[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 871 Introduced in Senate (IS)]






108th CONGRESS
  1st Session
                                 S. 871

       To provide for global pathogen surveillance and response.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 10, 2003

 Mr. Biden (for himself, Mr. Lugar, Mr. Kennedy, Mr. Hagel, Mr. 
        Domenici, and Mr. Feingold) introduced the following bill; 
        which was read twice and referred to the Committee on Foreign 
        RelationsYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY

_______________________________________________________________________

                                 A BILL


 
       To provide for global pathogen surveillance and response.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Global Pathogen Surveillance Act of 
2003''.

SEC. 2. FINDINGS; PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) Bioterrorism poses a grave national security threat to 
        the United States. The insidious nature of the threat, the 
        likely delayed recognition in the event of an attack, and the 
        underpreparedness of the domestic public health infrastructure 
        may produce catastrophic consequences following a biological 
        weapons attack upon the United States.
            (2) A contagious pathogen engineered as a biological weapon 
        and developed, tested, produced, or released in another country 
        can quickly spread to the United States. Given the realities of 
        international travel, trade, and migration patterns, a 
        dangerous pathogen released anywhere in the world can spread to 
        United States territory in a matter of days, before any 
        effective quarantine or isolation measures can be implemented.
            (3) To effectively combat bioterrorism and ensure that the 
        United States is fully prepared to prevent, diagnose, and 
        contain a biological weapons attack, measures to strengthen the 
        domestic public health infrastructure and improve domestic 
        surveillance and monitoring, while absolutely essential, are 
        not sufficient.
            (4) The United States should enhance cooperation with the 
        World Health Organization, regional health organizations, and 
        individual countries, including data sharing with appropriate 
        United States departments and agencies, to help detect and 
        quickly contain infectious disease outbreaks or bioterrorism 
        agents before they can spread.
            (5) The World Health Organization (WHO) has done an 
        impressive job in monitoring infectious disease outbreaks 
        around the world, including the recent emergence of the Severe 
        Acute Respiratory Syndrome (SARS) epidemic, particularly with 
        the establishment in April 2000 of the Global Outbreak Alert 
        and Response network.
            (6) The capabilities of the World Health Organization are 
        inherently limited by the quality of the data and information 
        it receives from member countries, the narrow range of diseases 
        (plague, cholera, and yellow fever) upon which its disease 
        surveillance and monitoring is based, and the consensus process 
        it uses to add new diseases to the list. Developing countries 
        in particular often cannot devote the necessary resources to 
        build and maintain public health infrastructures.
            (7) In particular, developing countries could benefit 
        from--
                    (A) better trained public health professionals and 
                epidemiologists to recognize disease patterns;
                    (B) appropriate laboratory equipment for diagnosis 
                of pathogens;
                    (C) disease reporting is based on symptoms and 
                signs (known as ``syndrome surveillance''), enabling 
                the earliest possible opportunity to conduct an 
                effective response;
                    (D) a narrowing of the existing technology gap in 
                syndrome surveillance capabilities and real-time 
                information dissemination to public health officials; 
                and
                    (E) appropriate communications equipment and 
                information technology to efficiently transmit 
                information and data within national and regional 
                health networks, including inexpensive, Internet-based 
                Geographic Information Systems (GIS) and relevant 
                telephone-based systems for early recognition and 
                diagnosis of diseases.
            (8) An effective international capability to monitor and 
        quickly diagnose infectious disease outbreaks will offer 
        dividends not only in the event of biological weapons 
        development, testing, production, and attack, but also in the 
        more likely cases of naturally occurring infectious disease 
        outbreaks that could threaten the United States. Furthermore, 
a robust surveillance system will serve to deter terrorist use of 
biological weapons, as early detection will help mitigate the intended 
effects of such malevolent uses.
