Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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Question: Duck droppings from the central Dutch province tested positive for the highly contagious H5 strain of the disease, the deputy economic affairs minister wrote in a letter to parliament. “Based on this information I am considering follow-up measures,” deputy minister Sharon Dijksma wrote. Dutch authorities said earlier on Monday they will slaughter 50,000 birds at a poultry farm after bird flu was discovered nearby. Separate testing indicated that farm infections, which have led to the culling of around 300,000 birds at four locations, were not all from the same source, the letter said. The H5N8 strain of bird flu detected at the farms has never been founded in humans. It has led to the destruction of millions of farm birds in Asia, mainly South Korea, after an outbreak earlier this year. A government statement said tests had confirmed an outbreak of the H5N8 strain at one farm in the western municipality of Zoeterwoude, where 28,000 laying hens were ordered destroyed on Sunday. A cull at a nearby farm announced on Monday was a precautionary measure, it said. Animal health authorities are testing poultry at other farms in the area. Transport restrictions were imposed on the sector two weeks ago that have hit around 2,000 poultry businesses. The Netherlands is the world’s largest exporter of eggs and the largest exporter of poultry meat in the European Union. Some experts believe that wild birds migrating from Asia carried the disease to Europe, where it infected flocks in Germany, Britain and the Netherlands.

Answer: Dutch discover bird flu in wild ducks, cull continues.


Question: The decision by Cleveland County District Judge Thad Balkman in Norman, Oklahoma, came in the first case to go to trial out of 2,700 nationally by states, counties and cities seeking to hold drug companies responsible for the deadly epidemic. Balkman reduced the amount he had awarded in August by $107 million after agreeing with New Brunswick, New Jersey-based J&J that he had made a math error. J&J said it will appeal, and that the award and finding of liability were “neither supported by the facts nor the law.”  A spokesman for Oklahoma Attorney General Mike Hunter said that office is reviewing the decision and will formally respond within the next few days. Opioids were involved in almost 400,000 overdose deaths from 1999 to 2017, according to the U.S. Centers for Disease Control and Prevention. Following a non-jury trial, Balkman ruled in August that Oklahoma had proven that J&J engaged in misleading marketing about the benefits of painkillers, and that their addictive risks caused a public nuisance in the form of the opioid crisis. Hunter had sought to have J&J pay $17 billion to help fund addiction treatment and other services to repair damage from the opioid epidemic over the next 30 years. Balkman, however, awarded only enough money for one year of programs, saying Oklahoma failed to support its claims regarding the need to abate the epidemic in future years. Following the August ruling, Oklahoma asked Balkman for permission to return to his courtroom annually to prove those costs, but Balkman on Friday maintained his prior ruling. J&J, meanwhile, argued that it deserved a $355 million credit, reflecting pre-trial settlements by the drugmakers Purdue Pharma LP and Teva Pharmaceutical Industries Ltd.  Balkman concluded on Friday that state law did not allow such credits. Last month, J&J and four other companies proposed a $48 billion settlement framework to resolve all of the opioid cases they face, with J&J paying $4 billion. Lawyers for the local governments have opposed the proposal. If approved, the settlement would let J&J resolve some of the thousands of product liability lawsuits it faces. The company also faces litigation over whether its baby powder causes cancer, a claim it denies.

Answer: Oklahoma judge reduces Johnson & Johnson opioid payout to $465 million.


