[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 391 Engrossed in House (EH)]

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117th CONGRESS
  1st Session
                                H. R. 391

_______________________________________________________________________

                                 AN ACT


 
  To authorize a comprehensive, strategic approach for United States 
foreign assistance to developing countries to strengthen global health 
                   security, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Global Health Security Act of 
2021''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) In December 2009, President Obama released the National 
        Strategy for Countering Biological Threats, which listed as one 
        of seven objectives ``Promote global health security: Increase 
        the availability of and access to knowledge and products of the 
        life sciences that can help reduce the impact from outbreaks of 
        infectious disease whether of natural, accidental, or 
        deliberate origin''.
            (2) In February 2014, the United States and nearly 30 other 
        nations launched the Global Health Security Agenda (GHSA) to 
        address several high-priority, global infectious disease 
        threats. The GHSA is a multi-faceted, multi-country initiative 
        intended to accelerate partner countries' measurable 
        capabilities to achieve specific targets to prevent, detect, 
        and respond to infectious disease threats, whether naturally 
        occurring, deliberate, or accidental.
            (3) In 2015, the United Nations adopted the Sustainable 
        Development Goals (SDGs), which include specific reference to 
        the importance of global health security as part of SDG 3 
        ``ensure healthy lives and promote well-being for all at all 
        ages'' as follows: ``strengthen the capacity of all countries, 
        in particular developing countries, for early warning, risk 
        reduction and management of national and global health risks''.
            (4) On November 4, 2016, President Obama signed Executive 
        Order No. 13747, ``Advancing the Global Health Security Agenda 
        to Achieve a World Safe and Secure from Infectious Disease 
        Threats''.
            (5) In October 2017 at the GHSA Ministerial Meeting in 
        Uganda, the United States and more than 40 GHSA member 
        countries supported the ``Kampala Declaration'' to extend the 
        GHSA for an additional 5 years to 2024.
            (6) In December 2017, President Trump released the National 
        Security Strategy, which includes the priority action: ``Detect 
        and contain biothreats at their source: We will work with other 
        countries to detect and mitigate outbreaks early to prevent the 
        spread of disease. We will encourage other countries to invest 
        in basic health care systems and to strengthen global health 
        security across the intersection of human and animal health to 
        prevent infectious disease outbreaks''.
            (7) In September 2018, President Trump released the 
        National Biodefense Strategy, which includes objectives to 
        ``strengthen global health security capacities to prevent local 
        bioincidents from becoming epidemics'', and ``strengthen 
        international preparedness to support international response 
        and recovery capabilities''.
            (8) In January 2021, President Biden issued Executive Order 
        13987 (86 Fed. Reg. 7019; relating to Organizing and Mobilizing 
        the United States Government to Provide a Unified and Effective 
        Response to Combat COVID-19 and to Provide United States 
        Leadership on Global Health and Security), as well as National 
        Security Memorandum on United States Global Leadership to 
        Strengthen the International COVID-19 Response and to Advance 
        Global Health Security and Biological Preparedness, which 
        include objectives to strengthen and reform the World Health 
        Organization, increase United States leadership in the global 
        response to COVID-19, and to finance and advance global health 
        security and pandemic preparedness.

SEC. 3. STATEMENT OF POLICY.

    It is the policy of the United States to--
            (1) promote and invest in global health security and 
        pandemic preparedness as a core national security interest;
            (2) advance the aims of the Global Health Security Agenda;
            (3) collaborate with other countries to detect and mitigate 
        outbreaks early to prevent the spread of disease;
            (4) encourage and support other countries to advance 
        pandemic preparedness by investing in basic resilient and 
        sustainable health care systems; and
            (5) strengthen global health security across the 
        intersection of human and animal health to prepare for and 
        prevent infectious disease outbreaks and combat the growing 
        threat of antimicrobial resistance.

SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY REVIEW COUNCIL.

