215 
(2) commodities and supplies (such as food aid 
and medical supplies); 
(3) public outreach materials (such as banners, 
posters, websites, and social media); 
(4) reports and publications; and 
(5) signage at project sites and events. 
Such regulations shall specify minimum size requirements, 
color accuracy, placement, and other relevant design ele-
ments to ensure clear and prominent display of the flag. 
(c) PROHIBITION OF OTHER BRANDS.—Except as 
specifically authorized by the Secretary under exceptional 
circumstances as outlined in subsection (d), no other na-
tional flags, organizational logos, or branding elements 
shall be displayed alongside or in place of the United 
States flag on any United States foreign assistance pro-
gram, project, activity, good, service, or publication. 
(d) EXCEPTIONS.—The Secretary may, on a case-by- 
case basis, authorize the limited use of additional branding 
elements in conjunction with the United States flag only 
when— 
(1) required by international agreements or 
partnerships where co-branding is a formal condi-
tion; 
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(2) necessary for clear identification of imple-
menting partners, provided that the United States 
flag remains the most prominent visual element; or 
(3) determined to be essential for the safety or 
security of personnel or beneficiaries in specific high- 
risk environments. 
SEC. 616. GLOBAL FUND. 
Section 202(d) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (22 U.S.C. 7622(d)) is amended— 
(1) in paragraph (4)— 
(A) in subparagraph (A)— 
(i) in clause (i)— 
(I) by striking ‘‘2025’’ and in-
serting ‘‘2027’’; and 
(II) by striking ‘‘33 percent of 
the total amount of funds contributed 
to the Global Fund from all sources. 
Contributions to the Global Fund 
from the International Bank for Re-
construction and Development and the 
International Monetary Fund shall 
not be considered in determining com-
pliance with this paragraph.’’ and in-
serting ‘‘20 percent of the total 
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amount of funds contributed to the 
Global Fund from all sources, or 
$800,000,000, whichever is lesser.’’; 
and 
(ii) in clause (ii), by striking ‘‘2025’’ 
and inserting ‘‘2027’’; and 
(B) in subparagraph (B)(iii), by striking 
‘‘2025’’ and inserting ‘‘2027’’; and 
(2) in paragraph (5), by striking ‘‘2025’’ and 
inserting ‘‘2027’’. 
SEC. 617. GLOBAL HEALTH COMPACT MODEL. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, the Assistant Secretary for Global Health (in 
this section referred to as the ‘‘Assistant Secretary’’), in 
consultation with the Secretary, is authorized to provide 
assistance for fiscal years 2026 and 2027 to partner coun-
tries that enter into global health compacts with the 
United States to— 
(1) support policies and programs that burden 
shift global health programs to partner countries; 
(2) perpetuate the wind-down of the President’s 
Emergency Plan for AIDS Relief (PEPFAR) under 
the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (Public Law 
108–25); and 
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(3) address health security and tuberculosis, 
malaria, HIV/AIDS, neglected tropical diseases, and 
any disease or additional global health assistance as 
determined by the Assistant Secretary. 
(b) MATTERS TO BE INCLUDED.—Each global health 
compact under this section shall include the following: 
(1) A clear articulation of the interests and re-
quests of the partner country, or nongovernmental 
organization or private entity, as the case may be, 
and the United States. 
(2) The proposed amount of funding to be pro-
vided under the compact and the number of years of 
the compact. 
(3) A plan for a phase-out of funding under the 
compact, with United States funding to be reduced 
each fiscal year, to enable the transition to full own-
ership of global health programs by the partner 
country by ensuring that activities under such pro-
grams will continue to be implemented by such part-
ner countries. 
(4) Metrics to determine the success of the 
compact and benchmarks to reevaluate the continued 
funding of the compact at the start of each subse-
quent fiscal year. 
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(5) A strategy, where applicable, to incorporate 
the interests and capabilities of private sector devel-
opment and investment, including with respect to 
HIV/AIDS testing and treatment as determined by 
the Assistant Secretary— 
(A) ensuring infants born to mothers re-
ceiving prevention of mother to child trans-
mission (PMTCT) are provided viral load test-
ing within the intervals recommended by health 
standard organizations; 
(B) ensuring new patients on antiretroviral 
treatment receive a viral load test within the 
timing interval recommended by health stand-
ard organizations; and 
(C) ensuring that persons living with HIV 
in the country receive a viral load test within 
the intervals recommended by health standard 
organizations. 
