Kaiser Daily Global Health Policy Report

In The News

Trump Administration Drops Plan To Rescind Unobligated U.S. Foreign Assistance Funding

Devex: White House abandons plan to rescind billions in U.S. foreign aid
“Facing broad pushback, both from within the administration and from lawmakers on Capitol Hill, the White House abandoned its plan to rescind unobligated foreign assistance funding on Tuesday, according to sources with knowledge of the decision…” (Igoe, 8/29).

Washington Post: Administration decides not to roll back foreign aid funds
“…The Office of Management and Budget, which had considered taking back more than $3 billion in unspent foreign aid as the fiscal year nears an end, notified members of Congress on Tuesday that the rollback will not occur, according to congressional aides. Only foreign aid from the budgets for the State Department and the U.S. Agency for International Development were targeted. The decision quashed for now a freeze on funds that the State Department and USAID had not already obligated…” (Morello/Werner, 8/28).

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Trump Administration Ends U.S. Funding To U.N. Agency Assisting Palestinian Refugees

Washington Post: U.S. ends aid to United Nations agency supporting Palestinian refugees
“The United States will no longer contribute to the United Nations relief agency for Palestinian refugees, the State Department announced Friday, amid widespread Palestinian outrage charging that the decision violates international law and will aggravate an already dire humanitarian situation, particularly in Gaza. The statement called the U.N. Relief and Works Agency, or UNRWA, an ‘irredeemably flawed operation’ and criticized other countries for not sharing the burden of supporting the Palestinians…” (DeYoung et al., 8/31).

Additional coverage of the U.S. decision to end funding to UNRWA is available from Foreign Policy, The Guardian, and New York Times.

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Response Efforts To Latest Ebola Outbreak In Congo Showing Success But Risks Remain

IRIN: Q&A: Congo Ebola outbreak at critical juncture, says top WHO official
“It’s too soon to say the outbreak of Ebola … in a conflict-prone eastern region of the Democratic Republic of Congo is fully under control, but great progress has been made in learning how to contain and respond to such emergencies, according to the World Health Organization’s response chief…” (Morland, 8/31).

New York Times: Ebola Attacked Congo Again. But Now Congo Seems to Be Winning
“The month-old Ebola outbreak in the Democratic Republic of Congo, which emerged unexpectedly in a dangerous region and quickly soared to over 100 cases, now appears to be fading. … However, it is far too early to relax, health experts warned…” (McNeil, 9/2).

Washington Times: CDC committed to fighting Ebola across globe, says director
“The Democratic Republic of the Congo is half a world away, but stopping the Ebola outbreak … in the African nation is still an integral part of President Trump’s goal of ‘putting America first,’ the nation’s top disease fighter said [in August]. Dr. Robert R. Redfield, director of the Centers for Disease Control and Prevention, … said U.S. efforts there are critical to stopping spread of the disease that terrorized the globe just a few years ago, during a previous outbreak in West Africa…” (Howell, 8/22).

Additional coverage of the DRC Ebola outbreak response is available from the Associated Press, Nature, and Reuters, as well as the WHO.

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Devex Examines U.K. Prime Minister May's Plan To Increase Investments In Africa

Devex: Theresa May in Africa: The key development issues
“During a week-long trip to several African countries last week, United Kingdom Prime Minister Theresa May pledged to deliver ‘a radical expansion of the U.K.’s presence in Africa,’ the heart of which is a £4 billion ($5.13 billion) investment strategy, largely channeled through the U.K. government’s development finance institution, CDC. But aid experts have questioned whether May will be able to get her government to deliver on the ambitious plan, and also expressed concerns that using the aid budget to boost trade and investment on the continent could compromise pro-poor development…” (Edwards, 9/4).

