Why Trump’s Combative Trade Stance Makes US Farmers Nervous

A sizable majority of rural Americans backed Donald Trump’s presidential bid, drawn to his calls to slash environmental rules, strengthen law enforcement and replace the federal health care law.

But last month, many of them struck a sour note after White House aides signaled that Trump would deliver on another signature vow by edging toward abandoning the North American Free Trade Agreement.

Farm Country suddenly went on red alert.

Trump’s message that NAFTA was a job-killing disaster had never resonated much in rural America. NAFTA had widened access to Mexican and Canadian markets, boosting U.S. farm exports and benefiting many farmers.

“Mr. President, America’s corn farmers helped elect you,” Wesley Spurlock of the National Corn Growers Association warned in a statement. “Withdrawing from NAFTA would be disastrous for American agriculture.”

Within hours, Trump softened his stance. He wouldn’t actually dump NAFTA, he said. He’d first try to forge a more advantageous deal with Mexico and Canada – a move that formally began Thursday when his top trade negotiator, Robert Lighthizer, announced the administration’s intent to renegotiate NAFTA.

Farmers have been relieved that NAFTA has survived so far. Yet many remain nervous about where Trump’s trade policy will lead.

As a candidate, Trump defined his “America First” stance as a means to fight unfair foreign competition. He blamed unjust deals for swelling U.S. trade gaps and stealing factory jobs.

But NAFTA and other deals have been good for American farmers, who stand to lose if Trump ditches the pact or ignites a trade war. The United States has enjoyed a trade surplus in farm products since at least 1967, government data show. Last year, farm exports exceeded imports by $20.5 billion.

“You don’t start off trade negotiations … by picking fights with your trade partners that are completely unnecessary,” says Aaron Lehman, a fifth-generation Iowa farmer who produces corn, soybeans, oats and hay.

Many farmers worry that Trump’s policies will jeopardize their exports just as they face weaker crop and livestock prices.

“It comes up pretty quickly in conversation,” says Blake Hurst, a corn and soybean farmer in northwestern Missouri’s Atchison County.

That county’s voters backed Trump more than 3-to-1 in the election but now feel “it would be better if the rhetoric (on trade) was a little less strident,” says Hurst, president of the Missouri Farm Bureau.

Trump’s main argument against NAFTA and other pacts was that they exposed American workers to unequal competition with low-wage workers in countries like Mexico and China.

NAFTA did lead some American manufacturers to move factories and jobs to Mexico. But since it took effect in 1994 and eased tariffs, annual farm exports to Mexico have jumped nearly five-fold to about $18 billion. Mexico is the No. 3 market for U.S. agriculture, notably corn, soybeans and pork.

“The trade agreements that we’ve had have been very beneficial,” says Stephen Censky, CEO of the American Soybean Association. “We need to take care not to blow the significant gains that agriculture has won.”

The U.S. has run a surplus in farm trade with Mexico for 20 of the 23 years since NAFTA took effect. Still, the surpluses with Mexico became deficits in 2015 and 2016 as global livestock and grain prices plummeted and shrank the value of American exports, notes Joseph Glauber of the International Food Policy Research Institute.

Mexico has begun to seek alternatives to U.S. food because, as its agriculture secretary, Jose Calzada Rovirosa, said in March, Trump’s remarks on trade “have injected uncertainty” into the agriculture business.

Once word had surfaced that Trump was considering pulling out of NAFTA, Sonny Perdue, two days into his job as the president’s agriculture secretary, hastened to the White House with a map showing areas that would be hurt most by a pullout, overlapped with many that voted for Trump.

“I tried to demonstrate to him that in the agricultural market, sometimes words like ‘withdraw’ or ‘terminate’ can have a major impact on markets,” Perdue said in an interview with The Associated Press. “I think the president made a very wise decision for the benefit of many agricultural producers across the country” by choosing to remain in NAFTA.

Trump delivered another disappointment for U.S. farm groups in January by fulfilling a pledge to abandon the Trans-Pacific Partnership, which the Obama administration negotiated with 11 Asia-Pacific countries. Trump argued that the pact would cost Americans jobs by pitting them against low-wage Asian labor.

But the deal would have given U.S. farmers broader access to Japan’s notoriously impregnable market and easier entry into fast-growing Vietnam. Philip Seng of the U.S. Meat Export Federation notes that the U.S. withdrawal from TPP left Australia with a competitive advantage because it had already negotiated lower tariffs in Japan.

Trump has also threatened to impose tariffs on Chinese and Mexican imports, thereby raising fears that those trading partners would retaliate with their own sanctions.

Farmers know they’re frequently the first casualties of trade wars. Many recall a 2009 trade rift in which China responded to U.S. tire tariffs by imposing tariffs on U.S. chicken parts. And Mexico slapped tariffs on U.S. goods ranging from ham to onions to Christmas trees in 2009 to protest a ban on Mexican trucks crossing the border.

The White House declined to comment on farmers’ fears that Trump’s trade policy stands to hurt them. But officials say they’ve sought to ease concerns, by, for example, having Agriculture Secretary Perdue announce a new undersecretary to oversee trade and foreign agricultural affairs.

Many farmers are still hopeful about the Trump administration. Some, for example, applaud his plans to slash environmental rules that they say inflate the cost of running a farm. Some also hold out hope that the author of “The Art of the Deal” will negotiate ways to improve NAFTA.

One such way might involve Canada. NAFTA let Canada shield its dairy farmers from foreign competition behind tariffs and regulations but left at least one exception – an American ultra-filtered milk used in cheese. When Canadian farmers complained about the cheaper imports, Canada changed its policy and effectively priced ultra-filtered American milk out of the market.

“Canada has made business for our dairy farmers in Wisconsin and other border states very difficult,” Trump tweeted last month. “We will not stand for this. Watch!”

Some U.S. cattle producers would also like a renegotiated NAFTA to give them something the current version doesn’t: The right to label their product “Made in America.” In 2015, the World Trade Organization struck down the United States’ country-of-origin labeling rules as unfair to Mexico and Canada.

Many still worry that Trump’s planned overhaul of American trade policy is built to revive manufacturing and that farming remains an afterthought.

“So much of the conversation in the campaign had been in Detroit or in Indiana” and focused on manufacturing jobs,” said Kathy Baylis, an economist at the University of Illinois. The importance of American farm exports “never made it into the rhetoric.”

 

Yemen Cholera Outbreak Could Reach 300,000

Yemen could see as many as 250,000 new cases of cholera within six months, in addition to 50,000 already reported, the World Health Organization said Friday.

“The speed of the resurgence of this cholera epidemic is unprecedented,” Nevio Zagaria, WHO country representative for Yemen, told reporters during a conference call on Friday.

