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The surge in buy antibiotics cases that began in early November has raised questions about flagyl used for yeast s how hospital systems nationwide are handling the flagyl pills online flagyl and whether there are enough beds and staff to take care of hospitalized patients.A big concern is whether hospitals in nonmetropolitan areas will be able to keep up.A number of groups, such as the University of Minnesota buy antibiotics Hospitalization Tracking Project, which I work on, The Atlanticâs buy antibiotics Tracking Project, and others have been tracking key hospitalization metrics obtained from state department of health and governorâs websites daily since mid-March. The federal government, through it HHS Protect, also started releasing daily updates in late-July.advertisement While these daily figures help describe hospital capacity for entire states, they do not make it possible to understand the local impact of hospitalizations across states. For example, are hospitals in metro areas flagyl pills online experiencing the surge of hospitalizations and capacity strains differently than those in nonmetro areas?.

Anecdotes in the media have raised concerns that rural areas, which already have lower capacity, are no longer able to transfer their patients to nearby cities as the hospitalization surge is affecting cities and rural areas alike. In addition, even when capacity may not appear to be problematic at a state level, capacity in an individual county or city may be flagyl pills online seriously constrained. Such concerns emerged with reference to a high number of cases and high positivity rates in local areas such as Metro East, five counties in Southern Illinois across the river from St.

Louis, where about 8% of those being tested for buy antibiotics are positive for it â even though Illinois as a whole had not have experienced significant flagyl pills online increases in hospitalization in previous weeks.advertisement This week, the Department of Health and Human Services released new data on buy antibiotics capacity data at the hospital facility level. It includes information on hospitalizations, intensive care unit use, and hospital bed capacity, represented as either daily averages or aggregates in a given week. These data are expected to be released on a weekly basis going forward.Our team reviewed the data and collaborated with several teams of journalists and data scientists from Careset Systems and flagyl pills online buy antibiotics Exit Strategy, among others, to prepare a community FAQ about the facility-level capacity data.

In addition to describing the data in detail and providing links to potential outside resources (such as census data and hospital cost data from the Centers for Medicare and Medicaid Services), we addressed the questions users of these data may have. We have also created a first-of-its-kind interactive dashboard to visualize hospital capacity at the flagyl pills online county-level for the entire U.S.Courtesy University of MinnesotaThis data release makes it possible to examine whether metro and nonmetro areas are experiencing buy antibiotics hospitalizations and capacity in different ways, and whether certain counties and cities are particularly strained even though the larger state or metro area may not be.The surge in new buy antibiotics hospitalizations has been particularly higher in metro communities. During the week of Nov.

27 (the last week with complete data available), the hospitalization rate in metro areas was five times higher, at 0.99 new hospitalizations per 100,000 people, than in nonmetro areas, which has 0.2 per 100,000 people.During that week, nonmetro and metro flagyl pills online counties had, on average, slightly more than 200 staffed beds per 100,000 people. However, nonmetro counties had about half the capacity of staffed ICU beds, 12 per 100,000 people, compared to 23 staffed ICU beds per 100,000 people in metro counties.During the month of November, occupancy of hospital beds and ICU beds for all patients, including those without buy antibiotics, were relatively stable, with an average of 67% and 78% respectively in metro counties, and 54% and 79% respectively in nonmetro counties. During the same period, the percentage of hospital beds and ICU beds occupied by buy antibiotics patients increased across flagyl pills online counties and states.

The average hospital in nonmetro areas, however, experienced a substantially larger percentage buy antibiotics patients occupying its hospital beds and ICU beds.Limited access to hospital beds in nonmetro raises important concerns about how to address this resource shortage. In earlier work, our team showed that buy antibiotics occupancy in a hospital on a given day, particularly occupancy of ICU beds, is significantly associated with increased mortality in flagyl pills online the next seven days.Unfortunately, infrastructure constraints make it difficult to add ICU beds. And while transferring patients from non-metro hospitals to hospitals in nearby metro areas may have been an option earlier, surge-related capacity constraints in metro-area hospitals may make such transfers more difficult.These data reveal an important distinction between the average occupancy rate of hospitals within a geographic area (a city, metro area, or state) and the overall occupancy rate overall in that geographic area.

The latter compares the aggregated number of buy antibiotics hospitalizations across the geographic region to the aggregated number of beds. Itâs a useful metric, but it may mask widely different experiences of flagyl pills online individual hospitals. On average, a state may look stable in terms of beds occupied by buy antibiotics patients â there could be many hospitals with relatively few buy antibiotics patients â while several hospitals, or a particular city or county, may be close to or exceeding capacity.In Minnesota, for example, as I write this the number of buy antibiotics patients is 1,885, and the number of staffed hospital beds is 9,812, suggesting that only 19.2% of beds are filled.

However, a deeper dive into Minnesota counties suggests that hospitals in Stearns County had a 66% buy antibiotics occupancy while Morrison County had a much lower occupancy at 9%.The new data release from HHS can identify flagyl pills online individual facilities, cities, and regions as hot zones and make it possible to implement strategic plans to target resources accordingly across the nationsâ hospital system.Pinar Karaca-Mandic is a professor of health care risk management, academic director of the Medical Industry Leadership Institute, and a project director for the Carlson School of Managementâs buy antibiotics Hospitalization Tracking Project, all at the University of Minnesota. Zachary Levin, Yi Zhu, Khoa Vu, Kimberly Choyke, Archelle Georgiou, and Soumya Sen contributed valuable work to the tracking project.More than 250,000 people in the U.S. Alone have died from buy antibiotics flagyl pills online this year.

Researchers at the Institute for Health Metrics Evaluation estimate that 1 in 4 deaths could be avoided in the next three months if people take wearing masks in public more seriously. In spite of early fumbles and mixed messages from local governments, the messaging around masks from public health officials eventually became clear.Yet many people follow this recommendation only sometimes, or not at all.As treatment developments come in rapidly, the messaging around treatments must accomplish what the messaging around masks could flagyl pills online not. Convince people to adopt a safe and effective buy antibiotics treatment.advertisement That, however, may be a problem.

Recent surveys by Pew Research and Gallup found that only 51% to 58% of respondents said they would get a buy antibiotics treatment if it were flagyl pills online available today, well below the minimum 70% threshold needed for herd immunity. The immediate challenge ahead, then, is not trying to vaccinate 100% of the population but persuading just 12% to 19% of those taking a wait-and-see approach â the additional number needed to reach herd immunity â to get vaccinated. To bridge the gap, we need to pivot from presenting facts about the treatment to persuading people that the choice to get immunized against buy antibiotics aligns with their world views.advertisement When the treatment is presented as the right flagyl pills online choice based on its clinical and biological merits alone, we fail to make inroads with those who distrust these treatments or the process to developing them.

In a hyper-polarized news environment, people arenât persuaded by facts alone, especially when the facts are about a new, rapidly developed treatment. Perception isnât flagyl pills online objective because we filter the world through our values and beliefs. That means it is important to present these treatments as logical extensions of individualsâ belief systems that fit within their existing mindsets.This isnât a new concept.

For example, in 1986, the Texas Department of Transportation sought to flagyl pills online reduce litter on its roadways. For years it tried standard beautification messages like âKeep America Beautiful.â To the 18- to 35-year-old men responsible for the bulk of the litter problem, the messaging failed to resonate with their worldview. When the litter problem showed no signs of improvement, officials switched the messaging to lean on a tried-and-true value.

Texas pride flagyl pills online. They replaced the word âlitterâ with âmessâ and coined the phrase âDonât Mess with Texas.â After just five years of âDonât Mess with Texasâ signs on every Texas highway, roadway littering had fallen by 72%.When it comes to a treatment, many people have inklings about what the most resonant mindsets among reluctant people might be, but weâre not yet sure. More work flagyl pills online is needed.

We believe that the following four steps are a good place to start.Step 1. Launch a survey to identify âwilling skeptics.â According to adoption theory, individuals are most likely to listen flagyl pills online to the opinions of people who are one step ahead of them on the adoption curve. A devoted carnivore, for example, might be receptive to an advocate of âMeatless Mondaysâ about eating less meat, but brush off a strict vegan.To identify skeptical individuals who are most likely to be swayed about getting a buy antibiotics treatment, a national survey could be launched to collect peopleâs attitudes on the treatment and their general willingness to adopt new technologies.

From the results, it would be possible to create a psychographic profile of five to eight unique flagyl pills online segments. From these it would be possible to identify the âwilling skepticsâ â the group of people tilting in the direction of getting vaccinated who may be able to influence those who are further away from choosing to be vaccinated. Persuading this flagyl pills online group will have the most success convincing the larger skeptical population.

Step 2. Conduct semi-structured interviews with willing skeptics to gather flagyl pills online their stories around health. Understanding individualsâ true mindsets around treatment adoption requires pushing beyond obvious questions.

To reveal underlying â perhaps subconscious â beliefs, willing skeptics should flagyl pills online be asked to share stories about a range of health topics. Tell me about a time you felt really healthy. What is the dumbest thing youâve flagyl pills online ever seen someone do when it comes to their health?.

Whatâs your guiltiest pleasure?. Conduct eight to 12 of these semi-structured interviews to uncover these stories and the recurrent themes that arise to reveal what deeply held beliefs drive the way people feel about treatments.Step 3. Analyze patterns in the stories people tell to pull out common mindsets around health flagyl pills online.

To distill dominant mindsets and values, the interviews should be analyzed for common themes, conflicting beliefs, and topics. Tools like semiotic analysis and Brennerian framing analysis can help identify patterns to be used as flagyl pills online guides for developing resonant solutions.For example, take the common retort, âIâll wait and see if the treatment worksâ that many treatment skeptics make. Alone, it is too vague because it doesnât tell us what they need to see.

But hearing multiple stories about when waiting worked out well might lead to common visuals or narratives that willing skeptics will tune flagyl pills online into and share with others.Step 4. Design solutions and messaging that speaks to common mindsets, then run experiments on a small scale and iterate on the solutions before scaling them. Once the key mindsets and beliefs have been identified, it will be possible to generate a broad and diverse flagyl pills online set of solutions.

At this point, quantity yields quality. Some ideas will be bad, but flagyl pills online they may inspire better ideas. Âtraveling vaccinators who go door-to-doorâ might be a terrible idea to avoid long wait times, but it may lead to âmobile clinic trailers that set up in the parking lots of community centers.âFrom this information it should be possible to define a set of criteria that willing skeptics require for a good solution and use it to cull the list down to the five most promising options.

Launch a series flagyl pills online of experiments in key geographical areas and, using collected metrics and feedback, revise the concept or communication strategy. Separate and scale the best ideas from there.As we embark on one of the largest public health initiatives in U.S. History, itâs time to pivot from flagyl pills online presenting facts about buy antibiotics treatments to persuading people to get immunized.

Rather than telling people to get vaccinated, itâs essential to listen to the willing skeptics and understand their hesitations.We believe this approach will increase the number of people who will choose to get a buy antibiotics treatment when they become available and hopefully close this chapter of American history much sooner.Joseph S. Salama is a senior consultant at Jump Associates, a strategy and innovation consultancy in the Bay Area, and an adviser for the University of California, San Franciscoâs Health Hub. Jenna Borges is a consultant at Jump Associates and a cofounder of Swiv.

Ryan Baum is a principal at Jump Associates and teaches needfinding at Stanford Universityâs Hasso Plattner Institute of Design..

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Artificial intelligence flagyl for bv technologies are being increasingly relied upon in Kamagra jelly price the healthcare domain, particularly when it comes to decision support, precision medicine, and the improvement of the quality of care. Regarding primary flagyl for bv care specifically, AI also represents an opportunity to assist with electronic health record documentation. A new study published in the Journal of American Medical Informatics Association this week shows that, although AI documentation assistants (or digital scribes) offer great potential in the primary care setting, they will need to be supervised by a human until strong evidence is available for their autonomous potential.

In workshops with primary care doctors, wrote researchers from the Australian Institute of Health Innovation, flagyl for bv "There was consensus that consultations of the future would increasingly involve more automated and AI-supported systems. However, there were differing views on how this human-AI collaboration would work, what roles doctors and AI would take, and what tasks could be delegated to AI." HIMSS20 Digital Learn on-demand, earn credit, find products and solutions. Get Started flagyl for bv >>.

WHY IT MATTERS Researchers worked with primary care doctors who use EHRs regularly for documentation purposes to understand their views on future AI documentation assistants. They identified flagyl for bv three major themes that emerged from the discussions. Professional autonomy, human-AI collaboration and new models of care.

