II 

113TH CONGRESS 

2D SESSION S. 2407 

To amend the Foreign Assistance Act of 1961 by authorizing the United 

States Agency for International Development to continue supporting the 

development of technologies for global health under the Health Technologies Program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 22, 2014 

Mrs. MURRAY introduced the following bill; which was read twice and referred 

to the Committee on Foreign Relations 

A BILL 

To amend the Foreign Assistance Act of 1961 by authorizing 

the United States Agency for International Development 

to continue supporting the development of technologies 

for global health under the Health Technologies Program, 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 ‘‘21st Century Global 

5 Health Technology Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) Research and development is a critical com2 ponent of United States leadership in global health. 

3 (2) Research and innovation can help to break 

4 the cycle of aid dependency by providing sustainable 

5 solutions to long-term problems. 

6 (3) Research and development for global health 

7 is crucial for meeting new and emerging challenges, 

8 creating efficiencies, strengthening health systems, 

9 shifting tasks, strengthening workforces, and in10 creasing access to health services for the most vul11 nerable people. 

12 (4) Advances in health and medical technologies 

13 have been the major drivers behind massive improve14 ments in health worldwide during the past century, 

15 resulting in an average increase in life expectancy of 

16 21 years in low- and middle-income countries be17 tween 1960 and 2002. 

18 (5) New health technologies have a high return 

19 on investment. For example, a new meningitis A 

20 vaccine developed in collaboration with the United 

21 States Agency for International Development (re22 ferred to in this section as ‘‘USAID’’), the Centers 

23 for Disease Control and Prevention, the National In24 stitutes of Health, and the Food and Drug Adminis25 tration, will save an estimated $570,000,000 in costs 


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1 that would otherwise be incurred for emergency vac2 cination campaigns during the next decade, freeing 

3 much needed resources for use elsewhere in over4 stretched health systems. 

5 (6) USAID, the Centers for Disease Control 

6 and Prevention, the National Institutes of Health, 

7 the Food and Drug Administration, and the Depart8 ment of Defense provide significant contributions 

9 each year to global health research and development. 

10 The United States Government is supporting the de11 velopment of 200 of the 365 products in the global 

12 pipeline of products for neglected and poverty-re13 lated diseases. 

14 (7) This commitment from the United States 

15 Government has led to a remarkable increase in 

16 global health products. Forty-five new health tools 

17 were registered between 2000 and 2010, and the 

18 United States Government was involved in 24 of 

19 these new global health products in the last decade, 

20 including— 

21 (A) 6 drugs for malaria; 

22 (B) 2 vaccines for pneumonia; 

23 (C) 6 diagnostics for tuberculosis; and 

24 (D) 2 drugs for leishmaniasis. 


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1 (8) Although investments from the United 

2 States Government have enabled tremendous 

3 progress in the introduction of new technologies for 

4 global health, gaps still exist in bringing certain 

5 technologies through the development process and 

6 rapidly scaling them up in the field. 

7 (9) Better coordination is needed between Fed8 eral agencies— 

9 (A) to align research strategies; 

10 (B) to identify and address gaps in prod11 uct development activity; and 

12 (C) to move products efficiently along the 

13 research-to-introduction continuum. 

14 (10) Infectious diseases disproportionately im15 pact populations in low-income nations across Latin 

16 America, sub-Saharan Africa, and Asia. Poor and 

17 vulnerable communities in the United States are also 

18 at risk for contracting diseases usually considered to 

19 be diseases of the developing world. For example, 

20 cases of Chagas disease, which is found throughout 

21 Latin America, and dengue fever, endemic to Mexico 

22 and Central America, have been detected in commu23 nities with high poverty rates in States along the 

24 United States border with Mexico. 


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1 (11) In collaboration with the World Health Or2 ganization and its member states, the United States 

3 is a leading participant in discussions to improve co4 ordination and financing of global health research 

5 and development. This process will establish mecha6 nisms to map research needs, identify resource gaps, 

7 and set priorities to ensure that the most crucial 

8 global health products are developed and delivered 

9 for maximum global health impact. 

