OF THE PHILIPPINES
First Regular Session
SENATE
S.
B. No.2865
(In substitution of SB 2378 and 2768, taking into
consideration PSR 238)
Prepared Jointly by the Committees on Health and
Demography; Finance; and Youth,
Women and Family Relations with Senators
Defensor-Santiago, Lacson and (P.)
Cayetano as authors
AN
ACT
PROVIDING
FOR A NATIONAL POLICY ON REPRODUCTIVE
HEALTH
AND POPULATION AND DEVELOPMENT
Be it enacted by the Senate and the House of
Representatives of the House of
Representatives of the Philippines in Congress
assembled:
SECTION 1. Short Title. -
This Act shall be known as the "The Reproductive Health Act of 2011."
SEC. 2. State Policies. -
The State recognizes and guarantees the human rights of all persons including
their right to equality and non-discrimination of these rights, the right to
sustainable human development, the right to health which includes reproductive health,
the right to education and information, and the right to choose and make
decisions for themselves in accordance with their religious convictions,
ethics, cultural beliefs, and the demands of responsible parenthood.
The State shall comply with
all its international obligations under various human rights instruments
relative to reproductive health and women's empowerment including the Universal
Declaration of Human Rights, International Covenant on Civil and Political
Rights, International Covenant on Economic, Social and Cultural Rights (ICESCR),
Beijing Declaration, UN Declaration on the Elimination of Violence Against Women
(DEVAW), Convention on the Elimination of All Forms of Discrimination Against
Women (CEDAW), International Conference on Population and Development (ICPD)
and the Millennium Development Goals (MDGs).
Moreover, the State
recognizes and guarantees the promotion of gender equality, gender equity,
women empowerment and dignity as a health and human rights concern and as a
social responsibility. The advancement and protection of women's human rights shall
be central to the efforts of the State to address reproductive health care. The
State also recognizes and guarantees the promotion of the welfare and rights of
children and the youth.
The State likewise
guarantees universal access to medically-safe, effective, legal, affordable,
and quality reproductive health care services, methods, devices, supplies and relevant
information and education thereon according to the priority needs of women, children
and other underprivileged sectors.
The State shall address and
seek to eradicate discriminatory practices, laws and policies that infringe on
a person's exercise of sexual health and reproductive health and rights.
SEC. 3. Guiding Principles
for Implementation. - This Act declares the following as
guiding principles:
(a) The right to make free
and informed decisions, which is central to the exercise of any right, shall
not be subjected to any form of coercion and must be fully guaranteed by the
State, like the right itself.
(b) Respect for, protection
and fulfillment of, reproductive health and rights seek to promote the rights
and welfare of every person.
(c) Effective and quality
reproductive health care services must be given primacy to ensure maternal and
child health, and birth of healthy children, in line with the State's duty to
promote the right to health, responsible parenthood, social justice and full
human development.
(d) The provision of
medically-safe, effective, legal, accessible, affordable, and quality
reproductive health care services is essential in the promotion of the people's
right to health, especially those of women, the poor, and the marginalized, and
shall be incorporated as a component of basic health care.
(e) The State will provide
information and access, without bias, to all methods of family planning which
have been proven safe and effective in accordance with scientific and
evidence-based medical standards such as those set by the World Health Organization
(WHO) and registered and approved by the Food and Drug Administration (FDA).
(f) The State shall promote
programs that: (l) enable individuals and couples to have the number of
children they desire with due consideration to the health, particularly of
women, and the resources available and affordable to them; (2) ensure effective
partnership among the National Goverl1l11ent, Local Goverl1l11ent Units (LGUs) and
the private sector in the design, implementation, coordination, integration,
monitoring and evaluation of people-centered programs towards quality of life
and environmental protection; and (3) conduct studies to analyze demographic
trends towards sustainable human development in keeping with the principles of
gender equality and the promotion and protection of women's reproductive rights
and health.
(g) The provision of
reproductive health care and information must be the joint primary
responsibility of the National Government and the LGUs consistent with their obligation
to respect, protect and promote the right to health.
(h) Active participation by
non-goverl1l11ent, women's and people's organizations, and communities is
crucial to ensure that reproductive health and population and development
policies, plans, and programs will address the priority needs of women, the poor,
and the marginalized. The State shall ensure equitable allocation and
utilization of resources in the provision of health care.
