,I 
117TH CONGRESS 
1ST SESSION 
H. R. 391 
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 
JANUARY 21, 2021 
Mr. CONNOLLY (for himself, Mr. CHABOT, Mrs. WAGNER, Mr. BERA, Mr. 
FITZPATRICK, Mr. LARSEN of Washington, Ms. BASS, Mrs. BEATTY, Mr. 
BEYER, Ms. BLUNT ROCHESTER, Ms. BROWNLEY, Mr. CARTWRIGHT, 
Mr. CASE, Mr. CASTEN, Mr. CICILLINE, Mr. CLEAVER, Mr. COLE, Mr. 
COOPER, Mr. COSTA, Ms. DEAN, Mr. DEFAZIO, Mr. DEUTCH, Mr. 
ESPAILLAT, Ms. LOIS FRANKEL of Florida, Mr. VICENTE GONZALEZ of 
Texas, Mr. HASTINGS, Mrs. HAYES, Ms. HOULAHAN, Ms. JACKSON LEE, 
Mr. KEATING, Mr. KHANNA, Mr. KILMER, Mr. LANGEVIN, Mr. LEVIN of 
Michigan, Mr. LIEU, Mr. LYNCH, Mr. MALINOWSKI, Mr. MCGOVERN, Ms. 
MENG, Ms. NORTON, Mr. PHILLIPS, Mr. RUSH, Mr. SEAN PATRICK 
MALONEY of New York, Ms. SEWELL, Mr. SHERMAN, Mr. SIRES, Mr. 
SOTO, Ms. SPANBERGER, Mr. SUOZZI, Ms. TITUS, Mr. TONKO, Mrs. 
TRAHAN, Mr. TRONE, Mrs. WATSON COLEMAN, Ms. WEXTON, Mr. WIL-
SON of South Carolina, and Ms. SA´NCHEZ) introduced the following bill; 
which was referred to the Committee on Foreign Affairs 
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, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Global Health Security 
Act of 2021’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) 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’’. 
(2) 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. The 
GHSA 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) In 2015, the United Nations adopted the 
Sustainable Development Goals (SDGs), which in-
clude specific reference to the importance of global 
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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’’. 
(4) On November 4, 2016, President Obama 
signed Executive Order No. 13747, ‘‘Advancing the 
Global Health Security Agenda to Achieve a World 
Safe and Secure from Infectious Disease Threats’’. 
(5) 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. 
(6) In December 2017, President Trump re-
leased the National Security Strategy, which in-
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’’. 
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(7) 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. 
It is the policy of the United States to— 
(1) promote global health security as a core na-
tional security interest; 
(2) advance the aims of the Global Health Se-
curity Agenda; 
(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 
resilient and sustainable health care systems; and 
(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. 
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SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY 
REVIEW COUNCIL. 
(a) ESTABLISHMENT.—The President shall establish 
a Global Health Security Agenda Interagency Review 
Council (in this section referred to as the ‘‘Council’’) to 
perform the general responsibilities described in sub-
section (c) and the specific roles and responsibilities de-
scribed in subsection (e). 
(b) MEETINGS.—The Council shall meet not less than 
four times per year to advance its mission and fulfill its 
responsibilities. 
(c) GENERAL RESPONSIBILITIES.—The Council shall 
be responsible for the following activities: 
(1) Provide policy-level recommendations to 
participating agencies on Global Health Security 
Agenda (GHSA) goals, objectives, and implementa-
tion. 
(2) Facilitate interagency, multi-sectoral en-
gagement to carry out GHSA implementation. 
(3) Provide a forum for raising and working to 
resolve interagency disagreements concerning the 
GHSA. 
(4)(A) Review the progress toward and work to 
resolve challenges in achieving United States com-
mitments under the GHSA, including commitments 
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to assist other countries in achieving the GHSA tar-
gets. 
(B) The Council shall consider, among other 
issues, the following: 
(i) The status of United States financial 
commitments to the GHSA in the context of 
commitments by other donors, and the con-
tributions of partner countries to achieve the 
GHSA targets. 
