[Congressional Record Volume 151, Number 54 (Thursday, April 28, 2005)]
[Senate]
[Pages S4581-S4585]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. OBAMA:
  S. 969. A bill to amend the Public Health Service Act with respect to 
preparation for an influenza pandemic, including an avian influenza 
pandemic, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. OBAMA. Mr. President, today I am introducing the Attacking Viral 
Influenza Across Nations Act of 2005, or the AVIAN Act.
  The Nation is becoming increasingly aware of the very serious threat 
we face from avian flu. This virus is found primarily in chickens, 
ducks, and other birds. Despite major efforts to eradicate this virus, 
the virus has become endemic in poultry and birds in some countries and 
is spreading rapidly in others. Humans can contract the virus when they 
come into contact with infected birds, and when this happens, the 
consequences are often deadly. Of the 88 humans infected with avian 
influenza in Vietnam, Thailand, and Cambodia, only 37 have survived.
  Right now, avian flu is thought to only pass from birds to humans. 
However, doctors and scientists have expressed the very real concern 
that this virus will mutate into a form that can spread easily from 
human to human. If this happens, the world could face its next 
pandemic, which could cause more illness and death than virtually any 
other natural health threat.
  The Nation experienced 3 pandemics in the 20th Century--the Spanish 
flu pandemic in 1918, the Asian flu pandemic in 1957, and the Hong Kong 
flu pandemic in 1968. The Spanish flu pandemic was the most severe, 
causing over 500,000 deaths in the United States and more than 20 
million deaths worldwide.
  The Centers for Disease Control and Prevention (CDC) has estimated 
that up to 207,000 Americans could die, and up to 734,000 could be 
hospitalized during the next pandemic. The costs of the pandemic, 
including the medical costs and the costs associated with infected 
Americans being unable to work and dying early, are estimated at 
between $71 billion and $166.5 billion. These costs do not include the 
impact of a pandemic on commerce and society. On February 21, 2005, Dr. 
Julie Gerberding, Director of the CDC, discussed the possibility of a 
pandemic and stated that ``this is a very ominous situation for the 
globe . . . the most important threat that we are facing right now.''
  We are in a race against time. The Nation's health officials have 
made some progress in preparing for pandemic influenza. Yet, we have 
much work to do. The Department of Health and Human Services has not 
released its final pandemic preparedness plan nor have about half of 
the states. A survey by the Association of State and Public Health 
Laboratory Directors found that 20 percent of States had no State 
public health laboratory capacity to isolate viruses, and 25 percent 
reported no ability to subtype influenza isolates.
  We know antivirals can prevent flu infection and treat those already 
infected, but we have not stockpiled enough doses to cover even the 
high-risk populations. We need more research to improve the 
effectiveness and the safety of vaccines against avian flu and other 
strains. Many of our hospital emergency rooms and clinics are already 
bursting at the seams, and it is unclear how they would care for a 
dramatically increased influx of patients during a pandemic.
  The AVIAN Act is a comprehensive measure to deal with an influenza 
pandemic by emphasizing domestic and international cooperation and 
collaboration. It creates a high-level inter-agency policy coordinating 
committee tasked with creating an integrated plan for the nation, with 
attention to health, agriculture, commerce, transportation, and 
international relations. Similarly, states are required to finalize 
pandemic preparedness plans that address surveillance, medical care, 
workforce, communication, and maintenance of core public functions. 
Private health providers and hospitals will

[[Page S4582]]

play a critical role in diagnosing and treating their patients for flu, 
and this bill provides grants to make sure their efforts and 
information networks are coordinated with those by the state. Health 
and veterinary officials are encouraged to work with our international 
partners on all of these initiatives.
  This bill provides for a public education and awareness campaign and 
health professional training for a pandemic. The CDC is tasked with 
researching communication strategies, and developing and implementing a 
public, non-commercial, and non-competitive broadcast system. The NIH 
is required to expand and intensify its research on vaccines, 
antivirals, and other protective measures. An economics advisory 
committee is established to assess and make recommendations on how to 
finance pandemic preparedness, while minimizing its economic impact.
  Finally, the AVIAN Act provides for an Institute of Medicine study to 
study the legal, ethical, and social implications of pandemic 
influenza. Americans may be asked to isolate themselves, to stay home 
from work, to share their medical diagnoses, and to take certain 
medications. All of these actions may be critical in preventing 
millions of Americans from getting sick, spreading disease, and dying. 
Yet, we must make sure that we are fully cognizant of how these 
decisions will affect the rights of every American.
  We face a terrible threat from pandemic avian influenza, and we must 
not squander the opportunity before us to plan and prepare. In 
endorsing the AVIAN Act, the Trust for America's Health states: ``The 
avian flu is a real and dangerous threat to the health to our nation 
and the world. If the virus mutates slightly, we could have a million 
Americans hit by the first wave of a pandemic.''
  The time to act is now, and I urge my colleagues to join me and pass 
the AVIAN Act of 2005.
  I ask unanimous consent that the text of this bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 969

