I 

116TH CONGRESS 

1ST SESSION H. R. 4847 

To establish a United States Global Health Commission and a United States 

Global Health Attache ́ Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 23, 2019 

Mr. SHERMAN introduced the following bill; which was referred to the Committee on Foreign Affairs, and in addition to the Committees on Intelligence (Permanent Select), and Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To establish a United States Global Health Commission and 

a United States Global Health Attache ́ Program, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Global Health Act’’. 

5 SEC. 2. FINDINGS; SENSE OF CONGRESS; AND PURPOSES. 

6 (a) FINDINGS.—Congress makes the following find7 ings: 


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1 (1) Of all foreign assistance provided by the 

2 United States, global health appropriations are sec3 ond only to security assistance. 

4 (2) Several Federal agencies and departments 

5 execute global health activities, including the United 

6 States Agency for International Development, the 

7 Department of Health and Human Services, the De8 partment of Defense, the Department of Agriculture, 

9 and the Department of State. 

10 (3) Global health assistance provided by the 

11 United States supports— 

12 (A) activities carried out by numerous pri13 vate, corporate, and nongovernmental organiza14 tions worldwide; and 

15 (B) multilateral organizations, such as the 

16 Global Fund to Fight AIDS, Tuberculosis, and 

17 Malaria and the World Health Organization. 

18 (4) The United States provides foreign assist19 ance to achieve national security, commercial, and 

20 humanitarian objectives while demonstrating global 

21 leadership. 

22 (5) All United States funded foreign assistance 

23 programs, regardless of the implementing agency, 

24 support the objectives referred to in paragraph (4), 


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1 but the manner in which the programs achieve the 

2 objectives varies widely. 

3 (6) The approach for global health assistance 

4 provided by the United States is largely program5 based or disease-based and often does not allow 

6 agencies to work across the health system or on 

7 issues of greatest concern to the host country. 

8 (7) Such an approach hampers long-term sta9 bility, diplomacy with key partnerships, and sustain10 able capacity building. 

11 (b) SENSE OF CONGRESS.—It is the sense of Con12 gress that— 

13 (1) each global health implementing agency 

14 should establish a program for the development of a 

15 cadre of health advisors who can serve as United 

16 States global health attache ́s; 

17 (2) country or regional health teams and health 

18 development partners working groups should be es19 tablished in all countries with significant United 

20 States health investments; and 

21 (3) all global health activities supported by the 

22 United States Government should be implemented in 

23 a coordinated manner. 

24 (c) PURPOSES.—The purposes of this Act are— 


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1 (1) to establish a governmental framework and 

2 national policy, priorities, and goals that ensure 

3 interagency coordination for global health assistance 

4 with the overall diplomacy, development, and defense 

5 efforts of the United States Government; 

6 (2) to establish the Senior United States Global 

7 Health Advisor and the United States Global Health 

8 Commission at the level of the National Security 

9 Council to harmonize the global health goals and 

10 priorities of the United States and promote inter11 agency coordination for global health assistance with 

12 the overall efforts of the United States Government; 

13 (3) to establish an Interagency Global Health 

14 Committee to implement the Unified Global Health 

15 Strategy and develop policies and frameworks to im16 prove coordination and outcomes; and 

17 (4) to establish the United States Global Health 

18 Attache ́ Program to field global health attache ́s as 

19 key interlocutors who coordinate the country or re20 gional health team and ensure effective health as21 sessment, planning, integration, and implementation 

22 across all agencies in support of the interests of the 

23 United States. 

24 SEC. 3. DEFINITIONS. 

25 In this Act: 


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1 (1) CHIEF OF MISSION.—The term ‘‘chief of 

2 mission’’ has the meaning given such term in section 

3 102 of the Foreign Service Act of 1980 (22 U.S.C. 

4 3902). 

5 (2) COMMISSION.—The term ‘‘Commission’’ 

6 means the United States Global Health Commission 

7 established under section 4. 

8 (3) COMMITTEE.—The term ‘‘Committee’’ 

9 means the Interagency Global Health Committee es10 tablished under section 6. 

11 (4) COUNTRY OR REGIONAL HEALTH TEAM.— 

12 The term ‘‘country or regional health team’’ includes 

13 employees of global health implementing agencies 

14 operating in a country or designated geographic re15 gion. 

