[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2297 Reported in Senate (RS)]
<DOC>
Calendar No. 112
117th CONGRESS
1st Session
S. 2297
To improve global health, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 24, 2021
Mr. Risch (for himself, Mr. Menendez, Mr. Murphy, and Mr. Portman)
introduced the following bill; which was read twice and referred to the
Committee on Foreign Relations
July 30, 2021
Reported by Mr. Menendez, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To improve global health, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This Act may be cited as the
``International Pandemic Preparedness and COVID-19 Response Act of
2021''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents for this Act
is as follows:</DELETED>
<DELETED>Sec. 1. Short title; table of contents.
<DELETED>Sec. 2. Definitions.
<DELETED>Sec. 3. Purpose.
<DELETED>TITLE I--ENHANCING THE UNITED STATES INTERNATIONAL RESPONSE TO
COVID-19 AND FUTURE PANDEMICS
<DELETED>Sec. 101. Statement of policy regarding international
cooperation to end the COVID-19 pandemic.
<DELETED>Sec. 102. Oversight of United States foreign assistance to end
the COVID-19 pandemic.
<DELETED>Sec. 103. United States contributions to the Global Fund to
Fight AIDS, Tuberculosis, and Malaria
COVID-19 response mechanism.
<DELETED>Sec. 104. Global COVID-19 vaccine distribution and delivery.
<DELETED>Sec. 105. Leveraging United States bilateral global health
programs for the international COVID-19
response.
<DELETED>Sec. 106. Report on humanitarian response to the COVID-19
pandemic.
<DELETED>Sec. 107. Safeguarding democracy and human rights during the
COVID-19 pandemic.
<DELETED>Sec. 108. Public diplomacy and combating disinformation and
misinformation about COVID-19.
<DELETED>Sec. 109. Findings and sense of Congress regarding the United
States International Development Finance
Corporation.
<DELETED>Sec. 110. Sense of Congress regarding international
cooperation to prevent and respond to
future pandemics.
<DELETED>Sec. 111. Roles of the Department of State, the United States
Agency for International Development, and
the Centers for Disease Control and
Prevention in pandemic response.
<DELETED>Sec. 112. USAID disaster surge capacity.
<DELETED>Sec. 113. Statement of policy on humanitarian assistance to
countries affected by pandemics.
<DELETED>TITLE II--INTERNATIONAL PANDEMIC PREVENTION AND PREPAREDNESS
<DELETED>Sec. 201. Partner country defined.
<DELETED>Sec. 202. Global health security strategy and report.
<DELETED>Sec. 203. Committee on Global Health Security and Pandemic and
Biological Threats.
<DELETED>Sec. 204. United States overseas global health security and
diplomacy coordination and strategy.
<DELETED>Sec. 205. Resilience.
<DELETED>Sec. 206. Strengthening health systems.
<DELETED>Sec. 207. Additional authorities.
<DELETED>Sec. 208. Authorization for United States participation in the
Coalition for Epidemic Preparedness
Innovations.
<DELETED>Sec. 209. National intelligence estimate and briefing
regarding novel diseases and pandemic
threats.
<DELETED>Sec. 210. Pandemic early warning network.
<DELETED>Sec. 211. International emergency operations.
<DELETED>TITLE III--FINANCING MECHANISM FOR GLOBAL HEALTH SECURITY AND
PANDEMIC PREVENTION AND PREPAREDNESS
<DELETED>Sec. 301. Eligible partner country defined.
<DELETED>Sec. 302. Establishment of Fund for Global Health Security and
Pandemic Prevention and Preparedness.
<DELETED>Sec. 303. Authorities.
<DELETED>Sec. 304. Administration.
<DELETED>Sec. 305. Advisory Board.
<DELETED>Sec. 306. Reports to Congress.
<DELETED>Sec. 307. United States contributions.
<DELETED>Sec. 308. Compliance with the Foreign Aid Transparency and
Accountability Act of 2016.
<DELETED>SEC. 2. DEFINITIONS.</DELETED>
<DELETED> In this Act:</DELETED>
<DELETED> (1) Appropriate congressional committees.--The
term ``appropriate congressional committees'' means--</DELETED>
<DELETED> (A) the Committee on Foreign Relations of
the Senate;</DELETED>
<DELETED> (B) the Committee on Appropriations of the
Senate;</DELETED>
<DELETED> (C) the Committee on Foreign Affairs of
the House of Representatives; and</DELETED>
<DELETED> (D) the Committee on Appropriations of the
House of Representatives.</DELETED>
<DELETED> (2) Global health security agenda; ghsa.--The
terms ``Global Health Security Agenda'' and ``GHSA'' mean the
multi-sectoral initiative launched in 2014 and renewed in 2017
that brings together countries, regions, international
organizations, nongovernmental organizations, and the private
sector to elevate global health security as a national-level
priority, to share best practices, and to facilitate national
capacity to comply with and adhere to--</DELETED>
<DELETED> (A) the International Health Regulations
(2005);</DELETED>
<DELETED> (B) the World Organisation for Animal
Health international standards and
guidelines;</DELETED>
<DELETED> (C) United Nations Security Council
Resolution 1540 (2004);</DELETED>
<DELETED> (D) the Convention on the Prohibition of
the Development, Production and Stockpiling of
Bacteriological and Toxin Weapons and on their
Destruction, done at Washington, London, and Moscow,
April 10, 1972 (commonly referred to as the
``Biological Weapons Convention'');</DELETED>
<DELETED> (E) the Global Health Security Agenda 2024
Framework; and</DELETED>
<DELETED> (F) other relevant frameworks that
contribute to global health security.</DELETED>
<DELETED> (3) Global health security index.--The term
``Global Health Security Index'' means the comprehensive
assessment and benchmarking of health security and related
capabilities across the countries that make up the States
Parties to the International Health Regulations
(2005).</DELETED>
<DELETED> (4) Global health security initiative.--The term
``Global Health Security Initiative'' means the informal
network of countries and organizations that came together in
2001 to undertake concerted global action to strengthen public
health preparedness and response to chemical, biological,
radiological, and nuclear threats, as well as pandemic
influenza.</DELETED>
<DELETED> (5) Joint external evaluation.--The term ``Joint
External Evaluation'' means the World Health Organization-
facilitated, voluntary, collaborative, multi-sectoral process
to assess country capacity to prevent, detect, and rapidly
respond to public health risks occurring naturally or due to
deliberate or accidental events, assess progress in achieving
the targets under the International Health Regulations (2005),
and recommend priority actions.</DELETED>
<DELETED> (6) Key stakeholders.--The term ``key
stakeholders'' means actors engaged in efforts to advance
global health security programs and objectives, including--
</DELETED>
<DELETED> (A) national and local governments in
partner countries;</DELETED>
<DELETED> (B) other bilateral donors;</DELETED>
<DELETED> (C) international, regional, and local
organizations, including private, voluntary,
nongovernmental, and civil society
organizations;</DELETED>
<DELETED> (D) international, regional, and local
financial institutions;</DELETED>
<DELETED> (E) representatives of historically
marginalized groups, including women, youth, and
indigenous peoples;</DELETED>
<DELETED> (F) the private sector, including medical
device, technology, pharmaceutical, manufacturing,
logistics, and other relevant companies; and</DELETED>
<DELETED> (G) public and private research and
academic institutions.</DELETED>
<DELETED> (7) One health approach.--The term ``One Health
approach'' means the collaborative, multi-sectoral, and
transdisciplinary approach toward achieving optimal health
outcomes in a manner that recognizes the interconnection
between people, animals, plants, and their shared
environment.</DELETED>
<DELETED> (8) Relevant federal departments and agencies.--
The term ``relevant Federal departments and agencies'' means
any Federal department or agency implementing United States
policies and programs relevant to the advancement of United
States global health security and diplomacy overseas, which may
include--</DELETED>
<DELETED> (A) the Department of State;</DELETED>
<DELETED> (B) the United States Agency for
International Development;</DELETED>
<DELETED> (C) the Department of Health and Human
Services;</DELETED>
<DELETED> (D) the Centers for Disease Control and
Prevention;</DELETED>
<DELETED> (E) the National Institutes of
Health;</DELETED>
<DELETED> (F) the Department of the
Treasury;</DELETED>
<DELETED> (G) the Department of
Agriculture;</DELETED>
<DELETED> (H) the Department of Defense;</DELETED>
<DELETED> (I) the Defense Threat Reduction
Agency;</DELETED>
<DELETED> (J) the Millennium Challenge
Corporation;</DELETED>
<DELETED> (K) the Development Finance
Corporation;</DELETED>
<DELETED> (L) the Peace Corps; and</DELETED>
<DELETED> (M) any other department or agency that
the President determines to be relevant for these
purposes.</DELETED>
<DELETED> (9) Resilience.--The term ``resilience'' means the
ability of people, households, communities, systems,
institutions, countries, and regions to reduce, mitigate,
withstand, adapt to, and quickly recover from stresses and
shocks in a manner that reduces chronic vulnerability and
facilitates inclusive growth.</DELETED>
<DELETED>SEC. 3. PURPOSE.</DELETED>
<DELETED> The purpose of this Act is to accelerate and enhance the
United States international response to pandemics, including the COVID-
19 pandemic, and to operationalize lessons learned from current and
prior emergency responses in a manner that--</DELETED>
<DELETED> (1) advances the global health security and
diplomacy objectives of the United States;</DELETED>
<DELETED> (2) improves coordination among the relevant
Federal departments and agencies implementing United States
foreign assistance for global health security; and</DELETED>
<DELETED> (3) more effectively enables partner countries to
strengthen and sustain resilient health systems and supply
chains with the resources, capacity, and personnel required to
prevent, prepare for, detect, and respond to infectious disease
threats before they become pandemics.</DELETED>
<DELETED>TITLE I--ENHANCING THE UNITED STATES INTERNATIONAL RESPONSE TO
COVID-19 AND FUTURE PANDEMICS</DELETED>
<DELETED>SEC. 101. STATEMENT OF POLICY REGARDING INTERNATIONAL
COOPERATION TO END THE COVID-19 PANDEMIC.</DELETED>
<DELETED> It shall be the policy of the United States to lead and
implement a comprehensive and coordinated international response to end
the COVID-19 pandemic in a manner that recognizes the critical role
that multilateral and regional organizations can and should play in
pandemic response, including by--</DELETED>
<DELETED> (1) seeking adoption of a United Nations Security
Council resolution that--</DELETED>
<DELETED> (A) declares pandemics, including the
COVID-19 pandemic, to be a threat to international
peace and security; and</DELETED>
<DELETED> (B) urges member states to address this
threat by aligning their health preparedness plans with
international best practices and those established by
the Global Health Security Agenda to improve country
capacity to prevent, detect, and respond to infectious
disease threats;</DELETED>
<DELETED> (2) advancing efforts to reform the World Health
Organization so that it serves as an effective normative and
capable coordinating body empowered to align member countries
around a single strategic operating plan to detect, contain,
treat, and deter the further spread of COVID-19;</DELETED>
<DELETED> (3) providing timely, appropriate levels of
financial support to United Nations agencies responding to the
COVID-19 pandemic;</DELETED>
<DELETED> (4) prioritizing United States foreign assistance
for the COVID-19 response in the most vulnerable countries and
regions;</DELETED>
<DELETED> (5) encouraging other donor governments to
similarly increase contributions to the United Nations agencies
responding to the COVID-19 pandemic in the world's poorest and
most vulnerable countries;</DELETED>
<DELETED> (6) working with key stakeholders to accelerate
progress toward meeting and exceeding, as practicable, the
global COVID-19 vaccination goals jointly proposed by the
International Monetary Fund, the World Health Organization, the
World Bank, and the World Trade Organization, whereby--
</DELETED>
<DELETED> (A) at least 40 percent of the population
in all countries is vaccinated by the end of 2021;
and</DELETED>
<DELETED> (B) at least 60 percent of the population
in all countries is vaccinated by the first half of
2022;</DELETED>
<DELETED> (7) engaging with key stakeholders, including
through multilateral facilities such as the COVID-19 Vaccines
Global Access initiative (referred to in this title as
``COVAX'') and the Access to COVID-19 Tools (ACT) Accelerator
initiative, and expanding bilateral efforts, including through
the International Development Finance Corporation, to
accelerate the development, manufacturing, local production,
and efficient and equitable distribution of--</DELETED>
<DELETED> (A) vaccines and related raw materials to
meet or exceed the vaccination goals under paragraph
(6); and</DELETED>
<DELETED> (B) global health commodities, including
personal protective equipment, test kits, medicines and
therapeutics, and other essential supplies to combat
COVID-19;</DELETED>
<DELETED> (8) supporting global COVID-19 vaccine
distribution strategies that strengthen underlying health
systems and ensure that people living in vulnerable and
marginalized communities, including women, do not face undue
barriers to vaccination;</DELETED>
<DELETED> (9) working with key stakeholders, including
through the World Bank Group, the International Monetary Fund,
the World Trade Organization, the International Finance
Corporation, and other relevant regional and bilateral
financial institutions, to address the economic and financial
implications of the COVID-19 pandemic, while taking into
account the differentiated needs of disproportionately
affected, vulnerable, and marginalized populations;</DELETED>
<DELETED> (10) establishing clear timelines, benchmarks, and
goals for COVID-19 response strategies and activities under
this section; and</DELETED>
<DELETED> (11) generating commitments of resources in
support of the goals referred to in paragraph (10).</DELETED>
<DELETED>SEC. 102. OVERSIGHT OF UNITED STATES FOREIGN ASSISTANCE TO END
THE COVID-19 PANDEMIC.</DELETED>
<DELETED> (a) Reporting Requirements.--Not later than 60 days after
the date of the enactment of this Act, the Secretary of State and the
Administrator for the United States Agency for International
Development shall jointly submit to the appropriate congressional
committees--</DELETED>
<DELETED> (1) an unclassified report containing a
description of funds already obligated and expended under title
X of the American Rescue Plan Act of 2021 (Public Law 117-2);
and</DELETED>
<DELETED> (2) a plan that describes the objectives and
timeline for the obligation and expenditure of all remaining
funds appropriated under the American Rescue Plan Act of 2021,
which shall be submitted in an unclassified form, and should
include a description of steps taken pursuant to each objective
specified in the plan.</DELETED>
<DELETED> (b) Congressional Consultation.--Not less frequently than
once every 60 days, until the completion or termination of the
implementation plan required under subsection (a)(2), and upon the
request from one or more of the appropriate congressional committees,
the Secretary of State and the Administrator for the United States
Agency for International Development shall provide a briefing to the
appropriate congressional committees regarding the report required
under subsection (a)(1) and the status of the implementation of the
plan required under subsection (a)(2).</DELETED>
<DELETED> (c) Branding.--In providing assistance under this title,
the Secretary of State and the Administrator of the United States
Agency for International Development, with due consideration for the
safety and security of implementing partners and beneficiaries, and
pursuant to current branding and marking regulations and procedures
shall prescribe the use of logos or other insignia, which may include
the flag of the United States, to appropriately identify such
assistance as being from the people of the United States.</DELETED>
<DELETED>SEC. 103. UNITED STATES CONTRIBUTIONS TO THE GLOBAL FUND TO
FIGHT AIDS, TUBERCULOSIS, AND MALARIA COVID-19 RESPONSE
MECHANISM.</DELETED>
<DELETED> (a) United States Contributions to the Global Fund To
Fight AIDS, Tuberculosis, and Malaria COVID-19 Response Mechanism.--
United States contributions to the Global Fund to Fight AIDS,
Tuberculosis, and Malaria COVID-19 Response Mechanism under section
10003(a)(2) of the American Rescue Plan Act of 2021 (Public Law 107-
2)--</DELETED>
<DELETED> (1) shall be meaningfully leveraged in a manner
that incentivizes other public and private donor contributions;
and</DELETED>
<DELETED> (2) shall be subject to the reporting and
withholding requirements under subsections (c), (d)(4)(A)(ii),
(d)(4)(C), (d)(5), (d)(6), (f), and (g) of section 202 of the
United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (22 U.S.C. 7622).</DELETED>
<DELETED>SEC. 104. GLOBAL COVID-19 VACCINE DISTRIBUTION AND
DELIVERY.</DELETED>
<DELETED> (a) Accelerating Global Vaccine Distribution Strategy.--
The Secretary of State, in consultation with the Secretary of Health
and Human Services, the Administrator of the United States Agency for
International Development, the Chief Executive Officer of the United
States International Development Finance Corporation, and the heads of
other relevant Federal departments and agencies, as determined by the
President, shall develop a strategy to expand access to, and accelerate
the global distribution of, COVID-19 vaccines to other countries, which
shall--</DELETED>
<DELETED> (1) identify the countries that have the highest
infection and death rates due to COVID-19, the lowest COVID-19
vaccination rates, and face the most difficult, political,
logistical, and financial challenges to obtaining and
delivering COVID-19 vaccines, and describe the basis and
metrics used to make such determinations;</DELETED>
<DELETED> (2) identify which countries and regions will be
prioritized and targeted for COVID-19 vaccine delivery, and the
rationale for such prioritization;</DELETED>
<DELETED> (3) describe efforts that the United States is
making to increase COVID-19 vaccine manufacturing capacity,
including through the provision of development finance, and
estimate when, how many, and which types of vaccines will be
provided by the United States Government bilaterally and
through COVAX;</DELETED>
<DELETED> (4) describe efforts to encourage international
partners to take actions similar to the efforts referred to in
paragraph (3);</DELETED>
<DELETED> (5) describe how the United States Government will
ensure efficient delivery of COVID-19 vaccines to intended
recipients, including United States citizens residing overseas,
and identify complementary United States foreign assistance
that will facilitate vaccine readiness, distribution, delivery,
monitoring, and administration activities;</DELETED>
<DELETED> (6) describe the roles, responsibilities, tasks,
and, as appropriate, the authorities of the Secretary of State,
the Administrator of the United States Agency for International
Development, the Secretary of Health and Human Services, the
Chief Executive Officer of the United States International
Development Finance Corporation, and the heads of other
relevant Federal departments and agencies with respect to the
implementation of such strategy; and</DELETED>
<DELETED> (7) summarize the United States public diplomacy
strategies for branding and addressing vaccine misinformation
and hesitancy.</DELETED>
<DELETED> (b) Submission of Strategy.--Not later than 90 days after
the date of the enactment of this Act, the Secretary of State shall
submit the strategy described in subsection (a) to the appropriate
congressional committees.</DELETED>
<DELETED>SEC. 105. LEVERAGING UNITED STATES BILATERAL GLOBAL HEALTH
PROGRAMS FOR THE INTERNATIONAL COVID-19
RESPONSE.</DELETED>
<DELETED> (a) Authorization for Leveraging Bilateral Program
Activities.--Amounts authorized to be appropriated or otherwise made
available to carry out section 104 of the Foreign Assistance Act (22
U.S.C. 2151b) may be used in countries receiving United States foreign
assistance--</DELETED>
<DELETED> (1) to combat the COVID-19 pandemic, including
through the sharing of COVID-19 vaccines; and</DELETED>
<DELETED> (2) to support related activities, including--
</DELETED>
<DELETED> (A) strengthening vaccine
readiness;</DELETED>
<DELETED> (B) reducing vaccine hesitancy and
misinformation;</DELETED>
<DELETED> (C) delivering and administering COVID-19
vaccines;</DELETED>
<DELETED> (D) strengthening health systems and
supply chains;</DELETED>
<DELETED> (E) supporting health care workforce
planning, training, and management;</DELETED>
<DELETED> (F) enhancing transparency, quality, and
reliability of health data;</DELETED>
<DELETED> (G) increasing bidirectional testing;
and</DELETED>
<DELETED> (H) building lab capacity.</DELETED>
<DELETED> (b) Adjustment of Targets and Goals.--The Secretary of
State, in coordination with the heads of other relevant Federal
departments and agencies, shall submit an annual report to the
appropriate congressional committees that identifies--</DELETED>
<DELETED> (1) any adjustments to original program targets
and goals that result from the use of funds for the purposes
authorized under subsection (a); and</DELETED>
<DELETED> (2) the amounts needed in the following fiscal
year to meet the original program goals.</DELETED>
<DELETED>SEC. 106. REPORT ON HUMANITARIAN RESPONSE TO THE COVID-19
PANDEMIC.</DELETED>
<DELETED> (a) In General.--Not later than 120 days after the date of
the enactment of this Act, the Secretary of State, in consultation with
the Administrator of the United States Agency for International
Development and the Secretary of Health and Human Services, shall
submit a report to the appropriate congressional committees that--
</DELETED>
<DELETED> (1) assesses the global humanitarian response to
COVID-19; and</DELETED>
<DELETED> (2) outlines specific elements of the United
States Government's country-level response to the COVID-19
pandemic.</DELETED>
<DELETED> (b) Elements.--The report required under subsection (a)
shall include--</DELETED>
<DELETED> (1) for countries receiving United States
assistance, a description of humanitarian and health-worker
access to crisis-affected areas, including--</DELETED>
<DELETED> (A) legal and bureaucratic restrictions on
the entry of humanitarian workers from abroad, to
include visa authorizations that do not allow adequate
time for humanitarian workers to quarantine upon
arrival in-line with host country regulations, conduct
needs assessments, and subsequently implement
multilateral and United States-funded programming in an
efficient, effective, and unrestricted
manner;</DELETED>
<DELETED> (B) restrictions on travel by humanitarian
workers within such country to reach the areas of
operation where vulnerable and marginalized populations
reside;</DELETED>
<DELETED> (C) access to medical evacuation in the
event of a health emergency;</DELETED>
<DELETED> (D) access to personal protective
equipment for United States Government implementing
partners; and</DELETED>
<DELETED> (E) efforts to support access to COVID-19
vaccines for humanitarian and health-workers and
crisis-affected communities;</DELETED>
<DELETED> (2) an analysis and description of countries
(regardless of whether such countries have received direct
United States assistance) that have expressly prevented
vulnerable populations from accessing necessary assistance
related to COVID-19, including--</DELETED>
<DELETED> (A) the omission of vulnerable populations
from national response plans;</DELETED>
<DELETED> (B) laws, policies, or practices that
restrict or preclude treatment of vulnerable
populations at public hospitals and health facilities;
and</DELETED>
<DELETED> (C) exclusion of, or discrimination
against, vulnerable populations in law, policy, or
practice that prevents equal access to food, shelter,
and other basic assistance;</DELETED>
<DELETED> (3) a description of United States Government
efforts to facilitate greater humanitarian access, including--
</DELETED>
<DELETED> (A) advocacy and diplomatic efforts with
relevant foreign governments and multilateral
institutions to ensure that vulnerable and marginalized
populations are included in national response plans and
other relevant plans developed in response to the
COVID-19 pandemic; and</DELETED>
<DELETED> (B) advocacy and diplomatic efforts with
relevant foreign governments to ensure that appropriate
visas, work permits, and domestic travel exemptions are
issued for humanitarian and health workers responding
to the COVID-19 pandemic; and</DELETED>
<DELETED> (4) a description of United States Government
plans and efforts to address the second-order impacts of the
COVID-19 pandemic and an assessment of the resources required
to implement such plans, including efforts to address--
</DELETED>
<DELETED> (A) famine and acute food
insecurity;</DELETED>
<DELETED> (B) gender-based violence;</DELETED>
<DELETED> (C) mental health and psychosocial support
needs;</DELETED>
<DELETED> (D) child protection needs;</DELETED>
<DELETED> (E) health, education, and
livelihoods;</DELETED>
<DELETED> (F) shelter; and</DELETED>
<DELETED> (G) attempts to close civil society space,
including through bureaucratic, administrative, and
health or security related impediments.</DELETED>
<DELETED>SEC. 107. SAFEGUARDING DEMOCRACY AND HUMAN RIGHTS DURING THE
COVID-19 PANDEMIC.</DELETED>
<DELETED> (a) Sense of Congress.--It is the sense of Congress that--
</DELETED>
<DELETED> (1) governments may be required to take
appropriate extraordinary measures during public health
emergencies to halt the spread of disease, including closing
businesses and public events, limiting access to public spaces,
and restricting the movement of people;</DELETED>
<DELETED> (2) certain foreign governments have taken
measures in response to COVID-19 that violate the human rights
of their citizens without clear public health justification,
oversight measures, or sunset provisions;</DELETED>
<DELETED> (3) governments using the COVID-19 pandemic as a
pretext for repression have undermined democratic institutions,
debilitated institutions for transparency and public integrity,
quashed legitimate dissent, and attacked journalists, civil
society organizations, activists, independent voices, and
vulnerable and marginalized populations, including refugees and
migrants, with far-reaching consequences that will extend
beyond the current crisis;</DELETED>
<DELETED> (4) COVID-19 threatens to roll back decades of
progress for women and girls, disproportionately affecting
women economically, educationally, and with respect to health,
while also leading to alarming rises in gender based violence;
and</DELETED>
<DELETED> (5) during and after the pandemic, the Department
of State and the United States Agency for International
Development should directly, and through nongovernmental
organizations or international organizations, provide
assistance and implement programs that support democratic
institutions, civil society, free media, and the advancement of
internationally recognized human rights.</DELETED>
<DELETED> (b) Funding for Civil Society and Human Rights
Defenders.--</DELETED>
<DELETED> (1) Program priorities.--Amounts made available
for each of the fiscal years 2022 through 2026 to carry out the
purposes of sections 101 and 102 of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151 and 2151-1), including programs to
support democratic institutions, human rights defenders, civil
society, and freedom of the press, should be targeted, to the
extent feasible, toward civil society organizations in
countries in which emergency government measures taken in
response to the COVID-19 pandemic have violated internationally
recognized human rights.</DELETED>
<DELETED> (2) Eligible organizations.--Civil society
organizations operating in countries in which emergency
government measures taken in response to the COVID-19 pandemic
violated internationally recognized human rights shall be
eligible to receive funds made available to carry out the
purposes of sections 101 and 102 of the Foreign Assistance Act
of 1961 for each of the fiscal years 2022 through 2026, for--
</DELETED>
<DELETED> (A) programs designed to strengthen and
support civil society, human rights defenders, freedom
of association, and the freedom of the press;</DELETED>
<DELETED> (B) programs to restore democratic
institutions; and</DELETED>
<DELETED> (C) peacebuilding and conflict prevention
to address the impacts of COVID-19 on social cohesion,
public trust, and conflict dynamics by adapting
existing programs or investing in new ones.</DELETED>
<DELETED> (3) Final report.--Not later than 180 days after
the date of the enactment of this Act, the Secretary of State
shall submit a report to the appropriate congressional
committees that--</DELETED>
<DELETED> (A) lists the countries whose emergency
measures limiting internationally recognized human
rights in a manner inconsistent with the principles of
limitation and derogation remain in place;</DELETED>
<DELETED> (B) describes such countries' emergency
measures, including--</DELETED>
<DELETED> (i) how such procedures violate
internationally recognized human rights;
and</DELETED>
<DELETED> (ii) an analysis of the impact of
such measures on access to health and efforts
to control the COVID-19 pandemic within the
country;</DELETED>
<DELETED> (C) describes--</DELETED>
<DELETED> (i) security and intelligence
surveillance measures implemented by countries
during the COVID-19 pandemic;</DELETED>
<DELETED> (ii) the extent to which such
measures have been, or have not been, rolled
back; and</DELETED>
<DELETED> (iii) whether and how such
measures impact internationally recognized
human rights; and</DELETED>
<DELETED> (D) includes a strategic plan by the
Department of State and the United States Agency for
International Development that addresses, through
multilateral and bilateral diplomacy and foreign
assistance, the persistent issues related to the
restriction of internationally recognized human rights
in the COVID-19 response.</DELETED>
<DELETED>SEC. 108. PUBLIC DIPLOMACY AND COMBATING DISINFORMATION AND
MISINFORMATION ABOUT COVID-19.</DELETED>
<DELETED> (a) United States Agency for Global Media.--</DELETED>
<DELETED> (1) Finding.--Congress finds that the United
States Agency for Global Media (referred to in this section as
``USAGM'') broadcasting entities and grantees have proven
valuable in providing timely and accurate information,
particularly in countries in which the free press is under
threat.</DELETED>
<DELETED> (2) Sense of congress.--It is the sense of
Congress that--</DELETED>
<DELETED> (A) accurate, investigative, and
scientific journalism is critical for societies to
effectively combat global health threats; and</DELETED>
<DELETED> (B) Congress supports--</DELETED>
<DELETED> (i) accurate and objective
investigative and scientific reporting by USAGM
networks and grantees regarding COVID-19;
and</DELETED>
<DELETED> (ii) platforms that help dispel
and combat misinformation about the COVID-19
pandemic.</DELETED>
<DELETED> (3) Voice of america.--It is the sense of Congress
that amounts authorized to be appropriated or otherwise made
available to Voice of America should be used--</DELETED>
<DELETED> (A) to expand programs such as
POLYGRAPH.info;</DELETED>
<DELETED> (B) to provide critical tools for
combating propaganda associated with COVID-19;
and</DELETED>
<DELETED> (C) to assist journalists in providing
accurate information to local media outlets.</DELETED>
<DELETED> (4) Office of cuba broadcasting.--It is the sense
of Congress that Radio Television Marti and Digital Marti
should continue to broadcast programs that detect, highlight,
and dispel disinformation.</DELETED>
<DELETED> (5) Radio free europe/radio liberty.--</DELETED>
<DELETED> (A) Finding.--Congress finds that Radio
Free Europe/Radio Liberty (referred to in this section
