The NewsHour with Jim Lehrer

GWEN IFILL: Good evening, I'm Gwen Ifill. Jim Lehrer is off. On the NewsHour tonight, our summary of the news, then: Choosing to live or die, Oregon's assisted suicide law makes it to the Supreme Court; is a bird flu pandemic on the way, and is the nation prepared? Part two of Paul Solman's series on China's booming economy: Tonight, learning to shop till you drop; and Africa's efforts to protect its own in Darfur.

NEWS SUMMARY

GWEN IFILL: New Chief Justice John Roberts had tough questions at the Supreme Court today for backers of a state law that permits assisted suicide. The Oregon statute, the only one of its kind in the nation, allows doctors to prescribe drugs to help terminally-ill patients end their lives. In today's high court arguments, the Bush administration argued that violates federal drug laws. Oregon insisted it's a matter for the states to decide. Later, groups on either side spoke outside the court.

KATHRYN TUCKER: There has not been any threat to the public posed in Oregon. This has brought an additional choice to dying patients who have a prolonged dying process and for whom this is a least worst alternative. In the wake of passage of the Oregon law, improvements across the board in end-of-life medical care were realized.

JAMES BOPP, JR.: It's inconceivable that the federal government in adopting the Controlled Substances Act had in mind the idea that state by state we should be able to decide that controlled substances can be used to kill patients under the guise or pretext that it is medical treatment. It is not medical treatment.

GWEN IFILL: In 1997, the court decided there is no constitutional right to doctor-assisted suicide. Today's case presented a different question. We'll have more on all this right after this News Summary.

Also today, the court heard a special education dispute from Maryland. The question was: Do public schools have to prove a teaching plan works for a special needs child, or do parents have to prove it does not work? The outcome could affect schools across the country.

At least 25 people were killed, and 87 wounded, when a bomb exploded in southern Iraq today. The attack occurred outside a Shiite mosque in Hillah. Hundreds of men were gathered to mark the beginning of Ramadan, the Muslim holy month. Elsewhere, U.S. troops continued two offensives to rout al-Qaida from strongholds in western Iraq. They were backed up by hundreds of Iraqi troops. The Iraqi parliament today reversed last-minute changes in election rules for next week's constitutional referendum. The changes, opposed by the United States and the United Nations, would have made it nearly impossible to defeat the draft constitution. In Washington, State Department spokesman Sean McCormack was asked if the U.S. applied pressure.

SEAN McCORMACK: I think that it is the role of friends to speak out and offer their counsel when various actions might not meet international standards in terms of the political process or the electoral process. We certainly provided our counsel to the Iraqis, but this was an Iraqi decision and an Iraqi process that arrived at the decision they've taken.

GWEN IFILL: After today's action, Sunnis dropped a threat to boycott the vote. They largely oppose the constitution. The 19th tropical storm of the season formed off Cape Canaveral, Florida, today. Tropical Storm Tammy was not expected to become a hurricane. But, it could bring heavy rain as it moves north toward Georgia and the Carolinas. And in Central America, Hurricane Stan killed 99 people mostly in El Salvador. The storm came ashore yesterday in southern Mexico and caused flooding and landslides across several countries.

The Nobel prize in chemistry went to two Americans and a French scientist today. The Americans were Richard Schrock of the Massachusetts Institute of Technology and Robert Grubbs of the California Institute of Technology. The third winner was Yves Chauvin of the French Petroleum Institute. Their work has opened the way to making stronger plastics and better drugs and reducing hazardous by-products.

Researchers have resurrected a killer virus to get ready for a possible bird flu pandemic. The journal Science reported today military scientists re-created the Spanish Flu virus. In 1918, it caused a global outbreak that killed up to 50 million people. A study of the virus could give clues to fighting the Asian bird flu, in case it begins spreading from human to human. We'll have more on that story later in the program.

On Wall Street today, stocks fell sharply over growing concerns about higher energy costs. The Dow Jones Industrial Average lost more than 123 points to close at 10,317. The NASDAQ fell 36 points to close at 2,103.

That's it for the News Summary tonight, now it's on to: Assisted suicide and the law; the possibility of a flu pandemic; China's new consumers; and, the continuing troubles in Darfur.

FOCUS ASSISTED SUICIDE

GWEN IFILL: Do states have the power to grant terminally ill patients the right to die? That's the question the nine justices on the U.S. Supreme Court wrestled with today. We'll find out what happened in court in a moment, but first, some background from the NewsHour's Lee Hochberg of Oregon Public Broadcasting.

LEE HOCHBERG: When Caleb Heppner was diagnosed with terminal lung and bone cancer, he thought immediately of the horrid end to his father's life. He'd died of leukemia.

CALEB HEPPNER: Nobody wants to go through an excruciating last few hours like my father did. I'm thinking about those last hours, when instead of being around my family, being able to talk to them and then pass on very quietly, we're mopping up blood and they're trying to manage this horrible, horrible disease process that is just tortuous.

LEE HOCHBERG: With aggressive treatment he's outlived his six- to nine-month prognosis. But he's preparing to use Oregon's right-to-die law if he needs to. The nation's only such law allows patients who two doctors say have only six months to live the right to ingest a physician-prescribed lethal medication.

CALEB HEPPNER: Having the law available in Oregon and that that might be an option available to me, gave me a huge sense of relief that if worse comes to worse there was always that other option. And knowing that, I essentially put those issues about the last few hours of my life, days of my life aside, and went on living.

LEE HOCHBERG: That's meant peaceful days gardening, reading and writing. But he is uneasy this week about a Bush administration effort to overturn the law in the U.S. Supreme Court.

