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IntroductionIdentification of where can i buy amoxil over the counter a germline pathogenic TP53 (MIM. *191170) variant in a patient with cancer has drastic medical impacts.1 Indeed, in TP53 variant carriers, chemotherapy and radiotherapy have where can i buy amoxil over the counter been shown to contribute to the development of subsequent primary cancers, the incidence of which is remarkably high (above 40%).1–4 Therefore, in these patients, surgical treatment should be prioritised and radiotherapy and chemotherapy avoided, if possible, or at least carefully discussed in terms of benefit:risk ratio between risk of recurrence and risk of inducing second primary tumours. Furthermore, TP53 variant carriers should have specific surveillance protocols, including annual whole-body MRI,5 6 whose efficiency for early tumour detection has recently been shown by numerous studies.5–14Interpretation of germline TP53 variants, which are mainly missense variants, remains particularly complex.

Whereas germline variants of TP53 were initially detected in Li-Fraumeni syndrome (LFS, MIM#151623),15–17 our perception of cancers related to germline alterations of TP53 has drastically evolved over time.1 2 18 19 The presence of a disease-causing germline variant should be considered in patients fulfilling Chompret criteria, which were sequentially updated and extended.1 The question of germline TP53 variant interpretation is becoming a growing concern in the field because the TP53 gene is currently included in many cancer gene panels, where can i buy amoxil over the counter and the number of TP53 tests performed in patients not fulfilling the criteria mentioned earlier has increased exponentially. 20 21Classification of TP53 variants, in agreement with the American College of Medical Genetics and Genomics/Association for Molecular Pathology guidelines, is based on several items, including frequency of the variant in the general population (gnomAD. Https://gnomad.broadinstitute.org/), segregation data, bioinformatics predictions and functional assays developed in yeast or human cancer cell lines.22 One of the first assays commonly used for TP53 missense variant interpretation was developed in yeast and is based on the expression of TP53 cDNA in strains containing reporter plasmids with different p53 binding sites.23 In this assay, p53 variants are classified as functional, not functional or partially functional if the transcriptional activity is conserved for some but not all yeast reporter plasmids where can i buy amoxil over the counter (http://p53.iarc.fr/).

More recently, two teams have developed in human cancer cell lines high throughput p53 functional assays.24 25 Kotler et al24 generated a synthetic library of TP53 variants located within the p53 DNA-binding domain and quantified the antiproliferative activity of these variants in the p53-null H1299 cancer cell line. In this assay, TP53 variants are categorised where can i buy amoxil over the counter as ‘wild-type TP53-like variant’ (functional) or ‘disrupting’ (non-functional). In another assay, Giacomelli et al25 generated by saturation mutagenesis a TP53 library and tested the ability of the variants (1) to restore the survival of the p53-null A459 cell line exposed to high doses of DNA damaging agents, in order to detect loss of function (LOF) variants and (2) to induce in p53-wild-type A459 cells resistance to Nutlin-3, in order to detect variants with dominant negative effect (DNE).We previously developed, in Epstein-Barr amoxil-immortalised lymphocytes, a p53 functional assay exploring the transcriptional activity of the protein underlying its tumour suppressor activity.26 This assay is based on the exposure of cells to DNA where can i buy amoxil over the counter damaging agents followed by the measurement of the p53 transcriptional response.27 28 With this assay, we showed that pathogenic TP53 variant carriers exhibit a constitutive defect in the transcriptional response to DNA damage, establishing a biological endophenotype associated with germline pathogenic variants.27 28 Compared with the other assays, its main advantage is to evaluate the impact of heterozygous variants in the genetic context of the patients.

Its main disadvantage is that it requires EBV immortalisation, which is time-consuming and, therefore, not suited for a rapid classification and interpretation of TP53 variants in medical practice.Therefore, despite the different tools indicated previously and before the completion in the future of curated international databases, interpretation of germline TP53 variants remains challenging in clinical practice. This prompted us to develop a p53 functional assay derived from where can i buy amoxil over the counter the previous one but performed on fresh blood samples and suitable for rapid interpretation and medical management of patients. We show here that this assay can accurately detect pathogenic variants and can be used to reallocate unclassified variants by integrating the results to the classification strategy.22 Furthermore, this assay revealed that a TP53 polymorphism (rs78378222), present in 1.7% of the European population, compromises p53 functional activity with the same magnitude as a heterozygous null variant, when carried on both alleles.MethodsCell culture and treatmentEBV-immortalised cell lines were maintained in RPMI 1640 medium (GIBCO.

Life Technologies, Carlsbad, where can i buy amoxil over the counter California, USA) with 10% fetal calf serum (Invitrogen, Life Technologies) and 1% L-glutamine (Invitrogen) at 37°C with 5% CO2. Cells were seeded in duplicate in 12-well plates (Corning, New York, USA) at a density of 106 cells/well. Cells were treated or not with where can i buy amoxil over the counter 200 ng/mL (0.3 µM final concentration) of doxorubicin (Sigma Aldrich, St.

Louis, Missouri, USA) for 8 hours. Cells were washed with 1× PBS and harvested for RNA extraction.Peripheral blood mononuclear cell (PBMC) isolation and cultureBlood samples were collected in EDTA tubes and kept for 2 days at where can i buy amoxil over the counter room temperature before PBMC isolation on a lymphocyte separation medium (Eurobio, Evry, France). From 2.5 to 10.0 mL of blood where can i buy amoxil over the counter per patient was used for PBMC isolation.

Cell number and cell viability were assessed on a NanoEnTek Adam automatic cell counter with the AccuChip Kit (ScienceTEC, Villebon-sur-Yvette, France). One million cells were seeded per well in a 24-well plate and were where can i buy amoxil over the counter let to grow for 48 hours in a lymphocyte activating medium (Chromosome Medium P, AmpliTech, Compiègne, France). At least two wells were seeded per patient (treated and untreated) and duplicates or triplicates were performed whenever possible.

Cells were treated with 800 ng/mL of doxorubicin for 8 hours, where can i buy amoxil over the counter washed with 1× PBS, harvested and RNA extraction was performed using the NucleoSpin RNA XS kit (Macherey Nagel, Düren, Germany) according to the manufacturer’s instructions and quantified using a UV-VIS ND-1000 spectrophotometer (Biocompare, Nanodrop Technologies, USA).RNA-SeqFour control EBV cell lines wild-type for TP53 and four heterozygous TP53-mutant cell lines, corresponding to three canonical dominant negative missense variants (p.(Arg175His), p.(Arg248Trp) and p.(Arg273His)) and one complete deletion of the TP53 locus, were treated or not with doxorubicin. RNA was extracted using the Nucleospin RNAII kit (Macherey Nagel). Libraries were prepared using the NEBNext Ua Directional RNA Library Kit for Illumina (NEB, Ipswich, USA) and NGS sequencing of the libraries was performed on an Illumina NextSeq500 (Illumina, San Diego, USA) using 2*75 bp sequencing to generate 50M read where can i buy amoxil over the counter pairs on average per sample.

Experiments were performed in where can i buy amoxil over the counter triplicates. Bioinformatic analysis was carried out using an in-house automated pipeline AURIGA that uses the STAR V.2.5.3a tool for alignment, FeatureCounts tool V.1.5.2 for read counting and DESeq2 V.1.18.1 for statistical analysis.Selection of biomarkers indicative of p53-transcriptional activityNew biomarkers were selected among the transcripts strongly up-egulated by doxorubicin in control cells but not in the cells harbouring heterozygous TP53 alterations. CEP170B (NM_015005), where can i buy amoxil over the counter PODXL (MIM*602632, NM_001018111), RRAD (MIM*179503, NM_004165), GLS2 (MIM*606365, NM_013267), CABYR (MIM*612135, NM_012189), TP53I3 (MIM*605171, NM_004881), EPS8L2 (MIM*614988, NM_022772), SULF2 (MIM*610013, NM_001161841), SESN1 (MIM*606103, NM_014454) and FHL2 (MIM*602633, NM_201555).

Three control transcripts with a steady expression across all conditions and genotypes and expressed at the same level as the selected targets were also selected. TBP (MIM*600075, NM_003194), RIC8B (MIM*609147, NM_001330145) and MPP5 where can i buy amoxil over the counter (MIM*606958, NM_022474.3). An internal control of treatment efficacy was included.

PLK1 (MIM*602098, NM_005030.5), whose transcript is downregulated by doxorubicin treatment both in wild-type and mutant cells.Reverse transcription–quantitative multiplex PCR of short fluorescent fragment (RT-QMPSF)Reverse transcription (RT) was performed on where can i buy amoxil over the counter 100 ng of total RNA using the Verso cDNA Synthesis Kit (Thermo Scientific, Waltham, USA). RT-QMPSF was performed on 1.5 µL of RT using Diamond Taq DNA polymerase (Kaneka Eurogentec, Seraing, Belgium), 6% Dymethyl sulfoxide and 26 PCR cycles (94°C. 30 s/58°C.

1 min/72°C. 30 s). Primer sequences are listed in online supplemental table 1.

Amplicons were analysed on an ABI Prism 3500 Genetic Analyzer (Applied Biosystems, Foster City, California, USA) using GeneScan 3.7 software.Supplemental materialReverse transcription–multiplex ligation probe amplification (RT-MLPA)RT-MLPA probes were pooled at a concentration of 1 fmol/µL each in 10 mM Tris/1 mM EDTA. Probe sequences are given in online supplemental table 1. RT (6.5 µL), probe mixture (1.5 µL) and SALSA-MLPA buffer (1.5 µL, MRC-Holland, Amsterdam, The Netherlands) were mixed before denaturation (95°C, 2 min) and hybridisation (60°C, 1 hour).

Ligation was performed at 54°C for 15 min, adding 32 µL of ligation mixture, and heated 5 min at 98°C. Then, 2.5 µL of the ligation was added to 7.5 µL of a Q5Hot Start High-Fidelity 2X Master Mix (NEB) supplemented with universal fluorescent PCR primers. PCR was performed using 35 cycles (94°C.

30 s/58°C. 30 s/72°C. 30 s).

Amplicons were analysed on an ABI Prism 3500 Genetic Analyzer using GeneScan V.3.7 software.Calculation of p53 functionality score and p53 mRNA ratioThe RT-MLPA or RT-QMPSF profiles of doxorubicin-treated and untreated cells were superimposed after adjusting the control amplicons to the same height. In the treated condition, the peak height of each of the 10 p53 target genes was measured and divided by the sum of the heights of the three control genes. This value was then divided by the same ratio calculated in the untreated condition.

In the assay, the mean of the 10 values defines the p53 functionality score. The final p53 functionality score is the mean of the scores obtained in RT-MLPA and RT-QMPSF assays. The p53 mRNA levels were expressed as a ratio of the normal values obtained for 3 TP53 wild-type control individuals.

The efficacy of the genotoxic treatment was assessed by calculating a PLK1 (MIM*602098) ratio (treated/untreated) normalised with the three controls, which should be less than 0.5.ResultsDevelopment of a rapid p53 functional assay performed on bloodThe rationale of the assay is that p53 acts as a powerful transcriptional inductor when DNA damage occurs and that the common deleterious impact of pathogenic variants is the alteration of this transcriptional activity.26 To develop a functional assay directly performed on patient’s fresh blood, we first optimised the quantitative assay that we had previously developed in EBV-immortalised cell lines.27 28 To this aim, we performed a new comparative transcriptomic analysis using RNA-Seq, including non-polyadenylated RNAs. Four control EBV cell lines wild type for TP53 and four patients with LFS EBV cell lines were compared in the context of genotoxic stress induced by doxorubicin treatment. We selected 10 biomarkers corresponding to p53 targets involved in different biological pathways controlled by p53, such as cell adhesion and migration, cellular response to stress, apoptosis, cytoskeleton organisation, glycolysis or regulation of other metabolic pathways.

To normalise the results, we selected three transcripts with a steady expression across all conditions and genotypes. All these biomarkers were then included in two quantitative assays based on RT-MLPA and RT-QMPSF. To detect in the same assay the potential effect of variants on the TP53 transcript levels, we added different amplicons or probes corresponding to TP53 cDNA.

As a defect in treatment efficacy would result in a low functionality score leading to the misinterpretation of a wild-type genotype as a mutant one, we also integrated in the assays an internal control of treatment efficacy. After exposure to doxorubicin, cells were harvested and the RT-MLPA and RT-QMPSF assays were performed in parallel for each sample to increase the robustness of the assay. An arbitrary functionality score was calculated from the induction score of the 10 p53 targets.

The p53 RNA levels were evaluated and expressed as a percentage of the mean levels obtained for three wild-type TP53 individuals. This new quantitative assay, based on both RT-QMPSF and RT-MLPA, was first validated on 31 lymphoblastoid cell lines derived from patients with LFS harbouring different germline heterozygous TP53 variants (online supplemental table 2).Supplemental materialWe then set up the conditions allowing the assay to be performed directly on the patients’ peripheral blood. Blood was collected in conventional EDTA tubes and kept at room temperature for 2 days to mimic sample shipping delays.

PBMCs were isolated and cultured for 48 hours in a lymphocyte activating medium. Under these conditions, a strong p53 transcriptional response could be monitored in wild-type individuals (figure 1), indicating that testing p53 function directly on patients’ blood cells was feasible.P53 functional assay on peripheral blood. (A) Schematic representation of the blood p53 functional assay workflow.

(B,C) Typical RT-QMPSF (B) and RT-MLPA (C) results obtained for individual 15 with a wild-type TP53 genotype. The fluorescent profiles of doxorubicin-treated cells (red line) and untreated cells (blue line) were superimposed using the three control amplicons (RIC8B, TBP and MPP5). The horizontal bars indicate for each p53 target gene the level of expression in untreated cells.

Treatment efficacy was evaluated by the transcriptional repression of the PLK1 marker (Plk1 treated/untreated ratio below 0.5). In the treated condition, the peak height of each of the 10 p53 target genes was measured and divided by the sum of the heights of the three control genes. This value was divided by the same ratio calculated in the untreated condition to yield an arbitrary p53 functionality score.

The p53 mRNA levels were expressed as a ratio of the normal values obtained for three control individuals. PBMC, peripheral blood mononuclear cell. RT-MLPA, reverse transcription–multiplex ligation probe amplification.

RT-QMPSF, reverse transcription–quantitative multiplex PCR of short fluorescent fragment." data-icon-position data-hide-link-title="0">Figure 1 P53 functional assay on peripheral blood. (A) Schematic representation of the blood p53 functional assay workflow. (B,C) Typical RT-QMPSF (B) and RT-MLPA (C) results obtained for individual 15 with a wild-type TP53 genotype.

The fluorescent profiles of doxorubicin-treated cells (red line) and untreated cells (blue line) were superimposed using the three control amplicons (RIC8B, TBP and MPP5). The horizontal bars indicate for each p53 target gene the level of expression in untreated cells. Treatment efficacy was evaluated by the transcriptional repression of the PLK1 marker (Plk1 treated/untreated ratio below 0.5).

In the treated condition, the peak height of each of the 10 p53 target genes was measured and divided by the sum of the heights of the three control genes. This value was divided by the same ratio calculated in the untreated condition to yield an arbitrary p53 functionality score. The p53 mRNA levels were expressed as a ratio of the normal values obtained for three control individuals.

PBMC, peripheral blood mononuclear cell. RT-MLPA, reverse transcription–multiplex ligation probe amplification. RT-QMPSF, reverse transcription–quantitative multiplex PCR of short fluorescent fragment.p53 functional analysis of patient’s blood cells with different TP53 genotypesWe then applied the p53 functional assay on blood samples sent to our laboratory for TP53 molecular analysis (NGS screening of the 11 exons complemented by QMPSF).

Molecular and functional analyses were performed in parallel, in double blind conditions. We analysed a total of 82 blood samples derived from 77 individuals (online supplemental table 3). These 77 individuals corresponded either to new index cases suspected to harbour a pathogenic TP53 variant or to relatives of index cases harbouring TP53 variants.

This sample reflects the real-life recruitment of our diagnostic laboratory as it includes unaffected individuals as well as individuals affected by cancer who may have undergone different chemotherapy treatments. Molecular analyses revealed that 51 individuals had no detectable germline TP53 variant. For these 51 individuals, the mean p53 functionality score measured was 12.7 (13.6 for the RT-QMPSF assay and 11.9 for the RT-MLPA assay) with a range of 7.5–22.8 (online supplemental table 3 and figure 2).

The mean observed p53 mRNA levels were 93% with a range of 74%–125% (online supplemental table 3). In eight tested individuals, molecular analysis revealed seven distinct TP53 variants which could be considered as likely pathogenic or pathogenic based on their ClinVar classification or their truncating nature (table 1). All the variants tested were confirmed to be germline heterozygous variants.

For these eight patients, the assay yielded a reduced score compared with the wild-type individuals (mean 4.8, range 3.1–7.1. Table 1 and figure 2). In the patients with missense variants, p53 mRNA levels were above 75%.

In contrast, p53 mRNA was clearly reduced in patients harbouring frameshift or splice variants (mean 58%, table 1 and figure 2) probably reflecting the activity of the nonsense-mediated mRNA decay.Supplemental materialView this table:Table 1 Interpretation of germline TP53 variants integrating the blood p53 functional assayp53 functional scores and mRNA level ratios in individuals with wild-type TP53 or with germline TP53 variants. (A) p53 functionality scores obtained in 51 wild-type TP53 individuals, compared with the scores obtained for nine samples from eight individuals carrying a classified TP53 variant (online supplemental table 3) using a Mann-Whitney non-parametric test. (B) Comparison of the p53 mRNA ratios obtained in 51 wild-type TP53 individuals and in samples carrying a missense (five samples) or a truncating variant of TP53 (four samples), using a Kruskal-Wallis test with Dunns post-test (p=0.0031).

