HR 391 RFS
paredness, which may be known as the Fund for 
Global Health Security and Pandemic Preparedness 
(in this title referred to as ‘‘the Fund’’), in accord-
ance with the provisions of this section; and 
(2) an Advisory Board to the Fund in accord-
ance with section 9. 
(b) PURPOSE.—The purpose of the Fund should be 
to close critical gaps in global health security and pan-
demic preparedness and build capacity in eligible partner 
countries in the areas of global health security, infectious 
disease control, and pandemic preparedness, such that 
it— 
(1) prioritizes capacity building and financing 
availability in eligible partner countries; 
(2) incentivizes countries to prioritize the use of 
domestic resources for global health security and 
pandemic preparedness; 
(3) leverages government, nongovernment, and 
private sector investments; 
(4) regularly responds to and evaluates progress 
based on clear metrics and benchmarks, such as the 
Joint External Evaluation and Global Health Secu-
rity Index; 
(5) aligns with and complements ongoing bilat-
eral and multilateral efforts and financing, including 
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through the World Bank, the World Health Organi-
zation, the Global Fund to Fight AIDS, Tuber-
culosis, and Malaria, and Gavi, the Vaccine Alliance; 
and 
(6) accelerates country compliance with the 
International Health Regulations (2005) and fulfill-
ment of the Global Health Security Agenda 2024 
Framework, in coordination with the ongoing Joint 
External Evaluation national action planning proc-
ess. 
(c) EXECUTIVE BOARD.— 
(1) IN GENERAL.—The Fund should be gov-
erned by an Executive Board, which should be com-
posed of not more than 20 representatives of donor 
governments, foundations, academic institutions, 
civil society, and the private sector that meet a min-
imum threshold in annual contributions and agree to 
uphold transparency measures. 
(2) DUTIES.—The Executive Board should be 
charged with approving strategies, operations, and 
grant-making authorities, such that it is able to con-
duct effective fiduciary, monitoring, and evaluation 
efforts, and other oversight functions. In addition, 
the Executive Board should— 
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(A) be comprised only of contributors to 
the Fund at not less than the minimum thresh-
old to be established pursuant to paragraph (1); 
(B) determine operational procedures such 
that the Fund is able to effectively fulfill its 
mission; and 
(C) provide oversight and accountability 
for the Fund in collaboration with the Inspector 
General to be established pursuant to section 
10(e)(1)(A). 
(3) 
COMPOSITION.—The 
Executive 
Board 
should include— 
(A) representatives of the governments of 
founding permanent member countries who, in 
addition to the requirements in paragraph (1), 
qualify based upon meeting an established ini-
tial contribution threshold, which should be not 
less than 10 percent of total initial contribu-
tions, and a demonstrated commitment to sup-
porting the International Health Regulations 
(2005); 
(B) term members, who are from academic 
institutions, civil society, and the private sector 
and are selected by the permanent members on 
the basis of their experience and commitment to 
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innovation, best practices, and the advancement 
of global health security objectives; and 
(C) representatives of the World Health 
Organization, and the chair of the Global 
Health Security Steering Group. 
(4) QUALIFICATIONS.—Individuals appointed to 
the Executive Board should have demonstrated 
knowledge and experience across a variety of sectors, 
including human and animal health, agriculture, de-
velopment, defense, finance, research, and academia. 
(5) CONFLICTS OF INTEREST.— 
(A) TECHNICAL EXPERTS.—The Executive 
Board may include independent technical ex-
perts, provided they are not affiliated with or 
employed by a recipient country or organiza-
tion. 
(B) MULTILATERAL BODIES AND INSTITU-
TIONS.—Executive Board members appointed 
under paragraph (3)(C) should recuse them-
selves from matters presenting conflicts of in-
terest, including financing decisions relating to 
such bodies and institutions. 
(6) UNITED STATES REPRESENTATION.— 
(A) IN GENERAL.— 
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(i) 
FOUNDING
PERMANENT
MEM-
BER.—The Secretary of State shall seek to 
establish the United States as a founding 
permanent member of the Fund. 
(ii) UNITED
STATES
REPRESENTA-
TION.—The United States shall be rep-
resented on the Executive Board by an of-
ficer or employee of the United States ap-
pointed by the President. 
(B) 
EFFECTIVE
AND
TERMINATION 
DATES.— 
(i) EFFECTIVE
DATE.—This para-
graph shall take effect upon the date the 
Secretary of State certifies and transmits 
to Congress an agreement establishing the 
Fund. 
