Fear of failure looms over EU budget summit

BRUSSELS: An EU budget summit seemed set for trouble before it began on Thursday as leaders were to start two days of talks to agree a trillion-euro budget that has bitterly divided a 27-nation union already mired in crisis.

European Union officials were scrambling to find an all but impossible compromise on the 2014-2020 budget that could successfully move richer nations looking for cutbacks closer to poorer ones who look to Brussels to prop up hard hit industries and regions.

"All the talk is only about cuts," said the president of the European Commission Jose Manuel Barroso in an impassioned speech before the European parliament on Wednesday.

"No one is discussing the quality of investments, it's all cut, cut, cut."

Much of the European Union is in or dangerously close to recession and austerity-driven nations led by British Prime Minister David Cameron are demanding huge cuts in EU spending to match belt-tightening at home, raising the ire of cash-strapped nations to the east and south.

Central to the upcoming two-day battle, that diplomats fear could drag on even longer, are development funds, the billions of euros outlayed each year to the EU's newer and poorer entrants so they may make up the economic lag with rich neighbours.

These poorer countries, mostly net beneficiaries of the EU budget, have pledged to fight dearly to preserve funds that eurosceptics to the west and north hint are wasted, generating little real growth.

Eight of the net contributor nations -- Austria, Britain, Denmark, France, Finland, Germany, Netherlands and Sweden -- have banded together to demand spending cuts, though they are far from being on the same page on what should go or by how much.

Lined up against them are 15 nations who are net recipients, most often of the so-called "cohesion funds" used to help poor regions catch up. This is the second biggest budget item after the CAP.

Chaired by Poland and Portugal, the group includes Bulgaria, Czech Republic, Estonia, Greece, Hungary, Latvia, Lithuania, Malta, Romania, Slovakia, Slovenia -- and most recently, once mighty Spain.

Farm and fishing subsidies, funnelled through the EU's huge Common Agricultural Policy, are another bone of contention, especially for France which is the biggest beneficiary by far of what is the budget's biggest line item.

French President Francois Hollande has vowed "to fight" to keep France's prized farm subsidies, which is viewed as an red line not to be crossed by the powerful agricultural lobbyists in Paris.

In defending the CAP, Hollande this week lashed out at countries that defended rebates and discounts, the third hot-button issue that could send the budget summit off the rails without an agreement.

Hollande did not name any specific countries, but Britain in particular cherishes its budget rebate, won by then-prime minister Margaret Thatcher in the 1980s and which has since become a potent symbol of London's defiance to European meddling and bureaucrats.

Germany, the Netherlands, Sweden and Austria are also demanding to keep their rebates and Denmark is seeking one too.

Before the start of the summit at 1900 GMT later on Thursday, European council president Herman Van Rompuy is to sit down with individual heads of state and government to finesse a one-size-fits-all compromise.

"Let there be no mistake: the absence of an agreement would be harmful for all of us," Van Rompuy said in a summit invitation letter to the EU's 27 members which also pledged "a revised version" of the budget when leaders begin the two-day talks.

Britain had appeared to warm towards a proposal made last week by Van Rompuy for a 75-billion-euro decrease in the 1.047-billion-euro (US$1.3 trillion) budget that would leave Britain's rebate intact.

But Cameron, who is expected to meet Rompuy head-to-head early Tuesday in Brussels, told Britain's parliament he would be "fighting incredibly hard for a good deal."

German Chancellor Angela Merkel told lawmakers on Wednesday she did not "know if we will have a definitive deal" by Friday. "If necessary we will have to meet again at the beginning of next year," she said.

- AFP/xq

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Kasab hanged day after UN vote on penalty

NEW DELHI: As chance would have it, India hanged Ajmal Kasab a day after opposing a UN resolution on abolition of the death penalty.

On Tuesday, India joined 38 other countries to vote against a non-binding UN General Assembly resolution, calling for the removal of the death penalty, saying every nation had the "sovereign right" to determine its own legal system. The resolution called for a moratorium on executions before the abolition of the penalty. The resolution was carried through after 110 nations voted for it.

