BMJ, European group criticize WHO pandemic actions

first_imgJun 4, 2010 (CIDRAP News) – An article published by the British Medical Journal says three scientists who helped frame World Health Organization (WHO) guidance on pandemic influenza preparedness had consulted for pharmaceutical companies that stood to profit from the WHO guidance and that the WHO did not disclose the scientists’ industry ties.The lengthy report, published online yesterday, says the scientists had declared their industry connections in other publications, but the WHO did not reveal them in its guidance document, WHO Guidelines on the Use of Antivirals and Vaccines During an Influenza Pandemic, issued in 2004.The report also raises other questions about the WHO’s transparency and its management of potential conflicts of interest. In particular, it is critical of the WHO’s refusal to reveal the names of the members of its Emergency Committee, which was set up to help guide the WHO response to the H1N1 pandemic, including when to change pandemic alert phases. The secrecy fuels conspiracy theories about issues such as the triggering of vaccine contracts, the article says.In related developments, a committee of the Parliamentary Assembly of the Council of Europe (PACE) today approved a report that denounced the response of the WHO and European national health agencies to the pandemic as an “unjustified scare” that led to a waste of public resources, according to a Council of Europe press release. PACE’s social, health, and family affairs committee approved the report in Paris today, setting the stage for a debate on Jun 24 during PACE’s summer session.The WHO in recent months has repeatedly rejected charges of undue pharmaceutical company influence on its pandemic preparations and response and has said it has appropriate procedures for managing potential conflicts of interest. The agency recently commissioned a group of independent experts to review the WHO response to the pandemic.WHO advisors namedThe BMJ article was written by the journal’s features editor, Deborah Cohen, and Philip Carter, a journalist with the London-based Bureau of Investigative Journalism.The article lists the three experts who helped develop the WHO guidance as Fred Hayden, of the University of Virginia and the Wellcome Trust; Arnold Monto of the University of Michigan, and Karl Nicholson of the University of Leicester, England.Hayden authored the part of the 2004 guidance document dealing with the use of antivirals in a pandemic, the article says. He told the BMJ that he was being paid by Roche, maker of oseltamivir (Tamiflu), for lectures and consulting when the guidance was produced. The guidance advised governments to consider making plans to ensure they would have a supply of antivirals in the event of a pandemic.The article says Monto wrote an annex to the WHO guidance that covered vaccine usage in a pandemic. At the time, he was declaring receiving honorariums, consulting fees, and/or research support form three companies, Roche, GlaxoSmithKline (GSK), and ViroPharma, according to the report.Nicholson wrote another annex, “Pandemic Influenza,” to the WHO guidance, the article says. According to declarations he made in BMJ and The Lancet in 2003, he had received travel funding and honoraria from Roche and GSK for consulting and for speaking at medical conferences.All three experts told the BMJ that the WHO required experts attending agency meetings to complete declarations of interest. But the article adds, “WHO itself did not publicly disclose any of these conflicts of interest when it published the 2004 guidance. It is not known whether information about these conflicts of interest was relayed privately to governments around the world when they were considering the advice contained in the guidelines.”The BMJ writers say they asked the WHO for the conflict-of-interest declarations for the meeting that launched the development of the 2004 guidance document. The request was turned down by WHO Director-General Margaret Chan.Since 2004, according to the BMJ, the WHO has produced additional pandemic guidance prepared by experts who had received payments from manufacturers of antivirals and vaccines. These activities included a global preparedness plan in 2005 and an interim Pandemic Influenza Task Force in 2006.The article also contends that the WHO is inconsistent in its approach to transparency and its management of possible conflicts of interest. While it has kept secret the names of its Emergency Committee members, the names of its Strategic Advisory Group of Experts (SAGE) on Immunization are public knowledge, and the agency publishes summaries of their declarations of interest.Following a Jun 1 meeting of the Emergency Committee, the WHO yesterday announced it would maintain the current phase 6 pandemic alert for the time being. In the announcement, Chan said the agency guards the names of the committee members “to protect the integrity and independence of the members while doing this crucial work,” but promised to reveal them eventually.The agency told the BMJ it protects the names of the Emergency Committee members to shield them from being influenced or targeted by industry.The BMJ article also raises questions about the quality and disclosure of data that led to the licensing of oseltamivir and zanamavir (Relenza) in Europe and the United States, a topic that the journal covered in a review in December. At that time the journal said it couldn’t get access to manufacturer data on the two drugs. Since then, staff members of the US Food and Drug Administration and the European Medicines Agency have said the two agencies struggled with the “paucity” of data on zanamivir and oseltamivir, respectively, during the licensing process, the article says.Call for transparency supportedSteven Miles, MD, a bioethicist at the University of Minnesota Medical School in Minneapolis, said the BMJ article shows that the WHO needs to be more transparent about its advisors’ potential conflicts of interest and the data it relies on.”The bottom line is that the WHO is looked to for health policy by the world community, including many countries which do not have the capacity to evaluate the health policy and technical questions that they turn to the WHO for guidance on,” he said.”For this reason the WHO has to have the strongest possible standard both with regard to managing conflicts of interest and transparency regarding the origins of its