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Jackson, Claro’s bait-and-switch scam

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THEM
“Hay que gritar. Es un robo.” Carlos Slim’s boys threatened to have me arrested for shouting at them, when for the third time in a little more than a year they defrauded me. I paid my $16 and change for a month’s worth of wireless connection and I got five days. THEY programmed for a cell phone instead of a wireless modem when THEY took the chip out of said modem, punched in the code on a cell phone, then put the chip back in.

Claro.com’s bait-and-switch scam

by Eric Jackson

For me, it was the third time in a little more than a year. I got my wireless Internet modem chip recharged at the Claro.com service center in the Albrook Mall, told them that I wanted to put another month on the stick, went to the cashier and paid for a $15 card — more, with tax — the lady punched in the code for me and told me that I was set for a month, and after about five days the computer informed me that the chip had run out.

They had loaded my wireless modem chip as if it were for cell phone service. A rookie error by a company at a locale where you deal with a new person every time, a business that can’t keep employees? Occam’s Razor suggests just that.

So the next time I was in Albrook and had a bit of time to kill, I went to complain and to demand that I get the Internet time for which I had paid. I knew from past experiences that they would tell me that it had never happened before and that the problem was me, in some fashion or another, and I would not have the slightly more than $10 worth of service that was stolen from me restored.

And indeed, I was accused of stupidly buying the wrong plan, the distinctions of which they do not advertise or explain to the customers. I fact what was represented to me was 30 days of Internet connection, I paid for it, and they gave me much less. It’s a classic bait-ans switch consumer fraud.

So, is THIS how Carlos Slim became one of the world’s richest men? Two facts suggest otherwise to me:

1. If a thousand other people get rooked the way I was over the course of a year, that’s less than $40,000 in extra income for the company, with consumer ill will on the other side of the balance sheet. Multiply it how many times, and perhaps all across Slim’s telecom empire, and it still looks like peanuts to a billionaire.

2. They pull this stuff on me at Albrook, but so far never when I recharge the stick in Penonome or Coronado.

So, as much as I can cite a litany of things about Mr. Slim’s business history, I think that it’s not directly from or for him. Perhaps the people at the Albrook venue are running a scam for their profit at his expense. It’s a corporate culture thing, maybe from Slim down but perhaps residing in the sorts of people that his company has hired in Panama.

But the Arab-Mexican billionaire’s company does show a customer unfriendly face, more than the monopolistic practices that most of the clients never consider. It’s unseemly, and at odds with cultural realities that it has become popular among many Americans to deny. There are these stereotypes.

Once upon a time I got to know them as a lawyer working with clientele in Dearborn, Michigan’s Arab community and getting to know the varieties of fraud that flourished among the Palestinians and Lebanese immigrants who were uprooted in terror by the Lebanese civil war. But you know what? The older Arab community, and those who had come from less conflicted places, were rarely like that. Generosity is a big part of Arab culture. Keepíng the customers satisfied is a big part of Arab business culture. The mafia stuff that ended up in lawyers’ offices was one of the many effects of war that those who glorify it will never mention or admit. It’s the abnormality of those who have been acclimated to Hell.

And Mexicans? The conquest of the northern third of their country by the Americans has left many scars and created many realities through good and bad times ever since, with the Mexican bandit stereotypes in US culture a distortion and amplification of something that has actually existed. Now Mexico is a patchwork of war zones, with a mobbed up government whose main political parties are in the pay of the rival warlords, who are mainly in the business of moving drugs into the United States. Such is the made-in-Washington “War on Drugs,” and it reaches into almost every nook and cranny of Mexican society, such that Donald Trump could win a US election by calling Mexicans a collection of thugs. But Laura Nader, the consumer activist Ralph’s sociologist sister, once did a comparative study on how Mexicans and Americans deal with consumer complaints. The standardized “we have never seen this happen before — the problem is YOU” is a banal indictment of US corporate culture, but she didn’t find much of that in Mexico. For all of the horror stories that Americans tell about their experiences in Mexican border towns, she found a far more civilized norm in the ways that consumer complaints are resolved in most of Mexico.

Yeah, well, that was then, but now we have this globalized kleptocracy. Even worse than the people at the top are the wannabes who want to get to the top. Then there are those who have no hope of getting to the top but emulate what they think that rapacious billionaires are like because they think it’s cool. Whatever moral instruction that they may have had to the contrary did not stick. Such is the cultural wreckage of globalization on corporate terms.

In any case, the runaround that I get at the Claro center at Albrook is by traditional lights un-Arab and un-Mexican. It’s just a rootless hustle and nothing new. Read the Old Testament and the Code of Hammurabi and they get into those sorts of business mores. Get into the Gospels and it’s about a Jewish resistance to the corruption of a religious establishment that aligned itself with Roman occupation authorities, a moral revival against among other things the triumph of acquisitiveness over ethics. Martin Luther, Rabbi Hillel and Mahatma Gandhi were all moral revivalists in their own traditions who lodged similar protests. If you want to listen to the world’s real Muslim radicals these days they are not looking to recruit young men with no prospects to explode themselves among crowds leaving concerts but denouncing the decadence, false piety, loose morals and sticky fingers of the oil sheikhs who just got billions of dollars worth of arms from Donald Trump to wage their perverse Sunni jihad.

My complaint? Five-sixths of a $15 Internet service charge, times three? There are many injustices in this world that are far worse. But I am not the only one.

Meanwhile, we hear from the Varela administration that they intend to concentrate the cellular telecommunications scene here in Panama — which is already divided up in ways that create local monopolies, which do get abused. In the Central American banana republics, with their rapacious elites bolstered by death squad regimes, nobody has as many cell phone companies as Panama does, we are told. Therefore, to get in with the business and ethical standards of Honduras, Panama should drop its prohibition on one cell phone concessionaire acquiring another.

