Academic literature on the topic 'US-Jordan FTA'

After Israel and the US entered their free trade agreement in 1985, the parties realized that this FTA could be leveraged to support regional peace by fostering economic cooperation between Israel and its neighbours. The idea was to allow goods produced in certain industrial zones, which resulted in substantial economic cooperation between Israel and the other parties, as qualifying for preferential treatment under the Israel-US FTA. Ultimately, two Qualifying Industrial Zone (QIZ) agreements were signed: one between Israel, the US, and Jordan, and the second between Israel, the US, and Egypt. This article outlines the background and rules of these QIZ agreements within the larger framework of the Israel-US FTA. Israel-US FTA, ‘Qualifying Industrial Zone’ agreements, QIZ, preferential treatment, joint supply chains, substantially transformed, direct processing costs, rules of origin of textiles and apparel, domestic content standards.

AbstractThe value of preferential market access schemes has fallen sharply. Drawing on a relaxation announcement of July 2016 simplifying origin requirements for access to the EU that should help improve market access, thereby contributing to alleviate the refugee crisis in Jordan, this paper argues that a simplification of origin requirements is a straightforward way to enhance preferential market access. Yet, the EU decision limits the beneficiaries who must be located in designated special economic zones, which limits preferential market access. The paper compares the performance of Jordanian exports to the EU and the US under their respective FTAs. It shows that Jordanian exports to the US have grown more rapidly than exports to the EU over the last 15 years. The study documents lower utilisation of preferences in the EU than in the US, especially in Textiles and Apparel (T&A) in spite of non-negligible preferences. Three contributing factors are identified: (i) higher adjusted preferences for apparel in the US than in the EU; (ii) greater competition from other suppliers (mostly from LDCs) in the EU market than in the US market; (iii) simpler origin requirements in the case of the Jordan–US FTA. Comparative evidence from the two FTAs and econometric estimates suggest that this should help restore market access for Jordanian exports to the EU. These estimates provide additional evidence that origin requirements suppress market access. Other pathways to simplify origin requirements are offered in the conclusion.

The world has changed dramatically from the impact of the COVID-19. It has impacted the normality of daily life, highlighting the failure of rich and poor nations alike, which is evident from the high number of human lives lost in rich and powerful countries like the USA with total deaths of 32,735,704 and Europe with 43,708,958 until April 24, 2021, as per Worldometer. The COVID-19 pandemic has shown that all of us ‘have and have-not’, no one can escape from the effects of the lockdowns, disruption of normal life including education, businesses, etc. reminding all of us that equitable access to vaccines is the best possible choice not to further exacerbate the challenges because ‘no country is safe until every country is safe’. It is a remarkable scientific achievement that within a year of the identification of the virus, we have COVID-19 vaccines, albeit available mostly in rich countries. The benefit of research is possible only with solidarity, by sharing the available resources, vaccine included, for the control of the ongoing COVID-19 pandemic. Modern science and technology, including the development and marketing of COVID-19 vaccines, have been focused in the USA and Europe. China joined this club of elites of science following the Chinese FDA approval of Sinopharm (the subsidiary of state-owned China National Pharmaceutical Group- CNPG), first COVID-19 vaccine (inactivated Sars-Cov-2) based on the results of the phase-3 clinical trial in UAE and Bahrain showing up to 86% efficacy of the vaccine in preventing COVID-19. Detail of trials of Sinopharm inactivated COVID-19 vaccines (Vero Cells) available on two early trials in China (Phase I/II ChiCTR2000031809, enrollment 1,456) and later 4 trials outside China (phase III, NCT04510207 Bahrain, Egypt, Jordan, United Arab Emirates- enrollment of 45,000; ChiCTR2000034780 United Arab Emirates, enrollment of 15,000; NCT04612972 Peru, enrollment of 6,000) show the progress of research and approval in China and UAE. Modern science and technology, including the development and marketing of COVID-19 vaccines, have been focused in the USA and Europe. China joined this club of elites of science following the Chinese FDA approval of Sinopharm (the subsidiary of state-owned China National Pharmaceutical Group- CNPG) first COVID-19 vaccine (inactivated Sars-Cov-2) based on the results of the phase-3 clinical trial in UAE and Bahrain showing up to 86% efficacy of the vaccine in preventing COVID-19.3

Abstract Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by overactivation of the immune system due to systemic release of proinflammatory cytokines, especially of interferon gamma (IFNγ), and persistent activation of macrophages/histiocytes and T cells. Emapalumab, a fully human, anti-IFNγ monoclonal antibody that binds to both free and receptor-bound IFNy, neutralizing its biologic activity, was approved by the Food and Drug Administration (FDA) in 2018 for the treatment of adult and pediatric patients with primary HLH with refractory, recurrent or progressive disease or intolerance with conventional HLH therapy. The safety and efficacy of emapalumab was based on results from a pivotal phase 2/3 trial which reported a 63% overall response in patients treated with emapalumab. Since approval, no study has evaluated the use of emapalumab in a larger cohort of patients in the real-world clinical setting. Aim: To assess real-world treatment patterns and outcomes, clinical and demographic characteristics among patients treated with emapalumab. Method: This retrospective, non-interventional, observational medical chart review study will include patients treated across treatment centers in the US with emapalumab in a non-clinical trial setting. The study aims to include more than 100 patients who have been treated with at least one dose of emapalumab between November 20, 2018 and December 31, 2020 (patient identification period). The date that the patient initiates treatment with emapalumab within the patient identification period is defined as the index date. The post-index date is defined as the period from the index date through to the study end date (June 30, 2021), end of data availability for the patient, or date of death, whichever occurs first. Patients will be classified into three groups (i.e. primary HLH, secondary HLH, or non-HLH) based on the information obtained from their charts, the HLH 2004 diagnostic criteria, and adjudication by the REAL-HLH Steering Committee. Results: The primary objective of the study is to describe treatment patterns in patients with HLH treated with emapalumab in a real-world clinical setting, including emapalumab dose, treatment duration, and reasons for initiating or discontinuing treatment. The secondary objectives are to describe demographic and clinical characteristics of patients with HLH treated with emapalumab, and their outcomes. The exploratory objectives include detailing the demographic, clinical characteristics, treatment patterns, and outcomes of patients with non-HLH clinical conditions treated with emapalumab (Table 1). Demographics and clinical characteristics will be analyzed at the time of diagnosis. Treatment patterns and outcomes will be analyzed during the post-index date. Conclusion: The study aims to assess treatment patterns and outcomes, clinical and demographic characteristics among patients treated with emapalumab, a novel IFNγ blocking agent, in real-world clinical settings in the US. Figure 1 Figure 1. Disclosures Allen: Sobi: Consultancy. Leiding: Sobi: Consultancy. Chandrakasan: Sobi: Consultancy. Walkovich: X4 Pharmaceuticals: Other: Local PI for clinical trial involving mavorixafor and patients with neutropenia; Swedish Orphan Biovitrum AB (Sobi): Consultancy, Honoraria; Pharming: Honoraria, Membership on an entity's Board of Directors or advisory committees; Horizon Pharmaceuticals: Honoraria, Membership on an entity's Board of Directors or advisory committees. Oladapo: Sobi: Current Employment. Yee: Sobi: Current Employment. Pednekar: Sobi: Consultancy; PRECISIONheor: Current Employment. Raza: Sobi: Consultancy; PRECISIONheor: Current Employment. Jordan: Sobi: Consultancy.

