[Congressional Record Volume 167, Number 198 (Monday, November 15, 2021)]
[Senate]
[Pages S8163-S8175]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 4644. Mr. RISCH (for himself and Mr. Menendez) submitted an 
amendment intended to be proposed to amendment SA 3867 submitted by Mr. 
Reed and intended to be proposed to the bill H.R. 4350, to authorize 
appropriations for fiscal year 2022 for military activities of the 
Department of Defense, for military construction, and for defense 
activities of the Department of Energy, to prescribe military personnel 
strengths for such fiscal year, and for other purposes; which was 
ordered to lie on the table; as follows:

       At the end of title XII, add the following:

 Subtitle H--International Pandemic Preparedness and COVID-19 Response

     SEC. 1291. SHORT TITLE.

       This subtitle may be cited as the ``International Pandemic 
     Preparedness and COVID-19 Response Act of 2021''.

     SEC. 1292. DEFINITIONS.

       In this subtitle:
       (1) Appropriate congressional committees.--The term 
     ``appropriate congressional committees'' means--
       (A) the Committee on Foreign Relations of the Senate;
       (B) the Committee on Appropriations of the Senate;
       (C) the Committee on Foreign Affairs of the House of 
     Representatives; and
       (D) the Committee on Appropriations of the House of 
     Representatives.
       (2) Global health security agenda; ghsa.--The terms 
     ``Global Health Security Agenda'' and ``GHSA'' mean the 
     multi-sectoral initiative launched in 2014 and renewed in 
     2018 that brings together countries, regions, international 
     organizations, nongovernmental organizations, and the private 
     sector to elevate global health security as a national-level 
     priority, to share best practices, and to facilitate national 
     capacity to comply with and adhere to--
       (A) the International Health Regulations (2005);
       (B) the World Organisation for Animal Health international 
     standards and guidelines;
       (C) United Nations Security Council Resolution 1540 (2004);
       (D) the Convention on the Prohibition of the Development, 
     Production and Stockpiling of Bacteriological and Toxin 
     Weapons and on their Destruction, done at Washington, London, 
     and Moscow, April 10, 1972 (commonly referred to as the 
     ``Biological Weapons Convention'');
       (E) the Global Health Security Agenda 2024 Framework; and
       (F) other relevant frameworks that contribute to global 
     health security.
       (3) Global health security index .--The term ``Global 
     Health Security Index'' means the comprehensive assessment 
     and benchmarking of health security and related capabilities 
     across the countries that make up the States Parties to the 
     International Health Regulations (2005).
       (4) Global health security initiative.--The term ``Global 
     Health Security Initiative'' means the informal network of 
     countries and organizations that came together in 2001 to 
     undertake concerted global action to strengthen public health 
     preparedness and response to chemical, biological, 
     radiological, and nuclear threats, including pandemic 
     influenza.
       (5) Joint external evaluation.--The term ``Joint External 
     Evaluation'' means the World Health Organization-facilitated, 
     voluntary, collaborative, multi-sectoral process to assess 
     country capacity to prevent, detect, and rapidly respond to 
     public health risks occurring naturally or due to deliberate 
     or accidental events, assess progress in achieving the 
     targets under the International Health Regulations (2005), 
     and recommend priority actions.
       (6) Key stakeholders.--The term ``key stakeholders'' means 
     actors engaged in efforts to advance global health security 
     programs and objectives, including--
       (A) national and local governments in partner countries;

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       (B) other bilateral donors;
       (C) international, regional, and local organizations, 
     including private, voluntary, nongovernmental, and civil 
     society organizations;
       (D) international, regional, and local financial 
     institutions;
       (E) representatives of historically marginalized groups, 
     including women, youth, and indigenous peoples;
       (F) the private sector, including medical device, 
     technology, pharmaceutical, manufacturing, logistics, and 
     other relevant companies; and
       (G) public and private research and academic institutions.
       (7) One health approach.--The term ``One Health approach'' 
     means the collaborative, multi-sectoral, and 
     transdisciplinary approach toward achieving optimal health 
     outcomes in a manner that recognizes the interconnection 
     between people, animals, plants, and their shared 
     environment.
       (8) Relevant federal departments and agencies.--The term 
     ``relevant Federal departments and agencies'' means any 
     Federal department or agency implementing United States 
     policies and programs relevant to the advancement of United 
     States global health security and diplomacy overseas, which 
     may include--
       (A) the Department of State;
       (B) the United States Agency for International Development;
       (C) the Department of Health and Human Services;
       (D) the Department of Defense;
       (E) the Defense Threat Reduction Agency;
       (F) the Millennium Challenge Corporation;
       (G) the Development Finance Corporation;
       (H) the Peace Corps; and
       (I) any other department or agency that the President 
     determines to be relevant for these purposes.
       (9) Resilience.--The term ``resilience'' means the ability 
     of people, households, communities, systems, institutions, 
     countries, and regions to reduce, mitigate, withstand, adapt 
     to, and quickly recover from stresses and shocks in a manner 
     that reduces chronic vulnerability to pandemic threats and 
     facilitates inclusive growth.
       (10) USAID.--The term ``USAID'' means the United States 
     Agency for International Development.

     SEC. 1293. PURPOSE.

       The purpose of this subtitle is to accelerate and enhance 
     the United States international response to pandemics, 
     including the COVID-19 pandemic, and to operationalize 
     lessons learned from current and prior emergency responses in 
     a manner that--
       (1) advances the global health security and diplomacy 
     objectives of the United States;
       (2) improves coordination among the relevant Federal 
     departments and agencies implementing United States foreign 
     assistance for global health security; and
       (3) more effectively enables partner countries to 
     strengthen and sustain resilient health systems and supply 
     chains with the resources, capacity, and personnel required 
     to prevent, prepare for, detect, and respond to infectious 
     disease threats before they become pandemics.

     SEC. 1294. ENHANCING THE UNITED STATES' INTERNATIONAL 
                   RESPONSE TO COVID-19 AND FUTURE PANDEMICS.

       (a) Statement of Policy Regarding International Cooperation 
     to End the COVID-19 Pandemic.--It shall be the policy of the 
     United States to lead and implement a comprehensive and 
     coordinated international response to end the COVID-19 
     pandemic in a manner that recognizes the critical role that 
     multilateral and regional organizations can and should play 
     in pandemic response, including by--
       (1) seeking adoption of a United Nations Security Council 
     resolution that--
       (A) declares pandemics, including the COVID-19 pandemic, to 
     be a threat to international peace and security; and
       (B) urges member states to address this threat by aligning 
     their health preparedness plans with international best 
     practices, including those established by the Global Health 
     Security Agenda, to improve country capacity to prevent, 
     detect, and respond to infectious disease threats;
       (2) advancing efforts to reform the World Health 
     Organization so that it serves as an effective, normative, 
     and coordinating body that is capable of aligning member 
     countries around a strategic operating plan to detect, 
     contain, treat, and deter the further spread of COVID-19;
       (3) providing timely, appropriate levels of financial 
     support to United Nations agencies responding to the COVID-19 
     pandemic;
       (4) prioritizing United States foreign assistance for the 
     COVID-19 response in the most vulnerable countries and 
     regions;
       (5) encouraging other donor governments to similarly 
     increase contributions to the United Nations agencies 
     responding to the COVID-19 pandemic in the world's poorest 
     and most vulnerable countries;
       (6) working with key stakeholders to accelerate progress 
     toward meeting and exceeding, as practicable, global COVID-19 
     vaccination goals, whereby--
       (A) at least 40 percent of the population in all countries 
     is vaccinated by the end of 2021; and
       (B) at least 70 percent of the population in all countries 
     is vaccinated by the opening date of the 77th regular session 
     of the United Nations General Assembly;
       (7) engaging with key overseas stakeholders, including 
     through multilateral facilities such as the COVID-19 Vaccines 
     Global Access initiative (referred to in this section as 
     ``COVAX'') and the Access to COVID-19 Tools (ACT) Accelerator 
     initiative, and expanding bilateral efforts, including 
     through the International Development Finance Corporation, to 
     accelerate the development, manufacturing, production, and 
     efficient and equitable distribution of--
       (A) vaccines and related raw materials to meet or exceed 
     the vaccination goals under paragraph (6); and
       (B) global health commodities, including supplies to combat 
     COVID-19 and to help immediately disrupt the transmission of 
     SARS-CoV-2;
       (8) supporting global COVID-19 vaccine distribution 
     strategies that strengthen underlying health systems and 
     ensure that people living in vulnerable and marginalized 
     communities, including women, do not face undue barriers to 
     vaccination;
       (9) working with key stakeholders, including through the 
     World Bank Group, the International Monetary Fund, the 
     International Finance Corporation, and other relevant 
     regional and bilateral financial institutions, to address the 
     economic and financial implications of the COVID-19 pandemic, 
     while taking into account the differentiated needs of 
     disproportionately affected, vulnerable, and marginalized 
     populations;
       (10) entering into discussions with vaccine manufacturing 
     companies to support partnerships, with the goal of ensuring 
     adequate global supply of vaccines, which may include 
     necessary components and raw materials;
       (11) establishing clear timelines, benchmarks, and goals 
     for COVID-19 response strategies and activities under this 
     section; and
       (12) generating commitments of resources in support of the 
     goals referred to in paragraph (6).
       (b) Oversight of United States Foreign Assistance to End 
     the COVID-19 Pandemic.--
       (1) Reporting requirements.--Not later than 60 days after 
     the date of the enactment of this Act, the Secretary of State 
     and the USAID Administrator shall jointly submit to the 
     appropriate congressional committees--
       (A) an unclassified report containing a description of 
     funds already obligated and expended under title X of the 
     American Rescue Plan Act of 2021 (Public Law 117-2); and
       (B) a plan that describes the objectives and timeline for 
     the obligation and expenditure of all remaining funds 
     appropriated under title X of the American Rescue Plan Act of 
     2021, to include support for civil society for the protection 
     of human rights in the context of the COVID-19 pandemic, 
     which shall be submitted in an unclassified form, and should 
     include a description of steps taken pursuant to each 
     objective specified in the plan.
       (2) Congressional consultation.--Not less frequently than 
     once every 60 days, until the completion or termination of 
     the implementation plan required under paragraph (1)(B), and 
     upon the request from one or more of the appropriate 
     congressional committees, the Secretary of State and the 
     USAID Administrator shall provide a briefing to the 
     appropriate congressional committees regarding the report 
     required under paragraph (1)(A) and the status of the 
     implementation of the plan required under paragraph (1)(B).
       (3) Branding.--In providing assistance under this section, 
     the Secretary of State and the USAID Administrator, with due 
     consideration for the safety and security of implementing 
     partners and beneficiaries, shall prescribe the use of logos 
     or other insignia, which may include the flag of the United 
     States, to appropriately identify such assistance as being 
     from the people of the United States.
       (c) United States Contributions to the Global Fund to Fight 
     AIDS, Tuberculosis, and Malaria COVID-19 Response 
     Mechanism.--United States contributions to the Global Fund to 
     Fight AIDS, Tuberculosis, and Malaria COVID-19 Response 
     Mechanism under section 10003(a)(2) of the American Rescue 
     Plan Act of 2021 (Public Law 107-2)--
       (1) shall be meaningfully leveraged in a manner that 
     incentivizes other public and private donor contributions; 
     and
       (2) shall be subject to the reporting and withholding 
     requirements under subsections (c), (d)(4)(A)(ii), (d)(4)(C), 
     (d)(5), (d)(6), (f), and (g) of section 202 of the United 
     States Leadership Against HIV/AIDS, Tuberculosis, and Malaria 
     Act of 2003 (22 U.S.C. 7622).
       (d) Global COVID-19 Vaccine Distribution and Delivery.--
       (1) Accelerating global vaccine distribution strategy.--The 
     President shall develop a strategy to expand access to, and 
     accelerate the global distribution of, COVID-19 vaccines to 
     other countries, which shall--
       (A) identify the countries that have the highest infection 
     and death rates due to COVID-19, the lowest COVID-19 
     vaccination rates, and face the most difficult political, 
     logistical, and financial challenges to obtaining and 
     delivering COVID-19 vaccines, and describe the basis and 
     metrics used to make such determinations;
       (B) identify which countries and regions will be 
     prioritized and targeted for COVID-19 vaccine delivery, and 
     the rationale for such prioritization;
       (C) describe efforts that the United States is making to 
     increase COVID-19 vaccine manufacturing capacity, both 
     domestically and internationally, as appropriate, through

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     support for the establishment or refurbishment of regional 
     manufacturing hubs in South America, South Africa, and South 
     Asia, including through the provision of international 
     development finance, and estimate when, how many, and which 
     types of vaccines will be provided by the United States 
     Government bilaterally and through COVAX;
       (D) describe efforts to encourage international partners to 
     take actions similar to the efforts referred to in 
     subparagraph (C);
       (E) describe how the United States Government will ensure 
     efficient delivery of COVID-19 vaccines to intended 
     recipients, including United States citizens residing 
     overseas, and identify complementary United States foreign 
     assistance that will facilitate vaccine readiness, 
     distribution, delivery, monitoring, and administration 
     activities;
       (F) describe how the United States Government will ensure 
     the efficient delivery and administration of COVID-19 
     vaccines to United States citizens residing overseas, 
     including through the donation of vaccine doses to United 
     States embassies and consulates, as appropriate, giving 
     priority to--
       (i) countries in which United States citizens are deemed 
     ineligible or low priority in the national vaccination 
     deployment plan; and
       (ii) countries that are not presently distributing a COVID-
     19 vaccine that--

