,,ii #aafth ,,congress #b;d ,session ,s4 #ccjb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #ac1 #bjbj,mr4 ,king introduced the following bill2 which was read twice and referred to the ,committee on ,foreign ,relations ,a ,,bill ,to improve global health security1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,global ,health ,security ,act of #bjbj4 #b4 ,findings ,congress makes the following findings3 7#a7 ,an infectious disease threat anywhere can become a threat everywhere4 ,in today's interconnected world1 a pathogen can travel around the globe to major cities in as few as #bd hours4 7#b7 ,infectious diseases have killed more humans than war and conflict4 ,before its eradication1 smallpox killed at least #cjj1jjj1jjj people in the #bjth century4 ,mosquito-borne illnesses are responsible for #ej percent more human deaths each year than deaths caused by other humans1 including war and civil violence4 ,the influenza pandemic of #aiah-ai caused the deaths of #c times as many people as all of those killed in ,world ,war ,i4 7#c7 ,population growth has brought people closer to one another and closer to animals1 which has increased the opportunities for pathogens to be transmitted between animals and humans4 7#d7 ,human health is intimately connected to animal and environmental health at the national and international levels4 7#e7 ,zoonotic diseases are responsible for-- 7,a7 approximately #fj percent of all human infections2 7,b7 approximately #ge percent of recently emerging infectious diseases affecting humans2 and 7,c7 more than #hj percent of biological agents that could be intentionally released as biological weapons4 7#f7 ,environmental change has made it easy for disease vectors1 such as mosquitoes1 to cover more territory4 7#g7 ,there are many recent examples of new1 reemerging1 and zoonotic pathogens quickly spreading across the globe1 including-- 7,a7 ,ebola virus disease1 which killed more than #aa1jjj people and infected more than #bh1jjj people in ,west ,africa between #bjad and #bjaf1 and which has infected and killed an unknown number of people in the ,democratic ,republic of the ,congo since #bjah2 7,b7 novel coronavirus disease 7,,covid71 which1 as of ,february #ab1 #bjbj1 had infected at least #de1jjj people in at least #be countries1 resulting in more than #a1ajj deaths in ,china2 7,c7 yellow fever virus2 7,d7 cholera2 7,e7 avian influenza virus 7,h#g,n#i72 7,f7 novel ,middle ,east ,respiratory ,syndrome 7,,mers7 coronavirus2 and 7,g7 ,zika virus4 7#h7 ,the costs of new1 reemerging1 and zoonotic infections are high in human and financial terms4 ,for example-- 7,a7 the anthrax attacks in the eastern ,united ,states in late #bjja infected #bb people1 killed #e1 and cost more than #a1jjj1jjj1jjj to clean up2 7,b7 an outbreak of severe acute respiratory syndrome 7,,sars7 originating in southern ,china in late #bjjb infected more than #h1jjj people1 resulted in #ggd deaths1 and had an economic impact estimated at #cj1jjj1jjj1jjj in only a few months2 7,c7 the #bjji ,h#a,n#a influenza pandemic killed an estimated #bhd1jjj people in a single year2 and 7,d7 human immunodeficiency virus 7,,hiv7 spread silently for decades before detection1 has led to the death of #ce1jjj1jjj people1 and currently affects #cg1jjj1jjj people who are living with the virus4 7#i7 ,the enormous costs of pandemics can be averted with strategic investment in capacity building and preparedness4 7#aj7 ,the ,global ,health ,security ,agenda1 which was launched in ,february #bjad in partnership with countries from around the world1 is designed-- 7,a7 to measurably address global vulnerability to infectious diseases2 7,b7 to strengthen systems2 and 7,c7 to ensure that a trained workforce has the tools needed to prevent1 detect1 and respond rapidly and effectively to infectious disease threats4 7#aa7 ,stopping an outbreak at its source1 whether naturally occurring1 deliberate1 or accidental1 requires close collaboration among the health1 animal1 agriculture1 defense1 security1 development1 commercial1 and other sectors4 #c4 ,sense of ,congress ,it is the sense of ,congress that-- 7#a7 advancing global health security is a core tenet of our national strategy for countering biological threats2 7#b7 supporting global health security requires operationalizing the ,one ,health concept linking human1 animal1 and environmental health2 7#c7 the ,united ,states must be prepared to prevent1 detect1 and respond to the threat posed by bioterrorism1 as well as accidental releases from a laboratory2 7#d7 it is in the national interest of the ,united ,states-- 7,a7 to promote global health security2 and 7,b7 to accelerate efforts to build the capacity of countries-- 7i7 to prevent1 detect1 and respond to infectious diseases2 and 7ii7 to achieve the core capacities required by the ,world ,health ,organization's ,international ,health ,regulations1 