In gesture to Trump, US allies close to deal to pay more for NATO running costs

By Robin Emmott

BRUSSELS (Reuters) – NATO allies are closing in on a deal to contribute more to allied running costs to reduce the United States’ share of funding, three diplomats familiar with the matter said.

Agreement would meet a demand by U.S. President Donald Trump, though France has made clear it will have no part in the deal, which the alliance hopes to reach before its 70th anniversary summit in London next week.

Trump has accused European allies, especially Europe’s biggest economy Germany, of taking U.S. protection for granted and says they need to spend much more on their own defense.

The reform of financing for the U.S.-led military alliance would seal months of negotiations after NATO Secretary-General Jens Stoltenberg put forward a proposal.

The agreement would mean European allies, Turkey and Canada contribute more towards the annual $2.5-billion budget to run the North Atlantic Treaty Organisation headquarters, international staff and military assets under NATO command.

Compared to the hundreds of billions of dollars that allies spend on their armed forces each year, it is a small sum. But it is one that allies hope would silence Trump’s statement in July 2018 that the United States “pays tens of billions of dollars too much to subsidize Europe”.

“It is a political gesture,” one senior NATO diplomat of the possible deal. “There is no alliance without the Americans.”

France opposed the proposal long before President Emmanuel Macron described the alliance on Nov. 7 as “experiencing brain death”, French diplomats have said.

With 30,000 troops deployed and ships across the world, Paris says it already does more than its fair share in defense, maintaining a high level of combat readiness of French forces and pouring billions of euros into defense research.

Paris will not block the proposal, but will abstain, the three NATO diplomats said.

France’s defense spending is higher than Germany’s as a percentage of economic output, data shows. Paris says it will also meet a NATO target to spend 2% of national output on defense by 2025 at the latest, while Germany will reach that level only in 2031, according to French and German officials.

NUMBERS GAME

Canada has said its support for the funding agreement should not set a precedent for other international organizations, the diplomats said. Italy has yet to decide its position, they said.

All 29 NATO member states contribute to the budget on an agreed formula based on gross national income, but this formula would change after the proposed reform.

“It will be a more cumbersome mechanism,” a second NATO diplomat said.

Under the proposal being negotiated for the 2021 budget, the U.S. contribution to the alliance’s annual budget would fall to around 16% from 22%. Germany’s would rise to the same level as the United States and others’ contributions would also rise.

Only seven NATO countries currently meet or exceed the NATO target of spending 2% of national output on defense – the United States, Britain, Greece, Poland, Latvia, Lithuania and Estonia.

(Editing by Timothy Heritage)

China envoy warns of ‘very bad damage’ if Canada follows U.S. lead on Hong Kong

OTTAWA (Reuters) – China’s new ambassador to Canada on Friday warned Ottawa not to follow the U.S. lead and formally back protesters in Hong Kong, saying such a move would cause “very bad damage” to already poor ties with Beijing.

Canada, which has been locked in a trade and diplomatic dispute with China, has repeatedly expressed concern about the safety of its 300,000 citizens in Hong Kong, hit by five months of mass demonstrations for more democracy and autonomy.

The U.S. House of Representatives on Wednesday passed two bills to back the protesters and send a warning to China about human rights.

“If somebody here really tries to … have this kind of law like that in the United States, it’s very dangerous,” said Chinese envoy Cong Peiwu, speaking in English.

“If anything happens like this it will certainly have a very bad damage on our bilateral relationship and that is not in the interests of Canada,” he told a news conference in the embassy. He formally presented his credentials on Nov 1.

The uncompromising tone of his message indicated that while the ambassador may have changed, China’s approach has not.

Cong repeated Beijing’s demand that Canada immediately release Huawei Technologies Co Ltd Chief Financial Officer Meng Wanzhou, who is out on bail after Canadian police detained her on a U.S. arrest warrant last December.

“This incident has led to the severe difficulties the two countries are facing nowadays,” said Cong.

Shortly after Meng’s arrest, China picked up two Canadian citizens on state secret charges, and has since blocked imports of canola seed from Canada.