       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 ``Attacking Viral Influenza 
     Across Nations Act of 2005''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) The Department of Health and Human Services reports 
     that an influenza pandemic has a greater potential to cause 
     rapid increases in death and illness than virtually any other 
     natural health threat.
       (2) Three pandemics occurred during the 20th century: the 
     Spanish flu pandemic in 1918, the Asian flu pandemic in 1957, 
     and the Hong Kong flu pandemic in 1968. The Spanish flu 
     pandemic was the most severe, causing over 500,000 deaths in 
     the United States and more than 20,000,000 deaths worldwide.
       (3) The Centers for Disease Control and Prevention has 
     estimated conservatively that up to 207,000 Americans would 
     die, and up to 734,000 would be hospitalized, during the next 
     pandemic. The costs of the pandemic, including the total 
     direct costs associated with medical care and indirect costs 
     of lost productivity and death, are estimated at between 
     $71,000,000,000 and $166,500,000,000. These costs do not 
     include the economic effects of pandemic on commerce and 
     society.
       (4) Recent studies suggest that avian influenza strains, 
     which are endemic in wild birds and poultry populations in 
     some countries, are becoming increasingly capable of causing 
     severe disease in humans and are likely to cause the next 
     pandemic flu.
       (5) In 2004, 8 nations--Thailand, Vietnam, Indonesia, 
     Japan, Laos, China, Cambodia, and the Republic of Korea--
     experienced outbreaks of avian flu (H5N1) among poultry 
     flocks. Cases of human infections were confirmed in Thailand 
     and Vietnam (including a possible human-to-human infection in 
     Thailand).
       (6) As of April 15, 2005, 88 confirmed human cases of avian 
     influenza (H5N1) have been reported, 51 of which resulted in 
     death. Of these cases, 68 were in Vietnam, 17 in Thailand, 
     and 3 in Cambodia.
       (7) On February 21, 2005, Dr. Julie Gerberding, Director of 
     the Centers for Disease Control and Prevention, stated that 
     ``this is a very ominous situation for the globe. . .the most 
     important threat we are facing right now.''.
       (8) On February 23, 2005, Dr. Shigeru Omi, Asia regional 
     director of the World Health Organization (WHO), stated with 
     respect to the avian flu, ``We at WHO believe that the world 
     is now in the gravest possible danger of a pandemic.''.
       (9) The best defense against influenza pandemics is a 
     heightened global surveillance system. In many of the nations 
     where avian flu (H5N1) has become endemic the early detection 
     capabilities are severely lacking, as is the transparency in 
     the health systems.
       (10) In addition to surveillance, pandemic preparedness 
     requires domestic and international coordination and 
     cooperation to ensure an adequate medical response, including 
     communication and information networks, public health 
     measures to prevent spread, use of vaccination and 
     antivirals, provision of health outpatient and inpatient 
     services, and maintenance of core public functions.

     SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

       Title XXI of the Public Health Service Act (42 U.S.C. 
     300aa-1 et seq.) is amended by adding at the end the 
     following:

             ``Subtitle 3--Pandemic Influenza Preparedness

     ``SEC. 2141. DEFINITION.

       ``For purposes of this subtitle, the term `State' shall 
     have the meaning given such term in section 2(f) and shall 
     include Indian tribes and tribal organizations (as defined in 
     section 4(b) and 4(c) of the Indian Self-Determination and 
     Education Assistance Act).

     ``SEC. 2142. PROPOSAL FOR INTERNATIONAL FUND TO SUPPORT 
                   PANDEMIC INFLUENZA CONTROL.

       ``(a) In General.--The Secretary should submit to the 
     Director of the World Health Organization a proposal to study 
     the feasibility of establishing a fund, (referred to in this 
     section as the `Pandemic Fund') to support pandemic influenza 
     control and relief activities conducted in countries affected 
     by pandemic influenza, including pandemic avian influenza.
       ``(b) Content of Proposal.--The proposal submitted under 
     subsection (a) shall describe, with respect to the Pandemic 
     Fund--
       ``(1) funding sources;
       ``(2) administration;
       ``(3) application process by which a country may apply to 
     receive assistance from such Fund;
       ``(4) factors used to make a determination regarding a 
     submitted application, which may include--
       ``(A) the gross domestic product of the applicant country;
       ``(B) the burden of need, as determined by human morbidity 
     and mortality and economic impact related to pandemic 
     influenza and the existing capacity and resources of the 
     applicant country to control the spread of the disease; and
       ``(C) the willingness of the country to cooperate with 
     other countries with respect to preventing and controlling 
     the spread of the pandemic influenza; and
       ``(5) any other information the Secretary determines 
     necessary.
       ``(c) Use of Funds.--Funds from any Pandemic Fund 
     established as provided for in this section shall be used to 
     complement and augment ongoing bilateral programs and 
     activities from the United States and other donor nations.

