Setback for first malaria vaccine in African trial

LONDON (Reuters) – The world’s first potential malaria vaccine proved only 30 percent effective in African babies in a crucial trial, calling into question whether it can be a useful weapon in the fight against the deadly disease.

The surprisingly poor result for the vaccine, which GlaxoSmithKline has been developing for three decades, leaves several years of work ahead before a protective malaria shot could be ready for countries that desperately need one.

Malaria, a mosquito-borne parasitic disease, kills hundreds of thousands a year, mainly babies in Africa, and scientists say an effective vaccine is key to hopes to eradicate it.

Philanthropist Bill Gates, who helped fund the GSK vaccine’s development, said further research was now needed to see whether and how it might be used.

“The efficacy came back lower than we had hoped, but developing a vaccine against a parasite is a very hard thing to do,” he said in a statement.

Results from the final-stage trial with 6,537 babies aged six to 12 weeks showed the vaccine provided “modest protection”, reducing episodes of the disease by 30 percent compared to immunisation with a control vaccine, researchers said on Friday.

That efficacy rate a year after vaccination is less than half the 65 percent in an earlier trial in babies which analysed protection rates after six months. It is also a lot less than the 50 percent rate seen in five to 17 month-olds.

Vaccinating babies, rather than toddlers, is the preferred option, since the new vaccine could then be added to other routine infant immunisations. A separate programme for older children would involve a lot of extra costs.

Eleanor Riley, a professor of immunology at the London School of Hygiene and Tropical Medicine said the results showed that GSK’s vaccine, called RTS,S or Mosquirix, is potentially useful, but “not the complete solution”.

“The slightly lower than expected efficacy will … affect the cost-benefit analysis that health providers and funders will have to undertake before deciding whether the vaccine represents the best use of limited financial resources,” she said.

NOT GIVING UP

Despite the setback, Britain’s top drugmaker said it would push ahead with developing RTS,S and GSK Chief Executive Andrew Witty said it could be an important tool in fighting malaria.

“We’ve been at this for 30 years, and we’re certainly not going to give up now,” he told reporters on a conference call.

GSK does not expect to make any profit from the vaccine, which would only be sold in poor countries.

Witty reiterated a promise that if RTS,S is ultimately approved for market, it would be priced at cost of manufacture plus a 5 percent margin, and the margin would be reinvested by GSK in malaria research.

Given the target market, it is governments and international groups that will fund the vaccine’s roll-out, and they now need more positive data before deciding whether it is worth buying.

“We will have to have more information to give us a clearer idea as to how useful this vaccine will be,” said Seth Berkley, CEO of the GAVI Alliance, which funds bulk-buy vaccination programmes for poorer nations.

In particular, Berkley told Reuters he wanted to see longer-term data, including the effect of booster shots, and an analysis of how the vaccine performed in different settings.

Details of the malaria trial, which is Africa’s largest ever clinical trial involving almost 15,500 children in seven countries, were presented at a medical meeting in Cape Town and published online by the New England Journal of Medicine.

Witty said he would have liked to have seen efficacy rates of around 50 percent in infants, but stressed that more data would become available before the trial ends in 2014 which may throw more light on why rates of success are so variable.

“It may open up a more customised approach to how this potential vaccine gets used,” he said.

Malaria is caused by a parasite carried in the saliva of mosquitoes. It is endemic in more than 100 countries worldwide and infected around 216 million people in 2010, killing around 655,000 of them, according to the World Health Organisation.

Control measures such as insecticide-treated bed nets, indoor spraying and anti-malaria drugs have helped cut cases and deaths significantly in recent years, but scientists say it will take an effective vaccine and many more years work to wipe out malaria.

Scientists around the world are working on other potential malaria vaccines but RTS,S is by far the furthest ahead in development.

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Canada Pension Plan looks for big, global deals

TORONTO (Reuters) – The Canada Pension Plan Investment Board, one of the world’s biggest pension funds and global dealmakers, said it was looking for big, complex acquisitions to boost its portfolio and outmaneuver rivals as the world’s economy improves.

