[Congressional Record Volume 148, Number 108 (Thursday, August 1, 2002)]
[Senate]
[Pages S8022-S8025]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                GLOBAL PATHOGEN SURVEILLANCE ACT OF 2002

  Mr. REID. Mr. President, I ask unanimous consent that the Senate 
proceed to the consideration of Calendar No. 388, S. 2487.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 2487) to provide for global pathogen 
     surveillance and response.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. BIDEN. Mr. President, I am extremely pleased that the Senate 
today is taking up S. 2487, the ``Global Pathogen Surveillance Act of 
2002.'' This bill authorizes $150 million over the next two fiscal 
years to provide assistance to developing nations to improve global 
disease surveillance to help prevent and contain both biological 
weapons attacks and naturally occurring infectious disease outbreaks 
around the world.
  This bill is the result of a joint effort by Senator Helms and I to 
act on key lessons learned during an important hearing the Foreign 
Relations Committee held last September on the

[[Page S8023]]

threat of bioterrorism and emerging infectious diseases. I am also 
proud that Senators Kennedy and Frist, the Chairman and Ranking Member 
of the Public Health Subcommittee of the Senate Health, Education, 
Labor, and Pensions Committee, are original cosponsors of this bill.
  Senator Helms and I recognize all too well that biological weapons 
are a global threat with no respect for borders. A terrorist group 
could launch a biological weapons attack in Mexico in the expectation 
that the epidemic would quickly spread to the United States. A rogue 
state might experiment with new disease strains in another country, 
intending later to release them here. A biological weapons threat need 
not begin in the United States to reach our shores.
  For that reason, our response to the biological weapons threat cannot 
be limited to the United States alone. Global disease surveillance, a 
systematic approach to tracking disease outbreaks as they occur and 
evolve around the world, is essential to any real international 
response.
  This country is making enormous advances on the domestic front in 
bioterrorism defense. Mr. President, $3 billion has been appropriated 
for this purpose in FY 2002, including $1.1 billion to improve State 
and local public health infrastructure. Delaware's share will include 
$6.7 million from the Centers for Disease Control and Prevention to 
improve the public health infrastructure and $548,000 to improve 
hospital readiness in my State.
  Earlier this year, the President signed into law a comprehensive 
bioterrorism bill drafted last fall following the anthrax attacks via 
the U.S. postal system. Those attacks, which killed five individuals 
and infected more than 20 people, highlighted our domestic 
vulnerabilities to a biological weapons attack. We need to further 
strengthen our nation's public health system, improve federal public 
health laboratories, and fund the necessary research and procurement 
for vaccines and treatments to respond better to future bioterrorist 
attacks. As an original cosponsor of the ``Kennedy-Frist'' bill in the 
Senate, I know the implementation of this new law will help achieve 
many of those objectives.
  Nevertheless, any effective response to the challenge of biological 
weapons must also have an international component. Limiting our 
response to U.S. territory would be shortsighted and doomed to failure. 
A dangerous pathogen released on another continent can quickly spread 
to the United States in a matter of days, if not hours. This is the 
dark side of globalization. International trade, travel, and migration 
patterns offer unlimited opportunities for pathogens to spread across 
national borders and to move from one continent to another. Moreover, 
an overseas epidemic could give us our first warning of a new disease 
strain that was developed by a country or by terrorists for use as a 
biological weapon, or that could be used by others for that purpose.
  How does disease surveillance fit into all of this? A biological 
weapons attack succeeds partly through the element of surprise. A 
cluster of flu-like symptoms in a city or region may be dismissed by 
individual physicians as just the flu when in fact it may be anthrax, 
plague, or another biological weapon. Armed with the 
knowledge, however, that a biological weapons attack has in fact 
occurred, doctors and nurses can examine their patients in a different 
light and, in many cases, effectively treat infected individuals.