In its explanation of vote, New Delhi said it could not support the resolution in its present form. Other nations voting against were Bangladesh, China , Korea, Iran, Iraq, Japan, Kuwait, Libya, Pakistan and US.

India said the death penalty was imposed only in "rarest of rare" cases and Indian law provides for the suspension of the sentence for pregnant women.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Cops: Murder Gun Found in 'John Doe's' Duffel Bag

The man known as "John Doe Duffel Bag" was arrested today in connection with the slayings of three shopkeepers of Middle Eastern descent in Brooklyn, N.Y.

Salvatore Perrone, 63, was arrested following a long night of questioning by detectives.

Officials told ABC News that Perrone had been charged with three counts of murder. He has made admissions to police in connection with committing two of the murders but stopped talking before any discussion of the third, law enforcement sources said.

The murders took place in July, August and last Friday, Nov. 16. All three slain men were killed by .22 caliber slugs and one was stabbed as well as shot.

Police Commissioner Ray Kelly told reporters Wednesday evening that ballistics, a fingerprint and statements by the suspect linked him to the crimes.

"NYPD homicide detectives today arrested Salvatore E. Perrone of Staten Island in the shooting deaths of three Brooklyn merchants after he made statements implicating himself, and after the .22-caliber rifle he used in the slayings was recovered from his duffel bag and subjected to ballistic tests," Kelly said.

"Those tests indicated that shell casings found at all three crime scenes were fired from Perrone's rifle. Perrone's fingerprint also was lifted from the murder weapon," he added.

"When crime scene detectives searched the bag early this morning, they found the carbine with a sawed-off stock, and a combination laser-flashlight attached to its barrel with duct tape and two, thick pink rubber bands," Kelly said. "It had a single live round in the chamber. They also recovered a box of 22-caliber long-rifle ammunition, an empty magazine and a 12-inch kitchen knife with dried blood on it. Detectives also found two Buck folding knives, each with seven-inch blades.

Brooklyn Shopkeeper Murders: Person of Interest Questioned Watch Video

NYPD Links Brooklyn Shopkeeper Murders to Same Gun Watch Video

"Perrone was recognized yesterday [Tuesday] at a pharmacy in Bay Ridge, [Brooklyn], and voluntarily agreed to accompany responding officers to the station house," he said. "Detectives obtained a warrant to search Perrone's duffel bag, which was found at his girlfriend's apartment. It was the same bag that Perrone was seen carrying in videotaped images of him in the vicinity of the most recent homicide."

Perrone, a Staten Island resident and native of Bensonhurst, Brooklyn, has a rap sheet that includes stalking a former girlfriend and kicking in her door, burglary and driving while intoxicated on Staten Island.

The suspect had connections with the clothing business and possibly once had a clothing store, officials said. He reportedly carried merchandise in his duffel bag, law enforcement sources said.

Clothing or cardboard was used to cover the bodies of the murder victims, police have said.

When police released video stills of the duffel bag man near some of the murder scenes, store proprietors recognized them as Perrone, a merchant who would try to sell to them, Kelly said.

"The individual who yesterday recognized Perrone [from the video still] ... that individual does not want to be identified," Kelly said.

The man, later identified as Perrone, was captured on video last Friday at 6 p.m. within a block and a half of the latest crime scene, a women's boutique on Flatbush Avenue. The latest victim, 78-year-old Rahmatollah Vahidipour, was killed sometime between 4:30 p.m. and 7:11 p.m. Friday.

The second video, from Aug. 2, appeared to show "John Doe Duffel Bag" near the Bensonhurst shop where Isaac Kadare, a Jewish man from Egypt, was murdered with the same .22 caliber gun that was used to kill Vahidipour, sources told ABC News.

On July 6, clothing store owner Mohamed Gebeli, an Egyptian Muslim, was killed inside Valentino Fashion in Bay Ridge. Gebeli was shot in the neck and was found with several pieces of clothing on top of him. Police said $383 in receipts was missing, but $1,500 was found inside a cabinet.

The trio of killings took place within a five-mile radius. Each occurred at a small shop that lacked security cameras, and each victim was over 50 years old, police said. It was not clear whether the victims had been robbed.

ABC News' Michael S. James and Kevin Dolak contributed to this report.

