Don fahimta da ba da fifiko ga tarin yiwuwar mayar da martani ga ci gaban yanayin cin hanci da rashawa a cikin Ma'aikatar Kiwon Lafiya da Sabis na Jama'a na Amurka, yi tunanin tsarin matsaloli da batutuwa masu siffar dala. Asalin waɗannan al'amura da Jiha Mai Gudanarwa na iya zama gabaɗaya An samo shi zuwa Dokar Pendleton na 1883, wanda aka kafa don kawo karshen tsarin mulkin da ya gabace shi. Kawai don kwatanta girma da girman matsalar gaba ɗaya, duba Biden-Harris Gudanar da Agenda Vision sanarwa, wanda ke wakiltar yadda Hukumar Gudanarwa ke kallon kanta, matsalolinta, da shawarwarin da za ta magance.
Don samar da mahallin game da girman HHS Administrative State, na Shugaban kasa Kasafin kudin 2022 HHS yana ba da shawarar dala biliyan 131.8 a cikin ikon kasafin kuɗi na hankali da dala tiriliyan 1.5 a cikin kudade na tilas. Sabanin haka, bukatar shugaban kasa na kasafin kudin shekarar 2022 DoD shine dala biliyan 715. Bisa lafazin Cibiyar Labaran Tarayya, da Bukatar Kasafin Kudi na Shugaban Kasa sun hada da kusan dala biliyan 62.5 na NIH, idan aka kwatanta da dala biliyan 42.9 da hukumar ta samu a ci gaba da kudurin 2022, da dala biliyan 42.8 a cikin kasafin 2021 na karshe. Buƙatar tana wakiltar haɓaka 7.2% don tallafin aikin bincike, haɓaka 50% a cikin ƙayyadaddun gine-gine da kayan aiki, da haɓaka 5% don horo. The Shirin 2023 ya hada da Dala biliyan 12.1 ƙarin don shirye-shiryen cutar sankara, da ƙarin dala biliyan 5 don tsayawa sabuwar Hukumar Binciken Ci Gaban Kiwon Lafiya (ARPA-H). Dangane da lambobi 2022, kasafin NIH (shi kaɗai, ba tare da ASPR/BARDA ba) yana wakiltar 8.7% na duk kasafin kudin DoD.
Dakatar da Ci gaban COVIDcrisis na Jiha
Tushen rashin sarrafa HHS COVIDcrisis an gina shi akan izini wanda ya ba da damar HHS na Jiha Gudanarwa don dakatar da ɗimbin dokokin tarayya da aiki tare da ketare bangarori daban-daban na Dokar Haƙƙin Tsarin Mulkin Amurka: "Ƙaddamar da Cewa Akwai Gaggawar Kiwon Lafiyar Jama'aDa farko sakataren HHS Alex Azar ya sanya wa hannu a ranar 31 ga Janairu, 2020, a lokacin ne sabunta ta Azar/Trump yana aiki Afrilu 26, 2020, kuma kuma a ranar 23 ga Yuli (Azar/Trump), sake kunnawa Oktoba 02, 2020 (Trump/Azar) Janairu 07, 2021 (Azar/Trump), sannan mu canza gwamnatin shugaban kasa.
Gwamnatin Biden ba ta rasa komai ba. A ranar 22 ga Janairu, 2021, Sakatare na riko na HHS Norris Cochran sanar da gwamnonin kasar nan cikakkun bayanai game da ci gaba da sanarwar gaggawar lafiyar jama'a don COVID-19. Daga cikin wasu abubuwa, Mukaddashin Sakatare Cochran ya nuna cewa HHS za ta ba jihohi sanarwar kwanaki 60 kafin kawo karshen sanarwar gaggawa ta lafiyar jama'a na COVID-19.
Sakataren HHS Xavier Becerra daga nan ya fara sabunta ƙudirin cewa akwai gaggawar Kiwon Lafiyar Jama'a akan Afrilu 15, 2021, sabunta Yuli 19, 2021; Oktoba 15, 2021; Janairu 14, 2022. kuma Afrilu 12, 2022. Dangane da wannan jadawali, wani sabon sabuntawa zai kasance a cikin mako na uku a watan Yuli, 2022. Duk wannan yana dogara ne akan ikon da majalisar ta baiwa HHS reshen Jihar Gudanarwa lokacin da ta zartar da dokar. Annoba da Duk Dokar Sake Izinin Shirye-shiryen Hadari (PAHPRA) a cikin 2013.
