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AbstractIntroduction. We report a very rare case of familial breast cancer and diffuse gastric cancer, with germline pathogenic variants in both BRCA1 and CDH1 genes. To the best of our knowledge, this is the first report of such an association.Family description.

The proband is a woman diagnosed with breast cancer at the age of 52 years. She requested genetic counselling in 2012, at the age of 91 years, because of a history of breast cancer in her daughter, her sister, her niece and her paternal grandmother and was therefore concerned about her relatives. Her sister and maternal aunt also had gastric cancer.

She was tested for several genes associated with hereditary breast cancer.Results. A large deletion of BRCA1 from exons 1 to 7 and two CDH1 pathogenic cis variants were identified.Conclusion. This complex situation is challenging for genetic counselling and management of at-risk individuals.cancer.

Breastcancer. Gastricclinical geneticsgenetic screening/counsellingmolecular geneticsIntroductionGLI-Kruppel family member 3 (GLI3) encodes for a zinc finger transcription factor which plays a key role in the sonic hedgehog (SHH) signalling pathway essential in both limb and craniofacial development.1 2 In hand development, SHH is expressed in the zone of polarising activity (ZPA) on the posterior side of the handplate. The ZPA expresses SHH, creating a gradient of SHH from the posterior to the anterior side of the handplate.

In the presence of SHH, full length GLI3-protein is produced (GLI3A), whereas absence of SHH causes cleavage of GLI3 into its repressor form (GLI3R).3 4 Abnormal expression of this SHH/GLI3R gradient can cause both preaxial and postaxial polydactyly.2Concordantly, pathogenic DNA variants in the GLI3 gene are known to cause multiple syndromes with craniofacial and limb involvement, such as. Acrocallosal syndrome5 (OMIM. 200990), Greig cephalopolysyndactyly syndrome6 (OMIM.

175700) and Pallister-Hall syndrome7 (OMIM. 146510). Also, in non-syndromic polydactyly, such as preaxial polydactyly-type 4 (PPD4, OMIM.

174700),8 pathogenic variants in GLI3 have been described. Out of these diseases, Pallister-Hall syndrome is the most distinct entity, defined by the presence of central polydactyly and hypothalamic hamartoma.9 The other GLI3 syndromes are defined by the presence of preaxial and/or postaxial polydactyly of the hand and feet with or without syndactyly (Greig syndrome, PPD4). Also, various mild craniofacial features such as hypertelorism and macrocephaly can occur.

Pallister-Hall syndrome is caused by truncating variants in the middle third of the GLI3 gene.10–12 The truncation of GLI3 causes an overexpression of GLI3R, which is believed to be the key difference between Pallister-Hall and the GLI3-mediated polydactyly syndromes.9 11 Although multiple attempts have been made, the clinical and genetic distinction between the GLI3-mediated polydactyly syndromes is less evident. This has for example led to the introduction of subGreig and the formulation of an Oro-facial-digital overlap syndrome.10 Other authors, suggested that we should not regard these diseases as separate entities, but as a spectrum of GLI3-mediated polydactyly syndromes.13Although phenotype/genotype correlation of the different syndromes has been cumbersome, clinical and animal studies do provide evidence that distinct regions within the gene, could be related to the individual anomalies contributing to these syndromes. First, case studies show isolated preaxial polydactyly is caused by both truncating and non-truncating variants throughout the GLI3 gene, whereas in isolated postaxial polydactyly cases truncating variants at the C-terminal side of the gene are observed.12 14 These results suggest two different groups of variants for preaxial and postaxial polydactyly.

Second, recent animal studies suggest that posterior malformations in GLI3-mediated polydactyly syndromes are likely related to a dosage effect of GLI3R rather than due to the influence of an altered GLI3A expression.15Past attempts for phenotype/genotype correlation in GLI3-mediated polydactyly syndromes have directly related the diagnosed syndrome to the observed genotype.10–12 16 Focusing on individual hand phenotypes, such as preaxial and postaxial polydactyly and syndactyly might be more reliable because it prevents misclassification due to inconsistent use of syndrome definition. Subsequently, latent class analysis (LCA) provides the possibility to relate a group of observed variables to a set of latent, or unmeasured, parameters and thereby identifying different subgroups in the obtained dataset.17 As a result, LCA allows us to group different phenotypes within the GLI3-mediated polydactyly syndromes and relate the most important predictors of the grouped phenotypes to the observed GLI3 variants.The aim of our study was to further investigate the correlation of the individual phenotypes to the genotypes observed in GLI3-mediated polydactyly syndromes, using LCA. Cases were obtained by both literature review and the inclusion of local clinical cases.

Subsequently, we identified two subclasses of limb anomalies that relate to the underlying GLI3 variant. We provide evidence for two different phenotypic and genotypic groups with predominantly preaxial and postaxial hand and feet anomalies, and we specify those cases with a higher risk for corpus callosum anomalies.MethodsLiterature reviewThe Human Gene Mutation Database (HGMD Professional 2019) was reviewed to identify known pathogenic variants in GLI3 and corresponding phenotypes.18 All references were obtained and cases were included when they were diagnosed with either Greig or subGreig syndrome or PPD4.10–12 Pallister-Hall syndrome and acrocallosal syndrome were excluded because both are regarded distinct syndromes and rather defined by the presence of the non-hand anomalies, than the presence of preaxial or postaxial polydactyly.13 19 Isolated preaxial or postaxial polydactyly were excluded for two reasons. The phenotype/genotype correlations are better understood and both anomalies can occur sporadically which could introduce falsely assumed pathogenic GLI3 variants in the analysis.

Additionally, cases were excluded when case-specific phenotypic or genotypic information was not reported or if these two could not be related to each other. Families with a combined phenotypic description, not reducible to individual family members, were included as one case in the analysis.Clinical casesThe Sophia Children’s Hospital Database was reviewed for cases with a GLI3 variant. Within this population, the same inclusion criteria for the phenotype were valid.

Relatives of the index patients were also contacted for participation in this study, when they showed comparable hand, foot, or craniofacial malformations or when a GLI3 variant was identified. Phenotypes of the hand, foot and craniofacial anomalies of the patients treated in the Sophia Children's Hospital were collected using patient documentation. Family members were identified and if possible, clinically verified.

Alternatively, family members were contacted to verify their phenotypes. If no verification was possible, cases were excluded.PhenotypesThe phenotypes of both literature cases and local cases were extracted in a similar fashion. The most frequently reported limb and craniofacial phenotypes were dichotomised.

The dichotomised hand and foot phenotypes were preaxial polydactyly, postaxial polydactyly and syndactyly. Broad halluces or thumbs were commonly reported by authors and were dichotomised as a presentation of preaxial polydactyly. The extracted dichotomised craniofacial phenotypes were hypertelorism, macrocephaly and corpus callosum agenesis.

All other phenotypes were registered, but not dichotomised.Pathogenic GLI3 variantsAll GLI3 variants were extracted and checked using Alamut Visual V.2.14. If indicated, variants were renamed according to standard Human Genome Variation Society nomenclature.20 Variants were grouped in either missense, frameshift, nonsense or splice site variants. In the group of frameshift variants, a subgroup with possible splice site effect were identified for subgroup analysis when indicated.

Similarly, nonsense variants prone for nonsense mediated decay (NMD) and nonsense variants with experimentally confirmed NMD were identified.21 Deletions of multiple exons, CNVs and translocations were excluded for analysis. A full list of included mutations is available in the online supplementary materials.Supplemental materialThe location of the variant was compared with five known structural domains of the GLI3 gene. (1) repressor domain, (2) zinc finger domain, (3) cleavage site, (4) activator domain, which we defined as a concatenation of the separately identified transactivation zones, the CBP binding domain and the mediator binding domain (MBD) and (5) the MID1 interaction region domain.1 6 22–24 The boundaries of each of the domains were based on available literature (figure 1, exact locations available in the online supplementary materials).

The boundaries used by different authors did vary, therefore a consensus was made.In this figure the posterior probability of an anterior phenotype is plotted against the location of the variant, stratified for the type of mutation that was observed. For better overview, only variants with a location effect were displayed. The full figure, including all variant types, can be found in the online supplementary figure 1.

Each mutation is depicted as a dot, the size of the dot represents the number of observations for that variant. If multiple observations were made, the mean posterior odds and IQR are plotted. For the nonsense variants, variants that were predicted to produce nonsense mediated decay, are depicted using a triangle.

Again, the size indicates the number of observations." data-icon-position data-hide-link-title="0">Figure 1 In this figure the posterior probability of an anterior phenotype is plotted against the location of the variant, stratified for the type of mutation that was observed. For better overview, only variants with a location effect were displayed. The full figure, including all variant types, can be found in the online supplementary figure 1.

Each mutation is depicted as a dot, the size of the dot represents the number of observations for that variant. If multiple observations were made, the mean posterior odds and IQR are plotted. For the nonsense variants, variants that were predicted to produce nonsense mediated decay, are depicted using a triangle.

