Features

As a winter chill descends over Amman and the temperatures dip to the lowest of lows, one strives to make the best of the cold bonanza. Crisp sunshine marks our mornings and afternoons, and it is a delight to walk outdoors under the clear blue sky. Evening approaches earlier than intended and by six, the envelope of darkness is near complete. Dinner parties start commencing at a reasonable time and it is no longer scandalous for the invite to read 7pm, or the guests to turn up on the dot of the appointed hour.

Watching movies in winter also has a different charm because matinee shows become easily manageable. Why so? Well, if it gets dark earlier one goes to bed earlier and after the requisite eight hours, one surfaces earlier, so you see how well it all works?

If I have to recommend “Charlie Wilson’s War” or “A Beautiful Mind” as the top two most rented movies of all time, I’m afraid I will urge you to see both. If the former has Tom Hanks and Julia Roberts, the latter has Russell Crowe in one of his finest and most exceptional roles, playing John Forbes Nash Jr, a Nobel Laureate and genius mathematician who suffers from schizophrenia.

There are some films where the actors enacting certain characters perform to such a high level of perfection that they almost replace the original in the eyes of the viewer. I do not exaggerate when I say that if I were to picture the real John Nash, who is till today a senior research mathematician at Princeton University, I’m sure I would have him look like Russell Crowe.

His walk, talk, mannerisms, gestures, his shyness or arrogance, his mutterings, his vacant look, all of it is done brilliantly. Crowe does not act the character, he becomes this character. The movie, when released in 2002, won four Oscar awards and was nominated for another eight. The only regret is that the Academy did not deem it fit to award Russell Crowe for his performance of a lifetime. But as DVD’s go, this is the most borrowed movie according to my rental library, and one has to book the film well in advance if one wants to have a chance at viewing it.

On another note, I was invited for a simulated flight recently.

A trip to this side of the airport is a first for me and upon entering the building I am immediately taken around the training classrooms, briefing rooms, CBT-computer based instruction rooms, and refreshment area. Then I continue to the spot where the three flight simulators are housed. Training is in progress in two of them. I am requested to enter the third empty cabin.

Gary, who is an engineer by profession, takes me on my first simulated flight. The interior of the cubicle resembles an airplane cockpit. The screen projections, the visual systems and the computer graphics are identical to the original ones to provide a realistic environment during training, says Gary.

With the turn of a switch or the push of button difficult scenarios like engine failure, system malfunction, sudden turbulence, extreme weather conditions, bird hits, or emergency landing, can be simulated.

I am an amateur pilot for the next hour and discover a number of hidden talents. I take an uneven u-turn, almost crash the flight thrice, and then proceed to make the smoothest landing on autopilot.

Born to fly? Yes, I know! 

PARIS — Surging air pollution from China and other fast-growing Asian economies has intensified winter cyclones in the northwest Pacific, scientists said Tuesday.

Winter cyclones in latitudes including northwestern China, Korea and Japan have packed stronger winds and more rain as a result of rising levels of particulate pollution, they said.

The dusty fallout affects how moisture develops in clouds and how heat is distributed in storm systems, said Yuan Wang of the prestigious Jet Propulsion Laboratory at the California Institute of Technology.

"The significant change of the Pacific storm intensity was estimated to start in the middle of the 1990s," Wang told AFP by e-mail.

"(This was) when industrial plants, power plants and automobiles produced huge amounts of air pollutants, along with the booming economy, in many Asian countries like China."

The study, published in the journal Nature Communications, is the latest probe into the environmental hazard from particulates, which are mainly the sooty residue from burning fossil fuels.

Aerosols accelerate the formation of droplets because they provide a nucleus on which water vapour condenses, according to Wang's investigation.

Clouds influenced by aerosols carry as much as four times more droplets, leading to a roughly 7 per cent increase in rainfall across the region, it found.

The aerosols are also likelier to encourage the formation of brighter high-altitude cirrus or "anvil" clouds.

