Saturday, February 05, 2011

What the White House Isn't Saying by Carl Bernstein

For the past week, a series of realities unstated by the White House or the State Department has driven American diplomacy in regards to the momentous events in Egypt, according to high-level sources familiar with the process.

First and foremost, The United States—in concert increasingly with other governments—is seeking an immediate transition to democratic pluralism and procedures that, simultaneously, will prevent the Muslim Brotherhood from overwhelming or co-opting the process to become the dominant political force in Egypt’s post-Mubarak future.

To accomplish this, President Obama and Secretary of State Hillary Clinton, while sympathetic to the desire of Egyptian democratic forces that want Mubarak step down immediately, in fact have been working toward a solution that would permit him to stay for a brief period as a powerless, defacto head of state.
He would remain as such until new mechanisms, and perhaps a new Egyptian constitution, are in place for a stable transition that would also prevent authoritarian and corrupt Mubarak apparatchiks from controlling the process of succession.

This is particularly true in terms of the speaker of the Egyptian parliament, Fathi Surur, who has been speaker of the People's Assembly since 1990, described by someone familiar with his record as “a corrupt, venal man,” who under the existing constitution would become president of the country if Mubarak should abruptly resign or be removed from office.

Thus, Obama and Clinton, with help from other world leaders, including figures in the Arab world, have been trying to achieve a consensus among prominent Egyptian politicians, academics, bankers, cultural leaders, and representatives of the fledging democracy movement personified by young people in Tahrir Square, that Mubarak should be effectively stripped of his power and convinced to cede his presidential powers while briefly retaining the title of president. Ideally under ths scenario, Mubarak would leave the presidential palace in the next few days, but retain the presidency as a means of keeping it from passing—under the existing constitution—to the Parliamentary speaker, Surur.
State Department officials and anti-Mubarak forces in Egypt consider Surur inimical to the interests of both the United States and advocates of democracy in Egypt, as well as other Arab leaders who fear that further chaos there could feed radical Islamic influence in their own countries.

A powerless but constitutionally present Mubarak--for another few weeks, at least—would be consistent with the intricate dance that the White House and Secretary Clinton have been trying to encourage.

These underlying realities are what have driven the events described in Saturday morning’s New York Times report, that Egypt’s new vice president Omar Suleiman and military leaders have begun discussions to strip Mubarak of his decision-making powers and perhaps have him taken from the presidential palace in Cairo—while still remaining president.
Then, a “transition government” led by Suleiman would begin negotiating with various factions that have opposed Mubarak to amend the constitution, end the “emergency” under which Mubarak has governed with an iron fist since 1981, and draft a series of democratic reforms including rights to assembly, free speech, religious freedom (particularly for Egypt’s million-plus Christians), presidential term limits, and the rules for the next presidential election, scheduled for September.

These same underlying realities explain the urgency of Secretary Clinton’s comments Saturday morning on the need to support Suleiman in brokering agreements with opposition groups while Mubarak remains in office.

Such a solution—a powerless but constitutionally present Mubarak for another few weeks, at least—would be consistent with the intricate dance that the White House and Secretary Clinton have been trying to encourage, according to aides, and one that has prevented them from playing their cards in the open—i.e., from enunciating publicly that one of the primary objectives is to prevent the Brotherhood from walking through the door or power to be ceded to the Speaker of the Parliament. “He is ghastly, and there could be no consensus if he were to govern,” said one American diplomat.
Similarly, there is fear among top players in the national security apparatus in Washington and among democracy advocates in Cairo that if too much authority is claimed by the Egyptian military in formulating a post-Mubarak future, another authoritarian era could ensue.

“Part of the difficulty is the perception that the problems will all be solved if Mubarak simply is pushed out… and resigns,” said a source familiar the American strategy. “Mubarak is already history, but the real issue is how you build a bridge to the future and get a stable outcome that protects democratic principles and gets a decent, participatory system and doesn’t leave the door wide open for the Muslim Brotherhood to walk in. Our focus is a stable outcome where the great mass of responsible Egypt is able to express itself.”

“That’s why you don’t actually want Mubarak to leave right away, though on the surface it might seem the case,” said a source familiar with the U.S. strategy. “What you want to do is have him go off to his home at Sharm el Sheik [a seaside resort], or take one of his medical holidays in Europe. Meanwhile, we are hearing too much from some [American] political scientists blathering that we have nothing to fear from the Muslim brothers. The people saying this are full of shit.”

