Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping to finance the upcoming one.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated the source of the vaccine and some financing for the campaign. The vaccine and financing is being provided by the GAVI Alliance, not the Measles and Rubella Initiative.

Read More..

Groupon Shares Crumple After Dismal Outlook, Take-Rate Cut

SAN FRANCISCO (Reuters) - Groupon Inc lost a quarter of its market value on Wednesday after the company revealed it began to take a smaller cut of revenue on daily deals during the holidays, sacrificing revenue and profits to attract and keep merchants.

The cut in its "take rate", which some analysts had said was needed to revive flagging interest among merchants in its Internet offers, was a blow to fourth-quarter results. And a sharper-than-expected post-holiday slowdown in its new e-commerce business contributed to a disappointing first-quarter sales forecast.

The stream of bad numbers, which included a surprise loss in the fourth quarter, drove Groupon's stock down 26 percent to $4.43 in after hours trade. Overall, the company has shed more than three-quarters of its value since debuting at $20 in November of 2011.

"This raises questions about how these guys are going to be able to scale the business," said Tom White, an analyst at Macquarie. "The forecast is underwhelming."

Groupon is among a group of consumer-focused Internet startups that went public to much fanfare in 2011 - before losing massive chunks of market value as investors realized they had over-rated their prospects.

Within a year, Groupon had run into problems dealing with European merchants and sustaining interest among users as deals fever receded. In 2012, analysts speculated that Chief Executive Andrew Mason, known for a quirky sense of humor, may have fallen out of favor with the board.

A company spokesman said Mason remained in charge and the CEO addressed analysts on Wednesday's post-results call.

Groupon reported fourth-quarter revenue rose 30 percent to $638.3 million from $492.2 million in the year-ago period. But it slid into the red with a 1 cent per share loss excluding items, versus expectations for a slim profit of 3 cents a share.

It forecast first-quarter revenue of $560 million to $610 million, sharply below the $650 million average estimate of analysts polled by Thomson Reuters I/B/E/S.

Chief Financial Officer Jason Child told Reuters that Groupon began sharing more money from its deals with merchants early in the fourth quarter, to persuade them to come onboard and run an offer for the first time, or work on another.

This was done selectively in the United States and in Europe, he added.

Historically, Groupon has kept about 40 percent of the money generated by daily deals. That declined to about 35 percent in the fourth quarter. Groupon then "fine tuned" take rates later in the quarter and Child said the company expects profitability to improve as a result.

"We are focused on driving growth," he said in an interview. "We will make the investments we feel we need to optimize for growth and merchant profitability."

THE GOODS ON EUROPE

Merchants have complained that Groupon takes too large a cut of online offers.

Groupon executives forecast long-term take rates of 30 percent to 40 percent for the daily deals business, during a conference call with analysts. One of the reasons Groupon reduced take rates was to create more daily deals for a new business called Local Marketplace, which launched in November.

Groupon has mostly focused on sending daily emails to customers offering vouchers for activities in their area. Local Marketplace relies instead on people searching for something to do or buy nearby, such as an oil change or a massage. By the end of the third quarter, before the launch, Groupon had amassed an online store of more than 27,000 deals for the new marketplace.

Analysts have said the move has potential because Groupon's deals may be more likely to show up in Google searches. By the end of 2012, Groupon claimed almost 37,000 active deals running in North America, and many were longer-term offers for Local Marketplace.

For now, Groupon Goods, the company's discounted product sales business, generated a lot of the fourth-quarter revenue growth, though it's seasonally volatile and generates lower margins than daily deals.

Groupon's limp outlook revived fears its business model may be in jeopardy. Chief among their concerns have been intensifying competition in e-commerce, and a struggling European division walloped by the recession there.

Executives warned a turnaround effort there would take time, and signaled that cost cuts are coming for the company's International business.

Groupon is trying to fix it by reducing the size of discounts on deals there and testing faster payments to higher-quality merchants. Technology used to automate its U.S. operations and sales efforts is being rolled out in Europe now.

