Amgen Workers Helped U.S. in Aranesp Marketing Inquiry

“I hope no one is taping this,” the Amgen manager remarked at a company sales meeting in 2005.

The manager then boasted of how she had given a $10,000 unrestricted grant to a pet project of a doctor who was an adviser to the local Medicare contractor. In turn, she said, the doctor would help persuade the contractor to provide reimbursement for an unapproved use of Amgen’s anemia drug, Aranesp.

Someone, it turned out, was taping it. Jill Osiecki, a longtime sales representative at Amgen, was wearing a recording device under her clothes, transmitting the proceedings to agents of the Department of Health and Human Services.

The result of Ms. Osiecki’s undercover work, and information provided by other whistle-blowers, led to Amgen’s agreement this week to pay $762 million to settle federal investigations regarding the marketing of some of its top-selling drugs.

Judge Sterling Johnson Jr. of Federal District Court in Brooklyn accepted the settlement on Wednesday, clearing the way for 10 whistle-blower lawsuits to be unsealed.

Amgen, the world’s largest biotechnology company, will pay $150 million in criminal penalties after pleading guilty to one misdemeanor count of marketing Aranesp for unapproved uses and in unapproved doses.

The rest of the money — $612 million — will go to settle civil false claims lawsuits filed by the federal government, states and whistle-blowers. These contain accusations that go well beyond the off-label marketing of Aranesp.

They include off-label marketing of other drugs like Enbrel for psoriasis and Neulasta, which increases the levels of white blood cells. Amgen is also accused of offering kickbacks to doctors and clinics to induce them to use its drugs. These reportedly came as cash, rebates, free samples, educational and research grants, dinners and travel, and other inducements. The government also accused the company of knowingly misreporting the prices of some of its drugs.

Except for those in the criminal count, Amgen denied the other accusations, though it did issue a statement on Wednesday acknowledging the settlement.

“The government raised important concerns in the criminal prosecution,” Cynthia M. Patton, chief compliance officer at Amgen, said in the statement. “Amgen acknowledges that mistakes were made, and we did not live up to our standards.”

Ms. Osiecki, 52, was one of the main whistle-blowers and will be entitled to a share of the settlement. The amount each whistle-blower will receive has not been determined or is being kept confidential, their lawyers said.

Ms. Osiecki worked as a sales representative for Merck for nine years before joining Amgen in 1990, soon after the biotechnology company won regulatory approval for its first product. The company, based outside Los Angeles, had “good science, good products, strong ethics,” Ms. Osiecki said in an interview.

But, she said, the corporate culture changed starting around 2000. That was when new management came in and Aranesp was approved, setting up a fierce marketing battle with Johnson & Johnson and its rival anemia drug, Procrit.

“It was more important to make your numbers than to follow the rules,” said Ms. Osiecki, who was based in Milwaukee and sold Aranesp.

In August 2004, with her concerns mounting, Ms. Osiecki called the Office of Inspector General of the Department of Health and Human Services and left a message. Within days, she was called back, and she went to see an agent, who persuaded her to secretly record meetings. She did that 13 times over about 15 months, mainly sales meetings.

Aranesp is used mainly in a hospital, clinic or physician’s office. It is bought by the medical practice, which can make a profit if the patient and insurers pay more for the use of the drug than the practice paid.

Ms. Osiecki said Amgen “marketed the spread,” trying to make it more profitable for doctors to use Aranesp rather than Procrit.

Such financial inducements could also spur greater overall use of a drug and can violate anti-kickback laws, said Ms. Osiecki’s lawyer, Brian P. Kenney of Kenney & McCafferty in Blue Bell, Pa.

Ms. Osiecki said the first sales meeting at which she wore the recording device, wrapped around her midriff under baggy clothes, was in October 2004 in a Milwaukee hotel. She could look down from the meeting room and see the car parked across the street containing the agent with the receiving device. She said she was not particularly nervous.

The speaker was a pharmacist from an oncology practice going through the numbers on how his practice could make a million dollars more a year using Aranesp rather than Procrit.

Ms. Osiecki said Amgen was careful to cover up such marketing. Spreadsheets showing doctors how much more money they could make using Aranesp were “homemade bread,” meaning they were created by each sales representative, not by the company. And representatives were told not to leave the presentations behind after showing them to doctors.

Her 107-page complaint, filed in late 2004, contains many other accusations.

Other whistle-blowers made other accusations. Kassie Westmoreland, a former sales representative, said Amgen overfilled vials of Aranesp, essentially providing free drugs to doctors. They could then bill Medicare or private insurers for the use of that drug, making an extra profit.

“Amgen was offering a kickback in the form of extra product subsidized by the taxpayers,” said Robert M. Thomas Jr., one of Ms. Westmoreland’s lawyers.

Elena Ferrante and Marc Engelman, both former sales representatives, contended that Amgen promoted Enbrel’s off-label use for mild psoriasis when the drug was approved only for moderate or severe cases of the disease.

Lydia Cotz, one of their lawyers, said the two refused to go along with the off-label marketing. They are now pursuing wrongful termination claims against Amgen in arbitration proceedings that Amgen requires be kept confidential, she said.

“It’s been a very long heroic journey for my clients,” she said.

Ms. Osiecki is now also a former Amgen sales representative. She said that she was fired in December 2005 after she let slip that she had retained a company voice mail message that she thought provided evidence of illegal activity. Leaving the pharmaceutical industry, she moved to Amelia Island, Fla. She now works for a small business.

Mosi Secret and Barry Meier contributed reporting.

Read More..

Amgen Workers Helped U.S. in Aranesp Marketing Inquiry

“I hope no one is taping this,” the Amgen manager remarked at a company sales meeting in 2005.

