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The WTO’s [TRIPs} Convention on Trade-related Aspects of Intellectual Property establishes standards for protection of [IP] intellectual property applicable to biotechnology; several other WTO agreements also apply to biotechnology related trade disputes. The United Nations Education, Scientific and Cultural Organization has announced the ‘‘possible preparation’’ of an ‘‘international instrument on genetic data’’ and a ‘‘universal instrument on bioethics’’ as a follow-up to its Universal Declaration on the Human Genome and Human Rights (32); it is unclear whether these proposed instruments would be designed as binding international law. Most recently, in December 2001, the United Nations General Assembly established an Ad Hoc Working Group of the Sixth Committee to consider an international treaty to ban reproductive cloning of human beings (20)…International law in biotechnology is thus emerging in a fragmented and amorphous manner in which intergovernmental organizations with overlapping jurisdictions are addressing sector-specific aspects of the genetics revolution in a piecemeal and incomplete manner. The splintered legal process exacerbates uncertainties about the legal regime that governs biotechnology. This is partly because standards adopted under the auspices of different international organizations are being developed in increasingly contradictory ways, including conflicting legal standards related to intellectual property (33, 34). The experience of international lawmaking in biotechnology strongly suggests that the current decentralized organizational framework is ill-equipped to deal with international legal aspects of the massive public health implications of new genetic technologies and other realms of global public health. Taking the agenda forward: WHO and international health law An international health law mandate for WHO: coordination and collective management A larger role for WHO, involving coordination of the international health law enterprise, is essential for rational development and effective implementation of international health law policy.

Given that the Global North is responsible for a majority of the world’s biotechnology innovation and thereby owns most of the intellectual property (“IP”) for these technologies, a fine balance must be achieved between increasing international access to care without deterring essential [R&D]Research & Development investment. The World Health Organization (“WHO”) has created a voluntary patent pool in an attempt to resolve this tension. Known as the COVID-19 Technology Access Pool (“C-TAP”), this effort led by Costa Rica and the WHO aims to leverage collective research and incentivize international cooperation to address the pandemic. The goal of such a patent pool is to bundle multiple pieces of IP together so as to reduce the transaction costs of knowledge sharing on a patent-by-patent basis. Signatory nations to this proposal agree to sharing data, knowledge, and IP surrounding COVID-19 detection, prevention, and treatment. Thus far, 35+ countries have signed, but many of the world’s leading biotechnology innovators (including the US, UK, France, Germany, China, Russia, Canada, and India) have not joined the international effort. Importantly, such a voluntary patent pool is preferable to the pharmaceutical industry relative to a compulsory licensing approach, in which countries could entirely circumvent the patents of innovator pharmaceutical companies and allow domestic generic companies to manufacture and distribute the products.

Humans have fought over food and the means of producing it for 20,000 years, as rock art in Australia shows. Food, water and land scarcity are primary drivers in two thirds of modern conflicts today. Indeed, many people seem to have forgotten that the primary German war aim in World War II was to take farmland from the Soviets and put German farmers on it. It is very likely that controlling the Ukraine’s bountiful and reliable food bowl is among Putin’s main aims also. In the short run this is imposing hunger and even starvation on hundreds of millions of people far beyond Europe. 

Spreading hunger in turn snowballs into government failures, civil wars and refugee tsunamis around the world – as it did in 2008 when a shortfall in Ukrainian grain exports led to revolutions in three Arab countries. Already, a third of a billion people – equal to the entire population of Europe – leave their homes each year, either as refugees or economic migrants, to seek better lives in countries which seem more stable and food secure. War will add to the flood.