(ii) The progress toward the milestones 
outlined in GHSA national plans for those 
countries where the United States Government 
has committed to assist in implementing the 
GHSA and in annual work-plans outlining 
agency priorities for implementing the GHSA. 
(iii) The external evaluations of United 
States and partner country capabilities to ad-
dress infectious disease threats, including the 
ability to achieve the targets outlined within the 
WHO Joint External Evaluation (JEE) tool, as 
well as gaps identified by such external evalua-
tions. 
(d) PARTICIPATION.—The Council shall consist of 
representatives, serving at the Assistant Secretary level or 
higher, from the following agencies: 
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(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 Labor. 
(7) The Department of Homeland Security. 
(8) The Office of Management and Budget. 
(9) The United States Agency for International 
Development. 
(10) The Environmental Protection Agency. 
(11) The Centers for Disease Control and Pre-
vention. 
(12) The Office of Science and Technology Pol-
icy. 
(13) The National Institutes of Health. 
(14) The National Institute of Allergy and In-
fectious Diseases. 
(15) Such other agencies as the Council deter-
mines to be appropriate. 
(e) SPECIFIC ROLES AND RESPONSIBILITIES.— 
(1) IN GENERAL.—The heads of agencies de-
scribed in subsection (d) shall— 
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(A) make the GHSA and its implementa-
tion a high priority within their respective agen-
cies, and include GHSA-related activities within 
their respective agencies’ strategic planning and 
budget processes; 
(B) designate a senior-level official to be 
responsible for the implementation of this Act; 
(C) designate, in accordance with sub-
section (d), an appropriate representative at the 
Assistant Secretary level or higher to partici-
pate on the Council; 
(D) keep the Council apprised of GHSA- 
related activities undertaken within their re-
spective agencies; 
(E) maintain responsibility for agency-re-
lated programmatic functions in coordination 
with host governments, country teams, and 
GHSA in-country teams, and in conjunction 
with other relevant agencies; 
(F) coordinate with other agencies that are 
identified in this section to satisfy pro-
grammatic goals, and further facilitate coordi-
nation of country teams, implementers, and do-
nors in host countries; and 
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(G) coordinate across GHSA national 
plans and with GHSA partners to which the 
United States is providing assistance. 
(2) ADDITIONAL
ROLES
AND
RESPONSIBIL-
ITIES.—In addition to the roles and responsibilities 
described in paragraph (1), the heads of agencies de-
scribed in subsection (d) shall carry out their respec-
tive roles and responsibilities described in sub-
sections (b) through (i) of section 3 of Executive 
Order No. 13747 (81 Fed. Reg. 78701; relating to 
Advancing the Global Health Security Agenda to 
Achieve a World Safe and Secure from Infectious 
Disease Threats), as in effect on the day before the 
date of the enactment of this Act. 
SEC. 5. UNITED STATES COORDINATOR FOR GLOBAL 
HEALTH SECURITY. 
(a) IN GENERAL.—The President shall appoint an in-
dividual to the position of United States Coordinator for 
Global Health Security, who shall be responsible for the 
coordination of the interagency process for responding to 
global health security emergencies. As appropriate, the 
designee shall coordinate with the President’s Special Co-
ordinator for International Disaster Assistance. 
(b) CONGRESSIONAL BRIEFING.—Not less frequently 
than twice each year, the employee designated under this 
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section shall provide to the appropriate congressional com-
mittees a briefing on the responsibilities and activities of 
the individual under this section. 
SEC. 6. SENSE OF CONGRESS. 
