I 

115TH CONGRESS 

2D SESSION H. R. 7290 

To authorize a comprehensive, strategic approach for United States foreign 

assistance to developing countries to strengthen global health security, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 13, 2018 

Mr. CONNOLLY (for himself, Mr. CHABOT, Mr. ENGEL, Mr. FITZPATRICK, Mr. 

BERA, and Mrs. WAGNER) introduced the following bill; which was referred to the Committee on Foreign Affairs, and in addition to the Committees on Armed Services, and Intelligence (Permanent Select), for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

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, 

3 SECTION 1. SHORT TITLE. 

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

5 Act of 2018’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


pamtmann on DSKBFK8HB2PROD with BILLS
2 

•HR 7290 IH

1 (1) In 2005, each of the 196 World Health Or2 ganization member states signed the International 

3 Health Regulations to improve the world’s ability to 

4 prevent, detect, and respond to public health events. 

5 (2) In December 2009, President Obama re6 leased the National Strategy for Countering Biologi7 cal Threats, which listed as one of seven objectives 

8 ‘‘Promote global health security: Increase the avail9 ability of and access to knowledge and products of 

10 the life sciences that can help reduce the impact 

11 from outbreaks of infectious disease whether of nat12 ural, accidental, or deliberate origin’’. 

13 (3) In September 2011, the United States and 

14 the World Health Organization signed a memo15 randum of understanding to help developing coun16 tries strengthen their capabilities to meet the Inter17 national Health Regulations. 

18 (4) In February 2014, the United States and 

19 nearly 30 other nations launched the Global Health 

20 Security Agenda (GHSA) to address several high21 priority, global infectious disease threats. 

22 (5) The GHSA was funded with a 

23 $1,000,000,000, one-time, 5-year supplemental ap24 propriation that expires at the end of fiscal year 

25 2019. 


pamtmann on DSKBFK8HB2PROD with BILLS
3 

•HR 7290 IH

1 (6) Approximately 67 percent of nations have 

2 not fully implemented the International Health Reg3 ulations and built appropriate core capacities to de4 tect, assess, report, and respond to public health 

5 emergencies. 

6 (7) In 2015, the United Nations adopted the 

7 Sustainable Development Goals (SDGs), which in8 clude specific reference to the importance of global 

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

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

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

12 particular developing countries, for early warning, 

13 risk reduction and management of national and 

14 global health risks’’. 

15 (8) On November 4, 2016, President Obama 

16 signed Executive Order 13747, ‘‘Advancing the 

17 Global Health Security Agenda to Achieve a World 

18 Safe and Secure from Infectious Disease Threats’’. 

19 (9) In October 2017 at the GHSA Ministerial 

20 Meeting in Uganda, the United States and more 

21 than 40 GHSA member countries supported the 

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

23 additional 5 years to 2024. 

24 (10) In December 2017, President Trump re25 leased the National Security Strategy, which inVerDate Sep 11 2014 22:47 Dec 17, 2018 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7290.IH H7290

pamtmann on DSKBFK8HB2PROD with BILLS
4 

•HR 7290 IH

1 cludes the priority action: ‘‘Detect and contain bio2 threats at their source: We will work with other 

3 countries to detect and mitigate outbreaks early to 

4 prevent the spread of disease. We will encourage 

5 other countries to invest in basic health care systems 

6 and to strengthen global health security across the 

7 intersection of human and animal health to prevent 

8 infectious disease outbreaks’’. 

9 (11) In February 2018, the Director of Na10 tional Intelligence, Daniel R. Coats, released the 

11 Worldwide Threat Assessment of the U.S. Intel12 ligence Community, which said ‘‘The increase in fre13 quency and diversity of reported disease outbreaks— 

14 such as dengue and Zika—probably will continue 

15 through 2018, including the potential for a severe 

16 global health emergency that could lead to major 

17 economic and societal disruptions, strain govern18 mental and international resources, and increase 

19 calls on the United States for support’’. 

