II 

117TH CONGRESS 

1ST SESSION S. 2297 

To improve global health, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 24, 2021 

Mr. RISCH (for himself and Mr. MENENDEZ) introduced the following bill; 

which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To improve global health, and for other purposes. 

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘International Pandemic Preparedness and COVID–19 

6 Response Act of 2021’’. 

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

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

Sec. 3. Purpose. 

TITLE I—ENHANCING THE UNITED STATES INTERNATIONAL 

RESPONSE TO COVID–19 AND FUTURE PANDEMICS 


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Sec. 101. Statement of policy regarding international cooperation to end the 

COVID–19 pandemic. 

Sec. 102. Oversight of United States foreign assistance to end the COVID–19 

pandemic. 

Sec. 103. United States contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria COVID–19 response mechanism. 

Sec. 104. Global COVID–19 vaccine distribution and delivery. 

Sec. 105. Leveraging United States bilateral global health programs for the 

international COVID–19 response. 

Sec. 106. Report on humanitarian response to the COVID–19 pandemic. 

Sec. 107. Safeguarding democracy and human rights during the COVID–19 

pandemic. 

Sec. 108. Public diplomacy and combating disinformation and misinformation 

about COVID–19. 

Sec. 109. Findings and sense of Congress regarding the United States International Development Finance Corporation. 

Sec. 110. Sense of Congress regarding international cooperation to prevent and 

respond to future pandemics. 

Sec. 111. Roles of the Department of State, the United States Agency for 

International Development, and the Centers for Disease Control and Prevention in pandemic response. 

Sec. 112. USAID disaster surge capacity. 

Sec. 113. Statement of policy on humanitarian assistance to countries affected 

by pandemics. 

TITLE II—INTERNATIONAL PANDEMIC PREVENTION AND 

PREPAREDNESS 

Sec. 201. Partner country defined. 

Sec. 202. Global health security strategy and report. 

Sec. 203. Committee on Global Health Security and Pandemic and Biological 

Threats. 

Sec. 204. United States overseas global health security and diplomacy coordination and strategy. 

Sec. 205. Resilience. 

Sec. 206. Strengthening health systems. 

Sec. 207. Additional authorities. 

Sec. 208. Authorization for United States participation in the Coalition for Epidemic Preparedness Innovations. 

Sec. 209. National intelligence estimate and briefing regarding novel diseases 

and pandemic threats. 

Sec. 210. Pandemic early warning network. 

Sec. 211. International emergency operations. 

TITLE III—FINANCING MECHANISM FOR GLOBAL HEALTH 

SECURITY AND PANDEMIC PREVENTION AND PREPAREDNESS 

Sec. 301. Eligible partner country defined. 

Sec. 302. Establishment of Fund for Global Health Security and Pandemic 

Prevention and Preparedness. 

Sec. 303. Authorities. 

Sec. 304. Administration. 

Sec. 305. Advisory Board. 

Sec. 306. Reports to Congress. 

Sec. 307. United States contributions. 


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Sec. 308. Compliance with the Foreign Aid Transparency and Accountability 

Act of 2016. 

1 SEC. 2. DEFINITIONS. 

2 In this Act: 

3 (1) APPROPRIATE CONGRESSIONAL COMMIT4 TEES.—The term ‘‘appropriate congressional com5 mittees’’ means— 

6 (A) the Committee on Foreign Relations of 

7 the Senate; 

8 (B) the Committee on Appropriations of 

9 the Senate; 

10 (C) the Committee on Foreign Affairs of 

11 the House of Representatives; and 

12 (D) the Committee on Appropriations of 

13 the House of Representatives. 

14 (2) GLOBAL HEALTH SECURITY AGENDA; 

15 GHSA.—The terms ‘‘Global Health Security Agenda’’ 

16 and ‘‘GHSA’’ mean the multi-sectoral initiative 

17 launched in 2014 and renewed in 2017 that brings 

18 together countries, regions, international organiza19 tions, nongovernmental organizations, and the pri20 vate sector to elevate global health security as a na21 tional-level priority, to share best practices, and to 

22 facilitate national capacity to comply with and ad23 here to— 


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1 (A) the International Health Regulations 

2 (2005); 

3 (B) the World Organisation for Animal 

4 Health international standards and guidelines; 

5 (C) United Nations Security Council Reso6 lution 1540 (2004); 

7 (D) the Convention on the Prohibition of 

8 the Development, Production and Stockpiling of 

9 Bacteriological and Toxin Weapons and on 

10 their Destruction, done at Washington, London, 

11 and Moscow, April 10, 1972 (commonly re12 ferred to as the ‘‘Biological Weapons Conven13 tion’’); 

14 (E) the Global Health Security Agenda 

15 2024 Framework; and 

16 (F) other relevant frameworks that con17 tribute to global health security. 

18 (3) GLOBAL HEALTH SECURITY INDEX.—The 

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

20 comprehensive assessment and benchmarking of 

21 health security and related capabilities across the 

22 countries that make up the States Parties to the 

23 International Health Regulations (2005). 

24 (4) GLOBAL HEALTH SECURITY INITIATIVE.— 

25 The term ‘‘Global Health Security Initiative’’ means 


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1 the informal network of countries and organizations 

2 that came together in 2001 to undertake concerted 

3 global action to strengthen public health prepared4 ness and response to chemical, biological, radio5 logical, and nuclear threats, as well as pandemic in6 fluenza. 

7 (5) JOINT EXTERNAL EVALUATION.—The term 

8 ‘‘Joint External Evaluation’’ means the World 

9 Health Organization-facilitated, voluntary, collabo10 rative, multi-sectoral process to assess country ca11 pacity to prevent, detect, and rapidly respond to 

12 public health risks occurring naturally or due to de13 liberate or accidental events, assess progress in 

14 achieving the targets under the International Health 

15 Regulations (2005), and recommend priority actions. 

16 (6) KEY STAKEHOLDERS.—The term ‘‘key 

17 stakeholders’’ means actors engaged in efforts to ad18 vance global health security programs and objectives, 

19 including— 

20 (A) national and local governments in 

21 partner countries; 

22 (B) other bilateral donors; 

23 (C) international, regional, and local orga24 nizations, including private, voluntary, non25 governmental, and civil society organizations; 


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1 (D) international, regional, and local finan2 cial institutions; 

3 (E) representatives of historically 

4 marginalized groups, including women, youth, 

5 and indigenous peoples; 

6 (F) the private sector, including medical 

7 device, technology, pharmaceutical, manufac8 turing, logistics, and other relevant companies; 

9 and 

10 (G) public and private research and aca11 demic institutions. 

12 (7) ONE HEALTH APPROACH.—The term ‘‘One 

13 Health approach’’ means the collaborative, multi-sec14 toral, and transdisciplinary approach toward achiev15 ing optimal health outcomes in a manner that recog16 nizes the interconnection between people, animals, 

17 plants, and their shared environment. 

18 (8) RELEVANT FEDERAL DEPARTMENTS AND

19 AGENCIES.—The term ‘‘relevant Federal depart20 ments and agencies’’ means any Federal department 

21 or agency implementing United States policies and 

22 programs relevant to the advancement of United 

23 States global health security and diplomacy overseas, 

24 which may include— 

25 (A) the Department of State; 


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1 (B) the United States Agency for Inter2 national Development; 

3 (C) the Department of Health and Human 

4 Services; 

5 (D) the Centers for Disease Control and 

6 Prevention; 

7 (E) the National Institutes of Health; 

8 (F) the Department of the Treasury; 

9 (G) the Department of Agriculture; 

10 (H) the Department of Defense; 

11 (I) the Defense Threat Reduction Agency; 

12 (J) the Millennium Challenge Corporation; 

13 (K) the Development Finance Corporation; 

14 (L) the Peace Corps; and 

15 (M) any other department or agency that 

16 the President determines to be relevant for 

17 these purposes. 

18 (9) RESILIENCE.—The term ‘‘resilience’’ means 

19 the ability of people, households, communities, sys20 tems, institutions, countries, and regions to reduce, 

21 mitigate, withstand, adapt to, and quickly recover 

22 from stresses and shocks in a manner that reduces 

23 chronic vulnerability and facilitates inclusive growth. 


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1 SEC. 3. PURPOSE. 

2 The purpose of this Act is to accelerate and enhance 

3 the United States international response to pandemics, in4 cluding the COVID–19 pandemic, and to operationalize 

5 lessons learned from current and prior emergency re6 sponses in a manner that— 

7 (1) advances the global health security and di8 plomacy objectives of the United States; 

9 (2) improves coordination among the relevant 

10 Federal departments and agencies implementing 

11 United States foreign assistance for global health se12 curity; and 

13 (3) more effectively enables partner countries to 

14 strengthen and sustain resilient health systems and 

15 supply chains with the resources, capacity, and per16 sonnel required to prevent, prepare for, detect, and 

17 respond to infectious disease threats before they be18 come pandemics. 


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1 TITLE I—ENHANCING THE 

2 UNITED STATES INTER3 NATIONAL RESPONSE TO 

4 COVID–19 AND FUTURE 

5 PANDEMICS 

6 SEC. 101. STATEMENT OF POLICY REGARDING INTER7 NATIONAL COOPERATION TO END THE 

8 COVID–19 PANDEMIC. 

9 It shall be the policy of the United States to lead and 

10 implement a comprehensive and coordinated international 

11 response to end the COVID–19 pandemic in a manner 

12 that recognizes the critical role that multilateral and re13 gional organizations can and should play in pandemic re14 sponse, including by— 

15 (1) seeking adoption of a United Nations Secu16 rity Council resolution that— 

17 (A) declares pandemics, including the 

18 COVID–19 pandemic, to be a threat to inter19 national peace and security; and 

20 (B) urges member states to address this 

21 threat by aligning their health preparedness 

22 plans with international best practices and 

23 those established by the Global Health Security 

24 Agenda to improve country capacity to prevent, 


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1 detect, and respond to infectious disease 

2 threats; 

3 (2) advancing efforts to reform the World 

4 Health Organization so that it serves as an effective 

5 normative and capable coordinating body empowered 

6 to align member countries around a single strategic 

7 operating plan to detect, contain, treat, and deter 

8 the further spread of COVID–19; 

9 (3) providing timely, appropriate levels of finan10 cial support to United Nations agencies responding 

11 to the COVID–19 pandemic; 

12 (4) prioritizing United States foreign assistance 

13 for the COVID–19 response in the most vulnerable 

14 countries and regions; 

15 (5) encouraging other donor governments to 

16 similarly increase contributions to the United Na17 tions agencies responding to the COVID–19 pan18 demic in the world’s poorest and most vulnerable 

19 countries; 

20 (6) working with key stakeholders to accelerate 

21 progress toward meeting and exceeding, as prac22 ticable, the global COVID–19 vaccination goals 

23 jointly proposed by the International Monetary 

24 Fund, the World Health Organization, the World 


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1 Bank, and the World Trade Organization, where2 by— 

3 (A) at least 40 percent of the population in 

4 all countries is vaccinated by the end of 2021; 

5 and 

6 (B) at least 60 percent of the population 

7 in all countries is vaccinated by the first half of 

8 2022; 

9 (7) engaging with key stakeholders, including 

10 through multilateral facilities such as the COVID– 

11 19 Vaccines Global Access initiative (referred to in 

12 this title as ‘‘COVAX’’) and the Access to COVID– 

13 19 Tools (ACT) Accelerator initiative, and expand14 ing bilateral efforts, including through the Inter15 national Development Finance Corporation, to accel16 erate the development, manufacturing, local produc17 tion, and efficient and equitable distribution of— 

18 (A) vaccines and related raw materials to 

19 meet or exceed the vaccination goals under 

20 paragraph (6); and 

21 (B) global health commodities, including 

22 personal protective equipment, test kits, medi23 cines and therapeutics, and other essential sup24 plies to combat COVID–19; 


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1 (8) supporting global COVID–19 vaccine dis2 tribution strategies that strengthen underlying 

3 health systems and ensure that people living in vul4 nerable and marginalized communities, including 

5 women, do not face undue barriers to vaccination; 

6 (9) working with key stakeholders, including 

7 through the World Bank Group, the International 

8 Monetary Fund, the World Trade Organization, the 

9 International Finance Corporation, and other rel10 evant regional and bilateral financial institutions, to 

11 address the economic and financial implications of 

12 the COVID–19 pandemic, while taking into account 

13 the differentiated needs of disproportionately af14 fected, vulnerable, and marginalized populations; 

15 (10) establishing clear timelines, benchmarks, 

16 and goals for COVID–19 response strategies and ac17 tivities under this section; and 

18 (11) generating commitments of resources in 

19 support of the goals referred to in paragraph (10). 

20 SEC. 102. OVERSIGHT OF UNITED STATES FOREIGN ASSIST21 ANCE TO END THE COVID–19 PANDEMIC. 

22 (a) REPORTING REQUIREMENTS.—Not later than 60 

23 days after the date of the enactment of this Act, the Sec24 retary of State and the Administrator for the United 


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1 States Agency for International Development shall jointly 

2 submit to the appropriate congressional committees— 

3 (1) an unclassified report containing a descrip4 tion of funds already obligated and expended under 

5 title X of the American Rescue Plan Act of 2021 

6 (Public Law 117–2); and 

7 (2) a plan that describes the objectives and 

8 timeline for the obligation and expenditure of all re9 maining funds appropriated under the American 

10 Rescue Plan Act of 2021, which shall be submitted 

11 in an unclassified form, and should include a de12 scription of steps taken pursuant to each objective 

13 specified in the plan. 

14 (b) CONGRESSIONAL CONSULTATION.—Not less fre15 quently than once every 60 days, until the completion or 

16 termination of the implementation plan required under 

17 subsection (a)(2), and upon the request from one or more 

18 of the appropriate congressional committees, the Secretary 

19 of State and the Administrator for the United States 

20 Agency for International Development shall provide a 

21 briefing to the appropriate congressional committees re22 garding the report required under subsection (a)(1) and 

23 the status of the implementation of the plan required 

24 under subsection (a)(2). 


