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2 police officers protecting Pakistan polio team shot dead

PESHAWAR, Pakistan (AP) — Gunmen on a motorcycle Wednesday shot and killed two police officers assigned to protect polio vaccination workers in northwest Pakistan before fleeing, police said.

The attack happened in the district of Mardan in Khyber Pakhtunkhwa province as the officers returned to a police station after providing security for the polio team, said Adnan Azam, a senior police officer.

No one claimed responsibility for the attack, which came two days after Pakistan launched a nationwide drive to eradicate the crippling disease by the end of the year. Azam said a search for the attackers was underway and all the polio workers were safe.

Pakistani militants often target polio teams and police assigned to protect them claiming the vaccination campaigns are a Western conspiracy to sterilize children.

Pakistan and neighboring Afghanistan are the only two remaining countries in the world where polio is endemic, after Nigeria was last year declared free of the virus.

In Lebanon, a search for medicine and a stranger’s help

To all the struggles of life in Lebanon — the pandemic, the power outages, the inflation, the punishing financial and political crises — add one more: shortages of crucial medications.

But as residents struggle to find the medicines they need, some are finding that their fellow Lebanese are doing what they can to help.

Christiane Massoud, a 41-year-old nurse, scoured pharmacies for an elusive drug to manage her Crohn’s disease, had friends around the country search on her behalf and asked her doctor if there was a substitute. She also appealed to strangers online for pointers to track it down.

Nada Waked responded to one of those online pleas: She had a small amount that her mom no longer needed. Massoud offered to pay; Waked and her mom declined the money. Instead, Waked asked for a prayer.

In this bleak landscape, Massoud found in Waked’s gesture a bright spot.

“It showed that we are a people who stand by one another and feel for one another,” she said. “There are still people who help each other out.”

As the country’s crises deepened, pharmacist Chadi Geha said he noticed more were eager to help strangers. Some of his customers started refusing to take back change, asking him instead to use the cash to pay for the medications of others in need.

“That didn’t happen before,” he said. “You feel like there’s still good in the world. … They don’t even want to know who they’re helping; they just care about helping.”

But money or no money, Geha has had to turn away many customers as more medications became unavailable, shortages that had been exacerbated by panic buying and by some suppliers holding on to the drugs. The difference between the official and black-market dollar rates has also fueled smuggling of subsidized drugs out of the country.

In late May, Lebanon’s central bank said it could not continue with its subsidies of medical items without dipping into the mandatory reserves, hard currency deposits parked by local lenders at the bank, and asked authorities to find a solution.

Geha started closing the pharmacy early. “I’m tired of telling people we’re out of this and out of that.”

Frantic pleas for tracking down medications abound on LibanTroc, the Facebook group where Massoud and Waked connected. Members point some to organizations who may have the drugs or to pharmacies they know carry them.

“We’ve seen amazing interaction and a lot of good deeds that keep us from working on migrating elsewhere, as we’re still trying to fix whatever remains of our wounded roots,” said Hala Dahrouge, founder of LibanTroc, which has evolved into a nongovernmental organization facilitating different kinds of assistance and requests.

Massoud thinks of others who may not know how to navigate social media like she did to find medications. She’s thinking of moving her family out of the country, but amid the despair of life in Lebanon, she takes heart from the ways, small and big, in which many are helping strangers.

Waked said that even though she has no extra means to help others financially, she still wanted to offer a little relief.

“I know very well that if you give from the heart, God will provide for you whenever you are in need,” she said. “I gave from the heart.”

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Associated Press writer Bassem Mroue in Beirut contributed.

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“One Good Thing” is a series that highlights individuals or groups whose actions provide glimmers of joy in hard times — stories of those who find a way to make a difference, no matter how small. Read the stories at https://apnews.com/hub/one-good-thing

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Associated Press religion coverage receives support from the Lilly Endowment through The Conversation U.S. The AP is solely responsible for this content.

UK court rules government acted unlawfully in contract award

LONDON (AP) — Britain’s High Court ruled Wednesday that the U.K. government acted unlawfully in awarding a contract to a company run by friends of the former top adviser to Prime Minister Boris Johnson.

In her ruling, Judge Finola O’Farrell found that a June 2020 decision by Cabinet Office minister Michael Gove to pay more than 500,000 pounds ($700,000) to market research firm Public First “gave rise to apparent bias and was unlawful.”

The case was brought by the Good Law Project, a legal campaigning group which argued that Dominic Cummings, Johnson’s then-chief adviser, wanted focus group and communications support services work to be given during the coronavirus pandemic to a company with executives who were his friends.

Critics have accused the Conservative government of taking shortcuts in awarding contracts during the early months of the pandemic to the benefit of close friends, supporters and associates.

