Study: People worldwide living longer, but sicker

LONDON (AP) — Nearly everywhere around the world, people are living longer and fewer children are dying. But increasingly, people are grappling with the diseases and disabilities of modern life, according to the most expansive global look so far at life expectancy and the biggest health threats.

The last comprehensive study was in 1990 and the top health problem then was the death of children under 5 — more than 10 million each year. Since then, campaigns to vaccinate kids against diseases like polio and measles have reduced the number of children dying to about 7 million.

Malnutrition was once the main health threat for children. Now, everywhere except Africa, they are much more likely to overeat than to starve.

With more children surviving, chronic illnesses and disabilities that strike later in life are taking a bigger toll, the research said. High blood pressure has become the leading health risk worldwide, followed by smoking and alcohol.

"The biggest contributor to the global health burden isn't premature (deaths), but chronic diseases, injuries, mental health conditions and all the bone and joint diseases," said one of the study leaders, Christopher Murray, director of the Institute of Health Metrics and Evaluation at the University of Washington.

In developed countries, such conditions now account for more than half of the health problems, fueled by an aging population. While life expectancy is climbing nearly everywhere, so too are the number of years people will live with things like vision or hearing loss and mental health issues like depression.

The research appears in seven papers published online Thursday by the journal Lancet. More than 480 researchers in 50 countries gathered data up to 2010 from surveys, censuses and past studies. They used statistical modeling to fill in the gaps for countries with little information. The series was mainly paid for by the Bill & Melinda Gates Foundation.

As in 1990, Japan topped the life expectancy list in 2010, with 79 for men and 86 for women. In the U.S. that year, life expectancy for men was 76 and for women, 81.

The research found wide variations in what's killing people around the world. Some of the most striking findings highlighted by the researchers: — Homicide is the No. 3 killer of men in Latin America; it ranks 20th worldwide. In the U.S., it is the 21st cause of death in men, and in Western Europe, 57th.

— While suicide ranks globally as the 21st leading killer, it is as high as the ninth top cause of death in women across Asia's "suicide belt," from India to China. Suicide ranks 14th in North America and 15th in Western Europe.

— In people aged 15-49, diabetes is a bigger killer in Africa than in Western Europe (8.8 deaths versus 1 death per 100,000).

— Central and Southeast Asia have the highest rates of fatal stroke in young adults at about 15 cases per 100,000 deaths. In North America, the rate is about 3 per 100,000.

Globally, heart disease and stroke remain the top killers. Reflecting an older population, lung cancer moved to the 5th cause of death globally, while other cancers including those of the liver, stomach and colon are also in the top 20. AIDS jumped from the 35th cause of death in 1990 to the sixth leading cause two decades later.

While chronic diseases are killing more people nearly everywhere, the overall trend is the opposite in Africa, where illnesses like AIDS, malaria and tuberculosis are still major threats. And experts warn again shifting too much of the focus away from those ailments.

"It's the nature of infectious disease epidemics that if you turn away from them, they will crop right back up," said Jennifer Cohn, a medical coordinator at Doctors Without Borders.

Still, she acknowledged the need to address the surge of other health problems across Africa. Cohn said the agency was considering ways to treat things like heart disease and diabetes. "The way we treat HIV could be a good model for chronic care," she said.

Others said more concrete information is needed before making any big changes to public health policies.

"We have to take this data with some grains of salt," said Sandy Cairncross, an epidemiologist at the London School of Hygiene and Tropical Medicine.

He said the information in some of the Lancet research was too thin and didn't fully consider all the relevant health risk factors.

"We're getting a better picture, but it's still incomplete," he said.

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Online:

www.lancet.com

http://healthmetricsandevaluation.org

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Health-Exchange Deadline Looms

All of the Affordable Care Act, also known as "Obamacare," doesn't go into effect until 2014, but states are required to set up their own health care exchanges or leave it to the federal government to step in by next year. The deadline for the governors' decisions is Friday.

The health insurance exchanges are one of the key stipulations of the new health care law. They will offer consumers an Internet-based marketplace for purchasing private health insurance plans.

But the president's signature health care plan has become so fraught with politics that whether governors agreed to set up the exchanges has fallen mostly along party lines.

