Change Rattles Leading Health-Funding Agency

Major changes erupted at one of the world’s leading health-funding agencies Thursday as it hired a new director, dismissed the inspector general who had clashed with a previous director and announced a new approach to making grants.

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Dr. Mark Dybul, who led the President's Emergency Plan for AIDS Relief, in 2007.

Dr. Mark Dybul, the Bush administration’s global AIDS czar who was abruptly dismissed when President Obama took office, was named the new executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Dr. Dybul, who was selected over candidates from Canada, Britain and France, was backed by the United States, which donates about a third of the fund’s budget, and by Bill Gates, who helped the fund through a cash crisis earlier this year.

He is respected by many AIDS activists in the United States, though there is some lingering controversy about his time in the Bush administration related to abstinence policies and anti-prostitution pledges imposed by conservative lawmakers as well as concerning strict licensing requirements for generic drugs.

The fund, which is based in Geneva and has given away more than $20 billion since its founding in 2002, has been in crisis for more than a year. Some donors shied away after widely publicized corruption scandals, while others, notably Mr. Gates, said the scandals were exaggerated and increased donations.

Its last executive director, Dr. Michel Kazatchkine, quit in January after the day-to-day management duties of his job were given to a Brazilian banker, Gabriel Jaramillo, who was charged with cutting expenses.

By some accounts, 40 percent of the employees soon left, although Seth Faison, a fund spokesman, said the total number of employees declined by only 8 percent. The fund also dismissed its inspector general, John Parsons, on Thursday, citing unsatisfactory work.

Mr. Parsons and Dr. Kazatchkine had privately clashed. Mr. Parsons’s teams aggressively pursued theft and fraud, and found it in Mali, Mauritania and elsewhere. But the total amount stolen — $10 million to $20 million — was relatively small, and aides to Dr. Kazatchkine said the fund cut off those countries and sought to retrieve the money. The aides claimed that Mr. Parsons, who reported only to the board, went to news outlets and left the impression that the fund was covering up rampant theft.

The fuss scared off some donor countries that were already looking for excuses to cut back on foreign aid because of the global economic crisis.

Mr. Parsons did not return messages left for him Thursday.

Dr. Dybul’s appointment was welcomed by the United Nations AIDS program, the Bill and Melinda Gates Foundation, the Elizabeth Glaser Pediatric AIDS Foundation, Malaria No More and Results.org, an anti-poverty lobbying group. By contrast, Jamie Love, an American advocate for cheaper AIDS drugs who works in Washington and Geneva, said he expected Dr. Dybul “to protect drug companies.”

The fund also announced a new application process, which it said would be faster and focus more on the hardest-hit countries rather than all 150 that received some help in the past.

In an interview, Dr. Dybul said he felt the fund was “on a strong forward trajectory” after changes were put in place in the last year by Mr. Jaramillo, and now would focus on “hard-nosed implementation of value for money.”

Both the President’s Emergency Plan for AIDS Relief and the fund spend billions, but in different ways.

The fund supports projects proposed by national health ministers and then hires local auditors to make sure the money is not wasted or stolen. Pepfar usually gives grants to American nonprofit groups or medical schools and lets them form partnerships with hospitals or charities in the affected countries.

The conventional wisdom is that the Global Fund’s model is more likely to win the cooperation of government officials but more vulnerable to corruption — and also spends less on salaries and travel for American overseers.

Dr. Kazatchkine said he did not expect Dr. Dybul to “Pepfarize” the Global Fund.

“I hope that, after a year of turbulence, the fund finds the serenity needed to move forward again,” he said.

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In BP Indictments, U.S. Shifts to Hold Individuals Accountable

HOUSTON — Donald J. Vidrine and Robert Kaluza were the two BP supervisors on board the Deepwater Horizon rig who made the last critical decisions before it exploded. David Rainey was a celebrated BP deepwater explorer who testified to members of Congress about how many barrels of oil were spewing daily in the offshore disaster.

Mr. Vidrine, 65, of Lafayette, La., and Mr. Kaluza, 62, of Henderson, Nev., were indicted on Thursday on manslaughter charges in the deaths of 11 fellow workers; Mr. Rainey, 58, of Houston, was accused of making false estimates and charged with obstruction of Congress. They are the faces of a renewed effort by the Justice Department to hold executives accountable for their actions. While their lawyers said the men were scapegoats, Attorney General Eric H. Holder Jr. said at a news conference, “I hope that this sends a clear message to those who would engage in this kind of reckless and wanton conduct.”

The defense lawyers were adamant that their clients would contest the charges, and prosecutors said that the federal investigations were continuing.

Legal scholars said that by charging individuals, the government was signaling a return to the practice of prosecuting officers and managers, and not just their companies, in industrial accidents, which was more common in the 1980s and 1990s.

“If senior managers cut corners, or if they make decisions that put people in harm’s way, then the criminal law is appropriate,” said Jane Barrett, a University of Maryland law professor and former federal prosecutor.

She noted that it was unusual for the Justice Department to prosecute individual corporate officers in recent years, including in the 2005 BP Texas City refinery explosion that killed 15 workers, where only the company was fined.

BP said on Thursday it would pay $4.5 billion in fines and other payments, and the corporation pleaded guilty to 14 criminal charges in connection with spill. The $1.26 billion in criminal fines was the highest since Pfizer in 2009 paid $1.3 billion for illegally marketing an arthritis medication.

