114 S2297 RS: International Pandemic Preparedness and COVID–19 Response Act of 2021
U.S. Senate
2021-06-24
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EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents(a)This Act may be cited as the International Pandemic Preparedness and COVID–19 Response Act of 2021
.(b)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 pandemicsSec. 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 preparednessSec. 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 and strategy.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 preparednessSec. 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 2016.2.In this Act:(1)Appropriate congressional committeesThe 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; GHSAThe 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—(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 indexThe 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 initiativeThe 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 evaluationThe 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)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)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 agenciesThe 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)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. 3.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.<enum>I</enum><header>Enhancing the United States international response to COVID–19 and future pandemics</header><section id="idA28B179BF87047539C741D951E2F6B9D"><enum>101.</enum><header>Statement of policy regarding international cooperation to end the COVID–19 pandemic</header><text display-inline="no-display-inline">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— </text><paragraph id="id0a5fc22040ae473985aecb890ba8ca9e"><enum>(1)</enum><text>seeking adoption of a United Nations Security Council resolution that—</text><subparagraph id="id7a030442ead84b888a48ed107924f19c"><enum>(A)</enum><text>declares pandemics, including the COVID–19 pandemic, to be a threat to international peace and security; and</text></subparagraph><subparagraph id="id597d58ca0bff4e17a926cc157f583748"><enum>(B)</enum><text>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;</text></subparagraph></paragraph><paragraph id="id9f366578b85d49c1b90089b9166cea3f"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="id8a37e051808745249d19b41c90899561"><enum>(3)</enum><text>providing timely, appropriate levels of financial support to United Nations agencies responding to the COVID–19 pandemic;</text></paragraph><paragraph id="id8e2fbaa7475b4bc891798e33454b41ba"><enum>(4)</enum><text>prioritizing United States foreign assistance for the COVID–19 response in the most vulnerable countries and regions;</text></paragraph><paragraph id="id9aa2baee245049228c361c88d05edc93"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="id1897901e01af470a9d99995718793699"><enum>(6)</enum><text>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—</text><subparagraph id="id9fce5846efc845c6a5830a2b82b0e95d"><enum>(A)</enum><text>at least 40 percent of the population in all countries is vaccinated by the end of 2021; and</text></subparagraph><subparagraph id="id7bd4afbd5c0a4912892dfb0a05374676"><enum>(B)</enum><text>at least 60 percent of the population in all countries is vaccinated by the first half of 2022;</text></subparagraph></paragraph><paragraph id="id48559909c17d4220908beb509b91ade7"><enum>(7)</enum><text>engaging with key stakeholders, including through multilateral facilities such as the COVID–19 Vaccines Global Access initiative (referred to in this title as <quote>COVAX</quote>) 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—</text><subparagraph id="id682978af6ca44e35970502eb618d0afa"><enum>(A)</enum><text>vaccines and related raw materials to meet or exceed the vaccination goals under paragraph (6); and</text></subparagraph><subparagraph id="id03740be26b2b4f5aaee17098649633e6"><enum>(B)</enum><text>global health commodities, including personal protective equipment, test kits, medicines and therapeutics, and other essential supplies to combat COVID–19;</text></subparagraph></paragraph><paragraph id="idE25C70273ED04E5C852F8A2472418488"><enum>(8)</enum><text>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;</text></paragraph><paragraph id="id0d3b1330f82b443d9410f405c08591df"><enum>(9)</enum><text>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;</text></paragraph><paragraph id="id1227e6a044444d67afa1902a3db9c7df"><enum>(10)</enum><text>establishing clear timelines, benchmarks, and goals for COVID–19 response strategies and activities under this section; and</text></paragraph><paragraph id="ida202e3610d624ece83dae8a9b7f0053f"><enum>(11)</enum><text>generating commitments of resources in support of the goals referred to in paragraph (10). </text></paragraph></section><section id="id0118511312A84E918AE49D86C262EC8C"><enum>102.</enum><header>Oversight of United States foreign assistance to end the COVID–19 pandemic</header><subsection id="id7e882ef7a2a84f08a2d67d3dec49c930"><enum>(a)</enum><header>Reporting requirements</header><text>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—</text><paragraph id="id268104b2be13426b84ab15abf897c114"><enum>(1)</enum><text>an unclassified report containing a description of funds already obligated and expended under title X of the <short-title>American Rescue Plan Act of 2021</short-title> (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>); and</text></paragraph><paragraph id="id296e0098129e4e05abcadc16adb65a89"><enum>(2)</enum><text>a plan that describes the objectives and timeline for the obligation and expenditure of all remaining funds appropriated under the <short-title>American Rescue Plan Act of 2021</short-title>, which shall be submitted in an unclassified form, and should include a description of steps taken pursuant to each objective specified in the plan.</text></paragraph></subsection><subsection id="id77393cba29fe4c36a5c7abdbee01cab7"><enum>(b)</enum><header>Congressional consultation</header><text>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).</text></subsection><subsection id="id83d3ca313e714beba21617e20f90cab6"><enum>(c)</enum><header>Branding</header><text>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.</text></subsection></section><section id="id48DC97F541114DB6A01DD16406917801"><enum>103.</enum><header>United States contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria COVID–19 response mechanism</header><subsection id="idd0e57e5c9d8e4f9ca6ffdfdec9cf4c05"><enum>(a)</enum><header>United States contributions to the Global Fund To Fight AIDS, Tuberculosis, and Malaria COVID–19 response mechanism</header><text>United States contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria COVID–19 Response Mechanism under section 10003(a)(2) of the <short-title>American Rescue Plan Act of 2021</short-title> (<external-xref legal-doc="public-law" parsable-cite="pl/107/2">Public Law 107–2</external-xref>)—</text><paragraph id="idd7b072a78c85460b86e050ec7128ae93"><enum>(1)</enum><text>shall be meaningfully leveraged in a manner that incentivizes other public and private donor contributions; and</text></paragraph><paragraph id="idab15a5f7121748eda932bb63288cd805"><enum>(2)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/7622">22 U.S.C. 7622</external-xref>). </text></paragraph></subsection></section><section id="id597707da8e5d4231a0d0e4722f90649b"><enum>104.</enum><header>Global COVID–19 vaccine distribution and delivery</header><subsection id="id91b7e8645c3a40c0a87acf7a68e6e0e8"><enum>(a)</enum><header>Accelerating global vaccine distribution strategy</header><text>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—</text><paragraph id="id0b5f2692032240fb9dec2c5490070727"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id404ffb1501074148a0ba224a4fe33f75"><enum>(2)</enum><text>identify which countries and regions will be prioritized and targeted for COVID–19 vaccine delivery, and the rationale for such prioritization;</text></paragraph><paragraph id="idfc37c9de45354dd3abe0718ce2e269e9"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id0be2a78e7fd9479fabc93c747d654c65"><enum>(4)</enum><text>describe efforts to encourage international partners to take actions similar to the efforts referred to in paragraph (3);</text></paragraph><paragraph id="id73f811aa9f744cf7a389211e35f09ae6"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="idd0472c9d4b9b4867bb4f62aa8ab0a618"><enum>(6)</enum><text>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</text></paragraph><paragraph id="id6f36788129ac4b5285d95f78f5ad25cd"><enum>(7)</enum><text>summarize the United States public diplomacy strategies for branding and addressing vaccine misinformation and hesitancy.</text></paragraph></subsection><subsection id="id123a0c0c61484a9fa774c7782dc27fdd"><enum>(b)</enum><header>Submission of strategy</header><text>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.</text></subsection></section><section id="id8E3C4FA683274725B1B6181A3F461DD2"><enum>105.</enum><header>Leveraging United States bilateral global health programs for the international COVID–19 response</header><subsection id="id9d561b4c6a0348f3960c31e693010475"><enum>(a)</enum><header>Authorization for leveraging bilateral program activities</header><text>Amounts authorized to be appropriated or otherwise made available to carry out section 104 of the Foreign Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b">22 U.S.C. 2151b</external-xref>) may be used in countries receiving United States foreign assistance—</text><paragraph id="id67BAA516A8CF44CF89A5720190FBFD0B"><enum>(1)</enum><text>to combat the COVID–19 pandemic, including through the sharing of COVID–19 vaccines; and </text></paragraph><paragraph id="id534BFD97D0AE41D28D3A1C6B7101313A"><enum>(2)</enum><text>to support related activities, including—</text><subparagraph id="id43f881c2c44a4f198587f1a559f84948"><enum>(A)</enum><text>strengthening vaccine readiness;</text></subparagraph><subparagraph id="idf574fa5ded9e47608d801ecc99dc3f35"><enum>(B)</enum><text>reducing vaccine hesitancy and misinformation;</text></subparagraph><subparagraph id="id5e5c12885c1a4fa492f74cf0b30792e3"><enum>(C)</enum><text>delivering and administering COVID–19 vaccines;</text></subparagraph><subparagraph id="idd082144898614bc4917a01e01531df20"><enum>(D)</enum><text>strengthening health systems and supply chains;</text></subparagraph><subparagraph id="idd1fac8206bd14c06ab3a0eee77eb92b8"><enum>(E)</enum><text>supporting health care workforce planning, training, and management;</text></subparagraph><subparagraph id="id1711d1fe401f4704b6ce1b9343866461"><enum>(F)</enum><text>enhancing transparency, quality, and reliability of health data;</text></subparagraph><subparagraph id="id87404875708e4362b68318c21524581e"><enum>(G)</enum><text>increasing bidirectional testing; and</text></subparagraph><subparagraph id="id1db7932369ec4ca5bd2aeb8f72dcd650"><enum>(H)</enum><text>building lab capacity.</text></subparagraph></paragraph></subsection><subsection id="id0a5c3e3472a949d49b790a84dee97813"><enum>(b)</enum><header>Adjustment of targets and goals</header><text>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—</text><paragraph id="id5e88ce6dbb864b8f8336ad5fe7808855"><enum>(1)</enum><text>any adjustments to original program targets and goals that result from the use of funds for the purposes authorized under subsection (a); and</text></paragraph><paragraph id="idf391e57a33f9479a961564dedbf97ef5"><enum>(2)</enum><text>the amounts needed in the following fiscal year to meet the original program goals.</text></paragraph></subsection></section><section id="id457FD41838AE43D98140E2D0BC46F430"><enum>106.</enum><header>Report on humanitarian response to the COVID–19 pandemic</header><subsection id="idac073b1039c04fcc9fb7f48bb97ecc36"><enum>(a)</enum><header>In general</header><text>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—</text><paragraph id="id64fd8dc769e640de9e546cc0582ad0f8"><enum>(1)</enum><text>assesses the global humanitarian response to COVID–19; and</text></paragraph><paragraph id="id1f1b0658385e4dd2bf15a01f9c181eb6"><enum>(2)</enum><text>outlines specific elements of the United States Government’s country-level response to the COVID–19 pandemic.</text></paragraph></subsection><subsection id="idbb410693c7274b61993c429ddda4bf76"><enum>(b)</enum><header>Elements</header><text>The report required under subsection (a) shall include—</text><paragraph id="id13b37cc7180c4929aabf28307c022d2b"><enum>(1)</enum><text>for countries receiving United States assistance, a description of humanitarian and health-worker access to crisis-affected areas, including—</text><subparagraph id="id7d47b07f73224b798c8b84a3075ba572"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="idafc305be3cb34599982702b2c6f60b08"><enum>(B)</enum><text>restrictions on travel by humanitarian workers within such country to reach the areas of operation where vulnerable and marginalized populations reside;</text></subparagraph><subparagraph id="ida480989d16754b9287ba009f2c451dfa"><enum>(C)</enum><text>access to medical evacuation in the event of a health emergency;</text></subparagraph><subparagraph id="id8c21c88ec7e641bc93dc02c4e02eac47"><enum>(D)</enum><text>access to personal protective equipment for United States Government implementing partners; and</text></subparagraph><subparagraph id="idc7d10a478ca74131a7626e77ef71d318"><enum>(E)</enum><text>efforts to support access to COVID–19 vaccines for humanitarian and health-workers and crisis-affected communities;</text></subparagraph></paragraph><paragraph id="ida85e88be4f84459cb40e899583b0ca0d"><enum>(2)</enum><text>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—</text><subparagraph id="idbbce553e9a6549c686dae2b366d13a91"><enum>(A)</enum><text>the omission of vulnerable populations from national response plans;</text></subparagraph><subparagraph id="ide5c423b54ad34ffeb540fc0f1a6a2e42"><enum>(B)</enum><text>laws, policies, or practices that restrict or preclude treatment of vulnerable populations at public hospitals and health facilities; and</text></subparagraph><subparagraph id="idb7dbacaceaa644efb33ed83cf6f3bfce"><enum>(C)</enum><text>exclusion of, or discrimination against, vulnerable populations in law, policy, or practice that prevents equal access to food, shelter, and other basic assistance;</text></subparagraph></paragraph><paragraph id="idf3fa25177d4948b1a986bf842e8b47b2"><enum>(3)</enum><text>a description of United States Government efforts to facilitate greater humanitarian access, including—</text><subparagraph id="id0da01bb2e47844d996cd2a73927bc7c5"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="id832f46e10512406e85c697218eca6108"><enum>(B)</enum><text>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</text></subparagraph></paragraph><paragraph id="id16719b0359e040ba8c5ea41dc8240771"><enum>(4)</enum><text>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—</text><subparagraph id="ide67110c4a7eb47dab14b2c883a2bc8de"><enum>(A)</enum><text>famine and acute food insecurity;</text></subparagraph><subparagraph id="iddb82ef1b8a9741a5be52e343f5cb1faf"><enum>(B)</enum><text>gender-based violence;</text></subparagraph><subparagraph id="id6be26b07aa264bf083114475b7e922f2"><enum>(C)</enum><text>mental health and psychosocial support needs;</text></subparagraph><subparagraph id="idc0aa7a2c49b34c589ab0704e9ffa7b22"><enum>(D)</enum><text>child protection needs;</text></subparagraph><subparagraph id="idbde6d64fb8624437bc208a8797c6c39d"><enum>(E)</enum><text>health, education, and livelihoods;</text></subparagraph><subparagraph id="idbef8601735af4cf0a38bee0ae36651b5"><enum>(F)</enum><text>shelter; and</text></subparagraph><subparagraph id="id6cb619646325434a973e598c504a2849"><enum>(G)</enum><text>attempts to close civil society space, including through bureaucratic, administrative, and health or security related impediments. </text></subparagraph></paragraph></subsection></section><section id="id49A7B052CE77431C8FA06DF0D42F86C0"><enum>107.</enum><header>Safeguarding democracy and human rights during the COVID–19 pandemic</header><subsection id="id44e58cdfeb12409ea13c236b3f3fdbe2"><enum>(a)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text><paragraph id="id497445f7b20b49019daa8236efac96e5"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id847775452bbf4301b1c4af105d399564"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="idd161c7baa73b42ddadf2b0654ea73d08"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id74fb087b77dd4cfb96d8a27b9e0f3b10"><enum>(4)</enum><text>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</text></paragraph><paragraph id="id03d8caa525ef429bbca24ae281ac58d9"><enum>(5)</enum><text>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.</text></paragraph></subsection><subsection id="id28aa3a578e99494f96ed5ada2a29fa1f"><enum>(b)</enum><header>Funding for civil society and human rights defenders</header><paragraph id="id15e02af6d12f4e738264f0da9e1c2272"><enum>(1)</enum><header>Program priorities</header><text>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.</text></paragraph><paragraph id="idabb9537b98e94f0caca85394d516e371"><enum>(2)</enum><header>Eligible organizations</header><text>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—</text><subparagraph id="id67674e7355cd4d108b3d004118b6e809"><enum>(A)</enum><text>programs designed to strengthen and support civil society, human rights defenders, freedom of association, and the freedom of the press;</text></subparagraph><subparagraph id="id9c4096b8e0b149e1aaf5c8b97412ebaa"><enum>(B)</enum><text>programs to restore democratic institutions; and</text></subparagraph><subparagraph id="id19f00dfe54224183a5763f8c8969a543"><enum>(C)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id6661791181d74c69b62037bb94a13be6"><enum>(3)</enum><header>Final report</header><text>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—</text><subparagraph id="iddf06b2338c2344418099cb66df5d019b"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id9d124cfa75d94d3aa7244dfe045b1685"><enum>(B)</enum><text>describes such countries’ emergency measures, including—</text><clause id="id27186afbcc944d07a2b6b3408de94d04"><enum>(i)</enum><text>how such procedures violate internationally recognized human rights; and</text></clause><clause id="id95ba365209da4a7abbc53cd626a7b9a3"><enum>(ii)</enum><text>an analysis of the impact of such measures on access to health and efforts to control the COVID–19 pandemic within the country;</text></clause></subparagraph><subparagraph id="idd5256a00e46b458d9fc79d46a85775aa"><enum>(C)</enum><text>describes—</text><clause id="id163189d8a72e42cba1e812fa092d953a"><enum>(i)</enum><text>security and intelligence surveillance measures implemented by countries during the COVID–19 pandemic;</text></clause><clause id="id4e025559762344078bc6989e53d632a6"><enum>(ii)</enum><text>the extent to which such measures have been, or have not been, rolled back; and</text></clause><clause id="idd078beeb4a0343e28e0fc1d47d36c31d"><enum>(iii)</enum><text>whether and how such measures impact internationally recognized human rights; and</text></clause></subparagraph><subparagraph id="idc358937b535d47f5a8754a14d68f8d9d"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection></section><section id="id7D812F81694B431484BD641E83728E3E"><enum>108.</enum><header>Public diplomacy and combating disinformation and misinformation about COVID–19</header><subsection id="id6a6b3234a623450a89df2e4e09b0cdc8"><enum>(a)</enum><header>United States Agency for Global Media</header><paragraph id="idc701b25706fd49518f3a8e188ebdd44f"><enum>(1)</enum><header>Finding</header><text>Congress finds that the United States Agency for Global Media (referred to in this section as <quote>USAGM</quote>) broadcasting entities and grantees have proven valuable in providing timely and accurate information, particularly in countries in which the free press is under threat.</text></paragraph><paragraph id="id9717a56d662c4da4b818b123462a1197"><enum>(2)</enum><header>Sense of congress</header><text>It is the sense of Congress that—</text><subparagraph id="id5c3c31b45b1441ef8a2dc0013bff35c8"><enum>(A)</enum><text>accurate, investigative, and scientific journalism is critical for societies to effectively combat global health threats; and</text></subparagraph><subparagraph id="idd2493e3f5b224365bd33225e45d669a2"><enum>(B)</enum><text>Congress supports—</text><clause id="id61a35fd5729f43a19b3a22d56e1a9e36"><enum>(i)</enum><text>accurate and objective investigative and scientific reporting by USAGM networks and grantees regarding COVID–19; and</text></clause><clause id="ide15ce514884346b7b3aaba2d53ce21c9"><enum>(ii)</enum><text>platforms that help dispel and combat misinformation about the COVID–19 pandemic.</text></clause></subparagraph></paragraph><paragraph id="id658ba679985b49f8b16bbb27883c811e"><enum>(3)</enum><header>Voice of america</header><text>It is the sense of Congress that amounts authorized to be appropriated or otherwise made available to Voice of America should be used—</text><subparagraph id="id46df36e48c4e4e4d82a64cc87d1cef7a"><enum>(A)</enum><text>to expand programs such as POLYGRAPH.info;</text></subparagraph><subparagraph id="id1827b3d9ec924bf2b5ae521ea93a28d8"><enum>(B)</enum><text>to provide critical tools for combating propaganda associated with COVID–19; and</text></subparagraph><subparagraph id="idfa9849389d074edc8955e0243147c56f"><enum>(C)</enum><text>to assist journalists in providing accurate information to local media outlets.</text></subparagraph></paragraph><paragraph id="id6520f76a270748a593f294f81b7bce0a"><enum>(4)</enum><header>Office of cuba broadcasting</header><text>It is the sense of Congress that Radio Televisión Martí and Digital Martí should continue to broadcast programs that detect, highlight, and dispel disinformation.</text></paragraph><paragraph id="id67e5664a52e4472bba4bbfd848a845fa"><enum>(5)</enum><header>Radio free europe/radio liberty</header><subparagraph id="id3a01dc902eab49168c0a1d954412bb23"><enum>(A)</enum><header>Finding</header><text>Congress finds that Radio Free Europe/Radio Liberty (referred to in this section as <quote>RFE/RL</quote>) 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.</text></subparagraph><subparagraph id="id2d78d9aa57f8465fba8086c5048a6ffa"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that RFE/RL should—</text><clause id="id95a5be36e88f4174ae07f36e01d0bdd8"><enum>(i)</enum><text>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</text></clause><clause id="idf674e03b7f5047058503524a6e1a39bc"><enum>(ii)</enum><text>expand its <quote>digital first</quote> strategy.</text></clause></subparagraph></paragraph><paragraph id="id68d37abc810f4366ade07a6c4b6ddb94"><enum>(6)</enum><header>Radio free asia</header><subparagraph id="id9c71516d62bf449d8246f3143b78cb22"><enum>(A)</enum><header>Finding</header><text>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.</text></subparagraph><subparagraph id="id5a087888b57d43bd8bf30f7e8f99562e"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that RFA should—</text><clause id="idc7bbcefad6234ad7a686e5adf68d6465"><enum>(i)</enum><text>commission technical experts to bolster efforts to counter social media tools, including bots used by some countries to promote misinformation;</text></clause><clause id="idc1de628601c64460b83d4af977a7bde1"><enum>(ii)</enum><text>expand digital programming and local coverage to expose China’s media manipulation techniques; and</text></clause><clause id="id72ad41ab500b4044b567b095f59159c7"><enum>(iii)</enum><text>increase English language content to help counter China’s propaganda directed toward English-speaking audiences.</text></clause></subparagraph></paragraph><paragraph id="id47483487cdb24744aac6be8f428e318a"><enum>(7)</enum><header>Middle east broadcasting networks</header><subparagraph id="id0b68d02084c84afebfc4ac54330c2c6e"><enum>(A)</enum><header>Finding</header><text>Congress finds that the Middle East Broadcasting Networks operate largely in closed media markets in which malign state and nonstate actors remain active.</text></subparagraph><subparagraph id="ide8bf72b6e36a488b819aea6b1fd955df"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that the Middle East Broadcasting Networks should—</text><clause id="idb7901ea2f9f24b7db822602c79dabfd4"><enum>(i)</enum><text>continue plans to expand an investigative news unit; and</text></clause><clause id="id1923b894b32947b5adde9143ed452ecf"><enum>(ii)</enum><text>work to ensure that reporting continues amidst operational challenges on the ground. </text></clause></subparagraph></paragraph><paragraph id="idbe8e1a1443c54918b8b3ffdc7bd9feaf"><enum>(8)</enum><header>Open technology fund</header><subparagraph id="idbd10f1ca82ea41d4b91060c48f1ad5fa"><enum>(A)</enum><header>Finding</header><text>Congress finds that the Open Technology Fund works to advance internet freedom in repressive environments by supporting technologies that—</text><clause id="iddfb7364c8e954d6ca79f0878cd15d541"><enum>(i)</enum><text>provide secure and uncensored access to USAGM’s content and the broader internet; and</text></clause><clause id="id5347eacbc83f4db9aabd4e59520f8a06"><enum>(ii)</enum><text>counter attempts by authoritarian governments to control the internet and restrict freedom online.</text></clause></subparagraph><subparagraph id="id49012444765444fd90aac99ecd671173"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that the Open Technology Fund should—</text><clause id="id01c5227c94e340cbbe9e2078701d5dd7"><enum>(i)</enum><text>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</text></clause><clause id="idab790a71642547b19ec64983cc0fad9f"><enum>(ii)</enum><text>provide direct assistance to USAGM’s networks to improve the digital security of reporting operations and journalists. </text></clause></subparagraph></paragraph></subsection><subsection id="idcfeaf5ae009246ebaf34d7caa7bc7817"><enum>(b)</enum><header>Department of state public diplomacy programs</header><paragraph id="id9a8847d11445429fa97aa4ebc2cc0f07"><enum>(1)</enum><header>Findings</header><text>Congress finds the following:</text><subparagraph id="id74e4c91e5a9f4956a6f2552f14098c01"><enum>(A)</enum><text>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.</text></subparagraph><subparagraph id="id45c9b6cfef914955bf38505bf2585154"><enum>(B)</enum><text>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—</text><clause id="id0aef4159df454ded95a0605dc7e3bb8c"><enum>(i)</enum><text>improving media quality with journalist training and reporting tours;</text></clause><clause id="id42137285f84d4b9a8c80459b2e57fcab"><enum>(ii)</enum><text>conducting media literacy programs; and</text></clause><clause id="id41b9dbe883fb478f9e8c9a0fbbe85913"><enum>(iii)</enum><text>supporting media access activities. </text></clause></subparagraph><subparagraph id="id34cbcfda127640cba00c1a08fd4f3efc"><enum>(C)</enum><text>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.</text></subparagraph><subparagraph id="id49d15ead7a6e4b3397ce373213841356"><enum>(D)</enum><text>More than 12,000 physicians holding J–1 visas from 130 countries—</text><clause id="idf63c0591b0314d8f8d3b3c2c4c7837ec"><enum>(i)</enum><text>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</text></clause><clause id="idf88ecdfb313043bfa8d1a31e9569cf9c"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><paragraph id="id80c230bbf4234b16b535fe5fa0265754"><enum>(2)</enum><header>Visa processing briefing</header><text>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—</text><subparagraph id="idae77f528f92940989a2aeee03955e3dc"><enum>(A)</enum><text>a timeline for increasing visa processing capacities at embassies around the world, notably where there are—</text><clause id="id6b41c9350d23420da1162f520ca93f8d"><enum>(i)</enum><text>many American citizens, including dual nationals; and</text></clause><clause id="ida14582a23c22429ebd3a6e26e1c6164b"><enum>(ii)</enum><text>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</text></clause></subparagraph><subparagraph id="idc30eb51d440641f291be80501f9f79fe"><enum>(B)</enum><text>a detailed plan for using existing authorities to waive in-person appointments and interviews.</text></subparagraph></paragraph><paragraph id="id8d8c217ceaa34782a7ba097fc3293edf"><enum>(3)</enum><header>Global engagement center</header><subparagraph id="id8ad5e284dc514dcfb4a48f771ee422f3"><enum>(A)</enum><header>Finding</header><text>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.</text></subparagraph><subparagraph id="id3c03b902a6e24d26867deba2bcab79ed"><enum>(B)</enum><header>Sense of congress</header><text>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. </text></subparagraph></paragraph></subsection></section><section id="id8B01DE7E9A0C4FFCB9B97F78F360E233"><enum>109.</enum><header>Findings and sense of Congress regarding the United States International Development Finance Corporation</header><subsection id="idE60010BAD7A94ABA9BEF6F105A460158"><enum>(a)</enum><header>Findings</header><text>Congress finds the following:</text><paragraph id="id4715883D6DDB4AA7BE59CCA23863C017"><enum>(1)</enum><text>The COVID–19 pandemic is causing a global economic recession, as evidenced by the global economic indicators described in paragraphs (2) through (4).</text></paragraph><paragraph id="id4E61D0F226654FF29854D94BAFF6BCBB"><enum>(2)</enum><text>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.</text></paragraph><paragraph id="idE394FC92B5374221820E9C51C0EE43FD"><enum>(3)</enum><text>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.</text></paragraph><paragraph id="idA9C410499E544C5FAE9777512863766E"><enum>(4)</enum><text>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—</text><subparagraph id="id23EF7DAE4648495CA14C6AF18ABAC87B"><enum>(A)</enum><text>approximately 33,000,000 labor hours have been lost globally (13 per cent of the total hours lost) due to outright unemployment; and</text></subparagraph><subparagraph id="id02B9EB5D5D1D4177BDDC3494E21D4DCE"><enum>(B)</enum><text>an estimated additional 81,000,000 labor hours have been lost due to inactivity or underemployment.