Since 2003, the virus has killed 128 people in nine countries including Indonesia, Vietnam and China, according to the World Health Organization, but the highly pathogenic strain of bird flu has not been found in North America.

The small Alaskan community of Barrow -- the northern-most city in the U.S. and a crossroads for migratory birds from Asia -- is the front line for the government's efforts for early detection of bird-flu's North American arrival.

The work has a sense of urgency because experts fear H5N1 could evolve into a form that easily infects people and that people can easily pass to others - perhaps sparking a pandemic.

The role of wild birds in carrying H5N1 avian influenza is unclear, but wild swans are believed to have infected feather-pluckers in Azerbaijan earlier this year. The more immediate threat is that the wild birds will infect poultry.

IDEAL SPOT

In Barrow, as the frozen tundra starts to thaw in the summer, migratory birds stop to drink and rest in the area's wetlands.

It is an ideal spot to find rare birds like the spectacled eider, which is on the threatened species list and one of 33 bird species the government has identified for priority testing due to its flights between Asia and North America.

Barrow is also considered a hub for bird-flu testing, because it is home to the world's largest Inupiat Eskimo community. Subsistence hunting of waterfowl still plays a crucial role in the local diet, and officials can test harvested birds for the virus.

Even in a birder's paradise like Barrow, collecting samples poses a challenge to biologists who admit that success is often the result of luck and lots of patience.

"You could walk around the tundra 20 years and not get that close to a spectacled eider," said Rossi, noting that this type of duck tends to congregate miles away on the ice atop the frozen ocean. "Some days, you spend a lot of energy and you come up with an empty sack."

Wildlife biologists spent two days at a landfill trying to lure a group of glaucous gulls with whale blubber to a spot where they could launch a 50-foot by 60-foot (15-meter by 18-meter) net to quickly capture, test and release the birds.

The gulls only approached the bait after the officials left in the evening. In a separate attempt to catch shorebirds, a group of biologists set up a thin "mist" net in a coastal marsh only to be foiled when the net billowed in a stiff breeze, and the birds easily avoided the trap.

The Bush administration's $29 million call to arms to combat bird flu will involve biologists from several government agencies.

Rick Lanctot, a biologist at the U.S. Fish and Wildlife Service, plans to send teams of biologists into remote areas of Alaska's National Petroleum Reserve via helicopter to sample a larger area and increase the odds of detecting the virus.

"I'm a shorebird biologist, so swabbing butts is not my highest priority, but it's national emergency kind of thing," said Lanctot, who normally monitors shorebirds' nesting patterns and survival rates.

The report surfaces as more and more clinical research relocates to the Global South in order to escape burdensome regulation schemes in the United States and Western Europe. AlterNet has obtained an early look at a book to be published later this year -- The Body Hunters: How the Drug Industry Tests Its Products On the World's Poorest Patients (New Press), by investigative journalist Sonia Shah -- that raises the curtain on a trend that's harming patients and health care systems while eroding the developing world's trust in conventional medicine.

Researchers needing patients and freer working conditions have for years found a honey pot in the world's slums and shantytowns. The fact that poor, desperate patients are willing to try anything, means companies like GlaxoSmithKline, Merck and Wyeth currently conduct 30 percent to 50 percent of their experiments outside Western Europe and the United States, and plan to boost foreign trials by 67 percent this year, according to USA Today. Their urgency is understandable; Shah's book notes that to get a single drug to market, drug companies are forced "to convince more than 4,000 patients to undergo 141 medical procedures each in more than 65 separate trials."

Clinical investigators and the companies backing them argue that overseas trials get drugs to a lucky few and lead to faster cures for us all. But Shah, the author of Crude: The Story of Oil, deftly takes that Big Pharma myth to task, tracing how drug trial exports ruin third-world health care systems, steer attention away from public health needs like clean water and sanitation, and ignore the health safety of subjects.

From the history of placebo controls to a modern map of how loophole-prone laws in the 1980s paved Big Pharma's easy way, Shah shows that "the main business of clinical research is not enhancing or saving lives but acquiring stuff: data" -- making it an industry instead of a social service, as it would have the world believe. As an industry, she argues, they should be denied the regulatory winks and nods reserved for a public health entity.

Hearn: What struck you as the worst case of excess or neglect you found while researching this book?

Shah: It was probably the trial I covered in Zambia [involving a drug to combat cryptosporidium, a diarrhea-causing infection]. It was stark, children dying, little kids dying. But from what I can tell if these kids had received antiretroviral therapy they could have survived. But they were put into a trial for a drug that never benefited them or their families or siblings because the drug was so completely targeted for other populations, almost a luxury drug for fighting an infection that in Western children means a day of diarrhea. It is so mild in kids who are healthy that lots of people don't even notice it.

So for such a minor condition they tested the drug on people who were so, so sick. And in the end, 12 kids died.

