China to invest 80 billion yuan in oil and gas exploration this year

Cars drive into a Petrol China gas station, as other vehicles drive past on the Beijing-Tibet expressway in Beijing, March 23, 2012. C

Credit: Reuters/Soo Hoo Zheyang

BEIJING | Sun Sep 15, 2013 3:46am EDT

BEIJING (Reuters) - China will invest 80 billion yuan ($13.07 billion) in oil and gas exploration in 2013, state media said on Sunday, as it tries to boost energy supplies reduce its dependence on energy imports.

Oil and gas investment in China has risen from 19 billion yuan in 2002 to 67.3 billion yuan in 2011, the official Xinhua news agency said, citing Ministry of Land and Resources figures.

More than 5 billion tons of petroleum reserves and 2.6 trillion cubic meters of natural gas were discovered between 2008-2011, Xinhua said.

China, the world's biggest energy consuming country, has promised to cut its growing dependence on overseas oil and gas supplies.

Still, some analysts expect China to overtake the United States as the world's biggest crude oil importer as soon as 2017. Much of it comes from the Middle East and Africa and is transported via vulnerable sea lanes.

Gas imports are important to China because domestic production is not sufficient to meet growing demand. Imported gas is delivered via pipeline from Central Asia and by ship from countries such as Australia, Indonesia and Qatar.

China bought 42.5 billion cubic metres (bcm) of gas from overseas last year. That was up more than 30 percent compared with 2011 and a nearly 10-fold increase from 2007.

(Reporting by Michael Martina; Editing by Robert Birsel)

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Global Fund seeks $15 billion to control three big killers

By Kate Kelland

LONDON | Thu Sep 12, 2013 12:07pm EDT

LONDON (Reuters) - The world's biggest funder of the fight against AIDS, tuberculosis (TB) and malaria said on Thursday it needs $15 billion over the next three years to begin bringing "the three big global pandemics" under control.

In a report released ahead of a pledging conference later this year, the Global Fund to Fight AIDS, TB and Malaria said timely investments could avert $47 billion in extra treatment costs and save millions of lives, but warned that acting too late would mean missing important opportunities.

"The cost of inaction is far greater than the cost of action, from both a moral and an economic perspective," Joanne Carter, head of the RESULTS Educational Fund in the United States and a former Global Fund board member, told reporters.

"We are at the tipping point in the fight against HIV, TB and malaria. If we invest ambitiously now we can save millions of lives and literally defeat these diseases in our lifetime."

The public-private Global Fund, based in Geneva, accounts for around a quarter of international financing to fight HIV and AIDS, and the majority of global funds to fight TB and malaria.

Founded in 2002, the fund raises money from donors every three years and in 2010 secured just under $12 billion for the years 2011 to 2013.

According to the World Health Organisation, malaria infected some 219 million people in 2010, killing around 660,000 of them. Robust figures are, however, hard to establish and other health experts say the annual malaria death toll could be double that.

Some 34 million people were living with the human immunodeficiency virus (HIV) that causes AIDS at the end of 2011, while deaths from AIDS fell to 1.7 million that year from a peak of 2.3 million in 2005.

The Global Fund says that of the estimated 9 million cases of TB worldwide in 2012, only 6 million were diagnosed and treated - leaving an estimated 3 million people with TB who went undiagnosed, untreated or unreported.

International health experts say the tools, medicines and expertise already exist to be able to all but end these three infectious diseases, but say it is a battle to keep up funding levels in a tough global economic climate.

"There are three compelling factors that make this a unique opportunity to fight and defeat these diseases," said Mark Dybul, the Global Funds' executive director.

"We have the experience to know how to fight them effectively, we have new scientific tools, and we understand the epidemiology of these diseases better than ever. We can make a transformative difference, and if we do not act now, the costs will be staggering."

If international donors fail to stump up the at least $15 billion needed, Dybul said this could lead to millions of avoidable cases of HIV during the funding period of 2014 to 2016, which over these patients lifetimes would add up to $47 billion of treatment costs.

