[Congressional Record Volume 167, Number 112 (Monday, June 28, 2021)]
[House]
[Pages H3165-H3171]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
GLOBAL HEALTH SECURITY ACT OF 2021
Mr. MEEKS. Mr. Speaker, I move to suspend the rules and pass the bill
(H.R. 391) to authorize a comprehensive, strategic approach for United
States foreign assistance to developing countries to strengthen global
health security, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 391
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Global Health Security Act
of 2021''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) In December 2009, President Obama released the National
Strategy for Countering Biological Threats, which listed as
one of seven objectives ``Promote global health security:
Increase the availability of and access to knowledge and
products of the life sciences that can help reduce the impact
from outbreaks of infectious disease whether of natural,
accidental, or deliberate origin''.
(2) In February 2014, the United States and nearly 30 other
nations launched the Global Health Security Agenda (GHSA) to
address several high-priority, global infectious disease
threats. The GHSA is a multi-faceted, multi-country
initiative intended to accelerate partner countries'
measurable capabilities to achieve specific targets to
prevent, detect, and respond to infectious disease threats,
whether naturally occurring, deliberate, or accidental.
(3) In 2015, the United Nations adopted the Sustainable
Development Goals (SDGs), which include specific reference to
the importance of global health security as part of SDG 3
``ensure healthy lives and promote well-being for all at all
ages'' as follows: ``strengthen the capacity of all
countries, in particular developing countries, for early
warning, risk reduction and management of national and global
health risks''.
(4) On November 4, 2016, President Obama signed Executive
Order No. 13747, ``Advancing the Global Health Security
Agenda to Achieve a World Safe and Secure from Infectious
Disease Threats''.
(5) In October 2017 at the GHSA Ministerial Meeting in
Uganda, the United States and more than 40 GHSA member
countries supported the ``Kampala Declaration'' to extend the
GHSA for an additional 5 years to 2024.
(6) In December 2017, President Trump released the National
Security Strategy, which includes the priority action:
``Detect and contain bio-threats at their source: We will
work with other countries to detect and mitigate outbreaks
early to prevent the spread of disease. We will encourage
other countries to invest in basic health care systems and to
strengthen global health security across the intersection of
human and animal health to prevent infectious disease
outbreaks''.
(7) In September 2018, President Trump released the
National Biodefense Strategy, which includes objectives to
``strengthen global health security capacities to prevent
local bioincidents from becoming epidemics'', and
``strengthen international preparedness to support
international response and recovery capabilities''.
(8) In January 2021, President Biden issued Executive Order
13987 (86 Fed. Reg. 7019; relating to Organizing and
Mobilizing the United States Government to Provide a Unified
and Effective Response to Combat COVID-19 and to Provide
United States Leadership on Global Health and Security), as
well as National Security Memorandum on United States Global
Leadership to Strengthen the International COVID-19 Response
and to Advance Global Health Security and Biological
Preparedness, which include objectives to strengthen and
reform the World Health Organization, increase United States
leadership in the global response to COVID-19, and to finance
and advance global health security and pandemic preparedness.
SEC. 3. STATEMENT OF POLICY.
It is the policy of the United States to--
(1) promote and invest in global health security and
pandemic preparedness as a core national security interest;
(2) advance the aims of the Global Health Security Agenda;
(3) collaborate with other countries to detect and mitigate
outbreaks early to prevent the spread of disease;
(4) encourage and support other countries to advance
pandemic preparedness by investing in basic resilient and
sustainable health care systems; and
(5) strengthen global health security across the
intersection of human and animal health to prepare for and
prevent infectious disease outbreaks and combat the growing
threat of antimicrobial resistance.
SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY REVIEW
COUNCIL.
(a) Establishment.--The President shall establish a Global
Health Security Agenda Interagency Review 23 Council (in this
section referred to as the ``Council'') to 24 perform the
general responsibilities described in sub-section (c) and the
specific roles and responsibilities described in subsection
(e).
(b) Meetings.--The Council shall meet not less than four
times per year to advance its mission and fulfill its
responsibilities.
(c) General Responsibilities.--The Council shall be
responsible for the following activities:
(1) Provide policy-level recommendations to participating
agencies on Global Health Security Agenda (GHSA) goals,
objectives, and implementation, and other international
efforts to strengthen pandemic preparedness and response.
(2) Facilitate interagency, multi-sectoral engagement to
carry out GHSA implementation.
(3) Provide a forum for raising and working to resolve
interagency disagreements concerning the GHSA, and other
international efforts to strengthen pandemic preparedness and
response.
(4)(A) Review the progress toward and work to resolve
challenges in achieving United States commitments under the
GHSA, including commitments to assist other countries in
achieving the GUSA targets.
