```

[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5278 Introduced in Senate (IS)]

<DOC>

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 low-resource settings, and for other 
                               purposes.

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

SECTION 1. SHORT TITLES; TABLE OF CONTENTS.

    (a) Short Titles.--This Act may be cited as the ``Supporting 
Innovative Global Health Technologies Act of 2024'' or the ``SIGHT 
Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

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.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The United States Agency for International Development 
        has--
                    (A) a unique role in the research and development 
                of health technologies for global health that 
                complements the work of other departments and agencies 
                of the United States Government; and
                    (B) both an advantage and a unique mandate for the 
                development of health technologies to be used in low-
                resource settings.
            (2) It is in the national interest of the United States to 
        build greater country capacity for research and development of 
        new health technologies to be used in low- and middle-income 
        countries.
            (3) Investments by the United States Government in global 
        health research and development should be coordinated with, and 
        leverage investments from, partner country governments, other 
        government donors, and the private sector.
            (4) Human immunodeficiency virus (HIV), tuberculosis (TB), 
        malaria, neglected tropical diseases, emerging infectious 
        diseases (such as COVID-19, Ebola, and Zika), and many other 
        health conditions (such as complications in pregnancy) have a 
        disproportionate public health burden in low- and middle-income 
        countries.
            (5) Health technologies that were developed for use in 
        high-income countries often cannot be implemented in low-
        resource settings in low- and middle-income countries or 
        require adaptation to be effective.
            (6) Due to poverty or low incidence, many neglected 
        tropical diseases and emerging infectious diseases either lack 
        or have limited commercial markets to drive health technology 
        innovation.
            (7) Achieving the ambitious goals set through initiatives 
        such as the President's Emergency Plan for AIDS Relief 
        (commonly referred to as ``PEPFAR)'' and the President's 
        Malaria Initiative (commonly referred to as ``PMI'') will not 
        be possible without the development and scale-up of new health 
        technologies designed for use in low-resource settings, which 
        are needed to address both long-standing endemic diseases and 
        prepare for potential pandemic threats.
            (8) Public funding has proven highly successful at 
        incentivizing the development of health technologies for global 
        health that are high-impact, accessible, and cost-saving.
            (9) COVID-19 has demonstrated the importance of global 
        access to health technologies designed for low-resource 
        settings.
            (10) Support for the development of accessible health 
        technologies for low-resource settings can have reciprocal 
        value and produce tools that reduce health care costs, improve 
        public health, and strengthen health security for the United 
        States.
            (11) For decades, USAID has been a catalyst in the global 
        health innovation ecosystem. While other Federal departments 
        and agencies, including the National Institutes of Health, the 
        Centers for Disease Control and Prevention, and the Department 
        of Defense, provide support for global health technologies, 
        USAID is the only Federal agency that provides broad support 
        for the late-stage development of new health technologies to 
        combat neglected tropical diseases, emerging infectious 
        diseases, and other health conditions for low-resource 
        settings.
            (12) While the need for new tools to tackle disease threats 
        has grown in recent years, investments by USAID in research and 
        development have shrunk as a proportion of its overall global 
        health spending and have been squeezed by stagnant budgets and 
        growing needs.
            (13) Innovation at USAID is primarily supported from siloed 
        disease- and population-specific appropriations accounts, 
        resulting in the limitation of its ability to seek shared value 
        across health sectors or health threats.
            (14) USAID is compelled to prioritize support for immediate 
        program needs with imperfect tools at the expense of support 
        for technologies that can improve clinical effectiveness, 
        increase access to care, save costs, and build capacity and 
        ownership by partner countries.

SEC. 3. STATEMENT OF POLICY.

    It is the policy of the United States that--
            (1) research and development for new health technologies--
                    (A) is essential for the success of the global 
                health programs of the United States Government; and
                    (B) provides for the improved effectiveness, cost-
                effectiveness, and sustainability of such programs; and
            (2) funding and other support for global health research 
        and development under this Act shall be additional and 
        complementary to, and may not replace, displace, or otherwise 
        compromise, funding otherwise provided for--
                    (A) existing and ongoing global health research and 
                development of the United States Government; or
                    (B) activities relating to the implementation of 
                the global health programs of the United States 
                Government.