Some 3 million fewer people would be treated for TB, and a million lives would be unnecessarily lost because of that, he said, and in malaria the consequences of inadequate funding would be 196,000 lives lost per year and 430 million malaria cases that could have been prevented.

The lion's share of the funding for the Global Fund comes from OECD governments. Private sector entities such as the Bill and Melinda Gates Foundation and Coca-Cola also contribute financially and with services.

(Editing by Sonya Hepinstall)

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Rhoen-Klinikum to sell hospitals to Fresenius for $4 billion

1 of 3. The headquarters of German healthcare company Rhoen-Klinikum AG are pictured in Bad Neustadt near Fulda September 3, 2012.

Credit: Reuters/Alex Domanski

By Ludwig Burger and Jonathan Gould

FRANKFURT | Fri Sep 13, 2013 7:07am EDT

FRANKFURT (Reuters) - Germany's Rhoen-Klinikum is to sell most of its hospitals to rival Fresenius SE for 3.07 billion euros ($4.1 billion), in an attempt by Rhoen's founder, Eugen Muench, to outflank opponents to an outright sale of the company.

The sale comes exactly 12 months after Fresenius dropped plans to buy all of Rhoen for 3.1 billion euros after an industry rival and service supplier bought blocking stakes in Rhoen.

The 43 hospitals and 15 outpatient facilities now being sold account for about two thirds of Rhoen's revenues, with mainly specialized clinics and university teaching hospitals remaining with Rhoen.

Rhoen and Fresenius have long wanted to merge to create a countrywide network of private hospitals, extensive enough to enable Fresenius to start offering its own medical insurance.

The transaction, which according to Rhoen does not require a shareholder vote, would make Fresenius's German hospitals unit Helios Europe's largest private hospital operator, Fresenius said in a statement.

Shares in Rhoen were up 11 percent at 19.4 euros by 0950 GMT, while those of Fresenius were up 4.4 percent at 91.0 euros.

Konrad Lieder, an analyst with Equinet Bank, said the add-on insurance offering should improve Fresenius's pricing power in the mid-term but warned of legal uncertainties.

"We see two major sources of risk: anti-trust and a legal appeal against the transaction by minority shareholders."

Fresenius's chief executive Ulf Schneider, who last year refrained from reviving the failed bid for Rhoen, told Reuters that the purchase of Rhoen's assets was soundly structured to withstand any legal challenges.

"We're a company driven by opportunities, not by fear. That's why we've done our deals in the past," he added.

Apart from last year's setback, Fresenius has a history of successful takeovers. Recent deals include the 850 million-euro takeover of U.S. blood transfusion equipment maker Fenwal and the 2008 purchase of APP Pharmaceuticals for $3.7 billion to boost its infusion drug business in the U.S.

Rhoen's founder and chairman Muench last year initiated the proposed sale of the entire group, in which he and his wife hold 12.5 percent, to Fresenius for 22.40 euros a share in cash.

But rival German hospitals operator Asklepios and a medical supplies maker B. Braun weighed in with the purchase of enough shares to fend off the suitor.

Muench has continued to campaign for a sale and he and his detractors have been locked in legal action.

Sources familiar with the company have said B. Braun fears a deal will jeopardize its business where it competes with Fresenius as a service supplier to Rhoen, while Asklepios doesn't want its two main rivals to merge.

B. Braun and Asklepios declined to comment on Friday.

Last year Helios had sales of 3.2 billion euros and Asklepios had sales of 3 billion while Rhoen turned over 2.9 billion euros.

The acquisition would boost Helios's sales by about 2 billion euros and earnings before interest, tax, depreciation and amortization (EBITDA) by about 250 million, Fresenius said.

Fresenius said the purchase price would be entirely debt financed and it would not assume any of Rhoen's debt.

The ratio of the Fresenius group's net debt to core earnings would temporarily rise above 3 this year but remain below 3.5 before returning to the 2.5-3.0 target range next year, the company added.

Rhoen said it planned to pay out a special dividend of up to 1.9 billion euros, or 13.8 euros per share, as a result of the sale, on top of its regular dividend.