A cewar ofishin mataimakin sakataren shirye-shirye da mayar da martani, da Annoba da Duk Dokar Sake Izinin Shirye-shiryen Hadari (PAHPRA) wanda aka gyara sashe na 564 na Dokar Abinci, Magunguna da Kayan Aiki (FD&C), 21 USC 360bbb-3, an yi niyya don samar da ƙarin sassauci ga Sakataren Lafiya da Ayyukan Jama'a don ba da izinin Hukumar Abinci da Magunguna ta Amurka (FDA) don ba da izini. Izinin Amfani da Gaggawa (EU).
Ba a buƙatar Sakatariyar don yin ƙayyadaddun ƙayyadaddun yanayin gaggawa na lafiyar jama'a a ƙarƙashin sashe na 319 na Dokar Sabis na Kiwon Lafiyar Jama'a, 42 USC 247d kafin ayyana cewa yanayi ya ba da hujjar bayar da EUA. Ƙarƙashin sashe na 564 na Dokar FFD&C, kamar yadda aka gyara, Sakataren yanzu na iya ƙayyade cewa akwai gaggawar lafiyar jama'a ko muhimmiyar yuwuwar gaggawar lafiyar jama'a da ta shafi, ko kuma tana da gagarumin yuwuwar tasiri, tsaron ƙasa ko lafiya da tsaron 'yan ƙasar Amurka da ke zaune a ƙasashen waje kuma ya haɗa da kwayoyin halitta, sinadarai, rediyo, ko wakili na nukiliya ko cuta ko yanayin da zai iya kasancewa ga irin waɗannan wakilai. Sakatare na iya ayyana cewa yanayi ya ba da izinin izinin samfur na gaggawa, yana baiwa FDA damar ba da EUA kafin gaggawar ta faru.
Dangane da fahimtara game da Dokar Gudanarwa ta Tarayya, PAHPRA ba ta bisa ka'ida ba kuma ya kamata kotuna ta soke su nan da nan saboda koyarwar rashin wakilci. Wannan shine mataki na farko da ya kamata a ɗauka don wargaza ci gaban HHS wanda ya haifar da matsalar lafiyar jama'a ta COVIDcrisis, kuma ba zai buƙaci babban canjin zaɓe ba kafin a ci gaba. Kamar yadda a baya an tattauna, " koyaswar ba tare da izini ba " shine mafi mahimmancin batun Gudanarwa na Jiha wanda ake la'akari da shi sosai a cikin Kotun Koli na yanzu. Ka'idar ta dogara ne akan Kundin Tsarin Mulki Mataki na ashirin da na I, wanda ya tanadi cewa duk wani ikon doka da aka bayar a nan zai kasance ga Majalisa.
Wannan baiwar iko, hujjar ta tafi, ba za a iya mayar da ita ga bangaren zartarwa ba. Idan Majalisa ta ba wa wata hukuma cikakkiyar hankali mara iyaka (kamar yadda take tare da PAHPRA), to ta keta ka'idar "nodelegation" na tsarin mulki. Idan PAHPRA ta juye, to, gabaɗayan ayyukan HHS na Gudanarwa na Jiha waɗanda suka ba da damar ƙetare abubuwan da suka dace (duba “Dokar gama-gari”) 48 CFR § 1352.235-70 - Kariyar batutuwan ɗan adam) da kuma duka magunguna na yau da kullun da hanyoyin sarrafa maganin rigakafi.
Bugu da ƙari, PAHPRA ita ce abin da ke taimakawa Izinin Amfani da Gaggawa (EUA) na magunguna da alluran rigakafi, kuma idan aka yi watsi da su, za a shiga cikin hatsarin ba da izinin tsari na waɗannan EUA marasa lasisi. Baya ga kalubalantar halaccin PAHPRA bisa koyarwar rashin wakilai, ya kamata a taso irin wannan kalubale tare da Dokar Maganin Karni na 21 (HR 34; PL: 114-255), da Dokar Jama'a 115-92 (HR 4374).
