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Even before buy antibiotics, almost half of rural adults went without dental care zithromax buy canada - NC Health News Read our antibiotics Coverage Here [email][email][zip][zip][listGroups][listGroups][email][email][zip][zip][listGroups][listGroups]The Centers for Medicare &. Medicaid Services (CMS) is proposing changes to address the widening gap in health equity highlighted by the buy antibiotics Public Health Emergency (PHE) and to expand patient access to comprehensive care, especially in underserved populations. In CMSâs annual Physician Fee Schedule (PFS) proposed rule, the agency is recommending steps that continue the Biden-Harris Administrationâs commitment to strengthen and build upon zithromax buy canada Medicare by promoting health equity. Expanding access to services furnished via telehealth and other telecommunications technologies for behavioral health care. Enhancing diabetes prevention programs.

And further improving CMSâs quality programs to ensure quality care for Medicare beneficiaries and to create equal opportunities for physicians in zithromax buy canada both small and large clinical practices.âOver the past year, the public health emergency has highlighted the disparities in the U.S. Health care system, while at the same time demonstrating the positive impact of innovative policies to reduce these disparities,â said CMS Administrator Chiquita Brooks-LaSure. ÂCMS aims to take the lessons learned during this time and move forward toward a system where no patient is left out and everyone has access to comprehensive quality health services.â CMS Seeks Feedback on zithromax buy canada Health Equity Data Collection CMS is committed to addressing the significant and persistent inequities in health outcomes in the U.S. By improving data collection to better measure and analyze disparities across programs and policies. In the proposed PFS rule, CMS is soliciting feedback on the collection of data, and on how the agency can advance health equity for people with Medicare (while protecting individual privacy), potentially through the creation of confidential reports that allow providers to look at patient impact through a variety of data pointsÂÂ Ì¶Ì¶ including, but not limited to, LGBTQ+, race and ethnicity, dual-eligible beneficiaries, disability, and rural populations.

Access to these zithromax buy canada data may enable a more comprehensive assessment of health equity and support initiatives to close the equity gap. In addition, hospitals and health care providers may be able to use the results from the disparity analyses to identify and develop strategies to promote health equity. Expanding Telehealth and Other Telecommunications Technologies for Behavioral and Mental Health Care In the proposed rule, CMS is reinforcing its commitment to expanding access to behavioral health care and reducing barriers zithromax buy canada to treatment. CMS is proposing to implement recently enacted legislation that removes certain statutory restrictions to allow patients in any geographic location and in their homes access to telehealth services for diagnosis, evaluation, and treatment of mental health disorders. Along with this change, CMS is proposing to expand access to mental health services for rural and vulnerable populations by allowing, for the first time, Medicare to pay for mental health visits when they are provided by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to include visits furnished through interactive telecommunications technology.

This proposal would expand access to Medicare beneficiaries, especially those living in rural and other zithromax buy canada underserved areas. To further expand access to care, CMS is proposing to allow payment to eligible practitioners when they provide certain mental and behavioral health services to patients via audio-only telephone calls from their homes when certain conditions are met. This includes counseling and therapy services provided through Opioid Treatment Programs. These changes would be particularly helpful for those in areas with poor broadband infrastructure and among people with Medicare who are not capable of, or do not consent to the use of, devices that permit a two-way, audio/video interaction for their zithromax buy canada health care visits. âThe buy antibiotics zithromax has put enormous strain on families and individuals, making access to behavioral health services more crucial than ever,â said Brooks-LaSure.

ÂThe changes we are proposing will enhance the availability zithromax buy canada of telehealth and similar options for behavioral health care to those in need, especially in traditionally underserved communities.â Boosting Participation in the Medicare Diabetes Prevention Program CMS is proposing a change to expand the reach of the Medicare Diabetes Prevention Program (MDPP) expanded model. MDPP was developed to help people with Medicare with prediabetes from developing type 2 diabetes. The expanded model is implemented at the local level by MDPP suppliers. Organizations who provide structured, coach-led sessions in community and health care settings zithromax buy canada using a Centers for Disease Control and Prevention approved curriculum to provide training in dietary change, increased physical activity, and weight loss strategies. Approximately one in three American adults (over 88 million) have prediabetes, and more than eight in 10 do not even know they have it.

Many are at risk for developing type 2 diabetes within five zithromax buy canada years. Several underserved communities Ì¶Ì¶ including African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans Ì¶Ì¶ are at particularly high risk for type 2 diabetes. During the buy antibiotics PHE, CMS has been waiving the Medicare enrollment fee for new MDPP suppliers and has observed increased supplier enrollment. CMS is proposing to waive this fee for all organizations that submit an application to enroll in Medicare as an MDPP zithromax buy canada supplier on or after January 1, 2022. Additionally, CMS is proposing changes to make delivery of MDPP services more sustainable and to improve patient access by making it easier for local suppliers to participate and reach their communities by proposing to shorten the MDPP services period to one year instead of two years.

This proposal would reduce the administrative burden and costs to suppliers. CMS is also proposing to restructure payments so zithromax buy canada MDPP suppliers receive larger payments for participants who reach milestones for attendance and weight loss. Advancing the Quality Payment Program CMS is taking further steps to improve the quality of care for people with Medicare through changes to the agencyâs Quality Payment Program (QPP), a value-based payment program that promotes the delivery of high-value care by clinicians through a combination of financial incentives and disincentives. CMS is proposing to require clinicians to meet a higher zithromax buy canada performance threshold to be eligible for incentives. This new threshold aligns with the requirements established for the QPPâs Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act of 2015.

To ensure more meaningful participation for clinicians and improved outcomes for patients, CMS is moving forward with the next evolution of QPP and proposing its first seven MIPS Value Pathways (MVPs) Ì¶ subsets of connected and complementary measures and activities, established through rulemaking, used to meet MIPS reporting requirements. The initial set of proposed zithromax buy canada MVP clinical areas include. Rheumatology, stroke care and prevention, heart disease, chronic disease management, lower extremity joint repair (e.g., knee replacement), emergency medicine, and anesthesia. MVPs will more effectively measure and zithromax buy canada compare performance across clinician types and provide clinicians more meaningful feedback. CMS is also proposing to revise the current eligible clinician definition to include clinical social workers and certified nurse-midwives, as these professionals are often on the front lines serving communities with acute health care needs.

Additionally, CMS is proposing to implement a recent statutory change that authorizes Medicare to make direct Medicare payments to Physician Assistants (PAs) for professional services they furnish under Part B. Beginning January 1, 2022, for the first time, physician assistants would be able to bill Medicare directly, thus expanding access to care and reducing the administrative burden that currently zithromax buy canada requires a PAâs employer or independent contractor to bill Medicare for a PAâs professional services. Updating treatment Payment Rates The buy antibiotics zithromax has highlighted the importance of access to treatments. The Biden-Harris Administration has taken steps to increase Americanâs access to buy antibiotics vaccinations and is committed to meeting people where they are and making it as easy as possible for all Americans to get vaccinated. That commitment extends to zithromax buy canada other, more common vaccinations.