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1 (c) BRANDING.—In providing assistance under this 

2 title, the Secretary of State and the Administrator of the 

3 United States Agency for International Development, with 

4 due consideration for the safety and security of imple5 menting partners and beneficiaries, and pursuant to cur6 rent branding and marking regulations and procedures 

7 shall prescribe the use of logos or other insignia, which 

8 may include the flag of the United States, to appropriately 

9 identify such assistance as being from the people of the 

10 United States. 

11 SEC. 103. UNITED STATES CONTRIBUTIONS TO THE GLOBAL 

12 FUND TO FIGHT AIDS, TUBERCULOSIS, AND 

13 MALARIA COVID–19 RESPONSE MECHANISM. 

14 (a) UNITED STATES CONTRIBUTIONS TO THE GLOB15 AL FUND TO FIGHT AIDS, TUBERCULOSIS, AND MA16 LARIA COVID–19 RESPONSE MECHANISM.—United 

17 States contributions to the Global Fund to Fight AIDS, 

18 Tuberculosis, and Malaria COVID–19 Response Mecha19 nism under section 10003(a)(2) of the American Rescue 

20 Plan Act of 2021 (Public Law 107–2)— 

21 (1) shall be meaningfully leveraged in a manner 

22 that incentivizes other public and private donor con23 tributions; and 

24 (2) shall be subject to the reporting and with25 holding requirements under subsections (c), 


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1 (d)(4)(A)(ii), (d)(4)(C), (d)(5), (d)(6), (f), and (g) of 

2 section 202 of the United States Leadership Against 

3 HIV/AIDS, Tuberculosis, and Malaria Act of 2003 

4 (22 U.S.C. 7622). 

5 SEC. 104. GLOBAL COVID–19 VACCINE DISTRIBUTION AND 

6 DELIVERY. 

7 (a) ACCELERATING GLOBAL VACCINE DISTRIBUTION

8 STRATEGY.—The Secretary of State, in consultation with 

9 the Secretary of Health and Human Services, the Admin10 istrator of the United States Agency for International De11 velopment, the Chief Executive Officer of the United 

12 States International Development Finance Corporation, 

13 and the heads of other relevant Federal departments and 

14 agencies, as determined by the President, shall develop a 

15 strategy to expand access to, and accelerate the global dis16 tribution of, COVID–19 vaccines to other countries, which 

17 shall— 

18 (1) identify the countries that have the highest 

19 infection and death rates due to COVID–19, the 

20 lowest COVID–19 vaccination rates, and face the 

21 most difficult, political, logistical, and financial chal22 lenges to obtaining and delivering COVID–19 vac23 cines, and describe the basis and metrics used to 

24 make such determinations; 


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1 (2) identify which countries and regions will be 

2 prioritized and targeted for COVID–19 vaccine de3 livery, and the rationale for such prioritization; 

4 (3) describe efforts that the United States is 

5 making to increase COVID–19 vaccine manufac6 turing capacity, including through the provision of 

7 development finance, and estimate when, how many, 

8 and which types of vaccines will be provided by the 

9 United States Government bilaterally and through 

10 COVAX; 

11 (4) describe efforts to encourage international 

12 partners to take actions similar to the efforts re13 ferred to in paragraph (3); 

14 (5) describe how the United States Government 

15 will ensure efficient delivery of COVID–19 vaccines 

16 to intended recipients, including United States citi17 zens residing overseas, and identify complementary 

18 United States foreign assistance that will facilitate 

19 vaccine readiness, distribution, delivery, monitoring, 

20 and administration activities; 

21 (6) describe the roles, responsibilities, tasks, 

22 and, as appropriate, the authorities of the Secretary 

23 of State, the Administrator of the United States 

24 Agency for International Development, the Secretary 

25 of Health and Human Services, the Chief Executive 


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1 Officer of the United States International Develop2 ment Finance Corporation, and the heads of other 

3 relevant Federal departments and agencies with re4 spect to the implementation of such strategy; and 

5 (7) summarize the United States public diplo6 macy strategies for branding and addressing vaccine 

7 misinformation and hesitancy. 

8 (b) SUBMISSION OF STRATEGY.—Not later than 90 

9 days after the date of the enactment of this Act, the Sec10 retary of State shall submit the strategy described in sub11 section (a) to the appropriate congressional committees. 

12 SEC. 105. LEVERAGING UNITED STATES BILATERAL GLOB13 AL HEALTH PROGRAMS FOR THE INTER14 NATIONAL COVID–19 RESPONSE. 

15 (a) AUTHORIZATION FOR LEVERAGING BILATERAL

16 PROGRAM ACTIVITIES.—Amounts authorized to be appro17 priated or otherwise made available to carry out section 

18 104 of the Foreign Assistance Act (22 U.S.C. 2151b) may 

19 be used in countries receiving United States foreign assist20 ance— 

21 (1) to combat the COVID–19 pandemic, includ22 ing through the sharing of COVID–19 vaccines; and 

23 (2) to support related activities, including— 

24 (A) strengthening vaccine readiness; 


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1 (B) reducing vaccine hesitancy and misin2 formation; 

3 (C) delivering and administering COVID– 

4 19 vaccines; 

5 (D) strengthening health systems and sup6 ply chains; 

7 (E) supporting health care workforce plan8 ning, training, and management; 

9 (F) enhancing transparency, quality, and 

10 reliability of health data; 

11 (G) increasing bidirectional testing; and 

12 (H) building lab capacity. 

13 (b) ADJUSTMENT OF TARGETS AND GOALS.—The 

14 Secretary of State, in coordination with the heads of other 

15 relevant Federal departments and agencies, shall submit 

16 an annual report to the appropriate congressional commit17 tees that identifies— 

18 (1) any adjustments to original program targets 

19 and goals that result from the use of funds for the 

20 purposes authorized under subsection (a); and 

21 (2) the amounts needed in the following fiscal 

22 year to meet the original program goals. 


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1 SEC. 106. REPORT ON HUMANITARIAN RESPONSE TO THE 

2 COVID–19 PANDEMIC. 

3 (a) IN GENERAL.—Not later than 120 days after the 

4 date of the enactment of this Act, the Secretary of State, 

5 in consultation with the Administrator of the United 

6 States Agency for International Development and the Sec7 retary of Health and Human Services, shall submit a re8 port to the appropriate congressional committees that— 

9 (1) assesses the global humanitarian response 

10 to COVID–19; and 

11 (2) outlines specific elements of the United 

12 States Government’s country-level response to the 

13 COVID–19 pandemic. 

14 (b) ELEMENTS.—The report required under sub15 section (a) shall include— 

16 (1) for countries receiving United States assist17 ance, a description of humanitarian and health18 worker access to crisis-affected areas, including— 

19 (A) legal and bureaucratic restrictions on 

20 the entry of humanitarian workers from abroad, 

21 to include visa authorizations that do not allow 

22 adequate time for humanitarian workers to 

23 quarantine upon arrival in-line with host coun24 try regulations, conduct needs assessments, and 

25 subsequently implement multilateral and United 


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1 States-funded programming in an efficient, ef2 fective, and unrestricted manner; 

3 (B) restrictions on travel by humanitarian 

4 workers within such country to reach the areas 

5 of operation where vulnerable and marginalized 

6 populations reside; 

7 (C) access to medical evacuation in the 

8 event of a health emergency; 

9 (D) access to personal protective equip10 ment for United States Government imple11 menting partners; and 

12 (E) efforts to support access to COVID–19 

13 vaccines for humanitarian and health-workers 

14 and crisis-affected communities; 

15 (2) an analysis and description of countries (re16 gardless of whether such countries have received di17 rect United States assistance) that have expressly 

18 prevented vulnerable populations from accessing nec19 essary assistance related to COVID–19, including— 

20 (A) the omission of vulnerable populations 

21 from national response plans; 

22 (B) laws, policies, or practices that restrict 

23 or preclude treatment of vulnerable populations 

24 at public hospitals and health facilities; and 


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1 (C) exclusion of, or discrimination against, 

2 vulnerable populations in law, policy, or practice 

3 that prevents equal access to food, shelter, and 

4 other basic assistance; 

5 (3) a description of United States Government 

6 efforts to facilitate greater humanitarian access, in7 cluding— 

8 (A) advocacy and diplomatic efforts with 

9 relevant foreign governments and multilateral 

10 institutions to ensure that vulnerable and 

11 marginalized populations are included in na12 tional response plans and other relevant plans 

13 developed in response to the COVID–19 pan14 demic; and 

15 (B) advocacy and diplomatic efforts with 

16 relevant foreign governments to ensure that ap17 propriate visas, work permits, and domestic 

18 travel exemptions are issued for humanitarian 

19 and health workers responding to the COVID– 

20 19 pandemic; and 

21 (4) a description of United States Government 

22 plans and efforts to address the second-order im23 pacts of the COVID–19 pandemic and an assess24 ment of the resources required to implement such 

25 plans, including efforts to address— 


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1 (A) famine and acute food insecurity; 

2 (B) gender-based violence; 

3 (C) mental health and psychosocial support 

4 needs; 

5 (D) child protection needs; 

6 (E) health, education, and livelihoods; 

7 (F) shelter; and 

8 (G) attempts to close civil society space, 

9 including through bureaucratic, administrative, 

10 and health or security related impediments. 

11 SEC. 107. SAFEGUARDING DEMOCRACY AND HUMAN 

12 RIGHTS DURING THE COVID–19 PANDEMIC. 

13 (a) SENSE OF CONGRESS.—It is the sense of Con14 gress that— 

15 (1) governments may be required to take appro16 priate extraordinary measures during public health 

17 emergencies to halt the spread of disease, including 

18 closing businesses and public events, limiting access 

19 to public spaces, and restricting the movement of 

20 people; 

21 (2) certain foreign governments have taken 

22 measures in response to COVID–19 that violate the 

23 human rights of their citizens without clear public 

24 health justification, oversight measures, or sunset 

25 provisions; 


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1 (3) governments using the COVID–19 pan2 demic as a pretext for repression have undermined 

3 democratic institutions, debilitated institutions for 

4 transparency and public integrity, quashed legiti5 mate dissent, and attacked journalists, civil society 

6 organizations, activists, independent voices, and vul7 nerable and marginalized populations, including ref8 ugees and migrants, with far-reaching consequences 

9 that will extend beyond the current crisis; 

10 (4) COVID–19 threatens to roll back decades of 

11 progress for women and girls, disproportionately af12 fecting women economically, educationally, and with 

13 respect to health, while also leading to alarming 

14 rises in gender based violence; and 

15 (5) during and after the pandemic, the Depart16 ment of State and the United States Agency for 

17 International Development should directly, and 

18 through nongovernmental organizations or inter19 national organizations, provide assistance and imple20 ment programs that support democratic institutions, 

21 civil society, free media, and the advancement of 

22 internationally recognized human rights. 

23 (b) FUNDING FOR CIVIL SOCIETY AND HUMAN

24 RIGHTS DEFENDERS.— 


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1 (1) PROGRAM PRIORITIES.—Amounts made 

2 available for each of the fiscal years 2022 through 

3 2026 to carry out the purposes of sections 101 and 

4 102 of the Foreign Assistance Act of 1961 (22 

5 U.S.C. 2151 and 2151–1), including programs to 

6 support democratic institutions, human rights de7 fenders, civil society, and freedom of the press, 

8 should be targeted, to the extent feasible, toward 

9 civil society organizations in countries in which 

10 emergency government measures taken in response 

11 to the COVID–19 pandemic have violated inter12 nationally recognized human rights. 

13 (2) ELIGIBLE ORGANIZATIONS.—Civil society 

14 organizations operating in countries in which emer15 gency government measures taken in response to the 

16 COVID–19 pandemic violated internationally recog17 nized human rights shall be eligible to receive funds 

18 made available to carry out the purposes of sections 

19 101 and 102 of the Foreign Assistance Act of 1961 

20 for each of the fiscal years 2022 through 2026, 

21 for— 

22 (A) programs designed to strengthen and 

23 support civil society, human rights defenders, 

24 freedom of association, and the freedom of the 

25 press; 


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1 (B) programs to restore democratic institu2 tions; and 

3 (C) peacebuilding and conflict prevention 

4 to address the impacts of COVID–19 on social 

5 cohesion, public trust, and conflict dynamics by 

6 adapting existing programs or investing in new 

7 ones. 

8 (3) FINAL REPORT.—Not later than 180 days 

9 after the date of the enactment of this Act, the Sec10 retary of State shall submit a report to the appro11 priate congressional committees that— 

12 (A) lists the countries whose emergency 

13 measures limiting internationally recognized 

14 human rights in a manner inconsistent with the 

15 principles of limitation and derogation remain 

16 in place; 

17 (B) describes such countries’ emergency 

18 measures, including— 

19 (i) how such procedures violate inter20 nationally recognized human rights; and 

21 (ii) an analysis of the impact of such 

22 measures on access to health and efforts to 

23 control the COVID–19 pandemic within 

24 the country; 

25 (C) describes— 


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1 (i) security and intelligence surveil2 lance measures implemented by countries 

3 during the COVID–19 pandemic; 

4 (ii) the extent to which such measures 

5 have been, or have not been, rolled back; 

6 and 

7 (iii) whether and how such measures 

8 impact internationally recognized human 

9 rights; and 

10 (D) includes a strategic plan by the De11 partment of State and the United States Agen12 cy for International Development that address13 es, through multilateral and bilateral diplomacy 

14 and foreign assistance, the persistent issues re15 lated to the restriction of internationally recog16 nized human rights in the COVID–19 response. 

17 SEC. 108. PUBLIC DIPLOMACY AND COMBATING 

18 DISINFORMATION AND MISINFORMATION 

19 ABOUT COVID–19. 

20 (a) UNITED STATES AGENCY FOR GLOBAL MEDIA.— 

21 (1) FINDING.—Congress finds that the United 

22 States Agency for Global Media (referred to in this 

23 section as ‘‘USAGM’’) broadcasting entities and 

24 grantees have proven valuable in providing timely 


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1 and accurate information, particularly in countries 

2 in which the free press is under threat. 

3 (2) SENSE OF CONGRESS.—It is the sense of 

4 Congress that— 

5 (A) accurate, investigative, and scientific 

6 journalism is critical for societies to effectively 

7 combat global health threats; and 

8 (B) Congress supports— 

9 (i) accurate and objective investigative 

10 and scientific reporting by USAGM net11 works and grantees regarding COVID–19; 

12 and 

13 (ii) platforms that help dispel and 

14 combat misinformation about the COVID– 

15 19 pandemic. 

16 (3) VOICE OF AMERICA.—It is the sense of Con17 gress that amounts authorized to be appropriated or 

18 otherwise made available to Voice of America should 

19 be used— 

20 (A) to expand programs such as POLY21 GRAPH.info; 

22 (B) to provide critical tools for combating 

23 propaganda associated with COVID–19; and 

24 (C) to assist journalists in providing accu25 rate information to local media outlets. 


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1 (4) OFFICE OF CUBA BROADCASTING.—It is the 

2 sense of Congress that Radio Televisio ́n Martı ́ and 

3 Digital Martı ́ should continue to broadcast programs 

4 that detect, highlight, and dispel disinformation. 