(B) The Council shall consider, among other issues, the
following:
(i) The status of United States financial commitments to
the GHSA in the context of commitments by other donors, and
the contributions of partner countries to achieve the GHSA
targets.
(ii) The progress toward the milestones outlined in GHSA
national plans for those countries where the United States
Government has committed to assist in implementing the GHSA
and in annual work-plans outlining agency priorities for
implementing the GHSA.
(iii) The external evaluations of United States and partner
country capabilities to address infectious disease threats,
including the ability to achieve the targets outlined within
the WHO Joint External Evaluation tool, as well as gaps
identified by such external evaluations.
(d) Participation.--The Council shall be headed by the
Assistant to the President for National Security Affairs, in
coordination with the heads of relevant Federal agencies. The
Council shall consist of representatives from the following
agencies:
(1) The Department of State.
(2) The Department of Defense.
(3) The Department of Justice.
(4) The Department of Agriculture.
(5) The Department of Health and Human Services.
(6) The Department of the Treasury.
(7) The Department of Labor.
(8) The Department of Homeland Security.
(9) The Office of Management and Budget.
(10) The Office of the Director of National Intelligence.
(11) The United States Agency for International
Development.
(12) The Environmental Protection Agency.
(13) The Centers for Disease Control and Prevention.
(14) The Office of Science and Technology Policy.
(15) The National Institutes of Health.
(16) The National Institute of Allergy and Infectious
Diseases.
(17) Such other agencies as the Council determines to be
appropriate.
(e) Specific Roles and Responsibilities.--
[[Page H3166]]
(1) In general.--The heads of agencies described in
subsection (d) shall--
(A) make the GHSA and its implementation and global
pandemic preparedness a high priority within their respective
agencies, and include GHSA- and global pandemic preparedness-
related activities within their respective agencies'
strategic planning and budget processes;
(B) designate a senior-level official to be responsible for
the implementation of this Act;
(C) designate, in accordance with subsection (d), an
appropriate representative at the Assistant Secretary level
or higher to participate on the Council;
(D) keep the Council apprised of GHSA-related activities
undertaken within their respective agencies;
(E) maintain responsibility for agency-related programmatic
functions in coordination with host governments, country
teams, and GHSA in-country teams, and in conjunction with
other relevant agencies;
(F) coordinate with other agencies that are identified in
this section to satisfy programmatic goals, and further
facilitate coordination of country teams, implementers, and
donors in host countries; and
(G) coordinate across national health security action plans
and with GHSA and other partners, as appropriate, to which
the United States is providing assistance.
(2) Additional roles and responsibilities.--In addition to
the roles and responsibilities described in paragraph (1),
the heads of agencies described in subsection (d) shall carry
out their respective roles and responsibilities described in
subsections (b) through (i) of section 3 of Executive Order
13747 (81 Fed. Reg. 78701; relating to Advancing the Global
Health Security Agenda to Achieve a World Safe and Secure
from Infectious Disease Threats), as in effect on the day
before the date of the enactment of this Act.
SEC. 5. UNITED STATES COORDINATOR FOR GLOBAL HEALTH SECURITY.
(a) In General.--The President shall appoint an individual
to the position of United States Coordinator for Global
Health Security, who shall be responsible for the
coordination of the interagency process for responding to
global health security emergencies. As appropriate, the
designee shall coordinate with the President's Special
Coordinator for International Disaster Assistance.
(b) Congressional Briefing.--Not less frequently than twice
each year, the employee designated under this section shall
provide to the appropriate congressional committees a
briefing on the responsibilities and activities of the
individual under this section.
SEC. 6. SENSE OF CONGRESS.
It is the sense of the Congress that, given the complex and
multisectoral nature of global health threats to the United
States, the President--
(1) should consider appointing an individual with
significant background and expertise in public health or
emergency response management to the position of United
States Coordinator for Global Health Security, as required by
section 5 (a), who is an employee of the National Security
Council at the level of Deputy Assistant to the President or
higher; and
(2) in providing assistance to implement the strategy
required under section 7(a), should--
(A) coordinate, through a whole-of-government approach, the
efforts of relevant Federal departments and agencies to
implement the strategy;
(B) seek to fully utilize the unique capabilities of each
relevant Federal department and agency while collaborating
with and leveraging the contributions of other key
stakeholders; and
(C) utilize open and streamlined solicitations to allow for
the participation of a wide range of implementing partners
through the most appropriate procurement mechanisms, which
may include grants, contracts, cooperative agreements, and
other instruments as necessary and appropriate.
SEC. 7. STRATEGY AND REPORTS.