     ``SEC. 2143. POLICY COORDINATING COMMITTEE ON PANDEMIC 
                   INFLUENZA PREPAREDNESS.

       ``(a) In General.--There is established the Pandemic 
     Influenza Preparedness Policy Coordinating Committee 
     (referred to in this section as the `Committee').
       ``(b) Membership.--
       ``(1) In general.--The Committee shall be composed of--
       ``(A) the Secretary;
       ``(B) the Secretary of Agriculture;
       ``(C) the Secretary of State;
       ``(D) the Secretary of Defense;
       ``(E) the Secretary of Commerce;
       ``(F) the Administrator of the Environmental Protection 
     Agency;
       ``(G) the Secretary of Transportation;
       ``(H) the Secretary of Homeland Security;
       ``(I) the Secretary of Veterans Affairs; and
       ``(J) other representatives as determined appropriate by 
     the Co-Chairs of the Committee.
       ``(2) Co-chairs.--The Secretary and the Secretary of 
     Agriculture shall serve as the Co-Chairs of the Committee.
       ``(3) Term.--The members of the Committee shall serve for 
     the life of the Committee.
       ``(c) Meetings.--
       ``(1) In general.--The Committee shall meet not less often 
     than 2 times per year at the call of the Co-Chairs or as 
     determined necessary by the President.
       ``(2) Representation.--A member of the Committee under 
     subsection (b) may designate a representative to participate 
     in Committee meetings, but such representative shall hold the 
     position of at least an assistant secretary or equivalent 
     position.
       ``(d) Duties of the Committee.--
       ``(1) Preparedness plans.--Each member of the Committee 
     shall submit to the Committee a pandemic influenza 
     preparedness plan for the agency involved that describes--
       ``(A) initiatives and proposals by such member to address 
     pandemic influenza (including avian influenza) preparedness; 
     and
       ``(B) any activities and coordination with international 
     entities related to such initiatives and proposals.
       ``(2) Interagency plan and recommendations.--
       ``(A) In general.--
       ``(i) Preparedness plan.--Based on the preparedness plans 
     described under paragraph (1), and not later than 90 days 
     after the date of enactment of the Pandemic Influenza 
     Preparedness Act of 2005, the Committee shall develop an 
     Interagency Preparedness

[[Page S4583]]

     Plan that integrates and coordinates such preparedness plans.
       ``(ii) Content of plan.--The Interagency Preparedness Plan 
     under clause (i) shall include a description of--

       ``(I) departmental or agency responsibility and 
     accountability for each component of such plan;
       ``(II) funding requirements and sources;
       ``(III) international collaboration and coordination 
     efforts; and
       ``(IV) recommendations and a timeline for implementation of 
     such plan.

       ``(B) Report.--
       ``(i) In general.--The Committee shall submit to the 
     President and Congress, and make available to the public, a 
     report that includes the Interagency Preparedness Plan.
       ``(ii) Updated report.--The Committee shall submit to the 
     President and Congress, and make available to the public, on 
     a biannual basis, an update of the report that includes a 
     description of--

       ``(I) progress made toward plan implementation, as 
     described under clause (i); and
       ``(II) progress of the domestic preparedness programs under 
     section 2144 and of the international assistance programs 
     under section 2145.

       ``(C) Consultation with international entities.--In 
     developing the preparedness plans described under 
     subparagraph (A) and the report under subparagraph (B), the 
     Committee may consult with representatives from the World 
     Health Organization, the World Organization for Animal 
     Health, and other international bodies, as appropriate.

     ``SEC. 2144. DOMESTIC PANDEMIC INFLUENZA PREPAREDNESS 
                   ACTIVITIES.