CPPIB, whose assets rose to a record C$ 170.1 billion in the third quarter from C$ 165.8 billion three months earlier, said its long-term investment horizon and increasingly skilled team of dealmakers will give it an advantage as improving U.S. and Chinese economies bring competitors back to the playing field.

“I think you’ll expect to see us favoring larger and more complex deals that are global in nature,” Chief Executive Officer Mark Wiseman said in an interview after the fund’s second-quarter results were released.

“What we try to do is exploit the areas where we have comparative advantages, and that tends to be in larger transactions, in transactions where the value creation will play out over a long period of time, and in transactions that are occasionally complex in nature,” he said.

“We’ve now built a team with high capabilities that can transact globally and in complex large-scale opportunities.”

He said the fund, which invests on behalf of 18 million Canadian contributors and beneficiaries, was still trying to diversify geographically out of Canada. He said it is focusing on emerging markets where the pace of growth was higher than the rest of the world.

Wiseman was optimistic about improving prospects for recovery in the United States, despite the fiscal cliff concern, and in China, where data on Friday showed infrastructure investment accelerated and output from the country’s factories ran at its fastest in five months.

“I do think you are seeing signs of longer-term prospects for growth, both in the U.S. — and that will obviously have an impact on Canada as well — but also some of the numbers that came out of China this morning are cautiously encouraging,” Wiseman said.

Toronto-based CPPIB reported a 1.9 percent return on investments for the fiscal second quarter ended Sept 30, as financial markets gained globally. The C$ 4.3 billion increase in net assets after operating expenses resulted from C$ 3.1 billion in investment income and $ 1.3 billion in net Canada Pension Plan contributions.

The massive size and long investment horizon of CPPIB has enabled it to do deals around the world, especially as cash-strapped governments and companies seek partners with deep pockets.

CPPIB shifted to an active investment strategy six years ago, seeking to boost returns on its portfolio by buying real estate, infrastructure and other assets while providing private equity and credit to partners looking for cash.

Wiseman said prices are recovering in some of the fund’s favorite investment areas, including real estate, as investors seek stable returns and the low volatility the asset promises.

“I’m talking about really Class A office buildings and that sort of thing. We’re seeing pricing in those assets increasing, with the arrival of a larger number of investors into the asset class. That doesn’t mean we can’t find value there, but we’re feeling very cautious,” he said.

In recent months, CPPIB has announced acquisitions across a broad swath of asset classes, including deals in motor sports, Australian shopping malls, British heating and air conditioning and Chinese logistics, adding to its massive portfolio of investments in real estate, infrastructure, private equity and global stocks and bonds.

The fund’s five-year annualized investment rate of return edged up to 2.5 percent at the end of the quarter, while the 10-year rate of return rose to 6.7 percent.

CPPIB still has about nine years before benefits paid exceed contributions and it will need investments to help pay pensions.

(Reporting by Andrea Hopkins; Editing by Gerald E. McCormick, Nick Zieminski, Lisa Von Ahn and David Gregorio)

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‘World of Warcraft’ State Senate Candidate Wins Election

Add another demographic to the list of winners on Tuesday night; in addition to Democrats, women, and marijuana advocates, gamers scored a political victory in Maine‘s state senate.

Colleen Lachowitz, the Democratic state senate candidate in Maine whose race drew national attention when the state’s Republican party attacked her for her world of warcraft persona, won election on Tuesday, ousting Republican incumbent Tom H. Martin Jr. by a little over 900 votes, according to the Morning Sentinel.

Lachowitz drew criticism from the Maine state GOP for comments the candidate made online while playing World of Warcraft (Lachowicz is a level 85 orc in the popular multi-player online role-playing game.) Only, it wasn’t Lachowicz herself who made the comments-it was Lachowicz’s warcraft alter-ego, Santiaga.

Santiaga said some not-so-nice things about Republicans, including conservative tax icon and promoter of the “Taxpayer Protection Pledge” Grover Norquist. Santiaga commented that she “may have to go and hunt down Grover Norquist and drown him in my bath tub.”

Republicans launched a series of attacks against Lachowicz, maintaining that their criticism was not based on Lachowicz’s gaming habit, but rather the comments made by her alter-ego while gaming.