(a) Strategy.--The President shall coordinate the
development and implementation of a strategy to implement the
policy aims described in section 3, which shall--
(1) seek to strengthen United States diplomatic leadership
and improve the effectiveness of United States foreign
assistance for global health security to prevent, detect, and
respond to infectious disease threats, including through
advancement of the Global Health Security Agenda (GHSA), the
International Health Regulations (2005), and other relevant
frameworks that contribute to global health security and
pandemic preparedness;
(2) establish specific and measurable goals, benchmarks,
timetables, performance metrics, and monitoring and
evaluation plans for United States foreign assistance for
global health security that promote learning and reflect
international best practices relating to global health
security, transparency, and accountability;
(3) establish mechanisms to improve coordination and avoid
duplication of effort between the United States Government
and partner countries, donor countries, the private sector,
multilateral organizations, and other key stakeholders;
(4) prioritize working with partner countries with
demonstrated--
(A) need, as identified through the Joint External
Evaluation process, the Global Health Security Index
classification of health systems, national action plans for
health security, GHSA Action Packages, and other
complementary or successor indicators of global health
security and pandemic preparedness; and
(B) 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;
(5) reduce long-term reliance upon United States foreign
assistance for global health security by promoting partner
country ownership, improved domestic resource mobilization,
co-financing, and appropriate national budget allocations for
global health security and pandemic preparedness and
response;
(6) assist partner countries in building the technical
capacity of relevant ministries, systems, and networks to
prepare, execute, monitor, and evaluate effective national
action plans for health security, including mechanisms to
enhance budget and global health data transparency, as
necessary and appropriate;
(7) support and be aligned with country-owned global health
security policy and investment plans developed with input
from key stakeholders, as appropriate;
(8) facilitate communication and collaboration, as
appropriate, among local stakeholders in support of a multi-
sectoral approach to global health security;
(9) support the long-term success of programs by building
the capacity of local organizations and institutions in
target countries and communities;
(10) develop community resilience to infectious disease
threats and emergencies;
(11) support global health budget and workforce planning in
partner countries, including training in financial management
and budget and global health data transparency;
(12) align United States foreign assistance for global
health security with national action plans for health
security in partner countries, developed with input from key
stakeholders, including the private sector, to the greatest
extent practicable and appropriate;
(13) strengthen 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, and
Gavi, the Vaccine Alliance, 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;
(14) support innovation and public-private partnerships to
improve pandemic preparedness and response, including for the
development and deployment of effective, accessible, and
affordable infectious disease tracking tools, diagnostics,
therapeutics, and vaccines;
(15) support collaboration with and among relevant public
and private research entities engaged in global health
security; and
(16) support collaboration between United States
universities and public and private institutions in partner
countries that promote global health security and innovation.
(b) Strategy Submission.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the President, in consultation
with the head of each relevant Federal department and agency,
shall submit to the appropriate congressional committees the
strategy required under subsection (a) that provides a
detailed description of how the United States intends to
advance the policy set forth in section 3 and the agency-
specific plans described in paragraph (2).
(2) Agency-specific plans.--The strategy required under
subsection (a) shall include specific implementation plans
from each relevant Federal department and agency that
describe--
(A) the anticipated contributions of the department or
agency, including technical, financial, and in-kind
contributions, to implement the strategy; and
(B) the efforts of the department or agency to ensure that
the activities and programs carried out pursuant to the
strategy are designed to achieve maximum impact and long-term
sustainability.
(c) Report.--
(1) In general.--Not later than 1 year after the date on
which the strategy required under subsection (a) is submitted
to the appropriate congressional committees under subsection
(b), and not later than October 1 of each year thereafter,
the President shall submit to the appropriate congressional
committees a report that describes the status of the
implementation of the strategy.
(2) Contents.--The report required under paragraph (1)
shall--
(A) identify any substantial changes made in the strategy
during the preceding calendar year;
(B) describe the progress made in implementing the
strategy;
(C) identify the indicators used to establish benchmarks
and measure results over time, as well as the mechanisms for
reporting such results in an open and transparent manner;
(D) contain a transparent, open, and detailed accounting of
expenditures by relevant Federal departments and agencies to
[[Page H3167]]
implement the strategy, including, to the extent practicable,
for each Federal department and agency, the statutory source
of expenditures, amounts expended, partners, targeted
populations, and types of activities supported;
(E) describe how the strategy leverages other United States
global health and development assistance programs and
bilateral and multilateral institutions;
(F) assess efforts to coordinate United States global
health security programs, activities, and initiatives with
key stakeholders;
(G) incorporate a plan for regularly reviewing and updating
strategies, partnerships, and programs and sharing lessons
learned with a wide range of stakeholders, including key
stakeholders, in an open, transparent manner; and
(H) describe the progress achieved and challenges
concerning the United States Government's ability to advance
GHSA and pandemic preparedness, including data disaggregated
by priority country using indicators that are consistent on a
year-to-year basis and recommendations to resolve, mitigate,
or otherwise address the challenges identified therein.
