I 

118TH CONGRESS 

1ST SESSION H. R. 6424 

To provide additional authorities for the leadership of the United States 

Agency for International Development in health technology innovation 

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

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 15, 2023 

Mr. FITZPATRICK (for himself, Ms. HOULAHAN, and Ms. SALAZAR) introduced 

the following bill; which was referred to the Committee on Foreign Affairs 

A BILL 

To provide additional authorities for the leadership of the 

United States Agency for International Development in 

health technology innovation for global health in lowresource settings, and for other purposes. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Supporting Innovative 

5 Global Health Technologies Act of 2023’’ or the ‘‘SIGHT 

6 Act’’. 

7 SEC. 2. FINDINGS. 

8 Congress finds the following: 


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1 (1) The United States Agency for International 

2 Development has a unique role in the research and 

3 development of health technologies for global health 

4 that complements the work of other departments 

5 and agencies of the United States Government, hav6 ing both an advantage and unique mandate for de7 velopment of health technologies for use in low-re8 source settings. 

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

10 States to build greater country capacity for research 

11 and development of new health technologies in low 

12 and middle-income countries. 

13 (3) Investments by the United States Govern14 ment in global health research and development 

15 should be coordinated with and leverage investments 

16 from partner country governments, other govern17 ment donors, and the private sector. 

18 (4) Human immunodeficiency virus, tuber19 culosis, malaria, neglected tropical diseases, emerg20 ing infectious diseases (such as COVID–19, Ebola, 

21 and Zika), and many other health conditions (such 

22 as complications in pregnancy) have a dispropor23 tionate public health burden in low- and middle-in24 come countries. 


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1 (5) Health technologies that were developed for 

2 use in high-income countries often cannot be imple3 mented in low-resource settings in low- and middle4 income countries or require adaptation to be effec5 tive. 

6 (6) Due to poverty or to low incidence, many 

7 neglected tropical diseases and emerging infectious 

8 diseases either lack or have limited commercial mar9 kets to drive health technology innovation. 

10 (7) Achieving the ambitious goals set through 

11 initiatives such as the President’s Emergency Plan 

12 for AIDS Relief (commonly referred to as 

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

14 (commonly referred to as ‘‘PMI’’) will not be pos15 sible without the development and scale-up of new 

16 health technologies designed for use in low-resource 

17 settings, which are needed to address both long18 standing endemic diseases and prepare for potential 

19 pandemic threats. 

20 (8) Public funding has proven highly successful 

21 at incentivizing the development of health tech22 nologies for global health that are high-impact, ac23 cessible, and cost-saving. 


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1 (9) COVID–19 has demonstrated the impor2 tance of global access to health technologies de3 signed for low-resource settings. 

4 (10) Support for the development of accessible 

5 health technologies for low-resource settings can 

6 have reciprocal value and produce tools that reduce 

7 health care costs, improve public health, and 

8 strengthen health security for the United States. 

9 (11) For decades, the United States Agency for 

10 International Development has been a catalyst in the 

11 global health innovation ecosystem. While other Fed12 eral departments and agencies, including the Na13 tional Institutes of Health, the Centers for Disease 

14 Control and Prevention, and the Department of De15 fense, provide support for global health technologies, 

16 the United States Agency for International Develop17 ment is the only Federal agency that provides broad 

18 support for the late-stage development of new health 

19 technologies to combat neglected tropical diseases 

20 and emerging infectious diseases and other health 

21 conditions for low-resource settings specifically. 

22 (12) While the need for new tools to tackle dis23 ease threats has grown, in recent years, investments 

24 by the United States Agency for International De25 velopment in research and development have shrunk 


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1 as a proportion of its overall global health spending, 

2 squeezed by both stagnant budgets and growing 

3 needs. 

4 (13) Innovation at the United States Agency 

5 for International Development is primarily supported 

6 from siloed disease- and population-specific appro7 priations accounts, resulting in the limitation of its 

8 ability to seek shared value across health sectors or 

9 health threats. 

10 (14) The United States Agency for Inter11 national Development is compelled to prioritize sup12 port for immediate program needs with imperfect 

13 tools at the expense of support for technologies that 

14 can improve clinical effectiveness, increase access to 

15 care, save costs, and build capacity and ownership 

16 by partner countries. 