He said the death toll from the outbreak has already reached 240 and more than 50,000 cases have been registered in the past three weeks.

Two years into a war between Houthi rebels and government forces allied with a Saudi-led Arab military coalition, which has killed more than 8,000 people, Yemen has declared a state of emergency Sunday in the capital, Sana’a, over the outbreak.

Fighting has taken a toll on medical facilities in the war-torn country, as more than half of Yemen’s facilities, which are now operated by Houthi rebels, no longer function.

The U.N. says some 17 million of Yemen’s 26 million people lack sufficient food and at least three million malnourished children are in “grave peril.”

Yemen, which is the Arab world’s poorest nation, is now classified by the World Health Organization as a level three emergency, alongside Syria, South Sudan, Nigeria and Iraq. This is the country’s second cholera outbreak in less than a year.

Cholera is highly contagious and can be contracted from ingesting contaminated food and water.

WHO Says Time to Stop Ignoring Adolescent Health

The World Health Organization has delivered dramatic news about the causes of death for young people the world over. Governments and health agencies have made great strides in reducing deaths of young children through immunization and programs that address maternal and infant care. But adolescents have somehow fallen through the cracks.

Dr. Anthony Costello, director of WHO’s Department of Maternal, Newborn, Child and Adolescent Health told VOA, “We’re finding 1.2 million (adolescents) die each year. That’s 3,000 deaths a day. That’s 10 jumbo jets.” What’s more, Costello says these deaths are largely preventable.

The study shows traffic injuries are the top cause of death among adolescents, those between 10 and 19. In most cases, the adolescent is struck by a car while walking or riding a bicycle.

Other leading causes of death include lower respiratory infections and suicide, the report found. The causes differ by gender, age and region. Boys between 15 and 19 years old are more likely to die from traffic injuries than girls or than younger boys. In sub-Saharan Africa, children are more likely to contract HIV.   

Girls between 10 and 14 are at risk for getting respiratory infections from indoor air pollution and from breathing in fumes from cooking fuels. Older girls, between 15 and 19, had a greater risk of death from pregnancy complications, childbirth or unsafe abortions. Teenage girls generally have small pelvises which lead to difficult labor.  

Costello said pregnant adolescent girls are also “more likely to get high blood pressure; they may be more vulnerable to bleeding, they may be more anemic. They may be in situations more vulnerable to malaria, to HIV.”  

The point of the study that was conducted by the WHO and partners at other U.N. agencies and the World Bank.

Looking forward

While the study focuses on the causes of death, Costello said the point was to help develop a framework and a plan to improve the health of adolescents. If adolescents had access to good health services, education and social support, fewer young people would die. In the case of traffic related deaths, he said better traffic laws, speed limits, the use of seatbelts could save lives in countries that don’t have strict driving safety laws. Costello pointed out that “In India, for example, there are 90,000 deaths on the road each year; many of those are adolescents and children.”

Dr. Flavia Bustreo, the assistant director-general at WHO, said, “Adolescents have been entirely absent from national health plans for decades.” The report proposes changing these plans and trying to help adolescents develop healthy lifestyle habits.

Costello said, “The roots of diabetes, of heart attacks, of strokes, of lung cancer, the root of that lies in the adolescent years, how the adolescents approach nutrition, and diet and exercise, whether they start to smoke or not, or abuse other substances.

Concept shift

Costello said countries need to create more adolescent friendly cities so adolescents have places to play, gather together safely and avoid gang violence.  

“Governments have got to invest in young people,” Costello said, because “they’re the future. We mustn’t be afraid to involve children in designing their own environments, in coming up with creative ideas, in working with peer groups, and investing in things that will give them an exciting life without exposing them to long term risks that could be avoidable.”

A study published in The Lancet in April shows that improving the physical, mental and sexual health of adolescents could result in significant economic returns. The study contends that an investment of about $4.60 per person per year would yield more than 10 times as much in benefits to society. This study was conducted by researchers from Victoria University and the University of Melbourne along with the United Nations Populations Fund.

OPEC May Extend, Deepen Cuts to Oil Output

An OPEC panel reviewing scenarios for next week’s policy-setting meeting is looking at the option of deepening and extending an OPEC-led deal to reduce oil output, OPEC sources said Friday.

OPEC’s national representatives — officials representing the 13 member countries, plus officials from OPEC’s Vienna secretariat — met Wednesday and Thursday to discuss the market.

The two-day meeting, called the Economic Commission Board, was scheduled to finish Thursday but will conclude later Friday, two OPEC sources said.

“We have not agreed on final scenarios,” said one of the sources.

A second source said a deeper supply cut was an option depending on estimated growth in supply from non-OPEC and U.S. shale oil.

The meeting precedes a policy-setting gathering of OPEC and non-OPEC oil ministers May 25 to decide whether to extend their deal to reduce output beyond June 30.

The Organization of the Petroleum Exporting Countries, Russia and other producers originally agreed to cut production by 1.8 million barrels per day (bpd) for six months from Jan. 1 to support the market.

Oil prices, trading around $53 a barrel, have gained support from reduced output, but high inventories and rising supply from producers outside the deal have limited the rally, pressing the case for extending the deal.

Experts: N. Korea Role in WannaCry Cyberattack Unlikely

A couple of things about the WannaCry cyberattack are certain. It was the biggest in history and it’s a scary preview of things to come. But one thing is a lot less clear: whether North Korea had anything to do with it.

 

Despite bits and pieces of evidence that suggest a possible North Korea link, experts warn there is nothing conclusive yet, and a lot of reasons to be dubious.

 

Within days of the attack, respected cybersecurity firms Symantec and Kaspersky Labs hinted at a North Korea link. Google researcher Neel Mehta identified coding similarities between WannaCry and malware from 2015 that was tied to the North. And the media have since spun out stories on Pyongyang’s league of hackers, its past involvement in cyberattacks and its perennial search for new revenue streams, legal or shady.

Meet Lazarus

 

But identifying hackers behind sophisticated attacks is a notoriously difficult task. Proving they are acting under the explicit orders of a nation state is even trickier.

 

When experts say North Korea is behind an attack, what they often mean is that Pyongyang is suspected of working with or through a group known as Lazarus. The exact nature of Lazarus is cloudy, but it is thought by some to be a mixture of North Korean hackers operating in cahoots with Chinese “cyber-mercenaries” willing to at times do Pyongyang’s bidding. 

 

Lazarus is a serious player in the cybercrime world.

 

It is referred to as an “advanced persistent threat” and has been fingered in some very sophisticated operations, including an attempt to breach the security of dozens of banks this year, an attack on the Bangladesh central bank that netted $81 million last year, the 2014 Sony wiper hack and DarkSeoul, which targeted the South Korean government and businesses.

