IIB 

116TH CONGRESS 

2D SESSION H. R. 2166 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 23, 2020 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

To authorize a comprehensive, strategic approach for United 

States foreign assistance to developing countries to 

strengthen global health security, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Global Health Security 

3 Act of 2020’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

6 (1) In December 2009, President Obama re7 leased the National Strategy for Countering Biologi8 cal Threats, which listed as one of seven objectives 

9 ‘‘Promote global health security: Increase the avail10 ability of and access to knowledge and products of 

11 the life sciences that can help reduce the impact 

12 from outbreaks of infectious disease whether of nat13 ural, accidental, or deliberate origin’’. 

14 (2) In February 2014, the United States and 

15 nearly 30 other nations launched the Global Health 

16 Security Agenda (GHSA) to address several high17 priority, global infectious disease threats. The 

18 GHSA is a multi-faceted, multi-country initiative in19 tended to accelerate partner countries’ measurable 

20 capabilities to achieve specific targets to prevent, de21 tect, and respond to infectious disease threats, 

22 whether naturally occurring, deliberate, or acci23 dental. 

24 (3) In 2015, the United Nations adopted the 

25 Sustainable Development Goals (SDGs), which in26 clude specific reference to the importance of global 


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1 health security as part of SDG 3 ‘‘ensure healthy 

2 lives and promote well-being for all at all ages’’ as 

3 follows: ‘‘strengthen the capacity of all countries, in 

4 particular developing countries, for early warning, 

5 risk reduction and management of national and 

6 global health risks’’. 

7 (4) On November 4, 2016, President Obama 

8 signed Executive Order No. 13747, ‘‘Advancing the 

9 Global Health Security Agenda to Achieve a World 

10 Safe and Secure from Infectious Disease Threats’’. 

11 (5) In October 2017 at the GHSA Ministerial 

12 Meeting in Uganda, the United States and more 

13 than 40 GHSA member countries supported the 

14 ‘‘Kampala Declaration’’ to extend the GHSA for an 

15 additional 5 years to 2024. 

16 (6) In December 2017, President Trump re17 leased the National Security Strategy, which in18 cludes the priority action: ‘‘Detect and contain bio19 threats at their source: We will work with other 

20 countries to detect and mitigate outbreaks early to 

21 prevent the spread of disease. We will encourage 

22 other countries to invest in basic health care systems 

23 and to strengthen global health security across the 

24 intersection of human and animal health to prevent 

25 infectious disease outbreaks’’. 


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1 (7) In September 2018, President Trump re2 leased the National Biodefense Strategy, which in3 cludes objectives to ‘‘strengthen global health secu4 rity capacities to prevent local bioincidents from be5 coming epidemics’’, and ‘‘strengthen international 

6 preparedness to support international response and 

7 recovery capabilities’’. 

8 SEC. 3. STATEMENT OF POLICY. 

9 It is the policy of the United States to— 

10 (1) promote global health security as a core na11 tional security interest; 

12 (2) advance the aims of the Global Health Se13 curity Agenda; 

14 (3) collaborate with other countries to detect 

15 and mitigate outbreaks early to prevent the spread 

16 of disease; 

17 (4) encourage other countries to invest in basic 

18 resilient and sustainable health care systems; and 

19 (5) strengthen global health security across the 

20 intersection of human and animal health to prevent 

21 infectious disease outbreaks and combat the growing 

22 threat of antimicrobial resistance. 


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1 SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY 

2 REVIEW COUNCIL. 

3 (a) ESTABLISHMENT.—The President shall establish 

4 a Global Health Security Agenda Interagency Review 

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

6 perform the general responsibilities described in sub7 section (c) and the specific roles and responsibilities de8 scribed in subsection (e). 

9 (b) MEETINGS.—The Council shall meet not less than 

10 four times per year to advance its mission and fulfill its 

11 responsibilities. 

12 (c) GENERAL RESPONSIBILITIES.—The Council shall 

13 be responsible for the following activities: 

14 (1) Provide policy-level recommendations to 

15 participating agencies on Global Health Security 

16 Agenda (GHSA) goals, objectives, and implementa17 tion. 

18 (2) Facilitate interagency, multi-sectoral en19 gagement to carry out GHSA implementation. 