First, the doctors emphasized the importance of their ability to care for patients in their own way with the abilities AI technology provided."If they flagyl for bv [patients] think that we're just getting suggestions from a computer, then maybe they can just get suggestions from a computer. I think it becomes more difficult to convince them that our recommendations are more valuable than what they can pick up on the internet," said one physician. They noted the need for a bottom-up approach to technology development, with a focus on flagyl for bv delivering clear benefits to practice and workflow, and expressed fears around potential legal complications that could stem from working with an AI assistant.With regard to human-AI collaboration, doctors expressed a variety of viewpoints about what tasks could be delegated to AI.

Many believed that an AI system could assist with tasks such as documentation, referrals and other paperwork. Most said flagyl for bv that AI systems would lack empathy. "GPs voiced several concerns, including some potential biases in patient data and system design, the time needed to fix the errors and train the system, challenges of dealing with complex cases, and the auditing of AI," wrote the researchers.

However, doctors also flagyl for bv discussed how AI could help with emerging models of primary care, including preconsultation, mobile health and telehealth. THE LARGER TREND The question of reducing EHR-related clinician burnout has loomed large, with vendors and researchers trying to pinpoint major causes â and, in turn, potential solutions. AI has been raised as flagyl for bv one such solution, with several major EHR vendors offering plans for incorporating the technology into their workflows.

But human input remains vital, as the new JAMIA study and other research has noted. AI could "bring flagyl for bv back meaning and purpose in the practice of medicine while providing new levels of efficiency and accuracy," wrote Stanford researchers in a 2017 Journal of the American Medical Association study. But, they continued, physicians must "proactively guide, oversee, and monitor the adoption of artificial intelligence as a partner in patient care."ON THE RECORD"AI documentation assistants will likely ...

Be integral to the flagyl for bv future primary care consultations. However, these technologies will still need to be supervised by a human until strong evidence for reliable autonomous performance is available. Therefore, different human-AI collaboration models will need to be designed and evaluated to ensure patient safety, quality of care, doctor safety, and doctor autonomy," wrote the Australian Institute for Health Innovation researchers flagyl for bv.

Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichHealthcare IT News is a HIMSS Media publication.Konica Minolta Healthcare Americas will pay flagyl for bv $500,000 to settle a whistleblower case that alleged its Viztek electronic health record subsidiary had falsified data for certification tests.WHY IT MATTERSIn the qui tam complaint, filed in 2017 in U.S. District Court in New Jersey â where Konica Minolta is based â was filed by whistleblower Leighsa Wilson, who worked for two years at Viztek, best known for its PACS and imaging technologies, as a project manager for its EXA EHR product.In mid-2015, the complaint alleges, Viztek, which was in negotiations to be acquired by Konica Minolta, worked together with InfoGard Laboratories (which was then an ONC-authorized certification and testing body) to make false representations that the EHR software complied with requirements for certification â and qualified for receipt of incentive payments under the federal meaningful use program."To ensure that their product was certified and that their customers received incentive payments, Viztek and Konica Minolta.

(a) falsely attested to flagyl for bv InfoGard that their software met the certification criteria. (b) hard-coded their software to pass certification testing requirements temporarily without ensuring that the software released to customers met certification criteria. And (c) caused their users to falsely attest to using a certified EHR technology, when their software could not support the applicable certification criteria in the field," according to the complaint, which also alleges that InfoGard "facilitated and participated in" these false attestations, "knowingly or with reckless disregard," certifying the EHR software despite its inability to meet ONC's certification criteria.The flaws in Viztek's software "not only rendered the system unreliable and unable to meet meaningful use standards, but the flaws also created a risk to patient health and flagyl for bv safety.

Rather than spend the time and resources necessary to correct the flaws in its EHR software, the EHR defendants opted to do nothing."THE LARGER TRENDThis is only the most recent settlement of this type from health IT vendors accused of False Claims Act violations, of course.Most notable, was the case of eClinicalWorks, which was alleged by the Department of Justice to have falsely claimed meaningful use certification, to have neglected to have safety addressed issues in its software and to have paid kickbacks to clients. That case flagyl for bv was settled in 2017 for $155 million.More recently, similar complaints were lodged against companies such as Practice Fusion and Greenway Health. They settled with DOJ for $145 million and $57 million, respectively."We will be unflagging in our efforts to preserve the accuracy and reliability of Americansâ health records and guard the public against corporate greed," said U.S.

Attorney for the District of Vermont Christina Nolan after the Greenway flagyl for bv case this past year. "EHR companies should consider themselves on notice."ON THE RECORD"The lives of patients depend upon the information processed by electronic health records," said Wilson â who, as a qui tam whistleblower will receive 20% of the financial settlement â in a statement. "Functionality testing and subsequent certification must be performed and obtained through a reliable, measurable process.""Filing a qui tam lawsuit is a powerful and effective way to report problems with EHR software purchased with federal funds and get the problems fixed when they are ignored," said Luke Diamond, an associate at Phillips & flagyl for bv.

Cohen. "The False Claims Act protects whistleblowers from job retaliation and offers rewards if the government recovers funds as a result of flagyl for bv the qui tam case.""Our client was concerned about possible patient harm that can occur if EHR software isn't properly certified, so she stepped forward to inform the government about what she had witnessed," said Colette Matzzie, a partner and whistleblower attorney with Phillips &. Cohen, which brought the case.

"Ensuring that EHR software meets all governmental requirements is important to safeguard both patient care and federal funds."The Arc Madison Cortland in Oneida, New York, knows that there is a lack of providers that specialize in flagyl for bv the intellectual/developmental disability field. Making the problem worse, not flagyl for bv so many that understand dual diagnosis.THE PROBLEMWith buy antibiotics minimizing the ability for individuals to receive face-to-face services with their providers, many patients are resorting to emergency department visits.Additionally, The Arc is in a rural area requiring travel to see a provider, and there is a lack of providers in the field. The population itself is underserved, with a lack of transportation to get to appointments.

Without the ability to institute telemedicine as a solution to these problems, the population supported by The Arc would flagyl for bv have seen a lengthy (permanent?. ) pause for needed medical services.PROPOSALThe Arc this year received funding from the FCC to help provide telehealth services.âWith this funding we can further treat patients, reduce crisis and allow for social distancing, which is imperative to our vulnerable population,â said Jackie Fahey, director of clinic services at The Arc Madison Cortland. ÂWe could provide ongoing services to the individuals we serve to flagyl for bv ensure there are no unnecessary emergency department visits.

This places less of a strain on our local emergency departments and unneeded additional costs.âWith the purchase of tablets and headsets and telehealth services from vendor Doxy.me, The Arc was able to still provide medical care to its population of people with an I/DD. Additionally, eliminating emergency department visits also eliminates their exposure to buy antibiotics and eases the burden of the ED providers who are overburdened right now.MARKETPLACEThere are many vendors of telemedicine technology and services on the health IT market flagyl for bv today. Healthcare IT News recently compiled a comprehensive list of these vendors with detailed descriptions.

To read this special flagyl for bv report, click here.MEETING THE CHALLENGEâWhen all of our locations were closed abruptly in the middle of March due to the buy antibiotics flagyl, we needed to determine a way to quickly and easily implement a telehealth solution so that we were able to still support the individuals that we serve during the crisis, especially when many were under strict quarantine protocols for a variety of reasons,â Fahey explained.âWe signed up immediately for the Doxy.me telehealth platform as it was a user-friendly platform that is HIPAA-compliant. The feature we liked about Doxy.me was that it is web-based, so nothing had to be downloaded and it could easily be used on a laptop, tablet or smartphone.âThe Arc rolled out the technology initially with its mental health providers, who offer psychiatry/medication monitoring services, social work counseling and mental health counseling. More than half the organizationâs enrollment is enrolled in one or all of these three services, so it was able to continue providing services to a large number of enrolled individuals.âWe then began to roll the telehealth services out to nutrition, speech therapy, physical therapy and occupational therapy caseloads if individuals were appropriate to flagyl for bv receive the service through telehealth,â Fahey said.RESULTSThe first success metric The Arc has been able to achieve with the technology is maintaining its utilization for mental health services.

When everything was running normal prior to buy antibiotics, The Arcâs mental health services made up about 25% of the services it provided on a monthly basis. With the implementation of telehealth services during the buy antibiotics flagyl for bv flagyl, the organization was able to achieve 20% of the services provided on a monthly basis.This has shown to staff that they have been able to still serve and respond to the needs of their psychiatry, social work and mental health counseling patients with minimal issues by implementing the telehealth technology.âThe second success metric we have been able to achieve with the technology is we have been able to continue to receive referrals for our services and enroll new individuals into the services they need if the services are able to be completed via telehealth,â she said. ÂBetween April, May and June, we have enrolled 16 new individuals into ongoing clinic services, which is right on par for our normal enrollment average per month.âUSING FCC AWARD FUNDSThe Arc Madison Cortland was awarded $49,455 by the FCC earlier this year for laptop computers and headsets to provide remote consultations and treatment during the buy antibiotics flagyl for psychological services, counseling, and occupational and physical therapy for people with developmental and other disabilities.âWith the funds, we purchased headsets and tablets to allow the people we support to have access to medical appointments, along with physical therapy, occupational therapy and psychology appointments remotely,â Fahey explained.

ÂThe technology enables us to continue to flagyl for bv provide these services at a time when the people we support are unable to leave for traditional in-person appointments.âBecause these are such uncertain times, and a time frame for when we may return to ânormalcyâ is unknown, the technology allows us to continue delivering medical support without the concern of a pause in those services.âTwitter. @SiwickiHealthITEmail the writer. Bill.siwicki@himss.orgHealthcare IT News is a HIMSS Media publication.HIMSSCast host Jonah Comstock convenes flagyl for bv a panel of HIMSS Media editors â HITN Senior Editor Kat Jercich, MobiHealthNews Associate Editor Dave Muoio and HFN Associate Editor Jeff Lagasse â to discuss recent delivery slowdowns at the Post Office and how they have and haven't affected healthcare stakeholders, including startups and patients.

The team also looks into the broader trend of the politicization of traditionally apolitical government agencies and how that could affect public faith in buy antibiotics treatments or treatments.More about this episode:USPS service delays are hitting some mail-order pharmacies and telehealth platforms harder than othersMail delays may affect medication supply for nearly 1 in 4 Americans over 50Postmaster General Louis DeJoy's full testimony (C-SPAN)The Package Coalition homepageThe Trump administration this week asked the U.S. Supreme Court to reverse a lower court ruling that allowed for mail-order and telemedicine abortion flagyl for bv during the buy antibiotics crisis. U.S.

Food and Drug Administration regulations require mifepristone, which is used in flagyl for bv medication abortion, to be dispensed at a clinic, hospital or medical office. In June, U.S. District Judge for the District of Maryland Theodore Chuang blocked the requirements during the flagyl, finding them flagyl for bv to be a "substantial obstacle." Mifepristone, in combination with misoprostol, is FDA-approved for abortions up to ten weeks' gestation.

In 2017, a New England Journal of Medicine article argued against the FDA regulations for mifepristone given the drug's safety record. WHY IT MATTERS flagyl for bv Acting Solicitor General Jeffrey B. Wall applied for a stay of Chuang's injunction on Wednesday as the case makes its way through the lower courts, arguing that the regulations do not represent an undue burden.

"The safety requirements here concern only medication flagyl for bv abortions using Mifeprex, which is approved for use only during the first ten weeks of pregnancy. They have no effect on the availability of surgical abortions, a method that this Court has treated as safe for women," wrote Wall. Reproductive rights groups spoke out against the move, noting that people of flagyl for bv color are disproportionately affected both by abortion restrictions and by the buy antibiotics flagyl.

"Black, Brown, Indigenous people and people of color are already dying/getting sick at disproportionate rates from buy antibiotics," said All Above All* on Twitter. "The Trump-Pence admin is trying to make this worse by asking flagyl for bv SCOTUS to require people face unnecessary risk just to get abortion care." "The FDAâs in-person requirements on mifepristone subject patients to unnecessary exposure to a deadly flagyl, and two federal courts have already rejected the Trump administrationâs argument. Forcing patients to travel to a health center to access the safe, effective medication they need especially hurts people of color and people with low-incomes, who already face more barriers to care," said Planned Parenthood Federation of America President and CEO Alexis McGill-Johnson in a statement.THE LARGER TREND The buy antibiotics flagyl has exacerbated many existing barriers to care, including for reproductive health services.

"Weâve seen the undue burden and flagyl for bv hardship these restrictions create during buy antibiotics, especially in communities hit hardest by the flagyl," said Skye Perryman, chief legal officer at the American College of Obstetricians and Gynecologists, a co-plaintiff in the telemedicine case, to Healthcare IT News. In response to the July ruling, some abortion providers reportedly moved to delivering mifepristone by mail. Still, others faced state laws that restricted flagyl for bv the provision of abortion via telemedicine.And as Dr.

