II 

118TH CONGRESS 

2D SESSION S. 5278 

To provide additional authorities for the leadership of the United States 

Agency for International Development in health technology innovation 

for global health in low-resource settings, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2024 

Mr. BOOKER introduced the following bill; which was read twice and referred 

to the Committee on Foreign Relations 

A BILL 

To provide additional authorities for the leadership of the 

United States Agency for International Development in 

health technology innovation for global health in lowresource settings, 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 TITLES; TABLE OF CONTENTS. 

4 (a) SHORT TITLES.—This Act may be cited as the 

5 ‘‘Supporting Innovative Global Health Technologies Act of 

6 2024’’ or the ‘‘SIGHT Act’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 


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Sec. 1. Short titles; table of contents. 

Sec. 2. Findings. 

Sec. 3. Statement of policy. 

Sec. 4. Definitions. 

Sec. 5. Chief Innovation Officer for Health. 

Sec. 6. Global Health Research and Development Advisory Council. 

Sec. 7. Global Health Research and Development program area activities and 

budget. 

Sec. 8. Grant program for expanded use of global health research and development. 

Sec. 9. Strategy and reports. 

1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) The United States Agency for International 

4 Development has— 

5 (A) a unique role in the research and de6 velopment of health technologies for global 

7 health that complements the work of other de8 partments and agencies of the United States 

9 Government; and 

10 (B) both an advantage and a unique man11 date for the development of health technologies 

12 to be used in low-resource settings. 

13 (2) It is in the national interest of the United 

14 States to build greater country capacity for research 

15 and development of new health technologies to be 

16 used in low- and middle-income countries. 

17 (3) Investments by the United States Govern18 ment in global health research and development 

19 should be coordinated with, and leverage investments 


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1 from, partner country governments, other govern2 ment donors, and the private sector. 

3 (4) Human immunodeficiency virus (HIV), tu4 berculosis (TB), malaria, neglected tropical diseases, 

5 emerging infectious diseases (such as COVID–19, 

6 Ebola, and Zika), and many other health conditions 

7 (such as complications in pregnancy) have a dis8 proportionate public health burden in low- and mid9 dle-income countries. 

10 (5) Health technologies that were developed for 

11 use in high-income countries often cannot be imple12 mented in low-resource settings in low- and middle13 income countries or require adaptation to be effec14 tive. 

15 (6) Due to poverty or low incidence, many ne16 glected tropical diseases and emerging infectious dis17 eases either lack or have limited commercial markets 

18 to drive health technology innovation. 

19 (7) Achieving the ambitious goals set through 

20 initiatives such as the President’s Emergency Plan 

21 for AIDS Relief (commonly referred to as 

22 ‘‘PEPFAR)’’ and the President’s Malaria Initiative 

23 (commonly referred to as ‘‘PMI’’) will not be pos24 sible without the development and scale-up of new 

25 health technologies designed for use in low-resource 


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1 settings, which are needed to address both long2 standing endemic diseases and prepare for potential 

3 pandemic threats. 

4 (8) Public funding has proven highly successful 

5 at incentivizing the development of health tech6 nologies for global health that are high-impact, ac7 cessible, and cost-saving. 

8 (9) COVID–19 has demonstrated the impor9 tance of global access to health technologies de10 signed for low-resource settings. 

11 (10) Support for the development of accessible 

12 health technologies for low-resource settings can 

13 have reciprocal value and produce tools that reduce 

14 health care costs, improve public health, and 

15 strengthen health security for the United States. 

16 (11) For decades, USAID has been a catalyst 

17 in the global health innovation ecosystem. While 

18 other Federal departments and agencies, including 

19 the National Institutes of Health, the Centers for 

20 Disease Control and Prevention, and the Depart21 ment of Defense, provide support for global health 

22 technologies, USAID is the only Federal agency that 

23 provides broad support for the late-stage develop24 ment of new health technologies to combat neglected 


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1 tropical diseases, emerging infectious diseases, and 

2 other health conditions for low-resource settings. 

