II 

Calendar No. 112 

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, Mr. MENENDEZ, Mr. MURPHY, and Mr. PORTMAN) 

introduced the following bill; which was read twice and referred to the 

Committee on Foreign Relations 

JULY 30, 2021 

Reported by Mr. MENENDEZ, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

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: 


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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 

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. 


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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. 

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 


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1 facilitate national capacity to comply with and ad2 here to— 

3 (A) the International Health Regulations 

4 (2005); 

5 (B) the World Organisation for Animal 

6 Health international standards and guidelines; 

7 (C) United Nations Security Council Reso8 lution 1540 (2004); 

9 (D) the Convention on the Prohibition of 

10 the Development, Production and Stockpiling of 

11 Bacteriological and Toxin Weapons and on 

12 their Destruction, done at Washington, London, 

13 and Moscow, April 10, 1972 (commonly re14 ferred to as the ‘‘Biological Weapons Conven15 tion’’); 

16 (E) the Global Health Security Agenda 

17 2024 Framework; and 

18 (F) other relevant frameworks that con19 tribute to global health security. 

20 (3) GLOBAL HEALTH SECURITY INDEX.—The 

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

22 comprehensive assessment and benchmarking of 

23 health security and related capabilities across the 

24 countries that make up the States Parties to the 

25 International Health Regulations (2005). 


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1 (4) GLOBAL HEALTH SECURITY INITIATIVE.— 

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

3 the informal network of countries and organizations 

4 that came together in 2001 to undertake concerted 

5 global action to strengthen public health prepared6 ness and response to chemical, biological, radio7 logical, and nuclear threats, as well as pandemic in8 fluenza. 

9 (5) JOINT EXTERNAL EVALUATION.—The term 

10 ‘‘Joint External Evaluation’’ means the World 

11 Health Organization-facilitated, voluntary, collabo12 rative, multi-sectoral process to assess country ca13 pacity to prevent, detect, and rapidly respond to 

14 public health risks occurring naturally or due to de15 liberate or accidental events, assess progress in 

16 achieving the targets under the International Health 

17 Regulations (2005), and recommend priority actions. 

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

19 stakeholders’’ means actors engaged in efforts to ad20 vance global health security programs and objectives, 

21 including— 

22 (A) national and local governments in 

23 partner countries; 

24 (B) other bilateral donors; 


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1 (C) international, regional, and local orga2 nizations, including private, voluntary, non3 governmental, and civil society organizations; 

4 (D) international, regional, and local finan5 cial institutions; 

6 (E) representatives of historically 

7 marginalized groups, including women, youth, 

8 and indigenous peoples; 

9 (F) the private sector, including medical 

10 device, technology, pharmaceutical, manufac11 turing, logistics, and other relevant companies; 

12 and 

13 (G) public and private research and aca14 demic institutions. 

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

16 Health approach’’ means the collaborative, multi-sec17 toral, and transdisciplinary approach toward achiev18 ing optimal health outcomes in a manner that recog19 nizes the interconnection between people, animals, 

20 plants, and their shared environment. 

21 (8) RELEVANT FEDERAL DEPARTMENTS AND

22 AGENCIES.—The term ‘‘relevant Federal depart23 ments and agencies’’ means any Federal department 

24 or agency implementing United States policies and 

25 programs relevant to the advancement of United 


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1 States global health security and diplomacy overseas, 

2 which may include— 

3 (A) the Department of State; 

4 (B) the United States Agency for Inter5 national Development; 

6 (C) the Department of Health and Human 

7 Services; 

8 (D) the Centers for Disease Control and 

9 Prevention; 

10 (E) the National Institutes of Health; 

11 (F) the Department of the Treasury; 

12 (G) the Department of Agriculture; 

13 (H) the Department of Defense; 

14 (I) the Defense Threat Reduction Agency; 

15 (J) the Millennium Challenge Corporation; 

16 (K) the Development Finance Corporation; 

17 (L) the Peace Corps; and 

18 (M) any other department or agency that 

19 the President determines to be relevant for 

20 these purposes. 

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

22 the ability of people, households, communities, sys23 tems, institutions, countries, and regions to reduce, 

24 mitigate, withstand, adapt to, and quickly recover 


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1 from stresses and shocks in a manner that reduces 

2 chronic vulnerability and facilitates inclusive growth. 

3 SEC. 3. PURPOSE. 

4 The purpose of this Act is to accelerate and enhance 

5 the United States international response to pandemics, in6 cluding the COVID–19 pandemic, and to operationalize 

7 lessons learned from current and prior emergency re8 sponses in a manner that— 

9 (1) advances the global health security and di10 plomacy objectives of the United States; 

11 (2) improves coordination among the relevant 

12 Federal departments and agencies implementing 

13 United States foreign assistance for global health se14 curity; and 

15 (3) more effectively enables partner countries to 

16 strengthen and sustain resilient health systems and 

17 supply chains with the resources, capacity, and per18 sonnel required to prevent, prepare for, detect, and 

19 respond to infectious disease threats before they be20 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 Televisi ́on Mart ́ı and 

3 Digital Mart ́ı 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 

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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 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00086 Fmt 6652 Sfmt 6401 E:\BILLS\S2297.RS 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 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00099 Fmt 6652 Sfmt 6401 E:\BILLS\S2297.RS 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 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00103 Fmt 6652 Sfmt 6401 E:\BILLS\S2297.RS 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.’’. 

14 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

16 ‘‘International Pandemic Preparedness and COVID-19 Re17 sponse Act of 2021’’. 

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

19 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 

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. 


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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. 

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. 

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

of 2016. 

Sec. 309. Prohibition against United States foreign assistance for the Government 

of the People’s Republic of China. 

1 SEC. 2. DEFINITIONS. 

2 In this Act: 


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1 (1) APPROPRIATE CONGRESSIONAL COMMIT2 TEES.—The term ‘‘appropriate congressional commit3 tees’’ means— 

4 (A) the Committee on Foreign Relations of 

5 the Senate; 

6 (B) the Committee on Appropriations of the 

7 Senate; 

8 (C) the Committee on Foreign Affairs of the 

9 House of Representatives; and 

10 (D) the Committee on Appropriations of the 

11 House of Representatives. 

12 (2) GLOBAL HEALTH SECURITY AGENDA; 

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

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

15 launched in 2014 and renewed in 2018 that brings to16 gether countries, regions, international organizations, 

17 nongovernmental organizations, and the private sec18 tor to elevate global health security as a national-level 

19 priority, to share best practices, and to facilitate na20 tional capacity to comply with and adhere to— 

21 (A) the International Health Regulations 

22 (2005); 

23 (B) the World Organisation for Animal 

24 Health international standards and guidelines; 


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1 (C) United Nations Security Council Reso2 lution 1540 (2004); 

3 (D) the Convention on the Prohibition of 

4 the Development, Production and Stockpiling of 

5 Bacteriological and Toxin Weapons and on their 

6 Destruction, done at Washington, London, and 

7 Moscow, April 10, 1972 (commonly referred to as 

8 the ‘‘Biological Weapons Convention’’); 

9 (E) the Global Health Security Agenda 

10 2024 Framework; and 

11 (F) other relevant frameworks that con12 tribute to global health security. 

13 (3) GLOBAL HEALTH SECURITY INDEX .—The 

14 term ‘‘Global Health Security Index’’ means the com15 prehensive assessment and benchmarking of health se16 curity and related capabilities across the countries 

17 that make up the States Parties to the International 

18 Health Regulations (2005). 

19 (4) GLOBAL HEALTH SECURITY INITIATIVE.—The 

20 term ‘‘Global Health Security Initiative’’ means the 

21 informal network of countries and organizations that 

22 came together in 2001 to undertake concerted global 

23 action to strengthen public health preparedness and 

24 response to chemical, biological, radiological, and nu25 clear threats, as well as pandemic influenza. 


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1 (5) JOINT EXTERNAL EVALUATION.—The term 

2 ‘‘Joint External Evaluation’’ means the World Health 

3 Organization-facilitated, voluntary, collaborative, 

4 multi-sectoral process to assess country capacity to 

5 prevent, detect, and rapidly respond to public health 

6 risks occurring naturally or due to deliberate or acci7 dental events, assess progress in achieving the targets 

8 under the International Health Regulations (2005), 

9 and recommend priority actions. 

10 (6) KEY STAKEHOLDERS.—The term ‘‘key stake11 holders’’ means actors engaged in efforts to advance 

12 global health security programs and objectives, includ13 ing— 

14 (A) national and local governments in part15 ner countries; 

16 (B) other bilateral donors; 

17 (C) international, regional, and local orga18 nizations, including private, voluntary, non19 governmental, and civil society organizations; 

20 (D) international, regional, and local finan21 cial institutions; 

22 (E) representatives of historically 

23 marginalized groups, including women, youth, 

24 and indigenous peoples; 


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1 (F) the private sector, including medical de2 vice, technology, pharmaceutical, manufacturing, 

3 logistics, and other relevant companies; and 

4 (G) public and private research and aca5 demic institutions. 

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

7 Health approach’’ means the collaborative, multi-sec8 toral, and transdisciplinary approach toward achiev9 ing optimal health outcomes in a manner that recog10 nizes the interconnection between people, animals, 

11 plants, and their shared environment. 

12 (8) RELEVANT FEDERAL DEPARTMENTS AND

13 AGENCIES.—The term ‘‘relevant Federal departments 

14 and agencies’’ means any Federal department or 

15 agency implementing United States policies and pro16 grams relevant to the advancement of United States 

17 global health security and diplomacy overseas, which 

18 may include— 

19 (A) the Department of State; 

20 (B) the United States Agency for Inter21 national Development; 

22 (C) the Department of Health and Human 

23 Services; 

24 (D) the Centers for Disease Control and 

25 Prevention; 


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1 (E) the National Institutes of Health; 

2 (F) the Department of the Treasury; 

3 (G) the Department of Agriculture; 

4 (H) the Department of Defense; 

5 (I) the Defense Threat Reduction Agency; 

6 (J) the Millennium Challenge Corporation; 

7 (K) the Development Finance Corporation; 

8 (L) the Peace Corps; and 

9 (M) any other department or agency that 

10 the President determines to be relevant for these 

11 purposes. 

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

13 the ability of people, households, communities, sys14 tems, institutions, countries, and regions to reduce, 

15 mitigate, withstand, adapt to, and quickly recover 

16 from stresses and shocks in a manner that reduces 

17 chronic vulnerability and facilitates inclusive growth. 

18 (10) USAID.—The term ‘‘USAID’’ means the 

19 United States Agency for International Development. 

20 SEC. 3. PURPOSE. 

21 The purpose of this Act is to accelerate and enhance 

22 the United States international response to pandemics, in23 cluding the COVID–19 pandemic, and to operationalize les24 sons learned from current and prior emergency responses 

25 in a manner that— 


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1 (1) advances the global health security and di2 plomacy objectives of the United States; 

3 (2) improves coordination among the relevant 

4 Federal departments and agencies implementing 

5 United States foreign assistance for global health se6 curity; and 

7 (3) more effectively enables partner countries to 

8 strengthen and sustain resilient health systems and 

9 supply chains with the resources, capacity, and per10 sonnel required to prevent, prepare for, detect, and re11 spond to infectious disease threats before they become 

12 pandemics. 

13 TITLE I—ENHANCING THE 

14 UNITED STATES’ INTER15 NATIONAL RESPONSE TO 

16 COVID–19 AND FUTURE 

17 PANDEMICS 

18 SEC. 101. STATEMENT OF POLICY REGARDING INTER19 NATIONAL COOPERATION TO END THE 

20 COVID–19 PANDEMIC. 

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

22 implement a comprehensive and coordinated international 

23 response to end the COVID–19 pandemic in a manner that 

24 recognizes the critical role that multilateral and regional 


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1 organizations can and should play in pandemic response, 

2 including by— 

3 (1) seeking adoption of a United Nations Secu4 rity Council resolution that— 

5 (A) declares pandemics, including the 

6 COVID–19 pandemic, to be a threat to inter7 national peace and security; and 

8 (B) urges member states to address this 

9 threat by aligning their health preparedness 

10 plans with international best practices and those 

11 established by the Global Health Security Agen12 da to improve country capacity to prevent, de13 tect, and respond to infectious disease threats; 

14 (2) advancing efforts to reform the World Health 

15 Organization so that it serves as an effective nor16 mative and capable coordinating body empowered to 

17 align member countries around a single strategic op18 erating plan to detect, contain, treat, and deter the 

19 further spread of COVID–19; 

20 (3) providing timely, appropriate levels of finan21 cial support to United Nations agencies responding to 

22 the COVID–19 pandemic; 

23 (4) prioritizing United States foreign assistance 

24 for the COVID–19 response in the most vulnerable 

25 countries and regions; 


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1 (5) encouraging other donor governments to 

2 similarly increase contributions to the United Nations 

3 agencies responding to the COVID–19 pandemic in 

4 the world’s poorest and most vulnerable countries; 

5 (6) working with key stakeholders to accelerate 

6 progress toward meeting and exceeding, as prac7 ticable, the global COVID–19 vaccination goals joint8 ly proposed by the International Monetary Fund, the 

9 World Health Organization, the World Bank, and the 

10 World Trade Organization, whereby— 

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

12 all countries is vaccinated by the end of 2021; 

13 and 

14 (B) at least 60 percent of the population in 

15 all countries is vaccinated by the first half of 

16 2022; 

17 (7) engaging with key stakeholders, including 

18 through multilateral facilities such as the COVID–19 

19 Vaccines Global Access initiative (referred to in this 

20 title as ‘‘COVAX’’) and the Access to COVID–19 Tools 

21 (ACT) Accelerator initiative, and expanding bilateral 

22 efforts, including through the International Develop23 ment Finance Corporation, to accelerate the develop24 ment, manufacturing, local production, and efficient 

25 and equitable distribution of— 


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1 (A) vaccines and related raw materials to 

2 meet or exceed the vaccination goals under para3 graph (6); and 

4 (B) global health commodities, including 

5 personal protective equipment, test kits, medi6 cines and therapeutics, and other essential sup7 plies to combat COVID–19 and help immediately 

8 disrupt transmission; 

9 (8) supporting global COVID–19 vaccine dis10 tribution strategies that strengthen underlying health 

11 systems and ensure that people living in vulnerable 

12 and marginalized communities, including women, do 

13 not face undue barriers to vaccination; 

14 (9) working with key stakeholders, including 

15 through the World Bank Group, the International 

16 Monetary Fund, the World Trade Organization, the 

17 International Finance Corporation, and other rel18 evant regional and bilateral financial institutions, to 

19 address the economic and financial implications of 

20 the COVID–19 pandemic, while taking into account 

21 the differentiated needs of disproportionately affected, 

22 vulnerable, and marginalized populations; 

23 (10) entering into discussions with vaccine man24 ufacturing companies to incentivize technology shar25 ing, with the goal of ensuring adequate global supply 


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1 of vaccines, necessary components, and raw materials, 

2 including through existing authorities under the De3 fense Production Act of 1950 (50 U.S.C. 4501 et seq.) 

4 and chapter 18 of title 35, United States Code (com5 monly referred to as the ‘‘Bayh-Dole Act’’); 

6 (11) establishing clear timelines, benchmarks, 

7 and goals for COVID–19 response strategies and ac8 tivities under this section; and 

9 (12) generating commitments of resources in 

10 support of the goals referred to in paragraph (6). 

