Congressional Record, Senate, November 15, 2021 — Amendments to H.R. 4350
Summary
This is S8163 of the Congressional Record, Senate, November 15, 2021, with interleaved columns of submitted amendments to H.R. 4350, the defense authorization bill for fiscal year 2022. The page includes SA 4643 by Mr. Risch, intended to be proposed to amendment SA 3867 submitted by Mr. Reed, with a statement of the sense of Congress on NATO and the European Deterrence Initiative. It also prints a section limiting funding for peacekeeping training exercises with the People's Republic of China, and Subtitle H, the International Pandemic Preparedness and COVID-19 Response Act of 2021, whose definitions refer to the Global Health Security Agenda and the International Health Regulations.
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“Congressional Record, Senate, November 15, 2021 — Amendments to H.R. 4350.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/crec-crec-2021-11-15-crec-2021-11-15-pt1-pgs8163-2-f90e116b76/
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8163
SEC. 1253. LIMITATION ON FUNDING FOR PEACE- (B) encourage security sector cooperation ment of Energy, to prescribe military
KEEPING TRAINING EXERCISES between NATO and non-NATO defense part-
WITH THE PEOPLE’S REPUBLIC OF
personnel strengths for such fiscal
ners that complements and strengthens col- year, and for other purposes; which was
CHINA.
lective defense, interoperability, and allies’
Section 552 of the Foreign Assistance Act commitment to Article 3 of the North Atlan-
ordered to lie on the table; as follows:
of 1961 (22 U.S.C. 2348a) is amended by adding At the end of title XII, add the following:
tic Treaty;
at the end the following new subsection: Subtitle H—International Pandemic
(9) bolstering NATO cooperation and en-
‘‘(e) LIMITATION ON FUNDING FOR PEACE-
hancing security relationships with non- Preparedness and COVID–19 Response
KEEPING TRAINING EXERCISES WITH THE PEO-
PLE’S REPUBLIC OF CHINA.—None of the funds
NATO European partners to counter Russian SEC. 1291. SHORT TITLE.
authorized to be appropriated or otherwise aggression, including Russia’s use of hybrid This subtitle may be cited as the ‘‘Inter-
made available to carry out this chapter, in- warfare tactics and its willingness to use national Pandemic Preparedness and COVID-
cluding for the Global Peace Operations Ini- military power to alter the status quo, 19 Response Act of 2021’’.
tiative of the Department of State, may be strengthens the United States security inter- SEC. 1292. DEFINITIONS.
used to train or support foreign military ests for long-term strategic competition; In this subtitle:
forces that participate in peacekeeping (10) the European Deterrence Initiative, (1) APPROPRIATE CONGRESSIONAL COMMIT-
training exercises hosted by the Government through investments to increase United TEES.—The term ‘‘appropriate congressional
of the People’s Republic of China or the Peo- States military presence, bolster exercises
committees’’ means—
ple’s Liberation Army unless, by not later and training, enhance pre-positioning of
(A) the Committee on Foreign Relations of
than October 1 of each year, the Secretary of equipment, improve infrastructure, and
the Senate;
State certifies to the Committee on Foreign build partner capacity, and investments to-
(B) the Committee on Appropriations of
Relations of the Senate and the Committee ward such efforts by NATO allies and other
the Senate;
on Foreign Affairs of the House of Represent- allies and partners, remain critical to ensur-
(C) the Committee on Foreign Affairs of
atives that such training or support is im- ing collective defense in the future;
the House of Representatives; and
portant to the national security interests of (11) the United States should—
(D) the Committee on Appropriations of
the United States.’’. (A) continue to support efforts by NATO
the House of Representatives.
allies to replace Soviet-era military systems
(2) GLOBAL HEALTH SECURITY AGENDA;
SA 4643. Mr. RISCH submitted an and equipment with systems that are inter-
GHSA.—The terms ‘‘Global Health Security
amendment intended to be proposed to operable among NATO members; and
(B) work with NATO allies and other allies Agenda’’ and ‘‘GHSA’’ mean the multi-sec-
amendment SA 3867 submitted by Mr. toral initiative launched in 2014 and renewed
and partners to build permanent mechanisms
REED and intended to be proposed to in 2018 that brings together countries, re-
to strengthen supply chains, enhance supply
the bill H.R. 4350, to authorize appro- chain security, and fill supply chain gaps, in- gions, international organizations, non-
priations for fiscal year 2022 for mili- cluding in critical sectors such as defense, governmental organizations, and the private
tary activities of the Department of energy, and health; sector to elevate global health security as a
Defense, for military construction, and (12) the United States and NATO allies national-level priority, to share best prac-
for defense activities of the Depart- should— tices, and to facilitate national capacity to
(A) continue— comply with and adhere to—
ment of Energy, to prescribe military (A) the International Health Regulations
personnel strengths for such fiscal (i) to carry out key initiatives to enhance
readiness, military mobility, and national (2005);
year, and for other purposes; which was (B) the World Organisation for Animal
resilience in support of NATO’s ongoing
ordered to lie on the table; as follows: COVID–19 pandemic response efforts; Health international standards and guide-
Beginning on page 566, strike line 10 and (ii) to collaborate on ways to enhance col- lines;
all that follows through page 570, line 6, and lective security, with a focus on emerging (C) United Nations Security Council Reso-
insert the following: and revolutionary technologies such as quan- lution 1540 (2004);
(2) NATO remains the strongest and most tum computing, artificial intelligence, fifth (D) the Convention on the Prohibition of
successful political-military alliance in the generation telecommunications networks, the Development, Production and Stock-
world, founded on a commitment by its and machine learning; and piling of Bacteriological and Toxin Weapons
members to uphold the principles of democ- (iii) to build on recent progress in achiev- and on their Destruction, done at Wash-
racy, individual liberty, and the rule of law; ing defense spending goals agreed to at the ington, London, and Moscow, April 10, 1972
(3) NATO’s contributions to collective de- 2014 Wales Summit and reaffirmed at the 2016 (commonly referred to as the ‘‘Biological
fense are indispensable to the security, pros- Warsaw Summit and the 2021 Brussels Sum- Weapons Convention’’);
perity, and freedom of its members; mit, and to build consensus to invest in the (E) the Global Health Security Agenda 2024
(4) the United States reaffirms its ironclad full range of defense capabilities necessary Framework; and
commitment to NATO as the foundation of to deter and defend against potential adver- (F) other relevant frameworks that con-
transatlantic security and to upholding its saries; and tribute to global health security.
obligations under the North Atlantic Treaty, (B) expand cooperation efforts on cyberse- (3) GLOBAL HEALTH SECURITY INDEX .—The
including Article 5; curity issues to prevent adversaries and term ‘‘Global Health Security Index’’ means
(5) NATO is meant to be an alliance of criminals from compromising critical sys- the comprehensive assessment and
countries with shared democratic values and tems and infrastructure; and benchmarking of health security and related
the United States reaffirms its commitment (13) øthe United States should¿ encourage capabilities across the countries that make
to Article 2 of the North Atlantic Treaty, the development of a new NATO strategic up the States Parties to the International
which states the following: ‘‘The Parties will concept that addresses the threats to NATO Health Regulations (2005).
contribute toward the further development that have emerged since NATO’s last stra- (4) GLOBAL HEALTH SECURITY INITIATIVE.—
of peaceful and friendly international rela- tegic concept was published in 2010, includ- The term ‘‘Global Health Security Initia-
tions by strengthening their free institu- ing— tive’’ means the informal network of coun-
tions, by bringing about a better under- (A) a militarily resurgent Russia Federa- tries and organizations that came together
standing of the principles upon which these tion, which is engaged in conflicts in Eastern in 2001 to undertake concerted global action
institutions are founded, and by promoting Europe, the Caucasus, and the Middle East; to strengthen public health preparedness and
conditions of stability and well-being. They (B) the expansionist ambitions of the Peo- response to chemical, biological, radio-
will seek to eliminate conflict in their inter- ple’s Republic of China, which increasingly logical, and nuclear threats, including pan-
national economic policies and will encour- threaten the economic and political integ- demic influenza.
age economic collaboration between any or rity and physical security of NATO mem- (5) JOINT EXTERNAL EVALUATION.—The term
all of them.’’; bers; and ‘‘Joint External Evaluation’’ means the
(6) the commitment of NATO allies during (C) transnational threats from rogue enti- World Health Organization-facilitated, vol-
18 years of security, humanitarian, and sta- ties, such as extremist terrorist groups and untary, collaborative, multi-sectoral process
bilization operations in Afghanistan has criminal hacker groups. to assess country capacity to prevent, de-
been invaluable, and the sacrifices of NATO tect, and rapidly respond to public health
allies deserve the highest order of respect SA 4644. Mr. RISCH (for himself and risks occurring naturally or due to delib-
and gratitude; Mr. MENENDEZ) submitted an amend- erate or accidental events, assess progress in
(7) the United States remains focused on ment intended to be proposed to achieving the targets under the Inter-
long-term strategic competition with Rus- amendment SA 3867 submitted by Mr. national Health Regulations (2005), and rec-
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sia, and a strong NATO alliance plays an es- ommend priority actions.
REED and intended to be proposed to
sential role in addressing such competition (6) KEY STAKEHOLDERS.—The term ‘‘key
and mitigating shared security concerns; the bill H.R. 4350, to authorize appro- stakeholders’’ means actors engaged in ef-
(8) the United States should— priations for fiscal year 2022 for mili- forts to advance global health security pro-
(A) deepen defense cooperation with non- tary activities of the Department of grams and objectives, including—
NATO European partners, bilaterally and as Defense, for military construction, and (A) national and local governments in
part of the NATO alliance; and for defense activities of the Depart- partner countries;
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S8164 CONGRESSIONAL RECORD — SENATE November 15, 2021
(B) other bilateral donors; nizations can and should play in pandemic (12) generating commitments of resources
(C) international, regional, and local orga- response, including by— in support of the goals referred to in para-
nizations, including private, voluntary, non- (1) seeking adoption of a United Nations graph (6).
governmental, and civil society organiza- Security Council resolution that— (b) OVERSIGHT OF UNITED STATES FOREIGN
tions; (A) declares pandemics, including the ASSISTANCE TO END THE COVID–19 PAN-
(D) international, regional, and local fi- DEMIC.—
COVID–19 pandemic, to be a threat to inter-
nancial institutions; national peace and security; and (1) REPORTING REQUIREMENTS.—Not later
(E) representatives of historically than 60 days after the date of the enactment
(B) urges member states to address this
marginalized groups, including women, of this Act, the Secretary of State and the
threat by aligning their health preparedness
youth, and indigenous peoples; USAID Administrator shall jointly submit to
plans with international best practices, in-
(F) the private sector, including medical the appropriate congressional committees—
cluding those established by the Global
device, technology, pharmaceutical, manu- (A) an unclassified report containing a de-
Health Security Agenda, to improve country scription of funds already obligated and ex-
facturing, logistics, and other relevant com- capacity to prevent, detect, and respond to
panies; and pended under title X of the American Rescue
infectious disease threats; Plan Act of 2021 (Public Law 117–2); and
(G) public and private research and aca- (2) advancing efforts to reform the World
demic institutions. (B) a plan that describes the objectives and
Health Organization so that it serves as an timeline for the obligation and expenditure
(7) ONE HEALTH APPROACH.—The term ‘‘One effective, normative, and coordinating body
Health approach’’ means the collaborative, of all remaining funds appropriated under
that is capable of aligning member countries title X of the American Rescue Plan Act of
multi-sectoral, and transdisciplinary ap- around a strategic operating plan to detect,
proach toward achieving optimal health out- 2021, to include support for civil society for
contain, treat, and deter the further spread the protection of human rights in the con-
comes in a manner that recognizes the inter- of COVID–19;
connection between people, animals, plants, text of the COVID–19 pandemic, which shall
(3) providing timely, appropriate levels of be submitted in an unclassified form, and
and their shared environment.
financial support to United Nations agencies should include a description of steps taken
(8) RELEVANT FEDERAL DEPARTMENTS AND
responding to the COVID–19 pandemic; pursuant to each objective specified in the
AGENCIES.—The term ‘‘relevant Federal de-
(4) prioritizing United States foreign as- plan.
partments and agencies’’ means any Federal
sistance for the COVID–19 response in the (2) CONGRESSIONAL CONSULTATION.—Not less
department or agency implementing United
most vulnerable countries and regions; frequently than once every 60 days, until the
States policies and programs relevant to the
(5) encouraging other donor governments completion or termination of the implemen-
advancement of United States global health
to similarly increase contributions to the tation plan required under paragraph (1)(B),
security and diplomacy overseas, which may
United Nations agencies responding to the and upon the request from one or more of the
include—
COVID–19 pandemic in the world’s poorest appropriate congressional committees, the
(A) the Department of State;
(B) the United States Agency for Inter- and most vulnerable countries; Secretary of State and the USAID Adminis-
national Development; (6) working with key stakeholders to accel- trator shall provide a briefing to the appro-
(C) the Department of Health and Human erate progress toward meeting and exceed- priate congressional committees regarding
Services; ing, as practicable, global COVID–19 vaccina- the report required under paragraph (1)(A)
(D) the Department of Defense; tion goals, whereby— and the status of the implementation of the
(E) the Defense Threat Reduction Agency; (A) at least 40 percent of the population in plan required under paragraph (1)(B).