10 (12) Because of its presence in the field, 

11 USAID is uniquely placed— 

12 (A) to assess local health conditions; 

13 (B) to partner with public and private 

14 stakeholders to ensure the development and 

15 timely introduction and scale-up of tools that 

16 are culturally acceptable; 

17 (C) to address serious and all-too-common 

18 health problems; and 

19 (D) to contribute to the strengthening of 

20 health systems. 

21 (13) In a recent report to Congress, USAID as22 serts that— 

23 (A) health research is ‘‘integral’’ to its 

24 ‘‘ability to achieve its health and development 

25 objectives worldwide’’; and 


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1 (B) innovation through research allows the 

2 agency ‘‘to develop and introduce affordable 

3 health products and practices and contribute to 

4 policies appropriate for addressing health-re5 lated concerns in the developing world’’. 

6 (14)(A) In ‘‘Report to Congress: Health-Re7 lated Research and Development Activities at 

8 USAID (HRRD), May 2011’’, USAID analyzed its 

9 activities from 2006 through 2010 and set forth a 

10 5-year health research strategy for the next 5 years. 

11 (B) The new strategy is— 

12 (i) an important source of information on 

13 USAID’s programs for global health product 

14 development; and 

15 (ii) an effective tool for measuring ex16 pected results from 2011 through 2015. 

17 (C) The strategy does not articulate USAID’s 

18 investments and programming for research and de19 velopment in several critical areas, including— 

20 (i) new tools to diagnose, prevent, and 

21 treat neglected tropical diseases; 

22 (ii) research addressing the leading causes 

23 of death and illness of women, newborns, and 

24 children; and 

25 (iii) new tuberculosis vaccines. 


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1 (15) USAID has established a variety of instru2 ments to promote innovation and global health, such 

3 as— 

4 (A) Grand Challenges for Development; 

5 (B) the Innovation Fund for the Americas; 

6 (C) Higher Education Solutions Network 

7 (HESN); 

8 (D) university Development Labs; and 

9 (E) Research and Innovation Fellowships. 

10 (16) Research and development at USAID— 

11 (A) facilitates public-private collaboration 

12 in the development of global health tech13 nologies; 

14 (B) leverages public and private sector 

15 support for early stage research and develop16 ment of health technologies to encourage pri17 vate sector investment in late-stage technology 

18 development and product introduction in devel19 oping countries; 

20 (C) benefits the United States economy by 

21 investing in the growing United States global 

22 health technology sector, which— 

23 (i) provides skilled jobs for American 

24 workers (64 cents of every United States 


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1 dollar invested in global health research 

2 benefits United States-based researchers); 

3 (ii) creates opportunities for United 

4 States businesses in the development and 

5 production of new technologies; and 

6 (iii) enhances United States competi7 tiveness in the increasingly technological 

8 and knowledge-based global economy; and 

9 (D) enhances United States national secu10 rity by— 

11 (i) reducing the risk of pandemic dis12 ease; and 

13 (ii) contributing to economic develop14 ment and stability in developing countries. 

15 (17) The United States should invest in afford16 able, appropriate health technologies, including— 

17 (A) medical devices for maternal, newborn, 

18 and child care; 

19 (B) new vaccines; 

20 (C) new vaccine technologies and delivery 

21 tools; 

22 (D) safe injection devices; 

23 (E) diagnostic tests for infectious diseases; 

24 (F) new tools for water, sanitation, and 

25 nutrition; 


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1 (G) multipurpose prevention technologies; 

2 (H) information systems and mobile health 

3 and information systems; and 

4 (I) innovative disease prevention strategies. 

5 (18) United States investments in the health 

6 technologies set forth in paragraph (17) would— 

7 (A) reduce the risk of disease transmission; 

8 (B) accelerate access to life-saving global 

9 health interventions for the world’s poor; 

10 (C) reduce the burden on local health sys11 tems; and 

12 (D) result in significant cost savings for 

13 development assistance funds. 

14 (19) In circumstances where markets fail, pub15 lic-private partnerships are an effective way to de16 velop, introduce and scale up new health tech17 nologies. 