“This is not about her playing video games, this is about the comments she made while gaming,” David Sorenson, communications director for the Maine Republican Party, told ABC News, referring to the comments about Norquist, as well as things said about other Republicans. “These are all things that are unbecoming to a state Senator.”

The attacks didn’t sway voters though. Lachowicz, who works as a social worker in Kennebec, Maine, is now a state senator-elect in the Pine Tree state.

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Cancer trials can lack clear information on biopsies

NEW YORK (Reuters Health) – People participating in cancer drug trials aren’t always given the most straightforward explanation of possible risks and benefits from invasive procedures that may be involved, according to a new study.

Biopsies of tumor tissue can help researchers figure out how well a test drug is working – but the invasive, sometimes painful procedures are typically of little benefit to study participants themselves.

The new findings show more than five percent of biopsies in such trials may result in complications, but that informed consent documents spend less time explaining those risks than they do for simple blood draws, which are much less invasive.

“Most of these procedures don’t have any therapeutic value for patients, they are burdensome, they’re painful and they carry risk,” said Jonathan Kimmelman, from the Biomedical Ethics Unit at McGill University in Montreal, Canada.

“Before you do a procedure like that on patients, you really want to have their adequate informed consent,” Kimmelman, who wasn’t involved in the new study, told Reuters Health.

“The only reason (patients) should submit to them is to contribute to science in some way,” and not with the hope the biopsies will help them get better, he said.

For the new study, researchers from the University of Texas MD Anderson Cancer Center in Houston reviewed 57 cancer trials by their institution that involved tumor biopsies for study subjects and were conducted in 2005 through 2010.

In 38 of those trials, a biopsy was mandatory for all participants, often as a way for researchers to tell if the drug in question had worked as intended. In some other cases, biopsies were used as pre-study checks to see if patients had the right type of tumor for a certain targeted drug.

Lead author Dr. Michael Overman and his colleagues found almost all informed consent documents didn’t specifically address the research alternatives to biopsies or the lack of likely benefits for patients themselves. The average document had just 39 words addressing the potential risks from study biopsies, compared to 48 words for blood draws.

In those trials, 576 patients had a total of 745 tumor biopsies – including lung, liver and head and neck biopsies. Thirty-nine of those resulted in complications, such as lung air leaks and bleeding, and six in major complications requiring patients to be hospitalized or to get further surgery, according to findings published Monday in the Journal of Clinical Oncology.

Overman said one of the problems has been that until now, there hasn’t been enough available data for study investigators to give patients a reliable estimate of their chance of a biopsy-related complication.

“The informed consent documents that are used are not always as clear as they could be,” Kimmelman said.

He added that not all cancer studies requiring biopsies are of the highest quality. And some don’t make it into the published scientific literature, where they could potentially help determine if a drug is approved or could guide treatment decisions for future patients.

“I think a lot of patients understandably think that when they’re volunteering for these studies they’re giving tissue for what is cutting-edge science, and sometimes that’s true, but not always,” Kimmelman said.

Both researchers agreed that as more targeted drugs are designed for patients with very specific types of cancer, research biopsies will become increasingly necessary to determine how well those drugs are working on the tumor itself.

“I think giving biopsies is a good thing. I think you learn from it, but you need to do it in an honest fashion,” Overman told Reuters Health.

Especially in early drug studies, the patients involved typically have few established treatment options.

“This is where we should say (to patients), ‘This is an experimental therapy, an experimental biopsy, and you don’t have to do it,’” Overman said.

SOURCE: http://bitly.com/U9NXK1 Journal of Clinical Oncology, online November 5, 2012.

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Ghana building collapse traps dozens, kills 1

ACCRA, Ghana (AP) — A five-story shopping center built earlier this year in a bustling suburb of Ghana‘s capital collapsed Wednesday, killing at least one person and leaving several dozen people trapped in the rubble, authorities and eyewitnesses said.

Rescue crews used cranes to try and remove debris from the top of the building amid fears that machinery sifting through the wreckage could injure trapped survivors. Crowds of bystanders gathered as rescuers sifted through cement and glass.

The fatality at the Melcom Shopping Center at Achimota, a suburb of Accra, was confirmed by Public Affairs Officer of the Ghana Fire Service Billy Anaglate. “We are still working to find out the fate of others who may be trapped under,” he said.

