The Globe and Mail - 21.10.2019

A4 | NEWS OTHEGLOBEANDMAIL | MONDAY,OCTOBER21,

Britain is facing another Brexit
delay and more controversy after
Prime Minister Boris Johnson
was forced to grudgingly ask the
European Union for a three-
month extension to the country’s
departure.
Mr. Johnson had to seek the
delay Saturday night after parlia-
mentarians voted to withhold ap-
proval of a Brexit deal he struck
with the EU last week. Members
of Parliament voted 322 to 306
during a special session earlier on
Saturday to hold off on consider-
ing the deal until the Prime Min-
ister has introduced legislation
outlining how it would be imple-
mented.
Under a law passed last month
by MPs, over the Prime Minister’s
objections, the vote meant that
Mr. Johnson had to send a letter
to EU leaders asking them to ex-
tend the deadline for Britain to
leave the bloc to Jan. 31, 2020,
from Oct. 31.
Donald Tusk, the head of the
EU Council, said Sunday that the
bloc’s leaders would consider the
request over the next few days.
French President Emmanuel Ma-
cron and some other leaders
have expressed reservations
about a delay, but it is widely ex-
pected they will ultimately grant
one since the EU wants to avoid a
no-deal Brexit.
The extension request ended a
tumultuous weekend for the
Prime Minister’s Brexit strategy
and increased the uncertainty
about what comes next. There’s a
chance the deal could still be rat-
ified by Parliament before the
end of the month, but there are
also growing calls for a snap elec-
tion or a referendum on the

agreement. There’s also a possi-

bility that Britain could leave

without a deal on Halloween if

the EU refuses to grant an exten-

sion.

Mr. Johnson has vowed to

push ahead with ratification and

he called on the EU not to agree

to a delay. He made it clear Sat-

urday that he only sent the letter

requesting an extension because

he was compelled to by law. He

demonstrated his frustration by

refusing to sign it, and sent a sec-

ond note to Mr. Tusk urging the

EU to reject the request.

Mr. Johnson wrote that he

believed “that a further exten-

sion would damage the interests

of the UK and our EU partners.”

He also insisted that he re-

mained committed to leaving the

EU on Oct. 31 and he plans to in-

troduce legislation implement-

ing the deal this week in Parlia-

ment.

On Sunday, the cabinet minis-

ter in charge of Brexit prepara-

tions, Michael Gove, said the gov-

ernment had “the means and

ability” to leave on Oct. 31. “We

know that the EU want us to

leave, we know that we have a

deal that allows us to leave,” Mr.

Gove told Sky TV. In a warning to

MPs, Mr. Gove added that there

was no guarantee the EU would

agree to a delay, which meant

“the risk of leaving without a deal

has grown.”

Opposition MPs signalled Sun-

day that they won’t be backing

down either. The Scottish Nation-

alist Party (SNP) plans to move a

motion of non-confidence in the

government this week, which

could trigger an election. “We are

prepared, once we’ve got that ex-

tension in place, to take our re-

sponsibilities and move a motion

of no confidence and I would be

looking for parliamentary time to

do that and I would expect every-

one else to step up,” Ian Black-

ford, the SNP’s leader at West-

minster, told the BBC.

The Labour Party said it would

seek parliamentary support for a

referendum on Mr. Johnson’s

deal. “Whether it’s this deal or

any future deal, it has got to go

back so the public can say, do you

want to leave on these terms? If

so, then we do. If not, we remain

[in the EU],” Labour MP Keir

Starmer told the BBC. He added

that Mr. Johnson had acted like a

child in refusing to sign the ex-

tension request. “If we crash out

because of what he’s done with

the letters ... he bears personal

responsibility for that.”

There are signs that Mr. John-

son might just have enough sup-

port in Parliament to get the deal

ratified when it comes up for a

vote. Many MPs who voted for a

delay on Saturday said they

would likely back the agreement

once they saw the detailed legis-

lation. In particular, Mr. Johnson

appears to have won over several

members of a group of 21 Conser-

vative MPs he expelled from cau-

cus last month after they sided

with the opposition to block a

no-deal Brexit. Many of those

MPs welcomed the agreement

and indicated that they will vote

for it once the legislation is intro-

duced.

Mr. Johnson needs more than

fellow Tories to get the deal

through Parliament. The Conser-

vatives don’t hold a majority of

seats and their ally, Northern Ire-

land’s Democratic Unionist Party,

won’t support the agreement.