Again, the size indicates the number of observations.Supplemental materialLatent class analysisTo cluster phenotypes and relate those to the genotypes of the patients, an explorative analysis was done using LCA in R (R V.3.6.1 for Mac. Polytomous variable LCA, poLCA V.1.4.1.). We used our LCA to detect the number of phenotypic subgroups in the dataset and subsequently predict a class membership for each case in the dataset based on the posterior probabilities.In order to make a reliable prediction, only phenotypes that were sufficiently reported and/or ruled out were feasible for LCA, limiting the analysis to preaxial polydactyly, postaxial polydactyly and syndactyly of the hands and feet.

Only full cases were included. To determine the optimal number of classes, we fitted a series of models ranging from a one-class to a six-class model. The optimal number of classes was based on the conditional Akaike information criterion (cAIC), the non adjusted and the sample-size adjusted Bayesian information criterion (BIC and aBIC) and the obtained entropy.25 The explorative LCA produces both posterior probabilities per case for both classes and predicted class membership.

Using the predicted class membership, the phenotypic features per class were determined in a univariate analysis (χ2, SPSS V.25). Using the posterior probabilities on latent class (LC) membership, a scatter plot was created using the location of the variant on the x-axis and the probability of class membership on the y-axis for each of the types of variants (Tibco Spotfire V.7.14). Using these scatter plots, variants that give similar phenotypes were clustered.Genotype/phenotype correlationBecause an LC has no clinical value, the correlation between genotypes and phenotypes was investigated using the predictor phenotypes and the clustered phenotypes.

First, those phenotypes that contribute most to LC membership were identified. Second those phenotypes were directly related to the different types of variants (missense, nonsense, frameshift, splice site) and their clustered locations. Quantification of the relation was performed using a univariate analysis using a χ2 test.

Because of our selection criteria, meaning patients at least have two phenotypes, a multivariate using a logistic regression analysis was used to detect the most significant predictors in the overall phenotype (SPSS V.25). Finally, we explored the relation of the clustered genotypes to the presence of corpus callosum agenesis, a rare malformation in GLI3-mediated polydactyly syndromes which cannot be readily diagnosed without additional imaging.ResultsWe included 251 patients from the literature and 46 local patients,10–12 16 21 26–43 in total 297 patients from 155 different families with 127 different GLI3 variants, 32 of which were large deletions, CNVs or translocations. In six local cases, the exact variant could not be retrieved by status research.The distribution of the most frequently observed phenotypes and variants are presented in table 1.

Other recurring phenotypes included developmental delay (n=22), broad nasal root (n=23), frontal bossing or prominent forehead (n=16) and craniosynostosis (n=13), camptodactyly (n=8) and a broad first interdigital webspace of the foot (n=6).View this table:Table 1 Baseline phenotypes and genotypes of selected populationThe LCA model was fitted using the six defined hand/foot phenotypes. Model fit indices for the LCA are displayed in table 2. Based on the BIC, a two-class model has the best fit for our data.

The four-class model does show a gain in entropy, however with a higher BIC and loss of df. Therefore, based on the majority of performance statistics and the interpretability of the model, a two-class model was chosen. Table 3 displays the distribution of phenotypes and genotypes over the two classes.View this table:Table 2 Model fit indices for the one-class through six-class model evaluated in our LCAView this table:Table 3 Distribution of phenotypes and genotypes in the two latent classes (LC)Table 1 depicts the baseline phenotypes and genotypes in the obtained population.

Note incomplete data especially in the cranium phenotypes. In total 259 valid genotypes were present. In total, 289 cases had complete data for all hand and foot phenotypes (preaxial polydactyly, postaxial polydactyly and syndactyly) and thus were available for LCA.

Combined, for phenotype/genotype correlation 258 cases were available with complete genotypes and complete hand and foot phenotypes.Table 2 depicts the model fit indices for all models that have been fitted to our data.Table 3 depicts the distribution of phenotypes and genotypes over the two assigned LCs. Hand and foot phenotypes were used as input for the LCA, thus are all complete cases. Malformation of the cranium and genotypes do have missing cases.

Note that for the LCA, full case description was required, resulting in eight cases due to incomplete phenotypes. Out of these eight, one also had a genotype that thus needed to be excluded. Missingness of genotypic data was higher in LC2, mostly due to CNVs (table 1).In 54/60 cases, a missense variant produced a posterior phenotype.

Likewise, splice site variants show the same phenotype in 23/24 cases (table 3). For both frameshift and nonsense variants, this relation is not significant (52 anterior vs 54 posterior and 26 anterior vs 42 posterior, respectively). Therefore, only for nonsense and frameshift variants the location of the variant was plotted against the probability for LC2 membership in figure 1.

A full scatterplot of all variants is available in online supplementary figure 1.Figure 1 reveals a pattern for these nonsense and frameshift variants that reveals that variants at the C-terminal of the gene predict anterior phenotypes. When relating the domains of the GLI3 protein to the observed phenotype, we observe that the majority of patients with a nonsense or frameshift variant in the repressor domain, the zinc finger domain or the cleavage site had a high probability of an LC2/anterior phenotype. This group contains all variants that are either experimentally determined to be subject to NMD (triangle marker in figure 1) or predicted to be subject to NMD (diamond marker in figure 1).

Frameshift and nonsense variants in the activator domain result in high probability for an LC1/posterior phenotype. These variants will be further referred to as truncating variants in the activator domain.The univariate relation of the individual phenotypes to these two groups of variants are estimated and presented in table 4. In our multivariate analysis, postaxial polydactyly of the foot and hand are the strongest predictors (Beta.

2.548, p<0001 and Beta. 1.47, p=0.013, respectively) for patients to have a truncating variant in the activator domain. Moreover, the effect sizes of preaxial polydactyly of the hand and feet (Beta.

ˆ’0.797, p=0123 and −1.772, p=0.001) reveals that especially postaxial polydactyly of the foot is the dominant predictor for the genetic substrate of the observed anomalies.View this table:Table 4 Univariate and multivariate analysis of the phenotype/genotype correlationTable 4 shows exploration of the individual phenotypes on the genotype, both univariate and multivariate. The multivariate analysis corrects for the presence of multiple phenotypes in the underlying population.Although the craniofacial anomalies could not be included in the LCA, the relation between the observed anomalies and the identified genetic substrates can be studied. The prevalence of hypertelorism was equally distributed over the two groups of variants (47/135 vs 21/47 respectively, p<0.229).

However for corpus callosum agenesis and macrocephaly, there was a higher prevalence in patients with a truncating variant in the activator domain (3/75 vs 11/41, p<0.001. OR. 8.8, p<0.001) and 42/123 vs 24/48, p<0.05).

Noteworthy is the fact that 11/14 cases with corpus callosum agenesis in the dataset had a truncating variant in the activator domain.DiscussionIn this report, we present new insights into the correlation between the phenotype and the genotype in patients with GLI3-mediated polydactyly syndromes. We illustrate that there are two LCs of patients, best predicted by postaxial polydactyly of the hand and foot for LC1, and the preaxial polydactyly of the hand and foot and syndactyly of the foot for LC2. Patients with postaxial phenotypes have a higher risk of having a truncating variant in the activator domain of the GLI3 gene which is also related to a higher risk of corpus callosum agenesis.

These results suggest a functional difference between truncating variants on the N-terminal and the C-terminal side of the GLI3 cleavage site.Previous attempts of phenotype to genotype correlation have not yet provided the clinical confirmation of these assumed mechanisms in the pathophysiology of GLI3-mediated polydactyly syndromes. Johnston et al have successfully determined the Pallister-Hall region in which truncating variants produce a Pallister-Hall phenotype rather than Greig syndrome.11 However, in their latest population study, subtypes of both syndromes were included to explain the full spectrum of observed malformations. In 2015, Demurger et al reported the higher incidence of corpus callosum agenesis in the Greig syndrome population with truncating mutations in the activator domain.12 Al-Qattan in his review summarises the concept of a spectrum of anomalies dependent on haplo-insufficiency (through different mechanisms) and repressor overexpression.13 However, he bases this theory mainly on reviewed experimental data.

Our report is the first to provide an extensive clinical review of cases that substantiate the phenotypic difference between the two groups that could fit the suggested mechanisms. We agree with Al-Qattan et al that a variation of anomalies can be observed given any pathogenic variant in the GLI3 gene, but overall two dominant phenotypes are present. A population with predominantly preaxial anomalies and one with postaxial anomalies.

The presence of preaxial or postaxial polydactyly and syndactyly is not mutually exclusive for one of these two subclasses. Meaning that preaxial polydactyly can co-occur with postaxial polydactyly. However, truncating mutations in the activator domain produce a postaxial phenotype, as can be derived from the risk in table 4.

The higher risk of corpus callosum agenesis in this population shows that differentiating between a preaxial phenotype and a postaxial phenotype, instead of between the different GLI3-mediated polydactyly syndromes, might be more relevant regarding diagnostics for corpus callosum agenesis.We chose to use LCA as an exploratory tool only in our population for two reasons. First of all, LCA can be useful to identify subgroups, but there is no ‘true’ model or number of subgroups you can detect. The best fitting model can only be estimated based on the available measures and approximates the true subgroups that might be present.

Second, LC membership assignment is a statistical procedure based on the posterior probability, with concordant errors of the estimation, rather than a clinical value that can be measured or evaluated. Therefore, we decided to use our LCA only in an exploratory tool, and perform our statistics using the actual phenotypes that predict LC membership and the associated genotypes. Overall, this method worked well to differentiate the two subgroups present in our dataset.

