Monthly Archives: April 2019

World Bank seeks health corps as Ebola risks eroding WHO

The World Bank, headed for the first time by a doctor, wants to create a cadre of outbreak specialists who could be sent anywhere to end deadly epidemics.

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A similar idea, floated by a World Health Organization panel three years ago in the wake of the swine flu pandemic, didn’t get enough support. The WHO says the idea might not be practical and countries should ideally have the capacity to respond themselves.

The Ebola outbreak, which has so far sickened more than 20,000 people in eight countries, shows major weaknesses in global health security. The 2003 SARS outbreak and the 2009 swine flu pandemic were reminders, too, yet the measures necessary to stop Ebola from mushrooming into a three-continent scourge weren’t in place. World Bank President Jim Yong Kim is determined to ensure lessons are learned this time.

“What the Ebola epidemic has taught every single one of us is that we were not prepared for an outbreak of this size,” Kim, a Harvard University-trained physician and anthropologist, told reporters in Liberia on Dec. 2. “I for one, as president of the World Bank Group, will continue to remind all of the leaders that this flaw that was exposed must be taken care of and must be taken care of as quickly as possible.”

The virus has killed at least 7,842 people, mostly in Sierra Leone, Liberia and Guinea, according to the WHO. If it continues to spread further in Africa, it could cost as much as $32.6 billion by the end of 2015, the Washington-based World Bank estimated in October.

Kim, who previously headed the WHO’s HIV/AIDS department, has voiced his opinions on Ebola more than a dozen times in op-eds, speeches, statements, media briefings and in webcasts detailing the World Bank’s response and what needs to be done. He’s also been critical of the initial global response, describing it as “late, inadequate and slow.”

“Our president is responding to a crisis that he sees first and foremost as a major impediment to the twin objectives of the bank, which are to eliminate extreme poverty and to share prosperity,” said Tim Evans, the World Bank’s senior director of health, nutrition and population. “The fact that he’s had experience with pandemics before and global health perhaps increases his legitimacy as an advocate to bring this epidemic to an end as soon as possible.”

The World Bank’s observations on the current epidemic and its proposals for global health security will be discussed at a meeting of the WHO’s 34-member executive board at its Geneva headquarters on Jan. 26. The WHO secretariat will review the response by WHO, the United Nations system as a whole and other international partners, according to a provisional agenda.

The WHO has come under fire for grasping the magnitude of the Ebola threat too late, which raised questions about its ability to respond to important disease outbreaks. Director- General Margaret Chan said in October that her organization’s initial response may not have matched the scale and complexity of the outbreak.

After declaring Ebola “a public health emergency of international concern” on Aug. 8, the WHO produced a plan for a scaled-up response to the Ebola outbreak and has worked with scientists from around the world to develop vaccines and therapies, including potential cures, in clinical trials.

Still, one of the casualties of the current outbreak may be the WHO itself, said Adam Kamradt-Scott, a senior lecturer at the University of Sydney’s Center for International Security Studies, who is calling for support for the embattled UN agency.

“There is a genuine risk that governments will use the Ebola outbreak as a basis for further undermining the WHO’s authority, which would simply be disastrous,” Kamradt-Scott said.

The health agency had been subjected to “extensive budget cuts” as part of a reform process, he said. “While this doesn’t entirely explain why the organization was slow to respond to the outbreak, it has certainly had an impact on the WHO’s operational response. Rather than erode the organization’s capacity further, Ebola should be a wakeup call that we can’t have global health security without appropriate investment.”

A letter co-authored by Kamradt-Scott backing WHO and endorsed by almost 100 public health workers, academics and researchers in international relations is slated for publication in the Lancet medical journal on Jan. 10, he said.

“In terms of how we tackle diseases and pandemics and problems in our world, I do think we have to have a serious look at the World Health Organization,” British Prime Minister David Cameron told parliament in London on Nov. 26.

The WHO may have more competition for donor money, with the World Bank calling for a pandemic emergency facility, as well as a global health reserve corps to expedite the response to future outbreaks.

The World Bank’s idea is to create a team made up of specially trained experts in areas spanning infectious diseases, logistics, supply-chain management and medical evacuations, Evans said.

“Surge capacity to respond in a timely and definitive way to an epidemic is absolutely essential,” Evans said in an interview. “We need to make sure that the institutions that are meant to respond are much more fit-for-purpose and that we have an ever-ready financing capability that can be deployed on the appropriate outbreak trigger to mobilize the scale and the speed of a response that is required to mitigate the impact of any future pandemic.”

The World Bank is in discussion with the WHO and major donor countries about its proposal for a reserve corps, according to Evans, a former WHO assistant director-general. Kim’s idea would be to ensure a rapid-fire brigade could be assembled at a day’s notice or less. Plans are still at an early stage and details such as employment arrangements have yet to be worked out, Evans said.

