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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Preservation of Antibiotics for
Medical Treatment Act of 2011''.

SEC. 2. FINDINGS.

The Congress finds the following:
(1) In January 2001, a Federal interagency task force--
(A) released an action plan to address the
continuing decline in effectiveness of antibiotics
against common bacterial infections, referred to as
antibiotic resistance;
(B) determined that antibiotic resistance is a
growing menace to all people and poses a serious threat
to public health; and
(C) cautioned that if current trends continue,
treatments for common infections will become
increasingly limited and expensive, and, in some cases,
nonexistent.
(2) Antibiotic resistance, resulting in a reduced number of
effective antibiotics, may significantly impair the ability of
the United States to respond to terrorist attacks involving
bacterial infections or a large influx of hospitalized
patients.
(3)(A) Any overuse or misuse of antibiotics contributes to
the spread of antibiotic resistance, whether in human medicine
or in agriculture.
(B) Recognizing the public health threat caused by
antibiotic resistance, Congress took several steps to curb
antibiotic overuse in human medicine through amendments to the
Public Health Service Act (42 U.S.C. 201 et seq.) made by
section 102 of the Public Health Threats and Emergencies Act
(Public Law 106-505, title I; 114 Stat. 2315), but has not yet
addressed antibiotic overuse in agriculture.
(4) In a March 2003 report, the National Academy of
Sciences stated that--
(A) a decrease in antimicrobial use in human
medicine alone will have little effect on the current
situation; and
(B) substantial efforts must be made to decrease
inappropriate overuse in animals and agriculture.
(5) In 2010, the FDA determined that--
(A) 13.1 million kilograms of antibacterial drugs
were sold for use on food animals in the United States
in 2009;
(B) 3.3 million kilograms of antibacterial drugs
were used for human health in 2009; and
(C) therefore, 80 percent of antibacterial drugs
disseminated in the United States in 2009 were sold for
use on food animals, rather than being used for human
health.
(6)(A) Large-scale, voluntary surveys by the Department of
Agriculture's Animal and Plant Health Inspection Service in
1999, 2001, and 2006 revealed that--
(i) 84 percent of grower-finisher swine farms, 83
percent of cattle feedlots, and 84 percent of sheep
farms administer antimicrobials in the feed or water
for health or growth promotion reasons; and
(ii) many of the antimicrobials identified are
identical or closely related to drugs used in human
medicine, including tetracyclines, macrolides,
Bacitracin, penicillins, and sulfonamides; and
(B) these drugs are used in people to treat serious
diseases such as pneumonia, scarlet fever, rheumatic fever,
venereal disease, skin infections, and even pandemics like
malaria and plague, as well as bioterrorism agents like
smallpox and anthrax.
(7) Many scientific studies confirm that the nontherapeutic
use of antibiotics in agricultural animals contributes to the
development of antibiotic-resistant bacterial infections in
people.
(8) The periodical entitled ''Clinical Infectious
Diseases'' published a report in June 2002, that--
(A) was based on a 2-year review by experts in
human and veterinary medicine, public health,
microbiology, biostatistics, and risk analysis, of more
than 500 scientific studies on the human health impacts
of antimicrobial use in agriculture; and
(B) recommended that antimicrobial agents should no
longer be used in agriculture in the absence of
disease, but should be limited to therapy for diseased
individual animals and prophylaxis when disease is
documented in a herd or flock.
(9) The United States Geological Survey reported in March
2002 that--
(A) antibiotics were present in 48 percent of the
streams tested nationwide; and
(B) almost half of the tested streams were
downstream from agricultural operations.
(10) An April 1999 study by the General Accounting Office
concluded that resistant strains of 3 microorganisms that cause
food-borne illness or disease in humans (Salmonella,
Campylobacter, and E. coli) are linked to the use of
antibiotics in animals.
(11) Epidemiological research has shown that resistant
Salmonella and Campylobacter infections are associated with
increased numbers of ill patients and bloodstream infections,
and increased death.
(12) In 2010, the peer-reviewed journal Molecular Cell
published a study demonstrating that low-dosage use of
antibiotics causes a dramatic increase in genetic mutation,
raising new concerns about the agricultural practice of using
low-dosage antibiotics in order to stimulate growth promotion
and routinely prevent disease in unhealthy conditions.
(13)(A) In January 2003, Consumer Reports published test
results on poultry products bought in grocery stores nationwide
showing disturbingly high levels of Campylobacter and
Salmonella bacteria that were resistant to the antibiotics used
to treat food-borne illnesses.
(B) The Food and Drug Administration's National
Antimicrobial Resistance Monitoring System routinely finds that
retail meat products are contaminated with bacteria (including
the foodborne pathogens Campylobacter and Salmonella) that are
resistant to antibiotics important in human medicine.
(C) In December 2007, the USDA issued a fact sheet on the
recently recognized link between antimicrobial drug use in
animals and Methicillin Resistant Staphylococcus Aureas (MRSA)
infections in humans.
(14) In October 2001, the New England Journal of Medicine
published an editorial urging a ban on nontherapeutic use of
medically important antibiotics in animals.
(15)(A) In 1998, the National Academy of Sciences noted
that antibiotic-resistant bacteria generate a minimum of
$4,000,000,000 to $5,000,000,000 in costs to United States
society and individuals yearly.
(B) In 2009, Cook County Hospital and the Alliance for
Prudent Use of Antibiotics estimated that the total health care
cost of antibiotic resistant infections in the United States
was between $16,600,000,000 and $26,000,000,000 annually.
(16) The American Medical Association, the American Public
Health Association, the National Association of County and City
Health Officials, and the National Campaign for Sustainable
Agriculture are among the more than 300 organizations
representing health, consumer, agricultural, environmental,
humane, and other interests that have supported enactment of
legislation to phase out nontherapeutic use in farm animals of
medically important antibiotics.
(17) In 2010, the Danish Veterinary and Food Administration
testified that the Danish ban of the non-therapeutic use of
antibiotics in food animal production resulted in a marked
reduction in antimicrobial resistance in multiple bacterial
species, including Campylobacter and Enterococci.
(18) In 2009, the Congressional Research Service concluded
that restrictions overseas on the use of antimicrobial drugs in
the production of livestock could impact U.S. export markets
for livestock and poultry.
(19) The Federal Food, Drug, and Cosmetic Act (21 U.S.C.
301 et seq.)--
(A) requires that all drugs be shown to be safe
before the drugs are approved; and
(B) places the burden on manufacturers to account
for health consequences and prove safety.
(20)(A) The Food and Drug Administration recently modified
the drug approval process for antibiotics to recognize the
development of resistant bacteria as an important aspect of
safety, but most antibiotics currently used in animal
production systems for nontherapeutic purposes were approved
before the Food and Drug Administration began considering
resistance during the drug-approval process.
(B) The Food and Drug Administration has not established a
schedule for reviewing those existing approvals.
(21) Certain non-routine uses of antibiotics in animal
agriculture are legitimate to prevent animal disease.
(22) An April 2004 study by the General Accounting Office--
(A) concluded that Federal agencies do not collect
the critical data on antibiotic use in animals that
they need to support research on human health risks;
and
(B) recommends that the Department of Agriculture
and the Department of Health and Human Services develop
and implement a plan to collect data on antibiotic use
in animals.