“This is not government for the public good. It is government for the good of friends of the Conservative Party,” Good Law Project director Jo Maugham said. “We just don’t understand how the prime minister can run a Cabinet that acts without proper regard for the law or value for public money.”

The government and Cummings, who left his job in late 2020, denied any favoritism was shown and said decisions had to be made in haste early in the coronavirus pandemic.

Lawyers representing the Cabinet Office, which awarded the contract, had argued that, during a national emergency, Cummings “recommended a firm he knew could get the job done.”

The judge said the “failure to consider any other research agency, by reference to experience, expertise, availability or capacity, would lead a fair-minded and informed observer to conclude that there was a real possibility, or a real danger, that the decision-maker was biased.”

A spokesperson for Public First said the company was “deeply proud of the work we did in the early stages of the pandemic, which helped save lives.”

Peru’s presidential runoff election too close to call

LIMA, Peru (AP) — A rural teacher-turned-political novice and the daughter of an imprisoned former president traded the lead Monday in a tight race for Peru’s presidency in a runoff election as the coronavirus pandemic continues to batter the Andean country.

With 96% of ballots tallied, leftist Pedro Castillo had 50.2% of the vote, while conservative Keiko Fujimori had 49.7%, according to official results. This is Fujimori’s third run for president, a role her father held in the 1990s.

The difference between the two polarizing candidates was just over 87,000 votes. The figures released by Peru’s elections agency, the National Office of Electoral Processes, included almost all votes cast near the country’s electoral processing centers. The agency was still waiting for the arrival of votes from remote rural areas and abroad.

“No one can say for sure at this point who is going to win,” Fernando Tuesta, a political scientist at the Pontifical Catholic University of Peru and former Peruvian elections chief, told a local radio station. In 2016, now-former President Pedro Pablo Kuczynski defeated Fujimori by just 42,597 votes.

The partial map of votes showed a country split in two. Castillo overwhelmingly dominated the impoverished rural areas of the Andes and much of the Amazon. Fujimori was the candidate of the business elite, dominating the capital and other cities on the Pacific coast.

The cities hardest hit by the Shining Path rebel group during Peru’s internal conflict between 1980 and 2000, which left almost 70,000 people dead, voted for Castillo. It was an adverse result for Fujimori, who during the campaign accused the professor without evidence of ties to terrorism.

The areas where international mining companies are seeking to expand extractive projects also voted almost entirely for Castillo. In the country’s poorest district, Uchuraccay, the teacher captured 87% of the votes, while in the richest district, San Isidro, Fujimori prevailed with 88%.

Fujimori, at a news conference, charged that her rival’s campaign staff carried out a “a series of irregularities” during the election, but she did not present conclusive evidence. She predicted her support would increase when votes from Peruvians living abroad were counted.

Meanwhile, Castillo told supporters that the “popular will” should be respected.

“I will be the first to enforce the will of the Peruvian people, here and there,” he said.

The polarizing populist candidates have promised coronavirus vaccines for all and other strategies to alleviate the health emergency that has killed more than 180,000 people in Peru and pushed millions into poverty. The election followed a statistical revision from Peru’s government that more than doubled the COVID-19 death toll previously acknowledged by officials.

Voters across Peru, where voting is mandatory, headed to the polls throughout Sunday under a set schedule meant to minimize long lines. Pre-election polls indicated the candidates were virtually tied heading into the runoff. In the first round of voting, featuring 18 candidates, neither received more than 20% support and both were strongly opposed by sectors of Peruvian society.

“The candidate who becomes (president), either Keiko or Pedro, the people, the only thing we have to do is accept it, but they better govern well,” said Lucia Carrion, a street vendor in Lima. “There is so much corruption. One of them has to stop so much corruption that there is here in Peru.”

The pandemic not only has strained Peru’s medical and cemetery infrastructure, left millions unemployed and highlighted longstanding inequalities in the country. It has also deepened people’s mistrust of government as it mismanaged the COVID-19 response and a secret vaccination drive for the well-connected erupted into a national scandal.

Amid protests and corruption allegations, the South American country cycled through three presidents in November. Some analysts warn this election could be another tipping point for people’s simmering frustrations and bring more political instability.

President Francisco Sagasti after voting said the candidates should respect the results and ask their followers to refrain from staging protests over the outcome.

Fujimori, a former congresswoman, has promised various bonuses to people, including a $2,500 one-time payment to each family with at least one COVID-19 victim. She has also proposed distributing 40% of a tax for the extraction of minerals, oil or gas among families who live near those areas.

Keiko Fujimori herself has been imprisoned as part of a graft investigation though she was later released. Her father, Alberto Fujimori, governed between 1990 and 2000 and is serving a 25-year sentence for corruption and the killings of 25 people. She has promised to free him should she win.