“I’m sort of scratching my head on how that can work,” Susan Desmond-Hellmann, chief executive officer of the Bill and Melinda Gates Foundation, told reporters on a Dec. 18 conference call. “I am intrigued by the notion of a corps that could go in when needed, but I am also aware, having lived through SARS and its aftermath, that it’s very hard to maintain momentum in between outbreaks.”

The idea isn’t new. Three years ago, a WHO panel reviewing the swine flu pandemic recommended a global health emergency force be created, backed by a $100 million contingency fund, to help respond to health emergencies. The global financial crisis and “pandemic fatigue” that followed stymied any progress, the University of Sydney’s Kamradt-Scott said.

While a reserve group is a great idea in principle, the sticking point is “how to make it a practical reality,” said Keiji Fukuda, WHO’s assistant director-general for health security.

“The long-term goal is to have every country be in a position to mount its own response,” Fukuda said in a Nov. 20 e-mail. “In a full pandemic situation, especially something like a severe influenza pandemic in which most, if not all, countries are going to have to take urgent actions, there is no other good solution.”

There is no cure for Ebola, a virus that spreads from contact with bodily fluids such as blood, vomit and feces. While drugmakers are developing experimental medicines, the current practice is to provide supportive care, especially fluids.

The current crisis, greater than all previous Ebola outbreaks combined, underscores the importance of strengthening primary care and health systems, Desmond-Hellmann said.

“There is nothing better than people in the community who know the community, know the cultural norms,” she said. “My strong bias is to strengthen health systems as the best, first line of defense, and then if we need to respond to an epidemic anywhere in the world, you are starting from so much of a better place.”

Evans agreed there are basic public health functions and capacities that every country needs, including the ability to detect, diagnose and report diseases.

“At the same time though, it’s not simply the national preparedness and response that’s necessary,” he said. “We also need to strengthen the global response capability.”

Not everyone thinks a fresh intervention force is needed.

“We should be ready,” says Julio Frenk, dean of the Harvard School of Public Health in Boston and a former minister of health in Mexico. “That doesn’t mean that you have a standby group sitting at the UN waiting to be called on.”

A new UN agency would duplicate bureaucracy and add yet more competition among agencies with similar mandates, Kamradt- Scott said. The money would be better spent supporting the Global Outbreak Alert and Response Network, a 14-year-old collaboration among the WHO and groups including the Red Cross, U.S. Centers for Disease Control and Prevention, and Doctors Without Borders, he said.

“The solution for bureaucratic inefficiency cannot be yet another bureaucracy that replicates the function of existing networks like the WHO-led Global Outbreak Alert and Response Network,” Kamradt-Scott said.

_ With assistance from John Lauerman in Boston and Simeon Bennett in Geneva.

WP-Bloomberg Morning Briefing

Here are the top overnight offerings in news, analysis and commentary from The Washington Post News Service, with Bloomberg News, which includes Slate, Foreign Policy, The Root and The Japan News, Japan’s leading newspaper.

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Washington Post

JOURNALIST — WASHINGTON — U.S. Special Operations forces staged an unsuccessful operation this summer to rescue photojournalist James Foley and other Americans being held in Syria by Islamic State militants, the Obama administration confirms. 1,330 words, by Adam Goldman and Karen DeYoung (Post).

JOURNALIST-APPRECIATE — As a freelancer chasing big stories without the support of a major news organization, James Foley moved among a particularly intrepid and courageous set of international journalists. 1,070 words, by Manuel Roig-Franzia (Post). Also moved: JOURNALIST-MEDIA-ESSAY.

MIDEAST-BEHEAD — WASHINGTON — From Daniel Pearl to James Foley: The modern tactic of Islamist beheadings. 990 words, by Adam Taylor (Post).

EBOLA-GROUP — The drastic measures taken to rescue Ebola-stricken missionaries puts Christian relief groups Samaritan’s Purse and SIM in the spotlight. 1,600 words, by Brady Dennis (Post).

PEACE — WASHINGTON — Determining the world’s “most peaceful” countries. 760 words, by Adam Taylor (Post).

FERGUSON-ACTIVIST — FERGUSON, Mo. — The experience of a St. Louis magazine publisher who has joined protesters in Ferguson helps illustrate why some people interrupt their lives to take to the streets, pausing jobs and studies and parenting for something they consider more important. 930 words, by Chico Harlan (Post). One photo.

FERGUSON-CAMERAS — The fatal shooting of Michael Brown bolsters calls to have police officers wear cameras at all times — an idea that has given a big boost to firms that make them for police use. 680 words, by Hayley Tsukayama (Post).

FERGUSON-CAPTAIN — Missouri Highway Patrol Capt. Ron Johnson has had mixed results in keeping his vow to protect Ferguson’s citizens while ensuring their right to protest, illustrating how difficult it can be for anyone to succeed when the leadership job is this complex and the problems are this systemic. 520 words, by Jena McGregor (Post).

