I 

108TH CONGRESS 

1ST SESSION H. R. 1857

To authorize assistance to combat the growing HIV/AIDS problem in 

countries in sub-Saharan Africa and the Caribbean. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 29, 2003

Mr. HASTINGS of Florida introduced the following bill; which was referred to 

the Committee on International Relations 

A BILL

To authorize assistance to combat the growing HIV/AIDS 

problem in countries in sub-Saharan Africa and the Caribbean.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Humanitarian Assist5 ance to Combat HIV/AIDS in sub-Saharan Africa and the 

6 Caribbean and National Security Act of 2003’’. 

7 SEC. 2. FINDINGS. 

8 Congress makes the following findings: 

9 (1) The National Security Strategy of the 

10 United States, dated September 17, 2002, states: 
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1 ‘‘[I]n Africa, promise and opportunity sit side-by2 side with disease, war and desperate poverty. This 

3 threatens both a core value of the United States pre4 serving human dignity and our strategic priority 

5 combating global terror. American interests and 

6 American principles, therefore, lead in the same di7 rection: we will work with others for an African con8 tinent that lives in liberty, peace, and growing pros9 perity.’’. 

10 (2) On March 19, 2002, the Director of Central 

11 Intelligence testified before Congress that ‘‘[T]he 

12 chronic problems of sub-Saharan Africa make it, too, 

13 fertile ground for direct and indirect threats to 

14 United States interests. Governments without ac15 countability and natural disasters have left Africa 

16 with the highest concentration of human misery in 

17 the world.’’. 

18 (3) Sub-Saharan Africa has been far more se19 verely affected by HIV/AIDS than any other part of 

20 the world. In fact, AIDS has surpassed malaria as 

21 the leading cause of death in sub-Saharan Africa, 

22 and it kills many times more people than Africa’s 

23 armed conflicts. 

24 (4) Africa, where an estimated 3,500,000 peo25 ple were newly infected with HIV in 2002, has ap-
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1 proximately 10 percent of the world’s population but 

2 more than 70 percent of the worldwide total of peo3 ple infected with HIV. 

4 (5) In November 2002, the Joint United Na5 tions Programme on HIV/AIDS (UNAIDS) reported 

6 that in 2002, 29,400,000 people were living with 

7 HIV/AIDS in sub-Saharan Africa, an increase from 

8 28,500,000 people in 2001. 

9 (6) At the end of 2001, an estimated 

10 21,500,000 Africans had lost their lives to AIDS, in11 cluding an estimated 2,200,000 individuals who died 

12 in that year. UNAIDS estimates that by 2020, an 

13 additional 55,000,000 Africans will lose their lives to 

14 the epidemic. 

15 (7) The HIV/AIDS epidemic in Africa is having 

16 a much greater impact on children than is the case 

17 in other parts of the world. 

18 (8) According to UNAIDS, more than 600,000 

19 African infants become infected with HIV each year 

20 through mother-to-child transmission, either at birth 

21 or through breast-feeding. These children have short 

22 life expectancies, and the number currently alive 

23 may be about 1,000,000 children. 

24 (9) In 2001, an estimated 11,000,000 children 

25 who became orphans by AIDS were living in Africa. 
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1 (10) Because of the stigma attached to AIDS, 

2 children who become orphans by AIDS are at high 

3 risk for being malnourished, abused, and denied an 

4 education. 

5 (11) According to UNAIDS, women make up 

6 an estimated 58 percent of the HIV-positive adult 

7 population in sub-Saharan Africa, as compared to 

8 50 percent of the HIV-positive adult population 

9 worldwide. 

10 (12) Young women are particularly at risk. In 

11 2001, an estimated 6 to 11 percent of African 

12 women aged 15 to 24 were HIV-positive, compared 

13 to 3 to 6 percent of young men. 

14 (13)(A) The HIV-infection rate among adults is 

15 approximately 8.8 percent in Africa, compared with 

16 1.2 percent worldwide. The HIV/AIDS epidemic in 

17 sub-Saharan Africa is a major component of this Af18 rican crisis. 

