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The Sunday Times International

Wolfowitz's war on Third World fraud
By Celia W. Dugger
World Bank president, Paul D. Wolfowitz, has laid out a broad strategy to help developing countries combat rampant corruption, as well as to halt fraud in antipoverty projects supported by billions of dollars in World Bank money.
In a speech in Jakarta, Indonesia, on Tuesday, Mr. Wolfowitz described for the first time his plans to make fighting corruption a pervasive issue in the bank's operations. The new efforts will range from intensified monitoring of projects in the field to an increased focus on reforming institutions that can hold governments accountable.

Mr. Wolfowitz also seems to be trying to change the culture of the bank. In remarks after the speech, he said he wanted bank managers to understand that they would be rewarded "as much for saying no to a bad loan as for getting a good one out the door."

Mr. Wolfowitz has in recent months made corruption the defining issue of his brief tenure at the bank, the largest financier of antipoverty programmes worldwide. An architect of the Iraq war when he was at the Pentagon, he took the helm at the bank 10 months ago.

In that time, he has delayed, suspended or cancelled hundreds of millions of dollars in loans to India, Bangladesh, Kenya, Chad and Argentina over corruption-related issues. OnTuesday, he tried to put those actions in a wider framework.

"Suspending loans on problem projects by itself does not deliver results for the poor," he said. His predecessor, James D. Wolfensohn, broke the taboo against talking bluntly about corruption, but Mr. Wolfowitz has set himself the task of more aggressively taking the issue into the guts of the bank's own bureaucracy.

Some experts, while praising Mr. Wolfowitz's determination, questioned how much leverage the bank really had to prevent corrupt elites from siphoning off money intended for the poor. Others said the execution of Mr. Wolfowitz's ideas had in some cases been ham-handed.

Mr. Wolfowitz's approach is certainly ambitious. In his speech, he defined it much more broadly than merely detecting and stopping graft. Countries also need assistance to build the institutions of accountability and the capacity to tackle corruption on their own, he said.

Toward that end, the bank will increase loans to reform the courts and civil services of poor countries and to decentralize public services, among other things.

To minimize corruption in bank-funded projects, the bank will deploy what he called "anti-corruption teams" to work on the ground in poor countries with government auditors and others.

Under Mr. Wolfowitz, the staff of the bank's department of institutional integrity will grow to 65 from 53. Its budget will expand by almost $5 million.
The bank says more than 140 suspected corruption cases in a backlog of 387 cases have been closed since Mr. Wolfowitz took over, but many new ones have been opened as staff members have been encouraged to report suspected instances of corruption. "He wants us to go more actively after corrupt companies," said Bart Stevens, a spokesman.

The bank is also changing the way it devises projects to put more emphasis on incentives to combat corruption, Mr. Wolfowitz said. He will direct staff members in the most-corrupt countries to mobilize all the bank's loans, grants, research and technical assistance "to strengthen governance and fight corruption."

Bangladesh is a case study of how the changes are playing out. Last December, the bank canceled $35 million in loans to Bangladesh after corruption was found in the bidding process on 14 road-building contracts.
But the bank is not washing its hands of Bangladesh. In discussions with the bank's board, bank managers noted that Bangladesh had made impressive strides in educating girls, reducing child mortality and increasing life expectancy despite what they called "serious governance weaknesses." They anticipate $3 billion in loans over the next five years, with a particular focus on strengthening accountability.

Pointing to the gradual progress against corruption in Indonesia, where he served as the American ambassador 20 years ago, Mr. Wolfowitz sounded a cautiously optimistic note in a brief news conference after the speech.
The bank's own experience suggests the daunting nature of the task, particularly in countries lacking the political will. In January, Mr. Wolfowitz suspended all loans to Chad, an impoverished African country, after its government gravely weakened an agreement to commit most revenues from an oil pipeline the bank had helped it build to poverty reduction.

Last month, the bank approved $2.9 billion in debt relief for the Congo Republic. At Mr. Wolfowitz's insistence, that relief depends on concrete steps to combat corruption in the state-run oil company. But two leading advocates for cleaning up Congo's oil sector were arrested last week and remain in jail.
At the news conference, Mr. Wolfowitz said he was aware of their arrest. "It suggests to me that it's not going to be easy to get the same performance there if the facts are as they appear," he said.