    (a) Establishment.--The President shall establish a Global Health 
Security Agenda Interagency Review Council (in this section referred to 
as the ``Council'') to perform the general responsibilities described 
in subsection (c) and the specific roles and responsibilities described 
in subsection (e).
    (b) Meetings.--The Council shall meet not less than four times per 
year to advance its mission and fulfill its responsibilities.
    (c) General Responsibilities.--The Council shall be responsible for 
the following activities:
            (1) Provide policy-level recommendations to participating 
        agencies on Global Health Security Agenda (GHSA) goals, 
        objectives, and implementation, and other international efforts 
        to strengthen pandemic preparedness and response.
            (2) Facilitate interagency, multi-sectoral engagement to 
        carry out GHSA implementation.
            (3) Provide a forum for raising and working to resolve 
        interagency disagreements concerning the GHSA, and other 
        international efforts to strengthen pandemic preparedness and 
        response.
            (4)(A) Review the progress toward and work to resolve 
        challenges in achieving United States commitments under the 
        GHSA, including commitments to assist other countries in 
        achieving the GHSA targets.
            (B) The Council shall consider, among other issues, the 
        following:
                    (i) The status of United States financial 
                commitments to the GHSA in the context of commitments 
                by other donors, and the contributions of partner 
                countries to achieve the GHSA targets.
                    (ii) The progress toward the milestones outlined in 
                GHSA national plans for those countries where the 
                United States Government has committed to assist in 
                implementing the GHSA and in annual work-plans 
                outlining agency priorities for implementing the GHSA.
                    (iii) The external evaluations of United States and 
                partner country capabilities to address infectious 
                disease threats, including the ability to achieve the 
                targets outlined within the WHO Joint External 
                Evaluation tool, as well as gaps identified by such 
                external evaluations.
    (d) Participation.--The Council shall be headed by the Assistant to 
the President for National Security Affairs, in coordination with the 
heads of relevant Federal agencies. The Council shall consist of 
representatives from the following agencies:
            (1) The Department of State.
            (2) The Department of Defense.
            (3) The Department of Justice.
            (4) The Department of Agriculture.
            (5) The Department of Health and Human Services.
            (6) The Department of the Treasury.
            (7) The Department of Labor.
            (8) The Department of Homeland Security.
            (9) The Office of Management and Budget.
            (10) The Office of the Director of National Intelligence.
            (11) The United States Agency for International 
        Development.
            (12) The Environmental Protection Agency.
            (13) The Centers for Disease Control and Prevention.
            (14) The Office of Science and Technology Policy.
            (15) The National Institutes of Health.
            (16) The National Institute of Allergy and Infectious 
        Diseases.
            (17) Such other agencies as the Council determines to be 
        appropriate.
    (e) Specific Roles and Responsibilities.--
            (1) In general.--The heads of agencies described in 
        subsection (d) shall--
                    (A) make the GHSA and its implementation and global 
                pandemic preparedness a high priority within their 
                respective agencies, and include GHSA- and global 
                pandemic preparedness-related activities within their 
                respective agencies' strategic planning and budget 
                processes;
                    (B) designate a senior-level official to be 
                responsible for the implementation of this Act;
                    (C) designate, in accordance with subsection (d), 
                an appropriate representative at the Assistant 
                Secretary level or higher to participate on the 
                Council;
                    (D) keep the Council apprised of GHSA-related 
                activities undertaken within their respective agencies;
                    (E) maintain responsibility for agency-related 
                programmatic functions in coordination with host 
                governments, country teams, and GHSA in-country teams, 
                and in conjunction with other relevant agencies;
                    (F) coordinate with other agencies that are 
                identified in this section to satisfy programmatic 
                goals, and further facilitate coordination of country 
                teams, implementers, and donors in host countries; and
                    (G) coordinate across national health security 
                action plans and with GHSA and other partners, as 
                appropriate, to which the United States is providing 
                assistance.
            (2) Additional roles and responsibilities.--In addition to 
        the roles and responsibilities described in paragraph (1), the 
        heads of agencies described in subsection (d) shall carry out 
        their respective roles and responsibilities described in 
        subsections (b) through (i) of section 3 of Executive Order 
        13747 (81 Fed. Reg. 78701; relating to Advancing the Global 
        Health Security Agenda to Achieve a World Safe and Secure from 
        Infectious Disease Threats), as in effect on the day before the 
        date of the enactment of this Act.

SEC. 5. UNITED STATES COORDINATOR FOR GLOBAL HEALTH SECURITY.

    (a) In General.--The President shall appoint an individual to the 
position of United States Coordinator for Global Health Security, who 
shall be responsible for the coordination of the interagency process 
for responding to global health security emergencies. As appropriate, 
the designee shall coordinate with the President's Special Coordinator 
for International Disaster Assistance.
    (b) Congressional Briefing.--Not less frequently than twice each 
year, the employee designated under this section shall provide to the 
appropriate congressional committees a briefing on the responsibilities 
and activities of the individual under this section.

SEC. 6. SENSE OF CONGRESS.

    It is the sense of the Congress that, given the complex and 
multisectoral nature of global health threats to the United States, the 
President--
            (1) should consider appointing an individual with 
        significant background and expertise in public health or 
        emergency response management to the position of United States 
        Coordinator for Global Health Security, as required by section 
        5(a), who is an employee of the National Security Council at 
        the level of Deputy Assistant to the President or higher; and
            (2) in providing assistance to implement the strategy 
        required under section 7(a), should--
                    (A) coordinate, through a whole-of-government 
                approach, the efforts of relevant Federal departments 
                and agencies to implement the strategy;
                    (B) seek to fully utilize the unique capabilities 
                of each relevant Federal department and agency while 
                collaborating with and leveraging the contributions of 
                other key stakeholders; and
                    (C) utilize open and streamlined solicitations to 
                allow for the participation of a wide range of 
                implementing partners through the most appropriate 
                procurement mechanisms, which may include grants, 
                contracts, cooperative agreements, and other 
                instruments as necessary and appropriate.

