AP IMPACT: Big Pharma cashes in on HGH abuse

A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.

But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.

From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.

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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.

The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.

Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.

Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.

Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.

Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.

Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.

HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.

Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.

Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.

The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.

On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.

Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.

Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.

While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.

"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.

And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.

First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.

Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.

FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.

Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.

Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.

These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.

For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)

These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.

"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."

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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.

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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh

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The AP National Investigative Team can be reached at investigate(at)ap.org

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Fiscal Cliffhanger: Tax Deal 'Within Sight,' Not Done

President Obama said an 11th-hour agreement to avert year-end tax hikes on 98 percent of Americans is "within sight" but not yet complete with just hours to go before the nation reaches the so-called fiscal cliff.

"There are still issues left to resolve but we're hopeful Congress can get it done," Obama said at a midday White House news conference. "But it's not done."

Congressional and White House negotiators have forged the contours of an agreement that would extend current tax rates for households making $450,000 or less; raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the Alternative Minimum Tax from hammering millions of middle-class workers, sources said.

The deal would also extend for one year unemployment insurance benefits set to expire Tuesday, and avert a steep cut to Medicare payments for doctors.

"I can report that we've reached an agreement on the all the tax issues," Senate Minority Leader Mitch McConnell said in an afternoon speech on the Senate floor.

But Sen. John McCain, R-Ariz., was among the less conciliatory Republicans.
Rather than staging a "cheerleading rally," he said, the president should have been negotiating the finishing touches of the deal.

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'Fiscal Cliff': Lawmakers Scramble for Last-Minute Deal Watch Video

"What did the president of the United States just do? Well, he kind of made fun, he made a couple of jokes, laughed about how people are going to be here for New Year's, sent a message of confrontation to the Republicans," McCain said. "I guess I have to wonder, and I think the American people have to wonder whether the president really wants this issue resolved or is it to his short-term political benefit for us to go over the cliff?"

McCain said the president's speech today "clearly will antagonize members of the House," and "that's not the way presidents should lead."

Both sides remained at odds on what to do about the other significant piece of the "fiscal cliff" -- the more than $1 trillion of automatic cuts to defense and domestic programs set to begin tomorrow.

The White House has proposed a three-month delay of the cuts to allow more time to hash out details for deficit reduction, while many Senate Democrats want a flat one-year delay. Republicans insist that some spending cuts should be implemented now as part of any deal.

"In order to get the sequester moved, you're going to have to have real, concrete spending cuts," Rep. Mike Rogers, R-Mich., said. "[Without that], I don't know how it passes the House."

Vice President Joe Biden and McConnell, R-Ky., have been locked in behind-the-scenes negotiations for much of the day, sources said, following several "good" conversations that stretched late into Sunday night.

"We are very, very close," McConnell said today. "We can do this. We must do this."

If a deal is reached between Biden and McConnell, members in both chambers would still need to review it and vote on it later today. Passage is far from guaranteed.

"This is one Democrat that doesn't agree with that at all," Iowa Democratic Sen. Tom Harkin said of the tentative deal. "No deal is better than a bad deal, and this looks like a very bad deal the way this is shaping up."

"I don't see how you get something voted on today," Rogers said. "Even if they get a handshake deal today, you have to put the whole thing together and that's probably not going to happen before midnight. So it would make sense to roll into tomorrow to do that."

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State Department made "grievous mistake" over Benghazi: Senate report

WASHINGTON (Reuters) - The State Department made a "grievous mistake" in keeping the U.S. mission in Benghazi open despite inadequate security and increasingly alarming threat assessments in the weeks before a deadly attack by militants, a Senate committee said on Monday.

A report from the Senate Homeland Security Committee on the September 11 attacks on the U.S. mission and a nearby CIA annex, in which the U.S. ambassador to Libya and three other Americans died, faulted intelligence agencies for not focusing tightly enough on Libyan extremists.

It also faulted the State Department for waiting for specific warnings instead of improving security.

The committee's assessment, "Flashing Red: A Special Report On The Terrorist Attack At Benghazi," follows a scathing report by an independent State Department accountability review board that resulted in a top security official resigning and three others at the department being relieved of their duties.