</text></subparagraph></paragraph><paragraph id="id42fdee0436214eaaa202efe4d81902a7"><enum>(5)</enum><text>Given the prolonged nature of the COVID–19 pandemic, African finance ministers have requested continued efforts to provide—</text><subparagraph id="id152ca3e134724a5fa61296564aba51bc"><enum>(A)</enum><text>additional liquidity;</text></subparagraph><subparagraph id="id06108862903f47acbdf04f1221eda03b"><enum>(B)</enum><text>better market access;</text></subparagraph><subparagraph id="idde00393e6d0d424199ecb63964306cb2"><enum>(C)</enum><text>more concessional resources; and</text></subparagraph><subparagraph id="id4c80758655a04aaf8d7ba4a28e372f81"><enum>(D)</enum><text>an extension in the Debt Service Suspension Initiative established by the Group of 20. </text></subparagraph></paragraph></subsection><subsection id="id0A87EB06F50D45D4AC4B0A6CD748F046"><enum>(b)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text><paragraph id="id1B96EB5991D04E4F81DF5554AE7ADD8B"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id95B62CF3E3AA4AD6B02FBA595E9DC85E"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="id71D08CD271E14284B0372B795F2995F0"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id06CEB7F329444169B88BF453AC122BC8"><enum>(4)</enum><text>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;</text></paragraph><paragraph id="id3A919E02D2C94174B5A0802305FBCAA4"><enum>(5)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/9601">22 U.S.C. 9601 et seq.</external-xref>), is critical to ensuring lasting and resilient economic growth in light of the COVID–19 pandemic’s exacerbation of economic hardships and challenges;</text></paragraph><paragraph id="id5169F9B7BBD2438FACA935A87853C420"><enum>(6)</enum><text>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</text></paragraph><paragraph id="id8F8D82842B1C43DC8CC133F25BE1C5A9"><enum>(7)</enum><text>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—</text><subparagraph id="id03DF9738B0804605B7A41D26F79D32B1"><enum>(A)</enum><text>to ensure loan support for small- and medium-sized enterprises;</text></subparagraph><subparagraph id="idACEABFF1B1C348808FAEF7B7D9D9EF0F"><enum>(B)</enum><text>to offer local currency loans to borrowers for working capital needs;</text></subparagraph><subparagraph id="idAED16F9BE15E4215B8250D6507A7BDC1"><enum>(C)</enum><text>to create dedicated financing opportunities for new <quote>customers</quote> that are experiencing financial hardship due to the COVID–19 pandemic; and</text></subparagraph><subparagraph id="id24079E73C740459F857A1B4EBB29661D"><enum>(D)</enum><text>to work with other development finance institutions to create co-financing facilities to support customers experiencing hardship due to the COVID–19 pandemic.</text></subparagraph></paragraph></subsection></section><section id="idDA48C3BCEDF7460BB74F89D5DD6FD688"><enum>110.</enum><header>Sense of Congress regarding international cooperation to prevent and respond to future pandemics</header><text display-inline="no-display-inline">It is the sense of Congress that—</text><paragraph id="idfd990f26b18d4834a934eb2a666ff77c"><enum>(1)</enum><text>global pandemic preparedness and response requires international and regional cooperation and action;</text></paragraph><paragraph id="idd4136c2aec1a4103bea5168353ecbd67"><enum>(2)</enum><text>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</text></paragraph><paragraph id="id64bbb7545535422f9b49ff8bad2bee86"><enum>(3)</enum><text>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.</text></paragraph></section><section id="id641d1cda7975407e828b4dc3f7a73477"><enum>111.</enum><header>Roles of the Department of State, the United States Agency for International Development, and the Centers for Disease Control and Prevention in pandemic response</header><subsection id="id3c0403c929c54cf7945a33835dbf67c5"><enum>(a)</enum><header>Designation of lead agencies for coordination of the United States response to infectious disease outbreaks with severe or pandemic potential</header><text>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—</text><paragraph id="id3462e1b9daf24ecd9b0d58f6cb2cd7d7"><enum>(1)</enum><text>designating the Department of State to serve as the lead for diplomatic engagement, and related foreign policy efforts, including— </text><subparagraph id="id03af05027ec745778e4264ffb5c09744"><enum>(A)</enum><text>enhanced coordination of engagement with multilateral organizations and countries, and mobilization of donor contributions; and</text></subparagraph><subparagraph id="ide6b7ad11655e46c4996fdd0fd4696d6f"><enum>(B)</enum><text>support for United States citizens abroad;</text></subparagraph></paragraph><paragraph id="idb19f8e41e3e44fc3bbe4f52805fcfe07"><enum>(2)</enum><text>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—</text><subparagraph id="id7bbeddabfeac4c2b85ecf0ab56b6370f"><enum>(A)</enum><text>immediate health, disaster assistance, and humanitarian response needs and prevention and preparedness activities in neighboring at-risk countries;</text></subparagraph><subparagraph id="idfceba0b7a41a4efcbe14abcf7f6268ff"><enum>(B)</enum><text>testing, treatment, and assistance with preventative care units and community care facilities;</text></subparagraph><subparagraph id="id3c98b65deb89426c9265d5203a764841"><enum>(C)</enum><text>surveillance, case investigation, and rapid response capability;</text></subparagraph><subparagraph id="idda580e3104554947bf5c9e4bd0b0f92d"><enum>(D)</enum><text>providing supplies, such as personal protective, screening, and treatment equipment;</text></subparagraph><subparagraph id="idb50638239a004dc6956f7a8135871eef"><enum>(E)</enum><text>conducting community outreach and communication and mobilization efforts;</text></subparagraph><subparagraph id="idd44eefdb45024a8991ee35509f27b57b"><enum>(F)</enum><text>logistics support; and</text></subparagraph><subparagraph id="idc887717536334e8485d55e5309b00e77"><enum>(G)</enum><text>serving as lead agency for disease outbreak response abroad; and</text></subparagraph></paragraph><paragraph id="id2221ee0238ae4ede9c4c7f6fb105d3af"><enum>(3)</enum><text>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—</text><subparagraph id="id6b109dbbc8da46a582dd6de32c8c39c6"><enum>(A)</enum><text>infection prevention and control, contact tracing, and laboratory surveillance and training;</text></subparagraph><subparagraph id="ide870948800f14409ada6d7ff158da114"><enum>(B)</enum><text>building up, in coordination with the United States Agency for International Development, emergency operation centers;</text></subparagraph><subparagraph id="id963f9774920747f4ac0ab4616e1607e7"><enum>(C)</enum><text>providing education and outreach; and</text></subparagraph><subparagraph id="id0d5bd8f155df40859d120034bb240106"><enum>(D)</enum><text>assessing the safety and efficacy of vaccine and treatment candidates in the conduct of clinical trials in affected countries.</text></subparagraph></paragraph></subsection></section><section id="id8a91889475ec47a7b4a103f8080d169d"><enum>112.</enum><header>USAID disaster surge capacity</header><subsection id="id58d2302593a344a4b42edaba33ba767e"><enum>(a)</enum><header>Surge capacity</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151">22 U.S.C. 2151 et seq.</external-xref>), including funds made available for <quote>Assistance for Europe, Eurasia and Central Asia</quote>, 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.</text></subsection><subsection id="idc87bd18d5809455c9ac1134bb03c0aa8"><enum>(b)</enum><header>Notification</header><text>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.</text></subsection></section><section id="idaf8cf39955ad4247b132504b4a450298"><enum>113.</enum><header>Statement of policy on humanitarian assistance to countries affected by pandemics</header><subsection id="iddb7b74eaedeb46ea8618dddee7c49292"><enum>(a)</enum><header>Statement of policy</header><text>It shall be the policy of the United States—</text><paragraph id="id18600767b5114260b21d0a8c8e8d480c"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id480f89e69e2e4c178f0604f6662e0493"><enum>(2)</enum><text>to ensure that United States assistance, including development finance, addresses the second order effects of a pandemic, including acute food insecurity; and</text></paragraph><paragraph id="id93e8db6fc842475da4bede742127f6ac"><enum>(3)</enum><text>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—</text><subparagraph id="idF8051EB6053D471DA1140C82E70E81D2"><enum>(A)</enum><text>are exempted from unreasonable travel restrictions to ensure that they can effectively provide life-saving assistance; and </text></subparagraph><subparagraph id="id293888B20640493F861BF178BD437BC2"><enum>(B)</enum><text>are prioritized as frontline workers in country vaccine distribution plans.</text></subparagraph></paragraph></subsection><subsection id="id0933571751f8400a945c854a52747214"><enum>(b)</enum><header>Facilitating effective and safe humanitarian assistance</header><text>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—</text><paragraph id="idEFFE2FEE4DB64F4CACD5F339C67BFB87"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="idF1B9983ADFCC48EF843420337AC39922"><enum>(2)</enum><text>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</text></paragraph><paragraph id="id79C349E3F56D42A095A4108BE947FE65" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>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. </text></paragraph></subsection></section><enum>II</enum><header>International pandemic prevention and preparedness</header><section id="idf8983d70868b407397b0ae872db9a6a1"><enum>201.</enum><header>Partner country defined</header><text display-inline="no-display-inline">In this title, the term <term>partner country</term> 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.</text></section><section id="id5ccb5abfc7504deba8142177ce240a4c"><enum>202.</enum><header>Global health security strategy and report</header><subsection id="idcdfb63d6030a44f2a2e11130a9f70e67"><enum>(a)</enum><header>In general</header><text>The President shall develop, update, maintain, and advance a comprehensive strategy for improving global health security and pandemic prevention, preparedness, and response that—</text><paragraph id="id787c5ee95e724e25b1bc5050901e86bb"><enum>(1)</enum><text>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; </text></paragraph><paragraph id="id9E4862D47C0547B286E2BBE2A29BBE6B"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="id50ce5ec1c44c4c50aef9cec694381126"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id5faec67e609d4c36842f24059ae8fb8c"><enum>(4)</enum><text>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;</text></paragraph><paragraph id="id3ac7416e096e42c7b699e9449f554975"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="id086b61a15f56478393c069a7a99f8168"><enum>(6)</enum><text>supports, and is aligned with, partner country-led, global health security policy and investment plans, developed with input from key stakeholders, as appropriate;</text></paragraph><paragraph id="idd4eeef52006d4e27ba339c51aa860dda"><enum>(7)</enum><text>prioritizes working with partner countries with—</text><subparagraph id="id8a7424475871449ab5d28d12efb86a67"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="idecb83eac6bee4fb2adb062a2c72fef76"><enum>(B)</enum><text>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;</text></subparagraph></paragraph><paragraph id="id67294457386643ec88429b8119211d85"><enum>(8)</enum><text>reduces long-term reliance upon United States foreign assistance for global health security by—</text><subparagraph id="id0c76b13ac7df4f5a99957d2892bfc2f2"><enum>(A)</enum><text>helping build and enhance community resilience to infectious disease emergencies and threats, such as COVID–19 and Ebola;</text></subparagraph><subparagraph id="id381bfda959d041a4b7ce7352eed53f04"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="idf90954ba7a3f44248b9218952f23f179"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="ide9eb3100fd6b4b4f9449d314e60d75ad"><enum>(D)</enum><text>ensuring partner country ownership of global health security strategies, data, programs, and outcomes;</text></subparagraph></paragraph><paragraph id="idf5900eb8c7d3480297b4fb03008fdf8f"><enum>(9)</enum><text>supports health budget and workforce planning in partner countries, including training in public financial management and budget data transparency;</text></paragraph><paragraph id="id854f972a675e4881af25acceb1560677"><enum>(10)</enum><text>works to ensure that—</text><subparagraph id="id2CA1B0522AC94BD99A45812C24AB209B"><enum>(A)</enum><text>partner countries have national action plans for health security that are developed with input from key stakeholders, including communities and the private sector; and </text></subparagraph><subparagraph id="id14072F64479745DFAD117C865B98ACFD"><enum>(B)</enum><text>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; </text></subparagraph></paragraph><paragraph id="id7cca40f303be4380b26471d03724e3ee"><enum>(11)</enum><text>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</text></paragraph><paragraph id="id85483f0c4de3458cb9db3a19f5063507"><enum>(12)</enum><text>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.</text></paragraph></subsection><subsection id="idf81cd14cf42a4f138c491179f069589e"><enum>(b)</enum><header>Submission of strategy</header><text>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.</text></subsection><subsection id="id7cf5300f793442d4b993f1078bc9f8f7"><enum>(c)</enum><header>Annual report</header><paragraph id="idb116ae6b0ca7495f97a77fcecf3b1b60"><enum>(1)</enum><header>In general</header><text>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—</text><subparagraph id="id4323C671964040A2AFA4FFF1AF309C9A"><enum>(A)</enum><text>the status of the implementation of the strategy required under subsection (a);</text></subparagraph><subparagraph id="id41a27c622a954084b8ffd22ffc39cd10"><enum>(B)</enum><text>any necessary updates to the strategy;</text></subparagraph><subparagraph id="ida312e9cd264f40c1811ce3af0ed74443"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id0c4647277582414c907d798c207de5ec"><enum>(D)</enum><text>details on the status of funds made available to carry out the purposes of this title.</text></subparagraph></paragraph><paragraph id="id52eec83a626e4d0ca062da17ae8390ff"><enum>(2)</enum><header>Agency-specific plans</header><text>The reports required under paragraph (1) shall include specific implementation plans from each relevant Federal department and agency that describe—</text><subparagraph id="id5e24f637135c4391b08573fd70b87e86"><enum>(A)</enum><text>how updates to the strategy may have impacted the agency’s plan during the preceding calendar year;</text></subparagraph><subparagraph id="id75f995331bd446a89585b2adf24911b6"><enum>(B)</enum><text>the progress made in meeting the goals, objectives, and benchmarks under implementation plans during the preceding year;</text></subparagraph><subparagraph id="id5724521010db48f0955d7b92dc91751d"><enum>(C)</enum><text>the anticipated staffing plans and contributions of the department or agency, including technical, financial, and in-kind contributions, to implement the strategy;</text></subparagraph><subparagraph id="id58e49bdd3f424009b356899081725e3c"><enum>(D)</enum><text>a transparent, open, and detailed accounting of obligations by each of the relevant Federal departments and agencies to implement the strategy, including—</text><clause id="ida3d96c6d8e664269b9fdafaf27a9d651"><enum>(i)</enum><text>the statutory source of obligated funds;</text></clause><clause id="id222cf6fb4bc9439382fa350a410a2b3a"><enum>(ii)</enum><text>the amounts obligated;</text></clause><clause id="ide01c98dffd0b44009bc991b3f9506b18"><enum>(iii)</enum><text>implementing partners;</text></clause><clause id="id91ccaa3c32ea482ba7365ebaf5e3df7d"><enum>(iv)</enum><text>targeted beneficiaries; and</text></clause><clause id="idd486bc2fc237466ea4f592a5fa04fc9b"><enum>(v)</enum><text>activities supported;</text></clause></subparagraph><subparagraph id="idcbc866d543034636a48b083a6983ffdf"><enum>(E)</enum><text>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</text></subparagraph><subparagraph id="id53cbf86c454c4dc58edaaefa03176ef2"><enum>(F)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id6f29262cdda44f33b0fb5c2b97af6ca2"><enum>(3)</enum><header>Form</header><text>The reports required under paragraph (1) shall be submitted in unclassified form, but may contain a classified annex. </text></paragraph></subsection></section><section id="id038091B9489F474892BA61F2F63F3FD1"><enum>203.</enum><header>Committee on Global Health Security and Pandemic and Biological Threats</header><subsection id="ide6125f4c9b564b8c8aa0deaeff4a3857"><enum>(a)</enum><header>Statement of policy</header><text>It shall be the policy of the United States—</text><paragraph id="id8bb4501ab32e4b2e8c0fce06e171513b"><enum>(1)</enum><text>to promote global health security as a core national and security interest; and</text></paragraph><paragraph id="id9f9a364fdb744f67839490e1b167deac"><enum>(2)</enum><text>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). </text></paragraph></subsection><subsection id="ide87aa5053c09408bb7eefebdc18200ae"><enum>(b)</enum><header>Coordination</header><paragraph id="id11335fd34d1e441c8760d119608a6d1c"><enum>(1)</enum><header>Defined term</header><text>In this subsection, the term <term>pandemic threat</term> means any infectious disease that—</text><subparagraph id="id8AF61FAE05FC4DFE862D1CCA28D633A0"><enum>(A)</enum><text>has an aggregation of cases in a community that rises above what is normally expected in that population in that area;</text></subparagraph><subparagraph id="id612EC7040CA4495E8FCFDA0CEA4DC543"><enum>(B)</enum><text>has the potential to spread over several countries or continents; and </text></subparagraph><subparagraph id="idFBFF8D2FBB194D00BBA12483B75D2511"><enum>(C)</enum><text>could, if not addressed, threaten the national security of the United States.</text></subparagraph></paragraph><paragraph id="id81CC4C3783A04E429D41A405143C3ADE"><enum>(2)</enum><header>Committee on global health security and pandemic and biological threats</header><text>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 <quote>Committee</quote>), whose day to day operations should be led by the Special Advisor for Global Health Security.</text></paragraph><paragraph id="id1db5cfa556f7464bbe8bd9dc142c665e"><enum>(3)</enum><header>Special advisor for global health security</header><text>The Special Advisor for Global Health Security referred to in paragraph (2)—</text><subparagraph id="idB0BE8BDF558643E687DDA64C70187484"><enum>(A)</enum><text>should serve as part of the staff of the National Security Council; and </text></subparagraph><subparagraph id="id8C798544375A439FA45DCE4E3E02FD8B"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><paragraph id="ida570b9729bb246b994efafacdaccf790"><enum>(4)</enum><header>Composition</header><text>The Committee should include the following members:</text><subparagraph id="id79e75a9451414679bf8d5cf138121ead"><enum>(A)</enum><text>The Director of National Intelligence.</text></subparagraph><subparagraph id="idfe9a4d87e41a42ed9a6c9bc643ba9d02"><enum>(B)</enum><text>The Secretary of State.</text></subparagraph><subparagraph id="id3b63c89bb1b44eb88e8b2befd828cf5d"><enum>(C)</enum><text>The Secretary of Defense.</text></subparagraph><subparagraph id="id7ee3a8e72f44464490ef61e28dce60d1"><enum>(D)</enum><text>The Secretary of Health and Human Services.</text></subparagraph><subparagraph id="id2688e0db22694da79c920b626e26796a"><enum>(E)</enum><text>The Administrator of the United States Agency for International Development.</text></subparagraph><subparagraph id="id62b83340d7bb476b8c3658e50eca447a"><enum>(F)</enum><text>The Secretary of Agriculture.</text></subparagraph><subparagraph id="id0491f383d6104e52a5562e93a43a2c5e"><enum>(G)</enum><text>The Secretary of the Treasury.</text></subparagraph><subparagraph id="id3e160ae6ebad45fba97e30c7eeffed14"><enum>(H)</enum><text>The Attorney General.</text></subparagraph><subparagraph id="id4e367cc9d69d4d5daa993acfd612b1d0"><enum>(I)</enum><text>The Secretary of Homeland Security.</text></subparagraph><subparagraph id="id0f134afb6f5c40589122eed4ac6df440"><enum>(J)</enum><text>The Office of Management and Budget.</text></subparagraph><subparagraph id="idb2b8134dc478490ba31a62485b2df7ae"><enum>(K)</enum><text>The Administrator of the Environmental Protection Agency.</text></subparagraph><subparagraph id="id39f84d857ab74040a5f8909db28d8976"><enum>(L)</enum><text>The Director of the Centers for Disease Control and Prevention.</text></subparagraph><subparagraph id="idf308a6c4f4d144fca72e51c82c013d69"><enum>(M)</enum><text>The Director of the Office of Science and Technology Policy.</text></subparagraph><subparagraph id="idd9321c3cc7fd48d6aa93777256bf5ecd"><enum>(N)</enum><text>The Assistant to the President for National Security Affairs, who should serve as the chairperson of the Committee.</text></subparagraph><subparagraph id="ida0ffcc02ebea48a492324ede014a89d4"><enum>(O)</enum><text>Such other members as the President may designate.</text></subparagraph></paragraph><paragraph id="id73806694f9b342b6866b0740c37ddd84"><enum>(5)</enum><header>Functions</header><subparagraph id="idA90B2E086535467E9FBD89CFC9C7A63F"><enum>(A)</enum><header>In general</header><text>The functions of the Committee should be—</text><clause id="id7AD5AD33692444798DDB3DDE9F114A40"><enum>(i)</enum><text>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 </text></clause><clause id="idBB565845F3CA4A92AC8199E1AFA5012C"><enum>(ii)</enum><text>to ensure policy coordination between United States Government agencies, especially coordination between—</text><subclause id="idA63A61C40A7F465EA67E05A4736143D3"><enum>(I)</enum><text>agencies with a primarily domestic mandate; and </text></subclause><subclause id="id7E45AFCB2A134BD98F519655236BC08A"><enum>(II)</enum><text>agencies with an international mandate relating to global health security and pandemic threats.</text></subclause></clause></subparagraph><subparagraph id="idb90c6b5c8813448a8f5eb62079db0c6a"><enum>(B)</enum><header>Activities</header><text>In carrying out the functions described in subparagraph (A), the Committee should—</text><clause id="id8f77d00fc9df43ffa2684a5f03827319"><enum>(i)</enum><text>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;</text></clause><clause id="id1319af997ffa4aa2981a7251012691ec"><enum>(ii)</enum><text>develop a plan for—</text><subclause id="id1367BB00BE7F4FB8855C5BAB296C357E"><enum>(I)</enum><text>establishing an interagency National Center for Epidemic Forecasting and Outbreak Analytics; and </text></subclause><subclause id="id33CFE1BA436440AABE9985DECE5DAA50"><enum>(II)</enum><text>modernizing global early warning and trigger systems for scaling action to prevent, detect, respond to, and recover from emerging biological threats;</text></subclause></clause><clause id="id5061e6ecad19468f8322d3c9d2ab7a80"><enum>(iii)</enum><text>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;</text></clause><clause id="idab23e1ec348e4b19ad8bd18e56169b22"><enum>(iv)</enum><text>review the progress toward, and working to resolve challenges in, achieving United States commitments under the GHSA; </text></clause><clause id="id4221973367e24c0f8c48d7d1d86061b4"><enum>(v)</enum><text>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;</text></clause><clause id="id49be8097a7334ef3a1b95117a585ef40"><enum>(vi)</enum><text>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</text></clause><clause id="id931b7f8e25574a45ab79b5dce6f4cd87"><enum>(vii)</enum><text>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;</text></clause></subparagraph><subparagraph id="id83950d34bf7341fba5c5597277f2d1cf"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id89878b9c4d374ccfa7c51632fda6ed8f"><enum>(D)</enum><text>develop guidelines to enhance and improve the operational coordination between State and local governments and Federal agencies with respect to pandemic threats.</text></subparagraph></paragraph><paragraph id="id76b456ca68824434afa301f6df27713c" commented="no"><enum>(6)</enum><header>Foreign affairs responsibilities</header><text>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.</text></paragraph><paragraph id="id13b772b53021408880457f74eda8a520" commented="no"><enum>(7)</enum><header>Specific roles and responsibilities</header><subparagraph id="id2a1ad0e33594458cbffde53079ebb20c" commented="no"><enum>(A)</enum><header>In general</header><text>The heads of the agencies listed in paragraph (4) should—</text><clause id="idae4dbcb50f0e4a30828af076ba2cf95b" commented="no"><enum>(i)</enum><text>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;</text></clause><clause id="id11f32f0288ce4d2eb7b0a0705ca8078e" commented="no"><enum>(ii)</enum><text>designate a senior-level official to be responsible for global health security and pandemic threat reduction at each of their respective agencies;</text></clause><clause id="id8d35c1554dd945989f379e12f5914944" commented="no"><enum>(iii)</enum><text>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;</text></clause><clause id="ida8c374a1924a43e8b8244ec05642da72" commented="no"><enum>(iv)</enum><text>keep the Committee apprised of Global Health Security and pandemic threat reduction-related activities undertaken within their respective agencies;</text></clause><clause id="id017552bdfe8e48d893fde3bed76fc5cf" commented="no"><enum>(v)</enum><text>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</text></clause><clause commented="no" id="id24CA2194ABF4444FACB6A94C4CEAE27B"><enum>(vi)</enum><text>keep the Committee apprised of GHSA-related activities undertaken within their respective agencies.</text></clause></subparagraph><subparagraph id="id3d2f56d463684f90a2cb09ddcb906e01" commented="no" display-inline="no-display-inline"><enum>(B)</enum><header>Additional roles and responsibilities</header><text>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. </text></subparagraph></paragraph></subsection></section><section id="id5AFBA4099D404D3E90EA5AF819367724"><enum>204.</enum><header>United States overseas global health security and diplomacy coordination and strategy</header><subsection id="id3E5237F983354288901BAD2D13C78E80"><enum>(a)</enum><header>Establishment</header><text>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 <quote>Special Representative</quote>). </text></subsection><subsection id="idECC3BBE7FFBB451590A27F640BBF9C75"><enum>(b)</enum><header>Appointment; qualifications</header><text>The Special Representative—</text><paragraph id="idADF945ADBBA44B4CAC09B4E9B75E64EC"><enum>(1)</enum><text>shall be appointed by the President, by and with the advice and consent of the Senate;</text></paragraph><paragraph id="idD17A5EA526A34F4FAB8D98076360B280"><enum>(2)</enum><text>shall report to the Secretary of State; and</text></paragraph><paragraph id="id8468D0F089484D6F8745DF55CC92BD9F"><enum>(3)</enum><text>shall have—</text><subparagraph id="id932E2590D60E4C339B22ABEB60EECF8A"><enum>(A)</enum><text>demonstrated knowledge and experience in the fields of development and public health, epidemiology, or medicine; and</text></subparagraph><subparagraph id="id4CDB28E16E8243DE87C49353F2FC5525"><enum>(B)</enum><text>relevant diplomatic, policy, and political expertise.</text></subparagraph></paragraph></subsection><subsection id="idFDEAC58021EB410C83D29ED4F231806F"><enum>(c)</enum><header>Authorities</header><text>The Special Representative is authorized—</text><paragraph id="idBFCAD05D39774A6EA77F5D25D71E089D"><enum>(1)</enum><text>to operate internationally to carry out the purposes of this title;</text></paragraph><paragraph id="idb700cc0007a443389df38ea8657dbc0a"><enum>(2)</enum><text>to lead in developing a global pandemic prevention, preparedness and response framework to support global pandemic prevention, preparedness, responses and recovery efforts, including through—</text><subparagraph id="idC267B28A83DE49C3A712180908D5816C"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="id36E9A05A331D415F84B41CFB4D6D05A9"><enum>(B)</enum><text>support for United States citizens living abroad, including consular support;</text></subparagraph></paragraph><paragraph id="idf454fd356e4643ee93606ad21c1c3d24"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="ida96245a1688347dcae1eef693f9616d0"><enum>(4)</enum><text>to represent the United States on the Fund for Global Health Security and Pandemic Prevention and Preparedness established pursuant to section 302(a); </text></paragraph><paragraph id="id837C8F71C22E437EA30C73717312DECB"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="idC547E285BD884039A9A2A7079373CABB"><enum>(6)</enum><text>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</text></paragraph><paragraph id="id65E9024BF84E43998CA3DF0C56B81846"><enum>(7)</enum><text>to perform such other functions as the Secretary of State may assign.