HACKING CAMPAIGN
Eight things you need to know about US’s claims of Russian cyberattack on SA
(Photo: Chris Ratcliffe / Bloomberg)

By Daily Maverick Staff Writer
03 Apr 2022 

The US claims three Russians with links to that government targeted at least 135 countries, including South Africa, in a hacking campaign

The United States says government-linked Russian hackers have targeted the world’s energy sector, including in South Africa. This comes as news emerged that Russia is considering getting involved in a major South African contract relating to this very sector and as the Russia-Ukraine conflict evolves. Here are eight things you need to know to understand the story by Daily Maverick’s Caryn Dolley.

The US claims three Russians with links to the Russian government targeted at least 135 countries, including South Africa, in a hacking campaign.
According to the US Federal Bureau of Investigation (FBI), the global hacking campaign allegedly had the potential to “disrupt and damage” systems relating to energy sectors, including nuclear power plants.
The hacking activities allegedly occurred from July 2012 to November 2017.
The FBI has linked three suspects – Pavel Aleksandrovich Akulov, Mikhail Mikhailovich Gavrilov and Marat Valeryevich Tyukov – to operations it says were targeting countries including South Africa.
According to the US, Akulov, Gavrilov and Tyukov were members of “a discreet operation unit” working deep within a law enforcement agency called the Federal Security Service headquartered in Moscow.
The indictment against the three suspects indicates their alleged goals were “to establish and maintain surreptitious, unauthorised access to networks, computers, and devices of companies and other entities in the energy sector”. This “enabled the Russian government to disrupt and damage such systems, if it wished”.
South Africa’s state-owned electricity utility Eskom says it combats regular cyberattack attempts, but would not be drawn on this specific campaign.
The news of the alleged Russian cyberattack on South Africa comes after energy-related deals between the two countries have come under scrutiny, and while South Africa’s government has taken a neutral stance on the Russia-Ukraine conflict. DM

US claims South Africa targeted in Russia’s global hack attack campaigns
(Photos: iStock)

By Caryn Dolley
03 Apr 2022 

The US is hunting down four alleged hackers it believes are involved in campaigns to compromise critical infrastructure worldwide. South Africa is apparently on the hackers’ list of targets.

South Africa has emerged as one of about 135 countries the US claims Russian government employees targeted as part of two massive hacking campaigns aimed at disrupting energy companies and critical infrastructure.

The alleged aim was to “undertake a sophisticated campaign to target and compromise (i.e. ‘hack’), and maintain persistent access to the networks of critical infrastructure and energy companies worldwide”.

According to the US’s Federal Bureau of Investigation (FBI), this access would enable “the Russian government to disrupt and damage such systems, if it wished”.

South Africa’s state-owned electricity utility, Eskom, this week, in response to DM168 questions on whether Russian hackers targeted it, did not refer to Russia, but said: “Eskom, like every other organisation, combat[s] regular attempted attacks.


“We are aware that, daily, cybercriminals are actively targeting various sectors, including ours. We have an information and cybersecurity team and tools that assist us with combatting attempted attacks and for security reasons will not share the details of these.”

The Mineral Resources and Energy ministry, as well as PetroSA, did not respond to DM168 queries by the time of publication. Neither did the Russian embassy in South Africa.

Details of Russia’s alleged energy sector cyberattacks are surfacing as South Africa has taken a rather neutral stance on the Russian invasion of Ukraine. In early March, President Cyril Ramaphosa said it was hoped that negotiations would bring about peace.

In a previous statement that focused on 30 years of diplomatic ties with South Africa, stretching back to 1992, the Russian embassy had glowing words.

It said: “Our countries have been walking together on the path of mutual understanding, respect and friendship… With the rich history of bilateral ties that we already have, we are ready to expand this legacy further, and explore new ways and areas of cooperation for the benefit of our nations.”

This week, amaBhungane also reported that Gazprombank, owned by Russia’s state-owned gas supplier, was considering a bid for what could be a multibillion-rand contract relating to “a gas aggregator to help secure liquified natural gas (LNG) for various gas-to-power projects planned for the Coega special economic zone in the Eastern Cape”.

Should Gazprombank be awarded the contract, amaBhungane reported, this “would raise questions on whether South Africa’s stance on Ukraine is being influenced by its thirst for gas”.

In the hacking saga, among the many other claimed targets were a US government agency responsible for nuclear power plants and a Saudi Arabian petrochemical plant. The hackers behind the attack on the petrochemical plant are accused of using malware aimed at industrial safety systems, making their acts exceptionally dangerous.

Details of the scope and scale of the alleged worldwide energy sector hack are contained in two indictments – one against an individual from Russia and the second against three others – unsealed in the US on 24 March. The US has offered a reward of up to $10-million for information on the whereabouts of each of the four accused.

These individuals are also wanted by the FBI and are listed as international flight risks.