Other officials told The Associated Press that the death toll was likely to rise.

An AP reporter at the scene saw at least one man pulled from the debris, covered in dust and who was then whisked into an ambulance.

A Greater Accra Regional Public Affairs officer, deputy superintendent Freeman Tettey, confirmed that one person died and told the AP that 51 have been rescued and sent to hospitals around the capital.

“I was on my way to the shop when l saw it crumpling down,” Kojo Boadi, an eyewitness, said.

President John Mahama declared the scene a disaster zone and cut short his election campaign in the north of the country to be able to visit the site. The presidential election is scheduled for December.

The five-story store opened in February is part of the Melcom chain owned by Indian immigrant magnate, Bhagwan Khubchandani. His late father arrived in Ghana in 1929 as a 14-year-old to work as a store boy in the-then Gold Coast.

The store sells a variety of cheap, imported household goods and appliances that are popular with working-class Ghanaians.

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China’s leadership challenge in new era: douse “inequality volcano”

YANGCHANG, China (Reuters) – In the mountain village of Yangchang in the backwater province of Guizhou in southwestern China, the roof of the Yang family home is cracked and about to cave in, held upright only by a few rickety tree trunks.

Nearly penniless after quitting their jobs in a coastal city, Yang Hechun and her husband recently returned to the village to care for a sickly 71-year-old grandmother and two young children.

“We can hardly afford to eat, never mind mend our house,” said Yang, over a meal of rice, chilli bean sprouts, peanuts and tofu. “We earn one yuan, then we spend one yuan.”

As China prepares for its once in a decade leadership transition at the 18th Communist Party Congress, which begins on Thursday in Beijing, the outside world sees an inexorably rising economic power: Beijing is now the world’s largest exporter, the second-biggest economy overall, and it controls over $ 3.2 trillion in foreign exchange reserves.

Yet the disconnect between those numbers and the lives of families like the Yangs lies at the core of the most vexing issues the country’s incoming leadership will confront: sustaining economic growth, rooting out corruption, narrowing the wealth gap, and preserving the party’s legitimacy in the face of mounting public grievances over decades of iron-fisted rule.

President Hu Jintao, in a speech at the opening of the party congress on Thursday, is expected to tout the country’s economic advances over the past decade, while acknowledging that China still faces many difficulties.

Reforms, most economists agree, will be vital to avoid stagnation and bigger socio-economic disruptions. What’s unclear is just how aggressively the incoming leadership will push new policies.

Though Yang Hechun acknowledges her family’s life has improved over the past decade, their continuing daily struggles resonate in villages, cities, campuses and factory floors throughout China.

$ 1.25 A DAY

At a roundabout in Bijie, the region of Guizhou where the Yangs live, a towering billboard bedecked with flowers and adorned with an image of Hu Jintao proclaims: “Explore, develop and pioneer … work hard to lift, reform and construct Bijie to a higher level.”

The Yangs’ village was designated an experimental zone for poverty alleviation policies and economic development in 1988, during president Hu Jintao’s stint as party chief of Guizhou.

Development over the past few years has brought a two-lane highway and bridges to the once remote region, along with electricity.

But the Yangs still have no running water, and food, education and medical expenses swiftly erode their meager earnings from harvesting chilli peppers and corn on a tiny farm.

Thirteen percent of China’s 1.3 billion people still live on less than $ 1.25 per day according to the United Nations Development Program and Guizhou has the poorest per capita income of any of the country’s provinces.

Beijing set aside 415 billion yuan ($ 66.5 billion) over the past five years to fund minimum livelihood allowances for China’s most needy, while welfare coverage — including basic health insurance — has broadened to include almost 95 percent of households, as have primary school fee waivers in more areas.

Yet, goodwill earned from those measures has been corroded by deeply held suspicions of corruption. Nationwide, over half a million grassroots officials were punished for graft and other so called “discipline violations” over the last five years.

The Yangs believe the failure to pave broken roads and build water pipes in their village is because of local corruption. Public works projects have been talked about for years but never built, even with state funding and contributions from residents.