11 SEC. 102. OVERSIGHT OF UNITED STATES FOREIGN ASSIST12 ANCE TO END THE COVID–19 PANDEMIC. 

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

14 days after the date of the enactment of this Act, the Sec15 retary of State and the Administrator for the United States 

16 Agency for International Development shall jointly submit 

17 to the appropriate congressional committees— 

18 (1) an unclassified report containing a descrip19 tion of funds already obligated and expended under 

20 title X of the American Rescue Plan Act of 2021 

21 (Public Law 117–2); and 

22 (2) a plan that describes the objectives and 

23 timeline for the obligation and expenditure of all re24 maining funds appropriated under title X of the 

25 American Rescue Plan Act of 2021, to include supVerDate Sep 11 2014 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00124 Fmt 6652 Sfmt 6203 E:\BILLS\S2297.RS S2297

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1 port for civil society for the protection of human 

2 rights in the context of the COVID–19 pandemic, 

3 which shall be submitted in an unclassified form, and 

4 should include a description of steps taken pursuant 

5 to each objective specified in the plan. 

6 (b) CONGRESSIONAL CONSULTATION.—Not less fre7 quently than once every 60 days, until the completion or 

8 termination of the implementation plan required under 

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

10 of the appropriate congressional committees, the Secretary 

11 of State and the Administrator for the United States Agen12 cy for International Development shall provide a briefing 

13 to the appropriate congressional committees regarding the 

14 report required under subsection (a)(1) and the status of 

15 the implementation of the plan required under subsection 

16 (a)(2). 

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

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

19 United States Agency for International Development, with 

20 due consideration for the safety and security of imple21 menting partners and beneficiaries, shall prescribe the use 

22 of logos or other insignia, which may include the flag of 

23 the United States, to appropriately identify such assistance 

24 as being from the people of the United States. 


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1 SEC. 103. UNITED STATES CONTRIBUTIONS TO THE GLOBAL 

2 FUND TO FIGHT AIDS, TUBERCULOSIS, AND 

3 MALARIA COVID–19 RESPONSE MECHANISM. 

4 (a) UNITED STATES CONTRIBUTIONS TO THE GLOBAL

5 FUND TO FIGHT AIDS, TUBERCULOSIS, AND MALARIA

6 COVID–19 RESPONSE MECHANISM.—United States con7 tributions to the Global Fund to Fight AIDS, Tuberculosis, 

8 and Malaria COVID–19 Response Mechanism under section 

9 10003(a)(2) of the American Rescue Plan Act of 2021 (Pub10 lic Law 107–2)— 

11 (1) shall be meaningfully leveraged in a manner 

12 that incentivizes other public and private donor con13 tributions; and 

14 (2) shall be subject to the reporting and with15 holding requirements under subsections (c), 

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

17 section 202 of the United States Leadership Against 

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

19 (22 U.S.C. 7622). 

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

21 DELIVERY. 

22 (a) ACCELERATING GLOBAL VACCINE DISTRIBUTION

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

24 the Secretary of Health and Human Services, the Adminis25 trator of the United States Agency for International Devel26 opment, the Director of the Centers for Disease Control and 


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1 Prevention, the Chief Executive Officer of the United States 

2 International Development Finance Corporation, and the 

3 heads of other relevant Federal departments and agencies, 

4 as determined by the President, shall develop a strategy to 

5 expand access to, and accelerate the global distribution of, 

6 COVID–19 vaccines to other countries, which shall— 

7 (1) identify the countries that have the highest 

8 infection and death rates due to COVID–19, the low9 est COVID–19 vaccination rates, and face the most 

10 difficult, political, logistical, and financial challenges 

11 to obtaining and delivering COVID–19 vaccines, and 

12 describe the basis and metrics used to make such de13 terminations; 

14 (2) identify which countries and regions will be 

15 prioritized and targeted for COVID–19 vaccine deliv16 ery, and the rationale for such prioritization; 

17 (3) describe efforts that the United States is 

18 making to increase COVID–19 vaccine manufac19 turing capacity, both domestically and internation20 ally, as appropriate, through the establishment or re21 furbishment of regional manufacturing hubs in South 

22 America, South Africa, and South Asia, including 

23 through the provision of development finance, and es24 timate when, how many, and which types of vaccines 


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1 will be provided by the United States Government bi2 laterally and through COVAX; 

3 (4) describe efforts to encourage international 

4 partners to take actions similar to the efforts referred 

5 to in paragraph (3); 

6 (5) describe how the United States Government 

7 will ensure efficient delivery of COVID–19 vaccines to 

8 intended recipients, including United States citizens 

9 residing overseas, and identify complementary United 

10 States foreign assistance that will facilitate vaccine 

11 readiness, distribution, delivery, monitoring, and ad12 ministration activities; 

13 (6) describe how the United States Government 

14 will ensure the efficient delivery and administration 

15 of COVID–19 vaccines to United States citizens resid16 ing overseas, including through the donation of vac17 cine doses to United States embassies and consulates, 

18 as appropriate, giving priority to— 

19 (A) countries in which United States citi20 zens are deemed ineligible or low priority in the 

21 national vaccination deployment plan; and 

22 (B) countries that are not presently distrib23 uting a COVID–19 vaccine that— 


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1 (i) has been approved by the United 

2 States Food and Drug Administration for 

3 emergency use; or 

4 (ii) has met the necessary criteria for 

5 safety and efficacy established by the World 

6 Health Organization; 

7 (7) summarize the United States Government’s 

8 efforts to encourage and facilitate technology sharing 

9 and the licensing of intellectual property to the extent 

10 necessary to ensure an adequate and timely supply of 

11 vaccines and vaccine components to meet the vaccina12 tion goals specified in section 101(6), giving due con13 sideration to avoiding undermining intellectual prop14 erty innovation and intellectual property rights pro15 tections with respect to vaccine development in per16 forming the assessment required in this paragraph; 

17 (8) describe the roles, responsibilities, tasks, and, 

18 as appropriate, the authorities of the Secretary of 

19 State, the Administrator of the United States Agency 

20 for International Development, the Secretary of 

21 Health and Human Services, the Director of the Cen22 ters for Disease Control and Prevention, the Chief Ex23 ecutive Officer of the United States International De24 velopment Finance Corporation, and the heads of 


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1 other relevant Federal departments and agencies with 

2 respect to the implementation of such strategy; 

3 (9) describe how the Department of State and 

4 USAID will coordinate with the Secretary of Health 

5 and Human Services and the heads of other relevant 

6 Federal agencies to expedite the export and distribu7 tion of excess vaccines from Federal and State stock8 piles to support countries in need and ensure such 

9 vaccines will not be wasted; 

10 (10) summarize the United States public diplo11 macy strategies for branding and addressing vaccine 

12 misinformation and hesitancy; and 

13 (11) describe efforts that the United States is 

14 making to help countries disrupt the current trans15 mission of COVID–19, while simultaneously increas16 ing vaccination rates, utilizing non-vaccine health 

17 commodities, including diagnostics and personal pro18 tective equipment. 

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

20 days after the date of the enactment of this Act, the Sec21 retary of State shall submit the strategy described in sub22 section (a) to— 

23 (1) the appropriate congressional committees; 

24 (2) the Committee on Health, Education, Labor, 

25 and Pensions of the Senate; and 


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1 (3) the Committee on Energy and Commerce of 

2 the House of Representatives. 

3 (c) LIMITATION.— 

4 (1) IN GENERAL.—No Federal funds may be 

5 made available to COVAX to procure vaccines pro6 duced by any companies owned or controlled by the 

7 Government of the People’s Republic of China or by 

8 the Chinese Communist Party unless the Secretary of 

9 State certifies that the People’s Republic of China— 

10 (A) is providing financial support to 

11 COVAX that is commensurate with the United 

12 States’ contribution to COVAX; and 

13 (B) publically discloses transparent data on 

14 the quality, safety, and efficacy of its COVID–19 

15 vaccines. 

16 (2) SAFEGUARDS.—The President shall ensure 

17 that appropriate safeguards are put in place to en18 sure that the condition described in paragraph (1) is 

19 honored by Gavi, the Vaccine Alliance. 

20 SEC. 105. LEVERAGING UNITED STATES BILATERAL GLOBAL 

21 HEALTH PROGRAMS FOR THE INTER22 NATIONAL COVID–19 RESPONSE. 

23 (a) AUTHORIZATION FOR LEVERAGING BILATERAL

24 PROGRAM ACTIVITIES.—Amounts authorized to be appro25 priated or otherwise made available to carry out section 


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1 104 of the Foreign Assistance Act (22 U.S.C. 2151b) may 

2 be used in countries receiving United States foreign assist3 ance— 

4 (1) to combat the COVID–19 pandemic, includ5 ing through the sharing of COVID–19 vaccines; and 

6 (2) to support related activities, including— 

7 (A) strengthening vaccine readiness; 

8 (B) reducing vaccine hesitancy and misin9 formation; 

10 (C) delivering and administering COVID– 

11 19 vaccines; 

12 (D) strengthening health systems and sup13 ply chains; 

14 (E) supporting health care workforce plan15 ning, training, and management; 

16 (F) enhancing transparency, quality, and 

17 reliability of health data; 

18 (G) increasing bidirectional testing, includ19 ing screening for symptomatic and asymp20 tomatic cases; and 

21 (H) building lab capacity. 

22 (b) ADJUSTMENT OF TARGETS AND GOALS.—The Sec23 retary of State, in coordination with the heads of other rel24 evant Federal departments and agencies, shall submit an 


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1 annual report to the appropriate congressional committees 

2 that identifies— 

3 (1) any adjustments to original program targets 

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

5 purposes authorized under subsection (a); and 

6 (2) the amounts needed in the following fiscal 

7 year to meet the original program goals, as necessary 

8 and appropriate. 

9 SEC. 106. REPORT ON HUMANITARIAN RESPONSE TO THE 

10 COVID–19 PANDEMIC. 

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

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

13 in consultation with the Administrator of the United States 

14 Agency for International Development and the Secretary of 

15 Health and Human Services, shall submit a report to the 

16 appropriate congressional committees that— 

17 (1) assesses the global humanitarian response to 

18 COVID–19; and 

19 (2) outlines specific elements of the United States 

20 Government’s country-level humanitarian response to 

21 the COVID–19 pandemic. 

22 (b) ELEMENTS.—The report required under subsection 

23 (a) shall include— 


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1 (1) for countries receiving United States assist2 ance, a description of humanitarian and health-work3 er access to crisis-affected areas, including— 

4 (A) legal and bureaucratic restrictions on 

5 the entry of humanitarian workers from abroad, 

6 to include visa authorizations that do not allow 

7 adequate time for humanitarian workers to 

8 quarantine upon arrival in-line with host coun9 try regulations, conduct needs assessments, and 

10 subsequently implement multilateral and United 

11 States-funded programming in an efficient, effec12 tive, and unrestricted manner; 

13 (B) restrictions on travel by humanitarian 

14 workers within such country to reach the areas 

15 of operation where vulnerable and marginalized 

16 populations reside; 

17 (C) access to medical evacuation in the 

18 event of a health emergency; 

19 (D) access to personal protective equipment 

20 for United States Government implementing 

21 partners; and 

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

23 vaccines for humanitarian and health-workers 

24 and crisis-affected communities; 


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1 (2) an analysis and description of countries (re2 gardless of whether such countries have received direct 

3 United States assistance) that have expressly pre4 vented vulnerable populations from accessing nec5 essary assistance related to COVID–19, including— 

6 (A) the omission of vulnerable populations 

7 from national response plans; 

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

9 or preclude treatment of vulnerable populations 

10 at public hospitals and health facilities; and 

11 (C) exclusion of, or discrimination against, 

12 vulnerable populations in law, policy, or prac13 tice that prevents equitable access to food, shelter, 

14 and other basic assistance; 

15 (3) a description of United States Government 

16 efforts to facilitate greater humanitarian access, in17 cluding— 

18 (A) advocacy and diplomatic efforts with 

19 relevant foreign governments and multilateral 

20 institutions to ensure that vulnerable and 

21 marginalized populations are included in na22 tional response plans and other relevant plans 

23 developed in response to the COVID–19 pan24 demic; and 


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1 (B) advocacy and diplomatic efforts with 

2 relevant foreign governments to ensure that ap3 propriate visas, work permits, and domestic 

4 travel exemptions are issued for humanitarian 

5 and health workers responding to the COVID–19 

6 pandemic; and 

7 (4) a description of United States Government 

8 plans and efforts to address the second-order impacts 

9 of the COVID–19 pandemic and an assessment of the 

10 resources required to implement such plans, including 

11 efforts to address— 

12 (A) famine and acute food insecurity; 

13 (B) gender-based violence; 

14 (C) mental health and psychosocial support 

15 needs; 

16 (D) child protection needs; 

17 (E) health, education, and livelihoods; 

18 (F) shelter; and 

19 (G) attempts to close civil society space, in20 cluding through bureaucratic, administrative, 

21 and health or security related impediments. 

22 SEC. 107. SAFEGUARDING DEMOCRACY AND HUMAN RIGHTS 

23 DURING THE COVID–19 PANDEMIC. 

24 (a) SENSE OF CONGRESS.—It is the sense of Congress 

25 that— 


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1 (1) governments may be required to take appro2 priate extraordinary measures during public health 

3 emergencies to halt the spread of disease, including 

4 closing businesses and public events, limiting access to 

5 public spaces, and restricting the movement of people; 

6 (2) certain foreign governments have taken meas7 ures in response to COVID–19 that violate the human 

8 rights of their citizens without clear public health jus9 tification, oversight measures, or sunset provisions; 

10 (3) governments using the COVID–19 pandemic 

11 as a pretext for repression have undermined demo12 cratic institutions, debilitated institutions for trans13 parency and public integrity, quashed legitimate dis14 sent, and attacked journalists, civil society organiza15 tions, activists, independent voices, and vulnerable 

16 and marginalized populations, including refugees and 

17 migrants, with far-reaching consequences that will ex18 tend beyond the current crisis; 

19 (4) foreign governments should take immediate 

20 steps to release from prison all arbitrarily detained 

21 United States citizens and political prisoners who 

22 may be at increased risk for contracting or suffering 

23 from complications from COVID–19; 

24 (5) COVID–19 threatens to roll back decades of 

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1 fecting women economically, educationally, and with 

2 respect to health, while also leading to alarming rises 

3 in gender based violence; and 

4 (6) during and after the pandemic, the Depart5 ment of State and the United States Agency for Inter6 national Development should directly, and through 

7 nongovernmental organizations or international orga8 nizations, provide assistance and implement pro9 grams that support democratic institutions, civil soci10 ety, free media, and the advancement of internation11 ally recognized human rights. 

12 (b) FUNDING FOR CIVIL SOCIETY AND HUMAN RIGHTS

13 DEFENDERS.— 

14 (1) PROGRAM PRIORITIES.—Amounts made 

15 available for each of the fiscal years 2022 through 

16 2026 to carry out the purposes of sections 101 and 

17 102 of the Foreign Assistance Act of 1961 (22 U.S.C. 

18 2151 and 2151–1), including programs to support 

19 democratic institutions, human rights defenders, civil 

20 society, and freedom of the press, should be targeted, 

21 to the extent feasible, toward civil society organiza22 tions in countries in which emergency government 

23 measures taken in response to the COVID–19 pan24 demic have violated internationally recognized human 

25 rights. 