Jacquelyn Yeh from Physicians from Reproductive Health pointed out in July, telemedicine itself involves hurdles such as broadband access and privacy concerns. It remains to be seen flagyl for bv whether the Supreme Court will grant the Trump administration's request. ON THE RECORD "As buy antibiotics ravages Black, Latino, Indigenous, and other communities of color across the country, the Trump administration should be aiming to keep us healthy â not moving forward with an agenda to endanger people who seek abortion," said McGill-Johnson.

Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichHealthcare IT News is a HIMSS Media publication..

Artificial intelligence technologies are being increasingly relied upon in flagyl pills online the healthcare domain, particularly when it comes to decision support, precision medicine, and the improvement of the quality of care. Regarding primary care specifically, AI also represents flagyl pills online an opportunity to assist with electronic health record documentation. A new study published in the Journal of American Medical Informatics Association this week shows that, although AI documentation assistants (or digital scribes) offer great potential in the primary care setting, they will need to be supervised by a human until strong evidence is available for their autonomous potential. In workshops with primary care doctors, wrote researchers from the Australian Institute of Health Innovation, "There flagyl pills online was consensus that consultations of the future would increasingly involve more automated and AI-supported systems.

However, there were differing views on how this human-AI collaboration would work, what roles doctors and AI would take, and what tasks could be delegated to AI." HIMSS20 Digital Learn on-demand, earn credit, find products and solutions. Get Started flagyl pills online >>. WHY IT MATTERS Researchers worked with primary care doctors who use EHRs regularly for documentation purposes to understand their views on future AI documentation assistants. They identified three major themes that flagyl pills online emerged from the discussions.

Professional autonomy, human-AI collaboration and new models of care. First, the doctors emphasized the importance of their ability to care for patients in their own way with the abilities AI technology provided."If they [patients] think flagyl pills online that we're just getting suggestions from a computer, then maybe they can just get suggestions from a computer. I think it becomes more difficult to convince them that our recommendations are more valuable than what they can pick up on the internet," said one physician. They noted the need flagyl pills online for a bottom-up approach to technology development, with a focus on delivering clear benefits to practice and workflow, and expressed fears around potential legal complications that could stem from working with an AI assistant.With regard to human-AI collaboration, doctors expressed a variety of viewpoints about what tasks could be delegated to AI.

Many believed that an AI system could assist with tasks such as documentation, referrals and other paperwork. Most said that AI systems flagyl pills online would lack empathy. "GPs voiced several concerns, including some potential biases in patient data and system design, the time needed to fix the errors and train the system, challenges of dealing with complex cases, and the auditing of AI," wrote the researchers. However, doctors flagyl pills online also discussed how AI could help with emerging models of primary care, including preconsultation, mobile health and telehealth.

THE LARGER TREND The question of reducing EHR-related clinician burnout has loomed large, with vendors and researchers trying to pinpoint major causes â and, in turn, potential solutions. AI has flagyl pills online been raised as one such solution, with several major EHR vendors offering plans for incorporating the technology into their workflows. But human input remains vital, as the new JAMIA study and other research has noted. AI could "bring back meaning and purpose in the practice of medicine while providing new levels of efficiency and accuracy," wrote Stanford flagyl pills online researchers in a 2017 Journal of the American Medical Association study.

But, they continued, physicians must "proactively guide, oversee, and monitor the adoption of artificial intelligence as a partner in patient care."ON THE RECORD"AI documentation assistants will likely ... Be integral flagyl pills online to the future primary care consultations. However, these technologies will still need to be supervised by a human until strong evidence for reliable autonomous performance is available. Therefore, different human-AI collaboration flagyl pills online models will need to be designed and evaluated to ensure patient safety, quality of care, doctor safety, and doctor autonomy," wrote the Australian Institute for Health Innovation researchers.

Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichHealthcare IT News is a HIMSS flagyl pills online Media publication.Konica Minolta Healthcare Americas will pay $500,000 to settle a whistleblower case that alleged its Viztek electronic health record subsidiary had falsified data for certification tests.WHY IT MATTERSIn the qui tam complaint, filed in 2017 in U.S. District Court in New Jersey â where Konica Minolta is based â was filed by whistleblower Leighsa Wilson, who worked for two years at Viztek, best known for its PACS and imaging technologies, as a project manager for its EXA EHR product.In mid-2015, the complaint alleges, Viztek, which was in negotiations to be acquired by Konica Minolta, worked together with InfoGard Laboratories (which was then an ONC-authorized certification and testing body) to make false representations that the EHR software complied with requirements for certification â and qualified for receipt of incentive payments under the federal meaningful use program."To ensure that their product was certified and that their customers received incentive payments, Viztek and Konica Minolta. (a) falsely attested to InfoGard that their software met the certification criteria flagyl pills online.

(b) hard-coded their software to pass certification testing requirements temporarily without ensuring that the software released to customers met certification criteria. And (c) caused their users to falsely attest to using flagyl pills online a certified EHR technology, when their software could not support the applicable certification criteria in the field," according to the complaint, which also alleges that InfoGard "facilitated and participated in" these false attestations, "knowingly or with reckless disregard," certifying the EHR software despite its inability to meet ONC's certification criteria.The flaws in Viztek's software "not only rendered the system unreliable and unable to meet meaningful use standards, but the flaws also created a risk to patient health and safety. Rather than spend the time and resources necessary to correct the flaws in its EHR software, the EHR defendants opted to do nothing."THE LARGER TRENDThis is only the most recent settlement of this type from health IT vendors accused of False Claims Act violations, of course.Most notable, was the case of eClinicalWorks, which was alleged by the Department of Justice to have falsely claimed meaningful use certification, to have neglected to have safety addressed issues in its software and to have paid kickbacks to clients. That case was settled in 2017 for $155 flagyl pills online million.More recently, similar complaints were lodged against companies such as Practice Fusion and Greenway Health.

They settled with DOJ for $145 million and $57 million, respectively."We will be unflagging in our efforts to preserve the accuracy and reliability of Americansâ health records and guard the public against corporate greed," said U.S. Attorney for the District of Vermont Christina Nolan after the Greenway case this past year flagyl pills online. "EHR companies should consider themselves on notice."ON THE RECORD"The lives of patients depend upon the information processed by electronic health records," said Wilson â who, as a qui tam whistleblower will receive 20% of the financial settlement â in a statement. "Functionality testing and subsequent certification must be performed and obtained through a reliable, measurable process.""Filing a qui tam lawsuit is a powerful and effective way to report problems with EHR software purchased with federal funds and get the problems fixed when flagyl pills online they are ignored," said Luke Diamond, an associate at Phillips &.

Cohen. "The False Claims Act protects whistleblowers from job retaliation and offers rewards if the government recovers funds as a result of the qui tam case.""Our client was concerned about possible patient harm that can occur if EHR software isn't properly certified, so she stepped forward to inform the government about flagyl pills online what she had witnessed," said Colette Matzzie, a partner and whistleblower attorney with Phillips &. Cohen, which brought the case. "Ensuring that EHR software meets all governmental requirements is important to safeguard both patient care and federal funds."The Arc Madison Cortland in Oneida, New York, knows that there is a lack flagyl pills online of providers that specialize in the intellectual/developmental disability field.

Making the problem worse, not so many that understand dual diagnosis.THE PROBLEMWith buy antibiotics minimizing the ability for individuals to receive face-to-face services with their providers, many patients are resorting to emergency department visits.Additionally, The Arc is in a rural area requiring travel to see a provider, and there flagyl pills online is a lack of providers in the field. The population itself is underserved, with a lack of transportation to get to appointments. Without the ability to institute telemedicine as a flagyl pills online solution to these problems, the population supported by The Arc would have seen a lengthy (permanent?. ) pause for needed medical services.PROPOSALThe Arc this year received funding from the FCC to help provide telehealth services.âWith this funding we can further treat patients, reduce crisis and allow for social distancing, which is imperative to our vulnerable population,â said Jackie Fahey, director of clinic services at The Arc Madison Cortland.

ÂWe could provide ongoing services to the individuals we serve to ensure there are no unnecessary emergency department visits flagyl pills online. This places less of a strain on our local emergency departments and unneeded additional costs.âWith the purchase of tablets and headsets and telehealth services from vendor Doxy.me, The Arc was able to still provide medical care to its population of people with an I/DD. Additionally, eliminating emergency department visits also eliminates their exposure to buy antibiotics and eases the flagyl pills online burden of the ED providers who are overburdened right now.MARKETPLACEThere are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News recently compiled a comprehensive list of these vendors with detailed descriptions.

To read this special report, click here.MEETING THE CHALLENGEâWhen all of our locations were closed abruptly in the middle of March due to the buy antibiotics flagyl, we needed to determine a way to quickly and easily implement flagyl pills online a telehealth solution so that we were able to still support the individuals that we serve during the crisis, especially when many were under strict quarantine protocols for a variety of reasons,â Fahey explained.âWe signed up immediately for the Doxy.me telehealth platform as it was a user-friendly platform that is HIPAA-compliant. The feature we liked about Doxy.me was that it is web-based, so nothing had to be downloaded and it could easily be used on a laptop, tablet or smartphone.âThe Arc rolled out the technology initially with its mental health providers, who offer psychiatry/medication monitoring services, social work counseling and mental health counseling. More than half the organizationâs enrollment is enrolled in one or all of these three services, so it was able to continue providing services to a large number of enrolled individuals.âWe then began to roll the telehealth services out to nutrition, speech therapy, physical therapy and occupational therapy caseloads if individuals were appropriate to receive the service through telehealth,â Fahey said.RESULTSThe first success metric The Arc has been able to achieve with the technology is maintaining its utilization for mental health flagyl pills online services. When everything was running normal prior to buy antibiotics, The Arcâs mental health services made up about 25% of the services it provided on a monthly basis.

With the implementation of telehealth services during the buy antibiotics flagyl, the organization was able to achieve 20% of the services provided on a monthly basis.This has shown to staff flagyl pills online that they have been able to still serve and respond to the needs of their psychiatry, social work and mental health counseling patients with minimal issues by implementing the telehealth technology.âThe second success metric we have been able to achieve with the technology is we have been able to continue to receive referrals for our services and enroll new individuals into the services they need if the services are able to be completed via telehealth,â she said. ÂBetween April, May and June, we have enrolled 16 new individuals into ongoing clinic services, which is right on par for our normal enrollment average per month.âUSING FCC AWARD FUNDSThe Arc Madison Cortland was awarded $49,455 by the FCC earlier this year for laptop computers and headsets to provide remote consultations and treatment during the buy antibiotics flagyl for psychological services, counseling, and occupational and physical therapy for people with developmental and other disabilities.âWith the funds, we purchased headsets and tablets to allow the people we support to have access to medical appointments, along with physical therapy, occupational therapy and psychology appointments remotely,â Fahey explained. ÂThe technology enables us to continue to provide these services at a time when the people we support are unable to leave for traditional in-person flagyl pills online appointments.âBecause these are such uncertain times, and a time frame for when we may return to ânormalcyâ is unknown, the technology allows us to continue delivering medical support without the concern of a pause in those services.âTwitter. @SiwickiHealthITEmail the writer.

Bill.siwicki@himss.orgHealthcare IT News is a HIMSS Media publication.HIMSSCast host flagyl pills online Jonah Comstock convenes a panel of HIMSS Media editors â HITN Senior Editor Kat Jercich, MobiHealthNews Associate Editor Dave Muoio and HFN Associate Editor Jeff Lagasse â to discuss recent delivery slowdowns at the Post Office and how they have and haven't affected healthcare stakeholders, including startups and patients. The team also looks into the broader trend of the politicization of traditionally apolitical government agencies and how that could affect public faith in buy antibiotics treatments or treatments.More about this episode:USPS service delays are hitting some mail-order pharmacies and telehealth platforms harder than othersMail delays may affect medication supply for nearly 1 in 4 Americans over 50Postmaster General Louis DeJoy's full testimony (C-SPAN)The Package Coalition homepageThe Trump administration this week asked the U.S. Supreme Court to reverse a lower court ruling that allowed for flagyl pills online mail-order and telemedicine abortion during the buy antibiotics crisis. U.S.

Food and Drug Administration regulations require mifepristone, flagyl pills online which is used in medication abortion, to be dispensed at a clinic, hospital or medical office. In June, U.S. District Judge for the District of flagyl pills online Maryland Theodore Chuang blocked the requirements during the flagyl, finding them to be a "substantial obstacle." Mifepristone, in combination with misoprostol, is FDA-approved for abortions up to ten weeks' gestation. In 2017, a New England Journal of Medicine article argued against the FDA regulations for mifepristone given the drug's safety record.