FERGUSON-HOLDER — Attorney General Holder’s visit to the St. Louis area amid unrest in Ferguson, Missouri has provided another example of his penchant to go further and say more on racial issues than Obama is politically willing or able to do. 1,200 words, by David Nakamura and Nia-Malika Henderson (Post).

FERGUSON-MUSIC — ST. LOUIS, Mo. — Several hip-hop tracks referencing the death of Michael Brown have surfaced over the past 11 days in an expression of simmering frustration and release for the little known but vibrant community of independent artists in the St. Louis area. 1,370 words, by Krissah Thompson (Post). One photo.

POLLSTERS — WASHINGTON — No one gets second chances like political pollsters, who keep clients even after spectacular failures. 1,340 words, by Ben Terris (Post). One photo.

ASSAULT-ACCUSED — Men punished for sexual misconduct in the wave of cases sweeping college campuses decry what they call unfair student disciplinary systems and publicity that threatens to shatter reputations. 1,640 words, by Nick Anderson (Post). Also moved: ASSAULT-BRANDEIS.

VIRGINIA-ASSAULT — Virginia Gov. Terry McAuliffe will form a task force to combat sexual violence at the state’s colleges and universities. 780 words, by Nick Anderson (Post).

VIRGINIA-GOP — RICHMOND, Va. — Virginia GOP lawmakers say voters have given them a mandate that strengthens their bargaining position against Gov. Terry McAuliffe. 590 words, by Jenna Portnoy (Post).

MARYLAND-ALCOHOL — Maryland’s ban on sales of grain alcohol makes life harder for violin makers and bakers. 950 words, by Jessica Contrera (Post).

WARMING-TEACHER — TUCSON, Ariz. — How to teach about climate without making your students feel hopeless. 700 words, by Diana Liverman (Post special).

HOUSING — WASHINGTON — The cities where housing is more expensive than you would expect. 420 words, by Jeff Guo (Post). Two charts.

STORM-DAUGHTERS — WASHINGTON — As they grow up, five young sisters try to learn lessons about self-image and self-reliance in the way that their late mother established before she died in a storm five years ago. 2,420 words, by Ellen McCarthy (Post). Five photos.

ALBANESE-OBIT — Licia Albanese, the acclaimed soprano who ennobled the tragic heroines of Puccini and Verdi in hundreds of performances on leading world stages, dies at 105. 820 words, by Emily Langer (Post). One photo.

MASLOFF-OBIT — Sophie Masloff, a self-proclaimed “old Jewish grandmother” who in 1988 became Pittsburgh’s first female mayor and drew attention for her folksy, self-deprecating style, memorably misidentifying a certain Jersey-born rock star as “Bruce Bedspring,” dies at 96. 900 words, by Aaron Gregg (Post).

SCHWELB-OBIT — WASHINGTON — Frank Schwelb, a onetime Justice Department civil rights lawyer who became a D.C. judge for more than three decades, known for his sometimes floridly written judicial decisions, dies at 82. 820 words, by Matt Schudel (Post). One photo.

FERGUSON-TEENS-COMMENT — CHARLOTTE, N.C. — Do black teens who aren’t angels deserve whatever they get? Some profile and dismiss the life and death of Michael Brown in a way they would not with their own imperfect child. 1,100 words, by Mary C. Curtis (Post special).

Bloomberg

EBOLA-MILITARY — FREETOWN, Sierra Leone — West African nations who have only recently emerged from bloody civil wars are turning to their armed forces after the spread of Ebola spiraled out of control. 915 words, by Silgas Gbandia (Bloomberg). One photo.

MIDEAST-HAMAS-ASSESS — JERUSALEM — Weapons that Israel says were smuggled from Iran and a playbook inspired by Lebanon’s Hezbollah forces were key ingredients that enabled Hamas to hold out against Israel’s month-long offensive. 780 words, by Jonathan Ferziger and Saud Abu Ramadan (Bloomberg).

IRAN — WASHINGTON — While Iran’s military has toned down its rhetoric about military capabilities and exercises, it continues a low-profile buildup of weapons in and near the Strait of Hormuz, according to a document obtained by Bloomberg News. 580 words, by Tony Capaccio (Bloomberg).

HUNT — WASHINGTON — Republicans have grown even more confident about the midterm elections, convinced that the economy — where the actual data look good, though public perception remains sour — is moving in their favor. 495 words, by Albert R. Hunt (Bloomberg).

VENEZUELA-COMMENT — Venezuela’s dynastic diplomacy puts a Chavez at the U.N. 695 words, by Mac Margolis (Bloomberg).

FOLEY-JIHAD-COMMENT — The killing of free-lance journalist James Foley just confirms what the Islamic State is and what it intends. 590 words, by Marc Champion (Bloomberg).

MIDEAST-GAZA-COMMENT — The casualties from the Gaza war extend all the way into Jerusalem. 895 words, by Daniel Gordis (Bloomberg).

CALIF-DROUGHT-COMMENT — California’s drought will hit Americans in the palate. 665 words, by Megan McArdle (Bloomberg).