19 (B) In 7 sub-Saharan African countries, 20 

20 percent or more of the adult population is infected 

21 with HIV, and the rate has reached 38.8 percent in 

22 Botswana. 

23 (C) Moreover, in Cameroon, a West African 

24 country, the adult HIV-infection rate has increased 

25 from 4.7 percent in 1996 to 11.8 percent in 2001. 
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1 (D) In Nigeria, with a population that exceeds 

2 125,000,000, an estimated 5.8 percent of adults 

3 were HIV-positive in 2001, and infection rates in 

4 some areas of Nigeria have reached levels seen in 

5 neighboring Cameroon. 

6 (14) Nongovernmental organizations working in 

7 Africa, donor governments, and African governments 

8 have responded to the HIV/AIDS epidemic primarily 

9 by attempting to reduce the number of new HIV in10 fections, and to some degree, by trying to ameliorate 

11 the damage done by AIDS to families, societies, and 

12 economies. 

13 (15)(A) A 1999 United Nations study found 

14 that community-based organizations, sometimes with 

15 the support of nongovernmental organizations, have 

16 emerged to supply additional labor, home care for 

17 the sick, house repair, and other services to AIDS18 afflicted families. 

19 (B) Programs and projects aimed at combating 

20 the epidemic typically provide information on how 

21 HIV is spread, and on how it can be avoided, 

22 through the media, posters, lectures, and skits. 

23 AIDS awareness programs can be found in many 

24 African schools and increasingly in the workplace, 

25 where employers are recognizing their interest in re-
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1 ducing the HIV-infection rate among their employ2 ees. 

3 (16) Public-private partnerships have also be4 come an important vehicle for responding to the 

5 HIV/AIDS pandemic in Africa. 

6 (17)(A) The United States Agency for Inter7 national Development estimates that in fiscal year 

8 2000, all donors and lending agencies, together with 

9 African governments, spent approximately 

10 $500,000,000 in combating HIV/AIDS, but donors 

11 have committed to increasing this amount. 

12 (B) On July 23, 2000, leaders at the G–8 world 

13 economic summit in Okinawa, Japan, pledged to re14 duce the number of young people infected with the 

15 HIV virus by 25 percent. 

16 (18) The World Health Organization estimates 

17 that a pledge by the G–8 countries to combat ma18 laria and tuberculosis, and reduce the HIV virus in 

19 Africa by 25 percent, would cost at least 

20 $5,000,000,000 per year for 5 years. The World 

21 Bank launched its Multi-Country HIV/AIDS Pro22 gram (MAP) for Africa in September 2000, and a 

23 World Bank official said in October 2002 that to 

24 date, $1,000,000,000 had been committed. 
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1 (19) On December 9, 2001, Peter Piot, Execu2 tive Director of UNAIDS, told an international 

3 AIDS conference in Burkina Faso that assistance to 

4 fight HIV/AIDS in sub-Saharan Africa should be in5 creased ‘‘many-fold’’, and that the region requires 

6 $5,000,000,000 per year to confront the HIV/AIDS 

7 pandemic. 

8 (20) While the AIDS epidemic in Caribbean 

9 countries does not compare to the severity of the 

10 epidemic in Africa, there are an estimated 420,000 

11 people living with AIDS in Caribbean countries. 

12 Moreover, the HIV/AIDS adult prevalence rate in 

13 several countries in the Caribbean is among the 

14 highest outside of sub-Saharan Africa. 

15 (21) Caribbean countries with the highest prev16 alence of HIV infection rates are Haiti and the Ba17 hamas, with adult HIV infection rates at more than 

18 4 percent. Overall, an estimated 1 out of 50 people 

19 in Caribbean countries is infected with HIV. Haiti 

20 and the Dominican Republic, with a combined 

21 340,000 adults and children living with HIV/AIDS, 

22 account for approximately 87 percent of the infected 

23 population of Caribbean countries. As noted by the 

24 United States Agency for International Develop25 ment, Haiti’s poverty, civil conflict, and unstable 
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1 governance have contributed to the rapid spread of 

2 AIDS. In some urban areas of Haiti, HIV infection 

3 rates are at more than 10 percent of the population. 