Kal Raman, chief operating officer, said more than the twice the number of people are needed to handle and process an International division deal, than in the United States.

A Groupon spokesman said there are no "definite" plans for International job cuts, but there were staff reductions in the United States when the company automated.

"That is an enormous opportunity to organize Groupon's operations to be both more efficient," Raman told analysts during the conference call.

(Reporting by Alistair Barr; Editing by David Gregorio, Richard Chang and Tim Dobbyn)

Read More..

Balloon Explosion in Egypt Kills at Least 19 Tourists

CAIRO — The explosion of a hot-air balloon over the ancient temples at Luxor killed at least 19 sightseers Tuesday, delivering a grim blow to Egypt’s critical tourism business just as it had begun to show signs of recovery from the shock of the revolution two years ago.

All of those killed were tourists, including nine Chinese from Hong Kong, four Japanese, two French, two Britons, a Hungarian and an Egyptian, Health Ministry officials said. The balloon’s pilot and a British passenger survived by jumping from the balloon’s basket. But the surviving passenger’s wife, also British, died in the blaze.

“It is just another nail in tourism’s coffin,” Hisham A. Fahmy, the chief executive of the American Chamber of Commerce in Egypt, which represents international companies here, said of the crash. “They were probably the only tourists in Luxor as it was.”

Even Egyptians trying to minimize the disaster’s potential effect on the tourist business compared it to the 1997 massacre of 62 people, 58 of them tourists, at one of Luxor’s temples by a group of Islamist militants. At least this was an accident and not terrorism, Egyptian officials said Tuesday. Others noted hopefully that tourism had eventually recovered after 1997.

“I thought that would be the end of tourism,” said Heba Handoussa of the Economic Research Forum here. “But to my surprise, the next year it was back. People seem to take it in stride.”

The tombs and temples of Luxor and the nearby Valley of the Kings are among Egypt’s premier attractions, and hot-air balloon rides over the valley at dawn are a staple of the local tourist trade. In 2008 and 2009, balloons collided with utility poles and crashed to the ground, injuring passengers. But few visitors had raised safety concerns, tour operators said.

The disaster unfolded in just minutes, shortly after 7 a.m., as the balloon was preparing to land in a field of sugar cane. The pilot was pulling a rope to stabilize the balloon when a gas hose ripped and a fire started, security officials said.

The pilot and the passenger who survived quickly escaped over the side of the basket, risking a 30-foot fall. Then escaping gas or hot air from the fire evidently sent the balloon soaring back skyward. Some reports said it had climbed as high as 1,000 feet before a gas cylinder exploded and it burst into flames.

State media reported that some of the dead had been “cremated” in the fireball. The Health Ministry said it would use DNA testing to identify the remains.

The ministers of aviation and tourism said they were traveling to Luxor. Officials started investigations into the crash as well as an examination of the permit for the balloon and the license for its pilot.

Some in Luxor faulted regulators. Tharwat Agami, the chairman of the Luxor tourist industry trade group, accused the aviation ministry of renewing licenses for the balloon operator and others despite their failures to meet safety requirements. Like other forms of law enforcement, balloon regulation and inspection have deteriorated sharply since the revolution, he told the state newspaper Al Ahram.

“As if tourism can take any more!” Mr. Agami said, according to the newspaper. “Where is the inspection of each balloon before takeoff by civil aviation?”

Tourism typically accounted for about 11 percent of Egypt’s gross domestic product before the revolution, economists say. More important, tourism is Egypt’s second-largest source of hard currency, after remittances sent home by Egyptians working abroad. It helps reduce the trade imbalance, supporting the sagging value of the Egyptian pound.

But in the two years of unrest since President Hosni Mubarak was ousted, tourism revenue has plummeted to just a quarter of its former level, said Ms. Handoussa, the economist.