SEC. 3. PURPOSE.

The purpose of this Act is to preserve the effectiveness of
medically important antibiotics used in the treatment of human and
animal diseases by reviewing the safety of certain antibiotics for
nontherapeutic purposes in food-producing animals.

SEC. 4. PROOF OF SAFETY OF CRITICAL ANTIMICROBIAL ANIMAL DRUGS.

(a) Definitions.--Section 201 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 321) is amended by adding at the end the
following:
''(ss) Critical Antimicrobial Animal Drug.--The term 'critical
antimicrobial animal drug' means a drug that--
''(1) is intended for use in food-producing animals; and
''(2) is composed wholly or partly of--
''(A) any kind of penicillin, tetracycline,
macrolide, lincosamide, streptogramin, aminoglycoside,
or sulfonamide; or
''(B) any other drug or derivative of a drug that
is used in humans or intended for use in humans to
treat or prevent disease or infection caused by
microorganisms.
''(tt) Nontherapeutic Use.--The term 'nontherapeutic use', with
respect to a critical antimicrobial animal drug, means any use of the
drug as a feed or water additive for an animal in the absence of any
clinical sign of disease in the animal for growth promotion, feed
efficiency, weight gain, routine disease prevention, or other routine
purpose.''.
(b) Applications Pending or Submitted After Enactment.--Section
512(d)(1) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
360b(d)(1)) is amended--
(1) in the first sentence--
(A) in subparagraph (H), by striking ''or'' at the
end;
(B) in subparagraph (I), by inserting ''or'' at the
end; and
(C) by inserting after subparagraph (I) the
following:
''(J) with respect to a critical antimicrobial
animal drug or a drug of the same chemical class as a
critical antimicrobial animal drug, the applicant has
failed to demonstrate that there is a reasonable
certainty of no harm to human health due to the
development of antimicrobial resistance that is
attributable, in whole or in part, to the
nontherapeutic use of the drug; or''; and
(2) in the second sentence, by striking ''(A) through (I)''
and inserting ''(A) through (J)''.
(c) Phased Elimination of Nontherapeutic Use in Animals of Critical
Antimicrobial Animal Drugs Important for Human Health.--Section 512 of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360b) is amended by
adding at the end the following:
''(q) Phased Elimination of Nontherapeutic Use in Animals of
Critical Antimicrobial Animal Drugs Important for Human Health.--
''(1) Applicability.--This subsection applies to the
nontherapeutic use in a food-producing animal of a drug--
''(A)(i) that is a critical antimicrobial animal
drug; or
''(ii) that is of the same chemical class as a
critical antimicrobial animal drug; and
''(B)(i) for which there is in effect an approval
of an application or an exemption under subsection (b),
(i), or (j) of section 505; or
''(ii) that is otherwise marketed for use.
''(2) Withdrawal.--The Secretary shall withdraw the
approval of a nontherapeutic use in food-producing animals
described in paragraph (1) on the date that is 2 years after
the date of enactment of this subsection unless--
''(A) before the date that is 2 years after the
date of the enactment of this subsection, the Secretary
makes a final written determination that the holder of
the approved application has demonstrated that there is
a reasonable certainty of no harm to human health due
to the development of antimicrobial resistance that is
attributable in whole or in part to the nontherapeutic
use of the drug; or
''(B) before the date specified in subparagraph
(A), the Secretary makes a final written determination
under this subsection, with respect to a risk analysis
of the drug conducted by the Secretary and other
relevant information, that there is a reasonable
certainty of no harm to human health due to the
development of antimicrobial resistance that is
attributable in whole or in part to the nontherapeutic
use of the drug.
''(3) Exemptions.--Except as provided in paragraph (5), if
the Secretary grants an exemption under section 505(i) for a
drug that is a critical antimicrobial animal drug, the
Secretary shall rescind each approval of a nontherapeutic use
in a food-producing animal of the critical antimicrobial animal
drug, or of a drug in the same chemical class as the critical
antimicrobial animal drug, as of the date that is 2 years after
the date on which the Secretary grants the exemption.
''(4) Approvals.--Except as provided in paragraph (5), if
an application for a drug that is a critical antimicrobial
animal drug is submitted to the Secretary under section 505(b),
the Secretary shall rescind each approval of a nontherapeutic
use in a food-producing animal of the critical antimicrobial
animal drug, or of a drug in the same chemical class as the
critical antimicrobial animal drug, as of the date that is 2
years after the date on which the application is submitted to
the Secretary.
''(5) Exception.--Paragraph (3) or (4), as the case may be,
shall not apply if--
''(A) before the date on which approval would be
rescinded under that paragraph, the Secretary makes a
final written determination that the holder of the
application for the approved nontherapeutic use has
demonstrated that there is a reasonable certainty of no
harm to human health due to the development of
antimicrobial resistance that is attributable in whole
or in part to the nontherapeutic use in the food-
producing animal of the critical antimicrobial animal
drug; or
''(B) before the date specified in subparagraph
(A), the Secretary makes a final written determination
under this subsection, with respect to a risk analysis
of the critical antimicrobial animal drug conducted by
the Secretary and any other relevant information, that
there is a reasonable certainty of no harm to human
health due to the development of antimicrobial
resistance that is attributable in whole or in part to
the nontherapeutic use of the drug.''.