Rushe Jihar Gudanarwa ta HHS
An tsara tsarin jagoranci na Gwamnatin Tarayyar Amurka tare da layi daya da sojoji, tare da ci gaba da jerin matakan sabis na gabaɗaya (GS-1 zuwa GS-15, tare da 15 kasancewa mafi girma) waɗanda ƙungiyar jagoranci ta dabam da ake kira Babban Jami'in Gudanarwa (SES V ta I, tare da SES I shine mafi girma), wanda ke kula da ayyukan gwamnati na farar hula. A cewar hukumar Ofishin Kula da Ma'aikata:
Babban Babban Sabis na Gudanarwa (SES) ya jagoranci ma'aikatan Amurka. A matsayin babban jigon Dokar Gyaran Ma'aikata ta 1978, an kafa SES don "...tabbatar da cewa gudanar da gudanarwa na Gwamnatin Amurka yana da amsa ga buƙatu, manufofi, da manufofin al'umma kuma in ba haka ba yana da inganci mafi girma." Waɗannan shugabanni suna da ƙwarewar zartarwa da ta dace kuma suna da ra'ayi mai faɗi game da gwamnati da sadaukarwar hidimar jama'a waɗanda ke cikin Kundin Tsarin Mulki.
Membobin SES suna aiki a manyan mukamai da ke ƙasa da manyan waɗanda shugaban ƙasa ya nada. Membobin SES sune babbar hanyar haɗi tsakanin waɗannan waɗanda aka nada da sauran ma'aikatan Tarayya. Suna aiki da kula da kusan kowane ayyukan gwamnati a cikin kusan hukumomin tarayya 75.
Ofishin Gudanar da Ma'aikata na Amurka (OPM) yana kula da shirin ma'aikatan zartarwa na tarayya gabaɗaya, yana ba da kulawa ta yau da kullun da taimako ga hukumomi yayin da suke haɓakawa, zaɓi, da sarrafa shugabanninsu na Tarayya.
Gabaɗaya, SES ita ce jagorancin jaha ta Gudanarwa, amma ba shine kawai nau'in aikin ba wanda ya sami iko. Dokta Anthony Fauci, ɗaya daga cikin ma'aikatan tarayya mafi girma ($ 434,312 albashi na asali), shine keɓe daga zama memba na SES amma a maimakon haka hidima masu biyan haraji a matsayin a Jami'in Likita a Cibiyar Kiwon Lafiya ta Kasa a Bethesda, Maryland. Likitan ya kasance Aiki na 10 mafi shahara a cikin Gwamnatin Amurka a lokacin 2020, tare da 33,865 suna aiki a ƙarƙashin wannan rukunin. Anthony S. Fauci yana aiki a mafi girman jami'in likita na RF-00 a ƙarƙashin ma'aikatan da aka nada kuma aka biya su kamar mashawarta na musamman karkashin 42 usc 209 (f).
Duk da cewa Dokta Fauci mai ba da shawara ne, har yanzu yana ƙarƙashin Dokoki da Dokoki na 42-160, waɗanda ke nuna cewa ma'aikatan Title 42 dole ne su bi duk ka'idoji da ƙa'idodi masu alaƙa da ɗabi'a da suka shafi sauran ma'aikatan Reshen Zartarwa. Waɗannan sun haɗa da dokoki game da su bukatun kudi, bayyana kudi, da kuma gudanar da ka'idojin da Sashen, da Ofishin Da'a na Gwamnati, da sauran hukumomi suka fitar.
Fitar da ma'aikata Title 42 a ƙarƙashin ƙa'idodi da ƙa'idodi masu alaƙa da ɗabi'a waɗanda suka shafi ma'aikatan Reshen Zartarwa, ko zuwa Gudanar da Aiyuka da ƙetare 42-140 (misali, kwance a cikin rantsuwar shedar majalisa), sau da yawa yana buƙatar har zuwa Shekaru biyu na matakai na shari’a, wanda ke haifar da al’ada ta gama-gari na sanya irin waɗannan ma’aikata zuwa ofishin karin magana na “kabad ɗin tsintsiya” ba tare da tagogi, tarho ko ayyukan da aka ba su ba.