       (I) has been licensed or authorized for emergency use by 
     the Food and Drug Administration; or
       (II) has met the necessary criteria for safety and efficacy 
     established by the World Health Organization;

       (G) summarize the United States Government's efforts to 
     encourage and facilitate technology sharing and the licensing 
     of intellectual property, to the extent necessary, to support 
     the adequate and timely supply of vaccines and vaccine 
     components to meet the vaccination goals specified in 
     subsection (a)(6), giving due consideration to avoiding 
     undermining intellectual property innovation and intellectual 
     property rights or protections with respect to vaccine 
     development in performing the assessment required under this 
     subparagraph;
       (H) describe the roles, responsibilities, tasks, and, as 
     appropriate, the authorities of the Secretary of State, the 
     USAID Administrator, the Secretary of Health and Human 
     Services, the Director of the Centers for Disease Control and 
     Prevention, the Chief Executive Officer of the United States 
     International Development Finance Corporation, and the heads 
     of other relevant Federal departments and agencies with 
     respect to the implementation of such strategy;
       (I) describe how the Department of State and USAID will 
     coordinate with the Secretary of Health and Human Services 
     and the heads of other relevant Federal agencies to expedite 
     the export and distribution of excess federally purchased 
     vaccines to support countries in need and ensure such 
     vaccines will not be wasted;
       (J) summarize the United States public diplomacy strategies 
     for branding and addressing vaccine misinformation and 
     hesitancy within partner countries; and
       (K) describe efforts that the United States is making to 
     help countries disrupt the current transmission of COVID-19, 
     while simultaneously increasing vaccination rates, utilizing 
     medical products and medical supplies.
       (2) Submission of strategy.--Not later than 90 days after 
     the date of the enactment of this Act, the President shall 
     submit the strategy described in paragraph (1) to--
       (A) the appropriate congressional committees;
       (B) the Committee on Health, Education, Labor, and Pensions 
     of the Senate; and
       (C) the Committee on Energy and Commerce of the House of 
     Representatives.
       (3) Limitation.--
       (A) In general.--No Federal funds may be made available to 
     COVAX to procure vaccines produced by any companies owned or 
     controlled by the Government of the People's Republic of 
     China or by the Chinese Communist Party unless the Secretary 
     of State certifies that the People's Republic of China--
       (i) is providing financial support to COVAX that is 
     commensurate with the United States' contribution to COVAX; 
     and
       (ii) publically discloses transparent data on the quality, 
     safety, and efficacy of its COVID-19 vaccines.
       (B) Safeguards.--The President shall ensure that 
     appropriate safeguards are put in place to ensure that the 
     condition described in subparagraph (A) is honored by Gavi, 
     the Vaccine Alliance.
       (e) Leveraging United States Bilateral Global Health 
     Programs for the International COVID-19 Response.--
       (1) Authorization for leveraging bilateral program 
     activities.--Amounts authorized to be appropriated or 
     otherwise made available to carry out section 104 of the 
     Foreign Assistance Act (22 U.S.C. 2151b) may be used in 
     countries receiving United States foreign assistance--
       (A) to combat the COVID-19 pandemic, including through the 
     sharing of COVID-19 vaccines; and
       (B) to support related activities, including--
       (i) strengthening vaccine readiness;
       (ii) reducing vaccine hesitancy and misinformation;
       (iii) delivering and administering COVID-19 vaccines;
       (iv) strengthening health systems and supply chains;
       (v) supporting health care workforce planning, training, 
     and management;
       (vi) enhancing transparency, quality, and reliability of 
     public health data;
       (vii) increasing bidirectional testing, including screening 
     for symptomatic and asymptomatic cases; and
       (viii) building laboratory capacity.
       (2) Adjustment of targets and goals.--The Secretary of 
     State, in coordination with the heads of other relevant 
     Federal departments and agencies, shall submit an annual 
     report to the appropriate congressional committees that 
     identifies--
       (A) any adjustments to original program targets and goals 
     that result from the use of funds for the purposes authorized 
     under paragraph (1); and
       (B) the amounts needed in the following fiscal year to meet 
     the original program goals, as necessary and appropriate.
       (f) Report on Humanitarian Response to the COVID-19 
     Pandemic.--
       (1) In general.--Not later than 120 days after the date of 
     the enactment of this Act, the Secretary of State, in 
     consultation with the USAID Administrator and the Secretary 
     of Health and Human Services, shall submit a report to the 
     appropriate congressional committees that--
       (A) assesses the global humanitarian response to COVID-19; 
     and
       (B) outlines specific elements of the United States 
     Government's country-level humanitarian response to the 
     COVID-19 pandemic.
       (2) Elements.--The report required under paragraph (1) 
     shall include--
       (A) for countries receiving United States assistance, a 
     description of humanitarian and health-worker access to 
     crisis-affected areas, including--
       (i) legal and bureaucratic restrictions on the entry of 
     humanitarian workers from abroad, to include visa 
     authorizations that do not allow adequate time for 
     humanitarian workers to quarantine upon arrival in-line with 
     host country regulations, conduct needs assessments, and 
     subsequently implement multilateral and United States-funded 
     programming in an efficient, effective, and unrestricted 
     manner;
       (ii) restrictions on travel by humanitarian workers within 
     such country to reach the areas of operation where vulnerable 
     and marginalized populations reside;
       (iii) access to medical evacuation in the event of a health 
     emergency;
       (iv) access to personal protective equipment for United 
     States Government implementing partners; and
       (v) efforts to support access to COVID-19 vaccines for 
     humanitarian and health-workers and crisis-affected 
     communities;
       (B) an analysis and description of countries (regardless of 
     whether such countries have received direct United States 
     assistance) that have expressly prevented vulnerable 
     populations from accessing necessary assistance related to 
     COVID-19, including--
       (i) the omission of vulnerable populations from national 
     response plans;
       (ii) laws, policies, or practices that restrict or preclude 
     treatment of vulnerable populations at public hospitals and 
     health facilities; and
       (iii) exclusion of, or discrimination against, vulnerable 
     populations in law, policy, or practice that prevents 
     equitable access to food, shelter, and other basic 
     assistance;
       (C) a description of United States Government efforts to 
     facilitate greater humanitarian access, including--
       (i) advocacy and diplomatic efforts with relevant foreign 
     governments and multilateral institutions to ensure that 
     vulnerable and marginalized populations are included in 
     national response plans and other relevant plans developed in 
     response to the COVID-19 pandemic; and
       (ii) advocacy and diplomatic efforts with relevant foreign 
     governments to ensure that appropriate visas, work permits, 
     and domestic travel exemptions are issued for humanitarian 
     and health workers responding to the COVID-19 pandemic; and
       (D) a description of United States Government plans and 
     efforts to address the second-order impacts of the COVID-19 
     pandemic and an assessment of the resources required to 
     implement such plans, including efforts to address--
       (i) famine and acute food insecurity;
       (ii) gender-based violence;
       (iii) mental health and psychosocial support needs;
       (iv) child protection needs;
       (v) health, education, and livelihoods;
       (vi) shelter; and
       (vii) attempts to close civil society space, including 
     through bureaucratic, administrative, and health or security 
     related impediments.
       (g) Safeguarding Democracy and Human Rights During the 
     COVID-19 Pandemic.--
       (1) Sense of congress.--It is the sense of Congress that--
       (A) governments may be required to take appropriate 
     extraordinary measures during public health emergencies to 
     halt the spread of disease, including closing businesses and 
     public events, limiting access to public spaces, and 
     restricting the movement of people;
       (B) certain foreign governments have taken measures in 
     response to COVID-19 that violate the human rights of their 
     citizens without clear public health justification, oversight 
     measures, or sunset provisions;

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       (C) governments using the COVID-19 pandemic as a pretext 
     for repression have undermined democratic institutions, 
     debilitated institutions for transparency and public 
     integrity, quashed legitimate dissent, and attacked 
     journalists, civil society organizations, activists, 
     independent voices, and vulnerable and marginalized 
     populations, including refugees and migrants, with far-
     reaching consequences that will extend beyond the current 
     crisis;
       (D) foreign governments should take immediate steps to 
     release from prison all arbitrarily detained United States 
     citizens and political prisoners who may be at increased risk 
     for contracting or suffering from complications from COVID-
     19;
       (E) COVID-19 threatens to roll back decades of progress for 
     women and girls, disproportionately affecting women 
     economically, educationally, and with respect to health, 
     while also leading to alarming rises in gender based 
     violence; and
       (F) during and after the pandemic, the Department of State 
     and USAID should directly, and through nongovernmental 
     organizations or international organizations, provide 
     assistance and implement programs that support democratic 
     institutions, civil society, free media, and the advancement 
     of internationally recognized human rights.
       (2) Funding for civil society and human rights defenders.--
       (A) Program priorities.--Amounts made available for each of 
     the fiscal years 2022 through 2026 to carry out the purposes 
     of sections 101 and 102 of the Foreign Assistance Act of 1961 
     (22 U.S.C. 2151 and 2151-1), including programs to support 
     democratic institutions, human rights defenders, civil 
     society, and freedom of the press, should be targeted, to the 
     extent feasible, toward civil society organizations in 
     countries in which emergency government measures taken in 
     response to the COVID-19 pandemic have violated 
     internationally recognized human rights.
       (B) Eligible organizations.--Civil society organizations 
     operating in countries in which emergency government measures 
     taken in response to the COVID-19 pandemic violated 
     internationally recognized human rights shall be eligible to 
     receive funds made available to carry out the purposes of 
     sections 101 and 102 of the Foreign Assistance Act of 1961 
     for each of the fiscal years 2022 through 2026, for--
       (i) programs designed to strengthen and support civil 
     society, human rights defenders, freedom of association, and 
     the freedom of the press;
       (ii) programs to restore democratic institutions; and
       (iii) peacebuilding and conflict prevention to address the 
     impacts of COVID-19 on social cohesion, public trust, and 
     conflict dynamics by adapting existing programs or investing 
     in new ones.
       (C) Final report.--Not later than 180 days after the date 
     of the enactment of this Act, the Secretary of State shall 
     submit a report to the appropriate congressional committees 
     that--
       (i) lists the countries whose emergency measures limiting 
     internationally recognized human rights in a manner 
     inconsistent with the principles of limitation and derogation 
     remain in place;
       (ii) describes such countries' emergency measures, 
     including--

       (I) how such procedures violate internationally recognized 
     human rights; and
       (II) an analysis of the impact of such measures on access 
     to health and efforts to control the COVID-19 pandemic within 
     the country;

       (iii) describes--

       (I) security and intelligence surveillance measures 
     implemented by countries during the COVID-19 pandemic;
       (II) the extent to which such measures have been, or have 
     not been, rolled back; and
       (III) whether and how such measures impact internationally 
     recognized human rights; and

       (iv) includes a strategic plan by the Department of State 
     and USAID that addresses, through multilateral and bilateral 
     diplomacy and foreign assistance, the persistent issues 
     related to the restriction of internationally recognized 
     human rights in the COVID-19 response.
       (h) Public Diplomacy and Combating Disinformation and 
     Misinformation About COVID-19.--
       (1) United states agency for global media.--
       (A) Finding.--Congress finds that the United States Agency 
     for Global Media (referred to in this subsection as 
     ``USAGM'') broadcasting entities and grantees have proven 
     valuable in providing timely and accurate information, 
     particularly in countries in which the free press is under 
     threat.
       (B) Sense of congress.--It is the sense of Congress that--
       (i) accurate, investigative, and scientific journalism is 
     critical for societies to effectively combat global health 
     threats; and
       (ii) Congress supports--

       (I) accurate and objective investigative and scientific 
     reporting by USAGM networks and grantees regarding COVID-19; 
     and
       (II) platforms that help dispel and combat misinformation 
     about the COVID-19 pandemic.

       (C) Voice of america.--It is the sense of Congress that 
     amounts authorized to be appropriated or otherwise made 
     available to Voice of America should be used--
       (i) to expand programs such as POLYGRAPH.info;
       (ii) to provide critical tools for combating propaganda 
     associated with COVID-19; and
       (iii) to assist journalists in providing accurate 
     information to local media outlets.
       (D) Office of cuba broadcasting.--It is the sense of 
     Congress that Radio Television Marti and Digital Marti should 
     continue to broadcast programs that detect, highlight, and 
     dispel disinformation.
       (E) Radio free europe/radio liberty.--
       (i) Finding.--Congress finds that Radio Free Europe/Radio 
     Liberty (referred to in this section as ``RFE/RL'') operate 
     in media markets in which authoritarian state and nonstate 
     actors, including Russia, heavily invest in misinformation 
     and disinformation campaigns designed to promote confusion 
     and mistrust.
       (ii) Sense of congress.--It is the sense of Congress that 
     RFE/RL should--

       (I) increase investigative reporting regarding the impacts 
     of COVID-19, the political and social responses governments 
     are taking in response to COVID-19, and the lasting impacts 
     such actions will have on key political freedoms; and
       (II) expand its ``digital first'' strategy.