(i) While this Act does not
amend the penal law on abortion, the goverl1l11ent shall ensure that all women
needing care for post-abortion complications shall be treated and counseled in
a humane, non-judgmental and compassionate manner.
(j) Each family shall have
the right to determine its ideal family size; Provided, however, That the State
shall equip each parent with the necessary information on all aspects of family
life, including reproductive health, in order to make that determination.
SEC. 4. Definition of Terms. -
For the purpose of this Act, the following terms shall be defined as follows:
(a) Adolescent - refers to
young people between the ages of ten (l0) to nineteen (19) years who are in
transition from childhood to adulthood;
(b) Basic Emergency
Obstetric and Newborn Care (BEMONC) - refers to lifesaving services for
emergency maternal and newborn conditions/complications being provided by a
health facility or professional to include the following services: administration
of parenteral oxytocic drugs, administration of loading dose of parenteral anticonvulsants,
administration of initial dose of antibiotics, performance of assisted deliveries
in imminent breech, removal of retained placental products, and manual removal
of retained placenta. It also includes neonatal interventions which include at
the minimum: newborn resuscitation, provision of warmth, and referral;
(c) Comprehensive Emergency
Obstetric and Newborn Care (CEMONC) – refers to lifesaving services for
emergency maternal and newborn conditions/complications as in Basic Emergency
Obstetric and Newborn Care plus the provision of surgical delivery (caesarian
section) and blood bank services, and other highly specialized obstetric interventions.
It also includes emergency neonatal care which includes at the minimum: newborn
resuscitation, treatment of neonatal sepsis infection, oxygen support, and antenatal
administration of (maternal) steroids for threatened premature delivery;
(d) Employer - includes any
person acting in the interest of an employer, directly or indirectly. The term
shall not include any labor organization or any of its officers or agents except
when acting as an employer;
(e) Family Planning -
refers to a program which enables couples and individuals to decide freely and
responsibly the number and spacing of their children and to have the information
and means to do so, and to have access to a full range of safe, affordable, effective,
and modern methods of preventing or timing pregnancy;
(f) Gender Equality - refers
to the principle of equality between women and men and equal rights to enjoy
conditions in realizing their full human potentials to contribute to, and
benefit from, the results of development, with the State recognizing that all
human beings are free and equal in dignity and rights. It entails equality in
opportunities, in the allocation of resources or benefits, or in access to
services in furtherance of the rights to health and sustainable human
development among others, without discrimination on the basis of a person's
sex, sexual orientation and gender identity;
(g) Gender Equity - refers
to the policies, instruments, programs, policies, and actions that address the
disadvantaged position of women in society by providing preferential treatment
and affirmative action. It entails fairness and justice in the distribution of
benefits and responsibilities between women and men, and often requires women-specific
projects and programs to end existing inequalities. This concept recognizes
that while reproductive health involves women and men, it is more critical for
women's health;
(h) Healthcare Service
Provider - refers to (I) a public or private health care institution, which is
duly licensed and accredited and devoted primarily to the maintenance and
operation of facilities for health promotion, disease prevention, diagnosis,
treatment, and care of individuals suffering from illness, disease, injury, disability
or deformity, or in need of obstetrical or other medical and nursing care; (2)
a public or private health care professional, who is any doctor of medicine,
nurse, or midwife; (3) a public health worker engaged in the delivery of health
care services; and (4) a barangay health worker who has undergone training
programs under any accredited government and non-government organization and,
who voluntarily renders primarily health care services in the community after
having been accredited to function as such by the local health board in
accordance with the guidelines promulgated by the Department of Health (DOH);
(i) Indigent - refers to a
person who has no visible means of income, or whose income is insufficient for
the subsistence of his family, as identified by a means test determined by the
National Government;
(j) Male Responsibility -
refers to the involvement, commitment, accountability, and responsibility of
males in all areas of sexual health and reproductive health, as well as the
care of reproductive health concerns specific to men;
(k) Maternal Death Review -
refers to qualitative, quantitative and in-depth study of the causes, trends
and distribution of maternal death with the primary purpose of preventing
future deaths through changes or additions to programs, plans and policies;
(l) Maternal Health -
refers to the health of women during pregnancy, childbirth and the postpartum
