Congressional Record, Senate, November 4, 2021 — Amendments to H.R. 4350
Summary
Page S7903 of the Senate section of the Congressional Record for November 4, 2021, headed as amendments to H.R. 4350, in interleaved columns. SA 4396 from Mr. Risch and Mr. Menendez is among the submitted amendments. Amendment text includes a definition of derived information or evidence in surveillance provisions, a list of foreign assistance accounts such as International Disaster Assistance and Non-Proliferation, Antiterrorism, Demining, and Related, and a provision on prohibiting United States foreign assistance for the Government of the People's Republic of China.
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“Congressional Record, Senate, November 4, 2021 — Amendments to H.R. 4350.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/crec-crec-2021-11-04-crec-2021-11-04-pt1-pgs7903-2-5bf4e94d7a/
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7903
‘‘(3) DERIVED.—Information or evidence is through third parties, communications con- (G) International Disaster Assistance
‘derived’ from an acquisition when the Gov- tent, non-contents information, or business (IDA); and
ernment would not have originally possessed records, those authorizations shall provide (H) Non-Proliferation, Antiterrorism,
the information or evidence but for that ac- the exclusive means by which such searches Demining, and Related (NADR).
quisition, and regardless of any claim that or acquisition shall take place if the target
the information or evidence is attenuated of acquisition is a United States person and SA 4396. Mr. RISCH (for himself and
from the surveillance or search, would inevi- the information is sought for foreign intel- Mr. MENENDEZ) submitted an amend-
tably have been discovered, or was subse- ligence purposes. ment intended to be proposed to
quently reobtained through other means (3) LIMITATION ON USE IN LEGAL PRO- amendment SA 3867 submitted by Mr.
‘‘(b) LIMITATION ON AUTHORITIES.—Notwith- CEEDINGS.—Except as provided in paragraph REED and intended to be proposed to
standing any other provision of this Act, an (5), any information concerning a United the bill H.R. 4350, to authorize appro-
officer of the United States may not under States person acquired or derived from an
acquisition under Executive Order 12333 (50
priations for fiscal year 2022 for mili-
this Act request an order for, and the For-
eign Intelligence Surveillance Court may not U.S.C. 3001 note; relating to United States tary activities of the Department of
under this Act order— intelligence activities), where such acquisi- Defense, for military construction, and
‘‘(1) electronic surveillance of a United tion is not authorized by statute or by the for defense activities of the Depart-
States person; Federal Rules of Criminal Procedure, shall ment of Energy, to prescribe military
‘‘(2) a physical search of a premises, infor- not be used in evidence against that United personnel strengths for such fiscal
mation, material, or property used exclu- States person in any criminal, civil, or ad- year, and for other purposes; which was
sively by, or under the open and exclusive ministrative proceeding or as part of any ordered to lie on the table; as follows:
control of, a United States person; criminal, civil, or administrative investiga-
At the end of title XII, add the following:
‘‘(3) approval of the installation and use of tion.
(4) LIMITATION ON UNITED STATES PERSON Subtitle H—International Pandemic
a pen register or trap and trace device to ob-
QUERIES.—No governmental entity shall Preparedness and COVID–19 Response
tain information concerning a United States
query communications content, non-con- SEC. 1291. SHORT TITLE.
person;
‘‘(4) the production of tangible things (in- tents information, or business records ac- This subtitle may be cited as the ‘‘Inter-
cluding books, records, papers, documents, quired for foreign intelligence purposes national Pandemic Preparedness and COVID-
and other items) concerning a United States under Executive Order 12333 (50 U.S.C. 3001 19 Response Act of 2021’’.
note; relating to United States intelligence SEC. 1292. DEFINITIONS.
person; or
‘‘(5) the targeting of a United States per- activities) but without statutory authoriza- In this subtitle:
son for the acquisition of information. tion or authorization under the Federal (1) APPROPRIATE CONGRESSIONAL COMMIT-
‘‘(c) LIMITATION ON USE OF INFORMATION Rules of Criminal Procedure using search TEES.—The term ‘‘appropriate congressional
CONCERNING UNITED STATES PERSONS.— terms associated with a United States per- committees’’ means—
‘‘(1) DEFINITION OF AGGRIEVED PERSON.—In son. (A) the Committee on Foreign Relations of
this subsection, the term ‘aggrieved person’ (5) USE BY AGGRIEVED PERSONS.—An ag- the Senate;
means a person who is the target of any sur- grieved person who is a United States person (B) the Committee on Appropriations of
veillance activity under this Act or any may use information concerning such person the Senate;
other person whose communications or ac- acquired under Executive Order 12333 in a (C) the Committee on Foreign Affairs of
criminal, civil, or administrative proceeding the House of Representatives; and
tivities were subject to any surveillance ac-
or as part of a criminal, civil, or administra- (D) the Committee on Appropriations of
tivity under this Act.
tive investigation. the House of Representatives.
‘‘(2) IN GENERAL.—Except as provided in
(2) GLOBAL HEALTH SECURITY AGENDA;
paragraph (3), any information concerning a
United States person acquired or derived
SA 4395. Mr. PAUL submitted an GHSA.—The terms ‘‘Global Health Security
amendment intended to be proposed to Agenda’’ and ‘‘GHSA’’ mean the multi-sec-
from an acquisition under this Act shall not
amendment SA 3867 submitted by Mr. toral initiative launched in 2014 and renewed
be used in evidence against that United
REED and intended to be proposed to in 2018 that brings together countries, re-
States person in any criminal, civil, or ad-
gions, international organizations, non-
ministrative proceeding or as part of any the bill H.R. 4350, to authorize appro-
governmental organizations, and the private
criminal, civil, or administrative investiga- priations for fiscal year 2022 for mili- sector to elevate global health security as a
tion. tary activities of the Department of national-level priority, to share best prac-
‘‘(3) USE BY AGGRIEVED PERSONS.—An ag- Defense, for military construction, and tices, and to facilitate national capacity to
grieved person who is a United States person for defense activities of the Depart- comply with and adhere to—
may use information concerning such person
ment of Energy, to prescribe military (A) the International Health Regulations
acquired under this Act in a criminal, civil, (2005);
or administrative proceeding or as part of a
personnel strengths for such fiscal
year, and for other purposes; which was (B) the World Organisation for Animal
criminal, civil, or administrative investiga- Health international standards and guide-
tion.’’. ordered to lie on the table; as follows:
lines;
(2) CLERICAL AMENDMENT.—The table of Strike section 1213 and insert the fol-
(C) United Nations Security Council Reso-
contents preceding section 101 is amended by lowing:
lution 1540 (2004);
adding at the end the following: SEC. 1213. PROHIBITION ON USE OF FUNDS FOR
TALIBAN AND RESCISSION OF UNOB-
(D) the Convention on the Prohibition of
‘‘TITLE IX—LIMITATIONS the Development, Production and Stock-
LIGATED BALANCES FOR AFGHANI-
‘‘Sec. 901. Limitations on authorities to sur- STAN. piling of Bacteriological and Toxin Weapons
veil United States persons and (a) PROHIBITION.—None of the funds author- and on their Destruction, done at Wash-
on use of information con- ized to be appropriated by this Act or any ington, London, and Moscow, April 10, 1972
cerning United States per- other Act may be made available for the (commonly referred to as the ‘‘Biological
sons.’’. transfer of funds, supplies, or any other item Weapons Convention’’);
(b) LIMITATION ON SURVEILLANCE UNDER of monetary value to the Taliban. (E) the Global Health Security Agenda 2024
EXECUTIVE ORDER 12333.— (b) RESCISSION.— Framework; and
(1) DEFINITIONS.—In this subsection: (1) IN GENERAL.—There are hereby re- (F) other relevant frameworks that con-
(A) AGGRIEVED PERSON.—The term ‘‘ag- scinded all unobligated balances from the tribute to global health security.
grieved person’’ means a person who is the amounts appropriated or otherwise made (3) GLOBAL HEALTH SECURITY INDEX .—The
target of any surveillance activity under Ex- available to the covered funds for recon- term ‘‘Global Health Security Index’’ means
ecutive Order 12333 (50 U.S.C. 3001 note; relat- struction activities in Afghanistan. the comprehensive assessment and
ing to United States intelligence activities) (2) COVERED FUNDS DEFINED.—In this sub- benchmarking of health security and related
or any other person whose communications section, the term ‘‘covered funds’’ means, capabilities across the countries that make
or activities were subject to any surveillance with respect to amounts appropriated for Af- up the States Parties to the International
activity under such Executive Order. ghanistan— Health Regulations (2005).
(B) PEN REGISTER; TRAP AND TRACE DEVICE; (A) the Afghanistan Security Forces Fund (4) GLOBAL HEALTH SECURITY INITIATIVE.—
UNITED STATES PERSON.—The terms ‘‘pen reg- (ASFF); The term ‘‘Global Health Security Initia-
ister’’, ‘‘trap and trace device’’, and ‘‘United (B) the Economic Support Fund (ESF); tive’’ means the informal network of coun-
States person’’ have the meanings given such (C) International Narcotics Control and tries and organizations that came together
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terms in section 901 of the Foreign Intel- Law Enforcement (INCLE); in 2001 to undertake concerted global action
ligence Surveillance Act of 1978, as added by (D) the Commanders’ Emergency Response to strengthen public health preparedness and
subsection (a). Program (CERP); response to chemical, biological, radio-
(2) LIMITATION ON ACQUISITION.—Where au- (E) Drug Interdiction and Counter-Drug logical, and nuclear threats, including pan-
thority is provided by statute or by the Fed- Activities (DICDA); demic influenza.
eral Rules of Criminal Procedure to perform (F) Migration and Refugee Assistance (5) JOINT EXTERNAL EVALUATION.—The term
physical searches or to acquire, directly or (MRA); ‘‘Joint External Evaluation’’ means the
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S7904 CONGRESSIONAL RECORD — SENATE November 4, 2021
World Health Organization-facilitated, vol- resources, capacity, and personnel required cial implications of the COVID–19 pandemic,
untary, collaborative, multi-sectoral process to prevent, prepare for, detect, and respond while taking into account the differentiated
to assess country capacity to prevent, de- to infectious disease threats before they be- needs of disproportionately affected, vulner-
tect, and rapidly respond to public health come pandemics. able, and marginalized populations;
risks occurring naturally or due to delib- SEC. 1294. ENHANCING THE UNITED STATES’ (10) entering into discussions with vaccine
erate or accidental events, assess progress in INTERNATIONAL RESPONSE TO manufacturing companies to support part-
achieving the targets under the Inter- COVID–19 AND FUTURE PANDEMICS. nerships, with the goal of ensuring adequate
national Health Regulations (2005), and rec- (a) STATEMENT OF POLICY REGARDING global supply of vaccines, which may include
ommend priority actions. INTERNATIONAL COOPERATION TO END THE necessary components and raw materials;
(6) KEY STAKEHOLDERS.—The term ‘‘key COVID–19 PANDEMIC.—It shall be the policy (11) establishing clear timelines, bench-
stakeholders’’ means actors engaged in ef- of the United States to lead and implement marks, and goals for COVID–19 response
forts to advance global health security pro- a comprehensive and coordinated inter- strategies and activities under this section;
grams and objectives, including— national response to end the COVID–19 pan- and
(A) national and local governments in demic in a manner that recognizes the crit- (12) generating commitments of resources
ical role that multilateral and regional orga- in support of the goals referred to in para-
partner countries;
nizations can and should play in pandemic graph (6).
(B) other bilateral donors;
response, including by— (b) OVERSIGHT OF UNITED STATES FOREIGN
(C) international, regional, and local orga-
(1) seeking adoption of a United Nations ASSISTANCE TO END THE COVID–19 PAN-
nizations, including private, voluntary, non-
Security Council resolution that— DEMIC.—
governmental, and civil society organiza-
(A) declares pandemics, including the (1) REPORTING REQUIREMENTS.—Not later
tions;
COVID–19 pandemic, to be a threat to inter- than 60 days after the date of the enactment
(D) international, regional, and local fi-
national peace and security; and of this Act, the Secretary of State and the
nancial institutions;
(B) urges member states to address this USAID Administrator shall jointly submit to
(E) representatives of historically threat by aligning their health preparedness
marginalized groups, including women, the appropriate congressional committees—
plans with international best practices, in- (A) an unclassified report containing a de-
youth, and indigenous peoples; cluding those established by the Global
(F) the private sector, including medical scription of funds already obligated and ex-
Health Security Agenda, to improve country pended under title X of the American Rescue
device, technology, pharmaceutical, manu- capacity to prevent, detect, and respond to
facturing, logistics, and other relevant com- Plan Act of 2021 (Public Law 117–2); and
infectious disease threats; (B) a plan that describes the objectives and
panies; and (2) advancing efforts to reform the World
(G) public and private research and aca- timeline for the obligation and expenditure
Health Organization so that it serves as an of all remaining funds appropriated under
demic institutions. effective, normative, and coordinating body
(7) ONE HEALTH APPROACH.—The term ‘‘One title X of the American Rescue Plan Act of
that is capable of aligning member countries 2021, to include support for civil society for
Health approach’’ means the collaborative, around a strategic operating plan to detect,
multi-sectoral, and transdisciplinary ap- the protection of human rights in the con-
contain, treat, and deter the further spread text of the COVID–19 pandemic, which shall
proach toward achieving optimal health out- of COVID–19;
comes in a manner that recognizes the inter- be submitted in an unclassified form, and
(3) providing timely, appropriate levels of should include a description of steps taken
connection between people, animals, plants, financial support to United Nations agencies
and their shared environment. pursuant to each objective specified in the
responding to the COVID–19 pandemic; plan.
(8) RELEVANT FEDERAL DEPARTMENTS AND (4) prioritizing United States foreign as-
AGENCIES.—The term ‘‘relevant Federal de- (2) CONGRESSIONAL CONSULTATION.—Not less
sistance for the COVID–19 response in the frequently than once every 60 days, until the
partments and agencies’’ means any Federal most vulnerable countries and regions;
department or agency implementing United completion or termination of the implemen-
(5) encouraging other donor governments tation plan required under paragraph (1)(B),
States policies and programs relevant to the to similarly increase contributions to the
advancement of United States global health and upon the request from one or more of the
United Nations agencies responding to the appropriate congressional committees, the
security and diplomacy overseas, which may COVID–19 pandemic in the world’s poorest
include— Secretary of State and the USAID Adminis-
and most vulnerable countries; trator shall provide a briefing to the appro-
(A) the Department of State; (6) working with key stakeholders to accel-
(B) the United States Agency for Inter- priate congressional committees regarding
erate progress toward meeting and exceed- the report required under paragraph (1)(A)
national Development; ing, as practicable, global COVID–19 vaccina-
(C) the Department of Health and Human and the status of the implementation of the
tion goals, whereby— plan required under paragraph (1)(B).