SEC. 5. COMMITTEE HEARINGS ON IMPLEMENTATION.

(a) In General.--The Committee on Energy and Commerce of the House
of Representatives and the Committee on Energy of the Senate shall each
hold a hearing on the implementation by the Commissioner of Food and
Drugs of section 512(q) of the Federal Food, Drug, and Cosmetic Act, as
added by section 4 of this Act.
(b) Exercise of Rulemaking Authority.--Subsection (a) is enacted--
(1) as an exercise of the rulemaking power of the House of
Representatives and Senate, and, as such, they shall be
considered as part of the rules of the House or Senate (as the
case may be), and such rules shall supersede any other rule of
the House or Senate only to the extent that rule is
inconsistent therewith; and
(2) with full recognition of the constitutional right of
either House to change such rules (so far as relating to the
procedure in such House) at any time, in the same manner, and
to the same extent as in the case of any other rule of the
House or Senate.
Preservation of Antibiotics for Medical Treatment Act of 2011 - Amends the Federal Food, Drug, and Cosmetic Act to require the Secretary of Health and Human Services (HHS) to deny an application for a new animal drug that is a critical antimicrobial animal drug unless the applicant demonstrates that there is a reasonably certainty of no harm to human health due to the development of antimicrobial resistance attributable to the nontherapeutic use of the drug. Defines "critical antimicrobial animal drug" as a drug intended for use in food-producing animals that contains specified antibiotics or other drugs used in humans to treat or prevent disease or infection caused by microorganisms.

Requires the Secretary to withdraw approval of a nontherapeutic use of such drugs in food-producing animals two years after the date of enactment of this Act unless certain safety requirements are met. Directs specified congressional committees to hold hearings on the implementation of such a withdrawal of approval.

SECTION 1. SHORT TITLE.

