I 
109TH CONGRESS 
1ST SESSION H. R. 3369 
To amend the Public Health Service Act with respect to preparation for 
an influenza pandemic, including an avian influenza pandemic, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 20, 2005 
Mrs. LOWEY (for herself, Mr. FRELINGHUYSEN, Ms. DELAURO, Mr. CASE, 
Ms. SCHAKOWSKY, Mr. MCNULTY, Mr. MCDERMOTT, Ms. BORDALLO, 
Mr. SCHIFF, Mr. FARR, Ms. MCCOLLUM of Minnesota, and Mr. DAVIS 
of Illinois) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Agriculture, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend the Public Health Service Act with respect to 
preparation for an influenza pandemic, including an 
avian influenza pandemic, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Attacking Viral Influ-
enza Across Nations Act of 2005’’.
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) The Department of Health and Human 
Services reports that an influenza pandemic has a 
greater potential to cause rapid increases in death 
and illness than virtually any other natural health 
threat. 
(2) Three pandemics occurred during the 20th 
century: the Spanish flu pandemic in 1918, the 
Asian flu pandemic in 1957, and the Hong Kong flu 
pandemic in 1968. The Spanish flu pandemic was 
the most severe, causing over 500,000 deaths in the 
United States and more than 20,000,000 deaths 
worldwide. 
(3) The Centers for Disease Control and Pre-
vention has estimated conservatively that up to 
207,000 Americans would die, and up to 734,000 
would be hospitalized, during the next pandemic. 
The costs of the pandemic, including the total direct 
costs associated with medical care and indirect costs 
of lost productivity and death, are estimated at be-
tween 
$71,000,000,000 
and 
$166,500,000,000. 
These costs do not include the economic effects of 
pandemic on commerce and society. 
(4) Recent studies suggest that avian influenza 
strains, which are endemic in wild birds and poultry
populations in some countries, are becoming increas-
ingly capable of causing severe disease in humans 
and are likely to cause the next pandemic flu. 
(5) In 2004, 8 nations—Thailand, Vietnam, In-
donesia, Japan, Laos, China, Cambodia, and the Re-
public of Korea—experienced outbreaks of avian flu 
(H5N1) among poultry flocks. Cases of human in-
fections were confirmed in Thailand and Vietnam 
(including a possible human-to-human infection in 
Thailand). 
(6) As of April 15, 2005, 88 confirmed human 
cases of avian influenza (H5N1) have been reported, 
51 of which resulted in death. Of these cases, 68 
were in Vietnam, 17 in Thailand, and 3 in Cam-
bodia. 
(7) 
On 
February 
21, 
2005, 
Dr. 
Julie 
Gerberding, Director of the Centers for Disease 
Control and Prevention, stated that ‘‘this is a very 
ominous situation for the globe . . . the most impor-
tant threat we are facing right now.’’. 
(8) On February 23, 2005, Dr. Shigeru Omi, 
Asia regional director of the World Health Organiza-
tion (WHO), stated with respect to the avian flu, 
‘‘We at WHO believe that the world is now in the 
gravest possible danger of a pandemic.’’.
(9) 
The 
best 
defense 
against 
influenza 
pandemics is a heightened global surveillance sys-
tem. In many of the nations where avian flu (H5N1) 
has become endemic the early detection capabilities 
are severely lacking, as is the transparency in the 
health systems. 
(10) In addition to surveillance, pandemic pre-
paredness requires domestic and international co-
ordination and cooperation to ensure an adequate 
medical response, including communication and in-
formation networks, public health measures to pre-
vent spread, use of vaccination and antivirals, provi-
sion of health outpatient and inpatient services, and 
maintenance of core public functions. 
SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT. 
Title XXI of the Public Health Service Act (42 
U.S.C. 300aa–1 et seq.) is amended by adding at the end 
the following: 
‘‘Subtitle 3—Pandemic Influenza 
Preparedness 
‘‘SEC. 2141. DEFINITION. 
‘‘For purposes of this subtitle, the term ‘State’ shall 
have the meaning given such term in section 2(f) and shall 
include Indian tribes and tribal organizations (as defined
in section 4(b) and 4(c) of the Indian Self-Determination 
and Education Assistance Act). 
‘‘SEC. 2142. PROPOSAL FOR INTERNATIONAL FUND TO SUP-
PORT PANDEMIC INFLUENZA CONTROL. 
‘‘(a) IN GENERAL.—The Secretary should submit to 
the Director of the World Health Organization a proposal 
to study the feasibility of establishing a fund, (referred 
to in this section as the ‘Pandemic Fund’) to support pan-
demic influenza control and relief activities conducted in 
countries affected by pandemic influenza, including pan-
demic avian influenza. 
‘‘(b) CONTENT OF PROPOSAL.—The proposal sub-
mitted under subsection (a) shall describe, with respect 
to the Pandemic Fund— 
‘‘(1) funding sources; 
‘‘(2) administration; 
‘‘(3) application process by which a country 
may apply to receive assistance from such Fund; 
‘‘(4) factors used to make a determination re-
garding a submitted application, which may in-
clude— 
‘‘(A) the gross domestic product of the ap-
plicant country; 
‘‘(B) the burden of need, as determined by 
human morbidity and mortality and economic
impact related to pandemic influenza and the 
existing capacity and resources of the applicant 
country to control the spread of the disease; 
and 
‘‘(C) the willingness of the country to co-
operate with other countries with respect to 
preventing and controlling the spread of the 
pandemic influenza; and 
‘‘(5) any other information the Secretary deter-
mines necessary. 
