[Congressional Record Volume 147, Number 178 (Thursday, December 20, 2001)]
[Senate]
[Pages S13902-S13911]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      PUBLIC HEALTH SECURITY AND BIOTERRORISM RESPONSE ACT OF 2001

  Mr. REID. Mr. President, with the attention of the Senator from 
Mississippi, Mr. Lott, I ask unanimous consent that the Senate now 
proceed to H.R. 3448, which is at the desk.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (H. R. 3448) to improve the ability of the United 
     States to prevent, prepare for, and respond to bioterrorism 
     and other public health emergencies.

  There being no objection, the Senate proceeded to consider the bill.
  Ms. LANDRIEU. I am very concerned about help for for-profit hospitals 
if they must deal with bioterrorist attack. Their services are 
critical, and they face the same challenges as other hospitals. They 
should be eligible for Stafford Act assistance under certain 
circumstances.
  Mr. KENNEDY. I understand the concerns of my colleague. In many 
places for-profit hospitals are the only providers. I will work with 
her to address these legitimate needs in conference.


                              food safety

  Mr. DURBIN. Mr. President, I am pleased that the sponsors of the bill 
recognize the importance of strengthening our Nation's protections for 
food safety and of addressing potential bioterrorist threats against 
our food supply. Among the bill's provisions are new authorities for 
the Food and Drug Administration to require the maintenance of food 
records, to inspect such records, and to detain unsafe foods.
  I would appreciate clarification regarding the standard of serious 
adverse health consequences or death, which applies to the authorities 
for inspection of records and administrative detention, among others. 
It is my understanding that some have suggested that foodborne 
pathogens such as salmonella, listeria monocytogenes, shigella 
dysenteriae, and cryptosporidium parvum, which in 1993 sickenened over 
400,000 people in Wisconsin who drank contaminated water, may not pose 
a threat of serious adverse health consequences to healthy adults. Most 
of these pathogens have been identified by the CDC as possible 
biological agents that could be used in an attack against our citizens, 
and they could clearly pose a threat of serious adverse health 
consequences or death to vulnerable populations, such as children, 
pregnant women, the elderly, transplant recipients, persons with HIV/
AIDS and other immunocompro- mised persons.
  Do the sponsors intend for the standard in this bill, cited in the 
sections on inspection of records, administrative detention, debarment, 
and marking of refused articles, to enable the Food and Drug 
Administration to act when a foodborne pathogen presents a threat of 
serious adverse health consequences or death to such vulnerable 
populations mentioned above, even if healthy adults may not face the 
same risk? And do the sponsors agree that the pathogens I mentioned 
previously may present such a risk of serious adverse health 
consequences or death? I believe we must ensure that the law is fully 
protective of all American consumers. I hope that the sponsors share my 
concerns.
  Mr. KENNEDY. Will the Senator from Illinois yield?
  Mr. DURBIN. I am happy to yield to the Senator from Massachusetts.
  Mr. KENNEDY. First, I commend my colleague for his longstanding 
advocacy for food safety. He has been a

[[Page S13903]]

leader, both in the House of Representatives and here in the Senate, in 
seeking the resources, the authority and the public awareness which 
will reduce the yearly epidemic of foodborne illness. The CDC has 
estimated that foodborne diseases cause approximately 76 million 
illnesses, 325,000 hospitalizations, and 5,000 deaths in the United 
States each year.
  I also point out that he has played an instrumental role, with our 
colleagues, Senator Mikulski, Senator Collins, and Senator Clinton, in 
assuring that food safety is addressed in this legislation.
  In response to my colleague's inquiry, I fully concur with his 
interpretation of the food safety provisions in our legislation. It is 
precisely our intent, with respect to the food safety sections of this 
bill, that the standard of serious adverse health consequences or death 
with respect to these provisions in this bill should be understood to 
enable the FDA to protect all Americans, including vulnerable 
populations such as children and the elderly.
  I agree that there are instances where foodborne pathogens, such as 
those mentioned by my colleague, whether accidentally or deliberately 
introduced into food, may threaten some more vulnerable individuals but 
not the healthy adult population. For that reason, my colleague is 
correct that the agency would be able to exercise these food safety 
authorities to protect such vulnerable populations.
  Mr. FRIST. Will my colleague yield?
  Mr. KENNEDY. With pleasure.
  Mr. FRIST. I concur with Senator Kennedy's remarks regarding this 
standard as it applies to the food safety provisions in this bill. As 
21 C.F.R. 7.41 regarding health hazard evaluation makes clear, the FDA 
evaluation will take into account a list of factors, one of which is 
``an assessment of hazard to various segments of the population, 
including children, livestock, etc. who are expected to be exposed to 
the product being considered with particular attention paid to the 
hazard to those individuals who may be at greatest risk.''
  I believe these provisions will help protect the safety and security 
of our food supply.
  Mr. DURBIN. I appreciate my colleagues' willingness to clarify these 
important points, and join them in supporting this important 
legislation.


                          antitrust exemption

  Mr. WELLSTONE. Mr. President, I am a cosponsor of this legislation 
because it is extremely important, but as I noted when the bill was 
originally introduced, I am concerned about the scope of the antitrust 
exemption.
  I have three concerns in particular: There is no opportunity for 
public comment prior to the granting of an exemption; the period of 
exemption is too long; and the criteria for granting the exemption are 
too broad with respect to competitive impact on areas not directly 
related to the agreement.
  Mr. KENNEDY. I understand my colleague's concerns and commend him for 
his commitment to protecting consumers. His concerns are legitimate and 
I will work to improve these provisions in response to his concerns in 
the conference.


                         COMBATING BIOTERRORISM

  Mr. JEFFORDS. Mr. President, and my distinguished colleagues, I am 
pleased that we are moving so quickly on legislation to combat 
bioterrorism--this is certainly a timely issue.
  I would like to engage my colleagues in a colloquy to clarify our 
commitment to another important issue--the security of our Nation's 
water supply. At the end of October of this year, I was joined by the 
ranking member of the Environment and Public Works Committee in 
introducing S. 1593 and S. 1608. S. 1593 authorizes the Administrator 
of the Environmental Protection Agency to establish a grant program to 
support research projects on critical infrastructure protection for 
water supply systems. S. 1608 establishes a program to provide grants 
to drinking water and wastewater facilities to meet immediate security 
needs.
  I understand that the gentleman from Tennessee, the gentleman from 
Massachusetts and the gentleman from New Hampshire support the modified 
provisions of these bills. Is that correct?
  Mr. FRIST. That is correct.
  Mr. KENNEDY. Yes, that is correct.
  Mr. GREGG. Yes, that is correct because in the interest of time, we 
are unable to change the bill prior to conference.
  Mr. SMITH. I too would like to thank Senator Frist, Senator Kennedy, 
and Senator Gregg for agreeing to work with us to ensure these two 
proposals are included in the bioterrorism proposal. I regret that with 
the end of session quickly approaching, there is no time to incorporate 
these provisions into the underlying bill. As we all recognized in our 
support for these proposals, since the September 11 attacks, Americans 
throughout the country have become concerned about the security of our 
Nation's water supply. While it is widely believed that our water 
supply is safe, there are a few vulnerabilities that must be addressed. 
Our bills would provide resources for research into security at 
facilities and assessment tools while also providing seed money to 
encourage additional spending on security measures.
  Mr. JEFFORDS. Our colleagues on the House side also recognized this 
need by including water security provisions in the bioterrorism bill, 
H.R. 3448, that was passed by the House on December 12. I would like my 
colleagues' assurance that during conference they will press for 
adoption of the modified versions of S. 1593 and S. 1608.
  Mr. KENNEDY. I intend to press for adoption of these provisions. The 
security of our Nation's water supply is crucial to the health and 
well-being of our citizens.
  Mr. GREGG. I concur, and I intend to press for adoption of these 
provisions.
  Mr. FRIST. I agree and you have my commitment to do the same.
  Mr. SMITH. I again would like to thank my colleagues for agreeing to 
fight for these provisions during conference. It was with great 
reluctance that Senator Jeffords and I agreed to allow S. 1765 to be 
brought to the floor without our legislation included so that we can 
move forward on this important bill and conference it with the House. 
However, it is important that these immediate needs be addressed and 
that our proposals be included in the final legislation. I look forward 
to working with my colleagues to ensure that the provisions we agreed 
to that comprise the modified versions of S. 1593 and S. 1608 are 
included in the bioterrorism bill.
  Mr. JEFFORDS. Finally, I want to commend Senators Kennedy, Frist, and 
Gregg and say that I am looking forward to working with them during the 
conference on these measures.
  Mr. KENNEDY. Mr. President, I urge the Senate to approve this 
important bipartisan legislation to respond to one of the most severe 
dangers our country faces, the grave threat of bioterrorist attacks. I 
commend my colleagues Senator Frist and Senator Gregg for their 
impressive continuing leadership on this vital issue.
  We are all well aware of the emergency we face. In recent weeks, a 
handful of anthrax cases stretched our health care system to the 
breaking point. A larger attack could be a disaster, and the attack of 
the past weeks has clearly sounded the alarm. The clock is ticking on 
America's preparedness for a future attack. We've had the clearest 
possible warning, and we can't afford to ignore it. We know that lives 
are at stake, and we're not ready yet.
  The Department of Health and Human Services has made anthrax vaccine 
available to workers at risk for exposure to the deadly spores, but 
there has been few plans to distribute the vaccine and inform workers 
about the risks and benefits of vaccination. In a major outbreak, our 
public health agencies and hospitals would be strained to the breaking 
point by the task of providing vaccinations against anthrax, smallpox, 
or other deadly plagues to thousands or even millions of Americans. 
Some cities have already developed plans and procedures for providing 
care to patients affected by bioterrorism, but too few communities are 
adequately prepared.
  The needs are great. A summit meeting of experts on bioterrorism and 
public health concluded that $835 million was needed just to address 
the most pressing needs for public health at the State and local 
levels.
  The National Governors Association has said that States need $2 
billion to improve readiness for bioterrorism. John Hopkins Hospital is 
spending $7.5 million to improve its ability to serve as a regional 
bioterrorism resource for

