I 
116TH CONGRESS 
1ST SESSION H. R. 4847 
To establish a United States Global Health Commission and a United States 
Global Health Attache´ Program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 23, 2019 
Mr. SHERMAN introduced the following bill; which was referred to the Com-
mittee on Foreign Affairs, and in addition to the Committees on Intel-
ligence (Permanent Select), and Armed Services, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To establish a United States Global Health Commission and 
a United States Global Health Attache´ Program, 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 Act’’. 
SEC. 2. FINDINGS; SENSE OF CONGRESS; AND PURPOSES. 
(a) FINDINGS.—Congress makes the following find-
ings: 
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(1) Of all foreign assistance provided by the 
United States, global health appropriations are sec-
ond only to security assistance. 
(2) Several Federal agencies and departments 
execute global health activities, including the United 
States Agency for International Development, the 
Department of Health and Human Services, the De-
partment of Defense, the Department of Agriculture, 
and the Department of State. 
(3) Global health assistance provided by the 
United States supports— 
(A) activities carried out by numerous pri-
vate, corporate, and nongovernmental organiza-
tions worldwide; and 
(B) multilateral organizations, such as the 
Global Fund to Fight AIDS, Tuberculosis, and 
Malaria and the World Health Organization. 
(4) The United States provides foreign assist-
ance to achieve national security, commercial, and 
humanitarian objectives while demonstrating global 
leadership. 
(5) All United States funded foreign assistance 
programs, regardless of the implementing agency, 
support the objectives referred to in paragraph (4), 
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but the manner in which the programs achieve the 
objectives varies widely. 
(6) The approach for global health assistance 
provided by the United States is largely program- 
based or disease-based and often does not allow 
agencies to work across the health system or on 
issues of greatest concern to the host country. 
(7) Such an approach hampers long-term sta-
bility, diplomacy with key partnerships, and sustain-
able capacity building. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that— 
(1) each global health implementing agency 
should establish a program for the development of a 
cadre of health advisors who can serve as United 
States global health attache´s; 
(2) country or regional health teams and health 
development partners working groups should be es-
tablished in all countries with significant United 
States health investments; and 
(3) all global health activities supported by the 
United States Government should be implemented in 
a coordinated manner. 
(c) PURPOSES.—The purposes of this Act are— 
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(1) to establish a governmental framework and 
national policy, priorities, and goals that ensure 
interagency coordination for global health assistance 
with the overall diplomacy, development, and defense 
efforts of the United States Government; 
(2) to establish the Senior United States Global 
Health Advisor and the United States Global Health 
Commission at the level of the National Security 
Council to harmonize the global health goals and 
priorities of the United States and promote inter-
agency coordination for global health assistance with 
the overall efforts of the United States Government; 
(3) to establish an Interagency Global Health 
Committee to implement the Unified Global Health 
Strategy and develop policies and frameworks to im-
prove coordination and outcomes; and 
(4) to establish the United States Global Health 
Attache´ Program to field global health attache´s as 
key interlocutors who coordinate the country or re-
gional health team and ensure effective health as-
sessment, planning, integration, and implementation 
across all agencies in support of the interests of the 
United States. 
SEC. 3. DEFINITIONS. 
In this Act: 
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(1) CHIEF OF MISSION.—The term ‘‘chief of 
mission’’ has the meaning given such term in section 
102 of the Foreign Service Act of 1980 (22 U.S.C. 
3902). 
(2) COMMISSION.—The term ‘‘Commission’’ 
means the United States Global Health Commission 
established under section 4. 
(3) 
COMMITTEE.—The 
term 
‘‘Committee’’ 
means the Interagency Global Health Committee es-
tablished under section 6. 
(4) COUNTRY OR REGIONAL HEALTH TEAM.— 
The term ‘‘country or regional health team’’ includes 
employees of global health implementing agencies 
operating in a country or designated geographic re-
gion. 