WHY IT flagyl pills online MATTERS Acting Solicitor General Jeffrey B. Wall applied for a stay of Chuang's injunction on Wednesday as the case makes its way through the lower courts, arguing that the regulations do not represent an undue burden. "The safety requirements here concern only medication abortions flagyl pills online using Mifeprex, which is approved for use only during the first ten weeks of pregnancy. They have no effect on the availability of surgical abortions, a method that this Court has treated as safe for women," wrote Wall.

Reproductive rights groups spoke out against the move, noting that people of color are disproportionately affected both by abortion restrictions and by the flagyl pills online buy antibiotics flagyl. "Black, Brown, Indigenous people and people of color are already dying/getting sick at disproportionate rates from buy antibiotics," said All Above All* on Twitter. "The Trump-Pence admin is trying to make this worse by asking SCOTUS to require people face unnecessary risk flagyl pills online just to get abortion care." "The FDAâs in-person requirements on mifepristone subject patients to unnecessary exposure to a deadly flagyl, and two federal courts have already rejected the Trump administrationâs argument. Forcing patients to travel to a health center to access the safe, effective medication they need especially hurts people of color and people with low-incomes, who already face more barriers to care," said Planned Parenthood Federation of America President and CEO Alexis McGill-Johnson in a statement.THE LARGER TREND The buy antibiotics flagyl has exacerbated many existing barriers to care, including for reproductive health services.

"Weâve seen the undue burden and hardship these restrictions create during buy antibiotics, especially in communities hit hardest by the flagyl," flagyl pills online said Skye Perryman, chief legal officer at the American College of Obstetricians and Gynecologists, a co-plaintiff in the telemedicine case, to Healthcare IT News. In response to the July ruling, some abortion providers reportedly moved to delivering mifepristone by mail. Still, others faced state laws that restricted the provision of abortion via telemedicine.And as flagyl pills online Dr. Jacquelyn Yeh from Physicians from Reproductive Health pointed out in July, telemedicine itself involves hurdles such as broadband access and privacy concerns.

It remains to be seen whether the Supreme Court will grant the Trump administration's request. ON THE RECORD "As buy antibiotics ravages Black, Latino, Indigenous, and other communities of color across the country, the Trump administration should be aiming to keep us healthy â not moving forward with an agenda to endanger people who seek abortion," said McGill-Johnson. Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichHealthcare IT News is a HIMSS Media publication..

What should I watch for while taking Flagyl?

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If you are being treated for a sexually transmitted disease, avoid sexual contact until you have finished your treatment. Your sexual partner may also need treatment.

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The conditions included high blood pressure, diabetes and obesity, as well as problems that are caused by buy antibiotics itself, such as respiratory can a man take flagyl failure and pneumonia.The CDC data table is based on an analysis of death certificates that mention buy antibiotics as a cause. For 6% of the deaths, buy antibiotics was the only cause mentioned, the CDC notes.The other 94% list buy antibiotics and other conditions together. Among those deaths, there were, on average, 2.6 additional conditions can a man take flagyl or causes per death, the public health agency said.As of Aug.

26, the CDC said, can a man take flagyl there were 161,332 deaths where buy antibiotics was listed on the death certificate. Social media users over the weekend posted an older screenshot of the data that showed 153,504 deaths. The posts used the 6% can a man take flagyl figure to claim the U.S.

Death toll was much lower â 9,210."CDC just backpedaled (quietly) and adjusted the U.S. buy antibiotics deaths from 153,504 can a man take flagyl to 9,210. Admitting that their numbers can a man take flagyl are so (expletive) that they are off by a whopping 94%," said a post being shared on Facebook Monday.But such claims misrepresent the data.

A death isn't excluded from the buy antibiotics tally just because the person was obese or had diabetes or dementia. Someone with heart problems can still be killed by buy antibiotics, and the death certificate could mention both as contributing.Experts say it's not surprising that so few people who died from buy antibiotics had no underlying conditions listed can a man take flagyl on their death certificates. It is rare for people not to have multiple medical issues at death."The underlying can a man take flagyl cause of death is the condition that began the chain of events that ultimately led to the person's death," Dr.

Robert Anderson, who oversees the CDC's death statistics work, said in a statement. "In 92% of all deaths that mention buy antibiotics, can a man take flagyl buy antibiotics is listed as the underlying cause of death."Also, while death certificates are supposed to list any causes or conditions that contributed, past research has shown that the documents aren't perfect. Doctors might not know â or specify â all the reasons behind a particular death.More important, the CDC figures show what medical professionals have been saying since the outset of the flagyl â that the flagyl tends to have a more severe impact on people with underlying conditions.For example, people died with diabetes not because of it, said Dr.

William Schaffner, an infectious-diseases expert at Vanderbilt University."If it hadn't been for the buy antibiotics flagyl , these people can a man take flagyl would be living today," he said. "So yes, although they have contributing underlying chronic health factors, it's still the buy antibiotics flagyl that killed them.".

The Centers for Disease Control and Prevention did not "backpedal" on the number of deaths caused by buy antibiotics, reducing the figure from nearly 154,000 to just over 9,000, as social media posts claimed.The term "Only 6%" trended widely on Twitter over the weekend as supporters of the QAnon conspiracy theory promoted tweets that flagyl pills online falsely suggested the CDC http://www.ggs-regenbogen.bobi.net/zithromax-pfizer-price/ had updated its records to show that only 6% of U.S. Deaths tied to buy antibiotics were legitimate flagyl pills online. President Donald Trump was among those who tweeted the information, which was later taken down by Twitter for violating platform rules.The posts, which received hundreds of thousands of shares online, were based on a regularly updated CDC data table showing underlying conditions for those who died of buy antibiotics. The conditions included high blood pressure, diabetes and obesity, flagyl pills online as well as problems that are caused by buy antibiotics itself, such as respiratory failure and pneumonia.The CDC data table is based on an analysis of death certificates that mention buy antibiotics as a cause. For 6% of the deaths, buy antibiotics was the only cause mentioned, the CDC notes.The other 94% list buy antibiotics and other conditions together.

Among those deaths, there were, on average, 2.6 additional conditions or causes per death, the public flagyl pills online health agency said.As of Aug. 26, the CDC said, there were 161,332 deaths where buy antibiotics was listed on the death certificate flagyl pills online. Social media users over the weekend posted an older screenshot of the data that showed 153,504 deaths. The posts used the 6% figure to claim the U.S flagyl pills online. Death toll was much lower â 9,210."CDC just backpedaled (quietly) and adjusted the U.S.

buy antibiotics deaths flagyl pills online from 153,504 to 9,210. Admitting that their flagyl pills online numbers are so (expletive) that they are off by a whopping 94%," said a post being shared on Facebook Monday.But such claims misrepresent the data. A death isn't excluded from the buy antibiotics tally just because the person was obese or had diabetes or dementia. Someone with heart problems can still be killed by buy antibiotics, and the death certificate could mention both as contributing.Experts say it's not surprising flagyl pills online that so few people who died from buy antibiotics had no underlying conditions listed on their death certificates. It is rare for people not to have multiple medical issues at death."The underlying cause of death is the condition that began the chain of events that ultimately led to the person's death," Dr flagyl pills online.

Robert Anderson, who oversees the CDC's death statistics work, said in a statement. "In 92% of all deaths that mention buy antibiotics, buy antibiotics is listed as the underlying cause of death."Also, while death certificates are supposed to list any causes or conditions that contributed, past research has shown that flagyl pills online the documents aren't perfect. Doctors might not know â or specify â all the reasons behind a particular death.More important, the CDC figures show what medical professionals have been saying since the outset of the flagyl â that the flagyl tends to have a more severe impact on people with underlying conditions.For example, people died with diabetes not because of it, said Dr. William Schaffner, flagyl pills online an infectious-diseases expert at Vanderbilt University."If it hadn't been for the buy antibiotics flagyl , these people would be living today," he said. "So yes, although they have contributing underlying chronic health factors, it's still the buy antibiotics flagyl that killed them.".

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At the start of field work season, http://www.karpfenkaviar.at/member/eduard-hofbauer-domin/ ecologist syrup flagyl Jory Brinkerhoff usually advises his crew to watch out for summertime fevers. If you develop a fever at that time of year, he tells them, itâs probably not the flu, but a tick-borne illness.But this year, Brinkerhoff, who studies human risk for flea- and tick-transmitted diseases at the University of Richmond, didnât know exactly what to tell his field crew. A fever in the middle syrup flagyl of summer 2020 could mean a tick-borne illness.

Or, it could mean buy antibiotics.With the novel antibiotics flagyl still spreading across the country, some experts worry about the overlap between buy antibiotics and Lyme disease, which is caused by a bacterium carried by black-legged ticks. While itâs too soon to know exactly how the flagyl will affect Lyme disease rates this year, experts like Brinkerhoff wonder if more people spending time outside beating the quarantine blues could lead to syrup flagyl more people being exposed to disease-carrying ticks. Some overlapping symptoms might also lead to delayed diagnosis and treatment of Lyme, he notes.

At the same time, weather patterns in some parts of the country may actually lead to fewer Lyme disease cases this year. No matter the syrup flagyl broader trends, there are things anyone getting outside can do to protect themselves from ticks. Lyme Disease on the MoveOver the last few decades, Lyme disease has been on the rise in the United States.

There are many overlapping syrup flagyl reasons for this, says Brinkerhoff. Awareness has gone up since the 1970s, when Lyme was first described in the U.S. Landscape changes like cutting forests and building suburbs near wooded areas has put humans in closer contact with ticks and tick-carrying animals.

Deer populations have exploded syrup flagyl in the last 100 years, he notes. And climate change is likely allowing ticks to spread to and thrive in new parts of the continent. This year, people syrup flagyl have flocked to the great outdoors to escape their home quarantines and engage in socially-distant fun.

Itâs possible that more people trying to get outside could mean more people exposed to ticks and, therefore, Lyme disease, says Brinkerhoff, who wrote an article in The Conversation on the issue earlier this year. Animals have been behaving differently during the flagyl as well, especially during the early days of lockdown, and itâs unclear if that could also have an effect on Lyme disease rates, he says.In some parts of the country, however, Lyme may be less of a concern this summer than it normally is. Maine is usually a Lyme hotspot in early summer, but unusually hot and dry weather this year may be keeping syrup flagyl ticks close to the ground and away from human contact, says Robert P.

Smith Jr., an infectious disease physician and director of the division of infectious diseases at Maine Medical Center. While itâs too early to tell, Lyme disease rates in Maine could actually go down this summer as a result, he says.Overlapping syrup flagyl SymptomsWith everyone rightfully concerned about buy antibiotics, Lyme disease likely isnât at the forefront of someoneâs mind if they develop a fever. Plus, about two-thirds of people with Lyme disease donât remember being bitten by a tick, says Smith.

Many who develop Lyme disease are bitten by poppy seed-sized immature ticks that can stay on the body unnoticed for two or three days before dropping off, he says.There is some overlap between buy antibiotics and Lyme disease symptoms that could cause confusion. In both cases, people usually develop a fever and muscle aches, syrup flagyl says Smith. He has heard secondhand about a few cases in Maine in which patients with these symptoms were first tested for buy antibiotics and were later found to have Lyme disease.However, there are some crucial differences between the two illnesses, Smith says.

The majority of syrup flagyl people with symptomatic buy antibiotics will have a cough or shortness of breath, whereas Lyme disease generally has no respiratory component, says Smith. buy antibiotics patients also have a higher risk for gastrointestinal issues, and Lyme patients do not. While not all people with Lyme disease develop a rash, 70 to 80 percent do, Smith notes.

Rashes are syrup flagyl not common symptoms for buy antibiotics s. Receiving an accurate diagnosis and relatively quick treatment can greatly reduce the severity of a Lyme disease . ÂIt doesnât have to be immediate syrup flagyl.

If you think you might have Lyme disease, you need to get diagnosed with a week or so,â says Smith. ÂThatâs usually very early in the disease and you can expect an excellent response to antibiotic treatment.â Delaying treatment by a couple of weeks can lead to more serious complications, including nerve-related symptoms, Lyme meningitis, facial muscle weakness (Bellâs palsy), Lyme arthritis and other conditions, he says. While antibiotics are still syrup flagyl effective at this stage, it tends to take longer to fully recover.Fortunately, for anyone concerned about safe outdoor excursions here and now, there are several practical steps you can take to avoid ticks.

Use insect repellant and wear protective layers. Stick to syrup flagyl the path instead of straying into dense underbrush, says Smith. When you return from an adventure, put your clothes in the washer and check yourself for ticks.