16 (5) GLOBAL HEALTH ACTIVITIES.—The term 

17 ‘‘global health activities’’ means activities conducted 

18 in coordination with United States and foreign enti19 ties, including foreign governments— 

20 (A) to improve health care, the provision of 

21 public health services, responses to public 

22 health emergencies, and global health security; 

23 and 


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1 (B) to strengthen health systems and in2 frastructure, including the training and edu3 cation of health workers. 

4 (6) GLOBAL HEALTH IMPLEMENTING AGEN5 CIES.—The term ‘‘global health implementing agen6 cies’’ means— 

7 (A) the Department of State; 

8 (B) the United States Agency for Inter9 national Development; 

10 (C) the Department of Health and Human 

11 Services; 

12 (D) the Department of Defense; 

13 (E) the Department of Agriculture; and 

14 (F) the Department of Commerce. 

15 (7) REGIONAL.—The term ‘‘regional’’ refers to 

16 a geographic region as designated by a global health 

17 implementing agency. 

18 (8) STRATEGY.—The term ‘‘Strategy’’ means 

19 the Unified Global Health Strategy formulated 

20 under section 5. 

21 SEC. 4. UNITED STATES GLOBAL HEALTH COMMISSION. 

22 (a) ESTABLISHMENT.—Not later than 90 days after 

23 the date of the enactment of this Act, the President, work24 ing through the National Security Council, shall establish 

25 a commission to improve the interagency coordination, 


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1 stewardship, accountability, outcomes, and impact of glob2 al health investment by the United States. 

3 (b) DESIGNATION.—The commission established 

4 under subsection (a) shall be known as the ‘‘United States 

5 Global Health Commission’’. 

6 (c) CHAIRPERSON; ADVISOR.—The President shall 

7 appoint a noncabinet-level senior staff member to the Na8 tional Security Council to serve as— 

9 (1) the Chairperson of the Commission; and 

10 (2) the Senior United States Global Health Ad11 visor. 

12 (d) MEMBERSHIP.— 

13 (1) IN GENERAL.—The Commission shall be 

14 composed of— 

15 (A) the Chairperson; 

16 (B) a commissioners group (referred to in 

17 this section as the ‘‘principal group’’); 

18 (C) a staff group; and 

19 (D) any working group that the principal 

20 group determines to be necessary to carry out 

21 the duties under this section. 

22 (2) PRINCIPAL GROUP.—The principal group 

23 shall be composed of— 

24 (A) 12 voting members, of whom— 


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1 (i) 1 shall be appointed from each 

2 global health implementing agency by the 

3 head of the respective agency from among 

4 senior officials responsible for global 

5 health, emergency assistance, development, 

6 or a similar area; 

7 (ii) 3 shall be appointed by the Presi8 dent from among individuals from aca9 demic or research institutions with exper10 tise in global health policy, foreign rela11 tions, or public health emergencies; and 

12 (iii) 3 shall be appointed by the Presi13 dent from among individuals from the 

14 international development community with 

15 expertise in health, community, or eco16 nomic development; and 

17 (B) 2 nonvoting, ex officio members, of 

18 whom— 

19 (i) 1 shall be the President of the Na20 tional Academy of Medicine; and 

21 (ii) 1 shall be an employee of the Gov22 ernment Accountability Office who shall be 

23 appointed by the Comptroller General of 

24 the United States. 

25 (3) STAFF GROUP.— 


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1 (A) COMPOSITION.—The staff group de2 scribed in paragraph (1)(C) shall be composed 

3 of representatives of the National Security 

4 Council, the global health implementing agen5 cies, the Government Accountability Office, and 

6 the National Academy of Medicine, as des7 ignated by the head of the respective agency. 

8 (B) FUNCTION.—The staff group shall ad9 vise, provide subject-matter expertise to, and 

10 support the activities of, the Commission. 

11 (e) PERIODS OF APPOINTMENT; VACANCIES.— 

12 (1) PERIODS OF APPOINTMENT.— 

13 (A) GOVERNMENTAL OFFICIALS.—Each 

14 member of the principal group appointed under 

15 subsection (d)(2)(A)(i) shall serve at the discre16 tion of the head of the respective agency. 

17 (B) NONGOVERNMENTAL OFFICIALS.— 

18 Each member of the principal group appointed 

19 under clause (ii) or (iii) of subsection (d)(2)(A) 

20 shall serve for a period of not fewer than 2 

21 years and not more than 5 years. 

22 (2) VACANCIES.—A vacancy in the Commis23 sion— 

24 (A) shall not affect the powers of the Com25 mission; and 


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1 (B) shall be filled in the same manner as 

2 the original appointment. 

