Those TV Ads for High Cholesterol and Erectile Dysfunction Probably Aren’t Going Away

It has been almost two decades since pharmaceutical manufacturers decided that they might have better luck promoting their products if they bypassed doctors and took their messages straight to consumers. And although the Food and Drug Administration is keeping a wary eye on direct-to-consumer advertising, the practice now appears solidly entrenched. The United States and New Zealand are the only two countries among developed nations that permit direct-to-consumer advertising.

Direct-to-consumer pharmaceutical advertising, or DTC, was never against the law. But pharmaceutical manufacturers began targeting consumers in the 1980s and, in 1999, the FDA clarified the rules on DTC advertising to better protect consumers. Since then, the practice has exploded. According to a 2011 report issued by the Congressional Budget Office, DTC advertising totaled $ 4.7 billion in 2008—about one-quarter of pharmaceutical manufacturers’ promotional budgets.

This year, the FDA launched two new studies on the impact of DTC drug ads and also issued new instructions to manufacturers on how it will review the content of drug ads. However, other attempts to reign in DTC ads, such as through legislation, haven’t progressed very far.

“I think there are a lot of people who want us to pull back from DTC advertising. They think it’s gotten out of hand,” Francis B. Palumbo, professor and executive director of the University of Maryland School of Pharmacy Center on Drugs & Public Policy, told TakePart. But, he adds: “It’s kind of woven into the fabric of American culture now. To pull it back would be very difficult. It’s a question of what would happen if you pulled the plug.”

Some studies suggest that DTC ads aren’t so bad. The ads can educate people, help them start a conversation with their doctors, and even prompt someone to see a doctor when they otherwise might not have. Information contained in the ads may improve patient compliance regarding instructions on how to take a particular drug and how to spot side effects.  

But the ads have generated considerable controversy. Doctor groups tend to dislike the practice, Palumbo says, because consumers demand prescriptions for certain medications they’ve heard about on TV. Sometimes, doctors say,  their patients would benefit more and save money by taking a different medication than the one advertised on television.

RELATED: Beware Rogue Online Pharmacies, FDA Says

“Patients put more pressure on their doctors to prescribe a particular drug when they see it on TV,” Palumbo says.

Other healthcare experts have questioned whether DTC leads to higher drug costs. And, because many DTC ads are for newly approved medications, some critics say the ads expose consumers to unnecessary risks. For example, the drug Vioxx was heavily advertised and sold to millions of people but was later taken off the market because of serious health risks linked to its use.

Certain classes of medications advertised to consumers have triggered considerable controversy, such as advertisements for drugs to treat depression, Palumbo says. While it may be helpful for consumers to know there are treatments for depression, drug companies have been criticized for pitching atypical antipsychotics, a newer class of drugs, for the treatment of depression. Many atypical antipsychotics are costly and carry harsh side effects. Typically, such medications are only prescribed when other treatment options have been exhausted.

RELATED: Americans Struggling to Pay for Prescription Drugs

According to the Congressional Budget Office report, pharmaceutical manufacturers only promote a small set of specific drugs using DTC. The CBO looked at 366 brand-name drugs that were promoted to doctors and other healthcare professionals from 1999 to 2008. Of those drugs, only 73 were advertised directly to consumers. Drug companies spent an average of $ 71 million per drug for a two-year period of DTC advertising.

The CBO found that the average number of prescriptions for newly approved brand-name drugs with DTC advertising was nine times greater than the average number of prescriptions written for newly approved brand-name drugs that weren’t advertised. But pharmaceutical companies are selective about which products are advertised to consumers. They tend to focus on medications for common conditions that affect large numbers of people, like high cholesterol or seasonal allergies.

“When pharmaceutical companies advertise directly to the consumer their sales go up,” Palumbo says. “That’s why they do it. They garner huge sales.”

RELATED: The Most Expensive Prescription Drugs in the U.S.

The FDA is watching the DTC scene carefully. Earlier this year, the agency launched a study examining the impact of “corrective” direct-to-consumer advertising. This is a type of ad that the agency demands of pharmaceutical manufacturers when the company’s initial ad features false or misleading information. One of the best-known examples of a corrective ad was for the birth control pill Yaz. The agency is looking at how corrective ads impact consumer misperceptions about the drug. In other words, do the corrective ads reverse the false impression?

