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European Union Health

The chancellor of the Exchequer promised more money for health, education and even fixing potholes. But worry remains about the country’s withdrawal from the European Union.
www.nytimes.com | 10/30/18
The detention facility of Beirut’s military court has been renovated and health kits distributed to detention centers and prisons, according to a European Union press release published Wednesday.
Concerns mounted Saturday about the medical and psychological health of 150 migrants who were spending their 10th day stuck aboard an Italian coast guard ship while the government insists that other European Union nations must take them.
www.foxnews.com | 8/25/18
The many teaching aids adorning the walls are a reflection of the rich learning environment at New Life Basic School in Dunbeholden, St Catherine.The school, which recently benefited from significant funding from the European Union for refurbishing...
The claim that leaving the European Union would free up money for health care, a potent argument during the referendum, was long ago dismissed as bogus.
www.nytimes.com | 6/18/18
The U.K. plans to relax immigration rules for doctors and nurses, an effort to address a staffing crunch in the state-run National Health Service that has worsened since voters chose to leave the European Union.
www.wsj.com | 6/15/18
The U.K. plans to relax immigration rules for doctors and nurses, an effort to address a staffing crunch in the state-run National Health Service that has worsened since voters chose to leave the European Union.
www.wsj.com | 6/14/18
A program for reducing out-of-pocket spending on health care for refugees and Lebanese citizens was launched Wednesday by the European Union at a primary care facility in Burj Hammoud.

"Human Rights in a Digital Age" is the theme of this year's RightsCon conference in Toronto. An essential human right is access to safe, affordable prescription medications. The Internet makes this possible, our organization has proven it's achievable and sustainable over an extended period of time, and our proposed "Brussels Principles" provide the framework to take our proven success internationally. Across the Globe, to people everywhere.

Let me back up to RightsCon Brussels 2017. At that groundbreaking conference, the Canadian International Pharmacy Association (CIPA) participated in a workshop entitled: Online Access to Affordable Medication: Applying Human Rights Law to Cyber Rule-Making and Internet Governance. Together with Knowledge Ecology International, Public Citizen, Electronic Frontier Foundation, and Prescription Justice, we jointly formulated the aforementioned Brussels Principles, which are best practices for licensed pharmacies that enable safe, reliable, and affordable medication sales over the Internet.

At RightsCon 2018 (Toronto, May 16-18) with our session: Making Safe Online Access to Affordable Medication Real, we will serve on a panel of distinguished international experts, addressing this urgent issue and discussing the proactive framework that will ensure its success.

Heading into the conference, it's important to give this critical discussion some historical context. Specifically, why this is such an important issue, how we're qualified to address it, and how the Brussels Principles will help negotiate the intersection of human rights and digital technology.

As the Executive Director of the Canadian International Pharmacy Association, every day I receive emails and speak to people who are trying to find a safe source of medications from a pharmacy online. Why? Because they can't afford or don't have access to their prescribed medication where they live. In fact, CIPA has served more than one million patients annually, providing safe and affordable daily medications (but not controlled substances). The high cost of medications in the U.S. is something already on the radar at both the federal and state levels; witness repeated comments by the U.S. president, as well as a recent, overwhelming (141 to 2!) vote by the Vermont House of Representatives in support of a bill to reduce the cost of prescription medications through importation.

Senator Rand Paul also clearly voiced the general feeling of the average American during Health and Human Services Secretary Alex Azar's confirmation hearing. Mr. Azar noted that "Importation must be reliable and safe, in the mind of the president." Senator Paul interrupted him: "You would have to sit there and say the drugs from the European Union or Canada or Australia are not safe… It is frankly just not true… It's a canard that has been going on year after year after year… It's just BS! ... to serve the pharmaceutical companies..."

But access and affordability to safe medications is not just a U.S. problem, and we have seen a growing number of patients from countries around the world seeking to have their prescriptions filled from Canadian and international licensed pharmacies.

Can medications be ordered safely on the Internet? Yes, with proper regulation and vigilance.

The Canadian International Pharmacy Association is visible proof this can be done. Remember the one million patients a year I mentioned above? We've been serving that many for more than 15 years, and we have a 100% perfect safety record.

We achieve this perfect safety record through rigorous procedures and controls established and monitored by our organization, and adhered to by our pharmacy members. We also are fully engaged in the fight against "rogue" pharmacies illegitimately using our certification mark or otherwise trying to leverage our good Canadian name and reputation. CIPA works closely with both attorneys and law enforcement on an ongoing basis in this effort.

Based on our experiences and safety record selling medications online since 2002, we are pleased to work with so many other Internet and industry experts on the Brussels Principles.

