II 

116TH CONGRESS 

2D SESSION S. 3829 

To advance the global health security and diplomacy objectives of the United 

States, improve coordination among the relevant Federal departments 

and agencies implementing United States foreign assistance for global 

health security, and more effectively enable partner countries to strengthen and sustain resilient health systems and supply chains with the 

resources, capacity, and personnel required to prevent, detect, mitigate, 

and respond to infectious disease threats before they become pandemics, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 21, 2020 

Mr. RISCH (for himself, Mr. MURPHY, and Mr. CARDIN) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To advance the global health security and diplomacy objectives of the United States, improve coordination among 

the relevant Federal departments and agencies implementing United States foreign assistance for global 

health security, and more effectively enable partner countries to strengthen and sustain resilient health systems 

and supply chains with the resources, capacity, and personnel required to prevent, detect, mitigate, and respond 

to infectious disease threats before they become 

pandemics, and for other purposes. 


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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 Security 

5 and Diplomacy Act of 2020’’. 

6 SEC. 2. DEFINITIONS. 

7 In this Act: 

8 (1) APPROPRIATE CONGRESSIONAL COMMIT9 TEES.—The term ‘‘appropriate congressional com10 mittees’’ means— 

11 (A) the Committee on Foreign Relations 

12 and the Committee on Appropriations of the 

13 Senate; and 

14 (B) the Committee on Foreign Affairs and 

15 the Committee on Appropriations of the House 

16 of Representatives. 

17 (2) GLOBAL HEALTH SECURITY AGENDA.—The 

18 term ‘‘Global Health Security Agenda’’ means the 

19 multi-sectoral initiative launched in 2014 and re20 newed in 2017 that brings together countries, re21 gions, international organizations, nongovernmental 

22 organizations, and the private sector to elevate glob23 al health security as a national-level priority, share 

24 best practices, and facilitate national capacity to 

25 comply with and adhere to the World Health OrgaVerDate Sep 11 2014 03:31 Jun 17, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3829.IS S3829

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1 nization International Health Regulations, the World 

2 Organization for Animal Health international stand3 ards and guidelines, United Nations Security Coun4 cil Resolution 1540 (2004), the Biological Weapons 

5 Convention, and other relevant frameworks that con6 tribute to global health security. 

7 (3) GLOBAL HEALTH SECURITY AGENDA JOINT

8 EXTERNAL EVALUATION.—The term ‘‘Global Health 

9 Security Agenda Joint External Evaluation’’ means 

10 the voluntary, collaborative, multi-sectoral process to 

11 assess country capacity to prevent, detect, and rap12 idly respond to public health risks occurring natu13 rally or due to deliberate or accidental events, assess 

14 progress in achieving the targets under the World 

15 Health Organization International Health Regula16 tions, and recommend priority actions. 

17 (4) GLOBAL HEALTH SECURITY INDEX.—The 

18 term ‘‘Global Health Security Index’’ means the 

19 comprehensive assessment and benchmarking of 

20 health security and related capabilities across the 

21 195 countries that make up the States Parties to 

22 the World Health Organization International Health 

23 Regulations. 

24 (5) KEY STAKEHOLDERS.—The term ‘‘key 

25 stakeholders’’ means actors engaged in efforts to adVerDate Sep 11 2014 03:39 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3829.IS S3829

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1 vance global health security programs and objectives, 

2 including— 

3 (A) national and local governments in 

4 partner countries; 

5 (B) other bilateral donors; 

6 (C) international and regional organiza7 tions; 

8 (D) international, regional, and local finan9 cial institutions; 

10 (E) international, regional, and local pri11 vate voluntary, nongovernmental, faith-based, 

12 and civil society organizations; 

13 (F) representatives of historically margin14 alized groups, including women and youth; 

15 (G) the private sector, including medical 

16 device, technology, and pharmaceutical compa17 nies; and 

18 (H) public and private research and aca19 demic institutions. 

20 (6) ONE HEALTH APPROACH.—The term ‘‘One 

21 Health approach’’ means the collaborative, multi-sec22 toral, and transdisciplinary approach toward achiev23 ing optimal health outcomes in a manner that recog24 nizes the interconnection between people, animals, 

25 plants, and their shared environment. 


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1 (7) RELEVANT FEDERAL DEPARTMENTS AND

2 AGENCIES.—The term ‘‘relevant Federal depart3 ments and agencies’’ means any Federal department 

4 or agency operating under Chief of Mission author5 ity and implementing United States foreign assist6 ance relevant to the advancement of United States 

7 global health security and diplomacy overseas, which 

8 may include— 

9 (A) the Department of State; 

10 (B) the United States Agency for Inter11 national Development; 

12 (C) the Department of Health and Human 

13 Services; 

14 (D) the Centers for Disease Control and 

15 Prevention; 

16 (E) the National Institutes of Health; 

17 (F) the Department of the Treasury; 

18 (G) the Department of Defense; 

19 (H) the Defense Threat Reduction Agency; 

20 (I) the Millennium Challenge Corporation; 

21 (J) the Development Finance Corporation; 

22 (K) the Peace Corps; and 

23 (L) any other department or agency that 

24 the President determines to be relevant for 

25 these purposes. 


