I 

108TH CONGRESS 

1ST SESSION H. R. 3386

To provide assistance to combat infectious diseases in Haiti and to establish 

a comprehensive health infrastructure in Haiti, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 29, 2003

Ms. LEE (for herself, Mrs. CHRISTENSEN, Mr. WYNN, Mr. PAYNE, Mr. 

THOMPSON of Mississippi, Ms. JACKSON-LEE of Texas, Mr. CUMMINGS, 

Ms. MILLENDER-MCDONALD, Mr. WEXLER, Mr. CONYERS, Mr. OWENS, 

and Ms. CORRINE BROWN of Florida) introduced the following bill; which 

was referred to the Committee on International Relations 

A BILL

To provide assistance to combat infectious diseases in Haiti 

and to establish a comprehensive health infrastructure 

in Haiti, and for other purposes.

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘New Partnership for Haiti Act of 2003’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows:

Sec. 1. Short title; table of contents. 
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TITLE I—GENERAL PROVISIONS 

Sec. 101. Findings. 

Sec. 102. Purpose. 

Sec. 103. Definitions. 

Sec. 104. Development of a comprehensive strategy. 

TITLE II—UNITED STATES ASSISTANCE FOR HAITI 

Sec. 201. Assistance for health sector development. 

Sec. 202. Assistance for health infrastructure development. 

Sec. 203. Assistance for water and sanitation infrastructure development. 

Sec. 204. Professional exchange for areas in Haiti severely affected by dilapidated physical health infrastructures.

1 TITLE I—GENERAL PROVISIONS 

2 SEC. 101. FINDINGS. 

3 Congress finds the following: 

4 (1) Haiti is the most impoverished nation in the 

5 Western Hemisphere. 

6 (2) The United Nations Joint Programme on 

7 HIV/AIDS states that Haiti accounts for 90 percent 

8 of the HIV/AIDS infections and case rates in the 

9 Caribbean. 

10 (3) HIV infections and AIDS have approached 

11 epidemic proportions in Haiti. More than 300,000 

12 infected people have been identified and deaths from 

13 HIV/AIDS have left approximately 200,000 children 

14 orphaned, while more than 12,000 children in Haiti 

15 are living with HIV/AIDS. 

16 (4) The infant and maternal mortality rate in 

17 Haiti continues to rise and only 1 in every 10,000 

18 Haitians has access to a physician. 
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1 (5) The Global Fund to Fight AIDS, Tuber2 culosis and Malaria has approved the control mecha3 nisms of the Government of Haiti, which include 

4 measures to address transparency and for disburse5 ment of grants from the Global Fund. 

6 (6) The President has included Haiti in the list 

7 of 15 countries that qualify for United States assist8 ance to combat HIV/AIDS under the United States 

9 Leadership Against HIV/AIDS, Tuberculosis, and 

10 Malaria Act of 2003. 

11 (7) The people of Haiti have a constitutional 

12 and fundamental human right to health and govern13 ment has the obligation to fulfill these rights to the 

14 level of resources available. 

15 (8) The legal minimum daily wage in Haiti is 

16 approximately $.96 but many Haitians work in the 

17 informal economy or in subsistence agriculture for 

18 $.40 or less a day. 

19 (9) 76 percent of Haiti’s children under the age 

20 of five are underweight or suffer from wasting or 

21 stunting. 

22 (10) Only 46 percent of the population has ac23 cess to safe water and only 28 percent of the popu24 lation to sanitation services. 
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1 (11) 63 percent of Haitians are undernour2 ished. As stated by the United Nations Special 

3 Rapporteur on the Right to Food: ‘‘Despite the fact 

4 that global wealth and resources [are] sufficient to 

5 provide food for everyone, some 100,000 people [die] 

6 every day of hunger or hunger-related diseases 

7 [throughout the world].’’. 

8 (12) The infant mortality rate in Haiti is ap9 proximately 76 deaths for each 1,000 live female 

10 births and 81 deaths for each 1,000 live male births. 

11 (13) Life expectancy at birth in Haiti is ap12 proximately 51 years. 

13 (14) Approximately 80 percent of Haiti’s popu14 lation lives in abject poverty. 

15 (15) Unemployment and underemployment is 

16 widespread in Haiti as evidenced by the fact that 

17 more than two-thirds of the labor force are without 

18 formal jobs. 