Some are skeptical of the bank's recent efforts to use its clout to change the kleptocratic ways of some powerful government officials. The bank's announcement of $145 million in new lending for Kenya in January - when the country was in the thick of a huge corruption scandal - struck Sir Edward Clay, the former British high commissioner to Kenya, as so ill-timed that he wrote Mr. Wolfowitz an open letter published Jan. 29 in The Daily Nation, a Kenyan newspaper.

Sir Edward said in a subsequent telephone interview that though one of the loans, for $25 million, was specifically to combat corruption, the bank should never have announced it just as the press and protesters were uniting to condemn the government for its failures on corruption, as laid out by the country's former anticorruption czar, John Githongo.

"It's unbelievably dense and the mark of a bureaucracy so caught up in its own processes that it doesn't pay attention to the environment in which it's operating," Sir Edward said. "Donors have been giving money to help improve governance for generations and that's not the answer at the moment."
Mr. Wolfowitz took only a few questions during his brief telephone news conference on Tuesday, and there was no time to ask about the Kenya incident. But officials noted that the bank had suspended $260 million in loans to Kenya since October pending the outcome of bank audits.

The bank went forward with the $25 million anticorruption loan, and with another for $120 million that was Kenya's share of a regional plan for trade and transportation, because there were enough guarantees built in to assure accountability, bank officials said. - New York Times

China: Buddhism contributes to harmony in society
Buddhism, a major religion in China, can play a unique role in promoting a "harmonious society" and contributing to world peace, a top religious affairs official and researcher said.

As a religion with "profound ideas of harmony and a conception of peace," Buddhism can relieve strain and stress among people and between humans and nature, thus enhancing social accord, said Ye Xiaowen, chief of the State Administration for Religious Affairs.

China has been striving to build a harmonious society and advocating the construction of a harmonious world. Advocating the Buddhist spirit of harmony, peace and benevolence will undoubtedly push forward harmony in China and the world, Xinhua quoted Ye as saying.

"As a responsible country, China has had its own deep thinking and measures of foresight for the promotion of world harmony," Ye said.
"Religious force is one of the important social forces from which China draws strength."

The official made the remarks just days before the World Buddhist Forum convened in the scenic city of Hangzhou, and nearby Zhoushan, in East China's Zhejiang Province on Thursday.

It is the first time since Buddhism came to China 2,000 years ago that the country has hosted such an event. A popular doctrine of Buddhism is "to do no evil, to do only good and to purify the will," said Wei Daoru, a researcher with the Institute of World Religions under the Chinese Academy of Social Sciences.
As proven in the past hundreds of years, Buddhism has helped avert various strife among people, and taught believers to re-adjust their mindset for peaceful co-existence with nature and others, Wei told China Daily.
The religion also preaches that all different Buddhist sects are equal and should live in amity, Wei said.

In addition, Buddhism has become a bridge for international cultural exchange, he said. Venerable Guoguang said that Buddhism advocates fusion rather than conflict, and sticks to the truth of accepting differences.

The religious doctrine of selflessness, charity, respect, equality and tolerance makes it culturally advantageous in safeguarding world peace, he said in an article submitted for the Buddhist forum.

China has at least 20,000 Buddhist temples and about 200,000 Buddhist monks and nuns, according to official statistics. - People’s Daily online.

Drug firms accused of turning healthy people into patients
Pharmaceutical giants exaggerating ailments, claim experts’ reports
By Ian Sample
You are lying on the sofa after a hard day at work and should be relaxing. But you are overcome by an insatiable urge to kick your legs about. As you struggle to control yourself, your kids run riot in the room. And to cap it all, your sex life is rubbish.

Just an everyday scene in many people's ordinary lives, or the combination of three newly identified medical conditions that can be treated at the pop of a pill?