3 (f) MEETINGS.— 

4 (1) IN GENERAL.—The Commission shall meet 

5 at the call of the Chairperson. 

6 (2) INITIAL MEETING.—Not later than 180 

7 days after the date of the enactment of this Act, the 

8 Commission shall hold its initial meeting. 

9 (3) PRINCIPAL GROUP.—The principal group 

10 shall meet not less frequently than twice each year. 

11 (4) STAFF GROUP.—The staff group described 

12 in subsection (d)(1)(C) shall meet as determined by 

13 the Chairperson based on the activities of the Com14 mission. 

15 (g) BYLAWS.— 

16 (1) IN GENERAL.—Not later than 180 days 

17 after the date of the enactment of this Act, the 

18 Commission shall develop bylaws for the operation of 

19 the Commission. 

20 (2) ELEMENTS.—The bylaws developed under 

21 paragraph (1) shall include— 

22 (A) information on the membership of the 

23 Commission; 


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1 (B) the number of annual meetings re2 quired for the principal group and the staff 

3 group; 

4 (C) the decision-making process of the 

5 Commission; 

6 (D) the process by which disputes are re7 solved; and 

8 (E) such other information and policies as 

9 the Commission considers appropriate. 

10 (h) PRIMARY RESPONSIBILITIES.—The Commission 

11 shall— 

12 (1) develop an integrated, comprehensive global 

13 health strategy, in accordance with section 5 and in 

14 cooperation with global health implementing agen15 cies, to ensure that global health activities and pro16 grams supported by the United States are consistent 

17 with the strategic priorities and policies of the 

18 United States; 

19 (2) recommend methods to improve alignment, 

20 coordination, planning, and implementation to en21 sure the greatest possible impact and overall effec22 tiveness of United States global health efforts and 

23 programs; 

24 (3) in coordination with the Committee, advise 

25 the National Security Council on global health issues 


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1 that potentially impact the domestic health status, 

2 defense operations, development programs, diplo3 macy efforts, and strategic interests of the United 

4 States; 

5 (4) advise the Committee on country and re6 gional challenges; 

7 (5) based on the priorities of the United States, 

8 recommend countries or regions that would greatly 

9 benefit from— 

10 (A) receiving a global health attache ́ under 

11 section 7; and 

12 (B) the establishment of a country or re13 gional health development implementation plan 

14 under section 8; 

15 (6) recommend agenda items and provide other 

16 recommendations and advice to the Committee; and 

17 (7) facilitate cooperation between the United 

18 States Government and academic and research insti19 tutions, civil society, international nongovernmental 

20 organizations, and other public and private entities. 

21 (i) REPORTS.— 

22 (1) INITIAL REPORT.—Not later than 1 year 

23 after the date of the enactment of this Act, the 

24 Commission shall submit to the President and Con25 gress an initial report that includes— 


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1 (A) the bylaws and membership of the 

2 Commission; 

3 (B) a description of the methodology for 

4 the development of the Strategy; and 

5 (C) a description of progress made toward 

6 developing the Strategy. 

7 (2) BIENNIAL REPORT.— 

8 (A) IN GENERAL.—Not later than 1 year 

9 after the submission of the initial report under 

10 paragraph (1), and biennially thereafter, the 

11 Commission shall submit to the President and 

12 Congress a report on the activities of the Com13 mission during the period covered by the report. 

14 (B) ELEMENTS.—Each report submitted 

15 under subparagraph (A) shall include— 

16 (i) any updates to the Strategy since 

17 the submission of the most recent report; 

18 (ii) a description of major global 

19 health threats of concern to the United 

20 States Government; 

21 (iii) recommendations for improving 

22 alignment, coordination, planning, and im23 plementation to ensure the greatest pos24 sible impact and overall effectiveness of 


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1 United States global health efforts and 

2 programs; and 

3 (iv) a description of opportunities for 

4 future engagement on global health. 

5 (j) PERSONNEL MATTERS.— 

6 (1) SENIOR UNITED STATES GLOBAL HEALTH

7 ADVISOR.—Section 5313 of title 5, United States 

8 Code, is amended by adding at the end the fol9 lowing: 

10 ‘‘Senior United States Global Health Advisor.’’. 

11 (2) COMPENSATION OF MEMBERS.—A member 

12 of the Commission who is not an officer or employee 

13 of the Federal Government shall be compensated at 

14 a rate equal to the daily equivalent of the annual 

15 rate of basic pay prescribed for level IV of the Exec16 utive Schedule under section 5315 of title 5, United 

17 States Code, for each day (including travel time) 

18 during which the member is engaged in the perform19 ance of the duties of the Commission. 

