Two council members assail LAFD over response times

The Los Angeles Fire Department, which has been embroiled in a months-long controversy over response-time data, has failed to move decisively to resolve the problem, two Los Angeles City Council members said Friday.

In a formal motion, council members Eric Garcetti and Mitch Englander demanded that fire officials appear before the full council as soon as possible to explain why the department has not presented specific actions that could be taken to improve response times by rescuers during life-and-death emergencies.

"The department's managers are either unwilling or unable to do their job to reduce response times and make L.A. safer," said Garcetti, who is running for mayor, in a statement.

Battalion Chief Armando Hogan said Fire Chief Brian Cummings would respond to issues regarding the agency's data on Tuesday at LAFD headquarters, after a regularly scheduled meeting of the Fire Commission.

Friday's comments by the council members were some of the most critical to date about Cummings and his department since the data controversy erupted in March. That's when the LAFD acknowledged it was using response time figures that made it appear that rescuers were reaching victims in need faster than they actually were.

The motion comes after a series of Times investigations on delays in processing 911 calls, dispatching rescuers and summoning the nearest firefighters from other jurisdictions in medical emergencies.

On Thursday, The Times reported that waits for medical aid vary dramatically across Los Angeles' diverse neighborhoods. Residents in some of the city's most exclusive hillside communities can wait twice as long for rescuers to arrive as people who live in densely packed areas in and around downtown, according to the analysis that mapped out more than 1 million LAFD dispatches since 2007.

A task force of experts formed by Cummings has found that inaccurate response time data were a result of systemic problems in the LAFD's 30-year-old computer-assisted dispatch system and a lack of training by LAFD personnel who were assigned to complex data analysis projects.

Earlier this year, Garcetti and other council members asked the LAFD to return with a five-year plan laying out what is needed to improve response times. The council members wanted specifics regarding technology, more firefighters and other resources.

"Six months later, we have bupkis, and that's unacceptable," said Garcetti's spokesman, Yusef Robb.

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Israel's Rocket-Hunting Ace Got His Start Playing <em>Warcraft</em>

War has once again erupted between Hamas and the Israel Defense Forces, with the Gaza-based militant group launching hundreds of rockets and missiles at Israeli towns. But many of these projectiles never made it to their targets, thanks to the new Iron Dome missile defense system that’s arguably become this conflict’s most important technological difference-maker. This article, first published in April, tracks the story of Iron Dome’s most prolific “gunner.” While his record for shooting down missiles and rockets has by now undoubtedly fallen, the tale still gives insight into the battle now gripping Israel and Gaza.

KFAR GVIROL, Israel — While many of the boys in Idan Yahya’s high school class were buffing up and preparing themselves for selection into elite combat units, this gawky teenager was spending “a lot of time” playing Warcraft — the real-time strategy computer game where opposing players command virtual armies in a battle to dominate the fictional world of Azeroth.

Four years later, the high school jocks who sweated it out in pre-military academies so they could make the cut into the Israel Defense Force’s Special Operations units are now crawling through the sand dunes on the outskirts of the Gaza Strip and watching while Idan knocks rockets out of the sky hundreds of meters above their heads. Idan Yahya, 22, an Iron Dome “gunner” in the Active Air Defense Wing 167, currently holds the record for the number of rockets intercepted: eight.

People in the army describe him variously as a geek and an ace. But the geek who grew up playing Warcraft is now a highly prized soldier on the cutting edge of real war craft. He’s the Israeli army’s top rocket interceptor.

The Iron Dome is a mobile anti-rocket interception system that Israel moves around the country to shoot down the rockets fired at its civilian population centers by armed groups in Gaza and southern Lebanon. Its radar picks up launches and fires interceptor missiles at them if they’re calculated to be heading towards populated centers. The system has become increasingly important as Hamas, Hezbollah and other groups amass surface-to-surface missiles to hit the Israeli home front with, thus bypassing the Israel Defense Force’s overwhelming advantage of concentrated firepower and fighter aircraft. Should Israel attack Iran’s nuclear installations, the expected rocket reprisals from the armed groups on its borders will keep Iron Dome very, very busy.