Another FDA study, announced in August, will examine whether consumers understand ads for drugs that have “composite scores.” These are drugs that are advertised for multiple symptoms, such as an allergy drug touted for sneezing, runny nose, watery eyes and wheezing. Such drugs are given a single composite score (encompassing the effectiveness scores for each particular symptom) that shows how effective the drug is compared to another drug. But, the FDA states: “Because most DTC prescription drug ads do not explicitly state that they used composite scores” consumers may not understand the drug’s actual efficacy.

Also this year, the FDA informed pharmaceutical companies that it wants to review DTC ads for new drugs and drugs with new indication before they appear before the public to make sure the ads include all pertinent risk information. The agency will have 45 days to conduct the review

“FDA is under a lot of criticism for that,” Palumbo notes. “FDA is always under-resourced, and the question is whether FDA will get back to the manufacturer in a timely manner. The manufacturers are spending millions of dollars putting out these ads. They want to run them.”

Question: Should FDA tighten the reins on DTC drug ads? Tell us what you think in the comments.

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Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.

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Black Friday and the Triumph of Marketing

A century ago “Black Friday” referred to the market crash of Sept. 24, 1869, which was caused by two financiers’ failed attempt to corner the gold market. Today we know Black Friday as the country’s busiest shopping day, falling right after Thanksgiving. How did that happen?

One popular but false explanation is that the name marks the day retailers end an 11-month stretch of red ink and harvest profits for the first time all year. Others say it refers to the dark day thousands of retail workers will spend greeting shoppers, stocking shelves, folding garments, and ringing registers.

In fact, factory owners in the 1950s first coined Black Friday to lament the high number of workers who wouldn’t show up for work, as linguist Ben Zimmer pointed out last year. The connection between Black Friday, crowds, and shopping came in the early 1960s from some Philadelphia cops, he explained. They used the phrase to describe the mad traffic downtown on the day holiday shoppers converged with football fans arriving for the Army-Navy game, traditionally played in Philly on the Saturday after Thanksgiving.

The name Black Friday, picked up by the press, presented a branding problem from the start. Zimmer quotes a 1961 story from Public Relations News that called the label “hardly a stimulus for good business,” and notes city spinmeister Abe Rosen’s efforts to replace it with the anodyne “Big Friday.” The Philadelphia newspapers refused, and Black Friday stuck.

It’s not exactly clear when, in the decades since, retailers across the country embraced the name. By the time they did, it came with the reassuring myth that Black Friday was the day they turned a profit to be “in the black.” (A quick look at retailers’ quarterly earnings should put that canard to rest.) The retail industry shed any queasiness it had about the Black Friday brand in recent years, as big-box stores and shopping malls embraced “door-buster” sales that got shoppers to line up for discounts before opening time.

Although Black Friday has long been called the busiest shopping day of the year, that’s only become true in the past decade, according to data from retail analyst ShopperTrak. Before 2004, holiday shopping generally peaked on the Saturday before Christmas, the International Council of Shopping Centers reported (PDF). But after enough years of retailers and reporters and shoppers repeating that Black Friday was the busiest day, the myth eventually became true.

More recently, the hoopla has spread throughout the week. Cyber Monday was invented in 2005 by the National Retail Federation’s digital division in an attempt to promote online shopping when office workers get back to their desks after the holiday; it was not the highest volume day for e-commerce sales. In 2010, American Express (AXP) made up Small Business Saturday, with promotions and rebates aimed at getting gift-seekers to swipe their AmEx cards at local merchants’ shops. Note to retailers: Three days of Thanksgiving week remain unbranded. Or four, if Thanksgiving itself is not off limits.