Joseph Lieberman, an independent senator who chairs the committee, said that in thousands of documents it reviewed, there was no indication that Secretary of State Hillary Clinton had personally denied a request for extra funding or security for the Benghazi mission. He said key decisions were made by "midlevel managers" who have since been held accountable.

Republican Senator Susan Collins said it was likely that others needed to be held accountable, but that decision was best made by the Secretary of State, who has the best understanding "of how far up the chain of command the request for additional security went."

The attacks and the death of U.S. Ambassador Christopher Stevens put diplomatic security practices at posts in risky areas under scrutiny and raised questions about whether intelligence on militant activity in the region was adequate.

The Senate report said the lack of specific intelligence of an imminent threat in Benghazi "may reflect a failure" by intelligence agencies to focus closely enough on militant groups with weak or no operational ties to al Qaeda and its affiliates.

"With Osama bin Laden dead and core al Qaeda weakened, a new collection of violent Islamist extremist organizations and cells have emerged in the last two to three years," the report said. That trend has been seen in the "Arab Spring" countries undergoing political transition or military conflict, it said.

NEED FOR BETTER INTELLIGENCE

The report recommended that U.S. intelligence agencies "broaden and deepen their focus in Libya and beyond, on nascent violent Islamist extremist groups in the region that lack strong operational ties to core al Qaeda or its main affiliate groups."

Neither the Senate report nor the unclassified accountability review board report pinned blame for the Benghazi attack on a specific militant group. The FBI is investigating who was behind the assaults.

President Barack Obama, in an interview on NBC's "Meet the Press" on Sunday, said the United States had "very good leads" about who carried out the attacks. He did not provide details.

The Senate committee said the State Department should not have waited for specific warnings before acting on improving security in Benghazi.

It also said it was widely known that the post-revolution Libyan government was "incapable of performing its duty to protect U.S. diplomatic facilities and personnel," but the State Department failed to fill the security gap.

"Despite the inability of the Libyan government to fulfill its duties to secure the facility, the increasingly dangerous threat assessments, and a particularly vulnerable facility, the Department of State officials did not conclude the facility in Benghazi should be closed or temporarily shut down," the report said. "That was a grievous mistake."

The Senate panel reviewed changing comments made by the Obama administration after the attack, which led to a political firestorm in the run-up to the November presidential election and resulted in U.S. Ambassador to the United Nations Susan Rice withdrawing her name from consideration to replace Clinton, who is stepping down early next year.

Rice had said her initial comments that the attack grew out of a spontaneous protest over an anti-Islam film were based on talking points provided by intelligence agencies.

Lieberman said it was not the job of intelligence agencies to formulate unclassified talking points and they should decline such requests in the future.

The report said the original talking points included a line saying "we know" that individuals associated with al Qaeda or its affiliates participated in the attacks. But the final version had been changed to say: "There are indications that extremists participated," and the reference to al Qaeda and its affiliates was deleted.

The report said that while James Clapper, the director of national intelligence, had offered to provide the committee with a detailed chronology of how the talking points were written and evolved, this had still not been delivered to Capitol Hill because the administration had spent weeks "debating internally" whether or not it should turn over information considered "deliberative" to Congress.

(Editing by Warren Strobel and David Brunnstrom)

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E. Timor bids farewell to peacekeepers after 13 years

DILI: The UN ends its peacekeeping mission in East Timor Monday after 13 years of boots on the ground in Asia's youngest nation following a bloody transition to independence.

The mission, which saw the presence of some 1,500 UN troops and police, will take down its flag and send home the last of its peacekeepers, including five Portuguese officers, while a "liquidation team" of 79 will remain to tie up loose ends.

The mission began withdrawing troops in earnest in October when national police resumed responsibility for security, following the peaceful election of a new president and parliament.

"The Timorese people and its leaders have shown courage and unswerving resolve to overcome great challenges," United Nations Integrated Mission in Timor-Leste (UNMIT) chief Finn Reske-Nielsen said in a statement.