However, outliers were observed. A qualitative analysis of these outliers is available in the online supplementary data.The genetic substrate for the two phenotypic clusters can be discussed based on multiple experiments. Overall, we hypothesise two genetic clusters.

One that is due to haploinsufficiency and one that is due to abnormal truncation of the activator. The hypothesised cluster of variants that produce haploinsufficiency is mainly based on the experimental data that confirms NMD in two variants and the NMD prediction of other nonsense variants in Alamut. For the frameshift variants, it is also likely that the cleavage of the zinc finger domain results in functional haploinsufficiency either because of a lack of signalling domains or similarly due to NMD.

Missense variants could cause haploinsufficiency through the suggested mechanism by Krauss et al who have illustrated that missense variants in the MID1 domain hamper the functional interaction with the MID1-α4-PP2A complex, leading to a subcellular location of GLI3.24 The observed missense variants in our study exceed the region to which Krauss et al have limited the MID-1 interaction domain. An alternative theory is suggested by Zhou et al who have shown that missense variants in the MBD can cause deficiency in the signalling of GLI3A, functionally implicating a relative overexpression of GLI3R.22 However, GLI3R overexpression would likely produce a posterior phenotype, as determined by Hill et al in their fixed homo and hemizygous GLI3R models.15 Therefore, our hypothesis is that all included missense variants have a similar pathogenesis which is more likely in concordance with the mechanism introduced by Krauss et al. To our knowledge, no splice site variants have been functionally described in literature.

However, it is noted that the 15 and last exon encompasses the entire activator domain, thus any splice site mutation is by definition located on the 5′ side of the activator. Based on the phenotype, we would suggest that these variants fail to produce a functional protein. We hypothesise that the truncating variants of the activator domain lead to overexpression of GLI3R in SHH rich areas.

In normal development, the presence of SHH prevents the processing of full length GLI34 into GLI3R, thus producing the full length activator. In patients with a truncating variant of the activator domain of GLI3, thus these variants likely have the largest effect in SHH rich areas, such as the ZPA located at the posterior side of the hand/footplate. Moreover, the lack of posterior anomalies in the GLI3∆699/- mouse model (hemizygous fixed repressor model) compared with the GLI3∆699/∆699 mouse model (homozygous fixed repressor model), suggesting a dosage effect of GLI3R to be responsible for posterior hand anomalies.15 These findings are supported by Lewandowski et al, who show that the majority of the target genes in GLI signalling are regulated by GLI3R rather than GLI3A.44 Together, these findings suggest a role for the location and type of variant in GLI3-mediated syndromes.Interestingly, the difference between Pallister-Hall syndrome and GLI3-mediated polydactyly syndromes has also been attributed to the GLI3R overexpression.

However, the difference in phenotype observed in the cases with a truncating variant in the activator domain and Pallister-Hall syndrome suggest different functional consequences. When studying figure 1, it is noted that the included truncating variants on the 3′ side of the cleavage site seldomly affect the CBP binding region, which could provide an explanation for the observed differences. This binding region is included in the Pallister-Hall region as defined by Johnston et al and is necessary for the downstream signalling with GLI1.10 11 23 45 Interestingly, recent reports show that pathogenic variants in GLI1 can produce phenotypes concordant with Ellis von Krefeld syndrome, which includes overlapping features with Pallister-Hall syndrome.46 The four truncating variants observed in this study that do affect the CBP but did not result in a Pallister-Hall phenotype are conflicting with this theory.

Krauss et al postulate an alternative hypothesis, they state that the MID1-α4-PP2A complex, which is essential for GLI3A signalling, could also be the reason for overlapping features of Opitz syndrome, caused by variants in MID1, and Pallister-Hall syndrome. Further analysis is required to fully appreciate the functional differences between truncating mutations that cause Pallister-Hall syndrome and those that result in GLI3-mediated polydactyly syndromes.For the clinical evaluation of patients with GLI3-mediated polydactyly syndromes, intracranial anomalies are likely the most important to predict based on the variant. Unfortunately, the presence of corpus callosum agenesis was not routinely investigated or reported thus this feature could not be used as an indicator phenotype for LC membership.

Interestingly when using only hand and foot phenotypes, we did notice a higher prevalence of corpus callosum agenesis in patients with posterior phenotypes. The suggested relation between truncating mutations in the activator domain causing these posterior phenotypes and corpus callosum agenesis was statistically confirmed (OR. 8.8, p<0.001).

Functionally this relation could be caused by the GLI3-MED12 interaction at the MBD. Pathogenic DNA variants in MED12 can cause Opitz-Kaveggia syndrome, a syndrome in which presentation includes corpus callosum agenesis, broad halluces and thumbs.47In conclusion, there are two distinct phenotypes within the GLI3-mediated polydactyly population. Patients with more posteriorly and more anteriorly oriented hand anomalies.

Furthermore, this difference is related to the observed variant in GLI3. We hypothesise that variants that cause haploinsufficiency produce anterior anomalies of the hand, whereas variants with abnormal truncation of the activator domain have more posterior anomalies. Furthermore, patients that have a variant that produces abnormal truncation of the activator domain, have a greater risk for corpus callosum agenesis.

Thus, we advocate to differentiate preaxial or postaxial oriented GLI3 phenotypes to explain the pathophysiology as well as to get a risk assessment for corpus callosum agenesis.Data availability statementData are available upon reasonable request.Ethics statementsPatient consent for publicationNot required.Ethics approvalThe research protocol was approved by the local ethics board of the Erasmus MC University Medical Center (MEC 2015-679)..

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Establishing a new Behavioral Health Coordinating Council will assure the right prioritization and guidelines are in place to provide pathways to prevention, intervention, treatment and recovery services." "The Biden-Harris Administration's support through the American Rescue Plan funding will increase community-level supports for Americans who have been grappling with devastating emotional and mental challenges during the hypertension medications lasix," said Acting Assistant Secretary for Mental Health and Substance Use Tom Coderre. "Given the significant impact mental and substance use disorders can have on the lives of individuals, families and communities, the establishment of the where to buy diuretic lasix BHCC provides a critical tool in addressing these issues in a collaborative and strategic way." The MHBG program enables states and territories to provide comprehensive community mental health services and address needs and gaps in existing treatment services for those with severe mental health conditions. The SABG program allows states and territories to plan, implement and evaluate activities to prevent, treat and help more people recover from substance use disorder.

This funding will also where to buy diuretic lasix allow recipients to make investments in existing prevention, treatment and recovery infrastructure, promote support for providers and address unique local needs to deliver substance use disorder services. Funding allocation tables can be viewed here. People searching for treatment for mental or substance use disorders can find it by visiting https://findtreatment.samhsa.gov or by calling SAMHSA's National Helpline, 1-800-662-HELP (4357).Reporters with questions should send inquiries to media@samhsa.hhs.gov..

Funding Will check that Expand Use of Telehealth to Integrate Mental and Behavioral Health into online doctor lasix Pediatric Primary CareToday, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of $14.2 million from the American Rescue Plan to expand pediatric mental health care access by integrating telehealth services into pediatric primary care. The funding will online doctor lasix expand Pediatric Mental Health Care Access (PMHCA) projects into new states and geographic areas nationwide, including tribal areas. These new state and regional networks of pediatric mental health care teams will provide teleconsultations, training, technical assistance and care coordination for pediatric primary care providers to diagnose, treat and refer children and youth with mental health conditions and substance use disorders.

Currently, there online doctor lasix are 21 PMCHA projects in the country. “Children are struggling with a range of emotional and behavioral challenges arising from the hypertension medications lasix, especially those in families with lower incomes or who face other obstacles to health care,” said HHS Secretary Xavier Becerra. €œThis program online doctor lasix harnesses the power of technology to make mental and behavioral health care more accessible and equitable for our nation’s children, and links pediatric care providers to children and their families who need that specialized care.” Research demonstrates an increased need for pediatric mental and behavioral health care. In the United States, about 22 percent of children ages 3 to 17 are currently affected by some type of mental, emotional, developmental, or behavioral condition.

Only about 20% of children with mental, emotional, or behavioral disorders receive care from online doctor lasix a specialized provider. €œNow more than ever, families need mental and behavioral health care for their children, but significant disparities in access to this treatment continue to exist,” said Acting HRSA Administrator Diana Espinosa. €œThe expansion of the Pediatric Mental Health Care Access Program paves the way for more children online doctor lasix to receive necessary mental health services, especially those in underserved communities.” Pediatric mental health care teams will include child and adolescent psychiatrists, licensed mental health professionals, and care coordinators. Pediatric primary care providers can include, but are not limited to, pediatricians, family physicians, nurse practitioners, physician assistants, and care coordinators.

Teams will use telehealth to consult with pediatric primary care providers. To learn about online doctor lasix eligibility and to apply for the American Rescue Plan Act - Pediatric Mental Health Care Access (PMHCA) – New Area Expansion Notice of Funding Opportunity, visit https://www.grants.gov/web/grants/view-opportunity.html?. OppId=333181. Applications are due online doctor lasix July 6, 2021, at 11:59 p.m.