4 (22) In Caribbean countries, access to treat5 ment and care is non-existent for many infected with 

6 HIV. Nevertheless, many projects demonstrate that 

7 even in severely impoverished countries with little 

8 health infrastructure, there can be sustained treat9 ment for people with HIV/AIDS. 

10 SEC. 3. SENSE OF CONGRESS. 

11 It is the sense of Congress that—

12 (1) effectively addressing the HIV/AIDS prob13 lem in countries in sub-Saharan Africa and the Car14 ibbean is a moral issue of the greatest magnitude 

15 and is in the national security interest of the United 

16 States; and 

17 (2) the President should enter into direct talks 

18 with the governments of other member countries of 

19 the G–8 and member countries of the European 

20 Union to increase the amount of financial support to 

21 combat the HIV/AIDS pandemic in sub-Saharan Af22 rica and the Caribbean. 
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1 SEC. 4. GRANTS TO COMBAT HIV/AIDS IN SUB-SAHARAN AF2 RICA AND CARIBBEAN COUNTRIES. 

3 The Administrator of the United States Agency for 

4 International Development is authorized to award grants 

5 to nongovernmental organizations for the prevention, 

6 treatment, and control of HIV/AIDS in countries in sub7 Saharan Africa and Caribbean countries, including by ex8 panding activities to prevent the mother-to-child trans9 mission of HIV by providing treatment, medical care, and 

10 support services to HIV-infected parents and their chil11 dren. In carrying out the preceding sentence, it is the 

12 sense of Congress that the Secretary of Health and 

13 Human Services, acting through the Director of the Cen14 ters for Disease Control and Prevention, should provide 

15 appropriate medical and technical expertise to the Admin16 istrator and recipient governments. 

17 SEC. 5. APPOINTMENT OF HEALTH OFFICERS TO UNITED 

18 STATES EMBASSIES IN SUB-SAHARAN AFRICA 

19 AND THE CARIBBEAN. 

20 The Secretary of State, in conjunction with the Sec21 retary of Health and Human Services, is authorized to ap22 point to the country team in each United States embassy 

23 in sub-Saharan Africa and the Caribbean a health officer 

24 to advise the United States Ambassador and assist in co25 ordination of the effort to combat HIV/AIDS with local 

26 governments. 
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1 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

2 (a) IN GENERAL.—There are authorized to be appro3 priated to carry out this Act $500,000,000 for each of 

4 the fiscal years 2004 through 2008. 

5 (b) AVAILABILITY.—Amounts appropriated pursuant 

6 to the authorization of appropriations under subsection (a) 

7 are authorized to remain available until expended. 

8 SEC. 7. DEFINITIONS. 

9 In this Act: 

10 (1) AIDS.—The term ‘‘AIDS’’ means acquired 

11 immune deficiency syndrome. 

12 (2) CARIBBEAN COUNTRIES.—The term ‘‘Carib13 bean countries’’ means the countries described in 

14 section 212(b) of the Caribbean Basin Economic Re15 covery Act (19 U.S.C. 2702(b)). 

16 (3) HIV.—The term ‘‘HIV’’ means the human 

17 immunodeficiency virus, the pathogen that causes 

18 AIDS. 

19 (4) HIV/AIDS.—The term ‘‘HIV/AIDS’’ means, with 

20 respect to an individual, an individual who is infected with 

21 HIV or living with AIDS. 

22 (5) COUNTRIES IN SUB-SAHARAN AFRICA.—The 

23 term ‘‘countries in sub-Saharan Africa’’ has the 

24 meaning given such term in section 107 of the Afri25 can Growth and Opportunity Act (19 U.S.C. 3706).

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