(d) Form.--The strategy required under subsection (a) and
the report required under subsection (c) shall be submitted
in unclassified form but may contain a classified annex.
SEC. 8. ESTABLISHMENT OF FUND FOR GLOBAL HEALTH SECURITY AND
PANDEMIC PREPAREDNESS.
(a) Negotiations for Establishment of a Fund for Global
Health Security and Pandemic Preparedness.--The Secretary of
State, in coordination 16 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, for the establishment of--
(1) a multilateral, catalytic financing mechanism for
global health security and pandemic preparedness, which may
be known as the Fund for Global Health Security and Pandemic
Preparedness (in this title referred to as ``the Fund''), in
accordance with the provisions of this section; and
(2) an Advisory Board to the Fund in accordance with
section 9.
(b) Purpose.--The purpose of the Fund should be to close
critical gaps in global health security and pandemic
preparedness and build capacity in eligible partner countries
in the areas of global health security, infectious disease
control, and pandemic preparedness, such that it--
(1) prioritizes capacity building and financing
availability in eligible partner countries;
(2) incentivizes countries to prioritize the use of
domestic resources for global health security and pandemic
preparedness;
(3) leverages government, nongovernment, and private sector
investments;
(4) regularly responds to and evaluates progress based on
clear metrics and benchmarks, such as the Joint External
Evaluation and Global Health Security Index;
(5) 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, and Gavi, the Vaccine
Alliance; and
(6) accelerates country compliance with the International
Health Regulations (2005) and fulfillment of the Global
Health Security Agenda 2024 Framework, in coordination with
the ongoing Joint External Evaluation national action
planning process.
(c) Executive Board.--
(1) In general.--The Fund should be governed by an
Executive Board, which should be composed of not more than 20
representatives of donor governments, foundations, academic
institutions, civil society, and the private sector that meet
a minimum threshold in annual contributions and agree to
uphold transparency measures.
(2) Duties.--The Executive Board should be charged with
approving strategies, operations, and grant-making
authorities, such that it is able to conduct effective
fiduciary, monitoring, and evaluation efforts, and other
oversight functions. In addition, the Executive Board
should--
(A) be comprised only of contributors to the Fund at not
less than the minimum threshold to be established pursuant to
paragraph (1);
(B) determine operational procedures such that the Fund is
able to effectively fulfill its mission; and
(C) provide oversight and accountability for the Fund in
collaboration with the Inspector General to be established
pursuant to section 1O(e)(1)(A).
(3) Composition.--The Executive Board should include--
(A) representatives of the governments of founding
permanent member countries who, in addition to the
requirements in 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) term members, who are from academic institutions, civil
society, and the private sector and 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; and
(C) representatives of the World Health Organization, and
the chair of the Global Health Security Steering Group.
(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.
(5) Conflicts of interest.--
(A) Technical experts.--The Executive Board may include
independent technical experts, provided they are not
affiliated with or employed by a recipient country or
organization.
(B) Multilateral bodies and institutions.--Executive Board
members appointed under paragraph (3)(C) should recuse
themselves from matters presenting conflicts of interest,
including financing decisions relating to such bodies and
institutions.
(6) United states representation.--
(A) In general.--
(i) Founding permanent member.--The Secretary of State
shall seek to establish the United States as a founding
permanent member of the Fund.
(ii) United states representation.--The United States shall
be represented on the Executive Board by an officer or
employee of the United States appointed by the President.
(B) Effective and termination dates.--
(i) Effective date.--This paragraph shall take effect upon
the date the Secretary of State certifies and transmits 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.
(7) Removal procedures.--The Fund should establish
procedures for the removal of members of the Executive Board
who engage in a consistent pattern of human rights abuses,
fail to uphold global health data transparency requirements,
or otherwise violate the established standards of the Fund,
including in relation to corruption.
(8) Enforceability.--Any agreement concluded under the
authorities provided by this section shall be legally
effective and binding upon the United States, as may be
provided in the agreement, upon--
(A) the enactment of appropriate implementing legislation
which provides for the approval of the specific agreement or
agreements, including attachments, annexes, and supporting
documentation, as appropriate; or
(B) if concluded and submitted as a treaty, receiving the
necessary consent of the Senate.
(9) Eligible partner country defined.--In this section, the
term ``eligible partner country'' means a country with
demonstrated--
(A) 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
preparedness; and
(B) 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, and in which the
Fund for Global Health Security and Pandemic Preparedness
established under this section may finance global health
security and pandemic preparedness assistance programs under
this Act.