The crew was drilling 5,000 feet under the sea floor 41 miles off the Louisiana coast in April 2010 when they lost control of the well during its completion. They tested the pressure of the well, but misinterpreted the test results and underestimated the pressure exerted by the flow of oil or gas up the well. Had the results been properly interpreted, operations would have ceased.

Mr. Vidrine and Mr. Kaluza were negligent in their reading of the kicks of gas popping up from the well that should have suggested that the Deepwater Horizon crew was fast losing control of the ill-fated Macondo well, according to their indictment, and they failed to act or even communicate with their superiors. “Despite these ongoing, glaring indications on the drill pipe that the well was not secure, defendants Kaluza and Vidrine again failed to phone engineers onshore to alert them to the problem, and failed to investigate any further,” the indictment said.

The indictment said they neglected to account for abnormal pressure test results on the well that indicated problems, accepting “illogical” explanations from members of the crew, which caused the “blowout of the well to later occur.”

In a statement, Mr. Kaluza’s lawyers said: “No one should take any satisfaction in this indictment of an innocent man. This is not justice.”

Bob Habans, a lawyer for Mr. Vidrine, called the charges “a miscarriage of justice.”

“We cannot begin to explain or understand the misguided effort of the United States attorney and the Department of Justice to blame Don Vidrine and Bob Kaluza, the other well site leader, for this terrible tragedy.”

Several government and independent reports over the last two years have pointed to sloppy cement jobs in completing the well or the poor design of the well itself as major reasons for the spill. But none of the three was indicted in connection with those problems.

Mr. Rainey was a far more senior executive, one who was known around Houston and the oil world as perhaps the most knowledgeable authority on Gulf oil and gas deposits. According to his indictment, Mr. Rainey obstructed Congressional inquiries and made false statements by underestimating the flow rate to 5,000 barrels a day even as millions were gushing into the Gulf.

Campbell Robertson contributed reporting.

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BBC Failures Show Limits of Guidelines

LONDON — It was 2004, and the British Broadcasting Corporation was gripped by a crisis over journalistic standards that had led to Parliamentary hearings, public recrimination and the resignations of its two top officials. Vowing change, the corporation established elaborate bureaucratic procedures that placed more formal responsibility for delicate decisions in the hands not of individual managers, but of rigid hierarchies.

The corporation also appointed a deputy director general in charge of news operations; established a “journalism board” to monitor editorial policy; issued numerous new guidelines on journalistic procedures; and put an increasing emphasis on “compliance” — a system in which managers are required to file cumbersome forms flagging dozens of potential trouble spots, from bad language to “disturbing content” like exorcism or beheadings, in every program taped for broadcast.

More crises would follow — the history of the BBC can be measured out in crises — and with each new one, the management team under Mark Thompson, director general from 2004 through mid-September 2012, added more guidelines and put more emphasis on form-filling and safety checks in news and entertainment programs. An organization already known for its bureaucracy became even more unwieldy (the editorial guidelines are now 215 pages long).

But it is these very structures that seem to have failed the BBC in the most recent scandal, in which its news division first canceled a child abuse segment it should have broadcast, and later broadcast one it should have canceled. In the first instance, it appears that people overseeing the program were too cautious, so that top managers were left unaware of its existence; in the second, managers may have relied too much on rigid procedures at the expense of basic journalistic principles.

“They burned their fingers,” said Tim Luckhurst, a journalism professor at the University of Kent who worked at the BBC for 10 years. “They wanted systems that could take responsibility instead of people.”

The recent scandal has had a number of immediate results. Mr. Thompson’s successor as director general, George Entwistle, resigned after just 54 days on the job. (Mr. Thompson is now president and chief executive of The New York Times Company.) Outside investigators were appointed to interrogate BBC employees in at least three different inquiries. A number of lower- and midlevel managers had to withdraw temporarily from their jobs and, facing possible disciplinary action, hired lawyers. And, once again, the BBC is talking about reorganizing structures.

Through a spokesman, Mr. Entwistle declined to comment on the scandal or the BBC’s management practices, saying he was “not doing any media interviews at present.” Mr. Thompson also declined to comment.

But Mr. Entwistle’s temporary successor, Tim Davie, who had previously been director of BBC Audio & Music, acknowledged that changes had to be made. “If the public are going to get journalism they trust from the BBC I have to be, as director general, very clear on who’s running the news operation and ensuring that journalism that we put out passes muster,” Mr. Davie said in his first week on the job. The first thing to do, he said, was to “take action and build trust by putting a clear line of command in.”

This is a complicated scandal in two parts. The first part was over the BBC’s decision last December not to broadcast a report saying that Jimmy Savile, a longtime BBC television host, had been a serial child molester, and instead to broadcast several glowing tributes to his career. The second part was its decision on Nov. 2 to accuse a member of Margaret Thatcher’s government of being a pedophile, an accusation that turned out to be patently false.

But both exposed the problems in a system that seems to insulate the BBC’s director general — who is also the editor in chief — from knowledge of basic issues like what potentially contentious programs are scheduled for broadcast. And both decisions were the result, it seems, of a system that failed in practice, even as it was correctly followed in theory.