Objective:Direct acting antivirals (DAA) is a class of antivirals that hasbeen extensively used in chronic hepatitis C virus (HCV) patients over the past 6 years.Despite the excellent therapeutic benefits of DAA, there is a knowledge gap regardingthe safety of this class. Several reports of possible renal toxicity associated with DAAadministration can be found in the literature. The aims of this study are: to assess therenal safety of DAA used for the treatment of chronic HCV infection and to quantify the odds ofdeveloping renaltoxicityin patients withchronicHCV viralinfection. Study Design: Disproportionalityanalysiswasusedtodetectsignalsofpotentialsideeffects. Place andDuration: Amman –Jordan,One year study since September 2017 to march 2018. Methods: The method that was applied in the current study is obtaining the data from United States (US) food and drug administration(FDA)adverseeventreportingsystem(FAERS).DatabetweenJuly,2014andSeptember,2017werecombinedandexplored.Disproportionalityanalysiswasconducted to reports from chronic HCV patients to explore possible association betweenDAA administrationand renalsideeffects. Results: This study showed that a total of 3,837,418 safety reports were available in the period between July,2014 and September, 2017. Patients with chronic HCV infection represent 22,022 cases.When considering all DAA as drug of interest, the use of DAA alone or in combinationwith interferon and/or ribavirin did not increase the risk of having renal side effects.Exploring individual DAA demonstrated a significant association between the incidenceofrenalsideeffectsandtheadministrationoftelapreviranddasabuvir.ConsideringrenalsideeffectsindividuallyshowedasignificantassociationbetweenDAAadministrationand chronickidney disease. Conclusions: In this study, we reported a significant association between DAA administration andchronic kidney disease and between telaprevir or dasabuvir and renal side effect. Thesefindings are used for hypothesis generation rather than testing.

Introduction Medical misinformation and conspiracies have thrived during the current infodemic as a result of the volume of information people have been exposed to during the disease outbreak. Given that SARS-CoV-2 (COVID-19) is a novel coronavirus discovered in 2019, much remains unknown about the disease. Moreover, a considerable amount of what was originally thought to be known has turned out to be inaccurate, incomplete, or based on an obsolete knowledge of the virus. It is in this context of uncertainty and confusion that conspiracies flourish. Michael Golebiewski and danah boyd’s work on ‘data voids’ highlights the ways that actors can work quickly to produce conspiratorial content to fill a void. The data void absent of high-quality data surrounding COVID-19 provides a fertile information environment for conspiracies to prosper (Chou et al.). Conspiracism is the belief that society and social institutions are secretly controlled by a powerful group of corrupt elites (Douglas et al.). Michael Barkun’s typology of conspiracy reveals three components: 1) the belief that nothing happens by accident or coincidence; 2) nothing is as it seems: the "appearance of innocence" is to be suspected; 3) the belief that everything is connected through a hidden pattern. At the heart of conspiracy theories is narrative storytelling, in particular plots involving influential elites secretly colluding to control society (Fenster). Conspiracies following this narrative playbook have flourished during the pandemic. Pharmaceutical corporations profiting from national vaccine rollouts, and the emergency powers given to governments around the world to curb the spread of coronavirus, have led some to cast these powerful commercial and State organisations as nefarious actors – 'big evil' drug companies and the ‘Deep State’ – in conspiratorial narratives. Several drugs believed to be potential treatments for COVID-19 have become entangled with conspiracy. At the start of the pandemic scientists experimented with repurposing existing drugs as potential treatments for COVID-19 because safe and effective vaccines were not yet available. A series of antimicrobials with potential activity against SARS-CoV-2 were tested in clinical trials, including lopinavir/ritonavir, favipiravir and remdesivir (Smith et al.). Only hydroxychloroquine and ivermectin transformed from potential COVID treatments into conspiracy objects. This article traces how the hydroxychloroquine and ivermectin conspiracy theories were amplified in the news media and online. It highlights how debunking processes contribute to amplification effects due to audience segmentation in the current media ecology. We conceive of these amplification and debunking processes as key components of a ‘Conspiracy Course’ (Baker and Maddox), identifying the interrelations and tensions between amplification and debunking practices as a conspiracy develops, particularly through mainstream news, social media and alternative media spaces. We do this in order to understand how medical claims about potential treatments for COVID-19 succumb to conspiracism and how we can intervene in their development and dissemination. In this article we present a commentary on how public discourse and actors surrounding two potential treatments for COVID-19: the anti-malarial drug hydroxychloroquine and the anti-parasitic drug ivermectin became embroiled in conspiracy. We examine public discourse and events surrounding these treatments over a 24-month period from January 2020, when the virus gained global attention, to January 2022, the time this article was submitted. Our analysis is contextually informed by an extended digital ethnography into medical misinformation, which has included social media monitoring and observational digital field work of social media sites, news media, and digital media such as blogs, podcasts, and newsletters. Our analysis focusses on the role that public figures and influencers play in amplifying these conspiracies, as well as their amplification by some wellness influencers, referred to as “alt.health influencers” (Baker), and those affiliated with the Intellectual Dark Web, many of whom occupy status in alternative media spaces. The Intellectual Dark Web (IDW) is a term used to describe an alternative influence network comprised of public