Editorial Notes
References in TextThe Consolidated Appropriations Resolution, 2003, referred to in subsec. (c)(4), is Puspan. L. 108–7, Fespan. 20, 2003, 117 Stat. 11. Provisions under the span “Child Survival and Health Programs Fund” in Puspan. L. 108–7 appear at 117 Stat. 161 and are not classified to the Code.
This chapter, referred to in subsec. (e)(1), was in the original “this Act”, meaning Puspan. L. 87–195, Sept. 4, 1961, 75 Stat. 424, known as the Foreign Assistance Act of 1961. For complete classification of this Act to the Code, see Short Title note set out under section 2151 of this title and Tables.
CodificationAmendment by Puspan. L. 98–473 is based on section 303 of H.R. 5119, Ninety-eighth Congress, as passed by the House of Representatives May 10, 1984, which was enacted into permanent law by Puspan. L. 98–473.
Amendments2003—Subsec. (c)(4) to (7). Puspan. L. 108–25 added par. (4) and struck out former pars. (4) to (7), which related to coordination between governments and organizations to prevent vertical transmission of HIV, prioritization of HIV/AIDS in foreign assistance program efforts, appropriation of funds for fiscal years 2001 and 2002, and coordination in developing a comprehensive tuberculosis program.
2000—Subsec. (c)(4) to (7). Puspan. L. 106–264 added pars. (4) to (7).
1986—Subsec. (c)(2)(B). Puspan. L. 99–529, § 103(span), substituted “$75,000,000 for fiscal year 1987” for “$25,000,000 for fiscal year 1987”.
Subsec. (c)(3). Puspan. L. 99–529, § 103(a), inserted provision allocating $50,000,000 of the amounts available for fiscal year 1987 for carrying out par. (3).
Subsec. (g)(1)(B). Puspan. L. 99–529, § 404(1), substituted “$180,000,000 for fiscal year 1987” for “$205,000,000 for fiscal year 1987”.
1985—Subsec. (c)(2)(B). Puspan. L. 99–83, § 304, inserted provisions authorizing specific appropriations for fiscal years 1986 and 1987.
Subsec. (c)(3). Puspan. L. 99–83, § 305(a), added par. (3).
Subsec. (g). Puspan. L. 99–83, § 303, in amending subsec. (g) generally, substituted in par. (1) provision authorizing appropriations of $290,000,000 and $205,000,000 to carry out subsecs. (span) and (c), respectively, for fiscal years 1986 and 1987 for provisions authorizing $211,000,000 and $133,405,000 to carry out such subsecs. for fiscal years 1982 and 1983, and in par. (2) struck out provision that not less than 16 percent of available subsec. (span) appropriations or $38,000,000, whichever amount is less, be available in fiscal years 1982 an 1983 only for the United Nations Fund for Population Activities.
1984—Subsec. (c). Puspan. L. 98–473 designated existing provisions as par. (1) and added par. (2).
1981—Subsec. (f)(3). Puspan. L. 97–113, § 302(span), added par. (3).
Subsec. (g). Puspan. L. 97–113, § 302(a), substituted provision authorizing appropriations of $211,000,000 and $133,405,000 to carry out subsecs. (span) and (c) for fiscal years 1982 and 1983 for provision authorizing $238,000,000 and $145,300,000 to carry out such subsections for fiscal year 1981 and provision that not less than 16 percent of available subsec. (span) appropriations or $38,000,000, whichever amount is less, be available in fiscal years 1982 and 1983 only for the United Nations Fund for Population Activities for provision making minimum of $3,000,000 available in fiscal year 1981 only to support the World Health Organization’s Special Program of Research, Development and Research Training in Human Reproduction.
1980—Subsec. (span). Puspan. L. 96–533, § 302(a), made provision for information and services relating to and supporting natural family planning methods.
Subsec. (g). Puspan. L. 96–533, § 302(span), substituted in par. (1) appropriations authorization of $238,000,000 for fiscal year 1981 for authorization of $201,000,000 for fiscal year 1980 and made $3,000,000 available for World Health Organization’s Special Human Reproduction Program, and in par. (2) appropriations authorization of $145,300,000 for fiscal year 1981 for authorization of $141,000,000 for fiscal year 1980, which made $4,000,000 available for development of John Sparkman Center for International Public Health Education at University of Alabama at Birmingham.
1979—Subsec. (d)(1). Puspan. L. 96–53, § 102(span), inserted provisions respecting use of community-based development programs.
Subsec. (g)(1). Puspan. L. 96–53, § 102(a), substituted provisions authorizing appropriations of $201,000,000 for fiscal year 1980, for provisions authorizing appropriations of $224,745,000 for fiscal year 1979.