Medicare payments to physicians and mass immunizers for administering flu, pneumonia, and hepatitis B treatments have decreased by around 30% over the last seven years. In the PFS proposed rule, CMS is zithromax buy canada requesting feedback to help update payment rates for administration of preventive treatments covered under Part B. In addition to seeking information on the types of health care providers who furnish treatments and their associated costs, CMS is looking for feedback on its recently adopted payment add-on of $35 for immunizers who vaccinate certain underserved patients in the patientâs home. CMS is also seeking comments on the treatment of buy antibiotics monoclonal antibody products as treatments, and whether those products should be treated like other monoclonal antibody products after the buy antibiotics PHE. Proposal to Phase Out Coinsurance for Colorectal Screening Additional Services CMS is also proposing to implement a recent statutory change to provide a special coinsurance rule for procedures that are planned as colorectal zithromax buy canada cancer screening tests but become diagnostic tests when the practitioner identifies the need for additional services (e.g., removal of polyps).

Currently, the addition of any procedure beyond the planned colorectal screening (for which there is no coinsurance) results in a patient having to pay coinsurance. Under the proposed change, beginning January 1, 2022, the amount of coinsurance patients will pay for such additional services would be reduced zithromax buy canada over time, so that by January 1, 2030, it would be down to zero. For a fact sheet on the CY 2022 Physician Fee Schedule proposed rule, please visit. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2022-medicare-physician-fee-schedule-proposed-rule For a fact sheet on the CY 2022 Quality Payment Program proposed changes, please visit. Https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1517/2022%20QPP%20Proposed%20Rule%20Overview%20Fact%20Sheet.pdf For a fact sheet on the proposed Medicare Diabetes Prevention Program changes, please visit.

https://www.cms.gov/newsroom/fact-sheets/proposed-policies-medicare-diabetes-prevention-program-mdpp-expanded-model-calendar-year-2022 To view the CY 2022 Physician Fee Schedule and Quality Payment Program proposed rule, please visit. Https://www.federalregister.gov/public-inspection/current #### Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov.

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What are http://auxilium-international.com/buy-ventolin-online-usa the key features of hospitals that consistently deliver safe care on labour and zithromax interactions delivery?. This is the primary question posed by Liberati and colleagues in this zithromax interactions issue of BMJ Quality &. Safety.1 The authors propose a framework distilled from observations on a group of high-performing units in the UK participating in a training activity to improve patient safety. This study combined ethnography with individual interviews and focus groups and involved over 400 hours of total observations at six different maternity care zithromax interactions sites.

The seven features in their resulting For Us framework correspond well to existing theoretical as well as applied quality improvement strategies. While we agree that their framework describes features that every labour and delivery unit should strive to zithromax interactions include, this approach has some limitations in terms of generalisability. Specifically, Liberati and colleagues studied maternity units that are high performing, but their sample included only large-volume hospitals in what appear to be well-resourced settings. What is zithromax interactions potentially missing is observations on underperforming units, and how these findings may or may not apply to smaller, lower resourced settings.

Additionally, the structure of the UKâs National Health Service (NHS) also limits generalisability. For example, this is most analogous to employed physician zithromax interactions models in the USA, with the potential advantage of a more organisationally oriented provider workforce. Given that most US hospitals do not have an employed provider model, we canât assume that these factors will have the same impact in other models of care.In the USA, the Agency for Healthcare Research and Quality (AHRQ) developed a Culture of Safety framework that delineates four key features. (1) organisations recognise that their primary activities are inherently high zithromax interactions risk and make it their goal to operate in a reliably safe manner.

(2) organisations create a safe and blame-free reporting zithromax interactions environment. (3) interdisciplinary and interprofessional collaboration is encouraged to address safety problems. And (4) resources are deliberately allocated and zithromax interactions made available to address safety.2 This framework, as does For Us, focuses on a healthcare-oriented conceptualisation of safety and quality, and details medical outcomes as the primary metrics by which to measure success. Although achievement of these medical quality outcomes is imperative, we propose that there are additional domains needed to provide safe intrapartum care.

(A) prioritising patient experienceâincluding emotional safety, birthing with dignity and an expectation of zithromax interactions person-centred care. And (B) a unit culture that values low intervention births. Let us consider these domains in more depth.Patient experience and safety are inextricable zithromax interactions. While much work has been done to improve physicianâpatient communication,3 4 few have successfully targeted the perpetuation of dysfunctional behaviours grounded in healthcare professionalsâ implicit and explicit biases.5 This may be in part due to the tendency to observe and look for answers from the standpoint of the healthcare system rather than patients.

Women who had recently given birth were included in the study of Liberati and colleagues, but represented only 8 of 65 individual stakeholder interviews, zithromax interactions and were not included in focus groups. The framework thus describes a high-functioning system from primarily the healthcare systemâs zithromax interactions perspective. In general, the patientâs role in achieving safe care includes many aspects, including providing personal information to reach the correct diagnosis, providing their values and lived experience in shared decision-making discussions, choosing their provider such that their needs regarding provider experience and safe practice are met, making sure that they receive the recommended treatments in a timely manner, as well as identifying and reporting errors.6 The detriment to health outcomes among patients who have failed interactions with providers is well documented (eg, leaving against medical advice or experiencing disrespect during their care) while other harms, such as psychological trauma, often go unmeasured.7Emotional and psychological trauma are safety errors, whether or not a patient leaves the hospital physically intact.8 Research has shown that patients experience psychological trauma both as a result of an adverse outcome and as a result of how the incident was managed. In birth, patients conceptualise the meaning of safety very differently from that of the medical system, with physical and emotional safety being inextricably interwoven into a single concept.9 Psychological trauma may manifest in postpartum depression, post-traumatic stress disorder10 and, some studies suggest, reduced childbearing in patients who experience traumatic birth.11 The experience of emotional safety on the part of the patient is zithromax interactions only knowable to the patient, and only addressable when health systemsâand health services researchâask the appropriate questions.

Therefore, patient-reported experience measures and critical examination of the process of patient-centred care should be at the centre of quality improvement.High-performing units prioritise patient voice and patient experience as a part of their culture. In a recent article, Morton and Simkin12 delineate steps to promote respectful maternity care in institutions, including obtaining unit commitment to respectful care, implementing training programmes to support respectful care as the norm and, finally, instituting respectful treatment of healthcare staff and clinicians by administrators and leadersâin other words, a unit culture of mutual respect and care among the entire team enables respectful care zithromax interactions of the patient. Liberati and colleagues address the issue of hierarchies on labour and delivery, making the key observation that high-performing units create hierarchies around expertise rather than formal titles or disciplinary silos. However, this power differential applies zithromax interactions to patients as well.

The existing hierarchy on most labour units places physicians at the top and patients at the bottom, which often acts to silence patientsâ voices.13 Implicit bias and interpersonal racism and sexism contribute to this cycle of silence and mistreatment on labour and delivery units.14 Disrespect and dismissal of patient concerns have been increasingly described, but still lack quantitative measurement in association with maternal and child health outcomes.15 Interventions aimed at harm reduction are emerging,16 but more work is desperately needed in this area.Valuing low intervention is an important dimension of safety. Safety culture, as it is conceptualised by zithromax interactions AHRQ and the current study, is ideally created to prevent or respond to harmful safety lapses. This model is more difficult to apply to an environment where the goal is safe facilitation of a normal biological process. In this setting, interventions (that often beget more interventions) can increase zithromax interactions complications.

