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The US will dramatically expand its efforts to enforce a rule that denies funding to overseas aid groups and health organizations that provide or promote abortion services, Secretary of State Mike Pompeo said Tuesday.The move will undermine a broad array of health programs focused on HIV, malaria, maternal and child health, and likely result in more unsafe abortions, aid groups said."We will refuse to provide assistance to groups who provide funding to other groups" that provide or discuss abortion with clients, Pompeo said in an announcement at the State Department. "American taxpayer dollars will not be used to underwrite abortions."Pompeo said that the US would also reduce funding for the Organization of American States for promoting abortion.The Mexico City policy, also known as the global gag rule, is a US mandate that requires foreign organizations to pledge that they won't perform or promote abortion as a condition of receiving US funding for family planning programs.'Just wrong'The policy, applied sporadically by US administrations and broadened by the Trump administration, has been criticized for undercutting services that reduce maternal death and abortions, provide treatment for HIV, tuberculosis and the Zika virus, among other health challenges.The Trump administration, which reapplied and expanded the rule in January 2017, told foreign aid and medical groups that if they promoted or performed abortions, they would be denied US funding for nearly all health assistance programs, including nutrition, malaria, tuberculosis, tropical diseases and maternal and child health, including water, sanitation and hygiene programs.Pompeo said that claims that the expanded policy has negatively impacted HIV, tuberculosis, malaria & unsafe abortion are "just wrong."Spike in unsafe abortionsBut aid groups in Africa and Latin America are documenting a steep decline in services in areas where clinics have closed, staff have been laid off and family planning programs have been eliminated because of the policy."It affects other communicable diseases like tuberculosis, malaria, HIV," Mevine Ouyo, manager of a medical center in Nairobi, Kenya, told CNN. "You cannot separate some of these conditions from reproductive health services."A 2011 2285

The Senate Tuesday voted overwhelmingly 90 to 8 to confirm President Donald Trump's pick for secretary of defense, Mark Esper, giving the Pentagon its first permanent chief since James Mattis stepped down in January.While he received broad bipartisan backing, several Democratic presidential hopefuls including Sens. Kirsten Gillibrand, Kamala Harris, Cory Booker and Elizabeth Warren voted against Esper who had been Army Secretary and had briefly served as the acting secretary of defense after Trump's initial pick to replace Mattis, Patrick Shanahan's nomination dramatically imploded last month.Following his confirmation vote Trump is expected to formally appoint Esper later on Tuesday and a Pentagon spokesman told reporters a swearing in ceremony is expected Tuesday evening.Esper, a former army officer and West Point classmate of Secretary of State Mike Pompeo also worked as a senior staffer on Capitol Hill.Though he received broad bipartisan support he has received some criticism from at least one Democratic lawmaker over his ties to Raytheon, a major defense contractor, where he worked as a lobbyist.The unprecedented length of time without a permanent secretary of defense had been cited as a problem by both Republican and Democrat lawmakers as well as veterans of the defense department.A large number of senior roles at the Pentagon continue to lack permanent appointees.Esper had to step down as acting secretary following his formal nomination due to regulations. Secretary of the Navy Richard V. Spencer has been performing the acting role as Esper went through the confirmation process, making him the third consecutive acting defense secretary since Mattis resigned. 1705

This map from the Ohio Department of Health shows where cases of Hepatitis A have been diagnosed across the state since the beginning of 2018. 154

TULSA, Oklahoma — Pharmacists are fighting for new legislation that would keep insurance companies from telling customers which pharmacies to use. Pharmacy Benefit Managers often referred to as PBMs, are companies hired to help insurance companies save money.But Tulsa Pharmacist Chris Schiller said it's the patients who end up paying more. "They negotiated drug prices and did lower costs," Shiller said. "But since that time 15 years ago, they've used all these different tactics to make money where they've actually increased costs 1,010 percent."Schiller hopes HB2632 and SB841 will pass and help regulate PBMs. He said PBMs tell the patient what pharmacy they can use, eliminating your choice of where to get your prescription filled. "I'm hoping to see a level playing field for all pharmacies that protects the patient's right to choose," Schiller said. "Patients shouldn't be penalized to use the pharmacy they are most comfortable with." "I've been coming to Economy Pharmacy since they opened years ago," Kenda Skaggs said. Skaggs travels from Sand Springs to get her prescriptions. She said it's important to her to see a pharmacist she trusts. "They don't make mistakes," Skaggs said. "They know me and they know the meds I am on, and I trust them with their advice." Schiller said because of PBMs, local pharmacies may not be here a few years down the road."It's getting to that point, to where they're reimbursing so low, and directing so many patients out of state, that there aren't going to be as many pharmacies if we do not pass some regulations," Schiller said. 1597

The White House and Senate leaders of both major political parties announced agreement early Wednesday on unprecedented emergency legislation to rush sweeping aid to businesses, workers and a health care system slammed by 234