       (F) Radio free asia.--
       (i) Finding.--Congress finds that Radio Free Asia (RFA) 
     operates in a media market dominated by powerful state-run 
     media that have invested heavily in media distortion and 
     disinformation, including about COVID-19.
       (ii) Sense of congress.--It is the sense of Congress that 
     RFA should--

       (I) commission technical experts to bolster efforts to 
     counter social media tools, including bots used by some 
     countries to promote misinformation;
       (II) expand digital programming and local coverage to 
     expose China's media manipulation techniques; and
       (III) increase English language content to help counter 
     China's propaganda directed toward English-speaking 
     audiences.

       (G) Middle east broadcasting networks.--
       (i) Finding.--Congress finds that the Middle East 
     Broadcasting Networks operate largely in closed media markets 
     in which malign state and nonstate actors remain active.
       (ii) Sense of congress.--It is the sense of Congress that 
     the Middle East Broadcasting Networks should--

       (I) continue plans to expand an investigative news unit; 
     and
       (II) work to ensure that reporting continues amidst 
     operational challenges on the ground.

       (H) Open technology fund.--
       (i) Finding.--Congress finds that the Open Technology Fund 
     works to advance internet freedom in repressive environments 
     by supporting technologies that--

       (I) provide secure and uncensored access to USAGM's content 
     and the broader internet; and
       (II) counter attempts by authoritarian governments to 
     control the internet and restrict freedom online.

       (ii) Sense of congress.--It is the sense of Congress that 
     the Open Technology Fund should--

       (I) support a broad range of technologies to respond to 
     increasingly aggressive and sophisticated censorship and 
     surveillance threats and provide more comprehensive and 
     tailored support to USAGM's networks; and
       (II) provide direct assistance to USAGM's networks to 
     improve the digital security of reporting operations and 
     journalists.

       (2) Department of state public diplomacy programs.--
       (A) Findings.--Congress finds the following:
       (i) The Department of State's public diplomacy programs 
     build global networks that can address shared challenges, 
     such as the COVID-19 pandemic, including through exchanges of 
     researchers, public health experts, and scientists.
       (ii) The programs referred to in clause (i) play a critical 
     role in creating open and resilient information environments 
     where democracies can thrive, as articulated in the 2020 
     Public Diplomacy Strategic Plan, including by--

       (I) improving media quality with journalist training and 
     reporting tours;
       (II) conducting media literacy programs; and
       (III) supporting media access activities.

       (iii) The International Visitor Leadership Program and 
     Digital Communications Network engaged journalists around the 
     world to combat COVID-19 disinformation, promote unbiased 
     reporting, and strengthen media literacy.
       (iv) More than 12,000 physicians holding J-1 visas from 130 
     countries--

       (I) are engaged in residency or fellowship training at 
     approximately 750 hospitals throughout the United States, the 
     majority of whom are serving in States that have been the 
     hardest hit by COVID-19; and
       (II) throughout the pandemic, have served on the front 
     lines of the medical workforce and in United States 
     university laboratories researching ways to detect and treat 
     the virus.

       (B) Visa processing briefing.--Not later than 30 days after 
     the date of the enactment of this Act, the Assistant 
     Secretary for Consular Affairs shall brief the appropriate 
     congressional committees by providing--
       (i) a timeline for increasing visa processing capacities at 
     embassies around the world, notably where there are--

[[Page S8167]]

       (I) many American citizens, including dual nationals; and
       (II) many visa applicants for educational and cultural 
     exchange programs that promote United States foreign policy 
     objectives and economic stability to small businesses, 
     universities, and communities across the United States;

       (ii) a detailed plan for using existing authorities to 
     waive or provide other alternatives to in-person appointments 
     and interviews;
       (iii) an assessment of whether additional authorities and 
     resources are required for the use of videoconference 
     appointments and interviews as an alternative to in-person 
     appointments and interviews; and
       (iv) a detailed plan for using existing authorities to 
     rapidly cross-train and surge temporary personnel to support 
     consular services at embassies and consulates of the United 
     States around the world, and an assessment of whether 
     additional authorities and resources are required.
       (C) Global engagement center.--
       (i) Finding.--Congress finds that since the beginning of 
     the COVID-19 pandemic, publications, websites, and platforms 
     associated with China, Russia, and Iran have sponsored 
     disinformation campaigns related to the COVID-19 pandemic, 
     including falsely blaming the United States for the disease.
       (ii) Sense of congress.--It is the sense of Congress that 
     the Global Engagement Center should continue its efforts to 
     expose and counter state and non-state-sponsored 
     disinformation related to COVID-19, the origins of COVID-19, 
     and COVID-19 vaccinations.
       (i) Findings and Sense of Congress Regarding the United 
     States International Development Finance Corporation.--
       (1) Findings.--Congress finds the following:
       (A) The COVID-19 pandemic is causing a global economic 
     recession, as evidenced by the global economic indicators 
     described in subparagraphs (B) through (D).
       (B) The United Nations Conference on Trade and Development 
     determined that the COVID-19 pandemic pushed the global 
     economy into recession in 2020 on a scale that has not been 
     witnessed since the 1930s.
       (C) Developed countries are expected to experience a 
     relatively more significant rebound in gross domestic product 
     growth during 2021 than is expected to be experienced in 
     developing countries, leading to concerns about a further 
     expansion in the gap between rich and poor countries, 
     particularly if this trend continues into 2022.
       (D) Global markets have suffered losses ranging between 5 
     percent and over 10 percent since the beginning of the 
     pandemic. While markets are recovering in 2021, global job 
     losses and unemployment rates remain high, with--
       (i) approximately 33,000,000 labor hours lost globally (13 
     per cent of the total hours lost) due to outright 
     unemployment; and
       (ii) an estimated additional 81,000,000 labor hours lost 
     due to inactivity or underemployment.
       (E) Given the prolonged nature of the COVID-19 pandemic, 
     African finance ministers have requested continued efforts to 
     provide--
       (i) additional liquidity;
       (ii) better market access;
       (iii) more concessional resources; and
       (iv) an extension in the Debt Service Suspension Initiative 
     established by the Group of 20.
       (2) Sense of congress.--It is the sense of Congress that--
       (A) even when markets begin to recover in the future, it is 
     likely that access to capital will be especially challenging 
     for developing countries, which still will be struggling with 
     the containment of, and recovery from, the COVID-19 pandemic;
       (B) economic uncertainty and the inability of individuals 
     and households to generate income are major drivers of 
     political instability and social discord, which create 
     conditions for insecurity;
       (C) it is in the security and economic interests of the 
     United States to assist in the economic recovery of 
     developing countries that are made more vulnerable and 
     unstable from the public health and economic impacts of the 
     COVID-19 pandemic;
       (D) United States foreign assistance and development 
     finance institutions should seek to blunt the impacts of a 
     COVID-19 related economic recession by supporting investments 
     in sectors critical to maintaining economic stability and 
     resilience in low and middle income countries;
       (E) the need for the United States International 
     Development Finance Corporation's support for advancing 
     development outcomes in less developed countries, as mandated 
     by the Better Utilization of Investments Leading to 
     Development Act of 2018 (22 U.S.C. 9601 et seq.), is critical 
     to ensuring lasting and resilient economic growth in light of 
     the COVID-19 pandemic's exacerbation of economic hardships 
     and challenges;
       (F) The United States International Development Finance 
     Corporation should adjust its view of risk versus return by 
     taking smart risks that may produce a lower rate of financial 
     return, but produce significant development outcomes in 
     responding to the economic effects of COVID-19;
       (G) to mitigate the economic impacts of the COVID-19 
     recession, the United States International Development 
     Finance Corporation should use its resources and authorities, 
     among other things--
       (i) to ensure loan support for small- and medium-sized 
     enterprises;
       (ii) to offer local currency loans to borrowers for working 
     capital needs;
       (iii) to create dedicated financing opportunities for new 
     ``customers'' that are experiencing financial hardship due to 
     the COVID-19 pandemic; and
       (iv) to work with other development finance institutions to 
     create co-financing facilities to support customers 
     experiencing hardship due to the COVID-19 pandemic.
       (j) Sense of Congress Regarding International Cooperation 
     to Prevent and Respond to Future Pandemics.--It is the sense 
     of Congress that--
       (1) global pandemic preparedness and response requires 
     international and regional cooperation and action;
       (2) the United States should lead efforts in multilateral 
     fora, such as the Group of 7, the Group of 20, and the United 
     Nations, by collaborating and cooperating with other 
     countries and international and regional organizations, 
     including the World Health Organization and other key 
     stakeholders, to implement international strategies, tools, 
     and agreements to better prevent, detect, and respond to 
     future infectious disease threats before they become 
     pandemics; and
       (3) the United States should enhance and expand 
     coordination and collaboration among the relevant Federal 
     departments and agencies, the Food and Agriculture 
     Organization of the United Nations, the World Health 
     Organization, and the World Organization for Animal Health, 
     to advance a One Health approach toward preventing, 
     detecting, and responding to zoonotic threats in the human-
     animal interface.
       (k) Roles of the Department of State, the United States 
     Agency for International Development, and the Department of 
     Health and Human Services in International Pandemic 
     Response.--
       (1) Designation of lead agencies for coordination of the 
     united states' international response to infectious disease 
     outbreaks with severe or pandemic potential.--The President 
     shall designate relevant Federal departments and agencies, 
     including the Department of State, USAID, and the Department 
     of Health and Human Services (including the Centers for 
     Disease Control and Prevention), to lead specific aspects of 
     the United States' international response to outbreaks of 
     emerging high-consequence infectious disease threats.
       (2) Notification.--Not later than 120 days after the date 
     of the enactment of this Act, the President shall notify the 
     appropriate congressional committees, the Committee on 
     Health, Education, Labor, and Pensions of the Senate, and the 
     Committee on Energy and Commerce of the House of 
     Representatives of the designations made pursuant to 
     paragraph (1), including detailed descriptions of the roles 
     and responsibilities of each relevant department and agency.
       (l) USAID Disaster Surge Capacity.--
       (1) Surge capacity.--Amounts authorized to be appropriated 
     or otherwise made available to carry out part I and chapter 4 
     of part II of the Foreign Assistance Act of 1961 (22 U.S.C. 
     2151 et seq.), including funds made available for 
     ``Assistance for Europe, Eurasia and Central Asia'', may be 
     used, in addition to amounts otherwise made available for 
     such purposes, for the cost (including support costs) of 
     individuals detailed to or employed by USAID whose primary 
     responsibility is to carry out programs in response to global 
     health emergencies and natural or man-made disasters.
       (2) Notification.--Not later than 15 days before making 
     funds available to address man-made disasters pursuant to 
     paragraph (1), the Secretary of State or the USAID 
     Administrator shall notify the appropriate congressional 
     committees of such action.
       (m) Statement of Policy on Humanitarian Assistance to 
     Countries Affected by Pandemics.--
       (1) Statement of policy.--It shall be the policy of the 
     United States--
       (A) to ensure that United States assistance to address 
     pandemics, including the provision of vaccines, reaches 
     vulnerable and marginalized populations, including racial and 
     religious minorities, refugees, internally displaced persons, 
     migrants, stateless persons, women, children, the elderly, 
     and persons with disabilities;
       (B) to ensure that United States assistance, including 
     development finance, addresses the second order effects of a 
     pandemic, including acute food insecurity; and
       (C) to protect and support humanitarian actors who are 
     essential workers in preventing, mitigating and responding to 
     the spread of a pandemic among vulnerable and marginalized 
     groups described in subparagraph (A), including ensuring that 
     such humanitarian actors--
       (i) are exempted from unreasonable travel restrictions to 
     ensure that they can effectively provide life-saving 
     assistance; and
       (ii) are prioritized as frontline workers in country 
     vaccine distribution plans.
       (2) Facilitating effective and safe humanitarian 
     assistance.--The Secretary of State, in coordination with the 
     USAID Administrator, should carry out actions that accomplish 
     the policies set forth in paragraph (1), including by--
       (A) taking steps to ensure that travel restrictions 
     implemented to help contain the spread of a pandemic are not 
     applied to individuals authorized by the United States 
     Government to travel to, or reside in, a designated country 
     to provide assistance related to, or otherwise impacted by, 
     an outbreak;

[[Page S8168]]

       (B) approving the use of foreign assistance for the 
     procurement of personal protective equipment by United States 
     Government implementing partners from businesses within or 
     nearby the country receiving foreign assistance on an urgent 
     basis and in a manner consistent with efforts to respond to 
     the spread of a pandemic in the United States; and
       (C) waiving certain travel restrictions implemented to help 
     contain the spread of a pandemic in order to facilitate the 
     medical evacuation of United States Government implementing 
     partners, regardless of nationality.

     SEC. 1295. INTERNATIONAL PANDEMIC PREVENTION AND 
                   PREPAREDNESS.