intellectuals including the Canadian psychologist Jordan Peterson and the British political commentator Douglas Murray. The term was coined by the American mathematician and podcast host Eric Weinstein, who described the IDW as a group opposed to “the gated institutional narrative” of the mainstream media and the political establishment (Kelsey). As a consequence, many associated with the IDW use alternative media, including podcasts and newsletters, as an "eclectic conversational space" where those intellectual thinkers excluded from mainstream conversational spaces in media, politics, and academia can “have a much easier time talking amongst ourselves” (Kelsey). In his analysis of the IDW, Parks describes these figures as "organic" intellectuals who build identification with their audiences by branding themselves as "reasonable thinkers" and reinforcing dominant narratives of polarisation. Hence, while these influential figures are influencers in so far as they cultivate an online audience as a vocation in exchange for social, economic and political gain, they are distinct from earlier forms of micro-celebrity (Senft; Marwick) in that they do not merely achieve fame on social media among a niche community of followers, but appeal to those disillusioned with the mainstream media and politics. The IDW are contrasted not with mainstream celebrities, as is the case with earlier forms of micro-celebrity (Abidin Internet Celebrity), but with the mainstream media and politics. A public figure, on the other hand, is a “famous person” broadcast in the media. While celebrities are public figures, public figures are not necessarily celebrities; a public figure is ‘a person of great public interest or familiarity’, such as a government official, politician, entrepreneur, celebrity, or athlete. Analysis In what follows we explore the role of influencers and public figures in amplifying the hydroxychloroquine and ivermectin conspiracy theories during the pandemic. As part of this analysis, we consider how debunking processes can further amplify these conspiracies, raising important questions about how to most effectively respond to conspiracies in the current media ecology. Discussions around hydroxychloroquine and ivermectin as potential treatments for COVID-19 emerged in early 2020 at the start of the pandemic when people were desperate for a cure, and safe and effective vaccines for the virus were not yet publicly available. While claims concerning the promising effects of both treatments emerged in the mainstream, the drugs remained experimental COVID treatments and had not yet received widespread acceptance among scientific and medical professionals. Much of the hype around these drugs as COVID “cures” emerged from preprints not yet subject to peer review and scientific studies based on unreliable data, which were retracted due to quality issues (Mehra et al.). Public figures, influencers, and news media organisations played a key role in amplifying these narratives in the mainstream, thereby extending the audience reach of these claims. However, their transformation into conspiracy objects followed different amplification processes for each drug. Hydroxychloroquine, the “Game Changer” Hydroxychloroquine gained public attention on 17 March 2020 when the US tech entrepreneur Elon Musk shared a Google Doc with his 40 million followers on Twitter, proposing “maybe worth considering chloroquine for C19”. Musk’s tweet was liked over 50,200 times and received more than 13,500 retweets. The tweet was followed by several other tweets that day in which Musk shared a series of graphs and a paper alluding to the “potential benefit” of hydroxychloroquine in in vitro and early clinical data. Although Musk is not a medical expert, he is a public figure with status and large online following, which contributed to the hype around hydroxychloroquine as a potential treatment for COVID-19. Following Musk’s comments, search interest in chloroquine soared and mainstream media outlets covered his apparent endorsement of the drug. On 19 March 2020, the Fox News programme Tucker Carlson Tonight cited a study declaring hydroxychloroquine to have a “100% cure rate against coronavirus” (Gautret et al.). Within hours another public figure, the then-US President Donald Trump, announced at a White House Coronavirus Task Force briefing that the FDA would fast-track approval of hydroxychloroquine, a drug used to treat malaria and arthritis, which he said had, “tremendous promise based on the results and other tests”. Despite the Chief Medical Advisor to the President, Dr Anthony Fauci, disputing claims concerning the efficacy of hydroxychloroquine as a potential therapy for coronavirus as “anecdotal evidence”, Trump continued to endorse hydroxychloroquine describing the drug as a “game changer”: HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. He said that the drugs should be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST, and GOD BLESS EVERYONE! Trump’s tweet was shared over 102,800 times and liked over 384,800 times. His statements correlated with a 2000% increase in prescriptions for the anti-malarial drugs hydroxychloroquine and chloroquine in the US between 15 and 21 March 2020, resulting in many lupus patients unable to source the drug. There were also reports of overdoses as individuals sought to self-medicate with the drug to treat the virus. Once Trump declared himself a proponent of hydroxychloroquine, scientific inquiry into the drug was eclipsed by an overtly partisan debate. An analysis by Media Matters found that Fox News had promoted the drug 109 times between 23 and 25 March 2020, with other right wing media outlets following suit. The drug was further amplified and politicised by conservative public figures including Trump’s attorney Rudy Giuliani, who claimed on 27 March 2020 that “hydroxychloroquine has been shown to have a 100% effective rate in treating COVID-19”, and Brazil’s President, Jair Bolsonaro, who shared a Facebook post on 8 July 2020 admitting to taking the drug to treat the virus: “I’m one more person for whom this is working. So I trust hydroxychloroquine”. In addition to these conservative political figures endorsing hydroxychloroquine, on 27 July 2020 the right-wing syndicated news outlet Breitbart livestreamed a video depicting America’s Frontline Doctors – a