(ii) TERMINATION DATE.—The mem-
bership established pursuant to subpara-
graph (A) shall terminate upon the date of 
termination of the Fund. 
(7) REMOVAL PROCEDURES.—The Fund should 
establish procedures for the removal of members of 
the Executive Board who engage in a consistent pat-
tern of human rights abuses, fail to uphold global 
health data transparency requirements, or otherwise 
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violate the established standards of the Fund, in-
cluding in relation to corruption. 
(8) ENFORCEABILITY.—Any agreement con-
cluded under the authorities provided by this section 
shall be legally effective and binding upon the 
United States, as may be provided in the agreement, 
upon— 
(A) the enactment of appropriate imple-
menting legislation which provides for the ap-
proval of the specific agreement or agreements, 
including attachments, annexes, and supporting 
documentation, as appropriate; or 
(B) if concluded and submitted as a treaty, 
receiving the necessary consent of the Senate. 
(9) ELIGIBLE PARTNER COUNTRY DEFINED.— 
In this section, the term ‘‘eligible partner country’’ 
means a country with demonstrated— 
(A) need, as identified through the Joint 
External Evaluation process, the Global Health 
Security Index classification of health systems, 
national action plans for health security, and 
other complementary or successor indicators of 
global health security and pandemic prepared-
ness; and 
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(B) commitment to transparency, including 
budget and global health data transparency, 
complying with the International Health Regu-
lations (2005), investing in domestic health sys-
tems, and achieving measurable results, and in 
which the Fund for Global Health Security and 
Pandemic Preparedness established under this 
section may finance global health security and 
pandemic preparedness assistance programs 
under this Act. 
SEC. 9. FUND AUTHORITIES. 
(a) PROGRAM OBJECTIVES.— 
(1) IN GENERAL.—In carrying out the purpose 
set forth in section 8, the Fund, acting through the 
Executive Board, should provide grants, including 
challenge grants, technical assistance, concessional 
lending, catalytic investment funds, and other inno-
vative funding mechanisms, as appropriate, to— 
(A) help eligible partner countries close 
critical gaps in health security, as identified 
through the Joint External Evaluation process, 
the Global Health Security Index classification 
of health systems, and national action plans for 
health security and other complementary or 
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successor indicators of global health security 
and pandemic preparedness; and 
(B) support measures that enable such 
countries, at both national and sub-national lev-
els, and in partnership with civil society and the 
private sector, to strengthen and sustain resil-
ient health systems and supply chains with the 
resources, capacity, and personnel required to 
prevent, detect, mitigate, and respond to infec-
tious disease threats before they become 
pandemics. 
(2) ACTIVITIES SUPPORTED.—The activities to 
be supported by the Fund should include efforts 
to— 
(A) enable eligible partner countries to for-
mulate and implement national health security 
and pandemic preparedness action plans, ad-
vance action packages under the Global Health 
Security Agenda, and adopt and uphold com-
mitments under the International Health Regu-
lations (2005) and other related international 
health agreements, as appropriate; 
(B) support global health security budget 
planning in eligible partner countries, including 
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training in financial management and budget 
and global health data transparency; 
(C) strengthen the health security work-
force, including hiring, training, and deploying 
experts to improve frontline preparedness for 
emerging epidemic and pandemic threats; 
(D) improve infection control and the pro-
tection of healthcare workers within healthcare 
settings; 
(E) combat the threat of antimicrobial re-
sistance; 
(F) strengthen laboratory capacity and 
promote biosafety and biosecurity through the 
provision of material and technical assistance; 
(G) reduce the risk of bioterrorism, 
zoonotic disease spillover, and accidental bio-
logical release; 
(H) build technical capacity to manage 
global health security related supply chains, in-
cluding for personal protective equipment, oxy-
gen, testing reagents, and other lifesaving sup-
plies, through effective forecasting, procure-
ment, warehousing, and delivery from central 
warehouses to points of service in both the pub-
lic and private sectors; 
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(I) enable bilateral, regional, and inter-
national partnerships and cooperation, includ-
ing through pandemic early warning systems 
and emergency operations centers, to identify 
and address transnational infectious disease 
threats exacerbated by natural and man-made 
disasters, human displacement, and zoonotic in-
fection; 
(J) establish partnerships for the sharing 
of best practices and enabling eligible countries 
to meet targets and indicators under the Joint 
External Evaluation process, the Global Health 
Security Index classification of health systems, 
and national action plans for health security re-
lating to the detection, treatment, and preven-
tion of neglected tropical diseases; 
(K) build the technical capacity of eligible 
partner countries to prepare for and respond to 
second order development impacts of infectious 
disease outbreaks, while accounting for the dif-
ferentiated 
needs 
and 
vulnerabilities 
of 
marginalized populations; 
(L) develop and utilize metrics to monitor 
and evaluate programmatic performance and 
identify best practices, including in accordance 
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with Joint External Evaluation benchmarks, 
Global Health Security Agenda targets, and 
Global Health Security Index indicators; 
(M) develop and deploy mechanisms to en-
hance the transparency and accountability of 
global health security and pandemic prepared-
ness programs and data, in compliance with the 
International Health Regulations (2005), in-
cluding through the sharing of trends, risks, 
and lessons learned; and 
(N) develop and implement simulation ex-
ercises, produce and release after action re-
ports, and address related gaps. 