as ``RFE/RL'') operate in media markets in which
authoritarian state and nonstate actors, including
Russia, heavily invest in misinformation and
disinformation campaigns designed to promote confusion
and mistrust.</DELETED>
<DELETED> (B) Sense of congress.--It is the sense of
Congress that RFE/RL should--</DELETED>
<DELETED> (i) increase investigative
reporting regarding the impacts of COVID-19,
the political and social responses governments
are taking in response to COVID-19, and the
lasting impacts such actions will have on key
political freedoms; and</DELETED>
<DELETED> (ii) expand its ``digital first''
strategy.</DELETED>
<DELETED> (6) Radio free asia.--</DELETED>
<DELETED> (A) Finding.--Congress finds that Radio
Free Asia (RFA) operates in a media market dominated by
powerful state-run media that have invested heavily in
media distortion and disinformation, including about
COVID-19.</DELETED>
<DELETED> (B) Sense of congress.--It is the sense of
Congress that RFA should--</DELETED>
<DELETED> (i) commission technical experts
to bolster efforts to counter social media
tools, including bots used by some countries to
promote misinformation;</DELETED>
<DELETED> (ii) expand digital programming
and local coverage to expose China's media
manipulation techniques; and</DELETED>
<DELETED> (iii) increase English language
content to help counter China's propaganda
directed toward English-speaking
audiences.</DELETED>
<DELETED> (7) Middle east broadcasting networks.--</DELETED>
<DELETED> (A) Finding.--Congress finds that the
Middle East Broadcasting Networks operate largely in
closed media markets in which malign state and nonstate
actors remain active.</DELETED>
<DELETED> (B) Sense of congress.--It is the sense of
Congress that the Middle East Broadcasting Networks
should--</DELETED>
<DELETED> (i) continue plans to expand an
investigative news unit; and</DELETED>
<DELETED> (ii) work to ensure that reporting
continues amidst operational challenges on the
ground.</DELETED>
<DELETED> (8) Open technology fund.--</DELETED>
<DELETED> (A) Finding.--Congress finds that the Open
Technology Fund works to advance internet freedom in
repressive environments by supporting technologies
that--</DELETED>
<DELETED> (i) provide secure and uncensored
access to USAGM's content and the broader
internet; and</DELETED>
<DELETED> (ii) counter attempts by
authoritarian governments to control the
internet and restrict freedom online.</DELETED>
<DELETED> (B) Sense of congress.--It is the sense of
Congress that the Open Technology Fund should--
</DELETED>
<DELETED> (i) support a broad range of
technologies to respond to increasingly
aggressive and sophisticated censorship and
surveillance threats and provide more
comprehensive and tailored support to USAGM's
networks; and</DELETED>
<DELETED> (ii) provide direct assistance to
USAGM's networks to improve the digital
security of reporting operations and
journalists.</DELETED>
<DELETED> (b) Department of State Public Diplomacy Programs.--
</DELETED>
<DELETED> (1) Findings.--Congress finds the
following:</DELETED>
<DELETED> (A) The Department of State's public
diplomacy programs build global networks that can
address shared challenges, such as the COVID-19
pandemic, including through exchanges of researchers,
public health experts, and scientists.</DELETED>
<DELETED> (B) The programs referred to in
subparagraph (A) play a critical role in creating open
and resilient information environments where
democracies can thrive, as articulated in the 2020
Public Diplomacy Strategic Plan, including by--
</DELETED>
<DELETED> (i) improving media quality with
journalist training and reporting
tours;</DELETED>
<DELETED> (ii) conducting media literacy
programs; and</DELETED>
<DELETED> (iii) supporting media access
activities.</DELETED>
<DELETED> (C) The International Visitor Leadership
Program and Digital Communications Network engaged
journalists around the world to combat COVID-19
disinformation, promote unbiased reporting, and
strengthen media literacy.</DELETED>
<DELETED> (D) More than 12,000 physicians holding J-
1 visas from 130 countries--</DELETED>
<DELETED> (i) are engaged in residency or
fellowship training at approximately 750
hospitals throughout the United States, the
majority of whom are serving in States that
have been the hardest hit by COVID-19;
and</DELETED>
<DELETED> (ii) throughout the pandemic, have
served on the front lines of the medical
workforce and in United States university labs
researching ways to detect and treat the
virus.</DELETED>
<DELETED> (2) Visa processing briefing.--Not later than 30
days after the date of the enactment of this Act, the Assistant
Secretary for Consular Affairs shall brief the appropriate
congressional committees by providing--</DELETED>
<DELETED> (A) a timeline for increasing visa
processing capacities at embassies around the world,
notably where there are--</DELETED>
<DELETED> (i) many American citizens,
including dual nationals; and</DELETED>
<DELETED> (ii) many visa applicants for
educational and cultural exchange programs that
promote United States foreign policy objectives
and economic stability to small businesses,
universities, and communities across the United
States; and</DELETED>
<DELETED> (B) a detailed plan for using existing
authorities to waive in-person appointments and
interviews.</DELETED>
<DELETED> (3) Global engagement center.--</DELETED>
<DELETED> (A) Finding.--Congress finds that since
the beginning of the COVID-19 pandemic, publications,
websites, and platforms associated with China, Russia,
and Iran have sponsored disinformation campaigns
related to the COVID-19 pandemic, including falsely
blaming the United States for the disease.</DELETED>
<DELETED> (B) Sense of congress.--It is the sense of
Congress that the Global Engagement Center should
continue its efforts to expose and counter state and
non-state-sponsored disinformation related to COVID-19,
the origins of COVID-19, and COVID-19
vaccinations.</DELETED>
<DELETED>SEC. 109. FINDINGS AND SENSE OF CONGRESS REGARDING THE UNITED
STATES INTERNATIONAL DEVELOPMENT FINANCE
CORPORATION.</DELETED>
<DELETED> (a) Findings.--Congress finds the following:</DELETED>
<DELETED> (1) The COVID-19 pandemic is causing a global
economic recession, as evidenced by the global economic
indicators described in paragraphs (2) through (4).</DELETED>
<DELETED> (2) The United Nations Conference on Trade and
Development determined that the COVID-19 pandemic pushed the
global economy into recession in 2020 on a scale that has not
been witnessed since the 1930s.</DELETED>
<DELETED> (3) Developed countries are expected to experience
a relatively more significant rebound in gross domestic product
growth during 2021 than is expected to be experienced in
developing countries, leading to concerns about a further
expansion in the gap between rich and poor countries,
particularly if this trend continues into 2022.</DELETED>
<DELETED> (4) Global markets have suffered losses ranging
between 5 percent and over 10 percent since the beginning of
the pandemic. While markets are recovering in 2021, global job
losses and unemployment rates remain high, with--</DELETED>
<DELETED> (A) approximately 33,000,000 labor hours
have been lost globally (13 per cent of the total hours
lost) due to outright unemployment; and</DELETED>
<DELETED> (B) an estimated additional 81,000,000
labor hours have been lost due to inactivity or
underemployment.</DELETED>
<DELETED> (5) Given the prolonged nature of the COVID-19
pandemic, African finance ministers have requested continued
efforts to provide--</DELETED>
<DELETED> (A) additional liquidity;</DELETED>
<DELETED> (B) better market access;</DELETED>
<DELETED> (C) more concessional resources;
and</DELETED>
<DELETED> (D) an extension in the Debt Service
Suspension Initiative established by the Group of
20.</DELETED>
<DELETED> (b) Sense of Congress.--It is the sense of Congress that--
</DELETED>
<DELETED> (1) even when markets begin to recover in the
future, it is likely that access to capital will be especially
challenging for developing countries, which still will be
struggling with the containment of, and the recovery from, the
COVID-19 pandemic;</DELETED>
<DELETED> (2) economic uncertainty and the inability of
individuals and households to generate income are major drivers
of political instability and social discord, which creates
conditions for insecurity;</DELETED>
<DELETED> (3) it is in the security and economic interests
of the United States to assist in the economic recovery of
developing countries that are made more vulnerable and unstable
from the public health and economic impacts of the COVID-19
pandemic;</DELETED>
<DELETED> (4) United States foreign assistance and
development finance institutions should seek to blunt the
impacts of a COVID-19 related economic recession by supporting
investments in sectors critical to maintaining economic
stability and resilience in low and middle income
countries;</DELETED>
<DELETED> (5) the need for the United States International
Development Finance Corporation's support for advancing
development outcomes in less developed countries, as mandated
by the Better Utilization of Investments Leading to Development
Act of 2018 (22 U.S.C. 9601 et seq.), is critical to ensuring
lasting and resilient economic growth in light of the COVID-19
pandemic's exacerbation of economic hardships and
challenges;</DELETED>
<DELETED> (6) the United States International Development
Finance Corporation should adjust its view of risk versus
return by taking smart risks that may produce a lower rate of
financial return, but produce significant development outcomes
in responding to the economic effects of COVID-19;
and</DELETED>
<DELETED> (7) to mitigate the economic impacts of the COVID-
19 recession, the United States International Development
Finance Corporation should use its resources and authorities,
among other things--</DELETED>
<DELETED> (A) to ensure loan support for small- and
medium-sized enterprises;</DELETED>
<DELETED> (B) to offer local currency loans to
borrowers for working capital needs;</DELETED>
<DELETED> (C) to create dedicated financing
opportunities for new ``customers'' that are
experiencing financial hardship due to the COVID-19
pandemic; and</DELETED>
<DELETED> (D) to work with other development finance
institutions to create co-financing facilities to
support customers experiencing hardship due to the
COVID-19 pandemic.</DELETED>
<DELETED>SEC. 110. SENSE OF CONGRESS REGARDING INTERNATIONAL
COOPERATION TO PREVENT AND RESPOND TO FUTURE
PANDEMICS.</DELETED>
<DELETED> It is the sense of Congress that--</DELETED>
<DELETED> (1) global pandemic preparedness and response
requires international and regional cooperation and
action;</DELETED>
<DELETED> (2) the United States should lead efforts in
multilateral fora, such as the Group of 7, the Group of 20, and
the United Nations, by collaborating and cooperating with other
countries and international and regional organizations,
including the World Health Organization and other key
stakeholders, to implement international strategies, tools, and
agreements to better prevent, detect, and respond to future
infectious disease threats before they become pandemics;
and</DELETED>
<DELETED> (3) the United States should enhance and expand
coordination and collaboration among the relevant Federal
departments and agencies, the Food and Agriculture Organization
of the United Nations, the World Health Organization, and the
World Organization for Animal Health, to advance a One Health
approach toward preventing, detecting, and responding to
zoonotic threats in the human-animal interface.</DELETED>
<DELETED>SEC. 111. ROLES OF THE DEPARTMENT OF STATE, THE UNITED STATES
AGENCY FOR INTERNATIONAL DEVELOPMENT, AND THE CENTERS FOR
DISEASE CONTROL AND PREVENTION IN PANDEMIC
RESPONSE.</DELETED>
<DELETED> (a) Designation of Lead Agencies for Coordination of the
United States Response to Infectious Disease Outbreaks With Severe or
Pandemic Potential.--In the event of an infectious disease outbreak
outside of the United States with pandemic potential, the President
should designate agencies to lead specific aspects of the response
efforts, including--</DELETED>
<DELETED> (1) designating the Department of State to serve
as the lead for diplomatic engagement, and related foreign
policy efforts, including--</DELETED>
<DELETED> (A) enhanced coordination of engagement
with multilateral organizations and countries, and
mobilization of donor contributions; and</DELETED>
<DELETED> (B) support for United States citizens
abroad;</DELETED>
<DELETED> (2) designating the United States Agency for
International Development to serve as the key lead agency for
design and implementation of the United States international
response, relief, and recovery assistance associated with the
potential pandemic outbreak by leading programmatic activities,
as necessary and appropriate, including--</DELETED>
<DELETED> (A) immediate health, disaster assistance,
and humanitarian response needs and prevention and
preparedness activities in neighboring at-risk
countries;</DELETED>
<DELETED> (B) testing, treatment, and assistance
with preventative care units and community care
facilities;</DELETED>
<DELETED> (C) surveillance, case investigation, and
rapid response capability;</DELETED>
<DELETED> (D) providing supplies, such as personal
protective, screening, and treatment
equipment;</DELETED>
<DELETED> (E) conducting community outreach and
communication and mobilization efforts;</DELETED>
<DELETED> (F) logistics support; and</DELETED>
<DELETED> (G) serving as lead agency for disease
outbreak response abroad; and</DELETED>
<DELETED> (3) designating the Centers for Disease Control
and Prevention to serve as the public health lead for the
international response to the potential pandemic outbreak by
conducting activities, such as--</DELETED>
<DELETED> (A) infection prevention and control,
contact tracing, and laboratory surveillance and
training;</DELETED>
<DELETED> (B) building up, in coordination with the
United States Agency for International Development,
emergency operation centers;</DELETED>
<DELETED> (C) providing education and outreach;
and</DELETED>
<DELETED> (D) assessing the safety and efficacy of
vaccine and treatment candidates in the conduct of
clinical trials in affected countries.</DELETED>
<DELETED>SEC. 112. USAID DISASTER SURGE CAPACITY.</DELETED>
<DELETED> (a) Surge Capacity.--Amounts authorized to be appropriated
or otherwise made available to carry out part I and chapter 4 of part
II of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.),
including funds made available for ``Assistance for Europe, Eurasia and
Central Asia'', may be used, in addition to amounts otherwise made
available for such purposes, for the cost (including support costs) of
individuals detailed to or employed by the United States Agency for
International Development whose primary responsibility is to carry out
programs in response to global health emergencies and natural or man-
made disasters.</DELETED>
<DELETED> (b) Notification.--Not later than 15 days before making
funds available to address man-made disasters pursuant to subsection
(a), the Secretary of State or the Administrator of the United States
Agency for International Development shall notify the appropriate
congressional committees of such action.</DELETED>
<DELETED>SEC. 113. STATEMENT OF POLICY ON HUMANITARIAN ASSISTANCE TO
COUNTRIES AFFECTED BY PANDEMICS.</DELETED>
<DELETED> (a) Statement of Policy.--It shall be the policy of the
United States--</DELETED>
<DELETED> (1) to ensure that United States assistance to
address pandemics, including the provision of vaccines, reaches
vulnerable and marginalized populations, including racial and
religious minorities, refugees, internally displaced persons,
migrants, stateless persons, women, children, the elderly, and
persons with disabilities;</DELETED>
<DELETED> (2) to ensure that United States assistance,
including development finance, addresses the second order
effects of a pandemic, including acute food insecurity;
and</DELETED>
<DELETED> (3) to protect and support humanitarian actors who
are essential workers in preventing, mitigating and responding
to the spread of a pandemic among vulnerable and marginalized
groups described in paragraph (1), including ensuring that such
humanitarian actors--</DELETED>
<DELETED> (A) are exempted from unreasonable travel
restrictions to ensure that they can effectively
provide life-saving assistance; and</DELETED>
<DELETED> (B) are prioritized as frontline workers
in country vaccine distribution plans.</DELETED>
<DELETED> (b) Facilitating Effective and Safe Humanitarian
Assistance.--The Secretary of State, in coordination with the
Administrator of the United States Agency for International
Development, should carry out actions that accomplish the policies set
forth in subsection (a), including by--</DELETED>
<DELETED> (1) taking steps to ensure that travel
restrictions implemented to help contain the spread of a
pandemic are not applied to individuals authorized by the
United States Government to travel to, or reside in, a
designated country to provide assistance related to, or
otherwise impacted by, an outbreak;</DELETED>
<DELETED> (2) approving the usage of foreign assistance
funding for the procurement of personal protective equipment by
United States Government implementing partners from businesses
within or nearby the country receiving foreign assistance on an
urgent basis and in a manner consistent with efforts to respond
to the spread of a pandemic in the United States; and</DELETED>
<DELETED> (3) waiving certain travel restrictions
implemented to help contain the spread of a pandemic in order
to facilitate the medical evacuation of United States
Government implementing partners, regardless of
nationality.</DELETED>
<DELETED>TITLE II--INTERNATIONAL PANDEMIC PREVENTION AND
PREPAREDNESS</DELETED>
<DELETED>SEC. 201. PARTNER COUNTRY DEFINED.</DELETED>
<DELETED> In this title, the term ``partner country'' means a
foreign country in which the relevant Federal departments and agencies
are implementing United States assistance for global health security
and pandemic prevention and preparedness under this Act.</DELETED>
<DELETED>SEC. 202. GLOBAL HEALTH SECURITY STRATEGY AND
REPORT.</DELETED>
<DELETED> (a) In General.--The President shall develop, update,
maintain, and advance a comprehensive strategy for improving global
health security and pandemic prevention, preparedness, and response
that--</DELETED>
<DELETED> (1) clearly articulates the policy goals related
to pandemic prevention, preparedness, and response, and actions
necessary to elevate and strengthen United States diplomatic
leadership in global health security and pandemic preparedness,
including by building the expertise of the diplomatic
corps;</DELETED>
<DELETED> (2) improves the effectiveness of United States
foreign assistance to prevent, detect, and respond to
infectious disease threats, through a One Health approach,
including through the advancement of the Global Health Security
Agenda, the International Health Regulations (2005), and other
relevant frameworks and programs that contribute to global
health security and pandemic preparedness;</DELETED>
<DELETED> (3) establishes specific and measurable goals,
benchmarks, timetables, performance metrics, and monitoring and
evaluation plans for United States foreign policy and
assistance for global health security that promote learning and
adaptation and reflect international best practices relating to
global health security, transparency, and
accountability;</DELETED>
<DELETED> (4) establishes transparent means to improve
coordination and performance by the relevant Federal
departments and agencies and sets out clear roles and
responsibilities that reflect the unique capabilities and
resources of each such department and agency;</DELETED>
<DELETED> (5) establishes mechanisms to improve coordination
and avoid duplication of effort among the relevant Federal
departments and agencies, partner countries, donor countries,
the private sector, multilateral organizations, and other key
stakeholders, and ensures collaboration at the country
level;</DELETED>
<DELETED> (6) supports, and is aligned with, partner
country-led, global health security policy and investment
plans, developed with input from key stakeholders, as
appropriate;</DELETED>
<DELETED> (7) prioritizes working with partner countries
with--</DELETED>
<DELETED> (A) demonstrated need, as identified
through the Joint External Evaluation process, the
Global Health Security Index classification of health
systems, national action plans for health security,
Global Health Security Agenda Action Packages, other
risk-based assessments, and other complementary or
successor indicators of global health security and
pandemic preparedness; and</DELETED>
<DELETED> (B) demonstrated commitment to
transparency, including budget and global health data
transparency, complying with the International Health
Regulations (2005), investing in domestic health
systems, and achieving measurable results;</DELETED>
<DELETED> (8) reduces long-term reliance upon United States
foreign assistance for global health security by--</DELETED>
<DELETED> (A) helping build and enhance community
resilience to infectious disease emergencies and
threats, such as COVID-19 and Ebola;</DELETED>
<DELETED> (B) ensuring that United States global
health assistance is strategically planned and
coordinated in a manner that contributes to the
strengthening of overall health systems and builds the
capacity of local organizations and
institutions;</DELETED>
<DELETED> (C) promoting improved domestic resource
mobilization, co-financing, and appropriate national
budget allocations for strong health systems, global
health security, and pandemic preparedness and response
in partner countries; and</DELETED>
<DELETED> (D) ensuring partner country ownership of
global health security strategies, data, programs, and
outcomes;</DELETED>
<DELETED> (9) supports health budget and workforce planning
in partner countries, including training in public financial
management and budget data transparency;</DELETED>
<DELETED> (10) works to ensure that--</DELETED>
<DELETED> (A) partner countries have national action
plans for health security that are developed with input
from key stakeholders, including communities and the
private sector; and</DELETED>
<DELETED> (B) United States foreign assistance for
global health security is aligned with existing
national action plans for health security in partner
countries, developed with input from key stakeholders,
including communities and the private sector, to the
greatest extent practicable and appropriate;</DELETED>
<DELETED> (11) strengthens linkages between complementary
bilateral and multilateral foreign assistance programs,
including efforts of the World Bank, the World Health
Organization, the Global Fund to Fight AIDS, Tuberculosis, and
Malaria, Gavi, the Vaccine Alliance, and regional health
organizations, that contribute to the development of more
resilient health systems and supply chains in partner countries
with the capacity, resources, and personnel required to
prevent, detect, and respond to infectious disease threats;
and</DELETED>
<DELETED> (12) supports innovation and partnerships with the
private sector, health organizations, civil society,
nongovernmental organizations, and health research and academic
institutions to improve pandemic preparedness and response,
including for the prevention and detection of infectious
disease, and the development and deployment of effective,
accessible, and affordable infectious disease tracking tools,
diagnostics, therapeutics, and vaccines.</DELETED>
<DELETED> (b) Submission of Strategy.--Not later than 120 days after
the date of the enactment of this Act, the President shall submit the
strategy required under subsection (a) to the appropriate congressional
committees.</DELETED>
<DELETED> (c) Annual Report.--</DELETED>
<DELETED> (1) In general.--Not later than 1 year after the
submission of the strategy to the appropriate congressional
committees under subsection (b), and not later than October 1
of each year thereafter for the following 4 fiscal years, the
President shall submit a report to the appropriate
congressional committees that describes--</DELETED>
<DELETED> (A) the status of the implementation of
the strategy required under subsection (a);</DELETED>
<DELETED> (B) any necessary updates to the
strategy;</DELETED>
<DELETED> (C) the progress made in implementing the
strategy, with specific information related to the
progress toward improving countries' ability to detect,
respond and prevent the spread of infectious disease
threats, such as COVID-19 and Ebola; and</DELETED>
<DELETED> (D) details on the status of funds made
available to carry out the purposes of this
title.</DELETED>
<DELETED> (2) Agency-specific plans.--The reports required
under paragraph (1) shall include specific implementation plans
from each relevant Federal department and agency that
describe--</DELETED>
<DELETED> (A) how updates to the strategy may have
impacted the agency's plan during the preceding
calendar year;</DELETED>
<DELETED> (B) the progress made in meeting the
goals, objectives, and benchmarks under implementation
plans during the preceding year;</DELETED>
<DELETED> (C) the anticipated staffing plans and
contributions of the department or agency, including
technical, financial, and in-kind contributions, to
implement the strategy;</DELETED>
<DELETED> (D) a transparent, open, and detailed
accounting of obligations by each of the relevant
Federal departments and agencies to implement the
strategy, including--</DELETED>
<DELETED> (i) the statutory source of
obligated funds;</DELETED>
<DELETED> (ii) the amounts
obligated;</DELETED>
<DELETED> (iii) implementing
partners;</DELETED>
<DELETED> (iv) targeted beneficiaries;
and</DELETED>
<DELETED> (v) activities
supported;</DELETED>
<DELETED> (E) the efforts of the relevant Federal
department or agency to ensure that the activities and
programs carried out pursuant to the strategy are
designed to achieve maximum impact and enduring
returns, including through specific activities to
strengthen health systems, as appropriate;
and</DELETED>
<DELETED> (F) a plan for regularly reviewing and
updating programs and partnerships, and for sharing
lessons learned with a wide range of stakeholders in an
open, transparent manner.</DELETED>
<DELETED> (3) Form.--The reports required under paragraph
(1) shall be submitted in unclassified form, but may contain a
classified annex.</DELETED>
<DELETED>SEC. 203. COMMITTEE ON GLOBAL HEALTH SECURITY AND PANDEMIC AND
BIOLOGICAL THREATS.</DELETED>
<DELETED> (a) Statement of Policy.--It shall be the policy of the
United States--</DELETED>
<DELETED> (1) to promote global health security as a core
national and security interest; and</DELETED>
<DELETED> (2) to ensure effective coordination and
collaboration between the relevant Federal departments and
agencies engaged domestically and internationally in efforts to
advance the global health security of the United States, in
accordance with paragraph (1).</DELETED>
<DELETED> (b) Coordination.--</DELETED>
<DELETED> (1) Defined term.--In this subsection, the term
``pandemic threat'' means any infectious disease that--
</DELETED>
<DELETED> (A) has an aggregation of cases in a
community that rises above what is normally expected in
that population in that area;</DELETED>
<DELETED> (B) has the potential to spread over
several countries or continents; and</DELETED>
<DELETED> (C) could, if not addressed, threaten the
national security of the United States.</DELETED>
<DELETED> (2) Committee on global health security and
pandemic and biological threats.--There is authorized to be
established, within the National Security Council, the
Committee on Global Health Security and Pandemic and Biological
Threats (referred to in this subsection as the ``Committee''),
whose day to day operations should be led by the Special
Advisor for Global Health Security.</DELETED>
<DELETED> (3) Special advisor for global health security.--
The Special Advisor for Global Health Security referred to in
paragraph (2)--</DELETED>
<DELETED> (A) should serve as part of the staff of
the National Security Council; and</DELETED>
<DELETED> (B) may also be the Senior Director for a
Global Health Security and Biodefense Directorate
within the Executive Office of the President, who
reports to the Assistant to the President for National
Security Affairs.</DELETED>
<DELETED> (4) Composition.--The Committee should include the
following members:</DELETED>
<DELETED> (A) The Director of National
Intelligence.</DELETED>
<DELETED> (B) The Secretary of State.</DELETED>
<DELETED> (C) The Secretary of Defense.</DELETED>
<DELETED> (D) The Secretary of Health and Human
Services.</DELETED>
<DELETED> (E) The Administrator of the United States
Agency for International Development.</DELETED>
<DELETED> (F) The Secretary of
Agriculture.</DELETED>
<DELETED> (G) The Secretary of the
Treasury.</DELETED>
<DELETED> (H) The Attorney General.</DELETED>
<DELETED> (I) The Secretary of Homeland
Security.</DELETED>
<DELETED> (J) The Office of Management and
Budget.</DELETED>
<DELETED> (K) The Administrator of the Environmental
Protection Agency.</DELETED>
<DELETED> (L) The Director of the Centers for
Disease Control and Prevention.</DELETED>
<DELETED> (M) The Director of the Office of Science
and Technology Policy.</DELETED>
<DELETED> (N) The Assistant to the President for
National Security Affairs, who should serve as the
chairperson of the Committee.</DELETED>
<DELETED> (O) Such other members as the President
may designate.</DELETED>
<DELETED> (5) Functions.--</DELETED>
<DELETED> (A) In general.--The functions of the
Committee should be--</DELETED>
<DELETED> (i) to provide strategic guidance
for the development of a policy framework for
activities of the United States Government
relating to global health security, including
pandemic prevention, preparedness and response;
and</DELETED>
<DELETED> (ii) to ensure policy coordination
between United States Government agencies,
especially coordination between--</DELETED>
<DELETED> (I) agencies with a
primarily domestic mandate;
and</DELETED>
<DELETED> (II) agencies with an
international mandate relating to
global health security and pandemic
threats.</DELETED>
<DELETED> (B) Activities.--In carrying out the
functions described in subparagraph (A), the Committee
should--</DELETED>
<DELETED> (i) conduct, in coordination with
the heads of relevant Federal agencies, a
review of existing United States health
security policies and strategies and develop
recommendations for how the Federal Government
may regularly update and harmonize such
policies and strategies to ensure the timely
development of a comprehensive coordinated
strategy to enable the United States Government
to respond to pandemic threats and to monitor
the implementation of such
strategies;</DELETED>
<DELETED> (ii) develop a plan for--
</DELETED>
<DELETED> (I) establishing an
interagency National Center for
Epidemic Forecasting and Outbreak
Analytics; and</DELETED>
<DELETED> (II) modernizing global
early warning and trigger systems for
scaling action to prevent, detect,
respond to, and recover from emerging
biological threats;</DELETED>
<DELETED> (iii) provide policy-level
recommendations to participating agencies
regarding the Global Health Security Agenda
goals, objectives, and implementation, and
other international efforts to strengthen
pandemic prevention, preparedness and
response;</DELETED>
<DELETED> (iv) review the progress toward,
and working to resolve challenges in, achieving
United States commitments under the
GHSA;</DELETED>
<DELETED> (v) develop protocols for
coordinating and deploying a global response to
emerging high-consequence infectious disease
threats that outline the respective roles for
relevant Federal agencies in facilitating and
supporting such response operations that should
facilitate the operational work of Federal
agencies, and of the Special Advisor for Global
Health Security;</DELETED>
<DELETED> (vi) make recommendations