The almost stillborn competitor is Digicell. The decrepit and hated old original from the first days of Panama’s cell phone services is Cable & Wireless, the remnant of the British Empire’s imperial phone company, which has been nailed for securities fraud in the USA and kicked out of by governments in, or rendered marginal by consumers in, many a former British possession. If there is to be consolidation, it will be Claro or Spain’s Telefonica buying up weaker competitors.

The public hearings for such a move would create a good opportunity for all of us who have been cheated in one way or another by Claro.com — or any of its wireless telecom corporate colleagues — to denounce consumer fraud. It’s just smart economics and politics to object to anything that would strengthen the hands of abusive companies.

Do I want to take my complaint to one of the government institutions that’s supposed to police consumer fraud? I will look into it, but these institutions tend to be captured by the companies that they are supposed to regulate.

An even bigger problem is the limitation of Panamanian jurisprudence. The Civil Code doesn’t have anything like equity in its meaning within Common Law systems. A judge or administrative referee here can’t see a systematic injustice involving many petty offenses and fashion a remedy to be handed down in an injuction. She or he has to look at the applicable statutes and limit any decision to those narrow provision. (Surprise, surprise — when they wrote the laws about telecommunications, lobbyists for the company were on the scene and consumer advocates were not.)

An equitable solution to my complaint would involve the restoration of some 75 days of Internet connection for which I paid and which I didn’t get, but also a cease and desist order to Claro against such practices and requiring some prominent, fair and simple notices on the premises of every Claro store about the various plans that are offered, with receipts clearly spelling out what was bought and who updated the chip. But the sort of solution that typically comes out of Panama’s regulatory system and courts is a combination of restitution and fines in an amount far less than what the company brought in through its improper practice, and that ordered years later.

Shouting at petty managers who won’t look you in they eye as they lie to you because they know that you know that they are lying to you? That serves to let everyone on the premises know that everything is not right. But what Panama really needs is a consumer law revolution that makes hustlers practice their juega vivo other than in the telecommunications industry.

UPDATE: After this insulting hustle being run on me at the Claro office in the Albrook Mall, I did not pay them any money. I did go to one of their offices in Penonome the next morning, and the lady there explained to me that there had been some recent changes in plans, which were contained in a little code guide list for those who ask for it so as to load their chips from a Claro.com phone.

For $14.99 plus tax I get an “unlimited” package of 30 days worth of service with a 1.5 GB capacity. Gone is the $44 and change option of 30 days at a faster speed, which is relevant in some parts of Panama but I found to be not so different given the limited capacities of their system in my part of the boondocks. HOWEVER, they now have $14.99 smartphone plan, which is “limited” and they advertise as for 30 days of connection at 2 GB. However, with that “limited” plan you get 200 minutes that might be used at any time within a month. Of no use to me to run The Panama News, but perhaps if I want a higher speed for some video conference that might be a reasonable thing to put onto the chip of my other dongle stick.

In any case, what was run on me, and I suspect many other people, was the classic bait-and-switch consumer fraud.

 

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Paddywagon cannibalism behind the Metro station

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graveyard
Where police vehicles go to die, they tend to be stripped for parts to keep the large fleet of law enforcement vehicles on the road.

Where cop cars go when they die

photos by Eric Jackson

The police vehicle maintenance center is behind the Albrook Metro station. It does not exude the aura of spit and polish of a police department that wants to be an army — it looks more like a haphazard junkyard. In fact, that’s part of what it is. When police vehicles die, the useful parts tend to be reused to keep the law enforcement fleet running.

It’s an interesting habitat if you are a cat, but in recent years the National Police have had a cooperative relationship with Spay Panama to keep the feline population of this place under control. There isn’t much need for junk yard dogs, as this is, after all, a police facility that your garden variety maleante will hesitated to loot.

 

cop cannibalism 2
The sign forbids people to walk through this gate, but this reporter has seen people doing that.

 

cop cannibalism 3
With the same “canvas” as the diablos rojos, police culture is austere.

 

cop cannibalism 4
In case of spontaneous revolution, they try to keep a good backup supply of riot squad vehicles ready.

 

cop cannibalism 5
If there is a great fire or big natural disaster, these caps removed from pickup trucks converted into paddywagons might be quickly pressed into service as parts of temporary shelters from the elements.

 

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Gandásegui, The transition to post-neoliberalism

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duh now

The transition to post-neoliberalism

by Marco A. Gandásegui, hijo

In the case of Panama the dominant capitalist sectors are unaware that the neoliberal ideology nad policies have now been superseded. To cite some international proofs: Trump, Brexit and global stagnation. The so-called “Washington Consensus” has sunk into a swamp from which nothing reappears. The speculators and those who strip the country of its wealth believe that neoliberalism continues to be a good ideological disguise for their abuses. It’s a problem not only for the governing class — in power since the 1989 US invasion — but also affects all other sectors of the country.

What is meant by neoliberalism? Let’s start with the simplest, what is liberalism? It is “free trade.” It is the ideology that promoted the free circulation of goods in a country, eliminating the collection of taxes by the landowners and also by the church. This capitalist conquest was achieved in many cases in the nineteenth century and in others more recently. Neoliberalism takes an additional step. In the struggle to free the flow of goods, there were regulations, public companies and labor conquests. Equally, “free trade” became a global goal, crossing national boundaries. Neoliberalism ends all the residue of that through deregulation, flexibilization of labor and privatization of public enterprises. It also promotes free trade agreements.