</text></paragraph></subsection><subsection id="id2129B59A7D0C411081FF1194E31A5C6F"><enum>(d)</enum><header>Duties</header><text>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—</text><paragraph id="id8afb3faa2ea144f1abfbf3e767770ff2"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="ide1db5c9f24b14f638c6bfad05946607d"><enum>(2)</enum><text>enhancing engagement with multilateral organizations and partner countries, including through the mobilization of donor support;</text></paragraph><paragraph id="id4d84dea7ee5143f29fdac3b61550098b"><enum>(3)</enum><text>enhancing coordination of consular services for United States citizens abroad in the event of a global health emergency;</text></paragraph><paragraph id="idFC50714874AC40A3B29E4024E547EF82"><enum>(4)</enum><text>ensuring effective program coordination and implementation by the relevant Federal departments and agencies by—</text><subparagraph id="id71065B45FD0F4A97BB6F291D6B904ABF"><enum>(A)</enum><text>formulating, issuing, and updating related policy guidance;</text></subparagraph><subparagraph id="id4321D27EF2E540A0AEB2DC9DB15738D1"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id31E22EB2165F47B6ADEA61301B1F290D"><enum>(C)</enum><text>aligning, in coordination with United States chiefs of mission and country teams in partner countries—</text><clause id="id7015DA1999A84547A44703AEA2673D23"><enum>(i)</enum><text>the foreign assistance resources funded with amounts appropriated pursuant to subsection (f); and </text></clause><clause id="id2101781795814C4BA1A15FE9A259DA25"><enum>(ii)</enum><text>the implementation plans required under section 202(c)(2) with the relevant Federal departments and agencies in a manner that—</text><subclause id="id148651BB52234D2B8BD11ABD85A8F94F"><enum>(I)</enum><text>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); </text></subclause><subclause id="idE621647C0B604A8BAE637969BE91F0A6"><enum>(II)</enum><text>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 </text></subclause><subclause id="id70CEFBD829E446B6A78817F082F78160"><enum>(III)</enum><text>reflects and leverages the unique capabilities of each such department and agency;</text></subclause></clause></subparagraph><subparagraph id="id81D17FA1BAB84E7B852D4F649E79C572"><enum>(D)</enum><text>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;</text></subparagraph><subparagraph id="id5858242371AA49DA821768AF858E4940"><enum>(E)</enum><text>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</text></subparagraph><subparagraph id="id5C0CB88D75E44E4F9AC90E219EDB249D"><enum>(F)</enum><text>avoiding duplication of effort and working to resolve policy, program, and funding disputes among the relevant Federal departments and agencies;</text></subparagraph></paragraph><paragraph id="id5400D0B2402A4F61AFA2E1AEDB63BC99"><enum>(5)</enum><text>leading diplomatic efforts to identify and address current and emerging threats to global health security;</text></paragraph><paragraph id="id8664FA77D4F24186A8EEFEA57BE0D2C3"><enum>(6)</enum><text>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;</text></paragraph><paragraph id="idBD5E85EDCBB447A5AD69F357464D1B3D"><enum>(7)</enum><text>working to enhance coordination with, and transparency among, the governments of partner countries and key stakeholders, including the private sector;</text></paragraph><paragraph id="id4224EB765431482F94944754DABB5699"><enum>(8)</enum><text>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;</text></paragraph><paragraph id="id05C6A96812204BD5B66A167621D35698"><enum>(9)</enum><text>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</text></paragraph><paragraph id="id639C486D07E142B6B253894A3BD1B2ED"><enum>(10)</enum><text>providing regular updates to the appropriate congressional committees regarding the fulfillment of the duties described in this subsection.</text></paragraph></subsection><subsection id="idD0EAC9A37C5C4508835C87B5BFD353B3"><enum>(e)</enum><header>Deputy Representative</header><text>The Special Representative should be supported by a deputy, who—</text><paragraph id="id8E564F1DD92948F38C933F43DC101732"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id90CDE075ACD94882A6262C70808832EB"><enum>(2)</enum><text>should have demonstrated knowledge and experience in the fields of development and public health, epidemiology, or medicine; and </text></paragraph><paragraph id="id925D7DF0B7044319824CC55536249456" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>serves concurrently as the deputy and performs the functions described in section 3(h) of Executive Order 13747 (81 Fed. Reg. 78701). </text></paragraph></subsection><subsection id="idaa2e379d97cf4675852ed71ff3c7c498"><enum>(f)</enum><header>Authorization of appropriations</header><paragraph id="idB0777D8EAF7F46E7A36532431C842101"><enum>(1)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151">22 U.S.C. 2151 et seq.</external-xref>), may include support for—</text><subparagraph id="id816843a373b5463c8c79ae8937288460"><enum>(A)</enum><text>enhancing preparedness in partner countries through implementation of the Global Health Security Strategy developed pursuant to section 202;</text></subparagraph><subparagraph id="id7a757af1c3b642f696bf12e0c8377bfc"><enum>(B)</enum><text>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 <external-xref legal-doc="public-law" parsable-cite="pl/115/31">Public Law 115–31</external-xref>) to address new or emerging infectious disease threats, as necessary and appropriate;</text></subparagraph><subparagraph id="id0749baf3af8f4ed28afc3276dd9ea2fe"><enum>(C)</enum><text>United States contributions to the World Bank Health Emergency Preparedness and Response Multi-Donor Fund; and</text></subparagraph><subparagraph id="idf0561b641b6544d6ad5dda67358ad6c4"><enum>(D)</enum><text>United States contributions to a multilateral, catalytic financing mechanism for global health security and pandemic prevention and preparedness described in section 302.</text></subparagraph></paragraph><paragraph id="id455734900d48448cb5770dd197f1b3e3" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Exception</header><text>Section 110 of the Trafficking Victims Protection Act of 2000 (<external-xref legal-doc="usc" parsable-cite="usc/22/7107">22 U.S.C. 7107</external-xref>) shall not apply to assistance made available pursuant to this subsection. </text></paragraph></subsection></section><section id="id4c58ea4120974eeb969d16c9606440bb"><enum>205.</enum><header>Resilience</header><text display-inline="no-display-inline">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—</text><paragraph id="id7e4a1708d8304226aca3138bef5a9e9f"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="idbfd74f032d59409b98a42439bc80f616"><enum>(2)</enum><text>to develop effective tools to identify, analyze, forecast, and mitigate the risks that make such countries vulnerable;</text></paragraph><paragraph id="idc086dbdea97d452c8ee708fde05111b2"><enum>(3)</enum><text>to better integrate short-, medium-, and long-term recovery efforts into global health emergency response and disaster relief; and</text></paragraph><paragraph id="id7becc70bdd7f49b8bfcc5a39c87a7630"><enum>(4)</enum><text>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.</text></paragraph></section><section id="idcb1cc11156a44de18211fcf3ed77cad8"><enum>206.</enum><header>Strengthening health systems</header><subsection id="idcad2fed30e364f0b932230544a25379f"><enum>(a)</enum><header>Statement of policy</header><text>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.</text></subsection><subsection id="ided7c760c868947e5957e24c510dfe213"><enum>(b)</enum><header>Coordination</header><text>The Administrator of the United States Agency for International Development (referred to in this section as <quote>USAID</quote>) 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 (<external-xref legal-doc="public-law" parsable-cite="pl/108/25">Public Law 108–25</external-xref>) and other relevant statutes to ensure that such activities contribute to health systems strengthening.</text></subsection><subsection id="id9f1cce2610814ff0b9e284ffa66d14ac"><enum>(c)</enum><header>Pilot program</header><paragraph id="id5a7f8631390f4f78ad41bf0792a2e3b3"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="idcda38f08174348f183d170c1dbdfc305"><enum>(2)</enum><header>Assessment</header><text>In the countries selected under paragraph (1), USAID missions, in consultation with USAID’s Office of Health Systems Strengthening, should conduct an assessment that—</text><subparagraph id="id2d45a0cd14ef44f7a12e963cab702394"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id8ec6a87f82084e40a4ec872c80538de8"><enum>(B)</enum><text>identifies the best opportunities for improving health systems to achieve improved outcomes, including obstacles to health service delivery;</text></subparagraph><subparagraph id="idc5ff21b7d4114ac6bcc16590c7c3bd0f"><enum>(C)</enum><text>maps the resources of the country and other donors in the health sector with a focus on investment in health system strengthening; and</text></subparagraph><subparagraph id="id835ae775f0504b8ab73dc2238a58d26e"><enum>(D)</enum><text>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—</text><clause id="idd088d914be3c4291a5c1eed02685aea9"><enum>(i)</enum><text>provides a framework for implementing such strategy;</text></clause><clause id="id66fdd2b4c3044cfa90f3ea2caf2c79d7"><enum>(ii)</enum><text>identifies key areas for United States Government investments to strengthen the health system in alignment with other donors;</text></clause><clause id="id6ab625e56a494a61b8e395a71fd14e0a"><enum>(iii)</enum><text>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</text></clause><clause id="idee16c3358c0f4bb3b4c3d65b5122d478"><enum>(iv)</enum><text>includes clear goals, benchmarks, outputs, desired outcomes, a means of measuring progress and a cost analysis.</text></clause></subparagraph></paragraph><paragraph id="id50c90c620af9473eba153dfc0906b3ca"><enum>(3)</enum><header>Strategies to strengthen health systems</header><text>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—</text><subparagraph id="id1887b0ff835241da9e69d3cccfed44a7"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id1e4b341947714f5b8316cca0c0393bf6"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id7173eebb891c4d41b983332ae85c72a4"><enum>(C)</enum><text>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;</text></subparagraph><subparagraph id="id6a8b7f284aa0410a8a2a9d946ea0b80c"><enum>(D)</enum><text>includes proposals for mobilizing sufficient and durable financing for health systems;</text></subparagraph><subparagraph id="idca3e5d610e8c442bad80d1cc96f4478f"><enum>(E)</enum><text>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—</text><clause id="id8692DBFA464A4C8F95DF776CAD36701B"><enum>(i)</enum><text>strengthened data collection and analysis;</text></clause><clause id="id783CB5786BF44871B7D5DC7419C8D6C4"><enum>(ii)</enum><text>data driven decisionmaking capacity; and</text></clause><clause id="id2E5544FFF6DB459EB90BF74821449163"><enum>(iii)</enum><text>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;</text></clause></subparagraph><subparagraph id="id7d4630a9981942c59874fe55d71c0409"><enum>(F)</enum><text>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; </text></subparagraph><subparagraph id="id795a91d101424e33aea41dc9c8e7bbb4"><enum>(G)</enum><text>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;</text></subparagraph><subparagraph id="ida144d2295d424748a2856d95472219dd"><enum>(H)</enum><text>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;</text></subparagraph><subparagraph id="id0907c6ded4b64dabb356a6ea3a7e7529"><enum>(I)</enum><text>includes plans for integrating innovations in health technologies, services, and systems;</text></subparagraph><subparagraph id="id774181fdaa1341738d706d1127f6a399"><enum>(J)</enum><text>identifies barriers to health literacy, community engagement, and patient empowerment, and recommendations for overcoming such barriers; </text></subparagraph><subparagraph id="idBF16363FF8A8483A96397C04807A9FE6"><enum>(K)</enum><text>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 </text></subparagraph><subparagraph id="id58069b916e8c4e46b7dc84f76d5fe884"><enum>(L)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id2e9d05033629419d9c246a56bcba4aeb"><enum>(4)</enum><header>Consultation</header><text>In developing a strategy pursuant to paragraph (3), each USAID mission should consult with a wide variety of stakeholders, including—</text><subparagraph id="id84509745824d4aa8855b8d61e00ddd45"><enum>(A)</enum><text>relevant partner government institutions;</text></subparagraph><subparagraph id="id52e36892dd554b318f994666f7edf2da"><enum>(B)</enum><text>professional associations;</text></subparagraph><subparagraph id="idda35752d11f8468cb2beebd0f6ebd3cb"><enum>(C)</enum><text>patient groups;</text></subparagraph><subparagraph id="id45f9e9cd76a9433699eb4d9b9755acec"><enum>(D)</enum><text>civil society organizations (including international nongovernmental organizations with relevant expertise in program implementation); and</text></subparagraph><subparagraph id="id831b5ff6b0d541bb8b0e19e723c9ff22"><enum>(E)</enum><text>the private sector.</text></subparagraph></paragraph></subsection><subsection id="idfdba2909e9a24296b60452b63a8a878b"><enum>(d)</enum><header>International efforts</header><paragraph id="ideddf6340dcb340a18cf23e2cd0738a7e"><enum>(1)</enum><header>Coordination</header><text>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—</text><subparagraph id="idc6f2f1f11fbd439bb0ad7eb0073e7fab"><enum>(A)</enum><text>shared core indicators for strengthened health systems;</text></subparagraph><subparagraph id="iddac0b149f2564f72b9a981a689e8c026"><enum>(B)</enum><text>agreements among donors that reporting requirements for health systems come from country systems to reduce the burden placed on partner countries;</text></subparagraph><subparagraph id="id06a7296477f842ab95b089d2f5decab9"><enum>(C)</enum><text>structures for joint assessments, plans, auditing, and consultations; and</text></subparagraph><subparagraph id="id9471f9beb3fb4ab7a8691cb558d9dd9f"><enum>(D)</enum><text>a regularized approach to coordination on health systems strengthening.</text></subparagraph></paragraph></subsection><subsection id="id668a4343b13640a3b6a3df54c4c8c8c4"><enum>(e)</enum><header>Public private partnerships To improve health systems strengthening</header><paragraph id="ide6181eb5527c48949eaa2600dc8decc5"><enum>(1)</enum><header>Inclusion in country strategies</header><text>The country strategies developed under subsection (c)(3) should include a section that—</text><subparagraph id="id9db4f0c1afe0430b9f732c4da9e37e54"><enum>(A)</enum><text>discusses the role of the private sector (including corporate, local, and international organizations with relevant expertise); and</text></subparagraph><subparagraph id="idabdb3c4141ea4c63ab17e70e100be127"><enum>(B)</enum><text>identifies relevant opportunities for the private sector—</text><clause id="id6e79caac59434938a1bdd250be9b0638"><enum>(i)</enum><text>to accelerate research and development of innovative health and information technology, and to offer training related to its use;</text></clause><clause id="idd8700c7204d44c02bb4226d577f04c1a"><enum>(ii)</enum><text>to contribute to improvements in health administration and management processes;</text></clause><clause id="id07d8b83bafee48688ad05f22cfdf16bb"><enum>(iii)</enum><text>to improve system efficiency;</text></clause><clause id="id92a36e5d28a64e4e8f19f59028861838"><enum>(iv)</enum><text>to develop training related to clinical practice guidelines; and</text></clause><clause id="iddde85f7c4de64d1db16591ebb0018e8f"><enum>(v)</enum><text>to help countries develop systems for documenting outcomes and achievements related to activities undertaken to strengthen the health sector.</text></clause></subparagraph></paragraph></subsection><subsection id="idef80f783632f4017ab6ade6cb799adbb" commented="no" display-inline="no-display-inline"><enum>(f)</enum><header>Authorization for use of funds</header><text>Amounts authorized to be appropriated or otherwise made available to carry out section 104 of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b">22 U.S.C. 2151b</external-xref>) may be made available to carry out this section. </text></subsection></section><section id="id325f7fb4b16148dcb2fa66f729e66103"><enum>207.</enum><header>Additional authorities</header><subsection id="idA69FF9E9D3BF4647A80A5462C40DBD2A"><enum>(a)</enum><header>Foreign Assistance Act of 1961</header><text display-inline="yes-display-inline">Chapter 1 of part I of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151">22 U.S.C. 2151 et seq.</external-xref>) is amended—</text><paragraph id="idf2fc88648e3448ee8b60b4c16b743754"><enum>(1)</enum><text>in section 104(c)(1) (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b">22 U.S.C. 2151b(c)(1)</external-xref>), by inserting <quote>(emphasizing health systems strengthening, as appropriate)</quote> after <quote>health services</quote>;</text></paragraph><paragraph id="ida83968d37b2f4df98c8fa261835a611c"><enum>(2)</enum><text>in section 104A (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2</external-xref>)—</text><subparagraph id="id064ed16c1d5f4a3baa3ec05e518b11ed"><enum>(A)</enum><text>in subsection (b)(3)(D), by striking <quote>including health care systems, under other international donor support</quote> and inserting <quote>including through support for health systems strengthening, under other donor support</quote>; and</text></subparagraph><subparagraph id="id347e028fa1cc456fb3e54980bc79f957"><enum>(B)</enum><text>in subsection (f)(3)(Q), by inserting <quote>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</quote> after <quote>efforts by</quote>; and</text></subparagraph></paragraph><paragraph id="idf60be0dfb42a4da782aaf230eaaf47f3"><enum>(3)</enum><text>in section 104B(g)(2) (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-3">22 U.S.C. 2151b–3(g)(2)</external-xref>), by inserting <quote>strengthening the health system of the country and</quote> after <quote>contribute to</quote>.</text></paragraph></subsection><subsection id="id53e2279b31a94a53a67379073972b010"><enum>(b)</enum><header>United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</header><text>Section 204 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7623">22 U.S.C. 7623</external-xref>) is amended—</text><paragraph id="idaadb6f46c3c14cbf8f2fad5ccdb577cf"><enum>(1)</enum><text>in subsection (a)—</text><subparagraph id="idA10EA369EB394295B38F031D569B7239"><enum>(A)</enum><text>in paragraph (1)(A), by inserting <quote>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</quote> after <quote>systems</quote>; and</text></subparagraph><subparagraph id="ida559457e922c4e8dbd91b59f6dea90bc"><enum>(B)</enum><text>in paragraph (2)—</text><clause id="id4bb5c71e829d474fb14a63c426d44e76"><enum>(i)</enum><text>in subparagraph (C), by inserting <quote>as part of a strategy to improve overall health</quote> before the semicolon at the end;</text></clause><clause id="id0d906c0236ef4e8fbf3acdf10f6170cb"><enum>(ii)</enum><text>in subparagraph (D), by striking <quote>and</quote> at the end;</text></clause><clause id="id78cf619233b94bbbbbd1a3c785028e33"><enum>(iii)</enum><text>in subparagraph (E), by striking the period at the end and inserting <quote>; and</quote>; and</text></clause><clause id="id49baff4d5c2a4076a865d047c818f124"><enum>(iv)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idA13DAB08383D41C6A609BCFE2669E95F" changed="deleted" reported-display-style="strikethrough" committee-id="SSFR00"><subparagraph id="id1A88DA35C4394FCB8EE030FD7D873AA3"><enum>(F)</enum><text>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.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph></paragraph><paragraph id="idf8829fc84b0e4cce9e8632599dc01449" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text>in subsection (b), by striking <quote>receive funding to carry out programs to combat HIV/AIDS, tuberculosis, and malaria</quote> and inserting <quote>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,</quote>. </text></paragraph></subsection></section><section id="id2aaa1849056b4f92908579bed5662112"><enum>208.</enum><header>Authorization for United States participation in the Coalition for Epidemic Preparedness Innovations</header><subsection id="id58fb99d1e1b34506bde5bfee9c98751f"><enum>(a)</enum><header>In general</header><text>The United States is authorized to participate in the Coalition for Epidemic Preparedness Innovations (referred to in this section as <quote>CEPI</quote>).</text></subsection><subsection id="id47ab3a3ca861490ea4ed5f907cac220a"><enum>(b)</enum><header>Investors Council and Board of Directors</header><paragraph id="id4e2de440543a4d929bceb9057e98eab1"><enum>(1)</enum><header>Initial designation</header><text>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.</text></paragraph><paragraph id="id485BBAD40F944866938CD29E198754A7"><enum>(2)</enum><header>Ongoing designations</header><text>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. </text></paragraph><paragraph id="idEDF9A178F042439BB32EAE740A9BF0DF"><enum>(3)</enum><header>Qualifications</header><text>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).</text></paragraph></subsection><subsection id="id5a84afc420a64cdc93b70fa0c66f1fb3"><enum>(c)</enum><header>Consultation</header><text>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—</text><paragraph id="idca9bf6f180d64cd080252ee8b18da580"><enum>(1)</enum><text>the manner and extent to which the United States plans to participate in CEPI, including through the governance of CEPI;</text></paragraph><paragraph id="idc93d8e9b9f1d477aa4296779397ae80b"><enum>(2)</enum><text>any planned financial contributions from the United States to CEPI; and</text></paragraph><paragraph id="id2d2a83b0cae84ffb9d0acfc804eebe27"><enum>(3)</enum><text>how participation in CEPI is expected to support—</text><subparagraph id="id22B567163724469BA24276BEB5B794F1"><enum>(A)</enum><text>the United States Global Health Security Strategy required under this Act;</text></subparagraph><subparagraph id="id6B1CF0C832C445C5BDCB2AA4B7ECEBBC"><enum>(B)</enum><text>the applicable revision of the National Biodefense Strategy required under section 1086 of the National Defense Authorization Act for Fiscal Year 2017 (<external-xref legal-doc="usc" parsable-cite="usc/6/104">6 U.S.C. 104</external-xref>); and </text></subparagraph><subparagraph id="id1DE7129743CC4AD9B94D566A06866B59"><enum>(C)</enum><text>any other relevant programs relating to global health security and biodefense.</text></subparagraph></paragraph></subsection><subsection id="id878a60b7898645bc9b6d258c5648c5e2"><enum>(d)</enum><header>United States contributions</header><paragraph id="id309A06A9549C484EB4572C599496874A"><enum>(1)</enum><header>Sense of congress</header><text>It is the sense of Congress that the President, consistent with the provisions under section 10003(a)(1) of the <short-title>American Rescue Plan Act of 2021</short-title>, 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. </text></paragraph><paragraph id="id16d5d500799e45009202abce17ccc97a" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Notification</header><text>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. </text></paragraph></subsection></section><section id="id18135ee0a1734ade8a8290c07c519e1c"><enum>209.</enum><header>National intelligence estimate and briefing regarding novel diseases and pandemic threats</header><subsection id="id12773692345b4eab81fe0b72432ab488"><enum>(a)</enum><header>Defined term</header><text>In this section, the term <term>appropriate committees of Congress</term> means—</text><paragraph id="idc80f689ac4d944808dda26537097d177"><enum>(1)</enum><text>the <committee-name committee-id="SSFR00">Committee on Foreign Relations of the Senate</committee-name>;</text></paragraph><paragraph id="idC2B7E9A90E5E47B9924AC10ED3E4D8D6"><enum>(2)</enum><text>the <committee-name committee-id="SLIN00">Select Committee on Intelligence of the Senate</committee-name>;</text></paragraph><paragraph id="id6670A63FA19A4DB896EFD8A361C5CA92"><enum>(3)</enum><text>the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions of the Senate</committee-name>;</text></paragraph><paragraph id="idaf5bcd6ebc6248a1916a04fbf7887e90"><enum>(4)</enum><text>the <committee-name committee-id="">Committee on Foreign Affairs of the House of Representatives</committee-name>;</text></paragraph><paragraph id="id0293DB3050904B86A1603FBA4B2FD68E"><enum>(5)</enum><text>the <committee-name committee-id="">Permanent Select Committee on Intelligence of the House of Representatives</committee-name>; and</text></paragraph><paragraph id="id82D30561FD734AD29B2DF3C138D2EF00"><enum>(6)</enum><text>the <committee-name committee-id="">Committee on Energy and Commerce of the House of Representatives</committee-name>.</text></paragraph></subsection><subsection id="id968b989846104a368cc1e4393c292d23"><enum>(b)</enum><header>National Intelligence Estimates</header><paragraph id="id81e619ad32fb4c3293ba249384730339"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="id2ff595c7e9da40578b926158f61fff96"><enum>(2)</enum><header>Elements</header><text>The National Intelligence Estimate submitted pursuant to paragraph (1) shall—</text><subparagraph id="id6a8c5a95ae634484ad93488942cd3080"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id0894a083ec284c5ab03cc9fb0acc04f7"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id943d18bf853d4944b783e7c4ef48e496"><enum>(C)</enum><text>assess the preparedness of countries around the world, particularly those identified pursuant to subparagraph (A), to prevent, detect, and respond to pandemic threats; and</text></subparagraph><subparagraph id="idc59dfc87a99d4051a10222ac4a1f7581"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection><subsection id="id55410baf0ff84c5da9165025007d41e7"><enum>(c)</enum><header>Congressional briefings</header><text>The National Intelligence Council shall provide an annual briefing to the appropriate committees of Congress regarding—</text><paragraph id="idbba44350f35549d8bf608c3db2997c5a"><enum>(1)</enum><text>the most recent National Intelligence Estimate submitted pursuant to subsection (b)(1); and</text></paragraph><paragraph id="id4271818215864aacba4f479e4bc438c8"><enum>(2)</enum><text>the emergence or reemergence of pathogens with pandemic potential that could lead to an epidemic described in subsection (b)(2)(B).</text></paragraph></subsection><subsection id="id9f7a0eb51ac34ee8bcd2ffe0656b437f" commented="no" display-inline="no-display-inline"><enum>(d)</enum><header>Public availability</header><text>The Director of National Intelligence shall make publicly available an unclassified version of each National Intelligence Estimate submitted pursuant to subsection (b)(1). </text></subsection></section><section id="iddf8aefeb7a5a4dec9a54298073a38cb7"><enum>210.</enum><header>Pandemic early warning network</header><subsection id="id23cc93fd9dc7452d8a8f4b6f5de2d77c"><enum>(a)</enum><header>In general</header><text>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.</text></subsection><subsection id="id00924ae765f54533a3e289425ec90b93"><enum>(b)</enum><header>Report</header><text>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.</text></subsection></section><section id="iddeb167aba9b840e681bcee7055b7f1f3"><enum>211.</enum><header>International emergency operations</header><subsection id="id0ec0c76313dc47f3aa0c689bb82085e4"><enum>(a)</enum><header>Sense of Congress</header><text>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.</text></subsection><subsection id="id0b4d760fbd6f475783782e9bba892510"><enum>(b)</enum><header>Public health emergencies of international concern</header><text>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.</text></subsection><subsection id="idda24bcf9702c4c13b8ad901225d9cf8f"><enum>(c)</enum><header>Emergency operations</header><text>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—</text><paragraph id="id3f2431bf37dd4027886a986f4c366637"><enum>(1)</enum><text>to collect and share data, assess risk, and operationalize early warning;</text></paragraph><paragraph id="id70bf15c27984444ca32203bb39544239"><enum>(2)</enum><text>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</text></paragraph><paragraph id="ide2b106bb156e4bfa9e9ac7cd2ab96204" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>to organize and conduct emergency simulations. </text></paragraph></subsection></section><enum>III</enum><header>Financing mechanism for global health security and pandemic prevention and preparedness</header><section id="ide1326cfee07a48c58aaf638bcf52b7e4"><enum>301.</enum><header>Eligible partner country defined</header><text display-inline="no-display-inline">In this title, the term <term>eligible partner country</term> 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—</text><paragraph id="id0a0d65404e16426f8f1f0d88d2e7458d"><enum>(1)</enum><text>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</text></paragraph><paragraph id="iddcc482c75f064789b6f5b94ec1652eaf"><enum>(2)</enum><text>commitment to transparency, including—</text><subparagraph id="id458F07F3904443D9992F253A8B6F109A"><enum>(A)</enum><text>budget and global health data transparency;</text></subparagraph><subparagraph id="id16B0468EC33E4BD9B3BD8345125E21D1"><enum>(B)</enum><text>complying with the International Health Regulations (2005);</text></subparagraph><subparagraph id="idB72C47A3B7FA469F824DFF0727E14AAF"><enum>(C)</enum><text>investing in domestic health systems; and </text></subparagraph><subparagraph id="id0624F407E1BF401FA04032C8B8ACFF9F"><enum>(D)</enum><text>achieving measurable results.</text></subparagraph></paragraph></section><section id="id23816c6e74dc4411b1f75aa8886c6e13"><enum>302.</enum><header>Establishment of Fund for Global Health Security and Pandemic Prevention and Preparedness</header><subsection id="id0da0c62029e9450c9556a7b63890c3ea"><enum>(a)</enum><header>Negotiations for establishment of Fund for Global Health Security and Pandemic Prevention and Preparedness</header><text>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—</text><paragraph id="idb1409be4ed3e4fa786a11558f1ce7cf1"><enum>(1)</enum><text>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 <quote>the Fund</quote>), to address the need for and secure durable financing in accordance with the provisions of this section; and</text></paragraph><paragraph id="ideac69e5892114f3ebe7e6b1a5f473cb4"><enum>(2)</enum><text>an Advisory Board to the Fund in accordance with section 305.