As the war between Israelis and Arabs enters its sixth decade (or its 500th depending on who you ask), it is increasingly becoming a hi-tech rocket war. The IDF’s Director of Military Intelligence Maj. Gen. Aviv Kochavi in February said there were 200,000 rockets aimed at Israel from the south, north and east. And in this increasingly technological battlefield of rockets, anti-rocket interceptors, radars, control rooms, drones and drone hacking, it is soldiers like Idan Yahya (and whoever his counterparts on the Arab side are) who are making the most impact.

Computer geek, keyboard combatant, soldier, call him what you will, Idan and others like him man the controls of the latest rock star in advanced military technology. “There are a lot of flashing blips, signs, symbols, colors and pictures on the screen. You look at your tactical map; see where the threat is coming from. You have to make sure you’re locked onto the right target. There’s a lot of information and there is very little time. It definitely reminds me of Warcraft and other online strategy games,” Idan says.

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“Sister” Director Tackles Taboo of Switzerland’s Class Divide With Her Oscar Contender

LOS ANGELES (TheWrap.com) – Director Ursula Meier can hardly believe that her film “Sister” – which depicts tenements, poverty and a seemingly rigid class system in lovely Switzerland – has made it over the Alps to Hollywood for Academy consideration.

“It shows a not-very-usual aspect of Switzerland,” Meier told the audience at a showing of “Sister” Thursday night at the Landmark, part of TheWrap’s Academy Screening Series. “We don’t show the beautiful mountains and the green and the lush life … For me it was important to show another point of view on this country to the world. Because usually it’s Montblanc, chocolate, and Swatch.”

Indeed, with her second film, Meier has given international audiences something else to associate with Switzerland: larcenous snow urchins.

“Sister” centers mostly around 12-year-old Simon (Kacey Mottet Klein), who lives in a high-rise tenement in a not-so-snowy valley far below a ski resort and takes gondolas to the top to steal wealthy tourists’ skis right out from under their goggles.

Wily Simon is financing not just his own existence but that of Louise (Lea Seydoux), the title character, who just might be the worst parental figure or caretaker in a cinematic year that did, after all, include “Beasts of the Southern Wild.”

It would involve spoilers to explain why Simon’s older sis is not everything she’s cracked up to be. But there’s nothing misleading about this boy-crazy, substance-abusing twentysomething gal’s unfitness to watch over Simon, the breadwinner of their sad two-person family.

He has to empty out his cash drawer to bribe Louise into snuggling with him, and when he entrusts her with the mere task of waxing skis, she can’t even do that without spilling cigarette ashes on the stolen merchandise.

“It was important for me, when we were at the ski resort, to showing the back door of the restaurant, and the workers inside … And it’s just at the end, when it’s finished, when there is no more snow and the ski resort is closed, for the first time Simon looks at the landscape. And we can see how beautiful this place is, but it’s too late now.”

Meier worked with her young leading man on her first theatrical feature, 2009′s “Home,” where he played Isabella Huppert’s son when he was just 7. She’s emphatic that Klein is not the kind of child actor who has to be tricked into giving a performance.

“During the first casting, I ask him, ‘What do you like to do in your life, Kasey?’ And he told me, ‘Thinking.’ So I said ‘OK, think,’ and I turned on the camera, and he was amazing … He understands that acting is to be, not to look like. So I really wanted to write for him with this film, because it was such an amazing experience on my first film.”

The role of the severely neglectful “sister” was tougher to nail down, both for the director and her leading actress.

“This character was the challenge of the film,” Meier said. “Because Kacey’s character is a child, so for the spectator, of course he’s a victim. But with the character of Louise, for Lea as an actress, at the beginning for her it was very hard to find the fragility of the character. I showed her a lot of films like ‘Vagabond’ … I explained to her, you were 14 when you were pregnant; it was too young for a girl, and you stopped your studies and got bad jobs you cut with your family.”

Sometimes, she said, they’d fight because “she couldn’t find the fragility of the character, and suddenly, months later, wow – it was like we cut something open and all the emotion that came out from her was very deep. I was afraid of the spectators judging the character. It was not easy, in the writing, or in the directing with the actors, because I wanted that they would love these characters, even if they’re sometimes terrible. But I like terrible characters.”