regarding appropriate responses to specific
pandemic threats and ensure the coordination of
domestic and international agencies regarding
the Federal Government's efforts to prevent,
detect, respond to, and recover from biological
events; and</DELETED>
<DELETED> (vii) take steps to strengthen the
global pandemic supply chain and address any
barriers to the timely delivery of supplies in
response to a pandemic, including through
engagement with the private sector, as
appropriate;</DELETED>
<DELETED> (C) develop policies and procedures to
ensure the effective sharing of information from
domestic and international sources about pandemic
threats among the relevant Federal departments and
agencies, State and local governments, and
international partners and organizations; and</DELETED>
<DELETED> (D) develop guidelines to enhance and
improve the operational coordination between State and
local governments and Federal agencies with respect to
pandemic threats.</DELETED>
<DELETED> (6) Foreign affairs responsibilities.--The
Committee should not assume any foreign affairs
responsibilities of the Secretary of State, including the
responsibility to oversee the implementation of programs and
policies that advance global health security within foreign
countries.</DELETED>
<DELETED> (7) Specific roles and responsibilities.--
</DELETED>
<DELETED> (A) In general.--The heads of the agencies
listed in paragraph (4) should--</DELETED>
<DELETED> (i) make global health security
and pandemic threat reduction a high priority
within their respective agencies, and include
global health security and pandemic threat
reduction-related activities within their
respective agencies' strategic planning and
budget processes;</DELETED>
<DELETED> (ii) designate a senior-level
official to be responsible for global health
security and pandemic threat reduction at each
of their respective agencies;</DELETED>
<DELETED> (iii) designate, in accordance
with paragraph (4), an appropriate
representative at the Assistant Secretary level
or higher to participate on the Committee in
instances where the head of the agency cannot
participate;</DELETED>
<DELETED> (iv) keep the Committee apprised
of Global Health Security and pandemic threat
reduction-related activities undertaken within
their respective agencies;</DELETED>
<DELETED> (v) ensure interagency cooperation
and collaboration and maintain responsibility
for agency-related programmatic functions
including, as applicable, in coordination with
host governments, country teams, and global
health security in-country teams; and</DELETED>
<DELETED> (vi) keep the Committee apprised
of GHSA-related activities undertaken within
their respective agencies.</DELETED>
<DELETED> (B) Additional roles and
responsibilities.--In addition to the roles and
responsibilities described in subparagraph (A), the
heads of the agencies described in paragraph (4) should
carry out their respective roles and responsibilities
described in 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) and the National Security Memorandum-1
on United States Global Leadership to Strengthen the
International COVID-19 Response and to Advance Global
Health Security and Biological Preparedness, as in
effect on the day before the date of the enactment of
this Act.</DELETED>
<DELETED>SEC. 204. UNITED STATES OVERSEAS GLOBAL HEALTH SECURITY AND
DIPLOMACY COORDINATION AND STRATEGY.</DELETED>
<DELETED> (a) Establishment.--There is established, within the
Department of State, a Special Representative for United States
International Activities to Advance Global Health Security and
Diplomacy Overseas (referred to in this section as the ``Special
Representative'').</DELETED>
<DELETED> (b) Appointment; Qualifications.--The Special
Representative--</DELETED>
<DELETED> (1) shall be appointed by the President, by and
with the advice and consent of the Senate;</DELETED>
<DELETED> (2) shall report to the Secretary of State;
and</DELETED>
<DELETED> (3) shall have--</DELETED>
<DELETED> (A) demonstrated knowledge and experience
in the fields of development and public health,
epidemiology, or medicine; and</DELETED>
<DELETED> (B) relevant diplomatic, policy, and
political expertise.</DELETED>
<DELETED> (c) Authorities.--The Special Representative is
authorized--</DELETED>
<DELETED> (1) to operate internationally to carry out the
purposes of this title;</DELETED>
<DELETED> (2) to lead in developing a global pandemic
prevention, preparedness and response framework to support
global pandemic prevention, preparedness, responses and
recovery efforts, including through--</DELETED>
<DELETED> (A) diplomatic engagement and related
foreign policy efforts, such as multilateral and
bilateral arrangements, enhanced coordination of
engagement with multilateral organizations and
countries, and the mobilization of donor contributions;
and</DELETED>
<DELETED> (B) support for United States citizens
living abroad, including consular support;</DELETED>
<DELETED> (3) to serve as the representative of the
Secretary of the State on the Committee on Global Health
Security and Pandemic and Biological Threats under section
202;</DELETED>
<DELETED> (4) to represent the United States on the Fund for
Global Health Security and Pandemic Prevention and Preparedness
established pursuant to section 302(a);</DELETED>
<DELETED> (5) to transfer and allocate United States foreign
assistance funding authorized to be appropriated pursuant to
subsection (f) to the relevant Federal departments and agencies
implementing the strategy required under section 202, in
coordination with the Office of Management and Budget, the
United States Agency for International Development, the
Department of Health and Human Services, and the Office of
Foreign Assistance Resources in the Department of
State;</DELETED>
<DELETED> (6) to utilize detailees, on a reimbursable or
nonreimbursable basis, from the relevant Federal departments
and agencies and hire personal service contractors, who may
operate domestically and internationally, to ensure that the
Office of the Special Representative has access to the highest
quality experts available to the United States Government to
carry out the functions under this Act; and</DELETED>
<DELETED> (7) to perform such other functions as the
Secretary of State may assign.</DELETED>
<DELETED> (d) Duties.--The Special Representative shall coordinate,
manage, and oversee United States foreign policy, diplomatic efforts,
and foreign assistance funded with amounts appropriated pursuant to
subsection (f) to advance the United States Global Health Security and
Diplomacy Strategy developed pursuant to section 202, including by--
</DELETED>
<DELETED> (1) developing and coordinating a global pandemic
prevention, preparedness and response framework to support
pandemic preparedness, responses and recovery efforts, and
related foreign policy measures, such as multilateral and
bilateral arrangements;</DELETED>
<DELETED> (2) enhancing engagement with multilateral
organizations and partner countries, including through the
mobilization of donor support;</DELETED>
<DELETED> (3) enhancing coordination of consular services
for United States citizens abroad in the event of a global
health emergency;</DELETED>
<DELETED> (4) ensuring effective program coordination and
implementation by the relevant Federal departments and agencies
by--</DELETED>
<DELETED> (A) formulating, issuing, and updating
related policy guidance;</DELETED>
<DELETED> (B) establishing, in consultation with the
United States Agency for International Development and
the Centers for Disease Control and Prevention, unified
auditing, monitoring, and evaluation plans;</DELETED>
<DELETED> (C) aligning, in coordination with United
States chiefs of mission and country teams in partner
countries--</DELETED>
<DELETED> (i) the foreign assistance
resources funded with amounts appropriated
pursuant to subsection (f); and</DELETED>
<DELETED> (ii) the implementation plans
required under section 202(c)(2) with the
relevant Federal departments and agencies in a
manner that--</DELETED>
<DELETED> (I) is consistent with
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);</DELETED>
<DELETED> (II) is consistent with
the National Security Memorandum on
United States Global Leadership to
Strengthen the International COVID-19
Response and to Advance Global Health
Security and Biological Preparedness,
issued by President Biden on January
21, 2021; and</DELETED>
<DELETED> (III) reflects and
leverages the unique capabilities of
each such department and
agency;</DELETED>
<DELETED> (D) convening, as appropriate, an
interagency working group on pandemic prevention and
preparedness, headed by the Special Representative and
including representatives from the relevant Federal
departments and agencies, to facilitate coordination of
activities relating to pandemic prevention and
preparedness in partner countries under this
Act;</DELETED>
<DELETED> (E) working with, and leveraging the
expertise and activities of, the Office of the United
States Global AIDS Coordinator, the Office of the
United States Global Malaria Coordinator, and similar
or successor entities that are implementing United
States global health assistance overseas; and</DELETED>
<DELETED> (F) avoiding duplication of effort and
working to resolve policy, program, and funding
disputes among the relevant Federal departments and
agencies;</DELETED>
<DELETED> (5) leading diplomatic efforts to identify and
address current and emerging threats to global health
security;</DELETED>
<DELETED> (6) ensuring, in coordination with the Secretary
of Health and Human Services and the Administrator of the
United States Agency for International Development, effective
representation of the United States in relevant international
forums, including at the World Health Organization, the World
Health Assembly, and meetings of the Global Health Security
Agenda and of the Global Health Security Initiative;</DELETED>
<DELETED> (7) working to enhance coordination with, and
transparency among, the governments of partner countries and
key stakeholders, including the private sector;</DELETED>
<DELETED> (8) promoting greater donor and national
investment in partner countries to build more resilient health
systems and supply chains, including through representation and
participation in a multilateral, catalytic financing mechanism
for global health security and pandemic prevention and
preparedness, consistent with title III;</DELETED>
<DELETED> (9) securing bilateral and multilateral financing
commitments to advance the Global Health Security Agenda,
including through funding for the financing mechanism described
in title III; and</DELETED>
<DELETED> (10) providing regular updates to the appropriate
congressional committees regarding the fulfillment of the
duties described in this subsection.</DELETED>
<DELETED> (e) Deputy Representative.--The Special Representative
should be supported by a deputy, who--</DELETED>
<DELETED> (1) should be an employee of the United States
Agency for International Development serving in a career or
noncareer position in the Senior Executive Service or at the
level of a Deputy Assistant Administrator or higher;</DELETED>
<DELETED> (2) should have demonstrated knowledge and
experience in the fields of development and public health,
epidemiology, or medicine; and</DELETED>
<DELETED> (3) serves concurrently as the deputy and performs
the functions described in section 3(h) of Executive Order
13747 (81 Fed. Reg. 78701).</DELETED>
<DELETED> (f) Authorization of Appropriations.--</DELETED>
<DELETED> (1) In general.--There is authorized to be
appropriated $3,000,000,000, for the 5-year period beginning on
October 1, 2022, to carry out the purposes of this section and
title III, which, in consultation with the appropriate
congressional committees and subject to the requirements under
chapters 1 and 10 of part I and section 634A of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151 et seq.), may include
support for--</DELETED>
<DELETED> (A) enhancing preparedness in partner
countries through implementation of the Global Health
Security Strategy developed pursuant to section
202;</DELETED>
<DELETED> (B) replenishing the Emergency Reserve
Fund at the United States Agency for International
Development, established pursuant to section 7058(c)(1)
of the Department of State, Foreign Operations, and
Related Programs Appropriations Act, 2017 (division J
of Public Law 115-31) to address new or emerging
infectious disease threats, as necessary and
appropriate;</DELETED>
<DELETED> (C) United States contributions to the
World Bank Health Emergency Preparedness and Response
Multi-Donor Fund; and</DELETED>
<DELETED> (D) United States contributions to a
multilateral, catalytic financing mechanism for global
health security and pandemic prevention and
preparedness described in section 302.</DELETED>
<DELETED> (2) Exception.--Section 110 of the Trafficking
Victims Protection Act of 2000 (22 U.S.C. 7107) shall not apply
to assistance made available pursuant to this
subsection.</DELETED>
<DELETED>SEC. 205. RESILIENCE.</DELETED>
<DELETED> It shall be the policy of the United States to support the
growth of healthier, more stable societies, while advancing the global
health security interests of the United States by working with key
stakeholders--</DELETED>
<DELETED> (1) in developing countries that are highly
vulnerable to the emergence, reemergence, and spread of
infectious diseases with pandemic potential, including diseases
resulting from natural and manmade disasters, human
displacement, loss of natural habitat, poor access to water,
sanitation, and hygiene, and other political, security,
economic, and climatic shocks and stresses;</DELETED>
<DELETED> (2) to develop effective tools to identify,
analyze, forecast, and mitigate the risks that make such
countries vulnerable;</DELETED>
<DELETED> (3) to better integrate short-, medium-, and long-
term recovery efforts into global health emergency response and
disaster relief; and</DELETED>
<DELETED> (4) to ensure that international assistance and
financing tools are effectively designed, objectively informed,
strategically targeted, carefully coordinated, reasonably
adapted, and rigorously monitored and evaluated in a manner
that advances the policy objectives under this
section.</DELETED>
<DELETED>SEC. 206. STRENGTHENING HEALTH SYSTEMS.</DELETED>
<DELETED> (a) Statement of Policy.--It shall be the policy of the
United States to ensure that bilateral global health assistance
programs are effectively managed and coordinated to contribute to the
strengthening of health systems in each country in which such programs
are carried out, as necessary and appropriate.</DELETED>
<DELETED> (b) Coordination.--The Administrator of the United States
Agency for International Development (referred to in this section as
``USAID'') shall work with the Director of the Centers for Disease
Control and Prevention, the Global Malaria Coordinator, and the United
States Global AIDS Coordinator and Special Representative for Global
Health Diplomacy at the Department of State to identify areas of
collaboration and coordination in countries with global health programs
and activities undertaken by USAID pursuant to the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003
(Public Law 108-25) and other relevant statutes to ensure that such
activities contribute to health systems strengthening.</DELETED>
<DELETED> (c) Pilot Program.--</DELETED>
<DELETED> (1) In general.--The Administrator of USAID should
identify not fewer than 5 countries in which the United States
has significant bilateral investments in global health to
develop an integrated approach toward health systems
strengthening that takes advantage of all sources of funding
for global health in such country, with the aim of establishing
a model for coordinating health systems strengthening
activities in additional countries in the future.</DELETED>
<DELETED> (2) Assessment.--In the countries selected under
paragraph (1), USAID missions, in consultation with USAID's
Office of Health Systems Strengthening, should conduct an
assessment that--</DELETED>
<DELETED> (A) takes a comprehensive view of the
constraints in the country's health system that prevent
the achievement of desired outcomes of United States
Government-supported health programs;</DELETED>
<DELETED> (B) identifies the best opportunities for
improving health systems to achieve improved outcomes,
including obstacles to health service
delivery;</DELETED>
<DELETED> (C) maps the resources of the country and
other donors in the health sector with a focus on
investment in health system strengthening;
and</DELETED>
<DELETED> (D) develops and implements a new or
revised 5-year strategy for United States assistance,
based on the results of the assessment described in
subparagraph (A), to strengthen the country's health
system that--</DELETED>
<DELETED> (i) provides a framework for
implementing such strategy;</DELETED>
<DELETED> (ii) identifies key areas for
United States Government investments to
strengthen the health system in alignment with
other donors;</DELETED>
<DELETED> (iii) specifies the anticipated
role of health programs undertaken by each of
the relevant Federal departments and agencies
operating in the country in implementing such
strategy; and</DELETED>
<DELETED> (iv) includes clear goals,
benchmarks, outputs, desired outcomes, a means
of measuring progress and a cost
analysis.</DELETED>
<DELETED> (3) Strategies to strengthen health systems.--
USAID missions in countries identified pursuant paragraph (1)
should develop a strategy to strengthen health systems based on
the assessment developed pursuant to paragraph (2) that--
</DELETED>
<DELETED> (A) ensures complementarity with
priorities identified under any other action plan
focused on strengthening a country's health system,
such as the World Health Organization's Joint External
Evaluation and National Action Plans for Health
Security;</DELETED>
<DELETED> (B) identifies bureaucratic barriers and
inefficiencies, including poor linkages between
government ministries and between ministries and donor
agencies and the extent of any corruption, and identify
actions to overcome such barriers;</DELETED>
<DELETED> (C) identifies potential obstacles to the
implementation of the strategy, such as issues relating
to lack of political will or poor governance of an
effective health system at all levels of the country's
public health systems, especially with respect to
governing bodies and councils at the provincial,
district, and community levels;</DELETED>
<DELETED> (D) includes proposals for mobilizing
sufficient and durable financing for health
systems;</DELETED>
<DELETED> (E) identifies barriers to building and
retaining an effective frontline health workforce with
key global health security capacities, informed by the
International Health Regulations (2005), including--
</DELETED>
<DELETED> (i) strengthened data collection
and analysis;</DELETED>
<DELETED> (ii) data driven decisionmaking
capacity; and</DELETED>
<DELETED> (iii) recommendations for partner
country actions to achieve a workforce that
conforms with the World Health Organization's
recommendation for at least 44.5 doctors,
nurses, and midwives for every 10,000
people;</DELETED>
<DELETED> (F) identifies deficiencies in information
systems and communication technologies that prevent
linkages at all levels of the health system delivery
and medical supply systems and promotes
interoperability across data systems with real time
data, while protecting data security;</DELETED>
<DELETED> (G) identifies weaknesses in supply chain
and procurement systems and practices, and recommends
ways to improve the efficiency, transparency, and
effectiveness of such systems and practices;</DELETED>
<DELETED> (H) identifies obstacles to health service
access and quality and improved health outcomes for
women and girls, and for the poorest and most
vulnerable, including a lack of social support and
other underlying causes, and recommendations for how to
overcome such obstacles;</DELETED>
<DELETED> (I) includes plans for integrating
innovations in health technologies, services, and
systems;</DELETED>
<DELETED> (J) identifies barriers to health
literacy, community engagement, and patient
empowerment, and recommendations for overcoming such
barriers;</DELETED>
<DELETED> (K) includes proposals for strengthening
community health systems and the community-based health
workforce informed by the World Health Organization
guideline on health policy and system support to
optimize community health worker programmes (2018),
including the professionalization of community health
workers; and</DELETED>
<DELETED> (L) describes the role of the private
sector and nongovernmental health providers, including
community groups engaged in health promotion and mutual
assistance and other institutions engaged in health
delivery, including the extent to which the local
population utilizes such health services.</DELETED>
<DELETED> (4) Consultation.--In developing a strategy
pursuant to paragraph (3), each USAID mission should consult
with a wide variety of stakeholders, including--</DELETED>
<DELETED> (A) relevant partner government
institutions;</DELETED>
<DELETED> (B) professional associations;</DELETED>
<DELETED> (C) patient groups;</DELETED>
<DELETED> (D) civil society organizations (including
international nongovernmental organizations with
relevant expertise in program implementation);
and</DELETED>
<DELETED> (E) the private sector.</DELETED>
<DELETED> (d) International Efforts.--</DELETED>
<DELETED> (1) Coordination.--The Secretary of State, in
coordination with the Administrator of USAID, should work with
the Global Fund to Fight AIDS, Tuberculosis, and Malaria, Gavi,
the Vaccine Alliance, bilateral donors, and other relevant
multilateral and international organizations and stakeholders
to develop--</DELETED>
<DELETED> (A) shared core indicators for
strengthened health systems;</DELETED>
<DELETED> (B) agreements among donors that reporting
requirements for health systems come from country
systems to reduce the burden placed on partner
countries;</DELETED>
<DELETED> (C) structures for joint assessments,
plans, auditing, and consultations; and</DELETED>
<DELETED> (D) a regularized approach to coordination
on health systems strengthening.</DELETED>
<DELETED> (e) Public Private Partnerships To Improve Health Systems
Strengthening.--</DELETED>
<DELETED> (1) Inclusion in country strategies.--The country
strategies developed under subsection (c)(3) should include a
section that--</DELETED>
<DELETED> (A) discusses the role of the private
sector (including corporate, local, and international
organizations with relevant expertise); and</DELETED>
<DELETED> (B) identifies relevant opportunities for
the private sector--</DELETED>
<DELETED> (i) to accelerate research and
development of innovative health and
information technology, and to offer training
related to its use;</DELETED>
<DELETED> (ii) to contribute to improvements
in health administration and management
processes;</DELETED>
<DELETED> (iii) to improve system
efficiency;</DELETED>
<DELETED> (iv) to develop training related
to clinical practice guidelines; and</DELETED>
<DELETED> (v) to help countries develop
systems for documenting outcomes and
achievements related to activities undertaken
to strengthen the health sector.</DELETED>
<DELETED> (f) Authorization for Use of Funds.--Amounts authorized to
be appropriated or otherwise made available to carry out section 104 of
the Foreign Assistance Act of 1961 (22 U.S.C. 2151b) may be made
available to carry out this section.</DELETED>
<DELETED>SEC. 207. ADDITIONAL AUTHORITIES.</DELETED>
<DELETED> (a) Foreign Assistance Act of 1961.--Chapter 1 of part I
of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is
amended--</DELETED>
<DELETED> (1) in section 104(c)(1) (22 U.S.C. 2151b(c)(1)),
by inserting ``(emphasizing health systems strengthening, as
appropriate)'' after ``health services'';</DELETED>
<DELETED> (2) in section 104A (22 U.S.C. 2151b-2)--
</DELETED>
<DELETED> (A) in subsection (b)(3)(D), by striking
``including health care systems, under other
international donor support'' and inserting ``including
through support for health systems strengthening, under
other donor support''; and</DELETED>
<DELETED> (B) in subsection (f)(3)(Q), by inserting
``the Office of the United States Global AIDS
Coordinator, partner countries, and the Global Fund to
Fight AIDS, Tuberculosis, and Malaria to ensure that
their actions support the activities taken to
strengthen the overall health systems in recipient
countries, and efforts by'' after ``efforts by'';
and</DELETED>
<DELETED> (3) in section 104B(g)(2) (22 U.S.C. 2151b-
3(g)(2)), by inserting ``strengthening the health system of the
country and'' after ``contribute to''.</DELETED>
<DELETED> (b) United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003.--Section 204 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (22 U.S.C. 7623) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) in paragraph (1)(A), by inserting ``in
a manner that is coordinated with, and contributes to,
efforts through other assistance activities being
carried out to strengthen national health systems and
health policies'' after ``systems''; and</DELETED>
<DELETED> (B) in paragraph (2)--</DELETED>
<DELETED> (i) in subparagraph (C), by
inserting ``as part of a strategy to improve
overall health'' before the semicolon at the
end;</DELETED>
<DELETED> (ii) in subparagraph (D), by
striking ``and'' at the end;</DELETED>
<DELETED> (iii) in subparagraph (E), by
striking the period at the end and inserting
``; and''; and</DELETED>
<DELETED> (iv) by adding at the end the
following:</DELETED>
<DELETED> ``(F) to contribute to efforts that build
health systems capable of preventing, detecting and
responding to HIV/AIDS, tuberculosis, malaria and other
infectious diseases with pandemic potential.'';
and</DELETED>
<DELETED> (2) in subsection (b), by striking ``receive
funding to carry out programs to combat HIV/AIDS, tuberculosis,
and malaria'' and inserting ``more effectively budget for and
receive funding to carry out programs to strengthen health
systems such that countries are able to more effectively combat
HIV/AIDS, tuberculosis, and malaria, to prevent, respond and
detect other diseases with pandemic potential,''.</DELETED>
<DELETED>SEC. 208. AUTHORIZATION FOR UNITED STATES PARTICIPATION IN THE
COALITION FOR EPIDEMIC PREPAREDNESS
INNOVATIONS.</DELETED>
<DELETED> (a) In General.--The United States is authorized to
participate in the Coalition for Epidemic Preparedness Innovations
(referred to in this section as ``CEPI'').</DELETED>
<DELETED> (b) Investors Council and Board of Directors.--</DELETED>
<DELETED> (1) Initial designation.--The President shall
designate an employee of the United States Agency for
International Development to serve on the Investors Council
and, if nominated, on the Board of Directors of CEPI, as a
representative of the United States during the period beginning
on the date of such designation and ending on September 30,
2022.</DELETED>
<DELETED> (2) Ongoing designations.--The President may
designate an employee of the relevant Federal department or
agency with fiduciary responsibility for United States
contributions to CEPI to serve on the Investors Council and, if
nominated, on the Board of Directors of CEPI, as a
representative of the United States.</DELETED>
<DELETED> (3) Qualifications.--Any employee designated
pursuant to paragraph (1) or (2) shall have demonstrated
knowledge and experience in the fields of development and
public health, epidemiology, or medicine, from the Federal
department or agency with primary fiduciary responsibility for
United States contributions pursuant to subsection
(c).</DELETED>
<DELETED> (c) Consultation.--Not later than 60 days after the date
of the enactment of this Act, the employee designated pursuant to
subsection (b)(1) shall consult with the appropriate congressional
committees regarding--</DELETED>
<DELETED> (1) the manner and extent to which the United
States plans to participate in CEPI, including through the
governance of CEPI;</DELETED>
<DELETED> (2) any planned financial contributions from the
United States to CEPI; and</DELETED>
<DELETED> (3) how participation in CEPI is expected to
support--</DELETED>
<DELETED> (A) the United States Global Health
Security Strategy required under this Act;</DELETED>
<DELETED> (B) the applicable revision of the
National Biodefense Strategy required under section
1086 of the National Defense Authorization Act for
Fiscal Year 2017 (6 U.S.C. 104); and</DELETED>
<DELETED> (C) any other relevant programs relating
to global health security and biodefense.</DELETED>
<DELETED> (d) United States Contributions.--</DELETED>
<DELETED> (1) Sense of congress.--It is the sense of
Congress that the President, consistent with the provisions
under section 10003(a)(1) of the American Rescue Plan Act of
2021, should make an immediate contribution to CEPI in the
amount of $300,000,000, to expand research and development of
vaccines to combat the spread of COVID-19 variants.</DELETED>
<DELETED> (2) Notification.--Not later than 15 days before a
contribution is made available pursuant to paragraph (1), the
President shall notify the appropriate congressional committees
of the details of the amount, purposes, and national interests
served by such contribution.</DELETED>
<DELETED>SEC. 209. NATIONAL INTELLIGENCE ESTIMATE AND BRIEFING
REGARDING NOVEL DISEASES AND PANDEMIC THREATS.</DELETED>
<DELETED> (a) Defined Term.--In this section, the term ``appropriate
committees of Congress'' means--</DELETED>
<DELETED> (1) the Committee on Foreign Relations of the
Senate;</DELETED>
<DELETED> (2) the Select Committee on Intelligence of the
Senate;</DELETED>
<DELETED> (3) the Committee on Health, Education, Labor, and
Pensions of the Senate;</DELETED>
<DELETED> (4) the Committee on Foreign Affairs of the House
of Representatives;</DELETED>
<DELETED> (5) the Permanent Select Committee on Intelligence
of the House of Representatives; and</DELETED>
<DELETED> (6) the Committee on Energy and Commerce of the
House of Representatives.</DELETED>
<DELETED> (b) National Intelligence Estimates.--</DELETED>
<DELETED> (1) In general.--Not later than 1 year after the
date of the enactment of this Act, and annually thereafter for
the following 4 years, the National Intelligence Council shall
submit to the appropriate committees of Congress a National
Intelligence Estimate regarding the risks posed to the national
security interests of the United States by the emergence,
reemergence, and overseas transmission of pathogens with
pandemic potential.</DELETED>
<DELETED> (2) Elements.--The National Intelligence Estimate
submitted pursuant to paragraph (1) shall--</DELETED>
<DELETED> (A) identify the countries or regions most
vulnerable to the emergence or reemergence of a
pathogen with pandemic potential, including the most
likely sources and pathways of such emergence or
reemergence, whether naturally occurring, accidental,
or deliberate;</DELETED>
<DELETED> (B) assess the likelihood that a pathogen
described in subparagraph (A) will spread to the United
States, the United States Armed Forces, diplomatic or
development personnel of the United States stationed
abroad, or citizens of the United States living abroad
in a manner that could lead to an epidemic in the
United States or otherwise affect the national security
or economic prosperity of the United States;</DELETED>
<DELETED> (C) assess the preparedness of countries
around the world, particularly those identified
pursuant to subparagraph (A), to prevent, detect, and
respond to pandemic threats; and</DELETED>
<DELETED> (D) identify any scientific, capacity, or
governance gaps in the preparedness of countries
identified pursuant to subparagraph (A), including an
analysis of the capacity and performance of any country
or entity described in subparagraph (C) in complying
with biosecurity standards, as applicable.</DELETED>
<DELETED> (c) Congressional Briefings.--The National Intelligence
Council shall provide an annual briefing to the appropriate committees
of Congress regarding--</DELETED>