SEC. 7. STRATEGY AND REPORTS.

    (a) Strategy.--The President shall coordinate the development and 
implementation of a strategy to implement the policy aims described in 
section 3, which shall--
            (1) seek to strengthen United States diplomatic leadership 
        and improve the effectiveness of United States foreign 
        assistance for global health security to prevent, detect, and 
        respond to infectious disease threats, including through 
        advancement of the Global Health Security Agenda (GHSA), the 
        International Health Regulations (2005), and other relevant 
        frameworks that contribute to global health security and 
        pandemic preparedness;
            (2) establish specific and measurable goals, benchmarks, 
        timetables, performance metrics, and monitoring and evaluation 
        plans for United States foreign assistance for global health 
        security that promote learning and reflect international best 
        practices relating to global health security, transparency, and 
        accountability;
            (3) establish mechanisms to improve coordination and avoid 
        duplication of effort between the United States Government and 
        partner countries, donor countries, the private sector, 
        multilateral organizations, and other key stakeholders;
            (4) prioritize working with partner countries with 
        demonstrated--
                    (A) need, as identified through the Joint External 
                Evaluation process, the Global Health Security Index 
                classification of health systems, national action plans 
                for health security, GHSA Action Packages, and other 
                complementary or successor indicators of global health 
                security and pandemic preparedness; and
                    (B) commitment to transparency, including budget 
                and global health data transparency, complying with the 
                International Health Regulations (2005), investing in 
                domestic health systems, and achieving measurable 
                results;
            (5) reduce long-term reliance upon United States foreign 
        assistance for global health security by promoting partner 
        country ownership, improved domestic resource mobilization, co-
        financing, and appropriate national budget allocations for 
        global health security and pandemic preparedness and response;
            (6) assist partner countries in building the technical 
        capacity of relevant ministries, systems, and networks to 
        prepare, execute, monitor, and evaluate effective national 
        action plans for health security, including mechanisms to 
        enhance budget and global health data transparency, as 
        necessary and appropriate;
            (7) support and be aligned with country-owned global health 
        security policy and investment plans developed with input from 
        key stakeholders, as appropriate;
            (8) facilitate communication and collaboration, as 
        appropriate, among local stakeholders in support of a multi-
        sectoral approach to global health security;
            (9) support the long-term success of programs by building 
        the capacity of local organizations and institutions in target 
        countries and communities;
            (10) develop community resilience to infectious disease 
        threats and emergencies;
            (11) support global health budget and workforce planning in 
        partner countries, including training in financial management 
        and budget and global health data transparency;
            (12) align United States foreign assistance for global 
        health security with national action plans for health security 
        in partner countries, developed with input from key 
        stakeholders, including the private sector, to the greatest 
        extent practicable and appropriate;
            (13) strengthen linkages between complementary bilateral 
        and multilateral foreign assistance programs, including efforts 
        of the World Bank, the World Health Organization, the Global 
        Fund to Fight AIDS, Tuberculosis, and Malaria, and Gavi, the 
        Vaccine Alliance, that contribute to the development of more 
        resilient health systems and supply chains in partner countries 
        with the capacity, resources, and personnel required to 
        prevent, detect, and respond to infectious disease threats;
            (14) support innovation and public-private partnerships to 
        improve pandemic preparedness and response, including for the 
        development and deployment of effective, accessible, and 
        affordable infectious disease tracking tools, diagnostics, 
        therapeutics, and vaccines;
            (15) support collaboration with and among relevant public 
        and private research entities engaged in global health 
        security; and
            (16) support collaboration between United States 
        universities and public and private institutions in partner 
        countries that promote global health security and innovation.
    (b) Strategy Submission.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the President, in consultation with 
        the head of each relevant Federal department and agency, shall 
        submit to the appropriate congressional committees the strategy 
        required under subsection (a) that provides a detailed 
        description of how the United States intends to advance the 
        policy set forth in section 3 and the agency-specific plans 
        described in paragraph (2).
            (2) Agency-specific plans.--The strategy required under 
        subsection (a) shall include specific implementation plans from 
        each relevant Federal department and agency that describe--
                    (A) the anticipated contributions of the department 
                or agency, including technical, financial, and in-kind 
                contributions, to implement the strategy; and
                    (B) the efforts of the department or agency to 
                ensure that the activities and programs carried out 
                pursuant to the strategy are designed to achieve 
                maximum impact and long-term sustainability.
    (c) Report.--
            (1) In general.--Not later than 1 year after the date on 
        which the strategy required under subsection (a) is submitted 
        to the appropriate congressional committees under subsection 
        (b), and not later than October 1 of each year thereafter, the 
        President shall submit to the appropriate congressional 
        committees a report that describes the status of the 
        implementation of the strategy.
            (2) Contents.--The report required under paragraph (1) 
        shall--
                    (A) identify any substantial changes made in the 
                strategy during the preceding calendar year;
                    (B) describe the progress made in implementing the 
                strategy;
                    (C) identify the indicators used to establish 
                benchmarks and measure results over time, as well as 
                the mechanisms for reporting such results in an open 
                and transparent manner;
                    (D) contain a transparent, open, and detailed 
                accounting of expenditures by relevant Federal 
                departments and agencies to implement the strategy, 
                including, to the extent practicable, for each Federal 
                department and agency, the statutory source of 
                expenditures, amounts expended, partners, targeted 
                populations, and types of activities supported;
                    (E) describe how the strategy leverages other 
                United States global health and development assistance 
                programs and bilateral and multilateral institutions;
                    (F) assess efforts to coordinate United States 
                global health security programs, activities, and 
                initiatives with key stakeholders;
                    (G) incorporate a plan for regularly reviewing and 
                updating strategies, partnerships, and programs and 
                sharing lessons learned with a wide range of 
                stakeholders, including key stakeholders, in an open, 
                transparent manner; and
                    (H) describe the progress achieved and challenges 
                concerning the United States Government's ability to 
                advance GHSA and pandemic preparedness, including data 
                disaggregated by priority country using indicators that 
                are consistent on a year-to-year basis and 
                recommendations to resolve, mitigate, or otherwise 
                address the challenges identified therein.
    (d) Form.--The strategy required under subsection (a) and the 
report required under subsection (c) shall be submitted in unclassified 
form but may contain a classified annex.