20 (3) Provide a forum for raising and working to 

21 resolve interagency disagreements concerning the 

22 GHSA. 

23 (4)(A) Review the progress toward and work to 

24 resolve challenges in achieving United States com25 mitments under the GHSA, including commitments 


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1 to assist other countries in achieving the GHSA tar2 gets. 

3 (B) The Council shall consider, among other 

4 issues, the following: 

5 (i) The status of United States financial 

6 commitments to the GHSA in the context of 

7 commitments by other donors, and the con8 tributions of partner countries to achieve the 

9 GHSA targets. 

10 (ii) The progress toward the milestones 

11 outlined in GHSA national plans for those 

12 countries where the United States Government 

13 has committed to assist in implementing the 

14 GHSA and in annual work-plans outlining 

15 agency priorities for implementing the GHSA. 

16 (iii) The external evaluations of United 

17 States and partner country capabilities to ad18 dress infectious disease threats, including the 

19 ability to achieve the targets outlined within the 

20 WHO Joint External Evaluation (JEE) tool, as 

21 well as gaps identified by such external evalua22 tions. 

23 (d) PARTICIPATION.—The Council shall consist of 

24 representatives, serving at the Assistant Secretary level or 

25 higher, from the following agencies: 


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1 (1) The Department of State. 

2 (2) The Department of Defense. 

3 (3) The Department of Justice. 

4 (4) The Department of Agriculture. 

5 (5) The Department of Health and Human 

6 Services. 

7 (6) The Department of Labor. 

8 (7) The Department of Homeland Security. 

9 (8) The Office of Management and Budget. 

10 (9) The United States Agency for International 

11 Development. 

12 (10) The Environmental Protection Agency. 

13 (11) The Centers for Disease Control and Pre14 vention. 

15 (12) The Office of Science and Technology Pol16 icy. 

17 (13) The National Institutes of Health. 

18 (14) The National Institute of Allergy and In19 fectious Diseases. 

20 (15) Such other agencies as the Council deter21 mines to be appropriate. 

22 (e) SPECIFIC ROLES AND RESPONSIBILITIES.— 

23 (1) IN GENERAL.—The heads of agencies de24 scribed in subsection (d) shall— 


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1 (A) make the GHSA and its implementa2 tion a high priority within their respective agen3 cies, and include GHSA-related activities within 

4 their respective agencies’ strategic planning and 

5 budget processes; 

6 (B) designate a senior-level official to be 

7 responsible for the implementation of this Act; 

8 (C) designate, in accordance with sub9 section (d), an appropriate representative at the 

10 Assistant Secretary level or higher to partici11 pate on the Council; 

12 (D) keep the Council apprised of GHSA13 related activities undertaken within their re14 spective agencies; 

15 (E) maintain responsibility for agency-re16 lated programmatic functions in coordination 

17 with host governments, country teams, and 

18 GHSA in-country teams, and in conjunction 

19 with other relevant agencies; 

20 (F) coordinate with other agencies that are 

21 identified in this section to satisfy pro22 grammatic goals, and further facilitate coordi23 nation of country teams, implementers, and do24 nors in host countries; and 


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1 (G) coordinate across GHSA national 

2 plans and with GHSA partners to which the 

3 United States is providing assistance. 

4 (2) ADDITIONAL ROLES AND RESPONSIBIL5 ITIES.—In addition to the roles and responsibilities 

6 described in paragraph (1), the heads of agencies de7 scribed in subsection (d) shall carry out their respec8 tive roles and responsibilities described in sub9 sections (b) through (i) of section 3 of Executive 

10 Order No. 13747 (81 Fed. Reg. 78701; relating to 

11 Advancing the Global Health Security Agenda to 

12 Achieve a World Safe and Secure from Infectious 

13 Disease Threats), as in effect on the day before the 

14 date of the enactment of this Act. 