***PFigure 3 Impact of the heterozygous and homozygous TP53 c.*1175A>C variation on p53 pre-mRNA 3′ end processing. (A) Schematic representation of the TP53 3′ end region. The c.*1175A>C variant is predicted to yield at least two different transcripts.

The upper one corresponds to the normal transcript with pre-mRNA cleavage and polyadenylation, and the lower one to longer transcript that extends after the poly-A signal. €˜Exon 11’ primers amplify both transcripts, while ‘postpoly-A’ primers specifically amplify the longer transcripts. As postpoly-A primers could also amplify gDNA, primers ‘exon 7’ and ‘exon 10’, which are specific to gDNA, were added to the reaction in order to monitor DNA contamination.

(B) RT-QMPSF result obtained for the index case’s father (individual 58, S1. Table 1 and online supplemental table 3) carrying the variant TP53 c.723del, p.(Cys242Alafs*5). The profile (in red) was superimposed on the profile of a control individual wild type for TP53 (in blue), using the control amplicons RIC8B and TBP.

(C) RT-QMPSF result obtained for the index case’s mother (individual 76, S1. Table 1 and online supplemental table 3) carrying the c.*1175A>C variant at the homozygous state. (D) RT-QMPSF result for the index case (individual 77, online supplemental table 3) carrying the c.723del, p.(Cys242Alafs*5) variant and the c.*1175A>C in trans.

Red arrows indicate the appearance of longer p53 transcripts. The horizontal bars show the reduction of the normal p53 transcript level, as compared with the control. RT-QMPSF, reverse transcription–quantitative multiplex PCR of short fluorescent fragment.DiscussionThe interpretation of germline TP53 variants in patients with cancer is critical and should be performed before starting treatment considering their medical impact.

The main objective of our assay was to provide a fast functional classification of rare uncharacterised variants in order to help clinicians with decision-making. Compared with the previous assay that we developed in EBV-immortalised lymphocytes,27 28 this blood assay does not require long-term cell culture and the results can be obtained within 1 week, fulfilling the timing required for diagnostic practice. The only constraint is to perform it within 48 hours after blood sampling in order to obtain robust results.

Under these conditions, we were able to successfully analyse samples sent from other European countries.Our assay fulfils most of the recommendations recently published by the Clinical Genome Resource Sequence Variant Interpretation working group regarding the clinical validity of functional assays29. (1) compared with the previously described p53 functional assays that test in vitro either cloned cDNA in yeast or artificial mutant libraries in cancer cell lines,23–25 this blood assay is performed in clinical samples in the patients’ genetic context. (2) the assay evaluates the transcriptional activity of p53 and not a specific domain of the protein.

(3) it analyses simultaneously the impact of the variant on protein function and mRNA levels. (4) it was validated using 51 wild-type TP53 controls and 8 patients with seven distinct pathogenic or likely-pathogenic TP53 variants. And finally, (5) results show the robustness of the assay.

Indeed, as shown in table 1, for 12 tested variants, we were able to perform the assay on EBV-immortalised cell lines and the results were very similar. Moreover, for five individuals, two different blood samples were tested and yielded similar results (table 1), and two variants (c.844C>T, p.(Arg282Trp). C.847C>T, p.(Arg283Cys)) were tested on two different individuals’ blood with concordant results (4.8 vs 5.0 and 5.3 vs 6.4).We observed among the wild-type TP53 individuals a wide range of functionality scores (7.5–22.8).

This probably suggests that there is a variability of the p53-mediated transcriptional response to DNA damage in the general population, although no obvious impact of age, clinical status or sex could be observed. The thresholds used in this study could be refined by testing additional deleterious variants. Despite this variability, all pathogenic/likely pathogenic variants generated low p53 functionality scores, and variants resulting in premature stop codons were also detected by a clear reduction of p53 mRNA levels.

In addition, our assay allows testing of non-missense variants such as in frame indels. It should be highlighted that none of the previously published functional assays can be considered as a gold-standard method to classify germline TP53 variants.23–25 Therefore, no available p53 functional assay can be used to calibrate the blood assay. Indeed, as illustrated in table 1, discordant results were obtained for variants unambiguously classified in ClinVar as pathogenic or likely pathogenic.

In particular, the founder Brazilian p.(Arg337His), an example of a variant with low penetrance, highlights the limits of the available tools. Whereas segregation data performed on large Brazilian pedigrees have clearly shown that this variant is pathogenic,34 bioinformatic predictions and functional analyses35 are conflicting (table 1). Our blood functional assay clearly shows that this variant alters the transcriptional activity of p53, although to a lesser extent than DNE missense variations, highlighting the limits of functional assays based on overexpression of cDNA.

This result was confirmed in four additional patients carrying this variant using EBV cell lines (table 1).The blood functional assay performed on PBMC harbouring unclassified variants led us to consider 12 variants (p.(Pro72His), p.(Gly105Asp), p.(Arg110His), p.(Phe134Leu), p.(Arg158Cys), p.(Pro278Arg), p.(Arg283Cys), p.(Leu348Ser), p.(Asp352Tyr), p.(Gly108_Phe109delinsVal), p.(Asn131del), p.(Leu265del)) as ‘functionally abnormal’, some with high impact. The interpretation is particularly challenging for p.(Pro72His), p.(Arg110His), p.(Arg158Cys), p.(Arg283Cys) and p.(Asp352Tyr) variants, as they were considered in yeast assays as functional or partially functional, and the Giacomelli assay classified them as not LOF_not DNE or was not conclusive. The low functionality score observed for p.(Arg110His) was confirmed in an EBV cell line derived from the patient and confirmed in two EBV cell lines from other patients carrying this variant.

The result for the p.(Asp352Tyr) variant was confirmed on a second blood sample and with an EBV cell line derived from another patient also carrying this variant. The effect of p.(Arg283Cys) was also confirmed in EBV cell lines derived from the patient and from three additional patients with the same variant (table 1).The clinical utility of the p53 functional assay is highlighted by the p.(Pro191Arg) variant. This variant was initially detected in a child with medulloblastoma at 2 years of age and whose brother died from a fibrosarcoma.

Presymptomatic testing revealed that an unaffected brother (18 months), the mother and two maternal aunts were also carriers. We were then requested to evaluate this variant, and the functional assay performed in the maternal aunt (individual 65, online supplemental table 3) clearly showed that this variant does not alter the p53 transcriptional activity (table 1 and online supplemental table 3). Considering this result, segregation analysis was performed on the brother’s fibrosarcoma sample, revealing the absence of the variant and consolidating the conclusion of a non-pathogenic variant.Our results show that this blood functional assay is also able to detect TP53 variations outside the coding regions, which are the only regions commonly analysed.

Thanks to this assay, we discovered that the unaffected mother of an index case was homozygous for the polymorphic c.*1175A>C variant, and we show that this variant decreases p53 mRNA by altering the polyadenylation signal and produces longer transcripts extending beyond the poly-A site, as previously reported.30 When present on both alleles, this variant impacts p53 functionality with the same magnitude as a germline pathogenic TP53 variant. This prompted us to recommend breast MRI every year for this unaffected adult relative. We had the opportunity to perform the assay on EBV-immortalised lymphocytes harbouring only this heterozygous variant, and we observed a normal score (data not shown), suggesting that the heterozygous c.*1175A>C variant alone is insufficient to alter p53 function.

The comparison of the p53 functional scores observed in the index case who developed a high-grade glioma at 5 years of age and harbours the null c.723del, p.(Cys242Alafs*5) variant and in trans the polymorphic c.*1175A>C variant, and in her father carrying only the TP53 null variant suggests that the c.*1175A>C variant may act as a genetic modifier in pathogenic TP53 variant carriers and could increase the risk of glioma in carriers, as previously shown in the general population.30–33In summary, we suggest that our blood p53 functional assay should be a useful tool not only for the rapid interpretation of germline TP53 variants of unknown significance in clinical practice, in complement to the previously developed assays, but also for the indirect detection of cryptic alterations within regulatory regions impacting p53 function.Data availability statementAll data relevant to the study are included in the article or uploaded as supplementary information. Deidentified participant data are available from thierry.frebourg@chu-rouen.fr.Ethics statementsPatient consent for publicationNot required.AcknowledgmentsThe authors are grateful to their French and European colleagues for providing clinical information and sending blood samples for TP53 analysis. The authors are indebted to Philippe Ruminy (Inserm U1245, Comprehensive Cancer Centre Becquerel, Rouen) for advices on the reverse transcription–multiplex ligation probe amplification experiments and to Nikki Sabourin-Gibbs (Rouen University Hospital) for her assistance in editing the manuscript..

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Download Article buy amoxil without prescription next. Download (PDF 70.7 kb) No AbstractNo Reference information available - sign in for access. No Supplementary Data.No Article MediaNo MetricsDocument Type.

EditorialAffiliations:1. International Union Against Tuberculosis and Lung Disease, Paris, France 2. International Union Against Tuberculosis and Lung Disease, Paris, France, Norwegian Institute of Public Health, Oslo, Norway 3.

Department of Medicine, Psychiatry, Dermatology and Therapeutics, Kenyatta University, Nairobi, Kenya, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UKPublication date:01 November 2020More about this publication?. The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.Editorial BoardInformation for AuthorsSubscribe to this TitleInternational Journal of Tuberculosis and Lung DiseasePublic Health ActionIngenta Connect is not responsible for the content or availability of external websitesRapid diagnostics, newer drugs, repurposed medications, and shorter regimens have radically altered the landscape for treating rifampicin-resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB).

There are multiple ongoing clinical trials aiming to build a robust evidence base to guideRR/MDR-TB treatment, and both observational studies and programmatic data have contributed to advancing the treatment field. In December 2019, the WHO issued their second ‘Rapid Communication´ related to RR-TB management. This reiterated their prior recommendation that a majorityof people with RR/MDR-TB receive all-oral treatment regimens, and now allow for specific shorter duration regimens to be used programmatically as well.

Many TB programs need clinical advice as they seek to roll out such regimens in their specific setting. In this Perspective, we highlightour early experiences and lessons learned from working with National TB Programs, adult and pediatric clinicians and civil society, in optimizing treatment of RR/MDR-TB, using shorter, highly-effective, oral regimens for the majority of people with RR/MDR-TB.No Reference information available - sign in for access. No Supplementary Data.No Article MediaNo MetricsKeywords:MDR-TB;TB;drug-resistant;human rights;oral regimenDocument Type.

Research ArticleAffiliations:1. Center for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Soauth Africa 2. Treatment Action Group, New York, NY, USA 3.

Médecins Sans Frontières (MSF), Khayelitsha, South Africa 4. Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, and Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University ofCape Town, Cape Town, South Africa 5. Eswatini National TB Control Programme, Manzini, Eswatini 6.

EditorialAffiliations:1 discover this info here where can i buy amoxil over the counter. International Union Against Tuberculosis and Lung Disease, Paris, France 2. International Union Against Tuberculosis and Lung Disease, Paris, France, Norwegian Institute of Public Health, Oslo, Norway 3. Department of Medicine, Psychiatry, Dermatology and Therapeutics, Kenyatta University, Nairobi, Kenya, Department of Clinical where can i buy amoxil over the counter Sciences, Liverpool School of Tropical Medicine, Liverpool, UKPublication date:01 November 2020More about this publication?. The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research.

The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide. To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain where can i buy amoxil over the counter articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.Editorial BoardInformation for AuthorsSubscribe to this TitleInternational Journal of Tuberculosis and Lung DiseasePublic Health ActionIngenta Connect is not responsible for the content or availability of external websitesRapid diagnostics, newer drugs, repurposed medications, and shorter regimens have radically altered the landscape for treating rifampicin-resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB). There are where can i buy amoxil over the counter multiple ongoing clinical trials aiming to build a robust evidence base to guideRR/MDR-TB treatment, and both observational studies and programmatic data have contributed to advancing the treatment field.

In December 2019, the WHO issued their second ‘Rapid Communication´ related to RR-TB management. This reiterated their prior recommendation that a majorityof people with RR/MDR-TB receive all-oral treatment regimens, and now allow for specific shorter duration regimens to be used programmatically as well. Many TB programs need clinical advice as they seek to roll out such regimens in where can i buy amoxil over the counter their specific setting. In this Perspective, we highlightour early experiences and lessons learned from working with National TB Programs, adult and pediatric clinicians and civil society, in optimizing treatment of RR/MDR-TB, using shorter, highly-effective, oral regimens for the majority of people with RR/MDR-TB.No Reference information available - sign in for access. No Supplementary Data.No Article MediaNo MetricsKeywords:MDR-TB;TB;drug-resistant;human rights;oral regimenDocument Type.

Research ArticleAffiliations:1 where can i buy amoxil over the counter. Center for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Soauth Africa 2. Treatment Action Group, New York, NY, USA 3. Médecins Sans where can i buy amoxil over the counter Frontières (MSF), Khayelitsha, South Africa 4. Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, and Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University ofCape Town, Cape Town, South Africa 5.

Eswatini National TB Control Programme, Manzini, Eswatini 6. Global TB Program, Baylor College of Medicine, Houston, TX, USA 7. Hinduja Hospital &. Research Centre, Mumbai, India 8.

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Global Health Legislation During the 117th Congress(as of buy cheap amoxil Oct. 5, 2021)TitleDate IntroducedBill #SponsorStatusTopicSummary of Global Health-Related ProvisionsAbortion is Health Care Everywhere Act of 2021To amend the Foreign Assistance Act of 1961 to authorize the use of funds for comprehensive reproductive health care services, and for other purposes.3/9/2021H.R. 1670Rep. Janice Schakowsky (D-IL-9)Referred to HFACAbortion, Helms amendmentIncludes statement of U.S. Policy regarding safe abortion and working to end unsafe abortion.

Repeals the Helms Amendment (which prohibits the use of foreign assistance to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion). States that notwithstanding any other provision of law, certain funds may be used to provide comprehensive reproductive health care services, including abortion services, training, and equipment.Advancing Emergency Preparedness Through One Health Act of 2021To establish an interagency One Health Program, and for other purposes.3/18/2021S. 861Sen. Tina Smith (D-MN)Read twice and referred to S. HELPOne Health, global health securityRequires the heads of HHS, USDA, USAID, DoD, and certain other agencies to develop, publish, and submit to Congress a national One Health Framework for coordinated federal activities under the One Health Program not later than one year after enactment.

Among other things, states the framework must describe existing efforts and contain recommendations for building upon and complementing the activities of the CDC, the FDA, USAID, NIH, and certain others and also establish specific federal goals and priorities and describe specific activities required to achieve these. Requires the submission of an addendum to the framework not later than three years after its original submission, describing progress in advancing these activities. Authorizes to be appropriated such sums as necessary to develop the framework above. Requires GAO to submit a report to Congress not later than two years after the addendum is submitted, detailing existing collaborative efforts among certain agencies for this purpose and containing an evaluation of the framework and its specified activities.American Medical Investment Generating Overseas Security Act(AMIGOS Act)To prohibit the President from taking any action to support the waiver of obligations of members of the World Trade Organization under the Agreement on Trade-Related Aspects of Intellectual Property Rights in relation to the prevention, containment, mitigation, or treatment of buy antibiotics–19 unless a statute is enacted expressly authorizing such a waiver with respect to the prevention, containment, mitigation, or treatment of buy antibiotics–19, and for other purposes.5/14/2021H.R. 3236Maria Elvira Salazar (R-FL-27)Referred to HFAC and H.

Ways and MeansTRIPS, WTO, intellectual property rights, buy antibiotics treatmentsStates the President may not take any action to support waiver of obligations of WRO members under the TRIPS agreement in relation to the prevention, containment, mitigation, or treatment of buy antibiotics unless a statute is enacted expressly authorizing such a waiver with respect to such. Requires the President to allocate excess U.S. buy antibiotics treatments in a specified order of priority, with certain exceptions, and to monitor the allocation of such to ensure assisted governments provide treatments to their peoples in a timely manner and do not otherwise withhold them. Requires such treatments provided to foreign countries to be marked as assistance from the American people or the U.S. Government and to include a depiction of the flag of the U.S.

If appropriate.American Rescue Plan Act of 2021To provide for reconciliation pursuant to title II of S. Con. Res. 5.2/24/2021H.R. 1319Rep.

John Yarmuth (D-KY-3)Became law (P.L. 117-2)buy antibiotics, Global FundSee KFF summary.American Values ActTo permanently enact certain appropriations Act restrictions on the use of funds for abortions and involuntary sterilizations, and for other purposes.2/4/2021S. 239Sen. James Risch (R-ID)Read twice and referred to SFRCAbortion, involuntary sterilization amendment, Siljander amendment, Kemp-Kasten amendment, Peace Corps provision, Helms amendment, Biden amendmentAmends the Foreign Assistance Act of 1961 to codify in permanent law the Siljander amendment, which prohibits the use of funds to lobby for or against abortion, and the Kemp-Kasten amendment, which prohibits funding any organization or program, as determined by the President, that supports or participates in the management of a program of coercive abortion or involuntary sterilization. Restates the Helms amendment, the Involuntary Sterilization amendment (which prohibits the use of funds to pay for involuntary sterilizations as a method of family planning or to coerce or provide a financial incentive to anyone to undergo sterilization), and the Biden amendment (which states that funds may not be used for biomedical research related to methods of or the performance of abortion or involuntary sterilization as a means of family planning) that are already in permanent law.

Also amends the Peace Corps Act to codify in permanent law the Peace Corps provision, which prohibits Peace Corps funding from paying for an abortion for a Peace Corps volunteer or trainee, except in cases where the life of the woman is endangered by pregnancy or in cases of rape or incest. In the past these have been included only in annual State-Foreign Operations appropriations language. See also the KFF fact sheet on FP/RH statutory requirements and policies and the KFF explainer on UNFPA funding and Kemp-Kasten.Binational Health Strategies Act of 2021To amend the United States-Mexico Border Health Commission Act, with respect to preparedness for buy antibiotics–19 and other infectious diseases in the border region, and for other purposes.3/03/2021H.R. 1538Rep.. Veronica Escobar (D-TX-16)Referred to H.