19 (16)(A) The Office of Technical Assistance 

20 within the Bureau of International Affairs of the 

21 Department of the Treasury has provided advisers 

22 to governments in Central and Eastern Europe and 

23 the independent states of the former Soviet Union to 

24 assist in the transition from command to market 

25 economies. 
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1 (B) In the typical mission, a Treasury Depart2 ment ‘‘resident advisor’’ provides assistance to a 

3 senior finance ministry or central bank counterpart 

4 in one of several areas: tax policy and administra5 tion, government debt issuance and management, fi6 nancial institutions policy and regulation, budget 

7 policy and management, and the prevention, detec8 tion, and prosecution of financial crimes. These resi9 dent advisers are supported by short-term experts 

10 and technicians. 

11 (17) More recently, the Department of the 

12 Treasury has addressed challenges in other parts of 

13 the world by assisting the South African Depart14 ment of Finance in restructuring its budget office 

15 and process, working in the Haitian Finance Min16 istry to improve apportionment and budget execu17 tion, and helping to resolve the banking crisis in In18 donesia. 

19 SEC. 102. PURPOSE. 

20 The purpose of this Act is to strengthen United 

21 States leadership and the effectiveness of the United 

22 States response to infectious diseases in Haiti and Haiti’s

23 struggling health sector while assisting with the rebuilding 

24 of physical infrastructure by—
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1 (1) establishing a comprehensive, integrated 

2 strategy to develop Haiti’s health infrastructure, 

3 combat HIV/AIDS and other infectious diseases, 

4 and improve coordination among relevant Federal 

5 departments and agencies and between the United 

6 States and the Government of Haiti, nongovern7 mental organizations, and other international orga8 nizations; 

9 (2) providing increased resources for United 

10 States efforts, particularly for technical assistance 

11 and training, to combat HIV/AIDS, tuberculosis, 

12 and malaria in Haiti; 

13 (3) encouraging the expansion of the inter14 national community to reengage with the Govern15 ment of Haiti and expand private sector efforts and 

16 public-private sector partnerships to establish a 

17 functional health sector in Haiti; 

18 (4) assisting and securing a system of basic 

19 water, sanitation, and other physical infrastructure; 

20 and 

21 (5) encouraging a continued exchange of knowl22 edge and professionalism between the Government of 

23 Haiti and the United States Department of the 

24 Treasury through the Department’s Office of Tech25 nical Assistance within the Bureau of International 
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1 Affairs, including by providing Department of the 

2 Treasury advisers to work to explain such concepts 

3 as budgeting and the decision making process, tax 

4 policy as a means of financing the annual govern5 ment budget, treasury bill markets to replace central 

6 bank monetization of deficits, and the banking as a 

7 system of intermediation rather than financial ac8 counting. 

9 SEC. 103. DEFINITIONS. 

10 In this Act: 

11 (1) AIDS.—The term ‘‘AIDS’’ means the ac12 quired immune deficiency syndrome. 

13 (2) APPROPRIATE CONGRESSIONAL COMMIT14 TEES.—The term ‘‘appropriate congressional com15 mittees’’ means the Committee on International Re16 lations of the House of Representatives and the 

17 Committee on Foreign Relations of the Senate. 

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

19 immunodeficiency virus, the pathogen that causes 

20 AIDS. 

21 (4) HIV/AIDS.—The term ‘‘HIV/AIDS’’ 

22 means, with respect to an individual, an individual 

23 who is infected with HIV or living with AIDS. 
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1 SEC. 104. DEVELOPMENT OF A COMPREHENSIVE STRAT2 EGY. 

3 The President shall seek to work with the Govern4 ment of Haiti, the international financial community, civil 

5 society, and other international organizations to establish 

6 a comprehensive and integrated strategy to combat infec7 tious diseases in Haiti and to establish a comprehensive 

8 health infrastructure in Haiti. 

9 TITLE II—UNITED STATES 

10 ASSISTANCE FOR HAITI 

11 SEC. 201. ASSISTANCE FOR HEALTH SECTOR DEVELOP12 MENT. 

13 (a) STATEMENT OF POLICY.—It is the policy of the 

14 United States—

15 (1) to assist in empowering the people of Haiti, 

16 particularly, women, young people and children, so17 cially, economically, and intellectually to seek health 

18 as a human right and to prevent the transmission 

19 and contraction of HIV/AIDS, tuberculosis, malaria, 

20 and other infectious and endemic diseases; and 

21 (2) to ensure that affordable effective health 

22 technologies, preventatives, and curatives are widely 

23 available to the people of Haiti. 