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Gaza shakes, Israelis killed as Clinton seeks truce

GAZA/JERUSALEM (Reuters) - Israeli air strikes shook the Gaza Strip and Palestinian rockets struck across the border as U.S. Secretary of State Hillary Clinton held talks in Jerusalem in the early hours of Wednesday, seeking a truce that can hold back Israel's ground troops.

Hamas, the Islamist movement controlling Gaza, and Egypt, whose new, Islamist government is trying to broker a truce, had floated hopes for a ceasefire by late Tuesday; but by the time Clinton met Israeli Prime Minister Benjamin Netanyahu it was clear there would be more argument, and more violence, first.

Hamas leaders in Cairo accused the Jewish state of failing to respond to proposals and said an announcement on holding fire would not come before daylight on Wednesday. Israel Radio quoted an Israeli official saying a truce was held up due to "a last-minute delay in the understandings between Hamas and Israel".

An initial halt to attacks may, however, not see the sides stand their forces down from battle stations immediately; Clinton, who flies to Cairo to see Egyptian President Mohamed Mursi later on Wednesday, spoke of a deal "in the days ahead".

As she arrived in Israel after nightfall, Israel was stepping up its bombardment. Artillery shells and missiles fired from naval gunboats offshore slammed into the territory and air strikes came at a frequency of about one every 10 minutes.

After seven days of hostilities that have killed over 130 Palestinians and five Israelis, two of these on Tuesday, both sides are looking for more than a return to the sporadic calm that has prevailed across the blockaded enclave since Israel ended a much bloodier air and ground offensive four years ago.

ELECTION

Netanyahu, who faces an election in two months that he is, for now, favored to win, told Clinton he wanted a "long-term" solution. Failing that, Netanyahu made clear, he stood ready to step up the military campaign to silence Hamas's rockets.

Hamas for its part is exploring the opportunities that last year's Arab Spring has given it to enjoy favor from the new Islamist governments of states once ruled by U.S. proteges, and from Sunni Gulf powers keen to woo it away from Shi'ite Iran. It has used longer-range missiles, some sent by Tehran, and hopes to eclipse Western-backed Palestinian President Mahmoud Abbas.

Hamas has spoken of an easing of Israel's blockade on the 40-km (25-mile) slice of Mediterranean coast that is home to 1.7 million people. It may count on some sympathy from Mursi, though Egypt's first freely elected leader, whose Muslim Brotherhood inspired Hamas's founders, has been careful to stick by the 1979 peace deal with Israel struck by Cairo's former military rulers.

Clinton, who broke off from an Asian tour with President Barack Obama and assured Netanyahu of "rock-solid" U.S. support for Israel's security, spoke of seeking a "durable outcome" and of Egypt's "responsibility" for promoting peace.

She repeated international calls for the kind of lasting, negotiated, comprehensive Israeli-Palestinian settlement that has eluded the two peoples for decades - something neither of the two warring parties seems seriously to be anticipating.

"In the days ahead, the United States will work with our partners here in Israel and across the region toward an outcome that bolsters security for the people of Israel, improves conditions for the people of Gaza and moves toward a comprehensive peace for all people of the region," Clinton said.

"It is essential to de-escalate the situation in Gaza. The rocket attacks from terrorist organizations inside Gaza on Israeli cities and towns must end and a broader calm restored.

"The goal must be a durable outcome that promotes regional stability and advances the security and legitimate aspirations of Israelis and Palestinians alike."

"SELF-DEFENCE"

Netanyahu, who has appeared in no immediate rush to repeat the invasion of winter 2008-09 in which over 1,400 Palestinians died, said: "If there is a possibility of achieving a long-term solution to this problem with diplomatic means, we prefer that.

"But if not, I'm sure you understand that Israel will have to take whatever action is necessary to defend its people."

As Israeli aircraft have carried out hundreds of strikes on rocket stores, launchpads and suspected Hamas command posts since assassinating the head of its military wing a week ago, tens of thousands of Israeli soldiers have been preparing tanks and infantry units for a possible invasion.

During the night, explosions again rocked the city of Gaza and other parts of the Strip, while rockets from the enclave, some essentially home-made, others Iranian-designed and smuggled through tunnels from Egypt, landed in southern Israel.