(F) the Millennium Challenge Corporation; all countries is vaccinated by the end of 2021; (3) BRANDING.—In providing assistance
(G) the Development Finance Corporation; and under this section, the Secretary of State
(H) the Peace Corps; and (B) at least 70 percent of the population in and the USAID Administrator, with due con-
(I) any other department or agency that all countries is vaccinated by the opening sideration for the safety and security of im-
the President determines to be relevant for date of the 77th regular session of the United plementing partners and beneficiaries, shall
these purposes. Nations General Assembly; prescribe the use of logos or other insignia,
(9) RESILIENCE.—The term ‘‘resilience’’ (7) engaging with key overseas stake- which may include the flag of the United
means the ability of people, households, holders, including through multilateral fa- States, to appropriately identify such assist-
communities, systems, institutions, coun- cilities such as the COVID–19 Vaccines Glob- ance as being from the people of the United
tries, and regions to reduce, mitigate, with- al Access initiative (referred to in this sec- States.
tion as ‘‘COVAX’’) and the Access to COVID– (c) UNITED STATES CONTRIBUTIONS TO THE
stand, adapt to, and quickly recover from
19 Tools (ACT) Accelerator initiative, and GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS,
stresses and shocks in a manner that reduces
expanding bilateral efforts, including AND MALARIA COVID–19 RESPONSE MECHA-
chronic vulnerability to pandemic threats
through the International Development Fi- NISM.—United States contributions to the
and facilitates inclusive growth.
nance Corporation, to accelerate the devel- Global Fund to Fight AIDS, Tuberculosis,
(10) USAID.—The term ‘‘USAID’’ means and Malaria COVID–19 Response Mechanism
the United States Agency for International opment, manufacturing, production, and effi-
under section 10003(a)(2) of the American
Development. cient and equitable distribution of—
Rescue Plan Act of 2021 (Public Law 107–2)—
SEC. 1293. PURPOSE. (A) vaccines and related raw materials to
(1) shall be meaningfully leveraged in a
The purpose of this subtitle is to accel- meet or exceed the vaccination goals under
manner that incentivizes other public and
erate and enhance the United States inter- paragraph (6); and
private donor contributions; and
national response to pandemics, including (B) global health commodities, including
(2) shall be subject to the reporting and
the COVID–19 pandemic, and to supplies to combat COVID–19 and to help im-
withholding requirements under subsections
operationalize lessons learned from current mediately disrupt the transmission of SARS–
(c), (d)(4)(A)(ii), (d)(4)(C), (d)(5), (d)(6), (f), and
and prior emergency responses in a manner CoV–2;
(g) of section 202 of the United States Lead-
that— (8) supporting global COVID–19 vaccine dis- ership Against HIV/AIDS, Tuberculosis, and
(1) advances the global health security and tribution strategies that strengthen under- Malaria Act of 2003 (22 U.S.C. 7622).
diplomacy objectives of the United States; lying health systems and ensure that people (d) GLOBAL COVID–19 VACCINE DISTRIBU-
(2) improves coordination among the rel- living in vulnerable and marginalized com- TION AND DELIVERY.—
evant Federal departments and agencies im- munities, including women, do not face (1) ACCELERATING GLOBAL VACCINE DIS-
plementing United States foreign assistance undue barriers to vaccination; TRIBUTION STRATEGY.—The President shall
for global health security; and (9) working with key stakeholders, includ- develop a strategy to expand access to, and
(3) more effectively enables partner coun- ing through the World Bank Group, the accelerate the global distribution of, COVID–
tries to strengthen and sustain resilient International Monetary Fund, the Inter- 19 vaccines to other countries, which shall—
health systems and supply chains with the national Finance Corporation, and other rel- (A) identify the countries that have the
resources, capacity, and personnel required evant regional and bilateral financial insti- highest infection and death rates due to
to prevent, prepare for, detect, and respond tutions, to address the economic and finan- COVID–19, the lowest COVID–19 vaccination
to infectious disease threats before they be- cial implications of the COVID–19 pandemic, rates, and face the most difficult political,
come pandemics. while taking into account the differentiated logistical, and financial challenges to ob-
SEC. 1294. ENHANCING THE UNITED STATES’ needs of disproportionately affected, vulner- taining and delivering COVID–19 vaccines,
INTERNATIONAL RESPONSE TO able, and marginalized populations; and describe the basis and metrics used to
COVID–19 AND FUTURE PANDEMICS. (10) entering into discussions with vaccine make such determinations;
(a) STATEMENT OF POLICY REGARDING manufacturing companies to support part- (B) identify which countries and regions
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INTERNATIONAL COOPERATION TO END THE nerships, with the goal of ensuring adequate will be prioritized and targeted for COVID–19
COVID–19 PANDEMIC.—It shall be the policy global supply of vaccines, which may include vaccine delivery, and the rationale for such
of the United States to lead and implement necessary components and raw materials; prioritization;
a comprehensive and coordinated inter- (11) establishing clear timelines, bench- (C) describe efforts that the United States
national response to end the COVID–19 pan- marks, and goals for COVID–19 response is making to increase COVID–19 vaccine
demic in a manner that recognizes the crit- strategies and activities under this section; manufacturing capacity, both domestically
ical role that multilateral and regional orga- and and internationally, as appropriate, through
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8165
support for the establishment or refurbish- (C) the Committee on Energy and Com- do not allow adequate time for humanitarian
ment of regional manufacturing hubs in merce of the House of Representatives. workers to quarantine upon arrival in-line
South America, South Africa, and South (3) LIMITATION.— with host country regulations, conduct needs
Asia, including through the provision of (A) IN GENERAL.—No Federal funds may be assessments, and subsequently implement
international development finance, and esti- made available to COVAX to procure vac- multilateral and United States-funded pro-
mate when, how many, and which types of cines produced by any companies owned or gramming in an efficient, effective, and un-
vaccines will be provided by the United controlled by the Government of the Peo- restricted manner;
States Government bilaterally and through ple’s Republic of China or by the Chinese (ii) restrictions on travel by humanitarian
COVAX; Communist Party unless the Secretary of workers within such country to reach the
(D) describe efforts to encourage inter- State certifies that the People’s Republic of areas of operation where vulnerable and
national partners to take actions similar to China— marginalized populations reside;
the efforts referred to in subparagraph (C); (i) is providing financial support to COVAX (iii) access to medical evacuation in the
(E) describe how the United States Govern- that is commensurate with the United event of a health emergency;
ment will ensure efficient delivery of States’ contribution to COVAX; and (iv) access to personal protective equip-
COVID–19 vaccines to intended recipients, in- (ii) publically discloses transparent data ment for United States Government imple-
cluding United States citizens residing over- on the quality, safety, and efficacy of its menting partners; and
seas, and identify complementary United COVID–19 vaccines. (v) efforts to support access to COVID–19
States foreign assistance that will facilitate (B) SAFEGUARDS.—The President shall en- vaccines for humanitarian and health-work-
vaccine readiness, distribution, delivery, sure that appropriate safeguards are put in
ers and crisis-affected communities;
monitoring, and administration activities; place to ensure that the condition described
(B) an analysis and description of countries
(F) describe how the United States Govern- in subparagraph (A) is honored by Gavi, the
(regardless of whether such countries have
ment will ensure the efficient delivery and Vaccine Alliance.
(e) LEVERAGING UNITED STATES BILATERAL received direct United States assistance)
administration of COVID–19 vaccines to
GLOBAL HEALTH PROGRAMS FOR THE INTER- that have expressly prevented vulnerable
United States citizens residing overseas, in-
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- foreign assistance— ties; and
tributing a COVID–19 vaccine that— (A) to combat the COVID–19 pandemic, in- (iii) exclusion of, or discrimination
(I) has been licensed or authorized for cluding through the sharing of COVID–19 against, vulnerable populations in law, pol-
emergency use by the Food and Drug Admin- vaccines; and icy, or practice that prevents equitable ac-
istration; or (B) to support related activities, includ- cess to food, shelter, and other basic assist-
(II) has met the necessary criteria for safe- ing— ance;
ty and efficacy established by the World (i) strengthening vaccine readiness; (C) a description of United States Govern-
Health Organization; (ii) reducing vaccine hesitancy and misin- ment efforts to facilitate greater humani-
(G) summarize the United States Govern- formation; tarian access, including—
ment’s efforts to encourage and facilitate (iii) delivering and administering COVID– (i) advocacy and diplomatic efforts with
technology sharing and the licensing of in- 19 vaccines; relevant foreign governments and multilat-
tellectual property, to the extent necessary, (iv) strengthening health systems and sup- eral institutions to ensure that vulnerable
to support the adequate and timely supply of ply chains; and marginalized populations are included in
vaccines and vaccine components to meet (v) supporting health care workforce plan- national response plans and other relevant
the vaccination goals specified in subsection ning, training, and management; plans developed in response to the COVID–19
(a)(6), giving due consideration to avoiding (vi) enhancing transparency, quality, and pandemic; and
undermining intellectual property innova- reliability of public health data; (ii) advocacy and diplomatic efforts with
tion and intellectual property rights or pro- (vii) increasing bidirectional testing, in- relevant foreign governments to ensure that
tections with respect to vaccine development cluding screening for symptomatic and appropriate visas, work permits, and domes-
in performing the assessment required under asymptomatic cases; and tic travel exemptions are issued for humani-
this subparagraph; (viii) building laboratory capacity. tarian and health workers responding to the
(H) describe the roles, responsibilities, (2) ADJUSTMENT OF TARGETS AND GOALS.— COVID–19 pandemic; and
tasks, and, as appropriate, the authorities of The Secretary of State, in coordination with (D) a description of United States Govern-
the Secretary of State, the USAID Adminis- the heads of other relevant Federal depart- ment plans and efforts to address the second-
trator, the Secretary of Health and Human ments and agencies, shall submit an annual order impacts of the COVID–19 pandemic and
Services, the Director of the Centers for Dis- report to the appropriate congressional com- an assessment of the resources required to
ease Control and Prevention, the Chief Exec- mittees that identifies— implement such plans, including efforts to
utive Officer of the United States Inter- (A) any adjustments to original program address—
national Development Finance Corporation, targets and goals that result from the use of (i) famine and acute food insecurity;
and the heads of other relevant Federal de- funds for the purposes authorized under (ii) gender-based violence;
partments and agencies with respect to the paragraph (1); and (iii) mental health and psychosocial sup-
implementation of such strategy; (B) the amounts needed in the following port needs;
(I) describe how the Department of State fiscal year to meet the original program (iv) child protection needs;
and USAID will coordinate with the Sec- goals, as necessary and appropriate. (v) health, education, and livelihoods;
retary of Health and Human Services and the (f) REPORT ON HUMANITARIAN RESPONSE TO
(vi) shelter; and
heads of other relevant Federal agencies to THE COVID–19 PANDEMIC.—
(vii) attempts to close civil society space,
expedite the export and distribution of ex- (1) IN GENERAL.—Not later than 120 days
including through bureaucratic, administra-
cess federally purchased vaccines to support after the date of the enactment of this Act,
tive, and health or security related impedi-
countries in need and ensure such vaccines the Secretary of State, in consultation with
ments.
will not be wasted; the USAID Administrator and the Secretary
(J) summarize the United States public di- of Health and Human Services, shall submit (g) SAFEGUARDING DEMOCRACY AND HUMAN
plomacy strategies for branding and address- a report to the appropriate congressional RIGHTS DURING THE COVID–19 PANDEMIC.—
ing vaccine misinformation and hesitancy committees that— (1) SENSE OF CONGRESS.—It is the sense of
within partner countries; and (A) assesses the global humanitarian re- Congress that—
(K) describe efforts that the United States sponse to COVID–19; and (A) governments may be required to take
is making to help countries disrupt the cur- (B) outlines specific elements of the United appropriate extraordinary measures during
rent transmission of COVID–19, while simul- States Government’s country-level humani- public health emergencies to halt the spread
taneously increasing vaccination rates, uti- tarian response to the COVID–19 pandemic. of disease, including closing businesses and
lizing medical products and medical supplies. (2) ELEMENTS.—The report required under public events, limiting access to public
(2) SUBMISSION OF STRATEGY.—Not later paragraph (1) shall include— spaces, and restricting the movement of peo-
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than 90 days after the date of the enactment (A) for countries receiving United States ple;
of this Act, the President shall submit the assistance, a description of humanitarian (B) certain foreign governments have
strategy described in paragraph (1) to— and health-worker access to crisis-affected taken measures in response to COVID–19
(A) the appropriate congressional commit- areas, including— that violate the human rights of their citi-
tees; (i) legal and bureaucratic restrictions on zens without clear public health justifica-
(B) the Committee on Health, Education, the entry of humanitarian workers from tion, oversight measures, or sunset provi-
Labor, and Pensions of the Senate; and abroad, to include visa authorizations that sions;
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S8166 CONGRESSIONAL RECORD — SENATE November 15, 2021
(C) governments using the COVID–19 pan- (I) security and intelligence surveillance (III) increase English language content to
demic as a pretext for repression have under- measures implemented by countries during help counter China’s propaganda directed to-
mined democratic institutions, debilitated the COVID–19 pandemic; ward English-speaking audiences.
institutions for transparency and public in- (II) the extent to which such measures (G) MIDDLE EAST BROADCASTING NET-
tegrity, quashed legitimate dissent, and at- have been, or have not been, rolled back; and WORKS.—
tacked journalists, civil society organiza- (III) whether and how such measures im- (i) FINDING.—Congress finds that the Mid-
tions, activists, independent voices, and vul- pact internationally recognized human dle East Broadcasting Networks operate
nerable and marginalized populations, in- rights; and largely in closed media markets in which
cluding refugees and migrants, with far- (iv) includes a strategic plan by the De- malign state and nonstate actors remain ac-
reaching consequences that will extend be- partment of State and USAID that address- tive.
yond the current crisis; es, through multilateral and bilateral diplo- (ii) SENSE OF CONGRESS.—It is the sense of
(D) foreign governments should take im- macy and foreign assistance, the persistent Congress that the Middle East Broadcasting
mediate steps to release from prison all arbi- issues related to the restriction of inter- Networks should—
trarily detained United States citizens and nationally recognized human rights in the (I) continue plans to expand an investiga-
political prisoners who may be at increased COVID–19 response. tive news unit; and
(h) PUBLIC DIPLOMACY AND COMBATING
risk for contracting or suffering from com- (II) work to ensure that reporting con-
DISINFORMATION AND MISINFORMATION ABOUT
plications from COVID–19; tinues amidst operational challenges on the
COVID–19.—
(E) COVID–19 threatens to roll back dec- ground.