The FBI has linked three of the four accused – Pavel Aleksandrovich Akulov, Mihkail Mikhailovich Gavrilov and Marat Valeryevich Tyukov – to operations targeting countries including South Africa.

SA among targeted countries

The indictment against the trio provides exceptionally detailed information about just how far-reaching their alleged activities are.

“Hundreds of foreign victims and targets of the conspiracy were based in more than 135 countries, including Albania, Australia, Belgium, Brazil, Canada, China, Croatia, Denmark, Finland, France, Germany, Hungary, India, Ireland, Italy, the Netherlands, New Zealand, Norway, Pakistan, Singapore, Slovakia, South Africa, South Korea, Spain, Sweden, Switzerland and the United Kingdom,” the indictment said.

“This group included global oil and gas firms, utility and electrical grid companies, nuclear power plants, renewable energy companies, consulting and engineering groups, and advanced technology firms.”

The indictment did not name any South African entities or detail what happened to these – whether they were successfully targeted. These broad hacking activities allegedly occurred from July 2012 to November 2017.

South Africa has a history with Russia in the energy sector. In early 2017, the Western Cape High Court ruled that a nuclear procurement process involving Russia was unlawful and unconstitutional. This procurement process became a key marker of former president Jacob Zuma’s presidency. Later that year, in September 2017, Daily Maverick reported on a deal between PetroSA and Rosgeo involving a partnership that would see the Russian company invest about $400-million (R5.8-billion) to develop oil and gas blocks off the Cape coast.

However, based on what the US has now revealed, it seems that while these deals were waxing and waning, Russia was allegedly involved in trying to hack aspects of the energy sector around the world, including in South Africa.

In July last year, the same month as an attempted insurrection in South Africa saw deadly riots flare up mainly in KwaZulu-Natal after the jailing of Jacob Zuma, cybercriminals targeted Transnet and Transnet Port Terminals.

It was reported the attack could have been carried out by eastern European or Russian criminals. However, no cyberattacks in South Africa have outright or officially been attributed to Russia.

The recently unsealed indictment against Akulov, Gavrilov and Tyukov said they worked in a unit concealed within another unit beneath an overall unit.

According to the indictment, Russia operated an intelligence and law enforcement agency called the Federal Security Service that was headquartered in Moscow.

The Federal Security Service consisted of several units, including one called Military Unit 771330, known within the service’s circles as Center 16.

According to the US, Akulov, Gavrilov and Tyukov were members of “a discreet operation unit” working within Center 16.



‘Crouching Yeti’s’ two-phase attack

Cybersecurity researchers know the discreet unit by various names, including “Dragonfly”, “Berzerk Bear”, “Energetic Bear” and “Crouching Yeti”.

The alleged campaign was carried out in two phases.

A common focus for both phases was software and hardware controlling equipment in power generation facilities, known as Industrial Control Systems (ICS) or Supervisory Control and Data Acquisition (Scada) systems.

Phase one of the alleged operation was known as “Dragonfly” or “Havex” and was carried out between 2012 and 2014. It involved the accused compromising networks of ICS/Scada manufacturers and software providers, then hiding malware inside legitimate software updates for such systems. When downloaded by unsuspecting clients, malicious software compromised their ICS/Scada systems. “The [accused],” the US alleged, “installed malware on more than 17,000 unique devices in the United States and elsewhere, including ICS/Scada controllers used by power and energy companies.”

Phase two, known as “Dragonfly 2.0”, was more targeted and was carried out between 2014 and 2017. It focused on individuals and engineers who worked with ICS/Scada systems. This phase allegedly targeted “more than 3,300 users at more than 500 US and international companies and entities”. Servers that hosted websites visited by engineers in the energy sector were also compromised.

The indictment against Akulov, Gavrilov and Tyukov said: “[Their] goals remained the same: to establish and maintain surreptitious, unauthorised access to networks, computers, and devices of companies and other entities in the energy sector, including power generation facilities, in the United States and elsewhere.

“Such accesses enabled the Russian government to disrupt and damage such systems, if it wished.”

Aside from hundreds of big US and international energy sector companies, the US believed “small commercial companies working with the energy sector, including companies that provide software and hardware used to control ICS/Scada systems”, were targeted.

Among the targets was the US’s Nuclear Regulatory Commission, a government agency “responsible for regulating entities that use nuclear materials, including nuclear power plants”, as well as the Wolf Creek Nuclear Operating Corporation, a company in Kansas operating the Wolf Creek Generating station, a nuclear power plant.

‘Potentially catastrophic’ hacking plans

A second indictment unsealed in the US about a week ago was against Evgeny Viktorovich Gladkikh, also from Russia and now also wanted by the FBI.

This indictment did not mention South Africa.

According to the US, Gladkikh worked as a computer programmer for an institute affiliated with Russia’s defence ministry.

