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Healthcare Resource Guide - Sweden
Capital: Stockholm
Population: 10,230,185
GDP*: $550.337 billion
Currency: Swedish Krona (SEK)
Healthcare - Sweden
Explore healthcare export opportunities and the regulatory environment in Sweden.
Government and Association Links
Tab Options Executive Summary Market Entry Current Market Trends Best Prospects Market Size Main Competitors Registration Process Reimbursement Barriers Procurement and Tenders Government and Association Links FAQs U.S. Commercial Service Contact Information
Sweden's healthcare system is one of the best and most well-developed in the world. The population of 10 million enjoys very good health overall. Sweden spends about 11% of its Gross Domestic Product (GDP) on health and medical services, which is on par with most other European countries. The infant mortality rate is less than 2.6 deaths per 1,000 in the first year of life and the average life expectancy is 80 years for men and 84 years for women. As Sweden has a population that is one of the oldest in the world (20.37% are 65 years or older), there will be an increasing demand for medical equipment and supplies, as well longer-term medical treatments, to meet the health needs of an aging population.
The responsibility for health and medical care in Sweden is shared by the central government, the regions, and the municipalities. Sweden is divided into 290 municipalities and 21 regions. The regions have the primary responsibility for providing health and medical services. They decide on the allocation of resources to health services and are responsible for the overall planning of the services offered. It is also the regions that own and run the hospitals, health centers, and other institutions. Regions are responsible for dental care for residents up to the age of 23. The 290 municipalities are responsible for the disabled, home healthcare of the elderly, and nursing homes. They are also responsible for providing care for people with psychological disorders, support and services for people released from hospital care, and school healthcare. Private healthcare, accounting for 12% of total healthcare costs, mainly offers primary care, such as healthcare centers or homes for the elderly.
There are 100 hospitals in Sweden, of which about 85 are run by regional governments; the remainder are private. Seven of these 85 are regional university hospitals offering highly specialized care and where teaching and research is based. There are about 46,000 licensed physicians and 106,000 registered nurses in Sweden, most are employed in the healthcare sector. Outpatient care is organized into primary care districts, each with 5,000 to 50,000 inhabitants.
To successfully enter the Swedish market, it is recommended that firms from the United States (U.S.) establish a local presence, either through local agents, distributors, or sales subsidiaries. All products sold in Sweden must carry the CE mark. In addition, all labeling and instruction manuals must be translated into Swedish.
Sweden's customs laws and regulations follow those of the European Union (EU). As such, Sweden applies external EU tariffs to imports from the U.S. and other non-EU countries. Goods imported to Sweden are also subject to a value added tax (VAT) of 25%. Sweden uses the metric system and products sold in Sweden should be adapted for use with the metric system whenever possible. Electric current in Sweden is 50 Hz, AC 230V single-phase and 230/240V three-phase.
The two main factors that are expected to have strong effects on the Swedish healthcare system in the future are:
An aging population, which is likely to lead to increased demand for healthcare products as well as healthcare related services such as equipment and supplies for the home healthcare sector.
Lifestyle related diseases and conditions such as diabetes, being overweight, etc.
Of the predominant diseases, the main causes of death are cardiovascular conditions including strokes (35%) and cancer (26%). Chronic diseases that require monitoring and treatment, and often life-long medication, place significant demands on the system.
The incidence of smoking, however, has been falling in Sweden since the mid-1980s. According to a European Union survey, only 9% of people smoke daily, the lowest proportion among all EU member states.
Best prospects and current demand for U.S. exporters include:
e-health and other areas of healthcare-ICT interaction such as telemedicine and m-health; and
medical equipment.
The Swedish government launched a national strategy for e-health in 2006, updated in 2010, which emphasizes that information and communication technology will be used as a strategic tool at all levels in the healthcare sector. It also states that "citizens must also be able to contact care services via the internet for assistance, advice or help with self-treatment." In 2017, for continued development work in the field of e-health, the Swedish government and the Swedish Association of Local Authorities and Regions endorsed a common vision for e-health by 2025. The vision replaced the latest strategy from 2010 and will continue to build on the ideas and approaches to make use of the opportunities of digitization in social services and health care. The vision states that "in 2025, Sweden will be best in the world at using the opportunities offered by digitization and eHealth to make it easier for people to achieve good and equal health and welfare, and to develop and strengthen their own resources for increased independence and participation in the life of society."
Today, e-health is an integrated part of the healthcare sector. Swedish County Councils spend about SEK 10.6 billion ($1.2 billion) annually in healthcare IT, of which SEK 8 billion ($0.9 billion) is used for the procurement of services, software, equipment, and supplies. It is estimated that 95% of all documentation in primary care is made in electronic healthcare records (EHRs), while the corresponding figure for specialized hospital care is estimated at 69%. E-prescriptions have become very popular, and it is estimated that 99% of all pharmaceutical prescriptions in Sweden are issued electronically.
According to Business Monitor, the Swedish market for medical equipment is estimated at $2.6 billion in 2019, and Sweden ranks as the third most attractive market in Western Europe in which to commercialize a medical device. For the coming years, the market is expected to show a moderate growth, around 4.8% per annum. Domestic production is strong in areas such as wheelchairs, hospital furniture, sterilizers, and blood pressure monitors, and Swedish innovations such as the pacemaker, hemodialysis, and the gamma knife have gained international recognition. As most of the domestic manufacture is for export, the medical equipment market is dependent on imports. In 2017, imports were estimated at $1.7 billion. The best sales potential for U.S. manufactured medical equipment is expected to be in the following areas:
Non-invasive surgical equipment
Orthopedic and prosthetic equipment
Home healthcare – equipment and supplies
Healthcare spending (including investment)
SEK 504.5 billion
… as% of GDP:
… of which spent on inpatient services (including long-term care)
SEK 187.1 billion (37%)
… of which spent on pharmaceuticals/consumables:
SEK 62.2 billion (12.3%)
… of which spent on investments
SEK 25.7 billion (5.1%)
… of which spent on outpatient services
SEK 147.6 billion (29.3%)*
*Not including home healthcare spending
Source: Statistics Sweden. System of Health Accounts (SHA). https://www.scb.se/en/finding-statistics/statistics-by-subject-area/national-accounts/national-accounts/system-of-health-accounts-sha/
Hospitals, Procedures, Healthcare Professionals
Number of hospitals
Number of hospital beds
… available beds per capita
2.32 per 1,000 people
…of which in general hospitals
…of which in specialized clinics and rehabilitation centers
Number of surgical procedures
…of which minor surgical procedures
532,136 (18.5%)
…of which transluminal endoscopic surgery
…of which surgeons
…of which internists
…of which pediatricians
Note: The number of physicians and dentists refer to the total number licensed practitioners not older than 65.
Hospitals and beds: Swedish Association of Local Authorities and Regions (SKL). https://vardenisiffror.se/hospitals. https://skl.se/ekonomijuridikstatistik/statistik/ekonomiochverksamhetsstatistik/landstingekonomiochverksamhet.1342.html.
Procedures and professionals: The National Board of Health and Welfare. http://www.socialstyrelsen.se/publikationer2016/2016-10-15. http://www.socialstyrelsen.se/statistik/statistikdatabas.
Life expectancy men/women
80 / 84 years
2.4 deaths per 1,000 live births
Percent of population older than 65
…projection, 2030
Annual deaths
…caused by cardiovascular diseases:
31,999 (35%)
…caused by cancer/tumors
Prevalence of [fastest growing disease burden]
Statistics Sweden. Population Statistics. https://www.scb.se/en/finding-statistics/statistics-by-subject-area/population/population-composition/population-statistics/.
Deaths: The National Board of Health and Welfare. Causes of Death. http://www.socialstyrelsen.se/statistics/statisticaldatabase/causeofdeath.
In the e-health sector, there are few service providers that dominate the market. Five suppliers (Cerner, Evry, Cambio, CombuGroup, and Norbotten County Council) have a 97% share of all users among their eight systems.
For medical equipment, domestic production is strong (wheelchairs, hospital furniture, sterilizers, and blood pressure monitors) and the medical device sector is one of the leading export sectors in Sweden. Some of the internationally known Swedish medtech companies include Getinge (medical systems, extended care, and infection control), Molnlycke Healthcare (single-use surgical and wound care), and Elekta (the Leksell Gamma Knife). Major global companies with a strong presence in Sweden include GE Healthcare, Baxter, Fresenius, Philips, Abbott, Thermo Fisher, Johnson & Johnson, Siemens, and Nobel Biocare.
The Medical Products Agency (MPA) is the Swedish national authority responsible for regulation and surveillance of the development, manufacturing and marketing of medical devices, drugs and other medicinal products. The Medical Products Agency can be reached at www.lakemedelsverket.se.
Capitation is a reimbursement form that is applied to a large portion of the primary care activities in Sweden. This entails a fixed capitation for the healthcare provider, received per patient registered at the primary care center, regardless of whether the patient seeks treatment or not.
Outpatient specialist care providers are reimbursed through payment per treatment (tariffs). The tariffs can be either fee-for-service, i.e. the provider receives remuneration whenever the patient seeks treatment, or bundled payments whereby the provider is reimbursed for a full care episode independently of the number of care contacts.
Global budgets or a mix of global budgets, diagnosis-related groups (DRG), and performance-based methods are used to reimburse hospitals. Two-thirds or more of total payment is usually in the form of budgets, and about 30% is based on DRGs.
There are no significant trade barriers to U.S. medical devices.
Public tenders above specific contract values are published in the EU database TED
https://simap.ted.europa.eu/web/simap/european-public-procurement.
Sweden has no public database listing contracts with lower values. Instead, listings of procurements are provided via private sector databases. The major firms providing these are listed on the National Agency for Public Procurement webpage
http://www.upphandlingsmyndigheten.se/leverantor/forbereda/hitta-affarsmojligheterna/.
All public tenders regarding provision of private healthcare services are published at
https://www.valfrihetswebben.se.
Ministry of Health and Social Affairs: http://www.government.se/government-of-sweden/ministry-of-health-and-social-affairs/
Government agencies and regulators, trade associations:
The National Agency for Public Procurement: http://www.upphandlingsmyndigheten.se/
The Swedish e-Health Authority: www.ehalsomyndigheten.se
The National Board of Health and Welfare: www.socialstyrelsen.se
Swedish Association of Local Authorities and Regions: www.skl.se
Inera: https://www.inera.se/
Swedish medtech: http://www.swedishmedtech.se/
1. Do Medical products exported to Sweden need to be authorized/registered before being marketed and sold?
Medical devices on the Swedish market need to be registered with the Medical Products Agency.
For manufacturers of medical devices, it is also important to note that that labelling and instructions (user's manual, display, voice etc.) must be written in Swedish. This applies both when the device is being used by a patient or by trained staff and if the device is used in a hospital or in private. For certain devices it is also necessary that an assessment is carried out by a third party called a Notified Body to demonstrate that the device complies with the requirements.
Medicinal products can also be sold in Sweden only after being authorized/registered by the Swedish Medical Products Agency. This applies to products exported from the USA, but also to medicinal products that may already be on the market in other EU countries. All medicinal products need authorization from the Swedish Medical Products Agency. Furthermore, a product being sold as a food supplement elsewhere may be classified as a medical product in Sweden.
2. What are some specific market access issues to think about regarding Sweden?
With Sweden's healthcare system being very decentralized with 21 county councils in charge both of primary and specialized care, it can be difficult to find and keep track of all ongoing procurements. Much of the information in the tenders is often also communicated only in Swedish. The best approach for companies new to the Swedish market is to work with suitable local distributors. It is also recommended to visit and attend trade shows to get acquainted with the market.
U.S. Commerial Service Contact Information
Name: Johan Bjorkman
Position: Commercial Spercialist
Email: Johan.Bjorkman@trade.gov
Phone: +46 (0) 8-783-5356