Services; (A) at least 40 percent of the population in
(D) the Department of Defense; (3) BRANDING.—In providing assistance
all countries is vaccinated by the end of 2021; under this section, the Secretary of State
(E) the Defense Threat Reduction Agency; and
(F) the Millennium Challenge Corporation; and the USAID Administrator, with due con-
(B) at least 70 percent of the population in sideration for the safety and security of im-
(G) the Development Finance Corporation; all countries is vaccinated by the opening
(H) the Peace Corps; and plementing partners and beneficiaries, shall
date of the 77th regular session of the United prescribe the use of logos or other insignia,
(I) any other department or agency that Nations General Assembly;
the President determines to be relevant for which may include the flag of the United
(7) engaging with key overseas stake- States, to appropriately identify such assist-
these purposes. holders, including through multilateral fa-
(9) RESILIENCE.—The term ‘‘resilience’’ ance as being from the people of the United
cilities such as the COVID–19 Vaccines Glob- States.
means the ability of people, households, al Access initiative (referred to in this sec- (c) UNITED STATES CONTRIBUTIONS TO THE
communities, systems, institutions, coun- tion as ‘‘COVAX’’) and the Access to COVID– GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS,
tries, and regions to reduce, mitigate, with- 19 Tools (ACT) Accelerator initiative, and AND MALARIA COVID–19 RESPONSE MECHA-
stand, adapt to, and quickly recover from expanding bilateral efforts, including NISM.—United States contributions to the
stresses and shocks in a manner that reduces through the International Development Fi- Global Fund to Fight AIDS, Tuberculosis,
chronic vulnerability to pandemic threats nance Corporation, to accelerate the devel- and Malaria COVID–19 Response Mechanism
and facilitates inclusive growth. opment, manufacturing, production, and effi- under section 10003(a)(2) of the American
(10) USAID.—The term ‘‘USAID’’ means cient and equitable distribution of— Rescue Plan Act of 2021 (Public Law 107–2)—
the United States Agency for International (A) vaccines and related raw materials to (1) shall be meaningfully leveraged in a
Development. meet or exceed the vaccination goals under manner that incentivizes other public and
SEC. 1293. PURPOSE. paragraph (6); and private donor contributions; and
The purpose of this subtitle is to accel- (B) global health commodities, including (2) shall be subject to the reporting and
erate and enhance the United States inter- supplies to combat COVID–19 and to help im- withholding requirements under subsections
national response to pandemics, including mediately disrupt the transmission of SARS– (c), (d)(4)(A)(ii), (d)(4)(C), (d)(5), (d)(6), (f), and
the COVID–19 pandemic, and to CoV–2; (g) of section 202 of the United States Lead-
operationalize lessons learned from current (8) supporting global COVID–19 vaccine dis- ership Against HIV/AIDS, Tuberculosis, and
and prior emergency responses in a manner tribution strategies that strengthen under- Malaria Act of 2003 (22 U.S.C. 7622).
that— lying health systems and ensure that people (d) GLOBAL COVID–19 VACCINE DISTRIBU-
(1) advances the global health security and living in vulnerable and marginalized com- TION AND DELIVERY.—
diplomacy objectives of the United States; munities, including women, do not face (1) ACCELERATING GLOBAL VACCINE DIS-
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(2) improves coordination among the rel- undue barriers to vaccination; TRIBUTION STRATEGY.—The President shall
evant Federal departments and agencies im- (9) working with key stakeholders, includ- develop a strategy to expand access to, and
plementing United States foreign assistance ing through the World Bank Group, the accelerate the global distribution of, COVID–
for global health security; and International Monetary Fund, the Inter- 19 vaccines to other countries, which shall—
(3) more effectively enables partner coun- national Finance Corporation, and other rel- (A) identify the countries that have the
tries to strengthen and sustain resilient evant regional and bilateral financial insti- highest infection and death rates due to
health systems and supply chains with the tutions, to address the economic and finan- COVID–19, the lowest COVID–19 vaccination
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7905
rates, and face the most difficult political, (K) describe efforts that the United States (A) assesses the global humanitarian re-
logistical, and financial challenges to ob- is making to help countries disrupt the cur- sponse to COVID–19; and
taining and delivering COVID–19 vaccines, rent transmission of COVID–19, while simul- (B) outlines specific elements of the United
and describe the basis and metrics used to taneously increasing vaccination rates, uti- States Government’s country-level humani-
make such determinations; lizing medical products and medical supplies. tarian response to the COVID–19 pandemic.
(B) identify which countries and regions (2) SUBMISSION OF STRATEGY.—Not later (2) ELEMENTS.—The report required under
will be prioritized and targeted for COVID–19 than 90 days after the date of the enactment paragraph (1) shall include—
vaccine delivery, and the rationale for such of this Act, the President shall submit the (A) for countries receiving United States
prioritization; strategy described in paragraph (1) to— assistance, a description of humanitarian
(C) describe efforts that the United States (A) the appropriate congressional commit- and health-worker access to crisis-affected
is making to increase COVID–19 vaccine tees; areas, including—
manufacturing capacity, both domestically (B) the Committee on Health, Education, (i) legal and bureaucratic restrictions on
and internationally, as appropriate, through Labor, and Pensions of the Senate; and the entry of humanitarian workers from
support for the establishment or refurbish- (C) the Committee on Energy and Com- abroad, to include visa authorizations that
ment of regional manufacturing hubs in merce of the House of Representatives. do not allow adequate time for humanitarian
South America, South Africa, and South (3) LIMITATION.— workers to quarantine upon arrival in-line
Asia, including through the provision of (A) IN GENERAL.—No Federal funds may be with host country regulations, conduct needs
international development finance, and esti- made available to COVAX to procure vac- assessments, and subsequently implement
mate when, how many, and which types of cines produced by any companies owned or multilateral and United States-funded pro-
vaccines will be provided by the United controlled by the Government of the Peo- gramming in an efficient, effective, and un-
States Government bilaterally and through ple’s Republic of China or by the Chinese restricted manner;
COVAX; Communist Party unless the Secretary of (ii) restrictions on travel by humanitarian
(D) describe efforts to encourage inter- State certifies that the People’s Republic of workers within such country to reach the
national partners to take actions similar to China— areas of operation where vulnerable and
the efforts referred to in subparagraph (C); (i) is providing financial support to COVAX marginalized populations reside;
(E) describe how the United States Govern- that is commensurate with the United (iii) access to medical evacuation in the
ment will ensure efficient delivery of States’ contribution to COVAX; and event of a health emergency;
COVID–19 vaccines to intended recipients, in- (ii) publically discloses transparent data (iv) access to personal protective equip-
cluding United States citizens residing over- on the quality, safety, and efficacy of its ment for United States Government imple-
seas, and identify complementary United COVID–19 vaccines. menting partners; and
States foreign assistance that will facilitate (B) SAFEGUARDS.—The President shall en- (v) efforts to support access to COVID–19
vaccine readiness, distribution, delivery, sure that appropriate safeguards are put in vaccines for humanitarian and health-work-
monitoring, and administration activities; place to ensure that the condition described ers and crisis-affected communities;
(F) describe how the United States Govern- in subparagraph (A) is honored by Gavi, the (B) an analysis and description of countries
ment will ensure the efficient delivery and Vaccine Alliance. (regardless of whether such countries have
administration of COVID–19 vaccines to
(e) LEVERAGING UNITED STATES BILATERAL received direct United States assistance)
United States citizens residing overseas, in-
GLOBAL HEALTH PROGRAMS FOR THE INTER- that have expressly prevented vulnerable
cluding through the donation of vaccine
NATIONAL COVID–19 RESPONSE.— populations from accessing necessary assist-
doses to United States embassies and con-
(1) AUTHORIZATION FOR LEVERAGING BILAT- ance related to COVID–19, including—
sulates, as appropriate, giving priority to—
ERAL PROGRAM ACTIVITIES.—Amounts author- (i) the omission of vulnerable populations
(i) countries in which United States citi-
ized to be appropriated or otherwise made from national response plans;
zens are deemed ineligible or low priority in
available to carry out section 104 of the For- (ii) laws, policies, or practices that restrict
the national vaccination deployment plan;
eign Assistance Act (22 U.S.C. 2151b) may be or preclude treatment of vulnerable popu-
and
used in countries receiving United States lations at public hospitals and health facili-
(ii) countries that are not presently dis-
tributing a COVID–19 vaccine that— foreign assistance— ties; and
(I) has been licensed or authorized for (A) to combat the COVID–19 pandemic, in- (iii) exclusion of, or discrimination
emergency use by the Food and Drug Admin- cluding through the sharing of COVID–19 against, vulnerable populations in law, pol-
istration; or vaccines; and icy, or practice that prevents equitable ac-
(II) has met the necessary criteria for safe- (B) to support related activities, includ- cess to food, shelter, and other basic assist-
ty and efficacy established by the World ing— ance;
Health Organization; (i) strengthening vaccine readiness; (C) a description of United States Govern-
(G) summarize the United States Govern- (ii) reducing vaccine hesitancy and misin- ment efforts to facilitate greater humani-
ment’s efforts to encourage and facilitate formation; tarian access, including—
technology sharing and the licensing of in- (iii) delivering and administering COVID– (i) advocacy and diplomatic efforts with
tellectual property, to the extent necessary, 19 vaccines; relevant foreign governments and multilat-
to support the adequate and timely supply of (iv) strengthening health systems and sup- eral institutions to ensure that vulnerable
vaccines and vaccine components to meet ply chains; and marginalized populations are included in
the vaccination goals specified in subsection (v) supporting health care workforce plan- national response plans and other relevant
(a)(6), giving due consideration to avoiding ning, training, and management; plans developed in response to the COVID–19
undermining intellectual property innova- (vi) enhancing transparency, quality, and pandemic; and
tion and intellectual property rights or pro- reliability of public health data; (ii) advocacy and diplomatic efforts with
tections with respect to vaccine development (vii) increasing bidirectional testing, in- relevant foreign governments to ensure that
in performing the assessment required under cluding screening for symptomatic and appropriate visas, work permits, and domes-
this subparagraph; asymptomatic cases; and tic travel exemptions are issued for humani-
(H) describe the roles, responsibilities, (viii) building laboratory capacity. tarian and health workers responding to the
tasks, and, as appropriate, the authorities of (2) ADJUSTMENT OF TARGETS AND GOALS.— COVID–19 pandemic; and
the Secretary of State, the USAID Adminis- The Secretary of State, in coordination with (D) a description of United States Govern-
trator, the Secretary of Health and Human the heads of other relevant Federal depart- ment plans and efforts to address the second-
Services, the Director of the Centers for Dis- ments and agencies, shall submit an annual order impacts of the COVID–19 pandemic and
ease Control and Prevention, the Chief Exec- report to the appropriate congressional com- an assessment of the resources required to
utive Officer of the United States Inter- mittees that identifies— implement such plans, including efforts to
national Development Finance Corporation, (A) any adjustments to original program address—
and the heads of other relevant Federal de- targets and goals that result from the use of (i) famine and acute food insecurity;
partments and agencies with respect to the funds for the purposes authorized under (ii) gender-based violence;
implementation of such strategy; paragraph (1); and (iii) mental health and psychosocial sup-
(I) describe how the Department of State (B) the amounts needed in the following port needs;
and USAID will coordinate with the Sec- fiscal year to meet the original program (iv) child protection needs;
retary of Health and Human Services and the goals, as necessary and appropriate. (v) health, education, and livelihoods;
heads of other relevant Federal agencies to (f) REPORT ON HUMANITARIAN RESPONSE TO (vi) shelter; and
expedite the export and distribution of ex- THE COVID–19 PANDEMIC.— (vii) attempts to close civil society space,
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cess federally purchased vaccines to support (1) IN GENERAL.—Not later than 120 days including through bureaucratic, administra-
countries in need and ensure such vaccines after the date of the enactment of this Act, tive, and health or security related impedi-
will not be wasted; the Secretary of State, in consultation with ments.
(J) summarize the United States public di- the USAID Administrator and the Secretary (g) SAFEGUARDING DEMOCRACY AND HUMAN
plomacy strategies for branding and address- of Health and Human Services, shall submit RIGHTS DURING THE COVID–19 PANDEMIC.—
ing vaccine misinformation and hesitancy a report to the appropriate congressional (1) SENSE OF CONGRESS.—It is the sense of
within partner countries; and committees that— Congress that—
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S7906 CONGRESSIONAL RECORD — SENATE November 4, 2021
(A) governments may be required to take nized human rights in a manner inconsistent have invested heavily in media distortion
appropriate extraordinary measures during with the principles of limitation and deroga- and disinformation, including about COVID–
public health emergencies to halt the spread tion remain in place; 19.
of disease, including closing businesses and (ii) describes such countries’ emergency (ii) SENSE OF CONGRESS.—It is the sense of
public events, limiting access to public measures, including— Congress that RFA should—
spaces, and restricting the movement of peo- (I) how such procedures violate inter- (I) commission technical experts to bolster
ple; nationally recognized human rights; and efforts to counter social media tools, includ-
(B) certain foreign governments have (II) an analysis of the impact of such meas- ing bots used by some countries to promote
taken measures in response to COVID–19 ures on access to health and efforts to con- misinformation;
that violate the human rights of their citi- trol the COVID–19 pandemic within the coun- (II) expand digital programming and local
zens without clear public health justifica- try; coverage to expose China’s media manipula-
tion, oversight measures, or sunset provi- (iii) describes— tion techniques; and
sions; (I) security and intelligence surveillance (III) increase English language content to
(C) governments using the COVID–19 pan- measures implemented by countries during help counter China’s propaganda directed to-
demic as a pretext for repression have under- the COVID–19 pandemic; ward English-speaking audiences.
mined democratic institutions, debilitated (II) the extent to which such measures (G) MIDDLE EAST BROADCASTING NET-
institutions for transparency and public in- have been, or have not been, rolled back; and WORKS.—
tegrity, quashed legitimate dissent, and at- (III) whether and how such measures im- (i) FINDING.—Congress finds that the Mid-
tacked journalists, civil society organiza- pact internationally recognized human dle East Broadcasting Networks operate
tions, activists, independent voices, and vul- rights; and largely in closed media markets in which
nerable and marginalized populations, in- (iv) includes a strategic plan by the De- malign state and nonstate actors remain ac-
cluding refugees and migrants, with far- partment of State and USAID that address- tive.
reaching consequences that will extend be- es, through multilateral and bilateral diplo- (ii) SENSE OF CONGRESS.—It is the sense of
yond the current crisis; macy and foreign assistance, the persistent Congress that the Middle East Broadcasting
(D) foreign governments should take im- issues related to the restriction of inter- Networks should—
mediate steps to release from prison all arbi- nationally recognized human rights in the (I) continue plans to expand an investiga-
trarily detained United States citizens and COVID–19 response. tive news unit; and
political prisoners who may be at increased (h) PUBLIC DIPLOMACY AND COMBATING (II) work to ensure that reporting con-
risk for contracting or suffering from com- DISINFORMATION AND MISINFORMATION ABOUT tinues amidst operational challenges on the
plications from COVID–19; COVID–19.— ground.
