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: Tuberculosis is North Korea’s biggest public health problem. With this American-made machine, his lab would be able to complete a TB test in just two hours, instead of two months. It took years, but Dr. O got the machines, only to discover that GeneXpert needs cartridges he can’t replace. It’s not entirely clear what about the cartridges would violate international sanctions. For a long time, the producer refused to disclose what agents were inside because that was patented information. But it doesn’t really matter. No one, it seems, is willing to help him procure them from abroad and run the risk of angering Washington. Despite a budding mood of detente on the Korean Peninsula since the summit between President Donald Trump and North Korean leader Kim Jong Un last month in Singapore, ongoing sanctions championed by the U.S. and Trump’s “maximum pressure” policy continue to generate an atmosphere of hesitation and the fear of even unintentional violations. And that is keeping lifesaving medicines and supplies from thousands of North Korean tuberculosis patients. Dr. O’s laboratory, built with help from Stanford University and Christian Friends of Korea aid group, has essentially been running on empty since April. But the idle GeneXperts may soon be the least of his troubles. ___ Tuberculosis kills more than 1.6 million people a year. When left untreated it will be fatal in half of those it infects. It’s the world’s most deadly infectious disease and is so contagious that each case can be expected to lead to 10 to 20 more. In developed countries, it has largely been brought under control. There’s a vaccine that prevents it and a cocktail of drugs that can be used to treat, and often cure, it in a matter of months. But it’s a major scourge in less affluent places, including North Korea and sub-Saharan Africa. To help North Korea control its tuberculosis problem, a Geneva-based international aid organization called the Global Fund to Fight AIDS, Tuberculosis and Malaria has dispersed more than $100 million in grants since 2010. Last year it supported the treatment of about 190,000 North Korean TB patients. But, two weeks ago, Global Fund ended all of its North Korea-related grants, saying it could no longer accept the North’s “unique operating conditions.” Spokesman Seth Faison said the fund informed Pyongyang in February so it would have time to look for alternative funding sources. He said Global Fund is providing buffer stocks of medicines and health products to help support the treatment of tuberculosis patients through June next year. Faison said Global Fund welcomes the “positive diplomatic efforts underway” between Pyongyang and its neighbors. But the fund’s position stands. The decision shocked the doctors at the Pyongyang tuberculosis lab, who praised Global Fund for the work it had done but accused it of bowing to political pressure from the United States and Trump’s vow to keep the pressure on and not ease sanctions until the North makes major steps toward denuclearization. The United States government, which has pledged $1.4 billion this year, is one of Global Fund’s biggest donors. The fund’s retreat sparked outrage outside of North Korea as well. In an open letter published in the medical journal Lancet, Harvard physician Kee Park, director of North Korea programs for the Korean American Association, warned the fund’s withdrawal could create a “humanitarian and public health crisis” and called the move “a cataclysmic betrayal of the people of the DPRK.” Whatever the reason, its departure is valid cause for concern. When tuberculosis patients reduce or go off their medications prematurely, or begin taking lower quality ones, the bacteria that causes their disease can develop a resistance to the two most powerful anti-TB drugs, making the condition harder and much more expensive to treat. This kind of multi-drug resistant TB is most often found in China, India and Russia. And it’s a big problem in North Korea. ___ North Korea’s health system is fragile and strapped for resources. But in keeping with Kim’s directives to lift the nation’s standard of living, officials are looking for ways to improve. “We have been waging a vigorous struggle with a highly ambitious plan to increase the average life expectancy of the population and bring other health indices in line with those of the world’s most advanced countries,” explained Ri Jong Chang, who is the director of the Central Tuberculosis Prevention Institute and has worked with TB patients for the past 25 years. Ri explained that at the most basic level, the country maintains a network of about 7,000 clinics and a system initiated