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Sunday, 28 July 2013

Don't burn money, use it wisely


It is time to learn from our past and put our skills and resources into positive value creation.



NEXT month will be 68 years since the Hiroshima and Nagasaki atomic bombings in Japan.

To some, it is just another month at work. Some may celebrate their birthday, some become parents and for some, it may coincide with festive celebrations. Certainly few of us are old enough to remember the impact of the devastating events.

Being an avid reader, this date reminds me that the real tragedy of war is that it uses man’s best skills to do man’s worst work.

The creativity and perseverance that led to the discovery of the power of atoms, which could light up the world and potentially solve our energy issue, was used to create hell on earth.

The discovery of neutron by James Chadwick in February 1932, Niels Bohr’s discovery of fission and ultimately, Leo Szilard’s method of producing a nuclear chain reaction or a nuclear explosion, of which he even filed a patent, would lead to the creation of what was euphemistically called Little Boy.

Hardly little at all, for the bomb had the power of more than 20,000 tonnes of TNT, which destroyed most of Hiroshima, killing an estimated 130,000 people on Aug 6, 1945. Three days later, a second bomb, nicknamed Fat Man, was dropped on Nagasaki, killing between 60,000 and 70,000 people.

Looking at the incident as a case of creative discoveries being used for war efforts, one can’t help but reflect on how much of these resources could be used if such a detonation did not take place.

Going beyond the obvious tragedy of the loss of human life, there is the immense economic cost of cleaning up contaminated areas, reconstruction of buildings, productivity lost due to the physical injuries and sickness of the casualties, loss of national income, psychological damage, etc. How does one quantify that?

To me, it’s very clear that we need to divert our military resources to build more educational and medical institutions, research facilities, provide housing or even venture capital funds for start-ups that could create a world that is different, not destructive.

The 34th US President, Dwight D. Eisenhower, said in a speech to the American Society of Newspaper Editors that “every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those whose hunger and are not fed, those who are cold and are not clothed”.

And he was a military man, the former supreme commander of the Allied Forces during World War II.

We may not be sure of how much Eisenhower’s grasp of value is, but it makes sense.

He said that the cost of a modern heavy bomber could finance a modern brick school in more than 30 cities.

It could even contribute to two electric power plants, with each serving a town of 60,000 in population. It could even construct two fully equipped hospitals.

As headlines blaring financial uncertainties continue today, it is a good time to wonder where all the money is going, and where are all the innovators and entrepreneurs to lift the standard of living and to fulfil the needs of society?

According to the Stockholm International Peace Research Institute, nearly RM6 trillion is spent annually on military, defence and armaments.

In economics, the idea of opportunity cost always arises in business. An entrepreneur will always need to consider the cost of giving up something in order to achieve a business objective.

So what is humanity giving up by laying down arms?

- Open Season by LIM WING HOOI The Star
Business writer Lim Wing Hooi believes that the human race needs to invest wisely in its own future.

Saturday, 27 July 2013

Love your liver! World Hepatitis Day today

A look at one of the most insidious infectious in the world 

Many people are unaware that being diagnosed with hepatitis B and C is a lifelong sentence.


Dr Syed ... Patients diagnosed with hepatitis B and C need to come for their annual check-ups to catch signs of liver damage in the early stages. – LOW LAY PHON/The Star
Dr Syed ... Patients diagnosed with hepatitis B and C need to come for their annual check-ups to catch signs of liver damage in the early stages. – LOW LAY PHON/The Star

MANY ancient civilisations rightfully believed that the liver is one of the most crucial organs in our body.

Although their understanding was not based in scientific fact – for example, the Babylonians, Estrucans, Romans and Greeks believed that the liver was the seat of all emotions and the organ closest to divinity, while in traditional Chinese medicine, it purportedly helps to regulate the flow of qi and blood in the body, and governs anger – the liver is indeed vital to our existence.

Like the heart, we cannot function without our liver.

It is one of the most hardworking organs in our body, performing over 500 different functions, including processing and storing nutrients, manufacturing proteins and hormones, neutralising toxins, breaking down drugs and removing waste from our body.

It is the second largest organ in the body after the skin, and the only one that has significant regenerative capabilities, being able to grow back to full size from as little as a quarter of its cells.

However, even this ability cannot overcome the insidious presence of the two hepatitis viruses that cause chronic infection in the liver.

These viruses work silently – often residing in the infected person’s body quietly, slowly damaging the liver without causing any outward signs of illness, until it is too late.