These are a type of cloud that help to warm the sea surface, thus providing heat to fuel cyclones. The additional warming effect can be as much as 11 per cent.

The scientists drew up a computer model to simulate aerosol pollution flowing downwind from east Asia to a cyclonic breeding ground east of Japan in January and February, a zone lying north of 30 degrees latitude.

They found a good match with two decades of satellite data: 1979-1988 — before the Asian economic boom got underway — and 2002-2011, when growth really hit its stride, especially in China.

In the latter period, there was a clear rise in cyclone intensity but no change in frequency of storms or location, said Wang.

On January 16, a study led by Chang-Hoi Ho from Seoul National University in South Korea found that China, Korea and Japan had been hit by more powerful cyclones between 1977 and 2010, due to a warming of water in the tropical western Pacific.

The two investigations are not comparable, Wang said.

The first looked at cyclones forming in winter time in mid-latitude in the northwest of the ocean, and the second examined cyclones in the summer and autumn that form in tropical latitudes.

Research into the effect of aerosols on clouds has returned highly variable findings — indeed, it is considered to be one of the biggest areas of uncertainty in climate science.

WASHINGTON — Forever thin, effortlessly chic, a culinary goddess with well-behaved children raised on broccoli — a certain image of French women thrives in the United States, or at least in its bookstores.

“French Women Don’t Get Facelifts” is the latest addition to an ever-growing list of self-help books that lay bare the secrets of the sophisticated French mademoiselle to her awkward American sister.

For American women, “France has always been a country of chic, fashion, seduction, savoir-faire and charm,” said the author, Mireille Guiliano, whose previous book “French Women Don’t Get Fat” was a best-seller in 2004.

“I don’t want to give the impression of saying that we’re better or superior,” added Guiliano, 67, a former chief executive of Veuve Clicquot champagne who is married to an American and lives in New York, Paris and the south of France.

“It’s not a matter of who’s right or wrong,” she told AFP. “I just try to say that there are other options. I make suggestions. The American woman is curious to know how to make something better or different.”

Guiliano is something of a pioneer in the genre of self-help books with a French accent, having built on the success of “French Women Don’t Get Fat” with cookbooks and lifestyle guides for Americans forever wrestling with their work-life balance.

From other writers, the past year has seen such titles as “French Twist Cupcakes: 32 Recipes for that Ooh La La Experience” by Lyon-based baker Lucinda Segneri, “How to be Chic and Elegant: Tips from a French Woman” by Marie-Anne Lecoeur, and “Forever Chic: Frenchwomen’s Secrets for Timeless Beauty, Style and Substance” by Tish Jett.

Last year, American author Pamela Druckerman touched off something of a minor national debate when she came out with “Bringing Up Bébé”, which celebrated the upbringing of French children who, she argued, learned how to say hello and eat vegetables.

‘Look for simplicity’

“We aren’t envious, but curious,” said Jennifer Scott, whose 2012 book “Lessons from Madame Chic: 20 Stylish Secrets I Learned While Living in Paris” was inspired by her stint as an exchange student in the French capital.

French women, Scott said, “don’t appear to be worried about trends or what other people think of them. In fact, with regard to style, living and ageing, they don’t appear to be worried at all. I think that’s something we can all admire.”

Jean Beaman, a sociologist at Duke University, said it’s true that many American women perceive their French counterparts to be “fashionable and stylish (and) beautiful in an sort of effortless way”.

By way of example, she cited photographs of former French first lady Carla Bruni-Sarkozy, who was born in Italy but grew up in France from the age of seven.

But Beaman, who studies immigrants who settle in France, added: “As an American, it’s sometimes a little bit frustrating that these books sort of paint a very idealised version of France to Americans, and don’t necessarily reflect the multi-ethnic diversity that exists in France.”

Indeed, the kind of French woman who informs these self-help books is typically Parisian and living in the capital’s better neighborhoods.