CALEB HEPPNER: If it's taken away, then I know that there is the possibility that I'm going to die a very excruciating death of bone cancer.

LEE HOCHBERG: The high court will rule on whether the Bush administration can legally prohibit Oregon doctors from providing aid in dying when Oregon law expressly allows the practice. Oregon voters passed their right-to-die measure by ballot initiative in 1994, then again by a large majority in 1997.

But in 2001, Attorney General John Ashcroft directed the U.S. Drug Enforcement Administration to revoke the licenses of Oregon doctors who prescribed drugs to help patients die. He said such drugs can be used only for "legitimate medical purposes."

"I hereby determine that assisting suicide is not a legitimate medical purpose," Ashcroft wrote in his directive.

JOHN ASHCROFT: I certainly believe that people who are in pain should be helped and assisted in every way possible, that the drugs should be used to mitigate their pain but I believe the law of the United States of America which requires that drugs not be used, except for legitimate health purposes, that those laws need to be enforced, and that's my responsibility.

LEE HOCHBERG: Oregon sued the administration, claiming it's the state's responsibility, not the attorney general's, to set state medical standards. A U.S. District Court agreed, as did the 9th U.S. Circuit Court of Appeals.

"The Attorney General's unilateral attempt to regulate medical practices …far exceeds the scope of his authority," the appeals court wrote in its decision.

DR. R. PETER RASMUSSEN: You've got down to a quarter the number of cancer cells than before.

PATIENT: Sounds good to me.

LEE HOCHBERG: Oncologist Peter Rasmussen is one of many Oregon physicians infuriated by the administration's challenge. He joined the state's lawsuit, calling Ashcroft's directive offensive.'

DR. R. PETER RASMUSSEN: I think morality does enter into this whole arena, but it's the patient's morality, not the federal government's morality. First of all, he is not a physician; he's not an expert on what is appropriate and inappropriate medical practice; it's very clear that what he wanted to do was to just stop Oregon's death with dignity law.

LEE HOCHBERG: Attorney Kathryn Tucker of the right-to-die group Compassion and Choices argues that as science extends the duration of dying, offering dignity in dying is a legitimate medical practice.

KATHRYN TUCKER: This case is about an unprecedented intrusion of federal power into that domain and in fact by a single unelected federal official.

LEE HOCHBERG: She says Oregon's law has prompted increased use of hospice and palliative care in the state, and has not been subject to abuse. In seven years, 208 patients have ingested lethal medication. Almost 80 percent of them had cancer. Almost all, 196 of them, died at home. Oncologist Rasmussen says he's been present at a dozen deaths.

DR. PETER RASMUSSEN: It is simply falling asleep. There are no seizures, there's no retching, no vomiting, no gasping. It is a very gentle passing into sleep, coma and then death.

DR. GREG HAMILTON: Killing a patient has never been a medical purpose.

LEE HOCHBERG: But opponents in Oregon agree with Ashcroft that it's bad medicine. Oregon psychiatrist Greg Hamilton helped write an amicus brief to the court.

DR. GREG HAMILTON: You can call it aid-in-dying but when you give someone an overdose with the intention of their taking it to die, you're participating in them killing themselves. You can use all the euphemisms you want, but that's what's happening.

If one of my patients is going to die tomorrow and I give them an overdose today, then I've killed them today.

LEE HOCHBERG: Hundreds of Oregonians at the end of their lives are watching the case closely. A ruling in Oregon's favor could pave the way for other states, like California, Vermont and Wisconsin, to pass their own right-to-die legislation.

GWEN IFILL: Now, Margaret Warner takes us inside the high court chambers with NewsHour court watcher Jan Crawford Greenburg of the Chicago Tribune.

MARGARET WARNER: Jan, this case, the shorthand and we've used it and the tape just used it, this is a right-to-die case. Now this isn't really about a constitutional right to die, is it?

JAN CRAWFORD GREENBURG: It's not. In fact, the court took up that very issue in 1997 and it specifically refused to read the Constitution so broadly to say that the Constitution protected a broad right to die. And in that case in an opinion by Justice O'Connor, the court emphasized that these end-of-life issues were best handled by the states which were laboratories to kind of look at and experiment and think about how best to handle these critical end-of-life issues. And, in fact the government's lawyer today, those were some of the first questions that he got particularly by Justice Ginsberg about how he can swear today's case with that one in 1997.

MARGARET WARNER: Take us inside the courtroom now. The solicitor general went first. What was his basic argument on behalf of the attorney general?

JAN CRAWFORD GREENBURG: Paul Clement, the solicitor general said that the attorney general had properly interpreted federal law to prohibit this kind of drug prescriptions; that it was not a legitimate medical use and it was not in the public interest. He said the federal Controlled Substances Act was a paternalistic law that it didn't allow people to make choices.

MARGARET WARNER: And that's where that phrase legitimate medical purpose' comes from, right? It gives the executive branch the right to yank any doctor's license who prescribed drugs that aren't for legitimate medical purposes?

JAN CRAWFORD GREENBURG: Right. The regulations attached to the law say the drugs must be prescribed for that legitimate medical purpose. And it gives the federal government the right to withhold these prescription privileges from doctors if they violate it.

MARGARET WARNER: All right. So tell us how the justices responded. Start with the new chief justice, John Roberts.