The manager then boasted of how she had given a $10,000 unrestricted grant to a pet project of a doctor who was an adviser to the local Medicare contractor. In turn, she said, the doctor would help persuade the contractor to provide reimbursement for an unapproved use of Amgen’s anemia drug, Aranesp.

Someone, it turned out, was taping it. Jill Osiecki, a longtime sales representative at Amgen, was wearing a recording device under her clothes, transmitting the proceedings to agents of the Department of Health and Human Services.

The result of Ms. Osiecki’s undercover work, and information provided by other whistle-blowers, led to Amgen’s agreement this week to pay $762 million to settle federal investigations regarding the marketing of some of its top-selling drugs.

Judge Sterling Johnson Jr. of Federal District Court in Brooklyn accepted the settlement on Wednesday, clearing the way for 10 whistle-blower lawsuits to be unsealed.

Amgen, the world’s largest biotechnology company, will pay $150 million in criminal penalties after pleading guilty to one misdemeanor count of marketing Aranesp for unapproved uses and in unapproved doses.

The rest of the money — $612 million — will go to settle civil false claims lawsuits filed by the federal government, states and whistle-blowers. These contain accusations that go well beyond the off-label marketing of Aranesp.

They include off-label marketing of other drugs like Enbrel for psoriasis and Neulasta, which increases the levels of white blood cells. Amgen is also accused of offering kickbacks to doctors and clinics to induce them to use its drugs. These reportedly came as cash, rebates, free samples, educational and research grants, dinners and travel, and other inducements. The government also accused the company of knowingly misreporting the prices of some of its drugs.

Except for those in the criminal count, Amgen denied the other accusations, though it did issue a statement on Wednesday acknowledging the settlement.

“The government raised important concerns in the criminal prosecution,” Cynthia M. Patton, chief compliance officer at Amgen, said in the statement. “Amgen acknowledges that mistakes were made, and we did not live up to our standards.”

Ms. Osiecki, 52, was one of the main whistle-blowers and will be entitled to a share of the settlement. The amount each whistle-blower will receive has not been determined or is being kept confidential, their lawyers said.

Ms. Osiecki worked as a sales representative for Merck for nine years before joining Amgen in 1990, soon after the biotechnology company won regulatory approval for its first product. The company, based outside Los Angeles, had “good science, good products, strong ethics,” Ms. Osiecki said in an interview.

But, she said, the corporate culture changed starting around 2000. That was when new management came in and Aranesp was approved, setting up a fierce marketing battle with Johnson & Johnson and its rival anemia drug, Procrit.

“It was more important to make your numbers than to follow the rules,” said Ms. Osiecki, who was based in Milwaukee and sold Aranesp.

In August 2004, with her concerns mounting, Ms. Osiecki called the Office of Inspector General of the Department of Health and Human Services and left a message. Within days, she was called back, and she went to see an agent, who persuaded her to secretly record meetings. She did that 13 times over about 15 months, mainly sales meetings.

Aranesp is used mainly in a hospital, clinic or physician’s office. It is bought by the medical practice, which can make a profit if the patient and insurers pay more for the use of the drug than the practice paid.

Ms. Osiecki said Amgen “marketed the spread,” trying to make it more profitable for doctors to use Aranesp rather than Procrit.

Such financial inducements could also spur greater overall use of a drug and can violate anti-kickback laws, said Ms. Osiecki’s lawyer, Brian P. Kenney of Kenney & McCafferty in Blue Bell, Pa.

Ms. Osiecki said the first sales meeting at which she wore the recording device, wrapped around her midriff under baggy clothes, was in October 2004 in a Milwaukee hotel. She could look down from the meeting room and see the car parked across the street containing the agent with the receiving device. She said she was not particularly nervous.

The speaker was a pharmacist from an oncology practice going through the numbers on how his practice could make a million dollars more a year using Aranesp rather than Procrit.

Ms. Osiecki said Amgen was careful to cover up such marketing. Spreadsheets showing doctors how much more money they could make using Aranesp were “homemade bread,” meaning they were created by each sales representative, not by the company. And representatives were told not to leave the presentations behind after showing them to doctors.

Her 107-page complaint, filed in late 2004, contains many other accusations.

Other whistle-blowers made other accusations. Kassie Westmoreland, a former sales representative, said Amgen overfilled vials of Aranesp, essentially providing free drugs to doctors. They could then bill Medicare or private insurers for the use of that drug, making an extra profit.

“Amgen was offering a kickback in the form of extra product subsidized by the taxpayers,” said Robert M. Thomas Jr., one of Ms. Westmoreland’s lawyers.

Elena Ferrante and Marc Engelman, both former sales representatives, contended that Amgen promoted Enbrel’s off-label use for mild psoriasis when the drug was approved only for moderate or severe cases of the disease.

Lydia Cotz, one of their lawyers, said the two refused to go along with the off-label marketing. They are now pursuing wrongful termination claims against Amgen in arbitration proceedings that Amgen requires be kept confidential, she said.

“It’s been a very long heroic journey for my clients,” she said.

Ms. Osiecki is now also a former Amgen sales representative. She said that she was fired in December 2005 after she let slip that she had retained a company voice mail message that she thought provided evidence of illegal activity. Leaving the pharmaceutical industry, she moved to Amelia Island, Fla. She now works for a small business.

Mosi Secret and Barry Meier contributed reporting.

Read More..

Adding to Rules for Online Privacy

In a move intended to give parents greater control over data collected about their children online, federal regulators on Wednesday broadened longstanding privacy safeguards covering children’s mobile apps and Web sites. Members of the Federal Trade Commission said they updated the rules to keep pace with the growing use of mobile phones and tablets by children.