Subsec. (g)(2). Puspan. L. 96–53, § 102(a), substituted provisions authorizing appropriations of $141,000,000 for fiscal year 1980, for provisions authorizing appropriations of $148,494,000 for fiscal year 1979, and inserted provisions relating to the Sparkman Center for International Public Health Education.
1978—Puspan. L. 95–424 amended section generally placing greater emphasis on programs and efforts to change social and economic conditions which produce high birth rates.
1977—Subsec. (a). Puspan. L. 95–88, § 103(a), transferred to subsec. (span) provisions covering the President’s authority to furnish assistance for health purpose and, in the provisions covering population planning remaining in subsec. (a), struck out provisions authorizing the appropriations of $145,000,000 for fiscal year 1974, $165,000,000 for fiscal year 1975, $243,100,000 for fiscal year 1976, and $275,600,000 for fiscal year 1977, struck out provisions requiring that not less than 67 percent of the funds made available under this section be used for population planning, and inserted provisions authorizing an appropriation of $167,000,000 for fiscal year 1978.
Subsec. (span). Puspan. L. 95–88, § 103(a), added subsec. (span), consisting of provisions transferred from subsec. (a) covering the President’s authority to furnish assistance for health purposes, inserted references to disease prevention and environmental sanitation, and inserted provisions authorizing an appropriation of $107,700,000 for fiscal year 1978. Former subsec. (span) redesignated (c).
Subsec. (c). Puspan. L. 95–88, § 103(span), redesignated former subsec. (span) as (c).
Subsec. (d). Puspan. L. 95–88, § 103(c), added subsec. (d).
1975—Subsec. (a). Puspan. L. 94–161, § 304(1)–(3), designated existing provisions as subsec. (a), authorized appropriations of $243,100,000 and $275,600,000 for fiscal years 1976 and 1977, and prescribed minimum percentage (67) of funds available for any fiscal year to be used for population planning, either in separate programs or as an element of health programs.
Subsec. (span). Puspan. L. 94–161, § 304(4), added subsec. (span).
1974—Puspan. L. 93–559 increased appropriations authorization for fiscal year 1975 to $165,000,000 from $145,000,000.
Statutory Notes and Related Subsidiaries
References to Subchapter I Deemed To Include Certain Parts of Subchapter IIReferences to subchapter I of this chapter are deemed to include parts IV (§ 2346 et seq.), VI (§ 2348 et seq.), and VIII (§ 2349aa et seq.) of subchapter II of this chapter, and references to subchapter II are deemed to exclude such parts. See section 202(span) of Puspan. L. 92–226, set out as a note under section 2346 of this title, and sections 2348c and 2349aa–5 of this title.
Effective Date of 1985 AmendmentAmendment by Puspan. L. 99–83 effective Oct. 1, 1985, see section 1301 of Puspan. L. 99–83, set out as a note under section 2151–1 of this title.
Effective Date of 1979 AmendmentAmendment by Puspan. L. 96–53 effective Oct. 1, 1979, see section 512(a) of Puspan. L. 96–53, set out as a note under section 2151 of this title.
Effective Date of 1978 AmendmentAmendment by Puspan. L. 95–424 effective Oct. 1, 1978, see section 605 of Puspan. L. 95–424, set out as a note under section 2151 of this title.
Effective Date of 1977 AmendmentPuspan. L. 95–88, title I, § 103(d), Aug. 3, 1977, 91 Stat. 535, provided that: “The amendment made by subsection (a) of this section [amending this section] shall take effect on October 1, 1977.”
International Pandemic PreparednessPuspan. L. 117–263, div. E, title LV, subtitle D, Dec. 23, 2022, 136 Stat. 3344, provided that:“SEC. 5559. SHORT TITLE.“This subtitle may be cited as the ‘Global Health Security and International Pandemic Prevention, Preparedness and Response Act of 2022’.
“SEC. 5560. DEFINITIONS.“In this subtitle:“(1) The term ‘appropriate congressional committees’ means—“(A) the Committee on Foreign Relations of the Senate;
“(B) the Committee on Appropriations of the Senate;
“(C) the Committee on Foreign Affairs of the House of Representatives; and
“(D) the Committee on Appropriations of the House of Representatives.