SEC. 9. FUND AUTHORITIES.
(a) Program Objectives.--
(1) In general.--In carrying out the purpose set forth in
section 8, the Fund, acting through the Executive Board,
should provide grants, including challenge grants, technical
assistance, concessional lending, catalytic investment funds,
and other innovative funding mechanisms, as appropriate, to--
(A) 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
preparedness; and
(B) support measures that enable such countries, at both
national and sub-national 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
before they become pandemics.
(2) Activities supported.--The activities to be supported
by the Fund should include efforts to--
(A) enable eligible partner countries to formulate and
implement national health security and pandemic 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, as appropriate;
(B) support global health security budget planning in
eligible partner countries, including training in financial
management and budget and global health data transparency;
(C) strengthen the health security workforce, including
hiring, training, and deploying experts to improve frontline
preparedness for emerging epidemic and pandemic threats;
[[Page H3168]]
(D) improve infection control and the protection of
healthcare workers within healthcare settings;
(E) combat the threat of antimicrobial resistance;
(F) strengthen laboratory capacity and promote biosafety
and biosecurity through the provision of material and
technical assistance;
(G) reduce the risk of bioterrorism, zoonotic disease
spillover, and accidental biological release;
(H) build technical capacity to manage global health
security related supply chains, including for personal
protective equipment, oxygen, 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;
(I) 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;
(J) 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 detection, treatment, and prevention of
neglected tropical diseases;
(K) 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;
(L) 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;
(M) develop and deploy mechanisms to enhance the
transparency and accountability of global health security and
pandemic preparedness programs and data, in compliance with
the International Health Regulations (2005), including
through the sharing of trends, risks, and lessons learned;
and
(N) develop and implement simulation exercises, produce and
release after action reports, and address related gaps.
(3) Implementation of program objectives.--In carrying out
the objectives of 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 preparedness,
including--
(A) governments, civil society, faith-based, and
nongovernmental organizations, research and academic
institutions, and private sector entities in eligible partner
countries;
(B) the pandemic early warming systems and emergency
operations centers to be established under section 9;
(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 Global Polio Eradication Initiative; and
(K) the United States Coordinator for Global Health
Security and Diplomacy established under section 5.
(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 m global health security and pandemic
preparedness identified under Joint External Evaluations and
national action plans for health security;
(3) demonstrated political and financial commitment to
pandemic 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. 10. FUND ADMINISTRATION.
(a) Appointment of an Administrator--The Executive Board of
the Fund should appoint an Administrator who should be
responsible for managing the day-to-day operations of the
Fund.
(b) Authority To Solicit and Accept Contributions.--The
Fund should be authorized to solicit and accept contributions
from governments, the private sector, foundations,
individuals, and nongovernmental entities of all kinds.
(c) Accountability of Funds and Criteria for Programs.--As
part of the negotiations described in section 8(a), the
Secretary of the State, shall, consistent with 4 subsection
(d)--
(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
(2) 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 preparedness strengths and
vulnerabilities in countries seeking assistance;
(2) minimum standards for ensuring eligible partner country
ownership and commitment to longterm 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 Fund maintains an independent Office of the
Inspector General and ensure that the 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.
(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.
SEC. 11. FUND ADVISORY BOARD.
(a) In General.--There should be an Advisory Board to the
Fund.
(b) Appointments.--There members of the Advisory Board
should be composed of--
(1) individuals with experience and leadership in the
fields of development, global health, epidemiology, medicine,
biomedical research, and social sciences; and
(2) 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 9 conflicts of
interest prior to serving on the Advisory Board.
SEC. 12. REPORTS TO CONGRESS ON THE FUND.
(a) Status Report.--Not later than 6 months after the date
of 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 to
the appropriate congressional committees a report detailing
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,
[[Page H3169]]
and annually thereafter for the duration of the Fund, the
Secretary of State, shall submit to the appropriate
congressional committees a report on the Fund.
(2) Report elements.--The report shall include a
description of--
(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.
(c) GAO Report on Effectiveness.--Not later than 2 years
after the date that the Fund comes into effect, the
Comptroller General of the United States shall submit to the
appropriate congressional committees a report evaluating the
effectiveness of the Fund, including--
(1) the effectiveness of the programs, projects, and
activities supported by the Fund; and
(2) an assessment of the merits of continued United States
participation in the Fund.
SEC. 13. 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 authorized to be 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.--At no point during the five years after
enactment of this Act shall a United States contribution to
the Fund 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) Witholdings.--
(1) Support for acts of international terrorism.--If at any
time 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.--If at any time during the five
years after enactment of this Act, 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 that fiscal year, then 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. 14. 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 (C), by striking ``and'' at the end;
(2) in subparagraph (D), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(E) the Global Health Security Act of 2021.''.