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Experts Discuss Trajectory Of HIV/AIDS Epidemic, Warn Of Complacency At Washington Event

VOA News: Experts Warn of a Return of the AIDS Epidemic
“…Experts predict that by 2030, 100 million people will have been infected with the HIV virus. Despite the alarming numbers, there have been great strides in treatment. HIV is no longer a death sentence, and researchers say people receiving treatment for HIV are able to live normal lives and do not pose a risk to others when they are being treated proactively. But success carries a price: complacency…” (Pearson, 8/24).

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Political Commitment Vital To Achieve Health For All, WHO DG Writes In Annual Letter

Health Policy Watch: WHO’s Dr. Tedros: “It’s Not Often You Get A Second Chance, But This Year, We Do”
“In his first annual letter since taking office in July last year, the director general of the World Health Organization has outlined the importance of political commitment, a key to success to — finally — achieve health for all. … He also outlined WHO’s work in emergency situations and its efforts to drive increased political commitment for health at the highest levels, and its advocacy for universal health coverage…” (Ueberschlag, 8/22).

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Life Expectancy Increases In Africa, But National Health Systems Must Improve To Maintain Gains, WHO Report Says

U.N. News: Impressive African health gains at risk from changing trends: WHO report
“Life expectancy across Africa has improved significantly, says a new United Nations World Health Organization (WHO) report released on Thursday, but national health systems must be improved to ensure that services get to the people who need them most…” (8/30).

VOA News: WHO: Africans Living Longer, Healthier Lives
“…News of the uptick came in Dakar [last] week where WHO representatives met with officials from 47 African countries. Healthy life expectancy on the continent rose from 44.4 years at the turn of the century to 53.8 years in 2015. Overall life expectancy climbed from 50.8 years to 61.2…” (Christensen, 8/30).

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U.S. Continues Support For Taiwan To Participate In World Health Assembly, Taiwan Health Minister Says

CNA/Focus Taiwan: U.S. still supports Taiwan’s WHA participation: health minister
“U.S. Health and Human Services Secretary Alex Azar has pledged to support Taiwan’s efforts to participate in the World Health Assembly (WHA), Taiwan’s health minister said Saturday. Speaking at a press conference, Minister of Health and Welfare Chen Shih-chung said he met with Azar in Washington, D.C., [last] week to exchange opinions on diseases and disaster prevention, as well as other issues related to public health…” (9/1)

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U.N. Warns Of New Wave Of Cholera In War-Torn Yemen

Xinhua/New China: Feature: Fear of new cholera wave rising in war-torn Yemen
“Fear of a possible third deadly wave of cholera is rising in Yemen, as a public hospital in Sanaa is receiving over 60 suspected cases of the epidemic each day, mostly children. The United Nations humanitarian agencies have recorded more than 1.1 million suspected cases and more than 2,300 associated deaths since April last year, labeling the country with ‘the largest outbreak on record’…” (al-Azaki, 9/3).

Additional coverage of the humanitarian and health crises in Yemen is available from the Associated Press, IRIN, and PBS NewsHour.

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More News In Global Health

Associated Press: U.N. rights chief: Vowed U.S. cuts wouldn’t be ‘fatal’ to office (Keaten, 8/29).

Agence France-Presse/SABC News: U.N. summit on TB seeks to put spotlight on killer disease (8/24).

Borgen Magazine: The Future of U.S. Foreign Aid: Moving Forward (Hallum, 9/2).

Deutsche Welle: President Trump’s Global Gag Rule endangers lives in Africa (Wanyonyi, 8/15).

Devex: In India, can universal health care become a reality? (Bader, 9/4).

Devex: Can PPPs help ensure vaccine supplies for future global epidemics? (Pallares, 9/3).

Devex: WASH advocates call for political support ahead of major meeting (Edwards, 8/24).

Devex: Inside Namibia’s HIV success story (Edwards, 8/14).

Healio: Only 1.6% of global funding focused on adolescent health (Bortz, 8/17).

Intellectual Property Watch: U.N. Tuberculosis Negotiations: What Is At Stake? (Branigan, 8/30).