Jeffrey Tucker na Cibiyar Brownstone ya taƙaita saiti ɗaya na dabarun da aka samar don wargaza Jihar Gudanarwa. Shugaba Trump yayi kokarin karya karfin SES ta amfani da a jerin umarnin zartarwa (EO 13837, EO 13836, da EO13839) da zai rage samun damar ma'aikatan tarayya (ciki har da SES) zuwa kariya ga ƙungiyoyin ƙwadago lokacin da aka matsa musu kan sharuɗɗan aikinsu. Duk waɗannan ukun sun kasance buga ƙasa tare da yanke shawara ta Kotun gundumar DC.
Alkalin da ke jagorantar shari’ar shi ne Ketanji Brown Jackson, wadda daga baya aka ba ta tukuicin shawarar da ta yanke da nadin nata a Kotun Koli, wanda Majalisar Dattawan Amurka ta tabbatar. Daga baya aka sauya hukuncin da Jackson ya yanke amma ayyukan Trump sun shiga cikin rudani na shari'a wanda ya sa suka yi tazarce.
Duk da haka, bisa la'akari da hukunce-hukuncen Kotun Koli na baya-bayan nan, mai yiyuwa ne tsarin wadannan umarni na zartarwa na iya jure wa matakin shari'a a nan gaba. Makonni biyu kafin babban zaben 2020, a ranar 21 ga Oktoba, 2020, Donald Trump ya ba da sanarwar. Tsarin tsari (EO 13957) akan "Ƙirƙirar Jadawalin F a cikin Sabis ɗin Banda." wanda aka tsara shi don shawo kan matsalolin da aka yi a baya kuma ya haɗa da ƙirƙirar sabon nau'in aikin tarayya mai suna Schedule F. Ma'aikatan gwamnatin tarayya da aka lasafta a matsayin Jadawalin F zai kasance karkashin jagorancin shugaban da aka zaba da sauran wakilai, kuma waɗannan ma'aikata za su hada da:
"Matsayi na sirri, ƙayyadaddun manufofi, tsara manufofi, ko halaye masu ba da shawara ba bisa ka'ida ba saboda canji na shugaban kasa za a jera su a cikin Jadawalin F. A cikin nada mutum zuwa matsayi a cikin Jadawalin F, kowace hukuma za ta bi ka'idar fifikon tsohon soja gwargwadon ikon gudanarwa."
Umurnin ya bukaci cikakken nazari na gwamnati game da abin da ke matsayin sake fasalin SES.
"Kowane shugaban hukumar zartarwa (kamar yadda aka ayyana a sashe na 105 na take 5, Amurka Code, amma ban da Ofishin Ba da Lamuni na Gwamnati) zai gudanar, a cikin kwanaki 90 na ranar wannan odar, yin nazari na farko na mukaman hukuma wanda subbi na II na babi na 75 na taken 5, Code na Amurka, kuma zai gudanar da cikakken nazari kan irin wadannan mukamai a cikin kwanakin 210 na wannan rana."
Jaridar Washington Post, wacce galibi ke aiki a matsayin sashin hukuma na Gwamnatin Jiha, hakika ta yaba da karfin wannan dabarar lokacin da aka gabatar da ita, ta buga OpEd mai taken "Sabuwar umarnin Trump na iya tabbatar da daya daga cikin mafi girman makircinsa":
Umurnin daga Fadar White House, wanda aka bayar a yammacin Laraba, yana da sautin fasaha: ƙirƙirar sabon "Jadawalin F" a cikin "ban da sabis" na gwamnatin tarayya don ma'aikata a cikin ayyukan tsara manufofi, da kuma jagorantar hukumomi don tantance wanda ya cancanta. Abubuwan da ke tattare da shi, duk da haka, yana da zurfi da ban tsoro. Yana ba wa masu mulki ikon kori ko žasa bisa ga dama, daga dubun-dubatar ma'aikata zuwa gasa ga ma'aikata a halin yanzu, daga dubun dubatar ma'aikata zuwa gasa ga manyan ma'aikata. Masana tattalin arziki ga, eh, masana kimiyya, odar wannan makon babban jigo ne a cikin harin da shugaban ya kai kan ma'aikatan gwamnati masu kwazo wadanda ya kira "jihar mai zurfi" - kuma su ne mafi girman karfin gwamnatin Amurka.