And if you do start to feel feverish a few days later, call your doctor and be sure to mention youâve been spending time outside..

At the start of field work season, ecologist Jory Brinkerhoff usually advises his crew to watch out for summertime flagyl pills online fevers. If you develop a fever at that time of year, he tells them, itâs probably not the flu, but a tick-borne illness.But this year, Brinkerhoff, who studies human risk for flea- and tick-transmitted diseases at the University of Richmond, didnât know exactly what to tell his field crew. A fever in the middle flagyl pills online of summer 2020 could mean a tick-borne illness.

Or, it could mean buy antibiotics.With the novel antibiotics flagyl still spreading across the country, some experts worry about the overlap between buy antibiotics and Lyme disease, which is caused by a bacterium carried by black-legged ticks. While itâs too soon to know exactly how the flagyl will affect Lyme disease flagyl pills online rates this year, experts like Brinkerhoff wonder if more people spending time outside beating the quarantine blues could lead to more people being exposed to disease-carrying ticks. Some overlapping symptoms might also lead to delayed diagnosis and treatment of Lyme, he notes.

At the same time, weather patterns in some parts of the country may actually lead to fewer Lyme disease cases this year. No matter the broader trends, flagyl pills online there are things anyone getting outside can do to protect themselves from ticks. Lyme Disease on the MoveOver the last few decades, Lyme disease has been on the rise in the United States.

There are many overlapping reasons for flagyl pills online this, says Brinkerhoff. Awareness has gone up since the 1970s, when Lyme was first described in the U.S. Landscape changes like cutting forests and building suburbs near wooded areas has put humans in closer contact with ticks and tick-carrying animals.

Deer populations have exploded in the last 100 years, he notes flagyl pills online. And climate change is likely allowing ticks to spread to and thrive in new parts of the continent. This year, people have flocked to the great outdoors to escape their home flagyl pills online quarantines and engage in socially-distant fun.

Itâs possible that more people trying to get outside could mean more people exposed to ticks and, therefore, Lyme disease, says Brinkerhoff, who wrote an article in The Conversation on the issue earlier this year. Animals have been behaving differently during the flagyl as well, especially during the early days of lockdown, and itâs unclear if that could also have an effect on Lyme disease rates, he says.In some parts of the country, however, Lyme may be less of a concern this summer than it normally is. Maine is usually a Lyme hotspot in early summer, but unusually hot and dry weather this year may be keeping ticks close to flagyl pills online the ground and away from human contact, says Robert P.

Smith Jr., an infectious disease physician and director of the division of infectious diseases at Maine Medical Center. While itâs too early to tell, Lyme disease rates in Maine could actually go down this summer as a result, he says.Overlapping SymptomsWith everyone rightfully concerned about buy antibiotics, Lyme disease likely isnât at the forefront of someoneâs mind if they develop a fever flagyl pills online. Plus, about two-thirds of people with Lyme disease donât remember being bitten by a tick, says Smith.

Many who develop Lyme disease are bitten by poppy seed-sized immature ticks that can stay on the body unnoticed for two or three days before dropping off, he says.There is some overlap between buy antibiotics and Lyme disease symptoms that could cause confusion. In both cases, people usually develop a fever flagyl pills online and muscle aches, says Smith. He has heard secondhand about a few cases in Maine in which patients with these symptoms were first tested for buy antibiotics and were later found to have Lyme disease.However, there are some crucial differences between the two illnesses, Smith says.

The majority of people with symptomatic buy antibiotics flagyl pills online will have a cough or shortness of breath, whereas Lyme disease generally has no respiratory component, says Smith. buy antibiotics patients also have a higher risk for gastrointestinal issues, and Lyme patients do not. While not all people with Lyme disease develop a rash, 70 to 80 percent do, Smith notes.

Rashes are not common symptoms for buy antibiotics flagyl pills online s. Receiving an accurate diagnosis and relatively quick treatment can greatly reduce the severity of a Lyme disease . ÂIt doesnât have to be flagyl pills online immediate.

If you think you might have Lyme disease, you need to get diagnosed with a week or so,â says Smith. ÂThatâs usually very early in the disease and you can expect an excellent response to antibiotic treatment.â Delaying treatment by a couple of weeks can lead to more serious complications, including nerve-related symptoms, Lyme meningitis, facial muscle weakness (Bellâs palsy), Lyme arthritis and other conditions, he says. While antibiotics are still effective at this stage, it tends to take longer to fully recover.Fortunately, for anyone concerned about safe outdoor excursions here and now, there are several practical steps you flagyl pills online can take to avoid ticks.

Use insect repellant and wear protective layers. Stick to the path instead of straying into dense underbrush, says flagyl pills online Smith. When you return from an adventure, put your clothes in the washer and check yourself for ticks.

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About This TrackerThis tracker provides the number of confirmed cases and deaths from novel antibiotics by country, the trend in confirmed case and death counts by country, and a global map showing how can i get flagyl which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) antibiotics Resource Centerâs buy antibiotics Map and the World Health Organizationâs (WHO) antibiotics Disease (buy antibiotics-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About buy antibiotics antibioticsIn late 2019, a how can i get flagyl new antibiotics emerged in central China to cause disease in humans.

Cases of this disease, known as buy antibiotics, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the flagyl represents a public health emergency of international concern, and how can i get flagyl on January 31, 2020, the U.S. Department of Health and Human Services declared it to be a health emergency for the United States.Key PointsOn January 23, 2017, President Donald Trump reinstated and expanded the Mexico City Policy via presidential memorandum, renaming it âProtecting Life in Global Health Assistance.â This explainer provides an overview of the policy, including its history, changes over time, and current application.First announced in 1984 by the Reagan administration, the policy has been rescinded and reinstated by subsequent administrations along party lines and has now been in effect for 19 of the past 34 years.The policy requires foreign non-governmental organizations (NGOs) to certify that they will not âperform or actively promote abortion as a method of family planningâ using funds from any source (including non-U.S.

Funds) as how can i get flagyl a condition of receiving U.S. Government global family planning assistance and, as of Jan. 23, 2017, how can i get flagyl most other U.S.

Global health assistance.The Trump administrationâs application of the policy extends to the vast majority of U.S. Bilateral global health assistance, including funding for HIV under PEPFAR, maternal and how can i get flagyl child health, malaria, nutrition, and other programs. This marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounts for approximately $600 million of that total).Additionally, as a result of a March 2019 policy announcement and subsequent information released in June 2019, the policy, for the first time, prohibits foreign NGOs who accept the policy from providing any financial support using any source of funds and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning.

This greatly how can i get flagyl extends its reach to other areas of U.S. Development assistance beyond global health and to other non-U.S. Funding streams.More recently, in September 2020, how can i get flagyl a proposed rule to extend the policy to contracts was published.

If finalized, it would greatly extend the reach of the policy beyond grants and cooperative agreements to also include contracts.KFF analyses have found that:more than half of the countries in which the U.S. Provides bilateral global health assistance allow for legal abortion in at least one case not permitted by how can i get flagyl the policy (analysis). Andhad the expanded policy been in effect during the FY 2013 â FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy (analysis).What is the Mexico City Policy?.

The Mexico City Policy is how can i get flagyl a U.S. Government policy that â when in effect â has required foreign NGOs to certify that they will not âperform or actively promote abortion as a method of family planningâ using funds from any source (including non-U.S. Funds) as a condition how can i get flagyl of receiving U.S.

Global family planning assistance and, as of Jan. 23, 2017, most other how can i get flagyl U.S. Global health assistance.The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name.

See Box how can i get flagyl 1). Under the Trump administration, the policy has been renamed âProtecting Life in Global Health Assistanceâ (PLGHA). Among opponents, it is also known as the âGlobal how can i get flagyl Gag Rule,â because among other activities, it prohibits foreign NGOs from using any funds (including non-U.S.

Funds) to provide information about abortion as a method of family planning and to lobby a foreign government to legalize abortion. Â[T]he United States does not consider how can i get flagyl abortion an acceptable element of family planning programs and will no longer contribute to those of which it is a part. Â¦[T]he United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.âWhen first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S.

Funding for abortion how can i get flagyl internationally, with some exceptions (see below). Prior to the policy, foreign NGOs could use non-U.S. Funds to engage in certain voluntary abortion-related activities as long as they maintained segregated accounts how can i get flagyl for any U.S.

Money received, but after the Mexico City Policy was in place, they were no longer permitted to do so if they wanted to receive U.S. Family planning assistance.The Trump administrationâs application of the policy to the vast majority how can i get flagyl of U.S. Bilateral global health assistance, including funding for HIV under the U.S.

Presidentâs Emergency Plan for AIDS Relief (PEPFAR), maternal and child health, malaria, nutrition, and other programs, marks how can i get flagyl a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounted for approximately $600 million of that total). The Administrationâs more recent extension of the policy to include any financial support (health or otherwise) provided by foreign NGOs for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning is likely to encompass significant additional funding.When has it been in effect?. The Mexico City Policy has been in effect for 19 of the past 34 years, primarily through executive action, and has been instated, rescinded, and reinstated by presidential administrations along party lines (see Table 1).The policy was first instituted in 1984 (taking effect in 1985) by President Ronald Reagan and continued to be in effect through President George H.W.

Bushâs administration how can i get flagyl. It was rescinded by President Bill Clinton in 1993 (although it was reinstated legislatively for one year during his second term. See below) how can i get flagyl.

The policy was reinstated by President George W. Bush in 2001 and then rescinded by President Barack how can i get flagyl Obama in 2009. It is currently in effect, having been reinstated by President Trump in 2017.

YearsIn Effect? how can i get flagyl. Presidential Administration (Party Affiliation)Executive (E) or Congressional (C) Action?. 1985-1989YesReagan (R)E1989-1993YesBush how can i get flagyl (R)E1993-1999 Sept.NoClinton (D)E1999 Oct.-2000 Sept.Yes*Clinton (D)C2000 Oct.-2001NoClinton (D)E2001-2009YesBush (R)E2009-2017NoObama (D)E2017-presentYesTrump (R)ENOTES.

Shaded blue indicate periods when policy was in effect. * There was a temporary, one-year legislative imposition of the policy, how can i get flagyl which included a portion of the restrictions in effect in other years and an option for the president to waive these restrictions in part. However, if the waiver option was exercised (for no more than $15 million in family planning assistance), then $12.5 million of this funding would be transferred to maternal and child health assistance.

The president did exercise the how can i get flagyl waiver option.SOURCES. ÂPolicy Statement of the United States of America at the United Nations International Conference on Population (Second Session), Mexico City, Mexico, August 6-14, 1984,â undated. Bill Clinton Administration, âSubject how can i get flagyl.

AID Family Planning Grants/Mexico City Policy,â Memorandum for the Acting Administrator of the Agency for International Development, January 22, 1993, Clinton White House Archives, https://clintonwhitehouse6.archives.gov/1993/01/1993-01-22-aid-family-planning-grants-mexico-city-policy.html. FY 2000 Consolidated Appropriations Act, P.L how can i get flagyl. 106-113.

George W how can i get flagyl. Bush Administration, âSubject. Restoration of the Mexico City Policy,â Memorandum for the Administrator of the United States Agency for International Development, January 22, 2001, Bush how can i get flagyl Administration White House Archives, https://georgewbush-whitehouse.archives.gov/news/releases/20010123-5.html.

ÂSubject. Restoration of the Mexico City Policy,â Memorandum for the Administrator of the United States Agency how can i get flagyl for International Development, March 28, 2001, Federal Register, https://www.federalregister.gov/documents/2001/03/29/01-8011/restoration-of-the-mexico-city-policy. George W.

Bush Administration, âSubject how can i get flagyl. Assistance for Voluntary Population Planning,â Memorandum for the Secretary of State, August 29, 2003, Bush Administration White House Archives, http://georgewbush-whitehouse.archives.gov/news/releases/2003/08/20030829-3.html. Barack Obama Administration, âMexico City Policy and Assistance for Voluntary Population Planning,â Memorandum for the Secretary of State, the Administrator of the United States Agency for International Development, January 23, 2009, Obama White House how can i get flagyl Archives, https://obamawhitehouse.archives.gov/the-press-office/mexico-city-policy-and-assistance-voluntary-population-planning.

White House, âThe Mexico City Policy,â Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, how can i get flagyl https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.How is it instituted (and rescinded)?. The Mexico City Policy has, for the most part, been instituted or rescinded through executive branch action (typically via presidential memoranda).

While Congress has the ability to institute the policy through how can i get flagyl legislation, this has happened only once in the past. A modified version of the policy was briefly applied by Congress during President Clintonâs last year in office as part of a broader arrangement to pay the U.S. Debt to the United how can i get flagyl Nations.