(E) COVID–19 threatens to roll back dec- (1) UNITED STATES AGENCY FOR GLOBAL (H) OPEN TECHNOLOGY FUND.—
ades of progress for women and girls, dis- MEDIA.— (i) FINDING.—Congress finds that the Open
proportionately affecting women economi- (A) FINDING.—Congress finds that the Technology Fund works to advance internet
cally, educationally, and with respect to United States Agency for Global Media (re- freedom in repressive environments by sup-
health, while also leading to alarming rises ferred to in this subsection as ‘‘USAGM’’) porting technologies that—
in gender based violence; and broadcasting entities and grantees have (I) provide secure and uncensored access to
(F) during and after the pandemic, the De- proven valuable in providing timely and ac- USAGM’s content and the broader internet;
partment of State and USAID should di- curate information, particularly in countries and
rectly, and through nongovernmental orga- in which the free press is under threat. (II) counter attempts by authoritarian gov-
nizations or international organizations, (B) SENSE OF CONGRESS.—It is the sense of ernments to control the internet and restrict
provide assistance and implement programs Congress that— freedom online.
that support democratic institutions, civil (i) accurate, investigative, and scientific (ii) SENSE OF CONGRESS.—It is the sense of
society, free media, and the advancement of journalism is critical for societies to effec- Congress that the Open Technology Fund
internationally recognized human rights. tively combat global health threats; and should—
(2) FUNDING FOR CIVIL SOCIETY AND HUMAN (ii) Congress supports— (I) support a broad range of technologies to
RIGHTS DEFENDERS.— (I) accurate and objective investigative respond to increasingly aggressive and so-
(A) PROGRAM PRIORITIES.—Amounts made and scientific reporting by USAGM networks phisticated censorship and surveillance
available for each of the fiscal years 2022 and grantees regarding COVID–19; and threats and provide more comprehensive and
through 2026 to carry out the purposes of sec- (II) platforms that help dispel and combat tailored support to USAGM’s networks; and
tions 101 and 102 of the Foreign Assistance misinformation about the COVID–19 pan- (II) provide direct assistance to USAGM’s
Act of 1961 (22 U.S.C. 2151 and 2151–1), includ- demic. networks to improve the digital security of
ing programs to support democratic institu- (C) VOICE OF AMERICA.—It is the sense of reporting operations and journalists.
tions, human rights defenders, civil society, Congress that amounts authorized to be ap- (2) DEPARTMENT OF STATE PUBLIC DIPLO-
and freedom of the press, should be targeted, propriated or otherwise made available to MACY PROGRAMS.—
to the extent feasible, toward civil society Voice of America should be used— (A) FINDINGS.—Congress finds the fol-
organizations in countries in which emer- (i) to expand programs such as POLY- lowing:
gency government measures taken in re- GRAPH.info; (i) The Department of State’s public diplo-
sponse to the COVID–19 pandemic have vio- (ii) to provide critical tools for combating macy programs build global networks that
lated internationally recognized human propaganda associated with COVID–19; and can address shared challenges, such as the
rights. (iii) to assist journalists in providing accu- COVID–19 pandemic, including through ex-
(B) ELIGIBLE ORGANIZATIONS.—Civil society rate information to local media outlets. changes of researchers, public health ex-
organizations operating in countries in (D) OFFICE OF CUBA BROADCASTING.—It is perts, and scientists.
which emergency government measures the sense of Congress that Radio Televisión (ii) The programs referred to in clause (i)
taken in response to the COVID–19 pandemic Martı́ and Digital Martı́ should continue to play a critical role in creating open and re-
violated internationally recognized human broadcast programs that detect, highlight, silient information environments where de-
rights shall be eligible to receive funds made and dispel disinformation. mocracies can thrive, as articulated in the
available to carry out the purposes of sec- (E) RADIO FREE EUROPE/RADIO LIBERTY.— 2020 Public Diplomacy Strategic Plan, in-
tions 101 and 102 of the Foreign Assistance (i) FINDING.—Congress finds that Radio cluding by—
Act of 1961 for each of the fiscal years 2022 Free Europe/Radio Liberty (referred to in (I) improving media quality with jour-
through 2026, for— this section as ‘‘RFE/RL’’) operate in media nalist training and reporting tours;
(i) programs designed to strengthen and markets in which authoritarian state and (II) conducting media literacy programs;
support civil society, human rights defend- nonstate actors, including Russia, heavily and
ers, freedom of association, and the freedom invest in misinformation and disinformation (III) supporting media access activities.
of the press; campaigns designed to promote confusion (iii) The International Visitor Leadership
(ii) programs to restore democratic insti- and mistrust. Program and Digital Communications Net-
tutions; and (ii) SENSE OF CONGRESS.—It is the sense of work engaged journalists around the world
(iii) peacebuilding and conflict prevention Congress that RFE/RL should— to combat COVID–19 disinformation, pro-
to address the impacts of COVID–19 on social (I) increase investigative reporting regard- mote unbiased reporting, and strengthen
cohesion, public trust, and conflict dynamics ing the impacts of COVID–19, the political media literacy.
by adapting existing programs or investing and social responses governments are taking (iv) More than 12,000 physicians holding J–
in new ones. in response to COVID–19, and the lasting im- 1 visas from 130 countries—
ctelli on DSK11ZRN23PROD with SENATE
(C) FINAL REPORT.—Not later than 180 days pacts such actions will have on key political (I) are engaged in residency or fellowship
after the date of the enactment of this Act, freedoms; and training at approximately 750 hospitals
the Secretary of State shall submit a report (II) expand its ‘‘digital first’’ strategy. throughout the United States, the majority
to the appropriate congressional committees (F) RADIO FREE ASIA.— of whom are serving in States that have been
that— (i) FINDING.—Congress finds that Radio the hardest hit by COVID–19; and
(i) lists the countries whose emergency Free Asia (RFA) operates in a media market (II) throughout the pandemic, have served
measures limiting internationally recog- dominated by powerful state-run media that on the front lines of the medical workforce
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7907
and in United States university laboratories (ii) better market access; Organization, and the World Organization for
researching ways to detect and treat the (iii) more concessional resources; and Animal Health, to advance a One Health ap-
virus. (iv) an extension in the Debt Service Sus- proach toward preventing, detecting, and re-
(B) VISA PROCESSING BRIEFING.—Not later pension Initiative established by the Group sponding to zoonotic threats in the human-
than 30 days after the date of the enactment of 20. animal interface.
of this Act, the Assistant Secretary for Con- (2) SENSE OF CONGRESS.—It is the sense of (k) ROLES OF THE DEPARTMENT OF STATE,
sular Affairs shall brief the appropriate con- Congress that— THE UNITED STATES AGENCY FOR INTER-
gressional committees by providing— (A) even when markets begin to recover in NATIONAL DEVELOPMENT, AND THE DEPART-
(i) a timeline for increasing visa processing the future, it is likely that access to capital MENT OF HEALTH AND HUMAN SERVICES IN
capacities at embassies around the world, will be especially challenging for developing INTERNATIONAL PANDEMIC RESPONSE.—
notably where there are— countries, which still will be struggling with (1) DESIGNATION OF LEAD AGENCIES FOR CO-
(I) many American citizens, including dual the containment of, and recovery from, the ORDINATION OF THE UNITED STATES’ INTER-
nationals; and COVID–19 pandemic; NATIONAL RESPONSE TO INFECTIOUS DISEASE
(II) many visa applicants for educational (B) economic uncertainty and the inability OUTBREAKS WITH SEVERE OR PANDEMIC POTEN-
and cultural exchange programs that pro- of individuals and households to generate in- TIAL.—The President shall designate rel-
mote United States foreign policy objectives come are major drivers of political insta- evant Federal departments and agencies, in-
and economic stability to small businesses, bility and social discord, which create condi- cluding the Department of State, USAID,
universities, and communities across the tions for insecurity; and the Department of Health and Human
United States; (C) it is in the security and economic inter- Services (including the Centers for Disease
(ii) a detailed plan for using existing au- ests of the United States to assist in the eco- Control and Prevention), to lead specific as-
thorities to waive or provide other alter- nomic recovery of developing countries that pects of the United States’ international re-
natives to in-person appointments and inter- are made more vulnerable and unstable from sponse to outbreaks of emerging high-con-
views; the public health and economic impacts of sequence infectious disease threats.
(iii) an assessment of whether additional the COVID–19 pandemic; (2) NOTIFICATION.—Not later than 120 days
authorities and resources are required for (D) United States foreign assistance and after the date of the enactment of this Act,
the use of videoconference appointments and development finance institutions should the President shall notify the appropriate
interviews as an alternative to in-person ap- seek to blunt the impacts of a COVID–19 re- congressional committees, the Committee on
pointments and interviews; and lated economic recession by supporting in- Health, Education, Labor, and Pensions of
(iv) a detailed plan for using existing au- vestments in sectors critical to maintaining the Senate, and the Committee on Energy
thorities to rapidly cross-train and surge economic stability and resilience in low and and Commerce of the House of Representa-
temporary personnel to support consular middle income countries; tives of the designations made pursuant to
services at embassies and consulates of the (E) the need for the United States Inter- paragraph (1), including detailed descriptions
United States around the world, and an as- national Development Finance Corporation’s of the roles and responsibilities of each rel-
sessment of whether additional authorities support for advancing development outcomes evant department and agency.
and resources are required. in less developed countries, as mandated by (l) USAID DISASTER SURGE CAPACITY.—
(C) GLOBAL ENGAGEMENT CENTER.— the Better Utilization of Investments Lead- (1) SURGE CAPACITY.—Amounts authorized
(i) FINDING.—Congress finds that since the ing to Development Act of 2018 (22 U.S.C. 9601 to be appropriated or otherwise made avail-
beginning of the COVID–19 pandemic, publi- et seq.), is critical to ensuring lasting and re- able to carry out part I and chapter 4 of part
cations, websites, and platforms associated silient economic growth in light of the II of the Foreign Assistance Act of 1961 (22
with China, Russia, and Iran have sponsored COVID–19 pandemic’s exacerbation of eco- U.S.C. 2151 et seq.), including funds made
disinformation campaigns related to the nomic hardships and challenges; available for ‘‘Assistance for Europe, Eurasia
COVID–19 pandemic, including falsely blam- (F) The United States International Devel- and Central Asia’’, may be used, in addition
ing the United States for the disease. opment Finance Corporation should adjust to amounts otherwise made available for
(ii) SENSE OF CONGRESS.—It is the sense of its view of risk versus return by taking such purposes, for the cost (including sup-
Congress that the Global Engagement Center smart risks that may produce a lower rate of port costs) of individuals detailed to or em-
should continue its efforts to expose and financial return, but produce significant de- ployed by USAID whose primary responsi-
counter state and non-state-sponsored velopment outcomes in responding to the bility is to carry out programs in response to
disinformation related to COVID–19, the ori- economic effects of COVID–19; global health emergencies and natural or
gins of COVID–19, and COVID–19 vaccina- (G) to mitigate the economic impacts of man-made disasters.
tions. the COVID–19 recession, the United States (2) NOTIFICATION.—Not later than 15 days
(i) FINDINGS AND SENSE OF CONGRESS RE- International Development Finance Corpora- before making funds available to address
GARDING THE UNITED STATES INTERNATIONAL tion should use its resources and authorities, man-made disasters pursuant to paragraph
DEVELOPMENT FINANCE CORPORATION.— among other things— (1), the Secretary of State or the USAID Ad-
(1) FINDINGS.—Congress finds the following: (i) to ensure loan support for small- and ministrator shall notify the appropriate con-
(A) The COVID–19 pandemic is causing a medium-sized enterprises; gressional committees of such action.
global economic recession, as evidenced by (ii) to offer local currency loans to bor- (m) STATEMENT OF POLICY ON HUMANI-
the global economic indicators described in rowers for working capital needs; TARIAN ASSISTANCE TO COUNTRIES AFFECTED
subparagraphs (B) through (D). (iii) to create dedicated financing opportu- BY PANDEMICS.—
(B) The United Nations Conference on nities for new ‘‘customers’’ that are experi- (1) STATEMENT OF POLICY.—It shall be the
Trade and Development determined that the encing financial hardship due to the COVID– policy of the United States—
COVID–19 pandemic pushed the global econ- 19 pandemic; and (A) to ensure that United States assistance
omy into recession in 2020 on a scale that has (iv) to work with other development fi- to address pandemics, including the provi-
not been witnessed since the 1930s. nance institutions to create co-financing fa- sion of vaccines, reaches vulnerable and
(C) Developed countries are expected to ex- cilities to support customers experiencing marginalized populations, including racial
perience a relatively more significant re- hardship due to the COVID–19 pandemic. and religious minorities, refugees, internally
bound in gross domestic product growth dur- (j) SENSE OF CONGRESS REGARDING INTER- displaced persons, migrants, stateless per-
ing 2021 than is expected to be experienced in NATIONAL COOPERATION TO PREVENT AND RE- sons, women, children, the elderly, and per-
developing countries, leading to concerns SPOND TO FUTURE PANDEMICS.—It is the sense sons with disabilities;
about a further expansion in the gap between of Congress that— (B) to ensure that United States assist-
rich and poor countries, particularly if this (1) global pandemic preparedness and re- ance, including development finance, ad-
trend continues into 2022. sponse requires international and regional dresses the second order effects of a pan-
(D) Global markets have suffered losses cooperation and action; demic, including acute food insecurity; and
ranging between 5 percent and over 10 per- (2) the United States should lead efforts in (C) to protect and support humanitarian
cent since the beginning of the pandemic. multilateral fora, such as the Group of 7, the actors who are essential workers in pre-
While markets are recovering in 2021, global Group of 20, and the United Nations, by col- venting, mitigating and responding to the
job losses and unemployment rates remain laborating and cooperating with other coun- spread of a pandemic among vulnerable and
high, with— tries and international and regional organi- marginalized groups described in subpara-
(i) approximately 33,000,000 labor hours lost zations, including the World Health Organi- graph (A), including ensuring that such hu-
globally (13 per cent of the total hours lost) zation and other key stakeholders, to imple- manitarian actors—
due to outright unemployment; and ment international strategies, tools, and (i) are exempted from unreasonable travel
(ii) an estimated additional 81,000,000 labor agreements to better prevent, detect, and re- restrictions to ensure that they can effec-
ctelli on DSK11ZRN23PROD with SENATE
hours lost due to inactivity or underemploy- spond to future infectious disease threats be- tively provide life-saving assistance; and
ment. fore they become pandemics; and (ii) are prioritized as frontline workers in
(E) Given the prolonged nature of the (3) the United States should enhance and country vaccine distribution plans.
