<?xml version="1.0" encoding="UTF-8"?><edgarSubmission xmlns="http://www.sec.gov/edgar/nport" xmlns:com="http://www.sec.gov/edgar/common" xmlns:ncom="http://www.sec.gov/edgar/nportcommon" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.sec.gov/edgar/nport eis_NPORT_Filer.xsd">
  <headerData>
    <submissionType>NPORT-P</submissionType>
    <isConfidential>false</isConfidential>
    <filerInfo>
      
      <filer>
        <issuerCredentials>
          <cik>0000734383</cik>
          <ccc>XXXXXXXX</ccc>
        </issuerCredentials>
      </filer>
      
      
      <seriesClassInfo>
        <seriesId>S000002922</seriesId>
        <classId>C000008007</classId>
        <classId>C000008008</classId>
      </seriesClassInfo>
      
      
    </filerInfo>
  </headerData>
  <formData>
    <genInfo>
      <regName>VANGUARD SPECIALIZED FUNDS</regName>
      <regFileNumber>811-03916</regFileNumber>
      <regCik>0000734383</regCik>
      <regLei>549300OM0CLBHZ9MZW59</regLei>
      <regStreet1>100 Vanguard Boulevard</regStreet1>
      <regCity>Malvern</regCity>
      <regStateConditional regCountry="US" regState="US-PA"/>
      <regZipOrPostalCode>19355</regZipOrPostalCode>
      <regPhone>610-669-1000</regPhone>
      <seriesName>VANGUARD HEALTH CARE FUND</seriesName>
      <seriesId>S000002922</seriesId>
      <seriesLei>V3VSQJG5SDM3YTFC5I04</seriesLei>
      <repPdEnd>2027-01-31</repPdEnd>
      <repPdDate>2026-07-31</repPdDate>
      <isFinalFiling>N</isFinalFiling>
    </genInfo>
    <fundInfo>
      <totAssets>38254025021.49</totAssets>
      <totLiabs>80654141.34</totLiabs>
      <netAssets>38173370880.15</netAssets>
      <assetsAttrMiscSec>0.00000000</assetsAttrMiscSec>
      <assetsInvested>0.00000000</assetsInvested>
      <amtPayOneYrBanksBorr>0.00000000</amtPayOneYrBanksBorr>
      <amtPayOneYrCtrldComp>0.00000000</amtPayOneYrCtrldComp>
      <amtPayOneYrOthAffil>0.00000000</amtPayOneYrOthAffil>
      <amtPayOneYrOther>0.00000000</amtPayOneYrOther>
      <amtPayAftOneYrBanksBorr>0.00000000</amtPayAftOneYrBanksBorr>
      <amtPayAftOneYrCtrldComp>0.00000000</amtPayAftOneYrCtrldComp>
      <amtPayAftOneYrOthAffil>0.00000000</amtPayAftOneYrOthAffil>
      <amtPayAftOneYrOther>0.00000000</amtPayAftOneYrOther>
      <delayDeliv>0.00000000</delayDeliv>
      <standByCommit>0.00000000</standByCommit>
      <liquidPref>0.00000000</liquidPref>
      <cshNotRptdInCorD>2992337.45000000</cshNotRptdInCorD>
      <borrowers>
        <borrower aggrVal="6637847.00000000" lei="9R7GPTSO7KV3UQJZQ078" name="Morgan Stanley &amp; Co. LLC"/>
        <borrower aggrVal="2867942.00000000" lei="G5GSEF7VJP5I7OUK5573" name="Barclays Bank PLC"/>
        <borrower aggrVal="3090552.00000000" lei="58PU97L1C0WSRCWADL48" name="Jefferies LLC"/>
        <borrower aggrVal="662100.00000000" lei="T6FIZBDPKLYJKFCRVK44" name="UBS Securities LLC"/>
        <borrower aggrVal="14996880.00000000" lei="549300QQRY1JCFQHYS08" name="Janney Montgomery Scott, LLC"/>
        <borrower aggrVal="23614584.00000000" lei="VYVVCKR63DVZZN70PB21" name="Wells Fargo Securities LLC"/>
      </borrowers>
      <isNonCashCollateral>N</isNonCashCollateral>
      <returnInfo>
        <monthlyTotReturns>
          <monthlyTotReturn classId="C000008007" rtn1="1.40704573" rtn2="6.21278799" rtn3="-0.98464538"/>
          <monthlyTotReturn classId="C000008008" rtn1="1.41967621" rtn2="6.21316307" rtn3="-0.97109827"/>
        </monthlyTotReturns>
        <monthlyReturnCats>
          <commodityContracts>
            <mon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <forwardCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </forwardCategory>
            <futureCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </futureCategory>
            <optionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </optionCategory>
            <swaptionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swaptionCategory>
            <swapCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swapCategory>
            <warrantCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </warrantCategory>
            <otherCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </otherCategory>
          </commodityContracts>
          <creditContracts>
            <mon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <forwardCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </forwardCategory>
            <futureCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </futureCategory>
            <optionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </optionCategory>
            <swaptionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swaptionCategory>
            <swapCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swapCategory>
            <warrantCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </warrantCategory>
            <otherCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </otherCategory>
          </creditContracts>
          <equityContracts>
            <mon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <forwardCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </forwardCategory>
            <futureCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </futureCategory>
            <optionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </optionCategory>
            <swaptionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swaptionCategory>
            <swapCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swapCategory>
            <warrantCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </warrantCategory>
            <otherCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </otherCategory>
          </equityContracts>
          <foreignExchgContracts>
            <mon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <forwardCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </forwardCategory>
            <futureCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </futureCategory>
            <optionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </optionCategory>
            <swaptionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swaptionCategory>
            <swapCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swapCategory>
            <warrantCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </warrantCategory>
            <otherCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </otherCategory>
          </foreignExchgContracts>
          <interestRtContracts>
            <mon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <forwardCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </forwardCategory>
            <futureCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </futureCategory>
            <optionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </optionCategory>
