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Kaiser Daily Global Health Policy Report

In The News

U.S., E.U., U.N., World Bank Officials Call For Additional HCWs For Ebola Response In West Africa

News outlets report on calls from several officials for more nations to dispatch additional health workers to West Africa to respond to Ebola.

Associated Press: 5,000 Ebola health care workers needed in W. Africa
“More than 5,000 additional health care workers are needed to fight Ebola in the three most affected countries in West Africa, the president of the World Bank said Tuesday…” (Meseret, 10/28).

Associated Press: E.U. wants massive increase in staff to fight Ebola
“The European Union’s newly appointed Ebola coordinator on Monday said fresh E.U. funds should be used to finance a vast increase in health staff and hospital beds to treat patients in West Africa…” (Casert, 10/27).

IRIN: Ebola: Experienced doctors still rare
“The difficulty of finding doctors with field experience is hampering international medical intervention to help curb Ebola in West Africa. … During a visit to the three most affected countries that began in Guinea this weekend, the U.S. ambassador to the United Nations, Samantha Power, criticized those countries who promised to send doctors and other aid, but have not yet delivered…” (10/27).

Reuters: Don’t let quarantine hysteria deter Ebola health workers: U.N.
“Governments must not deter health workers from coming to West Africa to fight Ebola and quarantine decisions should not be based on hysteria, the head of the U.N. mission battling the virus said on Monday…” (Bigg, 10/27).

U.N. News Centre: Ebola: U.N. envoy concludes visits to affected countries, presents ‘robust’ recovery plan
“…Over the past week, UNMEER chief, Anthony Banbury, met with the Presidents of Guinea, Sierra Leone, and, on Friday, Liberia, in a series of consultations focusing on how an operational framework for international efforts could be ‘adapted and implemented to best support the ongoing national responses,’ the mission said in a press release…” (10/27).

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International Community Steps Up Efforts Against Ebola

Associated Press: International community ramps up Africa Ebola aid
“…Accra, the capital of Ghana, has become the main staging area and headquarters for the U.N. Mission for Ebola Emergency Response, or UNMEER. The establishment in September of what the U.N. describes as its first-ever emergency health mission comes as international efforts against Ebola, which has killed nearly 5,000 people in Liberia, Sierra Leone, and Guinea, are finally being stepped up…” (Muhumuza/DiLorenzo, 10/27).

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CDC Issues Guidance For Monitoring HCWs, Others Coming To U.S. From Ebola-Hit West African Nations

News outlets report on new CDC guidelines for monitoring health care workers and others coming to the U.S. from Ebola-hit West African countries.

Agence France-Presse: U.S. modifies Ebola guidelines after quarantine uproar
“U.S. health authorities have issued new guidelines for health workers returning from Ebola-hit nations after a firestorm of criticism over state quarantine restrictions, including from the U.N. chief…” (Sheridan/Fortin, 10/28).

Financial Times: U.S. issues guidelines over Ebola
“…The U.S. Centers for Disease Control and Prevention, which is leading the U.S. Ebola response, published the guidance on Monday after days of disagreements between the federal government and state governors…” (Jopson, 10/27).

The Hill: CDC wants tight restrictions on only high-risk Ebola workers
“…Only individuals known to have direct exposure to the disease, such as a family member who cared for an Ebola patient without protective gear, are told to remain home under the new recommendations. Health workers are only required to self-isolate if they had direct exposure — for example, if a needle-stick punctured their protective gear or if contaminated fluids accidentally splashed into their eyes or mouth…” (Viebeck/Ferris, 10/27).

New York Times: Seeking Unity, U.S. Revises Ebola Monitoring Rules
“The federal government on Monday tried to take charge of an increasingly acrimonious national debate over how to treat people in contact with Ebola patients by announcing guidelines that stopped short of tough measures in New York and New Jersey and were carefully devised, officials said, not to harm the effort to recruit badly needed medical workers to West Africa…” (Tavernise, 10/27).

PBS NewsHour: CDC offers new guidelines for U.S. health workers returning from West Africa — Part 1
“…Along with New York and New Jersey, the state of Illinois, which has no Ebola cases so far, announced its own quarantine plan for those who’ve come in contact with Ebola patients abroad. Four other states, Pennsylvania, Maryland, Virginia, and Georgia, stopped short of outright quarantines, but ramped up their monitoring efforts…” (Woodruff, 10/27).

PBS NewsHour: Understanding the U.S. guidelines on Ebola quarantine — Part 2
“…[Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said,] ‘The CDC is really indeed working very closely with state health authorities and other local health authorities to try and get a coordination to all of this. But it has always been the situation where the CDC sets the base below which you can’t go’…” (Woodruff, 10/27).