recommendations,” he added. “That includes disclosure not only of conflicts of interest bearing on its experts, but also transparency regarding the data they’re relying on.”In this circumstance it appears that neither was present—that there was no disclosure of industry ties of experts, but also that at least some of the data they were relying on was from industry-funded studies which were under proprietary control.”Miles said the fact that the three experts’ connections with industry were known because of their declarations in other publications doesn’t excuse the WHO from listing those ties in its guidance document.’It’s not enough if you disclose in one location if you don’t disclose in all the locations where you publish,” he said. Also, many of the journals in which the experts publish are not open-source journals, so many of the users of WHO guidelines, such as health officials in countries like Thailand or Nepal, would not have access to the publications in which disclosures were made, he added.In defense of the WHOThe WHO was defended today by Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, which publishes CIDRAP News.Osterholm said the WHO needs to rely on leading experts on issues such as antivirals, and such experts will often have some ties to industry. He also said the BMJ writers presented no evidence that the industry connections of its advisors led to any inappropriate actions or recommendations by the WHO.”Over the years there’s been a small group of researchers who have concentrated in antiviral treatment and prevention for flu. Why should it be surprising that they may have worked with drug companies on these drugs?” he said. “To exclude them would be to exclude the universe of expertise.””Today it’s very easy to do science witch hunts or character assassination by inference. There’s no evidence whatever that any of these individuals acted improperly, nor did WHO,” Osterholm added.If the WHO wanted authoritative information on the use of antivirals, he said, “I can’t think of anybody in the world who would know more about it” than Hayden. “Is there any evidence that Fred or anyone like him recommended drugs that benefited him financially?”Osterholm said he is very supportive of transparency and disclosure, while asserting that the WHO has systems in place to prevent conflicts of interest from distorting recommendations or votes. Ultimately, he said, the relevant decisions were made by the WHO itself, not by its expert advisors.Council of Europe reportThe PACE committee report denouncing the pandemic response by the WHO and European governments was produced by committee member Paul Flynn, a Labour member of the British parliament.The Council of Europe, a group separate from the European Union, works on issues such as civil rights, economics, and democracy. The group was established after World War II and is made up of elected officials from 47 nations.The committee’s report charges that there were “grave shortcomings” in the transparency of decision making during the pandemic, which they say raises questions about pharmaceutical industry influence. They questioned why the WHO emergency group and European advisory groups didn’t publicize the names and conflict-of-interest declarations of their members.Fiona Godlee, editor-in-chief of the BMJ, appeared before the committee today to detail the journal’s report that scientists with drug industry ties helped WHO develop guidelines on flu vaccine stockpiling.The PACE committee’s report recommends several measures designed to improve transparency and safeguard against what it says is undue influence. The group also calls for a public fund to support independent research and expert advice, possibly funded by the pharmaceutical industry, and closer collaboration with the media to avoid sensationalistic coverage of public health events.Before and during a PACE committee hearing in January, the WHO defended itself from the accusations. Keiji Fukuda, MD, special advisor on pandemic influenza to the WHO director-general, said the new virus that quickly swept the globe required an unprecedented global cooperation from wide-ranging groups, including pharmaceutical companies.He said the International Health Regulations (IHR) provide an orderly framework for assessing and declaring a pandemic.A pharmaceutical company representative also rejected the committee’s charges at its hearing in January. Dr Luc Hessel, chairman of the European Vaccine Manufacturers Public Health Policy and Advocacy working group, said vaccine companies delivered a safe, effective vaccine in a timely manner, as countries asked them to do, based on the best information they had at the time.He said many governments had preexisting contracts for pandemic vaccine to avoid difficult negotiations and ease the response during a public health emergency. Hessel countered that vaccine companies have shouldered financial risks in advance of the pandemic by expanding production capacity.Several top health officials have defended government and WHO actions in the wake of the PACE committee’s criticisms.  For example, British Heath Secretary Andy Burnham told the House of Commons in January that he would not apologize for preparing to protect the public during a pandemic, and Australia’s chief medical officer, Jim Bishop, in a media report called some of the groups claims “historically and medically inaccurate” and said the WHO made its pandemic decisions based on cases and deaths in Mexico and the United States, not on pharmaceutical industry influence.At the recent World Health Assembly, which wrapped up its work on May 21, representatives from several nations, including France, India, and the United States, also defended the WHO’s pandemic actions, according to media reports. French health minister Roselyne Bachelot called criticism of the WHO’s response unfair.”The vaccine, which was the answer to a real danger, turned into a source of risk in the collective mind,” Bachelot said, according to Agence France-Presse. “The effects of this smear campaign are potentially devastating.”Cohen D, Carter P. Conflicts of interest: WHO and the pandemic flu “conspiracies.” BMJ 2010;340 (published online Jun 3) [Full text]See also:Jun 4 PACE statementJan 14 CIDRAP News story “WHO, vaccine group deny pandemic scare charges”Jan 26 CIDRAP News story “European hearing airs WHO pandemic response, critics’ charges”Jun 3 WHO emergency committee statementlast_img read more