(3) IMPLEMENTATION
OF
PROGRAM
OBJEC-
TIVES.—In carrying out the objectives of paragraph 
(1), the Fund should work to eliminate duplication 
and waste by upholding strict transparency and ac-
countability standards and coordinating its programs 
and activities with key partners working to advance 
global health security and pandemic preparedness, 
including— 
(A) governments, civil society, faith-based, 
and nongovernmental organizations, research 
and academic institutions, and private sector 
entities in eligible partner countries; 
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(B) the pandemic early warning systems 
and emergency operations centers to be estab-
lished under section 9; 
(C) the World Health Organization; 
(D) the Global Health Security Agenda; 
(E) the Global Health Security Initiative; 
(F) the Global Fund to Fight AIDS, Tu-
berculosis, and Malaria; 
(G) the United Nations Office for the Co-
ordination of Humanitarian Affairs, UNICEF, 
and other relevant funds, programs, and spe-
cialized agencies of the United Nations; 
(H) Gavi, the Vaccine Alliance; 
(I) the Coalition for Epidemic Prepared-
ness Innovations (CEPI); 
(J) the Global Polio Eradication Initiative; 
and 
(K) the United States Coordinator for 
Global Health Security and Diplomacy estab-
lished under section 5. 
(b) PRIORITY.—In providing assistance under this 
section, the Fund should give priority to low-and lower- 
middle income countries with— 
(1) low scores on the Global Health Security 
Index classification of health systems; 
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(2) measurable gaps in global health security 
and pandemic preparedness identified under Joint 
External Evaluations and national action plans for 
health security; 
(3) demonstrated political and financial com-
mitment to pandemic preparedness; and 
(4) demonstrated commitment to upholding 
global health budget and data transparency and ac-
countability standards, complying with the Inter-
national Health Regulations (2005), investing in do-
mestic health systems, and achieving measurable re-
sults. 
(c) ELIGIBLE GRANT RECIPIENTS.—Governments 
and nongovernmental organizations should be eligible to 
receive grants as described in this section. 
SEC. 10. FUND ADMINISTRATION. 
(a) APPOINTMENT OF AN ADMINISTRATOR.—The Ex-
ecutive Board of the Fund should appoint an Adminis-
trator who should be responsible for managing the day- 
to-day operations of the Fund. 
(b) AUTHORITY TO SOLICIT AND ACCEPT CONTRIBU-
TIONS.—The Fund should be authorized to solicit and ac-
cept contributions from governments, the private sector, 
foundations, individuals, and nongovernmental entities of 
all kinds. 
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(c) ACCOUNTABILITY OF FUNDS AND CRITERIA FOR 
PROGRAMS.—As part of the negotiations described in sec-
tion 8(a), the Secretary of the State, shall, consistent with 
subsection (d)— 
(1) take such actions as are necessary to ensure 
that the Fund will have in effect adequate proce-
dures and standards to account for and monitor the 
use of funds contributed to the Fund, including the 
cost of administering the Fund; and 
(2) seek agreement on the criteria that should 
be used to determine the programs and activities 
that should be assisted by the Fund. 