Ben Bradshaw, a former BBC correspondent and now a Labour member of Parliament, said the 2004 scandal, touched off by reporting about British intelligence on Iraqi weapons of mass destruction, had created a system based on “fear and anxiety.” The BBC, he added, became “even more bureaucratic and had even more layers, which exacerbated the problem of buck passing and no one being able to take a decision.”

Speaking of the Nov. 2 broadcast, the chairman of the BBC Trust, Chris Patten, said in a television interview that the piece went through “every damned layer of BBC management bureaucracy, legal checks” without anyone raising any serious objections.

Matthew Purdy contributed reporting from New York, and Lark Turner from London.

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R.A. Dickey, David Price win Cy Young awards

NEW YORK (AP) — R.A. Dickey languished in the minors for 14 years, bouncing from one team to another before finally perfecting that perplexing knuckleball that made him a major league star.

David Price was the top pick in the draft and an ace by age 25, throwing 98 mph heat with a left arm live enough to make the most hardened scout sing.

Raised only 34 miles apart in central Tennessee, Dickey and Price won baseball's Cy Young awards on Wednesday — one by a wide margin, the other in a tight vote.

Two paths to the pantheon of pitching have rarely been more different.

"Isn't that awesome?" said Dickey, the first knuckleballer to win a Cy Young. "It just shows you there's not just one way to do it, and it gives hope to a lot of people."

Dickey said he jumped up and yelled in excitement, scaring one of his kids, when he saw on television that Price edged Justin Verlander for the American League prize. Both winners are represented by Bo McKinnis, who watched the announcements with Dickey at his home in Nashville, Tenn.

"I guess we can call him Cy agent now," Price quipped on a conference call.

The hard-throwing lefty barely beat out Verlander in balloting by the Baseball Writers' Association of America, preventing the Detroit Tigers' ace from winning consecutive Cy Youngs.

Runner-up two years ago, Price was the pick this time. He received 14 of 28 first-place votes and finished with 153 points to 149 for Verlander, chosen first on 13 ballots.

"It means a lot," Price said. "It's something that I'll always have. It's something that they can't take away from me."

Other than a 1969 tie between Mike Cuellar and Denny McLain, it was the closest race in the history of the AL award.

Rays closer Fernando Rodney got the other first-place vote and came in fifth.

The 38-year-old Dickey was listed first on 27 of 32 National League ballots and totaled 209 points, 113 more than 2011 winner Clayton Kershaw of the Los Angeles Dodgers. Washington lefty Gio Gonzalez finished third.

Cincinnati right-hander Johnny Cueto and Atlanta closer Craig Kimbrel each received a first-place vote, as did Gonzalez. Kershaw had two.

Dickey joined Dwight Gooden (1985) and three-time winner Tom Seaver as the only Mets to win the award. The right-hander went 20-6 with a 2.73 ERA, making him the club's first 20-game winner since Frank Viola in 1990, and became the first major leaguer in 24 years to throw consecutive one-hitters.

Perhaps most impressive, Dickey did it all during a season when the fourth-place Mets finished 74-88.

"It just feels good all over," he said on MLB Network.

Dickey switched from conventional pitcher to full-time knuckleballer in a last-ditch effort to save his career. It took him years to finally master the floating, darting pitch, which he often throws harder (around 80 mph) and with more precision than almost anyone who used it before him.

"I knew what I was going to be up against in some regard when I embraced this pitch," Dickey said.

He was the first cut at Mets spring training in 2010 but earned a spot in the big league rotation later that season and blossomed into a dominant All-Star this year. He led the NL in strikeouts (230), innings (233 2-3), complete games (five) and shutouts (three) — pitching through an abdominal injury most of the way.

"I am not a self-made man by any stretch of the imagination," Dickey said. "The height of this story, it's mind-blowing to me, it really is."

A member of the 1996 U.S. Olympic team and a first-round draft pick out of Tennessee, Dickey was devastated when the Texas Rangers reduced their signing-bonus offer from more than $800,000 to $75,000 after they discovered during a physical that he was missing a major ligament in his pitching elbow.

Undeterred, perseverance got him to the big leagues anyway. When he failed, the knuckleball brought him back.

Among those he thanked ceaselessly for helping him on that long and winding road to success were all his proud knuckleball mentors, including Charlie Hough, Tim Wakefield and Hall of Famer Phil Niekro.

"It brings a real degree of legitimacy I think to the knuckleball fraternity and I'm glad to represent them and I'm certainly grateful to all those guys," Dickey said. "This was a victory for all of us."

Dickey said he received 127 text messages and 35-40 phone calls in the moments immediately following the Cy Young announcement.

The only call he took was from Niekro, a 318-game winner from 1964-87. The first texts Dickey responded to were from Wakefield and Hough.

"Most well-deserved," Niekro said in a comment provided by the Hall of Fame. "I'm super proud of him, as a pitcher and as an individual."

Dickey has one year left on his contract at $5.25 million and New York general manager Sandy Alderson has said signing the pitcher to a multiyear deal is one of his top offseason priorities. Alderson, however, would not rule out trading his unlikely ace.

"I believe the Mets are going to be a lot better and I want to be part of the solution," Dickey said, adding that he hopes the sides can strike a deal and he'd be happy to end his career in New York.