It was alleged that around May and September 2017, Gladkikh and others “gained unauthorised access to the systems of a refinery outside of the United States using techniques and tools designed to enable an attacker to cause effects including physical damage, with potentially catastrophic effects, rather than merely causing a plant shutdown”.

“They triggered an emergency shutdown of that facility’s operations.”

The US alleged Gladkikh was linked to Triton malware, widely reported to have been used to target a petrochemical plant in Saudi Arabia in 2017.

In October 2020, the US sanctioned the State Research Center of the Russian Federation FGUP Central Scientific Research Institute of Chemistry and Mechanics (also known as TsNIIKhM) over Triton malware.

“The Triton malware … was designed specifically to target and manipulate industrial safety systems,” the US’s Treasury said at the time.

“Such systems provide for the safe emergency shutdown of industrial processes at critical infrastructure facilities in order to protect human life. The cyber actors behind the Triton malware have been referred to by the private cybersecurity industry as ‘the most dangerous threat activity publicly known’.”

In apparent reference to the Saudi Arabia attack, the US’s Treasury said researchers who investigated it found Triton “was designed to give the attackers complete control of infected systems and had the capability to cause significant physical damage and loss of life”.

In a statement last week, Duston Slinkard, the US attorney for the Kansas district, said: “The potential of cyberattacks to disrupt, if not paralyse, the delivery of critical energy services to hospitals, homes, businesses and other locations essential to sustaining our communities is a reality in today’s world.”

The US’s Cybersecurity and Infrastructure Security Agency has detailed broader Russian cybersecurity threats.

“The Russian government engages in malicious cyberactivities to enable broad-scope cyber espionage, to suppress certain social and political activity, to steal intellectual property, and to harm regional and international adversaries,” its website said.

In November last year, DM168 reported how cyberattacks on government entities had shown how vulnerable South Africa is to cybercriminals and ransomware assaults. A few months earlier, in September, the Department of Justice and Constitutional Development became the victim of an attack. DM168

This story first appeared in our weekly Daily Maverick 168 newspaper which is available for R25 at Pick n Pay, Woolworths, Spar, Checkers, Exclusive Books and airport bookstores. For your nearest stockist, please click here.

Costa Rica election: Will a newcomer beat an ex-president

IMAGE SOURCE,EPA

Image caption,

Ex-President Jose María Figueres (left) is being challenged by Rodrigo Chaves

Costa Ricans are heading to the polls on Sunday to choose who will lead the Central American nation for the next four years. And as BBC Monitoring's Blaire Toedte reports, there are signs that voters may be a looking for a change from familiar politicians.

Following a first round in February in which none of the 25 candidates managed to gain the 40% of votes necessary to win outright, two men are left in the running.

Jose María Figueres, a 67-year-old centre-right former president from the country's best-known political family, was the winner of the first round.

But his rival, 60-year-old career economist and political outsider, Rodrigo Chaves, has overtaken him in recent polls.

Polls published on 29 March suggested between 41% to 45% of voters preferred Mr Chaves over ex-President Figueres, who was the first choice of 33% of those polled.

But with 15% of voters reportedly still undecided, the race could turn out to be tight.

Scandal-tainted campaign

Mr Chaves is a long-time World Bank official who served as Costa Rica's finance minister but who stepped down from the government post after only six months.

His second-place finish in the first round came as a surprise to many.

IMAGE SOURCE,REUTERS

Image caption,

Rodrigo Chaves is seen as a political newcomer

But with concerns about the economy and political corruption high on voters' minds, many Costa Ricans seem to be leaning in favour of the economist, whose short time in government is seen as a plus by those fed up with traditional politics.

Standing for the Social Democratic Progress Party, Mr Chaves has been banking on his economic know-how, which he acquired during his nearly 27-year career as a professional economist for the World Bank.

However, his time at the World Bank ended under a cloud. He resigned in 2019 following complaints of sexual harassment which he has denied.

Mr Figueres on the other hand is an establishment politician. The son of a three-time former president José "Pepe" Figueres Ferrer, he is running for the mainstream National Liberation Party (PLN), which was founded by his father.

IMAGE SOURCE,EPA

Image caption,

Mr Figueres was president once before and is a veteran politician

Mr Figueres has served as president once before, from 1994 to 1998, and has also been minister of foreign trade and agriculture.

But like his rival, a resignation from a previous job has also come back to haunt him in this campaign.

In 2004, he stepped down as CEO of the World Economic Forum following allegations in Costa Rica that he had influenced state contracts made with telecommunications multinational Alcatel.

Mr Figueres denied any wrongdoing, and in 2007 the investigation was closed.

Economic stability with a green agenda

Costa Rica, which has a reputation for political stability, is fighting hard to shake off the economic impact of the Covid-19 pandemic.

Not surprisingly therefore, both candidates have put economic policies at the centre of their campaigns, promising to increase economic growth, create jobs and reduce the fiscal deficit.