       (a) Partner Country Defined.--In this section, the term 
     ``partner country'' means a foreign country in which the 
     relevant Federal departments and agencies are implementing 
     United States assistance for global health security and 
     pandemic prevention and preparedness under this subtitle.
       (b) United States Global Health Security and Diplomacy 
     Strategy and Report.--
       (1) In general.--The President shall develop, update, 
     maintain, and advance a comprehensive strategy for improving 
     global health security and pandemic prevention, preparedness, 
     and response that--
       (A) clearly articulates the policy goals related to 
     pandemic prevention, preparedness, and response, and actions 
     necessary to elevate and strengthen United States diplomatic 
     leadership in global health security and pandemic 
     preparedness, including by building the expertise of the 
     diplomatic corps;
       (B) improves the effectiveness of United States foreign 
     assistance to prevent, detect, and respond to infectious 
     disease threats, including through the advancement of a One 
     Health approach, the Global Health Security Agenda, the 
     International Health Regulations (2005), and other relevant 
     frameworks and programs that contribute to global health 
     security and pandemic preparedness;
       (C) establishes specific and measurable goals, benchmarks, 
     timetables, performance metrics, and monitoring and 
     evaluation plans for United States foreign policy and 
     assistance for global health security that promote learning 
     and adaptation and reflect international best practices 
     relating to global health security, transparency, and 
     accountability;
       (D) establishes transparent means to improve coordination 
     and performance by the relevant Federal departments and 
     agencies and sets out clear roles and responsibilities that 
     reflect the unique capabilities and resources of each such 
     department and agency;
       (E) establishes mechanisms to improve coordination and 
     avoid duplication of effort among the relevant Federal 
     departments and agencies, partner countries, donor countries, 
     the private sector, multilateral organizations, and other key 
     stakeholders, and ensures collaboration at the country level;
       (F) supports, and is aligned with, partner country-led, 
     global health security policy and investment plans, developed 
     with input from key stakeholders, as appropriate;
       (G) prioritizes working with partner countries with--
       (i) demonstrated need, as identified through the Joint 
     External Evaluation process, the Global Health Security Index 
     classification of health systems, national action plans for 
     health security, the Global Health Security Agenda, other 
     risk-based assessments, and other complementary or successor 
     indicators of global health security and pandemic 
     preparedness; and
       (ii) demonstrated commitment to transparency, including 
     budget and global health data transparency, complying with 
     the International Health Regulations (2005), investing in 
     domestic health systems, and achieving measurable results;
       (H) reduces long-term reliance upon United States foreign 
     assistance for global health security by--
       (i) helping build and enhance community resilience to 
     infectious disease emergencies and threats, such as COVID-19 
     and Ebola;
       (ii) ensuring that United States global health assistance 
     is strategically planned and coordinated in a manner that 
     contributes to the strengthening of overall health systems 
     and builds the capacity of local organizations and 
     institutions;
       (iii) promoting improved domestic resource mobilization, 
     co-financing, and appropriate national budget allocations for 
     strong public health systems, global health security, and 
     pandemic preparedness and response in partner countries; and
       (iv) ensuring partner country ownership of global health 
     security strategies, data, programs, and outcomes;
       (I) supports health budget and workforce planning in 
     partner countries, including training in public financial 
     management and budget data transparency;
       (J) works to ensure that--
       (i) partner countries have national action plans for health 
     security that are developed with input from key stakeholders, 
     including communities and the private sector;
       (ii) United States foreign assistance for global health 
     security is aligned with such national action plans for 
     health security in partner countries, developed with input 
     from key stakeholders, including communities and the private 
     sector, to the greatest extent practicable and appropriate; 
     and
       (iii) United States global health security efforts are 
     aligned with ongoing strategies and initiatives across 
     government agencies to help nations better identify and 
     prevent health impacts related to deforestation, climate-
     related events, and increased unsafe interactions between 
     wildlife, livestock, and people, including the emergence, 
     reemergence, and spread of zoonoses;
       (K) strengthens linkages between complementary bilateral 
     and multilateral foreign assistance programs, including 
     efforts of the World Bank, the World Health Organization, the 
     Global Fund to Fight AIDS, Tuberculosis, and Malaria, Gavi, 
     the Vaccine Alliance, and regional health organizations, that 
     contribute to the development of more resilient health 
     systems and supply chains in partner countries with the 
     capacity, resources, and personnel required to prevent, 
     detect, and respond to infectious disease threats; and
       (L) supports innovation and partnerships with the private 
     sector, health organizations, civil society, nongovernmental 
     organizations, and health research and academic institutions 
     to improve pandemic preparedness and response, including for 
     the prevention and detection of infectious disease, and the 
     development and deployment of effective and accessible 
     infectious disease tracking tools, diagnostics, therapeutics, 
     and vaccines.
       (2) Submission of strategy.--Not later than 120 days after 
     the date of the enactment of this Act, the President shall 
     submit the strategy required under paragraph (1) to the 
     appropriate congressional committees, the Committee on 
     Health, Education, Labor, and Pensions of the Senate, and the 
     Committee on Energy and Commerce of the House of 
     Representatives.
       (3) Annual report.--
       (A) In general.--Not later than 1 year after the submission 
     of the strategy to the congressional committees referred to 
     in paragraph (2), and not later than October 1 of each year 
     thereafter for the following 4 fiscal years, the President 
     shall submit a report to such congressional committees that 
     describes--
       (i) the status of the implementation of the strategy 
     required under paragraph (1);
       (ii) any necessary updates to the strategy;
       (iii) the progress made in implementing the strategy, with 
     specific information related to the progress toward improving 
     countries' ability to detect, respond and prevent the spread 
     of infectious disease threats, such as COVID-19 and Ebola; 
     and
       (iv) details on the status of funds made available to carry 
     out the purposes of this section.
       (B) Agency-specific plans.--The reports required under 
     subparagraph (A) shall include specific implementation plans 
     from each relevant Federal department and agency that 
     describe--
       (i) how updates to the strategy may have impacted the 
     agency's plan during the preceding calendar year;
       (ii) the progress made in meeting the goals, objectives, 
     and benchmarks under implementation plans during the 
     preceding year;
       (iii) the anticipated staffing plans and contributions of 
     the department or agency, including technical, financial, and 
     in-kind contributions, to implement the strategy;
       (iv) a transparent, open, and detailed accounting of 
     obligations by each of the relevant Federal departments and 
     agencies to implement the strategy, including--

       (I) the statutory source of obligated funds;
       (II) the amounts obligated;
       (III) implementing partners;
       (IV) targeted beneficiaries; and
       (V) activities supported;

       (v) the efforts of the relevant Federal department or 
     agency to ensure that the activities and programs carried out 
     pursuant to the strategy are designed to achieve maximum 
     impact and enduring returns, including through specific 
     activities to strengthen health systems, as appropriate; and
       (vi) a plan for regularly reviewing and updating programs 
     and partnerships, and for sharing lessons learned with a wide 
     range of stakeholders in an open, transparent manner.
       (C) Form.--The reports required under subparagraph (A) 
     shall be submitted in unclassified form, but may contain a 
     classified annex.
       (c) Committee on Global Health Security and Pandemic and 
     Biological Threats.--
       (1) Statement of policy.--It shall be the policy of the 
     United States--
       (A) to promote global health security as a core national 
     security interest; and
       (B) to ensure effective coordination and collaboration 
     between the relevant Federal departments and agencies engaged 
     in efforts to advance the global health security of the 
     United States.
       (2) Coordination.--
       (A) Establishment of committee.--There is authorized to be 
     established, within the National Security Council, the 
     Committee on Global Health Security and Pandemic and 
     Biological Threats (referred to in this subsection as the 
     ``Committee''), whose day-to-day operations should be led by 
     the Special Advisor for Global Health Security.
       (B) Special advisor for global health security.--The 
     Special Advisor for Global Health Security--
       (i) should serve on the staff of the National Security 
     Council; and
       (ii) may also be the Senior Director for the Global Health 
     Security and Biodefense Directorate within the Executive 
     Office of the President, who reports to the Assistant to the 
     President for National Security Affairs.
       (C) Functions.--

[[Page S8169]]

       (i) In general.--The functions of the Committee should be--

       (I) to provide strategic guidance for the development of a 
     policy framework for United States Government activities 
     relating to global health security, including pandemic 
     prevention, preparedness and response; and
       (II) to ensure policy coordination between United States 
     Government agencies.

       (ii) Activities.--In carrying out the functions described 
     in clause (i), the Committee should--

       (I) conduct, in coordination with the heads of relevant 
     Federal departments and agencies, a review of existing United 
     States global health security policies and strategies;
       (II) develop recommendations for how the Federal Government 
     may regularly update and harmonize the policies and 
     strategies referred to in subclause (I) to enable the United 
     States Government to respond to pandemic threats and to 
     monitor the implementation of such strategies;
       (III) develop a plan for modernizing global early warning 
     and trigger systems for scaling action to prevent, detect, 
     respond to, and recover from emerging biological threats;
       (IV) provide policy-level recommendations regarding the 
     Global Health Security Agenda goals, objectives, and 
     implementation, and other international efforts to strengthen 
     pandemic prevention, preparedness and response;
       (V) review the progress toward, and working to resolve 
     challenges in, achieving United States commitments under the 
     Global Health Security Agenda;
       (VI) develop protocols for coordinating and deploying a 
     global response to emerging high-consequence infectious 
     disease threats that outline the respective roles for 
     relevant Federal agencies in facilitating and supporting such 
     response operations that should facilitate the operational 
     work of Federal agencies and of the Special Advisor for 
     Global Health Security;
       (VII) make recommendations regarding appropriate responses 
     to specific pandemic threats and ensure the coordination of 
     domestic and international agencies regarding the Federal 
     Government's efforts to prevent, detect, respond to, and 
     recover from biological events;
       (VIII) take steps to strengthen the global pandemic supply 
     chain and address any barriers to the timely delivery of 
     supplies in response to a pandemic, including through 
     engagement with the private sector, as appropriate;
       (IX) develop recommendations to ensure the effective 
     sharing of information from domestic and international 
     sources about pandemic threats among the relevant Federal 
     departments and agencies, State and local governments, and 
     international partners and organizations; and
       (X) develop guidelines to enhance and improve the 
     operational coordination between State and local governments 
     and Federal agencies with respect to pandemic threats.

       (D) Responsibilities of departments and agencies.--The 
     Committee and the Special Advisor for Global Health Security 
     shall not assume any responsibilities or authorities of the 
     head of any Federal department, agency, or office, including 
     the foreign affairs responsibilities and authorities of the 
     Secretary of State to oversee the implementation of programs 
     and policies that advance global health security within 
     foreign countries.
       (E) Specific roles and responsibilities.--
       (i) In general.--The heads of the relevant Federal 
     departments and agencies should--

       (I) make global health security and pandemic threat 
     reduction a high priority within their respective departments 
     and agencies, and include global health security and pandemic 
     threat reduction-related activities within their respective 
     agencies' strategic planning and budget processes;
       (II) designate a senior-level official to be responsible 
     for global health security and pandemic threat reduction at 
     each of their respective departments and agencies;
       (III) designate an appropriate representative at the 
     Assistant Secretary level or higher to participate on the 
     Committee whenever the head of the department or agency 
     cannot participate;
       (IV) keep the Committee apprised of Global Health Security 
     and pandemic threat reduction-related activities undertaken 
     within their respective departments and agencies;
       (V) ensure interagency cooperation and collaboration and 
     maintain responsibility for agency-related programmatic 
     functions including, as applicable, in coordination with 
     partner governments, country teams, and global health 
     security in-country teams; and
       (VI) keep the Committee apprised of GHSA-related activities 
     undertaken within their respective agencies.

       (ii) Additional roles and responsibilities.--In addition to 
     the roles and responsibilities described in clause (i), the 
     heads of the relevant Federal departments and agencies should 
     carry out their respective roles and responsibilities 
     described in--

       (I) Executive Order 13747 (81 Fed. Reg. 78701; relating to 
     Advancing the Global Health Security Agenda to Achieve a 
     World Safe and Secure from Infectious Disease Threats); and
       (II) the National Security Memorandum-1 on United States 
     Global Leadership to Strengthen the International COVID-19 
     Response and to Advance Global Health Security and Biological 
     Preparedness, as in effect on the day before the date of the 
     enactment of this Act.

