I 
115TH CONGRESS 
2D SESSION 
H. R. 7290 
To authorize a comprehensive, strategic approach for United States foreign 
assistance to developing countries to strengthen global health security, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 13, 2018 
Mr. CONNOLLY (for himself, Mr. CHABOT, Mr. ENGEL, Mr. FITZPATRICK, Mr. 
BERA, and Mrs. WAGNER) introduced the following bill; which was re-
ferred to the Committee on Foreign Affairs, and in addition to the Com-
mittees on Armed Services, and Intelligence (Permanent Select), for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To authorize a comprehensive, strategic approach for United 
States foreign assistance to developing countries to 
strengthen global health security, 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 ‘‘Global Health Security 
Act of 2018’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) In 2005, each of the 196 World Health Or-
ganization member states signed the International 
Health Regulations to improve the world’s ability to 
prevent, detect, and respond to public health events. 
(2) In December 2009, President Obama re-
leased the National Strategy for Countering Biologi-
cal Threats, which listed as one of seven objectives 
‘‘Promote global health security: Increase the avail-
ability of and access to knowledge and products of 
the life sciences that can help reduce the impact 
from outbreaks of infectious disease whether of nat-
ural, accidental, or deliberate origin’’. 
(3) In September 2011, the United States and 
the World Health Organization signed a memo-
randum of understanding to help developing coun-
tries strengthen their capabilities to meet the Inter-
national Health Regulations. 
(4) In February 2014, the United States and 
nearly 30 other nations launched the Global Health 
Security Agenda (GHSA) to address several high- 
priority, global infectious disease threats. 
(5) 
The 
GHSA 
was 
funded 
with 
a 
$1,000,000,000, one-time, 5-year supplemental ap-
propriation that expires at the end of fiscal year 
2019. 
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(6) Approximately 67 percent of nations have 
not fully implemented the International Health Reg-
ulations and built appropriate core capacities to de-
tect, assess, report, and respond to public health 
emergencies. 
(7) In 2015, the United Nations adopted the 
Sustainable Development Goals (SDGs), which in-
clude specific reference to the importance of global 
health security as part of SDG 3 ‘‘ensure healthy 
lives and promote well-being for all at all ages’’ as 
follows: ‘‘strengthen the capacity of all countries, in 
particular developing countries, for early warning, 
risk reduction and management of national and 
global health risks’’. 
(8) On November 4, 2016, President Obama 
signed Executive Order 13747, ‘‘Advancing the 
Global Health Security Agenda to Achieve a World 
Safe and Secure from Infectious Disease Threats’’. 
(9) In October 2017 at the GHSA Ministerial 
Meeting in Uganda, the United States and more 
than 40 GHSA member countries supported the 
‘‘Kampala Declaration’’ to extend the GHSA for an 
additional 5 years to 2024. 
(10) In December 2017, President Trump re-
leased the National Security Strategy, which in-
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cludes the priority action: ‘‘Detect and contain bio-
threats at their source: We will work with other 
countries to detect and mitigate outbreaks early to 
prevent the spread of disease. We will encourage 
other countries to invest in basic health care systems 
and to strengthen global health security across the 
intersection of human and animal health to prevent 
infectious disease outbreaks’’. 
(11) In February 2018, the Director of Na-
tional Intelligence, Daniel R. Coats, released the 
Worldwide Threat Assessment of the U.S. Intel-
ligence Community, which said ‘‘The increase in fre-
quency and diversity of reported disease outbreaks— 
such as dengue and Zika—probably will continue 
through 2018, including the potential for a severe 
global health emergency that could lead to major 
economic and societal disruptions, strain govern-
mental and international resources, and increase 
calls on the United States for support’’. 
(12) In the Consolidated Appropriations Act, 
2018 (Public Law 115–141), Congress provided 
$172,600,000 for global health security and required 
the President to submit a global health security 
strategy to Congress not later than 180 days after 
the date of the enactment of that Act. 
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(13) In September 2018, President Trump re-
leased the National Biodefense Strategy, which in-
cludes objectives to ‘‘strengthen global health secu-
rity capacities to prevent local bioincidents from be-
coming epidemics’’, and ‘‘strengthen international 
preparedness to support international response and 
recovery capabilities’’. 
SEC. 3. STATEMENT OF POLICY; SENSE OF CONGRESS. 
(a) STATEMENT OF POLICY.—It is the policy of the 
United States to— 
(1) promote global health security as a core na-
tional security interest; 
(2) advance the Global Health Security Agenda, 
which is a multi-faceted, multi-country initiative in-
tended to accelerate partner countries’ measurable 
capabilities to achieve specific targets to prevent, de-
tect, and respond to infectious disease threats, 
whether naturally occurring, deliberate, or acci-
dental; 
(3) collaborate with other countries to detect 
and mitigate outbreaks early to prevent the spread 
of disease; 
(4) encourage other countries to invest in basic 
health care systems; and 
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(5) strengthen global health security across the 
intersection of human and animal health to prevent 
infectious disease outbreaks and combat the growing 
threat of antimicrobial resistance. 