Kaiser Health News: Religious Conservatives’ Ties To Trump Officials Pay Off In AIDS Policies, Funding (Taylor, 8/22).

New York Times: U.S. Ambassador Denies Threatening Ecuador Over Breast-Feeding Resolution (Jacobs/Belluck, 8/12).

Reuters Health: Fake, low quality drugs come at high cost (Rapaport, 8/31).

U.N. News: Rohingya emergency one year on: U.N. says thousands of lives saved, but challenges remain (8/24).

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Editorials and Opinions

U.S. Must Continue To Invest In Disease Outbreak, Pandemic Preparedness

STAT: Securing the U.S. from its most dangerous invader: infectious disease
Ashley Arabasadi, health security policy adviser at Management Sciences for Health

“…[W]hat investments must we make to keep America — and the world — safe from infectious disease epidemics? First, it’s imperative to continue funding the overseas operations of the Centers for Disease Control and Prevention. … Likewise, the U.S. should continue supporting global health efforts, including those that focus on animal health and zoonotic disease threats funded under the United States Agency for International Development (USAID) and the CDC. … It is critical for the U.S. to have sufficient and flexible funding, such as the CDC’s Emergency Response Fund, to deal with emerging threats without requiring congressional approval. … The U.S. should also establish a well-funded, centralized coordinating body for global health security. … Only stalwart leadership in the U.S. and in vulnerable countries can keep us safe” (8/31).

The Hill: Pandemics have an edge in our most vulnerable countries — here’s how to fight back
Ashley Arabasadi, health security policy adviser at Management Sciences for Health

“…As we face repeated outbreaks of infectious diseases, including new pathogens, it is essential that U.S. policymakers continue funding the operations that make containment possible. … These investments help us conduct disease surveillance in the low-income countries where the next deadly virus is likely to originate. … Likewise, the U.S. should continue to support global health efforts, including those that focus on animal health and zoonotic disease threats. … Global health security is only as strong as its weakest link. We learned so much from the 2014 Ebola epidemic, and it is vital that the U.S. continues to invest in preventing a repeat of such an event — or worse” (8/14).

The Conversation: Three reasons the U.S. is not ready for the next pandemic
Christine Crudo Blackburn, postdoctoral research fellow at the Scowcroft Institute of International Affairs at the Bush School of Government and Public Service at Texas A&M University; Andrew Natsios, director of the Scowcroft Institute of International Affairs and executive professor at Texas A&M University; and Gerald W. Parker, associate dean for Global One Health at the College of Veterinary Medicine & Biomedical Sciences, and director of the Pandemic and Biosecurity Policy Program at the Scowcroft Institute for International Affairs

“…[T]he U.S. must address the threat of pandemics in cooperation with all other nations and with multilateral institutions … We believe that investment in global health security … and remaining engaged with the international community to prevent an outbreak from becoming a pandemic is the best way to protect the American people. Additionally, we believe that the U.S. should commit to pandemic preparedness by creating a position of authority within the White House that transcends administrations and elevates pandemics as existential threats to a national security priority. There is a need to have decision-making authority and oversight vested at the highest levels of government. … The need for high-level leadership, coordination, and a new strategy are essential to mitigate the threat of pandemics, but these fundamental pandemic preparedness gaps persist. … Right now, … the country lacks the sufficient safeguards we have outlined. … Outbreaks are inevitable, but pandemics are not if we take action now” (8/20).

