A debate about medical ethics how much should we spend on expensive treatments especially when there are so new that its not certain bill be as effective as hoped. Im sumi some of gone thats good to have you with us there appears to have been a breakthrough in efforts to secure a truce in the civil war in libya German Foreign minister heikal moss has announced that the powerful rebel leader. Has agreed in principle to abide by a cease fire that the country and its backers are split between 2 rival governments one is in tripoli and that is the seat of the un backed government a led by fire yes also raj and the other here is in tobruk which is the base of the Libyan National army was led by general huffed are germany and the European Union are pushing for stability in libya to help stem the flow of migrants who are making the journey across the mediterranean but its a multilevel conflict and there are no easy solutions or word of another color. Strongman general highly for have wants tripoli. Together with his Libyan National army he hopes to capture the countrys capital and take full control of this oil rich nation. And its partly because of oil that russia and turkey have waded in on either side of this conflict with turkey behind fires alsa rajas un backed government and russia supporting have to. Moscow has denied reports it sent a messenger is to reinforce the generals fighters but on thursday turkey confirmed it had started deploying troops to help in tripoli despite a un arms embargo. With libyas so unstable the fear of resurgent islamist terror has worried many European Countries but other factors mean the e. U. Is split over its alliances. Officially the tripoli based government has the backing of europe including germany but italy has openly supported general hafta who it sees as crucial in stemming the flow of migrants across the mediterranean and frances concerns over terrorism as well as its interests in libyas oil wealth has pushed it towards with the e. U. Sufficient line there are claims its given Covert Military help to general half. Earlier this week peace talks in moscow broke down. Despite the many interests at stake and the players involved germany seems determined to pursue its mediation role. But even if a ceasefire is agreed the road to peace looks long and bumpy. Lets get some analysis on this story now we have all of her detail with us hes the managing director of global strapped thats an International Security and geopolitical Risk Consultancy firm over thank you very much for joining us here in studio 1st of all this question do you think there will actually abide by this cease fire. Of the track record is not very good i mean weve seen course tried to be the main deal brokered between siraj the un backed government after are. Even were after a communique of a cease fire of an agreement Nothing Happened because both sides didnt sign and so we have to make sure that when it comes to well actually sign the piece of paper along with iraq but at the same time. No inkling to basically have a ceasefire is winning on the ground more than before because of the help of the russians of the mercenaries that putin has sent about 2000 people from wagners but at the same time as youve seen turkeys becoming extremely involved in sending also this week 2000 syrian mercenaries so we have the risk of a major escalation between extremely motivated and well trained people who could have a bloodbath in tripoli and thats why the International Community is trying to put an end to this what about the peace conference this weekend here in berlin a lot of people are saying this is such a multilayered conflict the fact that all these sides are coming together to a table to speak including general have to art is in itself a victory and how do you see this it has happened in the past i mean the french and italians were extremely successful to put gold of people around the table but when it came to action Nothing Happened so yes its going to be a p. R. Coup to say look everybody is coming to berlin but at the same time on the ground things are extremely fluid and also you have on both sides patrons are giving the orders we know that in moscow the ceasefire didnt get signed between off because egypt was pushing for after not sign it was a big setback for me or 14 that it didnt happen because hes hes playing both sides russia is playing both sides theyre edging their bets at the same time here in berlin the fact that. America is now getting involved is the 3rd actor if you will within the e. U. That is pushing for this i dont think shell have a miracle recipe that the whole or the italians tried or we hear the German Foreign minister say that if developments in libya are allowed to continue then libya will become the next syria and nobody wants that to. Happen what is at stake on the ground here what are we talking about libya is much more complicated than syria if it can be but it is it is much more dangerous and it has a much closer tie to europe so its a triple they are risk the 1st one being that this war goes on protracted for another 10 years and its a proxy war so you its basically world war 3 by proxy in libya because on one side you have egypt the u. A. E. Saudi arabia friends and russia on the other side you have qatar turkey and russia. The u. S. Was involved at one point in 2016 to get rid of Islamic State so the 2nd risk is Islamic State using this opportunity of the fighting between surat and after to come in and regroup and weve had information this week that about assad and fighters from Islamic State in need to leave syria settled in libya ok so they want to rekindle Islamic State there ok so definitely a lot at stake there managing director of Global Global strat and you so much for joining us here if youre here. Lets check in now on some of the other stories making news around the world irans Supreme Leader ayatollah and how many has addressed the nation during friday prayers for the 1st time since 2012 he called iran strikes against the u. S. In retaliation for the killing of general customs on the money a day of god. Impeachment proceedings against u. S. President donald trump have started with americas top justice sworn in to preside over the trial senators pledge to deliver impartial justice it is only the 3rd impeachment trial