Energy and HFACMexicoAuthorizes and directs the President to seek to begin negotiations with Mexico to amend an existing agreement addressing infectious disease preparedness in the U.S.-Mexico Border Area, with respect to buy antibiotics and other infectious diseases, specifically requiring the U.S.-Mexico Border Health Commission to submit a report on the border area’s response to buy antibiotics and requiring it to also develop and publicly publish a binational strategic plan that addresses how the area should strengthen its buy antibiotics response, sharing relevant health data, and how a buy antibiotics treatment should be disbursed throughout the area, among other things. Requires the Commission to publish what actions federal agencies in the U.S. And Mexico will take to facilitate implementation of the strategic plan and then to submit a report on actions taken each year. Requires the Commission to develop and publish a plan to prepare and respond to infectious diseases (other than buy antibiotics) within the border area, to update the plan at least once every three years for as long as necessary, and to publish what actions federal agencies in the U.S. And Mexico will take to facilitate implementation of this plan, with a report on actions taken each year required to be submitted.BLUE Pacific ActTo establish a comprehensive, long-term United States strategy and policy for the Pacific Islands, and for other purposes.5/4/2021H.R.

2967Rep. Ed Case (D-HI-1)Referred to HFAC, H. Ways and Means, H. Natural ResourcesPublic health capacity building, buy antibiotics, gender-based violenceStates U.S. Policy is to develop and commit to a comprehensive, multifaceted, and principled U.S.

Policy in the Pacific Islands that, among other things, assists the Pacific Islands in preventing and containing the spread of the buy antibiotics amoxil. Requires the USAID Administrator, in coordination with the Secretary of States, to develop and implement a strategy to assist the Pacific Islands in improving public health outcomes and building public health capacity, including in response to the buy antibiotics amoxil. Requires the strategy include programming to address maternal and child health, family planning and reproductive health, gender-based violence, food security and nutrition, NCDs, NTDs, tuberculosis, HIV/AIDS, STDs, and zoonotic and emerging infectious disease threats, clean water, sanitation, and hygiene (WASH), health system strengthening, and other activities. Requires a report not later than 180 days after enactment with strategy. Authorizes to be appropriated $20 million for each FY22-FY26 to carry out these efforts.

Requires the Secretary of State and USAID Administrator to develop and implement an initiative to encourage and support efforts by the Pacific Island to reduce and combat gender-based violence.Climate Change Health Protection and Promotion Act of 2021To direct the Secretary of Health and Human Services to develop and implement a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.5/17/2021H.R. 3271Rep. Matt Cartwright (D-PA-8)Referred to H. Energy and CommerceClimate change, global healthDirects Secretary of HHS to publish a strategic action plan and establish a climate change and health program (at CDC, in collaboration with other agencies, as appropriate) to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the U.S. And other nations.

Requires the action plan include an assessment of U.S. Capacity to address climate change including, among other things, providing technical assistance and support for preparedness and response plans for the health threats of climate change in developing countries, and developing or strengthening domestic and international disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change. Describes priority health actions for the climate and health program, including with regard to global health aspects of climate change. Requires periodic updates of action plan. Establishes science advisory board and its functions, including with regarding to international impacts of climate change on health.

And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Climate Change Health Protection and Promotion Act of 2021To direct the Secretary of Health and Human Services to develop and implement a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.5/19/2021S. 1702Sen. Edward Markey (D-MA)Read twice and referred to S. HELPClimate change, global healthDirects Secretary of HHS to publish a strategic action plan and establish a climate change and health program (at CDC, in collaboration with other agencies, as appropriate) to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the U.S. And other nations.

Requires the action plan include an assessment of U.S. Capacity to address climate change including, among other things, providing technical assistance and support for preparedness and response plans for the health threats of climate change in developing countries, and developing or strengthening domestic and international disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change. Describes priority health actions for the climate and health program, including with regard to global health aspects of climate change. Requires periodic updates of action plan. Establishes science advisory board and its functions, including with regarding to international impacts of climate change on health.

And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Curbing China’s treatment Diplomacy ActTo prioritize the international distribution of buy antibiotics treatment doses, and for other purposes.7/6/2021H.R.4362Rep. Carlos Gimenez (R-FL-26)Referred to HFACbuy antibiotics, treatmentsRequires the Secretary of States to prioritize, in carrying out the international distribution of buy antibiotics treatment doses, distribution to Taiwan and crucial Latin American allies, subject first to Administration certification to Congress that it has determined all Americans have been afforded ample opportunity to be fully vaccinated against buy antibiotics. Requires the Secretary to ensure that not less than 25% of the total number of buy antibiotics treatment doses intended for international distribution are reserved for and distributed to Taiwan and crucial Latin American allies and states the Secretary may not distribute any doses to other recipients or countries until the above have each received at least a first shipment of their reserved doses. States the Secretary may not distribute buy antibiotics treatment doses to any country which has a government that has been determined to have engaged in systemic or widespread human rights abuses. Terminates five days after the date on which the Secretary determines the above have each achieved 40% vaccination rates of their respective populations.Department of State, Foreign Operations, and Related Programs Appropriations Act, 2022(State/Foreign Ops – SFOPS Approps)Making appropriations for the Department of State, foreign operations, and related programs for the fiscal year ending September 30, 2022, and for other purposes.7/6/2021H.R.

4373Rep. Barbara Lee (D-CA-13)Passed House, received in the SenateAppropriationsSee KFF summary. Includes the text of the Global Health, Empowerment, and Rights (Global HER) Act (H.R. 556), which codifies prohibition of the expanded Mexico City policy (rescinded by President Biden in Jan. 2021, see KFF explainer).

Global Autism ActTo establish a Global Autism Assistance Program.6/24/2021H.R. 4160Rep. Christopher Smith (R-NJ-4)Referred to HFACAutismEstablishes a health and education grant program known as the Global Autism Assistance Program at USAID to support activities focused on autism spectrum disorder (ASD) in developing countries and to establish a program, known as Train the Trainers, to train health and education professionals working with children with ASD in developing countries. Outlines designation of eligible regions and selection of implementing NGO and activities it may carry out with the grant. Requires the implementing NGO to establish a Project Advisory Board to review local applications for content and appropriateness.

To carry out this program, requires the USAID Administrator to allocate amounts that have been appropriated or otherwise made available to USAID. Requires an annual report on activities.Global Health, Empowerment and Rights Act(Global HER Act) To prohibit the application of certain restrictive eligibility requirements to foreign nongovernmental organizations with respect to the provision of assistance under part I of the Foreign Assistance Act of 1961.1/28/2021H.R. 556Rep. Barbara Lee (D-CA-13)Referred to HFACAbortion, Mexico City policyCodifies prohibition of the expanded Mexico City policy (rescinded by President Biden in Jan. 2021, see KFF explainer).

States that notwithstanding any provision of law, regulation, or policy, foreign non-governmental organizations (NGOs) shall not be ineligible for certain foreign aid under the Foreign Assistance Act solely on the basis of health or medical services provided with non-U.S. Funds (insofar as legal in country where provided and under U.S. Law) and shall not be subject to requirements relating to their use of non-U.S. Funds for advocacy and lobbying activities.*Global Health, Empowerment and Rights Act(Global HER Act) To prohibit the application of certain restrictive eligibility requirements to foreign nongovernmental organizations with respect to the provision of assistance under part I of the Foreign Assistance Act of 1961.1/28/2021S. 142Sen.

Jeanne Shaheen (D-NH)Read twice and referred to SFRCAbortion, Mexico City policyCodifies prohibition of the expanded Mexico City policy (rescinded by President Biden in Jan. 2021, see KFF explainer). States that notwithstanding any provision of law, regulation, or policy, foreign non-governmental organizations (NGOs) shall not be ineligible for certain foreign aid under the Foreign Assistance Act solely on the basis of health or medical services provided with non-U.S. Funds (insofar as legal in country where provided and under U.S. Law) and shall not be subject to requirements relating to their use of non-U.S.

Funds for advocacy and lobbying activities.*Global Health Security Act of 2021To authorize a comprehensive, strategic approach for United States foreign assistance to developing countries to strengthen global health security, and for other purposes.1/21/2021H.R. 391Rep. Gerald Connolly (D-VA-11)Passed House, read twice and referred to SFRCGlobal health security, global health emergenciesStates it is U.S. Policy to promote and invest in global health security and amoxil preparedness as a core national security interest. Establishes a Global Health Security Agenda Interagency Review Council, designates members, responsibilities, and frequency of meetings.

Designates a U.S. Coordinator for Global Health Security responsible for coordination of the interagency process for responding to global health security emergencies. Express Sense of Congress that the President should consider appointing an individual with significant background and expertise in public health or emergency response management to such position. Requires a U.S. Global health security strategy, its implementation (including agency-specific plans), and an annual report on status of implementation.

Directs the Secretary of State, Treasury Secretary, USAID Administrator, and HHS Secretary, among others, to seek to enter into negotiations with donors, relevant U.N. Agencies (including WHO), and other stakeholders to establish a fund for global health security and amoxil preparedness as a multilateral, catalytic financing mechanism. Describes Fund’s Advisory Board, purpose, Executive Board and its makeup and duties. Creates a Coordinator of U.S. Government activities to advance global health security, who shall be appointed by the President to represent the U.S.

On the Executive Board. Outlines eligible partner country definition and Fund program objectives, supported activities, administration, including appointment of an Administrator appointed by the Executive Board, and transparency and accountability requirements. Requires reports to Congress on the Fund including a 6 month status report and then annual reports after the Fund’s establishment. And authorizes U.S. Contributions to the Fund with a limit that the U.S.

Share not exceed 33% of total contributions to the Fund cumulatively.Global Malnutrition Prevention and Treatment Act of 2021To advance targeted and evidence-based interventions for the prevention and treatment of global malnutrition and to improve the coordination of such programs, and for other purposes.07/26/2021H.R. 4693Rep. Michael McCaul (R-TX-10)Passed HFAC (Ordered to be Reported by Voice Vote)MalnutritionAuthorizes the USAID Administrator to support efforts to prevent and treat malnutrition globally, including by targeting resources and nutrition interventions to support the most vulnerable populations susceptible to severe malnutrition, including children under the age of 5 and pregnant and lactating women. Directs the Administrator and others to coordinate with bilateral and multilateral donors, governments of partner countries, U.N. Agencies, and others to prevent and treat malnutrition globally.

Requires the Administrator and others to seek to leverage additional resources to this end by increasing interagency cooperation among relevant departments and agencies represented in the Global Nutrition Coordination Plan. Requires the selection of priority countries and outlines criteria. Express Sense of Congress that efforts to undertake nutrition interventions in countries not selected as priority countries should continue. Authorizes the establishment of the Nutrition Leadership Council within USAID and outlines its duties and membership. Requires the development of an implementation plan.

Requires an annual progress report for five years.Global amoxil Prevention and Biosecurity ActTo establish a global zoonotic disease task force, and for other purposes. 5/20/2021H.R. 3424Rep. Grace Meng (D-NY-6)Referred to HFACamoxil, zoonotic diseases, One Health, global health security, biosecurityRequires the Secretary of State and USAID Administrator to work with certain relevant agency heads to coordinate, work with, and engage governments, multilateral entities, and certain others to prevent zoonotic spillover events through various actions such as addressing the commercial trade in wildlife, strengthening global capacity for detection of zoonotic diseases with amoxil potential, and supporting the development of One Health systems at the community level. Establishes the global zoonotic disease task force and outlines its membership and their terms, duties (including developing and publishing a plan for global biosecurity and zoonotic disease prevention and response and expanding the scope of the global health security strategy to more robustly support the prevention of zoonotic spillover and to respond to zoonotic disease investigations and outbreaks by establishing a 10 year strategy), required reports from agencies to the task force as well as from the task force to Congress, and its termination date 7 years after the date of enactment or a later date that is not later than two years after that.Global amoxil Prevention and Biosecurity ActTo establish a global zoonotic disease task force, and for other purposes.

5/20/2021S.1737Sen. Chris Coons (D-DE)Read twice and referred to SFRCamoxil, zoonotic diseases, One Health, global health security,biosecurityRequires the Secretary of State and USAID Administrator to work with certain relevant agency heads to coordinate, work with, and engage governments, multilateral entities, and certain others to prevent zoonotic spillover events through various actions such as addressing the commercial trade in wildlife, strengthening global capacity for detection of zoonotic diseases with amoxil potential, and supporting the development of One Health systems at the community level. Establishes the global zoonotic disease task force and outlines its membership and their terms, duties (including developing and publishing a plan for global biosecurity and zoonotic disease prevention and response and expanding the scope of the global health security strategy to more robustly support the prevention of zoonotic spillover and to respond to zoonotic disease investigations and outbreaks by establishing a 10 year strategy), required reports from agencies to the task force as well as from the task force to Congress, and its termination date 7 years after the date of enactment or a later date that is not later than two years after that.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes. 6/9/2021S. 1996Sen.

Edward Markey (D-MA)Read twice and referred to SFRCLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S. Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community.

And expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes. 6/8/2021H.R. 3800Rep. Dina Titus (D-NV-1)Referred to HFAC, H.

JudiciaryLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S. Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community.

Expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination. And repeals the Mexico City policy by removing certain limitations on eligibility for foreign assistance.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021H.R. 3373Rep. Ami Bera (D-CA-7)Referred to HFAC, H.

Veterans’ Affairs, H. Natural Resources, H. Armed Services, H. Financial Services, H. Judiciary, H.

Transportation and Infrastructure, H. Homeland SecurityPublic health capacity building, global health securityStates it is U.S. Policy to, among other things, improve the local capacity of the countries of Oceania to address public health challenges and improve global health security. Requires the Secretary of State, in consultation with the HHS Secretary, to establish a program to support building public health capacity and improving access to care and local health outcomes in Oceania related to maternal and child health, STDs, HIV/AIDS, tuberculosis, malaria, NTDs, NCDs, gender-based violence, substance use disorder, mortality due to epidemics, disasters, and the impacts from severe weather and environmental change, and other health issues. Requires a report on these efforts annually.

Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021S. 1774Sen. Brian Schatz (D-HI)Read twice and referred to SFRCPublic health capacity building, global health securityStates it is U.S. Policy to, among other things, improve the local capacity of the countries of Oceania to address public health challenges and improve global health security.

Requires the Secretary of State, in consultation with the HHS Secretary, to establish a program to support building public health capacity and improving access to care and local health outcomes in Oceania related to maternal and child health, STDs, HIV/AIDS, tuberculosis, malaria, NTDs, NCDs, gender-based violence, substance use disorder, mortality due to epidemics, disasters, and the impacts from severe weather and environmental change, and other health issues. Requires a report on these efforts annually. Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.International Human Rights Defense Act of 2021To establish in the Bureau of Democracy, Human Rights, and Labor of the Department of State a Special Envoy for the Human Rights of LGBTI Peoples, and for other purposes.2/22/2021H.R. 1201Rep.

Alan Lowenthal (D-CA-47)Referred to HFACLGBTI health, HIVIncludes statement of U.S. Policy regarding LGBTI issues globally, including employing a multisectoral approach to preventing and responding to criminalization, discrimination, and violence against LGBTI people internationally, including activities in the health sector. Authorizes the provision of U.S. Assistance to prevent and respond to these issues internationally, including enhancement of health sector capacity related to violence against LGBTI people and communities and to combat HIV.International Human Rights Defense Act of 2021To establish in the Bureau of Democracy, Human Rights, and Labor of the Department of State a Special Envoy for the Human Rights of LGBTI Peoples, and for other purposes.2/24/2021S. 424Sen.

Edward Markey (D-MA)Read twice and referred to SFRCLGBTI health, HIVIncludes statement of U.S. Policy regarding LGBTI issues globally, including employing a multisectoral approach to preventing and responding to criminalization, discrimination, and violence against LGBTI people internationally, including activities in the health sector. Authorizes the provision of U.S. Assistance to prevent and respond to these issues internationally, including enhancement of health sector capacity related to violence against LGBTI people and communities and to combat HIV.International amoxil Preparedness and buy antibiotics Response Act of 2021To improve global health, and for other purposes.6/24/2021S. 2297Sen.

James Risch (R-ID)Placed on Senate Legislative Calendar under General Ordersamoxil preparedness, buy antibiotics, treatments, WHO, health systems strengthening, CEPI, global health security, Global Fund to Fight AIDS, Tuberculosis and malariaRequires a report describing certain foreign assistance obligated/expended under the American Rescue Plan Act of 2021 and a plan for certain remaining funds. Requires development of a strategy to expand access to, and accelerate the global distribution of, buy antibiotics treatments to other countries. Requires a report that assesses the global humanitarian response to buy antibiotics and outlines specific elements of the U.S. Government’s country-level response to the buy antibiotics amoxil. In the event of an infectious disease outbreak outside the U.S.

With amoxil potential, states the President should designate the Department of State to serve as the lead for diplomatic engagement and related foreign policy efforts, USAID to serve as the key lead agency for design and implementation of the U.S. International response, relief, and recovery assistance, and the CDC to serve as the public health lead for the international response such as building up (in coordination with USAID) emergency operation centers. Allows certain foreign assistance funding to be used to support USAID disaster surge capacity. Requires a U.S. Global health security strategy and report.

Authorizes to be established a committee on global health security and amoxil and biological threats within the National Security Council (NSC) led by the Special Advisor for Global Health Security of the NSC. Within the Department of State, establishes a Special Representative for U.S. International activities to advance global health security and diplomacy overseas, to be appointed by the President and report to the Secretary of State and to lead in developing a global amoxil prevention, preparedness and response framework. Authorizes the Representative to transfer and allocate certain U.S. Foreign assistance funding to the relevant departments and agencies implementing the U.S.