Reuters: CDC says returning Ebola medical workers should not be quarantined
“…The Obama administration’s new guidelines are not mandatory, and states will have the right to put in place policies that are more strict. Some state officials, grappling with an unfamiliar public health threat, had called federal restrictions placed on people traveling from Ebola-affected countries insufficient to protect Americans and have imposed tougher measures…” (Wolfhurst/Morgan, 10/27).

Wall Street Journal: CDC Rejects Mandatory Ebola Quarantines
“…The CDC announcement came as the Obama administration sharpened its criticism of states that decided to forcibly quarantine medical workers returning from West Africa. Senior administration officials say mandatory quarantines could dissuade volunteers from going overseas to offer much-needed assistance in Ebola-stricken countries…” (McKay et al., 10/27).

Washington Post: No unity over Ebola monitoring of travelers
“The Ebola quarantine controversy has become a chaotic brawl involving politics, science and the law. The rules on quarantining health care workers returning from West Africa are changing almost daily and varying according to geography and political climate. The Pentagon announced Monday that Army personnel returning to their home base in Italy from Liberia will be held in quarantine for 21 days — even though none have symptoms of Ebola or were exposed to patients infected with the virus…” (Achenbach, 10/27).

The Hill: Three more states set Ebola restrictions (Ferris, 10/27).
New York Times: Two Governors’ Shifts on Ebola Are Criticized as Politics, Not Science (Zernicke/Kaplan, 10/27).
Wall Street Journal: Cuomo Shifts From Christie Over Ebola Quarantines (Orden et al., 10/27).
Washington Post: The Insiders: Governors take a stand against Ebola and the president (Rogers, 10/27).

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U.S. Soldiers Isolated For Ebola Monitoring After West Africa Mission

News outlets report on the Pentagon’s decision to place American soldiers who served in West Africa under isolation at a U.S. military base in Italy to monitor them for Ebola.

Foreign Policy: Will the Pentagon Split With the White House on Ebola Response?
“As the federal government maintains that quarantines for medical workers possibly exposed to Ebola in West Africa are unnecessary, the Army is monitoring troops working in the region as part of the Pentagon’s response to the crisis ‘in a separate location’ at their home base in Italy…” (Francis, 10/27).

Reuters: U.S. isolates soldiers after Ebola response mission in West Africa
“The U.S. Army has started isolating soldiers returning from an Ebola response mission in West Africa, even though they showed no symptoms of infection and were not believed to have been exposed to the deadly virus, officials said on Monday…” (Stewart et al., 10/27).

USA Today: U.S. soldiers isolated for Ebola screening after Liberia mission
“The commander of U.S. Army Africa is among a dozen soldiers who have been placed in isolation over Ebola concerns at a U.S. military base in Italy after wrapping up a mission to Liberia, the Pentagon said Monday…” (Zoroya/Bacon, 10/27).

Wall Street Journal: U.S. Soldiers Being Monitored for Ebola In Italy
“The first American soldiers to leave Liberia since the onset of the Ebola crisis, including the commanding general of the U.S. Army Africa, are in a controlled monitoring facility in Italy, and all Army soldiers who serve in West Africa will undergo similar monitoring, the Army said on Monday…” (Schwartz, 10/27).

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News Outlets Examine Roles Of U.S. Congress, Ebola Coordinator In Epidemic Response

News outlets examine the roles of Congress and the U.S. Ebola coordinator in responding to the Ebola epidemic.

CQ News: Congress Has Thin Legislative Record on Combating Disease Outbreaks
“Although Congress has publicly fretted over the threat of infectious disease pandemics, there have been few legislative attempts in the last two decades to address such health emergencies, leaving lawmakers with a limited set of policy options as they try to contain the Ebola outbreak…” (Zanona, 10/27).

The Hill: Ebola czar faces first big test
“Confusion over how to handle health care workers returning to the United States from Ebola hot zones is becoming the first serious test for Ron Klain, the man President Obama asked to coordinate the federal response to the virus…” (Sink, 10/27).

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WHO Coordinating Monitoring Of 82 People Possibly Exposed To Ebola In Mali

Reuters: WHO says 82 being monitored for Ebola in Mali
“Health workers are monitoring 82 people who had contact with a toddler who died of Ebola in Mali last week, but no new cases of the disease have yet been reported, World Health Organization spokesman Tarik Jasarevic said on Tuesday…” (Nebehay/Miles, 10/28).