(5) GLOBAL
HEALTH
ACTIVITIES.—The term 
‘‘global health activities’’ means activities conducted 
in coordination with United States and foreign enti-
ties, including foreign governments— 
(A) to improve health care, the provision of 
public health services, responses to public 
health emergencies, and global health security; 
and 
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(B) to strengthen health systems and in-
frastructure, including the training and edu-
cation of health workers. 
(6) GLOBAL
HEALTH
IMPLEMENTING
AGEN-
CIES.—The term ‘‘global health implementing agen-
cies’’ means— 
(A) the Department of State; 
(B) the United States Agency for Inter-
national Development; 
(C) the Department of Health and Human 
Services; 
(D) the Department of Defense; 
(E) the Department of Agriculture; and 
(F) the Department of Commerce. 
(7) REGIONAL.—The term ‘‘regional’’ refers to 
a geographic region as designated by a global health 
implementing agency. 
(8) STRATEGY.—The term ‘‘Strategy’’ means 
the Unified Global Health Strategy formulated 
under section 5. 
SEC. 4. UNITED STATES GLOBAL HEALTH COMMISSION. 
(a) ESTABLISHMENT.—Not later than 90 days after 
the date of the enactment of this Act, the President, work-
ing through the National Security Council, shall establish 
a commission to improve the interagency coordination, 
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stewardship, accountability, outcomes, and impact of glob-
al health investment by the United States. 
(b) DESIGNATION.—The commission established 
under subsection (a) shall be known as the ‘‘United States 
Global Health Commission’’. 
(c) CHAIRPERSON; ADVISOR.—The President shall 
appoint a noncabinet-level senior staff member to the Na-
tional Security Council to serve as— 
(1) the Chairperson of the Commission; and 
(2) the Senior United States Global Health Ad-
visor. 
(d) MEMBERSHIP.— 
(1) IN
GENERAL.—The Commission shall be 
composed of— 
(A) the Chairperson; 
(B) a commissioners group (referred to in 
this section as the ‘‘principal group’’); 
(C) a staff group; and 
(D) any working group that the principal 
group determines to be necessary to carry out 
the duties under this section. 
(2) PRINCIPAL
GROUP.—The principal group 
shall be composed of— 
(A) 12 voting members, of whom— 
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(i) 1 shall be appointed from each 
global health implementing agency by the 
head of the respective agency from among 
senior 
officials 
responsible 
for 
global 
health, emergency assistance, development, 
or a similar area; 
(ii) 3 shall be appointed by the Presi-
dent from among individuals from aca-
demic or research institutions with exper-
tise in global health policy, foreign rela-
tions, or public health emergencies; and 
(iii) 3 shall be appointed by the Presi-
dent from among individuals from the 
international development community with 
expertise in health, community, or eco-
nomic development; and 
(B) 2 nonvoting, ex officio members, of 
whom— 
(i) 1 shall be the President of the Na-
tional Academy of Medicine; and 
(ii) 1 shall be an employee of the Gov-
ernment Accountability Office who shall be 
appointed by the Comptroller General of 
the United States. 
(3) STAFF GROUP.— 
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(A) COMPOSITION.—The staff group de-
scribed in paragraph (1)(C) shall be composed 
of representatives of the National Security 
Council, the global health implementing agen-
cies, the Government Accountability Office, and 
the National Academy of Medicine, as des-
ignated by the head of the respective agency. 
(B) FUNCTION.—The staff group shall ad-
vise, provide subject-matter expertise to, and 
support the activities of, the Commission. 
(e) PERIODS OF APPOINTMENT; VACANCIES.— 
(1) PERIODS OF APPOINTMENT.— 
(A) GOVERNMENTAL
OFFICIALS.—Each 
member of the principal group appointed under 
subsection (d)(2)(A)(i) shall serve at the discre-
tion of the head of the respective agency. 
(B) 
NONGOVERNMENTAL
OFFICIALS.— 
Each member of the principal group appointed 
under clause (ii) or (iii) of subsection (d)(2)(A) 
shall serve for a period of not fewer than 2 
years and not more than 5 years. 
(2) VACANCIES.—A vacancy in the Commis-
sion— 
(A) shall not affect the powers of the Com-
mission; and 
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(B) shall be filled in the same manner as 
the original appointment. 
