I 
108TH CONGRESS 
1ST SESSION H. R. 2329
To provide for global pathogen surveillance and response. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 4, 2003
Mr. KIRK (for himself and Mrs. TAUSCHER) introduced the following bill; 
which was referred to the Committee on International Relations 
A BILL 
To provide for global pathogen surveillance and response.
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 ‘‘Global Pathogen Sur-
veillance Act of 2003’’. 
SEC. 2. FINDINGS; PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) Bioterrorism poses a grave national security 
threat to the United States. The insidious nature of 
the threat, the likely delayed recognition in the event 
of an attack, and the underpreparedness of the do-
mestic public health infrastructure may produce cat-
astrophic consequences following a biological weap-
ons attack upon the United States. 
(2) A contagious pathogen engineered as a bio-
logical weapon and developed, tested, produced, or 
released in another country can quickly spread to 
the United States. Given the realities of inter-
national travel, trade, and migration patterns, a 
dangerous pathogen released anywhere in the world 
can spread to United States territory in a matter of 
days, before any effective quarantine or isolation 
measures can be implemented. 
(3) To effectively combat bioterrorism and en-
sure that the United States is fully prepared to pre-
vent, diagnose, and contain a biological weapons at-
tack, measures to strengthen the domestic public 
health infrastructure and improve domestic surveil-
lance and monitoring, while absolutely essential, are 
not sufficient. 
(4) The United States should enhance coopera-
tion with the World Health Organization, regional 
health organizations, and individual countries, in-
cluding data sharing with appropriate United States 
departments and agencies, to help detect and quickly
contain infectious disease outbreaks or bioterrorism 
agents before they can spread. 
(5) The World Health Organization (WHO) has 
done an impressive job in monitoring infectious dis-
ease outbreaks around the world, including the re-
cent emergence of the Severe Acute Respiratory 
Syndrome (SARS) epidemic, particularly with the 
establishment in April 2000 of the Global Outbreak 
Alert and Response network. 
(6) The capabilities of the World Health Orga-
nization are inherently limited by the quality of the 
data and information it receives from member coun-
tries, the narrow range of diseases (plague, cholera, 
and yellow fever) upon which its disease surveillance 
and monitoring is based, and the consensus process 
it uses to add new diseases to the list. Developing 
countries in particular often cannot devote the nec-
essary resources to build and maintain public health 
infrastructures. 
(7) In particular, developing countries could 
benefit from—
(A) better trained public health profes-
sionals and epidemiologists to recognize disease 
patterns;
(B) appropriate laboratory equipment for 
diagnosis of pathogens; 
(C) disease reporting is based on symp-
toms and signs (known as ‘‘syndrome surveil-
lance’’), enabling the earliest possible oppor-
tunity to conduct an effective response; 
(D) a narrowing of the existing technology 
gap in syndrome surveillance capabilities and 
real-time information dissemination to public 
health officials; and 
(E) appropriate communications equip-
ment and information technology to efficiently 
transmit information and data within national 
and regional health networks, including inex-
pensive, Internet-based Geographic Information 
Systems (GIS) and relevant telephone-based 
systems for early recognition and diagnosis of 
diseases. 
(8) An effective international capability to mon-
itor and quickly diagnose infectious disease out-
breaks will offer dividends not only in the event of 
biological weapons development, testing, production, 
and attack, but also in the more likely cases of natu-
rally occurring infectious disease outbreaks that 
could threaten the United States. Furthermore, a
robust surveillance system will serve to deter ter-
rorist use of biological weapons, as early detection 
will help mitigate the intended effects of such malev-
olent uses. 
(b) PURPOSE.—The purposes of this Act are as fol-
lows: 
(1) To enhance the capability and cooperation 
of the international community, including the World 
Health 
Organization 
and 
individual 
countries, 
through enhanced pathogen surveillance and appro-
priate data sharing, to detect, identify, and contain 
infectious disease outbreaks, whether the cause of 
those outbreaks is intentional human action or nat-
ural in origin. 
(2) To enhance the training of public health 
professionals and epidemiologists from eligible devel-
oping countries in advanced Internet-based and 
other electronic syndrome surveillance systems, in 
addition to traditional epidemiology methods, so that 
they may better detect, diagnose, and contain infec-
tious disease outbreaks, especially those due to
pathogens most likely to be used in a biological 
weapons attack. 
(3) To provide assistance to developing coun-
tries to purchase appropriate public health labora-
tory equipment necessary for infectious disease sur-
veillance and diagnosis. 