 

“The Lazarus Group’s activity spans multiple years, going back as far as 2009,” Kaspersky Labs said in a report last year. “Their focus, victimology, and guerrilla-style tactics indicate a dynamic, agile and highly malicious entity, open to data destruction in addition to conventional cyberespionage operations.”

WannaCry doesn’t fit

 

But some experts see the latest attack as an anomaly.

 

WannaCry infected more than 200,000 systems in more than 150 countries with demands for payments of $300 in Bitcoin per victim in exchange for the decryption of the files it had taken hostage. Victims received warnings on their computer screens that if they did not pay the ransom within three days, the demand would double. If no ransom was paid, the victim’s data would be deleted. 

 

As ransomware attacks go, that’s a pretty typical setup.

 

But that’s not — or at least hasn’t been — the way North Korean hackers are believed to work. 

 

“This is not part of the previously observed behavior of DPRK cyberwar units and hacking groups,” Michael Madden, a visiting scholar at the Johns Hopkins School of Advanced International Studies and founder of North Korea Leadership Watch, said in an email to The Associated Press. “It would represent an entirely new type of cyberattack by the DPRK.” 

 

Madden said the North, officially known as the Democratic People’s Republic of Korea, if it had a role at all, could have instead been involved by giving or providing parts of the packet used in the attack to another state-sponsored hacking group with whom it is in contact. 

 

“This type of ransomware/jailbreak attack is not at all part of the M.O. of the DPRK’s cyberwar units,” he said. “It requires a certain level of social interaction and file storage, outside of those with other hacking groups, that DPRK hackers and cyberwar units would not engage. Basically they’d have to wait on Bitcoin transactions, store the hacked files and maintain contact with the targets of the attack.”

Attack not strategic

 

Other cybersecurity experts question the Pyongyang angle on different grounds. 

 

James Scott, a senior fellow at the Institute for Critical Infrastructure Technology, a cybersecurity think tank, argues that the evidence remains “circumstantial at best,” and believes WannaCry spread because of luck and negligence, not sophistication.

 

“While it is possible that the Lazarus group is behind the WannaCry malware, the likelihood of that attribution proving correct is dubious,” he wrote in a recent blog post laying out his case. “It remains more probable that the authors of WannaCry borrowed code from Lazarus or a similar source.”

 

Scott said he believes North Korea would likely have attacked more strategic targets — two of the hardest-hit countries, China and Russia, are the North’s closest strategic allies — or tried to capture more significant profits. 

 

Very few victims of the WannaCry attack appear to have paid up. As of Friday, only $91,000 had been deposited in the three Bitcoin accounts associated with the ransom demands, according to London-based Elliptic Enterprises, which tracks illicit Bitcoin activity.

Japan, China Pull Combustible Ice From Seafloor

Commercial development of the globe’s huge reserves of a frozen fossil fuel known as “combustible ice” has moved closer to reality after Japan and China successfully extracted the material from the seafloor off their coastlines.

 

But experts said Friday that large-scale production remains many years away, and if not done properly could flood the atmosphere with climate-changing greenhouse gases. 

Frozen mix of water, gas

 

Combustible ice is a frozen mixture of water and concentrated natural gas. Technically known as methane hydrate, it can be lit on fire in its frozen state and is believed to comprise one of the world’s most abundant fossil fuels. 

 

The official Chinese news agency Xinhua reported that the fuel was successfully mined from beneath the South China Sea on Thursday. Chinese Minister of Land and Resources Jiang Daming declared the event a breakthrough moment heralding a potential “global energy revolution.” 

 

A drilling crew in Japan reported a similar successful operation two weeks earlier, on May 4 along the Shima Peninsula. 

For Japan, methane hydrate offers the chance to reduce its heavy reliance on imported fuels. In China, it could serve as a cleaner substitute for coal-burning power plants and steel factories that have polluted much of the country with lung-damaging smog.

Estimated reserves are large

 

Methane hydrate has been found beneath seafloors and buried inside Arctic permafrost and beneath Antarctic ice. 

 

Estimates of worldwide reserves range from 280 trillion cubic meters (10,000 trillion cubic feet) up to 2,800 trillion cubic meters (100,000 trillion cubic feet), according to the U.S. Energy Information Administration. By comparison, total worldwide production of natural gas was 3.5 billion cubic meters (124 billion cubic feet) in 2015, the most recent year available.

 

That means methane hydrate reserves could meet global gas demands for 80 to 800 years at current consumption rates.

 

Yet efforts to successfully extract the fuel at a profit have eluded private and state-owned energy companies for decades. That’s in part because of the cost of extraction techniques, which involve large amounts of water and power to flood methane hydrate reserves so the fuel can be released and brought to the surface.

 

There are also environmental concerns, said David Sandalow, a former senior official with the U.S. State Department now at Columbia University’s Center on Global Energy Policy.

 

If methane hydrate leaks during the extraction process, it can increase greenhouse gas emissions. If it can be used without leaking, it has the potential to replace dirtier coal in the power sector.

 

“The climate implications of producing natural gas hydrates are complicated.There are potential benefits, but substantial risks,” Sandalow said.

Greek Parliament Approves More Economic Austerity

The Greek Parliament approved another round of tough economic cuts and austerity measures Thursday to assure itself another installment payment of European bailout funds.

Greece may have again faced bankruptcy in July without the payment.

More cuts for pensioners

All 153 lawmakers in Prime Minister Alexis Tsipras’ leftist coalition voted for the cuts; all 128 opposition members voted no.

More than 10,000 Greeks weary of the nation’s economic problems, including elderly pensioners facing more cuts, marched outside Parliament against the measures.

Several dozen young marchers wearing masks broke away from the crowd to throw gasoline bombs at police, who responded with tear gas.

Greece desperately needs about $8 billion of bailout money from its eurozone lenders in order to make a scheduled debt payment.

Tax hikes part of deal

In exchange, the government agreed to EU demands for more austerity measures, including tax hikes and programs aimed at easing poverty.

With Thursday’s vote, Greek officials hope they can renegotiate payment terms on the nation’s massive debt payment — nearly 180 percent of Greece’s gross domestic product. The International Monetary Fund calls this number unsustainable.

Greece has been relying on international bailouts since 2010, when the outgoing conservative government badly underreported the country’s debt.

Mnuchin: Cut Taxes, Regulations to Boost Growth to 3 Percent

U.S. Treasury Secretary Steven Mnuchin says the nation’s economic growth can rise to 3 percent annually if taxes and regulations are cut.

