[Congressional Record Volume 149, Number 58 (Thursday, April 10, 2003)]
[Senate]
[Pages S5194-S5198]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN (for himself, Mr. Lugar, Mr. Kennedy, Mr. Hagel, Mr. 
        Domenici, and Mr. Feingold):
  S. 871. A bill to provide for global pathogen surveillance and 
response, to the Committee on Foreign Relations.
  Mr. President, I am pleased to re-introduce today the ``Global 
Pathogen Surveillance Act''.
  Last year, this bill passed the Senate by unanimous consent on August 
1st, but died when the House of Representatives failed to take timely 
action.
  The Global Pathogen Surveillance Act authorizes $150 million over the 
next two years to help developing nations improve global disease 
surveillance.
  That will go a long way to prevent and contain both biological 
weapons attacks, if, God forbid, it happens, and naturally occurring 
infectious disease outbreaks around the world.
  I'm happy to announce that Senators Lugar, Kennedy, Hagel, Domenici, 
and Feingold are joining me in co-sponsoring this bill.
  The mysterious global outbreak of severe acute respiratory syndrome, 
or SARS, is an unfortunate reminder of why this bill is so important. 
We've heard a lot about it. We don't know much about it yet.
  We know it's a contagious respiratory illness which apparently 
originated in the Guangdong province of China last November, has 
stricken more than 2600 individuals in 17 countries, taking the lives 
of at least 100 individuals.
  The World Health Organization is concerned. They've issued a rare 
global health alert and discouraged travel to certain nations as 
authorities struggle to determine the cause of this flu-like illness 
and what viral or infectious agent is involved.
  The WHO has not ruled out bioterrorism as a potential cause for the 
epidemic, although it is unlikely that a disease with only a 4 to 5 
percent mortality would be used.
  What's so scary about this outbreak is that doctors and nurses taking 
care of sick patients have fallen ill themselves; initial tests have 
not revealed evidence of infection with any previously known virus or 
bacterial agent; and patients are not being cured by standard 
treatments, although the vast majority do recover.
  How would better disease surveillance have helped in dealing with 
this kind of crisis?
  Experts suspect this epidemic first originated in the Guangdong 
province in southern China in November, but peaked in early February.
  A comprehensive surveillance network might have picked up the unique 
symptoms of this epidemic earlier . . . might have led to quicker 
diagnosis and better containment measures.
  We would have had a better chance to keep this epidemic contained 
within China, before the pathogen spread to neighboring nations, and 
now to Canada and the United States.
  Over the last eighteen months, Americans have become all too familiar 
with the threat of bioterrorism and the army of deadly agents capable 
of spreading death and disease--anthrax, Ebola, and smallpox are only 
the most sensational examples.
  We've had to strengthen our homeland defenses--not just against 
terrorists armed with bombs and explosives--but against shadowy figures 
carrying vials of deadly pathogens.
  But all in all, this country is making important advances on the 
domestic front in bioterrorism defense.
  Last year, the President signed into law the Bioterrorism Prevention 
Act of 2002, a comprehensive domestic initiative co-sponsored by 
Senators Kennedy and Frist.
  In January, the Centers for Disease Control announced an initiative 
to establish electronic surveillance systems in eight American cities 
as the cornerstone of an eventual national network.
  In Delaware, we're developing the very first, comprehensive, state-
wide electronic reporting system for infectious diseases.
  It'll serve as a prototype for other states by enabling much earlier 
detection of infectious disease outbreaks.
  But a domestic defense against biological weapons isn't sufficient 
alone.

[[Page S5195]]