(6) A provision that ensures an exemption from 
taxation in the partner country with respect to as-
sistance provided by the United States under the 
compact. 
(7) An end date for the compact. 
(c) FORM.—Assistance under global health compacts 
under this section—. 
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(1) may be provided in the form of grants, con-
tracts, and cooperative agreements to or with eligible 
entities described in subsection (d); and 
(2) may not be provided in the form of loans. 
(d) ELIGIBLE ENTITIES DESCRIBED.— 
(1) IN GENERAL.—An eligible entity described 
in this subsection is— 
(A) with respect to a partner country— 
(i) the national government of the 
country; or 
(ii) a regional or local governmental 
unit of the country; or 
(B) a nongovernmental or nonprofit orga-
nization or private entity. 
(2) LEVEL OF NEGOTIATION AND ENTRY.—A 
global health compact shall be negotiated and en-
tered into at the country-level, but components of a 
compact may be entered into with any eligible entity 
described in paragraph (1) as determined by the As-
sistant Secretary. 
(3) PRIORITY.—The Assistant Secretary shall, 
in entering into grants, contracts, and cooperative 
agreements to or with nongovernmental organiza-
tions and private entities under this section, 
prioritize entering into grants, contracts, and coop-
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erative agreements to or with faith-based organiza-
tions if it is in the national interest of the United 
States as determined by the Assistant Secretary. 
(4) PROHIBITIONS.—A global health compact 
may not be entered into under this section with any 
of the following: 
(A) The countries of the People’s Republic 
of China, the Democratic People’s Republic of 
Korea, and Cuba. 
(B) A country the government of which the 
Secretary determines has repeatedly provided 
support for international terrorism pursuant 
to— 
(i) section 1754(c)(1)(A) of the Ex-
port Control Reform Act of 2018 (50 
U.S.C. 4813(c)(1)(A)); 
(ii) section 620A of the Foreign As-
sistance Act of 1961 (22 U.S.C. 2371); 
(iii) section 40 of the Arms Export 
Control Act (22 U.S.C. 2780); or 
(iv) any other provision of law. 
(C) A country that engages in intelligence 
activities in the United States that are adverse 
to the national security interests of the United 
States. 
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(D) An entity that is funded by the Peo-
ple’s Republic of China. 
(E) The African Union or any affiliated 
entity of the African Union, including Africa 
CDC or affiliated multilateral funds. 
(e) APPLICATION.—The Assistant Secretary, in con-
sultation with the appropriate congressional committees, 
shall develop and recommend procedures for applications 
to enter into compacts under this section and to transfer 
existing programs to the compact framework. 
(f) LIMITATIONS.—The prohibitions on use of funds 
contained in paragraphs (1) through (3) of section 104(f) 
of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151b(f)) shall apply to funds made available to carry out 
this section to the same extent and in the same manner 
as such prohibitions apply to funds made available to carry 
out chapter 1 of part I of such Act, as aligned with the 
most stringent of restrictions and clearest oversight provi-
sions, determined by the Assistant Secretary. 
(g) CONGRESSIONAL NOTIFICATION.— 
(1) IN
GENERAL.—The Assistant Secretary 
shall consult with and notify the appropriate con-
gressional committees not later than 15 days before 
taking any of the actions described in paragraph (2). 
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(2) ACTIONS
DESCRIBED.—The actions de-
scribed in this paragraph are— 
(A) commencing negotiations with a part-
ner country to enter into a global health com-
pact under this section; 
(B) entering into a global health compact 
under this section; and 
(C) terminating or reinstating assistance 
under a global health compact under this sec-
tion. 
(3) ADDITIONAL NOTIFICATION RELATING TO 
ENTRY
INTO
COMPACT.—Not later than 10 days 
after entering into a global health compact under 
this section, the Assistant Secretary shall— 
(A) publish the text of the compact on a 
publicly available website of the Department; 
(B) provide a detailed summary of the 
compact and, upon request, the full text of the 
compact to the appropriate congressional com-
mittees; and 
(C) publish in the Federal Register a de-
tailed summary of the compact and a notice of 
availability of the text of the compact on the 
website described in clause (i). 
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(h) TRANSITION.—The Assistant Secretary shall take 
such actions as may be necessary to provide for all United 
States global health programs to be carried out through 
global health compacts under this section. This shall be 
completed by the end of fiscal year 2026. 
