I 

110TH CONGRESS 

2D SESSION H. R. 5485 

To establish a program to evaluate HIV/AIDS programs in order to improve 

accountability, increase transparency, and ensure the delivery of evidencebased services. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 25, 2008 

Mr. MILLER of North Carolina introduced the following bill; which was 

referred to the Committee on Foreign Affairs 

A BILL 

To establish a program to evaluate HIV/AIDS programs 

in order to improve accountability, increase transparency, 

and ensure the delivery of evidence-based services. 

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 ‘‘PEPFAR Account5 ability and Transparency Act’’. 

6 SEC. 2. EVALUATION OF HIV/AIDS PROGRAMS. 

7 Subtitle A of title III of the United States Leadership 

8 Against HIV/AIDS, Tuberculosis, and Malaria Act of 


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1 2003 (22 U.S.C. 7631 et seq.) is amended by adding at 

2 the end the following: 

3 ‘‘SEC. 308. PROGRAM MONITORING, OPERATIONS RE4 SEARCH, AND IMPACT EVALUATION RE5 SEARCH. 

6 ‘‘(a) PROGRAM ESTABLISHED.—The Coordinator of 

7 United States Government Activities to Combat HIV/ 

8 AIDS Globally (referred to in this section as the ‘Coordi9 nator’) shall establish a mechanism to evaluate global 

10 HIV/AIDS programs financed by the United States Gov11 ernment in order to improve accountability, increase 

12 transparency, and ensure the delivery of evidence-based 

13 services. Such mechanism shall include program moni14 toring, operations research, and impact evaluation re15 search. 

16 ‘‘(b) DEFINITIONS.—In this subsection: 

17 ‘‘(1) IMPACT EVALUATION RESEARCH.—The 

18 term ‘impact evaluation research’ means the applica19 tion of research methods and statistical analysis to 

20 measure the extent to which a change in a popu21 lation-based outcome can be attributed to program 

22 intervention instead of other environmental factors. 

23 ‘‘(2) OPERATIONS RESEARCH.—The term ‘oper24 ations research’ means the application of social 

25 science research methods and statistical analysis to 


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1 judge, compare, and improve policies and program 

2 outcomes, from the earliest stages of defining and 

3 designing programs through their development and 

4 implementation. 

5 ‘‘(3) PROGRAM MONITORING.—The term ‘pro6 gram monitoring’ means the collection, analysis, and 

7 use of routine program data to determine how well 

8 a program is carried out and how much the program 

9 costs. 

10 ‘‘(4) ELIGIBLE ENTITIES.—The term ‘eligible 

11 entities’ means public or private organizations, in12 cluding academic institutions, that have documented 

13 experience in analyzing and evaluating the effective14 ness of health, development, or other international 

15 aid programs. 

16 ‘‘(c) USE OF FUNDS.—The Coordinator shall use 

17 amounts provided under this section, either directly or in18 directly through grants, contracts, or cooperative agree19 ments to eligible entities, to conduct program monitoring, 

20 operations research, and impact evaluation research re21 lated to programs authorized under this Act. Such activi22 ties shall be conducted to— 

23 ‘‘(1) improve the coverage, efficiency, effective24 ness, quality, and accessibility of services provided 

25 under this Act; 


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1 ‘‘(2) establish the cost-effectiveness of program 

2 models; 

3 ‘‘(3) assess the population-level impact of pro4 grams implemented, including the impact of pro5 grams on women, children, and other at-risk or vul6 nerable populations; 

7 ‘‘(4) ensure the transparency and accountability 

8 of services provided under this Act; 

9 ‘‘(5) disseminate and promote the utilization of 

10 evaluation findings, lessons, and best practices in the 

11 implementation of the programs receiving financial 

12 assistance under this Act; 

13 ‘‘(6) encourage and evaluate innovative service 

14 models and strategies to optimize the delivery of 

15 care, treatment, and prevention programs financed 

16 by the United States Government; and 

17 ‘‘(7) strengthen ongoing program monitoring 

18 and enhance program quality through routine pro19 gram evaluations, such as midterm and final pro20 gram evaluations. 

21 ‘‘(d) REPORT.—Not later than 90 days after the date 

22 of the enactment of the PEPFAR Accountability and 

23 Transparency Act, the Coordinator shall submit a report 

24 to Congress that describes the resources provided under 

25 this Act for program monitoring, operations research, and 


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1 impact evaluation research during the 5-year period end2 ing on September 30, 2008, that describes— 

3 ‘‘(1) the projects for which resources were obli4 gated and the outcomes of those projects; 

5 ‘‘(2) the program improvements, including cost 

6 or other resource savings, which have been made as 

7 a result of program monitoring, operations research, 

8 and impact evaluation research; 

9 ‘‘(3) how program monitoring, operations re10 search, and impact evaluation research priorities are 

11 determined and how input from external experts is 

12 incorporated; and 

13 ‘‘(4) the process used to allocate funding for 

14 implementation of program monitoring, operations 

15 research, and impact evaluation research. 