            <swaptionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swaptionCategory>
            <swapCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swapCategory>
            <warrantCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </warrantCategory>
            <otherCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </otherCategory>
          </interestRtContracts>
          <otherContracts>
            <mon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <mon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            <forwardCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </forwardCategory>
            <futureCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </futureCategory>
            <optionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </optionCategory>
            <swaptionCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swaptionCategory>
            <swapCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </swapCategory>
            <warrantCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </warrantCategory>
            <otherCategory>
              <instrMon1 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon2 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
              <instrMon3 netRealizedGain="0.00000000" netUnrealizedAppr="0.00000000"/>
            </otherCategory>
          </otherContracts>
        </monthlyReturnCats>
        <othMon1 netRealizedGain="583492245.06000000" netUnrealizedAppr="-91218549.59000000"/>
        <othMon2 netRealizedGain="215103937.40000000" netUnrealizedAppr="2026143409.57000000"/>
        <othMon3 netRealizedGain="422806438.31000000" netUnrealizedAppr="-812191668.82000000"/>
      </returnInfo>
      <mon1Flow redemption="611777028.37000000" reinvestment="1041.76000000" sales="213442390.76001000"/>
      <mon2Flow redemption="435078898.81000000" reinvestment="156.03000000" sales="45132863.30999760"/>
      <mon3Flow redemption="359545549.28000000" reinvestment="0.00000000" sales="46995525.30999760"/>
      
      
    </fundInfo>
    <invstOrSecs>
      <invstOrSec>
        <name>CG oncology Inc</name>
        <lei>N/A</lei>
        <title>CG ONCOLOGY INC</title>
        <cusip>156944100</cusip>
        <identifiers>
          <isin value="US1569441009"/>
        </identifiers>
        <balance>2860428.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>203633869.32000000</valUSD>
        <pctVal>0.533444819320</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Thermo Fisher Scientific Inc</name>
        <lei>HCHV7422L5HDJZCRFL38</lei>
        <title>THERMO FISHER</title>
        <cusip>883556102</cusip>
        <identifiers>
          <isin value="US8835561023"/>
        </identifiers>
        <balance>458983.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>263593936.90000000</valUSD>
        <pctVal>0.690517842208</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>GenFleet Therapeutics Shanghai Inc</name>
        <lei>836800OP0710UUAGDU40</lei>
        <title>GENFLEET THERA-H</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="CNE1000074L2"/>
        </identifiers>
        <balance>18491938.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="HKD" exchangeRt="0.12751200"/>
        <valUSD>65324718.65000000</valUSD>
        <pctVal>0.171126408655</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>HK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Option Care Health Inc</name>
        <lei>549300DI3Q5ACSYJRI17</lei>
        <title>OPTION CARE HEAL</title>
        <cusip>68404L201</cusip>
        <identifiers>
          <isin value="US68404L2016"/>
        </identifiers>
        <balance>6748598.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>155420211.94000000</valUSD>
        <pctVal>0.407143011886</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Medtronic PLC</name>
        <lei>549300GX3ZBSQWUXY261</lei>
        <title>MEDTRONIC PLC</title>
        <cusip>G5960L103</cusip>
        <identifiers>
          <isin value="IE00BTN1Y115"/>
        </identifiers>
        <balance>4228128.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>361039849.92000000</valUSD>
        <pctVal>0.945789804766</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Novartis AG</name>
        <lei>5493007HIVTX6SY6XD66</lei>
        <title>NOVARTIS AG-REG</title>
        <cusip>H5820Q150</cusip>
        <identifiers>
          <isin value="CH0012005267"/>
        </identifiers>
        <balance>4658547.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="CHF" exchangeRt="1.23693500"/>
        <valUSD>728558333.42000000</valUSD>
        <pctVal>1.908551214162</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>CH</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Definium Therapeutics Inc</name>
        <lei>549300QY8KN1O6RPFJ13</lei>
        <title>DEFINIUM THERAPE</title>
        <cusip>24477V105</cusip>
        <identifiers>
          <isin value="CA24477V1058"/>
        </identifiers>
        <balance>740600.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>32230912.00000000</valUSD>
        <pctVal>0.084432973187</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Celldex Therapeutics Inc</name>
        <lei>529900F018DMYWH38923</lei>
        <title>CELLDEX THERAPEU</title>
        <cusip>15117B202</cusip>
        <identifiers>
          <isin value="US15117B2025"/>
        </identifiers>
        <balance>3783994.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>144018811.64000000</valUSD>
        <pctVal>0.377275593743</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Barclays Capital Inc.</name>
        <lei>AC28XWWI3WIBK2824319</lei>
        <title>BZW TRIPARTY TREASURY</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4SH"/>
        </identifiers>
        <balance>59100000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>59100000.00000000</valUSD>
        <pctVal>0.154819966477</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="AC28XWWI3WIBK2824319" name="Barclays Capital Inc."/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>61382700.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>60282044.80000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Zenas Biopharma Inc</name>
        <lei>N/A</lei>
        <title>ZENAS BIOPHARMA</title>
        <cusip>98937L105</cusip>
        <identifiers>
          <isin value="US98937L1052"/>
        </identifiers>
        <balance>2937055.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>92341009.20000000</valUSD>
        <pctVal>0.241899017746</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <loanByFundCondition isLoanByFund="Y" loanVal="43566408.00000000"/>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Duality Biotherapeutics Inc</name>