(i) REPORT.—Not later than 90 days after the date 
of the enactment of this Act, the Assistant Secretary shall 
submit to the appropriate congressional committees a re-
port that— 
(1) summarizes the global health foreign assist-
ance programs being provided to partner countries; 
(2) includes— 
(A) a plan to enter into global health com-
pacts under this section to address and carry 
out such global health programs of partner 
countries in accordance with subsection (h)(1); 
(B) with respect to partner countries for 
which subsection (h)(1) will not initially apply, 
a justification for such inapplicability; and 
(C) a plan to burden-share programs oper-
ated under the President’s Emergency Plan for 
AIDS Relief (PEPFAR) and authorized under 
the United States Leadership Against HIV/ 
AIDS, Tuberculosis, and Malaria Act of 2003 
(Public Law 108–25) to partner country owner-
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ship by reducing by a minimum of 50 percent 
the total amount of funds made available for 
such programs for the last fiscal year ending 
before the date of the enactment of this Act by 
the end of fiscal year 2028, including by ensur-
ing that activities under such programs will 
continue to be implemented by such partner 
countries. 
(j) DEFINITIONS.—In this section— 
(1) the term ‘‘appropriate congressional com-
mittees’’ means— 
(A) the Committee on Foreign Affairs and 
the Committee on Appropriations of the House 
of Representatives; and 
(B) the Committee on Foreign Relations 
and the Committee on Appropriations of the 
Senate; 
(2) the term ‘‘global health compact’’ or ‘‘com-
pact’’ means an agreement between the United 
States Government and an eligible entity to provide 
foreign assistance related to global health programs, 
which may include any global health-related issues 
as required by the Assistant Secretary; and 
(3) the term ‘‘partner country’’ means any 
country that is receiving or will receive United 
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States foreign assistance for the purposes of global 
health programs, regardless of the dollar value of 
such assistance. 
SEC. 618. REVISIONS TO EXISTING GLOBAL HEALTH SECU-
RITY AND DIPLOMACY AUTHORITY. 
Section 5562 of the James M. Inhofe National De-
fense Authorization Act for Fiscal Year 2023 (22 U.S.C. 
2151b note) is amended as follows: 
(1) By striking ‘‘Ambassador-At-Large’’ and 
‘‘Ambassador-at-Large’’ each place it appears and 
inserting ‘‘Assistant Secretary’’. 
(2) In subsection (e)(1), by striking ‘‘the World 
Health Organization and’’. 
(3) By striking subsection (f)(2). 
(4) In subsection (f)(3), by striking ‘‘in co-
operation with the World Health Organization,’’. 
SEC. 619. PANDEMIC FUND. 
Section. 5563(i)(3) of the James M. Inhofe National 
Defense Authorization Act for Fiscal Year 2023 (22 
U.S.C. 2151b note) is amended by striking ‘‘33 percent’’ 
and inserting ‘‘20 percent’’. 
SEC. 620. CONSOLIDATION OF GLOBAL HEALTH REPORT-
ING REQUIREMENTS. 
(a) REPORTING.—The following reports shall be pro-
vided by the Assistant Secretary for Global Health on an 
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annual basis or as otherwise designated by the appropriate 
underlying statutory provisions. All such reports shall be 
consolidated into one searchable, annual report, required 
by September 30 of each year beginning in 2026. For any 
reports that are unavailable to be consolidated into this 
report and issued pursuant to this deadline, the Assistant 
Secretary for Global Health may instead include a notice 
listing the report and providing that the report shall not 
be made available until the statutorily- required due date. 
The reports that shall continue to apply and are eligible 
for consolidation under this portion are as follows: 
(1) All reports as required elsewhere in this Act 
related to global health. 
(2) The Global Fund report required under sec-
tion 202(c) of the United States Leadership against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 
(22 U.S.C. 7622(c)). 
(3) The PEPFAR annual report, as required by 
section 403(a)(4) of the United States Leadership 
against HIV/AIDS, Tuberculosis, and Malaria Act 
of 2003 (22 U.S.C. 7673(a)(4)). 
(4) The PEPFAR annual treatment report re-
quired by section 101(g) of the United States Lead-
ership against HIV/AIDS, Tuberculosis, and Malaria 
Act of 2003 (22 U.S.C. 7611(g)). 
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(5) Existing reports on health systems strength-
ening and health capacity building, as required by 
any of the provisions of subtitle D of title LV of the 
James M. Inhofe National Defense Authorization 
Act for Fiscal Year 2023 (22 U.S.C. 2151b note). 