(f) MEETINGS.— 
(1) IN GENERAL.—The Commission shall meet 
at the call of the Chairperson. 
(2) INITIAL
MEETING.—Not later than 180 
days after the date of the enactment of this Act, the 
Commission shall hold its initial meeting. 
(3) PRINCIPAL
GROUP.—The principal group 
shall meet not less frequently than twice each year. 
(4) STAFF GROUP.—The staff group described 
in subsection (d)(1)(C) shall meet as determined by 
the Chairperson based on the activities of the Com-
mission. 
(g) BYLAWS.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the 
Commission shall develop bylaws for the operation of 
the Commission. 
(2) ELEMENTS.—The bylaws developed under 
paragraph (1) shall include— 
(A) information on the membership of the 
Commission; 
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(B) the number of annual meetings re-
quired for the principal group and the staff 
group; 
(C) the decision-making process of the 
Commission; 
(D) the process by which disputes are re-
solved; and 
(E) such other information and policies as 
the Commission considers appropriate. 
(h) PRIMARY RESPONSIBILITIES.—The Commission 
shall— 
(1) develop an integrated, comprehensive global 
health strategy, in accordance with section 5 and in 
cooperation with global health implementing agen-
cies, to ensure that global health activities and pro-
grams supported by the United States are consistent 
with the strategic priorities and policies of the 
United States; 
(2) recommend methods to improve alignment, 
coordination, planning, and implementation to en-
sure the greatest possible impact and overall effec-
tiveness of United States global health efforts and 
programs; 
(3) in coordination with the Committee, advise 
the National Security Council on global health issues 
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that potentially impact the domestic health status, 
defense operations, development programs, diplo-
macy efforts, and strategic interests of the United 
States; 
(4) advise the Committee on country and re-
gional challenges; 
(5) based on the priorities of the United States, 
recommend countries or regions that would greatly 
benefit from— 
(A) receiving a global health attache´ under 
section 7; and 
(B) the establishment of a country or re-
gional health development implementation plan 
under section 8; 
(6) recommend agenda items and provide other 
recommendations and advice to the Committee; and 
(7) facilitate cooperation between the United 
States Government and academic and research insti-
tutions, civil society, international nongovernmental 
organizations, and other public and private entities. 
(i) REPORTS.— 
(1) INITIAL REPORT.—Not later than 1 year 
after the date of the enactment of this Act, the 
Commission shall submit to the President and Con-
gress an initial report that includes— 
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(A) the bylaws and membership of the 
Commission; 
(B) a description of the methodology for 
the development of the Strategy; and 
(C) a description of progress made toward 
developing the Strategy. 
(2) BIENNIAL REPORT.— 
(A) IN GENERAL.—Not later than 1 year 
after the submission of the initial report under 
paragraph (1), and biennially thereafter, the 
Commission shall submit to the President and 
Congress a report on the activities of the Com-
mission during the period covered by the report. 
(B) ELEMENTS.—Each report submitted 
under subparagraph (A) shall include— 
(i) any updates to the Strategy since 
the submission of the most recent report; 
(ii) a description of major global 
health threats of concern to the United 
States Government; 
(iii) recommendations for improving 
alignment, coordination, planning, and im-
plementation to ensure the greatest pos-
sible impact and overall effectiveness of 
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United States global health efforts and 
programs; and 
(iv) a description of opportunities for 
future engagement on global health. 
(j) PERSONNEL MATTERS.— 
(1) SENIOR UNITED STATES GLOBAL HEALTH 
ADVISOR.—Section 5313 of title 5, United States 
Code, is amended by adding at the end the fol-
lowing: 
‘‘Senior United States Global Health Advisor.’’. 
(2) COMPENSATION OF MEMBERS.—A member 
of the Commission who is not an officer or employee 
of the Federal Government shall be compensated at 
a rate equal to the daily equivalent of the annual 
rate of basic pay prescribed for level IV of the Exec-
utive Schedule under section 5315 of title 5, United 
States Code, for each day (including travel time) 
during which the member is engaged in the perform-
ance of the duties of the Commission. 