adopted at ,geneva ,may #bc1 #bjje2 7#e7 no single nation can be prepared or protected if other nations remain unprepared to counter biological threats2 7#f7 national and international multi-sectoral cooperation and preparedness are at the core of effective control of infectious diseases through strengthened health systems and preparedness2 7#g7 global health security depends upon collaborations across all societal sectors1 including human and animal health1 agriculture1 development1 environmental1 national security and defense1 science and technology1 academic and research communities1 nongovernmental organizations1 and the private sector1 to meet the policy objective set forth in section #d7c7 of strengthening health systems and pandemic preparedness2 7#h7 an effective global health security strategy should include-- 7,a7 preventing avoidable incidents and catastrophes1 such as antimicrobial resistance1 zoonotic diseases1 outbreaks1 breaches of biosafety and security1 and immunization-preventable deaths2 7,b7 detecting threats early through-- 7i7 building and sustaining national and global laboratory systems2 7ii7 improving disease surveillance2 7iii7 enhancing the reporting of infectious disease outbreaks2 and 7iv7 developing the health workforce2 and 7,c7 responding to threats rapidly and effectively through-- 7i7 emergency operations centers2 7ii7 linking public health with multisectoral rapid response2 and 7iii7 medical countermeasures and personnel deployment2 7#i7 strategic global health security action requires ,united ,states coordination and collaboration with international governance entities1 including-- 7,a7 the ,world ,health ,organization2 7,b7 the ,food and ,agriculture ,organization of the ,united ,nations2 7,c7 the ,world ,organization for ,animal ,health2 7,d7 the ,global ,partnership ,against the ,spread of ,weapons and ,materials of ,mass ,destruction2 7,e7 the ,international ,criminal ,police ,organization 7commonly known as ,,interpol72 7,f7 the ,economic ,community of ,west ,african ,states2 7,g7 the ,united ,nations ,office for ,disaster ,risk ,reduction2 7,h7 the ,global ,alliance for ,vaccines and ,immunization 7commonly known as ,,gavi72 and 7,i7 other relevant international stakeholders and organizations2 and 7#aj7 the strategic goals described in paragraph 7#h7 must be subject to measurement1 assessment1 and analysis4 #d4 ,defined term ,in this ,act1 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 boundaries4 #e4 ,policy objectives ,it is the policy of the ,united ,states-- 7#a7 to advance global health security through engagement in a multi-faceted1 multi-country1 multi-sectoral framework to accelerate targeted partner countries' measurable capabilities to achieve specific targets to prevent1 detect1 and respond to infectious disease threats1 whether naturally occurring1 deliberate1 or accidental2 7#b7 to encourage governments and multilateral agencies1 development banks1 nongovernmental organizations1 and private sector stakeholders throughout the world to make fortifying health security a national priority and a key commitment2 and 7#c7 to emphasize improving coordination and collaboration across governmental and societal sectors to help strengthen health systems and pandemic preparedness4 #f4 ,global ,health ,security ,special ,advisor 7a7 ,in general ,there is established1 within the ,executive ,office of the ,president1 the position of ,special ,advisor for ,global ,health ,security 7referred to in this ,act as the ,advisor71 who shall be appointed by the ,president1 at a level not lower than that of a ,senior ,director4 7b7 ,general duties ,the ,advisor shall-- 7#a7 serve as the ,president's principal advisor on global health security and global health emergencies2 7#b7 coordinate the ,united ,states ,government's efforts to carry out global health security activities1 including participation in the ,global ,health ,security ,agenda2 7#c7 convene and chair the ,global ,health ,security ,interagency ,review ,council described in section #g2 and 7#d7 submit a report to ,congress not less frequently than twice per year that describes the activities and accomplishments of the ,advisor during the reporting period4 7c7 ,specific duties ,the duties of the ,advisor shall also include-- 7#a7 ensuring program and policy coordination among the relevant executive branch agencies and nongovernmental organizations1 including auditing1 monitoring1 and evaluation of all such programs2 7#b7 ensuring that each relevant executive branch agency undertakes programs primarily in areas in which the agency has the greatest expertise1 technical capabilities1 and potential for success2 7#c7 avoiding duplication of effort2 7#d7 ensuring1 through interagency and international coordination1 that global health security programs of the ,united ,states are coordinated with1 and complementary to1 the delivery