(1) UNITED STATES AGENCY FOR GLOBAL
ades of progress for women and girls, dis- MEDIA.—
(H) OPEN TECHNOLOGY FUND.—
proportionately affecting women economi- (A) FINDING.—Congress finds that the (i) FINDING.—Congress finds that the Open
cally, educationally, and with respect to United States Agency for Global Media (re- Technology Fund works to advance internet
health, while also leading to alarming rises ferred to in this subsection as ‘‘USAGM’’) freedom in repressive environments by sup-
in gender based violence; and broadcasting entities and grantees have porting technologies that—
(F) during and after the pandemic, the De- proven valuable in providing timely and ac- (I) provide secure and uncensored access to
partment of State and USAID should di- curate information, particularly in countries USAGM’s content and the broader internet;
rectly, and through nongovernmental orga- in which the free press is under threat. and
nizations or international organizations, (B) SENSE OF CONGRESS.—It is the sense of (II) counter attempts by authoritarian gov-
provide assistance and implement programs Congress that— ernments to control the internet and restrict
that support democratic institutions, civil (i) accurate, investigative, and scientific freedom online.
society, free media, and the advancement of journalism is critical for societies to effec- (ii) SENSE OF CONGRESS.—It is the sense of
internationally recognized human rights. tively combat global health threats; and Congress that the Open Technology Fund
(2) FUNDING FOR CIVIL SOCIETY AND HUMAN (ii) Congress supports— should—
RIGHTS DEFENDERS.— (I) accurate and objective investigative (I) support a broad range of technologies to
(A) PROGRAM PRIORITIES.—Amounts made and scientific reporting by USAGM networks respond to increasingly aggressive and so-
available for each of the fiscal years 2022 and grantees regarding COVID–19; and phisticated censorship and surveillance
through 2026 to carry out the purposes of sec- (II) platforms that help dispel and combat threats and provide more comprehensive and
tions 101 and 102 of the Foreign Assistance misinformation about the COVID–19 pan- tailored support to USAGM’s networks; and
Act of 1961 (22 U.S.C. 2151 and 2151–1), includ- demic. (II) provide direct assistance to USAGM’s
ing programs to support democratic institu- (C) VOICE OF AMERICA.—It is the sense of networks to improve the digital security of
tions, human rights defenders, civil society, Congress that amounts authorized to be ap- reporting operations and journalists.
and freedom of the press, should be targeted, propriated or otherwise made available to (2) DEPARTMENT OF STATE PUBLIC DIPLO-
to the extent feasible, toward civil society Voice of America should be used— MACY PROGRAMS.—
organizations in countries in which emer- (i) to expand programs such as POLY- (A) FINDINGS.—Congress finds the fol-
gency government measures taken in re- GRAPH.info; lowing:
sponse to the COVID–19 pandemic have vio- (ii) to provide critical tools for combating (i) The Department of State’s public diplo-
lated internationally recognized human propaganda associated with COVID–19; and macy programs build global networks that
rights. (iii) to assist journalists in providing accu- can address shared challenges, such as the
(B) ELIGIBLE ORGANIZATIONS.—Civil society rate information to local media outlets. COVID–19 pandemic, including through ex-
organizations operating in countries in (D) OFFICE OF CUBA BROADCASTING.—It is changes of researchers, public health ex-
which emergency government measures the sense of Congress that Radio Televisión perts, and scientists.
taken in response to the COVID–19 pandemic Martı́ and Digital Martı́ should continue to (ii) The programs referred to in clause (i)
violated internationally recognized human broadcast programs that detect, highlight, play a critical role in creating open and re-
rights shall be eligible to receive funds made and dispel disinformation. silient information environments where de-
available to carry out the purposes of sec- (E) RADIO FREE EUROPE/RADIO LIBERTY.— mocracies can thrive, as articulated in the
tions 101 and 102 of the Foreign Assistance (i) FINDING.—Congress finds that Radio 2020 Public Diplomacy Strategic Plan, in-
Act of 1961 for each of the fiscal years 2022 Free Europe/Radio Liberty (referred to in cluding by—
through 2026, for— this section as ‘‘RFE/RL’’) operate in media (I) improving media quality with jour-
(i) programs designed to strengthen and markets in which authoritarian state and nalist training and reporting tours;
support civil society, human rights defend- nonstate actors, including Russia, heavily (II) conducting media literacy programs;
ers, freedom of association, and the freedom invest in misinformation and disinformation and
of the press; campaigns designed to promote confusion (III) supporting media access activities.
(ii) programs to restore democratic insti- and mistrust. (iii) The International Visitor Leadership
tutions; and (ii) SENSE OF CONGRESS.—It is the sense of Program and Digital Communications Net-
(iii) peacebuilding and conflict prevention Congress that RFE/RL should— work engaged journalists around the world
to address the impacts of COVID–19 on social (I) increase investigative reporting regard- to combat COVID–19 disinformation, pro-
cohesion, public trust, and conflict dynamics ing the impacts of COVID–19, the political mote unbiased reporting, and strengthen
by adapting existing programs or investing and social responses governments are taking media literacy.
in new ones. in response to COVID–19, and the lasting im- (iv) More than 12,000 physicians holding J–
(C) FINAL REPORT.—Not later than 180 days pacts such actions will have on key political 1 visas from 130 countries—
after the date of the enactment of this Act, freedoms; and (I) are engaged in residency or fellowship
the Secretary of State shall submit a report (II) expand its ‘‘digital first’’ strategy. training at approximately 750 hospitals
to the appropriate congressional committees (F) RADIO FREE ASIA.— throughout the United States, the majority
that— (i) FINDING.—Congress finds that Radio of whom are serving in States that have been
(i) lists the countries whose emergency Free Asia (RFA) operates in a media market the hardest hit by COVID–19; and
measures limiting internationally recog- dominated by powerful state-run media that (II) throughout the pandemic, have served
nized human rights in a manner inconsistent have invested heavily in media distortion on the front lines of the medical workforce
with the principles of limitation and deroga- and disinformation, including about COVID– and in United States university laboratories
tion remain in place; 19. researching ways to detect and treat the
(ii) describes such countries’ emergency (ii) SENSE OF CONGRESS.—It is the sense of virus.
measures, including— Congress that RFA should— (B) VISA PROCESSING BRIEFING.—Not later
ctelli on DSK11ZRN23PROD with SENATE
(I) how such procedures violate inter- (I) commission technical experts to bolster than 30 days after the date of the enactment
nationally recognized human rights; and efforts to counter social media tools, includ- of this Act, the Assistant Secretary for Con-
(II) an analysis of the impact of such meas- ing bots used by some countries to promote sular Affairs shall brief the appropriate con-
ures on access to health and efforts to con- misinformation; gressional committees by providing—
trol the COVID–19 pandemic within the coun- (II) expand digital programming and local (i) a timeline for increasing visa processing
try; coverage to expose China’s media manipula- capacities at embassies around the world,
(iii) describes— tion techniques; and notably where there are—
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8167
(I) many American citizens, including dual the containment of, and recovery from, the (1) DESIGNATION OF LEAD AGENCIES FOR CO-
nationals; and COVID–19 pandemic; ORDINATION OF THE UNITED STATES’ INTER-
(II) many visa applicants for educational (B) economic uncertainty and the inability NATIONAL RESPONSE TO INFECTIOUS DISEASE
and cultural exchange programs that pro- of individuals and households to generate in- OUTBREAKS WITH SEVERE OR PANDEMIC POTEN-
mote United States foreign policy objectives come are major drivers of political insta- TIAL.—The President shall designate rel-
and economic stability to small businesses, bility and social discord, which create condi- evant Federal departments and agencies, in-
universities, and communities across the tions for insecurity; cluding the Department of State, USAID,
United States; (C) it is in the security and economic inter- and the Department of Health and Human
(ii) a detailed plan for using existing au- ests of the United States to assist in the eco- Services (including the Centers for Disease
thorities to waive or provide other alter- nomic recovery of developing countries that Control and Prevention), to lead specific as-
natives to in-person appointments and inter- are made more vulnerable and unstable from pects of the United States’ international re-
views; the public health and economic impacts of sponse to outbreaks of emerging high-con-
(iii) an assessment of whether additional the COVID–19 pandemic; sequence infectious disease threats.
authorities and resources are required for (D) United States foreign assistance and (2) NOTIFICATION.—Not later than 120 days
the use of videoconference appointments and development finance institutions should after the date of the enactment of this Act,
interviews as an alternative to in-person ap- seek to blunt the impacts of a COVID–19 re- the President shall notify the appropriate
pointments and interviews; and lated economic recession by supporting in- congressional committees, the Committee on
(iv) a detailed plan for using existing au- vestments in sectors critical to maintaining Health, Education, Labor, and Pensions of
thorities to rapidly cross-train and surge economic stability and resilience in low and the Senate, and the Committee on Energy
temporary personnel to support consular middle income countries; and Commerce of the House of Representa-
services at embassies and consulates of the (E) the need for the United States Inter- tives of the designations made pursuant to
United States around the world, and an as- national Development Finance Corporation’s paragraph (1), including detailed descriptions
sessment of whether additional authorities support for advancing development outcomes of the roles and responsibilities of each rel-
and resources are required. in less developed countries, as mandated by evant department and agency.
(C) GLOBAL ENGAGEMENT CENTER.— the Better Utilization of Investments Lead- (l) USAID DISASTER SURGE CAPACITY.—
(i) FINDING.—Congress finds that since the ing to Development Act of 2018 (22 U.S.C. 9601 (1) SURGE CAPACITY.—Amounts authorized
beginning of the COVID–19 pandemic, publi- et seq.), is critical to ensuring lasting and re- to be appropriated or otherwise made avail-
cations, websites, and platforms associated silient economic growth in light of the able to carry out part I and chapter 4 of part
with China, Russia, and Iran have sponsored COVID–19 pandemic’s exacerbation of eco- II of the Foreign Assistance Act of 1961 (22
disinformation campaigns related to the nomic hardships and challenges; U.S.C. 2151 et seq.), including funds made
COVID–19 pandemic, including falsely blam- (F) The United States International Devel- available for ‘‘Assistance for Europe, Eurasia
ing the United States for the disease. opment Finance Corporation should adjust and Central Asia’’, may be used, in addition
(ii) SENSE OF CONGRESS.—It is the sense of its view of risk versus return by taking to amounts otherwise made available for
Congress that the Global Engagement Center smart risks that may produce a lower rate of such purposes, for the cost (including sup-
should continue its efforts to expose and financial return, but produce significant de-
counter state and non-state-sponsored port costs) of individuals detailed to or em-
velopment outcomes in responding to the ployed by USAID whose primary responsi-
disinformation related to COVID–19, the ori-
economic effects of COVID–19; bility is to carry out programs in response to
gins of COVID–19, and COVID–19 vaccina-
(G) to mitigate the economic impacts of global health emergencies and natural or
tions.
(i) FINDINGS AND SENSE OF CONGRESS RE- the COVID–19 recession, the United States man-made disasters.