The Treasury secretary spoke Thursday to a Senate committee in his first congressional testimony since he was confirmed in the new job. Mnuchin’s boss, Donald Trump, says tax and regulatory reform will boost the economy, and he made the promise of such changes a key part of his campaign for president.

Recently, annual economic growth has been at 2 percent or lower, and most economists say that is due to a large number of retirements by aging workers and meager productivity growth.

Trump’s efforts to change taxes have been moving slowly in Congress, where they face strong opposition from Democrats, and skepticism from some of his Republican allies who worry that cutting taxes will make government debt problems worse.

Clues Found to Ransomware Worm’s Lingering Risks

Two-thirds of those caught up in the past week’s global ransomware attack were running Microsoft’s Windows 7 operating system without the latest security updates, a survey for Reuters by security ratings firm BitSight found.

Researchers are struggling to try to find early traces of WannaCry, which remains an active threat in hardest-hit China and Russia, believing that identifying “patient zero” could help catch its criminal authors.

They are having more luck dissecting flaws that limited its spread.

Security experts warn that while computers at more than 300,000 internet addresses were hit by the ransomware strain, further attacks that fix weaknesses in WannaCry will follow that hit larger numbers of users, with more devastating consequences.

“Some organizations just aren’t aware of the risks; some don’t want to risk interrupting important business processes; sometimes they are short-staffed,” said Ziv Mador, vice president of security research at Israel’s SpiderLabs Trustwave.

“There are plenty of reasons people wait to patch and none of them are good,” said Mador, a former long-time security researcher for Microsoft.

WannaCry’s worm-like capacity to infect other computers on the same network with no human intervention appear tailored to Windows 7, said Paul Pratley, head of investigations & incident response at UK consulting firm MWR InfoSecurity.

Data from BitSight covering 160,000 internet-connected computers hit by WannaCry, shows that Windows 7 accounts for 67 percent of infections, although it represents less than half of the global distribution of Windows PC users.

Computers running older versions, such as Windows XP used in Britain’s NHS health system, while individually vulnerable to attack, appear incapable of spreading infections and played a far smaller role in the global attack than initially reported.

In laboratory testing, researchers at MWR and Kyptos say they have found Windows XP crashes before the virus can spread.

Windows 10, the latest version of Microsoft’s flagship operating system franchise, accounts for another 15 percent, while older versions of Windows including 8.1, 8, XP and Vista, account for the remainder, BitSight estimated.

Computer basics

Any organization which heeded strongly worded warnings from Microsoft to urgently install a security patch it labeled “critical” when it was released on March 14 on all computers on their networks are immune, experts agree.

Those hit by WannaCry also failed to heed warnings last year from Microsoft to disable a file sharing feature in Windows known as SMB, which a covert hacker group calling itself Shadow Brokers had claimed was used by NSA intelligence operatives to sneak into Windows PCs.

“Clearly people who run supported versions of Windows and patched quickly were not affected”, Trustwave’s Mador said.

Microsoft has faced criticism since 2014 for withdrawing support for older versions of Windows software such as 16-year-old Windows XP and requiring users to pay hefty annual fees instead. The British government canceled a nationwide NHS support contract with Microsoft after a year, leaving upgrades to local trusts.

Seeking to head off further criticism in the wake of the WannaCry outbreak, the U.S. software giant last weekend released a free patch for Windows XP and other older Windows versions that it previously only offered to paying customers.

Microsoft declined to comment for this story.

On Sunday, the U.S. software giant called on intelligence services to strike a better balance between their desire to keep software flaws secret – in order to conduct espionage and cyber warfare – and sharing those flaws with technology companies to better secure the internet.

Half of all internet addresses corrupted globally by WannaCry are located in China and Russia, with 30 and 20 percent respectively. Infection levels spiked again in both countries this week and remained high through Thursday, according to data supplied to Reuters by threat intelligence firm Kryptos Logic.

By contrast, the United States accounts for 7 percent of WannaCry infections while Britain, France and Germany each represent just 2 percent of worldwide attacks, Kryptos said.

Dumb and sophisticated

The ransomware mixes copycat software loaded with amateur coding mistakes and recently leaked spy tools widely believed to have been stolen from the U.S. National Security Agency, creating a vastly potent class of crimeware.

“What really makes the magnitude of this attack so much greater than any other is that the intent has changed from information stealing to business disruption”, said Samil Neino, 32, chief executive of Los Angeles-based Kryptos Logic.

Last Friday, the company’s British-based 22-year-old data breach research chief, Marcus Hutchins, created a “kill-switch”, which security experts have widely hailed as the decisive step in halting the ransomware’s rapid spread around the globe.

WannaCry appears to target mainly enterprises rather than consumers: Once it infects one machine, it silently proliferates across internal networks which can connect hundreds or thousands of machines in large firms, unlike individual consumers at home.

An unknown number of computers sit behind the 300,000 infected internet connections identified by Kryptos.

Because of the way WannaCry spreads sneakily inside organization networks, a far larger total of ransomed computers sitting behind company firewalls may be hit, possibly numbering upward of a million machines. The company is crunching data to arrive at a firmer estimate it aims to release later Thursday.

Liran Eshel, chief executive of cloud storage provider CTERA Networks, said: “The attack shows how sophisticated ransomware has become, forcing even unaffected organizations to rethink strategies.”

Security Experts Find Clues to Ransomware Worm’s Lingering Risks

Researchers from a variety of security firms say they have so far failed to find a way to decrypt files locked up by WannaCry and say chances are low anyone will succeed.

However, a bug in WannaCry code means the attackers cannot use unique bitcoin addresses to track payments, security researchers at Symantec found this week. The result: “Users unlikely to get files restored”, the company’s Security Response team tweeted.

The rapid recovery by many organizations with unpatched computers caught out by the attack may largely be attributed to back-up and retrieval procedures they had in place, enabling technicians to re-image infected machines, experts said.

While encrypting individual computers it infects, WannaCry code does not attack network data-backup systems, as more sophisticated ransomware packages typically do, security experts who have studied WannaCry code agree.

These factors help explain the mystery of why such a tiny number of victims appear to have paid ransoms into the three bitcoin accounts to which WannaCry directs victims.

Less than 300 payments worth around $83,000 had been paid into WannaCry blackmail accounts by Thursday (1800 GMT), six days after the attack began and one day before the ransomware threatens to start locking up victim computers forever.

The Verizon 2017 Data Breach Investigations Report, the most comprehensive annual survey of security breakdowns, found that it takes three months before at least half of organizations install major new software security patches.

WannaCry landed nine weeks after Microsoft’s patch arrived.

“The same things are causing the same problems. That’s what the data shows,” MWR research head Pratley said.

“We haven’t seen many organizations fall over and that’s because they did some of the security basics,” he said.