[[Page S13904]]

Baltimore. Equipping just one hospital to this level in each of 100 
cities across America would cost $750 million.
  The Appropriations Committee has recognized the importance of 
significant investments in bioterrorism preparedness. The Department of 
Defense conference bill provides as important down payment for the 
Nation's needs for bioterrorism preparedness. I commend Senator Byrd, 
Senator Stevens, Senator Inouye, Senator Harkin, and Senator Specter 
for their impressive leadership in this area. In particular, they have 
begun to address the basic issue of State and local preparedness and 
the readiness of hospitals to deal with bioterrorism by providing $1 
billion for these purposes.
  The need for help at the State and local level is especially urgent. 
In the first 3 weeks of October alone, state health departments spent a 
quarter billion dollars responding to the anthrax attack. Many 
departments were forced to put aside other major public health 
responsibilities.
  Massachusetts has suspended many public health activities other than 
bioterrorism, and has fielded over 2,000 calls from worried residents, 
each one taking half an hour of time for personnel. South Dakota has 
had to suspend an investigation of serious food poisoning outbreak to 
investigate rumors of anthrax attacks, even though no actual attack 
appears to have occurred. The Georgia Health Department has spent 3,000 
person-hours just in 1 week on anthrax.
  Hospitals across the country have immediate needs. According to the 
American Public Health Association, hospitals are hard-pressed even 
during a heavy flu season, and could not cope with a lethal contagious 
disease like smallpox.
  The Bioterrorism Preparedness Act we are proposing will address these 
deficiencies. It provides new resources for bioterrorism preparedness 
to the States under a formula that guarantees help to each State. These 
resources will be available to improve hospital readiness, equip 
emergency personnel, enhance State planning, and strengthen the ability 
of public health agencies to detect and contain dangerous disease 
outbreaks.
  The need is great at the State and local level, but gaps need to be 
addressed at the Federal level too.
  So far, we have had only a handful of patients diagnosed with 
anthrax, but our resources have been stretched to the breaking point. 
We can't afford further delays in meeting these critical needs.
  Ft. Detrick, one of our two national reference laboratories, 
processed over 19,000 samples after the attacks began, and they are 
already stretched to the limit.
  The story was the same at CDC. Usually, a few dozen CDC experts 
respond to a disease outbreak. But CDC assigned nearly 500 specialists 
to the anthrax attacks. One out of eight employees at CDC headquarters 
in Atlanta is working on the current outbreak. Staffers worked round 
the clock and slept in hallways and only 18 cases of actual illness was 
known.
  In a recent article, CDC Director Koplan summed up the situation this 
way:

       Right now, we are working flat out. I keep thinking, if you 
     know you;re in a marathon, you pace yourself for a marathon; 
     if you know you're in a sprint, ou pace yourself for a 
     sprint. But our guys are sprinting, and the sprint distance 
     is long over. We're sprinting a marathon.

  The diversion of resources to anthrax has also led to the neglect of 
other important health priorities. According to a recent article in the 
Chicago Tribune, CDC has had to postpone programs to prevent meningitis 
among college students. They've delayed the development of vaccines 
urgently needed to combat diseases in the developing world. They've 
deferred activities to contain the spread of deadly infections 
resistant to antibiotics. Hawaii is facing a serious outbreak of dengue 
fever. When local health authorities asked CDC to analyze lab samples, 
they were told that no facilities were available due to the anthrax 
outbreak. Instead, the Hawaii doctors had to send their important 
samples to a lab in Puerto Rico for analysis.
  Dr. David Satcher, the Surgeon General, recently said that the 
country ``should be ashamed of the condition of the laboratories of the 
CDC.'' These vital national resources, he said, were without power for 
15 hours during the early days of the anthrax outbreak. Computers are 
covered in plastic to protect them from leaky roofs, and termites have 
chewed holes through laboratory floors.
  Dr. Satcher is right to call this problem a national disgrace. We 
cannot continue to expect the CDC to do a first class job, if we 
provide only third-rate facilities.
  Clearly, our legislation is an important downpayment on preparedness. 
But we must make sure that our commitment to achieving full readiness 
is sustained in the weeks and months to come.
  Since September 11, the American people have supported our commitment 
of billions of dollars and thousands of troops to battle terrorism 
abroad. But Americans also want to be safe at home. We have an 
obligation to every American that we will do no less to protect them 
against terrorism at home than we do to fight terrorism abroad.
  Federal stockpiles of antibiotics, vaccines, and other medical 
supplies are an essential part of the national response. We have a 
strategic petroleum reserve to safeguard our energy supply in times of 
crisis. We need a strategic pharmaceutical reserve as well, to ensure 
that we have the medicines and vaccines stockpiled to respond to 
bioterrorist attacks. Our legislation establishes this reserve, and 
authorizes the development of sufficient smallpox and other vaccines to 
meet the needs of the entire U.S. population.
  The legislation will also help protect the safety of the food supply, 
through increased research and surveillance of dangerous agricultural 
pathogens.
  Our legislation draws on the work and suggestions of numerous 
colleagues on both sides of the aisle. One of the important areas 
addressed in the legislation is the threat of agricultural 
bioterrorism. Deliberate introduction of animal diseases could pose 
rave dangers to the safety of the food supply. Such acts of 
agricultural bioterrorism would also be economically devastating. The 
outbreaks of ``mad cow'' disease in Europe cost over $10 billion, and 
the foot and mouth outbreak cost billions more. We must guard against 
this danger.
  Protecting the safety of the food supply is a central concern in 
addressing the problem of bioterrorism. Senator Clinton, Senator 
Mikulski, Senator Harkin, Senator Collins, and Senator Durbin have all 
contributed thoughtful proposals about food safety. Our bill will 
enable FDA and USDA to protect the Nation's food supply more 
effectively.
  We are grateful for the leadership of other Senators who have made 
significant contributions to this legislation. Senator Bayh and Senator 
Edwards contributed important proposals on providing block grants to 
States, so that each State will be able to increase its preparedness. 
Their proposals ensure that each state will receive at least a minimum 
level of funding.
  We are also grateful for the contributions that many of our 
distinguished colleagues have made to meet the special needs of 
children. Senator Dodd, Senator Collins, Senator Clinton, Senator 
DeWine and Senator Murray have emphasized the crucial needs of children 
in any plan to deal with bioterrorism. The legislation includes 
significant initiatives to provide for the special needs of children 
and other vulnerable populations.
  The events of recent weeks have also shown the importance of 
effective communication with the public. Our legislation incorporates 
proposals offered by several of our colleagues on improving 
communication. Senator Carnahan has recognized the importance of the 
internet in providing information to the public. The legislation 
includes the provisions of her legislation to establish the official 
Federal internet site on bioterrorism, to help inform the public.
  Senator Mikulski also contributed provisions on improving 
communication with the public. A high-level, blue-ribbon task force can 
provide vitally needed insights on how best to provide information to 
the public. Senator Mikulski also recommended ways to ensure that 
states have coordinated plans for communicating information about 
bioterrorism and other emergencies to the public.