3 (12) While the need for new tools to tackle dis4 ease threats has grown in recent years, investments 

5 by USAID in research and development have shrunk 

6 as a proportion of its overall global health spending 

7 and have been squeezed by stagnant budgets and 

8 growing needs. 

9 (13) Innovation at USAID is primarily sup10 ported from siloed disease- and population-specific 

11 appropriations accounts, resulting in the limitation 

12 of its ability to seek shared value across health sec13 tors or health threats. 

14 (14) USAID is compelled to prioritize support 

15 for immediate program needs with imperfect tools at 

16 the expense of support for technologies that can im17 prove clinical effectiveness, increase access to care, 

18 save costs, and build capacity and ownership by 

19 partner countries. 

20 SEC. 3. STATEMENT OF POLICY. 

21 It is the policy of the United States that— 

22 (1) research and development for new health 

23 technologies— 


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1 (A) is essential for the success of the glob2 al health programs of the United States Gov3 ernment; and 

4 (B) provides for the improved effective5 ness, cost-effectiveness, and sustainability of 

6 such programs; and 

7 (2) funding and other support for global health 

8 research and development under this Act shall be 

9 additional and complementary to, and may not re10 place, displace, or otherwise compromise, funding 

11 otherwise provided for— 

12 (A) existing and ongoing global health re13 search and development of the United States 

14 Government; or 

15 (B) activities relating to the implementa16 tion of the global health programs of the United 

17 States Government. 

18 SEC. 4. DEFINITIONS. 

19 In this Act: 

20 (1) ADMINISTRATOR.—The term ‘‘Adminis21 trator’’ means the Administrator of the United 

22 States Agency for International Development. 

23 (2) APPROPRIATE CONGRESSIONAL COMMIT24 TEES.—The term ‘‘appropriate congressional com25 mittees’’ means— 


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1 (A) the Committee on Foreign Relations of 

2 the Senate; and 

3 (B) the Committee on Foreign Affairs of 

4 the House of Representatives. 

5 (3) GLOBAL HEALTH.—The term ‘‘global 

6 health’’ includes efforts to combat and prepare for— 

7 (A) neglected tropical diseases; 

8 (B) emerging infectious diseases; 

9 (C) antimicrobial resistance; and 

10 (D) any other condition that may not be 

11 easily treated, diagnosed, or prevented in low12 resource settings. 

13 (4) GLOBAL HEALTH RESEARCH AND DEVELOP14 MENT.—The term ‘‘global health research and devel15 opment’’ includes an activity, or the support for 

16 such an activity, related to research, development, 

17 testing, evaluation, deployment, or implementation 

18 of any new health technology. 

19 (5) HEALTH TECHNOLOGY.—The term ‘‘health 

20 technology’’— 

21 (A) means a vaccine, therapeutic, diag22 nostic, device, or other tool designed, modified, 

23 or adapted for use in low-resource settings to 

24 improve global health; and 


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1 (B) includes personal protective equipment 

2 and insecticide so used. 

3 (6) LOW-RESOURCE SETTING.—The term ‘‘low4 resource setting’’ means a location with limited or 

5 inconsistent access to running water, electricity, re6 frigeration, supply chains, lab services, medical 

7 equipment, trained health care personnel, or other 

8 resources important for global health. 

9 (7) USAID.—The term ‘‘USAID’’ means the 

10 United States Agency for International Develop11 ment. 

12 SEC. 5. CHIEF INNOVATION OFFICER FOR HEALTH. 

13 (a) ESTABLISHMENT.—There is established, within 

14 the USAID Bureau for Global Health, the position of 

15 Chief Innovation Officer for Health, which shall be classi16 fied at the level of Deputy Assistant Administrator or 

17 equivalent. 

18 (b) APPOINTMENT.—The Administrator shall appoint 

19 the Chief Innovation Officer for Health from among such 

20 individuals as the Administrator determines have— 

21 (1) relevant experience within private sector in22 dustry; and 

23 (2) an expert understanding of health finance 

24 and the research, development, testing, evaluation, 


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1 deployment, and implementation of new health tech2 nology. 

