Tamiflu: Millions wasted on flu drug, claims major report

Hundreds of millions of pounds may have been wasted on a drug for flu that works no better than paracetamol, a landmark analysis has said.

The UK has spent £473m on Tamiflu, which is stockpiled by governments globally to prepare for flu pandemics,

The Cochrane Collaboration claimed the drug did not prevent the spread of flu or reduce dangerous complications, and only slightly helped symptoms.

The manufacturers Roche and other experts say the analysis is flawed.

The antiviral drug Tamiflu was stockpiled from 2006 in the UK when some agencies were predicting that a pandemic of bird flu could kill up to 750,000 people in Britain. Similar decisions were made in other countries.

Hidden data

The drug was widely prescribed during the swine flu outbreak in 2009.

Drug companies do not publish all their research data. This report is the result of a colossal fight for the previously hidden data into the effectiveness and side-effects of Tamiflu.

It concluded that the drug reduced the persistence of flu symptoms from seven days to 6.3 days in adults and to 5.8 days in children. But the report's authors said drugs such as paracetamol could have a similar impact.

On claims that the drug prevented complications such as pneumonia developing, Cochrane suggested the trials were so poor there was "no visible effect".

Tamiflu was widely used during the swine flu outbreak
Another justification for stockpiling was to slow the spread of the disease to give time for a vaccine to be developed. The report's authors said "the case for this is simply unproven" and "there is no credible way these drugs could prevent a pandemic".

It also claimed that the drug had a number of side-effects, including nausea, headaches, psychiatric events, kidney problems and hyperglycaemia.

Carl Heneghan, Professor of Evidence-Based Medicine at the University of Oxford and one of the report's authors, told the BBC: "I think the whole £500m has not benefited human health in any way and we may have harmed people.

"The system that exists for producing evidence on drugs is so flawed and open to misuse that the public has been misled."

Dr Tom Jefferson, a clinical epidemiologist and former GP, said: "I wouldn't give it for symptom relief, I'd give paracetamol."

The Cochrane Collaboration researchers have not placed the blame on any individual or organisation, instead saying there had been failings at every step from the manufacturers to the regulators and government.

'Wrong statistics'

However, there is disagreement about the findings and accusations that a simultaneous campaign to open up drug research is influencing the findings.

The pharmaceutical company Roche said "we disagree with the overall conclusions" and warned they could "potentially have serious public health implications".

Its UK medical director, Dr Daniel Thurley, told the BBC News website: "The definitive piece of research stands as the randomised control trials, which were shared with the regulators, which led to them in 100 countries around the world approving Tamiflu for treatment and prevention of flu."

He said the Cochrane group had used the wrong statistics, which "systematically underestimate the benefits" of the drug, and used "unorthodox" methods to analyse the side-effects.

He concluded: "One of the challenges we have here is actually knowing what they've done."

Prof Wendy Barclay, who researches the influenza virus at Imperial College London, said reducing symptoms is children by 29 hours would be "pretty beneficial".

She told the BBC: "Tamiflu works as well as any drug we have now or [that] is on the cards.

"Yes, I think they should replenish the stockpile. What else can you do if a pandemic strikes? We won't have a vaccine for the first six months."

She also questioned the validity of the research as it analysed the impact during seasonal flu: "If it works a little bit in season flu, the chances are they'll work quite a lot better in a pandemic situation and get more people back to school and work."

Kevin McConway, a professor of applied statistics at the Open University, said it was an "impressive" piece of work.

He said: "It is a potential limitation of this study that the work has been carried out alongside campaigning on access to trial data.

"The writers of the review have a clear position in this controversy, and, although I personally do generally agree with their position, I feel it does at times lead to some confusion between reporting the results of the review of these particular drugs and commenting on the general position on access to and use of unpublished data."

The UK Department of Health said Britain was recognised as "one of the best prepared countries in the world for a potential flu pandemic" and "our stockpile of antivirals is a key part of this.

"We regularly review all published data and will consider the Cochrane review closely."