Prime Minister Justin Trudeau, asked on Wednesday what additional measures Canada would take to protect its citizens in Hong Kong, said “we will continue to call for de-escalation and an end to violence” while urging dialogue.

If Canada wanted to protect its citizens, it should ask “those rioters to stop the violence, otherwise those Canadians living in Hong Kong, how can they be safe?” Cong said.

(Reporting by David Ljunggren; Editing by Bill Berkrot)

Deaths, bad outcomes elude scrutiny at Canada’s indigenous clinics

Deaths, bad outcomes elude scrutiny at Canada’s indigenous clinics
By Allison Martell

TORONTO (Reuters) – Ina Matawapit was barely conscious – intoxicated and suffering from a blow to the head – when police drove her to the North Caribou Lake clinic in Ontario, Canada, one summer evening in 2012.

The nurse at the federal government-run clinic, the only source of emergency care in this remote indigenous community, told the officers the 37-year-old could sober up in jail, according to testimony at a 2018 inquest. Minutes after leaving the clinic, the police sped back. Matawapit had no pulse and could not be revived.

At the inquest, the nurse testified that in sending Matawapit on to jail, she had been following a standard protocol for intoxicated patients in the northern reserves. Government officials testified there was no such thing.

The coroner found that in the nearly six years between the death and the inquest, there was no evidence of any formal review of the case “or any learning from the events of that evening” akin to typical procedures in hospitals or emergency rooms. Matawapit’s death, attributed to heart disease, likely would have passed under the radar but for the fact that she died in police custody, which made the inquest mandatory.

Over at least nine years, the Canadian federal government has not consistently tracked, let alone investigated, poor outcomes at clinics on indigenous reserves, according to a Reuters analysis of documents, including internal reports and meeting notes obtained through public records requests.

Record-keeping on deaths and other critical incidents at the clinics, which provide basic and emergency care to about 115,000 people, has been erratic and fragmented, Reuters found. The incidents often are detailed in separate provincial computer systems, when they are tracked or reported at all.

As a result, there is no way for the federal government to know how often patients die or suffer injury at the clinics or how that compares to the rest of the Canadian health system.

The federal government’s First Nations and Inuit Health Branch (FNIHB), which funds 79 clinics and manages 50 of them, is hampered in identifying potentially harmful patterns and preventing future mistakes, documents and interviews with medical experts indicate.

Whether turning away apparently intoxicated patients in the northern reserves – described in the coroner’s verdict as the “northern protocol”- has been a widespread practice is difficult to say. Reuters was able to find one other similar death, detailed in Manitoba police records, that occurred five months after Matawapit’s. The federal government enacted a policy saying it was “not appropriate” to hold intoxicated patients in cells – but only after last year’s inquest brought the issue to light.

Reuters’ findings come as the country is in the midst of a public reckoning with the legacy of settler colonization, a hotter issue today than in nations such as the United States and Australia where European settlers also displaced local peoples.

With an indigenous population that is growing and gaining political clout, Prime Minster Justin Trudeau came to power in 2015 promising “reconciliation” with aboriginal people. Reduced to a minority government in this week’s election, he needs the support of other parties to govern and will face pressure from the left to address poverty, poor housing and health problems that are especially acute on remote reserves.

It will not be an easy task. Even reviewing critical health care incidents could be a challenge because of the multiple jurisdictions and providers involved, said Michael Green, a professor at Queen’s University who was once chief of staff at a small northern hospital that often received patients from clinics in indigenous communities.

But “without review, there’s no opportunity to learn and make the system safer for everybody,” he said.

Staff at FNIHB, part of Indigenous Services Canada, say they strive to provide the best possible care and have been working on a replacement reporting system, slated to roll out next year.

The effort, which documents show began in 2014, has been planned behind closed doors and has not previously been reported, although pilot programs are running in Manitoba and Alberta.

Documents reviewed by Reuters indicate the system is designed to provide national case tracking and a consistent process for investigating and following up on cases.

