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Amanda Kistler, Communications Director, CIEL: +1.202.742.5832, akistler@ciel.org
A new report released today reveals that plastic is a human health crisis hiding in plain sight. Plastic & Health: The Hidden Costs of a Plastic Planet, authored by the Center for International Environmental Law (CIEL), Earthworks, Global Alliance for Incinerator Alternatives (GAIA), Healthy Babies Bright Futures (HBBF), IPEN, Texas Environmental Justice Advocacy Services (t.e.j.a.s.), University of Exeter, and UPSTREAM, brings together research that exposes the distinct toxic risks plastic poses to human health at every stage of the plastic lifecycle, from extraction of fossil fuels, to consumer use, to disposal and beyond.
Since 1989, the Center for International Environmental Law (CIEL) has worked to strengthen and use international law and institutions to protect the environment, promote human health, and ensure a just and sustainable society.
"As a cease-fire in Gaza is near, Israel is expanding its assault on the West Bank," said one expert. "It was always a war on Palestinian existence."
As negotiators in Qatar navigated the " final stage" of a cease-fire agreement to end the U.S.-backed Israeli assault on the Gaza Strip, Israel's forces on Tuesday continued to kill Palestinians in the besieged coastal enclave and the illegally occupied West Bank.
Since the Hamas-led October 7, 2023 attack, the Israel Defense Forces (IDF) have killed at least 46,645 Palestinians in Gaza and wounded 110,012, with over 10,000 others missing, health officials said Tuesday. The true death toll could be much higher. A peer-reviewed analysis published last week in The Lancetfound that the official tally through last June was likely a 41% undercount.
The Palestinian National Authority's news agency WAFA reported Tuesday that IDF shelling killed at least two civilians at the Nuseirat refugee camp and a correspondent in Gaza City "said that Israeli warplanes fired missiles at a house in the Sheikh Radwan neighborhood, north of Gaza City, and another house in the Manara neighborhood, south of Khan Younis City, killing several civilians and injuring others."
According to multiple media outlets, Israeli forces also killed at least 13 people in an attack on a home in Deir al-Balah.
Israel faces a genocide case at the International Court of Justice over its assault on Gaza and in November the International Criminal Court issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and his former defense minister, Yoav Gallant, as well as Hamas leader Mohammed Diab Ibrahim Al-Masri.
In addition to waging war on Gaza over the past 15 months, Israel has stepped up its military activity in the West Bank—where a Tuesday strike on the Jenin refugee camp killed at least six Palestinians and wounded several others. The Times of Israelreported that "the IDF said it carried out the strike in a joint operation with the Shin Bet, without immediately providing further information."
The Israeli newspaper also noted that "on Tuesday evening, as on many previous Tuesday nights, thousands gather for a unity rally of prayer and song held in Tel Aviv's Hostages Square," while hundreds of right-wing demonstrators blocked "an intersection in central Jerusalem, in protest of the ongoing hostage negotiations between Israel and Hamas."
According to a draft obtained by The Associated Press, the first part of the three-stage deal would involve a halt to the fighting, both sides releasing captives, displaced Palestinians in Gaza returning home, and more humanitarian aid entering the strip.
Phase two would feature a declaration of "sustainable calm" and Hamas freeing more hostages in exchange for additional Palestinian prisoners and the full withdrawal of Israeli troops from Gaza, AP reported. The third part would include an exchange of bodies, a reconstruction plan for the strip—where civilian infrastructure is in ruins—and the reopening of border crossings.
"The terms of the deal being negotiated are largely consistent with what was on the table last May when outgoing President Joe Biden first announced it. Biden allowed Netanyahu to steamroll him for months—rewarding Israel with billions of dollars in arms transfers and political support after rejecting that cease-fire deal," Jeremy Scahill detailed at Drop Site News.
The latest cease-fire talks come as U.S. President-elect Donald Trump prepares for his inauguration next Monday. The Republican has been pushing for a resolution to Israel's assault on Gaza—or at least an appearance of one—before he returns to office.