Pond told Meier that when it came to supporting actress Gillian Anderson, of “X-Files” fame, “the first time I watched, I didn’t realize it was her till the end credits” – an experience probably shared by most of those in attendance at the screening.

“I’m very happy that you say that,” said Meier, “because if you recognize the actress, you think about the actress.” But the director did want Armstrong to provoke a where-have-I-seen-you-before vibe.

“I really wanted to be played by a star – not to have a star in my film, but because it was important for Simon to have a kind of phantasma this lady, of what he wants as a mother.

And as a spectator, you can have a phantasma on the star. So I like that she came from another country, and not speak French, because she’s almost an apparition.”

Meier admitted she was frightened before the Swiss premiere – before “Sister” went on to play various fests and win the special Golden Bear award at the Berlin Film Festival.

“When I had the first screening in Switzerland, a lady came back to me and was very moved by the film, because it’s usually a taboo to show poverty in Switzerland. She cried and told me, ‘I grew up in exactly the same place. My father was a worker in the factory we saw in the film, and as a child we never had the money to go up.’ I liked that she just said up.”

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Well: Meatless Main Dishes for a Holiday Table

Most vegetarian diners are happy to fill their plates with delicious sides and salads, but if you want to make them feel special, consider one of these main course vegetarian dishes from Martha Rose Shulman. All of them are inspired by Greek cooking, which has a rich tradition of vegetarian meals.

I know that Greek food is not exactly what comes to mind when you hear the word “Thanksgiving,” yet why not consider this cuisine if you’re searching for a meatless main dish that will please a crowd? It’s certainly a better idea, in my mind, than Tofurky and all of the other overprocessed attempts at making a vegan turkey. If you want to serve something that will be somewhat reminiscent of a turkey, make the stuffed acorn squashes in this week’s selection, and once they’re out of the oven, stick some feathers in the “rump,” as I did for the first vegetarian Thanksgiving I ever cooked: I stuffed and baked a huge crookneck squash, then decorated it with turkey feathers. The filling wasn’t nearly as good as the one you’ll get this week, but the creation was fun.

Here are five new vegetarian recipes for your Thanksgiving table — or any time.

Giant Beans With Spinach, Tomatoes and Feta: This delicious, dill-infused dish is inspired by a northern Greek recipe from Diane Kochilas’s wonderful new cookbook, “The Country Cooking of Greece.”

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Northern Greek Mushroom and Onion Pie: Meaty portobello mushrooms make this a very substantial dish.

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Roasted Eggplant and Chickpeas With Cinnamon-Tinged Tomato Sauce and Feta: This fragrant and comforting dish can easily be modified for vegans.

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Coiled Greek Winter Squash Pie: The extra time this beautiful vegetable pie takes to assemble is worth it for a holiday dinner.

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Baked Acorn Squash Stuffed With Wild Rice and Kale Risotto: Serve one squash to each person at your Thanksgiving meal: They’ll be like miniature vegetarian (or vegan) turkeys.

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Drug Shortages Are Becoming Persistent in U.S.

Paul Davis, the chief of a rural ambulance squad in southern Ohio, was down to his last vial of morphine earlier this fall when a woman with a broken leg needed a ride to the hospital.

The trip was 30 minutes, and the patient was in pain. But because of a nationwide shortage, his morphine supply had dwindled from four doses to just one, presenting Mr. Davis with a stark quandary. Should he treat the woman, who was clearly suffering? Or should he save it for a patient who might need it more?

In the end, he opted not to give her the morphine, a decision that haunts him still. “I just feel like I’m not doing my job,” said Mr. Davis, who is chief of the rescue squad in Vernon, Ohio. He has since refilled his supply. “I shouldn’t have to make those kinds of decisions.”

From rural ambulance squads to prestigious hospitals, health care workers are struggling to keep vital medicines in stock because of a drug shortage crisis that is proving to be stubbornly difficult to fix. Rationing is just one example of the extraordinary lengths being taken to address the shortage, which health care workers say has ceased to be a temporary emergency and is now a fact of life. In desperation, they are resorting to treating patients with less effective alternative medicines and using expired drugs. The Cleveland Clinic has hired a pharmacist whose only job is to track down hard-to-find drugs.