This Act may be cited as the ''Senator Paul Simon Water for the
World Act of 2009''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) The Senator Paul Simon Water for the Poor Act of 2005
(Public Law 109-121)--
(A) makes access to safe water and sanitation for
developing countries a specific policy objective of
United States foreign assistance programs;
(B) requires the Secretary of State to--
(i) develop a strategy to elevate the role
of water and sanitation policy; and
(ii) improve the effectiveness of United
States assistance programs undertaken in
support of that strategy;
(C) codifies Target 10 of the United Nations
Millennium Development Goals; and
(D) seeks to reduce by half between 1990 (the
baseline year) and 2015--
(i) the proportion of people who are unable
to reach or afford safe drinking water; and
(ii) the proportion of people without
access to basic sanitation.
(2) On December 20, 2006, the United Nations General
Assembly, in GA Resolution 61/192, declared 2008 as the
International Year of Sanitation, in recognition of the impact
of sanitation on public health, poverty reduction, economic and
social development, and the environment.
(3) On August 1, 2008, Congress passed H. Con. Res. 318,
which--
(A) supports the goals and ideals of the
International Year of Sanitation; and
(B) recognizes the importance of sanitation on
public health, poverty reduction, economic and social
development, and the environment.
(4) While progress is being made on safe water and
sanitation efforts--
(A) more than 884,000,000 people throughout the
world lack access to safe drinking water; and
(B) 2 of every 5 people in the world do not have
access to basic sanitation services.
(5) The health consequences of unsafe drinking water and
poor sanitation are significant, accounting for--
(A) nearly 10 percent of the global burden of
disease; and
(B) more than 2,000,000 deaths each year.
(6) The effects of climate change are expected to produce
severe consequences for water availability and resource
management in the future, with 2,800,000,000 people in more
than 48 countries expected to face severe and chronic water
shortages by 2025.
(7) According to the November 2008 report entitled,
''Global Trends 2025: A Transformed World'', the National
Intelligence Council expects rapid urbanization and future
population growth to exacerbate already limited access to
water, particularly in agriculture-based economies.
(8) A 2009 report published in the Proceedings of the
National Academy of Sciences projects that the effects of
climate change will produce long-term droughts and raise sea
levels for the next 1,000 years, regardless of future efforts
to combat climate change.
(9) According to the 2005 Millennium Ecosystem Assessment,
commissioned by the United Nations, more than /5\ of the
world population relies on freshwater that is either polluted
or excessively withdrawn.
(10) The impact of water scarcity on conflict and
instability is evident in many parts of the world, including
the Darfur region of Sudan, where demand for water resources
has contributed to armed conflict between nomadic ethnic groups
and local farming communities.
(11) In order to further the United States contribution to
safe water and sanitation efforts, it is necessary to--
(A) expand foreign assistance capacity to address
the challenges described in this section; and
(B) represent issues related to water and
sanitation at the highest levels of United States
foreign assistance and diplomatic deliberations,
including those related to issues of global health,
food security, the environment, global warming, and
maternal and child mortality.

SEC. 3. SENSE OF CONGRESS.

It is the sense of Congress that the United States should lead a
global effort to bring sustainable access to clean water and sanitation
to poor people throughout the world.

SEC. 4. PURPOSE.

The purpose of this Act is--
(1) to provide first-time access to safe water and
sanitation, on a sustainable basis, for 100,000,000 people in
high priority countries (as designated under section 6(f) of
the Senator Paul Simon Water for the Poor Act of 2005 (22
U.S.C. 2152h note)) by 2015; and
(2) to enhance the capacity of the United States Government
to fully implement the Senator Paul Simon Water for the Poor
Act of 2005 (Public Law 109-121).

SEC. 5. DEVELOPING UNITED STATES GOVERNMENT CAPACITY.

Section 135 of the Foreign Assistance Act of 1961 (22 U.S.C. 2152h)
is amended by adding at the end the following:
''(e) Office of Water.--
''(1) Establishment.--To carry out the purposes of
subsection (a), the Administrator of the United States Agency
for International Development shall establish the Office of
Water within the Bureau for Economic Growth, Agriculture, and
Trade.
''(2) Leadership.--The Office of Water shall be headed by a
Director for Safe Water and Sanitation, who shall report
directly to the Assistant Administrator of the Bureau for
Economic Growth, Agriculture, and Trade.
''(3) Duties.--The Director shall--
''(A) implement this section and the Senator Paul
Simon Water for the Poor Act of 2005 (Public Law 109-
121);
''(B) develop and implement country-specific water
strategies and expertise, in collaboration with
appropriate United States Agency for International
Development Mission Directors, to meet the goal of
providing 100,000,000 additional people with
sustainable access to safe water and sanitation by
2015; and
''(C) place primary emphasis on providing safe,
affordable, and sustainable drinking water, sanitation,
and hygiene in a manner that--
''(i) is consistent with sound water
resource management principles; and
''(ii) utilizes such approaches as direct
service provision, capacity building,
institutional strengthening, regulatory reform,
and partnership collaboration.
''(4) Capacity.--The Director may utilize interagency
details or partnerships with universities, civil society, and
the private sector, as needed, to strengthen implementation
capacity.
''(f) Special Coordinator for International Water.--
''(1) Establishment.--To increase the capacity of the
Department of State to address international issues regarding
safe water, sanitation, integrated river basin management, and
other international water programs, the Secretary of State
shall establish a Special Coordinator for International Water
(referred to in this subsection as the 'Special Coordinator'),
who shall report to the Under Secretary for Democracy and
Global Affairs.
''(2) Duties.--The Special Coordinator shall--
''(A) oversee and coordinate the diplomatic policy
of the United States Government with respect to global
freshwater issues, including interagency coordination
related to--
''(i) sustainable access to safe drinking
water, sanitation, and hygiene;
''(ii) integrated river basin and watershed
management;
''(iii) transboundary conflict;
''(iv) agricultural and urban productivity
of water resources;
''(v) disaster recovery, response, and
rebuilding;
''(vi) pollution mitigation; and
''(vii) adaptation to hydrologic change due
to climate variability; and
''(B) ensure that international freshwater issues
are represented--
''(i) within the United States Government;
and
''(ii) in key diplomatic, development, and
scientific efforts with other nations and
multilateral organizations.
''(3) Staff.--The Special Coordinator is authorized to hire
a limited number of staff to carry out the duties described in
paragraph (2).''.