She said government figures, widely believed to understate the malaise, put unemployment at 14 percent, up from 8 percent before the revolt, while the number of Egyptians officially considered to be living in poverty has risen to 25 percent from 20 percent.

Two major European tour operators, TUI of Germany and Thomas Cook of Britain, said around the beginning of this year that they saw signs of recovery in the demand for vacations to North Africa, including Tunisia and Egypt. Tour operators and travel agents say the Red Sea beach resorts, farther from the unrest in Cairo, have suffered far less than other destinations.

But then at the end of January, vandals in Cairo capitalized on the chaos surrounding a street protest to loot and ransack the lobby of the historic Semiramis InterContinental Hotel. It was the first time since Mr. Mubarak’s exit that the unrest had so directly affected a tourist institution. Now the balloon accident may add new concerns about safety to the continuing fears of political instability.

Mina Agnos, a vice president of Travelive, a high-end tour operator based in Athens and Montclair, N.J., said it had stopped marketing trips to Egypt. Each fall in the last two years, seasonal demand would pick up, and then violence would erupt again, as it did around the American Embassy here last September over an online video mocking Islam.

“Something would happen,” she said. “We found that a lot of people who were thinking of going to Egypt ended up going other places.”

Mayy El Sheikh contributed reporting.

Read More..

Advanced Breast Cancer May Be Rising Among Young Women, Study Finds

The incidence of advanced breast cancer among younger women, ages 25 to 39, may have increased slightly over the last three decades, according to a study released Tuesday.

But more research is needed to verify the finding, which was based on an analysis of statistics, the study’s authors said. They do not know what may have caused the apparent increase.

Some outside experts questioned whether the increase was real, and expressed concerns that the report would frighten women needlessly.

The study, published in The Journal of the American Medical Association, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 — an increase of 1.37 cases per 100,000 women in 34 years. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

Though small, the increase was statistically significant, and the researchers said it was worrisome because it involved cancer that had already spread to organs like the liver or lungs by the time it was diagnosed, which greatly diminishes the odds of survival.

For now, the only advice the researchers can offer to young women is to see a doctor quickly if they notice lumps, pain or other changes in the breast, and not to assume that they cannot have breast cancer because they are young and healthy, or have no family history of the disease.

“Breast cancer can and does occur in younger women,” said Dr. Rebecca H. Johnson, the first author of the study and medical director of the adolescent and young adult oncology program at Seattle Children’s Hospital.

But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. “We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” she said.

Expert groups differ about when screening should begin; some say at age 40, others 50.

Breast cancer is not common in younger women; only 1.8 percent of all cases are diagnosed in women from 20 to 34, and 10 percent in women from 35 to 44. However, when it does occur, the disease tends to be more deadly in younger women than in older ones. Researchers are not sure why.

The researchers analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics on 28 percent of the population of the United States. The study also used data from the past when SEER was smaller.

The study is based on information from 936,497 women who had breast cancer from 1976 to 2009. Of those, 53,502 were 25 to 39 years old, including 3,438 who had advanced breast cancer, also called metastatic or distant disease.

Younger women were the only ones in whom metastatic disease seemed to have increased, the researchers found.

Dr. Archie Bleyer, a clinical research professor in radiation medicine at the Knight Cancer Institute at the Oregon Health and Science University in Portland who helped write the study, said scientists needed to verify the increase in advanced breast cancer in young women in the United States and find out whether it is occurring in other developed Western countries. “This is the first report of this kind,” he said, adding that researchers had already asked colleagues in Canada to analyze data there.

“We need this to be sure ourselves about this potentially concerning, almost alarming trend,” Dr. Bleyer said. “Then and only then are we really worried about what is the cause, because we’ve got to be sure it’s real.”

Dr. Johnson said her own experience led her to look into the statistics on the disease in young women. She had breast cancer when she was 27; she is now 44. Over the years, friends and colleagues often referred young women with the disease to her for advice.