ET. Applicants should contact Madhavi Reddy with any questions online doctor lasix. Learn more about HRSA’s Pediatric Mental Health Care Access program.HHS Secretary Becerra forms new Behavioral Health Coordinating CouncilThe Substance Abuse and Mental Health Services Administration (SAMHSA) is distributing $3 billion in American Rescue Plan funding — the largest aggregate amount of funding to date for its mental health and substance use block grant programs. The Community Mental Health Services Block Grant online doctor lasix (MHBG) Program and Substance Abuse Prevention and Treatment Block Grant Program (SABG) will disperse $1.5 billion each to states and territories (with the latter also awarding money to a tribe).

This follows the March announcement of supplemental funding of nearly $2.5 billion for these programs. SAMHSA, an online doctor lasix operating division of the U.S. Department of Health and Human Services, has expedited federal funding to grantees to help communities grappling with mental health and substance use needs during the hypertension medications lasix. The hypertension medications lasix and online doctor lasix the corresponding economic crisis have been especially devastating for Black, American Indian, Alaska Native and Hispanic communities, who are experiencing a disproportionate number of hypertension medications s and deaths as well as higher-than-average unemployment rates.

Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations have experienced increased stigma and hate due to hypertension medications anti-Asian rhetoric, which is impacting the behavioral health of AANHPI communities. The Centers for Disease Control and Prevention (CDC) preliminary data points to 90,000 overdose deaths for the 12 months ending last September – about 20,000 more than the same period the year before. CDC data also shows that American adults in June 2020 reported elevated levels online doctor lasix of adverse mental health conditions, substance use, and suicidal ideation. The prevalence of symptoms of anxiety was approximately three times those reported in the second quarter of 2019, and prevalence of depression was approximately four times that reported in the second quarter of 2019.

Last week, the Centers online doctor lasix for Medicare &. Medicaid Services (CMS) released data highlighting health services received by millions of Medicaid and Children Health Insurance Program beneficiaries during the hypertension medications Public Health Emergency. Despite an overall rebound for most of these online doctor lasix services, mental health utilization remains below pre-lasix levels. With the nation's mental and substance use disorder needs squarely in focus, HHS Secretary Xavier Becerra is establishing a new Behavioral Health Coordinating Council (BHCC).

The Assistant Secretary for Mental Health and Substance Use and the Assistant Secretary for Health online doctor lasix will serve as the co-chairs of this coordinating body, which is comprised of senior leadership from across the Department. The BHCC's primary goal is to facilitate collaborative, innovative, transparent, equitable, and action-oriented approaches to addressing the HHS' behavioral health agenda. "Behavioral health is a priority for the Department of online doctor lasix Health and Human Services. The hypertension medications lasix has made clear the need to invest resources in our nation's mental health and address the inequities that still exist around behavioral health care.

That's why we are making this historic investment in mental health and substance use services," said HHS Secretary Xavier Becerra. "In addition, this online doctor lasix national problem calls for Department-wide coordination to address the issue. That's why I am convening the Behavioral Health Coordinating Council to work across HHS to facilitate collaboration and strategic planning as we implement our behavioral health agenda." "Across America, we are seeing a startling rise in mental health and substance use disorders during the hypertension medications lasix," said Assistant Secretary for Health Dr. Rachel Levine online doctor lasix.

"We know multiple stressors during the lasix – isolation, sickness, grief, job loss, food instability, and loss of routines – have devastated many Americans and presented the unprecedented behavioral health challenges across the nation. Addressing the online doctor lasix hypertension medications mental and behavioral health impacts on vulnerable and disenfranchised populations are among the top priorities of the Biden-Harris Administration. Establishing a new Behavioral Health Coordinating Council will assure the right prioritization and guidelines are in place to provide pathways to prevention, intervention, treatment and recovery services." "The Biden-Harris Administration's support through the American Rescue Plan funding will increase community-level supports for Americans who have been grappling with devastating emotional and mental challenges during the hypertension medications lasix," said Acting Assistant Secretary for Mental Health and Substance Use Tom Coderre. "Given the significant impact mental and substance use disorders can have on the lives of individuals, families and communities, the establishment of the BHCC provides a critical tool in addressing these issues in a collaborative and strategic way." The MHBG program enables states and territories to provide comprehensive community mental health services and address needs and gaps in existing treatment services for those with severe mental online doctor lasix health conditions.

The SABG program allows states and territories to plan, implement and evaluate activities to prevent, treat and help more people recover from substance use disorder. This funding will also allow recipients to make investments in existing prevention, treatment and recovery infrastructure, promote support for providers and online doctor lasix address unique local needs to deliver substance use disorder services. Funding allocation tables can be viewed here. People searching for treatment for mental or substance use disorders can find it by visiting https://findtreatment.samhsa.gov or by calling SAMHSA's National Helpline, 1-800-662-HELP (4357).Reporters with questions should send inquiries to media@samhsa.hhs.gov..

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If you buy something, online doctor lasix we may get a cut of the sale.Infants need to eat. Why does online doctor lasix society still have a problem with it?. Despite it being a normal part of life and something so important it's literally life or death, ensuring infant children are fed with their mother's milk is still somewhat frowned upon.

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About This TrackerThis tracker provides the number of confirmed cases and deaths from novel hypertension by country, the trend in confirmed case and death counts by lasix cost for dogs country, and a global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) hypertension Resource Center’s hypertension medications Map and the World Health Organization’s (WHO) hypertension Disease (hypertension medications-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About hypertension medications hypertensionIn late 2019, a new hypertension emerged lasix cost for dogs in central China to cause disease in humans. Cases of this disease, known as hypertension medications, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the lasix represents a public health emergency of international concern, and on January 31, lasix cost for dogs 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 hypertension medications–19 unless a statute is enacted expressly authorizing such a waiver with respect to the prevention, containment, mitigation, or treatment of hypertension medications–19, and for other purposes.5/14/2021H.R. 3236Maria Elvira Salazar (R-FL-27)Referred to HFAC and H.

Ways and MeansTRIPS, WTO, intellectual property rights, hypertension medications 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 hypertension medications unless a statute is enacted expressly authorizing such a waiver with respect to such. Requires the President to allocate excess U.S. hypertension medications 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)hypertension medications, 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 hypertension medications–19 and other infectious diseases in the border region, and for other purposes.3/03/2021H.R. 1538Rep.. Veronica Escobar (D-TX-16)Referred to H.

Energy and HFACMexicoAuthorizes and directs the President to seek to begin negotiations with Mexico to amend an existing agreement addressing infectious disease preparedness in the U.S.-Mexico Border Area, with respect to hypertension medications and other infectious diseases, specifically requiring the U.S.-Mexico Border Health Commission to submit a report on the border area’s response to hypertension medications and requiring it to also develop and publicly publish a binational strategic plan that addresses how the area should strengthen its hypertension medications response, sharing relevant health data, and how a hypertension medications 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 hypertension medications) 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, hypertension medications, 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 hypertension medications lasix. 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 hypertension medications lasix. Requires the strategy include programming to address maternal and child health, family planning and reproductive health, gender-based violence, food security and nutrition, NCDs, NTDs, tuberculosis, HIV/AIDS, STDs, and zoonotic and emerging infectious disease threats, clean water, sanitation, and hygiene (WASH), health system strengthening, and other activities. Requires a report not later than 180 days after enactment with strategy. Authorizes to be appropriated $20 million for each FY22-FY26 to carry out these efforts.

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

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

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

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

And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Curbing China’s treatment Diplomacy ActTo prioritize the international distribution of hypertension medications treatment doses, and for other purposes.7/6/2021H.R.4362Rep. Carlos Gimenez (R-FL-26)Referred to HFAChypertension medications, treatmentsRequires the Secretary of States to prioritize, in carrying out the international distribution of hypertension medications 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 hypertension medications. Requires the Secretary to ensure that not less than 25% of the total number of hypertension medications 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 hypertension medications treatment doses to any country which has a government that has been determined to have engaged in systemic or widespread human rights abuses. Terminates five days after the date on which the Secretary determines the above have each achieved 40% vaccination rates of their respective populations.Department of State, Foreign Operations, and Related Programs Appropriations Act, 2022(State/Foreign Ops – SFOPS Approps)Making appropriations for the Department of State, foreign operations, and related programs for the fiscal year ending September 30, 2022, and for other purposes.7/6/2021H.R.

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

Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022(Labor/HHS – 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.

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 lasix 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 lasix preparedness as a multilateral, catalytic financing mechanism. Describes Fund’s Advisory Board, purpose, Executive Board and its makeup and duties.

Creates a Coordinator of U.S. Government activities to advance global health security, who shall be appointed by the President to represent the U.S. On the Executive Board. Outlines eligible partner country definition and Fund program objectives, supported activities, administration, including appointment of an Administrator appointed by the Executive Board, and transparency and accountability requirements. Requires reports to Congress on the Fund including a 6 month status report and then annual reports after the Fund’s establishment.

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

Directs the Administrator and others to coordinate with bilateral and multilateral donors, governments of partner countries, U.N. Agencies, and others to prevent and treat malnutrition globally. Requires the Administrator and others to seek to leverage additional resources to this end by increasing interagency cooperation among relevant departments and agencies represented in the Global Nutrition Coordination Plan. Requires the selection of priority countries and outlines criteria. Express Sense of Congress that efforts to undertake nutrition interventions in countries not selected as priority countries should continue.