‘‘(c) USE OF FUNDS.—Funds from any Pandemic 
Fund established as provided for in this section shall be 
used to complement and augment ongoing bilateral pro-
grams and activities from the United States and other 
donor nations. 
‘‘SEC. 2143. POLICY COORDINATING COMMITTEE ON PAN-
DEMIC INFLUENZA PREPAREDNESS. 
‘‘(a) IN GENERAL.—There is established the Pan-
demic Influenza Preparedness Policy Coordinating Com-
mittee (referred to in this section as the ‘Committee’). 
‘‘(b) MEMBERSHIP.— 
‘‘(1) IN
GENERAL.—The Committee shall be 
composed of— 
‘‘(A) the Secretary; 
‘‘(B) the Secretary of Agriculture;
‘‘(C) the Secretary of State; 
‘‘(D) the Secretary of Defense; 
‘‘(E) the Secretary of Commerce; 
‘‘(F) the Administrator of the Environ-
mental Protection Agency; 
‘‘(G) the Secretary of Transportation; 
‘‘(H) the Secretary of Homeland Security; 
‘‘(I) the Secretary of Veterans Affairs; and 
‘‘(J) other representatives as determined 
appropriate by the Co-Chairs of the Committee. 
‘‘(2) CO-CHAIRS.—The Secretary and the Sec-
retary of Agriculture shall serve as the Co-Chairs of 
the Committee. 
‘‘(3) TERM.—The members of the Committee 
shall serve for the life of the Committee. 
‘‘(c) MEETINGS.— 
‘‘(1) IN GENERAL.—The Committee shall meet 
not less often than 2 times per year at the call of 
the Co-Chairs or as determined necessary by the 
President. 
‘‘(2) REPRESENTATION.—A member of the 
Committee under subsection (b) may designate a 
representative to participate in Committee meetings, 
but such representative shall hold the position of at 
least an assistant secretary or equivalent position.
‘‘(d) DUTIES OF THE COMMITTEE.— 
‘‘(1) PREPAREDNESS PLANS.—Each member of 
the Committee shall submit to the Committee a pan-
demic influenza preparedness plan for the agency in-
volved that describes— 
‘‘(A) initiatives and proposals by such 
member to address pandemic influenza (includ-
ing avian influenza) preparedness; and 
‘‘(B) any activities and coordination with 
international entities related to such initiatives 
and proposals. 
‘‘(2) INTERAGENCY PLAN AND RECOMMENDA-
TIONS.— 
‘‘(A) IN GENERAL.— 
‘‘(i) PREPAREDNESS PLAN.—Based on 
the preparedness plans described under 
paragraph (1), and not later than 90 days 
after the date of enactment of the Pan-
demic Influenza Preparedness Act of 2005, 
the Committee shall develop an Inter-
agency Preparedness Plan that integrates 
and coordinates such preparedness plans. 
‘‘(ii) CONTENT OF PLAN.—The Inter-
agency Preparedness Plan under clause (i) 
shall include a description of—
‘‘(I) departmental or agency re-
sponsibility and accountability for 
each component of such plan; 
‘‘(II) funding requirements and 
sources; 
‘‘(III) international collaboration 
and coordination efforts; and 
‘‘(IV) recommendations and a 
timeline for implementation of such 
plan. 
‘‘(B) REPORT.— 
‘‘(i) IN
GENERAL.—The Committee 
shall submit to the President and Con-
gress, and make available to the public, a 
report that includes the Interagency Pre-
paredness Plan. 
‘‘(ii) UPDATED
REPORT.—The Com-
mittee shall submit to the President and 
Congress, and make available to the public, 
on a biannual basis, an update of the re-
port that includes a description of— 
‘‘(I) progress made toward plan 
implementation, as described under 
clause (i); and
‘‘(II) progress of the domestic 
preparedness programs under section 
2144 and of the international assist-
ance programs under section 2145. 
‘‘(C) 
CONSULTATION
WITH
INTER-
NATIONAL
ENTITIES.—In developing the pre-
paredness plans described under subparagraph 
(A) and the report under subparagraph (B), the 
Committee may consult with representatives 
from the World Health Organization, the World 
Organization for Animal Health, and other 
international bodies, as appropriate. 
‘‘SEC. 2144. DOMESTIC PANDEMIC INFLUENZA PREPARED-
NESS ACTIVITIES. 
‘‘(a) PANDEMIC PREPAREDNESS ACTIVITIES.—The 
Secretary shall strengthen, expand, and coordinate domes-
tic pandemic influenza preparedness activities. 
‘‘(b) STATE PREPAREDNESS PLAN.— 
‘‘(1) IN GENERAL.—As a condition of receiving 
funds from the Centers for Disease Control and Pre-
vention or the Health Resources and Services Ad-
ministration related to bioterrorism, a State shall— 
‘‘(A) designate an official or office as re-
sponsible for pandemic influenza preparedness;