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Home oxygen fire death toll falls

first_imgGet instant access to must-read content today!To access hundreds of features, subscribe today! At a time when the world is forced to go digital more than ever before just to stay connected, discover the in-depth content our subscribers receive every month by subscribing to gasworld.Don’t just stay connected, stay at the forefront – join gasworld and become a subscriber to access all of our must-read content online from just $270. Subscribelast_img

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Canada: Douglas Channel LNG project shelved

first_imgThe Douglas Channel LNG Consortium, led by Canadian AltaGas, said on Thursday it will halt further development of its floating LNG export project in British Columbia due to unfavourable market conditions.The consortium, which includes Japan’s Idemitsu, EDF Trading of France and Exmar of Belgium, had planned to achieve a final investment decision on the small-scale LNG project by the end of 2015.However, the “worsening global energy price levels and a challenging market environment have caused the consortium to withdraw from the project,” Douglas Channel LNG said in a statement.Canadian National Energy Board issued a licence in January to Douglas Channel LNG project to export up to 10.3 billion cubic metres of natural gas per annum for a period of 25 years.The plans for the LNG project included a barge-based 0.55 mtpa LNG facility with natural gas sourced from Western Canada and transported to the project site at District Lot 99, near Kitimat, British Columbia for liquefaction. LNG World News Stafflast_img read more

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What about conservatories in the Part L consultation?

first_imgStay at the forefront of thought leadership with news and analysis from award-winning journalists. Enjoy company features, CEO interviews, architectural reviews, technical project know-how and the latest innovations.Limited access to building.co.ukBreaking industry news as it happensBreaking, daily and weekly e-newsletters Get your free guest access  SIGN UP TODAY Subscribe to Building today and you will benefit from:Unlimited access to all stories including expert analysis and comment from industry leadersOur league tables, cost models and economics dataOur online archive of over 10,000 articlesBuilding magazine digital editionsBuilding magazine print editionsPrinted/digital supplementsSubscribe now for unlimited access.View our subscription options and join our community Subscribe now for unlimited access To continue enjoying Building.co.uk, sign up for free guest accessExisting subscriber? LOGINlast_img read more