"I want to be loyal to an organization that's given me an opportunity," he said. "At the same time, you don't want to be taken advantage of. I've been on that side of it, too, as a player."

Price went 20-5 to tie Jered Weaver for the American League lead in victories and winning percentage. The 27-year-old lefty had the lowest ERA at 2.56 and finished sixth in strikeouts with 205.

Verlander, also the league MVP a year ago, followed that up by going 17-8 with a 2.64 ERA and pitching the Detroit Tigers to the World Series. He led the majors in strikeouts (239), innings (238 1-3) and complete games (six).

Price tossed 211 innings in 31 starts, while Verlander made 33. One factor that could have swung some votes, however, was this: Price faced stiffer competition in the rugged AL East than Verlander did in the AL Central.

"I guess it's a blessing and a curse at the same time," Price said. "There's not an easy out in the lineups every game. It feels like a postseason game."

The No. 1 pick in the 2007 amateur draft out of Vanderbilt, Price reached the majors the following year and has made three straight All-Star teams.

Despite going 19-6 with a 2.72 ERA in 2010, he finished a distant second in Cy Young voting to Felix Hernandez, who won only 13 games for last-place Seattle but dominated most other statistical categories that year.

The two MVP awards will be announced Thursday. Verlander's teammate, Triple Crown winner Miguel Cabrera, is a leading contender in the American League.

NOTES: The last AL pitcher to win back-to-back Cy Youngs was Boston's Pedro Martinez in 1999 and 2000. San Francisco RHP Tim Lincecum did it in the National League in 2008-09. ... Price and Dickey became the fourth pair of Cy Young winners born in the same state, according to STATS. The others were Jim Lonborg and Mike McCormick in 1967 (California), Viola and Orel Hershiser in 1988 (New York) and Pat Hentgen and John Smoltz in 1996 (Michigan). ... Niekro and his brother, Joe, both finished second in Cy Young voting, as did fellow knuckleballer Wilbur Wood.

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I Was Misinformed: The Time She Tried Viagra

I have noticed, in the bragging-rights department, that “he doesn’t need Viagra” has become the female equivalent of the male “and, I swear, she’s a real blonde.” Personally, I do not care a bit. To me, anything that keeps you happy and in the game is a good thing.

But then, I am proud to say, I was among the early, and from what I gather, rare female users.

It happened when the drug was introduced around 1998. I was 50, but after chemotherapy for breast cancer — and later, advanced ovarian cancer — I was, hormonally speaking, pretty much running on fumes. Whether this had diminished my sex drive I did not yet know. One may have Zorba-esque impulses when a cancer diagnosis first comes in; but a treatment that leaves you bald, moon-faced and exhausted knocks that out of your system pretty fast.

But by 1998, the cancer was gone, my hair was back and I was ready to get back in the game. I was talking to an endocrinologist when I brought up Viagra. This was not to deal with the age-related physical changes I knew it would not address, it was more along the feminist lines of equal pay for equal work: if men have this new sex drug, I want this new sex drug.

“I know it’s supposed to work by increasing blood flow,” I told the doctor, “But if that’s true for men, shouldn’t it be true for women, too?”

“You’re the third woman who asked me that this week,” he said.

He wrote me a prescription. I was not seeing anyone, so I understood that I would have to do both parts myself, but that was fine. I have a low drug threshold and figured it might be best the first time to fly solo. My memory of the directions are hazy: I think there was a warning that one might have a facial flush or headaches or drop dead of a heart attack; that you were to take a pill at least an hour before you planned to get lucky, and, as zero hour approached, you were supposed to help things along by thinking beautiful thoughts, kind of like Peter Pan teaching Wendy and the boys how to fly.

But you know how it is: It’s hard to think beautiful thoughts when you’re wondering, “Is it happening? Do I feel anything? Woof, woof? Hello, sailor? Naaah.”

After about an hour, however, I was aware of a dramatic change. I had developed a red flush on my face; I was a hot tomato, though not the kind I had planned. I had also developed a horrible headache. The sex pill had turned into a bad joke: Not now, honey, I have a headache.

I put a cold cloth on my head and went to sleep. But here’s where it got good: When I slept, I dreamed; one of those extraordinary, sensual, swimming in silk sort of things. I woke up dazed and glowing with just one thought: I gotta get this baby out on the highway and see what it can do.

A few months later I am fixed up with a guy, and after a time he is, under the Seinfeldian definition of human relations (Saturday night date assumed) my official boyfriend. He is middle aged, in good health. How to describe our romantic life with the delicacy a family publication requires? Perhaps a line from “Veronika, der Lenz ist da” (“Veronica, Spring Is Here”), a song popularized by the German group the Comedian Harmonists: “Veronika, der Spargel Wächst” (“Veronica, the asparagus are blooming”). On the other hand, sometimes not. And so, one day, I put it out there in the manner of sport:

“Want to drop some Viagra?” I say.

Here we go again, falling into what I am beginning to think is an inevitable pattern: lying there like a lox, or two loxes, waiting for the train to pull into the station. (Yes, I know it’s a mixed metaphor, but at least I didn’t bring in the asparagus.) So there we are, waiting. And then, suddenly, spring comes to Suffolk County. It’s such a presence. I’m wondering if I should ask it if it hit traffic on the L.I.E. We sit there staring.