(3) TRAVEL
EXPENSES.—A member of the 
Commission shall be allowed travel expenses, includ-
ing per diem in lieu of subsistence, at rates author-
ized for employees of agencies under subchapter I of 
chapter 57 of title 5, United States Code, while 
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away from their homes or regular places of business 
in the performance of services for the Commission. 
(k) NONAPPLICABILITY OF FACA.—The Federal Ad-
visory Committee Act (5 U.S.C. App.) shall not apply to 
the Commission. 
SEC. 5. UNIFIED GLOBAL HEALTH STRATEGY. 
(a) IN GENERAL.—Not later than 18 months after 
the date of the enactment of this Act, the Commission 
shall formulate an integrated, comprehensive global health 
strategy, to be known as the ‘‘Unified Global Health 
Strategy’’, that communicates to Federal agencies, non-
governmental organizations, and allied partners of the 
United States the overall health assistance priorities of the 
United States. The Strategy shall be— 
(1) aligned with the National Security Strategy 
of the United States; and 
(2) based on— 
(A) highest-impact, evidence-based out-
comes and the mission, strategy, assessment, 
planning, and guidance documents of each glob-
al health implementing agency; and 
(B) recommendations from the National 
Security Council on issues that impact national 
security. 
(b) REQUIREMENTS.—The Strategy shall— 
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(1) describe the overarching, integrated stra-
tegic vision for health-related foreign assistance 
vertically and horizontally across the global health 
implementing agencies and to implementing part-
ners; 
(2) establish and communicate the global health 
goals and priorities of the United States Government 
for the purpose of improving the coordination, part-
nerships, and implementation of global health and 
foreign assistance effectiveness; 
(3) communicate the role of global health with 
respect to the overall foreign development goals of 
the United States; 
(4) provide consensus on global health efforts 
across the global health implementing agencies re-
garding foreign assistance health policy that dem-
onstrates the collective commitment of all inter-
agency partners to transparency, accountability, and 
a unified approach to maximizing the impact of 
United States investments; and 
(5) ensure that the health programs of the 
United States Government align, to the maximum 
extent possible, with country and regional health and 
development priorities to achieve long-term sustain-
ability, security, and stability. 
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(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—The Strategy shall take ef-
fect upon approval by the President. 
(2) APPROVAL BY PRESIDENT.— 
(A) SENSE OF CONGRESS.—It is the sense 
of Congress that the President should approve 
the Strategy not later than 90 days after receiv-
ing the Strategy from the Commission. 
(B) EXPLANATION TO CONGRESS.—If the 
President has not approved the Strategy within 
90 days after receiving it from the Commission, 
the President shall submit to Congress a writ-
ten statement explaining the reason for the 
delay and a timeline for approval of the Strat-
egy. 
(3) PROHIBITION ON DELEGATION.—The Presi-
dent may not delegate the responsibilities under this 
subsection. 
(d) UPDATES.— 
(1) IN GENERAL.—The Commission shall up-
date the Strategy not less frequently than once every 
5 years. 
(2) 
CONSIDERATION
OF
COUNTRY-LEVEL 
PLANS.—In updating the Strategy pursuant to para-
graph (1), the Commission shall consider the coun-
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try or regional health development implementation 
plans developed under section 8. 
SEC. 6. INTERAGENCY GLOBAL HEALTH COMMITTEE. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the President shall es-
tablish the Interagency Global Health Committee to imple-
ment the Strategy, improve the coordination of global 
health efforts, and oversee the United States Global 
Health Attache´ Program. 
(b) CHAIRPERSON.— 
(1) IN GENERAL.—The President shall appoint, 
by and with the advice and consent of the Senate, 
the Chairperson of the Committee. 
(2) 
AMBASSADOR-AT-LARGE
FOR
GLOBAL 
HEALTH.—The Chairperson shall have the rank of 
Ambassador-at-Large for Global Health. 