Robin Buckland, executive director of primary healthcare at FNIHB, said the current system is “not a bad policy” but the agency is working to build an environment in which staff members can learn.

“It’s taken a long time,” she said. “But we want it to be right, and we want to implement it well.”

Reuters was not able to reach the nurses involved in treatment described in this story.

“We truly believe that nurses are working hard to deliver the best health care possible, under difficult work conditions,” said Debi Daviau, president of the Professional Institute of the Public Service of Canada, which represents permanent staff nurses and other civil servants.

‘SECOND-CLASS CITIZENS’

For years, indigenous communities have complained about poor treatment on remote reserves, which are often hundreds of miles from top-tier or specialized medical services in major cities. Matawapit died in a community more than 300 km (186 miles) from the nearest major highway.

For a map of reserves see: https://tmsnrt.rs/32uE3yk

These federally funded clinics, usually called nursing stations, struggle to retain nurses, often filling gaps with the help of private staffing agencies.

Services there need more government scrutiny, not less, some critics say.

“We are treating members of the First Nations communities as second-class citizens,” said Emily Hill, a senior staff lawyer with Aboriginal Legal Services, which represented the Matawapit family at the inquest. “This is a large government health service. You would expect there to be layers of oversight and accountability.”

Documents reviewed by Reuters show FNIHB staffers have repeatedly called for a modern reporting system for poor or unexpected outcomes.

The FNIHB started to track critical incidents in 2006. By 2010, however, a federal audit found that “monitoring and analysis at both the national and regional level is not occurring.”

Four years later, a FNIHB working group said that a common national policy was needed with “clear processes for reporting and tracking” incidents, according to meeting notes reviewed by Reuters.

In 2016, an internal report by a member of the working group looked at how other public organizations, including federal prisons, reviewed outcomes. Every policy was found to be more “robust” than the one at FNIHB.

The report, reviewed by Reuters, said that while some patient safety incidents had been recorded in a national database between 2006 and 2014, regions had stopped using it because of the difficulty in collecting data.

Federal policy focused mainly on nurses’ well-being, not patients’, the report said.

The nurse at the Matawapit inquest illustrated that point, testifying that a debriefing after the patient’s death was geared “more to how we were feeling as opposed to what we did.”

A SIMILAR DEATH

On November 28, 2012, the Royal Canadian Mounted Police in God’s Lake Narrows, Manitoba, responded to a report that Tracy Okemow, 31, was drinking and threatening suicide. Police found her next to two empty pill bottles labeled “metformin,” a diabetes drug, according to a police review of the incident seen by Reuters. She agreed to go to the local nursing station.

The nurses told officers they had consulted with a doctor off the reserve who felt her “consumption of medication was not of concern and she could be incarcerated until sober,” according to the police report.

Okemow spent the night in jail. A witness later told police that she seemed to be in agony. In the morning, she was flown to a Winnipeg hospital, where she died the next day of metformin toxicity, the report said.

There was no inquest or federal inquiry. “In the case of Ms. Okemow, the death occurred outside of a federally operated facility – therefore FNIHB did not undertake a formal review,” Indigenous Services Canada said in a statement.

Off reserve, healthcare is under provincial jurisdiction.

‘THEY BRUSH US OFF’

The federal government has reviewed some patient deaths, often after they draw media attention. Documents reviewed by Reuters show officials have found serious systemic problems, including nurses who are stretched thin and do not always appreciate the seriousness of patients’ symptoms.

After two children died from complications of strep infections in 2014, an internal review looked at a “sampling” of young people who had died, and called for better recruitment and retention of nurses, as well as more physician services.

A 2018 review looked at a 15-month-old toddler seen on a Saturday night for a seizure and infections. The nurse on duty did not consult a doctor, and the child died the next day. The report called for better oversight of nurses, as well as changes to shifts and staffing to address fatigue.

FNIHB’s Buckland said the agency is working to improve hiring and retention amid a global shortage of healthcare workers.

In Manitoba, the family of Tyson McKay is suing the federal government, alleging that the 32-year-old man died of a heart attack 31 hours after visiting a clinic complaining of chest pain in 2015. The suit alleges the nurse did not perform the appropriate tests that could have diagnosed his condition.