CARLSON — RICHMOND, Va. — Virginia’s former governor wages his last campaign. 1,090 words, by Margaret Carlson (Bloomberg).

COMCAST-COMMENT — The story of the Comcast call center fiasco just gets weirder and weirder. 550 words, by Stephen L. Carter (Bloomberg).

Foreign Policy

MIDEAST-GAZA — DEIR AL-BALAH, Gaza — In the ruins of the Gaza Strip, the devastation has spared no one. 1,160 words, by David Kenner (FP).

CHINA-CONFUCIUS — Confucius: China’s most famous single dad. With divorce rates spiraling, the biography of ancient sage Confucius resonates once again. 850 words, by Alexa Alesen (FP).

Slate

DOGS — Why do people look like their pets? 1,500 words, by Jesse Bering (Slate).

TV-PASKIN — NEW YORK — One tough female detective and hardly any guns. If you like “Prime Suspect” and “The Fall,” watch “Happy Valley.” 975 words, by Willa Paskin (Slate).

The Japan News

JAPAN-SOLICIT — TOKYO — The National Police Agency reports that police gave “correctional guidance” to 220 minors nationwide who tried to provide sex for money or sell their used underwear online from January to June. 220 words (Yomiuri Shimbun).

JAPAN-STORMS — TOKYO — A series of thunderclouds generated one after another at the same location, a phenomenon called “back building,” seems to have been behind the downpour that caused extensive landslide damage in Hiroshima, according to meteorologists. Developing (Yomiuri Shimbun).

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Coming up this morning: editorials and commentary from The Post, Bloomberg View and The Japan News.

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Editors: A features budget will move at 12:30 p.m. ET. The daily budget for tomorrow’s editions will move at 3 p.m. ET.

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Meet the 19th most likely guy to win the GOP presidential nomination

Nineteen! How did we get to 19 already? Is it really that easy to get a spot on stage in front of national press outlets, undecided voters and crucial primary-state powerbrokers to pitch your worth for the highest office in the land?

In the case of Dennis Michael Lynch, a documentary filmmaker and Fox News personality, it took a $10,000 donation to the New Hampshire Republican Party.

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“A lot of you are probably sitting here and thinking, ‘Wait a minute — did he just say president 2016? Who is this guy?'” said Lynch, a tough-guy New Yorker with a powerful quiff of black hair who got his speaking gig after shelling out to be a platinum sponsor for the First in the Nation Leadership Summit. “I get it. I’m not even a dark horse. I’m like a dark pony.”

Lynch may lack money, name recognition or any campaign infrastructure — but he said he has thousands of letters urging him to run from fans of his various films about immigration (he brought DVDs to hand out), and he promised to “wipe ISIS off the face of the earth.”

“Don’t ignore him,” said Sen. Lindsey O. Graham, who had come to the Crowne Plaza Hotel in the small state’s second largest town because he is thinking about launching his own long-shot, but still infinitely more plausible, bid for the White House. “I will, though, because I don’t know who he is.”

The joke was too good for him to stop. “We aren’t going to take him for granted,” Graham deadpanned. “We’re going to kill him early. Go negative on him.”

The fight for the top may have been raging among those with names like Bush, Rubio and Walker, but so too was the fight just to get some attention. That was the goal for a list of back-end candidates — has-been political forces like former governors George Pataki, Jim Gilmore and Bob Ehrlich; headline-friendly business moguls like Donald Trump and Carly Fiorina; and relative unknowns like former U.N. ambassador John Bolton — as they gave 30-minute speeches in a hotel ballroom.

“The truth is (that) running for president is defying every possible odd,” said Republican focus group guru Frank Luntz, who noted that Jimmy Carter was perhaps a third-tier candidate when he started his 1976 presidential campaign. “But there are some people who have lost touch with reality.”

There are also plenty of reasons to run for president beyond just winning. Sometimes it’s about trying to move the needle on a particular policy point. Sometimes it’s a bid to get back into the public eye. Sometimes it’s about book sales and TV gigs, and sometimes it’s just about ego. Or all of these things combined.

“I have the biggest crowds, I have the most responsive crowds, I get standing ovations,” Trump said at a breakfast at which The Washington Post was the only media outlet to attend. “And then people will report, ‘Donald Trump got a smattering of applause …’ The press has to treat Trump fairly.”

Trump wanted the press to report that he got a standing ovation at this particular speech. Indeed, he got it after calling America a “laughingstock” that is being “led by amateurs and it’s a very sad thing.” He also went after another long-shot candidate’s record — because when you’re this low on the totem pole, everything counts as punching up.

“We have a woman running who got fired from a company, now she’s running for president,” he said, in obvious reference to Fiorina, the former Hewlett-Packard chief executive and California Senate candidate. “She got fired from a company in a vicious manner. They eventually walked her out. And she also lost an election, not by a little bit, by a landslide. I won’t use names. Now I turn on the television and she’s running for president. I don’t know.”