The World Health Organization, which classes Tamiflu as an essential medicine, said: "We welcome a new and rigorous analysis of available data, and look forward to consideration of its findings after it appears."
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Flight 370: 2 new signals detected

Two new, fainter signals detected
In a sea of uncertainty, two bits of good news emerged Wednesday.

Searchers picked up fresh signals that officials hope came from locator beacons attached to the so-called black boxes in the tail of Malaysia Airlines Flight 370, which disappeared more than a month ago while carrying 239 people from Kuala Lumpur to Beijing.

The Australian ship Ocean Shield first picked up two sets of underwater pulses Saturday. It heard nothing more until Tuesday, when it reacquired the signals twice. The four signals were within 17 miles of one another.

"I believe we are searching in the right area, but we need to visually identify wreckage before we can confirm with certainty that this is the final resting place of MH370," said retired Air Chief Marshal Angus Houston, who's coordinating the Australian operation.

The second piece of good news? Authorities analyzed the signals picked up over the weekend and concluded that they probably came from specific electronic equipment rather than from marine life, which can make similar sounds.

"They believe the signals to be consistent with the specification and description of a flight data recorder," Houston said. "I'm now optimistic that we will find the aircraft or what's left of the aircraft in the not too distant future."

How to hunt for pings

Signals getting weaker

Thursday is Day 34 in the search for Flight 370, which went missing March 8. Authorities are pinning their hopes of finding it on the pings.

Time is of the essence: The batteries powering the flight recorders' locator beacons are certified to emit high-pitched signals for 30 days after they get wet.
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Missing Malaysia plane: Search area narrows

Australia's Ocean Shield has picked up signals that could be consistent with flight recorders four times
Teams are focusing on a narrowed search area in the hunt for the missing Malaysia Airlines plane, after more signals were heard earlier this week.

Thursday's search was set to involve up to 14 aircraft and 13 ships, the agency co-ordinating the search announced.

They will search 57,923 sq km (22 364 sq miles) - the smallest designated search area in the hunt to date.

On Wednesday, the official leading the search said he believed teams were looking "in the right area".

"I'm now optimistic that we will find the aircraft, or what's left of the aircraft, in the not too distant future," said Air Chief Marshal Angus Houston.

Flight MH370 disappeared on 8 March, carrying 239 people. It was travelling from Kuala Lumpur to Beijing when it lost contact with air traffic controllers.

Malaysian officials say that based on satellite data, they believe it ended its flight in the southern Indian Ocean, thousands of kilometres from its intended flight path.

Planes and ships are searching for debris based on analysis of ocean drift
A multinational search is under way, based out of the Western Australian city of Perth, both for possible wreckage and for audio signals from the plane's "black box" flight recorders.

So far an Australian vessel, the Ocean Shield, has picked up four acoustic signals in the same broad area, using a US Navy "towed pinger locator" to listen.

The signals were acquired twice over the weekend and again twice on Tuesday.

Expert analysis of the first two signals found that they were likely to be from specific electronic equipment consistent with a flight data recorder, ACM Houston said on Wednesday.

An Australian air force plane has been dropping buoys equipped with hydrophone listening devices into the water to help pick up more signals.

The batteries on the black box only last about a month, so teams need to work quickly to track the audio signals before they stop broadcasting.

"It looks like the signals we've picked up recently have been much weaker than the original signals we picked up," ACM Houston said on Wednesday.

"So that means probably we're either a long way away from it, or in my view more likely, the batteries are starting to fade. So we need to, as we say in Australia, make hay while the sun shines."

Officials want as much data as possible from the acoustic signals before they send down a submersible drone, the Bluefin 21, to search for wreckage on the sea floor.

Thursday's search area for floating debris lies west of the location where the signals were heard, some 2,280km (1,400 miles) north-west of Perth, the Joint Agency Co-ordination Centre (JACC) said.

"Aircraft and ships reported spotting a large number of objects during yesterday's search, but only a small number were able to be recovered," it said in a statement early on Thursday.

"None of the recovered items were believed to be associated with MH370."

Investigators still do not know why MH370 strayed so far off course, after disappearing over the South China Sea between Malaysia and Vietnam.