Global health security strategy. Authorizes to be appropriated $3 billion for the five-year period beginning Oct. 1, 2022, to support enhancing preparedness in partner countries, replenishing the USAID Emergency Reserve Fund, U.S. Contributions to the World Bank Health Emergency Preparedness and Response Multi-Donor Fund, and U.S. Contributions to a new multilateral, catalytic financing mechanism for global health security and amoxil prevention and preparedness (see “the Fund” below).

Requires U.S. Global health program leadership identify areas of collaboration and coordination to ensure that such activities contribute to health systems strengthening. Directs the Secretary of State, with the USAID Administrator, to work with the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the treatment Alliance, bilateral donors, and others to develop shared core indicators for strengthened health systems. Authorizes the U.S. To participate in the Coalition for Epidemic Preparedness Innovations (CEPI).

Expresses Sense of Congress that the President should make an immediate contribution to CEPI of $300 million to expand research and development of treatments to combat the spread of buy antibiotics variants. Requires an annual National Intelligence Estimate (for five years) regarding the risks posed to the national security interests of the U.S. By the emergence, reemergence, and overseas transmission of pathogens with amoxil potential. Requires the Secretary of State and others to work with WHO and other key stakeholders to establish or strengthen effective early warning systems for infectious disease threats with epidemic and amoxil potential. Directs the Secretary of State, with the HHS Secretary, to work with WHO and like-minded member states to adopt an approach toward assessing infectious disease threats under the International Health Regulations (2005) for the WHO to identify and transparently communicate on an ongoing basis varying levels of risk leading up to, and during and after, a public health emergency of international concern (PHEIC) declaration.

Directs the Secretary of State and others to seek to enter into negotiations to establish “the Fund;” authorizes the President to make available for U.S. Contributions to the Fund such funds as may be appropriated or otherwise made available for such purpose. Limits the U.S. Contribution to the Fund to not exceed 33% of the total contributions from all sources.Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022(FY22 Consolidated Appropriations Act)Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2022, and for other purposes.7/19/2021H.R. 4502Rep.

Rosa DeLauro (D-CT-3)Passed House, received in the SenateAppropriationsSee KFF summary.Mental Health in International Development and Humanitarian Settings Act(MINDS Act)To enhance mental health and psychosocial support within United States foreign assistance programs.6/17/2021H.R. 3988Rep. Theodore Deutch (D-FL-22)Referred to HFACMental health, children in adversity, buy antibioticsExpresses Sense of Congress that mental health is integral and essential to overall health outcomes and other development objectives. Codifies the position of USAID coordinator for mental health and psychosocial support and describes the position’s duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Group’s duties and members.

States U.S. Policy is to integrate mental health and psychosocial support across all foreign assistance programs funded by the U.S.. Requires USAID and the Department of State regional bureaus and missions to utilize such policy for local capacity building, as appropriate and that such programming be evidence-based and culturally competent and respond to the specific needs of children in adversity. Requires USAID to brief Congress on progress and challenges to implementation, including programming in conflict and humanitarian settings, as well as the impact of buy antibiotics on programming. Requires the USAID Administrator in consultation with the OMB Director to brief Congress annually for five years (FY22 – FY26) on spending for this programming in U.S.

Foreign assistance.Mental Health in International Development and Humanitarian Settings Act(MINDS Act)To enhance mental health and psychosocial support within United States foreign assistance programs.6/17/2021S. 2105Sen. Robert Casey (D-PA)Read twice and referred to SFRCMental health, children in adversity, buy antibioticsExpresses Sense of Congress that mental health is integral and essential to overall health outcomes and other development objectives. Codifies the position of USAID coordinator for mental health and psychosocial support and describes the position’s duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Group’s duties and members.

States U.S. Policy is to integrate mental health and psychosocial support across all foreign assistance programs funded by the U.S.. Requires USAID and the Department of State regional bureaus and missions to utilize such policy for local capacity building, as appropriate and that such programming be evidence-based and culturally competent and respond to the specific needs of children in adversity. Requires USAID to brief Congress on progress and challenges to implementation, including programming in conflict and humanitarian settings, as well as the impact of buy antibiotics on programming. Requires the USAID Administrator in consultation with the OMB Director to brief Congress annually for five years (FY22 – FY26) on spending for this programming in U.S.

Foreign assistance.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act)To establish a program to oversee the global buy antibiotics response and prepare for future amoxils, and for other purposes.6/8/2021H.R. 3778Rep. Raja Krishnamoorthi (D-IL-8)Referred to HFAC and H. Energy and Commercebuy antibiotics, global health security, amoxil preparedness and responseEstablishes the amoxil preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics amoxil and protect Americans from the emergence of buy antibiotics variants and other pathogens with amoxil potential.

Require President to appoint program director who will coordinate the work of identified agencies, including USAID, CDC, and the Department of State, among others. Requires development of a comprehensive strategy to end the buy antibiotics amoxil worldwide as well as a long-term strategy for preventing future amoxils. Authorizes to be appropriated $34 billion for these efforts, and expresses Sense of Congress that $25 billion be made available to scale treatment manufacturing capacity and produce treatments, $8.5 billion to cover the cost of end-to-end delivery and administration of treatments in target countries, and $500 million to establish a global disease surveillance network to protect against future amoxils. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S.

treatment stockpile to determine whether further treatments can be sent abroad and to coordinate with BARDA to rapidly scale manufacturing capacity around the world to produce 8 billion treatment doses as soon as possible. Also requires director to ensure equitable access to treatments in collaboration with COVAX and to work with international partners to provide enough treatments to lower- and middle-income countries to fully vaccinate at least 60% of their respective populations, especially 92 countries identified by COVAX as being most in need of assistance. Requires the program to, among other things, build on PEPFAR and other existing U.S. Programs and relationships bilaterally and multilaterally. Express Sense of Congress that in the face of a global health emergency, the U.S.

Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act) To establish a program to oversee the global buy antibiotics response and prepare for future amoxils, and for other purposes.6/8/2021S. 1976Sen. Jeff Merkley (D-OR)Read twice and referred to SFRCbuy antibiotics, global health security, amoxil preparedness and responseEstablishes the amoxil preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics amoxil and protect Americans from the emergence of buy antibiotics variants and other pathogens with amoxil potential. Require President to appoint program director who will coordinate the work of identified agencies, including USAID, CDC, and the Department of State, among others.

Requires development of a comprehensive strategy to end the buy antibiotics amoxil worldwide as well as a long-term strategy for preventing future amoxils. Authorizes to be appropriated $34 billion for these efforts, and expresses Sense of Congress that $25 billion be made available to scale treatment manufacturing capacity and produce treatments, $8.5 billion to cover the cost of end-to-end delivery and administration of treatments in target countries, and $500 million to establish a global disease surveillance network to protect against future amoxils. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S. treatment stockpile to determine whether further treatments can be sent abroad and to coordinate with BARDA to rapidly scale manufacturing capacity around the world to produce 8 billion treatment doses as soon as possible.

Also requires director to ensure equitable access to treatments in collaboration with COVAX and to work with international partners to provide enough treatments to lower- and middle-income countries to fully vaccinate at least 60% of their respective populations, especially 92 countries identified by COVAX as being most in need of assistance. Requires the program to, among other things, build on PEPFAR and other existing U.S. Programs and relationships bilaterally and multilaterally. Express Sense of Congress that in the face of a global health emergency, the U.S. Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Preventing Foreign Attempts To Erode Healthcare Innovation ActTo prohibit the use of funds to support a measure at the World Trade Organization waiving intellectual property rights, and for other purposes.5/18/2021S.

1683Sen. Tim Scott (R-SC)Read twice and referred to S. FinanceTRIPS, WTO, intellectual property rights, buy antibiotics treatmentsExpresses Sense of Congress that U.S. Should continue to promote strong international [sic] property rights internationally and that it is in the national interest of the U.S. To oppose efforts to transfer U.S.

Intellectual property and technology to China or other countries seeking to profit off U.S. Investments. Prohibits use of funds to support, allow, or facilitate the negotiation or approval of the TRIPS waiver for the prevention, containment, and treatment of buy antibiotics proposed by India and South Africa or any other measure at the WTO to waive intellectual property rights.Preventing Future amoxils Act of 2021To address the public health risks posed by wildlife markets, and for other purposes.1/4/2021H.R. 151Rep. Mike Quigley (D-IL-5)Referred to HFAC, H.

Energy and Commerce, H. Judiciary, H. Ways and Means, H. Financial Services, H. Natural ResourcesGlobal health security, One Health, zoonotic diseasesRequires the HHS Secretary to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine for it to conduct a study on the risk of wildlife markets on the emergency of novel viral pathogens, to be submitted not later than one year after the date of agreement.

Expresses Sense of Congress that global institutions, including WHO, and others including USAID should promote the paradigm of One Health. States U.S. Policy is to facilitate international cooperation to close high risk wildlife markets around that world and to work to develop agreements and protocols to close these markets. Allows the President to impose sanctions on any country (or nationals of a country) continuing to license or enable commercial wildlife markets or engaged in certain activities. Authorizes FY 2021 – FY 2030 funding for USAID activities related to sustainable food systems.

Requires the USAID administrator to increase activities related to biodiversity, global health, and resilience, among other things, in order to address the threats and causes of zoonotic disease outbreaks.. Requires reporting from the Department of State and USAID describing these efforts.Preventing Future amoxils Act of 2021To address the public health risks posed by wildlife markets, and for other purposes.1/25/2021S. 37Sen. John Cornyn (R-TX)Read twice and referred to SFRCGlobal health security, One Health, zoonotic diseasesRequires the HHS Secretary to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine for it to conduct a study on the risk of wildlife markets on the emergency of novel viral pathogens, to be submitted not later than one year after the date of agreement. Expresses Sense of Congress that global institutions, including WHO, and others including USAID should promote the paradigm of One Health.

States U.S. Policy is to facilitate international cooperation to close high risk wildlife markets around that world and to work to develop agreements and protocols to close these markets. Allows the President to impose sanctions on any country (or nationals of a country) continuing to license or enable commercial wildlife markets or engaged in certain activities. Authorizes FY 2021 – FY 2030 funding for USAID activities related to sustainable food systems. Requires the USAID administrator to increase activities related to biodiversity, global health, and resilience, among other things, in order to address the threats and causes of zoonotic disease outbreaks..

Requires reporting from the Department of State and USAID describing these efforts.Protecting Life in Foreign Assistance ActTo restrict the availability of Federal funds to organizations associated with the abortion industry.1/28/2021H.R. 534Rep. Virginia Foxx (R-NC-5)Referred to HFACAbortion, Mexico City policyCodifies the expanded Mexico City policy (rescinded by President Biden in Jan. 2021. See KFF explainer) and expands it to apply more broadly to federal funding made available for purposes outside of the U.S.

To 1) any foreign nonprofit organization, foreign nongovernmental organization, foreign multilateral organization, or foreign quasi-autonomous nongovernmental organization that carries out certain activities, and 2) any domestic nonprofit organization or domestic nongovernmental organization that carries out certain activities.Protecting Life in Foreign Assistance ActTo restrict the availability of Federal funds to organizations associated with the abortion industry.1/28/2021S. 137Sen. Mike Lee (R-UT)Read twice and referred to SFRCAbortion, Mexico City policyCodifies the expanded Mexico City policy (rescinded by President Biden in Jan. 2021. See KFF explainer) and expands it to apply more broadly to federal funding made available for purposes outside of the U.S.

To 1) any foreign nonprofit organization, foreign nongovernmental organization, foreign multilateral organization, or foreign quasi-autonomous nongovernmental organization that carries out certain activities, and 2) any domestic nonprofit organization or domestic nongovernmental organization that carries out certain activities.Reach Every Mother and Child ActTo amend the Foreign Assistance Act of 1961 to implement policies to end preventable maternal, newborn, and child deaths globally.4/29/2021S. 1451Sen. Susan Collins (R-ME)Read twice and referred to SFRCMaternal health, child healthIncludes statement of U.S. Policy to establish and implement a coordinated, integrated, and comprehensive strategy to end preventable child and maternal deaths and ensure healthy and productive lives. Requires the establishment and implementation of a five-year comprehensive strategy to contribute toward the global goal of ending preventable child and maternal deaths by 2030.

States the President should designate a Child and Maternal Survival Coordinator and describes their duties. Requires an annual report on progress.Reproductive Rights are Human Rights Act of 2021To amend the Foreign Assistance Act of 1961 to require a section on reproductive rights in the Annual Country Reports on Human Rights Practices.5/28/2021H.R. 3576Rep. Katherine Clark (D-MA-5)Referred to HFACState Dept. Annual human rights report, family planning/reproductive health (FP/RH), maternal mortality, abortion, violence against womenAmends existing law to require annual reporting by the Department of State on human rights to include, among other things.

The status of reproductive rights in each country. Description of the rates and causes of pregnancy-related injuries and deaths (including deaths due to unsafe abortions), violence against women, and access to family planning. Requires that civil society and multilateral organizations’ representatives in the U.S. And countries included in such reporting be consulted with during the preparation of annual reporting.Reproductive Rights are Human Rights Act of 2021To amend the Foreign Assistance Act of 1961 to require a section on reproductive rights in the Annual Country Reports on Human Rights Practices.5/26/2021S. 1864Sen.

Robert Menendez (D-NJ)Read twice and referred to SFRCState Dept. Annual human rights report, family planning/reproductive health (FP/RH), maternal mortality, abortion, violence against womenAmends existing law to require annual reporting by the Department of State on human rights to include, among other things. The status of reproductive rights in each country. Description of the rates and causes of pregnancy-related injuries and deaths (including deaths due to unsafe abortions), violence against women, and access to family planning. Requires that civil society and multilateral organizations’ representatives in the U.S.

And countries included in such reporting be consulted with during the preparation of annual reporting.Robust International Response to amoxil ActTo provide support for a robust global response to the buy antibiotics amoxil.2/11/2021H.R. 986Rep. Jesus “Chuy” Garcia (D-IL-4)Referred to H. Financial Servicesbuy antibioticsDirects the Secretary of the Treasury to instruct U.S. Executive Directors at international financial institutions to ensure international financial institution support for a robust international response to the global buy antibiotics amoxil, including to oppose the approval or endorsement of any loan, grant, document, or strategy that would lead to a decrease in health care spending or in any other spending that would impede the ability of any country to prevent or contain the spread of, or treat persons who are or may be infected with, the buy antibiotics amoxil.Securing America From Epidemics Act(SAFE Act) To authorize United States participation in the Coalition for Epidemic Preparedness Innovations, and for other purposes.3/23/2021H.R.

2118Rep. Ami Bera (D-CA-7)Passed House, read twice and referred to SFRCResearch &. Development (R&D), global health security, amoxil, epidemicAuthorizes U.S. Participation in the Coalition for Epidemic Preparedness Innovation (CEPI). Reports to Congress required to be submitted by the President not later than 180 days after enactment of the Act and to outline planned U.S.

Contributions to CEPI, the manner and extent to which the U.S. Will participate in the governance of CEPI, and how participation in CEPI supports relevant U.S. Strategies and programs in health security and biodefense, among other things. Authorizes certain appropriated funding to be made available for U.S. Contributions to CEPI.Strategic Competition Act of 2021To address issues involving the People’s Republic of China.

4/15/2021S. 1169Sen. Robert Menendez (D-NJ)Placed on Senate Legislative Calendar under General Ordersbuy antibiotics, health cooperation, WHO, global health security, abortion, forced sterilization, debt reliefExpresses sense of Congress that the U.S. Government should encourage other foreign governments to use the official and scientific names for the buy antibiotics amoxil. States U.S.

Policy is to deepen cooperation between and among the U.S., Japan, South Korea, the Philippines, Thailand, and Australia, including through scientific and health partnerships. Expresses sense of Congress that recent pledge from the first-ever Quad (Australia, India, Japan, U.S.) leaders meeting on March 12, 2021, to respond to the economic and health impacts of buy antibiotics, including expanding treatment production and equitable access, further advances cooperation among Quad nations. States it is U.S. Policy to stand with the nations of ASEAN as they respond to buy antibiotics and support greater cooperation in building capacity to prepare for and respond to amoxils and other public health challenges. States it is U.S.

Policy to advocate and actively advance Taiwan’s meaningful participation in the World Health Assembly, among other bodies. Requires report on the origins of the buy antibiotics amoxil to be submitted by the Director of National Intelligence, in coordination with the Secretary of State, HHS Secretary, and others, not later than 180 days after enactment. Requires strategies that describe how the U.S. Will enhance cooperation with Canada, the European Union, NATO, and European partner countries in managing relations with China, including detailing diplomatic efforts to work with them to track and counter Chinese attempts to exert influence across the multilateral system, including at WHO. Requires a strategy for countering and limiting Chinese influence in, and access to, the Middle East and North Africa, including efforts to encourage U.S.

Private sector and public-private partnerships in healthcare technology, among other things. States it is U.S. Policy to work with Australia, New Zealand, and Japan to advance shared alliance goals of the Oceania region concerning health, among other things, and to improve the local capacity of the countries of Oceania to address public health challenges and improve global health security. Address the imposition of sanctions with respect to systematic rape, coercive abortion, forced sterilization, or involuntary contraceptive implantation in the Xinjiang Uyghur Autonomous Region. Addresses reporting related to debt relief via the International Development Association (IDA) for certain countries to respond to the buy antibiotics amoxil.Support for Global Financial Institution amoxil Response Act of 2021To support efforts by international financial institutions to provide a robust global response to the buy antibiotics–19 amoxil.1/27/2021S.