(d) SELECTION OF PARTNER COUNTRIES, PROJECTS, 
AND RECIPIENTS.—The Executive Board should estab-
lish— 
(1) eligible partner country selection criteria, to 
include transparent metrics to measure and assess 
global health security and pandemic preparedness 
strengths and vulnerabilities in countries seeking as-
sistance; 
(2) minimum standards for ensuring eligible 
partner country ownership and commitment to long- 
term results, including requirements for domestic 
budgeting, resource mobilization, and co-investment; 
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(3) criteria for the selection of projects to re-
ceive support from the Fund; 
(4) standards and criteria regarding qualifica-
tions of recipients of such support; 
(5) such rules and procedures as may be nec-
essary for cost-effective management of the Fund; 
and 
(6) such rules and procedures as may be nec-
essary to ensure transparency and accountability in 
the grant-making process. 
(e) ADDITIONAL TRANSPARENCY
AND ACCOUNT-
ABILITY REQUIREMENTS.— 
(1) INSPECTOR GENERAL.— 
(A) IN GENERAL.—The Secretary of State 
shall seek to ensure that the Fund maintains 
an independent Office of the Inspector General 
and ensure that the office has the requisite re-
sources and capacity to regularly conduct and 
publish, on a publicly accessible website, rig-
orous financial, programmatic, and reporting 
audits and investigations of the Fund and its 
grantees. 
(B) SENSE
OF
CONGRESS
ON
CORRUP-
TION.—It is the sense of Congress that— 
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(i) corruption within global health 
programs contribute directly to the loss of 
human life and cannot be tolerated; and 
(ii) in making financial recoveries re-
lating to a corrupt act or criminal conduct 
under a grant, as determined by the In-
spector General, the responsible grant re-
cipient should be assessed at a recovery 
rate of up to 150 percent of such loss. 
(2) ADMINISTRATIVE
EXPENSES.—The Sec-
retary of State shall seek to ensure the Fund estab-
lishes, maintains, and makes publicly available a sys-
tem to track the administrative and management 
costs of the Fund on a quarterly basis. 
(3) FINANCIAL TRACKING SYSTEMS.—The Sec-
retary of State shall ensure that the Fund estab-
lishes, maintains, and makes publicly available a sys-
tem to track the amount of funds disbursed to each 
grant recipient and sub-recipient during a grant’s 
fiscal cycle. 
SEC. 11. FUND ADVISORY BOARD. 
(a) IN GENERAL.—There should be an Advisory 
Board to the Fund. 
(b) APPOINTMENTS.—The members of the Advisory 
Board should be composed of— 
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(1) individuals with experience and leadership 
in the fields of development, global health, epidemi-
ology, medicine, biomedical research, and social 
sciences; and 
(2) representatives of relevant United Nations 
agencies, including the World Health Organization, 
and nongovernmental organizations with on-the- 
ground experience in implementing global health 
programs in low and lower-middle income countries. 
(c) RESPONSIBILITIES.—The Advisory Board should 
provide advice and guidance to the Executive Board of the 
Fund on the development and implementation of programs 
and projects to be assisted by the Fund and on leveraging 
donations to the Fund. 
(d) PROHIBITION
ON
PAYMENT
OF
COMPENSA-
TION.— 
(1) IN GENERAL.—Except for travel expenses 
(including per diem in lieu of subsistence), no mem-
ber of the Advisory Board should receive compensa-
tion for services performed as a member of the 
Board. 
(2) UNITED
STATES
REPRESENTATIVE.—Not-
withstanding any other provision of law (including 
an international agreement), a representative of the 
United States on the Advisory Board may not accept 
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compensation for services performed as a member of 
the Board, except that such representative may ac-
cept travel expenses, including per diem in lieu of 
subsistence, while away from the representative’s 
home or regular place of business in the perform-
ance of services for the Board. 
(e) CONFLICTS OF INTEREST.—Members of the Advi-
sory Board should be required to disclose any potential 
conflicts of interest prior to serving on the Advisory 
Board. 
SEC. 12. REPORTS TO CONGRESS ON THE FUND. 
(a) STATUS REPORT.—Not later than 6 months after 
the date of enactment of this Act, the Secretary of State, 
in coordination with the Administrator of the United 
States Agency for International Development, and the 
heads of other relevant Federal departments and agencies, 
shall submit to the appropriate congressional committees 
a report detailing the progress of international negotia-
tions to establish the Fund. 
(b) ANNUAL REPORT.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of the establishment of the Fund, and an-
nually thereafter for the duration of the Fund, the 
Secretary of State, shall submit to the appropriate 
congressional committees a report on the Fund. 
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(2) REPORT ELEMENTS.—The report shall in-
clude a description of— 
(A) the goals of the Fund; 
(B) the programs, projects, and activities 
supported by the Fund; 
(C) private and governmental contributions 
to the Fund; and 
(D) the criteria utilized to determine the 
programs and activities that should be assisted 
by the Fund. 