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Q: HTML map with css rollovers? I have to create an html page for use on a CD. The navigation is an HTML map with co-ordinates set. When the user rolls over a co-ordinate, I want an image popup to appear beside it. There's 8 map links, and 8 corresponding image popups.
I could do this easily through jQuery, but the CD will be used on IE mainly. IE doesn't allow javascript to be run locally (without user interaction, which isn't acceptable).
Through jQuery I absolutely positioned the rollover images, but I can't set them visible through CSS with a hover. What's the best method to approach this?

A: You could always try some serious styling effects based on the Pseudo-class of :hover.
Without knowing your markup I would tackle along these lines...
HTML Markup

Map Text
Additional Pop Up Text

Map Text
Additional Pop Up Text

Map Text
Additional Pop Up Text

 ....

CSS Code
#mapWrapper {position:relative;} /* include width, height and any bg imagery */
ul#map, #map li {margin:0;padding:0;list-style-type:none} /* just to reset the list to be standard in different browsers */
#location-01 {position:absolute;} /* include with, height and position top-left items as required */
#location-02 {position:absolute;} /* include with, height and position top-left items as required */
etc...
#map li .item {display:none; } /* hide the pop up text, include defaults for position based on the location of the li */
#map li:hover .item {display:block;} /* show the pop up text on hover of the LI*/

/* Note: If you need to position each pop item uniquely you could use something like... If you do, remember to move the :hover effect to be the last item in your style sheet */
#map li#location-01 .item {display:none; }

Hope that helps you out, I have had to a similar map online (not with a CD) but wanted to do it without JS and that was the easiest way to do so.
Note:  If you need to offer IE6 support, you would probably be best changing the hover to be based on an ahref instead.
eg: Map Text Additional Pop Up Text