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1 SEC. 3. PURPOSE. 

2 The purpose of this Act is to advance the global 

3 health security and diplomacy objectives of the United 

4 States, improve coordination among the relevant Federal 

5 departments and agencies implementing United States 

6 foreign assistance for global health security, and more ef7 fectively enable partner countries to strengthen and sus8 tain resilient health systems and supply chains with the 

9 resources, capacity, and personnel required to prevent, de10 tect, mitigate, and respond to infectious disease threats 

11 before they become pandemics by— 

12 (1) establishing a comprehensive United States 

13 Global Health Security Strategy with a One Health 

14 approach and clear goals, objectives, and bench15 marks, as well as instruments to monitor and evalu16 ate outputs and outcomes, measure impact, and 

17 share data and learning; 

18 (2) establishing a mechanism to coordinate 

19 United States global health security policies, activi20 ties, and assistance, including efforts to advance the 

21 United States Global Health Security Strategy and 

22 the Global Health Security Agenda, while fully uti23 lizing the unique capabilities of the relevant Federal 

24 departments and agencies; 

25 (3) coordinating with key stakeholders and sup26 porting partner country efforts to strengthen and 


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1 sustain more resilient health systems and supply 

2 chains; 

3 (4) accelerating progress under the United 

4 States Global Health Security Strategy, the Global 

5 Health Security Agenda, the World Health Organi6 zation International Health Regulations, and other 

7 relevant frameworks that contribute to global health 

8 security; 

9 (5) enhancing support for innovation and pub10 lic-private partnerships for research, development, 

11 and deployment of effective and affordable disease 

12 tracking tools, diagnostics, therapeutics, and vac13 cines; 

14 (6) authorizing appropriations to advance the 

15 United States Global Health Security Strategy and 

16 provide for a global health security emergency re17 serve; and 

18 (7) authorizing the Secretary of State, in co19 ordination with the Secretary of the Treasury, to 

20 enter into negotiations for the establishment of the 

21 Trust Fund for Global Health Security. 


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1 TITLE I—UNITED STATES GLOB2 AL HEALTH SECURITY STRAT3 EGY AND ASSISTANCE 

4 SEC. 101. PARTNER COUNTRY DEFINED. 

5 In this title, the term ‘‘partner country’’ means a 

6 country in which the relevant Federal departments and 

7 agencies are implementing United States foreign assist8 ance for global health security under this Act. 

9 SEC. 102. GLOBAL HEALTH SECURITY STRATEGY. 

10 (a) GENERAL.—The President shall maintain and ad11 vance a comprehensive strategy with a One Health ap12 proach toward advancing the global health security and 

13 diplomacy objectives of the United States overseas, which 

14 shall— 

15 (1) seek to strengthen United States diplomatic 

16 leadership and improve the effectiveness of United 

17 States foreign assistance for global health security to 

18 prevent, detect, and respond to infectious disease 

19 threats, including through advancement of the Glob20 al Health Security Agenda; 

21 (2) establish specific and measurable goals, 

22 benchmarks, timetables, performance metrics, and 

23 monitoring and evaluation plans for United States 

24 foreign assistance for global health security that pro25 mote learning and reflect international best practices 


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1 relating to global health security, transparency, and 

2 accountability; 

3 (3) establish mechanisms to improve coordina4 tion and performance by the relevant Federal de5 partments and agencies, including by setting out 

6 clear roles and responsibilities that reflect the 

7 unique capabilities and resources of each such de8 partment and agency; 

9 (4) establish mechanisms to improve coordina10 tion and avoid duplication of effort among the rel11 evant Federal departments and agencies, partner 

12 countries, donor countries, multilateral organiza13 tions, and other key stakeholders; 

14 (5) prioritize working with partner countries 

15 with low scores on the Global Health Security Index 

16 classification of health systems and on the Global 

17 Health Security Agenda Joint External Evaluation; 

18 (6) reduce long-term reliance upon United 

19 States foreign assistance for global health security 

20 by promoting partner country ownership, improved 

21 domestic resource mobilization, co-financing, and ap22 propriate national budget allocations for global 

23 health security and pandemic preparedness and re24 sponse; 


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1 (7) assist partner countries in building the tech2 nical capacity of relevant ministries to prepare, exe3 cute, monitor, and evaluate effective national action 

4 plans for health security, including mechanisms to 

5 enhance budget and global health data transparency, 

6 as necessary and appropriate; 

7 (8) align United States foreign assistance for 

8 global health security with partner country national 

9 action plans for health security, developed with input 

10 from key stakeholders, to the greatest extent prac11 ticable and appropriate; 

12 (9) create linkages between complementary bi13 lateral and multilateral foreign assistance programs 

14 that contribute to the development of more resilient 

15 health systems and supply chains in partner coun16 tries with the capacity, resources, and personnel re17 quired to prevent, detect, and respond to infectious 

18 disease threats; 

19 (10) support innovation and public-private part20 nerships to improve pandemic preparedness and re21 sponse, including for the development and deploy22 ment of effective infectious disease tracking tools, 

23 diagnostics, therapeutics, and vaccines; 


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1 (11) support collaboration with and among rel2 evant public and private research entities engaged in 

3 global health security; and 

4 (12) support collaboration between United 

5 States universities and public and private institu6 tions in partner countries that promote global health 

7 security and innovation. 