Such partisanship is largely symbolic because if a state opts not to set up the exchange, the Department of Health and Human Services will do it for them as part of the federal program. That would not likely be well-received by Republican governors, either, but the law forces each state's chief executive to make a decision one way or the other.

Here's what it looks like in all 50 states and the District of Columbia:

20 states that have opted out -- N.J., S.C., La., Wis., Ohio, Maine, Ala., Alaska, Ariz., Ga., Pa., Kan., Neb., N.H., N.D., Okla., S.D., Tenn., Texas and Wyo.

Charles Dharapak/AP Photo

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Several Republican governors have said they will not set up the exchanges, including Chris Christie (N.J.), Nikki Haley (S.C.), Bobby Jindal (La.), Scott Walker (Wis.), John Kasich (Ohio), Paul LePage (Maine), Robert Bentley (Ala.), Sean Parnell (Ark.), Jan Brewer (Ariz.), Nathan Deal (Ga.), Tom Corbett (Pa.), Sam Brownback (Kan.), Dave Heineman (Neb.), John Lynch (N.H.), Jack Dalrymple (N.D.), Mary Fallin (Okla.), Dennis Daugaard (S.D.), Bill Haslam (Tenn.), Rick Perry (Texas), and Matt Mead (Wyo.).

3 States Out, but a Little More Complicated -- Mont., Ind. and Mo.

The Montana outgoing and incoming governors are both Democrats, but the Republican state legislature rejected the Democratic state auditor's request to start setting up a state exchange. So a federal exchange will be set up in Montana as well.

The Indiana outgoing and incoming governors are both Republicans and outgoing Gov. Mitch Daniels deferred the decision to governor-elect and U.S. Rep. Mike Pence, who said his preference is not to set up a state health care exchange, paving the way for the feds to come in too.

In Missouri, Gov. Jay Nixon is a Democrat, but Prop E passed on Nov. 6, which barred his administration from creating a state-based exchange without a public vote or the approval of the state legislature. After the election, he sent a letter to the Department of Health and Human Services saying he would be unable to set up a state-based exchange, meaning the federal government would have to set up its own.

1 State Waiting for the White House -- Utah

Utah already has a state exchange set up, a Web-based tool where small-business employees can shop and compare health insurance with contributions from their employee. In a letter Republican Gov. Gary Herbert sent to the White House Tuesday, he asked for its exchange, called Avenue H, to be approved as a state-based exchange under the Affordable Care Act as long as state officials can open it to individuals and larger businesses.

Norm Thurston, the state's health reform implementation coordinator, says authorities there "haven't received an official response" from the White House, but "we anticipate getting one soon."

There are some sticking points that don't comply with the exchanges envisioned by the Affordable Care Act and Utah would like to keep it that way.

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U.S., rebels urge gloomy Moscow to help oust Assad

BEIRUT (Reuters) - Syria's rebel leadership and the United States seized on Russian pessimism over President Bashar al-Assad's future to urge Moscow to help push its ally into ceding power and end the battles closing in around his capital.

"We want to commend the Russian government for finally waking up to the reality and acknowledging that the regime's days are numbered," the U.S. State Department spokeswoman said after a senior Kremlin envoy conceded publicly on Thursday that Assad's opponents could win the 20-month-old civil war.

"The question now is, will the Russian government join those of us in the international community who are working with the opposition to try to have a smooth democratic transition?" U.S. spokeswoman Victoria Nuland added in Washington.

In Marrakech, where his new coalition won recognition from other international powers as the legitimate leadership of Syria, rebel political leader Mouaz al-Khatib said he believed Russia, ally and arms supplier to the Assad dynasty since Soviet times, was looking for ways out of its support for a lost cause.

"I believe that the Russians have woken up and are sensing that they have implicated themselves with this regime, but they don't know how to get out," al-Khatib told Reuters. He held them "particularly responsible" for helping Assad with arms but said Moscow need not "lose everything" in Syria if it changed tack.

Under President Vladimir Putin, wary since last year's Libyan war of what Russia sees as a Western drive to use the United Nations to overthrow national leaders it dislikes, Russia has blocked U.N. efforts to squeeze Assad, who has also had strong support from his long-time sponsor Iran.