Agricultural biotechnology in ensuring global food security New plant breeding techniques (NPBTs) constitute a toolkit of agricultural biotechnology, which are used in the food and agriculture sectors for genetic improvement of plant varieties and animal populations, characterization and conservation of genetic resources, diagnosis of plant and animal diseases, and other purposes. They offer various science-driven approaches to mitigate global food insecurity and the impacts of climate change, both of which are accelerating at an alarming pace. It was estimated nearly a decade ago that global food production must be doubled by 2050 if the needs of the continuously growing human population are to be met. In addition, the COVID-19 pandemic and geopolitical instability have seriously threatened food security worldwide. Farmers can adopt an integrated set of tools, such as biotech crops that are climate-resilient and can better withstand various stresses, including drought, heat, and flooding. To date, 44 countries have granted regulatory approvals to 385 genetic modification events (either stacked or singular traits) for use in food (direct use or additive), covering 24 plant species. The most widely modified plants are maize, cotton, potato, soybean, and Argentine canola. The most widely targeted traits are herbicide tolerance and insect resistance, followed by modified product quality, pollination control system, disease resistance, abiotic stress tolerance, altered growth/yield, and nematode resistance.

Genetically edited crops have the potential to lower both pesticide use and soil damage and reduce greenhouse gas (GHG) emissions. Brookes and Barfoot reported that through the adoption of genetically modified (GM) crops in agriculture, a significant reduction in the total amount of herbicides and pesticides used has been achieved between 1996 and 2018. As a consequence, the environmental impact of these chemicals decreased the Environmental Impact Quotient by 18.5%. Moreover, a considerable reduction in fuel use and tillage practices resulted in a significant reduction in the release of GHG from the GM crop area. In addition, researchers are focusing on designing many traits for conserving water and land, while increasing yields.

1.1 Revisiting the patent thickets of the telecommunications industry

Patent thicket concerns never looked so real as for 5G, which is more complex, patented, and fragmented than older cellular standards. 5G relies on many different technologies, some employed by older generations of standards ensuring backwards compatibility, while others are new, such as a new radio interface, massive multi-input multi-output or heterogeneous cells

Patent pools are the oldest type of patent aggregators. They bundle patents from different owners and license them back to their members, outside implementers or both. Patent pools emerged in the US since the second half of the 19th century to provide freedom- to-operate to contributing members rather than licensing the pooled technologies to non-members. After a period of antitrust hostility in the US beginning in the mid-1900, patent pools gradually re-emerged during the 1980s for audio-visual technologies, such as the CD Audio pool between Philips, Sony and Pioneer. The MPEG-2 patent pool, approved by the US Department of Justice in 1997, set the conditions for modern pools over highly complex and fragmented information communication technology (ICT) stan- dards. After that, several standard-related pools followed, including for disks, audio-video compression, and telecommunication technologies.

The structure of pool is similar. Participation in pools requires agreement on both the internal management of pooled patents and the pool’s licensing terms and conditions. A pool member can be appointed as licensing administrator on behalf of all members, or pool members may entrust specialised entities as independent licensing administrators. By design, independent licensing administrators avoid conflicts of interest between pool members and implementers since their success rests on bringing both market sides aboard through impartial services at market-based prices. Further, pool members can monitor independent administrators with less antitrust suspicion, while these latter do not risk retaliatory infringement lawsuits if suing alleged infringers.

In June 2011, the Supreme Court upheld a $290 million decision against Microsoft and maintained the standard of proof required to invalidate a patent. (Microsoft v. i4i Ltd. Partnership). (The standard of proof is a scale of how convincing the evidence has to be. On the low end is a "preponderance of the evidence." On the high end is "beyond a reasonable doubt." "Clear and convincing" is in between.)

The decision is considered a victory for patent trolls (entities who purchase patents and enforce them even though they don’t [sic] sell or use the patent, themselves also known as nonpracticing entities). Microsoft was sued for patent infringement by i4i, a Canadian company. i4i's pursuit eventually forced Microsoft to disable[remove] an XML feature of Microsoft Word. Microsoft had been offered a chance to license the patent by i4i before the case blew up, but passed, perhaps believing that the patent would be proven invalid.