17 SEC. 3. STATEMENT OF POLICY. 

18 It is the policy of the United States that— 

19 (1) research and development for new health 

20 technologies is essential for the success of the global 

21 health programs of the United States Government, 

22 by providing for the improved effectiveness, cost-ef23 fectiveness, and sustainability of such programs; and 

24 (2) funding and other support for global health 

25 research and development under this Act shall be 


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1 additional and complementary to, and may not re2 place, displace, or otherwise compromise, funding 

3 otherwise provided for existing and ongoing global 

4 health research and development of the United 

5 States Government or activities relating to the im6 plementation of the global health programs of the 

7 United States Government. 

8 SEC. 4. CHIEF INNOVATION OFFICER FOR HEALTH. 

9 (a) ESTABLISHMENT.—There is established within 

10 the Bureau for Global Health of the Agency the position 

11 of Chief Innovation Officer for Health. Such position is 

12 at the level of Deputy Assistant Administrator or equiva13 lent. 

14 (b) APPOINTMENT.—The Administrator shall appoint 

15 the Chief Innovation Officer for Health from among such 

16 individuals as the Administrator determines have relevant 

17 experience within private sector industry and an expert 

18 understanding of health finance and of the research, devel19 opment, testing, evaluation, deployment, and implementa20 tion of new health technology. 

21 (c) RELATIONSHIP TO ASSISTANT ADMINISTRATOR

22 FOR GLOBAL HEALTH.—The Chief Innovation Officer for 

23 Health shall— 

24 (1) serve as the principal advisor to the Assist25 ant Administrator for Global Health on global health 


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1 research and development necessary to meet the re2 quirements of the United States Government and 

3 the governments of partner countries for improving 

4 global health; and 

5 (2) report directly to the Assistant Adminis6 trator for Global Health. 

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

8 Health shall be responsible for the following: 

9 (1) Ensuring cross-sector, Agency-wide coopera10 tion, support, and programming for global health re11 search and development, for the purpose of increas12 ing the effectiveness of international development 

13 programs of the Agency and supporting the foreign 

14 policy and development goals of the United States 

15 Government. 

16 (2) Drawing on the expertise of other depart17 ments and agencies of the United States Govern18 ment and of nongovernmental organizations (includ19 ing affected communities and institutions in low- or 

20 middle-income countries, businesses, health and 

21 science research organizations, and institutions of 

22 higher education) that pursue global health-related 

23 research and development, to identify the most 

24 pressing requirements for the development of health 


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1 technologies to improve global health and programs 

2 of the Agency relating to global health. 

3 (3) Leveraging research and investments by 

4 other elements of the Agency, other departments 

5 and agencies of the United States Government, and 

6 nongovernmental organizations (including busi7 nesses, health and science research organizations, in8 stitutions of higher education, and governments or 

9 other institutions of partner countries) to support 

10 the research and development of new health tech11 nologies by the Chief Innovation Officer of Health. 

12 (4) Administering the processes for the award 

13 of grants, entry into partnerships, and joint estab14 lishment of other arrangements, to support global 

15 health research and development (including by ad16 ministering the grant program under section 7). 

17 (5) Serving as the Chairperson of the Global 

18 Health Research and Development Advisory Council 

19 established under section 5. 

20 (e) AUTHORITIES.—The Assistant Administrator for 

21 Global Health shall take such steps as may be necessary 

22 to ensure that the Chief Innovation Officer for Health has 

23 sufficient authority within the Bureau for Global Health 

24 to carry out the duties under subsection (d). 


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1 SEC. 5. GLOBAL HEALTH RESEARCH AND DEVELOPMENT 

2 ADVISORY COUNCIL. 

3 (a) ESTABLISHMENT.—The Administrator shall es4 tablish an advisory council to be known as the ‘‘Global 

5 Health Research and Development Advisory Council’’ (in 

6 this section referred to as the ‘‘Council’’). 

7 (b) MEMBERSHIP.—The Council shall be composed of 

8 the following: 

9 (1) The Chief Innovation Officer for Health of 

10 the Agency under section 4, who shall serve as the 

11 Chairperson of the Council (in this section referred 

12 to as the ‘‘Chairperson’’). 

13 (2) Not more than 8 other members appointed 

14 by the Administrator from among individuals— 

15 (A) recommended for such appointment by 

16 the Chairperson; and 

17 (B) who are scientists or other experts 

18 with experience in global health research and 

19 development through or on behalf of— 

20 (i) the Agency; 

21 (ii) any other department or agency of 

22 the United States Government; 

23 (iii) affected communities in low- or 

24 middle-income countries; and 


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1 (iv) nongovernmental organizations, 

2 including nonprofit organizations, busi3 nesses, and institutes of higher education. 