20 (12) In the Consolidated Appropriations Act, 

21 2018 (Public Law 115–141), Congress provided 

22 $172,600,000 for global health security and required 

23 the President to submit a global health security 

24 strategy to Congress not later than 180 days after 

25 the date of the enactment of that Act. 


pamtmann on DSKBFK8HB2PROD with BILLS
5 

•HR 7290 IH

1 (13) 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; SENSE OF CONGRESS. 

9 (a) STATEMENT OF POLICY.—It is the policy of the 

10 United States to— 

11 (1) promote global health security as a core na12 tional security interest; 

13 (2) advance the Global Health Security Agenda, 

14 which is a multi-faceted, multi-country initiative in15 tended to accelerate partner countries’ measurable 

16 capabilities to achieve specific targets to prevent, de17 tect, and respond to infectious disease threats, 

18 whether naturally occurring, deliberate, or acci19 dental; 

20 (3) collaborate with other countries to detect 

21 and mitigate outbreaks early to prevent the spread 

22 of disease; 

23 (4) encourage other countries to invest in basic 

24 health care systems; and 


pamtmann on DSKBFK8HB2PROD with BILLS
6 

•HR 7290 IH

1 (5) strengthen global health security across the 

2 intersection of human and animal health to prevent 

3 infectious disease outbreaks and combat the growing 

4 threat of antimicrobial resistance. 

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

6 Congress that the President, in providing assistance to im7 plement the strategy required under section 7(a), should— 

8 (1) coordinate, through a whole-of-government 

9 approach, the efforts of relevant Federal depart10 ments and agencies to implement the strategy; 

11 (2) seek to fully utilize the unique capabilities 

12 of each relevant Federal department and agency 

13 while collaborating with and leveraging the contribu14 tions of other key stakeholders; and 

15 (3) utilize open and streamlined solicitations to 

16 allow for the participation of a wide range of imple17 menting partners through the most appropriate pro18 curement mechanisms, which may include grants, 

19 contracts, cooperative agreements, and other instru20 ments as necessary and appropriate. 

21 SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY 

22 REVIEW COUNCIL. 

23 (a) ESTABLISHMENT.—The President shall direct the 

24 staff of the National Security Council to establish a Global 

25 Health Security Agenda Interagency Review Council (in 


pamtmann on DSKBFK8HB2PROD with BILLS
7 

•HR 7290 IH

1 this section referred to as the ‘‘Council’’) to perform the 

2 general responsibilities described in subsection (d) and the 

3 specific roles and responsibilities described in subsection 

4 (f). 

5 (b) CHAIR.—The Special Advisor to the President for 

6 Global Health Security (designated under subsection (i) 

7 of section 101 of the National Security Act of 1947 (50 

8 U.S.C. 3021), as added by section 6 of this Act) shall 

9 serve as Chair for the Council. 

10 (c) MEETINGS.—The Council shall meet not less than 

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

12 responsibilities. 

13 (d) GENERAL RESPONSIBILITIES.— 

14 (1) IN GENERAL.—The Council shall be respon15 sible for the following activities: 

16 (A) Provide, by consensus, policy-level 

17 guidance to participating agencies on Global 

18 Health Security Agenda (GHSA) goals, objec19 tives, and implementation. 

20 (B) Facilitate interagency, multi-sectoral 

21 engagement to carry out GHSA implementa22 tion. 

23 (C) Provide a forum for raising and work24 ing to resolve interagency disagreements con25 cerning the GHSA. 


pamtmann on DSKBFK8HB2PROD with BILLS
8 

•HR 7290 IH

1 (D)(i) Review the progress toward and 

2 work to resolve challenges in achieving United 

3 States commitments under the GHSA, includ4 ing commitments to assist other countries in 

5 achieving the GHSA targets. 

6 (ii) The Council shall consider, among 

7 other issues, the following: 

8 (I) The status of United States finan9 cial commitments to the GHSA in the con10 text of commitments by other donors, and 

11 the contributions of partner countries to 

12 achieve the GHSA targets. 