decades ago that focuses on “household doctors.” Each doctor is responsible for the care of 150 households within their administrative area. Along with primary care, they keep their patients informed and educated about health issues and conduct activities to prevent diseases. If a suspected case of tuberculosis is found, the patient is sent to a county-level hospital for testing. Aware of its needs and vulnerabilities, North Korea, which is generally secretive and deeply suspicious of anything that smacks of foreign “meddling,” has demonstrated a surprising willingness to accept help, allow access and share information with United Nations’ agencies and foreign aid organizations. Along with Global Fund, the most established group treating TB patients in the North is the Eugene Bell Foundation, which supports the treatment of more than 1,000 patients at 12 centers across the country. Unlike Global Fund, since 2008 the Eugene Bell Foundation has been solely focused on fighting multi drug-resistant tuberculosis, which typically takes about 18 months to treat and costs nearly $5,000 per patient. Stephen Linton, who founded the group in 1995, has a grim assessment of the situation. “We are probably only covering about one-tenth of the MDR-TB patients in the country right now,” he told The Associated Press. He said about half of his patients are in Pyongyang, a city of 3 million and the place where most of the North’s elites reside. The reason is straightforward — MDR-TB develops after exposure to medications that failed. In rural areas, fewer people have access to those medicines to begin with. “If you are living in the countryside in North Korea, you are much less likely to get MDR-TB than if you live in Pyongyang. It’s horrendous,” he said. “We can’t get to the bottom of it, even though we focus a lot of resources there.” What really worries him, and the North Korean government, is what will happen if the patients who relied on Global Fund support run out of medications, stop getting help or turn to cheaper, less effective treatments. Many will die. But not before infecting many others. “This is an airborne infection,” he said. “Every time you are in a closed space with a TB patient, you are at risk. So for all the people that travel to North Korea, all the tourists, all the diplomats — they are a risk to everyone who comes near them.” ___ This was supposed to be the year Eugene Bell began to really up its game in North Korea, tripling to 3,000 the number of patients it treats. Many of the sanatoria where TB patients are treated in the North were built 30 or 40 years ago. They have poor insulation, are overcrowded and are often fire hazards. To address those problems and the sort of transparency issues Global Fund was concerned about, Eugene Bell has developed pre-fabricated wards tailor-made to meet the North’s conditions. They are simple, single-story duplexes. Each can be put up quickly by three or four people, meaning the entire process can be monitored while Linton and other Eugene Bell people are in the country on their bi-annual medical team visits. The wards are already paid for when they are shipped from China, so the money isn’t going into the pockets of government officials or funding Kim Jong Un’s missile programs. The idea was to begin putting up 80-100 wards to create large centers in each of North Korea’s nine provinces. A pilot project with 10 wards is now operating on the outskirts of Pyongyang, not far from the airport. Linton said everything was going well until last December. “Then we ran into this sanctions problem,” he said. “It’s officially approved. The design is approved. And it’s not that we can’t send anything in. But these buildings have a metal roof — a panel that has metal in it, aluminum — and that’s the issue.” Linton said Eugene Bell has a quarter of a million dollars’ worth of them “rotting in monsoon weather” in a dockyard outside of Seoul. He believes that until Washington makes it clear it is not against humanitarian aid, other countries and aid organizations will be reluctant to act — or even approve the shipment of items like Dr. O’s GeneXpert cartridges or Eugene Bell’s patient wards that are clearly intended for humanitarian use. As an American, Linton says, he is concerned the U.S. will be held responsible for whatever bad happens with TB in North Korea since no country is as seen as “owning” the sanctions as much as America. “Unless something is done and done soon, this medical emergency will become known in Korea as the ‘Sanctions TB Epidemic,’” he said. “And it will haunt the peninsula for generations.” ___ Talmadge is the AP’s Pyongyang bureau chief. Follow him on Instagram and Twitter: @EricTalmadge