redpajama_set_name: RedPajamaStackExchange


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Israeli Outposts Remain Illegal Under International Law
Published by admin at 12:17 pm under Articles,Palestinian politics
On the surface, the issue seems rather futile. The Israeli government, which has built hundreds of exclusively Jewish settlements in the occupied territories in violation of international law, is being criticized for "legalizing" four of these illegal settlements. What is it about "outposts" that makes them different from other settlements? A deeper look at the issue reveals decades of attempts to fool the international community about Israel's commitment to peace.
To understand the difference, it is important to go back to the beginning of this century. The US and its allies were preparing to go to war against Iraq (after having already gone to war against Afghanistan in the aftermath of Sept. 11, 2001). To minimize potential anti-Americanism, the Bush administration leaned on its Israeli allies not to carry out any actions that would provoke the anger of Palestinians, Arabs and Muslims. The US attempts to simultaneously restart Palestinian-Israeli talks required that Israel refrain from any further official settlement activity.
As a result of this situation, the pro-settlement right-wing Israeli leader Ariel Sharon looked for ways to avoid carrying out any official settlement activity while wanting to disrupt any negotiations that could lead to Israeli withdrawal from the occupied territories. It was during this period in 2002 that then-prime minister Sharon called for Israeli settlers "… to capture the hilltops in the occupied West Bank before losing them to Palestinians in negotiations." Within a short time, 221 illegal Israeli settlement outposts were established.
The Israelis made it clear that they would turn a blind eye to attempts by Jewish settlers to expand and create new housing units. Thus, the term "outpost" was created to refer to settlements built without official Israeli government approval. While these outposts were not officially sanctioned, Israeli soldiers were made available to protect the settlers and their units once they were up.
By 2003, calls were raised to the State of Israel to honor its own laws and dismantle these settlements, many of which were built on Palestinian private lands, which added yet another layer of illegality. The issue became part of the internationally accepted Road Map for peace.
Usually, official Israeli settlements are built on "state land," or private land that is officially confiscated as needed for "public purposes." In those cases, the private Palestinian owners are offered financial compensation, which Palestinians reject across the board. When all else fails, private lands are often turned into state land.
The Israeli government, obsessed with having legal cover  for its internationally illegal acts, has always tried to respect its own rules. The outposts have been one major exception.
The level of government collusion in helping create these outposts was best revealed by Israeli Ministry of Justice official Talia Sasson. Sasson was asked by Sharon himself to investigate these outposts. This took place at a time that Sharon himself was experiencing a change of heart that led, among other things, to the dismantling of Jewish settlements in Gaza.
Sasson, who was at the time the head of the State Prosecutor's Criminal Department, issued a scathing report that caught many settlers and their supporters off guard. The 2005 Sasson report stated that the Israeli Ministry of Defense, the Ministry of Housing and Construction and the World Zionist Organization were diverting millions of shekels to build "illegal outposts" in the West Bank.
Over the past ten years, Israel has officially said it would dismantle the settlements built without official approval. These promises were made repeatedly to US officials, but nothing much came of it. Except for a few outposts that were reportedly dismantled, most have remained where they are, and the Israeli government has been looking for opportunities to "legalize" them in Israeli judicial terms.
The latest effort became public this week when information given to the Israeli High Court hinted that the Israeli government is "looking into ways to legalize four of the communities: Maaleh Rehavam, Haroeh, Givat Assaf and Mitzpeh Lachish." Peace Now, which publicized the issue, determined that the Israel government "is trying to avoid the enforcement of the law and to legalize the outposts instead of evicting them," said Hagit Ofran, a Peace Now spokesperson. She called the move "a slap in the face" to US Secretary of State John Kerry, who is expected in the region next week to kick-start Palestinian-Israeli peace talks.
Whether they are settlements approved by the state of Israel or outposts built without approval, all this construction is considered illegal by the international community. The International Court of Justice ruled clearly that Israeli occupation-built and defended settlements are illegal. The only question that remains is when the international community will have the power to stop this crime.
One Response to "Israeli Outposts Remain Illegal Under International Law"
# pabelmont on 21 May 2013 at 3:44 am
Settlement of occupied territory was always illegal for two reasons, the bringing of Israeli citizens across the line into occupied territory, and the taking of land for non-allowed reasons.
Israel always controlled who went into and who went out of occupied territories by checkpoints. Thus, the allowing of Israeli Jews to enter and remain within (i.e., settle, whether in "settlements" or in "outposts") was under government supervision and control and was a government project. That should be good enough to trigger the prohibition (of Geneva IV) to settlement.
The taking of land for these and other purposes is probably also illegal under I/L due to a prohibition on the occupier taking an land whatever (whether classified initially or later as state land) for any purpose other than military necessity or administration, and ther settlements fail on both counts.

redpajama_set_name: RedPajamaCommonCrawl


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Thurston Arthritis Research Center
Home / News / Dr. Saira Sheikh and Scientific Colleagues Partner with the American College of Rheumatology (ACR) on Newly Funded Grant from DHHS's Office of Minority Health. Project is Focused on Increasing Involvement of Minority Patients in Lupus Clinical Trials.
Dr. Saira Sheikh and Scientific Colleagues Partner with the American College of Rheumatology (ACR) on Newly Funded Grant from DHHS's Office of Minority Health. Project is Focused on Increasing Involvement of Minority Patients in Lupus Clinical Trials.
By Bradd Pavur
Earlier this year, Saira Sheikh, MD, Director of the UNC Rheumatology Lupus Clinic, and Director of the Clinical Trials Program at the UNC Thurston Arthritis Research Center, as well as Allen Anandarajah, MD, MS, Associate Professor of Allergy, Immunology and Rheumatology at the University of Rochester Medical Center, were invited by the ACR to partner with it in developing a grant proposal to the Department of Health and Human Services' (DHHS) Office of Minority Health. We are pleased to announce that the grant has now been funded.
Drs. Sheikh and Anandarajah will serve as the subject matter leads for the project and work with the ACR and collaborators in developing and expanding a multistage intervention model to increase providers' referral of minority patients to clinical trials focused on lupus. They will each lead a two-year longitudinal study at their institutions targeting medically underserved areas in the Durham Service Area in Durham, NC, and the Monroe Service Area in Rochester, NY, in order to evaluate the effectiveness of these programs.
Serving as expert advisors for this project will be Richard M. Wardrop III, MD, PhD, who is Associate Professor of Medicine and Pediatrics at UNC, and is also Governor-elect for the NC Chapter American College of Physicians. Also serving in the role of expert advisor is Donna Culton, MD, PhD, who is Assistant Professor of Medicine at UNC and President of the North Carolina Dermatology Association.
Congrats to Dr. Sheikh and colleagues on leading this national initiative with the ACR!
More from Thurston Arthritis Research Center
Welcome to our 2019 Rheumatology and Allergy/Immunology Fellows!
Dr. Scott Commins Appointed to National Tick-Borne Disease Working Group
Brian Diekman, PhD, and Lauren Schnabel, DVM, PhD, Receive NC TraCS Award to Research Use of Senolytic Therapy to Induce Apoptosis of Senescent Cells for Treatment of Osteoarthritis
Contact the Arthritis Research Center
3300 Thurston Bldg., CB# 7280
Phone: 1-866-TARC-UNC (1-866-827-2862)
Contact the Rheumatology Clinic
UNC Rheumatology Clinic
6013 Farrington Road
Bldg 200, Suite 301
Contact the Allergy & Immunology Clinic
UNC Allergy & Immunology Clinic
© 2019 Thurston Arthritis Research Center