Caused largely by an array of manufacturing problems, the shortage has prompted Congressional hearings, a presidential order and pledges by generic drug makers to communicate better with federal regulators.

The problem peaked in 2011, when a record 251 drugs were declared in short supply. This year, slightly more than 100 were placed on the list, and workers say the battle to keep pharmacy shelves stocked continues unabated. The list of hard-to-find medicines ranges from basic drugs like the heart medicine nitroglycerin to a lidocaine injection, which is used to numb tissue before surgery.

A deadly meningitis outbreak caused by contamination at a large drug producer could worsen the situation, federal officials have warned. The Food and Drug Administration said that shortages of six drugs — medicines used during surgery and to treat conditions like congestive heart failure — could get worse after a big compounding pharmacy closed over concerns about drug safety. The pharmacy, Ameridose, shares some management with the New England Compounding Center, which is at the center of a meningitis outbreak that has claimed 33 lives.

“When you can’t treat basic things — cardiac arrest, pain management, seizures — you’re in trouble,” said Dr. Carol Cunningham, the state medical director for the Ohio Department of Public Safety’s emergency services division. “When you only have five tools in your toolbox and three of them are gone, what do you do?”

Dr. Margaret A. Hamburg, the F.D.A. commissioner, said in an interview this week that she was “guardedly optimistic” that the shortage crisis was abating. “I think there’s been an enormous amount of progress,” she said. “We’re seeing real change in the number of shortages that we’re able to recognize early.” More than 150 new shortages have been prevented this year, according to the agency.

But Erin Fox, who tracks supply levels for a broader range of drugs at the University of Utah, said once a drug became scarce, it tended to stay scarce. The university’s Drug Information Service was actively tracking 282 hard-to-find products by the end of the third quarter of this year, a record.

“The shortages we have aren’t going away — they’re not resolving,” she said. “But the good news is we’re not piling more shortages on top.”

In 2011, prompted by emotional pleas by cancer patients and others who said the drug shortage was threatening lives, President Obama issued an executive order requiring drug makers to notify the F.D.A. when a shortage appeared imminent. The agency also loosened some restrictions on importing drugs, and sped up approvals by other manufacturers to make certain medicines.

A law passed this summer contains several provisions aimed at improving the situation, including expediting approval of new generic medicines and requiring the agency’s enforcement unit to better coordinate with its drug-shortage officials before it takes action against a manufacturer.

Ralph G. Neas, the chief executive of the Generic Pharmaceutical Association, said fixing the drug shortage was complex and would take time, but was a top priority. “One shortage is one shortage too many,” he said. “One patient not getting a critical drug is one patient too many.”

Federal drug officials trace much of the drug shortage crisis to delays at plants that make sterile injectable drugs, which account for about 80 percent of the scarce medicines. Nearly a third of the industry’s manufacturing capacity is not running because of plant closings or shutdowns to fix serious quality issues. Other shortages have been caused by supply disruptions of the raw ingredients used to make the drugs, or by manufacturers exiting the market.

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Obama, Hill leaders optimistic on fiscal cliff

WASHINGTON -- Emerging from a closed meeting with President Obama at the White House on Friday, the administration and congressional leaders sounded optimistic on areas of possible compromise over looming fiscal deadlines for tax hikes and spending cuts begin to come into focus.

“The president and the leadership had a constructive meeting and agreed to do everything possible to find a solution that averts the so-called ‘fiscal cliff,’” said Press Secretary Jay Carney. “Both sides agreed that while there may be differences in our preferred approaches, we will continue a constructive process to find a solution and come to a conclusion as soon as possible.”

Administration and congressional leadership staff plan to work while the president travels to Asia, and through the Thanksgiving holiday week, on a framework to discuss once the parties return.

“It’s going to be incumbent on my colleagues to show the American people we’re serious,” said House Speaker John A. Boehner of Ohio as the congressional leaders emerged from the White House to deliver brief comments.

“We have the cornerstones of being able to work something out,” said Senate Majority Leader Harry Reid of Nevada. “This is not something we’re going to wait until the last day of December to get done. We have a plan; we’re going to move forward on it.”