Kelly Hearn: You write that by the late 1990s, pharmaceutical companies had grown frustrated with the pace of academic hospitals and research centers, and changed the contracting focus to "contract research organizations," private companies that promise to get drug trials done quickly. What role do these companies play in the scheme of drug trials, and to what degree are they responsible for the growth in overseas trials?

Sonia Shah: There are two things, a push and a pull, that force trials overseas. The push is a patient recruitment bottleneck. Most trials don't meet recruitment deadlines, whether it's because Americans aren't interested or their profiles are wrong. Often the right kind of patients don't exist in enough quantity in the U.S., or if they do they drop out of trials.

The big pull is the contract research organizations (CROs). If anyone is a body hunter, it's the CRO industry, an industry that has largely escaped public notice, perhaps because of the weird, vague sounding moniker, CRO. Public Citizen called them, more accurately, "human experiment corporations." They are, though, just a business, and are not any more venal than other actors involved.

Hearn: Like you, many journalists and health experts I have interviewed almost invariably say the FDA should require new drugs to outperform existing ones rather than simply work better than a placebo. Given your sense of the FDA's ruling culture, the growing public frustration with drug companies, Washington's current political climate, and so on, is there real hope of this happening in the next few years?

Shah: I think not. But the history of regulation goes in fits and starts based on scandals, horrible mistakes like thalidomide, and then regulations change rapidly. And we can't predict disasters, something that will come into the limelight and expose a controversy, something that can change headlines. The FDA is vulnerable to headlines, to politics.

Hearn: What are the most dangerous structural impacts overseas trials can have on developing countries' health systems?

Shah: The main thing is misallocation of resources. You're talking about such a scarcity in terms of clinics, nurses, doctors, facilities, medicine, tools and time. You have places where all this is in short supply and in that setting they have this fruit dangled in front of them -- we'll pay you so many hundreds per patient, we'll give you new technology, new MRI machines, etc.

But what this means is that doctors and nurses there are performing experiments for treatments for things like diabetes, arthritis, erectile dysfunction. These things are important in the West but these people have malaria, cholera, and other infections. In that sense, the industry sponsored trials are distorting health care.

Part of a larger trend, as is happening in places like India that have and want more foreign trials, is the rise of privatized, two-tiered health care where high-tech facilities and highly specialized physicians are available for the wealthy, but the poor just have basic service that they have to pay for. In India and in South Africa, they are building hospitals not for people who live there but for foreigners. Doing trial business is part of the trend toward creating two-tiered systems in these countries, a private one for the rich and nothing for the poor.

Hearn: You talk about the phrase "due to ethical concerns" appearing frequently in biomedical conversations. You note that it is almost "exclusively reserved for biomedical transgressions." Can you explain?

Shah: It's just that you never hear it outside these circles it seems. If you're talking about something unethical, you don't say, "It's not possible due to ethical concerns." You don't say, "It's not possible to gas people due to ethical concerns." You say, "Such and such happened, and it was wrong, immoral and illegal."

Hearn: Rep. Tom Lantos of California said after the Washington Post's coverage of the Nigerian report that he will offer a bill making U.S. researchers give federal regulators details of tests planned in developing countries. What do you think of that idea, and what are some of the necessary regulatory changes for reining in the transgressions you address in the book?

Shah: I think it's a baby step in right direction. But most important, there needs to be restraints and breaks in the exportation of drug trials. It's not possible to put in enough oversight to protect these subjects, at the present time. Restraint is necessary. I was giving a talk at the FDA, and the regulators wanted to know what they can do to make it better. What about a new rule that says there should be an ethics committee review in this country and the country taking the trial? That's already true for NIH trials.

That would be good, but we know from NIH trials that lots of things fall through cracks, and that just requiring the ethics review is not sufficient. Another thing you could do is require verification of informed consent and really make sure people understand what's happening, that they fill out forms or take quizzes to show they understand.

Hearn: You put hope into the rise of the nonprofit drug companies. What are some of the key ways they can help?

Shah: I don't think it's wrong to do trials in developing countries. It's about what kind of drugs that are being developed. Are the drugs a public health priority? Those who take on the burden of experimentation should enjoy the fruits of research rather than watching the benefits go only to a tiny percentage of white, overweight bald men.

Hearn: Having now written about two of the world's most powerful interests, Big Oil and Big Pharma, what common themes emerge?

Shah: What's interesting to me is they produce commodities that are public goods. Society needs energy and medicine, but we let private companies do it for us. And their goals are to enrich shareholders. We need these things, but we decide the responsibility for providing it should go to for-profit entities. This develops all kinds of distortions.

Kelly Hearn is a former UPI staff writer who divides his time between the United States and South America. A correspondent for the Christian Science Monitor, his work has appeared in The Nation, The American Prospect and other publications. He is a regular contributor to AlterNet.

