BBC 2024-02-03 12:02:13


Iraq warns of disastrous consequences for region after US strikes

As we’ve been reporting, the Islamic Resistance in Iraq responsible for the deadly attack on US troops in Jordan is part of what is known as Iran’s “axis of resistance”.

The core of the “axis of resistance” is made up of Hezbollah in Lebanon, the Assad regime in Syria, the Houthis in Yemen and assorted Iraqi militias that are armed and trained by Iran. The Iranians have also supported Hamas and Palestinian Islamic Jihad (PIJ) in Gaza.

The US and many other countries have designated Hezbollah, Hamas, PIJ and the Houthis as terrorist organisations.

Members of these armed groups receive weapons and funding from Iran and are under the influence of Iranian President Ebrahim Raisi, though they often operate outside of his chain of command.

Why did US wait to retaliate for drone attack on its troops?

Nearly a week after a drone strike in Jordan killed three US soldiers, retaliatory strikes against Iran-backed militias have begun.

The strikes had been expected for several days, and in the interim, the Biden administration began to face questions and criticism from Republicans about the timing and forcefulness of the US response.

But foreign policy experts believed the approach allowed Iran to withdraw personnel, potentially avoiding a wider conflict between the US and Iran.

“This would allow them to degrade the capacity of these Iranian-backed militias to attack US forces, but not escalate,” Mick Mulroy, a former deputy assistant secretary of defence for the Middle East, told the BBC. “Although it is likely not going to be a deterrent to future attacks.”

The ultimate benefit, he said, would be “to avoid a direct war” between the US and Iran.

The US struck the Iranian Revolutionary Guards Corps (IRGC) Quds Force and affiliated militias in Iraq and Syria, at seven sites in total. Bombers hit 85 individual targets, according to US defence officials.

“Let all those who might seek to do us harm know this: If you harm an American, we will respond,” President Joe Biden said.

US officials have blamed an Iranian-backed militia group, the Islamic Resistance in Iraq, for the Jordan attack. The organisation – an umbrella group of multiple militias – is believed to have been armed, funded and trained by Iran.

Iran has denied any involvement in the drone strike, which also injured 41 US troops.

Defence and security officials said that weather had made it difficult to retaliate sooner, with Friday presenting the best conditions for launching strikes.

Though the White House and Pentagon also repeatedly said they were avoiding “telegraphing” operations in the days leading up to the strikes, experts believe they did just that – with the ultimate intention of avoiding a wider war with Iran.

Arabian Gulf States Institute of Washington fellow Hussein Ibish, said the delay appeared to be the US signalling “what they’re not going to do, which is strike inside Iran”.

Mr Mulroy told the BBC it is possible that the US allowed Iranian Revolutionary Guard personnel “to leave the facilities that are going to be struck”.

Experts noted the US must walk a fine line between deterring a country like Iran without igniting a greater conflict.

“Telegraphing” the strikes could allow the US to adopt a “Goldilocks” approach to the operation that is “not too hard and not too soft”, said Bradley Bowman, senior director of the Center on Military and Political Power at the Washington DC-based Foundation for Defense of Democracies.

That approach “would inflict pain on our adversaries so they stop attacking our forces, but not so much that they feel a need for a massive escalation, thereby avoiding a regional war”.

National Security Council spokesman John Kirby said on Friday that Washington won’t “telegraph future operations” but confirmed “there will be additional response action taken in coming days”.

However, Republicans in Congress have been quick to condemn Mr Biden’s approach for being too lenient on Iran.

Speaker Mike Johnson, the most powerful Republican in Congress, said after the attacks that “public handwringing and excessive signalling undercuts our ability to put a decisive end to the barrage of attacks endured over the past few months”.

In a post on X, Senator Tom Cotton of Arkansas called Mr Biden’s response “anaemic” and claimed “it has only emboldened the ayatollahs further.”

“Only further, more devastating attacks against Iranian forces will scare the ayatollahs,” he wrote.

Senator Markwayne Mullin invoked the more aggressive actions of past Republican presidents, Ronald Reagan and Donald Trump, as a contrast to Mr Biden’s plan of attack.

“Deterrence isn’t delayed half-measures,” he wrote on X. “Deterrence is taking the head off the snake.”

But Mr Ibish noted that the Biden administration may be trying to avoid domestic political pitfalls that would come with the US getting dragged into a more serious conflict.

“If they did strike in Iran, the Republican standard bearers like Donald Trump would denounce Biden for being a warmonger,” he said. “It’s a political trap. Everybody gets that, so they’re not going to fall into that trap.”

Trump’s federal trial on election meddling postponed

A federal judge has postponed the election subversion trial of former US president Donald Trump while his appeal plays out in court.