[[Page S13905]]

  The Centers for Disease Control and Prevention have a leading role in 
responding to bioterrorism. Senator Cleland has been an effective and 
skillful advocate for the needs of the CDC. Our legislation today 
incorporates many of the proposals in his legislation on public health 
authorities.
  Hospitals are also one of the keys to an effective response to 
bioterrorism. We must do more to strengthen the ability of the Nation's 
hospitals to cope with such attacks. Senator Corzine has proposed to 
strengthen designated hospitals to serve as regional resources for 
bioterrorism preparedness. I commend him for his thoughtful proposals, 
which we have incorporated in the legislation.
  We must also ensure that we monitor dangerous biological agents that 
can be used for bioterrorism. There is a serious loophole in current 
regulations, and we are grateful for the proposals offered by Senator 
Durbin and Senator Feinstein to achieve more effective control of these 
pathogens.
  In a biological threat or attack, mental health care will be 
extremely important. We are indebted to Senator Wellstone for his 
skillful and compassionate advocacy for the needs of those with mental 
illnesses. In the event of a terrorist attack, thousands of persons 
would have mental health needs, and our legislation includes key 
proposals by Senator Wellstone to meet these needs.
  Mobilizing the Nation's pharmaceutical and biotech companies so that 
they can fully contribute to this effort is also critical. Senator 
Leahy, Senator Hatch, Senator DeWine, and Senator Kohl made thoughtful 
contributions to the antitrust provisions of the bill, which will help 
encourage a helpful public-private partnership to combat bioterrorism.
  This legislation is urgent because the need to prepare for a 
bioterrorist attack is urgent. I urge my colleagues to approve this 
legislation, so that the American people can have the protection they 
need.
  Mr. FRIST. Mr. President, I am thankful to be able to come to the 
floor today, along with many of my colleagues, to announce the Senate 
passage of the Frist-Kennedy Bioterrorism Preparedness Act of 2001. 
Over the past several weeks, we have been working in a bipartisan 
manner to address this critical issue, and I am grateful for the work 
of Senators Gregg, Kennedy, and others. Everyone has worked very hard 
to get us to this point, and I will continue to work with them in 
conference to ensure final passage of this crucial legislation.
  I am also thankful for the work of my colleagues to ensure that there 
is an appropriate level of funding for bioterrorism preparedness and 
response activities that will be available immediately. I commend 
Senators Stevens, Byrd, Specter, Inouye, and Roberts and others for 
their strong support in securing the necessary funding. With the 
passage of the latest appropriations bills, we have secured well over 
$2.5 billion for bioterrorism activities in addition to those provided 
for agroterrorism. I am also pleased with the level of funding for 
State and local preparedness and response activities--at least $1 
billion--which is one of my top priorities.
  However, our efforts cannot end when the funding is secured. We must 
provide greater guidance and authorities through an authorization bill, 
which is why final passage of a bioterrorism authorization bill is 
equally important. Both the House and the Senate have signaled the need 
for increased authorization with the passage of the Tauzin-Dingell 
Public Health Security and Bioterrorism Response Act of 2001 and the 
Frist-Kennedy Bioterrorism Preparedness Act of 2001. We must work 
together in conference to ensure final passage.
  A variety of increased authorizations are necessary to protect our 
food supply, prevent agroterrorism, develop appropriate 
countermeasures, and ensure appropriate State and local preparedness 
and response. For example, in the Frist-Kennedy Bioterrorism 
Preparedness Act of 2001, we have greatly expanded the ability to 
protect our Nation's food supply by increasing authorities for the 
Department of Agriculture and the Food and Drug Administration.
  We need to ensure that our food supply is safe. With 57,000 
establishments under its jurisdiction and only 700-800 food inspectors, 
including 175 import inspectors for more than 300 ports of entry, the 
Food and Drug Administration (FDA) needs increased resources for 
inspections of imported food.
  Our legislation grants FDA needed authorities to ensure the safety of 
domestic and imported food. It allows FDA to use qualified employees 
from other agencies and departments to help conduct food inspections. 
Any domestic or foreign facility that manufactures or processes food 
for use in the U.S. must register with FDA. Importers must provide at 
least four hours notice of the food, the country of origin, and the 
amount of food to be imported. FDA's authority is made more explicit to 
prevent ``port-shopping'' by marking food shipments denied entry at one 
U.S. port to ensure such shipments do not reappear at another U.S. 
port.

  This bill also gives additional tools to FDA to ensure proper records 
are maintained by those who manufacture, process, pack, transport, 
distribute, receive, hold or import food. The FDA's ability to inspect 
such records will strengthen their ability to trace the source and 
chain of distribution of food and to determine the scope and cause of 
the adulteration or misbranding that presents a threat of serious 
adverse health consequences or death to humans or animals. Importantly, 
the bill also enables FDA to detain food for a limited period of time 
while FDA seeks a seizure order if such food is believed to present a 
threat of serious adverse health consequences or death to humans or 
animals. The FDA may also debar a person who engages in a pattern of 
seeking to import such food.
  This important legislation also includes several measures to help 
safeguard the nation's agriculture industry from the threats of 
bioterrorism. Toward this end, it contains a series of grants and 
incentives to help encourage the development of vaccines and antidotes 
to protect the nation's food supply, livestock, or crops, as well as 
preventing crop and livestock diseases form finding their way to our 
fields and feedlots.
  It also authorizes emergency funding to update and modernize USDA 
research facilities at the Plum Island Animal Disease Laboratory in New 
York, the National Animal Disease Center in Iowa, the Southwest Poultry 
Research Laboratory in Georgia, and the Animal Disease Research 
Laboratory in Wyoming. Also, it funds training and implements a rapid 
response strategy through a consortium of universities, the USDA, and 
agricultural industry groups.
  No one has worked harder on these agricultural provisions than my 
colleague Senator Roberts. I know he understands deeply the threat that 
we face in these areas and has helped provide real leadership in 
pointing the way to solutions.
  Additionally, the Frist-Kennedy ``Bioterrorism Preparedness Act of 
2001'' expands our nation's stockpile of smallpox vaccine and critical 
pharmaceuticals and devices. The bill also expands research on 
biological agents and toxins, as well as new treatments and vaccines 
for such agents and toxins.
  Since the effectiveness of vaccines, drugs, and therapeutics for many 
biological agents and toxins often may not ethically be tested in 
humans, this crucial legislation ensures that the FDA will finalize by 
a date certain its rule regarding the approval of new priority 
countermeasures on the basis of animal data. Priority countermeasures 
will also be given expedited review by the FDA.
  Because of the limitations on a market for vaccines for these agents 
and toxins, our legislation gives the Secretary of HHS authority to 
enter into long-term contracts with sponsors to ``guarantee'' that the 
government will purchase a certain quantity of a vaccine at a certain 
price.
  This legislation also provides a limited antitrust exemption to allow 
potential sponsors to discuss and agree upon how to develop, 
manufacture, and produce new priority countermeasures, including 
vaccines, and drugs. Federal Trade Commission and the Department of 
Justice approval of such agreements is required to ensure such 
agreements are not anti-competitive. I appreciate the work of Senator 
Hatch and his advice in crafting the antitrust language.
  These FDA authorities and market incentives--which can only be 
provided

