Administration of Joseph R. Biden, Jr., 2021

January 21, 2021

National Security Directiveâ1

Subject: United States Global Leadership to Strengthen the International COVIDâ19 Response and to Advance Global Health Security and Biological Preparedness

The coronavirus disease 2019 (COVIDâ19) pandemic is a grave reminder that biological threats, whether naturally occurring, accidental, or deliberate, can have significant and potentially existential consequences for humanity. This directive reaffirms Executive Order 13747 of November 4, 2016, which made clear that these threats pose global challenges that require global solutions. United States international engagement to combat COVIDâ19 and advance global health security and biopreparedness is thus an urgent priorityâto save lives, promote economic recovery, and develop resilience against future biological catastrophes. My Administration will treat epidemic and pandemic preparedness, health security, and global health as top national security priorities, and will work with other nations to combat COVIDâ19 and seek to create a world that is safe and secure from biological threats.

Section 1. Strengthening and Reforming the World Health Organization. On January 20, 2021, the United States reversed its decision to withdraw from the World Health Organization (WHO) by submitting a letter to the United Nations Secretary-General informing him of the President's decision that the United States will remain a member of the organization.

Accordingly, the Assistant to the President for National Security Affairs (APNSA) shall, in coordination with the Secretary of State, the Secretary of Health and Human Services (HHS), the heads of other relevant executive departments and agencies (agencies), and the Coordinator of the COVIDâ19 Response and Counselor to the President (COVIDâ19 Response Coordinator), provide to the President within 30 days of the date of this directive recommendations on how the United States can: (1) exercise leadership at the WHO and work with partners to lead and reinvigorate the international COVIDâ19 response; (2) participate in international efforts to advance global health, health security, and the prevention of future biological catastrophes; and

otherwise strengthen and reform the WHO.

Sec. 2. United States Leadership in the Global Response to COVIDâ19.

COVIDâ19 Global Vaccination, Research, and Development. In order to support global vaccination and research and development for treatments, tests, and vaccines:

The Secretary of State and the Secretary of HHS shall inform the WHO and Gavi, the Vaccine Alliance, of the United States' intent to support the Access to COVIDâ19 Tools (ACT) Accelerator and join the multilateral vaccine distribution facility, known as the COVIDâ19 Vaccine Global Access (COVAX) Facility. The Secretaries shall also promptly deliver to the President, through the APNSA and the COVIDâ19 Response Coordinator, a framework for donating surplus vaccines, once there is sufficient supply in the United States, to countries in need, including through the COVAX Facility.

The Secretary of State and the Secretary of HHS, in coordination with the heads of other relevant agencies, shall promptly deliver to the APNSA and the COVIDâ19 Response Coordinator a plan for engaging with and strengthening multilateral initiatives focused on the global COVIDâ19 response, including the organizations

identified in section 2(a)(i) and other initiatives focused on equitable development and distribution of vaccines, therapeutics, tests, and personal protective equipment, such as the Coalition for Epidemic Preparedness Innovations and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Health, Diplomatic, and Humanitarian Response to COVIDâ19. In order to enable the United States to play an active role in the international COVIDâ19 public health and humanitarian response, including with respect to the pandemic's secondary effects:

The Secretary of State, in coordination with the Secretary of HHS, the Administrator of the United States Agency for International Development (USAID), the Director of the Centers for Disease Control and Prevention (CDC), and the heads of other relevant agencies, shall promptly develop and submit to the President, through the APNSA and the COVIDâ19 Response Coordinator, a Government-wide plan to combat the global COVIDâ19 pandemic, which shall identify principal strategic objectives, corresponding lines of effort, and lead agencies.

The Secretary of State shall, in coordination with the heads of other relevant agencies, promptly review and, as necessary, adjust the United States' current and planned future deployments of public health, health security, and health diplomacy personnel overseas focused on the COVIDâ19 response, taking into account best practices for such deployments from partner nations' COVIDâ19 response strategies.

Within 14 days of the date of this directive or as soon as possible thereafter, the Secretary of State shall develop, in consultation with the Secretary of HHS, the Representative of the United States to the United Nations, the Administrator of USAID, and the Director of the CDC, a diplomatic outreach plan for enhancing the United States' response to the COVIDâ19 pandemic, with a focus on engaging partner nations, the United Nations (including the United Nations Security Council), and other multilateral stakeholders on:

the financing of and capacity for strengthening the global COVIDâ19 response;

the provision of assistance, including in humanitarian settings and to mitigate secondary impacts of the COVIDâ19 pandemic such as food insecurity and gender-based violence; and

the provision of support, including with the United Nations and other relevant multilateral fora, for the capacity of the most vulnerable communities to prevent, detect, respond to, mitigate, and recover from impacts of COVIDâ19.

COVIDâ19 Sanctions Relief. The Secretary of State, the Secretary of the Treasury, and the Secretary of Commerce, in consultation with the Secretary of HHS and the Administrator of USAID, shall promptly review existing United States and multilateral financial and economic sanctions to evaluate whether they are unduly hindering responses to the COVIDâ19 pandemic, and provide recommendations to the President, through the APNSA and the COVIDâ19 Response Coordinator, for any changes in approach.

Sec. 3. Review of Funding for COVIDâ19 Response and Global Health Security and Biodefense. In order to ensure that global health security considerations are central to United States foreign policy, global health policy, and national security, the Director of the Office of Management and Budget shall, in coordination with the heads of relevant agencies and the APNSA:

review the funding allocated for the COVIDâ19 response, including the secondary impacts of the pandemic, as well as for global health security, global health, pandemic preparedness, and biodefense; and

provide the President with an assessment of whether that funding, as well as funding for subsequent budgetary years, is sufficient to support operations and administrative needs related to the COVIDâ19 response, as well as future global health security, global health, pandemic preparedness, and biodefense needs.