In a court filing, the government said a staffing agency was responsible for ensuring the nurse was qualified. The staffing agency defended its care and referred questions to the government.

Kelvin McKay, Tyson’s 41-year-old brother, has been going to the clinics since childhood. He said he sees a pattern.

“Nurses come in and out of our community, and they fail to take the time to get to know our people, and they think we come in with fake illnesses. They brush us off. And that’s not how it’s supposed to be.”

For a graphic on clinics on indigenous reserves often distant from major cities, click https://graphics.reuters.com/CANADA-HEALTH-NURSINGSTATIONS/0100B2H81S6/canada-map.jpg

(This story refiles to add dropped word in paragraph nine)

(Additional reporting by Rod Nickel in Winnipeg; Editing by Denny Thomas and Julie Marquis)

Neurotoxin may have caused diplomats’ illness in Cuba: study

HAVANA (Reuters) – Fumigation against mosquitoes in Cuba and not “sonic attacks” may have caused some 40 U.S. and Canadian diplomats and family members in Havana to fall ill, according to a new study commissioned by the Canadian government.

The incidents took place from late 2016 into 2018, causing the administration of U.S. President Donald Trump to charge that diplomats were attacked by some sort of secret weapon. Canada has refrained from such charges.

The United States in 2017 reduced its embassy staff to a minimum and Canada followed more recently, citing the incidents and the danger posed to staff from what has become known as the “Havana Syndrome.”

Various scientific studies have yet to identify the cause of the diplomats’ cognitive ailments, ranging from dizziness and blurred vision to memory loss and difficulty concentrating.

The Canadian study by a team of researchers affiliated with the Brain Repair Centre at Dalhousie University and the Nova Scotia Health Authority studied Canadian victims and even the brain of a pet dog after its demise in Canada.

The study was the first to include diplomats for whom there was baseline medical testing from before their postings in Havana, so as to better compare with the tests from afterwards. Canada started implementing the practice after diplomats first started complaining of sickness.

The researchers said they had detected different levels of brain damage in an area that causes symptoms reported by the diplomats and which is susceptible to neurotoxins. They then concluded that cholinesterase, a key enzyme required for the proper functioning of the nervous system, was being blocked there.

Some pesticides work by inhibiting cholinesterase, the report said, and during the 2016-2018 period when diplomats became ill normal fumigation in Cuba was stepped up due to the Zika epidemic in the Caribbean.

The report said the diplomats’ illnesses coincided with increased fumigation in and around residences where they lived. One of the authors of the study, Professor Alon Friedman, clarified in an email to Reuters that both Canadian and Cuban authorities were fumigating.

“We report the clinical, imaging and biochemical evidence consistent with the hypothesis of over-exposure to cholinesterase inhibitors as the cause of brain injury,” the study concluded while cautioning that other causes could not be ruled out and more study was needed.

Friedman said it was not clear whether the broader Cuban population was affected by the fumigation and if not, why, but his team was planning a further study on this together with Cuban scientists.

(Reporting by Marc Frank; Editing by Leslie Adler)

Canada bids to reassure U.S., other allies after intelligence official arrested

Cameron Ortis, director general with the Royal Canadian Mounted Police's intelligence unit, is shown in a court sketch from his court hearing in Ottawa, Canada, September 13, 2019. Lauren Foster-MacLeod/Handout via REUTERS

By David Ljunggren

OTTAWA (Reuters) – Canada is working to reassure the United States and other allies after a top police intelligence official was charged with leaking secrets, Prime Minister Justin Trudeau said on Tuesday.

Cameron Ortis, a director general with the national police force’s intelligence unit, had access to highly sensitive domestic and foreign intelligence, and his arrest last week sparked fears of a possible major security breach.

Ortis was charged on Friday under a 2012 security information law used to prosecute spies.

Security experts say the case could damage Canada’s standing inside the Five Eyes intelligence-sharing network that also includes the United States, Australia, New Zealand and Britain.

