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CMAJ. 2010 May 18; 182(8): E344–E346.
Published online 2010 March 24. doi:  10.1503/cmaj.109-3234
PMCID: PMC2871237


Calorie counts: United States President Barack Obama’s health care reform legislation will obligate all restaurant chains with more than 20 outlets to include calorie counts on menus and menu boards. It’s estimated that more than 200 000 restaurants fall under that umbrella. The legislation also compels the US Food and Drug Administration to develop new standards for menu labelling (

Drug-resistant TB: The World Health Organization says that as many as 440 000 people around the world had multidrug-resistant tuberculosis in 2008, with almost 50% of those cases occurring in China and India. The report, Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 Global Report on Surveillance and Response, also indicated that there were 9.4 million tuberculosis cases and 1.8 million tuberculosis deaths in 2008 (

Breadwinners: The average American specialist generates more than US$1.5 million in revenues for his or her hospital, according to a survey of 114 US hospitals conducted by the Irving, Texas-based physician recruiting firm Merritt Hawkins. The survey indicated that a general internist generates nearly US$1.7 million a year for his or her hospital, while a family physician brings in US$1.6 million and a pediatrician US$856 000 (

Global drug market: The pharmaceutical market in China will become the world’s third largest in 2011, according to IMS Health, a private market intelligence and consulting firm. The Chinese market, and that of 16 other nations, will constitute 48% of pharmaceutical industry growth in 2013, the firm said in a study, Pharmerging Shake-Up: New Imperatives in a Redefined World. It predicts the 17 “pharmerging” markets will expand by US$90 billion between 2009 and 2013. “With a raft of pharmerging countries rapidly gaining market share, we’re seeing a new world order take hold within the pharmaceutical industry,” Murray Aitken, senior vice-president of healthcare insight, said in a press release (

Multiplying delays: Scant weeks after announcing that it was pushing back the restart date for the medical isotope-producing National Research Universal reactor in Chalk River, Ontario, into May, Atomic Energy of Canada has added a few months to the delay, saying restart won’t occur until the end of July at the earliest. The agency said in a press release that 56% of the repairs are completed, but the size and location of 2 of 10 weld repair sites “make these final sequences particularly challenging. For each of these repairs, four distinct phases of work must be completed in sequence: weld development; welder qualification and reliability; integration testing; and, the actual repair itself. In light of this complexity, and the accumulated experience from the repair work completed to date, it became evident that the schedule needed to be revised,” (

Pandemic review: The World Health Organization’s handling of the pandemic (H1N1) 2009 influenza outbreak, its pandemic alert scale and the functioning of International Health regulations during the pandemic will be subject to the review of an independent panel of about 29 public health experts and “very well-known scientists,” Dr. Keiji Fukuda, the WHO’s special adviser to the director-general on pandemic influenza announced Mar. 29. Fukuda said that among the issues for the expert panel to consider are: “Could we have made decisions better? Could we have considered things in a different way at the time?” ( The panel was expected to present a preliminary report to the World Health Assembly this May and a final report in May 2011.

Handout noose tightens: Stanford University in Palo Alto, California, has further tightened the noose of industry handouts by announcing that 660 physicians who serve as adjunct clinical faculty will be obliged to abide by the school’s industry-interactions policy, including a prohibition on paid participation in speakers’ bureaus. “Our local, national and global communities do not differentiate whether an ‘adjunct’ title refers to a paid or unpaid member of our school community,” Dr. Philip Pizzo, dean of the Stanford School of Medicine, said in a press release. “If an adjunct clinical faculty member does not follow our policy on industry interactions, that creates confusion in the eyes of the public, and our reputation can be tarnished,” ( The move furthers a bid by the Association of American Medical Colleges to enforce a zero-tolerance approach to industry handouts within the United States’ teaching hospitals and 129 medical schools (CMAJ 2008. DOI:10.1503/cmaj090780).

Satellite campuses: India’s cabinet has approved a plan to allow foreign universities to establish satellite campuses within the country and offer degrees, including MDs. The Foreign Educational Institution (Regulation of Entry and Operation) Bill, 2010 must still be approved by Parliament. Four years in the making, the legislation requires foreign institutions to first obtain the approval of a government regulatory body for higher education but some hope India’s growing economy will persuade such prestigious institutions as Oxford and Harvard to establish campuses. “This is a milestone which will enhance choices, increase competition and benchmark quality,” Human Resource Development Minister Kapil Sibal said in a press release.

PPP green light: The McGill University Health Centre in Montréal, Quebec, has announced that the McGill Health Infrastructure Group, a public–private partnership (PPP) led by SNC-Lavalin Inc. and Innisfree Ltd. has been selected to build a hospital on the school’s Glen campus. The partnership group was one of two asked to resubmit construction proposals earlier this year after exceeding original budget limits (CMAJ 2010. doi:10.1503/cmaj.109-3159). Innisfree manages more than 50 PPP projects around the world. McGill Principal and Vice-Chancellor Heather Munroe-Blum was effusive, stating in a press release that “it is a pivotal moment in health care and science for Quebec.”