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Australia Bans Visas For People From Ebola-Affected West African Countries

News outlets report on Australia’s decision to issue a blanket ban on visas for people from Ebola-affected West African nations.

Reuters: Australia issues blanket visa ban on Ebola-hit countries
“Australia came under fire on Tuesday from health experts and rights advocates after it issued a blanket ban on visas from West African nations affected by the Ebola outbreak, making it the first rich nation to shut its doors to the region…” (Siegel/Feast, 10/28).

Sydney Morning Herald: Australia shuts borders to Ebola-affected countries
“Australia has temporarily closed its borders to people from Ebola-affected West African nations as it steps up the nation’s defenses against the virus. Immigration Minister Scott Morrison told parliament on Monday Australia had suspended its immigration program, including its humanitarian intake, from Ebola-affected countries including Liberia, Sierra Leone, and Guinea…” (Harrison, 10/28).

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Asia Prepares For Ebola After Disease Spread To U.S., Spain

New York Times: As Ebola Spreads, Asia Senses Vulnerability
“With hundreds of advanced infection-control hospital rooms left over from the fight against SARS, and with some medical professionals suggesting that the Ebola virus was inherently fragile and unlikely to spread in places with modern medical facilities, many doctors in Asia paid little attention to the disease until very recently. But that confidence — some say complacency — was punctured two weeks ago when two nurses in Dallas and another in Madrid fell ill while treating patients who had contracted the Ebola virus in West Africa. Governments and doctors around Asia are now much more worried that the region’s densely populated cities and towns could be vulnerable if infected people start flying [to Asia] from Africa…” (Bradsher, 10/26).

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Researchers Use Mobile Phone System To Check Food Security Among West Africans Affected By Ebola

The Atlantic: A New Tool in Humanitarian Relief: Texting
“Pandemics, like war, have a higher cost than their death toll. On top of the 5,000 lives that Ebola has claimed, there are other sorts of victims in the six West African countries the virus has reached. The emergency erodes trust and infrastructures, threatening local economics and livelihoods. One infrastructure that’s relatively hard to take down with disease, though, is the cellular phone system. Now, researchers are using it to check on the well-being of people living among the Ebola pandemic…” (Meyer, 10/27).

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Health Workers, Contact Tracers Face Challenges Containing Ebola In Liberia

Newspapers publish articles on the impact of Ebola on Liberia, including the challenges facing health care workers and contact tracers.

New York Times: Wish to Do More in Ebola Fight Meets Reality in Liberia
“…Because of the limited time they can spend in the sick wards in their stifling protective suits, the risks of certain procedures and even the amount of medicines available, health workers here and elsewhere in West Africa ration care, operating under constraints they often find frustrating. The mainstays of fighting the Ebola epidemic — isolation and basic treatment — have resulted in more dead than survivors among those infected…” (Fink, 10/27).

Washington Post: In a Liberian slum swarming with Ebola, a race against time to save two little girls
“…There may be only one way to halt the worst Ebola outbreak in history: find the disease’s victims, strictly quarantine them and monitor everyone with whom they interacted. … But doing contact tracing and enforcing quarantines in a place like New Kru Town is a different story. Everything here is shared: mattresses, toilets, food, the burden of caring for the ill…” (Sieff, 10/27).

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PBS NewsHour Examines Impact Of Ebola On Children In West Africa

PBS NewsHour aired a two-part report on the impact of the Ebola epidemic on children in West Africa.

PBS NewsHour: Number of children orphaned by Ebola grows — Part 1
“As the number of deaths from the Ebola virus continue to climb in West Africa, so too does the number of children left behind without parents…” (Woodruff/Rivers, 10/27).

PBS NewsHour: Children orphaned by Ebola face long-term consequences — Part 2
“Jeffrey Brown has more on the growing number of orphans in West Africa and how aid agencies are dealing with that crisis…” (Woodruff/Brown, 10/27).

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Global Leaders Pledge $8B To Spur Development In Horn Of Africa

News outlets report on new commitments to help spur development in the Horn of Africa.

U.N. News Centre: U.N.’s Ban, global leaders join forces in multi-billion dollar Horn of Africa pledge
“Spearheading a high-level delegation of global and regional leaders in a visit to the Horn of Africa, United Nations Secretary-General Ban Ki-moon [Monday] announced a new $8 billion development initiative aimed at boosting economic growth, reducing poverty, and spurring business activity across the African region’s eight countries…” (10/27).

Wall Street Journal: Aid Pledged For Horn of Africa by International Development Lenders
“…The construction and improvement of oil pipelines, transport links, and health and education facilities are among the projects to be funded by the African Development Bank, the Islamic Development Bank, and the European Union, as well as the World Bank, the lenders said…” (Bariyo, 10/27).