COVID–19 pandemic, African finance min- expand coordination and collaboration (2) FACILITATING EFFECTIVE AND SAFE HU-
isters have requested continued efforts to among the relevant Federal departments and MANITARIAN ASSISTANCE.—The Secretary of
provide— agencies, the Food and Agriculture Organiza- State, in coordination with the USAID Ad-
(i) additional liquidity; tion of the United Nations, the World Health ministrator, should carry out actions that
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S7908 CONGRESSIONAL RECORD — SENATE November 4, 2021
accomplish the policies set forth in para- ess, the Global Health Security Index classi- Committee on Health, Education, Labor, and
graph (1), including by— fication of health systems, national action Pensions of the Senate, and the Committee
(A) taking steps to ensure that travel re- plans for health security, the Global Health on Energy and Commerce of the House of
strictions implemented to help contain the Security Agenda, other risk-based assess- Representatives.
spread of a pandemic are not applied to indi- ments, and other complementary or suc- (3) ANNUAL REPORT.—
viduals authorized by the United States Gov- cessor indicators of global health security (A) IN GENERAL.—Not later than 1 year
ernment to travel to, or reside in, a des- and pandemic preparedness; and after the submission of the strategy to the
ignated country to provide assistance related (ii) demonstrated commitment to trans- congressional committees referred to in
to, or otherwise impacted by, an outbreak; parency, including budget and global health paragraph (2), and not later than October 1 of
(B) approving the use of foreign assistance data transparency, complying with the each year thereafter for the following 4 fiscal
for the procurement of personal protective International Health Regulations (2005), in- years, the President shall submit a report to
equipment by United States Government im- vesting in domestic health systems, and such congressional committees that de-
plementing partners from businesses within achieving measurable results; scribes—
or nearby the country receiving foreign as- (H) reduces long-term reliance upon United (i) the status of the implementation of the
sistance on an urgent basis and in a manner States foreign assistance for global health strategy required under paragraph (1);
consistent with efforts to respond to the security by— (ii) any necessary updates to the strategy;
spread of a pandemic in the United States; (i) helping build and enhance community (iii) the progress made in implementing
and resilience to infectious disease emergencies the strategy, with specific information re-
(C) waiving certain travel restrictions im- and threats, such as COVID–19 and Ebola;
lated to the progress toward improving coun-
plemented to help contain the spread of a (ii) ensuring that United States global
tries’ ability to detect, respond and prevent
pandemic in order to facilitate the medical health assistance is strategically planned
the spread of infectious disease threats, such
evacuation of United States Government im- and coordinated in a manner that contrib-
as COVID–19 and Ebola; and
plementing partners, regardless of nation- utes to the strengthening of overall health
(iv) details on the status of funds made
ality. systems and builds the capacity of local or-
ganizations and institutions; available to carry out the purposes of this
SEC. 1295. INTERNATIONAL PANDEMIC PREVEN-
TION AND PREPAREDNESS. (iii) promoting improved domestic resource section.
(a) PARTNER COUNTRY DEFINED.—In this mobilization, co-financing, and appropriate (B) AGENCY-SPECIFIC PLANS.—The reports
section, the term ‘‘partner country’’ means a national budget allocations for strong public required under subparagraph (A) shall in-
foreign country in which the relevant Fed- health systems, global health security, and clude specific implementation plans from
eral departments and agencies are imple- pandemic preparedness and response in part- each relevant Federal department and agen-
menting United States assistance for global ner countries; and cy that describe—
health security and pandemic prevention and (iv) ensuring partner country ownership of (i) how updates to the strategy may have
preparedness under this subtitle. global health security strategies, data, pro- impacted the agency’s plan during the pre-
(b) UNITED STATES GLOBAL HEALTH SECU- grams, and outcomes; ceding calendar year;
RITY AND DIPLOMACY STRATEGY AND RE- (I) supports health budget and workforce (ii) the progress made in meeting the goals,
PORT.— planning in partner countries, including objectives, and benchmarks under implemen-
(1) IN GENERAL.—The President shall de- training in public financial management and tation plans during the preceding year;
velop, update, maintain, and advance a com- budget data transparency; (iii) the anticipated staffing plans and con-
prehensive strategy for improving global (J) works to ensure that— tributions of the department or agency, in-
health security and pandemic prevention, (i) partner countries have national action cluding technical, financial, and in-kind con-
preparedness, and response that— plans for health security that are developed tributions, to implement the strategy;
(A) clearly articulates the policy goals re- with input from key stakeholders, including (iv) a transparent, open, and detailed ac-
lated to pandemic prevention, preparedness, communities and the private sector; counting of obligations by each of the rel-
and response, and actions necessary to ele- (ii) United States foreign assistance for evant Federal departments and agencies to
vate and strengthen United States diplo- global health security is aligned with such implement the strategy, including—
matic leadership in global health security national action plans for health security in (I) the statutory source of obligated funds;
and pandemic preparedness, including by partner countries, developed with input from (II) the amounts obligated;
building the expertise of the diplomatic key stakeholders, including communities (III) implementing partners;
corps; and the private sector, to the greatest extent (IV) targeted beneficiaries; and
(B) improves the effectiveness of United practicable and appropriate; and (V) activities supported;
States foreign assistance to prevent, detect, (iii) United States global health security (v) the efforts of the relevant Federal de-
and respond to infectious disease threats, in- efforts are aligned with ongoing strategies partment or agency to ensure that the ac-
cluding through the advancement of a One and initiatives across government agencies tivities and programs carried out pursuant
Health approach, the Global Health Security to help nations better identify and prevent to the strategy are designed to achieve max-
Agenda, the International Health Regula- health impacts related to deforestation, cli- imum impact and enduring returns, includ-
tions (2005), and other relevant frameworks mate-related events, and increased unsafe ing through specific activities to strengthen
and programs that contribute to global interactions between wildlife, livestock, and health systems, as appropriate; and
health security and pandemic preparedness; people, including the emergence, reemer- (vi) a plan for regularly reviewing and up-
(C) establishes specific and measurable gence, and spread of zoonoses; dating programs and partnerships, and for
goals, benchmarks, timetables, performance (K) strengthens linkages between com- sharing lessons learned with a wide range of
metrics, and monitoring and evaluation plementary bilateral and multilateral for- stakeholders in an open, transparent man-
plans for United States foreign policy and as- eign assistance programs, including efforts ner.
sistance for global health security that pro- of the World Bank, the World Health Organi- (C) FORM.—The reports required under sub-
mote learning and adaptation and reflect zation, the Global Fund to Fight AIDS, Tu- paragraph (A) shall be submitted in unclassi-
international best practices relating to glob- berculosis, and Malaria, Gavi, the Vaccine fied form, but may contain a classified
al health security, transparency, and ac- Alliance, and regional health organizations, annex.
countability; that contribute to the development of more
(D) establishes transparent means to im- resilient health systems and supply chains in (c) COMMITTEE ON GLOBAL HEALTH SECU-
prove coordination and performance by the partner countries with the capacity, re- RITY AND PANDEMIC AND BIOLOGICAL
relevant Federal departments and agencies sources, and personnel required to prevent, THREATS.—
and sets out clear roles and responsibilities detect, and respond to infectious disease (1) STATEMENT OF POLICY.—It shall be the
that reflect the unique capabilities and re- threats; and policy of the United States—
sources of each such department and agency; (L) supports innovation and partnerships (A) to promote global health security as a
(E) establishes mechanisms to improve co- with the private sector, health organiza- core national security interest; and
ordination and avoid duplication of effort tions, civil society, nongovernmental organi- (B) to ensure effective coordination and
among the relevant Federal departments and zations, and health research and academic collaboration between the relevant Federal
agencies, partner countries, donor countries, institutions to improve pandemic prepared- departments and agencies engaged in efforts
the private sector, multilateral organiza- ness and response, including for the preven- to advance the global health security of the
tions, and other key stakeholders, and en- tion and detection of infectious disease, and United States.
sures collaboration at the country level; the development and deployment of effective (2) COORDINATION.—
(F) supports, and is aligned with, partner and accessible infectious disease tracking (A) ESTABLISHMENT OF COMMITTEE.—There
ctelli on DSK11ZRN23PROD with SENATE
country-led, global health security policy tools, diagnostics, therapeutics, and vac- is authorized to be established, within the
and investment plans, developed with input cines. National Security Council, the Committee
from key stakeholders, as appropriate; (2) SUBMISSION OF STRATEGY.—Not later on Global Health Security and Pandemic and
(G) prioritizes working with partner coun- than 120 days after the date of the enactment Biological Threats (referred to in this sub-
tries with— of this Act, the President shall submit the section as the ‘‘Committee’’), whose day-to-
(i) demonstrated need, as identified strategy required under paragraph (1) to the day operations should be led by the Special
through the Joint External Evaluation proc- appropriate congressional committees, the Advisor for Global Health Security.
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7909
(B) SPECIAL ADVISOR FOR GLOBAL HEALTH retary of State to oversee the implementa- (i) diplomatic engagement and related for-
SECURITY.—The Special Advisor for Global tion of programs and policies that advance eign policy efforts, such as multilateral and
Health Security— global health security within foreign coun- bilateral arrangements, enhanced coordina-
(i) should serve on the staff of the National tries. tion of engagement with multilateral organi-
Security Council; and (E) SPECIFIC ROLES AND RESPONSIBILITIES.— zations and countries, and the mobilization
(ii) may also be the Senior Director for the (i) IN GENERAL.—The heads of the relevant of donor contributions; and
Global Health Security and Biodefense Di- Federal departments and agencies should— (ii) support for United States citizens liv-
rectorate within the Executive Office of the (I) make global health security and pan- ing abroad, including consular support;
President, who reports to the Assistant to demic threat reduction a high priority with- (C) to serve as the representative of the
the President for National Security Affairs. in their respective departments and agen- Department of State on the Committee on
(C) FUNCTIONS.— cies, and include global health security and Global Health Security and Pandemic and
(i) IN GENERAL.—The functions of the Com- pandemic threat reduction-related activities Biological Threats authorized to be estab-
mittee should be— within their respective agencies’ strategic lished under subsection (b)(2)(B);
(I) to provide strategic guidance for the de- planning and budget processes; (D) to represent the United States in the
velopment of a policy framework for United (II) designate a senior-level official to be multilateral, catalytic financing mechanism
States Government activities relating to responsible for global health security and
global health security, including pandemic described in section 1296(b)(1);
pandemic threat reduction at each of their (E) to transfer and allocate United States
prevention, preparedness and response; and respective departments and agencies;
(II) to ensure policy coordination between foreign assistance funding authorized to be
(III) designate an appropriate representa- appropriated pursuant to paragraph (6) to
United States Government agencies. tive at the Assistant Secretary level or high-
(ii) ACTIVITIES.—In carrying out the func- the relevant Federal departments and agen-
er to participate on the Committee whenever cies implementing the strategy required
tions described in clause (i), the Committee the head of the department or agency cannot
should— under subsection (b), in coordination with
participate;
(I) conduct, in coordination with the heads the Office of Management and Budget and
(IV) keep the Committee apprised of Glob-
of relevant Federal departments and agen- USAID;
al Health Security and pandemic threat re-
cies, a review of existing United States glob- (F) to utilize detailees, on a reimbursable
duction-related activities undertaken within
al health security policies and strategies; or nonreimbursable basis, from the relevant
their respective departments and agencies;
(II) develop recommendations for how the Federal departments and agencies and hire
(V) ensure interagency cooperation and
Federal Government may regularly update personal service contractors, who may oper-
collaboration and maintain responsibility
and harmonize the policies and strategies re- ate domestically and internationally, to en-
for agency-related programmatic functions
ferred to in subclause (I) to enable the sure that the Office of the Special Represent-
including, as applicable, in coordination
United States Government to respond to ative has access to the highest quality ex-
with partner governments, country teams,
pandemic threats and to monitor the imple- and global health security in-country teams; perts available to the United States Govern-
mentation of such strategies; and ment to carry out the functions under this
(III) develop a plan for modernizing global (VI) keep the Committee apprised of subtitle; and
early warning and trigger systems for scal- (G) to perform such other functions as the
GHSA-related activities undertaken within
ing action to prevent, detect, respond to, and Secretary of State may assign.
their respective agencies.
recover from emerging biological threats; (4) DUTIES.—The Special Representative
(ii) ADDITIONAL ROLES AND RESPONSIBIL-
(IV) provide policy-level recommendations shall coordinate, manage, and oversee United
ITIES.—In addition to the roles and respon-
regarding the Global Health Security Agenda States foreign policy, diplomatic efforts, and
sibilities described in clause (i), the heads of
goals, objectives, and implementation, and foreign assistance funded with amounts ap-
the relevant Federal departments and agen-
other international efforts to strengthen propriated pursuant to paragraph (6) to ad-
cies should carry out their respective roles
pandemic prevention, preparedness and re- vance the relevant elements of the United
and responsibilities described in—
sponse; States Global Health Security and Diplo-
(I) Executive Order 13747 (81 Fed. Reg.