<DELETED> (1) the most recent National Intelligence Estimate
submitted pursuant to subsection (b)(1); and</DELETED>
<DELETED> (2) the emergence or reemergence of pathogens with
pandemic potential that could lead to an epidemic described in
subsection (b)(2)(B).</DELETED>
<DELETED> (d) Public Availability.--The Director of National
Intelligence shall make publicly available an unclassified version of
each National Intelligence Estimate submitted pursuant to subsection
(b)(1).</DELETED>
<DELETED>SEC. 210. PANDEMIC EARLY WARNING NETWORK.</DELETED>
<DELETED> (a) In General.--The Secretary of State, in coordination
with the Administrator of the United States Agency for International
Development, the Secretary of Health and Human Services, and the heads
of the other relevant Federal departments and agencies, shall work with
the World Health Organization and other key stakeholders to establish
or strengthen effective early warning systems, at the partner country,
regional, and international levels, that utilize innovative information
and analytical tools and robust review processes to track, document,
analyze, and forecast infectious disease threats with epidemic and
pandemic potential.</DELETED>
<DELETED> (b) Report.--Not later than 1 year after the date of the
enactment of this Act, the Secretary of State, in coordination with the
Secretary of Health and Human Services and the heads of the other
relevant Federal departments and agencies, shall submit a report to the
appropriate congressional committees that describes United States
Government efforts and opportunities to establish or strengthen
effective early warning systems for infectious disease
threats.</DELETED>
<DELETED>SEC. 211. INTERNATIONAL EMERGENCY OPERATIONS.</DELETED>
<DELETED> (a) Sense of Congress.--It is the sense of Congress that
it is essential to enhance the capacity of key stakeholders to
effectively operationalize early warning and execute multi-sectoral
emergency operations during an infectious disease outbreak,
particularly in countries and areas that deliberately withhold critical
global health data and delay access during an infectious disease
outbreak in advance of the next infectious disease outbreak with
pandemic potential.</DELETED>
<DELETED> (b) Public Health Emergencies of International Concern.--
The Secretary of State, in coordination with the Secretary of Health
and Human Services, should work with the World Health Organization and
like-minded member states to adopt an approach toward assessing
infectious disease threats under the International Health Regulations
(2005) for the World Health Organization to identify and transparently
communicate, on an ongoing basis, varying levels of risk leading up to
a declaration by the Director General of the World Health Organization
of a Public Health Emergency of International Concern for the duration
and in the aftermath of such declaration.</DELETED>
<DELETED> (c) Emergency Operations.--The Secretary of State, in
coordination with the United States Agency for International
Development and other relevant Federal departments and agencies and
consistent with the requirements under the International Health
Regulations (2005) and the objectives of the World Health
Organization's Health Emergencies Programme, the Global Health Security
Agenda, and national actions plans for health security, shall work, in
coordination with the World Health Organization, with partner countries
and other key stakeholders to support the establishment, strengthening,
and rapid response capacity of global health emergency operations
centers, at the national and international levels, including efforts--
</DELETED>
<DELETED> (1) to collect and share data, assess risk, and
operationalize early warning;</DELETED>
<DELETED> (2) to secure, including through utilization of
stand-by arrangements and emergency funding mechanisms, the
staff, systems, and resources necessary to execute cross-
sectoral emergency operations during the 48-hour period
immediately following an infectious disease outbreak with
pandemic potential; and</DELETED>
<DELETED> (3) to organize and conduct emergency
simulations.</DELETED>
<DELETED>TITLE III--FINANCING MECHANISM FOR GLOBAL HEALTH SECURITY AND
PANDEMIC PREVENTION AND PREPAREDNESS</DELETED>
<DELETED>SEC. 301. ELIGIBLE PARTNER COUNTRY DEFINED.</DELETED>
<DELETED> In this title, the term ``eligible partner country'' means
a country in which the Fund for Global Health Security and Pandemic
Prevention and Preparedness to be established under section 302 may
finance global health security and pandemic prevention and preparedness
assistance programs under this Act based on the country's
demonstrated--</DELETED>
<DELETED> (1) need, as identified through the Joint External
Evaluation process, the Global Health Security Index
classification of health systems, national action plans for
health security, and other complementary or successor
indicators of global health security and pandemic prevention
and preparedness; and</DELETED>
<DELETED> (2) commitment to transparency, including--
</DELETED>
<DELETED> (A) budget and global health data
transparency;</DELETED>
<DELETED> (B) complying with the International
Health Regulations (2005);</DELETED>
<DELETED> (C) investing in domestic health systems;
and</DELETED>
<DELETED> (D) achieving measurable
results.</DELETED>
<DELETED>SEC. 302. ESTABLISHMENT OF FUND FOR GLOBAL HEALTH SECURITY AND
PANDEMIC PREVENTION AND PREPAREDNESS.</DELETED>
<DELETED> (a) Negotiations for Establishment of Fund for Global
Health Security and Pandemic Prevention and Preparedness.--The
Secretary of State, in coordination with the Secretary of the Treasury,
the Administrator of the United States Agency for International
Development, the Secretary of Health and Human Services, and the heads
of other relevant Federal departments and agencies, as necessary and
appropriate, should seek to enter into negotiations with donors,
relevant United Nations agencies, including the World Health
Organization, and other key multilateral stakeholders, to establish--
</DELETED>
<DELETED> (1) a multilateral, catalytic financing mechanism
for global health security and pandemic prevention and
preparedness, which may be known as the Fund for Global Health
Security and Pandemic Prevention and Preparedness (in this
title referred to as ``the Fund''), to address the need for and
secure durable financing in accordance with the provisions of
this section; and</DELETED>
<DELETED> (2) an Advisory Board to the Fund in accordance
with section 305.</DELETED>
<DELETED> (b) Purposes.--The purposes of the Fund should be--
</DELETED>
<DELETED> (1) to close critical gaps in global health
security and pandemic prevention and preparedness;
and</DELETED>
<DELETED> (2) to build capacity in eligible partner
countries in the areas of global health security, infectious
disease control, and pandemic prevention and preparedness, in a
manner that--</DELETED>
<DELETED> (A) prioritizes capacity building and
financing availability in eligible partner
countries;</DELETED>
<DELETED> (B) incentivizes countries to prioritize
the use of domestic resources for global health
security and pandemic prevention and
preparedness;</DELETED>
<DELETED> (C) leverages government, nongovernment,
and private sector investments;</DELETED>
<DELETED> (D) regularly responds to and evaluates
progress based on clear metrics and benchmarks, such as
the Joint External Evaluation and the Global Health
Security Index;</DELETED>
<DELETED> (E) aligns with and complements ongoing
bilateral and multilateral efforts and financing,
including through the World Bank, the World Health
Organization, the Global Fund to Fight AIDS,
Tuberculosis, and Malaria, the Coalition for Epidemic
Preparedness and Innovation, and Gavi, the Vaccine
Alliance; and</DELETED>
<DELETED> (F) helps countries accelerate and achieve
compliance with the International Health Regulations
(2005) and the fulfillment of the Global Health
Security Agenda 2024 Framework not later than 5 years
after the date on which the Fund is established, in
coordination with the ongoing Joint External Evaluation
national action planning process.</DELETED>
<DELETED> (c) Executive Board.--</DELETED>
<DELETED> (1) In general.--The Fund should be governed by a
transparent and accountable body (referred to in this title as
the ``Executive Board''), which should be composed of not more
than 20 representatives of donor governments, foundations,
academic institutions, civil society, indigenous people, and
the private sector that meet a minimum threshold in annual
contributions and agree to uphold transparency
measures.</DELETED>
<DELETED> (2) Duties.--The Executive Board should--
</DELETED>
<DELETED> (A) be charged with approving strategies,
operations, and grant making authorities in order to
conduct effective fiduciary, monitoring, and evaluation
efforts, and other oversight functions;</DELETED>
<DELETED> (B) be comprised only of contributors to
the Fund at not less than the minimum threshold to be
established pursuant to paragraph (1);</DELETED>
<DELETED> (C) determine operational procedures such
that the Fund is able to effectively fulfill its
mission;</DELETED>
<DELETED> (D) provide oversight and accountability
for the Fund in collaboration with the Inspector
General to be established pursuant to section
304(e)(1)(A); and</DELETED>
<DELETED> (E) develop and utilize a mechanism to
obtain formal input from partner countries relative to
lessons learned with regard to program
implementation.</DELETED>
<DELETED> (3) Composition.--The Executive Board should
include--</DELETED>
<DELETED> (A) representatives of the governments of
founding permanent member countries who, in addition to
the requirements under paragraph (1), qualify based
upon meeting an established initial contribution
threshold, which should be not less than 10 percent of
total initial contributions, and a demonstrated
commitment to supporting the International Health
Regulations (2005);</DELETED>
<DELETED> (B) a geographically diverse group of term
members who--</DELETED>
<DELETED> (i) come from academic
institutions, civil society, including
indigenous organizations, and the private
sector; and</DELETED>
<DELETED> (ii) are selected by the permanent
members on the basis of their experience and
commitment to innovation, best practices, and
the advancement of global health security
objectives;</DELETED>
<DELETED> (C) representatives of the World Health
Organization;</DELETED>
<DELETED> (D) the chair of the Global Health
Security Steering Group; and</DELETED>
<DELETED> (E) representatives from low- and middle-
income countries that are or will be implementing a
national pandemic prevention plan.</DELETED>
<DELETED> (4) Qualifications.--Individuals appointed to the
Executive Board should have demonstrated knowledge and
experience across a variety of sectors, including human and
animal health, agriculture, development, defense, finance,
research, and academia.</DELETED>
<DELETED> (5) Conflicts of interest.--</DELETED>
<DELETED> (A) Technical experts.--The Executive
Board may include independent technical experts who are
not affiliated with, or employed by, a recipient
country or organization.</DELETED>
<DELETED> (B) Multilateral bodies and
institutions.--Executive Board members appointed
pursuant to paragraph (3)(C) should recuse themselves
from matters presenting conflicts of interest,
including financing decisions relating to such bodies
and institutions.</DELETED>
<DELETED> (6) United states representation.--</DELETED>
<DELETED> (A) Founding permanent member.--The
Secretary of State should seek--</DELETED>
<DELETED> (i) to establish the United States
as a founding permanent member of the Fund;
and</DELETED>
<DELETED> (ii) to ensure that the United
States is represented on the Executive Board by
an officer or employee of the United States,
who shall be appointed by the
President.</DELETED>
<DELETED> (B) Effective and termination dates.--
</DELETED>
<DELETED> (i) Effective date.--This
paragraph shall take effect upon the date on
which the Secretary of State certifies and
submits to Congress an agreement establishing
the Fund.</DELETED>
<DELETED> (ii) Termination date.--The
membership established pursuant to subparagraph
(A) shall terminate upon the date of
termination of the Fund.</DELETED>
<DELETED> (7) Removal procedures.--The Fund should establish
procedures for the removal of members of the Executive Board
who--</DELETED>
<DELETED> (A) engage in a consistent pattern of
human rights abuses;</DELETED>
<DELETED> (B) fail to uphold global health data
transparency requirements; or</DELETED>
<DELETED> (C) otherwise violate the established
standards of the Fund, including in relation to
corruption.</DELETED>
<DELETED>SEC. 303. AUTHORITIES.</DELETED>
<DELETED> (a) Program Objectives.--</DELETED>
<DELETED> (1) In general.--In carrying out the purpose set
forth in section 302, the Fund, acting through the Executive
Board, should--</DELETED>
<DELETED> (A) provide grants, including challenge
grants, technical assistance, concessional lending,
catalytic investment funds, and other innovative
funding mechanisms, as appropriate--</DELETED>
<DELETED> (i) to help eligible partner
countries close critical gaps in health
security, as identified through the Joint
External Evaluation process, the Global Health
Security Index classification of health
systems, and national action plans for health
security and other complementary or successor
indicators of global health security and
pandemic prevention and preparedness;
and</DELETED>
<DELETED> (ii) to support measures that
enable such countries, at the national and
subnational levels, and in partnership with
civil society and the private sector, to
strengthen and sustain resilient health systems
and supply chains with the resources, capacity,
and personnel required to prevent, detect,
mitigate, and respond to infectious disease
threats, including zoonotic spillover, before
they become pandemics; and</DELETED>
<DELETED> (B) develop recommendations for a
mechanism for assisting countries that are at high risk
for zoonotic spillover events with pandemic potential
to participate in the Global Health Security Agenda and
the Joint External Evaluations.</DELETED>
<DELETED> (2) Activities supported.--The activities to be
supported by the Fund should include efforts--</DELETED>
<DELETED> (A) to enable eligible partner countries
to formulate and implement national health security and
pandemic prevention and preparedness action plans,
advance action packages under the Global Health
Security Agenda, and adopt and uphold commitments under
the International Health Regulations (2005) and other
related international health agreements and
arrangements, as appropriate;</DELETED>
<DELETED> (B) to support health security budget
planning in eligible partner countries, including
training in public financial management and budget and
health data transparency;</DELETED>
<DELETED> (C) to strengthen the health workforce,
including hiring, training, and deploying experts to
improve frontline prevention of, and monitoring and
preparedness for, unknown, new, emerging, or reemerging
pathogens, epidemics, and pandemic threats;</DELETED>
<DELETED> (D) to improve infection prevention and
control and the protection of healthcare workers within
healthcare settings;</DELETED>
<DELETED> (E) to combat the threat of antimicrobial
resistance;</DELETED>
<DELETED> (F) to strengthen laboratory capacity and
promote biosafety and biosecurity through the provision
of material and technical assistance;</DELETED>
<DELETED> (G) to reduce the risk of bioterrorism,
zoonotic disease spillover, and accidental biological
release;</DELETED>
<DELETED> (H) to build technical capacity to manage
health supply chains for commodities, equipment, and
supplies, including for personal protective equipment,
testing reagents, and other lifesaving supplies,
through effective forecasting, procurement,
warehousing, and delivery from central warehouses to
points of service in both the public and private
sectors;</DELETED>
<DELETED> (I) to enable bilateral, regional, and
international partnerships and cooperation, including
through pandemic early warning systems and emergency
operations centers, to identify and address
transnational infectious disease threats exacerbated by
natural and man-made disasters, human displacement, and
zoonotic infection;</DELETED>
<DELETED> (J) to establish partnerships for the
sharing of best practices and enabling eligible
countries to meet targets and indicators under the
Joint External Evaluation process, the Global Health
Security Index classification of health systems, and
national action plans for health security relating to
the prevention, detection, and treatment of neglected
tropical diseases;</DELETED>
<DELETED> (K) to build the technical capacity of
eligible partner countries to prepare for and respond
to second order development impacts of infectious
disease outbreaks, while accounting for the
differentiated needs and vulnerabilities of
marginalized populations;</DELETED>
<DELETED> (L) to develop and utilize metrics to
monitor and evaluate programmatic performance and
identify best practices, including in accordance with
Joint External Evaluation benchmarks, Global Health
Security Agenda targets, and Global Health Security
Index indicators;</DELETED>
<DELETED> (M) to develop and deploy mechanisms to
enhance the transparency and accountability of global
health security and pandemic prevention and
preparedness programs and data, in compliance with the
International Health Regulations (2005), including
through the sharing of trends, risks, and lessons
learned;</DELETED>
<DELETED> (N) to develop and implement simulation
exercises, produce and release after action reports,
and address related gaps;</DELETED>
<DELETED> (O) to support countries in conducting
Joint External Evaluations; and</DELETED>
<DELETED> (P) to improve surveillance capacity in
partner counties such that those countries are better
able to detect and respond to known and unknown
pathogens and zoonotic infectious diseases.</DELETED>
<DELETED> (3) Implementation of program objectives.--In
carrying out the objectives under paragraph (1), the Fund
should work to eliminate duplication and waste by upholding
strict transparency and accountability standards and
coordinating its programs and activities with key partners
working to advance global health security and pandemic
prevention and preparedness, including--</DELETED>
<DELETED> (A) governments, civil society,
nongovernmental organizations, research and academic
institutions, and private sector entities in eligible
partner countries;</DELETED>
<DELETED> (B) the pandemic early warning systems and
international emergency operations centers to be
established under sections 210 and 211;</DELETED>
<DELETED> (C) the World Health
Organization;</DELETED>
<DELETED> (D) the Global Health Security
Agenda;</DELETED>
<DELETED> (E) the Global Health Security
Initiative;</DELETED>
<DELETED> (F) the Global Fund to Fight AIDS,
Tuberculosis, and Malaria;</DELETED>
<DELETED> (G) the United Nations Office for the
Coordination of Humanitarian Affairs, UNICEF, and other
relevant funds, programs, and specialized agencies of
the United Nations;</DELETED>
<DELETED> (H) Gavi, the Vaccine Alliance;</DELETED>
<DELETED> (I) the Coalition for Epidemic
Preparedness Innovations (CEPI); and</DELETED>
<DELETED> (J) the Global Polio Eradication
Initiative.</DELETED>
<DELETED> (b) Priority.--In providing assistance under this section,
the Fund should give priority to low-and lower middle income countries
with--</DELETED>
<DELETED> (1) low scores on the Global Health Security Index
classification of health systems;</DELETED>
<DELETED> (2) measurable gaps in global health security and
pandemic prevention and preparedness identified under Joint
External Evaluations and national action plans for health
security;</DELETED>
<DELETED> (3) demonstrated political and financial
commitment to pandemic prevention and preparedness;
and</DELETED>
<DELETED> (4) demonstrated commitment to upholding global
health budget and data transparency and accountability
standards, complying with the International Health Regulations
(2005), investing in domestic health systems, and achieving
measurable results.</DELETED>
<DELETED> (c) Eligible Grant Recipients.--Governments and
nongovernmental organizations should be eligible to receive grants as
described in this section.</DELETED>
<DELETED>SEC. 304. ADMINISTRATION.</DELETED>
<DELETED> (a) Appointment of Administrator.--The Executive Board
should appoint an Administrator, who should be responsible for managing
the day-to-day operations of the Fund.</DELETED>
<DELETED> (b) Authority To Accept and Solicit Contributions.--The
Fund should be authorized to solicit and accept contributions from
governments, the private sector, foundations, individuals, and
nongovernmental entities.</DELETED>
<DELETED> (c) Accountability of Funds and Criteria for Programs.--As
part of the negotiations described in section 302(a), the Secretary of
the State, consistent with subsection (d), shall--</DELETED>
<DELETED> (1) take such actions as are necessary to ensure
that the Fund will have in effect adequate procedures and
standards to account for and monitor the use of funds
contributed to the Fund, including the cost of administering
the Fund; and</DELETED>
<DELETED> (2) seek agreement on the criteria that should be
used to determine the programs and activities that should be
assisted by the Fund.</DELETED>
<DELETED> (d) Selection of Partner Countries, Projects, and
Recipients.--The Executive Board should establish--</DELETED>
<DELETED> (1) eligible partner country selection criteria,
to include transparent metrics to measure and assess global
health security and pandemic prevention and preparedness
strengths and vulnerabilities in countries seeking
assistance;</DELETED>
<DELETED> (2) minimum standards for ensuring eligible
partner country ownership and commitment to long-term results,
including requirements for domestic budgeting, resource
mobilization, and co-investment;</DELETED>
<DELETED> (3) criteria for the selection of projects to
receive support from the Fund;</DELETED>
<DELETED> (4) standards and criteria regarding
qualifications of recipients of such support;</DELETED>
<DELETED> (5) such rules and procedures as may be necessary
for cost-effective management of the Fund; and</DELETED>
<DELETED> (6) such rules and procedures as may be necessary
to ensure transparency and accountability in the grant-making
process.</DELETED>
<DELETED> (e) Additional Transparency and Accountability
Requirements.--</DELETED>
<DELETED> (1) Inspector general.--</DELETED>
<DELETED> (A) In general.--The Secretary of State
shall seek to ensure that--</DELETED>
<DELETED> (i) the Fund maintains an
independent Office of the Inspector General;
and</DELETED>
<DELETED> (ii) such office has the requisite
resources and capacity to regularly conduct and
publish, on a publicly accessible website,
rigorous financial, programmatic, and reporting
audits and investigations of the Fund and its
grantees.</DELETED>
<DELETED> (B) Sense of congress on corruption.--It
is the sense of Congress that--</DELETED>
<DELETED> (i) corruption within global
health programs contribute directly to the loss
of human life and cannot be tolerated;
and</DELETED>
<DELETED> (ii) in making financial
recoveries relating to a corrupt act or
criminal conduct under a grant, as determined
by the Inspector General, the responsible grant
recipient should be assessed at a recovery rate
of up to 150 percent of such loss.</DELETED>
<DELETED> (2) Administrative expenses.--The Secretary of
State shall seek to ensure the Fund establishes, maintains, and
makes publicly available a system to track the administrative
and management costs of the Fund on a quarterly
basis.</DELETED>
<DELETED> (3) Financial tracking systems.--The Secretary of
State shall ensure that the Fund establishes, maintains, and
makes publicly available a system to track the amount of funds
disbursed to each grant recipient and sub-recipient during a
grant's fiscal cycle.</DELETED>
<DELETED> (4) Exemption from duties and taxes.--The
Secretary should ensure that the Fund adopts rules that
condition grants upon agreement by the relevant national
authorities in an eligible partner country to exempt from
duties and taxes all products financed by such grants,
including procurements by any principal or sub-recipient for
the purpose of carrying out such grants.</DELETED>
<DELETED>SEC. 305. ADVISORY BOARD.</DELETED>
<DELETED> (a) In General.--There should be an Advisory Board to the
Fund.</DELETED>
<DELETED> (b) Appointments.--The members of the Advisory Board
should be composed of--</DELETED>
<DELETED> (1) a geographically diverse group of individuals
that includes representation from low- and middle-income
countries;</DELETED>
<DELETED> (2) individuals with experience and leadership in
the fields of development, global health, epidemiology,
medicine, biomedical research, and social sciences;
and</DELETED>
<DELETED> (3) representatives of relevant United Nations
agencies, including the World Health Organization, and
nongovernmental organizations with on-the-ground experience in
implementing global health programs in low and lower-middle
income countries.</DELETED>
<DELETED> (c) Responsibilities.--The Advisory Board should provide
advice and guidance to the Executive Board of the Fund on the
development and implementation of programs and projects to be assisted
by the Fund and on leveraging donations to the Fund.</DELETED>
<DELETED> (d) Prohibition on Payment of Compensation.--</DELETED>
<DELETED> (1) In general.--Except for travel expenses
(including per diem in lieu of subsistence), no member of the
Advisory Board should receive compensation for services
performed as a member of the Board.</DELETED>
<DELETED> (2) United states representative.--Notwithstanding
any other provision of law (including an international
agreement), a representative of the United States on the
Advisory Board may not accept compensation for services
performed as a member of the Board, except that such
representative may accept travel expenses, including per diem
in lieu of subsistence, while away from the representative's
home or regular place of business in the performance of
services for the Board.</DELETED>
<DELETED> (e) Conflicts of Interest.--Members of the Advisory Board
should be required to disclose any potential conflicts of interest
prior to serving on the Advisory Board and, in the event of any
conflicts of interest, recuse themselves from such matters during their
service on the Advisory Board.</DELETED>
<DELETED>SEC. 306. REPORTS TO CONGRESS.</DELETED>
<DELETED> (a) Status Report.--Not later than 180 days after the date
of the enactment of this Act, the Secretary of State, in coordination
with the Administrator of the United States Agency for International
Development, and the heads of other relevant Federal departments and
agencies, shall submit a report to the appropriate congressional
committees that describes the progress of international negotiations to
establish the Fund.</DELETED>
<DELETED> (b) Annual Report.--</DELETED>
<DELETED> (1) In general.--Not later than 1 year after the
date of the establishment of the Fund, and annually thereafter
for the duration of the Fund, the Secretary of State, shall
submit a report to the appropriate congressional committees
regarding the administration of the Fund.</DELETED>
<DELETED> (2) Report elements.--The report required under
paragraph (1) shall describe--</DELETED>
<DELETED> (A) the goals of the Fund;</DELETED>
<DELETED> (B) the programs, projects, and activities
supported by the Fund;</DELETED>
<DELETED> (C) private and governmental contributions
to the Fund; and</DELETED>
<DELETED> (D) the criteria utilized to determine the
programs and activities that should be assisted by the
Fund, including baselines, targets, desired outcomes,
measurable goals, and extent to which those goals are
being achieved.</DELETED>
<DELETED> (c) GAO Report on Effectiveness.--Not later than 2 years
after the date on which the Fund is established, the Comptroller
General of the United States shall submit a report to the appropriate
congressional committees that evaluates the effectiveness of the Fund,
including the effectiveness of the programs, projects, and activities
supported by the Fund, as described in section 303(a).</DELETED>
<DELETED>SEC. 307. UNITED STATES CONTRIBUTIONS.</DELETED>
<DELETED> (a) In General.--Subject to submission of the
certification under this section, the President is authorized to make
available for United States contributions to the Fund such funds as may
be appropriated or otherwise made available for such purpose.</DELETED>
<DELETED> (b) Notification.--The Secretary of State shall notify the
appropriate congressional committees not later than 15 days in advance
of making a contribution to the Fund, including--</DELETED>
<DELETED> (1) the amount of the proposed
contribution;</DELETED>
<DELETED> (2) the total of funds contributed by other
donors; and</DELETED>
<DELETED> (3) the national interests served by United States
participation in the Fund.</DELETED>
<DELETED> (c) Limitation.--During the 5-year period beginning on the
date of the enactment of this Act, a United States contribution to the
Fund may not cause the cumulative total of United States contributions
to the Fund to exceed 33 percent of the total contributions to the Fund
from all sources.</DELETED>
<DELETED> (d) Withholdings.--</DELETED>
<DELETED> (1) Support for acts of international terrorism.--
If the Secretary of State determines that the Fund has provided
assistance to a country, the government of which the Secretary
of State has determined, for purposes of section 620A of the
Foreign Assistance Act of 1961 (22 U.S.C. 2371) has repeatedly
provided support for acts of international terrorism, the
United States shall withhold from its contribution to the Fund
for the next fiscal year an amount equal to the amount expended
by the Fund to the government of such country.</DELETED>
<DELETED> (2) Excessive salaries.--During the 5-year period
beginning on the date of the enactment of this Act, if the
Secretary of State determines that the salary of any individual
employed by the Fund exceeds the salary of the Vice President
of the United States for such fiscal year, the United States
should withhold from its contribution for the next fiscal year
an amount equal to the aggregate amount by which the salary of
each such individual exceeds the salary of the Vice President
of the United States.</DELETED>
<DELETED> (3) Accountability certification requirement.--The
Secretary of State may withhold not more than 20 percent of
planned United States contributions to the Fund until the
Secretary certifies to the appropriate congressional committees
that the Fund has established procedures to provide access by
the Office of Inspector General of the Department of State, as
cognizant Inspector General, the Inspector General of the
Department of Health and Human Services, the Inspector General
of the United States Agency for International Development, and
the Comptroller General of the United States to the Fund's
financial data and other information relevant to United States
contributions to the Fund (as determined by the Inspector
General of the Department of State, in consultation with the
Secretary of State).</DELETED>
<DELETED>SEC. 308. COMPLIANCE WITH THE FOREIGN AID TRANSPARENCY AND
ACCOUNTABILITY ACT OF 2016.</DELETED>
<DELETED> Section 2(3) of the Foreign Aid Transparency and
Accountability Act of 2016 (Public Law 114-191; 22 U.S.C. 2394c note)
is amended--</DELETED>
<DELETED> (1) in subparagraph (D), by striking ``and'' at
the end;</DELETED>
<DELETED> (2) in subparagraph (E), by striking the period at
the end and inserting ``; and''; and</DELETED>
<DELETED> (3) by adding at the end the following:</DELETED>
<DELETED> ``(F) the International Pandemic
Preparedness and COVID-19 Response Act of
2021.''.</DELETED>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``International
Pandemic Preparedness and COVID-19 Response Act of 2021''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Purpose.