Serving patients economically and safely, doing what is expected of industry leaders by assisting law enforcement, participating in the development of the Brussels Principles, active engagement in ICANN, all add up to a solution that is effective, practical, and easily within our reach.

We'll be discussing this topic in detail, and seeking feedback to the Brussels Principles, at our RightsCon 2018 session. I welcome you to participate with us in Toronto, on May 17 at 9 am (Session #636).

Our renowned panel of thought leaders includes Dr. Jillian Kohler, Professor, Leslie Dan Faculty of Pharmacy and Munk School of Global Affairs, and Aria Ilyad Ahmand who is a Consultant to the World Health Organization on Substandard and Falsified Medical Products. Jillian pioneered the methodology on good governance in the pharmaceutical system for the World Bank, which was subsequently adopted by the WHO and has been applied in over 35 countries globally. Aria is a policy advisor at the Dahdaleh Institute for Global Health Research at York University, where he has also served since 2014 as a consultant to the WHO's Department of Essential Medicines and Health Products. A past Duke University Global Health Fellow and past faculty member of the Global Health Education Initiative at the University of Toronto, Aria is currently completing his PhD in Global Health Governance. Joining these two experts will be other industry representatives, including Gabriel Levitt (Prescription Justice); Tracy Cooley (Campaign for Personal Prescription Importation); Dr. Shivam Patel (PharmacyChecker); Robert Guerra (Privaterra); and myself.

I hope to see you there!

Written by Tim Smith, General Manager

www.circleid.com | 5/14/18
The European Union launched a health and psychosocial project in the Bekaa town of Al-Marj Wednesday to provide support to Syrian refugees and vulnerable Lebanese host communities.
The policy of local health insurance companies to have expectant mothers pay for their healthcare costs upfront and claim refunds later has potentially disastrous outcomes for pregnant women. According to representatives from the European Union (EU)-...
[New Era] Windhoek -The Ministry of Health and Social Services, the World Health Organisation and the European Union will tomorrow launch the Angelika Kazetjindire Muharukua maternity waiting home at Opuwo.
allafrica.com | 2/19/18
EU lawmakers call for daylight saving time to be reviewed amid long-term health concerns.
www.bbc.co.uk | 2/8/18
The UK government on Monday announced plans to double a so-called "health surcharge" paid by long- term visitors and students from countries outside the European Union (EU) including India to 400 pounds per year.
www.dnaindia.com | 2/5/18
The European Union is revamping its water quality rules to address possible new health hazards and limit plastic waste by discouraging people from drinking bottled water.

U.S. Chamber of Commerce President Thomas J. Donohue on January 10, 2018, warned that "techlash" is a threat to prosperity in 2018. What was he getting at? A "backlash against major tech companies is gaining strength — both at home and abroad, and among consumers and governments alike." "Techlash" is a shorthand reference to a variety of impulses by government and others to shape markets, services, and products; protect local interests; and step in early to prevent potential harm to competition or consumers.

These impulses lead to a variety of actions and legal standards that can slow or change the trajectory of innovations from artificial intelligence to the Internet of Things (IoT) to business process improvements. According to Mr. Donohue, "[w]e must be careful that this 'techlash' doesn't result in broad regulatory overreach that stifles innovation and stops positive advancements in their tracks." Here are a few examples of the challenges ahead:

