Sec. 205. United States Government actions to detect and prevent global pandemics
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In each country in which the United States Government is implementing at least three United States Government supported health programs, missions of the United States Agency for International Development, in consultation with relevant host country entities, shall— conduct an assessment that is similar to the Health Systems Assessment Approach, that— takes a comprehensive view of the constraints in the health system that prevent the achievement of desired outcomes of United States Government supported health programs in the country from multiple perspectives; and identifies the best opportunities for improving health systems performance for the achievement of multiple United States Government supported health programs, including obstacles to health service delivery; map the resources of the country and other donors in the health sector; and develop and implement a new or revised 5-year strategy for United States assistance, based on the results of the assessment described in subparagraph (A), to strengthen the country’s health system that— provides a framework for achieving such strategy; identifies key areas for United States Government investments in the sector; specifies the role of health programs undertaken by each Federal Government agency operating in the country in achieving such strategy; and includes cost analysis, benchmarks, outputs, and desired outcomes.
The strategy developed pursuant to paragraph
(1)shall— be informed by the assessment required under paragraph (1)(A); incorporate the health security priorities identified under the country’s Joint External Evaluation, if applicable; outline how assistance provided by each Federal Government agency operating in the country will support the development and implementation of a national action plan; identify potential obstacles to the implementation of the strategy, such as issues relating to governance of an effective health system at all levels of the country’s public health systems, especially with respect to governing bodies and councils at the provincial, district, and community levels; identify bureaucratic barriers and inefficiencies, including poor linkages between government ministries and between ministries and donor agencies, and the extent of any corruption; include proposals for sustainable financing mechanisms for health systems; identify barriers to building and retaining an effective frontline health workforce with key global health security capacities laid out by the International Health Regulations (2005), and include recommendations for host country actions to achieve a workforce that conforms with the World Health Organization’s recommendation for at least 44.5 doctors, nurses, and midwives per every 10,000 people; identify deficiencies in information systems and communication technologies that prevent linkages at all levels of the health system delivery and medical supply systems; identify weaknesses in supply chain and procurement systems and practices, and recommend ways to improve the efficiency, transparency, and effectiveness of such systems and practices; identify obstacles to health service access and quality and improved health outcomes for women and girls, and for the poorest and most vulnerable, including a lack of social support and other underlying causes, and recommendations for how to overcome such obstacles; include plans for integrating innovations in health technologies, services, and systems; identify barriers to health literacy, community engagement, and patient empowerment, and recommendations for overcoming such barriers; and describe the role of the private sector and nongovernmental health providers, including community groups engaged in health promotion and mutual assistance and faith-based institutions engaged in health delivery, including the extent to which the local population utilizes such health services. In developing a strategy pursuant to paragraph (1), each United States Agency for International Development mission shall consult with— relevant host government institutions; professional associations; patient groups; civil society organizations (including international nongovernmental organizations with relevant expertise in program implementation); and the private sector. The President, acting through the United States Agency for International Development mission director in each country described in subsection (a)(1), shall— ensure that not less than five percent of the amounts appropriated to carry out each United States Government supported health program in countries identified in subsection (a)(1) is provided to carry out activities identified in paragraph (2); coordinate the implementation of programs and activities undertaken by relevant Federal agencies, bureaus, and offices to ensure that United States Government supported health programs— improve a country’s ability to detect, prevent, and respond to infectious disease outbreaks, such as COVID–19 and Ebola; strengthen, in an integrated manner, cross-cutting health systems of host countries that impact more than one health program; are designed to make sustained improvements in health outcomes and health security, such that health systems are broadly available, particularly to people with poor access to quality health services; complement, or are aligned with, to the extent applicable, national strategies to strengthen health systems; utilize, to the fullest extent practicable, service delivery platforms that do not fragment care or build parallel or disease-specific procurement processes or supply chains; complement, or are aligned with, efforts by the host government— to prevent, detect, and respond to infectious disease outbreaks; to provide appropriate training to health system professionals, including managers, administrators, frontline health workers, paraprofessionals, and professionals; and to coordinate health programs and activities with multilateral and bilateral donors to ensure that such activities support efforts to strengthen the health system; help host countries address the issues that create barriers to the retention of skilled health care professionals; help national governments to devise implementable options for mobilizing sustainable domestic and external resources and financing for health systems strengthening; and encourage the coordination of programs and activities with multilateral and bilateral donors; provide funds to local health organizations, whenever practicable, by contracting directly with such organizations; ensure that contractors and grantees receiving United States Government funds for the purpose of carrying out health-related activities— build local capacity through such activities; and subcontract, to the fullest