(3) 
RESPONSIBILITIES.—The 
Chairperson 
shall— 
(A) chair the Committee and ensure that 
the responsibilities of the Committee are carried 
out; 
(B) be impartial with respect to any global 
health implementing agency; and 
(C) ensure coordination and synergy of ef-
fort in global health programming and policies 
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among the relevant global health implementing 
agencies. 
(c) MEMBERSHIP OF COMMITTEE.—The Committee 
shall be composed of— 
(1) the Chairperson; and 
(2) representatives from each global health im-
plementing agency, who shall be appointed by the 
head of the applicable agency; and 
(3) representatives from any other Federal 
agency, as the Chairperson considers appropriate to 
implement the Strategy and oversee the United 
States Global Health Attache´ Program. 
(d) SUBCOMMITTEES.— 
(1) GLOBAL HEALTH ATTACHE´ BOARD.— 
(A) IN
GENERAL.—The Committee shall 
establish a permanent subcommittee, to be 
known as the ‘‘Global Health Attache´ Board’’, 
to advise and oversee the United States Global 
Health Attache´ Program, in accordance with 
subsection (e)(4) and section 7. 
(B) CHAIRPERSON.—The Secretary of 
State shall designate the Chairperson of the 
Global Health Attache´ Board from among em-
ployees of the Bureau of Oceans and Inter-
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national Environmental and Scientific Affairs of 
the Department of State. 
(2) SUBCOMMITTEES AND WORKING GROUPS.— 
The Chairperson of the Committee may establish 
such other subcommittees and working groups as the 
Chairperson considers necessary to carry out the re-
sponsibilities of the Committee. 
(e) RESPONSIBILITIES.—The Committee shall— 
(1) develop a 5-year plan of actions and mile-
stones to implement the Unified Global Health 
Strategy; 
(2) develop and establish integrated national 
policies for global health that will guide Federal 
agencies in development, programming, and imple-
mentation of global health efforts; 
(3) coordinate the global health assistance ef-
forts of the United States Government to ensure 
greater alignment, programmatic impact, and overall 
effectiveness; 
(4) develop, design, and oversee all aspects of 
the United States Global Health Attache´ Program, 
in accordance with section 7, including with respect 
to the selection of the countries or regions in which 
global health attache´s will be posted; 
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(5) develop guidance for the country and re-
gional health development implementation plans 
under section 8; 
(6) facilitate cooperation between Federal agen-
cies and international counterparts for planning and 
implementation of global health programs and ef-
forts; and 
(7) promote Federal interagency coordination 
and planning across all global health activities, in-
cluding logistical planning and coordination and the 
sharing of data and information associated with 
global health programs, development, and informa-
tion that may impact investment outcomes. 
(f) 5-YEAR PLAN.—Not later than 270 days after the 
date on which the Strategy takes effect, the Committee 
shall submit to Congress the 5-year plan of actions and 
milestones developed under subsection (e)(1). 
(g) REPORTS.— 
(1) INITIAL
REPORT.—Not later than 18 
months after the date of the enactment of this Act, 
the Committee shall submit to the President and 
Congress an initial report that includes— 
(A) the structure, membership, and bylaws 
of the Committee; 
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(B) a statement of the activities and ac-
complishments of the Committee since the es-
tablishment of the Committee; and 
(C) an update on the development and im-
plementation of the United States Global 
Health Attache´ Program established under sec-
tion 7. 
(2) BIENNIAL
REPORT.—Not less frequently 
than biennially, the Committee shall submit to Con-
gress through the President a concise report con-
taining— 
(A) a description of progress on or set-
backs or updates to the plan of actions and 
milestones developed under subsection (e)(1); 
(B) a statement of the activities and ac-
complishments of the Committee since the sub-
mission of the most recent report; 
(C) a statement detailing with particularity 
the recommendations of the Committee with re-
spect to improving coordination, accountability, 
outcomes, and impact of global health invest-
ment by the United States; and 
(D) an update on the development and im-
plementation of the United States Global 
Health Attache´ Program established under sec-
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tion 7, including post locations for and training 
of global health attache´s, outcome measures, 
and recommendations to increase the impact of 
the program. 