15 SEC. 5. UNITED STATES COORDINATOR FOR GLOBAL 

16 HEALTH SECURITY. 

17 (a) IN GENERAL.—The President shall appoint an in18 dividual to the position of United States Coordinator for 

19 Global Health Security, who shall be responsible for the 

20 coordination of the interagency process for responding to 

21 global health security emergencies. As appropriate, the 

22 designee shall coordinate with the President’s Special Co23 ordinator for International Disaster Assistance. 

24 (b) CONGRESSIONAL BRIEFING.—Not less frequently 

25 than twice each year, the employee designated under this 


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1 section shall provide to the appropriate congressional com2 mittees a briefing on the responsibilities and activities of 

3 the individual under this section. 

4 (c) APPROPRIATE CONGRESSIONAL COMMITTEES DE5 FINED.—In this subsection, the term ‘‘appropriate con6 gressional committees’’ has the meaning given such term 

7 in section 8 of the Global Health Security Act of 2019. 

8 SEC. 6. SENSE OF CONGRESS. 

9 It is the sense of the Congress that, given the complex 

10 and multisectoral nature of global health threats to the 

11 United States, the President— 

12 (1) should consider appointing an individual 

13 with significant background and expertise in public 

14 health or emergency response management to the 

15 position of United States Coordinator for Global 

16 Health Security, as required by section 5(a), who is 

17 an employee of the National Security Council at the 

18 level of Deputy Assistant to the President or higher; 

19 and 

20 (2) in providing assistance to implement the 

21 strategy required under section 7(a), should— 

22 (A) coordinate, through a whole-of-govern23 ment approach, the efforts of relevant Federal 

24 departments and agencies to implement the 

25 strategy; 


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1 (B) seek to fully utilize the unique capa2 bilities of each relevant Federal department and 

3 agency while collaborating with and leveraging 

4 the contributions of other key stakeholders; and 

5 (C) utilize open and streamlined solicita6 tions to allow for the participation of a wide 

7 range of implementing partners through the 

8 most appropriate procurement mechanisms, 

9 which may include grants, contracts, coopera10 tive agreements, and other instruments as nec11 essary and appropriate. 

12 SEC. 7. STRATEGY AND REPORTS. 

13 (a) STRATEGY.—The United States Coordinator for 

14 Global Health Security (appointed under section 5(a)) 

15 shall coordinate the development and implementation of 

16 a strategy to implement the policy aims described in sec17 tion 3, which shall— 

18 (1) set specific and measurable goals, bench19 marks, timetables, performance metrics, and moni20 toring and evaluation plans that reflect international 

21 best practices relating to transparency, account22 ability, and global health security; 

23 (2) support and be aligned with country-owned 

24 global health security policy and investment plans 


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1 developed with input from key stakeholders, as ap2 propriate; 

3 (3) facilitate communication and collaboration, 

4 as appropriate, among local stakeholders in support 

5 of a multi-sectoral approach to global health secu6 rity; 

7 (4) support the long-term success of programs 

8 by building the capacity of local organizations and 

9 institutions in target countries and communities; 

10 (5) develop community resilience to infectious 

11 disease threats and emergencies; 

12 (6) leverage resources and expertise through 

13 partnerships with the private sector, health organi14 zations, civil society, nongovernmental organizations, 

15 and health research and academic institutions; and 

16 (7) support collaboration, as appropriate, be17 tween United States universities, and public and pri18 vate institutions in target countries and communities 

19 to promote health security and innovation. 

20 (b) COORDINATION.—The President, acting through 

21 the United States Coordinator for Global Health Security, 

22 shall coordinate, through a whole-of-government approach, 

23 the efforts of relevant Federal departments and agencies 

24 in the implementation of the strategy required under sub25 section (a) by— 


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1 (1) establishing monitoring and evaluation sys2 tems, coherence, and coordination across relevant 

3 Federal departments and agencies; and 

4 (2) establishing platforms for regular consulta5 tion and collaboration with key stakeholders and the 

6 appropriate congressional committees. 

7 (c) STRATEGY SUBMISSION.— 

8 (1) IN GENERAL.—Not later than 180 days 

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

10 President, in consultation with the head of each rel11 evant Federal department and agency, shall submit 

12 to the appropriate congressional committees the 

13 strategy required under subsection (a) that provides 

14 a detailed description of how the United States in15 tends to advance the policy set forth in section 3 and 

16 the agency-specific plans described in paragraph (2). 

