AP IMPACT: Big Pharma cashes in on HGH abuse

A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.

But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.

From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.

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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.

The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.

Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.

Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.

Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.

Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.

Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.

HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.

Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.

Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.

The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.

On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.

Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.

Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.

While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.

"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.

And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.

First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.

Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.

FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.

Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.

Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.

These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.

For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)

These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.

"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."

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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.

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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh

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The AP National Investigative Team can be reached at investigate(at)ap.org

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Obama Still an 'Optimist' on Cliff Deal

Mandel Ngan/AFP/Getty Images

WASHINGTON D.C. – Ten days remain before the mandatory spending cuts and tax increases known as the “fiscal cliff” take effect, but President Obama said he is still a “hopeless optimist” that a federal budget deal can be reached before the year-end deadline that economists agree might plunge the country back into recession.

“Even though Democrats and Republicans are arguing about whether those rates should go up for the wealthiest individuals, all of us – every single one of us -agrees that tax rates shouldn’t go up for the other 98 percent of Americans, which includes 97 percent of small businesses,” he said.

He added that there was “no reason” not to move forward on that aspect, and that it was “within our capacity” to resolve.

The question of whether to raise taxes on incomes over $250,000 remains at an impasse, but is only one element of nuanced legislative wrangling that has left the parties at odds.

For ABC News’ breakdown of the rhetoric versus the reality, click here.

At the White House news conference this evening, the president confirmed he had spoken today to Senate Majority Leader Harry Reid, D-Nev., and House Speaker John Boehner, R-Ohio, although no details of the conversations were disclosed.

The talks came the same day Speaker Boehner admitted “God only knows” the solution to the gridlock, and a day after mounting pressure from within his own Republican Party forced him to pull his alternative proposal from a prospective House vote. That proposal, ”Plan B,” called for extending current tax rates for Americans making up to $1 million a year, a far wealthier threshold than Democrats have advocated.

Boehner acknowledged that even the conservative-leaning “Plan B” did not have the support necessary to pass in the Republican-dominated House, leaving a resolution to the fiscal cliff in doubt.

“In the next few days, I’ve asked leaders of Congress to work towards a package that prevents a tax hike on middle-class Americans, protects unemployment insurance for 2 million Americans, and lays the groundwork for further work on both growth and deficit reduction,” Obama said. ”That’s an achievable goal.  That can get done in 10 days.”

Complicating matters: The halls of Congress are silent tonight. The House of Representatives began its holiday recess Thursday and Senate followed this evening.

Meanwhile, the president has his own vacation to contend with. Tonight, he was embarking for Hawaii and what is typically several weeks of Christmas vacation.

However, during the press conference the president said he would see his congressional colleagues “next week” to continue negotiations, leaving uncertain how long Obama plans to remain in the Aloha State.

The president said he hoped the time off would give leaders “some perspective.”

“Everybody can cool off; everybody can drink some eggnog, have some Christmas cookies, sing some Christmas carols, enjoy the company of loved ones,” he said. “And then I’d ask every member of Congress, while they’re back home, to think about that.  Think about the obligations we have to the people who sent us here.

“This is not simply a contest between parties in terms of who looks good and who doesn’t,” he added later. “There are real-world consequences to what we do here.”

Obama concluded by reiterating that neither side could walk away with “100 percent” of its demands, and that it negotiations couldn’t remain “a contest between parties in terms of who looks good and who doesn’t.”

Boehner’s office reacted quickly to the remarks, continuing recent Republican statements that presidential leadership was at fault for the ongoing gridlock.

“Though the president has failed to offer any solution that passes the test of balance, we remain hopeful he is finally ready to get serious about averting the fiscal cliff,” Boehner said. “The House has already acted to stop all of the looming tax hikes and replace the automatic defense cuts. It is time for the Democratic-run Senate to act, and that is what the speaker told the president tonight.”

The speaker’s office said Boehner “will return to Washington following the holiday, ready to find a solution that can pass both houses of Congress.”

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Syrian rebels fight for strategic town in Hama province

BEIRUT (Reuters) - Rebels began to push into a strategic town in Syria's central Hama province on Thursday and laid siege to at least one town dominated by President Bashar al-Assad's minority sect, activists said.

The operation risks inflaming already raw sectarian tensions as the 21-month-old revolt against four decades of Assad family rule - during which the president's Alawite sect has dominated leadership of the Sunni Muslim majority - rumbles on.