  Disease surveillance, a comprehensive reporting system to quickly 
identify and communicate abnormal patterns of symptoms and illnesses, 
can quickly alert doctors across a region that a suspicious disease 
outbreak has occurred. Epidemiological specialists can then investigate 
and combat the outbreak. And if it is a new disease or strain, we can 
begin to develop treatments that much earlier.
  A good surveillance system requires trained epidemiological 
personnel, adequate laboratory tools for quick diagnosis, and 
communications equipment to circulate information. Even in the United 
States today, many states and localities rely on old-fashioned pencil 
and paper methods of tracking disease patterns. Thankfully, we are 
addressing those domestic deficiencies through the new bioterrorism law 
and substantially increased appropriations.
  For example, in Delaware, we are developing the first, comprehensive, 
state-wide electronic reporting system for infectious diseases. This 
system will be used as a prototype for other states, and will enable 
much earlier detection of infectious disease outbreaks, both natural 
and bioterrorist. My congressional colleagues from Delaware and I have 
been working for over 2 years to get this project up and running, and 
we were successful in obtaining $2.6 million in funding for this 
project over the past 2 years. I and my colleagues have requested $1.4 
million for additional funding in FY 2003, and we are extremely 
optimistic that this funding will be forthcoming.
  It is vitally important that we extend these initiatives into the 
international arena. However, as many developing countries are way 
behind us in terms of public health resources, laboratories, personnel, 
and communications, these countries will need help just to get to the 
starting point we have already reached in this country.
  An effective disease surveillance system is beneficial even in the 
absence of biological weapons attacks. Bubonic plague is bubonic 
plague, whether it is deliberately engineered or naturally occurring. 
Just as disease surveillance can help contain a biological weapons 
attack, it can also help contain a naturally occurring outbreak of 
infectious disease. According to the World Health Organization, 30 new 
infectious diseases have emerged over the past 30 years; between 1996 
and 2001 alone, more than 800 infectious disease outbreaks occurred 
around the world, on every continent. With better surveillance, we can 
do a better job of mitigating the consequences of these disease 
outbreaks.
  According to a report by the National Intelligence Council, 
developing nations in Africa and Asia have established only rudimentary 
systems, if any at all, for disease surveillance, response, and 
prevention. The World Health Organization reports that more than sixty 
percent of laboratory equipment in developing countries is either 
outdated or nonfunctioning.
  This lack of preparedness can lead to tragic results. In August 1994 
in Surat, a city in western India, a surge of complaints on flea 
infestation and a growing rat population was followed by a cluster of 
reports on patients exhibiting the symptoms of pneumonic plague. 
However, authorities were unable to connect the dots until the plague 
had spread to seven states across India, ultimately killing 56 people 
and costing the Indian economy $600 million. Had the Indian authorities 
employed better surveillance tools, they may well have contained the 
epidemic, limited the loss of life, and surely avoided the panic that 
led to economically disastrous embargoes on trade and travel. An 
outbreak of pneumonic plague in India this February was detected more 
quickly and contained with only a few deaths--and no costly panic.
  Developing nations are the weak links in any comprehensive global 
disease surveillance network. Unless we take action to shore up their 
capabilities to detect and contain disease outbreaks, we leave the 
entire world vulnerable to a deliberate biological weapons attack or a 
virulent natural epidemic.
  It is for these reasons that Senator Helms and I have worked together 
to craft the Global Pathogen Surveillance Act of 2002. This bill 
authorizes $150 million in FY 2003 and FY 2004 to strengthen the 
disease surveillance capabilities of developing nations. First, the 
bill seeks to ensure in developing nations a greater number of 
personnel trained in basic epidemiological techniques. It offers 
enhanced in-country training for medical and laboratory personnel and 
the opportunity for select personnel to come to the United States to 
receive training in our Centers for Disease Control laboratories and 
Master of Public Health programs in American universities.
  Second, the bill provides assistance to developing nations to acquire 
basic laboratory equipment, including items as mundane as microscopes, 
to facilitate the quick diagnosis of pathogens.
  Third, the bill enables developing nations to obtain communications 
equipment and information technology to

[[Page S8024]]

quickly transmit data on disease patterns and pathogen diagnoses, both 
inside a nation and to regional organizations and the WHO. Again, we 
are not talking about fancy high-tech equipment, but basics like fax 
machines and Internet-equipped computers.
  Finally, the bill gives preference to countries that agree to let 
experts from the United States or international organizations promptly 
investigate any suspicious disease outbreaks.