As a policy, neoliberalism went bankrupt with the so-called “Great Recession” of 2008, which provoked a crisis in capitalist accumulation that is still being felt, especially in the USA and Europe. The capitalist system was rescued by the transfer of public funds — of working people’s money — of trillions of dollars to the banking and major industry monopolies. The transition to post-neoliberalism stalled in the middle of the road. The capitalist economy centered in the most developed countries can’t stay stalled forever. On the one hand, the most “conservative” sectors insist on maintaining their ideological positions in defense of neoliberalism. They don’t take into account that it no longer exists. On the other hand, the “progressive” forces propose urgent measures to undermine neoliberal policies. But neither one side nor the other are capable of presenting alternatives.

The reactionary element in Panama insists that it’s necessry to reduce the size of government, to reduce workers’ pay and to give business more subsidies. They have been saying the same thing for 25 years and the country’s political and economic structure continues to decline. It’s no solution.

The Panamanian governments from when President Endara took office in 1989 up to the present day have managed to privatize almost all public services. The most damaging privatization was Law 51 of 2005, which privatized the Seguro Social retirement funds. Those who were incorporeated into a so-called “mixed” sector of private pensions recognized the fraud when they didn’t receive their “individual” pensions in the following decade.

Now the government of President Varela is making an effort to privatize the drinking water service in this country. The international monopolies are awaiting the announcement of an IDAAN offer that would give the more favorable concession terms. They are interested, above all, in buying the water sources in order to monopolize access to the precious liquid. Theypre probably working for an agreement similar to the one for the privatized production, transmission and distribution of electricity that has been in place for two decades. With water they’d create three types of businesses. The first would be the concessionaire of the water sources, such as the rivers, the second would be the water purification plants and the third would be the distribution of water to homes and industries.

Privatization, deregulation and flexibilization do not constitute solutions. They are actually the problem. What is the alternative? Panama has an advantage over other countries. Since 2000 the revenues generated by its privileged position — the canal, the ports and so on — allow for investment in the development of all national resources, especially human resources. Between the begining of this century and 2016 the gross domestic product has multiplied tenfold. In 2016 it reached $57 billion.

If the small elite that is connected to political power — and its enormous benefits — is unable to devise a strategy for the transition to post-neoliberalism, other sectors need to do so quickly and energetically.

 

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Editorials, Someone had to die; and Obliterating unspecified ideologies

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poor kitty
Animal abuse for kicks. WhatsApp photo by one of the perps.

Someone had to die

Someone had to die for the Ministry of Education’s foolish ban on high schools expelling students for serious misconduct to end. Sadly, the one who died was an innocent little kitten, thrown from the elevated Metro Station in San Miguelito to its death. Those who did it thought it was merry fun, took videos and were caught on video by the Metro. Why they were not immediately arrested is a safety and law enforcement concern of relevance to all Metro riders.

In the hue and cry there was the inevitable observation that the perpetrators should see a psychiatrist. Indeed they should, but not as a substitute for penalties under Panama’s animal cruelty laws, for which a lot of people have gone out of their ways to get passed and enforced. The proper procedure would be for them to been seen by a doctor at the juvie home, both as a matter of developing their case files for the courts and to determine if they need some sort of therapy, and which would be best if they do. Psychiatry as a rich people’s dodge around responsibility for antisocial actions demeans both that profession and society, but studies suggest that certain sorts of animal cruelty by kids are often connected with specific sorts of violent crimes when they become adults. An understanding and response to those sorts of conditions should not be confused with an excuse for crimes.

There are also the predictable calls for draconian punishment. Perhaps if the perpetrators were drawn and quartered in a public ceremony public safety would be enhanced by police and mental health workers taking careful note of just who attends such an atrocity. But severity of punishment is a sop to the streak of sadism in society that doesn’t serve a useful public safety purpose. Reasonable certainty of punishment, though, is an essential ingredient of the rule of law.

Let’s hope that what happened in the public school that these students attended is neither a one-time-only outlier event, nor restricted to just the public schools. For certain serious matters schools should have the right to expel students. This power, however, can be abused and must be regulated to avoid that. Even a crazy kid or one confined in a juvenile detention facility for a crime committed has a right to an education. Racism or other social prejudices must by law not be allowed to intrude into matters of school discipline.

Bottom line? Panama needs serious education reform and one part of that is an end to the “anything goes” attitude that the Ministry of Education has exuded over the years. If that has ended now, then this little orange kitten died as a martyr for Panama’s development in the fields of education and common decency.


Saudi Sunni jihad
The aftermath of the Saudi bombing of a residential neighborhood in Yemen’s capital. Wikimedia image.

Trump and the Sunni jihad

In the Middle East Donald Trump promised more than $400 million to further the Saudi Arabia’s Sunni jihad against the Shiites by, among other things, blowing Yemeni kids to bits with bombs dropped from the air. Then, when the US president was in the Holy Land, a British jihadi of Libyan extraction took his Sunni jihad to the exits of an arena in Manchester, England.

So Trump, in an appearance with Mahmoud Abbas, vowed that “This wicked ideology must be obliterated, and I mean completely obliterated.”

Obliterating anyone in the Middle East, and any and all Muslims, is an idea that plays well with Trump’s white supremacist base. ‘But wait,’ Trump supporters might argue. ‘He didn’t mean….’ And the president probably didn’t himself know what he means, leaving it to everyone else to put his or her own spin on it. But meanwhile, more war to “obliterate” an unnamed ideolgy, an inanimate concept that can’t be shot dead on a battlefield like a soldier or unconditionally surrender like a country. Just like the War on Terror, just like the War on Drugs. Cruel and expensive wars with no exit strategy because victory can’t be defined and even were that done it would not be possible in any meaningful way.