“We are in direct communications with our allies on security, not only the Five Eyes group,” Trudeau said during a campaign stop in St. John’s, Newfoundland.

“We are also working with them to reassure them, but we want to ensure that everyone understands that we are taking this situation very seriously.”

Canadian security officials are working urgently to see what if any data might have been leaked, said a senior source with direct knowledge of the situation.

Canada’s allies are working on the assumption that if any secrets were shared, China and Russia are likely to have been the main beneficiaries, said a second source with direct knowledge of the matter.

Canadian officials say China, in particular, has been aggressively seeking to obtain sensitive information.

The Canadian Broadcasting Corp., citing government documents, said the U.S. Federal Bureau of Investigation had tipped off Canada as it probed a separate criminal matter. The FBI discovered in 2018 that someone had contacted the head of Canadian company Phantom Secure offering to sell secrets.

The chief executive of the firm last year pleaded guilty to facilitating international narcotics traffic by supplying drug cartels with encrypted communications devices.

Royal Canadian Mounted Police (RCMP) Commissioner Brenda Lucki is expected to provide a “short update” and answer questions on the case on Tuesday at 1 p.m. EDT (1700 GMT).

On Monday, Lucki said the leaks could have hurt allied nations’ intelligence operations and promised that “mitigation strategies are being put in place as required.”

(Additional reporting by Kelsey Johnson and Steve Scherer in Ottawa; Editing by Edmund Blair and Bernadette Baum)

Explainer: What do you do after a data breach?

FILE PHOTO: The logo and ticker for Capital One are displayed on a screen on the floor of the New York Stock Exchange (NYSE) in New York, U.S., May 21, 2018. REUTERS/Brendan McDermid/File Photo

(Reuters) – A hacker has stolen the personal information of over 100 million people from Capital One Financial Corp, the company said this week, in the latest high-profile breach of sensitive consumer data.

Security experts say data breaches will continue to happen as cyber criminals and state-backed hackers target the protected information held by companies and government agencies.

Such attacks leave consumers vulnerable to fraud and identity theft. Here are some steps you can take to assess the severity of the breach and better secure yourself:

WHAT WAS COMPROMISED?

Breaches often cover a wide range of data. Information which is already publicly available, such as your name or email address, is seen as less of a concern.

Other details, however, can be extremely sensitive and need to remain private. For example, full credit card numbers, which could be used to make fraudulent purchases in your name, or passwords for your online accounts.

Even if stolen, the data may still be protected by encryption. Hacks by foreign governments are also usually seen as less dangerous for general consumers compared to data thefts by financially-motivated criminal gangs because most spy agencies do not sell or trade such information.

Much of the information stolen from Capital One was already public, including names and addresses of over 100 million people in the United States and Canada. But the breach also included 140,000 Social Security numbers which could be used to steal people’s identities.

To assess the severity of the breach, try and determine what information was compromised and in what format it was stolen.

AM I AFFECTED?

Try to establish if your data is likely to have been compromised in the breach. Are you a customer of the affected company? Do you know what data they hold on you? Does the breach only concern data collected in a specific time period?

Answering those questions will allow you to judge the level of risk, but remember some organizations may hold your data without you being aware. Those include credit-reporting companies such as Equifax Inc <EFX.N>, which suffered a breach in 2017 that affected 147 million people.

Breached companies are usually obliged to notify the people who are impacted, but this does not always happen immediately. Affected companies will typically post guidance for consumers on their own websites about data breaches.

Under the European Union’s General Data Protection Regulation (GDPR), companies have to inform victims of severe data breaches “without undue delay.” They must then describe in “clear and plain language” the nature of the breach, the likely consequences and what measures being taken to deal with it.

IS THIS A SCAM?

If you think you data was compromised, be on high alert for scams and fraud.

Watch your bank account balances and payment card statements carefully, especially if you believe your financial information has been compromised. If you spot any unusual activity, contact your bank or card provider immediately and inform the appropriate law enforcement agency.