“It just struck me how many of those people there were,” she said.

Dr. Donald A. Berry, an expert on breast cancer data and a professor of biostatistics at the University of Texas’ M. D. Anderson Cancer Center in Houston, said he was dubious about the finding, even though it was statistically significant, because the size of the apparent increase was so small — 1.37 cases per 100,000 women, over the course of 30 years.

More screening and more precise tests to identify the stage of cancer at the time of diagnosis might account for the increase, he said.

“Not many women aged 25 to 39 get screened, but some do, but it only takes a few to account for a notable increase from one in 100,000,” Dr. Berry said.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

A spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase.

“We’re looking at this data with caution,” said the spokeswoman, Michelle Esser. “We don’t want to invite panic or alarm.”

She said it was important to note that the findings applied only to women who had metastatic disease at the time of diagnosis, and did not imply that women who already had early-stage cancer faced an increased risk of advanced disease.

Dr. J. Leonard Lichtenfeld
, deputy chief medical officer of the American Cancer Society, said he and an epidemiologist for the society thought the increase was real.

“We want to make sure this is not oversold or that people suddenly get very frightened that we have a huge problem,” Dr. Lichtenfeld said. “We don’t. But we are concerned that over time, we might have a more serious problem than we have today.”

Read More..

DealBook: Wall Street Pay Rises, for Those Who Still Have a Job

7:39 p.m. | Updated

Wall Street may be shrinking — cutting thousands of jobs over the last year — but for those who remain, the pay is still very lucrative.

The average cash bonus for those employed in the financial industry in New York last year rose roughly 9 percent, to $121,900, Thomas P. DiNapoli, New York State’s comptroller, said on Tuesday.

Cash bonuses in total are forecast to increase by roughly 8 percent, to $20 billion this year.

The total, however, is down from 2010, when it was $22.8 billion. Wall Street’s peak came in 2006, before the financial crisis, with a total $34.3 billion in bonuses. The year-end bonus can account for the bulk of a finance professional’s annual compensation.

The report from the state comptroller’s office gives estimates on the bonuses, based on tax withholding data, data from banks and conversations with industry experts. It came the same day that JPMorgan Chase, one of the country’s biggest banks, announced it was eliminating 17,000 jobs over the next two years through layoffs and attrition, adding its name to a string of large banks that continue to cut jobs to reduce expenses.

Wall Street has regained 30 percent of the 28,300 jobs lost during the financial crisis, Mr. DiNapoli said. And firms are continuing to streamline as they cope with a sluggish economic recovery, difficult markets and a heavier regulatory burden. While financial industry employment in New York City was steady in the first half of 2012, it was down slightly in the second half of the year, the comptroller’s office said.

“Wall Street is still in transition, but it is very slowly adjusting to changes in its economic and regulatory environment,” he said.

In an effort to hold down — albeit temporarily — compensation costs, a number of financial firms have deferred cash payments to employees in recent years. Mr. DiNapoli said on Tuesday that part of the increase in 2012 was cash promised in recent years but actually paid out last year. He said that it was difficult to break out what percentage of the total was deferrals, but he believed that it was still a small part of the total.

The ebbs and flows of Wall Street pay have a major impact on the economy of New York City, where 169,700 are employed in finance. Local businesses like restaurants, luxury goods retailers and the upper end of the real estate market pin their fortunes to the flood of cash from year-end bonuses.

Before the start of the financial crisis, business and personal income tax collections from finance-related activities accounted for up to 20 percent of New York State tax revenue. In 2012, that contribution fell to 14 percent.

Yet finance remains the best paying sector in New York City, Mr. DiNapoli told reporters during a conference call.

All told, the average pay package for securities industry employees in New York was $362,900 in 2011, the last year for which data is available, almost unchanged from 2010.

“Profits and bonuses rebounded in 2012, but the industry is still restructuring,” Mr. DiNapoli said. Despite its smaller size, the securities industry is still a very important part of the New York City and New York State economies.”