</text></paragraph></subsection><subsection id="idf47deb733b434096aa2cf1276d632e0a"><enum>(b)</enum><header>Purposes</header><text>The purposes of the Fund should be—</text><paragraph id="idCEFDADC271ED4EA4AE922312DD382F24"><enum>(1)</enum><text>to close critical gaps in global health security and pandemic prevention and preparedness; and </text></paragraph><paragraph id="id3F335B70010A4573BF1214760572738A"><enum>(2)</enum><text>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—</text><subparagraph id="id9ecb110f53b5414cb9164ee230dafacf"><enum>(A)</enum><text>prioritizes capacity building and financing availability in eligible partner countries;</text></subparagraph><subparagraph id="id0d5940f5791e496e9420e0aaca227780"><enum>(B)</enum><text>incentivizes countries to prioritize the use of domestic resources for global health security and pandemic prevention and preparedness;</text></subparagraph><subparagraph id="idaf3f96f6c6c344e09ac6a7065af15fd3"><enum>(C)</enum><text>leverages government, nongovernment, and private sector investments;</text></subparagraph><subparagraph id="id31dc3de809b94cd7b90f752175c65226"><enum>(D)</enum><text>regularly responds to and evaluates progress based on clear metrics and benchmarks, such as the Joint External Evaluation and the Global Health Security Index;</text></subparagraph><subparagraph id="id0b78ca9930bc4bd882bfa0b77e1004e0"><enum>(E)</enum><text>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</text></subparagraph><subparagraph id="id72f8cc6a09c0479ca8687ce34edf14a0"><enum>(F)</enum><text>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.</text></subparagraph></paragraph></subsection><subsection id="id7de650e747a4483aa1759f922c108591"><enum>(c)</enum><header>Executive Board</header><paragraph id="id1e8f87b8551d4327a83f882dda638257"><enum>(1)</enum><header>In general</header><text>The Fund should be governed by a transparent and accountable body (referred to in this title as the <quote>Executive Board</quote>), 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.</text></paragraph><paragraph id="idf80ad74f64914dfd91f4985e8f216ac5"><enum>(2)</enum><header>Duties</header><text>The Executive Board should—</text><subparagraph id="id337AFD64E0584F5CB011F2AD755EBE70"><enum>(A)</enum><text>be charged with approving strategies, operations, and grant making authorities in order to conduct effective fiduciary, monitoring, and evaluation efforts, and other oversight functions;</text></subparagraph><subparagraph id="ide12ac85cec094ae8a57cd848c245f6ad"><enum>(B)</enum><text>be comprised only of contributors to the Fund at not less than the minimum threshold to be established pursuant to paragraph (1);</text></subparagraph><subparagraph id="id6ee9900c8c47485eb815320ec13eb2fa"><enum>(C)</enum><text>determine operational procedures such that the Fund is able to effectively fulfill its mission; </text></subparagraph><subparagraph id="idb8e30f78189e4b25b5171630cb69f3b7"><enum>(D)</enum><text>provide oversight and accountability for the Fund in collaboration with the Inspector General to be established pursuant to section 304(e)(1)(A); and </text></subparagraph><subparagraph id="id6824E195AD57430EA4828A0D5E500667"><enum>(E)</enum><text>develop and utilize a mechanism to obtain formal input from partner countries relative to lessons learned with regard to program implementation. </text></subparagraph></paragraph><paragraph id="id389b54add26c4664b1229f2ab6069d90"><enum>(3)</enum><header>Composition</header><text>The Executive Board should include—</text><subparagraph id="id062ff19715f4487aaf053fe5d906ab95"><enum>(A)</enum><text>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);</text></subparagraph><subparagraph id="idc288dbbf4a58473d875d56630301057a"><enum>(B)</enum><text>a geographically diverse group of term members who—</text><clause id="id15490082923E452B8B174440832A6825"><enum>(i)</enum><text>come from academic institutions, civil society, including indigenous organizations, and the private sector; and </text></clause><clause id="idD60DABF28A82490384A012DB8AB91ACB"><enum>(ii)</enum><text>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; </text></clause></subparagraph><subparagraph id="idbeacad5270eb4156990ced9ec198030b"><enum>(C)</enum><text>representatives of the World Health Organization;</text></subparagraph><subparagraph id="id26BB94E443BC4C08BD389958C1A2FE70"><enum>(D)</enum><text>the chair of the Global Health Security Steering Group; and</text></subparagraph><subparagraph id="id2D373135C39A4792BB532A4DD67CBBA5"><enum>(E)</enum><text>representatives from low- and middle-income countries that are or will be implementing a national pandemic prevention plan.</text></subparagraph></paragraph><paragraph id="id5ddd98e295854a1faf2abd285e10f244"><enum>(4)</enum><header>Qualifications</header><text>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.</text></paragraph><paragraph id="idb5cb058138a04d6c9ec20fc1037df8f6"><enum>(5)</enum><header>Conflicts of interest</header><subparagraph id="idd8947b17fe6d4916aa11bc2a55b850f9"><enum>(A)</enum><header>Technical experts</header><text>The Executive Board may include independent technical experts who are not affiliated with, or employed by, a recipient country or organization.</text></subparagraph><subparagraph id="id2920dd2b12124afdafc33ced1857ac0d"><enum>(B)</enum><header>Multilateral bodies and institutions</header><text>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.</text></subparagraph></paragraph><paragraph id="idcb6149e6d11e4ba1a74138d647fd5a2f"><enum>(6)</enum><header>United states representation</header><subparagraph id="id054bd6981f0b436681fcfa2684f3f326" commented="no"><enum>(A)</enum><header>Founding permanent member</header><text>The Secretary of State should seek—</text><clause commented="no" id="id24AB3BB77C3F448DBCA1B220C55FA2C1"><enum>(i)</enum><text>to establish the United States as a founding permanent member of the Fund; and </text></clause><clause commented="no" id="idC780B18790354E0FB9B00CBB3FEBA1EA"><enum>(ii)</enum><text>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.</text></clause></subparagraph><subparagraph id="idCFD992928D644B36A44EE7D5A455BB21"><enum>(B)</enum><header>Effective and termination dates</header><clause id="idf1c998576a1e47349c179d7213b92167"><enum>(i)</enum><header>Effective date</header><text>This paragraph shall take effect upon the date on which the Secretary of State certifies and submits to Congress an agreement establishing the Fund.</text></clause><clause id="ide2ddfde18a0c4878a6f83a5b4c87f8f0"><enum>(ii)</enum><header>Termination date</header><text>The membership established pursuant to subparagraph (A) shall terminate upon the date of termination of the Fund.</text></clause></subparagraph></paragraph><paragraph id="id8cb3dcb1a335487e8c17f37b00ee3491"><enum>(7)</enum><header>Removal procedures</header><text>The Fund should establish procedures for the removal of members of the Executive Board who—</text><subparagraph id="idD9E58DA181A64082A1763879DBC99914"><enum>(A)</enum><text>engage in a consistent pattern of human rights abuses;</text></subparagraph><subparagraph id="id5EB88EA3277049E2AFAB3B2F22391A80"><enum>(B)</enum><text>fail to uphold global health data transparency requirements; or </text></subparagraph><subparagraph id="id58399324817D4B66872F138F030BB22D"><enum>(C)</enum><text>otherwise violate the established standards of the Fund, including in relation to corruption.</text></subparagraph></paragraph></subsection></section><section id="id3c3b6942df9d4f25918d11f814993e52"><enum>303.</enum><header>Authorities</header><subsection id="id0b9d444c7ee6435c96a824c61403c71c"><enum>(a)</enum><header>Program objectives</header><paragraph id="id6066ea892df346bc94cf71087a2c0daf"><enum>(1)</enum><header>In general</header><text>In carrying out the purpose set forth in section 302, the Fund, acting through the Executive Board, should— </text><subparagraph id="idBC9E6FC7BBA7474E8FE545E69B76CAA3"><enum>(A)</enum><text>provide grants, including challenge grants, technical assistance, concessional lending, catalytic investment funds, and other innovative funding mechanisms, as appropriate—</text><clause id="ida82b089922a84258b73d2057b98196c1"><enum>(i)</enum><text>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</text></clause><clause id="id1eb2ea4a2717411bbeaabca9273e39e4"><enum>(ii)</enum><text>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 </text></clause></subparagraph><subparagraph id="id44630F9395504DC3BE49BF74AC5D8BFB"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id1b7cc184836d4c5c841a47a9b1880169"><enum>(2)</enum><header>Activities supported</header><text>The activities to be supported by the Fund should include efforts—</text><subparagraph id="id0b3949f72cc248b3827d70ba5759a1d2"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id2842af6811b84f77bdc0fbe8ba2f3011"><enum>(B)</enum><text>to support health security budget planning in eligible partner countries, including training in public financial management and budget and health data transparency;</text></subparagraph><subparagraph id="iddc05c661845140288781971b2de65b76"><enum>(C)</enum><text>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;</text></subparagraph><subparagraph id="id96b95d3b024f4d5b8a2f40b4ed7acc17"><enum>(D)</enum><text>to improve infection prevention and control and the protection of healthcare workers within healthcare settings;</text></subparagraph><subparagraph id="ida05d31a9022f4b2589dbe81c0e685639"><enum>(E)</enum><text>to combat the threat of antimicrobial resistance;</text></subparagraph><subparagraph id="idf00a8b579cba427bae369d25165958e9"><enum>(F)</enum><text>to strengthen laboratory capacity and promote biosafety and biosecurity through the provision of material and technical assistance;</text></subparagraph><subparagraph id="id47a9a8ff2b1f471ca569197ef0258170"><enum>(G)</enum><text>to reduce the risk of bioterrorism, zoonotic disease spillover, and accidental biological release;</text></subparagraph><subparagraph id="idcfd4cc7bc072483888f1de78d4fde3e5"><enum>(H)</enum><text>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;</text></subparagraph><subparagraph id="id4f57259d28944d62a17533c7d0193172"><enum>(I)</enum><text>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;</text></subparagraph><subparagraph id="id3dfea4c79ff348969eecec8d9b083803"><enum>(J)</enum><text>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;</text></subparagraph><subparagraph id="idb5411c0759aa45fb883f283333dc55ab"><enum>(K)</enum><text>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;</text></subparagraph><subparagraph id="id2401135f74f04c87855477fec6b04492"><enum>(L)</enum><text>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;</text></subparagraph><subparagraph id="ide62430ae416e4216a1f90177b18c424c"><enum>(M)</enum><text>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; </text></subparagraph><subparagraph id="idcedaa236d1e64b6c91b8b065c63dc3f3"><enum>(N)</enum><text>to develop and implement simulation exercises, produce and release after action reports, and address related gaps; </text></subparagraph><subparagraph id="idC08898BCB02140C294E629E7075186D1"><enum>(O)</enum><text>to support countries in conducting Joint External Evaluations; and</text></subparagraph><subparagraph id="idD03C0EBE8FD34A9F8928C521C01AC777"><enum>(P)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id9b74e2223ba54614a94d7e05aa14bdc2"><enum>(3)</enum><header>Implementation of program objectives</header><text>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—</text><subparagraph id="id894d729def144c8f80d97bf3047e5d59"><enum>(A)</enum><text>governments, civil society, nongovernmental organizations, research and academic institutions, and private sector entities in eligible partner countries;</text></subparagraph><subparagraph id="id209ffc9366ee4ece88eb92a4a365c233"><enum>(B)</enum><text>the pandemic early warning systems and international emergency operations centers to be established under sections 210 and 211;</text></subparagraph><subparagraph id="idc8c3760aaf2444eda22fee439afe916b"><enum>(C)</enum><text>the World Health Organization;</text></subparagraph><subparagraph id="id269309ecf652430ab27885e9fb518ca5"><enum>(D)</enum><text>the Global Health Security Agenda;</text></subparagraph><subparagraph id="id1b51a8d1424b418380c49837e18d4807"><enum>(E)</enum><text>the Global Health Security Initiative;</text></subparagraph><subparagraph id="id6c2cc44551d84dfc8e2909636267bd5a"><enum>(F)</enum><text>the Global Fund to Fight AIDS, Tuberculosis, and Malaria;</text></subparagraph><subparagraph id="ideb770df4cb8444408503fe2ba92aa1b6"><enum>(G)</enum><text>the United Nations Office for the Coordination of Humanitarian Affairs, UNICEF, and other relevant funds, programs, and specialized agencies of the United Nations;</text></subparagraph><subparagraph id="id215f36135a32490494e1cf4b6e79d389"><enum>(H)</enum><text>Gavi, the Vaccine Alliance;</text></subparagraph><subparagraph id="id725e66a8934042e99fdba6121380021c"><enum>(I)</enum><text>the Coalition for Epidemic Preparedness Innovations (CEPI); and</text></subparagraph><subparagraph id="idb4e5535d86f5441f9f044a523b1a01fa"><enum>(J)</enum><text>the Global Polio Eradication Initiative.</text></subparagraph></paragraph></subsection><subsection id="id7388dcca599a4cf593e2d60ccf991822"><enum>(b)</enum><header>Priority</header><text>In providing assistance under this section, the Fund should give priority to low-and lower middle income countries with—</text><paragraph id="id8a360dc3f7d6454aadf0c48b12097c63"><enum>(1)</enum><text>low scores on the Global Health Security Index classification of health systems;</text></paragraph><paragraph id="idfa4c91342eda4886bbc44ab5bad7c893"><enum>(2)</enum><text>measurable gaps in global health security and pandemic prevention and preparedness identified under Joint External Evaluations and national action plans for health security;</text></paragraph><paragraph id="id98f6f838331645469782d05bf0c078ce"><enum>(3)</enum><text>demonstrated political and financial commitment to pandemic prevention and preparedness; and</text></paragraph><paragraph id="ideae883b5b49d4b27a63bcbd911597892"><enum>(4)</enum><text>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.</text></paragraph></subsection><subsection id="id3d4970e1a8cb455ba4539aee98589841"><enum>(c)</enum><header>Eligible grant recipients</header><text>Governments and nongovernmental organizations should be eligible to receive grants as described in this section.</text></subsection></section><section id="id2f6a084e72e944d18ae31a5728a9e375"><enum>304.</enum><header>Administration</header><subsection id="ided940215468544de9bb4bcce86db233a"><enum>(a)</enum><header>Appointment of Administrator</header><text>The Executive Board should appoint an Administrator, who should be responsible for managing the day-to-day operations of the Fund.</text></subsection><subsection id="id81de35bfb9d84922ace9c4dce12d2fb9"><enum>(b)</enum><header>Authority To accept and solicit contributions</header><text>The Fund should be authorized to solicit and accept contributions from governments, the private sector, foundations, individuals, and nongovernmental entities.</text></subsection><subsection id="id82dda070df6b4e51b8d35550b9efcbfc"><enum>(c)</enum><header>Accountability of funds and criteria for programs</header><text>As part of the negotiations described in section 302(a), the Secretary of the State, consistent with subsection (d), shall—</text><paragraph id="id33a0af1f05314157a00be6d55763693a"><enum>(1)</enum><text>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</text></paragraph><paragraph id="id26b156d604d742bfa96a4c177481e811"><enum>(2)</enum><text>seek agreement on the criteria that should be used to determine the programs and activities that should be assisted by the Fund.</text></paragraph></subsection><subsection id="idf5c3272c2b2243b98fc28a4be78082a4"><enum>(d)</enum><header>Selection of partner countries, projects, and recipients</header><text>The Executive Board should establish—</text><paragraph id="idc09834180b864a9a8fe451d308f5e5e7"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="ided62fb816abf48ff91224c2ba22419f7"><enum>(2)</enum><text>minimum standards for ensuring eligible partner country ownership and commitment to long-term results, including requirements for domestic budgeting, resource mobilization, and co-investment;</text></paragraph><paragraph id="ide25342d99ed942d3a779b76d2ada638d"><enum>(3)</enum><text>criteria for the selection of projects to receive support from the Fund;</text></paragraph><paragraph id="ida9740324e90146e7a997ce16815cc290"><enum>(4)</enum><text>standards and criteria regarding qualifications of recipients of such support;</text></paragraph><paragraph id="ida85bdd9ba4a44d58979adabb416f7c00"><enum>(5)</enum><text>such rules and procedures as may be necessary for cost-effective management of the Fund; and</text></paragraph><paragraph id="id332ab0e8c4d240d5880e41cba6cd16ab"><enum>(6)</enum><text>such rules and procedures as may be necessary to ensure transparency and accountability in the grant-making process.</text></paragraph></subsection><subsection id="id3285f41194e641f39c8b10d6acbd8cb2"><enum>(e)</enum><header>Additional transparency and accountability requirements</header><paragraph id="id1805b7608cf34150b6250477700e999a"><enum>(1)</enum><header>Inspector general</header><subparagraph id="idf151008e9b9d46bb9337fbcc814743a0"><enum>(A)</enum><header>In general</header><text>The Secretary of State shall seek to ensure that—</text><clause id="id158B3EDFECA14228A073D4304A0101B0"><enum>(i)</enum><text>the Fund maintains an independent Office of the Inspector General; and</text></clause><clause id="id4E9C887804C247CC899D5AFE40111218"><enum>(ii)</enum><text>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.</text></clause></subparagraph><subparagraph id="id91f5808f895a42c18f9469a027194426"><enum>(B)</enum><header>Sense of congress on corruption</header><text>It is the sense of Congress that—</text><clause id="id9d84e77f5ae94bf59033cccd41799a00"><enum>(i)</enum><text>corruption within global health programs contribute directly to the loss of human life and cannot be tolerated; and</text></clause><clause id="id2adb93eed2c84e8081886b381e56ef39"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><paragraph id="id38b5e093c9b54ddc835af79753edf851"><enum>(2)</enum><header>Administrative expenses</header><text>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.</text></paragraph><paragraph id="iddbe68c4f645e4ae6933a871ca0f50a71"><enum>(3)</enum><header>Financial tracking systems</header><text>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.</text></paragraph><paragraph id="id1a0956fb49d74c57a920a2dc63c7691f"><enum>(4)</enum><header>Exemption from duties and taxes</header><text>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.</text></paragraph></subsection></section><section id="id121d50c3aece48d6a1b59fdde9d91061"><enum>305.</enum><header>Advisory Board</header><subsection id="id59e2979204cd4ff885875c53fecf009e"><enum>(a)</enum><header>In general</header><text>There should be an Advisory Board to the Fund.</text></subsection><subsection id="id0baa1d49c4dc4626ac708dcf1b53ed33"><enum>(b)</enum><header>Appointments</header><text>The members of the Advisory Board should be composed of—</text><paragraph id="id627F16D36ADC47BA9B177471C807B623"><enum>(1)</enum><text>a geographically diverse group of individuals that includes representation from low- and middle-income countries;</text></paragraph><paragraph id="idd92dfd3fead04d098304764bbbac6d4b"><enum>(2)</enum><text>individuals with experience and leadership in the fields of development, global health, epidemiology, medicine, biomedical research, and social sciences; and</text></paragraph><paragraph id="ide7c61ea576b14f48a18076b6d5fe3b2c"><enum>(3)</enum><text>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.</text></paragraph></subsection><subsection id="idcb3388e0882844ff8e66d189d72edb0c"><enum>(c)</enum><header>Responsibilities</header><text>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.</text></subsection><subsection id="id75b60b96fa3646f08c66d487378ffc76"><enum>(d)</enum><header>Prohibition on payment of compensation</header><paragraph id="id484b960b7607410cb4957417372c44b4"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="ide83e36c16b694cdbb1585fa0d1f92c83"><enum>(2)</enum><header>United states representative</header><text>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.</text></paragraph></subsection><subsection id="id06725656741740d08988b2ecd41e2606"><enum>(e)</enum><header>Conflicts of interest</header><text>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.</text></subsection></section><section id="id7208e9f6443847f8ae27662046f45c4f"><enum>306.</enum><header>Reports to Congress</header><subsection id="id01ec85ce812242f296a2ef7a8d397cf9"><enum>(a)</enum><header>Status report</header><text>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.</text></subsection><subsection id="idad5a0ca3c0f149c0b1efe004e0dd9135"><enum>(b)</enum><header>Annual report</header><paragraph id="idb0a485d6091549f4845b0240abc69762"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="id8721fa16203f4b89a9b9d102a4250b8f"><enum>(2)</enum><header>Report elements</header><text>The report required under paragraph (1) shall describe—</text><subparagraph id="id30722819d8f244a9ab228aecff9067ca"><enum>(A)</enum><text>the goals of the Fund;</text></subparagraph><subparagraph id="id92cac28e5ece4175aaee3e2c717a9f3c"><enum>(B)</enum><text>the programs, projects, and activities supported by the Fund;</text></subparagraph><subparagraph id="id58ca15887848416bae85f290ee5529fa"><enum>(C)</enum><text>private and governmental contributions to the Fund; and</text></subparagraph><subparagraph id="ide5405da8c5ee4e9a92c547a3e061dcf2"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection><subsection id="idf5d13666419b40e39efb1530e9ef4cfb" commented="no"><enum>(c)</enum><header>GAO report on effectiveness</header><text>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). </text></subsection></section><section id="id9b4e5d2603cc4489b91e43373f74e8d8"><enum>307.</enum><header>United States contributions</header><subsection id="id36725bb55491465aa6f7f0d946c1c3aa"><enum>(a)</enum><header>In general</header><text>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.</text></subsection><subsection id="id2746508bb4fd4ad8a0cecd14a32a4e5c"><enum>(b)</enum><header>Notification</header><text>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—</text><paragraph id="id7a3af2defce84744a92cd5d0de239921"><enum>(1)</enum><text>the amount of the proposed contribution;</text></paragraph><paragraph id="id752bf6eb65aa40759f11b714b5c5ab09"><enum>(2)</enum><text>the total of funds contributed by other donors; and</text></paragraph><paragraph id="idab814668232049bd86682730937882ea"><enum>(3)</enum><text>the national interests served by United States participation in the Fund.</text></paragraph></subsection><subsection id="id97eff813a339442da56c780c61002028"><enum>(c)</enum><header>Limitation</header><text>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.</text></subsection><subsection id="id043dbee4751b454d8e92b0d0fb51f956"><enum>(d)</enum><header>Withholdings</header><paragraph id="idb8fff5a1f3944c4d936566e3a5207a20"><enum>(1)</enum><header>Support for acts of international terrorism</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/2371">22 U.S.C. 2371</external-xref>) 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.</text></paragraph><paragraph id="ide1fad8f6c6494d9e8c25b664f0591900"><enum>(2)</enum><header>Excessive salaries</header><text>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.</text></paragraph><paragraph id="id6f0cc86ebc814016b05c996261367331"><enum>(3)</enum><header>Accountability certification requirement</header><text>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).</text></paragraph></subsection></section><section id="ida1c1d82ddbc5468fb1850279106f4c92"><enum>308.</enum><header>Compliance with the Foreign Aid Transparency and Accountability Act of 2016</header><text display-inline="no-display-inline">Section 2(3) of the Foreign Aid Transparency and Accountability Act of 2016 (<external-xref legal-doc="public-law" parsable-cite="pl/114/191">Public Law 114–191</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/22/2394c">22 U.S.C. 2394c</external-xref> note) is amended—</text><paragraph id="id13336357cb514f0fa78575d02ae060a4"><enum>(1)</enum><text>in subparagraph (D), by striking <quote>and</quote> at the end;</text></paragraph><paragraph id="id068ad9fa2f2b4d9eb0ad643191fa76c7" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text>in subparagraph (E), by striking the period at the end and inserting <quote>; and</quote>; and </text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id9526CE9F302345389255C5066F94481A"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idE4BE5DA55C55476E90AE8C40E56474FE" changed="deleted" reported-display-style="strikethrough" committee-id="SSFR00"><subparagraph commented="no" display-inline="no-display-inline" id="id8D7F117D57694CB09C6FACB1036B1DEC"><enum>(F)</enum><text>the <short-title>International Pandemic Preparedness and COVID–19 Response Act of 2021</short-title>.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>1.Short title; table of contents(a)This Act may be cited as the International Pandemic Preparedness and COVID-19 Response Act of 2021
.(b)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 pandemicsSec. 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 preparednessSec. 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 preparednessSec. 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.2.In this Act:(1)Appropriate congressional committeesThe 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; GHSAThe 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 initiativeThe 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 evaluationThe 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)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)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 agenciesThe 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)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)The term USAID means the United States Agency for International Development.3.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.<enum>I</enum><header>Enhancing the United States’ international response to COVID–19 and future pandemics</header><section id="idf0a1219e-d85e-4d2e-8154-715899e4654c"><enum>101.</enum><header>Statement of policy regarding international cooperation to end the COVID–19 pandemic</header><text display-inline="no-display-inline">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— </text><paragraph id="idb34af056-c0ed-452e-8f7b-99b061d42d9e"><enum>(1)</enum><text>seeking adoption of a United Nations Security Council resolution that—</text><subparagraph id="idcdd282bb-5bb5-442e-9e10-f2ba27e0362b"><enum>(A)</enum><text>declares pandemics, including the COVID–19 pandemic, to be a threat to international peace and security; and</text></subparagraph><subparagraph id="id13b66186-1ef7-4958-8e69-5054670d2147"><enum>(B)</enum><text>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;</text></subparagraph></paragraph><paragraph id="id39529158-bca2-4f12-8cf5-5abab3ae7719"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="id7c791b3d-886a-4ce0-b5c8-d31ce91684cd"><enum>(3)</enum><text>providing timely, appropriate levels of financial support to United Nations agencies responding to the COVID–19 pandemic;</text></paragraph><paragraph id="idd11c3516-9c4c-4a43-b569-08e616b2af04"><enum>(4)</enum><text>prioritizing United States foreign assistance for the COVID–19 response in the most vulnerable countries and regions;</text></paragraph><paragraph id="id1fe3df69-0c15-4d5b-b2f4-cb170f2fcfc9"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="id139a0b76-63da-4974-abc4-db729fa4c357"><enum>(6)</enum><text>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—</text><subparagraph id="id39518581-fc35-44ee-a971-0fa9694fa4c7"><enum>(A)</enum><text>at least 40 percent of the population in all countries is vaccinated by the end of 2021; and</text></subparagraph><subparagraph id="idc5cf2cc6-4d8f-4e69-b6e4-645ae1e7d4fe"><enum>(B)</enum><text>at least 60 percent of the population in all countries is vaccinated by the first half of 2022;</text></subparagraph></paragraph><paragraph id="idc4f09245-7229-47f1-bf95-aca0cb25642f"><enum>(7)</enum><text>engaging with key stakeholders, including through multilateral facilities such as the COVID–19 Vaccines Global Access initiative (referred to in this title as <quote>COVAX</quote>) 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—</text><subparagraph id="idf5626338-dc48-4678-93d9-c03629777bbe"><enum>(A)</enum><text>vaccines and related raw materials to meet or exceed the vaccination goals under paragraph (6); and</text></subparagraph><subparagraph id="ide03bb363-0861-4fc6-b12e-1bd9220cabae"><enum>(B)</enum><text>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;</text></subparagraph></paragraph><paragraph id="iddc164916-4c0c-48aa-b63e-60eea1399713"><enum>(8)</enum><text>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;</text></paragraph><paragraph id="id325bcb3d-e468-418e-ba97-b43176401314"><enum>(9)</enum><text>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;</text></paragraph><paragraph id="id2ada834af4834d528063772677e09c80"><enum>(10)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/50/4501">50 U.S.C. 4501 et seq.</external-xref>) and <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/35/18">chapter 18</external-xref> of title 35, United States Code (commonly referred to as the <quote>Bayh-Dole Act</quote>); </text></paragraph><paragraph id="idacb8e37f-5394-428a-844d-c51edcee144d"><enum>(11)</enum><text>establishing clear timelines, benchmarks, and goals for COVID–19 response strategies and activities under this section; and</text></paragraph><paragraph id="id59c8f983-9d05-43f5-bd18-eb7f119f69d5"><enum>(12)</enum><text>generating commitments of resources in support of the goals referred to in paragraph (6). </text></paragraph></section><section id="idc1493693-1d59-4ea6-80ca-47c9556b499f"><enum>102.