High rates of primary and repeat caesarean deliveries, and other invasive obstetric interventions seen in many birthing units are now widely acknowledged to be overused and overuse constitutes a patient safety risk.17 In our work in California, we have been able to demonstrate that provider attitudes, zithromax interactions beliefs and unit culture can drive caesarean delivery overuse in ways that do not contribute to patient safety.18 19 Each intervention needs to be carefully and jointly considered for value and safety. This in no way diminishes the life-saving nature of caesarean delivery when it is medically indicated, but it sets up the expectation that safety measures, processes and procedures must be in place to actively work towards supporting vaginal birth rather than treating each labour as an emergency waiting to happen. The striking variation in zithromax interactions obstetric intervention rates among hospitals and providers can provide critical insights. So, what is the right balance of intervention rates and mother/baby safety outcomes?.

In many instances, this may be a false dichotomy zithromax interactions. In a study of California hospital labour practices, Lundsberg et al found that hospitals that prioritised low labour interventions and actively supported vaginal birth (eg, delaying admission until active labour onset, use of doulas, intermittent auscultation of fetal heart tones, non-pharmacological pain relief, and so on) had reduced caesarean delivery rates with well-preserved neonatal outcomes.20 It should be noted that in the USA, rates of intervention are starting at a high level so there is less danger of harm from achieving too low a rate. This may not be the case in the UK where there are now formal inquiries examining obstetric care in multiple NHS hospital trusts where poor perinatal outcomes have been linked to a systematic aversion to medical interventions even when indicated.21 Getting this balance right has been referred to as the Goldilocks zithromax interactions quandary. Doing too little, too much or just right?.

22In conclusion, physical safety is the bare minimum of what should be expected in zithromax interactions childbirth. Patients have a right, and healthcare providers and systems have an obligation to aim higher, to ensure patients emerge from childbirth as healthy or healthierâboth physically and psychologicallyâthan before entering the hospital. This can be best achieved by broadening the lens of what we consider essential to safety on maternity units to include prioritising patient experience, birthing with dignity zithromax interactions and valuing low intervention rates. All of these domains need to be in balance.

Good mother or baby medical outcomes at the cost of high rates of intervention and high maternal psychological trauma are not a success, zithromax interactions nor is the opposite. The true âsafeâ maternity unit is one that does well on all of these dimensions, which, of course, means that we need zithromax interactions to be able to measure each of them. Finally, all of these safety domains, including the âFor Usâ framework proposed by Liberati and colleagues, focus on unit culture, provider behaviours and processes of care, and thus are within the reach of all maternity units no matter their level of resources.Healthcare-associated s (HCAIs) are those s acquired by an individual who is seeking medical care in any healthcare facility, including acute care hospitals, long-term care facilities (including nursing homes), outpatient surgical centres, dialysis centres or ambulatory care clinics.1 They are further defined as occurring at least 48 hours after hospitalisation or within 30 days of receiving medical care.2 HCAIs have plagued hospitals, physicians and patients for centuries and likely played a role in the reputation that hospitals historically had as dangerous places.3 In the mid-19th century, Ignaz Semmelweis observed that labouring mothers in an obstetrics unit had a high incidence of Puerperal (Childbed) fever, which he thought was related to direct contact with medical students. After working with cadavers, students often moved directly from the anatomy lab to the zithromax interactions hospital, leading Semmelweis to postulate that students were contaminated and bringing a pathogen into the unit.

He saw dramatic improvements in maternal mortality after introducing a chlorinated lime hand wash for healthcare providers.4 Though not quickly accepted at large, his observations would become part of the foundation of the germ theory that we intuitively accept today.Over a century after Semmelweis introduced the idea of hand hygiene, prevention in healthcare settings has been thrust into the spotlight worldwide. In the 1960s, the US Centers for Disease zithromax interactions Control and Prevention (CDC) conducted research within the Comprehensive Hospital s Project and introduced surveillance and control techniques still used today. The creation of the National Healthcare Safety Network (NHSN) propelled control onto a national public health platform in the USA.3 Today, reduction of HCAIs has become a regulatory, financial and quality imperative across the world.Healthcare frequently involves the use of invasive devices and procedures that can increase the risk of HCAIs, including catheter-associated urinary tract s, central-line associated bloodstream s (CLABSIs), surgical site s and ventilator-associated events.5 The development of antimicrobial resistance related to antibiotic misuse or overuse6 has given rise to multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae and diarrheal s with Clostridioides difficile. Today, most states in the USA have passed legislation mandating that healthcare facilities publicly report HCAIs, most often using the CDC NHSN surveillance definition for event reporting.7 Globally, the WHOâs Clean Care is Safer Care Programme is working zithromax interactions alongside many nations to introduce surveillance and reporting programmes to strengthen the international response.8The patient environment has become a major focus of control interventions.

Although a large proportion of HCAIs are attributed to a patientâs endogenous microflora, up to 40% of nosocomial s are cross-s from the hands of healthcare providers, including transmission from high-touch patient-care surfaces.9 In order for pathogens to be transmitted, they generally must have characteristics that make them more robust in the environment, such as the ability to frequently colonise, survive and remain virulent on environmental surfaces and the ability to transiently colonise and pass from the hands of healthcare providers to patients or environmental surfaces.9 C. Difficile poses additional challenges for environmental control because of its ability to form spores that resist dry heat and many disinfectants.9 Even with active surveillance and the introduction zithromax interactions of new environmental dis technologies, such as uaviolet germicidal irradiation,10 studies have demonstrated that patients hospitalised in rooms with previous occupants who were MRSA colonised or infected with C. Difficile were more likely to become contaminated,7 supporting the notion that hospital environments play an important role in HCAI transmission.Both the duration of hospitalisation and frequency of transfer between and within healthcare facilities increase the likelihood of exposure to contaminated environments. Intrahospital transfers refer to the movement of a patient within a healthcare facility, including transfers from the emergency room to an inpatient unit on admission, between two different units, to a different department for a procedure or diagnostic study or between rooms zithromax interactions on the same unit.11 McHaney-Lindstrom and colleagues conducted a retrospective case-control study that found that with every additional intrahospital transfer, the odds of acquiring an with C.

Difficile increased by 7%.12 These transfers require a complex cascade of events and are affected by environmental control and communication challenges, professional conflicts related to variation in culture between units, hospital census and provider workload.13 In a systematic review, Bristol and colleagues found that intrahospital transfers are frequently associated with adverse outcomes, such as delirium, increased risk of falls, increased length of stay and prolonged duration of mechanical ventilation and central venous catheterisation.13 This therefore further highlights the significance of intrahospital transfers on patient outcomes.In this issue, Boncea and colleagues report on a retrospective case-control study conducted to estimate the risk of developing a HCAI depending on the number of intrahospital transfers between inpatient zithromax interactions units or the same unit.11 The study was conducted in three urban hospitals within one UK hospital organisation. The study focused on patients aged 65 or older, given their higher frequency of access to medical care. Data were collected from the electronic health record (EHR) over a 3-year period and included a total of 24 240 hospitalisations of which 2877 were cases where the patient had a positive clinical culture obtained at least 48 zithromax interactions hours after hospitalisation. Cases and controls were matched by potential confounding variables, including Elixhauser comorbidities, age, gender and total number of admissions.

