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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1545 Enrolled Bill (ENR)]

        S.1545

                     One Hundred Thirteenth Congress

                                 of the

                        United States of America

                          AT THE FIRST SESSION

          Begun and held at the City of Washington on Thursday,
           the third day of January, two thousand and thirteen

                                 An Act

 
    To extend authorities related to global HIV/AIDS and to promote 
                  oversight of United States programs.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
    This Act may be cited as the ``PEPFAR Stewardship and Oversight Act 
of 2013''.
SEC. 2. INSPECTOR GENERAL OVERSIGHT.
    Section 101(f)(1) of the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7611(f)(1)) is 
amended--
        (1) in subparagraph (A), by striking ``5 coordinated annual 
    plans for oversight activity in each of the fiscal years 2009 
    through 2013'' and inserting ``coordinated annual plans for 
    oversight activity in each of the fiscal years 2009 through 2018''; 
    and
        (2) in subparagraph (C)--
            (A) in clause (ii)--
                (i) in the heading, by striking ``Subsequent'' and 
            inserting ``2010 through 2013''; and
                (ii) by striking ``the last four plans'' and inserting 
            ``the plans for fiscal years 2010 through 2013''; and
            (B) by adding at the end the following new clause:
                ``(iii) 2014 plan.--The plan developed under 
            subparagraph (A) for fiscal year 2014 shall be completed 
            not later than 60 days after the date of the enactment of 
            the PEPFAR Stewardship and Oversight Act of 2013.
                ``(iv) Subsequent plans.--Each of the last four plans 
            developed under subparagraph (A) shall be completed not 
            later than 30 days before each of the fiscal years 2015 
            through 2018, respectively.''.
SEC. 3. ANNUAL TREATMENT STUDY.
    (a) Annual Study; Message.--Section 101(g) of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7611(g)) is amended--
        (1) in paragraph (1), by striking ``through September 30, 
    2013'' and inserting ``through September 30, 2019'';
        (2) by redesignating paragraph (2) as paragraph (3);
        (3) by inserting after paragraph (1) the following new 
    paragraph:
        ``(2) 2013 through 2018 studies.--The studies required to be 
    submitted by September 30, 2014, and annually thereafter through 
    September 30, 2018, shall include, in addition to the elements set 
    forth under paragraph (1), the following elements:
            ``(A) A plan for conducting cost studies of United States 
        assistance under section 104A of the Foreign Assistance Act of 
        1961 (22 U.S.C. 2151b-2) in partner countries, taking into 
        account the goal for more systematic collection of data, as 
        well as the demands of such analysis on available human and 
        fiscal resources.
            ``(B) A comprehensive and harmonized expenditure analysis 
        by partner country, including--
                ``(i) an analysis of Global Fund and national partner 
            spending and comparable data across United States, Global 
            Fund, and national partner spending; or
                ``(ii) where providing such comparable data is not 
            currently practicable, an explanation of why it is not 
            currently practicable, and when it will be practicable.''; 
            and
        (4) by adding at the end the following new paragraph:
        ``(4) Partner country defined.--In this subsection, the term 
    `partner country' means a country with a minimum United States 
    Government investment of HIV/AIDS assistance of at least $5,000,000 
    in the prior fiscal year.''.
SEC. 4. PARTICIPATION IN THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS, 
AND MALARIA.
    (a) Limitation.--Section 202(d)(4) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 
7622(d)(4)) is amended--
        (1) in subparagraph (A)--
            (A) in clause (i), by striking ``2013'' and inserting 
        ``2018'';
            (B) in clause (ii)--
                (i) by striking ``2013'' and inserting ``2018''; and
                (ii) by striking the last two sentences; and
            (C) in clause (vi), by striking ``2013'' and inserting 
        ``2018''; and
        (2) in subparagraph (B)--
            (A) by striking ``under this subsection'' each place it 
        appears;
            (B) in clause (ii), by striking ``pursuant to the 
        authorization of appropriations under section 401'' and 
        inserting ``to carry out section 104A of the Foreign Assistance 
        Act of 1961''; and
            (C) in clause (iv), by striking ``2013'' and inserting 
        ``2018''.
    (b) Withholding Funds.--Section 202(d)(5) of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7622(d)) is amended by--
        (1) in paragraph (5)--
            (A) by striking ``2013'' and inserting ``2018'';
            (B) in subparagraph (C)--
                (i) by inserting ``in an open, machine readable 
            format'' after ``site'';
                (ii) by amending clause (v) to read as follows:
                ``(v) a regular collection, analysis, and reporting of 
            performance data and funding of grants of the Global Fund, 
            which covers all principal recipients and all subrecipients 
            on the fiscal cycle of each grant, and includes the 
            distribution of resources, by grant and principal recipient 
            and subrecipient, for prevention, care, treatment, drugs, 
            and commodities purchase, and other purposes as 
            practicable;'';
            (C) in subparagraph (D)(ii), by inserting ``, in an open, 
        machine readable format,'' after ``audits'';
            (D) in subparagraph (E), by inserting ``, in an open, 
        machine readable format,'' after ``publicly'';
            (E) in subparagraph (F)--
                (i) in clause (i), by striking ``; and'' and inserting 
            a semicolon; and
                (ii) by striking clause (ii) and inserting the 
            following new clauses:
                ``(ii) all principal recipients and subrecipients and 
            the amount of funds disbursed to each principal recipient 
            and subrecipient on the fiscal cycle of the grant;
                ``(iii) expenditure data--