SEC. 6. SAFE WATER, SANITATION, AND HYGIENE STRATEGY.

Section 6 of the Senator Paul Simon Water for the Poor Act of 2005
(22 U.S.C. 2152h note) is amended--
(1) in subsection (c), by adding at the end the following:
''In developing the program activities needed to implement the
strategy, the Secretary shall consider the results of the
assessment described in subsection (e)(9).''; and
(2) in subsection (e)--
(A) in paragraph (5), by striking ''and'' at the
end;
(B) in paragraph (6), by striking the period at the
end and inserting a semicolon; and
(C) by adding at the end the following:
''(7) an assessment of all United States Government foreign
assistance allocated to the drinking water and sanitation
sector during the 3 previous fiscal years, across all United
States Government agencies and programs, including an
assessment of the extent to which the United States
Government's efforts are reaching the goal of providing first-
time access to safe water and sanitation on a sustainable basis
for 100,000,000 people in high priority countries;
''(8) recommendations on what the United States Government
would need to do to achieve the goals referred to in paragraph
(7), in support of the United Nation's Millennium Development
Goal on access to safe drinking water; and
''(9) an assessment of best practices for mobilizing and
leveraging the financial and technical capacity of business,
governments, nongovernmental organizations, and civil society
in forming public-private partnerships that measurably increase
access to safe drinking water and sanitation.''.

SEC. 7. DEVELOPING LOCAL CAPACITY.

The Senator Paul Simon Water for the Poor Act of 2005 (Public Law
109-121) is amended--
(1) by redesignating sections 9, 10, and 11 as sections 10,
11, and 12, respectively; and
(2) by inserting after section 8 the following:

''SEC. 9. WATER AND SANITATION INSTITUTIONAL CAPACITY-BUILDING PROGRAM.

''(a) Establishment.--
''(1) In general.--The Secretary of State and the
Administrator of the United States Agency for International
Development (referred to in this section as the 'Secretary' and
the 'Administrator', respectively), in consultation with host
country institutions, the Centers for Disease Control and
Prevention, the Department of Agriculture, and other agencies,
as appropriate, shall establish, in every high priority
country, a program to build the capacity of host country
institutions and officials responsible for water and sanitation
in countries that receive assistance under section 135 of the
Foreign Assistance Act of 1961, including training at
appropriate levels, to--
''(A) provide affordable, equitable, and
sustainable access to safe drinking water and
sanitation;
''(B) educate the populations of such countries
about the dangers of unsafe drinking water and lack of
proper sanitation; and
''(C) encourage behavior change to reduce
individuals' risk of disease from unsafe drinking water
and lack of proper sanitation and hygiene.
''(2) Coordination.--The programs established under
subsection (a) shall be coordinated in each country by the lead
country water manager designated in subsection (b)(2).
''(3) Expansion.--The Secretary and the Administrator may
establish the program described in this section in additional
countries if the receipt of such capacity building would be
beneficial for promoting access to safe drinking water and
sanitation, with due consideration given to good governance.
''(4) Capacity.--The Secretary and the Administrator--
''(A) shall designate staff with appropriate
expertise to carry out the strategy developed under
section 4; and
''(B) may utilize, as needed, interagency details
or partnerships with universities, civil society, and
the private sector to strengthen implementation
capacity.
''(b) Designation.--The United States Agency for International
Development Mission Director for each country receiving a 'high
priority' designation under section 6(f) and for each region containing
a country receiving such designation shall--
''(1) designate safe drinking water and sanitation as a
strategic objective;
''(2) appoint an employee of the United States Agency for
International Development as in-country water and sanitation
manager to coordinate the in-country implementation of this Act
and section 135 of the Foreign Assistance Act of 1961 (22
U.S.C. 2152h) with host country officials at various levels of
government responsible for water and sanitation, the Department
of State, and other relevant United States Government agencies;
and
''(3) coordinate with the Development Credit Authority and
the Global Development Alliance to further the purposes of this
Act.''.

SEC. 8. OTHER ACTIVITIES SUPPORTED.

Section 135(c) of the Foreign Assistance Act (22 U.S.C. 2152h(c))
is amended--
(1) in paragraph (3), by striking ''and'' at the end;
(2) in paragraph (4), by striking the period at the end;
and
(3) by adding at the end the following:
''(5) foster global cooperation on research and technology
development, including regional partnerships among water
experts to address safe drinking water, sanitation, water
resource management, and other water-related issues;
''(6) establish regional and cross-border cooperative
activities between scientists and specialists that work to
share technologies and best practices, mitigate shared water
challenges, foster international cooperation, and defuse cross-
border tensions;
''(7) provide grants through the United States Agency for
International Development to foster the development,
dissemination, and increased and consistent use of low cost and
sustainable technologies, such as household water treatment,
hand washing stations, and latrines, for providing safe
drinking water, sanitation, and hygiene that are suitable for
use in high priority countries, particularly in places with
limited resources and infrastructure;
''(8) in collaboration with the Centers for Disease Control
and Prevention, Department of Agriculture, the Environmental
Protection Agency, the National Oceanic and Atmospheric
Administration, and other agencies, as appropriate, conduct
formative and operational research and monitor and evaluate the
effectiveness of programs that provide safe drinking water and
sanitation; and
''(9) integrate efforts to promote safe drinking water,
sanitation and hygiene with existing foreign assistance
programs, as appropriate, including activities focused on HIV/
AIDS, malaria, tuberculosis, maternal and child health, food
security, and nutritional support.''.