GARDING THE UNITED STATES INTERNATIONAL
International Development Finance Corpora- (2) NOTIFICATION.—Not later than 15 days
DEVELOPMENT FINANCE CORPORATION.— tion should use its resources and authorities, before making funds available to address
(1) FINDINGS.—Congress finds the following: among other things— man-made disasters pursuant to paragraph
(A) The COVID–19 pandemic is causing a (i) to ensure loan support for small- and (1), the Secretary of State or the USAID Ad-
global economic recession, as evidenced by medium-sized enterprises; ministrator shall notify the appropriate con-
the global economic indicators described in (ii) to offer local currency loans to bor- gressional committees of such action.
subparagraphs (B) through (D). rowers for working capital needs; (m) STATEMENT OF POLICY ON HUMANI-
(B) The United Nations Conference on (iii) to create dedicated financing opportu- TARIAN ASSISTANCE TO COUNTRIES AFFECTED
Trade and Development determined that the nities for new ‘‘customers’’ that are experi- BY PANDEMICS.—
COVID–19 pandemic pushed the global econ- encing financial hardship due to the COVID– (1) STATEMENT OF POLICY.—It shall be the
omy into recession in 2020 on a scale that has 19 pandemic; and policy of the United States—
not been witnessed since the 1930s. (iv) to work with other development fi- (A) to ensure that United States assistance
(C) Developed countries are expected to ex- nance institutions to create co-financing fa- to address pandemics, including the provi-
perience a relatively more significant re- cilities to support customers experiencing sion of vaccines, reaches vulnerable and
bound in gross domestic product growth dur- hardship due to the COVID–19 pandemic. marginalized populations, including racial
ing 2021 than is expected to be experienced in (j) SENSE OF CONGRESS REGARDING INTER- and religious minorities, refugees, internally
developing countries, leading to concerns NATIONAL COOPERATION TO PREVENT AND RE- displaced persons, migrants, stateless per-
about a further expansion in the gap between SPOND TO FUTURE PANDEMICS.—It is the sense sons, women, children, the elderly, and per-
rich and poor countries, particularly if this of Congress that— sons with disabilities;
trend continues into 2022. (1) global pandemic preparedness and re- (B) to ensure that United States assist-
(D) Global markets have suffered losses sponse requires international and regional ance, including development finance, ad-
ranging between 5 percent and over 10 per- cooperation and action; dresses the second order effects of a pan-
cent since the beginning of the pandemic. (2) the United States should lead efforts in demic, including acute food insecurity; and
While markets are recovering in 2021, global multilateral fora, such as the Group of 7, the (C) to protect and support humanitarian
job losses and unemployment rates remain Group of 20, and the United Nations, by col- actors who are essential workers in pre-
high, with— laborating and cooperating with other coun- venting, mitigating and responding to the
(i) approximately 33,000,000 labor hours lost tries and international and regional organi- spread of a pandemic among vulnerable and
globally (13 per cent of the total hours lost) zations, including the World Health Organi- marginalized groups described in subpara-
due to outright unemployment; and zation and other key stakeholders, to imple- graph (A), including ensuring that such hu-
(ii) an estimated additional 81,000,000 labor ment international strategies, tools, and manitarian actors—
hours lost due to inactivity or underemploy- agreements to better prevent, detect, and re- (i) are exempted from unreasonable travel
ment. spond to future infectious disease threats be- restrictions to ensure that they can effec-
(E) Given the prolonged nature of the fore they become pandemics; and tively provide life-saving assistance; and
COVID–19 pandemic, African finance min- (3) the United States should enhance and (ii) are prioritized as frontline workers in
isters have requested continued efforts to expand coordination and collaboration country vaccine distribution plans.
provide— among the relevant Federal departments and (2) FACILITATING EFFECTIVE AND SAFE HU-
(i) additional liquidity; agencies, the Food and Agriculture Organiza- MANITARIAN ASSISTANCE.—The Secretary of
(ii) better market access; tion of the United Nations, the World Health State, in coordination with the USAID Ad-
(iii) more concessional resources; and Organization, and the World Organization for ministrator, should carry out actions that
(iv) an extension in the Debt Service Sus- Animal Health, to advance a One Health ap- accomplish the policies set forth in para-
pension Initiative established by the Group proach toward preventing, detecting, and re- graph (1), including by—
ctelli on DSK11ZRN23PROD with SENATE
of 20. sponding to zoonotic threats in the human- (A) taking steps to ensure that travel re-
(2) SENSE OF CONGRESS.—It is the sense of animal interface. strictions implemented to help contain the
Congress that— (k) ROLES OF THE DEPARTMENT OF STATE, spread of a pandemic are not applied to indi-
(A) even when markets begin to recover in THE UNITED STATES AGENCY FOR INTER- viduals authorized by the United States Gov-
the future, it is likely that access to capital NATIONAL DEVELOPMENT, AND THE DEPART- ernment to travel to, or reside in, a des-
will be especially challenging for developing MENT OF HEALTH AND HUMAN SERVICES IN ignated country to provide assistance related
countries, which still will be struggling with INTERNATIONAL PANDEMIC RESPONSE.— to, or otherwise impacted by, an outbreak;
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S8168 CONGRESSIONAL RECORD — SENATE November 15, 2021
(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- available to carry out the purposes of this
SEC. 1295. INTERNATIONAL PANDEMIC PREVEN- ganizations and institutions; section.
TION AND PREPAREDNESS. (iii) promoting improved domestic resource (B) AGENCY-SPECIFIC PLANS.—The reports
(a) PARTNER COUNTRY DEFINED.—In this mobilization, co-financing, and appropriate required under subparagraph (A) shall in-
section, the term ‘‘partner country’’ means a national budget allocations for strong public clude specific implementation plans from
foreign country in which the relevant Fed- health systems, global health security, and each relevant Federal department and agen-
eral departments and agencies are imple- pandemic preparedness and response in part- cy that describe—
menting United States assistance for global ner countries; and (i) how updates to the strategy may have
health security and pandemic prevention and (iv) ensuring partner country ownership of impacted the agency’s plan during the pre-
preparedness under this subtitle. global health security strategies, data, pro- ceding calendar year;
(b) UNITED STATES GLOBAL HEALTH SECU- grams, and outcomes; (ii) the progress made in meeting the goals,
RITY AND DIPLOMACY STRATEGY AND RE- (I) supports health budget and workforce objectives, and benchmarks under implemen-
PORT.— planning in partner countries, including tation plans during the preceding year;
(1) IN GENERAL.—The President shall de- training in public financial management and (iii) the anticipated staffing plans and con-
velop, update, maintain, and advance a com- budget data transparency; tributions of the department or agency, in-
prehensive strategy for improving global (J) works to ensure that— cluding technical, financial, and in-kind con-
health security and pandemic prevention, (i) partner countries have national action tributions, to implement the strategy;
preparedness, and response that— plans for health security that are developed (iv) a transparent, open, and detailed ac-
(A) clearly articulates the policy goals re- with input from key stakeholders, including counting of obligations by each of the rel-
lated to pandemic prevention, preparedness, communities and the private sector; evant Federal departments and agencies to
and response, and actions necessary to ele- (ii) United States foreign assistance for implement the strategy, including—
vate and strengthen United States diplo- global health security is aligned with such (I) the statutory source of obligated funds;
matic leadership in global health security national action plans for health security in (II) the amounts obligated;
and pandemic preparedness, including by partner countries, developed with input from (III) implementing partners;
building the expertise of the diplomatic key stakeholders, including communities (IV) targeted beneficiaries; and
corps; and the private sector, to the greatest extent (V) activities supported;
(B) improves the effectiveness of United practicable and appropriate; and (v) the efforts of the relevant Federal de-
States foreign assistance to prevent, detect, (iii) United States global health security partment or agency to ensure that the ac-
and respond to infectious disease threats, in- efforts are aligned with ongoing strategies tivities and programs carried out pursuant
cluding through the advancement of a One and initiatives across government agencies to the strategy are designed to achieve max-
Health approach, the Global Health Security to help nations better identify and prevent imum impact and enduring returns, includ-
Agenda, the International Health Regula- health impacts related to deforestation, cli- ing through specific activities to strengthen
tions (2005), and other relevant frameworks mate-related events, and increased unsafe health systems, as appropriate; and
and programs that contribute to global interactions between wildlife, livestock, and (vi) a plan for regularly reviewing and up-
health security and pandemic preparedness; people, including the emergence, reemer- dating programs and partnerships, and for
(C) establishes specific and measurable gence, and spread of zoonoses; sharing lessons learned with a wide range of
goals, benchmarks, timetables, performance (K) strengthens linkages between com- stakeholders in an open, transparent man-
metrics, and monitoring and evaluation plementary bilateral and multilateral for- ner.
plans for United States foreign policy and as- eign assistance programs, including efforts (C) FORM.—The reports required under sub-
sistance for global health security that pro- of the World Bank, the World Health Organi- paragraph (A) shall be submitted in unclassi-
mote learning and adaptation and reflect zation, the Global Fund to Fight AIDS, Tu- fied form, but may contain a classified
international best practices relating to glob- berculosis, and Malaria, Gavi, the Vaccine annex.
al health security, transparency, and ac- Alliance, and regional health organizations, (c) COMMITTEE ON GLOBAL HEALTH SECU-
countability; that contribute to the development of more RITY AND PANDEMIC AND BIOLOGICAL
(D) establishes transparent means to im- resilient health systems and supply chains in THREATS.—
prove coordination and performance by the partner countries with the capacity, re- (1) STATEMENT OF POLICY.—It shall be the
relevant Federal departments and agencies sources, and personnel required to prevent, policy of the United States—
and sets out clear roles and responsibilities detect, and respond to infectious disease (A) to promote global health security as a
that reflect the unique capabilities and re- threats; and core national security interest; and
sources of each such department and agency; (L) supports innovation and partnerships (B) to ensure effective coordination and
(E) establishes mechanisms to improve co- with the private sector, health organiza- collaboration between the relevant Federal
ordination and avoid duplication of effort tions, civil society, nongovernmental organi- departments and agencies engaged in efforts
among the relevant Federal departments and zations, and health research and academic to advance the global health security of the
agencies, partner countries, donor countries, institutions to improve pandemic prepared- United States.
the private sector, multilateral organiza- ness and response, including for the preven- (2) COORDINATION.—
tions, and other key stakeholders, and en- tion and detection of infectious disease, and (A) ESTABLISHMENT OF COMMITTEE.—There
sures collaboration at the country level; the development and deployment of effective is authorized to be established, within the
(F) supports, and is aligned with, partner and accessible infectious disease tracking National Security Council, the Committee
country-led, global health security policy tools, diagnostics, therapeutics, and vac- on Global Health Security and Pandemic and
and investment plans, developed with input cines. Biological Threats (referred to in this sub-
from key stakeholders, as appropriate; (2) SUBMISSION OF STRATEGY.—Not later section as the ‘‘Committee’’), whose day-to-
(G) prioritizes working with partner coun- than 120 days after the date of the enactment day operations should be led by the Special
tries with— of this Act, the President shall submit the Advisor for Global Health Security.
(i) demonstrated need, as identified strategy required under paragraph (1) to the (B) SPECIAL ADVISOR FOR GLOBAL HEALTH
through the Joint External Evaluation proc- appropriate congressional committees, the SECURITY.—The Special Advisor for Global
ess, the Global Health Security Index classi- Committee on Health, Education, Labor, and Health Security—
fication of health systems, national action Pensions of the Senate, and the Committee (i) should serve on the staff of the National
ctelli on DSK11ZRN23PROD with SENATE
plans for health security, the Global Health on Energy and Commerce of the House of Security Council; and
Security Agenda, other risk-based assess- Representatives. (ii) may also be the Senior Director for the
ments, and other complementary or suc- (3) ANNUAL REPORT.— Global Health Security and Biodefense Di-
cessor indicators of global health security (A) IN GENERAL.—Not later than 1 year rectorate within the Executive Office of the
and pandemic preparedness; and after the submission of the strategy to the President, who reports to the Assistant to
(ii) demonstrated commitment to trans- congressional committees referred to in the President for National Security Affairs.
parency, including budget and global health paragraph (2), and not later than October 1 of (C) FUNCTIONS.—
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8169
(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 described in section 1296(b)(1);
global health security, including pandemic pandemic threat reduction at each of their (E) to transfer and allocate United States
prevention, preparedness and response; and respective departments and agencies; foreign assistance funding authorized to be
(II) to ensure policy coordination between (III) designate an appropriate representa- appropriated pursuant to paragraph (6) to
United States Government agencies. tive at the Assistant Secretary level or high- the relevant Federal departments and agen-
(ii) ACTIVITIES.—In carrying out the func- 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 under subsection (b), in coordination with
should— participate; the Office of Management and Budget and
(I) conduct, in coordination with the heads (IV) keep the Committee apprised of Glob- USAID;
of relevant Federal departments and agen- al Health Security and pandemic threat re- (F) to utilize detailees, on a reimbursable
cies, a review of existing United States glob- duction-related activities undertaken within or nonreimbursable basis, from the relevant
al health security policies and strategies; their respective departments and agencies; Federal departments and agencies and hire
(II) develop recommendations for how the (V) ensure interagency cooperation and personal service contractors, who may oper-
Federal Government may regularly update collaboration and maintain responsibility ate domestically and internationally, to en-
and harmonize the policies and strategies re- for agency-related programmatic functions sure that the Office of the Special Represent-
ferred to in subclause (I) to enable the including, as applicable, in coordination ative has access to the highest quality ex-
United States Government to respond to with partner governments, country teams, perts available to the United States Govern-
pandemic threats and to monitor the imple- and global health security in-country teams; ment to carry out the functions under this
mentation of such strategies; and subtitle; and
(III) develop a plan for modernizing global (VI) keep the Committee apprised of (G) to perform such other functions as the
early warning and trigger systems for scal- GHSA-related activities undertaken within Secretary of State may assign.