(V) review the progress toward, and work- macy Strategy developed pursuant to sub-
78701; relating to Advancing the Global
ing to resolve challenges in, achieving section (b), including by—
United States commitments under the Glob- Health Security Agenda to Achieve a World
Safe and Secure from Infectious Disease (A) developing and coordinating a global
al Health Security Agenda; pandemic prevention, preparedness and re-
(VI) develop protocols for coordinating and Threats); and
(II) the National Security Memorandum-1 sponse framework consistent with paragraph
deploying a global response to emerging (3)(B);
high-consequence infectious disease threats on United States Global Leadership to
Strengthen the International COVID–19 Re- (B) enhancing engagement with multilat-
that outline the respective roles for relevant
sponse and to Advance Global Health Secu- eral organizations and partner countries, in-
Federal agencies in facilitating and sup-
rity and Biological Preparedness, as in effect cluding through the mobilization of donor
porting such response operations that should
on the day before the date of the enactment support;
facilitate the operational work of Federal
of this Act. (C) enhancing coordination of consular
agencies and of the Special Advisor for Glob-
(d) UNITED STATES OVERSEAS GLOBAL services for United States citizens abroad in
al Health Security;
(VII) make recommendations regarding ap- HEALTH SECURITY AND DIPLOMACY COORDINA- the event of a global health emergency;
propriate responses to specific pandemic TION.—
(D) ensuring effective program coordina-
threats and ensure the coordination of do- (1) ESTABLISHMENT.—There is established, tion and implementation of international ac-
mestic and international agencies regarding within the Department of State, a Special tivities, by the relevant Federal departments
the Federal Government’s efforts to prevent, Representative for United States Inter- and agencies by—
detect, respond to, and recover from biologi- national Activities to Advance Global Health (i) formulating, issuing, and updating re-
cal events; Security and Diplomacy Overseas (referred lated policy guidance;
(VIII) take steps to strengthen the global to in this subsection as the ‘‘Special Rep- (ii) establishing, in consultation with
pandemic supply chain and address any bar- resentative’’). USAID and the Department of Health and
riers to the timely delivery of supplies in re- (2) APPOINTMENT; QUALIFICATIONS.—The Human Services, unified auditing, moni-
sponse to a pandemic, including through en- Special Representative— toring, and evaluation plans;
gagement with the private sector, as appro- (A) shall be appointed by the President, by (iii) aligning, in coordination with United
priate; and with the advice and consent of the Sen- States chiefs of mission and country teams
(IX) develop recommendations to ensure ate; in partner countries—
the effective sharing of information from do- (B) shall report to the Secretary of State; (I) the foreign assistance resources funded
mestic and international sources about pan- and with amounts appropriated pursuant to para-
demic threats among the relevant Federal (C) shall have— graph (6); and
departments and agencies, State and local (i) demonstrated knowledge and experience (II) international activities described in
governments, and international partners and in the fields of development and public the implementation plans required under
organizations; and health, epidemiology, or medicine; and subsection (b)(3)(B) with the relevant Fed-
(X) develop guidelines to enhance and im- (ii) relevant diplomatic, policy, and polit- eral departments and agencies in a manner
prove the operational coordination between ical expertise. that—
State and local governments and Federal (3) AUTHORITIES.—The Special Representa- (aa) is consistent with Executive Order
agencies with respect to pandemic threats. tive is authorized— 13747 (81 Fed. Reg. 78701; relating to Advanc-
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(D) RESPONSIBILITIES OF DEPARTMENTS AND (A) to operate internationally to carry out ing the Global Health Security Agenda to
AGENCIES.—The Committee and the Special the purposes of this section; Achieve a World Safe and Secure from Infec-
Advisor for Global Health Security shall not (B) to lead in developing a global pandemic tious Disease Threats);
assume any responsibilities or authorities of prevention, preparedness and response (bb) is consistent with the National Secu-
the head of any Federal department, agency, framework to support global pandemic pre- rity Memorandum on United States Global
or office, including the foreign affairs re- vention, preparedness, responses and recov- Leadership to Strengthen the International
sponsibilities and authorities of the Sec- ery efforts, including through— COVID–19 Response and to Advance Global
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S7910 CONGRESSIONAL RECORD — SENATE November 4, 2021
Health Security and Biological Prepared- eign Assistance Act of 1961 (22 U.S.C. 2151 et global health in such country, with the aim
ness, issued by President Biden on January seq.), may include support for— of establishing an enduring model for coordi-
21, 2021; and (i) enhancing preparedness in partner coun- nating health systems strengthening activi-
(cc) reflects and leverages the unique capa- tries through implementation of the Global ties, including improving pandemic pre-
bilities of each such department and agency; Health Security Strategy developed pursu- paredness in additional countries in the fu-
(iv) convening, as appropriate, an inter- ant to subsection (b); ture.
agency working group on international pan- (ii) replenishing the Emergency Reserve (B) ASSESSMENT.—In each of the countries
demic prevention and preparedness, headed Fund at USAID, established pursuant to sec- selected under subparagraph (A), USAID mis-
by the Special Representative and including tion 7058(c)(1) of the Department of State, sions, in consultation with USAID’s Office of
representatives from the relevant Federal Foreign Operations, and Related Programs Health Systems, should conduct an assess-
departments and agencies, to facilitate co- Appropriations Act, 2017 (division J of Public ment that—
ordination of activities relating to pandemic Law 115–31) to address new or emerging in- (i) takes a comprehensive view of the con-
prevention and preparedness in partner coun- fectious disease threats, as necessary and ap- straints in the country’s health system that
tries under this subtitle; propriate; prevent the achievement of desired outcomes
(v) working with, and leveraging the exper- (iii) United States contributions to the of United States Government-supported
tise and activities of, the Office of the United World Bank Health Emergency Preparedness health programs;
States Global AIDS Coordinator, the Office and Response Multi-Donor Fund; and (ii) identifies the best opportunities for im-
of the United States Global Malaria Coordi- (iv) United States contributions to a mul- proving health systems to achieve improved
tilateral, catalytic financing mechanism for
nator, and similar or successor entities that outcomes, including obstacles to health serv-
global health security and pandemic preven-
are implementing United States global ice delivery;
tion and preparedness described in section
health assistance overseas; and (iii) maps the resources of the country and
1296(b).
(vi) avoiding duplication of effort and other donors in the health sector with a
(B) EXCEPTION.—Section 110 of the Traf-
working to resolve policy, program, and focus on investment in health system
ficking Victims Protection Act of 2000 (22
funding disputes among the relevant Federal strengthening; and
U.S.C. 7107) shall not apply to assistance
departments and agencies; (iv) develops, based on the results of the
made available pursuant to this subsection.
(E) leading diplomatic efforts to identify (e) RESILIENCE.—It shall be the policy of assessment described in clause (i), and imple-
and address current and emerging threats to the United States to support the growth of ments a new or revised 5-year strategy for
global health security; healthier, more stable societies, while ad- United States assistance to strengthen the
(F) coordinating, in consultation with the vancing the global health security interests country’s health system that—
Secretary of Health and Human Services and of the United States by working with key (I) provides a framework for implementing
the USAID Administrator, effective rep- stakeholders— such strategy;
resentation of the United States in relevant (1) in developing countries that are highly (II) identifies key areas for investments to
international forums, including at the World vulnerable to the emergence, reemergence, strengthen the health system in alignment
Health Organization, the World Health As- and spread of infectious diseases with pan- with other donors and achieve health out-
sembly, and meetings of the Global Health demic potential, including disease outbreaks comes beyond a single sector;
Security Agenda and of the Global Health resulting from natural and manmade disas- (III) specifies the anticipated role of health
Security Initiative; ters, human displacement, loss of natural programs undertaken by each of the relevant
(G) working to enhance coordination with, habitat, poor access to water, sanitation, Federal departments and agencies operating
and transparency among, the governments of and hygiene, and other political, security, in the country in implementing such strat-
partner countries and key stakeholders, in- economic, and climatic shocks and stresses; egy;
cluding the private sector; (2) to develop effective tools to identify, (IV) includes clear goals, benchmarks, out-
(H) promoting greater donor and national analyze, forecast, and mitigate the risks puts, desired outcomes, a means of meas-
investment in partner countries to build that make such countries vulnerable; uring progress and a cost analysis; and
more resilient health systems and supply (3) to better integrate short-, medium-, and (V) requires reporting by each Federal de-
chains, including through representation and long-term recovery efforts into global health partment and agency regarding their partici-
participation in a multilateral, catalytic fi- emergency response and disaster relief; and pation and contribution, including in the
nancing mechanism for global health secu- (4) to ensure that international assistance PEPFAR Annual Report to Congress.
rity and pandemic prevention and prepared- and financing tools are effectively designed, (C) STRATEGIES TO STRENGTHEN HEALTH
ness, consistent with section 1296; objectively informed, strategically targeted, SYSTEMS.—USAID missions in countries
(I) securing bilateral and multilateral fi- carefully coordinated, reasonably adapted, identified pursuant subparagraph (A) should
nancing commitments to advance the Global and rigorously monitored and evaluated in a develop a strategy to strengthen health sys-
Health Security Agenda, in coordination manner that advances the policy objectives tems based on the assessment developed pur-
with the relevant Federal departments and under this subsection. suant to subparagraph (B) that—
agencies, including through funding for the (f) STRENGTHENING HEALTH SYSTEMS.— (i) ensures complementarity with prior-
financing mechanism described in section (1) STATEMENT OF POLICY.—It shall be the ities identified under any other action plan
1296; and policy of the United States to ensure that bi- focused on strengthening a country’s health
(J) providing regular updates to the appro- lateral global health assistance programs are system, such as the World Health Organiza-
priate congressional committees, the Com- effectively managed and coordinated to con- tion’s Joint External Evaluation and Na-
mittee on Health, Education, Labor, and tribute to the strengthening of health sys- tional Action Plans for Health Security;
Pensions of the Senate, and the Committee tems in each country in which such pro- (ii) identifies bureaucratic barriers and in-
on Energy and Commerce of the House of grams are carried out, as necessary and ap- efficiencies, including poor linkages between
Representatives regarding the fulfillment of propriate for the purposes of achieving im- government ministries and between min-
the duties described in this subsection. proved health outcomes. istries and donor agencies and the extent of
(5) DEPUTY REPRESENTATIVE.—The Special (2) COORDINATION.—The Administrator of any corruption, and identify actions to over-
Representative should be supported by a dep- USAID shall work with the Global Malaria come such barriers;
uty, who— Coordinator and the United States Global (iii) identifies potential obstacles to the
(A) should be an employee of USAID serv- AIDS Coordinator and Special Representa- implementation of the strategy, such as
ing in a career or noncareer position in the tive for Global Health Diplomacy at the De- issues relating to lack of political will, poor
Senior Executive Service or at the level of a partment of State, and, as appropriate, the governance of an effective health system at
Deputy Assistant Administrator or higher; Secretary of Health and Human Services, to all levels of the country’s public health sys-
(B) should have demonstrated knowledge identify areas of collaboration and coordina- tems, especially with respect to governing
and experience in the fields of development tion in countries with global health pro- bodies and councils at the provincial, dis-
and public health, epidemiology, or medi- grams and activities undertaken by USAID trict, and community levels, and the exclu-
cine; and pursuant to the United States Leadership sion of women, minorities, other underserved
(C) serves concurrently as the deputy and Against HIV/AIDS, Tuberculosis, and Ma- groups, and frontline health workers in deci-
performs the functions described in section laria Act of 2003 (Public Law 108–25) and sion making;
3(h) of Executive Order 13747 (81 Fed. Reg. other relevant statutes to ensure that such (iv) includes proposals for mobilizing suffi-
78701). activities contribute to health systems cient and durable financing for health sys-
(6) AUTHORIZATION OF APPROPRIATIONS.— strengthening. tems;
(A) IN GENERAL.—There is authorized to be (3) PILOT PROGRAM .— (v) identifies barriers to building and re-
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appropriated $5,000,000,000, for the 5-year pe- (A) IN GENERAL.—The Administrator of taining an effective frontline health work-
riod beginning on October 1, 2022, to carry USAID should identify not fewer than 5 force with key global health security capac-
out the purposes of this subsection and sec- countries in which the United States has sig- ities, informed by the International Health
tion 1296, which, in consultation with the ap- nificant bilateral investments in global Regulations (2005), including—
propriate congressional committees and sub- health to develop an integrated approach to- (I) strengthened data collection and anal-
ject to the requirements under chapters 1 ward health systems strengthening that ysis;
and 10 of part I and section 634A of the For- takes advantage of all sources of funding for (II) data driven decision making capacity;
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7911
(III) recommendations for partner country (I) progress made toward the integration (i) in subsection (b)(3)(D), by striking ‘‘in-
actions to achieve a workforce that conforms and co-financing of health systems strength- cluding health care systems, under other
with the World Health Organization’s rec- ening activities by USAID and the Office of international donor support’’ and inserting
ommendation for at least 44.5 doctors, the Global AIDS Coordinator; and ‘‘including through support for health sys-
nurses, and midwives and at least 15 paid, (II) the results of integrated efforts under tems strengthening, under other donor sup-
trained, equipped, and professionally super- this section, including for cross-cutting ef- port’’; and
vised community health workers for every forts to strengthen local health workforces. (ii) in subsection (f)(3)(Q), by inserting
10,000 people, while supporting proper dis- (4) TECHNICAL CAPACITY.— ‘‘the Office of the United States Global AIDS
tribution and high-quality job performance; (A) IN GENERAL.—The Administrator of Coordinator, partner countries, and the
and USAID shall ensure that USAID is suffi- Global Fund to Fight AIDS, Tuberculosis,
(IV) inclusion of the community health ciently resourced and staffed to ensure per- and Malaria to ensure that their actions sup-
workforce in planning for a resilient health formance, consistency, and adoption of best port the activities taken to strengthen the
system to ensure essential service delivery practices in USAID’s health systems pro- overall health systems in recipient coun-
and pandemic response; grams, including the pilot program author- tries, and efforts by’’ after ‘‘efforts by’’; and
(vi) identifies deficiencies in information ized under paragraph (3). (C) in section 104B(g)(2) (22 U.S.C. 2151b–
systems and communication technologies (B) RESOURCES.—The Administrator of 3(g)(2)), by inserting ‘‘strengthening the
that prevent linkages at all levels of the USAID and the United States Global AIDS health system of the country and’’ after
health system delivery and medical supply Coordinator shall include detail in the fiscal ‘‘contribute to’’.