Using multivariable logistic regression modelling, they found that for every additional intrahospital transfer, the odds of acquiring a HCAI increased by 9%, with the most common HCAI being C zithromax interactions. Difficile .This study is one of the first to quantify the risk associated with the number of intrahospital transfers and HCAIs. Cases and controls were well matched, and the statistical modelling zithromax interactions provides very compelling results. However, it is worth noting some features of the study that can affect the findings.

The study does not provide specific details on the active zithromax interactions surveillance testing practices of the hospital network. Without these data, theoretically (and by chance), cases selected for this study could have been colonised by MRSA more frequently than controls, which would introduce a level of bias. C. Difficile was measured from the EHR by positive toxin immunoassay results, but the clinical context of this testing is not clear, raising the possibility that some positive patients may have represented colonisation and not acute .

The study also did not adjust for the indication for transfer (eg, transfer to or from the intensive care unit based on patient acuity, transfer for isolation precautions or transfer due to bed capacity or staffing issues) to determine if the patient care needs, isolation status or hospital strain modify the observed risk. As the authors acknowledge, prospective studies are needed to identify the clinical, administrative and systems factors that contribute to more frequent intrahospital transfers.Guidelines for prevention and control of HCAIs include evidence-based interventions that can be broadly categorised as either vertical or horizontal. Vertical interventions focus on reducing colonisation, and transmission of specific pathogens,7 and include surveillance testing for asymptomatic carriers, contact isolation precautions and targeted decolonisation.7 Horizontal interventions aim to reduce the risk of by a larger group of pathogens, independent of patient-specific conditions, such as optimisation of hand hygiene, antimicrobial stewardship and environmental cleaning practices.7 control programmes are tasked with weighing the risks and benefits of interventions to reduce rates of HCAIs while also being cost effective. Vertical approaches to prevent MRSA transmission and remain controversial due to inconsistent findings.7 In a nationwide US Veteranâs Affairs study that assessed the impact of MRSA surveillance testing and contact isolation in MRSA carriers, researchers demonstrated that these interventions resulted in reduced rates of MRSA and colonisation as well as reductions in the incidence of healthcare-associated C.

Difficile and vancomycin-resistant Enterococcus s.14 In contrast, other studies evaluating similar practices in intensive care units found little impact of vertical control measures on MRSA rates15 and describe unintended consequences, such as decreased provider-patient contact, increased patient anxiety and patient dissatisfaction with quality of care.16Under endemic conditions, horizontal interventions may be more cost effective and beneficial given the broader number of microorganisms that can be targeted.7 Hand hygiene remains a core horizontal intervention, but hand hygiene compliance varies widely, with some countriesâ hospitals compliance reported as low as 15%.17 Several studies focused on intensive care units have shown significant declines in MRSA colonisation rates when hand hygiene practices improve.7 In addition to hand hygiene, universal decolonisation strategies that typically use chlorhexidine gluconate bathing of high risk patients are more impactful than active surveillance testing for individual pathogens at reducing rates of HCAIs such as CLABSIs.7 A central pillar of control is antimicrobial stewardship. These programmes use coordinated interventions to promote appropriate antimicrobial use, improve patient outcomes, decrease antibiotic resistance and reduce the incidence of s secondary to multidrug-resistant organisms.18 Given variation in environmental dis practices and provider-to-provider communication, reducing the frequency of intrahospital transfers is another potential horizontal intervention to reduce the burden of HCAIs.Boncea and colleaguesâ study adds to the growing body of literature that intrahospital transfers may increase the risk of HCAIs. Prior studies have identified that patients experience an average of 2.4 transfers during a hospitalisation and approximately 96% of individuals experience a transfer during hospitalisation.13 Transfers within the hospital also affect patient care and safety in other ways, resulting in delays in diagnosis and treatment due, in part, to poor coordination of care and inadequate handoffs between units.19 Additionally, intrahospital transfers take an average of 1âhour to complete, adding significantly to nursing workload.19The field of control must continue to adapt to changing hospital environments in order to further reduce the risk of HCAIs. In the most recent progress report from US CDC, one in every 31 US patients will experience a HCAI while hospitalised,20 contributing to preventable deaths and permanent harm and to a tremendous excess cost of care.21 While the impact of these s is readily recognised in the developed world, recent studies indicate that the impact of HCAIs in the developing world is staggering, with one study reporting that the pooled-prevalence of HCAIs in resource-limited settings is 15.5 per 100 patients, compared with 4.5 per 100 patients in the USA and 7.1 per 100 patients in Europe.22 control programmes must continue to survey their respective hospital populations and evolve to the demand of the time, weighing benefits, balancing measures and costs.

Reducing the number of intrahospital transfers and improving care coordination across these transitions represent a future opportunity to further reduce the burden of HCAIs..

What are the key features of hospitals that zithromax buy canada consistently deliver safe care on labour and delivery?. This is the primary question posed by Liberati and colleagues in this issue zithromax buy canada of BMJ Quality &. Safety.1 The authors propose a framework distilled from observations on a group of high-performing units in the UK participating in a training activity to improve patient safety. This study combined ethnography with individual interviews and zithromax buy canada focus groups and involved over 400 hours of total observations at six different maternity care sites.

The seven features in their resulting For Us framework correspond well to existing theoretical as well as applied quality improvement strategies. While we agree that their framework describes features that every labour and delivery unit should strive to include, zithromax buy canada this approach has some limitations in terms of generalisability. Specifically, Liberati and colleagues studied maternity units that are high performing, but their sample included only large-volume hospitals in what appear to be well-resourced settings. What is potentially missing is observations on underperforming units, and how these findings zithromax buy canada may or may not apply to smaller, lower resourced settings.

Additionally, the structure of the UKâs National Health Service (NHS) also limits generalisability. For example, this is most analogous to employed zithromax buy canada physician models in the USA, with the potential advantage of a more organisationally oriented provider workforce. Given that most US hospitals do not have an employed provider model, we canât assume that these factors will have the same impact in other models of care.In the USA, the Agency for Healthcare Research and Quality (AHRQ) developed a Culture of Safety framework that delineates four key features. (1) organisations recognise that their primary activities are inherently high risk and make it their goal to operate in a reliably safe zithromax buy canada manner.

(2) organisations create zithromax buy canada a safe and blame-free reporting environment. (3) interdisciplinary and interprofessional collaboration is encouraged to address safety problems. And (4) resources are deliberately allocated and made available to address safety.2 This framework, as does For Us, focuses zithromax buy canada on a healthcare-oriented conceptualisation of safety and quality, and details medical outcomes as the primary metrics by which to measure success. Although achievement of these medical quality outcomes is imperative, we propose that there are additional domains needed to provide safe intrapartum care.