Be aware of so-called “phishing” websites purporting to offer information about the breach, or even compensation, but actually set up by criminals to try and trick you into revealing more personal details or making a payment to the wrong account.

Fraudsters may also contact you directly, by phone or email, and could now be armed with large amounts of detailed personal information which will make them harder to spot. If you’re unsure about someone’s identity, find the affected company’s contact information and contact them independently.

Experts recommend changing passwords frequently and using a combination of letters, characters and symbols to maintain a complex passphrase that is less likely to be guessed.

(Reporting by Jack Stubbs and Christopher Bing; Editing by Jonathan Weber and Susan Thomas)

Trump administration opens door to importing medicine from Canada

A pharmacist counts pills in a pharmacy in Toronto in this January 31, 2008 file photo. REUTERS/Mark Blinch/Files

By Michael Erman

(Reuters) – The Trump administration took a first step on Wednesday toward allowing the importation of medicines from Canada, an action the president has advocated as a way to bring cheaper prescription drugs to Americans.

The U.S. Department of Health and Human Services said it and the Food and Drug Administration will propose a rule that will allow it to authorize states and other groups to pursue pilot projects related to importing drugs from Canada.

The agency also said that it would allow drugmakers to bring drugs that they sell more cheaply in foreign countries into the United States for sale here, potentially enabling them to sell below their contracted prices in the U.S.

Drug industry shares were lower slightly, with the NYSE Arca Pharmaceutical Index <.DRG> off 0.25 percent versus a broader flat market. Wall Street analysts said importation was far from being put into place and was limited to certain drugs from Canada.

Health and Human Services Secretary Alex Azar said he has had prior discussion with Canada about importation and that it would be up to the states, pharmacies and distributors to address any hurdles.

“There are hurdles of course, but the hurdles now are known. They are being laid out and they are surmountable,” he said during a call with reporters.

Canadian officials were not immediately available for comment. Reuters has previously reported that Canada opposes any U.S. plans to buy Canadian prescription drugs that might threaten the country’s drug supply or raise costs for its own citizens.

Many drug purchase agreements in Canada forbid the re-export of drugs to other countries, according to a Canadian government memo obtained by Reuters.

“Given the size of the U.S. market and of large states such as Florida, which alone is two-thirds of the population of Canada, reliance on imports from Canada would have limited viability as a long term solution to the high cost of drugs in the U.S.,” Health Canada said in a statement on July 17.

Evercore ISI analysts Ross Muken and Michael Newshel said in a research note that any implementation is still far away given the technical steps of rulemaking and that the proposals will face challenges. For instance, he said, most Republicans in Congress oppose importation.

The first part of the proposal would allow states, wholesalers or pharmacists to submit plans for pilot projects for Canadian drugs if their raw materials are manufactured in the same plant as the U.S. version and are in line with the FDA’s approval. It would exclude biologics, infused drugs, injected drugs, inhaled drugs for surgery and certain parenteral drugs.

The Trump Administration has experienced several recent failures in its efforts to bring down drug prices. Its plans to make drugmakers disclose prices in TV ads had to be thrown out after it lost a legal battle with drugmakers, and it abandoned efforts to force pharmacy benefit managers to pass discounts onto Medicare recipients.

Drug pricing is an important election issue for Trump and also for Democrats, many of whom have said they would support importing medicines to lower U.S. drug prices. Pharmaceutical companies have opposed importing medicine.

(Reporting by Manas Mishra in Bengaluru; Michael Erman and Caroline Humer in New York and Allison Martell in Toronto; Editing by Steve Orlofsky)

Canadian police descend on tiny Manitoba hamlet as teen murder suspects spotted

Canadian Mounted Police (RCMP) continue their search for Kam McLeod and Bryer Schmegelsky, two teenage fugitives wanted in the murders of three people, near Gillam, Manitoba, Canada July 28, 2019. Manitoba RCMP/Handout via REUTERS

TORONTO (Reuters) – Canadian police descended on a tiny hamlet in northern Manitoba on Sunday after a reported sighting of two teenage fugitives wanted in the murders of three people, including American and Australian tourists.