Yet more irresponsible words, and irresponsible actions, from Mr. Trump.

 

Bear in mind…

 

Totalitarianism teaches to subjugate; democracy illustrates to convince.
Ricardo J. Alfaro

 

Marriage probably originated as a straightforward food-for-sex deal among foraging primates. Compatibility was not a big issue, nor, of course, was there any tension over who would control the remote.
Barbara Ehrenreich

 

If there is no sacred respect for the country, for its laws and for its authorities, society is a confusion, an abyss, a singular conflict of man against man, of band against band.
Simón Bolívar

 

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Bernal, Yet more Odebrecht impunity

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bad guys' work
Expensive and often ill-advised public works projects, undertaken with overcharges and kickbacks built in, for the purpose making a few corrupt individuals rich. Graphic by Odebrecht.

Yet more impunity accords

by Miguel Antonio Bernal

There is still an absolute lack of determination on the part of the Panamanian authorities — mainly the Executive, the Public Prosecutor’s Office and the Comptroller’s Office — to proceed in the case of Odebrecht, that Brazilian mega-criminal enterprise.

This they maintain, mistakenly, with a growing lack of will and interest in the citizens’ inalienable right to know the truth, the whole truth and nothing but the truth about this scandal, which has done irreparable moral damage to our people, our national identity and our international standing.

It’s a notorious public fact that Odebrecht continues to operate with impunity in Panama, with the blessing and sponsorship of national provincial and municipal officials. Their overcharges and bribes have gone uninterrupted for the past 10 years, while the authorities, especially the Public Ministry, attempts to manipulate the citizenry with fallacies, falsehoods and deceptions.

They continue with this stuff about a “formal oral agreement” between the prosecutor’s office and the criminal conglomerate Odebrecht, in which they “agreed to agree” rather than to duly investigate and impose neither fines nor sanctions for the bribes and other crimes perpetrated. The Attorney General and the Comptroller General, with the prosecutors and auditors under them, happily trample on the Constitution, the anti-corruption treaties and our national dignity.

As I have been saying, bribe givers and bribe takers tread with impunity through our national territory, continue in the public and private positions, while to date Panamanian officials have undertaken all kinds of juggling acts and political and diplomatic maneuvers in Brazil and Washington with that aim of concealing what has been done in Panama.

And again I quote Professor Pizzurno: “Within this scenario those who denounce acts of corruption and demand justice are turned ipso facto into enemies of the state, political opportunists and despicable anti-patriots who end up socially discredited and expelled. This in a way so that, in order to avoid worse things and be turned into social pariahs, they opt for silence.”

 

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Dr. Margaret Chan’s last address to a World Health Assembly

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Margaret Chan
“Scientific evidence is the bedrock of policy. Protect it. No one knows whether evidence will retain its persuasive power in what many now describe as a post-truth world.” Photo by the WHO.

Address to the 70th World Health Assembly

by Dr. Margaret Chan

Madame President, Excellencies, honorable ministers, ambassadors, distinguished delegates, friends and colleagues, ladies and gentlemen,

I thank Member States for the trust shown when you appointed me as your Director-General more than ten years ago. I promised to work tirelessly, and have done so, but never got tired of the job, in the best and worst of times.

When I took office, I also promised that I would hold myself accountable for the Organization’s performance. This month, I have issued a report tracking how public health evolved during the ten years of my administration.

The report sets out the facts and assesses the trends, but makes no effort to promote my administration. The report goes some way towards dispelling the frequent criticism that WHO has lost its relevance. The facts tell a different story.

The report covers setbacks as well as successes and some landmark events. Above all, it is a tribute to the power of partnerships and the capacity of public health to take solutions found for one problem and apply them to others.

As just one example, it took nearly a decade to get the prices for antiretroviral treatments for HIV down. In contrast, thanks to teamwork and collaboration, prices for the new drugs that cure hepatitis C plummeted within two years.

This is the culture of evidence-based learning that improves efficiency, gives health efforts their remarkable resilience, and keeps us irrepressibly optimistic.

We falter sometimes, but we never give up.

Excellencies, ladies, and gentlemen,

As I speak to you, the political and economic outlook is much less optimistic than it was when I took office in 2007.

That was before the 2008 financial crisis changed the economic outlook from prosperity to austerity almost overnight, with effects on economies and health budgets that are still being felt.

That was before acts of international terrorism and violent extremism became commonplace, before the word “mega-disaster” entered the humanitarian vocabulary, before seemingly endless armed conflicts caused the largest population displacements and flights of refugees seen since the end of World War II.

That was before the alarming frequency of attacks on health facilities and aid convoys made a mockery of international humanitarian law. We condemn all these attacks on health care facilities and workers. According to reports consolidated by WHO, more than 300 attacks on health care facilities occurred in 2016 in 20 countries, with the majority documented in the Syrian Arab Republic.

We are also seeing how a world full of threats can toss out deadly combinations, like the dual threats from drought and armed conflict that have brought famine to parts of Africa and the Middle East on a scale never experienced since the United Nations was founded in 1945.

The world was fortunate that the 2009 influenza pandemic was so mild. The world is fortunate that the new viruses that emerged to cause MERS in 2012 and human cases of H7N9 avian influenza in 2013 are not yet spreading easily from person to person. But they have the potential to do so and we dare not let down our guard.

The world was less fortunate with Zika, an outbreak that WHO continues to monitor closely. The world was not at all fortunate with the 2014 Ebola outbreak that utterly devastated the populations of Guinea, Liberia, and Sierra Leone. This was West Africa’s first experience with Ebola, and the outbreak took everyone, including WHO, by surprise.