(A) prioritising patient experienceâincluding emotional safety, birthing with dignity and an expectation of person-centred care zithromax buy canada. And (B) a unit culture that values low intervention births. Let us zithromax buy canada consider these domains in more depth.Patient experience and safety are inextricable. While much work has been done to improve physicianâpatient communication,3 4 few have successfully targeted the perpetuation of dysfunctional behaviours grounded in healthcare professionalsâ implicit and explicit biases.5 This may be in part due to the tendency to observe and look for answers from the standpoint of the healthcare system rather than patients.

Women who had recently given birth were zithromax buy canada included in the study of Liberati and colleagues, but represented only 8 of 65 individual stakeholder interviews, and were not included in focus groups. The framework thus describes zithromax buy canada a high-functioning system from primarily the healthcare systemâs perspective. In general, the patientâs role in achieving safe care includes many aspects, including providing personal information to reach the correct diagnosis, providing their values and lived experience in shared decision-making discussions, choosing their provider such that their needs regarding provider experience and safe practice are met, making sure that they receive the recommended treatments in a timely manner, as well as identifying and reporting errors.6 The detriment to health outcomes among patients who have failed interactions with providers is well documented (eg, leaving against medical advice or experiencing disrespect during their care) while other harms, such as psychological trauma, often go unmeasured.7Emotional and psychological trauma are safety errors, whether or not a patient leaves the hospital physically intact.8 Research has shown that patients experience psychological trauma both as a result of an adverse outcome and as a result of how the incident was managed. In birth, patients conceptualise the meaning of safety very differently from that of the medical system, with physical and emotional safety being inextricably zithromax buy canada interwoven into a single concept.9 Psychological trauma may manifest in postpartum depression, post-traumatic stress disorder10 and, some studies suggest, reduced childbearing in patients who experience traumatic birth.11 The experience of emotional safety on the part of the patient is only knowable to the patient, and only addressable when health systemsâand health services researchâask the appropriate questions.

Therefore, patient-reported experience measures and critical examination of the process of patient-centred care should be at the centre of quality improvement.High-performing units prioritise patient voice and patient experience as a part of their culture. In a recent article, Morton and Simkin12 delineate steps to promote respectful zithromax buy canada maternity care in institutions, including obtaining unit commitment to respectful care, implementing training programmes to support respectful care as the norm and, finally, instituting respectful treatment of healthcare staff and clinicians by administrators and leadersâin other words, a unit culture of mutual respect and care among the entire team enables respectful care of the patient. Liberati and colleagues address the issue of hierarchies on labour and delivery, making the key observation that high-performing units create hierarchies around expertise rather than formal titles or disciplinary silos. However, this power differential zithromax buy canada applies to patients as well.

The existing hierarchy on most labour units places physicians at the top and patients at the bottom, which often acts to silence patientsâ voices.13 Implicit bias and interpersonal racism and sexism contribute to this cycle of silence and mistreatment on labour and delivery units.14 Disrespect and dismissal of patient concerns have been increasingly described, but still lack quantitative measurement in association with maternal and child health outcomes.15 Interventions aimed at harm reduction are emerging,16 but more work is desperately needed in this area.Valuing low intervention is an important dimension of safety. Safety culture, zithromax buy canada as it is conceptualised by AHRQ and the current study, is ideally created to prevent or respond to harmful safety lapses. This model is more difficult to apply to an environment where the goal is safe facilitation of a normal biological process. In this setting, interventions (that often beget zithromax buy canada more interventions) can increase complications.

High rates of primary and repeat caesarean deliveries, and other invasive obstetric interventions seen in many birthing units are now widely acknowledged to be overused zithromax buy canada and overuse constitutes a patient safety risk.17 In our work in California, we have been able to demonstrate that provider attitudes, beliefs and unit culture can drive caesarean delivery overuse in ways that do not contribute to patient safety.18 19 Each intervention needs to be carefully and jointly considered for value and safety. This in no way diminishes the life-saving nature of caesarean delivery when it is medically indicated, but it sets up the expectation that safety measures, processes and procedures must be in place to actively work towards supporting vaginal birth rather than treating each labour as an emergency waiting to happen. The striking variation in zithromax buy canada obstetric intervention rates among hospitals and providers can provide critical insights. So, what is the right balance of intervention rates and mother/baby safety outcomes?.

In zithromax buy canada many instances, this may be a false dichotomy. In a study of California hospital labour practices, Lundsberg et al found that hospitals that prioritised low labour interventions and actively supported vaginal birth (eg, delaying admission until active labour onset, use of doulas, intermittent auscultation of fetal heart tones, non-pharmacological pain relief, and so on) had reduced caesarean delivery rates with well-preserved neonatal outcomes.20 It should be noted that in the USA, rates of intervention are starting at a high level so there is less danger of harm from achieving too low a rate. This may not be the case in the UK where there are now formal inquiries examining obstetric care in multiple NHS hospital trusts where poor perinatal outcomes have been linked to a systematic aversion to medical zithromax buy canada interventions even when indicated.21 Getting this balance right has been referred to as the Goldilocks quandary. Doing too little, too much or just right?.

22In conclusion, physical safety is the bare minimum of zithromax buy canada what should be expected in childbirth. Patients have a right, and healthcare providers and systems have an obligation to aim higher, to ensure patients emerge from childbirth as healthy or healthierâboth physically and psychologicallyâthan before entering the hospital. This can be best achieved by broadening the lens of what we consider essential to safety on maternity units to zithromax buy canada include prioritising patient experience, birthing with dignity and valuing low intervention rates. All of these domains need to be in balance.

Good mother or baby medical outcomes at the cost of high rates zithromax buy canada of intervention and high maternal psychological trauma are not a success, nor is the opposite. The true zithromax buy canada âsafeâ maternity unit is one that does well on all of these dimensions, which, of course, means that we need to be able to measure each of them. Finally, all of these safety domains, including the âFor Usâ framework proposed by Liberati and colleagues, focus on unit culture, provider behaviours and processes of care, and thus are within the reach of all maternity units no matter their level of resources.Healthcare-associated s (HCAIs) are those s acquired by an individual who is seeking medical care in any healthcare facility, including acute care hospitals, long-term care facilities (including nursing homes), outpatient surgical centres, dialysis centres or ambulatory care clinics.1 They are further defined as occurring at least 48 hours after hospitalisation or within 30 days of receiving medical care.2 HCAIs have plagued hospitals, physicians and patients for centuries and likely played a role in the reputation that hospitals historically had as dangerous places.3 In the mid-19th century, Ignaz Semmelweis observed that labouring mothers in an obstetrics unit had a high incidence of Puerperal (Childbed) fever, which he thought was related to direct contact with medical students. After working with cadavers, students often moved directly from the anatomy lab to the hospital, leading Semmelweis to postulate zithromax buy canada that students were contaminated and bringing a pathogen into the unit.

