

Their wives also reportedly shared a separate vehicle to the guesthouse.

The Paekwawon Guesthouse was also where former South Korean Presidents Kim Dae-jung and Roh Moo-hyun stayed during their summits with Kim’s father in 2000 and 2007.

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10:15 a.m.

North Korean leader Kim Jong Un has greeted South Korean President Moon Jae-in upon his arrival in Pyongyang for their third summit this year to improve ties and help resolve the nuclear standoff.

Moon and Kim embraced at the Sunan International Airport on Tuesday as thousands of North Koreans cheered and waved flowers, North Korean flags and a blue-and-white map symbolizing a unified peninsula.

Moon and Kim and their wives shook the hands of North Korean and South Korean officials before they were saluted by a North Korean ceremonial guard.

They then inspected goose-stepping soldiers, and Moon shook hands with North Korean civilians and bowed deeply to them.