Global health compact model

(a) In general Notwithstanding any other provision of law, the Assistant Secretary for Global Health (in this section referred to as the Assistant Secretary), in consultation with the Secretary, is authorized to provide assistance for fiscal years 2026 and 2027 to partner countries that enter into global health compacts with the United States to— (1) support policies and programs that burden shift global health programs to partner countries; (2) perpetuate the wind-down of the President’s Emergency Plan for AIDS Relief (PEPFAR) under the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law 108–25); and (3) address health security and tuberculosis, malaria, HIV/AIDS, neglected tropical diseases, and any disease or additional global health assistance as determined by the Assistant Secretary. (b) Matters To be included Each global health compact under this section shall include the following: (1) A clear articulation of the interests and requests of the partner country, or nongovernmental organization or private entity, as the case may be, and the United States. (2) The proposed amount of funding to be provided under the compact and the number of years of the compact. (3) A plan for a phase-out of funding under the compact, with United States funding to be reduced each fiscal year, to enable the transition to full ownership of global health programs by the partner country by ensuring that activities under such programs will continue to be implemented by such partner countries. (4) Metrics to determine the success of the compact and benchmarks to reevaluate the continued funding of the compact at the start of each subsequent fiscal year. (5) A strategy, where applicable, to incorporate the interests and capabilities of private sector development and investment, including with respect to HIV/AIDS testing and treatment as determined by the Assistant Secretary— (A) ensuring infants born to mothers receiving prevention of mother to child transmission (PMTCT) are provided viral load testing within the intervals recommended by health standard organizations; (B) ensuring new patients on antiretroviral treatment receive a viral load test within the timing interval recommended by health standard organizations; and (C) ensuring that persons living with HIV in the country receive a viral load test within the intervals recommended by health standard organizations. (6) A provision that ensures an exemption from taxation in the partner country with respect to assistance provided by the United States under the compact. (7) An end date for the compact. (c) Form Assistance under global health compacts under this section—. (1) may be provided in the form of grants, contracts, and cooperative agreements to or with eligible entities described in subsection (d); and (2) may not be provided in the form of loans. (d) Eligible entities described (1) In general An eligible entity described in this subsection is— (A) with respect to a partner country— (i) the national government of the country; or (ii) a regional or local governmental unit of the country; or (B) a nongovernmental or nonprofit organization or private entity. (2) Level of negotiation and entry A global health compact shall be negotiated and entered into at the country-level, but components of a compact may be entered into with any eligible entity described in paragraph (1) as determined by the Assistant Secretary. (3) Priority The Assistant Secretary shall, in entering into grants, contracts, and cooperative agreements to or with nongovernmental organizations and private entities under this section, prioritize entering into grants, contracts, and cooperative agreements to or with faith-based organizations if it is in the national interest of the United States as determined by the Assistant Secretary. (4) Prohibitions A global health compact may not be entered into under this section with any of the following: (A) The countries of the People’s Republic of China, the Democratic People’s Republic of Korea, and Cuba. (B) A country the government of which the Secretary determines has repeatedly provided support for international terrorism pursuant to— (i) section 1754(c)(1)(A) of the Export Control Reform Act of 2018 (50 U.S.C. 4813(c)(1)(A)); (ii) section 620A of the Foreign Assistance Act of 1961 (22 U.S.C. 2371); (iii) section 40 of the Arms Export Control Act (22 U.S.C. 2780); or (iv) any other provision of law. (C) A country that engages in intelligence activities in the United States that are adverse to the national security interests of the United States. (D) An entity that is funded by the People’s Republic of China. (E) The African Union or any affiliated entity of the African Union, including Africa CDC or affiliated multilateral funds. (e) Application The Assistant Secretary, in consultation with the appropriate congressional committees, shall develop and recommend procedures for applications to enter into compacts under this section and to transfer existing programs to the compact framework. (f) Limitations The prohibitions on use of funds contained in paragraphs (1) through (3) of section 104(f) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(f)) shall apply to funds made available to carry out this section to the same extent and in the same manner as such prohibitions apply to funds made available to carry out chapter 1 of part I of such Act, as aligned with the most stringent of restrictions and clearest oversight provisions, determined by the Assistant Secretary. (g) Congressional notification (1) In general The Assistant Secretary shall consult with and notify the appropriate congressional committees not later than 15 days before taking any of the actions described in paragraph (2). (2) Actions described The actions described in this paragraph are— (A) commencing negotiations with a partner country to enter into a global health compact under this section; (B) entering into a global health compact under this section; and (C) terminating or reinstating assistance under a global health compact under this section. (3) Additional notification relating to entry into compact Not later than 10 days after entering into a global health compact under this section, the Assistant Secretary shall— (A) publish the text of the compact on a publicly available website of the Department; (B) provide a detailed summary of the compact and, upon request, the full text of the compact to the appropriate congressional committees; and (C) publish in the Federal Register a detailed summary of the compact and a notice of availability of the text of the compact on the website described in clause (i). (h) Transition The Assistant Secretary shall take such actions as may be necessary to provide for all United States global health programs to be carried out through global health compacts under this section. This shall be completed by the end of fiscal year 2026. (i) Report Not later than 90 days after the date of the enactment of this Act, the Assistant Secretary shall submit to the appropriate congressional committees a report that— (1) summarizes the global health foreign assistance programs being provided to partner countries; (2) includes— (A) a plan to enter into global health compacts under this section to address and carry out such global health programs of partner countries in accordance with subsection (h)(1); (B) with respect to partner countries for which subsection (h)(1) will not initially apply, a justification for such inapplicability; and (C) a plan to burden-share programs operated under the President’s Emergency Plan for AIDS Relief (PEPFAR) and authorized under the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law 108–25) to partner country ownership by reducing by a minimum of 50 percent the total amount of funds made available for such programs for the last fiscal year ending before the date of the enactment of this Act by the end of fiscal year 2028, including by ensuring that activities under such programs will continue to be implemented by such partner countries. (j) Definitions In this section— (1) the term appropriate congressional committees means— (A) the Committee on Foreign Affairs and the Committee on Appropriations of the House of Representatives; and (B) the Committee on Foreign Relations and the Committee on Appropriations of the Senate; (2) the term global health compact or compact means an agreement between the United States Government and an eligible entity to provide foreign assistance related to global health programs, which may include any global health-related issues as required by the Assistant Secretary; and (3) the term partner country means any country that is receiving or will receive United States foreign assistance for the purposes of global health programs, regardless of the dollar value of such assistance.