"To be candid, I hope it is a hypothetical problem. I hope we spent a lot of time creating a rule we never have to invoke," said Dr. Steve Gutman, director of the FDA's in-vitro diagnostics office.

Determining what constitutes a life-threatening public health emergency would be left up to the laboratories doing the testing. That creates the potential for conflicts of interest and other abuses, critics said.

"I don't like a rule like this because its most likely use is likely to be a form of abuse. The emergency exception it creates will be stretched to encompass non-emergency situations," said Jim Harper, director of information policy studies at the Cato Institute.

The FDA said it published the rule to ensure the ability to identify quickly whatever chemical, biological, radiological or nuclear agent is involved in a terrorist attack or natural outbreak of disease. Doing so could save the lives of those being tested as well as of others exposed, the FDA said.

"Baloney," said Dr. Deborah Peel, chairwoman of the Patient Privacy Rights Foundation, a watchdog group. "This sounds like they're taking for themselves the right to test individuals every time they declare a public health emergency. There is no way getting consent would delay testing."

The FDA said that obtaining informed consent in those cases would be impracticable or unfeasible.

The rule lays out a scenario where a laboratory discovers what appears to be an unusual bug in a sample taken from a patient before a public health emergency was even suspected. With the apparent bug in the lab but the patient gone, going back for permission to use a confirmatory but experimental test - often the only type of test available - would introduce "unacceptable delays," the FDA said.

"They're basically overriding state informed-consent laws," said Sue Blevins, president of the Institute for Health Freedom. Blevins said her group advocates for informed consent but that in emergencies it could be sought after the fact.

"If they don't have the time to get it, at least inform them retroactively what's been done, so people can keep track of what information has been collected from them," Blevins said.

The rule took effect Wednesday but remains subject to public comment until Aug. 7. The FDA said it published the rule without first seeking comments because it would hinder the response to an outbreak of bird flu or other public health emergency.

"Nobody said two airplanes would fly into the World Trade Center, did they? We wouldn't have written the rule unless we thought it was a possibility," Gutman said.

The FDA said the lack of such an exemption impeded the public health response to the Severe Acute Respiratory Syndrome, or SARS, epidemic of 2003.

Gardasil protects against the two types of HPV responsible for about 70 percent of cervical cancer cases. The vaccine also blocks infection by two other strains responsible for 90 percent of genital wart cases. The vaccine will be available by the end of the month, with a three-shot series costing $360.

Its manufacturer, Merck & Co. Inc., seeks similar approval elsewhere around the world. Each year, cervical cancer kills an estimated 240,000 women worldwide, including 3,700 in the United States.

"FDA approval of the HPV vaccine, the first vaccine targeted specifically to preventing cancer, is one of the most important advances in women's health in recent years," said Dr. Carolyn Runowicz, president of the American Cancer Society. The vaccine developed for hepatitis B has been shown to protect against liver cancer.

Clinical trials showed Gardasil prevented 100 percent of cervical cancer related to the two HPV strains in women who had not been previously infected, Merck said. It also prevented 99 percent of the cases of genital warts caused by the two other strains.

"Fortunately, we can now include the worst types of HPV and most cervical cancer in the list of diseases that no one need suffer or die from ever again," said Alex Azar, deputy Health and Human Services secretary.

Research presented earlier suggests an added bonus to Gardasil: It also protects against vaginal and vulvar cancers linked to the four types of HPV.

Gardasil works best when given to girls before they begin having sex and run the risk of HPV infection. The vaccine does not protect those already infected.

The FDA said that Gardasil appeared very safe. It remains unclear if its effect is long-lasting or if women will need booster shots later in life. Merck will monitor its long-term effectiveness. The company also continues to study whether the vaccine is safe and effective in males.

Merck intends to market Gardasil as a cancer, rather than an STD, vaccine. Its cost, along with conservative opposition to making the vaccine mandatory for school attendance, may curb its widespread use.

The national Advisory Committee on Immunization Practices will decide June 29 whether to endorse routine vaccination with Gardasil. That endorsement is critical if a vaccine is to become a standard of care.

Sen. Frank Lautenberg (news, bio, voting record), D-N.J., urged the panel to put "science and women's health ahead of ideological opposition" in considering a recommendation.

It then will be up to individual states to decide whether to add the vaccine to the list of others required before students may attend public schools.

Conservative groups like Focus on the Family support availability of the vaccine but oppose making it mandatory, saying the decision to vaccinate should rest with a child's parents or guardians. It promotes abstinence as the best way to prevent infection by HPV and other STDs.

Inda Blatch-Geib, an Akron, Ohio mother of four, said she'd consider vaccinating her daughters, ages 9 and 16. Blatch-Geib, 41, doesn't think it would signal a parental OK for her girls to have sex.