of related global health1 food security1 development1 and education programs2 7#e7 establishing due diligence criteria for all recipients of funds appropriated by the ,federal ,government for global health security assistance2 7#f7 developing policy that will prioritize global health security1 especially the role of building low- and middle-income country capacity to contain pandemic threats1 in all relevant future global and national health1 research and development1 and biodefense strategies1 including the ,national ,health ,security ,strategy1 the ,national ,security ,strategy1 and the ,national ,biodefense ,strategy2 and 7#g7 articulating assessment standards that-- 7,a7 measure countries' individual status and progress in building the necessary capacities to prevent1 detect1 and respond to infectious disease threats1 in accordance with agreed bilateral or multilateral targets and in support of full implementation of the ,international ,health ,regulations1 adopted at ,geneva ,may #bc1 #bjje2 7,b7 are based on a peer-to-peer model in which external experts are invited to work with the country to evaluate capacity2 7,c7 ensure an objective approach and facilitate cross-sectoral learning2 and 7,d7 are part of the capacity building cycle designed to inform national priority setting1 target resources1 and track progress4 7d7 ,coordination ,in carrying out the duties set forth in subsection 7b71 the ,advisor shall ensure the coordination of ,united ,states ,government efforts referred to in subsection 7b77#b7 with relevant international stakeholders and organizations4 7e7 ,monitoring ,to ensure that adequate measures are established and implemented1 the ,centers for ,disease ,control and ,prevention should-- 7#a7 advise the ,advisor on monitoring1 surveillance1 and evaluation activities2 and 7#b7 be a key implementer of such activities under this section4 7f7 ,form ,the reports required under subsection 7b77#d7 shall be submitted in unclassified form1 but may contain a classified annex4 #g4 ,interagency ,review ,council 7a7 ,establishment ,the ,global ,health ,security ,interagency ,review ,council 7referred to in this section as the ,council7 shall be composed of representatives of-- 7#a7 the ,department of ,state2 7#b7 the ,centers for ,disease ,control and ,prevention2 7#c7 the ,united ,states ,agency for ,international ,development2 7#d7 the ,department of ,agriculture1 including the ,animal ,plant ,health ,inspection ,service and the ,food ,safety and ,inspection ,service2 7#e7 the ,department of ,defense1 including the ,assistant ,secretary of ,defense for ,health ,affairs2 7#f7 the ,department of ,health and ,human ,services1 including the ,national ,institutes of ,health2 7#g7 the ,department of ,homeland ,security2 7#h7 the ,department of ,justice1 including the ,federal ,bureau of ,investigation2 7#i7 the ,environmental ,protection ,agency2 7#aj7 the ,office of ,management and ,budget2 7#aa7 the ,office of ,science and ,technology ,policy2 and 7#ab7 any other agency that the representatives of the agencies set forth in paragraphs 7#a7 through 7#aa7 determine1 by consensus1 to be appropriate4 7b7 ,meetings ,the ,council shall meet at least #d times per year to advance its mission and fulfill its responsibilities under this section4 7c7 ,functions ,the ,council shall-- 7#a7 provide policy-level guidance to participating agencies on global health security goals1 objectives1 and implementation2 7#b7 facilitate interagency1 multi-sectoral engagement to carry out global health security activities1 including the ,global ,health ,security ,agenda2 7#c7 provide a forum for raising and working to resolve interagency disagreements concerning the global health security goals1 objectives1 and benchmarks2 7#d7 develop and set benchmarks for-- 7,a7 assessing1 measuring1 and improving global health security outcomes2 and 7,b7 identifying criteria for designating priority partner countries2 7#e7 review the progress toward1 and work to resolve challenges to1 achieving ,united ,states ,government commitments to global health security activities1 agreements1 and organizations1 including the ,global ,health ,security ,agenda and other commitments to assist other countries in achieving agreed-upon global health security targets2 and 7#f7 consider1 among other issues-- 7,a7 the status of ,united ,states financial commitments to global health security in the context of commitments by other donors1 and the contributions of partner countries to achieve global health security targets1 including the ,global ,health ,security ,agenda2 7,b7 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 strategies1 including the ,global ,health ,security ,agenda2 and 7,c7 external evaluations of the capabilities of the ,united ,states and partner countries to address infectious disease threats1 including-- 7i7 the ability to achieve the targets outlined