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1 (2) ELIGIBLE ORGANIZATIONS.—Civil society or2 ganizations operating in countries in which emer3 gency government measures taken in response to the 

4 COVID–19 pandemic violated internationally recog5 nized human rights shall be eligible to receive funds 

6 made available to carry out the purposes of sections 

7 101 and 102 of the Foreign Assistance Act of 1961 for 

8 each of the fiscal years 2022 through 2026, for— 

9 (A) programs designed to strengthen and 

10 support civil society, human rights defenders, 

11 freedom of association, and the freedom of the 

12 press; 

13 (B) programs to restore democratic institu14 tions; and 

15 (C) peacebuilding and conflict prevention to 

16 address the impacts of COVID–19 on social cohe17 sion, public trust, and conflict dynamics by 

18 adapting existing programs or investing in new 

19 ones. 

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

21 after the date of the enactment of this Act, the Sec22 retary of State shall submit a report to the appro23 priate congressional committees that— 

24 (A) lists the countries whose emergency 

25 measures limiting internationally recognized 


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1 human rights in a manner inconsistent with the 

2 principles of limitation and derogation remain 

3 in place; 

4 (B) describes such countries’ emergency 

5 measures, including— 

6 (i) how such procedures violate inter7 nationally recognized human rights; and 

8 (ii) an analysis of the impact of such 

9 measures on access to health and efforts to 

10 control the COVID–19 pandemic within the 

11 country; 

12 (C) describes— 

13 (i) security and intelligence surveil14 lance measures implemented by countries 

15 during the COVID–19 pandemic; 

16 (ii) the extent to which such measures 

17 have been, or have not been, rolled back; and 

18 (iii) whether and how such measures 

19 impact internationally recognized human 

20 rights; and 

21 (D) includes a strategic plan by the Depart22 ment of State and the United States Agency for 

23 International Development that addresses, 

24 through multilateral and bilateral diplomacy 

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1 lated to the restriction of internationally recog2 nized human rights in the COVID–19 response. 

3 SEC. 108. PUBLIC DIPLOMACY AND COMBATING 

4 DISINFORMATION AND MISINFORMATION 

5 ABOUT COVID–19. 

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

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

8 States Agency for Global Media (referred to in this 

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

10 grantees have proven valuable in providing timely 

11 and accurate information, particularly in countries 

12 in which the free press is under threat. 

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

14 Congress that— 

15 (A) accurate, investigative, and scientific 

16 journalism is critical for societies to effectively 

17 combat global health threats; and 

18 (B) Congress supports— 

19 (i) accurate and objective investigative 

20 and scientific reporting by USAGM net21 works and grantees regarding COVID–19; 

22 and 

23 (ii) platforms that help dispel and 

24 combat misinformation about the COVID– 

25 19 pandemic. 


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1 (3) VOICE OF AMERICA.—It is the sense of Con2 gress that amounts authorized to be appropriated or 

3 otherwise made available to Voice of America should 

4 be used— 

5 (A) to expand programs such as POLY6 GRAPH.info; 

7 (B) to provide critical tools for combating 

8 propaganda associated with COVID–19; and 

9 (C) to assist journalists in providing accu10 rate information to local media outlets. 

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

12 sense of Congress that Radio Televisio ́n Martı ́ and 

13 Digital Martı ́ should continue to broadcast programs 

14 that detect, highlight, and dispel disinformation. 

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

16 (A) FINDING.—Congress finds that Radio 

17 Free Europe/Radio Liberty (referred to in this 

18 section as ‘‘RFE/RL’’) operate in media markets 

19 in which authoritarian state and nonstate ac20 tors, including Russia, heavily invest in misin21 formation and disinformation campaigns de22 signed to promote confusion and mistrust. 

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

24 Congress that RFE/RL should— 


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1 (i) increase investigative reporting re2 garding the impacts of COVID–19, the po3 litical and social responses governments are 

4 taking in response to COVID–19, and the 

5 lasting impacts such actions will have on 

6 key political freedoms; and 

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

8 (6) RADIO FREE ASIA.— 

9 (A) FINDING.—Congress finds that Radio 

10 Free Asia (RFA) operates in a media market 

11 dominated by powerful state-run media that 

12 have invested heavily in media distortion and 

13 disinformation, including about COVID–19. 

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

15 Congress that RFA should— 

16 (i) commission technical experts to bol17 ster efforts to counter social media tools, in18 cluding bots used by some countries to pro19 mote misinformation; 

20 (ii) expand digital programming and 

21 local coverage to expose China’s media ma22 nipulation techniques; and 

23 (iii) increase English language content 

24 to help counter China’s propaganda di25 rected toward English-speaking audiences. 


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1 (7) MIDDLE EAST BROADCASTING NETWORKS.— 

2 (A) FINDING.—Congress finds that the Mid3 dle East Broadcasting Networks operate largely 

4 in closed media markets in which malign state 

5 and nonstate actors remain active. 

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

7 Congress that the Middle East Broadcasting Net8 works should— 

9 (i) continue plans to expand an inves10 tigative news unit; and 

11 (ii) work to ensure that reporting con12 tinues amidst operational challenges on the 

13 ground. 

14 (8) OPEN TECHNOLOGY FUND.— 

15 (A) FINDING.—Congress finds that the Open 

16 Technology Fund works to advance internet free17 dom in repressive environments by supporting 

18 technologies that— 

19 (i) provide secure and uncensored ac20 cess to USAGM’s content and the broader 

21 internet; and 

22 (ii) counter attempts by authoritarian 

23 governments to control the internet and re24 strict freedom online. 


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

2 Congress that the Open Technology Fund 

3 should— 

4 (i) support a broad range of tech5 nologies to respond to increasingly aggres6 sive and sophisticated censorship and sur7 veillance threats and provide more com8 prehensive and tailored support to 

9 USAGM’s networks; and 

10 (ii) provide direct assistance to 

11 USAGM’s networks to improve the digital 

12 security of reporting operations and jour13 nalists. 

14 (b) DEPARTMENT OF STATE PUBLIC DIPLOMACY PRO15 GRAMS.— 

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

17 (A) The Department of State’s public diplo18 macy programs build global networks that can 

19 address shared challenges, such as the COVID–19 

20 pandemic, including through exchanges of re21 searchers, public health experts, and scientists. 

22 (B) The programs referred to in subpara23 graph (A) play a critical role in creating open 

24 and resilient information environments where 

25 democracies can thrive, as articulated in the 


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1 2020 Public Diplomacy Strategic Plan, includ2 ing by— 

3 (i) improving media quality with jour4 nalist training and reporting tours; 

5 (ii) conducting media literacy pro6 grams; and 

7 (iii) supporting media access activi8 ties. 

9 (C) The International Visitor Leadership 

10 Program and Digital Communications Network 

11 engaged journalists around the world to combat 

12 COVID–19 disinformation, promote unbiased re13 porting, and strengthen media literacy. 

14 (D) More than 12,000 physicians holding 

15 J–1 visas from 130 countries— 

16 (i) are engaged in residency or fellow17 ship training at approximately 750 hos18 pitals throughout the United States, the ma19 jority of whom are serving in States that 

20 have been the hardest hit by COVID–19; 

21 and 

22 (ii) throughout the pandemic, have 

23 served on the front lines of the medical 

24 workforce and in United States university 


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1 labs researching ways to detect and treat the 

2 virus. 

3 (2) VISA PROCESSING BRIEFING.—Not later than 

4 30 days after the date of the enactment of this Act, 

5 the Assistant Secretary for Consular Affairs shall 

6 brief the appropriate congressional committees by 

7 providing— 

8 (A) a timeline for increasing visa proc9 essing capacities at embassies around the world, 

10 notably where there are— 

11 (i) many American citizens, including 

12 dual nationals; and 

13 (ii) many visa applicants for edu14 cational and cultural exchange programs 

15 that promote United States foreign policy 

16 objectives and economic stability to small 

17 businesses, universities, and communities 

18 across the United States; 

19 (B) a detailed plan for using existing au20 thorities to waive or provide other alternatives to 

21 in-person appointments and interviews; 

22 (C) an assessment of whether additional au23 thorities and resources are required for the use of 

24 videoconference appointments and interviews as 


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1 an alternative to in-person appointments and 

2 interviews; and 

3 (D) a detailed plan for using existing au4 thorities to rapidly cross-train and surge tem5 porary personnel to support consular services at 

6 embassies and consulates of the United States 

7 around the world, and an assessment of whether 

8 additional authorities and resources are re9 quired. 

10 (3) GLOBAL ENGAGEMENT CENTER.— 

11 (A) FINDING.—Congress finds that since the 

12 beginning of the COVID–19 pandemic, publica13 tions, websites, and platforms associated with 

14 China, Russia, and Iran have sponsored 

15 disinformation campaigns related to the 

16 COVID–19 pandemic, including falsely blaming 

17 the United States for the disease. 

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

19 Congress that the Global Engagement Center 

20 should continue its efforts to expose and counter 

21 state and non-state-sponsored disinformation re22 lated to COVID–19, the origins of COVID–19, 

23 and COVID–19 vaccinations. 


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1 SEC. 109. FINDINGS AND SENSE OF CONGRESS REGARDING 

2 THE UNITED STATES INTERNATIONAL DEVEL3 OPMENT FINANCE CORPORATION. 

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

5 (1) The COVID–19 pandemic is causing a global 

6 economic recession, as evidenced by the global eco7 nomic indicators described in paragraphs (2) through 

8 (4). 

9 (2) The United Nations Conference on Trade and 

10 Development determined that the COVID–19 pan11 demic pushed the global economy into recession in 

12 2020 on a scale that has not been witnessed since the 

13 1930s. 

14 (3) Developed countries are expected to experi15 ence a relatively more significant rebound in gross 

16 domestic product growth during 2021 than is expected 

17 to be experienced in developing countries, leading to 

18 concerns about a further expansion in the gap be19 tween rich and poor countries, particularly if this 

20 trend continues into 2022. 

21 (4) Global markets have suffered losses ranging 

22 between 5 percent and over 10 percent since the begin23 ning of the pandemic. While markets are recovering 

24 in 2021, global job losses and unemployment rates re25 main high, with— 


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

2 lost globally (13 per cent of the total hours lost) 

3 due to outright unemployment; and 

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

5 labor hours lost due to inactivity or under6 employment. 

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

8 19 pandemic, African finance ministers have re9 quested continued efforts to provide— 

10 (A) additional liquidity; 

11 (B) better market access; 

12 (C) more concessional resources; and 

13 (D) an extension in the Debt Service Sus14 pension Initiative established by the Group of 

15 20. 

16 (b) SENSE OF CONGRESS.—It is the sense of Congress 

17 that— 

18 (1) even when markets begin to recover in the fu19 ture, it is likely that access to capital will be espe20 cially challenging for developing countries, which still 

21 will be struggling with the containment of, and recov22 ery from, the COVID–19 pandemic; 

23 (2) economic uncertainty and the inability of in24 dividuals and households to generate income are 


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1 major drivers of political instability and social dis2 cord, which create conditions for insecurity; 

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

4 of the United States to assist in the economic recovery 

5 of developing countries that are made more vulnerable 

6 and unstable from the public health and economic im7 pacts of the COVID–19 pandemic; 

8 (4) United States foreign assistance and develop9 ment finance institutions should seek to blunt the im10 pacts of a COVID–19 related economic recession by 

11 supporting investments in sectors critical to main12 taining economic stability and resilience in low and 

13 middle income countries; 

14 (5) the need for the United States International 

15 Development Finance Corporation’s support for ad16 vancing development outcomes in less developed coun17 tries, as mandated by the Better Utilization of Invest18 ments Leading to Development Act of 2018 (22 

19 U.S.C. 9601 et seq.), is critical to ensuring lasting 

20 and resilient economic growth in light of the COVID– 

21 19 pandemic’s exacerbation of economic hardships 

22 and challenges; 

23 (6) The United States International Develop24 ment Finance Corporation should adjust its view of 

25 risk versus return by taking smart risks that may 


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1 produce a lower rate of financial return, but produce 

2 significant development outcomes in responding to the 

3 economic effects of COVID–19; 

4 (7) to mitigate the economic impacts of the 

5 COVID–19 recession, the United States International 

6 Development Finance Corporation should use its re7 sources and authorities, among other things— 

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

9 medium-sized enterprises; 

10 (B) to offer local currency loans to bor11 rowers for working capital needs; 

12 (C) to create dedicated financing opportuni13 ties for new ‘‘customers’’ that are experiencing fi14 nancial hardship due to the COVID–19 pan15 demic; and 

16 (D) to work with other development finance 

17 institutions to create co-financing facilities to 

18 support customers experiencing hardship due to 

19 the COVID–19 pandemic. 

20 SEC. 110. SENSE OF CONGRESS REGARDING INTER21 NATIONAL COOPERATION TO PREVENT AND 

22 RESPOND TO FUTURE PANDEMICS. 

23 It is the sense of Congress that— 


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1 (1) global pandemic preparedness and response 

2 requires international and regional cooperation and 

3 action; 

4 (2) the United States should lead efforts in mul5 tilateral fora, such as the Group of 7, the Group of 

6 20, and the United Nations, by collaborating and co7 operating with other countries and international and 

8 regional organizations, including the World Health 

9 Organization and other key stakeholders, to imple10 ment international strategies, tools, and agreements to 

11 better prevent, detect, and respond to future infectious 

12 disease threats before they become pandemics; and 

13 (3) the United States should enhance and expand 

14 coordination and collaboration among the relevant 

15 Federal departments and agencies, the Food and Ag16 riculture Organization of the United Nations, the 

17 World Health Organization, and the World Organiza18 tion for Animal Health, to advance a One Health ap19 proach toward preventing, detecting, and responding 

20 to zoonotic threats in the human-animal 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 COORDINA7 TION OF THE UNITED STATES’ RESPONSE TO INFECTIOUS

8 DISEASE OUTBREAKS WITH SEVERE OR PANDEMIC POTEN9 TIAL.—The President shall designate relevant Federal de10 partments and agencies, including the Department of State, 

11 USAID, and the Centers for Disease Control and Preven12 tion, to lead specific aspects of the United States response 

13 to infectious disease outbreaks with severe or pandemic po14 tential. 

15 (b) NOTIFICATION.—Not later than 120 days after the 

16 date of the enactment of this Act, the President shall notify 

17 the appropriate congressional committees, the Committee on 

18 Health, Education, Labor, and Pensions of the Senate, and 

19 the Committee on Energy and Commerce of the House of 

20 Representatives of the designations made pursuant to sub21 section (a), including detailed descriptions of the roles and 

22 responsibilities of each relevant department and agency. 

23 SEC. 112. USAID DISASTER SURGE CAPACITY. 

24 (a) SURGE CAPACITY.—Amounts authorized to be ap25 propriated or otherwise made available to carry out part 

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


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

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

3 Asia’’, may be used, in addition to amounts otherwise made 

4 available for such purposes, for the cost (including support 

5 costs) of individuals detailed to or employed by the United 

6 States Agency for International Development whose pri7 mary responsibility is to carry out programs in response 

8 to global health emergencies and natural or man-made dis9 asters. 

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

11 making funds available to address man-made disasters pur12 suant to subsection (a), the Secretary of State or the Admin13 istrator of the United States Agency for International De14 velopment shall notify the appropriate congressional com15 mittees of such action. 