group of physicians backed by the Tea Party Patriots, a conservative political organisation supportive of Trump – at a press conference outside the US Supreme Court in Washington. In the video, Stella Immanuel, a primary care physician in Texas, said “You don’t need masks…There is prevention and there is a cure!”, explaining that Americans could resume their normal lives by preemptively taking hydroxychloroquine. The video was retweeted by public figures including President Trump and Trump’s son Donald Trump Jr., before going viral reaching over 20 million users on Facebook. The video explicitly framed hydroxychloroquine as an effective “cure” for COVID-19 suppressed by “fake doctors”, thereby transferring it from potential treatment to a conspiracy object. These examples not only demonstrate the role of prominent public figures in amplifying conspiratorial claims about hydroxychloroquine as an effective cure for COVID-19, they reveal how these figures converted the drug into an “article of faith” divorced from scientific evidence. Consequently, to believe in its efficacy as a cure for COVID-19 demonstrated support for Trump and ideological skepticism of the scientific and medical establishment. Ivermectin, the “Miracle Cure” Ivermectin followed a different amplification trajectory. The amplifying process was primarily led by influencers in alternative media spaces and those associated with the IDW, many of whom position themselves in contrast to the mainstream media and politics. Despite scientists conducting clinical trials for ivermectin in early 2020, the ivermectin conspiracy peaked much later that year. On 8 December 2020, the pulmonary and ICU specialist Dr. Pierre Kory testified to the US Senate Committee about I-MASK: a prevention and early outpatient treatment protocol for COVID-19. During the hearing, Kory claimed that “ivermectin is effectively a ‘miracle drug’ against COVID-19”, which could end the pandemic. Kory’s depiction of ivermectin as a panacea, and the subsequent media hype, elevated him as a public figure and led to an increase in public demand for ivermectin in early 2021. This resulted in supply issues and led some people to seek formulations of the drug designed for animals, which were in greater supply and easier to access. Several months later in June 2021, Kory’s description of ivermectin as a “miracle cure” was amplified by a series of influencers, including Bret Weinstein and Joe Rogan, both of whom featured Kory on their podcasts as a key public figure in the fight against COVID Conspiratorial associations with ivermectin were further amplified on 9 July 2021 when Bret Weinstein appeared on Fox Nation's Tucker Carlson Today claiming he had “been censored for raising concerns about the shots and the medical establishment's opposition to alternative treatments”. The drug was embroiled in further controversy on 1 September 2021 when Joe Rogan shared an Instagram post explaining that he had taken ivermectin as one of many drugs to treat the virus. In the months that followed, Rogan featured several controversial scientists on his podcast who implied that ivermectin was an effective COVID “cure” suppressed as part of a global agenda to promote vaccine uptake. These public figures included Dr Robert Malone, an American physician who contributed to the development of mRNA technology, and Dr Peter McCullough, an American cardiologist with expertise in vaccines. As McCullough explained to Rogan in December 2021: it seemed to me early on that there was an intentional very comprehensive suppression of early treatment in order to promote fear, suffering, isolation, hospitalisation and death and it seemed to be completely organised and intentional in order to create acceptance for and then promote mass vaccination. McCullough went on to imply that the pandemic was planned and that vaccine manufacturers were engaged in a coordinated response to profit from mass vaccination. Consequently, whereas conservative public figures, such as Trump and Bolsonaro, played a primary role in amplifying the hype around hydroxychloroquine as a COVID cure and embroiling it in a political and conspiratorial narrative of collusion, influencers, especially those associated with alternative media and the IDW, were crucial in amplifying the ivermectin conspiracy online by platforming controversial scientists who espoused the drug as a “miracle cure”, which could allegedly end the pandemic but was being suppressed by the government and medical establishment. Debunking Debunking processes refuting the efficacy of these drugs as COVID “cures” contributed to the amplification of these conspiracies. In April 2020 the paper endorsing hydroxychloroquine that Trump tweeted about a week earlier was debunked. The debunking process for hydroxychloroquine involved a series of statements, papers, randomised clinical trials and retractions not only rejecting the efficacy of hydroxychloroquine, but suggesting it was unsafe and had the potential to cause harm (Boulware et al.; Mehra; Voss). In April 2020, the FDA released a statement cautioning against the use of hydroxychloroquine for COVID-19 outside of a hospital setting or a clinical trial due to risk of heart rhythm problems, and in June the FDA revoked its emergency use authorisation to treat COVID-19 in certain hospitalised patients. The debunking process was not limited to fact-based claims, it also involved satire and ridicule of those endorsing the drug as a treatment for COVID-19. Given the politicisation of the drug, much of this criticism was directed at Trump, as a key proponent of the drug, and Republicans in general, both of whom were cast as scientifically illiterate. The debunking process for ivermectin was similarly initiated by scientific and medical authorities who questioned the efficacy of ivermectin as a COVID-19 treatment due to reliability issues with trials and the quality of evidence (Lawrence). In response to claims that supply issues led people to seek formulations of the drug designed for animals, in April 2021 the FDA released a statement cautioning people not to take ivermectin to prevent or treat COVID-19: While there are approved uses for ivermectin in people and animals, it is not approved for the prevention or treatment of COVID-19 … . People should never take animal drugs … . Using these products in