24 (b) ASSISTANCE.—

25 (1) IN GENERAL.—The President, acting 

26 through the Administrator of the United States 
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1 Agency for International Development, the Director 

2 of the Centers for Disease Control and Prevention, 

3 and the heads of other appropriate Federal depart4 ments and agencies, is authorized to provide assist5 ance, on such terms and conditions as the President 

6 may determine, to facilitate the development of the 

7 health sector of Haiti. 

8 (2) ACTIVITIES SUPPORTED.—Assistance pro9 vided under paragraph (1) shall, to the maximum 

10 extent practicable, be used to carry out the following 

11 activities: 

12 (A) Develop and expand the health sector 

13 in Haiti by expanding the current health infra14 structure, targeting resources toward sanitation 

15 and water improvements, and developing best 

16 practices to fight serious health conditions in 

17 the country, including HIV/AIDS, tuberculosis, 

18 and malaria. 

19 (B) Education, prevention, care, treat20 ment, support, capacity development, and other 

21 activities relating to the prevention, treatment, 

22 and control of infectious diseases. 

23 (c) AUTHORIZATION OF APPROPRIATIONS.—

24 (1) IN GENERAL.—There are authorized to be 

25 appropriated to carry out this section such sums as 
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1 may be necessary for each of the fiscal years 2004 

2 and 2005. 

3 (2) AVAILABILITY.—Amounts appropriated pur4 suant to the authorization of appropriations under 

5 paragraph (1) are authorized to remain available 

6 until expended. 

7 SEC. 202. ASSISTANCE FOR HEALTH INFRASTRUCTURE DE8 VELOPMENT. 

9 (a) ASSISTANCE.—

10 (1) IN GENERAL.—The President, acting 

11 through the Secretary of State and the United 

12 States Army Corps of Engineers, is authorized to 

13 provide assistance, on such terms and conditions as 

14 the President may determine, to facilitate the devel15 opment of the basic sanitation and transportation 

16 infrastructure of Haiti. 

17 (2) ACTIVITIES SUPPORTED.—Assistance pro18 vided under paragraph (1) shall, to the maximum 

19 extent practicable, be used to carry out the following 

20 activities: 

21 (A) Expand and further develop transpor22 tation and infrastructure projects in Haiti, in23 cluding paving of roads and the availability of 

24 a health care vehicle or establishment of an 

25 emergency transportation plan in townships or
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1 villages located more than 30 to 40 miles away 

2 from a health clinic. 

3 (B) Commission an environmental impact 

4 study focused on the cost of development and 

5 paving of primary ‘‘dirt roads’’ located up to 

6 30–40 miles away from major health clinics and 

7 provide the basic resources for the development 

8 and paving of such roads. 

9 (b) REPORT.—The President shall prepare and trans10 mit to the appropriate congressional committees a report 

11 that contains the results of the environmental impact 

12 study carried out pursuant to subsection (a)(2)(B), includ13 ing a cost analysis of carrying out the activities described 

14 in such subsection. 

15 (c) AUTHORIZATION OF APPROPRIATIONS.—

16 (1) IN GENERAL.—There are authorized to be 

17 appropriated to carry out this section such sums as 

18 may be necessary for each of the fiscal years 2004 

19 and 2005. 

20 (2) AVAILABILITY.—Amounts appropriated pur21 suant to the authorization of appropriations under 

22 paragraph (1) are authorized to remain available 

23 until expended. 
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1 SEC. 203. ASSISTANCE FOR WATER AND SANITATION INFRA2 STRUCTURE DEVELOPMENT. 

3 (a) ASSISTANCE.—

4 (1) IN GENERAL.—The President, acting 

5 through the Secretary of State and the United 

6 States Army Corps of Engineers, is authorized to 

7 provide assistance, on such terms and conditions as 

8 the President may determine, to facilitate the devel9 opment of the water and sanitation infrastructure of 

10 Haiti. 

11 (2) ACTIVITIES SUPPORTED.—Assistance pro12 vided under paragraph (1) shall, to the maximum 

13 extent practicable, be used to carry out the following 

14 activities: 

15 (A) Expand and further develop water and 

16 sanitation infrastructure projects in Haiti, in17 cluding assistance for development of sanitation 

18 and trash removal services in urban and rural 

19 areas of Haiti, development of sewage systems 

20 in areas with populations of at least 100,000 

21 people, assistance and educational resources to 

22 improve water quality and delivery, and imple23 mentation of community water reserves to be 

24 maintained by public-private partnerships. 