ing action to prevent, detect, respond to, and their respective agencies.
recover from emerging biological threats; (4) DUTIES.—The Special Representative
(ii) ADDITIONAL ROLES AND RESPONSIBIL- shall coordinate, manage, and oversee United
(IV) provide policy-level recommendations 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 foreign assistance funded with amounts ap-
goals, objectives, and implementation, and 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 vance the relevant elements of the United
pandemic prevention, preparedness and re- and responsibilities described in—
sponse; States Global Health Security and Diplo-
(I) Executive Order 13747 (81 Fed. Reg. macy Strategy developed pursuant to sub-
(V) review the progress toward, and work- 78701; relating to Advancing the Global
ing to resolve challenges in, achieving section (b), including by—
Health Security Agenda to Achieve a World (A) developing and coordinating a global
United States commitments under the Glob- Safe and Secure from Infectious Disease
al Health Security Agenda; pandemic prevention, preparedness and re-
Threats); and sponse framework consistent with paragraph
(VI) develop protocols for coordinating and
(II) the National Security Memorandum-1 (3)(B);
deploying a global response to emerging
on United States Global Leadership to (B) enhancing engagement with multilat-
high-consequence infectious disease threats
Strengthen the International COVID–19 Re- eral organizations and partner countries, in-
that outline the respective roles for relevant
sponse and to Advance Global Health Secu- cluding through the mobilization of donor
Federal agencies in facilitating and sup-
rity and Biological Preparedness, as in effect support;
porting such response operations that should
on the day before the date of the enactment (C) enhancing coordination of consular
facilitate the operational work of Federal
of this Act. services for United States citizens abroad in
agencies and of the Special Advisor for Glob-
al Health Security; (d) UNITED STATES OVERSEAS GLOBAL the event of a global health emergency;
(VII) make recommendations regarding ap- HEALTH SECURITY AND DIPLOMACY COORDINA- (D) ensuring effective program coordina-
propriate responses to specific pandemic TION.— tion and implementation of international ac-
threats and ensure the coordination of do- (1) ESTABLISHMENT.—There is established, tivities, by the relevant Federal departments
mestic and international agencies regarding within the Department of State, a Special and agencies by—
the Federal Government’s efforts to prevent, Representative for United States Inter- (i) formulating, issuing, and updating re-
detect, respond to, and recover from biologi- national Activities to Advance Global Health lated policy guidance;
cal events; Security and Diplomacy Overseas (referred (ii) establishing, in consultation with
(VIII) take steps to strengthen the global to in this subsection as the ‘‘Special Rep- USAID and the Department of Health and
pandemic supply chain and address any bar- resentative’’). Human Services, unified auditing, moni-
riers to the timely delivery of supplies in re- (2) APPOINTMENT; QUALIFICATIONS.—The toring, and evaluation plans;
sponse to a pandemic, including through en- Special Representative— (iii) aligning, in coordination with United
gagement with the private sector, as appro- (A) shall be appointed by the President, by States chiefs of mission and country teams
priate; and with the advice and consent of the Sen- in partner countries—
(IX) develop recommendations to ensure ate; (I) the foreign assistance resources funded
the effective sharing of information from do- (B) shall report to the Secretary of State; with amounts appropriated pursuant to para-
mestic and international sources about pan- and graph (6); and
demic threats among the relevant Federal (C) shall have— (II) international activities described in
departments and agencies, State and local (i) demonstrated knowledge and experience the implementation plans required under
governments, and international partners and in the fields of development and public subsection (b)(3)(B) with the relevant Fed-
organizations; and health, epidemiology, or medicine; and eral departments and agencies in a manner
(X) develop guidelines to enhance and im- (ii) relevant diplomatic, policy, and polit- that—
prove the operational coordination between ical expertise. (aa) is consistent with Executive Order
State and local governments and Federal (3) AUTHORITIES.—The Special Representa- 13747 (81 Fed. Reg. 78701; relating to Advanc-
agencies with respect to pandemic threats. tive is authorized— ing the Global Health Security Agenda to
(D) RESPONSIBILITIES OF DEPARTMENTS AND (A) to operate internationally to carry out Achieve a World Safe and Secure from Infec-
AGENCIES.—The Committee and the Special the purposes of this section; tious Disease Threats);
Advisor for Global Health Security shall not (B) to lead in developing a global pandemic (bb) is consistent with the National Secu-
assume any responsibilities or authorities of prevention, preparedness and response rity Memorandum on United States Global
the head of any Federal department, agency, framework to support global pandemic pre- Leadership to Strengthen the International
or office, including the foreign affairs re- vention, preparedness, responses and recov- COVID–19 Response and to Advance Global
sponsibilities and authorities of the Sec- ery efforts, including through— Health Security and Biological Prepared-
retary of State to oversee the implementa- (i) diplomatic engagement and related for- ness, issued by President Biden on January
tion of programs and policies that advance eign policy efforts, such as multilateral and 21, 2021; and
global health security within foreign coun- bilateral arrangements, enhanced coordina- (cc) reflects and leverages the unique capa-
tries. tion of engagement with multilateral organi- bilities of each such department and agency;
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(E) SPECIFIC ROLES AND RESPONSIBILITIES.— zations and countries, and the mobilization (iv) convening, as appropriate, an inter-
(i) IN GENERAL.—The heads of the relevant of donor contributions; and agency working group on international pan-
Federal departments and agencies should— (ii) support for United States citizens liv- demic prevention and preparedness, headed
(I) make global health security and pan- ing abroad, including consular support; by the Special Representative and including
demic threat reduction a high priority with- (C) to serve as the representative of the representatives from the relevant Federal
in their respective departments and agen- Department of State on the Committee on departments and agencies, to facilitate co-
cies, and include global health security and Global Health Security and Pandemic and ordination of activities relating to pandemic
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S8170 CONGRESSIONAL RECORD — SENATE November 15, 2021
prevention and preparedness in partner coun- fectious disease threats, as necessary and ap- (i) takes a comprehensive view of the con-
tries under this subtitle; propriate; straints in the country’s health system that
(v) working with, and leveraging the exper- (iii) United States contributions to the prevent the achievement of desired outcomes
tise and activities of, the Office of the United World Bank Health Emergency Preparedness of United States Government-supported
States Global AIDS Coordinator, the Office and Response Multi-Donor Fund; and health programs;
of the United States Global Malaria Coordi- (iv) United States contributions to a mul- (ii) identifies the best opportunities for im-
nator, and similar or successor entities that tilateral, catalytic financing mechanism for proving health systems to achieve improved
are implementing United States global global health security and pandemic preven- outcomes, including obstacles to health serv-
health assistance overseas; and tion and preparedness described in section ice delivery;
(vi) avoiding duplication of effort and 1296(b). (iii) maps the resources of the country and
working to resolve policy, program, and (B) EXCEPTION.—Section 110 of the Traf- other donors in the health sector with a
funding disputes among the relevant Federal ficking Victims Protection Act of 2000 (22 focus on investment in health system
departments and agencies; U.S.C. 7107) shall not apply to assistance strengthening; and
(E) leading diplomatic efforts to identify made available pursuant to this subsection. (iv) develops, based on the results of the
and address current and emerging threats to (e) RESILIENCE.—It shall be the policy of assessment described in clause (i), and imple-
global health security; the United States to support the growth of ments a new or revised 5-year strategy for
(F) coordinating, in consultation with the healthier, more stable societies, while ad- United States assistance to strengthen the
Secretary of Health and Human Services and vancing the global health security interests country’s health system that—
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, Federal departments and agencies operating
and transparency among, the governments of habitat, poor access to water, sanitation,
in the country in implementing such strat-
partner countries and key stakeholders, in- and hygiene, and other political, security,
egy;
cluding the private sector; economic, and climatic shocks and stresses;
(IV) includes clear goals, benchmarks, out-
(H) promoting greater donor and national (2) to develop effective tools to identify,
puts, desired outcomes, a means of meas-
investment in partner countries to build analyze, forecast, and mitigate the risks
uring progress and a cost analysis; and
more resilient health systems and supply that make such countries vulnerable;
(V) requires reporting by each Federal de-
chains, including through representation and (3) to better integrate short-, medium-, and
partment and agency regarding their partici-
participation in a multilateral, catalytic fi- long-term recovery efforts into global health
pation and contribution, including in the
nancing mechanism for global health secu- emergency response and disaster relief; and
PEPFAR Annual Report to Congress.
rity and pandemic prevention and prepared- (4) to ensure that international assistance (C) STRATEGIES TO STRENGTHEN HEALTH
ness, consistent with section 1296; and financing tools are effectively designed, SYSTEMS.—USAID missions in countries
(I) securing bilateral and multilateral fi- objectively informed, strategically targeted, identified pursuant subparagraph (A) should
nancing commitments to advance the Global carefully coordinated, reasonably adapted, develop a strategy to strengthen health sys-
Health Security Agenda, in coordination and rigorously monitored and evaluated in a tems based on the assessment developed pur-
with the relevant Federal departments and manner that advances the policy objectives suant to subparagraph (B) that—
agencies, including through funding for the under this subsection. (i) ensures complementarity with prior-
financing mechanism described in section (f) STRENGTHENING HEALTH SYSTEMS.— ities identified under any other action plan
1296; and (1) STATEMENT OF POLICY.—It shall be the focused on strengthening a country’s health
(J) providing regular updates to the appro- policy of the United States to ensure that bi- system, such as the World Health Organiza-
priate congressional committees, the Com- lateral global health assistance programs are tion’s Joint External Evaluation and Na-
mittee on Health, Education, Labor, and effectively managed and coordinated to con- tional Action Plans for Health Security;
Pensions of the Senate, and the Committee tribute to the strengthening of health sys- (ii) identifies bureaucratic barriers and in-
on Energy and Commerce of the House of tems in each country in which such pro- efficiencies, including poor linkages between
Representatives regarding the fulfillment of grams are carried out, as necessary and ap- government ministries and between min-
the duties described in this subsection. propriate for the purposes of achieving im- istries and donor agencies and the extent of
(5) DEPUTY REPRESENTATIVE.—The Special proved health outcomes. any corruption, and identify actions to over-
Representative should be supported by a dep- (2) COORDINATION.—The Administrator of come such barriers;
uty, who— USAID shall work with the Global Malaria (iii) identifies potential obstacles to the
(A) should be an employee of USAID serv- Coordinator and the United States Global implementation of the strategy, such as
ing in a career or noncareer position in the AIDS Coordinator and Special Representa- issues relating to lack of political will, poor
Senior Executive Service or at the level of a tive for Global Health Diplomacy at the De- governance of an effective health system at
Deputy Assistant Administrator or higher; partment of State, and, as appropriate, the all levels of the country’s public health sys-
(B) should have demonstrated knowledge Secretary of Health and Human Services, to tems, especially with respect to governing
and experience in the fields of development identify areas of collaboration and coordina- bodies and councils at the provincial, dis-
and public health, epidemiology, or medi- tion in countries with global health pro- trict, and community levels, and the exclu-
cine; and grams and activities undertaken by USAID sion of women, minorities, other underserved
(C) serves concurrently as the deputy and pursuant to the United States Leadership groups, and frontline health workers in deci-
performs the functions described in section Against HIV/AIDS, Tuberculosis, and Ma- sion making;
3(h) of Executive Order 13747 (81 Fed. Reg. laria Act of 2003 (Public Law 108–25) and (iv) includes proposals for mobilizing suffi-
78701). other relevant statutes to ensure that such cient and durable financing for health sys-
(6) AUTHORIZATION OF APPROPRIATIONS.— activities contribute to health systems tems;
(A) IN GENERAL.—There is authorized to be strengthening. (v) identifies barriers to building and re-
appropriated $5,000,000,000, for the 5-year pe- (3) PILOT PROGRAM .— taining an effective frontline health work-
riod beginning on October 1, 2022, to carry (A) IN GENERAL.—The Administrator of force with key global health security capac-
out the purposes of this subsection and sec- USAID should identify not fewer than 5 ities, informed by the International Health
tion 1296, which, in consultation with the ap- countries in which the United States has sig- Regulations (2005), including—
propriate congressional committees and sub- nificant bilateral investments in global (I) strengthened data collection and anal-
ject to the requirements under chapters 1 health to develop an integrated approach to- ysis;
and 10 of part I and section 634A of the For- ward health systems strengthening that (II) data driven decision making capacity;
eign Assistance Act of 1961 (22 U.S.C. 2151 et takes advantage of all sources of funding for (III) recommendations for partner country
seq.), may include support for— global health in such country, with the aim actions to achieve a workforce that conforms
(i) enhancing preparedness in partner coun- of establishing an enduring model for coordi- with the World Health Organization’s rec-
tries through implementation of the Global nating health systems strengthening activi- ommendation for at least 44.5 doctors,
Health Security Strategy developed pursu- ties, including improving pandemic pre- nurses, and midwives and at least 15 paid,
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ant to subsection (b); paredness in additional countries in the fu- trained, equipped, and professionally super-
(ii) replenishing the Emergency Reserve ture. vised community health workers for every
Fund at USAID, established pursuant to sec- (B) ASSESSMENT.—In each of the countries 10,000 people, while supporting proper dis-
tion 7058(c)(1) of the Department of State, selected under subparagraph (A), USAID mis- tribution and high-quality job performance;
Foreign Operations, and Related Programs sions, in consultation with USAID’s Office of and
Appropriations Act, 2017 (division J of Public Health Systems, should conduct an assess- (IV) inclusion of the community health
Law 115–31) to address new or emerging in- ment that— workforce in planning for a resilient health
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8171
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;
community health worker programmes (C) structures for joint assessments, plans, (h) AUTHORIZATION FOR UNITED STATES
(2018), including the professionalization of auditing, and consultations; and PARTICIPATION IN THE COALITION FOR EPI-
community health workers; (D) a regularized approach to coordination DEMIC PREPAREDNESS INNOVATIONS.—
(xii) describes the role of the private sector on health systems strengthening. (1) IN GENERAL.—The United States is au-
and nongovernmental health providers, in- (6) PUBLIC PRIVATE PARTNERSHIPS TO IM- thorized to participate in the Coalition for
cluding community groups engaged in health PROVE HEALTH SYSTEMS STRENGTHENING.—The Epidemic Preparedness Innovations (referred
promotion and mutual assistance and other country strategies developed under para- to in this subsection as ‘‘CEPI’’).
