Global Health Security Act of 2021

IIB 117TH CONGRESS 1ST SESSION H. R. 391 IN THE SENATE OF THE UNITED STATES JULY 12, 2021 Received; read twice and referred to the Committee on Foreign Relations AN ACT To authorize a comprehensive, strategic approach for United States foreign assistance to developing countries to strengthen global health security, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 2 HR 391 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Global Health Security 2 Act of 2021’’. 3 SEC. 2. FINDINGS. 4 Congress finds the following: 5 (1) In December 2009, President Obama re- 6 leased the National Strategy for Countering Biologi- 7 cal Threats, which listed as one of seven objectives 8 ‘‘Promote global health security: Increase the avail- 9 ability of and access to knowledge and products of 10 the life sciences that can help reduce the impact 11 from outbreaks of infectious disease whether of nat- 12 ural, accidental, or deliberate origin’’. 13 (2) In February 2014, the United States and 14 nearly 30 other nations launched the Global Health 15 Security Agenda (GHSA) to address several high- 16 priority, global infectious disease threats. The 17 GHSA is a multi-faceted, multi-country initiative in- 18 tended to accelerate partner countries’ measurable 19 capabilities to achieve specific targets to prevent, de- 20 tect, and respond to infectious disease threats, 21 whether naturally occurring, deliberate, or acci- 22 dental. 23 (3) In 2015, the United Nations adopted the 24 Sustainable Development Goals (SDGs), which in- 25 clude specific reference to the importance of global 26 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 3 HR 391 RFS health security as part of SDG 3 ‘‘ensure healthy 1 lives and promote well-being for all at all ages’’ as 2 follows: ‘‘strengthen the capacity of all countries, in 3 particular developing countries, for early warning, 4 risk reduction and management of national and 5 global health risks’’. 6 (4) On November 4, 2016, President Obama 7 signed Executive Order No. 13747, ‘‘Advancing the 8 Global Health Security Agenda to Achieve a World 9 Safe and Secure from Infectious Disease Threats’’. 10 (5) In October 2017 at the GHSA Ministerial 11 Meeting in Uganda, the United States and more 12 than 40 GHSA member countries supported the 13 ‘‘Kampala Declaration’’ to extend the GHSA for an 14 additional 5 years to 2024. 15 (6) In December 2017, President Trump re- 16 leased the National Security Strategy, which in- 17 cludes the priority action: ‘‘Detect and contain bio- 18 threats at their source: We will work with other 19 countries to detect and mitigate outbreaks early to 20 prevent the spread of disease. We will encourage 21 other countries to invest in basic health care systems 22 and to strengthen global health security across the 23 intersection of human and animal health to prevent 24 infectious disease outbreaks’’. 25 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 4 HR 391 RFS (7) In September 2018, President Trump re- 1 leased the National Biodefense Strategy, which in- 2 cludes objectives to ‘‘strengthen global health secu- 3 rity capacities to prevent local bioincidents from be- 4 coming epidemics’’, and ‘‘strengthen international 5 preparedness to support international response and 6 recovery capabilities’’. 7 (8) In January 2021, President Biden issued 8 Executive Order 13987 (86 Fed. Reg. 7019; relating 9 to Organizing and Mobilizing the United States Gov- 10 ernment to Provide a Unified and Effective Re- 11 sponse to Combat COVID–19 and to Provide United 12 States Leadership on Global Health and Security), 13 as well as National Security Memorandum on 14 United States Global Leadership to Strengthen the 15 International COVID–19 Response and to Advance 16 Global Health Security and Biological Preparedness, 17 which include objectives to strengthen and reform 18 the World Health Organization, increase United 19 States leadership in the global response to COVID– 20 19, and to finance and advance global health secu- 21 rity and pandemic preparedness. 22 SEC. 3. STATEMENT OF POLICY. 23 It is the policy of the United States to— 24 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 5 HR 391 RFS (1) promote and invest in global health security 1 and pandemic preparedness as a core national secu- 2 rity interest; 3 (2) advance the aims of the Global Health Se- 4 curity Agenda; 5 (3) collaborate with other countries to detect 6 and mitigate outbreaks early to prevent the spread 7 of disease; 8 (4) encourage and support other countries to 9 advance pandemic preparedness by investing in basic 10 resilient and sustainable health care systems; and 11 (5) strengthen global health security across the 12 intersection of human and animal health to prepare 13 for and prevent infectious disease outbreaks and 14 combat the growing threat of antimicrobial resist- 15 ance. 16 SEC. 4. GLOBAL HEALTH SECURITY AGENDA INTERAGENCY 17 REVIEW COUNCIL. 