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What do the #Moscow protests mean for #MayorSobyanin?

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These are trying times for Russian president Vladimir Putin. After years of grimly bearing the reports of economic stagnation and political repression, the people of Russia have taken to the streets by the thousands. While the scale of the ongoing demonstrations is still smaller than during the last bout of popular anger in 2011/2012, they are widely seen as a showdown over the fate of Russia after Putin steps down in 2024.

But for the man some have tipped to be Putin’s successor, the fall-out from the recent demonstrations could be even more seismic. Sergei Sobyanin has spent nearly 40 years climbing Russia’s political ladder, with barely a ripple in the international press. Now, as Moscow’s mayor, he finds himself at the center of an international storm, and the next few weeks will be crucial.

Since he joined the Young Communist League in the early 1980s, Sobyanin has proved himself a highly skilled operator, able to ride the current of Russian politics without being sucked into the maelstroms it whips up. He’s been close to Putin ever since 2000, when he helped him remove a prosecutor-general right at the start of his presidency. Putin and his ally Dmitry Medvedev rewarded Sobyanin by naming him chief of staff and then deputy prime minister, but the Moscow mayoralty was the juiciest prize of all.

In Russia, control of the capital has long been a stepping stone to national power. Nikita Khrushchev ran the Moscow branch of the Communist Party, the forerunner of today’s mayoralty, before being elected general secretary of the entire Soviet Union; Boris Yeltsin took the same path to become the Russian Federation’s inaugural president. Moscow’s previous mayor, Yuri Luzhkov, aspired to the presidency himself before eventually being ousted by the Kremlin, but many believe that Sobyanin has a better shot, given his ability to position himself on both sides of the political divide.

Since being appointed mayor in 2010, Sobyanin has negotiated a careful course that has oftentimes been at odds with the desires of the Kremlin. He’s spent trillions of rubles building a cleaner, greener Moscow, with a vastly improved transport system and myriad parks and cafes for young, liberal thinkers to discuss their ideas.

This middle-ground approach has proved successful. Surveys released in May 2018 show that only 11% of Muscovites have a negative view of Sobyanin. Many admire him for allowing opposition figurehead Alexei Navalny to contest the mayoral elections of 2013, and then appoint pro-democracy newspaperman Konstantin Remchukov to run his own campaign. By the standards of Russia’s ‘managed democracy’, in which dissent is only tolerated if it is weak and ineffective, Sobyanin’s concession was very much a high water-mark. It’s no wonder then that Sobyanin’s more liberal credentials have earned him the support of private Russian companies such as Lukoil or Sistema.

In the corridors of power, however, they remember the fact that Navalny nearly forced Sobyanin to a second round, a development which apparently earned a rebuke from the Kremlin. Sobyanin has strived to defend his position, but many among Russia’s siloviki, the power-brokers who have Putin’s ear, are unconvinced. Critics such as Vyacheslav Volodin, speaker of the Russian parliament and a potential rival for the presidency, believe him to be a dangerous maverick who might take a more liberal path than what the establishment would tolerate.

These suspicions have only been fuelled by the recent Moscow protests. The decision to prevent dozens of opposition candidates from standing in Moscow’s city council elections, which triggered the two days of demonstrations, may have been taken by the Kremlin, but it was prompted by a desire to crack down hard on liberal parties.

Now, parts of the establishment are blaming Sobyanin for allowing the unrest to fester. As if that weren’t enough, the mayor responded to the first day of protests by suggesting that protesters be allowed to hold authorized demonstrations - a far cry from the brutal response Putin and his advisors eventually meted out.

Make or break

As the fallout continues, things could go one of two ways for Sobyanin. On the one hand, it appears that Putin is about to face the most trying period of his presidency. His approval ratings were already plummeting before the recent demonstrations, and the discontent is unlikely to be quelled by his heavy-handed response. If Putin were to stand aside, Sobyanin’s attempts to find a conciliatory route through the recent unrest may enable him to pitch himself as a more moderate, progressive alternative that could normalize relations with the West.

On the other hand, Sobyanin’s rivals have been emboldened by his recent travails. According to media reports, Volodin has been particularly vehement, blaming the mayor for the recent protests. The siloviki, meanwhile, have been whispering on social media that Sobyanin might be. After years of grumbling about Sobyanin’s cautious embrace of liberalism, Putin’s other would-be successors now have the perfect chance to stick the knife in.

With the reports of fresh demonstrations, Sobyanin faces a career-defining choice. His balancing act so far and good reputation has positioned him as the only working candidate for Russia post-2024 for many Kremlin opponents. His career, and Russia’s future direction, may hang on the decision the Moscow mayor makes in the coming days.

coronavirus

EAPM and ESMO bring innovations to health policymakers

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For the eighth year in succession, the European Alliance for Personalised Medicine (EAPM) has held a high-level conference series alongside the annual ESMO Congress, writes EAPM Executive Director Denis Horgan.

