[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3302 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
2d Session
S. 3302
To improve global health security, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 13, 2020
Mr. King introduced the following bill; which was read twice and
referred to the Committee on Foreign Relations
_______________________________________________________________________
A BILL
To improve global health security, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Global Health Security Act of
2020''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) An infectious disease threat anywhere can become a
threat everywhere. In today's interconnected world, a pathogen
can travel around the globe to major cities in as few as 24
hours.
(2) Infectious diseases have killed more humans than war
and conflict. Before its eradication, smallpox killed at least
300,000,000 people in the 20th century. Mosquito-borne
illnesses are responsible for 50 percent more human deaths each
year than deaths caused by other humans, including war and
civil violence. The influenza pandemic of 1918-19 caused the
deaths of 3 times as many people as all of those killed in
World War I.
(3) Population growth has brought people closer to one
another and closer to animals, which has increased the
opportunities for pathogens to be transmitted between animals
and humans.
(4) Human health is intimately connected to animal and
environmental health at the national and international levels.
(5) Zoonotic diseases are responsible for--
(A) approximately 60 percent of all human
infections;
(B) approximately 75 percent of recently emerging
infectious diseases affecting humans; and
(C) more than 80 percent of biological agents that
could be intentionally released as biological weapons.
(6) Environmental change has made it easy for disease
vectors, such as mosquitoes, to cover more territory.
(7) There are many recent examples of new, reemerging, and
zoonotic pathogens quickly spreading across the globe,
including--
(A) Ebola virus disease, which killed more than
11,000 people and infected more than 28,000 people in
West Africa between 2014 and 2016, and which has
infected and killed an unknown number of people in the
Democratic Republic of the Congo since 2018;
(B) novel coronavirus disease (COVID), which, as of
February 12, 2020, had infected at least 45,000 people
in at least 25 countries, resulting in more than 1,100
deaths in China;
(C) yellow fever virus;
(D) cholera;
(E) avian influenza virus (H7N9);
(F) novel Middle East Respiratory Syndrome (MERS)
coronavirus; and
(G) Zika virus.
(8) The costs of new, reemerging, and zoonotic infections
are high in human and financial terms. For example--
(A) the anthrax attacks in the eastern United
States in late 2001 infected 22 people, killed 5, and
cost more than $1,000,000,000 to clean up;
(B) an outbreak of severe acute respiratory
syndrome (SARS) originating in southern China in late
2002 infected more than 8,000 people, resulted in 774
deaths, and had an economic impact estimated at
$30,000,000,000 in only a few months;
(C) the 2009 H1N1 influenza pandemic killed an
estimated 284,000 people in a single year; and
(D) human immunodeficiency virus (HIV) spread
silently for decades before detection, has led to the
death of 35,000,000 people, and currently affects
37,000,000 people who are living with the virus.
(9) The enormous costs of pandemics can be averted with
strategic investment in capacity building and preparedness.
(10) The Global Health Security Agenda, which was launched
in February 2014 in partnership with countries from around the
world, is designed--
(A) to measurably address global vulnerability to
infectious diseases;
(B) to strengthen systems; and
(C) to ensure that a trained workforce has the
tools needed to prevent, detect, and respond rapidly
and effectively to infectious disease threats.
(11) Stopping an outbreak at its source, whether naturally
occurring, deliberate, or accidental, requires close
collaboration among the health, animal, agriculture, defense,
security, development, commercial, and other sectors.