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Report Says Pakistan Is Largest Obstacle To Global Polio Eradication

Wall Street Journal: Pakistan’s Polio Eradication Efforts Slammed
“A global body issued a scathing report Monday on Pakistan’s efforts to eradicate polio, saying the country was the biggest obstacle to the goal of stopping world-wide transmission of the disease by the end of 2014…” (Nauman, 10/27).

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Global Population Growth Will Outpace Wars, Pandemics, Report Says

The Guardian: Global overpopulation would ‘withstand war, disasters, and disease’
“The pace of population growth is so quick that even draconian restrictions of childbirth, pandemics, or a third world war would still leave the world with too many people for the planet to sustain, according to a study. Rather than reducing the number of people, cutting the consumption of natural resources and enhanced recycling would have a better chance of achieving effective sustainability gains in the next 85 years, said the report published in the proceedings of the National Academy of Sciences…” (Tran, 10/28).

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Latrine Building In India May Do Little To Improve Children's Health, Study Shows

New York Times: Latrines May Not Improve Health of Poor Children
“Because of the well-known dangers of open defecation — especially for children’s health — bringing millions of latrines to the poor has long been a goal of public health experts. But now a major study in India has stunned advocates of latrine building by showing that it may do little good…” (McNeil, 10/27).

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Niger Sees Spike In Number Of Cholera Deaths

Agence France-Presse/Al Jazeera: Cholera outbreak kills dozens in Niger
“Niger has seen more than 1,300 cases of cholera since the beginning of the year, with 51 people dying of the disease, the United Nations has said. … The spike in the number of cholera deaths was due in part of heavy flooding which has inundated Niger since June…” (10/27).

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Christian Science Monitor Examines FAO Report On Hunger

Christian Science Monitor: Report: Fewer people in the world are malnourished
“Fewer people in the world are going hungry, as the number of chronically undernourished dropped from 18.7 percent of the total population to 11.3 percent between 1990 and 2014. A report released in September by the Food and Agriculture Organization (FAO) of the United Nations estimates that 209 million people who faced hunger by that definition nearly 25 years ago no longer do today, owing to increased commitment by political bodies, agricultural leaders, and nonstate actors…” (Landen, 10/27).

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Brazil Experiencing Severe Drought, Water Shortages

Washington Post: In Brazil, 20 million people may not have enough water
“Southeastern Brazil is experiencing one of its worst droughts in decades. The country’s water supply has almost run dry. Satellite images released by NASA’s Earth Observatory show Brazil’s reservoirs reduced to as little as three percent of their capacity, prompting water restrictions throughout the region…” (Kirkpatrick, 10/27).

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Editorials and Opinions

Editorials, Opinion Pieces Discuss Various Aspects Of Ebola Epidemic

The following editorials and opinion pieces discuss various aspects of the Ebola epidemic.

New England Journal of Medicine: Ebola and Quarantine
Editorial Board

“The governors of a number of states, including New York and New Jersey, recently imposed 21-day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease. We understand their motivation for this policy — to protect the citizens of their states from contracting this often-fatal illness. … In the end, the calculus is simple, and we think the governors have it wrong. … As we continue to learn more about this virus, its transmission, and associated illness, we must continue to revisit our approach to its control and treatment. We should be guided by the science and not the tremendous fear that this virus evokes…” (10/27).

New York Times: The Dangers of Quarantines
Editorial Board

“…There is absolutely no public health justification for mandatory quarantines. … The problem with a mandatory quarantine, even if done at home, is that it can discourage heath care workers from volunteering to fight the virus at its source in West Africa. … Policies that will reduce the chances of recruiting additional volunteers — without actually protecting the public — will only make the Ebola crisis worse” (10/27).

Washington Post: Ebola fears should not lead to overreaction
Editorial Board

“…The right answer is to protect the public without overreacting. Mistakes made in the Dallas hospital ought to be a warning and a lesson, and it seems to us that they are being taken as such. … The most serious shortcoming in the global response to Ebola has been a lack of health care workers where they’re most needed. Those … who volunteer for this duty deserve our utmost respect and thanks, and proper care upon return. They must not be stigmatized or mistreated even in understandable moments of dread, and irrational steps that could discourage others from volunteering must be avoided” (10/27).

