[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3302 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  2d Session
                                S. 3302

       To improve global health security, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 13, 2020

   Mr. King introduced the following bill; which was read twice and 
             referred to the Committee on Foreign Relations

_______________________________________________________________________

                                 A BILL


 
       To improve global health security, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Global Health Security Act of 
2020''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) An infectious disease threat anywhere can become a 
        threat everywhere. In today's interconnected world, a pathogen 
        can travel around the globe to major cities in as few as 24 
        hours.
            (2) Infectious diseases have killed more humans than war 
        and conflict. Before its eradication, smallpox killed at least 
        300,000,000 people in the 20th century. Mosquito-borne 
        illnesses are responsible for 50 percent more human deaths each 
        year than deaths caused by other humans, including war and 
        civil violence. The influenza pandemic of 1918-19 caused the 
        deaths of 3 times as many people as all of those killed in 
        World War I.
            (3) Population growth has brought people closer to one 
        another and closer to animals, which has increased the 
        opportunities for pathogens to be transmitted between animals 
        and humans.
            (4) Human health is intimately connected to animal and 
        environmental health at the national and international levels.
            (5) Zoonotic diseases are responsible for--
                    (A) approximately 60 percent of all human 
                infections;
                    (B) approximately 75 percent of recently emerging 
                infectious diseases affecting humans; and
                    (C) more than 80 percent of biological agents that 
                could be intentionally released as biological weapons.
            (6) Environmental change has made it easy for disease 
        vectors, such as mosquitoes, to cover more territory.
            (7) There are many recent examples of new, reemerging, and 
        zoonotic pathogens quickly spreading across the globe, 
        including--
                    (A) Ebola virus disease, which killed more than 
                11,000 people and infected more than 28,000 people in 
                West Africa between 2014 and 2016, and which has 
                infected and killed an unknown number of people in the 
                Democratic Republic of the Congo since 2018;
                    (B) novel coronavirus disease (COVID), which, as of 
                February 12, 2020, had infected at least 45,000 people 
                in at least 25 countries, resulting in more than 1,100 
                deaths in China;
                    (C) yellow fever virus;
                    (D) cholera;
                    (E) avian influenza virus (H7N9);
                    (F) novel Middle East Respiratory Syndrome (MERS) 
                coronavirus; and
                    (G) Zika virus.
            (8) The costs of new, reemerging, and zoonotic infections 
        are high in human and financial terms. For example--
                    (A) the anthrax attacks in the eastern United 
                States in late 2001 infected 22 people, killed 5, and 
                cost more than $1,000,000,000 to clean up;
                    (B) an outbreak of severe acute respiratory 
                syndrome (SARS) originating in southern China in late 
                2002 infected more than 8,000 people, resulted in 774 
                deaths, and had an economic impact estimated at 
                $30,000,000,000 in only a few months;
                    (C) the 2009 H1N1 influenza pandemic killed an 
                estimated 284,000 people in a single year; and
                    (D) human immunodeficiency virus (HIV) spread 
                silently for decades before detection, has led to the 
                death of 35,000,000 people, and currently affects 
                37,000,000 people who are living with the virus.
            (9) The enormous costs of pandemics can be averted with 
        strategic investment in capacity building and preparedness.
            (10) The Global Health Security Agenda, which was launched 
        in February 2014 in partnership with countries from around the 
        world, is designed--
                    (A) to measurably address global vulnerability to 
                infectious diseases;
                    (B) to strengthen systems; and
                    (C) to ensure that a trained workforce has the 
                tools needed to prevent, detect, and respond rapidly 
                and effectively to infectious disease threats.
            (11) Stopping an outbreak at its source, whether naturally 
        occurring, deliberate, or accidental, requires close 
        collaboration among the health, animal, agriculture, defense, 
        security, development, commercial, and other sectors.

SEC. 3. SENSE OF CONGRESS.