    (b) Purpose.--The purposes of this Act are as follows:
            (1) To enhance the capability and cooperation of the 
        international community, including the World Health 
        Organization and individual countries, through enhanced 
        pathogen surveillance and appropriate data sharing, to detect, 
        identify, and contain infectious disease outbreaks, whether the 
        cause of those outbreaks is intentional human action or natural 
        in origin.
            (2) To enhance the training of public health professionals 
        and epidemiologists from eligible developing countries in 
        advanced Internet-based and other electronic syndrome 
        surveillance systems, in addition to traditional epidemiology 
        methods, so that they may better detect, diagnose, and contain 
        infectious disease outbreaks, especially those due to pathogens 
        most likely to be used in a biological weapons attack.
            (3) To provide assistance to developing countries to 
        purchase appropriate public health laboratory equipment 
        necessary for infectious disease surveillance and diagnosis.
            (4) To provide assistance to developing countries to 
        purchase appropriate communications equipment and information 
        technology, including, as appropriate, relevant computer 
        equipment, Internet connectivity mechanisms, and telephone-
        based applications to effectively gather, analyze, and transmit 
        public health information for infectious disease surveillance 
        and diagnosis.
            (5) To make available greater numbers of United States 
        Government public health professionals to international health 
        organizations, regional health networks, and United States 
        diplomatic missions where appropriate.
            (6) To establish ``lab-to-lab'' cooperative relationships 
        between United States public health laboratories and 
        established foreign counterparts.
            (7) To expand the training and outreach activities of 
        overseas United States laboratories, including Centers for 
        Disease Control and Prevention and Department of Defense 
        entities, to enhance the disease surveillance capabilities of 
        developing countries.
            (8) To provide appropriate technical assistance to existing 
        regional health networks and, where appropriate, seed money for 
        new regional networks.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Eligible developing country.--The term ``eligible 
        developing country'' means any developing country that--
                    (A) has agreed to the objective of fully complying 
                with requirements of the World Health Organization on 
                reporting public health information on outbreaks of 
                infectious diseases;
                    (B) has not been determined by the Secretary, for 
                purposes of section 40 of the Arms Export Control Act 
                (22 U.S.C. 2780), section 620A of the Foreign 
                Assistance Act of 1961 (22 U.S.C. 2371), or section 
                6(j) of the Export Administration Act of 1979 (50 
                U.S.C. App. 2405), to have repeatedly provided support 
                for acts of international terrorism, unless the 
                Secretary exercises a waiver certifying that it is in 
                the national interest of the United States to provide 
                assistance under the provisions of this Act; and
                    (C) is a state party to the Biological Weapons 
                Convention.
            (2) Eligible national.--The term ``eligible national'' 
        means any citizen or national of an eligible developing country 
        who is eligible to receive a visa under the provisions of the 
        Immigration and Nationality Act (8 U.S.C. 1101 et seq.).
            (3) International health organization.--The term 
        ``international health organization'' includes the World Health 
        Organization and the Pan American Health Organization.
            (4) Laboratory.--The term ``laboratory'' means a facility 
        for the biological, microbiological, serological, chemical, 
        immuno-hematological, hematological, biophysical, cytological, 
        pathological, or other examination of materials derived from 
        the human body for the purpose of providing information for the 
        diagnosis, prevention, or treatment of any disease or 
        impairment of, or the assessment of the health of, human 
        beings.
            (5) Secretary.--Unless otherwise provided, the term 
        ``Secretary'' means the Secretary of State.
            (6) Select agent.--The term ``select agent'' has the 
        meaning given such term for purposes of section 72.6 of title 
        42, Code of Federal Regulations.
            (7) Syndrome surveillance.--The term ``syndrome 
        surveillance'' means the recording of symptoms (patient 
        complaints) and signs (derived from physical examination) 
        combined with simple geographic locators to track the emergence 
        of a disease in a population.