67Sen. Richard Durbin (D-IL)Read twice and referred to SFRCbuy antibioticsDirects the Secretary of the Treasury to instruct U.S. Executive Directors at international financial institutions to ensure international financial institution support for a robust international response to the global buy antibiotics amoxil, including to oppose the approval or endorsement of any loan, grant, document, or strategy that would lead to a decrease in health care spending or in any other spending that would impede the ability of any country to prevent or contain the spread of, or treat persons who are or may be infected with, the buy antibiotics amoxil.Support UNFPA Funding ActTo authorize contributions to the United Nations Population Fund, and for other purposes.6/16/2021H.R. 3938Rep. Chrissy Houlahan (D-PA-6)Referred to HFACUNFPA, family planning/reproductive health (FP/RH)Includes statement of U.S.

Policy regarding financial support for UNFPA as a crucial part of U.S. Global health commitment. Authorizes appropriations for five years for an annual contribution to UNFPA to support core functions and programs.To amend the National Security Act of 1947 to require the President to designate an employee of the National Security Council to be responsible for amoxil prevention and response, and for other purposes.2/8/2021S. 290Sen. Edward Markey (D-MA)Read twice and referred to HSGACamoxilRequires the President to designate an employee of the National Security Council to be the permanent coordinator for amoxil prevention and response for the federal government, outlines duties, and grants them authority to represent the U.S.

In bilateral and multilateral discussions and agreements on relevant matters.To direct the Secretary of State to develop a strategy to regain observer status for Taiwan in the World Health Organization, and for other purposes.2/18/2021H.R. 1145Rep. Young Kim (R-CA-39)Passed HFAC (Ordered to be Reported in the Nature of a Substitute by Voice Vote)WHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwan’s participation at WHO’s World Health Assembly as an observer.To direct the Secretary of State to develop a strategy to regain observer status for Taiwan in the World Health Organization, and for other purposes.3/17/2021S. 812Sen. Robert Menendez (D-NJ)Passed Senate, received in House, held at deskWHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwan’s participation at WHO’s World Health Assembly as an observer.To prohibit the use of funds to seek membership in the World Health Organization or to provide assessed or voluntary contributions to the World Health Organization.1/28/2021H.R.

497Rep. Jodey Arrington (R-TX-19)Referred to HFACWHOProhibits the use of federal funds to seek membership by the U.S. In WHO or to provide assessed or voluntary U.S. Contributions to WHO until such time as the President certifies that WHO meets certain conditions, including. WHO has adopted meaningful reforms to ensure that humanitarian assistance is not politicized and is to be provided to those with the most need, WHO is not under the control or significant malign influence of the Chinese Communist party, WHO is not involved in a coverup of the Chinese Communist Party’s response to the buy antibiotics amoxil, WHO grants observer status to Taiwan, WHO does not divert humanitarian or medical supplies to Iran, North Korea, or Syria, and WHO has put in place mechanisms to increase transparency and accountability in its operations and eliminate waste, fraud, and abuse.To rescind 1.3 percent of total defense spending and authorize the same amount for international buy antibiotics treatment production and distribution.9/30/2021H.R.

5461Rep. Mark Pocan (D-WI-2)Referred to HFAC and H. Approps.buy antibiotics, treatmentsAccording to the press release on the bill, it “would remove $9.6 billion in defense spending – 1.3% of the $740.5 billion authorized in the 2021 National Defense Authorization Act – and authorize President Biden to direct the same amount of funding to buy antibiotics treatment production and distribution efforts benefitting the low-income international community.” Full bill text not available yetUnited States Climate Leadership in International Mitigation, Adaptation, and Technology Enhancement Act of 2021(U.S. CLIMATE Act) To restore the United States international leadership on climate change and clean energy, and for other purposes. 4/19/2021S.

1201Sen. Robert Menendez (D-NJ)Read twice and referred to SFRCClimate change, global healthRequires the Secretary of State, in consultation with other relevant agencies, to conduct biennial comprehensive evaluations of present and ongoing disruptions to the global climate system, including the scarcity of global natural resources including fresh water, global food, health, and energy insecurities and conditions that contribute to gender-based violence, among other things. Requires these evaluations to be used by the Secretary of State to inform the development and implementation of a climate security strategy, and to develop and implement plans to account for the impacts of climate change on global human health, fresh water, and marginalized groups. States U.S. Policy is to ensure that the International Climate Change Adaptation, Mitigation, and Security Program (required to be established under the act by the Secretary of State, in coordination with the Secretary of the Treasury and the Administrator of USAID) provide resources to developing countries to support efforts that reduce the vulnerability and increase the resilience capacities of communities to the effects of climate change, including effects on water availability and health and diseases.

Directs the Secretary of the Treasury to use the influence of the U.S. To ensure that the Green Climate Fund requires country recipients to submit investment plan that describes how adaptation projects will advance public health outcomes, among other things. Incorporates the Women and Climate Change Act.Uyghur Stop Oppressive Sterilizations Act(Uyghur SOS Act)To address state-sanctioned violence against women in the People’s Republic of China, including rape and torture in detention and forced sterilizations, forced abortions, and other coercive birth restriction policies, particularly in the Xinjiang Uyghur Autonomous Region, and for other purposes.5/18/2021H.R. 3306Rep. Vicky HartzlerReferred to HFAC and H.

JudiciaryForced sterilization, abortionStates U.S. Policy is to regard the prevention of genocide and other atrocity crimes as a national interest particularly when those actions target certain groups in the Xinjiang Uyghur Autonomous Region through, among other things, forced sterilizations, forced abortions and other coercive birth restrictions policies, and sexual violence and other torture in detention, to raise the issue of state-sanctioned violence against women, including rape, torture, and coercively enforced population control policies in China in all multilateral organizations where the U.S. And China are members, including at the U.N. Security Council, and to consider state-sanctioned violence against women, including forced sterilizations and forced abortions and the systematic use of rape and torture in mass internment camps in the Region as a gross violation of internationally-recognized human rights. Expresses the Sense of Congress that all governments, including the U.S., and international organizations, such as the U.N., should call the atrocities perpetuated by the government of China, including forced sterilizations and forced abortions and other sexual violence, as genocide and crimes against humanity and that the U.S.

Should strongly condemn the intimidation and threats targeting Uyghur and Kazakh women who provide public evidence of sexual violence and forced sterilizations and forced abortions in mass internment camps and the journalist who report these stories. Also expresses Sense of Congress that U.N. Member states should condemn such atrocities by demanding that China end all forced sterilization, forced abortions, and other state-sanctioned violence against women, among other things. Requires the president to submit a strategy for ending atrocity crimes in the Region. Requires the Secretary of State to provide all appropriate assistance to women who belong to certain groups and who experienced sexual violence, torture, forced sterilizations and forced abortions in China in order for them to receive needed medical care and psychological support.

Requires all existing authorities to be used to allow such women to at least temporarily enter the U.S.Women and Climate Change Act of 2021To address the disparate impact of climate change on women and support the efforts of women globally to address climate change, and for other purposes.1/11/2021H.R. 260Rep. Barbara Lee (D-CA-13)Referred to HFAC, H. Energy &. CommerceClimate change, global health, reproductive healthAddresses climate change and its effects on women and girls.

Establishes the Federal Interagency Working Group on Women and Climate Change within the Department of State and outlines its functions, such as identifying best practices for collecting data on the disparate impact of climate change on women – including in access to comprehensive health care, including reproductive health and rights. Requires the Department of State’s Office of Global Women’s Issues (GWI) to submit a strategy (and shortly thereafter an implementation plan and budget) to prevent and respond to the effects of climate change on women, including effective action to promote public health. Requires the Ambassador-at-Large of GWI to designate a Senior Coordinator for Women and Climate Change. Requires the GWI Ambassador and the Senior Coordinator to submit to the appropriate congressional committees an assessment of the human and financial resources necessary to carry out the Act.World Health Organization Accountability ActTo prohibit the availability of United States contributions to the World Health Organization until Congress receives a full report on China and the buy antibiotics–19 amoxil, and for other purposes.1/21/2021H.R. 374Rep.

Lauren Boebert (R-CO-3)Referred to HFACWHO, buy antibioticsProhibits the use of federal funds for U.S. Contributions to WHO or U.S. Participation in any of the activities of WHO until the Secretary of State and HHS Secretary jointly submit a report to Congress describing the manner and extent to which the handling of the buy antibiotics outbreak prior to March 11, 2020, by WHO and China contributed to the emergency of the amoxil.NOTES. SFRC means Senate Committee on Foreign Relations. HFAC means the House Committee on Foreign Affairs.

H. Means House. S. Means Senate. SFOPS means Department of State, foreign operations, and related programs.

LGBTI means lesbian, gay, bisexual, transgender, or intersex. WHO is the World Health Organization. ASEAN is the Association of Southeast Asian Nations. * Other than those that apply to U.S. NGOs receiving certain foreign aid under the Foreign Assistance Act.The Henry J.

Kaiser Family Foundation Headquarters. 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 Washington Offices and Barbara Jordan Conference Center. 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270 www.kff.org | Email Alerts. Kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California..

Global Health Legislation During the amoxil capsule 500mg price in canada 117th Congress(as of Oct where can i buy amoxil over the counter. 5, 2021)TitleDate IntroducedBill #SponsorStatusTopicSummary of Global Health-Related ProvisionsAbortion is Health Care Everywhere Act of 2021To amend the Foreign Assistance Act of 1961 to authorize the use of funds for comprehensive reproductive health care services, and for other purposes.3/9/2021H.R. 1670Rep. Janice Schakowsky (D-IL-9)Referred to HFACAbortion, Helms amendmentIncludes statement of U.S. Policy regarding safe abortion and working to end unsafe abortion.

Repeals the Helms Amendment (which prohibits the use of foreign assistance to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion). States that notwithstanding any other provision of law, certain funds may be used to provide comprehensive reproductive health care services, including abortion services, training, and equipment.Advancing Emergency Preparedness Through One Health Act of 2021To establish an interagency One Health Program, and for other purposes.3/18/2021S. 861Sen. Tina Smith (D-MN)Read twice and referred to S. HELPOne Health, global health securityRequires the heads of HHS, USDA, USAID, DoD, and certain other agencies to develop, publish, and submit to Congress a national One Health Framework for coordinated federal activities under the One Health Program not later than one year after enactment.

Among other things, states the framework must describe existing efforts and contain recommendations for building upon and complementing the activities of the CDC, the FDA, USAID, NIH, and certain others and also establish specific federal goals and priorities and describe specific activities required to achieve these. Requires the submission of an addendum to the framework not later than three years after its original submission, describing progress in advancing these activities. Authorizes to be appropriated such sums as necessary to develop the framework above. Requires GAO to submit a report to Congress not later than two years after the addendum is submitted, detailing existing collaborative efforts among certain agencies for this purpose and containing an evaluation of the framework and its specified activities.American Medical Investment Generating Overseas Security Act(AMIGOS Act)To prohibit the President from taking any action to support the waiver of obligations of members of the World Trade Organization under the Agreement on Trade-Related Aspects of Intellectual Property Rights in relation to the prevention, containment, mitigation, or treatment of buy antibiotics–19 unless a statute is enacted expressly authorizing such a waiver with respect to the prevention, containment, mitigation, or treatment of buy antibiotics–19, and for other purposes.5/14/2021H.R. 3236Maria Elvira Salazar (R-FL-27)Referred to HFAC and H.

Ways and MeansTRIPS, WTO, intellectual property rights, buy antibiotics treatmentsStates the President may not take any action to support waiver of obligations of WRO members under the TRIPS agreement in relation to the prevention, containment, mitigation, or treatment of buy antibiotics unless a statute is enacted expressly authorizing such a waiver with respect to such. Requires the President to allocate excess U.S. buy antibiotics treatments in a specified order of priority, with certain exceptions, and to monitor the allocation of such to ensure assisted governments provide treatments to their peoples in a timely manner and do not otherwise withhold them. Requires such treatments provided to foreign countries to be marked as assistance from the American people or the U.S. Government and to include a depiction of the flag of the U.S.

If appropriate.American Rescue Plan Act of 2021To provide for reconciliation pursuant to title II of S. Con. Res. 5.2/24/2021H.R. 1319Rep.

John Yarmuth (D-KY-3)Became law (P.L. 117-2)buy antibiotics, Global FundSee KFF summary.American Values ActTo permanently enact certain appropriations Act restrictions on the use of funds for abortions and involuntary sterilizations, and for other purposes.2/4/2021S. 239Sen. James Risch (R-ID)Read twice and referred to SFRCAbortion, involuntary sterilization amendment, Siljander amendment, Kemp-Kasten amendment, Peace Corps provision, Helms amendment, Biden amendmentAmends the Foreign Assistance Act of 1961 to codify in permanent law the Siljander amendment, which prohibits the use of funds to lobby for or against abortion, and the Kemp-Kasten amendment, which prohibits funding any organization or program, as determined by the President, that supports or participates in the management of a program of coercive abortion or involuntary sterilization. Restates the Helms amendment, the Involuntary Sterilization amendment (which prohibits the use of funds to pay for involuntary sterilizations as a method of family planning or to coerce or provide a financial incentive to anyone to undergo sterilization), and the Biden amendment (which states that funds may not be used for biomedical research related to methods of or the performance of abortion or involuntary sterilization as a means of family planning) that are already in permanent law.

Also amends the Peace Corps Act to codify in permanent law the Peace Corps provision, which prohibits Peace Corps funding from paying for an abortion for a Peace Corps volunteer or trainee, except in cases where the life of the woman is endangered by pregnancy or in cases of rape or incest. In the past these have been included only in annual State-Foreign Operations appropriations language. See also the KFF fact sheet on FP/RH statutory requirements and policies and the KFF explainer on UNFPA funding and Kemp-Kasten.Binational Health Strategies Act of 2021To amend the United States-Mexico Border Health Commission Act, with respect to preparedness for buy antibiotics–19 and other infectious diseases in the border region, and for other purposes.3/03/2021H.R. 1538Rep.. Veronica Escobar (D-TX-16)Referred to H.

Energy and HFACMexicoAuthorizes and directs the President to seek to begin negotiations with Mexico to amend an existing agreement addressing infectious disease preparedness in the U.S.-Mexico Border Area, with respect to buy antibiotics and other infectious diseases, specifically requiring the U.S.-Mexico Border Health Commission to submit a report on the border area’s response to buy antibiotics and requiring it to also develop and publicly publish a binational strategic plan that addresses how the area should strengthen its buy antibiotics response, sharing relevant health data, and how a buy antibiotics treatment should be disbursed throughout the area, among other things. Requires the Commission to publish what actions federal agencies in the U.S. And Mexico will take to facilitate implementation of the strategic plan and then to submit a report on actions taken each year. Requires the Commission to develop and publish a plan to prepare and respond to infectious diseases (other than buy antibiotics) within the border area, to update the plan at least once every three years for as long as necessary, and to publish what actions federal agencies in the U.S. And Mexico will take to facilitate implementation of this plan, with a report on actions taken each year required to be submitted.BLUE Pacific ActTo establish a comprehensive, long-term United States strategy and policy for the Pacific Islands, and for other purposes.5/4/2021H.R.

2967Rep. Ed Case (D-HI-1)Referred to HFAC, H. Ways and Means, H. Natural ResourcesPublic health capacity building, buy antibiotics, gender-based violenceStates U.S. Policy is to develop and commit to a comprehensive, multifaceted, and principled U.S.

Policy in the Pacific Islands that, among other things, assists the Pacific Islands in preventing and containing the spread of the buy antibiotics amoxil. Requires the USAID Administrator, in coordination with the Secretary of States, to develop and implement a strategy to assist the Pacific Islands in improving public health outcomes and building public health capacity, including in response to the buy antibiotics amoxil. Requires the strategy include programming to address maternal and child health, family planning and reproductive health, gender-based violence, food security and nutrition, NCDs, NTDs, tuberculosis, HIV/AIDS, STDs, and zoonotic and emerging infectious disease threats, clean water, sanitation, and hygiene (WASH), health system strengthening, and other activities. Requires a report not later than 180 days after enactment with strategy. Authorizes to be appropriated $20 million for each FY22-FY26 to carry out these efforts.

Requires the Secretary of State and USAID Administrator to develop and implement an initiative to encourage and support efforts by the Pacific Island to reduce and combat gender-based violence.Climate Change Health Protection and Promotion Act of 2021To direct the Secretary of Health and Human Services to develop and implement a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.5/17/2021H.R. 3271Rep. Matt Cartwright (D-PA-8)Referred to H. Energy and CommerceClimate change, global healthDirects Secretary of HHS to publish a strategic action plan and establish a climate change and health program (at CDC, in collaboration with other agencies, as appropriate) to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the U.S. And other nations.

Requires the action plan include an assessment of U.S. Capacity to address climate change including, among other things, providing technical assistance and support for preparedness and response plans for the health threats of climate change in developing countries, and developing or strengthening domestic and international disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change. Describes priority health actions for the climate and health program, including with regard to global health aspects of climate change. Requires periodic updates of action plan. Establishes science advisory board and its functions, including with regarding to international impacts of climate change on health.

And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Climate Change Health Protection and Promotion Act of 2021To direct the Secretary of Health and Human Services to develop and implement a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.5/19/2021S. 1702Sen. Edward Markey (D-MA)Read twice and referred to S. HELPClimate change, global healthDirects Secretary of HHS to publish a strategic action plan and establish a climate change and health program (at CDC, in collaboration with other agencies, as appropriate) to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the U.S. And other nations.

Requires the action plan include an assessment of U.S. Capacity to address climate change including, among other things, providing technical assistance and support for preparedness and response plans for the health threats of climate change in developing countries, and developing or strengthening domestic and international disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change. Describes priority health actions for the climate and health program, including with regard to global health aspects of climate change. Requires periodic updates of action plan. Establishes science advisory board and its functions, including with regarding to international impacts of climate change on health.