(6) The annual nutrition report, as required by 
the Global Malnutrition Prevention and Treatment 
Act (22 U.S.C. 9301 note). 
(7) The annual President’s Malaria Initiative 
Report, as required by section 104C of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151b–4). 
(8) Existing reports required under any provi-
sion of law on maternal and child health. 
(9) Any future reporting requirements, unless 
specifically requested by Congress on a quarterly 
basis. 
(b) OTHER
EXTENDED
REPORTING
REQUIRE-
MENTS.—The reports that shall continue to apply and are 
not eligible for consolidation include any quarterly and ex-
penditure reports as related to the budget of the Depart-
ment. This section shall not be interpreted to limit the 
transmission of congressional notifications required else-
where. 
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SEC. 621. PROHIBITION ON FUNDING GLOBAL HEALTH 
WORKER INITIATIVE. 
No funds shall be appropriated or expended related 
to the Global Health Worker Initiative. 
SEC. 622. SAFE PASSAGES PROGRAM. 
(a) ESTABLISHMENT.—The Assistant Secretary for 
Global Health is authorized to provide assistance through 
establishing a ‘‘Safe Passages Maternal and Child Health 
Program’’, to reduce maternal and child mortality in low 
and lower-middle income countries with high maternal and 
child mortality rates through fiscal year 2027. Interven-
tions supported by the program shall be for training and 
resource assistance for the following: 
(1) Prevention, recognition, diagnosis and treat-
ment of obstetrical hemorrhage, and its complica-
tions. 
(2) Prevention, recognition, diagnosis and man-
agement of preeclampsia and other hypertensive, 
metabolic and cardiovascular disorders of pregnancy, 
and their complications, up to one-year postpartum. 
(3) Prevention, recognition, diagnosis and treat-
ment of infections and their complications associated 
with ectopic pregnancy, normal pregnancy, childbirth 
and the postpartum period. 
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(4) Prevention, recognition, diagnosis and man-
agement of obstructed labor, including uterine rup-
ture, obstetric fistulas, and their complications. 
(5) Reduction of fetal, perinatal, neonatal and 
infant mortality, including stillbirth, by preventing, 
recognizing, diagnosing and treating fetal distress, 
newborn asphyxia, birth trauma, premature birth, 
small size for gestational age, and neonatal infec-
tions and sepsis. 
(6) Nutritional and health education for the 
mother and provision of nutritional resources for the 
mother and child during the first 1,000 days of life, 
from conception to two years of age. 
(b) IMPLEMENTATION.—The Assistant Secretary 
shall prioritize the implementation of this program in col-
laboration with new and existing global health partner-
ships determined to be efficient and reliable in the expend-
iture of taxpayer dollars, prioritizing local faith-based pro-
viders and faith-based organizations with strong local 
partnerships and which have experience and expertise in 
maternal and child health delivery in resource-limited set-
tings. 
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SEC. 623. SPECIAL ADVISOR FOR ASSISTANCE TO ORPHANS 
AND VULNERABLE CHILDREN. 
(a) DEADLINE FOR APPOINTMENT.—Not later than 
90 days after the date of the enactment of this Act, the 
Secretary shall appoint a Special Advisor for Assistance 
to Orphans and Vulnerable Children, pursuant to section 
135(e)(1) of the Foreign Assistance Act of 1961 (22 
U.S.C. 2152f(e)(1)). 
(b) EXTENSION OF REQUIREMENT TO ISSUE IMPLE-
MENTING DIRECTIVES.—Section 137(c) of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2152k(c)) is amended 
by inserting ‘‘and 6 years’’ after ‘‘1 year’’. 
(c) 
EXTENSION
OF
AUTHORIZATION.—Section 
1283(a) of the National Defense Authorization Act for 
Fiscal Year 2021 (Public Law 116–283; referred to as the 
‘‘Global Child Thrive Act of 2020’’) is amended by strik-
ing ‘‘2025’’ and inserting ‘‘2027’’. 
SEC. 624. DEVELOPMENT INNOVATION VENTURES PRO-
GRAM. 
(a) IN GENERAL.—There is established within the 
relevant foreign assistance agency a program to be known 
as the Development Innovation Ventures Program (in this 
section referred to as the ‘‘Program’’). 
(b) DUTIES.—In carrying out the Program, the rel-
evant foreign assistance agency shall provide flexible fund-
ing to global innovators and researchers to test new ideas, 
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