institutions engaged in health delivery, in- graph (3)(C) should include a section that— (2) INVESTORS COUNCIL AND BOARD OF DIREC-
cluding the extent to which the local popu- (A) discusses the role of the private sector TORS.—
lation utilizes such health services; (including corporate, local, and inter- (A) INITIAL DESIGNATION.—The President
(xiii) facilitates rapid response during national organizations with relevant exper- shall designate an employee of USAID to
health emergencies, such as last mile deliv- tise); and serve on the Investors Council and, if nomi-
ery of vaccines to respond to and prevent the (B) identifies relevant opportunities for nated, on the Board of Directors of CEPI, as
spread of infectious diseases with epidemic the private sector— a representative of the United States during
and pandemic potential; and (i) to accelerate research and development the period beginning on the date of such des-
(xiv) ensures that relevant USAID missions of innovative health and information tech- ignation and ending on September 30, 2022.
and bureaus are appropriately staffed and nology, and to offer training related to its (B) ONGOING DESIGNATIONS.—The President
resourced to carry out such activities effi- use; may designate an employee of the relevant
ciently, effectively, and in-line with best (ii) to contribute to improvements in Federal department or agency with fiduciary
practices. health administration and management responsibility for United States contribu-
(D) CONSULTATION AND REPORTING REQUIRE- processes; tions to CEPI to serve on the Investors Coun-
MENTS.— (iii) to improve system efficiency; cil and, if nominated, on the Board of Direc-
(i) CONSULTATION.—In developing a strat- (iv) to develop training related to clinical tors of CEPI, as a representative of the
egy pursuant to subparagraph (C), each practice guidelines; and United States.
USAID mission should consult with a wide (v) to help countries develop systems for (C) QUALIFICATIONS.—Any employee des-
variety of stakeholders, including— documenting outcomes and achievements re- ignated pursuant to subparagraph (A) or (B)
(I) relevant partner government institu- lated to activities undertaken to strengthen shall have demonstrated knowledge and ex-
tions; the health sector. perience in the fields of development and
(II) professional associations; (7) AUTHORIZATION FOR USE OF FUNDS.— public health, epidemiology, or medicine,
(III) patient groups; Amounts authorized to be appropriated or from the Federal department or agency with
(IV) civil society organizations (including otherwise made available to carry out sec- primary fiduciary responsibility for United
international nongovernmental organiza- tion 104 of the Foreign Assistance Act of 1961 States contributions pursuant to paragraph
tions with relevant expertise in program im- (22 U.S.C. 2151b) may be made available to (3).
plementation); and carry out this subsection. (D) COORDINATION .—In carrying out the re-
(V) the private sector. (g) ADDITIONAL AUTHORITIES.— sponsibilities under this subsection, an em-
(ii) REPORTING.—Not later than 180 days (1) FOREIGN ASSISTANCE ACT OF 1961.—Chap- ployee designated by the President to serve
after the date of the enactment of this Act, ter 1 of part I of the Foreign Assistance Act on the Investors Council or the Board of Di-
the Administrator of USAID and the United of 1961 (22 U.S.C. 2151 et seq.) is amended— rectors, as applicable, shall coordinate with
States Global AIDS Coordinator shall submit (A) in section 104(c)(1) (22 U.S.C. the Secretary of Health and Human Services
a report to the appropriate congressional 2151b(c)(1)), by inserting ‘‘(emphasizing to promote alignment, as appropriate, be-
committees detailing the progress of the health systems strengthening, as appro- tween CEPI and the strategic objectives and
pilot program authorized under this para- priate)’’ after ‘‘health services’’; activities of the Secretary of Health and
graph, including— (B) in section 104A (22 U.S.C. 2151b–2)— Human Services with respect to the re-
(I) progress made toward the integration (i) in subsection (b)(3)(D), by striking ‘‘in- search, development, and procurement of
and co-financing of health systems strength- cluding health care systems, under other medical countermeasures, consistent with ti-
ening activities by USAID and the Office of international donor support’’ and inserting tles III and XXVIII of the Public Health
the Global AIDS Coordinator; and ‘‘including through support for health sys- Service Act (42 U.S.C. 241 et seq. and 300hh et
(II) the results of integrated efforts under tems strengthening, under other donor sup- seq.).
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this section, including for cross-cutting ef- port’’; and (3) CONSULTATION.—Not later than 60 days
forts to strengthen local health workforces. (ii) in subsection (f)(3)(Q), by inserting after the date of the enactment of this Act,
(4) TECHNICAL CAPACITY.— ‘‘the Office of the United States Global AIDS the employee designated pursuant to para-
(A) IN GENERAL.—The Administrator of Coordinator, partner countries, and the graph (2)(A) shall consult with the appro-
USAID shall ensure that USAID is suffi- Global Fund to Fight AIDS, Tuberculosis, priate congressional committees, the Com-
ciently resourced and staffed to ensure per- and Malaria to ensure that their actions sup- mittee on Health, Education, Labor, and
formance, consistency, and adoption of best port the activities taken to strengthen the Pensions of the Senate, and the Committee
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S8172 CONGRESSIONAL RECORD — SENATE November 15, 2021
on Energy and Commerce of the House of (iv) identify any scientific, capacity, or USAID Administrator, the Director of the
Representatives regarding— governance gaps in the preparedness of coun- Centers for Disease Control and Prevention,
(A) the manner and extent to which the tries identified pursuant to clause (i), includ- and the heads of other relevant Federal de-
United States plans to participate in CEPI, ing an analysis of the capacity and perform- partments and agencies, and consistent with
including through the governance of CEPI; ance of any country or entity described in the requirements under the International
(B) any planned financial contributions clause (iii) in complying with biosecurity Health Regulations (2005) and the objectives
from the United States to CEPI; and standards, as applicable. of the World Health Organization’s Health
(C) how participation in CEPI is expected (3) CONGRESSIONAL BRIEFINGS.—The Na- Emergencies Programme, the Global Health
to support— tional Intelligence Council shall provide an Security Agenda, and national actions plans
(i) the United States Global Health Secu- annual briefing to the appropriate commit- for health security, shall work, in coordina-
rity Strategy required under this subtitle; tees of Congress regarding— tion with the World Health Organization,
(ii) the applicable revision of the National (A) the most recent intelligence assess- with partner countries and other key stake-
Biodefense Strategy required under section ments submitted pursuant to paragraph holders to support the establishment,
1086 of the National Defense Authorization (2)(A); and strengthening, and rapid response capacity
Act for Fiscal Year 2017 (6 U.S.C. 104); and (B) the emergence or reemergence of of global health emergency operations cen-
(iii) any other relevant programs relating pathogens with pandemic potential that ters, at the partner country and inter-
to global health security and biodefense. could lead to an epidemic described in para- national levels, including efforts—
(4) UNITED STATES CONTRIBUTIONS.— graph (2)(A)(ii). (A) to collect and share public health data,
(A) SENSE OF CONGRESS.—It is the sense of (4) PUBLIC AVAILABILITY.—The Director of assess risk, and operationalize early warn-
Congress that the President, consistent with National Intelligence shall make publicly ing;
the provisions under section 10003(a)(1) of the available an unclassified version of each in- (B) to secure, including through utilization
American Rescue Plan Act of 2021, should telligence assessment submitted pursuant to of stand-by arrangements and emergency
make an immediate contribution to CEPI in paragraph (2)(A). funding mechanisms, the staff, systems, and
the amount of $300,000,000, to expand re- (j) PANDEMIC EARLY WARNING NETWORK.— resources necessary to execute cross-sectoral
search and development of vaccines to com- (1) IN GENERAL.—The Secretary of State emergency operations during the 48-hour pe-
bat the spread of COVID–19 variants. and the Secretary of Health and Human riod immediately following an infectious dis-
(B) NOTIFICATION.—Not later than 15 days Services, in coordination with the USAID ease outbreak with pandemic potential; and
before a contribution is made available pur- Administrator, the Director of the Centers (C) to organize and conduct emergency
suant to subparagraph (A), the President for Disease Control and Prevention, and the simulations.
heads of the other relevant Federal depart- SEC. 1296. FINANCING MECHANISM FOR GLOBAL
shall notify the appropriate congressional
ments and agencies, shall work with the HEALTH SECURITY AND PANDEMIC
committees of the details of the amount,
World Health Organization and other key PREVENTION AND PREPAREDNESS.
purposes, and national interests served by
stakeholders to establish or strengthen ef- (a) ELIGIBLE PARTNER COUNTRY DEFINED.—
such contribution.
fective early warning systems, at the partner In this section, the term ‘‘eligible partner
(i) INTELLIGENCE ASSESSMENTS REGARDING country, regional, and international levels, country’’ means a country in which the Fund
NOVEL DISEASES AND PANDEMIC THREATS.— that utilize innovative information and ana- for Global Health Security and Pandemic
(1) DEFINED TERM.—In this subsection, the lytical tools and robust review processes to Prevention and Preparedness to be estab-
term ‘‘appropriate committees of Congress’’ track, document, analyze, and forecast infec- lished under subsection (b) may finance glob-
means— tious disease threats with epidemic and pan- al health security and pandemic prevention
(A) the Committee on Foreign Relations of demic potential. and preparedness assistance programs under
the Senate; (2) REPORT.—Not later than 1 year after this subtitle based on the country’s dem-
(B) the Select Committee on Intelligence the date of the enactment of this Act, and onstrated—
of the Senate; annually thereafter for the following 4 years, (1) need, as identified through the Joint
(C) the Committee on Health, Education, the Secretary of State, in coordination with External Evaluation process, the Global
Labor, and Pensions of the Senate; the Secretary of Health and Human Services Health Security Index classification of
(D) the Committee on Foreign Affairs of and the heads of the other relevant Federal health systems, national action plans for
the House of Representatives; departments and agencies, shall submit a re- health security, the World Organization for
(E) the Permanent Select Committee on port to the appropriate congressional com- Animal Health’s Performance of Veterinary
Intelligence of the House of Representatives; mittees, the Committee on Health, Edu- Services evaluation, and other complemen-
and cation, Labor, and Pensions of the Senate, tary or successor indicators of global health
(F) the Committee on Energy and Com- and the Committee on Energy and Commerce security and pandemic prevention and pre-
merce of the House of Representatives. of the House of Representatives that de- paredness; and
(2) INTELLIGENCE ASSESSMENTS.— scribes United States Government efforts (2) commitment to transparency, includ-
(A) IN GENERAL.—Not later than 1 year and opportunities to establish or strengthen ing—
after the date of the enactment of this Act, effective early warning systems to detect in- (A) budget and global health data trans-
and annually thereafter for the following 4 fectious disease threats internationally. parency;
years, the National Intelligence Council (k) INTERNATIONAL EMERGENCY OPER- (B) complying with the International
shall submit to the appropriate committees ATIONS.— Health Regulations (2005);
of Congress an intelligence assessment re- (1) SENSE OF CONGRESS.—It is the sense of (C) investing in domestic health systems;
garding the risks posed to the national secu- Congress that it is essential to enhance the and
rity interests of the United States by the capacity of key stakeholders to effectively (D) achieving measurable results.
emergence, reemergence, and overseas trans- operationalize early warning and execute (b) ESTABLISHMENT OF FUND FOR GLOBAL
mission of pathogens with pandemic poten- multi-sectoral emergency operations during HEALTH SECURITY AND PANDEMIC PREVENTION
tial. an infectious disease outbreak, particularly AND PREPAREDNESS.—
(B) ELEMENTS.—The intelligence assess- in countries and areas that deliberately (1) NEGOTIATIONS FOR ESTABLISHMENT OF
ments submitted pursuant to subparagraph withhold critical global health data and FUND FOR GLOBAL HEALTH SECURITY AND PAN-
(A) shall— delay access during an infectious disease DEMIC PREVENTION AND PREPAREDNESS.—The
(i) identify the countries or regions most outbreak in advance of the next infectious Secretary of State, in coordination with the
vulnerable to the emergence or reemergence disease outbreak with pandemic potential. USAID Administrator, the Secretary of
of a pathogen with pandemic potential, in- (2) PUBLIC HEALTH EMERGENCIES OF INTER- Health and Human Services, and the heads of
cluding the most likely sources and path- NATIONAL CONCERN.—The Secretary of State, other relevant Federal departments and
ways of such emergence or reemergence, in coordination with the Secretary of Health agencies, as necessary and appropriate,
whether naturally occurring, accidental, or and Human Services, should work with the should seek to enter into negotiations with
deliberate; World Health Organization and like-minded donors, relevant United Nations agencies, in-
(ii) assess the likelihood that a pathogen member states to adopt an approach toward cluding the World Health Organization, and
described in clause (i) will spread to the assessing infectious disease threats under other key multilateral stakeholders, to es-
United States, the United States Armed the International Health Regulations (2005) tablish—
Forces, diplomatic or development personnel for the World Health Organization to iden- (A) a multilateral, catalytic financing
of the United States stationed abroad, or tify and transparently communicate, on an mechanism for global health security and
citizens of the United States living abroad in ongoing basis, varying levels of risk leading pandemic prevention and preparedness,
a manner that could lead to an epidemic in up to a declaration by the Director General which may be known as the Fund for Global
ctelli on DSK11ZRN23PROD with SENATE
the United States or otherwise affect the na- of the World Health Organization of a Public Health Security and Pandemic Prevention
tional security or economic prosperity of the Health Emergency of International Concern and Preparedness (referred to in this section
United States; for the duration and in the aftermath of such as ‘‘the Fund’’), to address the need for and
(iii) assess the preparedness of countries declaration. secure durable financing in accordance with
around the world, particularly those identi- (3) EMERGENCY OPERATIONS.—The Secretary the provisions of this subsection; and
fied pursuant to clause (i), to prevent, de- of State and the Secretary of Health and (B) an Advisory Board to the Fund in ac-
tect, and respond to pandemic threats; and Human Services, in coordination with the cordance with subsection (e).