in the ,joint ,external ,evaluation process2 and 7ii7 gaps identified by such external evaluations4 7d7 ,specific roles and responsibilities 7#a7 ,in general ,the heads of the agencies referred to in subsection 7a7 shall-- 7,a7 make the implementation of the ,global ,health ,security ,agenda 7referred to in this subsection as ,,ghsa7 and successor activities a high priority within their respective agencies1 and include ,,ghsa-related activities within their respective agencies' strategic planning and budget processes2 7,b7 designate a senior level official to be responsible for the implementation of this section2 7,c7 designate an appropriate representative1 at the ,assistant ,secretary level or higher1 to represent the agency on the ,council2 7,d7 keep the ,council apprised of global health security-related activities1 including the ,global ,health ,security ,agenda1 undertaken within their respective agencies2 7,e7 maintain responsibility for agency-related programmatic functions1 in coordination with host governments1 country teams1 and global health security in country teams1 and in conjunction with other relevant agencies2 7,f7 coordinate with other agencies referred to in subsection 7a7 to satisfy programmatic goals1 and further facilitate coordination of country teams1 implementers1 and donors in host countries2 and 7,g7 coordinate across ,,ghsa national plans and with ,,ghsa partners to which the ,united ,states is providing assistance4 7#b7 ,additional roles and responsibilities ,in addition to the roles and responsibilities described in paragraph 7#a71 the heads of agencies referred to in subsection 7a7 shall carry out their respective roles and responsibilities described in subsections 7b7 through 7i7 of section #c of ,executive ,order #acgdg 7#ha ,fed4 ,reg4 #ghgja2 relating to ,advancing the ,global ,health ,security ,agenda to ,achieve a ,world ,safe and ,secure from ,infectious ,disease ,threats71 as in effect on the day before the date of the enactment of this ,act4 7e7 ,limitations ,the ,council may not perform any activities or functions that interfere with the foreign affairs responsibilities of the ,secretary of ,state1 including the responsibility to oversee the implementation of programs and policies that advance the global health security activities within foreign countries4 #h4 ,strategy and reports 7a7 ,strategy ,the ,special ,advisor for ,global ,health ,security appointed under section #f shall coordinate the development and implementation of a strategy to implement the policy described in section #e1 which shall-- 7#a7 set specific and measurable goals1 benchmarks1 timetables1 performance metrics1 and monitoring and evaluation plans that reflect international best practices relating to transparency1 accountability1 and global health security2 7#b7 support and be aligned with country-owned global health security policy and investment plans developed with input from key stakeholders1 as appropriate2 7#c7 facilitate communication and collaboration1 as appropriate1 among local stakeholders in support of a multi-sectoral approach to global health security2 7#d7 support the long-term success of programs by building the capacity of local organizations and institutions in target countries and communities2 7#e7 develop community resilience to infectious disease threats and emergencies2 7#f7 leverage resources and expertise through partnerships with the private sector1 health organizations1 civil society1 nongovernmental organizations1 and health research and academic institutions2 and 7#g7 support collaboration1 as appropriate1 between ,united ,states universities1 and public and private institutions in target countries and communities to promote health security and innovation4 7b7 ,coordination ,the ,president1 acting through the ,special ,advisor for ,global ,health ,security1 shall coordinate1 through a whole-of-government approach1 the efforts of relevant ,federal departments and agencies in the implementation of the strategy required under subsection 7a7 by establishing-- 7#a7 monitoring and evaluation systems1 coherence1 and coordination across relevant ,federal departments and agencies2 and 7#b7 platforms for regular consultation and collaboration with key stakeholders and the appropriate congressional committees4 7c7 ,strategy submission 7#a7 ,in general ,not later than #f months after the date of the enactment of this ,act1 the ,president1 in consultation with the head of each relevant ,federal department and agency1 shall submit1 to the appropriate congressional committees-- 7,a7 the strategy required under subsection 7a72 and 7,b7 a detailed description of how the ,united ,states intends to advance the policy set forth in section #e and the agency-specific plans described in paragraph 7#b74 7#b7 ,agency-specific plans ,the strategy required under subsection 7a7 shall include specific