Passed on through bodily fluids, they can be contracted through sex, the sharing or reuse of unsterilised sharp objects like needles, razors, and even earrings, from mother to child in the womb, and basically, any activity that can result in the transference of blood, semen, vaginal fluid and saliva directly from the infected person to someone else.

The virus usually gains access into the body via the bloodstream through minor wounds, like nicks or cuts, that one may not even notice.

But because these viruses rarely cause any specific symptoms during the acute stage, people are unaware that they have been infected, and may go on to infect other people unknowingly.

This is why, according to consultant hepatologist Dr Syed Mohd Redha Syed Nasir, the most important form of transmission is perinatal or early childhood transmission.

He explains: “If someone in the family has hepatitis B, it is likely that someone else will have it too; that’s why we have to screen everyone in the house.”

This is especially in the case of children whose immune systems have not completely matured yet.

As a rule, hepatitis is usually only picked up upon screening, or when patients have already developed complications from the disease.

A chronic problem

Despite being considered a major global health threat – it is one of only four diseases that the World Health Organisation (WHO) considers crucial enough to mark with an international World Day, the awareness of hepatitis is still disturbingly low among the general population.

This infectious disease, which causes inflammation of the liver, is caused by five viruses: hepatitis A, B, C, D and E.

Of these, hepatitis B and C are the most worrisome as they can become chronic infections, which may result in liver cirrhosis (also known in layman’s terms as scarring or hardening) and liver cancer. (See Acute infections for more information on the three other viruses.)

These two viruses are also the main focus of the World Hepatitis Day campaign.

According to the World Hepatitis Alliance website, “The long-term objective of the campaign is to prevent new infections and to deliver real improvements in health outcomes for people living with hepatitis B and C.”

In Malaysia, hepatitis B is an important enough health concern that the vaccine is part of the compulsory national immunisation programme for all babies.

Despite that, Dr Syed says that around 5% of the population still has hepatitis B.

There is no vaccine for hepatitis C; neither is there any local data on the spread of hepatitis C or the three other hepatitis viruses in the country, according to him.

“In our setting, from my experience, we often encounter patients, who are diagnosed to have hepatitis B in particular, many years ago.

“Little do they realise that hepatitis B is a chronic infection that has the potential to cause long-term damage to the liver,” he says.

The doctor, who was previously with the national referral centre for liver diseases at Hospital Selayang and is now in private practice, adds that this often results in the patient being unaware of the importance of long-term follow-up, and creates the tendency for them to skip their annual check-ups.

“For these patients, you can’t be sure whether their infection will become active again, or develop into liver cancer.

“A few years down the road, they will come and you discover they have liver cirrhosis, and it is already a lost battle.”

He says that most patients tend to come in when they already have decompensated liver cirrhosis, which presents with abdominal swelling, with or without accompanying leg swelling, and either vomiting or passing motion with blood.

Some may also come in with a yellowish complexion (jaundice), episodes of losing awareness of their surroundings (hepatic encephalopathy), and other bacterial infections, as the liver is part of the immune system.

Too late to treat

While treatment is available for both hepatitis B and C, Dr Syed cautions that patients need to be carefully evaluated before the decision to start treatment is made.

This evaluation is to determine the degree of viral activity, as well as the level of liver damage. Both these factors need to be carefully balanced in order for treatment to be fully effective.

“When we give treatment, we must make sure it is indicated, because it is for life. For example, if a patient is 25 years old, he has to take it for the next 40 to 50 years (until he dies),” he says.

The development of resistance to the antiviral medication given for the disease is also another reason why doctors need to make the decision to treat judiciously.

Aside from oral antiviral drugs, patients may also be treated with interferon injections, which are typically given for the period of one year.

Dr Syed explains: “Interferon modulates your immune system, as well as clears the virus, so there is an added effect. After one year, your immune system will be able to clear the virus on its own.”

According to studies, the percentage of patients on interferon in which the virus can no longer be detected increases from 3-5% in the first year to 12% five years after completing their treatment.

However, he adds that this treatment is often not an option for most Malaysian patients, as the damage to the liver is already too advanced by the time they go see the doctor.

Unfortunately, the reality of the situation in Malaysia is that most patients with chronic hepatitis only see the doctor when their condition is so advanced that they are already well on the way to requiring a liver transplant.

- By TAN SHIOW CHIN The Star

Related Notes:

Hepatitis A
Transmitted through the oral-faecal route, usually through water or food that has been contaminated with the faeces of an infected person. Prevalent in places with poor hygiene and sanitation. There are an estimated 1.4 million cases of hepatitis A every year worldwide. Symptoms include fever, malaise, loss of appetite, diarrhoea, nausea, abdomi -nal discomfort, dark-coloured urine and jaundice. There is no treatment, but the immune system is usually able to get rid of the infection by itself. There are a number of vaccines available.