        <lei>N/A</lei>
        <title>DUALITY BIOTHERA</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="KYG2929M1087"/>
        </identifiers>
        <balance>2771377.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="HKD" exchangeRt="0.12751200"/>
        <valUSD>64435787.43000000</valUSD>
        <pctVal>0.168797740268</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>HK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>United Therapeutics Corp</name>
        <lei>5299005C4HZL4UWROC14</lei>
        <title>UNITED THERAPEUT</title>
        <cusip>91307C102</cusip>
        <identifiers>
          <isin value="US91307C1027"/>
        </identifiers>
        <balance>719385.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>372432808.35000000</valUSD>
        <pctVal>0.975635108356</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Amgen Inc</name>
        <lei>62QBXGPJ34PQ72Z12S66</lei>
        <title>AMGEN INC</title>
        <cusip>031162100</cusip>
        <identifiers>
          <isin value="US0311621009"/>
        </identifiers>
        <balance>984663.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>379252801.08000000</valUSD>
        <pctVal>0.993500946695</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Immunome Inc</name>
        <lei>N/A</lei>
        <title>IMMUNOME INC</title>
        <cusip>45257U108</cusip>
        <identifiers>
          <isin value="US45257U1088"/>
        </identifiers>
        <balance>3703461.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>84290772.36000000</valUSD>
        <pctVal>0.220810398496</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>AbbVie Inc</name>
        <lei>FR5LCKFTG8054YNNRU85</lei>
        <title>ABBVIE INC</title>
        <cusip>00287Y109</cusip>
        <identifiers>
          <isin value="US00287Y1091"/>
        </identifiers>
        <balance>3506192.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>879843820.48000000</valUSD>
        <pctVal>2.304862788362</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Natixis SA</name>
        <lei>KX1WK48MPD4Y2NCUIZ63</lei>
        <title>NATIXIS TRIPARTY TR</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D401"/>
        </identifiers>
        <balance>149800000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>149800000.00000000</valUSD>
        <pctVal>0.392420151917</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="KX1WK48MPD4Y2NCUIZ63" name="Natixis SA"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>158100900.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>151033268.88000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
            <repurchaseCollateral>
              <principalAmt>2675000.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>1762752.72000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>AMBS</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>ICON PLC</name>
        <lei>6354008SRQGEMC4XFI67</lei>
        <title>ICON PLC</title>
        <cusip>G4705A100</cusip>
        <identifiers>
          <isin value="IE0005711209"/>
        </identifiers>
        <balance>933744.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>152727837.36000000</valUSD>
        <pctVal>0.400089994251</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bank of America Securities, LLC</name>
        <lei>8NAV47T0Y26Q87Y0QP81</lei>
        <title>BOA-MTG TRIPARTY REPO</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4H3"/>
        </identifiers>
        <balance>18900000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>18900000.00000000</valUSD>
        <pctVal>0.049510953746</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="8NAV47T0Y26Q87Y0QP81" name="Bank of America Securities, LLC"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.65000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>20511632.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>19278001.08000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>AMBS</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Stryker Corp</name>
        <lei>5493002F0SC4JTBU5137</lei>
        <title>STRYKER CORP</title>
        <cusip>863667101</cusip>
        <identifiers>
          <isin value="US8636671013"/>
        </identifiers>
        <balance>1087087.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>354064235.90000000</valUSD>
        <pctVal>0.927516296665</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Kymera Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>KYMERA THERAPEUT</title>
        <cusip>501575104</cusip>
        <identifiers>
          <isin value="US5015751044"/>
        </identifiers>
        <balance>1796469.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>185754894.60000000</valUSD>
        <pctVal>0.486608571150</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Pharvaris NV</name>
        <lei>9845003BE146D3B75D32</lei>
        <title>PHARVARIS NV</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="NL00150005Y4"/>
        </identifiers>
        <balance>1165414.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>38015804.68000000</valUSD>
        <pctVal>0.099587235299</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Alignment Healthcare Inc</name>
        <lei>N/A</lei>
        <title>ALIGNMENT HEALTH</title>
        <cusip>01625V104</cusip>
        <identifiers>
          <isin value="US01625V1044"/>
        </identifiers>
        <balance>6928007.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>102880903.95000000</valUSD>
        <pctVal>0.269509612533</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Dyne Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>DYNE THERAPEUTIC</title>
        <cusip>26818M108</cusip>
        <identifiers>
          <isin value="US26818M1080"/>
        </identifiers>
        <balance>2808140.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>70708965.20000000</valUSD>
        <pctVal>0.185231127274</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Nomura Securities International, Inc.</name>
        <lei>OXTKY6Q8X53C9ILVV871</lei>
        <title>NOM TSY FICC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4RK"/>
        </identifiers>
        <balance>85000000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>85000000.00000000</valUSD>
        <pctVal>0.222668310500</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="OXTKY6Q8X53C9ILVV871" name="Nomura Securities International, Inc."/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>89552800.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>86700041.34000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bristol-Myers Squibb Co</name>
        <lei>HLYYNH7UQUORYSJQCN42</lei>
        <title>BRISTOL-MYER SQB</title>
        <cusip>110122108</cusip>