5 (5) RADIO FREE EUROPE/RADIO LIBERTY.— 

6 (A) FINDING.—Congress finds that Radio 

7 Free Europe/Radio Liberty (referred to in this 

8 section as ‘‘RFE/RL’’) operate in media mar9 kets in which authoritarian state and nonstate 

10 actors, including Russia, heavily invest in misin11 formation and disinformation campaigns de12 signed to promote confusion and mistrust. 

13 (B) SENSE OF CONGRESS.—It is the sense 

14 of Congress that RFE/RL should— 

15 (i) increase investigative reporting re16 garding the impacts of COVID–19, the po17 litical and social responses governments 

18 are taking in response to COVID–19, and 

19 the lasting impacts such actions will have 

20 on key political freedoms; and 

21 (ii) expand its ‘‘digital first’’ strategy. 

22 (6) RADIO FREE ASIA.— 

23 (A) FINDING.—Congress finds that Radio 

24 Free Asia (RFA) operates in a media market 

25 dominated by powerful state-run media that 


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1 have invested heavily in media distortion and 

2 disinformation, including about COVID–19. 

3 (B) SENSE OF CONGRESS.—It is the sense 

4 of Congress that RFA should— 

5 (i) commission technical experts to 

6 bolster efforts to counter social media 

7 tools, including bots used by some coun8 tries to promote misinformation; 

9 (ii) expand digital programming and 

10 local coverage to expose China’s media ma11 nipulation techniques; and 

12 (iii) increase English language content 

13 to help counter China’s propaganda di14 rected toward English-speaking audiences. 

15 (7) MIDDLE EAST BROADCASTING NET16 WORKS.— 

17 (A) FINDING.—Congress finds that the 

18 Middle East Broadcasting Networks operate 

19 largely in closed media markets in which malign 

20 state and nonstate actors remain active. 

21 (B) SENSE OF CONGRESS.—It is the sense 

22 of Congress that the Middle East Broadcasting 

23 Networks should— 

24 (i) continue plans to expand an inves25 tigative news unit; and 


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1 (ii) work to ensure that reporting con2 tinues amidst operational challenges on the 

3 ground. 

4 (8) OPEN TECHNOLOGY FUND.— 

5 (A) FINDING.—Congress finds that the 

6 Open Technology Fund works to advance inter7 net freedom in repressive environments by sup8 porting technologies that— 

9 (i) provide secure and uncensored ac10 cess to USAGM’s content and the broader 

11 internet; and 

12 (ii) counter attempts by authoritarian 

13 governments to control the internet and re14 strict freedom online. 

15 (B) SENSE OF CONGRESS.—It is the sense 

16 of Congress that the Open Technology Fund 

17 should— 

18 (i) support a broad range of tech19 nologies to respond to increasingly aggres20 sive and sophisticated censorship and sur21 veillance threats and provide more com22 prehensive and tailored support to 

23 USAGM’s networks; and 

24 (ii) provide direct assistance to 

25 USAGM’s networks to improve the digital 


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1 security of reporting operations and jour2 nalists. 

3 (b) DEPARTMENT OF STATE PUBLIC DIPLOMACY

4 PROGRAMS.— 

5 (1) FINDINGS.—Congress finds the following: 

6 (A) The Department of State’s public di7 plomacy programs build global networks that 

8 can address shared challenges, such as the 

9 COVID–19 pandemic, including through ex10 changes of researchers, public health experts, 

11 and scientists. 

12 (B) The programs referred to in subpara13 graph (A) play a critical role in creating open 

14 and resilient information environments where 

15 democracies can thrive, as articulated in the 

16 2020 Public Diplomacy Strategic Plan, includ17 ing by— 

18 (i) improving media quality with jour19 nalist training and reporting tours; 

20 (ii) conducting media literacy pro21 grams; and 

22 (iii) supporting media access activi23 ties. 

24 (C) The International Visitor Leadership 

25 Program and Digital Communications Network 


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1 engaged journalists around the world to combat 

2 COVID–19 disinformation, promote unbiased 

3 reporting, and strengthen media literacy. 

4 (D) More than 12,000 physicians holding 

5 J–1 visas from 130 countries— 

6 (i) are engaged in residency or fellow7 ship training at approximately 750 hos8 pitals throughout the United States, the 

9 majority of whom are serving in States 

10 that have been the hardest hit by COVID– 

11 19; and 

12 (ii) throughout the pandemic, have 

13 served on the front lines of the medical 

14 workforce and in United States university 

15 labs researching ways to detect and treat 

16 the virus. 

17 (2) VISA PROCESSING BRIEFING.—Not later 

18 than 30 days after the date of the enactment of this 

19 Act, the Assistant Secretary for Consular Affairs 

20 shall brief the appropriate congressional committees 

21 by providing— 

22 (A) a timeline for increasing visa proc23 essing capacities at embassies around the world, 

24 notably where there are— 


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1 (i) many American citizens, including 

2 dual nationals; and 

3 (ii) many visa applicants for edu4 cational and cultural exchange programs 

5 that promote United States foreign policy 

6 objectives and economic stability to small 

7 businesses, universities, and communities 

8 across the United States; and 

9 (B) a detailed plan for using existing au10 thorities to waive in-person appointments and 

11 interviews. 

12 (3) GLOBAL ENGAGEMENT CENTER.— 

13 (A) FINDING.—Congress finds that since 

14 the beginning of the COVID–19 pandemic, pub15 lications, websites, and platforms associated 

16 with China, Russia, and Iran have sponsored 

17 disinformation campaigns related to the 

18 COVID–19 pandemic, including falsely blaming 

19 the United States for the disease. 

20 (B) SENSE OF CONGRESS.—It is the sense 

21 of Congress that the Global Engagement Center 

22 should continue its efforts to expose and 

23 counter state and non-state-sponsored 

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1 gins of COVID–19, and COVID–19 vaccina2 tions. 

3 SEC. 109. FINDINGS AND SENSE OF CONGRESS REGARDING 

4 THE UNITED STATES INTERNATIONAL DE5 VELOPMENT FINANCE CORPORATION. 

6 (a) FINDINGS.—Congress finds the following: 

7 (1) The COVID–19 pandemic is causing a glob8 al economic recession, as evidenced by the global 

9 economic indicators described in paragraphs (2) 

10 through (4). 

11 (2) The United Nations Conference on Trade 

12 and Development determined that the COVID–19 

13 pandemic pushed the global economy into recession 

14 in 2020 on a scale that has not been witnessed since 

15 the 1930s. 

16 (3) Developed countries are expected to experi17 ence a relatively more significant rebound in gross 

18 domestic product growth during 2021 than is ex19 pected to be experienced in developing countries, 

20 leading to concerns about a further expansion in the 

21 gap between rich and poor countries, particularly if 

22 this trend continues into 2022. 

23 (4) Global markets have suffered losses ranging 

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1 ering in 2021, global job losses and unemployment 

2 rates remain high, with— 

3 (A) approximately 33,000,000 labor hours 

4 have been lost globally (13 per cent of the total 

5 hours lost) due to outright unemployment; and 

6 (B) an estimated additional 81,000,000 

7 labor hours have been lost due to inactivity or 

8 underemployment. 

9 (5) Given the prolonged nature of the COVID– 

10 19 pandemic, African finance ministers have re11 quested continued efforts to provide— 

12 (A) additional liquidity; 

13 (B) better market access; 

14 (C) more concessional resources; and 

15 (D) an extension in the Debt Service Sus16 pension Initiative established by the Group of 

17 20. 

18 (b) SENSE OF CONGRESS.—It is the sense of Con19 gress that— 

20 (1) even when markets begin to recover in the 

21 future, it is likely that access to capital will be espe22 cially challenging for developing countries, which still 

23 will be struggling with the containment of, and the 

24 recovery from, the COVID–19 pandemic; 


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1 (2) economic uncertainty and the inability of in2 dividuals and households to generate income are 

3 major drivers of political instability and social dis4 cord, which creates conditions for insecurity; 

5 (3) it is in the security and economic interests 

6 of the United States to assist in the economic recov7 ery of developing countries that are made more vul8 nerable and unstable from the public health and eco9 nomic impacts of the COVID–19 pandemic; 

10 (4) United States foreign assistance and devel11 opment finance institutions should seek to blunt the 

12 impacts of a COVID–19 related economic recession 

13 by supporting investments in sectors critical to 

14 maintaining economic stability and resilience in low 

15 and middle income countries; 

16 (5) the need for the United States International 

17 Development Finance Corporation’s support for ad18 vancing development outcomes in less developed 

19 countries, as mandated by the Better Utilization of 

20 Investments Leading to Development Act of 2018 

21 (22 U.S.C. 9601 et seq.), is critical to ensuring last22 ing and resilient economic growth in light of the 

23 COVID–19 pandemic’s exacerbation of economic 

24 hardships and challenges; 


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1 (6) the United States International Develop2 ment Finance Corporation should adjust its view of 

3 risk versus return by taking smart risks that may 

4 produce a lower rate of financial return, but produce 

5 significant development outcomes in responding to 

6 the economic effects of COVID–19; and 

7 (7) to mitigate the economic impacts of the 

8 COVID–19 recession, the United States Inter9 national Development Finance Corporation should 

10 use its resources and authorities, among other 

11 things— 

12 (A) to ensure loan support for small- and 

13 medium-sized enterprises; 

14 (B) to offer local currency loans to bor15 rowers for working capital needs; 

16 (C) to create dedicated financing opportu17 nities for new ‘‘customers’’ that are experi18 encing financial hardship due to the COVID–19 

19 pandemic; and 

20 (D) to work with other development fi21 nance institutions to create co-financing facili22 ties to support customers experiencing hardship 

23 due to the COVID–19 pandemic. 


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1 SEC. 110. SENSE OF CONGRESS REGARDING INTER2 NATIONAL COOPERATION TO PREVENT AND 

3 RESPOND TO FUTURE PANDEMICS. 

4 It is the sense of Congress that— 

5 (1) global pandemic preparedness and response 

6 requires international and regional cooperation and 

7 action; 

8 (2) the United States should lead efforts in 

9 multilateral fora, such as the Group of 7, the Group 

10 of 20, and the United Nations, by collaborating and 

11 cooperating with other countries and international 

12 and regional organizations, including the World 

13 Health Organization and other key stakeholders, to 

14 implement international strategies, tools, and agree15 ments to better prevent, detect, and respond to fu16 ture infectious disease threats before they become 

17 pandemics; and 

18 (3) the United States should enhance and ex19 pand coordination and collaboration among the rel20 evant Federal departments and agencies, the Food 

21 and Agriculture Organization of the United Nations, 

22 the World Health Organization, and the World Or23 ganization for Animal Health, to advance a One 

24 Health approach toward preventing, detecting, and 

25 responding to zoonotic threats in the human-animal 

26 interface. 


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1 SEC. 111. ROLES OF THE DEPARTMENT OF STATE, THE 

2 UNITED STATES AGENCY FOR INTER3 NATIONAL DEVELOPMENT, AND THE CEN4 TERS FOR DISEASE CONTROL AND PREVEN5 TION IN PANDEMIC RESPONSE. 

6 (a) DESIGNATION OF LEAD AGENCIES FOR COORDI7 NATION OF THE UNITED STATES RESPONSE TO INFEC8 TIOUS DISEASE OUTBREAKS WITH SEVERE OR PANDEMIC

9 POTENTIAL.—In the event of an infectious disease out10 break outside of the United States with pandemic poten11 tial, the President should designate agencies to lead spe12 cific aspects of the response efforts, including— 

13 (1) designating the Department of State to 

14 serve as the lead for diplomatic engagement, and re15 lated foreign policy efforts, including— 

16 (A) enhanced coordination of engagement 

17 with multilateral organizations and countries, 

18 and mobilization of donor contributions; and 

19 (B) support for United States citizens 

20 abroad; 

21 (2) designating the United States Agency for 

22 International Development to serve as the key lead 

23 agency for design and implementation of the United 

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1 break by leading programmatic activities, as nec2 essary and appropriate, including— 

3 (A) immediate health, disaster assistance, 

4 and humanitarian response needs and preven5 tion and preparedness activities in neighboring 

6 at-risk countries; 

7 (B) testing, treatment, and assistance with 

8 preventative care units and community care fa9 cilities; 

10 (C) surveillance, case investigation, and 

11 rapid response capability; 

12 (D) providing supplies, such as personal 

13 protective, screening, and treatment equipment; 

14 (E) conducting community outreach and 

15 communication and mobilization efforts; 

16 (F) logistics support; and 

17 (G) serving as lead agency for disease out18 break response abroad; and 

19 (3) designating the Centers for Disease Control 

20 and Prevention to serve as the public health lead for 

21 the international response to the potential pandemic 

22 outbreak by conducting activities, such as— 

23 (A) infection prevention and control, con24 tact tracing, and laboratory surveillance and 

25 training; 


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1 (B) building up, in coordination with the 

2 United States Agency for International Devel3 opment, emergency operation centers; 

4 (C) providing education and outreach; and 

5 (D) assessing the safety and efficacy of 

6 vaccine and treatment candidates in the con7 duct of clinical trials in affected countries. 

8 SEC. 112. USAID DISASTER SURGE CAPACITY. 

9 (a) SURGE CAPACITY.—Amounts authorized to be 

10 appropriated or otherwise made available to carry out part 

11 I and chapter 4 of part II of the Foreign Assistance Act 

12 of 1961 (22 U.S.C. 2151 et seq.), including funds made 

13 available for ‘‘Assistance for Europe, Eurasia and Central 

14 Asia’’, may be used, in addition to amounts otherwise 

15 made available for such purposes, for the cost (including 

16 support costs) of individuals detailed to or employed by 

17 the United States Agency for International Development 

18 whose primary responsibility is to carry out programs in 

19 response to global health emergencies and natural or man20 made disasters. 

21 (b) NOTIFICATION.—Not later than 15 days before 

22 making funds available to address man-made disasters 

23 pursuant to subsection (a), the Secretary of State or the 

24 Administrator of the United States Agency for InterVerDate Sep 11 2014 20:23 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6201 E:\BILLS\S2297.IS S2297

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1 national Development shall notify the appropriate congres2 sional committees of such action. 