“Kwanaki casa’in bayan 21 ga Oktoba, 2020 ya kasance ranar 19 ga Janairu, 2021, kwana daya kafin a rantsar da sabon shugaban kasa. Washington Post yayi sharhi mai ban tsoro: "Mr. Trump zai yi ƙoƙari ya gane bacin ransa a wa'adinsa na biyu, sai dai idan masu jefa ƙuri'a ba su da hikimar hana shi."
An ayyana Biden a matsayin wanda ya yi nasara saboda galibin kuri'un da aka aika.
A ranar 21 ga Janairu, 2021, washegarin rantsar da shi, Biden ya sauya odar. Yana daya daga cikin ayyukansa na farko a matsayinsa na shugaban kasa. Ba mamaki, saboda, kamar yadda The Hill ruwaito, wannan umarni na zartarwa zai kasance "babban canji ga kariyar ma'aikatan tarayya a cikin ƙarni, yana mai da yawancin ma'aikatan tarayya zuwa aikin 'a so'."
Ma'aikatan tarayya nawa ne a cikin hukumomi da aka ware su a Jadawalin F? Ba mu sani ba domin daya ne kawai ya kammala bitar kafin sakamakon zabe ya ceci ayyukansu. Wanda ya yi shi ne ofishin kasafin kudi na Majalisa. Ƙarshensa: cikakken 88% na ma'aikata da an rarraba su a matsayin Jadawalin F, don haka ba da damar shugaban kasa ya dakatar da aikin su.
Wannan zai zama sauyi na juyin juya hali, cikakken sake fasalin Washington, DC, da duk siyasa kamar yadda aka saba.
Idan za a wargaza Jihar Gudanarwa ta HHS, ta yadda za a sake samun damar gudanar da hukumomin reshen zartarwa daban-daban, Jadawalin F yana ba da kyakkyawan tsari da samfuri don cimma manufar. Idan ba a cimma wannan mafi mahimmancin dukkan ayyuka ba, to, za mu kasance cikin haɗari cewa HHS za ta sake yin ƙoƙarin yin ciniki da ikon mallakar ƙasa don ƙarin iko ta hanyar daidaitawa da WHO, kamar yadda aka yi ƙoƙari na kwanan nan game da batun 28 ga Janairu, 2022. gyare-gyaren da aka ba da shawarar ga Dokokin Kiwon Lafiya ta Duniya. Waɗannan ayyukan, waɗanda ba a bayyana su ba har zuwa 12 ga Afrilu, 2022, sun nuna a fili cewa HHS Gudanarwar Jiha tana wakiltar haɗari a bayyane kuma a halin yanzu ga Tsarin Mulki na Amurka da ikon mallakar ƙasa, kuma dole ne a rushe da wuri-wuri.
Dakatar da Ƙungiya-Gudanar da Cin Hanci da Rashawa
Matsala ta uku wacce dole ne a magance ta ta ƙunshi dokoki daban-daban, manufofin gudanarwa, da ayyuka masu banƙyama waɗanda suka ba da ikon haɗin gwiwa (ko kuma parasitic?) ƙawance wanda ya ƙulla tsakanin rukunin magunguna-magunguna da na HHS Administrative State.
Har yanzu, yana da mahimmanci a gane ainihin tsarin siyasa wanda aka ƙirƙira; a Fascist Inverse Totalitarianism. Fuskar farkisanci na zamani galibi ana yin la’akari da yadda ‘yan jaridun kamfanoni ke yi a matsayin gungun ‘yan Tiki-torch da ke daga Proud Boys a cikin rigunan da suke tafiya a Charlottesville da kuma aikata ta’addanci a cikin mutum da jemagu ko ta mota. To amma wannan ba fasikanci ba ne na zamani, rukuni ne na mafi yawan samari da suke yin abubuwan da ba su dace ba na Jamus ta Uku Reich yayin da suke sanye da rigunan zamani da kuma rera kalamai masu banƙyama da aka tsara don tada hankali. Fascism tsarin siyasa ne wanda aka fi sani da Corporatism, cewa kasancewar haɗin gwiwar kamfanoni da ikon gwamnati. Kuma kamar yadda aka tattauna a baya, a halin yanzu ainihin ikon Gwamnatin Amurka yana cikin ƙasa ta huɗu, Jihar Gudanarwa.