"Although there remains much work ahead, this is an historic moment in recognising the progress already made."

Reske-Nielsen said the withdrawal did not mark an end to the partnership between the UN and the country, officially called Timor-Leste, as "challenges still remain".

"As peacekeepers depart, we look forward to a new phase in this relationship focusing on social and economic development."

Observers say there is little indication that there will be renewed violence in the short term, but public institutions, including the police force and judiciary, remain weak.

There are also concerns that rampant poverty, high unemployment rates among the youth and a fast-growing population could lead to future unrest.

Government critics have highlighted the economy's heavy reliance on significant but depleting offshore oil and gas reserves that they say benefit urban Timorese more than the regional poor.

The UN played a key role in the birth of East Timor, organising the 1999 vote that ended Indonesia's 24-year occupation, in which around 183,000 people -- then a quarter of the population -- died from fighting, starvation or disease.

It oversaw East Timor until 2002, when an independent government took over.

UN peacekeepers streamed in again in 2006, when a mass desertion among the armed forces prompted fighting between military factions and police, and street violence left at least 37 people dead and tens of thousands displaced.

The only major violence since was a failed assassination attempt on then-President Jose Ramos-Horta in 2008.

- AFP/jc

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Tourists boom brings back smiles on hoteliers in Manali

MANALI: Quenching the thirst of tourism industry of Manali, which had been plagued by slowdown, large number of tourists have belatedly thronged here for New Year celebration and the town has been jammed with the crowd of visitors from all over the country.

Most of the hotels are fully occupied, while others doing better than the average business. People involved in tourism business were shocked after lean Christmas season. But, unexpected flow of tourists has brought back smiles on their faces. Thousands of tourists have thronged Solang, Hadimba Temple, Vashisht and all tourist places of Manali. Recent snowfall has also proved fruitful for Manali, which is attracting more and more tourists.

Over three dozen luxury and ordinary buses plying on Delhi-Manali route are already booked for next few days and tourists are facing problems in reaching Manali. Most of them are opting for personal cars and tourist cabs. "All Volvo buses to Manali had already been booked and we had to spend Rs 5,000 more to hire a car on Saturday evening," Vikram Seth from Delhi said, who is in Manali along with his family for New Year celebrations.

Over 10,000 tourists on Sunday reached Solang valley, the snow point of Manali. Even more tourists are expected on December 31. Fearing overcrowd in Srinagar, Joshi family from Ahmadabad decided to visit Manali at the last stage. "Our travel agent suggested us to visit either Shimla or Manali and we opted for Manali. We had lot of fun during snowfall but had not expected the crowd here," Ashish Joshi said.

According to data from Manali green tax barrier, number of vehicles entering the area has increased many folds in last two days. Seeing the crowd of tourists, Manali Beopar Mandal decided to open the market on Sunday, which otherwise remains closed. Good flow of tourists seems like healing the wounds of tourism entrepreneurs who have made special arrangements for New Year celebrations.

While private hotels have arranged for DJ parties and Himachal folk dance, the Himachal Pradesh Tourism Development Corporation (HPTDC) is organizing New Year party at its Club house in Manali. HPTDC assistant general manager Mohan Lal Sharma said couple can enjoy delicious food, couple games and folk dances on New Year eve and 2013 Miss Queen contest would be the main attraction, he said.

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Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

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Associated Press reporter Tom Odula contributed to this report.

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Cliffhanger: 'Major Setback' For Budget Talks

With less than two days remaining for Congress to reach a budget agreement that would avoid the so-called "fiscal cliff," ABC News has learned that negotiations have reached a "major setback."

According to Democratic sources the row was sparked when the GOP offered a proposal that included a new method of calculating entitlement benefits with inflation. Called the "chained consumer price index," or Chained CPI, the strategy has been criticized by some Democrats because it would lower cost of living increases for Social Security recipients.

"We thought it was mutually understood that it was off the table for a scaled-back deal," an aide said. "It's basically a poison pill."

President Obama has floated chained CPI in the past as part of a grand bargain, despite opposition from the AARP and within his own party.