Opposition sources said rebels had won some territory in the strategic southern town of Morek and were surrounding the Alawite town of al-Tleisia.

They were also planning to take the town of Maan, arguing that the army was present there and in al-Tleisia and was hindering their advance on nearby Morek, a town on the highway that runs from Damascus north to Aleppo, Syria's largest city and another battleground in the conflict.

"The rockets are being fired from there, they are being fired from Maan and al-Tleisia, we have taken two checkpoints in the southern town of Morek. If we want to control it then we need to take Maan," said a rebel captain in Hama rural area, who asked not to be named.

Activists said heavy army shelling had targeted the town of Halfaya, captured by rebels two days earlier. Seven people were killed, 30 were wounded, and dozens of homes were destroyed, said activist Safi al-Hamawi.

Hama is home to dozens of Alawite and Christian villages among Sunni towns, and activists said it may be necessary to lay siege to many minority areas to seize Morek. Rebels want to capture Morek to cut off army supply lines into northern Idlib, a province on the northern border with Turkey where rebels hold swathes of territory.

From an offshoot of Shi'ite Islam, Alawites have largely stood behind Assad, many out of fear of revenge attacks. Christians and some other minorities have claimed neutrality, with a few joining the rebels and a more sizeable portion of them supporting the government out of fear of hardline Islamism that has taken root in some rebel groups.

Activists in Hama said rebels were also surrounding the Christian town of al-Suqeilabiya and might enter the city to take out army positions as well as those of "shabbiha" - pro-Assad militias, the bulk of whom are usually Alawite but can also include Christians and even Sunnis.

"We have been in touch with Christian opposition activists in al-Suqeilabiya and we have told them to stay downstairs or on the lowest floor of their building as possible, and not to go outside. The rebels have promised not to hurt anyone who stays at home," said activist Mousab al-Hamdee, speaking by Skype.

He said he was optimistic that potential sectarian tensions with Christians could be resolved but that Sunni-Alawite strife may be harder to suppress.

SECTARIAN FEARS

U.N. human rights investigators said on Thursday that Syria's conflict was becoming more "overtly sectarian", with more civilians seeking to arm themselves and foreign fighters - mostly Sunnis - flocking in from 29 countries.

"They come from all over, Europe and America, and especially the neighboring countries," said Karen Abuzayd, one of the U.N. investigators, told a news conference in Brussels.

Deeper sectarian divisions may diminish prospects for post-conflict reconciliation even if Assad is ousted, and the influx of foreigners raises the risk of fighting spilling into neighboring countries riven by similar communal fault lines.

Some activists privately voiced concerns of sectarian violence, but the rebel commander in Hama said fighters had been told "violations" would not be tolerated and argued that the move to attack the towns was purely strategic.

"If we are fired at from a Sunni village that is loyal to the regime we go in and we liberate it and clean it," he said. "So should we not do the same when it comes to an Alawite village just because there is a fear of an all-out sectarian war? We respond to the source of fire."

President Vladimir Putin of Russia, Assad's main ally and arms supplier, warned that any solution to the conflict must ensure government and rebel forces do not merely swap roles and fight on forever. It appeared to be his first direct comment on the possibility of a post-Assad Syria.

The West and some Arab states accuse Russia of shielding Assad after Moscow blocked three U.N. Security Council resolutions intended to increase pressure on Damascus to end the violence, which has killed more than 40,000 people. Putin said the Syrian people would ultimately decide their own fate.

Assad's forces have been hitting back at rebel advances with heavy shelling, particularly along the eastern ring of suburbs outside Damascus, where rebels are dominant.

A Syrian security source said the army was planning heavy offensives in northern and central Syria to stem rebel advances, but there was no clear sign of such operations yet.

Rebels seized the Palestinian refugee district of Yarmouk earlier this week, which put them within 3 km (2 miles) of downtown Damascus. Heavy shelling and fighting forced thousands of Palestinian and Syrian residents to flee the Yarmouk area.

Rebels said on Thursday they had negotiated to put the camp - actually a densely packed urban district - back into the hands of pro-opposition Palestinian fighters. There are some 500,000 Palestinian refugees and their descendants living in Syria, and they have been divided by the uprising.

Palestinian factions, some backed by the government and others by the rebels, had begun fighting last week, a development that allowed Syrian insurgents to take the camp.