My reaction is less impressive. I don’t get a headache this time. And romantically, things are more so, but not so much that I feel compelled to try the little blue pills again.

Onward roll the years. I have a new man in my life, who is 63. He does have health problems, for which his doctor prescribes an E.D. drug. I no longer have any interest in them. My curiosity has been satisfied. Plus I am deeply in love, an aphrodisiac yet to be encapsulated in pharmaceuticals.

We take a vacation in mountain Mexico. We pop into a drugstore to pick up sunscreen and spot the whole gang, Cialis, Viagra, Levitra, on a shelf at the checkout counter. No prescription needed in Mexico, the clerk says. We buy all three drugs and return to the hotel. I try some, he tries some. In retrospect, given the altitude and his health, we are lucky we did not kill him. I came across an old photo the other day. He is on the bed, the drugs in their boxes lined up a in a semi-circle around him. He looks a bit dazed and his nose is red.

Looking at the picture, I wonder if he had a cold.

Then I remember: the flush, the damn flush. If I had kids, I suppose I would have to lie about it.

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Obama Meets C.E.O.’s as Fiscal Reckoning Nears

Luke Sharrett for The New York Times

Ursula M. Burns, chief of Xerox, said the president discussed few specifics of a potential agreement but emphasized that “we cannot go over the fiscal cliff.”

WASHINGTON — President Obama extended an olive branch to business leaders Wednesday, seeking their support as he prepared to negotiate with Congressional Republicans over the fiscal impasse in Washington.

If Congress and the president cannot reach a deal to reduce the deficit by January, more than $600 billion in tax increases and spending cuts will go into effect immediately — a prospect many chief executives and others warn could tip the economy back into recession.

Even so, Mr. Obama has some fence-mending to do before he can count on any serious backing from the business community.

“The president brought up that he hadn’t always had the best relationship with business, and he didn’t think he deserved that, but he understood that’s where things were and wanted it to be better,” said David M. Cote, chief executive of Honeywell. He was one of a dozen corporate leaders invited to meet Mr. Obama at the White House for 90 minutes Wednesday afternoon, after the president’s first news conference since the election.

While Mr. Obama did not present a detailed plan at Wednesday’s meeting or reveal what he would propose in terms of new corporate taxes, he strongly reiterated that he would not allow tax cuts for the middle class to expire. The president, according to attendees and aides, said he was committed to a balanced approach of reductions in entitlements and other government spending and increases in revenue.

With time running out, many people expect the president and Republican leaders in Congress to come up with a short-term compromise that prevents the full slate of tax increases and spending cuts from hitting in January. That would give both sides more time to come up with a far-reaching deal on entitlement spending, even as they work on a broad tax overhaul later next year.

One corporate official briefed on the meeting said that the chief executives came away with a sense that Mr. Obama was poised to present a more formal proposal in the next few days, but that he did not press them for support on particular policies. “It was more of a back and forth,” he said.

The chief executives from some of the country’s biggest and best-known companies, including Procter & Gamble and I.B.M., were not unified on everything, according to one who was interviewed after the meeting.

Many of the executives who described the meeting would speak only on condition of anonymity.

The outreach to business comes as both the White House and corporate America maneuver ahead of the year-end deadline, as well as the beginning of Mr. Obama’s second term. Many executives were put off by what they saw as antibusiness rhetoric coming from the White House in his first term, and many also oppose tax increases on the rich that Mr. Obama favors but would hit them personally.

Both sides have plenty to gain from a better relationship. Business leaders want to buffer their image after the recession and the financial crisis, while Mr. Obama would gain valuable leverage if he could persuade even a few chief executives to come out in favor of higher taxes on people with incomes over $250,000.

Lloyd C. Blankfein, chief executive of Goldman Sachs, publicly endorsed higher tax rates in an opinion article published in The Wall Street Journal on Wednesday.

“I believe that tax increases, especially for the wealthiest, are appropriate, but only if they are joined by serious cuts in discretionary spending and entitlements,” he wrote.

While Mr. Blankfein and other Wall Street leaders have been speaking out about the dangers of the fiscal impasse, only one executive from the financial services industry, Kenneth I. Chenault of American Express, was at Wednesday’s meeting.

Afterward, the corporate leaders seemed pleased with the tone of the meeting but cautious about the prospect of finding common ground with the White House on the budget choices facing Congress and the president.

“I’d say everybody came away feeling pretty good about the whole discussion,” Mr. Cote said. “Now, all of us are C.E.O.’s, so we’ve learned not to confuse words with results. And that’s what we still need to see.”

Ursula M. Burns, chief executive of Xerox, who was also at the meeting, said afterward that it was clear that “we’re going to have to work through some sticking points.” But while “we didn’t get into too many specifics,” she said, it was also made clear that “we cannot go over the fiscal cliff.”

Ms. Burns’s comments about the potentially dire consequences of the fiscal impasse echoed those of other chief executives, including many in the Business Roundtable, which began an ad campaign Tuesday calling on lawmakers to resolve the issue quickly. The Campaign to Fix the Debt, a new group with a $40 million budget and the support of many Fortune 500 chiefs, began its own ad campaign on Monday.