“Of course, there are French women who are fat and who undergo cosmetic surgery,” said Guiliano, “but not to the scale that’s seen among American women — far from it.”

Guiliano is known as “the high priestess of French lady wisdom” and her latest book — which comes as American baby boomers settle into middle age — is subtitled “The secret of ageing with style and attitude.”

She’s horrified by the notion of Botox (“I say ‘non’ to the needle”) and proposes in its place robust skin moisturising, daily exercise and an “anti-ageing food prescription” that includes beet mille-feuille, tartare of cucumber and tomatoes, and chocolate souffles with piment d’Esplette.

Most of all, she tells American women, just shift your attitude, stop living in extremes, and start accepting yourself for who you are.

“My advice is first of all to look for simplicity,” she said. “The older you get, the more you appreciate that less is better.”

With the new 2015 generation Mercedes C-Class just revealed and due to go on sale later this year and to then be followed by high performance AMG and coupe version, the current Mercedes AMG C63 Edition 507 Coupe, is in fact the swan song for both the outgoing C-Class and is the last car expected to retain its glorious 6.2-litre naturally aspirated V8 powerhouse. Launched last year, the Edition 507 version of this most inspired of Benz bruisers is the second most powerful version of the C63, considerably more powerful than the common, garden-variety C63 and falling just short of the Black Series version’s output and performance.

Designated to reflect its 507PS continental European horsepower rating, the 507 Edition’s burly large displacement V8’s output translates to 500BHP developed at a haughty 6,800rpm, while a gut-wrenching 450lb/ft of torque twist force is generated by 5,200rpm. Mercedes’ in-house tuner AMG’s first specially designed engine, the 6.2-litre V8 brute was first introduced in 2006 to combine copious power and torque output with a racier engine speed and more precise throttle control, but is now being phased out in favour of more efficient but lower-revving and smaller twin-turbo V8s, including an expected four-litre unit for the AMG version of the forthcoming C-Class.

Unrelenting surge

While there have been more powerful iterations of Mercedes AMG’s 6.2-litre powerhouse motor, the Edition 507’s 500BHP output is a healthy dose more powerful than the standard C63’s 451BHP and the performance package version’s 480BHP. Additionally the C63 Edition 507 benefits from a new engine control system and the use of engine internals borrowed from the AMG SLS-Class supercar. Fitted with the SLS’ forged pistons and lightweight crankshaft, the Edition 507’s benefits from a three kilogramme weight reduction and reduced mass inertia, which makes it even more eager to be revved hard, and would be expected to translate to slightly more precise and responsive engine speed control.

Brawny and brutal, the Edition 507’s vast and muscular V8 mill responds with whip-crack eagerness and lunge the smart executive-class super coupe from standstill to 100km/h is a scant 4.2-seconds. With deep-lunged and metallic bark developing into a bass-heavy growl and relentless howl, the Edition 507 pulls with a ferociously progressive consistency from idling to its high rev redline. Effortlessly versatile and with electrifying responsiveness, the C63 Edition 507 overtakes with finger-snap swiftness and ease when on the move, and indefatigably charging past the 200km/h mark, as tested at Abu Dhabi’s Yas Marina Formula One circuit — with driver’s package, top speed is derestricted from 250km/h to 280km/h.

Connected and controlled

With such explosive power delivered to the rear wheel, it is all too satisfyingly easy to chirp the fat rear 255/30R19 tyres if launching aggressively, before a combination of electronic traction and safety controls and a mechanical limited-slip differential modulate power and traction. Best launched with a smooth and consistent throttle application, the Edition 507 is phenomenally quick off the line, while through hard and fast corners, its limited-slip differential distributes more power to the driven rear wheel with more traction, to avoid slippage and ensure power is effectively translated to forward momentum. Electronic stability control interventions were as effective as ever, but however seemed to be more subtle.