That means Mr. Johnson must

win over some Labour MPs, and

so far about a dozen have hinted

that they will defy their party’s

leadership and support the

agreement.

The government is expected to

introduce legislation implement-

ing the deal as early as Monday

with a vote coming on Tuesday.

JohnsonreluctantlyrequestsBrexitdelay

U.K.PMforcedtoaskEU

forthree-monthdeadline

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latestdealuntildetailed

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PAULWALDIE
EUROPECORRESPONDENT
LONDON

BritishPrimeMinisterBorisJohnsonsitsintheHouseofCommonsinLondonaheadofavoteonhisrenegotiatedBrexitdealonSaturday.Mr.Johnson

vowedtopushaheadwithratificationandevencalledontheEUnottoagreetothedelayhewaslegallyrequiredtoaskfor.UKPARLIAMENT/REUTERS

Australia’s biggest newspapers were expected to run front

pages on Monday made up to appear heavily redacted to pro-

test against recent legislation that restricts news media free-

doms, a rare show of unity by the usually tribal media indus-

try.

Mastheads from the domestic unit of Rupert Murdoch’s

News Corp., The Australian Financial Review publisher Nine

Entertainment and the website of the government-funded

Australian Broadcasting Corp. (ABC) were expected to show

current news stories with most of the words blacked out.

The protest was designed to put public pressure on the gov-

ernment to exempt journalists from laws restricting access to

sensitive information, enact a properly functioning freedom

of information system and raise the benchmark for defama-

tion lawsuits.

“It’s about defending the basic right of every Australian to

be properly informed about the important decisions the gov-

ernment is making in their name,” Nine chief executive offi-

cer Hugh Marks said in a state-

ment.

News Corp. Australasia execu-

tive chairman Michael Miller said

people “should always be suspi-

cious of governments that want to

restrict their right to know what’s

going on.”

Australia has no constitutional

safeguards for free speech. The

government added a provision to

protect whistle-blowers when it

strengthened counterespionage

laws in 2018, although media or-

ganizations say news freedoms

remain restricted.

Global attention turned to

media freedoms in Australia this year, when a court order pre-

vented media from reporting that the former Vatican treasur-

er, Cardinal George Pell, had been found guilty on child sexual

abuse charges.

Some Australian outlets reported that an unidentified per-

son had been convicted, but some foreign media companies

identified Cardinal Pell because they were outside Australia’s

jurisdiction.

Prosecutors are now seeking fines and jail sentences for

three dozen Australian journalists and publishers for their

coverage of the trial. Cardinal Pell is appealing against his con-

victions.

The subject came to a boil again in June, when police raided

the head office of the ABC in Sydney and the home of a News

Corp. editor on suspicion of receiving national secrets.

The raids, which involved police examination of about

9,000 computer files at the ABC and sifting through the fe-

male News Corp. editor’s underwear drawer, drew interna-

tional condemnation.

Under intense pressure, thegovernment issued a directive

to the Commonwealth Director of Public Prosecutions in Sep-

tember that will require permission from Attorney-General

Christian Porter to approve any charges against journalists.

REUTERS

Australiannews

organizationsunite

inprotestagainstnew

mediarestrictions

BYRONKAYESYDNEY

Thegovernment

addedaprovision

toprotectwhistle-

blowerswhen

itstrengthened

counterespionage

lawsin2018,

althoughmedia

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remainrestricted.

A group of doctors is urging offi-
cials in Nunavut to offer an effec-
tive but costly drug to all Inuit
babies living in remote commu-
nities in the territory to protect
them against a respiratory virus
that disproportionately leads to
their hospitalization.
A petition, started by mem-
bers of the 1989 graduating class
of University of Toronto’s Faculty
of Medicine, says giving the pro-
phylaxis palivizumab to Inuit in-
fants would reduce their rates of
serious complications from re-
spiratory syncytial virus (RSV),
and would also save the govern-
ment money it currently spends
on air ambulance services and
hospital stays.
But Nunavut’s chief medical
officer disagrees, saying there
isn’t enough evidence to support
such an approach.
For most people, symptoms of
RSV infection are indistinguish-
able from the common cold, al-
though an estimated 1 per cent
to 3 per cent of infants in devel-
oping countries experience com-
plications requiring hospitaliza-
tion.
Inuit babies in Canada, how-
ever, have an exceptionally high
rate of RSV complications.
Among some Inuit communi-
ties on Baffin Island, as many as
half to two-thirds of babies are
hospitalized with lower respira-
tory lung infections, mostly ow-
ing to RSV, according to Anna
Banerji, an expert on Indigenous
and refugee health and associate
professor of pediatrics at the
University of Toronto who
helped start the petition. Al-
though it is not entirely under-
stood why, experts believe Inuit
infants are disproportionately af-
fected because of a combination
of genetic and environmental
factors, including food insecurity
and a lack of adequate housing
arising from a history of forced
settlement.
Palivizumab, the only availa-
ble prophylactic treatment for
RSV, is currently given to infants
in Canada who are considered at
high risk of complications, such
as those born prematurely or
who have underlying heart or
lung conditions. But it is not rou-