JAN CRAWFORD GREENBURG: Well, he was very active at argument today. And, of course we've all been wondering how he would be from the bench. He was replacing a chief justice who was not as active as some of the ones but would also be relatively aggressive at times. Chief Justice Roberts asked lawyers on both sides of this issue very aggressive questions; he saved most of his aggressive questions for the lawyer for the state of Oregon who was defending Oregon's law. The lawyer for the federal government who said it could block these efforts in Oregon ran into the most trouble from Justices Souter and O'Connor and Ginsberg who were really pressing him on why the federal government could step in here and interfere with these state efforts in Oregon.

For example, Justice Ginsberg referred back to the 1997 right-to-die case and said, look, the government then argued there was no constitutional right to die. It said this is something for the states to decide. How do you square that position with your argument today that the federal government can step in and prohibit these kinds of prescriptions, these lethal doses of medication?

And the solicitor general, Paul Clement, said we're not saying this is to ban all cases of assisted-suicide. There are other ways that people can commit suicide with assistance of a doctor but that doctors simply can't prescribe these lethal drugs.

And then, of course, Justice Ginsberg immediately said but we're told that this is a much gentler way to die.

MARGARET WARNER: And then of course it was the turn for Oregon's lawyer. What did he have to say?

JAN CRAWFORD GREENBURG: He said that Congress when it passed this Controlled Substances Act in 1970 did not intend for the federal government to regulate the kind of drugs in this manner, that it never intended to kind of preempt the states from regulating the practice of medicine and that states for hundreds of years have shown that they can responsibly regulate the practice of medicine.

And that was an argument some of the justices had already made in their questions with Paul Clement. Justice O'Connor, for example, said, Don't states regulate medicine?' So he came in with some of the justices seeming to be already on his side.

MARGARET WARNER: And then you said here's where Chief Justice Roberts was really assertive in his questions.

JAN CRAWFORD GREENBURG: That's right. He seemed very troubled by the fact that this could undermine the federal scheme and the uniformity of federal law. And he raised a number of hypothetical questions. I mean, this is a man who has argued on the other side of the bench and is very well versed with hypotheticals and so, for example, what about a drug, let's say, morphine, that the state said, well, you can prescribe it for any reason -- just to make people happy. One state might say that that's okay. Is that allowed under federal law? And the lawyer for Oregon said, well, yes, and if Congress has a problem with that, it can pass a specific law banning it. But again Chief Justice Roberts went back saying again, but doesn't this undermine the federal scheme and uniformity?

Justice Scalia, also very aggressive in questioning the lawyer for the state of Oregon and saying, you know, Congress -- while you say Congress may never have intended to authorize, you know, the attorney general to come in, congress certainly never intended or imagined that states would authorize the use of drugs in this kind of situation.

MARGARET WARNER: So you've been watching not this exact court but most of this court for a long time. Are you willing to venture any prediction based on the questioning?

JAN CRAWFORD GREENBURG: Margaret, the court was very difficult to read today. And it showed what one new justice, the impact one new justice can have. It's more than just one vote. The dynamics of the argument even felt really different. Now this is a court that's been together for 11 years, as of last June -- the longest in any period in history, nine justices have been together. So it became relatively easy in some cases to predict how they would go.

But with the addition of Chief Justice Roberts, it was harder to read, so I wouldn't venture a guess today.

MARGARET WARNER: And, briefly, are you willing to venture a guess as to whether O'Connor will actually get to vote?

JAN CRAWFORD GREENBURG: I would say no. This is a very controversial case. As Justice Kennedy said explicitly this is a hard case. And we all know that if the court has not decided and released its decision when her successor comes on board, her vote will not count. But that didn't stop her from really pressing the lawyers today.

MARGARET WARNER: All right. Jan, thanks a lot.

GWEN IFILL: Still to come on the NewsHour tonight: Preparing for an avian flu pandemic; Paul Solman on China's new consumers; and a troubled Darfur mission.

FOCUS PANDEMIC PERIL

GWEN IFILL: The flu season approaches, but with a twist, as government, from the top down, worries about the potential for a new and deadly pandemic. Susan Dentzer of our health unit begins with some background. The unit is a partnership with the Robert Wood Johnson Foundation.

SUSAN DENTER: For years scientists have warned of a devastating outbreak of bird or avian flu, starting in Asia, then spreading to the United States and the rest of the world. President Bush was asked about that prospect yesterday.

PRESIDENT GEORGE W. BUSH: The people of the country ought to rest assured that we're doing everything we can. We're watching it, we're careful. We're in communications with the world. I'm not predicting an outbreak. I'm just suggesting to you that we better be thinking about it, and we are.

SUSAN DENTER: In the past two years, there have been reports of 116 known cases of avian flu and 60 deaths -- all of them in southeast Asia. Last week Indonesian officials announced the latest known death, that of a 27-year-old woman at this hospital in Jakarta.

So far, the avian flu virus, dubbed H5N1, has apparently spread only from birds usually chickens, to humans but scientists worry the virus will mutate and then spread from one person to another. Since virtually no one has immunity to this new virus that could quickly spark a global pandemic. Experts fear that could result in the worst world flu pandemic since 1918 and 1919 when twenty million to forty million people died. Andrew Jakomas lived through that era.

ANDREW JAKOMAS: We had little caskets for the little babies that stretched for four and five blocks, eight high, ten high.

SUSAN DENTER: The core issue for U.S. policymakers is how prepared the nation is to cope. Iowa Sen. Tom Harkin raised that concern on the Senate floor last week.

SEN. TOM HARKIN: We've had two disasters in the last four years: 9/11 and Katrina followed by Rita. And the federal government was totally unprepared for both despite clear warnings. Similarly we have been warned in no uncertain terms about avian flu, but our preparations so far have been grossly inadequate.