Michael T. Duke, chief executive of Wal-Mart Stores, warned in a statement after the meeting that “before the end of the year, Washington needs to find an agreement to avoid the fiscal cliff.” He said Walmart customers “are working hard to adapt to the ‘new normal,’ but their confidence is still very fragile. They are shopping for Christmas now, and they don’t need uncertainty over a tax increase.”

 

Helene Cooper reported from Washington and Nelson D. Schwartz from New York. Jackie Calmes contributed reporting from Washington.

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France Grants Its Recognition to Syria Rebels

Javier Manzano/Agence France-Presse — Getty Images

Smoke billowed from burning tires as a Syria rebel fired towards regime forces during clashes in the Al-Amariya district of Aleppo in Syria on Tuesday.

PARIS — France announced Tuesday that it was recognizing the newly formed Syrian rebel coalition and would consider arming the group, seeking to inject momentum into a broad Western and Arab effort to build a viable and effective opposition that would hasten the end of a stalemated civil war that has destabilized the Middle East.

The announcement by President François Hollande made France the first Western country to fully embrace the new coalition, which came together this past weekend under Western pressure after days of difficult negotiations in Doha, Qatar.

The goal was to make an opposition leadership — both inside and outside the country — representative of the array of Syrian groups pressing for the downfall of President Bashar al-Assad. Although Mr. Assad is increasingly isolated as his country descends further into mayhem and despair after 20 months of conflict, he has survived partly because of the disagreements and lack of unity among his opponents.

Throughout the conflict, the West has taken half measures and been reluctant to back an aggressive effort to oust Mr. Assad. This appears to be the first time that Western nations, with Arab allies, are determined to build a viable opposition leadership that can ultimately function as a government. Whether it can succeed remains unclear.

Mr. Hollande went beyond other Western pledges of support for the new Syrian umbrella rebel group, which calls itself the National Coalition of Syrian Revolutionary and Opposition Forces. But Mr. Hollande’s announcement clearly signaled expectations that if the group can establish political legitimacy and an operational structure inside Syria, creating an alternative to the Assad family’s four decades in power, it will be rewarded with further recognition, money and possibly weapons.

“I announce that France recognizes the Syrian National Coalition as the sole representative of the Syrian people and thus as the future provisional government of a democratic Syria and to bring an end to Bashar al-Assad’s regime,” said Mr. Hollande, who has been one of the Syrian president’s harshest critics.

As for weapons, Mr. Hollande said, France had not supported arming the rebels up to now, but “with the coalition, as soon as it is a legitimate government of Syria, this question will be looked at by France, but also by all countries that recognize this government.”

Political analysts called Mr. Hollande’s announcement an important moment in the Syrian conflict, which began as a peaceful Arab Spring uprising in March 2011. It was harshly suppressed by Mr. Assad, turned into a civil war and has left nearly 40,000 Syrians dead, displaced about 2.5 million and forced more than 400,000 to flee to neighboring countries, according to international relief agencies.

“It’s certainly another page of the story,” Augustus Richard Norton, a professor of international relations at Boston University and an expert on Middle East political history, said of the French announcement. “I think it’s important. But it will be much more important if other countries follow suit. I don’t think we’re quite there yet.”

Some drew an analogy to France’s leading role in the early days of the Libyan uprising when it helped funnel aid, and later military support, to the rebels who had firmly established themselves in eastern Libya and would later topple Col. Muammar el-Qaddafi. But in Syria, rebels have not been as organized and have no hold on significant amounts of territory — at least not enough to create a provisional government that could resist Mr. Assad’s military assaults. The West has also refused, so far, to impose a no-fly zone over Syria, which was critical to the success of the Libyan uprising.

Andrew J. Tabler, a Syria expert at the Washington Institute for Near East Policy, said that the new coalition would have to create a secure zone in Syria to be successful, and that that step would require support from the United States, which was instrumental in the negotiations that led to the group’s creation but has not yet committed to giving it full recognition.

What the French have done, Mr. Tabler said, is significant because they have started the process of broader recognition, putting pressure on the group to succeed. “They’ve decided to back this umbrella organization and hope that it has some kind of political legitimacy and keep it from going to extremists,” he said. “It’s a gamble. The gamble is that it will stiffen the backs of the opposition.”

Steven Erlanger reported from Paris, and Rick Gladstone from New York. Reporting was contributed by Neil MacFarquhar and Hwaida Saad from Beirut, Lebanon; Nick Cumming-Bruce from Geneva; and Richard Berry from Paris.

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Curry scores 23, Duke holds off Kentucky 75-68

ATLANTA (AP) — Seth Curry scored 23 points and No. 9 Duke held off a furious comeback by No. 3 Kentucky, beating the defending national champions 75-68 Tuesday night in the first matchup between the storied programs since 2001.

Duke (2-0) appeared to be in control, even with Mason Plumlee on the bench in foul trouble. The Blue Devils ripped off a 13-3 run, capped by Rasheed Sulaimon's 3-pointer that made it 58-44 with 9 1/2 minutes remaining.

But Kentucky (1-1) wasn't done, rallying like the defending champ even though this is essentially a whole new team in coach John Calipari's one-and-done system. The Wildcats outscored Duke 17-6 over the next six minutes and actually had a chance to tie it.

Julius Mays missed a 3-pointer with the Blue Devils clinging to a 64-61 lead.