And, of course, it’s not. Black Friday has been creeping earlier, from dawn to midnight to Thursday evening. Wal-Mart Stores (WMT) plans to open its doors on Thanksgiving day at 8 p.m. this year, two hours earlier than last year, a decision that’s helped provoke some workers to strike. Perhaps the earlier hour is an attempt to avoid the sometimes unruly crowds that door-buster sales attract. Last year, a Wal-Mart shopper in California reportedly pepper-sprayed fellow customers to reach coveted merchandise. But even that’s not Black Friday’s darkest moment: In 2008, Jdimytai Damour, a 34-year-old Queens man who took a seasonal job at a Wal-Mart in Valley Stream, N.Y, was killed when a pre-dawn Black Friday mob broke the glass doors and trampled him to death.

Long before such deadly excess, some activists seized the symbolism of Black Friday to make people think twice about consumer culture. Since the 1990s, the day after Thanksgiving has also been dubbed Buy Nothing Day, an idea championed by Adbusters magazine and, lately, the Occupy movement. The thought of getting masses of consumers to stay home on what has become the biggest shopping day of the year may sound like a pipe dream. But Black Friday only holds its current place in our culture through miracles of marketing, spin, and rebranding. Those celebrating Buy Nothing Day, at least, don’t have to explain the name.

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Turbulence on Cuba-Italy flight leaves 30 bruised

ROME (AP) — An airliner flying from Havana to Milan abruptly plunged some 1,000 meters (3,300 feet) when it hit unusually strong turbulence over the Atlantic on Monday, terrifying passengers and leaving some 30 people aboard with bruises and scrapes, airline officials said.

The flight continued to Milan’s Malpensa airport after the plane’s captain determined that it suffered no structural damage and two passengers who are physicians found no serious injuries, Giulio Buzzi, head of the pilots division at Neos Air, told Sky TG24 TV.

The ANSA news agency quoted bruised passenger Edoardo De Lucchi as saying meals were being served when suddenly there was “10 seconds of terror.” He recounted how plates went flying and some passengers not wearing seatbelts bounced about.

Buzzi had said that the drop measured some 3,000 meters (10,000 feet) in a cloudless sky. But Milan daily’s Corriere della Sera’s web site, quoting Neos official Davide Martini, later reported that the plane first bounced up some 500 meters (1,650 feet), then dropped some 1,000 meters (3,300 feet) to some 500 meters (1,650 feet) below the original altitude.

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People turn to Twitter for CPR information: study

(Reuters) – Amid snarky comments and links to cat videos, some Twitter users turn to the social network to find and post information on health issues like cardiac arrest and CPR, according to a U.S. study.

Over a month, researchers found 15,234 messages on Twitter that included specific information about resuscitation and cardiac arrest, said the study published in the journal Resuscitation.

“From a science standpoint, we wanted to know if we can reliably find information on a public health topic, or is (Twitter) just a place where people describe what they ate that day,” said Raina Merchant, the study’s lead author and a professor at the Department of Emergency Medicine at the University of Pennsylvania.

According to the researchers, they found people using Twitter to send and receive a wide variety of information on CPR and cardiac arrest, including their personal experiences, questions and current events.

Some researchers and organizations already use Twitter for public health matters, including tracking the 2009 H1N1 “swine flu” pandemic and finding the source of the Haitian cholera outbreak, the researchers said.

For the study, the researchers created a Twitter search for key terms, such as CPR, AED (automatic external defibrillators), resuscitation and sudden death.

Between April and May 2011, their search returned 62,163 tweets, which were whittled down to 15,324 messages that contained specific information about cardiac arrest and resuscitation.

Only 7 percent of the tweets were about specific cardiac arrest events, such as a user saying they just saw a man being resuscitated, or a user asking for prayers for a sick family member.

About 44 percent of the tweets were about performing CPR and using an AED. Those types of tweets included information on rules about keeping AEDs in businesses and questions about how to resuscitate a person.

The rest of the tweets were about education, research and news events, such as links to articles about celebrities going into cardiac arrest.

The vast majority of the Twitter users send fewer than three tweets about cardiac arrest or CPR throughout the month. Users that sent more tweets typically had more followers – people who subscribe to their messages – and often worked in a health-care related field.

About 13 percent of the tweets were re-sent, or retweeted, by other users. The most popular retweeted messages were about celebrity-related cardiac arrest news, such as an AED being used to revive a fan at a Lady Gaga concert.