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8173
(2) PURPOSES.—The purposes of the Fund be not less than 10 percent of total initial ordination with ongoing bilateral and multi-
should be— contributions, and a demonstrated commit- lateral efforts, as appropriate—
(A) to close critical gaps in global health ment to supporting the International Health (I) to help eligible partner countries close
security and pandemic prevention and pre- Regulations (2005); critical gaps in health security, as identified
paredness; and (ii) a geographically diverse group of mem- through the Joint External Evaluation proc-
(B) to work with, and build the capacity of, bers who— ess, the Global Health Security Index classi-
eligible partner countries in the areas of (I) come from donor countries, eligible fication of health systems, and national ac-
global health security, infectious disease partner countries, academic institutions, tion plans for health security and other com-
control, and pandemic prevention and pre- independent civil society, including indige- plementary or successor indicators of global
paredness, in a manner that— nous organizations, and the private sector; health security and pandemic prevention and
(i) prioritizes capacity building and financ- and preparedness; and
ing availability in eligible partner countries; (II) are selected on the basis of their expe- (II) to support measures that enable such
(ii) incentivizes countries to prioritize the rience and commitment to innovation, best countries, at the national and subnational
use of domestic resources for global health practices, and the advancement of global levels, and in partnership with civil society
security and pandemic prevention and pre- health security objectives; and the private sector, to strengthen and
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- to be supported by the Fund should include
ployed by, a recipient country or organiza-
tion with the ongoing Joint External Eval- efforts—
tion.
uation national action planning process. (i) to enable eligible partner countries to
(ii) MULTILATERAL BODIES AND INSTITU-
(3) EXECUTIVE BOARD.— formulate and implement national health se-
TIONS.—Executive Board members appointed
(A) IN GENERAL.—The Fund should be gov- curity and pandemic prevention and pre-
pursuant to subparagraph (C)(iii) should be
erned by a transparent and accountable body paredness action plans, advance action pack-
required to recuse themselves from matters
(referred to in this section as the ‘‘Executive ages under the Global Health Security Agen-
presenting conflicts of interest, including fi-
Board’’), which should— da, and adopt and uphold commitments
nancing decisions relating to such bodies and
(i) function as a partnership with, and under the International Health Regulations
institutions.
through full engagement by, donor govern- (2005) and other related international health
ments, eligible partner countries, and inde- (G) UNITED STATES REPRESENTATION.—
agreements and arrangements, as appro-
pendent civil society; and (i) FOUNDING MEMBER.—The Secretary of priate;
(ii) be composed of not more than 20 rep- State should seek— (ii) to support health security budget plan-
resentatives of governments, foundations, (I) to establish the United States as a ning in eligible partner countries, including
academic institutions, independent civil so- founding member of the Fund; and training in public financial management,
ciety, indigenous people, vulnerable commu- (II) to ensure that the United States is rep- budget and health data transparency, human
nities, frontline health workers, and the pri- resented on the Executive Board by an offi- resource information systems, and inte-
vate sector with demonstrated commitment cer or employee of the United States, who grated and transparent budget and health
to carrying out the purposes of the Fund and shall be appointed by the President. data;
upholding transparency and accountability (ii) EFFECTIVE AND TERMINATION DATES.— (iii) to strengthen the health workforce,
requirements. (I) EFFECTIVE DATE.—This subparagraph including hiring, training, and deploying ex-
(B) DUTIES.—The Executive Board should— shall take effect upon the date on which the perts and other essential staff, including
(i) be charged with approving strategies, Secretary of State certifies and submits to community health workers, to improve
operations, and grant making authorities in Congress an agreement establishing the frontline prevention of, and monitoring and
order to conduct effective fiduciary, moni- Fund. preparedness for, unknown, new, emerging,
toring, and evaluation efforts, and other (II) TERMINATION DATE.—The membership or reemerging pathogens, epidemics, and
oversight functions; established pursuant to clause (i) shall ter- pandemic threats, including capacity to
(ii) determine operational procedures such minate upon the date of termination of the surge and manage additional staff during
that the Fund is able to effectively fulfill its Fund. emergencies;
mission; (H) REMOVAL PROCEDURES.—The Fund (iv) to improve the quality of community
(iii) provide oversight and accountability should establish procedures for the removal health worker programs as the foundation of
for the Fund in collaboration with the In- of members of the Executive Board who— pandemic preparedness and response through
spector General to be established pursuant (i) engage in a consistent pattern of human application of appropriate assessment tools;
to subsection (d)(5)(A)(i); rights abuses; (v) to improve infection prevention and
(iv) develop and utilize a mechanism to ob- (ii) fail to uphold global health data trans- control, the protection of healthcare work-
tain formal input from eligible partner coun- parency requirements; or ers, including community health workers,
tries, independent civil society, and imple- (iii) otherwise violate the established and access to water and sanitation within
menting entities relative to program design, standards of the Fund, including in relation healthcare settings;
review, and implementation and associated to corruption. (vi) to combat the threat of antimicrobial
lessons learned; and (c) AUTHORITIES.— resistance;
(v) coordinate and align with other multi- (1) PROGRAM OBJECTIVES.— (vii) to strengthen laboratory capacity and
lateral financing and technical assistance (A) IN GENERAL.—In carrying out the pur- promote biosafety and biosecurity through
activities, and with the United States and pose set forth in subsection (b), the Fund, the provision of material and technical as-
other nations leading outbreak prevention, acting through the Executive Board, sistance;
preparedness, and response activities in part- should— (viii) to reduce the risk of bioterrorism,
ner countries, as appropriate. (i) develop grant making requirements to the emergence, reemergence, or spread of
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(C) COMPOSITION.—The Executive Board be administered by an independent technical zoonotic disease (whether through loss of
should include— review panel comprised of entities barred natural habitat, the commercial trade in
(i) representatives of the governments of from applying for funding or support; wildlife for human consumption, or other
founding member countries who, in addition (ii) provide grants, including challenge means), and accidental biological release;
to the requirements under subparagraph (A), grants, technical assistance, concessional (ix) to build technical capacity to manage,
qualify based upon meeting an established lending, catalytic investment funds, and as appropriate, supply chains for applicable
initial contribution threshold, which should other innovative funding mechanisms, in co- global health commodities through effective
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S8174 CONGRESSIONAL RECORD — SENATE November 15, 2021
forecasting, procurement, warehousing, and (vi) the Global Fund to Fight AIDS, Tuber- (A) eligible partner country selection cri-
delivery from central warehouses to points culosis, and Malaria; teria, to include transparent metrics to
of service in both the public and private sec- (vii) the United Nations Office for the Co- measure and assess global health security
tors; ordination of Humanitarian Affairs, and pandemic prevention and preparedness
(x) to enable bilateral, regional, and inter- UNICEF, and other relevant funds, pro- strengths and vulnerabilities in countries
national partnerships and cooperation, in- grams, and specialized agencies of the United seeking assistance;
cluding through pandemic early warning sys- Nations; (B) minimum standards for ensuring eligi-
tems and emergency operations centers, to (viii) Gavi, the Vaccine Alliance; ble partner country ownership and commit-
identify and address transnational infectious (ix) the Coalition for Epidemic Prepared- ment to long-term results, including require-
disease threats exacerbated by natural and ness Innovations (CEPI); ments for domestic budgeting, resource mo-
man-made disasters, human displacement, (x) The World Organisation for Animal bilization, and co-investment;
and zoonotic infection; Health; (C) criteria for the selection of projects to
(xi) to establish partnerships for the shar- (xi) The United Nations Environment Pro- receive support from the Fund;
ing of best practices and enabling eligible gramme; (D) standards and criteria regarding quali-
countries to meet targets and indicators (xii) Food and Agriculture Organization; fications of recipients of such support;
under the Joint External Evaluation process, and (E) such rules and procedures as may be
the Global Health Security Index classifica- (xiii) the Global Polio Eradication Initia- necessary for cost-effective management of
tion of health systems, and national action tive. the Fund; and
(2) PRIORITY.—In providing assistance (F) such rules and procedures as may be
plans for health security relating to the pre-
under this section, the Fund should give pri- necessary to ensure transparency and ac-
vention, detection, and treatment of ne-
ority to low-and lower middle income coun- countability in the grant-making process.
glected tropical diseases;
tries with— (5) ADDITIONAL TRANSPARENCY AND AC-
(xii) to build the capacity of eligible part-
(A) low scores on the Global Health Secu- COUNTABILITY REQUIREMENTS.—
ner countries to prepare for and respond to
rity Index classification of health systems; (A) INSPECTOR GENERAL.—
second order development impacts of infec-
(B) measurable gaps in global health secu- (i) IN GENERAL.—The Secretary of State
tious disease outbreaks and maintain essen-
rity and pandemic prevention and prepared- shall seek to ensure that the Inspector Gen-
tial health services, while accounting for the eral appointed pursuant to paragraph (1)—
differentiated needs and vulnerabilities of ness identified under Joint External Evalua-
tions and national action plans for health se- (I) is fully enabled to operate independ-
marginalized populations, including women ently and transparently;
and girls; curity;
(C) demonstrated political and financial (II) is supported by and with the requisite
(xiii) to develop and utilize metrics to resources and capacity to regularly conduct
monitor and evaluate programmatic per- commitment to pandemic prevention and
preparedness; and and publish, on a publicly accessible website,
formance and identify best practices, includ- rigorous financial, programmatic, and re-
ing in accordance with Joint External Eval- (D) demonstrated commitment to uphold-
ing global health budget and data trans- porting audits and investigations of the
uation benchmarks, Global Health Security Fund and its grantees; and
Agenda targets, and Global Health Security parency and accountability standards, com-
(III) establishes an investigative unit
Index indicators; plying with the International Health Regula-
that—
(xiv) to develop and deploy mechanisms to tions (2005), investing in domestic health sys-
(aa) develops an oversight mechanism to
enhance and independently monitor the tems, and achieving measurable results.
ensure that grant funds are not diverted to
transparency and accountability of global (3) ELIGIBLE GRANT RECIPIENTS.—Govern-
illicit or corrupt purposes or activities; and
health security and pandemic prevention and ments and nongovernmental organizations
(bb) submits an annual report to the Exec-
preparedness programs and data, in compli- should be eligible to receive grants as de-
utive Board describing its activities, inves-
ance with the International Health Regula- scribed in this section.
tigations, and results.
tions (2005), including through the sharing of (d) ADMINISTRATION.— (ii) SENSE OF CONGRESS ON CORRUPTION.—It
trends, risks, and lessons learned; (1) APPOINTMENTS.—The Executive Board is the sense of Congress that—
(xv) to promote broad participation in should appoint— (I) corruption within global health pro-
health emergency planning and advisory (A) an Administrator, who should be re- grams contribute directly to the loss of
bodies, including by women and frontline sponsible for managing the day-to-day oper- human life and cannot be tolerated; and
health workers; ations of the Fund; and (II) in making financial recoveries relating
(xvi) to develop and implement simulation (B) an independent Inspector General, who to a corrupt act or criminal conduct under a
exercises, produce and release after action should be responsible for monitoring grants grant, as determined by the Inspector Gen-
reports, and address related gaps; implementation and proactively safe- eral, the responsible grant recipient should
(xvii) to support countries in conducting guarding against conflicts of interests. be assessed at a recovery rate of up to 150
Joint External Evaluations; (2) AUTHORITY TO ACCEPT AND SOLICIT CON- percent of such loss.