Authorizes the establishment of the Nutrition Leadership Council within USAID and outlines its duties and membership. Requires the development of an implementation plan. Requires an annual progress report for five years.Global lasix 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 HFAClasix, 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 lasix 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 lasix 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 SFRClasix, 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 lasix potential, and supporting the development of One Health systems at the community level. Establishes the global zoonotic disease task force and outlines its membership and their terms, duties (including developing and publishing a plan for global biosecurity and zoonotic disease prevention and response and expanding the scope of the global health security strategy to more robustly support the prevention of zoonotic spillover and to respond to zoonotic disease investigations and outbreaks by establishing a 10 year strategy), required reports from agencies to the task force as well as from the task force to Congress, and its termination date 7 years after the date of enactment or a later date that is not later than two years after that.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes.

6/9/2021S. 1996Sen. Edward Markey (D-MA)Read twice and referred to SFRCLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S.

Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community. And expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes. 6/8/2021H.R.

3800Rep. Dina Titus (D-NV-1)Referred to HFAC, H. JudiciaryLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S.

Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community. Expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination. And repeals the Mexico City policy by removing certain limitations on eligibility for foreign assistance.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021H.R.

3373Rep. Ami Bera (D-CA-7)Referred to HFAC, H. Veterans’ Affairs, H. Natural Resources, H. Armed Services, H.

Financial Services, H. Judiciary, H. Transportation and Infrastructure, H. Homeland SecurityPublic health capacity building, global health securityStates it is U.S. Policy to, among other things, improve the local capacity of the countries of Oceania to address public health challenges and improve global health security.

Requires the Secretary of State, in consultation with the HHS Secretary, to establish a program to support building public health capacity and improving access to care and local health outcomes in Oceania related to maternal and child health, STDs, HIV/AIDS, tuberculosis, malaria, NTDs, NCDs, gender-based violence, substance use disorder, mortality due to epidemics, disasters, and the impacts from severe weather and environmental change, and other health issues. Requires a report on these efforts annually. Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021S. 1774Sen.

Brian Schatz (D-HI)Read twice and referred to SFRCPublic health capacity building, global health securityStates it is U.S. Policy to, among other things, improve the local capacity of the countries of Oceania to address public health challenges and improve global health security. Requires the Secretary of State, in consultation with the HHS Secretary, to establish a program to support building public health capacity and improving access to care and local health outcomes in Oceania related to maternal and child health, STDs, HIV/AIDS, tuberculosis, malaria, NTDs, NCDs, gender-based violence, substance use disorder, mortality due to epidemics, disasters, and the impacts from severe weather and environmental change, and other health issues. Requires a report on these efforts annually. Authorizes to be appropriated such sums as may be necessary to carry out the program.

Requires amounts appropriated or made available to remain available under expended.International Human Rights Defense Act of 2021To establish in the Bureau of Democracy, Human Rights, and Labor of the Department of State a Special Envoy for the Human Rights of LGBTI Peoples, and for other purposes.2/22/2021H.R. 1201Rep. Alan Lowenthal (D-CA-47)Referred to HFACLGBTI health, HIVIncludes statement of U.S. Policy regarding LGBTI issues globally, including employing a multisectoral approach to preventing and responding to criminalization, discrimination, and violence against LGBTI people internationally, including activities in the health sector. Authorizes the provision of U.S.

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

Assistance to prevent and respond to these issues internationally, including enhancement of health sector capacity related to violence against LGBTI people and communities and to combat HIV.International lasix Preparedness and hypertension medications 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 Orderslasix preparedness, hypertension medications, 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, hypertension medications treatments to other countries. Requires a report that assesses the global humanitarian response to hypertension medications and outlines specific elements of the U.S.

Government’s country-level response to the hypertension medications lasix. In the event of an infectious disease outbreak outside the U.S. With lasix 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 lasix 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 lasix 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 lasix prevention and preparedness (see “the Fund” below). Requires U.S. Global health program leadership identify areas of collaboration and coordination to ensure that such activities contribute to health systems strengthening. Directs the Secretary of State, with the USAID Administrator, to work with the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the treatment Alliance, bilateral donors, and others to develop shared core indicators for strengthened health systems.

Authorizes the U.S. To participate in the Coalition for Epidemic Preparedness Innovations (CEPI). Expresses Sense of Congress that the President should make an immediate contribution to CEPI of $300 million to expand research and development of treatments to combat the spread of hypertension medications 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 lasix 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 lasix potential. Directs the Secretary of State, with the HHS Secretary, to work with WHO and like-minded member states to adopt an approach toward assessing infectious disease threats under the International Health Regulations (2005) for the WHO to identify and transparently communicate on an ongoing basis varying levels of risk leading up to, and during and after, a public health emergency of international concern (PHEIC) declaration. Directs the Secretary of State and others to seek to enter into negotiations to establish “the Fund;” authorizes the President to make available for U.S. Contributions to the Fund such funds as may be appropriated or otherwise made available for such purpose. Limits the U.S.

Contribution to the Fund to not exceed 33% of the total contributions from all sources.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, hypertension medicationsExpresses Sense of Congress that mental health is integral and essential to overall health outcomes and other development objectives. Codifies the position of USAID coordinator for mental health and psychosocial support and describes the position’s duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Group’s duties and members.

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

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

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

Foreign assistance.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act)To establish a program to oversee the global hypertension medications response and prepare for future lasixs, and for other purposes.6/8/2021H.R. 3778Rep. Raja Krishnamoorthi (D-IL-8)Referred to HFAC and H. Energy and Commercehypertension medications, global health security, lasix preparedness and responseEstablishes the lasix preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the hypertension medications lasix and protect Americans from the emergence of hypertension medications variants and other pathogens with lasix 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 hypertension medications lasix worldwide as well as a long-term strategy for preventing future lasixs. 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 lasixs. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S.

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

Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act) To establish a program to oversee the global hypertension medications response and prepare for future lasixs, and for other purposes.6/8/2021S. 1976Sen. Jeff Merkley (D-OR)Read twice and referred to SFRChypertension medications, global health security, lasix preparedness and responseEstablishes the lasix preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the hypertension medications lasix and protect Americans from the emergence of hypertension medications variants and other pathogens with lasix 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 hypertension medications lasix worldwide as well as a long-term strategy for preventing future lasixs. 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 lasixs. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S. treatment stockpile to determine whether further treatments can be sent abroad and to coordinate with BARDA to rapidly scale manufacturing capacity around the world to produce 8 billion treatment doses as soon as possible.

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

1683Sen. Tim Scott (R-SC)Read twice and referred to S. FinanceTRIPS, WTO, intellectual property rights, hypertension medications 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 hypertension medications proposed by India and South Africa or any other measure at the WTO to waive intellectual property rights.Preventing Future lasixs Act of 2021To address the public health risks posed by wildlife markets, and for other purposes.1/4/2021H.R. 151Rep. Mike Quigley (D-IL-5)Referred to HFAC, H.

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

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

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

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

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

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

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

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

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

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

And countries included in such reporting be consulted with during the preparation of annual reporting.Robust International Response to lasix ActTo provide support for a robust global response to the hypertension medications lasix.2/11/2021H.R. 986Rep. Jesus “Chuy” Garcia (D-IL-4)Referred to H. Financial Serviceshypertension medicationsDirects 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 hypertension medications lasix, 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 hypertension medications lasix.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, lasix, epidemicAuthorizes U.S. Participation in the Coalition for Epidemic Preparedness Innovation (CEPI). Reports to Congress required to be submitted by the President not later than 180 days after enactment of the Act and to outline planned U.S.

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

4/15/2021S. 1169Sen. Robert Menendez (D-NJ)Placed on Senate Legislative Calendar under General Ordershypertension medications, 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 hypertension medications lasix. 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 hypertension medications, 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 hypertension medications and support greater cooperation in building capacity to prepare for and respond to lasixs and other public health challenges. States it is U.S.

Policy to advocate and actively advance Taiwan’s meaningful participation in the World Health Assembly, among other bodies. Requires report on the origins of the hypertension medications lasix 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 hypertension medications lasix.Support for Global Financial Institution lasix Response Act of 2021To support efforts by international financial institutions to provide a robust global response to the hypertension medications–19 lasix.1/27/2021S.

67Sen. Richard Durbin (D-IL)Read twice and referred to SFRChypertension medicationsDirects 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 hypertension medications lasix, 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 hypertension medications lasix.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 lasix prevention and response, and for other purposes.2/8/2021S. 290Sen. Edward Markey (D-MA)Read twice and referred to HSGAClasixRequires the President to designate an employee of the National Security Council to be the permanent coordinator for lasix prevention and response for the federal government, outlines duties, and grants them authority to represent the U.S.