(c) GAO REPORT ON EFFECTIVENESS.—Not later 
than 2 years after the date that the Fund comes into ef-
fect, the Comptroller General of the United States shall 
submit to the appropriate congressional committees a re-
port evaluating the effectiveness of the Fund, including— 
(1) the effectiveness of the programs, projects, 
and activities supported by the Fund; and 
(2) an assessment of the merits of continued 
United States participation in the Fund. 
SEC. 13. UNITED STATES CONTRIBUTIONS. 
(a) IN GENERAL.—Subject to submission of the cer-
tification under this section, the President is authorized 
to make available for United States contributions to the 
Fund such funds as may be authorized to be made avail-
able for such purpose. 
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(b) NOTIFICATION.—The Secretary of State shall no-
tify the appropriate congressional committees not later 
than 15 days in advance of making a contribution to the 
Fund, including— 
(1) the amount of the proposed contribution; 
(2) the total of funds contributed by other do-
nors; and 
(3) the national interests served by United 
States participation in the Fund. 
(c) LIMITATION.—At no point during the five years 
after enactment of this Act shall a United States contribu-
tion to the Fund cause the cumulative total of United 
States contributions to the Fund to exceed 33 percent of 
the total contributions to the Fund from all sources. 
(d) WITHHOLDINGS.— 
(1) SUPPORT
FOR
ACTS
OF
INTERNATIONAL 
TERRORISM.—If at any time the Secretary of State 
determines that the Fund has provided assistance to 
a country, the government of which the Secretary of 
State has determined, for purposes of section 620A 
of the Foreign Assistance Act of 1961 (22 U.S.C. 
2371) has repeatedly provided support for acts of 
international terrorism, the United States shall with-
hold from its contribution to the Fund for the next 
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fiscal year an amount equal to the amount expended 
by the Fund to the government of such country. 
(2) EXCESSIVE SALARIES.—If at any time dur-
ing the five years after enactment of this Act, the 
Secretary of State determines that the salary of any 
individual employed by the Fund exceeds the salary 
of the Vice President of the United States for that 
fiscal year, then the United States should withhold 
from its contribution for the next fiscal year an 
amount equal to the aggregate amount by which the 
salary of each such individual exceeds the salary of 
the Vice President of the United States. 
(3) ACCOUNTABILITY CERTIFICATION REQUIRE-
MENT.—The Secretary of State may withhold not 
more than 20 percent of planned United States con-
tributions to the Fund until the Secretary certifies 
to the appropriate congressional committees that the 
Fund has established procedures to provide access 
by the Office of Inspector General of the Depart-
ment of State, as cognizant Inspector General, the 
Inspector General of the Department of Health and 
Human Services, the Inspector General of the 
United States Agency for International Develop-
ment, and the Comptroller General of the United 
States to the Fund’s financial data and other infor-
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mation relevant to United States contributions to 
the Fund (as determined by the Inspector General 
of the Department of State, in consultation with the 
Secretary of State). 
SEC. 14. COMPLIANCE WITH THE FOREIGN AID TRANS-
PARENCY AND ACCOUNTABILITY ACT OF 
2016. 
Section 2(3) of the Foreign Aid Transparency and 
Accountability Act of 2016 (Public Law 114–191; 22 
U.S.C. 2394c note) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (D), by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(E) the Global Health Security Act of 
2021.’’. 
SEC. 15. DEFINITIONS. 
In this Act: 
(1) APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.—The term ‘‘appropriate congressional Com-
mittees’’ means— 
(A) the Committee on Foreign Affairs and 
the Committee on Appropriations of the House 
of Representatives; and 
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(B) the Committee on Foreign Relations 
and the Committee on Appropriations of the 
Senate. 
(2) GLOBAL
HEALTH
SECURITY.—The term 
‘‘global health security’’ means activities supporting 
epidemic and pandemic preparedness and capabili-
ties at the country and global levels in order to mini-
mize vulnerability to acute public health events that 
can endanger the health of populations across geo-
graphical regions and international boundaries. 
SEC. 16. SUNSET. 
This Act, and the amendments made by this Act shall 
cease to be effective 5 fiscal years after the enactment of 
this Act. 
Passed the House of Representatives June 28, 2021. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
VerDate Sep 11 2014 
02:20 Jul 13, 2021
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