(4) To provide assistance to developing coun-
tries to purchase appropriate communications equip-
ment and information technology, including, as ap-
propriate, relevant computer equipment, Internet 
connectivity mechanisms, and telephone-based appli-
cations to effectively gather, analyze, and transmit 
public health information for infectious disease sur-
veillance and diagnosis. 
(5) To make available greater numbers of 
United States Government public health profes-
sionals to international health organizations, re-
gional health networks, and United States diplo-
matic missions where appropriate. 
(6) To establish ‘‘lab-to-lab’’ cooperative rela-
tionships between United States public health lab-
oratories and established foreign counterparts. 
(7) To expand the training and outreach activi-
ties of overseas United States laboratories, including 
Centers for Disease Control and Prevention and De-
partment of Defense entities, to enhance the disease 
surveillance capabilities of developing countries.
(8) To provide appropriate technical assistance 
to existing regional health networks and, where ap-
propriate, seed money for new regional networks. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) ELIGIBLE
DEVELOPING
COUNTRY.—The 
term ‘‘eligible developing country’’ means any devel-
oping country that—
(A) has agreed to the objective of fully 
complying with requirements of the World 
Health Organization on reporting public health 
information on outbreaks of infectious diseases; 
(B) has not been determined by the Sec-
retary, for purposes of section 40 of the Arms 
Export Control Act (22 U.S.C. 2780), section 
620A of the Foreign Assistance Act of 1961 
(22 U.S.C. 2371), or section 6(j) of the Export 
Administration Act of 1979 (50 U.S.C. App. 
2405), to have repeatedly provided support for 
acts of international terrorism, unless the Sec-
retary exercises a waiver certifying that it is in 
the national interest of the United States to 
provide assistance under the provisions of this 
Act; and
(C) is a state party to the Biological 
Weapons Convention. 
(2) ELIGIBLE NATIONAL.—The term ‘‘eligible 
national’’ means any citizen or national of an eligible 
developing country who is eligible to receive a visa 
under the provisions of the Immigration and Nation-
ality Act (8 U.S.C. 1101 et seq.). 
(3) INTERNATIONAL HEALTH ORGANIZATION.—
The term ‘‘international health organization’’ in-
cludes the World Health Organization and the Pan 
American Health Organization. 
(4) 
LABORATORY.—The 
term 
‘‘laboratory’’ 
means a facility for the biological, microbiological, 
serological, 
chemical, 
immuno-hematological, 
hematological, biophysical, cytological, pathological, 
or other examination of materials derived from the 
human body for the purpose of providing informa-
tion for the diagnosis, prevention, or treatment of 
any disease or impairment of, or the assessment of 
the health of, human beings. 
(5) SECRETARY.—Unless otherwise provided, 
the term ‘‘Secretary’’ means the Secretary of State. 
(6) SELECT AGENT.—The term ‘‘select agent’’ 
has the meaning given such term for purposes of
section 72.6 of title 42, Code of Federal Regula-
tions. 
(7) SYNDROME
SURVEILLANCE.—The term 
‘‘syndrome surveillance’’ means the recording of 
symptoms (patient complaints) and signs (derived 
from physical examination) combined with simple ge-
ographic locators to track the emergence of a disease 
in a population. 
SEC. 4. PRIORITY FOR CERTAIN COUNTRIES. 
Priority in the provision of United States assistance 
for eligible developing countries under all the provisions 
of this Act shall be given to those countries that permit 
personnel from the World Health Organization and the 
Centers for Disease Control and Prevention to investigate 
outbreaks of infectious diseases on their territories, pro-
vide early notification of disease outbreaks, and provide 
pathogen surveillance data to appropriate United States 
departments and agencies in addition to international 
health organizations. 
SEC. 5. RESTRICTION. 
Notwithstanding any other provision of this Act, no 
foreign nationals participating in programs authorized 
under this Act shall have access, during the course of such
participation, to select agents that may be used as, or in,
a biological weapon, except in a supervised and controlled 
setting. 
SEC. 6. FELLOWSHIP PROGRAM. 
(a) ESTABLISHMENT.—There is established a fellow-
ship program (in this section referred to as the ‘‘pro-
gram’’) under which the Secretary, in consultation with 
the Secretary of Health and Human Services, and, subject 
to the availability of appropriations, award fellowships to 
eligible nationals to pursue public health education or 
training, as follows: 
(1) MASTER
OF
PUBLIC
HEALTH
DEGREE.—
Graduate courses of study leading to a master of 
public health degree with a concentration in epidemi-
ology from an institution of higher education in the 
United States with a Center for Public Health Pre-
paredness, as determined by the Centers for Disease 
Control and Prevention. 
