II

107TH CONGRESS

1ST SESSION S. 1120

To amend the Foreign Assistance Act of 1961 to increase the authorization

of appropriations for fiscal year 2002, and to authorize appropriations

for fiscal year 2003, to combat HIV and AIDS, and for other purposes.

IN THE SENATE OF THE UNITED STATES

JUNE 28, 2001

Mrs. BOXER (for herself and Mr. SMITH of Oregon) introduced the following

bill; which was read twice and referred to the Committee on Foreign Relations

A BILL

To amend the Foreign Assistance Act of 1961 to increase

the authorization of appropriations for fiscal year 2002,

and to authorize appropriations for fiscal year 2003,

to combat HIV and AIDS, 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.

4 This Act may be cited as the ‘‘Global AIDS Research

5 and Relief Act of 2001’’.

6 SEC. 2. DEFINITIONS.

7 In this Act:
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1 (1) AIDS.—The term ‘‘AIDS’’ means the ac2 quired immune deficiency syndrome.

3 (2) ASSOCIATION.—The term ‘‘Association’’

4 means the International Development Association.

5 (3) BANK.—The term ‘‘Bank’’ or ‘‘World

6 Bank’’ means the International Bank for Recon7 struction and Development.

8 (4) HIV.—The term ‘‘HIV’’ means the human

9 immunodeficiency virus, the pathogen, which causes

10 AIDS.

11 (5) HIV/AIDS.—The term ‘‘HIV/AIDS’’

12 means, with respect to an individual, an individual

13 who is infected with HIV or living with AIDS.

14 SEC. 3. FINDINGS AND PURPOSES.

15 (a) FINDINGS.—Congress makes the following find16 ings:

17 (1) According to the Surgeon General of the

18 United States, the epidemic of human immuno19 deficiency virus/acquired immune deficiency syn20 drome (HIV/AIDS) will soon become the worst epi21 demic of infectious disease in recorded history,

22 eclipsing both the bubonic plague of the 1300s and

23 the influenza epidemic of 1918–1919 which killed

24 more than 20,000,000 people worldwide.
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1 (2) According to the Joint United Nations Pro2 gramme on HIV/AIDS (UNAIDS), more than

3 36,100,000 people in the world today are living with

4 HIV/AIDS, of which approximately 95 percent live

5 in the developing world.

6 (3) UNAIDS data shows that among children

7 age 15 and under worldwide, more than 4,300,000

8 have died from AIDS, more than 1,400,000 are liv9 ing with the disease; and in 1 year alone—2000—

10 an estimated 600,000 became infected, of which over

11 90 percent were babies born to HIV-positive women.

12 (4) Although sub-Saharan Africa has only 10

13 percent of the world’s population, it is home to more

14 than 25,300,000—roughly 70 percent—of the

15 world’s HIV/AIDS cases.

16 (5) Worldwide, there have already been an esti17 mated 21,800,000 deaths because of HIV/AIDS, of

18 which more than 80 percent occurred in sub-Saha19 ran Africa.

20 (6) According to UNAIDS, by the end of 1999,

21 13,200,000 children have lost at least one parent to

22 AIDS, including 12,100,000 children in sub-Saharan

23 Africa, and are thus considered AIDS orphans.

24 (7) At current infection and growth rates for

25 HIV/AIDS, the National Intelligence Council esti-
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1 mates that the number of AIDS orphans worldwide

2 will increase dramatically, potentially increasing

3 threefold or more in the next 10 years, contributing

4 to economic decay, social fragmentation, and polit5 ical destabilization in already volatile and strained

6 societies. Children without care or hope are often

7 drawn into prostitution, crime, substance abuse, or

8 child soldiery.

9 (8) The discovery of a relatively simple and in10 expensive means of interrupting the transmission of

11 HIV from an infected mother to the unborn child—

12 namely with nevirapine (NVP), which costs $4 a

13 tablet—has created a great opportunity for an un14 precedented partnership between the United States

15 Government and the governments of Asian, African,

16 and Latin American countries to reduce mother-to17 child transmission (also known as ‘‘vertical trans18 mission’’) of HIV.

19 (9) According to UNAIDS, if implemented this

20 strategy will decrease the proportion of orphans that

21 are HIV-infected and decrease infant and child mor22 tality rates in these developing regions.

23 (10) A mother-to-child antiretroviral drug strat24 egy can be a force for social change, providing the

25 opportunity and impetus needed to address often
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1 longstanding problems of inadequate services and

2 the profound stigma associated with HIV-infection

3 and the AIDS disease. Strengthening the health in4 frastructure to improve mother-and-child health,

5 antenatal, delivery, and postnatal services, and cou6 ples counseling generates enormous spillover effects

7 toward combating the AIDS epidemic in developing

8 regions.

9 (11) A January 2000 United States National

10 Intelligence Estimate (NIE) report on the global in11 fectious disease threat concluded that the economic

12 costs of infectious diseases—especially HIV/AIDS—

13 are already significant and could reduce GDP by as

14 much as 20 percent or more by 2010 in some sub15 Saharan African nations.