The backgrounds of both passengers and crew have been scrutinised as officials considered hijacking, sabotage, pilot action or mechanical failure as possible causes.
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‘Russia trying to create climate of chaos in Ukraine’

CNN speaks with Fareed Zakaria about recent developments in Ukraine, what Russia might be planning next, and how the United States should respond. This is an edited version of the transcript.

You've got pro- Russian demonstrators taking over government buildings in eastern Ukraine. You've got this ultimatum being laid out by the Ukrainian government. What do you make of the state of play inside Ukraine right now?

It feels like we're now in phase two of the Russian operation in Ukraine. Remember, Crimea was never the prize. Putin took Crimea because he could, because there was a naval base, because he feared Ukraine was slipping out of his control and he wanted to take that one piece that he knew he could get.

Ukraine was the prize. The whole purpose of Russian policy for the last decade has been to try to dominate Ukraine. So now phase two is, OK, we have Crimea. But Ukraine has become more anti-Russian and wants to move to the West. What do we do?

So, they've done two things. Over the last week or two, they've tried to essentially crash the Ukrainian economy. So, they have really essentially cut off supplies, contracts, business dealings. Now what they're trying to do is foment pro-Russian forces in Ukraine so that they create an atmosphere of general chaos.

At that point Putin can say, look, there's general chaos in Ukraine, we need to protect our Russian speakers. We happen to have 40,000 troops right near the border and we can go in. He may not need to go in physically, though he's clearly preparing for that option. But that also allows him to go to the Ukrainian government and say you've got to negotiate on my terms now, and those terms are substantial autonomy for eastern Ukraine, a permanent role for Russia in a kind of special relationship.

So, he's now moved on to the issue that was always his prize, how do I dominate Ukraine?

What is the next move for Ukraine, and for the United States and E.U. and NATO, who are trying to get Russia to stand down? Secretary of State John Kerry in a Senate hearing said very clearly, do not be fooled, this could be very easily viewed as a pretext for moving into Ukraine even further. What can they do?

It's a tough question. The first thing I think is the Ukrainian government is going to have to act well. The Ukrainian government has to be able to assert control over the territory. They did a pretty good job in the last day or two getting rid of some of these demonstrators. But at the end of the day, the Ukrainian government cannot control these protests.

Getting Americans or Europeans in, it's not going to look good or work. Russia just says, 'you see there are foreigners involved on one side'. First Ukrainians have to get their act together and they're trying.

More from CNN: Turning Crimea into 'Putinland'?

I think secondly, we have to start specifying exactly what would happen if the Russians were to invade. I think that really involves getting the Europeans to take a tougher line. If the Germans were to outline tough sanctions, real sanctions, that might make Moscow have second thoughts.
There's not much we can do. We're not going to fight a war with a nuclear superpower over Ukraine. But the Germans do a lot of trade with the Russians. It would be a body blow to the Russian economy.

It's pretty interesting that the foreign ministers of Ukraine and Russia might meet. Isn't that a huge step?

That is actually a bigger step. And it's gotten lost in some of the protests. The Russians, remember, had never accepted the Ukrainian government. They argued this was illegitimate. Now, the Russian foreign minister is meeting with the foreign minister. The Russians have said they would be willing to meet with all parties in the Ukrainian political system, meaning some of the pro-Russian ones. So, Putin is very clever. He's making some very tough moves. He's at the same time making some diplomatic overtures. And he's trying to see which ones work out. I don't believe he's ever had a master plan. He's a master opportunist.
More from CNN: Putin won't stop at Crimea.

Part of what he's trying to figure out is how much support does he have in eastern Ukraine? Remember, people say eastern Ukraine is pro-Russian.

From my understanding of it and from our good reporting, the younger people in eastern Ukraine, even the younger speakers, are not that pro-Russian. It's an older generation coming out of the Soviet Union that are. So Putin is trying to play all these dynamics and see what he can do.

What we need to do is be a little more specific on what we can do. The reason we're not, of course, is we don't have agreement, particularly with the Europeans.