SEC. 7. UNITED STATES GLOBAL HEALTH ATTACHE´ PRO-
GRAM. 
(a) ESTABLISHMENT OF PROGRAM.—There is estab-
lished a United States Global Health Attache´ Program 
(referred to in this section as the ‘‘Program’’). 
(b) PROGRAM
MANAGEMENT.—The Secretary of 
Health and Human Services shall manage the Program 
under the oversight and direction of the Committee. 
(c) GLOBAL HEALTH ATTACHE´S.— 
(1) IN GENERAL.—Each global health attache´ 
shall serve on behalf of a chief of mission and the 
global health implementing agencies to assist in the 
coordination, strategic planning, and implementation 
of all global health assistance in the country or re-
gion in which the global health attache´ is posted. 
(2) ELIGIBILITY.—An individual is eligible to 
serve as a global health attache´ if the individual— 
(A) is an employee of the Federal Govern-
ment, such as a member of the uniformed serv-
ices or the Foreign Service, or other civilian 
Federal employee, in a position at, or with pro-
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motion potential to, level 15 of the General 
Schedule (or equivalent); 
(B) has expertise and experience in public 
health or global health; 
(C) has leadership experience within one or 
more of the global health implementing agen-
cies; 
(D) is a United States citizen; and 
(E) has a security clearance at the secret 
level or above. 
(3) GLOBAL HEALTH ATTACHE´ EDUCATION AND 
TRAINING.— 
(A) REQUIREMENTS.— 
(i) IN
GENERAL.—The Committee 
shall establish requirements for a global 
health attache´ education and training pro-
gram (referred to in this section as the 
‘‘education and training program’’). 
(ii) ELEMENTS.—The requirements 
established under clause (i) shall ensure 
that each global health attache´— 
(I) receives education and train-
ing on— 
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(aa) the strategic planning 
process of the United States Gov-
ernment; 
(bb) the role of the global 
health implementing agencies in 
foreign assistance, and the orga-
nizational structure and global 
health and development programs 
of such agencies; 
(cc) effective communication 
with foreign and domestic media, 
including strategic communica-
tion; 
(dd) the impact of inter-
national affairs; 
(ee) the public health issues 
affecting host countries and re-
gions; and 
(ff) such other health-related 
training that the Committee con-
siders necessary to create highly 
effective global health diplomats; 
(II) completes the training for 
Foreign Service officers described in 
section 708 of the Foreign Service Act 
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of 1980 (22 U.S.C. 4028), or equiva-
lent training; and 
(III) meets foreign language pro-
ficiency requirements established by 
the Secretary of State for Foreign 
Service officers under section 702 of 
the Foreign Service Act of 1980 (22 
U.S.C. 4022) and receives appropriate 
language training consistent with such 
section. 
(B) CURRICULUM
DEVELOPMENT.—The 
institution described in section 701 of the For-
eign Service Act of 1980 (22 U.S.C. 4021) 
(commonly known as the ‘‘Foreign Service In-
stitute’’) and the Uniformed Services University 
of the Health Sciences, in cooperation with ap-
propriate Federal agencies, academic institu-
tions, and other entities, shall— 
(i) develop a comprehensive cur-
riculum for the education and training pro-
gram, consistent with the requirements es-
tablished pursuant to subparagraph (A); 
and 
(ii) submit such curriculum to the 
Committee for approval. 
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(C) ADMINISTRATION.—The education and 
training program shall be administered by one 
or more training institutions, as determined by 
the Committee. 
(D) ELIGIBILITY FOR PARTICIPATION BY 
OTHER INDIVIDUALS.—An individual who is not 
a candidate for the position of global health 
attache´ may participate in some or all of the 
education and training program if such indi-
vidual is— 
(i) a health official of a global health 
implementing agency; or 
(ii) an in-country staff member of a 
global health implementing agency. 