The days-long manhunt for Kam McLeod, 19, and Bryer Schmegelsky, 18, which has crossed half the country, shifted to the area of York Landing, Manitoba, about 3,000 km (1,865 miles) from the crime scenes in British Columbia.

“Multiple resources are being sent to York Landing, Manitoba, to investigate a tip that the two suspects are possibly in, or near, the community,” the Royal Canadian Mounted Police said on Twitter. ” … despite reports, there’s no-one in custody at this time.”

The pair were originally reported as missing on July 19 but were later described as suspects in the killing of American Chynna Deese, 24, and her boyfriend, Australian Lucas Fowler, 23. Police charged the fugitives last week with the second-degree murder of Leonard Dyck, 64, a Vancouver botany professor. ]

Police had concentrated their search in recent days in the harsh terrain in the Gillam, Manitoba, area, more than 1,000 km (620 miles) north of Winnipeg, deploying drones, dogs and military help before shifting focus to York Landing on Sunday.

An official there said there had been sightings of the pair around the community’s landfill.

Chief Leroy Constant of York Factory Cree Nation&nbsp;said heavy winds were limiting police helicopters and drones.

“We are urging everyone to remain indoors with windows and doors locked. Patrols of the community will be done on a 24-hour basis,” he said in a statement.

(Writing by Amran Abocar; Editing by Paul Tait)

U.S.-Mexico-Canada trade deal will help stave off U.S. recession: U.S. Chamber CEO

By Andrea Shalal and Jonas Ekblom

WASHINGTON (Reuters) – Approval and implementation of the U.S.-Mexico-Canada (USMCA) trade agreement will provide a major boost to the U.S. economy and help stave off a recession, Thomas Donohue, chief executive of the U.S. Chamber of Commerce, said on Thursday.

Donohue, whose organization is spearheading a major campaign to win passage of the trade agreement, said moving ahead with the USMCA would also help pave the way for trade agreements with China, the European Union, Japan and other countries.

“It is a major component in keeping us out of a recession,” Donohue told Reuters after a news conference with other trade associations pushing the U.S. Congress to ratify the replacement for the current North American Free Trade Agreement (NAFTA).

He said the timing was critical given other drags on the U.S. economy, including troubles at top U.S. exporter Boeing Co, which this week reported its biggest-ever quarterly loss due to the spiraling cost of resolving issues with its 737 MAX.

Boeing has reduced production of the grounded jet and suspended deliveries, but on Wednesday warned it might have to shut production completely if it runs into new hurdles with global regulators.

The single-aisle plane was grounded worldwide in March after two fatal crashes in Ethiopia and Indonesia.

“A reduction in our economic growth and our trade is taking place with the Boeing problem,” Donohue said. “They’ll survive this, they’ll move forward.”

House of Representatives Republican Leader Kevin McCarthy on Thursday criticized House Speaker Nancy Pelosi and other House Democrats, who control the chamber, for not bringing the USMCA up for a vote before lawmakers leave for their summer recess.

“What will this do? Only make our country stronger, more prosperous, create more jobs, make the debate with China even in a stronger position for America and make the future better than it is today. But they didn’t do anything about it,” McCarthy told reporters at a news conference.

Donohue and other business leaders cited growing bipartisan support for the USMCA and expressed optimism that the House would move to ratify the agreement in September.

Nearly 600 trade and commerce groups sent a letter urging lawmakers to approve the deal as soon as possible.

“If we don’t move positively on Canada and Mexico, it will be very, very difficult for us to muster the goodwill in other places to get agreements with China, with Japan and the EU,” Donohue told a news conference.

Leaders from the United States, Mexico and Canada signed the agreement in November, but it must be ratified by lawmakers in all three countries.

House Democrats have promised to block the deal until their concerns over environmental, labor and pharmaceutical aspects of the agreement are met, but Donohue and others said they were upbeat those issues could be resolved.

White House officials say the agreement would add about half a percentage point of economic growth to the U.S. economy, creating several hundred thousand jobs and sparking up to $100 billion in new investments in the United States.