He saw dramatic improvements in maternal mortality after introducing a chlorinated lime hand wash for healthcare providers.4 Though not quickly accepted at large, his observations would become part of the foundation of the germ theory that we intuitively accept today.Over a century after Semmelweis introduced the idea of hand hygiene, prevention in healthcare settings has been thrust into the spotlight worldwide. In the 1960s, the US Centers for Disease Control and Prevention (CDC) conducted research within the Comprehensive Hospital s Project and introduced surveillance zithromax buy canada and control techniques still used today. The creation of the National Healthcare Safety Network (NHSN) propelled control onto a national public health platform in the USA.3 Today, reduction of HCAIs has become a regulatory, financial and quality imperative across the world.Healthcare frequently involves the use of invasive devices and procedures that can increase the risk of HCAIs, including catheter-associated urinary tract s, central-line associated bloodstream s (CLABSIs), surgical site s and ventilator-associated events.5 The development of antimicrobial resistance related to antibiotic misuse or overuse6 has given rise to multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae and diarrheal s with Clostridioides difficile. Today, most states in the USA have passed legislation mandating that healthcare facilities publicly report HCAIs, most often using the CDC NHSN surveillance definition for event reporting.7 Globally, the WHOâs Clean Care is Safer Care Programme is working zithromax buy canada alongside many nations to introduce surveillance and reporting programmes to strengthen the international response.8The patient environment has become a major focus of control interventions.

Although a large proportion of HCAIs are attributed to a patientâs endogenous microflora, up to 40% of nosocomial s are cross-s from the hands of healthcare providers, including transmission from high-touch patient-care surfaces.9 In order for pathogens to be transmitted, they generally must have characteristics that make them more robust in the environment, such as the ability to frequently colonise, survive and remain virulent on environmental surfaces and the ability to transiently colonise and pass from the hands of healthcare providers to patients or environmental surfaces.9 C. Difficile poses additional challenges for environmental control because of its ability to form spores that resist dry heat and many disinfectants.9 Even with active surveillance and the introduction of new environmental dis technologies, such as uaviolet germicidal irradiation,10 studies have demonstrated zithromax buy canada that patients hospitalised in rooms with previous occupants who were MRSA colonised or infected with C. Difficile were more likely to become contaminated,7 supporting the notion that hospital environments play an important role in HCAI transmission.Both the duration of hospitalisation and frequency of transfer between and within healthcare facilities increase the likelihood of exposure to contaminated environments. Intrahospital transfers refer to the movement of a patient within a healthcare facility, including transfers from the emergency room to an inpatient unit on admission, between two different units, to a different department for a procedure or diagnostic study or between rooms on the same unit.11 McHaney-Lindstrom and colleagues conducted a retrospective case-control study that found that with every additional intrahospital transfer, the odds of acquiring an zithromax buy canada with C.

Difficile increased by 7%.12 These transfers require a complex cascade of events and are affected by environmental control and zithromax buy canada communication challenges, professional conflicts related to variation in culture between units, hospital census and provider workload.13 In a systematic review, Bristol and colleagues found that intrahospital transfers are frequently associated with adverse outcomes, such as delirium, increased risk of falls, increased length of stay and prolonged duration of mechanical ventilation and central venous catheterisation.13 This therefore further highlights the significance of intrahospital transfers on patient outcomes.In this issue, Boncea and colleagues report on a retrospective case-control study conducted to estimate the risk of developing a HCAI depending on the number of intrahospital transfers between inpatient units or the same unit.11 The study was conducted in three urban hospitals within one UK hospital organisation. The study focused on patients aged 65 or older, given their higher frequency of access to medical care. Data were collected from the electronic health record (EHR) over a 3-year period and included a total of 24 240 zithromax buy canada hospitalisations of which 2877 were cases where the patient had a positive clinical culture obtained at least 48 hours after hospitalisation. Cases and controls were matched by potential confounding variables, including Elixhauser comorbidities, age, gender and total number of admissions.

Using multivariable logistic regression modelling, they found zithromax buy canada that for every additional intrahospital transfer, the odds of acquiring a HCAI increased by 9%, with the most common HCAI being C. Difficile .This study is one of the first to quantify the risk associated with the number of intrahospital transfers and HCAIs. Cases and controls were well matched, and the statistical zithromax buy canada modelling provides very compelling results. However, it is worth noting some features of the study that can affect the findings.

The study does not provide specific details on the active surveillance testing practices of the hospital zithromax buy canada network. Without these data, theoretically (and by chance), cases selected for this study could have been colonised by MRSA more frequently than controls, which would introduce a level of bias. C. Difficile was measured from the EHR by positive toxin immunoassay results, but the clinical context of this testing is not clear, raising the possibility that some positive patients may have represented colonisation and not acute .

Reducing the number of intrahospital transfers and improving care coordination across these transitions represent a future opportunity to further reduce the burden of HCAIs..

What is Zithromax?

AZITHROMYCIN is a macrolide antibiotic that interferes with the growth of bacterial cells. It is used to treat bacterial s in many different parts of the body. Azithromycin also treats sexually transmitted vaginal or urinary tract s caused by chlamydia. It will not work for colds, flu, or other zithromax s.

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Funding will redirect people who can zithromax make you tired use drugs from the criminal justice system August 26, 2020 - Peterborough, Ontario - Best place to buy amoxil Health Canada Problematic substance use has devastating impacts on people, families and communities across Canada. Tragically, the buy antibiotics outbreak has worsened the situation for many Canadians struggling with substance use. The Government of Canada continues to address this serious public health issue by focusing on increasing access to can zithromax make you tired quality treatment and harm reduction services nationwide.

Today, on behalf of the Honourable Patty Hajdu, Minister of Health, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, announced more than $1.9 million in funding over the next three years to the Peterborough Police Service. Through this funding, people who use drugs can zithromax make you tired and experience mental health issues will be connected to newly-created community-based outreach and support services. As part of this project, the Peterborough Police Service is working with local partners to create a community-based outreach team to increase the capacity for front-line community services to help people at risk who are referred by police.

With the help of this new team, people who use drugs or experience mental health issues will be redirected from the criminal justice system to can zithromax make you tired harm reduction, peer support, health and social services. Additionally, this initiative will increase access to culturally appropriate services for Indigenous Peoples, LGBTQ2+ populations, youth, women, and those living with HIV through partnerships with other organizations such as Nogojiwanong Friendship Centre and Peterborough AIDS Research Network. The Government can zithromax make you tired of Canada is committed to working with partners, peer workers, people with lived and living experience and other stakeholders to ensure Canadians receive the support they need to reduce the harms related to substance use.From.

Health Canada Media advisory Government of Canada to announce funding for community-based, multi-sector outreach and support services in Peterborough PETERBOROUGH, August 25, 2020 â On behalf of the Federal Minister of Health, Patty Hajdu, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, will announce federal funding to help connect people at risk of experiencing opioid-related overdoses to community-based outreach and support services in Peterborough.There will be a media availability immediately following the announcement.DateWednesday, August 26, 2020Time10:00 AM (EDT)LocationThe media availability will be held on Zoom.Zoom link. Https://us02web.zoom.us/j/89698543218Meeting ID can zithromax make you tired. 896 9854 3218 Contacts Media Inquiries:Cole DavidsonOffice of the Honourable Patty HajduMinister of Health613-957-0200Media RelationsHealth Canada613-957-2983hc.media.sc@canada.ca.