SEC. 4. DEFINITIONS.

    In this Act:
            (1) Administrator.--The term ``Administrator'' means the 
        Administrator of the United States Agency for International 
        Development.
            (2) Appropriate congressional committees.--The term 
        ``appropriate congressional committees'' means--
                    (A) the Committee on Foreign Relations of the 
                Senate; and
                    (B) the Committee on Foreign Affairs of the House 
                of Representatives.
            (3) Global health.--The term ``global health'' includes 
        efforts to combat and prepare for--
                    (A) neglected tropical diseases;
                    (B) emerging infectious diseases;
                    (C) antimicrobial resistance; and
                    (D) any other condition that may not be easily 
                treated, diagnosed, or prevented in low-resource 
                settings.
            (4) Global health research and development.--The term 
        ``global health research and development'' includes an 
        activity, or the support for such an activity, related to 
        research, development, testing, evaluation, deployment, or 
        implementation of any new health technology.
            (5) Health technology.--The term ``health technology''--
                    (A) means a vaccine, therapeutic, diagnostic, 
                device, or other tool designed, modified, or adapted 
                for use in low-resource settings to improve global 
                health; and
                    (B) includes personal protective equipment and 
                insecticide so used.
            (6) Low-resource setting.--The term ``low-resource 
        setting'' means a location with limited or inconsistent access 
        to running water, electricity, refrigeration, supply chains, 
        lab services, medical equipment, trained health care personnel, 
        or other resources important for global health.
            (7) USAID.--The term ``USAID'' means the United States 
        Agency for International Development.

SEC. 5. CHIEF INNOVATION OFFICER FOR HEALTH.

    (a) Establishment.--There is established, within the USAID Bureau 
for Global Health, the position of Chief Innovation Officer for Health, 
which shall be classified at the level of Deputy Assistant 
Administrator or equivalent.
    (b) Appointment.--The Administrator shall appoint the Chief 
Innovation Officer for Health from among such individuals as the 
Administrator determines have--
            (1) relevant experience within private sector industry; and
            (2) an expert understanding of health finance and the 
        research, development, testing, evaluation, deployment, and 
        implementation of new health technology.
    (c) Relationship to Assistant Administrator for Global Health.--The 
Chief Innovation Officer for Health shall--
            (1) serve as the principal advisor to the USAID Assistant 
        Administrator for Global Health regarding global health 
        research and development necessary to meet the requirements of 
        the United States Government and the governments of partner 
        countries for improving global health; and
            (2) report directly to the USAID Assistant Administrator 
        for Global Health.
    (d) Duties.--The Chief Innovation Officer for Health shall--
            (1) ensure cross-sector, USAID-wide cooperation, support, 
        and programming for global health research and development--
                    (A) to increase the effectiveness of USAID 
                international development programs; and
                    (B) to support the foreign policy and development 
                goals of the United States Government;
            (2) draw on the expertise of other Federal departments and 
        agencies and of nongovernmental organizations (including 
        affected communities and institutions in low- or middle-income 
        countries, businesses, health and science research 
        organizations, and institutions of higher education) that 
        pursue global health-related research and development to 
        identify the most pressing requirements for the development of 
        health technologies that will improve global health and USAID 
        programs relating to global health;
            (3) leverage research and investments by other USAID 
        components, other Federal departments and agencies, and 
        nongovernmental organizations (including businesses, health and 
        science research organizations, institutions of higher 
        education, and governments or other institutions of partner 
        countries) to support the research and development of new 
        health technologies by the Chief Innovation Officer for Health;
            (4) administer the processes for awarding grants, entering 
        into partnerships, and jointly establishing other arrangements 
        to support global health research and development (including by 
        administering the grant program required under section 8); and
            (5) serve as the Chairperson of the Global Health Research 
        and Development Advisory Council established pursuant to 
        section 6.