“I think the pilot (study) illustrated for us that there is an opportunity to potentially provide research and information for people in real time about cardiac arrest and resuscitation,” Marchant said.

“I can imagine in the future we will see systems that would automatically respond to tweets of individual users. Twitter is a really powerful tool, and we’re just beginning to understand its abilities.”

SOURCE: http://bit.ly/T2bj7u

(Reporting from New York by Andrew Seaman at Reuters Health; editing by Elaine)

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Jackie Chan: upcoming film will be last big action movie

BEIJING (Reuters) – Kung Fu superstar Jackie Chan said that while the upcoming film “Chinese Zodiac 2012″ will be his last major action movie, citing his increasing age, he will still be packing punches in the world of philanthropy.

Chan wrote, directed and produced his latest film, set to premiere in cinemas in China next month. He also plays the lead role and said that he regarded it the “best film for myself” in the last ten years.

“I’m the director, I’m the writer, I’m the producer, I’m the action director, almost everything,” the 58-year-old Hong Kong actor told Reuters while in Beijing to film a documentary.

“This really, really is my baby. You know, I’ve been writing the script for seven years,” and the film took a year and half to make, he added.

In the film, Chan is a treasure hunter seeking to repatriate sculpture heads of the 12 animals of the Chinese zodiac, which were taken from Beijing‘s Summer Palace by French and British forces during the Opium Wars.

He said it was an important movie for him because it will be his last major action feature, although he insisted it is not the end of his action career.

“I’m not young any more, honestly,” he said, noting that with special effects technology and doubles a lot can be done without physical risk.

“Why (do) I have to use my own life to still do these kind of things?” he said. “I will still do as much as I can. But I just don’t want to risk my life to sit in a wheelchair, that’s all.”

Chan was recently awarded the Social Philanthropist of the Year award by Harpers Bazaar magazine. He said he wanted to increase time devoted to charitable work and hoped China’s leagues of newly wealthy will follow his example – which he underlined by auctioning a Bentley 666 for around 6 million yuan ($ 961,837).

China now has more billionaires than any other Asian country, but very few philanthropic organizations, and giving to charity remains a relatively new phenomenon in the world’s most populous country.

Chan said while Chinese philanthropists have made some encouraging strides, much more still needs to be done – a task made harder by the Internet, with netizens willing to leap on every perceived wrong move.

“Right now people (must) very, very be careful, but that doesn’t stop them to want to do the charity. I think it’s a good sign,” Chan said. (Reporting by Reuters Television, editing by Elaine Lies and Christine Kearney)

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Pharmacies Dispense Meds Even After Docs Stop Prescription