The regulations also reflect innovations like voice recognition technology, global positioning systems and behavior-based online advertising, or ads tailored to an individual Internet user.

Regulators had not significantly changed the original rule, based on the Children’s Online Privacy Protection Act of 1998, or Coppa. That rule required operators of Web sites directed at children under 13 to notify parents and obtain their permission before collecting or sharing personal information — like first and last names, phone numbers, home addresses or e-mail addresses — from children.

The intent of that was to give parents control over entities seeking to collect information about their children so that parents could, among other things, prevent unwanted contact by strangers.

The new rule, unveiled at a news conference in Washington, significantly expands the types of companies required to obtain parental permission before knowingly collecting personal details from children, as well as the types of information that will require parental consent to collect.

Jon D. Leibowitz, the chairman of the trade commission, described the rule revision as a major advance for children’s privacy. “Congress enacted Coppa in the desktop era and we live in an era of smartphones and mobile marketing,” Mr. Leibowitz said. “This is a landmark update of a seminal piece of legislation.”

The agency’s expanded privacy protections for children also represent the first step in a larger effort by a few regulators and legislators to give adult consumers some rights to control data collected about them.

“The Coppa rule revisions which we are announcing today are a critical piece in our overall approach to how we deal with consumer privacy in this technological age,” said Julie Brill, a member of the commission.

Industry analysts said the new rule represented a partial victory for Web site operators, app developers and advertising networks because regulators watered down some of their original proposals to which companies like Apple, Facebook, Google and Twitter had objected. Apple and Google, for example, opposed proposals that suggested they would be responsible for the data collected by children’s apps sold in their app stores. Regulators have now clarified that general-interest app stores would not be held liable for that.

Yet, few companies lent any support to the commission at its news conference; Viacom and Disney sent representatives, but other companies were absent.

“What we’ve got here is an expansion of Coppa that some in the industry would say has gone too far,” said Alan Friel, a lawyer who leads the media and technology practice at the firm of Edwards Wildman Palmer. “But the F.T.C. has provided exceptions that continue to allow internal use of a child’s data, including one-time use of contact information for facilitating promotions and send-a-friend e-mails.”

In an era of widespread photo sharing, video chatting and location-based apps, the revised children’s privacy rule makes clear that companies must obtain parental consent before collecting certain details that could be used to identify, contact or locate a child. These include photos, video and audio as well as the location of a child’s mobile device.

While the new rule strengthens such safeguards, it could also disrupt online advertising. Web sites and online advertising networks often use persistent identification systems — like a cookie in a person’s browser, the unique serial number on a mobile phone, or the I.P. address of a computer — to collect information about a user’s online activities and tailor ads for that person.

The new rule expands the definition of personal information to include persistent IDs if they are used to show a child behavior-based ads. It also requires third parties like ad networks and social networks that know they are operating on children’s sites to notify and obtain consent from parents before collecting such personal information. And it makes children’s sites responsible for notifying parents about data collection by third parties integrated into their services.

Collecting data to show children contextual ads based on the content of a site or app, however, will not require parental consent. “The only limit we place is on behavioral advertising,” Mr. Leibowitz said. “Until and unless you get parental consent, you may not track children to create massive profiles” for behavior-based ads.

Stuart P. Ingis, a lawyer representing several marketing associations, said that reputable online marketers did not knowingly profile children to show them behavior-based ads. He added that industry guidelines prohibited the practice.

He agreed with regulators that privacy protections for children online needed to keep pace with new technologies. But he said he was concerned that the restrictions on cookie-based identifiers might cause some children’s sites to reduce their use of ad networks to avoid having to notify parents about data collection by those services.

“There might be overreaction that would limit just general third-party collection of data, which is very useful to businesses and consumers,” said Mr. Ingis, who represents the Direct Marketing Association and the Association of National Advertisers.

The revised rule also clarifies requirements for sites that are not primarily directed at young children but whose audience may include them, like a Disney family site, for example. Those sites can now screen visitors by age, but they will be required to obtain permission from a parent to collect personal data about children under 13.

Children’s advocates generally welcomed the strengthened protections.

“Clearly, this is a major step forward, but the devil is in the details,” said Jeffrey Chester, the executive director of the Center for Digital Democracy, an advocacy group in Washington.

Read More..

Russia Sends Warships Toward Syria for Possible Evacuation

MOSCOW — Russia sent warships to the eastern Mediterranean Sea on Tuesday, the Defense Ministry announced, in what appeared to be preparation for a possible evacuation of Russian citizens from Syria.

Russian officials began formulating plans during the summer for an evacuation, but have delayed announcements, analysts say, to avoid signaling a loss of confidence in President Bashar al-Assad, a longtime strategic ally. Moscow staunchly opposes international intervention in Syria and has blocked United Nations Security Council resolutions meant to force Mr. Assad from power. Officials have repeatedly said that Russia’s position has not changed.

However, Moscow has signaled in recent days that it sees Mr. Assad’s forces losing ground, and that it is beginning to prepare for a chaotic transition period. One immediate concern is the large number of Russian citizens scattered across Syria, as a result of decades of intermarriage and longstanding economic ties.

Late on Monday, Russian diplomats said that two Russian citizens had been kidnapped by an armed group. The two Russians, evidently workers in a privately owned steel factory, were seized as they traveled on a road between Homs and Tartus and were held for ransom. An Italian citizen, Mario Belluomo, was abducted with them, the Italian Foreign Ministry said.

Then on Tuesday, the Russian Defense Ministry announced that a flotilla of five ships — a destroyer, a tugboat, a tanker and two large landing vessels — was being sent from Baltiysk, a port in the Baltic Sea, to relieve ships that have been near Syria for months. At typical cruising speeds for such vessels, the ships would arrive on station around the beginning of January.