SEC. 9. UPDATED REPORT REGARDING WATER FOR PEACE AND SECURITY.

Section 11(b) of the Senator Paul Simon Water for the Poor Act of
2005, as redesignated by section 7, is amended by adding at the end the
following: ''The report submitted under this subsection shall include
an assessment of current and likely future political tensions over
water sources and multidisciplinary assessment of the expected impacts
of global climate change on water supplies in 10, 25, and 50 years.''.

SEC. 10. AUTHORIZATION OF APPROPRIATIONS.

(a) In General.--There are authorized to be appropriated for fiscal
year 2009 and for each subsequent fiscal year such sums as may be
necessary to carry out this Act and the amendments made by this Act,
pursuant to the criteria set forth in the Senator Paul Simon Water for
the Poor Act of 2005 (Public Law 109-121).
(b) Use of Funds.--
(1) General water resource management activities.--Up to 20
percent of the amounts appropriated to implement this Act may
be used to support general water resource management activities
that improve countries' overall water sources.
(2) Other activities.--Any amounts appropriated to
implement this Act that are not used to carry out the
activities described in paragraph (1) shall be allocated for
activities related to safe drinking water, sanitation, and
hygiene.
Senator Paul Simon Water for the World Act of 2009 - Amends the Foreign Assistance Act of 1961 to direct the Administrator of the United States Agency for International Development (USAID) to establish the Office of Water within the Bureau for Economic Growth, Agriculture, and Trade to: (1) give assistance to provide safe water and sanitation for people worldwide; and (2) be headed by a Director for Safe Water and Sanitation. Outlines the Director's duties.

Requires the Secretary of State, in order to increase the capacity of the Department of State to address international issues regarding safe water, sanitation, integrated river basin management, and other international water programs, to establish a Special Coordinator for International Water. Outlines the Special Coordinator's duties.

Amends the Senator Paul Simon Water for the Poor Act of 2005 to: (1) revise requirements concerning the safe water and sanitation strategy; (2) provide for the establishment of a program to build the capacity of host country institutions and officials responsible for water and sanitation in countries that receive assistance to provide safe water and sanitation under the Foreign Assistance Act of 1961; (3) expand the list of activities that may be supported by assistance furnished by the President for programs in developing countries to provide affordable and equitable access to safe water and sanitation; and (4) require the report regarding water for peace and security to include an assessment of political tensions over water sources and a multidisciplinary assessment of the expected impacts of global climate change on water supplies in 10, 25, and 50 years.

SECTION 1. SHORT TITLE.

This Act may be cited as the ''National Defense Enhancement and
National Guard Empowerment Act of 2006''.

SEC. 2. EXPANDED AUTHORITY OF CHIEF OF THE NATIONAL GUARD BUREAU AND
EXPANDED FUNCTIONS OF THE NATIONAL GUARD BUREAU.