 

Scientists Discover Human Antibodies to Fight Ebola Virus

Scientists have discovered a possible cure for all five known Ebola viruses, one of which ravaged West Africa in recent years.

The so-called broadly neutralizing antibodies were discovered in the blood of a survivor of the West African epidemic, which ran from late 2013 to mid-2016. The deadly virus killed more than 11,000 people of the nearly 29,000 who became infected in Liberia, Guinea and Sierra Leone.

Ebola got its name from the first documented outbreak, which occurred along the Ebola River in the Democratic Republic of the Congo, formerly Zaire, in 1976. Since then, there have been two dozen outbreaks of Ebola in Africa, including a current one that has infected nine people in the DRC. Three people have died.

Kartik Chandran, a professor in the Department of Microbiology and Immunology at the Albert Einstein College of Medicine in Bronx, New York, helped identify the antibodies, which were described online in the journal Cell. He is optimistic that the antibodies can be used as a single therapy to treat all Ebola viruses.

“Based on the nonhuman primate studies that are ongoing, and given the fact that they are pretty predictive, I would be optimistic that they could be used to protect people and reverse disease,” Chandran said.

350 antibodies isolated

Researchers isolated about 350 antibodies from the human blood sample, two of which showed promise in neutralizing three viruses in tissue culture. The antibodies work by interfering with a process that the pathogen uses to infect and multiply inside cells.

The drug company Mapp Pharmaceutical Inc. is now testing the antibodies in monkeys to make sure they are safe and effective.

A forerunner of the experimental drug, called Zmapp, was in the experimental stages when it was pressed into service during the last epidemic. Zmapp is a combination of cloned antibodies discovered in mice that enlist the body’s natural immune system to fight infection. If given up to five days after symptoms appear, it can cure the disease.

The problem, Chandran said, is Zmapp is not terribly specific and works to neutralize only Ebola Zaire, one of the five known viruses. He said the broadly neutralizing human antibodies attack and destroy all of the viruses.   

It took scientists just six months to discover the antibodies, according to Chandran, “so this is really incredibly fast and incredibly gratifying.  And we are hoping that things will continue at this pace and that in very short order we will be in a position to be able to test these things in people.”

While the broadly neutralizing antibodies are being developed as a treatment, Chandran envisions using them in a vaccine that can be given ahead of an Ebola outbreak to guard against infection.

Heavy Rain May Have Once Fallen on Mars

Heavy rain shaped the Martian landscape billions of years ago, according to a new study.

According to researchers at the Smithsonian Institution and the Johns Hopkins University Applied Physics Laboratory, rain on Mars once carved river beds and created valleys much like rain on Earth has, and does. It no longer rains on the Red Planet, and the water that remains is mostly in the form of ice.

The rain appears to have slowly changed over time, researchers said, noting that changes in the Martian atmosphere influenced how heavy the rain was, particularly the size of the raindrops.

When Mars formed 4.5 billion years ago, it had a much thicker atmosphere and higher atmospheric pressure. Pressure, researchers say, influences the size of raindrops.

They say that early in the planet’s history, the rain would have actually been more like fog, so it would unlikely have made much of an impact on the terrain. But as the atmosphere thinned over time, larger raindrops could form and were heavy enough to “cut into the soil” changing the shape of craters and leading to running water that could have carved valleys.

Specifically, researcher say the atmospheric pressure on the Red Planet was about four bars, compared to one bar on Earth today. This means the raindrops could not have been bigger than three millimeters across. Over time the pressure dropped to 1.5 bars allowing for larger drops measuring about 7.3 millimeters across.

“By using basic physical principles to understand the relationship between the atmosphere, raindrop size and rainfall intensity, we have shown that Mars would have seen some pretty big raindrops that would have been able to make more drastic changes to the surface than the earlier fog-like droplets,” said Ralph Lorenz of John Hopkins APL.

Risk of Colon Cancer Death Reduced in Patients with Healthy Lifestyle

Colon cancer patients who adopt a healthy lifestyle after treatment could potentially reduce their risk of death from a recurrence by more than 40 percent, according to new research.

The findings were released ahead of a conference of the American Society of Clinical Oncology, the world’s largest organization of clinical cancer professionals.

Researchers from the University of California, San Francisco analyzed data gathered in a prospective study of 1,000 advanced, stage III colon cancer patients from across the United States who were enrolled from 1999-2001. The volunteers, from 13 institutions, were evaluated over a period of seven years.

At two points during the trial, participants filled out a questionnaire asking whether their lifestyle following treatment matched prevention guidelines recommended by the American Cancer Society.

Body weight

The guidelines include maintaining a healthy body weight, eating a diet rich in fruits and vegetables, limiting consumption of red and processed meats, and engaging in regular physical activity.

Nine percent of patients in the study adhered to the guidelines. Of those, there was a reduction in death by 42 percent and a 31 percent lower risk of cancer recurrence compared to patients who did not follow the guidelines. In the study, colon cancer returned in 355 patients, 256 of whom died.

The federally-funded study was the first to look at colon cancer survivorship. Other studies have focused on cancer prevention through adoption of a healthy lifestyle.

There are a reported one million colon cancer survivors in the United States; the disease is the second-leading cause of cancer death. 

UCSF lead author Erin Van Blarigan said treated colon cancer patients are living longer than ever before, but there needs to be more emphasis on survivorship care. She called for an increase in resources to help more people adopt a healthy lifestyle in the aftermath of a diagnosis and treatment.

“There is a pressing need for improved survivorship care and resources to help people adopt and maintain a healthy lifestyle after cancer diagnosis,” Blarigan said.

Harvard University in Massachusetts administered the lifestyle questionnaire. The results were analyzed by researchers at the University of California.

Trump Administration Begins NAFTA Renegotiation Process

U.S. President Donald Trump’s administration says it has notified Congress it intends to renegotiate the North American Free Trade Agreement with Canada and Mexico.

In a letter sent Thursday to congressional leaders, U.S. Trade Representative Robert Lighthizer said the administration plans 90 days of consultations with lawmakers over how to rewrite the agreement followed by negotiations with Canada and Mexico that could begin after August 16.

Renegotiation of NAFTA was a key promise of Trump’s during his presidential campaign, when he frequently called the treaty a “disaster.”

Lighthizer told reporters NAFTA has helped strengthen the U.S. agriculture, investment services and energy sectors, but it has hurt U.S. factories and resulted in well-paying manufacturing jobs being sent to Mexico.

Lighthizer said in the letter that NAFTA needs to be updated to more effectively address matters involving digital trade, intellectual property rights and labor and environmental standards.