8 (b) FISCAL YEAR 2021 COMPLIANCE.—The United 

9 States Global Health Security Strategy, published on May 

10 9, 2019, in compliance with section 7058(c)(3) of the De11 partment of State, Foreign Operations, and Related Pro12 grams Appropriations Act, 2020 (division K of Public Law 

13 115–141), shall be deemed to comply with the requirement 

14 under this section for fiscal year 2021. 

15 (c) STRATEGY UPDATES.— 

16 (1) IN GENERAL.—Concurrent with the submis17 sion of the report required by section 634 of the 

18 Foreign Assistance Act of 1961 (22 U.S.C. 2394) 

19 for fiscal years 2022 through 2025, the President, 

20 in consultation with the head of each relevant Fed21 eral department and agency, shall submit to the ap22 propriate congressional committees updates to the 

23 United States Global Health Security Strategy, in24 cluding the agency-specific plans required under 

25 paragraph (2). 


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1 (2) AGENCY-SPECIFIC PLANS.—The strategy 

2 updates required under this subsection shall include 

3 specific implementation plans from each relevant 

4 Federal department and agency that describe— 

5 (A) the anticipated staffing plans and con6 tributions of the department or agency, includ7 ing technical, financial, and in-kind contribu8 tions, to implement the strategy; and 

9 (B) the efforts of the department or agen10 cy to ensure that the activities and programs 

11 carried out pursuant to the strategy are de12 signed to achieve maximum impact and long13 term results. 

14 SEC. 103. GLOBAL HEALTH SECURITY COORDINATION. 

15 (a) ESTABLISHMENT.—There is established within 

16 the Department of State a Coordinator of United States 

17 Government Activities to Advance Global Health Security 

18 and Diplomacy overseas, who shall be appointed by the 

19 President, by and with the advice and consent of the Sen20 ate. 

21 (b) AUTHORITIES.—The Coordinator is authorized 

22 to— 

23 (1) operate internationally to carry out the pur24 poses of this Act; 


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1 (2) transfer and allocate United States foreign 

2 assistance resources for global health security to the 

3 relevant Federal departments and agencies, in co4 ordination with the Office of Management and 

5 Budget, the United States Agency for International 

6 Development, and the Department of State Office of 

7 Foreign Assistance Resources; and 

8 (3) utilize open and streamlined solicitations to 

9 allow for the participation of a wide range of imple10 menting partners through the most appropriate pro11 curement mechanisms, which may include grants, 

12 contracts, cooperative agreements, and other instru13 ments as necessary and appropriate. 

14 (c) DUTIES.—The Coordinator shall have primary re15 sponsibility for the coordination, management, and over16 sight of United States diplomatic efforts and foreign as17 sistance resources to advance the relevant elements of the 

18 United States Global Health Security Strategy under sec19 tion 102 and the duties described under subsection (f)(2), 

20 including the international programs, projects, and activi21 ties of the United States Government relating to the Glob22 al Health Security Agenda and the Trust Fund for Global 

23 Health Security established under title II, including— 


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1 (1) ensuring effective program coordination and 

2 implementation by the relevant Federal departments 

3 and agencies, including by— 

4 (A) managing the budget and planning of 

5 United States foreign assistance resources au6 thorized to be appropriated or otherwise made 

7 available to carry out the purposes of chapters 

8 1 and 10 of part I and chapter 4 of part II of 

9 the Foreign Assistance Act of 1961 (22 U.S.C. 

10 2151 et seq.) relating to infectious disease pre11 vention, detection, mitigation, and response, in12 cluding efforts to enable partner countries to 

13 strengthen and sustain resilient health systems 

14 and supply chains; 

15 (B) formulating, issuing, and updating re16 lated program guidance; 

17 (C) establishing unified auditing, moni18 toring, and evaluation plans; 

19 (D) aligning resources and implementation 

20 plans under the strategy with the relevant Fed21 eral departments and agencies with the greatest 

22 expertise, technical capabilities, comparative ad23 vantage, and potential for success; 

24 (E) working with and leveraging the exper25 tise and activities of the Office of the Global 


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1 AIDS Coordinator, the President’s Malaria Co2 ordinator, and similar or successor entities im3 plementing United States global health assist4 ance overseas; and 

5 (F) avoiding duplication of effort and 

6 working to resolve policy, program, and funding 

7 disputes among the relevant Federal depart8 ments and agencies; 

9 (2) leading diplomatic efforts to address current 

10 and emerging threats to global health security; 

11 (3) ensuring effective representation of the 

12 United States in relevant international forums, in13 cluding at the World Health Assembly and meetings 

14 of the Global Health Security Agenda, in coordina15 tion with the Secretary of the Department of Health 

16 and Human Services, as necessary and appropriate; 

17 (4) promoting greater donor and partner coun18 try investment in building more resilient health sys19 tems and supply chains, including through represen20 tation and participation in a multilateral trust fund 

21 for global health security, consistent with title II; 

22 (5) working to enhance coordination with and 

23 transparency among partner countries and key 

24 stakeholders, including the private sector; and 


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1 (6) regularly updating the appropriate congres2 sional committees. 