period;
(m) Modern Methods of
Family Planning - refer to safe, effective and legal methods, whether natural
or artificial;
(n) Population and
Development - refers to the conscious and explicit consideration of population
and development variables (e.g. health, environment, education, housing,
employment, etc.) in planning and policymaking. It puts people and human
development as the primary consideration for any development initiatives;
(o) Reproductive Health
(RH) - refers to the state of complete physical, mental and social wellbeing and
not merely the absence of disease or infirmity, in all matters relating to the
reproductive system and to its functions and processes. This implies that people
are able to have a safe and satisfying sex life, that they have the capability
to reproduce and the freedom to decide if, when, and how often to do so. This
further implies that women and men attain equal relationships in matters
related to sexual relations and reproduction;
(p) Reproductive Health
Care - refers to a full range of methods, techniques, facilities and services
that contribute to reproductive health and well being by preventing and solving
reproductive health-related problems. The elements of reproductive health care
include:
1. Maternal health and nutrition,
including breastfeeding;
2. Family planning
information and services;
3. Prevention of abortion
and management of abortion complications;
4. Adolescent and youth
reproductive health, guidance and counseling;
5. Prevention, treatment
and management of reproductive tract infections (RTIs) as defined in Section 4
(t), sexually transmittable infections (STIs) as defined in Section 4 (w),
breast and reproductive tract cancers and other gynecological conditions and
disorders;
6. Elimination of violence
against women and children and other forms of sexual and gender-based violence;
7. Education and counseling
on sexual health;
8. Male responsibility and
involvement and men's reproductive health; and
9. Prevention and treatment
of infertility and sexual dysfunction;
(q) Reproductive Health
Care Program - refers to the systematic and integrated provision of
reproductive health care elements to all citizens especially women, the poor, marginalized
and those in vulnerable situations;
(r) Reproductive Health
Education - refers to lifelong learning process of providing and acquiring
complete, accurate and relevant information and education on sexual health and
reproductive health through life skills education and other approaches;
(s) Reproductive Rights -
refers to the rights of individuals and couples, to decide freely and
responsibly whether or not to have children; the number, spacing and timing of their
children; to make other decisions concerning reproduction, fi'ee of
discrimination, coercion and violence; to have the information and means to do
so; and to attain the highest standard of sexual health and reproductive health;
(t) Reproductive Tract
Infection (RTI) - refers to infections of the reproductive system, including
STls, and other types of infections affecting the reproductive system;
(u) Responsible Parenthood
- refers to the will and ability of a parent to respond to the needs and
aspirations of the family and children. It is likewise a shared responsibility
between parents to determine and achieve the desired number of children, spacing
and timing of their children according to their own family life aspirations, taking
into account psychological preparedness, health status, socio-cultural, and
economic concerns;
(v) Sexual Health - refers
to a state of physical, mental and social well-being in relation to sexuality.
It requires a positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable and safe sexual
experiences, free from coercion, discrimination and violence;
(w) Sexually Transmitted
Infections (STIs) - refers to any infection that may be acquired or passed on
through sexual contact;
(x) Skilled Birth
Attendance - childbirth managed by a skilled health professional plus the
enabling conditions of necessary equipment and support of a functioning health system,
including transport and referral facilities for emergency obstetric care;
(y) Skilled Health
Professional - refers to an accredited health professional, such as a doctor,
nurse or registered' midwife; and
(z) Sustainable Human
Development - refers to bringing people particularly the poor and vulnerable at
the center of development process, the central purpose of which is the creation
of an enabling environment in which all can enjoy long, healthy and creative lives,
and done in a manner that promotes their rights and protects the life
opportunities of future generations and the natural ecosystem on which all life
depends.
SEC. 5. Hiring of Skilled
Health Professionals for Maternal Health Care and Skilled Birth Attendance. -
The LGUs, with the assistance of the DOH, shall employ an adequate number of
midwives and other skilled health professionals for maternal health care and
skilled birth attendance to achieve a minimum ratio of one (1) fulltime equivalent
skilled health professional for everyone hundred fifty (150) deliveries per year,
to be based on the annual number of actual deliveries or live births for the
past two (2) years; Provided, That
people in geographically isolated or highly populated and depressed areas shall
not be neglected.