humans could cause serious harm. The CDC echoed this warning, claiming that “veterinary formulations intended for use in large animals such as horses, sheep, and cattle can be highly concentrated and result in overdoses when used by humans”. Many journalists and Internet users involved in debunking ivermectin reduced the drug to horse paste. Social media feeds debunking ivermectin were filled with memes ridiculing those consuming “horse dewormer”. Mockery of those endorsing ivermectin extended beyond social media, with the popular US sketch comedy show Saturday Night Live featuring a skit mocking Joe Rogan for consuming “horse medicine” to treat the virus. The skit circulated on social media in the following days, further deriding advocates of the drug as a COVID cure as not only irresponsible, but stupid. This type of ridicule, visually expressed in videos and Internet memes, fuelled polarisation. This polarisation was then weaponised by influencers associated with the IDW to sell ivermectin as a “miracle drug” suppressed by the medical and political establishment, thereby embroiling the drug further in conspiracy (Baker and Maddox). This type of opportunistic marketing is not intended for a mass audience. Instead, audiences are taking advantage of what Crystal Abidin refers to as “silosociality”, wherein content is tailored for specific subcommunities, which are not necessarily “accessible” or “legible” to outsiders (Abidin Refracted Publics 4). This dynamic both reflects and reinforces the audience segmentation that occurs in the current media ecology by virtue of alternative media with mockery and ridicule strengthening in- and out-group dynamics. Conclusion In this article we have traced how hydroxychloroquine and ivermectin moved from promising potential COVID-19 treatments to objects tainted by conspiracy. Despite common associations of conspiracy theories with the fringe, both the hydroxychloroquine and ivermectin conspiracy theories emerged in the mainstream, amplified across mainstream social networks with the help of influencers and public figures whose claims were further amplified by the news media commenting on their apparent endorsement of these drugs as COVID cures. Whereas hydroxychloroquine was politicised as a result of controversial public figures and right-wing media outlets endorsing the drug and the conspiratorial narrative espoused by America’s Frontline Doctors, notably much of the conspiracy around ivermectin shifted to alternative media spaces amplified by influencers disillusioned with the mainstream media. We have demonstrated how debunking processes, which sought to discredit these drugs as potential treatments for COVID-19, often ridiculed those who endorsed them, further polarising discussions involving these treatments and pushing advocates to the extreme. By encouraging proponents of these treatments to retreat to alternative media spaces, such as podcasts and newsletters, polarisation strengthened in-group dynamics, assisting the ability for opportunistic influencers to weaponise these conspiracies for social, economic, and political gain. These findings raise important questions about how to effectively counter conspiracies. When debunking not only refutes claims but ridicules advocates, debunking can have unintended consequences by strengthening in-group dynamics and fuelling the legitimacy of conspiratorial narratives. References Abidin, Crystal. Internet Celebrity: Understanding Fame Online. Emerald Group Publishing, 2018. Abidin, Crystal. "From ‘Networked Publics’ to ‘Refracted Publics’: A Companion Framework for Researching ‘below the Radar’ Studies." Social Media + Society 7.1 (2021). Baker, Stephanie Alice. "Alt.Health Influencers: How Wellness Culture and Web Culture Have Been Weaponised to Promote Conspiracy Theories and Far-Right Extremism during the COVID-19 Pandemic." European Journal of Cultural Studies 25.1 (2022): 3-24. Baker, Stephanie Alice, and Alexia Maddox. “COVID-19 Treatment or Miracle 'Cure'?: Tracking the Hydroxychloroquine, Remdesivir and Ivermectin Conspiracies on Social Media.” Paper presented at the BSA Annual Conference 2022: Building Equality and Justice Now, 20-22 April 2022. <https://www.britsoc.co.uk/media/25695/ac2022_draft_conf_prog.pdf>. Barkun, Michael. A Culture of Conspiracy. University of California Press, 2013. Boulware, David R., et al. "A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19." New England Journal of Medicine 383.6 (2020): 517-525. Chou, Wen-Ying Sylvia, Anna Gaysynsky, and Robin C. Vanderpool. "The COVID-19 Misinfodemic: Moving beyond Fact-Checking." Health Education & Behavior 48.1 (2021): 9-13. Douglas, Karen M., et al. "Understanding Conspiracy Theories." Political Psychology 40 (2019): 3-35. Fenster, Mark. Conspiracy Theories: Secrecy and Power in American Culture. University of Minnesota Press, 1999. Gautret, Philippe, et al. "Hydroxychloroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-Label Non-Randomized Clinical Trial." International Journal of Antimicrobial Agents 56.1 (2020): 105949. Golebiewski, Michael, and danah boyd. "Data Voids: Where Missing Data Can Easily Be Exploited." Data & Society (2019). Kelsey, Darren. "Archetypal Populism: The ‘Intellectual Dark Web’ and the ‘Peterson Paradox’." Discursive Approaches to Populism across Disciplines. Cham: Palgrave Macmillan, 2020. 171-198. Lawrence, Jack M., et al. "The Lesson of Ivermectin: Meta-Analyses Based on Summary Data Alone Are Inherently Unreliable." Nature Medicine 27.11 (2021): 1853-1854. Marwick, Alice E. Status Update. Yale University Press, 2013. Mehra, Mandeep R., et al. "RETRACTED: Hydroxychloroquine or Chloroquine with or without a Macrolide for Treatment of COVID-19: A Multinational Registry Analysis." (2020). Parks, Gabriel. "Considering the Purpose of ‘an Alternative Sense-Making Collective’: A Rhetorical Analysis of the Intellectual Dark Web." Southern Communication Journal 85.3 (2020): 178-190. Senft, Theresa M. Camgirls: Celebrity and Community in the Age of Social Networks. Peter Lang, 2008. Smith, Tim, et al. "COVID-19 Drug Therapy." Elsevier (2020). Voss, Andreas. “Official Statement from International Society of Antimicrobial Chemotherapy (ISAC).” International Society of Antimicrobial Chemotherapy 3 Apr. 2020. <https://www.isac.world/news-and-publications/official-isac-statement>.