In recent years, however, a significant cottage industry has grown up around the lucrative patent model of not manufacturing or inventing anything. Instead, certain enterprises merely buy up patents just sitting on someone's shelves, patents that were never - or in actuality could never be - practiced by the so-called inventor, and dust off these patents for the purpose of extorting nuisance settlements from manufacturers of purportedly related goods. 4 These companies ushered in the era of "patent trolls." 5

Like the fiendish figures of Scandinavian folklore living under bridges and never actually building the bridge through trial and error or sweat and toil, but, nonetheless, trying to prevent passersby from crossing it without paying a toll, the patent troll [*411] never conceives of, builds, or makes the alleged invention work. Even so, the patent troll levies those patents against innocent 6 would-be defendants who opt for a settlement in lieu of the exorbitant costs associated with defending against the high-stakes expense of patent litigation. 7

A study from the Perryman Group – an economic and financial analysis firm based in Waco, Texas – confirmed that proposals contained in both the United States Patent and Trademark Office’s (USPTO) Advanced Notice for Proposed Rulemaking (ANPRM) and the PREVAIL Act would impose significant costs on the U.S. economy by making it more difficult to challenge invalid patents at the USPTO.

According to the analysis, if the proposals go into effect, U.S. business activity will decrease by approximately -$482.1 million in gross product, -$230.4 million in personal income, and -2,000 job-years of employment over the next decade. What’s more, the manufacturing sector would be the hardest hit, with a decrease of -$230.1 million in gross product.

Policymakers are scrutinizing high prices for specialty drugs like never before. Gilead’s Sovaldi at $84,000 for a treatment course is in part to blame -- or credit -- for this, but so are Vertex’ Kalydeco, Merck’s Keytruda , and a series of other six figure drugs.

The pharmaceutical industry has responded in a predictable way. High prices are needed to fuel the fire of innovation they explain. True. Absent a potential return, investors would certainly stay far away. But what about the follow on question? Just how high do prices need to be? When does the potential to profit exceed that which is needed to drive innovation and pervert the market?

Big Pharma and their allies have even taken to challenging the Inter Partes Review (IPR) process, an important aspect of the US patent system. The IPR is a procedure conducted by the Patent Trial and Appeal Board within the US Patent and Trademark Office that is an effective tool for weeding out invalid patents. IPR gives the patent office the authority to revisit questionable patents and remove bad ones that should not have been granted in the first place. Often, Big Pharma will write overly broad patents which manage to be granted due to time constraints that limit the examiners ability to carefully review the patent application. IPR helps to ensure that only valid patents are allowed in the market.

Patent reform will be a critical element of any real solution to the problem of rising prescription drug prices in the United States. Streamlining the patent process and strengthening Inter Partes Review as a cost-effective means of challenging bad patents would help to bring generic medications to market and encourage innovations that will benefit patients.