A resident in Damascus said dozens of families were returning to the camp but that the army had erected checkpoints. Many families were still hesitant to return.

LEBANON BORDER POST TAKEN

Elsewhere, Syrian insurgents took over an isolated border post on the western frontier with Lebanon earlier this week, local residents told Reuters on Thursday.

The rebels already hold much of the terrain along Syria's northern and eastern borders with Turkey and Iraq respectively.

They said around 20 rebels from the Qadissiyah Brigade overran the post at Rankus, which is linked by road to the remote Lebanese village of Tufail.

Video footage downloaded on the Internet on Thursday, dated December 16, showed a handful of fighters dressed in khaki fatigues and wielding rifles as they kicked down a stone barricade around a small, single-storey army checkpoint.

Syrian Interior Minister Ibrahim al-Shaar arrived in Lebanon on Wednesday for treatment of wounds sustained in a bomb attack on his ministry in Damascus a week ago.

Lebanese medical sources said Shaar had shrapnel wounds in his shoulder, stomach and legs but they were not critical.

The Syrian opposition has tried to peel off defectors from the government as well as from the army, though only a handful of high-ranking officials have abandoned Assad.

The conflict has divided many Syrian families. Security forces on Thursday arrested an opposition activist who is also the relative of Vice President Farouq al-Sharaa, the Syrian Observatory said. The man was arrested along with five other activists who are considered pacifists, it said.

Sharaa, a Sunni Muslim who has few powers in Assad's Alawite-dominated power structure, said earlier this week that neither side could win the war in Syria. He called for the formation of a national unity government.

(Reporting by Erika Solomon; Editing by Andrew Osborn)

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Kingfisher shares rise on new licence application

NEW DELHI: Shares in India's grounded Kingfisher Airlines climbed nearly three per cent on Friday on news that the stricken carrier has applied to renew its operating licence.

The move came days after Kingfisher, whose liquor baron owner Vijay Mallya has been desperately seeking investment from foreign carriers, said it aims to resume operations in a "phased manner".

Kingfisher's shares rose to 15.88 rupees in morning trade after regulatory authorities confirmed it had applied Thursday for the licence renewal.

An official said, however, that the application had not included the revival plan that has been demanded by regulators.

"This application needs to be made as their licence is expiring but there can be no (licence) renewal without a revival plan," the official at the Directorate General of Civil Aviation told AFP, asking not to be named.

Kingfisher, once India's second-largest airline by market share, could not be immediately reached for comment but it said on Monday it has come up with a full recapitalisation plan.

The firm has not flown since its planes were grounded in October by an employees' strike over unpaid wages, leading the regulator to suspend its operating licence until it comes up with a "viable" revival formula.

The airline, whose current licence expires on December 31, said last week it was in talks with investors including Abu Dhabi-based Etihad Airways.

But aviation analysts have expressed doubt whether Etihad would be interested in Bangalore-based Kingfisher given its debt load, which is estimated at $2.5 billion by the consultancy firm Centre for Asia Pacific Aviation.

Kingfisher's shares have climbed from an all-time low of 7.05 rupees in August on investor hopes a stake sale will avert a shutdown but they are still trading at a fraction of their record 2007 peak of 334 rupees.

- AFP/il

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CWG scam: Delhi court orders framing of charges against Suresh Kalmadi & others

NEW DELHI: A Delhi court today ordered framing of charges against sacked CWG organising committee chairman Suresh Kalmadi and others for offences of forgery, cheating and conspiracy in a games-related graft case.

Special CBI Judge Talwant Singh passed the order on framing of charges against Kalmadi, former OC secretary general Lalit Bhanot and nine others for illegally awarding a contract to Swiss firm, Swiss Timing Omega, causing huge loss to the exchequer.

The court said "prima facie" charges of cheating, forgery, criminal conspiracy and for offences under the provisions of the Prevention of Corruption Act are made out against eight accused persons and three companies.

"Charges under section 120B (criminal conspiracy), 201 (destruction of evidence), 420 (cheating), 467, 468, 471 (relating to forgery), 506 (criminal intimidation) of the IPC and section 13(1)(d) read with section 13(2) (criminal misconduct by public servants) of the PC Act is ordered to be framed against all the accused," the court said.