What do you think about what Senator McCain and other Republican members of the Foreign Relations Committee basically saying that the administration, the U.S., has lost all credibility in foreign policy right now?
I think it's mostly partisan posturing…I would suggest that the way you gain credibility in a situation like Russia is not to have gone around invading other countries. I mean, the idea that if we had only intervened in Syria, we would have more credibility with the Russians. I feel like we tried that experiment in the last administration. We invaded Iraq, we invaded Afghanistan, and Putin still invaded Georgia and he still annexed Abkhazia and South Ossetia.

These situations are sufficiently complicated, that if you decide you want to put a partisan spin on them, you can read almost anything the way you want to. I think that this is a tough period we're going through, and a very serious crisis we're confronting in eastern Ukraine, and I just wish that the United States were able to speak with one voice rather than using this occasion and this crisis to turn it into yet one more partisan slinging match.
You've suggested this may be the most significant crisis involving the U.S. and Russia since the end of the Cold War. Are you still buying that?

Absolutely, because since the Cold War ended, we have had a set of rules of the road that have allowed for an unprecedented level of political stability, the global economy has prospered, the great powers have all been playing by a certain set of rules of the road. And what Russia has been doing over the last few years, but particularly here, is essentially saying, we're going to tear up this order. We are not going to abide by the idea that borders are sacrosanct, because what they are trying to do now in eastern Ukraine is they're trying to foment extreme instability.

The idea, I think, is to create a general climate of chaos, then declaim that the Russian army has to go in as a matter of protecting its own borders, protecting its own Russian speakers…This is stuff that really has not been employed by any major power really since 1945, but certainly since the end of the Cold War. So it's a big deal.
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'I've never really become an adult' - Michael Palin

Michael Palin says he has been very much "blown by the winds" in his career.

After hitting the stage with Monty Python in July, Michael Palin is to embark on his first ever one-man theatre tour.

"I look with envy at all these people like Sandi Toksvig and Billy Connolly and Kate Bush - they're all at it," Michael Palin says laughingly.

Now the Monty Python star has announced a 21-date UK tour in the autumn to accompany the third volume of his diaries, Travelling to Work 1988-1998.

As the title suggests, the focus is on Palin's transition from comedy performer to television globe-trotter that took off with BBC travel show Around The World in 80 Days.

"I made my name as a travel presenter but at the same time I was desperately keen to try lots of other things," says Palin, in an interview shortly before the tour was announced at the London Book Fair on Tuesday.

"I was coming up to 50 in 1993 and I thought I'd never get the chance again."

Palin's projects in that decade included Alan Bleasdale's TV drama GBH in 1991, in which Palin played a school headmaster intimidated by a newly-elected city council leader, played by Robert Lindsay.

In the past Palin has described GBH as a career highlight, but says his diaries reveal he had "a lot of fear as to whether I was really up to playing a major part like this".

The same year Palin starred in the film American Friends, which he also co-wrote, based on a true story involving his great-grandfather. In 1994 his first stage play, The Weekend, premiered in the West End. Hemingway's Chair, his first novel was published a year later.

"Lots of different things were vying with each other in that period - some of them more successful than others," he recalls.

What has he noticed about going back over his memoirs? "What intrigues me about diaries is how many contradictions there are in it. One day you can feel incredibly clear about the rest of your life and the next you get a phone call and backtrack completely."

Palin admits that while he enjoyed huge popularity with travel shows such as 80 Days, Pole to Pole and Full Circle, he never thought of it as a second career.

"When I was young. I remember thinking 'one day I'll become an adult' and I'd become rather serious and wear a tie and go to cocktail parties.

"But I realised that's not really what it's about. It's about a state of mind. And I've never really, properly become an adult. Nor have I done that other thing that was my father's dearest wish, that I should have a job and career.

"I've always been freelance. I've very much been blown by the winds. Career doesn't really come into it. Looking back now, yes it gave me another branch to my life but I kept all the other things going at the same time."

'You got cut!'

As well as the Monty Python films, Palin's big screen appearances include The Missionary, A Private Function, A Fish Called Wanda and Fierce Creatures.