A naval official, speaking on the condition of anonymity as is customary, told the Interfax news service that the ships were “on their way to the coast of Syria for possible participation in the evacuation of Russian citizens” to a Russian port on the Black Sea. The official said that the mission had been planned swiftly but under total secrecy, and that the timeline for the ships’ return to port “depends on the development of the situation in Syria.”

Aleksandr I. Shumilin, a regional analyst and a foreign correspondent, said Russian leaders had avoided openly taking steps toward evacuation until now, to avoid signaling that Russia was scaling back its support for Mr. Assad, but that they also risked public anger if Russians became targets of violence in Syria.

“It appears that some break has taken place, but whether that means a change of policy, or a modification of policy, that’s hard to say,” said Mr. Shumilin, who is head of the Middle East conflict analysis center at the Russian Academy of Science’s Institute for Canada and the United States. “The decision-makers are now concentrating on humanitarian questions, the protection of Russian citizens.”

The Syrian rebels have been moving aggressively around the capital, Damascus, in recent weeks, and Mr. Assad’s forces have responded by firing with Scud missiles. On Tuesday, Syrian fighter jets bombed the Palestinian refugee camp of Yarmouk for the second time this week, seeking to drive back rebel forces that had moved in, The Associated Press reported.

Iran, Syria’s last ally in its region, appeared to remain firmly committed to Mr. Assad. On Tuesday, Deputy Foreign Minister Hossein Amir Abdollahianof Iran told reporters in Moscow, “The Syrian Army and the state machine are working smoothly.”

A planned visit by the president of Iran, Mahmoud Ahmadinejad, to Ankara, the capital of Turkey, was suddenly canceled on Monday amid tensions between Iran and Turkey over NATO’s decision to deploy Patriot antimissile batteries on the Turkish border with Syria.

Iranian leaders, politicians and commanders of the Islamic Revolutionary Guards Corps have denounced NATO’s decision on Dec. 4 to send six batteries of American, German and Dutch Patriot systems to intercept any Scud missiles that the embattled Syrian government may launch toward Turkey.

Iran fears that NATO will use the batteries, which are staffed by about 1,000 soldiers and can also be used against aircraft, to set up a no-fly zone and create a rebel safe haven in northern Syria.

Iran’s top general, Hassan Firouzabadi, said at a meeting of senior commanders on Saturday that the deployment was part of a Western plan to start a “world war,” and that Iran’s own ambitious missile program was the real target.

“They signify concerns over Iran’s missiles and the presence of Russia for defending Syria,” he said. “The sensible people in America, Turkey and Europe must prevent this situation from getting out of control.”

The mobile Patriot systems could technically be used to intercept Iranian as well as Syrian missiles. They are effective against missiles at a range of about 12 miles, and against aircraft up to 100 miles.

Iran has threatened to fire missiles at Israel if its nuclear installations come under attack.

On Tuesday, Iran’s defense minister, Brig. Gen. Ahmad Vahidi, said Israel was the winner in the Syrian conflict, because it was witnessing the destruction of an enemy — the Assad government — while the Syrian people were being “manipulated” by “terrorists.”

Turkey’s foreign minister, Ahmet Davutoglu, urged Iran to use its political clout with Damascus to end the violence in Syria, instead of making statements about the Patriot systems.

“Turkey and NATO have stressed over and over again that this system is solely for defensive purposes,” Mr. Davutoglu told reporters. “Turkey has the right to do what it wants in order to protect its territory. It is time for Iran to give a clear message to the Syrian regime.”

Ellen Barry reported from Moscow, and Thomas Erdbrink from Tehran.

Read More..

F.T.C. Opens an Inquiry Into Data Brokers

It’s getting tougher to be a data broker.

Companies that collect, analyze and sell billions of details about the activities of consumers for marketing purposes have increasingly found themselves under government scrutiny this year.

The latest salvo comes from the Federal Trade Commission, which said on Tuesday that it had opened an inquiry into the practices of nine companies that collect and resell or analyze consumer data.

The agency issued 15-page administrative subpoenas to the information resellers. The orders require each company to provide extensive details about how it collects consumer data and how it uses, stores, analyzes and shares that data. The agency also asked for information about whether the company allows consumers to see and correct the records held about them.

After it reviews this information, the agency plans to issue a report to advise lawmakers on whether more regulation is needed; data brokers are currently largely unregulated.

The F.T.C.’s inquiry seeks far more comprehensive details than similar investigations this year in Congress. And executives at the companies may be more forthcoming about their practices with regulators because, unlike Congressional inquiries that often make their results public, the F.T.C. keeps the specifics it gathers confidential.

The subpoenas went to, among other companies, Acxiom of Little Rock, Ark., one of the world’s largest information resellers, which manages customer databases for major banks, automakers and retailers; eBureau, a company in St. Cloud, Minn., which, on behalf of clients like credit card companies, lenders, insurers and educational institutions, evaluates and scores online consumers in the market for those companies’ products; Intelius, a company in Bellevue, Wash., which offers people-search look-up services and background checks; and Peek-You, a company that analyzes social media sentiment.

“We are going to get a huge amount of data,” David C. Vladeck, the director of the Bureau of Consumer Protection at the F.T.C., said in a phone interview on Tuesday. “We are going to get answers.”

In an e-mail, Jennifer Barrett Glasgow, the chief privacy officer of Acxiom, said the company had not yet received the F.T.C.’s letter, but was looking forward to cooperating with the inquiry. “We consider this request as an avenue to promote a better understanding of why what we do is vital for the American economy as it creates enormous value for people and businesses while respecting and protecting consumers’ interests,” she wrote.

Gordon Meyer, the chief executive of eBureau, wrote in an e-mail that the consumer scoring company “welcomes the opportunity to describe, to the F.T.C., its practices and the benefits we provide to businesses as well as consumers.”