       (d) United States Overseas Global Health Security and 
     Diplomacy Coordination.--
       (1) Establishment.--There is established, within the 
     Department of State, a Special Representative for United 
     States International Activities to Advance Global Health 
     Security and Diplomacy Overseas (referred to in this 
     subsection as the ``Special Representative'').
       (2) Appointment; qualifications.--The Special 
     Representative--
       (A) shall be appointed by the President, by and with the 
     advice and consent of the Senate;
       (B) shall report to the Secretary of State; and
       (C) shall have--
       (i) demonstrated knowledge and experience in the fields of 
     development and public health, epidemiology, or medicine; and
       (ii) relevant diplomatic, policy, and political expertise.
       (3) Authorities.--The Special Representative is 
     authorized--
       (A) to operate internationally to carry out the purposes of 
     this section;
       (B) to lead in developing a global pandemic prevention, 
     preparedness and response framework to support global 
     pandemic prevention, preparedness, responses and recovery 
     efforts, including through--
       (i) diplomatic engagement and related foreign policy 
     efforts, such as multilateral and bilateral arrangements, 
     enhanced coordination of engagement with multilateral 
     organizations and countries, and the mobilization of donor 
     contributions; and
       (ii) support for United States citizens living abroad, 
     including consular support;
       (C) to serve as the representative of the Department of 
     State on the Committee on Global Health Security and Pandemic 
     and Biological Threats authorized to be established under 
     subsection (b)(2)(B);
       (D) to represent the United States in the multilateral, 
     catalytic financing mechanism described in section 
     1296(b)(1);
       (E) to transfer and allocate United States foreign 
     assistance funding authorized to be appropriated pursuant to 
     paragraph (6) to the relevant Federal departments and 
     agencies implementing the strategy required under subsection 
     (b), in coordination with the Office of Management and Budget 
     and USAID;
       (F) to utilize detailees, on a reimbursable or 
     nonreimbursable basis, from the relevant Federal departments 
     and agencies and hire personal service contractors, who may 
     operate domestically and internationally, to ensure that the 
     Office of the Special Representative has access to the 
     highest quality experts available to the United States 
     Government to carry out the functions under this subtitle; 
     and
       (G) to perform such other functions as the Secretary of 
     State may assign.
       (4) Duties.--The Special Representative shall coordinate, 
     manage, and oversee United States foreign policy, diplomatic 
     efforts, and foreign assistance funded with amounts 
     appropriated pursuant to paragraph (6) to advance the 
     relevant elements of the United States Global Health Security 
     and Diplomacy Strategy developed pursuant to subsection (b), 
     including by--
       (A) developing and coordinating a global pandemic 
     prevention, preparedness and response framework consistent 
     with paragraph (3)(B);
       (B) enhancing engagement with multilateral organizations 
     and partner countries, including through the mobilization of 
     donor support;
       (C) enhancing coordination of consular services for United 
     States citizens abroad in the event of a global health 
     emergency;
       (D) ensuring effective program coordination and 
     implementation of international activities, by the relevant 
     Federal departments and agencies by--
       (i) formulating, issuing, and updating related policy 
     guidance;
       (ii) establishing, in consultation with USAID and the 
     Department of Health and Human Services, unified auditing, 
     monitoring, and evaluation plans;
       (iii) aligning, in coordination with United States chiefs 
     of mission and country teams in partner countries--

       (I) the foreign assistance resources funded with amounts 
     appropriated pursuant to paragraph (6); and
       (II) international activities described in the 
     implementation plans required under subsection (b)(3)(B) with 
     the relevant Federal departments and agencies in a manner 
     that--

       (aa) is consistent with Executive Order 13747 (81 Fed. Reg. 
     78701; relating to Advancing the Global Health Security 
     Agenda to Achieve a World Safe and Secure from Infectious 
     Disease Threats);
       (bb) is consistent with the National Security Memorandum on 
     United States Global Leadership to Strengthen the 
     International COVID-19 Response and to Advance Global Health 
     Security and Biological Preparedness, issued by President 
     Biden on January 21, 2021; and
       (cc) reflects and leverages the unique capabilities of each 
     such department and agency;
       (iv) convening, as appropriate, an interagency working 
     group on international pandemic prevention and preparedness, 
     headed by the Special Representative and including 
     representatives from the relevant Federal departments and 
     agencies, to facilitate coordination of activities relating 
     to pandemic

[[Page S8170]]

     prevention and preparedness in partner countries under this 
     subtitle;
       (v) working with, and leveraging the expertise and 
     activities of, the Office of the United States Global AIDS 
     Coordinator, the Office of the United States Global Malaria 
     Coordinator, and similar or successor entities that are 
     implementing United States global health assistance overseas; 
     and
       (vi) avoiding duplication of effort and working to resolve 
     policy, program, and funding disputes among the relevant 
     Federal departments and agencies;
       (E) leading diplomatic efforts to identify and address 
     current and emerging threats to global health security;
       (F) coordinating, in consultation with the Secretary of 
     Health and Human Services and the USAID Administrator, 
     effective representation of the United States in relevant 
     international forums, including at the World Health 
     Organization, the World Health Assembly, and meetings of the 
     Global Health Security Agenda and of the Global Health 
     Security Initiative;
       (G) working to enhance coordination with, and transparency 
     among, the governments of partner countries and key 
     stakeholders, including the private sector;
       (H) promoting greater donor and national investment in 
     partner countries to build more resilient health systems and 
     supply chains, including through representation and 
     participation in a multilateral, catalytic financing 
     mechanism for global health security and pandemic prevention 
     and preparedness, consistent with section 1296;
       (I) securing bilateral and multilateral financing 
     commitments to advance the Global Health Security Agenda, in 
     coordination with the relevant Federal departments and 
     agencies, including through funding for the financing 
     mechanism described in section 1296; and
       (J) providing regular updates to the appropriate 
     congressional committees, the Committee on Health, Education, 
     Labor, and Pensions of the Senate, and the Committee on 
     Energy and Commerce of the House of Representatives regarding 
     the fulfillment of the duties described in this subsection.
       (5) Deputy representative.--The Special Representative 
     should be supported by a deputy, who--
       (A) should be an employee of USAID serving in a career or 
     noncareer position in the Senior Executive Service or at the 
     level of a Deputy Assistant Administrator or higher;
       (B) should have demonstrated knowledge and experience in 
     the fields of development and public health, epidemiology, or 
     medicine; and
       (C) serves concurrently as the deputy and performs the 
     functions described in section 3(h) of Executive Order 13747 
     (81 Fed. Reg. 78701).
       (6) Authorization of appropriations.--
       (A) In general.--There is authorized to be appropriated 
     $5,000,000,000, for the 5-year period beginning on October 1, 
     2022, to carry out the purposes of this subsection and 
     section 1296, which, in consultation with the appropriate 
     congressional committees and subject to the requirements 
     under chapters 1 and 10 of part I and section 634A of the 
     Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.), may 
     include support for--
       (i) enhancing preparedness in partner countries through 
     implementation of the Global Health Security Strategy 
     developed pursuant to subsection (b);
       (ii) replenishing the Emergency Reserve Fund at USAID, 
     established pursuant to section 7058(c)(1) of the Department 
     of State, Foreign Operations, and Related Programs 
     Appropriations Act, 2017 (division J of Public Law 115-31) to 
     address new or emerging infectious disease threats, as 
     necessary and appropriate;
       (iii) United States contributions to the World Bank Health 
     Emergency Preparedness and Response Multi-Donor Fund; and
       (iv) United States contributions to a multilateral, 
     catalytic financing mechanism for global health security and 
     pandemic prevention and preparedness described in section 
     1296(b).
       (B) Exception.--Section 110 of the Trafficking Victims 
     Protection Act of 2000 (22 U.S.C. 7107) shall not apply to 
     assistance made available pursuant to this subsection.
       (e) Resilience.--It shall be the policy of the United 
     States to support the growth of healthier, more stable 
     societies, while advancing the global health security 
     interests of the United States by working with key 
     stakeholders--
       (1) in developing countries that are highly vulnerable to 
     the emergence, reemergence, and spread of infectious diseases 
     with pandemic potential, including disease outbreaks 
     resulting from natural and manmade disasters, human 
     displacement, loss of natural habitat, poor access to water, 
     sanitation, and hygiene, and other political, security, 
     economic, and climatic shocks and stresses;
       (2) to develop effective tools to identify, analyze, 
     forecast, and mitigate the risks that make such countries 
     vulnerable;
       (3) to better integrate short-, medium-, and long-term 
     recovery efforts into global health emergency response and 
     disaster relief; and
       (4) to ensure that international assistance and financing 
     tools are effectively designed, objectively informed, 
     strategically targeted, carefully coordinated, reasonably 
     adapted, and rigorously monitored and evaluated in a manner 
     that advances the policy objectives under this subsection.
       (f) Strengthening Health Systems.--
       (1) Statement of policy.--It shall be the policy of the 
     United States to ensure that bilateral global health 
     assistance programs are effectively managed and coordinated 
     to contribute to the strengthening of health systems in each 
     country in which such programs are carried out, as necessary 
     and appropriate for the purposes of achieving improved health 
     outcomes.
       (2) Coordination.--The Administrator of USAID shall work 
     with the Global Malaria Coordinator and the United States 
     Global AIDS Coordinator and Special Representative for Global 
     Health Diplomacy at the Department of State, and, as 
     appropriate, the Secretary of Health and Human Services, to 
     identify areas of collaboration and coordination in countries 
     with global health programs and activities undertaken by 
     USAID pursuant to the United States Leadership Against HIV/
     AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law 108-
     25) and other relevant statutes to ensure that such 
     activities contribute to health systems strengthening.
       (3) Pilot program .--
       (A) In general.--The Administrator of USAID should identify 
     not fewer than 5 countries in which the United States has 
     significant bilateral investments in global health to develop 
     an integrated approach toward health systems strengthening 
     that takes advantage of all sources of funding for global 
     health in such country, with the aim of establishing an 
     enduring model for coordinating health systems strengthening 
     activities, including improving pandemic preparedness in 
     additional countries in the future.
       (B) Assessment.--In each of the countries selected under 
     subparagraph (A), USAID missions, in consultation with 
     USAID's Office of Health Systems, should conduct an 
     assessment that--
       (i) takes a comprehensive view of the constraints in the 
     country's health system that prevent the achievement of 
     desired outcomes of United States Government-supported health 
     programs;
       (ii) identifies the best opportunities for improving health 
     systems to achieve improved outcomes, including obstacles to 
     health service delivery;
       (iii) maps the resources of the country and other donors in 
     the health sector with a focus on investment in health system 
     strengthening; and
       (iv) develops, based on the results of the assessment 
     described in clause (i), and implements a new or revised 5-
     year strategy for United States assistance to strengthen the 
     country's health system that--

       (I) provides a framework for implementing such strategy;
       (II) identifies key areas for investments to strengthen the 
     health system in alignment with other donors and achieve 
     health outcomes beyond a single sector;
       (III) specifies the anticipated role of health programs 
     undertaken by each of the relevant Federal departments and 
     agencies operating in the country in implementing such 
     strategy;
       (IV) includes clear goals, benchmarks, outputs, desired 
     outcomes, a means of measuring progress and a cost analysis; 
     and
       (V) requires reporting by each Federal department and 
     agency regarding their participation and contribution, 
     including in the PEPFAR Annual Report to Congress.

       (C) Strategies to strengthen health systems.--USAID 
     missions in countries identified pursuant subparagraph (A) 
     should develop a strategy to strengthen health systems based 
     on the assessment developed pursuant to subparagraph (B) 
     that--
       (i) ensures complementarity with priorities identified 
     under any other action plan focused on strengthening a 
     country's health system, such as the World Health 
     Organization's Joint External Evaluation and National Action 
     Plans for Health Security;
       (ii) identifies bureaucratic barriers and inefficiencies, 
     including poor linkages between government ministries and 
     between ministries and donor agencies and the extent of any 
     corruption, and identify actions to overcome such barriers;
       (iii) identifies potential obstacles to the implementation 
     of the strategy, such as issues relating to lack of political 
     will, poor governance of an effective health system at all 
     levels of the country's public health systems, especially 
     with respect to governing bodies and councils at the 
     provincial, district, and community levels, and the exclusion 
     of women, minorities, other underserved groups, and frontline 
     health workers in decision making;
       (iv) includes proposals for mobilizing sufficient and 
     durable financing for health systems;
       (v) identifies barriers to building and retaining an 
     effective frontline health workforce with key global health 
     security capacities, informed by the International Health 
     Regulations (2005), including--

       (I) strengthened data collection and analysis;
       (II) data driven decision making capacity;
       (III) recommendations for partner country actions to 
     achieve a workforce that conforms with the World Health 
     Organization's recommendation for at least 44.5 doctors, 
     nurses, and midwives and at least 15 paid, trained, equipped, 
     and professionally supervised community health workers for 
     every 10,000 people, while supporting proper distribution and 
     high-quality job performance; and
       (IV) inclusion of the community health workforce in 
     planning for a resilient health

[[Page S8171]]

     system to ensure essential service delivery and pandemic 
     response;

       (vi) identifies deficiencies in information systems and 
     communication technologies that prevent linkages at all 
     levels of the health system delivery and medical supply 
     systems and promotes interoperability across data systems 
     with near real-time data, while protecting data security;
       (vii) identifies weaknesses in supply chain and procurement 
     systems and practices, and recommends ways to improve the 
     efficiency, transparency, and effectiveness of such systems 
     and practices;
       (viii) identifies obstacles to health service access and 
     quality and improved health outcomes for women and girls, and 
     for the poorest and most vulnerable, including a lack of 
     social support and other underlying causes, and 
     recommendations for how to overcome such obstacles;
       (ix) includes plans for integrating innovations in health 
     technologies, services, and systems;
       (x) identifies barriers to health literacy, community 
     engagement, and patient empowerment, and recommendations for 
     overcoming such barriers;
       (xi) includes proposals for strengthening community health 
     systems and the community-based health workforce informed by 
     the World Health Organization guideline on health policy and 
     system support to optimize community health worker programmes 
     (2018), including the professionalization of community health 
     workers;
       (xii) describes the role of the private sector and 
     nongovernmental health providers, including community groups 
     engaged in health promotion and mutual assistance and other 
     institutions engaged in health delivery, including the extent 
     to which the local population utilizes such health services;
       (xiii) facilitates rapid response during health 
     emergencies, such as last mile delivery of vaccines to 
     respond to and prevent the spread of infectious diseases with 
     epidemic and pandemic potential; and
       (xiv) ensures that relevant USAID missions and bureaus are 
     appropriately staffed and resourced to carry out such 
     activities efficiently, effectively, and in-line with best 
     practices.
       (D) Consultation and reporting requirements.--
       (i) Consultation.--In developing a strategy pursuant to 
     subparagraph (C), each USAID mission should consult with a 
     wide variety of stakeholders, including--

       (I) relevant partner government institutions;
       (II) professional associations;
       (III) patient groups;
       (IV) civil society organizations (including international 
     nongovernmental organizations with relevant expertise in 
     program implementation); and
       (V) the private sector.

