Global Health Coordination and Development Act

II 116TH CONGRESS 1ST SESSION S. 2698 To establish a United States Global Health Commission and a United States Global Health Attache´ Program, and for other purposes. IN THE SENATE OF THE UNITED STATES OCTOBER 24, 2019 Mr. MARKEY introduced the following bill; which was read twice and referred to the Committee on Foreign Relations A BILL To establish a United States Global Health Commission and a United States Global Health Attache´ Program, 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 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Global Health Coordi- 4 nation and Development Act’’. 5 SEC. 2. FINDINGS; SENSE OF CONGRESS; AND PURPOSES. 6 (a) FINDINGS.—Congress makes the following find- 7 ings: 8 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 2698 IS (1) Of all foreign assistance provided by the 1 United States, global health appropriations are sec- 2 ond only to security assistance. 3 (2) Several Federal agencies and departments 4 execute global health activities, including the United 5 States Agency for International Development, the 6 Department of Health and Human Services, the De- 7 partment of Defense, the Department of Agriculture, 8 and the Department of State. 9 (3) Global health assistance provided by the 10 United States supports— 11 (A) activities carried out by numerous pri- 12 vate, corporate, and nongovernmental organiza- 13 tions worldwide; and 14 (B) multilateral organizations, such as the 15 Global Fund to Fight AIDS, Tuberculosis, and 16 Malaria and the World Health Organization. 17 (4) The United States provides foreign assist- 18 ance to achieve national security, commercial, and 19 humanitarian objectives while demonstrating global 20 leadership. 21 (5) All United States funded foreign assistance 22 programs, regardless of the implementing agency, 23 support the objectives referred to in paragraph (4), 24 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 2698 IS but the manner in which the programs achieve the 1 objectives varies widely. 2 (6) The approach for global health assistance 3 provided by the United States is largely program- 4 based or disease-based and often does not allow 5 agencies to work across the health system or on 6 issues of greatest concern to the host country. 7 (7) Such an approach hampers long-term sta- 8 bility, diplomacy with key partnerships, and sustain- 9 able capacity building. 10 (b) SENSE OF CONGRESS.—It is the sense of Con- 11 gress that— 12 (1) each global health implementing agency 13 should establish a program for the development of a 14 cadre of health advisors who can serve as United 15 States global health attache´s; 16 (2) country or regional health teams and health 17 development partners working groups should be es- 18 tablished in all countries with significant United 19 States health investments; and 20 (3) all global health activities supported by the 21 United States Government should be implemented in 22 a coordinated manner. 23 (c) PURPOSES.—The purposes of this Act are— 24 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 2698 IS (1) to establish a governmental framework and 1 national policy, priorities, and goals that ensure 2 interagency coordination for global health assistance 3 with the overall diplomacy, development, and defense 4 efforts of the United States Government; 5 (2) to establish the Senior United States Global 6 Health Advisor and the United States Global Health 7 Commission at the level of the National Security 8 Council to harmonize the global health goals and 9 priorities of the United States and promote inter- 10 agency coordination for global health assistance with 11 the overall efforts of the United States Government; 12 (3) to establish an Interagency Global Health 13 Committee to implement the Unified Global Health 14 Strategy and develop policies and frameworks to im- 15 prove coordination and outcomes; and 16 (4) to establish the United States Global Health 17 Attache´ Program to field global health attache´s as 18 key interlocutors who coordinate the country or re- 19 gional health team and ensure effective health as- 20 sessment, planning, integration, and implementation 21 across all agencies in support of the interests of the 22 United States. 23 SEC. 3. DEFINITIONS. 24 In this Act: 25 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 2698 IS (1) CHIEF OF MISSION.—The term ‘‘chief of 1 mission’’ has the meaning given such term in section 2 102 of the Foreign Service Act of 1980 (22 U.S.C. 3 3902). 