systems and promotes interoperability year 2023 Congressional Budget Justification (2) UNITED STATES LEADERSHIP AGAINST HIV/
across data systems with near real-time regarding health systems strengthening ac- AIDS, TUBERCULOSIS, AND MALARIA ACT OF
data, while protecting data security; tivities, including— 2003.—Section 204(a) of the United States
(vii) identifies weaknesses in supply chain (i) the plans for, and the progress toward, Leadership Against HIV/AIDS, Tuberculosis,
and procurement systems and practices, and reaching the capacity described in subpara- and Malaria Act of 2003 (22 U.S.C. 7623(a)) is
recommends ways to improve the efficiency, graph (A); amended—
transparency, and effectiveness of such sys- (ii) the requirements for sustaining such (A) in paragraph (1)(A), by inserting ‘‘in a
tems and practices; capacity, including the resources needed by manner that is coordinated with, and con-
(viii) identifies obstacles to health service USAID; and tributes to, efforts through other assistance
access and quality and improved health out- (iii) budget detail on the integration and activities being carried out to strengthen na-
comes for women and girls, and for the poor- joint funding of health systems capacity tional health systems and health policies’’
est and most vulnerable, including a lack of building, as appropriate. after ‘‘systems’’; and
social support and other underlying causes, (5) INTERNATIONAL EFFORTS.—The Sec- (B) in paragraph (2)—
and recommendations for how to overcome retary of State, in coordination with the Ad- (i) in subparagraph (C), by inserting ‘‘as
such obstacles; ministrator of USAID and, as appropriate, part of a strategy to improve overall health’’
(ix) includes plans for integrating innova- the Secretary of Health and Human Services, before the semicolon at the end;
tions in health technologies, services, and should work with the Global Fund to Fight (ii) in subparagraph (D), by striking ‘‘and’’
systems; AIDS, Tuberculosis, and Malaria, Gavi, the at the end;
(x) identifies barriers to health literacy, Vaccine Alliance, bilateral donors, and other (iii) in subparagraph (E), by striking the
community engagement, and patient em- relevant multilateral and international or- period at the end and inserting ‘‘; and’’; and
powerment, and recommendations for over- ganizations and stakeholders to develop— (iv) by adding at the end the following:
coming such barriers; (A) shared core indicators for strengthened ‘‘(F) to contribute to efforts that build
(xi) includes proposals for strengthening health systems; health systems capable of preventing, de-
community health systems and the commu- (B) agreements among donors that report- tecting and responding to HIV/AIDS, tuber-
nity-based health workforce informed by the ing requirements for health systems come culosis, malaria and other infectious dis-
World Health Organization guideline on from country systems to reduce the burden eases with pandemic potential.’’.
health policy and system support to optimize placed on partner countries; (h) AUTHORIZATION FOR UNITED STATES
community health worker programmes (C) structures for joint assessments, plans, PARTICIPATION IN THE COALITION FOR EPI-
(2018), including the professionalization of auditing, and consultations; and DEMIC PREPAREDNESS INNOVATIONS.—
community health workers; (D) a regularized approach to coordination (1) IN GENERAL.—The United States is au-
(xii) describes the role of the private sector on health systems strengthening. thorized to participate in the Coalition for
and nongovernmental health providers, in- (6) PUBLIC PRIVATE PARTNERSHIPS TO IM- Epidemic Preparedness Innovations (referred
cluding community groups engaged in health PROVE HEALTH SYSTEMS STRENGTHENING.—The to in this subsection as ‘‘CEPI’’).
promotion and mutual assistance and other country strategies developed under para- (2) INVESTORS COUNCIL AND BOARD OF DIREC-
institutions engaged in health delivery, in- graph (3)(C) should include a section that— TORS.—
cluding the extent to which the local popu- (A) discusses the role of the private sector (A) INITIAL DESIGNATION.—The President
lation utilizes such health services; (including corporate, local, and inter- shall designate an employee of USAID to
(xiii) facilitates rapid response during national organizations with relevant exper- serve on the Investors Council and, if nomi-
health emergencies, such as last mile deliv- tise); and nated, on the Board of Directors of CEPI, as
ery of vaccines to respond to and prevent the (B) identifies relevant opportunities for a representative of the United States during
spread of infectious diseases with epidemic the private sector— the period beginning on the date of such des-
and pandemic potential; and (i) to accelerate research and development ignation and ending on September 30, 2022.
(xiv) ensures that relevant USAID missions of innovative health and information tech- (B) ONGOING DESIGNATIONS.—The President
and bureaus are appropriately staffed and nology, and to offer training related to its may designate an employee of the relevant
resourced to carry out such activities effi- use; Federal department or agency with fiduciary
ciently, effectively, and in-line with best (ii) to contribute to improvements in responsibility for United States contribu-
practices. health administration and management tions to CEPI to serve on the Investors Coun-
(D) CONSULTATION AND REPORTING REQUIRE- processes; cil and, if nominated, on the Board of Direc-
MENTS.— (iii) to improve system efficiency; tors of CEPI, as a representative of the
(i) CONSULTATION.—In developing a strat- (iv) to develop training related to clinical United States.
egy pursuant to subparagraph (C), each practice guidelines; and (C) QUALIFICATIONS.—Any employee des-
USAID mission should consult with a wide (v) to help countries develop systems for ignated pursuant to subparagraph (A) or (B)
variety of stakeholders, including— documenting outcomes and achievements re- shall have demonstrated knowledge and ex-
(I) relevant partner government institu- lated to activities undertaken to strengthen perience in the fields of development and
tions; the health sector. public health, epidemiology, or medicine,
(II) professional associations; (7) AUTHORIZATION FOR USE OF FUNDS.— from the Federal department or agency with
(III) patient groups; Amounts authorized to be appropriated or primary fiduciary responsibility for United
(IV) civil society organizations (including otherwise made available to carry out sec- States contributions pursuant to paragraph
international nongovernmental organiza- tion 104 of the Foreign Assistance Act of 1961 (3).
tions with relevant expertise in program im- (22 U.S.C. 2151b) may be made available to (D) COORDINATION .—In carrying out the re-
plementation); and carry out this subsection. sponsibilities under this subsection, an em-
(V) the private sector. (g) ADDITIONAL AUTHORITIES.— ployee designated by the President to serve
(ii) REPORTING.—Not later than 180 days (1) FOREIGN ASSISTANCE ACT OF 1961.—Chap- on the Investors Council or the Board of Di-
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after the date of the enactment of this Act, ter 1 of part I of the Foreign Assistance Act rectors, as applicable, shall coordinate with
the Administrator of USAID and the United of 1961 (22 U.S.C. 2151 et seq.) is amended— the Secretary of Health and Human Services
States Global AIDS Coordinator shall submit (A) in section 104(c)(1) (22 U.S.C. to promote alignment, as appropriate, be-
a report to the appropriate congressional 2151b(c)(1)), by inserting ‘‘(emphasizing tween CEPI and the strategic objectives and
committees detailing the progress of the health systems strengthening, as appro- activities of the Secretary of Health and
pilot program authorized under this para- priate)’’ after ‘‘health services’’; Human Services with respect to the re-
graph, including— (B) in section 104A (22 U.S.C. 2151b–2)— search, development, and procurement of
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S7912 CONGRESSIONAL RECORD — SENATE November 4, 2021
medical countermeasures, consistent with ti- of the United States stationed abroad, or tify and transparently communicate, on an
tles III and XXVIII of the Public Health citizens of the United States living abroad in ongoing basis, varying levels of risk leading
Service Act (42 U.S.C. 241 et seq. and 300hh et a manner that could lead to an epidemic in up to a declaration by the Director General
seq.). the United States or otherwise affect the na- of the World Health Organization of a Public
(3) CONSULTATION.—Not later than 60 days tional security or economic prosperity of the Health Emergency of International Concern
after the date of the enactment of this Act, United States; for the duration and in the aftermath of such
the employee designated pursuant to para- (iii) assess the preparedness of countries declaration.
graph (2)(A) shall consult with the appro- around the world, particularly those identi- (3) EMERGENCY OPERATIONS.—The Secretary
priate congressional committees, the Com- fied pursuant to clause (i), to prevent, de- of State and the Secretary of Health and
mittee on Health, Education, Labor, and tect, and respond to pandemic threats; and Human Services, in coordination with the
Pensions of the Senate, and the Committee (iv) identify any scientific, capacity, or USAID Administrator, the Director of the
on Energy and Commerce of the House of governance gaps in the preparedness of coun- Centers for Disease Control and Prevention,
Representatives regarding— tries identified pursuant to clause (i), includ- and the heads of other relevant Federal de-
(A) the manner and extent to which the ing an analysis of the capacity and perform- partments and agencies, and consistent with
United States plans to participate in CEPI, ance of any country or entity described in the requirements under the International
including through the governance of CEPI; clause (iii) in complying with biosecurity Health Regulations (2005) and the objectives
(B) any planned financial contributions standards, as applicable. of the World Health Organization’s Health
from the United States to CEPI; and (3) CONGRESSIONAL BRIEFINGS.—The Na- Emergencies Programme, the Global Health
(C) how participation in CEPI is expected tional Intelligence Council shall provide an Security Agenda, and national actions plans
to support— annual briefing to the appropriate commit- for health security, shall work, in coordina-
(i) the United States Global Health Secu- tees of Congress regarding— tion with the World Health Organization,
rity Strategy required under this subtitle; (A) the most recent intelligence assess- with partner countries and other key stake-
(ii) the applicable revision of the National ments submitted pursuant to paragraph holders to support the establishment,
Biodefense Strategy required under section (2)(A); and strengthening, and rapid response capacity
1086 of the National Defense Authorization (B) the emergence or reemergence of of global health emergency operations cen-
Act for Fiscal Year 2017 (6 U.S.C. 104); and pathogens with pandemic potential that ters, at the partner country and inter-
(iii) any other relevant programs relating could lead to an epidemic described in para- national levels, including efforts—
to global health security and biodefense. graph (2)(A)(ii). (A) to collect and share public health data,
(4) UNITED STATES CONTRIBUTIONS.— (4) PUBLIC AVAILABILITY.—The Director of assess risk, and operationalize early warn-
(A) SENSE OF CONGRESS.—It is the sense of National Intelligence shall make publicly ing;
Congress that the President, consistent with available an unclassified version of each in- (B) to secure, including through utilization
the provisions under section 10003(a)(1) of the telligence assessment submitted pursuant to of stand-by arrangements and emergency
American Rescue Plan Act of 2021, should paragraph (2)(A). funding mechanisms, the staff, systems, and
make an immediate contribution to CEPI in (j) PANDEMIC EARLY WARNING NETWORK.—
resources necessary to execute cross-sectoral
the amount of $300,000,000, to expand re- (1) IN GENERAL.—The Secretary of State
emergency operations during the 48-hour pe-
search and development of vaccines to com- and the Secretary of Health and Human
riod immediately following an infectious dis-
bat the spread of COVID–19 variants. Services, in coordination with the USAID
ease outbreak with pandemic potential; and
(B) NOTIFICATION.—Not later than 15 days Administrator, the Director of the Centers
for Disease Control and Prevention, and the (C) to organize and conduct emergency
before a contribution is made available pur-
heads of the other relevant Federal depart- simulations.
suant to subparagraph (A), the President
shall notify the appropriate congressional ments and agencies, shall work with the SEC. 1296. FINANCING MECHANISM FOR GLOBAL
World Health Organization and other key HEALTH SECURITY AND PANDEMIC
committees of the details of the amount,
PREVENTION AND PREPAREDNESS.
purposes, and national interests served by stakeholders to establish or strengthen ef-
such contribution. fective early warning systems, at the partner (a) ELIGIBLE PARTNER COUNTRY DEFINED.—
(i) INTELLIGENCE ASSESSMENTS REGARDING country, regional, and international levels, In this section, the term ‘‘eligible partner
NOVEL DISEASES AND PANDEMIC THREATS.— that utilize innovative information and ana- country’’ means a country in which the Fund
(1) DEFINED TERM.—In this subsection, the lytical tools and robust review processes to for Global Health Security and Pandemic
term ‘‘appropriate committees of Congress’’ track, document, analyze, and forecast infec- Prevention and Preparedness to be estab-
means— tious disease threats with epidemic and pan- lished under subsection (b) may finance glob-
(A) the Committee on Foreign Relations of demic potential. al health security and pandemic prevention
the Senate; (2) REPORT.—Not later than 1 year after and preparedness assistance programs under
(B) the Select Committee on Intelligence the date of the enactment of this Act, and this subtitle based on the country’s dem-
of the Senate; annually thereafter for the following 4 years, onstrated—
(C) the Committee on Health, Education, the Secretary of State, in coordination with (1) need, as identified through the Joint
Labor, and Pensions of the Senate; the Secretary of Health and Human Services External Evaluation process, the Global
(D) the Committee on Foreign Affairs of and the heads of the other relevant Federal Health Security Index classification of
the House of Representatives; departments and agencies, shall submit a re- health systems, national action plans for
(E) the Permanent Select Committee on port to the appropriate congressional com- health security, the World Organization for
Intelligence of the House of Representatives; mittees, the Committee on Health, Edu- Animal Health’s Performance of Veterinary
and cation, Labor, and Pensions of the Senate, Services evaluation, and other complemen-
(F) the Committee on Energy and Com- and the Committee on Energy and Commerce tary or successor indicators of global health
merce of the House of Representatives. of the House of Representatives that de- security and pandemic prevention and pre-
(2) INTELLIGENCE ASSESSMENTS.— scribes United States Government efforts paredness; and
(A) IN GENERAL.—Not later than 1 year and opportunities to establish or strengthen (2) commitment to transparency, includ-
after the date of the enactment of this Act, effective early warning systems to detect in- ing—
and annually thereafter for the following 4 fectious disease threats internationally. (A) budget and global health data trans-
years, the National Intelligence Council (k) INTERNATIONAL EMERGENCY OPER- parency;
shall submit to the appropriate committees ATIONS.— (B) complying with the International
of Congress an intelligence assessment re- (1) SENSE OF CONGRESS.—It is the sense of Health Regulations (2005);
garding the risks posed to the national secu- Congress that it is essential to enhance the (C) investing in domestic health systems;
rity interests of the United States by the capacity of key stakeholders to effectively and
emergence, reemergence, and overseas trans- operationalize early warning and execute (D) achieving measurable results.