        <identifiers>
          <isin value="US1101221083"/>
        </identifiers>
        <balance>3063693.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>200089789.83000000</valUSD>
        <pctVal>0.524160652351</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Dianthus Therapeutics Inc</name>
        <lei>549300Z3N6ODPCOFC890</lei>
        <title>DIANTHUS THERAPE</title>
        <cusip>252828108</cusip>
        <identifiers>
          <isin value="US2528281080"/>
        </identifiers>
        <balance>1503955.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>160802868.60000000</valUSD>
        <pctVal>0.421243565586</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Regeneron Pharmaceuticals Inc</name>
        <lei>549300RCBFWIRX3HYQ56</lei>
        <title>REGENERON PHARM</title>
        <cusip>75886F107</cusip>
        <identifiers>
          <isin value="US75886F1075"/>
        </identifiers>
        <balance>1072221.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>817707901.23000000</valUSD>
        <pctVal>2.142089845293</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>BNP Paribas Securities Corp.</name>
        <lei>2J5703FH5U5M97R1I237</lei>
        <title>PARIB TRIPARTY MORTGAGE</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4NR"/>
        </identifiers>
        <balance>60600000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>60600000.00000000</valUSD>
        <pctVal>0.158749407251</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="2J5703FH5U5M97R1I237" name="BNP Paribas Securities Corp."/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.65000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>82697724.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>61812000.06000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>AMBS</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>HeartFlow Inc</name>
        <lei>N/A</lei>
        <title>HEARTFLOW INC</title>
        <cusip>42238D107</cusip>
        <identifiers>
          <isin value="US42238D1072"/>
        </identifiers>
        <balance>5795579.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>146222458.17000000</valUSD>
        <pctVal>0.383048326093</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Argenx SE</name>
        <lei>7245009C5FZE6G9ODQ71</lei>
        <title>ARGENX SE</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="NL0010832176"/>
        </identifiers>
        <balance>749701.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="EUR" exchangeRt="1.15315000"/>
        <valUSD>642116654.44000000</valUSD>
        <pctVal>1.682106242217</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>BE</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Eisai Co Ltd</name>
        <lei>353800HDEE0ZYEX4QV91</lei>
        <title>EISAI CO LTD</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3160400002"/>
        </identifiers>
        <balance>7339417.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00628500"/>
        <valUSD>220643706.13000000</valUSD>
        <pctVal>0.578004250195</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bridgebio Pharma Inc</name>
        <lei>54930028YG89VTY2J114</lei>
        <title>BRIDGEBIO PHARMA</title>
        <cusip>10806X102</cusip>
        <identifiers>
          <isin value="US10806X1028"/>
        </identifiers>
        <balance>3162851.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>253312736.59000000</valUSD>
        <pctVal>0.663584930409</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>HCA Healthcare Inc</name>
        <lei>529900PH4ZGUH2MNEU89</lei>
        <title>HCA HEALTHCARE I</title>
        <cusip>40412C101</cusip>
        <identifiers>
          <isin value="US40412C1018"/>
        </identifiers>
        <balance>1594006.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>641730875.54000000</valUSD>
        <pctVal>1.681095645325</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Genmab A/S</name>
        <lei>529900MTJPDPE4MHJ122</lei>
        <title>GENMAB A/S</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DK0010272202"/>
        </identifiers>
        <balance>1278865.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="DKK" exchangeRt="0.15427300"/>
        <valUSD>368106472.03000000</valUSD>
        <pctVal>0.964301720132</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>DK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Vanguard Cmt Funds-Vanguard Market Liquidity Fund</name>
        <lei>1I6HV0TLSTR3A4XQ6L78</lei>
        <title>Vanguard Market Liquidity Fund</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="FAID" value="SLBBH1142"/>
        </identifiers>
        <balance>518687.61900000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>51863575.02000000</valUSD>
        <pctVal>0.135863230896</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>STIV</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <cashCollateralCondition cashCollateralVal="51863575.02000000" isCashCollateral="Y"/>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bank of Nova Scotia</name>
        <lei>L3I9ZG2KFGXZ61BMYR72</lei>
        <title>SCOTIA TRIPARTY TREASURY</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4G5"/>
        </identifiers>
        <balance>63300000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>63300000.00000000</valUSD>
        <pctVal>0.165822400643</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="L3I9ZG2KFGXZ61BMYR72" name="Bank of Nova Scotia"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>65000800.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>64585651.76000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Biogen Inc</name>
        <lei>W8J5WZB5IY3K0NDQT671</lei>
        <title>BIOGEN INC</title>
        <cusip>09062X103</cusip>
        <identifiers>
          <isin value="US09062X1037"/>
        </identifiers>
        <balance>2745486.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>557196383.70000000</valUSD>
        <pctVal>1.459646792653</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Merck &amp; Co Inc</name>
        <lei>4YV9Y5M8S0BRK1RP0397</lei>
        <title>MERCK &amp; CO</title>
        <cusip>58933Y105</cusip>
        <identifiers>
          <isin value="US58933Y1055"/>
        </identifiers>
        <balance>15950834.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>2076798586.80000000</valUSD>
        <pctVal>5.440438030270</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Kailera Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>KAILERA THERAPEU</title>
        <cusip>482931102</cusip>
        <identifiers>
          <isin value="US4829311020"/>
        </identifiers>
        <balance>2191928.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>37131260.32000000</valUSD>