3 SEC. 113. STATEMENT OF POLICY ON HUMANITARIAN AS4 SISTANCE TO COUNTRIES AFFECTED BY 

5 PANDEMICS. 

6 (a) STATEMENT OF POLICY.—It shall be the policy 

7 of the United States— 

8 (1) to ensure that United States assistance to 

9 address pandemics, including the provision of vac10 cines, reaches vulnerable and marginalized popu11 lations, including racial and religious minorities, ref12 ugees, internally displaced persons, migrants, state13 less persons, women, children, the elderly, and per14 sons with disabilities; 

15 (2) to ensure that United States assistance, in16 cluding development finance, addresses the second 

17 order effects of a pandemic, including acute food in18 security; and 

19 (3) to protect and support humanitarian actors 

20 who are essential workers in preventing, mitigating 

21 and responding to the spread of a pandemic among 

22 vulnerable and marginalized groups described in 

23 paragraph (1), including ensuring that such humani24 tarian actors— 


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1 (A) are exempted from unreasonable travel 

2 restrictions to ensure that they can effectively 

3 provide life-saving assistance; and 

4 (B) are prioritized as frontline workers in 

5 country vaccine distribution plans. 

6 (b) FACILITATING EFFECTIVE AND SAFE HUMANI7 TARIAN ASSISTANCE.—The Secretary of State, in coordi8 nation with the Administrator of the United States Agen9 cy for International Development, should carry out actions 

10 that accomplish the policies set forth in subsection (a), 

11 including by— 

12 (1) taking steps to ensure that travel restric13 tions implemented to help contain the spread of a 

14 pandemic are not applied to individuals authorized 

15 by the United States Government to travel to, or re16 side in, a designated country to provide assistance 

17 related to, or otherwise impacted by, an outbreak; 

18 (2) approving the usage of foreign assistance 

19 funding for the procurement of personal protective 

20 equipment by United States Government imple21 menting partners from businesses within or nearby 

22 the country receiving foreign assistance on an urgent 

23 basis and in a manner consistent with efforts to re24 spond to the spread of a pandemic in the United 

25 States; and 


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1 (3) waiving certain travel restrictions imple2 mented to help contain the spread of a pandemic in 

3 order to facilitate the medical evacuation of United 

4 States Government implementing partners, regard5 less of nationality. 

6 TITLE II—INTERNATIONAL PAN7 DEMIC PREVENTION AND 

8 PREPAREDNESS 

9 SEC. 201. PARTNER COUNTRY DEFINED. 

10 In this title, the term ‘‘partner country’’ means a for11 eign country in which the relevant Federal departments 

12 and agencies are implementing United States assistance 

13 for global health security and pandemic prevention and 

14 preparedness under this Act. 

15 SEC. 202. GLOBAL HEALTH SECURITY STRATEGY AND RE16 PORT. 

17 (a) IN GENERAL.—The President shall develop, up18 date, maintain, and advance a comprehensive strategy for 

19 improving global health security and pandemic prevention, 

20 preparedness, and response that— 

21 (1) clearly articulates the policy goals related to 

22 pandemic prevention, preparedness, and response, 

23 and actions necessary to elevate and strengthen 

24 United States diplomatic leadership in global health 


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1 security and pandemic preparedness, including by 

2 building the expertise of the diplomatic corps; 

3 (2) improves the effectiveness of United States 

4 foreign assistance to prevent, detect, and respond to 

5 infectious disease threats, through a One Health ap6 proach, including through the advancement of the 

7 Global Health Security Agenda, the International 

8 Health Regulations (2005), and other relevant 

9 frameworks and programs that contribute to global 

10 health security and pandemic preparedness; 

11 (3) establishes specific and measurable goals, 

12 benchmarks, timetables, performance metrics, and 

13 monitoring and evaluation plans for United States 

14 foreign policy and assistance for global health secu15 rity that promote learning and adaptation and re16 flect international best practices relating to global 

17 health security, transparency, and accountability; 

18 (4) establishes transparent means to improve 

19 coordination and performance by the relevant Fed20 eral departments and agencies and sets out clear 

21 roles and responsibilities that reflect the unique ca22 pabilities and resources of each such department and 

23 agency; 

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1 evant Federal departments and agencies, partner 

2 countries, donor countries, the private sector, multi3 lateral organizations, and other key stakeholders, 

4 and ensures collaboration at the country level; 

5 (6) supports, and is aligned with, partner coun6 try-led, global health security policy and investment 

7 plans, developed with input from key stakeholders, 

8 as appropriate; 

9 (7) prioritizes working with partner countries 

10 with— 

11 (A) demonstrated need, as identified 

12 through the Joint External Evaluation process, 

13 the Global Health Security Index classification 

14 of health systems, national action plans for 

15 health security, Global Health Security Agenda 

16 Action Packages, other risk-based assessments, 

17 and other complementary or successor indica18 tors of global health security and pandemic pre19 paredness; and 

20 (B) demonstrated commitment to trans21 parency, including budget and global health 

22 data transparency, complying with the Inter23 national Health Regulations (2005), investing 

24 in domestic health systems, and achieving meas25 urable results; 


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1 (8) reduces long-term reliance upon United 

2 States foreign assistance for global health security 

3 by— 

4 (A) helping build and enhance community 

5 resilience to infectious disease emergencies and 

6 threats, such as COVID–19 and Ebola; 

7 (B) ensuring that United States global 

8 health assistance is strategically planned and 

9 coordinated in a manner that contributes to the 

10 strengthening of overall health systems and 

11 builds the capacity of local organizations and 

12 institutions; 

13 (C) promoting improved domestic resource 

14 mobilization, co-financing, and appropriate na15 tional budget allocations for strong health sys16 tems, global health security, and pandemic pre17 paredness and response in partner countries; 

18 and 

19 (D) ensuring partner country ownership of 

20 global health security strategies, data, pro21 grams, and outcomes; 

22 (9) supports health budget and workforce plan23 ning in partner countries, including training in pub24 lic financial management and budget data trans25 parency; 


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1 (10) works to ensure that— 

2 (A) partner countries have national action 

3 plans for health security that are developed 

4 with input from key stakeholders, including 

5 communities and the private sector; and 

6 (B) United States foreign assistance for 

7 global health security is aligned with existing 

8 national action plans for health security in part9 ner countries, developed with input from key 

10 stakeholders, including communities and the 

11 private sector, to the greatest extent practicable 

12 and appropriate; 

13 (11) strengthens linkages between complemen14 tary bilateral and multilateral foreign assistance pro15 grams, including efforts of the World Bank, the 

16 World Health Organization, the Global Fund to 

17 Fight AIDS, Tuberculosis, and Malaria, Gavi, the 

18 Vaccine Alliance, and regional health organizations, 

19 that contribute to the development of more resilient 

20 health systems and supply chains in partner coun21 tries with the capacity, resources, and personnel re22 quired to prevent, detect, and respond to infectious 

23 disease threats; and 

24 (12) supports innovation and partnerships with 

25 the private sector, health organizations, civil society, 


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1 nongovernmental organizations, and health research 

2 and academic institutions to improve pandemic pre3 paredness and response, including for the prevention 

4 and detection of infectious disease, and the develop5 ment and deployment of effective, accessible, and af6 fordable infectious disease tracking tools, 

7 diagnostics, therapeutics, and vaccines. 

8 (b) SUBMISSION OF STRATEGY.—Not later than 120 

9 days after the date of the enactment of this Act, the Presi10 dent shall submit the strategy required under subsection 

11 (a) to the appropriate congressional committees. 

12 (c) ANNUAL REPORT.— 

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

14 the submission of the strategy to the appropriate 

15 congressional committees under subsection (b), and 

16 not later than October 1 of each year thereafter for 

17 the following 4 fiscal years, the President shall sub18 mit a report to the appropriate congressional com19 mittees that describes— 

20 (A) the status of the implementation of the 

21 strategy required under subsection (a); 

22 (B) any necessary updates to the strategy; 

23 (C) the progress made in implementing the 

24 strategy, with specific information related to 

25 the progress toward improving countries’ ability 


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1 to detect, respond and prevent the spread of in2 fectious disease threats, such as COVID–19 

3 and Ebola; and 

4 (D) details on the status of funds made 

5 available to carry out the purposes of this title. 

6 (2) AGENCY-SPECIFIC PLANS.—The reports re7 quired under paragraph (1) shall include specific im8 plementation plans from each relevant Federal de9 partment and agency that describe— 

10 (A) how updates to the strategy may have 

11 impacted the agency’s plan during the pre12 ceding calendar year; 

13 (B) the progress made in meeting the 

14 goals, objectives, and benchmarks under imple15 mentation plans during the preceding year; 

16 (C) the anticipated staffing plans and con17 tributions of the department or agency, includ18 ing technical, financial, and in-kind contribu19 tions, to implement the strategy; 

20 (D) a transparent, open, and detailed ac21 counting of obligations by each of the relevant 

22 Federal departments and agencies to implement 

23 the strategy, including— 

24 (i) the statutory source of obligated 

25 funds; 


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1 (ii) the amounts obligated; 

2 (iii) implementing partners; 

3 (iv) targeted beneficiaries; and 

4 (v) activities supported; 

5 (E) the efforts of the relevant Federal de6 partment or agency to ensure that the activities 

7 and programs carried out pursuant to the strat8 egy are designed to achieve maximum impact 

9 and enduring returns, including through spe10 cific activities to strengthen health systems, as 

11 appropriate; and 

12 (F) a plan for regularly reviewing and up13 dating programs and partnerships, and for 

14 sharing lessons learned with a wide range of 

15 stakeholders in an open, transparent manner. 

16 (3) FORM.—The reports required under para17 graph (1) shall be submitted in unclassified form, 

18 but may contain a classified annex. 

19 SEC. 203. COMMITTEE ON GLOBAL HEALTH SECURITY AND 

20 PANDEMIC AND BIOLOGICAL THREATS. 

21 (a) STATEMENT OF POLICY.—It shall be the policy 

22 of the United States— 

23 (1) to promote global health security as a core 

24 national and security interest; and 


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1 (2) to ensure effective coordination and collabo2 ration between the relevant Federal departments 

3 and agencies engaged domestically and internation4 ally in efforts to advance the global health security 

5 of the United States, in accordance with paragraph 

6 (1). 

7 (b) COORDINATION.— 

8 (1) DEFINED TERM.—In this subsection, the 

9 term ‘‘pandemic threat’’ means any infectious dis10 ease that— 

11 (A) has an aggregation of cases in a com12 munity that rises above what is normally ex13 pected in that population in that area; 

14 (B) has the potential to spread over several 

15 countries or continents; and 

16 (C) could, if not addressed, threaten the 

17 national security of the United States. 

18 (2) COMMITTEE ON GLOBAL HEALTH SECURITY

19 AND PANDEMIC AND BIOLOGICAL THREATS.—There 

20 is authorized to be established, within the National 

21 Security Council, the Committee on Global Health 

22 Security and Pandemic and Biological Threats (re23 ferred to in this subsection as the ‘‘Committee’’), 

24 whose day to day operations should be led by the 

25 Special Advisor for Global Health Security. 


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1 (3) SPECIAL ADVISOR FOR GLOBAL HEALTH SE2 CURITY.—The Special Advisor for Global Health Se3 curity referred to in paragraph (2)— 

4 (A) should serve as part of the staff of the 

5 National Security Council; and 

6 (B) may also be the Senior Director for a 

7 Global Health Security and Biodefense Direc8 torate within the Executive Office of the Presi9 dent, who reports to the Assistant to the Presi10 dent for National Security Affairs. 

11 (4) COMPOSITION.—The Committee should in12 clude the following members: 

13 (A) The Director of National Intelligence. 

14 (B) The Secretary of State. 

15 (C) The Secretary of Defense. 

16 (D) The Secretary of Health and Human 

17 Services. 

18 (E) The Administrator of the United 

19 States Agency for International Development. 

20 (F) The Secretary of Agriculture. 

21 (G) The Secretary of the Treasury. 

22 (H) The Attorney General. 

23 (I) The Secretary of Homeland Security. 

24 (J) The Office of Management and Budg25 et. 


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1 (K) The Administrator of the Environ2 mental Protection Agency. 

3 (L) The Director of the Centers for Dis4 ease Control and Prevention. 

5 (M) The Director of the Office of Science 

6 and Technology Policy. 

7 (N) The Assistant to the President for Na8 tional Security Affairs, who should serve as the 

9 chairperson of the Committee. 

10 (O) Such other members as the President 

11 may designate. 

12 (5) FUNCTIONS.— 

13 (A) IN GENERAL.—The functions of the 

14 Committee should be— 

15 (i) to provide strategic guidance for 

16 the development of a policy framework for 

17 activities of the United States Government 

18 relating to global health security, including 

19 pandemic prevention, preparedness and re20 sponse; and 

21 (ii) to ensure policy coordination be22 tween United States Government agencies, 

23 especially coordination between— 

24 (I) agencies with a primarily do25 mestic mandate; and 


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1 (II) agencies with an inter2 national mandate relating to global 

3 health security and pandemic threats. 

4 (B) ACTIVITIES.—In carrying out the 

5 functions described in subparagraph (A), the 

6 Committee should— 

7 (i) conduct, in coordination with the 

8 heads of relevant Federal agencies, a re9 view of existing United States health secu10 rity policies and strategies and develop rec11 ommendations for how the Federal Gov12 ernment may regularly update and har13 monize such policies and strategies to en14 sure the timely development of a com15 prehensive coordinated strategy to enable 

16 the United States Government to respond 

17 to pandemic threats and to monitor the 

18 implementation of such strategies; 

19 (ii) develop a plan for— 

20 (I) establishing an interagency 

21 National Center for Epidemic Fore22 casting and Outbreak Analytics; and 

23 (II) modernizing global early 

24 warning and trigger systems for scal25 ing action to prevent, detect, respond 


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1 to, and recover from emerging biologi2 cal threats; 

3 (iii) provide policy-level recommenda4 tions to participating agencies regarding 

5 the Global Health Security Agenda goals, 

6 objectives, and implementation, and other 

7 international efforts to strengthen pan8 demic prevention, preparedness and re9 sponse; 

10 (iv) review the progress toward, and 

11 working to resolve challenges in, achieving 

12 United States commitments under the 

13 GHSA; 

14 (v) develop protocols for coordinating 

15 and deploying a global response to emerg16 ing high-consequence infectious disease 

17 threats that outline the respective roles for 

18 relevant Federal agencies in facilitating 

19 and supporting such response operations 

20 that should facilitate the operational work 

21 of Federal agencies, and of the Special Ad22 visor for Global Health Security; 

23 (vi) make recommendations regarding 

24 appropriate responses to specific pandemic 

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1 mestic and international agencies regard2 ing the Federal Government’s efforts to 

3 prevent, detect, respond to, and recover 

4 from biological events; and 

5 (vii) take steps to strengthen the glob6 al pandemic supply chain and address any 

7 barriers to the timely delivery of supplies 

8 in response to a pandemic, including 

9 through engagement with the private sec10 tor, as appropriate; 

11 (C) develop policies and procedures to en12 sure the effective sharing of information from 

13 domestic and international sources about pan14 demic threats among the relevant Federal de15 partments and agencies, State and local govern16 ments, and international partners and organiza17 tions; and 

18 (D) develop guidelines to enhance and im19 prove the operational coordination between 

20 State and local governments and Federal agen21 cies with respect to pandemic threats. 

22 (6) FOREIGN AFFAIRS RESPONSIBILITIES.—The 

23 Committee should not assume any foreign affairs re24 sponsibilities of the Secretary of State, including the 

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1 grams and policies that advance global health secu2 rity within foreign countries. 