25 (B) Commission an environmental impact 

26 study focused on the effects of the deteriorating 
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1 water and sanitation conditions in Haiti and 

2 provide the necessary resources for the improve3 ment of such conditions. 

4 (b) REPORT.—The President shall prepare and trans5 mit to the appropriate congressional committees a report 

6 that contains the results of the environmental impact 

7 study carried out pursuant to subsection (a)(2)(B), includ8 ing a cost analysis of carrying out the activities described 

9 in such subsection and subparagraphs (C) and (D) of sub10 section (a)(2). 

11 (c) AUTHORIZATION OF APPROPRIATIONS.—

12 (1) IN GENERAL.—There are authorized to be 

13 appropriated to carry out this section such sums as 

14 may be necessary for each of the fiscal years 2004 

15 and 2005. 

16 (2) AVAILABILITY.—Amounts appropriated pur17 suant to the authorization of appropriations under 

18 paragraph (1) are authorized to remain available 

19 until expended.

20 SEC. 204. PROFESSIONAL EXCHANGE FOR AREAS IN HAITI 

21 SEVERELY AFFECTED BY DILAPIDATED 

22 PHYSICAL HEALTH INFRASTRUCTURES. 

23 (a) IN GENERAL.—The President shall establish a 

24 program to demonstrate the feasibility of facilitating the 

25 service of United States health care professionals and en-
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1 gineers in Haiti and its localities severely affected by di2 lapidated physical and health infrastructure, including but 

3 not limited to development of health clinics and health 

4 care, roads and sanitation development, and reconstruc5 tion of public facilities such as schools, hospitals, and clin6 ics. 

7 (b) REQUIREMENTS.—Participants in the program 

8 shall provide basic services through training and participa9 tion, enter into partnerships with nongovernmental orga10 nizations and the United States Army Corp of Engineers, 

11 facilitate on-the-job training for residents of the area, and 

12 serve for a period of up to 3 years. 

13 (c) ELIGIBILITY REQUIREMENTS.—Candidates shall 

14 be residents of the Unites States who are trained profes15 sional in their respective field who meets licensure require16 ments necessary to be such a professional, including but 

17 not limited to physicians, nurses, nurse practictioners, 

18 pharmacists, and other types of health care professionals, 

19 engineers, architects, and any other individual determined 

20 to be appropriate by the President. 

21 (d) RECRUITMENT.—The President shall ensure that 

22 information on the program is widely distributed, includ23 ing the distribution of information to schools and univer24 sities where professionals attain certification, hospitals, 

25 clinics, nongovernmental organizations working in the 
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1 areas of international health and development, and any 

2 other location the President deems fit. 

3 (e) COORDINATION.—Placement of participants in 

4 the program shall be coordinated with the United States 

5 Agency for International Development in countries in 

6 which the Agency is conducting such programs. Overall 

7 placement of participants in the program shall be made 

8 by the President or his designee. 

9 (f) INCENTIVES.—The President may offer such in10 centives as the President determines to be necessary to 

11 encourage individuals to participate in the program, such 

12 as partial payment of principal, interest, and related ex13 penses on government and commercials loans for edu14 cational expenses relating to professional training in their 

15 respective fields, and where possible, deferment of repay16 ments on such loans, the provision of retirement benefits 

17 that would otherwise jeopardize participation in the pro18 gram, and other incentives. 

19 (g) REPORT.—Not later than 18 months after the 

20 date of enactment of the Act, the President shall transmit 

21 to the appropriate congressional committees a report on 

22 steps taken to establish the program, including—

23 (1) the process of recruitment, including the 

24 venues for recruitment, the number of candidates re-
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1 cruited, the incentives offered, if any, and the cost 

2 of those incentives; 

3 (2) the process, including the criteria used, for 

4 the selection of participants; 

5 (3) the number of participants placed, the local6 ity in which they were placed, and why those profes7 sionals were selected for that particular region of 

8 Haiti; and 

9 (4) the potential for expansion of the program. 

10 (h) AUTHORIZATION OF APPROPRIATIONS.—

11 (1) IN GENERAL.—There are authorized to be 

12 appropriated to carry out this section such sums as 

13 may be necessary for each of the fiscal years 2004 

14 and 2005. 

15 (2) AVAILABILITY.—Amounts appropriated pur16 suant to the authorization of appropriations under 

17 paragraph (1) are authorized to remain available 

18 until expended.

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