3 (c) RELATIONSHIP TO ASSISTANT ADMINISTRATOR

4 FOR GLOBAL HEALTH.—The Chief Innovation Officer for 

5 Health shall— 

6 (1) serve as the principal advisor to the USAID 

7 Assistant Administrator for Global Health regarding 

8 global health research and development necessary to 

9 meet the requirements of the United States Govern10 ment and the governments of partner countries for 

11 improving global health; and 

12 (2) report directly to the USAID Assistant Ad13 ministrator for Global Health. 

14 (d) DUTIES.—The Chief Innovation Officer for 

15 Health shall— 

16 (1) ensure cross-sector, USAID-wide coopera17 tion, support, and programming for global health re18 search and development— 

19 (A) to increase the effectiveness of USAID 

20 international development programs; and 

21 (B) to support the foreign policy and de22 velopment goals of the United States Govern23 ment; 

24 (2) draw on the expertise of other Federal de25 partments and agencies and of nongovernmental orVerDate Sep 11 2014 19:42 Oct 15, 2024 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S5278.IS S5278

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1 ganizations (including affected communities and in2 stitutions in low- or middle-income countries, busi3 nesses, health and science research organizations, 

4 and institutions of higher education) that pursue 

5 global health-related research and development to 

6 identify the most pressing requirements for the de7 velopment of health technologies that will improve 

8 global health and USAID programs relating to glob9 al health; 

10 (3) leverage research and investments by other 

11 USAID components, other Federal departments and 

12 agencies, and nongovernmental organizations (in13 cluding businesses, health and science research orga14 nizations, institutions of higher education, and gov15 ernments or other institutions of partner countries) 

16 to support the research and development of new 

17 health technologies by the Chief Innovation Officer 

18 for Health; 

19 (4) administer the processes for awarding 

20 grants, entering into partnerships, and jointly estab21 lishing other arrangements to support global health 

22 research and development (including by admin23 istering the grant program required under section 

24 8); and 


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1 (5) serve as the Chairperson of the Global 

2 Health Research and Development Advisory Council 

3 established pursuant to section 6. 

4 (e) AUTHORITIES.—The USAID Assistant Adminis5 trator for Global Health shall take such steps as may be 

6 necessary to ensure that the Chief Innovation Officer for 

7 Health has sufficient authority within the Bureau for 

8 Global Health to carry out the duties described in sub9 section (d). 

10 SEC. 6. GLOBAL HEALTH RESEARCH AND DEVELOPMENT 

11 ADVISORY COUNCIL. 

12 (a) ESTABLISHMENT.—The Administrator shall es13 tablish an advisory council, which shall be known as the 

14 ‘‘Global Health Research and Development Advisory 

15 Council’’ (referred to in this section as the ‘‘Council’’). 

16 (b) MEMBERSHIP.—The Council shall be composed 

17 of— 

18 (1) the USAID Chief Innovation Officer for 

19 Health, who shall serve as the Chair of the Council 

20 (referred to in this section as the ‘‘Chair’’); 

21 (2) not more than 8 additional members, who 

22 shall be appointed by the Administrator from among 

23 individuals who— 

24 (A) have been recommended for such ap25 pointment by the Chair; and 


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1 (B) are scientists or other experts with ex2 perience in global health research and develop3 ment through or on behalf of— 

4 (i) USAID; 

5 (ii) any other Federal department or 

6 agency; 

7 (iii) affected communities in low- or 

8 middle-income countries; or 

9 (iv) nongovernmental organizations, 

10 including nonprofit organizations, busi11 nesses, and institutes of higher education. 

12 (c) TERMS.— 

13 (1) IN GENERAL.—Each member of the Council 

14 other than the Chair shall be appointed for a 6-year 

15 term. 

16 (2) VACANCIES.—Any member appointed to fill 

17 a vacancy occurring before the expiration of the 

18 term for which the predecessor of the member was 

19 appointed shall be appointed only for the remainder 

20 of such term. A vacancy in the Council shall be filled 

21 in the manner in which the original appointment was 

22 made. 