SEC. 15. DEFINITIONS.
In this Act:
(1) Appropriate congressional committees.--The term
``appropriate congressional Committees'' means--
(A) the Committee on Foreign Affairs and the Committee on
Appropriations of the House of Representatives; and
(B) the Committee on Foreign Relations and the Committee on
Appropriations of the Senate.
(2) Global health security.--The term ``global health
security'' means activities supporting epidemic and pandemic
preparedness and capabilities at the country and global
levels in order to minimize vulnerability to acute public
health events that can endanger the health of populations
across geographical regions and international boundaries.
SEC. 16. SUNSET.
This Act, and the amendments made by this Act shall cease
to be effective 5 fiscal years after the enactment of this
Act.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
York (Mr. Meeks) and the gentleman from Texas (Mr. McCaul) each will
control 20 minutes.
The Chair recognizes the gentleman from New York.
General Leave
Mr. MEEKS. Mr. Speaker, I ask unanimous consent that all Members have
5 legislative days in which to revise and extend their remarks and
include extraneous material on H.R. 391, as amended.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New York?
There was no objection.
Mr. MEEKS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 391, the Global Health
Security Act of 2021.
As the saying goes: ``An ounce of prevention is worth a pound of
cure,'' and that is undoubtedly true in global health. Pandemics don't
respect borders and they don't care about nationalities, and we are
seeing that play out on the front pages of the news these days as the
coronavirus pandemic continues to cause severe disruptions around the
world.
Over the past few years, global health security has become
increasingly tied to U.S. national security, as evidenced by not only
our experience with COVID-19, but also previous pandemics, such as
Ebola and Zika, both overseas and at home.
Having a coordinated, whole-of-government approach to prepare for and
respond to these threats is critical. We must build on the lessons
learned from the COVID-19 pandemic.
The Global Health Security Agenda, which the United States has
committed to, helps countries invest in preparedness and strengthens
systems that prevent, detect, and respond to disease outbreaks.
H.R. 391, a bipartisan bill by Representative Connolly and
Representative Chabot, would institutionalize the best practices the
United States has learned in global health security. This bill
establishes an interagency review council to not only advance global
health security, but also mandates a U.S. Global Health Security
Coordinator to manage the U.S. response in these emergencies and allow
the interagency review council to speak with one voice.
I believe this person should be at the National Security Council as
the natural nexus between diplomacy, development, and defense. This
person would help build capacity, apply lessons learned, and prepare
for the future.
While I am heartened to see that the Biden administration has
recently appointed such a person to tackle the pandemic that we are
facing, this legislation would create a permanent position focused on
U.S. global health security.
Furthermore, this bill would require the U.S. Global Health Security
Coordinator to develop a strategy and regularly report to Congress on
the progress the United States is making toward making global health
security a core national security interest.
Finally, this bill outlines a framework to leverage assistance to
increase contributions from other donors, along the lines of the Global
Fund, to support global health security activities around the world.
This bill passed the House multiple times in the past, and is more
timely than ever as we continue to address COVID-19 and seek to prepare
ourselves for the next outbreak.
So I would like to thank Representative Connolly and Representative
Chabot for their work on this legislation over the past several years
and for recognizing the vital importance of global health security as
part of America's national security.
Mr. Speaker, I reserve the balance of my time.
Mr. McCAUL. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, first of all, I want to thank the chairman for his
leadership bringing this very timely bill to the floor. I want to thank
Mr. Connolly for his leadership, and Mr. Chabot, who, I think, is
trying to get here as well.
[[Page H3170]]
COVID-19 could end up, at the end of the day, costing the global
economy upwards of $10 trillion. Of course, the full impact of viruses
like COVID-19 is not just measured in economic disruption around the
world, but also in the millions of lives that have been lost, somewhere
upwards of four million people.
COVID-19 has proven viruses know no borders, as the chairman said. It
is imperative the United States work to prevent future pandemics and be
prepared to respond to diseases with pandemic potential.
So, again, I want to thank my colleagues who have been involved in
this for introducing the Global Health Security Act and for their work
to address this important issue.
This bill ensures a whole-of-government approach to prepare for and,
hopefully, prevent future pandemics. It also establishes a new
multilateral fund that will ensure all countries have access to the
necessary resources to prevent and respond to future outbreaks.
Our committee has a history of working together to achieve bipartisan
success, but particularly on legislation related to global health. It
is not Republican or Democrat. This is an American issue. It is also a
human issue and an international issue.