(2) ADVANCED PUBLIC HEALTH EPIDEMIOLOGY 
TRAINING.—Advanced public health training in epi-
demiology to be carried out at the Centers for Dis-
ease Control and Prevention (or equivalent State fa-
cility), or other Federal facility (excluding the De-
partment of Defense or United States National Lab-
oratories), for a period of not less than 6 months or 
more than 12 months.
(b) SPECIALIZATION IN BIOTERRORISM.—In addition 
to the education or training specified in subsection (a), 
each recipient of a fellowship under this section (in this 
section referred to as a ‘‘fellow’’) may take courses of 
study at the Centers for Disease Control and Prevention 
or at an equivalent facility on diagnosis and containment 
of likely bioterrorism agents. 
(c) FELLOWSHIP AGREEMENT.—
(1) IN
GENERAL.—In awarding a fellowship 
under the program, the Secretary, in consultation 
with the Secretary of Health and Human Services, 
shall require the recipient to enter into an agree-
ment under which, in exchange for such assistance, 
the recipient—
(A) will maintain satisfactory academic 
progress (as determined in accordance with reg-
ulations issued by the Secretary and confirmed 
in regularly scheduled updates to the Secretary 
from the institution providing the education or 
training on the progress of the recipient’s edu-
cation or training); 
(B) will, upon completion of such edu-
cation or training, return to the recipient’s 
country of nationality or last habitual residence 
(so long as it is an eligible developing country)
and complete at least four years of employment 
in a public health position in the government or 
a nongovernmental, not-for-profit entity in that 
country or, with the approval of the Secretary 
in an international health organization; and 
(C) agrees that, if the recipient is unable 
to meet the requirements described in subpara-
graph (A) or (B), the recipient will reimburse 
the United States for the value of the assist-
ance provided to the recipient under the fellow-
ship, together with interest at a rate deter-
mined in accordance with regulations issued by 
the Secretary but not higher than the rate gen-
erally applied in connection with other Federal 
loans. 
(2) WAIVERS.—The Secretary may waive the 
application of paragraphs (1)(B) and (1)(C) if the 
Secretary determines that it is in the national inter-
est of the United States to do so. 
(d) IMPLEMENTATION.—The Secretary, in consulta-
tion with the Secretary of Health and Human Services, 
is authorized to enter into an agreement with any eligible 
developing country under which the country agrees—
(1) to establish a procedure for the nomination 
of eligible nationals for fellowships under this sec-
tion; 
(2) to guarantee that a fellow will be offered a 
professional public health position within the country 
upon completion of his studies; and 
(3) to certify to the Secretary when a fellow has 
concluded the minimum period of employment in a 
public health position required by the fellowship 
agreement, with an explanation of how the require-
ment was met. 
(e) PARTICIPATION OF UNITED STATES CITIZENS.—
On a case-by-case basis, the Secretary may provide for the 
participation of United States citizens under the provi-
sions of this section if the Secretary determines that it 
is in the national interest of the United States to do so. 
Upon completion of such education or training, a United 
States recipient shall complete at least five years of em-
ployment in a public health position in an eligible devel-
oping country or the World Health Organization. 
SEC. 7. IN-COUNTRY TRAINING IN LABORATORY TECH-
NIQUES AND SYNDROME SURVEILLANCE. 
(a) IN GENERAL.—In conjunction with the Centers 
for Disease Control and Prevention and the Department 
of Defense, the Secretary shall, subject to the availability
of appropriations, support short training courses in-coun-
try (not in the United States) to laboratory technicians 
and other public health personnel from eligible developing 
countries in laboratory techniques relating to the identi-
fication, diagnosis, and tracking of pathogens responsible 
for possible infectious disease outbreaks. Training under 
this section may be conducted in overseas facilities of the 
Centers for Disease Control and Prevention or in Overseas 
Medical Research Units of the Department of Defense, as 
appropriate. The Secretary shall coordinate such training 
courses, where appropriate, with the existing programs 
and activities of the World Health Organization. 