23 (d) COMPENSATION.— 

24 (1) PROHIBITION OF COMPENSATION OF FED25 ERAL EMPLOYEES.—Except as provided in paraVerDate Sep 11 2014 19:42 Oct 15, 2024 Jkt 059200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S5278.IS S5278

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1 graph (2), members of the Council who are full-time 

2 officers or employees of the United States may not 

3 receive additional pay, allowances, or benefits by rea4 son of their service on the Council. 

5 (2) TRAVEL EXPENSES.—Each member of the 

6 Council shall receive travel expenses, including per 

7 diem in lieu of subsistence, in accordance with appli8 cable provisions under subchapter I of chapter 57 of 

9 title 5, United States Code. 

10 (e) MEETINGS.—The Council shall meet at the call 

11 of the Chair. 

12 (f) DUTIES.—The Council shall be responsible for ad13 vising the Administrator regarding USAID priorities and 

14 objectives with respect to global health research and devel15 opment, including by providing such advice on an indi16 vidual member basis or as a collective Council, as the 

17 Chair may direct. 

18 (g) NONAPPLICABILITY OF FEDERAL ADVISORY

19 COMMITTEE ACT.—Chapter 10 of title 5, United States 

20 Code (commonly referred to as the ‘‘Federal Advisory 

21 Committee Act’’), shall not apply to the Council. 

22 SEC. 7. GLOBAL HEALTH RESEARCH AND DEVELOPMENT 

23 PROGRAM AREA ACTIVITIES AND BUDGET. 

24 (a) IN GENERAL.—The Administrator shall carry out 

25 global health research and development activities with reVerDate Sep 11 2014 19:42 Oct 15, 2024 Jkt 059200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S5278.IS S5278

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1 spect to new health technologies with the potential to ad2 vance the effectiveness and sustainability of USAID global 

3 health programs, including the potential to advance— 

4 (1) health technologies with characteristics 

5 identified or otherwise prioritized by affected com6 munities and partner countries; 

7 (2) health technologies with characteristics that 

8 facilitate introduction and access of the respective 

9 technology to ensure use by those in need; and 

10 (3) support for capacity-building within partner 

11 countries and the transition by such countries to 

12 greater country-level ownership, responsibility, and 

13 decision-making with respect to global health. 

14 (b) BUDGET.—Not later than 90 days after the date 

15 of the enactment of this Act, the Administrator shall— 

16 (1) establish a single, separate budget line for 

17 the activities described in subsection (a), under 

18 which funds made available to the Administrator to 

19 carry out such activities shall be categorized; and 

20 (2) include information regarding amounts ex21 pended and requested to be expended under such 

22 budget line in the budget justification materials sub23 mitted in support of the budget of the President for 

24 each fiscal year beginning on or after the date on 

25 which such budget line is established. 


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1 SEC. 8. GRANT PROGRAM FOR EXPANDED USE OF GLOBAL 

2 HEALTH RESEARCH AND DEVELOPMENT. 

3 (a) GRANT PROGRAM.—The Administrator, acting 

4 through the Chief Innovation Officer for Health appointed 

5 pursuant to section 5, shall carry out a grant program 

6 under which the Administrator may award competitive 

7 grants to nongovernmental organizations that the Admin8 istrator determines to be eligible. 

9 (b) USE OF AMOUNTS.—Grant amounts awarded 

10 pursuant to this section may only be used— 

11 (1) to develop new health technologies designed 

12 for use in low-resource settings to improve global 

13 health; 

14 (2) to evaluate and improve the implementa15 tion, production, and scale-up of health technologies 

16 in low-resource settings in partner countries; and 

17 (3) to invest in the research capacity of institu18 tions in low- and middle-income partner countries to 

19 lead and contribute to the development of health 

20 technologies. 