Also in the Republican plan brought today: An extension of the current estate tax and no increase in the debt ceiling. Higher income earners would see their taxes increase, but at levels "well above $250,000," the sources said.

That "major setback" in the talks was evident on the floor of the Senate this afternoon.

"I'm concerned about the lack of urgency here, I think we all know we are running out of time," Senate Minority Leader Mitch McConnell, R-Ky., said, "I want everyone to know I am willing to get this done, but I need a dance partner."

J. Scott Applewhite/AP Photo

Sens. Charles Schumer and Jon Kyl on 'This Week' Watch Video

Fiscal Cliff Negotiations: Could Economy Slip Back into Recession? Watch Video

McConnell said he submitted the Republican's latest offer to Majority Leader Harry Reid, D-Nev., at 7:10 pm last night and was willing to work through the night. Reid promised to get back to him at 10 this morning, but has yet to do so.

Why have the Democrats not come up with a counteroffer? Reid admitted it himself moments later.

"At this stage we're not able to make a counteroffer," Reid said noting that he's had numerous conversations with Obama, but the two parties are still far apart on some big issues, "I don't have a counteroffer to make. Perhaps as the day wears on I will be able to."

McConnell said he believes there is no major issue that is the sticking point but rather, "the sticking point appears to be a willingness, an interest, or frankly the courage to close the deal."

Reid said the fiscal cliff negotiations are getting "real close" to falling apart completely.

"At some point in the negotiating process, it appears that there are things that stop us from moving forward," he said. "I hope we're not there but we're getting real close and that's why I still hold out hope that we can get something done. But I'm not overly optimistic but I am cautiously optimistic that we can get something done."

Reid said there are serious difference between the two sides, starting with Social Security. He said Democrats are not willing to cut Social Security benefits as part of a smaller, short-term agreement, as was proposed in the latest Republican proposal.

"We're not going to have any Social Security cuts. At this stage it just doesn't seem appropriate," he said. "We're open to discussion about entitlement reforms, but we're going to have to take a different direction. The present status will not work."

Reid said that even 36 hours before the country could go over the cliff, he remains "hopeful" but "realistic," about the prospects of reaching an agreement.

"The other side is intentionally demanding concessions they know we are not willing to make," he said.

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Body of India rape victim cremated in New Delhi

NEW DELHI (Reuters) - The body of a woman, whose gang rape provoked protests and rare national debate about violence against women in India, arrived back in New Delhi on Sunday and was cremated at a private ceremony.

Scuffles broke out in central Delhi between police and protesters who say the government is doing too little to protect women. But the 2,000-strong rally was confined to a single area, unlike last week when protests raged up throughout the capital.

Riot police manned barricades along streets leading to India Gate war memorial - a focal point for demonstrators - and, at another gathering point - the centuries-old Jantar Mantar - protesters held banners reading "We want justice!" and "Capital punishment".

Most sex crimes in India go unreported, many offenders go unpunished, and the wheels of justice turn slowly, according to social activists, who say that successive governments have done little to ensure the safety of women.

The unidentified 23-year-old victim of the December 16 gang rape died of her injuries on Saturday, prompting promises of action from a government that has struggled to respond to public outrage.

The medical student had suffered brain injuries and massive internal injuries in the attack and died in hospital in Singapore where she had been taken for treatment.

She and a male friend had been returning home from the cinema, media reports say, when six men on a bus beat them with metal rods and repeatedly raped the woman. The friend survived.

New Delhi has the highest number of sex crimes among India's major cities, with a rape reported on average every 18 hours, police figures show. Reported rape cases rose by nearly 17 percent between 2007 and 2011, according to government data.

Six suspects were charged with murder after her death and face the death penalty if convicted.

In Kolkata, one of India's four biggest cities, police said a man reported that his mother had been gang-raped and killed by a group of six men in a small town near the city on Saturday.

She was killed on her way home with her husband, a senior official said, and the attackers had thrown acid at the husband, raped and killed her, and dumped her body in a roadside pond.