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

497Rep. Jodey Arrington (R-TX-19)Referred to HFACWHOProhibits the use of federal funds to seek membership by the U.S. In WHO or to provide assessed or voluntary U.S. Contributions to WHO until such time as the President certifies that WHO meets certain conditions, including. WHO has adopted meaningful reforms to ensure that humanitarian assistance is not politicized and is to be provided to those with the most need, WHO is not under the control or significant malign influence of the Chinese Communist party, WHO is not involved in a coverup of the Chinese Communist Party’s response to the hypertension medications lasix, 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 People’s Republic of China, including rape and torture in detention and forced sterilizations, forced abortions, and other coercive birth restriction policies, particularly in the Xinjiang Uyghur Autonomous Region, and for other purposes.5/18/2021H.R.

3306Rep. Vicky HartzlerReferred to HFAC and H. JudiciaryForced sterilization, abortionStates U.S. Policy is to regard the prevention of genocide and other atrocity crimes as a national interest particularly when those actions target certain groups in the Xinjiang Uyghur Autonomous Region through, among other things, forced sterilizations, forced abortions and other coercive birth restrictions policies, and sexual violence and other torture in detention, to raise the issue of state-sanctioned violence against women, including rape, torture, and coercively enforced population control policies in China in all multilateral organizations where the U.S. And China are members, including at the U.N.

Security Council, and to consider state-sanctioned violence against women, including forced sterilizations and forced abortions and the systematic use of rape and torture in mass internment camps in the Region as a gross violation of internationally-recognized human rights. Expresses the Sense of Congress that all governments, including the U.S., and international organizations, such as the U.N., should call the atrocities perpetuated by the government of China, including forced sterilizations and forced abortions and other sexual violence, as genocide and crimes against humanity and that the U.S. Should strongly condemn the intimidation and threats targeting Uyghur and Kazakh women who provide public evidence of sexual violence and forced sterilizations and forced abortions in mass internment camps and the journalist who report these stories. Also expresses Sense of Congress that U.N. Member states should condemn such atrocities by demanding that China end all forced sterilization, forced abortions, and other state-sanctioned violence against women, among other things.

Requires the president to submit a strategy for ending atrocity crimes in the Region. Requires the Secretary of State to provide all appropriate assistance to women who belong to certain groups and who experienced sexual violence, torture, forced sterilizations and forced abortions in China in order for them to receive needed medical care and psychological support. Requires all existing authorities to be used to allow such women to at least temporarily enter the U.S.Women and Climate Change Act of 2021To address the disparate impact of climate change on women and support the efforts of women globally to address climate change, and for other purposes.1/11/2021H.R. 260Rep. Barbara Lee (D-CA-13)Referred to HFAC, H.

Energy &. CommerceClimate change, global health, reproductive healthAddresses climate change and its effects on women and girls. Establishes the Federal Interagency Working Group on Women and Climate Change within the Department of State and outlines its functions, such as identifying best practices for collecting data on the disparate impact of climate change on women – including in access to comprehensive health care, including reproductive health and rights. Requires the Department of State’s Office of Global Women’s Issues (GWI) to submit a strategy (and shortly thereafter an implementation plan and budget) to prevent and respond to the effects of climate change on women, including effective action to promote public health. Requires the Ambassador-at-Large of GWI to designate a Senior Coordinator for Women and Climate Change.

Requires the GWI Ambassador and the Senior Coordinator to submit to the appropriate congressional committees an assessment of the human and financial resources necessary to carry out the Act.World Health Organization Accountability ActTo prohibit the availability of United States contributions to the World Health Organization until Congress receives a full report on China and the hypertension medications–19 lasix, and for other purposes.1/21/2021H.R. 374Rep. Lauren Boebert (R-CO-3)Referred to HFACWHO, hypertension medicationsProhibits 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 hypertension medications outbreak prior to March 11, 2020, by WHO and China contributed to the emergency of the lasix.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..

About This TrackerThis tracker provides the number of confirmed cases and deaths from novel hypertension by country, the trend in confirmed case and death counts by country, and a online doctor lasix global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) hypertension Resource Center’s hypertension medications Map and the World Health Organization’s (WHO) hypertension Disease (hypertension medications-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About hypertension medications hypertensionIn late 2019, a new hypertension emerged in central China online doctor lasix to cause disease in humans. Cases of this disease, known as hypertension medications, have since been reported across around the globe.

On January 30, 2020, the World Health Organization (WHO) declared the lasix represents a online doctor lasix 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 hypertension medications–19 unless a statute is enacted expressly authorizing such a waiver with respect to the prevention, containment, mitigation, or treatment of hypertension medications–19, and for other purposes.5/14/2021H.R. 3236Maria Elvira Salazar (R-FL-27)Referred to HFAC and H.

Ways and MeansTRIPS, WTO, intellectual property rights, hypertension medications 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 hypertension medications unless a statute is enacted expressly authorizing such a waiver with respect to such. Requires the President to allocate excess U.S. hypertension medications 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)hypertension medications, 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 hypertension medications–19 and other infectious diseases in the border region, and for other purposes.3/03/2021H.R. 1538Rep.. Veronica Escobar (D-TX-16)Referred to H.

Energy and HFACMexicoAuthorizes and directs the President to seek to begin negotiations with Mexico to amend an existing agreement addressing infectious disease preparedness in the U.S.-Mexico Border Area, with respect to hypertension medications and other infectious diseases, specifically requiring the U.S.-Mexico Border Health Commission to submit a report on the border area’s response to hypertension medications and requiring it to also develop and publicly publish a binational strategic plan that addresses how the area should strengthen its hypertension medications response, sharing relevant health data, and how a hypertension medications 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 hypertension medications) 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, hypertension medications, 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 hypertension medications lasix. 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 hypertension medications lasix.

Requires the strategy include programming to address maternal and child health, family planning and reproductive health, gender-based violence, food security and nutrition, NCDs, NTDs, tuberculosis, HIV/AIDS, STDs, and zoonotic and emerging infectious disease threats, clean water, sanitation, and hygiene (WASH), health system strengthening, and other activities. Requires a report not later than 180 days after enactment with strategy. Authorizes to be appropriated $20 million for each FY22-FY26 to carry out these efforts. Requires the Secretary of State and USAID Administrator to develop and implement an initiative to encourage and support efforts by the Pacific Island to reduce and combat gender-based violence.Climate Change Health Protection and Promotion Act of 2021To direct the Secretary of Health and Human Services to develop and implement a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.5/17/2021H.R.

3271Rep. Matt Cartwright (D-PA-8)Referred to H. Energy and CommerceClimate change, global healthDirects Secretary of HHS to publish a strategic action plan and establish a climate change and health program (at CDC, in collaboration with other agencies, as appropriate) to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the U.S. And other nations.

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

Establishes science advisory board and its functions, including with regarding to international impacts of climate change on health. And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Climate Change Health Protection and Promotion Act of 2021To direct the Secretary of Health and Human Services to develop and implement a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.5/19/2021S. 1702Sen. Edward Markey (D-MA)Read twice and referred to S.

HELPClimate change, global healthDirects Secretary of HHS to publish a strategic action plan and establish a climate change and health program (at CDC, in collaboration with other agencies, as appropriate) to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the U.S. And other nations. Requires the action plan include an assessment of U.S. Capacity to address climate change including, among other things, providing technical assistance and support for preparedness and response plans for the health threats of climate change in developing countries, and developing or strengthening domestic and international disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change.

Describes priority health actions for the climate and health program, including with regard to global health aspects of climate change. Requires periodic updates of action plan. Establishes science advisory board and its functions, including with regarding to international impacts of climate change on health. And directs HHS Secretary to have National Academies prepare reports on topic, with the first due in one year and then every 4 years thereafter.Curbing China’s treatment Diplomacy ActTo prioritize the international distribution of hypertension medications treatment doses, and for other purposes.7/6/2021H.R.4362Rep.

Carlos Gimenez (R-FL-26)Referred to HFAChypertension medications, treatmentsRequires the Secretary of States to prioritize, in carrying out the international distribution of hypertension medications 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 hypertension medications. Requires the Secretary to ensure that not less than 25% of the total number of hypertension medications 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 hypertension medications treatment doses to any country which has a government that has been determined to have engaged in systemic or widespread human rights abuses. Terminates five days after the date on which the Secretary determines the above have each achieved 40% vaccination rates of their respective populations.Department of State, Foreign Operations, and Related Programs Appropriations Act, 2022(State/Foreign Ops – SFOPS Approps)Making appropriations for the Department of State, foreign operations, and related programs for the fiscal year ending September 30, 2022, and for other purposes.7/6/2021H.R.

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

2021, see KFF explainer). Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022(Labor/HHS – 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. 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 lasix 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 lasix preparedness as a multilateral, catalytic financing mechanism. Describes Fund’s Advisory Board, purpose, Executive Board and its makeup and duties.

Creates a Coordinator of U.S. Government activities to advance global health security, who shall be appointed by the President to represent the U.S. On the Executive Board. Outlines eligible partner country definition and Fund program objectives, supported activities, administration, including appointment of an Administrator appointed by the Executive Board, and transparency and accountability requirements.

Requires reports to Congress on the Fund including a 6 month status report and then annual reports after the Fund’s establishment. And authorizes U.S. Contributions to the Fund with a limit that the U.S. Share not exceed 33% of total contributions to the Fund cumulatively.Global Malnutrition Prevention and Treatment Act of 2021To advance targeted and evidence-based interventions for the prevention and treatment of global malnutrition and to improve the coordination of such programs, and for other purposes.07/26/2021H.R.