New York Times: Letters To The Editor: Are Ebola Quarantines Necessary?
Joan Bregstein and colleagues from Columbia University, and others

Washington Post: Ebola, smallpox and anthrax show how public health doctors err, and then respond
David Brown, former Washington Post science writer

Toronto Star: Ebola outbreak exposes flawed Canadian aid policy
Jonathan Millard, African studies scholar

Washington Post: Ebola and Obama’s crisis of competence
Marc Thiessen, Washington Post columnist

The Hill: Why West Africa’s Ebola fight matters in the West
Peter Westmacott, U.K. ambassador to the United States

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Devex Series Examines Ways To Advance Global Health In New Campaign

Devex: What does healthy mean to you? Devex, partners examine future of global health in new campaign
Rolf Rosenkranz, editor at Devex

“…What does a comprehensive health system entail? The answer will vary depending on who you ask. But more likely than not, it’ll be built on strong supply chains and partnerships, capacity building and good governance. It will encourage innovation and the prevention of disease. And it is inclusive — by guaranteeing universal access to at least basic care. At the end of it all, it puts the individual — us — at the center so we can live better and longer lives. Over the coming weeks, Devex will explore ways to advance global health in a campaign we call Healthy Means…” (10/27).

The following opinion pieces are part of the series:

Devex: Innovations for malaria control: Advancing progress for a healthier, more prosperous world
Fatoumata Nafo-Traoré, executive director of the Roll Back Malaria Partnership

Devex: Where does mHealth fit into the post-2015 agenda?
Kaakpema Yelpaala, social entrepreneur

Devex: Beyond Band-Aids: Social well-being as a strategy for health, social development gains
Mark Edberg, director of the global Center for Social Well-Being and Development

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Private Finance, Policy Shifts Needed For Sustainable Development

The Guardian: $2.5tn shortfall for sustainable development in developing countries
Paul Hohnen, independent consultant, associate fellow of Chatham House, and participant of the 2014 World Investment Forum

“At the level of international agenda-setting for the rest of the century, 2015 is shaping up to be a big year. Possibly the defining one. That is why this month’s U.N. Conference on Trade and Development (UNCTAD) World Investment Forum was so important, because it addressed the fundamental questions ‘what would it cost to become sustainable?,’ ‘do we have the money?,’ and ‘how can we mobilize it?’… If private finance is to be successfully leveraged for sustainable development, government economic and trade policies need to be more clearly oriented towards sustainability, more internally (and internationally) consistent and integrated, and more transparent. Judging from the conversations at the WIF, the bad news is that we’re still heading, rapidly, in the wrong direction. The good news is that there are more finance and investment experts than ever willing to help in crafting a turn-around” (10/27).

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Tanzania Measles, Rubella Vaccination Campaign Aims To Reach 21M Children

The Guardian: Tanzania aims to reach 21m children in rubella vaccination campaign
James Thornberry, director of Sense International

“…[I]f the Ebola outbreak has taught the world anything it is perhaps that ignoring basic health care — in terms of programs and facilities — can have devastating consequences. That is why a campaign to vaccinate 21 million children against measles and rubella in Tanzania is so important. … The vaccination campaign in Tanzania will have a huge impact on the incidence of rubella in the region. By providing funding, the country’s government has shown a real commitment to eradicating the disease, especially with the decision to add the vaccine to the national immunization program later this year. … Until the rubella vaccine is integrated into all national immunization campaigns so that we can reach every child, the dangers of rubella will remain high for pregnant women and their unborn children” (10/27).

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From the Global Health Policy Community

Blog Examines Ebola Donor Contributions, Calls for Better Data, Accountability

Center for Global Development’s “Global Health Policy Blog”: How Much Is Actually Being Spent on Ebola?
Amanda Glassman, senior fellow and director of global health policy at CGD, examines donor funding for Ebola and the discrepancies in reported funding among information sources. She writes, “The importance of reliable information about donor contributions in the aftermath of a crisis cannot be overstated. In an ongoing crisis, reliable and accurate information helps donors decide how to allocate funding in order to avoid overlap. However, it is difficult to assure accountability when it is impossible to match the total amounts in the press announcements with the actual money that has been allocated and spent in these countries…” (10/27).

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Circumcision For HIV Prevention Popular Among Young Men In Northern Tanzania

IntraHealth’s “Vital”: Men and Boys Come Out in Droves for HIV Services in Tanzania
James McMahan, senior program manager with IntraHealth International’s Tanzania HIV Prevention Project, discusses a circumcision program in the north of the country and how undergoing the procedure has become popular with young men (10/27).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, has published Issue 253 of the “Global Fund Observer.” The newsletter includes several articles, including pieces addressing incentive funding and investigations by the Global Fund’s Office of the Inspector General (10/27).

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