        <pctVal>0.097270058849</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <loanByFundCondition isLoanByFund="Y" loanVal="4712708.00000000"/>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Encompass Health Corp</name>
        <lei>549300FVRPM9DRQZRG64</lei>
        <title>ENCOMPASS HEALTH</title>
        <cusip>29261A100</cusip>
        <identifiers>
          <isin value="US29261A1007"/>
        </identifiers>
        <balance>1252498.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>139114952.86000000</valUSD>
        <pctVal>0.364429311984</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Protagonist Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>PROTAGONIST THER</title>
        <cusip>74366E102</cusip>
        <identifiers>
          <isin value="US74366E1029"/>
        </identifiers>
        <balance>1243618.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>169927963.52000000</valUSD>
        <pctVal>0.445147912280</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Aktis Oncology Inc</name>
        <lei>N/A</lei>
        <title>AKTIS ONCOLOGY I</title>
        <cusip>01021M104</cusip>
        <identifiers>
          <isin value="US01021M1045"/>
        </identifiers>
        <balance>1462244.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>32271725.08000000</valUSD>
        <pctVal>0.084539888241</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <loanByFundCondition isLoanByFund="Y" loanVal="3590789.00000000"/>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Inspire Medical Systems Inc</name>
        <lei>549300XQQCQ7HCJKTW25</lei>
        <title>INSPIRE MEDICAL</title>
        <cusip>457730109</cusip>
        <identifiers>
          <isin value="US4577301090"/>
        </identifiers>
        <balance>2093826.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>105131003.46000000</valUSD>
        <pctVal>0.275404034372</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>UCB SA</name>
        <lei>2138008J191VLSGY5A09</lei>
        <title>UCB SA</title>
        <cusip>B93562120</cusip>
        <identifiers>
          <isin value="BE0003739530"/>
        </identifiers>
        <balance>2482070.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="EUR" exchangeRt="1.15315000"/>
        <valUSD>637106199.14000000</valUSD>
        <pctVal>1.668980717318</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>BE</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>JP Morgan Securities LLC</name>
        <lei>ZBUT11V806EZRVTWT807</lei>
        <title>JPM TRIPARTY TREAS FICC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D45Q"/>
        </identifiers>
        <balance>55000000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>55000000.00000000</valUSD>
        <pctVal>0.144079495029</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="ZBUT11V806EZRVTWT807" name="JP Morgan Securities LLC"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>56439900.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>56100075.36000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>M3 Inc</name>
        <lei>3538001UOKRWIODYM055</lei>
        <title>M3 INC</title>
        <cusip>J4697J108</cusip>
        <identifiers>
          <isin value="JP3435750009"/>
        </identifiers>
        <balance>9451653.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00628500"/>
        <valUSD>105888549.19000000</valUSD>
        <pctVal>0.277388521758</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Elevance Health Inc</name>
        <lei>8MYN82XMYQH89CTMTH67</lei>
        <title>ELEVANCE HEALTH</title>
        <cusip>036752103</cusip>
        <identifiers>
          <isin value="US0367521038"/>
        </identifiers>
        <balance>1858361.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>698446398.24000000</valUSD>
        <pctVal>1.829669170251</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Shionogi &amp; Co Ltd</name>
        <lei>35380049VXDTHZI3DY35</lei>
        <title>SHIONOGI &amp; CO</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3347200002"/>
        </identifiers>
        <balance>21427449.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00628500"/>
        <valUSD>387435903.24000000</valUSD>
        <pctVal>1.014937623550</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Scholar Rock Holding Corp</name>
        <lei>549300Z1FLPGL4OWJ459</lei>
        <title>SCHOLAR ROCK HOL</title>
        <cusip>80706P103</cusip>
        <identifiers>
          <isin value="US80706P1030"/>
        </identifiers>
        <balance>3859866.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>182552362.47000000</valUSD>
        <pctVal>0.478219130930</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Stoke Therapeutics Inc</name>
        <lei>549300RD25SS2DIJHJ67</lei>
        <title>STOKE THERAPEUTI</title>
        <cusip>86150R107</cusip>
        <identifiers>
          <isin value="US86150R1077"/>
        </identifiers>
        <balance>2260550.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>65239473.00000000</valUSD>
        <pctVal>0.170903096833</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Shandong Weigao Group Medical Polymer Co Ltd</name>
        <lei>5299005WQUU15JQU8S60</lei>
        <title>SHANDONG WEIG-H</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="CNE100000171"/>
        </identifiers>
        <balance>77092000.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="HKD" exchangeRt="0.12751200"/>
        <valUSD>33001567.03000000</valUSD>
        <pctVal>0.086451802052</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>HK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Incyte Corp</name>
        <lei>549300Z4WN6JVZ3T4680</lei>
        <title>INCYTE CORP</title>
        <cusip>45337C102</cusip>
        <identifiers>
          <isin value="US45337C1027"/>
        </identifiers>
        <balance>2386201.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>285198743.52000000</valUSD>
        <pctVal>0.747114380900</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Ionis Pharmaceuticals Inc</name>
        <lei>549300SI4ZGLG0BLUZ92</lei>
        <title>IONIS PHARMACEUT</title>
        <cusip>462222100</cusip>
        <identifiers>
          <isin value="US4622221004"/>
        </identifiers>
        <balance>6212640.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>321628372.80000000</valUSD>
        <pctVal>0.842546428005</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Zai Lab Ltd</name>
        <lei>549300P2UYQ9U5LY1T58</lei>
        <title>ZAI LAB LTD</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="KYG9887T1168"/>
        </identifiers>
        <balance>36431700.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="HKD" exchangeRt="0.12751200"/>