(xviii) to improve disease surveillance ca- TRIBUTIONS.—The Fund should be authorized (B) ADMINISTRATIVE EXPENSES.—The Sec-
pacity in partner counties, including at the to solicit and accept contributions from gov- retary of State shall seek to ensure the Fund
community level, such that those countries ernments, the private sector, foundations, establishes, maintains, and makes publicly
are better able to detect and respond to individuals, and nongovernmental entities. available a system to track the administra-
known and unknown pathogens and zoonotic (3) ACCOUNTABILITY; CONFLICTS OF INTER- tive and management costs of the Fund on a
infectious diseases; and EST; CRITERIA FOR PROGRAMS.—As part of the quarterly basis.
(xix) to support governments through co- negotiations described in subsection (b)(1), (C) FINANCIAL TRACKING SYSTEMS.—The
ordinated and prioritized assistance efforts the Secretary of the State, consistent with Secretary of State shall ensure that the
to prevent the emergence, reemergence, or paragraph (4), should— Fund establishes, maintains, and makes pub-
spread of zoonotic diseases caused by defor- (A) take such actions as are necessary to licly available a system to track the amount
estation, commercial trade in wildlife for ensure that the Fund will have in effect ade- of funds disbursed to each grant recipient
human consumption, climate-related events, quate procedures and standards to account and sub-recipient during a grant’s fiscal
and unsafe interactions between wildlife, for and monitor the use of funds contributed cycle.
livestock, and people. to the Fund, including the cost of admin- (D) EXEMPTION FROM DUTIES AND TAXES.—
(C) IMPLEMENTATION OF PROGRAM OBJEC- istering the Fund; The Secretary should ensure that the Fund
TIVES.—In carrying out the objectives under (B) ensure there is agreement to put in adopts rules that condition grants upon
subparagraph (A), the Fund should work to place a conflict of interest policy to ensure agreement by the relevant national authori-
eliminate duplication and waste by uphold- fairness and a high standard of ethical con- ties in an eligible partner country to exempt
ing strict transparency and accountability duct in the Fund’s decision-making proc- from duties and taxes all products financed
standards and coordinating its programs and esses, including proactive procedures to by such grants, including procurements by
activities with key partners working to ad- screen staff for conflicts of interest and any principal or sub-recipient for the pur-
vance global health security and pandemic measures to address any conflicts, such as pose of carrying out such grants.
prevention and preparedness, including— potential divestments of interests, prohibi- (e) ADVISORY BOARD.—
(i) governments, independent civil society, tion from engaging in certain activities, (1) IN GENERAL.—There should be an Advi-
nongovernmental organizations, research recusal from certain decision-making and sory Board to the Fund.
and academic institutions, and private sec- administrative processes, and representation (2) APPOINTMENTS.—The members of the
tor entities in eligible partner countries; by an alternate board member; and Advisory Board should be composed of—
ctelli on DSK11ZRN23PROD with SENATE
(ii) the pandemic early warning systems (C) seek agreement on the criteria that (A) a geographically diverse group of indi-
and international emergency operations cen- should be used to determine the programs viduals that includes representation from
ters to be established under subsections (j) and activities that should be assisted by the low- and middle-income countries;
and (k) of section 1295; Fund. (B) individuals with experience and leader-
(iii) the World Health Organization; (4) SELECTION OF PARTNER COUNTRIES, ship in the fields of development, global
(iv) the Global Health Security Agenda; PROJECTS, AND RECIPIENTS.—The Executive health, epidemiology, medicine, biomedical
(v) the Global Health Security Initiative; Board should establish— research, and social sciences; and
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November 15, 2021 CONGRESSIONAL RECORD — SENATE S8175
(C) representatives of relevant United Na- (2) NOTIFICATION.—The Secretary of State proposed to amendment SA 3867 sub-
tions agencies, including the World Health shall notify the appropriate congressional mitted by Mr. REED and intended to be
Organization, and nongovernmental organi- committees not later than 15 days in ad- proposed to the bill H.R. 4350, to au-
zations with on-the ground experience in im- vance of making a contribution to the Fund,
thorize appropriations for fiscal year
plementing global health programs in low including—
and lower-middle income countries. (A) the amount of the proposed contribu- 2022 for military activities of the De-
(3) RESPONSIBILITIES.—The Advisory Board tion; partment of Defense, for military con-
should provide advice and guidance to the (B) the total of funds contributed by other struction, and for defense activities of
Executive Board of the Fund on the develop- donors; and the Department of Energy, to prescribe
ment and implementation of programs and (C) the national interests served by United military personnel strengths for such
projects to be assisted by the Fund and on States participation in the Fund. fiscal year, and for other purposes;
leveraging donations to the Fund. (3) LIMITATION.—During the 5-year period which was ordered to lie on the table;
(4) PROHIBITION ON PAYMENT OF COMPENSA- beginning on the date of the enactment of as follows:
TION.— this Act, a United States contribution to the
At the end, add the following:
(A) IN GENERAL.—Except for travel ex- Fund may not cause the cumulative total of
United States contributions to the Fund to DIVISION E—REAUTHORIZATION OF NA-
penses (including per diem in lieu of subsist-
exceed 33 percent of the total contributions TIVE AMERICAN HOUSING ASSISTANCE
ence), no member of the Advisory Board
to the Fund from all sources. AND SELF-DETERMINATION ACT OF 1996
should receive compensation for services per-
formed as a member of the Board. (4) WITHHOLDINGS.— SEC. 5001. SHORT TITLE.
(B) UNITED STATES REPRESENTATIVE.—Not- (A) SUPPORT FOR ACTS OF INTERNATIONAL This division may be cited as the ‘‘Native
withstanding any other provision of law (in- TERRORISM.—If the Secretary of State deter- American Housing Assistance and Self-De-
cluding an international agreement), a rep- mines that the Fund has provided assistance termination Reauthorization Act of 2021’’.
resentative of the United States on the Advi- to a country, the government of which the SEC. 5002. CONSOLIDATION OF ENVIRONMENTAL
Secretary of State has determined, for pur- REVIEW REQUIREMENTS.
sory Board may not accept compensation for
poses of section 620A of the Foreign Assist- Section 105 of the Native American Hous-
services performed as a member of the
ance Act of 1961 (22 U.S.C. 2371) has repeat- ing Assistance and Self-Determination Act
Board, except that such representative may
edly provided support for acts of inter- of 1996 (25 U.S.C. 4115) is amended by adding
accept travel expenses, including per diem in
national terrorism, the United States shall at the end the following:
lieu of subsistence, while away from the rep- ‘‘(e) CONSOLIDATION OF ENVIRONMENTAL RE-
resentative’s home or regular place of busi- withhold from its contribution to the Fund
VIEW REQUIREMENTS.—
ness in the performance of services for the for the next fiscal year an amount equal to
the amount expended by the Fund to the ‘‘(1) IN GENERAL.—In the case of a recipient
Board. of grant amounts under this Act that is car-
(5) CONFLICTS OF INTEREST.—Members of government of such country.
(B) EXCESSIVE SALARIES.—During the 5- rying out a project that qualifies as an af-
the Advisory Board should be required to dis- fordable housing activity under section 202,
close any potential conflicts of interest prior year period beginning on the date of the en-
if the recipient is using 1 or more additional
to serving on the Advisory Board and, in the actment of this Act, if the Secretary of State
sources of Federal funds to carry out the
event of any conflicts of interest, recuse determines that the salary of any individual
project, and the grant amounts received
themselves from such matters during their employed by the Fund exceeds the salary of
under this Act constitute the largest single
service on the Advisory Board. the Vice President of the United States for
source of Federal funds that the recipient
(f) REPORTS TO CONGRESS.— such fiscal year, the United States should
reasonably expects to commit to the project
(1) STATUS REPORT.—Not later than 180 withhold from its contribution for the next
at the time of environmental review, the In-
days after the date of the enactment of this fiscal year an amount equal to the aggregate
dian tribe of the recipient may assume, in
Act, the Secretary of State, in coordination amount by which the salary of each such in-
addition to all of the responsibilities for en-
with the USAID Administrator, and the dividual exceeds the salary of the Vice Presi-
vironmental review, decision making, and
heads of other relevant Federal departments dent of the United States.
action under subsection (a), all of the addi-
and agencies, shall submit a report to the ap- (C) ACCOUNTABILITY CERTIFICATION REQUIRE-
tional responsibilities for environmental re-
MENT.—The Secretary of State may withhold
propriate congressional committees that de- view, decision making, and action under pro-
scribes the progress of international negotia- not more than 20 percent of planned United
visions of law that would apply to each Fed-
tions to establish the Fund. States contributions to the Fund until the
eral agency providing additional funding
(2) ANNUAL REPORT.— Secretary certifies to the appropriate con-
were the Federal agency to carry out the
(A) IN GENERAL.—Not later than 1 year gressional committees that the Fund has es-
project as a Federal project.
after the date of the establishment of the tablished procedures to provide access by the
‘‘(2) DISCHARGE.—The assumption by the
Fund, and annually thereafter for the dura- Office of Inspector General of the Depart-
Indian tribe of the additional responsibilities
tion of the Fund, the Secretary of State, ment of State, as cognizant Inspector Gen-
for environmental review, decision making,
shall submit a report to the appropriate con- eral, the Inspector General of the Depart-
and action under paragraph (1) with respect
gressional committees regarding the admin- ment of Health and Human Services, the In-
to a project shall be deemed to discharge the
istration of the Fund. spector General of USAID, and the Comp-
responsibility of the applicable Federal agen-
(B) REPORT ELEMENTS.—The report re- troller General of the United States to the
cy for environmental review, decision mak-
quired under subparagraph (A) shall de- Fund’s financial data and other information
ing, and action with respect to the project.
scribe— relevant to United States contributions to
‘‘(3) CERTIFICATION.—An Indian tribe that
(i) the goals of the Fund; the Fund (as determined by the Inspector
assumes the additional responsibilities under
(ii) the programs, projects, and activities General of the Department of State, in con-
paragraph (1), shall certify, in addition to
supported by the Fund; sultation with the Secretary of State).
(h) COMPLIANCE WITH THE FOREIGN AID the requirements under subsection (c)—
(iii) private and governmental contribu- ‘‘(A) the additional responsibilities that
TRANSPARENCY AND ACCOUNTABILITY ACT OF
tions to the Fund; and the Indian tribe has fully carried out under
2016.—Section 2(3) of the Foreign Aid Trans-
(iv) the criteria utilized to determine the parency and Accountability Act of 2016 (Pub- this subsection; and
programs and activities that should be as- lic Law 114–191; 22 U.S.C. 2394c note) is ‘‘(B) that the certifying officer consents to
sisted by the Fund, including baselines, tar- amended— assume the status of a responsible Federal
gets, desired outcomes, measurable goals, (1) in subparagraph (D), by striking ‘‘and’’ official under the provisions of law that
and extent to which those goals are being at the end; would apply to each Federal agency pro-
achieved. (2) in subparagraph (E), by striking the pe- viding additional funding under paragraph
(3) GAO REPORT ON EFFECTIVENESS.—Not riod at the end and inserting ‘‘; and’’; and (1).
later than 2 years after the date on which (3) by adding at the end the following: ‘‘(4) LIABILITY.—
the Fund is established, the Comptroller ‘‘(F) the International Pandemic Prepared- ‘‘(A) IN GENERAL.—An Indian tribe that
General of the United States shall submit a ness and COVID-19 Response Act of 2021.’’. completes an environmental review under
report to the appropriate congressional com- (i) PROHIBITION AGAINST UNITED STATES this subsection shall assume sole liability for
mittees that evaluates the effectiveness of FOREIGN ASSISTANCE FOR THE GOVERNMENT the content and quality of the review.
the Fund, including the effectiveness of the OF THE PEOPLE’S REPUBLIC OF CHINA.—None ‘‘(B) REMEDIES AND SANCTIONS.—Except as
programs, projects, and activities supported of the assistance authorized to be appro- provided in subparagraph (C), if the Sec-
by the Fund, as described in subsection priated under this subtitle may be made retary approves a certification and release of
(c)(1). available to the Government of the People’s funds to an Indian tribe for a project in ac-
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(g) UNITED STATES CONTRIBUTIONS.— Republic of China or to any entity owned or cordance with subsection (b), but the Sec-
(1) IN GENERAL.—Subject to submission of controlled by the Government of the Peo- retary or the head of another Federal agency
the certification under this subsection, the ple’s Republic of China. providing funding for the project subse-
President is authorized to make available for --- quently learns that the Indian tribe failed to
United States contributions to the Fund SA 4645. Mr. SCHATZ (for himself, carry out the responsibilities of the Indian
such funds as may be appropriated or other- Ms. MURKOWSKI, and Mr. ROUNDS) sub- tribe as described in subsection (a) or para-
wise made available for such purpose. mitted an amendment intended to be graph (1), as applicable, the Secretary or
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File and source
- File
- CREC_crec-2021-11-15_crec-2021-11-15-pt1-pgs8163-2.pdf
- Size
- 380,572 bytes
- SHA-256
- 590028567722d5f71e0a26216bd09ee05b528cba1f13ce1fcd9ac7fdc67f4132
- Original
- www.govinfo.gov