Read More..

2 Palestinian Youths Hurt in Clashes With Israel

Mussa Issa Qawasma/Reuters

A Palestinian protester threw stones during clashes with Israeli soldiers on Monday in Hebron, West Bank, after a funeral for a Palestinian prisoner.

JERUSALEM — Two Palestinian teenagers were seriously injured Monday when Israeli soldiers used live ammunition to disperse a demonstration at a holy site outside Bethlehem, as clashes in the West Bank continued for a fifth day and thousands attended the burial of a 30-year-old Palestinian who died in an Israeli jail over the weekend.

The Palestinian president, Mahmoud Abbas, spoke for the first time on Monday about the prisoner, Arafat Jaradat, saying that Israel must be held responsible for his death and that its leaders were trying to foment chaos rather than work toward peace.

Other Palestinian officials have said Mr. Jaradat died because of torture during interrogation. An autopsy conducted Sunday did not immediately determine the cause of death, but an Israeli official said Monday that a report on the findings should be released by the end of the week and that the police and courts were investigating the death separately.

“Jaradat went to jail and returned back a dead body,” Mr. Abbas said Monday in Ramallah, hours before the teenagers were shot near Bethlehem. “We insist to know how this happened and who did this. We will not let them play in the lives of our sons. They are confronting children and killing them with live ammunition. We will not allow our prisoners to remain in the occupation jails all their lives for things that they did not commit.”

About 10,000 people accompanied Mr. Jaradat’s body from a hospital in Hebron to his family’s home in Sa’ir, a village nearby, and then to the cemetery. The Israeli military closed a main road for the procession, in which members of Al Aksa Martyrs Brigades, the militant wing of the Fatah party, fired guns into the air.

Israel’s prime minister, Benjamin Netanyahu, who sent a message on Sunday to the Palestinian leadership demanding that it restore calm in the West Bank, held security consultations on the matter on Monday, according to a statement from his office. Defense Minister Ehud Barak convened a special meeting on Monday with the military chief of staff and the leaders of Israel’s police force and prison service “during which possible scenarios were introduced,” according to a statement from Mr. Barak’s office, “as well as possible ways to cope with them and maintain security needs while trying to restore the calm on the ground.”

The United States Consulate in Jerusalem limited travel by government employees to the West Bank because of the demonstrations and advised all American citizens to avoid the area and “to exercise an extra measure of caution during this period.”

“The U.S. Consulate General takes this opportunity to remind U.S. citizens that demonstrations, even peaceful ones, can turn violent with little or no warning,” it said in a statement. “U.S. citizens should be aware of their surroundings at all times, and avoid large crowds.”

The Egyptian foreign minister, Mohamed Kamel Amr, called on the international community to take a firm stance against what he described as Israel’s inhumane practices against the Palestinian prisoners, according to the state newspaper, and warned that a continuation of such policies could lead to an explosion in the region.

So far, the situation seems to be on a simmer. Every day since Thursday, demonstrations have occurred in several West Bank cities and villages in which Palestinians have thrown rocks and sometimes gasoline bombs at Israeli soldiers, who generally respond with tear gas, rubber bullets and occasionally water cannons or live ammunition. Most of the demonstrations, including those in Hebron and Beituniya on Monday, have drawn crowds of a few hundred and resulted in a handful of light to moderate injuries.

But more serious clashes broke out near Rachel’s Tomb on Monday afternoon and evening. An Israeli military official who spoke on the condition of anonymity said that soldiers fired .22-caliber rounds at Palestinians who were throwing improvised grenades at worshipers near the tomb, which is next to the Aida refugee camp just outside Bethlehem.

A doctor at Beit Jala Hospital who spoke on the condition that he not be identified said a 13-year-old had been shot in a lung during that protest and was in the intensive care unit Monday night after undergoing surgery. Hours later, a 19-year-old Palestinian was shot as the demonstration raged on, the doctor said.