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Money where the mouth is

first_imgThe government’s mission to eradicate the UK’s most run-down housing estates by “knocking them down and starting again” took another step last week, with a call to estate regeneration promoters to express their interest in receiving help from the Lord Heseltine-led taskforce set up to drive the initiative.The ambition – to renew the country’s 100 most run-down “sink estates”, as the government terms them – has already proved controversial in relation to its potential social consequence. The prime minister, launching the initiative, made it central to a package of measures he claimed could “end poverty”, evoking a picture of brutal high-rise buildings and dark alleyways haunted by criminals. This bleak image is shamefully in evidence in the architecture of many of the UK’s poorest estates. And as Building reported in January, evidence abounds, too, of the link between run-down, hostile urban environments, and a poverty trap that lays generations of families to waste through a hopeless cycle of low incomes, limited education and low aspiration.But, as we reported then, the picture painted by the government of a fresh regeneration push as a fix to poverty ignores the complexity of the communities it is designed to help. Many contain close-knit social groups, particularly among elderly residents, which offer a source of emotional relief from financial poverty. The question of what happens to these communities as their homes are “knocked down” has so far barely been addressed by the government. Instead, the chair of one lobby group indicated this week, the alarming rhetoric from Whitehall has bulldozed the fear of God into tens of thousands of people.Now, on top of the social consequences, initial fears over the viability of the programme from a developer perspective are also looking increasingly well founded.Some housebuilders, such as Countryside, have welcomed the government’s initiative as offering a potential boost to their regeneration businesses. And it’s easy to see the allure of schemes that, if these regeneration experts navigate their complexities as they have proven they can, will drive a significant premium on selling prices within the developments.This bleak image is shamefully in evidence in the architecture of many of the UK’s poorest estatesBut notwithstanding this, the emerging detail of the support behind the government’s scheme offers little encouragement over the scale of its reach. The £140m seed funding announced by Downing Street – a paltry amount given it is spread over six years and 100 schemes – did at least look to have been supported by a £2.3bn loan package unveiled in the last Autumn Statement, to “help regenerate large council estates” and support “major housing developments”. However, Building was told by the communities department this week that just £290m of that would actually go to estate regeneration – and £150m of that has already been spent. So, we’re back to just the £140m.As well as raising questions over how many schemes can really be kick-started by the government, this funding crunch is also in danger of geographically restricting the projects that can be supported, due to the inescapable conclusion that schemes will need to be largely self-funding. This is possible where there are areas of deprivation close to existing house price hot spots, such as the South-east, but is much less likely elsewhere, as the money made on homes for sale is unlikely to offset the costs of the scheme.So if the government really wants to drive a top down, national regeneration push, it needs to much better co-ordinate its funding and its ambition. It also needs far greater harmonisation of its policies towards affordable housing, given that a significant factor undermining the viability of regeneration schemes is the increased cost its extension of Right to Buy will pass on to councils, who will need to compensate eligible leaseholders on estates before any redevelopment can get off the ground.In the meantime, pockets of regeneration will still happen, and there are other ways in which the housebuilding sector is helping to address the country’s housing problems, such as through developing prototypes for lower cost affordable housing.But there is no escaping the fact that the UK’s failure to provide enough good quality housing for its population is a problem on a national scale. And it’s a problem that will only find a solution when policy co-ordination rather than rhetoric is central to the government’s thinking.Sarah Richardson, editorlast_img read more

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Grenfell calls for urgent action, so why are we still dragging our feet?

first_imgSubscribe to Building today and you will benefit from:Unlimited access to all stories including expert analysis and comment from industry leadersOur league tables, cost models and economics dataOur online archive of over 10,000 articlesBuilding magazine digital editionsBuilding magazine print editionsPrinted/digital supplementsSubscribe now for unlimited access.View our subscription options and join our community Subscribe now for unlimited access Stay at the forefront of thought leadership with news and analysis from award-winning journalists. Enjoy company features, CEO interviews, architectural reviews, technical project know-how and the latest innovations.Limited access to building.co.ukBreaking industry news as it happensBreaking, daily and weekly e-newsletters Get your free guest access  SIGN UP TODAY To continue enjoying Building.co.uk, sign up for free guest accessExisting subscriber? LOGINlast_img read more