       (ii) Reporting.--Not later than 180 days after the date of 
     the enactment of this Act, the Administrator of USAID and the 
     United States Global AIDS Coordinator shall submit a report 
     to the appropriate congressional committees detailing the 
     progress of the pilot program authorized under this 
     paragraph, including--

       (I) progress made toward the integration and co-financing 
     of health systems strengthening activities by USAID and the 
     Office of the Global AIDS Coordinator; and
       (II) the results of integrated efforts under this section, 
     including for cross-cutting efforts to strengthen local 
     health workforces.

       (4) Technical capacity.--
       (A) In general.--The Administrator of USAID shall ensure 
     that USAID is sufficiently resourced and staffed to ensure 
     performance, consistency, and adoption of best practices in 
     USAID's health systems programs, including the pilot program 
     authorized under paragraph (3).
       (B) Resources.--The Administrator of USAID and the United 
     States Global AIDS Coordinator shall include detail in the 
     fiscal year 2023 Congressional Budget Justification regarding 
     health systems strengthening activities, including--
       (i) the plans for, and the progress toward, reaching the 
     capacity described in subparagraph (A);
       (ii) the requirements for sustaining such capacity, 
     including the resources needed by USAID; and
       (iii) budget detail on the integration and joint funding of 
     health systems capacity building, as appropriate.
       (5) International efforts.--The Secretary of State, in 
     coordination with the Administrator of USAID and, as 
     appropriate, the Secretary of Health and Human Services, 
     should work with the Global Fund to Fight AIDS, Tuberculosis, 
     and Malaria, Gavi, the Vaccine Alliance, bilateral donors, 
     and other relevant multilateral and international 
     organizations and stakeholders to develop--
       (A) shared core indicators for strengthened health systems;
       (B) agreements among donors that reporting requirements for 
     health systems come from country systems to reduce the burden 
     placed on partner countries;
       (C) structures for joint assessments, plans, auditing, and 
     consultations; and
       (D) a regularized approach to coordination on health 
     systems strengthening.
       (6) Public private partnerships to improve health systems 
     strengthening.--The country strategies developed under 
     paragraph (3)(C) should include a section that--
       (A) discusses the role of the private sector (including 
     corporate, local, and international organizations with 
     relevant expertise); and
       (B) identifies relevant opportunities for the private 
     sector--
       (i) to accelerate research and development of innovative 
     health and information technology, and to offer training 
     related to its use;
       (ii) to contribute to improvements in health administration 
     and management processes;
       (iii) to improve system efficiency;
       (iv) to develop training related to clinical practice 
     guidelines; and
       (v) to help countries develop systems for documenting 
     outcomes and achievements related to activities undertaken to 
     strengthen the health sector.
       (7) Authorization for use of funds.--Amounts authorized to 
     be appropriated or otherwise made available to carry out 
     section 104 of the Foreign Assistance Act of 1961 (22 U.S.C. 
     2151b) may be made available to carry out this subsection.
       (g) Additional Authorities.--
       (1) Foreign assistance act of 1961.--Chapter 1 of part I of 
     the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) 
     is amended--
       (A) in section 104(c)(1) (22 U.S.C. 2151b(c)(1)), by 
     inserting ``(emphasizing health systems strengthening, as 
     appropriate)'' after ``health services'';
       (B) in section 104A (22 U.S.C. 2151b-2)--
       (i) in subsection (b)(3)(D), by striking ``including health 
     care systems, under other international donor support'' and 
     inserting ``including through support for health systems 
     strengthening, under other donor support''; and
       (ii) in subsection (f)(3)(Q), by inserting ``the Office of 
     the United States Global AIDS Coordinator, partner countries, 
     and the Global Fund to Fight AIDS, Tuberculosis, and Malaria 
     to ensure that their actions support the activities taken to 
     strengthen the overall health systems in recipient countries, 
     and efforts by'' after ``efforts by''; and
       (C) in section 104B(g)(2) (22 U.S.C. 2151b-3(g)(2)), by 
     inserting ``strengthening the health system of the country 
     and'' after ``contribute to''.
       (2) United states leadership against hiv/aids, 
     tuberculosis, and malaria act of 2003.--Section 204(a) of the 
     United States Leadership Against HIV/AIDS, Tuberculosis, and 
     Malaria Act of 2003 (22 U.S.C. 7623(a)) is amended--
       (A) in paragraph (1)(A), by inserting ``in a manner that is 
     coordinated with, and contributes to, efforts through other 
     assistance activities being carried out to strengthen 
     national health systems and health policies'' after 
     ``systems''; and
       (B) in paragraph (2)--
       (i) in subparagraph (C), by inserting ``as part of a 
     strategy to improve overall health'' before the semicolon at 
     the end;
       (ii) in subparagraph (D), by striking ``and'' at the end;
       (iii) in subparagraph (E), by striking the period at the 
     end and inserting ``; and''; and
       (iv) by adding at the end the following:
       ``(F) to contribute to efforts that build health systems 
     capable of preventing, detecting and responding to HIV/AIDS, 
     tuberculosis, malaria and other infectious diseases with 
     pandemic potential.''.
       (h) Authorization for United States Participation in the 
     Coalition for Epidemic Preparedness Innovations.--
       (1) In general.--The United States is authorized to 
     participate in the Coalition for Epidemic Preparedness 
     Innovations (referred to in this subsection as ``CEPI'').
       (2) Investors council and board of directors.--
       (A) Initial designation.--The President shall designate an 
     employee of USAID to serve on the Investors Council and, if 
     nominated, on the Board of Directors of CEPI, as a 
     representative of the United States during the period 
     beginning on the date of such designation and ending on 
     September 30, 2022.
       (B) Ongoing designations.--The President may designate an 
     employee of the relevant Federal department or agency with 
     fiduciary responsibility for United States contributions to 
     CEPI to serve on the Investors Council and, if nominated, on 
     the Board of Directors of CEPI, as a representative of the 
     United States.
       (C) Qualifications.--Any employee designated pursuant to 
     subparagraph (A) or (B) shall have demonstrated knowledge and 
     experience in the fields of development and public health, 
     epidemiology, or medicine, from the Federal department or 
     agency with primary fiduciary responsibility for United 
     States contributions pursuant to paragraph (3).
       (D) Coordination .--In carrying out the responsibilities 
     under this subsection, an employee designated by the 
     President to serve on the Investors Council or the Board of 
     Directors, as applicable, shall coordinate with the Secretary 
     of Health and Human Services to promote alignment, as 
     appropriate, between CEPI and the strategic objectives and 
     activities of the Secretary of Health and Human Services with 
     respect to the research, development, and procurement of 
     medical countermeasures, consistent with titles III and 
     XXVIII of the Public Health Service Act (42 U.S.C. 241 et 
     seq. and 300hh et seq.).
       (3) Consultation.--Not later than 60 days after the date of 
     the enactment of this Act, the employee designated pursuant 
     to paragraph (2)(A) shall consult with the appropriate 
     congressional committees, the Committee on Health, Education, 
     Labor, and Pensions of the Senate, and the Committee

[[Page S8172]]

     on Energy and Commerce of the House of Representatives 
     regarding--
       (A) the manner and extent to which the United States plans 
     to participate in CEPI, including through the governance of 
     CEPI;
       (B) any planned financial contributions from the United 
     States to CEPI; and
       (C) how participation in CEPI is expected to support--
       (i) the United States Global Health Security Strategy 
     required under this subtitle;
       (ii) the applicable revision of the National Biodefense 
     Strategy required under section 1086 of the National Defense 
     Authorization Act for Fiscal Year 2017 (6 U.S.C. 104); and
       (iii) any other relevant programs relating to global health 
     security and biodefense.
       (4) United states contributions.--
       (A) Sense of congress.--It is the sense of Congress that 
     the President, consistent with the provisions under section 
     10003(a)(1) of the American Rescue Plan Act of 2021, should 
     make an immediate contribution to CEPI in the amount of 
     $300,000,000, to expand research and development of vaccines 
     to combat the spread of COVID-19 variants.
       (B) Notification.--Not later than 15 days before a 
     contribution is made available pursuant to subparagraph (A), 
     the President shall notify the appropriate congressional 
     committees of the details of the amount, purposes, and 
     national interests served by such contribution.
       (i) Intelligence Assessments Regarding Novel Diseases and 
     Pandemic Threats.--
       (1) Defined term.--In this subsection, the term 
     ``appropriate committees of Congress'' means--
       (A) the Committee on Foreign Relations of the Senate;
       (B) the Select Committee on Intelligence of the Senate;
       (C) the Committee on Health, Education, Labor, and Pensions 
     of the Senate;
       (D) the Committee on Foreign Affairs of the House of 
     Representatives;
       (E) the Permanent Select Committee on Intelligence of the 
     House of Representatives; and
       (F) the Committee on Energy and Commerce of the House of 
     Representatives.
       (2) Intelligence assessments.--
       (A) In general.--Not later than 1 year after the date of 
     the enactment of this Act, and annually thereafter for the 
     following 4 years, the National Intelligence Council shall 
     submit to the appropriate committees of Congress an 
     intelligence assessment regarding the risks posed to the 
     national security interests of the United States by the 
     emergence, reemergence, and overseas transmission of 
     pathogens with pandemic potential.
       (B) Elements.--The intelligence assessments submitted 
     pursuant to subparagraph (A) shall--
       (i) identify the countries or regions most vulnerable to 
     the emergence or reemergence of a pathogen with pandemic 
     potential, including the most likely sources and pathways of 
     such emergence or reemergence, whether naturally occurring, 
     accidental, or deliberate;
       (ii) assess the likelihood that a pathogen described in 
     clause (i) will spread to the United States, the United 
     States Armed Forces, diplomatic or development personnel of 
     the United States stationed abroad, or citizens of the United 
     States living abroad in a manner that could lead to an 
     epidemic in the United States or otherwise affect the 
     national security or economic prosperity of the United 
     States;
       (iii) assess the preparedness of countries around the 
     world, particularly those identified pursuant to clause (i), 
     to prevent, detect, and respond to pandemic threats; and
       (iv) identify any scientific, capacity, or governance gaps 
     in the preparedness of countries identified pursuant to 
     clause (i), including an analysis of the capacity and 
     performance of any country or entity described in clause 
     (iii) in complying with biosecurity standards, as applicable.
       (3) Congressional briefings.--The National Intelligence 
     Council shall provide an annual briefing to the appropriate 
     committees of Congress regarding--
       (A) the most recent intelligence assessments submitted 
     pursuant to paragraph (2)(A); and
       (B) the emergence or reemergence of pathogens with pandemic 
     potential that could lead to an epidemic described in 
     paragraph (2)(A)(ii).
       (4) Public availability.--The Director of National 
     Intelligence shall make publicly available an unclassified 
     version of each intelligence assessment submitted pursuant to 
     paragraph (2)(A).
       (j) Pandemic Early Warning Network.--
       (1) In general.--The Secretary of State and the Secretary 
     of Health and Human Services, in coordination with the USAID 
     Administrator, the Director of the Centers for Disease 
     Control and Prevention, and the heads of the other relevant 
     Federal departments and agencies, shall work with the World 
     Health Organization and other key stakeholders to establish 
     or strengthen effective early warning systems, at the partner 
     country, regional, and international levels, that utilize 
     innovative information and analytical tools and robust review 
     processes to track, document, analyze, and forecast 
     infectious disease threats with epidemic and pandemic 
     potential.
       (2) Report.--Not later than 1 year after the date of the 
     enactment of this Act, and annually thereafter for the 
     following 4 years, the Secretary of State, in coordination 
     with the Secretary of Health and Human Services and the heads 
     of the other relevant Federal departments and agencies, shall 
     submit a report to the appropriate congressional committees, 
     the Committee on Health, Education, Labor, and Pensions of 
     the Senate, and the Committee on Energy and Commerce of the 
     House of Representatives that describes United States 
     Government efforts and opportunities to establish or 
     strengthen effective early warning systems to detect 
     infectious disease threats internationally.
       (k) International Emergency Operations.--
       (1) Sense of congress.--It is the sense of Congress that it 
     is essential to enhance the capacity of key stakeholders to 
     effectively operationalize early warning and execute multi-
     sectoral emergency operations during an infectious disease 
     outbreak, particularly in countries and areas that 
     deliberately withhold critical global health data and delay 
     access during an infectious disease outbreak in advance of 
     the next infectious disease outbreak with pandemic potential.
       (2) Public health emergencies of international concern.--
     The Secretary of State, in coordination with the Secretary of 
     Health and Human Services, should work with the World Health 
     Organization and like-minded member states to adopt an 
     approach toward assessing infectious disease threats under 
     the International Health Regulations (2005) for the World 
     Health Organization to identify and transparently 
     communicate, on an ongoing basis, varying levels of risk 
     leading up to a declaration by the Director General of the 
     World Health Organization of a Public Health Emergency of 
     International Concern for the duration and in the aftermath 
     of such declaration.
       (3) Emergency operations.--The Secretary of State and the 
     Secretary of Health and Human Services, in coordination with 
     the USAID Administrator, the Director of the Centers for 
     Disease Control and Prevention, and the heads of other 
     relevant Federal departments and agencies, and consistent 
     with the requirements under the International Health 
     Regulations (2005) and the objectives of the World Health 
     Organization's Health Emergencies Programme, the Global 
     Health Security Agenda, and national actions plans for health 
     security, shall work, in coordination with the World Health 
     Organization, with partner countries and other key 
     stakeholders to support the establishment, strengthening, and 
     rapid response capacity of global health emergency operations 
     centers, at the partner country and international levels, 
     including efforts--
       (A) to collect and share public health data, assess risk, 
     and operationalize early warning;
       (B) to secure, including through utilization of stand-by 
     arrangements and emergency funding mechanisms, the staff, 
     systems, and resources necessary to execute cross-sectoral 
     emergency operations during the 48-hour period immediately 
     following an infectious disease outbreak with pandemic 
     potential; and
       (C) to organize and conduct emergency simulations.