But Mikhail Bogdanov, a deputy foreign minister and the Kremlin's special envoy for Middle East affairs, was quoted as saying in Moscow: "One must look the facts in the face."

"Unfortunately, the victory of the Syrian opposition cannot be ruled out." The Syrian government, he said, was "losing control of more and more territory" and Moscow was preparing to evacuate Russian citizens if necessary.

Nuland said Bogdanov's comments demonstrated that Moscow now "sees the writing on the wall" on Syria and said Russia should now rally behind U.N. efforts to prevent a wider bloodbath.

"They can withdraw any residual support for the Assad regime, whether it is material support (or) financial support," she said. "They can also help us to identify people who might be willing, inside of Syria, to work on a transitional structure."

DIPLOMACY

International envoy Lakhdar Brahimi, who has met Russian and U.S. officials twice in the past week, is seeking a solution based on an agreement reached in Geneva in June that called for the creation of a transitional government in Syria.

But Russia has repeated warnings that recognition of al-Khatib's coalition, notably by the United States, is undermining diplomacy, and rejected U.S. contentions that the Geneva agreement sent a clear message that Assad should step down.

Nuland said the Brahimi meetings could lay the framework for a political structure to follow Assad:

"We've said all along to the Russians that we are concerned that the longer that this goes on, and the longer it takes us to get to an alternative political path for Syria, the only path is going to be the military one and that is just going to bring more violence.

"We all ought to be working together."

Bogdanov, whose government has suggested that Assad himself should be allowed to see through a transition he has promised, suggested the rebels and their allies were set on a military solution and he gave little hint of detente with Washington.

"The fighting will become even more intense and (Syria) will lose tens of thousands and, perhaps, hundreds of thousands of civilians," Bogdanov was quoted as saying. "If such a price for the removal of the president seems acceptable to you, what can we do? We, of course, consider it absolutely unacceptable."

The head of NATO, Anders Fogh Rasmussen, said elsewhere: "I think the regime in Damascus is approaching collapse."

A U.S. official said: "Assad probably still believes that Syria is his and illusions can die hard. But Assad and those closest to him have got to be feeling the psychological strain of fighting a long war that is not going their way."

DAMASCUS BATTLES

But Al-Khatib, who played down Western concerns of sectarian Sunni Islamists in rebel ranks, warned that the fighting was far from over, even as it has begun to rattle the heart of Assad's power in Damascus. On Wednesday, a car bomb killed at least 16 people in a nearby town which is home to many military families.

"The noose is tightening around the regime," al-Khatib said.

"(But) the regime still has power. People think that the regime is finished, but it still has power left, but it is demoralized and however long it lasted its end is clear."

Day and night, Damascenes can hear the thunderous sound of bombardment aimed at rebel-held and contested neighborhoods.

The city's streets have now turned into a labyrinth of checkpoints and road blocks, with several major roads permanently closed off to traffic by concrete barriers.

"We escape from one place and trouble follows," said one grandmother, Um Hassan, as she described to Reuters her family's flight from one neighborhood to another as fighting seeps into the capital. "I don't know where we can keep running to."

Nonetheless, al-Khatib played down demands for their allies to provide heavier weaponry - a request long resisted by governments wary of anti-aircraft missiles and other hardware reaching Islamist rebels who might turn them against the West.

"The Syrian people ... no longer need international forces to protect them," he said, not specifying whether he meant a no-fly zone, arms supplies or other military support.

The opposition chief said he was willing to listen to proposals for Assad to escape with his life - "The best thing is that he steps down and stops drinking the blood of the Syrian people" - and outlined three scenarios for a change of power:

Al-Khatib ruled out the Russian proposal suggesting Assad hand over power to a transitional government while remaining president, saying it was "disgraceful for a slaughtered nation to accept to have a killer and criminal at its head".

The British-based Syrian Observatory said war planes bombed rebel-held eastern suburbs of Damascus on Thursday and artillery was hitting Daraya and Moadamiyeh, southwestern areas near the centre where rebels have been fighting for a foothold.