21 (c) CONDITIONS ON GRANT AWARD.—The Adminis22 trator may not award a grant to an entity under this sec23 tion unless— 

24 (1) such entity submits to the Administrator a 

25 proposal demonstrating sufficient technical stand26 ards, as determined by the Administrator, for any of 


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1 the purposes listed in paragraphs (1) through (3) of 

2 subsection (b) for which the entity intends to use 

3 such grant amounts; 

4 (2) the entity agrees, as a condition of receiving 

5 such grant, to report not less frequently than annu6 ally to the Administrator regarding the use of such 

7 grant amounts during the grant period; and 

8 (3) the Administrator certifies to the appro9 priate congressional committees that such award is 

10 in compliance with section 3(2). 

11 (d) ADDITIONAL NATURE OF AUTHORITY.—The au12 thority to award grants under this section is in addition 

13 to, and not in lieu of, any other authority of the Adminis14 trator, including any such authority under part I or II 

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

16 et seq.). 

17 SEC. 9. STRATEGY AND REPORTS. 

18 (a) REPORT ON PROGRESS.—Not later than 180 days 

19 after the date of the enactment of this Act, and before 

20 submitting the budget justification materials in support 

21 of the budget of the President for the first fiscal year be22 ginning after the date of the enactment of this Act, the 

23 Administrator shall submit to the appropriate congres24 sional committees, and publish on a publicly available 

25 USAID website, a report containing— 


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1 (1) a detailed description of the status of the 

2 Global Health Research and Development Advisory 

3 Council established pursuant to section 6; 

4 (2) recommendations by the Global Health Re5 search and Development Advisory Council; 

6 (3) solicitations for grant awards authorized 

7 under section 8; 

8 (4) a comprehensive accounting of awards and 

9 objectives to be included within the annual report to 

10 Congress on the USAID health-related research and 

11 development strategy required under the Depart12 ment of State, Foreign Operations, and Related Pro13 grams Appropriations Act for the relevant fiscal year 

14 (or by a report accompanying such Act from the 

15 Committee on Appropriations of the Senate or the 

16 Committee on Appropriations of the House of Rep17 resentatives); 

18 (5) a detailed description of how planned invest19 ments by USAID in the activities described in sec20 tion 7(a) align with USAID’s multiyear strategy ti21 tled ‘‘Global Health Research and Development 

22 Strategy 2023–2028’’ and developed pursuant to 

23 section 7019(e) of division K of the Consolidated 

24 Appropriations Act, 2022 (Public Law 117–103); 

25 and 


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1 (6) a detailed description of how investments 

2 made by USAID in such activities advance the other 

3 USAID health-related programming goals. 

4 (b) ANNUAL REPORTS.—Not later than 1 year after 

5 the date of the enactment of this Act, and annually there6 after for the following 5 years as part of the annual report 

7 referred to in subsection (a)(4), the Administrator shall 

8 submit to the appropriate congressional committees, and 

9 publish on a publicly available USAID website, a report 

10 containing, with respect to the fiscal year covered by the 

11 report— 

12 (1) information on any grants awarded, or 

13 other assistance provided, by the Administrator dur14 ing such year pursuant to this Act or any other rel15 evant provision of law for the support of global 

16 health research and development in support of 

17 USAID programs; 

18 (2) the primary, secondary, and tertiary pur19 poses of— 

20 (A) any such grants awarded; and 

21 (B) any investments in the activities de22 scribed in section 7(a) made or proposed by the 

23 Administrator during such year; 


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1 (3) a summary of the consultations with com2 munities and researchers based in partner countries 

3 regarding any such investments; 

4 (4) a description of the outcomes and status of 

5 the activities described in section 7(a) that were car6 ried out or otherwise supported by the Administrator 

7 during such fiscal year; 

8 (5) the identification of any amounts obligated 

9 or expended during such year by the Administrator 

10 from any appropriations account to support global 

11 health research and development, presented both as 

12 a summary and in a table that is disaggregated by 

13 health area, type of research or development activity, 

14 and appropriations account; and 

15 (6) a description of relevant objectives and ex16 pected outcomes for the subsequent fiscal year. 

Æ 


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