One reached as far as Rishon Lezion, near Tel Aviv, on Tuesday, the latest to jar Israel's metropolis, long untroubled by Palestinian attacks. Another rocket fell close to Jerusalem, the holy city claimed by both sides in the conflict.

Medical officials in Gaza said 31 Palestinians were killed on Tuesday. An Israeli soldier and a civilian died when rockets exploded near the Gaza frontier, police and the army said.

Gaza medical officials say 138 people have died in Israeli strikes, mostly civilians, including 34 children. In all, five Israelis have died, including three civilians killed last week.

AMMUNITION STORES

Obama, whose relations with the hawkish Netanyahu have long been strained, has said he wants a diplomatic solution, rather than a possible Israeli ground operation in the densely populated territory, home to 1.7 million Palestinians.

Israel's military on Tuesday targeted more than 130 sites in Gaza, including ammunition stores and the Gaza headquarters of the National Islamic Bank. Israeli police said more than 150 rockets had been fired from Gaza by the evening.

"No country would tolerate rocket attacks against its cities and against its civilians," Netanyahu said with U.N. Secretary-General Ban Ki-moon, who arrived in Jerusalem from talks in Cairo, at his side. "Israel cannot tolerate such attacks."

Critics have accused Israel of using disproportionate force that has killed civilians. Israel accuses Hamas of putting Gaza's people in harm's way by siting rockets among them.

Media groups have criticized attacks on Gaza media facilities. On Tuesday, three local journalists died in air strikes on their vehicles.

A building housing AFP's bureau was bombed. The French news agency said its staff were unhurt. Israel's military said it had been targeting a Hamas intelligence center in the tower.

Hamas executed six Palestinians accused of spying for Israel, who a security source quoted by Hamas Aqsa radio said had been "caught red-handed" with "filming equipment to take footage of positions". The radio said they had been shot.

Militants on a motorcycle dragged the body of one of the men through the streets.

A delegation of nine Arab ministers, led by the Egyptian foreign minister, visited Gaza in a further signal of heightened Arab solidarity with the Palestinians.

(Additional reporting by Cairo bureau; Writing by Alastair Macdonald)

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Asian markets up on US hopes, weak yen helps Tokyo

HONG KONG: Asian markets rose on Wednesday with traders confident the United States will avoid a fiscal cliff and Greece will get its much-needed bailout, while Tokyo was boosted by the weak yen.

The Japanese currency continued its fall against the dollar and the euro on expectations of further central bank easing, given added impetus by data showing Tokyo posted its worst October trade figures in more than 30 years.

Tokyo rose 0.96 per cent, Hong Kong added 0.66 per cent and Seoul was up 0.30 per cent but Sydney was flat. Shanghai was up 0.21 per cent.

Stocks have been buoyed this week by hopes for an agreement in Washington on avoiding the fiscal cliff of tax hikes and spending cuts scheduled to come into effect on January 1.

If they are allowed to come in they will likely tip the US into recession, a danger reiterated by Federal Reserve chief Ben Bernanke on Tuesday.

Eyes are currently on Europe, where eurozone finance chiefs are holding an emergency meeting to decide whether to give Greece the next trance of much-needed bailout cash to help it avoid a default.

"Greece has delivered (on reform)," said Jean-Claude Juncker, who presides over the Eurogroup of finance ministers from the 17 countries that use the single currency. "(There are thus) good chances of an agreement."

The expectations of fresh cash for Greece lifted the euro against the yen, while it is also holding on to recent advances on the dollar.

The euro bought $1.2810 and 104.95 yen in early Asian trade, compared with $1.2818 and 104.70 yen in New York late Tuesday.

The dollar firmed to 81.93 yen from 81.67 yen in US trade and is sitting at seven-month highs.

Dealers continued to move out of the yen after the Bank of Japan held off further monetary easing on Tuesday but signalled fresh action could be in the pipeline after saying the economy remained weak.

The currency has weakened since last week, when the man likely to become prime minister after next month's general election said he would push for unlimited loosening monetary policy by the central bank.