Sec. 4. Financing for Global Health Security. In order to develop a health security financing mechanism, make strategic use of multilateral and bilateral channels and institutions, and assist developing countries in preparing for, preventing, detecting, and responding to COVIDâ19 and other infectious disease threats:

The APNSA, in coordination with the Secretary of State, the Secretary of the Treasury, the Secretary of HHS, the Administrator of USAID, the Chief Executive Officer of the United States International Development Finance Corporation, and the heads of other agencies providing foreign assistance and development financing, shall promptly provide to the President recommendations for creating an enduring international catalytic financing mechanism for advancing and improving existing bilateral and multilateral approaches to global health security.

The Secretary of the Treasury shall promptly provide to the President, through the APNSA, a strategy on how the United States can promote in international financial institutions, including the World Bank Group and International Monetary Fund, financing, relief, and other policies that are aligned with and support the goals of combating COVIDâ19 and strengthening global health security.

Sec. 5. Advancing Global Health Security and Epidemic and Pandemic Preparedness.

The APNSA shall:

coordinate the Federal Government's efforts to prepare for, prevent, detect, respond to, and recover from biological events, and to advance global health security, international pandemic preparedness, and global health resilience;

coordinate the development of priorities for, and elevate United States leadership and assistance in support of, the Global Health Security Agenda;

conduct, in coordination with the heads of relevant agencies, a review of existing United States health security policies and strategies and develop recommendations for how the Federal Government may update them, including by, as appropriate: developing stronger global institutions focused on harmonizing crisis response for emerging biological events and public health emergencies; taking steps to strengthen the global pandemic supply chain and address any barriers to the timely delivery of supplies in response to a pandemic; working with partner countries and international organizations to strengthen and implement the International Health Regulations; reducing racial and ethnic disparities in the COVIDâ19 global response and disproportionate impacts on marginalized and indigenous communities, women and girls, and other groups; reviewing and developing priorities for multilateral fora aimed at reducing the risk of deliberate or accidental biological events; combating antimicrobial resistance; and fighting climate change as a driver of health threats; and

develop, in coordination with the Secretary of State, the Secretary of HHS, the Administrator of USAID, the Director of the CDC, and the heads of other relevant agencies, protocols for coordinating and deploying a global response to emerging high- consequence infectious disease threats. These protocols should outline the respective

roles for relevant agencies in facilitating and supporting such response operations, including by establishing standard operating procedures for how USAID and the CDC coordinate their response efforts.

The APNSA, in coordination with the COVIDâ19 Response Coordinator, the Assistant to the President for Domestic Policy, and the heads of relevant agencies, shall promptly develop a plan for establishing an interagency National Center for Epidemic Forecasting and Outbreak Analytics and modernizing global early warning and trigger systems for scaling action to prevent, detect, respond to, and recover from emerging biological threats.

The Secretary of State and the Representative of the United States to the United Nations shall provide to the President, through the APNSA, recommendations regarding steps the United States should take to encourage or support the establishment of a new position in the office of the United Nations Secretary-General of a facilitator for high-consequence biological threats, particularly for events involving significant collaboration and equities across the United Nations.

To assist in the Federal Government's efforts to provide warning of pandemics, protect our biotechnology infrastructure from cyber attacks and intellectual property theft, identify and monitor biological threats from states and non-state actors, provide validation of foreign data and response efforts, and assess strategic challenges and opportunities from emerging biotechnologies, the Director of National Intelligence shall:

Review the collection and reporting capabilities in the United States Intelligence Community (IC) related to pandemics and the full range of high-consequence biological threats and develop a plan for how the IC may strengthen and prioritize such capabilities, including through organizational changes or the creation of National Intelligence Manager and National Intelligence Officer positions focused on biological threats, global public health, and biotechnology;

Develop and submit to the President, through the APNSA and the COVIDâ19 Response Coordinator, a National Intelligence Estimate on (A) the impact of COVIDâ 19 on national and economic security; and (B) current, emerging, reemerging, potential, and future biological risks to national and economic security; and

In coordination with the Secretary of State, the Secretary of Defense, the Secretary of HHS, the Director of the CDC, the Administrator of USAID, the Director of the Office of Science and Technology Policy, and the heads of other relevant agencies, promptly develop and submit to the APNSA an analysis of the security implications of biological threats that can be incorporated into modeling, simulation, course of action analysis, and other analyses.

Sec. 6. General Provisions. (a) Nothing in this directive shall be construed to impair or otherwise affect:

the authority granted by law to an executive department or agency, or the head thereof; or

the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

This directive shall be implemented consistent with applicable law and subject to the availability of appropriations.

This directive is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

JOSEPH R. BIDEN JR.

NOTE: An original was not available for verification of the content of this directive.

Categories: Directives : International COVIDâ19 response and global health security and biological preparedness, U.S. global leadership, strengthening efforts.

Subjects: Coronavirus pandemic, international cooperation efforts; Diseases : Coronavirus, domestic prevention efforts; Economy, national : Improvement; Foreign policy, U.S. : Foreign aid policies and funding; Foreign policy, U.S. : Infectious diseases, efforts to combat; Health and Human Services, Department of : Secretary; Monetary Fund, International; State, Department of : Secretary; United Nations : Secretary-General; United Nations : Security Council; White House Office : Assistants to the President :: Counselor; White House Office : COVIDâ19 Response Coordinator; White House Office : Security Council, National; World Bank; World Health Organization.

DCPD Number: DCPD202100076.