Image courtesy of iStockphoto/monkeybuisnessimages

When doctors take patients off of a prescription medicine, it is often for a good reason. But pharmacists don’t always get the memo. A new study finds that more than 1 in 100 discontinued prescriptions were filled by the pharmacy anyway, putting some patients at serious risk. In the U.S., pharmacists filled more than 3.7 trillion prescriptions in 2011. With so many prescriptions and refills–and our still largely human- and paper-based prescribing system–there are bound to be mistakes. Pharmacists may overlook drug interactions, dispense inappropriate medications, or commit other little-understood errors. One such underappreciated problem area is the process of taking patients off medication. While errors in initial prescribing have drawn much attention, potential for error when doctors order a prescription to stop also looms large. And electronic health records, which have helped to minimize medical errors in other areas, might be partly to blame. These electronic communiqu?s might be giving some doctors–and patients–a false sense of efficacy. Doctors might assume that when they make a note on a patient’s electronic health record to stop a prescription the pharmacy will automatically get the message as it does when they first prescribed that medication. This, however, is not always the case, wrote Adrienne Allen, of the North Shore Physician Group, and Thomas Sequist, of Brigham and Women’s Hospital in the new paper, published online November 19 in Annals of Internal Medicine. To find out how often the pharmacies continue to dispense meds the doctor no longer ordered, Allen and Sequist analyzed electronic health records of 30,406 adults in a Massachusetts health system whose doctor had discontinued a drug to treat a high-risk condition such as high cholesterol, hypertension, diabetes, blood coagulation or platelet aggregation. Some 83,900 medications were discontinued during the course of a year. Nevertheless, pharmacists still dispensed 1,218 of these prescriptions after they were discontinued. The most common drug that pharmacists dispensed after a doctor canceled the prescription was metoprolol (Lopressor or Toprol), which is often prescribed to treat high blood pressure after a heart attack and which can have harmful drug interactions with other commonly prescribed drugs. In a subset of medical records, a computer analysis flagged more than a third (34 percent) of the improper dispensations as creating a “high risk of potential adverse events” such as a harmful reaction, potential drug interaction or suspect lab test result, the researchers noted. And manual assessment verified that potential harm actually occurred in at least 12 percent of cases. Patients receiving these drugs were more likely to be taking more medications, older, enrolled in Medicare and black. Additional medications make it more likely that a patient will suffer an adverse drug interaction if they take an unintended prescription (especially if a doctor has subsequently prescribed a similar drug to take the discontinued drug’s place). And older adults might be less likely to notice a mistake. One limitation of the study is that the researchers could only study the 52 percent of discontinued prescriptions that were filled at participating health care system pharmacies; unaffiliated pharmacies might have even higher inappropriate dispensation rates. Additionally, the researchers only studied a limited number of drugs. Adding other drugs to the analysis would likely increase the number of discontinued prescriptions dispensed, even if the risk of side effects might be lower. They researchers see promise for filling this communication gap in the future. Electronic health records offer an opportunity to track these missteps, and adding more direct communication with pharmacies about prescription discontinuation should help avoid these errors. For now, however, the new technology is often not as powerful as many doctors think it is. So some of the responsibility will continue to lie with the patient. Officials would be wise to help “increase patient awareness of their medication list,” the researchers concluded. That is, until the computers can just do it for us.

Follow Scientific American on Twitter @SciAm and @SciamBlogs. Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.

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Maybe Diamonds Aren’t Forever

Ian Harebottle is looking for the next Marilyn Monroe. The chief executive officer of London-based Gemfields (GEM), the world’s largest producer of emeralds, says he’s seeking “an A-lister” who can do for the green gems what Monroe did for diamonds when she sang Diamonds Are a Girl’s Best Friend in Gentlemen Prefer Blondes. Monroe’s performance in the 1953 flick added extra sparkle to diamond sales.

Diamonds still dominate the $ 21 billion precious stone market, accounting for 90 percent of all sales, according to BMO Capital Markets (BMO). But for the first time in decades they have a little competition from the colored also-rans in the gem trade. Rarer than diamonds yet cheaper, emeralds, rubies, and sapphires are gaining favor just as sales for diamonds are beginning to show weakness. Polished diamond prices have fallen for five straight quarters as jewelry buyers in Asia and Europe become more cautious about luxury shopping, according to PolishedPrices.com. Uncut diamond prices are heading for their first annual decline since 2008, according to WWW International Diamond Consultants.

Colored gems’ rising popularity is starting to worry the diamond industry. “During the past three years these other gemstone categories have taken away yet another half percent from our market share,” Moti Ganz, president of the International Diamond Manufacturers Association, said in a speech at the World Diamond Congress on Oct. 15. As a result, colored stones are becoming more valuable. Prices for high-quality emeralds have soared more than tenfold in the past three years, according to Gemfields company filings. Cut rubies have risen in value 63 percent since 2005 and sapphires by 45 percent, according to Gemval, an online gem appraisal site.

The reason for the shift in tastes is multifaceted. Colored stones are still less expensive, a plus for star-struck lovers on a budget during hard times. A 0.9-carat round diamond that’s internally flawless and of rare white color costs about $ 7,000, according to online retailer Blue Nile (NILE). A round emerald with “excellent clarity” of the same size costs about half as much, according to online vendor AfricaGems.