3 (7) SPECIFIC ROLES AND RESPONSIBILITIES.— 

4 (A) IN GENERAL.—The heads of the agen5 cies listed in paragraph (4) should— 

6 (i) make global health security and 

7 pandemic threat reduction a high priority 

8 within their respective agencies, and in9 clude global health security and pandemic 

10 threat reduction-related activities within 

11 their respective agencies’ strategic plan12 ning and budget processes; 

13 (ii) designate a senior-level official to 

14 be responsible for global health security 

15 and pandemic threat reduction at each of 

16 their respective agencies; 

17 (iii) designate, in accordance with 

18 paragraph (4), an appropriate representa19 tive at the Assistant Secretary level or 

20 higher to participate on the Committee in 

21 instances where the head of the agency 

22 cannot participate; 

23 (iv) keep the Committee apprised of 

24 Global Health Security and pandemic 


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1 threat reduction-related activities under2 taken within their respective agencies; 

3 (v) ensure interagency cooperation 

4 and collaboration and maintain responsi5 bility for agency-related programmatic 

6 functions including, as applicable, in co7 ordination with host governments, country 

8 teams, and global health security in-coun9 try teams; and 

10 (vi) keep the Committee apprised of 

11 GHSA-related activities undertaken within 

12 their respective agencies. 

13 (B) ADDITIONAL ROLES AND RESPON14 SIBILITIES.—In addition to the roles and re15 sponsibilities described in subparagraph (A), 

16 the heads of the agencies described in para17 graph (4) should carry out their respective roles 

18 and responsibilities described in Executive 

19 Order 13747 (81 Fed. Reg. 78701; relating to 

20 Advancing the Global Health Security Agenda 

21 to Achieve a World Safe and Secure from Infec22 tious Disease Threats) and the National Secu23 rity Memorandum-1 on United States Global 

24 Leadership to Strengthen the International 

25 COVID–19 Response and to Advance Global 


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1 Health Security and Biological Preparedness, 

2 as in effect on the day before the date of the 

3 enactment of this Act. 

4 SEC. 204. UNITED STATES OVERSEAS GLOBAL HEALTH SE5 CURITY AND DIPLOMACY COORDINATION 

6 AND STRATEGY. 

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

8 the Department of State, a Special Representative for 

9 United States International Activities to Advance Global 

10 Health Security and Diplomacy Overseas (referred to in 

11 this section as the ‘‘Special Representative’’). 

12 (b) APPOINTMENT; QUALIFICATIONS.—The Special 

13 Representative— 

14 (1) shall be appointed by the President, by and 

15 with the advice and consent of the Senate; 

16 (2) shall report to the Secretary of State; and 

17 (3) shall have— 

18 (A) demonstrated knowledge and experi19 ence in the fields of development and public 

20 health, epidemiology, or medicine; and 

21 (B) relevant diplomatic, policy, and polit22 ical expertise. 

23 (c) AUTHORITIES.—The Special Representative is au24 thorized— 


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1 (1) to operate internationally to carry out the 

2 purposes of this title; 

3 (2) to lead in developing a global pandemic pre4 vention, preparedness and response framework to 

5 support global pandemic prevention, preparedness, 

6 responses and recovery efforts, including through— 

7 (A) diplomatic engagement and related for8 eign policy efforts, such as multilateral and bi9 lateral arrangements, enhanced coordination of 

10 engagement with multilateral organizations and 

11 countries, and the mobilization of donor con12 tributions; and 

13 (B) support for United States citizens liv14 ing abroad, including consular support; 

15 (3) to serve as the representative of the Sec16 retary of the State on the Committee on Global 

17 Health Security and Pandemic and Biological 

18 Threats under section 202; 

19 (4) to represent the United States on the Fund 

20 for Global Health Security and Pandemic Prevention 

21 and Preparedness established pursuant to section 

22 302(a); 

23 (5) to transfer and allocate United States for24 eign assistance funding authorized to be appro25 priated pursuant to subsection (f) to the relevant 


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1 Federal departments and agencies implementing the 

2 strategy required under section 202, in coordination 

3 with the Office of Management and Budget, the 

4 United States Agency for International Develop5 ment, the Department of Health and Human Serv6 ices, and the Office of Foreign Assistance Resources 

7 in the Department of State; 

8 (6) to utilize detailees, on a reimbursable or 

9 nonreimbursable basis, from the relevant Federal de10 partments and agencies and hire personal service 

11 contractors, who may operate domestically and inter12 nationally, to ensure that the Office of the Special 

13 Representative has access to the highest quality ex14 perts available to the United States Government to 

15 carry out the functions under this Act; and 

16 (7) to perform such other functions as the Sec17 retary of State may assign. 

18 (d) DUTIES.—The Special Representative shall co19 ordinate, manage, and oversee United States foreign pol20 icy, diplomatic efforts, and foreign assistance funded with 

21 amounts appropriated pursuant to subsection (f) to ad22 vance the United States Global Health Security and Diplo23 macy Strategy developed pursuant to section 202, includ24 ing by— 


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1 (1) developing and coordinating a global pan2 demic prevention, preparedness and response frame3 work to support pandemic preparedness, responses 

4 and recovery efforts, and related foreign policy 

5 measures, such as multilateral and bilateral arrange6 ments; 

7 (2) enhancing engagement with multilateral or8 ganizations and partner countries, including through 

9 the mobilization of donor support; 

10 (3) enhancing coordination of consular services 

11 for United States citizens abroad in the event of a 

12 global health emergency; 

13 (4) ensuring effective program coordination and 

14 implementation by the relevant Federal departments 

15 and agencies by— 

16 (A) formulating, issuing, and updating re17 lated policy guidance; 

18 (B) establishing, in consultation with the 

19 United States Agency for International Devel20 opment and the Centers for Disease Control 

21 and Prevention, unified auditing, monitoring, 

22 and evaluation plans; 

23 (C) aligning, in coordination with United 

24 States chiefs of mission and country teams in 

25 partner countries— 


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1 (i) the foreign assistance resources 

2 funded with amounts appropriated pursu3 ant to subsection (f); and 

4 (ii) the implementation plans required 

5 under section 202(c)(2) with the relevant 

6 Federal departments and agencies in a 

7 manner that— 

8 (I) is consistent with Executive 

9 Order 13747 (81 Fed. Reg. 78701; 

10 relating to Advancing the Global 

11 Health Security Agenda to Achieve a 

12 World Safe and Secure from Infec13 tious Disease Threats); 

14 (II) is consistent with the Na15 tional Security Memorandum on 

16 United States Global Leadership to 

17 Strengthen the International COVID– 

18 19 Response and to Advance Global 

19 Health Security and Biological Pre20 paredness, issued by President Biden 

21 on January 21, 2021; and 

22 (III) reflects and leverages the 

23 unique capabilities of each such de24 partment and agency; 


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1 (D) convening, as appropriate, an inter2 agency working group on pandemic prevention 

3 and preparedness, headed by the Special Rep4 resentative and including representatives from 

5 the relevant Federal departments and agencies, 

6 to facilitate coordination of activities relating to 

7 pandemic prevention and preparedness in part8 ner countries under this Act; 

9 (E) working with, and leveraging the ex10 pertise and activities of, the Office of the 

11 United States Global AIDS Coordinator, the 

12 Office of the United States Global Malaria Co13 ordinator, and similar or successor entities that 

14 are implementing United States global health 

15 assistance overseas; and 

16 (F) avoiding duplication of effort and 

17 working to resolve policy, program, and funding 

18 disputes among the relevant Federal depart19 ments and agencies; 

20 (5) leading diplomatic efforts to identify and 

21 address current and emerging threats to global 

22 health security; 

23 (6) ensuring, in coordination with the Secretary 

24 of Health and Human Services and the Adminis25 trator of the United States Agency for International 


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1 Development, effective representation of the United 

2 States in relevant international forums, including at 

3 the World Health Organization, the World Health 

4 Assembly, and meetings of the Global Health Secu5 rity Agenda and of the Global Health Security Ini6 tiative; 

7 (7) working to enhance coordination with, and 

8 transparency among, the governments of partner 

9 countries and key stakeholders, including the private 

10 sector; 

11 (8) promoting greater donor and national in12 vestment in partner countries to build more resilient 

13 health systems and supply chains, including through 

14 representation and participation in a multilateral, 

15 catalytic financing mechanism for global health secu16 rity and pandemic prevention and preparedness, con17 sistent with title III; 

18 (9) securing bilateral and multilateral financing 

19 commitments to advance the Global Health Security 

20 Agenda, including through funding for the financing 

21 mechanism described in title III; and 

22 (10) providing regular updates to the appro23 priate congressional committees regarding the fulfill24 ment of the duties described in this subsection. 


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1 (e) DEPUTY REPRESENTATIVE.—The Special Rep2 resentative should be supported by a deputy, who— 

3 (1) should be an employee of the United States 

4 Agency for International Development serving in a 

5 career or noncareer position in the Senior Executive 

6 Service or at the level of a Deputy Assistant Admin7 istrator or higher; 

8 (2) should have demonstrated knowledge and 

9 experience in the fields of development and public 

10 health, epidemiology, or medicine; and 

11 (3) serves concurrently as the deputy and per12 forms the functions described in section 3(h) of Ex13 ecutive Order 13747 (81 Fed. Reg. 78701). 

14 (f) AUTHORIZATION OF APPROPRIATIONS.— 

15 (1) IN GENERAL.—There is authorized to be 

16 appropriated $3,000,000,000, for the 5-year period 

17 beginning on October 1, 2022, to carry out the pur18 poses of this section and title III, which, in consulta19 tion with the appropriate congressional committees 

20 and subject to the requirements under chapters 1 

21 and 10 of part I and section 634A of the Foreign 

22 Assistance Act of 1961 (22 U.S.C. 2151 et seq.), 

23 may include support for— 

24 (A) enhancing preparedness in partner 

25 countries through implementation of the Global 


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1 Health Security Strategy developed pursuant to 

2 section 202; 

3 (B) replenishing the Emergency Reserve 

4 Fund at the United States Agency for Inter5 national Development, established pursuant to 

6 section 7058(c)(1) of the Department of State, 

7 Foreign Operations, and Related Programs Ap8 propriations Act, 2017 (division J of Public 

9 Law 115–31) to address new or emerging infec10 tious disease threats, as necessary and appro11 priate; 

12 (C) United States contributions to the 

13 World Bank Health Emergency Preparedness 

14 and Response Multi-Donor Fund; and 

15 (D) United States contributions to a multi16 lateral, catalytic financing mechanism for global 

17 health security and pandemic prevention and 

18 preparedness described in section 302. 

19 (2) EXCEPTION.—Section 110 of the Traf20 ficking Victims Protection Act of 2000 (22 U.S.C. 

21 7107) shall not apply to assistance made available 

22 pursuant to this subsection. 

23 SEC. 205. RESILIENCE. 

24 It shall be the policy of the United States to support 

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1 vancing the global health security interests of the United 

2 States by working with key stakeholders— 

3 (1) in developing countries that are highly vul4 nerable to the emergence, reemergence, and spread 

5 of infectious diseases with pandemic potential, in6 cluding diseases resulting from natural and man7 made disasters, human displacement, loss of natural 

8 habitat, poor access to water, sanitation, and hy9 giene, and other political, security, economic, and cli10 matic shocks and stresses; 

11 (2) to develop effective tools to identify, ana12 lyze, forecast, and mitigate the risks that make such 

13 countries vulnerable; 

14 (3) to better integrate short-, medium-, and 

15 long-term recovery efforts into global health emer16 gency response and disaster relief; and 

17 (4) to ensure that international assistance and 

18 financing tools are effectively designed, objectively 

19 informed, strategically targeted, carefully coordi20 nated, reasonably adapted, and rigorously monitored 

21 and evaluated in a manner that advances the policy 

22 objectives under this section. 

23 SEC. 206. STRENGTHENING HEALTH SYSTEMS. 

24 (a) STATEMENT OF POLICY.—It shall be the policy 

25 of the United States to ensure that bilateral global health 


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1 assistance programs are effectively managed and coordi2 nated to contribute to the strengthening of health systems 

3 in each country in which such programs are carried out, 

4 as necessary and appropriate. 

5 (b) COORDINATION.—The Administrator of the 

6 United States Agency for International Development (re7 ferred to in this section as ‘‘USAID’’) shall work with the 

8 Director of the Centers for Disease Control and Preven9 tion, the Global Malaria Coordinator, and the United 

10 States Global AIDS Coordinator and Special Representa11 tive for Global Health Diplomacy at the Department of 

12 State to identify areas of collaboration and coordination 

13 in countries with global health programs and activities un14 dertaken by USAID pursuant to the United States Lead15 ership Against HIV/AIDS, Tuberculosis, and Malaria Act 

16 of 2003 (Public Law 108–25) and other relevant statutes 

17 to ensure that such activities contribute to health systems 

18 strengthening. 

19 (c) PILOT PROGRAM.— 

20 (1) IN GENERAL.—The Administrator of 

21 USAID should identify not fewer than 5 countries in 

22 which the United States has significant bilateral in23 vestments in global health to develop an integrated 

24 approach toward health systems strengthening that 

25 takes advantage of all sources of funding for global 


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1 health in such country, with the aim of establishing 

2 a model for coordinating health systems strength3 ening activities in additional countries in the future. 