In the White House, there is hope that, by Monday, the strategy now being discussed sotto vocce in Cairo and Washington will be in place, and that a gathering of prominent politicians, bankers, young democracy advocates and others will meet to sort out the next steps: what kind of constitution, the date that the Mubarak “emergency” will be declared ended—“all the rules of the road ahead,” as an American official put it. “But until then, Mubarak is president, but you don’t hear from him, he’s the umbrella but not the CEO."

Carl Bernstein shared a Pulitzer Prize with Bob Woodward for his coverage of Watergate for The Washington Post

Egypt Officials Seek to Nudge Mubarak Out (Progessive update?)

CAIRO — President Hosni Mubarak appeared increasingly isolated on Friday, as hundreds of thousands of protesters returned to Tahrir Square and the Obama administration and some members of the Egyptian military and civilian elite pursued plans to nudge him from power.

The country’s newly named vice president, Omar Suleiman, and other top military leaders were discussing steps to limit Mr. Mubarak’s decision-making authority and possibly remove him from the presidential palace in Cairo — though not to strip him of his presidency immediately, Egyptian and American officials said. A transitional government headed by Mr. Suleiman would then negotiate with opposition figures to amend Egypt’s Constitution and begin a process of democratic changes.

Administration officials said that among the ideas that had been discussed were suggesting to Mr. Mubarak that he move to his home at Sharm el Sheik, the seaside resort, or that he embark on one of his annual medical leaves to Germany for an extended checkup. Such steps would provide him with a graceful exit and effectively remove him as the central political player, going partway toward addressing a central demand of protesters on the streets of Cairo.

Meanwhile, Mr. Suleiman and top military officers are being encouraged to have detailed discussions with opposition groups, conversations that would ultimately include how to open up the political system, establish term limits for the president and enshrine some key democratic principles ahead of elections scheduled for September.

“None of this can happen if Mubarak is at the center of the process,” said one senior administration official. “But it doesn’t necessarily require the president to leave office right now.”

Opposition leaders, however, have insisted that they will not negotiate with Mr. Suleiman until Mr. Mubarak is out of office. They have been counting on the impact of his resignation, should it occur, to ensure that senior Egyptian officials do not try to derail the movement toward a constitutional democracy.

At a news conference with Prime Minister Stephen Harper of Canada, President Obama said he believed that the Egyptian president had already made a “psychological break” from his hold on office by announcing that he would not run again. Mr. Obama again stopped short of declaring that Mr. Mubarak should leave office sooner, but he set out a series of steps that the Egyptian government must meet to assure an “orderly transition” that seemed to all but require that the Egyptian leader step out of the way, if not resign.

Mr. Mubarak said in an interview Thursday with ABC that he was eager to step down, but that if he did, “Egypt would sink into chaos.”

Leaders of the country’s opposition movements are already warning of the risk of another military-backed president for life if the military elite currently negotiating a transition from Mr. Mubarak were to block broader change.

But several groups of prominent intellectuals and political analysts are pushing plans to endorse an initial transfer of power to Mr. Suleiman, who already appears to be governing in Mr. Mubarak’s place, they said.

“The reality on the ground is that the vice president is the one managing the situation and what we want to do is legalize it,” said Wahid Abdel Neguid, the deputy director of the Al Ahram Center for Political and Strategic Studies and one of the figures working on the plans. “Given the current situation, the president really can’t do anything, not here and not abroad, given the amount of pressure that is on him.”

The groups putting forward the proposal include Nabil Fahmy, former Egyptian ambassador to the United States; Naguib Sawiris, one of the most prominent businessmen in Egypt; Ahmed Kamal Aboul Magd, a lawyer and influential Islamic thinker; and Ahmed Zewail, a Nobel Prize-winning chemist. One group met Friday at the office of Amr Moussa, the head of the Arab League and perhaps the most popular political figure in Egypt.

Mr. Suleiman, a former military officer, appears to share power with two close allies, Field Marshal Mohamed Tantawi, the defense minister, and Ahmed Shafiq, the prime minister, a retired general who previously ran the country’s national airline, said Abdel Moneim Qattou, a retired Army general close to all three.

But the three find themselves squeezed between their loyalties to Mr. Mubarak on one side and the military on the other, Mr. Qattou said. They have been unwilling to push Mr. Mubarak out, he said. But they are also unwilling or unable to deploy the military against the protesters — a move that would cut deeply against its self-image and prestige.