18 (20)(A) Product development partnerships (re19 ferred to in this paragraph as ‘‘PDPs’’) are a model 

20 of public-private partnership that is successfully ac21 celerating research to benefit the developing world. 

22 (B) PDPs are non-profit, nongovernmental en23 tities that work to accelerate the development of new 

24 tools to fight diseases in resource-poor settings. 


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1 (C) PDPs typically manage resources and part2 nerships from across public, private, and philan3 thropic sectors to drive the development of a full 

4 pipeline of potential new products that could save 

5 and improve lives in the developing world. 

6 (D) USAID has played a significant role in ad7 vancing the PDP model through its financial sup8 port. 

9 (E) Between 2004 and 2013, the achievements 

10 of PDPs have become increasingly successful at ad11 vancing new products through the development pipe12 line towards registration, product introduction, and 

13 use. 

14 (21) USAID supports research and introduction 

15 activities along a research-to-use continuum includ16 ing— 

17 (A) evidence reviews and health assess18 ments in developing countries; and 

19 (B) the development, testing, adaptation, 

20 and introduction of appropriate products and 

21 interventions within the context of strength22 ening health systems. 

23 (22)(A) A Center for Accelerating Innovation 

24 and Impact (referred to in this paragraph as the 

25 ‘‘Center’’) has been established at USAID to adVerDate Mar 15 2010 04:18 Jun 03, 2014 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2407.IS S2407

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1 dress technical, supply, and policy barriers in the de2 velopment, introduction, and scale-up of new prod3 ucts and technologies for global health. 

4 (B) For diseases and conditions in which mar5 ket forces have proven insufficient to generate and 

6 rapidly deliver new technologies, the Center pro7 motes and reinforces solutions to overcome obstacles 

8 such as regulatory inefficiencies in developing coun9 tries, limited user demand, gaps in market data and 

10 supply chain hurdles. 

11 (C) The Center also catalyzes partnerships with 

12 the public and private sectors to develop and rapidly 

13 deploy new products. 

14 (23) Since 1982, USAID has carried out a pro15 gram to support the development of health tech16 nologies through which USAID— 

17 (A) has maximized the limited resources 

18 available for global health; 

19 (B) has ensured that products and medi20 cines developed for use in low-resource settings 

21 have reached the people that need such prod22 ucts and medicines; 

23 (C) has invented, designed, developed, or 

24 co-developed 85 health technologies; and 


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1 (D) has collaborated with more than 100 

2 private-sector organizations, which have 

3 matched the funds received from USAID by a 

4 2:1 ratio. 

5 (24) The research and development activities of 

6 USAID are complementary to the work of other 

7 Federal agencies. 

8 SEC. 3. PURPOSES. 

9 The purposes of this Act are— 

10 (1) to acknowledge the role of the United 

11 States Agency for International Development (re12 ferred to in this section as ‘‘USAID’’) in product de13 velopment, introduction, and scale-up of new global 

14 health tools; and 

15 (2) to establish the Technologies for Health 

16 Program within USAID to support the development 

17 of technologies for global health that will— 

18 (A) improve global health; 

19 (B) reduce maternal, newborn, and child 

20 mortality rates; 

21 (C) improve health and nutrition; 

22 (D) reverse the incidence of HIV/AIDS, 

23 malaria, tuberculosis, and other infectious dis24 eases; 

25 (E) reduce the burden of chronic diseases; 


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1 (F) overcome technical, supply, and policy 

2 hurdles to product introduction and scale-up; 

3 and 

4 (G) support research and development that 

5 is consistent with a global development strategy 

6 and other related strategies developed by 

7 USAID. 

8 SEC. 4. ESTABLISHMENT OF HEALTH TECHNOLOGIES PRO9 GRAM. 

10 (a) IN GENERAL.—Section 107 of the Foreign Assist11 ance Act of 1961 (22 U.S.C. 2151e) is amended by adding 

12 at the end the following: 

13 ‘‘(c) TECHNOLOGIES FOR HEALTH.— 

14 ‘‘(1) ESTABLISHMENT.—There is established, 

15 within the Health and Infectious Diseases and Nu16 trition Section of the Global Health Bureau of the 

17 United States Agency for International Development 

18 (referred to in this subsection as ‘USAID’), the 

19 Technologies for Health Program (referred to in this 

20 subsection as the ‘Program’). 