16 SEC. 113. STATEMENT OF POLICY ON HUMANITARIAN AS17 SISTANCE TO COUNTRIES AFFECTED BY 

18 PANDEMICS. 

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

20 the United States— 

21 (1) to ensure that United States assistance to ad22 dress pandemics, including the provision of vaccines, 

23 reaches vulnerable and marginalized populations, in24 cluding racial and religious minorities, refugees, in25 ternally displaced persons, migrants, stateless persons, 


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1 women, children, the elderly, and persons with dis2 abilities; 

3 (2) to ensure that United States assistance, in4 cluding development finance, addresses the second 

5 order effects of a pandemic, including acute food inse6 curity; and 

7 (3) to protect and support humanitarian actors 

8 who are essential workers in preventing, mitigating 

9 and responding to the spread of a pandemic among 

10 vulnerable and marginalized groups described in 

11 paragraph (1), including ensuring that such humani12 tarian actors— 

13 (A) are exempted from unreasonable travel 

14 restrictions to ensure that they can effectively 

15 provide life-saving assistance; and 

16 (B) are prioritized as frontline workers in 

17 country vaccine distribution plans. 

18 (b) FACILITATING EFFECTIVE AND SAFE HUMANI19 TARIAN ASSISTANCE.—The Secretary of State, in coordina20 tion with the Administrator of the United States Agency 

21 for International Development, should carry out actions 

22 that accomplish the policies set forth in subsection (a), in23 cluding by— 

24 (1) taking steps to ensure that travel restrictions 

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1 demic are not applied to individuals authorized by 

2 the United States Government to travel to, or reside 

3 in, a designated country to provide assistance related 

4 to, or otherwise impacted by, an outbreak; 

5 (2) approving the use of foreign assistance for 

6 the procurement of personal protective equipment by 

7 United States Government implementing partners 

8 from businesses within or nearby the country receiv9 ing foreign assistance on an urgent basis and in a 

10 manner consistent with efforts to respond to the 

11 spread of a pandemic in the United States; and 

12 (3) waiving certain travel restrictions imple13 mented to help contain the spread of a pandemic in 

14 order to facilitate the medical evacuation of United 

15 States Government implementing partners, regardless 

16 of nationality. 

17 TITLE II—INTERNATIONAL PAN18 DEMIC PREVENTION AND 

19 PREPAREDNESS 

20 SEC. 201. PARTNER COUNTRY DEFINED. 

21 In this title, the term ‘‘partner country’’ means a for22 eign country in which the relevant Federal departments and 

23 agencies are implementing United States assistance for 

24 global health security and pandemic prevention and pre25 paredness under this Act. 


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1 SEC. 202. GLOBAL HEALTH SECURITY STRATEGY AND RE2 PORT. 

3 (a) IN GENERAL.—The President shall develop, up4 date, maintain, and advance a comprehensive strategy for 

5 improving global health security and pandemic prevention, 

6 preparedness, and response that— 

7 (1) clearly articulates the policy goals related to 

8 pandemic prevention, preparedness, and response, 

9 and actions necessary to elevate and strengthen 

10 United States diplomatic leadership in global health 

11 security and pandemic preparedness, including by 

12 building the expertise of the diplomatic corps; 

13 (2) improves the effectiveness of United States 

14 foreign assistance to prevent, detect, and respond to 

15 infectious disease threats, through a One Health ap16 proach, including through the advancement of the 

17 Global Health Security Agenda, the International 

18 Health Regulations (2005), and other relevant frame19 works and programs that contribute to global health 

20 security and pandemic preparedness; 

21 (3) establishes specific and measurable goals, 

22 benchmarks, timetables, performance metrics, and 

23 monitoring and evaluation plans for United States 

24 foreign policy and assistance for global health secu25 rity that promote learning and adaptation and reflect 


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1 international best practices relating to global health 

2 security, transparency, and accountability; 

3 (4) establishes transparent means to improve co4 ordination and performance by the relevant Federal 

5 departments and agencies and sets out clear roles and 

6 responsibilities that reflect the unique capabilities 

7 and resources of each such department and agency; 

8 (5) establishes mechanisms to improve coordina9 tion and avoid duplication of effort among the rel10 evant Federal departments and agencies, partner 

11 countries, donor countries, the private sector, multi12 lateral organizations, and other key stakeholders, and 

13 ensures collaboration at the country level; 

14 (6) supports, and is aligned with, partner coun15 try-led, global health security policy and investment 

16 plans, developed with input from key stakeholders, as 

17 appropriate; 

18 (7) prioritizes working with partner countries 

19 with— 

20 (A) demonstrated need, as identified 

21 through the Joint External Evaluation process, 

22 the Global Health Security Index classification 

23 of health systems, national action plans for 

24 health security, Global Health Security Agenda 

25 Action Packages, other risk-based assessments, 


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1 and other complementary or successor indicators 

2 of global health security and pandemic prepared3 ness; and 

4 (B) demonstrated commitment to trans5 parency, including budget and global health data 

6 transparency, complying with the International 

7 Health Regulations (2005), investing in domestic 

8 health systems, and achieving measurable results; 

9 (8) reduces long-term reliance upon United 

10 States foreign assistance for global health security 

11 by— 

12 (A) helping build and enhance community 

13 resilience to infectious disease emergencies and 

14 threats, such as COVID–19 and Ebola; 

15 (B) ensuring that United States global 

16 health assistance is strategically planned and co17 ordinated in a manner that contributes to the 

18 strengthening of overall health systems and 

19 builds the capacity of local organizations and in20 stitutions; 

21 (C) promoting improved domestic resource 

22 mobilization, co-financing, and appropriate na23 tional budget allocations for strong health sys24 tems, global health security, and pandemic pre25 paredness and response in partner countries; and 


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1 (D) ensuring partner country ownership of 

2 global health security strategies, data, programs, 

3 and outcomes; 

4 (9) supports health budget and workforce plan5 ning in partner countries, including training in pub6 lic financial management and budget data trans7 parency; 

8 (10) works to ensure that— 

9 (A) partner countries have national action 

10 plans for health security that are developed with 

11 input from key stakeholders, including commu12 nities and the private sector; 

13 (B) United States foreign assistance for 

14 global health security is aligned with such na15 tional action plans for health security in partner 

16 countries, developed with input from key stake17 holders, including communities and the private 

18 sector, to the greatest extent practicable and ap19 propriate; and 

20 (C) United States global health security ef21 forts are aligned with ongoing strategies and ini22 tiatives across government agencies to help na23 tions better identify and prevent health impacts 

24 related to deforestation, climate-related events, 

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1 life, livestock, and people, including the emer2 gence, reemergence, and spread of zoonoses; 

3 (11) strengthens linkages between complementary 

4 bilateral and multilateral foreign assistance pro5 grams, including efforts of the World Bank, the World 

6 Health Organization, the Global Fund to Fight 

7 AIDS, Tuberculosis, and Malaria, Gavi, the Vaccine 

8 Alliance, and regional health organizations, that con9 tribute to the development of more resilient health sys10 tems and supply chains in partner countries with the 

11 capacity, resources, and personnel required to pre12 vent, detect, and respond to infectious disease threats; 

13 and 

14 (12) supports innovation and partnerships with 

15 the private sector, health organizations, civil society, 

16 nongovernmental organizations, and health research 

17 and academic institutions to improve pandemic pre18 paredness and response, including for the prevention 

19 and detection of infectious disease, and the develop20 ment and deployment of effective, accessible, and af21 fordable infectious disease tracking tools, diagnostics, 

22 therapeutics, and vaccines. 

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

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1 dent shall submit the strategy required under subsection (a) 

2 to the appropriate congressional committees. 

3 (c) ANNUAL REPORT.— 

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

5 the submission of the strategy to the appropriate con6 gressional committees under subsection (b), and not 

7 later than October 1 of each year thereafter for the fol8 lowing 4 fiscal years, the President shall submit a re9 port to the appropriate congressional committees that 

10 describes— 

11 (A) the status of the implementation of the 

12 strategy required under subsection (a); 

13 (B) any necessary updates to the strategy; 

14 (C) the progress made in implementing the 

15 strategy, with specific information related to the 

16 progress toward improving countries’ ability to 

17 detect, respond and prevent the spread of infec18 tious disease threats, such as COVID–19 and 

19 Ebola; and 

20 (D) details on the status of funds made 

21 available to carry out the purposes of this title. 

22 (2) AGENCY-SPECIFIC PLANS.—The reports re23 quired under paragraph (1) shall include specific im24 plementation plans from each relevant Federal de25 partment and agency that describe— 


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1 (A) how updates to the strategy may have 

2 impacted the agency’s plan during the preceding 

3 calendar year; 

4 (B) the progress made in meeting the goals, 

5 objectives, and benchmarks under implementa6 tion plans during the preceding year; 

7 (C) the anticipated staffing plans and con8 tributions of the department or agency, includ9 ing technical, financial, and in-kind contribu10 tions, to implement the strategy; 

11 (D) a transparent, open, and detailed ac12 counting of obligations by each of the relevant 

13 Federal departments and agencies to implement 

14 the strategy, including— 

15 (i) the statutory source of obligated 

16 funds; 

17 (ii) the amounts obligated; 

18 (iii) implementing partners; 

19 (iv) targeted beneficiaries; and 

20 (v) activities supported; 

21 (E) the efforts of the relevant Federal de22 partment or agency to ensure that the activities 

23 and programs carried out pursuant to the strat24 egy are designed to achieve maximum impact 

25 and enduring returns, including through specific 


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1 activities to strengthen health systems, as appro2 priate; and 

3 (F) a plan for regularly reviewing and up4 dating programs and partnerships, and for shar5 ing lessons learned with a wide range of stake6 holders in an open, transparent manner. 

7 (3) FORM.—The reports required under para8 graph (1) shall be submitted in unclassified form, but 

9 may contain a classified annex. 

10 SEC. 203. COMMITTEE ON GLOBAL HEALTH SECURITY AND 

11 PANDEMIC AND BIOLOGICAL THREATS. 

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

13 the United States— 

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

15 national and security interest; and 

16 (2) to ensure effective coordination and collabo17 ration between the relevant Federal departments and 

18 agencies engaged domestically and internationally in 

19 efforts to advance the global health security of the 

20 United States, in accordance with paragraph (1). 

21 (b) COORDINATION.— 

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

23 term ‘‘pandemic threat’’ means any infectious disease 

24 that— 


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1 (A) has an aggregation of cases in a com2 munity that rises above what is normally ex3 pected in that population in that area; 

4 (B) has the potential to spread over several 

5 countries or continents; and 

6 (C) could, if not addressed, threaten the na7 tional security of the United States. 

8 (2) COMMITTEE ON GLOBAL HEALTH SECURITY

9 AND PANDEMIC AND BIOLOGICAL THREATS.—There is 

10 authorized to be established, within the National Se11 curity Council, the Committee on Global Health Secu12 rity and Pandemic and Biological Threats (referred 

13 to in this subsection as the ‘‘Committee’’), whose day 

14 to day operations should be led by the Special Advisor 

15 for Global Health Security. 

16 (3) SPECIAL ADVISOR FOR GLOBAL HEALTH SE17 CURITY.—The Special Advisor for Global Health Se18 curity referred to in paragraph (2)— 

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

20 National Security Council; and 

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

22 Global Health Security and Biodefense Direc23 torate within the Executive Office of the Presi24 dent, who reports to the Assistant to the Presi25 dent for National Security Affairs. 


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1 (4) COMPOSITION.—The Committee should in2 clude the following members: 

3 (A) The Director of National Intelligence. 

4 (B) The Secretary of State. 

5 (C) The Secretary of Defense. 

6 (D) The Secretary of Health and Human 

7 Services. 

8 (E) The Administrator of the United States 

9 Agency for International Development. 

10 (F) The Secretary of Agriculture. 

11 (G) The Secretary of Treasury. 

12 (H) The Attorney General. 

13 (I) The Secretary of Homeland Security. 

14 (J) The Office of Management and Budget. 

15 (K) The Administrator of the Environ16 mental Protection Agency. 

17 (L) The Director of the Centers for Disease 

18 Control and Prevention. 

19 (M) The Director of the Office of Science 

20 and Technology Policy. 

21 (N) The Assistant to the President for Na22 tional Security Affairs, who should serve as the 

23 chairperson of the Committee. 

24 (O) The Director of the National Institutes 

25 of Health. 


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1 (P) The Director of the National Institute of 

2 Allergy and Infectious Diseases. 

3 (Q) The Secretary of Labor. 

4 (R) Such other members as the President 

5 may designate. 

6 (5) FUNCTIONS.— 

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

8 Committee should be— 

9 (i) to provide strategic guidance for the 

10 development of a policy framework for ac11 tivities of the United States Government re12 lating to global health security, including 

13 pandemic prevention, preparedness and re14 sponse; and 

15 (ii) to ensure policy coordination be16 tween United States Government agencies, 

17 especially coordination between— 

18 (I) agencies with a primarily do19 mestic mandate; and 

20 (II) agencies with an inter21 national mandate relating to global 

22 health security and pandemic threats. 

23 (B) ACTIVITIES.—In carrying out the func24 tions described in subparagraph (A), the Com25 mittee should— 


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1 (i) conduct, in coordination with the 

2 heads of relevant Federal agencies, a review 

3 of existing United States health security 

4 policies and strategies and develop rec5 ommendations for how the Federal Govern6 ment may regularly update and harmonize 

7 such policies and strategies to ensure the 

8 timely development of a comprehensive co9 ordinated strategy to enable the United 

10 States Government to respond to pandemic 

11 threats and to monitor the implementation 

12 of such strategies; 

13 (ii) develop a plan for— 

14 (I) establishing an interagency 

15 National Center for Epidemic Fore16 casting and Outbreak Analytics; and 

17 (II) modernizing global early 

18 warning and trigger systems for scal19 ing action to prevent, detect, respond 

20 to, and recover from emerging biologi21 cal threats; 

22 (iii) provide policy-level recommenda23 tions to participating agencies regarding 

24 the Global Health Security Agenda goals, 

25 objectives, and implementation, and other 


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1 international efforts to strengthen pandemic 

2 prevention, preparedness and response; 

3 (iv) review the progress toward, and 

4 working to resolve challenges in, achieving 

5 United States commitments under the Glob6 al Health Security Agenda; 

7 (v) develop protocols for coordinating 

8 and deploying a global response to emerging 

9 high-consequence infectious disease threats 

10 that outline the respective roles for relevant 

11 Federal agencies in facilitating and sup12 porting such response operations that should 

13 facilitate the operational work of Federal 

14 agencies, and of the Special Advisor for 

15 Global Health Security; 

16 (vi) make recommendations regarding 

17 appropriate responses to specific pandemic 

18 threats and ensure the coordination of do19 mestic and international agencies regarding 

20 the Federal Government’s efforts to prevent, 

21 detect, respond to, and recover from biologi22 cal events; 

23 (vii) take steps to strengthen the global 

24 pandemic supply chain and address any 

25 barriers to the timely delivery of supplies in 


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1 response to a pandemic, including through 

2 engagement with the private sector, as ap3 propriate; 

4 (C) develop policies and procedures to en5 sure the effective sharing of information from do6 mestic and international sources about pandemic 

7 threats among the relevant Federal departments 

8 and agencies, State and local governments, and 

9 international partners and organizations; and 

10 (D) develop guidelines to enhance and im11 prove the operational coordination between State 

12 and local governments and Federal agencies with 

13 respect to pandemic threats. 