       ``(a) Pandemic Preparedness Activities.--The Secretary 
     shall strengthen, expand, and coordinate domestic pandemic 
     influenza preparedness activities.
       ``(b) State Preparedness Plan.--
       ``(1) In general.--As a condition of receiving funds from 
     the Centers for Disease Control and Prevention or the Health 
     Resources and Services Administration related to 
     bioterrorism, a State shall--
       ``(A) designate an official or office as responsible for 
     pandemic influenza preparedness;
       ``(B) submit to the Director of the Centers for Disease 
     Control and Prevention a Pandemic Influenza Preparedness Plan 
     described under paragraph (2); and
       ``(C) have such Preparedness Plan approved in accordance 
     with this subsection.
       ``(2) Preparedness plan.--
       ``(A) In general.--The Pandemic Influenza Preparedness Plan 
     required under paragraph (1) shall address--
       ``(i) human and animal surveillance activities, including 
     capacity for epidemiological analysis, isolation and 
     subtyping of influenza viruses year-round, including for 
     avian influenza among domestic poultry, and reporting of 
     information across human and veterinary sectors;
       ``(ii) methods to ensure surge capacity in hospitals, 
     laboratories, outpatient healthcare provider offices, medical 
     suppliers, and communication networks;
       ``(iii) assisting the recruitment and coordination of 
     national and State volunteer banks of healthcare 
     professionals;
       ``(iv) distribution of vaccines, antivirals, and other 
     treatments to priority groups, and monitor effectiveness and 
     adverse events;
       ``(v) networks that provide alerts and other information 
     for healthcare providers and organizations at the National, 
     State, and regional level;
       ``(vi) communication with the public with respect to 
     prevention and obtaining care during pandemic influenza;
       ``(vii) maintenance of core public functions, including 
     public utilities, refuse disposal, mortuary services, 
     transportation, police and firefighter services, and other 
     critical services;
       ``(viii) provision of security for--

       ``(I) first responders and other medical personnel and 
     volunteers;
       ``(II) hospitals, treatment centers, and isolation and 
     quarantine areas;
       ``(III) transport and delivery of resources, including 
     vaccines, medications and other supplies; and
       ``(IV) other persons or functions as determined appropriate 
     by the Secretary;

       ``(ix) the acquisition of necessary legal authority for 
     pandemic activities;
       ``(x) integration with existing national, State, and 
     regional bioterrorism preparedness activities or 
     infrastructure;
       ``(xi) coordination among public and private health sectors 
     with respect to healthcare delivery, including mass 
     vaccination and treatment systems, during pandemic influenza; 
     and
       ``(xii) coordination with Federal pandemic influenza 
     preparedness activities.
       ``(B) Underserved populations.--The Pandemic Influenza 
     Preparedness Plan required under paragraph (1) shall include 
     a specific focus on surveillance, prevention, and medical 
     care for traditionally underserved populations, including 
     low-income, racial and ethnic minority, immigrant, and 
     uninsured populations.
       ``(3) Approval of state plan.--
       ``(A) In general.--The Director of the Centers for Disease 
     Control and Prevention, in collaboration with the Secretary 
     of Agriculture and the Administrator of the Health Resources 
     and Services Administration, shall develop criteria to rate 
     State Pandemic Influenza Preparedness Plans required under 
     paragraph (1) and determine the minimum rating needed for 
     approval.
       ``(B) Timing of approval.--Not later than 180 days after a 
     State submits a State Pandemic Influenza Preparedness Plan as 
     required under paragraph (1), the Director of the Centers for 
     Disease Control and Prevention shall make a determination 
     regarding approval of such Plan.
       ``(4) Reporting of state plan.--All Pandemic Influenza 
     Preparedness Plans submitted and approved under this section 
     shall be made available to the public.
       ``(5) Assistance to states.--The Centers for Disease 
     Control and Prevention and the Health Resources and Services 
     Administration may provide assistance to States in carrying 
     out this subsection, or implementing an approved State 
     Pandemic Influenza Preparedness Plan, which may include the 