Police declined to give any further details. One officer told Reuters no criminal investigation had yet been launched.

"MISOGYNY"

The leader of India's ruling Congress party, Sonia Gandhi, was seen arriving at the airport when the plane carrying the woman's body from Singapore landed and Prime Minister Mannmohan Singh's convoy was also there.

A Reuters correspondent saw family members who had been with her in Singapore take her body from the airport to their Delhi home in an ambulance with a police escort.

Her body was then taken to a crematorium and cremated. Media were kept away but a Reuters witness saw the woman's family, New Delhi's chief minister, Sheila Dikshit, and the junior home minister, R P N Singh, coming out of the crematorium.

The outcry over the attack caught the government off guard. It took a week for the prime minister to make a statement, infuriating many protesters. Last weekend they fought pitched battles with police.

Issues such as rape, dowry-related deaths and female infanticide rarely enter mainstream political discourse.

Analysts say the death of the woman dubbed "Amanat", an Urdu word meaning "treasure", by some Indian media could change that, though it is too early to say whether the protesters can sustain their momentum through to national elections due in 2014.

U.N. Secretary General Ban Ki-Moon added his voice to those demanding change, calling for "further steps and reforms to deter such crimes and bring perpetrators to justice".

Commentators and sociologists say the incident earlier this month has tapped into a deep well of frustration many Indians feel over what they see as weak governance and poor leadership on social issues.

Newspapers raised doubts about the commitment of both male politicians and the police to protecting women.

"Would the Indian political system and class have been so indifferent to the problem of sexual violence if half or even one-third of all legislators were women?" the Hindu newspaper asked.

The Indian Express said it was more complicated than realizing that the police force was understaffed and underpaid.

"It is geared towards dominating citizens rather than working for them, not to mention being open to influential interests," the newspaper said. "It reflects the misogyny around us, rather than actively fighting for the rights of citizens who happen to be female."

(Additional reporting by Ross Colvin and Diksha Madhokin New Delhi and Sujoy Dhar in Kolkata; Editing by Louise Ireland)

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Obama, top lawmakers meet on cliff edge

WASHINGTON: President Barack Obama Friday sought a late deal to stop the US economy tumbling off a "fiscal cliff" next week, gathering top congressional leaders for crunch White House talks.

Obama is trying to broker a deal to avert huge tax increases and spending cuts due to come into force as the year turns on Tuesday, as dysfunctional Washington reluctantly works through a disrupted holiday period.

A sense of building crisis was exacerbated by sliding stock prices on Wall Street as the political stalemate threatened a set off chain reactions that could drive America back into recession and rattle the global economy.

Obama met top Republicans, House Speaker John Boehner and Senate Minority Leader Mitch McConnell, and top Democrats, Senate Majority Leader Harry Reid and House Minority Leader Nancy Pelosi, in the Oval Office.

But with time so short, the last-ditch talks to head off a $500 billion fiscal time bomb due to detonate on January 1 appeared unlikely to forge a permanent solution on a long-term deficit reduction deal.

Instead, Obama, now banking on a stopgap solution after talks on a grand debt and tax bargain with Boehner failed, wants taxes on American families earning more than $250,000 a year to go up but to spare the middle class.

Obama will not make a new offer to Republicans, a source familiar with the meeting said, adding that the president would ask for an extension of expiring unemployment insurance for two million people.

He will also tell Republicans that if they cannot come up with a counter-proposal to avert the fiscal cliff they must allow his plan to come up for a vote in both chambers of Congress, the source said.

Such a scenario would leave Republicans in a tough political spot as if they refuse, it would be easy for the White House to blame them for the economy toppling over the cliff.

It is not clear whether the Obama plan would avert massive spending cuts due to come into force on January 1, and does not deal with his request to raise the $16 trillion ceiling on government borrowing.

Republicans want to extend George W. Bush-era tax cuts due to expire on Tuesday for everyone and accuse the president of failing to offer meaningful spending cuts in a bargain in return for them agreeing to raise revenues.

Some top lawmakers clung to hope.