There was more gloom for the Japanese economy on Wednesday as finance ministry data showed October's trade deficit nearly doubled to 549 billion yen ($6.7 billion) from a year ago, coming on top of weakening factory output.

On Wall Street, the three main indexes all ended flat on weak corporate news.

However, there was support from the Commerce Department, which said home construction rose again in October following September's strong surge, a further sign of recovery in the crucial housing market.

Housing starts rose 3.6 per cent from October, surprising analysts who had expected a fall after September's jump.

Oil prices climbed, with New York's main contract, light sweet crude for delivery in January, rising 55 cents to $87.30 a barrel and Brent North Sea crude for January delivery adding 63 cents to $110.46.

Gold was at $1,727.60 at 0230 GMT compared with $1,733.45 late Tuesday.

- AFP/xq

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President Pranab Mukherjee rejects Kasab's mercy plea

NEW DELHI: President Pranab Mukherjee rejected the mercy petition filed by Ajmal Kasab, the Lashkar-e-Toiba terrorist sentenced to death for his role in the November 26, 2008 terror attack on Mumbai.

The decision comes after the home ministry on October 23 rejected Kasab's mercy petition that had been addressed to the President.

According to TV reports, Kasab, who was lodged at Mumbai's Arthur Road prison since his arrest, has been shifted to Yerwada jail.

On May 6, 2010, the Mumbai trial court had awarded death sentence to Kasab which was later upheld by the Bombay High Court on February 21, 2011. The apex court rejected his appeal on August 29.

The BJP had demanded that the apex court decision awarding death sentence to Kasab should be implemented at the earliest.

Kasab has been lodged at Arthur Road prison since his arrest.

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor's exam needed: The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday's surprise opinion from these gatekeepers of contraception could boost longtime efforts by women's advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it's not clear if any are considering it. Plus there are big questions about what such a move would mean for many women's wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn't need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it's safe to sell the pill that way.

Wait, why would doctors who make money from women's yearly visits for a birth-control prescription advocate giving that up?

Half of the nation's pregnancies every year are unintended, a rate that hasn't changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

"It's unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem," said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

ACOG's opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month's supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

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Online:

OB/GYN group: http://www.acog.org

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Clinton Pledges to 'De-Escalate' Gaza Conflict

Secretary of State Hillary Clinton met for more than two hours today behind closed doors with Israeli Prime Minister Benjamin Netanyahu and other Israeli officials, saying she sought to "de-escalate the situation in Gaza."

Clinton, who flew to Israel today, appeared with Netanyahu ahead of their 4 p.m. ET meeting to discuss a possible ceasefire to the fighting between Israel and Islamic militants in Gaza.

"They discussed efforts to de-escalate the situation and bring about a sustainable outcome that protects Israel's security and improves the lives of civilians in Gaza," State Department spokeswoman Victoria Nuland said in a written statement after the meeting. "They also consulted on [Clinton's] impending stops in Ramallah and Cairo, including Egyptian efforts to advance de-escalation. They pledged to stay in close touch as she continues her travels."

The meeting came amid statements from Hamas earlier today that a ceasefire would soon be announced.

Netanyahu said he would prefer to use "diplomatic means" to find a solution to the fighting, but that Israel would take "whatever actions necessary" to defend its people.

"One of the things that we are doing is trying to resist and counter a terrorist barrage which is aimed directly at our civilians," Netanyahu said. "No country can tolerate a wanton attack on its civilians."

Clinton relayed a message from President Obama, reinforcing America's commitment to Israel's security and calling for an end to the rockets coming from "terrorist organizations in Gaza."

The Israel-Gaza Conflict in Pictures

Matty Stern/U.S. Embassy Tel Aviv/Getty Images

Israeli-Palestinian Conflict: Families Pray for Ceasefire Watch Video

Middle East on the Brink: Israel Prepared to Invade Gaza Watch Video

"America's commitment to Israel's security is rock solid and unwavering. That is why we believe it is essential to de-escalate the situation in Gaza," Clinton said.

Clinton added that she would reiterate her message to Egyptian President Mohamed Morsi during a meeting on Wednesday.

