What’s in The News

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Week in Review

International
President Barack Obama and British Prime Minister David Cameron gave Moscow a month to meet their conditions in Ukraine or face further sanctions. The action was spelled out following a Group of Seven world leader summit that excluded Russian President Vladimir Putin.
The U.S. and Europe also have imposed economic sanctions in response. Cameron said Putin must meet three conditions: Recognize Petro Poroshenko’s election as the new leader in Ukraine, stop arms from crossing the border and cease support for pro-Russian separatist groups concentrated in eastern Ukraine.
“If these things don’t happen, then sectoral sanctions will follow,” Cameron said. “The next month will be vital in judging if President Putin has taken these steps. And that is what I will urge President Putin to do.”
President Obama said the G-7 leaders unanimously agree with the steps Cameron outlined. “If Mr. Putin takes those steps, then it is possible for us to begin to rebuild trust between Russia and its neighbors and Europe,” he said.
“We will have a chance to see what Mr. Putin does over the next two, three, four weeks. And if he remains on the current course, then we’ve already indicated the kinds of actions that we’re prepared to take.”
Mr. Obama acknowledged that so-called sectoral sanctions, which would hit key sectors of Russia’s economy, could have a bigger impact across Europe because of economic ties to Russia. He said he didn’t necessarily expect all European countries to agree on them.
But he said, “It’s important to take individual countries’ sensitivities in mind and make sure that everybody is ponying up…. My hope is that we don’t have to exercise them because Mr. Putin’s made some better decisions.”
The President’s foreign policy adviser Ben Rhodes later said it wasn’t certain that sectoral sanctions would be the punishment of choice.  “We’ll be calibrating those based on what the situation is and ... sectoral sanctions are in the tool kit,” Rhodes said.
President Obama was not meeting with Mr. Putin one-on-one, but said they may have an opportunity to speak when both attend events commemorating the 70th anniversary of the D-Day invasion in Normandy.
“There is a path on which Russia has the capacity to engage directly with President Poroshenko now. He should take it,” Obama said would be his message to Putin.
“If he does not, if he continues a strategy of undermining the sovereignty of Ukraine, then we have no choice but to respond.” President Obama said he thought the fact Putin didn't immediately denounce the outcome of Ukraine's election last month offers the hope he’s moving in a different direction. "But I think we have to see what he does and not what he says," he added.

National
President Barack Obama said he will make “no apologies” for trading five Taliban militants for captured Army Sgt. Bowe Bergdahl.
The exchange for Bergdahl – who was held captive for five years – has been criticized by lawmakers saying the move amounts to negotiating with terrorists and others furious that Congress was not notified.
Speaking in Brussels, Mr. Obama acknowledged that he is “never surprised” by controversies whipped up in Washington. He defended the decision by saying, “We saw an opportunity and we seized it” – noting that prisoner exchanges are not unique to his Administration.
“I make absolutely no apologies for making sure we get back a young man to his parents,” he told the press. “This is somebody’s child.”
The President mentioned the letters he gets from parents asking that he makes sure their children going off to war are taken care of, saying that “as commander in chief of the U.S. Armed Forces, I am responsible for those kids.”
White House officials have said one of the reasons Congress was not consulted is because Bergdahl’s health was deteriorating. U.S. Defense Secretary Chuck Hagel told BBC news that “it was our judgment, based on the information that we had, that his life, his health were in peril.”
Political
On the same day that Google, Facebook and other tech companies urged stricter reforms to the National Security Agency’s surveillance policy, members of the Senate debated whether a bill passed by the House went too far or not far enough in protecting the privacy of Americans.
“The NSA has shown time and time again that it will seize on any wiggle room, and there is plenty of that in this bill,” Sen. Tom Udall, D-N.M., said at a Senate Select Intelligence Committee hearing.
Most of the debate centered on whether language modified by the House defeated one of the major goals announced by President Barack Obama in the spring: to limit the bulk collection of data by the National Security Agency.
The USA Freedom Act passed by the House left the “specific selection terms” – which define exactly what kind of information the NSA can request – too vague and broad for some people and too restrictive for others.
“There is nothing in this bill that would prohibit Verizon or Gmail or the state of Georgia from being used as a specific selection term,” said Harley Geiger, senior counsel with the Center for Democracy and Technology, a privacy advocacy group.
Sen. Ron Wyden, D-Ore., Sen. John Rockefeller, D-W.Va., committee chairman Sen. Dianne Feinstein, D-Calif., and ranking member Sen. Saxby Chambliss, R-Ga., listened intently during a hearing before the Senate (Select) Intelligence Committee.
Geiger and other privacy advocates want to limit those terms to specific people, phones or physical locations. White House officials, however, argued that strict definitions could limit law enforcement if they were searching for something without the benefit of specific names or telephone numbers, like all purchases of a chemical in a certain area.
Some of the speakers had some choice words for former NSA contractor Edward Snowden, who recently told "NBC Nightly News" anchor Brian Williams that he was trained as a spy and worked for the United States at high levels. Snowden kick-started the privacy debate by leaking thousands of classified documents last summer.
Georgia Sen. Saxby Chambliss (Republican) referred to those leaks as “Snowden’s treasonous exposures.’ He said, “My phone data is in there with everybody else. I’m not worried because I’m not talking to terrorists, and hopefully I’m not talking to anybody who is talking to terrorists."
Business
Los Angeles Clippers owner Donald Sterling agreed to sign off on selling the team to former Microsoft CEO Steve Ballmer for a record $2 billion, according to his attorney.
Sterling “has made an agreement with the NBA to resolve all their differences” and as co-owner has given his consent to a deal that was negotiated by his wife, Shelly Sterling, to sell the team, said Atty. Maxwell Blecher.
Donald Sterling sued the NBA in federal court alleging the NBA violated his constitutional rights by relying on information from an “illegal” recording that publicized racist remarks he made to a girlfriend. It also says the league committed a breach of contract by fining Sterling $2.5 million and that it violated antitrust laws by trying to force a sale.
Blecher said the suit will be dismissed. NBA owners must approve the sale. Blecher’s co-counsel, Bobby Samini, says the vote by league owners is expected to take place in mid-July.