Wall Street's short sellers are beginning to talk about healthcare as the next major threat to the US economy. Costs are so high that the market will have to correct sooner rather than later.Left unchecked, a market-led correction will be brutal. Imagine a parasite living in the US economy, siphoning off the cash that has powered the middle class for decades. We know it's there, but no one - on the right or the left - is talking seriously about how to slow its growth. This parasite is our healthcare system. It is already causing more damage to the economy than you know, and at least one group of people seems to have this figured out: the same Wall Street doomsayers who predicted the financial crisis. Here's what they know, in the broadest terms. Healthcare spending took up , hit 8% in 2014, and then surged to 10% by 2016, according to the . Now of course there are some on Wall Street who see this as a reason to go long, with some companies poised to rake it in as baby boomers age and costly diseases like cancer proliferate. But the crowd I'm talking about is focusing instead on what inefficiencies in pricing are doing to American wallets. They're looking at the bad actors in this healthcare system, the drug companies that are taking a 60-year-old medicine and jacking up the price, the middlemen that inflate costs by inserting themselves between patients and providers. This crowd has noticed that these bad actors are pervasive in our system. So the bet here is simple: America, one way or another, will be forced to confront the parasite that is its healthcare system, and the companies that are using the sleaziest tactics will be picked off first - by prosecutors, lawmakers, insurance companies, or the press - leaving sick customers in the lurch. Short sellers (investors who bet that stocks will go down) are talking about this thesis at conferences and sending it around in their email newsletters. They're learning about scams and picking off weak companies to bet against. They see rising costs as a bubble that will be either gently deflated through federal-government intervention or violently popped by the merciless hand of the market - with a savvy investor making money either way. We have three options for dealing with this problem going forward: We can handle rising cost with good policy and change the way we think about paying for healthcare. We can handle this with bad policy and deliberately shift rising costs to consumers while the government abdicates its responsibility for the health of not only the American people but also the American economy. Or we can do nothing, which would result in more rising costs, more corporate rent-seeking behavior, and ultimately a recession as household resources go toward medicine and treatment instead of new cars, homes, clothes, or toys. The US is hurtling at full speed toward the third option. That's because, at least realistically, to rein in costs. Healthcare costs today make up a sixth of the economy; the Centers for Medicare and Medicaid Services estimate that the share will grow to a fifth in just eight years. Blame Bill and Mike There's an origin story for how Wall Street became aware of the gravity of this situation: Valeant Pharmaceuticals. The company's stock plunged 90% starting in October 2015 after the Street (and prosecutors) became aware of how Valeant was abusing the system to shove expensive drugs down the throat of insurance companies. In other words, Valeant - then under the guidance of CEO Michael Pearson - was the poster child for big pharma's even bigger greed. What's more, no one could ignore it because Wall Street's loudest megaphone, the hedge fund billionaire Bill Ackman, was telling everyone and their mother what a great stock it was. He got in himself, and, like a lot of his peers, he lost his shirt. Now that the dust has settled we know what Ackman, who joined Valeant's board, should have known: Valeant was handing any middleman that stood in the way of getting an insurer to pay for expensive Valeant drugs. It was spending tons of money acquiring and marketing old drugs instead of developing new ones. It used its own pharmacy to push out Valeant drugs at a mind-bending rate as long as insurers would continue to foot the bill. It was finding ways to make copays disappear so customers would never know how much their drugs were costing insurers. These are just some of the games Wall Street learned how to sniff out in big pharma, and once the short sellers on Wall Street could see it, they started to see it everywhere. A few weeks ago I spoke with Andy Slavitt, the man who ran the Affordable Care Act - also known as Obamacare - during the Obama administration, and he briefly touched on how to improve price transparency in healthcare. "It's going to take more than a few tweets from the president to bring real reform," Slavitt said, just before he hung up the phone. "Once pharmaceutical costs reach 25% of Medicare, we're not going to like the choices we'll have to make." We can handle this well First things first: Just because we're not ready to tackle this doesn't mean the market isn't. Wall Street has noticed that the market is pushing payers in a different direction. For one, more costs have shifted to consumers (part of why everyone is so outraged), and instead of our outdated fee-for-service model that pays the industry only when people are very sick, payers are experimenting with bundled payments - structuring payment on the basis of expected costs - and selective points of care. They're also trying to avoid expensive hospitals, sending patients