</enum><header>Oversight of United States foreign assistance to end the COVID–19 pandemic</header><subsection id="id94f29d03-f6f6-40ed-b675-079855e55297"><enum>(a)</enum><header>Reporting requirements</header><text>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—</text><paragraph id="idb92d4cd4-f64b-4ef0-a025-6823982e26a9"><enum>(1)</enum><text>an unclassified report containing a description of funds already obligated and expended under title X of the <short-title>American Rescue Plan Act of 2021</short-title> (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>); and</text></paragraph><paragraph id="id7383dffa-4b16-44a1-9706-e5b40a5809fe"><enum>(2)</enum><text>a plan that describes the objectives and timeline for the obligation and expenditure of all remaining funds appropriated under title X of the <short-title>American Rescue Plan Act of 2021</short-title>, 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. </text></paragraph></subsection><subsection id="id122842ef-0e16-41c7-8c5b-4eee0484afcf"><enum>(b)</enum><header>Congressional consultation</header><text>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).</text></subsection><subsection id="id2b4f9ff5-e1c2-49b6-9566-1ca16f9481c2"><enum>(c)</enum><header>Branding</header><text>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.</text></subsection></section><section id="id41e39c97-7642-42d1-8723-a09c938f7da0"><enum>103.</enum><header>United States contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria COVID–19 response mechanism</header><subsection id="id215be1ac-ac71-42c9-8393-a8b176249fa7"><enum>(a)</enum><header>United States contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria COVID–19 response mechanism</header><text>United States contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria COVID–19 Response Mechanism under section 10003(a)(2) of the <short-title>American Rescue Plan Act of 2021</short-title> (<external-xref legal-doc="public-law" parsable-cite="pl/107/2">Public Law 107–2</external-xref>)—</text><paragraph id="id19ced524-b721-4e5f-bb20-2573289ae028"><enum>(1)</enum><text>shall be meaningfully leveraged in a manner that incentivizes other public and private donor contributions; and</text></paragraph><paragraph id="id861adbe5-0546-4370-a4d7-f7ed48edefa2"><enum>(2)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/7622">22 U.S.C. 7622</external-xref>). </text></paragraph></subsection></section><section id="id8e353d02-bd51-49c8-b10a-d36a5cf12852"><enum>104.</enum><header>Global COVID–19 vaccine distribution and delivery</header><subsection id="id99629b45-5924-4050-a9f9-307be840b31d"><enum>(a)</enum><header>Accelerating global vaccine distribution strategy</header><text>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—</text><paragraph id="id7dbc773e-9b65-4199-8257-eed7b025996b"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id14724216-37a7-4a9c-a49b-e82d74ef1c99"><enum>(2)</enum><text>identify which countries and regions will be prioritized and targeted for COVID–19 vaccine delivery, and the rationale for such prioritization;</text></paragraph><paragraph id="id1bf08a2d-4d12-43ad-8708-64fe100af8b5"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="idcf64c13f-fb46-4d79-adab-a20f276d9dd0"><enum>(4)</enum><text>describe efforts to encourage international partners to take actions similar to the efforts referred to in paragraph (3);</text></paragraph><paragraph id="idbca310fa-1fc2-48a8-93c7-d0fb354989c3"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="idf01d33dfe1ac46ad8f02b104d9e4ea8d"><enum>(6)</enum><text>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—</text><subparagraph id="iddc8e80bd5713454da9482a10d61f29d1"><enum>(A)</enum><text>countries in which United States citizens are deemed ineligible or low priority in the national vaccination deployment plan; and</text></subparagraph><subparagraph id="idf93b1595ff124064b97df0d353d29eb8"><enum>(B)</enum><text>countries that are not presently distributing a COVID–19 vaccine that—</text><clause id="id1b781da6233a49c29d2bdb28f0ede55c"><enum>(i)</enum><text>has been approved by the United States Food and Drug Administration for emergency use; or</text></clause><clause id="idfd8ad69b27e54f70aa31219c0facad07"><enum>(ii)</enum><text>has met the necessary criteria for safety and efficacy established by the World Health Organization;</text></clause></subparagraph></paragraph><paragraph id="ide15d77488e924476ab2e8d02e0c43314"><enum>(7)</enum><text>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; </text></paragraph><paragraph id="id0c09a2ca-7e82-4e2e-8172-3d861823c883"><enum>(8)</enum><text>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;</text></paragraph><paragraph id="idf36cb91a4b3d47b5b337fef9ec67cf9f"><enum>(9)</enum><text>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;</text></paragraph><paragraph id="id323e6a30-f639-4dd5-a528-e1c48d390ad2"><enum>(10)</enum><text>summarize the United States public diplomacy strategies for branding and addressing vaccine misinformation and hesitancy; and</text></paragraph><paragraph id="id736bb91df805424c869523420b88df76"><enum>(11)</enum><text>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.</text></paragraph></subsection><subsection id="id0ce05d8d-cfa5-448f-8c20-d73ab7f8b5c4"><enum>(b)</enum><header>Submission of strategy</header><text>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—</text><paragraph id="id28BA2F031117451F927E081C445E590D"><enum>(1)</enum><text>the appropriate congressional committees; </text></paragraph><paragraph id="idDAEE82495E0E45F19071D13CFB5F1F66"><enum>(2)</enum><text>the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions of the Senate</committee-name>; and</text></paragraph><paragraph id="id1EAE7D6CBD42405D9C40A57A6A7FB4AE"><enum>(3)</enum><text>the <committee-name committee-id="">Committee on Energy and Commerce of the House of Representatives</committee-name>.</text></paragraph></subsection><subsection id="id7357bc8941784a598e51a0c40f46cb4d"><enum>(c)</enum><header>Limitation</header><paragraph id="idE967761FFA024A24807B879C11DB2484"><enum>(1)</enum><header>In general</header><text>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—</text><subparagraph id="id91979B569D3A4082B9E8F310643ABDA1"><enum>(A)</enum><text>is providing financial support to COVAX that is commensurate with the United States’ contribution to COVAX; and </text></subparagraph><subparagraph id="id364B27B6EA8245BAAA6A750FD832B4BA"><enum>(B)</enum><text>publically discloses transparent data on the quality, safety, and efficacy of its COVID–19 vaccines. </text></subparagraph></paragraph><paragraph id="idCFBF53C7ECB044E39C931BF1D39C2B01"><enum>(2)</enum><header>Safeguards</header><text>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. </text></paragraph></subsection></section><section id="ide52231a6-08f3-45d2-8a29-0d8de2ff2e56"><enum>105.</enum><header>Leveraging United States bilateral global health programs for the international COVID–19 response</header><subsection id="id4b5ff60e-19cd-44e4-b1e3-bd21825aacc7"><enum>(a)</enum><header>Authorization for leveraging bilateral program activities</header><text>Amounts authorized to be appropriated or otherwise made available to carry out section 104 of the Foreign Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b">22 U.S.C. 2151b</external-xref>) may be used in countries receiving United States foreign assistance—</text><paragraph id="ida700aa9f-08ed-42c0-b0a5-151037b17331"><enum>(1)</enum><text>to combat the COVID–19 pandemic, including through the sharing of COVID–19 vaccines; and </text></paragraph><paragraph id="ide0136a89-6ac6-426b-9875-24eee3697bf8"><enum>(2)</enum><text>to support related activities, including—</text><subparagraph id="id45cd5ce1-3e1b-4402-84d4-ae5892c8b3f3"><enum>(A)</enum><text>strengthening vaccine readiness;</text></subparagraph><subparagraph id="iddba645b2-59fa-4072-a823-fd91d33df349"><enum>(B)</enum><text>reducing vaccine hesitancy and misinformation;</text></subparagraph><subparagraph id="id29e8f569-5902-4c1f-b42b-33109e576120"><enum>(C)</enum><text>delivering and administering COVID–19 vaccines;</text></subparagraph><subparagraph id="id2d96bc02-2a38-4eaa-8fd2-afbaf3f85934"><enum>(D)</enum><text>strengthening health systems and supply chains;</text></subparagraph><subparagraph id="id4216bf6e-c54d-4c3c-86ff-f6a87cfac2e6"><enum>(E)</enum><text>supporting health care workforce planning, training, and management;</text></subparagraph><subparagraph id="idc8e5eaa3-1038-433a-b502-00a3c7be5d15"><enum>(F)</enum><text>enhancing transparency, quality, and reliability of health data;</text></subparagraph><subparagraph id="ide0cdf05b-90d1-4838-b1d0-b8a413c3f9e5"><enum>(G)</enum><text>increasing bidirectional testing, including screening for symptomatic and asymptomatic cases; and</text></subparagraph><subparagraph id="id6290027a-794c-446b-b286-260fff52436b"><enum>(H)</enum><text>building lab capacity.</text></subparagraph></paragraph></subsection><subsection id="idcda8e9a4-4b1a-42df-9e61-3fb64191d377"><enum>(b)</enum><header>Adjustment of targets and goals</header><text>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—</text><paragraph id="id13e1f522-389d-468c-a12a-5d1a4c6196a8"><enum>(1)</enum><text>any adjustments to original program targets and goals that result from the use of funds for the purposes authorized under subsection (a); and</text></paragraph><paragraph id="id4774304e-50b2-4dc6-b563-a0ee7ad08397"><enum>(2)</enum><text>the amounts needed in the following fiscal year to meet the original program goals, as necessary and appropriate.</text></paragraph></subsection></section><section id="id929e5135-6f20-4d35-9bd8-835063e39bb2"><enum>106.</enum><header>Report on humanitarian response to the COVID–19 pandemic</header><subsection id="iddf3d4a34-b89d-4b3a-8682-73c145ece8b7"><enum>(a)</enum><header>In general</header><text>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—</text><paragraph id="idcd7742c2-b22f-4274-bbe6-6b5f12c8dc36"><enum>(1)</enum><text>assesses the global humanitarian response to COVID–19; and</text></paragraph><paragraph id="id18b3d25b-474d-40d9-a963-d9ba53ae6384"><enum>(2)</enum><text>outlines specific elements of the United States Government’s country-level humanitarian response to the COVID–19 pandemic.</text></paragraph></subsection><subsection id="idc291c3d4-673c-4b67-b2fb-046d7cc933b4"><enum>(b)</enum><header>Elements</header><text>The report required under subsection (a) shall include—</text><paragraph id="idc4b75b3d-cc92-4775-bcd3-f27fc954e448"><enum>(1)</enum><text>for countries receiving United States assistance, a description of humanitarian and health-worker access to crisis-affected areas, including—</text><subparagraph id="idd785a5bb-5fa5-4566-9d2c-bbcd9bc21102"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id86fe9b3d-0c02-461f-8608-cab6f2596d05"><enum>(B)</enum><text>restrictions on travel by humanitarian workers within such country to reach the areas of operation where vulnerable and marginalized populations reside;</text></subparagraph><subparagraph id="id251aef99-d758-41d7-83a2-9f8848eb7fba"><enum>(C)</enum><text>access to medical evacuation in the event of a health emergency;</text></subparagraph><subparagraph id="ide922c489-84e6-486d-97cd-f754f8f20152"><enum>(D)</enum><text>access to personal protective equipment for United States Government implementing partners; and</text></subparagraph><subparagraph id="id86b557ca-da00-4d35-9653-6844cab0ba5e"><enum>(E)</enum><text>efforts to support access to COVID–19 vaccines for humanitarian and health-workers and crisis-affected communities;</text></subparagraph></paragraph><paragraph id="id548ab0c2-ce4c-4962-b4a2-3ed3f4e775db"><enum>(2)</enum><text>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—</text><subparagraph id="id5c6db8e0-0d1f-420f-b6ef-f7181fb71454"><enum>(A)</enum><text>the omission of vulnerable populations from national response plans;</text></subparagraph><subparagraph id="id2ce40046-bfde-4db0-8462-2dc0d7ab3124"><enum>(B)</enum><text>laws, policies, or practices that restrict or preclude treatment of vulnerable populations at public hospitals and health facilities; and</text></subparagraph><subparagraph id="id539a021a-62c9-4015-bacd-7b70258fdf17"><enum>(C)</enum><text>exclusion of, or discrimination against, vulnerable populations in law, policy, or practice that prevents equitable access to food, shelter, and other basic assistance;</text></subparagraph></paragraph><paragraph id="id4c764140-a189-4fe0-95a7-4b43aaa4a96b"><enum>(3)</enum><text>a description of United States Government efforts to facilitate greater humanitarian access, including—</text><subparagraph id="id8141dd5c-e927-45d1-b807-0849fb4e23b9"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="id8137fe0a-ad01-4791-a1bb-df34f3b26a26"><enum>(B)</enum><text>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</text></subparagraph></paragraph><paragraph id="ide16a79dd-179e-428a-863b-7031e18fa498"><enum>(4)</enum><text>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—</text><subparagraph id="ide012e12c-49e6-43ae-989e-9879abd72eb9"><enum>(A)</enum><text>famine and acute food insecurity;</text></subparagraph><subparagraph id="id934cd0be-2213-41e6-9e76-63edeb00ca00"><enum>(B)</enum><text>gender-based violence;</text></subparagraph><subparagraph id="ida5ec182d-7211-4345-8708-5faf65bf84cb"><enum>(C)</enum><text>mental health and psychosocial support needs;</text></subparagraph><subparagraph id="id5e82bdb9-c305-4ea8-8468-4a4344a0b674"><enum>(D)</enum><text>child protection needs;</text></subparagraph><subparagraph id="id66385822-9c79-4a4b-a179-7671083d0d9f"><enum>(E)</enum><text>health, education, and livelihoods;</text></subparagraph><subparagraph id="id55235cfc-6ae8-4771-ba83-3a0318d3970f"><enum>(F)</enum><text>shelter; and</text></subparagraph><subparagraph id="iddf5e0e23-cc5a-48b5-915e-b53607d11ab5"><enum>(G)</enum><text>attempts to close civil society space, including through bureaucratic, administrative, and health or security related impediments. </text></subparagraph></paragraph></subsection></section><section id="id0e6aea75-a33d-4724-ba41-6b1615d115f8"><enum>107.</enum><header>Safeguarding democracy and human rights during the COVID–19 pandemic</header><subsection id="idea588019-bb23-40f0-81d1-10bcc87bd5a1"><enum>(a)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text><paragraph id="id7e895870-8633-4ef4-acbc-5eb3feee5def"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id7b31707e-77e5-4db4-82d4-cb1385008ade"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="id44f1c97e-cde6-4069-862c-ec892025b5da"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id4124049e8e8c45fab9e8801f5a97b017"><enum>(4)</enum><text>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;</text></paragraph><paragraph id="id4238c06f-a7a0-470e-b327-d4a8665c537d"><enum>(5)</enum><text>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</text></paragraph><paragraph id="idafc77fa5-891f-44cb-b43f-6fea725f9e4f"><enum>(6)</enum><text>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.</text></paragraph></subsection><subsection id="id9ca17c98-e699-462e-8c89-95aa32d0a84d"><enum>(b)</enum><header>Funding for civil society and human rights defenders</header><paragraph id="id53854a91-9459-4dc5-90d5-9c5b963ae1d7"><enum>(1)</enum><header>Program priorities</header><text>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.</text></paragraph><paragraph id="id76a32319-4cc2-4847-b682-e3946e2195e1"><enum>(2)</enum><header>Eligible organizations</header><text>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—</text><subparagraph id="id8790981c-77f7-481a-aee7-3502a9918f7e"><enum>(A)</enum><text>programs designed to strengthen and support civil society, human rights defenders, freedom of association, and the freedom of the press;</text></subparagraph><subparagraph id="id50fe6f42-27ec-4398-bbec-6005408eed00"><enum>(B)</enum><text>programs to restore democratic institutions; and</text></subparagraph><subparagraph id="id22f76a0b-8be1-4480-a7ba-61293180779b"><enum>(C)</enum><text>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.</text></subparagraph></paragraph><paragraph id="idbaade2bc-8a71-4399-885c-5134f9b3c24a"><enum>(3)</enum><header>Final report</header><text>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—</text><subparagraph id="id0aeb8a17-c476-4344-9bb7-e935faafb4bc"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id5bb89292-f50b-4fd5-87e7-c7ef53eafbeb"><enum>(B)</enum><text>describes such countries’ emergency measures, including—</text><clause id="id6e7fabcf-daa8-4bb8-a674-7a49ecf120be"><enum>(i)</enum><text>how such procedures violate internationally recognized human rights; and</text></clause><clause id="id8b7da32d-5963-4f87-b6e2-177e2260d141"><enum>(ii)</enum><text>an analysis of the impact of such measures on access to health and efforts to control the COVID–19 pandemic within the country;</text></clause></subparagraph><subparagraph id="id4fc8486f-4652-4b6a-abf8-ebbd22e4e511"><enum>(C)</enum><text>describes—</text><clause id="id6e7d397b-70b3-48e8-ba8a-90c1093cf9eb"><enum>(i)</enum><text>security and intelligence surveillance measures implemented by countries during the COVID–19 pandemic;</text></clause><clause id="id10a9145b-a244-4330-a77c-9d61c2ff14ce"><enum>(ii)</enum><text>the extent to which such measures have been, or have not been, rolled back; and</text></clause><clause id="id2a1fe008-c0c5-4022-95c3-430ca47093ce"><enum>(iii)</enum><text>whether and how such measures impact internationally recognized human rights; and</text></clause></subparagraph><subparagraph id="id1edd0a34-9218-4ee1-94ce-0f82d7715d22"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection></section><section id="id3e2c388f-6b7c-4047-b88f-057657b49a0f"><enum>108.</enum><header>Public diplomacy and combating disinformation and misinformation about COVID–19</header><subsection id="id668491eb-2115-41b7-95f4-103ff14c5be2"><enum>(a)</enum><header>United States Agency for Global Media</header><paragraph id="ideb90d568-bc81-4aa5-9488-65e86acea6c1"><enum>(1)</enum><header>Finding</header><text>Congress finds that the United States Agency for Global Media (referred to in this section as <quote>USAGM</quote>) broadcasting entities and grantees have proven valuable in providing timely and accurate information, particularly in countries in which the free press is under threat.</text></paragraph><paragraph id="id60aee743-9f0d-4509-b33b-52a64c5a519c"><enum>(2)</enum><header>Sense of congress</header><text>It is the sense of Congress that—</text><subparagraph id="id16a0377c-57eb-4326-9f3b-06aa1cc43d2e"><enum>(A)</enum><text>accurate, investigative, and scientific journalism is critical for societies to effectively combat global health threats; and</text></subparagraph><subparagraph id="id79fcb5d3-e3f8-456e-a3a4-f5be69c67a1e"><enum>(B)</enum><text>Congress supports—</text><clause id="id7919ffe5-e913-4e9a-aa29-0ce9f3b25c64"><enum>(i)</enum><text>accurate and objective investigative and scientific reporting by USAGM networks and grantees regarding COVID–19; and</text></clause><clause id="id8604dd87-8071-4da6-a8cc-ca9c64c8c263"><enum>(ii)</enum><text>platforms that help dispel and combat misinformation about the COVID–19 pandemic.</text></clause></subparagraph></paragraph><paragraph id="ide3c8cc0c-497b-49b1-8bb5-0648e5e5c2c6"><enum>(3)</enum><header>Voice of america</header><text>It is the sense of Congress that amounts authorized to be appropriated or otherwise made available to Voice of America should be used—</text><subparagraph id="id98daf76d-438e-4166-b7e3-d4a9dd8f3828"><enum>(A)</enum><text>to expand programs such as POLYGRAPH.info;</text></subparagraph><subparagraph id="idb0a21df8-f464-44f2-a845-8045dac057de"><enum>(B)</enum><text>to provide critical tools for combating propaganda associated with COVID–19; and</text></subparagraph><subparagraph id="id48f0ee00-b2d1-43b5-a0a0-00fb117b1e8e"><enum>(C)</enum><text>to assist journalists in providing accurate information to local media outlets.</text></subparagraph></paragraph><paragraph id="id550ae937-652e-436c-984b-d624c8531653"><enum>(4)</enum><header>Office of cuba broadcasting</header><text>It is the sense of Congress that Radio Televisión Martí and Digital Martí should continue to broadcast programs that detect, highlight, and dispel disinformation.</text></paragraph><paragraph id="id475451ca-cee5-4453-a15f-9011bc880ad9"><enum>(5)</enum><header>Radio free europe/radio liberty</header><subparagraph id="idd9492c58-a453-4d3a-a3cd-a1c9ecdc469b"><enum>(A)</enum><header>Finding</header><text>Congress finds that Radio Free Europe/Radio Liberty (referred to in this section as <quote>RFE/RL</quote>) 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.</text></subparagraph><subparagraph id="ide9cea3bc-1507-4bfd-ab1a-24d19cfcd0d1"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that RFE/RL should—</text><clause id="id8de4c536-6954-4367-8810-1da70514fcac"><enum>(i)</enum><text>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</text></clause><clause id="id37f2fe2c-32cc-4a63-b60f-f350a67275df"><enum>(ii)</enum><text>expand its <quote>digital first</quote> strategy.</text></clause></subparagraph></paragraph><paragraph id="ida8f5a260-c61a-4cde-b014-241b476dd289"><enum>(6)</enum><header>Radio free asia</header><subparagraph id="idce8960b4-d317-4bb5-8351-8b355ca5c0ec"><enum>(A)</enum><header>Finding</header><text>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.</text></subparagraph><subparagraph id="idde37e915-fb0b-43b7-9396-01633c422ed7"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that RFA should—</text><clause id="ideaa26452-99b0-43c0-92a4-e7878e65159b"><enum>(i)</enum><text>commission technical experts to bolster efforts to counter social media tools, including bots used by some countries to promote misinformation;</text></clause><clause id="id58b638a2-9e2e-4388-b39c-b25b0e0f11c1"><enum>(ii)</enum><text>expand digital programming and local coverage to expose China’s media manipulation techniques; and</text></clause><clause id="idbf470388-93ae-4e64-9098-590b04c20839"><enum>(iii)</enum><text>increase English language content to help counter China’s propaganda directed toward English-speaking audiences.</text></clause></subparagraph></paragraph><paragraph id="id0f3a09bc-ae04-467f-9cf3-0f3a9010ed38"><enum>(7)</enum><header>Middle east broadcasting networks</header><subparagraph id="id548b3beb-4c99-46aa-8a8c-53cb4f24959d"><enum>(A)</enum><header>Finding</header><text>Congress finds that the Middle East Broadcasting Networks operate largely in closed media markets in which malign state and nonstate actors remain active.</text></subparagraph><subparagraph id="id31ec189c-10cb-44a0-b875-ca8cce3f4b3e"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that the Middle East Broadcasting Networks should—</text><clause id="idfe9fd763-e329-403e-91f2-df12bffc48de"><enum>(i)</enum><text>continue plans to expand an investigative news unit; and</text></clause><clause id="id8e7e1d6d-a821-4738-a02a-c3a3568ea6bc"><enum>(ii)</enum><text>work to ensure that reporting continues amidst operational challenges on the ground. </text></clause></subparagraph></paragraph><paragraph id="idc628c510-d6ac-47a2-9cfa-28bb8f0dd937"><enum>(8)</enum><header>Open technology fund</header><subparagraph id="id51c31d78-d4e1-49b3-ac96-83a983540860"><enum>(A)</enum><header>Finding</header><text>Congress finds that the Open Technology Fund works to advance internet freedom in repressive environments by supporting technologies that—</text><clause id="id35ece096-08e0-4bbe-a4e0-bff4da28cbb2"><enum>(i)</enum><text>provide secure and uncensored access to USAGM’s content and the broader internet; and</text></clause><clause id="id0be2ec19-5e66-4b3f-821a-7d4f21446f41"><enum>(ii)</enum><text>counter attempts by authoritarian governments to control the internet and restrict freedom online.</text></clause></subparagraph><subparagraph id="idfa12698e-eef5-41a3-addc-75ef19b37458"><enum>(B)</enum><header>Sense of congress</header><text>It is the sense of Congress that the Open Technology Fund should—</text><clause id="id9560bc74-21a1-459c-80b1-95b4ee0cfc6c"><enum>(i)</enum><text>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</text></clause><clause id="id7b9f9127-4dd9-4a03-8ed5-4fc2caf67bcd"><enum>(ii)</enum><text>provide direct assistance to USAGM’s networks to improve the digital security of reporting operations and journalists. </text></clause></subparagraph></paragraph></subsection><subsection id="id054ceebc-2774-4c13-a3d9-28158421caa3"><enum>(b)</enum><header>Department of State public diplomacy programs</header><paragraph id="id477a4bd8-f825-4beb-8e42-809dc943b8fb"><enum>(1)</enum><header>Findings</header><text>Congress finds the following:</text><subparagraph id="id74dd4e27-abdd-4ea2-a587-bbd0d89c4c38"><enum>(A)</enum><text>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.</text></subparagraph><subparagraph id="id237703fb-7522-47ae-a28f-23adbc61259b"><enum>(B)</enum><text>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—</text><clause id="id132c8ad3-b9cb-4861-b856-2e745371ae2d"><enum>(i)</enum><text>improving media quality with journalist training and reporting tours;</text></clause><clause id="id3ff58e48-5422-4f43-8b77-64dffe904048"><enum>(ii)</enum><text>conducting media literacy programs; and</text></clause><clause id="id5957d0ae-9fa8-443f-acb2-4da6b4e31ed9"><enum>(iii)</enum><text>supporting media access activities. </text></clause></subparagraph><subparagraph id="idbe32f676-d168-45bd-b7e3-6378044c6a46"><enum>(C)</enum><text>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.</text></subparagraph><subparagraph id="id6ece367b-47f2-40a2-b827-efc94cfbddfb"><enum>(D)</enum><text>More than 12,000 physicians holding J–1 visas from 130 countries—</text><clause id="ide42d7abe-9794-4ec3-9b03-4e680bd8f7c1"><enum>(i)</enum><text>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</text></clause><clause id="id678baaf1-e1aa-426b-ab53-8a4ccc3737bb"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><paragraph id="id414064bb-fbae-476b-b3cf-71c792a0cf4a"><enum>(2)</enum><header>Visa processing briefing</header><text>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—</text><subparagraph id="id24f4e837-c395-4449-9134-4879b14f0dab"><enum>(A)</enum><text>a timeline for increasing visa processing capacities at embassies around the world, notably where there are—</text><clause id="id03298a99-acc5-453b-b510-d5a6e5c90092"><enum>(i)</enum><text>many American citizens, including dual nationals; and</text></clause><clause id="ida85b6528-d1d9-4c16-ab36-933a2af2fc74"><enum>(ii)</enum><text>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;</text></clause></subparagraph><subparagraph id="id207a7435-931a-4e51-a225-e0b2da9e4784"><enum>(B)</enum><text>a detailed plan for using existing authorities to waive or provide other alternatives to in-person appointments and interviews;</text></subparagraph><subparagraph id="id08f7403664cb49f391af43af10458b6b"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id1fed93cfd8894650a497325db0532a9c"><enum>(D)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id49018a24-3293-4f87-aa2b-e09eec921ceb"><enum>(3)</enum><header>Global engagement center</header><subparagraph id="idd1cd46d6-f01d-445c-a8fe-b38824b04ad6"><enum>(A)</enum><header>Finding</header><text>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.</text></subparagraph><subparagraph id="id6055a788-451f-47e4-88b3-af6f1dab941c"><enum>(B)</enum><header>Sense of congress</header><text>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. </text></subparagraph></paragraph></subsection></section><section id="id8c89da70-4732-4c9c-b975-5df03e78dcdd"><enum>109.</enum><header>Findings and sense of Congress regarding the United States International Development Finance Corporation</header><subsection id="idf41488c6-df84-4f5a-961a-143ec75140a6"><enum>(a)</enum><header>Findings</header><text>Congress finds the following:</text><paragraph id="id7c6008d0-412a-4eae-8b57-62abf088c4cf"><enum>(1)</enum><text>The COVID–19 pandemic is causing a global economic recession, as evidenced by the global economic indicators described in paragraphs (2) through (4).</text></paragraph><paragraph id="id5893af49-fa2b-4fc0-94da-42d87a4f1903"><enum>(2)</enum><text>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.</text></paragraph><paragraph id="id2f48e085-43a9-4fc4-a421-8472274bfbe0"><enum>(3)</enum><text>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.</text></paragraph><paragraph id="idfdb93b15-9368-4fa6-8f74-c2b4c5e3c962"><enum>(4)</enum><text>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—</text><subparagraph id="idebb23604-b307-4951-9cb8-5709c234ec12"><enum>(A)</enum><text>approximately 33,000,000 labor hours lost globally (13 per cent of the total hours lost) due to outright unemployment; and</text></subparagraph><subparagraph id="id860adfd8-cbbb-41c6-bd25-e97639c084e1"><enum>(B)</enum><text>an estimated additional 81,000,000 labor hours lost due to inactivity or underemployment.</text></subparagraph></paragraph><paragraph id="idb88c8592-f197-43ae-b522-e660b830639d"><enum>(5)</enum><text>Given the prolonged nature of the COVID–19 pandemic, African finance ministers have requested continued efforts to provide—</text><subparagraph id="id5d6741ba-a9fa-4e0d-b110-d26934d0c9e7"><enum>(A)</enum><text>additional liquidity;</text></subparagraph><subparagraph id="id1d336447-db4c-4624-98aa-d10eb719a7c6"><enum>(B)</enum><text>better market access;</text></subparagraph><subparagraph id="id89989efb-a49e-4801-9443-2e52b04e6282"><enum>(C)</enum><text>more concessional resources; and</text></subparagraph><subparagraph id="id29c55e6f-fa3e-4ea0-adb4-1b4efc7397ff"><enum>(D)</enum><text>an extension in the Debt Service Suspension Initiative established by the Group of 20. </text></subparagraph></paragraph></subsection><subsection id="idd4034c73-d5e3-4013-ac2c-f968491a052e"><enum>(b)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text><paragraph id="id4ba8d644-dbb6-4b5c-a658-1125eda3605b"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="idb584fdc2-30a4-4977-9b21-e5659ee9b431"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="iddcc60893-a44a-421a-92cd-76e529be5503"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id6afcc1b0-2481-4305-8b53-32d643030be8"><enum>(4)</enum><text>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;</text></paragraph><paragraph id="id3538ef78-3efd-4959-a03a-04073f98304f"><enum>(5)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/9601">22 U.S.C. 9601 et seq.