  Biological weapons are a global threat with no respect for borders. A 
dangerous pathogen released on another continent can quickly spread to 
the United States in a matter of days, if not hours.
  A terrorist group could launch a biological weapons attacks 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.
  And international trade, travel, and migration patterns offer 
unlimited opportunities for pathogens to spread across national borders 
and to move from one continent to another.
  We should make no mistake: in today's world, all infectious disease 
epidemics, wherever they occur and whether they are deliberately 
engineered or are naturally occurring, are a potential threat to all 
nations, including the United States. Such a threat need not begin in 
the United States to reach our shores.
  For that reason, our response 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.
  Why is disease surveillance so important? A biological weapons attack 
succeeds partly through the element of surprise.
  As Dr. Alan P. Zelicoff of the Sandia National Laboratory testified 
before the Senate Foreign Relations Committee last spring, early 
warning of a biological weapons attack can prevent illness and death in 
all but a small fraction of those infected.
  A cluster of flu-like symptoms in a city or region may be dismissed 
by doctors as just the flu when in fact it may be anthrax, plague, or 
another biological weapon.
  But armed with the knowledge that a suspicious epidemic has emerged, 
doctors and nurses can examine their patients in a different light and, 
in many cases, effectively treat them.
  Disease surveillance is a fancy phrase for a comprehensive reporting 
system to quickly identify and communicate abnormal patterns of 
symptoms and illnesses that 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's a new disease or strain, we can begin to develop 
treatments that much earlier.
  An effective disease surveillance system helps 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, thirty new infectious 
diseases have emerged over the past thirty years; between 1996 and 2001 
alone, more than 800 infectious disease outbreaks occurred around the 
world, on every continent.
  The SARS epidemic is only the most recent such outbreak. With better 
surveillance, we can do a better job of mitigating the consequences of 
these disease outbreaks.
  A good surveillance system requires trained epidemiological 
personnel, adequate laboratory tools for quick diagnosis, and working 
communications equipment to circulate information.
  Even here, in the most advanced Nation in the world, many States and 
cities rely on old-fashioned pencil and paper methods of tracking 
disease patterns.
  Thankfully, the comprehensive bioterrorism legislation enacted into 
law last year is beginning to correct that.
  Now, it is vitally important that we extend these initiatives into 
the international arena.
  In 2000, the World Health Organization established the first truly 
global disease surveillance system, the Global Alert and Response 
Network, to monitor and track infectious disease outbreaks everywhere.
  The WHO has done an impressive job so far with this initiative, 
working on a shoestring budget. But this global network is only as good 
as its components--individual nations.
  Unfortunately, developing nations--those nations most likely to 
experience rapid disease outbreaks--simply don't have the trained 
personnel, the laboratory equipment, or the public health 
infrastructure to do the job. . . to track evolving disease patterns or 
detect emerging pathogens.
  According to a January 2000 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 60 percent of 
laboratory equipment in developing countries is either outdated or non-
functioning.
  This lack of preparedness can lead to tragic results. In August 1994 
in Surat, a city in western India, a surge of complaints about flea 
infestation and a growing rat population was followed by a cluster of 
reports about patients exhibiting the symptoms of pneumonic plague.
  But authorities were unable to connect the dots and warn people 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 possessed better surveillance tools, they 
may well have contained the epidemic, limited the loss of life, and 
avoided the panic that led to economically disastrous embargoes on 
trade and travel.
  Thanks to improved surveillance, an outbreak of pneumonic plague in 
India last year was detected more quickly and contained with only few 
deaths--with no costly panic.
  In short, 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's for these reasons that I'm reintroducing the Global Pathogen 
Surveillance Act. This bill will authorize $150 million in FY 2004 and 
FY 2005 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 enhances 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, it provides assistance to developing nations to acquire basic 
laboratory equipment, including items as basic as microscopes, so they 
can quickly diagnose pathogens.
  Third, it enables developing nations to obtain communications 
equipment to quickly transmit data on disease patterns and pathogen 
diagnoses, both inside a nation and to regional organizations and the 
WHO.
  Again, we're not talking about fancy high-tech equipment, but basics 
like fax machines and internet-equipped computers.
  Finally--to create a real incentive for nations to promptly report 
suspicious disease outbreaks and offer international health authorities 
prompt access--the bill gives preference to those countries that agree 
to let international health experts investigate any suspicious disease 
outbreaks.
  If passed, the Global Pathogen Surveillance Act 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.
  It's an inexpensive and common sense solution to a problem of global 
proportions--the dual threat of biological weapons and naturally 
occurring infectious diseases.
  Make no mistake--this bill will contribute to our homeland security. 
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 a report released only last month on global infectious disease, 
the National Academies' Institute of Medicine said, ``The United States 
should

[[Page S5196]]

take a leadership role in promoting the implementation of a 
comprehensive system of surveillance for global infectious diseases 
that builds on the current global capacity of infectious disease 
monitoring.'' By introducing this bill, I hope that our nation can 
begin to assume that mantle of leadership in this critical area.
  Let me close with an excerpt of testimony from a Foreign Relations 
Committee hearing held on September 5, 2001. Dr. D.A. Henderson, the 
man who spearheaded the successful international campaign to eradicate 
smallpox in the 1970's, most recently served as the principal advisor 
to Secretary of Health and Human Services Tommy Thompson in organizing 
the nation's defenses against bioterrorism.
  Dr. Henderson, who at the time of the hearing was a private citizen, 
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 if we are to have an early warning 
about the possible development and production of biological weapons by 
rogue nations or groups.''
  Dr. Henderson is exactly right. 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.
  I ask unanimous consent that the text of the ``Global Pathogen 
Surveillance Act'' be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 871

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

     SECTION 1. SHORT TITLE.

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

     SEC. 2. FINDINGS; PURPOSE.

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

     SEC. 3. DEFINITIONS.

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

[[Page S5197]]

     SEC. 4. PRIORITY FOR CERTAIN COUNTRIES.

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

     SEC. 5. RESTRICTION.

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

     SEC. 6. FELLOWSHIP PROGRAM.

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

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

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

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

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

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

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

[[Page S5198]]

     President may determine, technical assistance and grant 
     assistance to international health organizations to 
     facilitate standardization in the reporting of public health 
     information between and among developing countries and 
     international health organizations.
       (f) Host Country's Commitments.--The assistance provided 
     under this section shall be contingent upon the host 
     country's commitment to provide the resources, 
     infrastructure, and other assets required to house, support, 
     maintain, secure, and maximize use of this equipment and 
     appropriate technical personnel.

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

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

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

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

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

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

     SEC. 13. AUTHORIZATION OF APPROPRIATIONS.

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