3 (d) OTHER GLOBAL HEALTH ASSISTANCE.—This 

4 section shall not apply to funds authorized to be appro5 priated or otherwise made available to carry out the pur6 poses of chapters 1 and 10 of part I and chapter 4 of 

7 part II of the Foreign Assistance Act of 1961 (22 U.S.C. 

8 2151 et seq.) relating to global health that are— 

9 (1) apportioned directly to the Department of 

10 State to carry out programs authorized pursuant to 

11 the United States Leadership Against HIV/AIDS, 

12 Tuberculosis, and Malaria Act of 2003 (Public Law 

13 108–25); or 

14 (2) apportioned directly to the United States 

15 Agency for International Development to carry out 

16 programs that are not directly related to new or 

17 emerging infectious disease threats. 

18 (e) UNITED STATES AGENCY FOR INTERNATIONAL

19 DEVELOPMENT.—The Coordinator should be supported 

20 by a deputy, who should be an employee of the United 

21 States Agency for International Development serving in 

22 a career or noncareer position in the Senior Executive 

23 Service or at the level of a Deputy Assistant Administrator 

24 or higher, who serves concurrently as the deputy and perVerDate Sep 11 2014 03:39 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S3829.IS S3829

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1 forms the functions ascribed to the agency by section 3(b) 

2 of Executive Order 13747 of November 4, 2016. 

3 (f) SENSE OF CONGRESS.—It is the sense of Con4 gress that— 

5 (1) Executive Order 13474 of November 4, 

6 2016, and the United States Global Health Security 

7 Strategy, delivered to Congress on May 9, 2019, set 

8 out leadership and interagency coordinating roles for 

9 the National Security Council relating to global 

10 health security and the Global Health Security 

11 Agenda; 

12 (2) the Coordinator should perform the func13 tions in Executive Order 13747 ascribed to the De14 partment of State in section 3(b) of such executive 

15 order; 

16 (3) the Interagency Review Council described in 

17 Executive Order 13747 should perform the functions 

18 ascribed to it in section 2 of such executive order; 

19 and 

20 (4) the President should consider appointing an 

21 individual serving on the National Security Council, 

22 at the senior director level or higher and with sig23 nificant background and expertise in public health, 

24 health security, or emergency biological response 

25 management, to convene and coordinate— 


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1 (A) the interagency process of the Federal 

2 departments and agencies implementing the 

3 functions described in section 3 of Executive 

4 Order 13747; and 

5 (B) the interagency process to ensure con6 tinuity of effort across the Federal departments 

7 and agencies engaged in domestic and inter8 national global health security preparedness and 

9 response. 

10 SEC. 104. GLOBAL HEALTH EMERGENCIES. 

11 In responding to an international infectious disease 

12 outbreak that is sustained, severe, and is spreading inter13 nationally, which may include a declaration under the 

14 World Health Organization International Health Regula15 tions of a Public Health Emergency of International Con16 cern overseas— 

17 (1) the Secretary of State, acting through the 

18 Coordinator of United States Government Activities 

19 to Advance Global Health Security and Diplomacy, 

20 as appropriate, shall be represented at all relevant 

21 interagency meetings and lead United States diplo22 matic and coordination efforts with the relevant 

23 international organizations and key stakeholders; 

24 and 


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1 (2) the Administrator of the United States 

2 Agency for International Development shall be rep3 resented at all relevant interagency meetings and 

4 serve as the program lead on international emer5 gency humanitarian response, as well efforts to ad6 dress second order development impacts of such an 

7 emergency within partner countries. 

8 SEC. 105. USAID DISASTER SURGE CAPACITY. 

9 (a) IN GENERAL.—Funds authorized to be appro10 priated or otherwise made available to carry out part I 

11 of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 

12 et seq.), including funds made available for ‘‘Assistance 

13 for Europe, Eurasia and Central Asia’’, may be used, in 

14 addition to funds otherwise made available for such pro15 poses, for the cost (including support costs) of individuals 

16 detailed to or employed by the United States Agency for 

17 International Development whose primary responsibility is 

18 to carry out programs in response to global health emer19 gencies and natural or man-made disasters. 

20 (b) NOTIFICATION.—The Administrator shall notify 

21 the appropriate congressional committees not later than 

22 15 days before making funds available under this section. 


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1 SEC. 106. AUTHORIZATION FOR UNITED STATES PARTICI2 PATION IN COALITION FOR EPIDEMIC PRE3 PAREDNESS INNOVATIONS. 

4 (a) IN GENERAL.—The United States is authorized 

5 to participate in the Coalition for Epidemic Preparedness 

6 Innovations (CEPI). 

7 (b) BOARD OF DIRECTORS.—The Administrator of 

8 the United States Agency for International Development 

9 is authorized to designate an employee of such agency to 

10 serve on the Investors Council of CEPI as a representative 

11 of the United States. 