“The three of them are military men,” Mr. Qattou said. “They know each other very well and they are together trying to find a way out of this crisis. They want to do this without spilling blood and without hurting the dignity of Egypt or Mubarak while fulfilling the demands of the masses.”

There appeared to be signs on Friday that the three men may be recalibrating their positions. Mr. Shafiq announced for the first time that the government would make no effort to clear Tahrir Square, allowing the protesters to remain indefinitely.

Field Marshal Tantawi, meanwhile, visited the square himself in the morning to inspect the troops stationed around the Egyptian Museum. It was the first appearance there by any of the country’s top officials, and protesters and military experts took it as a signal to Mr. Mubarak’s plainclothes supporters not to assault the square again.

A cheer rose from the protesters as soon as Field Marshal Tantawi appeared, and they clasped hands to form a barrier around the area where he was walking. Several said they wanted to ensure that no Mubarak-supporting provocateur tried to incite violence.

Mr. Obama repeated twice at his news conference that exactly how the transition would occur is “not a decision ultimately the United States makes or any country outside of Egypt makes.” But he laid out a series of principles that seemed designed to hem Mr. Mubarak in, and reduce his options.

“Going back to the old ways is not going to work,” he said. One official said that these messages were being reinforced in what he called an effort to “flood the zone” with calls to military leaders, members of the Egyptian elite, and legislators. Secretary of Defense Robert M. Gates made another call to his Egyptian counterpart on Friday, part of the effort to assure that the military kept enough peace on the streets for serious discussions with the opposition to begin.

But administration officials remain concerned that removing Mr. Mubarak too early could create constitutional problems that would establish a political void. Under the existing Constitution, the speaker of the Parliament would take power, at least in name, if Mr. Mubarak resigned.

Opposition leaders contend that the existing Constitution so favors the governing party that it should be thrown out immediately and that Parliament, which is dominated by Mr. Mubarak’s party, should be disbanded.

In the opening stages of what promises to be a protracted round of negotiations, the diplomat Mohamed ElBaradei said in a news conference at his home near Cairo that opposition lawyers were preparing an interim Constitution. He said the opposition was calling on Mr. Mubarak to turn over power to a council of two to five members who would run the country until elections within a year.

Only one member would come from the military, Mr. ElBaradei said, adding that the armed forces’ most important task now was to “protect Egypt’s transition period in a smooth manner.”

“We have no interest in retribution,” he said. “Mubarak must leave in dignity and save his country.”

Mohamed el-Beltagui, a leader of the Muslim Brotherhood, the outlawed Islamist group that had been the major opposition in Egypt until the secular youth revolt, said that the organization would not run a candidate in any election to succeed Mr. Mubarak as president.

He said his members wanted to rebut Mr. Mubarak’s argument to the West that his iron-fisted rule was a crucial bulwark against Islamic extremism. “It is not a retreat,” he said in an interview at the group’s informal headquarters in the square. “It is to take away the scare tactics that Hosni Mubarak uses to deceive the people here and abroad that he should stay in power.”

Mr. Beltagui, who represents the Brotherhood on an opposition committee to negotiate a transitional government, said the group wanted a “civil state,” not a religious one. “We are standing for a real democracy, with general freedom and a real sense of social justice.”

Like many others in the square, Mr. Beltagui said he was not worried that the military might back a new dictator to succeed Mr. Mubarak. He said the determination of the protesters would forestall that, and noted that a religious leader who appeared to back away from some of the protesters’ democratic demands was booed from a makeshift stage in Tahrir Square.

Nor was he worried about new violence from Mubarak supporters. “They would be crazy,” he said.

The atmosphere in Tahrir Square reverted from embattled to jubilant. The protesters abandoned their makeshift barriers to chant, pray and sing the national anthem around the center of the square, where newcomers carried in bags of bread and water. Tens of thousands of others demonstrated in Alexandria and Suez.

Enthusiastic cheers rose several times at the appearance of Mr. Moussa, a straight-talking, charismatic foreign minister here in the 1990s whom Mr. Mubarak moved to the less-threatening position as head of the Arab League.

Mohamed Rafah Tahtawy, the public spokesman for Al Azhar — the center of Sunni Muslim learning and Egypt’s highest, state-run religious authority — said he was resigning to join the revolt.

“My position is a position of support to the revolution all the way,” he said. “I am part of it till the last drop of my blood.”