        <valUSD>66385168.84000000</valUSD>
        <pctVal>0.173904392798</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>HK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Boston Scientific Corp</name>
        <lei>Y6ZDD9FP4P8JSSJMW954</lei>
        <title>BOSTON SCIENTIFC</title>
        <cusip>101137107</cusip>
        <identifiers>
          <isin value="US1011371077"/>
        </identifiers>
        <balance>12474112.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>582915253.76000000</valUSD>
        <pctVal>1.527020643762</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Eli Lilly &amp; Co</name>
        <lei>FRDRIPF3EKNDJ2CQJL29</lei>
        <title>ELI LILLY &amp; CO</title>
        <cusip>532457108</cusip>
        <identifiers>
          <isin value="US5324571083"/>
        </identifiers>
        <balance>2861509.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>3287415999.56000000</valUSD>
        <pctVal>8.611804312176</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Abbott Laboratories</name>
        <lei>HQD377W2YR662HK5JX27</lei>
        <title>ABBOTT LABS</title>
        <cusip>002824100</cusip>
        <identifiers>
          <isin value="US0028241000"/>
        </identifiers>
        <balance>3719444.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>393145230.80000000</valUSD>
        <pctVal>1.029893933219</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Jiangsu Hengrui Pharmaceuticals Co Ltd</name>
        <lei>N/A</lei>
        <title>JIANGSU HENGRU-H</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="CNE100006XS6"/>
        </identifiers>
        <balance>9939973.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="HKD" exchangeRt="0.12751200"/>
        <valUSD>72450307.75000000</valUSD>
        <pctVal>0.189792795552</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>HK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Arcus Biosciences Inc</name>
        <lei>N/A</lei>
        <title>ARCUS BIOSCIENCE</title>
        <cusip>03969F109</cusip>
        <identifiers>
          <isin value="US03969F1093"/>
        </identifiers>
        <balance>3445827.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>97137863.13000000</valUSD>
        <pctVal>0.254464986691</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Madrigal Pharmaceuticals Inc</name>
        <lei>549300CHIMT2EUSNJB60</lei>
        <title>MADRIGAL PHARMAC</title>
        <cusip>558868105</cusip>
        <identifiers>
          <isin value="US5588681057"/>
        </identifiers>
        <balance>563117.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>263155836.44000000</valUSD>
        <pctVal>0.689370182335</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>GSK PLC</name>
        <lei>5493000HZTVUYLO1D793</lei>
        <title>GSK PLC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="GB00BN7SWP63"/>
        </identifiers>
        <balance>44047406.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="GBP" exchangeRt="1.34775100"/>
        <valUSD>1145358350.27000000</valUSD>
        <pctVal>3.000411867911</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>GB</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Chugai Pharmaceutical Co Ltd</name>
        <lei>529900T9LAII161DCN95</lei>
        <title>CHUGAI PHARMA CO</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3519400000"/>
        </identifiers>
        <balance>8264744.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00628500"/>
        <valUSD>358618352.10000000</valUSD>
        <pctVal>0.939446383254</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Intuitive Surgical Inc</name>
        <lei>54930052SRG011710797</lei>
        <title>INTUITIVE SURGIC</title>
        <cusip>46120E602</cusip>
        <identifiers>
          <isin value="US46120E6023"/>
        </identifiers>
        <balance>2725449.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>962982895.17000000</valUSD>
        <pctVal>2.522656168336</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Dexcom Inc</name>
        <lei>549300YSK3QDSFR5EU59</lei>
        <title>DEXCOM</title>
        <cusip>252131107</cusip>
        <identifiers>
          <isin value="US2521311074"/>
        </identifiers>
        <balance>5384037.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>449297887.65000000</valUSD>
        <pctVal>1.176992959465</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Daiichi Sankyo Co Ltd</name>
        <lei>353800XGIU2IHQGC9504</lei>
        <title>DAIICHI SANKYO</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3475350009"/>
        </identifiers>
        <balance>22675166.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00628500"/>
        <valUSD>366465270.29000000</valUSD>
        <pctVal>0.960002383443</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Cytokinetics Inc</name>
        <lei>549300BE5DY1HW7IHA64</lei>
        <title>CYTOKINETICS INC</title>
        <cusip>23282W605</cusip>
        <identifiers>
          <isin value="US23282W6057"/>
        </identifiers>
        <balance>3341262.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>257711538.06000000</valUSD>
        <pctVal>0.675108150310</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Structure Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>STRUCTURE THERAP</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="US86366E1064"/>
        </identifiers>
        <balance>3278237.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>157486505.48000000</valUSD>
        <pctVal>0.412555930610</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Agilent Technologies Inc</name>
        <lei>QUIX8Y7A2WP0XRMW7G29</lei>
        <title>AGILENT TECH INC</title>
        <cusip>00846U101</cusip>
        <identifiers>
          <isin value="US00846U1016"/>
        </identifiers>
        <balance>4119810.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>570058109.70000000</valUSD>
        <pctVal>1.493339719695</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Edwards Lifesciences Corp</name>
        <lei>YA13X31F3V31L8TMPR58</lei>
        <title>EDWARDS LIFE</title>
        <cusip>28176E108</cusip>
        <identifiers>
          <isin value="US28176E1082"/>
        </identifiers>
        <balance>11357910.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>977575313.70000000</valUSD>
        <pctVal>2.560882864573</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>AstraZeneca PLC</name>
        <lei>PY6ZZQWO2IZFZC3IOL08</lei>
        <title>ASTRAZENECA PLC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="GB0009895292"/>
        </identifiers>
        <balance>10300505.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="GBP" exchangeRt="1.34775100"/>