  If this bill becomes law, the Global Pathogen Surveillance Act of 
2002 will go a long way in ensuring that developing nations acquire the 
basic disease surveillance capabilities to link up effectively with the 
WHO's global network. This bill offers an inexpensive and common sense 
solution to a problem of global proportions--the dual threat of 
biological weapons and naturally occurring infectious diseases. The 
funding authorized is only a tiny fraction of what we will spend 
domestically on bioterrorism defenses, but this investment will pay 
enormous dividends in terms of our national security.
  In addition Senator Helms and I have introduced a managers' 
amendment, which I expect will be adopted. This amendment, drafted in 
response to specific suggestions by executive branch departments and 
agencies as well as nongovernmental organizations, addresses two 
important objectives.
  First, it ensures that priority in the provision of assistance to 
developing countries under the authority of this bill will be given 
those nations which agree to provide early notification of disease 
outbreaks. In the past, too many nations have sought to limit the 
release of information on disease outbreaks out of fear for the likely 
impact on their trade and tourism. In today's world, where an epidemic 
could be the first signs of a biological weapons attack, that type of 
reticence by national governments is simply unacceptable.
  The amendment also stipulates that priority in assistance under this 
bill be assigned to those countries which agree to share with the 
United States data collected through its pathogen suveillance networks. 
Our epidemiological experts at the Centers for Disease Control and 
other U.S. departments and agencies are among the best in the world in 
analyzing such data. We should strive to create an international 
framework where multilateral organizations, national governments, and 
even private groups can examine aggregrate data on disease 
characteristics and symptom reports to help detect emerging patterns 
and provide early warning on alarming developments. In short, the more 
information shared under pathogen surveillance, the better protected 
the world is against surprise bioterrorist attacks and rapid natural 
epidemics.
  Second, the managers' amendment makes the necessary changes to take 
into account the need for the quick transmission of data collected 
through pathogen surveillance networks to appropriately respond to 
local conditions. In the United States and other advanced industrial 
nations, disease surveillance may well operate most efficiently through 
Internet-based communications. In some developing countries, however, 
the cost of introducing new Internet links and computer equipment may 
be prohibitive. In those cases, leveraging existing telephone-based 
networks may prove a more cost-effective method in quickly relaying 
information such as patient reports. Under certain conditions, mobile 
phones may even prove a reliable tool. The managers' amendment will 
provide for such flexibility.
  In conclusion, the fundamental premise of the Global Pathogen 
Surveillance Act of 2002 is that we cannot leave the rest of the world 
to fend for itself in combating biological weapons and infectious 
diseases if we are to ensure America's security. Indeed, this bill can 
serve as a key contribution to strengthening our homeland security. I 
urge the Senate to pass S. 2487 and the related managers' amendment 
today.
 Mr. HELMS. Mr. President, the anthrax attacks against the 
Senate and the news media this past fall demanded that we recognize how 
vulnerable America is to bioterroism. The murderous and cowardly 
perpetrators of this terrorism must be brought to justice, but we must 
also prepare ourselves for other attacks in the future.
  I am proud to have worked with Senator Biden in co-authoring the 
Global Pathogen Surveillance Act of 2002, S. 2487, and I am pleased 
that a bipartisan effort has led to its consideration today.
  This bill recognizes that bioterrorism is a transnational threat and 
that the defense of the U.S. homeland is not an isolated activity. 
Rather, our homeland defense requires a comprehensive international 
strategy. A recent National Intelligence Estimate concluded that the 
prospect of a bioterrorist attack against U.S. civilian and military 
personnel will continue to grow as states and terrorist groups continue 
to acquire biological warfare capabilities. This same report warns that 
emerging and reemerging infectious diseases that originate overseas 
threaten Americans not only here in the United States, but also our 
military personnel stationed overseas participating in humanitarian and 
peacekeeping operations.
  On September 5, 2001, the Senate Foreign Relations Committee held a 
hearing on ``The Threat of Bioterrorism and the Spread of Infectious 
Diseases.'' The compelling testimony of several expert witnesses, along 
with the assessments of the intelligence community, prompted Senator 
Biden and I to undertake this important legislation with the goal of 
combating bioterrorism, and ultimately enhancing U.S. national 
security. In order to enhance U.S. efforts to combat bioterrorism, it 
is critical that we address the glaring gap that exists in the 
capabilities of developing countries to conduct pathogen surveillance 
and monitoring.
  This legislation authorizes the President a total of $150 million 
dollars over the next 2 years to fund pathogen surveillance and 
response activities through the Department of State, in consultation 
with the Department of Health and Human Services and the Department of 
Defense. Several provisions are designed to address shortfalls in 
public health education and training, including short-term public 
health training courses in epidemiology for public health professionals 
from eligible developing countries. The President is authorized to 
provide assistance for the purchase and maintenance of public health 
laboratory and communications equipment. In addition, the heads of 
appropriate Federal agencies are authorized to make available a greater 
number of U.S. government public health personnel U.S. missions abroad, 
international health organizations, and regional health networks.
  All of the provisions of S. 2487 are directed towards enabling 
developing countries to acquire basic disease surveillance and 
monitoring capabilities to effectively contribute to community, local, 
regional, and global surveillance networks.
  In order to ensure that the United States has all of the requisite 
tools at its disposal to protect U.S. civilians and military personnel 
against intentional or naturally occurring disease outbreaks, priority 
for assistance under S. 2487 will be for countries that provide early 
notification of disease outbreaks and pathogen surveillance data to 
appropriate U.S. departments and agencies. There is a critical need for 
transparency and information sharing of pathogen surveillance data so 
that the United States can utilize a comprehensive toolkit to combat 
bioterrorism. It is my expectation that developing countries receiving 
assistance under this Act will make a steadfast commitment to improving 
their pathogen surveillance and monitoring efforts.