Calling himself a "pragmatist", Mr Chaves has emphasised the importance of "efficient, transparent public spending".

He favours a "hands-off" policy, arguing that the state has previously acted as an "obstacle" to economic growth. He also sees no need to raise taxes to solve Costa Rica's fiscal crisis.

Mr Figueres' main proposals are the elimination of extreme poverty, cutting the fiscal deficit and reducing unemployment.

Both candidates have also pledged to foster Costa Rica's world-renowned ecotourism industry and to pursue policies of adaptation to climate change.

Mr Figueres has said he considers the fight against climate change to be an "opportunity" for growth, through creating new business and employment models, a lower emission economy and resilient infrastructure.

He proposes a move towards bio-fuels for local consumption.

Mr Chaves has also advocated reducing carbon emissions, and replacing use of fossil fuels with bio-fuels, "if costs allow".

Strong ties

Costa Rica's biggest trade and tourism partner by far is the United States. And with both candidates having personal ties to the US - they both studied there - these strong links are likely to continue whoever wins on 3 April.

IMAGE SOURCE,GETTY IMAGES

Image caption,

Costa Rica is keen to retains its credentials as a ecotourism haven

But with China's role as an important supplier to the Costa Rican economy growing, both Mr Chaves and Mr Figueres have said that they see opportunities for strengthening these economic links.

Mr Chaves has said that if he wins, he will emphasise the promotion of tourism coming from China while Mr Figueres said he would "recognise the importance of having a deeper relationship with China, without neglecting [Costa Rica's] friendship with the United States and Europe".

The outgoing Costa Rican government has strongly condemned the Russian attack on Ukraine and both candidates are expected to maintain this stance.

Threats from drugs trade

The US and other allies have expressed concern about the threats posed to small states like Costa Rica by international drug trafficking and related money laundering and corruption.

Costa Rica is a transit country for the illegal narcotics trade and has suffered its corrupting effects on business and political life.

To tackle crime and transhipments of drugs through Costa Rica, Mr Figueres proposes improving security coordination with foreign governments by sharing information with them.

Mr Chaves also promises tougher anti-drugs and security measures. "If you do not allow cocaine to leave Costa Rica, [the traffickers] will not bring cocaine" into the country, he argues.

Obituary: Pierre Zakrzewski, Irish cameraman killed in Ukraine who covered overseas conflicts with great flair

Pierre Zakrzewski, left, became “our man in Kabul, Syria, Kashmir, Caracas, Baghdad, Sudan, Liberia and Kyiv”

Deaglán de Bréadún
INDEPENDENT.IE
April 03 2022 

Among the vast number of casualties resulting from the Russian invasion of Ukraine, the death of Pierre Zakrzewski (pronounced “Zakshefski”) at the age of 55 years had a special impact in Ireland and internationally, not least in media circles. His life came to a tragic and violent end on March 14 while he was covering the conflict as a Fox News cameraman.

Both himself and 24-year-old Ukrainian journalist and producer Oleksandra “Sasha” Kuvshynova were killed and reporter Benjamin Hall was seriously wounded. The vehicle in which they were travelling was reported to have been attacked by Russian artillery at the village of Horenka, 30km from Kyiv.

Pierre had dual Irish-French citizenship and, shortly after his death, an official statement issued in France said that a war-crime investigation into the incident would be taking place. Anti-terror prosecutors are to investigate potential charges of causing “deliberate harm to a person protected by international law” and a “deliberate attack against a civilian who was not taking part in hostilities”. It is common practice for the French authorities to initiate cases following the deaths of their citizens under violent circumstances overseas.

France’s foreign minister Jean-Yves Le Drian, in a message of condolences to Pierre’s family two days after his death, said “armed forces have an obligation to protect journalists in accordance with international humanitarian law”. A similar view was expressed by President Michael D Higgins, who said in a statement: “The indiscriminate killing of civilians, including journalists, must be brought to an end.”

Born on August 15, 1966, in Paris, Pierre Zakrzewski was the second-eldest of four boys and two girls. His mother Marie-Ange is from France and his father Andrzej, who died in 1999, was from Poland. Andrzej had left his native country for Scotland during World War II and later moved to Dublin where he studied architecture at University College Dublin and went on to work in that field. They met in the mid-1960s when Marie-Ange was working in Ireland as an au pair and teacher of French. The couple lived in Leopardstown Road, Dublin, with their six children in a house designed by Andrzej himself.

Pierre attended St Conleth’s College in Ballsbridge in the city, as did his three brothers, and he went on to become an arts student at University College Dublin (UCD) for a time. He was already travelling abroad with his camera when he decided to acquire a formal qualification and enrolled in a course on television and audio operations at Ballyfermot College of Further Education. His former teacher John Moriarty remembers him as a keen and fun-loving mature student who embarked on a successful career in TV journalism from the moment he graduated.