20 (3) TRAVEL EXPENSES.—A member of the 

21 Commission shall be allowed travel expenses, includ22 ing per diem in lieu of subsistence, at rates author23 ized for employees of agencies under subchapter I of 

24 chapter 57 of title 5, United States Code, while 


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1 away from their homes or regular places of business 

2 in the performance of services for the Commission. 

3 (k) NONAPPLICABILITY OF FACA.—The Federal Ad4 visory Committee Act (5 U.S.C. App.) shall not apply to 

5 the Commission. 

6 SEC. 5. UNIFIED GLOBAL HEALTH STRATEGY. 

7 (a) IN GENERAL.—Not later than 18 months after 

8 the date of the enactment of this Act, the Commission 

9 shall formulate an integrated, comprehensive global health 

10 strategy, to be known as the ‘‘Unified Global Health 

11 Strategy’’, that communicates to Federal agencies, non12 governmental organizations, and allied partners of the 

13 United States the overall health assistance priorities of the 

14 United States. The Strategy shall be— 

15 (1) aligned with the National Security Strategy 

16 of the United States; and 

17 (2) based on— 

18 (A) highest-impact, evidence-based out19 comes and the mission, strategy, assessment, 

20 planning, and guidance documents of each glob21 al health implementing agency; and 

22 (B) recommendations from the National 

23 Security Council on issues that impact national 

24 security. 

25 (b) REQUIREMENTS.—The Strategy shall— 


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1 (1) describe the overarching, integrated stra2 tegic vision for health-related foreign assistance 

3 vertically and horizontally across the global health 

4 implementing agencies and to implementing part5 ners; 

6 (2) establish and communicate the global health 

7 goals and priorities of the United States Government 

8 for the purpose of improving the coordination, part9 nerships, and implementation of global health and 

10 foreign assistance effectiveness; 

11 (3) communicate the role of global health with 

12 respect to the overall foreign development goals of 

13 the United States; 

14 (4) provide consensus on global health efforts 

15 across the global health implementing agencies re16 garding foreign assistance health policy that dem17 onstrates the collective commitment of all inter18 agency partners to transparency, accountability, and 

19 a unified approach to maximizing the impact of 

20 United States investments; and 

21 (5) ensure that the health programs of the 

22 United States Government align, to the maximum 

23 extent possible, with country and regional health and 

24 development priorities to achieve long-term sustain25 ability, security, and stability. 


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1 (c) EFFECTIVE DATE.— 

2 (1) IN GENERAL.—The Strategy shall take ef3 fect upon approval by the President. 

4 (2) APPROVAL BY PRESIDENT.— 

5 (A) SENSE OF CONGRESS.—It is the sense 

6 of Congress that the President should approve 

7 the Strategy not later than 90 days after receiv8 ing the Strategy from the Commission. 

9 (B) EXPLANATION TO CONGRESS.—If the 

10 President has not approved the Strategy within 

11 90 days after receiving it from the Commission, 

12 the President shall submit to Congress a writ13 ten statement explaining the reason for the 

14 delay and a timeline for approval of the Strat15 egy. 

16 (3) PROHIBITION ON DELEGATION.—The Presi17 dent may not delegate the responsibilities under this 

18 subsection. 

19 (d) UPDATES.— 

20 (1) IN GENERAL.—The Commission shall up21 date the Strategy not less frequently than once every 

22 5 years. 

23 (2) CONSIDERATION OF COUNTRY-LEVEL

24 PLANS.—In updating the Strategy pursuant to para25 graph (1), the Commission shall consider the counVerDate Sep 11 2014 01:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H4847.IH H4847

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1 try or regional health development implementation 

2 plans developed under section 8. 

3 SEC. 6. INTERAGENCY GLOBAL HEALTH COMMITTEE. 

4 (a) IN GENERAL.—Not later than 180 days after the 

5 date of the enactment of this Act, the President shall es6 tablish the Interagency Global Health Committee to imple7 ment the Strategy, improve the coordination of global 

8 health efforts, and oversee the United States Global 

9 Health Attache ́ Program. 

10 (b) CHAIRPERSON.— 

11 (1) IN GENERAL.—The President shall appoint, 

12 by and with the advice and consent of the Senate, 

13 the Chairperson of the Committee. 