to lower-cost outpatient facilities for common treatments. But this is happening unevenly, and a lot can go wrong. When sick people are involved, the collateral damage of bankrupted companies and panicked executives eyeing falling stock prices can be death. So we should handle this correctly. On top of changing the way we pay for care (and thus incentivize care) we should make drug pricing transparent. We should allow Medicare to negotiate drug prices. We shouldn't allow drug companies to charge Americans a premium and pretend that it's going to research and development [R&D] (). We should change regulations for marketing pharmaceuticals. We should curb the pharma lobby's power. There are glimmers of hope. have passed laws addressing balance billing - when an out-of-network healthcare provider charges you for whatever your insurer didn't pay for. California and other states are trying to ; such companies often take a cut from drug companies and manage plans for insurers, but neither party knows the deal a PBM has cut with the other. It's secret, and it's stupid. Stocks, by the way, are starting to fall on this news: Express Scripts, the largest PBM, has seen its stock price decline by 17% over the past year. (This after one of its biggest clients, the insurer Anthem, sued it in a 2016 lawsuit accusing it of overcharging.) Stock prices for the largest for-profit hospital managers, Tenet Healthcare and Lifepoint, have fallen by 30% and 6% over the past year. The Food and Drug Administration has sped up generic-drug approval, putting pressure on prices. Unfortunately, none of this is enough. It's barely a start. Corruption still abounds, and we've done little to save ourselves from the chaos that could result from more dramatic, disorganized, market-led change. We can handle it badly So far, the healthcare debate in the US has centered on Obamacare - a program that covers about 10% of Americans - and doesn't go far enough in addressing the larger system's incentives. We're embarrassing ourselves. At least, I was embarrassed while watching a meeting of the Senate Health, Education, Labor, and Pensions Committee during the second (or maybe third) attempt to repeal Obamacare. The meeting was about curbing the rising cost of prescription drugs, and most of the Republicans were off doing something useless in secret that eventually they would have to undo clumsily in public. It was a frustrating session. Powerless Democrats listened as experts outlined ways to control costs that seemed fairly simple but are actually fairly insurmountable in our current system in which pharma money talks louder than any congressional expert witness. Sen. Sheldon Whitehouse, a Rhode Island Democrat, sounded exasperated. He said the Senate could solve drug pricing "in a week" if it weren't for the Supreme Court's Citizens United ruling on campaign spending - the pharmaceutical industry has spent billions of dollars lobbying Congress to keep this system opaque. Whitehouse thinks billions might be overkill. "We tend to come cheaper than that," he said, disgusted. Now, perhaps you're saying to yourself, "Linette, Bernie Sanders has a plan." Let me stop you right there. Bernie Sanders has a political pipe dream at best (a political litmus test at worse) that won't pass one chamber of Congress, let alone two. . We can do nothing When I say Wall Street has caught wind of this, I don't mean the whole of it. Some money managers in this market are still howling at the moon, shaking their fists at the Federal Reserve, blaming the distortions caused by low-interest rates for our economy's slow growth. But the economy is weak, in part, because of bad policy in healthcare - policy that has allowed healthcare expenditures to choke the life out of middle-class wallets. On Monday the Federal Reserve Bank of New York released a report saying discretionary consumer spending had finally reached the place it was in 2007. In other words, Americans are finally spending as much on things like dining out and going on vacation as they did in 2007. It's about time. As the New York Fed points out, discretionary spending recovered more slowly than it did in past downturns. One of the reasons for this, we can extrapolate, is the rising cost of nondiscretionary spending in healthcare. In a that unlike "discretionary services, nondiscretionary services expenditures ... fell less during the recent recession than they did in the early 1980s recession, primarily because real health care expenditures held up better in this recession." In other words, healthcare is gobbling up more and more of our paychecks. Even if the government stopped paying for stuff (i.e., we get rid of assistance through programs like Obamacare) someone has to pay for our country's sick. In a service-based economy like the US this matters a lot. The New York Fed thinks that Americans aren't spending because they're saving and that they're saving because they're worried about slow growth going forward. That could be true. But it could also be true that Americans simply don't have the money they used to because out-of-pocket healthcare costs are rising. America is nothing without a growing class of people who buy school supplies for their kids, take vacations to national parks, eat out at restaurants, and do all the things middle-class Americans have done since the 1950s. That's happening less and less, and Wall Street is starting to pinpoint one inescapable, intractable reason - and there's no plan to stop it. When the next recession comes, don't be surprised if healthcare costs are what delivers it.