Answer: Despite detente, sanctions on North Korea fan TB epidemic.


Question: The National Health Commission said on Monday that 78 new asymptomatic cases had been identified as of the end of Sunday, compared with 47 the day before. Imported cases and asymptomatic patients, who show no symptoms but can still pass the virus on, have become China’s chief concern after draconian containment measures succeeded in slashing the overall infection rate. Hubei province, the original epicentre, accounted for almost half the new asymptomatic cases. A total of 705 people with asymptomatic cases were under medical observation around mainland China. The surge in asymptomatic cases, which China only began reporting last week, poses a worry as Hubei’s capital Wuhan prepares to allow people to leave the city on April 8 for the first time since it was locked down in late January. Wuhan officials revoked the “epidemic-free” status of 45 residential compounds due to the emergence of asymptomatic cases and other unspecified reasons, according to a report on Monday by the official Xinhua news agency. “Epidemic-free” status allows people living in Wuhan compounds to leave their homes for two hours at a time. China has now reported a total of 81,708 cases, with 3,331 deaths. One new locally transmitted infection was reported in the latest data, in the southern province of Guangdong, down from five a day earlier in the same province. China has closed its borders to foreigners as the virus spreads globally, though most imported cases have involved Chinese nationals returning from overseas. It began testing all international arrivals for the coronavirus from April 1, customs official Song Yueqian said. Of the new cases showing symptoms, 38 entered China from abroad, compared with 25 a day earlier. Of those, 20 arrived in the northeastern province of Heilongjiang from neighbouring Russia. All were Chinese citizens who had flown from Moscow to Vladivostok and travelled to China overland. China will work to prevent cases being imported through land borders, the government said after a meeting chaired by Premier Li Keqiang on Monday，which noted the number of such cases had exceeded cases recorded at airports recently. Those who try to hide their travel history or health condition face a fine of up to 30,000 yuan ($4,230) or even criminal proceedings, Song said, adding such people will be placed on a customs “blacklist” of travellers who will be subject to tighter checks in future. Another possible source of infection are the 1.6 million Chinese who study overseas, many of whom have struggled to return home since international flights were reduced. Charter flights are being arranged to bring home Chinese students in the United States, starting with the youngest, China’s embassy in Washington said. The ambassador, Cui Tiankai, noted in the New York Times on Monday there had been “unpleasant talk” between the two countries about the virus. “But this is not the time for finger-pointing. This is a time for solidarity, collaboration and mutual support,” Cui wrote. Amid criticism China was too slow to warn the international community about the outbreak, Xinhua on Monday published a “detailed timeline” of the country’s coronavirus response and information sharing, from late December 2019 to March 2020. China started reporting to the United States “regularly” on the epidemic and containment measures from Jan. 3, according to the timeline. Click here for an interactive GRAPHIC tracking global spread of coronavirus

Answer: China sees rise in asymptomatic coronavirus cases, to tighten controls at land borders.


Question: A nurse extracts a vaccine in a file photo. Federal health officials said on Thursday the government has not conceded that vaccines cause autism even after a Georgia girl won federal compensation in a case arguing a vaccine led to her brain damage. REUTERS/Phil Klein  Hannah Poling, 9, had a rare mitochondrial disorder and a  federal court ruling said regular childhood vaccinations may  have contributed to some of her autism-like symptoms. She was  awarded compensation under the National Vaccine Injury  Compensation Program in a case that became public this week. Some activists who argue vaccines can trigger autism jumped  on the case as vindication of their cause. But Dr. Julie  Gerberding, director of the U.S. Centers for Disease Control  and Prevention, denied this. “Let me be very clear that (the) government has made  absolutely no statement about indicating that vaccines are a  cause of autism,” Gerberding told reporters in a telephone  briefing. “That is a complete mischaracterization of the findings of  the case, and a complete mischaracterization of any of the  science that we have at our disposal today. So I think we need  to set the record straight on that.”    The vaccine injury program is a no-fault system that has a  $2.5 billion fund built up from a 75-cent-per-dose tax on  vaccines. It was set up to ensure companies would not be afraid  to make vaccines, and to provide injured children an easier way  to seek compensation. Thousands of lawsuits have been filed by parents who argue  their children have autism caused by vaccines. The Institute of Medicine, an independent organization set  up to inform U.S. policy, has found there is no evidence that  vaccines can cause autism. Many recent studies have come to the  same conclusion. Some autism advocacy groups argue that a mercury-containing  preservative in vaccines called thimerosal can cause autism. Republican presidential candidate Sen. John McCain entered  the debate last week, saying there is “strong evidence” linking  autism to a thimerosal. Dr. Edwin Trevathan, director of the CDC’s National Center  on Birth Defects and Developmental Disabilities, said the  Poling case did not demonstrate any link between vaccines and  autism. “I think it’s also worth noting that most children with  autism do not seem to have a mitochondrial problem,” he told  the briefing. “So this association between mitochondrial disorders and  autism is actually probably relatively rare. But the  association between mitochondrial disorders and severe brain  damage and dysfunction is one that is not as rare and is  actually quite important.”    Trevathan said it is not clear whether a fever caused by a  vaccine might further stress a child with such a condition,  causing autism-like symptoms. Autism can have relatively mild symptoms or can severely  disable a child by interfering with speech and behavior. No one  knows what causes it. The CDC estimates that about one in every 150 children has  autism or a related disorder such as Asperger’s syndrome —  560,000 people up to age 21 in the United States. “Our message to parents is that immunization is  life-saving. There’s absolutely nothing changed in the adamant  recommendations that we are making to get children vaccinated,”  Gerberding said.

Answer:
Still no autism-vaccine link, say health officials.