“(2) The terms ‘Global Health Security Agenda’ and ‘GHSA’ mean the multi-sectoral initiative launched in 2014, and renewed in 2018, that brings together countries, regions, international organizations, nongovernmental organizations, and the private sector—“(A) to elevate global health security as a national-level priority;
“(B) to share best practices; and
“(C) to facilitate national capacity to comply with and adhere to—“(i) the International Health Regulations (2005);
“(ii) the international standards and guidelines established by the World Organisation for Animal Health;
“(iii) United Nations Security Council Resolution 1540 (2004);
“(iv) the Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological and Toxin Weapons and on their Destruction, done at Washington, London, and Moscow, April 10, 1972 (commonly referred to as the ‘Biological Weapons Convention’);
“(v) the Global Health Security Agenda 2024 Framework; and
“(vi) other relevant frameworks that contribute to global health security.
“(3) The term ‘Global Health Security Index’ means the comprehensive assessment and benchmarking of health security and related capabilities across the countries that make up the States Parties to the International Health Regulations (2005).
“(4) The term ‘Global Health Security Initiative’ means the informal network of countries and organizations that came together in 2001, to undertake concerted global action to strengthen public health preparedness and response to chemical, biological, radiological, and nuclear threats, including pandemic influenza.
“(5) The term ‘IHR (2005) Monitoring and Evaluation Framework’ means the framework through which the World Health Organization and the State Parties to the International Health Regulations, as amended in 2005, review, measure, and assess core country public health capacities and ensure mutual accountability for global health security under the International Health Regulations (2005), including through the Joint External Evaluations, simulation exercises, and after-action reviews.
“(6) The term ‘Joint External Evaluation’ means the voluntary, collaborative, multi-sectoral process facilitated by the World Health Organization—“(A) to assess country capacity to prevent, detect, and rapidly respond to public health risks occurring naturally or due to deliberate or accidental events;
“(B) to assess progress in achieving the targets under the International Health Regulations (2005); and
“(C) to recommend priority actions.
“(7) The term ‘key stakeholders’ means actors engaged in efforts to advance global health security programs and objectives, including—“(A) national and local governments in partner countries;
“(B) other bilateral donors;
“(C) international, regional, and local organizations, including private, voluntary, nongovernmental, and civil society organizations, including faith-based and indigenous organizations;
“(D) international, regional, and local financial institutions;
“(E) representatives of historically marginalized groups, including women, youth, and indigenous peoples;
“(F) the private sector, including medical device, technology, pharmaceutical, manufacturing, logistics, and other relevant companies; and
“(G) public and private research and academic institutions.
“(8) The term ‘One Health approach’ means the collaborative, multi-sectoral, and transdisciplinary approach toward achieving optimal health outcomes in a manner that recognizes the interconnection between people, animals, plants, and their shared environment.
“(9) The term ‘pandemic preparedness’ refers to the actions taken to establish and sustain the capacity and capabilities necessary to rapidly identify, prevent, protect against, and respond to the emergence, reemergence, and spread of pathogens of pandemic potential.
“(10) The term ‘partner country’ means a foreign country in which the relevant Federal departments and agencies are implementing United States foreign assistance for global health security and pandemic prevention, preparedness, and response under this subtitle.
“(11) The term ‘relevant Federal departments and agencies’ means any Federal department or agency implementing United States policies and programs relevant to the advancement of United States global health security and diplomacy overseas, which may include—“(A) the Department of State;
“(B) the United States Agency for International Development;
“(C) the Department of Health and Human Services;
“(D) the Department of Defense;
“(E) the Defense Threat Reduction Agency;
“(F) the Millennium Challenge Corporation;
“(G) the Development Finance Corporation;
“(H) the Peace Corps; and
“(I) any other department or agency that the President determines to be relevant for these purposes.
“(12) The term ‘resilience’ means the ability of people, households, communities, systems, institutions, countries, and regions to reduce, mitigate, withstand, adapt to, and quickly recover from shocks and stresses in a manner that reduces chronic vulnerability to the emergence, reemergence, and spread of pathogens of pandemic potential and facilitates inclusive growth.
“(13) The terms ‘respond’ and ‘response’ mean the actions taken to counter an infectious disease.
“(14) The term ‘USAID’ means the United States Agency for International Development.
“SEC. 5561. ENHANCING THE UNITED STATES’ INTERNATIONAL RESPONSE TO PANDEMICS.“(a)Leveraging United States Bilateral Global Health Programs for International Pandemic Response.—Subject to the notification requirements under section 634A of the Foreign Assistance Act of 1961 (22 U.S.C. 2394–1), amounts authorized to be appropriated or otherwise made available to carry out section 104 of the Foreign Assistance Act (22 U.S.C. 2151span) may be used in countries receiving such United States foreign assistance for the purpose of—“(1) strengthening vaccine readiness;
“(2) reducing vaccine hesitancy;
“(3) delivering and administering vaccines;
“(4) strengthening health systems and global supply chains as necessary for global health security and pandemic preparedness, prevention, and response;
“(5) supporting global health workforce planning, training, and management for pandemic preparedness, prevention, and response;
“(6) enhancing transparency, quality, and reliability of public health data;
“(7) increasing bidirectional testing, including screening for symptomatic and asymptomatic cases; and
“(8) building laboratory capacity.