4 (2) ASSESSMENT.—In the countries selected 

5 under paragraph (1), USAID missions, in consulta6 tion with USAID’s Office of Health Systems 

7 Strengthening, should conduct an assessment that— 

8 (A) takes a comprehensive view of the con9 straints in the country’s health system that pre10 vent the achievement of desired outcomes of 

11 United States Government-supported health 

12 programs; 

13 (B) identifies the best opportunities for im14 proving health systems to achieve improved out15 comes, including obstacles to health service de16 livery; 

17 (C) maps the resources of the country and 

18 other donors in the health sector with a focus 

19 on investment in health system strengthening; 

20 and 

21 (D) develops and implements a new or re22 vised 5-year strategy for United States assist23 ance, based on the results of the assessment de24 scribed in subparagraph (A), to strengthen the 

25 country’s health system that— 


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1 (i) provides a framework for imple2 menting such strategy; 

3 (ii) identifies key areas for United 

4 States Government investments to 

5 strengthen the health system in alignment 

6 with other donors; 

7 (iii) specifies the anticipated role of 

8 health programs undertaken by each of the 

9 relevant Federal departments and agencies 

10 operating in the country in implementing 

11 such strategy; and 

12 (iv) includes clear goals, benchmarks, 

13 outputs, desired outcomes, a means of 

14 measuring progress and a cost analysis. 

15 (3) STRATEGIES TO STRENGTHEN HEALTH SYS16 TEMS.—USAID missions in countries identified pur17 suant paragraph (1) should develop a strategy to 

18 strengthen health systems based on the assessment 

19 developed pursuant to paragraph (2) that— 

20 (A) ensures complementarity with prior21 ities identified under any other action plan fo22 cused on strengthening a country’s health sys23 tem, such as the World Health Organization’s 

24 Joint External Evaluation and National Action 

25 Plans for Health Security; 


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1 (B) identifies bureaucratic barriers and in2 efficiencies, including poor linkages between 

3 government ministries and between ministries 

4 and donor agencies and the extent of any cor5 ruption, and identify actions to overcome such 

6 barriers; 

7 (C) identifies potential obstacles to the im8 plementation of the strategy, such as issues re9 lating to lack of political will or poor govern10 ance of an effective health system at all levels 

11 of the country’s public health systems, espe12 cially with respect to governing bodies and 

13 councils at the provincial, district, and commu14 nity levels; 

15 (D) includes proposals for mobilizing suffi16 cient and durable financing for health systems; 

17 (E) identifies barriers to building and re18 taining an effective frontline health workforce 

19 with key global health security capacities, in20 formed by the International Health Regulations 

21 (2005), including— 

22 (i) strengthened data collection and 

23 analysis; 

24 (ii) data driven decisionmaking capac25 ity; and 


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1 (iii) recommendations for partner 

2 country actions to achieve a workforce that 

3 conforms with the World Health Organiza4 tion’s recommendation for at least 44.5 

5 doctors, nurses, and midwives for every 

6 10,000 people; 

7 (F) identifies deficiencies in information 

8 systems and communication technologies that 

9 prevent linkages at all levels of the health sys10 tem delivery and medical supply systems and 

11 promotes interoperability across data systems 

12 with real time data, while protecting data secu13 rity; 

14 (G) identifies weaknesses in supply chain 

15 and procurement systems and practices, and 

16 recommends ways to improve the efficiency, 

17 transparency, and effectiveness of such systems 

18 and practices; 

19 (H) identifies obstacles to health service 

20 access and quality and improved health out21 comes for women and girls, and for the poorest 

22 and most vulnerable, including a lack of social 

23 support and other underlying causes, and rec24 ommendations for how to overcome such obsta25 cles; 


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1 (I) includes plans for integrating innova2 tions in health technologies, services, and sys3 tems; 

4 (J) identifies barriers to health literacy, 

5 community engagement, and patient empower6 ment, and recommendations for overcoming 

7 such barriers; 

8 (K) includes proposals for strengthening 

9 community health systems and the community10 based health workforce informed by the World 

11 Health Organization guideline on health policy 

12 and system support to optimize community 

13 health worker programmes (2018), including 

14 the professionalization of community health 

15 workers; and 

16 (L) describes the role of the private sector 

17 and nongovernmental health providers, includ18 ing community groups engaged in health pro19 motion and mutual assistance and other institu20 tions engaged in health delivery, including the 

21 extent to which the local population utilizes 

22 such health services. 

23 (4) CONSULTATION.—In developing a strategy 

24 pursuant to paragraph (3), each USAID mission 


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1 should consult with a wide variety of stakeholders, 

2 including— 

3 (A) relevant partner government institu4 tions; 

5 (B) professional associations; 

6 (C) patient groups; 

7 (D) civil society organizations (including 

8 international nongovernmental organizations 

9 with relevant expertise in program implementa10 tion); and 

11 (E) the private sector. 

12 (d) INTERNATIONAL EFFORTS.— 

13 (1) COORDINATION.—The Secretary of State, in 

14 coordination with the Administrator of USAID, 

15 should work with the Global Fund to Fight AIDS, 

16 Tuberculosis, and Malaria, Gavi, the Vaccine Alli17 ance, bilateral donors, and other relevant multilat18 eral and international organizations and stake19 holders to develop— 

20 (A) shared core indicators for strengthened 

21 health systems; 

22 (B) agreements among donors that report23 ing requirements for health systems come from 

24 country systems to reduce the burden placed on 

25 partner countries; 


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1 (C) structures for joint assessments, plans, 

2 auditing, and consultations; and 

3 (D) a regularized approach to coordination 

4 on health systems strengthening. 

5 (e) PUBLIC PRIVATE PARTNERSHIPS TO IMPROVE

6 HEALTH SYSTEMS STRENGTHENING.— 

7 (1) INCLUSION IN COUNTRY STRATEGIES.—The 

8 country strategies developed under subsection (c)(3) 

9 should include a section that— 

10 (A) discusses the role of the private sector 

11 (including corporate, local, and international or12 ganizations with relevant expertise); and 

13 (B) identifies relevant opportunities for the 

14 private sector— 

15 (i) to accelerate research and develop16 ment of innovative health and information 

17 technology, and to offer training related to 

18 its use; 

19 (ii) to contribute to improvements in 

20 health administration and management 

21 processes; 

22 (iii) to improve system efficiency; 

23 (iv) to develop training related to clin24 ical practice guidelines; and 


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1 (v) to help countries develop systems 

2 for documenting outcomes and achieve3 ments related to activities undertaken to 

4 strengthen the health sector. 

5 (f) AUTHORIZATION FOR USE OF FUNDS.—Amounts 

6 authorized to be appropriated or otherwise made available 

7 to carry out section 104 of the Foreign Assistance Act 

8 of 1961 (22 U.S.C. 2151b) may be made available to carry 

9 out this section. 

10 SEC. 207. ADDITIONAL AUTHORITIES. 

11 (a) FOREIGN ASSISTANCE ACT OF 1961.—Chapter 1 

12 of part I of the Foreign Assistance Act of 1961 (22 U.S.C. 

13 2151 et seq.) is amended— 

14 (1) in section 104(c)(1) (22 U.S.C. 

15 2151b(c)(1)), by inserting ‘‘(emphasizing health sys16 tems strengthening, as appropriate)’’ after ‘‘health 

17 services’’; 

18 (2) in section 104A (22 U.S.C. 2151b–2)— 

19 (A) in subsection (b)(3)(D), by striking 

20 ‘‘including health care systems, under other 

21 international donor support’’ and inserting ‘‘in22 cluding through support for health systems 

23 strengthening, under other donor support’’; and 

24 (B) in subsection (f)(3)(Q), by inserting 

25 ‘‘the Office of the United States Global AIDS 


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1 Coordinator, partner countries, and the Global 

2 Fund to Fight AIDS, Tuberculosis, and Ma3 laria to ensure that their actions support the 

4 activities taken to strengthen the overall health 

5 systems in recipient countries, and efforts by’’ 

6 after ‘‘efforts by’’; and 

7 (3) in section 104B(g)(2) (22 U.S.C. 2151b– 

8 3(g)(2)), by inserting ‘‘strengthening the health sys9 tem of the country and’’ after ‘‘contribute to’’. 

10 (b) UNITED STATES LEADERSHIP AGAINST HIV/ 

11 AIDS, TUBERCULOSIS, AND MALARIA ACT OF 2003.— 

12 Section 204 of the United States Leadership Against HIV/ 

13 AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 

14 7623) is amended— 

15 (1) in subsection (a)— 

16 (A) in paragraph (1)(A), by inserting ‘‘in 

17 a manner that is coordinated with, and contrib18 utes to, efforts through other assistance activi19 ties being carried out to strengthen national 

20 health systems and health policies’’ after ‘‘sys21 tems’’; and 

22 (B) in paragraph (2)— 

23 (i) in subparagraph (C), by inserting 

24 ‘‘as part of a strategy to improve overall 

25 health’’ before the semicolon at the end; 


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1 (ii) in subparagraph (D), by striking 

2 ‘‘and’’ at the end; 

3 (iii) in subparagraph (E), by striking 

4 the period at the end and inserting ‘‘; 

5 and’’; and 

6 (iv) by adding at the end the fol7 lowing: 

8 ‘‘(F) to contribute to efforts that build 

9 health systems capable of preventing, detecting 

10 and responding to HIV/AIDS, tuberculosis, ma11 laria and other infectious diseases with pan12 demic potential.’’; and 

13 (2) in subsection (b), by striking ‘‘receive fund14 ing to carry out programs to combat HIV/AIDS, tu15 berculosis, and malaria’’ and inserting ‘‘more effec16 tively budget for and receive funding to carry out 

17 programs to strengthen health systems such that 

18 countries are able to more effectively combat HIV/ 

19 AIDS, tuberculosis, and malaria, to prevent, respond 

20 and detect other diseases with pandemic potential,’’. 


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1 SEC. 208. AUTHORIZATION FOR UNITED STATES PARTICI2 PATION IN THE COALITION FOR EPIDEMIC 

3 PREPAREDNESS INNOVATIONS. 

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

5 to participate in the Coalition for Epidemic Preparedness 

6 Innovations (referred to in this section as ‘‘CEPI’’). 

7 (b) INVESTORS COUNCIL AND BOARD OF DIREC8 TORS.— 

9 (1) INITIAL DESIGNATION.—The President 

10 shall designate an employee of the United States 

11 Agency for International Development to serve on 

12 the Investors Council and, if nominated, on the 

13 Board of Directors of CEPI, as a representative of 

14 the United States during the period beginning on 

15 the date of such designation and ending on Sep16 tember 30, 2022. 

17 (2) ONGOING DESIGNATIONS.—The President 

18 may designate an employee of the relevant Federal 

19 department or agency with fiduciary responsibility 

20 for United States contributions to CEPI to serve on 

21 the Investors Council and, if nominated, on the 

22 Board of Directors of CEPI, as a representative of 

23 the United States. 

24 (3) QUALIFICATIONS.—Any employee des25 ignated pursuant to paragraph (1) or (2) shall have 

26 demonstrated knowledge and experience in the fields 


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1 of development and public health, epidemiology, or 

2 medicine, from the Federal department or agency 

3 with primary fiduciary responsibility for United 

4 States contributions pursuant to subsection (c). 

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

6 the date of the enactment of this Act, the employee des7 ignated pursuant to subsection (b)(1) shall consult with 

8 the appropriate congressional committees regarding— 

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

10 States plans to participate in CEPI, including 

11 through the governance of CEPI; 

12 (2) any planned financial contributions from 

13 the United States to CEPI; and 

14 (3) how participation in CEPI is expected to 

15 support— 

16 (A) the United States Global Health Secu17 rity Strategy required under this Act; 

18 (B) the applicable revision of the National 

19 Biodefense Strategy required under section 

20 1086 of the National Defense Authorization Act 

21 for Fiscal Year 2017 (6 U.S.C. 104); and 

22 (C) any other relevant programs relating 

23 to global health security and biodefense. 

24 (d) UNITED STATES CONTRIBUTIONS.— 


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1 (1) SENSE OF CONGRESS.—It is the sense of 

2 Congress that the President, consistent with the pro3 visions under section 10003(a)(1) of the American 

4 Rescue Plan Act of 2021, should make an immediate 

5 contribution to CEPI in the amount of 

6 $300,000,000, to expand research and development 

7 of vaccines to combat the spread of COVID–19 

8 variants. 

9 (2) NOTIFICATION.—Not later than 15 days be10 fore a contribution is made available pursuant to 

11 paragraph (1), the President shall notify the appro12 priate congressional committees of the details of the 

13 amount, purposes, and national interests served by 

14 such contribution. 

15 SEC. 209. NATIONAL INTELLIGENCE ESTIMATE AND BRIEF16 ING REGARDING NOVEL DISEASES AND PAN17 DEMIC THREATS. 

18 (a) DEFINED TERM.—In this section, the term ‘‘ap19 propriate committees of Congress’’ means— 

20 (1) the Committee on Foreign Relations of the 

21 Senate; 

22 (2) the Select Committee on Intelligence of the 

23 Senate; 

24 (3) the Committee on Health, Education, 

25 Labor, and Pensions of the Senate; 


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1 (4) the Committee on Foreign Affairs of the 

2 House of Representatives; 

3 (5) the Permanent Select Committee on Intel4 ligence of the House of Representatives; and 

5 (6) the Committee on Energy and Commerce of 

6 the House of Representatives. 

7 (b) NATIONAL INTELLIGENCE ESTIMATES.— 

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

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

10 thereafter for the following 4 years, the National In11 telligence Council shall submit to the appropriate 

12 committees of Congress a National Intelligence Esti13 mate regarding the risks posed to the national secu14 rity interests of the United States by the emergence, 

15 reemergence, and overseas transmission of patho16 gens with pandemic potential. 

17 (2) ELEMENTS.—The National Intelligence Es18 timate submitted pursuant to paragraph (1) shall— 

19 (A) identify the countries or regions most 

20 vulnerable to the emergence or reemergence of 

21 a pathogen with pandemic potential, including 

22 the most likely sources and pathways of such 

23 emergence or reemergence, whether naturally 

24 occurring, accidental, or deliberate; 


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1 (B) assess the likelihood that a pathogen 

2 described in subparagraph (A) will spread to 

3 the United States, the United States Armed 

4 Forces, diplomatic or development personnel of 

5 the United States stationed abroad, or citizens 

6 of the United States living abroad in a manner 

7 that could lead to an epidemic in the United 

8 States or otherwise affect the national security 

9 or economic prosperity of the United States; 

10 (C) assess the preparedness of countries 

11 around the world, particularly those identified 

12 pursuant to subparagraph (A), to prevent, de13 tect, and respond to pandemic threats; and 

14 (D) identify any scientific, capacity, or 

15 governance gaps in the preparedness of coun16 tries identified pursuant to subparagraph (A), 

17 including an analysis of the capacity and per18 formance of any country or entity described in 

19 subparagraph (C) in complying with biosecurity 

20 standards, as applicable. 