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Guidance for law firms collecting diversity data

first_imgThe Law Society has published a guidance note to help firms collect and publish diversity data about their workforces. This year is the first that firms have been required to make their own arrangements. Last year the Solicitors Regulation Authority (SRA) sent out an online questionnaire and collated the responses itself. The guidance note gives details of what data is required, including job status and role as well as age, gender, disability, ethnicity, religion or belief, sexual orientation, socio-economic background and caring responsibilities. It also gives a timetable for publication. All practices regulated by the SRA, including sole practitioners, recognised bodies and alternative business structures, are required to collect, publish and report their workforce diversity data, whilst in-house practices or other bodies not regulated by the SRA are exempt. Data should be delivered online to the SRA by 31 January 2014. Law Society president Lucy Scott-Moncrieff said: ‘It’s important that firms understand the diversity of their own organisations. They can only improve diversity if they know what to target. Complying with regulatory requirements can help firms identify opportunities to develop greater diversity, opening the door to talent they may have been overlooking.’ The data is required under the Legal Services Act to encourage an independent, strong, diverse and effective legal profession. Approved regulators are to collect this data from firms and publish it at aggregate and practice level.last_img read more

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Pannone responds to Slater & Gordon link

first_imgManchester firm Pannone has moved to dampen speculation linking it to an acquisition by Australian-listed firm Slater & Gordon.Reports this morning included open speculation that Slater & Gordon is ready to buy the Deansgate firm.Both parties have admitted they are looking at opportunities to merge with other firms, but insisted the speculation of a deal is premature at this stage.A spokeswoman for Pannone said: ‘We have been linked to many firms over recent years and will always look at opportunities which align with the firm’s strategic aims. However, there is nothing to report on this particular rumour.’In a statement, Neil Kinsella, chief executive of Slater & Gordon UK, said the firm was not in a position to comment on specific reports at this time.‘It’s no secret that we have an ambition to continue to grow our business in the UK, including by acquiring firms who share our values,’ he said.‘At any point in time we are in discussions with a number of firms, but as a publicly listed company if we did have an announcement to make about a potential acquisition of a material nature we would of course first make an announcement to the ASX [Australian Stock Exchange].’Earlier this month Pannone reported a 12% profit rise to £10.4m for the year ending April 2013.Profit per equity partner (PEP) rose 7% to £239,000, compared with £224,200 last year, on turnover down 1.2% to £45.6m.The firm attributed its profit boost to a change in pricing policy as it adapted to the changing legal sector.Pannone has pioneered a group of firms in the north-west dedicated to paralegal apprenticeships, with the course starting this month.The firm also continues to seek new appointments, with five vacancies currently listed on the jobs section of its website.last_img read more

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Prime Minister of Bahamas Extends Hurricane Dorian Exigency Order

first_imgNASSAU, Bahamas, CMC – Prime Minister of Bahamas Dr. Hubert Minnis has announced the extension of an Exigency Order, in the aftermath of Hurricane Dorian, that slammed into the island chain, over a month ago.According to Minnis, the order has been extended to December 31.The order allows for individuals directly impacted by Hurricane to import approved goods, duty-free and VAT (Value added tax) -free, and applies to areas impacted by the storm, including Abaco and the Abaco Cays, Grand Bahama, Sweetings Cay, Deep Water Cay and Water Cay.VAT on fuel for generators will also be waived for areas still without electricity.The Prime Minister made the announcements in the House of Assembly earlier this week, during his wrap up of the debate on amendments to the Disaster Preparedness and Response Act.Minnis said this is yet another step taken by the Government to stimulate economic recovery on the islands of Grand Bahama, Abaco and the Cays, and to encourage residents to return home to begin the rebuilding process in the wake of Hurricane Dorian.He added that the concessions are part of the Government’s reconstruction effort that will require the assistance from many quarters.“The government of The Bahamas invited the international community to assist with the search, rescue, recovery and restoration phases of this disaster response,” said the Prime Minister. “The government’s efforts are in conjunction with the extraordinary efforts of the local private sector, churches, NGOs and individual Bahamians.”The extension to the Exigency Order is the latest concession being put in place to assist residents impacted by Hurricane Dorian.Affected islands have also been designated as Special Economic Recovery Zones for the next three years. This will enable the impacted communities to benefit from a broad range of tax breaks and incentives and allow for the rebuilding of homes and businesses.The special zone features seven key concessions – it allows for the duty-free purchase of all materials, fixtures, furniture, vehicles and equipment for business and residential construction needs. Business license fees for operations within the zone will also be waived.Real Property Tax payable on all eligible properties will be waived once these properties are reconstructed, restored or otherwise made inhabitable by October of 2020.A VAT credit of up to 50 per cent has been extended on the sale of real property, provided that the sale is immediately followed by material construction on, or enhancements to the property, or the utilization of the purchased property to material commercial activity.A one-stop-shop of all key ministries will be equipped and empowered to ensure the resumption of commercial activity in the affected areas.This hub will house representatives of the Small Business Development Centre, the Bahamas Investment Authority, the Ministry of Finance, The Bahamas Investment Authority, The Department of Inland Revenue, The Department of Environmental Health and Building Permits units of the various agencies.A US$10 million loan guarantee and equity financing program has also been established as well as the extension of the Provisional Business License Program to all businesses – with some exceptions.last_img read more