    It is the sense of Congress that--
            (1) advancing global health security is a core tenet of our 
        national strategy for countering biological threats;
            (2) supporting global health security requires 
        operationalizing the ``One Health'' concept linking human, 
        animal, and environmental health;
            (3) the United States must be prepared to prevent, detect, 
        and respond to the threat posed by bioterrorism, as well as 
        accidental releases from a laboratory;
            (4) it is in the national interest of the United States--
                    (A) to promote global health security; and
                    (B) to accelerate efforts to build the capacity of 
                countries--
                            (i) to prevent, detect, and respond to 
                        infectious diseases; and
                            (ii) to achieve the core capacities 
                        required by the World Health Organization's 
                        International Health Regulations, adopted at 
                        Geneva May 23, 2005;
            (5) no single nation can be prepared or protected if other 
        nations remain unprepared to counter biological threats;
            (6) national and international multi-sectoral cooperation 
        and preparedness are at the core of effective control of 
        infectious diseases through strengthened health systems and 
        preparedness;
            (7) global health security depends upon collaborations 
        across all societal sectors, including human and animal health, 
        agriculture, development, environmental, national security and 
        defense, science and technology, academic and research 
        communities, nongovernmental organizations, and the private 
        sector, to meet the policy objective set forth in section 4(3) 
        of strengthening health systems and pandemic preparedness;
            (8) an effective global health security strategy should 
        include--
                    (A) preventing avoidable incidents and 
                catastrophes, such as antimicrobial resistance, 
                zoonotic diseases, outbreaks, breaches of biosafety and 
                security, and immunization-preventable deaths;
                    (B) detecting threats early through--
                            (i) building and sustaining national and 
                        global laboratory systems;
                            (ii) improving disease surveillance;
                            (iii) enhancing the reporting of infectious 
                        disease outbreaks; and
                            (iv) developing the health workforce; and
                    (C) responding to threats rapidly and effectively 
                through--
                            (i) emergency operations centers;
                            (ii) linking public health with 
                        multisectoral rapid response; and
                            (iii) medical countermeasures and personnel 
                        deployment;
            (9) strategic global health security action requires United 
        States coordination and collaboration with international 
        governance entities, including--
                    (A) the World Health Organization;
                    (B) the Food and Agriculture Organization of the 
                United Nations;
                    (C) the World Organization for Animal Health;
                    (D) the Global Partnership Against the Spread of 
                Weapons and Materials of Mass Destruction;
                    (E) the International Criminal Police Organization 
                (commonly known as ``INTERPOL'');
                    (F) the Economic Community of West African States;
                    (G) the United Nations Office for Disaster Risk 
                Reduction;
                    (H) the Global Alliance for Vaccines and 
                Immunization (commonly known as ``GAVI''); and
                    (I) other relevant international stakeholders and 
                organizations; and
            (10) the strategic goals described in paragraph (8) must be 
        subject to measurement, assessment, and analysis.

SEC. 4. DEFINED TERM.

    In this Act, the term ``global health security'' means the 
activities required to minimize the danger and impact of acute public 
health events that endanger the collective health of populations living 
across geographical regions and international boundaries.

SEC. 5. POLICY OBJECTIVES.

    It is the policy of the United States--
            (1) to advance global health security through engagement in 
        a multi-faceted, multi-country, multi-sectoral framework to 
        accelerate targeted partner countries' measurable capabilities 
        to achieve specific targets to prevent, detect, and respond to 
        infectious disease threats, whether naturally occurring, 
        deliberate, or accidental;
            (2) to encourage governments and multilateral agencies, 
        development banks, nongovernmental organizations, and private 
        sector stakeholders throughout the world to make fortifying 
        health security a national priority and a key commitment; and
            (3) to emphasize improving coordination and collaboration 
        across governmental and societal sectors to help strengthen 
        health systems and pandemic preparedness.

SEC. 6. GLOBAL HEALTH SECURITY SPECIAL ADVISOR.