Writing about his career in the St Conleth’s school yearbook of 2004, Zakrzewski said: “It’s difficult to explain the attraction to this way of life, but when you experience the emotional roller-coaster of war, both positive and negative, as a cameraman I feel I have a duty to tell their story.”

St Conleth’s has published a photograph on its website of Pierre with his final-year class of 1984 and a statement expressing “great sadness” at his tragic passing. Under the heading, ‘Pierre Zakrzewski: Our Man in Kabul, Syria, Kashmir, Leopardstown, Caracas, Baghdad, Sudan, Liberia, Kyiv’, the website goes on to recall how he would sometimes turn up in person for informal class reunions at Christmas but, on other occasions, could only make contact by phone from some risky trouble-spot that he was covering as part of his job.

A friend and former classmate of Pierre’s at St Conleth’s, Stephen O’Dea, told Newstalk Breakfast: “He was always fun, always driven. He was intrepid. When he left school he wanted to go travelling and to climb Mount Everest and he did that.” He told how when other climbers got into distress Pierre went out of his way to help them: “That’s the kind of guy he was. He would prioritise other people.”

As recently as last December, Zakrzewski received the Fox News “Unsung Hero” award for his role in assisting Afghan freelancers and their families to leave their native country during the US troop withdrawal from Afghanistan. For the last 15 years his home-base was London with his wife Michelle, a journalist with the BBC.

In a vivid and eloquent online tribute published on St Patrick’s Day, Fox News senior correspondent Greg Palkot describes what it was like working with Pierre: “He saved my own life on many occasions. Now he’s gone and the world is poorer for it.” Zakrzewski, or “Zak” as his colleagues called him, had died “doing what he loved to do most: chasing a story”.

“So many people in the media will remember how he helped them in the field, selflessly, and earned friendship upon friendship. And he was a dear friend. We’d fight like cats and dogs over some angle of a story one moment. And the next moment we’d be rocking out to the Rolling Stones, our favourite band.

“We worked together for over 20 years. He got incredible video in story after story we’d cover: Iraq, Afghanistan, Syria, the Mideast, the DMZ [between North and South Korea], riots in Hong Kong, Paris terror, Asian earthquakes.

“He saved my own life on many occasions. We were embedded in the lead Marine company in the battle of Fallujah in Iraq in 2004. Three Marines were killed, 18 injured, just in our unit. He had my back.”

The tribute continues: “We’ve dodged bricks and bats and paving stones and stinging tear gas in riot after riot from Hong Kong to Athens to Paris. He always knew which way to turn and get the best pictures.”

A French author wanted to compile an illustrated book about Pierre’s colourful life. The fatal incident outside Kyiv was not the first time he had come close to death, and colleagues said he was “like a cat with nine lives”. His friend Greg comments: “Tragically, this week, those lives ran out.”

The pair of them attended the Rolling Stones 50th anniversary concert in London, and Palkot writes: “Just the other day, I saw the group planned a 60th-anniversary concert in Hyde Park this summer. I was all set to get another round of tickets.”

Speaking at the funeral, which was attended by Minister for Defence and Foreign Affairs Simon Coveney, Zakrzewski’s colleague Tim Santhouse said Pierre had gone out of his way to assist those affected by the US withdrawal from Afghanistan: “He was helping hundreds of terrified Afghans to get out of the country and into safety.”

In his homily, Fr Kieran Dunne said Pierre was “capable of vision, innovative in his work and in the world, a truth-teller, full of empathy, generous of heart”.

Pierre Zakrzewski is survived by his loving wife Michelle (née Husson), mother Marie-Ange, his sisters Zosia and Karola, brothers Stas, Greg and Nick, his nieces and nephews Clara, Lucie, Louise, Zoe, Juliette, Jake, Lola, Florence, Anna, Braedyn and Grayson, “to whom he gave so much time and brought nothing but fun, joy and laughter”; along with other relatives, in-laws, colleagues and friends at home and abroad.

His funeral Mass took place at the Church of Our Lady of Perpetual Succour in Foxrock, Co Dublin, last Tuesday. A video of the ceremony is available via the church website at
foxrockparishchallenges.com/home/webcam/

Ketamine clinics go beyond therapy

Thanks to legal loopholes and a patchwork of compelling research, businesses like Nushama in New York City are writing the rules as they go


PUBLISHED : 3 APR 2022 AT 04:00
NEWSPAPER SECTION: SUNDAY SPOTLIGHT
WRITER: MARISA  MELTZER & DANI  BLUM
Cassandra Cooksey undergoes a ketamine treatment at Nushama in New York. photos:  VICTOR LLORENTE/nyt

The decor of the Nushama Psychedelic Wellness Clinic was designed to look like bliss. "It doesn't feel like a hospital or a clinic, but more like a journey," said Jay Godfrey, the former fashion designer who co-founded the space with Richard Meloff, a lawyer turned cannabis entrepreneur.