14 (2) AMBASSADOR-AT-LARGE FOR GLOBAL

15 HEALTH.—The Chairperson shall have the rank of 

16 Ambassador-at-Large for Global Health. 

17 (3) RESPONSIBILITIES.—The Chairperson 

18 shall— 

19 (A) chair the Committee and ensure that 

20 the responsibilities of the Committee are carried 

21 out; 

22 (B) be impartial with respect to any global 

23 health implementing agency; and 

24 (C) ensure coordination and synergy of ef25 fort in global health programming and policies 


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1 among the relevant global health implementing 

2 agencies. 

3 (c) MEMBERSHIP OF COMMITTEE.—The Committee 

4 shall be composed of— 

5 (1) the Chairperson; and 

6 (2) representatives from each global health im7 plementing agency, who shall be appointed by the 

8 head of the applicable agency; and 

9 (3) representatives from any other Federal 

10 agency, as the Chairperson considers appropriate to 

11 implement the Strategy and oversee the United 

12 States Global Health Attache ́ Program. 

13 (d) SUBCOMMITTEES.— 

14 (1) GLOBAL HEALTH ATTACHE ́ BOARD.— 

15 (A) IN GENERAL.—The Committee shall 

16 establish a permanent subcommittee, to be 

17 known as the ‘‘Global Health Attache ́ Board’’, 

18 to advise and oversee the United States Global 

19 Health Attache ́ Program, in accordance with 

20 subsection (e)(4) and section 7. 

21 (B) CHAIRPERSON.—The Secretary of 

22 State shall designate the Chairperson of the 

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1 national Environmental and Scientific Affairs of 

2 the Department of State. 

3 (2) SUBCOMMITTEES AND WORKING GROUPS.— 

4 The Chairperson of the Committee may establish 

5 such other subcommittees and working groups as the 

6 Chairperson considers necessary to carry out the re7 sponsibilities of the Committee. 

8 (e) RESPONSIBILITIES.—The Committee shall— 

9 (1) develop a 5-year plan of actions and mile10 stones to implement the Unified Global Health 

11 Strategy; 

12 (2) develop and establish integrated national 

13 policies for global health that will guide Federal 

14 agencies in development, programming, and imple15 mentation of global health efforts; 

16 (3) coordinate the global health assistance ef17 forts of the United States Government to ensure 

18 greater alignment, programmatic impact, and overall 

19 effectiveness; 

20 (4) develop, design, and oversee all aspects of 

21 the United States Global Health Attache ́ Program, 

22 in accordance with section 7, including with respect 

23 to the selection of the countries or regions in which 

24 global health attache ́s will be posted; 


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1 (5) develop guidance for the country and re2 gional health development implementation plans 

3 under section 8; 

4 (6) facilitate cooperation between Federal agen5 cies and international counterparts for planning and 

6 implementation of global health programs and ef7 forts; and 

8 (7) promote Federal interagency coordination 

9 and planning across all global health activities, in10 cluding logistical planning and coordination and the 

11 sharing of data and information associated with 

12 global health programs, development, and informa13 tion that may impact investment outcomes. 

14 (f) 5-YEAR PLAN.—Not later than 270 days after the 

15 date on which the Strategy takes effect, the Committee 

16 shall submit to Congress the 5-year plan of actions and 

17 milestones developed under subsection (e)(1). 

18 (g) REPORTS.— 

19 (1) INITIAL REPORT.—Not later than 18 

20 months after the date of the enactment of this Act, 

21 the Committee shall submit to the President and 

22 Congress an initial report that includes— 

23 (A) the structure, membership, and bylaws 

24 of the Committee; 


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1 (B) a statement of the activities and ac2 complishments of the Committee since the es3 tablishment of the Committee; and 

4 (C) an update on the development and im5 plementation of the United States Global 

6 Health Attache ́ Program established under sec7 tion 7. 

8 (2) BIENNIAL REPORT.—Not less frequently 

9 than biennially, the Committee shall submit to Con10 gress through the President a concise report con11 taining— 

12 (A) a description of progress on or set13 backs or updates to the plan of actions and 

14 milestones developed under subsection (e)(1); 

15 (B) a statement of the activities and ac16 complishments of the Committee since the sub17 mission of the most recent report; 

18 (C) a statement detailing with particularity 

19 the recommendations of the Committee with re20 spect to improving coordination, accountability, 

21 outcomes, and impact of global health invest22 ment by the United States; and 

23 (D) an update on the development and im24 plementation of the United States Global 

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1 tion 7, including post locations for and training 

2 of global health attache ́s, outcome measures, 

3 and recommendations to increase the impact of 

4 the program. 