"The fact that Trump emerged as the decisive player in pushing a potential cease-fire forward is evidence that Biden never used the full powers available to a sitting U.S. president to seal the deal in the summer," wrote Scahill. "While Trump has publicly repeated his threat that he will 'unleash hell' on Hamas if the Israeli hostages are not freed, his pressure has not been solely focused on Hamas; Trump and his aides have made clear to Netanyahu that the president-elect expects Israel to comply with his demands, too."
Netanyahu on Tuesday told hostages' families that "he is willing to agree to a prolonged cease-fire Gaza in exchange for their return," according toHaaretz. Later Tuesday, The Times of Israelreported that the prime minister was meeting with "Israel's hostage negotiation team and with members of Israel's security establishment," and expected negotiations to go through the night.
Even if a deal is reached regarding Gaza, some experts fear the bloodshed will continue there and in the West Bank
"There will possibly be an end to the Gaza war, but there will be now another war in the West Bank," Sami Al-Arian, a Palestinian analyst and director of the Center for Islam and Global Affairs at Istanbul Zaim University, told Scahill. "It may not be on the same scale, but it would be as vicious from the settlers, from the Netanyahu government."
Gazan writer and analyst Muhammad Shehada wrote for the U.S.-based Center for International Policy last week that a senior Arab official told him the U.S. president-elect asked the Qataris and Egyptians to finalize a deal before he takes office but the Israeli prime minister "is not budging while at the same time issuing false positive statements of a breakthrough and progress to buy time and pretend to seek a deal until Trump is in office, where Netanyahu can trade the Gaza war for something big in the West Bank."
Sharing on social media a video of the Tuesday strike on Jenin, Middle East expert Assal Rad said that "as a cease-fire in Gaza is near, Israel is expanding its assault on the West Bank. The Gaza genocide is only the most recent atrocity Israel—with the help of the U.S.—has carried out against Palestinians. The same story for 77+ years. It was always a war on Palestinian existence."
"Seriously? You wait until six days before leaving office to do what you promised to do during your 2020 campaign?" said one observer.
In a move likely to be reversed by the incoming Trump administration, President Joe Biden on Tuesday notified Congress of his intent to remove Cuba from the U.S. State Sponsors of Terrorism list, a designation that critics have long condemned as politically motivated and meritless.
Noting that "the government of Cuba has not provided any support for international terrorism" and has "provided assurances" that it will not do so in the future, the White House said in a memo that the Biden administration is moving to rescind the first Trump administration's January 2021 addition of Cuba to the State Sponsors of Terrorism (SSOT) list and take other measures to ease some sanctions on the long-suffering island of 11 million inhabitants.
Cuba's SSOT designation was based mostly on the socialist nation's harboring of leftist Colombian rebels and several U.S. fugitives from justice for alleged crimes committed decades ago, even though no other country has been placed on the SSOT list for such a reason and despite right-wing Cuban exile terrorists enjoying citizenship—and even heroic status—in the United States.
"Despite its limited nature, it is a decision in the right direction and in line with the sustained and firm demand of the government and people of Cuba, and with the broad, emphatic, and repeated call of many governments, especially Latin America and the Caribbean, of Cubans living abroad, political, religious and social organizations, and numerous political figures from the United States and other countries," the Cuban Ministry of Foreign Affairs said in a statement.
"It is important to note that the economic blockade and much of the dozen coercive measures that have been put into effect since 2017 remain in force to strengthen it, with full extraterritorial effect and in violation of international law and human rights of all Cubans," the ministry added.
For 32 straight years, the United Nations General Assembly has overwhelmingly voted for resolutions condemning the U.S. blockade of Cuba. And for 32 years, the United States, usually along with a small handful of countries, has opposed the measures. Last year's vote was 187-2, with Israel joining the U.S. in voting against the resolution.