[[Page S13906]]

by additional authorizing legislation--are critical to the rapid 
development of vaccines and other countermeasures. I want to thank 
Senators Hutchinson and Collins for their important work with this 
portion of the bill.
  Both the House and Senate bills also include protections, similar to 
those currently provided to those who join the National Guard, to help 
protect the employment rights of medication volunteers within the 
National Disaster Medical Response System (NDMS). The bills also extend 
necessary liability protections to those volunteers. Senator Enzi 
provided beneficial advice about how to craft this portion of the 
legislation.
  Moreover, both bills contain additional measures to assist with the 
tracking and control of biological agents and toxins. With respect to 
the control of biological agents and toxins, the Secretary of Health 
and Human Services is required to review and update a list of 
biological agents and toxins that pose a severe threat to public health 
and safety and to enhance regulations regarding the possession, use and 
transfer to such agents or toxins.
  Again, these needed protections will not go into effect until we pass 
authorizing language.
  Although the ``Public Health Threats and Emergencies Act of 2000'' 
established basic grant programs to assist with strengthening the 
public health infrastructure, the language was based on the assumption 
that each year five more states would receive enough money to be 
prepared for a bioterrorist attack. Given the recent set of events, we 
cannot wait 10 more years for our public health infrastructure to be 
strengthened.
  We must put in place a mechanism to ensure that every state has 
sufficient funding to improve their public health infrastructure so 
that they are able to respond to a potential biological attack.
  I agree that we must provide resources necessary to develop smallpox 
and other needed vaccines, drugs, and biologics to counter potential 
biological agents. But it is even more important that we provide needed 
resources to those who will be on the front-lines in responding to a 
potential attack. Hospitals and other medical facilities must become 
better prepared to respond and to deal with the public health emergency 
after such an attack. And doctors, nurses, firefighters, police, and 
emergency medical response personnel need better training and equipment 
to combat biological threats and provide needed treatment.
  Therefore, the two new grant programs included in the ``Bioterrorism 
Preparedness Act''--the State Bioterrorism grant program and the 
Designated Bioterrorism Response Medical Center program--are essential.
  Finally, our legislation would also ensure that we enhance 
coordination among local, state and federal agencies responsible for 
responding to a biological attack, and that this response appropriately 
deals with the special needs of children and other vulnerable 
populations.
  Almost half of all public health departments serve jurisdictions 
whose emergency response plans do not address incidents of 
bioterrorism. Agencies have not determined a single list of biological 
agents likely to be used in a biological attack, several agencies have 
not been consulted in crafting the list or determining an overall 
emergency response plan, and agencies have developed programs to 
provide assistance to state and local governments that are similar and 
potentially duplicative.
  The Bioterrorism Preparedness Act of 2001 establishes an Assistant 
Secretary for Emergency Preparedness at HHS to coordinate all functions 
with the Department relating to emergency preparedness, including 
preparing for and responding to biological threats or attacks. It also 
creates a federal interdepartmental Working Group on Bioterrorism that 
consolidates and streamlines the functions of two existing working 
groups first established under the ``Public Health Threats and 
Emergencies Act of 2000.''
  Recent reports regarding the treatment of children during the anthrax 
scare, including the cutaneous anthrax case in a 7 month old boy, have 
highlighted the need to more fully address the special needs of 
children when responding to bioterrorism attacks. Within the Frist-
Kennedy ``Bioterrorism Preparedness Act of 2001,'' numerous provisions 
were added to specifically address this critical issue, with the 
emphasis on streamlining the language so that the children's health and 
welfare issues were considered in concert with the general provision of 
services. These provisions include a specific reference that the 
vaccines, therapies and medical supplies within the stockpile 
appropriately address the health needs of children and other vulnerable 
populations; requiring the Working Group to take into consideration the 
special needs of children and other vulnerable populations; 
establishing the National Task Force on Children and Terrorism--an 
advisory committee of child health experts on infectious disease, 
environmental health, toxicology, and other relevant professional 
disciplines--to offer advice to the Secretary; along with other crucial 
additions. I want to thank Senators Dodd, DeWine, Collins, and Clinton 
for their assistance in crafting appropriate language to address the 
special needs of children and other vulnerable populations.
  Along with my colleagues, I am appreciative of the steps we have 
taken thus far to ensure that we are prepared to respond to biological 
threats or attacks, and I look forward to continuing to work with them 
to ensure final passage of bioterrorism authorization legislation. I 
want to thank Senator Jeffords and Senator Bob Smith for their input 
and advice regarding water safety and how we should more adequately 
protect our nation, Senators Sessions and Shelby for their important 
input on the various training activities, and Senator Lieberman for his 
crucial input regarding our disease surveillance and coordination 
infrastructure. I look forward to continuing to work with all of the 
Senators and their staff.

  I must also commend Senator Kennedy again for his efforts. He has 
been a true partner on this bill and the Frist-Kennedy ``Public Health 
Threats and Emergencies Act of 2000,'' which we signed into law last 
year.
  Finally, I want to thank my staff--Allen Moore, Dean Rosen, Helen 
Rhee, Craig Burton, Allison Winnike, and Shana Christrup--as well as 
the staff of other Senate offices for all of their efforts, including 
Vince Ventimiglin, Katy French and Steve Irizarry of Senator Gregg's 
staff; David Nixon, David Bowen, David Dorsey, and Paul Kim of Senator 
Kennedy's staff; John Mashburn of Senator Lott's staff; Stacey Hughes 
of Senator Nichles' staff; Abby Kral of Senator DeWine's staff; Claire 
Bernard and Priscilla Hanley of Senator Collins' office; Kate Hull of 
Senator Hutchinson's staff; Raissa Geary of Senator Enzi's staff; Laura 
O'Neill of Senator Session's office; Debra Barrett and Jim Fenton of 
Senator Dodd's staff; and Bruce Artim and Patty DeLoatche of Senator 
Hatch's staff. Their tireless work has been essential in assisting us 
in getting this far.
  Mr. LIEBERMAN. Mr. President, I rise to discuss the Senate's action 
this evening on bioterrorism. Today, the Senate has taken an important 
step toward improving the Nation's ability to prepare for, and respond 
to, the threat of bioterrorism by adopting legislation, authored by 
Senator Kennedy and Senator Frist, and of which I am a cosponsor. The 
Senate bill, S. 1765, recognizes that any meaningful improvement in 
this area must begin with improvements in the Nation's public health 
system, a fact underscored by a series of hearings conducted by the 
Committee on Governmental Affairs on bioterrorism earlier this year. As 
a result of those hearings, I believe that there are several areas in 
which the Senate bill could be further strengthened especially in terms 
of the way the Federal Government's efforts to combat bioterrorism are 
organized. In anticipation of Senate consideration, I prepared an 
amendment to the original Kennedy/Frist bioterrorism bill, S. 1715, to 
address these concerns. However, given Senate's interest in acting on 
this important measure before adjournment, I agreed to defer offering 
this amendment at this time. I do, however, believe that the underlying 
issues need to be addressed
  Specifically, I would like to see additional attention given to 
bioterrorism within the Centers for Disease Control and Prevention, 
CDC. The underlying bill recognizes the need to strengthen

[[Page S13907]]