Both Republicans and Democrats remain far from a deal, which is needed by year-end to avoid a fiscal contraction that economists warn could launch another recession. But the outlines of a compromise can be seen as Boehner has signaled Republicans are open to new tax revenue and Obama has softened his insistence that income tax rates must rise to the top 39.6% rate from the Clinton era.

Friday’s closed-door gathering of the principle players is the first sit-down after the election, which emboldened Obama and his allies on Capitol Hill. Americans spoke at the polls, they maintain, preferring the Democratic approach, which asks the wealthiest taxpayers to contribute more revenue, while preventing steep cuts to domestic spending.

At the same time, rank-and-file Republicans emerged from the election with the take-away that voters want the GOP House majority to hold final “line of defense,” as Boehner puts it, against what they see as excessive government overreach. All tax rates will rise on Jan. 1 if no action is taken – about a $2,000 hit for average Americans.

During the meeting, Boehner presented the outline of a deal that resembles the framework he proposed in the days after the election – insisting that the details of a large deficit-reduction package could not be resolved in the short lame-duck session of this Congress.

Instead, the speaker wants the parties to agree to long-term “targets” for tax revenues and spending cuts that would be binding by statute.

Resolving the tax issue is, in many ways, the cornerstone to a deal, as both sides have found common ground in their desire to reverse the coming automatic spending cuts. On Jan. 2, massive across-the-board cuts would hit defense and domestic accounts, forced as part of  a deal last year when the two sides failed to develop a broader deficit reduction plan.

Tax revenue could be raised by closing tax loopholes or capping deductions for the wealthiest Americans, those couple earning incomes above $250,000, or $200,000 for singles -- though experts say that may not raise enough money toward a big deficit reduction deal that both parties want unless tax rates are also increased. Boehner has resisted lifting rates beyond the top bracket of 35%, which has been in place since the George W. Bush era.

As talks begin, both sides are aiming for a broad deficit-reduction deal that could slash some $4 trillion off the nation’s deficits over the next decade by tax and spending reforms.

Any deal on taxes would also require a compromise from Democrats to rein in spending on Medicare, Medicaid and other entitlement programs that are drivers of the nation’s long-term deficit problems. Obama has put forward earlier plans to do that.

With the year-end deadline looming, Obama has repeatedly sought to pressure House Republicans to at least extend the expiring tax rates for middle-class families, while talks on the upper-income rates continue. The president has warned that even the threat of new taxes in the New Year could damper the coming holiday shopping season.

All sides have tried to resist drawing the lines of a stalemate. The meeting opened Friday with the cordial greetings officials use on such occasions.

In a moment of brevity, Obama offered birthday wishes to the Boehner – the speaker turns 63 on Saturday. And the two shook hands.

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Lisa.mascaro@latimes.com

Twitter: @LisaMascaroinDC

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Honda's Mighty Morphin' Micro-Car Transforms to Your Whims

Electrically driven micro-cars haven’t quite caught on yet. Smart has the ForTwo Electric Drive, an overpriced two-seater that’s even more impractical than its gas-powered sibling. Toyota has the iQ EV, an electric version that will only be released in extremely limited quantities, despite Toyota’s lofty goals to the contrary. And now Honda is coming out with its own all-electric runabout, the Micro Commuter prototype.

What sets Honda’s ultra-small city car apart is its platform and size. It’s built atop the automaker’s Variable Design Platform, which houses the battery, control unit and a 15 kW motor. It’s the “skateboard” design we’ve been promised for over a decade, allowing multiple interior and exterior configurations, with a body that’s removable and customizable. Want a two-seat targa-topped convertible one day and a small pickup the next? The Micro Commuter has you covered. It can start off as a one-seater, but can also fit two, riding in tandem, bobsled-style. Even better, with a minuscule footprint that’s eight feet long by four feet wide, it’s smaller than the ForTwo.

The Micro Commuter has a top speed of 50 mph and a 60 mile range from it’s lithium ion battery. According to Honda, a full charge takes three hours, and drivers can also sync up smartphones and tablets and use them as a battery meter, navigation system or back-up camera.

Honda is testing the Micro Commuter, “in various uses including supporting everyday short-distance transportation for families with small children and for senior citizens, home delivery services, commuting and car sharing.” Read: limited-use.

