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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3177 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 3177

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

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           September 25, 2013

 Mr. Engel (for himself, Mr. Royce, Ms. Lee of California, and Ms. Ros-
  Lehtinen) introduced the following bill; which was referred to the 
                      Committee on Foreign Affairs

_______________________________________________________________________

                                 A BILL

 
    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 spending 
                        and partner country spending and comparable 
                        data across United States spending, Global Fund 
                        spending, and partner country spending at the 
                        national level; 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) Definition.--In this subsection, the term `partner 
        country' means a country that received not less than $5,000,000 
        in United States HIV/AIDS assistance under section 104A of the 
        Foreign Assistance Act of 1961 (22 U.S.C. 2151b-2) during the 
        immediately preceding 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) by striking ``2013'' each place it appears and 
        inserting ``2018'';
            (2) in subparagraph (A)(ii), by striking the last two 
        sentences;
            (3) in subparagraph (B)--
                    (A) in each of clauses (i) through (iv), by 
                striking ``under this subsection'' and inserting ``for 
                a contribution to the Global Fund''; and
                    (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''.
    (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)(5)) is amended--
            (1) by striking ``2013'' and inserting ``2018'';
            (2) in subparagraph (C)--
                    (A) by inserting ``in an open, machine readable 
                format'' after ``site'';
                    (B) by striking clause (v) and inserting the 
                following:
                            ``(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 sub-recipients on 
                        the fiscal cycle of each grant, and includes 
                        the distribution of resources, by grant and 
                        principal recipient and sub-recipient, for 
                        prevention, care, treatment, drugs, and 
                        commodities purchase, and other purposes, as 
                        practicable;'';
            (3) in subparagraph (D)(ii), by inserting ``, in an open 
        machine readable format,'' after ``audits'';
            (4) in subparagraph (E), by inserting ``, in an open 
        machine readable format,'' after ``publicly'';
            (5) in subparagraph (F)--
                    (A) in clause (i), by striking ``and'' at the end; 
                and
                    (B) by striking clause (ii) and inserting the 
                following:
                            ``(ii) all principal recipients and sub-
                        recipients 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 sub-recipients by 
                                program area, where practicable, in 
                                prevention, care, and treatment, 
                                reported in a format that allows 
                                comparison with other funding streams 
                                in each country; or
                                    ``(II) if expenditure data is not 
                                available, outlay or disbursement data, 
                                and each public report shall include an 
                                explanation of progress made toward 
                                providing expenditure data; and
                            ``(iv) high-quality grant performance 
                        evaluations measuring inputs, outputs, and 
                        outcomes, as appropriate, with the goal of 
                        achieving outcome reporting;''; and
            (6) by striking subparagraph (G) and inserting the 
        following:
                    ``(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 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.

    (a) In General.--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 elements.--Each report submitted after 
        February 15, 2014, shall include the following:
                    ``(A) A description based on internationally 
                available data, using high-quality country-based data 
                where practicable, 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 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 so that it falls below 
                                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 this section;
                                    ``(II) the number of adults and 
                                children to be otherwise supported on 
                                HIV treatment under this section; 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 bilateral 
                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 
                described 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;
                                    ``(II) the number of adults and 
                                children on HIV treatment otherwise 
                                supported by United States-funded 
                                programs;
                            ``(ii) HIV treatment coverage rates by 
                        country;
                            ``(iii) the net increase in persons on HIV 
                        treatment by partner country;
                            ``(iv) new infections of HIV by 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, 
                        including management of co-morbidities.
                    ``(H) A description of partner country and United 
                States-funded HIV/AIDS prevention programs and 
                policies, including--
                            ``(i) an assessment, by partner country, of 
                        progress to achieve the targets described 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) a description of 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 partner country ownership, 
                including--
                            ``(i) an explanation of the metrics used to 
                        determine whether the pace of any transition to 
                        such ownership is appropriate for such partner 
                        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 partner countries undergoing a 
                        transition to greater country ownership, a 
                        description of strategies to assess and 
                        mitigate programmatic and financial risk 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 counties and the Global 
                        Fund;
                            ``(ii) average costs, by partner 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 
                        partner country.
                    ``(M) A description of partnership framework 
                agreements with countries and regions, where 
                applicable, including--
                            ``(i) the objectives and structures of such 
                        agreements, including--
                                    ``(I) how such agreements are 
                                aligned with national HIV/AIDS plans, 
                                public health strategies, and 
                                commitments of such countries and 
                                regions; and
                                    ``(II) how such agreements 
                                incorporate a role for civil society; 
                                and
                            ``(ii) 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 
                        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, community-
                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.
            ``(3) Definition.--In this subsection, the term `partner 
        country' means a country that received not less than $5,000,000 
        in United States HIV/AIDS assistance under this section during 
        the immediately preceding fiscal year.''.
    (b) Report Elements for Fiscal Year 2013 Report.--The annual report 
required to be submitted by not later than February 15, 2014, to the 
Committee on Foreign Relations of the Senate and the Committee on 
Foreign Affairs of the House of Representatives under section 104A(f) 
of the Foreign Assistance Act of 1961, as amended by subsection (a) of 
this section, shall include the report elements contained in paragraph 
(2) of such section 104A(f) as such section was in effect on the day 
before the date of the enactment of this Act.

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'';
            (2) by striking ``amounts appropriated'' 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)''; and
            (3) by striking ``pursuant to section 401''.
                                 <all>
```