18 (a) ESTABLISHMENT.—The President shall establish 19 a Global Health Security Agenda Interagency Review 20 Council (in this section referred to as the ‘‘Council’’) to 21 perform the general responsibilities described in sub- 22 section (c) and the specific roles and responsibilities de- 23 scribed in subsection (e). 24 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 6 HR 391 RFS (b) MEETINGS.—The Council shall meet not less than 1 four times per year to advance its mission and fulfill its 2 responsibilities. 3 (c) GENERAL RESPONSIBILITIES.—The Council shall 4 be responsible for the following activities: 5 (1) Provide policy-level recommendations to 6 participating agencies on Global Health Security 7 Agenda (GHSA) goals, objectives, and implementa- 8 tion, and other international efforts to strengthen 9 pandemic preparedness and response. 10 (2) Facilitate interagency, multi-sectoral en- 11 gagement to carry out GHSA implementation. 12 (3) Provide a forum for raising and working to 13 resolve interagency disagreements concerning the 14 GHSA, and other international efforts to strengthen 15 pandemic preparedness and response. 16 (4)(A) Review the progress toward and work to 17 resolve challenges in achieving United States com- 18 mitments under the GHSA, including commitments 19 to assist other countries in achieving the GHSA tar- 20 gets. 21 (B) The Council shall consider, among other 22 issues, the following: 23 (i) The status of United States financial 24 commitments to the GHSA in the context of 25 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 7 HR 391 RFS commitments by other donors, and the con- 1 tributions of partner countries to achieve the 2 GHSA targets. 3 (ii) The progress toward the milestones 4 outlined in GHSA national plans for those 5 countries where the United States Government 6 has committed to assist in implementing the 7 GHSA and in annual work-plans outlining 8 agency priorities for implementing the GHSA. 9 (iii) The external evaluations of United 10 States and partner country capabilities to ad- 11 dress infectious disease threats, including the 12 ability to achieve the targets outlined within the 13 WHO Joint External Evaluation tool, as well as 14 gaps identified by such external evaluations. 15 (d) PARTICIPATION.—The Council shall be headed by 16 the Assistant to the President for National Security Af- 17 fairs, in coordination with the heads of relevant Federal 18 agencies. The Council shall consist of representatives from 19 the following agencies: 20 (1) The Department of State. 21 (2) The Department of Defense. 22 (3) The Department of Justice. 23 (4) The Department of Agriculture. 24 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 8 HR 391 RFS (5) The Department of Health and Human 1 Services. 2 (6) The Department of the Treasury. 3 (7) The Department of Labor. 4 (8) The Department of Homeland Security. 5 (9) The Office of Management and Budget. 6 (10) The Office of the Director of National In- 7 telligence. 8 (11) The United States Agency for Inter- 9 national Development. 10 (12) The Environmental Protection Agency. 11 (13) The Centers for Disease Control and Pre- 12 vention. 13 (14) The Office of Science and Technology Pol- 14 icy. 15 (15) The National Institutes of Health. 16 (16) The National Institute of Allergy and In- 17 fectious Diseases. 18 (17) Such other agencies as the Council deter- 19 mines to be appropriate. 20 (e) SPECIFIC ROLES AND RESPONSIBILITIES.— 21 (1) IN GENERAL.