4 (2) COMMISSION.—The term ‘‘Commission’’ 5 means the United States Global Health Commission 6 established under section 4. 7 (3) COMMITTEE.—The term ‘‘Committee’’ 8 means the Interagency Global Health Committee es- 9 tablished under section 6. 10 (4) COUNTRY OR REGIONAL HEALTH TEAM.— 11 The term ‘‘country or regional health team’’ includes 12 employees of global health implementing agencies 13 operating in a country or designated geographic re- 14 gion. 15 (5) GLOBAL HEALTH ACTIVITIES.—The term 16 ‘‘global health activities’’ means activities conducted 17 in coordination with United States and foreign enti- 18 ties, including foreign governments— 19 (A) to improve health care, the provision of 20 public health services, responses to public 21 health emergencies, and global health security; 22 and 23 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 2698 IS (B) to strengthen health systems and in- 1 frastructure, including the training and edu- 2 cation of health workers. 3 (6) GLOBAL HEALTH IMPLEMENTING AGEN- 4 CIES.—The term ‘‘global health implementing agen- 5 cies’’ means— 6 (A) the Department of State; 7 (B) the United States Agency for Inter- 8 national Development; 9 (C) the Department of Health and Human 10 Services; 11 (D) the Department of Defense; 12 (E) the Department of Agriculture; and 13 (F) the Department of Commerce. 14 (7) REGIONAL.—The term ‘‘regional’’ refers to 15 a geographic region as designated by a global health 16 implementing agency. 17 (8) STRATEGY.—The term ‘‘Strategy’’ means 18 the Unified Global Health Strategy formulated 19 under section 5. 20 SEC. 4. UNITED STATES GLOBAL HEALTH COMMISSION. 21 (a) ESTABLISHMENT.—Not later than 90 days after 22 the date of the enactment of this Act, the President, work- 23 ing through the National Security Council, shall establish 24 a commission to improve the interagency coordination, 25 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 2698 IS stewardship, accountability, outcomes, and impact of glob- 1 al health investment by the United States. 2 (b) DESIGNATION.—The commission established 3 under subsection (a) shall be known as the ‘‘United States 4 Global Health Commission’’. 5 (c) CHAIRPERSON; ADVISOR.—The President shall 6 appoint a noncabinet-level senior staff member to the Na- 7 tional Security Council to serve as— 8 (1) the Chairperson of the Commission; and 9 (2) the Senior United States Global Health Ad- 10 visor. 11 (d) MEMBERSHIP.— 12 (1) IN GENERAL.—The Commission shall be 13 composed of— 14 (A) the Chairperson; 15 (B) a commissioners group (referred to in 16 this section as the ‘‘principal group’’); 17 (C) a staff group; and 18 (D) any working group that the principal 19 group determines to be necessary to carry out 20 the duties under this section. 21 (2) PRINCIPAL GROUP.—The principal group 22 shall be composed of— 23 (A) 12 voting members, of whom— 24 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 2698 IS (i) 1 shall be appointed from each 1 global health implementing agency by the 2 head of the respective agency from among 3 senior officials responsible for global 4 health, emergency assistance, development, 5 or a similar area; 6 (ii) 3 shall be appointed by the Presi- 7 dent from among individuals from aca- 8 demic or research institutions with exper- 9 tise in global health policy, foreign rela- 10 tions, or public health emergencies; and 11 (iii) 3 shall be appointed by the Presi- 12 dent from among individuals from the 13 international development community with 14 expertise in health, community, or eco- 15 nomic development; and 16 (B) 2 nonvoting, ex officio members, of 17 whom— 18 (i) 1 shall be the President of the Na- 19 tional Academy of Medicine; and 20 (ii) 1 shall be an employee of the Gov- 21 ernment Accountability Office who shall be 22 appointed by the Comptroller General of 23 the United States. 24 (3) STAFF GROUP.— 25 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 2698 IS (A) COMPOSITION.—The staff group de- 1 scribed in paragraph (1)(C) shall be composed 2 of representatives of the National Security 3 Council, the global health implementing agen- 4 cies, the Government Accountability Office, and 5 the National Academy of Medicine, as des- 6 ignated by the head of the respective agency. 7 (B) FUNCTION.—The staff group shall ad- 8 vise, provide subject-matter expertise to, and 9 support the activities of, the Commission. 10 (e) PERIODS OF APPOINTMENT; VACANCIES.— 11 (1) PERIODS OF APPOINTMENT.— 12 (A) GOVERNMENTAL OFFICIALS.