The EAPM conference was opened with the announcement that the following article was published and contributed to by more than 40 experts across the EU on how to bring Greater Accuracy to Europe’s Healthcare Systems: The Unexploited Potential of Biomarker Testing in Oncology.  Please click here to have access.

Sessions include: Session I: Tumor Agnostic, Session II: Biomarkers and Molecular Diagnostics, and Session III: Utilising Real-World Evidence in a health-care setting.  The conference runs from 08.00 – 16.00. Here is the link to the agenda. The conference aims to bring  key recommendations to the EU level, so as to shape the EU Beating Cancer Plan, EU health Data Space, the updating EU Pharmaceutical Strategy as well as the EU Health Union. 

The conference is held following the first State of the Union address by European Commission President Ursula von der Leyen on Wednesday (16 September) – in her first annual address, von der Leyen said the coronavirus pandemic had underlined the need for closer cooperation, stressing that people were “still suffering”.

For me, it is crystal clear – we need to build a stronger European Health Union,” she said. “And we need to strengthen our crisis preparedness and management of cross-border health threats.” Von der Leyen said her commission would try to reinforce the European Medicines Agency and European Centre for Disease Prevention and Control.

And she also raised the importance of the European Beating Cancer Plan as well as European Health Data Space. “This will show Europeans that our Union is there to protect all,” she said.

Fabrice Barlesi, medical director of Gustave Roussy, said: “RCTs are no longer the way to go. A way ahead could be EU support for trialing a new drug and delivering data to a centralised registry, which could give good consolidated data from across Europe.”

Divided into three sessions, the EAPM conference at the ESMO Congress, as mentioned,  dealt with such diverse issues as tumour agnostics, biomarkers and molecular diagnostics and real-world evidence in a health-care setting. Concerning cancer, specifically tumours, the congress stated that  tissue-agnostic cancer drugs are antineoplastic medicines that treat cancers based on the mutations that they display, instead of the tissue type in which they appear.

These drugs include, for example, Entrectinib, Pembrolizumab and Larotrectinib. Former Spanish health minister and MEP Dolors Moseratt highlighted her support for the work of EAPM and looks forward to getting the recommendations of the outcomes from the conference.  “The European added value of health is obvious. It would avoid duplication and enable a better allocation of resources. And it will minimize the risk of fragmented access to therapy across member states.”

And the EAPM conference is at pains to seek the best ways forward for the implementation of Real-World Evidence (RWE) into health care in Europe – looking to find consensus with key decision makers, including at member state level, not least with representatives in the European Parliament, on how to proceed in this area. RWE for health care is a simple concept – harnessing various health data in real time to help make faster and better medical decisions.

Real-World Evidence is an umbrella term for different types of health-care data that are not collected in conventional randomised controlled trials, including patient data, data from clinicians, hospital data, data from payers and social data.

Rosa Giuliani, consultant in medical oncology at the Clatterbridge Cancer Center, said: “Key elements to advance the use of TACs is to conduct dialogue that transcends silos, and to explore re-engineering of the development pathway.” And, as far as biomarkers and molecular diagnostics are concerned, a lot has been said about testing, and often the lack of it, in terms of the COVID-19 outbreak, with different countries adopting different strategies and, also, having different resources when it comes to acquiring necessary kits.

The key focus in the ESMO session was on better and more equitable access to biomarkers and molecular diagnostics across Europe.  This is a must, but, as the attendees acknowledged, we’re a long way short of it. Access to personalised medicine and new diagnostic technologies can help resolve many inefficiencies, such as trial-and-error dosing, the potential for increased hospitalisation time due to adverse drug reactions and the problem of late diagnoses. It may also enhance the effectiveness of therapies through better tailored treatment administration.

In conclusion for the morning session, Giuseppe Curigliano, associate professor of Medical Oncology at the University of Milano, and head of the division of Early Drug Development, at the European Institute of Oncology said: “A real challenge to overcome is the different endpoints between investigators and payers. Policy frameworks and co-operation is essential.” The session in the afternoon will focus on utilizing real-world evidence in a health-care setting.

A report will be available next week. 

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Brexit

EU's Barnier still hopes trade deal with Britain possible, sources say

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The European Union’s Brexit negotiator told the bloc’s 27 national envoys to Brussels that he still hoped a trade deal with Britain was possible, stressing that the coming days would be decisive, diplomatic sources with the bloc told Reuters, write and

Michel Barnier addressed the gathering on Wednesday (16 September) and the three sources either participated in the discussion behind closed doors or were briefed on its content.

