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environment, health services); to aim to reduce inequalities inhealth; and to recognise both individual choice as an element indecisions concerning health and the importance of local communityparticipation.

35 cities have been designated participating cities, while themovement as a whole encompasses national networks across over400 cities in Europe alone. The expected timescales for the variouscomponents of the project are: 2-4 years for changing structures andprocesses; 3-4 years for developing healthy public policies; 4-8years for creating healthier cities; and 5-10 years for achievements tobe reflected in noticeable health gains.The drawing up of district health profiles in Copenhagen, as a

preliminary to formulating a city plan, is an example of how one cityis going about its planning process. Examples of multi-city plans inprogress include the Working for Tobacco-free Cities plan (inwhich 1 American and 12 European cities are taking part) and thataddressing environmental issues, with particular emphasis on waterin several cities around the Baltic Sea.

Crackdown on prescription drug fraud

On June 30, the US Department of Health and Human Services(HHS) announced the arrest of over 100 pharmacists and othersinvolved in nationwide multimillion-dollar health-care drug-diversion operations. These arrests are believed to be the mostextensive crackdown on prescription drug fraud in the US, whereearlier this year a new Health Care Fraud Unit was created (seeLancet April 4, p 866). In the scams that led to the arrest Medicaidand Medicare patients obtained prescriptions for unneeded drugsfrom physicians, had these prescriptions filled by pharmacists, andthen sold the drugs for a fraction of their value to middlemen, who inturn sold them at discount rates to pharmacists, who then re-soldthem to the public at full price."We are advising patients to look at their medicine to make sure it

is the one they are supposed to be taking, and once they have verifiedthat it’s the right drug, to keep taking it according to instructions",said Dr David Kessler, Food and Drug AdministrationCommissioner. "If you are suspicious, consult a physician orpharmacist you trust", Dr Kessler added. He said medicines thatare marked as a "sample" would be a reason for suspicion unlessthey had been dispensed as a sample by a physician; so wouldmedicines that look different from those previously purchased.

Human Fertilisation and Embryology AuthorityThere are no clearly defined qualifications for embryologists. In

their first report the UK Human Fertilisation and EmbryologyAuthority state that in the coming year they will be consideringwhether minimum qualifications for these practitioners can beidentified and what, if any, training should be required. Otherprojects that face the Authority include investigating whether theunlicensed gamete intrafallopian transfer (GIFT) process is beingused inappropriately instead of in-vitro fertilisation (IVF)-forwhich a licence is required.

In its first year the HFEA has succeeded in drawing up a code ofpractice and licensing system, installing a major data collection andstorage system, and creating a framework for the future monitoringof artificial fertilisation techniques and embryo research.

1. Human Fertilisation and Embryology Authority. Annual report. London: HFEA(Paxton House, 30 Artillery Lane, London El 7LS). 1992. Pp 35.

Outbreak of listeriosis in France

Since April there have been 100 cases of listeriosis in France, with20 deaths and 5 miscarriages. The last outbreak occurred 5 years agoat the French-Swiss border; 113 people were affected and therewere 31 deaths, mostly of newborn babies. 80% of the patients thenharboured Listeria monocytogenes serotype 4b. After a long search,the source of the infection was deemed to be Swiss vacherin cheese.

This time the outbreak has affected 46 districts. The serotype isagain 4b. Generally there are only 400-800 cases of listeriosis a yearand about 15 associated with any one serotype. The source of thisoutbreak has yet to be identified.

Mergers and acquisitionsPlans for the merger of King’s College London with the United

Medical and Dental Schools of Guys and St Thomas’s Hospitals(UMDS) have been announced. This merger was advocated in theKing’s Fund report on the future of London’s teaching hospitals(see Lancet June 27, p 1599), and will be overseen by a Joint PolicyCommittee. There are no plans to reduce preclinical and clinicalstudent numbers in the 3 medical schools from their present annualintake of 640. The King’s Fund proposals recommended a cut ofnearly 30% in London medical student intake. Mr Simon Argles,secretary of UMDS, agreed that this merger was designed toprevent any radical changes in these London medical schools,which might form part of the recommendations to be made by theTomlinson committee who are expected to report in the autumn of1992.

Legal action against Polish hospitalPoland’s new Code of Medical Ethics (see Lancet May 16,

p 1221), which runs counter to the current law on abortion, has ledto its first legal action. The Warsaw Central District Procurator’sOffice is preparing a case against one of the city’s hospitals, whichrefused to carry out an abortion. Management of the hospital (whichas defendant cannot, under Polish legal procedure, be named)refused to accept the referral letter from the patient’s doctor, andordered its own gynaecological examination. When this revealedthat the pregnancy was not life-threatening, the managementforbade the operation. The case was initiated by Poland’s newombudsman, Prof Tadeusz Zielinski. The Procurator’s Office,however (according to the daily Zycie Warsawy-Warsaw Life-on15 June), is not hurrying to complete the case, since "the issue iscomplicated".

Of lionesses and women

Lions living in their natural habitat have three main activities-sleeping, hunting and feeding, and mating. Not much differentfrom all other animals some might say, but in certain respects lionshave more in common with the human species than with their felinerelations. For instance, lions mate at will, copulation beingunrelated to oestrus, unlike that in other cats. Ovulation is notrelated to copulation-ie, lionesses ovulate spontaneously, in cyclesof about 5 weeks. Vaginal smears contain spermatozoa in 18% oflionesses (a figure very close to that of 12% in women)-which is anindication of the extent of sexual activity throughout the menstrualcycle. These, and more, fascinating facts were provided by Dr H. J.Orford at a meeting of the Section of Obstetrics and Gynaecology atthe Royal Society of Medicine on June 26. He reported an exercisein population control of these animals, done in the Etosha NationalPark, Namibia: ten lionesses living in prides were captured withdarts, and then had progesterone implants inserted and vaginalsmears taken. Treated and untreated lionesses did not differ in time

spent resting, feeding, walking, and hunting, or in sexual behaviour.All of them eventually cubbed, after as long as 5 years in one.Why are lions unique among cats in their reproductive

behaviour? Because they are the only cats who live in prides, theirsexual patterns are probably adaptions to living in social groups.The social behaviour of the king of beasts is not, of course, entirelycomparable with that of man-or is it?

Views on UK science soughtThe Office of Science and Technology, created three months

ago, is seeking the views of the scientific community, industry, andthe public on the future of science and technology in the UK, as apreliminary to the publication of a white paper on the subject in thefirst half of next year. Comments to Dr D. A. Anderson, Room417A, Office of Science and Technology, Cabinet Office, LondonSW1A 2AS, by Nov 30.