SEC. 8. ESTABLISHMENT OF FUND FOR GLOBAL HEALTH SECURITY AND PANDEMIC 
              PREPAREDNESS.

    (a) Negotiations for Establishment of a Fund for Global Health 
Security and Pandemic Preparedness.--The Secretary of State, in 
coordination with the Secretary of the Treasury, the Administrator of 
the United States Agency for International Development, the Secretary 
of Health and Human Services, and the heads of other relevant Federal 
departments and agencies as necessary and appropriate, should seek to 
enter into negotiations with donors, relevant United Nations agencies, 
including the World Health Organization, and other key multilateral 
stakeholders, for the establishment of--
            (1) a multilateral, catalytic financing mechanism for 
        global health security and pandemic preparedness, which may be 
        known as the Fund for Global Health Security and Pandemic 
        Preparedness (in this title referred to as ``the Fund''), in 
        accordance with the provisions of this section; and
            (2) an Advisory Board to the Fund in accordance with 
        section 9.
    (b) Purpose.--The purpose of the Fund should be to close critical 
gaps in global health security and pandemic preparedness and build 
capacity in eligible partner countries in the areas of global health 
security, infectious disease control, and pandemic preparedness, such 
that it--
            (1) prioritizes capacity building and financing 
        availability in eligible partner countries;
            (2) incentivizes countries to prioritize the use of 
        domestic resources for global health security and pandemic 
        preparedness;
            (3) leverages government, nongovernment, and private sector 
        investments;
            (4) regularly responds to and evaluates progress based on 
        clear metrics and benchmarks, such as the Joint External 
        Evaluation and Global Health Security Index;
            (5) aligns with and complements ongoing bilateral and 
        multilateral efforts and financing, including through the World 
        Bank, the World Health Organization, the Global Fund to Fight 
        AIDS, Tuberculosis, and Malaria, and Gavi, the Vaccine 
        Alliance; and
            (6) accelerates country compliance with the International 
        Health Regulations (2005) and fulfillment of the Global Health 
        Security Agenda 2024 Framework, in coordination with the 
        ongoing Joint External Evaluation national action planning 
        process.
    (c) Executive Board.--
            (1) In general.--The Fund should be governed by an 
        Executive Board, which should be composed of not more than 20 
        representatives of donor governments, foundations, academic 
        institutions, civil society, and the private sector that meet a 
        minimum threshold in annual contributions and agree to uphold 
        transparency measures.
            (2) Duties.--The Executive Board should be charged with 
        approving strategies, operations, and grant-making authorities, 
        such that it is able to conduct effective fiduciary, 
        monitoring, and evaluation efforts, and other oversight 
        functions. In addition, the Executive Board should--
                    (A) be comprised only of contributors to the Fund 
                at not less than the minimum threshold to be 
                established pursuant to paragraph (1);
                    (B) determine operational procedures such that the 
                Fund is able to effectively fulfill its mission; and
                    (C) provide oversight and accountability for the 
                Fund in collaboration with the Inspector General to be 
                established pursuant to section 10(e)(1)(A).
            (3) Composition.--The Executive Board should include--
                    (A) representatives of the governments of founding 
                permanent member countries who, in addition to the 
                requirements in paragraph (1), qualify based upon 
                meeting an established initial contribution threshold, 
                which should be not less than 10 percent of total 
                initial contributions, and a demonstrated commitment to 
                supporting the International Health Regulations (2005);
                    (B) term members, who are from academic 
                institutions, civil society, and the private sector and 
                are selected by the permanent members on the basis of 