"President Obama has emphasized the same points in his multiple conversations with President Morsi of Egypt, and we appreciate President Morsi's personal leadership and Egypt's efforts thus far," she said. "As a regional leader and neighbor, Egypt has the opportunity and responsibility to continue playing a crucial and constructive role in this process. I will carry this message to Cairo tomorrow."

Clinton expressed her condolences for the Palestinian and Israeli civilians who have been killed in the violent outbreak.

The rocket fire between Israel and Hamas, which began six days ago, has claimed more than 130 Palestinian lives and five Israeli lives. Half the Palestinian deaths were civilians; four of the five Israelis were civilians. A ceasefire, if reached, would bring a halt to the worst violence between Gaza and Israel in four years.

Israeli officials told ABC News earlier today that a final deal had not been brokered between Israel and Hamas, and that if a pact were reached, it would not be announced until after midnight local time, or 5 p.m. ET.

Hamas spokesman Sami Abu Zuhri told ABC News the news would be announced at a press conference in Cairo, where Morsi has been trying to broker an end to the fighting.

An Islamic Jihad website also reported that the ceasefire would go into effect tonight.

Clinton will also meet with Palestinian Authority President Mahmoud Abbas about the fighting.

In the meantime, however, Abu Zuhri called on all militant groups to continue firing rockets on Israel "in retaliation for the Israeli massacres."

Israeli missiles also continued to explode in Gaza while sirens sounded in Israel, signalling incoming rocket fire from Gaza.

Hamas said three Palestinian journalists were killed by an Israeli missile today, and Israel said one of its soldiers was killed by a Palestinian rocket today.

Gazans streamed out of northern neighborhoods during the afternoon after the Israel Defense Forces dropped leaflets telling residents to evacuate before dark. Scared Palestinians poured into Gaza City, cars and trucks piled high with belongings, many heading to schools for shelter.

ABC News' Matt Gutman contributed to this report

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Gaza truce pressure builds, Cairo in focus

GAZA/JERUSALEM (Reuters) - International pressure for a ceasefire in the Gaza Strip puts Egypt's new Islamist president in the spotlight on Tuesday after a sixth day of Palestinian rocket fire and Israeli air strikes that have killed over 100 people.

Israel's leaders weighed the benefits and risks of sending tanks and infantry into the densely populated coastal enclave two months before an Israeli election, and indicated they would prefer a diplomatic path backed by world powers, including U.S. President Barack Obama, the European Union and Russia.

Any such solution may pass through Egypt, Gaza's other neighbor and the biggest Arab nation, where the ousting of U.S. ally Hosni Mubarak and election of President Mohamed Mursi is part of a dramatic reshaping of the Middle East, wrought by the Arab Spring and now affecting the Israeli-Palestinian conflict.

Mursi, whose Muslim Brotherhood was mentor to the founders of Hamas, took a call from Obama on Monday telling him the group must stop rocket fire into Israel - effectively endorsing Israel's stated aim in launching the offensive last week. Obama, as quoted by the White House, also said he regretted civilian deaths - which have been predominantly among the Palestinians.

"The two leaders discussed ways to de-escalate the situation in Gaza, and President Obama underscored the necessity of Hamas ending rocket fire into Israel," the White House said.

"President Obama then called Prime Minister Netanyahu of Israel and received an update on the situation in Gaza and Israel. In both calls, President Obama expressed regret for the loss of Israeli and Palestinian civilian lives."

Three Israeli civilians and 108 Palestinians have been killed. Gaza officials say over half of those killed in the enclave were civilians, 27 of them children.

EGYPT SEES DEAL

Mursi has warned Netanyahu of serious consequences from a ground invasion of the kind that left over 1,400 people dead in Gaza four years ago. But he has been careful not to alienate Israel, with whom Egypt's former military rulers signed a peace treaty in 1979, or Washington, a major aid donor to Egypt.

A meeting on Tuesday in Cairo between Mursi and Ban Ki-moon, the secretary-general of the United Nations who flew in late on Monday, could shed light on the shape of any truce proposals.

Egyptian Prime Minister Hisham Kandil told Reuters: "I think we are close, but the nature of this kind of negotiation, (means) it is very difficult to predict."

Israeli media have said Israeli officials are also in Cairo to talk. And Ban is due to meet Netanyahu in Jerusalem soon.