It is the sense of the Congress that, given the complex 
and multisectoral nature of global health threats to the 
United States, the President— 
(1) should consider appointing an individual 
with significant background and expertise in public 
health or emergency response management to the 
position of United States Coordinator for Global 
Health Security, as required by section 5(a), who is 
an employee of the National Security Council at the 
level of Deputy Assistant to the President or higher; 
and 
(2) in providing assistance to implement the 
strategy required under section 7(a), should— 
(A) coordinate, through a whole-of-govern-
ment approach, the efforts of relevant Federal 
departments and agencies to implement the 
strategy; 
(B) seek to fully utilize the unique capa-
bilities of each relevant Federal department and 
agency while collaborating with and leveraging 
the contributions of other key stakeholders; and 
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(C) utilize open and streamlined solicita-
tions to allow for the participation of a wide 
range of implementing partners through the 
most appropriate procurement mechanisms, 
which may include grants, contracts, coopera-
tive agreements, and other instruments as nec-
essary and appropriate. 
SEC. 7. STRATEGY AND REPORTS. 
(a) STRATEGY.—The United States Coordinator for 
Global Health Security (appointed under section 5(a)) 
shall coordinate the development and implementation of 
a strategy to implement the policy aims described in sec-
tion 3, which shall— 
(1) set specific and measurable goals, bench-
marks, timetables, performance metrics, and moni-
toring and evaluation plans that reflect international 
best practices relating to transparency, account-
ability, and global health security; 
(2) support and be aligned with country-owned 
global health security policy and investment plans 
developed with input from key stakeholders, as ap-
propriate; 
(3) facilitate communication and collaboration, 
as appropriate, among local stakeholders in support 
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of a multi-sectoral approach to global health secu-
rity; 
(4) support the long-term success of programs 
by building the capacity of local organizations and 
institutions in target countries and communities; 
(5) develop community resilience to infectious 
disease threats and emergencies; 
(6) leverage resources and expertise through 
partnerships with the private sector, health organi-
zations, civil society, nongovernmental organizations, 
and health research and academic institutions; and 
(7) support collaboration, as appropriate, be-
tween United States universities, and public and pri-
vate institutions in target countries and communities 
to promote health security and innovation. 
(b) COORDINATION.—The President, acting through 
the United States Coordinator for Global Health Security, 
shall coordinate, through a whole-of-government approach, 
the efforts of relevant Federal departments and agencies 
in the implementation of the strategy required under sub-
section (a) by— 
(1) establishing monitoring and evaluation sys-
tems, coherence, and coordination across relevant 
Federal departments and agencies; and 
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(2) establishing platforms for regular consulta-
tion and collaboration with key stakeholders and the 
appropriate congressional committees. 
(c) STRATEGY SUBMISSION.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the 
President, in consultation with the head of each rel-
evant Federal department and agency, shall submit 
to the appropriate congressional committees the 
strategy required under subsection (a) that provides 
a detailed description of how the United States in-
tends to advance the policy set forth in section 3 and 
the agency-specific plans described in paragraph (2). 
(2) AGENCY-SPECIFIC PLANS.—The strategy re-
quired under subsection (a) shall include specific im-
plementation plans from each relevant Federal de-
partment and agency that describes— 
(A) the anticipated contributions of the de-
partment or agency, including technical, finan-
cial, and in-kind contributions, to implement 
the strategy; and 
(B) the efforts of the department or agen-
cy to ensure that the activities and programs 
carried out pursuant to the strategy are de-
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signed to achieve maximum impact and long- 
term sustainability. 
(d) REPORT.— 
(1) IN GENERAL.—Not later than 1 year after 
the date on which the strategy required under sub-
section (a) is submitted to the appropriate congres-
sional committees under subsection (c), and not later 
than October 1 of each year thereafter, the Presi-
dent shall submit to the appropriate congressional 
committees a report that describes the status of the 
implementation of the strategy. 
(2) CONTENTS.—The report required under 
paragraph (1) shall— 
(A) identify any substantial changes made 
in the strategy during the preceding calendar 
year; 
(B) describe the progress made in imple-
menting the strategy; 
(C) identify the indicators used to establish 
benchmarks and measure results over time, as 
well as the mechanisms for reporting such re-
sults in an open and transparent manner; 
(D) contain a transparent, open, and de-
tailed accounting of expenditures by relevant 
Federal departments and agencies to implement 
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