At a news conference Thursday at the State Department with Mexican officials and Secretary of State Rex Tillerson and other U.S. officials, Mexican Foreign Minister Luis Videgaray said Mexico “welcomes” the renegotiation of NAFTA.

“We understand that this is a 25-year-old agreement when it was negotiated,” Videgaray said. “The world has changed. We’ve learned a lot and we can make it better.”

Commerce Department Secretary Wilbur Ross said in a statement, “Since the signing of NAFTA, we have seen our manufacturing industry decimated, factories shuttered, and countless workers left jobless.  President Trump is going to change that.”

VOA State Department correspondent Nike Ching contributed to this report

Somali Community in Minnesota Fights Measles, Misinformation

An ongoing measles outbreak in Minnesota has shined a light on the fact that many Somali immigrants choose not to vaccinate their children.   

According to the Minnesota Department of Health, 63 measles cases have been reported statewide as of May 16, and 53 of those cases were Minnesotans of Somali origin. Sixty of the reported cases involve individuals confirmed to not be vaccinated.

Public health officials blame false rumors that vaccines are linked to autism and other health problems for the high rate of unvaccinated children in Minnesota’s Somali-American community.  

The department’s disease director, Kris Ehresmann, said anti-vaccination groups have targeted the community with events and have even translated the anti-vaccine documentary “Vaxxed: From Cover-Up to Catastrophe” into Somali.

“They have been very aggressive and are continuing in their efforts to reach out to the community with misinformation throughout the duration of this outbreak,” Ehresmann said.

Anti-vaccine views

In interviews with Somali mothers, VOA’s Somali Service found that anti-vaccine views are widespread.

“I have a baby boy who was well before the vaccine, but eventually he became autistic because of the vaccine. After him, I have never vaccinated my children,” said Safia Sheikh Mohamed, a mother of four children.

Mohamed listed a number of problems she believes are associated with vaccines, including food allergies, ear infections and eczema, a treatable condition in which the skin becomes inflamed or irritated.

Another mother said she vaccinated her child, but did so later in life. “I never gave vaccines to my last born child before he turned 6, during his first year of school.”  

Community leaders reach out

Multiple large-scale studies have found there is no connection between autism and the measles, mumps and rubella (MMR) vaccine, despite rumors to the contrary.

The Minnesota Department of Health is working hard to dispel such beliefs through outreach campaigns.  The department has a Somali staff member and a group of Somali health advisers who meet one-on-one with people and attend various community meetings.

“Our challenge at this point is really scalability,” Ehresmann said. “If we could multiply our efforts by 10-fold or more, that would be great, but obviously there are resource challenges.”

Ahmed Roble, a Somali-American physician who owns a clinic in Minnesota, said he and his colleagues try to dispel misinformation.

“As health professionals, our aim is not only to cure the patient but also to give them counseling,” he said. “That is what we do for the worrying mothers and fathers who are skeptical about MMR vaccination.”

Perhaps the best argument for vaccinating children is the current outbreak, which may be frightening parents into action. Prior to the outbreak, about 30 Somali children per week received the MMR vaccine in Minnesota, but, since the outbreak, that number has grown to 500 children per week.

“We know that as a result of the outbreak and perhaps as a result of seeing measles in real life there, that combined with other messaging has made an impact on a number of the parents,” Ehresmann said.

Additionally, parents are beginning to see the consequences of not vaccinating children. Children who are not vaccinated are forced to stay out of daycare for 21 days if a measles case is reported and could be forced to stay out indefinitely if multiple cases occur.

State Rep. Ilhan Omar, the first Somali-American elected to serve in a state legislature, invited parents, doctors, owners of clinics and community leaders to share their thoughts at a meeting on Wednesday. She called for parents who do not vaccinate their children to take responsibility.

“It will be the parents’ responsibility if they don’t want to vaccinate. They should go and discuss with doctors, and then, if they insist, it’s their responsibility.  It will be documented,” she said.

The state is bracing for an uptick in cases as the month of Ramadan approaches in late May and June and families gather for the celebration. The final celebration of Eid al-Fitr has the greatest potential for spreading the disease.

“It would represent the biggest risk for potential transmission,” said Ehresmann, because “it’s bringing together kids and adults and everybody, and it’s not just the population of a single mosque, it’s multiple mosques coming together.  That factor means that could have the potential for transmission.”

Reporter Steve Baragona contributed to this report.

9 Years After Market Crash, Some in US Still Struggling

Call them the unrecovered — a handful of states where job markets, nine years later, are still struggling back to where they were before the recession.

That’s true in Mississippi, where job numbers and the overall size of the economy remain below 2008 levels. Unlike states that have long since sprinted ahead, Mississippi is struggling with slow economic growth and slipping population in a place that’s rarely at peak economic health.

Miguel Brown, despite family ties to his hometown near the Alabama border, is working on oil rigs off the shore of Texas, chasing higher wages.

“It’s rough,” said the 49-year-old Brown. “There’s not a whole lot of jobs in Meridian, especially that pay anything.”

Not only Mississippi, but also Alabama, Michigan, New Mexico and West Virginia are still short of pre-recession job levels by multiple measures. That contrasts with states including Colorado, North Dakota, Texas and Utah, where employment numbers have soared. Nationwide, job numbers surpassed pre-recession peaks in the middle of 2014, about the same time Mississippi was saddled with the nation’s highest unemployment rate.

Emilia Istrate, who produces a yearly report on how local economies are faring for the National Association of Counties, said the recovery has been widespread but “uneven.”

“It explains why so many Americans don’t feel the national economic numbers. It’s because they live in one of these places that is still in recovery or struggling,” Istrate said.

Mississippi numbers

Growth has long lagged in Mississippi, and jobless rates are high even in good times. The unemployment rate fell to 5 percent in March, the lowest since the U.S. Labor Department began the current system of measurement in 1976. But at the same time that the Magnolia State’s unemployment rate was at a record low, it tied for the ninth highest among the states.

Mississippi suffers from a cluster of ills that make it an economic laggard. Only 53 percent of Mississippi adults were working in 2016, the second lowest share of any state. Mississippi’s economy depends on slow-growth sectors, including government employment. While nearly 30 percent of Americans older than 25 have a bachelor’s degree or higher, only 21 percent of Mississippians do.

The overall size of Mississippi’s economy was smaller in 2016 than it was in 2008, and people are beginning to vote with their feet: The state’s population has fallen in the last two years.

“I think the population is falling because of the economy,” said state economist Darrin Webb. “People have had to go where the jobs are.”

Education options

That doesn’t mean things haven’t improved for many people. Economists have long advised that a better-educated, more productive workforce could eventually spur growth. The state’s community colleges last year began offering not only adult education classes to high school dropouts, but also free training leading to career certification.