mission of pathogens with pandemic poten- multi-sectoral emergency operations during (b) ESTABLISHMENT OF FUND FOR GLOBAL
tial. an infectious disease outbreak, particularly HEALTH SECURITY AND PANDEMIC PREVENTION
(B) ELEMENTS.—The intelligence assess- in countries and areas that deliberately AND PREPAREDNESS.—
ments submitted pursuant to subparagraph withhold critical global health data and (1) NEGOTIATIONS FOR ESTABLISHMENT OF
(A) shall— delay access during an infectious disease FUND FOR GLOBAL HEALTH SECURITY AND PAN-
(i) identify the countries or regions most outbreak in advance of the next infectious DEMIC PREVENTION AND PREPAREDNESS.—The
vulnerable to the emergence or reemergence disease outbreak with pandemic potential. Secretary of State, in coordination with the
of a pathogen with pandemic potential, in- (2) PUBLIC HEALTH EMERGENCIES OF INTER- USAID Administrator, the Secretary of
cluding the most likely sources and path- NATIONAL CONCERN.—The Secretary of State, Health and Human Services, and the heads of
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ways of such emergence or reemergence, in coordination with the Secretary of Health other relevant Federal departments and
whether naturally occurring, accidental, or and Human Services, should work with the agencies, as necessary and appropriate,
deliberate; World Health Organization and like-minded should seek to enter into negotiations with
(ii) assess the likelihood that a pathogen member states to adopt an approach toward donors, relevant United Nations agencies, in-
described in clause (i) will spread to the assessing infectious disease threats under cluding the World Health Organization, and
United States, the United States Armed the International Health Regulations (2005) other key multilateral stakeholders, to es-
Forces, diplomatic or development personnel for the World Health Organization to iden- tablish—
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7913
(A) a multilateral, catalytic financing activities, and with the United States and acting through the Executive Board,
mechanism for global health security and other nations leading outbreak prevention, should—
pandemic prevention and preparedness, preparedness, and response activities in part- (i) develop grant making requirements to
which may be known as the Fund for Global ner countries, as appropriate. be administered by an independent technical
Health Security and Pandemic Prevention (C) COMPOSITION.—The Executive Board review panel comprised of entities barred
and Preparedness (referred to in this section should include— from applying for funding or support;
as ‘‘the Fund’’), to address the need for and (i) representatives of the governments of (ii) provide grants, including challenge
secure durable financing in accordance with founding member countries who, in addition grants, technical assistance, concessional
the provisions of this subsection; and to the requirements under subparagraph (A), lending, catalytic investment funds, and
(B) an Advisory Board to the Fund in ac- qualify based upon meeting an established other innovative funding mechanisms, in co-
cordance with subsection (e). initial contribution threshold, which should ordination with ongoing bilateral and multi-
(2) PURPOSES.—The purposes of the Fund be not less than 10 percent of total initial lateral efforts, as appropriate—
should be— contributions, and a demonstrated commit- (I) to help eligible partner countries close
(A) to close critical gaps in global health ment to supporting the International Health critical gaps in health security, as identified
security and pandemic prevention and pre- Regulations (2005); through the Joint External Evaluation proc-
paredness; and (ii) a geographically diverse group of mem- ess, the Global Health Security Index classi-
(B) to work with, and build the capacity of, bers who— fication of health systems, and national ac-
eligible partner countries in the areas of (I) come from donor countries, eligible tion plans for health security and other com-
global health security, infectious disease partner countries, academic institutions,
plementary or successor indicators of global
control, and pandemic prevention and pre- independent civil society, including indige-
health security and pandemic prevention and
paredness, in a manner that— nous organizations, and the private sector;
preparedness; and
(i) prioritizes capacity building and financ- and
(II) to support measures that enable such
ing availability in eligible partner countries; (II) are selected on the basis of their expe-
countries, at the national and subnational
(ii) incentivizes countries to prioritize the rience and commitment to innovation, best
levels, and in partnership with civil society
use of domestic resources for global health practices, and the advancement of global
and the private sector, to strengthen and
security and pandemic prevention and pre- health security objectives;
paredness; (iii) representatives of the World Health sustain resilient health systems and supply
(iii) leverages government, nongovern- Organization; and chains with the resources, capacity, and per-
ment, and private sector investments; (iv) the chair of the Global Health Security sonnel required to prevent, detect, mitigate,
(iv) regularly responds to and evaluates Steering Group. and respond to infectious disease threats, in-
progress based on clear metrics and bench- (D) CONTRIBUTIONS.—Each government or cluding the emergence or reemergence of
marks, such as the Joint External Evalua- private sector entity represented on the Ex- pathogens, before they become pandemics;
tion and the Global Health Security Index; ecutive Board should agree to make annual (iii) leverage the expertise, capabilities,
(v) aligns with and complements ongoing contributions to the Fund in an amount not and resources of proven, existing agencies
bilateral and multilateral efforts and financ- less than the minimum determined by the and organizations to effectively target and
ing, including through the World Bank, the Executive Board. manage resources for impact, including
World Health Organization, the Global Fund (E) QUALIFICATIONS.—Individuals appointed through alignment with, and co-financing of,
to Fight AIDS, Tuberculosis, and Malaria, to the Executive Board should have dem- complementary programs, as appropriate
the Coalition for Epidemic Preparedness and onstrated knowledge and experience across a and consistent with subparagraph (C); and
Innovation, and Gavi, the Vaccine Alliance; variety of sectors, including human and ani- (iv) develop recommendations for a mecha-
and mal health, agriculture, development, de- nism for assisting countries that are at high
(vi) helps countries accelerate and achieve fense, finance, research, and academia. risk for the emergence or reemergence of
compliance with the International Health (F) CONFLICTS OF INTEREST.— pathogens with pandemic potential to par-
Regulations (2005) and the fulfillment of the (i) TECHNICAL EXPERTS.—The Executive ticipate in the Global Health Security Agen-
Global Health Security Agenda 2024 Frame- Board may include independent technical ex- da and the Joint External Evaluations.
work not later than 5 years after the date on perts who are not affiliated with, or em- (B) ACTIVITIES SUPPORTED.—The activities
which the Fund is established, in coordina- ployed by, a recipient country or organiza- to be supported by the Fund should include
tion with the ongoing Joint External Eval- tion. efforts—
uation national action planning process. (ii) MULTILATERAL BODIES AND INSTITU- (i) to enable eligible partner countries to
(3) EXECUTIVE BOARD.— TIONS.—Executive Board members appointed formulate and implement national health se-
(A) IN GENERAL.—The Fund should be gov- pursuant to subparagraph (C)(iii) should be curity and pandemic prevention and pre-
erned by a transparent and accountable body required to recuse themselves from matters paredness action plans, advance action pack-
(referred to in this section as the ‘‘Executive presenting conflicts of interest, including fi- ages under the Global Health Security Agen-
Board’’), which should— nancing decisions relating to such bodies and da, and adopt and uphold commitments
(i) function as a partnership with, and institutions. under the International Health Regulations
through full engagement by, donor govern- (G) UNITED STATES REPRESENTATION.— (2005) and other related international health
ments, eligible partner countries, and inde- (i) FOUNDING MEMBER.—The Secretary of agreements and arrangements, as appro-
pendent civil society; and State should seek— priate;
(ii) be composed of not more than 20 rep- (I) to establish the United States as a (ii) to support health security budget plan-
resentatives of governments, foundations, founding member of the Fund; and ning in eligible partner countries, including
academic institutions, independent civil so- (II) to ensure that the United States is rep- training in public financial management,
ciety, indigenous people, vulnerable commu- resented on the Executive Board by an offi- budget and health data transparency, human
nities, frontline health workers, and the pri- cer or employee of the United States, who resource information systems, and inte-
vate sector with demonstrated commitment shall be appointed by the President. grated and transparent budget and health
to carrying out the purposes of the Fund and (ii) EFFECTIVE AND TERMINATION DATES.— data;
upholding transparency and accountability (I) EFFECTIVE DATE.—This subparagraph (iii) to strengthen the health workforce,
requirements. shall take effect upon the date on which the including hiring, training, and deploying ex-
(B) DUTIES.—The Executive Board should— Secretary of State certifies and submits to perts and other essential staff, including
(i) be charged with approving strategies, Congress an agreement establishing the community health workers, to improve
operations, and grant making authorities in Fund. frontline prevention of, and monitoring and
order to conduct effective fiduciary, moni- (II) TERMINATION DATE.—The membership preparedness for, unknown, new, emerging,
toring, and evaluation efforts, and other established pursuant to clause (i) shall ter- or reemerging pathogens, epidemics, and
oversight functions; minate upon the date of termination of the pandemic threats, including capacity to
(ii) determine operational procedures such Fund. surge and manage additional staff during
that the Fund is able to effectively fulfill its (H) REMOVAL PROCEDURES.—The Fund emergencies;
mission; should establish procedures for the removal (iv) to improve the quality of community
(iii) provide oversight and accountability of members of the Executive Board who— health worker programs as the foundation of
for the Fund in collaboration with the In- (i) engage in a consistent pattern of human pandemic preparedness and response through
spector General to be established pursuant rights abuses; application of appropriate assessment tools;
to subsection (d)(5)(A)(i); (ii) fail to uphold global health data trans- (v) to improve infection prevention and
(iv) develop and utilize a mechanism to ob- parency requirements; or control, the protection of healthcare work-
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tain formal input from eligible partner coun- (iii) otherwise violate the established ers, including community health workers,
tries, independent civil society, and imple- standards of the Fund, including in relation and access to water and sanitation within
menting entities relative to program design, to corruption. healthcare settings;
review, and implementation and associated (c) AUTHORITIES.— (vi) to combat the threat of antimicrobial
lessons learned; and (1) PROGRAM OBJECTIVES.— resistance;
(v) coordinate and align with other multi- (A) IN GENERAL.—In carrying out the pur- (vii) to strengthen laboratory capacity and
lateral financing and technical assistance pose set forth in subsection (b), the Fund, promote biosafety and biosecurity through
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S7914 CONGRESSIONAL RECORD — SENATE November 4, 2021
the provision of material and technical as- (i) governments, independent civil society, recusal from certain decision-making and
sistance; nongovernmental organizations, research administrative processes, and representation
(viii) to reduce the risk of bioterrorism, and academic institutions, and private sec- by an alternate board member; and
the emergence, reemergence, or spread of tor entities in eligible partner countries; (C) seek agreement on the criteria that
zoonotic disease (whether through loss of (ii) the pandemic early warning systems should be used to determine the programs
natural habitat, the commercial trade in and international emergency operations cen- and activities that should be assisted by the
wildlife for human consumption, or other ters to be established under subsections (j) Fund.
means), and accidental biological release; and (k) of section 1295; (4) SELECTION OF PARTNER COUNTRIES,
(ix) to build technical capacity to manage, (iii) the World Health Organization; PROJECTS, AND RECIPIENTS.—The Executive
as appropriate, supply chains for applicable (iv) the Global Health Security Agenda; Board should establish—
global health commodities through effective (v) the Global Health Security Initiative; (A) eligible partner country selection cri-
forecasting, procurement, warehousing, and (vi) the Global Fund to Fight AIDS, Tuber- teria, to include transparent metrics to
delivery from central warehouses to points culosis, and Malaria; measure and assess global health security
of service in both the public and private sec- (vii) the United Nations Office for the Co- and pandemic prevention and preparedness
tors; ordination of Humanitarian Affairs, strengths and vulnerabilities in countries
(x) to enable bilateral, regional, and inter- UNICEF, and other relevant funds, pro- seeking assistance;
national partnerships and cooperation, in- grams, and specialized agencies of the United (B) minimum standards for ensuring eligi-
cluding through pandemic early warning sys- Nations; ble partner country ownership and commit-
(viii) Gavi, the Vaccine Alliance; ment to long-term results, including require-
tems and emergency operations centers, to
(ix) the Coalition for Epidemic Prepared- ments for domestic budgeting, resource mo-
identify and address transnational infectious
ness Innovations (CEPI); bilization, and co-investment;
disease threats exacerbated by natural and
(x) The World Organisation for Animal (C) criteria for the selection of projects to
man-made disasters, human displacement,
Health; receive support from the Fund;
and zoonotic infection;
(xi) The United Nations Environment Pro- (D) standards and criteria regarding quali-
(xi) to establish partnerships for the shar-
gramme; fications of recipients of such support;
ing of best practices and enabling eligible
(xii) Food and Agriculture Organization; (E) such rules and procedures as may be
countries to meet targets and indicators and
under the Joint External Evaluation process, necessary for cost-effective management of
(xiii) the Global Polio Eradication Initia- the Fund; and
the Global Health Security Index classifica- tive.
tion of health systems, and national action (F) such rules and procedures as may be
(2) PRIORITY.—In providing assistance necessary to ensure transparency and ac-
plans for health security relating to the pre- under this section, the Fund should give pri-
vention, detection, and treatment of ne- countability in the grant-making process.