Introduction Eating is one of the most quintessential activities of human life. Because of this primacy, eating is, as food anthropologist Sidney Mintz has observed, “not merely a biological activity, but a vibrantly cultural activity as well” (48). This article posits that the current awareness of climate change in the Western world is animating such cultural activity as the Slow Food movement and is, as a result, stimulating what could be seen as an evolutionary change in popular foodways. Moreover, this paper suggests that, in line with modelling provided by the Slow Food example, an increased awareness of the connections of climate change to the social injustices of food production might better drive social change in such areas. This discussion begins by proposing that contemporary foodways—defined as “not only what is eaten by a particular group of people but also the variety of customs, beliefs and practices surrounding the production, preparation and presentation of food” (Davey 182)—are changing in the West in relation to current concerns about climate change. Such modification has a long history. Since long before the inception of modern Homo sapiens, natural climate change has been a crucial element driving hominidae evolution, both biologically and culturally in terms of social organisation and behaviours. Macroevolutionary theory suggests evolution can dramatically accelerate in response to rapid shifts in an organism’s environment, followed by slow to long periods of stasis once a new level of sustainability has been achieved (Gould and Eldredge). There is evidence that ancient climate change has also dramatically affected the rate and course of cultural evolution. Recent work suggests that the end of the last ice age drove the cultural innovation of animal and plant domestication in the Middle East (Zeder), not only due to warmer temperatures and increased rainfall, but also to a higher level of atmospheric carbon dioxide which made agriculture increasingly viable (McCorriston and Hole, cited in Zeder). Megadroughts during the Paleolithic might well have been stimulating factors behind the migration of hominid populations out of Africa and across Asia (Scholz et al). Thus, it is hardly surprising that modern anthropogenically induced global warming—in all its’ climate altering manifestations—may be driving a new wave of cultural change and even evolution in the West as we seek a sustainable homeostatic equilibrium with the environment of the future. In 1962, Rachel Carson’s Silent Spring exposed some of the threats that modern industrial agriculture poses to environmental sustainability. This prompted a public debate from which the modern environmental movement arose and, with it, an expanding awareness and attendant anxiety about the safety and nutritional quality of contemporary foods, especially those that are grown with chemical pesticides and fertilizers and/or are highly processed. This environmental consciousness led to some modification in eating habits, manifest by some embracing wholefood and vegetarian dietary regimes (or elements of them). Most recently, a widespread awareness of climate change has forced rapid change in contemporary Western foodways, while in other climate related areas of socio-political and economic significance such as energy production and usage, there is little evidence of real acceleration of change. Ongoing research into the effects of this expanding environmental consciousness continues in various disciplinary contexts such as geography (Eshel and Martin) and health (McMichael et al). In food studies, Vileisis has proposed that the 1970s environmental movement’s challenge to the polluting practices of industrial agri-food production, concurrent with the women’s movement (asserting women’s right to know about everything, including food production), has led to both cooks and eaters becoming increasingly knowledgeable about the links between agricultural production and consumer and environmental health, as well as the various social justice issues involved. As a direct result of such awareness, alternatives to the industrialised, global food system are now emerging (Kloppenberg et al.). The Slow Food (R)evolution The tenets of the Slow Food movement, now some two decades old, are today synergetic with the growing consternation about climate change. In 1983, Carlo Petrini formed the Italian non-profit food and wine association Arcigola and, in 1986, founded Slow Food as a response to the opening of a McDonalds in Rome. From these humble beginnings, which were then unashamedly positing a return to the food systems of the past, Slow Food has grown into a global organisation that has much more future focused objectives animating its challenges to the socio-cultural and environmental costs of industrial food. Slow Food does have some elements that could be classed as reactionary and, therefore, the opposite of evolutionary. In response to the increasing homogenisation of culinary habits around the world, for instance, Slow Food’s Foundation for Biodiversity has established the Ark of Taste, which expands upon the idea of a seed bank to preserve not only varieties of food but also local and artisanal culinary traditions. In this, the Ark aims to save foods and food products “threatened by industrial standardization, hygiene laws, the regulations of large-scale distribution and environmental damage” (SFFB). Slow Food International’s overarching goals and activities, however, extend far beyond the preservation of past foodways, extending to the sponsoring of events and activities that are attempting to create new cuisine narratives for contemporary consumers who have an appetite for such innovation. Such events as the Salone del Gusto (Salon of Taste) and Terra Madre (Mother Earth) held in Turin every two years, for example, while celebrating culinary traditions, also focus on contemporary artisanal foods and sustainable food production processes that incorporate the most current of agricultural knowledge and new technologies into this production. Attendees at these events are also driven by both an interest in tradition, and their own very current concerns with health, personal satisfaction and environmental sustainability, to change their consumer behavior through an expanded self-awareness of the consequences of their individual lifestyle choices. Such events have, in turn, inspired such events in other locations, moving Slow Food from local to global relevance, and affecting the intellectual evolution of foodway cultures far beyond its headquarters in Bra in Northern Italy. This includes in the developing world, where millions of farmers continue to follow many traditional agricultural practices by necessity. Slow Food Movement’s forward-looking values are codified in the International Commission on the Future of Food and Agriculture 2006 publication, Manifesto on the Future of Food. This calls for changes to the World Trade Organisation’s rules that promote the globalisation of agri-food production as a direct response to the “climate change [which] threatens to undermine the entire natural basis of ecologically benign agriculture and food preparation, bringing the likelihood of catastrophic outcomes in the near future” (ICFFA 8). It does not call, however, for a complete return to past methods. To further such foodway awareness and evolution, Petrini founded the University of Gastronomic Sciences at Slow Food’s headquarters in 2004. The university offers programs that are analogous with the Slow Food’s overall aim of forging sustainable partnerships between the best of old and new practice: to, in the organisation’s own words, “maintain an organic relationship between gastronomy and agricultural science” (UNISG). In 2004, Slow Food had over