(At that time, President Clinton was able to partially waive the policyâs restrictions.) Other attempts to institute the policy through legislation have not been enacted into law, nor have legislative attempts to overturn the policy. See Table 1.Who does the policy apply how can i get flagyl to?. The policy, when in effect, applies to foreign NGOs as a condition for receiving U.S.

Family planning support and, now, other global health assistance, either directly (as the main â or prime â recipient of U.S. Funding) or indirectly (as a recipient of U.S how can i get flagyl. Funding through an agreement with the prime recipient.

Referred to as how can i get flagyl a sub-recipient). Specifically, a foreign NGO ârecipient agrees that it will not, during the term of this award, perform or actively promote abortion as a method of family planning in foreign countries or provide financial support to any other foreign non-governmental organization that conducts such activities.âForeign NGOs include:international NGOs that are based outside the U.S.,regional NGOs that are based outside the U.S., andlocal NGOs in assisted countries.U.S. NGOs, while not directly subject how can i get flagyl to the Mexico City Policy, must also agree to ensure that they do not provide funding to any foreign NGO sub-recipients unless those sub-recipients have first certified adherence to the policy.

Specifically, a U.S. NGO ârecipient (A) agrees that it will not furnish how can i get flagyl health assistance under this award to any foreign non-governmental organization that performs or actively promotes abortion as a method of family planning in foreign countries. And (B) further agrees to require that such sub-recipients do not provide financial support to any other foreign non-governmental organization that conducts such activities.âAs in the past, the current policy does not apply to funding provided by the U.S.

Government to foreign governments (national or sub-national), public international organizations, and other multilateral entities, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria how can i get flagyl and Gavi, the treatment Alliance. However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See âWhat how can i get flagyl is âfinancial supportâ?.

Â below.To what assistance does it apply?. In the past, foreign NGOs have been required to adhere to the Mexico City how can i get flagyl Policy â when it was in effect â as a condition of receiving support through certain U.S. International funding streams.

Family planning assistance through how can i get flagyl the U.S. Agency for International Development (USAID) and, beginning in 2003, family planning assistance through the U.S. Department of how can i get flagyl State.

In the 2003 memorandum announcing the policyâs expansion to include the Department of State, President Bush stated that the policy did not apply to funding for global HIV/AIDS programs and that multilateral organizations that are associations of governments are not included among âforeign NGOs.âThe current policy, reinstated in 2017, applies to the vast majority of U.S. Bilateral global how can i get flagyl health assistance furnished by all agencies and departments. âAssistanceâ includes âthe provision of funds, commodities, equipment, or other in-kind global health assistance.â Specifically, the expanded policy applies to nearly all bilateral global health assistance, including.

family planning and reproductive healthfor the first time:maternal and how can i get flagyl child health (including household-level water, sanitation, and hygiene (WASH))nutritionHIV under PEPFARtuberculosismalaria under the Presidentâs Malaria Initiative (PMI)neglected tropical diseasesglobal health securitycertain types of research activitiesThe policy applies to the assistance described above that is appropriated directly to three agencies and departments. USAID. The Department how can i get flagyl of State, including the Office of the Global AIDS Coordinator, which oversees and coordinates U.S.

Global HIV funding under PEPFAR. And for the first time, the Department of Defense how can i get flagyl (DoD). When such funding is transferred to another agency, including the Centers for Disease Control (CDC) and the National Institutes of Health (NIH), it remains subject to the policy, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly.The policy applies to three types of funding agreements for such assistance.

Grants. Cooperative agreements. And, for the first time, contracts, pending necessary rule-making that would be needed to do so (a proposed rule to accomplish this was published in September 2020).The policy does not apply to U.S.

Assistance for. Water supply and sanitation activities, which is usually focused on infrastructure and systems. Humanitarian assistance, including activities related to migration and refugee assistance activities as well as disaster and humanitarian relief activities.

The American Schools and Hospitals Abroad (ASHA) program. And Food for Peace (FFP). However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy.

See âWhat is âfinancial supportâ?. Â below.What activities are prohibited?. The policy prohibits foreign NGOs that receive U.S.

Family planning assistance and, now, most other U.S. Bilateral global health assistance from using funds from any source (including non-U.S. Funds) to âperform or actively promote abortion as a method of family planning.â In addition to providing abortions with non-U.S.

Funds, restricted activities also include the following:providing advice and information about and offering referral for abortion â where legal â as part of the full range of family planning options,promoting changes in a countryâs laws or policies related to abortion as a method of family planning (i.e., engaging in lobbying), andconducting public information campaigns about abortion as a method of family planning.The prohibition of these activities are why the policy has been referred to by its critics as the âGlobal Gag Rule.âAdditionally, for the first time, the policy prohibits foreign NGOs from providing any financial support with any source of funds (including non-U.S. Funding) and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. See âWhat is âfinancial support?.

Â below.The policy, however, does not prohibit foreign NGOs from:providing advice and information about, performing, or offering referral for abortion in cases where the pregnancy has either posed a risk to the life of the mother or resulted from incest or rape. Andresponding to a question about where a safe, legal abortion may be obtained when a woman who is already pregnant clearly states that she has already decided to have a legal abortion (passively providing information, versus actively providing medically-appropriate information).In addition, the expanded policy does not apply to healthcare providers who have an affirmative duty required under local law to provide counseling about and referrals for abortion as a method of family planning.Does it restrict direct U.S. Funding for abortion overseas?.

U.S. Funding for abortion is already restricted under several provisions of the law. Specifically, before the Mexico City Policy was first announced in 1984, U.S.

Law already prohibited the use of U.S. Aid:to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion (the Helms Amendment, 1973, to the Foreign Assistance Act);for biomedical research related to methods of or the performance of abortion as a means of family planning (the Biden Amendment, 1981, to the Foreign Assistance Act). Andto lobby for or against abortion (the Siljander Amendment, first included in annual appropriations in 1981 and included each year thereafter).Then, shortly after the policy was announced in 1984, the Kemp-Kasten Amendment was passed in 1985, prohibiting the use of U.S.

Aid to fund 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 (it is now included in annual appropriations).Before the Mexico City Policy, U.S. Aid recipients could use non-U.S. Funds to engage in certain abortion-related activities but were required to maintain segregated accounts for U.S.

Assistance. The Mexico City Policy reversed this practice. No longer were foreign NGOs allowed to use non-U.S.

Funds, maintained in segregated accounts, for voluntary abortion-related activities if they wished to continue to receive or be able to receive U.S. Family planning funds.Does the policy prohibit post-abortion care?. The Mexico City Policy does not restrict the provision of post-abortion care, which is a supported activity of U.S.

Family planning assistance. Whether or not the Mexico City Policy is in effect, recipients of U.S. Family planning assistance are allowed to use U.S.

And non-U.S. Funding to support post-abortion care, no matter the circumstances of the abortion (whether it was legal or illegal).What has been the impact of the policy?. Several studies have looked at the impact of the policy.

Specifically, the updated study found that during periods when the policy was in place, abortion rates rose by 40% in countries with high exposure to the Mexico City Policy compared to those with low exposure, while the use of modern contraceptives declined by 14% and pregnancies increased by 12% in high exposure compared to low exposure countries. In other words, it found patterns that âstrengthen the case for the role played by the policyâ in âa substantial increase in abortions across sub-Saharan Africa among women affected by the U.S. Mexico City Policy â¦ [and] a corresponding decline in the use of modern contraception and increase in pregnancies,â likely because foreign NGOs that declined U.S.

Funding as a result of the Mexico City Policy â often key providers of womenâs health services in these areas â had fewer resources to support family planning services, particularly contraceptives. Increased access to and use of contraception have been shown to be key to preventing unintended pregnancies and thereby reducing abortion, including unsafe abortion. The study also found patterns that âsuggest that the effects of the policy are reversibleâ when the policy is not in place.Additionally, there has been anecdotal evidence and qualitative data on the impact of the policy, when it has been in force in the past, on the work of organizations that have chosen not to agree to the policy and, therefore, forgo U.S.

Funding that had previously supported their activities. For example, they have reported that they have fewer resources to support family planning and reproductive health services, including family planning counseling, contraceptive commodities, condoms, and reproductive cancer screenings.While it is likely too early to assess the full effects of the current policy on NGOs and the individuals they serve, as the policy is applied on a rolling basis as new funding agreements or modifications to existing agreements are made, some early data are available. Several early qualitative and quantitative studies have been released, and at least one long-term, quantitative assessment is underway.

Government departments and agencies have added a significant portion of the funding affected by the policy to grants and cooperative agreements only recently [i.e., after the period the review examined]. A follow-on analysis would allow an opportunity to address one of the primary concerns presented in feedback from third-party stakeholder organizations, namely that six months is insufficient time to gauge the impacts ofâ the policy.Nonetheless, it is already clear that the reinstated and expanded version of the policy applies to a much greater amount of U.S. Global health assistance, and greater number of foreign NGOs, across many program areas.

KFF has found that more than half (37) of the 64 countries that received U.S. Bilateral global health assistance in FY 2016 allow for legal abortion in at least one case not permitted by the policy and that had the expanded Mexico City Policy been in effect during the FY 2013 â FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy. In addition, at least 469 U.S.

NGOs that received U.S. Global health assistance during this period would have been required to ensure that their foreign NGO sub-recipients were in compliance. Additional foreign NGOs are likely to be impacted by the policy due to the revised interpretation of âfinancial supportâ announced in March 2019 and implemented beginning June 2019.

It found that from May 2017 through FY 2018:the policy had been applied to over 1,300 global health projects, with the vast majority of these through USAID and CDC, andNGOs declined to accept the policy in 54 instances, totaling $153 million in declined funding â specifically, seven prime awards amounting to $102 million and 47 sub-awards amounting to $51 million (more than two-thirds of sub-awards were intended for Africa) â across USAID and CDC. The Department of State and DoD did not identify any instances where NGOs declined to accept the policy conditions.What have the U.S. Governmentâs reviews of the policy found?.

The U.S. Government has published two reviews of the policy to date, with the first examining the initial six months of the policy released in February 2018 and the second examining the first 18 months of the policy released in August 2020.First ReviewIn February 2018, the Department of State announced the findings of an initial six-month review of implementation of the policy through the end of FY 2017 (September 2017). The report directed agencies to provide greater support for improving understanding of implementation among affected organizations and provided guidance to clarify terms included in standard provisions of grants and cooperative agreements.

In the six-month review report, the Department of State report identified a number of âactionsâ for implementing agencies, such as a need for:more central and field-based training and implementation tools,a clearer explanation of termination of awards for NGOs found to be in violation of the policy, anda clarification of âfinancial support,â which was not defined in the standard provisions (see âWhat is financial support?. Â below).The six month review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2017 (see Table 2). U.S.

Agency or DepartmentPolicy Implementation DateOverall # of Grants and Cooperative Agreements with Global Health Assistance FundingOf Overall #:(From the Policy Implementation Date through 9/30/2017)# That Received New Funding and Accepted Policy# That Received New Funding and Declined to Accept Policy^# That Had Not Received New Funding YetUSAIDMay 15, 20175804193158State*May 15, 2017142108034HHS+May 31, 20174991600339DoDMay 15, 20177742134TOTAL12987294565NOTES. * reflects PEPFAR funding implemented through the Department of State. Other departments and agencies implement the majority of PEPFAR funding.

+ At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2017, USAID reported it was aware of three centrally funded prime partners, and 12 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S.

NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries. And HHS reported that no HHS partners declined to agree.SOURCES. KFF analysis of data from Department of State, âProtecting Life in Global Health Assistance Six-Month Review,â report, Feb.

6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Second ReviewOn August 17, 2020, the Department of State released its second review of the policy, updating its initial six-month review (as an action item in the six-month review report, the department stated it would âconduct a further review of implementation of the policy by December 15, 2018, when more extensive experience will enable a more thorough examination of the benefits and challengesâ). The long-anticipated review, which examines the period from May 2017 through September 2018, found:the awards declined spanned a variety of program areas, including family planning and reproductive health (FP/RH), HIV and AIDS (HIV/AIDS), maternal and child health (MCH), tuberculosis (TB), and nutrition, in addition to cross-cutting awards;the awards declined spanned geographic areas but many were for activities in sub-Saharan Africa;agencies and departments made efforts to transition projects to another implementer in order to minimize disruption. Butnevertheless, among USAID awards involving health service delivery where prime and sub-award recipients declined to accept the policy, gaps or disruptions in service delivery were sometimes reported.The second review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2018 (see Table 3).