12 (c) CONSULTATION.—Not later than 60 days after 

13 the date of the enactment of this Act, the Secretary shall 

14 consult with the appropriate congressional committees 

15 on— 

16 (1) the manner and extent to which the United 

17 States plans to participate in CEPI, including 

18 through governance of CEPI; 

19 (2) any planned financial contributions to 

20 CEPI; and 

21 (3) how participation in CEPI is expected to 

22 support the United States Global Health Security 

23 Strategy and any other relevant programs relating 

24 to global health security and biodefense. 

25 (d) UNITED STATES CONTRIBUTIONS.—The Presi26 dent is authorized to make available funds authorized to 


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1 be appropriated under section 107 for United States con2 tributions to CEPI. 

3 (e) NOTIFICATION.—Not later than 15 days before 

4 making a contribution to CEPI, the Secretary of State 

5 shall notify the appropriate congressional committees of 

6 the amount, purposes, and national interests served by 

7 such planned contribution. 

8 SEC. 107. AUTHORIZATIONS OF APPROPRIATIONS. 

9 (a) IN GENERAL.—There is authorized to be appro10 priated, for fiscal years 2021 through 2025, 

11 $3,000,000,000 to advance the Global Health Security 

12 Strategy of the United States overseas, including support 

13 for— 

14 (1) the Emergency Reserve Fund established 

15 pursuant to section 7058(c)(1) of the Department of 

16 State, Foreign Operations, and Related Programs 

17 Appropriations Act, 2017 (division J of Public Law 

18 115–31) to address emerging global health threats; 

19 and 

20 (2) United States contributions to the Fund es21 tablished under title II of this Act. 

22 (b) EXCEPTION.—Section 110 of the Trafficking Vic23 tims Protection Act of 2000 (22 U.S.C. 7107) shall not 

24 apply to assistance made available pursuant to this sec25 tion. 


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1 (c) APPLICABILITY.—Section 104(f) of the Foreign 

2 Assistance Act of 1961 (22 U.S.C. 2151b(f)) shall apply 

3 to assistance made available pursuant to this section. 

4 TITLE II—TRUST FUND FOR 

5 GLOBAL HEALTH SECURITY 

6 SEC. 201. DEFINITION. 

7 In this title, the term ‘‘partner country’’ means a de8 veloping country with demonstrated need and commitment 

9 to transparency, including budget and global health data 

10 transparency, in which the Trust Fund for Global Health 

11 Security established under section 202 is working to de12 sign, implement, and evaluate global health security assist13 ance programs under this Act. 

14 SEC. 202. ESTABLISHMENT OF TRUST FUND FOR GLOBAL 

15 HEALTH SECURITY. 

16 (a) NEGOTIATIONS FOR ESTABLISHMENT OF A

17 TRUST FUND FOR GLOBAL HEALTH SECURITY.—The 

18 Secretary of State should seek to enter into negotiations 

19 with the World Bank or the International Development 

20 Association, in coordination with the Secretary of the 

21 Treasury, the Administrator of the United States Agency 

22 for International Development, and the heads of other rel23 evant Federal departments and agencies, and with the 

24 member nations of the World Bank or the International 


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1 Development Association and with other interested par2 ties, for the establishment within the World Bank of— 

3 (1) a Trust Fund for Global Health Security 

4 (in this subtitle referred to as ‘‘the Fund’’) in ac5 cordance with the provisions of this section; and 

6 (2) an Advisory Board to the Fund in accord7 ance with section 205. 

8 (b) PURPOSE.—The purpose of the Fund should be 

9 to advance global health security by catalyzing public and 

10 private investments in global health security, infectious 

11 disease control, and pandemic preparedness and response 

12 in developing countries with demonstrated need, commit13 ment to transparency, including budget and global health 

14 data transparency, and evidence-based outcomes. 

15 (c) COMPOSITION.— 

16 (1) IN GENERAL.—The Fund should be gov17 erned by a Board of Trustees, to be composed of 

18 representatives of World Bank member states that 

19 are donors and participants in the Fund. The Board 

20 of Trustees should include— 

21 (A) 5 permanent member countries, who 

22 qualify based upon meeting an established ini23 tial contribution threshold, which should be not 

24 less than 10 percent of total contributions, and 

25 by meeting minimum standards for upholding 


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1 the International Health Regulations, and who 

2 should hold veto power over programs and 

3 projects; 

4 (B) 5 term members, who are selected by 

5 the permanent members on the basis of their 

6 commitment to innovation, best practices, and 

7 the advancement of global health security objec8 tives in partner countries; and 

9 (C) 9 developing country members, who 

10 serve a period term, and who demonstrate a 

11 commitment to prioritizing global health secu12 rity for their citizens and to the purposes and 

13 principles of the Fund. 

14 (2) QUALIFICATIONS.—Individuals appointed to 

15 the Board shall have demonstrated knowledge and 

16 experience in the fields of public health, epidemi17 ology, supply chain management, health delivery sys18 tems, and development. 