Kathryn Winfield, 37, was one of the first graduates.

Returning to the labor force after two years spent caring for her dying father, she earned her high school equivalency degree and became a certified nursing assistant. After nearly a decade making the minimum wage of $7.25 an hour working as a cashier, Winfield is now making more than $13 an hour helping care for nursing home patients. She said the additional pay allows her to better provide for her three kids.

In some ways, Mississippi’s economy has healed from the scars of the recession. Archie McDonnell Jr., the CEO of Citizens National Bank, said loan demand has rebounded above prerecession highs at Meridian’s largest financial institution, and the bank’s profits have more than tripled from their bottom in 2011.

“People just decided, the recession’s over, I’ve got to get back to running my business and investing and doing things,” McDonnell said.

McDonnell said he’s hopeful about investment in Meridian, noting a $50 million museum being built downtown, an investor seeking to redevelop a derelict 16-story art-deco skyscraper into a hotel, and new ownership at the city’s mall.

The number of Mississippians who report being employed could top the precession high when April data is released Friday. But employer payrolls, another way to measure employment, leveled off last year and remains about 1 percent below where they were before Mississippi’s economy headed south in early 2008.

It is not just the number of jobs, but what they pay. Workers made an average of $669 a week in Meridian and surrounding Lauderdale County in late 2016, compared to $739 statewide and $1,027 nationwide. 

Good wages are the reason that Brown says he has left his hometown of Meridian.

“These are my roots,” Brown said. “Meridian will always be home, without a doubt, but you’ve got to make ends meet and you can’t do it here.”

Cuba Says Zika Tally Rises to Nearly 1,900 Cases

Cuba said on Thursday 1,847 residents had so far contracted the mosquito-borne Zika virus, warning that certain provinces on the Caribbean island still had high rates of infestation despite a series of measures to stave off the epidemic.

At the start of the global Zika outbreak, Cuba managed for months to fend off the virus that can cause microcephaly in babies as well as Guillain-Barre syndrome, even as neighboring territories like Puerto Rico were hard hit.

The Communist-run country called out the military to help fumigate, activated neighborhood watch groups to check for places with standing water where mosquitoes breed, and instituted health checks at airports and other entry points to the island.

“Even though we have managed to reduce the cases of infestation … there are still provinces like Havana, Guantanamo, Cienfuegos and Camaguey, with big risks and rates of infestation,” the head of the Civil Defense’s Department of Disaster Reduction, Gloria Gely, was quoted as saying by state-run media.

Although generally a mild disease, the virus is a particular risk to pregnant women as it can cause microcephaly – a severe birth defect in which babies are born with abnormally small heads and underdeveloped brains.

Gely did not detail how many of the cases were contracted locally nor whether there had been any instances of babies born with microcephaly on the island of 11.2 million inhabitants.

There is no preventive treatment against Zika, but drug companies are rushing to develop a vaccine. The virus has spread to more than 60 countries and territories since the current outbreak was identified in Brazil during 2015.

Kochs Unveil Campaign to ‘Jolt’ Stalled Tax debate

The Koch Brothers’ political network is preparing to spend millions of dollars to ensure their vision for tax reform isn’t lost in the increasing chaos consuming President Donald Trump’s administration.

The network’s leading organizations, Americans for Prosperity and Freedom Partners, on Thursday released a set of general preferences for major changes to the tax code. While explicitly stating their opposition to new border-adjustment or value-added taxes, there were few specifics in a document that was designed to inject a new sense of urgency into the stalled tax debate.

 

“Now is the time. We’ve got to unite around these principles,” network spokesman James Davis said. “The White House hopefully will see this as a jolt to support them in driving this forward.”

 

Beyond Thursday’s release, Davis said the network backed by billionaire industrialists Charles and David Koch is launching a multimillion-dollar campaign through the summer to ensure their conservative tax plan is not forgotten. The campaign will include digital ads and town hall meetings across the country, along with phone banks and direct mail.

 

The Koch push reflects broader concerns from the nation’s business community that Trump’s promise to overhaul the tax code may fall victim to his mounting political challenges. The stock market on Wednesday suffered its largest single-day loss of the Trump presidency. That was before the Justice Department appointed a special counsel to investigate allegations that Trump’s campaign collaborated with Russia to sway the 2016 election.

 

Late last month, Trump released a one-page proposal that included massive tax cuts for businesses and a bigger standard tax deduction for middle-income families, lower investment taxes for the wealthy and an end to the federal estate tax for the superrich. It’s largely in line with the Koch network’s preference, which calls for lower rates, fewer brackets and the elimination of “special loopholes” and deductions.

 

There were modest signs Wednesday that the Trump administration was trying to spark new momentum for its tax plan.

 

Treasury Secretary Steven Mnuchin and other administration officials met with Republican and Democratic members of the Senate Finance Committee in what Democrats described afterward as an opening conversation in the tax debate.

 

Even under the best of political circumstances, tax reform is difficult. Congress hasn’t overhauled the tax code in more than three decades.

 

“If we don’t start making the case to the American people and showing them how this improves their lives now, it becomes increasingly more and more difficult, particularly as we move closer to the election,” Davis said.

 

 

 

EU Fines Facebook over Misleading Information

The European Union’s competition watchdog has fined Facebook 110 million euros ($122 million) for providing misleading information over its buyout of mobile messaging service WhatsApp.

The European Commission said Thursday that when Facebook informed the Commission of the 2014 buyout, it said it would be unable to “establish reliable automated matching” between Facebook and WhatsApp user accounts.

But the Commission says that in 2016, WhatsApp offered updates including the possibility of linking user phone numbers with Facebook user IDs.

Competition Commissioner Margrethe Vestager said the fine is proportionate and serves as a deterrent.

She said “the Commission must be able to take decisions about mergers’ effects on competition in full knowledge of accurate facts.”

At Hong Kong Trade Fair, Funerals Go Green, High Tech

Death is inevitable, but it doesn’t have to be bad for the environment. 

 

Caskets made of paper and wicker coffins on display at a recent Hong Kong funeral industry trade highlighted a trend toward “green burials” in an industry booming as Asia’s population rapidly ages.

 

Chinese businessman Alex Sun’s company, Shandong Ecoffin International, makes wicker and seagrass coffins, which first became popular in the West and are now catching on in Asia. Basket-weaving dates to the Tang Dynasty (618-907 AD) in northeast China’s Shandong province, where Sun’s factory uses fast-growing willow reeds to make caskets that are an eco-friendly alternative to wood. 

 

“Eco funerals are a global trend,” Sun said. “European customers already know about this product, while Asian customers are also interested in it and would love to learn more,” he said. Interest is especially high in the Philippines, Malaysia and Vietnam as well as mainland China, he said. 