        <valUSD>1752222036.48000000</valUSD>
        <pctVal>4.590168476295</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>GB</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>HSBC Bank USA</name>
        <lei>CYYGQCGNHMHPSMRL3R97</lei>
        <title>HSBC TRIPARTY MTGE</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4F7"/>
        </identifiers>
        <balance>78500000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>78500000.00000000</valUSD>
        <pctVal>0.205640733815</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="CYYGQCGNHMHPSMRL3R97" name="HSBC Bank USA"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.65000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>170896010.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>80070000.01000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>AMBS</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Immunocore Holdings PLC</name>
        <lei>213800IUE3DFS84BVN18</lei>
        <title>IMMUNOCORE HOLDI</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="US45258D1054"/>
        </identifiers>
        <balance>4246274.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>143566523.94000000</valUSD>
        <pctVal>0.376090768590</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Vertex Pharmaceuticals Inc</name>
        <lei>54930015RAQRRZ5ZGJ91</lei>
        <title>VERTEX PHARM</title>
        <cusip>92532F100</cusip>
        <identifiers>
          <isin value="US92532F1003"/>
        </identifiers>
        <balance>1890142.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>901786748.20000000</valUSD>
        <pctVal>2.362345078277</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Danaher Corp</name>
        <lei>S4BKK9OTCEWQ3YHPFM11</lei>
        <title>DANAHER CORP</title>
        <cusip>235851102</cusip>
        <identifiers>
          <isin value="US2358511028"/>
        </identifiers>
        <balance>4275150.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>833568747.00000000</valUSD>
        <pctVal>2.183639348008</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Roche Holding AG</name>
        <lei>549300U41AUUVOAAOB37</lei>
        <title>ROCHE HOLDING AG-GENUSSCHEIN - PART.CERTIFICATES</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="CH1499059983"/>
        </identifiers>
        <balance>1029839.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="CHF" exchangeRt="1.23693500"/>
        <valUSD>450134774.93000000</valUSD>
        <pctVal>1.179185292132</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>CH</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Nomura Securities International, Inc.</name>
        <lei>OXTKY6Q8X53C9ILVV871</lei>
        <title>NOMURA TREAS TRIPARTY</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4QM"/>
        </identifiers>
        <balance>500000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>500000.00000000</valUSD>
        <pctVal>0.001309813591</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="OXTKY6Q8X53C9ILVV871" name="Nomura Securities International, Inc."/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>518900.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>510641.19000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>PTC Therapeutics Inc</name>
        <lei>549300UJLWOIWFDGB318</lei>
        <title>PTC THERAPEUTICS</title>
        <cusip>69366J200</cusip>
        <identifiers>
          <isin value="US69366J2006"/>
        </identifiers>
        <balance>2310268.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>157121326.68000000</valUSD>
        <pctVal>0.411599298299</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>HSBC Bank USA</name>
        <lei>CYYGQCGNHMHPSMRL3R97</lei>
        <title>HSBC TRIPARTY TREAS</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D48J"/>
        </identifiers>
        <balance>122700000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>122700000.00000000</valUSD>
        <pctVal>0.321428255275</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="CYYGQCGNHMHPSMRL3R97" name="HSBC Bank USA"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>95373300.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>125154037.84000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Ascendis Pharma A/S</name>
        <lei>549300B66JN3W3J8GH73</lei>
        <title>ASCENDIS PHARMA</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DK0060615755"/>
        </identifiers>
        <balance>1099854.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>268265389.14000000</valUSD>
        <pctVal>0.702755305477</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Novo Nordisk A/S</name>
        <lei>549300DAQ1CVT6CXN342</lei>
        <title>NOVO NORDISK-B</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DK0062498333"/>
        </identifiers>
        <balance>3322422.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="DKK" exchangeRt="0.15427300"/>
        <valUSD>157155792.31000000</valUSD>
        <pctVal>0.411689585400</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>DK</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Alnylam Pharmaceuticals Inc</name>
        <lei>529900S3ZI14OWRJII50</lei>
        <title>ALNYLAM PHARMACE</title>
        <cusip>02043Q107</cusip>
        <identifiers>
          <isin value="US02043Q1076"/>
        </identifiers>
        <balance>2136580.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>439109921.60000000</valUSD>
        <pctVal>1.150304286667</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Galderma Group AG</name>
        <lei>89450001OK6O8ELQ4584</lei>
        <title>GALDERMA GROUP A</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="CH1335392721"/>
        </identifiers>
        <balance>2410425.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="CHF" exchangeRt="1.23693500"/>
        <valUSD>524535728.28000000</valUSD>
        <pctVal>1.374088051921</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>CH</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Vaxcyte Inc</name>
        <lei>254900M7NMHTGASX8D95</lei>
        <title>VAXCYTE INC</title>
        <cusip>92243G108</cusip>
        <identifiers>
          <isin value="US92243G1085"/>
        </identifiers>
        <balance>2340735.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>126586948.80000000</valUSD>
        <pctVal>0.331610612008</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>CVS Health Corp</name>
        <lei>549300EJG376EN5NQE29</lei>
        <title>CVS HEALTH CORP</title>
        <cusip>126650100</cusip>
        <identifiers>
          <isin value="US1266501006"/>
        </identifiers>
        <balance>9210092.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>961809907.56000000</valUSD>