ority to low-and lower middle income coun- (5) ADDITIONAL TRANSPARENCY AND AC-
glected tropical diseases; tries with—
(xii) to build the capacity of eligible part- COUNTABILITY REQUIREMENTS.—
(A) low scores on the Global Health Secu- (A) INSPECTOR GENERAL.—
ner countries to prepare for and respond to rity Index classification of health systems;
second order development impacts of infec- (i) IN GENERAL.—The Secretary of State
(B) measurable gaps in global health secu- shall seek to ensure that the Inspector Gen-
tious disease outbreaks and maintain essen- rity and pandemic prevention and prepared-
tial health services, while accounting for the eral appointed pursuant to paragraph (1)—
ness identified under Joint External Evalua-
differentiated needs and vulnerabilities of (I) is fully enabled to operate independ-
tions and national action plans for health se-
marginalized populations, including women ently and transparently;
curity;
and girls; (II) is supported by and with the requisite
(C) demonstrated political and financial
(xiii) to develop and utilize metrics to resources and capacity to regularly conduct
commitment to pandemic prevention and
monitor and evaluate programmatic per- and publish, on a publicly accessible website,
preparedness; and
formance and identify best practices, includ- rigorous financial, programmatic, and re-
(D) demonstrated commitment to uphold-
ing in accordance with Joint External Eval- porting audits and investigations of the
ing global health budget and data trans-
uation benchmarks, Global Health Security Fund and its grantees; and
parency and accountability standards, com-
Agenda targets, and Global Health Security plying with the International Health Regula- (III) establishes an investigative unit
Index indicators; tions (2005), investing in domestic health sys- that—
(xiv) to develop and deploy mechanisms to tems, and achieving measurable results. (aa) develops an oversight mechanism to
enhance and independently monitor the (3) ELIGIBLE GRANT RECIPIENTS.—Govern- ensure that grant funds are not diverted to
transparency and accountability of global ments and nongovernmental organizations illicit or corrupt purposes or activities; and
health security and pandemic prevention and should be eligible to receive grants as de- (bb) submits an annual report to the Exec-
preparedness programs and data, in compli- scribed in this section. utive Board describing its activities, inves-
ance with the International Health Regula- (d) ADMINISTRATION.— tigations, and results.
tions (2005), including through the sharing of (1) APPOINTMENTS.—The Executive Board (ii) SENSE OF CONGRESS ON CORRUPTION.—It
trends, risks, and lessons learned; should appoint— is the sense of Congress that—
(xv) to promote broad participation in (A) an Administrator, who should be re- (I) corruption within global health pro-
health emergency planning and advisory sponsible for managing the day-to-day oper- grams contribute directly to the loss of
bodies, including by women and frontline ations of the Fund; and human life and cannot be tolerated; and
health workers; (B) an independent Inspector General, who (II) in making financial recoveries relating
(xvi) to develop and implement simulation should be responsible for monitoring grants to a corrupt act or criminal conduct under a
exercises, produce and release after action implementation and proactively safe- grant, as determined by the Inspector Gen-
reports, and address related gaps; guarding against conflicts of interests. eral, the responsible grant recipient should
(xvii) to support countries in conducting (2) AUTHORITY TO ACCEPT AND SOLICIT CON- be assessed at a recovery rate of up to 150
Joint External Evaluations; TRIBUTIONS.—The Fund should be authorized percent of such loss.
(xviii) to improve disease surveillance ca- to solicit and accept contributions from gov- (B) ADMINISTRATIVE EXPENSES.—The Sec-
pacity in partner counties, including at the ernments, the private sector, foundations, retary of State shall seek to ensure the Fund
community level, such that those countries individuals, and nongovernmental entities. establishes, maintains, and makes publicly
are better able to detect and respond to (3) ACCOUNTABILITY; CONFLICTS OF INTER- available a system to track the administra-
known and unknown pathogens and zoonotic EST; CRITERIA FOR PROGRAMS.—As part of the tive and management costs of the Fund on a
infectious diseases; and negotiations described in subsection (b)(1), quarterly basis.
(xix) to support governments through co- the Secretary of the State, consistent with (C) FINANCIAL TRACKING SYSTEMS.—The
ordinated and prioritized assistance efforts paragraph (4), should— Secretary of State shall ensure that the
to prevent the emergence, reemergence, or (A) take such actions as are necessary to Fund establishes, maintains, and makes pub-
spread of zoonotic diseases caused by defor- ensure that the Fund will have in effect ade- licly available a system to track the amount
estation, commercial trade in wildlife for quate procedures and standards to account of funds disbursed to each grant recipient
human consumption, climate-related events, for and monitor the use of funds contributed and sub-recipient during a grant’s fiscal
and unsafe interactions between wildlife, to the Fund, including the cost of admin- cycle.
livestock, and people. istering the Fund; (D) EXEMPTION FROM DUTIES AND TAXES.—
(C) IMPLEMENTATION OF PROGRAM OBJEC- (B) ensure there is agreement to put in The Secretary should ensure that the Fund
TIVES.—In carrying out the objectives under place a conflict of interest policy to ensure adopts rules that condition grants upon
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subparagraph (A), the Fund should work to fairness and a high standard of ethical con- agreement by the relevant national authori-
eliminate duplication and waste by uphold- duct in the Fund’s decision-making proc- ties in an eligible partner country to exempt
ing strict transparency and accountability esses, including proactive procedures to from duties and taxes all products financed
standards and coordinating its programs and screen staff for conflicts of interest and by such grants, including procurements by
activities with key partners working to ad- measures to address any conflicts, such as any principal or sub-recipient for the pur-
vance global health security and pandemic potential divestments of interests, prohibi- pose of carrying out such grants.
prevention and preparedness, including— tion from engaging in certain activities, (e) ADVISORY BOARD.—
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November 4, 2021 CONGRESSIONAL RECORD — SENATE S7915
(1) IN GENERAL.—There should be an Advi- programs, projects, and activities supported of the assistance authorized to be appro-
sory Board to the Fund. by the Fund, as described in subsection priated under this subtitle may be made
(2) APPOINTMENTS.—The members of the (c)(1). available to the Government of the People’s
Advisory Board should be composed of— (g) UNITED STATES CONTRIBUTIONS.— Republic of China or to any entity owned or
(A) a geographically diverse group of indi- (1) IN GENERAL.—Subject to submission of controlled by the Government of the Peo-
viduals that includes representation from the certification under this subsection, the ple’s Republic of China.
low- and middle-income countries; President is authorized to make available for
(B) individuals with experience and leader- United States contributions to the Fund SA 4397. Mr. GRASSLEY submitted
ship in the fields of development, global such funds as may be appropriated or other- an amendment intended to be proposed
health, epidemiology, medicine, biomedical wise made available for such purpose. to amendment SA 3867 submitted by
research, and social sciences; and (2) NOTIFICATION.—The Secretary of State
shall notify the appropriate congressional Mr. REED and intended to be proposed
(C) representatives of relevant United Na-
tions agencies, including the World Health committees not later than 15 days in ad- to the bill H.R. 4350, to authorize ap-
Organization, and nongovernmental organi- vance of making a contribution to the Fund, propriations for fiscal year 2022 for
zations with on-the ground experience in im- including— military activities of the Department
plementing global health programs in low (A) the amount of the proposed contribu- of Defense, for military construction,
and lower-middle income countries. tion; and for defense activities of the De-
(3) RESPONSIBILITIES.—The Advisory Board (B) the total of funds contributed by other partment of Energy, to prescribe mili-
should provide advice and guidance to the donors; and
(C) the national interests served by United
tary personnel strengths for such fiscal
Executive Board of the Fund on the develop-
ment and implementation of programs and States participation in the Fund. year, and for other purposes; which was
projects to be assisted by the Fund and on (3) LIMITATION.—During the 5-year period ordered to lie on the table; as follows:
leveraging donations to the Fund. beginning on the date of the enactment of At the end of subtitle F of title X, add the
(4) PROHIBITION ON PAYMENT OF COMPENSA- this Act, a United States contribution to the following:
TION.— Fund may not cause the cumulative total of SEC. 1054. COMPTROLLER GENERAL REPORT ON
(A) IN GENERAL.—Except for travel ex- United States contributions to the Fund to ACTUAL COST OF CERTAIN NET AS-
penses (including per diem in lieu of subsist- exceed 33 percent of the total contributions SESSMENTS CONDUCTED BY THE OF-
ence), no member of the Advisory Board to the Fund from all sources. FICE OF NET ASSESSMENT.
should receive compensation for services per- (4) WITHHOLDINGS.— Not later than 180 days after the date of
formed as a member of the Board. (A) SUPPORT FOR ACTS OF INTERNATIONAL the enactment of this Act, the Comptroller
(B) UNITED STATES REPRESENTATIVE.—Not- TERRORISM.—If the Secretary of State deter- General of the United States shall submit to
withstanding any other provision of law (in- mines that the Fund has provided assistance the congressional defense committees a re-
cluding an international agreement), a rep- to a country, the government of which the port setting forth the results of an analysis
resentative of the United States on the Advi- Secretary of State has determined, for pur- of the actual cost of performance of net as-
sory Board may not accept compensation for poses of section 620A of the Foreign Assist- sessments conducted by the Office of Net As-
services performed as a member of the ance Act of 1961 (22 U.S.C. 2371) has repeat- sessment of standing trends and future pros-
Board, except that such representative may edly provided support for acts of inter- pects of United States military capabilities
accept travel expenses, including per diem in national terrorism, the United States shall and national potential in comparison with
lieu of subsistence, while away from the rep- withhold from its contribution to the Fund those of other countries or groups of coun-
resentative’s home or regular place of busi- for the next fiscal year an amount equal to tries so as to identify emerging or future
ness in the performance of services for the the amount expended by the Fund to the threats or opportunities for the United
Board. government of such country. States.
(5) CONFLICTS OF INTEREST.—Members of (B) EXCESSIVE SALARIES.—During the 5-
the Advisory Board should be required to dis- year period beginning on the date of the en- SA 4398. Mr. COTTON submitted an
close any potential conflicts of interest prior actment of this Act, if the Secretary of State amendment intended to be proposed to
to serving on the Advisory Board and, in the determines that the salary of any individual amendment SA 3867 submitted by Mr.
event of any conflicts of interest, recuse employed by the Fund exceeds the salary of REED and intended to be proposed to
themselves from such matters during their the Vice President of the United States for
service on the Advisory Board. the bill H.R. 4350, to authorize appro-
such fiscal year, the United States should
(f) REPORTS TO CONGRESS.— priations for fiscal year 2022 for mili-
withhold from its contribution for the next
(1) STATUS REPORT.—Not later than 180 fiscal year an amount equal to the aggregate tary activities of the Department of
days after the date of the enactment of this amount by which the salary of each such in- Defense, for military construction, and
Act, the Secretary of State, in coordination dividual exceeds the salary of the Vice Presi- for defense activities of the Depart-
with the USAID Administrator, and the dent of the United States. ment of Energy, to prescribe military
heads of other relevant Federal departments (C) ACCOUNTABILITY CERTIFICATION REQUIRE- personnel strengths for such fiscal
and agencies, shall submit a report to the ap- MENT.—The Secretary of State may withhold
propriate congressional committees that de- year, and for other purposes; which was
not more than 20 percent of planned United ordered to lie on the table; as follows:
scribes the progress of international negotia- States contributions to the Fund until the
tions to establish the Fund. Secretary certifies to the appropriate con- At the end of subtitle E of title XII, add
(2) ANNUAL REPORT.— gressional committees that the Fund has es- the following:
(A) IN GENERAL.—Not later than 1 year tablished procedures to provide access by the SEC. 1253. AUSTRALIA-UNITED STATES LEGISLA-
after the date of the establishment of the TIVE EXCHANGE PROGRAM.
Office of Inspector General of the Depart-
Fund, and annually thereafter for the dura- ment of State, as cognizant Inspector Gen- (a) FINDINGS.—Congress finds the fol-
tion of the Fund, the Secretary of State, eral, the Inspector General of the Depart- lowing:
shall submit a report to the appropriate con- ment of Health and Human Services, the In- (1) The People’s Republic of China con-
gressional committees regarding the admin- spector General of USAID, and the Comp- tinues to assert its regional ambitions in the
istration of the Fund. troller General of the United States to the Indo-Pacific region.
(B) REPORT ELEMENTS.—The report re- Fund’s financial data and other information (2) The ideological aims driving the Chi-
quired under subparagraph (A) shall de- relevant to United States contributions to nese Communist Party’s foreign policy runs
scribe— the Fund (as determined by the Inspector counter to aims of democracies such as the
(i) the goals of the Fund; General of the Department of State, in con- United States and its allies.
(ii) the programs, projects, and activities sultation with the Secretary of State). (3) Australia has been one of the United
supported by the Fund; (h) COMPLIANCE WITH THE FOREIGN AID State’s staunchest allies for well over 100
(iii) private and governmental contribu- TRANSPARENCY AND ACCOUNTABILITY ACT OF years. This ‘‘Mateship’’ began with the visit
tions to the Fund; and 2016.—Section 2(3) of the Foreign Aid Trans- of the American Great White Fleet to Syd-
(iv) the criteria utilized to determine the parency and Accountability Act of 2016 (Pub- ney Harbor in 1908. The budding relationship
programs and activities that should be as- lic Law 114–191; 22 U.S.C. 2394c note) is was soon sealed through American and Aus-
sisted by the Fund, including baselines, tar- amended— tralian troops fighting and dying together in
gets, desired outcomes, measurable goals, (1) in subparagraph (D), by striking ‘‘and’’ the World War I.
and extent to which those goals are being at the end; (4) Since the World War I, Australians and
achieved. (2) in subparagraph (E), by striking the pe- Americans—
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(3) GAO REPORT ON EFFECTIVENESS.—Not riod at the end and inserting ‘‘; and’’; and (A) have supported each other in every
later than 2 years after the date on which (3) by adding at the end the following: major military conflict in which the United
the Fund is established, the Comptroller ‘‘(F) the International Pandemic Prepared- States was involved; and
General of the United States shall submit a ness and COVID-19 Response Act of 2021.’’. (B) have mutually supported each another
report to the appropriate congressional com- (i) PROHIBITION AGAINST UNITED STATES in intelligence-sharing.
mittees that evaluates the effectiveness of FOREIGN ASSISTANCE FOR THE GOVERNMENT (b) SENSE OF CONGRESS.—It is the sense of
the Fund, including the effectiveness of the OF THE PEOPLE’S REPUBLIC OF CHINA.—None Congress that—
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File and source
- File
- CREC_crec-2021-11-04_crec-2021-11-04-pt1-pgs7903-2.pdf
- Size
- 361,574 bytes
- SHA-256
- a7c0a2e290219bd335e8e46df09ad0823db89d292741f7049da577a4cdd681bc
- Original
- www.govinfo.gov