“He is in a dangerous situation,” the doctor said of the second patient. “Doctors are trying to save his life.”

Khaled Abu Aker contributed reporting from Ramallah, West Bank; Nayef Hashlamoun from Hebron and Sa’ir, West Bank; and Mayy El Sheikh from Cairo.

Read More..

AP source: Tom Brady gets 3-year extension

Tom Brady will be a Patriot until he is 40 years old.

Brady agreed to a three-year contract extension with New England on Monday, a person familiar with the contract told The Associated Press. The extension is worth about $27 million and will free up nearly $15 million in salary cap room for the team, which has several younger players it needs to re-sign or negotiate new deals with.

The person spoke on condition of anonymity because the extension has not been announced.

Sports Illustrated first reported the extension.

The 35-year-old two-time league MVP was signed through 2014, and has said he wants to play at least five more years.

A three-time Super Bowl champion, Brady will make far less in those three seasons than the going rate for star quarterbacks. Brady currently has a four-year, $72 million deal with $48 million guaranteed.

Drew Brees and Peyton Manning are the NFL's highest-paid quarterbacks, at an average of $20 million and $18 million a year, respectively.

Brady has made it clear he wants to finish his career with the Patriots, whom he led to Super Bowl wins for the 2001, 2003 and 2004 seasons, and losses in the big game after the 2007 and 2011 seasons. By taking less money in the extension and redoing his current contract, he's hopeful New England can surround him with the parts to win more titles.

Among the Patriots' free agents are top receiver Wes Welker and his backup, Julian Edelman; right tackle Sebastian Vollmer; cornerback Aqib Talib; and running back Danny Woodhead.

Brady has been the most successful quarterback of his era, of course, as well as one of the NFL's best leaders. His skill at running the no-huddle offense is unsurpassed, and he's easily adapted to the different offensive schemes New England has concentrated on through his 13 pro seasons.

The Patriots have gone from run-oriented in Brady's early days to a deep passing team with Randy Moss to an offense dominated by throws to tight ends, running backs and slot receivers.

Brady holds the NFL record for touchdown passes in a season with 50 in 2007, when the Patriots went 18-0 before losing the Super Bowl to the Giants. He has thrown for at least 28 touchdowns seven times and led the league three times.

Last season, Brady had 34 TD passes and eight interceptions as the Patriots went 12-4, leading the league with 557 points, 76 more than runner-up Denver.

Read More..

Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative, which will provide the vaccine and help pay for the campaign.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

Read More..

Lowe’s Fourth-Quarter Earnings Beat Expectations

Richard Drew/Associated Press

Robert Niblock, chief executive of Lowe’s, said consumer spending was increasing.

The results are a sign that people are beginning to feel better about spending money on their homes as the housing market slowly recovers.

Lowe’s chief executive, Robert A. Niblock, said the company was seeing a pickup in spending even in areas of the country hit hardest by the housing slump, like Florida, Arizona and California.

“Rising home values have given homeowners additional confidence in spending on their homes,” Mr. Niblock said in an interview.

Lowe’s net income fell 11 percent from the previous year’s quarter, which included an extra week of revenue. Its earnings forecast for the year was below expectations but its revenue projection beat the consensus.

Lowe’s has revamped its pricing structure, offering what it says are permanent low prices on many items across the store instead of fleeting discounts. It has also focused on hiring more workers and improving its inventory.

In a call with analysts, Lowe’s chief customer officer, Gregory M. Bridgeford, said the pricing strategy helped spur strong sales of cabinets and countertops, tools and outdoor power equipment.

Lowe’s reported net income totaled $288 million, or 26 cents per share, for the three months ended Feb. 1. That was down from $322 million, or 26 cents a share, a year earlier. Analysts expected 23 cents a share in the latest quarter, according to FactSet.

There were 11 percent fewer shares outstanding in the latest quarter than a year ago. An extra week in the quarter last year had increased year-earlier earnings by 5 cents a share.