After Hamas leader Khaled Meshaal laid out demands in Cairo that Israel take the first step in restoring calm, and warned Netanyahu that a ground war in Gaza could wreck his re-election prospects in January, a senior Israeli official denied a Hamas assertion that the prime minister had asked for a truce.

"Whoever started the war must end it," Meshaal said, referring to Israel's assassination from the air last Wednesday of Hamas's Gaza military chief, a move that followed a scaling up of rocket fire onto Israeli towns over several weeks.

An official close to Netanyahu told Reuters: "Israel is prepared and has taken steps and is ready for a ground incursion which will deal severely with the Hamas military machine.

"We would prefer to see a diplomatic solution that would guarantee the peace for Israel's population in the south. If that is possible, then a ground operation would no longer be required," he added. "If diplomacy fails, we may well have no alternative but to send in ground forces."

NETANYAHU CONSIDERS

Fortified by the ascendancy of fellow Islamists in Egypt and elsewhere, and courted by fellow Sunni Arab leaders in the Gulf, keen to draw the Palestinian group away from old ties to Shi'ite Iran, Hamas has tested its room for maneuver, as well as longer-range rockets that have reached the Tel Aviv metropolis.

As Netanyahu and his top ministers debated their next moves in a meeting that lasted past midnight, Israeli statistics showed some easing in the ferocity of the exchanges on Monday.

Israeli police counted 110 rockets, causing no casualties, of which 42 were shot down by anti-missile batteries. Israel said it had conducted 80 air strikes. Compared to over 1,000 rockets fired in total, and 1,350 air strikes, the indications were that the level of violence had fallen on Monday.

Nonetheless, blood was shed and anger seethed. Hamas said 4-year-old twin boys had died with their parents when their house in the town of Beit Lahiya was struck from the air. Neighbors said the occupants were not involved with militant groups.

Israel had no immediate comment on that attack. It says it takes extreme care to avoid civilians and accuses Hamas and other militant groups of deliberately placing Gaza's 1.7 million people in harm's way by siting rocket launchers among them.

Nonetheless, fighting Israel, whose right to exist Hamas refuses to recognize, is popular with many Palestinians and has kept the movement competitive with the secular Fatah movement of Palestinian President Mahmoud Abbas, who remains in the West Bank after losing Gaza to Hamas in a civil war five years ago.

"Hamas and the others, they're our sons and our brothers, we're fingers on the same hand," said 55-year-old Faraj al-Sawafir, whose home was blasted by Israeli forces. "They fight for us and are martyred, they take losses and we sacrifice too."

Thousands turned out on Monday to mourn four children and five women who were among 11 people killed in an Israeli air strike that flattened a three-storey home the previous day.

The bodies were wrapped in Palestinian and Hamas flags. Echoes of explosions mixed with cries of grief and defiant chants of "God is greatest!".

ISRAELI INVESTIGATION

Israel said it was investigating the strike that brought the block crashing down on the al-Dalu family, where the dead spanned four generations. Some Israeli newspapers said the house might have been targeted by mistake.

For the second straight day, Israeli missiles blasted a tower block in the city of Gaza housing international media. Two people were killed there, one of them an Islamic Jihad militant.

In scenes recalling Israel's 2008-2009 winter invasion of the coastal enclave, tanks, artillery and infantry have massed in field encampments along the sandy, fenced-off border.

Israel has also authorized the call-up of 75,000 military reservists, so far mobilizing around half that number.

Although 84 percent of Israelis support the current Gaza assault, according to a poll by Israel's Haaretz newspaper, only 30 percent want an invasion.

With the power balances of the Middle East drastically shifted by the Arab Spring during a first Obama term that began two days after Israel ended its last major Gaza offensive, the newly re-elected U.S. president faces testing choices to achieve Washington's hopes for peace and stability across the region.

In an echo of frictions over the civil war in Syria, Russia accused the United States on Monday of blocking a bid by the U.N. Security Council to condemn the escalating conflict in the Gaza Strip. Washington has generally stopped the U.N. body from putting what it sees as undue pressure on its Israeli ally.

(Writing by Alastair Macdonald; Editing by Kevin Liffey)

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