Evaluations are set to start in 2013 are part of a nation-wide initiative started by the Japanese Ministry of Land, Infrastructure, Transportation, and Tourism to look into small, electrically-powered vehicles best suited to urban environments. Honda hopes the car will fall under the “L7” category of regulations, making it a “quadricycle” rather than a motor car, if the production model hits Europe.

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Film defrocks church hierarchy over handling of sex abuse

NEW YORK (Reuters) – Four deaf Wisconsin men were some of the first to seek justice after suffering childhood sexual abuse at the hands of a priest, and a new documentary about the Catholic Church‘s poor handling of such cases stemming from the Vatican seeks to make their voices heard.

“Mea Maxima Culpa: Silence in the House of God” explores the impact of the Roman Catholic Church’s protocol as dictated from the Vatican for dealing with pedophile priests. It opens in U.S. cinemas on November 16, and will air on cable channel HBO in February.

Though American media coverage about child sex abuse by clergy has been extensive since a slew of cases came to light in Boston in 2002, Oscar-winning documentary director Alex Gibney wanted to connect individual stories with what he sees as systemic failures stemming from the top of the church.

“A lot of individual stories had been done about clerical sex abuse, but I hadn’t seen one that really connected the individual stories with the larger cover-up by the Vatican, so that was important,” Gibney told Reuters in an interview.

The film centers on the group of deaf men and their experiences as young boys attending St. John’s School for the Deaf in St. Francis, Wisconsin.

In a letter to the Vatican in 1998, the late Rev. Father Lawrence Murphy admitted abusing some 200 deaf boys over two decades beginning in the 1950s.

Murphy claimed he had repented, and asked to live out his last years as a priest, and was never defrocked or punished by civil authorities. He died in 1998.

In the film, the men communicate their frustrating attempts to bring their experiences to the attention of religious and civil authorities with effusive sign language and facial expressions, paired with voiceovers by actors such as Ethan Hawke.

The film also traces a convoluted bureaucracy – right up to the cardinal who is now Pope Benedict – to reveal a set of policies that the film portrays as often seeming more interested in preserving the Church’s image.

STRUGGLING TO BE HEARD

“These were deaf men whose voices literally couldn’t be heard, so there was a silence from them, and there was also this silence coming from the church, a refusal to confront this obvious crime, in part because they were covering it up,” said Gibney.

The Vatican has denied any cover-up in the Murphy case and in 2010 issued a statement condemning his abuse. It has criticized media reports about the Church’s handling of the cases as anti-Catholic.

Contrasting that, the film shows interviews with former church officials who talk openly of church policies to handle cases by “rehabilitating” abusive clergymen and snuffing out scandal.

Gibney said that all of the Vatican officials he contacted declined his interview requests.

Raised Catholic himself, Gibney no longer practices organized religion, but empathizes with Catholics who feel a sense of loyalty to the religion’s institutions and acknowledges that criticism of the church can feel like a personal attack.

“Mea Maxima Culpa,” a Latin phrase meaning “my most grievous fault” focuses on the failures of the Catholic Church‘s hierarchy. But Gibney – who won an Oscar for “Taxi to the Dark Side” – said the film’s theme transcends religion and is also relevant for secular institutions.

“This is obviously about the church, but it’s also a crime film,” he said. “It’s about abuse of power and it’s about how institutions instead of reckoning with problems try to cover them up. It’s always the cover-up that creates the problem.”

He cited the Jerry Sandusky sex abuse scandal that rocked Penn State University recently, and the BBC’s poor handling of abuse allegations against the late British TV personality Jimmy Savile as examples of secular institutions brought low by similar issues.

“The thing about predators is that they tend to hide in plain sight,” Gibney said. “You’re seeing it now with Sandusky, you’re seeing it now with Jimmy Savile in Great Britain, and you saw it with Father Murphy in the film.”

Gibney thinks that the public’s stubbornly rosy perceptions of charismatic authority figures, including priests, is a major factor in such scandals.

“They’re often involved in charity or good works,” he said of high-profile abusers. “That seems to give you license to do unbelievable things because people cut you all sorts of slack that they wouldn’t normally do for other people.”