13 (II) The progress toward the mile14 stones outlined in GHSA national plans for 

15 those countries where the United States 

16 Government has committed to assist in im17 plementing the GHSA and in annual work18 plans outlining agency priorities for imple19 menting the GHSA. 

20 (III) The external evaluations of 

21 United States and partner country capa22 bilities to address infectious disease 

23 threats, including the ability to achieve the 

24 targets outlined within the WHO Joint Ex25 ternal Evaluation (JEE) tool, as well as 


pamtmann on DSKBFK8HB2PROD with BILLS
9 

•HR 7290 IH

1 gaps identified by such external evalua2 tions. 

3 (E) Provide, by consensus, policy-level 

4 guidance on GHSA implementation. 

5 (F) Develop a report on an annual basis 

6 regarding the progress achieved and challenges 

7 concerning the United States Government’s 

8 ability to advance the GHSA across priority 

9 countries. The report shall include rec10 ommendations to resolve, mitigate, or otherwise 

11 address the challenges identified therein. The 

12 report shall be transmitted to the President and 

13 the appropriate congressional committees and, 

14 to the extent possible, made publicly available. 

15 (G) Conduct an overall review of the 

16 GHSA for submission to the President and the 

17 appropriate congressional committees by not 

18 later than September 1, 2019. The review 

19 should include an evaluation of the progress 

20 achieved during the 5 years of this initiative, as 

21 well as any challenges faced. The report should 

22 also provide recommendations on the future di23 rection of the initiative. 

24 (2) FORM.—The report required under para25 graph (1)(F) and the review required under paraVerDate Sep 11 2014 22:47 Dec 17, 2018 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H7290.IH H7290

pamtmann on DSKBFK8HB2PROD with BILLS
10 

•HR 7290 IH

1 graph (1)(G) shall be submitted in unclassified form 

2 but may contain a classified annex. 

3 (3) NON-INTERFERENCE IN FOREIGN AFFAIRS

4 RESPONSIBILITIES.—The Council shall not perform 

5 any activities or functions that interfere with the 

6 foreign affairs responsibilities of the Secretary of 

7 State, including the responsibility to oversee the im8 plementation of programs and policies that advance 

9 the GHSA within foreign countries. 

10 (e) PARTICIPATION.—The Council shall consist of 

11 representatives, serving at the Assistant Secretary level or 

12 higher, from the following agencies: 

13 (1) The Department of State. 

14 (2) The Department of Defense. 

15 (3) The Department of Justice. 

16 (4) The Department of Agriculture. 

17 (5) The Department of Health and Human 

18 Services. 

19 (6) The Department of Homeland Security. 

20 (7) The Office of Management and Budget. 

21 (8) The United States Agency for International 

22 Development. 

23 (9) The Environmental Protection Agency. 

24 (10) The Centers for Disease Control and Pre25 vention. 


pamtmann on DSKBFK8HB2PROD with BILLS
11 

•HR 7290 IH

1 (11) The Office of Science and Technology Pol2 icy. 

3 (12) Such other agencies as the representatives 

4 from the agencies described in paragraph (1) 

5 through (11), by consensus, determine to be appro6 priate. 

7 (f) SPECIFIC ROLES AND RESPONSIBILITIES.— 

8 (1) IN GENERAL.—The heads of agencies de9 scribed in subsection (e) shall— 

10 (A) make the GHSA and its implementa11 tion a high priority within their respective agen12 cies, and include GHSA-related activities within 

13 their respective agencies’ strategic planning and 

14 budget processes; 

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

16 responsible for the implementation of this Act; 

17 (C) designate, in accordance with sub18 section (e), an appropriate representative at the 

19 Assistant Secretary level or higher to partici20 pate on the Council; 

21 (D) keep the Council apprised of GHSA22 related activities undertaken within their re23 spective agencies; 