</external-xref>), is critical to ensuring lasting and resilient economic growth in light of the COVID–19 pandemic’s exacerbation of economic hardships and challenges;</text></paragraph><paragraph id="id8d52045a-15ff-4d75-886f-37d1c21e5b5b"><enum>(6)</enum><text>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;</text></paragraph><paragraph id="id72044762-f7b8-4fee-8e6b-a368737a4518"><enum>(7)</enum><text>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—</text><subparagraph id="id99bc7a87-ab59-4e38-98c2-e17c8e50eafe"><enum>(A)</enum><text>to ensure loan support for small- and medium-sized enterprises;</text></subparagraph><subparagraph id="ide69df98a-c79d-4eb3-a998-a5e475eb25af"><enum>(B)</enum><text>to offer local currency loans to borrowers for working capital needs;</text></subparagraph><subparagraph id="id1e624df9-6344-4cf4-ac71-14e3b5954f42"><enum>(C)</enum><text>to create dedicated financing opportunities for new <quote>customers</quote> that are experiencing financial hardship due to the COVID–19 pandemic; and</text></subparagraph><subparagraph id="id8c76fef0-ce22-4a62-aeca-14362586ffe3"><enum>(D)</enum><text>to work with other development finance institutions to create co-financing facilities to support customers experiencing hardship due to the COVID–19 pandemic.</text></subparagraph></paragraph></subsection></section><section id="id63738318-b63f-49ee-b553-243c61ade69a"><enum>110.</enum><header>Sense of Congress regarding international cooperation to prevent and respond to future pandemics</header><text display-inline="no-display-inline">It is the sense of Congress that—</text><paragraph id="ide5f57e0b-b2a8-4e96-96cf-3d9907784e7e"><enum>(1)</enum><text>global pandemic preparedness and response requires international and regional cooperation and action;</text></paragraph><paragraph id="id9b614cda-3e80-431b-8119-218644b2bcb2"><enum>(2)</enum><text>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</text></paragraph><paragraph id="idbdef07ff-e884-4dd8-8f47-66e14b505871"><enum>(3)</enum><text>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.</text></paragraph></section><section id="idb2212032-e734-4027-ba3a-6d11e2eed5c4"><enum>111.</enum><header>Roles of the Department of State, the United States Agency for International Development, and the Centers for Disease Control and Prevention in pandemic response</header><subsection id="id125afd3e-b64a-4cf2-a456-44f490a0d096"><enum>(a)</enum><header>Designation of lead agencies for coordination of the United States’ response to infectious disease outbreaks with severe or pandemic potential</header><text>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.</text></subsection><subsection id="id6C8855C4AF604A93A7C67D0A78BEEEC2"><enum>(b)</enum><header>Notification</header><text>Not later than 120 days after the date of the enactment of this Act, the President shall notify the appropriate congressional committees, the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions of the Senate</committee-name>, and the <committee-name committee-id="">Committee on Energy and Commerce of the House of Representatives</committee-name> of the designations made pursuant to subsection (a), including detailed descriptions of the roles and responsibilities of each relevant department and agency.</text></subsection></section><section id="id2f08e437-6e6e-41cf-a8d0-a39eb0251a15"><enum>112.</enum><header>USAID disaster surge capacity</header><subsection id="id6a24edf6-1d89-4056-82b2-c65489e833df"><enum>(a)</enum><header>Surge capacity</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151">22 U.S.C. 2151 et seq.</external-xref>), including funds made available for <quote>Assistance for Europe, Eurasia and Central Asia</quote>, 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.</text></subsection><subsection id="id0ff7e747-e0ee-4ead-ab98-04c930fc4c58"><enum>(b)</enum><header>Notification</header><text>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.</text></subsection></section><section id="idadae12d7-6f3f-4174-9571-f31beb86aa6a"><enum>113.</enum><header>Statement of policy on humanitarian assistance to countries affected by pandemics</header><subsection id="id26f017f0-aa48-4e11-94b9-b9a356ff1b9e"><enum>(a)</enum><header>Statement of policy</header><text>It shall be the policy of the United States—</text><paragraph id="idc4e3307d-a737-4fa3-a86f-3191be08996d"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="ide2ecff63-d58f-49b4-aa11-81bd85e4fd91"><enum>(2)</enum><text>to ensure that United States assistance, including development finance, addresses the second order effects of a pandemic, including acute food insecurity; and</text></paragraph><paragraph id="id5d9b99cf-70d4-4cbb-b3c8-a083a77c9139"><enum>(3)</enum><text>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—</text><subparagraph id="idc9fe687c-9a71-4483-bc8c-144ed444eed9"><enum>(A)</enum><text>are exempted from unreasonable travel restrictions to ensure that they can effectively provide life-saving assistance; and </text></subparagraph><subparagraph id="id7ad803fb-ad65-46dc-a96f-f823ecbc84b1"><enum>(B)</enum><text>are prioritized as frontline workers in country vaccine distribution plans.</text></subparagraph></paragraph></subsection><subsection id="id3dd98704-e221-44e3-9d88-4ae718391ba1"><enum>(b)</enum><header>Facilitating effective and safe humanitarian assistance</header><text>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—</text><paragraph id="id2e465a14-5024-4684-85cc-f582d73820d1"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="idb8963643-e324-49e5-a7ad-19b5ae84bf3d"><enum>(2)</enum><text>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</text></paragraph><paragraph id="idb03d0c3e-4073-447d-9ad7-cd753b524b10" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>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. </text></paragraph></subsection></section><enum>II</enum><header>International pandemic prevention and preparedness</header><section id="idc952fa5b-186e-4937-93dc-c5d75e812a1e"><enum>201.</enum><header>Partner country defined</header><text display-inline="no-display-inline">In this title, the term <term>partner country</term> 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.</text></section><section id="iddb11a742-930d-4bfa-9de6-d9679887e6b3"><enum>202.</enum><header>Global health security strategy and report</header><subsection id="id4054bd66-7011-4944-9550-d6411da97acb"><enum>(a)</enum><header>In general</header><text>The President shall develop, update, maintain, and advance a comprehensive strategy for improving global health security and pandemic prevention, preparedness, and response that—</text><paragraph id="id0479b71d-5e84-4990-8c92-84e8a41de7fe"><enum>(1)</enum><text>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; </text></paragraph><paragraph id="idadb5dfec-c34e-47ac-b84c-1b1cb77d13d5"><enum>(2)</enum><text>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;</text></paragraph><paragraph id="id50e6398e-9032-424e-9b49-de52fd9e85f8"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="id9b90baef-4742-49f3-845f-ad6b42039e1f"><enum>(4)</enum><text>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;</text></paragraph><paragraph id="ide8be0edd-e817-4daa-b996-9407724738a2"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="id69f8a7b5-d87e-43dc-af7b-f5ea53de3b78"><enum>(6)</enum><text>supports, and is aligned with, partner country-led, global health security policy and investment plans, developed with input from key stakeholders, as appropriate;</text></paragraph><paragraph id="id34a4f16d-bd46-49e1-a0c9-61cab9e42c78"><enum>(7)</enum><text>prioritizes working with partner countries with—</text><subparagraph id="id45974003-e3bc-41d6-a227-e6af95887bf2"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="idf96514c2-8136-4a90-8932-7b288b6aa451"><enum>(B)</enum><text>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;</text></subparagraph></paragraph><paragraph id="id9f45dcc0-c745-4c65-9833-22163f11df64"><enum>(8)</enum><text>reduces long-term reliance upon United States foreign assistance for global health security by—</text><subparagraph id="id2830298a-594e-4fae-94a6-a67bab4150ff"><enum>(A)</enum><text>helping build and enhance community resilience to infectious disease emergencies and threats, such as COVID–19 and Ebola;</text></subparagraph><subparagraph id="ida68974ce-5942-4b76-a290-d3f82b2d4694"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="idaaa1fcdf-4025-429a-8fe7-0028df32e60a"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id3d7b06a5-114c-4665-89c5-f0e5fe6bac1a"><enum>(D)</enum><text>ensuring partner country ownership of global health security strategies, data, programs, and outcomes;</text></subparagraph></paragraph><paragraph id="id67e965d0-17b0-4216-90f0-a2560f4559b2"><enum>(9)</enum><text>supports health budget and workforce planning in partner countries, including training in public financial management and budget data transparency;</text></paragraph><paragraph id="id1ebe3b7d-c506-470a-8771-cc12bd86cb26"><enum>(10)</enum><text>works to ensure that—</text><subparagraph id="id0137e793-e096-4576-a81e-b9024f0aa965"><enum>(A)</enum><text>partner countries have national action plans for health security that are developed with input from key stakeholders, including communities and the private sector;</text></subparagraph><subparagraph id="id90990b07-51a5-424b-8850-25e7c10f353d"><enum>(B)</enum><text>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</text></subparagraph><subparagraph id="idea69e0dd9e7a44a09dcdb65c5bb3da1c"><enum>(C)</enum><text>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;</text></subparagraph></paragraph><paragraph id="ida347e970-3d26-4520-b074-61a209c0ddfb"><enum>(11)</enum><text>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</text></paragraph><paragraph id="id2185bb29-614a-41cc-a0db-536af12b7f9d"><enum>(12)</enum><text>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.</text></paragraph></subsection><subsection id="idf3139985-358c-4d33-ad3b-ff42af1ae5d3"><enum>(b)</enum><header>Submission of strategy</header><text>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.</text></subsection><subsection id="idffd3efa3-ab86-4c78-9b7f-a0d610cda844"><enum>(c)</enum><header>Annual report</header><paragraph id="id9c57fcd0-6328-41ca-92e5-d730508b5dde"><enum>(1)</enum><header>In general</header><text>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—</text><subparagraph id="id892073b7-731a-48e9-b9f1-73b1b268e9f2"><enum>(A)</enum><text>the status of the implementation of the strategy required under subsection (a);</text></subparagraph><subparagraph id="id4cf35c35-539a-472d-a82f-0c778b553468"><enum>(B)</enum><text>any necessary updates to the strategy;</text></subparagraph><subparagraph id="ida3b4a704-1044-48b5-a17f-5faaf82f8be5"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id29792cd1-7b5a-40ed-aef3-659dd9cafce4"><enum>(D)</enum><text>details on the status of funds made available to carry out the purposes of this title.</text></subparagraph></paragraph><paragraph id="id6c63c291-8dab-46b7-8ebd-df6f0ea17275"><enum>(2)</enum><header>Agency-specific plans</header><text>The reports required under paragraph (1) shall include specific implementation plans from each relevant Federal department and agency that describe—</text><subparagraph id="id950c8572-da91-494c-b0e1-bba87e0993d0"><enum>(A)</enum><text>how updates to the strategy may have impacted the agency’s plan during the preceding calendar year;</text></subparagraph><subparagraph id="idedeba291-8576-4f6f-9ea2-e07e7adb26c0"><enum>(B)</enum><text>the progress made in meeting the goals, objectives, and benchmarks under implementation plans during the preceding year;</text></subparagraph><subparagraph id="id34407d48-11f9-45c3-abc8-cdb5d17b8fd8"><enum>(C)</enum><text>the anticipated staffing plans and contributions of the department or agency, including technical, financial, and in-kind contributions, to implement the strategy;</text></subparagraph><subparagraph id="idb48d90e8-6635-4834-9617-1ac26d52de7a"><enum>(D)</enum><text>a transparent, open, and detailed accounting of obligations by each of the relevant Federal departments and agencies to implement the strategy, including—</text><clause id="id448a4192-a622-47a3-8114-4be8ac8bfc4b"><enum>(i)</enum><text>the statutory source of obligated funds;</text></clause><clause id="id394feb9d-1dce-499d-bbd2-098e57f9f1b5"><enum>(ii)</enum><text>the amounts obligated;</text></clause><clause id="id95efa962-84dc-4b7f-86aa-285fcd206122"><enum>(iii)</enum><text>implementing partners;</text></clause><clause id="id938a70ee-7c5b-4d84-bb80-521e18f9210c"><enum>(iv)</enum><text>targeted beneficiaries; and</text></clause><clause id="id0dca8378-0508-40e3-85ad-301f830f141a"><enum>(v)</enum><text>activities supported;</text></clause></subparagraph><subparagraph id="idd76c3cd4-2a74-4f87-9264-c64c32de7435"><enum>(E)</enum><text>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</text></subparagraph><subparagraph id="id646658fb-ed8c-4459-a660-2cac69f48636"><enum>(F)</enum><text>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.</text></subparagraph></paragraph><paragraph id="idd89dfd60-4051-4646-aadb-6c133a6853d6"><enum>(3)</enum><header>Form</header><text>The reports required under paragraph (1) shall be submitted in unclassified form, but may contain a classified annex. </text></paragraph></subsection></section><section id="id9fde6052-6db4-4145-bb65-b82c66e91fe1"><enum>203.</enum><header>Committee on Global Health Security and Pandemic and Biological Threats</header><subsection id="id74a3b9d4-b7b6-4b78-862e-cd59d16c45ad"><enum>(a)</enum><header>Statement of policy</header><text>It shall be the policy of the United States—</text><paragraph id="id2d52519b-c0ce-41c5-aa75-0583516c7fe6"><enum>(1)</enum><text>to promote global health security as a core national and security interest; and</text></paragraph><paragraph id="id6298f805-fc54-4429-a1df-1b30309789e1"><enum>(2)</enum><text>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). </text></paragraph></subsection><subsection id="id3aed169a-b895-4b66-abc8-e0052d08bd11"><enum>(b)</enum><header>Coordination</header><paragraph id="ideed82a29-1013-4c75-aac1-69ca032c57be"><enum>(1)</enum><header>Defined term</header><text>In this subsection, the term <term>pandemic threat</term> means any infectious disease that—</text><subparagraph id="idf5ab3dac-95e3-4165-a6de-aff8e7ec7751"><enum>(A)</enum><text>has an aggregation of cases in a community that rises above what is normally expected in that population in that area;</text></subparagraph><subparagraph id="id74cde804-9c98-44d7-b61a-dfb3615f7d7c"><enum>(B)</enum><text>has the potential to spread over several countries or continents; and </text></subparagraph><subparagraph id="id9538c2fc-7e24-48a5-baae-49c8f1d249e3"><enum>(C)</enum><text>could, if not addressed, threaten the national security of the United States.</text></subparagraph></paragraph><paragraph id="id9847c3b1-2902-4cc0-b6be-0b66bfb6b220"><enum>(2)</enum><header>Committee on global health security and pandemic and biological threats</header><text>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 <quote>Committee</quote>), whose day to day operations should be led by the Special Advisor for Global Health Security.</text></paragraph><paragraph id="id6dc287e3-5769-4603-8648-e54b6c4d089c"><enum>(3)</enum><header>Special advisor for global health security</header><text>The Special Advisor for Global Health Security referred to in paragraph (2)—</text><subparagraph id="id39ca9d3f-ac5d-422d-a99e-e170d7597b75"><enum>(A)</enum><text>should serve as part of the staff of the National Security Council; and </text></subparagraph><subparagraph id="idc517283a-dfd9-4efb-81a2-d2ff4c41398c"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><paragraph id="idc4cda336-9b19-41ae-8b2b-806b6e242920"><enum>(4)</enum><header>Composition</header><text>The Committee should include the following members:</text><subparagraph id="ide9e92bbf-29b5-470e-b08c-f9ce5053cb63"><enum>(A)</enum><text>The Director of National Intelligence.</text></subparagraph><subparagraph id="id4eb24c88-6443-45fc-933d-f033fa9809ef"><enum>(B)</enum><text>The Secretary of State.</text></subparagraph><subparagraph id="id1da37556-f6e3-464b-ac34-1d9e79301f1d"><enum>(C)</enum><text>The Secretary of Defense.</text></subparagraph><subparagraph id="idd0544f45-26ae-417b-a0a1-fc1f45e888f6"><enum>(D)</enum><text>The Secretary of Health and Human Services.</text></subparagraph><subparagraph id="ide4c8f0a2-1566-4aad-a39f-de1cb0a6cca3"><enum>(E)</enum><text>The Administrator of the United States Agency for International Development.</text></subparagraph><subparagraph id="id83edcf2a-7747-4932-b7e7-68012a6e5eab"><enum>(F)</enum><text>The Secretary of Agriculture.</text></subparagraph><subparagraph id="idd897a82a-a14c-467f-8689-cc2f6c5ed6a0"><enum>(G)</enum><text>The Secretary of Treasury.</text></subparagraph><subparagraph id="idafeea5d5-7c17-4578-ab43-7feb02ce620c"><enum>(H)</enum><text>The Attorney General.</text></subparagraph><subparagraph id="idec0f9ec8-fddd-4a18-91c9-c580ecdda81a"><enum>(I)</enum><text>The Secretary of Homeland Security.</text></subparagraph><subparagraph id="id201d3513-aa0a-4906-b711-031acd49b43d"><enum>(J)</enum><text>The Office of Management and Budget.</text></subparagraph><subparagraph id="id66ef42f8-5564-44a9-b478-6df5e0d56f18"><enum>(K)</enum><text>The Administrator of the Environmental Protection Agency.</text></subparagraph><subparagraph id="id39b97d35-7fee-4e92-a5c7-055a0e7a1786"><enum>(L)</enum><text>The Director of the Centers for Disease Control and Prevention.</text></subparagraph><subparagraph id="id4e52b1b6-548a-4f3a-85d2-947b2fdc377e"><enum>(M)</enum><text>The Director of the Office of Science and Technology Policy.</text></subparagraph><subparagraph id="idbdb52ef9-d8fc-4b8c-ac56-eebb30aa1e7c"><enum>(N)</enum><text>The Assistant to the President for National Security Affairs, who should serve as the chairperson of the Committee.</text></subparagraph><subparagraph id="id4155552d-2d01-4305-b447-4e8f7759b242"><enum>(O)</enum><text>The Director of the National Institutes of Health.</text></subparagraph><subparagraph id="id95C0DF26424A474A8B16B936E3F9976F"><enum>(P)</enum><text>The Director of the National Institute of Allergy and Infectious Diseases.</text></subparagraph><subparagraph id="idD14CC8A722C941049F28524B1B401402"><enum>(Q)</enum><text>The Secretary of Labor.</text></subparagraph><subparagraph id="id108625AF4AD346F79777A59E8A6AA621"><enum>(R)</enum><text>Such other members as the President may designate.</text></subparagraph></paragraph><paragraph id="ida1b09ef6-7f15-4bfb-b3fe-cddac7e7f54c"><enum>(5)</enum><header>Functions</header><subparagraph id="id5144bc9d-a432-4c1c-81e8-1b55eed7a662"><enum>(A)</enum><header>In general</header><text>The functions of the Committee should be—</text><clause id="idb417e8c1-fbae-48f3-8374-4bfa594a096a"><enum>(i)</enum><text>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 </text></clause><clause id="idd8541619-07c5-443d-a68c-9d73005d1c8a"><enum>(ii)</enum><text>to ensure policy coordination between United States Government agencies, especially coordination between—</text><subclause id="idbe8bbb97-0fca-45f9-ab56-536e37276799"><enum>(I)</enum><text>agencies with a primarily domestic mandate; and </text></subclause><subclause id="id5df1cf66-417f-430f-a689-8fc82559edc2"><enum>(II)</enum><text>agencies with an international mandate relating to global health security and pandemic threats.</text></subclause></clause></subparagraph><subparagraph id="id1d868915-b8d1-4b1b-b6e1-2faaa2b8217f"><enum>(B)</enum><header>Activities</header><text>In carrying out the functions described in subparagraph (A), the Committee should—</text><clause id="id59d334ae-0ca0-436d-ba5e-ff188a8c7f1d"><enum>(i)</enum><text>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;</text></clause><clause id="id1723f434-f6fb-466a-a145-b3ab29dd42b4"><enum>(ii)</enum><text>develop a plan for—</text><subclause id="idb3f1954b-a24e-4821-8d3b-5d48cab3d82f"><enum>(I)</enum><text>establishing an interagency National Center for Epidemic Forecasting and Outbreak Analytics; and </text></subclause><subclause id="id0a503fdd-e536-48ae-9201-e86a1c30b3a2"><enum>(II)</enum><text>modernizing global early warning and trigger systems for scaling action to prevent, detect, respond to, and recover from emerging biological threats;</text></subclause></clause><clause id="id7ef47517-0438-4b93-9543-ca18a92e3e00"><enum>(iii)</enum><text>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;</text></clause><clause id="idbc8061a8-e0e6-4233-bb64-bfe398478477"><enum>(iv)</enum><text>review the progress toward, and working to resolve challenges in, achieving United States commitments under the Global Health Security Agenda; </text></clause><clause id="id4410dda9-2d2d-4ae3-a5ef-5802a6b5a0dd"><enum>(v)</enum><text>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;</text></clause><clause id="id57c9ba3c-9baa-482f-b4a4-5c422204db50"><enum>(vi)</enum><text>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;</text></clause><clause id="id2c860844-2101-4fe9-97cb-4f076687d2c5"><enum>(vii)</enum><text>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;</text></clause></subparagraph><subparagraph id="idcf0c6ac8-46f7-49e0-a97e-265406b49e11"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id69ce93a0-25b3-4a33-8535-5ac96333fd06"><enum>(D)</enum><text>develop guidelines to enhance and improve the operational coordination between State and local governments and Federal agencies with respect to pandemic threats.</text></subparagraph></paragraph><paragraph id="idf4e7d62c-03cd-4c59-9e08-01c821a0bf34" commented="no"><enum>(6)</enum><header>Foreign affairs responsibilities</header><text>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.</text></paragraph><paragraph id="id0741af72-e9e8-4097-89d0-f9e64d8863ba" commented="no"><enum>(7)</enum><header>Specific roles and responsibilities</header><subparagraph id="id1ba7a8b3-632d-4c73-981a-b8ef90841070" commented="no"><enum>(A)</enum><header>In general</header><text>The heads of the agencies listed in paragraph (4) should—</text><clause id="id5b762c7e-b9b7-4f48-aa87-d947d12e88cd" commented="no"><enum>(i)</enum><text>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;</text></clause><clause id="id8d0d6d32-1785-4077-8ba7-b75c2175a61b" commented="no"><enum>(ii)</enum><text>designate a senior-level official to be responsible for global health security and pandemic threat reduction at each of their respective agencies;</text></clause><clause id="ide2342858-d682-4a97-b781-ff0209462fe6" commented="no"><enum>(iii)</enum><text>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;</text></clause><clause id="id0a46cd90-a6d0-4c2a-8520-bc5b3162bd9e" commented="no"><enum>(iv)</enum><text>keep the Committee apprised of Global Health Security and pandemic threat reduction-related activities undertaken within their respective agencies;</text></clause><clause id="id02b63fff-93a4-4fc0-9c70-9f0242a2e419" commented="no"><enum>(v)</enum><text>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</text></clause><clause commented="no" id="idd37a041c-08cb-4c56-aafe-a790235b8f1c"><enum>(vi)</enum><text>keep the Committee apprised of GHSA-related activities undertaken within their respective agencies.</text></clause></subparagraph><subparagraph id="idfb060cab-7c35-4ada-8a82-557fe25befb4" commented="no" display-inline="no-display-inline"><enum>(B)</enum><header>Additional roles and responsibilities</header><text>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. </text></subparagraph></paragraph><paragraph id="id402a0173d2d94d6fb4fb4295b6d81836"><enum>(8)</enum><header>Regular briefings</header><text>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-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions of the Senate</committee-name> and the <committee-name committee-id="">Committee on Energy and Commerce of the House of Representatives</committee-name>. </text></paragraph></subsection></section><section id="id891eedbf-3f81-4da7-917f-eaab053663e1"><enum>204.</enum><header>United States overseas global health security and diplomacy coordination</header><subsection id="id4cd9e32a-f585-4e18-a02c-251e7ed22193"><enum>(a)</enum><header>Establishment</header><text>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 <quote>Special Representative</quote>). </text></subsection><subsection id="id1b1536c8-c93c-476f-8caf-8776067fe25e"><enum>(b)</enum><header>Appointment; qualifications</header><text>The Special Representative—</text><paragraph id="idab622db6-5b7c-4454-8873-f08e9fdab541"><enum>(1)</enum><text>shall be appointed by the President, by and with the advice and consent of the Senate;</text></paragraph><paragraph id="id6807caad-0f4b-46fb-8fc9-34017b622ed3"><enum>(2)</enum><text>shall report to the Secretary of State; and</text></paragraph><paragraph id="idf1a90b48-0a97-4f88-abbf-9ad9cb457cbb"><enum>(3)</enum><text>shall have—</text><subparagraph id="id033b54df-8930-46f3-8a51-ef5caae49248"><enum>(A)</enum><text>demonstrated knowledge and experience in the fields of development and public health, epidemiology, or medicine; and</text></subparagraph><subparagraph id="idda97332d-cf28-45f5-a4e7-4e054e0db876"><enum>(B)</enum><text>relevant diplomatic, policy, and political expertise.</text></subparagraph></paragraph></subsection><subsection id="ide72f9555-0c3c-4ec2-969d-73bf4e9a38cb"><enum>(c)</enum><header>Authorities</header><text>The Special Representative is authorized—</text><paragraph id="id91591f3f-5f33-4baa-b87d-3abe6e63dc01"><enum>(1)</enum><text>to operate internationally to carry out the purposes of this title;</text></paragraph><paragraph id="idf8509d0c-63cd-4436-9a61-6dc785936f2c"><enum>(2)</enum><text>to lead in developing a global pandemic prevention, preparedness and response framework to support global pandemic prevention, preparedness, responses and recovery efforts, including through—</text><subparagraph id="ide320dbcb-186c-4552-a2fe-6db09cde1a99"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="id697f5d5e-be9e-415e-90d9-2c6403f07845"><enum>(B)</enum><text>support for United States citizens living abroad, including consular support;</text></subparagraph></paragraph><paragraph id="id9423b87f-b214-4a08-8455-9900a9c755ac"><enum>(3)</enum><text>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;</text></paragraph><paragraph id="idc6b2f466-2a6f-4c58-9544-5955bb8dbd2c"><enum>(4)</enum><text>to represent the United States in the multilateral, catalytic financing mechanism described in section 302(a); </text></paragraph><paragraph id="id973ed413-ac37-40b2-90db-08e679583cbc"><enum>(5)</enum><text>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;</text></paragraph><paragraph id="id9fbce615-7394-4ede-b7d6-f00c6ae40cdd"><enum>(6)</enum><text>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</text></paragraph><paragraph id="id85d68ee5-690c-44f3-812b-c63359bae3fa"><enum>(7)</enum><text>to perform such other functions as the Secretary of State may assign.</text></paragraph></subsection><subsection id="idd1dbdd57-8ce0-448c-a117-50f31a2916f1"><enum>(d)</enum><header>Duties</header><text>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—</text><paragraph id="idcce03e04-ef50-4df5-aff3-59c44a5b7439"><enum>(1)</enum><text>developing and coordinating a global pandemic prevention, preparedness and response framework consistent with subsection (c)(2);</text></paragraph><paragraph id="id9171d096-fded-4ed9-afab-5956efb86213"><enum>(2)</enum><text>enhancing engagement with multilateral organizations and partner countries, including through the mobilization of donor support;</text></paragraph><paragraph id="id521c0bbd-524f-47c3-bbcb-59c93c34c07a"><enum>(3)</enum><text>enhancing coordination of consular services for United States citizens abroad in the event of a global health emergency;</text></paragraph><paragraph id="idee2a2b84-ac95-4fb1-91e4-1816f9e9bd4e"><enum>(4)</enum><text>ensuring effective program coordination and implementation by the relevant Federal departments and agencies by—</text><subparagraph id="id8660bd2e-9577-4717-a09e-75a4bf5ecd85"><enum>(A)</enum><text>formulating, issuing, and updating related policy guidance;</text></subparagraph><subparagraph id="idcd2e889c-3595-42d3-891f-bab78b46ad0c"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id026d0ca9-f65f-4c42-ae33-24fb2203ed67"><enum>(C)</enum><text>aligning, in coordination with United States chiefs of mission and country teams in partner countries—</text><clause id="ida63b23ce-bf8e-4f9e-8adc-d7ec6197be71"><enum>(i)</enum><text>the foreign assistance resources funded with amounts appropriated pursuant to subsection (f); and </text></clause><clause id="idc079c19c-74b3-4216-a4d3-7f776bd92eca"><enum>(ii)</enum><text>the implementation plans required under section 202(c)(2) with the relevant Federal departments and agencies in a manner that—</text><subclause id="idfb4bebf0-06bd-4d64-85fb-514828c3ac92"><enum>(I)</enum><text>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); </text></subclause><subclause id="ideba441a9-af95-421c-9b1b-b0a4df2aecae"><enum>(II)</enum><text>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 </text></subclause><subclause id="id896a4bbd-eb6d-4196-8f4f-e8be262a22b1"><enum>(III)</enum><text>reflects and leverages the unique capabilities of each such department and agency;</text></subclause></clause></subparagraph><subparagraph id="id1af1f367-08f6-40e3-98fa-608f8e74bb70"><enum>(D)</enum><text>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;</text></subparagraph><subparagraph id="id29b0264c-045a-4c47-bf14-455aabcac723"><enum>(E)</enum><text>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</text></subparagraph><subparagraph id="id72a57e58-1509-487d-a35c-22fdf9b992e0"><enum>(F)</enum><text>avoiding duplication of effort and working to resolve policy, program, and funding disputes among the relevant Federal departments and agencies;</text></subparagraph></paragraph><paragraph id="id5ca3890e-14df-4515-b35f-da6f471f86e9"><enum>(5)</enum><text>leading diplomatic efforts to identify and address current and emerging threats to global health security;</text></paragraph><paragraph id="ide806fa26-15d8-4702-babd-f667595386d6"><enum>(6)</enum><text>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;</text></paragraph><paragraph id="id0a01be94-d030-4118-9d7a-127631e93fa3"><enum>(7)</enum><text>working to enhance coordination with, and transparency among, the governments of partner countries and key stakeholders, including the private sector;</text></paragraph><paragraph id="id52166f10-7bf8-4fae-94b3-9be53439a427"><enum>(8)</enum><text>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;</text></paragraph><paragraph id="id9564ff65-6003-4086-acf0-bb56fc36c4d4"><enum>(9)</enum><text>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</text></paragraph><paragraph id="id62e365a3-d80a-452f-887a-44af63515208"><enum>(10)</enum><text>providing regular updates to the appropriate congressional committees regarding the fulfillment of the duties described in this subsection.