"Giving the vaccine goes with a conversation. We are pretty open with our children, so it wouldn't be an issue. It would lead to conversations," Blatch-Geib said.

The vaccine does not eliminate the need for regular Pap tests, which can detect precancerous lesions and early cancer. Merck has said Gardasil could cut the number of abnormal Pap results due to HPV infection.

Analysts believe Gardasil sales could top $1 billion a year for Merck. The Whitehouse Station, N.J. company is battling thousands of lawsuits over its withdrawn painkiller
Vioxx. Eventually, it could face competition from GlaxoSmithKline PLC, which is also developing its own HPV vaccine.

The cost of Gardasil and the difficulty of getting young girls in to see a doctor three times in six months to receive the vaccine could pose problems, said Cynthia Dailard, senior public policy analyst at the Guttmacher Institute, which focuses on sexual and reproductive health. Ensuring its availability to poor and minority girls and women - and others less likely to receive regular Pap exams - also will be difficult. Merck plans to provide Gardasil for free to the poor and uninsured.

"This is an incredibly exciting breakthrough, but at the same time, it presents some major challenges, some the likes of which we have never confronted before," Dailard said.

But the biotechnology firm behind the project believes sensitive owners will happily fork out extra for the chance to have a cat that doesn't leave them wheezing and sneezing.

In a statement, the San Diego-based company, Allerca, said it had produced the cats using a technique known as genetic divergence.

After identifying the genes of kittens with proteins that provide less of a reaction in humans, they selectively bred litters over several generations to end up with an allergy-friendly "super cat."

The company said its customers are expected to take delivery of their hypoallergenic kittens in early 2007.

"For the first time, people who have been unable to own a cat because of their allergies can now enjoy a pet of their own without the associated risks and costs of allergy treatments," Allerca CEO Megan Young.

According to the American Academy of Allergy, Asthma and Immunology, approximately 30 million Americans suffer from some form of cat allergy.

Young said the company expected to be breeding 10,000 of the cats every year by 2009.

The American Society for the Protection of Cruelty to Animals (ASPCA) gave a cautious welcome to the Allerca announcement, saying it might help reduce the number of cats abandoned to shelters by allergic owners.

"But it will also be important to monitor the long term health of these cats to ensure that silencing the gene does not result in unforeseen effects on them," the ASPCA said in a statement.

The CDC survey of nearly 14,000 U.S. high school students has been conducted every other year, since 1991. Results reported Thursday were from last year's survey.

Questionnaires go to students in grades 9-12 in public and private high schools in all 50 states and the District of Columbia. Researchers got parental permission for each student who participated.

Adolescents cannot always be counted on to tell the truth about their sexual exploits, drug use, or other risky behaviors. But officials took many steps to ensure accurate responses, said Howell Wechsler, the director of the CDC's Division of Adolescent and School Health.

Participation was confidential, kids were spaced apart when answering the questions, teachers did not hover, and the questionnaire was designed so everyone would finish at about the same time - no matter how risky or safe their behavior, Wechsler said.

"We have every confidence if there's any lying going on, it's extremely negligible," he said.

The report contained some good news. Only 10 percent of high school students said they never or rarely wore a seat belt while riding in a car, down from 18 percent in 2003.

But the percentage of students who said they had smoked in the last month rose slightly - 23 percent, up from about 22 percent in 2003. Also, there was no decline in the percentage of students who said they'd had sexual intercourse, which held steady at 47 percent, or in the percentage of sexually active students who said they'd used a condom, which was 63 percent.

However, it's the first time in 14 years that condom use among sexually active high school students has not risen, noted Martha Kempner, spokeswoman for the Sexuality Information and Education Council of the United States, a New York-based nonprofit group.

"It calls into question the federal government's investment in abstinence-only-until-marriage programs, many of which openly discourage condom use," she said.

Black students reported the most sexual activity, the most TV-watching and the highest use of video or computer games. White kids were the most frequent smokers and heavy drinkers, and were worst about eating enough fruits and vegetables.

But Hispanic students had other problems.

About 36 percent of Hispanics reported prolonged feelings of sadness or hopelessness, slightly higher than previous years.

In contrast, about 28.5 percent of black students reported such feelings in the 2005 survey, about the same as two previous surveys. And about 26 percent of white students reported such feelings, down slightly from 2003 and 2001.

In the category of drug use, 1 in 8 Latino students said they had done cocaine, 1 in 10 had done ecstasy, 1 in 11 methamphetamines and 1 in 28 heroin.

Hispanics reported much higher rates of drug use in previous surveys, and that hasn't changed. The enduring disparity is concerning, said Flores, director of the Medical College of Wisconsin's Center for the Advancement of Underserved Children.

He noted that substance abuse is higher in Hispanic kids who are more at home with American culture.

"It's unclear why that is, but we need to understand that better because then we can learn how we can protect all of our youth," he said.