"Put up for formally framing of charges on January 10 at 10.30am," the judge said.

The accused have been charge sheeted by the CBI for "illegally" awarding a contract to install Timing, Scoring and Results (TSR) system for the 2010 CWG to Swiss Timing at inflated rates causing a loss of over Rs 90 crore to the public exchequer.

Besides Kalmadi and Bhanot, the other accused in the case are OC's director general V K Verma, director general (procurement) Surjit Lal, Joint director general (sports) ASV Prasad and treasurer M Jayachandran. They are no more associated with the sporting body.

Promoters of two construction companies — P D Arya and A K Madan of Faridabad-based Gem International and A K Reddy of Hyderabad-based AKR Constructions are also accused in the case. Swiss Timing Omega is also an accused in the case.

The CBI had alleged that Kalmadi and others had rejected Spanish firm MSL's much lower bid of Rs 62 crore and awarded the contract to Swiss Timing Omega, causing a loss of over Rs 90 crore to the exchequer.

During the arguments on charges, CBI counsel V K Sharma had argued that Kalmadi and others had decided to award the contract for installing the TSR system for the CWG to Swiss Timing even before the firm had bid for it.

Sharma had also said that for TSR installation, two bids had been received - one from Swiss Timing and other from MSL Spain, and the same were opened on November 4, 2009 but Kalmadi and Verma had announced in a meeting on October 12, 2009 itself that the contract would be given to Swiss Timing.

He had also said Kalmadi had made up his mind in advance to award the contract to the Swiss firm.

Kalmadi's counsel, however, had argued that the facts given in the CBI's charge sheet were contrary to the documents which the agency had filed in the court.

Kalmadi had told the court that he was only doing the work assigned to him as the OC chairman and nothing wrong was done by him in the entire process.

The counsel appearing for other accused had also opposed the allegations levelled against them by the CBI.

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AP IMPACT: Big Pharma cashes in on HGH abuse

An Associated Press investigation shows that a federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico. But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying aging.

An AP analysis of pharmaceutical company data shows that from 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent. During the same period, sales of the average prescription drug rose 12 percent.

Under U.S. law, HGH can only be dispensed for very rare conditions.

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Fiscal Cliff 'Plan B' Is Dead: Now What?

Dec 20, 2012 11:00pm

The defeat of his Plan B — Republicans pulled it when it became clear it would be voted down — is a big defeat for Speaker of the House John Boehner.  It demonstrates definitively that there is no fiscal cliff deal that can pass the House on Republican votes alone.

Boehner could not even muster the votes to pass something that would only allow tax rates on those making more than $1 million to go up.

Boehner’s Plan B ran into opposition from conservative and tea party groups -including Heritage Action, Freedom Works and the Club for Growth – but it became impossible to pass it after Senate Democrats vowed not to take up the bill and the president threatened to veto it.  Conservative Republicans saw no reason to vote for a bill conservative activists opposed – especially if it had no hopes of going anywhere anyway.

Plan B is dead.

Now what?

House Republicans say it is now up to the Senate to act.  Senate Democrats say it is now up to Boehner to reach an agreement with President Obama.

Each side is saying the other must move.

The bottom line:  The only plausible solution is for President Obama and Speaker Boehner to do what they have failed repeatedly to do:  come up with a truly bi-partisan deal.

The prospects look grimmer than ever. It will be interesting to see if the markets react.

SHOWS: This Week

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State Department security chief leaves post over Benghazi

WASHINGTON (Reuters) - The U.S. State Department said on Wednesday its security chief had resigned from his post and three other officials had been relieved of their duties following a scathing official inquiry into the September 11 attack on the U.S. mission in Benghazi.

Eric Boswell has resigned effective immediately as assistant secretary of state for diplomatic security, State Department spokeswoman Victoria Nuland said in a terse statement. A second official, speaking on condition of anonymity, said Boswell had not left the department entirely and remained a career official.

Nuland said that Boswell, and the three other officials, had all been put on administrative leave "pending further action."

An official panel that investigated the incident concluded that the Benghazi mission was completely unprepared to deal with the attack, which killed U.S. Ambassador Christopher Stevens and three other Americans.

The unclassified version of the report, which was released on Tuesday, cited "leadership and management" deficiencies, poor coordination among officials and "real confusion" in Washington and in the field over who had the authority to make decisions on policy and security concerns.