Hepatitis D
Transmitted through bodily fluids, usually through sex, contact with the blood of an infected person, sharing of sharp objects like needles, razors or syringes, and from mother to child in the womb. Requires the presence of the hepatitis B virus to replicate, and as such, is usually found together with hepatitis B as a co-infection or a superinfection. Not usually tested for in a clinical setting. Treatment and vaccination for hepatitis B is equally effective for hepatitis D.

Hepatitis E
Transmitted through the oral-faecal route, usually through contaminated drinking water and eating products from an infected animal. Every year, there are 20 million infections, over three million acute cases, and 57,000 deaths. Over 60% of infections occur in East and South Asia. Symptoms include jaundice, anorexia, an enlarged, tender liver (hepatomega -ly), abdominal pain and tenderness, nausea, vomiting and fever. There is no treatment, but the immune system is usually able to get rid of the infection by itself. However, complica -tions may arise in pregnant women. The first vaccine was registered in 2011 in China, but is not currently available globally.

Sources: WHO, the US Centres for Disease Control and Prevention, and consultant hepatologist Dr Syed Mohd Redha Syed Nasir.

 
There are vaccines available for hepatitis A, B and E, but the vaccine for hepatitis E is only available in China. – AFP

Facts an figures -by the Numbers:
  • There are over 400 million cases of  HEPATITIS every year, compared to 34 million cases of  HIV/AIDS cases (IN 2011) and almost 29 million cases of CANCER  (in 2008).
  • HEPATITIS B & C infections cause an estismated  57% of liver cirrhosis cases and 78% primary liver cancer. Liver cancer is the SIXTH most common cancer worldwide.
  • Around 240 million people have chronic Hepatitis B, with 600,000 dying every year due to complications from the infection.
  • The percentage of  those who develop chronic Hepatitis B infections are: 80-90% of infants infected before he age of one, 30-50% of children infected before six and <5% of otherwise healthy adults.
  • The Hepatitis B vaccine is administered at ZERO (at birth), one and six months of age in Malaysia. It is 95% effective at preventing infection.
  • About 150 million people have chronic Hepatitis C, with over 350,000 dying every year due to complications from the infection.
  • Around 80% of peopole do not exhibit any symptoms follwoing initial Hepatitis C infection.
  • Around 75-85% of Hepatitis C patients develop chronic infection, of which 60-70% develop chronic liver disease. 2-20% will develop cirrhosis, with 1-5% dying from cirrhosis or liver cancer. Hepatitis C causes 25% of liver cancer cases.
  • July 28 was chosen for World Hepatitis Day in honur of the birthday of Nobel Laureate Prof Baruch Samuel Blumberg, who discovered the Hepatitis B virus.

Friday, 26 July 2013

If China sneezes…

The world catches the flu, with Asian economies expected to be the hardest hit


GROWING fears of a slowdown in China may have, for the time being, been allayed by the country’s recently announced new slew of measures to stimulate its economy. But concerns of deep-seated structural problems coming back to haunt the world’s second-largest economy at a later stage remain.

A recent report by China’s Development Research Centre points that the country’s economy has become “unstable and uncertain like never before”.

State researcher Yu Bin was quoted by the foreign media as saying that the “downward pressure” faced by the Chinese economy had been larger than expected.

“Market expectations are unstable, downward pressure has increased, and existing and new structural mismatches exist,” Yu notes.

“Growth inertia should not be underestimated as new growth engines and patterns have not been formed,” he adds.

Major indicators have confirmed that China is bound for slower growth.

For instance, a preliminary survey of purchasing managers released over the week by HSBC Holdings Plc and Markit Economics show that China’s manufacturing sector in July has contracted further, with readings for the purchasing managers index (PMI) remaining below 50, the demarcation line between expansion and contraction.

Preliminary reading shows that China’s PMI for July has fallen to an 11-month low at 47.7. This is below the consensus forecast of 48.5, and has been taken as an indication that the worst of China’s slowdown has yet to be reached.

A slowing Chinese economy has a wide implication on the world’s gross domestic product (GDP).

The sheer size of China’s economy – with its GDP expected to reach US$9 trillion (RM28.8 trillion) by year-end – speaks of its significance. It is the second-largest and currently accounts for about 10% of global economy.