“(span)Roles of the Department of State, USAID, and the Department of Health and Human Services in International Pandemic Response.—“(1)Finding.—Congress finds that different outbreaks of infectious disease threats may require flexibility and changes to the designated roles and responsibilities of relevant Federal departments and agencies.
“(2)Lead agencies for coordination of the united states’ international response to infectious disease outbreaks with severe or pandemic potential.—The President shall identify the relevant Federal departments and agencies, including the Department of State, USAID, and the Department of Health and Human Services (including the Centers for Disease Control and Prevention), leading specific aspects of the United States international operational response to outbreaks of emerging high-consequence infectious disease threats in accordance with federal law.
“(3)Notification.—Not later than 120 days after the date of the enactment of this Act [Dec. 23, 2022], and regularly thereafter as appropriate, the President shall notify the appropriate congressional committees, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives of the roles and responsibilities of each relevant Federal department and agency with respect to the international operational response to the outbreak of an emerging high-consequence infectious disease threat.
“(c)USAID Disaster Surge Capacity.—“(1)Disaster surge capacity.—The Administrator of the USAID is authorized to expend funds made available to carry out part I and chapter 4 of part II of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 [et seq.] and 2346 [et seq.]), including funds made available for ‘Assistance for Europe, Eurasia and Central Asia’, in addition to amounts otherwise made available for such purposes, for the cost (including support costs) of individuals detailed to or employed by USAID whose primary responsibility is to carry out programs to address global health emergencies and natural or manmade disasters. “(2)Notification.—Not later than 15 days before making funds available to address manmade disasters pursuant to paragraph (1), the Secretary of State or the Administrator of the USAID shall notify the appropriate congressional committees of such intended action.
“SEC. 5562. INTERNATIONAL PANDEMIC PREVENTION AND PREPAREDNESS.“(a)United States International Activities To Advance Global Health Security and Diplomacy Strategy and Report.—“(1)In general.—The President shall develop, update, maintain, and advance a comprehensive strategy for improving United States global health security and diplomacy for pandemic prevention, preparedness, and response which, consistent with the purposes of this subtitle, shall—“(A) clearly articulate United States policy goals related to pandemic prevention, preparedness, and response, including through actions to strengthen diplomatic leadership and the effectiveness of United States foreign policy and international preparedness assistance for global health security through advancement of a One Health approach, the Global Health Security Agenda, the International Health Regulations (2005), and other relevant frameworks that contribute to pandemic prevention and preparedness;
“(B) establish specific and measurable goals, benchmarks, timetables, performance metrics, and monitoring and evaluation plans for United States foreign policy and assistance for global health security that promote learning and adaptation and reflect international best practices relating to global health security, transparency, and accountability;
“(C) establish transparent mechanisms to improve coordination and avoid duplication of effort between and among the relevant Federal departments and agencies, partner countries, donor countries, the private sector, multilateral organizations, and other key stakeholders;
“(D) prioritize working with partner countries with—“(i) demonstrated need, as identified through the Joint External Evaluation process, the Global Health Security Index classification of health systems, national action plans for health security, Global Health Security Agenda, other risk-based assessments, and complementary or successor indicators of global health security and pandemic preparedness; and
“(ii) demonstrated commitment to transparency, including budget and global health data transparency, complying with the International Health Regulations (2005), investing in domestic health systems, and achieving measurable results;
“(E) reduce long-term reliance upon United States foreign assistance for global health security by—“(i) ensuring that United States global health assistance authorized under this subtitle is strategically planned and coordinated in a manner that delivers immediate impact and contributes to enduring results, including through efforts to enhance community capacity and resilience to infectious disease threats and emergencies; and
“(ii) ensuring partner country ownership of global health security strategies, data, programs, and outcomes and improved domestic resource mobilization, co-financing, and appropriate national budget allocations for global health security and pandemic prevention, preparedness, and response;
“(F) assist partner countries in building the technical capacity of relevant ministries, systems, and networks to prepare, execute, monitor, and evaluate national action plans for global health security and pandemic prevention, preparedness, and response that are developed with input from key stakeholders, including mechanism to enhance budget and global health data transparency, as necessary and appropriate;
“(G) support and align United States foreign assistance authorized under this subtitle with such national action plans for health security and pandemic prevention, preparedness, and response, as appropriate;
“(H) facilitate communication and collaboration, as appropriate, among local stakeholders in support of country-led strategies and initiatives to better identify and prevent health impacts related to the emergence, reemergence, and spread of zoonoses;
“(I) support the long-term success of programs by building the pandemic preparedness capacity of local organizations and institutions in target countries and communities;
“(J) develop community resilience to infectious disease threats and emergencies;
“(K) support global health budget and workforce planning in partner countries, consistent with the purposes of this subtitle, including training in financial management and budget and global health data transparency;
“(L) strengthen linkages between complementary bilateral and multilateral foreign assistance programs, including efforts of the World Bank, the World Health Organization, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and Gavi, the Vaccine Alliance, that contribute to the development of more resilient health systems and global supply chains for global health security and pandemic prevention, preparedness, and response in partner countries with the capacity, resources, and personnel required to prevent, detect, and respond to infectious disease threats; and
“(M) support innovation and partnerships with the private sector, health organizations, civil society, nongovernmental, faith-based and indigenous organizations, and health research and academic institutions to improve pandemic prevention, preparedness, and response, including for the development and deployment of effective and accessible infectious disease tracking tools, diagnostics, therapeutics, and vaccines.