21 ‘‘(2) FUNCTIONS.—The Program shall develop, 

22 advance, and introduce affordable, available, and ap23 propriate and primarily late-stage technologies spe24 cifically designed— 


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1 ‘‘(A) to improve the health and nutrition of 

2 populations in developing countries; 

3 ‘‘(B) to reduce maternal, newborn, and 

4 child mortality in such countries; and 

5 ‘‘(C) to improve the diagnosis, prevention, 

6 and reduction of disease, especially HIV/AIDS, 

7 malaria, tuberculosis, and other infectious dis8 eases, in such countries. 

9 ‘‘(3) AGREEMENT.—The Program shall be car10 ried out under a cooperative agreement between 

11 USAID and 1 or more institutions with a successful 

12 record of— 

13 ‘‘(A) advancing the technologies described 

14 in paragraph (2); and 

15 ‘‘(B) integrating practical field experience 

16 into the research and development process in 

17 order to introduce the most appropriate tech18 nologies. 

19 ‘‘(d) ACTION PLANS.—The Administrator of USAID 

20 shall— 

21 ‘‘(1) establish and implement action plans to in22 corporate global health research and product devel23 opment within each of the global health and develop24 ment programs, with support from coordinating 

25 agencies; 


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1 ‘‘(2) establish metrics to measure progress in 

2 implementing the action plans; and 

3 ‘‘(3) consider all options in implementing the 

4 action plans, including the use of public-private part5 nerships. 

6 ‘‘(e) PRIORITY GLOBAL HEALTH INTERVENTIONS.— 

7 The Center for Accelerating Innovation and Impact of 

8 USAID shall continue its work to speed the development, 

9 introduction, and scale-up of priority global health inter10 ventions.’’. 

11 (b) SAVINGS PROVISION.—Section 107(c) of the For12 eign Assistance Act of 1961, as added by subsection (a)— 

13 (1) authorizes the United States Agency for 

14 International Development (referred to in this sub15 section and section 5 as ‘‘USAID’’) to continue the 

16 health technologies research and development activi17 ties carried out by USAID before the date of the en18 actment of this Act; and 

19 (2) does not establish a new program for such 

20 purposes. 

21 SEC. 5. ANNUAL REPORT ON RESEARCH AND DEVELOP22 MENT ACTIVITIES AT USAID. 

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

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

25 for the following 4 years, the Administrator of the United 


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1 States Agency for International Development, after con2 sultation with the Centers for Disease Control and Preven3 tion, the Department of Defense, the Food and Drug Ad4 ministration, and the National Institutes of Health, shall 

5 submit a separate report to Congress on the research and 

6 development activities carried out by USAID. 

7 (b) MATTERS TO BE INCLUDED.—Each report sub8 mitted under subsection (a) shall include— 

9 (1) updates on the implementation of USAID’s 

10 strategy for using research funds to stimulate the 

11 development and introduction of products in each of 

12 its global health and development programs; 

13 (2) a description of USAID’s collaborations and 

14 coordination with other Federal departments and 

15 agencies in support of translational and applied 

16 global health research and development; 

17 (3) a description of USAID’s collaborations and 

18 coordination with partner governments, bilateral and 

19 multilateral donors, and other relevant governmental 

20 entities in support of translational and applied glob21 al health research and development; 

22 (4) a description of USAID investments in 

23 science, technology, and innovation; 

24 (5) an explanation of how technologies and re25 search products developed by USAID complement 


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1 work being done by other Federal departments and 

2 agencies; and 

3 (6) a list of technologies and research products 

4 that have been introduced into field trials or use. 

5 (c) CONSULTATION.—The Administrator of USAID 

6 shall annually consult with the heads of other Federal de7 partments and agencies to improve alignment of USAID’s 

8 health-related research strategy with other similar agency 

9 strategies, with the intent of working towards a whole-of10 government strategy for global health research and devel11 opment. 

Æ 


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