        <pctVal>2.519583378108</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Centene Corp</name>
        <lei>549300Z7JJ4TQSQGT333</lei>
        <title>CENTENE CORP</title>
        <cusip>15135B101</cusip>
        <identifiers>
          <isin value="US15135B1017"/>
        </identifiers>
        <balance>6149030.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>382592646.60000000</valUSD>
        <pctVal>1.002250096804</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Moderna Inc</name>
        <lei>549300EI6OKH5K5Q2G38</lei>
        <title>MODERNA INC</title>
        <cusip>60770K107</cusip>
        <identifiers>
          <isin value="US60770K1079"/>
        </identifiers>
        <balance>2345644.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>128588204.08000000</valUSD>
        <pctVal>0.336853154738</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Cardinal Health Inc</name>
        <lei>CCU46N3GJMF4OK4N7U60</lei>
        <title>CARDINAL HEALTH</title>
        <cusip>14149Y108</cusip>
        <identifiers>
          <isin value="US14149Y1082"/>
        </identifiers>
        <balance>1904367.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>438061541.01000000</valUSD>
        <pctVal>1.147557920376</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>STERIS PLC</name>
        <lei>N/A</lei>
        <title>STERIS PLC</title>
        <cusip>G8473T100</cusip>
        <identifiers>
          <isin value="IE00BFY8C754"/>
        </identifiers>
        <balance>1100961.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>251459492.40000000</valUSD>
        <pctVal>0.658730121553</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bank of America Securities, LLC</name>
        <lei>8NAV47T0Y26Q87Y0QP81</lei>
        <title>BK AMER TSY FICC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D43V"/>
        </identifiers>
        <balance>15000000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>15000000.00000000</valUSD>
        <pctVal>0.039294407735</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="8NAV47T0Y26Q87Y0QP81" name="Bank of America Securities, LLC"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.65000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>22653200.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>15300015.72000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>QIAGEN NV</name>
        <lei>54930036WK3GMCN17Z57</lei>
        <title>QIAGEN NV</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="NL0015002SN0"/>
        </identifiers>
        <balance>6045368.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>250278235.20000000</valUSD>
        <pctVal>0.655635668083</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>UnitedHealth Group Inc</name>
        <lei>549300GHBMY8T5GXDE41</lei>
        <title>UNITEDHEALTH GRP</title>
        <cusip>91324P102</cusip>
        <identifiers>
          <isin value="US91324P1021"/>
        </identifiers>
        <balance>3730515.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>1545925416.00000000</valUSD>
        <pctVal>4.049748241656</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bank of America Securities, LLC</name>
        <lei>8NAV47T0Y26Q87Y0QP81</lei>
        <title>BK AMER MTG FICC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4LW"/>
        </identifiers>
        <balance>40000000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>40000000.00000000</valUSD>
        <pctVal>0.104785087294</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="8NAV47T0Y26Q87Y0QP81" name="Bank of America Securities, LLC"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.66000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>57794319.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>40800000.14000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>AMBS</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>BNP Paribas Securities Corp.</name>
        <lei>2J5703FH5U5M97R1I237</lei>
        <title>PARIB TRIPARTY TREASURY</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS00003D4MT"/>
        </identifiers>
        <balance>82400000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>82400000.00000000</valUSD>
        <pctVal>0.215857279826</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="2J5703FH5U5M97R1I237" name="BNP Paribas Securities Corp."/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.64000000</repurchaseRt>
          <maturityDt>2026-08-03</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>98186900.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>84048034.46000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Cencora Inc</name>
        <lei>AI8GXW8LG5WK7E9UD086</lei>
        <title>CENCORA INC</title>
        <cusip>03073E105</cusip>
        <identifiers>
          <isin value="US03073E1055"/>
        </identifiers>
        <balance>3033825.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>944551075.50000000</valUSD>
        <pctVal>2.474371672508</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Johnson &amp; Johnson</name>
        <lei>549300G0CFPGEF6X2043</lei>
        <title>JOHNSON&amp;JOHNSON</title>
        <cusip>478160104</cusip>
        <identifiers>
          <isin value="US4781601046"/>
        </identifiers>
        <balance>7191566.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>1843557944.10000000</valUSD>
        <pctVal>4.829434502622</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Otsuka Holdings Co Ltd</name>
        <lei>N/A</lei>
        <title>OTSUKA HOLDINGS</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3188220002"/>
        </identifiers>
        <balance>5423000.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00628500"/>
        <valUSD>376027578.57000000</valUSD>
        <pctVal>0.985052066139</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>REVOLUTION Medicines Inc</name>
        <lei>549300JU3X0LBCQ65892</lei>
        <title>REVOLUTION MEDIC</title>
        <cusip>76155X100</cusip>
        <identifiers>
          <isin value="US76155X1000"/>
        </identifiers>
        <balance>1988729.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>372946349.37000000</valUSD>
        <pctVal>0.976980394372</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        
        <isRestrictedSec>N</isRestrictedSec>
        
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
    </invstOrSecs>
    <signature>
      <ncom:dateSigned>2026-09-28</ncom:dateSigned>
      <ncom:nameOfApplicant>VANGUARD SPECIALIZED FUNDS</ncom:nameOfApplicant>
      <ncom:signature>My Trieu-Gatt</ncom:signature>
      <ncom:signerName>My Trieu-Gatt</ncom:signerName>
      <ncom:title>Treasurer</ncom:title>
    </signature>
  </formData>
</edgarSubmission>