Palin points out his diary also covers his movie non-appearances. He spent a week filming with Meg Ryan in You've Got Mail, but his scenes were dropped from the final edit. "My friend Basil, who takes all my photos, refers to You've Got Mail as You've Got Cut."

So what did Palin think made him a successful travel presenter? "I think what made the travel series popular was that it was very open. When I was feeling ill on a dhow I'd talk to the camera about it.

Michael Palin at London's Victoria Station in Around the World In 80 Days
"Or I'd make a point that there are toilets at the South Pole looking out over the icy wastes. It was the sort of thing not normally shown in documentaries."

In July, Palin will be back in the spotlight when Monty Python perform a 10 shows at the 02 Arena. I ask him why he thinks Kate Bush recently took the took the similar step of announcing a series of concerts after a long break from the stage.

"Someone might have said: 'You've go a terrific following, who not try some concerts? The Pythons are doing it. They sold out quickly.' I don't know if that made any difference at all."

He adds: "There are all sorts of motives. We're doing ours primarily for money - not through altruistic love for the audience, although we're going to love doing it.

"I don't know. Maybe Kate Bush has a mortgage problem!"
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Beyonce goes 'topless' for Out Magazine

In the May Power issue of LGBT magazine, Out, Beyonce channels Hollywood sex symbol Marilyn
Monroe and tackles the double standard between men & women regarding sexuality, telling the mag,
"There is a double standard when it comes to sexuality that still persists.

Men are free and women are not. That is crazy."

"You can be a businesswoman, a mother, an artist, and a feminist - whatever you want to be - and still be a sexual being. There is unbelievable
power in ownership and women should own their sexuality."

Beyonce's Out issue hits stands at the end of April.
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Scientists developing high-energy camera that detects the faintest atmospheric light

One of the CHEC photomultiplier modules currently being tested. Credit: Fabricio Sousa/SLAC
Scientists at the SLAC National Accelerator Laboratory, in Menlo Park, California, are currently building and testing unique components designed to collect the smallest traces of light in the sky. The end-result of this extensive research will be an innovative camera meant to complement a telescope capable of measuring wide-ranging gamma-rays.

The CTA will be able to detect ultra-high energy electromagnetic radiation, also known as gamma-rays. This radiation is so powerful that it breaks into small particles over our atmosphere faster than the speed of light, which necessitates the development of a specialized type of camera called the Compact High-energy Camera (CHEC); current CCD-based cameras in observatories are nowhere fast enough. The CHEC would be stronger than the Fermi Gamma-ray Space Telescope that's currently in orbit, and allow scientists to capture the faintest, fastest flashes of light in the night sky. As light is one thing scientists use to search for faraway objects in space, the CHEC's development could aid in space exploration.

According to SLAC, the CHEC camera will consist of several electronic components including photomultipliers, which are tiny modules able to collect and amplify individual particles of light. Another component is the TARGET chip, created by the combined efforts of University of Hawaii and SLAC researchers. The TARGET chip is an integral circuit chip that is able to read 16 pixels of photomultiplier signals up to one billion times a second.

Luigi Tibaldo, a researcher working on the CHEC project, said the prototype camera would utilize 32 different modules with 64-bit photomultipliers in addition to four TARGET chips. University of Hawaii researchers are currently working alongside Japanese electronics firm Hamamatsu Photonics in an effort to mass-produce the necessary modules for the new camera and telescope array.

The 32 photomultiplier modules that make up the camera.
SLAC seeks to install the first CHEC into a prototype telescope that will be used in the Cherenkov Telescope Array (CTA), a ground-based open observatory still under development by a consortium of more than a thousand members from countries such as Japan, Germany, India, the U.S., and others. The observatory will actually be comprise of two separate arrays, one in the Northern Hemisphere and the other in the Southern Hemisphere. There will be a total of more than 100 telescopes of three different sizes.

Researchers are set to continue testing the modules throughout the month of April before installing them into the final assembly of the CHEC camera. The CTA telescopes are currently in development.
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