The Hill: Sustained U.S. preparedness needed for Ebola and other pan-epidemic threats
Daniel Lucey, infectious diseases physician and adjunct professor of infectious diseases at Georgetown University Medical Center, senior scholar at the Georgetown University O’Neill Institute, and member and spokesperson for the Infectious Diseases Society of America

“…We need to remember the role [the U.S.-initiated, international partnership of the Global Health Security Agenda] has played in strengthening current [disease outbreak] responses when its funding comes up for renewal in the coming year. Similarly, the Pandemic and All Hazards Preparedness Act helped build community capacities at home to address public health threats while supporting needed biomedical innovation. Up for reauthorization this year, its purpose remains critical, and Congress should act swiftly to ensure that it contains provisions that ensure a prepared public health workforce and drives the development of medical countermeasures that include vaccines, diagnostics, and therapeutics. American leadership in West Africa and in the USA was essential in stopping the 2013-2016 Ebola pan-epidemic … Sustaining U.S. leadership in the perpetual war against outbreaks, pan-epidemics, and truly global pandemics is essential for our own protection as well as a more secure and stable world outside our borders” (8/10).

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U.S. Government Should Fully Fund, Prioritize Global WASH Efforts

USA TODAY: Make water a top global priority. It’s the best, cheapest way to save lives: Frist
Bill Frist, former U.S. Senate majority leader, and founder and chair of Hope Through Healing Hands

“…[T]he health intervention that has saved more lives than any other in recorded history remains alarmingly absent in global health care. … We call it WASH — water, sanitation, and hygiene. … The U.S. Agency for International Development needs to continue to elevate the central importance of WASH in its overall work and adopt an agency-wide policy that WASH be made available in every health care facility in which the agency is active. America alone cannot solve this problem — and we won’t solve it sitting inside our silos. We must lead a collaborative global effort to secure shared financing from governments, nongovernmental organizations, researchers, and private donors, and it needs to cut across the health, development, water, and finance sectors. Federal budgets are tight, which is precisely why, at this time of budget concerns and global health threats, Congress should fully fund WASH, and our government should specifically prioritize it in foreign assistance. It’s highly effective, cost-efficient, and quite literally a life saver” (8/15).

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Opinion Pieces Discuss Ebola Vaccination Strategies, Research

STAT: An ‘indefensible’ decision: not vaccinating pregnant and lactating women in an Ebola outbreak
Ruth R. Faden, founder and inaugural director of the Johns Hopkins Berman Institute of Bioethics; Ruth A. Karron, director of the Center for Immunization Research and director of the Johns Hopkins Vaccine Initiative; and Carleigh Krubiner, policy fellow at the Center for Global Development

“…[A]n experimental vaccine called rVSV-ZEBOV has been shown to be highly effective against [the Zaire] strain of Ebola virus. The DRC’s ministry of health, along with WHO and partners, has already begun employing the vaccine using the highly successful ring vaccination strategy, in which contacts and contacts-of-contacts of people with Ebola are offered the vaccine to halt the spread of the disease. Some contacts, though, won’t get the vaccine. Pregnant women and those who are lactating are being excluded from this life-saving intervention. From a public health perspective and an ethical perspective, the decision to exclude pregnant and lactating women is utterly indefensible. … Continued exclusion of pregnant and lactating women from the Ebola vaccine response would be profoundly unfair — and profoundly unwise. The DRC ministry of health and the WHO must recognize that women who are pregnant or lactating and who are contacts of Ebola patients must be given equal treatment. They are as entitled as any other contacts to the lifesaving benefits of the rVSV-ZEBOV vaccine” (8/27).

The Lancet: Prevention of Ebola virus disease through vaccination: where we are in 2018
Yves Lévy, CEO of the French Institute for Health and Medical Research, and colleagues

“…To build on the vaccine research studies that have been done thus far, the outstanding questions on the rapidity and durability of the immune response in adults, safety and immunogenicity in children, and the nature of the responses in immunocompromised and pregnant individuals using different vaccine strategies must be addressed. … Answering these questions will require improvement of global capacity to continue research on Ebola vaccines, and collaborative partnerships are needed to optimize the chances of success. … [I]t is important to investigate different scenarios for vaccination strategies and different vaccines to respond more effectively to future outbreaks. These strategies include contact and post-exposure vaccination, targeted preventive vaccination, and widespread preventive vaccination of at-risk populations such as health care workers and those residing in areas of recurrent outbreaks” (8/10).