Representatives of other companies did not return e-mails seeking comment.

Companies and organizations in the United States spend more than $2 billion a year on third-party data about individuals, according to a report last year on personal identity management from Forrester Research, a market research firm. That figure does not include spending on market research and customer data analytics, the report said.

Industry representatives argue that their practices benefit consumers. Data brokers, they say, collect information about individuals’ purchasing histories, estimated salaries, property ownership, family size, leisure pursuits — and sometimes also their race or ethnicity, age, gender, health concerns, online browsing history and social networks — to help marketers tailor pitches to a person’s demonstrated tastes. When these bespoke ad systems work properly, the companies argue, marketers can identify male Southern Californians who surf and show them ads for board shorts even as they avoid sending coupons for ski vacations to people who prefer Alaskan cruises.

But, as consumers conduct more of their personal and commercial lives online, that type of data collection has been steadily increasing, fueled by new online surveillance techniques and more sophisticated analytics. Some companies, for example, have compiled several thousand different pieces of information on a majority of adults in the United States. Regulators say they are concerned that such comprehensive data collection could be used to profile, score or segment consumers, with the potential to unfairly limit the kinds of financial, insurance, health, education or other marketing offers certain consumers receive.

Mr. Vladeck of the F.T.C. offered one possibility he worried about: a hypothetical consumer who buys a deep-fat fryer online may get typecast by data broker systems as a health risk, and then is passed over for marketing pitches for insurance or other services.

Read More..

Attackers in Pakistan Kill Anti-Polio Workers

Rizwan Tabassum/Agence France-Presse — Getty Images

A Pakistani mother mourned her daughter, who was killed on Tuesday in an attack on health workers participating in a drive to eradicate polio from Pakistan.

ISLAMABAD, Pakistan — Gunmen shot dead five female health workers who were immunizing children against polio on Tuesday, causing the Pakistani government to suspend vaccinations in two cities and dealing a fresh setback to an eradication campaign dogged by Taliban resistance in a country that is one of the disease’s last global strongholds.

“It is a blow, no doubt,” said Shahnaz Wazir Ali, an adviser on polio to Prime Minister Raja Pervez Ashraf. “Never before have female health workers been targeted like this in Pakistan. Clearly there will have to be more and better arrangements for security.”

No group claimed responsibility for the attacks, but most suspicion focused on the Pakistani Taliban, which has previously blocked polio vaccinators and complained that the United States is using the program as a cover for espionage.

The killings were a serious reversal for the multibillion-dollar global polio immunization effort, which over the past quarter century has reduced the number of endemic countries from 120 to just three: Pakistan, Afghanistan and Nigeria.

Nonetheless, United Nations officials insisted that the drive would be revived after a period for investigation and regrouping, as it had been after previous attacks on vaccinators here, in Afghanistan and elsewhere.

Pakistan has made solid gains against polio, with 56 new recorded cases of the diseases in 2012, compared with 192 at the same point last year, according to the government. Worldwide, cases of death and paralysis from polio have been reduced to less than 1,000 last year, from 350,000 worldwide in 1988.

But the campaign here has been deeply shaken by Taliban threats and intimidation, though several officials said Tuesday that they had never seen such a focused and deadly attack before.

Insurgents have long been suspicious of polio vaccinators, seeing them as potential spies. But that greatly intensified after the C.I.A. used a vaccination team headed by a local doctor, Shakil Afridi, to visit Osama bin Laden’s compound in Abbottabad, reportedly in an attempt to obtain DNA proof that the Bin Laden family was there before an American commando raid attacked it in May 2011.

In North Waziristan, one prominent warlord has banned polio vaccinations until the United States ceases drone strikes in the area.

Most new infections in Pakistan occur in the tribal belt and adjoining Khyber-Pakhtunkhwa Province — some of the most remote areas of the country, and also those with the strongest militant presence. People fleeing fighting in those areas have also spread the disease to Karachi, the country’s largest city, where the disease has been making a worrisome comeback in recent years.

After Tuesday’s attacks, witnesses described violence that was both disciplined and well coordinated. Five attacks occurred within an hour in different Karachi neighborhoods. In several cases, the killers traveled in pairs on motorcycle, opening fire on female health workers as they administered polio drops or moved between houses in crowded neighborhoods.

Of the five victims, three were teenagers, and some had been shot in the head, a senior government official said. Two male health workers were also wounded by gunfire; early reports incorrectly stated that one of them had died, the official said.

In Peshawar, the capital of Khyber-Pakhtunkhwa Province, gunmen opened fire on two sisters participating in the polio vaccination program, killing one of them. It was unclear whether that shooting was directly linked to the Karachi attacks.

In remote parts of the northwest, the Taliban threat is exacerbated by the government’s crumbling writ. In Bannu, on the edge of the tribal belt, one polio worker, Noor Khan, said he quit work on Tuesday once news of the attacks in Karachi and Peshawar filtered in. “We were told to stop immediately,” he said by phone.

Still, the Pakistani government has engaged considerable political and financial capital in fighting polio. President Asif Ali Zardari and his daughter Aseefa have been at the forefront of immunization drives. With the help of international donors, including the Bill and Melinda Gates Foundation, they have mounted a huge vaccination campaign aimed at up to 35 million children younger than 5, usually in three-day bursts that can involve 225,000 health workers.

The plan seeks to have every child in Pakistan immunized at least four times per year, although in the hardest-hit areas one child could be reached as many as 12 times in a year.

Declan Walsh reported from Islamabad, and Donald G. McNeil Jr. from New York. Salman Masood contributed reporting from Islamabad, and Zia ur-Rehman from Karachi, Pakistan.