(4) CREDENTIALS.—The Secretary of State 
shall— 
(A) notify the receiving state of each global 
health attache´ posted to such state, in accord-
ance with Article 10 of the Vienna Convention 
on Diplomatic Relations, done at Vienna April 
18, 1961; and 
(B) provide the appropriate diplomatic cre-
dentials to each global health attache´, at the re-
quest of the Committee. 
(5) POSTINGS AND ACCREDITATIONS.— 
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(A) IN
GENERAL.—Each global health 
attache´— 
(i) shall be posted in a country as de-
termined by the Committee; and 
(ii) may be accredited to one or more 
countries in a region as determined by the 
Committee. 
(B) CRITERIA
TO
ESTABLISH
A
GLOBAL 
HEALTH
ATTACHE´
OFFICE.—The Committee 
shall make determinations about where to es-
tablish global health attache´s based on— 
(i) the strategic interests and prior-
ities of the United States; 
(ii) large development and humani-
tarian assistance investments made by the 
United States; 
(iii) the strategic importance of health 
to the security and stability of the country 
or region; and 
(iv) such other criteria as the Com-
mittee considers appropriate. 
(6) RESPONSIBILITIES.—Each global health 
attache´ shall— 
(A) serve as the senior health advisor to 
the diplomatic mission of the United States in 
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the country or region in which the global health 
attache´ is posted; 
(B) convene and coordinate the country or 
regional health team on behalf of the chief of 
mission of the country or region in which the 
global health attache´ is posted; 
(C) oversee the development of the country 
or regional health development implementation 
plan for the country or region in which the 
global health attache´ is posted; 
(D) represent the United States Govern-
ment regarding health matters to foreign gov-
ernments, multilateral and international organi-
zations, and public and private entities; and 
(E) perform such other duties that align 
with advancing the global health interests of the 
United States, as determined by the chief of 
mission and the Committee. 
(7) PERIODIC REPORTS.— 
(A) IN
GENERAL.—Each global health 
attache´ shall periodically submit country or re-
gional updates to regional and headquarters 
components of the global health implementing 
agencies, through the chief of mission, as deter-
mined by the Committee. 
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(B) ELEMENTS.—Each report submitted 
under subparagraph (A) shall include a descrip-
tion of any health-related threats or critical 
concerns that may affect the national security, 
development efforts, or commercial interests of 
the United States. 
(C) 
HEADQUARTERS
COMPONENT
DE-
FINED.—In this paragraph, the term ‘‘head-
quarters component’’ means the senior leader-
ship and policymaking section of a global health 
implementing agency. 
(8) SUPERVISION.—Each global health attache´ 
shall work under the supervision of— 
(A) the chief of mission of the country in 
which the global health attache´ is posted; and 
(B) the chiefs of mission of the countries 
to which the global health attache´ is accredited. 
(9) EMPLOYMENT.— 
(A) SALARY
AND
BENEFITS.—The em-
ployer of each global health attache´ at the time 
the global health attache´ applies for the posi-
tion of global health attache´ shall continue to 
provide the salary and benefits for the global 
health attache´. 
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(B) OTHER EXPENSES.—The Secretary of 
State shall provide to each global health 
attache´— 
(i) allowances comparable to those 
provided by the Secretary to Foreign Serv-
ice officers under sections 5922 through 
5924 of title 5, United States Code; 
(ii) reimbursement for travel and re-
lated expenses set forth in section 901 of 
the Foreign Service Act of 1980 (22 
U.S.C. 4081); and 
(iii) reimbursement for administrative 
services consistent with the International 
Cooperative Administrative Support Serv-
ices Handbook. 
(10) IMPARTIALITY.—In carrying out their re-
sponsibilities under this section, global health 
attache´s— 
(A) shall represent the interests and the 
priorities of the United States Government; and 
(B) may not show favoritism to any par-
ticular Federal agency. 
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SEC. 8. COUNTRY OR REGIONAL HEALTH DEVELOPMENT 
IMPLEMENTATION PLANS. 
(a) IN GENERAL.—Each country or regional health 
team, under the direction of the global health attache´ for 
the country or region, shall develop a country or regional 
health development implementation plan for the respective 
country or region. 
