Congressional Record, Volume 147 Issue 178 (Thursday, December 20, 2001)

[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

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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

[[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.

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