</text></paragraph></subsection><subsection id="idaeebf522-56af-41cc-8516-c07ad553fa3d"><enum>(e)</enum><header>Deputy Representative</header><text>The Special Representative should be supported by a deputy, who—</text><paragraph id="idae0b854d-a624-407e-ba84-7b5e7e8c15f9"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="idd6096bcf-541e-4cc4-b019-187cd63d431b"><enum>(2)</enum><text>should have demonstrated knowledge and experience in the fields of development and public health, epidemiology, or medicine; and </text></paragraph><paragraph id="id7d755db2-1ada-4180-8b06-d815ebaa08c6" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>serves concurrently as the deputy and performs the functions described in section 3(h) of Executive Order 13747 (81 Fed. Reg. 78701). </text></paragraph></subsection><subsection id="id321578eb-cb3f-43c5-8a12-6d4120b41b57"><enum>(f)</enum><header>Authorization of appropriations</header><paragraph id="id3b3fe71d-2a29-4a16-aa2e-d0763d979808"><enum>(1)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151">22 U.S.C. 2151 et seq.</external-xref>), may include support for—</text><subparagraph id="id809d6064-b0bf-4db2-8256-d91c39f12114"><enum>(A)</enum><text>enhancing preparedness in partner countries through implementation of the Global Health Security Strategy developed pursuant to section 202;</text></subparagraph><subparagraph id="ida4976f05-64a1-425d-bbfb-63d674c71b16"><enum>(B)</enum><text>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 <external-xref legal-doc="public-law" parsable-cite="pl/115/31">Public Law 115–31</external-xref>) to address new or emerging infectious disease threats, as necessary and appropriate;</text></subparagraph><subparagraph id="id5fd8f94e-9ab8-46d7-a343-f0a7142e4f80"><enum>(C)</enum><text>United States contributions to the World Bank Health Emergency Preparedness and Response Multi-Donor Fund; and</text></subparagraph><subparagraph id="id16c4bdbc-9d8f-4c7d-8cd3-cf0ac8583986"><enum>(D)</enum><text>United States contributions to a multilateral, catalytic financing mechanism for global health security and pandemic prevention and preparedness described in section 302.</text></subparagraph></paragraph><paragraph id="idb79884e6-4c38-4451-bf11-50e229f9a519" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Exception</header><text>Section 110 of the Trafficking Victims Protection Act of 2000 (<external-xref legal-doc="usc" parsable-cite="usc/22/7107">22 U.S.C. 7107</external-xref>) shall not apply to assistance made available pursuant to this subsection. </text></paragraph></subsection></section><section id="id53db190c-3767-4320-a86e-f92ed491c6ba"><enum>205.</enum><header>Resilience</header><text display-inline="no-display-inline">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—</text><paragraph id="id1e4a66bb-0d31-44e6-b031-c81e21b8c02a"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id5fa8d8ac-5885-4d95-a3fe-d4db6e9d0b8c"><enum>(2)</enum><text>to develop effective tools to identify, analyze, forecast, and mitigate the risks that make such countries vulnerable;</text></paragraph><paragraph id="idd8f1ad07-d732-4b26-8551-958cd8594e47"><enum>(3)</enum><text>to better integrate short-, medium-, and long-term recovery efforts into global health emergency response and disaster relief; and</text></paragraph><paragraph id="idc631198c-0f5a-4c34-ba47-ac37b48e4107"><enum>(4)</enum><text>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.</text></paragraph></section><section id="id1c45bdcb-906a-45f3-9747-de226d64f097"><enum>206.</enum><header>Strengthening health systems</header><subsection id="idde061924-dd06-4c4b-ab57-fd3685800fe8"><enum>(a)</enum><header>Statement of policy</header><text>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.</text></subsection><subsection id="ideb3717e5-2104-49cc-a0d4-85a1face03b6"><enum>(b)</enum><header>Coordination</header><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/108/25">Public Law 108–25</external-xref>) and other relevant statutes to ensure that such activities contribute to health systems strengthening.</text></subsection><subsection id="idfffb8823-65f6-4515-8fb9-cf4aac8ab031"><enum>(c)</enum><header>Pilot program </header><paragraph id="id4dd91662-8186-45ef-a7eb-5ef19a23f159"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="idfc66f6af-ce69-42b6-b82b-925acbf33d07"><enum>(2)</enum><header>Assessment</header><text>In the countries selected under paragraph (1), USAID missions, in consultation with USAID’s Office of Health Systems, should conduct an assessment that—</text><subparagraph id="id774b95ad-6f91-44ab-a5f9-8108383c7905"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id843b3704-4efa-43e6-b604-c66ed779528d"><enum>(B)</enum><text>identifies the best opportunities for improving health systems to achieve improved outcomes, including obstacles to health service delivery;</text></subparagraph><subparagraph id="idc65a77bb-c0ce-4c83-a800-c73f773007b1"><enum>(C)</enum><text>maps the resources of the country and other donors in the health sector with a focus on investment in health system strengthening; and</text></subparagraph><subparagraph id="idf9581585-62a6-4aa8-8956-4d9e1cb3ca08"><enum>(D)</enum><text>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—</text><clause id="id2556a6cf-4b68-43b3-9e18-423828f2831f"><enum>(i)</enum><text>provides a framework for implementing such strategy;</text></clause><clause id="id9038c59f-91d4-4ce6-ab80-140479247345"><enum>(ii)</enum><text>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;</text></clause><clause id="id6c20c937-e6e5-476d-b177-5674dd04d471"><enum>(iii)</enum><text>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;</text></clause><clause id="id53df2cb2-43ec-4e9a-9f2b-503b122ecaf5"><enum>(iv)</enum><text>includes clear goals, benchmarks, outputs, desired outcomes, a means of measuring progress and a cost analysis; and</text></clause><clause id="id00A3DAC3D2C5467DBF80B437B27B58E5"><enum>(v)</enum><text>requires reporting by each Federal department and agency regarding their participation and contribution, including in the PEPFAR Annual Report to Congress.</text></clause></subparagraph></paragraph><paragraph id="ide410bebb-7da5-4d90-9956-fefbfc9a02e2"><enum>(3)</enum><header>Strategies to strengthen health systems</header><text>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—</text><subparagraph id="id6f211c5b-a700-49a5-ae5c-015c21b5f6a9"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="ide974db43-60fa-466f-bab7-f3f007cb184a"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id8f960a4e-6071-4ff2-90fc-b92bded8f25c"><enum>(C)</enum><text>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;</text></subparagraph><subparagraph id="id7dcbb999-5c63-4f2a-82d4-84ca899465d3"><enum>(D)</enum><text>includes proposals for mobilizing sufficient and durable financing for health systems;</text></subparagraph><subparagraph id="id5039ac3f-7345-4c62-9d21-3f503fa675a8"><enum>(E)</enum><text>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—</text><clause id="id1b4eda86-2eb8-4b41-bd4f-ee32b529602e"><enum>(i)</enum><text>strengthened data collection and analysis;</text></clause><clause id="idc166332e-982e-40fa-bfd8-2d9430a7b6f9"><enum>(ii)</enum><text>data driven decision making capacity;</text></clause><clause id="id169a026b-ddac-4dfd-9edf-ce9cc589b090"><enum>(iii)</enum><text>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</text></clause><clause id="id3557d078a84142d6b3239b766d21654d"><enum>(iv)</enum><text>the formalization and inclusion of the community health workforce in planning for a resilient health system to ensure essential service delivery and pandemic response;</text></clause></subparagraph><subparagraph id="idab573d19-fc27-4008-82b2-5eaf31bbc25b"><enum>(F)</enum><text>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; </text></subparagraph><subparagraph id="idaa18291b-d6f0-4baa-887d-fa385f8db73b"><enum>(G)</enum><text>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;</text></subparagraph><subparagraph id="id652b7d16-9815-4464-bd46-41b06e0e57e7"><enum>(H)</enum><text>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;</text></subparagraph><subparagraph id="id37d06a41-d5f4-44d0-8d59-cbe2a92f79ba"><enum>(I)</enum><text>includes plans for integrating innovations in health technologies, services, and systems;</text></subparagraph><subparagraph id="idce8d4c26-82f1-4845-8df4-fd0d328cca3e"><enum>(J)</enum><text>identifies barriers to health literacy, community engagement, and patient empowerment, and recommendations for overcoming such barriers; </text></subparagraph><subparagraph id="iddd8ee4e7-ebb1-4d0a-bacb-fe3159f0c71a"><enum>(K)</enum><text>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;</text></subparagraph><subparagraph id="id4ba7dc18-7137-4752-b25d-ebf0f0e8c401"><enum>(L)</enum><text>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;</text></subparagraph><subparagraph id="id0890f9cff40247cea868623ca8ae2452"><enum>(M)</enum><text>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</text></subparagraph><subparagraph id="id0a0b8d4c60714977a89377c9c71149c4"><enum>(N)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id3896aa2c-43f5-4067-9d71-f1f0fb5cc3de"><enum>(4)</enum><header>Consultation and reporting requirements</header><subparagraph id="id10B2CE4535154EBCA4DFA85329A600D6"><enum>(A)</enum><header>Consultation</header><text>In developing a strategy pursuant to paragraph (3), each USAID mission should consult with a wide variety of stakeholders, including—</text><clause id="id1f046363-aad5-44f8-82f0-fabb2deeed45"><enum>(i)</enum><text>relevant partner government institutions;</text></clause><clause id="idc2c56b28-f206-4a38-9458-8666107da471"><enum>(ii)</enum><text>professional associations;</text></clause><clause id="id75bc6f2e-e6bd-4198-9740-d3152c2072b5"><enum>(iii)</enum><text>patient groups;</text></clause><clause id="idbcabb883-4fe4-4b9f-85d2-76fff2fb2fe5"><enum>(iv)</enum><text>civil society organizations (including international nongovernmental organizations with relevant expertise in program implementation); and</text></clause><clause id="idc0a65b09-ba54-4de2-a0f7-2c3439443b98"><enum>(v)</enum><text>the private sector.</text></clause></subparagraph><subparagraph id="idc7d925d336ba4e90b8b034303e03692a"><enum>(B)</enum><header>Reporting</header><text>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—</text><clause id="id3e98ff9a58c84a7ca10eb8cb72f09b4b"><enum>(i)</enum><text>progress made toward the integration and co-financing of health systems strengthening activities by USAID and the Office of the Global AIDS Coordinator; and</text></clause><clause id="id0df6a5b5a2c44b06b7546df0318830cc"><enum>(ii)</enum><text>the results of integrated efforts under this section, including for cross-cutting efforts to strengthen local health workforces. </text></clause></subparagraph></paragraph></subsection><subsection id="id79808895-616f-429c-a949-986ce1722d8a"><enum>(d)</enum><header>Technical capacity</header><paragraph id="idf3c006fb0aab4566b7e08c2136add68b"><enum>(1)</enum><header>In general</header><text>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).</text></paragraph><paragraph id="idaf0d4907349e472295129da809659546"><enum>(2)</enum><header>Resources</header><text>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—</text><subparagraph id="idb7168e5b2dbe4a3bb2cef366cc7d3972"><enum>(A)</enum><text>the plans for, and the progress toward, reaching the capacity described in paragraph (1);</text></subparagraph><subparagraph id="id7210092946a549feb70ccf5788bc462c"><enum>(B)</enum><text>the requirements for sustaining such capacity, including the resources needed by USAID; and</text></subparagraph><subparagraph id="id83f3c4fc29264fdea56ec8c49584f1b8"><enum>(C)</enum><text>budget detail on the integration and joint funding of health systems capacity building, as appropriate. </text></subparagraph></paragraph></subsection><subsection id="id3C2198C205864C5A8505D01D42B450A3"><enum>(e)</enum><header>International efforts</header><text>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—</text><paragraph id="id92827ff1-a313-4edf-9596-2929d8569d2d"><enum>(1)</enum><text>shared core indicators for strengthened health systems;</text></paragraph><paragraph id="idfd7ac444-2da3-4730-b0d2-e248e908e799"><enum>(2)</enum><text>agreements among donors that reporting requirements for health systems come from country systems to reduce the burden placed on partner countries;</text></paragraph><paragraph id="id144319eb-04c5-49ad-b5d7-a0d1a40d553a"><enum>(3)</enum><text>structures for joint assessments, plans, auditing, and consultations; and</text></paragraph><paragraph id="id37e01add-98c1-427f-9b3e-4b7b9b23a8fa"><enum>(4)</enum><text>a regularized approach to coordination on health systems strengthening.</text></paragraph></subsection><subsection id="id3f5486a4-aecf-45bc-aa5e-44df29c1b190"><enum>(f)</enum><header>Public private partnerships to improve health systems strengthening</header><text>The country strategies developed under subsection (c)(3) should include a section that—</text><paragraph id="id2b203881-e942-41af-b432-acb96b675705"><enum>(1)</enum><text>discusses the role of the private sector (including corporate, local, and international organizations with relevant expertise); and</text></paragraph><paragraph id="id7033eb85-f028-4385-a793-8bb6f81baeaf"><enum>(2)</enum><text>identifies relevant opportunities for the private sector—</text><subparagraph id="id302d8809-72b7-4707-b9ac-716f00cfe83d"><enum>(A)</enum><text>to accelerate research and development of innovative health and information technology, and to offer training related to its use;</text></subparagraph><subparagraph id="id936a0d30-32ef-4206-b8a4-677e01ccea22"><enum>(B)</enum><text>to contribute to improvements in health administration and management processes;</text></subparagraph><subparagraph id="idf595b24a-3031-4468-9066-330c05bf6908"><enum>(C)</enum><text>to improve system efficiency;</text></subparagraph><subparagraph id="id521eaff8-2b66-4442-8e3e-cfd9c8dab3ec"><enum>(D)</enum><text>to develop training related to clinical practice guidelines; and</text></subparagraph><subparagraph id="id5207a553-3814-4bcf-be49-422a5f0f7762"><enum>(E)</enum><text>to help countries develop systems for documenting outcomes and achievements related to activities undertaken to strengthen the health sector.</text></subparagraph></paragraph></subsection><subsection id="id9d59c40e-445d-407b-b71a-19f055131265" commented="no" display-inline="no-display-inline"><enum>(g)</enum><header>Authorization for use of funds</header><text>Amounts authorized to be appropriated or otherwise made available to carry out section 104 of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b">22 U.S.C. 2151b</external-xref>) may be made available to carry out this section. </text></subsection></section><section id="idf93e722e-ac12-42d0-a013-848d0edccf36"><enum>207.</enum><header>Additional authorities</header><subsection id="id2797365e-3f0c-414d-99cd-4580abd182bd"><enum>(a)</enum><header>Foreign Assistance Act of 1961</header><text display-inline="yes-display-inline">Chapter 1 of part I of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151">22 U.S.C. 2151 et seq.</external-xref>) is amended—</text><paragraph id="ida05f4bd4-47be-409b-9536-7da803d8ebd9"><enum>(1)</enum><text>in section 104(c)(1) (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b">22 U.S.C. 2151b(c)(1)</external-xref>), by inserting <quote>(emphasizing health systems strengthening, as appropriate)</quote> after <quote>health services</quote>;</text></paragraph><paragraph id="id7550169f-cbe5-44f2-ac2c-f641973d0373"><enum>(2)</enum><text>in section 104A (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2</external-xref>)—</text><subparagraph id="idd09156e1-4e9a-413c-8cc3-16f9c3e393e6"><enum>(A)</enum><text>in subsection (b)(3)(D), by striking <quote>including health care systems, under other international donor support</quote> and inserting <quote>including through support for health systems strengthening, under other donor support</quote>; and</text></subparagraph><subparagraph id="idbd3ea401-c047-4f87-a3a7-3ee8ed2b65dc"><enum>(B)</enum><text>in subsection (f)(3)(Q), by inserting <quote>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</quote> after <quote>efforts by</quote>; and</text></subparagraph></paragraph><paragraph id="idac40b628-c951-48cb-9610-a3025c61b075"><enum>(3)</enum><text>in section 104B(g)(2) (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-3">22 U.S.C. 2151b–3(g)(2)</external-xref>), by inserting <quote>strengthening the health system of the country and</quote> after <quote>contribute to</quote>.</text></paragraph></subsection><subsection id="idf3f4cee0-7e44-4dd8-b0b3-97ae8e6c0025"><enum>(b)</enum><header>United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</header><text>Section 204 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7623">22 U.S.C. 7623</external-xref>) is amended—</text><paragraph id="id554db12b-8057-4e16-8750-c19d615a168b"><enum>(1)</enum><text>in subsection (a) —</text><subparagraph id="id82463d04-c24c-494c-a286-11f2d780917a"><enum>(A)</enum><text>in paragraph (1)(A), by inserting <quote>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</quote> after <quote>systems</quote>; and</text></subparagraph><subparagraph id="id95c50164-3e1a-4bc5-9400-4a91d941708a"><enum>(B)</enum><text>in paragraph (2)—</text><clause id="id2569b58c-af13-4040-a107-195e1f17e05b"><enum>(i)</enum><text>in subparagraph (C), by inserting <quote>as part of a strategy to improve overall health</quote> before the semicolon at the end;</text></clause><clause id="idab9d7fef-e852-4844-8f3f-ea90c25e6623"><enum>(ii)</enum><text>in subparagraph (D), by striking <quote>and</quote> at the end;</text></clause><clause id="id1a3d03b2-5935-4a9f-83d5-ab0349e9a829"><enum>(iii)</enum><text>in subparagraph (E), by striking the period at the end and inserting <quote>; and</quote>; and</text></clause><clause id="id8b06ad8e-5f9c-49f9-8e9f-f509465e9930"><enum>(iv)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id259d8ba1-b81a-4028-9697-43191e6dde9f" changed="added" reported-display-style="italic" committee-id="SSFR00"><subparagraph id="ide8527123-d3a7-4060-a822-79f7b058fe03"><enum>(F)</enum><text>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.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph></paragraph><paragraph id="id757f60d8-786d-4716-a986-d3fdab02cec1" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text>in subsection (b), by striking <quote>receive funding to carry out programs to combat HIV/AIDS, tuberculosis, and malaria</quote> and inserting <quote>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,</quote>. </text></paragraph></subsection></section><section id="id460aac61-b4a2-413f-923c-0045fa3c724f"><enum>208.</enum><header>Authorization for United States participation in the Coalition for Epidemic Preparedness Innovations</header><subsection id="idf03ac01a-52cf-4ef3-89f1-f901f6f4d381"><enum>(a)</enum><header>In general</header><text>The United States is authorized to participate in the Coalition for Epidemic Preparedness Innovations (referred to in this section as <quote>CEPI</quote>).</text></subsection><subsection id="id1f6a2db9-a82b-4849-880d-472fc414b082"><enum>(b)</enum><header>Investors Council and Board of Directors</header><paragraph id="idd1f83857-a930-494e-917c-ebff85d9984b"><enum>(1)</enum><header>Initial designation</header><text>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.</text></paragraph><paragraph id="id50ba371f-9dc2-4250-b980-39bfd5985738"><enum>(2)</enum><header>Ongoing designations</header><text>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. </text></paragraph><paragraph id="id14d403fc-c792-42de-811d-7471e75e930e"><enum>(3)</enum><header>Qualifications</header><text>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).</text></paragraph></subsection><subsection id="idb7aaa327-4f28-429e-b6a1-5a9ee3971c4f"><enum>(c)</enum><header>Consultation</header><text>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—</text><paragraph id="idbb4508cd-d233-4702-a173-33f27815953b"><enum>(1)</enum><text>the manner and extent to which the United States plans to participate in CEPI, including through the governance of CEPI;</text></paragraph><paragraph id="ide3e7443e-99a1-412f-bf59-820434ac7263"><enum>(2)</enum><text>any planned financial contributions from the United States to CEPI; and</text></paragraph><paragraph id="id64162693-19e3-4ac9-88a4-de55b2b745b8"><enum>(3)</enum><text>how participation in CEPI is expected to support—</text><subparagraph id="idfbf56003-d98b-4a2e-9502-502c9865b725"><enum>(A)</enum><text>the United States Global Health Security Strategy required under this Act;</text></subparagraph><subparagraph id="id3275297a-5e8e-4fc7-b36f-6790e04a011a"><enum>(B)</enum><text>the applicable revision of the National Biodefense Strategy required under section 1086 of the National Defense Authorization Act for Fiscal Year 2017 (<external-xref legal-doc="usc" parsable-cite="usc/6/104">6 U.S.C. 104</external-xref>); and </text></subparagraph><subparagraph id="id307e152a-3273-42c9-9555-6475b65ceb79"><enum>(C)</enum><text>any other relevant programs relating to global health security and biodefense.</text></subparagraph></paragraph></subsection><subsection id="id7693ac88-5462-449b-ae53-1839d04b4c89"><enum>(d)</enum><header>United States contributions</header><paragraph id="idc75141a5-de17-4a71-a4bd-ccc0609454ca"><enum>(1)</enum><header>Sense of congress</header><text>It is the sense of Congress that the President, consistent with the provisions under section 10003(a)(1) of the <short-title>American Rescue Plan Act of 2021</short-title>, 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. </text></paragraph><paragraph id="id6341971a-0494-49ce-a488-439aefcb6e60" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Notification</header><text>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. </text></paragraph></subsection></section><section id="idc90072b7-cb4b-4385-a1cd-9d52f1cd6078"><enum>209.</enum><header>National intelligence estimate and briefing regarding novel diseases and pandemic threats</header><subsection id="iddf8b5b37-4763-4ec3-97fb-1b5357d4ad5b"><enum>(a)</enum><header>Defined term</header><text>In this section, the term <term>appropriate committees of Congress</term> means—</text><paragraph id="ida5653a3c-e46b-4e44-8c29-37ca8ff24207"><enum>(1)</enum><text>the <committee-name committee-id="SSFR00">Committee on Foreign Relations of the Senate</committee-name>;</text></paragraph><paragraph id="id0a4d7737-bdfc-495f-bb88-6997321ffeaf"><enum>(2)</enum><text>the <committee-name committee-id="SLIN00">Select Committee on Intelligence of the Senate</committee-name>;</text></paragraph><paragraph id="ida54538d1-1340-41d9-ad8f-60b0e8d25ebf"><enum>(3)</enum><text>the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions of the Senate</committee-name>;</text></paragraph><paragraph id="id41c04596-bf6c-4ed7-9c94-d059f28ad785"><enum>(4)</enum><text>the <committee-name committee-id="">Committee on Foreign Affairs of the House of Representatives</committee-name>;</text></paragraph><paragraph id="id4828b45a-04d3-40b7-8a3a-fa2963b750cd"><enum>(5)</enum><text>the <committee-name committee-id="">Permanent Select Committee on Intelligence of the House of Representatives</committee-name>; and</text></paragraph><paragraph id="idc3125b55-63a2-4117-b293-44b2dd11fff4"><enum>(6)</enum><text>the <committee-name committee-id="">Committee on Energy and Commerce of the House of Representatives</committee-name>.</text></paragraph></subsection><subsection id="idada47c4a-0988-4c7c-8ac0-38f015b87160"><enum>(b)</enum><header>National Intelligence Estimates</header><paragraph id="ide59845a9-e7f7-476f-a8fe-14446de68fa2"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="id5d3b34bd-022b-456a-9475-e9452d143354"><enum>(2)</enum><header>Elements</header><text>The National Intelligence Estimate submitted pursuant to paragraph (1) shall—</text><subparagraph id="id2cc30ad9-a2b3-47b1-9b0a-89e9323ddaa3"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="id3b9f9454-d62e-4ac2-ba28-86bc4f728fa0"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id01b5ebd0-4c31-414e-8563-e00889dfb6ca"><enum>(C)</enum><text>assess the preparedness of countries around the world, particularly those identified pursuant to subparagraph (A), to prevent, detect, and respond to pandemic threats; and</text></subparagraph><subparagraph id="idae4bc01f-4800-43f3-b0f7-49cf4c0e48f9"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection><subsection id="idef061541-89da-45e6-8d26-231026afb777"><enum>(c)</enum><header>Congressional briefings</header><text>The National Intelligence Council shall provide an annual briefing to the appropriate committees of Congress regarding—</text><paragraph id="id6b5c5ee2-1d97-4e38-9cb1-0ebcdbdc7337"><enum>(1)</enum><text>the most recent National Intelligence Estimate submitted pursuant to subsection (b)(1); and</text></paragraph><paragraph id="id5bffd081-eb23-4bc4-92aa-cec5bd6190e8"><enum>(2)</enum><text>the emergence or reemergence of pathogens with pandemic potential that could lead to an epidemic described in subsection (b)(2)(B).</text></paragraph></subsection><subsection id="id33bf504c-5b72-4482-a890-18436aea9072" commented="no" display-inline="no-display-inline"><enum>(d)</enum><header>Public availability</header><text>The Director of National Intelligence shall make publicly available an unclassified version of each National Intelligence Estimate submitted pursuant to subsection (b)(1). </text></subsection></section><section id="idfc10779a-2193-415b-a8ff-a375fdae6e65"><enum>210.</enum><header>Pandemic early warning network</header><subsection id="id3b5631e2-4f87-48a6-8336-132b21f9bbfa"><enum>(a)</enum><header>In general</header><text>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.</text></subsection><subsection id="id800aad81-42a4-45ed-9eb4-16f0c77e8e41"><enum>(b)</enum><header>Report</header><text>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.</text></subsection></section><section id="id72900e18-d15a-4999-881b-7b39f16849ef"><enum>211.</enum><header>International emergency operations</header><subsection id="id8ff1c235-fb80-4ddb-9462-c317ac72068d"><enum>(a)</enum><header>Sense of Congress</header><text>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.</text></subsection><subsection id="id07288489-e991-4de2-8b75-4149fb720bbe"><enum>(b)</enum><header>Public health emergencies of international concern</header><text>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.</text></subsection><subsection id="id4c2ecca6-29cb-440d-9c69-41cfdea7c216"><enum>(c)</enum><header>Emergency operations</header><text>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—</text><paragraph id="id7cc002e4-2f05-4f1b-9c5d-ac4efd1e0862"><enum>(1)</enum><text>to collect and share data, assess risk, and operationalize early warning;</text></paragraph><paragraph id="id423a265d-a164-46f5-806a-88ff26d6b232"><enum>(2)</enum><text>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</text></paragraph><paragraph id="id59e23e2e-4efb-4901-b390-f3f0bed821a1" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>to organize and conduct emergency simulations. </text></paragraph></subsection></section><enum>III</enum><header>Financing mechanism for global health security and pandemic prevention and preparedness</header><section id="id924b4cf2-5a46-4da2-b369-597e22d48d41"><enum>301.</enum><header>Eligible partner country defined</header><text display-inline="no-display-inline">In this title, the term <term>eligible partner country</term> 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—</text><paragraph id="id5fe1d405-15b8-4a88-acb7-11a26bad3cc8"><enum>(1)</enum><text>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 </text></paragraph><paragraph id="idd855c2a3-4f4a-4a86-9346-a03d81ed2a1a"><enum>(2)</enum><text>commitment to transparency, including—</text><subparagraph id="id21f59830-e153-41da-a1b1-f8ebeed63f4b"><enum>(A)</enum><text>budget and global health data transparency;</text></subparagraph><subparagraph id="id3a406b46-c7a0-4c52-b9a3-330bee6fc1cf"><enum>(B)</enum><text>complying with the International Health Regulations (2005);</text></subparagraph><subparagraph id="id72e5f856-aa8a-4cde-b56e-08172c7a78d9"><enum>(C)</enum><text>investing in domestic health systems; and </text></subparagraph><subparagraph id="idf5206464-77ae-4977-aae9-fa879e47fbe2"><enum>(D)</enum><text>achieving measurable results.