     SEC. 1296. FINANCING MECHANISM FOR GLOBAL HEALTH SECURITY AND 
                   PANDEMIC PREVENTION AND PREPAREDNESS.

       (a) Eligible Partner Country Defined.--In this section, the 
     term ``eligible partner country'' means a country in which 
     the Fund for Global Health Security and Pandemic Prevention 
     and Preparedness to be established under subsection (b) may 
     finance global health security and pandemic prevention and 
     preparedness assistance programs under this subtitle based on 
     the country's demonstrated--
       (1) need, as identified through the Joint External 
     Evaluation process, the Global Health Security Index 
     classification of health systems, national action plans for 
     health security, the World Organization for Animal Health's 
     Performance of Veterinary Services evaluation, and other 
     complementary or successor indicators of global health 
     security and pandemic prevention and preparedness; and
       (2) commitment to transparency, including--
       (A) budget and global health data transparency;
       (B) complying with the International Health Regulations 
     (2005);
       (C) investing in domestic health systems; and
       (D) achieving measurable results.
       (b) Establishment of Fund for Global Health Security and 
     Pandemic Prevention and Preparedness.--
       (1) Negotiations for establishment of fund for global 
     health security and pandemic prevention and preparedness.--
     The Secretary of State, in coordination with the USAID 
     Administrator, the Secretary of Health and Human Services, 
     and the heads of other relevant Federal departments and 
     agencies, as necessary and appropriate, should seek to enter 
     into negotiations with donors, relevant United Nations 
     agencies, including the World Health Organization, and other 
     key multilateral stakeholders, to establish--
       (A) a multilateral, catalytic financing mechanism for 
     global health security and pandemic prevention and 
     preparedness, which may be known as the Fund for Global 
     Health Security and Pandemic Prevention and Preparedness 
     (referred to in this section as ``the Fund''), to address the 
     need for and secure durable financing in accordance with the 
     provisions of this subsection; and
       (B) an Advisory Board to the Fund in accordance with 
     subsection (e).

[[Page S8173]]

       (2) Purposes.--The purposes of the Fund should be--
       (A) to close critical gaps in global health security and 
     pandemic prevention and preparedness; and
       (B) to work with, and build the capacity of, eligible 
     partner countries in the areas of global health security, 
     infectious disease control, and pandemic prevention and 
     preparedness, in a manner that--
       (i) prioritizes capacity building and financing 
     availability in eligible partner countries;
       (ii) incentivizes countries to prioritize the use of 
     domestic resources for global health security and pandemic 
     prevention and preparedness;
       (iii) leverages government, nongovernment, and private 
     sector investments;
       (iv) regularly responds to and evaluates progress based on 
     clear metrics and benchmarks, such as the Joint External 
     Evaluation and the Global Health Security Index;
       (v) aligns with and complements ongoing bilateral and 
     multilateral efforts and financing, including through the 
     World Bank, the World Health Organization, the Global Fund to 
     Fight AIDS, Tuberculosis, and Malaria, the Coalition for 
     Epidemic Preparedness and Innovation, and Gavi, the Vaccine 
     Alliance; and
       (vi) helps countries accelerate and achieve compliance with 
     the International Health Regulations (2005) and the 
     fulfillment of the Global Health Security Agenda 2024 
     Framework not later than 5 years after the date on which the 
     Fund is established, in coordination with the ongoing Joint 
     External Evaluation national action planning process.
       (3) Executive board.--
       (A) In general.--The Fund should be governed by a 
     transparent and accountable body (referred to in this section 
     as the ``Executive Board''), which should--
       (i) function as a partnership with, and through full 
     engagement by, donor governments, eligible partner countries, 
     and independent civil society; and
       (ii) be composed of not more than 20 representatives of 
     governments, foundations, academic institutions, independent 
     civil society, indigenous people, vulnerable communities, 
     frontline health workers, and the private sector with 
     demonstrated commitment to carrying out the purposes of the 
     Fund and upholding transparency and accountability 
     requirements.
       (B) Duties.--The Executive Board should--
       (i) be charged with approving strategies, operations, and 
     grant making authorities in order to conduct effective 
     fiduciary, monitoring, and evaluation efforts, and other 
     oversight functions;
       (ii) determine operational procedures such that the Fund is 
     able to effectively fulfill its mission;
       (iii) provide oversight and accountability for the Fund in 
     collaboration with the Inspector General to be established 
     pursuant to subsection (d)(5)(A)(i);
       (iv) develop and utilize a mechanism to obtain formal input 
     from eligible partner countries, independent civil society, 
     and implementing entities relative to program design, review, 
     and implementation and associated lessons learned; and
       (v) coordinate and align with other multilateral financing 
     and technical assistance activities, and with the United 
     States and other nations leading outbreak prevention, 
     preparedness, and response activities in partner countries, 
     as appropriate.
       (C) Composition.--The Executive Board should include--
       (i) representatives of the governments of founding member 
     countries who, in addition to the requirements under 
     subparagraph (A), qualify based upon meeting an established 
     initial contribution threshold, which should be not less than 
     10 percent of total initial contributions, and a demonstrated 
     commitment to supporting the International Health Regulations 
     (2005);
       (ii) a geographically diverse group of members who--

       (I) come from donor countries, eligible partner countries, 
     academic institutions, independent civil society, including 
     indigenous organizations, and the private sector; and
       (II) are selected on the basis of their experience and 
     commitment to innovation, best practices, and the advancement 
     of global health security objectives;

       (iii) representatives of the World Health Organization; and
       (iv) the chair of the Global Health Security Steering 
     Group.
       (D) Contributions.--Each government or private sector 
     entity represented on the Executive Board should agree to 
     make annual contributions to the Fund in an amount not less 
     than the minimum determined by the Executive Board.
       (E) Qualifications.--Individuals appointed to the Executive 
     Board should have demonstrated knowledge and experience 
     across a variety of sectors, including human and animal 
     health, agriculture, development, defense, finance, research, 
     and academia.
       (F) Conflicts of interest.--
       (i) Technical experts.--The Executive Board may include 
     independent technical experts who are not affiliated with, or 
     employed by, a recipient country or organization.
       (ii) Multilateral bodies and institutions.--Executive Board 
     members appointed pursuant to subparagraph (C)(iii) should be 
     required to recuse themselves from matters presenting 
     conflicts of interest, including financing decisions relating 
     to such bodies and institutions.
       (G) United states representation.--
       (i) Founding member.--The Secretary of State should seek--

       (I) to establish the United States as a founding member of 
     the Fund; and
       (II) to ensure that the United States is represented on the 
     Executive Board by an officer or employee of the United 
     States, who shall be appointed by the President.

       (ii) Effective and termination dates.--

       (I) Effective date.--This subparagraph shall take effect 
     upon the date on which the Secretary of State certifies and 
     submits to Congress an agreement establishing the Fund.
       (II) Termination date.--The membership established pursuant 
     to clause (i) shall terminate upon the date of termination of 
     the Fund.

       (H) Removal procedures.--The Fund should establish 
     procedures for the removal of members of the Executive Board 
     who--
       (i) engage in a consistent pattern of human rights abuses;
       (ii) fail to uphold global health data transparency 
     requirements; or
       (iii) otherwise violate the established standards of the 
     Fund, including in relation to corruption.
       (c) Authorities.--
       (1) Program objectives.--
       (A) In general.--In carrying out the purpose set forth in 
     subsection (b), the Fund, acting through the Executive Board, 
     should--
       (i) develop grant making requirements to be administered by 
     an independent technical review panel comprised of entities 
     barred from applying for funding or support;
       (ii) provide grants, including challenge grants, technical 
     assistance, concessional lending, catalytic investment funds, 
     and other innovative funding mechanisms, in coordination with 
     ongoing bilateral and multilateral efforts, as appropriate--

       (I) to help eligible partner countries close critical gaps 
     in health security, as identified through the Joint External 
     Evaluation process, the Global Health Security Index 
     classification of health systems, and national action plans 
     for health security and other complementary or successor 
     indicators of global health security and pandemic prevention 
     and preparedness; and
       (II) to support measures that enable such countries, at the 
     national and subnational levels, and in partnership with 
     civil society and the private sector, to strengthen and 
     sustain resilient health systems and supply chains with the 
     resources, capacity, and personnel required to prevent, 
     detect, mitigate, and respond to infectious disease threats, 
     including the emergence or reemergence of pathogens, before 
     they become pandemics;

       (iii) leverage the expertise, capabilities, and resources 
     of proven, existing agencies and organizations to effectively 
     target and manage resources for impact, including through 
     alignment with, and co-financing of, complementary programs, 
     as appropriate and consistent with subparagraph (C); and
       (iv) develop recommendations for a mechanism for assisting 
     countries that are at high risk for the emergence or 
     reemergence of pathogens with pandemic potential to 
     participate in the Global Health Security Agenda and the 
     Joint External Evaluations.
       (B) Activities supported.--The activities to be supported 
     by the Fund should include efforts--
       (i) to enable eligible partner countries to formulate and 
     implement national health security and pandemic prevention 
     and preparedness action plans, advance action packages under 
     the Global Health Security Agenda, and adopt and uphold 
     commitments under the International Health Regulations (2005) 
     and other related international health agreements and 
     arrangements, as appropriate;
       (ii) to support health security budget planning in eligible 
     partner countries, including training in public financial 
     management, budget and health data transparency, human 
     resource information systems, and integrated and transparent 
     budget and health data;
       (iii) to strengthen the health workforce, including hiring, 
     training, and deploying experts and other essential staff, 
     including community health workers, to improve frontline 
     prevention of, and monitoring and preparedness for, unknown, 
     new, emerging, or reemerging pathogens, epidemics, and 
     pandemic threats, including capacity to surge and manage 
     additional staff during emergencies;
       (iv) to improve the quality of community health worker 
     programs as the foundation of pandemic preparedness and 
     response through application of appropriate assessment tools;
       (v) to improve infection prevention and control, the 
     protection of healthcare workers, including community health 
     workers, and access to water and sanitation within healthcare 
     settings;
       (vi) to combat the threat of antimicrobial resistance;
       (vii) to strengthen laboratory capacity and promote 
     biosafety and biosecurity through the provision of material 
     and technical assistance;
       (viii) to reduce the risk of bioterrorism, the emergence, 
     reemergence, or spread of zoonotic disease (whether through 
     loss of natural habitat, the commercial trade in wildlife for 
     human consumption, or other means), and accidental biological 
     release;
       (ix) to build technical capacity to manage, as appropriate, 
     supply chains for applicable global health commodities 
     through effective