Read More..

Attackers in Pakistan Kill Anti-Polio Workers

Rizwan Tabassum/Agence France-Presse — Getty Images

A Pakistani mother mourned her daughter, who was killed on Tuesday in an attack on health workers participating in a drive to eradicate polio from Pakistan.

ISLAMABAD, Pakistan — Gunmen shot dead five female health workers who were immunizing children against polio on Tuesday, causing the Pakistani government to suspend vaccinations in two cities and dealing a fresh setback to an eradication campaign dogged by Taliban resistance in a country that is one of the disease’s last global strongholds.

“It is a blow, no doubt,” said Shahnaz Wazir Ali, an adviser on polio to Prime Minister Raja Pervez Ashraf. “Never before have female health workers been targeted like this in Pakistan. Clearly there will have to be more and better arrangements for security.”

No group claimed responsibility for the attacks, but most suspicion focused on the Pakistani Taliban, which has previously blocked polio vaccinators and complained that the United States is using the program as a cover for espionage.

The killings were a serious reversal for the multibillion-dollar global polio immunization effort, which over the past quarter century has reduced the number of endemic countries from 120 to just three: Pakistan, Afghanistan and Nigeria.

Nonetheless, United Nations officials insisted that the drive would be revived after a period for investigation and regrouping, as it had been after previous attacks on vaccinators here, in Afghanistan and elsewhere.

Pakistan has made solid gains against polio, with 56 new recorded cases of the diseases in 2012, compared with 192 at the same point last year, according to the government. Worldwide, cases of death and paralysis from polio have been reduced to less than 1,000 last year, from 350,000 worldwide in 1988.

But the campaign here has been deeply shaken by Taliban threats and intimidation, though several officials said Tuesday that they had never seen such a focused and deadly attack before.

Insurgents have long been suspicious of polio vaccinators, seeing them as potential spies. But that greatly intensified after the C.I.A. used a vaccination team headed by a local doctor, Shakil Afridi, to visit Osama bin Laden’s compound in Abbottabad, reportedly in an attempt to obtain DNA proof that the Bin Laden family was there before an American commando raid attacked it in May 2011.

In North Waziristan, one prominent warlord has banned polio vaccinations until the United States ceases drone strikes in the area.

Most new infections in Pakistan occur in the tribal belt and adjoining Khyber-Pakhtunkhwa Province — some of the most remote areas of the country, and also those with the strongest militant presence. People fleeing fighting in those areas have also spread the disease to Karachi, the country’s largest city, where the disease has been making a worrisome comeback in recent years.

After Tuesday’s attacks, witnesses described violence that was both disciplined and well coordinated. Five attacks occurred within an hour in different Karachi neighborhoods. In several cases, the killers traveled in pairs on motorcycle, opening fire on female health workers as they administered polio drops or moved between houses in crowded neighborhoods.

Of the five victims, three were teenagers, and some had been shot in the head, a senior government official said. Two male health workers were also wounded by gunfire; early reports incorrectly stated that one of them had died, the official said.

In Peshawar, the capital of Khyber-Pakhtunkhwa Province, gunmen opened fire on two sisters participating in the polio vaccination program, killing one of them. It was unclear whether that shooting was directly linked to the Karachi attacks.

In remote parts of the northwest, the Taliban threat is exacerbated by the government’s crumbling writ. In Bannu, on the edge of the tribal belt, one polio worker, Noor Khan, said he quit work on Tuesday once news of the attacks in Karachi and Peshawar filtered in. “We were told to stop immediately,” he said by phone.

Still, the Pakistani government has engaged considerable political and financial capital in fighting polio. President Asif Ali Zardari and his daughter Aseefa have been at the forefront of immunization drives. With the help of international donors, including the Bill and Melinda Gates Foundation, they have mounted a huge vaccination campaign aimed at up to 35 million children younger than 5, usually in three-day bursts that can involve 225,000 health workers.

The plan seeks to have every child in Pakistan immunized at least four times per year, although in the hardest-hit areas one child could be reached as many as 12 times in a year.

Declan Walsh reported from Islamabad, and Donald G. McNeil Jr. from New York. Salman Masood contributed reporting from Islamabad, and Zia ur-Rehman from Karachi, Pakistan.

Read More..

The Media Equation: Buffeted by the Web, but Now Riding It

When the consumer Web exploded in the mid-1990s, part of the promise was that it would transform careers and the concept of work. Remember the signs on telephone poles and banners all over the Internet? “Work at home and turn your computer into a cash register! Ask me how.” The next generation of Americans would be able to work on their own terms.

It didn’t turn out that way. If anything, digital technology has overwhelmed those who sought to master it. The Web may be a technological marvel, but to most people who use it for work, it functions like an old-fashioned hamster wheel, except at Internet speed.

Brian Lam was both a prince and a casualty of that realm. After interning at Wired, he became the editor of Gizmodo, Gawker Media’s gadget blog. A trained Thai boxer, he focused his aggression on cranking out enough copy to increase the site’s traffic, to a peak of 180 million page views from 13 million in the five years he was there.

He and his writers broke news, sent shrapnel into many subject areas with provocative, opinionated copy and was part of the notorious pilfered iPhone 4 story that had law enforcement officials breaking down doors on Apple’s behalf. I saw Mr. Lam on occasional trips to San Francisco, and he crackled with jumpy digital energy.

And then, he burned out at age 34. He loved the ocean, but his frantic digital existence meant his surfboard was gathering cobwebs. “I came to hate the Web, hated chasing the next post or rewriting other people’s posts just for the traffic,” he told me. “People shouldn’t live like robots.”

So he quit Gizmodo, and though he had several lucrative offers, he decided to do exactly nothing. He sold his car, rented out his house, took time to mull things over and eventually moved to Hawaii because he loves surfing.