Funding will redirect people who use drugs from the criminal justice system http://www.kunstabstrakt-golling.de/best-place-to-buy-amoxil/ August 26, 2020 - Peterborough, Ontario - Health Canada Problematic substance use has devastating impacts on people, zithromax buy canada families and communities across Canada. Tragically, the buy antibiotics outbreak has worsened the situation for many Canadians struggling with substance use. The Government of Canada continues to address this serious public health issue by focusing on increasing access to quality treatment zithromax buy canada and harm reduction services nationwide. Today, on behalf of the Honourable Patty Hajdu, Minister of Health, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, announced more than $1.9 million in funding over the next three years to the Peterborough Police Service. Through this funding, people who use drugs and experience mental health issues will be connected to newly-created community-based outreach and support zithromax buy canada services.

As part of this project, the Peterborough Police Service is working with local partners to create a community-based outreach team to increase the capacity for front-line community services to help people at risk who are referred by police. With the help zithromax buy canada of this new team, people who use drugs or experience mental health issues will be redirected from the criminal justice system to harm reduction, peer support, health and social services. Additionally, this initiative will increase access to culturally appropriate services for Indigenous Peoples, LGBTQ2+ populations, youth, women, and those living with HIV through partnerships with other organizations such as Nogojiwanong Friendship Centre and Peterborough AIDS Research Network. The Government of Canada is committed to working with partners, peer workers, people with lived and living experience and other stakeholders to ensure Canadians receive the support they need to reduce the harms related to substance zithromax buy canada use.From. Health Canada Media advisory Government of Canada to announce funding for community-based, multi-sector outreach and support services in Peterborough PETERBOROUGH, August 25, 2020 â On behalf of the Federal Minister of Health, Patty Hajdu, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, will announce federal funding to help connect people at risk of experiencing opioid-related overdoses to community-based outreach and support services in Peterborough.There will be a media availability immediately following the announcement.DateWednesday, August 26, 2020Time10:00 AM (EDT)LocationThe media availability will be held on Zoom.Zoom link.

Https://us02web.zoom.us/j/89698543218Meeting ID zithromax buy canada. 896 9854 3218 Contacts Media Inquiries:Cole DavidsonOffice of the Honourable Patty HajduMinister of Health613-957-0200Media RelationsHealth Canada613-957-2983hc.media.sc@canada.ca.

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About This TrackerThis tracker provides the number of confirmed cases and deaths from novel antibiotics by country, the trend in zithromax price rite aid confirmed case and death counts see here now 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 Centerâs buy antibiotics Map and the World Health Organizationâs (WHO) antibiotics Disease (buy antibiotics-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About buy antibiotics zithromax price rite aid antibioticsIn late 2019, a new antibiotics emerged in central China to cause disease in 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 zithromax represents a public health emergency zithromax price rite aid 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.Global Health Legislation During the 117th Congress(as of Aug.

2, 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.

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 antibioticsâ19 unless a statute is enacted expressly authorizing such a waiver with respect to the prevention, containment, mitigation, or treatment of buy antibioticsâ19, 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.

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 antibioticsâ19 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 areaâs 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 zithromax.

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 zithromax. 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.

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 â 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). Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022(Labor/HHS â LHHS Approps)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 HouseAppropriationsSee KFF summary.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.

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 zithromax 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 zithromax preparedness as a multilateral, catalytic financing mechanism. Describes Fundâs 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 Fundâs 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 zithromax 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 HFACzithromax, 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 zithromax 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 zithromax 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 SFRCzithromax, 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 zithromax potential, and supporting the development of One Health systems at the community level.

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.

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. Veteransâ 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 zithromax 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 Orderszithromax 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. Governmentâs country-level response to the buy antibiotics zithromax.

In the event of an infectious disease outbreak outside the U.S. With zithromax 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 zithromax 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 zithromax 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 zithromax prevention and preparedness (see âthe Fundâ 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 zithromax 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 zithromax 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 âthe Fund;â 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.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 positionâs duties, including establishing a Mental Health and Psychosocial Support Working Group.

Describes the Groupâs 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 â FY26) on spending for this programming in U.S.

Codifies the position of USAID coordinator for mental health and psychosocial support and describes the positionâs duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Groupâs 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 â 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 zithromaxs, 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, zithromax preparedness and responseEstablishes the zithromax preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics zithromax and protect Americans from the emergence of buy antibiotics variants and other pathogens with zithromax 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 zithromax worldwide as well as a long-term strategy for preventing future zithromaxs. 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 zithromaxs.

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.

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 âBayh-Dole Actâ, 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 zithromaxs, and for other purposes.6/8/2021S. 1976Sen.

Jeff Merkley (D-OR)Read twice and referred to SFRCbuy antibiotics, global health security, zithromax preparedness and responseEstablishes the zithromax preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics zithromax and protect Americans from the emergence of buy antibiotics variants and other pathogens with zithromax 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 zithromax worldwide as well as a long-term strategy for preventing future zithromaxs. 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 zithromaxs. 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.

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 zithromaxs 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 â FY 2030 funding for USAID activities related to sustainable food systems.

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.

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.

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.

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 organizationsâ representatives in the U.S. And countries included in such reporting be consulted with during the preparation of annual reporting.Robust International Response to zithromax ActTo provide support for a robust global response to the buy antibiotics zithromax.2/11/2021H.R. 986Rep.

Jesus âChuyâ 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 zithromax, 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 zithromax.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, zithromax, 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 Peopleâs 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 zithromax. States 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 zithromaxs and other public health challenges. States it is U.S. Policy to advocate and actively advance Taiwanâs meaningful participation in the World Health Assembly, among other bodies.

Requires report on the origins of the buy antibiotics zithromax 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 zithromax.Support for Global Financial Institution zithromax Response Act of 2021To support efforts by international financial institutions to provide a robust global response to the buy antibioticsâ19 zithromax.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 zithromax, 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 zithromax.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 zithromax prevention and response, and for other purposes.2/8/2021S. 290Sen.

Edward Markey (D-MA)Read twice and referred to HSGACzithromaxRequires the President to designate an employee of the National Security Council to be the permanent coordinator for zithromax 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 Taiwanâs participation at WHOâs 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)Placed on Senate Legislative Calendar Under General OrdersWHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwanâs participation at WHOâs 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 Partyâs response to the buy antibiotics zithromax, 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.United 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 Peopleâs 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.

Requires the Department of Stateâs Office of Global Womenâs 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 antibioticsâ19 zithromax, 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 zithromax.NOTES. SFRC means Senate Committee on Foreign Relations. HFAC means the House Committee on Foreign Affairs.

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..

About This TrackerThis tracker provides the number of confirmed cases and deaths how much does zithromax cost at walgreens from novel antibiotics by country, the trend in confirmed case and death counts by country, and a global map showing which countries zithromax buy canada have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) antibiotics Resource Centerâs buy antibiotics Map and the World Health Organizationâs (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, zithromax buy canada a new antibiotics emerged in central China to cause disease in humans. Cases of this disease, known as buy antibiotics, have since been reported across around the globe. On January 30, 2020, the World Health zithromax buy canada Organization (WHO) declared the zithromax 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.Global Health Legislation During the 117th Congress(as of Aug. 2, 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 antibioticsâ19 unless a statute is enacted expressly authorizing such a waiver with respect to the prevention, containment, mitigation, or treatment of buy antibioticsâ19, 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 antibioticsâ19 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 areaâs 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 zithromax. 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 zithromax. 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.