    (a) In General.--There is established, within the Executive Office 
of the President, the position of Special Advisor for Global Health 
Security (referred to in this Act as the ``Advisor''), who shall be 
appointed by the President, at a level not lower than that of a Senior 
Director.
    (b) General Duties.--The Advisor shall--
            (1) serve as the President's principal advisor on global 
        health security and global health emergencies;
            (2) coordinate the United States Government's efforts to 
        carry out global health security activities, including 
        participation in the Global Health Security Agenda;
            (3) convene and chair the Global Health Security 
        Interagency Review Council described in section 7; and
            (4) submit a report to Congress not less frequently than 
        twice per year that describes the activities and 
        accomplishments of the Advisor during the reporting period.
    (c) Specific Duties.--The duties of the Advisor shall also 
include--
            (1) ensuring program and policy coordination among the 
        relevant executive branch agencies and nongovernmental 
        organizations, including auditing, monitoring, and evaluation 
        of all such programs;
            (2) ensuring that each relevant executive branch agency 
        undertakes programs primarily in areas in which the agency has 
        the greatest expertise, technical capabilities, and potential 
        for success;
            (3) avoiding duplication of effort;
            (4) ensuring, through interagency and international 
        coordination, that global health security programs of the 
        United States are coordinated with, and complementary to, the 
        delivery of related global health, food security, development, 
        and education programs;
            (5) establishing due diligence criteria for all recipients 
        of funds appropriated by the Federal Government for global 
        health security assistance;
            (6) developing policy that will prioritize global health 
        security, especially the role of building low- and middle-
        income country capacity to contain pandemic threats, in all 
        relevant future global and national health, research and 
        development, and biodefense strategies, including the National 
        Health Security Strategy, the National Security Strategy, and 
        the National Biodefense Strategy; and
            (7) articulating assessment standards that--
                    (A) measure countries' individual status and 
                progress in building the necessary capacities to 
                prevent, detect, and respond to infectious disease 
                threats, in accordance with agreed bilateral or 
                multilateral targets and in support of full 
                implementation of the International Health Regulations, 
                adopted at Geneva May 23, 2005;
                    (B) are based on a peer-to-peer model in which 
                external experts are invited to work with the country 
                to evaluate capacity;
                    (C) ensure an objective approach and facilitate 
                cross-sectoral learning; and
                    (D) are part of the capacity building cycle 
                designed to inform national priority setting, target 
                resources, and track progress.
    (d) Coordination.--In carrying out the duties set forth in 
subsection (b), the Advisor shall ensure the coordination of United 
States Government efforts referred to in subsection (b)(2) with 
relevant international stakeholders and organizations.
    (e) Monitoring.--To ensure that adequate measures are established 
and implemented, the Centers for Disease Control and Prevention 
should--
            (1) advise the Advisor on monitoring, surveillance, and 
        evaluation activities; and
            (2) be a key implementer of such activities under this 
        section.
    (f) Form.--The reports required under subsection (b)(4) shall be 
submitted in unclassified form, but may contain a classified annex.

SEC. 7. INTERAGENCY REVIEW COUNCIL.