Some of the interest in colored stones is “celebrity driven,” says Caitlin Mociun, a Brooklyn-based jewelry designer. “One reason might be Kate Middleton having a sapphire engagement ring, or even Beyoncé having a black diamond engagement ring. Those things, especially for a mass market, can definitely drive a trend.” Hollywood personality Jessica Simpson’s engagement ring sported two diamonds, but the ruby in its center got all the press and sparked numerous knockoffs. Halle Berry’s ring featured a 4-carat emerald that several celebrity magazines breathlessly announced came from “closed-down mines in Muzo, Colombia.” At a gem trade show in Hong Kong last year, Russell Shor, an analyst with the Gem Institute of America, immediately noticed the new interest in colored stones. “People were all of a sudden really hot to buy emeralds,” he says.

That may not be an accident. Harebottle, whose company produces about 20 percent of the world’s emeralds, is increasing Gemfields’ marketing budget, trying to exploit fissures in the diamond industry that until recent years was controlled by De Beers. Until the 1940s, the colored-stone market was about equal in size to the diamond industry. Then, in 1947, De Beers coined the slogan “A Diamond Is Forever,” later voted the best of the 20th century by Advertising Age. De Beers funded most of the marketing for the diamond industry through its generic marketing, similar to the dairy industry’s “Got Milk?” campaign. That changed in 2004 when De Beers’s monopoly ended after it pleaded guilty to price fixing in the U.S., concluding a 10-year legal battle. The diamond industry became chaotic and the amount spent on marketing plummeted, with De Beers cutting its ad budget in half, according to Stephen Lussier, the company’s executive director in London. The industry tried to reorganize in 2008 at a meeting in St. Petersburg, Russia, that led to the creation of the International Diamond Board. But members, including Russian state monopoly OAO Alrosa and mining giant Rio Tinto (RIO), failed to come to an agreement over how to fill the advertising void left by De Beers. “Not all people were willing to do their part,” says Lussier. “De Beers can do its part, but it alone is not enough.”

Anish Aggarwal, a partner at consulting firm Gemdax, says the diamond industry has had “four to five years without any real category marketing, and there are some markets that are suffering, such as Japan.” He adds that there’s “a danger of losing some of the cultural imperative.”

Even if Gemfields does find a modern Marilyn Monroe, it’s doubtful the company will ever be able to match De Beers’s old business model, in which a single firm mines, markets, and largely controls wholesale prices. Still, Harebottle has learned from the former monopoly’s experience. The colored-stone industry has traditionally been highly fragmented, divided up among many small, family-owned outfits. By bringing corporate heft to it, Harebottle hopes to boost supplies and raise prices at the same time. He aims to increase Gemfields’ share of the global emerald market to about 30 percent by expanding production at its African emerald and ruby mines. The company already owns 75 percent of the Kagem emerald mine in Zambia, the world’s largest, and controls 75 percent of the Montepuez ruby field in Mozambique.

De Beers still spends hundreds of millions of dollars a year on advertising, according to Lussier. But if Gemfields can demonstrate “clear industry leadership, they will have a chance” to capitalize on the diminished marketing power of diamonds, says Aggarwal of Gemdax.

Harebottle plans to boost his marketing budget to at least $ 4 million next year, up from just $ 150,000 in 2009. Next year’s budget will likely contain money for a celebrity endorser. Gemfields currently pays for about 70 percent of global emerald advertising, says Harebottle, but he doesn’t mind bearing the marketing cost for the entire colored- gems industry: “The fact that people free carry, I don’t mind—so long as it benefits us.”

The bottom line: Gemfields, the No. 1 emerald producer, is adding corporate heft to the colored-stone market, boosting its ad budget to $ 4 million.

With Caroline Winter

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Rebels in Congo reach door of Goma

GOMA, Congo (AP) — A Rwandan-backed rebel group advanced to within 3 kilometers (1.8 miles) of Goma, a crucial provincial capital in eastern Congo, marking the first time that rebels have come this close since 2008.

Congolese army spokesman Col. Olivier Hamuli said the fighting has been going on since 6 a.m. Sunday and the front line has moved to just a few kilometers (miles) outside the city. After more than nine hours of violent clashes the two sides took a break, with M23 rebels establishing a checkpoint just 100 meters (yards) away from one held by the military in the village of Munigi, exactly 3 kilometers (1.8 miles) outside the Goma city line.