4 (c) TERMS.— 

5 (1) IN GENERAL.—Each member other than the 

6 Chairperson shall be appointed for a term of 6 

7 years. 

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

9 a vacancy occurring before the expiration of the 

10 term for which the predecessor of the member was 

11 appointed shall be appointed only for the remainder 

12 of that term. A vacancy in the Council shall be filled 

13 in the manner in which the original appointment was 

14 made. 

15 (d) COMPENSATION.— 

16 (1) PROHIBITION OF COMPENSATION OF FED17 ERAL EMPLOYEES.—Except as provided in para18 graph (2), members of the Council who are full-time 

19 officers or employees of the United States may not 

20 receive additional pay, allowances, or benefits by rea21 son of their service on the Council. 

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

23 Council shall receive travel expenses, including per 

24 diem in lieu of subsistence, in accordance with appliVerDate Sep 11 2014 05:22 Nov 30, 2023 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6424.IH H6424

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1 cable provisions under subchapter I of chapter 57 of 

2 title 5, United States Code. 

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

4 of the Chairperson. 

5 (f) DUTIES.—The Council shall be responsible for ad6 vising the Administrator regarding the priorities and ob7 jectives for the Agency with respect to global health re8 search and development, including by providing such ad9 vice on an individual member basis or as a collective Coun10 cil, as the Chairperson may direct. 

11 (g) NONAPPLICABILITY OF FEDERAL ADVISORY

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

13 Code, shall not apply to the Council. 

14 SEC. 6. GLOBAL HEALTH RESEARCH AND DEVELOPMENT 

15 PROGRAM AREA ACTIVITIES AND BUDGET. 

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

17 global health research and development activities with re18 spect to new health technologies with the potential to ad19 vance the effectiveness and sustainability of the global 

20 health programs of the Agency, including the potential to 

21 advance— 

22 (1) health technologies with characteristics 

23 identified or otherwise prioritized by affected com24 munities and partner countries; 


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1 (2) health technologies with characteristics that 

2 facilitate introduction and access of the respective 

3 technology, to ensure use by those in need; and 

4 (3) support for capacity-building within partner 

5 countries and the transition by such countries to 

6 greater country-level ownership, responsibility, and 

7 decision-making with respect to global health. 

8 (b) BUDGET.—The Administrator shall— 

9 (1) not later than 90 days after the date of the 

10 enactment of this Act, establish a single, separate 

11 budget line for the activities under subsection (a), 

12 under which funds authorized to be appropriated or 

13 otherwise made available to the Administrator for 

14 the purpose of carrying out such activities shall be 

15 categorized; and 

16 (2) include information regarding amounts ex17 pended and requested to be expended under such 

18 budget line in the budget justification materials sub19 mitted in support of the budget of the President for 

20 any fiscal year beginning on or after the date of 

21 such establishment. 

22 SEC. 7. GRANT PROGRAM FOR EXPANDED USE OF GLOBAL 

23 HEALTH RESEARCH AND DEVELOPMENT. 

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

25 through the Chief Innovation Officer for Health under secVerDate Sep 11 2014 05:22 Nov 30, 2023 Jkt 049200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H6424.IH H6424

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1 tion 4, shall carry out a grant program under which the 

2 Administrator may award grants on a competitive basis 

3 to nongovernmental organizations that are determined eli4 gible by the Administrator. 

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

6 under this section may only be used for the following pur7 poses: 

8 (1) Developing new health technologies designed 

9 for use in low-resource settings to improve global 

10 health. 

11 (2) Evaluating and improving the implementa12 tion, production, and scale-up of health technologies 

13 in low-resource settings in partner countries. 

14 (3) Investing in the research capacity of institu15 tions in low- and middle-income partner countries to 

16 lead and contribute to the development of health 

17 technologies. 

18 (c) CONDITIONS ON GRANT AWARD.—The Adminis19 trator may not award a grant to an entity under this sec20 tion unless— 

21 (1) the entity submits to the Administrator a 

22 proposal demonstrating sufficient technical stand23 ards, as determined by the Administrator, for any of 

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


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

2 such grant amounts; 

3 (2) the entity agrees, as a condition of such 

4 award, to report to the Administrator regarding the 

5 use of such grant amounts on a basis that is not less 

6 frequent than annually for the duration of the grant 

7 period; and 

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

10 in compliance with section 3(2) of this Act. 

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

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

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

16 et seq.). 