This is the point in the story where we generally find out that the techie is now a wood carver, or an oboe player.

But leopards don’t change their spots, and they certainly don’t turn into unicorns. An accomplished technologist and writer, Mr. Lam worked to come up with a business that he could command instead of the other way around.

The problem is that these days, ad-supported media business models all depend on scale, because rates go lower every day. Success in Web media generally requires constant posting to build a big audience. Mr. Lam knew where that led.

With friends — including Brian X. Chen, who now works at The New York Times — he came up with his own version of a gadget site. But instead of chasing down every tidbit of tech news, he built The Wirecutter, a recommendation site that posts six to 12 updates a month — not a day — and began publishing in partnership with The Awl, a federation of blogs founded by two other veterans of Gawker Media, Choire Sicha and Alex Balk.

While there are many technology sites that evaluate and compare products, usually burying their assessments in a tsunami of other posts, Mr. Lam and his staff of freelancers decided to rely on deep examinations of specific product categories.

Using expert opinions, aggregated reviews and personal research, they recommend a single product in each category. There are no complicated rankings or deep analytics on the entire category. If you want new earphones or a robot vacuum, The Wirecutter will recommend The One and leave it at that.

“I was tired of doing posts that were obsolete three hours after I wrote them,” Mr. Lam said. “I wanted evergreen content that didn’t have to be updated constantly in order to hunt traffic. I wanted to publish things that were useful.”

He bootstrapped the site, spurning outside investment. “If you take the money, you have to pony up in terms of scale, and I don’t want to do that,” he said.

The clean, simple interface, without the clutter of news, is a tiny business; it has fewer than 350,000 unique visitors a month at a time when ad buyers are not much interested in anything less than 20 million.

But The Wirecutter is not really in the ad business. The vast majority of its revenue comes from fees paid by affiliates, mostly Amazon, for referrals to their sites. As advertising rates continue to tumble, affiliate fees could end up underwriting more and more media businesses.

“Brian’s insight is that in a world of loudest and fastest, he has turned it down, doing it slow and doing it right,” Mr. Sicha said. “And by being consumer facing, he doesn’t have to have monster numbers. The people come ready to buy.”

In fact, 10 to 20 percent of its visitors click on links, a rate that would make ad sellers drool. Mr. Lam hardly invented the model. The Web is full of mom-and-pop shops that live on referral fees for things like pet supplies and camping gear. Many companies also pay for referrals — eBay, Half.com, even retailers like Gap and Old Navy. A business that used to be mired in spam is becoming far more legitimate.

For small businesses like Wirecutter, it’s risky to rely so much on a single company, but Amazon seems disinclined to mess with its very successful model.

“We have been working hard to give publishers of all sizes the tools to work with Amazon,” said Steve Shure, Amazon’s vice president for worldwide marketing.

But it’s not just the little guys. Hearst’s Good Housekeeping has commerce links to Amazon, and Gawker Media, Mr. Lam’s old employer, is building affiliate revenue and other nonadvertising revenue into a seven-figure business by next year. In a sense, it’s back to the future, the days of the Whole Earth Catalog and its compendium of splendid things. Kevin Kelly, its former editor and publisher and now “senior maverick” at Wired, has a site called Cool Tools that will be observing its 10th anniversary.

“Affiliate income is six times as much as advertising by now,” Mr. Kelly said in a phone call, describing the revenue at Cool Tools. “Part of what is attractive about our site and Brian’s is that it is a distillation, a trusted friend. You don’t find out everything, just what you need to know.”

Mr. Lam’s revenue is low, about $50,000 a month, but it’s doubling every quarter, enough to pay his freelancers, invest in the site and keep him in surfboards. And now he actually has time to ride them. In that sense, Mr. Lam is living out that initial dream of the Web: working from home, working with friends, making something that saves others time and money.

“I don’t want to get too hippie about it, but surf is bad when it comes in lots of messy waves,” he said. “Our traffic is spaced out in manageable ways that we will grow over time. And even if it doesn’t, that’s fine by me.”

E-mail: carr@nytimes.com;

Twitter: @carr2n

This article has been revised to reflect the following correction:

Correction: December 16, 2012

An earlier version of this column misstated the revenue growth for Mr. Lam’s Web site. It is doubling every quarter, not every month.

This article has been revised to reflect the following correction:

Correction: December 17, 2012

An earlier version of this column misstated the length of Mr. Lam’s employment at Gizmodo. It was five years, not six years.

Read More..

N.I.H. to Start Initiatives to Raise Number of Minority Scientists

Few blacks enter biomedical research, and those who do often encounter obstacles in their career paths.

A study published last year found that a black scientist was markedly less likely to obtain research money from the National Institutes of Health than a white one — even when differences of education and stature were taken into account.

The institute has now announced initiatives aimed at helping blacks and other ethnic and racial groups who have been unrepresented among medical researchers, including a pilot program that will test a grant review process in which all identifying information about the applicant is removed.

The initiatives take a step further than addressing the problem identified in the study — the goal is to entice more minorities into the field.

“It needed to go well beyond that,” said Francis S. Collins, director of the N.I.H., “because even if we fixed that, it would still be the case that there would be a very distressingly low number of individuals from underrepresented groups who are part of what we’re trying to do in science.”

The N.I.H. program will provide research opportunities for undergraduate students, financial support for undergraduate and graduate students, and set up a mentoring program to help students and researchers beginning their careers.

When the program ramps up, it will cost about $50 million a year and support about 600 students.

The N.I.H. formed a group of 16 scientists to study the causes of the problem, and the group presented its recommendations in June. At a meeting this month of his advisory committee, Dr. Collins and other officials discussed how to implement the recommendations.