4693Rep. Michael McCaul (R-TX-10)Passed HFAC (Ordered to be Reported by Voice Vote)MalnutritionAuthorizes the USAID Administrator to support efforts to prevent and treat malnutrition globally, including by targeting resources and nutrition interventions to support the most vulnerable populations susceptible to severe malnutrition, including children under the age of 5 and pregnant and lactating women. Directs the Administrator and others to coordinate with bilateral and multilateral donors, governments of partner countries, U.N. Agencies, and others to prevent and treat malnutrition globally.

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

Requires the development of an implementation plan. Requires an annual progress report for five years.Global lasix 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 HFAClasix, 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 lasix 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 lasix 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 SFRClasix, 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 lasix potential, and supporting the development of One Health systems at the community level.

Establishes the global zoonotic disease task force and outlines its membership and their terms, duties (including developing and publishing a plan for global biosecurity and zoonotic disease prevention and response and expanding the scope of the global health security strategy to more robustly support the prevention of zoonotic spillover and to respond to zoonotic disease investigations and outbreaks by establishing a 10 year strategy), required reports from agencies to the task force as well as from the task force to Congress, and its termination date 7 years after the date of enactment or a later date that is not later than two years after that.Greater Leadership Overseas for the Benefit of Equality Act of 2021(GLOBE Act of 2021)To protect human rights and enhance opportunities for LGBTQI people around the world, and for other purposes. 6/9/2021S. 1996Sen. Edward Markey (D-MA)Read twice and referred to SFRCLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S.

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

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

Dina Titus (D-NV-1)Referred to HFAC, H. JudiciaryLGBTQI health, HIV, Mexico City policyRequires equal access of all elements of the population to programs funded by U.S. Assistance, including global health programs.Also requires PEPFAR to. Be implemented in a way that equitably serves LGBTQI people, submit a report to Congress describing international prosecutions for sex work or consensual sexual activity based on commodities provided by PEPFAR or other U.S.

Support, and submit a report to Congress on HIV/AIDS-related index testing. Requires GAO to submit a report to Congress that describes the impact of the implementation and enforcement of any iteration of the Mexico City Policy on the global LGBTQI community. Expresses Sense of Congress regarding the U.S. Engaging international organizations in efforts to eliminate LGBTQI discrimination.

And repeals the Mexico City policy by removing certain limitations on eligibility for foreign assistance.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021H.R. 3373Rep. Ami Bera (D-CA-7)Referred to HFAC, H. Veterans’ Affairs, H.

Natural Resources, H. Armed Services, H. Financial Services, H. Judiciary, H.

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

Requires a report on these efforts annually. Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.Honoring OCEANIA ActTo strengthen United States engagement in the Oceania region and enhance the security and resilience of allies and partners of the Oceania community, and for other purposes.5/20/2021S. 1774Sen.

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

Authorizes to be appropriated such sums as may be necessary to carry out the program. Requires amounts appropriated or made available to remain available under expended.International Human Rights Defense Act of 2021To establish in the Bureau of Democracy, Human Rights, and Labor of the Department of State a Special Envoy for the Human Rights of LGBTI Peoples, and for other purposes.2/22/2021H.R. 1201Rep. Alan Lowenthal (D-CA-47)Referred to HFACLGBTI health, HIVIncludes statement of U.S.

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

Edward Markey (D-MA)Read twice and referred to SFRCLGBTI health, HIVIncludes statement of U.S. Policy regarding LGBTI issues globally, including employing a multisectoral approach to preventing and responding to criminalization, discrimination, and violence against LGBTI people internationally, including activities in the health sector. Authorizes the provision of U.S. Assistance to prevent and respond to these issues internationally, including enhancement of health sector capacity related to violence against LGBTI people and communities and to combat HIV.International lasix Preparedness and hypertension medications 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 Orderslasix preparedness, hypertension medications, 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, hypertension medications treatments to other countries. Requires a report that assesses the global humanitarian response to hypertension medications and outlines specific elements of the U.S.

Government’s country-level response to the hypertension medications lasix. In the event of an infectious disease outbreak outside the U.S. With lasix 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 lasix 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 lasix 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 lasix prevention and preparedness (see “the Fund” below). Requires U.S. Global health program leadership identify areas of collaboration and coordination to ensure that such activities contribute to health systems strengthening. Directs the Secretary of State, with the USAID Administrator, to work with the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the treatment Alliance, bilateral donors, and others to develop shared core indicators for strengthened health systems.

Authorizes the U.S. To participate in the Coalition for Epidemic Preparedness Innovations (CEPI). Expresses Sense of Congress that the President should make an immediate contribution to CEPI of $300 million to expand research and development of treatments to combat the spread of hypertension medications 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 lasix 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 lasix potential. Directs the Secretary of State, with the HHS Secretary, to work with WHO and like-minded member states to adopt an approach toward assessing infectious disease threats under the International Health Regulations (2005) for the WHO to identify and transparently communicate on an ongoing basis varying levels of risk leading up to, and during and after, a public health emergency of international concern (PHEIC) declaration. Directs the Secretary of State and others to seek to enter into negotiations to establish “the Fund;” authorizes the President to make available for U.S.

Contributions to the Fund such funds as may be appropriated or otherwise made available for such purpose. Limits the U.S. Contribution to the Fund to not exceed 33% of the total contributions from all sources.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, hypertension medicationsExpresses Sense of Congress that mental health is integral and essential to overall health outcomes and other development objectives. Codifies the position of USAID coordinator for mental health and psychosocial support and describes the position’s duties, including establishing a Mental Health and Psychosocial Support Working Group. Describes the Group’s duties and members. States U.S.

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

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

Describes the Group’s duties and members. States U.S. Policy is to integrate mental health and psychosocial support across all foreign assistance programs funded by the U.S.. Requires USAID and the Department of State regional bureaus and missions to utilize such policy for local capacity building, as appropriate and that such programming be evidence-based and culturally competent and respond to the specific needs of children in adversity.

Requires USAID to brief Congress on progress and challenges to implementation, including programming in conflict and humanitarian settings, as well as the impact of hypertension medications on programming. Requires the USAID Administrator in consultation with the OMB Director to brief Congress annually for five years (FY22 – FY26) on spending for this programming in U.S. Foreign assistance.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act)To establish a program to oversee the global hypertension medications response and prepare for future lasixs, and for other purposes.6/8/2021H.R. 3778Rep.

Raja Krishnamoorthi (D-IL-8)Referred to HFAC and H. Energy and Commercehypertension medications, global health security, lasix preparedness and responseEstablishes the lasix preparedness and response program to be responsible for and provide oversight over the U.S. Global health response to the hypertension medications lasix and protect Americans from the emergence of hypertension medications variants and other pathogens with lasix 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 hypertension medications lasix worldwide as well as a long-term strategy for preventing future lasixs. 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 lasixs. Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S.

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

Express Sense of Congress that in the face of a global health emergency, the U.S. Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Nullifying Opportunities for Variants to Infect and Decimate Act(NOVID Act) To establish a program to oversee the global hypertension medications response and prepare for future lasixs, and for other purposes.6/8/2021S. 1976Sen. Jeff Merkley (D-OR)Read twice and referred to SFRChypertension medications, global health security, lasix preparedness and responseEstablishes the lasix preparedness and response program to be responsible for and provide oversight over the U.S.

Global health response to the hypertension medications lasix and protect Americans from the emergence of hypertension medications variants and other pathogens with lasix 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 hypertension medications lasix worldwide as well as a long-term strategy for preventing future lasixs. 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 lasixs.

Describes implementation of comprehensive strategy, including requiring director to ensure immediate release of 80 million treatment doses that the U.S. Has already committed to send abroad and to reassess the U.S. treatment stockpile to determine whether further treatments can be sent abroad and to coordinate with BARDA to rapidly scale manufacturing capacity around the world to produce 8 billion treatment doses as soon as possible. Also requires director to ensure equitable access to treatments in collaboration with COVAX and to work with international partners to provide enough treatments to lower- and middle-income countries to fully vaccinate at least 60% of their respective populations, especially 92 countries identified by COVAX as being most in need of assistance.

Requires the program to, among other things, build on PEPFAR and other existing U.S. Programs and relationships bilaterally and multilaterally. Express Sense of Congress that in the face of a global health emergency, the U.S. Government has broad authority, including under the Defense Production Act and the “Bayh-Dole Act”, to ensure adequate supply of treatments, necessary components, and raw materials through technology sharing and direct collaboration with manufacturers around the world.Preventing Foreign Attempts To Erode Healthcare Innovation ActTo prohibit the use of funds to support a measure at the World Trade Organization waiving intellectual property rights, and for other purposes.5/18/2021S.

1683Sen. Tim Scott (R-SC)Read twice and referred to S. FinanceTRIPS, WTO, intellectual property rights, hypertension medications 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 hypertension medications proposed by India and South Africa or any other measure at the WTO to waive intellectual property rights.Preventing Future lasixs Act of 2021To address the public health risks posed by wildlife markets, and for other purposes.1/4/2021H.R.

151Rep. Mike Quigley (D-IL-5)Referred to HFAC, H. Energy and Commerce, H. Judiciary, H.