TITLE I--ENHANCING THE UNITED STATES' INTERNATIONAL RESPONSE TO COVID-
19 AND FUTURE PANDEMICS
Sec. 101. Statement of policy regarding international cooperation to
end the COVID-19 pandemic.
Sec. 102. Oversight of United States foreign assistance to end the
COVID-19 pandemic.
Sec. 103. United States contributions to the Global Fund to Fight AIDS,
Tuberculosis, and Malaria COVID-19 response
mechanism.
Sec. 104. Global COVID-19 vaccine distribution and delivery.
Sec. 105. Leveraging United States bilateral global health programs for
the international COVID-19 response.
Sec. 106. Report on humanitarian response to the COVID-19 pandemic.
Sec. 107. Safeguarding democracy and human rights during the COVID-19
pandemic.
Sec. 108. Public diplomacy and combating disinformation and
misinformation about COVID-19.
Sec. 109. Findings and sense of Congress regarding the United States
International Development Finance
Corporation.
Sec. 110. Sense of Congress regarding international cooperation to
prevent and respond to future pandemics.
Sec. 111. Roles of the Department of State, the United States Agency
for International Development, and the
Centers for Disease Control and Prevention
in pandemic response.
Sec. 112. USAID disaster surge capacity.
Sec. 113. Statement of policy on humanitarian assistance to countries
affected by pandemics.
TITLE II--INTERNATIONAL PANDEMIC PREVENTION AND PREPAREDNESS
Sec. 201. Partner country defined.
Sec. 202. Global health security strategy and report.
Sec. 203. Committee on Global Health Security and Pandemic and
Biological Threats.
Sec. 204. United States overseas global health security and diplomacy
coordination.
Sec. 205. Resilience.
Sec. 206. Strengthening health systems.
Sec. 207. Additional authorities.
Sec. 208. Authorization for United States participation in the
Coalition for Epidemic Preparedness
Innovations.
Sec. 209. National intelligence estimate and briefing regarding novel
diseases and pandemic threats.
Sec. 210. Pandemic early warning network.
Sec. 211. International emergency operations.
TITLE III--FINANCING MECHANISM FOR GLOBAL HEALTH SECURITY AND PANDEMIC
PREVENTION AND PREPAREDNESS
Sec. 301. Eligible partner country defined.
Sec. 302. Establishment of Fund for Global Health Security and Pandemic
Prevention and Preparedness.
Sec. 303. Authorities.
Sec. 304. Administration.
Sec. 305. Advisory Board.
Sec. 306. Reports to Congress.
Sec. 307. United States contributions.
Sec. 308. Compliance with the Foreign Aid Transparency and
Accountability Act of 2016.
Sec. 309. Prohibition against United States foreign assistance for the
Government of the People's Republic of
China.
SEC. 2. DEFINITIONS.
In this Act:
(1) Appropriate congressional committees.--The term
``appropriate congressional committees'' means--
(A) the Committee on Foreign Relations of the
Senate;
(B) the Committee on Appropriations of the Senate;
(C) the Committee on Foreign Affairs of the House
of Representatives; and
(D) the Committee on Appropriations of the House of
Representatives.
(2) Global health security agenda; ghsa.--The terms
``Global Health Security Agenda'' and ``GHSA'' mean the multi-
sectoral initiative launched in 2014 and renewed in 2018 that
brings together countries, regions, international
organizations, nongovernmental organizations, and the private
sector to elevate global health security as a national-level
priority, to share best practices, and to facilitate national
capacity to comply with and adhere to--
(A) the International Health Regulations (2005);
(B) the World Organisation for Animal Health
international standards and guidelines;
(C) United Nations Security Council Resolution 1540
(2004);
(D) the Convention on the Prohibition of the
Development, Production and Stockpiling of
Bacteriological and Toxin Weapons and on their
Destruction, done at Washington, London, and Moscow,
April 10, 1972 (commonly referred to as the
``Biological Weapons Convention'');
(E) the Global Health Security Agenda 2024
Framework; and
(F) other relevant frameworks that contribute to
global health security.
(3) Global health security index .--The term ``Global
Health Security Index'' means the comprehensive assessment and
benchmarking of health security and related capabilities across
the countries that make up the States Parties to the
International Health Regulations (2005).
(4) Global health security initiative.--The term ``Global
Health Security Initiative'' means the informal network of
countries and organizations that came together in 2001 to
undertake concerted global action to strengthen public health
preparedness and response to chemical, biological,
radiological, and nuclear threats, as well as pandemic
influenza.
(5) Joint external evaluation.--The term ``Joint External
Evaluation'' means the World Health Organization-facilitated,
voluntary, collaborative, multi-sectoral process to assess
country capacity to prevent, detect, and rapidly respond to
public health risks occurring naturally or due to deliberate or
accidental events, assess progress in achieving the targets
under the International Health Regulations (2005), and
recommend priority actions.
(6) Key stakeholders.--The term ``key stakeholders'' means
actors engaged in efforts to advance global health security
programs and objectives, including--
(A) national and local governments in partner
countries;
(B) other bilateral donors;
(C) international, regional, and local
organizations, including private, voluntary,
nongovernmental, and civil society organizations;
(D) international, regional, and local financial
institutions;
(E) representatives of historically marginalized
groups, including women, youth, and indigenous peoples;
(F) the private sector, including medical device,
technology, pharmaceutical, manufacturing, logistics,
and other relevant companies; and
(G) public and private research and academic
institutions.
(7) One health approach.--The term ``One Health approach''
means the collaborative, multi-sectoral, and transdisciplinary
approach toward achieving optimal health outcomes in a manner
that recognizes the interconnection between people, animals,
plants, and their shared environment.
(8) Relevant federal departments and agencies.--The term
``relevant Federal departments and agencies'' means any Federal
department or agency implementing United States policies and
programs relevant to the advancement of United States global
health security and diplomacy overseas, which may include--
(A) the Department of State;
(B) the United States Agency for International
Development;
(C) the Department of Health and Human Services;
(D) the Centers for Disease Control and Prevention;
(E) the National Institutes of Health;
(F) the Department of the Treasury;
(G) the Department of Agriculture;
(H) the Department of Defense;
(I) the Defense Threat Reduction Agency;
(J) the Millennium Challenge Corporation;
(K) the Development Finance Corporation;
(L) the Peace Corps; and
(M) any other department or agency that the
President determines to be relevant for these purposes.
(9) Resilience.--The term ``resilience'' means the ability
of people, households, communities, systems, institutions,
countries, and regions to reduce, mitigate, withstand, adapt
to, and quickly recover from stresses and shocks in a manner
that reduces chronic vulnerability and facilitates inclusive
growth.
(10) USAID.--The term ``USAID'' means the United States
Agency for International Development.
SEC. 3. PURPOSE.
The purpose of this Act is to accelerate and enhance the United
States international response to pandemics, including the COVID-19
pandemic, and to operationalize lessons learned from current and prior
emergency responses in a manner that--
(1) advances the global health security and diplomacy
objectives of the United States;
(2) improves coordination among the relevant Federal
departments and agencies implementing United States foreign
assistance for global health security; and
(3) more effectively enables partner countries to
strengthen and sustain resilient health systems and supply
chains with the resources, capacity, and personnel required to
prevent, prepare for, detect, and respond to infectious disease
threats before they become pandemics.
TITLE I--ENHANCING THE UNITED STATES' INTERNATIONAL RESPONSE TO COVID-
19 AND FUTURE PANDEMICS
SEC. 101. STATEMENT OF POLICY REGARDING INTERNATIONAL COOPERATION TO
END THE COVID-19 PANDEMIC.
It shall be the policy of the United States to lead and implement a
comprehensive and coordinated international response to end the COVID-
19 pandemic in a manner that recognizes the critical role that
multilateral and regional organizations can and should play in pandemic
response, including by--
(1) seeking adoption of a United Nations Security Council
resolution that--
(A) declares pandemics, including the COVID-19
pandemic, to be a threat to international peace and
security; and
(B) urges member states to address this threat by
aligning their health preparedness plans with
international best practices and those established by
the Global Health Security Agenda to improve country
capacity to prevent, detect, and respond to infectious
disease threats;
(2) advancing efforts to reform the World Health
Organization so that it serves as an effective normative and
capable coordinating body empowered to align member countries
around a single strategic operating plan to detect, contain,
treat, and deter the further spread of COVID-19;
(3) providing timely, appropriate levels of financial
support to United Nations agencies responding to the COVID-19
pandemic;
(4) prioritizing United States foreign assistance for the
COVID-19 response in the most vulnerable countries and regions;
(5) encouraging other donor governments to similarly
increase contributions to the United Nations agencies
responding to the COVID-19 pandemic in the world's poorest and
most vulnerable countries;
(6) working with key stakeholders to accelerate progress
toward meeting and exceeding, as practicable, the global COVID-
19 vaccination goals jointly proposed by the International
Monetary Fund, the World Health Organization, the World Bank,
and the World Trade Organization, whereby--
(A) at least 40 percent of the population in all
countries is vaccinated by the end of 2021; and
(B) at least 60 percent of the population in all
countries is vaccinated by the first half of 2022;
(7) engaging with key stakeholders, including through
multilateral facilities such as the COVID-19 Vaccines Global
Access initiative (referred to in this title as ``COVAX'') and
the Access to COVID-19 Tools (ACT) Accelerator initiative, and
expanding bilateral efforts, including through the
International Development Finance Corporation, to accelerate
the development, manufacturing, local production, and efficient
and equitable distribution of--
(A) vaccines and related raw materials to meet or
exceed the vaccination goals under paragraph (6); and
(B) global health commodities, including personal
protective equipment, test kits, medicines and
therapeutics, and other essential supplies to combat
COVID-19 and help immediately disrupt transmission;
(8) supporting global COVID-19 vaccine distribution
strategies that strengthen underlying health systems and ensure
that people living in vulnerable and marginalized communities,
including women, do not face undue barriers to vaccination;
(9) working with key stakeholders, including through the
World Bank Group, the International Monetary Fund, the World
Trade Organization, the International Finance Corporation, and
other relevant regional and bilateral financial institutions,
to address the economic and financial implications of the
COVID-19 pandemic, while taking into account the differentiated
needs of disproportionately affected, vulnerable, and
marginalized populations;
(10) entering into discussions with vaccine manufacturing
companies to incentivize technology sharing, with the goal of
ensuring adequate global supply of vaccines, necessary
components, and raw materials, including through existing
authorities under the Defense Production Act of 1950 (50 U.S.C.
4501 et seq.) and chapter 18 of title 35, United States Code
(commonly referred to as the ``Bayh-Dole Act'');
(11) establishing clear timelines, benchmarks, and goals
for COVID-19 response strategies and activities under this
section; and
(12) generating commitments of resources in support of the
goals referred to in paragraph (6).
SEC. 102. OVERSIGHT OF UNITED STATES FOREIGN ASSISTANCE TO END THE
COVID-19 PANDEMIC.
(a) Reporting Requirements.--Not later than 60 days after the date
of the enactment of this Act, the Secretary of State and the
Administrator for the United States Agency for International
Development shall jointly submit to the appropriate congressional
committees--
(1) an unclassified report containing a description of
funds already obligated and expended under title X of the
American Rescue Plan Act of 2021 (Public Law 117-2); and
(2) a plan that describes the objectives and timeline for
the obligation and expenditure of all remaining funds
appropriated under title X of the American Rescue Plan Act of
2021, to include support for civil society for the protection
of human rights in the context of the COVID-19 pandemic, which
shall be submitted in an unclassified form, and should include
a description of steps taken pursuant to each objective
specified in the plan.
(b) Congressional Consultation.--Not less frequently than once
every 60 days, until the completion or termination of the
implementation plan required under subsection (a)(2), and upon the
request from one or more of the appropriate congressional committees,
the Secretary of State and the Administrator for the United States
Agency for International Development shall provide a briefing to the
appropriate congressional committees regarding the report required
under subsection (a)(1) and the status of the implementation of the
plan required under subsection (a)(2).
(c) Branding.--In providing assistance under this title, the
Secretary of State and the Administrator of the United States Agency
for International Development, with due consideration for the safety
and security of implementing partners and beneficiaries, shall
prescribe the use of logos or other insignia, which may include the
flag of the United States, to appropriately identify such assistance as
being from the people of the United States.
SEC. 103. UNITED STATES CONTRIBUTIONS TO THE GLOBAL FUND TO FIGHT AIDS,
TUBERCULOSIS, AND MALARIA COVID-19 RESPONSE MECHANISM.
(a) United States Contributions to the Global Fund to Fight AIDS,
Tuberculosis, and Malaria COVID-19 Response Mechanism.--United States
contributions to the Global Fund to Fight AIDS, Tuberculosis, and
Malaria COVID-19 Response Mechanism under section 10003(a)(2) of the
American Rescue Plan Act of 2021 (Public Law 107-2)--
(1) shall be meaningfully leveraged in a manner that
incentivizes other public and private donor contributions; and
(2) shall be subject to the reporting and withholding
requirements under subsections (c), (d)(4)(A)(ii), (d)(4)(C),
(d)(5), (d)(6), (f), and (g) of section 202 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Act of 2003 (22 U.S.C. 7622).
SEC. 104. GLOBAL COVID-19 VACCINE DISTRIBUTION AND DELIVERY.
(a) Accelerating Global Vaccine Distribution Strategy.--The
Secretary of State, in consultation with the Secretary of Health and
Human Services, the Administrator of the United States Agency for
International Development, the Director of the Centers for Disease
Control and Prevention, the Chief Executive Officer of the United
States International Development Finance Corporation, and the heads of
other relevant Federal departments and agencies, as determined by the
President, shall develop a strategy to expand access to, and accelerate
the global distribution of, COVID-19 vaccines to other countries, which
shall--
(1) identify the countries that have the highest infection
and death rates due to COVID-19, the lowest COVID-19
vaccination rates, and face the most difficult, political,
logistical, and financial challenges to obtaining and
delivering COVID-19 vaccines, and describe the basis and
metrics used to make such determinations;
(2) identify which countries and regions will be
prioritized and targeted for COVID-19 vaccine delivery, and the
rationale for such prioritization;
(3) describe efforts that the United States is making to
increase COVID-19 vaccine manufacturing capacity, both
domestically and internationally, as appropriate, through the
establishment or refurbishment of regional manufacturing hubs
in South America, South Africa, and South Asia, including
through the provision of development finance, and estimate
when, how many, and which types of vaccines will be provided by
the United States Government bilaterally and through COVAX;
(4) describe efforts to encourage international partners to
take actions similar to the efforts referred to in paragraph
(3);
(5) describe how the United States Government will ensure
efficient delivery of COVID-19 vaccines to intended recipients,
including United States citizens residing overseas, and
identify complementary United States foreign assistance that
will facilitate vaccine readiness, distribution, delivery,
monitoring, and administration activities;
(6) describe how the United States Government will ensure
the efficient delivery and administration of COVID-19 vaccines
to United States citizens residing overseas, including through
the donation of vaccine doses to United States embassies and
consulates, as appropriate, giving priority to--
(A) countries in which United States citizens are
deemed ineligible or low priority in the national
vaccination deployment plan; and
(B) countries that are not presently distributing a
COVID-19 vaccine that--
(i) has been approved by the United States
Food and Drug Administration for emergency use;
or
(ii) has met the necessary criteria for
safety and efficacy established by the World
Health Organization;
(7) summarize the United States Government's efforts to
encourage and facilitate technology sharing and the licensing
of intellectual property to the extent necessary to ensure an
adequate and timely supply of vaccines and vaccine components
to meet the vaccination goals specified in section 101(6),
giving due consideration to avoiding undermining intellectual
property innovation and intellectual property rights
protections with respect to vaccine development in performing
the assessment required in this paragraph;
(8) describe the roles, responsibilities, tasks, and, as
appropriate, the authorities of the Secretary of State, the
Administrator of the United States Agency for International
Development, the Secretary of Health and Human Services, the
Director of the Centers for Disease Control and Prevention, the
Chief Executive Officer of the United States International
Development Finance Corporation, and the heads of other
relevant Federal departments and agencies with respect to the
implementation of such strategy;
(9) describe how the Department of State and USAID will
coordinate with the Secretary of Health and Human Services and
the heads of other relevant Federal agencies to expedite the
export and distribution of excess vaccines from Federal and
State stockpiles to support countries in need and ensure such
vaccines will not be wasted;
(10) summarize the United States public diplomacy
strategies for branding and addressing vaccine misinformation
and hesitancy; and
(11) describe efforts that the United States is making to
help countries disrupt the current transmission of COVID-19,
while simultaneously increasing vaccination rates, utilizing
non-vaccine health commodities, including diagnostics and
personal protective equipment.
(b) Submission of Strategy.--Not later than 90 days after the date
of the enactment of this Act, the Secretary of State shall submit the
strategy described in subsection (a) to--
(1) the appropriate congressional committees;
(2) the Committee on Health, Education, Labor, and Pensions
of the Senate; and
(3) the Committee on Energy and Commerce of the House of
Representatives.
(c) Limitation.--
(1) In general.--No Federal funds may be made available to
COVAX to procure vaccines produced by any companies owned or
controlled by the Government of the People's Republic of China
or by the Chinese Communist Party unless the Secretary of State
certifies that the People's Republic of China--
(A) is providing financial support to COVAX that is
commensurate with the United States' contribution to
COVAX; and
(B) publically discloses transparent data on the
quality, safety, and efficacy of its COVID-19 vaccines.
(2) Safeguards.--The President shall ensure that
appropriate safeguards are put in place to ensure that the
condition described in paragraph (1) is honored by Gavi, the
Vaccine Alliance.
SEC. 105. LEVERAGING UNITED STATES BILATERAL GLOBAL HEALTH PROGRAMS FOR
THE INTERNATIONAL COVID-19 RESPONSE.
(a) Authorization for Leveraging Bilateral Program Activities.--
Amounts authorized to be appropriated or otherwise made available to
carry out section 104 of the Foreign Assistance Act (22 U.S.C. 2151b)
may be used in countries receiving United States foreign assistance--
(1) to combat the COVID-19 pandemic, including through the
sharing of COVID-19 vaccines; and
(2) to support related activities, including--
(A) strengthening vaccine readiness;
(B) reducing vaccine hesitancy and misinformation;
(C) delivering and administering COVID-19 vaccines;
(D) strengthening health systems and supply chains;
(E) supporting health care workforce planning,
training, and management;
(F) enhancing transparency, quality, and
reliability of health data;
(G) increasing bidirectional testing, including
screening for symptomatic and asymptomatic cases; and
(H) building lab capacity.
(b) Adjustment of Targets and Goals.--The Secretary of State, in
coordination with the heads of other relevant Federal departments and
agencies, shall submit an annual report to the appropriate
congressional committees that identifies--
(1) any adjustments to original program targets and goals
that result from the use of funds for the purposes authorized
under subsection (a); and
(2) the amounts needed in the following fiscal year to meet
the original program goals, as necessary and appropriate.
SEC. 106. REPORT ON HUMANITARIAN RESPONSE TO THE COVID-19 PANDEMIC.
(a) In General.--Not later than 120 days after the date of the
enactment of this Act, the Secretary of State, in consultation with the
Administrator of the United States Agency for International Development
and the Secretary of Health and Human Services, shall submit a report
to the appropriate congressional committees that--
(1) assesses the global humanitarian response to COVID-19;
and
(2) outlines specific elements of the United States
Government's country-level humanitarian response to the COVID-
19 pandemic.