    (a) Establishment.--The Global Health Security Interagency Review 
Council (referred to in this section as the ``Council'') shall be 
composed of representatives of--
            (1) the Department of State;
            (2) the Centers for Disease Control and Prevention;
            (3) the United States Agency for International Development;
            (4) the Department of Agriculture, including the Animal 
        Plant Health Inspection Service and the Food Safety and 
        Inspection Service;
            (5) the Department of Defense, including the Assistant 
        Secretary of Defense for Health Affairs;
            (6) the Department of Health and Human Services, including 
        the National Institutes of Health;
            (7) the Department of Homeland Security;
            (8) the Department of Justice, including the Federal Bureau 
        of Investigation;
            (9) the Environmental Protection Agency;
            (10) the Office of Management and Budget;
            (11) the Office of Science and Technology Policy; and
            (12) any other agency that the representatives of the 
        agencies set forth in paragraphs (1) through (11) determine, by 
        consensus, to be appropriate.
    (b) Meetings.--The Council shall meet at least 4 times per year to 
advance its mission and fulfill its responsibilities under this 
section.
    (c) Functions.--The Council shall--
            (1) provide policy-level guidance to participating agencies 
        on global health security goals, objectives, and 
        implementation;
            (2) facilitate interagency, multi-sectoral engagement to 
        carry out global health security activities, including the 
        Global Health Security Agenda;
            (3) provide a forum for raising and working to resolve 
        interagency disagreements concerning the global health security 
        goals, objectives, and benchmarks;
            (4) develop and set benchmarks for--
                    (A) assessing, measuring, and improving global 
                health security outcomes; and
                    (B) identifying criteria for designating priority 
                partner countries;
            (5) review the progress toward, and work to resolve 
        challenges to, achieving United States Government commitments 
        to global health security activities, agreements, and 
        organizations, including the Global Health Security Agenda and 
        other commitments to assist other countries in achieving 
        agreed-upon global health security targets; and
            (6) consider, among other issues--
                    (A) the status of United States financial 
                commitments to global health security in the context of 
                commitments by other donors, and the contributions of 
                partner countries to achieve global health security 
                targets, including the Global Health Security Agenda;
                    (B) progress toward the milestones outlined in 
                global health security national plans for those 
                countries where the United States Government has 
                committed to assist in global health security 
                activities and in annual work plans outlining agency 
                priorities for implementing global health security 
                strategies, including the Global Health Security 
                Agenda; and
                    (C) external evaluations of the capabilities of the 
                United States and partner countries to address 
                infectious disease threats, including--
                            (i) the ability to achieve the targets 
                        outlined in the Joint External Evaluation 
                        process; and
                            (ii) gaps identified by such external 
                        evaluations.
    (d) Specific Roles and Responsibilities.--
            (1) In general.--The heads of the agencies referred to in 
        subsection (a) shall--
                    (A) make the implementation of the Global Health 
                Security Agenda (referred to in this subsection as 
                ``GHSA'') and successor activities a high priority 
                within their respective agencies, and include GHSA-
                related activities within their respective agencies' 
                strategic planning and budget processes;
                    (B) designate a senior level official to be 
                responsible for the implementation of this section;
                    (C) designate an appropriate representative, at the 
                Assistant Secretary level or higher, to represent the 
                agency on the Council;
                    (D) keep the Council apprised of global health 
                security-related activities, including the Global 
                Health Security Agenda, undertaken within their 
                respective agencies;
                    (E) maintain responsibility for agency-related 
                programmatic functions, in coordination with host 
                governments, country teams, and global health security 
                in country teams, and in conjunction with other 
                relevant agencies;
                    (F) coordinate with other agencies referred to in 
                subsection (a) to satisfy programmatic goals, and 
                further facilitate coordination of country teams, 
                implementers, and donors in host countries; and
                    (G) coordinate across GHSA national plans and with 
                GHSA partners to which the United States is providing 
                assistance.
            (2) Additional roles and responsibilities.--In addition to 
        the roles and responsibilities described in paragraph (1), the 
        heads of agencies referred to in subsection (a) shall carry out 
        their respective roles and responsibilities described in 
        subsections (b) through (i) of section 3 of 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), as in effect on the day before the 
        date of the enactment of this Act.
    (e) Limitations.--The Council may not perform any activities or 
functions that interfere with the foreign affairs responsibilities of 
the Secretary of State, including the responsibility to oversee the 
implementation of programs and policies that advance the global health 
security activities within foreign countries.

SEC. 8. STRATEGY AND REPORTS.

    (a) Strategy.--The Special Advisor for Global Health Security 
appointed under section 6 shall coordinate the development and 
implementation of a strategy to implement the policy described in 
section 5, which shall--
            (1) set specific and measurable goals, benchmarks, 
        timetables, performance metrics, and monitoring and evaluation 
        plans that reflect international best practices relating to 
        transparency, accountability, and global health security;
            (2) support and be aligned with country-owned global health 
        security policy and investment plans developed with input from 
        key stakeholders, as appropriate;
            (3) facilitate communication and collaboration, as 
        appropriate, among local stakeholders in support of a multi-
        sectoral approach to global health security;
            (4) support the long-term success of programs by building 
        the capacity of local organizations and institutions in target 
        countries and communities;
            (5) develop community resilience to infectious disease 
        threats and emergencies;
            (6) leverage resources and expertise through partnerships 
        with the private sector, health organizations, civil society, 
        nongovernmental organizations, and health research and academic 
        institutions; and
            (7) support collaboration, as appropriate, between United 
        States universities, and public and private institutions in 
        target countries and communities to promote health security and 
        innovation.
    (b) Coordination.--The President, acting through the Special 
Advisor for Global Health Security, shall coordinate, through a whole-
of-government approach, the efforts of relevant Federal departments and 
agencies in the implementation of the strategy required under 
subsection (a) by establishing--
            (1) monitoring and evaluation systems, coherence, and 
        coordination across relevant Federal departments and agencies; 
        and
            (2) platforms for regular consultation and collaboration 
        with key stakeholders and the appropriate congressional 
        committees.
    (c) Strategy Submission.--
            (1) In general.--Not later than 6 months after the date of 
        the enactment of this Act, the President, in consultation with 
        the head of each relevant Federal department and agency, shall 
        submit, to the appropriate congressional committees--
                    (A) the strategy required under subsection (a); and
                    (B) a detailed description of how the United States 
                intends to advance the policy set forth in section 5 
                and the agency-specific plans described in paragraph 
                (2).
            (2) Agency-specific plans.--The strategy required under 
        subsection (a) shall include specific implementation plans from 
        each relevant Federal department and agency that describes--
                    (A) the anticipated contributions of the department 
                or agency, including technical, financial, and in-kind 
                contributions, to implement the strategy; and
                    (B) the efforts of the department or agency to 
                ensure that the activities and programs carried out 
                pursuant to the strategy are designed to achieve 
                maximum impact and long-term sustainability.
    (d) Report.--
            (1) In general.--Not later than 1 year after the date on 
        which the strategy required under subsection (a) is submitted 
        to the appropriate congressional committees under subsection 
        (c), and not later than October 1 of each year thereafter, the 
        President shall submit a report to the appropriate 
        congressional committees that describes the status of the 
        implementation of the strategy.
            (2) Content.--The report required under paragraph (1) 
        shall--
                    (A) contain a summary of the strategy as an 
                appendix;
                    (B) identify any substantial changes made in the 
                strategy during the preceding calendar year;
                    (C) describe the progress made in implementing the 
                strategy;
                    (D) identify the indicators used to establish 
                benchmarks and measure results over time, as well as 
                the mechanisms for reporting such results in an open 
                and transparent manner;
                    (E) contain a transparent, open, and detailed 
                accounting of expenditures by relevant Federal 
                departments and agencies to implement the strategy, 
                including, for each Federal department and agency, the 
                statutory source of expenditures, amounts expended, 
                implementing partners, targeted beneficiaries, and 
                activities supported;
                    (F) describe how the strategy leverages other 
                United States global health and development assistance 
                programs;
                    (G) assess efforts to coordinate United States 
                global health security programs, activities, and 
                initiatives with key stakeholders; and
                    (H) incorporate a plan for regularly reviewing and 
                updating strategies, partnerships, and programs and 
                sharing lessons learned with a wide range of 
                stakeholders, including key stakeholders, in an open, 
                transparent manner.
    (e) Form.--The strategy required under subsection (a) and the 
report required under subsection (d) shall be submitted in unclassified 
form, but may contain a classified annex.