Castillo until recently was a rural schoolteacher in the country’s third-poorest district, deep in the Andes. The son of illiterate peasants entered politics by leading a teachers’ strike. While his stance on nationalizing key sectors of the economy has softened, he remains committed to rewriting the constitution that was approved under the regime of Fujimori’s father.

Both candidates oppose abortion and same-sex marriage.

Peru is the second largest copper exporter in the world and mining accounts for almost 10% of its GDP and 60% of its exports, so Castillo’s initial proposal to nationalize the nation’s mining industry set off alarm bells among business leaders. But regardless of who gets picked to succeed Sagasti on July 28, investors will remain skittish.

The stock market in Lima registered declines of more than 7% and, complying with its regulations, closed its operations for 20 minutes and then reopened. The dollar exchange rate also reached a record high.

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Associated Press writer Regina Garcia Cano reported this story from Mexico City and AP writer Franklin Briceno reported in Lima.

EXPLAINER: How will insurers cover a new Alzheimer’s drug?

Federal regulators have approved the first new drug for Alzheimer’s disease in nearly 20 years, leaving patients waiting to see how insurers will handle the pricey new treatment.

Health care experts expect broad coverage of the drug, which was approved Monday. But what that means for patients will vary widely depending on their insurance plan. In some cases, that could mean coming up with several thousand dollars to pay for what the insurer didn’t cover.

And there’s no guarantee that every case will be covered.

Here’s what you need to know:

WHAT WAS APPROVED?

The Food and Drug Administration said it granted approval to a drug from Biogen based on clinical research results that seemed “reasonably likely” to benefit Alzheimer’s patients.

It’s the only drug that U.S. regulators have said can likely treat the underlying disease, rather than just manage symptoms. The new drug, which Biogen developed with Japan’s Eisai Co., did not reverse mental decline. It slowed it in one study.

The FDA’s decision came despite the conclusion of its advisory committee that there wasn’t enough evidence that the drug slowed the brain-destroying disease.

WHAT DOES IT DO?

It aims to help clear harmful clumps of a protein called beta-amyloid from the brain. The medication will be marketed as Aduhelm and is to be given as an infusion every four weeks.

WHAT WILL IT COST?

Biogen said the drug would cost approximately $56,000 for a typical year’s worth of treatment, and it said the price would not be raised for four years.

HOW WILL INSURERS COVER IT?

They will likely request some documentation first that the patient needs the drug. Many plans will require doctors to submit records and other paperwork justifying the treatment before they agree to cover it.

Insurers also will likely require pre-approval for brain scans needed to determine that the patient is a candidate for treatment, said Lance Grady of Avalere Health consultants.

He noted that some plans also may want to see the results of a scan before they decide to cover the next infusion, which could delay treatment.

IS COVERAGE GUARANTEED?

Medicare is widely expected to cover the treatment. Insurers that offer private or commercial coverage also will pay for care that doctors deem medically necessary.

That may not mean every case, though. If the treatment is proposed for a patient with advanced Alzheimer’s, and research shows the drug isn’t effective in that population, then the insurer may not pay for it.

“That happens all the time with drugs,” said Robert Laszewski, a health care consultant and former insurance executive. “Just because the FDA says its safe doesn’t mean it’s appropriate for everybody.”

WHAT WILL PATIENTS PAY?

That’s impossible to say broadly.

It can depend on the person’s coverage and their out-of-pocket maximum, which is a plan’s limit for how much a patient pays in a year for in-network care before insurance picks up the rest of the bill.

Some patients who are already receiving a lot of care may not wind up with a huge added expense from the drug before they hit that limit.

Patients who have a supplemental plan for their Medicare coverage also may wind up with few out-of-pocket costs for the drug.

Patients with Medicare Advantage coverage, which is run by private insurers, or individual health insurance could pay several thousand dollars before they hit their plan’s annual limit, depending on the plan.

“That could be very burdensome for someone, especially if a person is looking at this cost every single year, and they don’t have an option to get a better health plan,” said Stacie Dusetzina, an associate professor at Vanderbilt University and drug pricing expert. “It can add up.”

ARE THE DRUGMAKERS HELPING?

Cambridge, Massachusetts-based Biogen plans to begin shipping millions of doses within two weeks.

The company says it will help patients figure out their options for financial assistance and find providers and care infusion sites. The drugmaker also is offering programs to help reduce the out-of-pocket cost for some patients with commercial coverage.

But people with Medicare and Medicare Advantage coverage cannot get drugmaker discounts like that. Health care researchers say most of the people who will need this drug will have some form of Medicare coverage.

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Follow Tom Murphy on Twitter: @thpmurphy

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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