(b) TRAINING
IN SYNDROME SURVEILLANCE.—In 
conjunction with the Centers for Disease Control and Pre-
vention and the Department of Defense, the Secretary 
shall, subject to the availability of appropriations, estab-
lish and support short training courses in-country (not in 
the United States) for public health personnel from eligi-
ble developing countries in techniques of syndrome surveil-
lance reporting and rapid analysis of syndrome informa-
tion using Geographic Information System (GIS) and 
other Internet-based tools. Training under this subsection 
may be conducted via the Internet or in appropriate facili-
ties as determined by the Secretary. The Secretary shall 
coordinate such training courses, where appropriate, with
the existing programs and activities of the World Health 
Organization. 
SEC. 8. ASSISTANCE FOR THE PURCHASE AND MAINTE-
NANCE OF PUBLIC HEALTH LABORATORY 
EQUIPMENT. 
(a) AUTHORIZATION.—The President is authorized, 
on such terms and conditions as the President may deter-
mine, to furnish assistance to eligible developing countries 
to purchase and maintain public health laboratory equip-
ment described in subsection (b). 
(b) EQUIPMENT COVERED.—Equipment described in 
this subsection is equipment that is—
(1) appropriate, where possible, for use in the 
intended geographic area; 
(2) necessary to collect, analyze, and identify 
expeditiously a broad array of pathogens, including 
mutant strains, which may cause disease outbreaks 
or may be used as a biological weapon; 
(3) compatible with general standards set forth, 
as appropriate, by the World Health Organization 
and the Centers for Disease Control and Prevention, 
to ensure interoperability with regional and inter-
national public health networks; and
(4) not defense articles or defense services as 
those terms are defined under section 47 of the 
Arms Export Control Act. 
(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to exempt the exporting of goods 
and technology from compliance with applicable provisions 
of the Export Administration Act of 1979 (or successor 
statutes). 
(d) LIMITATION.—Amounts appropriated to carry 
out this section shall not be made available for the pur-
chase from a foreign country of equipment that, if made 
in the United States, would be subject to the Arms Export 
Control Act or likely be barred or subject to special condi-
tions under the Export Administration Act of 1979 (or 
successor statutes). 
(e) HOST COUNTRY’S COMMITMENTS.—The assist-
ance provided under this section shall be contingent upon 
the host country’s commitment to provide the resources, 
infrastructure, and other assets required to house, main-
tain, support, secure, and maximize use of this equipment 
and appropriate technical personnel. 
SEC. 9. ASSISTANCE FOR IMPROVED COMMUNICATION OF 
PUBLIC HEALTH INFORMATION. 
(a) ASSISTANCE FOR PURCHASE OF COMMUNICATION 
EQUIPMENT
AND
INFORMATION
TECHNOLOGY.—The
President is authorized to provide, on such terms and con-
ditions as the President may determine, assistance to eligi-
ble developing countries for the purchase and maintenance 
of communications equipment and information technology 
described in subsection (b), and supporting equipment, 
necessary to effectively collect, analyze, and transmit pub-
lic health information. 
(b) COVERED EQUIPMENT.—Equipment (and infor-
mation technology) described in this subsection is equip-
ment that—
(1) is suitable for use under the particular con-
ditions of the area of intended use; 
(2) meets appropriate World Health Organiza-
tion standards to ensure interoperability with like 
equipment of other countries and international 
health organizations; and 
(3) is not defense articles or defense services as 
those terms are defined under section 47 of the 
Arms Export Control Act. 
(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to exempt the exporting of goods 
and technology from compliance with applicable provisions 
of the Export Administration Act of 1979 (or successor 
statutes).
(d) LIMITATION.—Amounts appropriated to carry 
out this section shall not be made available for the pur-
chase from a foreign country of equipment that, if made 
in the United States, would be subject to the Arms Export 
Control Act or likely be barred or subject to special condi-
tions under the Export Administration Act of 1979 (or 
successor statutes). 
(e) ASSISTANCE FOR STANDARDIZATION OF REPORT-
ING.—The President is authorized to provide, on such 
terms and conditions as the President may determine, 
technical assistance and grant assistance to international 
health organizations to facilitate standardization in the re-
porting of public health information between and among 
developing countries and international health organiza-
tions. 
(f) HOST COUNTRY’S COMMITMENTS.—The assist-
ance provided under this section shall be contingent upon 
the host country’s commitment to provide the resources, 
infrastructure, and other assets required to house, sup-
port, maintain, secure, and maximize use of this equip-
ment and appropriate technical personnel.
SEC. 10. ASSIGNMENT OF PUBLIC HEALTH PERSONNEL TO 
UNITED 
STATES 
MISSIONS 
AND 
INTER-
NATIONAL ORGANIZATIONS. 