WOLF FANGS

Across China, the perception of widespread corruption is intensifying grassroots demands for official accountability —demands that the party all too often ignores.

Shen Zhiyun is a crippled former farmer who lives in the nearby village of Guole. He and other villagers were told by village officials recently that hundreds of hectares of farmland would be flooded to form a reservoir serving a new industrial estate in a nearby town.

Despite the threat to local livelihoods, district cadres never consulted the villagers, and will soon build a dam.

“We oppose it, but we also can’t oppose it. That’s how things are in China,” said Shen. “They eat the people and don’t even spit out the bones … those officials with wolf’s fangs.”

The sense of powerlessness Shen expresses is widespread, and poses, in the minds of some analysts, a broad threat to the party’s cherished stability.

As vast as the income disparity is between the rich and poor — Beijing hasn’t published official inequality statistics for over a decade, but the United Nations estimates the gap has grown steadily wider over the last decade — the maltreatment of ordinary Chinese citizens by officials may be the more dangerous flashpoint.

“The main challenge is not income inequality, it’s power inequality, and it’s much less easy to deal with,” said Martin Whyte, a Harvard University sociologist and author of a book on China and its disparities.

“Keeping this power inequality volcano dormant may be much more difficult than keeping the income inequality volcano under control, since to do so would require not simply new programs and financial resources, but fundamental political reforms.”

RISING EXPECTATIONS

Even in the more prosperous parts of China, the pressures on the government from the bottom up are no less relentless. Two years ago, in the factory town of Xiaolan in the Pearl River Delta — China’s factory for the world — workers at a Honda Lock auto parts manufacturer went on strike, weary of their low-paid, grinding work.

Word of their action — a rare, early instance of a strike that crippled production at a multinational corporation in China — spread rapidly on social media. It inspired other factory workers across the country and forced many firms and local authorities to respond by raising minimum wages and benefits.

At Honda Lock, pay has increased 30 per cent since 2010, including increases in housing and transport subsidies.

Lin Wenwu is one of the workers who benefited from the strike. He makes about $ 560 a month now. A new desktop computer sits in the small one-room flat he and his wife rent, and he zips around Xiaolan on a newly purchased black motorcycle.

Still, Lin’s not satisfied. He is one of China’s army of migrant workers — 150 million strong — who largely remain second class citizens, denied welfare benefits that accrue to local city dwellers through a household registration (or “hukou”) system, an outdated policy from the Mao era originally intended to control rural-urban drift.

The system means Lin’s two children can’t get free schooling in Xiaolan, so he leaves them behind in his home province of Guangxi, where they’re cared for by relatives. He sees them roughly three times a year for several weeks.

“I miss them,” he said. “We hope that after the (party congress) the leaders will do more to improve the livelihoods of people like us.”

LOSING FAITH

Back in Guizhou, huddled around a stove, the Yangs have little faith in their political leaders. The family is wondering how to raise the 40,000 yuan needed to rebuild the roof, now propped up by bricks and sawed-off tree-trunks.

So far, local village officials have rebuffed requests for a construction subsidy of 5,000 yuan normally eligible to most villagers, unless the family first coughs up 1,000 yuan to facilitate the application.

“Several neighbors paid up last year, but they’ve haven’t gotten any money back at all,” said Yang.

“Sometimes I feel the poorest people get nothing, and the richest get everything. We can only rely on ourselves.”

(Additional reporting by David Stanway in Beijing; Editing by Raju Gopalakrishnan)

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A Minute With: Taylor Lautner finding new dawn after “Twilight”

LOS ANGELES (Reuters) – As dusk sets on the “Twilight” saga with the final film, actor Taylor Lautner is looking at a new dawn for the next stage in his career.

Lautner, 20, shot to fame after being cast as werewolf Jacob Black in the “Twilight” films, entangled in a torrid love triangle with Kristen Stewart‘s Bella Swan and Robert Pattinson‘s vampire Edward Cullen. He became a household name and pin-up for his clean-cut good looks and shirtless scenes.

In “Breaking Dawn – Part 2,” out in U.S. theaters on November 16, Lautner’s character finds new love, albeit unusual, and indulges his comedic side as the story comes to an end.