The "journey", in this instance, is brought on by ketamine, administered intravenously, as a treatment for mental health disorders, albeit one that has not yet been approved by the Food and Drug Administration (FDA).

"I thought, what does bliss look like?" Mr Godfrey said. At Nushama, which occupies the entire 21st floor of a building in midtown Manhattan, it looks like 3,000 silk pastel flowers hanging from the ceiling, and a flat-screen TV in the waiting room playing a "landscape of wonder" NFT featuring lily pads and garlands of leaves that are, upon closer inspection, tiny nymphs -- with wallpaper to match.

Mr Godfrey closed his fashion business and founded Nushama in 2020. He had become disenchanted with the fashion world, he said, and had been using psychedelics for his own mental health for many years after being inspired by Michael Pollan's best-selling book How to Change Your Mind. The light-bulb moment -- Mr Godfrey called it "an open-hearted experience" -- came at the beginning of the pandemic when he realised, "I have the ability to bring these medicines to people."

It may be a calling, but Mr Godfrey's career pivot from fashion to wellness came as there was less of a need for the clothes he designed, while there was a ballooning interest in psychedelics as alternative treatments for mental health. Investors are banking on various psychedelic startups, including delivery services and luxury travel offerings. Nushama is just one example of what many see as the next frontier in health, which, thanks to legal loopholes and a patchwork of compelling research, is able to operate with limited oversight.

The FDA doesn't authorise ketamine for mental health treatment, though it allows the drug to be used as a sedative, making it possible to get a prescription in New York. It has authorised a version of ketamine, called esketamine, which is administered as a nasal spray, to be used for mental health, but only for treatment-resistant cases of depression -- and while esketamine contains a molecular component of ketamine, the FDA says these drugs are not the same.

In other words, ketamine treatment at Nushama is an "off-label" use of the drug, and representatives from the FDA, Federal Trade Commission and the Drug Enforcement Administration said they do not regulate off-label drug use, and therefore cannot comment on clinics like Nushama.

Wallpaper at the Nushama Psychedelic Wellness Clinic in New York. 

VICTOR LLORENTE/nyt

"There's nothing suspicious" about off-label prescription use in general, said Mason Marks, a senior fellow at Harvard Law School specialising in the regulations around psychedelics, but ketamine providers need to be careful about over-promising the drug's benefits, particularly when there's limited evidence of its efficacy.

According to Dr Dan Iosifescu, a psychiatrist at NYU Langone, ketamine is also potentially addictive, heightening the risk of using the drug, even in a therapeutic setting.

Many researchers and mental health professionals do consider ketamine to be effective for treating depression where other drugs have failed, but Nushama's website says it uses the drug to treat eating disorders, obsessive-compulsive disorder, addiction and chronic pain, conditions where there is far less evidence of its efficacy.

"I think the 'spa for the brain' concept trivialises both the illness and the treatment. Ketamine is a medical treatment intended to address a significant illness," such as severe depression or suicidal ideation, said Dr Joshua Berman, medical director for interventional psychiatry at Columbia University.

"It has not been developed to provide diverting, relaxing or novel experiences for the bored or the worried well."

And perhaps most concerning to experts, it's up to individual centres to determine if, and how, patients work with mental health providers.

"With ketamine, there's so much off-label use. It's really concerning because, most of the time, it's not administered with any psychotherapy at all," said Natalie Ginsberg, a representative from the Multidisciplinary Association for Psychedelic Studies (Maps), a research and advocacy group. It's critical that ketamine centres incorporate therapy throughout a patient's process, she said.

Checking In

After making an appointment at Nushama, patients have a virtual psychological evaluation with Dr Steven Radowitz, the centre's medical director. (Mr Meloff said Nushama avoids the word "patients" internally, in favour of "clients" or "members".)

They turn away an estimated 10% of potential patients if they lack a "good foundation or support network", struggle with substance abuse, have high blood pressure or haven't been treated previously for a psychiatric condition, Dr Radowitz said.

Alternatively, if someone comes in with a concurrent pain diagnosis, the first appointment is with Dr Elena Ocher, Nushama's chief medical officer, who received her medical degree in Russia from Pavlov First Saint-Petersburg State Medical University and trained in neurosurgery at S M Kirov Military Medical Academy, also in Saint Petersburg. Dr Ocher runs pain management clinics on the Upper East Side and in Brooklyn. Mr Godfrey met her through a cosmetic surgeon friend.

About a week before an infusion, patients come on-site for a medical exam, including an electrocardiogram, blood pressure testing and oxygen saturation. They may also meet with Devorah Kamman, a psychiatric nurse practitioner, who joined the staff a few weeks ago.