When reached for comment about Trump’s remarks, a Fiorina spokeswoman groaned, “Oh my God, this makes my head hurt. Why?”

But if Trump can’t get any respect, there are plenty of “serious” candidates who are themselves just looking for a way to get into the pipeline. Bolton, the former George W. Bush appointee, spent a lot of his weekend responding to questions about his mustache. During a live interview with the IJReview, Bolton was asked whether he would shave off his mustache if it would kill a nuclear deal with Iran. He said no.

When asked by The Post what it was like to have had such a long career and still mostly be known for having a mustache, Bolton seemed untroubled.

“I think it helps with the vital political issue of recognition,” he said. “We’ll see what happens going forward.”

After the interview, he walked into the press room. It was mostly empty other than a few reporters on deadline. Bolton stood in the back for a moment. When no one looked up from their computers, he walked away.

Graham, though, doesn’t think he needs facial hair to get recognized. Even though recent polls found that 55 percent of constituents in his home state of South Carolina wouldn’t vote for him for president, he feels he can win over support on the strength of his hawkish message and his ability to connect on a retail level. He has a powerful life story, having grown up in the back room of a liquor store and raised his little sister after his parents passed away. He is charming and funny on the stump and can serve as an anti-Rand Paul on the issues of national security.

So how exactly does he break away from the other seemingly endless number of candidates to become president?

“Message, means and momentum,” he said without explaining exactly where the means and momentum will come from.

Anything can happen in a presidential race. Strong candidates can turn out to be weak ones, scandals can hit, unknowns can catch fire. But if it seems like there’s no downside to running for president, you’re not paying attention.

“This is the easy part,” Luntz said. “The hard part is if they start to gain traction. Then the ads start. Then their children find out what a bad father they’ve got. And friends find out how creepy you are. You end up millions of dollars in debt with people who were once your friends not liking you, with your family against you. It’s a really horrific process we put them through.”

It turns out there is a limit on who can show up to the First in the Nation Republican Leadership Conference and declare a candidacy. And Vermin Supreme, a Massachusetts man with a long white beard known for wearing a giant rubber boot on his head, was that limit.

“They’re loving me obviously,” Supreme said. He expects he’ll do a lot better than the last time he ran in the New Hampshire Republican primary, when he got 43 votes. “They’re taking my stickers, they’re taking the free candy that I’m giving them. And nobody’s kicked me out yet, so that’s a big plus.”

He turned to Graham, who happened to be walking past.

“What do you think of my ‘free ponies for each American’ platform?” he asked.

“I’ll have to get back to you on that,” Graham said.

He wouldn’t get the chance. Moments later security escorted Supreme off the premises. And like that, the conference lost its opportunity for a 20th candidate.

On Long Island, upscale emporium still enjoys a luxury of ‘one-percent’ shoppers

Situated on Long Island’s Gold Coast about 30 minutes from Manhattan, the open-air shopping center is one of several American malls that have figured out how to thrive by catering to “one percenters.

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Americana Manhasset’s 60 shops sell the priciest status brands — Dior, Gucci, Hermes, Cartier, Prada. Some customers spend more than $100,000 a year. Danielle Merollo, the mall’s personal shopper, recently accompanied a client to a private Prada show in New York to buy a bespoke fur cape.

“Danielle always finds what I need,” said the client, Cynthia Rosicki, an attorney who also runs the Sparkling Pointe vineyard.

Even as middle-class Americans struggle with stagnant wages and demand deals that are hurting discount chains, wealthy shoppers are helping fuel sales at luxury retailers. Total retail sales are projected to grow 4.1 percent this holiday season — the highest rate in three years, according to the National Retail Federation.

Still, with malls closing all around the country, the proprietors of Americana Manhasset can take nothing for granted. Each year the services get more lavish, the shops larger and more resplendent. Stores that aren’t hitting sales targets don’t get their leases renewed. While luxury retail is relatively immune to Web disruption, the mall is adding blogs and videos featuring the latest fashions to its website.

“We know our customers can shop anywhere — and they travel a lot — so we have to go overboard with service,” said Deirdre Costa Major, president of mall owner Castagna Realty Co.’s retail group.

Americana Manhasset shuns the word mall, preferring “premier shopping destination.” And with its limestone shopfronts, granite sidewalks and colorful flower beds, the place looks nothing like the original strip mall that opened in 1956 with a drive-through bank, ice-cream parlor, moderate- priced retailers including Lerner’s and Bakers Shoes and, later, a Waldbaum’s supermarket.

The shopping center might have ended up like so many other malls — losing customers, teetering on the edge of oblivion — were it not for the foresight of Frank Castagna, Castagna Realty’s chairman.