SUSAN DENTER: Recent congressional hearings have probed the fact that there's just one current vaccine that shows promise in fighting the virus. It could take months to make enough of it. Anti-viral drugs like Tamiflu and Relenza could help fight flu infections and cut the numbers of deaths.

The U.S. Government has stockpiled more than 4 million courses of therapy of both drugs. It ultimately wants to acquire 20 million but with many other nations also competing for the drugs it's having trouble getting more.

DR. ANTHONY FAUCI: We certainly don't have enough right now. We're well aware of that which is the reason why we are in the process of negotiating to get more.

SUSAN DENTER: Another issue echoes one that surfaced after hurricane Katrina, dividing up responsibility for preparing and responding to emergencies among the federal government, states and localities. Health and Human Services Secretary Michael Leavitt has emphasized that local officials must be ready to act first in the event of a flu pandemic.

MICHAEL LEAVITT: It will be absolutely essential that local communities are well prepared, have a plan, and that we have sorted out who will be responsible for what.

SUSAN DENTER: President Bush suggested this week that the military could be called on to respond to a pandemic and to enforce mandatory quarantines.

PRESIDENT GEORGE W. BUSH: If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country? And who best to be able to effect a quarantine? One option is the use of a military that's able to plan and move. So that's why I put it on the table. I think it's an important debate for Congress to have.

SUSAN DENTER: Lawmakers have now vowed to devote far more attention in coming weeks to preparing and responding to a flu pandemic.

GWEN IFILL: To assess the risks of avian flu and what options should be considered to prepare for it, we turn to: Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention; and Dr. William Schaffner, head of the Department of Preventive Medicine at Vanderbilt University.

Dr. Gerberding, how serious is the potential for an avian flu pandemic here in the U.S.?

DR. JULIE GERBERDING: Most experts are saying that it's not really a question of if. It's a question of when. We're overdue for a pandemic. That's part of the reason why we're putting so much emphasis on preparedness. That and the situation that we see in Asia right now with this H5N1 strain which is very, very serious from our standpoint in public health.

GWEN IFILL: What preparedness are you talking about? We just heard Dr. Fauci said there is not enough vaccine. What else is being done to prepare?

DR. JULIE GERBERDING: We're working on a comprehensive strategy in the Department of Health and Human Services. One of the most important components is our ability to detect the emergence of a pandemic strain before it leaves the local community where the outbreak exists. That's going to take international cooperation, laboratories and scientists who are able to investigate and respond quickly.

We also need those kinds of capabilities here in the United States as well as vaccine supplies, anti-viral drugs, a communications strategy for sure, and then the ability to take the public health measures to isolate and quarantine people if those steps become necessary.

GWEN IFILL: Dr. Schaffner, what is your sense on how prepared we might be for any potential pandemic?

DR. WILLIAM SCHAFFNER: Well, preparation is a process. It's a process that's ongoing. We're better prepared than we were, but we still have quite a ways to go.

GWEN IFILL: What does that mean quite a ways? How much of a ways? Will we get to that way before the actual pandemic hits?

DR. WILLIAM SCHAFFNER: Well, Dr. Gerberding mentioned that the federal government has an influenza pandemic preparedness plan in the works, and we have seen early drafts of that.

In my conversations with colleagues over the last several days, they're really waiting for the last draft to come down so that they can dovetail their plans into what it is that the federal government intends to do. In the meantime, we have to think globally but we must act locally.

And so at the state level in communities and in my own hospital, for example, we have our own contingency plans and, certainly at Vanderbilt, we have drilled those plans several times. We hope that we are reasonably well prepared.

GWEN IFILL: Now, let me ask you this, Dr. Schaffner and I want to ask Dr. Gerberding as well, the president yesterday suggested at least opened the door to the possibility of the use of the military in the case of a widespread problem and also to quarantines. What did you think about that as part of a plan?

DR. WILLIAM SCHAFFNER: I'm a little skeptical about that because I think this is the sort of infection, should it be introduced into the United States, it wouldn't just go to one or two small places and stay there and have us be able to detect that infection and then kind of put a circle around it and keep folks in and keep folks out. I think it will spread more widely than that. I think most public health folks are dubious about the use of military to enclose Asian influenza.

GWEN IFILL: Dr. Gerberding, how do you respond to that kind of skepticism?

DR. JULIE GERBERDING: Well, we've made a strategic decision in the department that our initial strategy will be containment if that's feasible. And obviously containment will work best if we find the virus early and we can act in one or a small number of locations.

If we are dealing with the situation where there are multiple locations of infection, then we'll have to look at those local situations as Dr. Schaffner has suggested to determine at the local level is containment possible? Do we need to quarantine the people who are exposed to prevent spread to vulnerable people? Or are we going to have to fall back on the anti-viral treatments and the vaccine that is not going to be able for some period of time?

There are certainly scenarios where the use of military personnel or the National Guard to maintain civil order, particularly in the context of scarce resources or an overwhelming epidemic, where we would need to have that kind of capability to enforce public health laws and to take the steps necessary to protect people's health. I hope we never have that situation, but it would be foolish not to at least consider it and plan for that as a possibility.

GWEN IFILL: Dr. Gerberding, in Susan Dentzer's piece she quoted Sen. Tom Harkin, who suggested that maybe some of this talk of bringing the military in for disaster relief is a little post-Katrina talk. Is this something that's been discussed all along?