CDC bioterrorism role. Currently, CDC's bioterrorism activities are 
currently coordinated by the Bioterrorism Preparedness and Response 
Program within the National Center for Infectious Diseases. While many 
of the agents of concern are infectious diseases, many are not, 
including toxins and chemical agents. Even more to the point, many of 
the elements of the CDC bioterrorism program actually reside in other 
Programs and Centers. The pharmaceutical stockpile program resides 
within the National Center of Environmental Health. The Health Alert 
Network is in the Public Health Practices Program. Surveillance and 
detection activities are in the Epidemiology Program Office. 
Coordination of these activities, competition for resources, and line 
authority is a major problem. The importance and unique nature of the 
bioterrorism mission also requires creation of a separate 
``intellectual'' center.
  The underlying bill also recognizes both the importance of expanding 
the role of HHS within the Government to provide leadership on 
bioterrorism preparedness and response. In addition, it recognizes the 
need to coordinate such activities within the many parts of HHS, 
including FDA, CDC, OEP, NIH, etc. The amendment would codify basic 
government management responsibilities and tools for the new Assistant 
Secretary position including agency performance measures, performance 
evaluation capability, technology verification.
  Detection is key to responding to bioterrorism attacks. Although 
health agencies have surveillance systems, they do not rely upon 
standard methodologies or real-time data collection. Though some States 
and localities have also begun to incorporate ``syndromic'' indicators, 
this practice is not widespread or standardized and they are not 
integrated into other health data systems. CDC is working on 
development of a new internet-based system, the National Electronic 
Disease Surveillance System, NEDSS, but its deployment is many years in 
the future. The amendment establishes an accelerated deployment 
schedule, including the development of data collection and reporting 
protocols, in consultation with state and local health agencies.
  CDC has initiated an internet-based Health Alert Network to provide 
real-time information to state and local health officials. 
Unfortunately, a number of States are not yet included in the network 
and very few county and municipal health departments are included. The 
amendment would establish an accelerated schedule for deployment.
  Lack of interoperability of communication systems, and more recently 
in IT systems, is a long-standing problem in emergency response among 
federal agencies, much less between federal and state agencies. The 
underlying bill recognizes the need for better interagency coordination 
through the creation of an interagency working group. The amendment 
would specifically charge the group with addressing interoperability of 
IT and communication systems and give the Secretary of HHS authority to 
provide technical and financial support to resolve such problems.
  The amendment would require the Secretary of HHS to contract with the 
Institute of Medicine to analyze the response of the public health 
system of the recent anthrax attacks and provide a ``lessons-learned'' 
report to help guide improvements at the federal, state, and local 
level.
  Finally, I would note that the House bill also recognizes the need to 
improve our public health surveillance and communications systems. The 
House bill also seeks to incorporate performance measures as part of 
expanded bioterrorism program in a manner similar to what I propose. 
Now that Senate has acted, I look forward to working with the conferees 
to ensure that our Nation is prepared for meeting this new threat.
  I ask unanimous consent that the amendment that I was prepared to 
submit, be printed in the Record.
  There being no objection, the amendment was ordered to be printed in 
the Record, as follows:

                            Amendment No.--

       On page 11, between lines 19 and 20, insert the following:
       ``(d) National Center for Bioterrorism.--There is 
     established within the Centers for Disease Control and 
     Prevention a National Center for Bioterrorism, to develop, 
     manage, and provide scientific and medical capabilities to 
     prepare for, and respond to, bioterrorism attacks, 
     including--
       ``(1) analyzing and applying intelligence and threat 
     assessment information to the preparation, development and 
     stockpile of vaccines, antibiotics and other pharmaceuticals, 
     medical training, and other preparation and response 
     capabilities;
       ``(2) detecting biological and chemical agents, detecting 
     and conducting surveillance, and making a diagnosis of 
     related diseases;
       ``(3) disease investigation and mitigation; and
       ``(4) the provision of guidance to Federal, State, tribal, 
     and local officials, concerning preparation for and response 
     to bioterrorism attacks.''.
       On page 13, strike line 3.
       On page 13, line 7, strike the period and insert a 
     semicolon.
       On page 13, between lines 7 and 8, insert the following:
       ``(3) coordinate the standards and interoperability of 
     information technology and communications systems within the 
     Department of Health and Human Services and among Federal, 
     State, tribal, and local health officials and health service 
     providers relevant to emergency preparedness and biological 
     threats or attacks;
       ``(4) develop and maintain advanced health surveillance 
     systems to provide early warning of natural disease outbreaks 
     or bioterrorist attacks to Federal, State, tribal, and local 
     health officials and to aid response management; and
       ``(5) develop and maintain a program to continuously 
     evaluate the capabilities and vulnerabilities of the national 
     health and emergency preparedness plans and systems to 
     identify and respond to natural disease outbreaks or 
     bioterrorist attacks, including the establishment of 
     performance measures.
       ``(c) Evaluation Group and Exercises.--
       ``(1) In general.--The Assistant Secretary for Emergency 
     Preparedness shall establish an evaluation group, to be 
     composed of at least 10 individuals who are experts on public 
     health preparedness and bioterrorism from both within and 
     without the federal government, to test and evaluate the 
     capabilities and vulnerabilities of the national health and 
     emergency preparedness plans and systems to identify and 
     respond to natural disease outbreaks or bioterrorist attacks 
     on a continuous basis, including the conduct of local, 
     regional, and national-scale exercises.
       ``(2) Annual report.--At least annually, the evaluation 
     group established under paragraph (1) shall prepare and 
     submit to the Secretary and to the Committee on Health, 
     Education, Labor and Pensions, the Committee on Governmental 
     Affairs, and the Committee on Appropriations of the Senate 
     and the Committee on Energy and Commerce, Committee on 
     Government Reform, and the Committee on Appropriations of the 
     House of Representatives a report concerning the results of 
     the tests and evaluations conducted under paragraph (1).
       ``(d) Performance Measures.--
       ``(1) In general.--Not later than 1 year after the date of 
     enactment of this title, the Assistant Secretary for 
     Emergency Preparedness, in cooperation with the evaluation 
     group established under subsection (c)(1), shall establish a 
     system of performance measures to evaluate responses to 
     bioterrorism threats and vulnerabilities. Such system shall 
     establish benchmarks and evaluate the corresponding roles and 
     performances of agencies with responsibilities for 
     bioterrorism responses in Federal, State, tribal, and local 
     governments.
       ``(2) Report.--Not later than 30 days after the date on 
     which the system is established under paragraph (1), the 
     Assistant Secretary for Emergency Preparedness shall prepare 
     and submit to the Secretary, and to the appropriate 
     committees of Congress, a report concerning the performance 
     measures and evaluations developed as a part of the system.
       ``(3) Revisions.--The Assistant Secretary for Emergency 
     Preparedness, in cooperation with the Evaluation Group, shall 
     periodically review and revise the performance measures 
     developed under paragraph (1) and promptly report any 
     revisions to the Committee on Health, Education, Labor and 
     Pensions, the Committee on Governmental Affairs, and the 
     Committee on Appropriations of the Senate and the Committee 
     on Energy and Commerce, the Committee on Government Reform, 
     and the Committee on Appropriations of the House of 
     Representatives.
       ``(e) Technology Verification.--The Assistant Secretary for 
     Emergency Preparedness shall establish a technology 
     verification group from among relevant agencies of the 
     Federal Government, including the Department of Defense, the 
     Centers for Disease Control and Prevention, the Federal 
     laboratories, and the National Institute for Standards and 
     Technology. Such group, in consultation with appropriate 
     representatives of the private sector, shall--
       ``(1) evaluate, test, and verify the performance of 
     promising technologies for reducing and responding to 
     bioterrorism threats;
       ``(2) make recommendations to relevant Federal, State, and 
     local agencies for the acquisition of successful technologies 
     that can significantly reduce bioterrorism threats; and
       ``(3) prepare and submit to the Committee on Health, 
     Education, Labor and Pensions,

[[Page S13908]]

     the Committee on Governmental Affairs, and the Committee on 
     Appropriations of the Senate and the Committee on Energy and 
     Commerce, the Committee on Government Reform, and the 
     Committee on Appropriations of the House of Representatives, 
     a report concerning the recommendations made under paragraph 
     (2).
       On page 17, between lines 8 and 9, insert the following:

     ``SEC. 2815. NATIONAL HEALTH SURVEILLANCE SYSTEM.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary, acting through the 
     Assistant Secretary for Emergency Preparedness, shall 
     establish a National Health Surveillance System that utilizes 
     computerized information systems and the Internet to provide 
     early warning of natural disease outbreaks or bioterrorist 
     attacks to Federal, State, tribal, and local health officials 
     and assist such officials in response management.
       ``(2) Use of existing systems.--Such system, to the maximum 
     extent feasible, shall utilize existing health care data 
     systems of primary care providers, health insurance and 
     reimbursement programs, and other sources of health 
     information including those maintained by Federal, State, 
     tribal and local health agencies.
       ``(b) Data and Information Standards.--Not later than 12 
     months after the date of enactment of this title, the 
     Assistant Secretary for Emergency Preparedness, in 
     cooperation with medical providers and State and local public 
     health officials, shall identify the nature and manner of 
     health surveillance data to be compiled for purposes of 
     subsection (a) and shall establish standards and procedures 
     to ensure the standardization and interoperability of such 
     data.
       ``(c) Collection and Analysis Capability.--As soon as 
     practicable, but not later than 36 months after the date of 
     enactment of this title, the Assistant Secretary for 
     Emergency Preparedness shall establish the mechanisms and 
     information systems necessary for the collection and rapid 
     real time evaluation of data transmitted for purposes of 
     subsection (a) concerning public health and bioterrorist 
     emergencies, and provide such evaluations on at least a daily 
     basis to Federal, State, tribal, and local public health and 
     emergency authorities.
       ``(d) Assistance to State and Local Health Agencies and 
     Health Care Providers.--The Assistant Secretary for Emergency 
     Preparedness may provide technical, material, and financial 
     assistance to State, tribal, and local public health 
     agencies, health providers, and other entities that the 
     Assistant Secretary recommends participate in the 
     surveillance system developed under this section.
       ``(e) Authorization of Appropriations.--There is authorized 
     to be appropriated $120,000,000 for fiscal year 2002 to carry 
     out this section.