(b) Elements.--The report required under subsection (a) shall
include--
(1) for countries receiving United States assistance, a
description of humanitarian and health-worker access to crisis-
affected areas, including--
(A) legal and bureaucratic restrictions on the
entry of humanitarian workers from abroad, to include
visa authorizations that do not allow adequate time for
humanitarian workers to quarantine upon arrival in-line
with host country regulations, conduct needs
assessments, and subsequently implement multilateral
and United States-funded programming in an efficient,
effective, and unrestricted manner;
(B) restrictions on travel by humanitarian workers
within such country to reach the areas of operation
where vulnerable and marginalized populations reside;
(C) access to medical evacuation in the event of a
health emergency;
(D) access to personal protective equipment for
United States Government implementing partners; and
(E) efforts to support access to COVID-19 vaccines
for humanitarian and health-workers and crisis-affected
communities;
(2) an analysis and description of countries (regardless of
whether such countries have received direct United States
assistance) that have expressly prevented vulnerable
populations from accessing necessary assistance related to
COVID-19, including--
(A) the omission of vulnerable populations from
national response plans;
(B) laws, policies, or practices that restrict or
preclude treatment of vulnerable populations at public
hospitals and health facilities; and
(C) exclusion of, or discrimination against,
vulnerable populations in law, policy, or practice that
prevents equitable access to food, shelter, and other
basic assistance;
(3) a description of United States Government efforts to
facilitate greater humanitarian access, including--
(A) advocacy and diplomatic efforts with relevant
foreign governments and multilateral institutions to
ensure that vulnerable and marginalized populations are
included in national response plans and other relevant
plans developed in response to the COVID-19 pandemic;
and
(B) advocacy and diplomatic efforts with relevant
foreign governments to ensure that appropriate visas,
work permits, and domestic travel exemptions are issued
for humanitarian and health workers responding to the
COVID-19 pandemic; and
(4) a description of United States Government plans and
efforts to address the second-order impacts of the COVID-19
pandemic and an assessment of the resources required to
implement such plans, including efforts to address--
(A) famine and acute food insecurity;
(B) gender-based violence;
(C) mental health and psychosocial support needs;
(D) child protection needs;
(E) health, education, and livelihoods;
(F) shelter; and
(G) attempts to close civil society space,
including through bureaucratic, administrative, and
health or security related impediments.
SEC. 107. SAFEGUARDING DEMOCRACY AND HUMAN RIGHTS DURING THE COVID-19
PANDEMIC.
(a) Sense of Congress.--It is the sense of Congress that--
(1) governments may be required to take appropriate
extraordinary measures during public health emergencies to halt
the spread of disease, including closing businesses and public
events, limiting access to public spaces, and restricting the
movement of people;
(2) certain foreign governments have taken measures in
response to COVID-19 that violate the human rights of their
citizens without clear public health justification, oversight
measures, or sunset provisions;
(3) governments using the COVID-19 pandemic as a pretext
for repression have undermined democratic institutions,
debilitated institutions for transparency and public integrity,
quashed legitimate dissent, and attacked journalists, civil
society organizations, activists, independent voices, and
vulnerable and marginalized populations, including refugees and
migrants, with far-reaching consequences that will extend
beyond the current crisis;
(4) foreign governments should take immediate steps to
release from prison all arbitrarily detained United States
citizens and political prisoners who may be at increased risk
for contracting or suffering from complications from COVID-19;
(5) COVID-19 threatens to roll back decades of progress for
women and girls, disproportionately affecting women
economically, educationally, and with respect to health, while
also leading to alarming rises in gender based violence; and
(6) during and after the pandemic, the Department of State
and the United States Agency for International Development
should directly, and through nongovernmental organizations or
international organizations, provide assistance and implement
programs that support democratic institutions, civil society,
free media, and the advancement of internationally recognized
human rights.
(b) Funding for Civil Society and Human Rights Defenders.--
(1) Program priorities.--Amounts made available for each of
the fiscal years 2022 through 2026 to carry out the purposes of
sections 101 and 102 of the Foreign Assistance Act of 1961 (22
U.S.C. 2151 and 2151-1), including programs to support
democratic institutions, human rights defenders, civil society,
and freedom of the press, should be targeted, to the extent
feasible, toward civil society organizations in countries in
which emergency government measures taken in response to the
COVID-19 pandemic have violated internationally recognized
human rights.
(2) Eligible organizations.--Civil society organizations
operating in countries in which emergency government measures
taken in response to the COVID-19 pandemic violated
internationally recognized human rights shall be eligible to
receive funds made available to carry out the purposes of
sections 101 and 102 of the Foreign Assistance Act of 1961 for
each of the fiscal years 2022 through 2026, for--
(A) programs designed to strengthen and support
civil society, human rights defenders, freedom of
association, and the freedom of the press;
(B) programs to restore democratic institutions;
and
(C) peacebuilding and conflict prevention to
address the impacts of COVID-19 on social cohesion,
public trust, and conflict dynamics by adapting
existing programs or investing in new ones.
(3) Final report.--Not later than 180 days after the date
of the enactment of this Act, the Secretary of State shall
submit a report to the appropriate congressional committees
that--
(A) lists the countries whose emergency measures
limiting internationally recognized human rights in a
manner inconsistent with the principles of limitation
and derogation remain in place;
(B) describes such countries' emergency measures,
including--
(i) how such procedures violate
internationally recognized human rights; and
(ii) an analysis of the impact of such
measures on access to health and efforts to
control the COVID-19 pandemic within the
country;
(C) describes--
(i) security and intelligence surveillance
measures implemented by countries during the
COVID-19 pandemic;
(ii) the extent to which such measures have
been, or have not been, rolled back; and
(iii) whether and how such measures impact
internationally recognized human rights; and
(D) includes a strategic plan by the Department of
State and the United States Agency for International
Development that addresses, through multilateral and
bilateral diplomacy and foreign assistance, the
persistent issues related to the restriction of
internationally recognized human rights in the COVID-19
response.
SEC. 108. PUBLIC DIPLOMACY AND COMBATING DISINFORMATION AND
MISINFORMATION ABOUT COVID-19.
(a) United States Agency for Global Media.--
(1) Finding.--Congress finds that the United States Agency
for Global Media (referred to in this section as ``USAGM'')
broadcasting entities and grantees have proven valuable in
providing timely and accurate information, particularly in
countries in which the free press is under threat.
(2) Sense of congress.--It is the sense of Congress that--
(A) accurate, investigative, and scientific
journalism is critical for societies to effectively
combat global health threats; and
(B) Congress supports--
(i) accurate and objective investigative
and scientific reporting by USAGM networks and
grantees regarding COVID-19; and
(ii) platforms that help dispel and combat
misinformation about the COVID-19 pandemic.
(3) Voice of america.--It is the sense of Congress that
amounts authorized to be appropriated or otherwise made
available to Voice of America should be used--
(A) to expand programs such as POLYGRAPH.info;
(B) to provide critical tools for combating
propaganda associated with COVID-19; and
(C) to assist journalists in providing accurate
information to local media outlets.
(4) Office of cuba broadcasting.--It is the sense of
Congress that Radio Television Marti and Digital Marti should
continue to broadcast programs that detect, highlight, and
dispel disinformation.
(5) Radio free europe/radio liberty.--
(A) Finding.--Congress finds that Radio Free
Europe/Radio Liberty (referred to in this section as
``RFE/RL'') operate in media markets in which
authoritarian state and nonstate actors, including
Russia, heavily invest in misinformation and
disinformation campaigns designed to promote confusion
and mistrust.
(B) Sense of congress.--It is the sense of Congress
that RFE/RL should--
(i) increase investigative reporting
regarding the impacts of COVID-19, the
political and social responses governments are
taking in response to COVID-19, and the lasting
impacts such actions will have on key political
freedoms; and
(ii) expand its ``digital first'' strategy.
(6) Radio free asia.--
(A) Finding.--Congress finds that Radio Free Asia
(RFA) operates in a media market dominated by powerful
state-run media that have invested heavily in media
distortion and disinformation, including about COVID-
19.
(B) Sense of congress.--It is the sense of Congress
that RFA should--
(i) commission technical experts to bolster
efforts to counter social media tools,
including bots used by some countries to
promote misinformation;
(ii) expand digital programming and local
coverage to expose China's media manipulation
techniques; and
(iii) increase English language content to
help counter China's propaganda directed toward
English-speaking audiences.
(7) Middle east broadcasting networks.--
(A) Finding.--Congress finds that the Middle East
Broadcasting Networks operate largely in closed media
markets in which malign state and nonstate actors
remain active.
(B) Sense of congress.--It is the sense of Congress
that the Middle East Broadcasting Networks should--
(i) continue plans to expand an
investigative news unit; and
(ii) work to ensure that reporting
continues amidst operational challenges on the
ground.
(8) Open technology fund.--
(A) Finding.--Congress finds that the Open
Technology Fund works to advance internet freedom in
repressive environments by supporting technologies
that--
(i) provide secure and uncensored access to
USAGM's content and the broader internet; and
(ii) counter attempts by authoritarian
governments to control the internet and
restrict freedom online.
(B) Sense of congress.--It is the sense of Congress
that the Open Technology Fund should--
(i) support a broad range of technologies
to respond to increasingly aggressive and
sophisticated censorship and surveillance
threats and provide more comprehensive and
tailored support to USAGM's networks; and
(ii) provide direct assistance to USAGM's
networks to improve the digital security of
reporting operations and journalists.
(b) Department of State Public Diplomacy Programs.--
(1) Findings.--Congress finds the following:
(A) The Department of State's public diplomacy
programs build global networks that can address shared
challenges, such as the COVID-19 pandemic, including
through exchanges of researchers, public health
experts, and scientists.
(B) The programs referred to in subparagraph (A)
play a critical role in creating open and resilient
information environments where democracies can thrive,
as articulated in the 2020 Public Diplomacy Strategic
Plan, including by--
(i) improving media quality with journalist
training and reporting tours;
(ii) conducting media literacy programs;
and
(iii) supporting media access activities.
(C) The International Visitor Leadership Program
and Digital Communications Network engaged journalists
around the world to combat COVID-19 disinformation,
promote unbiased reporting, and strengthen media
literacy.
(D) More than 12,000 physicians holding J-1 visas
from 130 countries--
(i) are engaged in residency or fellowship
training at approximately 750 hospitals
throughout the United States, the majority of
whom are serving in States that have been the
hardest hit by COVID-19; and
(ii) throughout the pandemic, have served
on the front lines of the medical workforce and
in United States university labs researching
ways to detect and treat the virus.
(2) Visa processing briefing.--Not later than 30 days after
the date of the enactment of this Act, the Assistant Secretary
for Consular Affairs shall brief the appropriate congressional
committees by providing--
(A) a timeline for increasing visa processing
capacities at embassies around the world, notably where
there are--
(i) many American citizens, including dual
nationals; and
(ii) many visa applicants for educational
and cultural exchange programs that promote
United States foreign policy objectives and
economic stability to small businesses,
universities, and communities across the United
States;
(B) a detailed plan for using existing authorities
to waive or provide other alternatives to in-person
appointments and interviews;
(C) an assessment of whether additional authorities
and resources are required for the use of
videoconference appointments and interviews as an
alternative to in-person appointments and interviews;
and
(D) a detailed plan for using existing authorities
to rapidly cross-train and surge temporary personnel to
support consular services at embassies and consulates
of the United States around the world, and an
assessment of whether additional authorities and
resources are required.
(3) Global engagement center.--
(A) Finding.--Congress finds that since the
beginning of the COVID-19 pandemic, publications,
websites, and platforms associated with China, Russia,
and Iran have sponsored disinformation campaigns
related to the COVID-19 pandemic, including falsely
blaming the United States for the disease.
(B) Sense of congress.--It is the sense of Congress
that the Global Engagement Center should continue its
efforts to expose and counter state and non-state-
sponsored disinformation related to COVID-19, the
origins of COVID-19, and COVID-19 vaccinations.
SEC. 109. FINDINGS AND SENSE OF CONGRESS REGARDING THE UNITED STATES
INTERNATIONAL DEVELOPMENT FINANCE CORPORATION.
(a) Findings.--Congress finds the following:
(1) The COVID-19 pandemic is causing a global economic
recession, as evidenced by the global economic indicators
described in paragraphs (2) through (4).
(2) The United Nations Conference on Trade and Development
determined that the COVID-19 pandemic pushed the global economy
into recession in 2020 on a scale that has not been witnessed
since the 1930s.
(3) Developed countries are expected to experience a
relatively more significant rebound in gross domestic product
growth during 2021 than is expected to be experienced in
developing countries, leading to concerns about a further
expansion in the gap between rich and poor countries,
particularly if this trend continues into 2022.
(4) Global markets have suffered losses ranging between 5
percent and over 10 percent since the beginning of the
pandemic. While markets are recovering in 2021, global job
losses and unemployment rates remain high, with--
(A) approximately 33,000,000 labor hours lost
globally (13 per cent of the total hours lost) due to
outright unemployment; and
(B) an estimated additional 81,000,000 labor hours
lost due to inactivity or underemployment.
(5) Given the prolonged nature of the COVID-19 pandemic,
African finance ministers have requested continued efforts to
provide--
(A) additional liquidity;
(B) better market access;
(C) more concessional resources; and
(D) an extension in the Debt Service Suspension
Initiative established by the Group of 20.
(b) Sense of Congress.--It is the sense of Congress that--
(1) even when markets begin to recover in the future, it is
likely that access to capital will be especially challenging
for developing countries, which still will be struggling with
the containment of, and recovery from, the COVID-19 pandemic;
(2) economic uncertainty and the inability of individuals
and households to generate income are major drivers of
political instability and social discord, which create
conditions for insecurity;
(3) it is in the security and economic interests of the
United States to assist in the economic recovery of developing
countries that are made more vulnerable and unstable from the
public health and economic impacts of the COVID-19 pandemic;
(4) United States foreign assistance and development
finance institutions should seek to blunt the impacts of a
COVID-19 related economic recession by supporting investments
in sectors critical to maintaining economic stability and
resilience in low and middle income countries;
(5) the need for the United States International
Development Finance Corporation's support for advancing
development outcomes in less developed countries, as mandated
by the Better Utilization of Investments Leading to Development
Act of 2018 (22 U.S.C. 9601 et seq.), is critical to ensuring
lasting and resilient economic growth in light of the COVID-19
pandemic's exacerbation of economic hardships and challenges;
(6) The United States International Development Finance
Corporation should adjust its view of risk versus return by
taking smart risks that may produce a lower rate of financial
return, but produce significant development outcomes in
responding to the economic effects of COVID-19;
(7) to mitigate the economic impacts of the COVID-19
recession, the United States International Development Finance
Corporation should use its resources and authorities, among
other things--
(A) to ensure loan support for small- and medium-
sized enterprises;
(B) to offer local currency loans to borrowers for
working capital needs;
(C) to create dedicated financing opportunities for
new ``customers'' that are experiencing financial
hardship due to the COVID-19 pandemic; and
(D) to work with other development finance
institutions to create co-financing facilities to
support customers experiencing hardship due to the
COVID-19 pandemic.
SEC. 110. SENSE OF CONGRESS REGARDING INTERNATIONAL COOPERATION TO
PREVENT AND RESPOND TO FUTURE PANDEMICS.
It is the sense of Congress that--
(1) global pandemic preparedness and response requires
international and regional cooperation and action;
(2) the United States should lead efforts in multilateral
fora, such as the Group of 7, the Group of 20, and the United
Nations, by collaborating and cooperating with other countries
and international and regional organizations, including the
World Health Organization and other key stakeholders, to
implement international strategies, tools, and agreements to
better prevent, detect, and respond to future infectious
disease threats before they become pandemics; and
(3) the United States should enhance and expand
coordination and collaboration among the relevant Federal
departments and agencies, the Food and Agriculture Organization
of the United Nations, the World Health Organization, and the
World Organization for Animal Health, to advance a One Health
approach toward preventing, detecting, and responding to
zoonotic threats in the human-animal interface.
SEC. 111. ROLES OF THE DEPARTMENT OF STATE, THE UNITED STATES AGENCY
FOR INTERNATIONAL DEVELOPMENT, AND THE CENTERS FOR
DISEASE CONTROL AND PREVENTION IN PANDEMIC RESPONSE.
(a) Designation of Lead Agencies for Coordination of the United
States' Response to Infectious Disease Outbreaks With Severe or
Pandemic Potential.--The President shall designate relevant Federal
departments and agencies, including the Department of State, USAID, and
the Centers for Disease Control and Prevention, to lead specific
aspects of the United States response to infectious disease outbreaks
with severe or pandemic potential.
(b) Notification.--Not later than 120 days after the date of the
enactment of this Act, the President shall notify the appropriate
congressional committees, the Committee on Health, Education, Labor,
and Pensions of the Senate, and the Committee on Energy and Commerce of
the House of Representatives of the designations made pursuant to
subsection (a), including detailed descriptions of the roles and
responsibilities of each relevant department and agency.
SEC. 112. USAID DISASTER SURGE CAPACITY.
(a) Surge Capacity.--Amounts authorized to be appropriated or
otherwise made available to carry out part I and chapter 4 of part II
of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.),
including funds made available for ``Assistance for Europe, Eurasia and
Central Asia'', may be used, in addition to amounts otherwise made
available for such purposes, for the cost (including support costs) of
individuals detailed to or employed by the United States Agency for
International Development whose primary responsibility is to carry out
programs in response to global health emergencies and natural or man-
made disasters.
(b) Notification.--Not later than 15 days before making funds
available to address man-made disasters pursuant to subsection (a), the
Secretary of State or the Administrator of the United States Agency for
International Development shall notify the appropriate congressional
committees of such action.
SEC. 113. STATEMENT OF POLICY ON HUMANITARIAN ASSISTANCE TO COUNTRIES
AFFECTED BY PANDEMICS.
(a) Statement of Policy.--It shall be the policy of the United
States--
(1) to ensure that United States assistance to address
pandemics, including the provision of vaccines, reaches
vulnerable and marginalized populations, including racial and
religious minorities, refugees, internally displaced persons,
migrants, stateless persons, women, children, the elderly, and
persons with disabilities;
(2) to ensure that United States assistance, including
development finance, addresses the second order effects of a
pandemic, including acute food insecurity; and
(3) to protect and support humanitarian actors who are
essential workers in preventing, mitigating and responding to
the spread of a pandemic among vulnerable and marginalized
groups described in paragraph (1), including ensuring that such
humanitarian actors--
(A) are exempted from unreasonable travel
restrictions to ensure that they can effectively
provide life-saving assistance; and
(B) are prioritized as frontline workers in country
vaccine distribution plans.
(b) Facilitating Effective and Safe Humanitarian Assistance.--The
Secretary of State, in coordination with the Administrator of the
United States Agency for International Development, should carry out
actions that accomplish the policies set forth in subsection (a),
including by--
(1) taking steps to ensure that travel restrictions
implemented to help contain the spread of a pandemic are not
applied to individuals authorized by the United States
Government to travel to, or reside in, a designated country to
provide assistance related to, or otherwise impacted by, an
outbreak;
(2) approving the use of foreign assistance for the
procurement of personal protective equipment by United States
Government implementing partners from businesses within or
nearby the country receiving foreign assistance on an urgent
basis and in a manner consistent with efforts to respond to the
spread of a pandemic in the United States; and
(3) waiving certain travel restrictions implemented to help
contain the spread of a pandemic in order to facilitate the
medical evacuation of United States Government implementing
partners, regardless of nationality.
TITLE II--INTERNATIONAL PANDEMIC PREVENTION AND PREPAREDNESS
SEC. 201. PARTNER COUNTRY DEFINED.
In this title, the term ``partner country'' means a foreign country
in which the relevant Federal departments and agencies are implementing
United States assistance for global health security and pandemic
prevention and preparedness under this Act.
SEC. 202. GLOBAL HEALTH SECURITY STRATEGY AND REPORT.
(a) In General.--The President shall develop, update, maintain, and
advance a comprehensive strategy for improving global health security
and pandemic prevention, preparedness, and response that--
(1) clearly articulates the policy goals related to
pandemic prevention, preparedness, and response, and actions
necessary to elevate and strengthen United States diplomatic
leadership in global health security and pandemic preparedness,
including by building the expertise of the diplomatic corps;
(2) improves the effectiveness of United States foreign
assistance to prevent, detect, and respond to infectious
disease threats, through a One Health approach, including
through the advancement of the Global Health Security Agenda,
the International Health Regulations (2005), and other relevant
frameworks and programs that contribute to global health
security and pandemic preparedness;
(3) establishes specific and measurable goals, benchmarks,
timetables, performance metrics, and monitoring and evaluation
plans for United States foreign policy and assistance for
global health security that promote learning and adaptation and
reflect international best practices relating to global health
security, transparency, and accountability;
(4) establishes transparent means to improve coordination
and performance by the relevant Federal departments and
agencies and sets out clear roles and responsibilities that
reflect the unique capabilities and resources of each such
department and agency;
(5) establishes mechanisms to improve coordination and
avoid duplication of effort among the relevant Federal
departments and agencies, partner countries, donor countries,
the private sector, multilateral organizations, and other key
stakeholders, and ensures collaboration at the country level;
(6) supports, and is aligned with, partner country-led,
global health security policy and investment plans, developed
with input from key stakeholders, as appropriate;
(7) prioritizes working with partner countries with--
(A) demonstrated need, as identified through the
Joint External Evaluation process, the Global Health
Security Index classification of health systems,
national action plans for health security, Global
Health Security Agenda Action Packages, other risk-
based assessments, and other complementary or successor
indicators of global health security and pandemic
preparedness; and
(B) demonstrated commitment to transparency,
including budget and global health data transparency,
complying with the International Health Regulations
(2005), investing in domestic health systems, and
achieving measurable results;
(8) reduces long-term reliance upon United States foreign
assistance for global health security by--
(A) helping build and enhance community resilience
to infectious disease emergencies and threats, such as
COVID-19 and Ebola;
(B) ensuring that United States global health
assistance is strategically planned and coordinated in
a manner that contributes to the strengthening of
overall health systems and builds the capacity of local
organizations and institutions;
(C) promoting improved domestic resource
mobilization, co-financing, and appropriate national
budget allocations for strong health systems, global
health security, and pandemic preparedness and response
in partner countries; and
(D) ensuring partner country ownership of global
health security strategies, data, programs, and
outcomes;
(9) supports health budget and workforce planning in
partner countries, including training in public financial
management and budget data transparency;
(10) works to ensure that--
(A) partner countries have national action plans
for health security that are developed with input from
key stakeholders, including communities and the private
sector;
(B) United States foreign assistance for global
health security is aligned with such national action
plans for health security in partner countries,
developed with input from key stakeholders, including
communities and the private sector, to the greatest
extent practicable and appropriate; and
(C) United States global health security efforts
are aligned with ongoing strategies and initiatives
across government agencies to help nations better
identify and prevent health impacts related to
deforestation, climate-related events, and increased
unsafe interactions between wildlife, livestock, and
people, including the emergence, reemergence, and
spread of zoonoses;
(11) strengthens linkages between complementary bilateral
and multilateral foreign assistance programs, including efforts
of the World Bank, the World Health Organization, the Global
Fund to Fight AIDS, Tuberculosis, and Malaria, Gavi, the
Vaccine Alliance, and regional health organizations, that
contribute to the development of more resilient health systems
and supply chains in partner countries with the capacity,
resources, and personnel required to prevent, detect, and
respond to infectious disease threats; and
(12) supports innovation and partnerships with the private
sector, health organizations, civil society, nongovernmental
organizations, and health research and academic institutions to
improve pandemic preparedness and response, including for the
prevention and detection of infectious disease, and the
development and deployment of effective, accessible, and
affordable infectious disease tracking tools, diagnostics,
therapeutics, and vaccines.
(b) Submission of Strategy.--Not later than 120 days after the date
of the enactment of this Act, the President shall submit the strategy
required under subsection (a) to the appropriate congressional
committees.
(c) Annual Report.--
(1) In general.--Not later than 1 year after the submission
of the strategy to the appropriate congressional committees
under subsection (b), and not later than October 1 of each year
thereafter for the following 4 fiscal years, the President
shall submit a report to the appropriate congressional
committees that describes--
(A) the status of the implementation of the
strategy required under subsection (a);
(B) any necessary updates to the strategy;
(C) the progress made in implementing the strategy,
with specific information related to the progress
toward improving countries' ability to detect, respond
and prevent the spread of infectious disease threats,
such as COVID-19 and Ebola; and
(D) details on the status of funds made available
to carry out the purposes of this title.
(2) Agency-specific plans.--The reports required under
paragraph (1) shall include specific implementation plans from
each relevant Federal department and agency that describe--
(A) how updates to the strategy may have impacted
the agency's plan during the preceding calendar year;
(B) the progress made in meeting the goals,
objectives, and benchmarks under implementation plans
during the preceding year;
(C) the anticipated staffing plans and
contributions of the department or agency, including
technical, financial, and in-kind contributions, to
implement the strategy;
(D) a transparent, open, and detailed accounting of
obligations by each of the relevant Federal departments
and agencies to implement the strategy, including--
(i) the statutory source of obligated
funds;
(ii) the amounts obligated;
(iii) implementing partners;
(iv) targeted beneficiaries; and
(v) activities supported;
(E) the efforts of the relevant Federal department
or agency to ensure that the activities and programs
carried out pursuant to the strategy are designed to
achieve maximum impact and enduring returns, including
through specific activities to strengthen health
systems, as appropriate; and
(F) a plan for regularly reviewing and updating
programs and partnerships, and for sharing lessons
learned with a wide range of stakeholders in an open,
transparent manner.
(3) Form.--The reports required under paragraph (1) shall
be submitted in unclassified form, but may contain a classified
annex.
SEC. 203. COMMITTEE ON GLOBAL HEALTH SECURITY AND PANDEMIC AND
BIOLOGICAL THREATS.
(a) Statement of Policy.--It shall be the policy of the United
States--
(1) to promote global health security as a core national
and security interest; and
(2) to ensure effective coordination and collaboration
between the relevant Federal departments and agencies engaged
domestically and internationally in efforts to advance the
global health security of the United States, in accordance with
paragraph (1).
(b) Coordination.--
(1) Defined term.--In this subsection, the term ``pandemic
threat'' means any infectious disease that--
(A) has an aggregation of cases in a community that
rises above what is normally expected in that
population in that area;
(B) has the potential to spread over several
countries or continents; and
(C) could, if not addressed, threaten the national
security of the United States.
(2) Committee on global health security and pandemic and
biological threats.--There is authorized to be established,
within the National Security Council, the Committee on Global
Health Security and Pandemic and Biological Threats (referred
to in this subsection as the ``Committee''), whose day to day
operations should be led by the Special Advisor for Global
Health Security.
(3) Special advisor for global health security.--The
Special Advisor for Global Health Security referred to in
paragraph (2)--
(A) should serve as part of the staff of the
National Security Council; and
(B) may also be the Senior Director for a Global
Health Security and Biodefense Directorate within the
Executive Office of the President, who reports to the
Assistant to the President for National Security
Affairs.