"The ARB identified the performance of four officials, three in the Bureau of the Diplomatic Security and one in the Bureau of (Near Eastern) Affairs," Nuland said in her statement, referring to the panel known as an Accountability Review Board.

Secretary of State Hillary Clinton accepted Boswell's decision to resign effective immediately, the spokeswoman said.

Earlier, a U.S. official who spoke on condition of anonymity said Boswell, one of his deputies, Charlene Lamb, and a third unnamed official has been asked to resign. The Associated Press first reported that three officials had resigned.

PANEL STOPS SHORT OF BLAMING CLINTON

The Benghazi incident appeared likely to tarnish Clinton's four-year tenure as secretary of state but the report did not fault her specifically and the officials who led the review stopped short of blaming her.

"We did conclude that certain State Department bureau-level senior officials in critical positions of authority and responsibility in Washington demonstrated a lack of leadership and management ability appropriate for senior ranks," retired Admiral Michael Mullen, one of the leaders of the inquiry, told reporters on Wednesday.

The panel's chair, retired Ambassador Thomas Pickering, said it had determined that responsibility for security shortcomings in Benghazi belonged at levels lower than Clinton's office.

"We fixed (responsibility) at the assistant secretary level, which is, in our view, the appropriate place to look for where the decision-making in fact takes place, where - if you like - the rubber hits the road," Pickering said after closed-door meetings with congressional committees.

The panel's report and the comments by its two lead authors suggested that Clinton, who accepted responsibility for the incident in a television interview about a month after the Benghazi attack, would not be held personally culpable.

Pickering and Mullen spoke to the media after briefing members of the House of Representatives Foreign Affairs Committee and Senate Foreign Relations Committee behind closed doors on classified elements of their report.

Clinton had been expected to appear at an open hearing on Benghazi on Thursday, but is recuperating after suffering a concussion, dehydration and a stomach bug last week. She will instead be represented by her two top deputies.

Clinton, who intends to step down in January, said in a letter accompanying the review that she would adopt all of its recommendations, which include stepping up security staffing and requesting more money to fortify U.S. facilities.

The National Defense Authorization Act for 2013, which is expected to go to Congress for final approval this week, includes a measure directing the Pentagon to increase the Marine Corps presence at diplomatic facilities by up to 1,000 Marines.

Some Capitol Hill Republicans who had criticized the Obama administration's handling of the Benghazi attacks said they were impressed by the report.

"It was very thorough," said Senator Johnny Isakson. Senator John Barrasso said: "It was very, very critical of major failures at the State Department at very high levels." Both spoke after the closed-door briefing.

Others, however, took a harsher line and called for Clinton to testify as soon as she is able.

"The report makes clear the massive failure of the State Department at all levels, including senior leadership, to take action to protect our government employees abroad," Representative Mike Rogers, the Republican chairman of the House Intelligence Committee, said in a statement.

Senator Bob Corker, who will be the top Republican on the Senate Foreign Relations Committee when the new Congress is seated early next year, said Clinton should testify about Benghazi before her replacement is confirmed by the Senate.

Republicans have focused much of their firepower on U.S. Ambassador to the United Nations Susan Rice, who appeared on TV talk shows after the attack and suggested it was the result of a spontaneous protest rather than a premeditated attack.

The report concluded that there was no such protest.

Rice, widely seen as President Barack Obama's top pick to succeed Clinton, withdrew her name from consideration last week.

(Additional reporting by Tabassum Zakaria and Susan Cornwell; Editing by Christopher Wilson)

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Park Geun-Hye: South Korea's president-elect with history

SEOUL: Park Geun-Hye's historic election victory that will see her installed as South Korea's first woman president of a still male-dominated nation caps a political career founded in privilege and personal tragedy.

One might assume Park's upbringing to be one of privilege, having lived in the presidential Blue House as a child and served there after her mother's murder as first lady to her later-assassinated father.

The Daegu native was just nine years old when her father, Park Chung-Hee, came to power in 1961 in a military coup that set the stage for 18 years of authoritarian rule.

Wednesday's presidential result was, in some ways, a referendum on the legacy of her father whose name still triggers polarised emotions in many South Koreans.

Admired for dragging the war-torn nation out of poverty, but reviled in some quarters for his repression of dissent, his shadow loomed large over Park's election campaign.

