Joint Statement on the Signing of the U.S.-Taliban Agreement

Office of the Spokesperson

The text of the following statement was agreed by Special Envoys and Special Representatives of the European Union, France, Germany, Italy, Norway, the United Kingdom, the United Nations and the United States of America on the occasion of the signing of the U.S.-Taliban Agreement on February 29 in Qatar.

Begin Text:

Representatives of the United States of America, France, Germany, Italy, Norway, the European Union, the United Kingdom, and the United Nations met on March 1 in Doha, Qatar and:

  1. Welcomed the important steps, enabled by the United States – Taliban agreement and the United States – Afghanistan joint declaration of February 29, towards ending the war and opening the door to intra-Afghan negotiations scheduled for March 10.
  2. Expressed their readiness to work towards a comprehensive and sustainable peace agreement that ends the war, contributes to regional stability and global security, respects the internationally-recognized rights of all Afghans also reflected in the Afghan Constitution, and is honored by all Afghans, including the Government of the Islamic Republic of Afghanistan, political leaders, civil society and the Taliban.
  3. Reiterated that a comprehensive and sustainable peace can be achieved only through an inclusive negotiated political settlement among Afghans, in which, notably, women participate meaningfully, and by respecting Afghanistan’s integrity and sovereignty.
  4. Reaffirmed that the Islamic Emirate of Afghanistan is not recognized by the international community, and furthermore, the international community will not accept or support the restoration of the Islamic Emirate of Afghanistan.
  5. Welcomed the Taliban committing to join a political process and their prospective role in a new post-settlement Afghan Islamic government as determined by the intra-Afghan negotiations.
  6. Appreciated the February 22-28 reduction of violence and urged all sides to further decrease violence in order to create an environment conducive to intra-Afghan negotiations.
  7. Called on the Taliban and other Afghan armed groups to take concrete steps to ensure that the territory of Afghanistan should not be used by either them or al-Qa-ida, Daesh, or other international terrorist groups to threaten or attack other countries.
  8. Stated their expectations that all sides will observe a ceasefire for the duration of intra-Afghan negotiations to enable participants to reach agreement on a political roadmap for Afghanistan’s future and the modalities of a permanent and comprehensive ceasefire.
  9. Called on all Afghans to begin discussions immediately on issues of mutual concern, such as prisoner releases and a ceasefire.
  10. Reaffirmed existing commitments to provide political support and economic and development assistance to a future Afghan government, provided that it preserves and respects the internationally-recognized rights of all Afghans also reflected in the Afghan Constitution, including for women, youth and minorities, and responds to the desire of Afghans to build on the gains achieved since 2001.
  11. Reaffirmed existing commitments to continue assistance to the Afghan National Defense and Security Forces on a sustainable basis.
  12. Took note of the readiness of the United States upon the commencement of the intra-Afghan negotiations to engage with other members of the United Nations Security Council and Afghanistan to review  the status of sanctions designations in order to support the peace process, noting that Taliban action to further reduce violence, make sustained efforts to advance intra-Afghan negotiations, and otherwise cease to engage in or support activities that threaten the peace, stability and security of Afghanistan or other countries will affect the review.
  13. Encouraged all countries to support the Afghan people and contribute to a lasting peace settlement in the interest of all.
  14. Welcomed all international efforts that support the Afghan peace process.

 