extent practicable and on an increasing basis, with local health organizations; and encourage civil society and the private sector to collaborate with donors and host country governments— to increase the sense of ownership by citizens; and to improve program and activity effectiveness. The Administrator of the United States Agency for International Development, in coordination with the Secretary of State, shall lead interagency efforts to work with the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Gavi, the Vaccine Alliance; bilateral donors; and other relevant multilateral and international organizations and stakeholders to develop— shared core indicators for strengthened health security and health systems; standardized reporting requirements among donors to reduce the burden placed on host countries; structures for joint assessments, plans, auditing, and consultations; and a regularized approach to coordination on health systems strengthening. The Office of Health Systems in the Bureau for Global Health at the United States Agency for International Development, in consultation with the working group established under subsection (e), shall— issue technical guidance to carry out the strategy and elements described in this section; and determine whether approaches carried out at the country level with combined resources in pursuit of country level health systems strategies comply with the guidance issued pursuant to subparagraph (A). Not later than one year after the date of enactment of this Act, the President shall submit a report to the appropriate congressional committees that describes the implementation of this subsection. The country strategies developed under subsection
(a)shall include a section that— discusses the role of the private sector (including corporate, local, and international organizations with relevant expertise); and identifies opportunities for the private sector— to accelerate research and development of innovative health and information technology, and to offer training related to its use; to contribute to improvements in health administration and management processes; to improve system efficiency; to develop training related to clinical practice guidelines; and to help countries develop systems for documenting outcomes and achievements related to activities undertaken to strengthen the health sector. Not later than 180 days after the date of enactment of this Act, the Administrator of the United States Agency for International Development shall submit a plan to the appropriate congressional committees that— addresses how the Global Development Alliance will partner with the private sector to increase health security and health systems strengthening activities, including shortening the period during which companies may register; and includes recommendations for streamlining and improving means for partnering with the private sector— to detect and respond to pandemic diseases; and to strengthen health systems and health security. The President shall convene an interagency working group to coordinate efforts and track progress on United States Government activities related to health systems strengthening, and shall appoint the Administrator of the United States Agency for International Development to lead the working group. The working group shall be composed of representatives of the Department of State, the Department of Health and Human Services, including the Centers for Disease Control and Prevention, relevant United States credit authorities, and other relevant Federal agencies. The Working Group shall meet not less frequently than quarterly— to establish goals and measurable targets and to develop metrics for measuring progress in health system strengthening by United States Government supported health programs, including— increasing human resources for health and for reduced attrition in the health sector; improving supply chain systems, including reducing drug and health commodity stockouts; improving surveillance capacity; improving health information systems; and strengthening health systems outcomes, as measured by essential proxy measures, such as resource optimization, delivery of essential services, and population coverage; to ensure that activities carried out through the President’s Emergency Plan for AIDS Relief, the President’s Malaria Initiative, and other bilateral health funding are meeting the minimum requirements for, and are wholly aligned with, supporting and complementing national strategies on health systems strengthening, as applicable; to ensure coordination with the Global Health Security Agenda; to ensure coordination with other donors and multilateral organizations, including the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Gavi, the Vaccine Alliance; and the Global Financing Facility; and to seek regular input from civil society and the private sector regarding best practices for strengthening health systems at the country level. Members of the Working Group shall provide the Administrator of the United States Agency for International Development with any requested data and information that is related to health system strengthening activities and programs. Not later than 90 days after the date of the enactment of this Act, the Administrator of the United States Agency for International Development shall submit a report to the appropriate congressional committees that identifies— the members of the Working Group; the Working Group’s plans to carry out the duties described in paragraph (2); and the countries in which such duties will be carried out. Not later than one year after submission of the initial report under subparagraph (A), and annually thereafter for the next five years, the Administrator of the United States Agency for International Development shall submit a report to the appropriate congressional committees that describes, with respect to the reporting period— the progress achieved in strengthening health systems; and the amount of funding from the President’s Emergency Plan for AIDS Relief, the President’s Malaria Initiative, Maternal and Child Health, Neglected Tropical Diseases, Nutrition, Tuberculosis, Family Planning, Pandemic Preparedness, and other United States Government supported health programs that was spent on strengthening health systems in cross cutting ways. Amounts appropriated by this Act and amounts appropriated for purposes of carrying out section 104 of the Foreign Assistance Act of 1961 ( 22 U.S.C. 2151b ) may be used to carry out the activities described in subsections
(a)and (b).
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- 22 USC 2151b
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Sec. 205
United States Government actions to detect and prevent global pandemics
Cite22 USC 2151b
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