For the purposes of this
Act, midwives and nurses shall be allowed to administer life-saving drugs, in
accordance with the guidelines set by DOH, under emergency conditions and when
there are no physicians available; Provided,
That they are appropriately trained and certified proficient to administer
these life-saving drugs.
SEC. 6. Provision of
Emergency Obstetric and Newborn Care. - Each LGU shall ensure
the establishment or upgrading of hospitals or facilities with adequate and
qualified personnel, equipment and supplies to be able to provide emergency obstetric
and newborn care. For every 500,000 population, there shall ideally be at least
one (1) public or private hospital for CEMONC and four (4) public or private
health facilities for BEMONC which shall also be capable of providing blood transfusion
services; Provided, That people in
geographically isolated or highly populated and depressed areas shall not be neglected.
SEC. 7. Access to Family
Planning. - All accredited public and private health
facilities shall provide a full range of modern family planning methods, except
in specialty hospitals which may render such services on an optional basis. No
person shall be denied information and access to family planning services.
SEC. 8. Maternal Death
Review. - All LGUs, national and local government hospitals,
and other public health units shall conduct an annual Maternal Death Review in accordance
with the guidelines set by the DOH.
SEC. 9. Family Planning
Supplies as Essential Medicines. - The National Drug
Formulary shall include hormonal contraceptives, intrauterine devices,
injectables and other safe, legal and effective family planning products and
supplies in accordance with Section 17 (d). These products and supplies shall also
be included in the regular purchase of essential medicines and supplies of all
national and local hospitals, provincial, city, and municipal health offices,
including rural health units.
SEC. 10. Procurement and
Distribution of Family Planning Supplies. – The DOH shall
lead and coordinate the efficient procurement and distribution to LGUs and usage-monitoring
of family planning supplies for the whole country. The DOH shall coordinate
with all appropriate LGU bodies to plan and implement this procurement and
distribution program. The supply and budget allotments shall be based on, among
others, the current levels and projections of the following:
(a) Number of women of
reproductive age and couples who want to space or limit their children;
(b) Contraceptive
prevalence rate, by type of method used; and
(c) Cost of family planning
supplies.
SEC. 11. PhilHealth Benefits
for Serious and Life-Threatening Reproductive Health Conditions. -
All serious and life threatening reproductive health conditions such as HIV and
AIDS, breast and reproductive tract cancers, and obstetric complications shall be
given the maximum benefits, including the provision of Anti-Retroviral
Medicines (ARVs), as provided in the guidelines set by the Philippine Health
Insurance Corporation (PHlC).
SEC. 12. Mobile Health Care
Service. - Each congressional district shall
acquire a Mobile Health Care Service (MHCS) in the form of a van or other means
of transportation appropriate to coastal and mountainous areas. The MHCS shall
deliver health care goods and services to its constituents, more particularly
to the poor and needy, as well as disseminate knowledge and information on reproductive
health. The purchase of such may be funded from the Priority Development
Assistance Fund (PDAF) of each Congressional District. The MHCS shall be
operated by skilled health providers and adequately equipped with a wide range
of reproductive health care materials and information dissemination devices and
equipment, the latter including, but not limited to, a television set for
audio-visual presentations. All MHCS shall be operated by LGUs of provinces and
highly urbanized cities.
SEC. 13. Age- and
Development- Appropriate Reproductive Health Education. The
State shall provide age- and development-appropriate reproductive health
education which shall be taught by adequately trained teachers in formal
and non-formal educational system and integrated in relevant subjects such
as, but not limited, to values formation; knowledge and skills in
self-protection against discrimination, sexual abuse and violence against
women and children and other forms of gender based violence and teen
pregnancy; physical, social and emotional changes in adolescents; women's
rights and children's rights; responsible teenage behavior; gender
and development; and responsible parenthood.
SEC. 14. Capacity Building
of Barangay Health Workers (BHWs). - The DOH shall
be responsible for disseminating information and providing training programs to
the
LGUs. The LGUs, with the technical assistance of DOH, shall be
responsible for the training of BHWs and other barangay volunteers on the
promotion of reproductive health.
SEC. 15. Employers'
Responsibilities. - The Department of Labor and Employment
(DOLE) shall ensure that employers respect the reproductive rights of workers
and their right to gender equality.