David D. Kirkpatrick reported from Cairo, and David E. Sanger from Washington. Kareem Fahim, Mona El-Naggar and Liam Stack contributed reporting from Cairo.

How Washington Avoids an "Adult Conversation" on the Budget

Politicians in Washington like to talk about talking about the budget deficit. They acknowledge it. They emphasize the importance of talking about it.
They suggest they have strong feelings about it. But when it comes to details, they get vague. Not since Bill Clinton's second term has there been a topic people talk about so much without wanting to be specific.

On Wednesday, senior White House officials offered an example of this phenomenon. They held a briefing for reporters about the president's new energy initiative. Part of his "Win the Future" campaign, there were the requisite new slogans.
The "Better Building Initiative" sets goals for improvements in energy efficiency. "Race to Green" offers grants to state and local governments that make it easier to retrofit buildings to install energy-saving technology. But when asked how much it would all cost, there were no numbers.
The Wall Street Journal's Laura Meckler asked why, since the president's budget--which will be released in two weeks--has been completed. The senior administration officials should know exactly how much the initiatives cost. After all, they are senior.

There were three possible answers to her question: a) We are spending a lot and don't want criticism of how much we're spending to overshadow coverage of the president's exciting new initiative; b) We're spending very little and don't want the headline on the president's exciting new initiative to be "Big Whoop"; or c) We really don't know because we're making this up.

Meckler got d) No answer at all: "There's a lot of information in the budget. It will be out in due course. There'll be plenty of details about these proposals and lots of other proposals when the budget actually comes out." It was a phone briefing, but I imagined lots of waving of senior hands as this was being said.

This is typical, and just one of the ways to stay unspecific about how to reduce the deficit that this year is estimated to be $1.5 trillion. Here are some other ways, ranked in rough order from most embarrassing to most courageous:

Diet Tomorrow: Suggest new programs but don't say how you'll pay for them.

Blue Ribbon Duck: Call for a commission to study the deficit, or entitlement spending, or whatever it is about the budget you don't want to talk about.

Blue Ribbon Dodge: Call for a commission and when it offers suggestions, ignore them. (This is the president's present posture toward his deficit commission.)

Spinach Some Day: Declare that pruning entitlements is necessary but suggest no way to do so.

The Big Empty: Call for a balanced budget amendment or a spending cap, with no specifics about how to implement either.

Fear: Say that any spending reductions beyond those you like will shut down the government.

Lafferable: Declaring that the budget must be shrunk by spending cuts alone.

Fish Story: Boast about tiny cuts that address only a fraction of the problem.

Young Adult: Support a tough deficit commission report even though you don't like some provisions. Sens. Dick Durbin and Tom Coburn did this.

There is one man who likes to get specific about spending cuts. Rep. Paul Ryan, the House budget chairman, is the Kenneth Starr of budgets: When he gets specific about the deficit, even his allies wince. He's got a deficit reduction plan that few of his Republican colleagues will sign on to. The cuts are too big and the changes to programs like Medicare and Social Security are too politically potent. Democrats won't sign on because he doesn't account for lost revenue from tax cuts. ( Rep. Paul Ryan, R-Wis., delivers the GOP response to the State of the Union.

On Thursday, Ryan introduced a smaller version that he says is just the start of a programmatic attack on federal spending. He proposed a $74 billion discretionary reduction for this spending year, the largest single year cut in decades. It included a $16 billion cut in defense spending that Majority Leader Eric Cantor had been telegraphing for weeks.

Ryan has company in his specificity. There are several bipartisan groups of lawmakers. My colleague David Weigel writes about Sens. Claire McCaskill and Bob Corker. Sens. Mark Warner and Saxby Chambliss are also trying to work out budget deficit proposals. There are even hints that the White House is trying to work out a quiet deal on entitlements with Republicans like the secret one they hatched with Minority Leader Mitch McConnell on continuing the Bush tax cuts.

In two weeks the president will offer his own budget, making the conversation more specific. Gauzy deficit talk will continue, of course. But it may turn out to be a lot like the deficit itself: In a few months, we might see a net reduction.

Study: Rise in some cancers linked to oral sex

There's a worrisome uptick in the incidence of certain head and neck cancers among middle-aged and even younger Americans, and some experts link the trend to a rise in the popularity of oral sex over the past few decades.