(Editing by Christine Kearney and Richard Chang)

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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.

Alex Wong/Getty Images

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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Wealth Matters: Advisers Caution Against Hasty Decisions in Advance of Tax Changes

WITH all the ominous talk of tax increases and a “fiscal cliff” if President Obama and Congressional leaders can’t agree on a plan to avert automatic tax increases on Dec. 31, some investors may be tempted to act soon to take advantage of the current tax rates.

But financial advisers say that in their rush to doing something this year, investors may end up with regrets.

“Any time you make a decision purely for tax reasons, it has a way of coming back and biting you,” said Mag Black-Scott, chief executive of Beverly Hills Wealth Management. “Could you be at a 43 percent tax on dividends instead of 15 percent? The straight answer is yes, of course you could. But what if that doesn’t happen? What if they increase just slightly?”

Various proposals are on the table, but the taxes the wealthy say they worry most about are an increase in the capital gains rate to 20 percent from 15 percent, which would affect investments like stocks and second homes; an increase in the 15 percent tax on dividends; and a limitation on deductions, which would effectively increase the tax bill. For the truly wealthy, there is also the question of what will happen to estate and gift taxes.

In addition, the health care law sets a 3.8 percent Medicare tax on investment income for individuals with more than $200,000 in annual income (and couples with more than $250,000). Taking taxes on capital gains as an example, Ms. Black-Scott, who started her career at Morgan Stanley in the late 1970s, said people needed to remember that the rates were 28 percent when Ronald Reagan was president. “If they go from 15 to 20 percent, is it really that bad?” she asked. “You need to say, ‘Do I like the stock?’ If you do, why would you get rid of it?”

Here is a look at some of the top areas where short-term decisions based solely on taxes could end up hindering long-term investment goals.

APPRECIATED STOCK Many people have large holdings in a single stock, often the result of working for a company for many years. And the stock may have appreciated significantly over that time. But if they are selling now solely for tax reasons, advisers say they shouldn’t. The stock may continue to do well and more than compensate for increased capital gains.

But there is an upside to an increase in the capital gains rate: wealthier clients may finally be pushed to diversify their holdings. “If you have 75 percent of your wealth in one stock, then it’s a really appropriate time to think about this,” said Timothy R. Lee, managing director of Monument Wealth Management. If the increased tax rate “is a motivating factor for some people, O.K. Letting go of that control and the pride that goes with it is a really difficult decision.”

Selling stock now may also make sense when it is in the form of stock options set to expire early next year. “Do you want to take the risk the price will drop in January?” asked Melissa Labant, director of the tax team at the American Institute of Certified Public Accountants. “What if we have a fiscal cliff or a change in the markets? If you’re comfortable, do it now.”

Some investors may also fear that higher taxes will drive all stocks down. Patrick S. Boyle, investment strategist at Bessemer Trust, said there was no historical link between tax increases and stock market performance.

In the most recent three tax increases, he says, “the market has actually gone up in the six months before and after.” He added: “It’s not that tax rates aren’t important. They are. It’s just that there are so many other things going on that are more important than tax policy.”

MUNICIPAL BONDS Bonds sold to finance state and local government projects are tax-free now and will be tax-free next year. That is no reason to load up on them.

Tax-free municipal bonds have always been attractive to people in higher-income tax brackets. Now, advisers fear that individuals just above the $200,000 threshold, people who say they do not feel wealthy but will probably be paying higher taxes on their income and investments, will try to offset that increase by moving more of their investments into municipal bonds.

Beth Gamel, a certified public accountant and executive vice president at Pillar Financial Advisers, imagined a case where people in higher tax brackets, thinking they were acting rationally, sold stocks this year to take advantage of the lower capital gains rates and then, to avoid higher taxes next year, put all or some of that money into municipal bonds. Maybe they outsmart the tax man, but they do so at risk to their retirement.

“It will be very difficult for them to reach their long-term goals,” she said, “because the yield on muni bonds is lower than stocks over time.”

Or as Will Braman, chief investment officer of Ballentine Partners, said of this trade-off: “It’s not about minimizing the taxes but maximizing the after-tax returns.”

He suggested that people use their deductions to reduce what is owed from taxable securities.

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