(a) Expanded Authority.--
(1) In general.--Subsection (a) of section 10501 of title
10, United States Code, is amended by striking ''joint bureau
of the Department of the Army and the Department of the Air
Force'' and inserting ''joint activity of the Department of
Defense''.
(2) Purpose.--Subsection (b) of such section is amended by
striking ''between'' and all that follows and inserting
''between--
''(1)(A) the Secretary of Defense, the Joint Chiefs of
Staff, and the commanders of the combatant commands for the
United States, and (B) the Department of the Army and the
Department of the Air Force; and
''(2) the several States.''.
(b) Enhancements of Position of Chief of the National Guard
Bureau.--
(1) Advisory function on national guard matters.--
Subsection (c) of section 10502 of title 10, United States
Code, is amended by inserting ''to the Secretary of Defense, to
the Chairman of the Joint Chiefs of Staff,'' after ''principal
advisor''.
(2) Member of joint chiefs of staff.--(A) Such section is
further amended--
(i) by redesignating subsection (d) as subsection
(e); and
(ii) by inserting after subsection (c) the
following new subsection (d):
''(d) Member of Joint Chiefs of Staff.--The Chief of the National
Guard Bureau shall perform the duties prescribed for him or her as a
member of the Joint Chiefs of Staff under section 151 of this title.''.
(B) Section 151(a) of such title is amended by adding at
the end the following new paragraph:
''(7) The Chief of the National Guard Bureau.''.
(3) Grade.--Subsection (e) of such section, as redesignated
by paragraph (2)(A)(i) of this subsection, is further amended
by striking ''lieutenant general'' and inserting ''general''.
(4) Annual report to congress on validated requirements.--
Section 10504 of such title is amended by adding at the end the
following new subsection:
''(c) Annual Report on Validated Requirements.--Not later than
December 31 each year, the Chief of the National Guard Bureau shall
submit to Congress a report on the following:
''(1) The requirements validated under section 10503a(b)(1)
of this title during the preceding fiscal year.
''(2) The requirements referred to in paragraph (1) for
which funding is to be requested in the next budget for a
fiscal year under section 10544 of this title.
''(3) The requirements referred to in paragraph (1) for
which funding will not be requested in the next budget for a
fiscal year under section 10544 of this title.''.
(c) Enhancement of Functions of National Guard Bureau.--
(1) Development of charter.--Section 10503 of title 10,
United States Code, is amended--
(A) in the matter preceding paragraph (1), by
striking ''The Secretary of the Army and the Secretary
of the Air Force shall jointly develop'' and inserting
''The Secretary of Defense, in consultation with the
Secretary of the Army and the Secretary of the Air
Force, shall develop''; and
(B) in paragraph (12), by striking ''the
Secretaries'' and inserting ''the Secretary of
Defense''.
(2) Additional general functions.--Such section is further
amended--
(A) by redesignating paragraph (12), as amended by
paragraph (1)(B) of this subsection, as paragraph (13);
and
(B) by inserting after paragraph (11) the following
new paragraph (12):
''(12) Facilitating and coordinating with other Federal
agencies, and with the several States, the use of National
Guard personnel and resources for and in contingency
operations, military operations other than war, natural
disasters, support of civil authorities, and other
circumstances.''.
(3) Military assistance for civil authorities.--Chapter
1011 of such title is further amended by inserting after
section 10503 the following new section:
''Sec. 10503a. Functions of National Guard Bureau: military assistance
to civil authorities
''(a) Identification of Additional Necessary Assistance.--The Chief
of the National Guard Bureau shall--
''(1) identify gaps between Federal and State capabilities
to prepare for and respond to emergencies; and
''(2) make recommendations to the Secretary of Defense on
programs and activities of the National Guard for military
assistance to civil authorities to address such gaps.
''(b) Scope of Responsibilities.--In meeting the requirements of
subsection (a), the Chief of the National Guard Bureau shall, in
coordination with the Adjutant Generals of the States, have
responsibilities as follows:
''(1) To validate the requirements of the several States
and Territories with respect to military assistance to civil
authorities.
''(2) To develop doctrine and training requirements
relating to the provision of military assistance to civil
authorities.
''(3) To acquire equipment, materiel, and other supplies
and services for the provision of military assistance to civil
authorities.
''(4) To assist the Secretary of Defense in preparing the
budget required under section 10544 of this title.
''(5) To administer amounts provided the National Guard for
the provision of military assistance to civil authorities.
''(6) To carry out any other responsibility relating to the
provision of military assistance to civil authorities as the
Secretary of Defense shall specify.
''(c) Assistance.--The Chairman of the Joint Chiefs of Staff shall
assist the Chief of the National Guard Bureau in carrying out
activities under this section.
''(d) Consultation.--The Chief of the National Guard Bureau shall
carry out activities under this section in consultation with the
Secretary of the Army and the Secretary of the Air Force.''.
(4) Budgeting for training and equipment for military
assistance to civil authorities and other domestic missions.--
Chapter 1013 of title 10, United States Code, is amended by
adding at the end the following new section:
''Sec. 10544. National Guard training and equipment: budget for
military assistance to civil authorities and for other
domestic operations
''(a) In General.--The budget justification documents materials
submitted to Congress in support of the budget of the President for a
fiscal year (as submitted with the budget of the President under
section 1105(a) of title 31) shall specify separate amounts for
training and equipment for the National Guard for purposes of military
assistance to civil authorities and for other domestic operations
during such fiscal year.
''(b) Scope of Funding.--The amounts specified under subsection (a)
for a fiscal year shall be sufficient for purposes as follows:
''(1) The development and implementation of doctrine and
training requirements applicable to the assistance and
operations described in subsection (a) for such fiscal year.
''(2) The acquisition of equipment, materiel, and other
supplies and services necessary for the provision of such
assistance and such operations in such fiscal year.''.
(5) Limitation on increase in personnel of national guard
bureau.--The Secretary of Defense shall, to the extent
practicable, ensure that no additional personnel are assigned
to the National Guard Bureau in order to address administrative
or other requirements arising out of the amendments made by
this subsection.
(d) Conforming and Clerical Amendments.--
(1) Conforming amendment.--The heading of section 10503 of
such title is amended to read as follows:
''Sec. 10503. Functions of National Guard Bureau: charter''.
(2) Clerical amendments.--(A) The table of sections at the
beginning of chapter 1011 of such title is amended by striking
the item relating to section 10503 and inserting the following
new items:

''10503. Functions of National Guard Bureau: charter.
''10503a. Functions of National Guard Bureau: military assistance to
civil authorities.''.
(B) The table of sections at the beginning of chapter 1013
of such title is amended by adding at the end the following new
item:

''10544. National Guard training and equipment: budget for military
assistance to civil authorities and for
other domestic operations.''.
(e) Termination of Position of Assistant to Chairman of Joint
Chiefs of Staff for National Guard Matters.--Section 901 of the
National Defense Authorization Act for Fiscal Year 1998 (Public Law
105-85; 111 Stat. 1853; 10 U.S.C. 155 note) is amended to read as
follows:

''SEC. 901. ASSISTANT TO THE CHAIRMAN OF THE JOINT CHIEFS OF STAFF FOR
RESERVE MATTERS.