(b) GUIDANCE.—The Committee shall develop guid-
ance for the country and regional health development im-
plementation plans, including with respect to— 
(1) the elements of and templates for the plans; 
and 
(2) policies and processes relating to plan ap-
proval, consultation, and submission. 
(c) PLAN DESCRIBED.— 
(1) IN
GENERAL.—Each country or regional 
health development implementation plan developed 
under subsection (a) shall be a country- or regional- 
level operational plan— 
(A) for supporting the health goals of the 
host country or countries; and 
(B) for ensuring that the national security 
priorities of the United States are met. 
(2) CONTENTS.—Each country or regional 
health development implementation plan developed 
under subsection (a) shall include— 
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(A) a comprehensive assessment of the 
health sector in the applicable country or re-
gion, including the strengths and weaknesses of 
the health system; 
(B) an analysis of the key funders and 
stakeholders within the health system; 
(C) a plan of action with milestones de-
scribing how global health activities will be im-
plemented during the period covered by the 
country or regional health development imple-
mentation plan; 
(D) health links to non-health-related ac-
tivities, such as military assistance and infra-
structure projects; 
(E) metrics for measuring the impact of 
the plan; 
(F) opportunities for increased engagement 
of the United States and any consequences of 
failing to increase engagement; 
(G) a determination of the role of each 
agency in the execution of the plan; 
(H) a request for resources needed to en-
sure— 
(i) the success of the plan; and 
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(ii) the sustainability of the health 
sector of the host country; and 
(I) such other content as the Committee 
considers appropriate. 
(3) OBJECTIVES.—Each country health devel-
opment implementation plan shall— 
(A) align with and support the Integrated 
Country Strategy and the Mission Resource Re-
quest for the country; and 
(B) align the President’s Emergency Plan 
for 
AIDS 
Relief 
(commonly 
known 
as 
‘‘PEPFAR’’) and all other global health plans 
of the United States Government with the over-
all goals of the country or region— 
(i) to mitigate redundancy of re-
sources; and 
(ii) to improve the impact of efforts. 
(d) SUBMISSION; UPDATES.— 
(1) SUBMISSION TO CHIEF OF MISSION.—Not 
later than 270 days after a global health attache´ is 
first posted to a country or region, the global health 
attache´ shall submit a country or regional health de-
velopment implementation plan developed under sub-
section (a) to the appropriate chief of mission. 
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(2) APPROVAL; SUBMISSION TO COMMITTEE.— 
If the chief of mission approves the plan submitted 
under paragraph (1), the chief of mission shall sub-
mit the plan to the Committee. 
(3) UPDATES.—Not less frequently than once 
every 2 years, the country or regional health team 
shall update the country or regional health develop-
ment implementation plan. 
(e) HEALTH DEVELOPMENT PARTNERS WORKING 
GROUP.— 
(1) IN
GENERAL.—Not later than 180 days 
after a global health attache´ is first posted to a 
country or region, the country or regional health 
team shall establish a health development partners 
working group in each country or region with a glob-
al health attache´ to support implementation of coun-
try or regional health development implementation 
plans and to improve synergy with respect to such 
implementation. 
(2) MEMBERSHIP.—Each working group estab-
lished pursuant to paragraph (1) shall be composed 
of representatives from— 
(A) the country or regional health team; 
(B) civil society partners of the United 
States; 
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(C) international organizations to which 
the United States provides funding; 
(D) the government of each host country; 
and 
(E) one or more allied partners of the 
United States, as the chief of mission considers 
appropriate. 
(f) INTEGRATION
OF
GLOBAL
HEALTH
ACTIVI-
TIES.—The country or regional health team in each coun-
try or region with a global health attache´ shall integrate 
global health activities within the country or region with 
other development programs and activities, as appro-
priate— 
(1) to advance the interests of the United 
States; and 
(2) to create sustainable capacity for the host 
country or region. 
SEC. 9. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to be appropriated such sums 
as may be necessary to carry out this Act. 
Æ 
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