     ``SEC. 2816. NATIONAL HEALTH ALERT NETWORK.

       ``(a) In General.--The Secretary, acting through the 
     Assistant Secretary for Emergency Preparedness, shall 
     establish and maintain a National Health Alert Network, that 
     utilizes, to the maximum extent practical, advanced 
     information and Internet technology.
       ``(b) Requirements.--The network established under 
     subsection (a) shall--
       ``(1) be capable of the timely transmission of emergency 
     medical information and information identifying potential and 
     ongoing public health and bioterrorism emergencies to all 
     appropriate Federal health authorities, to all State and 
     local public health authorities, and to hospitals and other 
     medical practitioners in affected areas; and
       ``(2) include data on the medical nature of the emergency, 
     recognition of disease symptoms, the possible scope of 
     infections, recommended treatments, the sources and 
     availability of appropriate medicines, and such other data as 
     may be recommended by the Secretary.
       ``(c) Implementation Objectives.--Not later than 180 days 
     after the date of enactment of this title, the Secretary 
     shall ensure that all State public health departments are 
     connected to the network established under subsection (a). 
     Not later than 1 year after such date of enactment, the 
     Secretary shall ensure that all municipal public health 
     agencies in municipalities with populations larger than 
     250,000 persons, as well as all county and tribal public 
     health agencies, are included in the network.
       ``(d) Assistance to State and Local Health Agencies.--The 
     Secretary may provide technical, material, and financial 
     assistance to State and local public health agencies, health 
     providers, and other entities that the Assistant Secretary 
     for Emergency Preparedness recommends for participation in 
     the network.
       ``(e) Reporting Requirement.--The Secretary shall prepare 
     and submit to the appropriate committees of Congress reports 
     describing the progress made by the Secretary in implementing 
     the network described in subsection (a). Such reports shall 
     be submitted--
       ``(1) not later than 1 year after the date of enactment of 
     this title;
       ``(2) at such times as the Secretary determines to be 
     appropriate after the completion of each phase of the 
     implementation objectives described in subsection (c); and
       ``(3) annually thereafter as determined appropriate by 
     Congress.
       ``(f) Authorization of Appropriations.--There is authorized 
     to be appropriated $100,000,000 for fiscal year 2002 to carry 
     out this section.''.
       On page 19, line 3, strike ``Section'' and insert ``(a) In 
     General.--Section''.
       On page 21, line 8, strike ``and''.
       On page 21, line 11, strike the period and insert ``; 
     and''.
       On page 21, between lines 11 and 12, insert the following:
       ``(11) coordinate and standardize data and communication 
     systems and requirements to ensure the interoperability and 
     seamless data transmission necessary to prepare for, 
     identify, assess, and respond to health emergencies and 
     bioterrorist attacks, including the National Health 
     Surveillance System and the National Health Alert Network.
       On page 23, between lines 16 and 17, insert the following:
       ``(c) Technical Assistance and Grants to Ensure 
     Interoperability.--
       ``(1) In general.--The Secretary, in consultation with the 
     working group, may provide technical and financial assistance 
     to a public or private entity to ensure the interoperability 
     and seamless transmission of data and communications deemed 
     necessary to prepare for, identify, assess, or respond to a 
     health emergency or bioterrorism attack.
       ``(2) Authorization of appropriations.--There is authorized 
     to be appropriated $25,000,000 for fiscal year 2002 to carry 
     out this subsection.''.
       (b) Formal Inquiry into Anthrax Attacks and Bioterrorism 
     Preparedness.--
       (1) In general.--Not later than 45 days after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall enter into a contract with the Institute of 
     Medicine of the National Academy of Sciences for the conduct 
     of a formal independent inquiry into the response of the 
     United States to anthrax attacks throughout the United States 
     Postal System and the state of preparedness for other 
     biological and chemical threats, including the 
     recommendations described in paragraph (2).
       (2) Completion and report.--The inquiry conducted under 
     paragraph (1) shall be completed not later than 270 days 
     after the date on which the contract under such paragraph is 
     awarded. Not later than 30 days after the date on which such 
     inquiry is completed, the Secretary of Health and Human 
     Services shall submit to the appropriate committees of 
     Congress a report concerning the results of such inquiry, 
     including the recommendations of the Institute of Medicine 
     concerning the preparedness of the United States for future 
     bioterrorism attacks (including recommendations for both 
     occupational and public safety).
  Mr. BIDEN. Mr. President, the final day of a legislative session 
often brings a flurry of activity as bills get un-jammed, compromises 
emerge, and the Senate produces progress on important issues. Depending 
upon one's perspective, these last-minute actions include both good 
things and bad things. Nevertheless, I think we all can agree that 
today's passage of the Bioterrorism Preparedness Act is a real 
accomplishment in improving America's homeland defense. This bill 
authorizes $3.25 billion for comprehensive measures to take the first 
step in improving our nation's capability, in the event of a biological 
weapons attack, to respond quickly, contain the attack, and treat the 
victims. I want to applaud Senators Kennedy and Frist for coming 
together in a bipartisan spirit and displaying real leadership in 
drafting this bill.
  When Sam Nunn testified in early September before the Foreign 
Relations Committee on the threat posed by biological weapons, he was 
very clear--bioterrorism is a direct threat to the national security of 
the United States and we need to invest the necessary resources to 
counter this threat accordingly. As troubling as the recent spate of 
anthrax by mail attacks was, we were very fortunate that this was a 
comparatively small-scale attack. Eighteen Americans contracted 
inhalation or cutaneous anthrax; unfortunately, five individuals died. 
The next time a biological weapons attack occurs, we may not be so 
fortunate in dealing with a small number of victims who emerge over a 
period of weeks and months. Instead, we may face thousands of victims 
flooding local emergency rooms and overwhelming our hospitals in a 
matter of hours.
  Let's be real here--the anthrax attacks, as small-scale as they may 
have been, have greatly stressed our national public health 
infrastructure. One out of eight Centers for Disease Control employees 
at their headquarters in Atlanta is working on the current anthrax 
outbreak, forcing the CDC to sideline other essential core activities 
for the time being. Folks, what we have just been through is small 
potatoes compared to what we potentially will face. Plain and simple, 
we can't afford to be so under-prepared in the future.

[[Page S13909]]

  Among Sam Nunn's recommendations for countering biological terrorism, 
he declared, ``We need to recognize the central role of public health 
and medicine in this effort and engage these professionals fully as 
partners on the national security team.'' There are many good things in 
this bill, ranging from the expansion of the National 
Pharmaceutical Stockpile to efforts to enhance food safety, but I am 
especially pleased that the Bioterrorism Preparedness Act provides 
direct grants to improve the public health infrastructure at the state 
and local level. Our doctors, nurses, emergency medical technicians, 
and other public health personnel are our eyes and ears on the ground 
for detecting a biological weapons attack. We can't afford not to do 
everything we can to make sure they have the necessary tools and 
resources in containing any BW attack. This bill goes a long way toward 
fulfilling that core commitment.