“(2)Submission of strategy.—“(A)In general.—Not later than 180 days after the date of the enactment of this Act, the President, in consultation with the heads of the relevant Federal departments and agencies, shall submit the strategy required under paragraph (1) to—“(i) the appropriate congressional committees;
“(ii) the Committee on Health, Education, Labor, and Pensions of the Senate; and
“(iii) the Committee on Energy and Commerce of the House of Representatives.
“(B)
FindingsPuspan. L. 106–264, title II, § 202, Aug. 19, 2000, 114 Stat. 758, provided that: “Congress makes the following findings:“(1) Since the development of antibiotics in the 1950s, tuberculosis has been largely controlled in the United States and the Western World.
“(2) Due to societal factors, including growing urban decay, inadequate health care systems, persistent poverty, overcrowding, and malnutrition, as well as medical factors, including the HIV/AIDS epidemic and the emergence of multi-drug resistant strains of tuberculosis, tuberculosis has again become a leading and growing cause of adult deaths in the developing world.
“(3) According to the World Health Organization—“(A) in 1998, about 1,860,000 people worldwide died of tuberculosis-related illnesses;
“(B) one-third of the world’s total population is infected with tuberculosis; and
“(C) tuberculosis is the world’s leading killer of women between 15 and 44 years old and is a leading cause of children becoming orphans.
“(4) Because of the ease of transmission of tuberculosis, its international persistence and growth pose a direct public health threat to those nations that had previously largely controlled the disease. This is complicated in the United States by the growth of the homeless population, the rate of incarceration, international travel, immigration, and HIV/AIDS.
“(5) With nearly 40 percent of the tuberculosis cases in the United States attributable to foreign-born persons, tuberculosis will never be controlled in the United States until it is controlled abroad.
“(6) The means exist to control tuberculosis through screening, diagnosis, treatment, patient compliance, monitoring, and ongoing review of outcomes.
“(7) Efforts to control tuberculosis are complicated by several barriers, including—“(A) the labor intensive and lengthy process involved in screening, detecting, and treating the disease;
“(B) a lack of funding, trained personnel, and medicine in virtually every nation with a high rate of the disease;
“(C) the unique circumstances in each country, which requires the development and implementation of country-specific programs; and
“(D) the risk of having a bad tuberculosis program, which is worse than having no tuberculosis program because it would significantly increase the risk of the development of more widespread drug-resistant strains of the disease.
“(8) Eliminating the barriers to the international control of tuberculosis through a well-structured, comprehensive, and coordinated worldwide effort would be a significant step in dealing with the increasing public health problem posed by the disease.”
Progress Report on Implementation of Immunization and Oral Rehydration Promotion ProgramsPuspan. L. 99–83, title III, § 305(span), Aug. 8, 1985, 99 Stat. 215, provided that: “Each annual report required by section 634 of the Foreign Assistance Act of 1961 [22 U.S.C. 2394] shall describe the progress achieved during the preceding fiscal year in carrying out section 104(c)(3) of such Act [22 U.S.C. 2151span(c)(3)].”
Executive Documents
Delegation of FunctionsFor delegation of functions of President under this section, see Ex. Ord. No. 12163, Sept. 29, 1979, 44 F.R. 56673, as amended, set out as a note under section 2381 of this title.