A personal favourite among AMG’s prodigiously powerful line-up, the C63 Edition 507’s high-revving engine allows for long-legged reach within each of its’ gearbox ratios, and with greater consistency and linearity than a surging turbocharged engine, allows one to more precisely dial in power through corners. The result is a more connected and intimate driving experience, where one better manages power and mechanical traction, to drive at the edge of the C63’s handling and grip, rather than rely on electronic stability interventions. The big high-revving naturally aspirated engine is also better suited to AMG’s seven-speed automatic gearbox’ manual paddle shift function and can drive so with greater fluidity, consistency and intuitiveness.

Lively and consistent

The consistent low-end delivery and tall redline mean one doesn’t unintentionally downshift into a turbocharged engine’s lag-prone low-rev engine speeds or run into the rev limiter easily, and help make the Edition 507 AMG’s most involving and engaging driver’s car, next to the SLS-Class flagship. Gearshift response levels including “comfort” and “sport” settings for road driving, but “Sport+” automatic mode is most aggressive, with early downshifts and late upshifts keeping the engine on boil and ever-ready in its high rev sweet spot. Large, powerful ventilated and perforated disc brakes well contain the enormous forces available, shaving speed with stark promptness, and during the demanding track-based driving session, seemed better fade-resistant than heavier AMG models.

Impeccably stable at high speeds as is to be expected, the C63 Edition 507 is however a livelier, more responsive and connected cornering driver’s car than it more powerful and four-wheel-drive AMG stable-mates, and relies more on intimate detail and finess than sheer grip. Eager and crisp into a corner, the Edition 507’s steering is quick, well-weighted and precise, while body control is superbly taut, and remains so even through the sudden oscillitating weight transfers of a tight slalom circuit. Agile yet reassuringly planted, the Edition 507 delivers faithfully high levels of grip when coming back on power mid-corner or through long sweepers. Ride quality is firm and smooth, with buttoned-down vertical control.

Muscular and classy

A handsome and high-class hell-raiser, the AMG C63 Coupe strikes an athletic and vigorous stance, with its bulging wheel arches, gaping bumper air intakes and fat low profile footwear sit well with and complement its smooth and rakish roof arc, long bulging bonnet and curt boot. Though not as aggressively decked out as the 2012 Black Series, the Edition 507 does incorporate the said model’s prominent dual bonnet vents designed to help extract engine heat to the atmosphere. The Edition 507 also receives special alloy wheel designs, side graphics and high gloss black grille surround, rear spoiler and mirror covers to distinguish itself from the regular C63 Coupe.

A 2+2 coupe with better than expected rear accommodation, the C63’s cabin features supportive front sports seats and good space, but the low roof line does limit headroom for taller drivers if a helmet is worn during track driving. Ergonomic and classy inside, the Edition 507 features large speedometer dial and a grippy suede-like flat bottom and top steering wheel, while seat and steering adjustability is extensive. Safety and mod con amenities are extensive, including an optional Bang & Olufsen sound system, while function and control layouts are user-friendly. Sporty and classy, the Editon 507 features quality interior fit and finish, with contrasting leather upholstery stitching, piano black panels and metallic accents.

SPECIFICATIONS

Mercedes-Benz AMG C63 Edition 507 Coupe

Engine: 6.2-litre, V8-cylinders

Bore x stroke: 102.2 x 94.6mm

Compression ratio: 11.3:1

Valve-train: 32-valve, DOHC, variable timing

Gearbox: 7-speed wet-clutch automatic, rear-wheel-drive, limited-slip differential

Gear ratios: 1st 4.38:1; 2nd 2.86:1; 3rd 1.92:1; 4th 1.37:1; 5th 1:1; 6th 0.82:1; 7th 0.73:1

0-100 km/h: 4.2-seconds

Maximum speed: 280km/h (electronically governed)