    (e) Authorities.--The USAID Assistant Administrator for Global 
Health shall take such steps as may be necessary to ensure that the 
Chief Innovation Officer for Health has sufficient authority within the 
Bureau for Global Health to carry out the duties described in 
subsection (d).

SEC. 6. GLOBAL HEALTH RESEARCH AND DEVELOPMENT ADVISORY COUNCIL.

    (a) Establishment.--The Administrator shall establish an advisory 
council, which shall be known as the ``Global Health Research and 
Development Advisory Council'' (referred to in this section as the 
``Council'').
    (b) Membership.--The Council shall be composed of--
            (1) the USAID Chief Innovation Officer for Health, who 
        shall serve as the Chair of the Council (referred to in this 
        section as the ``Chair'');
            (2) not more than 8 additional members, who shall be 
        appointed by the Administrator from among individuals who--
                    (A) have been recommended for such appointment by 
                the Chair; and
                    (B) are scientists or other experts with experience 
                in global health research and development through or on 
                behalf of--
                            (i) USAID;
                            (ii) any other Federal department or 
                        agency;
                            (iii) affected communities in low- or 
                        middle-income countries; or
                            (iv) nongovernmental organizations, 
                        including nonprofit organizations, businesses, 
                        and institutes of higher education.
    (c) Terms.--
            (1) In general.--Each member of the Council other than the 
        Chair shall be appointed for a 6-year term.
            (2) Vacancies.--Any member appointed to fill a vacancy 
        occurring before the expiration of the term for which the 
        predecessor of the member was appointed shall be appointed only 
        for the remainder of such term. A vacancy in the Council shall 
        be filled in the manner in which the original appointment was 
        made.
    (d) Compensation.--
            (1) Prohibition of compensation of federal employees.--
        Except as provided in paragraph (2), members of the Council who 
        are full-time officers or employees of the United States may 
        not receive additional pay, allowances, or benefits by reason 
        of their service on the Council.
            (2) Travel expenses.--Each member of the Council shall 
        receive travel expenses, including per diem in lieu of 
        subsistence, in accordance with applicable provisions under 
        subchapter I of chapter 57 of title 5, United States Code.
    (e) Meetings.--The Council shall meet at the call of the Chair.
    (f) Duties.--The Council shall be responsible for advising the 
Administrator regarding USAID priorities and objectives with respect to 
global health research and development, including by providing such 
advice on an individual member basis or as a collective Council, as the 
Chair may direct.
    (g) Nonapplicability of Federal Advisory Committee Act.--Chapter 10 
of title 5, United States Code (commonly referred to as the ``Federal 
Advisory Committee Act''), shall not apply to the Council.

SEC. 7. GLOBAL HEALTH RESEARCH AND DEVELOPMENT PROGRAM AREA ACTIVITIES 
              AND BUDGET.

    (a) In General.--The Administrator shall carry out global health 
research and development activities with respect to new health 
technologies with the potential to advance the effectiveness and 
sustainability of USAID global health programs, including the potential 
to advance--
            (1) health technologies with characteristics identified or 
        otherwise prioritized by affected communities and partner 
        countries;
            (2) health technologies with characteristics that 
        facilitate introduction and access of the respective technology 
        to ensure use by those in need; and
            (3) support for capacity-building within partner countries 
        and the transition by such countries to greater country-level 
        ownership, responsibility, and decision-making with respect to 
        global health.
    (b) Budget.--Not later than 90 days after the date of the enactment 
of this Act, the Administrator shall--
            (1) establish a single, separate budget line for the 
        activities described in subsection (a), under which funds made 
        available to the Administrator to carry out such activities 
        shall be categorized; and
            (2) include information regarding amounts expended and 
        requested to be expended under such budget line in the budget 
        justification materials submitted in support of the budget of 
        the President for each fiscal year beginning on or after the 
        date on which such budget line is established.

SEC. 8. GRANT PROGRAM FOR EXPANDED USE OF GLOBAL HEALTH RESEARCH AND 
              DEVELOPMENT.

    (a) Grant Program.--The Administrator, acting through the Chief 
Innovation Officer for Health appointed pursuant to section 5, shall 
carry out a grant program under which the Administrator may award 
competitive grants to nongovernmental organizations that the 
Administrator determines to be eligible.