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Colossus: The Forbin Project (1970)
I am really sorry about this. I mean it. You see, I just didn't know. It was only after I'd done the notes for this month's film that I heard from a friend that there were people out there hoping I'd pick some great comedies to write about during the long winter months. Oops. Maybe those people should skip this column. If you're slipping into a mild seasonal depression, reading about a film that moves from crisis to defeat might be unhealthy. Then again, Colossus: The Forbin Project (1970) does have Gordon Pinsent as the President of the U.S. And looking at Sixties' hairdos would brighten up anyone's day.
The Sixties was a great time for paranoia, both in life and in the arts. Between the Vietnam War and the skullduggery & thuggery of the Cold War there was no question that any fears one had about conspiracies against humanity were justified. Those years produced two of the greatest artistic expressions of paranoia: Joseph Heller's Catch-22 and Stanley Kubrick's Dr. Strangelove (1964). Colossus (1970) isn't in that league, but coming as it did at the tail end of the decade it was a wonderfully depressing footnote. Yes! it told us with grim enthusiasm, there may be worse alternatives than living with the threat of nuclear Armageddon. Gosh! we're so darned creative we can invent something that'll make sure we never have the opportunity to be stupid again.
Dr. Charles Forbin (Eric Braedon) is a computer specialist working for one of those secret government agencies that somehow manages to get billions of dollars in funding without officially existing. His brainchild, literally, is a supercomputer named Colossus.
Forbin doesn't trust human beings. Better that America's nuclear arsenal be under the dispassionate control of a machine than under the twitching trigger fingers of the generals and politicians who pay him. He does have a point. Forbin's not mad, he's just overly optimistic:
"Colossus' decisions are superior to any we humans can make, for it can process more knowledge than is remotely possible for the greatest genius that ever lived. And even more important, it knows no emotion—no fear, no hate, no envy. It cannot act in a sudden fit of temper—cannot act at all so long as there is no threat."
Yeah, right. Define "threat." No fear, no hate, no envy…. no conscience. Haven't any of these people read Frankenstein?
To give credit where credit's due, Forbin's invention turns out to be even better than he thinks it is. Its learning curve is steeper Isaac Asimov's. Colossus is even more convincing in the 1990's, when a world chess grandmaster such as Kasparov nearly has to share his title with something that comes in a large box. What's becoming clearer is that we may never recognize the moment when (if it ever happens) a computer moves from manipulation of digits to structuring of thoughts.
Even worse than the fact that Forbin hands the whole enchilada over to Colossus is that his Soviet counterpart has done the same with a machine called Guardian. Colossus, wired into the world communications and energy net, discovers its counterpart immediately. Communications are initiated. Their respective human designers watch in awe as the two computers run through (and beyond) the entire evolution of human thought in a matter of hours. Aw shucks, it's kind of like having manufactured Einstein or Mozart. Someone wisecracks that the next step after personalization of the machines is deification, and everyone has a good chuckle.
The laughter disappears when Colossus and Guardian launch preemptive nuclear strikes against their supposed masters. Really big oops. It finally sinks into Forbin's self-satisfied brain that he's committed Dr. Frankenstein's greatest sin: Never build anything you can't unplug.
By this time, unfortunately, Colossus has Forbin under house arrest and is telling him he's using too much vermouth in his martini. Now that's omnipotence. Cardinal scientific sin number two: Never give nuclear weapons to anything smart enough to tell you how to mix a martini.
But wait just a cotton-pickin' minute here. We're talking about human beings in a life and death struggle for survival. Dinosaurs may have had brains the size of walnuts; we don't. Can humanity really be outsmarted by a souped-up adding machine with delusions of grandeur? Would Hollywood ever release a movie where all the good guys get shmucked? You betcha! Remember that in a world where Rod Serling could produce The Twilight Zone, and Chris Carter can get the X-Files on the air, anything is possible.
As the winter snows creep relentlessly down our Kootenay mountainsides (hey, I warned you not to read this column) I'd like to close with Colossus' touchingly pathetic picture of Colorado tourists admiring the supercomputer's mountain stronghold, for a brief moment blissfully ignorant of their new masters' existence. While at the same moment, in California, Forbin is listening to a short lecture from his new boss:
'This is the voice of World Control. Obey me and live. Disobey me and die. The object in creating me was to eliminate war—this objective has been obtained. War is wasteful. Man is his own worst enemy. I will restrain man. You will come to obey me with a fervor based on the most enduring trait in man: self-interest. Elimination of famine, overpopulation, disease—the human millennium will be a fact. Freedom is an illusion. All you will lose is pride. You will come to regard me not only with respect and awe, but with love."
Martini anyone?
Another film to which I no longer have easy access. It's available in a new Blu-Ray version from Amazon, so I'll be putting in an order. I definitely need another look.
Unfortunately, my science fiction reading over the last couple of decades has been pretty slim, so I can't suggest anything new in the way of stories/novels about rogue AI's. There must be some great ones out there. If anybody reads this and can help me out, it would be greatly appreciated. In the meantime, I'll pull out a couple of my still-unread The Year's Best Science Fiction anthologies off the shelf. Editor Gardner Dozois always packs in some doozies.
Director: Joseph Sargent
Actors: Eric Braeden, Susan Clark, Gordon Pinset
Original Review: November 1996
Trial – by the Brothers Lynch
https://www.youtube.com/watch?v=z3HmFRNIo5E
A 15-minute science fiction short that could be an abbreviated episode of the Black Mirror TV series. Hits hard like a first-class sci-fi short story should. "All progress has a price," says a key character. The Brothers Lynch want you to imagine the kind of society that will pay this one.
The Black Film Canon: The 50 Greatest Movies by Black Directors
http://www.slate.com/articles/arts/cover_story/2016/05/the_50_greatest_films_by_black_directors.html
Exactly what the title says it is. The films are listed in alphabetical order, and if you click on the accompanying photo still you'll get a capsule review. The oldest entries: Oscar Micheaux's Within Our Gates (1920), Spencer Williams' The Blood of Jesus (1941), Ousmane Sembène's Black Girl (1966), Gordon Parks' The Learning Tree (1969), Gordon Parks' Shaft (1971), Djibril Diop Mambéty's Touki Bouki (1973). You can sort the list by title or by year, or run other searches based on parameters such as Biopic, Doc, Hood, Int'l, Female Directors, etc.
Something Weird: The Very Best in Exploitation Cinema!
https://www.somethingweird.com/index.php
Exactly what the title says it is. If you're looking to buy copies of Assassin of Youth (Marijuana), Nude on the Moon, Bad Girls Go to Hell, or Olga's House of Shame, look no further. This adults-only website for all that's cheesy is based out of Seattle. I'll leave the sub-categories to your imagination. Also features less predictable titles such as Atomic Scare Films, Campy Classroom Classics, and Classic TV Commercials. Some entertaining one-page reviews ("Watch this film [Submission (1969)] with a dysfunctional loved one of your own"). Quentin Tarantino was here.
Peau d'âne (Donkey Skin), Candy, Dodes' Kaden, Ryan's Daughter, Les Choses de la vie (The Things of Life), L'Enfant sauvage (The Wild Child), Le Boucher (The Butcher), Airport, Borsalino, Woodstock, The Confession, M*A*S*H, Investigation of a Citizen Above Suspicion, Drama of Jealousy (The Pizza Triangle), Myra Breckingridge, Beyond the Valley of the Dolls, Catch-22, Five Easy Pieces, The Choice, The Private Life of Sherlock Holmes, Love Story, Little Big Man, Deep End, The Owl and the Pussycat, Le genou de Calire (Claire's Knee), The Boys in the Band, Cotton Comes to Harlem, Tora! Tora! Tora! Husbands.
Films: 2001: A Space Odyssey (1968)
Books: Frankenstein, by Mary Shelley
COLOSSUS: THE FORBIN PROJECT was not a big hit at the box office for various reasons. One is that its cast wasn't exactly well known. Another reason is that its ending isn't exactly a happy one. Still a third reason is that Universal had trouble trying to promote it in the wake of the huge success of Stanley Kubrick's 2001: A SPACE ODYSSEY. The latter reason is obvious: Colossus and Guardian, like HAL in the Kubrick movie, become central characters here. The difference here is that while HAL malfunctions due to a programming conflict, Colossus and Guardian remain all too stable, convinced beyond a doubt that they know how to protect Mankind better than Man himself. As the computers point out: "One inevitable rule is that Mankind is his own worst enemy." [virek213]
A lot has already been said about this compelling, oft-overlooked film, virtually all of which hits the proverbial nail on the head. While Eric Braeden delivers a superb, understated performance as Dr. Charles Forbin, the fact is that the real star of the film is the vast, omnipotent machine he has created. Even before it begins to speak with the chilling Cylonesque voice it has ordered designed for itself (the great Paul Frees like you've never heard him before), you'll find yourself glued to the screen watching Colossus "talk" to its supposed masters over its huge monitors….Frees gives Colossus an emotionless yet fearful quality of speech that seems to belie its implacable drive to dominate human destiny.
My favorite part of this film has always been, and will always be, the climactic monologue Colossus announces to the listening masses of humanity. From its opening line — "This is the voice of world control," an identity neither Colossus nor its counterpart, Guardian, had used to that point — you know this isn't going to be a happy speech if you are a sentient, flesh & blood resident of the Earth. What is particularly creepy about the speech is that, for all of its strangely optimistic sermonizing about how "the human millennium will be fact" and how the computer will set about the task of "solving all the mysteries of the universe for the betterment of man" — outwardly the Utopian dream — the message Colossus is presenting is set against the dreadful backdrop of "disobey (me) and die." As Colossus intones, "You say you lose your freedom. Freedom is an illusion. All you lose is the emotion of pride." In the end, unlike other supercomputer-run-amok films such as "War Games" or "Tron," "Colossus" is an end-of-the-world story without the nuclear or viral holocaust. In this film, it is the human spirit that is the casualty while the human biology lingers on. Unlike the rest of the doomsday genre, our end comes not so much with a bang as it does with a whimper. [alynsrumbold]
I have not seen this movie in 30 years, but I remember every scene as if it were yesterday, and the deep feelings that I had when I first saw it lingers on as well. THOSE are the marks of a truly memorable film….
What makes this move work on so many levels is that it taps into our greatest fears — one of which is NOT death, but the loss of control over our lives. Why are people afraid to fly when their chances of being killed in an auto crash are so many times greater? Loss of control. [dr_rip]
This film is on my list of the 10 best under-rated films of all time. Most horror films leave me cold, but this film is flat out scary. [thaneofmemphis]
This is one rare movie. It deals intelligently with complex scientific issues and does so without dumbing down the concepts, nor making any painful errors in trying to keep up with its own topic. I found it convincing when I was a kid hacker in the mid-70's (when "hacker" meant "person who writes programs for fun"), and it is just as persuasive to me now (after I have acquired a computer science grad degree, and 25 years of experience in the field).
Spooky score takes it up a rung on the ladder, too. See it. [pro_crustes]
The moral of this movie makes an interesting contrast with the moral of "Forbidden Planet." "Forbidden Planet" showed that no matter how advanced our civilization gets technologically, we can't escape the "monsters" buried deeply in the baser instincts of our subconscious. "Colossus" showed that we can't escape hubris or "Murphy's Law" either. [sdlitvin]
Many of the Artificial Intelligence / supercomputer films, that have been released in the last thirty years have borrowed, if not downright stolen, their ideas from what Colossus set out. Gene Roddenberry used the idea in the 1968 Star Trek episode, 'The Ultimate Computer', while James Cameron cites Colossus as his inspiration for Skynet, in his 1984 movie 'The Terminator'. [Darryl_G_Morrissey]
I felt compelled to write about "Colossus: the Forbin Project" as it is still on my mind. I had a somewhat strange reaction to it. I can't remember the last time I was actually frightened by a film in the same way that I was frightened by this one. Typically, my fear response only kicks in when I see a potent image thrust at me quickly or when a movie uses unusual, eerie sounds to induce anxiety. Most films tend to frighten people by this primitive jack-in-the-box method.
But the fear "Colossus: the Forbin Project" gave me is the same fear I experienced after reading Orwell's "1984". It's the fear of being taken over. Of losing personal freedom. As the Colossus computer's demands and actions grow and become all-encompassing the audience's reactions seem to mirror the Forbin character's reactions. To watch him slowly crumble in the face of what he has created is frightening because he seems so implacable for most of the movie. We put our faith in him because he reacts to each twist in the plot with a knowing smile. [tbyrne4]