SEC. 4. PRIORITY FOR CERTAIN COUNTRIES.

    Priority in the provision of United States assistance for eligible 
developing countries under all the provisions of this Act shall be 
given to those countries that permit personnel from the World Health 
Organization and the Centers for Disease Control and Prevention to 
investigate outbreaks of infectious diseases on their territories, 
provide early notification of disease outbreaks, and provide pathogen 
surveillance data to appropriate United States departments and agencies 
in addition to international health organizations.

SEC. 5. RESTRICTION.

    Notwithstanding any other provision of this Act, no foreign 
nationals participating in programs authorized under this Act shall 
have access, during the course of such participation, to select agents 
that may be used as, or in, a biological weapon, except in a supervised 
and controlled setting.

SEC. 6. FELLOWSHIP PROGRAM.

    (a) Establishment.--There is established a fellowship program (in 
this section referred to as the ``program'') under which the Secretary, 
in consultation with the Secretary of Health and Human Services, and, 
subject to the availability of appropriations, award fellowships to 
eligible nationals to pursue public health education or training, as 
follows:
            (1) Master of public health degree.--Graduate courses of 
        study leading to a master of public health degree with a 
        concentration in epidemiology from an institution of higher 
        education in the United States with a Center for Public Health 
        Preparedness, as determined by the Centers for Disease Control 
        and Prevention.
            (2) Advanced public health epidemiology training.--Advanced 
        public health training in epidemiology to be carried out at the 
        Centers for Disease Control and Prevention (or equivalent State 
        facility), or other Federal facility (excluding the Department 
        of Defense or United States National Laboratories), for a 
        period of not less than 6 months or more than 12 months.
    (b) Specialization in Bioterrorism.--In addition to the education 
or training specified in subsection (a), each recipient of a fellowship 
under this section (in this section referred to as a ``fellow'') may 
take courses of study at the Centers for Disease Control and Prevention 
or at an equivalent facility on diagnosis and containment of likely 
bioterrorism agents.
    (c) Fellowship Agreement.--
            (1) In general.--In awarding a fellowship under the 
        program, the Secretary, in consultation with the Secretary of 
        Health and Human Services, shall require the recipient to enter 
        into an agreement under which, in exchange for such assistance, 
        the recipient--
                    (A) will maintain satisfactory academic progress 
                (as determined in accordance with regulations issued by 
                the Secretary and confirmed in regularly scheduled 
                updates to the Secretary from the institution providing 
                the education or training on the progress of the 
                recipient's education or training);
                    (B) will, upon completion of such education or 
                training, return to the recipient's country of 
                nationality or last habitual residence (so long as it 
                is an eligible developing country) and complete at 
                least four years of employment in a public health 
                position in the government or a nongovernmental, not-
                for-profit entity in that country or, with the approval 
                of the Secretary in an international health 
                organization; and
                    (C) agrees that, if the recipient is unable to meet 
                the requirements described in subparagraph (A) or (B), 
                the recipient will reimburse the United States for the 
                value of the assistance provided to the recipient under 
                the fellowship, together with interest at a rate 
                determined in accordance with regulations issued by the 
                Secretary but not higher than the rate generally 
                applied in connection with other Federal loans.
            (2) Waivers.--The Secretary may waive the application of 
        paragraphs (1)(B) and (1)(C) if the Secretary determines that 
        it is in the national interest of the United States to do so.
    (d) Implementation.--The Secretary, in consultation with the 
Secretary of Health and Human Services, is authorized to enter into an 
agreement with any eligible developing country under which the country 
agrees--
            (1) to establish a procedure for the nomination of eligible 
        nationals for fellowships under this section;
            (2) to guarantee that a fellow will be offered a 
        professional public health position within the country upon 
        completion of his studies; and
            (3) to certify to the Secretary when a fellow has concluded 
        the minimum period of employment in a public health position 
        required by the fellowship agreement, with an explanation of 
        how the requirement was met.
    (e) Participation of United States Citizens.--On a case-by-case 
basis, the Secretary may provide for the participation of United States 
citizens under the provisions of this section if the Secretary 
determines that it is in the national interest of the United States to 
do so. Upon completion of such education or training, a United States 
recipient shall complete at least five years of employment in a public 
health position in an eligible developing country or the World Health 
Organization.

SEC. 7. IN-COUNTRY TRAINING IN LABORATORY TECHNIQUES AND SYNDROME 
              SURVEILLANCE.

    (a) In General.--In conjunction with the Centers for Disease 
Control and Prevention and the Department of Defense, the Secretary 
shall, subject to the availability of appropriations, support short 
training courses in-country (not in the United States) to laboratory 
technicians and other public health personnel from eligible developing 
countries in laboratory techniques relating to the identification, 
diagnosis, and tracking of pathogens responsible for possible 
infectious disease outbreaks. Training under this section may be 
conducted in overseas facilities of the Centers for Disease Control and 
Prevention or in Overseas Medical Research Units of the Department of 
Defense, as appropriate. The Secretary shall coordinate such training 
courses, where appropriate, with the existing programs and activities 
of the World Health Organization.
    (b) Training in Syndrome Surveillance.--In conjunction with the 
Centers for Disease Control and Prevention and the Department of 
Defense, the Secretary shall, subject to the availability of 
appropriations, establish and support short training courses in-country 
(not in the United States) for public health personnel from eligible 
developing countries in techniques of syndrome surveillance reporting 
and rapid analysis of syndrome information using Geographic Information 
System (GIS) and other Internet-based tools. Training under this 
subsection may be conducted via the Internet or in appropriate 
facilities as determined by the Secretary. The Secretary shall 
coordinate such training courses, where appropriate, with the existing 
programs and activities of the World Health Organization.