And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Curbing China’s treatment Diplomacy ActTo prioritize the international distribution of buy antibiotics treatment doses, and for other purposes.7/6/2021H.R.4362Rep. Carlos Gimenez (R-FL-26)Referred to HFACbuy antibiotics, treatmentsRequires the Secretary of States to prioritize, in carrying out the international distribution of buy antibiotics treatment doses, distribution to Taiwan and crucial Latin American allies, subject first to Administration certification to Congress that it has determined all Americans have been afforded ample opportunity to be fully vaccinated against buy antibiotics. Requires the Secretary to ensure that not less than 25% of the total number of buy antibiotics treatment doses intended for international distribution are reserved for and distributed to Taiwan and crucial Latin American allies and states the Secretary may not distribute any doses to other recipients or countries until the above have each received at least a first shipment of their reserved doses. States the Secretary may not distribute buy antibiotics treatment doses to any country which has a government that has been determined to have engaged in systemic or widespread human rights abuses. Terminates five days after the date on which the Secretary determines the above have each achieved 40% vaccination rates of their respective populations.Department of State, Foreign Operations, and Related Programs Appropriations Act, 2022(State/Foreign Ops – SFOPS Approps)Making appropriations for the Department of State, foreign operations, and related programs for the fiscal year ending September 30, 2022, and for other purposes.7/6/2021H.R.

4373Rep. Barbara Lee (D-CA-13)Passed House, received in the SenateAppropriationsSee KFF summary. Includes the text of the Global Health, Empowerment, and Rights (Global HER) Act (H.R. 556), which codifies prohibition of the expanded Mexico City policy (rescinded by President Biden in Jan. 2021, see KFF explainer).

Global Autism ActTo establish a Global Autism Assistance Program.6/24/2021H.R. 4160Rep. Christopher Smith (R-NJ-4)Referred to HFACAutismEstablishes a health and education grant program known as the Global Autism Assistance Program at USAID to support activities focused on autism spectrum disorder (ASD) in developing countries and to establish a program, known as Train the Trainers, to train health and education professionals working with children with ASD in developing countries. Outlines designation of eligible regions and selection of implementing NGO and activities it may carry out with the grant. Requires the implementing NGO to establish a Project Advisory Board to review local applications for content and appropriateness.

To carry out this program, requires the USAID Administrator to allocate amounts that have been appropriated or otherwise made available to USAID. Requires an annual report on activities.Global Health, Empowerment and Rights Act(Global HER Act) To prohibit the application of certain restrictive eligibility requirements to foreign nongovernmental organizations with respect to the provision of assistance under part I of the Foreign Assistance Act of 1961.1/28/2021H.R. 556Rep. Barbara Lee (D-CA-13)Referred to HFACAbortion, Mexico City policyCodifies prohibition of the expanded Mexico City policy (rescinded by President Biden in Jan. 2021, see KFF explainer).

States that notwithstanding any provision of law, regulation, or policy, foreign non-governmental organizations (NGOs) shall not be ineligible for certain foreign aid under the Foreign Assistance Act solely on the basis of health or medical services provided with non-U.S. Funds (insofar as legal in country where provided and under U.S. Law) and shall not be subject to requirements relating to their use of non-U.S. Funds for advocacy and lobbying activities.*Global Health, Empowerment and Rights Act(Global HER Act) To prohibit the application of certain restrictive eligibility requirements to foreign nongovernmental organizations with respect to the provision of assistance under part I of the Foreign Assistance Act of 1961.1/28/2021S. 142Sen.

Jeanne Shaheen (D-NH)Read twice and referred to SFRCAbortion, Mexico City policyCodifies prohibition of the expanded Mexico City policy (rescinded by President Biden in Jan. 2021, see KFF explainer). States that notwithstanding any provision of law, regulation, or policy, foreign non-governmental organizations (NGOs) shall not be ineligible for certain foreign aid under the Foreign Assistance Act solely on the basis of health or medical services provided with non-U.S. Funds (insofar as legal in country where provided and under U.S. Law) and shall not be subject to requirements relating to their use of non-U.S.

Funds for advocacy and lobbying activities.*Global Health Security Act of 2021To authorize a comprehensive, strategic approach for United States foreign assistance to developing countries to strengthen global health security, and for other purposes.1/21/2021H.R. 391Rep. Gerald Connolly (D-VA-11)Passed House, read twice and referred to SFRCGlobal health security, global health emergenciesStates it is U.S. Policy to promote and invest in global health security and amoxil preparedness as a core national security interest. Establishes a Global Health Security Agenda Interagency Review Council, designates members, responsibilities, and frequency of meetings.

Designates a U.S. Coordinator for Global Health Security responsible for coordination of the interagency process for responding to global health security emergencies. Express Sense of Congress that the President should consider appointing an individual with significant background and expertise in public health or emergency response management to such position. Requires a U.S. Global health security strategy, its implementation (including agency-specific plans), and an annual report on status of implementation.

Directs the Secretary of State, Treasury Secretary, USAID Administrator, and HHS Secretary, among others, to seek to enter into negotiations with donors, relevant U.N. Agencies (including WHO), and other stakeholders to establish a fund for global health security and amoxil preparedness as a multilateral, catalytic financing mechanism. Describes Fund’s Advisory Board, purpose, Executive Board and its makeup and duties. Creates a Coordinator of U.S. Government activities to advance global health security, who shall be appointed by the President to represent the U.S.

On the Executive Board. Outlines eligible partner country definition and Fund program objectives, supported activities, administration, including appointment of an Administrator appointed by the Executive Board, and transparency and accountability requirements. Requires reports to Congress on the Fund including a 6 month status report and then annual reports after the Fund’s establishment. And authorizes U.S. Contributions to the Fund with a limit that the U.S.

Share not exceed 33% of total contributions to the Fund cumulatively.Global Malnutrition Prevention and Treatment Act of 2021To advance targeted and evidence-based interventions for the prevention and treatment of global malnutrition and to improve the coordination of such programs, and for other purposes.07/26/2021H.R. 4693Rep. Michael McCaul (R-TX-10)Passed HFAC (Ordered to be Reported by Voice Vote)MalnutritionAuthorizes the USAID Administrator to support efforts to prevent and treat malnutrition globally, including by targeting resources and nutrition interventions to support the most vulnerable populations susceptible to severe malnutrition, including children under the age of 5 and pregnant and lactating women. Directs the Administrator and others to coordinate with bilateral and multilateral donors, governments of partner countries, U.N. Agencies, and others to prevent and treat malnutrition globally.

Requires the Administrator and others to seek to leverage additional resources to this end by increasing interagency cooperation among relevant departments and agencies represented in the Global Nutrition Coordination Plan. Requires the selection of priority countries and outlines criteria. Express Sense of Congress that efforts to undertake nutrition interventions in countries not selected as priority countries should continue. Authorizes the establishment of the Nutrition Leadership Council within USAID and outlines its duties and membership. Requires the development of an implementation plan.

Requires an annual progress report for five years.Global amoxil Prevention and Biosecurity ActTo establish a global zoonotic disease task force, and for other purposes. 5/20/2021H.R. 3424Rep. Grace Meng (D-NY-6)Referred to HFACamoxil, zoonotic diseases, One Health, global health security, biosecurityRequires the Secretary of State and USAID Administrator to work with certain relevant agency heads to coordinate, work with, and engage governments, multilateral entities, and certain others to prevent zoonotic spillover events through various actions such as addressing the commercial trade in wildlife, strengthening global capacity for detection of zoonotic diseases with amoxil potential, and supporting the development of One Health systems at the community level. Establishes the global zoonotic disease task force and outlines its membership and their terms, duties (including developing and publishing a plan for global biosecurity and zoonotic disease prevention and response and expanding the scope of the global health security strategy to more robustly support the prevention of zoonotic spillover and to respond to zoonotic disease investigations and outbreaks by establishing a 10 year strategy), required reports from agencies to the task force as well as from the task force to Congress, and its termination date 7 years after the date of enactment or a later date that is not later than two years after that.Global amoxil Prevention and Biosecurity ActTo establish a global zoonotic disease task force, and for other purposes.

5/20/2021S.1737Sen. Chris Coons (D-DE)Read twice and referred to SFRCamoxil, zoonotic diseases, One Health, global health security,biosecurityRequires the Secretary of State and USAID Administrator to work with certain relevant agency heads to coordinate, work with, and engage governments, multilateral entities, and certain others to prevent zoonotic spillover events through various actions such as addressing the commercial trade in wildlife, strengthening global capacity for detection of zoonotic diseases with amoxil potential, and supporting the development of One Health systems at the community level. Establishes the global zoonotic disease task force and outlines its membership and their terms, duties (including developing and publishing a plan for global biosecurity and zoonotic disease prevention and response and expanding the scope of the global health security strategy to more robustly support the prevention of zoonotic spillover and to respond to zoonotic disease investigations and outbreaks by establishing a 10 year strategy), required reports from agencies to the task force as well as from the task force to Congress, and its termination date 7 years after the date of enactment or a later date that is not later than two years after that.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes. 6/9/2021S. 1996Sen.

Edward Markey (D-MA)Read twice and referred to SFRCLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S. Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community.

And expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes. 6/8/2021H.R. 3800Rep. Dina Titus (D-NV-1)Referred to HFAC, H.

JudiciaryLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S. Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community.

Expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination. And repeals the Mexico City policy by removing certain limitations on eligibility for foreign assistance.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021H.R. 3373Rep. Ami Bera (D-CA-7)Referred to HFAC, H.

Veterans’ Affairs, H. Natural Resources, H. Armed Services, H. Financial Services, H. Judiciary, H.

Transportation and Infrastructure, H. Homeland SecurityPublic health capacity building, global health securityStates it is U.S. Policy to, among other things, improve the local capacity of the countries of Oceania to address public health challenges and improve global health security. Requires the Secretary of State, in consultation with the HHS Secretary, to establish a program to support building public health capacity and improving access to care and local health outcomes in Oceania related to maternal and child health, STDs, HIV/AIDS, tuberculosis, malaria, NTDs, NCDs, gender-based violence, substance use disorder, mortality due to epidemics, disasters, and the impacts from severe weather and environmental change, and other health issues. Requires a report on these efforts annually.

Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021S. 1774Sen. Brian Schatz (D-HI)Read twice and referred to SFRCPublic health capacity building, global health securityStates it is U.S. Policy to, among other things, improve the local capacity of the countries of Oceania to address public health challenges and improve global health security.

Requires the Secretary of State, in consultation with the HHS Secretary, to establish a program to support building public health capacity and improving access to care and local health outcomes in Oceania related to maternal and child health, STDs, HIV/AIDS, tuberculosis, malaria, NTDs, NCDs, gender-based violence, substance use disorder, mortality due to epidemics, disasters, and the impacts from severe weather and environmental change, and other health issues. Requires a report on these efforts annually. Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.International Human Rights Defense Act of 2021To establish in the Bureau of Democracy, Human Rights, and Labor of the Department of State a Special Envoy for the Human Rights of LGBTI Peoples, and for other purposes.2/22/2021H.R. 1201Rep.

Alan Lowenthal (D-CA-47)Referred to HFACLGBTI health, HIVIncludes statement of U.S. Policy regarding LGBTI issues globally, including employing a multisectoral approach to preventing and responding to criminalization, discrimination, and violence against LGBTI people internationally, including activities in the health sector. Authorizes the provision of U.S. Assistance to prevent and respond to these issues internationally, including enhancement of health sector capacity related to violence against LGBTI people and communities and to combat HIV.International Human Rights Defense Act of 2021To establish in the Bureau of Democracy, Human Rights, and Labor of the Department of State a Special Envoy for the Human Rights of LGBTI Peoples, and for other purposes.2/24/2021S. 424Sen.

Edward Markey (D-MA)Read twice and referred to SFRCLGBTI health, HIVIncludes statement of U.S. Policy regarding LGBTI issues globally, including employing a multisectoral approach to preventing and responding to criminalization, discrimination, and violence against LGBTI people internationally, including activities in the health sector. Authorizes the provision of U.S. Assistance to prevent and respond to these issues internationally, including enhancement of health sector capacity related to violence against LGBTI people and communities and to combat HIV.International amoxil Preparedness and buy antibiotics Response Act of 2021To improve global health, and for other purposes.6/24/2021S. 2297Sen.

James Risch (R-ID)Placed on Senate Legislative Calendar under General Ordersamoxil preparedness, buy antibiotics, treatments, WHO, health systems strengthening, CEPI, global health security, Global Fund to Fight AIDS, Tuberculosis and malariaRequires a report describing certain foreign assistance obligated/expended under the American Rescue Plan Act of 2021 and a plan for certain remaining funds. Requires development of a strategy to expand access to, and accelerate the global distribution of, buy antibiotics treatments to other countries. Requires a report that assesses the global humanitarian response to buy antibiotics and outlines specific elements of the U.S. Government’s country-level response to the buy antibiotics amoxil. In the event of an infectious disease outbreak outside the U.S.

With amoxil potential, states the President should designate the Department of State to serve as the lead for diplomatic engagement and related foreign policy efforts, USAID to serve as the key lead agency for design and implementation of the U.S. International response, relief, and recovery assistance, and the CDC to serve as the public health lead for the international response such as building up (in coordination with USAID) emergency operation centers. Allows certain foreign assistance funding to be used to support USAID disaster surge capacity. Requires a U.S. Global health security strategy and report.

Authorizes to be established a committee on global health security and amoxil and biological threats within the National Security Council (NSC) led by the Special Advisor for Global Health Security of the NSC. Within the Department of State, establishes a Special Representative for U.S. International activities to advance global health security and diplomacy overseas, to be appointed by the President and report to the Secretary of State and to lead in developing a global amoxil prevention, preparedness and response framework. Authorizes the Representative to transfer and allocate certain U.S. Foreign assistance funding to the relevant departments and agencies implementing the U.S.

Global health security strategy. Authorizes to be appropriated $3 billion for the five-year period beginning Oct. 1, 2022, to support enhancing preparedness in partner countries, replenishing the USAID Emergency Reserve Fund, U.S. Contributions to the World Bank Health Emergency Preparedness and Response Multi-Donor Fund, and U.S. Contributions to a new multilateral, catalytic financing mechanism for global health security and amoxil prevention and preparedness (see “the Fund” below).

Requires U.S. Global health program leadership identify areas of collaboration and coordination to ensure that such activities contribute to health systems strengthening. Directs the Secretary of State, with the USAID Administrator, to work with the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the treatment Alliance, bilateral donors, and others to develop shared core indicators for strengthened health systems. Authorizes the U.S. To participate in the Coalition for Epidemic Preparedness Innovations (CEPI).

Expresses Sense of Congress that the President should make an immediate contribution to CEPI of $300 million to expand research and development of treatments to combat the spread of buy antibiotics variants. Requires an annual National Intelligence Estimate (for five years) regarding the risks posed to the national security interests of the U.S. By the emergence, reemergence, and overseas transmission of pathogens with amoxil potential. Requires the Secretary of State and others to work with WHO and other key stakeholders to establish or strengthen effective early warning systems for infectious disease threats with epidemic and amoxil potential. Directs the Secretary of State, with the HHS Secretary, to work with WHO and like-minded member states to adopt an approach toward assessing infectious disease threats under the International Health Regulations (2005) for the WHO to identify and transparently communicate on an ongoing basis varying levels of risk leading up to, and during and after, a public health emergency of international concern (PHEIC) declaration.

Directs the Secretary of State and others to seek to enter into negotiations to establish “the Fund;” authorizes the President to make available for U.S. Contributions to the Fund such funds as may be appropriated or otherwise made available for such purpose. Limits the U.S. Contribution to the Fund to not exceed 33% of the total contributions from all sources.Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022(FY22 Consolidated Appropriations Act)Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2022, and for other purposes.7/19/2021H.R. 4502Rep.

Rosa DeLauro (D-CT-3)Passed House, received in the SenateAppropriationsSee KFF summary.Mental Health in International Development and Humanitarian Settings Act(MINDS Act)To enhance mental health and psychosocial support within United States foreign assistance programs.6/17/2021H.R. 3988Rep. Theodore Deutch (D-FL-22)Referred to HFACMental health, children in adversity, buy antibioticsExpresses Sense of Congress that mental health is integral and essential to overall health outcomes and other development objectives. Codifies the position of USAID coordinator for mental health and psychosocial support and describes the position’s duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Group’s duties and members.

States U.S. Policy is to integrate mental health and psychosocial support across all foreign assistance programs funded by the U.S.. Requires USAID and the Department of State regional bureaus and missions to utilize such policy for local capacity building, as appropriate and that such programming be evidence-based and culturally competent and respond to the specific needs of children in adversity. Requires USAID to brief Congress on progress and challenges to implementation, including programming in conflict and humanitarian settings, as well as the impact of buy antibiotics on programming. Requires the USAID Administrator in consultation with the OMB Director to brief Congress annually for five years (FY22 – FY26) on spending for this programming in U.S.

Foreign assistance.Mental Health in International Development and Humanitarian Settings Act(MINDS Act)To enhance mental health and psychosocial support within United States foreign assistance programs.6/17/2021S. 2105Sen. Robert Casey (D-PA)Read twice and referred to SFRCMental health, children in adversity, buy antibioticsExpresses Sense of Congress that mental health is integral and essential to overall health outcomes and other development objectives. Codifies the position of USAID coordinator for mental health and psychosocial support and describes the position’s duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Group’s duties and members.

States U.S. Policy is to integrate mental health and psychosocial support across all foreign assistance programs funded by the U.S.. Requires USAID and the Department of State regional bureaus and missions to utilize such policy for local capacity building, as appropriate and that such programming be evidence-based and culturally competent and respond to the specific needs of children in adversity. Requires USAID to brief Congress on progress and challenges to implementation, including programming in conflict and humanitarian settings, as well as the impact of buy antibiotics on programming. Requires the USAID Administrator in consultation with the OMB Director to brief Congress annually for five years (FY22 – FY26) on spending for this programming in U.S.