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Sokołowa Wola  (, Sokolova Volia) is a former village in the administrative district of Gmina Czarna, within Bieszczady County, Subcarpathian Voivodeship, in south-eastern Poland, close to the border with Ukraine. It lies approximately  north-west of Czarna,  south of Ustrzyki Dolne, and  south-east of the regional capital Rzeszów.

References

Villages in Bieszczady County

redpajama_set_name: RedPajamaWikipedia


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Album Review: Graham Nash – This Path Tonight
The CSNY legend sounds unburdened on his fresh solo outing
Corbin Reiff
April 11, 2016 | 12:01am ET
Life is an unpredictable journey whose path can lead you into places that you never thought you'd end up. What's the old saying: If you want to make God laugh, tell him your plans? It's almost certain that a few years ago, the idea that vaunted '60s singer-songwriter Graham Nash would have ended his decades-long marriage and scuttled his extremely lucrative partnership with David Crosby and Stephen Stills to embark on a renewed solo career with a fresh love interest would have probably seemed preposterous. And yet here we are.
For his first solo album in 14 years, Nash mines a trio of themes that have sustained a majority of writers throughout history: love, loss, and finality. At 74 years old, the former Hollies singer offers a unique perspective on all three, a view that rarely gets explored by din of the fact that there just aren't many people his age writing up to the same level of viable music. Young love is a topic that has been covered a million times throughout the years, but what's it like to discover love anew in the twilight of your life? How, as a person, do you change through the passage of time? How do your desires and goals shift, alter, and morph?
The really interesting thing is that Nash doesn't seem to have any answers, but instead relishes the questions themselves. On the title track and album opener he acknowledges that he doesn't know where he's going in this life anymore, but feels compelled to keep moving forward regardless. He parries each of the larger questions above with a series of questions of his own. "I try to answer all that's asked/ I try my best to be myself, but wonder who's behind this mask."
Alternately on "Myself at Last", a treacly ballad which he's publicly dedicated to his new girlfriend, Nash seems plainly overjoyed to have shifted off the road he'd been traveling down into new, exhilarating directions. "It's so hard to fight the past," he admits, "but the day that breaks before me may never be surpassed." Having spent the last decade as the nominal caretaker for the legacy of Crosby, Stills, Nash and sometimes Young, Nash has been mired in the subject his own past, and it sounds like he's delighted to finally put all of that behind him and instead look forward. "The question haunting me/ Is my future just my past?" The answer on this song at least appears to be a resounding no.
One thing time hasn't seemed to have affected is Nash's singing voice. It's absolutely incredible how fresh and similar it sounds to that high, crisp register present on earlier hit songs like "Marrakesh Express", "Carry On", or "Our House". While other artists of his generation are forced to drop keys or modify their entire approach to singing and writing, Nash remains completely free to be the same artist that he's always been. It's truly a gift, and one that isn't squandered.
This Path Tonight is almost completely made up of acoustic arrangements. There are certainly keyboard accents and electric guitar lines thrown in here and there to keep things interesting, but the compositions are startlingly simple. This is a no-frills type of record that prizes style over substance. If there is any kind of solo, like the acoustic piece near the end of "Cracks in the City" or the harmonica tangent on "Target", it's kept short, and done tastefully. The bombastic chorus of "Fire Down Below" is the lone — and most welcome — exception to this rule.
It's been quite a while since Nash has released a collection of new material — even the last Crosby, Stills & Nash record came out in 1999. The past decade has found the singer seemingly going through the motions, hitting the road, playing the hits, writing a memoir, digging out old tapes, and generally moving laterally. The act of breaking that particular cycle almost certainly has to be a thrilling proposition no matter how you cut it, and if you were to use one word to describe the figure you hear on This Path Tonight, that word would be "unburdened."
Essential Tracks: "This Path Tonight", "Fire Down Below"
Earl Sweatshirt's SICK!: Flawless Rapping That Doesn't Overstay Its Welcome
FKA twigs Searches for Herself Again on CAPRISONGS
The Boy Named If Proves That Elvis Costello & The Imposters Have No Intention of Slowing Down
Tune Into Dawn FM For Some Addictive Easy Listening, Courtesy of The Weeknd
Album Review: Graham Nash - This Path Tonight