     detail of an officer to approved domestic pandemic sites or 
     the purchase of equipment and supplies.
       ``(6) Waiver.--The Secretary may grant a temporary waiver 
     of 1 or more of the requirements under this subsection.
       ``(c) Domestic Surveillance.--
       ``(1) In general.--The Secretary, in coordination with the 
     Secretary of Agriculture, shall establish minimum thresholds 
     for States with respect to adequate surveillance for pandemic 
     influenza, including possible pandemic avian influenza.
       ``(2) Assistance to states.--
       ``(A) In general.--The Secretary, in coordination with the 
     Secretary of Agriculture, shall provide assistance to States 
     and regions to meet the minimum thresholds established under 
     paragraph (1).
       ``(B) Types of assistance.--Assistance provided to States 
     under subparagraph (A) may include--
       ``(i) the establishment or expansion of State surveillance 
     and alert systems, including the Sentinel Physician 
     Surveillance System and 122 Cities Mortalities Report System;
       ``(ii) the provision of equipment and supplies;
       ``(iii) support for epidemiological analysis and 
     investigation of novel strains;
       ``(iv) the sharing of biological specimens and 
     epidemiological and clinical data within and across States; 
     and
       ``(v) other activities determined appropriate by the 
     Secretary.
       ``(3) Detail of officers.--The Secretary may detail 
     officers to States for technical assistance as needed to 
     carry out this subsection.
       ``(d) Private Sector Involvement.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention 
     and the Administrator of the Health Resources and Services 
     Administration, and in coordination with private sector 
     entities, shall integrate and coordinate public and private 
     influenza surveillance activities, as appropriate.
       ``(2) Grant program.--
       ``(A) In general.--In carrying out the activities under 
     paragraph (1), the Secretary may establish a grant program to 
     provide grants to eligible entities to coordinate pandemic 
     preparedness surveillance activities between States and 
     private health sector entities, including health plans and 
     other health systems.
       ``(B) Eligibility.--To be eligible to receive a grant under 
     subparagraph (A), an entity shall--
       ``(i) submit an application at such time, in such manner, 
     and containing such information as the Secretary may require; 
     and
       ``(ii) be a State with a collaborative relationship with a 
     private health system organization or institution.
       ``(C) Use of funds.--Funds under a grant under subparagraph 
     (A) may be used to--
       ``(i) develop and implement surveillance protocols for 
     patients in outpatient and hospital settings;
       ``(ii) establish a communication alert plan for patients 
     for reportable signs and symptoms that may suggest influenza;
       ``(iii) purchase necessary equipment and supplies;
       ``(iv) increase laboratory testing and networking capacity;
       ``(v) conduct epidemiological and other analyses; or
       ``(vi) report and disseminate data.
       ``(D) Detail of officers.--The Secretary may detail 
     officers to grantees under subparagraph (A) for technical 
     assistance.
       ``(E) Requirement.--As a condition of receiving a grant 
     under subparagraph (A), a State shall have a plan to meet 
     minimum thresholds for State influenza surveillance 
     established by the Director of the Centers for Disease 
     Control and Prevention in coordination with the Secretary of 
     Agriculture under subsection (b).
       ``(e) Temporary Facility.--The Secretary may establish a 
     temporary Federal facility or body to coordinate Federal 
     support and assistance to States and localities, activities 
     across Federal agencies or departments, or direct 
     implementation of Federal authorities and responsibilities 
     when appropriate under Federal law or when State and local 
     actions to address the pandemic or threat of pandemic are 
     deemed insufficient by the Secretary or Director of the 
     Centers for Disease Control and Prevention.
       ``(f) Procurement of Antivirals for the Strategic National 
     Stockpile.--The Secretary shall determine the minimum number 
     of doses of antivirals needed to prevent infection or treat 
     infection during pandemic influenza, including possible 
     pandemic avian influenza, for health professionals (including 
     doctors, nurses, mental health professionals,