21 (c) CONGRESSIONAL BRIEFINGS.—The National In22 telligence Council shall provide an annual briefing to the 

23 appropriate committees of Congress regarding— 

24 (1) the most recent National Intelligence Esti25 mate submitted pursuant to subsection (b)(1); and 


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1 (2) the emergence or reemergence of pathogens 

2 with pandemic potential that could lead to an epi3 demic described in subsection (b)(2)(B). 

4 (d) PUBLIC AVAILABILITY.—The Director of Na5 tional Intelligence shall make publicly available an unclas6 sified version of each National Intelligence Estimate sub7 mitted pursuant to subsection (b)(1). 

8 SEC. 210. PANDEMIC EARLY WARNING NETWORK. 

9 (a) IN GENERAL.—The Secretary of State, in coordi10 nation with the Administrator of the United States Agen11 cy for International Development, the Secretary of Health 

12 and Human Services, and the heads of the other relevant 

13 Federal departments and agencies, shall work with the 

14 World Health Organization and other key stakeholders to 

15 establish or strengthen effective early warning systems, at 

16 the partner country, regional, and international levels, 

17 that utilize innovative information and analytical tools and 

18 robust review processes to track, document, analyze, and 

19 forecast infectious disease threats with epidemic and pan20 demic potential. 

21 (b) REPORT.—Not later than 1 year after the date 

22 of the enactment of this Act, the Secretary of State, in 

23 coordination with the Secretary of Health and Human 

24 Services and the heads of the other relevant Federal de25 partments and agencies, shall submit a report to the apVerDate Sep 11 2014 20:23 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00086 Fmt 6652 Sfmt 6201 E:\BILLS\S2297.IS S2297

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1 propriate congressional committees that describes United 

2 States Government efforts and opportunities to establish 

3 or strengthen effective early warning systems for infec4 tious disease threats. 

5 SEC. 211. INTERNATIONAL EMERGENCY OPERATIONS. 

6 (a) SENSE OF CONGRESS.—It is the sense of Con7 gress that it is essential to enhance the capacity of key 

8 stakeholders to effectively operationalize early warning 

9 and execute multi-sectoral emergency operations during 

10 an infectious disease outbreak, particularly in countries 

11 and areas that deliberately withhold critical global health 

12 data and delay access during an infectious disease out13 break in advance of the next infectious disease outbreak 

14 with pandemic potential. 

15 (b) PUBLIC HEALTH EMERGENCIES OF INTER16 NATIONAL CONCERN.—The Secretary of State, in coordi17 nation with the Secretary of Health and Human Services, 

18 should work with the World Health Organization and like19 minded member states to adopt an approach toward as20 sessing infectious disease threats under the International 

21 Health Regulations (2005) for the World Health Organi22 zation to identify and transparently communicate, on an 

23 ongoing basis, varying levels of risk leading up to a dec24 laration by the Director General of the World Health Or25 ganization of a Public Health Emergency of International 


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1 Concern for the duration and in the aftermath of such 

2 declaration. 

3 (c) EMERGENCY OPERATIONS.—The Secretary of 

4 State, in coordination with the United States Agency for 

5 International Development and other relevant Federal de6 partments and agencies and consistent with the require7 ments under the International Health Regulations (2005) 

8 and the objectives of the World Health Organization’s 

9 Health Emergencies Programme, the Global Health Secu10 rity Agenda, and national actions plans for health secu11 rity, shall work, in coordination with the World Health 

12 Organization, with partner countries and other key stake13 holders to support the establishment, strengthening, and 

14 rapid response capacity of global health emergency oper15 ations centers, at the national and international levels, in16 cluding efforts— 

17 (1) to collect and share data, assess risk, and 

18 operationalize early warning; 

19 (2) to secure, including through utilization of 

20 stand-by arrangements and emergency funding 

21 mechanisms, the staff, systems, and resources nec22 essary to execute cross-sectoral emergency oper23 ations during the 48-hour period immediately fol24 lowing an infectious disease outbreak with pandemic 

25 potential; and 


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1 (3) to organize and conduct emergency simula2 tions. 

3 TITLE III—FINANCING MECHA4 NISM FOR GLOBAL HEALTH 

5 SECURITY AND PANDEMIC 

6 PREVENTION AND PRE7 PAREDNESS 

8 SEC. 301. ELIGIBLE PARTNER COUNTRY DEFINED. 

9 In this title, the term ‘‘eligible partner country’’ 

10 means a country in which the Fund for Global Health Se11 curity and Pandemic Prevention and Preparedness to be 

12 established under section 302 may finance global health 

13 security and pandemic prevention and preparedness assist14 ance programs under this Act based on the country’s dem15 onstrated— 

16 (1) need, as identified through the Joint Exter17 nal Evaluation process, the Global Health Security 

18 Index classification of health systems, national ac19 tion plans for health security, and other complemen20 tary or successor indicators of global health security 

21 and pandemic prevention and preparedness; and 

22 (2) commitment to transparency, including— 

23 (A) budget and global health data trans24 parency; 


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1 (B) complying with the International 

2 Health Regulations (2005); 

3 (C) investing in domestic health systems; 

4 and 

5 (D) achieving measurable results. 

6 SEC. 302. ESTABLISHMENT OF FUND FOR GLOBAL HEALTH 

7 SECURITY AND PANDEMIC PREVENTION AND 

8 PREPAREDNESS. 

9 (a) NEGOTIATIONS FOR ESTABLISHMENT OF FUND

10 FOR GLOBAL HEALTH SECURITY AND PANDEMIC PRE11 VENTION AND PREPAREDNESS.—The Secretary of State, 

12 in coordination with the Secretary of the Treasury, the 

13 Administrator of the United States Agency for Inter14 national Development, the Secretary of Health and 

15 Human Services, and the heads of other relevant Federal 

16 departments and agencies, as necessary and appropriate, 

17 should seek to enter into negotiations with donors, rel18 evant United Nations agencies, including the World 

19 Health Organization, and other key multilateral stake20 holders, to establish— 

21 (1) a multilateral, catalytic financing mecha22 nism for global health security and pandemic preven23 tion and preparedness, which may be known as the 

24 Fund for Global Health Security and Pandemic Pre25 vention and Preparedness (in this title referred to as 


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1 ‘‘the Fund’’), to address the need for and secure du2 rable financing in accordance with the provisions of 

3 this section; and 

4 (2) an Advisory Board to the Fund in accord5 ance with section 305. 

6 (b) PURPOSES.—The purposes of the Fund should 

7 be— 

8 (1) to close critical gaps in global health secu9 rity and pandemic prevention and preparedness; and 

10 (2) to build capacity in eligible partner coun11 tries in the areas of global health security, infectious 

12 disease control, and pandemic prevention and pre13 paredness, in a manner that— 

14 (A) prioritizes capacity building and fi15 nancing availability in eligible partner countries; 

16 (B) incentivizes countries to prioritize the 

17 use of domestic resources for global health secu18 rity and pandemic prevention and preparedness; 

19 (C) leverages government, nongovernment, 

20 and private sector investments; 

21 (D) regularly responds to and evaluates 

22 progress based on clear metrics and bench23 marks, such as the Joint External Evaluation 

24 and the Global Health Security Index; 


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1 (E) aligns with and complements ongoing 

2 bilateral and multilateral efforts and financing, 

3 including through the World Bank, the World 

4 Health Organization, the Global Fund to Fight 

5 AIDS, Tuberculosis, and Malaria, the Coalition 

6 for Epidemic Preparedness and Innovation, and 

7 Gavi, the Vaccine Alliance; and 

8 (F) helps countries accelerate and achieve 

9 compliance with the International Health Regu10 lations (2005) and the fulfillment of the Global 

11 Health Security Agenda 2024 Framework not 

12 later than 5 years after the date on which the 

13 Fund is established, in coordination with the 

14 ongoing Joint External Evaluation national ac15 tion planning process. 

16 (c) EXECUTIVE BOARD.— 

17 (1) IN GENERAL.—The Fund should be gov18 erned by a transparent and accountable body (re19 ferred to in this title as the ‘‘Executive Board’’), 

20 which should be composed of not more than 20 rep21 resentatives of donor governments, foundations, aca22 demic institutions, civil society, indigenous people, 

23 and the private sector that meet a minimum thresh24 old in annual contributions and agree to uphold 

25 transparency measures. 


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1 (2) DUTIES.—The Executive Board should— 

2 (A) be charged with approving strategies, 

3 operations, and grant making authorities in 

4 order to conduct effective fiduciary, monitoring, 

5 and evaluation efforts, and other oversight 

6 functions; 

7 (B) be comprised only of contributors to 

8 the Fund at not less than the minimum thresh9 old to be established pursuant to paragraph (1); 

10 (C) determine operational procedures such 

11 that the Fund is able to effectively fulfill its 

12 mission; 

13 (D) provide oversight and accountability 

14 for the Fund in collaboration with the Inspector 

15 General to be established pursuant to section 

16 304(e)(1)(A); and 

17 (E) develop and utilize a mechanism to ob18 tain formal input from partner countries rel19 ative to lessons learned with regard to program 

20 implementation. 

21 (3) COMPOSITION.—The Executive Board 

22 should include— 

23 (A) representatives of the governments of 

24 founding permanent member countries who, in 

25 addition to the requirements under paragraph 


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1 (1), qualify based upon meeting an established 

2 initial contribution threshold, which should be 

3 not less than 10 percent of total initial con4 tributions, and a demonstrated commitment to 

5 supporting the International Health Regula6 tions (2005); 

7 (B) a geographically diverse group of term 

8 members who— 

9 (i) come from academic institutions, 

10 civil society, including indigenous organiza11 tions, and the private sector; and 

12 (ii) are selected by the permanent 

13 members on the basis of their experience 

14 and commitment to innovation, best prac15 tices, and the advancement of global health 

16 security objectives; 

17 (C) representatives of the World Health 

18 Organization; 

19 (D) the chair of the Global Health Security 

20 Steering Group; and 

21 (E) representatives from low- and middle22 income countries that are or will be imple23 menting a national pandemic prevention plan. 

24 (4) QUALIFICATIONS.—Individuals appointed to 

25 the Executive Board should have demonstrated 


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1 knowledge and experience across a variety of sectors, 

2 including human and animal health, agriculture, de3 velopment, defense, finance, research, and academia. 

4 (5) CONFLICTS OF INTEREST.— 

5 (A) TECHNICAL EXPERTS.—The Executive 

6 Board may include independent technical ex7 perts who are not affiliated with, or employed 

8 by, a recipient country or organization. 

9 (B) MULTILATERAL BODIES AND INSTITU10 TIONS.—Executive Board members appointed 

11 pursuant to paragraph (3)(C) should recuse 

12 themselves from matters presenting conflicts of 

13 interest, including financing decisions relating 

14 to such bodies and institutions. 

15 (6) UNITED STATES REPRESENTATION.— 

16 (A) FOUNDING PERMANENT MEMBER.— 

17 The Secretary of State should seek— 

18 (i) to establish the United States as a 

19 founding permanent member of the Fund; 

20 and 

21 (ii) to ensure that the United States 

22 is represented on the Executive Board by 

23 an officer or employee of the United 

24 States, who shall be appointed by the 

25 President. 


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1 (B) EFFECTIVE AND TERMINATION

2 DATES.— 

3 (i) EFFECTIVE DATE.—This para4 graph shall take effect upon the date on 

5 which the Secretary of State certifies and 

6 submits to Congress an agreement estab7 lishing the Fund. 

8 (ii) TERMINATION DATE.—The mem9 bership established pursuant to subpara10 graph (A) shall terminate upon the date of 

11 termination of the Fund. 

12 (7) REMOVAL PROCEDURES.—The Fund should 

13 establish procedures for the removal of members of 

14 the Executive Board who— 

15 (A) engage in a consistent pattern of 

16 human rights abuses; 

17 (B) fail to uphold global health data trans18 parency requirements; or 

19 (C) otherwise violate the established stand20 ards of the Fund, including in relation to cor21 ruption. 

22 SEC. 303. AUTHORITIES. 

23 (a) PROGRAM OBJECTIVES.— 


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

2 set forth in section 302, the Fund, acting through 

3 the Executive Board, should— 

4 (A) provide grants, including challenge 

5 grants, technical assistance, concessional lend6 ing, catalytic investment funds, and other inno7 vative funding mechanisms, as appropriate— 

8 (i) to help eligible partner countries 

9 close critical gaps in health security, as 

10 identified through the Joint External Eval11 uation process, the Global Health Security 

12 Index classification of health systems, and 

13 national action plans for health security 

14 and other complementary or successor in15 dicators of global health security and pan16 demic prevention and preparedness; and 

17 (ii) to support measures that enable 

18 such countries, at the national and sub19 national levels, and in partnership with 

20 civil society and the private sector, to 

21 strengthen and sustain resilient health sys22 tems and supply chains with the resources, 

23 capacity, and personnel required to pre24 vent, detect, mitigate, and respond to in25 fectious disease threats, including zoonotic 


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1 spillover, before they become pandemics; 

2 and 

3 (B) develop recommendations for a mecha4 nism for assisting countries that are at high 

5 risk for zoonotic spillover events with pandemic 

6 potential to participate in the Global Health Se7 curity Agenda and the Joint External Evalua8 tions. 