In the 1980s, Castagna concluded Americana could be more successful if it catered to the wealthy residents on Long Island’s North Shore. Increasing numbers of newly affluent professionals and entrepreneurs were moving to Manhasset, Great Neck and other suburbs within driving distance of the mall, and there was an abundance of old wealth in other Gold Coast towns, where the Vanderbilts and Roosevelts built their country mansions and F. Scott Fitzgerald set “The Great Gatsby.”

“I’ve lived in this area for 60 years, so I knew we had customers who wanted luxury products and no one else here was serving them,” Castagna said.

The trick was persuading locals to shop in the area rather than head to Madison Avenue boutiques or jet to Paris. Castagna took heart from Hirshleifers, a family-run store in the mall already doing a brisk business selling Armani and Chanel. As old leases expired, Castagna wooed top-tier retailers and Hirshleifers kept expanding. Renowned architect Peter Marino, the go-to designer for luxury brands, gave Americana a facelift; landscape architects added greenery and created a meadow around the shopping center’s perimeter.

Americana was among the first to link retailing and charity, now a popular practice at many department stores. In 1996, Castagna, a board member of a half dozen Long Island nonprofits, started Champions for Charity, which is held the first week of every December; customers direct 25 percent of the price of their purchases to local causes.

Americana sponsors a charity event almost every month. An Armani fashion show in September benefiting women’s health for the North Shore-Long Island Jewish Health Center, drew about 600 women who, after a three-course lunch, bought clothing they’d seen on models. A car show and contest in early October, featuring vintage Porsches, restored Bentleys and other luxury autos, raised more than $40,000 for Sunrise Day Camp, for children with cancer.

Castagna’s original hunch paid off. A designer boom that began in the Reagan years has continued almost unabated for three decades. In recent years, luxury retailers have benefited from the increasing concentration of income and wealth. In 2012, the top 1 percent of Americans held more than one-third of all U.S. wealth and the richest of these, the top 0.1 percent, with at least $20 million in assets, held 23.5 percent of U.S. wealth, according to economist Gabriel Zucman. Americana generates $1,800 in sales per square foot, more than triple the national average, according to the International Council of Shopping Centers.

Yet at 86, Castagna still spends part of each workday walking around stores to gauge what’s selling. He and his staff know that unless Americana Manhasset offers a shopping experience customers can’t get anywhere else, they’ll decamp to New York or to online luxury sites such as Net-A-Porter杭州桑拿会所,.

On a recent Friday morning, Tova Soto, a buyer and senior manager at Hirshleifers, arrived for work at 8 a.m., as soon as the store’s alarm system was turned off. She wanted several hours to prepare for a shopping visit from a longstanding customer, who was bringing along two friends.

Soto knew the sizes and tastes of each woman and canvassed the storeroom and store racks, handpicking an array of pants, shirts, dresses, coats and accessories. She and her assistant steamed and carefully hung the clothes — selecting handbags, scarves, belts, jewelry and shoes to complete different outfits. The customers were ushered to spacious fitting rooms, where they each found themselves in “a store, within a store, designed just for them,” Soto said.

After spending three hours trying everything on, the women purchased a wardrobe full of clothes, including a gray Stella McCartney jacket for $1,935 and skinny gray pants for $800, a Brunello Cucinelli silver-trimmed cardigan for $2,745 and a $6,835 shearling coat and an Avant Toi top for $1,880. Two of the shoppers each purchased short gray suede Manolo Blahnik boots for $1,045 a pair.

Hirshleifers treated the women to lunch at Cipollini Trattoria, one of the mall’s two upscale restaurants. Like Toku Modern Asian restaurant a few yards away, Cipollini was packed. While the women ate lunch and visited with one another, Hirshleifers’ shoe salon stretched their new boots.

Like Soto, Americana’s Merollo is a combination personal shopper, stylist and therapist. She helped one customer furnish her home and buy a car, “because she trusts my taste,” traveled in September to Paris with another to see the fall fashion shows and once spent part of her own vacation in Italy searching for lace for a shopper.

“What I do most is listen, so I can figure out what a customer needs,” she said. Sometimes that’s a handbag and sometimes it’s handholding.

Jacki Rogoff has shopped at Americana for 25 years. Her favorite store is Hirshleifers, now managed by the founding family’s fifth generation. Rogoff, who runs a Long Island nonprofit, says buyer Lori Hirshleifer caters to her exacting tastes.

“You won’t find what they have in Saks Fifth Avenue, because they have close relationships with vendors so they get one-of-a-kind items,” said Rogoff, who recently purchased several pairs of Jon Buscemi leather sneakers, which sell for $865 and have golden padlocks dangling from the ankle straps.

Behind the scenes, Castagna continues to tweak the formula. A recent renovation of more than half a dozen brands features curated art at Dior and Chanel fitting rooms the size of studio apartments where customers can while away afternoons trying on clothes and having lunch. The Hermes store will triple in size. Banana Republic, one of the mall’s few mass-market chains, is making way for the more upscale Rag & Bone.