SEC. 8. ASSISTANCE FOR THE PURCHASE AND MAINTENANCE OF PUBLIC HEALTH 
              LABORATORY EQUIPMENT.

    (a) Authorization.--The President is authorized, on such terms and 
conditions as the President may determine, to furnish assistance to 
eligible developing countries to purchase and maintain public health 
laboratory equipment described in subsection (b).
    (b) Equipment Covered.--Equipment described in this subsection is 
equipment that is--
            (1) appropriate, where possible, for use in the intended 
        geographic area;
            (2) necessary to collect, analyze, and identify 
        expeditiously a broad array of pathogens, including mutant 
        strains, which may cause disease outbreaks or may be used as a 
        biological weapon;
            (3) compatible with general standards set forth, as 
        appropriate, by the World Health Organization and the Centers 
        for Disease Control and Prevention, to ensure interoperability 
        with regional and international public health networks; and
            (4) not defense articles or defense services as those terms 
        are defined under section 47 of the Arms Export Control Act.
    (c) Rule of Construction.--Nothing in this section shall be 
construed to exempt the exporting of goods and technology from 
compliance with applicable provisions of the Export Administration Act 
of 1979 (or successor statutes).
    (d) Limitation.--Amounts appropriated to carry out this section 
shall not be made available for the purchase from a foreign country of 
equipment that, if made in the United States, would be subject to the 
Arms Export Control Act or likely be barred or subject to special 
conditions under the Export Administration Act of 1979 (or successor 
statutes).
    (e) Host Country's Commitments.--The assistance provided under this 
section shall be contingent upon the host country's commitment to 
provide the resources, infrastructure, and other assets required to 
house, maintain, support, secure, and maximize use of this equipment 
and appropriate technical personnel.

SEC. 9. ASSISTANCE FOR IMPROVED COMMUNICATION OF PUBLIC HEALTH 
              INFORMATION.

    (a) Assistance for Purchase of Communication Equipment and 
Information Technology.--The President is authorized to provide, on 
such terms and conditions as the President may determine, assistance to 
eligible developing countries for the purchase and maintenance of 
communications equipment and information technology described in 
subsection (b), and supporting equipment, necessary to effectively 
collect, analyze, and transmit public health information.
    (b) Covered Equipment.--Equipment (and information technology) 
described in this subsection is equipment that--
            (1) is suitable for use under the particular conditions of 
        the area of intended use;
            (2) meets appropriate World Health Organization standards 
        to ensure interoperability with like equipment of other 
        countries and international health organizations; and
            (3) is not defense articles or defense services as those 
        terms are defined under section 47 of the Arms Export Control 
        Act.
    (c) Rule of Construction.--Nothing in this section shall be 
construed to exempt the exporting of goods and technology from 
compliance with applicable provisions of the Export Administration Act 
of 1979 (or successor statutes).
    (d) Limitation.--Amounts appropriated to carry out this section 
shall not be made available for the purchase from a foreign country of 
equipment that, if made in the United States, would be subject to the 
Arms Export Control Act or likely be barred or subject to special 
conditions under the Export Administration Act of 1979 (or successor 
statutes).
    (e) Assistance for Standardization of Reporting.--The President is 
authorized to provide, on such terms and conditions as the President 
may determine, technical assistance and grant assistance to 
international health organizations to facilitate standardization in the 
reporting of public health information between and among developing 
countries and international health organizations.
    (f) Host Country's Commitments.--The assistance provided under this 
section shall be contingent upon the host country's commitment to 
provide the resources, infrastructure, and other assets required to 
house, support, maintain, secure, and maximize use of this equipment 
and appropriate technical personnel.

SEC. 10. ASSIGNMENT OF PUBLIC HEALTH PERSONNEL TO UNITED STATES 
              MISSIONS AND INTERNATIONAL ORGANIZATIONS.

