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International Co-operation Minister Bev Oda. Today’s topics: off-label drugs; Bev Oda’s spending; France’s angry voters; parting a sea ... and moreReuters

Worrisome? Yes, but …

Your editorial (Please Use As Directed – April 23) rightly argues that prescribing drugs off-label in the absence of "strong scientific evidence" can be "worrisome." Sometimes, it also may be the most responsible course of action.

My friend has been diagnosed with a fast-acting form of Alzheimer's. Bexarotene, a cancer drug, has been found to reverse the development of Alzheimer's-like symptoms in mice. Whether or not it will work with humans is unknown. Tests are just starting. But for people such as my friend, who will almost certainly be dead by the time conclusive tests are completed, what is there to lose in prescribing bexarotene off-label now?

The drug may not work. It may have side effects. But how could that be worse than what my friend otherwise faces: rapid loss of brain function and death?

Don LePan, Nanaimo

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Given the cuts to government departments being required by the Harper government in the name of efficiencies, which other service would you suggest Health Canada discontinue in order to institute tracking of off-label use of drugs?

Ann Sullivan, Peterborough, Ont.

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No stars for Oda

When a 2-cent vitamin pill can help prevent blindness, when $20 of antibiotics can prevent a death from TB, International Co-operation Minister Bev Oda changes her already five-star accommodation to stay at an even more expensive hotel in London (Bev Oda Repays Taxpayers After Opting For Swanky Hotel Favoured By Royalty – online, April 23).

The attitude this demonstrates is appalling. The Conservatives cut the Canadian International Development Agency's budget by $380-million, a decision that will hurt – or hasten the death of – thousands of the world's poorest, yet Ms. Oda spends like the royalty she obviously perceives herself to be. Her attitude is one of gross entitlement, while children in CIDA's care, children under her watch, suffer or die.

Nathaniel Poole, Victoria

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The letter 'F'

France's mood of anti-establishment (anti-capitalist/anti-rich) anger that put Socialist Party leader François Hollande ahead of Nicolas Sarkozy in the first-round presidential balloting will only confirm what most economists knew all along – that France's ride on Germany's well-disciplined economic coattails couldn't last forever (Anger Realigns France As Fringe Parties Take Record Share Of Vote – April 23).

Hmm. Let me think. What's a new acronym for PIIGS (internationally recognized as the derogatory acronym for Portugal, Ireland, Italy, Greece and Spain, all fine examples of countries with weak economies near bankruptcy caused by "reckless" public spending) that would include the letter "F"?

David Honigsberg, Toronto

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Cuts and corners

According to Neil Reynolds, if the public service increased its efficiency by 1 per cent a year, we'd see massive savings (Productivity Trumps Head Counts – April 23). That's great, but meaningless. Applying simple mathematics to complex administrative processes is oversimplification. What does a 1-per-cent efficiency mean? Pushing 1 per cent of cars and travellers across the border more quickly? Speeding up court trials by 1 per cent? Processing taxes 1 per cent more quickly? Passport applications? Refugee applications?

The fetish for "efficiency" is a high-level admission of lack of vision. For politicians or business leaders to shrug and say "we'll make this up through efficiencies" is to say, "we'll tell our managers to cut corners and they'll have to do it." Done and done.

In government, it is a dodge from the political suicide of raising tax revenue; in business, it is a way of increasing profits. Either way, it's not efficiency, it's ideology.

Dan Malleck, St. Catharines, Ont.

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The figures factor

Kudos to Neil Reynolds for putting some perspective on the recently announced federal bureaucracy cuts, which have drawn so much reaction from civil service unions and the media (Productivity Trumps Head Counts – April 23). He rightly points out how minuscule the announced cuts really are and how easily they could be offset by modest productivity gains. This problem exists in all three levels of government.

What is most disconcerting is that on the same day Mr. Reynolds's column was published, the front-page headline flagged the service reductions Statistics Canada proposes to make, resulting from the budget cutbacks: Statscan To Chop Surveys, Staff. Go figure.

Bruce Healy, Calgary

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The index of leading indicators provides advance warning of economic slowdowns and recoveries. As such, it allows decision-makers to take more timely and appropriate action in terms of government policy and business decisions. We are faced with a significant loss in our ability to understand economic events.

Patrick Laverty, Toronto

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Railway costs

Canada has few densely populated corridors (Tories Mull Sale Of VIA Routes – April 23). Privatization of VIA's profitable rail routes would have two results: the end of a national passenger rail network and an increase in taxpayer costs for services that remain.

VIA's tourist-driven services subsidize less-profitable routes. Similarly, high-season tourist travel on The Canadian helps offset the costs of running the national transcontinental train the rest of time.

If VIA's profitable services are sold to private enterprises, government subsidies for the remaining routes would have to increase. The alternative is to wind down the railway altogether, which would be a politically toxic move. The Harper government should be wary of such an action.

Communities across Canada value their passenger rail services. To reduce our national passenger railway to a skeleton service would be a slap in the face to people in those communities who prefer a clean alternative to the car or the plane.

Jason Shron, Concord, Ont.

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Toto's geography

Chief electoral officer Marc Mayrand argues that administrative mistakes shouldn't overturn the results of a vote (Administrative Errors Shouldn't Overturn Election Results, Watchdog Says – April 23). This implies that the will of the people is justifiably pushed aside for bureaucratic and/or political convenience. Toto, I've a feeling we aren't in a democracy any more …

Erik Dravnieks, Ottawa

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Age-old solutions

To settle the long-standing argument regarding the appropriate name for the sea between Japan and South Korea, the Secretariat of the International Hydrographic Organization suggested in 2007 "dividing the water in two," but the two countries didn't agree this was possible (National Pride On The Line In Sea Squabble – April 23).

Where's Moses when we need him?

Patrick Martin, Montreal

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