in u. S. History trump accused of abusing his office when he pressured ukraine to investigate his democratic rival joe biden. Chinas economy grew last year by 6 point one percent its lowest rate in almost 3 decades its been hit by trade tensions with the u. S. And we consumer demand at home this week beijing and washington signed a pact that will reduce tariffs on u. S. Imports of chinese goods. Now to australia which after 2 weeks of devastating bushfires is now having to cope with the flash floods heavy downpours in the east have suppressed the bushfires at least for the time being but with more rain forecast for the coming days australians are finding themselves moving from one whether driven crisis to another i from flames to flash floods just a week ago stuff of this nature park were protecting their animals from oncoming bushfires now theyre having to deal with another extreme theres the dr who is also saying absolutely inadequate. Never go to the whats coming in the park a wall of water. Starts rushed koalas to safety. Might be. Well for creatures more used to the wet it was more about keeping them in their place. Heavy rain has fallen across New South Wales or of this state. Worst affected by bushfires in the state capital sydney residents were remembering how to use an umbrella the orange hair use that had taken over the citys skyline now. We need a bit of rain in order to help with the prize because how dry it was part of the day and i think it will help with behaves as this push everything out there this is the latest in many many months weve only got about 4 days of right. And a lot run of only children. Well and truly the little stuff very little. For many in the country the wet weather has relief and joy. For more a case of sliding than singing in the rain. That rain has helped the north of the raging bushfires but it does bring with it another set of danger is with the land so dry and vegetation burnt away water just bounces off the ground as firefighters here are well aware changing weather doesnt automatically mean changing fortunes. Youre watching news still to come on our show it is fashion week here in berlin and one its come up with a new way of recycling the jeans yes they are shredded well tell you why. But 1st Pharmaceutical Company novartis has announced that it will use a lottery to supply the worlds most expensive drug to children suffering from a devastating genetic disease called spinal Muscular Atrophy but only 100. 00 Children Worldwide will receive the free treatment which usually costs millions of dollars the astronomical price of such drugs has triggered an ethical debate so michael story sounds like a modern fairy tale but it also poses questions. He was born with spinal Muscular Atrophy a life threatening neuromuscular disease when his condition deteriorated despite treatment his family launched an Online Fundraising campaign. For him to receive a gene therapy thats not yet licensed in europe he actually gets the help he said that he was. The treatment cost almost 2000000 euros professional athletes and celebrities lend their support bowing to pressure from the public the Health Insurance company agreed to pay michael received the most expensive therapy in the world. But that. Only grew through her answer was a miracle that it worked at all then on the 3rd day we had another miracle under that he could turn himself over properly and in the 2nd week he even sat up on his own. The joy i was shared by very many online supporters but there are other opinions about the treatment. Some say not enough tests have been done to guarantee its safety more parents have been demanding access to it Health Authorities are sounding the alarm. This is about our promise so healing this and i really hope its one that will be fulfilled but we still dont know if it will be and so this is a game of hope of one happening outside the normal system would say so its not how we should be doing things then the manufacturer in novartis has issued a statement on its product the decision to implement the therapy must be made by specialized doctors under careful consideration of the risks on an individual basis and we are prepared to offer financial concessions to Insurance Companies. But this Case Highlights another major question in a Public SectorHealth Care System how much may treatment cost many expensive gene therapies are set to gain market approval in the coming years what kind of results justify what kinds of costs at the University Hospital in bonn dr young band meets families who have the prescription that costs 2000000 euros he says it doesnt make sense yet to start prescribing the therapy on a wider scale i think its one of the. Very new kinds of therapies where were not sure how effective or safe they are we need consensus between all parties between specialist doctors experts centers Insurance Companies and licensing authorities only then can we properly decide which patients we should treat with a therapy thats at such an early stage. Michael seems to be doing well so far although no one knows if the 2000000 euro medication has really healed his disease for good still his story shows how vital it is to regulate costly new gene therapy. Oh. A story that raises a lot of questions that were going to talk about with our science reporter Karen Williams and our religious Affairs Correspondent martin good to have you both here in our studio darkened to start with you can you explain how this treatment actually works well this is a completely different kind of treatment than generally comes out of the Pharmaceuticals Industry this is the treatment end of healing a genetic disorder not genetic disorders cause if you have a genetic disorder its down to a faulty gene which isnt producing a particular protein correctly and the lack of that protein can have a greater or lesser impact on your health now what this these kinds of treatments do gene therapy treatments do is they replace that faulty gene with an intact copy of the gene and they do that using viruses they enjoy inject viruses into your body which are able to enter the cells and add themselves to your d. N. A. So that from that point on your cells have an intact copy of the d. N. A. And they can produce the protein properly now so ultimately what that means is that this is at