The silver lining is that the HPV-related head and neck cancers are eminently more treatable than those attributable to smoking or drinking, even though they tend to be diagnosed at a later stage.
That's because the human papillomavirus (HPV) is a major trigger for these cancers, and HPV can be transmitted through this type of sexual activity.

"It seems like a pretty good link that more sexual activity, particularly oral sex, is associated with increased HPV infection," said Dr. Greg Hartig, professor of otolaryngology — head and neck surgery at the University of Wisconsin School of Medicine and Public Health in Madison.

According to Dr. William Lydiatt, professor and chief of head and neck surgical oncology at the University of Nebraska Medical Center in Omaha, the overall incidence of head and neck cancers is going down, largely because fewer people are smoking (tobacco and drinking are the major traditional risk factors).

But the incidence of cancers of the tonsil and base of the tongue have been going up over the past decades, he said. And those are the ones that are more likely to test positive for HPV.

"It's gotten to the point now where 60 to 70% of all tonsil cancers in the U.S. are HPV-related," Lydiatt said.

Although the link between HPV and these types of cancers is indisputable, the association with oral sex is strong but a little more speculative, experts say.

A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime.

In the study, having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer — cancers of the base of the tongue, back of the throat or tonsils. Having 26 or more vaginal-sex partners tripled the risk.

And the association increased as the number of partners — in either category — increased.

The researchers also reported that cancers of the tonsil and base of the tongue have been increasing every year since 1973, and wrote that "widespread oral sex practices among adolescents may be a contributing factor in this increase."

The researchers concluded that in their study, oral sex was "strongly associated" with oropharyngeal cancer, but noted that they could not "rule out transmission through direct mouth-to-mouth contact" such as French kissing.

In 90% of cases of HPV infection in the body, the immune system clears HPV naturally within two years, according to federal health agencies, but in some cases, certain types of HPV can lead to cervical cancer or less common malignancies, such as oropharyngeal cancer. A 2010 Swedish study, in fact, suggested that the rise in oropharyngeal squamous cell cancer in a number of countries "is caused by a slow epidemic of HPV infection-induced (cancers)."

HPV tends to be site specific, explained Dr. Amesh A. Adalja, an adjunct instructor in the division of infectious diseases at the University of Pittsburgh Medical Center. In other words, it tends to stay wherever it first enters the body, be it the vagina (which in some cases could lead to cervical cancer), or the mouth and throat.

So does the increase in incidence mean that recent generations are having more sex than their grandparents?

"The general consensus on the street is that because people's (sexual) practices have changed over time, we're seeing an increase in these cancers," said Hartig. "I don't know why they're having more oral sex (but) the concept of having oral sex is something that seems less obscure to you than it did to your parents or grandparents."

"The thought would be that the baby boomers — the '60s and early '70s generation — probably had more freedom in sexual relationships in general, including oral sex," added Dr. Bert W. O'Malley Jr., chair of otorhinolaryngology — head and neck surgery at the University of Pennsylvania.

And at least in terms of oral sex, that appears true for those younger than boomers.

The U.S. Centers for Disease Control and Prevention (CDC) reports that, in 2002, some 90% of males and 88% of females aged 25 to 44 reported ever having oral sex with a partner of the opposite sex.

Comparable figures from 1992 showed that about three-quarters of men aged 20 to 39 and closer to 70% of women aged 18 to 59 having ever given or received oral sex.

The silver lining is that the HPV-related head and neck cancers are eminently more treatable than those attributable to smoking or drinking, even though they tend to be diagnosed at a later stage.

"(HPV-related head-and-neck cancers) have been a lot easier to treat. You can use less-intensive radiation," said Dr. D.J. Verret, clinical assistant professor at the University of Texas Southwestern Medical School and a facial plastic surgeon in Plano, Texas.

About 85% of non-smoking people with HPV-positive tumors survive. That number drops to 45 or 50% in people who smoke and are HPV-negative, Lydiatt said.

And tongue and tonsil cancers remain relatively rare in the United States. The other good news — at least for the younger set — is that there is a relatively new vaccine to prevent against HPV infection. It's not going to help those who are already infected, but it "absolutely" could help those who aren't yet infected with the ubiquitous virus, Verret said.

Meanwhile, people, especially younger people, need to realize that smoking is not the only risk factor for head and neck cancer. If you find a lump in your neck, even if you're only 20 or 30, "pay attention to it," Lydiatt said.

Amanda Gardner, HealthDay