DR. JULIE GERBERDING: Well, we have looked at the Department of Defense for help in a variety of public health operations. For example, just last year with the tsunami, it was the Department of Defense that provided the heavy lifting and helped coordinate among all of the countries with military presence in the region to help out the tsunami victims. The military has enormous operational capacity. At CDC we often turn to them for advice or help on how to improve our own operations. So I think we have an amazing resource.

We don't have to conjure up the image of armed people policing our streets to recognize that the DOD has some wonderful attributes to offer us and some experience and some real capabilities that we might benefit from.

GWEN IFILL: Dr. Schaffner, what would you like to see in a federal final plan as you described it, were it to come down, say, tomorrow from Mike Leavitt at the Department of Health and Human Services? What would you like to see them focus on: Prevention, on virus treatment; on quarantining and military relief?

DR. WILLIAM SCHAFFNER: Well, yes. All of those things. It will have to be a multifaceted plan, seriously, because we'll have to take care of the sick. We'll want to immunize those who are not yet ill. We'll want to distribute the anti-virals appropriately. We need a good communications strategy so that the people in the United States know what we're about and what the plan is.

There will have to be some security locally provided by local law enforcement. I like the emphasis on the military providing strong logistic support. They do that wonderfully well. It will have to be a multifaceted plan. Then there are some hard questions. Who will buy the vaccine? Under what conditions will the anti-virals be released and distributed?

And once we get the federal plan a lot of those key elements will be in place and the state plans and those of us in hospitals and smaller communities can also begin to key in on those features and once again visit our plans. As Dr. Gerberding and I both agree, planning -- preparedness planning is never a final event. You keep working on it. You develop relationships that you will rely upon when things really happen.

And you can call up your colleague with whom you have drilled and worked on problems in the past. It's preparing for flexibility and being able to respond appropriately.

GWEN IFILL: And, Dr. Gerberding, finally, you know, last year after the flu season, there was a lot of reports of running out of flu vaccine. We heard that there are 4 million courses of vaccine for this bird flu that exist and they need 20 million.

How do you go about reassuring people that the federal government, that the private sector have enough vaccine if something like this should happen?

DR. JULIE GERBERDING: When and if a flu pandemic virus emerges, we will need to make vaccine to that virus so it's really not possible to stock pile a vaccine in large quantities in advance. What we're doing as a nation is stockpiling an H5 vaccine that we believe would have some potential for cross protection, but we can't count on that to be a protective vaccine. And that's why our ability to recognize this emergence when it occurs to develop the seed vaccine products quickly and then scale up our entire nation's vaccine capacity to develop a pandemic vaccine is so essential.

Those are the kinds of things that Secretary Leavitt and the whole department, the FDA, the NIH, the CDC, we're all working to make sure that our nation can improve its ability to reliably make large quantities of vaccine for just this kind of an emergency.

GWEN IFILL: All right. Dr. Julie Gerberding and Dr. William Schaffner, thank you both very much.

DR. JULIE GERBERDING: Thank you.

DR. WILLIAM SCHAFFNER: Thank you.

SERIES CHINA RISING

GWEN IFILL: Now, another in our series of reports on the rise of China as a global economic power. Tonight, a look at a vast market that appeals to many companies: The Chinese consumer. The NewsHour's economics correspondent, Paul Solman of WGBH-Boston, has the story.

PAUL SOLMAN: Shanghai's trendy Bar Rouge, where the bartender mixes drinks with Vegas-like showmanship, and the customers are as cosmopolitan as the cocktails.

MONICA WANG. Actress: We live in a modern society now -- compared to 20 years ago where China was completely you know sewed up, right? We have McDonalds and we have KFC; we have Pepsi and Coke. Of course young people are going to love and enjoy those things, right?

PAUL SOLMAN: After decades of clich(c)s about a billion thirsts to quench, the Chinese global consumer, it would seem, is here at last…starting at the top.

HANDEL LEE, Entrepreneur (in Beijing Restaurant): I bought it in '91, and renovated it --

PAUL SOLMAN: American Handel Lee: restaurateur, art dealer, Shanghai's first Armani franchisee -- a typical global investor who's targeting Shanghai's high-end shoppers.

HANDEL LEE: We're going for the top 5 percent.

PAUL SOLMAN: And how many people is that?

HANDEL LEE: Well Shanghai according to our numbers is about 860,000 people.

PAUL SOLMAN: There are almost a million people in Shanghai who can afford stuff like this?

HANDEL LEE: Absolutely.

PAUL SOLMAN: Now even if that's not an extravagant estimate, it would still mean that 15 million people in Shanghai alone, and more than a billion Chinese in total, can't afford "stuff" like this - a Marni-label outfit: around $2000, twice the average Chinese annual income.

But the point is, it seems to be no problem for mainland fashionistas: Chinese consumers now scoop up 12 percent of the world's luxury goods --mostly when they travel abroad -- compared to 17 percent by U.S. consumers. And yet not long ago, almost everyone in China dressed exactly the same.

HANDEL LEE: From the blue Mao suit to Marni. Now, it's quite a journey. (laughs)

PAUL SOLMAN: Lee's women's boutique, where even the dressing rooms are theatrically upscale; a barbershop where Celine Dion serenades the clientele (music) -- this is how China's top 5 percent can afford to shop.

The next 30 percent can go to…Wal-Mart.

Because it's mainly reachable by car -- and there are still only 10 million cars here, about the number the U.S. had around 1930 -- Wal-Mart caters to China's upper middle class, those who average about $10,000 a year -- which goes roughly as far as $40,000 in the U.S. Fewer than 30 percent of Chinese may actually earn at this level -- we remind you, amidst all the city glitz, that more than half the population is still rural. But less than 25 percent of all Chinese is still more than the entire population of the United States.