WHO was too slow to recognize that the virus, during its first appearance in West Africa, would behave very differently than during past outbreaks in central Africa, where the virus was rare but familiar and containment measures were well-rehearsed.

But WHO made quick course corrections, brought the three outbreaks under control, and gave the world its first Ebola vaccine that confers substantial protection. This happened on my watch, and I am personally accountable.

I saw it as my duty, as your Director-General, to do everything possible to ensure that a tragedy on this scale will not happen again. History will judge whether the new emergencies program has given the world a stronger level of protection.

Ultimately, health systems with International Health Regulations core capacities must be strengthened in your countries to detect unexplained deaths much earlier. This is critical for improving global health security to protect our common vulnerability.

Last week, the Democratic Republic of Congo confirmed a new Ebola outbreak near the border with the Central African Republic. This is the country’s eighth Ebola outbreak. In its last outbreak, which coincided with the West Africa outbreak, DRC interrupted transmission within six weeks. Despite enormous logistical challenges, discussions engaging DRC continue about possible use of the new vaccine to augment the response.

The Ebola outbreak in West Africa had a number of spillover effects which can be judged more immediately. During the outbreak, WHO acquired extensive experience in facilitating R&D for new medical products, but poor coordination lost too much time. To speed things up, WHO and its partners finalized an R&D blueprint in 2016.

By setting up collaborative models, standardized protocols for clinical trials, and pathways for accelerated regulatory approval in advance, the blueprint cut the time needed to develop and manufacture candidate products from years to months.

The expert consultations that designed the blueprint led to the establishment of the Coalition for Epidemic Preparedness Innovations, announced in January 2017 with initial funding of nearly $500 million.

The Coalition is building a new system to develop affordable vaccines for priority pathogens, identified by WHO, as a head-start for responding to the next inevitable outbreak.

The world is better prepared but not nearly well enough.

Excellencies, ladies, and gentlemen,

The relevance of WHO’s work is demonstrated in many ways, some more visible than others.

The chronology of the HIV, tuberculosis, and malaria epidemics shows direct links between WHO changes in technical strategies and turning points in the disease situation.

WHO also made scientific breakthroughs more democratic by translating findings into a public health approach that works everywhere, even in extremely resource-constrained settings.

Relevance is readily apparent when WHO endorses a new medical product, and partners find ways to fund it, or issues a position paper on a new vaccine.

Many national immunization programs will not introduce a new vaccine until WHO has issued its formal seal of approval. Such approval triggers actions by Gavi, the Vaccine Alliance, to scale up access dramatically.

The prequalification program is now firmly established as a mechanism for ensuring that the quality, safety, and efficacy of low-cost generic products match those of originator products. For example, by the end of 2016, WHO had prequalified more than 250 finished pharmaceutical products for treating HIV-related conditions. This stretches the impact of funding agencies, like the Global Fund, in significant ways.

The relevance of WHO was most dramatically demonstrated during last month’s global partners meeting on the neglected tropical diseases.

Participants assessed, and celebrated, ten years of record-breaking progress that promises to eliminate many of these ancient diseases in the very near future. This is one of the most effective global partnerships, also with industry, in the modern history of public health.

The fact that, in 2015, nearly one billion people received free treatments that protect them from diseases that blind, maim, deform, and debilitate has little impact on the world’s geopolitical situation.

The people being protected are among the poorest in the world. But judging from the massive amount of media coverage, which included entry into the Guinness World Records for the most medication donated, this was a success story that the world was hungry to hear.

Less visible relevance comes from the way WHO has built a safety net that encircles the globe in the form of thousands of laboratories specialized in the surveillance and diagnosis of priority pathogens, hundreds of collaborating centres, and a vast network of scientific boards and strategic advisory groups. I thank the scientific institutions in your countries for contributing to the work of WHO.

No other health agency has this degree of technical expertise ready-to-hand.

Excellencies,

The resolutions you adopt also shape the health situation, especially by raising the profile of neglected problems. For example, the comprehensive mental health action plan, adopted in 2013, definitively took mental health out of the shadows and into the spotlight.

Likewise, beginning in 2010, viral hepatitis appeared as a stand-alone agenda item at three sessions of the World Health Assembly, contributing greatly to the international priority now given to this disease.

But the strongest call for action comes from high-level political commitment. This happened in 2011, when the United Nations General Assembly adopted a political declaration on noncommunicable diseases and again in 2016, when a political declaration gave full attention to antimicrobial resistance.

Both political declarations responded to a crisis in ways that triggered broad-based urgent action to find solutions.

Excellencies, ladies, and gentlemen,

I regard the 2010 World Health Report, on Health systems financing: the path to universal coverage, as the most influential publication issued during my administration.

It launched what is now a movement towards universal health coverage and inspired the 2012 UN General Assembly resolution that paved the way for inclusion of UHC in the Sustainable Development Goals. Our actions under the 2030 Agenda for Sustainable Development must be guided by the 5 Ps: people, planet, peace, prosperity, and partnership.

The recommendations that I most want to see implemented are those made by the Commission on Ending Childhood Obesity.

Childhood obesity is the most visible, and arguably the most tragic, expression of the forces that are driving the rise of NCDs. It is the warning signal that bad trouble, in the form of more heart disease, cancer, and diabetes, is on its way.

The initiatives we all most want to succeed are those for the eradication of polio and guinea worm disease. For both, the world has never been so close. We must keep up our efforts to make eradication a reality.

The trend that most profoundly reshaped the mind-set of public health was the rise of chronic noncommunicable diseases. This shift in the disease burden called for a move away from the biomedical model of health and its emphasis on curing diseases to a much broader approach based on prevention.

I regard Every Woman Every Child as the most game-changing strategy during my administration.