SEC. 3. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) advancing global health security is a core tenet of our
national strategy for countering biological threats;
(2) supporting global health security requires
operationalizing the ``One Health'' concept linking human,
animal, and environmental health;
(3) the United States must be prepared to prevent, detect,
and respond to the threat posed by bioterrorism, as well as
accidental releases from a laboratory;
(4) it is in the national interest of the United States--
(A) to promote global health security; and
(B) to accelerate efforts to build the capacity of
countries--
(i) to prevent, detect, and respond to
infectious diseases; and
(ii) to achieve the core capacities
required by the World Health Organization's
International Health Regulations, adopted at
Geneva May 23, 2005;
(5) no single nation can be prepared or protected if other
nations remain unprepared to counter biological threats;
(6) national and international multi-sectoral cooperation
and preparedness are at the core of effective control of
infectious diseases through strengthened health systems and
preparedness;
(7) global health security depends upon collaborations
across all societal sectors, including human and animal health,
agriculture, development, environmental, national security and
defense, science and technology, academic and research
communities, nongovernmental organizations, and the private
sector, to meet the policy objective set forth in section 4(3)
of strengthening health systems and pandemic preparedness;
(8) an effective global health security strategy should
include--
(A) preventing avoidable incidents and
catastrophes, such as antimicrobial resistance,
zoonotic diseases, outbreaks, breaches of biosafety and
security, and immunization-preventable deaths;
(B) detecting threats early through--
(i) building and sustaining national and
global laboratory systems;
(ii) improving disease surveillance;
(iii) enhancing the reporting of infectious
disease outbreaks; and
(iv) developing the health workforce; and
(C) responding to threats rapidly and effectively
through--
(i) emergency operations centers;
(ii) linking public health with
multisectoral rapid response; and
(iii) medical countermeasures and personnel
deployment;
(9) strategic global health security action requires United
States coordination and collaboration with international
governance entities, including--
(A) the World Health Organization;
(B) the Food and Agriculture Organization of the
United Nations;
(C) the World Organization for Animal Health;
(D) the Global Partnership Against the Spread of
Weapons and Materials of Mass Destruction;
(E) the International Criminal Police Organization
(commonly known as ``INTERPOL'');
(F) the Economic Community of West African States;
(G) the United Nations Office for Disaster Risk
Reduction;
(H) the Global Alliance for Vaccines and
Immunization (commonly known as ``GAVI''); and
(I) other relevant international stakeholders and
organizations; and
(10) the strategic goals described in paragraph (8) must be
subject to measurement, assessment, and analysis.
SEC. 4. DEFINED TERM.
In this Act, the term ``global health security'' means the
activities required to minimize the danger and impact of acute public
health events that endanger the collective health of populations living
across geographical regions and international boundaries.
SEC. 5. POLICY OBJECTIVES.
It is the policy of the United States--
(1) to advance global health security through engagement in
a multi-faceted, multi-country, multi-sectoral framework to
accelerate targeted partner countries' measurable capabilities
to achieve specific targets to prevent, detect, and respond to
infectious disease threats, whether naturally occurring,
deliberate, or accidental;
(2) to encourage governments and multilateral agencies,
development banks, nongovernmental organizations, and private
sector stakeholders throughout the world to make fortifying
health security a national priority and a key commitment; and
(3) to emphasize improving coordination and collaboration
across governmental and societal sectors to help strengthen
health systems and pandemic preparedness.
SEC. 6. GLOBAL HEALTH SECURITY SPECIAL ADVISOR.
(a) In General.--There is established, within the Executive Office
of the President, the position of Special Advisor for Global Health
Security (referred to in this Act as the ``Advisor''), who shall be
appointed by the President, at a level not lower than that of a Senior
Director.
(b) General Duties.--The Advisor shall--
(1) serve as the President's principal advisor on global
health security and global health emergencies;
(2) coordinate the United States Government's efforts to
carry out global health security activities, including
participation in the Global Health Security Agenda;
(3) convene and chair the Global Health Security
Interagency Review Council described in section 7; and
(4) submit a report to Congress not less frequently than
twice per year that describes the activities and
accomplishments of the Advisor during the reporting period.