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Lessons From Global HIV Response Can Help Guide Future Efforts Toward Strengthening Primary Health Care

Devex: Opinion: 4 lessons for primary health care from the global response to HIV
Beth Tritter, executive director for the Primary Health Care Performance Initiative, and Jeffrey Markuns, deputy director of the Primary Health Care Performance Initiative and executive director of the Boston University Family Medicine Global Health Collaborative

“…There is no more powerful, foundational step toward universal health care than strengthening primary health care … Reflecting on the decades of successes and setbacks in the global HIV response, we see four key lessons from the new Lancet-[International AIDS Society] Commission report to guide future efforts toward strengthening primary health care and achieving health for all. 1. Integrating health services saves lives and money … 2. People should always be at the center … 3. Low-income doesn’t have to mean low-impact … 4. More and better data makes a difference…” (8/17).

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From the Global Health Policy Community

National Academies Report Calls For Increased Efforts In LMICs To Achieve UHC

National Academies of Sciences, Engineering, and Medicine: Up to 8 Million Deaths Occur in Low- and Middle-Income Countries Yearly Due to Poor-Quality Health Care, Says New Report; Major Quality Chasm Must Be Fixed in Order to Reap Benefits of Universal Health Coverage
“Recent gains against the burden of illness, injury, and disability and commitment to universal health coverage (UHC) are insufficient to close the enormous gaps that remain between what is achievable in human health and where global health stands today, says a new report from the National Academies of Sciences, Engineering, and Medicine. The report calls for urgent, comprehensive efforts led by ministries of health worldwide to transform the design of health care through systems thinking and principles of human factors, acknowledge and engage the informal care sector, focus on settings of extreme adversity, embrace digital technologies and emerging innovations, and address corruption…” (8/28).

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Blog Posts Highlight Efforts To Improve Maternal Health Care In Humanitarian, Conflict Settings

Council on Foreign Relations’ “Women Around the World”: Pregnant in a War Zone: Why Respectful Maternity Care Matters in Humanitarian Settings
In this guest post, Betsy McCallon, CEO of the White Ribbon Alliance, discusses a recent meeting, hosted by the White Ribbon Alliance and the American Refugee Committee, held “to forge a new path for prioritizing respect and dignity as central to quality maternity care in humanitarian settings” (8/22).

Woodrow Wilson Center’s Environmental Change and Security Program’s “New Security Beat”: Too Little Too Late: Violence Disrupts Maternal Health Care in Conflict Settings
Yuval Cohen, intern with the Maternal Health Initiative at the Wilson Center, writes “the third in a three-part series on safe motherhood in conflict settings. The three delays of maternal mortality — delays in seeking care, reaching care, and receiving care — are exacerbated by conflict and cause hundreds of preventable deaths every day” (8/27).

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September 2018 Issue Of WHO Bulletin Available Online

WHO: Bulletin of the World Health Organization
The September 2018 WHO Bulletin features articles on various issues, including an editorial by U.N. Deputy Secretary-General Amina J. Mohammed and WHO Director-General Tedros Adhanom Ghebreyesus on health and the Sustainable Development Goals; several policy articles focusing on the SDGs; and a perspective piece on universal health coverage and community engagement (September 2018).

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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, published Issue 340 of the ‘Global Fund Observer.’ The newsletter includes articles on various topics, including a report from the Global Fund Advocates Network; the Global Fund’s sixth replenishment conference to take place next year in France; and an Aidspan analysis examining domestic financial contributions to HIV, malaria, and tuberculosis responses (8/22).

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FT Health Discusses Findings From WHO Report On Africa Region

FT Health: Africa squeezed by burden of disease and lack of investment
The latest issue of the Financial Times’ weekly global health newsletter discusses findings from a WHO report on the state of health in the WHO Africa region and provides a round-up of global health-related news stories (Jack/Dodd, 8/31).