The Global Health Security Act is just yet another example of this
great bipartisan work that we do and that makes me so proud to be a
Member of Congress.
Mr. Speaker, I reserve the balance of my time
Mr. MEEKS. Mr. Speaker, I yield 5 minutes to the gentleman from
Virginia (Mr. Connolly), the president of the NATO Parliamentary
Assembly and a valued member of the House Foreign Affairs Committee.
Mr. CONNOLLY. Mr. Speaker, I thank my dear friend, chairman of the
Foreign Affairs Committee; and my good friend, the ranking member of
the Foreign Affairs Committee, for their generous remarks, for their
leadership, and for bringing yet again a bipartisan bill to the floor
of the House, which many people think we can't do, but we, in fact, do
do.
I also want to thank the gentleman from Ohio (Mr. Chabot), my good
friend, for being my partner in this legislation for 3 years now.
Our legislation, the Global Health Security Act, reaffirms the United
States' commitment to promoting global health security.
Prior to COVID-19, there was a dearth of leadership and strategy
around U.S. planning for a global health security emergency. Now, as we
start to emerge from the worst of the pandemic, we understand just how
important planning is.
COVID-19 has underscored not only the need for a robust Federal
response, but also the importance of investing in global health
security and pandemic preparedness throughout the world. Diseases do
not stop at national borders.
I am honored and pleased the House Foreign Affairs Committee has
coalesced around this legislation, which offers a bipartisan solution
that addresses deficiencies in the current pandemic response effort. It
also demonstrates, I think, a commitment to a comprehensive and
sustainable approach to global health security moving forward.
The bill establishes a Global Health Security Agenda Interagency
Review Council overseen by a National Security Advisor, whose
membership includes the heads of agencies relevant to carrying out the
Global Health Security Agenda.
It establishes a U.S. Coordinator for Global Health Security
responsible for coordinating interagency responses.
It requires the President to develop a global health security
strategy with specific and measurable goals, benchmarks, and
performance metrics to improve U.S. leadership on global pandemic
preparedness.
Finally, it establishes an international Fund for Global Health
Security and Pandemic Preparedness.
Mr. Speaker, I also appreciate both Chairman Meeks' and Ranking
Member McCaul's willingness to work to strengthen this bill as it
passed through the committee during our markup. We made improvements,
with their suggestion, in elevating the participants of the interagency
review council in a manner commensurate with the scope of the work. We
strengthened the scope of the global health security strategy with
lessons learned; and we added a multilateral Federal fund.
These improvements are consistent with the Biden administration's
National Security Memorandum on United States Global Leadership to
Strengthen the International Response. This statutory framework is not
overly prescriptive, and it does not prejudge the outcome of the
current response framework offered by this administration.
Republican and Democratic Presidents alike have recognized the
critical importance of global health security; from President Obama's
role in launching a global health security agenda to President Trump's
National Security Strategy and National Biodefense Strategy.
{time} 1515
Global health crises are ongoing and increasing, and they affect
national security.
Saving lives from the next global pandemic starts now, by investing
in preparedness before it strikes.
Diseases, as I said, don't respect borders, and global health crises
have immense security, economic, and humanitarian consequences as all
too tragically we have learned from the one we are still going through.
I am proud that the Global Health Security Act has passed the House
three times already, and I hope the Senate will act swiftly on this
piece of legislation.
Mr. McCAUL. Mr. Speaker, I yield myself the balance of my time for
closing.
Mr. Speaker, this is a very timely bill. We have seen utter
devastation, in terms of human lives, and the economy being impacted by
this.
We need to ensure, Mr. Speaker, this never happens again. There will
be another COVID-like virus that will be a variant. We need to work
with the global community to ensure this never happens again.
We also need to find out the origins of COVID-19, how this happened
in the first place. Not for revenge, but to find out how it happened so
we can stop it from ever happening again.
I give my strong support to this important legislation. The timing
couldn't be more relevant and appropriate. I thank Mr. Connolly for his
leadership and the chairman for bringing this bill to the floor.
Mr. Speaker, I yield back the balance of my time.
Mr. MEEKS. Mr. Speaker, I yield myself the balance of my time for
closing.
Mr. Speaker, I want to thank the ranking member for his partnership
in working together to bring this bipartisan legislation to the floor,
because as we all have found, COVID-19, which has caused global
disruption unlike any other in recent memory, is not a Democratic
issue; it is not a Republican issue; it is all of our issue. It is an
issue for all of us, not just here in the United States, but around the
world.
Coming together on the committee, as we generally do, is extremely
important, working together to get this done.
