II 118th CONGRESS 2d Session S. 4581 IN THE SENATE OF THE UNITED STATES June 18, 2024 Mr. Kelly (for himself and Mr. Cornyn ) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations A BILL To require the Secretary of State, in coordination with the Secretary of Health and Human Services, the Administrator of the United States Agency for International Development, and such other heads of departments and agencies as the Secretary of State considers appropriate, to formulate a strategy for the Federal Government to secure support from foreign countries, multilateral organizations, and other appropriate entities to facilitate the development and commercialization of qualified pandemic or epidemic products, and for other purposes.

1. Short title This Act may be cited as the Saving Us from Pandemic Era Resistance by Building a Unified Global Strategy Act of 2024 or the SUPER BUGS Act of 2024 . 2. International strategy for development and commercialization of qualified pandemic or epidemic products (a) Strategy (1) In general Not later than 540 days after the date of the enactment of this Act, the Secretary of State, in coordination with the Secretary of Health and Human Services, the Administrator of the United States Agency for International Development, and such other heads of departments and agencies as the Secretary of State considers appropriate, shall— (A) formulate a strategy for the Federal Government to secure support from foreign countries, multilateral organizations, and other appropriate entities to facilitate the development and commercialization of qualified pandemic or epidemic products, including such products to address antimicrobial resistant pathogens— (i) with pandemic potential; or (ii) that are priority pathogens; and (B) submit such strategy to the appropriate committees of Congress. (2) Contents The strategy required by paragraph (1) shall— (A) provide for processes the Federal Government is using and would use to enter into arrangements with foreign countries, multilateral organizations, and other appropriate entities in certain circumstances to implement the strategy; (B) strive to ensure that the arrangements described in subparagraph (A) promote equitable contributions based on the budgets and technical expertise of participating countries, organizations, and other entities, as appropriate; (C) focus the arrangements described in subparagraph (A) on global priorities while enabling participating countries, organizations, and other entities to emphasize national or regional issues of importance; (D) seek to ensure new and existing arrangements described in subparagraph (A) are harmonized with each other and with other relevant existing or planned efforts to amplify impact, address gaps, prevent duplication of effort, and efficiently distribute funds; (E) provide for collaboration so that the arrangements described in subparagraph (A)— (i) allocate joint or individual responsibility across participating countries, organizations, and other entities for the development and commercialization of particular qualified pandemic or epidemic products; and (ii) describe such collaboration; (F) encourage the stewardship of qualified pandemic or epidemic products developed pursuant to the strategy; (G) ensure that priority actions are identified in the arrangements described in subparagraph (A) so that scarce domestic and international funds are allocated to develop and commercialize qualified pandemic or epidemic products that can achieve the greatest positive impact on human health, including unprecedented approaches to preventing, treating, and diagnosing infectious diseases; (H) consider approaches including— (i) securing development, production, and distribution contracts with the private sector; (ii) entering into public-private partnerships; (iii) implementing alternative payment models; (iv) creating coverage and reimbursement pathways; and (v) streamlining regulatory approval processes; and (I) align with pandemic preparedness and response priorities of the United States, such as those articulated in— (i) the National Strategy for Combating Antibiotic-Resistant Bacteria (dated September 2014); and (ii) the National Biodefense Strategy and Implementation Plan (dated October 2022) and the associated Action Plan (dated October 2022). (b) Arrangements The Secretary of State, in consultation with the Secretary of Health and Human Services, the Administrator of the United States Agency for International Development, and such other heads of departments and agencies as the Secretary of State considers appropriate, shall seek to enter into arrangements with foreign countries, multilateral organizations, and other appropriate entities to implement the strategy required by subsection (a). (c) Definitions In this section: (1) Appropriate committees of Congress The term appropriate committees of Congress means— (A) the Committee on Foreign Relations and the Committee on Health, Education, Labor, and Pensions of the Senate; and (B) the Committee on Foreign Affairs and the Committee on Energy and Commerce of the House of Representatives. (2) Priority pathogens The term priority pathogens means pathogens identified in— (A) the latest Antibiotic Resistance Threats Report of the Centers for Disease Control and Prevention (or any successor report); or (B) the latest global priority pathogens list or fungal priority pathogens list of the World Health Organization (or any successor list). (3) Qualified pandemic or epidemic product The term qualified pandemic or epidemic product has the meaning given that term in section 319F–3(i) of the Public Health Service Act (42 U.S.C. 247d–6d(i)).