5 SEC. 7. UNITED STATES GLOBAL HEALTH ATTACHE ́ PRO6 GRAM. 

7 (a) ESTABLISHMENT OF PROGRAM.—There is estab8 lished a United States Global Health Attache ́ Program 

9 (referred to in this section as the ‘‘Program’’). 

10 (b) PROGRAM MANAGEMENT.—The Secretary of 

11 Health and Human Services shall manage the Program 

12 under the oversight and direction of the Committee. 

13 (c) GLOBAL HEALTH ATTACHE ́S.— 

14 (1) IN GENERAL.—Each global health attache ́

15 shall serve on behalf of a chief of mission and the 

16 global health implementing agencies to assist in the 

17 coordination, strategic planning, and implementation 

18 of all global health assistance in the country or re19 gion in which the global health attache ́ is posted. 

20 (2) ELIGIBILITY.—An individual is eligible to 

21 serve as a global health attache ́ if the individual— 

22 (A) is an employee of the Federal Govern23 ment, such as a member of the uniformed serv24 ices or the Foreign Service, or other civilian 

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1 motion potential to, level 15 of the General 

2 Schedule (or equivalent); 

3 (B) has expertise and experience in public 

4 health or global health; 

5 (C) has leadership experience within one or 

6 more of the global health implementing agen7 cies; 

8 (D) is a United States citizen; and 

9 (E) has a security clearance at the secret 

10 level or above. 

11 (3) GLOBAL HEALTH ATTACHE ́ EDUCATION AND

12 TRAINING.— 

13 (A) REQUIREMENTS.— 

14 (i) IN GENERAL.—The Committee 

15 shall establish requirements for a global 

16 health attache ́ education and training pro17 gram (referred to in this section as the 

18 ‘‘education and training program’’). 

19 (ii) ELEMENTS.—The requirements 

20 established under clause (i) shall ensure 

21 that each global health attache ́— 

22 (I) receives education and train23 ing on— 


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1 (aa) the strategic planning 

2 process of the United States Gov3 ernment; 

4 (bb) the role of the global 

5 health implementing agencies in 

6 foreign assistance, and the orga7 nizational structure and global 

8 health and development programs 

9 of such agencies; 

10 (cc) effective communication 

11 with foreign and domestic media, 

12 including strategic communica13 tion; 

14 (dd) the impact of inter15 national affairs; 

16 (ee) the public health issues 

17 affecting host countries and re18 gions; and 

19 (ff) such other health-related 

20 training that the Committee con21 siders necessary to create highly 

22 effective global health diplomats; 

23 (II) completes the training for 

24 Foreign Service officers described in 

25 section 708 of the Foreign Service Act 


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1 of 1980 (22 U.S.C. 4028), or equiva2 lent training; and 

3 (III) meets foreign language pro4 ficiency requirements established by 

5 the Secretary of State for Foreign 

6 Service officers under section 702 of 

7 the Foreign Service Act of 1980 (22 

8 U.S.C. 4022) and receives appropriate 

9 language training consistent with such 

10 section. 

11 (B) CURRICULUM DEVELOPMENT.—The 

12 institution described in section 701 of the For13 eign Service Act of 1980 (22 U.S.C. 4021) 

14 (commonly known as the ‘‘Foreign Service In15 stitute’’) and the Uniformed Services University 

16 of the Health Sciences, in cooperation with ap17 propriate Federal agencies, academic institu18 tions, and other entities, shall— 

19 (i) develop a comprehensive cur20 riculum for the education and training pro21 gram, consistent with the requirements es22 tablished pursuant to subparagraph (A); 

23 and 

24 (ii) submit such curriculum to the 

25 Committee for approval. 


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1 (C) ADMINISTRATION.—The education and 

2 training program shall be administered by one 

3 or more training institutions, as determined by 

4 the Committee. 

5 (D) ELIGIBILITY FOR PARTICIPATION BY

6 OTHER INDIVIDUALS.—An individual who is not 

7 a candidate for the position of global health 

8 attache ́ may participate in some or all of the 

9 education and training program if such indi10 vidual is— 

11 (i) a health official of a global health 

12 implementing agency; or 

13 (ii) an in-country staff member of a 

14 global health implementing agency. 