Cuba followed Biden's move by announcing it would "gradually" release 553 political prisoners following negotiations with the Catholic Church, The New York Timesreported.
Many progressives welcomed Biden's shift. Congresswoman Nydia Velázquez (D-N.Y.) said in a statement that Cuba's SSOT designation "has only worsened life for the Cuban people without advancing U.S. interests" and "has made it harder for Cubans to access humanitarian aid, banking services, and the ability to travel abroad."
"It has also deepened food and medicine shortages and worsened the island's energy crisis, especially after Hurricane Rafael," she added. "These hardships have driven an unprecedented wave of migration, leading to the largest exodus in Cuba's history."
Rep. Ilhan Omar (D-Minn.) called Biden's move "a long overdue action that will help normalize relations with our neighbor."
"This is a step toward ending decades of failed policy that has only hurt Cuban families and strained diplomatic ties," Omar added. "Removing this designation will help the people of Cuba and create new opportunities for trade and cooperation between our nations. I look forward to continuing the work to build bridges between our countries and supporting policies that benefit both the American and Cuban people."
David Adler, the co-general coordinator at Progressive International, called the delisting "far too little, far too late."
"POTUS removing Cuba's SSOT designation in the final days of his presidency only means one thing: He knew—from day one—that the designation was simply an excuse to punish the Cuban people," Adler added. "But he maintained it anyway. Sickening."
The peace group CodePink released a statement welcoming Biden's shift, but adding that "it is unacceptable that it took this administration four years to address these injustices."
"President Biden made the inhumane decision every single day to not alleviate the suffering of millions of Cubans by keeping this designation in place," the group added. "As we mark this overdue progress, we can only hope that the Trump administration does not reverse these crucial steps towards justice and diplomacy."
Trump's nominee for secretary of state, Sen. Marco Rubio (R-Fla.) is the son of Cuban immigrants and a fierce critic of Cuba's socialist government. In 2021, Rubio introduced legislation aimed at blocking Cuba's removal from the SSOT list. Trump has also tapped Mauricio Claver-Carone—a staunch supporter of sanctioning Cuba—as his special envoy for Latin America.
Alex Main, director of international policy at the Center for Economic and Policy Research, said Tuesday that "while this decision, which comes years after 80 members of Congress urged Biden to reverse Trump's 'total pressure' approach should have been made long ago, it is better late than never."
"Sixty years of failed policy should be more than enough, and hopefully the new administration will have the wisdom and the courage to pursue a new course, one that's in the best interest of both the U.S. and the Cuban people," Main added.
Cuba was first placed on the SSOT list by the Reagan administration in 1982 amid an ongoing, decadeslong campaign of U.S.-backed exile terrorism, attempted subversion, failed assassination attempts, economic warfare, and covert operations large and small in a futile effort to overthrow the revolutionary government of longtime leader Fidel Castro. Cuba says U.S.-backed terrorism has killed or wounded more than 5,000 Cubans and cost its economy billions of dollars.
In stark contrast, Cuba has not committed any terrorism against the United States.
Former President Barack Obama removed Cuba from the SSOT in 2015 during a promising but ultimately short-lived rapprochement between the two countries that abruptly ended when Trump took office for the first time in 2017.
"Cuba will continue to confront and denounce this policy of economic war, the interference programs, and the disinformation and discredit operations financed each year with tens of millions of dollars from the United States federal budget," the Cuban Foreign Ministry said Tuesday. "It will also remain ready to develop a relationship of respect with that country, based on dialogue and noninterference in the internal affairs of both, despite differences."
Pharmacy benefit managers "are raking in billions in excess revenue—$7.3 billion over just five years—while squeezing independent pharmacies and leaving patients and health plan sponsors with skyrocketing costs."
The U.S. Federal Trade Commission on Tuesday published the second part of its investigation into how prescription drug middlemen are marking up the prices of specialty generic drugs dispensed at their affiliated pharmacies by hundreds—and in some cases, thousands—of percent, underscoring what advocates say is the need for urgent action by policymakers.