19 (3) UNITED STATES REPRESENTATION.— 

20 (A) IN GENERAL.— 

21 (i) FOUNDING PERMANENT MEM22 BER.—The Secretary of State shall seek to 

23 establish the United States as a founding 

24 permanent member of the Fund. 


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1 (ii) COORDINATOR OF UNITED STATES

2 GOVERNMENT ACTIVITIES TO ADVANCE

3 GLOBAL HEALTH SECURITY.—The United 

4 States shall be represented on the Board 

5 of Trustees by the Coordinator of United 

6 States Government Activities to Advance 

7 Global Health Security and Diplomacy es8 tablished under section 103. 

9 (B) EFFECTIVE AND TERMINATION

10 DATES.— 

11 (i) EFFECTIVE DATE.—This para12 graph shall take effect upon the date the 

13 Secretary of State, in coordination with the 

14 Secretary of the Treasury, certifies and 

15 transmits to Congress an agreement estab16 lishing the Fund. 

17 (ii) TERMINATION DATE.—The mem18 bership established pursuant to subpara19 graph (A) shall terminate upon the date of 

20 termination of the Fund. 

21 (4) REMOVAL PROCEDURES.—The Fund shall 

22 establish procedures for the removal of members of 

23 the Board who engage in a consistent pattern of 

24 human rights abuses, fail to uphold global health 


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1 data transparency requirements, or otherwise violate 

2 the established standards of the Fund. 

3 SEC. 203. GRANT AUTHORITIES. 

4 (a) PROGRAM OBJECTIVES.— 

5 (1) IN GENERAL.—In carrying out the purpose 

6 set forth in section 202(b), the Fund, acting through 

7 the Board of Trustees, should provide grants, in8 cluding challenge grants, technical assistance, 

9 concessional lending, catalytic investment funds, and 

10 other innovative funding mechanisms, as appro11 priate, to support measures that enable developing 

12 countries, at both national and sub-national levels, 

13 and in partnership with civil society and the private 

14 sector, to strengthen and sustain resilient health sys15 tems and supply chains with the resources, capacity, 

16 and personnel required to prevent, detect, mitigate, 

17 and respond to infectious disease threats before they 

18 become pandemics. 

19 (2) ACTIVITIES SUPPORTED.—Activities to be 

20 supported by the Fund should include efforts to— 

21 (A) enable partner countries with low 

22 scores on the Global Health Security Index 

23 classification of health systems and on the 

24 Global Health Security Agenda Joint External 

25 Evaluation to improve such scores and adopt 


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1 and uphold commitments under the Global 

2 Health Security Agenda, the World Health Or3 ganization International Health Regulations, 

4 and other related international health agree5 ments; 

6 (B) support global health budget and 

7 workforce planning in partner countries, includ8 ing training in financial management and budg9 et and global health data transparency; 

10 (C) advance research, development, and 

11 deployment of effective infectious disease track12 ing tools, diagnostics, therapeutics, and vac13 cines, including by establishing and leveraging 

14 public-private partnerships and supporting ad15 vance purchase agreements, as necessary and 

16 appropriate; 

17 (D) improve infection control within 

18 healthcare settings; 

19 (E) combat the threat of antimicrobial re20 sistance; 

21 (F) expand lab capacity through the provi22 sion of material and technical assistance; 

23 (G) build technical capacity to manage 

24 global health supply chains through effective 

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1 livery from central warehouses to points of serv2 ice; 

3 (H) enable bilateral and regional partner4 ships and cooperation to identify and address 

5 transnational infectious disease threats exacer6 bated by natural and man-made disasters, 

7 human displacement, and zoonotic infection; 

8 (I) establish partnerships to develop med9 ical interventions to detect, treat, and prevent 

10 the spread of neglected tropical diseases; 

11 (J) build the technical capacity of partner 

12 countries to prepare for and respond to second 

13 order development impacts of infectious disease 

14 outbreaks, while accounting for the differen15 tiated needs and vulnerabilities of marginalized 

16 populations; 

17 (K) develop and utilize metrics to monitor 

18 and evaluate program performance and identify 

19 best practices; and 

20 (L) develop and deploy mechanisms to en21 hance the transparency and accountability of 

22 global health security programs and data, in23 cluding through the sharing of trends, risks, 

24 and lessons learned. 


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1 (3) IMPLEMENTATION OF PROGRAM OBJEC2 TIVES.—In carrying out the objectives of paragraph 

3 (1), the Fund shall work to eliminate duplication 

4 and waste by upholding strict transparency and ac5 countability standards and coordinating its programs 

6 and activities with key partners working to advance 

7 global health security, including, at a minimum— 

8 (A) governments, civil society and non9 governmental organizations, research and aca10 demic institutions, and private sector entities in 

11 partner countries; 

12 (B) the Global Health Security Agenda; 

13 (C) the Global Fund to Fight AIDS, Tu14 berculosis, and Malaria; 

15 (D) the Vaccine Alliance, GAVI; 

16 (E) the Coalition for Epidemic Prepared17 ness Innovations (CEPI); 

18 (F) the Global Polio Eradication Initiative; 

19 and 

20 (G) the Coordinator of United States Gov21 ernment Activities to Advance Global Health 

22 Security and Diplomacy, established pursuant 

23 to section 103. 