"Sometimes, it's darkest before the dawn," said Democratic Senator Chuck Schumer on NBC, saying McConnell's role could be a catalyst for action.

But Republican Senator Bob Corker complained Obama and Democrats in Congress had balked at cutting spending on key social programs weighing on the budget, and inflating the deficit, accusing them of a "total dereliction of duty."

"We're going to end up with a small, kick-the-can-down-the-road bill that creates another fiscal cliff to deal with this fiscal cliff. How irresponsible is that?" Corker told reporters.

Retiring Democratic Senator Ben Nelson warned: "If this meeting is not successful in achieving a proposal, I think you need to get a parachute."

Obama broke off his vacation in Hawaii in search of a last-minute deal and Boehner called the House back to work on Sunday.

The president's scaled-down solution calls for an extension of tax cuts for people earning less than $250,000, and an extension of unemployment benefits before a wider effort to trim the deficit next year.

But it is doubtful the package could pass the House as restive conservatives last week rebuked Boehner by rejecting his fallback plan which would have raised taxes on people earning $1 million.

While each side must for the sake of appearances be seen to be seeking a deal, the easiest way out of the mess might be to allow the economy to go over the cliff, but to fix the problem in the first few days of next year.

In that scenario, Republicans, who are philosophically opposed to raising taxes, could back a bill to lower the newly raised rates on almost all Americans, thus sidestepping the stigma of raising taxes.

Recent polls show a majority of Americans back Obama's handling of the crisis, and would blame Republicans for a failure to fix it, so the president could get a short-term political boost from an early deal next year.

Should the stalemate linger however, the crisis would cloud the early months of Obama's second term, would dent his popularity and could detract from his key political goals like immigration reform and gun control.

-AFP/ac

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Park Street case no rape, but ‘deal’ gone sour: MP Kakoli Ghosh Dastidar

KOLKATA: How many times must a rape victim be humiliated when she sticks to her complaint? In Bengal, it is as many times as it suits the politicians. Or, so it seems, given the way Trinamool Congress MP Kakoli Ghosh Dastidar hit out at the Park Street rape victim yet again on Friday.

Not only did Ghosh Dastidar rubbish the rape complaint, in a crass attempt at character assassination she dubbed the case a misunderstanding between a "woman and her client".

"They (the Park Street rape and Delhi gang rape) are totally different. The incident at Park Street was not a rape at all. It was a misunderstanding between two parties involved in professional dealing — a woman and her client," Ghosh Dastidar told a private television channel on Friday.

The derogatory comment left the victim appalled and civil society disgusted. "I am shocked and pained at such a statement from an educated, polished public representative, that too a woman. I thought the Delhi gang rape would be an eye-opener for all of us, including politicians. But this kind of insensitivity has saddened me," the victim said.

"I went to the night club on my own. How did the MP know that I went there to strike a deal? Is it because the rapists left me alive? And what sort of a message is she trying to send out? Does she mean to say that sex workers can be raped?" she asked.

The victim was taken aback at the humiliation that continues even after the police had submitted the chargesheet and urged a collective statement from women slamming such a disparaging comment.

Writer-social activist Mahasweta Devi termed the remark "improper". "Such a comment should not have co-me from a woman. It reflects how insensitive she is. This is not expected from an educated lady and a public representative like her. So what if the victim is a 'public woman'? One should not even make such a remark against a sex worker," she said.

The Barasat MP is the new member of the club of irresponsible politicians after CPM's Anisur Rehman and Congress' Abhijeet Mukherjee who have drawn flak for maligning women in the past few days. While chief minister Mamata Banerjee had termed the Park Stree rape case a "sajano galpo (concocted story)", never before had any of her Trinamool colleagues raised questions about the victim's character in such blatant and gross terms. Immediately after the incident, transport minister Madan Mitra had questioned why a mother had to go to a night club.

Senior Trinamool leader Subrata Mukherjee, who was quick to condemn Anisur Rehman's sexist comment against the chief minister, was not so forthcoming when asked for his reaction on Ghosh Dastidar's insensitive remark. "You ask the person who made the comment," the minister said.

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