Nearly identical to its US prototype, with employee enthusiasm matching anything back home, Wal-Mart has 48 stores in China, will put up a dozen more before the year is out. At the chain's newest Super Center, in Beijing, the head of Wal-Mart Asia, Joe Hatfield, explained how the world's largest corporation views its fastest growing market.

JOE HATFIELD, President and CEO, Wal-Mart Asia: It's the one place in the world that you could recreate Wal-Mart all over again.

PAUL SOLMAN: Why?

JOE HATFIELD: Because of the population base and the growth and the income levels.

PAUL SOLMAN: To see how Chinese consumers increasingly go West, just look at cosmetics.

JOE HATFIELD: we started out with four foot of skin care; today it's twenty feet. Today we don't have deodorants, but someday down the road we will have deodorants in China. Five years ago perfumes were not a big business here. But if you look today it's the emerging market.

PAUL SOLMAN: Even sales of dairy products are booming, though most Chinese are lactose intolerant.

JOE HATFIELD: If you'd have come to Shanghai or Beijing four or five years ago, you would have seen about 25 percent of what you're seeing today. This market has just exploded.

PAUL SOLMAN: 'Exploded' may be apt, given the symptoms of lactose intolerance, and a new issue in China: eating too much in general.

JOE HATFIELD: They drink more milk; they eat more bread and snack crackers and they eat more meat in their diet; there's a lot less bicycles, so that takes away from the exercise side of it, so the size of people are getting larger, so what's that tell you? Exercise equipment's getting good, exercise wear, jogging outfits and at some point, we'll have Slimfast and all those type of products.

PAUL SOLMAN: Slimfast in China. But while Wal-Mart may be spurring Western-style over-consumption for those relatively few at the top, its style of merchandising may have benefits here. Criticized in America as leading "a race to the bottom," Wal-Mart in China could be leading a race in the opposite direction.

WAL-MART CUSTOMER (Translated): First, the price is good. Second, the environment is good.

WAL-MART CUSTOMER (Translated): They wear a smile on their face. They give us directions and help us to find the things we need very efficiently.

WAL-MART CUSTOMER (Translated): This supermarket is modern and cool.

PAUL SOLMAN: It's also clean. Its meat section, for instance, features workers in masks to guard against disease.

JOE HATFIELD: It evolved a couple years ago when we had SARS; and there's a lot of focus being given to food safety and cleanliness and sanitation; and the customers appreciate it.

PAUL SOLMAN: So, apparently, does the Chinese government. Hygiene has long been an afterthought for Chinese businesses; grocers, for example, still use fans to scatter flies. So the government can point to Wal-Mart as a model of modernization.

JOE HATFIELD: They hold us to a higher standard than others and to set the expectations for others to follow.

PAUL SOLMAN: Cleanliness, convenience, and opportunity for today's workers, and those of tomorrow.

JOE HATFIELD: In a store like this, where we'll hire five hundred to five hundred and fifty associates with opportunities to grow -- when I joined the company, I started out as an assistant manager and a store manager. How would I have ever dreamed 30 years ago I would be doing what I am doing today and I think we give ten or fifteen thousand people each year those opportunities to grow.

FEMALE WORKER (Translated): Before, as peasants, all we faced every day was fields and vegetables. Now I get information from all sides, and I can develop myself. That's the difference.

MALE WORKER (Translated): My goal is to become district manager in one year and manager of all of Wal-Mart in five years.

PAUL SOLMAN: Do you hope to be Joe Hatfield someday?

MALE WORKER (Translated): I'd like to be his boss. (laughs)

PAUL SOLMAN: There's the same can-do spirit in Wal-Mart's book section, where customers take their inspiration from the likes of Dale Carnegie and his How to Win Friends and Influence People:' A "Made in America" philosophy in a store whose goods are almost all made in China.

Still, as with so much foreign investment in China, the vast majority of the poor are out of the picture. And Wal-Mart's low-price policy forces Chinese suppliers, says labor activist Han Dongfang, to treat their workers badly.

HAN DONGFANG, Chinese Labor Activist: They make these subcontractors compete with each other, against each other and Wal-Mart just sit here and see these people biting against each other and they're bleeding and then they get the lowest point price; it's based on exploitation of Chinese workers.

PAUL SOLMAN: Meanwhile Wal-Mart itself has reportedly yet to turn a profit in China. The underground parking garage in Beijing was conspicuously empty. Plus, there are regulatory headaches galore to undermine the efficiencies of Wal-Mart's famed centralized distribution system.

JOE HATFIELD: We have to buy produce locally from the countryside; we have to buy liquor locally; we have to buy tobacco locally.

PAUL SOLMAN: A mile away, Wal-Mart's local competition, the giant Chinese chain, Wumart, takes a more traditional approach to wooing the urban Chinese consumer. Wumart subcontracts to local services, like this barbershop, and fills its supermarket settings with traditional Chinese sights and sounds.

PAUL SOLMAN: What did he say?

XU YING, Wumart: That's the price.

PAUL SOLMAN: Oh, he's shouting out the price.

XU YING: Yeah, the Chinese people still, we like this kind of atmosphere. It makes people feel very excited.

PAUL SOLMAN: And, says Wumart executive Xu Ying, so does the sale on a kilo of eggs, especially popular with older consumers -- 11 eggs for 30 cents -- and the bargain tables: most items a dime; top price, 60 cents.

PAUL SOLMAN: She put that one back and she's looking.