                their experience and commitment to innovation, best 
                practices, and the advancement of global health 
                security objectives; and
                    (C) representatives of the World Health 
                Organization, and the chair of the Global Health 
                Security Steering Group.
            (4) Qualifications.--Individuals appointed to the Executive 
        Board should have demonstrated knowledge and experience across 
        a variety of sectors, including human and animal health, 
        agriculture, development, defense, finance, research, and 
        academia.
            (5) Conflicts of interest.--
                    (A) Technical experts.--The Executive Board may 
                include independent technical experts, provided they 
                are not affiliated with or employed by a recipient 
                country or organization.
                    (B) Multilateral bodies and institutions.--
                Executive Board members appointed under paragraph 
                (3)(C) should recuse themselves from matters presenting 
                conflicts of interest, including financing decisions 
                relating to such bodies and institutions.
            (6) United states representation.--
                    (A) In general.--
                            (i) Founding permanent member.--The 
                        Secretary of State shall seek to establish the 
                        United States as a founding permanent member of 
                        the Fund.
                            (ii) United states representation.--The 
                        United States shall be represented on the 
                        Executive Board by an officer or employee of 
                        the United States appointed by the President.
                    (B) Effective and termination dates.--
                            (i) Effective date.--This paragraph shall 
                        take effect upon the date the Secretary of 
                        State certifies and transmits to Congress an 
                        agreement establishing the Fund.
                            (ii) Termination date.--The membership 
                        established pursuant to subparagraph (A) shall 
                        terminate upon the date of termination of the 
                        Fund.
            (7) Removal procedures.--The Fund should establish 
        procedures for the removal of members of the Executive Board 
        who engage in a consistent pattern of human rights abuses, fail 
        to uphold global health data transparency requirements, or 
        otherwise violate the established standards of the Fund, 
        including in relation to corruption.
            (8) Enforceability.--Any agreement concluded under the 
        authorities provided by this section shall be legally effective 
        and binding upon the United States, as may be provided in the 
        agreement, upon--
                    (A) the enactment of appropriate implementing 
                legislation which provides for the approval of the 
                specific agreement or agreements, including 
                attachments, annexes, and supporting documentation, as 
                appropriate; or
                    (B) if concluded and submitted as a treaty, 
                receiving the necessary consent of the Senate.
            (9) Eligible partner country defined.--In this section, the 
        term ``eligible partner country'' means a country with 
        demonstrated--
                    (A) need, as identified through the Joint External 
                Evaluation process, the Global Health Security Index 
                classification of health systems, national action plans 
                for health security, and other complementary or 
                successor indicators of global health security and 
                pandemic preparedness; and
                    (B) commitment to transparency, including budget 
                and global health data transparency, complying with the 
                International Health Regulations (2005), investing in 
                domestic health systems, and achieving measurable 
                results, and in which the Fund for Global Health 
                Security and Pandemic Preparedness established under 
                this section may finance global health security and 
                pandemic preparedness assistance programs under this 
                Act.

SEC. 9. FUND AUTHORITIES.