The trial was set to begin on 4 March, but will now be delayed indefinitely, Judge Tanya Chutkan said on Friday.

The case is over Mr Trump’s alleged efforts to overturn the 2020 election results.

His lawyers have argued that he should not face criminal charges because he was a sitting president at the time.

The Republican frontrunner for president in November’s election was charged last year over his alleged efforts to overturn his 2020 loss to Democrat Joe Biden.

The case could be delayed for several months as the appeal process plays out.

Currently a panel of three federal appeals judges is weighing Mr Trump’s argument that presidents are immune from prosecution for possible crimes committed while they are in office, even after they leave the White House. It could rule as early as next week.

The case is widely expected to end up before the US Supreme Court, where conservatives hold a 6-3 majority.

Experts have said it could have a profound effect on the future of the American presidency and what is allowable by an individual who holds the office.

The four counts in the indictment were: conspiracy to defraud the US, conspiracy to obstruct an official proceeding, obstruction of an official proceeding and conspiracy against the rights of citizens.

Mr Trump, 77, has repeatedly denied any wrongdoing and has accused the Justice Department and the Biden administration of political persecution.

He also faces three other criminal trials. One is related to alleged attempts to overturn the 2020 election results in the state of Georgia.

Another is related to his alleged mishandling of classified documents after leaving office, and the third is related to an alleged hush-money payment Mr Trump made to porn star Stormy Daniels.

With the delay of the federal election subversion case, Mr Trump’s first criminal trial will be over the alleged 2016 hush money payments, which is slated for 25 March in New York.

India on top in second Test, leading England by 171 after day two

Men’s International Test Match Series – Day 2 of 5
IndiaIndia

First innings 396 all outSecond innings 28 for 0 wickets5.0 overs

CloseEnglandEngland

First innings 253 all out

Close – India lead England by 171 runs with 10 wickets remaining

Cancer doctor takes gamble to treat his brain tumour

On opposite sides of the world, Richard Scolyer and Georgina Long each took one look at a scan and their hearts sank.

In front of them was, to the untrained eye, an innocuous-looking brain.

But these long-time friends – both leading skin cancer doctors – feared it held a ticking time bomb.

Nestled in the top right corner of Prof Scolyer’s skull was a section of matter lighter and cloudier than the rest.

“I’m no expert in radiology, but… in my heart I knew it was a tumour,” he tells the BBC.

Neurosurgeons soon confirmed it wasn’t just any brain tumour, but “the worst of the worst” – a subtype of glioblastoma so aggressive most patients survive less than a year.

Devastated but determined, he and Prof Long set out to do the impossible: to save his life by finding a cure.

And it may sound crazy, but the Australian researchers have done it before, with melanoma.

“It didn’t sit right with me… to just accept certain death without trying something,” Prof Scolyer says.

“It’s an incurable cancer? Well bugger that!”

National treasures

Thirty years ago, when Prof Scolyer and Prof Long met as bright, young doctors, advanced melanoma was a death sentence.

But that’s exactly what drew them to it.

Australia has long had the highest rate of the skin cancer on the planet and where many saw a daunting challenge, they saw potential.

“[Back] when I was doing the cancer block the most challenging patients to see were the ones with advanced melanoma. It was heartbreaking,” Prof Long says.

“I wanted to make a difference.”

Today, it’s near impossible to overstate their impact on the field.

Anyone who gets a diagnosis or treatment for melanoma worldwide does so because of the work pioneered by the Melanoma Institute that they now lead.

Over the past decade, their team’s research on immunotherapy, which uses the body’s immune system to attack cancer cells, has dramatically improved outcomes for advanced melanoma patients around the world. Half are now essentially cured, up from less than 10%.

That breakthrough – or as Prof Long calls it, “penicillin moment” – is now being applied to many other cancers, saving even more lives.

It has made the duo national treasures. Almost every Australian would know someone impacted by their work and this year they’ve been jointly named as the Australians of the Year.

But as they were transforming the field, they were also leaving their mark on each other.

They bonded over frustration at the cases they couldn’t crack, the highs of life-changing discoveries, a love of exercise, and a lofty ambition of reaching zero melanoma deaths in Australia.

“We’re very different but very similar in that sort of… roll up your sleeves, get things done way,” Prof Long says.

Eyes shining, the medical oncologist rattles off a list of qualities – brave, honest, upbeat, driven – which make Prof Scolyer the dream colleague and friend.

“He’s a delight,” she surmises.

And so, after she received that fateful call from Poland last June – where Prof Scolyer was on holiday when a seizure triggered his diagnosis – she spent the night crying.

“I’m grieving… I’m thinking my friend is going to be gone in 12 months.”

But then she spent the morning plotting – poring over textbooks, researching clinical trials, and firing off emails to colleagues globally.

