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Title II — Trust Fund for Global Health Security

S. 3829 · 116th Congress · May 21, 2020 · Lineage

II Trust Fund for Global Health Security

Sec. 201 Definition

In this title, the term partner country means a developing country with demonstrated need and commitment to transparency, including budget and global health data transparency, in which the Trust Fund for Global Health Security established under section 202 is working to design, implement, and evaluate global health security assistance programs under this Act.

Sec. 202 Establishment of Trust Fund for Global Health Security

(a)
Negotiations for establishment of a Trust Fund for Global Health Security— The Secretary of State should seek to enter into negotiations with the World Bank or the International Development Association, in coordination with the Secretary of the Treasury, the Administrator of the United States Agency for International Development, and the heads of other relevant Federal departments and agencies, and with the member nations of the World Bank or the International Development Association and with other interested parties, for the establishment within the World Bank of—
(1)
a Trust Fund for Global Health Security (in this subtitle referred to as “the Fund”) in accordance with the provisions of this section; and
(2)
an Advisory Board to the Fund in accordance with section 205.
(b)
Purpose— The purpose of the Fund should be to advance global health security by catalyzing public and private investments in global health security, infectious disease control, and pandemic preparedness and response in developing countries with demonstrated need, commitment to transparency, including budget and global health data transparency, and evidence-based outcomes.
(c)
Composition—
(1)
In general— The Fund should be governed by a Board of Trustees, to be composed of representatives of World Bank member states that are donors and participants in the Fund. The Board of Trustees should include—
(A)
5 permanent member countries, who qualify based upon meeting an established initial contribution threshold, which should be not less than 10 percent of total contributions, and by meeting minimum standards for upholding the International Health Regulations, and who should hold veto power over programs and projects;
(B)
5 term members, who are selected by the permanent members on the basis of their commitment to innovation, best practices, and the advancement of global health security objectives in partner countries; and
(C)
9 developing country members, who serve a period term, and who demonstrate a commitment to prioritizing global health security for their citizens and to the purposes and principles of the Fund.
(2)
Qualifications— Individuals appointed to the Board shall have demonstrated knowledge and experience in the fields of public health, epidemiology, supply chain management, health delivery systems, and development.
(3)
United States representation—
(A)
In general—
(i)
Founding permanent member— The Secretary of State shall seek to establish the United States as a founding permanent member of the Fund.
(ii)
Coordinator of United States Government Activities to Advance Global Health Security— The United States shall be represented on the Board of Trustees by the Coordinator of United States Government Activities to Advance Global Health Security and Diplomacy established under section 103.
(B)
Effective and termination dates—
(i)
Effective date— This paragraph shall take effect upon the date the Secretary of State, in coordination with the Secretary of the Treasury, certifies and transmits to Congress an agreement establishing the Fund.
(ii)
Termination date— The membership established pursuant to subparagraph (A) shall terminate upon the date of termination of the Fund.
(4)
Removal procedures— The Fund shall establish procedures for the removal of members of the Board who engage in a consistent pattern of human rights abuses, fail to uphold global health data transparency requirements, or otherwise violate the established standards of the Fund.