[[Page S4584]]

     pharmacists, veterinarians, laboratory personnel, 
     epidemiologists, virologists and public health 
     practitioners), core public utility employees, and those 
     persons expected to be at high risk for serious morbidity and 
     mortality from pandemic influenza, and take immediate steps 
     to procure this minimum number of doses for the Strategic 
     National Stockpile described under section 319F-2.
       ``(g) Procurement of Vaccines for the Strategic National 
     Stockpile.--Subject to development and testing of potential 
     vaccines for pandemic influenza, including possible pandemic 
     avian influenza, the Secretary shall determine the minimum 
     number of doses of vaccines needed to prevent infection 
     during at least the first wave of pandemic influenza for 
     health professionals (including doctors, nurses, mental 
     health professionals, pharmacists, veterinarians, laboratory 
     personnel, epidemiologists, virologists and public health 
     practitioners), core public utility employees, and those 
     persons expected to be at high risk for serious morbidity and 
     mortality from pandemic influenza, and take immediate steps 
     to procure this minimum number of doses for the Strategic 
     National Stockpile described under section 319F-2.

     ``SEC. 2145. INTERNATIONAL PANDEMIC INFLUENZA ASSISTANCE.

       ``(a) In General.--The Secretary shall assist other 
     countries in preparation for, and response to, pandemic 
     influenza, including possible pandemic avian influenza.
       ``(b) International Surveillance.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     and in collaboration with the Secretary of Agriculture, in 
     consultation with the World Health Organization and the World 
     Organization for Animal Health, shall establish minimum 
     standards for surveillance capacity for all countries with 
     respect to pandemic influenza, including possible pandemic 
     avian influenza.
       ``(2) Assistance.--The Secretary and the Secretary of 
     Agriculture shall assist other countries to meet the 
     standards established in paragraph (1) through--
       ``(A) the detail of officers to foreign countries for the 
     provision of technical assistance or training;
       ``(B) laboratory testing, including testing of specimens 
     for viral isolation or subtype analysis;
       ``(C) epidemiological analysis and investigation of novel 
     strains;
       ``(D) provision of equipment or supplies;
       ``(E) coordination of surveillance activities within and 
     among countries;
       ``(F) the establishment and maintenance of an Internet 
     database that is accessible to health officials domestically 
     and internationally, for the purpose of reporting new cases 
     or clusters of influenza and under information that may help 
     avert the pandemic spread of influenza; and
       ``(G) other activities as determined necessary by the 
     Secretary.
       ``(c) Increased International Medical Capacity During 
     Pandemic Influenza.--The Secretary, in consultation with the 
     Secretary of State, may provide vaccines, antiviral 
     medications, and supplies to foreign countries from the 
     Strategic National Stockpile described under section 319F-2.
       ``(d) Assistance to Foreign Countries.--The Centers for 
     Disease Control and Prevention and the Health Resources and 
     Services Administration may provide assistance to foreign 
     countries in carrying out this section, which may include the 
     detail of an officer to approved international pandemic sites 
     or the purchase of equipment and supplies.

     ``SEC. 2146. PUBLIC EDUCATION AND AWARENESS CAMPAIGN.

       ``(a) In General.--The Director of the Centers for Disease 
     Control and Prevention, in consultation with the United 
     States Agency for International Development, the World Health 
     Organization, the World Organization for Animal Health, and 
     foreign countries, shall develop an outreach campaign with 
     respect to public education and awareness of influenza and 
     influenza preparedness.
       ``(b) Details of Campaign.--The campaign established under 
     subsection (a) shall--
       ``(1) be culturally and linguistically appropriate for 
     domestic populations;
       ``(2) be adaptable for use in foreign countries;
       ``(3) target high-risk populations (those most likely to 
     contract, transmit, and die from influenza);
       ``(4) promote personal influenza precautionary measures and 
     knowledge, and the need for general vaccination, as 
     appropriate; and
       ``(5) describe precautions at the State and local level 
     that could be implemented during pandemic influenza, 
     including quarantine and other measures.

     ``SEC. 2147. HEALTH PROFESSIONAL TRAINING.

       ``The Secretary, directly or through contract, and in 
     consultation with professional health and medical societies, 
     shall develop and disseminate pandemic influenza training 
     curricula--
       ``(1) to educate and train health professionals, including 
     physicians, nurses, public health practitioners, virologists 
     and epidemiologists, veterinarians, mental health providers, 
     allied health professionals, and paramedics and other first 
     responders;
       ``(2) to educate and train volunteer, non-medical personnel 
     whose assistance may be required during a pandemic influenza 
     outbreak; and
       ``(3) that address prevention, including use of quarantine 
     and other isolation precautions, pandemic influenza 
     diagnosis, medical guidelines for use of antivirals and 
     vaccines, and professional requirements and responsibilities, 
     as appropriate.

     ``SEC. 2148. RESEARCH AT THE NATIONAL INSTITUTES OF HEALTH.

       ``The Director of the National Institutes of Health 
     (referred to in this section as the `Director of NIH'), in 
     collaboration with the Director of the Centers for Disease 
     Control and Prevention, and other relevant agencies, shall 
     expand and intensify--
       ``(1) human and animal research, with respect to influenza, 
     on--
       ``(A) vaccine development and manufacture, including 
     strategies to increase immunological response;
       ``(B) effectiveness of inducing heterosubtypic immunity;
       ``(C) antivirals, including minimal dose or course of 
     treatment and timing to achieve prophylactic or therapeutic 
     effect;
       ``(D) side effects and drug safety of vaccines and 
     antivirals in subpopulations;
       ``(E) alternative routes of delivery;
       ``(F) more efficient methods for testing and determining 
     virus subtype;
       ``(G) protective measures; and
       ``(H) other areas determined appropriate by the Director of 
     NIH; and
       ``(2) historical research on prior pandemics to better 
     understand pandemic epidemiology, transmission, protective 
     measures, high-risk groups, and other lessons that may be 
     applicable to future pandemics.

     ``SEC. 2149. RESEARCH AT THE CENTERS FOR DISEASE CONTROL AND 
                   PREVENTION.

       ``The Director of the Centers for Disease Control and 
     Prevention, in collaboration with other relevant agencies, 
     shall expand and intensify research, with respect to 
     influenza, on--
       ``(1) communication strategies for the public during 
     pandemic influenza, taking into consideration age, racial and 
     ethnic background, health literacy, and risk status;
       ``(2) changing and influencing human behavior as it relates 
     to vaccination; and
       ``(3) development and implementation of a public, non-
     commercial and non-competitive broadcast system and person-
     to-person networks.