24 (E) maintain responsibility for agency-re25 lated programmatic functions in coordination 


pamtmann on DSKBFK8HB2PROD with BILLS
12 

•HR 7290 IH

1 with host governments, country teams, and 

2 GHSA in-country teams, and in conjunction 

3 with other relevant agencies; 

4 (F) coordinate with other agencies that are 

5 identified in this section to satisfy pro6 grammatic goals, and further facilitate coordi7 nation of country teams, implementers, and do8 nors in host countries; and 

9 (G) coordinate across GHSA national 

10 plans and with GHSA partners to which the 

11 United States is providing assistance. 

12 (2) ADDITIONAL ROLES AND RESPONSIBIL13 ITIES.—In addition to the roles and responsibilities 

14 described in paragraph (1), the heads of agencies de15 scribed in subsection (e) shall carry out their respec16 tive roles and responsibilities described in sub17 sections (b) through (i) of section 3 of Executive 

18 Order 13747 (81 Fed. Reg. 78701; relating to Ad19 vancing the Global Health Security Agenda to 

20 Achieve a World Safe and Secure from Infectious 

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

22 date of the enactment of this Act. 


pamtmann on DSKBFK8HB2PROD with BILLS
13 

•HR 7290 IH

1 SEC. 5. SPECIAL ADVISOR TO THE PRESIDENT FOR GLOBAL 

2 HEALTH SECURITY. 

3 Section 101 of the National Security Act of 1947 (50 

4 U.S.C. 3021) is amended— 

5 (1) in subsection (b)— 

6 (A) in paragraph (3), by striking ‘‘and’’ at 

7 the end; 

8 (B) in paragraph (4), by striking the pe9 riod and inserting ‘‘; and’’; and 

10 (C) by adding at the end the following new 

11 paragraph: 

12 ‘‘(5) coordinate, without assuming operational 

13 authority, the United States Government response to 

14 global health security emergencies.’’; and 

15 (2) by adding at the end the following new sub16 section: 

17 ‘‘(i) SPECIAL ADVISOR TO THE PRESIDENT FOR

18 GLOBAL HEALTH SECURITY.— 

19 ‘‘(1) IN GENERAL.—The President shall des20 ignate an employee of the National Security Council 

21 to be responsible for the coordination of the inter22 agency process for responding to global health secu23 rity emergencies. 

24 ‘‘(2) CONGRESSIONAL BRIEFING.—Not less fre25 quently than twice each year, the employee des26 ignated under this subsection shall provide to the 


pamtmann on DSKBFK8HB2PROD with BILLS
14 

•HR 7290 IH

1 appropriate congressional committees a briefing on 

2 the responsibilities and activities of the individual 

3 under this subsection. 

4 ‘‘(3) APPROPRIATE CONGRESSIONAL COMMIT5 TEES DEFINED.—In this subsection, the term ‘ap6 propriate congressional committees’ has the meaning 

7 given such term in section 9 of the Global Health 

8 Security Act of 2018.’’. 

9 SEC. 6. STRATEGY AND REPORTS. 

10 (a) STRATEGY.—The Special Advisor to the Presi11 dent for Global Health Security (designated under sub12 section (i) of section 101 of the National Security Act of 

13 1947 (50 U.S.C. 3021), as added by section 6 of this Act) 

14 shall coordinate the development and implementation of 

15 a strategy to implement the policy described in section 

16 3(a), which shall— 

17 (1) set specific and measurable goals, bench18 marks, timetables, performance metrics, and moni19 toring and evaluation plans that reflect international 

20 best practices relating to transparency, account21 ability, and global health security; 

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

23 global health security policy and investment plans 

24 developed with input from key stakeholders, as ap25 propriate; 


pamtmann on DSKBFK8HB2PROD with BILLS
15 

•HR 7290 IH

1 (3) facilitate communication and collaboration, 

2 as appropriate, among local stakeholders in support 

3 of a multi-sectoral approach to global health secu4 rity; 

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

6 by building the capacity of local organizations and 

7 institutions in target countries and communities; 

8 (5) develop community resilience to infectious 

9 disease threats and emergencies; 

10 (6) leverage resources and expertise through 

11 partnerships with the private sector, health organi12 zations, civil society, nongovernmental organizations, 

13 and health research and academic institutions; and 

14 (7) support collaboration, as appropriate, be15 tween United States universities, and public and pri16 vate institutions in target countries and communities 

17 to promote health security and innovation. 