    (a) Program Objectives.--
            (1) In general.--In carrying out the purpose set forth in 
        section 8, the Fund, acting through the Executive Board, should 
        provide grants, including challenge grants, technical 
        assistance, concessional lending, catalytic investment funds, 
        and other innovative funding mechanisms, as appropriate, to--
                    (A) help eligible partner countries close critical 
                gaps in health security, as identified through the 
                Joint External Evaluation process, the Global Health 
                Security Index classification of health systems, and 
                national action plans for health security and other 
                complementary or successor indicators of global health 
                security and pandemic preparedness; and
                    (B) support measures that enable such countries, at 
                both national and sub-national levels, and in 
                partnership with civil society and the private sector, 
                to strengthen and sustain resilient health systems and 
                supply chains with the resources, capacity, and 
                personnel required to prevent, detect, mitigate, and 
                respond to infectious disease threats before they 
                become pandemics.
            (2) Activities supported.--The activities to be supported 
        by the Fund should include efforts to--
                    (A) enable eligible partner countries to formulate 
                and implement national health security and pandemic 
                preparedness action plans, advance action packages 
                under the Global Health Security Agenda, and adopt and 
                uphold commitments under the International Health 
                Regulations (2005) and other related international 
                health agreements, as appropriate;
                    (B) support global health security budget planning 
                in eligible partner countries, including training in 
                financial management and budget and global health data 
                transparency;
                    (C) strengthen the health security workforce, 
                including hiring, training, and deploying experts to 
                improve frontline preparedness for emerging epidemic 
                and pandemic threats;
                    (D) improve infection control and the protection of 
                healthcare workers within healthcare settings;
                    (E) combat the threat of antimicrobial resistance;
                    (F) strengthen laboratory capacity and promote 
                biosafety and biosecurity through the provision of 
                material and technical assistance;
                    (G) reduce the risk of bioterrorism, zoonotic 
                disease spillover, and accidental biological release;
                    (H) build technical capacity to manage global 
                health security related supply chains, including for 
                personal protective equipment, oxygen, testing 
                reagents, and other lifesaving supplies, through 
                effective forecasting, procurement, warehousing, and 
                delivery from central warehouses to points of service 
                in both the public and private sectors;
                    (I) enable bilateral, regional, and international 
                partnerships and cooperation, including through 
                pandemic early warning systems and emergency operations 
                centers, to identify and address transnational 
                infectious disease threats exacerbated by natural and 
                man-made disasters, human displacement, and zoonotic 
                infection;
                    (J) establish partnerships for the sharing of best 
                practices and enabling eligible countries to meet 
                targets and indicators under the Joint External 
                Evaluation process, the Global Health Security Index 
                classification of health systems, and national action 
                plans for health security relating to the detection, 
                treatment, and prevention of neglected tropical 
                diseases;
                    (K) build the technical capacity of eligible 
                partner countries to prepare for and respond to second 
                order development impacts of infectious disease 
                outbreaks, while accounting for the differentiated 
                needs and vulnerabilities of marginalized populations;
                    (L) develop and utilize metrics to monitor and 
                evaluate programmatic performance and identify best 
                practices, including in accordance with Joint External 
                Evaluation benchmarks, Global Health Security Agenda 
                targets, and Global Health Security Index indicators;
                    (M) develop and deploy mechanisms to enhance the 
                transparency and accountability of global health 
                security and pandemic preparedness programs and data, 
                in compliance with the International Health Regulations 
                (2005), including through the sharing of trends, risks, 
                and lessons learned; and
                    (N) develop and implement simulation exercises, 
                produce and release after action reports, and address 
                related gaps.
            (3) Implementation of program objectives.--In carrying out 
        the objectives of paragraph (1), the Fund should work to 
        eliminate duplication and waste by upholding strict 
        transparency and accountability standards and coordinating its 
        programs and activities with key partners working to advance 
        global health security and pandemic preparedness, including--
                    (A) governments, civil society, faith-based, and 
                nongovernmental organizations, research and academic 
                institutions, and private sector entities in eligible 
                partner countries;
                    (B) the pandemic early warning systems and 
                emergency operations centers to be established under 
                section 9;
                    (C) the World Health Organization;
                    (D) the Global Health Security Agenda;
                    (E) the Global Health Security Initiative;
                    (F) the Global Fund to Fight AIDS, Tuberculosis, 
                and Malaria;
                    (G) the United Nations Office for the Coordination 
                of Humanitarian Affairs, UNICEF, and other relevant 
                funds, programs, and specialized agencies of the United 
                Nations;
                    (H) Gavi, the Vaccine Alliance;
                    (I) the Coalition for Epidemic Preparedness 
                Innovations (CEPI);
                    (J) the Global Polio Eradication Initiative; and
                    (K) the United States Coordinator for Global Health 
                Security and Diplomacy established under section 5.
    (b) Priority.--In providing assistance under this section, the Fund 
should give priority to low-and lower-middle income countries with--
            (1) low scores on the Global Health Security Index 
        classification of health systems;
            (2) measurable gaps in global health security and pandemic 
        preparedness identified under Joint External Evaluations and 
        national action plans for health security;
            (3) demonstrated political and financial commitment to 
        pandemic preparedness; and
            (4) demonstrated commitment to upholding global health 
        budget and data transparency and accountability standards, 
        complying with the International Health Regulations (2005), 
        investing in domestic health systems, and achieving measurable 
        results.
    (c) Eligible Grant Recipients.--Governments and nongovernmental 
organizations should be eligible to receive grants as described in this 
section.

SEC. 10. FUND ADMINISTRATION.