U.S. Agency or DepartmentPolicy Implementation Date# of Grants and Cooperative Agreements with Global Health Assistance Funding# of Prime Awardees That Declined to Accept Policy^USAIDMay 15, 20174866State*May 15, 20173350HHS+May 31, 20174661DoDMay 15, 2017531TOTAL13408NOTES. * reflects PEPFAR funding implemented through the Department of State.

Other departments and agencies implement the majority of PEPFAR funding. + At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2018, USAID reported it was aware of six centrally funded prime partners, and 47 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards.

DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries. And HHS reported that one HHS partner declined to agree.SOURCES.

KFF analysis of data from Department of State, âReview of the Implementation of the Protecting Life in Global Health Assistance Policy ,â report, Aug. 17, 2020, https://www.state.gov/wp-content/uploads/2020/08/PLGHA-2019-Review-Final-8.17.2020-508.pdf, and Department of State, âProtecting Life in Global Health Assistance Six-Month Review,â report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Additionally, the review reports that 47 sub-awardees, all under USAID awards, declined to accept the policy.

Global health funding) to other foreign NGOs specifically for the purpose of performing or actively promoting abortion as a method of family planning or if it applied more broadly to certain funding provided by foreign NGOs to other foreign NGOs for any purpose, if that foreign NGO happened to perform or actively promote abortion as a method of family planning. The State Department clarified that it was the more narrow interpretation.However, on March 26, 2019, Secretary of State Pompeo reversed this interpretation, announcing further ârefinementsâ to the policy to clarify that it applied to the broader definition of financial support. Specifically, under the policy, U.S.-supported foreign NGOs agree to not provide any financial support (global health-related as well as other support), no matter the source of funds, to any other foreign NGO that performs or actively promotes abortion as a method of family planning.

In June 2019, USAID provided additional information to reflect this broader interpretation of the standard provisions.This marks the first time the policy has been applied this broadly, as it can now affect funding provided by other donors (such as other governments and foundations) and non-global health funding provided by the U.S. Government for a wide range of purposes if this funding is first provided to foreign NGOs who have accepted the policy (as recipients of U.S. Global health assistance) that then in turn provide that donor or U.S.

Non global health funding for any purpose to foreign NGOs that perform or actively promote abortion as a method of family planning. For example, under the prior interpretation, a foreign NGO recipient of U.S. Global health funding could not provide any non-U.S.

Funding to another foreign NGO to perform or actively promote abortion as a method of family planning but could provide funding for other activities, such as education, even if the foreign NGO carried out prohibited activities. Under the broader interpretation, a foreign NGO could not provide any non-U.S. Funding for any activity to a foreign NGO that carried out prohibited activities.

Similarly, while under the prior interpretation a foreign NGO recipient of U.S. Global health funding could provide other U.S. Funding (such as humanitarian assistance) to another foreign NGO for non-prohibited activities, even if the foreign NGO carried out prohibited activities, now under the broader interpretation, it could not do so.What are the next steps in implementing the expanded policy?.

The policy went into effect in May 2017 (see Table 2), although it is applied on a rolling basis, as new funding agreements and modifications to existing agreements occur. While it applies to all grants and cooperative agreements, the Trump administration has indicated that it intends the policy to apply to contracts, which would require a rule-making process (it began this process by publishing a proposed rule in September 2020)..

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

On January 30, 2020, the World Health Organization (WHO) declared flagyl pills online the flagyl represents a public health emergency of international concern, and on January 31, 2020, the U.S. Department of Health and Human Services declared it to be a health emergency for the United States.Key PointsOn January 23, 2017, President Donald Trump reinstated and expanded the Mexico City Policy via presidential memorandum, renaming it âProtecting Life in Global Health Assistance.â This explainer provides an overview of the policy, including its history, changes over time, and current application.First announced in 1984 by the Reagan administration, the policy has been rescinded and reinstated by subsequent administrations along party lines and has now been in effect for 19 of the past 34 years.The policy requires foreign non-governmental organizations (NGOs) to certify that they will not âperform or actively promote abortion as a method of family planningâ using funds from any source (including non-U.S. Funds) as a flagyl pills online condition of receiving U.S. Government global family planning assistance and, as of Jan.

23, 2017, most flagyl pills online other U.S. Global health assistance.The Trump administrationâs application of the policy extends to the vast majority of U.S. Bilateral global health assistance, including funding for HIV under PEPFAR, maternal and child health, malaria, flagyl pills online nutrition, and other programs. This marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounts for approximately $600 million of that total).Additionally, as a result of a March 2019 policy announcement and subsequent information released in June 2019, the policy, for the first time, prohibits foreign NGOs who accept the policy from providing any financial support using any source of funds and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning.

This greatly flagyl pills online extends its reach to other areas of U.S. Development assistance beyond global health and to other non-U.S. Funding streams.More recently, in September 2020, a proposed rule to extend the policy to flagyl pills online contracts was published. If finalized, it would greatly extend the reach of the policy beyond grants and cooperative agreements to also include contracts.KFF analyses have found that:more than half of the countries in which the U.S.

Provides bilateral global health assistance allow for legal abortion in at least one case not permitted by the policy flagyl pills online (analysis). Andhad the expanded policy been in effect during the FY 2013 â FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy (analysis).What is the Mexico City Policy?. The Mexico City Policy is a flagyl pills online U.S. Government policy that â when in effect â has required foreign NGOs to certify that they will not âperform or actively promote abortion as a method of family planningâ using funds from any source (including non-U.S.

Funds) as a condition of flagyl pills online receiving U.S. Global family planning assistance and, as of Jan. 23, 2017, most other flagyl pills online U.S. Global health assistance.The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name.

See Box 1) flagyl pills online. Under the Trump administration, the policy has been renamed âProtecting Life in Global Health Assistanceâ (PLGHA). Among opponents, it is also known as the âGlobal Gag flagyl pills online Rule,â because among other activities, it prohibits foreign NGOs from using any funds (including non-U.S. Funds) to provide information about abortion as a method of family planning and to lobby a foreign government to legalize abortion.

Â[T]he United States does not consider abortion an acceptable element of family planning programs and will no longer contribute to those of flagyl pills online which it is a part. Â¦[T]he United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.âWhen first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S. Funding for flagyl pills online abortion internationally, with some exceptions (see below). Prior to the policy, foreign NGOs could use non-U.S.

Funds to engage in certain voluntary abortion-related activities as flagyl pills online long as they maintained segregated accounts for any U.S. Money received, but after the Mexico City Policy was in place, they were no longer permitted to do so if they wanted to receive U.S. Family planning assistance.The Trump administrationâs application of the policy to the vast flagyl pills online majority of U.S. Bilateral global health assistance, including funding for HIV under the U.S.

Presidentâs Emergency Plan for AIDS Relief (PEPFAR), maternal and child health, malaria, nutrition, and other programs, marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the flagyl pills online extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounted for approximately $600 million of that total). The Administrationâs more recent extension of the policy to include any financial support (health or otherwise) provided by foreign NGOs for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning is likely to encompass significant additional funding.When has it been in effect?. The Mexico City Policy has been in effect for 19 of the past 34 years, primarily through executive action, and has been instated, rescinded, and reinstated by presidential administrations along party lines (see Table 1).The policy was first instituted in 1984 (taking effect in 1985) by President Ronald Reagan and continued to be in effect through President George H.W. Bushâs administration flagyl pills online.

It was rescinded by President Bill Clinton in 1993 (although it was reinstated legislatively for one year during his second term. See below) flagyl pills online. The policy was reinstated by President George W. Bush in flagyl pills online 2001 and then rescinded by President Barack Obama in 2009.

It is currently in effect, having been reinstated by President Trump in 2017. YearsIn Effect? flagyl pills online. Presidential Administration (Party Affiliation)Executive (E) or Congressional (C) Action?. 1985-1989YesReagan (R)E1989-1993YesBush (R)E1993-1999 Sept.NoClinton (D)E1999 Oct.-2000 Sept.Yes*Clinton (D)C2000 Oct.-2001NoClinton flagyl pills online (D)E2001-2009YesBush (R)E2009-2017NoObama (D)E2017-presentYesTrump (R)ENOTES.

Shaded blue indicate periods when policy was in effect. * There was a temporary, one-year legislative imposition of the policy, which included a portion of the restrictions in effect in other years and an option for the president to waive flagyl pills online these restrictions in part. However, if the waiver option was exercised (for no more than $15 million in family planning assistance), then $12.5 million of this funding would be transferred to maternal and child health assistance. The president did exercise the waiver flagyl pills online option.SOURCES.

ÂPolicy Statement of the United States of America at the United Nations International Conference on Population (Second Session), Mexico City, Mexico, August 6-14, 1984,â undated. Bill Clinton flagyl pills online Administration, âSubject. AID Family Planning Grants/Mexico City Policy,â Memorandum for the Acting Administrator of the Agency for International Development, January 22, 1993, Clinton White House Archives, https://clintonwhitehouse6.archives.gov/1993/01/1993-01-22-aid-family-planning-grants-mexico-city-policy.html. FY 2000 Consolidated flagyl pills online Appropriations Act, P.L.

106-113. George W flagyl pills online. Bush Administration, âSubject. Restoration of the Mexico City Policy,â Memorandum for the Administrator of the United States flagyl pills online Agency for International Development, January 22, 2001, Bush Administration White House Archives, https://georgewbush-whitehouse.archives.gov/news/releases/20010123-5.html.

ÂSubject. Restoration of the Mexico City Policy,â Memorandum for the Administrator of the United flagyl pills online States Agency for International Development, March 28, 2001, Federal Register, https://www.federalregister.gov/documents/2001/03/29/01-8011/restoration-of-the-mexico-city-policy. George W. Bush Administration, flagyl pills online âSubject.

Assistance for Voluntary Population Planning,â Memorandum for the Secretary of State, August 29, 2003, Bush Administration White House Archives, http://georgewbush-whitehouse.archives.gov/news/releases/2003/08/20030829-3.html. Barack Obama Administration, âMexico City Policy and Assistance for Voluntary Population Planning,â Memorandum for the Secretary of State, the Administrator flagyl pills online of the United States Agency for International Development, January 23, 2009, Obama White House Archives, https://obamawhitehouse.archives.gov/the-press-office/mexico-city-policy-and-assistance-voluntary-population-planning. White House, âThe Mexico City Policy,â Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.How is it instituted (and rescinded)? flagyl pills online.

The Mexico City Policy has, for the most part, been instituted or rescinded through executive branch action (typically via presidential memoranda). While Congress has the ability to institute the policy through legislation, this has flagyl pills online happened only once in the past. A modified version of the policy was briefly applied by Congress during President Clintonâs last year in office as part of a broader arrangement to pay the U.S. Debt to the flagyl pills online United Nations.

(At that time, President Clinton was able to partially waive the policyâs restrictions.) Other attempts to institute the policy through legislation have not been enacted into law, nor have legislative attempts to overturn the policy. See Table 1.Who does the policy flagyl pills online apply to?. The policy, when in effect, applies to foreign NGOs as a condition for receiving U.S. Family planning support and, now, other global health assistance, either directly (as the main â or prime â recipient of U.S.

Funding) or indirectly (as a flagyl pills online recipient of U.S. Funding through an agreement with the prime recipient. Referred to flagyl pills online as a sub-recipient). Specifically, a foreign NGO ârecipient agrees that it will not, during the term of this award, perform or actively promote abortion as a method of family planning in foreign countries or provide financial support to any other foreign non-governmental organization that conducts such activities.âForeign NGOs include:international NGOs that are based outside the U.S.,regional NGOs that are based outside the U.S., andlocal NGOs in assisted countries.U.S.

NGOs, while not directly subject to the Mexico City Policy, must also agree to flagyl pills online ensure that they do not provide funding to any foreign NGO sub-recipients unless those sub-recipients have first certified adherence to the policy. Specifically, a U.S. NGO ârecipient (A) agrees that it will not furnish health assistance under this award to any foreign non-governmental organization that performs or actively promotes abortion flagyl pills online as a method of family planning in foreign countries. And (B) further agrees to require that such sub-recipients do not provide financial support to any other foreign non-governmental organization that conducts such activities.âAs in the past, the current policy does not apply to funding provided by the U.S.

Government to foreign governments (national or sub-national), public international organizations, and other multilateral entities, such as flagyl pills online the Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi, the treatment Alliance. However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See âWhat flagyl pills online is âfinancial supportâ?. Â below.To what assistance does it apply?.

In the past, foreign NGOs have been required to adhere to the Mexico City Policy â when flagyl pills online it was in effect â as a condition of receiving support through certain U.S. International funding streams. Family planning flagyl pills online assistance through the U.S. Agency for International Development (USAID) and, beginning in 2003, family planning assistance through the U.S.