                    ``(I) tracked by principal recipients and 
                subrecipients by program area, where practicable, 
                prevention, care, and treatment and reported in a 
                format that allows comparison with other funding 
                streams in each country; or
                    ``(II) if such expenditure data is not available, 
                outlay or disbursement data, and an explanation of 
                progress made toward providing such expenditure data; 
                and

                ``(iv) high-quality grant performance evaluations 
            measuring inputs, outputs, and outcomes, as appropriate, 
            with the goal of achieving outcome reporting;''; and
            (F) by amending subparagraph (G) to read as follows:
            ``(G) has published an annual report on a publicly 
        available Web site in an open, machine readable format, that 
        includes--
                ``(i) a list of all countries imposing import duties 
            and internal taxes on any goods or services financed by the 
            Global Fund;
                ``(ii) a description of the types of goods or services 
            on which the import duties and internal taxes are levied;
                ``(iii) the total cost of the import duties and 
            internal taxes;
                ``(iv) recovered import duties or internal taxes; and
                ``(v) the status of country status-agreements;''.
SEC. 5. ANNUAL REPORT.
    Section 104A(f) of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151b-2(f)) is amended to read as follows:
    ``(f) Annual Report.--
        ``(1) In general.--Not later than February 15, 2014, and 
    annually thereafter, the President shall submit to the Committee on 
    Foreign Relations of the Senate and the Committee on Foreign 
    Affairs of the House of Representatives a report in an open, 
    machine readable format, on the implementation of this section for 
    the prior fiscal year.
        ``(2) Report due in 2014.--The report due not later than 
    February 15, 2014, shall include the elements required by law prior 
    to the enactment of the PEPFAR Stewardship and Oversight Act of 
    2013.
        ``(3) Report elements.--Each report submitted after February 
    15, 2014, shall include the following:
            ``(A) A description based on internationally available 
        data, and where practicable high-quality country-based data, of 
        the total global burden and need for HIV/AIDS prevention, 
        treatment, and care, including--
                ``(i) estimates by partner country of the global burden 
            and need; and
                ``(ii) HIV incidence, prevalence, and AIDS deaths for 
            the reporting period.
            ``(B) Reporting on annual targets across prevention, 
        treatment, and care interventions in partner countries, 
        including--
                ``(i) a description of how those targets are designed 
            to--