The proprietors are adapting to changing demographics. More than 25 percent of the mall’s shoppers are ethnic Chinese and Koreans living on Long Island or in Queens, who bring along relatives visiting from overseas. Americana has advertised in the World Journal, the largest Chinese-language newspaper in the U.S. More than half the center’s stores now employ at least one Mandarin-speaking sales associate.

Mindful of encroachment from the Web, Hirshleifers has partnered with the luxury site Farfetch杭州桑拿会所, so customers can buy some of its styles online.

For Rogoff, abandoning the mall’s personal service for the soulless experience of shopping on Web is unfathomable.

“Americana is like a fantasy land,” she said. “Shopping there is effortless and beautiful, with the reliability of a great car. It’s a destination.”

Top tomato finalists: 4 recipes

4 servings

Fish sauce, toasted sesame oil, the heat from crushed red pepper flakes and lime lend Thai flavor to this quick main course, which celebrates the overlap of spot prawn and tomato seasons in the Pacific Northwest.

杭州桑拿

Top Tomato finalist (and first-time contestant) JoAna Phillips of Bellingham, Wash., grows the tomatoes she uses in the dish and buys the Puget Sound seafood right off the dock, just-cooked. Spot prawns are known for their sweet taste and firm texture. “They often have roe in them, which adds flavor,” she says.

Because the prawns she uses are not easy to come by in other area, Phillips recommends using shell-on, frozen/defrosted langoustines.

Serve over jasmine rice.

Ingredients

3 tablespoons corn oil

1 medium white onion, cut into 3/4-inch-thick wedges

1 medium zucchini, cut into 1/4-inch half-moon slices

5 medium ripe tomatoes, preferably a mix of colors, cut into 3/4-inch wedges (2 1/4 pounds)

1 tablespoon minced garlic

1-inch square piece palm sugar

1/3 cup water

1 to 2 tablespoons fish sauce

2 teaspoons toasted sesame oil

1 teaspoon crushed red pepper flakes

8 jumbo spot prawns cooked with shell on; leave intact including any roe that may be attached (may substitute langoustines or extra-large shrimp; see headnote)

1 large top sprig Thai basil

Lime wedges, for serving

Steps

Preheat a wok or large, heavy skillet over medium-high heat. Add the oil and swirl to coat, then add the onion and stir-fry/cook just until it begins to soften. Add the zucchini and stir to coat, then add the tomatoes and garlic; cook just until the juices they give off start to bubble.

Meanwhile, dissolve the palm sugar in water in a heatproof container in the microwave or in a small saucepan over medium heat. Stir that into the wok or skillet, along with the fish sauce (to taste), toasted sesame oil and crushed red pepper flakes, stirring until well incorporated.

Nestle the prawns into the onion-tomato mixture; cook, undisturbed, for 3 to 5 minutes, until just warmed through, turning them as needed so they’re evenly cooked. (The tomatoes should still be intact.) Pluck the leaves and any flower tops from the sprig of basil and add them to the mix, gently working them in and turning the prawns 1 more time. Turn off the heat.

Divide among individual wide, shallow bowls. Serve hot, with lime wedges.

Nutrition: Per serving: 240 calories, 13 g protein, 18 g carbohydrates, 14 g fat, 2 g saturated fat, 65 mg cholesterol, 480 mg sodium, 4 g dietary fiber, 12 g sugar

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Tomato Shortcakes

6 to 8 servings

(makes 12 to 16 small shortcakes)

Here, elements of a juicy tomato bruschetta are presented dessert-style, with a soft, cheesy biscuit standing in for a slice of toasted baguette.

Top Tomato finalist and Frederick, Md., resident Nancy Luse’s colleagues earned an assist on the recipe.

You’ll need a 2 1/2-inch biscuit cutter.

Ingredient

For the tomatoes

3 large tomatoes

1/4 cup olive oil

1 clove garlic, finely minced

2 tablespoons chopped fresh basil

Salt

For the shortcakes

2 cups sifted flour, plus more for dusting

4 teaspoons baking powder

1/2 teaspoon salt

1/2 teaspoon cream of tartar

2 teaspoons sugar

8 tablespoons (1 stick) cold unsalted butter, cut into small pieces

1/2 cup freshly grated Parmigiano-Reggiano cheese

2 tablespoons chopped fresh basil, plus 8 small leaves for garnish

2/3 cup milk

Sour cream, for garnish

Steps

For the tomatoes: Plunge them into a pot of boiling water to loosen the skins. Peel, seed and chop, transferring the tomato flesh to a mixing bowl along with the oil, garlic and basil. Stir to combine, then season lightly with salt. Let the mixture sit at room temperature while you make the shortcakes. The yield is 2 1/2 cups.

For the shortcakes: Preheat the oven to 425 degrees. Use an ungreased baking sheet, or line the sheet with parchment paper or a silicone liner.