Department of State flagyl pills online. In the 2003 memorandum announcing the policyâs expansion to include the Department of State, President Bush stated that the policy did not apply to funding for global HIV/AIDS programs and that multilateral organizations that are associations of governments are not included among âforeign NGOs.âThe current policy, reinstated in 2017, applies to the vast majority of U.S. Bilateral global flagyl pills online health assistance furnished by all agencies and departments. âAssistanceâ includes âthe provision of funds, commodities, equipment, or other in-kind global health assistance.â Specifically, the expanded policy applies to nearly all bilateral global health assistance, including.

family planning and reproductive healthfor the first time:maternal and child health (including household-level water, sanitation, and hygiene (WASH))nutritionHIV under PEPFARtuberculosismalaria under the Presidentâs Malaria Initiative (PMI)neglected tropical diseasesglobal health securitycertain types of research activitiesThe policy applies flagyl pills online to the assistance described above that is appropriated directly to three agencies and departments. USAID. The Department of State, including the Office of the Global AIDS Coordinator, flagyl pills online which oversees and coordinates U.S. Global HIV funding under PEPFAR.

And for the first flagyl pills online time, the Department of Defense (DoD). When such funding is transferred to another agency, including the Centers for Disease Control (CDC) and the National Institutes of Health (NIH), it remains subject to the policy, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly.The policy applies to three types of funding agreements for such assistance. Grants. Cooperative agreements.

And, for the first time, contracts, pending necessary rule-making that would be needed to do so (a proposed rule to accomplish this was published in September 2020).The policy does not apply to U.S. Assistance for. Water supply and sanitation activities, which is usually focused on infrastructure and systems. Humanitarian assistance, including activities related to migration and refugee assistance activities as well as disaster and humanitarian relief activities.

The American Schools and Hospitals Abroad (ASHA) program. And Food for Peace (FFP). However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See âWhat is âfinancial supportâ?.

Â below.What activities are prohibited?. The policy prohibits foreign NGOs that receive U.S. Family planning assistance and, now, most other U.S. Bilateral global health assistance from using funds from any source (including non-U.S.

Funds) to âperform or actively promote abortion as a method of family planning.â In addition to providing abortions with non-U.S. Funds, restricted activities also include the following:providing advice and information about and offering referral for abortion â where legal â as part of the full range of family planning options,promoting changes in a countryâs laws or policies related to abortion as a method of family planning (i.e., engaging in lobbying), andconducting public information campaigns about abortion as a method of family planning.The prohibition of these activities are why the policy has been referred to by its critics as the âGlobal Gag Rule.âAdditionally, for the first time, the policy prohibits foreign NGOs from providing any financial support with any source of funds (including non-U.S. Funding) and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. See âWhat is âfinancial support?.

Funding for abortion is already restricted under several provisions of the law. Specifically, before the Mexico City Policy was first announced in 1984, U.S. Law already prohibited the use of U.S. Aid:to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion (the Helms Amendment, 1973, to the Foreign Assistance Act);for biomedical research related to methods of or the performance of abortion as a means of family planning (the Biden Amendment, 1981, to the Foreign Assistance Act).

Andto lobby for or against abortion (the Siljander Amendment, first included in annual appropriations in 1981 and included each year thereafter).Then, shortly after the policy was announced in 1984, the Kemp-Kasten Amendment was passed in 1985, prohibiting the use of U.S. Aid to fund 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 (it is now included in annual appropriations).Before the Mexico City Policy, U.S. Aid recipients could use non-U.S. Funds to engage in certain abortion-related activities but were required to maintain segregated accounts for U.S.

Assistance. The Mexico City Policy reversed this practice. No longer were foreign NGOs allowed to use non-U.S. Funds, maintained in segregated accounts, for voluntary abortion-related activities if they wished to continue to receive or be able to receive U.S.

Family planning funds.Does the policy prohibit post-abortion care?. The Mexico City Policy does not restrict the provision of post-abortion care, which is a supported activity of U.S. Family planning assistance. Whether or not the Mexico City Policy is in effect, recipients of U.S.

Family planning assistance are allowed to use U.S. And non-U.S. Funding to support post-abortion care, no matter the circumstances of the abortion (whether it was legal or illegal).What has been the impact of the policy?. Several studies have looked at the impact of the policy.

A 2011 quantitative analysis by Bendavid, et. Al, found a strong association between the Mexico City Policy and abortion rates in sub-Saharan Africa. This study was recently updated to include several more years of data, again identifying a strong association. Specifically, the updated study found that during periods when the policy was in place, abortion rates rose by 40% in countries with high exposure to the Mexico City Policy compared to those with low exposure, while the use of modern contraceptives declined by 14% and pregnancies increased by 12% in high exposure compared to low exposure countries.

In other words, it found patterns that âstrengthen the case for the role played by the policyâ in âa substantial increase in abortions across sub-Saharan Africa among women affected by the U.S. Mexico City Policy â¦ [and] a corresponding decline in the use of modern contraception and increase in pregnancies,â likely because foreign NGOs that declined U.S. Funding as a result of the Mexico City Policy â often key providers of womenâs health services in these areas â had fewer resources to support family planning services, particularly contraceptives. Increased access to and use of contraception have been shown to be key to preventing unintended pregnancies and thereby reducing abortion, including unsafe abortion.

The study also found patterns that âsuggest that the effects of the policy are reversibleâ when the policy is not in place.Additionally, there has been anecdotal evidence and qualitative data on the impact of the policy, when it has been in force in the past, on the work of organizations that have chosen not to agree to the policy and, therefore, forgo U.S. Funding that had previously supported their activities. For example, they have reported that they have fewer resources to support family planning and reproductive health services, including family planning counseling, contraceptive commodities, condoms, and reproductive cancer screenings.While it is likely too early to assess the full effects of the current policy on NGOs and the individuals they serve, as the policy is applied on a rolling basis as new funding agreements or modifications to existing agreements are made, some early data are available. Several early qualitative and quantitative studies have been released, and at least one long-term, quantitative assessment is underway.

Additionally, an official assessment by the U.S. Department of State on implementation during the first six months of the policy has been released (see below). This review acknowledged that it took âplace early in the policyâs implementation, when affected U.S. Government departments and agencies have added a significant portion of the funding affected by the policy to grants and cooperative agreements only recently [i.e., after the period the review examined].

A follow-on analysis would allow an opportunity to address one of the primary concerns presented in feedback from third-party stakeholder organizations, namely that six months is insufficient time to gauge the impacts ofâ the policy.Nonetheless, it is already clear that the reinstated and expanded version of the policy applies to a much greater amount of U.S. Global health assistance, and greater number of foreign NGOs, across many program areas. KFF has found that more than half (37) of the 64 countries that received U.S. Bilateral global health assistance in FY 2016 allow for legal abortion in at least one case not permitted by the policy and that had the expanded Mexico City Policy been in effect during the FY 2013 â FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy.

In addition, at least 469 U.S. NGOs that received U.S. Global health assistance during this period would have been required to ensure that their foreign NGO sub-recipients were in compliance. Additional foreign NGOs are likely to be impacted by the policy due to the revised interpretation of âfinancial supportâ announced in March 2019 and implemented beginning June 2019.

See âWhat is âfinancial supportâ?. Â below.A report released in March 2020 by the U.S. Government Accountability Office (GAO) provided new information on the number of projects (awards) and NGOs affected. It found that from May 2017 through FY 2018:the policy had been applied to over 1,300 global health projects, with the vast majority of these through USAID and CDC, andNGOs declined to accept the policy in 54 instances, totaling $153 million in declined funding â specifically, seven prime awards amounting to $102 million and 47 sub-awards amounting to $51 million (more than two-thirds of sub-awards were intended for Africa) â across USAID and CDC.

The Department of State and DoD did not identify any instances where NGOs declined to accept the policy conditions.What have the U.S. Governmentâs reviews of the policy found?. The U.S. Government has published two reviews of the policy to date, with the first examining the initial six months of the policy released in February 2018 and the second examining the first 18 months of the policy released in August 2020.First ReviewIn February 2018, the Department of State announced the findings of an initial six-month review of implementation of the policy through the end of FY 2017 (September 2017).

The report directed agencies to provide greater support for improving understanding of implementation among affected organizations and provided guidance to clarify terms included in standard provisions of grants and cooperative agreements. In the six-month review report, the Department of State report identified a number of âactionsâ for implementing agencies, such as a need for:more central and field-based training and implementation tools,a clearer explanation of termination of awards for NGOs found to be in violation of the policy, anda clarification of âfinancial support,â which was not defined in the standard provisions (see âWhat is financial support?. Â below).The six month review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2017 (see Table 2). U.S.

^ As of September 30, 2017, USAID reported it was aware of three centrally funded prime partners, and 12 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries. And HHS reported that no HHS partners declined to agree.SOURCES.

KFF analysis of data from Department of State, âProtecting Life in Global Health Assistance Six-Month Review,â report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Second ReviewOn August 17, 2020, the Department of State released its second review of the policy, updating its initial six-month review (as an action item in the six-month review report, the department stated it would âconduct a further review of implementation of the policy by December 15, 2018, when more extensive experience will enable a more thorough examination of the benefits and challengesâ). The long-anticipated review, which examines the period from May 2017 through September 2018, found:the awards declined spanned a variety of program areas, including family planning and reproductive health (FP/RH), HIV and AIDS (HIV/AIDS), maternal and child health (MCH), tuberculosis (TB), and nutrition, in addition to cross-cutting awards;the awards declined spanned geographic areas but many were for activities in sub-Saharan Africa;agencies and departments made efforts to transition projects to another implementer in order to minimize disruption. Butnevertheless, among USAID awards involving health service delivery where prime and sub-award recipients declined to accept the policy, gaps or disruptions in service delivery were sometimes reported.The second review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2018 (see Table 3).

+ At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2018, USAID reported it was aware of six centrally funded prime partners, and 47 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries.

And HHS reported that one HHS partner declined to agree.SOURCES. KFF analysis of data from Department of State, âReview of the Implementation of the Protecting Life in Global Health Assistance Policy ,â report, Aug. 17, 2020, https://www.state.gov/wp-content/uploads/2020/08/PLGHA-2019-Review-Final-8.17.2020-508.pdf, and Department of State, âProtecting Life in Global Health Assistance Six-Month Review,â report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Additionally, the review reports that 47 sub-awardees, all under USAID awards, declined to accept the policy.

It is important to note that the review also states that information on sub-awards is not systematically collected by departments and agencies and that DoD was not able to collect information on sub-awards.What is âfinancial supportâ?. In February 2018, in the initial six-month review issued when Secretary of State Tillerson led the department, the Department of State report included an âactionâ statement to clarify the definition of âfinancial supportâ as used in the standard provisions for grants and cooperative agreements. At issue was whether it applied more narrowly to certain funding provided by foreign NGOs (i.e., funding other than U.S. Global health funding) to other foreign NGOs specifically for the purpose of performing or actively promoting abortion as a method of family planning or if it applied more broadly to certain funding provided by foreign NGOs to other foreign NGOs for any purpose, if that foreign NGO happened to perform or actively promote abortion as a method of family planning.

The State Department clarified that it was the more narrow interpretation.However, on March 26, 2019, Secretary of State Pompeo reversed this interpretation, announcing further ârefinementsâ to the policy to clarify that it applied to the broader definition of financial support. Specifically, under the policy, U.S.-supported foreign NGOs agree to not provide any financial support (global health-related as well as other support), no matter the source of funds, to any other foreign NGO that performs or actively promotes abortion as a method of family planning. In June 2019, USAID provided additional information to reflect this broader interpretation of the standard provisions.This marks the first time the policy has been applied this broadly, as it can now affect funding provided by other donors (such as other governments and foundations) and non-global health funding provided by the U.S. Government for a wide range of purposes if this funding is first provided to foreign NGOs who have accepted the policy (as recipients of U.S.

Global health assistance) that then in turn provide that donor or U.S. Non global health funding for any purpose to foreign NGOs that perform or actively promote abortion as a method of family planning. For example, under the prior interpretation, a foreign NGO recipient of U.S. Global health funding could not provide any non-U.S.

Global health funding could provide other U.S. Funding (such as humanitarian assistance) to another foreign NGO for non-prohibited activities, even if the foreign NGO carried out prohibited activities, now under the broader interpretation, it could not do so.What are the next steps in implementing the expanded policy?. The policy went into effect in May 2017 (see Table 2), although it is applied on a rolling basis, as new funding agreements and modifications to existing agreements occur. While it applies to all grants and cooperative agreements, the Trump administration has indicated that it intends the policy to apply to contracts, which would require a rule-making process (it began this process by publishing a proposed rule in September 2020)..