Its adoption by the UN in 2010 captured financial support in the billions of dollars and launched a number of initiatives aimed at implementing its recommendations. Maternal and child deaths dropped dramatically.

The related WHO Commission on information and accountability for women’s and children’s health added greatly to the culture of measurement and accountability. As set out in this year’s World Health Statistics report, nearly half of all deaths worldwide now have a recorded cause of death. This is huge progress. I thank all countries that have made a special effort on this front.

The most contentious issue was access to medicines, especially when intellectual property and the patent system were perceived as barriers to both affordable prices and the development of new products for diseases of the poor.

The negotiations that led to the establishment of the Pandemic Influenza Preparedness Framework were tense, to say the least, but ultimately successful, as were those that led to the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.

Fortunately, several new initiative and public-private partnerships are contributing to both objectives. One example is the new Global antibiotic research and development partnership, launched last year by WHO and the Drugs for neglected diseases initiative (DNDi).

This is a needs-driven R&D initiative initially focused on the development of new antibiotics for treating sepsis and sexually transmitted infections, most notably gonorrhoea. The partnership aims to promote access and to ensure that prices are affordable.

Earlier this month, WHO announced the launch of a pilot project for prequalifying biosimilar medicines, a step towards making expensive cancer treatments more widely available.

WHO is also working with partners on a model for the fair pricing of pharmaceuticals. The rationale is obvious: universal health coverage depends on affordable medicines. No country on this planet can hope to treat its way out of all the diseases affecting their populations.

Excellencies, ladies, and gentlemen,

I will conclude with some brief advice that you may wish to consider as you continue to shape the future of this Organization.

WHO stands for fairness. Continue to make reductions in inequalities a guiding ethical principle.

What gets measured gets done. Continue to strengthen systems for civil registration and vital statistics and continue to make accountability frameworks an integral part of global health strategies.

Scientific evidence is the bedrock of policy. Protect it. No one knows whether evidence will retain its persuasive power in what many now describe as a post-truth world.

Vaccine refusals are at least one reason why the tremendous potential of vaccines is not yet fully realized. The current measles outbreaks in Europe and North America should never have happened.

Push for innovation. Meeting the ambitious health targets in the Sustainable Development Goals depends on innovation. Innovation that uses country experiences can be frugal and transformative. For example, the R&D partnership that gave Africa its meningitis A vaccine has transformed the lives of millions of people.

Safeguard WHO’s integrity in all stakeholder engagements. The Framework for engagement with non-state actors is a prime instrument for doing so. Many other UN agencies are following WHO’s lead with this framework.

While ministries of health are our principle partners, the multiple determinants of health demand engagement with non-health sectors, communities, and partners, businesses, and civil society organizations.

Listen to civil society. Civil society organizations are society’s conscience. They are best placed to hold governments and businesses, like the tobacco, food, and alcohol industries, accountable. They are the ones who can give the people who suffer the most a face and a voice.

Above all, remember the people. Behind every number is a person who defines our common humanity and deserves our compassion, especially when suffering or premature death can be prevented.

Excellencies, ladies, and gentlemen,

This is the last time I will address the World Health Assembly. I thank Member States for the privilege and honor of serving this Organization. I have done so with humility, but also with great pride.

I thank my Regional Directors for their wise counsel and their support for WHO reform, and my wonderful staff at headquarters, in the regional offices, and in countries, where the impact of our work matters most.

Last but not least, I thank my husband, David, and my family for love and support. David, thank you for listening.

Thank you.

 

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Venezuelan politics get ever uglier and spill over here

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Violence and blame assignments in Caracas (video in Spanish). There appears
to be a general Panamanian consensus against bringing that sort of stuff here.

Vene politics don’t go over well here

by Eric Jackson

Two recent Venezuelan gaffes — an anti-Chavista one, then a pro-government one — have caused discomforts in both official bilateral relations and the status of Venezuela’s diaspora community here.

In the backdrop we might notice Panama’s ever-shrinking “newspaper of record,” La Prensa. It still folds, but its dimensions are down to a size approaching those of a tabloid and it isn’t nearly as thick as it was. This is primordially a function of the revenue crises of print newspapers almost everywhere, but other than the physical downsizing another of La Prensa’s survival strategy appears to be accelerating its decline. In a country with corporate secrecy and business and media cultures to match, the gossip mill can take on added powers, and the bochinche is that La Prensa’s economic problems have shifted control from the mostly Panamanian shareholders — none of whom are allowed more than a one percent stake — to mostly Venezuelan bondholders. Whether it’s that, or just a play to the mostly upscale new Venezuelan immigrant community, La Prensa has taken on the appearance of a sensationalist Caracas opposition rag. Perhaps there are wealthy benefactors in the United States or elsewhere backing up this editorial stance, in which day by day La Prensa’s lead stories tend to come from Caracas. The problem with this, however, is that for a variety of reasons Venezuelans are not particularly popular in Panama.

The Chavistas? They have few supporters among the Venezuelan community here, and only modest Panamanian backing. The warm embrace is mainly a leftist fringe thing. Panama is a commercial crossroads with a strong bias toward capitalism. However, we are also one of the Bolivarian republics, with a traditional current in our political thinking that has called itself Bolivarian since long before the rise of Hugo Chávez. “Bolivarian” as in upholding the Great Liberator’s ideal of Latin American unity and greater insulation against control by powers from outside the region. While only a few Panamanians want the sorts of political and economic policies that the late Fidel Castro brought to Cuba, a lot of people here nevertheless lamented his passing as that of a man to be admired for standing up to tremendous US pressures for all of those decades. Similarly, there are Panamanians who would not embrace his policies who still admired Hugo Chávez for his defiant resistance against foreign manipulations.