Contacted by telephone on the front line, M23 rebel spokesman Col. Vianney Kazarama said the group will spend the night in Goma.

“We are about to take the town. We will spend the night in Goma tonight,” said Kazarama. “We are confident that we can take Goma and then our next step will be to take Bukavu,” he said mentioning the capital of the next province to the south.

The M23 rebel group is made up of soldiers from a now-defunct rebel army, the National Congress for the Defense of the People, or CNDP, a group made-up primarily of fighters from the Tutsi ethnic group, the ethnicity that was targeted in Rwanda‘s 1994 genocide. In 2008, the CNDP led by Rwandan commando Gen. Laurent Nkunda marched his soldiers to the doorstep of Goma, abruptly stopping just before taking the city.

In the negotiations that followed and which culminated in a March 23, 2009 peace deal, the CNDP agreed to disband and their fighters joined the national army of Congo. They did not pick up their arms again until this spring, when hundreds of ex-CNDP fighters defected from the army in April, claiming that the Congolese government had failed to uphold their end of the 2009 agreement.

Reports, including one by the United Nations Group of Experts, have shown that M23 is actively being backed by Rwanda and the new rebellion is likely linked to the fight to control Congo’s rich mineral wealth.

The latest fighting broke out Thursday and led to the deaths of 151 rebels and two soldiers. On Saturday U.N. attack helicopters targeted M23 positions in eastern Congo.

Also on Saturday, United Nations Secretary-General Ban Ki-Moon had called Rwandan President Paul Kagame “to request that he use his influence on the M23 to help calm the situation and restrain M23 from continuing their attack,” according to peacekeeping chief Herve Ladsous who spoke at the U.N. headquarters in New York on Saturday.

North Kivu governor Julien Paluku said Saturday that the Congolese army had earlier retreated from Kibumba, which is 30 kilometers (19 miles) north of Goma, after thousands of Rwandans, who he says were backing the rebels, attacked early Saturday.

“Rwandan forces bombarded our positions in Kibumba since early this morning and an estimated 3,500 crossed the border to attack us,” he said Saturday.

In downtown Goma, panicked residents had come out to try to get more information on what was happening. A 45-year-old mother of five said that she has nowhere to go.

“I don’t really know what is happening, I’ve seen soldiers and tanks in the streets and that scares me,” said Imaculee Kahindo. Asked if she planned to leave the city, she said: “What can we do? I will probably hide in my house with my children.”

Hamuli, the spokesman for the Congolese army, denied reports that soldiers were fleeing.

In 2008 as Nkunda’s CNDP rebels amassed at the gates of Goma, reporters inside the city were able to see Congolese soldiers running in the opposite direction, after having abandoned their posts. The Congolese army is notoriously dysfunctional with soldiers paid only small amounts, making it difficult to secure their loyalties during heavy fighting.

“We are fighting 3 kilometers from Goma, just past the airport. And our troops are strong enough to resist the rebels,” said Hamuli. “We won’t let the M23 march into our town,” he said. Asked if his troops were fleeing, he added: “These are false rumors. We are not going anywhere.”

U.N. peacekeeping chief Ladsous said that the rebels were very well-equipped, including with night vision equipment allowing them to fight at night.

Reports by United Nations experts have accused Rwanda, as well as Uganda, of supporting the rebels. Both countries strongly deny any involvement and Uganda said if the charges continue it will pull its peacekeeping troops out of Somalia, where they are playing an important role in pushing out the Islamist extremist rebels.

The U.N. Security Council called for an immediate stop to the violence following a two-hour, closed-door emergency meeting. The council said it would add sanctions against M23 rebels and demanded that rebels immediately stop their advance toward the provincial capital of Goma.

“We must stop the M23″ because Goma’s fall “would, inevitably, turn into a humanitarian crisis,” said France‘s U.N. Ambassador, Gerard Araud. He added that U.N. officials would decide in the coming days which M23 leaders to target for additional sanctions.