Glioblastomas, found in the brain’s connective tissue, are notoriously aggressive and the general protocol for treating them – immediate excision then radiotherapy and chemotherapy – has changed little in two decades.

Survival rates have fared similarly. Still, only 5% of all patients live beyond five years.

Desperate, Prof Long formulated a radical plan to treat Prof Scolyer based on what had worked in melanoma, but which had never been tested in brain cancer.

Risk vs reward

In melanoma, Prof Long and her team discovered that immunotherapy works better when a combination of drugs are used, and when they are administered before any surgery to remove a tumour.

It’s like training a sniffer dog, she explains: you give it a smell of the contraband, in this analogy the cancer cells, for it to be able to hunt them down later.

Prof Scolyer jokes that trying the treatment was a “no brainer”.

But it comes with huge risks.

Some oncologists were sceptical that the drugs would reach his brain at all, and even if they did, that his immune system would respond.

And they worried the experiment could kill him faster.

Many brain cancers grow so rapidly that even a two-week delay to surgery could mean it’s too late to operate, they said. Immunotherapy drugs are quite toxic, especially when mixed, so he could be poisoned. And if either of those things caused the brain to swell, he could die instantly.

At home colleagues quietly shared fears Prof Long’s emotional ties were clouding her judgement.

“They were saying… ‘Just let the neuro-oncology experts do their thing and be his friend’,” she says.

“[But] he needs us… We have all this depth of knowledge, it’s our duty.”

And so, under the care of Prof Long and a team of experts, Prof Scolyer became the first brain cancer patient to ever have combination, pre-surgery immunotherapy.

He is also the first to be administered a vaccine personalised to his tumour markers, which boosts the cancer-detecting powers of the drugs.

‘A glimmer of hope’

Weeks after that initial scan sent their lives into a tailspin, Prof Scolyer and Prof Long looked at another test result.

It was an analysis of the tumour that had been carefully plucked from Prof Scolyer’s skull.

“I was blown away. In a millisecond,” he says.

“It was bloody obvious that it is doing something.”

Not only were there traces of the drugs in the tumour – proving the medication had reached his brain – there was an explosion of immune cells. And they were “activated”, giving the team hope they would be attacking his cancers cells at that very moment.

The average time for a glioblastoma cancer to return is six months post-surgery. But eight months on, after continued immunotherapy, Prof Scolyer is showing no signs of active cancer.

Just last week, another scan came back clean and Prof Long says his brain is “normalising”.

The results so far have generated huge excitement.

There’s creeping hope that this could prolong Prof Scolyer’s life.

But there’s also optimism that the duo may be on the cusp of a discovery which could help the 300,000 people diagnosed with brain cancer globally each year.

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This kind of research would usually take years – even decades – but what Prof Scolyer and Prof Long have achieved in mere months has already attracted interest from pharmaceutical companies and generated talk of clinical trials.

Roger Stupp, though, is more tempered.

The doctor – after whom the current protocol for treating glioblastomas is named – says Prof Scolyer’s prognosis is “grim”, and that it’s too early to tell if this treatment is working.

“Promising is a difficult word… Encouraging, I would call it,” he tells the BBC from Chicago.

“It’s not a revolution, but it is still a step forward.”

He wants to see Prof Scolyer reach 12 months, even 18, without recurrence before he’ll be persuaded.

But Dr Stupp says he is “absolutely” confident that immunotherapy can change the treatment of brain cancer – the science just hasn’t been cracked yet.

“We need to get out of our silos and look at what worked in other tumour types,” he says.

Prof Scolyer and Prof Long are also trying to resist being swept up in the buzz.

The best-case scenario is that Prof Scolyer is cured, but they call the odds of that “miniscule”.

“A miracle could happen,” Prof Scolyer says.

As for the worst-case scenario, he tells the BBC he’s already beaten it: “I would have died before now.”

Instead, he celebrated his 57th birthday in December, and another Christmas with his family – wife Katie, and his teenage children Emily, Matthew, and Lucy.

But with the gratitude for each additional milestone, every clear scan, is the fear it’s his last.

“It’s tough,” Prof Long says of treating her friend.

They’ve had discussions about death and funerals. “He’s extraordinarily resilient,” she adds.

But sitting in his office – surrounded by pictures of his children, tasks scribbled on a whiteboard and shelves filled with framed accolades – Prof Scolyer tears up.

For all his outward positivity, he admits he’s also scared and soul-crushingly sad.

“I love my family. I love my wife… I like my work,” he says with a grimace.

“I’m pissed off. I’m devastated… I don’t want to die.”

But giving him comfort is the idea that this research could bring meaning, some purpose, to his diagnosis.

“The data that we’ve generated – I know it’s changing the field, and if I die tomorrow with that, I’m very proud.”