In addition to advancing the literature on patent quality, our findings have importance for ongoing policy debates. As described in detail infra in Section II.D.3, the continued existence of administrative patent challenges in the United States is uncertain. In both Congress and the courts, opponents of post-grant administrative review have sought to weaken or altogether eliminate existing procedures. At the core of this policy debate is a dispute about whether, on balance, administrative review of issued patents helps or harms innovation. Our results suggest that inter partes review is, on average, eliminating patents with characteristics traditionally associated with "weakness" and, thus, are consistent with arguments that the procedure is functioning as originally intended.

Before joining Expa, I was General Counsel at Kickstarter, the crowdfunding platform. Kickstarter was a place for artists, creators, and entrepreneurs of all kinds to raise funds from their communities to bring their ideas to life. Thousands of restaurants, bookstores, podcasts, gaming companies, and creative spaces got their start on Kickstarter and have been able to sustain themselves through continued funding.

During my time at Kickstarter, we faced five patent troll suits, directed both at Kickstarter and our users. Each of these suits involved low-quality patents, and alleged infringement on the vaguest of terms. We spent more than four years fighting the first of these suits, spending several millions of dollars in total until, eventually, a court ruled that the patent claimed against us was invalid because it attempted to patent an abstract idea. This helped us to establish a precedent of fighting patent troll suits, credibly telling plaintiffs when they tried to come after us that we were prepared to litigate. By doing this, we were able to force them to drop their suits without putting up the tens—or even hundreds—of thousands of dollars that businesses are often forced to pay in order to continue operating under the threat of patent trolls.

A new paper published in the European Journal of Risk Regulation considers the danger from existential terrorism, defined as acts that threaten the existence of humanity. The authors highlight what they term ‘spoiler attacks’ involving AI or other new technology, which might enable a group with limited resources to cause unprecedented destruction.

“I don't expect existential terrorism to be at the top of global agendas, nor do I believe it should be,” Zachary Kallenborn, one of the report’s, authors told me. “But global discourse is clearly changing around existential risk.”

Nuclear terrorism post-cold war: trigger for inadvertent nuclear war?

The possible catalytic effect of nuclear terrorism on the risk of state-based nuclear war is not a simple linkage. The multiple types and scales of nuclear terrorism may affect state-nuclear use decisions along multiple pathways that lead to inadvertent nuclear war. These include:

Although the costs of specific operations may be relatively inexpensive (and even more so for low level attacks), terrorist organizations require much larger budgets to function. Organizations need to devote resources to recruiting new members. If they are operating in failed or sympathetic states, they need funds to build training camps, and sometimes must provide food and housing for their members. Organizations must acquire the equipment necessary for conducting acts Of violence—guns, explosives, triggers, training simulators, as well as fake passports and other travel or identification documents—and communication devices such as phones and computers. They may need to bribe officials to turn a blind eye to their activities. Finally, many groups need funds to pay stipends to their "retired" veterans and the families of dead terrorists or suicide bombers. As a result of these expenses, terrorist groups have budgets that can range up to hundreds of millions of dollars per year, especially for the larger and more active groups. Although the following numbers are just estimates, they are indicative of the overall phenomenon: al-Qaeda's annual budget was estimated to be $30 millions until the 1990s, the Provisional IRA had a budget of up to $15 million per year;6 at its peak the 1 the PKK was thought to have an annual budget of $86 million" Hezbollah's budget is between $100 million and $200 million per year, and may range as high as $400 million* the FARC Colombia has an annual budget of somewhere between around $100 million and $1 billion the Afghan Taliban raises somewhere between $240 million and $360 million per year, 10 and all the different insurgent groups in Iraq collectively raised between $70 million and $200 million per year. Il As these figures demonstrate, the organizations that are responsible for terrorist attacks are much more expensive to operate than is indicated by the cost of any individual attack. Acquiring tens or even hundreds of millions of dollars requires that the organization must pay a certain degree of attention to its own financial portfolio.

The numerous cases of seizures, alerts and recalls of counterfeit medicines in almost all the regions of the world, corroborate the transnational scope of the phenomenon. This huge market and the level of organisation of the counterfeiting network supports the conclusion that counterfeiting is based on complex and sophisticated structures, often set and maintained by organised criminal groups. Counterfeiting is both a very lucrative and relatively low-risk illegal activity. This leads counterfeiters to act in coordinated ways -- adopting market behaviours, sophisticated methods of production and distribution and enter in the logic of industry and massive production. Counterfeiting is an organised criminal activity to the extent that it is depicted as a complicated network where numerous criminals undertake longlasting activities in order to make economic profits. There is serious evidence establishing links between counterfeiting and other forms of organised criminal activities such as drugs production and trafficking, trafficking in persons, arms trafficking and money laundering. The knot of this link is obviously economic benefit.

Criminal organisations are well aware of the economic profitability of counterfeiting medicines. According to the pharmaceutical company Pfizer (a company directly concerned about drugs’ counterfeiting as it manufactures and licences Viagra, one of the most counterfeited medicines worldwide) the difference in profitability when comparing the production of heroin with that of Viagra is remarkable -- namely, the production of 1 kg of heroin has higher costs and lower street value than the respective costs and profit entailed by the production and distribution of 1 kg of Viagra. In one case investigated by the Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom, 100,000 counterfeit pills imported at the price of about 25 pence each were being sold for up to 20 pounds each, thus worth more than 1.6 million pounds in total141.