(c) Specific Duties.--The duties of the Advisor shall also
include--
(1) ensuring program and policy coordination among the
relevant executive branch agencies and nongovernmental
organizations, including auditing, monitoring, and evaluation
of all such programs;
(2) ensuring that each relevant executive branch agency
undertakes programs primarily in areas in which the agency has
the greatest expertise, technical capabilities, and potential
for success;
(3) avoiding duplication of effort;
(4) ensuring, through interagency and international
coordination, that global health security programs of the
United States are coordinated with, and complementary to, the
delivery of related global health, food security, development,
and education programs;
(5) establishing due diligence criteria for all recipients
of funds appropriated by the Federal Government for global
health security assistance;
(6) developing policy that will prioritize global health
security, especially the role of building low- and middle-
income country capacity to contain pandemic threats, in all
relevant future global and national health, research and
development, and biodefense strategies, including the National
Health Security Strategy, the National Security Strategy, and
the National Biodefense Strategy; and
(7) articulating assessment standards that--
(A) measure countries' individual status and
progress in building the necessary capacities to
prevent, detect, and respond to infectious disease
threats, in accordance with agreed bilateral or
multilateral targets and in support of full
implementation of the International Health Regulations,
adopted at Geneva May 23, 2005;
(B) are based on a peer-to-peer model in which
external experts are invited to work with the country
to evaluate capacity;
(C) ensure an objective approach and facilitate
cross-sectoral learning; and
(D) are part of the capacity building cycle
designed to inform national priority setting, target
resources, and track progress.
(d) Coordination.--In carrying out the duties set forth in
subsection (b), the Advisor shall ensure the coordination of United
States Government efforts referred to in subsection (b)(2) with
relevant international stakeholders and organizations.
(e) Monitoring.--To ensure that adequate measures are established
and implemented, the Centers for Disease Control and Prevention
should--
(1) advise the Advisor on monitoring, surveillance, and
evaluation activities; and
(2) be a key implementer of such activities under this
section.
(f) Form.--The reports required under subsection (b)(4) shall be
submitted in unclassified form, but may contain a classified annex.
SEC. 7. INTERAGENCY REVIEW COUNCIL.
(a) Establishment.--The Global Health Security Interagency Review
Council (referred to in this section as the ``Council'') shall be
composed of representatives of--
(1) the Department of State;
(2) the Centers for Disease Control and Prevention;
(3) the United States Agency for International Development;
(4) the Department of Agriculture, including the Animal
Plant Health Inspection Service and the Food Safety and
Inspection Service;
(5) the Department of Defense, including the Assistant
Secretary of Defense for Health Affairs;
(6) the Department of Health and Human Services, including
the National Institutes of Health;
(7) the Department of Homeland Security;
(8) the Department of Justice, including the Federal Bureau
of Investigation;
(9) the Environmental Protection Agency;
(10) the Office of Management and Budget;
(11) the Office of Science and Technology Policy; and
(12) any other agency that the representatives of the
agencies set forth in paragraphs (1) through (11) determine, by
consensus, to be appropriate.
(b) Meetings.--The Council shall meet at least 4 times per year to
advance its mission and fulfill its responsibilities under this
section.
(c) Functions.--The Council shall--
(1) provide policy-level guidance to participating agencies
on global health security goals, objectives, and
implementation;
(2) facilitate interagency, multi-sectoral engagement to
carry out global health security activities, including the
Global Health Security Agenda;
(3) provide a forum for raising and working to resolve
interagency disagreements concerning the global health security
goals, objectives, and benchmarks;
(4) develop and set benchmarks for--
(A) assessing, measuring, and improving global
health security outcomes; and
(B) identifying criteria for designating priority
partner countries;
(5) review the progress toward, and work to resolve
challenges to, achieving United States Government commitments
to global health security activities, agreements, and
organizations, including the Global Health Security Agenda and
other commitments to assist other countries in achieving
agreed-upon global health security targets; and
(6) consider, among other issues--
(A) the status of United States financial
commitments to global health security in the context of
commitments by other donors, and the contributions of
partner countries to achieve global health security
targets, including the Global Health Security Agenda;
(B) progress toward the milestones outlined in
global health security national plans for those
countries where the United States Government has
committed to assist in global health security
activities and in annual work plans outlining agency
priorities for implementing global health security
strategies, including the Global Health Security
Agenda; and
(C) external evaluations of the capabilities of the
United States and partner countries to address
infectious disease threats, including--
(i) the ability to achieve the targets
outlined in the Joint External Evaluation
process; and
(ii) gaps identified by such external
evaluations.