17 (2) AGENCY-SPECIFIC PLANS.—The strategy re18 quired under subsection (a) shall include specific im19 plementation plans from each relevant Federal de20 partment and agency that describes— 

21 (A) the anticipated contributions of the de22 partment or agency, including technical, finan23 cial, and in-kind contributions, to implement 

24 the strategy; and 


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1 (B) the efforts of the department or agen2 cy to ensure that the activities and programs 

3 carried out pursuant to the strategy are de4 signed to achieve maximum impact and long5 term sustainability. 

6 (d) REPORT.— 

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

8 the date on which the strategy required under sub9 section (a) is submitted to the appropriate congres10 sional committees under subsection (c), and not later 

11 than October 1 of each year thereafter, the Presi12 dent shall submit to the appropriate congressional 

13 committees a report that describes the status of the 

14 implementation of the strategy. 

15 (2) CONTENTS.—The report required under 

16 paragraph (1) shall— 

17 (A) identify any substantial changes made 

18 in the strategy during the preceding calendar 

19 year; 

20 (B) describe the progress made in imple21 menting the strategy; 

22 (C) identify the indicators used to establish 

23 benchmarks and measure results over time, as 

24 well as the mechanisms for reporting such re25 sults in an open and transparent manner; 


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1 (D) contain a transparent, open, and de2 tailed accounting of expenditures by relevant 

3 Federal departments and agencies to implement 

4 the strategy, including, to the extent prac5 ticable, for each Federal department and agen6 cy, the statutory source of expenditures, 

7 amounts expended, partners, targeted popu8 lations, and types of activities supported; 

9 (E) describe how the strategy leverages 

10 other United States global health and develop11 ment assistance programs; 

12 (F) assess efforts to coordinate United 

13 States global health security programs, activi14 ties, and initiatives with key stakeholders; 

15 (G) incorporate a plan for regularly review16 ing and updating strategies, partnerships, and 

17 programs and sharing lessons learned with a 

18 wide range of stakeholders, including key stake19 holders, in an open, transparent manner; and 

20 (H) describe the progress achieved and 

21 challenges concerning the United States Gov22 ernment’s ability to advance the Global Health 

23 Security Agenda across priority countries, in24 cluding data disaggregated by priority country 

25 using indicators that are consistent on a yearVerDate Sep 11 2014 18:07 Sep 24, 2020 Jkt 099200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H2166.RFS H2166

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1 to-year basis and recommendations to resolve, 

2 mitigate, or otherwise address the challenges 

3 identified therein. 

4 (e) FORM.—The strategy required under subsection 

5 (a) and the report required under subsection (d) shall be 

6 submitted in unclassified form but may contain a classi7 fied annex. 

8 SEC. 8. COMPLIANCE WITH THE FOREIGN AID TRANS9 PARENCY AND ACCOUNTABILITY ACT OF 

10 2016. 

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

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

13 U.S.C. 2394c note) is amended— 

14 (1) in subparagraph (C), by striking ‘‘and’’ at 

15 the end; 

16 (2) in subparagraph (D), by striking the period 

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

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

19 ‘‘(E) the Global Health Security Act of 

20 2020.’’. 

21 SEC. 9. DEFINITIONS. 

22 In this Act: 

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


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1 (A) the Committee on Foreign Affairs and 

2 the Committee on Appropriations of the House 

3 of Representatives; and 

4 (B) the Committee on Foreign Relations 

5 and the Committee on Appropriations of the 

6 Senate. 

7 (2) GLOBAL HEALTH SECURITY.—The term 

8 ‘‘global health security’’ means activities supporting 

9 epidemic and pandemic preparedness and capabili10 ties at the country and global levels in order to mini11 mize vulnerability to acute public health events that 

12 can endanger the health of populations across geo13 graphical regions and international boundaries. 

14 SEC. 10. SUNSET. 

15 This Act, and the amendments made by this Act, 

16 (other than section 5) shall cease to be effective on Decem17 ber 31, 2024. 

Passed the House of Representatives September 22, 

2020. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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