Travel restrictions: A Tashkent, Uzbekistan, nonprofit corporation is reporting that the Uzbek Health Ministry has imposed limits on the ability of physicians to travel abroad for private or business purposes, such as participation in international medical conferences. A ministry order will oblige physicians to get approval to obtain an exit visa, the Expert Working Group told a press conference. Doctors will be required to submit a written statement of purpose to the Health Ministry; have all speeches vetted by the ministry, and provide written summaries of their trips within three days of returning to Uzbekistan.

Donation ban: Canadian Blood Services has announced that it will ban people with chronic fatigue syndrome from donating blood ( The not-for-profit organization says it made the decision on the basis of a study that indicates there may be an association between chronic fatigue syndrome and xenotropic murine leukemia virus-related virus as it is more common in CFS than healthy patients (Science 2009;326:585–9). It is not known whether the pathogen causes chronic fatigue syndrome but Canadian Blood Services said it is erring on the side of caution.

Pfizer handouts: Pfizer Inc. says it paid US$15.3 million to academic medical centres to conduct clinical trials between Jul. 1 and Dec. 31, 2009, and roughly US$20 million to about 4500 doctors in consulting and speakers’ bureau fees over the same time period. The latter included roughly 1500 doctors who received about US$5000 apiece for “input and advice to ensure the company addresses the real needs of clinicians and patients,” and about 2800 doctors who received an average US$3400 to “educate their peers about health conditions and the safe and appropriate use of Pfizer medicines” ( The disclosures are required as part of a US$2.3 billion settlement that Pfizer reached with the US Department of Justice for fraudulent, off-label marketing of four drugs (CMAJ 2009. DOI:10.15 03/cmaj.109-1039).

Access to health records: Manitoba’s Personal Health Information Act will be amended to make it easier for patients to access their health records, Health Minister Theresa Oswald has announced. Among the amendments is one requiring hospitals to respond to requests from patients within 24 hours and another requiring health care providers “in all other settings, including for hospital outpatients and in personal care homes, doctors offices and other community health services, to respond to requests for information about care currently being provided within 72 hours of receiving the request” ( The amendments also oblige health care providers to notify patients about their right to access personal health information.

Killam prizes: R. Mark Henkelman, Canada Research Chair in Imaging Technologies in Human Disease and Pre-clinical Models, is among five recipients of a 2010 Killam Prize for outstanding achievement in the humanities, social sciences, natural sciences, health sciences or engineering. Henkelman, professor of medical biophysics and medical imaging at the University of Toronto in Ontario and senior scientist in imaging research at the Sunnybrook Health Sciences Centre, receives $100 000 toward his research program. The other 2010 Killam recipients are: psychologist Ellen Bialystok of York University in Toronto, computer scientist Ming Li of the University of Waterloo in Ontario, particle physicist Arthur McDonald of Queen’s University in Kingston, Ont., and political scientist James Tully of the University of Victoria in British Columbia (

Afghanistan poverty: Roughly nine million people, or about 36% of Afghanistan’s population, live in absolute poverty and cannot meet their basic needs, according to a report by the United Nations Office of the High Commission for Human Rights. The report, Human Rights Dimension of Poverty in Afghanistan, states that corruption and abuse of power are contributing to higher poverty levels. It also notes that about US$35 billion in civil reconstruction and development money was delivered in Afghanistan by mid-2009 but that studies indicate as much as 40% of aid returns to donor countries through consultants’ fees and profits for aid distributors. “A growing number of Afghans are increasingly disillusioned and dispirited as the compact between the people, the Government, and its international partners is widely seen to have not delivered adequately on the most basic fundamentals including security, justice, food, shelter, health, jobs and the prospect of a better future,” the report states (

Don’t send in the clown: The watch-dog nonprofit organization Corporate Accountability International has launched a petition to retire the iconic Ronald McDonald, a clown used by McDonald’s Corporation to market its fast-food products and the public face of the firm’s charitable endeavours in public health, such as Ronald McDonald houses, accommodations for families of seriously ill children. The watchdog argues that the clown has helped to triple obesity rates among children and increase the incidence of diet-related conditions, such as type 2 diabetes. “In sum, we all ‘deserve a break.’ Children deserve a break from this ubiquitous corporate icon and the targeted marketing tactics designed to manipulate their psychological and physical appetites. Parents deserve a break from the nagging and pestering that the clown’s tactics foster. We all need a break from Ronald McDonald,” the organization states ( The petition will be sent to a McDonald’s shareholders’ meeting in May.

Concurrent disorders: Integrated treatment strategies for people with substance abuse disorders and mental health problems are needed because they are often concurrent conditions and therapy for one but not the other is typically ineffective, the Canadian Centre of Substance Abuse says in a new report, Substance Abuse in Canada: Concurrent Disorders. The report calls for the establishment of a “common national framework for understanding the interplay between substance abuse disorders and mental health disorders and to establish a unified approach to the care and treatment of those affected by concurrent disorders” (

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