14 (6) FOREIGN AFFAIRS RESPONSIBILITIES.—The 

15 Committee should not assume any foreign affairs re16 sponsibilities of the Secretary of State, including the 

17 responsibility to oversee the implementation of pro18 grams and policies that advance global health security 

19 within foreign countries. 

20 (7) SPECIFIC ROLES AND RESPONSIBILITIES.— 

21 (A) IN GENERAL.—The heads of the agencies 

22 listed in paragraph (4) should— 

23 (i) make global health security and 

24 pandemic threat reduction a high priority 

25 within their respective agencies, and include 


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1 global health security and pandemic threat 

2 reduction-related activities within their re3 spective agencies’ strategic planning and 

4 budget processes; 

5 (ii) designate a senior-level official to 

6 be responsible for global health security and 

7 pandemic threat reduction at each of their 

8 respective agencies; 

9 (iii) designate, in accordance with 

10 paragraph (4), an appropriate representa11 tive at the Assistant Secretary level or high12 er to participate on the Committee in in13 stances where the head of the agency cannot 

14 participate; 

15 (iv) keep the Committee apprised of 

16 Global Health Security and pandemic 

17 threat reduction-related activities under18 taken within their respective agencies; 

19 (v) ensure interagency cooperation and 

20 collaboration and maintain responsibility 

21 for agency-related programmatic functions 

22 including, as applicable, in coordination 

23 with host governments, country teams, and 

24 global health security in-country teams; and 


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1 (vi) keep the Committee apprised of 

2 GHSA-related activities undertaken within 

3 their respective agencies. 

4 (B) ADDITIONAL ROLES AND RESPONSIBIL5 ITIES.—In addition to the roles and responsibil6 ities described in subparagraph (A), the heads of 

7 the agencies described in paragraph (4) should 

8 carry out their respective roles and responsibil9 ities described in Executive Order 13747 (81 

10 Fed. Reg. 78701; relating to Advancing the Glob11 al Health Security Agenda to Achieve a World 

12 Safe and Secure from Infectious Disease Threats) 

13 and the National Security Memorandum-1 on 

14 United States Global Leadership to Strengthen 

15 the International COVID–19 Response and to 

16 Advance Global Health Security and Biological 

17 Preparedness, as in effect on the day before the 

18 date of the enactment of this Act. 

19 (8) REGULAR BRIEFINGS.—Not less frequently 

20 than twice each year, the Special Advisor for Global 

21 Health Security shall provide a briefing on the re22 sponsibilities and activities of the Committee to the 

23 appropriate congressional committees, the Committee 

24 on Health, Education, Labor, and Pensions of the 


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1 Senate and the Committee on Energy and Commerce 

2 of the House of Representatives. 

3 SEC. 204. UNITED STATES OVERSEAS GLOBAL HEALTH SE4 CURITY AND DIPLOMACY COORDINATION. 

5 (a) ESTABLISHMENT.—There is established, within the 

6 Department of State, a Special Representative for United 

7 States International Activities to Advance Global Health 

8 Security and Diplomacy Overseas (referred to in this sec9 tion as the ‘‘Special Representative’’). 

10 (b) APPOINTMENT; QUALIFICATIONS.—The Special 

11 Representative— 

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

13 with the advice and consent of the Senate; 

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

15 (3) shall have— 

16 (A) demonstrated knowledge and experience 

17 in the fields of development and public health, 

18 epidemiology, or medicine; and 

19 (B) relevant diplomatic, policy, and polit20 ical expertise. 

21 (c) AUTHORITIES.—The Special Representative is au22 thorized— 

23 (1) to operate internationally to carry out the 

24 purposes of this title; 


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1 (2) to lead in developing a global pandemic pre2 vention, preparedness and response framework to sup3 port global pandemic prevention, preparedness, re4 sponses and recovery efforts, including through— 

5 (A) diplomatic engagement and related for6 eign policy efforts, such as multilateral and bi7 lateral arrangements, enhanced coordination of 

8 engagement with multilateral organizations and 

9 countries, and the mobilization of donor con10 tributions; and 

11 (B) support for United States citizens liv12 ing abroad, including consular support; 

13 (3) to serve as the representative of the Secretary 

14 of State on the Committee on Global Health Security 

15 and Pandemic and Biological Threats under section 

16 202; 

17 (4) to represent the United States in the multi18 lateral, catalytic financing mechanism described in 

19 section 302(a); 

20 (5) to transfer and allocate United States foreign 

21 assistance funding authorized to be appropriated pur22 suant to subsection (f) to the relevant Federal depart23 ments and agencies implementing the strategy re24 quired under section 202, in coordination with the 

25 Office of Management and Budget, the United States 


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1 Agency for International Development, the Depart2 ment of Health and Human Services, and the Office 

3 of Foreign Assistance Resources in the Department of 

4 State; 

5 (6) to utilize detailees, on a reimbursable or non6 reimbursable basis, from the relevant Federal depart7 ments and agencies and hire personal service contrac8 tors, who may operate domestically and internation9 ally, to ensure that the Office of the Special Rep10 resentative has access to the highest quality experts 

11 available to the United States Government to carry 

12 out the functions under this Act; and 

13 (7) to perform such other functions as the Sec14 retary of State may assign. 

15 (d) DUTIES.—The Special Representative shall coordi16 nate, manage, and oversee United States foreign policy, 

17 diplomatic efforts, and foreign assistance funded with 

18 amounts appropriated pursuant to subsection (f) to advance 

19 the United States Global Health Security and Diplomacy 

20 Strategy developed pursuant to section 202, including by— 

21 (1) developing and coordinating a global pan22 demic prevention, preparedness and response frame23 work consistent with subsection (c)(2); 


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1 (2) enhancing engagement with multilateral or2 ganizations and partner countries, including through 

3 the mobilization of donor support; 

4 (3) enhancing coordination of consular services 

5 for United States citizens abroad in the event of a 

6 global health emergency; 

7 (4) ensuring effective program coordination and 

8 implementation by the relevant Federal departments 

9 and agencies by— 

10 (A) formulating, issuing, and updating re11 lated policy guidance; 

12 (B) establishing, in consultation with the 

13 United States Agency for International Develop14 ment and the Centers for Disease Control and 

15 Prevention, unified auditing, monitoring, and 

16 evaluation plans; 

17 (C) aligning, in coordination with United 

18 States chiefs of mission and country teams in 

19 partner countries— 

20 (i) the foreign assistance resources 

21 funded with amounts appropriated pursu22 ant to subsection (f); and 

23 (ii) the implementation plans required 

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


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1 Federal departments and agencies in a 

2 manner that— 

3 (I) is consistent with Executive 

4 Order 13747 (81 Fed. Reg. 78701; re5 lating to Advancing the Global Health 

6 Security Agenda to Achieve a World 

7 Safe and Secure from Infectious Dis8 ease Threats); 

9 (II) is consistent with the Na10 tional Security Memorandum on 

11 United States Global Leadership to 

12 Strengthen the International COVID– 

13 19 Response and to Advance Global 

14 Health Security and Biological Pre15 paredness, issued by President Biden 

16 on January 21, 2021; and 

17 (III) reflects and leverages the 

18 unique capabilities of each such de19 partment and agency; 

20 (D) convening, as appropriate, an inter21 agency working group on pandemic prevention 

22 and preparedness, headed by the Special Rep23 resentative and including representatives from 

24 the relevant Federal departments and agencies, 

25 to facilitate coordination of activities relating to 


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1 pandemic prevention and preparedness in part2 ner countries under this Act; 

3 (E) working with, and leveraging the exper4 tise and activities of, the Office of the United 

5 States Global AIDS Coordinator, the Office of 

6 the United States Global Malaria Coordinator, 

7 and similar or successor entities that are imple8 menting United States global health assistance 

9 overseas; and 

10 (F) avoiding duplication of effort and work11 ing to resolve policy, program, and funding dis12 putes among the relevant Federal departments 

13 and agencies; 

14 (5) leading diplomatic efforts to identify and ad15 dress current and emerging threats to global health se16 curity; 

17 (6) ensuring, in coordination with the Secretary 

18 of Health and Human Services and the Adminis19 trator of the United States Agency for International 

20 Development, effective representation of the United 

21 States in relevant international forums, including at 

22 the World Health Organization, the World Health As23 sembly, and meetings of the Global Health Security 

24 Agenda and of the Global Health Security Initiative; 


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1 (7) working to enhance coordination with, and 

2 transparency among, the governments of partner 

3 countries and key stakeholders, including the private 

4 sector; 

5 (8) promoting greater donor and national invest6 ment in partner countries to build more resilient 

7 health systems and supply chains, including through 

8 representation and participation in a multilateral, 

9 catalytic financing mechanism for global health secu10 rity and pandemic prevention and preparedness, con11 sistent with title III; 

12 (9) securing bilateral and multilateral financing 

13 commitments to advance the Global Health Security 

14 Agenda, including through funding for the financing 

15 mechanism described in title III; and 

16 (10) providing regular updates to the appro17 priate congressional committees regarding the fulfill18 ment of the duties described in this subsection. 

19 (e) DEPUTY REPRESENTATIVE.—The Special Rep20 resentative should be supported by a deputy, who— 

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

22 Agency for International Development serving in a 

23 career or noncareer position in the Senior Executive 

24 Service or at the level of a Deputy Assistant Adminis25 trator or higher; 


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1 (2) should have demonstrated knowledge and ex2 perience in the fields of development and public 

3 health, epidemiology, or medicine; and 

4 (3) serves concurrently as the deputy and per5 forms the functions described in section 3(h) of Execu6 tive Order 13747 (81 Fed. Reg. 78701). 

7 (f) AUTHORIZATION OF APPROPRIATIONS.— 

8 (1) IN GENERAL.—There is authorized to be ap9 propriated $5,000,000,000, for the 5-year period be10 ginning on October 1, 2022, to carry out the purposes 

11 of this section and title III, which, in consultation 

12 with the appropriate congressional committees and 

13 subject to the requirements under chapters 1 and 10 

14 of part I and section 634A of the Foreign Assistance 

15 Act of 1961 (22 U.S.C. 2151 et seq.), may include 

16 support for— 

17 (A) enhancing preparedness in partner 

18 countries through implementation of the Global 

19 Health Security Strategy developed pursuant to 

20 section 202; 

21 (B) replenishing the Emergency Reserve 

22 Fund at the United States Agency for Inter23 national Development, established pursuant to 

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

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1 propriations Act, 2017 (division J of Public Law 

2 115–31) to address new or emerging infectious 

3 disease threats, as necessary and appropriate; 

4 (C) United States contributions to the 

5 World Bank Health Emergency Preparedness 

6 and Response Multi-Donor Fund; and 

7 (D) United States contributions to a multi8 lateral, catalytic financing mechanism for global 

9 health security and pandemic prevention and 

10 preparedness described in section 302. 

11 (2) EXCEPTION.—Section 110 of the Trafficking 

12 Victims Protection Act of 2000 (22 U.S.C. 7107) shall 

13 not apply to assistance made available pursuant to 

14 this subsection. 

15 SEC. 205. RESILIENCE. 

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

17 the growth of healthier, more stable societies, while advanc18 ing the global health security interests of the United States 

19 by working with key stakeholders— 

20 (1) in developing countries that are highly vul21 nerable to the emergence, reemergence, and spread of 

22 infectious diseases with pandemic potential, including 

23 disease outbreaks resulting from natural and man24 made disasters, human displacement, loss of natural 

25 habitat, poor access to water, sanitation, and hygiene, 


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1 and other political, security, economic, and climatic 

2 shocks and stresses; 

3 (2) to develop effective tools to identify, analyze, 

4 forecast, and mitigate the risks that make such coun5 tries vulnerable; 

6 (3) to better integrate short-, medium-, and long7 term recovery efforts into global health emergency re8 sponse and disaster relief; and 

9 (4) to ensure that international assistance and 

10 financing tools are effectively designed, objectively in11 formed, strategically targeted, carefully coordinated, 

12 reasonably adapted, and rigorously monitored and 

13 evaluated in a manner that advances the policy objec14 tives under this section. 

15 SEC. 206. STRENGTHENING HEALTH SYSTEMS. 

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

17 the United States to ensure that bilateral global health as18 sistance programs are effectively managed and coordinated 

19 to contribute to the strengthening of health systems in each 

20 country in which such programs are carried out, as nec21 essary and appropriate for the purposes of achieving im22 proved health outcomes. 

23 (b) COORDINATION.—The Administrator of USAID 

24 shall work with the Director of the Centers for Disease Con25 trol and Prevention, the Global Malaria Coordinator, and 


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1 the United States Global AIDS Coordinator and Special 

2 Representative for Global Health Diplomacy at the Depart3 ment of State to identify areas of collaboration and coordi4 nation in countries with global health programs and activi5 ties undertaken by USAID pursuant to the United States 

6 Leadership Against HIV/AIDS, Tuberculosis, and Malaria 

7 Act of 2003 (Public Law 108–25) and other relevant stat8 utes to ensure that such activities contribute to health sys9 tems strengthening. 

10 (c) PILOT PROGRAM .— 

11 (1) IN GENERAL.—The Administrator of USAID 

12 should identify not fewer than 5 countries in which 

13 the United States has significant bilateral invest14 ments in global health to develop an integrated ap15 proach toward health systems strengthening that takes 

16 advantage of all sources of funding for global health 

17 in such country, with the aim of establishing an en18 during model for coordinating health systems 

19 strengthening activities in additional countries in the 

20 future. 

21 (2) ASSESSMENT.—In the countries selected 

22 under paragraph (1), USAID missions, in consulta23 tion with USAID’s Office of Health Systems, should 

24 conduct an assessment that— 


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1 (A) takes a comprehensive view of the con2 straints in the country’s health system that pre3 vent the achievement of desired outcomes of 

4 United States Government-supported health pro5 grams; 

6 (B) identifies the best opportunities for im7 proving health systems to achieve improved out8 comes, including obstacles to health service deliv9 ery; 

10 (C) maps the resources of the country and 

11 other donors in the health sector with a focus on 

12 investment in health system strengthening; and 

13 (D) develops, based on the results of the as14 sessment described in subparagraph (A), and im15 plements a new or revised 5-year strategy for 

16 United States assistance to strengthen the coun17 try’s health system that— 

18 (i) provides a framework for imple19 menting such strategy; 

20 (ii) identifies key areas for United 

21 States Government investments to strength22 en the health system in alignment with 

23 other donors and achieve health outcomes 

24 beyond a single sector; 


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1 (iii) specifies the anticipated role of 

2 health programs undertaken by each of the 

3 relevant Federal departments and agencies 

4 operating in the country in implementing 

5 such strategy; 

6 (iv) includes clear goals, benchmarks, 

7 outputs, desired outcomes, a means of meas8 uring progress and a cost analysis; and 

9 (v) requires reporting by each Federal 

10 department and agency regarding their par11 ticipation and contribution, including in 

12 the PEPFAR Annual Report to Congress. 