Some proceeds would also go towards repaying debt, with a further 200 million euros slated for investments, it said. ($1=0.7514 euros)

(Editing by Jane Merriman and Greg Mahlich)

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Hospital infections cost U.S. $10 billion a year

By Anne Harding

NEW YORK | Thu Sep 12, 2013 11:35am EDT

NEW YORK (Reuters Health) - Infections acquired in the hospital cost the U.S. health care system $10 billion a year, new findings show.

Past studies have pegged the annual cost of treating those infections at $20 billion to $40 billion, so the new numbers show progress is being made, Dr. Eyal Zimlichman of The Center for Patient Safety Research and Practice at Brigham and Women's Hospital in Boston, one of the new study's authors, told Reuters Health.

Nevertheless, he said, much more can be done.

According to the U.S. Centers for Disease Control and Prevention (CDC), about one in every 20 hospitalized patients contracts a hospital-acquired infection.

Zimlichman and his team reviewed 26 studies to identify the costs associated with treating the five most common, expensive and preventable infections among hospitalized patients.

Bloodstream infections from central lines, which are long tubes inserted in a large vein such as in the chest or arm to deliver medication, fluids, nutrients or blood products, were the most expensive, at a cost of $45,814 per case. Ventilator-associated pneumonia, or a lung infection that develops while a person is on a respirator, came in second, at $40,144 per case.

Post-surgery infections occurring at the site of the operation cost $20,785 per patient. Infection with Clostridium difficile, a tough-to-treat bacterium that causes severe diarrhea and can spread within hospital units, cost $11,285 per case. Catheter-associated urinary tract infections (UTIs) were the least costly, at $896 per case.

About 441,000 of these infections occur among hospitalized adults in the U.S. every year, for a total cost of $9.8 billion, Zimlichman and his colleagues reported in JAMA Internal Medicine.

Surgical site infections and ventilator-associated pneumonia each accounted for about one third of the total costs. That was followed by central line bloodstream infections (about 19 percent), C. difficile infections (15 percent) and catheter-associated UTIs, which accounted for less than 1 percent of all costs.

"This study really adds further evidence that not only are these infections too common and often lethal, they're extremely expensive," Dr. Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine in Baltimore, told Reuters Health.

"We really need to accelerate our efforts to reduce these infections."

Up to 70 percent of central line infections and ventilator-associated pneumonias can be prevented if the healthcare team treating the patient follows a checklist of best practices, added Pronovost, who did not take part in the new study.

Patients can protect themselves by asking hospitals about their infection rates and what they are doing to reduce them, he said.

Many states also require hospitals to report data on hospital-acquired infections to the CDC, which provides this information on its website (1.usa.gov/1aYZ1r2).

When patients are in the hospital, there are a few simple steps they can take to protect themselves, Pronovost added. "If someone walks into your room and you don't see them washing their hands, ask them if they did," he said.

Although there's ample evidence on how to prevent central line infections and ventilator-associated pneumonia, Zimlichman noted, less research has been done on the best strategies for heading off surgical site infections.

"There's not one magic bullet for them, but a series of small little things of being meticulous," Pronovost said - for example making sure a patient's skin is cleaned properly and that he or she is being prescribed the right dose of antibiotics.

Nevertheless, he added, if nurses and doctors follow these strategies they can reduce the rate of surgical site infections by 40 percent to 50 percent.

In the past, hospitals had little financial incentive to prevent these types of infections, since insurers would reimburse them for any additional costs associated with treating them, Dr. Mitchell H. Katz wrote in a note accompanying the study.

"Under this perverse payment scheme, a hospital that invested money to decrease infections would pay 'twice': once for the intervention and once through not getting the additional money for treating the patient for the additional complication," Katz, a deputy editor at the journal, wrote.

But that has begun to change, he added, since Medicare - the government-funded insurance program for the elderly and disabled - is no longer paying hospitals to treat these infections. "Not paying for hospital-acquired infections or errors is an important part of the movement toward paying for quality, not quantity, of care," Katz wrote.

SOURCE: bit.ly/1eb1COz JAMA Internal Medicine, online September 2, 2013.

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