</text></subparagraph></paragraph></section><section id="idda0a91e2-3040-4134-9b97-96c65e0aad7a"><enum>302.</enum><header>Establishment of Fund for Global Health Security and Pandemic Prevention and Preparedness</header><subsection id="id112a16a0-4755-418c-b121-e757a10b0d34"><enum>(a)</enum><header>Negotiations for establishment of Fund for Global Health Security and Pandemic Prevention and Preparedness</header><text>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—</text><paragraph id="ida6cf6bdf-92b1-4ca4-a840-5d70e5ae668c"><enum>(1)</enum><text>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 <quote>the Fund</quote>), to address the need for and secure durable financing in accordance with the provisions of this section; and</text></paragraph><paragraph id="id30812ec7-4e87-44eb-9f19-a54356fc4d74"><enum>(2)</enum><text>an Advisory Board to the Fund in accordance with section 305.</text></paragraph></subsection><subsection id="id5aa60dc1-45cc-40bd-9c47-c76ee25f50c9"><enum>(b)</enum><header>Purposes</header><text>The purposes of the Fund should be—</text><paragraph id="idf673d5d0-c9d5-4a29-9bc2-22995bd7f217"><enum>(1)</enum><text>to close critical gaps in global health security and pandemic prevention and preparedness; and </text></paragraph><paragraph id="idae92ea16-a837-4d0a-8792-3fdb315d8099"><enum>(2)</enum><text>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—</text><subparagraph id="idfd85ce88-dca0-448b-8ce1-a86bf1e2b201"><enum>(A)</enum><text>prioritizes capacity building and financing availability in eligible partner countries;</text></subparagraph><subparagraph id="id6b93ee2d-06c1-432d-bd0a-ffce396b0aa9"><enum>(B)</enum><text>incentivizes countries to prioritize the use of domestic resources for global health security and pandemic prevention and preparedness;</text></subparagraph><subparagraph id="idf47e1bf8-e7c1-4519-a589-4a03d0015ba3"><enum>(C)</enum><text>leverages government, nongovernment, and private sector investments;</text></subparagraph><subparagraph id="id07b870e7-6e8b-4a80-8a54-297c0e1c8f37"><enum>(D)</enum><text>regularly responds to and evaluates progress based on clear metrics and benchmarks, such as the Joint External Evaluation and the Global Health Security Index;</text></subparagraph><subparagraph id="id407d10e3-82bc-4bb0-90c3-4d0b3b4f2865"><enum>(E)</enum><text>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</text></subparagraph><subparagraph id="id7fa65692-c16a-41f1-b618-55f47b0b5508"><enum>(F)</enum><text>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.</text></subparagraph></paragraph></subsection><subsection id="id96cb2ecb-8814-44d3-a153-4911ae81d3c8"><enum>(c)</enum><header>Executive Board</header><paragraph id="id2a63ec8b-0d8d-4b39-818a-4b87989b044e"><enum>(1)</enum><header>In general</header><text>The Fund should be governed by a transparent and accountable body (referred to in this title as the <quote>Executive Board</quote>), which should—</text><subparagraph id="idCBB65CA9CEDC4D15961A22AB38F10595"><enum>(A)</enum><text>function as a partnership with, and through full engagement by, donor governments, eligible partner countries, and independent civil society; and</text></subparagraph><subparagraph id="idE0182AA1C6154E9DBD07B17E1FAFB712"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><paragraph id="idc64bb34a-29e0-4ef4-be51-fb684c877548"><enum>(2)</enum><header>Duties</header><text>The Executive Board should—</text><subparagraph id="id0e76943d-dd37-48dd-ac58-73c85ebdb0cd"><enum>(A)</enum><text>be charged with approving strategies, operations, and grant making authorities in order to conduct effective fiduciary, monitoring, and evaluation efforts, and other oversight functions;</text></subparagraph><subparagraph id="id7f35e629-3d51-47d1-a21b-5046b129d253"><enum>(B)</enum><text>determine operational procedures such that the Fund is able to effectively fulfill its mission; </text></subparagraph><subparagraph id="ide7acde16-9b54-48d7-92de-b91c0a6cad41"><enum>(C)</enum><text>provide oversight and accountability for the Fund in collaboration with the Inspector General to be established pursuant to section 304(e)(1)(A);</text></subparagraph><subparagraph id="id2fcddb18-c899-4935-b6a0-98f51c53253e"><enum>(D)</enum><text>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</text></subparagraph><subparagraph id="idC92C80730A444D9199B64B755D86E187"><enum>(E)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id8ae9746f-96a1-47d2-afb2-dfa35668a274"><enum>(3)</enum><header>Composition</header><text>The Executive Board should include—</text><subparagraph id="id4aa1608a-a712-4b74-8eba-3b6f67d9fc14"><enum>(A)</enum><text>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);</text></subparagraph><subparagraph id="id4868d98a-d579-46e2-8d6c-ae2b1ffa3ff8"><enum>(B)</enum><text>a geographically diverse group of members who—</text><clause id="id4f6cf894-fa84-4862-8d23-658ec2c8bcf3"><enum>(i)</enum><text>come from donor countries, eligible partner countries, academic institutions, independent civil society, including indigenous organizations, and the private sector; and </text></clause><clause id="ida615e98c-776e-47e9-86f0-2b0f40f75af9"><enum>(ii)</enum><text>are selected on the basis of their experience and commitment to innovation, best practices, and the advancement of global health security objectives; </text></clause></subparagraph><subparagraph id="id09d66cec-2de1-44e1-b029-aa18f4daece4"><enum>(C)</enum><text>representatives of the World Health Organization; and</text></subparagraph><subparagraph id="idc394f44b-4a69-4c3c-9f6b-b4c6127eae24"><enum>(D)</enum><text>the chair of the Global Health Security Steering Group.</text></subparagraph></paragraph><paragraph id="id4620321f-5cf1-4065-a231-49897e2474ea"><enum>(4)</enum><header>Contributions</header><text>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.</text></paragraph><paragraph id="idDD8BA659CE344359894EC41FD17E52C2"><enum>(5)</enum><header>Qualifications</header><text>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.</text></paragraph><paragraph id="idea805529-dfd3-4239-bb13-d55a9c4331bc"><enum>(6)</enum><header>Conflicts of interest</header><subparagraph id="idf66e57a5-1b21-4f64-8d41-1cd388a5f0ca"><enum>(A)</enum><header>Technical experts</header><text>The Executive Board may include independent technical experts who are not affiliated with, or employed by, a recipient country or organization.</text></subparagraph><subparagraph id="id77db8379-c2f9-4049-81b5-2fd41f5332b1"><enum>(B)</enum><header>Multilateral bodies and institutions</header><text>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.</text></subparagraph></paragraph><paragraph id="idba23de24-d318-471a-87ff-59b6d7f817e8"><enum>(7)</enum><header>United states representation</header><subparagraph id="id4bc7fd05-e4c5-491d-9b9a-dd559e58a555" commented="no"><enum>(A)</enum><header>Founding member</header><text>The Secretary of State should seek—</text><clause commented="no" id="id176ec488-3ca3-4fd1-9fc4-81c574ed9b68"><enum>(i)</enum><text>to establish the United States as a founding member of the Fund; and </text></clause><clause commented="no" id="id538ca760-43dd-4ed7-9057-511ce044360d"><enum>(ii)</enum><text>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.</text></clause></subparagraph><subparagraph id="id7ab7f35e-c1fc-42f1-96a4-09ff0bd85e25"><enum>(B)</enum><header>Effective and termination dates</header><clause id="idef08dd27-a1b2-48cb-9553-e07d26764783"><enum>(i)</enum><header>Effective date</header><text>This paragraph shall take effect upon the date on which the Secretary of State certifies and submits to Congress an agreement establishing the Fund.</text></clause><clause id="idf2ec5473-cece-4c4a-914b-e6e070e3c1bf"><enum>(ii)</enum><header>Termination date</header><text>The membership established pursuant to subparagraph (A) shall terminate upon the date of termination of the Fund.</text></clause></subparagraph></paragraph><paragraph id="idcfb750ed-9ceb-4525-9aa7-d57e9f4be3ad"><enum>(8)</enum><header>Removal procedures</header><text>The Fund should establish procedures for the removal of members of the Executive Board who—</text><subparagraph id="id49a54d21-ca88-4cde-9b70-ffa9de1a3ff7"><enum>(A)</enum><text>engage in a consistent pattern of human rights abuses;</text></subparagraph><subparagraph id="idb886f1e9-dbef-4698-ba47-143f869d593c"><enum>(B)</enum><text>fail to uphold global health data transparency requirements; or </text></subparagraph><subparagraph id="id87a6bafe-e792-4dd1-b308-72455b13ab3d"><enum>(C)</enum><text>otherwise violate the established standards of the Fund, including in relation to corruption.</text></subparagraph></paragraph></subsection></section><section id="idd40aaa4e-5cdc-42c9-93e9-ef4f52ea8b10"><enum>303.</enum><header>Authorities</header><subsection id="ida2bd274e-8a2e-463f-89d0-ce6e667be7c0"><enum>(a)</enum><header>Program objectives</header><paragraph id="id5e22257f-a370-47e0-8b67-055437d99f14"><enum>(1)</enum><header>In general</header><text>In carrying out the purpose set forth in section 302, the Fund, acting through the Executive Board, should— </text><subparagraph id="id61671fa9-016e-4089-abc8-3ba3c45f7985"><enum>(A)</enum><text>develop grant making requirements to be administered by an independent technical review panel comprised of entities barred from applying for funding or support; </text></subparagraph><subparagraph id="id9C913E66BB0D4C5C9AD0E58C5C250AAE"><enum>(B)</enum><text>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—</text><clause id="id547bcf22-2bea-45e5-8e45-2f1c0682b5b3"><enum>(i)</enum><text>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</text></clause><clause id="id5ee8e6dc-6c75-45a5-ba49-01b47447e8d5"><enum>(ii)</enum><text>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;</text></clause></subparagraph><subparagraph id="id0d5795e6-d3bd-4ff8-9d2c-7af3859c0794"><enum>(C)</enum><text>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</text></subparagraph><subparagraph id="id33F4E676589E424A9662904A136FEFFA"><enum>(D)</enum><text>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.</text></subparagraph></paragraph><paragraph id="id69612853-e987-4b60-ba65-f82056a9f39a"><enum>(2)</enum><header>Activities supported</header><text>The activities to be supported by the Fund should include efforts—</text><subparagraph id="id8f7ecbd7-5395-42c2-a845-ca18ec648d4b"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="idd6aa5165-9c04-441e-aa94-3908787e460a"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="id2473a810-79c0-490e-b6ea-dbc238463e09"><enum>(C)</enum><text>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;</text></subparagraph><subparagraph id="id11cb69ca-93dd-44b0-80e4-d0320e42740e"><enum>(D)</enum><text>to improve the quality of community health worker programs as the foundation of pandemic preparedness and response through application of appropriate assessment tools; </text></subparagraph><subparagraph id="id195D756CE1094652BBA56AE2AB44909A"><enum>(E)</enum><text>to improve infection prevention and control, the protection of healthcare workers, including community health workers, and access to water and sanitation within healthcare settings;</text></subparagraph><subparagraph id="ide27acc2d-8ee0-4330-860d-9b988b932fe1"><enum>(F)</enum><text>to combat the threat of antimicrobial resistance;</text></subparagraph><subparagraph id="idd4f58dc0-bed7-42ce-8346-a1e02703ed3b"><enum>(G)</enum><text>to strengthen laboratory capacity and promote biosafety and biosecurity through the provision of material and technical assistance;</text></subparagraph><subparagraph id="id2c37130d-df6d-4ce9-aadf-7b48e14db976"><enum>(H)</enum><text>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;</text></subparagraph><subparagraph id="idf336c2d4-76b7-413f-88fe-96c4b189db57"><enum>(I)</enum><text>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;</text></subparagraph><subparagraph id="id4b5d8eae-c361-46f0-8169-83908de4cc3c"><enum>(J)</enum><text>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;</text></subparagraph><subparagraph id="id97f119c3-2ce9-4a5c-ba92-916e812a6f89"><enum>(K)</enum><text>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;</text></subparagraph><subparagraph id="id7a07c5e4-306b-4e3e-b3dc-c2bdd48fc7d8"><enum>(L)</enum><text>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;</text></subparagraph><subparagraph id="idba186399-8461-459f-9ec2-9a8fbc849011"><enum>(M)</enum><text>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;</text></subparagraph><subparagraph id="idcd6155f1-4f97-472d-9535-cc802de605a4"><enum>(N)</enum><text>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; </text></subparagraph><subparagraph id="ide448c49c-b005-480f-bd5e-7a485e740bb6"><enum>(O)</enum><text>to promote broad participation in health emergency planning and advisory bodies, including by women and frontline health workers;</text></subparagraph><subparagraph id="idFEC394313F4E4C2A818B9B7299FE2BC1"><enum>(P)</enum><text>to develop and implement simulation exercises, produce and release after action reports, and address related gaps; </text></subparagraph><subparagraph id="id47730ba3-b55f-4ef9-acbd-a0024f0133bc"><enum>(Q)</enum><text>to support countries in conducting Joint External Evaluations;</text></subparagraph><subparagraph id="id6b422740-170a-46dc-9e07-db91f7540590"><enum>(R)</enum><text>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</text></subparagraph><subparagraph id="id730D50E98CD1447BBAE6D471F04EDB9C"><enum>(S)</enum><text>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.</text></subparagraph></paragraph><paragraph id="idc9f66003-6855-4667-81e5-23e9eb91f0a5"><enum>(3)</enum><header>Implementation of program objectives</header><text>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—</text><subparagraph id="idebe38a8b-5e82-48b6-bcde-74ffab31758c"><enum>(A)</enum><text>governments, independent civil society, nongovernmental organizations, research and academic institutions, and private sector entities in eligible partner countries;</text></subparagraph><subparagraph id="id2a4f2fb7-bcfe-47b5-8b56-f595f6a1aa20"><enum>(B)</enum><text>the pandemic early warning systems and international emergency operations centers to be established under sections 210 and 211;</text></subparagraph><subparagraph id="id70dd4942-73bb-4980-acfe-c5de85c75336"><enum>(C)</enum><text>the World Health Organization;</text></subparagraph><subparagraph id="idfd55bdc4-57af-4c47-bf41-d176aef371de"><enum>(D)</enum><text>the Global Health Security Agenda;</text></subparagraph><subparagraph id="idc2dbf5b0-f3fa-4d33-9892-a9da3b336073"><enum>(E)</enum><text>the Global Health Security Initiative;</text></subparagraph><subparagraph id="id5cd6684e-8f3f-4d2f-8b1b-4e43c2e36fa3"><enum>(F)</enum><text>the Global Fund to Fight AIDS, Tuberculosis, and Malaria;</text></subparagraph><subparagraph id="id2bb37bca-59b8-4dc3-8d62-0518295aabfc"><enum>(G)</enum><text>the United Nations Office for the Coordination of Humanitarian Affairs, UNICEF, and other relevant funds, programs, and specialized agencies of the United Nations;</text></subparagraph><subparagraph id="id673a7a3b-ba5d-4df8-afba-caf01f78362b"><enum>(H)</enum><text>Gavi, the Vaccine Alliance;</text></subparagraph><subparagraph id="id10217151-04bf-4042-91a9-0b882f7799c7"><enum>(I)</enum><text>the Coalition for Epidemic Preparedness Innovations (CEPI);</text></subparagraph><subparagraph id="idc7a15b002ab84fbca99ca0d8a547fdf3"><enum>(J)</enum><text>The World Organisation for Animal Health;</text></subparagraph><subparagraph id="idd7e1e10f9c9e479f9754a79e30174ecf"><enum>(K)</enum><text>The United Nations Environment Programme;</text></subparagraph><subparagraph id="id54d11eef331c498a94433226a556cb35"><enum>(L)</enum><text>Food and Agriculture Organization; and</text></subparagraph><subparagraph id="idd6a80b6a-eb14-4597-bbe5-9253889b37de"><enum>(M)</enum><text>the Global Polio Eradication Initiative.</text></subparagraph></paragraph></subsection><subsection id="idb0fe6188-17e2-489f-ae4b-151313222fa4"><enum>(b)</enum><header>Priority</header><text>In providing assistance under this section, the Fund should give priority to low-and lower middle income countries with—</text><paragraph id="idc8765f5f-ca84-4c9a-bc24-cbdc0bcb915c"><enum>(1)</enum><text>low scores on the Global Health Security Index classification of health systems;</text></paragraph><paragraph id="id9ca49efd-c377-4062-bb4c-35e40462068d"><enum>(2)</enum><text>measurable gaps in global health security and pandemic prevention and preparedness identified under Joint External Evaluations and national action plans for health security;</text></paragraph><paragraph id="ida9384ccb-1a03-478b-a171-81104bed5d40"><enum>(3)</enum><text>demonstrated political and financial commitment to pandemic prevention and preparedness; and</text></paragraph><paragraph id="iddb308947-de7f-4607-a5ec-387ba4e21359"><enum>(4)</enum><text>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.</text></paragraph></subsection><subsection id="id6e7350e8-3842-4c79-a026-4c9de54d2730"><enum>(c)</enum><header>Eligible grant recipients</header><text>Governments and nongovernmental organizations should be eligible to receive grants as described in this section.</text></subsection></section><section id="ida724584b-5b87-4712-afe3-b80eddb4f015"><enum>304.</enum><header>Administration</header><subsection id="id7b53fdb1-0ba8-4900-a459-38a876e62daa"><enum>(a)</enum><header>Appointments</header><text>The Executive Board should appoint—</text><paragraph id="id46FABE5BC3DB42D2BE4113440B9A7067"><enum>(1)</enum><text>an Administrator, who should be responsible for managing the day-to-day operations of the Fund; and</text></paragraph><paragraph id="id3D4A1CD0DE61483DA4FF701DE9E14EB4"><enum>(2)</enum><text>an independent Inspector General, who should be responsible for monitoring grants implementation and proactively safeguarding against conflicts of interests.</text></paragraph></subsection><subsection id="id74458875-3a69-4ada-985f-2fdb4c57aedd"><enum>(b)</enum><header>Authority to accept and solicit contributions</header><text>The Fund should be authorized to solicit and accept contributions from governments, the private sector, foundations, individuals, and nongovernmental entities.</text></subsection><subsection id="id6090ce2b-fc0e-45c5-98e8-b2c50f104a6e"><enum>(c)</enum><header>Accountability; conflicts of interest; criteria for programs</header><text>As part of the negotiations described in section 302(a), the Secretary of the State, consistent with subsection (d), should—</text><paragraph id="id827d0e83-e7f4-4fb3-9a96-cd6b6987f637"><enum>(1)</enum><text>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; </text></paragraph><paragraph id="id7F77286315A94FA0B39B2C8C40170A86"><enum>(2)</enum><text>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 </text></paragraph><paragraph id="id9171ea1b-1abb-4236-a36d-d8374b4e9ca4"><enum>(3)</enum><text>seek agreement on the criteria that should be used to determine the programs and activities that should be assisted by the Fund.</text></paragraph></subsection><subsection id="id2e4cd4ab-723f-441e-b395-4c8d3318c157"><enum>(d)</enum><header>Selection of partner countries, projects, and recipients</header><text>The Executive Board should establish—</text><paragraph id="id1c72fe3f-1f02-4394-bcc8-2487bb322e7a"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="id3cbbf53d-e7de-401e-bf53-16fb94797a1f"><enum>(2)</enum><text>minimum standards for ensuring eligible partner country ownership and commitment to long-term results, including requirements for domestic budgeting, resource mobilization, and co-investment;</text></paragraph><paragraph id="idd412f2d8-e98c-4815-b8cd-a333b0e5880b"><enum>(3)</enum><text>criteria for the selection of projects to receive support from the Fund;</text></paragraph><paragraph id="idbc2d3a2c-4cf8-49ac-8ef3-251ea5541adf"><enum>(4)</enum><text>standards and criteria regarding qualifications of recipients of such support;</text></paragraph><paragraph id="idc176c512-500c-4dc9-b103-1dc4dd7e4cfe"><enum>(5)</enum><text>such rules and procedures as may be necessary for cost-effective management of the Fund; and</text></paragraph><paragraph id="id7f37437c-e77e-4837-b6ec-c77c7411d21c"><enum>(6)</enum><text>such rules and procedures as may be necessary to ensure transparency and accountability in the grant-making process.</text></paragraph></subsection><subsection id="id522222e4-30ce-424b-a0d2-7aeb429ff79f"><enum>(e)</enum><header>Additional transparency and accountability requirements</header><paragraph id="id620bc318-dd8f-4908-9dad-2f809132c87b"><enum>(1)</enum><header>Inspector general</header><subparagraph id="id1106701e-95e3-4115-9b37-f574cd0bb22a"><enum>(A)</enum><header>In general</header><text>The Secretary of State shall seek to ensure that the Inspector General appointed pursuant to subsection (a)—</text><clause id="ida3c733d1-1c20-49ee-a926-0c22895bdaeb"><enum>(i)</enum><text>is fully enabled to operate independently and transparently;</text></clause><clause id="idcc2ccc7b-e6a0-4b10-a3cd-41a5f79a5d5e"><enum>(ii)</enum><text>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</text></clause><clause id="id5e3a60e3f7a64a7abdee655413ebb018"><enum>(iii)</enum><text>establishes an investigative unit that—</text><subclause id="id989f21d6304840fdb1343942af724532"><enum>(I)</enum><text>develops an oversight mechanism to ensure that grant funds are not diverted to illicit or corrupt purposes or activities; and</text></subclause><subclause id="id869863798ffa4e9092e4674d2eae09f8"><enum>(II)</enum><text>submits an annual report to the Executive Board describing its activities, investigations, and results.</text></subclause></clause></subparagraph><subparagraph id="id99479a82-ebc8-4304-9c73-06f6f5ea9ae1"><enum>(B)</enum><header>Sense of congress on corruption</header><text>It is the sense of Congress that—</text><clause id="idd9a38e7d-4d98-4e2c-bb07-019cae9a9f70"><enum>(i)</enum><text>corruption within global health programs contribute directly to the loss of human life and cannot be tolerated; and</text></clause><clause id="id50653411-fcf8-4017-88c1-ab1fb28c8cde"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><paragraph id="ide0367fb4-8567-46a0-a140-69a6445d80e8"><enum>(2)</enum><header>Administrative expenses</header><text>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.</text></paragraph><paragraph id="idea37bf5d-5b20-4feb-b900-2f581434a1f0"><enum>(3)</enum><header>Financial tracking systems</header><text>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.</text></paragraph><paragraph id="id46817e99-d2a3-4fec-9311-f03df4ed651b"><enum>(4)</enum><header>Exemption from duties and taxes</header><text>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.</text></paragraph></subsection></section><section id="idba48a263-32ad-456e-a96a-a928e78e5789"><enum>305.</enum><header>Advisory Board</header><subsection id="id8307c668-47c2-4485-a644-061970469dde"><enum>(a)</enum><header>In general</header><text>There should be an Advisory Board to the Fund.</text></subsection><subsection id="ida97d9407-bd90-4e2b-85c7-7b2d1eb16958"><enum>(b)</enum><header>Appointments</header><text>The members of the Advisory Board should be composed of—</text><paragraph id="id01262326-2279-4061-aad1-57e91841add9"><enum>(1)</enum><text>a geographically diverse group of individuals that includes representation from low- and middle-income countries;</text></paragraph><paragraph id="id961c943b-e586-4c9e-98c1-5c7180a3930c"><enum>(2)</enum><text>individuals with experience and leadership in the fields of development, global health, epidemiology, medicine, biomedical research, and social sciences; and</text></paragraph><paragraph id="id527e2201-f62a-4a03-9935-1e0fcb9d6436"><enum>(3)</enum><text>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.</text></paragraph></subsection><subsection id="ideb95c4a3-e407-40ec-b14f-113af98717ca"><enum>(c)</enum><header>Responsibilities</header><text>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.</text></subsection><subsection id="id9b40c106-7638-4c2c-9e1c-c7ed759ad35f"><enum>(d)</enum><header>Prohibition on payment of compensation</header><paragraph id="ida9f0249a-0fd9-422b-ad4b-cd607e0b6331"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="id0ea34af0-e313-4a68-ab48-014af1cea09a"><enum>(2)</enum><header>United states representative</header><text>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.</text></paragraph></subsection><subsection id="id906fa2b6-37d7-4cdc-a4ba-7c1f16698358"><enum>(e)</enum><header>Conflicts of interest</header><text>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.</text></subsection></section><section id="id8d9d09bf-f4a1-42c9-b99b-516c650cda95"><enum>306.</enum><header>Reports to Congress</header><subsection id="id6c4dad67-6604-4be5-aa68-46c80baa5ee0"><enum>(a)</enum><header>Status report</header><text>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.</text></subsection><subsection id="id93d80861-15e1-40e9-92ef-49faa81da484"><enum>(b)</enum><header>Annual report</header><paragraph id="id1dc06ea6-7e53-4254-8814-8c452f28d137"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="idd2733841-2f1e-4d39-b4f9-8d7db10d5e2f"><enum>(2)</enum><header>Report elements</header><text>The report required under paragraph (1) shall describe—</text><subparagraph id="idbb7ea929-8fab-49d0-90d8-c7544ccf8ff5"><enum>(A)</enum><text>the goals of the Fund;</text></subparagraph><subparagraph id="iddb7dc239-aa4c-4b99-b5a9-b0c5cac5ffff"><enum>(B)</enum><text>the programs, projects, and activities supported by the Fund;</text></subparagraph><subparagraph id="id55cf44d7-1c15-4992-ba45-17f909c368b6"><enum>(C)</enum><text>private and governmental contributions to the Fund; and</text></subparagraph><subparagraph id="idf9455baf-4a81-4f48-a6a4-c708c7633998"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection><subsection id="ida4506b85-708a-4609-86e2-64719dc2e08e" commented="no"><enum>(c)</enum><header>GAO report on effectiveness</header><text>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). </text></subsection></section><section id="id6ac52c2e-b590-4ef9-84b0-86d6acaf864c"><enum>307.</enum><header>United States contributions</header><subsection id="id54a09bae-3a98-4efe-b8b8-0e340231dcf6"><enum>(a)</enum><header>In general</header><text>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.</text></subsection><subsection id="idb4e05329-5045-4e1c-9dcf-e68d3a470c6b"><enum>(b)</enum><header>Notification</header><text>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—</text><paragraph id="idd53f52f8-dd56-4511-b31d-3b301402e92c"><enum>(1)</enum><text>the amount of the proposed contribution;</text></paragraph><paragraph id="id91ced9c5-5dd7-4eec-90ec-14fba79598f8"><enum>(2)</enum><text>the total of funds contributed by other donors; and</text></paragraph><paragraph id="id9665a9c7-40a7-48e7-a69d-685c022b9613"><enum>(3)</enum><text>the national interests served by United States participation in the Fund.</text></paragraph></subsection><subsection id="idcfcb5f8f-3e92-47fd-be37-d91637e60218"><enum>(c)</enum><header>Limitation</header><text>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.</text></subsection><subsection id="id5244ad48-2c37-4b10-b32c-391b5a1272c0"><enum>(d)</enum><header>Withholdings</header><paragraph id="id43751178-57e3-4719-be16-b713c61bd94b"><enum>(1)</enum><header>Support for acts of international terrorism</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/22/2371">22 U.S.C. 2371</external-xref>) 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.</text></paragraph><paragraph id="ida66592a8-3689-4621-8e5c-7f74859b14c1"><enum>(2)</enum><header>Excessive salaries</header><text>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.</text></paragraph><paragraph id="id7a163314-9256-4baf-8db1-8edc7e8848c1"><enum>(3)</enum><header>Accountability certification requirement</header><text>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).</text></paragraph></subsection></section><section id="id3770301c-0da8-4706-91e1-cea2365404b2"><enum>308.</enum><header>Compliance with the Foreign Aid Transparency and Accountability Act of 2016</header><text display-inline="no-display-inline">Section 2(3) of the Foreign Aid Transparency and Accountability Act of 2016 (<external-xref legal-doc="public-law" parsable-cite="pl/114/191">Public Law 114–191</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/22/2394c">22 U.S.C. 2394c</external-xref> note) is amended—</text><paragraph id="ide742ead2-5300-4543-90d9-49cc1d669fe2"><enum>(1)</enum><text>in subparagraph (D), by striking <quote>and</quote> at the end;</text></paragraph><paragraph id="id66b1785a-117f-48fd-be49-c82c79550f15" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text>in subparagraph (E), by striking the period at the end and inserting <quote>; and</quote>; and </text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ide479cdf3-1c97-4621-af8f-38ffd99b8967"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id5ebd24de-c0c9-4044-8625-f1b85274a85a" changed="added" reported-display-style="italic" committee-id="SSFR00"><subparagraph commented="no" display-inline="no-display-inline" id="id10f5ffb9-56fe-4d40-9975-f6451e4e5e80"><enum>(F)</enum><text>the <short-title>International Pandemic Preparedness and COVID-19 Response Act of 2021</short-title>.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section display-inline="no-display-inline" commented="no" id="idF942EFEAF5EA4CED91388B937D51A775"><enum>309.</enum><header>Prohibition against United States foreign assistance for the Government of the People's Republic of China</header><text display-inline="no-display-inline">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. </text></section>July 30, 2021Reported with an amendment