13 (3) STRATEGIES TO STRENGTHEN HEALTH SYS14 TEMS.—USAID missions in countries identified pur15 suant paragraph (1) should develop a strategy to 

16 strengthen health systems based on the assessment de17 veloped pursuant to paragraph (2) that— 

18 (A) ensures complementarity with priorities 

19 identified under any other action plan focused 

20 on strengthening a country’s health system, such 

21 as the World Health Organization’s Joint Exter22 nal Evaluation and National Action Plans for 

23 Health Security; 

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1 ernment ministries and between ministries and 

2 donor agencies and the extent of any corruption, 

3 and identify actions to overcome such barriers; 

4 (C) identifies potential obstacles to the im5 plementation of the strategy, such as issues relat6 ing to lack of political will, poor governance of 

7 an effective health system at all levels of the 

8 country’s public health systems, especially with 

9 respect to governing bodies and councils at the 

10 provincial, district, and community levels, and 

11 the exclusion of women, minorities, other under12 served groups, and frontline health workers in 

13 decision making; 

14 (D) includes proposals for mobilizing suffi15 cient and durable financing for health systems; 

16 (E) identifies barriers to building and re17 taining an effective frontline health workforce 

18 with key global health security capacities, in19 formed by the International Health Regulations 

20 (2005), including— 

21 (i) strengthened data collection and 

22 analysis; 

23 (ii) data driven decision making ca24 pacity; 


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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 doc5 tors, nurses, and midwives and at least 15 

6 paid, trained, equipped, and professionally 

7 supervised community health workers for 

8 every 10,000 people, while supporting prop9 er distribution and high-quality job per10 formance; and 

11 (iv) the formalization and inclusion of 

12 the community health workforce in plan13 ning for a resilient health system to ensure 

14 essential service delivery and pandemic re15 sponse; 

16 (F) identifies deficiencies in information 

17 systems and communication technologies that 

18 prevent linkages at all levels of the health system 

19 delivery and medical supply systems and pro20 motes interoperability across data systems with 

21 real time data, while protecting data security; 

22 (G) identifies weaknesses in supply chain 

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1 parency, and effectiveness of such systems and 

2 practices; 

3 (H) identifies obstacles to health service ac4 cess and quality and improved health outcomes 

5 for women and girls, and for the poorest and 

6 most vulnerable, including a lack of social sup7 port and other underlying causes, and rec8 ommendations for how to overcome such obsta9 cles; 

10 (I) includes plans for integrating innova11 tions in health technologies, services, and sys12 tems; 

13 (J) identifies barriers to health literacy, 

14 community engagement, and patient empower15 ment, and recommendations for overcoming such 

16 barriers; 

17 (K) includes proposals for strengthening 

18 community health systems and the community19 based health workforce informed by the World 

20 Health Organization guideline on health policy 

21 and system support to optimize community 

22 health worker programmes (2018), including the 

23 professionalization of community health workers; 

24 (L) describes the role of the private sector 

25 and nongovernmental health providers, including 


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1 community groups engaged in health promotion 

2 and mutual assistance and other institutions en3 gaged in health delivery, including the extent to 

4 which the local population utilizes such health 

5 services; 

6 (M) facilitates rapid response during health 

7 emergencies, such as last mile delivery of vac8 cines to respond to and prevent the spread of in9 fectious diseases with epidemic and pandemic 

10 potential; and 

11 (N) ensures that relevant USAID missions 

12 and bureaus are appropriately staffed and 

13 resourced to carry out such activities efficiently, 

14 effectively, and in-line with best practices. 

15 (4) CONSULTATION AND REPORTING REQUIRE16 MENTS.— 

17 (A) CONSULTATION.—In developing a strat18 egy pursuant to paragraph (3), each USAID 

19 mission should consult with a wide variety of 

20 stakeholders, including— 

21 (i) relevant partner government insti22 tutions; 

23 (ii) professional associations; 

24 (iii) patient groups; 


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1 (iv) civil society organizations (includ2 ing international nongovernmental organi3 zations with relevant expertise in program 

4 implementation); and 

5 (v) the private sector. 

6 (B) REPORTING.—Not later than 180 days 

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

8 Administrator of USAID and the United States 

9 Global AIDS Coordinator shall submit a report 

10 to the appropriate congressional committees de11 tailing the progress of the pilot program author12 ized under this subsection, including— 

13 (i) progress made toward the integra14 tion and co-financing of health systems 

15 strengthening activities by USAID and the 

16 Office of the Global AIDS Coordinator; and 

17 (ii) the results of integrated efforts 

18 under this section, including for cross-cut19 ting efforts to strengthen local health 

20 workforces. 

21 (d) TECHNICAL CAPACITY.— 

22 (1) IN GENERAL.—The Administrator of USAID 

23 shall ensure that USAID is sufficiently resourced and 

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1 grams, including the pilot program authorized under 

2 subsection (c). 

3 (2) RESOURCES.—The Administrator of USAID 

4 and the United States Global AIDS Coordinator shall 

5 include detail in the fiscal year 2023 Congressional 

6 Budget Justification regarding health systems 

7 strengthening activities, including— 

8 (A) the plans for, and the progress toward, 

9 reaching the capacity described in paragraph 

10 (1); 

11 (B) the requirements for sustaining such ca12 pacity, including the resources needed by 

13 USAID; and 

14 (C) budget detail on the integration and 

15 joint funding of health systems capacity build16 ing, as appropriate. 

17 (e) INTERNATIONAL EFFORTS.—The Secretary of 

18 State, in coordination with the Administrator of USAID, 

19 should work with the Global Fund to Fight AIDS, Tuber20 culosis, and Malaria, Gavi, the Vaccine Alliance, bilateral 

21 donors, and other relevant multilateral and international 

22 organizations and stakeholders to develop— 

23 (1) shared core indicators for strengthened health 

24 systems; 


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1 (2) agreements among donors that reporting re2 quirements for health systems come from country sys3 tems to reduce the burden placed on partner coun4 tries; 

5 (3) structures for joint assessments, plans, audit6 ing, and consultations; and 

7 (4) a regularized approach to coordination on 

8 health systems strengthening. 

9 (f) PUBLIC PRIVATE PARTNERSHIPS TO IMPROVE

10 HEALTH SYSTEMS STRENGTHENING.—The country strate11 gies developed under subsection (c)(3) should include a sec12 tion that— 

13 (1) discusses the role of the private sector (in14 cluding corporate, local, and international organiza15 tions with relevant expertise); and 

16 (2) identifies relevant opportunities for the pri17 vate sector— 

18 (A) to accelerate research and development 

19 of innovative health and information technology, 

20 and to offer training related to its use; 

21 (B) to contribute to improvements in health 

22 administration and management processes; 

23 (C) to improve system efficiency; 

24 (D) to develop training related to clinical 

25 practice guidelines; and 


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1 (E) to help countries develop systems for 

2 documenting outcomes and achievements related 

3 to activities undertaken to strengthen the health 

4 sector. 

5 (g) 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 of 

8 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. 2151b(c)(1)), 

15 by inserting ‘‘(emphasizing health systems strength16 ening, as appropriate)’’ after ‘‘health services’’; 

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

18 (A) in subsection (b)(3)(D), by striking ‘‘in19 cluding health care systems, under other inter20 national donor support’’ and inserting ‘‘includ21 ing through support for health systems strength22 ening, under other donor support’’; and 

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

24 ‘‘the Office of the United States Global AIDS Co25 ordinator, partner countries, and the Global 


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1 Fund to Fight AIDS, Tuberculosis, and Malaria 

2 to ensure that their actions support the activities 

3 taken to strengthen the overall health systems in 

4 recipient countries, and efforts by’’ after ‘‘efforts 

5 by’’; and 

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

7 3(g)(2)), by inserting ‘‘strengthening the health sys8 tem of the country and’’ after ‘‘contribute to’’. 

9 (b) UNITED STATES LEADERSHIP AGAINST HIV/ 

10 AIDS, TUBERCULOSIS, AND MALARIA ACT OF 2003.—Sec11 tion 204 of the United States Leadership Against HIV/ 

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

13 7623) is amended— 

14 (1) in subsection (a) — 

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

16 a manner that is coordinated with, and contrib17 utes to, efforts through other assistance activities 

18 being carried out to strengthen national health 

19 systems and health policies’’ after ‘‘systems’’; and 

20 (B) in paragraph (2)— 

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

22 ‘‘as part of a strategy to improve overall 

23 health’’ before the semicolon at the end; 

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

25 ‘‘and’’ at the end; 


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

2 the period at the end and inserting ‘‘; and’’; 

3 and 

4 (iv) by adding at the end the following: 

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

6 health systems capable of preventing, detecting 

7 and responding to HIV/AIDS, tuberculosis, ma8 laria and other infectious diseases with pan9 demic potential.’’; and 

10 (2) in subsection (b), by striking ‘‘receive fund11 ing to carry out programs to combat HIV/AIDS, tu12 berculosis, and malaria’’ and inserting ‘‘more effec13 tively budget for and receive funding to carry out 

14 programs to strengthen health systems such that coun15 tries are able to more effectively combat HIV/AIDS, 

16 tuberculosis, and malaria, to prevent, respond and de17 tect other diseases with pandemic potential,’’. 

18 SEC. 208. AUTHORIZATION FOR UNITED STATES PARTICIPA19 TION IN THE COALITION FOR EPIDEMIC PRE20 PAREDNESS INNOVATIONS. 

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

22 participate in the Coalition for Epidemic Preparedness In23 novations (referred to in this section as ‘‘CEPI’’). 

24 (b) INVESTORS COUNCIL AND BOARD OF DIREC25 TORS.— 


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1 (1) INITIAL DESIGNATION.—The President shall 

2 designate an employee of the United States Agency for 

3 International Development to serve on the Investors 

4 Council and, if nominated, on the Board of Directors 

5 of CEPI, as a representative of the United States dur6 ing the period beginning on the date of such designa7 tion and ending on September 30, 2022. 

8 (2) ONGOING DESIGNATIONS.—The President 

9 may designate an employee of the relevant Federal de10 partment or agency with fiduciary responsibility for 

11 United States contributions to CEPI to serve on the 

12 Investors Council and, if nominated, on the Board of 

13 Directors of CEPI, as a representative of the United 

14 States. 

15 (3) QUALIFICATIONS.—Any employee designated 

16 pursuant to paragraph (1) or (2) shall have dem17 onstrated knowledge and experience in the fields of de18 velopment and public health, epidemiology, or medi19 cine, from the Federal department or agency with 

20 primary fiduciary responsibility for United States 

21 contributions pursuant to subsection (c). 

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

23 date of the enactment of this Act, the employee designated 

24 pursuant to subsection (b)(1) shall consult with the appro25 priate congressional committees regarding— 


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

2 States plans to participate in CEPI, including 

3 through the governance of CEPI; 

4 (2) any planned financial contributions from the 

5 United States to CEPI; and 

6 (3) how participation in CEPI is expected to 

7 support— 

8 (A) the United States Global Health Secu9 rity Strategy required under this Act; 

10 (B) the applicable revision of the National 

11 Biodefense Strategy required under section 1086 

12 of the National Defense Authorization Act for 

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

14 (C) any other relevant programs relating to 

15 global health security and biodefense. 

16 (d) UNITED STATES CONTRIBUTIONS.— 

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

18 Congress that the President, consistent with the provi19 sions under section 10003(a)(1) of the American Res20 cue Plan Act of 2021, should make an immediate con21 tribution to CEPI in the amount of $300,000,000, to 

22 expand research and development of vaccines to com23 bat the spread of COVID–19 variants. 

24 (2) NOTIFICATION.—Not later than 15 days be25 fore a contribution is made available pursuant to 


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1 paragraph (1), the President shall notify the appro2 priate congressional committees of the details of the 

3 amount, purposes, and national interests served by 

4 such contribution. 

5 SEC. 209. NATIONAL INTELLIGENCE ESTIMATE AND BRIEF6 ING REGARDING NOVEL DISEASES AND PAN7 DEMIC THREATS. 

8 (a) DEFINED TERM.—In this section, the term ‘‘appro9 priate committees of Congress’’ means— 

10 (1) the Committee on Foreign Relations of the 

11 Senate; 

12 (2) the Select Committee on Intelligence of the 

13 Senate; 

14 (3) the Committee on Health, Education, Labor, 

15 and Pensions of the Senate; 

16 (4) the Committee on Foreign Affairs of the 

17 House of Representatives; 

18 (5) the Permanent Select Committee on Intel19 ligence of the House of Representatives; and 

20 (6) the Committee on Energy and Commerce of 

21 the House of Representatives. 

22 (b) NATIONAL INTELLIGENCE ESTIMATES.— 

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

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

25 thereafter for the following 4 years, the National InVerDate Sep 11 2014 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00199 Fmt 6652 Sfmt 6203 E:\BILLS\S2297.RS S2297

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1 telligence Council shall submit to the appropriate 

2 committees of Congress a National Intelligence Esti3 mate regarding the risks posed to the national secu4 rity interests of the United States by the emergence, 

5 reemergence, and overseas transmission of pathogens 

6 with pandemic potential. 

7 (2) ELEMENTS.—The National Intelligence Esti8 mate submitted pursuant to paragraph (1) shall— 

9 (A) identify the countries or regions most 

10 vulnerable to the emergence or reemergence of a 

11 pathogen with pandemic potential, including the 

12 most likely sources and pathways of such emer13 gence or reemergence, whether naturally occur14 ring, accidental, or deliberate; 

15 (B) assess the likelihood that a pathogen de16 scribed in subparagraph (A) will spread to the 

17 United States, the United States Armed Forces, 

18 diplomatic or development personnel of the 

19 United States stationed abroad, or citizens of the 

20 United States living abroad in a manner that 

21 could lead to lead to an epidemic in the United 

22 States or otherwise affect the national security or 

23 economic prosperity of the United States; 

24 (C) assess the preparedness of countries 

25 around the world, particularly those identified 


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1 pursuant to subparagraph (A), to prevent, detect, 

2 and respond to pandemic threats; and 

3 (D) identify any scientific, capacity, or gov4 ernance gaps in the preparedness of countries 

5 identified pursuant to subparagraph (A), includ6 ing an analysis of the capacity and performance 

7 of any country or entity described in subpara8 graph (C) in complying with biosecurity stand9 ards, as applicable. 

10 (c) CONGRESSIONAL BRIEFINGS.—The National Intel11 ligence Council shall provide an annual briefing to the ap12 propriate committees of Congress regarding— 

13 (1) the most recent National Intelligence Esti14 mate submitted pursuant to subsection (b)(1); and 

15 (2) the emergence or reemergence of pathogens 

16 with pandemic potential that could lead to an epi17 demic described in subsection (b)(2)(B). 

18 (d) PUBLIC AVAILABILITY.—The Director of National 

19 Intelligence shall make publicly available an unclassified 

20 version of each National Intelligence Estimate submitted 

21 pursuant to subsection (b)(1). 

22 SEC. 210. PANDEMIC EARLY WARNING NETWORK. 

23 (a) IN GENERAL.—The Secretary of State, in coordi24 nation with the Administrator of the United States Agency 

25 for International Development, the Secretary of Health and 


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1 Human Services, and the heads of the other relevant Federal 

2 departments and agencies, shall work with the World 

3 Health Organization and other key stakeholders to establish 

4 or strengthen effective early warning systems, at the partner 

5 country, regional, and international levels, that utilize in6 novative information and analytical tools and robust re7 view processes to track, document, analyze, and forecast in8 fectious disease threats with epidemic and pandemic poten9 tial. 

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

11 the enactment of this Act, and annually thereafter for the 

12 following 4 years, the Secretary of State, in coordination 

13 with the Secretary of Health and Human Services and the 

14 heads of the other relevant Federal departments and agen15 cies, shall submit a report to the appropriate congressional 

16 committees that describes United States Government efforts 

17 and opportunities to establish or strengthen effective early 

18 warning systems for infectious disease threats. 