Power, BHP (PS) [kW]: 500 (507) [373] @ 6,800rpm

Specific power: 80.5BHP/litre

Power-to-weight: 289BHP/ton

Torque, lb/ft (Nm): 450 (610) @ 5,200rpm

Specific torque: 98.2Nm/litre

Fuel consumption, combined: 12-litres/100km

CO2 emissions, combined: 280g/km

Fuel capacity: 66-litres

Length: 4,707mm

Width: 1,795mm

Height: 1,391mm

Wheelbase: 2,765mm

Track, F/R: 1,569 / 1,525mm

Headroom, F/R: 1,019 / 901mm

Boot capacity: 450-litres

Kerb weight: 1,730kg

Steering: Variable power assistance, rack and pinion

Turning circle: 11.1-metres

Suspension: Multi-link, coil springs, gas-charged dampers, anti-roll bar

Brakes: Ventilated & perforated discs

Tyres, F/R: 235/35R19 / 255/30R19

PARIS — Heart disease and stroke have replaced infectious disease as the top causes of early death in the Arab world, tracking the West in a trend towards lifestyle disorders, The Lancet reported Monday.

An international consortium of scientists compared the state of health in the 22 countries of the Arab League in 1990 and in 2010, using data from a vast study — the 2010 Global Burden of Diseases report.

In 1990, respiratory infection headed the list of concerns, accounting for 11 per cent of deaths, while stillbirths and poor nutrition also featured high on the mortality list.

These problems still persist in the low-income countries of the Comoros, Djibouti, Mauritania, Somalia and Yemen, the investigators found.

But overall, infectious diseases — with the exception of HIV — have receded, the paper said.

By 2010, the No. 1 cause of death in Arab countries was heart disease, which was implicated in 14.3 percent of cases. In 1990, it had ranked second.

Next on the mortality list was stroke, followed by respiratory infection, diarrhoea, diabetes, road injuries and cirrhosis, respectively.

The report also pointed to depression, anxiety, domestic violence, lower back pain and neck pain as common and growing sources of ill health — all signs of a region “undergoing a major epidemiological transition”.

“Indeed, the epidemiological profile closely resembles that of western Europe, the USA and Canada,” it said.

“Today, disorders related to drug and alcohol use are causing more premature death and disability in the Arab world than they were two decades ago.”

“Road injuries have taken a growing toll on health,” it added.

“The region has also seen a rapid increase in injuries associated with interpersonal violence and self-harm, but a decline in injuries from fire, drowning and poisonings.”

Despite the change, “the Arab world has made great progress” in increasing life expectancy and reducing infant mortality and maternal deaths, it said.

The report noted that its source material predated most of the events of the Arab uprising.

In some countries, the turbulence could have a big impact on health, said its authors.

“Many of the successes that we report here might now be lost because of war and a shortage of health services such as sanitation, surveillance and immunisation programmes, leading to disease outbreaks.”

PARIS — Sunlight may help to reduce high blood pressure, a danger factor for heart attacks and stroke, a study published in a specialist journal said on Monday.

British researchers found exposure to sunlight alters the level of nitric oxide in the skin, dilating blood vessels and thus easing hypertension.

“Small amounts of NO [nitric oxide] are transferred from the skin to the circulation, lowering blood vessel tone,” said Martin Feelisch, a professor of experimental medicine at the University of Southampton in southern England.

“As blood pressure drops, so does the risk of heart attack and stroke.”

The team analysed 24 volunteers who were exposed to ultraviolet (UVA) light from tanning lamps for two 20-minute sessions.

In one session, the volunteers were exposed to both the UVA rays and the heat of the lamps.

In the second, the UV was blocked so that only the heat of the lamps affected the skin.

The findings back up data about blood pressure and cardiovascular disease, which are known to vary according to season and latitude.

Higher levels are observed in winter and in countries that are farther from the equator, where ultraviolet from the sun is lower.

“These results are significant to the ongoing debate about potential health benefits of sunlight and the role of Vitamin D in this process,” Feelisch said in a press release.