Revenue fell 5 percent to $11.05 billion from $11.63 billion a year earlier. Analysts had expected sales of $10.85 billion. Revenue in stores open at least one year rose 1.9 percent. The measure is an important gauge of a retailer’s fiscal health because it excludes stores that open or close during the year.

Lowe’s, which operates 1,754 stores in the United States, Canada and Mexico, expects fiscal 2013 net income of $2.05 a share. Analysts expect $2.10 a share.

The company expects revenue to rise 4 percent, implying revenue of $52.54 billion. Analysts expect $51.69 billion.

Read More..

Kerry’s Meeting With Syrian Opposition at Risk

Pool photo by Jacquelyn Martin

Secretary of State John Kerry spoke to reporters on the way to London on Sunday. Mr. Kerry has said that he has new ideas on how to force President Bashar al-Assad from power in Syria.

Mr. Kerry and foreign ministers from Europe and the Middle East are scheduled to meet in Rome on Thursday with opponents of President Bashar al-Assad of Syria, including Sheik Ahmad Moaz al-Khatib, who leads the opposition. But they are threatening to boycott the conference to protest what they see as fainthearted international support.

To try to rescue the meeting, Robert S. Ford, the American ambassador to Syria and chief envoy to the opposition, was sent to Cairo on Sunday to implore opposition leaders to attend the session in Rome.

“The Syrian opposition leadership is under severe pressure now from its membership, from the Syrian people, to get more support from the international community,” said a senior administration official who was traveling on Mr. Kerry’s plane. “And in that context, there’s quite a bit of internal discussion about the value of going in international conferences.”

The issue upset the first day of a carefully choreographed trip that is intended to introduce Mr. Kerry as the chief American envoy and to give a lift to the diplomatic stalemate on Syria. Mr. Kerry, who took office this month, is traveling to Britain, Germany, France, Italy, Turkey, Egypt, Saudi Arabia, the United Arab Emirates and Qatar over 11 days.

Even before his trip was formally announced, Mr. Kerry raised expectations by saying he had new ideas on how to change Mr. Assad’s calculations that he could remain in power.

Mr. Kerry has not publicly explained the proposals, but they appear to include marshaling support from Russia, which has been providing arms and financial help to Mr. Assad. Toward that end, Mr. Kerry plans to meet in Berlin on Wednesday with Sergey V. Lavrov, Russia’s foreign minister.

The meeting with the Syrian opposition is to be hosted by Italy. Last week, the European Union agreed to extend its embargo on weapons shipments to Syria for another three months, a move that precludes European arms shipments to the opposition.

But the European Union did agree to a British proposal that nonlethal assistance be expanded. As a result, body armor, night-vision goggles, armored vehicles and other equipment can be sent to armed opposition groups in Syria, an American official said.

So far, the Obama administration has not gone that far in its support. While the United States provides nonlethal assistance like computers and radios to the opposition, it has not been willing to provide nonlethal aid to armed factions within Syria, an approach that experts say has limited its influence with these groups.

State Department officials traveling with Mr. Kerry declined to discuss whether the United States would soon be prepared to take that step.

President Obama rebuffed a proposal last year from the State Department, the Pentagon and the C.I.A. that the United States arm and train a cadre of opposition fighters.

With the violence escalating, Aleppo under attack by Scud missiles and members of a quarrelsome Syrian opposition challenging the value of the Rome meeting — which was supposed to be a highlight of Mr. Kerry’s trip — the State Department issued a statement on Saturday evening that condemned the rocket attacks “in the strongest possible terms” and prodded the Syrian opposition to attend the session.

The statement continued, “We look forward to meeting soon with the leadership of the legitimate representative of the Syrian people, the Syrian Opposition Coalition, to discuss how the United States and other friends of the Syrian people can do more to help the Syrian people achieve the political transition that they demand and that they deserve.”

Read More..