19 SEC. 211. INTERNATIONAL EMERGENCY OPERATIONS. 

20 (a) SENSE OF CONGRESS.—It is the sense of Congress 

21 that it is essential to enhance the capacity of key stake22 holders to effectively operationalize early warning and exe23 cute multi-sectoral emergency operations during an infec24 tious disease outbreak, particularly in countries and areas 

25 that deliberately withhold critical global health data and 


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1 delay access during an infectious disease outbreak in ad2 vance of the next infectious disease outbreak with pandemic 

3 potential. 

4 (b) PUBLIC HEALTH EMERGENCIES OF INTER5 NATIONAL CONCERN.—The Secretary of State, in coordina6 tion with the Secretary of Health and Human Services, 

7 should work with the World Health Organization and like8 minded member states to adopt an approach toward assess9 ing infectious disease threats under the International 

10 Health Regulations (2005) for the World Health Organiza11 tion to identify and transparently communicate, on an on12 going basis, varying levels of risk leading up to a declara13 tion by the Director General of the World Health Organiza14 tion of a Public Health Emergency of International Con15 cern for the duration and in the aftermath of such declara16 tion. 

17 (c) EMERGENCY OPERATIONS.—The Secretary of 

18 State, in coordination with the Administrator of USAID, 

19 the Director of the Centers for Disease Control and Preven20 tion, and the heads of other relevant Federal departments 

21 and agencies, and consistent with the requirements under 

22 the International Health Regulations (2005) and the objec23 tives of the World Health Organization’s Health Emer24 gencies Programme, the Global Health Security Agenda, 

25 and national actions plans for health security, shall work, 


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1 in coordination with the World Health Organization, with 

2 partner countries and other key stakeholders to support the 

3 establishment, strengthening, and rapid response capacity 

4 of global health emergency operations centers, at the na5 tional and international levels, including efforts— 

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

7 operationalize early warning; 

8 (2) to secure, including through utilization of 

9 stand-by arrangements and emergency funding mech10 anisms, the staff, systems, and resources necessary to 

11 execute cross-sectoral emergency operations during the 

12 48-hour period immediately following an infectious 

13 disease outbreak with pandemic potential; and 

14 (3) to organize and conduct emergency simula15 tions. 

16 TITLE III—FINANCING MECHA17 NISM FOR GLOBAL HEALTH 

18 SECURITY AND PANDEMIC 

19 PREVENTION AND PREPARED20 NESS 

21 SEC. 301. ELIGIBLE PARTNER COUNTRY DEFINED. 

22 In this title, the term ‘‘eligible partner country’’ means 

23 a country in which the Fund for Global Health Security 

24 and Pandemic Prevention and Preparedness to be estab25 lished under section 302 may finance global health security 


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1 and pandemic prevention and preparedness assistance pro2 grams under this Act based on the country’s dem3 onstrated— 

4 (1) need, as identified through the Joint Exter5 nal Evaluation process, the Global Health Security 

6 Index classification of health systems, national action 

7 plans for health security, the World Organization for 

8 Animal Health’s Performance of Veterinary Services 

9 evaluation, and other complementary or successor in10 dicators of global health security and pandemic pre11 vention and preparedness; and 

12 (2) commitment to transparency, including— 

13 (A) budget and global health data trans14 parency; 

15 (B) complying with the International 

16 Health Regulations (2005); 

17 (C) investing in domestic health systems; 

18 and 

19 (D) achieving measurable results. 

20 SEC. 302. ESTABLISHMENT OF FUND FOR GLOBAL HEALTH 

21 SECURITY AND PANDEMIC PREVENTION AND 

22 PREPAREDNESS. 

23 (a) NEGOTIATIONS FOR ESTABLISHMENT OF FUND

24 FOR GLOBAL HEALTH SECURITY AND PANDEMIC PREVEN25 TION AND PREPAREDNESS.—The Secretary of State, in coVerDate Sep 11 2014 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00205 Fmt 6652 Sfmt 6203 E:\BILLS\S2297.RS S2297

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1 ordination with the Secretary of the Treasury, the Adminis2 trator of the United States Agency for International Devel3 opment, the Secretary of Health and Human Services, the 

4 Director of the Centers for Disease Control and Prevention, 

5 and the heads of other relevant Federal departments and 

6 agencies, as necessary and appropriate, should seek to enter 

7 into negotiations with donors, relevant United Nations 

8 agencies, including the World Health Organization, and 

9 other key multilateral stakeholders, to establish— 

10 (1) a multilateral, catalytic financing mecha11 nism for global health security and pandemic preven12 tion and preparedness, which may be known as the 

13 Fund for Global Health Security and Pandemic Pre14 vention and Preparedness (in this title referred to as 

15 ‘‘the Fund’’), to address the need for and secure dura16 ble financing in accordance with the provisions of 

17 this section; and 

18 (2) an Advisory Board to the Fund in accord19 ance with section 305. 

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

21 (1) to close critical gaps in global health security 

22 and pandemic prevention and preparedness; and 

23 (2) to work with, and build the capacity of, eligi24 ble partner countries in the areas of global health seVerDate Sep 11 2014 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00206 Fmt 6652 Sfmt 6203 E:\BILLS\S2297.RS S2297

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1 curity, infectious disease control, and pandemic pre2 vention and preparedness, in a manner that— 

3 (A) prioritizes capacity building and fi4 nancing availability in eligible partner coun5 tries; 

6 (B) incentivizes countries to prioritize the 

7 use of domestic resources for global health secu8 rity and pandemic prevention and preparedness; 

9 (C) leverages government, nongovernment, 

10 and private sector investments; 

11 (D) regularly responds to and evaluates 

12 progress based on clear metrics and benchmarks, 

13 such as the Joint External Evaluation and the 

14 Global Health Security Index; 

15 (E) aligns with and complements ongoing 

16 bilateral and multilateral efforts and financing, 

17 including through the World Bank, the World 

18 Health Organization, the Global Fund to Fight 

19 AIDS, Tuberculosis, and Malaria, the Coalition 

20 for Epidemic Preparedness and Innovation, and 

21 Gavi, the Vaccine Alliance; and 

22 (F) helps countries accelerate and achieve 

23 compliance with the International Health Regu24 lations (2005) and the fulfillment of the Global 

25 Health Security Agenda 2024 Framework not 


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1 later than 5 years after the date on which the 

2 Fund is established, in coordination with the on3 going Joint External Evaluation national action 

4 planning process. 

5 (c) EXECUTIVE BOARD.— 

6 (1) IN GENERAL.—The Fund should be governed 

7 by a transparent and accountable body (referred to in 

8 this title as the ‘‘Executive Board’’), which should— 

9 (A) function as a partnership with, and 

10 through full engagement by, donor governments, 

11 eligible partner countries, and independent civil 

12 society; and 

13 (B) be composed of not more than 20 rep14 resentatives of governments, foundations, aca15 demic institutions, independent civil society, in16 digenous people, vulnerable communities, front17 line health workers, and the private sector with 

18 demonstrated commitment to carrying out the 

19 purposes of the Fund and upholding trans20 parency and accountability requirements. 

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

22 (A) be charged with approving strategies, 

23 operations, and grant making authorities in 

24 order to conduct effective fiduciary, monitoring, 


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1 and evaluation efforts, and other oversight func2 tions; 

3 (B) determine operational procedures such 

4 that the Fund is able to effectively fulfill its mis5 sion; 

6 (C) provide oversight and accountability for 

7 the Fund in collaboration with the Inspector 

8 General to be established pursuant to section 

9 304(e)(1)(A); 

10 (D) develop and utilize a mechanism to ob11 tain formal input from eligible partner coun12 tries, independent civil society, and imple13 menting entities relative to program design, re14 view, and implementation and associated lessons 

15 learned; and 

16 (E) coordinate and align with other multi17 lateral financing and technical assistance activi18 ties, and with the United States and other na19 tions leading outbreak prevention, preparedness, 

20 and response activities in partner countries, as 

21 appropriate. 

22 (3) COMPOSITION.—The Executive Board should 

23 include— 

24 (A) representatives of the governments of 

25 founding member countries who, in addition to 


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1 the requirements under paragraph (1), qualify 

2 based upon meeting an established initial con3 tribution threshold, which should be not less than 

4 10 percent of total initial contributions, and a 

5 demonstrated commitment to supporting the 

6 International Health Regulations (2005); 

7 (B) a geographically diverse group of mem8 bers who— 

9 (i) come from donor countries, eligible 

10 partner countries, academic institutions, 

11 independent civil society, including indige12 nous organizations, and the private sector; 

13 and 

14 (ii) are selected on the basis of their ex15 perience and commitment to innovation, 

16 best practices, and the advancement of glob17 al health security objectives; 

18 (C) representatives of the World Health Or19 ganization; and 

20 (D) the chair of the Global Health Security 

21 Steering Group. 

22 (4) CONTRIBUTIONS.—Each government or pri23 vate sector entity represented on the Executive Board 

24 should agree to make annual contributions to the 


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1 Fund in an amount not less than the minimum deter2 mined by the Executive Board. 

3 (5) QUALIFICATIONS.—Individuals appointed to 

4 the Executive Board should have demonstrated knowl5 edge and experience across a variety of sectors, in6 cluding human and animal health, agriculture, devel7 opment, defense, finance, research, and academia. 

8 (6) CONFLICTS OF INTEREST.— 

9 (A) TECHNICAL EXPERTS.—The Executive 

10 Board may include independent technical ex11 perts who are not affiliated with, or employed 

12 by, a recipient country or organization. 

13 (B) MULTILATERAL BODIES AND INSTITU14 TIONS.—Executive Board members appointed 

15 pursuant to paragraph (3)(C) should be required 

16 to recuse themselves from matters presenting con17 flicts of interest, including financing decisions 

18 relating to such bodies and institutions. 

19 (7) UNITED STATES REPRESENTATION.— 

20 (A) FOUNDING MEMBER.—The Secretary of 

21 State should seek— 

22 (i) to establish the United States as a 

23 founding member of the Fund; and 

24 (ii) to ensure that the United States is 

25 represented on the Executive Board by an 


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1 officer or employee of the United States, 

2 who shall be appointed by the President. 

3 (B) EFFECTIVE AND TERMINATION

4 DATES.— 

5 (i) EFFECTIVE DATE.—This paragraph 

6 shall take effect upon the date on which the 

7 Secretary of State certifies and submits to 

8 Congress an agreement establishing the 

9 Fund. 

10 (ii) TERMINATION DATE.—The mem11 bership established pursuant to subpara12 graph (A) shall terminate upon the date of 

13 termination of the Fund. 

14 (8) REMOVAL PROCEDURES.—The Fund should 

15 establish procedures for the removal of members of the 

16 Executive Board who— 

17 (A) engage in a consistent pattern of 

18 human rights abuses; 

19 (B) fail to uphold global health data trans20 parency requirements; or 

21 (C) otherwise violate the established stand22 ards of the Fund, including in relation to cor23 ruption. 

24 SEC. 303. AUTHORITIES. 

25 (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 the 

3 Executive Board, should— 

4 (A) develop grant making requirements to 

5 be administered by an independent technical re6 view panel comprised of entities barred from ap7 plying for funding or support; 

8 (B) provide grants, including challenge 

9 grants, technical assistance, concessional lending, 

10 catalytic investment funds, and other innovative 

11 funding mechanisms, in coordination with ongo12 ing bilateral and multilateral efforts, as appro13 priate— 

14 (i) to help eligible partner countries 

15 close critical gaps in health security, as 

16 identified through the Joint External Eval17 uation process, the Global Health Security 

18 Index classification of health systems, and 

19 national action plans for health security 

20 and other complementary or successor indi21 cators of global health security and pan22 demic prevention and preparedness; and 

23 (ii) to support measures that enable 

24 such countries, at the national and sub25 national levels, and in partnership with 


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1 civil society and the private sector, to 

2 strengthen and sustain resilient health sys3 tems and supply chains with the resources, 

4 capacity, and personnel required to prevent, 

5 detect, mitigate, and respond to infectious 

6 disease threats, including zoonotic spillover, 

7 before they become pandemics; 

8 (C) leverage the expertise, capabilities, and 

9 resources of proven, existing agencies and orga10 nizations to effectively target and manage re11 sources for impact, including through alignment 

12 with, and co-financing of, complementary pro13 grams, as appropriate and consistent with para14 graph (3); and 

15 (D) develop recommendations for a mecha16 nism for assisting countries that are at high risk 

17 for zoonotic spillover events with pandemic po18 tential to participate in the Global Health Secu19 rity Agenda and the Joint External Evaluations. 

20 (2) ACTIVITIES SUPPORTED.—The activities to be 

21 supported by the Fund should include efforts— 

22 (A) to enable eligible partner countries to 

23 formulate and implement national health secu24 rity and pandemic prevention and preparedness 

25 action plans, advance action packages under the 


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1 Global Health Security Agenda, and adopt and 

2 uphold commitments under the International 

3 Health Regulations (2005) and other related 

4 international health agreements and arrange5 ments, as appropriate; 

6 (B) to support health security budget plan7 ning in eligible partner countries, including 

8 training in public financial management, budget 

9 and health data transparency, human resource 

10 information systems, and integrated and trans11 parent budget and health data; 

12 (C) to strengthen the health workforce, in13 cluding hiring, training, and deploying experts 

14 and other essential staff, including community 

15 health workers, to improve frontline prevention 

16 of, and monitoring and preparedness for, un17 known, new, emerging, or reemerging pathogens, 

18 epidemics, and pandemic threats, including ca19 pacity to surge and manage additional staff dur20 ing emergencies; 

21 (D) to improve the quality of community 

22 health worker programs as the foundation of 

23 pandemic preparedness and response through ap24 plication of appropriate assessment tools; 


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1 (E) to improve infection prevention and 

2 control, the protection of healthcare workers, in3 cluding community health workers, and access to 

4 water and sanitation within healthcare settings; 

5 (F) to combat the threat of antimicrobial 

6 resistance; 

7 (G) to strengthen laboratory capacity and 

8 promote biosafety and biosecurity through the 

9 provision of material and technical assistance; 

10 (H) to reduce the risk of bioterrorism, 

11 zoonotic disease spillover (whether through loss of 

12 natural habitat, the commercial trade in wildlife 

13 for human consumption, or other means), and 

14 accidental biological release; 

15 (I) to build technical capacity to manage 

16 health supply chains for commodities, equip17 ment, and supplies, including for personal pro18 tective equipment, testing reagents, and other 

19 lifesaving supplies, through effective forecasting, 

20 procurement, warehousing, and delivery from 

21 central warehouses to points of service in both 

22 the public and private sectors; 

23 (J) to enable bilateral, regional, and inter24 national partnerships and cooperation, includ25 ing through pandemic early warning systems 


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1 and emergency operations centers, to identify 

2 and address transnational infectious disease 

3 threats exacerbated by natural and man-made 

4 disasters, human displacement, and zoonotic in5 fection; 

6 (K) to establish partnerships for the sharing 

7 of best practices and enabling eligible countries 

8 to meet targets and indicators under the Joint 

9 External Evaluation process, the Global Health 

10 Security Index classification of health systems, 

11 and national action plans for health security re12 lating to the prevention, detection, and treatment 

13 of neglected tropical diseases; 

14 (L) to build the capacity of eligible partner 

15 countries to prepare for and respond to second 

16 order development impacts of infectious disease 

17 outbreaks and maintain essential health services, 

18 while accounting for the differentiated needs and 

19 vulnerabilities of marginalized populations, in20 cluding women and girls; 

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

23 and identify best practices, including in accord24 ance with Joint External Evaluation benchVerDate Sep 11 2014 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00217 Fmt 6652 Sfmt 6203 E:\BILLS\S2297.RS S2297

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1 marks, Global Health Security Agenda targets, 

2 and Global Health Security Index indicators; 

3 (N) to develop and deploy mechanisms to 

4 enhance and independently monitor the trans5 parency and accountability of global health secu6 rity and pandemic prevention and preparedness 

7 programs and data, in compliance with the 

8 International Health Regulations (2005), includ9 ing through the sharing of trends, risks, and les10 sons learned; 

11 (O) to promote broad participation in 

12 health emergency planning and advisory bodies, 

13 including by women and frontline health work14 ers; 

15 (P) to develop and implement simulation 

16 exercises, produce and release after action re17 ports, and address related gaps; 

18 (Q) to support countries in conducting 

19 Joint External Evaluations; 

20 (R) to improve disease surveillance capacity 

21 in partner counties, including at the community 

22 level, such that those countries are better able to 

23 detect and respond to known and unknown 

24 pathogens and zoonotic infectious diseases; and 


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1 (S) to support governments through coordi2 nated and prioritized assistance efforts to pre3 vent zoonotic spillover caused by deforestation, 

4 commercial trade in wildlife for human con5 sumption, climate-related events, and unsafe 

6 interactions between wildlife, livestock, and peo7 ple to reduce the emergence, reemergence, and 

8 spread of zooneses. 