Lautner spoke to Reuters about leaving Jacob and his cast mates behind, and why the final film may leave fans in tears.

Q: What’s different about Jacob in “Breaking Dawn – Part 2″?

A: “He’s always been so stressed and emotional and things aren’t going his way and there was a huge weight lifted off his shoulders in this one, huge. It was nice to play that side of Jacob where he could sit back and relax and have a smile on his face and crack a few funny jokes every now and then.”

Q: Jacob finds his soul mate in Bella and Edward’s daughter Renesmee from the moment she is born. Was it challenging to balance his affection for her without coming across creepy?

A: “It was a challenge, and it is so complicated, but really nobody understands it more than Stephenie Meyer who created it. I was picking her brain all day long about it. She basically told me over and over again, ‘Taylor, stop trying to overthink it, stop trying to take it different places … It’s a life-long bond between two people, that’s it.’ In the movie, (Renesmee) is 10 years old, it’s much more of a protector relationship right now, and of course the relationship will grow but we don’t explore that, but it was important for me to keep it simple.”

Q: What are you going to miss most about your character and the franchise?

A: “These characters have never stopped changing throughout the entire franchise, and that’s what I love about Jacob. Jacob himself has grown up so much and gone through so many hurdles and it was a fantastic character to play. For me, it’ll be tough to say goodbye to spending time with people that I love. We’ve grown so close over the past few years. Our relationships will go on past this but to not have that excuse to spend day after day together while filming or promoting will be different.”

Q: “Twilight” fans are not just interested in your characters, they’re also interested in your personal lives. The past summer has seen a lot of attention on Robert and Kristen’s relationship. How do you handle that level of scrutiny?

A: “It’s unlike anything else because when we do talk about the movies, 90 percent of the time people want to know more about ourselves than the characters and what’s going on. I guess that just comes with a fan base like this, it comes with the job and you try and not let it affect you too much, but I have no complaints … The scrutiny, is it unfortunate? Yeah, but you just got to make your way around it and think about things more.”

Q: Do you feel protective of your cast members?

A: “Yes, I definitely do, we’re so close by this point, I think that it’s hard not to.”

Q: What do you hope “Twilight” fans take away from “Breaking Dawn – Part 2″?

A: “I just hope they’re happy and they’re proud because we really do make these movies for them. They’re the reason we are able to make them, their support is unreal and we’re so proud of this last one. This last one specifically wraps it up so nicely, it’s an amazing movie. During the movie, it’ll keep you on the edge of your seat but by the end, I think more than a few of the fans will be in tears.”

Q: Post-Twilight, where do you want to take your career to, what roles would you like to explore? I hear you have a cameo in the comedy “Grown Ups 2″?

A: “It was great to do (comedy), just hop in and show a different side, do something fun and work with somebody like Adam (Sandler). But now I’m looking forward to doing something different from that. There are a few projects that I’m very excited about that are extremely challenging and dramatic and would be tough.”

(Reporting By Piya Sinha-Roy, editing by Jill Serjeant and Patricia Reaney)

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Obama win clears health law hurdle, challenges remain

WASHINGTON (Reuters) – President Barack Obama‘s re-election eliminates the possibility of a wholesale repeal of his signature healthcare reform law, but leaves questions about how many of the changes will be implemented as the national focus shifts to tackling the U.S. debt and deficit.

The 2010 Patient Protection and Affordable Care Act, the biggest overhaul of the $ 2.8 trillion U.S. healthcare system since the 1960s, aims to extend health coverage to more than 30 million uninsured Americans beginning in January 2014.

Republican challenger Mitt Romney had vowed to repeal the law if elected, calling it a costly government expansion despite the fact that the reforms are based on healthcare legislation he signed as governor of Massachusetts.

“There’s sort of an immediate acceptance that this law will stay in place in some meaningful way,” said Chris Jennings, a top healthcare adviser to former Democratic President Bill Clinton. “It’s sort of like a big barrier has been removed.”

Shares in hospitals and insurers that cater to Medicaid, the government insurance for the poor, rose slightly on Wednesday as markets expected the reform laws to be enacted. But health insurers with large employer-based businesses were off slightly, as the health reform law sets limits on their profits and mandates on coverage.