  I am particularly proud of the provisions of S. 2487 that address the 
glaring need for syndrome surveillance--the recording of symptoms 
(patient complaints) and signs (derived from physical examination) 
combined with simple geographic locators--to track the emergence of a 
disease in a population. Provisions on syndrome surveillance address 
the need to narrow the existing technology gap in syndrome surveillance 
capabilities and real-time information dissemination to public health 
officials. Current disease reporting is paper-based and ineffective in 
transmitting important information to public health officials in 
developing countries where one doctor often cares for hundreds of 
patients. Thus, S. 2487 authorizes the President to provide assistance 
to eligible developing countries to purchase simple computer 
technology, including touch-screens and low-speed Internet connections 
for use by physicians in health clinics.

[[Page S8025]]

  Let me close with the astute words of Dr. Alan P. Zelicoff, Senior 
Scientist, Sandia National Laboratory, as stated during his testimony 
before the Foreign Relations Committee in a March 2002, on the threat 
posed by chemical and biological weapons. Dr. Zelicoff has spent a 
considerable amount of his distinguished career developing technology 
and solutions to assist the medical and public health communities 
identify natural and deliberate disease outbreaks. According to Dr. 
Zelicoff,

       When all is said and done, should would-be perpetrators of 
     bioterror know that the effects of their attack would be 
     blunted if not eliminated, they might well re-think their 
     strategy in the first place. A multi-national cadre of 
     clinicians and nurses, exchanging up-to-the-minute 
     information is our single best defense, and we have the 
     resource--now--to so equip them. All that is required is a 
     policy shift emphasizing and strengthening this lynchpin 
     capability.

  While we are supportive of the public health benefits of this Act, we 
should not lose sight of the intent of this legislation--to combat 
bioterrorism and enhance U.S. national security. I look forward to 
working with the Bush administration and members of Congress to secure 
funding for these invaluable activities directed towards global 
pathogen surveillance and monitoring.
  Mr. REID. Mr. President, I ask unanimous consent that the Biden 
amendment at the desk be agreed to; that the bill, as amended, be read 
a third time and passed; that the motion to reconsider be laid upon the 
table; and that any statement relating to the bill be printed in the 
Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 4468) was agreed to, as follows:


                           AMENDMENT NO. 4468

       On page 3, line 1, insert ``, including data sharing with 
     appropriate United States departments and agencies,'' after 
     ``countries''.
       On page 5, strike lines 9 through 14, and insert the 
     following:
       (1) To enhance the capability and cooperation of the 
     international community, including the World Health 
     Organization and individual countries, through enhanced 
     pathogen surveillance and appropriate data sharing, to 
     detect, identify, and contain infectious disease outbreaks, 
     whether the cause of those outbreaks is intentional human 
     action or natural in origin.
       On page 5, line 17, insert ``, and other electronic'' after 
     ``Internet-based''.
       On page 6, line 5, strike ``including'' and all that 
     follows through ``mechanisms,'' on line 7, and insert the 
     following: ``including, as appropriate, relevant computer 
     equipment, Internet connectivity mechanisms, and telephone-
     based applications,''.
       On page 9, line 15, insert before the period the following: 
     ``, provide early notification of disease outbreaks, and 
     provide pathogen surveillance data to appropriate United 
     States departments and agencies''.
       On page 17, line 12, insert ``(and information 
     technology)'' after ``Equipment''.
  The bill (S. 2487), as amended, was read the third time and passed.
  (The bill will be printed in a future edition of the Record.)

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