9 (3) IMPLEMENTATION OF PROGRAM OBJEC10 TIVES.—In carrying out the objectives under para11 graph (1), the Fund should work to eliminate dupli12 cation and waste by upholding strict transparency 

13 and accountability standards and coordinating its 

14 programs and activities with key partners working to 

15 advance global health security and pandemic preven16 tion and preparedness, including— 

17 (A) governments, independent civil society, 

18 nongovernmental organizations, research and 

19 academic institutions, and private sector entities 

20 in eligible partner countries; 

21 (B) the pandemic early warning systems 

22 and international emergency operations centers 

23 to be established under sections 210 and 211; 

24 (C) the World Health Organization; 

25 (D) the Global Health Security Agenda; 


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1 (E) the Global Health Security Initiative; 

2 (F) the Global Fund to Fight AIDS, Tuber3 culosis, and Malaria; 

4 (G) the United Nations Office for the Co5 ordination of Humanitarian Affairs, UNICEF, 

6 and other relevant funds, programs, and special7 ized agencies of the United Nations; 

8 (H) Gavi, the Vaccine Alliance; 

9 (I) the Coalition for Epidemic Preparedness 

10 Innovations (CEPI); 

11 (J) The World Organisation for Animal 

12 Health; 

13 (K) The United Nations Environment Pro14 gramme; 

15 (L) Food and Agriculture Organization; 

16 and 

17 (M) the Global Polio Eradication Initiative. 

18 (b) PRIORITY.—In providing assistance under this sec19 tion, the Fund should give priority to low-and lower middle 

20 income countries with— 

21 (1) low scores on the Global Health Security 

22 Index classification of health systems; 

23 (2) measurable gaps in global health security 

24 and pandemic prevention and preparedness identified 


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1 under Joint External Evaluations and national ac2 tion plans for health security; 

3 (3) demonstrated political and financial commit4 ment to pandemic prevention and preparedness; and 

5 (4) demonstrated commitment to upholding glob6 al health budget and data transparency and account7 ability standards, complying with the International 

8 Health Regulations (2005), investing in domestic 

9 health systems, and achieving measurable results. 

10 (c) ELIGIBLE GRANT RECIPIENTS.—Governments and 

11 nongovernmental organizations should be eligible to receive 

12 grants as described in this section. 

13 SEC. 304. ADMINISTRATION. 

14 (a) APPOINTMENTS.—The Executive Board should ap15 point— 

16 (1) an Administrator, who should be responsible 

17 for managing the day-to-day operations of the Fund; 

18 and 

19 (2) an independent Inspector General, who 

20 should be responsible for monitoring grants imple21 mentation and proactively safeguarding against con22 flicts of interests. 

23 (b) AUTHORITY TO ACCEPT AND SOLICIT CONTRIBU24 TIONS.—The Fund should be authorized to solicit and acVerDate Sep 11 2014 22:57 Jul 30, 2021 Jkt 019200 PO 00000 Frm 00221 Fmt 6652 Sfmt 6203 E:\BILLS\S2297.RS S2297

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1 cept contributions from governments, the private sector, 

2 foundations, individuals, and nongovernmental entities. 

3 (c) ACCOUNTABILITY; CONFLICTS OF INTEREST; CRI4 TERIA FOR PROGRAMS.—As part of the negotiations de5 scribed in section 302(a), the Secretary of the State, con6 sistent with subsection (d), should— 

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

8 that the Fund will have in effect adequate procedures 

9 and standards to account for and monitor the use of 

10 funds contributed to the Fund, including the cost of 

11 administering the Fund; 

12 (2) ensure there is agreement to put in place a 

13 conflict of interest policy to ensure fairness and a 

14 high standard of ethical conduct in the Fund’s deci15 sion-making processes, including proactive procedures 

16 to screen staff for conflicts of interest and measures to 

17 address any conflicts, such as potential divestments of 

18 interests, prohibition from engaging in certain activi19 ties, recusal from certain decision-making and ad20 ministrative processes, and representation by an al21 ternate board member; and 

22 (3) seek agreement on the criteria that should be 

23 used to determine the programs and activities that 

24 should be assisted by the Fund. 


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1 (d) SELECTION OF PARTNER COUNTRIES, PROJECTS, 

2 AND RECIPIENTS.—The Executive Board should establish— 

3 (1) eligible partner country selection criteria, to 

4 include transparent metrics to measure and assess 

5 global health security and pandemic prevention and 

6 preparedness strengths and vulnerabilities in coun7 tries seeking assistance; 

8 (2) minimum standards for ensuring eligible 

9 partner country ownership and commitment to long10 term results, including requirements for domestic 

11 budgeting, resource mobilization, and co-investment; 

12 (3) criteria for the selection of projects to receive 

13 support from the Fund; 

14 (4) standards and criteria regarding qualifica15 tions of recipients of such support; 

16 (5) such rules and procedures as may be nec17 essary for cost-effective management of the Fund; and 

18 (6) such rules and procedures as may be nec19 essary to ensure transparency and accountability in 

20 the grant-making process. 

21 (e) ADDITIONAL TRANSPARENCY AND ACCOUNTABILITY

22 REQUIREMENTS.— 

23 (1) INSPECTOR GENERAL.— 


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

2 shall seek to ensure that the Inspector General 

3 appointed pursuant to subsection (a)— 

4 (i) is fully enabled to operate inde5 pendently and transparently; 

6 (ii) is supported by and with the req7 uisite resources and capacity to regularly 

8 conduct and publish, on a publicly acces9 sible website, rigorous financial, pro10 grammatic, and reporting audits and inves11 tigations of the Fund and its grantees; and 

12 (iii) establishes an investigative unit 

13 that— 

14 (I) develops an oversight mecha15 nism to ensure that grant funds are 

16 not diverted to illicit or corrupt pur17 poses or activities; and 

18 (II) submits an annual report to 

19 the Executive Board describing its ac20 tivities, investigations, and results. 

21 (B) SENSE OF CONGRESS ON CORRUP22 TION.—It is the sense of Congress that— 

23 (i) corruption within global health pro24 grams contribute directly to the loss of 

25 human life and cannot be tolerated; and 


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

3 under a grant, as determined by the Inspec4 tor General, the responsible grant recipient 

5 should be assessed at a recovery rate of up 

6 to 150 percent of such loss. 

7 (2) ADMINISTRATIVE EXPENSES.—The Secretary 

8 of State shall seek to ensure the Fund establishes, 

9 maintains, and makes publicly available a system to 

10 track the administrative and management costs of the 

11 Fund on a quarterly basis. 

12 (3) FINANCIAL TRACKING SYSTEMS.—The Sec13 retary of State shall ensure that the Fund establishes, 

14 maintains, and makes publicly available a system to 

15 track the amount of funds disbursed to each grant re16 cipient and sub-recipient during a grant’s fiscal 

17 cycle. 

18 (4) EXEMPTION FROM DUTIES AND TAXES.—The 

19 Secretary should ensure that the Fund adopts rules 

20 that condition grants upon agreement by the relevant 

21 national authorities in an eligible partner country to 

22 exempt from duties and taxes all products financed 

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

25 such grants. 


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1 SEC. 305. ADVISORY BOARD. 

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

3 to the Fund. 

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

5 Board should be composed of— 

6 (1) a geographically diverse group of individuals 

7 that includes representation from low- and middle-in8 come countries; 

9 (2) individuals with experience and leadership 

10 in the fields of development, global health, epidemi11 ology, medicine, biomedical research, and social 

12 sciences; and 

13 (3) representatives of relevant United Nations 

14 agencies, including the World Health Organization, 

15 and nongovernmental organizations with on-the 

16 ground experience in implementing global health pro17 grams in low and lower-middle income countries. 

18 (c) RESPONSIBILITIES.—The Advisory Board should 

19 provide advice and guidance to the Executive Board of the 

20 Fund on the development and implementation of programs 

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

22 donations to the Fund. 

23 (d) PROHIBITION ON PAYMENT OF COMPENSATION.— 

24 (1) IN GENERAL.—Except for travel expenses (in25 cluding per diem in lieu of subsistence), no member 


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1 of the Advisory Board should receive compensation for 

2 services performed as a member of the Board. 

3 (2) UNITED STATES REPRESENTATIVE.—Not4 withstanding any other provision of law (including 

5 an international agreement), a representative of the 

6 United States on the Advisory Board may not accept 

7 compensation for services performed as a member of 

8 the Board, except that such representative may accept 

9 travel expenses, including per diem in lieu of subsist10 ence, while away from the representative’s home or 

11 regular place of business in the performance of serv12 ices for the Board. 

13 (e) CONFLICTS OF INTEREST.—Members of the Advi14 sory Board should be required to disclose any potential con15 flicts of interest prior to serving on the Advisory Board and, 

16 in the event of any conflicts of interest, recuse themselves 

17 from such matters during their service on the Advisory 

18 Board. 

19 SEC. 306. REPORTS TO CONGRESS. 

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

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

22 in coordination with the Administrator of the United States 

23 Agency for International Development, and the heads of 

24 other relevant Federal departments and agencies, shall sub25 mit a report to the appropriate congressional committees 


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1 that describes the progress of international negotiations to 

2 establish the Fund. 

3 (b) ANNUAL REPORT.— 

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

5 the date of the establishment of the Fund, and annu6 ally thereafter for the duration of the Fund, the Sec7 retary of State, shall submit a report to the appro8 priate congressional committees regarding the admin9 istration of the Fund. 

10 (2) REPORT ELEMENTS.—The report required 

11 under paragraph (1) shall describe— 

12 (A) the goals of the Fund; 

13 (B) the programs, projects, and activities 

14 supported by the Fund; 

15 (C) private and governmental contributions 

16 to the Fund; and 

17 (D) the criteria utilized to determine the 

18 programs and activities that should be assisted 

19 by the Fund, including baselines, targets, desired 

20 outcomes, measurable goals, and extent to which 

21 those goals are being achieved. 

22 (c) GAO REPORT ON EFFECTIVENESS.—Not later than 

23 2 years after the date on which the Fund is established, 

24 the Comptroller General of the United States shall submit 

25 a report to the appropriate congressional committees that 


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1 evaluates the effectiveness of the Fund, including the effec2 tiveness of the programs, projects, and activities supported 

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

4 SEC. 307. UNITED STATES CONTRIBUTIONS. 

5 (a) IN GENERAL.—Subject to submission of the certifi6 cation under this section, the President is authorized to 

7 make available for United States contributions to the Fund 

8 such funds as may be appropriated or otherwise made 

9 available for such purpose. 

10 (b) NOTIFICATION.—The Secretary of State shall no11 tify the appropriate congressional committees not later than 

12 15 days in advance of making a contribution to the Fund, 

13 including— 

14 (1) the amount of the proposed contribution; 

15 (2) the total of funds contributed by other do16 nors; and 

17 (3) the national interests served by United States 

18 participation in the Fund. 

19 (c) LIMITATION.—During the 5-year period beginning 

20 on the date of the enactment of this Act, a United States 

21 contribution to the Fund may not cause the cumulative 

22 total of United States contributions to the Fund to exceed 

23 33 percent of the total contributions to the Fund from all 

24 sources. 

25 (d) WITHHOLDINGS.— 


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1 (1) SUPPORT FOR ACTS OF INTERNATIONAL TER2 RORISM.—If the Secretary of State determines that 

3 the Fund has provided assistance to a country, the 

4 government of which the Secretary of State has deter5 mined, for purposes of section 620A of the Foreign 

6 Assistance Act of 1961 (22 U.S.C. 2371) has repeat7 edly provided support for acts of international ter8 rorism, the United States shall withhold from its con9 tribution to the Fund for the next fiscal year an 

10 amount equal to the amount expended by the Fund 

11 to the government of such country. 

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

13 period beginning on the date of the enactment of this 

14 Act,, if the Secretary of State determines that the sal15 ary of any individual employed by the Fund exceeds 

16 the salary of the Vice President of the United States 

17 for such fiscal year, the United States should withhold 

18 from its contribution for the next fiscal year an 

19 amount equal to the aggregate amount by which the 

20 salary of each such individual exceeds the salary of 

21 the Vice President of the United States. 

22 (3) ACCOUNTABILITY CERTIFICATION REQUIRE23 MENT.—The Secretary of State may withhold not 

24 more than 20 percent of planned United States con25 tributions to the Fund until the Secretary certifies to 


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1 the appropriate congressional committees that the 

2 Fund has established procedures to provide access by 

3 the Office of Inspector General of the Department of 

4 State, as cognizant Inspector General, the Inspector 

5 General of the Department of Health and Human 

6 Services, the Inspector General of the United States 

7 Agency for International Development, and the 

8 Comptroller General of the United States to the 

9 Fund’s financial data and other information relevant 

10 to United States contributions to the Fund (as deter11 mined by the Inspector General of the Department of 

12 State, in consultation with the Secretary of State). 

13 SEC. 308. COMPLIANCE WITH THE FOREIGN AID TRANS14 PARENCY AND ACCOUNTABILITY ACT OF 2016. 

15 Section 2(3) of the Foreign Aid Transparency and Ac16 countability Act of 2016 (Public Law 114–191; 22 U.S.C. 

17 2394c note) is amended— 

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

19 the end; 

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

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

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

23 ‘‘(F) the International Pandemic Prepared24 ness and COVID-19 Response Act of 2021.’’. 


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1 SEC. 309. PROHIBITION AGAINST UNITED STATES FOREIGN 

2 ASSISTANCE FOR THE GOVERNMENT OF THE 

3 PEOPLE’S REPUBLIC OF CHINA. 

4 None of the assistance authorized to be appropriated 

5 under this Act may be made available to the Government 

6 of the People’s Republic of China or to any entity owned 

7 or controlled by the Government of the People’s Republic 

8 of China. 


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Calendar No. 112 

117TH CONGRESS 

1ST SESSION S. 2297 

A BILL 

To improve global health, and for other purposes. 

JULY 30, 2021 

Reported with an amendment 


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