16 (12) The HIV/AIDS epidemic is of increasing

17 concern in other regions of the world, with UNAIDS

18 estimating that there are more than 5,800,000 cases

19 in South and Southeast Asia, that the rate of HIV

20 infection in the Caribbean is second only to sub-Sa21 haran Africa, and that HIV infections have doubled

22 in just 2 years in the former Soviet Union.

23 (13) Russia is the new ‘‘hot spot’’ for the pan24 demic and more Russians are expected to be diag-
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1 nosed with HIV/AIDS by the end of 2001 than all

2 cases from previous years combined.

3 (14) Despite the discouraging statistics on the

4 spread of HIV/AIDS, some developing nations—

5 such as Uganda, Senegal, and Thailand—have im6 plemented prevention programs that have substan7 tially curbed the rate of HIV infection.

8 (15) Accordingly, United States financial sup9 port for medical research, education, and disease

10 containment as a global strategy has beneficial rami11 fications for millions of Americans and their families

12 who are affected by this disease, and the entire pop13 ulation, which is potentially susceptible.

14 (b) PURPOSES.—The purposes of this Act are to—

15 (1) help prevent human suffering through the

16 prevention, diagnosis, and treatment of HIV/AIDS;

17 and

18 (2) help ensure the viability of economic devel19 opment, stability, and national security in the devel20 oping world by advancing research to—

21 (A) understand the causes associated with

22 HIV/AIDS in developing countries; and

23 (B) assist in the development of an AIDS

24 vaccine.
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1 SEC. 4. ADDITIONAL ASSISTANCE AUTHORITIES TO COM2 BAT HIV AND AIDS.

3 Paragraphs (4) through (6) of section 104(c) of the

4 Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)) are

5 amended to read as follows:

6 ‘‘(4)(A) Congress recognizes the growing inter7 national dilemma of children with the human im8 munodeficiency virus (HIV) and the merits of inter9 vention programs aimed at this problem. Congress

10 further recognizes that mother-to-child transmission

11 prevention strategies can serve as a major force for

12 change in developing regions, and it is, therefore, a

13 major objective of the foreign assistance program to

14 control the acquired immune deficiency syndrome

15 (AIDS) epidemic.

16 ‘‘(B) The agency primarily responsible for ad17 ministering this part shall—

18 ‘‘(i) coordinate with UNAIDS, UNICEF,

19 WHO, national and local governments, other

20 organizations, and other Federal agencies to de21 velop and implement effective strategies to pre22 vent vertical transmission of HIV; and

23 ‘‘(ii) coordinate with those organizations to

24 increase intervention programs and introduce

25 voluntary counseling and testing, antiretroviral
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1 drugs, replacement feeding, and other strate2 gies.

3 ‘‘(5)(A) Congress expects the agency primarily

4 responsible for administering this part to make the

5 human immunodeficiency virus (HIV) and the ac6 quired immune deficiency syndrome (AIDS) a pri7 ority in the foreign assistance program and to un8 dertake a comprehensive, coordinated effort to com9 bat HIV and AIDS.

10 ‘‘(B) Assistance described in subparagraph (A)

11 shall include help providing—

12 ‘‘(i) primary prevention and education;

13 ‘‘(ii) voluntary testing and counseling;

14 ‘‘(iii) medications to prevent the trans15 mission of HIV from mother to child;

16 ‘‘(iv) programs to strengthen and broaden

17 health care systems infrastructure and the ca18 pacity of health care systems in developing

19 countries to deliver HIV/AIDS pharmaceuticals,

20 prevention, and treatment to those afflicted

21 with HIV/AIDS; and

22 ‘‘(v) care for those living with HIV or

23 AIDS.

24 ‘‘(6)(A) In addition to amounts otherwise avail25 able for such purpose, there is authorized to be ap-
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1 propriated to the President $600,000,000 for each

2 of the fiscal years 2002 and 2003 to carry out para3 graphs (4) and (5).

4 ‘‘(B) Of the funds authorized to be appro5 priated under subparagraph (A), not less than 65

6 percent is authorized to be available through United

7 States and foreign nongovernmental organizations,

8 including private and voluntary organizations, for9 profit organizations, religious affiliated organiza10 tions, educational institutions, and research facili11 ties.

12 ‘‘(C)(i) Of the funds authorized to be appro13 priated by subparagraph (A), priority should be

14 given to programs that address the support and edu15 cation of orphans in sub-Saharan Africa, including

16 AIDS orphans and prevention strategies for vertical

17 transmission referred to in paragraph (4)(A).

18 ‘‘(ii) Assistance made available under this sub19 section, and assistance made available under chapter

20 4 of part II to carry out the purposes of this sub21 section, may be made available notwithstanding any

22 other provision of law that restricts assistance to

23 foreign countries.

24 ‘‘(D) Of the funds authorized to be appro25 priated by subparagraph (A), not more than 7 per-
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1 cent may be used for the administrative expenses of

2 the agency primarily responsible for carrying out

3 this part of this Act in support of activities de4 scribed in paragraphs (4) and (5).

5 ‘‘(E) Funds appropriated under this paragraph

6 are authorized to remain available until expended.’’.

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