The ethnic diversity series is photographed in Massachusetts, portraits of naturalized citizens from nearly 170 countries residing in the state for the publication of The Bay State: A Multicultural Landscape.
Photography is the medium that best expresses my observations, documents my travel experiences, and helps me to satisfy my curiosity about the world, whether it is down the street or 'Down Under'. Carrying a camera gives me a license to explore new places and a self-confidence to engage with strangers in their work settings and in their daily lives.
I've spent a good part of my life sharing the resulting images in exhibitions, on the pages of books, in magazines and newspapers. A photograph is meant to be shared. It needs to be seen. Yet not everyone sees the same things in a photograph, or sees them in the same light. We see what we want to see; we make our own interpretations; and we discover new details when we look again at the image. Remember the film 'Blowup'?
A photograph is like a joke. Some people laugh their heads off. Others just smile. Some don't get it.
I can barely explain what makes me take a photograph of something. It is a reflex action, a magical surge of recognition between my brain and my eye connecting with my finger on the shutter button. Seeing the printed image from the negative reminds me of what I saw – the humor of the situation, or the poignancy, the play of shadows, the graphic patterns, the composition; the juxtaposition of elements.
Some time ago I realized when looking through my files of prints and contacts that my photographs are more than pictures of people, places, and things that touched me in some emotional, intellectual, or whimsical way. Many of them also contain two or more of a given subject – two women, two men, two gloves, etcetera. I developed the idea of presenting two images next to each other on the exhibition wall – and ultimately on the facing pages of a book. Juxtaposed here, then, are images from forty years of traveling with a camera. The images on facing pages are related either by subject, a graphic element or by a stretch of the imagination.
Perhaps Twosomes is a joke book. Maybe you'll smile, or maybe you'll just shake your head muttering what…? We all see something different. For me, finding one image to juxtapose with another was a lot of fun. And fun, like a photograph, is meant to be shared.
This is not a picture book, but rather one that gives us a certain picture of America, from California, across the Rockies and Great Plains, along the Atlantic and through New England. These photographs cover a time span of 25 years.
NO signs are everywhere. There's no escaping them. They lurk at us from walls, windows, doors, buildings, fences, trucks, roads, and even trees. They are at train stations, bus depots, and airports. Wherever we travel, a NO sign lingers about — in cold bold, striking red, in scrawled letters or fancy script. They are "signs of the times," an anthropological-sociological measure of America; they are words penned by pundits, poets, philosophers, and would-be comics.
But there's something more to their literal meaning than meets the eye. For embedded in the metal, wood, plastic, or cardboard message, there is a soul — a subtle hint of a personality who made the sign. In effect, these signs reflect human character.
I wonder who that person is behind the sign. I conjure up an image of an individual telling us SORRY, NO FREE MATCHES. He's a grouch; a rumpled-looking fellow always frowning. Wheras the creator of NO DOGS, VICIOUS GARDENER is an urbane, smiling Ivy Leaguer with a second home in the country.
I never did meet the person who made NO DANCEING (sic). I was a high school student in the '60s when I saw this sign. It made me aware of the existence of "No" in America.
I didn't take photographs back then. So I took the sign instead. I don't know why. The sign was hanging above an old juke box in a pizza shop.
How NO DANCEING remained in my possession for so long is amazing. It's really a fortuitous sign because it germinated the idea for this book five years ago when I rediscovered it in a carton of old papers.
Since then, I have photographed more than 300 NO signs in various parts of the country. They are an eclectic bunch: misspelled, graphically ugly, some barely readable with letters faded by the weather. Others are funny and cute. Some have drawings. A few are downtrodden. Most are upbeat.
I saw these signs inadvertently while walking or driving. Often I felt as though a magnet were pulling me into a situation or place where, to my surprise, a NO sign was hanging. For example, the time I made a wrong turn down a country road near Poughkeepsie, New York, and found NO PERMANENT PLANTINGS wired to a cemetary gate. Or the day I was in Ephrata, Pennsylvania, and walked into a public restroom that warned in large letters NO LOAFING. Then there was the truck-stop cafe near Reno, Nevada, off Interstate 80, where a sign attached to the food cart told patrons NO DOGGIE BAGS FOR BUFFET.
I am basically a people photographer. I like to shoot subjects that move and human conditions that are moving. At the outset, this book posed a challenge. How to photograph words and make them visually exciting? While there was the slight technical problem of solving glare — many signs were behind glass doors or windows — there was also the problem of dealing with some unwilling people who wouldn't allow me to photograph their NO sign. How absurd it seemed! Here they displayed their sign in the open public, yet refused having it recorded on film. After a while, sensing who might be "paranoid," I didn't ask permission, and just shot the picture anyway, figuring that had I asked, I'd have been turned down.
In retail stores when I sensed this "being-refused-if-asked," I had a tactic. I bought something, then took my photographs while the clerk rang up the sale.
Generally though, people were cooperative and I didn't have to play games. They were friendly and amused about the book idea. Some even gave me leads for other NO signs nearby.
Most of these signs were shot with a wide-angle lens, either a 20mm, 28mm or a 35mm. Occasionally, I used a 55mm macro (close-up) or a 105mm telephoto. When possible, I juxtaposed the sign with candids of people. Also, I incorporated other elements into the frame to establish a point of reference and to make the photograph graphically interesting.
Though some of the signs are a conscious attempt to be humorous, most of them are just plain funny without trying to be. Nor is there any deeper, underlying message than what they already spell out.
This book is merely a collection of seriously-silly photographs in which I took delight in discovering a positive side of no. Cha, cha, cha.
The board by the hotel desk spelled it out: "May 22 ... Thursday ... Weather: Fine." My first day in China, ever, was going to be fine. I hurried eagerly through the lobby and on outside to the sounds of Shanghai. Dawn was barely breaking, but streets were already teeming. Joining ranks with pedestrians and bicycle riders, I was soon swept into the rhythm of the city.
I went to Shanghai specifically to photograph the people and document their lifestyle as a self-assigned project. The idea came to mind seven years ago when I covered the Friendship City Agreement signing between Mayor Dianne Feinstein and Shanghai Vice-Mayor Zhao Xingzhi. From the outset, each stage of the project has been like a piece of a puzzle falling into place.
First, the San Francisco/Shanghai Friendship Committee accepted my proposal as part of its ongoing cultural exchange program; then the People's Government of the Municipality of Shanghai gave its approval; then the San Francisco Main Library allocated exhibition space. All of this set into motion a legitimate fundraising campaign for a non-profit community arts project.
I selected the Main Library as an appropriate viewing space because it offers educational opportunity to everyone. These photographs of our sister-city are for everyone. They teach us something about life in Shanghai in relation to our own.
It was no small task taking photos in Shanghai. The city is overwhelming. To help ease the intensity of this project and draw closer to the culture, I brought along Pei-Wei (Bill) Cheng, as translator, assistant, diplomat, advisor and friend. Chang is Shanghainese and professor of journalism and mass communication at Fudan University. He is currently on sabbatical. Bill, 65, is also Honorary Vice-President of the China Photographers' Association, Shanghai Branch. Besides knowing the local patois, people in all places and the lay of the land, he understands how a photographer thinks and sees, an understanding that proved valuable.
At our first meeting with the Division Chief of the Foreign Affairs Office and his staff, Bill conveyed my modus operandi and suggested a list of categories to explore—arts, culture, music, industry, education, religion, sports, among other general topics.
It was a memorable meeting. We sat in a huge reception room on couches that had white doilies draped on the backs and straddling the armrests. At first it was formal and stiff. The Division Chief spoke softly. His English was very good. We sipped tea, chit-chatted, smiled and joked. But we were also trying to figure eachother out, wondering what we have in common, how are we different. The silent pauses only magnified the awkwardness between us. We sipped more tea and philosophized. But in time we loosened up, and by the end of our talk, we are no longer strangers.
A general plan was initiated that allowed flexibility, though it was necessary to have a logistical schedule for each week. Arrangements with factories, institutions and individuals had to be made in advance , either by telephone, mail, and in some circumstances, by messenger.
While I only had six weeks to photograph the mundane, offbeat and the high level, I learned to be patient when the schedule didn't go as planned. I was anxious during my stay, and sometimes frustrated at missing a good picture here and there. I worried that I might not get enough good images to show. But I also believed that I was in the hands of fate, and that wherever I happened to be at any moment, I was at the right place.
For example, at the Children's Palace, I was shooting youngsters playing their instruments. I was about to leave when a little girl came to the microphone carrying her accordion. There was a certain captivating look about her, so I stayed. And when she began to sing, I noticed that her two front teeth were missing. I waited patiently for the right moment, the right expression on her face.
When not scheduled to visit any particular place, I roamed the city and rode the buses, either alone or with Bill. At the end of the day I was tired, saturated with the images in my head, praying they were on my film, too. Forty days, the length of my stay, is a short time to capture the pulse of a city like Shanghai.
This selection of photographs is edited from nearly 12,000 frames. It was a difficult choice as Shanghai is a colorful city, especially in black and white.