The growing danger of counterfeit pharmaceuticals is well understood to pose a serious challenge to the health of North Americans (see Box 2), yet public health is not the only consequence of this sinister crime. Counterfeiters also work to evade legitimate taxation and quality controls. They threaten to destroy corporate brands and undermine public confidence in health infrastructures. Perhaps most distressingly, growing evidence suggests that these crimes are increasingly linked to criminal syndicates whose activities range from petty crimes to global terrorism. In short, the lucrative nature of counterfeiting threatens to feed larger and even more insidious criminal and terrorist activities in the United States and around the world.

These concerns go beyond the specious claims that terrorists may use the US drug supply to introduce poisons or biological agents to the homeland. Rather, these criminal entities are using the funds derived from counterfeiting indirectly to support their extremist and often violent activities around the globe. This trend is in keeping with a growing sophistication of terrorists and criminal networks that exploit the forces of globalization, such as a well-developed supply chain, in an effort to support their local, national, and even international operations. Examples in the sphere of proliferation of arms—both weapons of mass destruction and small arms—include individuals such as Viktor Bout and A.Q. Khan, who managed illicit international proliferation networks and shipping arms or materials to build them to the highest bidder worldwide. The increased focus on the counterfeit drugs industry by non-state actors is also a result, in part, of successful international efforts to cut off traditional sources of revenue to terrorist organizations.

Now, the field of medicine is able to achieve seemingly miraculous results, through organ transplantation, reviving patients who have been "clinically" dead, and curing supposedly "incurable diseases." Medical miracles are not cheap, however, and the costs of medical care and drugs have risen (and continue to rise) at a near-astronomical rate. Consequently, neither private medical insurance plans nor Medicare will now cover certain procedures, treatments, and medicines. In the future, with continuing reform of the US healthcare system, even fewer procedures, treatments, and medications might will be covered. Certainly, some medical treatment will be "rationed," and particular categories of people (such as the elderly) may be systematically denied the coverage they need. As a result of all this, medical- and health-related crime and deviance will inevitably rise. Medical insurance, Medicare, and Medicaid fraud, which is already prevalent today, will increase exponentially. Smugglers will "bootleg" ever more pharmaceuticals into the US, and a large, thriving, nationwide black market will develop for those who cannot afford to buy uncovered medications. More medicines and diagnostic equipment will be stolen, and back- street medical procedures using such stolen equipment may well be offered for cash with no questions asked. Armed robberies of valuable pharmaceuticals from drug stores and super- markets will increase, too. Bribery to obtain insurance-uncovered or rationed medical care (or, indeed, any kind of medical care where demand exceeds supply) will likely mushroom. This is actually common in some countries around the world. Counterfeiting expensive pharmaceuticals will be prevalent, and medical frauds of all kinds will be very widespread. Many of these frauds will be directed at the elderly population as it continues to increase in size. The elderly will be particularly vulnerable because they are most likely to be denied coverage for certain medical procedures or treatments. For instance, private health insurance and Medicare will both refuse to cover a woman in her mid-80s for potentially life-saving heart-bypass surgery. As a result, she will be a prime candidate for victimization by medical fraud that offers her affordable, but bogus, treatment. There is already a thriving international black market in human organs (Schepper-Hughes 2009). Kidneys are obtained from poor individuals in impoverished countries for relatively modest sums of money. This cash allows the donors to purchase luxuries, such as a small automobile, educate their children, or simply sustain their families for a few months. The organs are sometimes transferred quickly to a hospital in the donor's own country for transplant surgery. But on other occasions they are transported to the US or another Western country. In the US, obtaining an organ for transplantation in this fashion is illegal. Nevertheless, the practice will undoubtedly increase greatly in the future. Where medical care and medicines become exorbitantly expensive, cheaper ways to obtain them, even when these are illicit, will be sought. Where there are shortages of medical care or medicines, perhaps because of rationing, other means of obtaining them, even if deviant, will surely be employed. As the cost and the difficulty of obtaining medical care and medicines increase, the implications for increased crime and deviance become almost limitless.