sixty thousand members in forty-five countries (Paxson 15), with major events now held each year in many of these countries and membership continuing to grow apace. One of the frequently cited successes of the Slow Food movement is in relation to the tomato. Until recently, supermarkets stocked only a few mass-produced hybrids. These cultivars were bred for their disease resistance, ease of handling, tolerance to artificial ripening techniques, and display consistency, rather than any culinary values such as taste, aroma, texture or variety. In contrast, the vine ripened, ‘farmer’s market’ tomato has become the symbol of an “eco-gastronomically” sustainable, local and humanistic system of food production (Jordan) which melds the best of the past practice with the most up-to-date knowledge regarding such farming matters as water conservation. Although the term ‘heirloom’ is widely used in relation to these tomatoes, there is a distinctively contemporary edge to the way they are produced and consumed (Jordan), and they are, along with other organic and local produce, increasingly available in even the largest supermarket chains. Instead of a wholesale embrace of the past, it is the connection to, and the maintenance of that connection with, the processes of production and, hence, to the environment as a whole, which is the animating premise of the Slow Food movement. ‘Slow’ thus creates a gestalt in which individuals integrate their lifestyles with all levels of the food production cycle and, hence to the environment and, importantly, the inherently related social justice issues. ‘Slow’ approaches emphasise how the accelerated pace of contemporary life has weakened these connections, while offering a path to the restoration of a sense of connectivity to the full cycle of life and its relation to place, nature and climate. In this, the Slow path demands that every consumer takes responsibility for all components of his/her existence—a responsibility that includes becoming cognisant of the full story behind each of the products that are consumed in that life. The Slow movement is not, however, a regime of abstention or self-denial. Instead, the changes in lifestyle necessary to support responsible sustainability, and the sensual and aesthetic pleasure inherent in such a lifestyle, exist in a mutually reinforcing relationship (Pietrykowski 2004). This positive feedback loop enhances the potential for promoting real and long-term evolution in social and cultural behaviour. Indeed, the Slow zeitgeist now informs many areas of contemporary culture, with Slow Travel, Homes, Design, Management, Leadership and Education, and even Slow Email, Exercise, Shopping and Sex attracting adherents. Mainstreaming Concern with Ethical Food Production The role of the media in “forming our consciousness—what we think, how we think, and what we think about” (Cunningham and Turner 12)—is self-evident. It is, therefore, revealing in relation to the above outlined changes that even the most functional cookbooks and cookery magazines (those dedicated to practical information such as recipes and instructional technique) in Western countries such as the USA, UK and Australian are increasingly reflecting and promoting an awareness of ethical food production as part of this cultural change in food habits. While such texts have largely been considered as useful but socio-politically relatively banal publications, they are beginning to be recognised as a valid source of historical and cultural information (Nussel). Cookbooks and cookery magazines commonly include discussion of a surprising range of issues around food production and consumption including sustainable and ethical agricultural methods, biodiversity, genetic modification and food miles. In this context, they indicate how rapidly the recent evolution of foodways has been absorbed into mainstream practice. Much of such food related media content is, at the same time, closely identified with celebrity mass marketing and embodied in the television chef with his or her range of branded products including their syndicated articles and cookbooks. This commercial symbiosis makes each such cuisine-related article in a food or women’s magazine or cookbook, in essence, an advertorial for a celebrity chef and their named products. Yet, at the same time, a number of these mass media food celebrities are raising public discussion that is leading to consequent action around important issues linked to climate change, social justice and the environment. An example is Jamie Oliver’s efforts to influence public behaviour and government policy, a number of which have gained considerable traction. Oliver’s 2004 exposure of the poor quality of school lunches in Britain (see Jamie’s School Dinners), for instance, caused public outrage and pressured the British government to commit considerable extra funding to these programs. A recent study by Essex University has, moreover, found that the academic performance of 11-year-old pupils eating Oliver’s meals improved, while absenteeism fell by 15 per cent (Khan). Oliver’s exposé of the conditions of battery raised hens in 2007 and 2008 (see Fowl Dinners) resulted in increased sales of free-range poultry, decreased sales of factory-farmed chickens across the UK, and complaints that free-range chicken sales were limited by supply. Oliver encouraged viewers to lobby their local councils, and as a result, a number banned battery hen eggs from schools, care homes, town halls and workplace cafeterias (see, for example, LDP). The popular penetration of these ideas needs to be understood in a historical context where industrialised poultry farming has been an issue in Britain since at least 1848 when it was one of the contributing factors to the establishment of the RSPCA (Freeman). A century after Upton Sinclair’s The Jungle (published in 1906) exposed the realities of the slaughterhouse, and several decades since Peter Singer’s landmark Animal Liberation (1975) and Tom Regan’s The Case for Animal Rights (1983) posited the immorality of the mistreatment of animals in food production, it could be suggested that Al Gore’s film An Inconvenient Truth (released in 2006) added considerably to the recent concern regarding the ethics of industrial agriculture. Consciousness-raising bestselling books such as Jim Mason and Peter Singer’s The Ethics of What We Eat and Michael Pollan’s The Omnivore’s Dilemma (both published in 2006), do indeed ‘close the loop’ in this way in their discussions, by concluding that intensive food production methods used since the 1950s are not only inhumane and damage public health, but are also damaging an environment under pressure from climate change. In comparison, the use of forced labour and human trafficking in food production has attracted far less mainstream media, celebrity or public attention. It could be posited that this is, in part, because no direct relationship to the environment and climate change and, therefore, direct link to our own existence in the West, has been popularised. Kevin Bales, who has been described as a modern abolitionist, estimates that there are currently more than 27 million people living in conditions of slavery and exploitation against their wills—twice as many as during the 350-year long trans-Atlantic slave trade. Bales also chillingly reveals that, worldwide, the number of slaves is increasing, with contemporary individuals so inexpensive to purchase in relation to the value of their production that they are disposable once the slaveholder has used them. Alongside sex slavery, many other prevalent examples of contemporary slavery are concerned with food production (Weissbrodt et al; Miers). Bales and Soodalter, for example, describe how across Asia and Africa, adults and children