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

19 the Special Advisor for Global Health Security, shall co20 ordinate, through a whole-of-government approach, the ef21 forts of relevant Federal departments and agencies in the 

22 implementation of the strategy required under subsection 

23 (a) by— 


pamtmann on DSKBFK8HB2PROD with BILLS
16 

•HR 7290 IH

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 October 1, 

9 2019, the President, in consultation with the head of 

10 each relevant Federal department and agency, shall 

11 submit to the appropriate congressional committees 

12 the strategy required under subsection (a) that pro13 vides a detailed description of how the United States 

14 intends to advance the policy set forth in section 

15 3(a) and the agency-specific plans described in para16 graph (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 


pamtmann on DSKBFK8HB2PROD with BILLS
17 

•HR 7290 IH

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) CONTENT.—The report required under 

16 paragraph (1) shall— 

17 (A) contain a summary of the strategy as 

18 an appendix; 

19 (B) identify any substantial changes made 

20 in the strategy during the preceding calendar 

21 year; 

22 (C) describe the progress made in imple23 menting the strategy; 

24 (D) identify the indicators used to estab25 lish benchmarks and measure results over time, 


pamtmann on DSKBFK8HB2PROD with BILLS
18 

•HR 7290 IH

1 as well as the mechanisms for reporting such 

2 results in an open and transparent manner; 

3 (E) contain a transparent, open, and de4 tailed accounting of expenditures by relevant 

5 Federal departments and agencies to implement 

6 the strategy, including, for each Federal depart7 ment and agency, the statutory source of ex8 penditures, amounts expended, implementing 

9 partners, targeted beneficiaries, and activities 

10 supported; 

11 (F) describe how the strategy leverages 

12 other United States global health and develop13 ment assistance programs; 

14 (G) assess efforts to coordinate United 

15 States global health security programs, activi16 ties, and initiatives with key stakeholders; and 

17 (H) incorporate a plan for regularly re18 viewing and updating strategies, partnerships, 

19 and programs and sharing lessons learned with 

20 a wide range of stakeholders, including key 

21 stakeholders, in an open, transparent manner. 

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

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

24 submitted in unclassified form but may contain a classi25 fied annex. 


pamtmann on DSKBFK8HB2PROD with BILLS
19 

•HR 7290 IH

1 SEC. 7. 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 (C), by striking ‘‘and’’ at 

8 the end; 

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

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

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

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

13 2018.’’. 

14 SEC. 8. DEFINITIONS. 

15 In this Act: 

16 (1) APPROPRIATE CONGRESSIONAL COMMIT17 TEES.—The term ‘‘appropriate congressional com18 mittees’’ means— 

19 (A) the Committee on Foreign Affairs and 

20 the Committee on Appropriations of the House 

21 of Representatives; and 

22 (B) the Committee on Foreign Relations 

23 and the Committee on Appropriations of the 

24 Senate. 

25 (2) GLOBAL HEALTH SECURITY.—The term 

26 ‘‘global health security’’ means activities supporting 


pamtmann on DSKBFK8HB2PROD with BILLS
20 

•HR 7290 IH

1 epidemic and pandemic preparedness and capabili2 ties at the country and global levels in order to mini3 mize vulnerability to acute public health events that 

4 can endanger the health of populations across geo5 graphical regions and international boundaries. 

6 SEC. 9. SUNSET. 

7 This Act, and the amendments made by this Act 

8 (other than section 5), shall cease to be effective on De9 cember 31, 2024. 

Æ 


pamtmann on DSKBFK8HB2PROD with BILLS