''(a) In General.--There is within the Joint Staff the position of
Assistant to the Chairman of the Joint Chiefs of Staff for Reserve
Matters.
''(b) Selection.--The Assistant to the Chairman of the Joint Chiefs
of Staff for Reserve Matters shall be selected by the Chairman from
officers of the Army Reserve, the Navy Reserve, the Marine Corps
Reserve, or the Air Force Reserve who--
''(1) are recommended for such selection by the Secretary
of the military department concerned;
''(2) have had at least 10 years of commissioned service in
their reserve component; and
''(3) are in a grade above colonel or, in the case the Navy
Reserve, captain.
''(c) Term of Office.--The Assistant to the Chairman of the Joint
Chiefs of Staff for Reserve Matters serves at the pleasure of the
Chairman for a term of two years and may be continued in that
assignment in the same manner, for one additional term. However, in a
time of war there is no limit on the number of terms.
''(d) Grade.--The Assistant to the Chairman of the Joint Chiefs of
Staff for Reserve Matters while so serving, holds the grade of major
general or, in the case of the Navy Reserve, rear admiral. The officer
serving in the position shall be considered to be serving in a position
external to that officer's Armed Force for purposes of section 721 of
title 10, United States Code.
''(e) Duties.--The Assistant to the Chairman of the Joint Chiefs of
Staff for Reserve Matters is an advisor to the Chairman on matters
relating to the reserves and performs the duties prescribed for the
position by the Chairman.
''(f) Other Reserve Component Representation on Joint Staff.--The
Secretary of Defense, in consultation with the Chairman of the Joint
Chiefs of Staff, shall develop appropriate policy guidance to ensure
that, to the maximum extent practicable, the level of reserve component
officer representation within the Joint Staff is commensurate with the
significant role of the reserve components within the Total Force.''.

SEC. 3. PROMOTION OF ELIGIBLE RESERVE OFFICERS TO LIEUTENANT GENERAL
AND VICE ADMIRAL GRADES ON THE ACTIVE-DUTY LIST.

(a) Sense of Congress.--It is the sense of Congress that, whenever
officers are considered for promotion to the grade of lieutenant
general, or vice admiral in the case of the Navy, on the active duty
list, officers of the reserve components of the Armed Forces who are
eligible for promotion to such grade should be considered for promotion
to such grade.
(b) Proposal.--The Secretary of Defense shall submit to Congress a
proposal for mechanisms to achieve the objective specified in
subsection (a). The proposal shall include such recommendations for
legislative or administrative action as the Secretary considers
appropriate in order to achieve that objective.
(c) Notice Accompanying Nominations.--The President shall include
with each nomination of an officer to the grade of lieutenant general,
or vice admiral in the case of the Navy, on the active-duty list that
is submitted to the Senate for consideration a certification that all
reserve officers who were eligible for consideration for promotion to
such grade were considered in the making of such nomination.

SEC. 4. REQUIREMENT THAT POSITION OF DEPUTY COMMANDER OF THE UNITED
STATES NORTHERN COMMAND BE FILLED BY A QUALIFIED NATIONAL
GUARD OFFICER.

(a) In General.--The position of Deputy Commander of the United
States Northern Command shall be filled by a qualified officer of the
National Guard who is eligible for promotion to the grade of lieutenant
general.
(b) Purpose.--The purpose of the requirement in subsection (a) is
to ensure that information received from the National Guard Bureau
regarding the operation of the National Guard of the several States is
integrated into the plans and operations of the United States Northern
Command.
National Defense Enhancement and National Guard Empowerment Act of 2006 - Expands the: (1) authority of the Chief of the National Guard Bureau (Bureau) to include membership on the Joint Chiefs of Staff (JCS) (and raises the grade of the Chief from lieutenant general to general); and (2) functions of the Bureau to include facilitating and coordinating, with other federal agencies and the states, the use of Guard personnel and resources for, and in, contingency operations, military operations other than war, natural disasters, and support of civil authorities.

Directs the Chief to: (1) identify gaps between federal and state capabilities to prepare for and respond to emergencies; and (2) make recommendations to the Secretary of Defense on Guard programs and activities to address such gaps.

Requires annual Department of Defense (DOD) budget justification documents to include separate amounts for Guard training and equipment for military assistance to civil authorities and other domestic operations.

Establishes within the JCS an Assistant to the Chairman of the Joint Chiefs of Staff for Reserve Matters.

Expresses the sense of Congress calling for consideration of eligible reserve officers for promotion to the grades of lieutenant general or vice admiral on the active duty list.

Requires the position of Deputy Commander of the U.S. Northern Command to be filled by a qualified Guard officer eligible for promotion to the grade of lieutenant general.