Curry made sure youthful Kentucky didn't get any closer. He schooled freshman guard Archie Goodwin on a drive — using a pump fake to get past the Wildcat — that essentially clinched the win.

Alex Poythress led Kentucky with 20 points, while Nerlens Noel and Goodwin added 16 apiece. All are freshmen, showing this team has plenty of room to grow before tournament time.

Even though Kentucky opened the season with a victory over Maryland, Calipari wasn't happy with his team's effort — especially on the boards. They were outrebounded 54-38 by the Terrapins, including 28 at the offensive end.

That was simply unacceptable given Kentucky's vaunted frontcourt featuring the 6-foot-10 Noel and 7-footer Willie Cauley-Stein.

Rebounding wasn't as much of an issue this time — Duke finished with a 31-30 edge — but the more experienced Blue Devils showed a bit more poise down the stretch. Especially Curry, a senior guard.

After Duke let Kentucky back in the game by continuing to put up errant 3-pointers, Curry finally changed things up. He pumped faked and took off for the hoop, drawing a foul on Goodwin with just over 2 minutes remaining. He knocked down both ends of the one-and-one, pushing Duke to a 66-61 lead with 2:04 remaining.

Poythress gave the Wildcats a semblance of hope, putting back a missed shot, but Curry blew by Goodwin for a layin that made it 68-63 with 1:13 left and essentially sealed it. Calipari called a timeout and screamed at Goodwin as the freshman walked toward the bench.

In the final minute, Curry added two more free throws to finish off the Wildcats.

Plumlee fouled out near the end, but not before scoring 18 points in 29 minutes. Ryan Kelly and Sulaimon had 10 points apiece. Both Curry and Sulaimon hit three shots beyond the arc, as the Blue Devils finished 8 of 18 from 3-point range.

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Kidney Donors Given Mandatory Safeguards

ST. LOUIS — Addressing long-held concerns about whether organ donors have adequate protections, the country’s transplant regulators acted late Monday to require that hospitals thoroughly inform living kidney donors of the risks they face, fully evaluate their medical and psychological suitability, and then track their health for two years after donation.

Enactment of the policies by the United Network for Organ Sharing, which manages the transplant system under a federal contract, followed six years of halting development and debate.

Meeting at a St. Louis hotel, the group’s board voted to establish uniform minimum standards for a field long regarded as a medical and ethical Wild West. The organ network, whose initial purpose was to oversee donation from people who had just died, has struggled at times to keep pace with rapid developments in donations from the living.

“There is no question that this is a major development in living donor protection,” said Dr. Christie P. Thomas, a nephrologist at the University of Iowa and the chairman of the network’s living donor committee.

Yet some donor advocates complained that the measures did not go far enough, and argued that the organ network, in its mission to encourage transplants, has a conflict of interest when it comes to safeguarding donors.

Three years ago, the network issued some of the same policies as voluntary guidelines, only to have the Department of Health and Human Services insist they be made mandatory.

Although long-term data on the subject is scarce, few living kidney donors are thought to suffer lasting physical or psychological effects. Kidney donations, known as nephrectomies, are typically done laparoscopically these days through a series of small incisions. The typical patient may spend only a few nights in a hospital and feel largely recovered after several months.

Kidneys are by far the most transplanted organs, and there have been nearly as many living donors as deceased ones over the last decade. What data is available suggests that those with one kidney typically live as long as those with two, and that the risk of a donor dying during the procedure is roughly 3 in 10,000.

But kidney transplants, like all surgery, can sometimes end in catastrophe.

In May at Montefiore Medical Center in the Bronx, a 41-year-old mother of three died when her aorta was accidentally cut during surgery to donate a kidney to her brother. In other recent isolated cases, patients have received donor kidneys infected with undetected H.I.V. or hepatitis C.

Less clear are any longer-term effects on donors. Research conducted by the United Network for Organ Sharing shows that of roughly 70,000 people who donated kidneys between late 1999 and early 2011, 27 died within two years of medical causes that may — or may not — have been related to donation. For a small number of donors, their remaining kidney failed, and they required dialysis or a transplant.

The number of living donors — 5,770 in 2011 — has dropped 10 percent over the last two years, possibly because the struggling economy has made it difficult for prospective donors to take time off from work to recuperate. With the national kidney waiting list now stretching past 94,000 people, and thousands on the list dying each year, transplant officials have said they must improve confidence in the system so more people will donate.

The average age of donors has been rising, posing additional medical risks. And new ethical questions have been raised by the emergence of paired kidney exchanges and transplant chains started by good Samaritans who give an organ to a stranger.

Brad Kornfeld, who donated a kidney to his father in 2004, told the board that it had been impossible to find good information about what to expect, leaving him to search for answers on unreliable Internet chat rooms. He said he had almost backed out.

“If information is power,” said Mr. Kornfeld, a Coloradan who serves on the living donor committee, “the lack of information is crippling.”

Under the policies approved this week, the organ network will require hospitals to collect medical data, including laboratory test results, on most living donors to study lasting effects. Results must be reported at six months, one year and two years.

Similar regulations have been in place since 2000, but they did not require blood and urine testing, and hospitals were allowed to report donors who could not be found as simply lost.

That happened often. In recent years, hospitals have submitted basic clinical information — like whether donors were alive or dead — for only 65 percent of donors and lab data for fewer than 40 percent, according to the organ network. Although the network holds the authority, no hospital has ever been seriously sanctioned for noncompliance.