    (a) Appointment of an Administrator.--The Executive Board of the 
Fund should appoint an Administrator who should be responsible for 
managing the day-to-day operations of the Fund.
    (b) Authority to Solicit and Accept Contributions.--The Fund should 
be authorized to solicit and accept contributions from governments, the 
private sector, foundations, individuals, and nongovernmental entities 
of all kinds.
    (c) Accountability of Funds and Criteria for Programs.--As part of 
the negotiations described in section 8(a), the Secretary of the State, 
shall, consistent with subsection (d)--
            (1) take such actions as are necessary to ensure that the 
        Fund will have in effect adequate procedures and standards to 
        account for and monitor the use of funds contributed to the 
        Fund, including the cost of administering the Fund; and
            (2) seek agreement on the criteria that should be used to 
        determine the programs and activities that should be assisted 
        by the Fund.
    (d) Selection of Partner Countries, Projects, and Recipients.--The 
Executive Board should establish--
            (1) eligible partner country selection criteria, to include 
        transparent metrics to measure and assess global health 
        security and pandemic preparedness strengths and 
        vulnerabilities in countries seeking assistance;
            (2) minimum standards for ensuring eligible partner country 
        ownership and commitment to long-term results, including 
        requirements for domestic budgeting, resource mobilization, and 
        co-investment;
            (3) criteria for the selection of projects to receive 
        support from the Fund;
            (4) standards and criteria regarding qualifications of 
        recipients of such support;
            (5) such rules and procedures as may be necessary for cost-
        effective management of the Fund; and
            (6) such rules and procedures as may be necessary to ensure 
        transparency and accountability in the grant-making process.
    (e) Additional Transparency and Accountability Requirements.--
            (1) Inspector general.--
                    (A) In general.--The Secretary of State shall seek 
                to ensure that the Fund maintains an independent Office 
                of the Inspector General and ensure that the office has 
                the requisite resources and capacity to regularly 
                conduct and publish, on a publicly accessible website, 
                rigorous financial, programmatic, and reporting audits 
                and investigations of the Fund and its grantees.
                    (B) Sense of congress on corruption.--It is the 
                sense of Congress that--
                            (i) corruption within global health 
                        programs contribute directly to the loss of 
                        human life and cannot be tolerated; and
                            (ii) in making financial recoveries 
                        relating to a corrupt act or criminal conduct 
                        under a grant, as determined by the Inspector 
                        General, the responsible grant recipient should 
                        be assessed at a recovery rate of up to 150 
                        percent of such loss.
            (2) Administrative expenses.--The Secretary of State shall 
        seek to ensure the Fund establishes, maintains, and makes 
        publicly available a system to track the administrative and 
        management costs of the Fund on a quarterly basis.
            (3) Financial tracking systems.--The Secretary of State 
        shall ensure that the Fund establishes, maintains, and makes 
        publicly available a system to track the amount of funds 
        disbursed to each grant recipient and sub-recipient during a 
        grant's fiscal cycle.

SEC. 11. FUND ADVISORY BOARD.

    (a) In General.--There should be an Advisory Board to the Fund.
    (b) Appointments.--The members of the Advisory Board should be 
composed of--
            (1) individuals with experience and leadership in the 
        fields of development, global health, epidemiology, medicine, 
        biomedical research, and social sciences; and
            (2) representatives of relevant United Nations agencies, 
        including the World Health Organization, and nongovernmental 
        organizations with on-the-ground experience in implementing 
        global health programs in low and lower-middle income 
        countries.
    (c) Responsibilities.--The Advisory Board should provide advice and 
guidance to the Executive Board of the Fund on the development and 
implementation of programs and projects to be assisted by the Fund and 
on leveraging donations to the Fund.
    (d) Prohibition on Payment of Compensation.--
            (1) In general.--Except for travel expenses (including per 
        diem in lieu of subsistence), no member of the Advisory Board 
        should receive compensation for services performed as a member 
        of the Board.
            (2) United states representative.--Notwithstanding any 
        other provision of law (including an international agreement), 
        a representative of the United States on the Advisory Board may 
        not accept compensation for services performed as a member of 
        the Board, except that such representative may accept travel 
        expenses, including per diem in lieu of subsistence, while away 
        from the representative's home or regular place of business in 
        the performance of services for the Board.
    (e) Conflicts of Interest.--Members of the Advisory Board should be 
required to disclose any potential conflicts of interest prior to 
serving on the Advisory Board.

SEC. 12. REPORTS TO CONGRESS ON THE FUND.