The past few years have also seen China’s trade and connectivity with the rest of the world, especially Asia, growing substantially. Hence, the state of China’s economy could affect the rest through various transmission channels, such as exports, commodity prices and financial markets.

In a simulation exercise to assess the effects of China’s economic slowdown on global growth, Japanese investment bank Nomura Research found that a one percentage point drop in China’s GDP would lower global growth outside the country by 0.3 percentage point, but with a wide variation among economies.

The hardest hit economies, Nomura argues in its report, would be in Asia, with growth falling by one percentage point or more in Hong Kong, Singapore and Taiwan.

The impact, it adds, is also large on commodity-producing countries, such as Australia, Malaysia and those in Latin America. Despite being located much further away from China, the impact on GDP in Latin America is as large as that of Asia, it says.

In general, emerging-market economies will be among those hardest hit, Rob Subbaraman, Nomura’s chief economist and head of global markets research for Asia ex-Japan, says in a media conference call.

He points out that the slowing down of emerging-market economies as a result of China’s slowdown will pose a second-round effect global growth.

“If you think arithmetically what is driving global growth now, it is not Europe… the US to an extent (and) Japan to an extent, but by far, the biggest driver of global growth is emerging-market economies. This would have an effect on global growth,” Subbaraman says.

Malaysia is one of the countries highly vulnerable to a China slowdown.

For one thing, China is Malaysia’s major export destination, accounting for about 13% of the latter’s total exports last year. Malaysia’s trade balances will also be affected negatively from falling global commodity prices and lower external demand given the knock-on impact globally of slower Chinese growth.

Slower growth

China’s economy, or GDP, grew 7.5% during the second quarter of this year, after growing 7.7% in the first quarter. It was the slowest growth in three quarters.

The country’s target is for its economy to grow 7.5% in 2013. That would be the lowest growth rate since 1990.

China’s government has recently stated it would not tolerate any GDP growth of below 7% as that is viewed as the minimum rate for it to achieve “a moderately prosperous society by 2020”.
In a move seen widely to protect its growth target for 2013, China unveiled a “mini stimulus” over the week to boost its sluggish economy.

The measures include a plan to eliminate taxes on small businesses, cut costs for exporters and speed up construction of railway plans. It remains to be seen whether there will be more measures in the pipeline to boost the country’s slowing growth.

Several investment banks have already downgraded their outlook for China, with many expecting the country to miss its growth target of 7.5% this year.

Among these are Citigroup, which has cut its estimate to 7.4% from 7.6% for 2013, and to 7.1% from 7.3% in 2014; as well as HSBC, which has cut its 2013 forecast to 7.4% from 8.2%; and to 7.4% from 8.4% for 2014.

According to French investment bank Societe Generale, a hard landing in China, while an extreme view, is no longer a “non-negligible” risk.

It argues that there are two major events that could trigger a hard landing in China, which it classifies as GDP growth falling below 6%, the minimum level required to keep the country’s job market stable and avoid systemic financial risk.

These events include trade shocks, which could lead to a sharp deterioration in exports and loss of jobs; and insufficient public investment or an intended deleveraging going out of control.

Nomura, which has recently cut its forecast for China’s 2014 GDP to 6.9% from 7.5%, believes there is now a 10%-20% chance for China’s economic growth to fall below 6% next year, as the country faces stress from many dimensions, including financial leverage, pollution and social tensions.

Nomura argues that there are both cyclical and structural factors contributing to China’s slowdown.

According to Nomura, China’s potential growth structurally is on a downtrend due to a dwindling labour force and a lack of reform, while cyclically, the monetary policy stance has changed from its loose bias in the second half of 2012 to a tightening bias since the second quarter of this year.

“Given the high level of leverage in the economy, policy tightening may lead to a faster deleveraging process, higher interest rates and a credit crunch, all of which would combine to cause a sharp slowdown in economic growth,” it says.

By CECILIA KOK The Star/Asia News Network


When China Sneezes, Everyone Gets Sick

Not too long ago, the story was that when Chinese buy an ounce more of rice and eat more chicken, commodities prices would rise. And indeed they did. But now the story is, if China sneezes, we all get the flu.
The Chinese economy is sick. Not deadly sick, but in a funk.

It’s not that the funk will put the U.S. or Brazil in negative growth, but it will in Europe. Indeed, if China does see growth in the hard landing territory of under 6%, every economy in the world will see their GDP fall. Asia will be hardest hit. The Eurozone, already flat, will go downhill.