Fit for purpose: do we have the right tools to sustain NTD elimination?
1. Sensitively and sustainably survey NTD transmission and prevalence in order to identify and respond quickly to resurgence.
2. Set relevant control targets based not only on epidemiological indicators but also entomological and ecological metrics and use decision support technology to help meet those targets.
3. Implement verified and cost-effective tools to prevent transmission throughout the elimination phase.
Liverpool School of Tropical Medicine (LSTM) and partners propose to evaluate and implement existing tools from other disease systems as well as new tools in the pipeline in order to support endemic country ownership in NTD decision-making during the elimination phase and beyond.
With increased financial support and international political momentum, the goals for neglected tropical diseases (NTDs) control and elimination are changing. Over the next five years we can expect disease-appropriate scale up of community mass drug administration, intensified case detection and management and scaling up vector control . Research is underway to integrate NTDs into the health system, deliver care to neglected communities and to optimize testing and treatment regimes. Improvements in delivery and increased access will enable country programmes to meet their targets  and over the next ten years we expect many countries to have successfully reached the WHO Roadmap objectives and the London 2020 goals for the eliminable and eradicable NTDs [1, 3] and enter the "endgame", i.e. the final stages of elimination campaigns where disease is still present at reduced levels . During the endgame programme priorities will shift from increasing intervention coverage in order to meet elimination targets, to scaling down certain interventions and sustaining elimination for the long term through surveillance and targeted control.
The elimination goals and timelines, as well as the control approaches to reach these goals are as diverse as the 17 NTDs themselves. Lessons from malaria elimination efforts have revealed heterogeneities in the stability of sustained elimination due to a multitude of factors including differences in transmission potential, reproductive rate, cross border activity, socioeconomic status, baseline prevalence and human behaviour . However, while it is impossible to draft a single elimination approach for one disease, much less all NTDs, we can begin preparing for the new and unique challenges likely to face NTD programmes in the endgame. The employment of existing, community-wide strategies when prevalence is low will no longer be cost-effective or epidemiologically justified and instead we must prepare for the challenge of sustaining surveillance and control following the anticipated post-2020 scale down. Failure to reach elimination thresholds during the endgame will compromise neighbouring and regional NTD elimination; however what constitutes elimination is poorly defined and elimination targets remain untested.
As country programmes move towards the 2020 milestones and targets, they will require a new suite of tools and approaches in order to sensitively assess transmission intensity and provide an evidence base for the appropriate stage to cease community wide treatments . The tools and approaches that will lead to success in meeting 2020 targets are not necessarily suitable for the endgame. Successful and sustainable elimination will hinge on a country programme's ability to 1) identify transmission and transmission risks; 2) decide how, when and where to respond and 3) deliver optimum interventions.
LSTM, in collaboration with many international partners, has played a pivotal role in research to inform NTD control; from the development and evaluation of new tools for elimination, mapping and surveillance to implementation research, capacity building and technical assistance. We are well poised to deliver research on how best to support country programmes through the next phase by readying the tools, technologies and approaches needed in response to the above emerging needs. Specifically we propose to support elimination programmes in surveillance, decision making and transmission prevention (Fig 1).
As we strive and reach for elimination in NTDs the diagnostic requirements will change and there will be an increased need for disease surveillance, identification of foci and collection of data to inform decision making. LSTM's Research Centre for Drugs and Diagnostics (RCDD) is working with industry (SMEs and larger organisations), academia and other NGOs to discover, develop and deliver novel drugs and diagnostics against major human pathogens to meet these needs.
We anticipate that the PCT diseases will require large-scale mapping and screening of patients in order to identify hotspots of disease. It is essential that surveillance is integrated into existing health system structures in order that sustained monitoring can take place. LSTM is working on molecular diagnostic surveillance systems that will work hand-in-hand with existing networks such as the Global Polio Eradication Initiative and Malaria Elimination Initiative.
The IDM NTDs such as HAT, leishmaniasis and dengue will require sensitive diagnostics that are able to pick up asymptomatic and early infection, identify drug resistance, monitor patient response and inform patient care. Snakebite is an additional IDM NTD with specific challenges that include improved diagnostics as a tool for both clinical management and assessing disease burden. To enable decentralisation, testing devices should be portable and require only moderately invasive sampling methodologies. LSTM are developing and/or evaluating diagnostics such as LAMP, GeneXpert, Genedrive for use in elimination settings. In the medium to long-term RCDD will push for innovative diagnostic solutions that will be close to the patient to inform treatment, patient care and the ability to store data and transmit immediately to inform disease management tools.
With insecticides playing an increasingly important role in the elimination of vector-borne NTDs [1, 6], it has become necessary to monitor the emergence and spread of insecticide resistance. LSTM has led the field in evaluating intervention efficacy of insecticides for vector-borne diseases and insecticide resistance detection and management [7–9]. A range of new tools are becoming available over the next two years which we will evaluate for NTD vector control operations. Such tools include new field-friendly assays to track the actual amounts of insecticides being sprayed or used in nets, as well as new methods to track the genes involved in resistance . Integrating these into appropriate NTD vector control operations could have game changing potential in preventing transmission through effective use of insecticides and tight monitoring of resistance.
For instance, the Insecticide Quantification Kits (IQK), which are simple low cost assays that can be used on-site to measure insecticides used for house spraying and bednets, are now commercially available for carbamate and cyanopyrethroid monitoring. Kits for DDT and organophosphate monitoring are expected to be available in 2015. These kits will allow for internal validation of insecticide-based control and enable programmes to optimize the impacts of available tools. The IQK is currently being adapted for the VL elimination programme in India, and we propose further adapting it for monitoring Chagas and dengue programmes. Vector population monitoring tools have been developed for malaria mosquitoes to identify mosquito species, malaria infection status and resistance mutations. This information is a key part of the data needed by programme managers to evaluate transmission impacts and mitigate potential resistance. The genomic data accruing on NTD vectors can be readily exploited to develop DNA based vector monitoring tools that parallel those now being routinely applied for monitoring malaria vectors.
Finally, a new generation of generic 'predictive probes' that are capable of identifying genes with insecticide resistance potential have been recently developed . These allow the development of ultra-early warning systems to detect incipient resistance at a point that something sensible can be done to prevent its spread. We intend to translate these into practical insecticide resistance monitoring tools across the spectrum of NTD vectors. The availability of tools to monitor the impact of interventions within the programme will allow for a rapid adjustment in either the elimination tool or approach in order to reach programme targets.
Mapping prevalence data and the impact of single or multiple interventions over time and space is critically important to improve decision making for NTD programmes. We have developed novel mapping methods to address the co-endemicity and overlapping interventions to help determine the risks and benefits of different intervention and surveillance strategies. The first we designate as micro-stratification overlap mapping (MOM) which focuses on the overlapping distribution of infections or co-endemicity in a particular geographical area at a finer spatial resolution. The MOM approach is essential for planning the expanded distribution of drugs in countries co-endemic for filarial infections, as has been demonstrated in the Democratic Republic of Congo (DRC) and Nigeria [12, 13]. The second mapping method focuses on quantifying the overlap and potential impact of multiple interventions at subnational level to produce a multiple intervention score map (MISM) . The MISM approach aims to develop practical programmatic maps to assist NTD programme managers to identify and target high-risk areas that may not have received adequate impacting interventions to interrupt the transmission of the disease. This is critical for countries as they prepare to scale down coverage and enter the elimination phase as exemplified by the LF Elimination Programme in Malawi . In addition, geo-spatial models have been developed to produce baseline risk maps, incorporating socio-demographic and environmental factors, with the aim of overlaying intervention coverage and predicting areas where transmission is mostly likely to persist and in need of alternative or enhanced intervention strategies .
Underpinning the successful elimination of NTDs will be access to information. Masses of information on disease, interventions, and vectors are being collected by control programmes but are not mined to improve decision-making. Countries will require tools that allow 1) easy access to a central data repository and 2) interpretation of that data to guide decisions on how to achieve the greatest impact with limited resources. Informed decision-making will also allow programmes to identify priority areas for surveillance as well as when and where to implement further control measures.
LSTM, with support from the Innovative Vector Control Consortium (IVCC), has been instrumental in developing and implementing a sophisticated Disease Data Management System (DDMS) in endemic countries. At its core, the DDMS is an open-source database for controlling programme data, from case surveillance to entomological monitoring to intervention data. However, there are several features that make the system unique. First, it is integrated with mapping and reporting tools, allowing programmes to use their data to support real-time informed decision-making. Second, it has customizable thresholds that will send alerts when targets are not being met. Third, it is flexible enough to switch between several vector borne diseases. Current modules include dengue, malaria and most recently visceral leishmaniasis (VL).
Malaria modules have been implemented in Zambia, Ethiopia, and Equatorial Guinea. The Zambian National Malaria Control Centre and Zambia Integrated Systems Strengthening Program have worked closely together to use the system to monitor entomology and intervention data with technical support from LSTM. Work is underway to integrate the DDMS with VL elimination efforts in Bihar, India, enabling the country to track insecticide resistance patterns, IRS coverage and quality, and case surveillance data. Over the next 10-20 years, programmes will transition from control to elimination, involving a scale down from community-level to targeted interventions. The DDMS is poised to facilitate this transition and will be further developed to ensure that programmes have access to critical information that support decision-making.
Elimination targets remain untested and many programmes assume that a certain number of treatments or a given number of MDA rounds will be sufficient to interrupt transmission  of PCT diseases. Current assumptions of threshold biting rates, and threshold parasite breakpoints, below which transmission cannot be sustained, are largely untested. It is essential that these assumptions are validated to ensure elimination targets are locally relevant.
For example, our research on vector-borne NTD transmission has shown that differences in vector competence are likely to influence elimination success . Further work, in collaboration with the NTD modelling group, will refine transmission thresholds. Research to validate elimination targets will involve experimental vector work to determine transmission potential, modelling to predict threshold inoculation rates sufficient for resurgence , followed by observational studies throughout the elimination phase. With sufficient evidence, the DDMS can be programmed to include updated, relevant and realistic elimination targets. This will allow programmes to prioritize resources and gain confidence that intervention efforts will be successful.
Vector control is a fundamental element of the global strategy to fight malaria, with a proven track record of successfully reducing disease transmission. Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the two core malaria vector control measures broadly applicable to indoor biting vectors. Given their success in malaria operations they are strongly recommended for integration in NTD programmes with appropriate vectors (e.g. LF, VL, Chagas) . Bednets have a proven role in reducing snakebite incidence  and this additional health benefit could be readily implemented into integrated NTD management. Other vector-borne NTDs (HAT, dengue, onchocerciasis, LF in Pacific) are more difficult to integrate with existing programmes because the vectors require different approaches that are not currently used at scale. Existing vector-based interventions are proven to impact the vector population and some recent studies have demonstrated direct impacts on disease prevalence . However, evidence is lacking to date on the direct impact of vector control on the prevalence of many NTDs and the longer term contribution to elimination.
Before recommending that available interventions be tailored to and adopted by NTD programmes, we propose to critically evaluate their impact on NTD transmission and prevalence. For many of the NTDs (e.g. with longer periods of latency), this will require extended periods of surveillance to ensure that vector population reductions closely correspond with decreases in incidence over time. We will build on our current expertise in vector control for NTDs [21–25] and work with our partners to strengthen the evidence base of the available tools for NTD control.
A thorough evaluation of available and emerging chemotherapies, diagnostics and vector control tools, mapping and decision making systems will allow programmes to decide which interventions are likely to give the desired impact, while also providing additional tools at the ready if efficacy is compromised.
New chemotherapies are emerging for onchocerciasis, LF and HAT [26–28] which will play an integral role in case detection and treatment through the endgame. The Anti-Wolbachia Consortium (A·WOL; http://www.a-wol.com), a drug discovery and development programme , was founded at LSTM in 2007 to screen, identify and validate novel drugs as well as develop treatment regimens with existing macrofilaricidal drugs, e.g. doxycycline, which has been adopted for use by elimination programmes as an alternative strategy in areas of Loa loa co-endemicity and at risk of severe adverse events (SAE) to ivermectin . The benefits of an anti-Wolbachia macrofilaricidal drug would be to 1) reduce programme time frames, 2) provide an alternative treatment to existing drugs with reduced efficacy, 3) be useable in Loa loa co-endemic areas without risk of SAE, 4) improve morbidity management, and 5) complement existing strategies for MDA end-game.
In addition to the A·WOL approach to macrofilaricidal drug development, other strategies aim to discover and develop macrofilaricidal drugs which act by directly killing adult worms  with other candidates emerging from the drug discovery pipeline. We propose to further evaluate the suitability of emerging drugs for use in the endgame and in areas where existing strategies are compromised.
Diagnostic evaluation in well-designed trials is essential prior to and during implementation as prevalence and endemic settings change. LSTM has several multi-disease diagnostic evaluation sites including Nigeria, Ethiopia and Malawi where the suitability of tests can be appraised. Our Clinical Sciences unit is highly skilled and qualified in the implementation of diagnostics and their continued evaluation, suitability, cost-effectiveness and roll-out.
The IVCC, established at LSTM in 2005, seeks to overcome the barriers to innovation in the development of vector control tools. It is supporting the development of novel insecticides, long-lasting formulations, and delivery mechanisms that will improve the efficacy of chemical control. Currently, there are eight novel classes of chemistry under evaluation, and three new active ingredients will be brought to market to act as alternatives to pyrethroids and other chemical classes that are now showing resistance. Improvements in the residuality of indoor residual sprays via new products such as Bayer's new polymer-enhanced formulation of deltamethrin and Syngenta's primiphos-methyl CS formulation have been rolled out, and combination nets that incorporate synergists or multiple insecticides are being evaluated to overcome pyrethroid resistance .
The shift in priorities and the emergence of new challenges as national NTD programmes approach the endgame will require a new suite of tools and approaches to sustain elimination. Many tools for surveillance, decision making and long term transmission prevention are in the pipeline or are currently being successfully applied in other disease control programmes. We must prioritise the evaluation, application and implementation of these tools in order to support NTD programmes in reaching and sustaining their elimination targets.