Employers shall also uphold
the right of all workers to know work conditions which may affect their
health, particularly those related to their reproductive health. Employers
shall furnish in writing the following information to all employees and applicants:
(a) The medical and health
benefits which workers are entitled to, including maternity and paternity
leave benefits; and
(b) The reproductive health
hazards associated with work, including hazards that may affect their
reproductive functions especially for pregnant women.
SEC. 16. Public Awareness. -
The DOH, Commission on Population (POPCOM) and the LGUs shall initiate and
sustain a heightened nationwide multi-media campaign to raise the level of
public awareness on the protection and promotion of reproductive health and
rights including family planning .
SEC. 17. Duties and
Responsibilities. - (a) Pursuant to the herein declared policy,
the DOH shall serve as the lead agency, along with the LGUs, for the implementation
of this Act and shall integrate in their regular operations the following functions:
1. Fully and efficiently
implement the reproductive health care program;
2. Ensure people's access
to medically safe, legal, quality and affordable reproductive health
goods and services; and
3. Perform such other
functions necessary to attain the purposes of this Act.
(b) The DOH, in
coordination with PHIC, as may be applicable, shall:
1. Strengthen the
capacities of health regulatory agencies to ensure safe, high quality,
accessible and affordable reproductive health services and commodities with the
concurrent strengthening and enforcement of regulatory mandates and mechanisms;
2. Facilitate the
involvement and participation of non-government organizations and the
private sector in reproductive health care service delivery and in the
production, distribution and delivery of quality reproductive health and
family planning supplies and commodities to make them accessible and
affordable to ordinary citizens;
3. Supervise and provide
assistance to LGUs in the delivery of reproductive health care services and
in the purchase of family planning goods and supplies; and
4. Furnish LGUs, through
their respective local health offices, appropriate information and
resources to keep the latter updated on current studies and researches relating to
family planning, responsible parenthood, breastfeeding and infant nutrition.
(c) Pursuant to the Local
Government Code, the LGUs shall:
1. Implement programs
formulated by the DOH to achieve the purposes of this Act;
2. Ensure provision of
basic health care services including, but not limited to, the operation and
maintenance of facilities and equipment necessary for the delivery of a full range
of reproductive health care services and the purchase and distribution of
family planning goods and supplies as pmi of the essential health package defined
by DOH and PHIC; and
3. Create mld organize
Reproductive Health Committees through their respective Local
Development Councils (LDCs) to ensure the implementation of this Act.
(d) The FDA shall issue
strict guidelines with respect to the use of contraceptives, taking
into consideration side effects or other harmful effects of their use.
(e) Corporate citizens
shall exercise prudence in advertising its products or services through all
forms of media, especially on matters relating to sexuality, further
taking into consideration its influence on children and the youth.
SEC. 18. Prohibited Acts. -
The following acts are prohibited:
(a) Any healthcare service
provider, whether public or private, who shall:
1. Knowingly withhold
information or restrict the dissemination thereof, and/or intentionally
provide incorrect information regarding programs and services on reproductive
health including the right to informed choice and access to a full range
of legal, medically-safe and effective family planning methods;
2. Refuse to perform legal
and medically-safe reproductive health procedures on any person of legal
age on the ground of lack of third party consent or authorization. In case
of married persons, the mutual consent of the spouses shall be preferred, if
the spouse is present; Provided, That
it is not an emergency case or one which requires immediate medical
attention or procedure; Provided,
further, That in the absence of the spouse or in case of disagreement
of the spouses, the decision of the one undergoing the procedure shall
prevail. In the case of minors, the written consent of parents or legal guardian
or, in their absence, persons exercising parental authority or next of kin
shall be required only in elective surgical procedures and in no case shall consent
be required in emergency or serious cases as defined in Republic Act 8344;
Provided, That in the case of abused
minors where parents and/or other family members are the perpetrators
or suspects, as certified by the DSWD, City or Municipal Social Welfare
and Development Office, no prior parental consent shall be necessary. In all
cases, the patient has to be informed of the medical procedure and
its consequences; and
3. Refuse to extend quality
health care services and information on account of the person's marital
status, gender, sexual orientation, age, religion, personal circumstances, or nature
of work; Provided, That the
conscientious objection of a healthcare service provider
based on his/her ethical or religious beliefs shall be respected;
however, the conscientious objector shall immediately refer the person seeking
such care and services to another healthcare service provider within the same
facility or one which is conveniently accessible; Provided, further, That the person is not in an emergency condition
or serious case as defined in RA 8344, which penalizes the refusal of
hospitals and medical clinics to administer appropriate initial medical
treatment and support in emergency and serious cases.