24 (b) PRIORITY.—In providing assistance under this 

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1 middle income countries, as classified in the most recent 

2 edition of the World Development Report for Reconstruc3 tion and Development published by the International 

4 Bank for Reconstruction and Development, with low 

5 scores on the Global Health Security Index classification 

6 of health systems and on the Global Health Security Agen7 da Joint External Evaluation, and demonstrated commit8 ment to upholding global health budget and data trans9 parency and accountability standards and investing in 

10 their own health systems. 

11 (c) ELIGIBLE GRANT RECIPIENTS.—Governments 

12 and nongovernmental organizations should be eligible to 

13 receive grants under this section. 

14 SEC. 204. ADMINISTRATION. 

15 (a) APPOINTMENT OF AN ADMINISTRATOR.—The 

16 Board of Trustees, in consultation with the appropriate 

17 officials of the Bank, should appoint an Administrator 

18 who should be responsible for managing the day-to-day op19 erations of the Fund. 

20 (b) AUTHORITY TO SOLICIT AND ACCEPT CONTRIBU21 TIONS.—The Fund should be authorized to solicit and ac22 cept contributions from governments, the private sector, 

23 and nongovernmental entities of all kinds. 

24 (c) ACCOUNTABILITY OF FUNDS AND CRITERIA FOR

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1 tion 202(a), the Secretary of the State, in coordination 

2 with the Secretary of the Treasury, shall, consistent with 

3 subsection (d)— 

4 (1) take such actions as are necessary to ensure 

5 that the Bank or the Association will have in effect 

6 adequate procedures and standards to account for 

7 and monitor the use of funds contributed to the 

8 Fund, including the cost of administering the Fund; 

9 and 

10 (2) seek agreement on the criteria that should 

11 be used to determine the programs and activities 

12 that should be assisted by the Fund. 

13 (d) SELECTION OF PARTNER COUNTRIES, PROJECTS, 

14 AND RECIPIENTS.—The Board of Trustees should estab15 lish— 

16 (1) partner country selection criteria, to include 

17 transparent metrics to measure and assess global 

18 health security strengths and vulnerabilities in devel19 oping countries seeking assistance; 

20 (2) minimum standards for ensuring partner 

21 country ownership and commitment to long-term re22 sults, including requirements for domestic budgeting, 

23 resource mobilization, and co-investment; 

24 (3) criteria for the selection of projects to re25 ceive support from the Fund; 


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1 (4) standards and criteria regarding qualifica2 tions of recipients of such support; 

3 (5) such rules and procedures as may be nec4 essary for cost-effective management of the Fund; 

5 and 

6 (6) such rules and procedures as may be nec7 essary to ensure transparency and accountability in 

8 the grant-making process. 

9 (e) ADDITIONAL TRANSPARENCY AND ACCOUNT10 ABILITY REQUIREMENTS.— 

11 (1) INSPECTOR GENERAL.— 

12 (A) IN GENERAL.—The Secretary of State 

13 shall ensure that the Fund maintains an inde14 pendent Office of the Inspector General and en15 sure that the office has the requisite resources 

16 and capacity to regularly conduct and publish, 

17 on a publicly accessible website, rigorous finan18 cial, programmatic, and reporting audits and 

19 investigations of the Fund and its grantees. 

20 (B) SENSE OF CONGRESS ON CORRUP21 TION.—It is the sense of Congress that— 

22 (i) corruption within global health 

23 programs contribute directly to the loss of 

24 human life and cannot be tolerated; and 


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1 (ii) in making financial recoveries re2 lating to a corrupt act or criminal conduct 

3 under a grant, as determined by the In4 spector General, the responsible grant re5 cipient should be assessed at a recovery 

6 rate of 150 percent of such loss. 

7 (2) ADMINISTRATIVE EXPENSES.—The Sec8 retary of State shall ensure the Fund establishes, 

9 maintains, and makes publicly available a system to 

10 track the administrative and management costs of 

11 the Fund on a quarterly basis. 

12 (3) GRANT TRACKING SYSTEMS.—The Sec13 retary of State shall ensure that the Fund estab14 lishes, maintains, and makes publicly available a sys15 tem to track the amount of funds disbursed to each 

16 grant recipient and sub-recipient during a grant’s 

17 fiscal cycle. 

18 (4) EXEMPTION FROM DUTIES AND TAXES.— 

19 The Secretary should ensure that the Fund adopts 

20 rules that condition grants upon agreement by the 

21 relevant national authorities in a partner country to 

22 exempt from duties and taxes all products financed 

23 by such grants, including procurements by any prin24 cipal or sub-recipient for the purpose of carrying out 

25 such grants. 


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1 SEC. 205. ADVISORY BOARD. 

2 (a) IN GENERAL.—There should be an Advisory 

3 Board to the Fund. 

4 (b) APPOINTMENTS.—The members of the Advisory 

5 Board should be composed of— 

6 (1) individuals with experience and leadership 

7 in the fields of development, global health, epidemi8 ology, medicine, biomedical research, and social 

9 sciences; and 

10 (2) representatives of relevant United Nations 

11 agencies and nongovernmental organizations with 

12 on-the-ground experience in implementing global 

13 health programs in low and lower-middle income 

14 countries. 