Foreign assistance.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act)To establish a program to oversee the global buy antibiotics response and prepare for future amoxils, and for other purposes.6/8/2021H.R. 3778Rep. Raja Krishnamoorthi (D-IL-8)Referred to HFAC and H. Energy and Commercebuy antibiotics, global health security, amoxil preparedness and responseEstablishes the amoxil preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics amoxil and protect Americans from the emergence of buy antibiotics variants and other pathogens with amoxil potential.

Require President to appoint program director who will coordinate the work of identified agencies, including USAID, CDC, and the Department of State, among others. Requires development of a comprehensive strategy to end the buy antibiotics amoxil worldwide as well as a long-term strategy for preventing future amoxils. Authorizes to be appropriated $34 billion for these efforts, and expresses Sense of Congress that $25 billion be made available to scale treatment manufacturing capacity and produce treatments, $8.5 billion to cover the cost of end-to-end delivery and administration of treatments in target countries, and $500 million to establish a global disease surveillance network to protect against future amoxils. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S.

treatment stockpile to determine whether further treatments can be sent abroad and to coordinate with BARDA to rapidly scale manufacturing capacity around the world to produce 8 billion treatment doses as soon as possible. Also requires director to ensure equitable access to treatments in collaboration with COVAX and to work with international partners to provide enough treatments to lower- and middle-income countries to fully vaccinate at least 60% of their respective populations, especially 92 countries identified by COVAX as being most in need of assistance. Requires the program to, among other things, build on PEPFAR and other existing U.S. Programs and relationships bilaterally and multilaterally. Express Sense of Congress that in the face of a global health emergency, the U.S.

Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act) To establish a program to oversee the global buy antibiotics response and prepare for future amoxils, and for other purposes.6/8/2021S. 1976Sen. Jeff Merkley (D-OR)Read twice and referred to SFRCbuy antibiotics, global health security, amoxil preparedness and responseEstablishes the amoxil preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics amoxil and protect Americans from the emergence of buy antibiotics variants and other pathogens with amoxil potential. Require President to appoint program director who will coordinate the work of identified agencies, including USAID, CDC, and the Department of State, among others.

Requires development of a comprehensive strategy to end the buy antibiotics amoxil worldwide as well as a long-term strategy for preventing future amoxils. Authorizes to be appropriated $34 billion for these efforts, and expresses Sense of Congress that $25 billion be made available to scale treatment manufacturing capacity and produce treatments, $8.5 billion to cover the cost of end-to-end delivery and administration of treatments in target countries, and $500 million to establish a global disease surveillance network to protect against future amoxils. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S. treatment stockpile to determine whether further treatments can be sent abroad and to coordinate with BARDA to rapidly scale manufacturing capacity around the world to produce 8 billion treatment doses as soon as possible.

Also requires director to ensure equitable access to treatments in collaboration with COVAX and to work with international partners to provide enough treatments to lower- and middle-income countries to fully vaccinate at least 60% of their respective populations, especially 92 countries identified by COVAX as being most in need of assistance. Requires the program to, among other things, build on PEPFAR and other existing U.S. Programs and relationships bilaterally and multilaterally. Express Sense of Congress that in the face of a global health emergency, the U.S. Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Preventing Foreign Attempts To Erode Healthcare Innovation ActTo prohibit the use of funds to support a measure at the World Trade Organization waiving intellectual property rights, and for other purposes.5/18/2021S.

1683Sen. Tim Scott (R-SC)Read twice and referred to S. FinanceTRIPS, WTO, intellectual property rights, buy antibiotics treatmentsExpresses Sense of Congress that U.S. Should continue to promote strong international [sic] property rights internationally and that it is in the national interest of the U.S. To oppose efforts to transfer U.S.

Intellectual property and technology to China or other countries seeking to profit off U.S. Investments. Prohibits use of funds to support, allow, or facilitate the negotiation or approval of the TRIPS waiver for the prevention, containment, and treatment of buy antibiotics proposed by India and South Africa or any other measure at the WTO to waive intellectual property rights.Preventing Future amoxils Act of 2021To address the public health risks posed by wildlife markets, and for other purposes.1/4/2021H.R. 151Rep. Mike Quigley (D-IL-5)Referred to HFAC, H.

Energy and Commerce, H. Judiciary, H. Ways and Means, H. Financial Services, H. Natural ResourcesGlobal health security, One Health, zoonotic diseasesRequires the HHS Secretary to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine for it to conduct a study on the risk of wildlife markets on the emergency of novel viral pathogens, to be submitted not later than one year after the date of agreement.

Expresses Sense of Congress that global institutions, including WHO, and others including USAID should promote the paradigm of One Health. States U.S. Policy is to facilitate international cooperation to close high risk wildlife markets around that world and to work to develop agreements and protocols to close these markets. Allows the President to impose sanctions on any country (or nationals of a country) continuing to license or enable commercial wildlife markets or engaged in certain activities. Authorizes FY 2021 – FY 2030 funding for USAID activities related to sustainable food systems.

Requires the USAID administrator to increase activities related to biodiversity, global health, and resilience, among other things, in order to address the threats and causes of zoonotic disease outbreaks.. Requires reporting from the Department of State and USAID describing these efforts.Preventing Future amoxils Act of 2021To address the public health risks posed by wildlife markets, and for other purposes.1/25/2021S. 37Sen. John Cornyn (R-TX)Read twice and referred to SFRCGlobal health security, One Health, zoonotic diseasesRequires the HHS Secretary to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine for it to conduct a study on the risk of wildlife markets on the emergency of novel viral pathogens, to be submitted not later than one year after the date of agreement. Expresses Sense of Congress that global institutions, including WHO, and others including USAID should promote the paradigm of One Health.

States U.S. Policy is to facilitate international cooperation to close high risk wildlife markets around that world and to work to develop agreements and protocols to close these markets. Allows the President to impose sanctions on any country (or nationals of a country) continuing to license or enable commercial wildlife markets or engaged in certain activities. Authorizes FY 2021 – FY 2030 funding for USAID activities related to sustainable food systems. Requires the USAID administrator to increase activities related to biodiversity, global health, and resilience, among other things, in order to address the threats and causes of zoonotic disease outbreaks..

Requires reporting from the Department of State and USAID describing these efforts.Protecting Life in Foreign Assistance ActTo restrict the availability of Federal funds to organizations associated with the abortion industry.1/28/2021H.R. 534Rep. Virginia Foxx (R-NC-5)Referred to HFACAbortion, Mexico City policyCodifies the expanded Mexico City policy (rescinded by President Biden in Jan. 2021. See KFF explainer) and expands it to apply more broadly to federal funding made available for purposes outside of the U.S.

To 1) any foreign nonprofit organization, foreign nongovernmental organization, foreign multilateral organization, or foreign quasi-autonomous nongovernmental organization that carries out certain activities, and 2) any domestic nonprofit organization or domestic nongovernmental organization that carries out certain activities.Protecting Life in Foreign Assistance ActTo restrict the availability of Federal funds to organizations associated with the abortion industry.1/28/2021S. 137Sen. Mike Lee (R-UT)Read twice and referred to SFRCAbortion, Mexico City policyCodifies the expanded Mexico City policy (rescinded by President Biden in Jan. 2021. See KFF explainer) and expands it to apply more broadly to federal funding made available for purposes outside of the U.S.

To 1) any foreign nonprofit organization, foreign nongovernmental organization, foreign multilateral organization, or foreign quasi-autonomous nongovernmental organization that carries out certain activities, and 2) any domestic nonprofit organization or domestic nongovernmental organization that carries out certain activities.Reach Every Mother and Child ActTo amend the Foreign Assistance Act of 1961 to implement policies to end preventable maternal, newborn, and child deaths globally.4/29/2021S. 1451Sen. Susan Collins (R-ME)Read twice and referred to SFRCMaternal health, child healthIncludes statement of U.S. Policy to establish and implement a coordinated, integrated, and comprehensive strategy to end preventable child and maternal deaths and ensure healthy and productive lives. Requires the establishment and implementation of a five-year comprehensive strategy to contribute toward the global goal of ending preventable child and maternal deaths by 2030.

States the President should designate a Child and Maternal Survival Coordinator and describes their duties. Requires an annual report on progress.Reproductive Rights are Human Rights Act of 2021To amend the Foreign Assistance Act of 1961 to require a section on reproductive rights in the Annual Country Reports on Human Rights Practices.5/28/2021H.R. 3576Rep. Katherine Clark (D-MA-5)Referred to HFACState Dept. Annual human rights report, family planning/reproductive health (FP/RH), maternal mortality, abortion, violence against womenAmends existing law to require annual reporting by the Department of State on human rights to include, among other things.

The status of reproductive rights in each country. Description of the rates and causes of pregnancy-related injuries and deaths (including deaths due to unsafe abortions), violence against women, and access to family planning. Requires that civil society and multilateral organizations’ representatives in the U.S. And countries included in such reporting be consulted with during the preparation of annual reporting.Reproductive Rights are Human Rights Act of 2021To amend the Foreign Assistance Act of 1961 to require a section on reproductive rights in the Annual Country Reports on Human Rights Practices.5/26/2021S. 1864Sen.

Robert Menendez (D-NJ)Read twice and referred to SFRCState Dept. Annual human rights report, family planning/reproductive health (FP/RH), maternal mortality, abortion, violence against womenAmends existing law to require annual reporting by the Department of State on human rights to include, among other things. The status of reproductive rights in each country. Description of the rates and causes of pregnancy-related injuries and deaths (including deaths due to unsafe abortions), violence against women, and access to family planning. Requires that civil society and multilateral organizations’ representatives in the U.S.

And countries included in such reporting be consulted with during the preparation of annual reporting.Robust International Response to amoxil ActTo provide support for a robust global response to the buy antibiotics amoxil.2/11/2021H.R. 986Rep. Jesus “Chuy” Garcia (D-IL-4)Referred to H. Financial Servicesbuy antibioticsDirects the Secretary of the Treasury to instruct U.S. Executive Directors at international financial institutions to ensure international financial institution support for a robust international response to the global buy antibiotics amoxil, including to oppose the approval or endorsement of any loan, grant, document, or strategy that would lead to a decrease in health care spending or in any other spending that would impede the ability of any country to prevent or contain the spread of, or treat persons who are or may be infected with, the buy antibiotics amoxil.Securing America From Epidemics Act(SAFE Act) To authorize United States participation in the Coalition for Epidemic Preparedness Innovations, and for other purposes.3/23/2021H.R.

2118Rep. Ami Bera (D-CA-7)Passed House, read twice and referred to SFRCResearch &. Development (R&D), global health security, amoxil, epidemicAuthorizes U.S. Participation in the Coalition for Epidemic Preparedness Innovation (CEPI). Reports to Congress required to be submitted by the President not later than 180 days after enactment of the Act and to outline planned U.S.

Contributions to CEPI, the manner and extent to which the U.S. Will participate in the governance of CEPI, and how participation in CEPI supports relevant U.S. Strategies and programs in health security and biodefense, among other things. Authorizes certain appropriated funding to be made available for U.S. Contributions to CEPI.Strategic Competition Act of 2021To address issues involving the People’s Republic of China.

4/15/2021S. 1169Sen. Robert Menendez (D-NJ)Placed on Senate Legislative Calendar under General Ordersbuy antibiotics, health cooperation, WHO, global health security, abortion, forced sterilization, debt reliefExpresses sense of Congress that the U.S. Government should encourage other foreign governments to use the official and scientific names for the buy antibiotics amoxil. States U.S.

Policy is to deepen cooperation between and among the U.S., Japan, South Korea, the Philippines, Thailand, and Australia, including through scientific and health partnerships. Expresses sense of Congress that recent pledge from the first-ever Quad (Australia, India, Japan, U.S.) leaders meeting on March 12, 2021, to respond to the economic and health impacts of buy antibiotics, including expanding treatment production and equitable access, further advances cooperation among Quad nations. States it is U.S. Policy to stand with the nations of ASEAN as they respond to buy antibiotics and support greater cooperation in building capacity to prepare for and respond to amoxils and other public health challenges. States it is U.S.

Policy to advocate and actively advance Taiwan’s meaningful participation in the World Health Assembly, among other bodies. Requires report on the origins of the buy antibiotics amoxil to be submitted by the Director of National Intelligence, in coordination with the Secretary of State, HHS Secretary, and others, not later than 180 days after enactment. Requires strategies that describe how the U.S. Will enhance cooperation with Canada, the European Union, NATO, and European partner countries in managing relations with China, including detailing diplomatic efforts to work with them to track and counter Chinese attempts to exert influence across the multilateral system, including at WHO. Requires a strategy for countering and limiting Chinese influence in, and access to, the Middle East and North Africa, including efforts to encourage U.S.

Private sector and public-private partnerships in healthcare technology, among other things. States it is U.S. Policy to work with Australia, New Zealand, and Japan to advance shared alliance goals of the Oceania region concerning health, among other things, and to improve the local capacity of the countries of Oceania to address public health challenges and improve global health security. Address the imposition of sanctions with respect to systematic rape, coercive abortion, forced sterilization, or involuntary contraceptive implantation in the Xinjiang Uyghur Autonomous Region. Addresses reporting related to debt relief via the International Development Association (IDA) for certain countries to respond to the buy antibiotics amoxil.Support for Global Financial Institution amoxil Response Act of 2021To support efforts by international financial institutions to provide a robust global response to the buy antibiotics–19 amoxil.1/27/2021S.

67Sen. Richard Durbin (D-IL)Read twice and referred to SFRCbuy antibioticsDirects the Secretary of the Treasury to instruct U.S. Executive Directors at international financial institutions to ensure international financial institution support for a robust international response to the global buy antibiotics amoxil, including to oppose the approval or endorsement of any loan, grant, document, or strategy that would lead to a decrease in health care spending or in any other spending that would impede the ability of any country to prevent or contain the spread of, or treat persons who are or may be infected with, the buy antibiotics amoxil.Support UNFPA Funding ActTo authorize contributions to the United Nations Population Fund, and for other purposes.6/16/2021H.R. 3938Rep. Chrissy Houlahan (D-PA-6)Referred to HFACUNFPA, family planning/reproductive health (FP/RH)Includes statement of U.S.

Policy regarding financial support for UNFPA as a crucial part of U.S. Global health commitment. Authorizes appropriations for five years for an annual contribution to UNFPA to support core functions and programs.To amend the National Security Act of 1947 to require the President to designate an employee of the National Security Council to be responsible for amoxil prevention and response, and for other purposes.2/8/2021S. 290Sen. Edward Markey (D-MA)Read twice and referred to HSGACamoxilRequires the President to designate an employee of the National Security Council to be the permanent coordinator for amoxil prevention and response for the federal government, outlines duties, and grants them authority to represent the U.S.

In bilateral and multilateral discussions and agreements on relevant matters.To direct the Secretary of State to develop a strategy to regain observer status for Taiwan in the World Health Organization, and for other purposes.2/18/2021H.R. 1145Rep. Young Kim (R-CA-39)Passed HFAC (Ordered to be Reported in the Nature of a Substitute by Voice Vote)WHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwan’s participation at WHO’s World Health Assembly as an observer.To direct the Secretary of State to develop a strategy to regain observer status for Taiwan in the World Health Organization, and for other purposes.3/17/2021S. 812Sen. Robert Menendez (D-NJ)Passed Senate, received in House, held at deskWHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwan’s participation at WHO’s World Health Assembly as an observer.To prohibit the use of funds to seek membership in the World Health Organization or to provide assessed or voluntary contributions to the World Health Organization.1/28/2021H.R.

497Rep. Jodey Arrington (R-TX-19)Referred to HFACWHOProhibits the use of federal funds to seek membership by the U.S. In WHO or to provide assessed or voluntary U.S. Contributions to WHO until such time as the President certifies that WHO meets certain conditions, including. WHO has adopted meaningful reforms to ensure that humanitarian assistance is not politicized and is to be provided to those with the most need, WHO is not under the control or significant malign influence of the Chinese Communist party, WHO is not involved in a coverup of the Chinese Communist Party’s response to the buy antibiotics amoxil, WHO grants observer status to Taiwan, WHO does not divert humanitarian or medical supplies to Iran, North Korea, or Syria, and WHO has put in place mechanisms to increase transparency and accountability in its operations and eliminate waste, fraud, and abuse.To rescind 1.3 percent of total defense spending and authorize the same amount for international buy antibiotics treatment production and distribution.9/30/2021H.R.

5461Rep. Mark Pocan (D-WI-2)Referred to HFAC and H. Approps.buy antibiotics, treatmentsAccording to the press release on the bill, it “would remove $9.6 billion in defense spending – 1.3% of the $740.5 billion authorized in the 2021 National Defense Authorization Act – and authorize President Biden to direct the same amount of funding to buy antibiotics treatment production and distribution efforts benefitting the low-income international community.” Full bill text not available yetUnited States Climate Leadership in International Mitigation, Adaptation, and Technology Enhancement Act of 2021(U.S. CLIMATE Act) To restore the United States international leadership on climate change and clean energy, and for other purposes. 4/19/2021S.

1201Sen. Robert Menendez (D-NJ)Read twice and referred to SFRCClimate change, global healthRequires the Secretary of State, in consultation with other relevant agencies, to conduct biennial comprehensive evaluations of present and ongoing disruptions to the global climate system, including the scarcity of global natural resources including fresh water, global food, health, and energy insecurities and conditions that contribute to gender-based violence, among other things. Requires these evaluations to be used by the Secretary of State to inform the development and implementation of a climate security strategy, and to develop and implement plans to account for the impacts of climate change on global human health, fresh water, and marginalized groups. States U.S. Policy is to ensure that the International Climate Change Adaptation, Mitigation, and Security Program (required to be established under the act by the Secretary of State, in coordination with the Secretary of the Treasury and the Administrator of USAID) provide resources to developing countries to support efforts that reduce the vulnerability and increase the resilience capacities of communities to the effects of climate change, including effects on water availability and health and diseases.