Nushama has no legal obligation to offer mental health care to patients, though, and a representative for Nushama originally stated that it was possible to go through their process without being seen by a mental health professional. They have since amended their policies. Ms Kamman, the only mental health professional on staff, will now evaluate any patient who does not have their own mental health provider, they said, but will not be present while patients receive their infusions.

Patients are not required to be in ongoing therapy, though. "I can't force people to go start seeing a mental health provider or a therapist," Dr Radowitz said.

Other clinics have more stringent requirements. "All of our patients in our clinic need to have an outpatient psychiatrist and we need a referral from them as well," said Dr Paul Kim, who directs a clinic at Johns Hopkins Medicine that offers esketamine.

At Soundmind Centre, a psychedelic healing centre in Philadelphia that administers ketamine, a trained mental health professional works with every patient, throughout their experience, said Dr Hannah McLane, the founder. "To really address their underlying problem you need to talk to them. You need to have a dedicated person that's doing the therapy.''

Nushama also has "integration specialists", who meet with patients to discuss their intentions before an infusion session, pop in to check on how it's going and return once it's finished. These coaches are not licensed health professionals, though; according to Dr Radowitz, "They're more like sitters."

The 'Journey'

The clinic's 18 treatment rooms are all named after psychedelic medicine pioneers, such as Ram Dass. Patients are given an eye mask and headphones to play spoken word meditations and instrumental music by Deuter, a German new age instrumentalist, that blends Eastern and Western musical elements.


Snacks and beverages for patients at the Nushama Psychedelic Wellness Clinic in New York. VICTOR LLORENTE/nyt

Each room has a leather zero-gravity lounge chair with a big red button on the armrest, to call a nurse who can stop the drip, in case of emergency. Ketamine can elevate a person's blood pressure and heart rate, said Dr Iosifescu from NYU, and some people experience nausea or discomfort during infusions; it also has the potential to trigger psychosis. For someone with an eating disorder, a condition Nushama says it treats, this is particularly risky because they are more likely to have cardiac issues from poor nutrition, Dr Iosifescu said.

Once the treatment is finished, an integration specialist like James Gangemi, a 32-year-old former marketer, takes over.

"Afterwards you're left with, what do I do now? How am I navigating traffic or my colleagues?" said Mr Gangemi, who came to the profession through his own use of psychedelics. He talks with each patient about what their experience was like; sometimes he'll do breathing exercises with them. A doctor also checks their vitals, monitoring heart rate and blood pressure.

Patients are encouraged to linger, to read or journal about the experience -- they can order from a menu featuring mint tea, fresh fruit and granola bars -- and to have a chaperone assist them on their way home. Most stay about an hour, Dr Radowitz said, but they are allowed to leave after a brief medical evaluation and a 15- to 20-minute meeting with the integration coach.

Dr Ginsberg, from Maps, was concerned with how short Nushama's window for monitoring is.

"In any form of psychedelic therapy, it's really important to have time after for you to give your mind and body time to process what happened," said Dr Ginsberg. Esketamine clinics generally require a doctor to supervise patients for two hours, according to FDA protocols.

Dr Radowitz said that he sees "no difference whatsoever" between esketamine and ketamine, contrary to the FDA's assessments. Even so, he doesn't think two hours is "necessary". He acknowledges that Nushama's practices differ from FDA protocols for administering esketamine, but said he is not worried about potential risks or legal liability. "It doesn't concern me," he said. "I have no problem using this medication."

What's Next?

Across the country, ketamine clinics have seen increased interest. Since SoundMind opened in August 2021, they have had over 100 people a month sign up on average. Boise Ketamine Clinic in Idaho is booked until the end of April for ketamine-assisted psychotherapy treatments. In San Diego, a clinic called South Coast TMS and Ketamine had a 40-person wait-list for months, until the centre raised its prices to US$1,500 (50,400 baht) per session, a representative said.

A vial of ketamine. SANDY HUFFAKER/nyt

Dustin Robinson, a founder of the venture-capital fund Iter Investments, which concentrates on the psychedelics space, estimated that a typical ketamine clinic with, say, five rooms makes $75,000 to $100,000 per month, and potentially double that if it's fully booked.

Profit margins, he added, can be more than 30%, which according to industry reports is far higher than most health care services. "There is not a huge amount of staff and the medicine is very cheap -- almost negligible. The staff is the main cost," he said.

Mr Robinson knows Mr Godfrey, but is not an investor in Nushama, which charges $4,500 for seven sessions; insurance rarely covers ketamine for mental health, but might if there is also a pain diagnosis. Neshama does not provide single sessions. "It's hard to get in shape going to the gym once," Mr Meloff said.


This article originally appeared in The New York Times.

