I 
109TH CONGRESS 
1ST SESSION H. R. 4062 
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 
OCTOBER 17, 2005 
Mrs. LOWEY (for herself, Mr. EMANUEL, Mr. CASE, Mr. CONYERS, Mrs. 
MALONEY, Mr. JACKSON of Illinois, Mrs. CHRISTENSEN, Mr. OWENS, 
Mr. KILDEE, Mr. MCNULTY, Mr. PAYNE, Mr. PRICE of North Carolina, 
Mr. REYES, Mr. HOYER, Mr. VAN
HOLLEN, Mr. PALLONE, Mr. 
DEFAZIO, Mr. INSLEE, Mr. MCGOVERN, Mr. GUTIERREZ, Ms. BEAN, Ms. 
JACKSON-LEE of Texas, Mr. NADLER, Mr. SCHIFF, Mr. SKELTON, Mr. 
SANDERS, Ms. BORDALLO, Mr. MORAN of Virginia, Mr. MARKEY, Mr. 
WEXLER, Mr. ACKERMAN, and Mr. ALLEN) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
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 ‘‘Pandemic Prepared-
ness and Response Act’’.
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 an estimated 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 10 million 
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, Cambodia, In-
donesia, and Vietnam (including a possible human- 
to-human infection in Thailand). 
(6) As of September 29, 2005, 116 confirmed 
human cases of avian influenza (H5N1) have been 
reported, 60 of which resulted in death. Of these 
cases, 91 were in Vietnam, 17 in Thailand, 4 in 
Cambodia, and 4 in Indonesia. 
(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. NATIONAL DIRECTOR OF PANDEMIC PRE-
PAREDNESS AND RESPONSE. 
‘‘(a) APPOINTMENT.—The President shall appoint an 
individual to serve as the National Director of Pandemic 
Preparedness and Response (referred to in this section as 
the ‘Director’) within the Executive Office of the Presi-
dent. 
‘‘(b) RESPONSIBILITIES.—The Director shall— 
‘‘(1) serve as the chairperson of the Pandemic 
Influenza Preparedness Policy Coordinating Com-
mittee (as described in section 2143); 
‘‘(2) coordinate the Federal interagency prepa-
ration for a pandemic; 
‘‘(3) coordinate the Federal interagency re-
sponse to a pandemic; 
‘‘(4) oversee approval of State pandemic plans 
to ensure nationwide preparedness standards and re-
gional coordination as provided for under section 
2144(b)(3); 
‘‘(5) ensure coordination between the govern-
mental and non-governmental economic and finance 
infrastructure as it relates to pandemic preparedness 
and response;
‘‘(6) as soon as practicable, finalize a National 
Pandemic Influenza Preparedness Plan that de-
scribes programs and activities to decrease the bur-
den of disease, minimize social disruption, and re-
duce economic impact from an influenza pandemic; 
‘‘(7) implement the National Pandemic Influ-
enza Preparedness Plan; 
‘‘(8) make the National Pandemic Influenza 
Preparedness Plan available to Congress, and the 
public as appropriate; 
‘‘(9) submit to Congress an annual budget re-
quest related to the National Pandemic Influenza 
Preparedness Plan; 
‘‘(10) report to Congress on a biannual basis 
progress regarding the implementation of the Na-
tional Pandemic Influenza Preparedness Plan; 
‘‘(11) address any deficiencies in the National 
Pandemic Influenza Preparedness Plan as deter-
mined by the Government Accountability Office re-
port under subsection (c); 
‘‘(12) coordinate the provision of technical as-
sistance related to pandemic preparedness across 
Federal agencies, States, and local governments;
‘‘(13) ensure outreach and education campaigns 
are conducted related to preparedness for busi-
nesses, health care providers, and the public; 
‘‘(14) address supply chain issues related to a 
pandemic; 
‘‘(15) ensure that the National Pandemic Influ-
enza Preparedness Plan includes a specific focus on 
traditionally underserved populations, including low- 
income, racial and ethnic minorities, immigrants, 
and uninsured populations; and 
‘‘(16) hire staff, request information, assist-
ance, or detailees from other Federal agencies, and 
carry out other activities related to staffing and ad-
ministration. 
‘‘(c) GAO REPORT.— 
‘‘(1) IN
GENERAL.—Not later than 60 days 
after the Director has finalized the National Pan-
demic Influenza Preparedness Plan under subsection 
(b)(5), the Government Accountability Office shall 
submit to the Director and Congress a report con-
cerning the National Pandemic Influenza Prepared-
ness Plan. 
‘‘(2) REQUIREMENTS.—At a minimum, the re-
port under paragraph (1) shall evaluate the ability
of the National Pandemic Influenza Preparedness 
Plan to— 
‘‘(A) address the organizational structure 
and chain of command, both in the Federal 
government and at the State level; 
‘‘(B) ensure adequate laboratory surveil-
lance of influenza, including the ability to iso-
late and subtype influenza viruses year round; 
‘‘(C) improve vaccine research, develop-
ment, and production; 
‘‘(D) procure adequate doses of antivirals 
for treatment. 
‘‘(E) develop systems for tracking and dis-
tributing antiviral medication and vaccines; 
‘‘(F) prioritize who would receive antivirals 
and vaccines based on limited supplies; 
‘‘(G) stockpile medical and safety equip-
ment for health care workers and first respond-
ers; 
‘‘(H) assure surge capacity capabilities for 
health care providers and institutions; 
‘‘(I) secure a backup health care workforce 
in the event of a pandemic; 
‘‘(J) ensure the availability of food, water, 
and other essential items during a pandemic;
‘‘(K) provide guidance on needed State and 
local authority to implement public health 
measures such as isolation or quarantine; 
‘‘(L) maintain core public functions, in-
cluding public utilities, refuse disposal, mor-
tuary services, transportation, police and fire-
fighter services, and other critical services; 
‘‘(M) establish networks that provide alerts 
and other information for health care providers; 
‘‘(N) communicate with the public with re-
spect to prevention and obtaining care during a 
pandemic; and 
‘‘(O) provide security for first responders 
and other medical personnel and volunteers, 
hospitals, treatment centers, isolation and quar-
antine areas, and transportation and delivery of 
resources. 
‘‘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 Homeland Security; 
‘‘(C) the Secretary of Agriculture; 
‘‘(D) the Secretary of State; 
‘‘(E) the Secretary of Defense; 
‘‘(F) the Secretary of Commerce; 
‘‘(G) the Administrator of the Environ-
mental Protection Agency; 
‘‘(H) the Secretary of Transportation; 
‘‘(I) the Secretary of Veterans Affairs; and 
‘‘(J) other representatives as determined 
appropriate by the Chair of the Committee. 
‘‘(2) CHAIR.—The Director of Pandemic Pre-
paredness and Response shall serve as the Chair 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 Chair or as determined necessary by the Presi-
dent. 
‘‘(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 this subtitle, 
the Committee shall develop an Inter-
agency Preparedness Plan that integrates 
and coordinates such preparedness plans.