(4) Composition.--The Committee should include the
following members:
(A) The Director of National Intelligence.
(B) The Secretary of State.
(C) The Secretary of Defense.
(D) The Secretary of Health and Human Services.
(E) The Administrator of the United States Agency
for International Development.
(F) The Secretary of Agriculture.
(G) The Secretary of Treasury.
(H) The Attorney General.
(I) The Secretary of Homeland Security.
(J) The Office of Management and Budget.
(K) The Administrator of the Environmental
Protection Agency.
(L) The Director of the Centers for Disease Control
and Prevention.
(M) The Director of the Office of Science and
Technology Policy.
(N) The Assistant to the President for National
Security Affairs, who should serve as the chairperson
of the Committee.
(O) The Director of the National Institutes of
Health.
(P) The Director of the National Institute of
Allergy and Infectious Diseases.
(Q) The Secretary of Labor.
(R) Such other members as the President may
designate.
(5) Functions.--
(A) In general.--The functions of the Committee
should be--
(i) to provide strategic guidance for the
development of a policy framework for
activities of the United States Government
relating to global health security, including
pandemic prevention, preparedness and response;
and
(ii) to ensure policy coordination between
United States Government agencies, especially
coordination between--
(I) agencies with a primarily
domestic mandate; and
(II) agencies with an international
mandate relating to global health
security and pandemic threats.
(B) Activities.--In carrying out the functions
described in subparagraph (A), the Committee should--
(i) conduct, in coordination with the heads
of relevant Federal agencies, a review of
existing United States health security policies
and strategies and develop recommendations for
how the Federal Government may regularly update
and harmonize such policies and strategies to
ensure the timely development of a
comprehensive coordinated strategy to enable
the United States Government to respond to
pandemic threats and to monitor the
implementation of such strategies;
(ii) develop a plan for--
(I) establishing an interagency
National Center for Epidemic
Forecasting and Outbreak Analytics; and
(II) modernizing global early
warning and trigger systems for scaling
action to prevent, detect, respond to,
and recover from emerging biological
threats;
(iii) provide policy-level recommendations
to participating agencies regarding the Global
Health Security Agenda goals, objectives, and
implementation, and other international efforts
to strengthen pandemic prevention, preparedness
and response;
(iv) review the progress toward, and
working to resolve challenges in, achieving
United States commitments under the Global
Health Security Agenda;
(v) develop protocols for coordinating and
deploying a global response to emerging high-
consequence infectious disease threats that
outline the respective roles for relevant
Federal agencies in facilitating and supporting
such response operations that should facilitate
the operational work of Federal agencies, and
of the Special Advisor for Global Health
Security;
(vi) make recommendations regarding
appropriate responses to specific pandemic
threats and ensure the coordination of domestic
and international agencies regarding the
Federal Government's efforts to prevent,
detect, respond to, and recover from biological
events;
(vii) take steps to strengthen the global
pandemic supply chain and address any barriers
to the timely delivery of supplies in response
to a pandemic, including through engagement
with the private sector, as appropriate;
(C) develop policies and procedures to ensure the
effective sharing of information from domestic and
international sources about pandemic threats among the
relevant Federal departments and agencies, State and
local governments, and international partners and
organizations; and
(D) develop guidelines to enhance and improve the
operational coordination between State and local
governments and Federal agencies with respect to
pandemic threats.
(6) Foreign affairs responsibilities.--The Committee should
not assume any foreign affairs responsibilities of the
Secretary of State, including the responsibility to oversee the
implementation of programs and policies that advance global
health security within foreign countries.
(7) Specific roles and responsibilities.--
(A) In general.--The heads of the agencies listed
in paragraph (4) should--
(i) make global health security and
pandemic threat reduction a high priority
within their respective agencies, and include
global health security and pandemic threat
reduction-related activities within their
respective agencies' strategic planning and
budget processes;
(ii) designate a senior-level official to
be responsible for global health security and
pandemic threat reduction at each of their
respective agencies;
(iii) designate, in accordance with
paragraph (4), an appropriate representative at
the Assistant Secretary level or higher to
participate on the Committee in instances where
the head of the agency cannot participate;
(iv) keep the Committee apprised of Global
Health Security and pandemic threat reduction-
related activities undertaken within their
respective agencies;
(v) ensure interagency cooperation and
collaboration and maintain responsibility for
agency-related programmatic functions
including, as applicable, in coordination with
host governments, country teams, and global
health security in-country teams; and
(vi) keep the Committee apprised of GHSA-
related activities undertaken within their
respective agencies.
(B) Additional roles and responsibilities.--In
addition to the roles and responsibilities described in
subparagraph (A), the heads of the agencies described
in paragraph (4) should carry out their respective
roles and responsibilities described in 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) and the
National Security Memorandum-1 on United States Global
Leadership to Strengthen the International COVID-19
Response and to Advance Global Health Security and
Biological Preparedness, as in effect on the day before
the date of the enactment of this Act.
(8) Regular briefings.--Not less frequently than twice each
year, the Special Advisor for Global Health Security shall
provide a briefing on the responsibilities and activities of
the Committee to the appropriate congressional committees, the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.
SEC. 204. UNITED STATES OVERSEAS GLOBAL HEALTH SECURITY AND DIPLOMACY
COORDINATION.
(a) Establishment.--There is established, within the Department of
State, a Special Representative for United States International
Activities to Advance Global Health Security and Diplomacy Overseas
(referred to in this section as the ``Special Representative'').
(b) Appointment; Qualifications.--The Special Representative--
(1) shall be appointed by the President, by and with the
advice and consent of the Senate;
(2) shall report to the Secretary of State; and
(3) shall have--
(A) demonstrated knowledge and experience in the
fields of development and public health, epidemiology,
or medicine; and
(B) relevant diplomatic, policy, and political
expertise.
(c) Authorities.--The Special Representative is authorized--
(1) to operate internationally to carry out the purposes of
this title;
(2) to lead in developing a global pandemic prevention,
preparedness and response framework to support global pandemic
prevention, preparedness, responses and recovery efforts,
including through--
(A) diplomatic engagement and related foreign
policy efforts, such as multilateral and bilateral
arrangements, enhanced coordination of engagement with
multilateral organizations and countries, and the
mobilization of donor contributions; and
(B) support for United States citizens living
abroad, including consular support;
(3) to serve as the representative of the Secretary of
State on the Committee on Global Health Security and Pandemic
and Biological Threats under section 202;
(4) to represent the United States in the multilateral,
catalytic financing mechanism described in section 302(a);
(5) to transfer and allocate United States foreign
assistance funding authorized to be appropriated pursuant to
subsection (f) to the relevant Federal departments and agencies
implementing the strategy required under section 202, in
coordination with the Office of Management and Budget, the
United States Agency for International Development, the
Department of Health and Human Services, and the Office of
Foreign Assistance Resources in the Department of State;
(6) to utilize detailees, on a reimbursable or
nonreimbursable basis, from the relevant Federal departments
and agencies and hire personal service contractors, who may
operate domestically and internationally, to ensure that the
Office of the Special Representative has access to the highest
quality experts available to the United States Government to
carry out the functions under this Act; and
(7) to perform such other functions as the Secretary of
State may assign.
(d) Duties.--The Special Representative shall coordinate, manage,
and oversee United States foreign policy, diplomatic efforts, and
foreign assistance funded with amounts appropriated pursuant to
subsection (f) to advance the United States Global Health Security and
Diplomacy Strategy developed pursuant to section 202, including by--
(1) developing and coordinating a global pandemic
prevention, preparedness and response framework consistent with
subsection (c)(2);
(2) enhancing engagement with multilateral organizations
and partner countries, including through the mobilization of
donor support;
(3) enhancing coordination of consular services for United
States citizens abroad in the event of a global health
emergency;
(4) ensuring effective program coordination and
implementation by the relevant Federal departments and agencies
by--
(A) formulating, issuing, and updating related
policy guidance;
(B) establishing, in consultation with the United
States Agency for International Development and the
Centers for Disease Control and Prevention, unified
auditing, monitoring, and evaluation plans;
(C) aligning, in coordination with United States
chiefs of mission and country teams in partner
countries--
(i) the foreign assistance resources funded
with amounts appropriated pursuant to
subsection (f); and
(ii) the implementation plans required
under section 202(c)(2) with the relevant
Federal departments and agencies in a manner
that--
(I) is consistent with 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);
(II) is consistent with the
National Security Memorandum on United
States Global Leadership to Strengthen
the International COVID-19 Response and
to Advance Global Health Security and
Biological Preparedness, issued by
President Biden on January 21, 2021;
and
(III) reflects and leverages the
unique capabilities of each such
department and agency;
(D) convening, as appropriate, an interagency
working group on pandemic prevention and preparedness,
headed by the Special Representative and including
representatives from the relevant Federal departments
and agencies, to facilitate coordination of activities
relating to pandemic prevention and preparedness in
partner countries under this Act;
(E) working with, and leveraging the expertise and
activities of, the Office of the United States Global
AIDS Coordinator, the Office of the United States
Global Malaria Coordinator, and similar or successor
entities that are implementing United States global
health assistance overseas; and
(F) avoiding duplication of effort and working to
resolve policy, program, and funding disputes among the
relevant Federal departments and agencies;
(5) leading diplomatic efforts to identify and address
current and emerging threats to global health security;
(6) ensuring, in coordination with the Secretary of Health
and Human Services and the Administrator of the United States
Agency for International Development, effective representation
of the United States in relevant international forums,
including at the World Health Organization, the World Health
Assembly, and meetings of the Global Health Security Agenda and
of the Global Health Security Initiative;
(7) working to enhance coordination with, and transparency
among, the governments of partner countries and key
stakeholders, including the private sector;
(8) promoting greater donor and national investment in
partner countries to build more resilient health systems and
supply chains, including through representation and
participation in a multilateral, catalytic financing mechanism
for global health security and pandemic prevention and
preparedness, consistent with title III;
(9) securing bilateral and multilateral financing
commitments to advance the Global Health Security Agenda,
including through funding for the financing mechanism described
in title III; and
(10) providing regular updates to the appropriate
congressional committees regarding the fulfillment of the
duties described in this subsection.
(e) Deputy Representative.--The Special Representative should be
supported by a deputy, who--
(1) should be an employee of the United States Agency for
International Development serving in a career or noncareer
position in the Senior Executive Service or at the level of a
Deputy Assistant Administrator or higher;
(2) should have demonstrated knowledge and experience in
the fields of development and public health, epidemiology, or
medicine; and
(3) serves concurrently as the deputy and performs the
functions described in section 3(h) of Executive Order 13747
(81 Fed. Reg. 78701).
(f) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated
$5,000,000,000, for the 5-year period beginning on October 1,
2022, to carry out the purposes of this section and title III,
which, in consultation with the appropriate congressional
committees and subject to the requirements under chapters 1 and
10 of part I and section 634A of the Foreign Assistance Act of
1961 (22 U.S.C. 2151 et seq.), may include support for--
(A) enhancing preparedness in partner countries
through implementation of the Global Health Security
Strategy developed pursuant to section 202;
(B) replenishing the Emergency Reserve Fund at the
United States Agency for International Development,
established pursuant to section 7058(c)(1) of the
Department of State, Foreign Operations, and Related
Programs Appropriations Act, 2017 (division J of Public
Law 115-31) to address new or emerging infectious
disease threats, as necessary and appropriate;
(C) United States contributions to the World Bank
Health Emergency Preparedness and Response Multi-Donor
Fund; and
(D) United States contributions to a multilateral,
catalytic financing mechanism for global health
security and pandemic prevention and preparedness
described in section 302.
(2) Exception.--Section 110 of the Trafficking Victims
Protection Act of 2000 (22 U.S.C. 7107) shall not apply to
assistance made available pursuant to this subsection.
SEC. 205. RESILIENCE.
It shall be the policy of the United States to support the growth
of healthier, more stable societies, while advancing the global health
security interests of the United States by working with key
stakeholders--
(1) in developing countries that are highly vulnerable to
the emergence, reemergence, and spread of infectious diseases
with pandemic potential, including disease outbreaks resulting
from natural and manmade disasters, human displacement, loss of
natural habitat, poor access to water, sanitation, and hygiene,
and other political, security, economic, and climatic shocks
and stresses;
(2) to develop effective tools to identify, analyze,
forecast, and mitigate the risks that make such countries
vulnerable;
(3) to better integrate short-, medium-, and long-term
recovery efforts into global health emergency response and
disaster relief; and
(4) to ensure that international assistance and financing
tools are effectively designed, objectively informed,
strategically targeted, carefully coordinated, reasonably
adapted, and rigorously monitored and evaluated in a manner
that advances the policy objectives under this section.
SEC. 206. STRENGTHENING HEALTH SYSTEMS.
(a) Statement of Policy.--It shall be the policy of the United
States to ensure that bilateral global health assistance programs are
effectively managed and coordinated to contribute to the strengthening
of health systems in each country in which such programs are carried
out, as necessary and appropriate for the purposes of achieving
improved health outcomes.
(b) Coordination.--The Administrator of USAID shall work with the
Director of the Centers for Disease Control and Prevention, the Global
Malaria Coordinator, and the United States Global AIDS Coordinator and
Special Representative for Global Health Diplomacy at the Department of
State to identify areas of collaboration and coordination in countries
with global health programs and activities undertaken by USAID pursuant
to the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (Public Law 108-25) and other relevant statutes to
ensure that such activities contribute to health systems strengthening.
(c) Pilot Program .--
(1) In general.--The Administrator of USAID should identify
not fewer than 5 countries in which the United States has
significant bilateral investments in global health to develop
an integrated approach toward health systems strengthening that
takes advantage of all sources of funding for global health in
such country, with the aim of establishing an enduring model
for coordinating health systems strengthening activities in
additional countries in the future.
(2) Assessment.--In the countries selected under paragraph
(1), USAID missions, in consultation with USAID's Office of
Health Systems, should conduct an assessment that--
(A) takes a comprehensive view of the constraints
in the country's health system that prevent the
achievement of desired outcomes of United States
Government-supported health programs;
(B) identifies the best opportunities for improving
health systems to achieve improved outcomes, including
obstacles to health service delivery;
(C) maps the resources of the country and other
donors in the health sector with a focus on investment
in health system strengthening; and
(D) develops, based on the results of the
assessment described in subparagraph (A), and
implements a new or revised 5-year strategy for United
States assistance to strengthen the country's health
system that--
(i) provides a framework for implementing
such strategy;
(ii) identifies key areas for United States
Government investments to strengthen the health
system in alignment with other donors and
achieve health outcomes beyond a single sector;
(iii) specifies the anticipated role of
health programs undertaken by each of the
relevant Federal departments and agencies
operating in the country in implementing such
strategy;
(iv) includes clear goals, benchmarks,
outputs, desired outcomes, a means of measuring
progress and a cost analysis; and
(v) requires reporting by each Federal
department and agency regarding their
participation and contribution, including in
the PEPFAR Annual Report to Congress.
(3) Strategies to strengthen health systems.--USAID
missions in countries identified pursuant paragraph (1) should
develop a strategy to strengthen health systems based on the
assessment developed pursuant to paragraph (2) that--
(A) ensures complementarity with priorities
identified under any other action plan focused on
strengthening a country's health system, such as the
World Health Organization's Joint External Evaluation
and National Action Plans for Health Security;
(B) identifies bureaucratic barriers and
inefficiencies, including poor linkages between
government ministries and between ministries and donor
agencies and the extent of any corruption, and identify
actions to overcome such barriers;
(C) identifies potential obstacles to the
implementation of the strategy, such as issues relating
to lack of political will, poor governance of an
effective health system at all levels of the country's
public health systems, especially with respect to
governing bodies and councils at the provincial,
district, and community levels, and the exclusion of
women, minorities, other underserved groups, and
frontline health workers in decision making;
(D) includes proposals for mobilizing sufficient
and durable financing for health systems;
(E) identifies barriers to building and retaining
an effective frontline health workforce with key global
health security capacities, informed by the
International Health Regulations (2005), including--
(i) strengthened data collection and
analysis;
(ii) data driven decision making capacity;
(iii) recommendations for partner country
actions to achieve a workforce that conforms
with the World Health Organization's
recommendation for at least 44.5 doctors,
nurses, and midwives and at least 15 paid,
trained, equipped, and professionally
supervised community health workers for every
10,000 people, while supporting proper
distribution and high-quality job performance;
and
(iv) the formalization and inclusion of the
community health workforce in planning for a
resilient health system to ensure essential
service delivery and pandemic response;
(F) identifies deficiencies in information systems
and communication technologies that prevent linkages at
all levels of the health system delivery and medical
supply systems and promotes interoperability across
data systems with real time data, while protecting data
security;
(G) identifies weaknesses in supply chain and
procurement systems and practices, and recommends ways
to improve the efficiency, transparency, and
effectiveness of such systems and practices;
(H) identifies obstacles to health service access
and quality and improved health outcomes for women and
girls, and for the poorest and most vulnerable,
including a lack of social support and other underlying
causes, and recommendations for how to overcome such
obstacles;
(I) includes plans for integrating innovations in
health technologies, services, and systems;
(J) identifies barriers to health literacy,
community engagement, and patient empowerment, and
recommendations for overcoming such barriers;
(K) includes proposals for strengthening community
health systems and the community-based health workforce
informed by the World Health Organization guideline on
health policy and system support to optimize community
health worker programmes (2018), including the
professionalization of community health workers;
(L) describes the role of the private sector and
nongovernmental health providers, including community
groups engaged in health promotion and mutual
assistance and other institutions engaged in health
delivery, including the extent to which the local
population utilizes such health services;
(M) facilitates rapid response during health
emergencies, such as last mile delivery of vaccines to
respond to and prevent the spread of infectious
diseases with epidemic and pandemic potential; and
(N) ensures that relevant USAID missions and
bureaus are appropriately staffed and resourced to
carry out such activities efficiently, effectively, and
in-line with best practices.
(4) Consultation and reporting requirements.--
(A) Consultation.--In developing a strategy
pursuant to paragraph (3), each USAID mission should
consult with a wide variety of stakeholders,
including--
(i) relevant partner government
institutions;
(ii) professional associations;
(iii) patient groups;
(iv) civil society organizations (including
international nongovernmental organizations
with relevant expertise in program
implementation); and
(v) the private sector.
(B) Reporting.--Not later than 180 days after the
date of the enactment of this Act, the Administrator of
USAID and the United States Global AIDS Coordinator
shall submit a report to the appropriate congressional
committees detailing the progress of the pilot program
authorized under this subsection, including--
(i) progress made toward the integration
and co-financing of health systems
strengthening activities by USAID and the
Office of the Global AIDS Coordinator; and
(ii) the results of integrated efforts
under this section, including for cross-cutting
efforts to strengthen local health workforces.
(d) Technical Capacity.--
(1) In general.--The Administrator of USAID shall ensure
that USAID is sufficiently resourced and staffed to ensure
performance, consistency, and adoption of best practices in
USAID's health systems programs, including the pilot program
authorized under subsection (c).
(2) Resources.--The Administrator of USAID and the United
States Global AIDS Coordinator shall include detail in the
fiscal year 2023 Congressional Budget Justification regarding
health systems strengthening activities, including--
(A) the plans for, and the progress toward,
reaching the capacity described in paragraph (1);
(B) the requirements for sustaining such capacity,
including the resources needed by USAID; and
(C) budget detail on the integration and joint
funding of health systems capacity building, as
appropriate.
(e) International Efforts.--The Secretary of State, in coordination
with the Administrator of USAID, should work with the Global Fund to
Fight AIDS, Tuberculosis, and Malaria, Gavi, the Vaccine Alliance,
bilateral donors, and other relevant multilateral and international
organizations and stakeholders to develop--
(1) shared core indicators for strengthened health systems;
(2) agreements among donors that reporting requirements for
health systems come from country systems to reduce the burden
placed on partner countries;
(3) structures for joint assessments, plans, auditing, and
consultations; and
(4) a regularized approach to coordination on health
systems strengthening.
(f) Public Private Partnerships to Improve Health Systems
Strengthening.--The country strategies developed under subsection
(c)(3) should include a section that--
(1) discusses the role of the private sector (including
corporate, local, and international organizations with relevant
expertise); and
(2) identifies relevant opportunities for the private
sector--
(A) to accelerate research and development of
innovative health and information technology, and to
offer training related to its use;
(B) to contribute to improvements in health
administration and management processes;
(C) to improve system efficiency;
(D) to develop training related to clinical
practice guidelines; and
(E) to help countries develop systems for
documenting outcomes and achievements related to
activities undertaken to strengthen the health sector.
(g) Authorization for Use of Funds.--Amounts authorized to be
appropriated or otherwise made available to carry out section 104 of
the Foreign Assistance Act of 1961 (22 U.S.C. 2151b) may be made
available to carry out this section.
SEC. 207. ADDITIONAL AUTHORITIES.
(a) Foreign Assistance Act of 1961.--Chapter 1 of part I of the
Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amended--
(1) in section 104(c)(1) (22 U.S.C. 2151b(c)(1)), by
inserting ``(emphasizing health systems strengthening, as
appropriate)'' after ``health services'';
(2) in section 104A (22 U.S.C. 2151b-2)--
(A) in subsection (b)(3)(D), by striking
``including health care systems, under other
international donor support'' and inserting ``including
through support for health systems strengthening, under
other donor support''; and
(B) in subsection (f)(3)(Q), by inserting ``the
Office of the United States Global AIDS Coordinator,
partner countries, and the Global Fund to Fight AIDS,
Tuberculosis, and Malaria to ensure that their actions
support the activities taken to strengthen the overall
health systems in recipient countries, and efforts by''
after ``efforts by''; and
(3) in section 104B(g)(2) (22 U.S.C. 2151b-3(g)(2)), by
inserting ``strengthening the health system of the country
and'' after ``contribute to''.
(b) United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003.--Section 204 of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C.
7623) is amended--
(1) in subsection (a) --
(A) in paragraph (1)(A), by inserting ``in a manner
that is coordinated with, and contributes to, efforts
through other assistance activities being carried out
to strengthen national health systems and health
policies'' after ``systems''; and
(B) in paragraph (2)--
(i) in subparagraph (C), by inserting ``as
part of a strategy to improve overall health''
before the semicolon at the end;
(ii) in subparagraph (D), by striking
``and'' at the end;
(iii) in subparagraph (E), by striking the
period at the end and inserting ``; and''; and
(iv) by adding at the end the following:
``(F) to contribute to efforts that build health
systems capable of preventing, detecting and responding
to HIV/AIDS, tuberculosis, malaria and other infectious
diseases with pandemic potential.''; and
(2) in subsection (b), by striking ``receive funding to
carry out programs to combat HIV/AIDS, tuberculosis, and
malaria'' and inserting ``more effectively budget for and
receive funding to carry out programs to strengthen health
systems such that countries are able to more effectively combat
HIV/AIDS, tuberculosis, and malaria, to prevent, respond and
detect other diseases with pandemic potential,''.
SEC. 208. AUTHORIZATION FOR UNITED STATES PARTICIPATION IN THE
COALITION FOR EPIDEMIC PREPAREDNESS INNOVATIONS.
(a) In General.--The United States is authorized to participate in
the Coalition for Epidemic Preparedness Innovations (referred to in
this section as ``CEPI'').
(b) Investors Council and Board of Directors.--
(1) Initial designation.--The President shall designate an
employee of the United States Agency for International
Development to serve on the Investors Council and, if
nominated, on the Board of Directors of CEPI, as a
representative of the United States during the period beginning
on the date of such designation and ending on September 30,
2022.
(2) Ongoing designations.--The President may designate an
employee of the relevant Federal department or agency with
fiduciary responsibility for United States contributions to
CEPI to serve on the Investors Council and, if nominated, on
the Board of Directors of CEPI, as a representative of the
United States.
(3) Qualifications.--Any employee designated pursuant to
paragraph (1) or (2) shall have demonstrated knowledge and
experience in the fields of development and public health,
epidemiology, or medicine, from the Federal department or
agency with primary fiduciary responsibility for United States
contributions pursuant to subsection (c).
(c) Consultation.--Not later than 60 days after the date of the
enactment of this Act, the employee designated pursuant to subsection
(b)(1) shall consult with the appropriate congressional committees
regarding--
(1) the manner and extent to which the United States plans
to participate in CEPI, including through the governance of
CEPI;
(2) any planned financial contributions from the United
States to CEPI; and
(3) how participation in CEPI is expected to support--
(A) the United States Global Health Security
Strategy required under this Act;
(B) the applicable revision of the National
Biodefense Strategy required under section 1086 of the
National Defense Authorization Act for Fiscal Year 2017
(6 U.S.C. 104); and
(C) any other relevant programs relating to global
health security and biodefense.
(d) United States Contributions.--
(1) Sense of congress.--It is the sense of Congress that
the President, consistent with the provisions under section
10003(a)(1) of the American Rescue Plan Act of 2021, should
make an immediate contribution to CEPI in the amount of
$300,000,000, to expand research and development of vaccines to
combat the spread of COVID-19 variants.
(2) Notification.--Not later than 15 days before a
contribution is made available pursuant to paragraph (1), the
President shall notify the appropriate congressional committees
of the details of the amount, purposes, and national interests
served by such contribution.
SEC. 209. NATIONAL INTELLIGENCE ESTIMATE AND BRIEFING REGARDING NOVEL
DISEASES AND PANDEMIC THREATS.
(a) Defined Term.--In this section, the term ``appropriate
committees of Congress'' means--
(1) the Committee on Foreign Relations of the Senate;
(2) the Select Committee on Intelligence of the Senate;
(3) the Committee on Health, Education, Labor, and Pensions
of the Senate;
(4) the Committee on Foreign Affairs of the House of
Representatives;
(5) the Permanent Select Committee on Intelligence of the
House of Representatives; and
(6) the Committee on Energy and Commerce of the House of
Representatives.
(b) National Intelligence Estimates.--
(1) In general.--Not later than 1 year after the date of
the enactment of this Act, and annually thereafter for the
following 4 years, the National Intelligence Council shall
submit to the appropriate committees of Congress a National
Intelligence Estimate regarding the risks posed to the national
security interests of the United States by the emergence,
reemergence, and overseas transmission of pathogens with
pandemic potential.