SEC. 9. COORDINATION OF FEDERAL RESPONSE TO GLOBAL HEALTH EMERGENCIES.

    (a) Leadership.--The Secretary of State, in consultation with other 
appropriate Federal departments, including the Department of 
Agriculture, the Department of Defense, the Department of Health and 
Human Services, and the Department of Homeland Security, shall 
coordinate and facilitate interagency, multi-sectoral activities 
outside of the United States in response to a declared global health 
emergency. The President may designate another Federal official to 
coordinate domestic and extra-territorial activities related to a 
global health emergency.
    (b) Coordination With International Organizations.--In responding 
to a declared global health emergency under subsection (a), the 
Secretary of State shall coordinate United States Government's efforts 
with the efforts and programs of relevant international organizations 
and stakeholders, including--
            (1) the World Health Organization;
            (2) the Food and Agriculture Organization of the United 
        Nations;
            (3) the World Organization for Animal Health;
            (4) the Global Partnership Against the Spread of Weapons 
        and Materials of Mass Destruction;
            (5) INTERPOL;
            (6) the Economic Community of West African States;
            (7) the United Nations Office for Disaster Risk Reduction;
            (8) GAVI, The Vaccine Alliance; and
            (9) other relevant international agencies and 
        organizations.
    (c) Interagency Coordination.--The Secretary of State shall ensure 
that global health security programs supported by the United States 
Government are coordinated with, and complementary to, related programs 
in global food security, development, and education.

SEC. 10. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated, for each of the fiscal 
years 2021 through 2025--
            (1) to the Centers for Disease Control and Prevention, 
        $190,000,000 for the Global Disease Detection and Emergency 
        Response and Global Public Health Capacity and Development 
        Accounts, which shall be used to support activities that--
                    (A) are consistent with United States global health 
                security policy, goals, and priorities;
                    (B) have measurable benchmarks; and
                    (C) focus on preventing avoidable catastrophes, 
                detecting threats early, and responding rapidly and 
                effectively; and
            (2) to the United States Agency for International 
        Development, $110,000,000 for the Global Health Security 
        Account, which shall be used to support activities that--
                    (A) are consistent with United States global health 
                security policy, goals, and priorities;
                    (B) have measurable benchmarks; and
                    (C) focus on preventing avoidable catastrophes, 
                detecting threats early, and responding rapidly and 
                effectively.
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