“The likelihood of China experiencing this risk scenario is a non-trivial 10-20%,” said Rob Subbaraman, Nomura’s Chief Economist and Head of Global Markets Research, Asia ex-Japan.

In Nomura’s baseline scenario, China’s GDP growth slows to 6.7% in the first half of 2014 and recovers slightly in the second half, bringing next year’s GDP forecast to 6.9%, China’s slowest since 2008. Both cyclical and structural factors contribute to this slowdown. Structurally, China’s potential growth is on a downtrend due to a dwindling and aging labor force and a lack of reform. The government still runs the national and local economies, making China slow and not very dynamic.

The current deleveraging process in China, which follows such a profound period of credit growth, is likely to last well into 2014. There will be less money to go around in the world’s No. 2 economy. In a higher risk scenario, GDP growth slows to 5.9% for full-year 2014 and to 5% in the first half of next year. If that doesn’t make the hard landing callers seem prescient, then I don’t know what does other than a bankruptcy of a major Chinese lender.

Not that bankruptcies are out of the question.

Earlier this year, China faced its first ever default on a $531 million loan by Suntech Power Holdings, one of the largest solar power companies in the world. Suntech power shares are now trading under $2, down 95.6% in five years.

There area few key sectors of the economy that need to downsize. After building up so much in the past as states looked to create their own industries and help with full employment, companies in the automotive and solar power space will be particularly hard hit.

And while some will be absorbed by larger players, it is probable that many will just fold due to lack of demand. Workers will be unemployed. China doesn’t have the safety net we have in the United States. If this gets out of hand, there is a chance for social unrest.

“We have considered a range of stresses which the economy faces from many dimensions, including financial leverage, pollution and social tensions,” said Subbaraman.

The Side Effects

“We find that stocks in the mining and energy-intensive U.K., Latin America and emerging Europe, Middle East and Africa exhibit the MSCI World’s highest — and in this scenario, adverse — correlations with China H-shares,” said Michael Kurtz, Nomura’s Global Head of Equity Strategy and Chief Asia ex-Japan Strategist. H-shares are priced in Hong Kong dollars.

Kurtz said that from a top down approach, Japan offers the world’s lowest equity correlation with China H-shares, along with key fundamental firebreaks that make Japan an attractive “defensive” equity market in a China slowdown scenario.

For global currencies, a sharp slowdown in China’s economy would have both direct and indirect negative impacts on commodity producers and countries with relatively large China trade links, mainly Australia, Canada, Brazil and Korea.

The hard landing scenario of less than 6% growth is not Nomura’s baseline case because they think the government can take action to smooth out the deleveraging process and growth slowdown to avoid a financial sector meltdown.  The banking sector is totally under the government’s control.

In a 58 page report to clients released by Nomura this week, analysts said they did not think Beijing will allow banks to fail. So the transmission of corporate default may not be amplified through bank failure. This is the key difference between financial risks in China and those we have seen unwind in market economies.

The indirect impact of a sharp investment-led China downturn, via a slump in commodity prices, stands to be substantial for some countries like Brazil.  China is Brazil’s biggest trading partner.  Brazil’s primary exports there are soy and iron ore, so any slowdown will be particularly bad for miners like Vale VALE -0.42%.

Vale shares this year are down 31.7%, worse than the Bovespa Index’s other major large cap, Petrobras PBR -0.41%, which is down by 26.03%.

China’s per capita imports for metals now rivals that of advanced economies, according to the International Monetary Fund. It accounts for some 30% of the world’s total imports of metals and a full 65% of total iron ore imports globally. In energy, China’s share of world imports is in the high single digits, while for food it is low single digits, with the substantial exception of soybeans, which is over 50%.

The IMF has estimated that a one percentage point fall in China’s GDP growth can result in price declines of 6% for oil and base metals.

Here’s what a decline will do for countries around the world. For areas already struggling, it means recession.

Achoooo!!!

Real GDP growth in 2014 under Nomura’s base case and China risk scenario.
China                              Base Case 6.9%             China Risk 5.9%        Difference (pp) -1%
Global Ex-China                  2.5%                               2.2%                            -0.3%
Asia                                          4.1%                               3.6%                            -0.5%
United States                        2.6%                               2.4%                            -0.2%
Eurozone                               0.0%                             -0.3%                            -0.3%
Japan                                       2.5%                              2.0%                             -0.5%
Brazil                                        1.8%                              1.3%                              -0.5%
India                                        5.5%                              5.2%                              -0.3%
Aggregates are calculated using purchasing power parity (PPP) adjusted shares of world GDP.
Source: Nomura Global Economics.