least in theory a one shot treatment that heals and after that your body continues to make the protein properly in your diet and your condition is taken care of and it seemed to be effective at least short term it hasnt been around for that long the question is whether or not it really is going to last forever whether its going to be or if theres going to have to be theyre going to have to be booster shots along the way thats one of the Big Questions actually in this debate right and there are also ethical questions that this gene therapy it raises i mean what do you think the biggest ethical concerns are here i mean one of the biggest issues that we have is that we are facing other misstating illness that affects children intuitively one would see this and immediately sort of you know removed the same time we have a. Drug that costs essentially a small fortune for a bar and or for a country for Health System to actually deploy so i think that at the forefront of the gusher is a question. Access to medicine and access to cures especially in light of new technologies that is a question derek that people are asking specifically of this homicidal company why does this therapy cost so much money well you have to its not its not only novartis its a question of the pharmaceutical industry the Business Model that its based on its not based on giving us one shot treatments that heal us the for all Pharmaceuticals Industry is based around Health Care Management its based around producing drugs that continues to possibly sell you for the rest of your life that will eventually allow them to recoup the cost and compensate them for the work that they put into that into the research and development of that particular drug you cant forget that the research and development for every 10 drugs that are that are that are in testing only one drug will actually make it through to the end in fact the pharmaceutical industry says that each and every drug that gets develops nowadays costs upwards of 2000000000. 00 euros Development Cost before its actually on the market so theres that aspect of it and they say that we have to recoup those costs in order to drive further innovation is that there were sponsibility market well its actually a very good question its one that i dont think can be solved by a Single Person sort of making moral or making scientific claims the one thing that i think we should be warned about particularly because of the heater of from a Studio Company is that the claims about the cost of development should not be taken at face value a few days true that were all being called to participate in essentially supporting the companies that are developing to slave saving cures then it is important that we see that as a matter of fact these are the costs at stake at the very same time there is a 2nd argument that is very usually the blow by buy from a Suitable Companies which is that there are no charges not only they have to recuperate the cost of the relevant but as a matter of fact they are in the business of making money i think that this is sort of a problem that is certainly a major ethical problem with this drug because of the pricing and illness that is a tax but its of questions i think that more broadly put to the pharmaceutical industry i think that children are have been into. Understanding of the fact that we should not be in the business of taking advantage of people in a position of suffering and when we have an industry that pretty creates a Business Model on the idea that bruff it is going to be extracted directly for people that are in a situation of suffering i think that we face mean a 1000000 that they go the limit if in fact we have a moral dilemma for most people they would say there is no the limit although its very clear that this is thrown in this case sorry were talking about dead children to put it in a way that maybe 6 plosive but i mean i really want to conjure the mage so that states the question becomes either a lot more complicated or a lot simpler the ending where you stand well i think the position that is and which is what this field particularly is is really causing us to ask basic fundamental questions about the monetization of health care in general i mean. A pharmaceutical product a medicine thats potentially lifesaving its not a product in the sense that we would think of say an i phone we have to but we still treat it and that way economically and in the Business World its a business its its about making money and the question is is that system has been in place for a very very long time monetizing health care but i think that precision therapies like this one are really going to have to force us to question that as we move forward into the future where this is not the only drug that this is happening with there are 5 that have been approved so far and there are dozens more in the pipeline and theyre all going to want to be charging a couple of 1000000. 00 or a couple of 1000000 euros for a single shot treatment and so the question is how do we deal with that both as a society and as a Public Health care and the Public Health care sector its really doesnt help you know part of this image here that they are now offering 100 free injections of this specific therapy to children are affected but based on a lottery system mean is that the right way to go about it but i think i mean its quite simply no i mean clearly no you know that the basic problem is one that again i think that its mostly intuitive for people that look at it from a certain distance lotteries are against the do. Children are not and when youre actually sort of formulating the deployment of life saving minutes in those terms i mean youre engaging in a pretty sinister game so i mean what youre basically saying is buy the ticket or take the ticket if you get the price your child is safe if not tough luck certainly i think that behind these i have to assume that there is a Good Intention which is actually to the ploy 100 of these cures for free and then of course the question is how we said that we effectively block this resource but in my estimation decide chile is a very good indicator of the very broad them which is if this is going to be presented as something that can only be selectively the ploy but then as a matter of fact its very likely that were not going to one to see 2000000. 