    (b) Use of Amounts.--Grant amounts awarded pursuant to this section 
may only be used--
            (1) to develop new health technologies designed for use in 
        low-resource settings to improve global health;
            (2) to evaluate and improve the implementation, production, 
        and scale-up of health technologies in low-resource settings in 
        partner countries; and
            (3) to invest in the research capacity of institutions in 
        low- and middle-income partner countries to lead and contribute 
        to the development of health technologies.
    (c) Conditions on Grant Award.--The Administrator may not award a 
grant to an entity under this section unless--
            (1) such entity submits to the Administrator a proposal 
        demonstrating sufficient technical standards, as determined by 
        the Administrator, for any of the purposes listed in paragraphs 
        (1) through (3) of subsection (b) for which the entity intends 
        to use such grant amounts;
            (2) the entity agrees, as a condition of receiving such 
        grant, to report not less frequently than annually to the 
        Administrator regarding the use of such grant amounts during 
        the grant period; and
            (3) the Administrator certifies to the appropriate 
        congressional committees that such award is in compliance with 
        section 3(2).
    (d) Additional Nature of Authority.--The authority to award grants 
under this section is in addition to, and not in lieu of, any other 
authority of the Administrator, including any such authority under part 
I or II of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.).

SEC. 9. STRATEGY AND REPORTS.

    (a) Report on Progress.--Not later than 180 days after the date of 
the enactment of this Act, and before submitting the budget 
justification materials in support of the budget of the President for 
the first fiscal year beginning after the date of the enactment of this 
Act, the Administrator shall submit to the appropriate congressional 
committees, and publish on a publicly available USAID website, a report 
containing--
            (1) a detailed description of the status of the Global 
        Health Research and Development Advisory Council established 
        pursuant to section 6;
            (2) recommendations by the Global Health Research and 
        Development Advisory Council;
            (3) solicitations for grant awards authorized under section 
        8;
            (4) a comprehensive accounting of awards and objectives to 
        be included within the annual report to Congress on the USAID 
        health-related research and development strategy required under 
        the Department of State, Foreign Operations, and Related 
        Programs Appropriations Act for the relevant fiscal year (or by 
        a report accompanying such Act from the Committee on 
        Appropriations of the Senate or the Committee on Appropriations 
        of the House of Representatives);
            (5) a detailed description of how planned investments by 
        USAID in the activities described in section 7(a) align with 
        USAID's multiyear strategy titled ``Global Health Research and 
        Development Strategy 2023-2028'' and developed pursuant to 
        section 7019(e) of division K of the Consolidated 
        Appropriations Act, 2022 (Public Law 117-103); and
            (6) a detailed description of how investments made by USAID 
        in such activities advance the other USAID health-related 
        programming goals.
    (b) Annual Reports.--Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter for the following 5 
years as part of the annual report referred to in subsection (a)(4), 
the Administrator shall submit to the appropriate congressional 
committees, and publish on a publicly available USAID website, a report 
containing, with respect to the fiscal year covered by the report--
            (1) information on any grants awarded, or other assistance 
        provided, by the Administrator during such year pursuant to 
        this Act or any other relevant provision of law for the support 
        of global health research and development in support of USAID 
        programs;
            (2) the primary, secondary, and tertiary purposes of--
                    (A) any such grants awarded; and
                    (B) any investments in the activities described in 
                section 7(a) made or proposed by the Administrator 
                during such year;
            (3) a summary of the consultations with communities and 
        researchers based in partner countries regarding any such 
        investments;
            (4) a description of the outcomes and status of the 
        activities described in section 7(a) that were carried out or 
        otherwise supported by the Administrator during such fiscal 
        year;
            (5) the identification of any amounts obligated or expended 
        during such year by the Administrator from any appropriations 
        account to support global health research and development, 
        presented both as a summary and in a table that is 
        disaggregated by health area, type of research or development 
        activity, and appropriations account; and
            (6) a description of relevant objectives and expected 
        outcomes for the subsequent fiscal year.
                                 <all>
```