“Barnier still believes a deal is possible though the next days are key,” said one of the EU diplomatic sources.

A second diplomat, asked what Barnier said on Wednesday and whether there was still a chance for a new agreement with the UK, said: “The hope is still there.”

The first source said tentative concessions offered by the UK on fisheries - a key point of discord that has so far prevented agreement on a new EU-UK trade deal to kick in from 2021 - were “a glimmer of hope”.

Reuters reported exclusively on Tuesday (15 September) that Britain has moved to break the deadlock despite that fact that publicly London has been threatening to breach the terms of its earlier divorce deal with the bloc.

A third source, a senior EU diplomat, confirmed the UK offer but stressed it was not going far enough for the bloc to accept.

Brexit talks descended into fresh turmoil this month over Prime Minister Boris Johnson’s plans to pass new domestic laws that would undercut London’s earlier EU divorce deal, which is also aimed at protecting peace on the island of Ireland.

US Democratic presidential candidate Joe Biden warned Britain that it must honour the Northern Irish peace deal as it extracts itself from the EU or there would be no US trade deal for the United Kingdom.

The third EU source, who spoke under condition of anonymity, said that the bloc would take a more rigid line in demanding a solid dispute settlement mechanism in any new UK trade deal should Johnson press ahead with the Internal Market Bill.

“There is unease about what Britain is doing but Barnier has stressed he will keep negotiating until his last breath,” said a fourth EU diplomat, highlighting the bloc’s wariness about being assigned blame should the troubled process eventually fail.

Asked about an estimate by Societe Generale bank, which put at 80% the probability of the most damaging economic split at the end of the year without a new deal to carry forward trade and business ties between the EU and the UK, the person said:

“I would put it around the same mark.”

Barnier is due to meet his UK counterpart, David Frost, around 1400 GMT in Brussels on Thursday.

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Brexit

Biden warns UK on #Brexit - No trade deal unless you respect Northern Irish peace deal

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US Democratic presidential candidate Joe Biden warned the United Kingdom that it must honour the Northern Irish peace deal as it extracts itself from the European Union or there would be no US trade deal, write and

“We can’t allow the Good Friday Agreement that brought peace to Northern Ireland to become a casualty of Brexit,” Biden said in a tweet.

“Any trade deal between the US and UK must be contingent upon respect for the Agreement and preventing the return of a hard border. Period.”

Johnson unveiled legislation that would break parts of the Brexit divorce treaty relating to Northern Ireland, blaming the EU for putting a revolver on the table in trade talks and trying to divide up the United Kingdom.

He says the United Kingdom has to have the ability to break parts of the 2020 Brexit treaty he signed to uphold London’s commitments under the 1998 peace deal which ended three decades of sectarian violence in Northern Ireland between pro-British Protestant unionists and Irish Catholic nationalists.

The EU says any breach of the Brexit treaty could sink trade talks, propel the United Kingdom towards a messy exit when it finally leaves informal membership at the end of the year and thus complicate the border between Northern Ireland and EU-member Ireland.

The EU’s Brexit negotiator told the bloc’s 27 national envoys that he still hoped a trade deal with Britain was possible, stressing that the coming days would be decisive, three diplomatic sources told Reuters.

Michel Barnier addressed the gathering on Wednesday and the three sources either participated in the discussion behind closed doors or were briefed on its content.

“Barnier still believes a deal is possible though the next days are key,” said one of the EU diplomatic sources.

Johnson told The Sun that the EU was being “abusive” to Britain and risking four decades of partnership.

He said the UK must “ring-fence” the Brexit deal “to put in watertight bulkheads that will stop friends and partners making abusive or extreme interpretations of the provisions.”

Societe Generale analysts said on Thursday they now see an 80% chance that Britain and the EU will fail to strike a trade deal before the end of the year.

Biden, who has talked about the importance of his Irish heritage, retweeted a letter from Eliot Engel, chair of the Foreign Affairs Committee of the US House of Representatives, to Johnson calling on the British leader to honour the 1998 Good Friday peace deal.

Engel urged Johnson to “abandon any and all legally questionable and unfair efforts to flout the Northern Ireland protocol of the Withdrawal Agreement.”

He called on Johnson to “ensure that Brexit negotiations do not undermine the decades of progress to bring peace to Northern Ireland and future options for the bilateral relationship between our two countries.”

Engel said Congress would not support a free trade agreement between the United States and the United Kingdom if Britain failed to uphold its commitments with Northern Ireland.

The letter was signed by Representatives Richard Neal, William Keating and Peter King.

Johnson is pushing ahead with his plan.

His government reached a deal on Wednesday (16 September) to avert a rebellion in his own party, giving parliament a say over the use of post-Brexit powers within its proposed Internal Market Bill that breaks international law.

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