—The heads of agencies de- 22 scribed in subsection (d) shall— 23 (A) make the GHSA and its implementa- 24 tion and global pandemic preparedness a high 25 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 9 HR 391 RFS priority within their respective agencies, and in- 1 clude GHSA- and global pandemic prepared- 2 ness-related activities within their respective 3 agencies’ strategic planning and budget proc- 4 esses; 5 (B) designate a senior-level official to be 6 responsible for the implementation of this Act; 7 (C) designate, in accordance with sub- 8 section (d), an appropriate representative at the 9 Assistant Secretary level or higher to partici- 10 pate on the Council; 11 (D) keep the Council apprised of GHSA- 12 related activities undertaken within their re- 13 spective agencies; 14 (E) maintain responsibility for agency-re- 15 lated programmatic functions in coordination 16 with host governments, country teams, and 17 GHSA in-country teams, and in conjunction 18 with other relevant agencies; 19 (F) coordinate with other agencies that are 20 identified in this section to satisfy pro- 21 grammatic goals, and further facilitate coordi- 22 nation of country teams, implementers, and do- 23 nors in host countries; and 24 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 10 HR 391 RFS (G) coordinate across national health secu- 1 rity action plans and with GHSA and other 2 partners, as appropriate, to which the United 3 States is providing assistance. 4 (2) ADDITIONAL ROLES AND RESPONSIBIL- 5 ITIES.—In addition to the roles and responsibilities 6 described in paragraph (1), the heads of agencies de- 7 scribed in subsection (d) shall carry out their respec- 8 tive roles and responsibilities described in sub- 9 sections (b) through (i) of section 3 of Executive 10 Order 13747 (81 Fed. Reg. 78701; relating to Ad- 11 vancing the Global Health Security Agenda to 12 Achieve a World Safe and Secure from Infectious 13 Disease Threats), as in effect on the day before the 14 date of the enactment of this Act. 15 SEC. 5. UNITED STATES COORDINATOR FOR GLOBAL 16 HEALTH SECURITY. 17 (a) IN GENERAL.—The President shall appoint an in- 18 dividual to the position of United States Coordinator for 19 Global Health Security, who shall be responsible for the 20 coordination of the interagency process for responding to 21 global health security emergencies. As appropriate, the 22 designee shall coordinate with the President’s Special Co- 23 ordinator for International Disaster Assistance. 24 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 11 HR 391 RFS (b) CONGRESSIONAL BRIEFING.—Not less frequently 1 than twice each year, the employee designated under this 2 section shall provide to the appropriate congressional com- 3 mittees a briefing on the responsibilities and activities of 4 the individual under this section. 5 SEC. 6. SENSE OF CONGRESS. 6 It is the sense of the Congress that, given the complex 7 and multisectoral nature of global health threats to the 8 United States, the President— 9 (1) should consider appointing an individual 10 with significant background and expertise in public 11 health or emergency response management to the 12 position of United States Coordinator for Global 13 Health Security, as required by section 5(a), who is 14 an employee of the National Security Council at the 15 level of Deputy Assistant to the President or higher; 16 and 17 (2) in providing assistance to implement the 18 strategy required under section 7(a), should— 19 (A) coordinate, through a whole-of-govern- 20 ment approach, the efforts of relevant Federal 21 departments and agencies to implement the 22 strategy; 23 (B) seek to fully utilize the unique capa- 24 bilities of each relevant Federal department and 25 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H391.RFS H391 pbinns on DSKJLVW7X2PROD with BILLS 12 HR 391 RFS agency while collaborating with and leveraging 1 the contributions of other key stakeholders; and 2 (C) utilize open and streamlined solicita- 3 tions to allow for the participation of a wide 4 range of implementing partners through the 5 most appropriate procurement mechanisms, 6 which may include grants, contracts, coopera- 7 tive agreements, and other instruments as nec- 8 essary and appropriate. 9 SEC. 7. STRATEGY AND REPORTS. 10 (a) STRATEGY.—The President shall coordinate the 11 development and implementation of a strategy to imple- 12 ment the policy aims described in section 3, which shall— 13 (1) seek to strengthen United States diplomatic 14 leadership and improve the effectiveness of United 15 States foreign assistance for global health security to 16 prevent, detect, and respond to infectious disease 17 threats, including through advancement of the Glob- 18 al Health Security Agenda (GHSA), the Inter- 19 national Health Regulations (2005), and other rel- 20 evant frameworks that contribute to global health 21 security and pandemic preparedness; 22 (2) establish specific and measurable goals, 23 benchmarks, timetables, performance metrics, and 24 monitoring and evaluation plans for United States 25 VerDate Sep 11 2014 02:20 Jul 13, 2021 Jkt 019200 PO 00000 Frm 00 [Text truncated for display. Full text available on Congress.gov.]