—Each 13 member of the principal group appointed under 14 subsection (d)(2)(A)(i) shall serve at the discre- 15 tion of the head of the respective agency. 16 (B) NONGOVERNMENTAL OFFICIALS.— 17 Each member of the principal group appointed 18 under clause (ii) or (iii) of subsection (d)(2)(A) 19 shall serve for a period of not fewer than 2 20 years and not more than 5 years. 21 (2) VACANCIES.—A vacancy in the Commis- 22 sion— 23 (A) shall not affect the powers of the Com- 24 mission; and 25 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 2698 IS (B) shall be filled in the same manner as 1 the original appointment. 2 (f) MEETINGS.— 3 (1) IN GENERAL.—The Commission shall meet 4 at the call of the Chairperson. 5 (2) INITIAL MEETING.—Not later than 180 6 days after the date of the enactment of this Act, the 7 Commission shall hold its initial meeting. 8 (3) PRINCIPAL GROUP.—The principal group 9 shall meet not less frequently than twice each year. 10 (4) STAFF GROUP.—The staff group described 11 in subsection (d)(1)(C) shall meet as determined by 12 the Chairperson based on the activities of the Com- 13 mission. 14 (g) BYLAWS.— 15 (1) IN GENERAL.—Not later than 180 days 16 after the date of the enactment of this Act, the 17 Commission shall develop bylaws for the operation of 18 the Commission. 19 (2) ELEMENTS.—The bylaws developed under 20 paragraph (1) shall include— 21 (A) information on the membership of the 22 Commission; 23 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 2698 IS (B) the number of annual meetings re- 1 quired for the principal group and the staff 2 group; 3 (C) the decision-making process of the 4 Commission; 5 (D) the process by which disputes are re- 6 solved; and 7 (E) such other information and policies as 8 the Commission considers appropriate. 9 (h) PRIMARY RESPONSIBILITIES.—The Commission 10 shall— 11 (1) develop an integrated, comprehensive global 12 health strategy, in accordance with section 5 and in 13 cooperation with global health implementing agen- 14 cies, to ensure that global health activities and pro- 15 grams supported by the United States are consistent 16 with the strategic priorities and policies of the 17 United States; 18 (2) recommend methods to improve alignment, 19 coordination, planning, and implementation to en- 20 sure the greatest possible impact and overall effec- 21 tiveness of United States global health efforts and 22 programs; 23 (3) in coordination with the Committee, advise 24 the National Security Council on global health issues 25 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 2698 IS that potentially impact the domestic health status, 1 defense operations, development programs, diplo- 2 macy efforts, and strategic interests of the United 3 States; 4 (4) advise the Committee on country and re- 5 gional challenges; 6 (5) based on the priorities of the United States, 7 recommend countries or regions that would greatly 8 benefit from— 9 (A) receiving a global health attache´ under 10 section 7; and 11 (B) the establishment of a country or re- 12 gional health development implementation plan 13 under section 8; 14 (6) recommend agenda items and provide other 15 recommendations and advice to the Committee; and 16 (7) facilitate cooperation between the United 17 States Government and academic and research insti- 18 tutions, civil society, international nongovernmental 19 organizations, and other public and private entities. 20 (i) REPORTS.— 21 (1) INITIAL REPORT.—Not later than 1 year 22 after the date of the enactment of this Act, the 23 Commission shall submit to the President and Con- 24 gress an initial report that includes— 25 VerDate Sep 11 2014 20:35 Oct 26, 2019 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S2698.IS S2698 pamtmann on DSKBC07HB2PROD with BILLS 13 •S 2698 IS (A) the bylaws and membership of the 1 Commission; 2 (B) a description of the methodology for 3 the development of the Strategy; and 4 (C) a description of progress made toward 5 developing the Strategy. 6 (2) BIENNIAL REPORT.— 7 (A) IN GENERAL.—Not later than 1 year 8 after the submission of the initial report under 9 paragraph (1), and biennially thereafter, the 10 Commission shall submit to the President and 11 Congress a report on the activities of the Com- 12 mission during the period covered by the report. 13 (B) ELEMENTS.—Each report submitted 14 under subparagraph (A) shall include— 15 (i) any updates to the Strat [Text truncated for display. 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