Venezuela’s opposition? Those who ask a local Venezuelan are likely to hear their narrative. Those who rely on mainstream corporate news corporations for their information about events in and around Caracas will also have heard that version. Home-grown libertarians and those Panamanians who follow US right-wing political thinkers will tell you about how Venezuela’s crisis proves the failure of socialism. Many of those who recognize the economic squeeze that’s strangling the Chavista regime as a function of an economy entirely dependent on oil in times of low prices are nevertheless annoyed with Venezuela — insolvency in Caracas has left many Panamanian businesses, particularly Colon Free Zone merchants and Copa Airlines, holding the bag. On the other hand the opposition to the Chavistas is led by white oligarchs, some palpably racist, some palpably manipulative of the news. To many Panamanians, it’s bad enough that we have the rabiblancos in positions of economic, political and cultural hegemony who are like that. Another social layer that replicates such attitudes and behaviors coming from Venezuela the Panamanians who resent that aspect of Panama’s elites will not readily accept. A few well publicized incidents have stamped that image on the Venezuelan community here, even if it’s unfair to cast all or most of Panama’s Venes in that light.

Both defending the current government of Venezuela and promoting its opposition are fringe causes here. Given the mainstream news coverage and his own clumsy moves, Nicolás Maduro probably gets the worst of that competition. Far more powerful in Panama than either of those poles, however, is support for the notion that all Venezuelans ought to be expelled from Panama. It appears that support for or opposition to this species of intolerance will be one of the major issues of the 2019 PRD presidential primary.

Most Venezuelans in Panama are of a well educated but ruined middle class. The oligarchs tend to get into Miami or Madrid. Some look to return once things have settled down in their country of origin, some flit back and forth between here and there, but on the whole Venezuelans who have come here in the 21st century look to establish new lives in Panama. They notice public fears and resentments and try to avoid stirring those. However, Panamanians of the right, both the libertarians and the thuggish authoritarian Martinelistas, have been wooing the Venes for years. Hence the La Prensa editorial line. Hence the 2014 election season Martinelli solidarity with Venezuela rally, which was actually more of a matter of Venes for the former president’s proxy ticket event.

On May 10, leftist groups on the University of Panama campus were holding a solidarity with the Venezuelan government event in the Humanities Department faculty lounge. Several dozen students, faculty members and administrators were there. About 20 young Venezuelans came onto the campus to register their objections to the meeting, and when a few tried to enter the room with their anti-Maduro signs fisticuffs ensued. Campus security was called in and the Venes were escorted off of the campus. Afterward Minister of the Presidency Álvaro Alemán blamed the incident on Venezuelan opposition supporters trying to provoke a confrontation and President Juan Carlos Varela ordered an increased police presence at all events in Panama related to Venezuela, from whichever side.

Venezuela’s ambassador to Panama, Jorge Duran Centeno, then weighed in on Twitter. He said that his diplomatic mission had “evaluated the aggressive conduct among social media users” and urged that “they have to be identified.” Vice President and Foreign Minister Isabel De Saint Malo took umbrage at that: “Mr. Ambassador, as a diplomat you have my respect, but it’s good to know that in Panama we respect freedom of expression and the right to dissent.”

Similar flaps have been ongoing in other countries, as Venezuelan emigres of the opposition camp have staged disruptions at events sponsored or attended by Venezuelan diplomatic missions, and the Maduro administration has pushed back with complaints and calls for crackdowns. In Madrid it took the form of an opposition demonstration at the Venezuelan Cultural Diversity Center, prompting Venezuela’s ambassador there to complain of “a campaign to incite hatred on an international level” that’s marked by “a streak of fascism.”

Varela was clear and even-handed about his policy in a statement on Telemetro: “It is unacceptable and we will not permit the conflict to cross these borders.” About the university incident he said that “if they insist on this behavior then Migracion will have to play its role.” In keeping with the opinions of most Latin American leaders, Varela reiterated his plea for Maduro to meet with his opponents and negotiate a settlement to Venezuela’s crisis.

 

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Sanders, Don’t let the FCC auction off the Internet

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From a White House vigil. Photo by by Stephen D. Melkisethian

We must stop Trump’s attempt to auction off
the Internet to the highest corporate bidder

by Bernie Sanders

Today [May 19], the FCC voted to start undoing the progress we’ve made toward making the Internet a space for the open exchange of ideas and information, free of discrimination and corporate control. What the telcom industry and their friends, including FCC Chairman Ajit Pai, want to do is change the fundamental architecture of the internet — to divide the Internet into slow and fast lanes, and to restrict information and content. They want to allow big corporations like Comcast, AT&T, and Verizon to control content online. At this moment when our democratic institutions are in peril, ending net neutrality protections would be devastating. Now is the time to stand together and stop this attempt to auction off the internet to the highest corporate bidder.