The latter, according to some of the world's biggest, most profitable pharmaceutical companies, which have come up with a range of new drugs to treat "restless legs syndrome", attention deficit hyperactivity disorder in children, and female sexual dysfunction. But according to reports published today, the truth is more complicated. Healthy people are being turned into patients by drug firms which publicise mental and sexual problems and promote little-known conditions only then to reveal the medicines they say will treat them.

The studies, published in a respected medical journal, accuse the pharmaceutical industry of "disease mongering" - a practice in which the market for a drug is inflated by convincing people they are sick and in need of medical treatment.

The "corporate-sponsored creation of disease" wastes resources and may even harm people because of the medication they turn to, the researchers add.

In 11 papers in the journal Public Library of Science Medicine, experts from Britain, the US and elsewhere argue that new diseases are being defined by specialists who are often funded by the drug industry.

According to the researchers, the campaigns boost drug sales by medicalising aspects of normal life such as sexuality, portray mild problems such as irritability in children as serious illnesses and suggest that rare health conditions, such as the urge to move ones' legs, are common.

"Disease mongering exploits the deepest atavistic fears of suffering and death," said Iona Heath, a general practitioner at the Caversham Practice in London who contributed to the journal. She added: "It is in the interests of pharmaceutical companies to extend the range of the abnormal so that the market for treatments is proportionately enlarged."

In the journal's editorial, guest editors Ray Moynihan and David Henry write: "Informal alliances of pharmaceutical corporations, public relations firms, doctors' groups and patient advocates promote these ideas to the public and policy makers, often using mass media to push a certain view of a particular health problem."

In one of the reports, Dr Joel Lexchin, a drug safety expert at York University in Toronto, alleges that Pfizer, the maker of Viagra, devised ways to "ensure that the drug was seen as a legitimate therapy for almost any man", and "took steps to make sure Viagra was not relegated to a niche role of just treating men with [erectile dysfunction] due to organic causes, such as diabetes or prostate surgery".

The message from adverts and Pfizer's website, "is that everyone, whatever their age, at one time or another, can use a little enhancement," he claims.
In a statement, Pfizer said it "only promotes prescription medicines to healthcare professionals and only in line with its licensed indications. Pfizer does not promote any of its prescription medicines to the general public and does not recommend, or promote the use of Viagra, outside of its licensed indications."

It added: "Viagra has been available in the UK for over seven years and is an important treatment for erectile dysfunction. All promotion of Viagra is aimed at educating health professionals on this serious condition, to enable them to effectively treat patients with this condition."

According to Leonore Tiefer, clinical professor of psychiatry at New York University, a textbook case of disease mongering is the creation and promotion of "female sexual dysfunction". The campaign by a number of drug companies has been especially successful in the US, he notes, where there has been a heavily contested attempt to convince the public that 43% of women live with the condition.

In another paper, David Healy, director of the department of psychosocial medicine at the University of Wales, Bangor, describes how a TV advertisement from Lilly Pharmaceuticals encouraged people to find out about mood disorders via a website sponsored by the company. "This advert markets bipolar disorder," he writes in the journal.

Dr Graham Archard, vice-chair of the Royal College of General Practitioners, said it was inevitable that drug companies benefited from such campaigns.
"If a company produces a product, they are going to want to market it in the best way they can and if they can increase public awareness of a condition that may or may not exist, then a person may well believe they have that condition and look for treatment," he said. "There's a limited amount of cash in the NHS and if people are spending limited resources on areas that aren't terribly important, that will detract from areas of greater importance. Potentially we could all be losers."

Lilly Pharmaceuticals said: "Bipolar disorder is one of the most debilitating and serious psychiatric illnesses there is. Appropriate treatment should be decided after the treating clinician has fully evaluated the person's condition and discussed the full range of treatment options. The advertisement that Dr Healy refers to was not designed for and was not shown to the general public in the UK. Olanzapine (Zyprexa) is not approved for use in children. Lilly does not market it for use in children."

GlaxoSmithKline said: "It's estimated that 10-15% of adults suffer from restless legs syndrome, yet it is a very underdiagnosed medical condition, which even when diagnosed, often leaves people without effective treatment. About 3% of adults experience moderate to severely distressing RLS symptoms at least two to three times a week and are likely to benefit from treatment." - The Guardian, UK

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