     ``SEC. 2150. INSTITUTE OF MEDICINE STUDY ON THE LEGAL, 
                   ETHICAL, AND SOCIAL IMPLICATIONS OF PANDEMIC 
                   INFLUENZA.

       ``(a) In General.--The Secretary shall contract with the 
     Institute of Medicine to--
       ``(1) study the legal, ethical, and social implications of, 
     with respect to pandemic influenza--
       ``(A) animal/human interchange;
       ``(B) global surveillance;
       ``(C) case contact investigations;
       ``(D) vaccination and medical treatment;
       ``(E) community hygiene;
       ``(F) travel and border controls;
       ``(G) decreased social mixing and increased social 
     distance;
       ``(H) civil confinement; and
       ``(I) other topics as determined appropriate by the 
     Secretary.
       ``(2) not later than 1 year after the date of enactment of 
     the Attacking Viral Influenza Across Nations Act of 2005, 
     submit to the Secretary a report that describes 
     recommendations based on the study conducted under paragraph 
     (1).
       ``(b) Implementation of Recommendations.--Not later than 
     180 days after the submission of the report of under 
     subsection (a)(2), the Secretary shall address the 
     recommendations of the Institute of Medicine regarding the 
     domestic and international allocation and distribution of 
     pandemic influenza vaccine and antivirals.

     ``SEC. 2151. NATIONAL PANDEMIC INFLUENZA ECONOMICS ADVISORY 
                   COMMITTEE.

       ``(a) In General.--There is established the National 
     Pandemic Influenza Economics Advisory Committee (referred to 
     in this section as the `Committee').
       ``(b) Membership.--
       ``(1) In general.--The members of the Committee shall be 
     appointed by the Comptroller General of the United States and 
     shall include domestic and international experts on pandemic 
     influenza, public health, veterinary science, commerce, 
     economics, finance, and international diplomacy.
       ``(2) Chair.--The Comptroller General of the United States 
     shall select a Chair from among the members of the Committee.
       ``(c) Duties.--The Committee shall study and make 
     recommendations to Congress and the Secretary on the 
     financial and economic impact of pandemic influenza and 
     possible financial structures for domestic and international 
     pandemic response, relating to--
       ``(1) the development, storage and distribution of 
     vaccines;
       ``(2) the storage and distribution of antiviral and other 
     medications and supplies;
       ``(3) increased surveillance activities;
       ``(4) provision of preventive and medical care during 
     pandemic;
       ``(5) reimbursement for health providers and other core 
     public function employees;
       ``(6) reasonable compensation for farmers and other workers 
     that bear direct or disproportionate loss of revenue; and
       ``(7) other issues determined appropriate by the Chair.
       ``(d) Compensation.--
       ``(1) In general.--Each member of the Committee who is not 
     an officer or employee of the Federal Government shall be 
     compensated at a rate equal to the daily equivalent of the 
     annual rate of basic pay prescribed for level IV of the 
     Executive Schedule under section 5315 of title 5, United 
     States Code, for each day (including travel time) during 
     which such member is engaged

[[Page S4585]]

     in the performance of the duties of the Committee. All 
     members who are officers or employees of the United States 
     shall serve without compensation in addition to that received 
     for their services as officers or employees of the United 
     States.
       ``(2) Travel expenses.--A member of the Committee shall be 
     allowed travel expenses, including per diem in lieu of 
     subsistence, at rates authorized for an employee of an agency 
     under subchapter I of chapter 57 of title 5, United States 
     Code, while away from the home or regular place of business 
     of the member in the performance of the duties of the 
     Committee.
       ``(e) Staff.--
       ``(1) In general.--The Chair of the Committee shall provide 
     the Committee with such professional and clerical staff, such 
     information, and the services of such consultants as may be 
     necessary to assist the Committee in carrying out the 
     functions under this section.
       ``(2) Detail of federal government employees.--
       ``(A) In general.--An employee of the Federal Government 
     may be detailed to the Committee without reimbursement.
       ``(B) Civil service status.--The detail of the employee 
     shall be without interruption or loss of civil service status 
     or privilege.
       ``(3) Procurement of temporary and intermittent services.--
     The Chair of the Committee may procure temporary and 
     intermittent services in accordance with section 3109(b) of 
     title 5, United States Code, at rates for individuals that do 
     not exceed the daily equivalent of the annual rate of basic 
     pay prescribed for level V of the Executive Schedule under 
     section 5316 of that title.''.

     SEC. 4. PANDEMIC INFLUENZA AND ANIMAL HEALTH.