Copyright: © 2022 by The New York Times

Overcoming Impact Of Pandemic And Climate Crises Crucial, Says Eminent Buddhist Preacher

SGI president Daisaku Ikeda. Credit: Seikyo Shimbun

 April 3, 2022

By Ramesh Jaura

2022 marks seven years since the United Nations adopted 17 interlinked global goals, termed as the Sustainable Development Goals (SDGs), which are designed to be a “blueprint to achieve a better and more sustainable future for all” by 2030.

Looking closely at what has been achieved so far, eminent Buddhist philosopher, peacebuilder and educator Daisaku Ikeda, who is also president of the Soka Gakkai International (SGI), says: “Progress toward the realization of the SDGs has been greatly hampered by the [COVID-19] pandemic.”

In order to “restart and accelerate that progress”, Dr Ikeda considers it “important to flesh out the core spirit of the SDGs—the determination to leave no one behind—by adding a further vision of building a society where all can savour the joys of being alive”.

SDGs, also known as Global Goals, comprise an important part of Dr Ikeda’s latest—and the 40th—peace proposal titled “Transforming Human History: The Light of Peace and Dignity“, released on January 26.

The SGI president discusses from three different perspectives, what he sees as essential to overcoming not only the COVID-19 crisis but also the other challenges that confront our world, thus opening a new chapter in human history.

The first is to face head-on the issues the pandemic has exposed and reweave the social fabric so that it can support people’s lives in the years and decades to come. “Now more than ever, we need to construct a society where people can confront and together overcome even the most severe challenges, a society in which the palpable sense that it is good to be alive, is shared by all,” says Dr Ikeda.

His second perspective relates to creating a consciousness of solidarity that extends to the entire world.

The SGI president finds that the global pandemic measures should focus on how governments can work together to overcome the COVID-19 threat—not on how each individual state can escape the crisis. “The G7 countries should lead efforts to negotiate a pandemic treaty that will establish international protocols for responding to future pandemics, and proactively develop the frameworks of international cooperation that can serve as a basis for such a treaty,” adds Dr Ikeda.

He calls for “an economy that inspires hope in young people and enables women to shine with dignity”.

The SGI president further pleads for looking for ways to eliminate gross disparities in impact of and recovery from the pandemic, and refers in this context to a lecture given by United Nations Secretary-General António Guterres in July 2020, some four months after the World Health Organization (WHO) declared COVID-19 a global pandemic.

Speaking at an event celebrating the birth anniversary of the late South African president Nelson Mandela (1918–2013), whose life was dedicated to the causes of human rights and social justice, the Secretary-General focused his analysis not on the dangers and threats posed by the pandemic but on the people who are actually impacted. He noted that the virus poses the greatest risk to the most marginalized, including those living in poverty, older people and people with disabilities and pre-existing conditions.

Describing how COVID-19 can be “likened to an x-ray, revealing fractures in the fragile skeleton of the societies we have built,” the UN chief called for the development of a new social contract for a new era.

He cited the following words President Mandela addressed to the people of South Africa, which offer a direction for the realization of that vision: “One of the challenges of our time . . . is to re-instil in the consciousness of our people that sense of human solidarity, of being in the world for one another and because of and through others.”

Dr Ikeda stresses the importance of climate change. “With every passing year, the damage caused by extreme weather events has intensified and become more widespread,” he says. During COP26, the US and China agreed to strengthen measures for cooperation on climate action. And  “strongly” urges Japan and China to reach a similar agreement.

He also calls for strengthening the framework of partnership between the UN and civil society and propose the establishment of a venue within the UN where civil society, led by youth, can freely discuss the comprehensive protection of the “global commons”, the resources required in order to survive and flourish. “A UN youth council would be a perfect vehicle for this,” he adds.

On environmental issues, the SGI president calls for more coordinated efforts in implementing the UN Framework Convention on Climate Change, Convention on Biological Diversity and Convention to Combat Desertification, stating: “Climate change, biodiversity and desertification are deeply intertwined, and solutions are likewise interconnected.”

Concerned about the impact of disruptions to education, the SGI president suggests that the UN Transforming Education Summit planned for September focus on education in emergencies, inclusive education and learning for global citizenship.

Dr Ikeda is convinced that nuclear weapons abolition is the key to a sustainable global future. “The first step is to find a way of ‘detoxifying’ ourselves from current nuclear-dependent security doctrines.”

His second proposal pertains to the Treaty on the Prohibition of Nuclear Weapons (TPNW). In this context, he “strongly” calls both for Japan and other nuclear-dependent states and for the nuclear-weapon states to participate as observers in the first meeting of states parties to the TPNW when it is held.

Japan will host the G7 Summit in 2023. The SGI president proposes that a high-level meeting on reducing the role of nuclear weapons be held concurrently in Hiroshima, in which the leaders of non-G7 countries could also participate.

IDN-InDepthNews offers news analyses and viewpoints on topics that impact the world and its peoples. IDN-InDepthNews serves as flagship of the International Press Syndicate Group, partner of the Global Cooperation Council.