Directs the Secretary of the Treasury to use the influence of the U.S. To ensure that the Green Climate Fund requires country recipients to submit investment plan that describes how adaptation projects will advance public health outcomes, among other things. Incorporates the Women and Climate Change Act.Uyghur Stop Oppressive Sterilizations Act(Uyghur SOS Act)To address state-sanctioned violence against women in the People’s Republic of China, including rape and torture in detention and forced sterilizations, forced abortions, and other coercive birth restriction policies, particularly in the Xinjiang Uyghur Autonomous Region, and for other purposes.5/18/2021H.R. 3306Rep. Vicky HartzlerReferred to HFAC and H.

JudiciaryForced sterilization, abortionStates U.S. Policy is to regard the prevention of genocide and other atrocity crimes as a national interest particularly when those actions target certain groups in the Xinjiang Uyghur Autonomous Region through, among other things, forced sterilizations, forced abortions and other coercive birth restrictions policies, and sexual violence and other torture in detention, to raise the issue of state-sanctioned violence against women, including rape, torture, and coercively enforced population control policies in China in all multilateral organizations where the U.S. And China are members, including at the U.N. Security Council, and to consider state-sanctioned violence against women, including forced sterilizations and forced abortions and the systematic use of rape and torture in mass internment camps in the Region as a gross violation of internationally-recognized human rights. Expresses the Sense of Congress that all governments, including the U.S., and international organizations, such as the U.N., should call the atrocities perpetuated by the government of China, including forced sterilizations and forced abortions and other sexual violence, as genocide and crimes against humanity and that the U.S.

Should strongly condemn the intimidation and threats targeting Uyghur and Kazakh women who provide public evidence of sexual violence and forced sterilizations and forced abortions in mass internment camps and the journalist who report these stories. Also expresses Sense of Congress that U.N. Member states should condemn such atrocities by demanding that China end all forced sterilization, forced abortions, and other state-sanctioned violence against women, among other things. Requires the president to submit a strategy for ending atrocity crimes in the Region. Requires the Secretary of State to provide all appropriate assistance to women who belong to certain groups and who experienced sexual violence, torture, forced sterilizations and forced abortions in China in order for them to receive needed medical care and psychological support.

Requires all existing authorities to be used to allow such women to at least temporarily enter the U.S.Women and Climate Change Act of 2021To address the disparate impact of climate change on women and support the efforts of women globally to address climate change, and for other purposes.1/11/2021H.R. 260Rep. Barbara Lee (D-CA-13)Referred to HFAC, H. Energy &. CommerceClimate change, global health, reproductive healthAddresses climate change and its effects on women and girls.

Establishes the Federal Interagency Working Group on Women and Climate Change within the Department of State and outlines its functions, such as identifying best practices for collecting data on the disparate impact of climate change on women – including in access to comprehensive health care, including reproductive health and rights. Requires the Department of State’s Office of Global Women’s Issues (GWI) to submit a strategy (and shortly thereafter an implementation plan and budget) to prevent and respond to the effects of climate change on women, including effective action to promote public health. Requires the Ambassador-at-Large of GWI to designate a Senior Coordinator for Women and Climate Change. Requires the GWI Ambassador and the Senior Coordinator to submit to the appropriate congressional committees an assessment of the human and financial resources necessary to carry out the Act.World Health Organization Accountability ActTo prohibit the availability of United States contributions to the World Health Organization until Congress receives a full report on China and the buy antibiotics–19 amoxil, and for other purposes.1/21/2021H.R. 374Rep.

Lauren Boebert (R-CO-3)Referred to HFACWHO, buy antibioticsProhibits the use of federal funds for U.S. Contributions to WHO or U.S. Participation in any of the activities of WHO until the Secretary of State and HHS Secretary jointly submit a report to Congress describing the manner and extent to which the handling of the buy antibiotics outbreak prior to March 11, 2020, by WHO and China contributed to the emergency of the amoxil.NOTES. SFRC means Senate Committee on Foreign Relations. HFAC means the House Committee on Foreign Affairs.

H. Means House. S. Means Senate. SFOPS means Department of State, foreign operations, and related programs.

LGBTI means lesbian, gay, bisexual, transgender, or intersex. WHO is the World Health Organization. ASEAN is the Association of Southeast Asian Nations. * Other than those that apply to U.S. NGOs receiving certain foreign aid under the Foreign Assistance Act.The Henry J.

Kaiser Family Foundation Headquarters. 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 Washington Offices and Barbara Jordan Conference Center. 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270 www.kff.org | Email Alerts. Kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California..

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About This how to get amoxil TrackerThis tracker provides the number of confirmed cases and deaths from novel antibiotics by country, the trend in confirmed how to buy amoxil case and death counts by country, and a global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) antibiotics Resource Center’s buy antibiotics Map and the World Health Organization’s (WHO) antibiotics Disease (buy antibiotics-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About buy antibiotics antibioticsIn late 2019, a new antibiotics emerged in central China to cause disease in how to buy amoxil humans. Cases of this disease, known as buy antibiotics, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the amoxil represents a public health how to buy amoxil emergency of international concern, and on January 31, 2020, the U.S.

Department of Health and Human Services declared it to be a health emergency for the United States.The Biden administration has inherited PEPFAR at a critical time for the program and the fight against HIV, and PEPFAR is at a turning point. Much has changed since the program was created in 2003, including important shifts in global HIV burden, a substantial expansion of the array how to buy amoxil of validated HIV prevention and treatment tools, and notable changes in the global health and development landscape. In addition, the program awaits the nomination by the President of a new Coordinator, is preparing a new five-year, Congressionally-mandated strategy, and, in two years, is due to be reauthorized by Congress. At the same time, the fight against HIV/AIDS is far from over and the buy antibiotics amoxil has presented new health and how to buy amoxil economic challenges for PEPFAR countries.This policy brief explores key issues and poses questions regarding PEPFAR’s future, providing a roadmap for the major decisions ahead for the program. It identifies eight key, interrelated issues facing the administration, Congress, and other PEPFAR stakeholders, as follows:Addressing the short- and long-term impacts of buy antibiotics on PEPFAR and the HIV response.

buy antibiotics continues to have profound health how to buy amoxil and economic effects in the countries that receive PEPFAR support and there is uncertainty about the future. While early actions by PEPFAR appear to have helped minimize treatment disruptions, buy antibiotics has also presented the program with new challenges and questions, including the extent to which buy antibiotics might set back PEPFAR’s progress, administrative and legislative actions that can be taken to mitigate impact and make-up lost ground, and whether the PEPFAR platform can be used more directly to address buy antibiotics through treatment delivery and other interventions.PEPFAR funding and bipartisan support. PEPFAR funding has been mostly stagnant for how to buy amoxil more than a decade, even as the number of people needing HIV treatment has increased and new s remain high. In addition, other donors have reduced their HIV funding in recent years and countries that receive PEPFAR support have faced challenges in mobilizing domestic HIV resources. Whether funding how to buy amoxil for PEPFAR will be increased, or even sustained, will in part depend on its ability to maintain bipartisan support, which has been one of its hallmarks to date.

Ultimately, many of the decisions facing the program will hinge on future funding levels, as well as the broader HIV financing landscape.PEPFAR’s geographic footprint, service portfolio, and population focus. Among the main programmatic levers available to PEPFAR to address the HIV epidemic are its geographic focus, the set of interventions it supports, and the population groups it prioritizes. Decisions in these areas have reflected a variety how to buy amoxil of factors over time, including HIV epidemiology, scientific advances, political and diplomatic considerations, and funding. Going forward, many of these same factors will likely affect PEPFAR’s strategic choices in these three interrelated areas. Other considerations may also come into play, including, for how to buy amoxil example, the extent to which a focus on promoting equity in access to HIV services might be incorporated into such decisions.The role of community and civil society in PEPFAR and the HIV response.

Since the onset of the HIV epidemic, communities, including people living with HIV, have played a key role in the HIV response – as advocates, providers of services, and accountability watchdogs. The participation of civil society in PEPFAR’s policy development and programming has a long history, one which how to buy amoxil has increased and become more formalized over time and is unique among other areas of global health and development. In addition to strengthening PEPFAR’s immediate efforts, the inclusion of community and civil society could affect the longer-term sustainability of programs in countries. As such, how PEPFAR seeks to further build how to buy amoxil upon and sustain its support for community-led HIV responses will have important implications for the program’s future.PEPFAR, epidemic control, and the long-term sustainability of the HIV response. Although PEPFAR was designed from the outset as an emergency response, the importance of building sustainable capacity in countries was recognized as a priority at its early stages and has been underscored over time.

Still, how best to define and sustain long-term success remains a challenge for PEPFAR, how to buy amoxil as well as for other HIV donors. It is not yet clear what the scope and nature of U.S. Assistance might be after a country achieves epidemic how to buy amoxil control or other program targets or how to sustain progress and guard against shocks. Ultimately, how best to promote sustainability and country ownership, including whether PEPFAR should consider instituting formal transition plans or criteria for determining when and at what pace to draw down support, are key questions for the future.PEPFAR’s role in global health security and broader health systems strengthening. The buy antibiotics how to buy amoxil amoxil has intensified attention to shoring up U.S.

Global health security efforts and creating more resilient health systems. It is unclear what this will mean how to buy amoxil for PEPFAR, and any major actions could pose both opportunities and risks for the program. As the first and largest U.S. Global health program specifically designed to address a amoxil, PEPFAR could offer key lessons for broader U.S. amoxil preparedness efforts and potentially be how to buy amoxil integral to such efforts.

However, an increased focus on health security more generally could conceivably crowd out other global health investments and reduce the emphasis on HIV, even when tremendous need still exists.PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. The U.S how to buy amoxil. Has played an integral role in the Global Fund since its inception, including providing the Global Fund with its founding contribution, serving as its single largest donor, and being active in the organization’s governance and oversight. The Global Fund, in turn, how to buy amoxil extends the reach of PEPFAR into more countries and populations. PEPFAR and the Global Fund work quite differently, however.

Given how critical both PEPFAR and the Global Fund are to the HIV response, there may be opportunities for the U.S how to buy amoxil. Government to rethink and strengthen their relationship going forward, including through more proactive and strategic coordination, particularly given concerns about future financing for HIV.PEPFAR’s structure and location within the U.S. Government’s global health architecture how to buy amoxil. When PEPFAR was first created, locating it at the State Department and providing its Coordinator with the power to oversee all U.S. Global HIV investments, as specified in its authorizing legislation, marked a departure from the way in how to buy amoxil which U.S.

Global health programs had been previously structured. Some have argued that PEPFAR’s location how to buy amoxil and structure should be reconsidered to further its transition from an “emergency” program to one more focused on long-term development and to better integrate activities across the U.S. Global health portfolio. Others, citing the program’s broadly recognized positive impact on the HIV response, have argued that it is important to keep how to buy amoxil the current structure, and that moving PEPFAR would present significant risks, including threatening the HIV response and diluting PEPFAR’s diplomatic role. Whether or not PEPFAR’s structure is reconsidered by policymakers, particularly in the context of an increasing focus on global health security, is likely to remain a key question facing the program’s future.

About This TrackerThis tracker provides the number of confirmed cases and deaths from novel antibiotics by country, the trend in confirmed where can i buy amoxil over the counter case and death counts by country, and a global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) antibiotics Resource Center’s buy antibiotics Map and the World Health Organization’s (WHO) antibiotics Disease (buy antibiotics-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About buy antibiotics antibioticsIn late 2019, a new antibiotics emerged in central China to cause disease in where can i buy amoxil over the counter humans. Cases of this disease, known as buy antibiotics, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared where can i buy amoxil over the counter the amoxil represents a public health emergency of international concern, and on January 31, 2020, the U.S.

Department of Health and Human Services declared it to be a health emergency for the United States.The Biden administration has inherited PEPFAR at a critical time for the program and the fight against HIV, and PEPFAR is at a turning point. Much has changed since the program was created in 2003, including important shifts in global HIV where can i buy amoxil over the counter burden, a substantial expansion of the array of validated HIV prevention and treatment tools, and notable changes in the global health and development landscape. In addition, the program awaits the nomination by the President of a new Coordinator, is preparing a new five-year, Congressionally-mandated strategy, and, in two years, is due to be reauthorized by Congress. At the same time, the fight against HIV/AIDS is far from over and the buy antibiotics amoxil has presented new health and economic challenges for PEPFAR countries.This policy brief explores key issues and poses questions where can i buy amoxil over the counter regarding PEPFAR’s future, providing a roadmap for the major decisions ahead for the program. It identifies eight key, interrelated issues facing the administration, Congress, and other PEPFAR stakeholders, as follows:Addressing the short- and long-term impacts of buy antibiotics on PEPFAR and the HIV response.

buy antibiotics continues to have profound health and economic effects in the countries that receive where can i buy amoxil over the counter PEPFAR support and there is uncertainty about the future. While early actions by PEPFAR appear to have helped minimize treatment disruptions, buy antibiotics has also presented the program with new challenges and questions, including the extent to which buy antibiotics might set back PEPFAR’s progress, administrative and legislative actions that can be taken to mitigate impact and make-up lost ground, and whether the PEPFAR platform can be used more directly to address buy antibiotics through treatment delivery and other interventions.PEPFAR funding and bipartisan support. PEPFAR funding has been mostly stagnant for more than where can i buy amoxil over the counter a decade, even as the number of people needing HIV treatment has increased and new s remain high. In addition, other donors have reduced their HIV funding in recent years and countries that receive PEPFAR support have faced challenges in mobilizing domestic HIV resources. Whether funding for PEPFAR will be increased, or even sustained, will in part where can i buy amoxil over the counter depend on its ability to maintain bipartisan support, which has been one of its hallmarks to date.

Ultimately, many of the decisions facing the program will hinge on future funding levels, as well as the broader HIV financing landscape.PEPFAR’s geographic footprint, service portfolio, and population focus. Among the main programmatic levers available to PEPFAR to address the HIV epidemic are its geographic focus, the set of interventions it supports, and the population groups it prioritizes. Decisions in these areas have reflected a variety of factors over where can i buy amoxil over the counter time, including HIV epidemiology, scientific advances, political and diplomatic considerations, and funding. Going forward, many of these same factors will likely affect PEPFAR’s strategic choices in these three interrelated areas. Other considerations may also come into play, including, for example, the extent to which a focus on where can i buy amoxil over the counter promoting equity in access to HIV services might be incorporated into such decisions.The role of community and civil society in PEPFAR and the HIV response.

Since the onset of the HIV epidemic, communities, including people living with HIV, have played a key role in the HIV response – as advocates, providers of services, and accountability watchdogs. The participation of civil society in PEPFAR’s policy development and programming has a long history, one which has increased and become more formalized over time where can i buy amoxil over the counter and is unique among other areas of global health and development. In addition to strengthening PEPFAR’s immediate efforts, the inclusion of community and civil society could affect the longer-term sustainability of programs in countries. As such, how PEPFAR seeks to further build upon and sustain its support for community-led HIV responses will have important implications for the program’s future.PEPFAR, epidemic where can i buy amoxil over the counter control, and the long-term sustainability of the HIV response. Although PEPFAR was designed from the outset as an emergency response, the importance of building sustainable capacity in countries was recognized as a priority at its early stages and has been underscored over time.

Still, how best to define and sustain long-term success remains a challenge for PEPFAR, as well where can i buy amoxil over the counter as for other HIV donors. It is not yet clear what the scope and nature of U.S. Assistance might be after a where can i buy amoxil over the counter country achieves epidemic control or other program targets or how to sustain progress and guard against shocks. Ultimately, how best to promote sustainability and country ownership, including whether PEPFAR should consider instituting formal transition plans or criteria for determining when and at what pace to draw down support, are key questions for the future.PEPFAR’s role in global health security and broader health systems strengthening. The buy antibiotics where can i buy amoxil over the counter amoxil has intensified attention to shoring up U.S.

Global health security efforts and creating more resilient health systems. It is unclear what this will mean for PEPFAR, where can i buy amoxil over the counter and any major actions could pose both opportunities and risks for the program. As the first and largest U.S. Global health program specifically designed to address a amoxil, PEPFAR could offer key lessons for broader U.S. amoxil preparedness efforts and potentially be integral to such efforts where can i buy amoxil over the counter.

However, an increased focus on health security more generally could conceivably crowd out other global health investments and reduce the emphasis on HIV, even when tremendous need still exists.PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. The U.S where can i buy amoxil over the counter. Has played an integral role in the Global Fund since its inception, including providing the Global Fund with its founding contribution, serving as its single largest donor, and being active in the organization’s governance and oversight. The Global Fund, in where can i buy amoxil over the counter turn, extends the reach of PEPFAR into more countries and populations. PEPFAR and the Global Fund work quite differently, however.

Given how critical both PEPFAR and the where can i buy amoxil over the counter Global Fund are to the HIV response, there may be opportunities for the U.S. Government to rethink and strengthen their relationship going forward, including through more proactive and strategic coordination, particularly given concerns about future financing for HIV.PEPFAR’s structure and location within the U.S. Government’s global health architecture where can i buy amoxil over the counter. When PEPFAR was first created, locating it at the State Department and providing its Coordinator with the power to oversee all U.S. Global HIV investments, as specified in where can i buy amoxil over the counter its authorizing legislation, marked a departure from the way in which U.S.

Global health programs had been previously structured. Some have where can i buy amoxil over the counter argued that PEPFAR’s location and structure should be reconsidered to further its transition from an “emergency” program to one more focused on long-term development and to better integrate activities across the U.S. Global health portfolio. Others, citing the program’s broadly recognized positive impact on the HIV response, have argued that it is important to keep the current structure, and that moving where can i buy amoxil over the counter PEPFAR would present significant risks, including threatening the HIV response and diluting PEPFAR’s diplomatic role. Whether or not PEPFAR’s structure is reconsidered by policymakers, particularly in the context of an increasing focus on global health security, is likely to remain a key question facing the program’s future.