17 SEC. 8. STRATEGY AND REPORTS. 

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

19 after the date of the enactment of this Act, and prior to 

20 the submission of the budget justification materials in 

21 support of the budget of the President for the first fiscal 

22 year following the date of the enactment of this Act, the 

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

25 website of the Agency, a report that contains the following: 


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

2 Global Health Research and Development Advisory 

3 Council under section 5. 

4 (2) Recommendations by such Global Health 

5 Research and Development Advisory Council. 

6 (3) Solicitations for grant awards under section 

7 7. 

8 (4) Comprehensive accounting of awards and 

9 objectives to be included within the annual report to 

10 Congress on the health-related research and develop11 ment strategy of the Agency required pursuant to 

12 the Department of State, Foreign Operations, and 

13 Related Programs Appropriations Act (or the report 

14 accompanying such appropriations bill reported by 

15 the Committees on Appropriations of the House or 

16 Representatives or Senate) for the respective fiscal 

17 year. 

18 (5) A detailed description of how the planned 

19 investments by the Agency in the activities under 

20 section 6(a) align with the multiyear strategy of the 

21 Agency titled ‘‘Global Health Research and Develop22 ment Strategy 2023–2028’’ and developed pursuant 

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

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


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1 (6) A detailed description of how investments 

2 made by the Agency in such activities advance the 

3 other health-related programming goals of the Agen4 cy. 

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

6 the date of the enactment of this Act, and annually there7 after for the next 5 years as part of the annual report 

8 specified in subsection (a)(4), the Administrator shall sub9 mit to the appropriate congressional committees, and pub10 lish on a publicly available website of the Agency, a report 

11 that contains, with respect to the year covered by the re12 port, the following: 

13 (1) Information on any grants awarded, or 

14 other assistance provided, by the Administrator dur15 ing such year pursuant to an authority under this 

16 Act or any other relevant provision of law for the 

17 support of global health research and development in 

18 support of programs of the Agency. 

19 (2) The primary, secondary, and tertiary pur20 poses of— 

21 (A) any such grants awarded; and 

22 (B) any investments in the activities under 

23 section 6(a) made or proposed by the Adminis24 trator during such year. 


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1 (3) A summary of how affected communities 

2 and researchers based in partner countries have 

3 been consulted with respect to any such investments. 

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

5 the activities under section 6(a) carried out or other6 wise supported by the Administrator during such 

7 year. 

8 (5) An identification of any amounts obligated 

9 or expended during such year by the Administrator, 

10 from any appropriations account, to support global 

11 health research and development. Such information 

12 shall be presented both as a summary and in a table 

13 delineated by— 

14 (A) health area; 

15 (B) type of research or development activ16 ity; and 

17 (C) appropriations account. 

18 (6) A description of relevant objectives and ex19 pected outcomes for the subsequent year. 

20 SEC. 9. DEFINITIONS. 

21 In this Act: 

22 (1) ADMINISTRATOR.—The term ‘‘Adminis23 trator’’ means the Administrator for the United 

24 States Agency for International Development. 


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1 (2) AGENCY.—The term ‘‘Agency’’ means the 

2 United States Agency for International Develop3 ment. 

4 (3) APPROPRIATE CONGRESSIONAL COMMIT5 TEES.—The term ‘‘appropriate congressional com6 mittees’’ means— 

7 (A) the Committee on Foreign Affairs of 

8 the House of Representatives; and 

9 (B) the Committee on Foreign Relations of 

10 the Senate. 

11 (4) GLOBAL HEALTH.—The term ‘‘global 

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

13 (A) neglected tropical diseases; 

14 (B) emerging infectious diseases; 

15 (C) antimicrobial resistance; and 

16 (D) any other condition that may not be 

17 easily treated, diagnosed, or prevented in low18 resource settings. 

19 (5) GLOBAL HEALTH RESEARCH AND DEVELOP20 MENT.—The term ‘‘global health research and devel21 opment’’ includes an activity, or the support for 

22 such an activity, related to research, development, 

23 testing, evaluation, deployment, or implementation 

24 of any new health technology. 


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1 (6) HEALTH TECHNOLOGY.—The term ‘‘health 

2 technology’’— 

3 (A) means a vaccine, therapeutic, diag4 nostic, device, or other tool designed, modified, 

5 or adapted for use in low-resource settings to 

6 improve global health; and 

7 (B) includes personal protective equipment 

8 and insecticide so used. 

9 (7) LOW-RESOURCE SETTING.—The term ‘‘low10 resource setting’’ means a location with limited or 

11 inconsistent access to running water, electricity, re12 frigeration, supply chains, lab services, medical 

13 equipment, trained health care personnel, or other 

14 resources important for global health. 

Æ 


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