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    The Department of Transportation (DOT) uses a multistep, centralized process to prioritize and select research activities it will fund. DOT's modal administrations—which focus on specific modes of transportation like air, rail, and highways—conduct and manage most of DOT's research. The modal administrations GAO spoke to used a variety of methods to prioritize and select research, including soliciting stakeholders' feedback on research needs. The Office of the Assistant Secretary for Research and Technology (OST-R) is responsible for reviewing this proposed research to ensure alignment with DOT's strategic plans and to prevent duplicative research efforts, as required by statute. DOT has multiple efforts to facilitate research collaboration both externally and internally, but in guidance to promote collaboration, OST-R did not incorporate all leading practices. Specifically, OST-R established topical-research working groups on 12 multimodal subject areas in October 2018 and issued accompanying guidance. This guidance incorporated some leading collaboration practices, such as directing working groups to identify leadership roles and relevant participants. However, the guidance did not incorporate two leading practices—defining and monitoring progress toward long-term outcomes and regularly updating and monitoring written agreements. Taking steps to ensure the working groups follow these practices could provide OST-R greater assurance that the groups coordinate their efforts effectively, better plan long-term research, and better position themselves to address future transportation challenges. OST-R has taken some steps to help ensure that its public database on DOT-funded research projects (the Research Hub) contains complete and accurate information, as required by DOT's data management policy; however, data reliability issues remained. For example, as of July 2019—the latest available data at the time of GAO's analysis—36 percent of records in the database were missing research partners' contact information, hindering the research community's ability to obtain current project details. Taking additional steps, such as providing instructions to the modal administrations on how to improve the completeness and accuracy of the information they give OST-R for the Research Hub, would help ensure the database is fulfilling DOT's intended purpose that it serve as a reliable source of information on the department's research portfolio. Examples of Research Activities on Advanced Driver-Assistance Systems and Connected Vehicles Funded by the U.S. Department of Transportation DOT's research activities are critical to DOT's mission to make the nation's transportation system safer and more efficient. To meet current research needs and prepare for emerging technologies, DOT partners with public and private entities. In fiscal year 2018, DOT funded about 2,300 partners and had a research budget exceeding $1 billion. GAO was asked to review DOT's research activities. This report addresses: (1) how DOT prioritizes and selects which research activities it will undertake; (2) the extent to which DOT facilitates research collaboration with external stakeholders and across the department; and (3) the extent to which DOT ensures its Research Hub database contains complete and accurate project information. GAO reviewed documents and analyzed data from DOT; observed DOT-funded research; interviewed DOT officials from OST-R and four selected modal administrations; and used GAO's leading collaboration practices to assess the extent of collaboration. GAO also interviewed 17 DOT research partners, including universities and associations. GAO recommends that OST-R (1) take steps to ensure the topical-research working groups follow all leading collaboration practices, and (2) take additional steps to ensure the information in the Research Hub is complete and accurate. DOT concurred with GAO's recommendations. For more information, contact Elizabeth Repko at (202) 512-2834 or repkoe@gao.gov.
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  • Drug Pricing Program: HHS Uses Multiple Mechanisms to Help Ensure Compliance with 340B Requirements
    In U.S GAO News
    The 340B Drug Pricing Program (340B Program) requires drug manufacturers to sell outpatient drugs at a discount to covered entities—eligible hospitals and other entities participating in the program—in order for their drugs to be covered by Medicaid. Participation in the 340B Program has grown from nearly 9,700 covered entities in 2010 to 12,700 in 2020. The Department of Health and Human Services' (HHS) Health Resources and Services Administration (HRSA) administers the program and oversees covered entities' compliance with 340B Program requirements through annual audits, among other efforts. If audits identify noncompliance with program requirements, HRSA issues findings to covered entities and requires them to take corrective action to continue participating in the 340B Program (see table). Audit Findings Issued to Covered Entities by the Health Resources and Services Administration (HRSA) for Fiscal Years 2012-2019, as of September 2020 340B Program findings of noncompliance Number Eligibility of covered entities. Failure to maintain eligibility-related requirements (e.g., covered entities' oversight of their contract pharmacies). 561 Diversion of 340B drugs to ineligible patients. 340B drugs distributed to individuals who are not eligible patients of a covered entity (e.g., patients' health records are not maintained by the covered entity). 546 Duplicate discounts. Prescribed drugs that may have been subject to both the 340B price and a Medicaid rebate. 