Mood is light at funeral expo

The mood was bright, not funereal, as coffin makers, morticians, funeral home operators and entrepreneurs converged on Hong Kong this week for the Asia Funeral and Cemetery Expo & Conference, a trade fair held every other year.

 

Participants were pitching caskets for pets, Italian hearses, German cremators with high-tech filters and Japanese mobile embalming units. From China, Truthkobo Jewelry offered pendants made with ashes from deceased relatives or pets while Shenyang Roundfin was looking for international distributors for its autopsy tables, morgue fridges and body bags. 

 

Aging populations

The death industry is a lucrative market: Asia’s aging population is projected to hit 923 million by midcentury, according to the Asian Development Bank, putting the region on track to become the oldest in the world. 

 

The region’s funeral services market has been growing steadily and is now worth about $62.6 billion a year, with China accounting for nearly half of that, according to data from market research firm Euromonitor. 

 

“This is a very promising industry in China,” said Gloria Chuang, marketing director at Yu Fu Xiang Memorial Group, a Chinese funeral services company. 

 

But she said the industry in China needs to expand and modernize. Most funeral home operators are family-run outfits selling one-size-fits all services. They’re not transparent about prices and other information for services and products like coffins and urns, she said. 

 

That’s partly because, as in many places, talk of death is taboo. 

 

“Our culture dictates that Chinese people are very sensitive to talk about matters of death. Therefore this industry has become a very closed one,” she said. 

Elaborate funerals

 

Under Mao Zedong, who ruled China until his death in 1976, elaborate funerals, like many other customs, were officially condemned as feudal superstition fell out of favor, though they persisted in many rural areas. Such rituals have seen a revival in recent years as the economy boomed, as the newly rich use lavish funeral rites to show off their social status and the accumulation of wealth. 

 

In 2013, the government banned Communist Party members from holding extravagant funerals for family members, seeking to curb waste, corruption and pomp. 

At the expo

On the Hong Kong show floor, the Luen Hing Coffin Co.’s paper casket looked deceptively like a traditional one. It costs more because of a specialized manufacturing process for its honeycomb paper construction, but burns twice as fast as wood in a crematorium, saving funeral operators time and money, said General Manager Carol Chan. 

 

On display at Yu Fu Xiang’s booth were custom-designed cremation urns adorned with faces of the deceased and an ornate “elite longevity costume” resembling robes worn by Chinese emperors. Chuang said attitudes are changing and demand is growing for more personalized service as the children of the older generation become wealthier and more tech savvy.

Cultural sensitivities regarding death are starting to ease, making it more acceptable to talk about preparing for the afterlife, she said at one of the fair’s seminars. 

 

Other speakers said that despite lingering resistance, there’s growing interest in online memorials that let family members upload pictures to the cloud and pay respects using their smartphones. 

Investors interested

 

The prospect of a lucrative investment opportunity even drew investors from outside the industry to the fair. 

 

Piyanuch Wattanasiritananwong and a friend came from Thailand, where they run a property business, after hearing about the show from a contact. 

 

“We want to know what opportunities there are in this industry because everybody dies,” she said. 

 

She pondered the possibility of starting a coffin business based on recycling — an elaborate outer shell is removed and re-used while the plain inner box is cremated with the body. 

 

“I don’t want people to spend a lot of money but still have a nice farewell,” she said.

Kilometers-Long Barrier Part of Plan to Clean Up Ocean Plastic

We producing nearly 300 million tons of plastic every year, half of which is used once, then thrown away. In the United States, we discard more than 33 million tons of plastics, and only a little more than 14 percent is recycled or used as fuel. The rest ends up in landfills or strewn along roadways or washed into the ocean. Getting rid of it will be an enduring challenge, but one man has a plan to start cleaning up our mess. VOA’s Faith Lapidus reports.

Few US Doctors Discuss Cancer Costs With Patients, Study Finds

Most doctors did not discuss the cost of cancer treatment with patients, spent less than two minutes on it when they did, and usually did so only after patients brought it up, a study that taped hundreds of visits at several large hospitals finds.

Cancer patients are three times more likely to declare bankruptcy than people without cancer are, but many doctors are not having the conversations that might help prevent this and sometimes don’t know the cost themselves, the results suggest.     

 

“That would not occur in any other industry I can think of” where a service or product is sold, said the study leader, Dr. Rahma Warsame of the Mayo Clinic.

Results were released Wednesday by the American Society of Clinical Oncology and will be discussed next month at its annual meeting in Chicago.

The study has some limitations – it’s not nationwide, and it includes newly diagnosed patients, where cost is most likely to come up, as well as others further along in treatment who may have discussed this earlier.

 

But the larger point is clear, Warsame said: The “financial toxicity” of treatments that can cost more than $100,000 a year is growing, and talks about that aren’t happening enough.

 

“I’ve had people say ‘no’ to really life-extending therapies” because of worries about bankrupting their family, she said.

 

For the study, researchers taped 529 conversations between doctors and patients with various types of cancer at three outpatient clinics – the kind of places chemo often is given – at Mayo, Los Angeles County Hospital and the University of Southern California’s Norris campus in Los Angeles.

 

Patients and doctors knew they were being taped but didn’t know why. Cost came up in 151 of the visits. Patients brought it up in 106 cases and doctors did in 45.

 

Appointments lasted about 15 minutes on average at the two California hospitals and half an hour at Mayo, but cost discussions ran only one to two minutes when they occurred at all.

 

Even when doctors acknowledged a cost concern, they rarely acted on it. Only six patients were referred to social services to seek help with affording care.

 

“Maybe a lot of patients don’t know to ask questions” about cost, said Karla Mees, 63, a nursing instructor from Rochester, Minnesota, who was treated for breast cancer at Mayo Clinic.

 

Doctors warned her in advance that she might have to pay $4,500 for gene tests on her tumor to help determine care, but she never knew how much chemo and radiation would cost until the bills came.  

 

“I just remember thinking, ‘I need the stuff, I’ll worry about payment later,’” she said, thankful that her insurance capped her annual out-of-pocket costs at $2,500.

 

Doctors also may be reluctant to talk money and have to give medical issues top priority in the short time they have during patient visits, said Dr. Lowell Schnipper, a cancer expert at Boston’s Beth Israel Deaconess Medical Center and head of the cancer group’s panel on value in cancer care.

 

“Most of us are not very well skilled in bringing it up,” he said. “In school you’re trained to simply take the best care you can of your patient and not worry about anything other than doing exactly that.”

 

In 2015, the cancer society launched a tool to help doctors and patients decide whether a cancer drug is worth it – the amount of benefit it gives versus its cost. It’s a good starting point for money talks, he said.