Ways and Means, H. Financial Services, H. Natural ResourcesGlobal health security, One Health, zoonotic diseasesRequires the HHS Secretary to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine for it to conduct a study on the risk of wildlife markets on the emergency of novel viral pathogens, to be submitted not later than one year after the date of agreement. Expresses Sense of Congress that global institutions, including WHO, and others including USAID should promote the paradigm of One Health.

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

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

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

Authorizes FY 2021 – FY 2030 funding for USAID activities related to sustainable food systems. Requires the USAID administrator to increase activities related to biodiversity, global health, and resilience, among other things, in order to address the threats and causes of zoonotic disease outbreaks.. Requires reporting from the Department of State and USAID describing these efforts.Protecting Life in Foreign Assistance ActTo restrict the availability of Federal funds to organizations associated with the abortion industry.1/28/2021H.R. 534Rep.

Virginia Foxx (R-NC-5)Referred to HFACAbortion, Mexico City policyCodifies the expanded Mexico City policy (rescinded by President Biden in Jan. 2021. See KFF explainer) and expands it to apply more broadly to federal funding made available for purposes outside of the U.S. To 1) any foreign nonprofit organization, foreign nongovernmental organization, foreign multilateral organization, or foreign quasi-autonomous nongovernmental organization that carries out certain activities, and 2) any domestic nonprofit organization or domestic nongovernmental organization that carries out certain activities.Protecting Life in Foreign Assistance ActTo restrict the availability of Federal funds to organizations associated with the abortion industry.1/28/2021S.

137Sen. Mike Lee (R-UT)Read twice and referred to SFRCAbortion, Mexico City policyCodifies the expanded Mexico City policy (rescinded by President Biden in Jan. 2021. See KFF explainer) and expands it to apply more broadly to federal funding made available for purposes outside of the U.S.

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

Requires the establishment and implementation of a five-year comprehensive strategy to contribute toward the global goal of ending preventable child and maternal deaths by 2030. States the President should designate a Child and Maternal Survival Coordinator and describes their duties. Requires an annual report on progress.Reproductive Rights are Human Rights Act of 2021To amend the Foreign Assistance Act of 1961 to require a section on reproductive rights in the Annual Country Reports on Human Rights Practices.5/28/2021H.R. 3576Rep.

Katherine Clark (D-MA-5)Referred to HFACState Dept. Annual human rights report, family planning/reproductive health (FP/RH), maternal mortality, abortion, violence against womenAmends existing law to require annual reporting by the Department of State on human rights to include, among other things. The status of reproductive rights in each country. Description of the rates and causes of pregnancy-related injuries and deaths (including deaths due to unsafe abortions), violence against women, and access to family planning.

Requires that civil society and multilateral organizations’ representatives in the U.S. And countries included in such reporting be consulted with during the preparation of annual reporting.Reproductive Rights are Human Rights Act of 2021To amend the Foreign Assistance Act of 1961 to require a section on reproductive rights in the Annual Country Reports on Human Rights Practices.5/26/2021S. 1864Sen. Robert Menendez (D-NJ)Read twice and referred to SFRCState Dept.

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

And countries included in such reporting be consulted with during the preparation of annual reporting.Robust International Response to lasix ActTo provide support for a robust global response to the hypertension medications lasix.2/11/2021H.R. 986Rep. Jesus “Chuy” Garcia (D-IL-4)Referred to H. Financial Serviceshypertension medicationsDirects 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 hypertension medications lasix, 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 hypertension medications lasix.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, lasix, epidemicAuthorizes U.S.

Participation in the Coalition for Epidemic Preparedness Innovation (CEPI). Reports to Congress required to be submitted by the President not later than 180 days after enactment of the Act and to outline planned U.S. Contributions to CEPI, the manner and extent to which the U.S. Will participate in the governance of CEPI, and how participation in CEPI supports relevant U.S.

Strategies and programs in health security and biodefense, among other things. Authorizes certain appropriated funding to be made available for U.S. Contributions to CEPI.Strategic Competition Act of 2021To address issues involving the People’s Republic of China. 4/15/2021S.

1169Sen. Robert Menendez (D-NJ)Placed on Senate Legislative Calendar under General Ordershypertension medications, 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 hypertension medications lasix. 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 hypertension medications, 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 hypertension medications and support greater cooperation in building capacity to prepare for and respond to lasixs and other public health challenges.

States it is U.S. Policy to advocate and actively advance Taiwan’s meaningful participation in the World Health Assembly, among other bodies. Requires report on the origins of the hypertension medications lasix 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 hypertension medications lasix.Support for Global Financial Institution lasix Response Act of 2021To support efforts by international financial institutions to provide a robust global response to the hypertension medications–19 lasix.1/27/2021S. 67Sen.

Richard Durbin (D-IL)Read twice and referred to SFRChypertension medicationsDirects 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 hypertension medications lasix, 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 hypertension medications lasix.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 lasix prevention and response, and for other purposes.2/8/2021S. 290Sen.

Edward Markey (D-MA)Read twice and referred to HSGAClasixRequires the President to designate an employee of the National Security Council to be the permanent coordinator for lasix prevention and response for the federal government, outlines duties, and grants them authority to represent the U.S. In bilateral and multilateral discussions and agreements on relevant matters.To direct the Secretary of State to develop a strategy to regain observer status for Taiwan in the World Health Organization, and for other purposes.2/18/2021H.R. 1145Rep. Young Kim (R-CA-39)Passed HFAC (Ordered to be Reported in the Nature of a Substitute by Voice Vote)WHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwan’s participation at WHO’s World Health Assembly as an observer.To direct the Secretary of State to develop a strategy to regain observer status for Taiwan in the World Health Organization, and for other purposes.3/17/2021S.

812Sen. Robert Menendez (D-NJ)Placed on Senate Legislative Calendar Under General OrdersWHO, TaiwanDirects the Department of State to include additional information in its annual reports concerning Taiwan’s participation at WHO’s World Health Assembly as an observer.To prohibit the use of funds to seek membership in the World Health Organization or to provide assessed or voluntary contributions to the World Health Organization.1/28/2021H.R. 497Rep. Jodey Arrington (R-TX-19)Referred to HFACWHOProhibits the use of federal funds to seek membership by the U.S.

In WHO or to provide assessed or voluntary U.S. Contributions to WHO until such time as the President certifies that WHO meets certain conditions, including. WHO has adopted meaningful reforms to ensure that humanitarian assistance is not politicized and is to be provided to those with the most need, WHO is not under the control or significant malign influence of the Chinese Communist party, WHO is not involved in a coverup of the Chinese Communist Party’s response to the hypertension medications lasix, 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 People’s Republic of China, including rape and torture in detention and forced sterilizations, forced abortions, and other coercive birth restriction policies, particularly in the Xinjiang Uyghur Autonomous Region, and for other purposes.5/18/2021H.R. 3306Rep. Vicky HartzlerReferred to HFAC and H. JudiciaryForced sterilization, abortionStates U.S.

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

Should strongly condemn the intimidation and threats targeting Uyghur and Kazakh women who provide public evidence of sexual violence and forced sterilizations and forced abortions in mass internment camps and the journalist who report these stories. Also expresses Sense of Congress that U.N. Member states should condemn such atrocities by demanding that China end all forced sterilization, forced abortions, and other state-sanctioned violence against women, among other things. Requires the president to submit a strategy for ending atrocity crimes in the Region.

Requires the Secretary of State to provide all appropriate assistance to women who belong to certain groups and who experienced sexual violence, torture, forced sterilizations and forced abortions in China in order for them to receive needed medical care and psychological support. Requires all existing authorities to be used to allow such women to at least temporarily enter the U.S.Women and Climate Change Act of 2021To address the disparate impact of climate change on women and support the efforts of women globally to address climate change, and for other purposes.1/11/2021H.R. 260Rep. Barbara Lee (D-CA-13)Referred to HFAC, H.

Energy &. CommerceClimate change, global health, reproductive healthAddresses climate change and its effects on women and girls. Establishes the Federal Interagency Working Group on Women and Climate Change within the Department of State and outlines its functions, such as identifying best practices for collecting data on the disparate impact of climate change on women – including in access to comprehensive health care, including reproductive health and rights. Requires the Department of State’s Office of Global Women’s Issues (GWI) to submit a strategy (and shortly thereafter an implementation plan and budget) to prevent and respond to the effects of climate change on women, including effective action to promote public health.

Requires the Ambassador-at-Large of GWI to designate a Senior Coordinator for Women and Climate Change. Requires the GWI Ambassador and the Senior Coordinator to submit to the appropriate congressional committees an assessment of the human and financial resources necessary to carry out the Act.World Health Organization Accountability ActTo prohibit the availability of United States contributions to the World Health Organization until Congress receives a full report on China and the hypertension medications–19 lasix, and for other purposes.1/21/2021H.R. 374Rep. Lauren Boebert (R-CO-3)Referred to HFACWHO, hypertension medicationsProhibits 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 hypertension medications outbreak prior to March 11, 2020, by WHO and China contributed to the emergency of the lasix.NOTES. SFRC means Senate Committee on Foreign Relations. HFAC means the House Committee on Foreign Affairs.

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..