XU YING: Yes just to compare the other, see if there's any small problem, check the quality; from the face you can see they are very happy.

PAUL SOLMAN: Here too, though, global marketing is having an impact on some of the world's pickiest shoppers.

PAUL SOLMAN: Do you go to Wal-Mart and see what they're doing? Do you check them out?

XU YING: Well we do. We could also send our staff there to learn and then compete. We are regarded as a competitor, direct competitor of Wal-Mart; that means we are approaching that level, the world class company level.

PAUL SOLMAN: So, do Chinese consumers want to become westernized? No, says ad man Tom Doctoroff, head of J. Walter Thompson's Shanghai office; they want to become modern, while remaining emphatically Chinese.

TOM DOCTOROFF, Greater China CEO, J. Walter Thompson: Chinese believe fundamentally in the superiority of the Chinese world view. The one thing that has unified China despites wars, despite emperors falling and dynasties rising, is the Chinese world view and a belief in it as almost a religion; it is almost spiritual cohesion. So people don't want to become westerners. People think that western is a dead-end. What they want to be is international. What they want to be is modern.

PAUL SOLMAN: So Doctoroff puts a, group-oriented Confucian spin on, for instance, his Nike ads in China. They seem to stress western individualism, but it's never outside the group.

TOM DOCTOROFF: Individualism in China it's the illusion of being different, of having a better, smarter, cleverer way, but it always has to remain understated within the context of social barriers of a Confucian society.

One thing that, you know, is interesting about Chinese youth is they're very ambitious. They want to show off in front of their peers, but because it's not truly an individual culture, they show off but in an understated way so the tone and the manner of these is very quiet and then the joy and the showing off and the peer endorsement happens.

So Chinese don't want to define themselves independent of society. They want to as individuals climb up a very regimented social hierarchy.

PAUL SOLMAN: Doctoroff applied the same insight to a Chinese diamond ad.

TOM DOCTOROFF: This is a fundamentally different ad than what you'd see in the West. A diamond is forever in the West, you know, it's really about sex. This is really a commercial not about romance but about commitment.

The man ties a red string to the woman's finger. The Chinese have a belief that two people, because of fate, are born with a red string attached to their intended, the person they're meant to be with.

PAUL SOLMAN: As for you PBS viewers who think fewer ads in general might not be a bad thing --

TOM DOCTOROFF: Advertising is about profit and profit is good for capitalism and capitalism is making China move forward.

PAUL SOLMAN: It's an argument that upscale young Chinese have now begun to buy.

PAUL SOLMAN: We've always heard that Chinese like to save, not spend money. Is that true of your parents?

MONICA: Very much so.

PAUL SOLMAN: And you?

MONICA: I spend ahead of my earnings. (laughing)

PAUL SOLMAN: You spend ahead of your earnings?

MONICA: Yeah.

PAUL SOLMAN: Is that true of your friends as well?

MONICA: I think so. It's true of all young people.

PAUL SOLMAN: Millions upon millions of new Chinese consumers, then, globalizing in their own way at a dizzying pace; yes, they're a tiny fraction of the total: more than a billion Chinese could never afford a drink here.

But at the rate China has been changing, it could become --with its own peculiar twists --the world's largest market some day -- perhaps, some day soon.

GWEN IFILL: Paul's next report will look at the question of Mao's mixed legacy in a new China. For more on this series or to sign up for a pod cast that automatically downloads audio versions of these reports, visit the Online NewsHour at pbs.org.

FINALLY DARFUR MISSION

GWEN IFILL: Now to our update on the continuing warfare in Darfur. Ray Suarez has that.

RAY SUAREZ: The African nation of Sudan -- a bloody conflict that's killed as many as 400,000 people and forced another two million from their homes over the last two years. The fighting in Sudan Darfur region pits government-backed militias known as the Janjaweed against local rebels. The U.S. has accused the government and Janjaweed of committing genocide; despite an official cease-fire and ongoing peace talks the violence shows little sign of abating.

The African Union has sent roughly 5,000 troops -- mostly Rwandans and Nigerians -- to protect civilians and monitor the cease-fire. Another 2500 will be deployed by the end of this month.

Just back from the region are Sally Chin and Jonathan Morgenstein from the humanitarian organization Refugees International. They visited five refugee camps and observed the work of the African Union troops.

Well, you're just back and your purpose was to monitor the AU's work in general. How are they doing? Sally Chin.

SALLY CHIN: How are they doing? You know, we were in North Darfur and West Darfur. We were able to spend some time with the troops. Where they are they're able to provide security. I mean, they're able to assist humanitarian agency s with their convoys. They're able to negotiate for the release of abducted aid workers, and they're able to be a sort of beacon of security where IDP's can come when there is instability.

The problem is, is they're not everywhere, and they can't be everywhere until they have more troops on the ground and until they have more equipment and better logistics. And then the third problem is they need a much stronger mandate. Their mandate right now, as you were saying, is to monitor the cease-fire. And it's also to protect civilians when they are in the vicinity of the AU. That means they can't proactively protect the citizens of Darfur. And that's a problem.

RAY SUAREZ: So, Jonathan, is it a case where when they're around, it's great and then when they leave basically civilians are vulnerable once again?

JONATHAN MORGENSTEIN: Well, I wouldn't say things are great. Where the African Union troops are as well as the humanitarian aid community, there is a modicum of stability. But there are internally displaced people camps that even just in the last week were attacked by Janjaweed and even reportedly government forces. And this resulted in over 30 people being killed.