tinely administered in Nunavut

to healthy Inuit infants who are

born at full term.

At the cost of roughly $6,500 a

child for each season, the drug is

expensive, Dr. Banerji says. Yet

according to her analyses, giving

it to all Inuit babies in remote

communities can cost less than

the alternative.

The petition had more than

21,600 signees as of late last week

and has the support of the Onta-

rio Medical Association.

Nunavut’s chief medical offi-

cer of health, Michael Patterson,

said while the high rates of RSV

complications are a problem,

there is not enough evidence to

show universal administration of

palivizumab is the best solution.

The number of RSV hospital-

izations and the costs involved

vary from year to year, and from

community to community, Dr.

Patterson said.

This makes it difficult to pre-

dict just how cost effective the

drug would be each year.

Moreover, RSV is only part of

the problem; a number of differ-

ent viruses can lead to the same

respiratory complications, Dr.

Patterson said.

“You get rid of one virus, and

there’s others that children will

be exposed to at the same time,”

he said.

The Canadian Paediatric So-

ciety issued a position statement

in 2015, stating health profes-

sionals may consider giving pal-

ivizumab to term infants in re-

mote northern communities.

It said other measures, such

as improved housing, preven-

tion of exposure to smoke and

the use of influenza and other

vaccines, appear to be more cost

effective than palivizumab in

the long term.

Joan Robinson, the principal

author of that statement, said

she is not opposed to offering

the drug to term Inuit babies. But

she said it is a question of wheth-

er this approach is a priority for a

territory with limited health re-

sources, and whether it is worth

giving babies injections every

month. (Palivizumab is an anti-

body, not a vaccine. Injections

are given monthly over the

course of an RSV season, which

typically lasts about five months

between fall and spring.)

Dr. Robinson said she expects

more answers to help guide this

decision will come from the Que-

bec region of Nunavik.

Quebec’s criteria for palivizu-

mab expanded in 2016 to in-

clude babies in Nunavik born at

term, and less than three

months old at the start of RSV

season. A report on the impact

of this change on RSV infections

and hospitalizations in Nunavik

is expected to be released in

2020.

Sheila Ningiuruvik, a board

member of the Nunavik Regional

Board of Health and Social Ser-

vices who lives in the northern

village of Quaqtaq, said she was

not aware of palivizumab being

administered to Inuit babies in

her region.

Ms. Ningiuruvik’s son,

Aggaajuk, now 6, suffered from

recurring lung infections as a ba-

by. He was once transported by

air ambulance to a hospital in

Kuujjuaq, an hour and 45 min-

utes away by air, with severe

pneumonia. She said she was not

told whether RSV was the cause

of his respiratory issues.

She said that as a parent, she

feels as long as palivizumab is

safe, it would be good for babies

to have the drug.

She said there are other prob-

lems that may hamper the

health of infants in her region.

The clinic that serves her village

of 400 people has a frequently

changing team of nurses and a

doctor who visits only once a

month, making it difficult to re-

ceive consistent medical care.

In addition, she said, mould is

widespread in social housing.

“Things [like] that could in-

crease the respiratory problems

in children. Maybe they need to

research on that,” she said.

PetitioncallsforallInuitbabies

toreceivepreventiverespiratorydrug

Palivizumab,theonly

availableprophylactic

treatmentforRSV,is

currentlygivento

infantsinCanadawho

areconsideredathigh

riskofcomplications,

suchasthoseborn

prematurelyorwho

haveunderlyingheartor

lungconditions.

WENCYLEUNG
HEALTHREPORTER