“Avoiding excess sunlight exposure is critical to prevent skin cancer, but not being exposed to it at all, out of fear or as a result of a certain lifestyle, could increase the risk of cardiovascular disease.”

Agency and Gender in Gaza: Masculinity, Femininity and Family during the Second Intifada
Aitemad Muhanna
UK/US: Ashgate Publishing Co., 2013, 208 pp

After much effort by scholars and activists in the Middle East, long-held stereotypes of Arab women as passive victims have given way to recognition of their agency. This book goes further to examine the multiple dimensions and effects of women’s agency in times of chronic crisis and impoverishment, as experienced in Gaza during the Second Intifada. Having grown up in Gaza and engaged in feminist activism and research on women for over two decades, Aitemad Muhanna is more than qualified to address this topic. Indeed, she breaks new ground and challenges many prevalent assumptions.

 The study’s groundbreaking findings emerge from the in-depth interviews, life histories and focus groups which the author conducted in 2007-2008 with sixty poor and vulnerable women, aged 18 to 65, all classified as housewives, from Beach Camp and the El Shujaeya neighborhood, supplemented by focus groups with 36 men. Thus, Muhanna gives voice to those who are often the objects of research and statistics but seldom asked how they evaluate their own agency. She concentrates on the women as individuals and on their subjectivity — their self-image, desires, goals and coping strategies.

 The overall context is the chronic livelihood crisis caused by Israel closing its borders to Palestinian workers, and further exacerbated by Gaza’s subsequent international isolation. Coming in the wake of decades of Israeli measures to destroy and subordinate the local economy, the closure led to mass unemployment among men. Muhanna describes the resulting reconfiguration of gender roles and power between men and women, and between generations, asserting that this unleashed a crisis of both femininity and masculinity. The most obvious change was that women became the sole providers for poor families; at the same time, shrinkage of the local market restricted opportunities in the informal economy on which they had previously relied to cope with financial difficulties. As a result, providing for the family was most often achieved by women obtaining coupons and sometimes short-term jobs from community-based organisations. To fulfil these tasks, women gained more independent mobility, and due to their success in providing for their families, they acquired greater decision-making power.

 All the above fits into standard assumptions about women’s agency, but the surprise comes when the women are asked how they feel about their new role. Across the board, they find it humiliating to have to go out and seek coupons, and would prefer to return to former times when “men were men,” i.e., provided for the family, and women stayed home and cared for the house and children. Partly, their reaction can be explained by the wish to avoid the humiliation of poverty and depending on charity, plus the new situation overburdens women as they continue to be responsible for housework and childcare, but the recurring expressions of the desire for men to be in charge cannot be dismissed. As Muhanna puts it, the overarching question posed by her findings is: “Why are women in Gaza interested in maintaining the image of male domination despite the actual power that they wield?” (p. 30)

Muhanna prefaces the report on her own research by an analytical review of feminist literature about whether increased agency leads women to challenge the patriarchal system or only to bargain for a better position within it. She rejects this either/or approach in favour of intersectional feminism which views women’s agency and subjectivity as situational, changing and influenced by many factors, such as history, economics, politics, class, nationality and state policy, and not only patriarchy and Islam. “I would argue that the enactments of bargaining and compromise by women — including those based on internalising their gender oppression — are a reflection of their conscious assessment of the situations in which they live and of a prioritisation of their own interests and desires. Women resist change in certain contexts because they are conscious of the social and moral rewards of acting within the existing gender order.” (p. 52) In the case of the women she studied, connectedness to family and community rank higher than individual power and mobility as would be supposed by liberal feminists.

Besides gender issues, this book provides much  information on Gaza and Palestine’s history, the effects of Israeli colonialism, the function of family and kinship in Palestinian society, resistance to the occupation, and how the poor cope with prolonged crisis. While Muhanna warns against generalisations, it would be interesting to apply her approach to women’s agency in other situations, whether in the Middle East or farther afield.

PARIS — Humans face the very real risk of a future without antibiotics, a world of plummeting life expectancy where people die from diseases easily treatable today, scientists say.