Health
Hepatitis C is a virus or infection that causes liver disease. It is spread through the blood of someone infected with hepatitis C and can cause life-long health problems, including some as severe as cirrhosis and liver cancer.
Many people do not experience any symptoms of hepatitis C until long after the disease has progressed. Even without symptoms, liver damage can and often does occur.
Treatment options for hepatitis C (HCV) have rapidly changed in the past several months and will continue to change in coming years as new medications are approved by the Food and Drug Administration (FDA). At the same time, updated treatment guidelines have been published to keep up with the new medications.
Dr. Donald Jensen is a liver specialist at the University of Chicago, and co-chair of the panel of experts that recently published the new HCV treatment guidelines.
Dr. Jensen said, “I think hepatitis C has been a concern, really, since it was first discovered back in 1989. I think what’s made it of more interest recently is perhaps that so many people have been infected with hepatitis C, and presumably infected for many years, and that a large group of these infected individuals happen to be baby boomers.
“Those born between 1945 and 1965 represent about 75 percent of all the people in the United States who carry the hepatitis C virus. Somewhere between 3.9 and 5.2 million people in the U.S. are infected with hepatitis.
“So I think it’s become more apparent recently because, in part, therapies have gotten better and in part because the Centers for Disease Control and Prevention (CDC) has estimated that fewer than 50 percent of people with hepatitis C have actually been diagnosed or know that they have the infection.
“Of those, very few have been treated for their infection. Therapies are getting better so this is a great time to find those individuals who have hepatitis C and aren’t aware of it and get them in for treatment.”
Since 1992, the treatment for hepatitis C has involved interferon, which is an injectable medicine that has a lot of side effects and has to be given once a week. At best, it has a success rate of between 50 and 70 percent.
But last December, the FDA – for the first time – approved a medicine called sofosbuvir (Sovaldi), which is a pill medicine that can be given with another oral medicine called Ribavirin, for 12 weeks without interferon.
It has cure rates in excess of 90 percent for one strain of hepatitis C called genotype 2.  Sofor the first time, there is FDA-approved therapy without interferon for at least one strain of hepatitis C. Another strain, genotype 3, also was treated with that same combination Sovaldi plus Ribavirin, although for 24 weeks.
Not quite the same 90 percent cure rate, but very good cure rates around 70 percent. For the first time, there are therapies that are easily tolerated, have very good efficacy and don’t have the side effects of interferon.
For genotype 1, the FDA also approved Sovaldi plus another medicine called someprefir, but the FDA is recommending that those medications still be used with interferon. Although the therapy and success rate have improved, interferon is still part of the treatment. And that’s likely to change within the next year.
What does it mean to be cured of hepatitis C? It means the virus is gone. The data for cure comes from studies over the last 10 or 20 years for hepatitis C. The current terminology is SVR – sustained viral response – and sustained viral response means that if we test a patient’s blood three months or six months after they stop therapy, the virus is no longer detectable in their blood. And that is considered a success.
The biggest challenge right now is the cost.  Twelve weeks of Sovaldi costs $84,000, about $1,000 a pill. And a lot of questions have been raised in the press about the cost of these medications such as: Will insurers pay for this? Will Medicare pay for it? Will public aid pay for this?
That said, there is less monitoring, fewer side effects and the treatment is of shorter duration. So although previous therapy cost less than that $84,000, when you added up the total cost of the older therapies, in terms of blood transfusions, hospitalizations and office visits, it turned out that the older therapy actually cost about $189,000 for every patient cured.

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