429 Total 1,536 Source: GAO analysis of information received from HRSA. | GAO-21-107 HRSA officials told GAO that, beginning in fall 2019, the agency started issuing findings only when audit information presents a clear and direct violation of the requirements outlined in the 340B Program statute. HRSA officials explained that guidance, which is used to interpret provisions of the 340B statute for the purposes of promoting program compliance among covered entities, does not provide the agency with appropriate enforcement capability. For example, HRSA officials reported that there were instances among fiscal year 2019 audits in which the agency did not issue findings for a failure to comply with guidance related to contract pharmacies in part because the 340B statute does not address contract pharmacy use and, therefore, there may not have been a clear statutory violation. In addition to audits, HRSA provides education to covered entities about 340B Program requirements and has implemented other efforts to identify noncompliance. For example, HRSA requires all covered entities to recertify their eligibility to participate in the 340B Program annually (e.g., self-attesting to compliance); and uses a self-disclosure process through which covered entities can disclose and correct self-identified instances of noncompliance. Covered entities can realize substantial savings through 340B Program price discounts, enabling them to stretch federal resources to reach more eligible patients and provide more comprehensive services. GAO was asked to provide information on HRSA's efforts to oversee covered entities' compliance with 340B Program requirements. This report describes (1) the audit findings that HRSA issued to address covered entity noncompliance with 340B Program requirements; and (2) other efforts HRSA uses to help ensure that covered entities comply with 340B Program requirements. GAO reviewed documentation, including relevant federal laws and regulations and HRSA's policies, procedures, and guidance, related to 340B Program oversight. GAO also reviewed HRSA data on the number and type of audit findings made from audits finalized during fiscal years 2012 through 2019 as of September 2020—the latest data available at the time of the audit. GAO also interviewed officials from HRSA, agency contractors, and 340B Program stakeholders. GAO provided a draft of this report to HHS for review. The agency provided written and technical comments on the draft, both of which were incorporated as appropriate. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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  • Prescription Drugs: Department of Veterans Affairs Paid About Half as Much as Medicare Part D for Selected Drugs in 2017
    In U.S GAO News
    GAO found that the Department of Veterans Affairs (VA) paid, on average, 54 percent less per unit for a sample of 399 brand-name and generic prescription drugs in 2017 as did Medicare Part D, even after accounting for applicable rebates and price concessions in the Part D program. GAO also found that 233 of the 399 drugs in the sample were at least 50 percent cheaper in VA than in Medicare, and 106 drugs were at least 75 percent cheaper. Only 43 drugs were cheaper in Medicare than in VA. The percent difference in price between the two programs was greater on average for generic drugs. Specifically, VA's prices were 68 percent lower than Medicare prices for the 203 generic drugs (an average difference of $0.19 per unit) and 49 percent lower for the 196 brand-name drugs (an average difference of $4.11 per unit). Average Per-Unit Net Prices Paid by Department of Veterans Affairs and Medicare Part D for Selected Drugs, 2017 Note: GAO's sample of 399 drugs included the top 100 brand-name and generic drugs in Medicare Part D in 2017, by: (1) highest expenditures; (2) highest utilization (by quantities dispensed); and (3) highest cost-per use. Per-unit prices are weighted to reflect differences in utilization in the two programs. Medicare prices reflect expenditures after accounting for rebates and other price concessions. While there are many factors that impact prices in the complex drug market, GAO identified several key program features that may contribute to the consistent price differential between VA and Medicare Part D. For example, Medicare's beneficiaries are divided among numerous prescription drug plans, which each negotiate drug prices with manufacturers. In contrast, VA is a single integrated health system with a unified list of covered drugs—thereby possibly strengthening its bargaining position when negotiating. In addition, VA has access to significant discounts defined by law, and can then negotiate further for lower prices. These discount prices are not available to Medicare Part D plans. GAO provided a draft of this product to HHS and VA for comment. Both agencies provided technical comments, which GAO incorporated as appropriate. In 2017, combined, Medicare Part D and VA accounted for approximately $105 billion in prescription drug sales—nearly one-third of total U.S. expenditures—and covered nearly 52 million individuals. The two programs use different methods to pay for prescription drugs. Medicare reimburses Part D plan sponsors, which in turn pay pharmacies to dispense drugs. VA primarily uses a direct purchase approach to acquire drugs from manufacturers. GAO was asked to examine differences in the amounts major federal programs paid for prescription drugs. This report: (1) compares average unit prices for prescription drugs in Medicare Part D to those in the VA; and (2) describes factors affecting prices in the two programs. GAO analyzed (1) CMS data for Medicare Part D payments to retail pharmacies as well as rebates and other price concessions Part D plans received and (2) VA drug purchasing data. These data were from 2017, the most recent data available at the time of GAO's analysis. To select a sample of drugs GAO identified the top 100 brand-name and 100 generic drugs in Medicare Part D in 2017 for three categories: (1) highest expenditure, (2) highest utilization, and (3) highest cost-per use. In total, this yielded 399 non-duplicate drugs (203 generic and 196 brand-name), which represented 44 percent of Medicare Part D spending in 2017. GAO compared weighted average unit prices for these drugs. GAO interviewed CMS and VA officials, and reviewed academic and government reports to understand factors that may affect prices in the two programs. For more information, contact John Dicken at (202) 512-7114 or dickenj@gao.gov.
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