15 (4) CREDENTIALS.—The Secretary of State 

16 shall— 

17 (A) notify the receiving state of each global 

18 health attache ́ posted to such state, in accord19 ance with Article 10 of the Vienna Convention 

20 on Diplomatic Relations, done at Vienna April 

21 18, 1961; and 

22 (B) provide the appropriate diplomatic cre23 dentials to each global health attache ́, at the re24 quest of the Committee. 

25 (5) POSTINGS AND ACCREDITATIONS.— 


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1 (A) IN GENERAL.—Each global health 

2 attache ́— 

3 (i) shall be posted in a country as de4 termined by the Committee; and 

5 (ii) may be accredited to one or more 

6 countries in a region as determined by the 

7 Committee. 

8 (B) CRITERIA TO ESTABLISH A GLOBAL

9 HEALTH ATTACHE ́ OFFICE.—The Committee 

10 shall make determinations about where to es11 tablish global health attache ́s based on— 

12 (i) the strategic interests and prior13 ities of the United States; 

14 (ii) large development and humani15 tarian assistance investments made by the 

16 United States; 

17 (iii) the strategic importance of health 

18 to the security and stability of the country 

19 or region; and 

20 (iv) such other criteria as the Com21 mittee considers appropriate. 

22 (6) RESPONSIBILITIES.—Each global health 

23 attache ́ shall— 

24 (A) serve as the senior health advisor to 

25 the diplomatic mission of the United States in 


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1 the country or region in which the global health 

2 attache ́ is posted; 

3 (B) convene and coordinate the country or 

4 regional health team on behalf of the chief of 

5 mission of the country or region in which the 

6 global health attache ́ is posted; 

7 (C) oversee the development of the country 

8 or regional health development implementation 

9 plan for the country or region in which the 

10 global health attache ́ is posted; 

11 (D) represent the United States Govern12 ment regarding health matters to foreign gov13 ernments, multilateral and international organi14 zations, and public and private entities; and 

15 (E) perform such other duties that align 

16 with advancing the global health interests of the 

17 United States, as determined by the chief of 

18 mission and the Committee. 

19 (7) PERIODIC REPORTS.— 

20 (A) IN GENERAL.—Each global health 

21 attache ́ shall periodically submit country or re22 gional updates to regional and headquarters 

23 components of the global health implementing 

24 agencies, through the chief of mission, as deter25 mined by the Committee. 


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1 (B) ELEMENTS.—Each report submitted 

2 under subparagraph (A) shall include a descrip3 tion of any health-related threats or critical 

4 concerns that may affect the national security, 

5 development efforts, or commercial interests of 

6 the United States. 

7 (C) HEADQUARTERS COMPONENT DE8 FINED.—In this paragraph, the term ‘‘head9 quarters component’’ means the senior leader10 ship and policymaking section of a global health 

11 implementing agency. 

12 (8) SUPERVISION.—Each global health attache ́

13 shall work under the supervision of— 

14 (A) the chief of mission of the country in 

15 which the global health attache ́ is posted; and 

16 (B) the chiefs of mission of the countries 

17 to which the global health attache ́ is accredited. 

18 (9) EMPLOYMENT.— 

19 (A) SALARY AND BENEFITS.—The em20 ployer of each global health attache ́ at the time 

21 the global health attache ́ applies for the posi22 tion of global health attache ́ shall continue to 

23 provide the salary and benefits for the global 

24 health attache ́. 


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1 (B) OTHER EXPENSES.—The Secretary of 

2 State shall provide to each global health 

3 attache ́— 

4 (i) allowances comparable to those 

5 provided by the Secretary to Foreign Serv6 ice officers under sections 5922 through 

7 5924 of title 5, United States Code; 

8 (ii) reimbursement for travel and re9 lated expenses set forth in section 901 of 

10 the Foreign Service Act of 1980 (22 

11 U.S.C. 4081); and 

12 (iii) reimbursement for administrative 

13 services consistent with the International 

14 Cooperative Administrative Support Serv15 ices Handbook. 

16 (10) IMPARTIALITY.—In carrying out their re17 sponsibilities under this section, global health 

18 attache ́s— 

19 (A) shall represent the interests and the 

20 priorities of the United States Government; and 

21 (B) may not show favoritism to any par22 ticular Federal agency. 


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1 SEC. 8. COUNTRY OR REGIONAL HEALTH DEVELOPMENT 

2 IMPLEMENTATION PLANS. 

3 (a) IN GENERAL.—Each country or regional health 

4 team, under the direction of the global health attache ́ for 

5 the country or region, shall develop a country or regional 

6 health development implementation plan for the respective 

7 country or region. 

