services that is a primary objective of the GATT 
1994 and other agreements of the World Trade Or-
ganization. 
(7) The experience with the SARS outbreak in 
2002 and 2003 should be a clear warning that the 
system of public health readiness can be easily com-
promised by delays in reporting the earliest cases of 
an outbreak by a country reluctant to publicize a 
problem with an economic downside, no matter the 
public health consequences. 
(8) If a country fails to abide by regulations 
which are designed to prevent, protect against, and 
control disease and provide a public health response 
to the international spread of disease without unnec-
essary interference with international traffic and 
trade, it may be necessary to take actions against 
that country which restrict or otherwise interfere 
with international traffic or trade in the best inter-
est of public health. 
SEC. 3. WTO PROPOSAL. 
(a) ACTION BY UNITED STATES TRADE REPRESENT-
ATIVE.—The United States Trade Representative shall— 
(1) propose to the World Trade Organization 
that the rights and obligations of the World Trade 
Organization should take into account whether coun-
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tries are undermining the trade system by failing to 
abide by the rules of other international organiza-
tions with regard to public health, specifically the 
International Health Regulations of the World 
Health Organization; and 
(2) include in the proposal options for its imple-
mentation, such as— 
(A) provisions that would give members of 
the World Trade Organization the right to im-
pose sanctions or other punitive measures on 
members that have been found to violate the 
International Health Regulations of the World 
Health Organization; and 
(B) membership criteria for current and 
potential members of the World trade Organiza-
tion that would include the requirement to up-
hold the trade system by abiding by rules of 
other international organizations with regard to 
public health. 
(b) REPORT
TO CONGRESS.—The United States 
Trade Representative shall report to the Congress, not 
later than 90 days after the date of the enactment of this 
Act, and not later than the end of each 90-day period 
thereafter, on steps the Trade Representative has taken 
to carry out subsection (a), and the results of those steps. 
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SEC. 4. ANNUAL REPORT ON COUNTRY COMPLIANCE WITH 
INTERNATIONAL HEALTH REGULATIONS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall transmit to the Speaker of the 
House of Representatives and the Committee on Energy 
and Commerce of the House of Representatives and the 
Committee on Health, Education, Labor, and Pensions of 
the Senate, not later than December 1, 2006, and not 
later than December 1 of each year thereafter, a full and 
complete report regarding the status of the compliance 
with and observance of the International Health Regula-
tions of the World Health Organization in each country 
that is a member of that Organization. 
(b) CONTENTS.—Each report under subsection (a) 
shall include the following information: 
(1) The extent to which each country complies 
with and enforces the requirements contained in the 
International Health Regulations. 
(2) The extent to which each country uses ef-
fective epidemiological principles to detect, reduce, 
or eliminate the sources from which infection 
spreads, to improve sanitation in and around ports 
and airports, to prevent the dissemination of vectors, 
and, in general, to encourage epidemiological activi-
ties on the national level so that there is little risk 
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of outside infection establishing itself in that coun-
try. 
(3) The steps that the Secretary has taken to 
alter United States programs or policies with respect 
to any country because of unsatisfactory compliance 
with the International Health Regulations. 
(4) For each country in which the report indi-
cates that the country’s health administration has 
failed to notify the World Health Organization with-
in 24 hours of its being informed that the first case 
of a disease subject to the International Health Reg-
ulations, that is neither an imported case nor a 
transferred case, has occurred in its territory, or, 
within the subsequent 24 hours, has failed to notify 
the infected area, the extent to which the United 
States has taken or will take action to encourage 
such notifications. 
(5) The extent to which each country commu-
nicates frequent and detailed information to the 
World Health Organization about the presence of 
plague, cholera, yellow fever, avian influenza, Severe 
Acute Respiratory Syndrome (SARS), and any other 
disease determined by the Secretary that is present 
in its country. The report shall describe whether 
each country communicates to the World Health Or-
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