U.S. Trade Representative Robert Lighthizer is due to meet with Democratic lawmakers about the agreement again this week, with a focus on enforcement issues.

Industry leaders said moving forward would reduce uncertainty and free businesses to make new investments.

“The thing we hear most about the need to move forward with this agreement is the need to provide certainty,” said Matthew Shay, president of the National Retail Federation.

The group said it would use state fairs and events in local districts in coming weeks to pressure lawmakers to back passage of the deal while campaigning against its opponents.

“We will be activating our grassroots network and targeting key districts,” Donohue said. “You can’t be pro-jobs and anti-USCMA.”

(Additional reporting by Susan Cornwell; editing by Chizu Nomiyama and Jonathan Oatis)

American caravan arrives in Canadian ‘birthplace of insulin’ for cheaper medicine

Type 1 diabetes advocates from the United States depart a Canadian pharmacy after purchasing lower cost insulin in London, Ontario, Canada June 29, 2019. REUTERS/Carlos Osor

By Tyler Choi

TORONTO (Reuters) – A self-declared “caravan” of Americans bused across the Canada-U.S. border on Saturday, seeking affordable prices for insulin and raising awareness of “the insulin price crisis” in the United States.

The group called Caravan to Canada started the journey from Minneapolis, Minnesota on Friday, and stopped at London, Ontario on Saturday, to purchase life-saving type 1 diabetes medication at a pharmacy.

The caravan numbers at approximately 20 people, according to Nicole Smith-Holt, a member of the group.&nbsp;Smith-Holt&nbsp;said her 26-year-old son died in June 2017 because he was forced to ration insulin due to the high cost. This is Smith-Holt’s second time on the caravan.

Caravan to Canada trekked the border in May for the same reasons, which Holt-Smith said was smaller than the group this week. She said Americans have gone to countries like Mexico and Canada for more affordable medications in the past and continue to do so.

The Canadian Broadcasting Corporation reported in May that Canadian pharmacists have seen a “quiet resurgence” in Americans coming to Canada looking for cheaper pharmaceuticals.

Insulin prices in the United States nearly doubled to an average annual cost of $5,705 in 2016 from $2,864 in 2012, according to a study in January.

Allison Nimlos, a Type 1 diabetes advocate from the United States, shows the less expensive Canadian insulin she purchased (right) after leaving a Canadian pharmacy in London, Ontario, Canada June 29, 2019. REUTERS/Carlos Osorio

Allison Nimlos, a Type 1 diabetes advocate from the United States, shows the less expensive Canadian insulin she purchased (right) after leaving a Canadian pharmacy in London, Ontario, Canada June 29, 2019. REUTERS/Carlos Osorio

While not everyone purchased the same amount of insulin, Smith-Holt said most people are saving around $3,000 for three months of insulin, and as a whole, the group is saving around $15,000 to $20,000.

Prescriptions for insulin are not required in Canadian pharmacies Smith-Holt said, but the caravan has them so they can prove to the border patrol they are not intending to resell them when returning to the United States.

Quinn Nystrom, a leader of T1International’s Minnesota chapter, said on May via Twitter that the price of insulin in the United States per vial was $320, while in Canada the same medication under a different name was $30.

T1International, a non-profit that advocates for increased access to type 1 diabetes medication, has described the situation in U.S. as an insulin crisis.

“We know that many people couldn’t make this trip because they cannot afford the costs associated with traveling to another country to buy insulin there,” said Elizabeth Pfiester, the executive director of T1International in a press release.

An itinerary states the caravan will stop at the Banting House in London, Ontario later in the day. The Banting House is where Canadian physician and scientist Frederick Banting, who discovered insulin, lived from 1920 to 1921, and is called the “birthplace of insulin”, according to the Banting House website.

Smith-Holt said the group is not currently planning any future trips, but they could be organized in the near future depending on need. She hopes for long-term solutions in the United States like price caps, anti-gouging laws, patent reform and transparency from pharmaceutical companies.

(Reporting by Tyler Choi, Editing by Franklin Paul)