(d) Specific Roles and Responsibilities.--
(1) In general.--The heads of the agencies referred to in
subsection (a) shall--
(A) make the implementation of the Global Health
Security Agenda (referred to in this subsection as
``GHSA'') and successor activities a high priority
within their respective agencies, and include GHSA-
related activities within their respective agencies'
strategic planning and budget processes;
(B) designate a senior level official to be
responsible for the implementation of this section;
(C) designate an appropriate representative, at the
Assistant Secretary level or higher, to represent the
agency on the Council;
(D) keep the Council apprised of global health
security-related activities, including the Global
Health Security Agenda, undertaken within their
respective agencies;
(E) maintain responsibility for agency-related
programmatic functions, in coordination with host
governments, country teams, and global health security
in country teams, and in conjunction with other
relevant agencies;
(F) coordinate with other agencies referred to in
subsection (a) to satisfy programmatic goals, and
further facilitate coordination of country teams,
implementers, and donors in host countries; and
(G) coordinate across GHSA national plans and with
GHSA partners to which the United States is providing
assistance.
(2) Additional roles and responsibilities.--In addition to
the roles and responsibilities described in paragraph (1), the
heads of agencies referred to in subsection (a) shall carry out
their respective roles and responsibilities described in
subsections (b) through (i) of section 3 of Executive Order
13747 (81 Fed. Reg. 78701; relating to Advancing the Global
Health Security Agenda to Achieve a World Safe and Secure from
Infectious Disease Threats), as in effect on the day before the
date of the enactment of this Act.
(e) Limitations.--The Council may not perform any activities or
functions that interfere with the foreign affairs responsibilities of
the Secretary of State, including the responsibility to oversee the
implementation of programs and policies that advance the global health
security activities within foreign countries.
SEC. 8. STRATEGY AND REPORTS.
(a) Strategy.--The Special Advisor for Global Health Security
appointed under section 6 shall coordinate the development and
implementation of a strategy to implement the policy described in
section 5, which shall--
(1) set specific and measurable goals, benchmarks,
timetables, performance metrics, and monitoring and evaluation
plans that reflect international best practices relating to
transparency, accountability, and global health security;
(2) support and be aligned with country-owned global health
security policy and investment plans developed with input from
key stakeholders, as appropriate;
(3) facilitate communication and collaboration, as
appropriate, among local stakeholders in support of a multi-
sectoral approach to global health security;
(4) support the long-term success of programs by building
the capacity of local organizations and institutions in target
countries and communities;
(5) develop community resilience to infectious disease
threats and emergencies;
(6) leverage resources and expertise through partnerships
with the private sector, health organizations, civil society,
nongovernmental organizations, and health research and academic
institutions; and
(7) support collaboration, as appropriate, between United
States universities, and public and private institutions in
target countries and communities to promote health security and
innovation.
(b) Coordination.--The President, acting through the Special
Advisor for Global Health Security, shall coordinate, through a whole-
of-government approach, the efforts of relevant Federal departments and
agencies in the implementation of the strategy required under
subsection (a) by establishing--
(1) monitoring and evaluation systems, coherence, and
coordination across relevant Federal departments and agencies;
and
(2) platforms for regular consultation and collaboration
with key stakeholders and the appropriate congressional
committees.
(c) Strategy Submission.--
(1) In general.--Not later than 6 months after the date of
the enactment of this Act, the President, in consultation with
the head of each relevant Federal department and agency, shall
submit, to the appropriate congressional committees--
(A) the strategy required under subsection (a); and
(B) a detailed description of how the United States
intends to advance the policy set forth in section 5
and the agency-specific plans described in paragraph
(2).