Obama still faces challenges in Congress. Republicans who retained control of the House of Representatives are expected to press for healthcare reform concessions, including delaying and 7scaling back a planned expansion of Medicaid, during negotiations to cut the federal deficit later this month.

But Julie Barnes, director of healthcare policy at the Bipartisan Policy Center, said Tuesday’s victory should give the president added leverage to set the healthcare segment of any deficit-cutting compromise largely on his own terms.

“President Obama has the opportunity to make bold leadership moves toward a bipartisan compromise on healthcare and the economy,” she said. “He has the standing to demand that each party see the investment all Americans have in reforming our broken healthcare system.”

DID MEDICARE HELP OBAMA?

In a related issue, Obama’s staunch defense of Medicare, the healthcare program for the elderly and disabled, may have helped his re-election, giving him an edge in close states including Ohio, Pennsylvania, Iowa, New Hampshire and Nevada.

Obama and his allies vigorously attacked Romney’s plan to convert the popular program that provides guaranteed benefits to one that gives beneficiaries a fixed payment to help them purchase their own health coverage.

Polls show older Americans oppose the idea by margins of 2-to-1, though it was unclear to what extent that opposition translated into votes.

Major provisions of the Affordable Care Act call for cooperation from individual U.S. states, including an expansion of Medicaid and the introduction of subsidized health insurance exchanges for individuals to buy their own coverage.

Governors and legislatures in as many as a half-dozen Republican-majority states oppose those plans and can refuse to act on them.

Other states may be ill-prepared for implementation but could begin to take action now that repeal is no longer a threat. States have until November 16 to say whether they intend to set up their own exchanges. Most will need to partner with the federal government to have one ready by 2014.

Soon after Obama emerged the winner, reform advocates called on his administration to encourage state support for Medicaid by assuring governors and legislatures that $ 930 billion in federal funds for financing the expansion will be pumped into struggling state budgets.

“This guarantee is essential for governors as they decide whether their programs should cover more low-income adults. It is therefore crucial that upcoming federal budget decisions give governors clear assurances that this funding is stable and won’t be reduced,” said Ron Pollack of Families USA, a Medicaid advocacy group.

The healthcare law that Republicans deride as “Obamacare” has already survived repeated attacks and emerged mostly intact.

The Supreme Court upheld the reforms in a landmark June ruling, but empowered states to opt out of the planned Medicaid expansion without losing federal funding for current programs.

The reform law is still the subject of about two-dozen lawsuits seeking to overturn a requirement that church-affiliated institutions cover birth control for employees.

(Editing by Michele Gershberg, Marilyn Thompson and David Storey)

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Canada firms to capitalize on nuclear trade with India

NEW DELHI (Reuters) – Canadian firms will be able to export uranium and nuclear reactors to India for the first time in almost four decades under an agreement between the two nations, their prime ministers said, but more work is needed to implement the deal.

Once implemented, the agreement will end a ban on nuclear cooperation Canada imposed in 1976 after India secretly exploded its first nuclear bomb in 1974, commonly called the “Smiling Buddha”, using material from a Canadian-built reactor in India.

“Being able to resolve these issues and move forward is, we believe, a really important economic opportunity for an important Canadian industry, part of the energy industry, that should pay dividends in terms of jobs and growth for Canadians down the road,” Canadian Prime Minister Stephen Harper said on Tuesday on a visit to New Delhi.

A negotiator with the Canadian Nuclear Safety Commission (CNSC), speaking on condition of anonymity because of the delicacy of the talks, said that what remained was a careful legal review of the language; translation into French and Hindi; and then a signing.

This is not expected to take very long, he said. The two sides have set up a joint committee to liaise on nuclear issues, but he said it would not be negotiating.

India aims to lift its nuclear capacity to 63,000 MW in the next 20 years by adding nearly 30 reactors. The country currently operates 20 mostly small reactors at six sites with a capacity of 4,780 MW, or 2 percent of its total power capacity, according to the Nuclear Power Corporation of India Limited.

Canada’s ambassador to India, Stewart Beck, said on Monday his country wanted to be able to track all nuclear material, but that India felt it only needed to report to the International Atomic Energy Agency (IAEA).