Syria has relied on war planes and helicopters to bombard rebel districts but Damascus denied accusations by U.S. and NATO officials that it had fired Scud missiles in recent days. The foreign ministry said the long-range missiles were not used against "terrorist groups," a term it uses for the rebels.

At least 40,000 people have been killed in Syria's uprising, which started in March 2011 with street protests which were met with gunfire by Assad's security forces, and which spiraled into the most enduring and destructive of the Arab revolts.

(Additional reporting by Steve Gutterman in Moscow and Andrew Quinn in Washington; Writing by Alastair Macdonald; Editing by Michael Roddy) For an interactive look at the uprising in Syria, please click on http://link.reuters.com/rut37s

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Unsafe ride-on animal toy recalled

SINGAPORE: SPRING Singapore has found that a toy given out as a free gift contains unsafe levels of phthalates, commonly used as a plasticiser in toys.

The free gift comes in the shape of cows, deers and ponies.

SPRING had sent samples of the toy for testing in response to a consumer's complaint.

As a precaution, SPRING had asked the retailer Aura Roboclean Singapore Pte Ltd to immediately stop distributing the product.

The retailer is contacting customers who were given the toys to stop using them and dispose of them immediately, or return them to the company.

So far, between 300 and 400 toy animals have been given out.

- CNA/ck

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Chilkur temple stage for Pandit Shankar’s secret wedding

HYDERABAD: For the older priests of the Balaji temple in Chilkur, the news of Pandit Ravi Shankar's sudden demise brought back vivid memories of the day he landed in Hyderabad and paid them a quiet visit, taking them all by surprise.

Not many people know but the sitar maestro married Sukanya Devi, mother of Anoushka Shankar in 1989 at the very temple, when it was frequented by only a handful of devotees.

"They came in a car on that day with their own purohit and nobody had even a faint idea that the marriage of a celebrity was going to take place," said M V Soundara Rajan, hereditary trustee of the Chilkur Balaji temple . "The temple authorities were not informed beforehand. It was a very low-key and simple affair bereft of any celebrity wedding. The marriage ritual was finished within an hour and the guests left soon," recalls Rajan, whose 99-year-old uncle C M Srinivasa Raghava Chary performed the marriage. The maestro, according to temple authorities, was a big devotee of Balaji and had visited the temple several times. Popularly known as the "visa god" as students pray there before applying for visa counseling, the temple witnesses over 5000 people visiting it every day.

Back in the days, the temple was very popular among members of Gujarati and Marwari community from the city who were ardent devotees of the lord.

A Gujarati businessman from the city, who was the patron of the temple, was instrumental in getting Ravi Shankar married here, priests say. "Ravi Shankar was a close friend of a Gujarati devotee who used to visit our temple. Probably this was the reason why he chose this temple. He had accompanied Ravi Shankar and his would-be wife to the temple that day," Rajan recalled.

Soundara Rajan also remembered the Gujarati devotee, whose name he does not remember , speaking of organizing a benefit programme with Ravi Shankar and promising to donate its proceeds to the development of the temple. "But our family had rejected that idea since we did not want any monetary help raised through such programmes since we consider this as a service," he said.

Recalling the marriage, priests said the marriage at this temple would have been confidential and not known to many had it not been for a lucky reporter who stumbled on the information . "Only after the news was splashed many knew that he had visited the city" a priest said.

According to them, Ravi Shankar also chose the temple as he was also a devotee of Chilkur Balaji. "He seemed to have visited the temple before and after the marriage."

C S Rangarajan, chief priest of the temple and son of Soundara Rajan recalled his conversation on this topic with his grandfather , who was the in-charge of the temple then. "This temple might have been chosen because it was quiet and hardly visited by any devotees. He had visited again in 2009 which showed he had faith in Chilkur Balaji," Rangarajan added.

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Congress examines science behind HGH test for NFL

WASHINGTON (AP) — A congressional committee has opened a hearing to examine the science behind a human growth hormone test the NFL wants to start using on its players.

Nearly two full seasons have passed since the league and the players' union signed a labor deal that set the stage for HGH testing.

The NFL Players Association won't concede the validity of a test that's used by Olympic sports and Major League Baseball, and the sides haven't been able to agree on a scientist to help resolve that impasse.