Experts tracking the rise of drug resistance say years of health gains could be rolled back by mutating microbes that make illnesses more difficult and expensive to cure and carry a higher risk of death.

Some say the threat to well-being is on the scale of global warming or terrorism — yet resistance is being allowed to spread through an entirely preventable means — improper use of antibiotics.

"It is a major public health problem," Patrice Courvalin, who heads the Antibacterial Agents Unit of France's Pasteur Institute, told AFP.

"It is about more than not being able to treat a disease. It will erase much progress made in the last 20-30 years."

Without antibiotics to tackle opportunistic bacteria that pose a particular risk for people who are very ill, major surgery, organ transplants or cancer and leukaemia treatment may become impossible, he explained.

"In some parts of the world, already we have run out of antibiotics," said Timothy Walsh, a professor of medical microbiology at Cardiff University.

"In places in India, Pakistan, Bangladesh, possibly Russia, Southeast Asia, central South America, we are at the end game. There's nothing left. And unfortunately there is nothing in the pipeline either."

Resistance to drugs emerges through changes in the bacterium's genetic code — altering the target on its surface to which antibiotics would normally bind, making the germ impenetrable or allowing it to destroy or "spit out" the antibiotic.

These super-germs triumph through Darwinian pressure, helped by humans.

The wrong antibiotics, taken for too short a period, in too low a dose or stopped to early, will fail to kill the altered microbes.

Instead, the drugs will indiscriminately damage other bacteria and give the resistant strain a competitive advantage — allowing it to dominate and spread.

At the base of the problem is doctors prescribing antibiotics wrongly or unnecessarily, and the ease with which medicines can be obtained without a script in some parts of the world, including Asia and Africa.

As much as 70 per cent of antibiotics are given for viral infections, against which they are wholly ineffective, the experts say.

Then there is the problem of farmers in countries like the United States adding antibiotics to animal feed to help herds grow faster.

Compounding all of this is the rise in global travel — a boon for bacterial spread, and a sharp drop in antibiotics development blamed on a lack of financial incentives for the pharmaceutical industry.

A return to the

pre-antibiotic era?

The World Health Organisation (WHO) says drug resistance "threatens a return to the pre-antibiotic era".

"Many infectious diseases risk becoming untreatable or uncontrollable," it states in a factsheet on antimicrobial resistance.

A case in point: Some 450,000 people developed multi-drug resistant (MDR) TB in 2012 and 170,000 died from it. MDR TB does not respond to the most potent TB drugs — isoniasid and rifampin.

Nearly 10 per cent of MDR cases are thought to be of the even deadlier XDR (extensively drug resistant) variety which does not respond to a yet wider range of drugs.

Like other drug-resistant microbes, MDR and XDR TB can be transferred directly between people — you can get it even if you have never taken antibiotics in your life.

"Antibiotic resistance is an emerging disease and a societal problem. The use you can make of an antibiotic depends on the use made by others," said Courvalin.

Another worry for health planners today is the spread of a multi-drug resistant strain of the bacterium Klebsiella pneumoniae — a common cause of infections of the urinary tract, respiratory tract and bloodstream, and a frequent source of hospital outbreaks.

In some parts of the world, only the carbapenem antibiotics class remains effective, but now signs are emerging of resistance even to this last line of defence.

Antibiotics are thought to have saved hundreds of millions of lives since Alexander Fleming first discovered penicillin in 1928.

But even Fleming's own warnings of impending drug resistance went unheeded, and now scientists say people may start dying from infections like meningitis and septicaemia that are eminently curable today.

"If we keep going like this, the vast majority of human bacterial pathogens will be multi-resistant to antibiotics," said Courvalin.

The answer? Prudent drug use — better and faster diagnosis to determine whether an infection is viral or bacterial and whether it is even susceptible to treatment.

Farmers must stop feeding antibiotics to their livestock, and hospital and individuals improve their hygiene to prevent bacterial spread.