Don wargaza waɗannan "haɗin gwiwar jama'a da masu zaman kansu" waɗanda ke yin sulhu da ikon HHS don aiwatar da mahimman ayyukan sa ido da kuma kare lafiyar jama'ar Amurka da gaske daga ayyukan lalata da ƙa'idodi masu banƙyama na rukunin likitanci-pharmaceutical (a cikin abin da suke yi a matsayin mafarauta, kuma mun zama ganima), dole ne mu raba kuɗin kuɗi da ƙungiyoyin masana'antu zuwa hadaddun masana'antu. Jiha, kuma waɗanda aka haɓaka kuma aka tura su cikin shekaru masu yawa.
Don dawo da ma'auni da aikin da Majalisa ta yi niyya ga HHS, dole ne a cika waɗannan matakai masu zuwa, babu ɗayansu da za a iya cika su har sai an karye ikon Hukumar Gudanarwa ta HHS kuma an kawo SES a dunƙule ta hanyar haɗin gwiwa na Kotun Koli, da duka sabon Majalisa da sabon reshe na zartarwa.
- Dole ne a gyara dokar Bayh-Dole, ta hanyar gudanarwa ko ta doka, ta yadda ta daina amfani da ma'aikatan tarayya. Masana kimiyya da masu gudanarwa na HHS ba dole ba ne su karɓi sarauta daga mallakar fasaha da aka ba da lasisi zuwa rukunin magunguna da magunguna, saboda wannan yana haifar da rikice-rikice na kudi na zahiri da na asiri.
- Yarjejeniyar majalisa don "Foundation ga National Cibiyoyin Lafiya"Da"CDC Foundation"Wajibi ne a soke shi." Waɗannan ƙungiyoyin haɗin gwiwar jama'a da masu zaman kansu sun ƙirƙiri kuɗaɗen da ba za a iya lissafta su ba waɗanda Gwamnatin HHS da SES ke amfani da su don saba wa nufin Majalisa (ta hanyar ba da damar ayyukan da ba a ba da kuɗaɗe ko izini daga Majalisa ba) da kuma haifar da haɗin kai tsakanin rukunin magunguna da magunguna da na HHS Administrative State.
- Ƙofar juyawa-masana'antu. Kofa mai jujjuyawa tsakanin ma'aikatan HHS da rukunin magunguna dole ne a kulle ko ta yaya. Faɗakarwa kawai game da yuwuwar samun aiki mai riba daga Pharma bayan yin ritaya ko tashi daga ayyukan sa ido na HHS ya riga ya nuna son zuciya kusan kowane mataki na FDA da CDC manyan ma'aikatan CDC. Ban san yadda za a cim ma hakan ta fuskar shari’a ba, kawai dai na san cewa dole ne a aiwatar da aikin idan ana son a samar da maslaha ga jama’a.
- Kudaden masana'antu. Tunanin tilastawa rukunin magunguna da magunguna don biyan kuɗin ƙa'ida ya kasance butulci ne, kuma dole ne a dakatar da wannan aikin. Idan 'yan ƙasa na Amurka masu biyan haraji suna son amintattu da ingantattun alluran rigakafi da magunguna, to suna buƙatar biyan kuɗin kuɗin don tabbatar da cewa an tilasta wa Pharma yin wasa da dokoki. Kuma idan ba haka ba, sakamakon ayyukan da tarar dole ne su kasance masu ƙarfi sosai ta yadda ba za a iya rubuta su kawai azaman farashin yin kasuwanci ba.
- Bayar da alhaki na allurar wata dabara ce ta majalisa wacce ta gaza cika manufarta a fili. Masana'antar rigakafin ta zama dodo mara lissafi wanda ke cinye manya da yara. Dokar Rauni ta Yara ta Kasa (NCVIA) na 1986 (42 USC §§ 300aa-1 zuwa 300aa-34) ta sanya hannu kan doka ta Shugaban Amurka Ronald Reagan a matsayin wani ɓangare na lissafin kiwon lafiya mafi girma a ranar 14 ga Nuwamba, 1986, kuma ya haifar da tsarin ƙarfafawa tare da saba matsalar cin hanci da rashawa da cin hanci da rashawa da cin hanci da rashawa da cin hanci da rashawa da cin hanci da rashawa na jama'a. CDC.