  So I am very pleased the Senate today has passed the Bioterrorism 
Preparedness Act and I look forward to a quick reconciliation of this 
bill with counterpart House legislation early next year. When this bill 
was introduced, I had expressed my serious concern that it was ignoring 
the international aspects to any effective response to potential 
bioterrorism. As Chairman of the Foreign Relations Committee, I know 
that we cannot address the threat of bioterrorism within the borders of 
the United States alone. A biological weapon attack need not originate 
in the United States to pose a threat to our nation. A dangerous 
pathogen deliberately released anywhere in the world can quickly spread 
to the United States in a matter of days, if not hours. The scope and 
frequency of international trade, travel, and migration patterns offer 
unlimited opportunities for pathogens to spread across national borders 
and even to move from one continent to another. Therefore, I continue 
to believe we need to view all infectious disease epidemics, wherever 
they occur, as a potential threat to all nations.
  It is for this reason that, when the Bioterrorism Preparedness Act 
was being drafted, Senator Helms, the distinguished Ranking Member on 
the Foreign Relations Committee, and I had worked together in seeking 
to insert provisions in this bill to enhance global disease monitoring 
and surveillance. With Senator Kennedy's strong backing, we had sought 
to ensure the full availability of information (i.e., disease 
characteristics, pathogen strains, transmission patterns) on infectious 
epidemics overseas that may provide clues indicating possible illegal 
biological weapons use or research. Even if an infectious disease 
outbreak occurs naturally, improved monitoring and surveillance can 
help contain the epidemic and tip off scientists and public health 
professionals to new disease that may be used as biological weapons in 
the future.
  The World Health Organization (WHO) established a formal worldwide 
network last year, called the Global Alert and Response Network, to 
monitor and track infectious disease outbreaks in every region of the 
world. The WHO has done an impressive job so far working on a 
shoestring budget. But this global network is only as good as its 
components--individual nations. Many developing nations simply do not 
possess the personnel, laboratory equipment or public health 
infrastructure to track disease patterns and detect traditional and 
emerging pathogens. In fact, these nations often just seek to keep up 
in treating those who have already fallen ill.

  Doctors and nurses in many developing countries only treat a small 
fraction of the patients who may be ill with a specific infectious 
disease--in effect, they are only witnessing the tip of a potentially 
much larger iceberg. According to the National Intelligence Council, 
governments in developing countries in Africa and Asia have established 
rudimentary or no systems at all for disease surveillance, response or 
prevention. For example, in 1994, an outbreak of plague occurred in 
India, resulting in 56 deaths and billions of dollars of economic 
damage as trade and travel with India ground to a halt. The plague 
outbreak was so severe because Indian authorities did not catch the 
epidemic in its early stages. Authorities had ignored or failed to 
respond to routine complaints a flea infestation, a sure warning signal 
for plague.
  Owing to the lack of resources, developing nations are the weak spots 
in global disease monitoring and surveillance. Without shoring up these 
nations' capabilities to detect and contain disease outbreaks, we are 
leaving the entire world vulnerable to either a deliberate biological 
weapons attack or an especially virulent naturally occurring epidemic.
  For all of these reasons, Senator Helms and I had worked together in 
proposing language to authorize $150 million in FY 1001 and FY 2003 to 
strengthen the capabilities of individual nations in the developing 
world to detect, diagnose, and contain infectious disease epidemics. 
The proposed title would have helped train entry-level public health 
professionals from developing countries and provide grants for the 
acquisition of modern laboratory and communications equipment essential 
to any effective disease surveillance network. Upon first glance, $150 
million is chump change in a bill that authorizes more than $3 billion. 
But I have been assured by public health experts that $150 million 
alone can go a long ways in making sure that developing countries the 
basic disease surveillance and monitoring capabilities to effectively 
contribute to the WHO's global network. The bottom line is that these 
provisions would have offered an inexpensive, common-sense solution to 
a problem of global proportions.

  I was greatly disappointed, therefore, when the White House expressed 
resistance to the language Senator Helms and I had worked out and 
sought to drop it from the final bill. While voicing support for our 
ideas, the White House believed that the Bioterrorism Preparedness Act 
should only focus on domestic defenses against bioterrorism and was not 
the appropriate vehicle for the international programs we proposed.
  I strongly disagreed. It doesn't make sense to draw artificial 
boundaries between ``domestic'' and ``international'' responses to 
bioterrorism. I have already pointed out that pathogens deliberately 
released in an attack anywhere in the world can quickly spread to the 
United States if we are unable to contain the epidemic at its source. 
The National Intelligence Council has concluded that infectious 
diseases are a real threat to U.S. national security. To ignore the 
international arena in favor of domestic solutions alone just doesn't 
make any sense.
  Therefore, when the Bioterrorism Preparedness Act was introduced in 
November without any provisions to enhance global disease surveillance, 
I announced my intention to introduce an amendment to ensure this bill 
would enhance the capabilities of developing nations to track, 
diagnose, and contain disease outbreaks resulting from both BW attacks 
and naturally occurring epidemics. This week, the Senate leadership 
chose to move this bill under an unanimous consent procedure. I 
initially objected because I strongly believed the Senate should have 
an opportunity, at the very least, to vote on an amendment to 
incorporate global disease surveillance activities in the Bioterrorism 
Preparedness Act. But I understand the urgency of the moment. There is 
no greater vulnerability in our nation's defenses than against the 
threat of bioterrorism and it is the responsibility of Congress to act 
quickly to correct this deficiency.
  Therefore, I have chosen, for now, to cease my effort to include this 
amendment in this bill. Office of Management and Budget Director Mitch 
Daniels today sent me a letter where he expresses appreciation for the 
proposals contained in this amendment and recognizes that 
``International public health has a critical role to play in protecting 
the United States and our global partners''. Furthermore, Daniels 
highlights the Administration's intention to engage in discussions with 
myself and other interested colleagues on these proposals when the 
Congress reconvenes in January. I ask for unanimous consent that the 
full text of this letter be included at the end of this statement in 
the Congressional Record.
  I expect the Administration to follow up on this letter by planning 
and budgeting for improved global pathogen surveillance in Fiscal Year 
2003. The need is urgent and our ability to lessen the threat posed by 
bioterrorism is real.

[[Page S13910]]

The steps we take to combat bioterrorism overseas can keep diseases 
from reaching our shores and will give us vital early warning of new 
diseases and strains for which we must prepare.
  Let me again salute today's passage by the Senate of the Bioterrorism 
Preparedness Act. While it does not include every essential proposal in 
enhancing our nation's bioterrorism defenses, it still accomplishes a 
great deal. If this bill becomes law, which I have no reason to doubt, 
it is my hope that the Congress will follow up next year with the 
necessary appropriations to carry out the programs authorized in this 
bill.
  Let me close with an excerpt of testimony from the Foreign Relations 
Committee hearing on bioterrorism in September from Dr. D.A. Henderson, 
the man who spearheaded the international campaign to eradicate 
smallpox in the 1970's. Today, he is the director of the newly-formed 
Office of Emergency Preparedness in the Department of Health and Human 
Services, which has the mandate to help organize the federal 
government's response to future bioterrorist attacks. Dr. Henderson was 
very clear on the value of global disease surveillance: ``In 
cooperation with the WHO and other countries, we need to strengthen 
greatly our intelligence gathering capability. A focus on international 
surveillance and on scientist-to-scientist communication will be 
necessary . . .''
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:

         Executive Office of the President, Office of Management 
           and Budget,
                               Washington, DC., December 20, 2001.
     Hon. Joseph R. Biden, Jr.,
     U.S. Senate,
     Washington, DC.
       Dear Senator Biden: I very much appreciate the important 
     proposals contained within Title VI of the Kennedy-Frist 
     bioterrorism bill. International public health has a critical 
     role to play in protecting the United States and our global 
     partners from the threat of infectious disease.
       As you are aware, the Administration supports the version 
     of the Kennedy bill that does not include Title VI. These 
     issues are critical, however, and I would very much like to 
     resolve them outside the context of the current bioterrorism 
     bill. Your willingness to discuss these matters in the future 
     is critical to the movement of this important piece of 
     legislation and I would welcome the opportunity to engage in 
     these discussions at the beginning of the next session.
       Thank you very much for your consideration of this request.
           Sincerely,
                                         Mitchell E. Daniels, Jr.,
                                                         Director.