Now the African Union force there has contributed to a situation where the number of people that have been killed on a daily basis has declined from what it was two years and one year ago, but the situation is not stable today. And the African Union really needs to be able to enforce its ability even where they are.

When we arrived in El Fasher, the capital of North Darfur, on Sunday the 18th, there was an attack by Janjaweed on villages to the southwest of that city. And the very next day, the African Union sent out an observer force to inspect what was going on. They were actually shot at and two Rwandan protection forces were actually hit by the Janjaweed.

The African Union force doesn't have the ability to respond in kind. They were 12 forces -- 12 Rwandan soldiers with rifles against hundreds of Janjaweed.

RAY SUAREZ: So the rules of engagement say that even when shot at they can't fight back?

JONATHAN MORGENSTEIN: They can fight back in that moment but they would have been all killed if they had really tried to fight back so they had to withdraw.

And when I asked the question of, well, why didn't you send a reaction force to respond and hunt down the people that had attacked you, let alone to try and go out and protect the civilians who were falling into the internally displaced camps, the response was, well, that's not in our mandate.

Right now they are not a peacekeeping force. They are actually a monitoring force and the primary objective of the force is to simply verify when violations of the cease-fire have been committed.

RAY SUAREZ: Sally Chin, were there episodes during your visit, things that you saw happen that sort of illustrate the tight spot that the AU force is in?

SALLY CHIN: Most definitely. As you were talking about this monitoring of the cease-fire commission they are there to monitor violations of the cease-fire what -- they send out teams; these teams are made up of military observers of the African Union as well as representatives of all the warring factions, that's the SLA, the GEM and the government of Sudan.

So as a team they go out to investigate what's happened, whether it's been a killing or people being displaced. This is a really problematic. For example, when we were in West Darfur, there was supposed to be an investigation team to go out and take a look in an area where there had been an attack by the GEM. And the GEM representative --

RAY SUAREZ: One of the anti-government --

SALLY CHIN: Exactly. And the GEM representative didn't want to go. He refused to go and basically the team was held hostage to that. They couldn't go and they couldn't investigate.

We also saw while they were having their investigation teams that when they're interviewing witnesses sometimes these witnesses feel intimidated by the fact that they're saying I saw the Janjaweed, I saw the government of Sudan, and that person is sitting right in front of them.

RAY SUAREZ: Clearly marked as being representatives of the government or one of the rebel armies.

SALLY CHIN: And this is how it was organized from the beginning. But really recently the African Union is starting to say this isn't working. Just this weekend Ambassador Kingibe, who is the head of the mission, he put out a really scathing press statement which said, you know, this could work if there was good faith between the warring parties but there is not good faith, and so this kind of system has to be changed.

And he also said that he always came out quite strongly against the government of Sudan in terms of its involvement in attacks. And this is something that's very new for the African Union who has been maybe accused in the past of being a bit passive when it came to the government of Sudan.

And I think we're at a really important right now because this month in October is the renewal of the mandate of the African Union. And what we think is really important is for the mandate to be stronger.

RAY SUAREZ: Stronger in what way? Would it mean simply more troops or a rewriting of the whole rule book that they're working under?

SALLY CHIN: It would mean all of this. And we're not alone in thinking this. There are many people and what was interesting for us were a lot of the African Union officers on the ground felt this as well. They said to us, we want to be here to protect civilians. With this mandate we can't protect civilians practically.

I mean, something that's interesting is that the Rwandans have given a large number of troops to this mission. And a lot of the Rwandans we spoke to say that they feel a real personal attachment to this mission because of the genocide that happened in Rwanda. They feel very much so that they don't want to see something like this happen again.

And so there is a strong feeling on the ground amongst the officers that the mandate has to change. It has to become more -- stronger for civilians. At the political level there isn't necessarily that understanding.

RAY SUAREZ: Jonathan Morgenstein, do Sudanese civilians understand that the people in the white armored personnel carriers are looking out for them?

JONATHAN MORGENSTEIN: There is actually a lot of confusion among not only the Sudanese civilians but even humanitarian aid organizations about exactly what the role of the African Union mission is supposed to be. That's one issue that really the African Union needs to take a hold of better, which is publicizing what specifically their role is and how they're executing it.

We spoke with a number of displaced people who said things such as, well, aren't they the same as the African -- I'm sorry, the Sudanese government or they didn't know the difference between the African Union and NGO's, humanitarian aid organizations, because they have similar looking vehicles.

One woman apparently told Sally that she understands that they are different than the Sudanese government because they're the men in the uniforms who don't shoot the displaced people. But it's clearly a situation that the African Union needs to have a public information campaign and in that way even let the humanitarian aid community understand that they are not peacekeepers. Their role, as Sally said, right now is not to protect the civilian population.

RAY SUAREZ: But is it rough to do that kind of public information campaign in an ocean of transient people who are living in reed huts covered in canvas?

SALLY CHIN: I would say most of the population unfortunately now are in camps. I mean you have a population that is there that can be informed, that can be educated. I think it's really important. One of the worst things that can happen is that the population has wrong expectations of what the African Union can do for them. If those expectations are frustrated, that can lead to unrest and attacks, which we've seen in peacekeeping missions in other countries.

RAY SUAREZ: Sally Chin, Jonathan Morgenstein, thank you both.

RECAP

GWEN IFILL: Again, the major developments of the day: The Supreme Court heard arguments on Oregon's law allowing doctor-assisted suicide. And at least 25 people were killed, and 87 wounded, when a bomb exploded in southern Iraq. We'll see you online, and again here tomorrow evening. I'm Gwen Ifill. Thank you, and good night.