- Amincewa da sauri. Duk da haka wani "bidi'a" wanda Majalisa ta ɓullo tare da fa'ida mai faɗi don aiwatarwa ta Jihar Gudanarwa, Dokar Kuɗin Amfani da Magungunan Magunguna (PDUFA) wata doka ce da Majalisar Dokokin Amurka ta zartar a cikin 1992 wanda ya ba Hukumar Abinci da Magunguna (FDA) damar karɓar kudade daga masana'antun magunguna don tallafawa sabon tsarin amincewa da magani. Rashin ingantaccen tsarin ka'idojin FDA yana da jagora (mafi yawa ta hanyar fiat gudanarwa) zuwa jerin hanyoyin "gaggauta yarda", wanda bi da bi an haɓaka da amfani da su. Pharma don ci gaba da manufofinsa, sau da yawa a kan kudin jama'a. Wani lamarin kuma na koma baya wanda ba a yi niyya ba wanda mafi kyawun tsare-tsare da Gwamnatin Gudanarwa ta karkatar da shi har ta kai ga daina yin hidima ga ainihin manufar Majalisa. Wannan wani yanayi ne wanda ya cancanci binciken shari'a bisa la'akari da sake duba koyarwar rashin wakilai.
- Masu ba da shawara na waje. Ana amfani da masu ba da shawara na waje don ba da kariya ga ma'aikata, musamman ga ma'aikatan SES, ta yadda za a iya dogara da kwamitin waje da aka zaɓa a hankali don samar da sakamakon da aka yi niyya yayin ba da damar mai gudanarwa ya guje wa alhakin da kuma kula da rashin amincewa ga yanke shawara wanda zai iya zama rashin amincewa ga ɗan ƙasa amma mai riba ko kuma mai amfani ga masana'antu na likita. Har ila yau, yayin da ainihin manufar ta kasance mai daraja, a aikace wannan ya zama wani kayan aiki ne kawai wanda Gwamnatin Jihar ta lankwasa don yin aikinta da na abokan hulɗarta.
- Bayyana gaskiya, rikice-rikice na sha'awa, da bayanai. Idan mun koyi wani abu daga COVIDcrisis, shine cewa Hukumar Gudanarwa ta HHS tana da niyyar hana bayanai daga masana kimiyya na waje da sauran jama'a. A bayyane yake wannan dole ne a daina, kuma a sake yanke hukuncin kotunan gunduma na baya-bayan nan sun haifar da bege cewa tilasta wa SES da Jiha gudanarwa su zama masu fa'ida da gaskiya shine makasudi da ake iya cimmawa.
- Yayi girma don kasawa. Yawancin sassan HHS sun zama masu girma da rashin ƙarfi, kuma dole ne a aiwatar da ƙayyadaddun kimanta manufa, fifiko, yawan aiki da ƙimar da aka bayar ta hanyar wargaza manyan cibiyoyin wutar lantarki (NIAID kasancewar misali ɗaya), sake mai da hankali kan kasuwancin gabaɗaya akan lafiya da lafiya, da kawar da ayyukan da ba su da mahimmanci.
karshe
An ɗaga muryoyi da yawa waɗanda ke ba da shawarar wasu haɗakar cokali mai yatsa da tocila don abin da COVIDcrisis ya bayyana a fili a matsayin siyasa da gurɓatacce HHS da ƙungiyoyin rassanta da cibiyoyi. Yana iya zama ya zama dole a ƙirƙiri ƙungiya mai kama da juna, ta balaga har ta kai ga ɗaukar mahimman ayyuka na HHS na yanzu, sannan kuma a rushe (a wancan lokacin) tsarin HHS da ba a gama ba.
Amma a cikin wucin gadi, gyare-gyaren da aka gabatar a sama na iya haifar da wasan ƙwallon ƙafa zuwa HHS wanda zai ba da ƙima ga masu biyan haraji na Amurka da ƴan ƙasa, kuma wanda Majalisa da Zartarwa za su iya sarrafa su yadda ya kamata maimakon yin aiki da kansa don biyan bukatun Gwamnatin da kanta.
-
Robert W. Malone likita ne kuma masanin ilimin halittu. Ayyukansa sun mayar da hankali kan fasahar mRNA, magunguna, da bincike na sake fasalin ƙwayoyi.
Duba dukkan posts