At the meeting, Dr. Reed Tuckson, an executive vice president and the chief of medical affairs for UnitedHealth Group, who was one of the group’s co-chairman, acknowledged the controversies that would inevitably accompany the effort, especially as the N.I.H., like the rest of the federal government, could soon face sizable cuts in its budget.

“This is a heavy, laden issue which no matter which way you turn, someone is going to be irritated,” he said.

Dr. Tuckson, who is black, urged his colleagues to support the efforts. “A lot of people put themselves on the line,” he said.

The study last year, published in the journal Science, reviewed 83,000 grant applications between 2000 and 2006. For every 100 applications submitted by white scientists, 29 were awarded grants. For every 100 applications from black scientists, only 16 were financed.

After statistical adjustments to ensure a more apples-to-apples comparison, the gap narrowed but persisted.

That raised the uncomfortable possibility that the scientists reviewing the applications were discriminating against black scientists, possibly reflecting an unconscious bias. Members of other races and ethnic groups, including Hispanics, do not appear to run into the same difficulties, the study said.

Only about 500 doctoral degrees in a year in biological sciences go to underrepresented minorities, like blacks, Hispanics and Native Americans.

To persuade more students to pursue this as a career, the N.I.H. aims to provide more summer research opportunities for undergraduates.

“That is the single strongest predictor of somebody deciding that that’s the career they want to pursue,” Dr. Collins said of mentored research.”

The program will also provide money to professors so that they can have more time to mentor students or train new mentors.

“They’re talking about a multipronged approach, which I think is a smart approach,” said Dr. Raynard S. Kington, president of Grinnell College in Iowa and a former deputy director of N.I.H. who was a co-author of the Science paper. “If they had just said, ‘We’re going to focus on review,’ I would have been deeply disappointed.”

Donna K. Ginther, an economics professor at the University of Kansas who led the Science study, has taken a closer look at a subset of 2,400 proposals included in the original study. It turns out, she said, that the black applicants published fewer papers and have fewer co-authors than other scientists.

That helps explain the financing gap, but also suggests that the professional networks of black scientists are smaller. “The hypothesis being that professionally, they’re not as integrated,” Dr. Ginther said, “and that’s why I think the mentoring network is such a good idea.”

Read More..

N.I.H. to Start Initiatives to Raise Number of Minority Scientists

Few blacks enter biomedical research, and those who do often encounter obstacles in their career paths.

A study published last year found that a black scientist was markedly less likely to obtain research money from the National Institutes of Health than a white one — even when differences of education and stature were taken into account.

The institute has now announced initiatives aimed at helping blacks and other ethnic and racial groups who have been unrepresented among medical researchers, including a pilot program that will test a grant review process in which all identifying information about the applicant is removed.

The initiatives take a step further than addressing the problem identified in the study — the goal is to entice more minorities into the field.

“It needed to go well beyond that,” said Francis S. Collins, director of the N.I.H., “because even if we fixed that, it would still be the case that there would be a very distressingly low number of individuals from underrepresented groups who are part of what we’re trying to do in science.”

The N.I.H. program will provide research opportunities for undergraduate students, financial support for undergraduate and graduate students, and set up a mentoring program to help students and researchers beginning their careers.

When the program ramps up, it will cost about $50 million a year and support about 600 students.

The N.I.H. formed a group of 16 scientists to study the causes of the problem, and the group presented its recommendations in June. At a meeting this month of his advisory committee, Dr. Collins and other officials discussed how to implement the recommendations.

At the meeting, Dr. Reed Tuckson, an executive vice president and the chief of medical affairs for UnitedHealth Group, who was one of the group’s co-chairman, acknowledged the controversies that would inevitably accompany the effort, especially as the N.I.H., like the rest of the federal government, could soon face sizable cuts in its budget.

“This is a heavy, laden issue which no matter which way you turn, someone is going to be irritated,” he said.

Dr. Tuckson, who is black, urged his colleagues to support the efforts. “A lot of people put themselves on the line,” he said.

The study last year, published in the journal Science, reviewed 83,000 grant applications between 2000 and 2006. For every 100 applications submitted by white scientists, 29 were awarded grants. For every 100 applications from black scientists, only 16 were financed.

After statistical adjustments to ensure a more apples-to-apples comparison, the gap narrowed but persisted.

That raised the uncomfortable possibility that the scientists reviewing the applications were discriminating against black scientists, possibly reflecting an unconscious bias. Members of other races and ethnic groups, including Hispanics, do not appear to run into the same difficulties, the study said.

Only about 500 doctoral degrees in a year in biological sciences go to underrepresented minorities, like blacks, Hispanics and Native Americans.

To persuade more students to pursue this as a career, the N.I.H. aims to provide more summer research opportunities for undergraduates.

“That is the single strongest predictor of somebody deciding that that’s the career they want to pursue,” Dr. Collins said of mentored research.”

The program will also provide money to professors so that they can have more time to mentor students or train new mentors.

“They’re talking about a multipronged approach, which I think is a smart approach,” said Dr. Raynard S. Kington, president of Grinnell College in Iowa and a former deputy director of N.I.H. who was a co-author of the Science paper. “If they had just said, ‘We’re going to focus on review,’ I would have been deeply disappointed.”

Donna K. Ginther, an economics professor at the University of Kansas who led the Science study, has taken a closer look at a subset of 2,400 proposals included in the original study. It turns out, she said, that the black applicants published fewer papers and have fewer co-authors than other scientists.

That helps explain the financing gap, but also suggests that the professional networks of black scientists are smaller. “The hypothesis being that professionally, they’re not as integrated,” Dr. Ginther said, “and that’s why I think the mentoring network is such a good idea.”

Read More..