Question: The dwindling stockpile of crucial medications follows the abrupt departure of the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international aid organization whose grants to North Korea supported the treatment of 120,000 TB patients last year. Its support officially ended in June despite an outcry among health officials in North Korea and in the international community that it could spark a major epidemic. Neurosurgeon Kee Park, of the Program in Global Surgery and Social Change at Harvard Medical School, said in an email to The Associated Press that the situation is extremely dire and likely to get dramatically worse in the years ahead if it is not properly dealt with. The U.S.-based nonprofit Eugene Bell Foundation, which works on the ground treating tuberculosis in North Korea, said Friday that the crisis is being compounded by U.S.-led sanctions over Pyongyang’s nuclear weapons and missile program. North Korea has one of the world’s highest rates of tuberculosis, a highly infectious disease that, while treatable, globally causes more than 1 million deaths each year. According to the World Health Organization, about 107,000 cases of tuberculosis were reported in North Korea in 2017. Making matters worse, North Korea has estimated that 6-7 percent of its tuberculosis population has the drug-resistant variety, known as MDR-TB, which is far more difficult and costly to cure. “As a result of the loss of the Global Fund grants for the DPRK, we expect a 50-75 percent reduction in treatment capacity for non-MDR-TB patients,” Park said. “Consequently, our model predicts between 155,000 to 210,000 more people will die from TB-related causes within five years. To be clear, these are new deaths that are expected on top of the current mortality rates. We have assumed that the treatment of MDR-TB will continue at current levels.” Drug-resistant tuberculosis generally results from patients not taking the proper amount or combination of medications to completely cure them of the disease, or by coming into contact with someone who has been infected with it already. It is often found among populations that have had some exposure to TB medications, such as cities or other places with populations that are relatively more affluent — or at least affluent enough to have paid for some form of TB medication already. Pyongyang, the North Korean capital, is believed to have a particularly high incidence of the drug-resistant TB strain. Global Fund announced in February that it was ending its grants to North Korea, effectively ending the largest outside public health assistance program ever for the North, because of a lack of transparency and difficult operating conditions. It has said its stockpile would last for a year, which is longer than the average 6- to 9-month course of treatment for a TB patient. But the concern is over what will happen after that, how any new cases can be treated if no one else steps in to fill the gap and whether the limited pool of medications would be “rationed” in an ill-advised effort to spread out what medications are left. “Time is ticking,” Park said. “I have heard from people who have been inside recently that the rationing has already started.” The problem is especially acute because North Korea has a fragile public health system that could easily be overwhelmed by a large outbreak, sending North Koreans streaming across the country’s border with China, making the epidemic a bigger, regional issue. Concerns over such a calamity prompted the North to essentially close its borders during the Ebola scare in 2015 and during the SARS outbreak in 2003 in China, though neither seemed to present much of a threat to the isolated North. Stephen Linton, chairman of the Eugene Bell Foundation, told reporters in Seoul that South Korea lacks the sense of urgency to help groups like his gain sanctions exemptions so that they can deliver supplies to treat patients in North Korea. He likened the problem to having the house next door on fire, and said North Korea’s tuberculosis problem could potentially have health consequences for South Korea. Linton said he believes Global Fund’s decision was at least partially connected to sanctions-related pressure. The U.S. government, which pledged $1.4 billion this year, is one of the biggest donors to Global Fund. He noted that it has also gotten harder for American aid workers to get permission to travel to the North since President Donald Trump announced his travel ban for U.S. citizens more than a year ago. Choi Seemoon, a Eugene Bell director, said that while Eugene Bell and Global Fund have provided MDR-TB medications to about 2,000 patients this year, that’s less than 30 percent of the estimated 8,000 North Koreans with the condition. Global Fund’s stock of regular tuberculosis medicine will run out in early 2020, she warned, while its stock of MDR-TB medicine can only cover patients registered by the autumn of this year. “There needs to be a quick purchase of medicine and supplies to overcome the void left by Global Fund,” Choi said. “Whether the issue is resolved through inter-Korean talks or through international bodies and non-governmental channels, there should be a quick delivery of tuberculosis medicine to North Korea regardless of what channel it takes.” ___ Talmadge is the AP’s Pyongyang bureau chief. He contributed to this report from Tokyo. Follow him on Twitter and Instagram: @EricTalmadge.

Answer:
North Korea running low on TB meds, experts fear epidemic.