                    ``(I) ensure that the annual increase in new 
                patients on antiretroviral treatment exceeds the number 
                of annual new HIV infections;
                    ``(II) reduce the number of new HIV infections 
                below the number of deaths among persons infected with 
                HIV; and
                    ``(III) achieve an AIDS-free generation;

                ``(ii) national targets across prevention, treatment, 
            and care that are--

                    ``(I) established by partner countries; or
                    ``(II) where such national partner country-
                developed targets are unavailable, a description of 
                progress towards developing national partner country 
                targets; and

                ``(iii) bilateral programmatic targets across 
            prevention, treatment, and care, including--

                    ``(I) the number of adults and children to be 
                directly supported on HIV treatment under United 
                States-funded programs;
                    ``(II) the number of adults and children to be 
                otherwise supported on HIV treatment under United 
                States-funded programs; and
                    ``(III) other programmatic targets for activities 
                directly and otherwise supported by United States-
                funded programs.

            ``(C) A description, by partner country, of HIV/AIDS 
        funding from all sources, including funding levels from partner 
        countries, other donors, and the private sector, as 
        practicable.
            ``(D) A description of how United States-funded programs, 
        in conjunction with the Global Fund, other donors, and partner 
        countries, together set targets, measure progress, and achieve 
        positive outcomes in partner countries.
            ``(E) An annual assessment of outcome indicator 
        development, dissemination, and performance for programs 
        supported under this section, including ongoing corrective 
        actions to improve reporting.
            ``(F) A description and explanation of changes in related 
        guidance or policies related to implementation of programs 
        supported under this section.
            ``(G) An assessment and quantification of progress over the 
        reporting period toward achieving the targets set forth in 
        subparagraph (B), including--
                ``(i) the number, by partner country, of persons on HIV 
            treatment, including specifically--

                    ``(I) the number of adults and children on HIV 
                treatment directly supported by United States-funded 
                programs; and
                    ``(II) the number of adults and children on HIV 
                treatment otherwise supported by United States-funded 
                programs;

                ``(ii) HIV treatment coverage rates by partner country;
                ``(iii) the net increase in persons on HIV treatment by 
            partner country;
                ``(iv) new infections of HIV by partner country;
                ``(v) the number of HIV infections averted;
                ``(vi) antiretroviral treatment program retention rates 
            by partner country, including--

                    ``(I) performance against annual targets for 
                program retention; and
                    ``(II) the retention rate of persons on HIV 
                treatment directly supported by United States-funded 
                programs; and

                ``(vii) a description of supportive care.
            ``(H) A description of partner country and United States-
        funded HIV/AIDS prevention programs and policies, including--
                ``(i) an assessment by country of progress towards 
            targets set forth in subparagraph (B), with a detailed 
            description of the metrics used to assess--

                    ``(I) programs to prevent mother to child 
                transmission of HIV/AIDS, including coverage rates;
                    ``(II) programs to provide or promote voluntary 
                medical male circumcision, including coverage rates;
                    ``(III) programs for behavior-change; and
                    ``(IV) other programmatic activities to prevent the 
                transmission of HIV;