15 (c) RESPONSIBILITIES.—The Advisory Board should 

16 provide advice and guidance to the Board of Trustees on 

17 the development and implementation of programs and 

18 projects to be assisted by the Fund and on leveraging do19 nations to the Fund. 

20 (d) PROHIBITION ON PAYMENT OF COMPENSA21 TION.— 

22 (1) IN GENERAL.—Except for travel expenses 

23 (including per diem in lieu of subsistence), no mem24 ber of the Advisory Board should receive compensa25 tion for services performed as a member of the 

26 Board. 


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1 (2) UNITED STATES REPRESENTATIVE.—Not2 withstanding any other provision of law (including 

3 an international agreement), a representative of the 

4 United States on the Advisory Board may not accept 

5 compensation for services performed as a member of 

6 the Board, except that such representative may ac7 cept travel expenses, including per diem in lieu of 

8 subsistence, while away from the representative’s 

9 home or regular place of business in the perform10 ance of services for the Board. 

11 SEC. 206. REPORTS TO CONGRESS. 

12 (a) ANNUAL REPORT.— 

13 (1) IN GENERAL.—Not later than 1 year after 

14 the date of the enactment of this Act, and annually 

15 thereafter for the duration of the Fund, the Sec16 retary of State, in coordination with the Secretary of 

17 the Treasury, shall submit to the appropriate con18 gressional committees a report on the Fund. 

19 (2) REPORT ELEMENTS.—The report shall in20 clude a description of— 

21 (A) the goals of the Fund; 

22 (B) the programs, projects, and activities 

23 supported by the Fund; 

24 (C) private and governmental contributions 

25 to the Fund; and 


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1 (D) the criteria utilized to determine the 

2 programs and activities that should be assisted 

3 by the Fund. 

4 (b) GAO REPORT ON TRUST FUND EFFECTIVE5 NESS.—Not later than 2 years after the date that the 

6 Fund is formally established, the Comptroller General of 

7 the United States shall submit to the appropriate congres8 sional committees a report evaluating the effectiveness of 

9 the Fund, including— 

10 (1) the effectiveness of the programs, projects, 

11 and activities supported by the Fund; and 

12 (2) an assessment of the merits of continued 

13 United States participation in the Fund. 

14 SEC. 207. UNITED STATES CONTRIBUTIONS. 

15 (a) IN GENERAL.—Subject to submission of the cer16 tification under section 202(c)(3)(B)(i), the President is 

17 authorized to make available funds authorized to be appro18 priated pursuant to section 107 for United States con19 tributions to the Fund. 

20 (b) NOTIFICATION.—The Secretary of State shall no21 tify the appropriate congressional committees not later 

22 than 15 days in advance of making a contribution to the 

23 Fund, including— 

24 (1) the amount of the proposed contribution; 


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1 (2) the total of funds contributed by other do2 nors; and 

3 (3) the national interests served by United 

4 States participation in the Fund. 

5 (c) LIMITATION.—At no point during fiscal years 

6 2021 through 2025 shall a United States contribution 

7 cause the cumulative total of United States contributions 

8 to exceed 33 percent of the total contributions to the Fund 

9 from all sources. 

10 (d) WITHHOLDINGS.— 

11 (1) SUPPORT FOR ACTS OF INTERNATIONAL

12 TERRORISM.—If at any time the Secretary of State 

13 determines that the Fund has provided assistance to 

14 a country, the government of which the Secretary of 

15 State has determined, for purposes of section 620A 

16 of the Foreign Assistance Act of 1961 (22 U.S.C. 

17 2371) has repeatedly provided support for acts of 

18 international terrorism, the United States shall with19 hold from its contribution for the next fiscal year an 

20 amount equal to the amount expended by the Fund 

21 to the government of such country. 

22 (2) EXCESSIVE SALARIES.—If at any time dur23 ing any of the fiscal years 2021 through 2025, the 

24 Secretary of State determines that the salary of any 

25 individual employed by the Fund exceeds the salary 


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1 of the Vice President of the United States for that 

2 fiscal year, then the United States should withhold 

3 from its contribution for the next fiscal year an 

4 amount equal to the aggregate amount by which the 

5 salary of each such individual exceeds the salary of 

6 the Vice President of the United States. 

7 (3) ACCOUNTABILITY CERTIFICATION REQUIRE8 MENT.—The Secretary of State shall withhold not 

9 less than 20 percent of planned United States con10 tributions to the Fund until the Secretary certifies 

11 to the appropriate congressional committees that the 

12 Fund has established procedures to provide access 

13 by the Office of Inspector General of the Depart14 ment of State, as cognizant Inspector General, the 

15 Inspector General of the Department of Health and 

16 Human Services, and the Inspector General of the 

17 United States Agency for International Develop18 ment, to the Fund’s financial data and other infor19 mation relevant to United States contributions (as 

20 determined by the Inspector General, in consultation 

21 with the Secretary of State). 

Æ 


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