[[Page S8174]]

     forecasting, procurement, warehousing, and delivery from 
     central warehouses to points of service in both the public 
     and private sectors;
       (x) to enable bilateral, regional, and international 
     partnerships and cooperation, including through pandemic 
     early warning systems and emergency operations centers, to 
     identify and address transnational infectious disease threats 
     exacerbated by natural and man-made disasters, human 
     displacement, and zoonotic infection;
       (xi) to establish partnerships for the sharing of best 
     practices and enabling eligible countries to meet targets and 
     indicators under the Joint External Evaluation process, the 
     Global Health Security Index classification of health 
     systems, and national action plans for health security 
     relating to the prevention, detection, and treatment of 
     neglected tropical diseases;
       (xii) to build the capacity of eligible partner countries 
     to prepare for and respond to second order development 
     impacts of infectious disease outbreaks and maintain 
     essential health services, while accounting for the 
     differentiated needs and vulnerabilities of marginalized 
     populations, including women and girls;
       (xiii) to develop and utilize metrics to monitor and 
     evaluate programmatic performance and identify best 
     practices, including in accordance with Joint External 
     Evaluation benchmarks, Global Health Security Agenda targets, 
     and Global Health Security Index indicators;
       (xiv) to develop and deploy mechanisms to enhance and 
     independently monitor the transparency and accountability of 
     global health security and pandemic prevention and 
     preparedness programs and data, in compliance with the 
     International Health Regulations (2005), including through 
     the sharing of trends, risks, and lessons learned;
       (xv) to promote broad participation in health emergency 
     planning and advisory bodies, including by women and 
     frontline health workers;
       (xvi) to develop and implement simulation exercises, 
     produce and release after action reports, and address related 
     gaps;
       (xvii) to support countries in conducting Joint External 
     Evaluations;
       (xviii) to improve disease surveillance capacity in partner 
     counties, including at the community level, such that those 
     countries are better able to detect and respond to known and 
     unknown pathogens and zoonotic infectious diseases; and
       (xix) to support governments through coordinated and 
     prioritized assistance efforts to prevent the emergence, 
     reemergence, or spread of zoonotic diseases caused by 
     deforestation, commercial trade in wildlife for human 
     consumption, climate-related events, and unsafe interactions 
     between wildlife, livestock, and people.
       (C) Implementation of program objectives.--In carrying out 
     the objectives under subparagraph (A), the Fund should work 
     to eliminate duplication and waste by upholding strict 
     transparency and accountability standards and coordinating 
     its programs and activities with key partners working to 
     advance global health security and pandemic prevention and 
     preparedness, including--
       (i) governments, independent civil society, nongovernmental 
     organizations, research and academic institutions, and 
     private sector entities in eligible partner countries;
       (ii) the pandemic early warning systems and international 
     emergency operations centers to be established under 
     subsections (j) and (k) of section 1295;
       (iii) the World Health Organization;
       (iv) the Global Health Security Agenda;
       (v) the Global Health Security Initiative;
       (vi) the Global Fund to Fight AIDS, Tuberculosis, and 
     Malaria;
       (vii) the United Nations Office for the Coordination of 
     Humanitarian Affairs, UNICEF, and other relevant funds, 
     programs, and specialized agencies of the United Nations;
       (viii) Gavi, the Vaccine Alliance;
       (ix) the Coalition for Epidemic Preparedness Innovations 
     (CEPI);
       (x) The World Organisation for Animal Health;
       (xi) The United Nations Environment Programme;
       (xii) Food and Agriculture Organization; and
       (xiii) the Global Polio Eradication Initiative.
       (2) Priority.--In providing assistance under this section, 
     the Fund should give priority to low-and lower middle income 
     countries with--
       (A) low scores on the Global Health Security Index 
     classification of health systems;
       (B) measurable gaps in global health security and pandemic 
     prevention and preparedness identified under Joint External 
     Evaluations and national action plans for health security;
       (C) demonstrated political and financial commitment to 
     pandemic prevention and preparedness; and
       (D) demonstrated commitment to upholding global health 
     budget and data transparency and accountability standards, 
     complying with the International Health Regulations (2005), 
     investing in domestic health systems, and achieving 
     measurable results.
       (3) Eligible grant recipients.--Governments and 
     nongovernmental organizations should be eligible to receive 
     grants as described in this section.
       (d) Administration.--
       (1) Appointments.--The Executive Board should appoint--
       (A) an Administrator, who should be responsible for 
     managing the day-to-day operations of the Fund; and
       (B) an independent Inspector General, who should be 
     responsible for monitoring grants implementation and 
     proactively safeguarding against conflicts of interests.
       (2) Authority to accept and solicit contributions.--The 
     Fund should be authorized to solicit and accept contributions 
     from governments, the private sector, foundations, 
     individuals, and nongovernmental entities.
       (3) Accountability; conflicts of interest; criteria for 
     programs.--As part of the negotiations described in 
     subsection (b)(1), the Secretary of the State, consistent 
     with paragraph (4), should--
       (A) take such actions as are necessary to ensure that the 
     Fund will have in effect adequate procedures and standards to 
     account for and monitor the use of funds contributed to the 
     Fund, including the cost of administering the Fund;
       (B) ensure there is agreement to put in place a conflict of 
     interest policy to ensure fairness and a high standard of 
     ethical conduct in the Fund's decision-making processes, 
     including proactive procedures to screen staff for conflicts 
     of interest and measures to address any conflicts, such as 
     potential divestments of interests, prohibition from engaging 
     in certain activities, recusal from certain decision-making 
     and administrative processes, and representation by an 
     alternate board member; and
       (C) seek agreement on the criteria that should be used to 
     determine the programs and activities that should be assisted 
     by the Fund.
       (4) Selection of partner countries, projects, and 
     recipients.--The Executive Board should establish--
       (A) eligible partner country selection criteria, to include 
     transparent metrics to measure and assess global health 
     security and pandemic prevention and preparedness strengths 
     and vulnerabilities in countries seeking assistance;
       (B) minimum standards for ensuring eligible partner country 
     ownership and commitment to long-term results, including 
     requirements for domestic budgeting, resource mobilization, 
     and co-investment;
       (C) criteria for the selection of projects to receive 
     support from the Fund;
       (D) standards and criteria regarding qualifications of 
     recipients of such support;
       (E) such rules and procedures as may be necessary for cost-
     effective management of the Fund; and
       (F) such rules and procedures as may be necessary to ensure 
     transparency and accountability in the grant-making process.
       (5) Additional transparency and accountability 
     requirements.--
       (A) Inspector general.--
       (i) In general.--The Secretary of State shall seek to 
     ensure that the Inspector General appointed pursuant to 
     paragraph (1)--

       (I) is fully enabled to operate independently and 
     transparently;
       (II) is supported by and with the requisite resources and 
     capacity to regularly conduct and publish, on a publicly 
     accessible website, rigorous financial, programmatic, and 
     reporting audits and investigations of the Fund and its 
     grantees; and
       (III) establishes an investigative unit that--

       (aa) develops an oversight mechanism to ensure that grant 
     funds are not diverted to illicit or corrupt purposes or 
     activities; and
       (bb) submits an annual report to the Executive Board 
     describing its activities, investigations, and results.
       (ii) Sense of congress on corruption.--It is the sense of 
     Congress that--

       (I) corruption within global health programs contribute 
     directly to the loss of human life and cannot be tolerated; 
     and
       (II) in making financial recoveries relating to a corrupt 
     act or criminal conduct under a grant, as determined by the 
     Inspector General, the responsible grant recipient should be 
     assessed at a recovery rate of up to 150 percent of such 
     loss.

       (B) Administrative expenses.--The Secretary of State shall 
     seek to ensure the Fund establishes, maintains, and makes 
     publicly available a system to track the administrative and 
     management costs of the Fund on a quarterly basis.
       (C) Financial tracking systems.--The Secretary of State 
     shall ensure that the Fund establishes, maintains, and makes 
     publicly available a system to track the amount of funds 
     disbursed to each grant recipient and sub-recipient during a 
     grant's fiscal cycle.
       (D) Exemption from duties and taxes.--The Secretary should 
     ensure that the Fund adopts rules that condition grants upon 
     agreement by the relevant national authorities in an eligible 
     partner country to exempt from duties and taxes all products 
     financed by such grants, including procurements by any 
     principal or sub-recipient for the purpose of carrying out 
     such grants.
       (e) Advisory Board.--
       (1) In general.--There should be an Advisory Board to the 
     Fund.
       (2) Appointments.--The members of the Advisory Board should 
     be composed of--
       (A) a geographically diverse group of individuals that 
     includes representation from low- and middle-income 
     countries;
       (B) individuals with experience and leadership in the 
     fields of development, global health, epidemiology, medicine, 
     biomedical research, and social sciences; and

[[Page S8175]]

       (C) representatives of relevant United Nations agencies, 
     including the World Health Organization, and nongovernmental 
     organizations with on-the ground experience in implementing 
     global health programs in low and lower-middle income 
     countries.
       (3) Responsibilities.--The Advisory Board should provide 
     advice and guidance to the Executive Board of the Fund on the 
     development and implementation of programs and projects to be 
     assisted by the Fund and on leveraging donations to the Fund.
       (4) Prohibition on payment of compensation.--
       (A) In general.--Except for travel expenses (including per 
     diem in lieu of subsistence), no member of the Advisory Board 
     should receive compensation for services performed as a 
     member of the Board.
       (B) United states representative.--Notwithstanding any 
     other provision of law (including an international 
     agreement), a representative of the United States on the 
     Advisory Board may not accept compensation for services 
     performed as a member of the Board, except that such 
     representative may accept travel expenses, including per diem 
     in lieu of subsistence, while away from the representative's 
     home or regular place of business in the performance of 
     services for the Board.
       (5) Conflicts of interest.--Members of the Advisory Board 
     should be required to disclose any potential conflicts of 
     interest prior to serving on the Advisory Board and, in the 
     event of any conflicts of interest, recuse themselves from 
     such matters during their service on the Advisory Board.
       (f) Reports to Congress.--
       (1) Status report.--Not later than 180 days after the date 
     of the enactment of this Act, the Secretary of State, in 
     coordination with the USAID Administrator, and the heads of 
     other relevant Federal departments and agencies, shall submit 
     a report to the appropriate congressional committees that 
     describes the progress of international negotiations to 
     establish the Fund.
       (2) Annual report.--
       (A) In general.--Not later than 1 year after the date of 
     the establishment of the Fund, and annually thereafter for 
     the duration of the Fund, the Secretary of State, shall 
     submit a report to the appropriate congressional committees 
     regarding the administration of the Fund.
       (B) Report elements.--The report required under 
     subparagraph (A) shall describe--
       (i) the goals of the Fund;
       (ii) the programs, projects, and activities supported by 
     the Fund;
       (iii) private and governmental contributions to the Fund; 
     and
       (iv) the criteria utilized to determine the programs and 
     activities that should be assisted by the Fund, including 
     baselines, targets, desired outcomes, measurable goals, and 
     extent to which those goals are being achieved.
       (3) GAO report on effectiveness.--Not later than 2 years 
     after the date on which the Fund is established, the 
     Comptroller General of the United States shall submit a 
     report to the appropriate congressional committees that 
     evaluates the effectiveness of the Fund, including the 
     effectiveness of the programs, projects, and activities 
     supported by the Fund, as described in subsection (c)(1).
       (g) United States Contributions.--
       (1) In general.--Subject to submission of the certification 
     under this subsection, the President is authorized to make 
     available for United States contributions to the Fund such 
     funds as may be appropriated or otherwise made available for 
     such purpose.
       (2) Notification.--The Secretary of State shall notify the 
     appropriate congressional committees not later than 15 days 
     in advance of making a contribution to the Fund, including--
       (A) the amount of the proposed contribution;
       (B) the total of funds contributed by other donors; and
       (C) the national interests served by United States 
     participation in the Fund.
       (3) Limitation.--During the 5-year period beginning on the 
     date of the enactment of this Act, a United States 
     contribution to the Fund may not cause the cumulative total 
     of United States contributions to the Fund to exceed 33 
     percent of the total contributions to the Fund from all 
     sources.
       (4) Withholdings.--
       (A) Support for acts of international terrorism.--If the 
     Secretary of State determines that the Fund has provided 
     assistance to a country, the government of which the 
     Secretary of State has determined, for purposes of section 
     620A of the Foreign Assistance Act of 1961 (22 U.S.C. 2371) 
     has repeatedly provided support for acts of international 
     terrorism, the United States shall withhold from its 
     contribution to the Fund for the next fiscal year an amount 
     equal to the amount expended by the Fund to the government of 
     such country.
       (B) Excessive salaries.--During the 5-year period beginning 
     on the date of the enactment of this Act, if the Secretary of 
     State determines that the salary of any individual employed 
     by the Fund exceeds the salary of the Vice President of the 
     United States for such fiscal year, the United States should 
     withhold from its contribution for the next fiscal year an 
     amount equal to the aggregate amount by which the salary of 
     each such individual exceeds the salary of the Vice President 
     of the United States.
       (C) Accountability certification requirement.--The 
     Secretary of State may withhold not more than 20 percent of 
     planned United States contributions to the Fund until the 
     Secretary certifies to the appropriate congressional 
     committees that the Fund has established procedures to 
     provide access by the Office of Inspector General of the 
     Department of State, as cognizant Inspector General, the 
     Inspector General of the Department of Health and Human 
     Services, the Inspector General of USAID, and the Comptroller 
     General of the United States to the Fund's financial data and 
     other information relevant to United States contributions to 
     the Fund (as determined by the Inspector General of the 
     Department of State, in consultation with the Secretary of 
     State).
       (h) Compliance With the Foreign Aid Transparency and 
     Accountability Act of 2016.--Section 2(3) of the Foreign Aid 
     Transparency and Accountability Act of 2016 (Public Law 114-
     191; 22 U.S.C. 2394c note) is amended--
       (1) in subparagraph (D), by striking ``and'' at the end;
       (2) in subparagraph (E), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(F) the International Pandemic Preparedness and COVID-19 
     Response Act of 2021.''.
       (i) Prohibition Against United States Foreign Assistance 
     for the Government of the People's Republic of China.--None 
     of the assistance authorized to be appropriated under this 
     subtitle may be made available to the Government of the 
     People's Republic of China or to any entity owned or 
     controlled by the Government of the People's Republic of 
     China.
                                 ______