 

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¿Wappin? Afrodescendiente

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congo
Baile Congo en Portobelo, desde Río Cuango. Foto por Gustavo Araujo / Almanaque Azul

¿Wappin? Afrodescendiente

Sam & Dave – Soul Man
https://youtu.be/ZVx2i6jGzf8

Yomira John – Mama Congo
https://youtu.be/C48fi2qtKn8

Randy Weston & Pharoah Sanders – Blue Moses
https://youtu.be/KeC68qpIq6s

John Coltrane – Dakar
https://youtu.be/XWYnfiSvjSk

Beachers – Africa Caliente
https://youtu.be/UZynwkFhmgU

Sandra de Sá – Olhos Coloridos
https://youtu.be/OQ3yhCVZqec

Aisha Davis – Trouble
https://youtu.be/gbzK2Ce57OM

David Gilmour & Mica Paris – I Put a Spell On You
https://youtu.be/W6MDjUwXskI

Mighty Sparrow – Obeah Wedding
https://youtu.be/Xh1EvmgT-5A

Koko Taylor – Voodoo Woman
https://youtu.be/SIj-onbFtX4

Todos Tus Muertos – Rasta Vive
https://youtu.be/ZhRNYQwYApc

Peter Tosh – Mystic Man
https://youtu.be/j8od_UP0omg

Stevie Wonder – A Wonder Summer’s Night Concert
https://youtu.be/9dB9ZyXtXlQ

 

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National Preventive Health Census comes to rural Cocle

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San Juan de Dios
While the US Congress was working on how many millions of Americans to deny health care, Panama’s socialized medical sector — we also have private practices here — was reaching out to determine the unmet needs of people 40 and over. Photo by Eric Jackson.

The editor’s sore left wing

by Eric Jackson

About a week before, two men appeared in front of the house in El Bajito, with leaflets announcing a free health fair, with transportation, breakfast and lunch thrown in. So, was it part of President Varela’s back stretch goodies distribution campaign in the province, touted by the Twitter hashtag #CocléProgresa? Perhaps, but officially not. This was part of a national health care census for those over 40, with blood work, measurements of body dimensions and weight, blood pressure checks, oral examinations, medical history, inoculations, health analysis and whatever medicines might be prescribed.

It had been irresponsible years since my last checkup, at which I was found just under the line of being diabetic. Then, the doc ordered me to cut the sugar and lose weight. I did both, but then I gained the weight back, lost it again, picked it up again and… so far about a 30-pound net loss. Not enough, and if the sugar has largely been cut out of the diet, sugary fruits and especially greasy and salty stuff remained a concern. Was I going to have to start shooting insulin? Was I a stroke waiting to happen?

The leaflets said to bring vaccination records — but I didn’t have any. I had not taken any such shots for more than 25 years, since before I moved back here from the USA.

I did not feel faint when they were taking blood. Sometimes I do. Then to the height, weight and waist size measurements, which reminded me that even if my belt is down to the skinniest hole, it’s still an ultra-gordo-sized belt which I didn’t find the first few places I looked. Then, to the inoculation room. The two women interrogated me, not about the little wound on my hand, but how ANYONE could be without shot records. Was I one of these organic hippie anti-vaccine guys? (Organic hippie, I try to be. Anti-vaccine I am not, although I am quite conservative about which medicines I will take. Sensible shots, yes, some pharmaceutical company’s new experiment, not unless absolutely necessary.) So it was the flu, etc., in the right arm, and a tetanus shot said good for 10 years in the left arm. Your editor still has leftist politics, but the tetanus shot left him with an aching left wing — even a couple of days later as this was written.

On to breakfast. Breakfast was ham and cheese on white bread, Panamanian white cheese, sugary fruit cocktail and sugary fruit drink. Ever the balance — many folks would not eat healthier fare, with which they would be unfamiliar.

Then to the blood pressure lady, then to the oral examination lady. The latter session was embarrassing. I need some dental work, including extractions, fillings, dentures and a good cleaning. She recorded all of this and advised me of where to go for inexpensive work in Anton district.

Then another wait, and lunch. The event, in the school in San Juan de Dios, brought in about 150 people from the Anton district neighborhoods of Juan Diaz (mine), Jaguito, El Jobo, La Colorada, La Tortuguilla, El Corotu, La Chapa, El Salado, El Chumical, Las Peñitas and Santa Elena. Among this overwhelmingly cholo crowd I was one of two fulos and there were a couple of afrodescendientes as well. Lunch was rice with guandu, stewed pollo de patio, a bit of plantain and a piece of corn cake, with bottled water.

A bunch of neighborhood dogs, who looked healthy and were wandering freely around the school, got wise. I was one of the first to give my chicken bones to one of the dogs, and people started to give those, and that part of the rice that they did not care to eat, for the doggie feast. Then they started calling numbers again — I was one of the last — and when mine came up I fell in line to see the doctor.

It’s a demographic trend that I have known about for a long time, but it was on striking display. By gender, there was close to parity among the senior physicians. The younger doctors were overwhelmingly female. It’s part of a national trend in which our politics and economy are oppressively male dominated, but women are much better educated on the whole than men and are coming to dominate almost all of the learned professions.

So the middle aged woman who examined my case asked more medical history questions, said that my blood sugar was fine, well below the diabetes threshold. However, cholesterol was now a problem. She prescribed a month’s course of fenofibrate, which was given to me for free in the form of a box of 30 tablets of 250 milligrams each, made by Abbott Laboratories. Looking it up online, the US list price for this medication runs over $100, although the generic versions are much cheaper.

Yep. Isn’t socialized medicine horrible? No wonder they have gated communities for the rich.

The thing is, Panama’s parallel socialized medical systems, the Ministry of Health and the Social Security Fund, drive down the prices of private health care. A lot of the professionals work in the public system but have private practices on the side. Is there gringo pricing for obvious foreigners? That does exist, particularly in the upscale hospitals.

We have problems in both our public and private health care systems. If we don’t have pervasive and often frivolous malpractice litigation and high insurance for that, we also have little accountability for injuries caused by health care mistakes. The Americans get way too exercised about the rule of law, while Panama hardly has such a thing. We are a poor country. Our public institutions, including in the health care sector, are prone to corruption and the inefficiencies of a political patronage system. All that said, however, Panama has a decent and caring system presided over by decent and caring professionals. At some point I will have a health crisis and die — all of us do. Death in the care of the Panamanian health care system is not something about which I lose sleep.

Gracias, doctoras.

 

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