Yet few experts believe the damage can be undone.

"The bugs have become very sophisticated, they've become very complex," said Walsh.

"You can decrease resistance or reduce it, but never completely reverse it."

CHICAGO/WASHINGTON — Another 5.6 million American children may die prematurely unless smoking rates fall in the United States, according to a report by the US surgeon general which links a range of new illnesses to the habit.

Fifty years after the first surgeon general’s report declared smoking a hazard to human health, the new study adds conditions ranging from colon cancer to diabetes and arthritis to the tally of tobacco-related diseases.

The report, the first in more than a decade, found that smoking has killed more than 20 million Americans prematurely in the last half century.

Although adult smoking rates have fallen to the current 18 per cent from 43 per cent of Americans in 1965, each day, more than 3,200 youths under the age 18 try their first cigarette, according to the report published on Friday.

“Enough is enough,” acting Surgeon General Dr Boris Lushniak said in a telephone interview. “We need to eliminate the use of cigarettes and create a tobacco-free generation.”

Federal health officials are calling on businesses, state and local governments, and society as a whole, to end smoking within a generation through hard-hitting media campaigns, smoke-free air policies, tobacco taxes, unhindered access to cessation treatment and more spending by state and local governments on tobacco control.

“It’s not just the federal lead on this anymore,” said Lushniak. “To get this done, we have to go to industry. We have to go to healthcare providers and remind them that this problem is not yet solved.”

The report, dubbed The Health Consequences of Smoking, 50 Years of Progress, details the growing science showing the diseases and health conditions caused by smoking since Dr Luther Terry issued the landmark report on January 11, 1964, that first confirmed smoking tobacco caused lung cancer.

In that first report, only lung cancer was associated with smoking. Now there are 13.

“We’re still a country very much addicted to tobacco,” US Health and Human Services Secretary Kathleen Sebelius said at a White House event to mark the anniversary.

The new report adds liver and colorectal cancer to that list, but it also details several other conditions caused by smoking, including diabetes, rheumatoid arthritis and impaired immune function, and cleft palate in infants.

And in a startling statistic, the report found that exposure to secondhand smoke increases the risk of stroke by 20 to 30 per cent.

“It really is astonishing that even 50 years in, we are finding new ways that tobacco maims and kills people,” Dr Thomas Frieden, director of the US Centres for Disease Control and Prevention, said in a telephone interview.

He said the report found that smoking costs the nation $130 billion in direct medical expenses each year.

Frieden reiterated that tobacco control efforts have saved as many as 8 million lives in the past five decades, but stressed that much more needs to be done to eliminate smoking, which remains the leading cause of preventable death in the United States.

At the White House, officials pointed squarely at the tobacco industry continued efforts to promote their products.

“This is not an accident,” Assistant Health Secretary Howard Koh said. “These deaths do not occur just by chance. Each year, the tobacco industry spends $8 billion — nearly $1 million an hour — to advertise and market cigarettes and smokeless tobacco products.”

As a result, Lushniak urged public health officials to take tougher action to curb tobacco use: “It’s all about getting more aggressive than we have been.”

Officials called on states to increase their investment in smoking prevention.
CDC’s Frieden said states get $80 per capita from tobacco companies related to a major legal settlement in 1998, in which big tobacco makers agreed to pay $206 billion to 46 states to help pay the costs of treating ailing smokers.

Although CDC recommends that states spend at least $12 per person on tobacco control, states “actually only spend about $1.50, and it’s been decreasing in recent years”, he said.

Harold Wimmer, president and chief executive of the American Lung Association, said the new report, coming on the heels of the 50th anniversary of the landmark 1964 report, present an opportunity for renewed political commitment to ending the tobacco epidemic.

On Wednesday, his group will release its own report grading state and federal efforts to control tobacco.

“Only a recommitment to a heightened level of action will enable us to finish the job,” Wimmer said.