(b) Any public officer,
elected or appointed, who, personally or through a subordinate, prohibits
or restricts the delivery of legal and medically-safe reproductive health care
services, including family planning; or forces, coerces or induces any person to
use such services; or refuses to allocate, approve or release any
budget for reproductive health care services, or to support reproductive health programs;
or shall do any act that hinders the full implementation of a reproductive
health program as mandated by this Act.
(c) Any employer who shall
suggest, require, unduly influence or cause any applicant
for employment
or an employee to submit himself/herself to sterilization, use any modern
methods of family planning, or not use such methods as a condition for
employment, continued employment, promotion or the provision of employment
benefits. Further, pregnancy or the number of children shall not be a ground
for non-hiring or termination from employment.
SEC. 19. Penalties. -
Any violation of this Act shall be penalized by imprisonment ranging
from one (1) month to six (6) months or a fine of Ten Thousand (PI0,000.00)
to One Hundred Thousand Pesos (P100,000.00) or both fine and imprisonment,
at the discretion of the court; Provided,
That, if the offender is a public officer,
elected or appointed, she/he shall also be administratively liable.
SEC. 20. Reporting
Requirements. - Before the end of April each year, the DOH
and POPCOM, in consultation with non-government organizations, women's organizations,
young people's organizations and the private sector, shall submit to the President
of the Philippines and Congress an annual consolidated report, which shall provide
a definitive and comprehensive assessment of the implementation of its programs and
those of other government agencies and instrumentalities and recommend
priorities for executive and legislative actions. The report shall be
printed and distributed to all national agencies, the LGUs,
non-government organizations and private sector organizations involved
in said programs.
The annual report shall
evaluate the content, implementation, and impact of all policies related to
reproductive health and family planning to ensure that such policies promote,
protect and fulfill women's reproductive health and rights.
SEC. 21. Appropriations. -
The amounts appropriated in the current annual General Appropriations
Act (GAA) for reproductive health and natural and artificial family
planning under the DOH and POPCOM and other concerned agencies shall be allocated
and utilized for the implementation of this Act. Such additional sums necessary to
provide for the upgrading of facilities necessary to meet BEMONC and CEMONC standards;
the training and deployment of skilled health providers; natural and artificial family
planning commodity requirements as outlined in Sec. 10, and for other reproductive
health services, shall be included in the subsequent years' general appropriations.
The Gender and Development (GAD) funds of LGUs and national agencies shall be a
source of funding for the implementation of this Act.
SEC. 22. Implementing Rules
and Regulations (IRR). - Within sixty (60) days from
the effectivity of this Act, the Secretary of Health or his/her designated representative
as Chairperson, the authorized representative/s of POPCOM, DepEd, DSWD,
Philippine Commission on Women, PHIC, Department of the Interior and Local Government,
National Economic and Development Authority, League of Provinces, League
of Cities, and League of Municipalities, together with non-government,
people's, women's and young people's organizations, shall jointly
promulgate the rules and regulations for the effective
implementation of this Act. At least four (4) members of the IRR
drafting committee, to be selected by the Secretary of Health, shall come from
non-government, women's, people's, and young people's organizations; Provided,
That one of them shall represent women's organizations and another
shall represent young people's organizations.
SEC. 23. Interpretation
Clause. - This Act shall be liberally construed to ensure the
provision, delivery and access to reproductive health care services, and to
promote, protect and fulfill women's reproductive health and rights.
SEC. 24. Separability
Clause. - If any provision or part hereof, is held
invalid or unconstitutional, the remainder of the law or the provision
not otherwise affected shall remain valid and subsisting.
SEC. 25. Repealing Clause. -
Any law, presidential decree or issuance, executive order, letter of instruction,
administrative order, rule or regulation contrary to or is inconsistent with
the provision of this Act is hereby repealed, modified, or amended accordingly
SEC. 26. Effectivity Clause. -
This Act shall take effect fifteen (15) days after its publication in at least
two (2) newspapers of general circulation.
Approved,
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