Among the witnesses before the House Oversight and Government Reform Committee on Wednesday is Pro Football Hall of Fame member Dick Butkus. In his prepared statement, Butkus writes: "Now, let's get on with it. The HGH testing process is proven to be reliable."

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McAfee Lands in Miami: I'm Free

Software mogul John McAfee has been released from detention in Guatemala City and has landed in Miami.

Immediately upon landing, according to passengers on the plane, McAfee's name was called and he was whisked off the aircraft. Federal officials escorted the 67-year-old Internet antivirus pioneer through customs spirit him out a side door, out of the view of reporters, according to Miami International Airport's communication director, Greg Chin.

It was not clear whether officials intended to help McAfee avoid the inevitable media circus or wanted to question him. However, he has not been charged with committing a crime in Guatemala or Belize, where the authorities have sought to question him about the murder of his neighbor.

McAfee's departure from Guatemala came earlier today.

"They took me out of my cell and put me on a freaking airplane," he told ABC News. "I had no choice in the matter."

McAfee said, however, that Guatemalan authorities had been "nice" and that his exit from the Central American country was "not at all" unpleasant.

"It was the most gracious expulsion I've ever experienced," he said. "Compared to my past two wives that expelled me this isn't a terrible trip."

McAfee said he would not be accompanied by his 20-year-old Belizean girlfriend, but is seeking a visa for her. He also said he had retained a lawyer in the U.S.

Guatemala's National Police/AP Photo

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When he was released earlier today, McAfee told the Associated Press, "I'm free. ... I'm going to America."

McAfee, who had been living in a beachfront house in Belize, went on the run after the Nov. 10 murder of his neighbor, fellow American expatriate Greg Faull. Belize police said they wanted to question McAfee about the murder, but McAfee said he feared for his life in Belizean custody.

He entered Guatemala last week seeking asylum, but was arrested and taken to an immigration detention center. He was taken to the hospital after suffering a nervous collapse and then returned to the detention center. The U.S. State Department has visited McAfee, who is a dual U.S.-British citizen, several times during his stay in Guatemala.

During his three-week journey, said McAfee, he disguised himself as handicapped, dyed his hair seven times and hid in many different places during his three-week journey.

He dismissed accounts of erratic behavior and reports that he had been using the synthetic drug bath salts. He said he had never used the drug, and said statements that he had were part of an elaborate prank.

Investigators in Belize said that McAfee was not a suspect in the death of Faull, a former developer who was found shot in the head in his house.

McAfee told ABC News that the poisoning death of his dogs and the murder just hours later of Faull, who had complained about his dogs, was a coincidence.

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Assad's forces fire Scuds in Syria escalation: U.S. official

WASHINGTON/BRUSSELS (Reuters) - Forces loyal to Syrian President Bashar al-Assad have fired Scud missiles at rebels trying to overthrow Syria's government, a senior U.S. official said on Wednesday, a step seen as an escalation in Assad's struggle to retain power.

U.S. officials said they were unaware of any previous instances in which Scuds were used against the rebels since the start of the 20-month-old uprising, which has killed more than 40,000 people.

White House spokesman Jay Carney declined to confirm the reports, saying he was aware of them but could not discuss intelligence matters.

"If true, this would be the latest desperate act from a regime that has shown utter disregard for innocent life," he said. "The idea that the Syrian regime would launch missiles in its borders at its own people is stunning, desperate, a completely disproportionate military escalation."

A senior U.S. official, speaking on condition of anonymity, said Scuds had been used.

In Brussels, a NATO official, who also spoke on condition of anonymity, said a number of "Scud-type" short-range ballistic missiles had been launched inside Syria in recent days.

"Allied intelligence, surveillance and reconnaissance assets have detected the launch of a number of unguided, short-range ballistic missiles inside Syria this week," the official said.

"Trajectory and distance travelled indicate they were Scud-type missiles," the NATO official said.

Thomas Houlahan, a military analyst at the Center for Security and Science, said the weapons were probably North Korean-made Hwasong-6 missiles, an improved variant of the original Soviet Scuds.

"In terms of the short-range battlefield missiles, they produce a pretty good missile and because of North Korea's constant need for hard currency, they sell them pretty cheap. So they have moved a lot of missiles around and Syria has ended up with a lot of them," Houlahan said.