The FTC's second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health's Caremark Rx, Cigna Group's Express Scripts, and UnitedHealth Group's OptumRx—"marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually."
"Of the specialty generic drugs analyzed in this report and dispensed by the 'Big Three' PBMs' affiliated pharmacies for commercial health plan members between 2020 and 2022, 63% were reimbursed at rates marked up by more than 100% over their estimated acquisition cost... while 22% were marked up by more than 1,000%," the report states.
"For the pulmonary hypertension drug tadalafil (generic Adcirca), for example, pharmacies purchased the drug at an average of $27 in 2022, yet the Big Three PBMs marked up the drug by $2,079 and paid their affiliated pharmacies $2,106, on average, for a 30-day supply of the medication on commercial claims," the publication notes. That's a staggering average markup of 7,736%.
"The FTC's second interim report lays bare the blatant profiteering by PBM giants."
"Such significant markups allowed the Big Three PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs' estimated acquisition costs from 2017-22," the FTC said. "The Big Three PBMs netted such significant revenues all while patient, employer, and other healthcare plan sponsor payments for drugs steadily increased annually."
The new analysis follows a July 2024 report that revealed Big Three PBM-affiliated pharmacies received 68% of the dispensing revenue generated by specialty drugs in 2023, a 14% increase from 2016.
"The FTC staff's second interim report finds that the three major pharmacy benefit managers hiked costs for a wide range of lifesaving drugs, including medications to treat heart disease and cancer," FTC Chair Lina Khan said in a statement Tuesday. "The FTC should keep using its tools to investigate practices that may inflate drug costs, squeeze independent pharmacies, and deprive Americans of affordable, accessible healthcare—and should act swiftly to stop any illegal conduct."
Khan's time as chair is limited. Republican U.S. President-elect Donald Trump's inauguration is next week and he has named Andrew Ferguson as the next FTC chair. As Ferguson is already on the commission, his elevation to chair won't require Senate confirmation.
Greg Lopes, spokesperson for the Pharmaceutical Care Management Association, a PBM lobby group, said Tuesday that "it's clear this report again fails to consider the entirety of the prescription drug supply chain and makes sweeping assertions about the role of PBMs disconnected from a full appreciation of their critical cost-saving role for employers, unions, taxpayers, and patients."
Last September, the FTC sued the Big Three and their affiliated group purchasing organizations for allegedly "engaging in anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs, impaired patients' access to lower list price products, and shifted the cost of high insulin list prices to vulnerable patients."
FTC Office of Policy Planning Director Hannah Garden-Monheit said Tuesday that the problem of PBM price inflation "is growing at an alarming rate, which means there is an urgent need for policymakers to address it."
To that end, U.S. Sens. Maria Cantwell (D-Wash.) and Chuck Grassley (R-Iowa) introduced the Pharmacy Benefit Manager Transparency Act of 2023, a bill backed by the AARP aimed at increasing transparency and "holding PBMs accountable for deceptive and unfair practices that drive up prescription drug costs and force independent pharmacies out of business."
"This report is a call to action for policymakers to dismantle these exploitative schemes."
Responding to the FTC report, Emma Freer, senior policy analyst for healthcare at the American Economic Liberties Project—a corporate accountability and antitrust advocacy group—said in a statement Tuesday that "the FTC's second interim report lays bare the blatant profiteering by PBM giants, which are marking up lifesaving drugs like cancer, HIV, and multiple sclerosis treatments by thousands of percent and forcing patients to pay the price."
"By steering prescriptions for the most expensive specialty generic drugs to their own pharmacies, PBMs are raking in billions in excess revenue—$7.3 billion over just five years—while squeezing independent pharmacies and leaving patients and health plan sponsors with skyrocketing costs," Freer added. "This report is a call to action for policymakers to dismantle these exploitative schemes, outlaw the rebate system driving up prices, and restore fairness and affordability to the U.S. healthcare system."