“It’s time we put some teeth into our policy,” said Jill McMaster, a board member from Tennessee.

By 2015, transplant programs will have to report thorough clinical information on at least 80 percent of donors and lab results on at least 70 percent. The requirements phase in at lower levels for the next two years.

Dr. Stuart M. Flechner of the Cleveland Clinic, the chairman of a coalition of medical societies that made recommendations to the organ network, said 9 of 10 hospitals would currently not meet the new requirement.

Donna Luebke, a kidney donor from Ohio who once served on the organ network’s board, said the new standards would matter only if enforcement were more rigorous. She noted that the organization was dominated by transplant doctors: “UNOS is nothing but the foxes watching the henhouse,” she said.

Another of the new regulations prescribes in detail the medical and psychological screenings that hospitals must conduct for potential donors. It requires automatic exclusion if the potential donor has diabetes, uncontrolled hypertension or H.I.V., among other conditions.

The new policies also require that hospitals appoint an independent advocate to counsel and represent donors, and that donors receive detailed information in advance about medical, psychological and financial risks.

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At Microsoft, Sinofsky Seen as Smart but Abrasive

On a warm night in late October, Steven Sinofsky stood on a platform in New York’s Times Square, smiling as a huge crowd roared at the unveiling of a Microsoft retail store, where Windows 8 and the company’s new Surface tablet were about to go on sale.

Less than three weeks later, Mr. Sinofsky — who, as the head of Windows, was arguably the second-most important leader at Microsoft — suddenly left the company. His abrasive style was a source of discord within Microsoft, and he and Steven A. Ballmer, Microsoft’s chief executive, agreed that it was time for him to leave, according to a person briefed on the situation who was not authorized to speak publicly about it.

Mr. Sinofsky was widely admired for his effectiveness in running one of the biggest and most important software development organizations on the planet. But his departure, which Microsoft announced late on Monday, parallels in many respects that of Scott Forstall, the headstrong former head of Apple’s mobile software development, who was fired by Apple’s chief executive, Timothy D. Cook, in late October.

Both cases underscore a quandary that chief executives sometimes face: when do the costs of keeping brilliant leaders who cannot seem to get along with others outweigh the benefits?

The tipping point that led to Mr. Sinofsky’s departure came after an accumulation of run-ins with Mr. Ballmer and other company leaders, rather than a single incident, according to interviews with several current and former Microsoft executives who declined to be named discussing internal matters.

One example of the kind of behavior that hurt Mr. Sinofsky’s standing at the company occurred this year at a two-day retreat for Microsoft’s senior executives at the Semiahmoo resort on the coast just below the Canadian border in Washington State. At the meeting, Microsoft’s various division heads were expected to make presentations on their businesses, answer questions and remain to hear their peers repeat the exercise.

When Mr. Sinofsky stood on the first day to speak about the Windows division, he told the group he had not prepared a presentation, and if they wanted to catch up on the progress of Windows 8, they could read his company blog, where he publicly chronicled the software’s development. He answered questions from the audience and then left the resort, while his colleagues remained until the next day, according to multiple people who were present.

Mr. Sinofsky’s early exit and halfhearted presentation were widely noted by his colleagues, irking even his admirers in the company. “He lost a lot of support,” one attendee said.

It wasn’t until this Monday, though, that Mr. Sinofsky and Mr. Ballmer both decided it would be best if Mr. Sinofsky left. Bill Gates, Microsoft’s chairman, supported the move, a person briefed on the matter said. Mr. Sinofsky served as a technical assistant to Mr. Gates in the 1990s.

In an e-mail to Microsoft employees, Mr. Sinofsky said the decision to leave “was a personal and private choice.” Many surprised Microsoft insiders noted that Mr. Sinofsky’s departure was immediate, an unusual arrangement for someone with a 23-year track record at the company. A Microsoft spokesman, Frank Shaw, said Mr. Sinofsky was not available to comment.

Although Mr. Ballmer grew increasingly impatient with Mr. Sinofsky throughout the year, he held back from taking any action earlier to avoid disrupting the release of Windows 8, the most important product Microsoft has unveiled in years, a person with knowledge of his thinking said.

The final decision could not have come lightly. Although many people at Microsoft viewed him as a ruthless corporate schemer, Mr. Sinofsky ran the highly complex organization responsible for Windows as a disciplined army that met deadlines, and he was respected by people on his team.

He achieved hero status within Microsoft several years ago by taking over the leadership of Windows after the debacle that was Windows Vista, a much-delayed operating system whose sluggish performance and technical problems worsened Microsoft’s reputation for mediocre software. Mr. Sinfosky led the development of a new version of the operating system, Windows 7, which was positively reviewed and sold well.

“He did great things with Windows,” said Michael Cusumano, a professor at the Sloan School of Management at the Massachusetts Institute of Technology. “That’s still the core of the company.”

But while Mr. Sinofsky was effective, Mr. Cusumano said, he could be secretive and difficult to get along with, as he learned while dealing with Mr. Sinofsky while Mr. Cusumano was writing a book on Microsoft in the early 1990s. “I could imagine that he burned a lot of bridges and created a bunch of enemies,” he said.

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