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.

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 Chinaâs 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 â 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).

Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022(Labor/HHS â LHHS Approps)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 HouseAppropriationsSee KFF summary.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.

Policy to promote and invest in global health security and zithromax 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 zithromax preparedness as a multilateral, catalytic financing mechanism. Describes Fundâs 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 Fundâs 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.

Grace Meng (D-NY-6)Referred to HFACzithromax, 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 zithromax 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 zithromax 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 SFRCzithromax, 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 zithromax 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. Veteransâ 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.

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.

Governmentâs country-level response to the buy antibiotics zithromax. In the event of an infectious disease outbreak outside the U.S. With zithromax 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 zithromax 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 zithromax 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 zithromax prevention and preparedness (see âthe Fundâ 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 click here for more 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 zithromax potential.

Contribution to the Fund to not exceed 33% of the total contributions from all sources.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 positionâs duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Groupâs 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 â 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 positionâs duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Groupâs duties and members.

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 zithromaxs, 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, zithromax preparedness and responseEstablishes the zithromax preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics zithromax and protect Americans from the emergence of buy antibiotics variants and other pathogens with zithromax potential.

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 âBayh-Dole Actâ, 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 zithromaxs, and for other purposes.6/8/2021S. 1976Sen. Jeff Merkley (D-OR)Read twice and referred to SFRCbuy antibiotics, global health security, zithromax preparedness and responseEstablishes the zithromax preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the buy antibiotics zithromax and protect Americans from the emergence of buy antibiotics variants and other pathogens with zithromax 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.

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 âBayh-Dole Actâ, 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.

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 â 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 zithromaxs 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 â 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 organizationsâ 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 organizationsâ representatives in the U.S.

And countries included in such reporting be consulted with during the preparation of annual reporting.Robust International Response to zithromax ActTo provide support for a robust global response to the buy antibiotics zithromax.2/11/2021H.R. 986Rep. Jesus âChuyâ 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 zithromax, 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 zithromax.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, zithromax, 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 Peopleâs 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 zithromax. 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 zithromaxs and other public health challenges. States it is U.S.

Policy to advocate and actively advance Taiwanâs meaningful participation in the World Health Assembly, among other bodies. Requires report on the origins of the buy antibiotics zithromax 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 zithromax.Support for Global Financial Institution zithromax Response Act of 2021To support efforts by international financial institutions to provide a robust global response to the buy antibioticsâ19 zithromax.1/27/2021S.

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 zithromax prevention and response, and for other purposes.2/8/2021S. 290Sen. Edward Markey (D-MA)Read twice and referred to HSGACzithromaxRequires the President to designate an employee of the National Security Council to be the permanent coordinator for zithromax 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 Taiwanâs participation at WHOâs 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)Placed on Senate Legislative Calendar Under General OrdersWHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwanâs participation at WHOâs 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 Partyâs response to the buy antibiotics zithromax, 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.United 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 Peopleâs 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 â including in access to comprehensive health care, including reproductive health and rights. Requires the Department of Stateâs Office of Global Womenâs 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 antibioticsâ19 zithromax, 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 zithromax.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..

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NCHS Data average price of zithromax Brief where can i buy generic zithromax No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40â59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40â59 were more likely than premenopausal women aged 40â59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40â59 (55.1%) were more likely than premenopausal women aged 40â59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep where can i buy generic zithromax is associated with an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is âthe permanent cessation where can i buy generic zithromax of menstruation that occurs after the loss of ovarian activityâ (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40â59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are premenopausal, 3.7% are perimenopausal, and where can i buy generic zithromax 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep where can i buy generic zithromax less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40â59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 where can i buy generic zithromax. Percentage of nonpregnant women aged 40â59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by menopausal status (p < where can i buy generic zithromax. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual where can i buy generic zithromax cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table where can i buy generic zithromax for Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40â59 who had trouble where can i buy generic zithromax falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40â59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 where can i buy generic zithromax. Percentage of nonpregnant women aged 40â59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant where can i buy generic zithromax linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less where can i buy generic zithromax. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 2pdf icon.SOURCE where can i buy generic zithromax.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40â59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one where can i buy generic zithromax in four nonpregnant women aged 40â59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40â59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 where can i buy generic zithromax. Percentage of nonpregnant women aged 40â59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by where can i buy generic zithromax menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was where can i buy generic zithromax 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for where can i buy generic zithromax Figure 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40â59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40â59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% where can i buy generic zithromax among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 where can i buy generic zithromax. Percentage of nonpregnant women aged 40â59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40â59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in womenâs reproductive hormone levels (5).

Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status. A three-level categorical variable was created from a series of questions that asked women. 1) âHow old were you when your periods or menstrual cycles started?.

Â. 2) âDo you still have periods or menstrual cycles?. Â. 3) âWhen did you have your last period or menstrual cycle?.

Â. And 4) âHave you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. Â Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less.

Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, âIn the past week, on how many days did you wake up feeling well rested?. ÂShort sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, âOn average, how many hours of sleep do you get in a 24-hour period?.

ÂTrouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, âIn the past week, how many times did you have trouble falling asleep?. ÂTrouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, âIn the past week, how many times did you have trouble staying asleep?.

Â Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondentsâ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS.

For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40â59 living in households across the United States. The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS.

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338â50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No.

141. Management of menopausal symptoms. Obstet Gynecol 123(1):202â16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011â2014pdf icon. 2016.Santoro N. Perimenopause.

From research to practice. J Womenâs Health (Larchmt) 25(4):332â9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult.

A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591â2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006â2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software].

2012. Suggested citationVahratian A. Sleep duration and quality among women aged 40â59, by menopausal status. NCHS data brief, no 286.

Hyattsville, MD. National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J. Blumberg, Ph.D., Associate Director for Science.

NCHS Data zithromax buy canada click resources Brief No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40â59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40â59 were more likely than premenopausal women aged 40â59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40â59 (55.1%) were more likely than premenopausal women aged 40â59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased zithromax buy canada risk for chronic conditions such as cardiovascular disease (1) and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is âthe permanent cessation of menstruation that occurs after the loss of ovarian activityâ zithromax buy canada (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40â59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women zithromax buy canada are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and zithromax buy canada postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40â59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 zithromax buy canada. Percentage of nonpregnant women aged 40â59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by menopausal status (p < zithromax buy canada. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less zithromax buy canada. Women were premenopausal if they still had a menstrual cycle. Access data zithromax buy canada table for Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40â59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40â59 had trouble falling asleep four times or more zithromax buy canada in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 zithromax buy canada. Percentage of nonpregnant women aged 40â59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image zithromax buy canada icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no zithromax buy canada longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data zithromax buy canada table for Figure 2pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40â59 who had trouble staying asleep four times or more in the past week varied zithromax buy canada by menopausal status.More than one in four nonpregnant women aged 40â59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40â59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 zithromax buy canada. Percentage of nonpregnant women aged 40â59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image zithromax buy canada icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer zithromax buy canada had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table zithromax buy canada for Figure 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40â59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40â59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested 4 days or more in the past week zithromax buy canada increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.