                ``(ii) antiretroviral treatment as prevention; and
                ``(iii) a description of any new preventative 
            interventions or methodologies.
            ``(I) A description of the goals, scope, and measurement of 
        program efforts aimed at women and girls.
            ``(J) A description of the goals, scope, and measurement of 
        program efforts aimed at orphans, vulnerable children, and 
        youth.
            ``(K) A description of the indicators and milestones used 
        to assess effective, strategic, and appropriately timed country 
        ownership, including--
                ``(i) an explanation of the metrics used to determine 
            whether the pace of any transition to such ownership is 
            appropriate for that country, given that country's level of 
            readiness for such transition;
                ``(ii) an analysis of governmental and local 
            nongovernmental capacity to sustain positive outcomes;
                ``(iii) a description of measures taken to improve 
            partner country capacity to sustain positive outcomes where 
            needed; and
                ``(iv) for countries undergoing a transition to greater 
            country ownership, a description of strategies to assess 
            and mitigate programmatic and financial risk and to ensure 
            continued quality of care for essential services.
            ``(L) A description, globally and by partner country, of 
        specific efforts to achieve and incentivize greater 
        programmatic and cost effectiveness, including--
                ``(i) progress toward establishing common economic 
            metrics across prevention, care and treatment with partner 
            countries and the Global Fund;
                ``(ii) average costs, by country and by core 
            intervention;
                ``(iii) expenditure reporting in all program areas, 
            supplemented with targeted analyses of the cost-
            effectiveness of specific interventions; and
                ``(iv) import duties and internal taxes imposed on 
            program commodities and services, by country.
            ``(M) A description of partnership framework agreements 
        with countries, and regions where applicable, including--
                ``(i) the objectives and structure of partnership 
            framework agreements with countries, including--

                    ``(I) how these agreements are aligned with 
                national HIV/AIDS plans and public health strategies 
                and commitments of such countries; and
                    ``(II) how these agreements incorporate a role for 
                civil society; and

                ``(ii) a description of what has been learned in 
            advancing partnership framework agreements with countries, 
            and regions as applicable, in terms of improved 
            coordination and collaboration, definition of clear roles 
            and responsibilities of participants and signers, and 
            implications for how to further strengthen these agreements 
            with mutually accountable measures of progress.
            ``(N) A description of efforts and activities to engage new 
        partners, including faith-based, locally-based, and United 
        States minority-serving institutions.
            ``(O) A definition and description of the differentiation 
        between directly and otherwise supported activities, including 
        specific efforts to clarify programmatic attribution and 
        contribution, as well as timelines for dissemination and 
        implementation.
            ``(P) A description, globally and by country, of specific 
        efforts to address co-infections and co-morbidities of HIV/
        AIDS, including--
                ``(i) the number and percent of people in HIV care or 
            treatment who started tuberculosis treatment; and
                ``(ii) the number and percentage of eligible HIV 
            positive patients starting isoniazid preventative therapy.
            ``(Q) A description of efforts by partner countries to 
        train, employ, and retain health care workers, including 
        efforts to address workforce shortages.
            ``(R) A description of program evaluations completed during 
        the reporting period, including whether all completed 
        evaluations have been published on a publically available 
        Internet website and whether any completed evaluations did not 
        adhere to the common evaluation standards of practice published 
        under paragraph (4).
        ``(4) Common evaluation standards.--Not later than February 1, 
    2014, the Global AIDS Coordinator shall publish on a publically 
    available Internet website the common evaluation standards of 
    practice referred to in paragraph (3)(R).
        ``(5) Partner country defined.--In this subsection, the term 
    `partner country' means a country with a minimum United States 
    Government investment of HIV/AIDS assistance of at least $5,000,000 
    in the prior fiscal year.''.
SEC. 6. ALLOCATION OF FUNDING.
    (a) Orphans and Vulnerable Children.--Section 403(b) of the United 
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (22 U.S.C. 7673(b)) is amended--
        (1) by striking ``2013'' and inserting ``2018''; and
        (2) by striking ``amounts appropriated pursuant to the 
    authorization of appropriations under section 401'' and inserting 
    ``amounts appropriated or otherwise made available to carry out the 
    provisions of section 104A of the Foreign Assistance Act of 1961 
    (22 U.S.C. 2151b-2)''.
    (b) Funding Allocation.--Section 403(c) of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7673(c)) is amended--
        (1) by striking ``2013'' and inserting ``2018''; and
        (2) by striking ``amounts appropriated for bilateral global 
    HIV/AIDS assistance pursuant to section 401'' and inserting 
    ``amounts appropriated or otherwise made available to carry out the 
    provisions of section 104A of the Foreign Assistance Act of 1961 
    (22 U.S.C. 2151b-2)''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
```