Sec. 203 Grant authorities

(a)
Program objectives—
(1)
In general— In carrying out the purpose set forth in section 202(b), the Fund, acting through the Board of Trustees, should provide grants, including challenge grants, technical assistance, concessional lending, catalytic investment funds, and other innovative funding mechanisms, as appropriate, to support measures that enable developing countries, at both national and sub-national levels, and in partnership with civil society and the private sector, to strengthen and sustain resilient health systems and supply chains with the resources, capacity, and personnel required to prevent, detect, mitigate, and respond to infectious disease threats before they become pandemics.
(2)
Activities supported— Activities to be supported by the Fund should include efforts to—
(A)
enable partner countries with low scores on the Global Health Security Index classification of health systems and on the Global Health Security Agenda Joint External Evaluation to improve such scores and adopt and uphold commitments under the Global Health Security Agenda, the World Health Organization International Health Regulations, and other related international health agreements;
(B)
support global health budget and workforce planning in partner countries, including training in financial management and budget and global health data transparency;
(C)
advance research, development, and deployment of effective infectious disease tracking tools, diagnostics, therapeutics, and vaccines, including by establishing and leveraging public-private partnerships and supporting advance purchase agreements, as necessary and appropriate;
(D)
improve infection control within healthcare settings;
(E)
combat the threat of antimicrobial resistance;
(F)
expand lab capacity through the provision of material and technical assistance;
(G)
build technical capacity to manage global health supply chains through effective forecasting, procurement, warehousing, and delivery from central warehouses to points of service;
(H)
enable bilateral and regional partnerships and cooperation to identify and address transnational infectious disease threats exacerbated by natural and man-made disasters, human displacement, and zoonotic infection;
(I)
establish partnerships to develop medical interventions to detect, treat, and prevent the spread of neglected tropical diseases;
(J)
build the technical capacity of partner countries to prepare for and respond to second order development impacts of infectious disease outbreaks, while accounting for the differentiated needs and vulnerabilities of marginalized populations;
(K)
develop and utilize metrics to monitor and evaluate program performance and identify best practices; and
(L)
develop and deploy mechanisms to enhance the transparency and accountability of global health security programs and data, including through the sharing of trends, risks, and lessons learned.
(3)
Implementation of program objectives— In carrying out the objectives of paragraph (1), the Fund shall work to eliminate duplication and waste by upholding strict transparency and accountability standards and coordinating its programs and activities with key partners working to advance global health security, including, at a minimum—
(A)
governments, civil society and nongovernmental organizations, research and academic institutions, and private sector entities in partner countries;
(B)
the Global Health Security Agenda;
(C)
the Global Fund to Fight AIDS, Tuberculosis, and Malaria;
(D)
the Vaccine Alliance, GAVI;
(E)
the Coalition for Epidemic Preparedness Innovations (CEPI);
(F)
the Global Polio Eradication Initiative; and
(G)
the Coordinator of United States Government Activities to Advance Global Health Security and Diplomacy, established pursuant to section 103.
(b)
Priority— In providing assistance under this section, the Fund should give priority to low and lower-middle income countries, as classified in the most recent edition of the World Development Report for Reconstruction and Development published by the International Bank for Reconstruction and Development, with low scores on the Global Health Security Index classification of health systems and on the Global Health Security Agenda Joint External Evaluation, and demonstrated commitment to upholding global health budget and data transparency and accountability standards and investing in their own health systems.
(c)
Eligible grant recipients— Governments and nongovernmental organizations should be eligible to receive grants under this section.

Sec. 204 Administration

(a)
Appointment of an administrator— The Board of Trustees, in consultation with the appropriate officials of the Bank, should appoint an Administrator who should be responsible for managing the day-to-day operations of the Fund.
(b)
Authority To solicit and accept contributions— The Fund should be authorized to solicit and accept contributions from governments, the private sector, and nongovernmental entities of all kinds.
(c)
Accountability of funds and criteria for programs— As part of the negotiations described in section 202(a), the Secretary of the State, in coordination with the Secretary of the Treasury, shall, consistent with subsection (d)—
(1)
take such actions as are necessary to ensure that the Bank or the Association will have in effect adequate procedures and standards to account for and monitor the use of funds contributed to the Fund, including the cost of administering the Fund; and
(2)
seek agreement on the criteria that should be used to determine the programs and activities that should be assisted by the Fund.
(d)
Selection of partner countries, projects, and recipients— The Board of Trustees should establish—
(1)
partner country selection criteria, to include transparent metrics to measure and assess global health security strengths and vulnerabilities in developing countries seeking assistance;
(2)
minimum standards for ensuring partner country ownership and commitment to long-term results, including requirements for domestic budgeting, resource mobilization, and co-investment;
(3)
criteria for the selection of projects to receive support from the Fund;
(4)
standards and criteria regarding qualifications of recipients of such support;
(5)
such rules and procedures as may be necessary for cost-effective management of the Fund; and
(6)
such rules and procedures as may be necessary to ensure transparency and accountability in the grant-making process.
(e)
Additional transparency and accountability requirements—
(1)
Inspector General—
(A)
In general— The Secretary of State shall ensure that the Fund maintains an independent Office of the Inspector General and ensure that the office has the requisite resources and capacity to regularly conduct and publish, on a publicly accessible website, rigorous financial, programmatic, and reporting audits and investigations of the Fund and its grantees.
(B)
Sense of Congress on corruption— It is the sense of Congress that—
(i)
corruption within global health programs contribute directly to the loss of human life and cannot be tolerated; and
(ii)
in making financial recoveries relating to a corrupt act or criminal conduct under a grant, as determined by the Inspector General, the responsible grant recipient should be assessed at a recovery rate of 150 percent of such loss.
(2)
Administrative expenses— The Secretary of State shall ensure the Fund establishes, maintains, and makes publicly available a system to track the administrative and management costs of the Fund on a quarterly basis.
(3)
Grant tracking systems— The Secretary of State shall ensure that the Fund establishes, maintains, and makes publicly available a system to track the amount of funds disbursed to each grant recipient and sub-recipient during a grant’s fiscal cycle.
(4)
Exemption from duties and taxes— The Secretary should ensure that the Fund adopts rules that condition grants upon agreement by the relevant national authorities in a partner country to exempt from duties and taxes all products financed by such grants, including procurements by any principal or sub-recipient for the purpose of carrying out such grants.