Whisk together the flour, baking powder, salt, cream of tartar and sugar in a separate mixing bowl. Add the butter; use your clean fingers or a pastry cutter to quickly work it in until the mixture resembles coarse crumbs. Add the cheese and basil, then pour in the milk; stir with a fork to form a wet dough.

Lightly flour a work surface. Transfer the dough there; knead gently, then pat or roll out to a thickness of 1/2 inch. Cut out 12 to 16 rounds of dough, rerolling scraps as needed; place them on the baking sheet, spaced at least 1 inch apart. Bake for 10 to 12 minutes or until lightly browned on top.

Let the shortcakes cool slightly, then cut them in half horizontally. Place two bottom halves on each plate. Spoon some of the tomato mixture on top of each one. Top with the shortcake tops, then spoon more of the tomato mixture on top. Garnish with a dollop of sour cream and a small basil leaf.

Serve warm.

Nutrition: Per serving (based on 8): 330 calories, 7 g protein, 28 g carbohydrates, 21 g fat, 10 g saturated fat, 40 mg cholesterol, 290 mg sodium, 1 g dietary fiber, 3 g sugar

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Mike’s Garlic Mint Tomatoes

2 to 4 servings

Sounds a bit odd, but the combination is quite refreshing, and certainly simple.

Top Tomato finalist Maggie Stemann Thompson of Afton, Va., apologized in the middle of her submitted recipe directions for refrigerating the tomato mixture — “a sacrilege, I know!” she wrote — but says the step is necessary so the garlic, mint and tomato flavors can more easily meld. The dish comes from her biochemist mother-in-law, Maria Michaela “Mike” Thompson, who learned it from her neighbor, Marion Loving. The two avid gardeners grew bushels of tomatoes, and this became a favorite way to enjoy them at large gatherings.

Serve with crusty bread.

MAKE AHEAD: The tomato mixture needs to be refrigerated for a few hours before serving.

Ingredients

20 to 24 mint leaves, finely chopped

2 cloves garlic, minced

1 teaspoon salt

5 tablespoons canola oil

1 tablespoon water

3 tablespoons red wine vinegar or apple cider vinegar

2 pounds large, ripe tomatoes, peeled and cut into wedges (see NOTE)

Steps

Combine the mint, garlic and salt in a mixing bowl. Use a pestle or the back of a wooden spoon to muddle/mash them together until the garlic has almost a pastelike consistency. Add the oil, water and vinegar, whisking to incorporate.

Add the tomatoes and toss to coat; cover and refrigerate for a few hours before serving, for maximum flavor.

NOTE: To peel the tomatoes, bring a pot of water to a boil. Fill a bowl with ice water. Cut an “X” in the bottom of each tomato and remove the stem. Place in the boiling water for 10 to 15 seconds — no longer. Use a slotted spoon to quickly transfer to the ice-water bath. The skins should simply slip off.

Nutrition: Per serving: 200 calories, 2 g protein, 9 g carbohydrates, 18 g fat, 2 g saturated fat, 0 mg cholesterol, 590 mg sodium, 3 g dietary fiber, 6 g sugar

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Tomato Popcorn

4 to 8 servings (makes 8 to 9 cups)

This is a why-didn’t-we-think-of-it kind of snack for serious tomato lovers that captures the tang of the fruit and the crunch of buttery popcorn.

DIYers will want to make their own tomato powder, as Top Tomato contestant Becky Hamill of Lewes, Del., does, by dehydrating, then pulverizing dried tomatoes; see the NOTE, below. The powder is good for enhancing tomato flavor in soups, stews and other recipes year-round. Otherwise, tomato powder is available through Amazon杭州桑拿会所,.

Hamill says this is her new favorite way to use all her summer tomatoes.

Ingredients

1 tablespoon vegetable oil

1/2 cup good-quality popping corn

2 to 3 tablespoons unsalted butter, melted and kept warm

2 tablespoons tomato powder (see NOTE and headnote)

Salt

Steps

Heat a 2-quart saucepan over medium heat. Add the oil and popping corn; cover with a tight-fitting lid. Cook, shaking the saucepan regularly, until all the kernels have popped. Transfer the popcorn to a large bowl. Pour the warm, melted butter (to taste) evenly over it and toss gently to coat, then sprinkle with the tomato powder and season lightly with salt.

Serve right away.

NOTE: To make tomato powder using a dehydrator, cut Romas or garden tomatoes into 1/4-inch slices. Arrange them on the racks of a dehydrator; dehydrate for 4 to 12 hours, depending on their moisture content. Check every 2 hours for doneness; the slices should be thoroughly dried and will snap when you try to bend them.

Working in batches, crumble the pieces into a dedicated (clean) spice grinder; pulverize to a powder. Transfer to an airtight container; the tomato powder can be kept in a cool, dry place for up to 6 months.

Nutrition: Per serving (based on 8): 90 calories, 2 g protein, 11 g carbohydrates, 5 g fat, 2 g saturated fat, 10 mg cholesterol, 40 mg sodium, 2 g dietary fiber, 0 g sugar