(2) Agency-specific plans.--The strategy required under
subsection (a) shall include specific implementation plans from
each relevant Federal department and agency that describes--
(A) the anticipated contributions of the department
or agency, including technical, financial, and in-kind
contributions, to implement the strategy; and
(B) the efforts of the department or agency to
ensure that the activities and programs carried out
pursuant to the strategy are designed to achieve
maximum impact and long-term sustainability.
(d) Report.--
(1) In general.--Not later than 1 year after the date on
which the strategy required under subsection (a) is submitted
to the appropriate congressional committees under subsection
(c), and not later than October 1 of each year thereafter, the
President shall submit a report to the appropriate
congressional committees that describes the status of the
implementation of the strategy.
(2) Content.--The report required under paragraph (1)
shall--
(A) contain a summary of the strategy as an
appendix;
(B) identify any substantial changes made in the
strategy during the preceding calendar year;
(C) describe the progress made in implementing the
strategy;
(D) identify the indicators used to establish
benchmarks and measure results over time, as well as
the mechanisms for reporting such results in an open
and transparent manner;
(E) contain a transparent, open, and detailed
accounting of expenditures by relevant Federal
departments and agencies to implement the strategy,
including, for each Federal department and agency, the
statutory source of expenditures, amounts expended,
implementing partners, targeted beneficiaries, and
activities supported;
(F) describe how the strategy leverages other
United States global health and development assistance
programs;
(G) assess efforts to coordinate United States
global health security programs, activities, and
initiatives with key stakeholders; and
(H) incorporate a plan for regularly reviewing and
updating strategies, partnerships, and programs and
sharing lessons learned with a wide range of
stakeholders, including key stakeholders, in an open,
transparent manner.
(e) Form.--The strategy required under subsection (a) and the
report required under subsection (d) shall be submitted in unclassified
form, but may contain a classified annex.
SEC. 9. COORDINATION OF FEDERAL RESPONSE TO GLOBAL HEALTH EMERGENCIES.
(a) Leadership.--The Secretary of State, in consultation with other
appropriate Federal departments, including the Department of
Agriculture, the Department of Defense, the Department of Health and
Human Services, and the Department of Homeland Security, shall
coordinate and facilitate interagency, multi-sectoral activities
outside of the United States in response to a declared global health
emergency. The President may designate another Federal official to
coordinate domestic and extra-territorial activities related to a
global health emergency.
(b) Coordination With International Organizations.--In responding
to a declared global health emergency under subsection (a), the
Secretary of State shall coordinate United States Government's efforts
with the efforts and programs of relevant international organizations
and stakeholders, including--
(1) the World Health Organization;
(2) the Food and Agriculture Organization of the United
Nations;
(3) the World Organization for Animal Health;
(4) the Global Partnership Against the Spread of Weapons
and Materials of Mass Destruction;
(5) INTERPOL;
(6) the Economic Community of West African States;
(7) the United Nations Office for Disaster Risk Reduction;
(8) GAVI, The Vaccine Alliance; and
(9) other relevant international agencies and
organizations.
(c) Interagency Coordination.--The Secretary of State shall ensure
that global health security programs supported by the United States
Government are coordinated with, and complementary to, related programs
in global food security, development, and education.
SEC. 10. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated, for each of the fiscal
years 2021 through 2025--
(1) to the Centers for Disease Control and Prevention,
$190,000,000 for the Global Disease Detection and Emergency
Response and Global Public Health Capacity and Development
Accounts, which shall be used to support activities that--
(A) are consistent with United States global health
security policy, goals, and priorities;
(B) have measurable benchmarks; and
(C) focus on preventing avoidable catastrophes,
detecting threats early, and responding rapidly and
effectively; and
(2) to the United States Agency for International
Development, $110,000,000 for the Global Health Security
Account, which shall be used to support activities that--
(A) are consistent with United States global health
security policy, goals, and priorities;
(B) have measurable benchmarks; and
(C) focus on preventing avoidable catastrophes,
detecting threats early, and responding rapidly and
effectively.
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