Sec. 205 Advisory Board

(a)
In general— There should be an Advisory Board to the Fund.
(b)
Appointments— The members of the Advisory Board should be composed of—
(1)
individuals with experience and leadership in the fields of development, global health, epidemiology, medicine, biomedical research, and social sciences; and
(2)
representatives of relevant United Nations agencies and nongovernmental organizations with on-the-ground experience in implementing global health programs in low and lower-middle income countries.
(c)
Responsibilities— The Advisory Board should provide advice and guidance to the Board of Trustees on the development and implementation of programs and projects to be assisted by the Fund and on leveraging donations to the Fund.
(d)
Prohibition on payment of compensation—
(1)
In general— Except for travel expenses (including per diem in lieu of subsistence), no member of the Advisory Board should receive compensation for services performed as a member of the Board.
(2)
United States representative— Notwithstanding any other provision of law (including an international agreement), a representative of the United States on the Advisory Board may not accept compensation for services performed as a member of the Board, except that such representative may accept travel expenses, including per diem in lieu of subsistence, while away from the representative's home or regular place of business in the performance of services for the Board.

Sec. 206 Reports to Congress

(a)
Annual report—
(1)
In general— Not later than 1 year after the date of the enactment of this Act, and annually thereafter for the duration of the Fund, the Secretary of State, in coordination with the Secretary of the Treasury, shall submit to the appropriate congressional committees a report on the Fund.
(2)
Report elements— The report shall include a description of—
(A)
the goals of the Fund;
(B)
the programs, projects, and activities supported by the Fund;
(C)
private and governmental contributions to the Fund; and
(D)
the criteria utilized to determine the programs and activities that should be assisted by the Fund.
(b)
GAO report on Trust Fund effectiveness— Not later than 2 years after the date that the Fund is formally established, the Comptroller General of the United States shall submit to the appropriate congressional committees a report evaluating the effectiveness of the Fund, including—
(1)
the effectiveness of the programs, projects, and activities supported by the Fund; and
(2)
an assessment of the merits of continued United States participation in the Fund.

Sec. 207 United States contributions

(a)
In general— Subject to submission of the certification under section 202(c)(3)(B)(i), the President is authorized to make available funds authorized to be appropriated pursuant to section 107 for United States contributions to the Fund.
(b)
Notification— The Secretary of State shall notify the appropriate congressional committees not later than 15 days in advance of making a contribution to the Fund, including—
(1)
the amount of the proposed contribution;
(2)
the total of funds contributed by other donors; and
(3)
the national interests served by United States participation in the Fund.
(c)
Limitation— At no point during fiscal years 2021 through 2025 shall a United States contribution cause the cumulative total of United States contributions to exceed 33 percent of the total contributions to the Fund from all sources.
(d)
Withholdings—
(1)
Support for acts of international terrorism— If at any time the Secretary of State determines that the Fund has provided assistance to a country, the government of which the Secretary of State has determined, for purposes of section 620A of the Foreign Assistance Act of 1961 (22 U.S.C. 2371) has repeatedly provided support for acts of international terrorism, the United States shall withhold from its contribution for the next fiscal year an amount equal to the amount expended by the Fund to the government of such country.
(2)
Excessive salaries— If at any time during any of the fiscal years 2021 through 2025, the Secretary of State determines that the salary of any individual employed by the Fund exceeds the salary of the Vice President of the United States for that fiscal year, then the United States should withhold from its contribution for the next fiscal year an amount equal to the aggregate amount by which the salary of each such individual exceeds the salary of the Vice President of the United States.
(3)
Accountability certification requirement— The Secretary of State shall withhold not less than 20 percent of planned United States contributions to the Fund until the Secretary certifies to the appropriate congressional committees that the Fund has established procedures to provide access by the Office of Inspector General of the Department of State, as cognizant Inspector General, the Inspector General of the Department of Health and Human Services, and the Inspector General of the United States Agency for International Development, to the Fund’s financial data and other information relevant to United States contributions (as determined by the Inspector General, in consultation with the Secretary of State).