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Experts Offer Recommendations For Strengthening USAID's 'Self-Reliance' Approach To Development

Brookings Institution: From fragility to resilience: Recommendations for strengthening USAID’s ‘self-reliance’ approach
George Ingram, senior fellow for global economy and development at Brookings, and Jonathan Papoulidis, executive adviser on fragile states at World Vision and visiting scholar at the Freeman Spogli Institute for International Studies at Stanford University, discuss USAID’s “Journey to Self-Reliance” approach to “help country partners eventually handle their own development challenges without U.S. foreign assistance” and offer recommendations for strengthening its approach (8/17).

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From the U.S. Government

U.S. Continues To Work With Namibia To End AIDS

U.S. Department of State’s “DipNote”: Working With Namibia To End AIDS
Lisa Johnson, U.S. ambassador to the Republic of Namibia, discusses U.S. efforts to help Namibia reach HIV epidemic control, highlighting the DREAMS partnership, which aims to reduce HIV infections among adolescent girls and young women. Johnson writes, “The struggle is far from over, but the United States will continue to stand with Namibia to find unique solutions to this very pressing challenge” (8/29).

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Scientists Call For Infrastructure Investments In Central Africa, As Rapid Growth Could Make Region More Vulnerable To Infectious Disease Outbreaks

NIH: Rapid development in Central Africa increases the risk of infectious disease outbreaks
“The Central Africa region is experiencing rapid urbanization, economic growth, and infrastructure development. These changes, while generally positive and welcome, also make the region more vulnerable to explosive infectious disease outbreaks, according to an international group of scientists. Writing in the New England Journal of Medicine, the authors … note that efforts to build up the health care infrastructure in Central Africa are critically needed to mitigate or prevent a large outbreak of Ebola or other infectious disease in the region…” (8/23).

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USAID Newsletter Focuses On Maternal, Child Health

USAID’s “Global Health News”: Healthy Beginnings
USAID’s August 2018 newsletter focuses on maternal and child health. “The 1,000 days from a woman’s pregnancy through her child’s second birthday offer a tremendous opportunity to build healthier and more prosperous futures for both mothers and their babies. … By focusing on improving maternal and child health and nutrition and reducing disease during the critical first 1,000 days, USAID helps children grow into strong, productive citizens and promotes more stable, self-reliant societies…” (August 2018).

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From the Kaiser Family Foundation

KFF Releases Fact Sheet Breaking Down U.S. Global Health Budget By Program Area

Kaiser Family Foundation: Breaking Down the U.S. Global Health Budget by Program Area
The U.S. government is the largest donor to global health in the world. This fact sheet breaks down the U.S. global health budget by program area: HIV/PEPFAR; tuberculosis (TB); malaria/the President’s Malaria Initiative (PMI); the Global Fund to Fight AIDS, Tuberculosis, and Malaria; maternal & child health (MCH); nutrition; family planning & reproductive health (FP/RH); global health security; and neglected tropical diseases (NTDs) (8/31).

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KFF Updates Fact Sheets On MCC, USG Role In FP/RH, MCH

Kaiser Family Foundation: The Millennium Challenge Corporation (MCC) and Global Health
This fact sheet describes the functions, governance, funding, and approach of the Millennium Challenge Corporation (MCC), with a particular focus on MCC’s engagement in global health (8/28).

Kaiser Family Foundation: The U.S. Government and International Family Planning & Reproductive Health Efforts
This fact sheet examines the U.S. government’s role in family planning and reproductive health (FP/RH) worldwide (8/29).

Kaiser Family Foundation: The U.S. Government and Global Maternal & Child Health Efforts
This fact sheet provides a snapshot of global maternal and child health (MCH) and examines the U.S. government’s role in addressing MCH worldwide (8/28).

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