Thus, in an effort at reconciliation, Park publicly acknowledged the excesses of her father's regime and apologised to the families of its victims, a move aimed to shed the historic baggage that has plagued her campaign.

"In the shadows of South Korea's rapid growth, there was pain," she said at a news conference held at the Grand National Party's (GNP's) headquarters in Seoul, September 24 earlier this year.

"I deeply apologise to all those who were personally hurt and family members of victims of government abuse."

And like Korea itself, Park was as much the victim of her father's legacy as the beneficiary.

Park was attending graduate school in France in 1974 when she was called back to Seoul after the First Lady Yook Young-soo was killed by a pro-North Korean gunman aiming for her father.

The then 22-year-old took on the duties of her mother and played a sizeable role as the First Lady of Korea, one of which included persuading the 39th US President Jimmy Carter of the importance of the ongoing presence of US troops in Korea when he visited in 1979.

She left the presidential palace after her father was shot dead by his spy chief in 1979 and after a nine-year hiatus finally began her political career in 1998 as an assemblywoman in her home town for the conservative GNP.

The unmarried 60-year-old with no children -- a fact Park used to gain traction with voters tired of corruption scandals surrounding their first families.

"I have no family to take care of and no children to pass wealth to," she said in a televised address on the last day of campaigning, "You, the people, are my family and your happiness is the reason that I stay in politics."

Park's image of a female politician who promised a strong, maternal style of leadership that would steer the country through the challenges of global economic troubles is at odds with that pushed by her critics, an aloof aristocrat they call the "Ice Queen".

But even dissenters acknowledge her strengths as a campaigner that helped her party secure strong results in local and national polls between 2004 and 2006, emerging victorious in all 40 re-elections and by-elections, earning her another royal moniker as the "Queen of Elections".

And despite her privileged upbringing, Park has demonstrated a tough streak.

In 2006, an attacker at an election event where she was speaking slashed her face with a utility knife, leaving an 11-centimetre wound that needed 60 stitches.

Park had previously ran in 2008 to become the presidential nominee for GNP but eventually lost to the now outgoing president Lee Myung-bak by a narrow margin. Park had won the "party member's bid", but she lost the "national bid" which is a larger percentage of the total presidential bid.

Now Park will face numerous challenges when she begins her five-year term in February, not least dealing with a North Korea.

Even before Park won her party's presidential nomination in August, the state-run Korean Central News Agency hat attacked her candidacy, warning that "a dictator's bloodline cannot change away from its viciousness".

Park has signalled a break from outgoing President Lee Myung-Bak's hard line on Pyongyang, and even held out the possibility of an eventual summit with North Korea leader Kim Jong-Un.

But she will be restricted by conservative forces in her party as well as an international community intent on punishing North Korea for its long-range rocket launch last week.

While Park's election as South Korea's first woman president marks a major breakthrough in a male-dominated country, which ranked 108th out of 135 countries in terms of gender equality by the World Economic Forum -- one place below the United Arab Emirates and just above Kuwait.

However, not everyone sees her victory as paving the way for greater women's rights.

Kim Eun-Ju, executive director of the Centre for Korean Women and Politics, believes Park is a female political leader "only in biological terms".

"For the past 15 years, Park has shown little visible effort to help women in politics or anywhere else as a policymaker," Kim told AFP.

-AFP/CNA/fl

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Samajwadi Party MP expresses regret over bill snatching incident: Speaker

NEW DELHI: Samajwadi Party member Yashvir Singh, who had stunned the Lok Sabha yesterday by snatching a copy of the quota bill from minister V Narayanasamy, today expressed regret over the incident.

Lok Sabha Speaker Meira Kumar said the member had expressed regret over the unfortunate incident which had shaken the foundation of democracy.

Kumar said the untoward incident had led to abrupt adjournment of the House yesterday.

"It had shaken the foundation of democracy. Issues should be discussed in the House," the Speaker observed.

Kumar said the member has expressed regret and expected all members to discuss issues in the House.

Singh had snatched the copy of the Constitution (117th Amendment) Bill Narayanasamy.

The incident led to commotion in the House and triggered a war of words outside between the Congress and its ally SP, which is strongly opposed to reservation in promotion for SCs and STs in government jobs.

Parliamentary affairs minister Kamal Nath had said he would urge the Speaker to take action against the SP member.

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