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Serie A faces backlash over anti-racism campaign

first_imgArt can be powerful, but we strongly disagree with the use of monkeys as images in the fight against racism and were surprised by the total lack of consultation. @SerieA_EN pic.twitter.com/M7wFjhsfj2— AC Milan (@acmilan) December 17, 2019Fans also took to social media to express their displeasure with the creations and Serie A’s decision to go ahead with them for the campaign.How in the world does #SerieA think this is okay? It’s an ANTI racist campaign, this shows the opposite. No longer watching or supporting Italian football#BoycottSerieA https://t.co/KFse1y1xCN— Joshua Hoffmann (@jhoff1222) December 17, 2019https://twitter.com/centuryantique/status/1206920080807878656 Serie A CEO Luigi de Siervo and artist Simone Fugazzotto during the unveiling of artworks commissioned as part of the top-flight league’s anti-racism campaign. COURTESY: Lega Serie AItalian football is yet again in the spotlight after artworks commissioned by Serie A for a campaign against racism in football were widely condemned following their release at a press conference on Monday.The artworks, which will be displayed at Serie A headquarters in Milan, are paintings of three monkeys which are supposed to show varying ethnicities, according to the artist, Simone Fugazzotto, who said he has been painting monkeys for five to six years.“I immediately thought to paint a western monkey, an Asian monkey and a black monkey, because I would like to change people’s perceptions by my work,” Fugazzotto said.Fugazzotto said he was present at a match in which Napoli’s Senegalese defender Kalidou Koulibaly was subjected to racist abuse noting that the experience made him feel “humiliated”.“The monkey becomes the spark to teach everyone that there is no difference, there is no man or monkey, we are all alike. If anything we are all monkeys.”Serie A chief executive Luigi De Siervo defended the league’s commitment to tackling racism describing it as strong and concrete.“…we know that racism is an endemic and very complex problem, which we will tackle on three different levels; the cultural one, through works like that of Simone; the sporting one, with a series of initiatives together with clubs and players, and the repressive one, thanks to collaboration with the police.”Italian football has been plagued by several incidents of racist abuse directed towards black players this year such as Inter Milan’s Romelu Lukaku, Brescia’s Mario Balotelli, AC Milan’s Franck Kessie and Fiorentina’s Dalbert Henrique.FIFA President Gianni Infantino has urged Italian football chiefs to take stern action against fans guilty of racist abuse by handing out stadium bans.Fare, an organisation that tackles inequality in football, condemned the creations terming them as counterproductive.Once again Italian football leaves the world speechless. In a country in which the authorities fail to deal with racism week after week #SerieA have launched a campaign that looks like a sick joke. https://t.co/3TwmlVznAW— Fare (@farenet) December 16, 2019Some Italian clubs have publicly criticised the manner in which the campaign against racism was characterised.#ASRoma was very surprised to see what appears to be an anti-racist campaign from Serie A featuring painted monkeys on social media today. We understand the league wants to tackle racism but we don’t believe this is the right way to do it. pic.twitter.com/jVLImrgS0y— AS Roma English (@ASRomaEN) December 16, 2019last_img read more

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