    (a) In General.--Upon the request of a United States chief of 
diplomatic mission or an international health organization, and with 
the concurrence of the Secretary of State, the head of a Federal agency 
may assign to the respective United States mission or organization any 
officer or employee of the agency occupying a public health position 
within the agency for the purpose of enhancing disease and pathogen 
surveillance efforts in developing countries.
    (b) Reimbursement.--The costs incurred by a Federal agency by 
reason of the detail of personnel under subsection (a) may be 
reimbursed to that agency out of the applicable appropriations account 
of the Department of State if the Secretary determines that the 
relevant agency may otherwise be unable to assign such personnel on a 
non-reimbursable basis.

SEC. 11. EXPANSION OF CERTAIN UNITED STATES GOVERNMENT LABORATORIES 
              ABROAD.

    (a) In General.--Subject to the availability of appropriations, the 
Centers for Disease Control and Prevention and the Department of 
Defense shall each--
            (1) increase the number of personnel assigned to 
        laboratories of the Centers or the Department, as appropriate, 
        located in eligible developing countries that conduct research 
        and other activities with respect to infectious diseases; and
            (2) expand the operations of those laboratories, especially 
        with respect to the implementation of on-site training of 
        foreign nationals and regional outreach efforts involving 
        neighboring countries.
    (b) Cooperation and Coordination between Laboratories.--Subsection 
(a) shall be carried out in such a manner as to foster cooperation and 
avoid duplication between and among laboratories.
    (c) Relation to Core Missions and Security.--The expansion of the 
operations of overseas laboratories of the Centers or the Department 
under this section shall not--
            (1) detract from the established core missions of the 
        laboratories; or
            (2) compromise the security of those laboratories, as well 
        as their research, equipment, expertise, and materials.

SEC. 12. ASSISTANCE FOR REGIONAL HEALTH NETWORKS AND EXPANSION OF 
              FOREIGN EPIDEMIOLOGY TRAINING PROGRAMS.

    (a) Authority.--The President is authorized, on such terms and 
conditions as the President may determine, to provide assistance for 
the purposes of--
            (1) enhancing the surveillance and reporting capabilities 
        for the World Health Organization and existing regional health 
        networks; and
            (2) developing new regional health networks.
    (b) Expansion of Foreign Epidemiology Training Programs.--The 
Secretary of Health and Human Services is authorized to establish new 
country or regional Foreign Epidemiology Training Programs in eligible 
developing countries.

SEC. 13. AUTHORIZATION OF APPROPRIATIONS.

    (a) Authorization of Appropriations.--
            (1) In general.--Subject to subsection (c), there are 
        authorized to be appropriated $70,000,000 for the fiscal year 
        2004 and $80,000,000 for fiscal year 2005, to carry out this 
        Act.
            (2) Allocation of funds.--Of the amounts made available 
        under paragraph (1)--
                    (A) $50,000,000 for the fiscal year 2004 and 
                $50,000,000 for the fiscal year 2005 are authorized to 
                be available to carry out sections 6, 7, 8, and 9;
                    (B) $2,000,000 for the fiscal year 2004 and 
                $2,000,000 for the fiscal year 2005 are authorized to 
                be available to carry out section 10;
                    (C) $8,000,000 for the fiscal year 2004 and 
                $18,000,000 for the fiscal year 2005 are authorized to 
                be available to carry out section 11; and
                    (D) $10,000,000 for the fiscal year 2004 and 
                $10,000,000 for the fiscal year 2005 are authorized to 
                be available to carry out section 12.
    (b) Availability of Funds.--The amount appropriated pursuant to 
subsection (a) is authorized to remain available until expended.
    (c) Reporting Requirement.--
            (1) Report.--Not later than 90 days after the date of 
        enactment of this Act, the Secretary shall submit a report, in 
        conjunction with the Secretary of Health and Human Services and 
        the Secretary of Defense, containing--
                    (A) a description of the implementation of programs 
                under this Act; and
                    (B) an estimate of the level of funding required to 
                carry out those programs at a sufficient level.
            (2) Limitation on obligation of funds.--Not more than 10 
        percent of the amount appropriated pursuant to subsection (a) 
        may be obligated before the date on which a report is 
        submitted, or required to be submitted, whichever first occurs, 
        under paragraph (1).
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