  • Global privacy and security regulations impose compliance obligations and erect barriers to the free flow of data, products, and services. Examples include the European Union's General Data Protection Regulation (GDPR), its Network Information Security Directive (NIS Directive), e-Privacy initiative, and a nascent effort on IoT certifications. "A growing number of countries are making it more expensive and time consuming, if not illegal, to transfer data overseas." [1] China's new cyber law "requires local and overseas firms to submit to security checks and store user data within the country." [2] Such efforts may be intended to level the playing field with large U.S. technology companies, but whatever their impetus, they create enormous compliance costs and impediments to multinational operations. [3] Emerging regulation around the world may do more harm than good, particularly to U.S.-based organizations.
  • Premature regulation and oversight drives up the costs of doing business, particularly for new entrants or disruptors. Government should act only when it has evidence of actual harms to consumers or competition and the benefits outweigh the costs. When government rushes in with a technical mandate, innovation suffers. Likewise, if the government demands business changes without evidence of anti-competitive effects, it distorts the marketplace. Premature regulations impose unnecessary compliance burdens, so governments should exercise "regulatory humility” and wait for experience and evidence.
  • Unjustified class action litigation over technology strikes fear in the hearts of innovators. The growth of "no injury" lawsuits in targeting the technology sector likewise is a concern. Class action plaintiffs were quick to sue GM and Toyota after news reports of a vulnerability in Jeeps, and dozens of plaintiffs immediately sued Intel after chip processor vulnerabilities named Meltdown and Spectre were reported. [4] While courts have generally rejected suits based on "risk of hacking," [5] plaintiffs continue to push these theories, along with novel "economic loss" claims from "overpaying for" [6] vulnerable devices. Legal uncertainty about such claims, and the rush to obtain damages awards and attorneys' fees, threatens to increase costs and chills companies' willingness to engage.
  • State laws, such as those attempting to impose "net neutrality" and online privacy obligations at the state level, threaten to balkanize regulation of technology. "Lawmakers in at least six states, including California and New York, have introduced bills in recent weeks that would forbid internet providers to block or slow down sites or online services." [7] State-by-state regulation of global ISP and carrier network practices is likely to create major inefficiencies. Likewise, state privacy laws create complexity for organizations whose operations, products, and customers cross state lines. Industry has decried "balkanized privacy regulation at the state level" which creates "a hazardous web of conflicting state-by-state laws for any company operating in the online space." [8]
  • Local barriers, like restrictive zoning regimes, stunt technology deployment and innovation. Tomorrow's innovations in health care, transportation, conservation, entertainment, and more depend on a robust technology infrastructure, including telecommunications facilities. [9] But many local jurisdictions are hesitant to allow deployment in public rights-of-way, and others see the explosion of small cell telecommunications facilities as a revenue stream. [10] Local barriers to deployment will slow innovation in communications technology, which may make many communities, and the United States at large, less competitive in the global economy. This is particularly troubling as other countries, like Japan and South Korea, welcome the next generation of communications technology.

2018 will be an important year for global regulation of technology, as issues from privacy to cybersecurity to competition percolate in legislatures around the world. As we enter what some call the Fourth Industrial Revolution, governments have to consider their role in supporting innovation. Hopefully the United States continues to lead by example, resisting "techlash" with a light regulatory touch and a lot of humility. The United States likewise should urge other countries not to punish success, and instead let innovators — not regulators — create the future.

[1] Cross-Border Data Flows: Where Are the Barriers, and What Do They Cost? https://itif.org/publications/2017/05/01/cross-border-data-flows-where-are-barriers-and-what-do-they-cost
[2] T. Miles, U.S. asks China not to enforce cyber security law, Reuters (Sept. 26, 2017) https://www.reuters.com/article/us-usa-china-cyber-trade/u-s-asks-china-not-to-enforce-cyber-security-law-idUSKCN1C11D1
[3] Ann M. Beauchesne, Megan Brown, Sean Heather, Principles for IoT Security; The IoT Revolution and Our Digital Security (Sept. 2017), https://www.uschamber.com/IoT-security
[4] See S. Czarnecki, Intel faces dozen class action lawsuits over chip flaws, https://www.prweek.com/article/1454201/intel-faces-dozen-class-action-lawsuits-chip-flaws (Jan. 10, 2018).
[5] Cahen v. Toyota Motor Corp., No. 16-15496 (9th Cir. Dec. 21, 2017) https://scholar.google.com/scholar_case?case=7591856924921942948&hl=en&as_sdt=6&as_vis=1&oi=scholarr
[6] Id. While the court in Cahen found that the "economic loss theory is not credible, as the allegations that the vehicles are worth less are conclusory and unsupported by any facts," a future Plaintiff may survive a motion to dismiss with stronger allegations.
[7] C. Kang, States Push Back After Net Neutrality Repeal, N.Y. Times (Jan. 11, 2018) https://www.nytimes.com/2018/01/11/technology/net-neutrality-states.html
[8] Et tu, California? ISP Privacy Bill Moving through the Legislature (June 21, 2017) https://www.ana.net/blogs/show/id/rr-blog-2017-06-et-tu-california
[9] Thomas K. Sawanobori & Paul V. Anuszkiewicz, CTIA, High Band Spectrum: The Key to Unlocking the Next Generation of Wireless, 1, (June 13, 2016), https://www.ctia.org/docs/default-source/default-document-library/5g-high-band-white-paper.pdf
[10] See Jonathan Babcock, Joshua Turner, and Anna Gomez, 5G Deployment Faces Unique Challenges Across The US, Law360 (Aug. 1, 2017) https://www.law360.com/articles/950330/5g-deployment-faces-unique-challenges-across-the-us

Written by Megan L. Brown, Partner at Wiley Rein LLP

www.circleid.com | 1/16/18
Poland’s new prime minister said misunderstandings had stalled a high-stakes dispute with the European Union over the health of Polish democracy.
www.wsj.com | 1/10/18
Poland’s new prime minister said misunderstandings had stalled a high-stakes dispute with the European Union over the health of Polish democracy.
www.wsj.com | 1/10/18