00 or thereabout sort of the very year for actually acquiring the drug its actually interesting to just one more quick that the companies that are selling these drugs theyre actually selling them as a cheap alternative to conventional medicines theyre saying conventional medicines to treat the symptoms of the patients that might have this will cost over the course of 10 years 5000000 dollars and were selling it for 2 so its actually a bargain really interesting discussion guys and i think that with us here in studio and Eric Williams thank you both youre welcome. Right lets check in now on some more stories are from around the world ukraines Prime Minister all lexi hunch i took has submitted his resignation in a Facebook Post the said he had offered his resignation to president followed him in said n. Ski the move comes days after hunch out of was caught on tape thing a president you nothing about the economy which i took says according have been doctor yeah more than a 1000 hunter in migrants got through a Police Barrier on the border with what their mala trying to joran hundreds of brothers heading for the Us Press Agency staff reported hundreds of people passing through a Police Cordon without going through migration protocol and japan as than marking the 25th anniversary have a deadly 7. 3 magnitude earthquake that hit the city of koby than 1995 quake an and suing fire killed more than 6000 people in destroyed 7000 homes many of the deaths were blamed on the failure to contain the fire sooner its berlin fashion week a time and place for Young Designers to earned their stripes and theyve been tapping into the mentality and aesthetics of millennial generation xeni which you mean sustainability is increasingly important in their product lines sustainability can be pretty shift some of the environmentally friendly fashions under splay or even run way ready sustainable style has moved on for me crunchy granola looks of the past thats a new you in it the berlin trait figure the for sustainable fashion the focus the is on blair ability and be 6 the berlin label bloops the sure store blood sisters has and sacrifice style in their pursuit of more ecological fashions but changing the industry will take time get my pretty i was both course everything those step by step initially people would say to us youre close we have here trade but youre not using organic conquer still many factoring is slowly catching up weve been working with manufacturers in india in china and are also trying to get them to implement fair working condition its you cant expect them i mediately be able to produce our kennicott. The dutch genes maker is taking a different route with my genes you dont buy the genes you rent them for 7 year olds 50 a month if you return them within a year the jeans are shredded and then recycle. Them again as i can we make new jeans out of old jeans we shred the origins to make yarn i combine with new organic cotton to make the fabric for our new jeans up and. Recycling is the sustainability trend of the new that all balls turned into new handbags. And shoes using renewable materials like cork or to make the big fat souls of these punks cauthen techno coppers recycled plastic. These spanish sneakers will run you 200. 00 euros sustainability doesnt come cheap studies however show that fully a 3rd of all purchased clothes are never even worn so maybe the solution is to buy fewer more expensive clothes that last longer. This is deja vu news these are our top stories German Foreign minister heikal mass says the powerful rebel leader in libya after has agreed in principle to abide by a cease fire the country and its backers are split between 2 rival governments. Irans Supreme LeaderAyatollah Ali Khamenei has agreed to address the nation during friday prayers for the 1st time since 2012 he called irans airstrikes against u. S. Forces in iraq in retaliation for the killing of general custom for the money a day of god. The 100 members of the u. S. Senate have been sworn in to act as jurors in the impeachment trial. President donald trump due to start on tuesday as the articles of impeachment were read out new evidence emerged or further implicating the president over his dealings with ukraine. Heavy downpours in eastern australia have triggered flash flooding in regions previously ravaged by catastrophic bushfires rain has lashed New South Wales one of the states worst affected by the flames. This is day to view news from berlin for more follow us on twitter at t w news or visit our website. Coming up next on Business News chinas economy grows that its lowest rate in decades is its an unjust precedent a 30 year boom coming to an end. Christopher cover has that story and much more coming right up and get your business they chant. Strong opinions clear Musicians International perspectives. The middle east is once again being taken to the brink of war on the back and also has a trump against iran iran against trolls but what about loving me a. Little peacemaker to find out join me in my guests on to the point 44. Point 0000000000 m. 16 members of the w a. Y subscribe to. You know when your books you meet your favorite writer write. To what i write is to share where to find beautiful. Over your books are new to earth home to millions of species a home worth saving. Google ideas tell stories of creative people and innovative projects around the world ideas that protect the climate boost Green Energy Solutions and reforestation. Using interactive content to inspire people to take action global audience the environment series of global 3000 on t w and online. Can i am. Sick closest place to hallams nuisance and skinning kin. And tents does a camp. All night it trains kimi and. You. Nice news and keeping the unfortunate. Well established story. Nikos a. Must. For starts in january 27th on d w. N. The bruises of the trade war china talks of its weakest economic expansion in decades tolerance cooling can the worlds 2nd largest economy take also coming up these sheep are the key to a croatian cull and their delights thats one of the highlights as the worlds biggest i recall troll trade fair gets underway here in berlin and gama and ivory coast are trying to fix cocoa prices to fight farmer poverty for their reports that global charter