              additional bioterrorism preparedness issues

  Mr. HATCH. I would like to commend my colleagues, Senators First, 
Kennedy, and Gregg for their work in crafting the bipartisan 
Bioterrorism Preparedness Act. The Act takes a significant step forward 
in providing the necessary tools to combat future acts of bioterrorism.
  Mr. FRIST. I thank the gentleman from Utah for his comments. On 
behalf of myself, Senator Kennedy, and Senator Gregg, I also want to 
thank him for his significant contributions to the legislation, and for 
his support for this measure.
  Mr. HATCH. I understand that there are efforts currently underway to 
pass this legislation by unanimous consent before the Senate adjourns 
for the year, and I strongly support those efforts. Because we are 
trying to clear this measure under a tight time frame, I also 
understand that there will not be an opportunity to make modifications 
to the text of the legislation prior to final Senate passage.
  Mr. KENNEDY. That is correct.
  Mr. FRIST. My friend from Utah is correct.
  Mr. HATCH. Before Congress passes a final anti-bioterrorism law, I 
believe there are several important issues that must be addressed. 
Because there will not be an opportunity to address these matters 
before the Senate passes anti-bioterrorism legislation, I strongly 
believe that the House-Senate conference committee should: (1) permit 
the approval of priority countermeasures solely based on data from 
animal studies; (2) clarify the Health and Human Service Secretary's 
role and authority in distribution, and use of, priority 
countermeasures and other medical responses to bioterrorist attacks; 
and (3) provide additional enforcement provisions with respect to 
prohibiting the unlawful shipment, transportation, and possession of 
biological agents and toxins.
  These issues have not been sufficiently addressed in the legislation 
before us. We must all recognize that this language the Senate is about 
to adopt has not been the subject of any congressional committee mark-
up. While the extraordinary situation confronting our nation regarding 
biological attacks requires expeditious action, we also must ensure 
that there is flexibility in the conference committee to guarantee that 
novel and, frankly, evolving issues, concerning bioterrorism are 
adequately addressed. This is what happened during the House-Senate 
conference of the U.S.A. Patriot Act and, with diligence, we can 
duplicate that success again.
  Mr. GREGG. I agree that the conference committee should address each 
of the issues that you have raised. I will actively work to ensure that 
these provisions are included.
  Mr. KENNEDY. I concur with my colleague from New Hampshire.
  Mr. FRIST. I also agree that these important issues should be 
addressed during a conference with the House of Representatives and we 
will call on the Senator from Utah to participate in discussions 
concerning these issues.
  Mr. GREGG. I agree with my colleague from Utah that additional 
specificity with respect to the language on animal trials would be 
desirable, particularly with respect to clarifying that the FDA has the 
authority to promptly promulgate a final rule in this area. I also 
believe that the Secretary of Health and Human Services should have 
clear authority to prioritize the distribution of scarce 
countermeasures under certain circumstances. Finally, I believe there 
is great value in considering the inclusion in a final bill of 
intermediate enforcement authority with respect to the unlawful 
shipment, transport, possession, or other use of biological agents or 
toxins.
  Mr. FRIST. I agree with Senator Gregg. The Senator from Utah can be 
assured that these issues will receive my active support during 
conference consideration of this measure.
  Mr. KENNEDY. I also agree with Senator Gregg. I thank the Senator 
from Utah for bringing these important issues to the attention of the 
Senate. I will look forward to working with him in resolving these 
issues during the conference.
  Mr. HATCH. I also request that my colleagues support the inclusion of 
provisions to establish an animal terrorism incident clearinghouse.
  Mr. GREGG. I will actively support this provision.
  Mr. FRIST. I concur with my colleague from New Hampshire.
  Mr. KENNEDY. I also believe that this issue should be given serious 
consideration.
  Mr. HATCH. I thank my colleagues for their comments. I look forward 
to working with them during the conference to ensure that this 
important legislation is passed by Congress so that our nation can be 
better prepared to meet the threat of bioterrorism and public health 
emergencies.


                         WATER SUPPLY SECURITY

  Mr. JEFFORDS. Mr. President, and my distinguished colleagues, I am 
pleased that we are moving so quickly on legislation to combat 
bioterrorism--this is certainly a timely issue.
  I would like to engage my colleagues in a colloquy to clarify our 
commitment to another important issue--the security of our Nation's 
water supply. At the end of October of this year, I was joined by the 
Ranking Member of the Environment and Public Works Committee in 
introducing S. 1593 and S. 1608. S. 1593 authorizes the Administrator 
of the Environmental Protection Agency to establish a grant program to 
support research projects on critical infrastructure protection for 
water supply systems. S. 1608 establishes a program to provide grants 
to drinking water and wastewater facilities to meet immediate security 
needs.
  I understand that the Senator from Tennessee, the Senator from 
Massachusetts and the Senator from New Hampshire support the modified 
provisions of these bills. Is that correct?
  Mr. FRIST. That is correct.
  Mr. KENNEDY. Yes, that is correct.
  Mr. GREGG. Yes, that is correct because in the interest of time, we 
re unable to change the bill prior to conference.

[[Page S13911]]

  Mr. SMITH of New Hampshire. I too would like to thank Senator Frist, 
Senator Kennedy and Senator Gregg for agreeing to work with us to 
ensure these two proposals are included in the bioterrorism proposal. I 
regret that with the end of session quickly approaching, there is not 
time to incorporate these provisions into the underlying bill. As we 
all recognized in our support for these proposals, since the September 
11th attacks, Americans throughout the country have become concerned 
about the security of our nation's water supply. While it is widely 
believed that our water supply is safe, there are a few vulnerabilities 
that must be addressed. Our bills would provide resources for research 
into security at facilities and assessment tools while also providing 
seed money to encourage additional spending on security measures.
  Mr. JEFFORDS. Our colleagues on the House side also recognized this 
need by including water security provisions in the bioterrorism bill, 
H.R. 3448, that was passed by the House on December 12th. I would like 
my colleagues' assurance that during conference they will press for 
adoption of the modified versions of S. 1593 and S. 1608.
  Mr. KENNEDY. I intend to press for adoption of these provisions. the 
security of our nation's water supply is crucial to the health and 
well-being of our citizens.
  Mr. GREGG. I concur, and I intend to press for adoption of these 
provisions.
  Mr. FRIST. I agree and you have my commitment to do the same.
  Mr. SMITH of New Hampshire. I again would like to thank my colleagues 
for agreeing to fight for these provisions during conference. It was 
with great reluctance that Senator Jeffords and I agreed to allow S. 
1765 to be brought to the floor without our legislation included so 
that we can move forward on this important bill and conference it with 
the House. However, it is important that these immediate needs be 
addresed and that our proposals be included in the the final 
legislation. I look forward to working with my colleagues to ensure 
that the provisions we agreed to that comprise the modified versions of 
S. 1593 and S. 1608 are included in the bioterrorism bill.
  Mr. JEFFORDS. Finally, I want to commend Senators Kennedy, Frist, and 
Gregg and say that I am looking forward to working with them during the 
conference on these measures.


                           Amendment No. 2692

  Mr. REID. Mr. President, I understand Senators Frist, Kennedy, and 
Gregg have a substitute amendment at the desk which is the text of S. 
1765. I ask unanimous consent that the amendment be considered and 
agreed to and the motion to reconsider be laid upon the table; that the 
bill, as amended, be read a third time and passed, the motion to 
reconsider be laid upon the table; that the Senate insist on its 
amendment, request a conference with the House on the disagreeing votes 
of the two Houses, and that the Chair be authorized to appoint 
conferees on the part of the Senate, without intervening action or 
debate.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 2692) was agreed to.
  (The text of the amendment is printed in today's Record under 
``Amendments Submitted and Proposed.'')
  Mr. LOTT. Mr. President, I thank Senator Reid for moving this very 
important Bioterrorism Preparedness Act forward. I commend Senators 
Frist, Kennedy, and Gregg for their work. We intend to work with the 
House and get this passed quickly when we return. I thank Senator Reid.
  Mr. REID. I appreciate everyone's cooperation.
  The Presiding Officer (Mr. Corzine) appointed Mr. Kennedy, Mr. Dodd, 
Mr. Harkin, Ms. Mikulski, Mr. Jeffords, Mr. Gregg, Mr. Frist, Mr. Enzi, 
and Mr. Hutchinson conferees on the part of the Senate.

                          ____________________