9 (2) ACTIVITIES SUPPORTED.—The activities to 

10 be supported by the Fund should include efforts— 

11 (A) to enable eligible partner countries to 

12 formulate and implement national health secu13 rity and pandemic prevention and preparedness 

14 action plans, advance action packages under the 

15 Global Health Security Agenda, and adopt and 

16 uphold commitments under the International 

17 Health Regulations (2005) and other related 

18 international health agreements and arrange19 ments, as appropriate; 

20 (B) to support health security budget plan21 ning in eligible partner countries, including 

22 training in public financial management and 

23 budget and health data transparency; 

24 (C) to strengthen the health workforce, in25 cluding hiring, training, and deploying experts 


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1 to improve frontline prevention of, and moni2 toring and preparedness for, unknown, new, 

3 emerging, or reemerging pathogens, epidemics, 

4 and pandemic threats; 

5 (D) to improve infection prevention and 

6 control and the protection of healthcare workers 

7 within healthcare settings; 

8 (E) to combat the threat of antimicrobial 

9 resistance; 

10 (F) to strengthen laboratory capacity and 

11 promote biosafety and biosecurity through the 

12 provision of material and technical assistance; 

13 (G) to reduce the risk of bioterrorism, 

14 zoonotic disease spillover, and accidental bio15 logical release; 

16 (H) to build technical capacity to manage 

17 health supply chains for commodities, equip18 ment, and supplies, including for personal pro19 tective equipment, testing reagents, and other 

20 lifesaving supplies, through effective fore21 casting, procurement, warehousing, and delivery 

22 from central warehouses to points of service in 

23 both the public and private sectors; 

24 (I) to enable bilateral, regional, and inter25 national partnerships and cooperation, includVerDate Sep 11 2014 20:23 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00099 Fmt 6652 Sfmt 6201 E:\BILLS\S2297.IS S2297

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1 ing through pandemic early warning systems 

2 and emergency operations centers, to identify 

3 and address transnational infectious disease 

4 threats exacerbated by natural and man-made 

5 disasters, human displacement, and zoonotic in6 fection; 

7 (J) to establish partnerships for the shar8 ing of best practices and enabling eligible coun9 tries to meet targets and indicators under the 

10 Joint External Evaluation process, the Global 

11 Health Security Index classification of health 

12 systems, and national action plans for health 

13 security relating to the prevention, detection, 

14 and treatment of neglected tropical diseases; 

15 (K) to build the technical capacity of eligi16 ble partner countries to prepare for and re17 spond to second order development impacts of 

18 infectious disease outbreaks, while accounting 

19 for the differentiated needs and vulnerabilities 

20 of marginalized populations; 

21 (L) to develop and utilize metrics to mon22 itor and evaluate programmatic performance 

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1 marks, Global Health Security Agenda targets, 

2 and Global Health Security Index indicators; 

3 (M) to develop and deploy mechanisms to 

4 enhance the transparency and accountability of 

5 global health security and pandemic prevention 

6 and preparedness programs and data, in com7 pliance with the International Health Regula8 tions (2005), including through the sharing of 

9 trends, risks, and lessons learned; 

10 (N) to develop and implement simulation 

11 exercises, produce and release after action re12 ports, and address related gaps; 

13 (O) to support countries in conducting 

14 Joint External Evaluations; and 

15 (P) to improve surveillance capacity in 

16 partner counties such that those countries are 

17 better able to detect and respond to known and 

18 unknown pathogens and zoonotic infectious dis19 eases. 

20 (3) IMPLEMENTATION OF PROGRAM OBJEC21 TIVES.—In carrying out the objectives under para22 graph (1), the Fund should work to eliminate dupli23 cation and waste by upholding strict transparency 

24 and accountability standards and coordinating its 

25 programs and activities with key partners working to 


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1 advance global health security and pandemic preven2 tion and preparedness, including— 

3 (A) governments, civil society, nongovern4 mental organizations, research and academic in5 stitutions, and private sector entities in eligible 

6 partner countries; 

7 (B) the pandemic early warning systems 

8 and international emergency operations centers 

9 to be established under sections 210 and 211; 

10 (C) the World Health Organization; 

11 (D) the Global Health Security Agenda; 

12 (E) the Global Health Security Initiative; 

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

15 (G) the United Nations Office for the Co16 ordination of Humanitarian Affairs, UNICEF, 

17 and other relevant funds, programs, and spe18 cialized agencies of the United Nations; 

19 (H) Gavi, the Vaccine Alliance; 

20 (I) the Coalition for Epidemic Prepared21 ness Innovations (CEPI); and 

22 (J) the Global Polio Eradication Initiative. 

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

24 section, the Fund should give priority to low-and lower 

25 middle income countries with— 


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1 (1) low scores on the Global Health Security 

2 Index classification of health systems; 

3 (2) measurable gaps in global health security 

4 and pandemic prevention and preparedness identi5 fied under Joint External Evaluations and national 

6 action plans for health security; 

7 (3) demonstrated political and financial com8 mitment to pandemic prevention and preparedness; 

9 and 

10 (4) demonstrated commitment to upholding 

11 global health budget and data transparency and ac12 countability standards, complying with the Inter13 national Health Regulations (2005), investing in do14 mestic health systems, and achieving measurable re15 sults. 

16 (c) ELIGIBLE GRANT RECIPIENTS.—Governments 

17 and nongovernmental organizations should be eligible to 

18 receive grants as described in this section. 

19 SEC. 304. ADMINISTRATION. 

20 (a) APPOINTMENT OF ADMINISTRATOR.—The Execu21 tive Board should appoint an Administrator, who should 

22 be responsible for managing the day-to-day operations of 

23 the Fund. 

24 (b) AUTHORITY TO ACCEPT AND SOLICIT CONTRIBU25 TIONS.—The Fund should be authorized to solicit and acVerDate Sep 11 2014 20:23 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00103 Fmt 6652 Sfmt 6201 E:\BILLS\S2297.IS S2297

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1 cept contributions from governments, the private sector, 

2 foundations, individuals, and nongovernmental entities. 

3 (c) ACCOUNTABILITY OF FUNDS AND CRITERIA FOR

4 PROGRAMS.—As part of the negotiations described in sec5 tion 302(a), the Secretary of the State, consistent with 

6 subsection (d), shall— 

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

8 that the Fund will have in effect adequate proce9 dures and standards to account for and monitor the 

10 use of funds contributed to the Fund, including the 

11 cost of administering the Fund; and 

12 (2) seek agreement on the criteria that should 

13 be used to determine the programs and activities 

14 that should be assisted by the Fund. 

15 (d) SELECTION OF PARTNER COUNTRIES, PROJECTS, 

16 AND RECIPIENTS.—The Executive Board should estab17 lish— 

18 (1) eligible partner country selection criteria, to 

19 include transparent metrics to measure and assess 

20 global health security and pandemic prevention and 

21 preparedness strengths and vulnerabilities in coun22 tries seeking assistance; 

23 (2) minimum standards for ensuring eligible 

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1 term results, including requirements for domestic 

2 budgeting, resource mobilization, and co-investment; 

3 (3) criteria for the selection of projects to re4 ceive support from the Fund; 

5 (4) standards and criteria regarding qualifica6 tions of recipients of such support; 

7 (5) such rules and procedures as may be nec8 essary for cost-effective management of the Fund; 

9 and 

10 (6) such rules and procedures as may be nec11 essary to ensure transparency and accountability in 

12 the grant-making process. 

13 (e) ADDITIONAL TRANSPARENCY AND ACCOUNT14 ABILITY REQUIREMENTS.— 

15 (1) INSPECTOR GENERAL.— 

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

17 shall seek to ensure that— 

18 (i) the Fund maintains an inde19 pendent Office of the Inspector General; 

20 and 

21 (ii) such office has the requisite re22 sources and capacity to regularly conduct 

23 and publish, on a publicly accessible 

24 website, rigorous financial, programmatic, 


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1 and reporting audits and investigations of 

2 the Fund and its grantees. 

3 (B) SENSE OF CONGRESS ON CORRUP4 TION.—It is the sense of Congress that— 

5 (i) corruption within global health 

6 programs contribute directly to the loss of 

7 human life and cannot be tolerated; and 

8 (ii) in making financial recoveries re9 lating to a corrupt act or criminal conduct 

10 under a grant, as determined by the In11 spector General, the responsible grant re12 cipient should be assessed at a recovery 

13 rate of up to 150 percent of such loss. 

14 (2) ADMINISTRATIVE EXPENSES.—The Sec15 retary of State shall seek to ensure the Fund estab16 lishes, maintains, and makes publicly available a sys17 tem to track the administrative and management 

18 costs of the Fund on a quarterly basis. 

19 (3) FINANCIAL TRACKING SYSTEMS.—The Sec20 retary of State shall ensure that the Fund estab21 lishes, maintains, and makes publicly available a sys22 tem to track the amount of funds disbursed to each 

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

24 fiscal cycle. 


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1 (4) EXEMPTION FROM DUTIES AND TAXES.— 

2 The Secretary should ensure that the Fund adopts 

3 rules that condition grants upon agreement by the 

4 relevant national authorities in an eligible partner 

5 country to exempt from duties and taxes all products 

6 financed by such grants, including procurements by 

7 any principal or sub-recipient for the purpose of car8 rying out such grants. 

9 SEC. 305. ADVISORY BOARD. 

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

11 Board to the Fund. 

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

13 Board should be composed of— 

14 (1) a geographically diverse group of individuals 

15 that includes representation from low- and middle16 income countries; 

17 (2) individuals with experience and leadership 

18 in the fields of development, global health, epidemi19 ology, medicine, biomedical research, and social 

20 sciences; and 

21 (3) representatives of relevant United Nations 

22 agencies, including the World Health Organization, 

23 and nongovernmental organizations with on-the24 ground experience in implementing global health 

25 programs in low and lower-middle income countries. 


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1 (c) RESPONSIBILITIES.—The Advisory Board should 

2 provide advice and guidance to the Executive Board of the 

3 Fund on the development and implementation of programs 

4 and projects to be assisted by the Fund and on leveraging 

5 donations to the Fund. 

6 (d) PROHIBITION ON PAYMENT OF COMPENSA7 TION.— 

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

9 (including per diem in lieu of subsistence), no mem10 ber of the Advisory Board should receive compensa11 tion for services performed as a member of the 

12 Board. 

13 (2) UNITED STATES REPRESENTATIVE.—Not14 withstanding any other provision of law (including 

15 an international agreement), a representative of the 

16 United States on the Advisory Board may not accept 

17 compensation for services performed as a member of 

18 the Board, except that such representative may ac19 cept travel expenses, including per diem in lieu of 

20 subsistence, while away from the representative’s 

21 home or regular place of business in the perform22 ance of services for the Board. 

23 (e) CONFLICTS OF INTEREST.—Members of the Advi24 sory Board should be required to disclose any potential 

25 conflicts of interest prior to serving on the Advisory Board 


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1 and, in the event of any conflicts of interest, recuse them2 selves from such matters during their service on the Advi3 sory Board. 

4 SEC. 306. REPORTS TO CONGRESS. 

5 (a) STATUS REPORT.—Not later than 180 days after 

6 the date of the enactment of this Act, the Secretary of 

7 State, in coordination with the Administrator of the 

8 United States Agency for International Development, and 

9 the heads of other relevant Federal departments and agen10 cies, shall submit a report to the appropriate congressional 

11 committees that describes the progress of international ne12 gotiations to establish the Fund. 

13 (b) ANNUAL REPORT.— 

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

15 the date of the establishment of the Fund, and an16 nually thereafter for the duration of the Fund, the 

17 Secretary of State, shall submit a report to the ap18 propriate congressional committees regarding the ad19 ministration of the Fund. 

20 (2) REPORT ELEMENTS.—The report required 

21 under paragraph (1) shall describe— 

22 (A) the goals of the Fund; 

23 (B) the programs, projects, and activities 

24 supported by the Fund; 


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1 (C) private and governmental contributions 

2 to the Fund; and 

3 (D) the criteria utilized to determine the 

4 programs and activities that should be assisted 

5 by the Fund, including baselines, targets, de6 sired outcomes, measurable goals, and extent to 

7 which those goals are being achieved. 

8 (c) GAO REPORT ON EFFECTIVENESS.—Not later 

9 than 2 years after the date on which the Fund is estab10 lished, the Comptroller General of the United States shall 

11 submit a report to the appropriate congressional commit12 tees that evaluates the effectiveness of the Fund, including 

13 the effectiveness of the programs, projects, and activities 

14 supported by the Fund, as described in section 303(a). 

15 SEC. 307. UNITED STATES CONTRIBUTIONS. 

16 (a) IN GENERAL.—Subject to submission of the cer17 tification under this section, the President is authorized 

18 to make available for United States contributions to the 

19 Fund such funds as may be appropriated or otherwise 

20 made available for such purpose. 

21 (b) NOTIFICATION.—The Secretary of State shall no22 tify the appropriate congressional committees not later 

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

24 Fund, including— 

25 (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.—During the 5-year period begin6 ning on the date of the enactment of this Act, a United 

7 States contribution to the Fund may not cause the cumu8 lative total of United States contributions to the Fund to 

9 exceed 33 percent of the total contributions to the Fund 

10 from all sources. 

11 (d) WITHHOLDINGS.— 

12 (1) SUPPORT FOR ACTS OF INTERNATIONAL

13 TERRORISM.—If the Secretary of State determines 

14 that the Fund has provided assistance to a country, 

15 the government of which the Secretary of State has 

16 determined, for purposes of section 620A of the For17 eign Assistance Act of 1961 (22 U.S.C. 2371) has 

18 repeatedly provided support for acts of international 

19 terrorism, the United States shall withhold from its 

20 contribution to the Fund for the next fiscal year an 

21 amount equal to the amount expended by the Fund 

22 to the government of such country. 

23 (2) EXCESSIVE SALARIES.—During the 5-year 

24 period beginning on the date of the enactment of 

25 this Act, if the Secretary of State determines that 


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1 the salary of any individual employed by the Fund 

2 exceeds the salary of the Vice President of the 

3 United States for such fiscal year, the United States 

4 should withhold from its contribution for the next 

5 fiscal year an amount equal to the aggregate amount 

6 by which the salary of each such individual exceeds 

7 the salary of the Vice President of the United 

8 States. 

9 (3) ACCOUNTABILITY CERTIFICATION REQUIRE10 MENT.—The Secretary of State may withhold not 

11 more than 20 percent of planned United States con12 tributions to the Fund until the Secretary certifies 

13 to the appropriate congressional committees that the 

14 Fund has established procedures to provide access 

15 by the Office of Inspector General of the Depart16 ment of State, as cognizant Inspector General, the 

17 Inspector General of the Department of Health and 

18 Human Services, the Inspector General of the 

19 United States Agency for International Develop20 ment, and the Comptroller General of the United 

21 States to the Fund’s financial data and other infor22 mation relevant to United States contributions to 

23 the Fund (as determined by the Inspector General 

24 of the Department of State, in consultation with the 

25 Secretary of State). 


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1 SEC. 308. COMPLIANCE WITH THE FOREIGN AID TRANS2 PARENCY AND ACCOUNTABILITY ACT OF 

3 2016. 

4 Section 2(3) of the Foreign Aid Transparency and 

5 Accountability Act of 2016 (Public Law 114–191; 22 

6 U.S.C. 2394c note) is amended— 

7 (1) in subparagraph (D), by striking ‘‘and’’ at 

8 the end; 

9 (2) in subparagraph (E), by striking the period 

10 at the end and inserting ‘‘; and’’; and 

11 (3) by adding at the end the following: 

12 ‘‘(F) the International Pandemic Prepared13 ness and COVID–19 Response Act of 2021.’’. 

Æ 


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