implementation plans from each relevant ,federal department and agency that describes-- 7,a7 the anticipated contributions of the department or agency1 including technical1 financial1 and in-kind contributions1 to implement the strategy2 and 7,b7 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 sustainability4 7d7 ,report 7#a7 ,in general ,not later than #a year after the date on which the strategy required under subsection 7a7 is submitted to the appropriate congressional committees under subsection 7c71 and not later than ,october #a of each year thereafter1 the ,president shall submit a report to the appropriate congressional committees that describes the status of the implementation of the strategy4 7#b7 ,content ,the report required under paragraph 7#a7 shall-- 7,a7 contain a summary of the strategy as an appendix2 7,b7 identify any substantial changes made in the strategy during the preceding calendar year2 7,c7 describe the progress made in implementing the strategy2 7,d7 identify the indicators used to establish benchmarks and measure results over time1 as well as the mechanisms for reporting such results in an open and transparent manner2 7,e7 contain a transparent1 open1 and detailed accounting of expenditures by relevant ,federal departments and agencies to implement the strategy1 including1 for each ,federal department and agency1 the statutory source of expenditures1 amounts expended1 implementing partners1 targeted beneficiaries1 and activities supported2 7,f7 describe how the strategy leverages other ,united ,states global health and development assistance programs2 7,g7 assess efforts to coordinate ,united ,states global health security programs1 activities1 and initiatives with key stakeholders2 and 7,h7 incorporate a plan for regularly reviewing and updating strategies1 partnerships1 and programs and sharing lessons learned with a wide range of stakeholders1 including key stakeholders1 in an open1 transparent manner4 7e7 ,form ,the strategy required under subsection 7a7 and the report required under subsection 7d7 shall be submitted in unclassified form1 but may contain a classified annex4 #i4 ,coordination of ,federal response to global health emergencies 7a7 ,leadership ,the ,secretary of ,state1 in consultation with other appropriate ,federal departments1 including the ,department of ,agriculture1 the ,department of ,defense1 the ,department of ,health and ,human ,services1 and the ,department of ,homeland ,security1 shall coordinate and facilitate interagency1 multi-sectoral activities outside of the ,united ,states in response to a declared global health emergency4 ,the ,president may designate another ,federal official to coordinate domestic and extra-territorial activities related to a global health emergency4 7b7 ,coordination with international organizations ,in responding to a declared global health emergency under subsection 7a71 the ,secretary of ,state shall coordinate ,united ,states ,government's efforts with the efforts and programs of relevant international organizations and stakeholders1 including-- 7#a7 the ,world ,health ,organization2 7#b7 the ,food and ,agriculture ,organization of the ,united ,nations2 7#c7 the ,world ,organization for ,animal ,health2 7#d7 the ,global ,partnership ,against the ,spread of ,weapons and ,materials of ,mass ,destruction2 7#e7 ,,interpol2 7#f7 the ,economic ,community of ,west ,african ,states2 7#g7 the ,united ,nations ,office for ,disaster ,risk ,reduction2 7#h7 ,,gavi1 ,the ,vaccine ,alliance2 and 7#i7 other relevant international agencies and organizations4 7c7 ,interagency coordination ,the ,secretary of ,state shall ensure that global health security programs supported by the ,united ,states ,government are coordinated with1 and complementary to1 related programs in global food security1 development1 and education4 #aj4 ,authorization of appropriations ,there are authorized to be appropriated1 for each of the fiscal years #bjba through #bjbe-- 7#a7 to the ,centers for ,disease ,control and ,prevention1 #aij1jjj1jjj for the ,global ,disease ,detection and ,emergency ,response and ,global ,public ,health ,capacity and ,development ,accounts1 which shall be used to support activities that-- 7,a7 are consistent with ,united ,states global health security policy1 goals1 and priorities2 7,b7 have measurable benchmarks2 and 7,c7 focus on preventing avoidable catastrophes1 detecting threats early1 and responding rapidly and effectively2 and 7#b7 to the ,united ,states ,agency for ,international ,development1 #aaj1jjj1jjj for the ,global ,health ,security ,account1 which shall be used to support activities that-- 7,a7 are consistent with ,united ,states global health security policy1 goals1 and priorities2 7,b7 have measurable benchmarks2 and 7,c7 focus on preventing avoidable catastrophes1 detecting threats early1 and responding rapidly and effectively4