(2) Elements.--The National Intelligence Estimate submitted
pursuant to paragraph (1) shall--
(A) identify the countries or regions most
vulnerable to the emergence or reemergence of a
pathogen with pandemic potential, including the most
likely sources and pathways of such emergence or
reemergence, whether naturally occurring, accidental,
or deliberate;
(B) assess the likelihood that a pathogen described
in subparagraph (A) will spread to the United States,
the United States Armed Forces, diplomatic or
development personnel of the United States stationed
abroad, or citizens of the United States living abroad
in a manner that could lead to lead to an epidemic in
the United States or otherwise affect the national
security or economic prosperity of the United States;
(C) assess the preparedness of countries around the
world, particularly those identified pursuant to
subparagraph (A), to prevent, detect, and respond to
pandemic threats; and
(D) identify any scientific, capacity, or
governance gaps in the preparedness of countries
identified pursuant to subparagraph (A), including an
analysis of the capacity and performance of any country
or entity described in subparagraph (C) in complying
with biosecurity standards, as applicable.
(c) Congressional Briefings.--The National Intelligence Council
shall provide an annual briefing to the appropriate committees of
Congress regarding--
(1) the most recent National Intelligence Estimate
submitted pursuant to subsection (b)(1); and
(2) the emergence or reemergence of pathogens with pandemic
potential that could lead to an epidemic described in
subsection (b)(2)(B).
(d) Public Availability.--The Director of National Intelligence
shall make publicly available an unclassified version of each National
Intelligence Estimate submitted pursuant to subsection (b)(1).
SEC. 210. PANDEMIC EARLY WARNING NETWORK.
(a) In General.--The Secretary of State, in coordination with the
Administrator of the United States Agency for International
Development, the Secretary of Health and Human Services, and the heads
of the other relevant Federal departments and agencies, shall work with
the World Health Organization and other key stakeholders to establish
or strengthen effective early warning systems, at the partner country,
regional, and international levels, that utilize innovative information
and analytical tools and robust review processes to track, document,
analyze, and forecast infectious disease threats with epidemic and
pandemic potential.
(b) Report.--Not later than 1 year after the date of the enactment
of this Act, and annually thereafter for the following 4 years, the
Secretary of State, in coordination with the Secretary of Health and
Human Services and the heads of the other relevant Federal departments
and agencies, shall submit a report to the appropriate congressional
committees that describes United States Government efforts and
opportunities to establish or strengthen effective early warning
systems for infectious disease threats.
SEC. 211. INTERNATIONAL EMERGENCY OPERATIONS.
(a) Sense of Congress.--It is the sense of Congress that it is
essential to enhance the capacity of key stakeholders to effectively
operationalize early warning and execute multi-sectoral emergency
operations during an infectious disease outbreak, particularly in
countries and areas that deliberately withhold critical global health
data and delay access during an infectious disease outbreak in advance
of the next infectious disease outbreak with pandemic potential.
(b) Public Health Emergencies of International Concern.--The
Secretary of State, in coordination with the Secretary of Health and
Human Services, should work with the World Health Organization and
like-minded member states to adopt an approach toward assessing
infectious disease threats under the International Health Regulations
(2005) for the World Health Organization to identify and transparently
communicate, on an ongoing basis, varying levels of risk leading up to
a declaration by the Director General of the World Health Organization
of a Public Health Emergency of International Concern for the duration
and in the aftermath of such declaration.
(c) Emergency Operations.--The Secretary of State, in coordination
with the Administrator of USAID, the Director of the Centers for
Disease Control and Prevention, and the heads of other relevant Federal
departments and agencies, and consistent with the requirements under
the International Health Regulations (2005) and the objectives of the
World Health Organization's Health Emergencies Programme, the Global
Health Security Agenda, and national actions plans for health security,
shall work, in coordination with the World Health Organization, with
partner countries and other key stakeholders to support the
establishment, strengthening, and rapid response capacity of global
health emergency operations centers, at the national and international
levels, including efforts--
(1) to collect and share data, assess risk, and
operationalize early warning;
(2) to secure, including through utilization of stand-by
arrangements and emergency funding mechanisms, the staff,
systems, and resources necessary to execute cross-sectoral
emergency operations during the 48-hour period immediately
following an infectious disease outbreak with pandemic
potential; and
(3) to organize and conduct emergency simulations.
TITLE III--FINANCING MECHANISM FOR GLOBAL HEALTH SECURITY AND PANDEMIC
PREVENTION AND PREPAREDNESS
SEC. 301. ELIGIBLE PARTNER COUNTRY DEFINED.
In this title, the term ``eligible partner country'' means a
country in which the Fund for Global Health Security and Pandemic
Prevention and Preparedness to be established under section 302 may
finance global health security and pandemic prevention and preparedness
assistance programs under this Act based on the country's
demonstrated--
(1) need, as identified through the Joint External
Evaluation process, the Global Health Security Index
classification of health systems, national action plans for
health security, the World Organization for Animal Health's
Performance of Veterinary Services evaluation, and other
complementary or successor indicators of global health security
and pandemic prevention and preparedness; and
(2) commitment to transparency, including--
(A) budget and global health data transparency;
(B) complying with the International Health
Regulations (2005);
(C) investing in domestic health systems; and
(D) achieving measurable results.
SEC. 302. ESTABLISHMENT OF FUND FOR GLOBAL HEALTH SECURITY AND PANDEMIC
PREVENTION AND PREPAREDNESS.
(a) Negotiations for Establishment of Fund for Global Health
Security and Pandemic Prevention and Preparedness.--The Secretary of
State, in coordination with the Secretary of the Treasury, the
Administrator of the United States Agency for International
Development, the Secretary of Health and Human Services, the Director
of the Centers for Disease Control and Prevention, and the heads of
other relevant Federal departments and agencies, as necessary and
appropriate, should seek to enter into negotiations with donors,
relevant United Nations agencies, including the World Health
Organization, and other key multilateral stakeholders, to establish--
(1) a multilateral, catalytic financing mechanism for
global health security and pandemic prevention and
preparedness, which may be known as the Fund for Global Health
Security and Pandemic Prevention and Preparedness (in this
title referred to as ``the Fund''), to address the need for and
secure durable financing in accordance with the provisions of
this section; and
(2) an Advisory Board to the Fund in accordance with
section 305.
(b) Purposes.--The purposes of the Fund should be--
(1) to close critical gaps in global health security and
pandemic prevention and preparedness; and
(2) to work with, and build the capacity of, eligible
partner countries in the areas of global health security,
infectious disease control, and pandemic prevention and
preparedness, in a manner that--
(A) prioritizes capacity building and financing
availability in eligible partner countries;
(B) incentivizes countries to prioritize the use of
domestic resources for global health security and
pandemic prevention and preparedness;
(C) leverages government, nongovernment, and
private sector investments;
(D) regularly responds to and evaluates progress
based on clear metrics and benchmarks, such as the
Joint External Evaluation and the Global Health
Security Index;
(E) aligns with and complements ongoing bilateral
and multilateral efforts and financing, including
through the World Bank, the World Health Organization,
the Global Fund to Fight AIDS, Tuberculosis, and
Malaria, the Coalition for Epidemic Preparedness and
Innovation, and Gavi, the Vaccine Alliance; and
(F) helps countries accelerate and achieve
compliance with the International Health Regulations
(2005) and the fulfillment of the Global Health
Security Agenda 2024 Framework not later than 5 years
after the date on which the Fund is established, in
coordination with the ongoing Joint External Evaluation
national action planning process.
(c) Executive Board.--
(1) In general.--The Fund should be governed by a
transparent and accountable body (referred to in this title as
the ``Executive Board''), which should--
(A) function as a partnership with, and through
full engagement by, donor governments, eligible partner
countries, and independent civil society; and
(B) be composed of not more than 20 representatives
of governments, foundations, academic institutions,
independent civil society, indigenous people,
vulnerable communities, frontline health workers, and
the private sector with demonstrated commitment to
carrying out the purposes of the Fund and upholding
transparency and accountability requirements.
(2) Duties.--The Executive Board should--
(A) be charged with approving strategies,
operations, and grant making authorities in order to
conduct effective fiduciary, monitoring, and evaluation
efforts, and other oversight functions;
(B) determine operational procedures such that the
Fund is able to effectively fulfill its mission;
(C) provide oversight and accountability for the
Fund in collaboration with the Inspector General to be
established pursuant to section 304(e)(1)(A);
(D) develop and utilize a mechanism to obtain
formal input from eligible partner countries,
independent civil society, and implementing entities
relative to program design, review, and implementation
and associated lessons learned; and
(E) coordinate and align with other multilateral
financing and technical assistance activities, and with
the United States and other nations leading outbreak
prevention, preparedness, and response activities in
partner countries, as appropriate.
(3) Composition.--The Executive Board should include--
(A) representatives of the governments of founding
member countries who, in addition to the requirements
under paragraph (1), qualify based upon meeting an
established initial contribution threshold, which
should be not less than 10 percent of total initial
contributions, and a demonstrated commitment to
supporting the International Health Regulations (2005);
(B) a geographically diverse group of members who--
(i) come from donor countries, eligible
partner countries, academic institutions,
independent civil society, including indigenous
organizations, and the private sector; and
(ii) are selected on the basis of their
experience and commitment to innovation, best
practices, and the advancement of global health
security objectives;
(C) representatives of the World Health
Organization; and
(D) the chair of the Global Health Security
Steering Group.
(4) Contributions.--Each government or private sector
entity represented on the Executive Board should agree to make
annual contributions to the Fund in an amount not less than the
minimum determined by the Executive Board.
(5) Qualifications.--Individuals appointed to the Executive
Board should have demonstrated knowledge and experience across
a variety of sectors, including human and animal health,
agriculture, development, defense, finance, research, and
academia.
(6) Conflicts of interest.--
(A) Technical experts.--The Executive Board may
include independent technical experts who are not
affiliated with, or employed by, a recipient country or
organization.
(B) Multilateral bodies and institutions.--
Executive Board members appointed pursuant to paragraph
(3)(C) should be required to recuse themselves from
matters presenting conflicts of interest, including
financing decisions relating to such bodies and
institutions.
(7) United states representation.--
(A) Founding member.--The Secretary of State should
seek--
(i) to establish the United States as a
founding member of the Fund; and
(ii) to ensure that the United States is
represented on the Executive Board by an
officer or employee of the United States, who
shall be appointed by the President.
(B) Effective and termination dates.--
(i) Effective date.--This paragraph shall
take effect upon the date on which the
Secretary of State certifies and submits to
Congress an agreement establishing the Fund.
(ii) Termination date.--The membership
established pursuant to subparagraph (A) shall
terminate upon the date of termination of the
Fund.
(8) Removal procedures.--The Fund should establish
procedures for the removal of members of the Executive Board
who--
(A) engage in a consistent pattern of human rights
abuses;
(B) fail to uphold global health data transparency
requirements; or
(C) otherwise violate the established standards of
the Fund, including in relation to corruption.
SEC. 303. AUTHORITIES.
(a) Program Objectives.--
(1) In general.--In carrying out the purpose set forth in
section 302, the Fund, acting through the Executive Board,
should--
(A) develop grant making requirements to be
administered by an independent technical review panel
comprised of entities barred from applying for funding
or support;
(B) provide grants, including challenge grants,
technical assistance, concessional lending, catalytic
investment funds, and other innovative funding
mechanisms, in coordination with ongoing bilateral and
multilateral efforts, as appropriate--
(i) to help eligible partner countries
close critical gaps in health security, as
identified through the Joint External
Evaluation process, the Global Health Security
Index classification of health systems, and
national action plans for health security and
other complementary or successor indicators of
global health security and pandemic prevention
and preparedness; and
(ii) to support measures that enable such
countries, at the national and subnational
levels, and in partnership with civil society
and the private sector, to strengthen and
sustain resilient health systems and supply
chains with the resources, capacity, and
personnel required to prevent, detect,
mitigate, and respond to infectious disease
threats, including zoonotic spillover, before
they become pandemics;
(C) leverage the expertise, capabilities, and
resources of proven, existing agencies and
organizations to effectively target and manage
resources for impact, including through alignment with,
and co-financing of, complementary programs, as
appropriate and consistent with paragraph (3); and
(D) develop recommendations for a mechanism for
assisting countries that are at high risk for zoonotic
spillover events with pandemic potential to participate
in the Global Health Security Agenda and the Joint
External Evaluations.
(2) Activities supported.--The activities to be supported
by the Fund should include efforts--
(A) to enable eligible partner countries to
formulate and implement national health security and
pandemic prevention and preparedness action plans,
advance action packages under the Global Health
Security Agenda, and adopt and uphold commitments under
the International Health Regulations (2005) and other
related international health agreements and
arrangements, as appropriate;
(B) to support health security budget planning in
eligible partner countries, including training in
public financial management, budget and health data
transparency, human resource information systems, and
integrated and transparent budget and health data;
(C) to strengthen the health workforce, including
hiring, training, and deploying experts and other
essential staff, including community health workers, to
improve frontline prevention of, and monitoring and
preparedness for, unknown, new, emerging, or reemerging
pathogens, epidemics, and pandemic threats, including
capacity to surge and manage additional staff during
emergencies;
(D) to improve the quality of community health
worker programs as the foundation of pandemic
preparedness and response through application of
appropriate assessment tools;
(E) to improve infection prevention and control,
the protection of healthcare workers, including
community health workers, and access to water and
sanitation within healthcare settings;
(F) to combat the threat of antimicrobial
resistance;
(G) to strengthen laboratory capacity and promote
biosafety and biosecurity through the provision of
material and technical assistance;
(H) to reduce the risk of bioterrorism, zoonotic
disease spillover (whether through loss of natural
habitat, the commercial trade in wildlife for human
consumption, or other means), and accidental biological
release;
(I) to build technical capacity to manage health
supply chains for commodities, equipment, and supplies,
including for personal protective equipment, testing
reagents, and other lifesaving supplies, through
effective forecasting, procurement, warehousing, and
delivery from central warehouses to points of service
in both the public and private sectors;
(J) to enable bilateral, regional, and
international partnerships and cooperation, including
through pandemic early warning systems and emergency
operations centers, to identify and address
transnational infectious disease threats exacerbated by
natural and man-made disasters, human displacement, and
zoonotic infection;
(K) to establish partnerships for the sharing of
best practices and enabling eligible countries to meet
targets and indicators under the Joint External
Evaluation process, the Global Health Security Index
classification of health systems, and national action
plans for health security relating to the prevention,
detection, and treatment of neglected tropical
diseases;
(L) to build the capacity of eligible partner
countries to prepare for and respond to second order
development impacts of infectious disease outbreaks and
maintain essential health services, while accounting
for the differentiated needs and vulnerabilities of
marginalized populations, including women and girls;
(M) to develop and utilize metrics to monitor and
evaluate programmatic performance and identify best
practices, including in accordance with Joint External
Evaluation benchmarks, Global Health Security Agenda
targets, and Global Health Security Index indicators;
(N) to develop and deploy mechanisms to enhance and
independently monitor the transparency and
accountability of global health security and pandemic
prevention and preparedness programs and data, in
compliance with the International Health Regulations
(2005), including through the sharing of trends, risks,
and lessons learned;
(O) to promote broad participation in health
emergency planning and advisory bodies, including by
women and frontline health workers;
(P) to develop and implement simulation exercises,
produce and release after action reports, and address
related gaps;
(Q) to support countries in conducting Joint
External Evaluations;
(R) to improve disease surveillance capacity in
partner counties, including at the community level,
such that those countries are better able to detect and
respond to known and unknown pathogens and zoonotic
infectious diseases; and
(S) to support governments through coordinated and
prioritized assistance efforts to prevent zoonotic
spillover caused by deforestation, commercial trade in
wildlife for human consumption, climate-related events,
and unsafe interactions between wildlife, livestock,
and people to reduce the emergence, reemergence, and
spread of zooneses.
(3) Implementation of program objectives.--In carrying out
the objectives under paragraph (1), the Fund should work to
eliminate duplication and waste by upholding strict
transparency and accountability standards and coordinating its
programs and activities with key partners working to advance
global health security and pandemic prevention and
preparedness, including--
(A) governments, independent civil society,
nongovernmental organizations, research and academic
institutions, and private sector entities in eligible
partner countries;
(B) the pandemic early warning systems and
international emergency operations centers to be
established under sections 210 and 211;
(C) the World Health Organization;
(D) the Global Health Security Agenda;
(E) the Global Health Security Initiative;
(F) the Global Fund to Fight AIDS, Tuberculosis,
and Malaria;
(G) the United Nations Office for the Coordination
of Humanitarian Affairs, UNICEF, and other relevant
funds, programs, and specialized agencies of the United
Nations;
(H) Gavi, the Vaccine Alliance;
(I) the Coalition for Epidemic Preparedness
Innovations (CEPI);
(J) The World Organisation for Animal Health;
(K) The United Nations Environment Programme;
(L) Food and Agriculture Organization; and
(M) the Global Polio Eradication Initiative.
(b) Priority.--In providing assistance under this section, the Fund
should give priority to low-and lower middle income countries with--
(1) low scores on the Global Health Security Index
classification of health systems;
(2) measurable gaps in global health security and pandemic
prevention and preparedness identified under Joint External
Evaluations and national action plans for health security;
(3) demonstrated political and financial commitment to
pandemic prevention and preparedness; and
(4) demonstrated commitment to upholding global health
budget and data transparency and accountability standards,
complying with the International Health Regulations (2005),
investing in domestic health systems, and achieving measurable
results.
(c) Eligible Grant Recipients.--Governments and nongovernmental
organizations should be eligible to receive grants as described in this
section.
SEC. 304. ADMINISTRATION.
(a) Appointments.--The Executive Board should appoint--
(1) an Administrator, who should be responsible for
managing the day-to-day operations of the Fund; and
(2) an independent Inspector General, who should be
responsible for monitoring grants implementation and
proactively safeguarding against conflicts of interests.
(b) Authority to Accept and Solicit Contributions.--The Fund should
be authorized to solicit and accept contributions from governments, the
private sector, foundations, individuals, and nongovernmental entities.
(c) Accountability; Conflicts of Interest; Criteria for Programs.--
As part of the negotiations described in section 302(a), the Secretary
of the State, consistent with subsection (d), should--
(1) take such actions as are necessary to ensure that the
Fund will have in effect adequate procedures and standards to
account for and monitor the use of funds contributed to the
Fund, including the cost of administering the Fund;
(2) ensure there is agreement to put in place a conflict of
interest policy to ensure fairness and a high standard of
ethical conduct in the Fund's decision-making processes,
including proactive procedures to screen staff for conflicts of
interest and measures to address any conflicts, such as
potential divestments of interests, prohibition from engaging
in certain activities, recusal from certain decision-making and
administrative processes, and representation by an alternate
board member; and
(3) seek agreement on the criteria that should be used to
determine the programs and activities that should be assisted
by the Fund.
(d) Selection of Partner Countries, Projects, and Recipients.--The
Executive Board should establish--
(1) eligible partner country selection criteria, to include
transparent metrics to measure and assess global health
security and pandemic prevention and preparedness strengths and
vulnerabilities in countries seeking assistance;
(2) minimum standards for ensuring eligible partner country
ownership and commitment to long-term results, including
requirements for domestic budgeting, resource mobilization, and
co-investment;
(3) criteria for the selection of projects to receive
support from the Fund;
(4) standards and criteria regarding qualifications of
recipients of such support;
(5) such rules and procedures as may be necessary for cost-
effective management of the Fund; and
(6) such rules and procedures as may be necessary to ensure
transparency and accountability in the grant-making process.
(e) Additional Transparency and Accountability Requirements.--
(1) Inspector general.--
(A) In general.--The Secretary of State shall seek
to ensure that the Inspector General appointed pursuant
to subsection (a)--
(i) is fully enabled to operate
independently and transparently;
(ii) is supported by and with the requisite
resources and capacity to regularly conduct and
publish, on a publicly accessible website,
rigorous financial, programmatic, and reporting
audits and investigations of the Fund and its
grantees; and
(iii) establishes an investigative unit
that--
(I) develops an oversight mechanism
to ensure that grant funds are not
diverted to illicit or corrupt purposes
or activities; and
(II) submits an annual report to
the Executive Board describing its
activities, investigations, and
results.
(B) Sense of congress on corruption.--It is the
sense of Congress that--
(i) corruption within global health
programs contribute directly to the loss of
human life and cannot be tolerated; and
(ii) in making financial recoveries
relating to a corrupt act or criminal conduct
under a grant, as determined by the Inspector
General, the responsible grant recipient should
be assessed at a recovery rate of up to 150
percent of such loss.
(2) Administrative expenses.--The Secretary of State shall
seek to ensure the Fund establishes, maintains, and makes
publicly available a system to track the administrative and
management costs of the Fund on a quarterly basis.
(3) Financial tracking systems.--The Secretary of State
shall ensure that the Fund establishes, maintains, and makes
publicly available a system to track the amount of funds
disbursed to each grant recipient and sub-recipient during a
grant's fiscal cycle.
(4) Exemption from duties and taxes.--The Secretary should
ensure that the Fund adopts rules that condition grants upon
agreement by the relevant national authorities in an eligible
partner country to exempt from duties and taxes all products
financed by such grants, including procurements by any
principal or sub-recipient for the purpose of carrying out such
grants.
SEC. 305. ADVISORY BOARD.
(a) In General.--There should be an Advisory Board to the Fund.
(b) Appointments.--The members of the Advisory Board should be
composed of--
(1) a geographically diverse group of individuals that
includes representation from low- and middle-income countries;
(2) individuals with experience and leadership in the
fields of development, global health, epidemiology, medicine,
biomedical research, and social sciences; and
(3) representatives of relevant United Nations agencies,
including the World Health Organization, and nongovernmental
organizations with on-the ground experience in implementing
global health programs in low and lower-middle income
countries.
(c) Responsibilities.--The Advisory Board should provide advice and
guidance to the Executive Board of the Fund on the development and
implementation of programs and projects to be assisted by the Fund and
on leveraging donations to the Fund.
(d) Prohibition on Payment of Compensation.--
(1) In general.--Except for travel expenses (including per
diem in lieu of subsistence), no member of the Advisory Board
should receive compensation for services performed as a member
of the Board.
(2) United states representative.--Notwithstanding any
other provision of law (including an international agreement),
a representative of the United States on the Advisory Board may
not accept compensation for services performed as a member of
the Board, except that such representative may accept travel
expenses, including per diem in lieu of subsistence, while away
from the representative's home or regular place of business in
the performance of services for the Board.
(e) Conflicts of Interest.--Members of the Advisory Board should be
required to disclose any potential conflicts of interest prior to
serving on the Advisory Board and, in the event of any conflicts of
interest, recuse themselves from such matters during their service on
the Advisory Board.
SEC. 306. REPORTS TO CONGRESS.
(a) Status Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of State, in coordination with the
Administrator of the United States Agency for International
Development, and the heads of other relevant Federal departments and
agencies, shall submit a report to the appropriate congressional
committees that describes the progress of international negotiations to
establish the Fund.
(b) Annual Report.--
(1) In general.--Not later than 1 year after the date of
the establishment of the Fund, and annually thereafter for the
duration of the Fund, the Secretary of State, shall submit a
report to the appropriate congressional committees regarding
the administration of the Fund.
(2) Report elements.--The report required under paragraph
(1) shall describe--
(A) the goals of the Fund;
(B) the programs, projects, and activities
supported by the Fund;
(C) private and governmental contributions to the
Fund; and
(D) the criteria utilized to determine the programs
and activities that should be assisted by the Fund,
including baselines, targets, desired outcomes,
measurable goals, and extent to which those goals are
being achieved.
(c) GAO Report on Effectiveness.--Not later than 2 years after the
date on which the Fund is established, the Comptroller General of the
United States shall submit a report to the appropriate congressional
committees that evaluates the effectiveness of the Fund, including the
effectiveness of the programs, projects, and activities supported by
the Fund, as described in section 303(a).
SEC. 307. UNITED STATES CONTRIBUTIONS.
(a) In General.--Subject to submission of the certification under
this section, the President is authorized to make available for United
States contributions to the Fund such funds as may be appropriated or
otherwise made available for such purpose.
(b) Notification.--The Secretary of State shall notify the
appropriate congressional committees not later than 15 days in advance
of making a contribution to the Fund, including--
(1) the amount of the proposed contribution;
(2) the total of funds contributed by other donors; and
(3) the national interests served by United States
participation in the Fund.
(c) Limitation.--During the 5-year period beginning on the date of
the enactment of this Act, a United States contribution to the Fund may
not cause the cumulative total of United States contributions to the
Fund to exceed 33 percent of the total contributions to the Fund from
all sources.
(d) Withholdings.--
(1) Support for acts of international terrorism.--If the
Secretary of State determines that the Fund has provided
assistance to a country, the government of which the Secretary
of State has determined, for purposes of section 620A of the
Foreign Assistance Act of 1961 (22 U.S.C. 2371) has repeatedly
provided support for acts of international terrorism, the
United States shall withhold from its contribution to the Fund
for the next fiscal year an amount equal to the amount expended
by the Fund to the government of such country.
(2) Excessive salaries.--During the 5-year period beginning
on the date of the enactment of this Act,, if the Secretary of
State determines that the salary of any individual employed by
the Fund exceeds the salary of the Vice President of the United
States for such fiscal year, the United States should withhold
from its contribution for the next fiscal year an amount equal
to the aggregate amount by which the salary of each such
individual exceeds the salary of the Vice President of the
United States.
(3) Accountability certification requirement.--The
Secretary of State may withhold not more than 20 percent of
planned United States contributions to the Fund until the
Secretary certifies to the appropriate congressional committees
that the Fund has established procedures to provide access by
the Office of Inspector General of the Department of State, as
cognizant Inspector General, the Inspector General of the
Department of Health and Human Services, the Inspector General
of the United States Agency for International Development, and
the Comptroller General of the United States to the Fund's
financial data and other information relevant to United States
contributions to the Fund (as determined by the Inspector
General of the Department of State, in consultation with the
Secretary of State).
SEC. 308. COMPLIANCE WITH THE FOREIGN AID TRANSPARENCY AND
ACCOUNTABILITY ACT OF 2016.
Section 2(3) of the Foreign Aid Transparency and Accountability Act
of 2016 (Public Law 114-191; 22 U.S.C. 2394c note) is amended--
(1) in subparagraph (D), by striking ``and'' at the end;
(2) in subparagraph (E), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(F) the International Pandemic Preparedness and
COVID-19 Response Act of 2021.''.
SEC. 309. PROHIBITION AGAINST UNITED STATES FOREIGN ASSISTANCE FOR THE
GOVERNMENT OF THE PEOPLE'S REPUBLIC OF CHINA.
None of the assistance authorized to be appropriated under this Act
may be made available to the Government of the People's Republic of
China or to any entity owned or controlled by the Government of the
People's Republic of China.
Calendar No. 112
117th CONGRESS
1st Session
S. 2297
_______________________________________________________________________
A BILL
To improve global health, and for other purposes.
_______________________________________________________________________
July 30, 2021
Reported with an amendment