    (a) Status Report.--Not later than 6 months after the date of 
enactment of this Act, the Secretary of State, in coordination with the 
Administrator of the United States Agency for International 
Development, and the heads of other relevant Federal departments and 
agencies, shall submit to the appropriate congressional committees a 
report detailing the progress of international negotiations to 
establish the Fund.
    (b) Annual Report.--
            (1) In general.--Not later than 1 year after the date of 
        the establishment of the Fund, and annually thereafter for the 
        duration of the Fund, the Secretary of State, shall submit to 
        the appropriate congressional committees a report on the Fund.
            (2) Report elements.--The report shall include a 
        description of--
                    (A) the goals of the Fund;
                    (B) the programs, projects, and activities 
                supported by the Fund;
                    (C) private and governmental contributions to the 
                Fund; and
                    (D) the criteria utilized to determine the programs 
                and activities that should be assisted by the Fund.
    (c) GAO Report on Effectiveness.--Not later than 2 years after the 
date that the Fund comes into effect, the Comptroller General of the 
United States shall submit to the appropriate congressional committees 
a report evaluating the effectiveness of the Fund, including--
            (1) the effectiveness of the programs, projects, and 
        activities supported by the Fund; and
            (2) an assessment of the merits of continued United States 
        participation in the Fund.

SEC. 13. UNITED STATES CONTRIBUTIONS.

    (a) In General.--Subject to submission of the certification under 
this section, the President is authorized to make available for United 
States contributions to the Fund such funds as may be authorized to be 
made available for such purpose.
    (b) Notification.--The Secretary of State shall notify the 
appropriate congressional committees not later than 15 days in advance 
of making a contribution to the Fund, including--
            (1) the amount of the proposed contribution;
            (2) the total of funds contributed by other donors; and
            (3) the national interests served by United States 
        participation in the Fund.
    (c) Limitation.--At no point during the five years after enactment 
of this Act shall a United States contribution to the Fund cause the 
cumulative total of United States contributions to the Fund to exceed 
33 percent of the total contributions to the Fund from all sources.
    (d) Withholdings.--
            (1) Support for acts of international terrorism.--If at any 
        time the Secretary of State determines that the Fund has 
        provided assistance to a country, the government of which the 
        Secretary of State has determined, for purposes of section 620A 
        of the Foreign Assistance Act of 1961 (22 U.S.C. 2371) has 
        repeatedly provided support for acts of international 
        terrorism, the United States shall withhold from its 
        contribution to the Fund for the next fiscal year an amount 
        equal to the amount expended by the Fund to the government of 
        such country.
            (2) Excessive salaries.--If at any time during the five 
        years after enactment of this Act, the Secretary of State 
        determines that the salary of any individual employed by the 
        Fund exceeds the salary of the Vice President of the United 
        States for that fiscal year, then the United States should 
        withhold from its contribution for the next fiscal year an 
        amount equal to the aggregate amount by which the salary of 
        each such individual exceeds the salary of the Vice President 
        of the United States.
            (3) Accountability certification requirement.--The 
        Secretary of State may withhold not more than 20 percent of 
        planned United States contributions to the Fund until the 
        Secretary certifies to the appropriate congressional committees 
        that the Fund has established procedures to provide access by 
        the Office of Inspector General of the Department of State, as 
        cognizant Inspector General, the Inspector General of the 
        Department of Health and Human Services, the Inspector General 
        of the United States Agency for International Development, and 
        the Comptroller General of the United States to the Fund's 
        financial data and other information relevant to United States 
        contributions to the Fund (as determined by the Inspector 
        General of the Department of State, in consultation with the 
        Secretary of State).

SEC. 14. COMPLIANCE WITH THE FOREIGN AID TRANSPARENCY AND 
              ACCOUNTABILITY ACT OF 2016.

    Section 2(3) of the Foreign Aid Transparency and Accountability Act 
of 2016 (Public Law 114-191; 22 U.S.C. 2394c note) is amended--
            (1) in subparagraph (C), by striking ``and'' at the end;
            (2) in subparagraph (D), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(E) the Global Health Security Act of 2021.''.

SEC. 15. DEFINITIONS.

    In this Act:
            (1) Appropriate congressional committees.--The term 
        ``appropriate congressional Committees'' means--
                    (A) the Committee on Foreign Affairs and the 
                Committee on Appropriations of the House of 
                Representatives; and
                    (B) the Committee on Foreign Relations and the 
                Committee on Appropriations of the Senate.
            (2) Global health security.--The term ``global health 
        security'' means activities supporting epidemic and pandemic 
        preparedness and capabilities at the country and global levels 
        in order to minimize vulnerability to acute public health 
        events that can endanger the health of populations across 
        geographical regions and international boundaries.

SEC. 16. SUNSET.

    This Act, and the amendments made by this Act shall cease to be 
effective 5 fiscal years after the enactment of this Act.

            Passed the House of Representatives June 28, 2021.

            Attest:

                                                                 Clerk.
117th CONGRESS

  1st Session

                               H. R. 391

_______________________________________________________________________

                                 AN ACT

  To authorize a comprehensive, strategic approach for United States 
foreign assistance to developing countries to strengthen global health 
                   security, and for other purposes.