"MORE ACCURATE"

He said the Hwasong-6 was more accurate than the original Scud, could carry a warhead of about 1,800 pounds (820 kg) and had a range of about 450 miles.

But he said the use of the weapon raised questions as to why the Syrians were not using their air force instead, which was a better alternative.

"If I want to dump 1,800 pounds of explosives on somebody with fairly decent accuracy and I have an air force and they don't, why the hell am I not using a plane?" Houlahan said.

"If you see a country or an army that has much better options not using them, you start to ask yourself why," he added. "Is it the old problem where dictators can't always trust their air forces?"

NATO agreed last week to send Patriot anti-missile systems to alliance member Turkey to reinforce its air defenses and calm its fears of coming under missile attack, possibly with chemical weapons, from neighboring Syria.

The NATO official said the Syrian missiles had landed inside Syria and no missiles had hit Turkish territory. He said the Western alliance had no information about what casualties or damage the missiles had caused.

Asked if there was any evidence of Syrian use of chemical weapons, he said: "We have no information concerning the payload."

U.S. President Barack Obama warned Assad last week not to use chemical weapons against Syrian opposition forces, saying there would be unspecified consequences if he did so.

The United States, Germany and Netherlands have all agreed to send Patriot missiles to protect Turkey, but the missile batteries are not expected to arrive for several more weeks.

The New York Times, which initially reported Syria's use of the missiles, quoted one official as saying more than six had been fired at the rebels. Another official said the missiles had been launched from the Damascus area at targets in northern Syria, the Times said.

U.S. officials, speaking on condition of anonymity, told Reuters they would not dispute the Times report.

News of Syria's use of Scud missiles broke as Western and Arab nations sympathetic to the uprising against Assad gave full political recognition to the opposition at a meeting in Morroco.

(Reporting by David Alexander in Washington and Adrian Croft in Brussels; Editing by Michael Roddy and David Brunnstrom)

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Birds, fish replace queen on Fiji currency

SUVA: Fiji dropped the image of Britain's Queen Elizabeth II from a new range of bank notes and coins, replacing her with plants and animals native to the Pacific island state.

Fiji President Ratu Epeli Nailatikau said on Wednesday the new currency was a milestone for the former British colony, which became independent in 1970 and declared itself a republic in 1987 following a military coup.

Nailatikau said the royal family had featured on Fiji's currency since 1934 but it was time for the country to move on and introduce new coins and notes, which will enter circulation in January.

"With the new series comes a little sadness for many of us," he said.

"We will witness a historical change. A change involving much feeling and sentiment and representing an emotional severance of a link to the British crown.

"But it is a change that is necessary. Our notes and coins will no longer feature the portrait of Her Majesty Queen Elizabeth II -- some will liken this to the dawning of a new era."

He said Fiji was "forever grateful" to the royal family for allowing it to use their likenesses on the currency, adding: "It is now time to move forward as we strive to create our own identity synonymous to what Fiji is all about."

Images on the polymer bank notes include the rare kulawai lorikeet, the beli fish and the tagimoucia flower, while the coins depict flying foxes, parrots and the banded iguana.

Reserve Bank governor Barry Whiteside said the new currency was more relevant to Fiji and would encourage pride in its environment.

"We've been a republic for 25 years, which means the queen has not been our head of state for 25 years," he said.

"We're just looking at the natural wonders around us and trying to reflect that in this issue."

- AFP/ck

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India successfully tests nuclear-capable surface-to-surface Agni-I missile

Bhubaneswar: India Wednesday carried out a successful test of its nuclear-capable surface-to-surface Agni-I missile from a military base in Odisha, an official said.

The intermediate-range ballistic missile, which can strike a target 700 km away, was tested from a facility on Wheeler Island near Dhamra in Bhadrak district, 170 km from here.

The test was carried out by the Strategic Forces Command of the Indian armed forces as part of a training exercise to ensure preparedness, director of the Integrated Test Range, M.V.K.V. Prasad, said.

"The mission was successful," he said.

Scientists from the Defence Research and Development Organisation (DRDO), which developed the missile, witnessed and supervised the test, Prasad added.

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