It was not clear who made concessions in the talks and how effective the safeguards would be to ensure that Canadian material did not get used again for making nuclear weapons.

However, the CNSC official said India would now be required to notify Canada of any transfers to a third country and trade could only go to facilities that are safeguarded by the IAEA.

PROBABLY BEATING AUSTRALIA

Harper said the CNSC had worked to “achieve all of our objectives in terms of non-proliferation”.

Canada is in a race against Australia, its strategic ally but a commercial rival in the uranium business. Australia is also trying to nail down safeguards under which it too could sell uranium to India.

“We are effectively ahead of the Australians,” the CNSC official said, noting however that Russia and Kazakhstan were already supplying into India.

Opening up the Indian market would be a big help to Canada’s Cameco Corp, which is the world’s largest publicly traded uranium producer but which recently cut its long-term output targets due to the Fukushima disaster.

“Anytime we can reduce the roadblocks to selling our product around the world is always helpful,” Cameco chief executive Tim Gitzel told Reuters in Canada. “It opens a new market for us with the appropriate safeguards in place. So this is good news.”

Another potential beneficiary is Canadian engineering firm SNC Lavalin Group Inc, which bought the government’s commercial nuclear division, which designed the Candu reactor that is in use in numerous countries.

“As far as the sales of reactors goes, we would normally now request that Canada be accorded the same treatment as the Russians, the French and the Americans and that a site be designated in India for the implementation of at least a twin- unit Candu nuclear power station,” SNC Lavalin International President Ronald Denom, part of Harper’s delegation in India, told Reuters.

He also said it should open up the market to service the existing reactors in India.

Harper also said Canada welcomed foreign investment, after the country temporarily blocked Malaysian state oil firm Petronas’ C$ 5.17 billion ($ 5.19 billion) bid for gas producer Progress Energy Resources on October 20.

Late on Friday, Canada extended to December 10 its review of a $ 15.1 billion bid made in July by China’s CNOOC Ltd for Canadian energy producer Nexen Inc.

“Those decisions have to be taken looking at the global evolving economy in which we operate,” Harper said.

($ 1 = C$ 0.9965)

(Additional reporting by Julie Gordon in Toronto; Additional writing by Frank Jack Daniel; Editing by Jonathan Thatcher and Michael Roddy)

Canada News Headlines – Yahoo! News

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Amazon’s offers monthly option on Prime, challenging Netflix

SAN FRANCISCO (Reuters) – Amazon.com Inc is testing a new monthly option for its popular Prime video-streaming service as the world’s largest Internet retailer steps up competition with Netflix Inc.

Prime typically costs $ 79 a year in the United States for free two-day shipping, free video streaming and access to Amazon‘s Kindle e-book lending library. The company is now offering the service for $ 7.99 a month on its website, which works out to $ 95.88 a year, but at that rate it can be purchased strictly on a month-to-month basis.

The monthly option is more comparable to Netflix’s streaming video subscription, which also costs $ 7.99 a month but does not come with free shipping and an e-book library. Another streaming rival, Hulu, also charges $ 7.99 a month.

An Amazon spokesman said the monthly Prime option was a test and declined to comment further.

Netflix and Hulu offer greater video selection than Amazon, though Amazon is spending hundreds of millions of dollars buying more content from Hollywood and TV studios.

“As Amazon continues to add movie and TV content to Prime, we see it likely adding more competitive pressure to the legacy online video services,” Colin Sebastian, an analyst at R.W. Baird, wrote in a note to investors on Tuesday.

Netflix shares fell 2.5 percent to $ 76.27 in afternoon trading on Tuesday. Amazon shares climbed 1.1 percent to $ 237.01.

Amazon’s new monthly Prime option coincides with the holiday shopping season, giving shoppers a way to use the two-day shipping service for gifts without the annual obligation, Sebastian noted.

“While one risk for Amazon is that consumers use Prime for just one month to take advantage of free shipping on large purchases, the test could also reveal that a ready market for alternative pricing and serve as a new customer acquisition tool,” the analyst wrote.

(Reporting By Alistair Barr; Editing by Leslie Adler)

Gadgets News Headlines – Yahoo! News

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