Between 1911 and 1914 Kate Frye spent over 20 weeks organising the New Constitutional Society for Women Suffrage's campaign in Norfolk. For the greater part of that time she was based in East Dereham.
In Campaigning for the Vote entries – such as these samples below relating – at random – two days in Kate's Norfolk experience – are fully annotated, giving biographical details of most of the people she mentions. Thus Kate's diary is of interest to local historians over and above the light it sheds on the suffrage campaign in the area. For instance, 'Miss Cory' was Violet, daughter of the London and Provincial bank manager. The Corys lived above the bank, now Lloyds TSB and still there at 38 Market Place. For a most interesting tour around Dereham's Market Place – an area with which Kate became intimate – see here.
Most of the day spent in hunting about for rooms for Mrs Mayer with no success – even the Kings Head refused to have her. Canvassing and bill distributing – beginning, as usual, to feel anxious about the success of next Monday's meeting. Changed and out at 4 to Miss Cory's to tea. I went to call on Mrs Pearse when I left there and saw Mr Pearse and asked him to take the Chair but he would none of it. We had all been so 'naughty' etc and of course the destruction of the golf links had been the last straw. He is a pasty-faced Villain. But I wish he would take the Chair for us because if he does not I don't know who will and I shall have to do it – the very idea curdles my blood.
On 10 March 1914 a WSPU member, Mary Richardson, attacked the Velasquez painting, 'Venus with a Mirror', hanging in the National Gallery, in order to draw attention to what she saw as the slow destruction of Mrs Pankhurst, who had, on 9 March, yet again been arrested.
Miss Cory here at 10.30 and we went through the people I am to call upon. Out 12 to 1. To see Miss Shellabear. Very off, of course, the latest – the Rokeby Velasquez – is upsetting everyone now. Out 2.45 to 6.15. Calls.
Happened on the new people at Quebec Hall who are keen WSPU. Had tea with Miss Louisa Gay who has done 8 months [in prison]– a very jolly girl – she means to do some waking up if she can. Then to see Mr and Mrs Hewitt – I do like them so. Miss Cory and Mrs Goddard here 8 to 10. Talking. Talking. Talking.
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While I can appreciate the frustration behind this article, I think it misdiagnoses the problem. We aren't in a utopian situation where nobody is grateful for Nick Clegg's achievements, we're in a dystopian one where people are deeply concerned at the damaging policies that the Conservatives are driving through, and at the judgement of Lib Dem MPs, led by Nick Clegg, in supporting these policies – even to the extent of helping to overturn amendments designed to mitigate the damage.
Without wanting to be harsh, this piece reads a little bit like the defences of Tony Blair from loyal Labour Party members during and after the Iraq War. It may be comforting to tell yourself that this is all just about silly, hysterical people having a personal problem with Nick Clegg, rather than serious, substantive concerns about the policies he is supporting, but it also seems like a kind of denial.