(b) SENSE OF CONGRESS.—It is the sense of the 
Congress that the President, in providing assistance to im-
plement the strategy required under section 7(a), should— 
(1) coordinate, through a whole-of-government 
approach, the efforts of relevant Federal depart-
ments and agencies to implement the strategy; 
(2) seek to fully utilize the unique capabilities 
of each relevant Federal department and agency 
while collaborating with and leveraging the contribu-
tions of other key stakeholders; and 
(3) utilize open and streamlined solicitations to 
allow for the participation of a wide range of imple-
menting partners through the most appropriate pro-
curement mechanisms, which may include grants, 
contracts, cooperative agreements, and other instru-
ments as necessary and appropriate. 
SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY 
REVIEW COUNCIL. 
(a) ESTABLISHMENT.—The President shall direct the 
staff of the National Security Council to establish a Global 
Health Security Agenda Interagency Review Council (in 
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this section referred to as the ‘‘Council’’) to perform the 
general responsibilities described in subsection (d) and the 
specific roles and responsibilities described in subsection 
(f). 
(b) CHAIR.—The Special Advisor to the President for 
Global Health Security (designated under subsection (i) 
of section 101 of the National Security Act of 1947 (50 
U.S.C. 3021), as added by section 6 of this Act) shall 
serve as Chair for the Council. 
(c) MEETINGS.—The Council shall meet not less than 
four times per year to advance its mission and fulfill its 
responsibilities. 
(d) GENERAL RESPONSIBILITIES.— 
(1) IN GENERAL.—The Council shall be respon-
sible for the following activities: 
(A) Provide, by consensus, policy-level 
guidance to participating agencies on Global 
Health Security Agenda (GHSA) goals, objec-
tives, and implementation. 
(B) Facilitate interagency, multi-sectoral 
engagement to carry out GHSA implementa-
tion. 
(C) Provide a forum for raising and work-
ing to resolve interagency disagreements con-
cerning the GHSA. 
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(D)(i) Review the progress toward and 
work to resolve challenges in achieving United 
States commitments under the GHSA, includ-
ing commitments to assist other countries in 
achieving the GHSA targets. 
(ii) The Council shall consider, among 
other issues, the following: 
(I) The status of United States finan-
cial commitments to the GHSA in the con-
text of commitments by other donors, and 
the contributions of partner countries to 
achieve the GHSA targets. 
(II) The progress toward the mile-
stones outlined in GHSA national plans for 
those countries where the United States 
Government has committed to assist in im-
plementing the GHSA and in annual work- 
plans outlining agency priorities for imple-
menting the GHSA. 
(III) The external evaluations of 
United States and partner country capa-
bilities 
to 
address 
infectious 
disease 
threats, including the ability to achieve the 
targets outlined within the WHO Joint Ex-
ternal Evaluation (JEE) tool, as well as 
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gaps identified by such external evalua-
tions. 
(E) Provide, by consensus, policy-level 
guidance on GHSA implementation. 
(F) Develop a report on an annual basis 
regarding the progress achieved and challenges 
concerning the United States Government’s 
ability to advance the GHSA across priority 
countries. 
The 
report 
shall 
include 
rec-
ommendations to resolve, mitigate, or otherwise 
address the challenges identified therein. The 
report shall be transmitted to the President and 
the appropriate congressional committees and, 
to the extent possible, made publicly available. 
(G) Conduct an overall review of the 
GHSA for submission to the President and the 
appropriate congressional committees by not 
later than September 1, 2019. The review 
should include an evaluation of the progress 
achieved during the 5 years of this initiative, as 
well as any challenges faced. The report should 
also provide recommendations on the future di-
rection of the initiative. 
(2) FORM.—The report required under para-
graph (1)(F) and the review required under para-
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graph (1)(G) shall be submitted in unclassified form 
but may contain a classified annex. 
(3) NON-INTERFERENCE IN FOREIGN AFFAIRS 
RESPONSIBILITIES.—The Council shall not perform 
any activities or functions that interfere with the 
foreign affairs responsibilities of the Secretary of 
State, including the responsibility to oversee the im-
plementation of programs and policies that advance 
the GHSA within foreign countries. 
(e) PARTICIPATION.—The Council shall consist of 
representatives, serving at the Assistant Secretary level or 
higher, from the following agencies: 
(1) The Department of State. 
(2) The Department of Defense. 
(3) The Department of Justice. 
(4) The Department of Agriculture. 
(5) The Department of Health and Human 
Services. 
(6) The Department of Homeland Security. 
(7) The Office of Management and Budget. 
(8) The United States Agency for International 
Development. 
(9) The Environmental Protection Agency. 
(10) The Centers for Disease Control and Pre-
vention. 
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