are enslaved to catch and process fish and shellfish for both human consumption and cat food. Other campaigners have similarly exposed how the cocoa in chocolate is largely produced by child slave labour on the Ivory Coast (Chalke; Off), and how considerable amounts of exported sugar, cereals and other crops are slave-produced in certain countries. In 2003, some 32 per cent of US shoppers identified themselves as LOHAS “lifestyles of health and sustainability” consumers, who were, they said, willing to spend more for products that reflected not only ecological, but also social justice responsibility (McLaughlin). Research also confirms that “the pursuit of social objectives … can in fact furnish an organization with the competitive resources to develop effective marketing strategies”, with Doherty and Meehan showing how “social and ethical credibility” are now viable bases of differentiation and competitive positioning in mainstream consumer markets (311, 303). In line with this recognition, Fair Trade Certified goods are now available in British, European, US and, to a lesser extent, Australian supermarkets, and a number of global chains including Dunkin’ Donuts, McDonalds, Starbucks and Virgin airlines utilise Fair Trade coffee and teas in all, or parts of, their operations. Fair Trade Certification indicates that farmers receive a higher than commodity price for their products, workers have the right to organise, men and women receive equal wages, and no child labour is utilised in the production process (McLaughlin). Yet, despite some Western consumers reporting such issues having an impact upon their purchasing decisions, social justice has not become a significant issue of concern for most. The popular cookery publications discussed above devote little space to Fair Trade product marketing, much of which is confined to supermarket-produced adverzines promoting the Fair Trade products they stock, and international celebrity chefs have yet to focus attention on this issue. In Australia, discussion of contemporary slavery in the press is sparse, having surfaced in 2000-2001, prompted by UNICEF campaigns against child labour, and in 2007 and 2008 with the visit of a series of high profile anti-slavery campaigners (including Bales) to the region. The public awareness of food produced by forced labour and the troubling issue of human enslavement in general is still far below the level that climate change and ecological issues have achieved thus far in driving foodway evolution. This may change, however, if a ‘Slow’-inflected connection can be made between Western lifestyles and the plight of peoples hidden from our daily existence, but contributing daily to them. Concluding Remarks At this time of accelerating techno-cultural evolution, due in part to the pressures of climate change, it is the creative potential that human conscious awareness brings to bear on these challenges that is most valuable. Today, as in the caves at Lascaux, humanity is evolving new images and narratives to provide rational solutions to emergent challenges. As an example of this, new foodways and ways of thinking about them are beginning to evolve in response to the perceived problems of climate change. The current conscious transformation of food habits by some in the West might be, therefore, in James Lovelock’s terms, a moment of “revolutionary punctuation” (178), whereby rapid cultural adaption is being induced by the growing public awareness of impending crisis. It remains to be seen whether other urgent human problems can be similarly and creatively embraced, and whether this trend can spread to offer global solutions to them. References An Inconvenient Truth. 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Eshel, Gidon, and Pamela A. Martin. “Diet, Energy, and Global Warming.” Earth Interactions 10, paper 9 (2006): 1–17. Fowl Dinners. Exec. Prod. Nick Curwin and Zoe Collins. Dragonfly Film and Television Productions and Fresh One Productions, 2008. Freeman, Sarah. Mutton and Oysters: The Victorians and Their Food. London: Gollancz, 1989. Gould, S. J., and N. Eldredge. “Punctuated Equilibrium Comes of Age.” Nature 366 (1993): 223–27. (ICFFA) International Commission on the Future of Food and Agriculture. Manifesto on the Future of Food. Florence, Italy: Agenzia Regionale per lo Sviluppo e l’Innovazione nel Settore Agricolo Forestale and Regione Toscana, 2006. Jamie’s School Dinners. Dir. Guy Gilbert. Fresh One Productions, 2005. Jordan, Jennifer A. “The Heirloom Tomato as Cultural Object: Investigating Taste and Space.” Sociologia Ruralis 47.1 (2007): 20-41. Khan, Urmee. “Jamie Oliver’s School Dinners Improve Exam Results, Report Finds.” Telegraph 1 Feb. 2009. 24 Aug. 2009 < http://www.telegraph.co.uk/education/educationnews/4423132/Jamie-Olivers-school-dinners-improve-exam-results-report-finds.html >. Kloppenberg, Jack, Jr, Sharon Lezberg, Kathryn de Master, G. W. Stevenson, and John Henrickson. ‘Tasting Food, Tasting Sustainability: Defining the Attributes of an Alternative Food System with Competent, Ordinary People.” Human Organisation 59.2 (Jul. 2000): 177–86. (LDP) Liverpool Daily Post. “Battery Farm Eggs Banned from Schools and Care Homes.” Liverpool Daily Post 12 Jan. 2008. 24 Aug. 2009 < http://www.liverpooldailypost.co.uk/liverpool-news/regional-news/2008/01/12/battery-farm-eggs-banned-from-schools-and-care-homes-64375-20342259 >. Lovelock, James. The Ages of Gaia: A Biography of Our Living Earth. New York: Bantam, 1990 (first published 1988). Mason, Jim, and Peter Singer. The Ethics of What We Eat. 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In 2000, Jordan signed the Agreement on Trade-related Aspects of Intellectual Property Rights (the TRIPS Agreement) and a free trade agreement with the US (USJFTA). Both commitments have required Jordan to comply with various obligations, including full compliance with the minimum standards for the protection of intellectual property rights (IPRs) under the TRIPS Agreement and TRIPS-Plus IP standards set out under the terms of the USJFTA. Enticed by views that strong IP protection would create prosperity in the Kingdom by promoting technological innovation and inducing transfer and dissemination of technology to Jordanians, Jordan implemented the provisions of TRIPS and the USJFTA to the letter. However, Jordan focused little attention on important “TRIPS flexibilities”. In particular, Jordan has qualified parallel importation and limited the grounds of compulsory licenses. In addition, Jordan provides pharmaceutical testing data with data exclusivity. This thesis focuses on the Jordanian experience in the pharmaceutical sector. It argues that strong patent protection has not been conducive to the promotion of technological innovation and the transfer and dissemination of technology. Moreover, this protection has resulted in adverse outcomes such as increased drug prices, unavailability of essential medicines in some public hospitals for serious diseases, and a dwindling local pharmaceutical industry, in part, as a consequence of its inability to access advanced, patented technology on reasonable commercial terms. The thesis also investigates the legitimacy of establishing certain grounds of compulsory licensing by Jordan, even in light of the TRIPS-Plus obligations under the USJFTA. It advocates that such grounds contribute to the promotion of technical innovation, lead to the transfer of advanced technology, and above all improve access to affordable medicines. Finally, the thesis explores Jordan’s obligations to protect pharmaceutical testing data under TRIPS and USFTA arguing that neither of these two instruments requires data exclusivity as claimed by Pharmaceutical Research and Manufacturers of America (PhRMA) and some developed countries.