8 (b) GUIDANCE.—The Committee shall develop guid9 ance for the country and regional health development im10 plementation plans, including with respect to— 

11 (1) the elements of and templates for the plans; 

12 and 

13 (2) policies and processes relating to plan ap14 proval, consultation, and submission. 

15 (c) PLAN DESCRIBED.— 

16 (1) IN GENERAL.—Each country or regional 

17 health development implementation plan developed 

18 under subsection (a) shall be a country- or regional19 level operational plan— 

20 (A) for supporting the health goals of the 

21 host country or countries; and 

22 (B) for ensuring that the national security 

23 priorities of the United States are met. 

24 (2) CONTENTS.—Each country or regional 

25 health development implementation plan developed 

26 under subsection (a) shall include— 


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1 (A) a comprehensive assessment of the 

2 health sector in the applicable country or re3 gion, including the strengths and weaknesses of 

4 the health system; 

5 (B) an analysis of the key funders and 

6 stakeholders within the health system; 

7 (C) a plan of action with milestones de8 scribing how global health activities will be im9 plemented during the period covered by the 

10 country or regional health development imple11 mentation plan; 

12 (D) health links to non-health-related ac13 tivities, such as military assistance and infra14 structure projects; 

15 (E) metrics for measuring the impact of 

16 the plan; 

17 (F) opportunities for increased engagement 

18 of the United States and any consequences of 

19 failing to increase engagement; 

20 (G) a determination of the role of each 

21 agency in the execution of the plan; 

22 (H) a request for resources needed to en23 sure— 

24 (i) the success of the plan; and 


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1 (ii) the sustainability of the health 

2 sector of the host country; and 

3 (I) such other content as the Committee 

4 considers appropriate. 

5 (3) OBJECTIVES.—Each country health devel6 opment implementation plan shall— 

7 (A) align with and support the Integrated 

8 Country Strategy and the Mission Resource Re9 quest for the country; and 

10 (B) align the President’s Emergency Plan 

11 for AIDS Relief (commonly known as 

12 ‘‘PEPFAR’’) and all other global health plans 

13 of the United States Government with the over14 all goals of the country or region— 

15 (i) to mitigate redundancy of re16 sources; and 

17 (ii) to improve the impact of efforts. 

18 (d) SUBMISSION; UPDATES.— 

19 (1) SUBMISSION TO CHIEF OF MISSION.—Not 

20 later than 270 days after a global health attache ́ is 

21 first posted to a country or region, the global health 

22 attache ́ shall submit a country or regional health de23 velopment implementation plan developed under sub24 section (a) to the appropriate chief of mission. 


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1 (2) APPROVAL; SUBMISSION TO COMMITTEE.— 

2 If the chief of mission approves the plan submitted 

3 under paragraph (1), the chief of mission shall sub4 mit the plan to the Committee. 

5 (3) UPDATES.—Not less frequently than once 

6 every 2 years, the country or regional health team 

7 shall update the country or regional health develop8 ment implementation plan. 

9 (e) HEALTH DEVELOPMENT PARTNERS WORKING

10 GROUP.— 

11 (1) IN GENERAL.—Not later than 180 days 

12 after a global health attache ́ is first posted to a 

13 country or region, the country or regional health 

14 team shall establish a health development partners 

15 working group in each country or region with a glob16 al health attache ́ to support implementation of coun17 try or regional health development implementation 

18 plans and to improve synergy with respect to such 

19 implementation. 

20 (2) MEMBERSHIP.—Each working group estab21 lished pursuant to paragraph (1) shall be composed 

22 of representatives from— 

23 (A) the country or regional health team; 

24 (B) civil society partners of the United 

25 States; 


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1 (C) international organizations to which 

2 the United States provides funding; 

3 (D) the government of each host country; 

4 and 

5 (E) one or more allied partners of the 

6 United States, as the chief of mission considers 

7 appropriate. 

8 (f) INTEGRATION OF GLOBAL HEALTH ACTIVI9 TIES.—The country or regional health team in each coun10 try or region with a global health attache ́ shall integrate 

11 global health activities within the country or region with 

12 other development programs and activities, as appro13 priate— 

14 (1) to advance the interests of the United 

15 States; and 

16 (2) to create sustainable capacity for the host 

17 country or region. 

18 SEC. 9. AUTHORIZATION OF APPROPRIATIONS. 

19 There are authorized to be appropriated such sums 

20 as may be necessary to carry out this Act. 

Æ 


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