As we begin to see the light at the end of the tunnel of this
pandemic, the United States must seize the opportunity and learn the
lessons and best practices from the crisis so that we can be better
prepared to respond to any future and similar threats to the U.S.
national and global security. COVID-19 caught America off guard, but
the Global Health and Security Act will ensure that this never happens
again.
Mr. Speaker, I thank Mr. Connolly and Mr. Chabot for their work on
this legislation and for recognizing the vital importance of global
health security as part of America's national security.
Mr. Speaker, I urge all of my colleagues to support this legislation,
and I yield back the balance of my time.
Mr. CHABOT. Mr. Speaker, I rise today in strong support of H.R. 391,
the Global Health Security Act, bipartisan legislation which
Congressman Gerry Connolly and I introduced to strengthen U.S. and
global preparedness for, and capacity to respond to pandemics, like
COVID-19. And I want to thank Chairman Meeks and Ranking Member McCaul
for working with us to improve this Congress's version of the
legislation in committee as the bill heads toward enactment.
After a year of lockdowns, masks, social distancing, working from
home, school closures and worst of all, a horrific death here at
[[Page H3171]]
home and across the globe, COVID-19 has taught us, like nothing else
has, the full costs of a pandemic. It has also shown us just how
vulnerable the United States is to disease outbreaks on the other side
of the world. A corrupt and opaque health system in China can cause
millions of deaths here in America. China's politically-motivated
censorship of coronavirus information early on caused the world untold
suffering. But a disease like COVID-19 could start anywhere, and if it
gets out, it can become a pandemic.
That is why, we must help less prepared countries identify and
contain future emerging deadly diseases when they originate, and
mitigate their impact before they have a chance to grow to pandemic
scale.
When Mr. Connolly and I first introduced this legislation in 2018,
COVID-19 didn't exist. However, we realized that Congress needed to
support, direct, and provide oversight for ongoing global health
security work and that the proper personnel needed to be in place to
coordinate our response to an emerging disease threat.
The Global Health Security Act supports each of these goals. First,
it gets personnel right. Second, it strengthens Congressional oversight
over global health security work. Third, it provides a Congressional
endorsement, and detailed guidance for, U.S. efforts to strengthen
health systems and pandemic preparedness across the globe.
Witnessing the death toll and the economic devastation that COVID-19
brought, I think all Americans will agree with me that protecting our
nation's health from future pandemics must be seen as a national
security priority. As the United States comes out of the pandemic, and
America returns to normal, we must recommit to leadership on global
health security and prepare the world to face the next deadly disease
before it becomes a pandemic.
So I would urge my colleagues to support this legislation.
Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 391,
the ``Global Health Security Act,'' important legislation that
reaffirms and strengthens the United States' strategic approach to
global health security.
This bill directs the President to create the Global Health Security
Agenda Interagency Review Council to be overseen by the National
Security Advisor, elevating United States' global health security to a
national security interest.
It also establishes the permanent position of the United States
Coordinator for Global Health Security who will be responsible for the
interagency process for responding to global health security
emergencies.
Additionally, H.R. 391 creates a multilateral Fund for Global Health
Security and Pandemic Preparedness to support the Global Health
Security Agenda and the 70 percent of the world's countries that are
unprepared and unable to respond to dangerous public health threats.
Protecting our local and global community from global health threats
is imperative as the United States has already exceeded 33 million
cases of COVID-19 and over 600,000 deaths.
Almost 3 million of those cases were in Texas and Harris county has
the largest number with around 403,000 cases to date.
My district in Houston has suffered the loss of almost 3,000 of its
citizens to the pandemic of the over 6,500 fatalities in Harris county
alone.
The United States plays a vital leadership role in the international
health security domain and the COVID-19 pandemic epitomizes the urgency
of global health security.
The Ebola and Zika epidemics in 2013 and 2015 respectively exposed
vulnerabilities in the United States' global health strategy,
highlighting the need for a designated official to coordinate
interagency response to global health security emergencies.
Alongside almost 30 other nations, the United States started the
Global Health Security Agenda to address significant global health
emergencies and threats.
As such, it is incumbent upon Congress to codify the United States'
commitment to addressing global infectious disease threats by requiring
the development of a sustainable and comprehensive U.S. global health
strategy strengthened by measurable goals and performance metrics.
I proudly support H.R. 391 and the advancement of global health
security so we can protect our communities, including my constituents
in Houston.
I thank my colleague, Congressman Connolly of Virginia, for
championing this bill and persisting in his effort to strengthen the
United States global health policy.
I urge all Members to join me in voting to pass H.R. 391, the Global
Health Security Act of 2021.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New York (Mr. Meeks) that the House suspend the rules
and pass the bill, H.R. 391, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. DAVIDSON. Mr. Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this motion
are postponed.
____________________