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Associated Press writer Maria Sanminiatelli at the United Nations and Rukmini Callimachi in Dakar, Senegal, contributed to this report.

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Cisco to buy cloud-networking start-up Meraki for $1.2 billion

(Reuters) – Networking equipment company Cisco Systems Inc said it will buy privately held cloud networking company Meraki for $ 1.2 billion in cash as part of its cloud and networking strategy.

Cisco said the acquisition of Meraki, which was founded in 2006 by members of MIT’s Laboratory for Computer Science, is expected to close in the second quarter of Cisco’s 2013 fiscal year and is subject to regulatory approval.

Cisco’s second quarter runs until the end of January.

Meraki – funded by Sequoia Capital and Google Inc – offers Wi-Fi technology, switching, security and mobile device management from the cloud with a focus on mid-sized businesses.

“This is a very logical move for Cisco,” said ZK research analyst Zeus Kerravala.

He said the deal will allow Cisco to offer alternative solutions to traditional Wi-Fi deployment models like smaller competitors, such as Aruba Networks and Ruckus Wireless, which debuted on Friday.

“Cisco didn’t really have anything to counter that before,” Kerravala noted.

Meraki’s Chief Executive Sanjit Biswas said in a letter to employees posted on the company website that Cisco had approached the company several weeks ago.

The company’s founders had at first rejected the offer in favor of continuing Meraki’s strategy aimed at an initial public listing.

“After several weeks of consideration, we decided late last week that joining Cisco was the right path for Meraki,” Biswas said.

He also said that Meraki had achieved a $ 100 million bookings run rate, grown to 330 employees and had a positive cash flow.

(Reporting by Nicola Leske, editing by Gary Crosse)

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Seacrest, Wonder, Usher, others praise Dick Clark

LOS ANGELES (AP) — Ryan Seacrest and Stevie Wonder paid homage to Dick Clark on stage, while Usher and will.i.am shared their praise for the TV icon and music lover off camera.

Clark, who died earlier this year, was the subject of a special tribute at the American Music Awards, which he created 40 years ago.

Seacrest said the show still reflects Clark’s original vision: Bring together the year’s most popular artists and “let the music speak for itself.”

“Dick loved the power of music and its ability to create pure joy,” Seacrest said Sunday before introducing Wonder, whom he described someone Clark loved as a friend and musician for 49 years.

“I remember his friendship and his kindness. I remember his love for music and his love for people,” Wonder said. “I challenge you, you as communicators, leaders, politicians, spiritual leaders: Put your love first like we musicians put our music first… Then we can be jamming until the break of dawn.”

Wonder played a medley of songs as images of Clark and the many musicians he worked with flashed across the screen.

Other artists shared their admiration for Clark on the red carpet and backstage at the Nokia Theatre. Will.i.am, who presented the artist of the year award to Justin Bieber, said Clark’s legacy for spotting and encouraging talent is why the American Music Awards have endured for 40 years.

“I remember seeing Whitney Houston on the American Music Awards. Lionel Richie. Santana. Jefferson Airplane,” he said. “Think of all the classic, iconic television moments. Now, my generation is part of it and the next generation is part of this American iconic family time.”

Usher, who was named favorite male soul/R&B artist Sunday, said he always admired Clark and aims to emulate his legacy of fostering young talent.

“He’s so rich with culture and been able to recognize talent for so many years and have an incredible legacy. I’m just really happy to still be a part of it and still take an award home,” Usher said. “To be an artist that’s been able to continue to evolve and transcend culture, it’s from the book of Dick Clark, the fact that he’s, throughout generations, been able to recognize incredible talent across genres.”

Usher helps guide the career of the night’s big winner, Bieber, who accepted awards for pop/rock male artist, pop/rock album for “Believe” and artist of the year Sunday.

“The proof is in the pudding,” Usher said. “The longer you do it, the more of an example you can set and being able to be that to him, being a mentor and just being an artist who continues to evolve… we’re just going to continue to push him to be his best self.”

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AP Entertainment Writer Sandy Cohen is on Twitter: www.twitter.com/APSandy .

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Online:

http://beta.abc.go.com/shows/american-music-awards

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