(a) IN GENERAL.—Upon the request of a United 
States chief of diplomatic mission or an international 
health organization, and with the concurrence of the Sec-
retary of State, the head of a Federal agency may assign 
to the respective United States mission or organization 
any officer or employee of the agency occupying a public 
health position within the agency for the purpose of en-
hancing disease and pathogen surveillance efforts in devel-
oping countries. 
(b) REIMBURSEMENT.—The costs incurred by a Fed-
eral agency by reason of the detail of personnel under sub-
section (a) may be reimbursed to that agency out of the 
applicable appropriations account of the Department of 
State if the Secretary determines that the relevant agency 
may otherwise be unable to assign such personnel on a 
non-reimbursable basis. 
SEC. 11. EXPANSION OF CERTAIN UNITED STATES GOVERN-
MENT LABORATORIES ABROAD. 
(a) IN GENERAL.—Subject to the availability of ap-
propriations, the Centers for Disease Control and Preven-
tion and the Department of Defense shall each—
(1) increase the number of personnel assigned 
to laboratories of the Centers or the Department, as
appropriate, located in eligible developing countries 
that conduct research and other activities with re-
spect to infectious diseases; and 
(2) expand the operations of those laboratories, 
especially with respect to the implementation of on-
site training of foreign nationals and regional out-
reach efforts involving neighboring countries. 
(b) COOPERATION
AND COORDINATION BETWEEN 
LABORATORIES.—Subsection (a) shall be carried out in 
such a manner as to foster cooperation and avoid duplica-
tion between and among laboratories. 
(c) RELATION TO CORE MISSIONS AND SECURITY.—
The expansion of the operations of overseas laboratories 
of the Centers or the Department under this section shall 
not—
(1) detract from the established core missions 
of the laboratories; or 
(2) compromise the security of those labora-
tories, as well as their research, equipment, exper-
tise, and materials.
SEC. 12. ASSISTANCE FOR REGIONAL HEALTH NETWORKS 
AND 
EXPANSION 
OF 
FOREIGN 
EPIDEMI-
OLOGY TRAINING PROGRAMS. 
(a) AUTHORITY.—The President is authorized, on 
such terms and conditions as the President may deter-
mine, to provide assistance for the purposes of—
(1) enhancing the surveillance and reporting ca-
pabilities for the World Health Organization and ex-
isting regional health networks; and 
(2) developing new regional health networks. 
(b) EXPANSION OF FOREIGN EPIDEMIOLOGY TRAIN-
ING PROGRAMS.—The Secretary of Health and Human 
Services is authorized to establish new country or regional 
Foreign Epidemiology Training Programs in eligible devel-
oping countries. 
SEC. 13. AUTHORIZATION OF APPROPRIATIONS. 
(a) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN
GENERAL.—Subject to subsection (c), 
there are authorized to be appropriated $70,000,000 
for the fiscal year 2004 and $80,000,000 for fiscal 
year 2005, to carry out this Act. 
(2) ALLOCATION OF FUNDS.—Of the amounts 
made available under paragraph (1)—
(A) $50,000,000 for the fiscal year 2004 
and $50,000,000 for the fiscal year 2005 are
authorized to be available to carry out sections 
6, 7, 8, and 9; 
(B) $2,000,000 for the fiscal year 2004 
and $2,000,000 for the fiscal year 2005 are au-
thorized to be available to carry out section 10; 
(C) $8,000,000 for the fiscal year 2004 
and $18,000,000 for the fiscal year 2005 are 
authorized to be available to carry out section 
11; and 
(D) $10,000,000 for the fiscal year 2004 
and $10,000,000 for the fiscal year 2005 are 
authorized to be available to carry out section 
12. 
(b) AVAILABILITY OF FUNDS.—The amount appro-
priated pursuant to subsection (a) is authorized to remain 
available until expended. 
(c) REPORTING REQUIREMENT.—
(1) REPORT.—Not later than 90 days after the 
date of enactment of this Act, the Secretary shall 
submit a report, in conjunction with the Secretary of 
Health and Human Services and the Secretary of 
Defense, containing—
(A) a description of the implementation of 
programs under this Act; and
(B) an estimate of the level of funding re-
quired to carry out those programs at a suffi-
cient level. 
(2) LIMITATION ON OBLIGATION OF FUNDS.—
Not more than 10 percent of the amount appro-
priated pursuant to subsection (a) may be obligated 
before the date on which a report is submitted, or 
required to be submitted, whichever first occurs, 
under paragraph (1).
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