       (a) In General.--The Secretary of Agriculture shall expand 
     and intensify efforts to prevent pandemic influenza, 
     including possible pandemic avian influenza.
       (b) Report.--Not later than 180 days after the date of 
     enactment this Act, the Secretary of Agriculture shall submit 
     to Congress a report that describes the anticipated impact of 
     pandemic influenza on the United States.
       (c) Assistance.--The Secretary of Agriculture, in 
     consultation with the Secretary of Health and Human Services, 
     the World Health Organization, and the World Organization for 
     Animal Health, shall provide domestic and international 
     assistance with respect to pandemic influenza preparedness 
     to--
       (1) support the eradication of infectious animal diseases 
     and zoonosis;
       (2) increase transparency in animal disease states;
       (3) collect, analyze, and disseminate veterinary data;
       (4) strengthen international coordination and cooperation 
     in the control of animal diseases; and
       (5) promote the safety of world trade in animals and animal 
     products.

     SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated such sums as may be 
     necessary to carry out this Act (and the amendments made by 
     this Act) for each of the fiscal years 2006 through 2010.
  Mr. ROCKEFELLER. Mr. President, it is my pleasure today to join the 
Senator from Utah, Mr. Hatch, and several of our colleagues in 
sponsoring the CLEAR ACT, a package of initiatives intended 
simultaneously to lessen this Nation's dependence on foreign oil and to 
promote a cleaner environment.
  Throughout my time in the Senate, and indeed going back to my time as 
Governor of West Virginia, I have believed that the United States 
needed to have a comprehensive and responsible national energy policy, 
and that a vital part of that policy should be promoting technologies 
and domestic resources to loosen the grip foreign suppliers of energy 
have on our economy. Alternative fuels and alternative fuel vehicles 
(AFVs) that use them must be part of our energy policy. As a Senator, I 
have been very interested in expanding the availability of alternative 
fuels and have worked with a number of my colleagues and experts in 
industry, academia, and in the environmental movement on several 
initiatives to accelerate their use and availability.
  The current high price of gasoline drives home the point that we must 
diversity our fuel supply. This issue is particularly important in West 
Virginia. Like many rural States, West Virginia has little public 
transportation, and most people must drive, often considerable 
distances, to work, to school, and to seek medical care. With every 
trip to the gas station and nearly every evening news report, West 
Virginians are reminded that our country is in the midst of an energy 
crisis. According to the American Automobile Association, the average 
price of gasoline has risen 23 percent in the past year. These 
increases have a serious impact on family budgets and on the economy in 
general.
  Today, more than 60 percent of the petroleum we consume is imported. 
This adds to our economic problems and raises additional concerns about 
national security. We must work to reduce the consumption, or at least 
the growth in consumption, of petroleum-based fuels in the United 
States. Emissions from gasoline-powered automobiles are a major source 
of air pollution and of carbon dioxide, which is the major contributor 
to global climate change. While I believe our energy policy should work 
in concert with a transportation policy that encourages the use of mass 
transit, it is unlikely in the short-term that many West Virginians, or 
a significant number of other Americans, will be able to greatly reduce 
the amount they drive. The CLEAR ACT will help our Nation lessen its 
dependence on foreign oil and, because the amount Americans drive is 
likely to increase, contribute to an overall cleaner environment by 
substituting cleaner-burning alternatives to gasoline and diesel.
  In the development of alternative fuels and AFVs, our Nation has been 
caught in what I've always thought of as the classic ``chicken and 
egg'' problem. Both alternative fuels and AFVs must be commercially 
available if the potential impact is to be achieved. Without the 
fueling infrastructure, wide commercial appeal of non-gasoline vehicles 
will top out before the market has reached its potential. The 
popularity of gasoline-electric hybrids demonstrates the public's 
hunger for alternatives to the rapidly rising price of gasoline and 
increasingly hazardous automobile emission. Appropriate tax incentives 
can address the equally important challenges of vehicle availability 
and infrastructure deployment. If consumers routinely see alternative 
fuels at reasonable prices at their local service stations, while also 
seeing reasonably-priced vehicles at dealerships, we know they will 
respond.
  The CLEAR ACT provides the tax incentives that we need, and which I 
believe must be included in the comprehensive energy policy the Senate 
will soon consider. In closing, let me thank my friends Senator Hatch 
and Senator Jeffords, with whom I've worked on this for many years. I 
am pleased as well to see that a growing number of my colleagues on 
both sides of the aisle are joining us in this effort to improve our 
Nation's energy, transportation, and environmental policy. I commend 
this bill to the remainder of the Senate, and look forward to its 
inclusion in the Energy bill we will take up later in the year.
                                 ______