16 ‘‘(e) STRATEGIC PLAN.— 

17 ‘‘(1) IN GENERAL.—Not later than 1 year after 

18 the date of the enactment of the PEPFAR Account19 ability and Transparency Act, the Coordinator shall 

20 develop a 5-year strategic plan for program moni21 toring, operations research, and impact evaluation 

22 research. 

23 ‘‘(2) PLAN ELEMENTS.—The plan developed 

24 under this subsection shall include— 


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1 ‘‘(A) the amount of funding provided for 

2 program monitoring, operations research, and 

3 impact evaluation research under this Act avail4 able through fiscal year 2009; 

5 ‘‘(B) strategies to address the goals de6 scribed in subsection (c); 

7 ‘‘(C) priorities for program monitoring, op8 erations research, and impact evaluation re9 search and a time line for completion of activi10 ties associated with such priorities; and 

11 ‘‘(D) other information that the Coordi12 nator determines to be necessary. 

13 ‘‘(3) CONSIDERATIONS.—In developing the plan 

14 under this subsection, the Coordinator shall consider 

15 a range of research priorities, including research 

16 in— 

17 ‘‘(A) preventing new HIV infections by re18 ducing behavioral risks for HIV transmission, 

19 particularly in at-risk and vulnerable popu20 lations, including— 

21 ‘‘(i) delaying sexual debut; 

22 ‘‘(ii) reducing the number of sexual 

23 partners; 

24 ‘‘(iii) practicing abstinence, fidelity, 

25 and monogamy; 


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1 ‘‘(iv) using condoms, other effective 

2 protection methods that have been devel3 oped and are available, and female 

4 condoms; and 

5 ‘‘(v) meeting the needs of discordant 

6 couples; 

7 ‘‘(B) improving health care delivery sys8 tems and HIV/AIDS-related policies; 

9 ‘‘(C) preventing mother-to-child trans10 mission, improving early identification of in11 fected children, and reducing the spread of HIV 

12 infections, particularly in women and girls; 

13 ‘‘(D) reducing HIV-related mortality and 

14 morbidity of HIV; 

15 ‘‘(E) treating adults and children infected 

16 by HIV more effectively, including establishing 

17 better approaches for increasing access to treat18 ment and increasing and sustaining treatment 

19 adherence; 

20 ‘‘(F) addressing the vulnerabilities of mar21 ried and unmarried women and girls to HIV in22 fection, including those who are victims of rape, 

23 sexual violence, and coercion; 


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1 ‘‘(G) integrating family planning into HIV/ 

2 AIDS prevention, care, and treatment strate3 gies and services; 

4 ‘‘(H) encouraging men to be responsible 

5 for their sexual behavior and to respect women, 

6 including the reduction and elimination of sex7 ual violence and coercion; 

8 ‘‘(I) developing models for scaling up HIV 

9 counseling, testing with informed consent, and 

10 other approaches that promote risk reduction 

11 and access to care and treatment; 

12 ‘‘(J) addressing risks associated with sub13 stance use; 

14 ‘‘(K) promoting the most effective models 

15 for scaling up care and treatment access; 

16 ‘‘(L) ensuring a safe blood supply; 

17 ‘‘(M) improving injection safety, including 

18 eliminating unnecessary injections and pro19 moting sterile injection practices and tech20 nologies; 

21 ‘‘(N) improving health care workers’ occu22 pational health and safety; 

23 ‘‘(O) strengthening hospice and palliative 

24 care; 


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1 ‘‘(P) scaling up the provision of prevention, 

2 care and treatment services to children, includ3 ing those orphaned by HIV/AIDS; 

4 ‘‘(Q) preventing HIV through male cir5 cumcision; and 

6 ‘‘(R) other research that the Coordinator 

7 determines to be necessary. 

8 ‘‘(4) CONSULTATION.—In developing the stra9 tegic plan and implementing, disseminating, and 

10 promoting the use of program monitoring, oper11 ations research, and impact evaluation research, the 

12 Coordinator shall consult with representatives of— 

13 ‘‘(A) the National Institutes of Health; 

14 ‘‘(B) the United States Agency for Inter15 national Development; 

16 ‘‘(C) the Centers for Disease Control and 

17 Prevention; 

18 ‘‘(D) the Agency for Healthcare Research 

19 and Quality; 

20 ‘‘(E) the Department of Health and 

21 Human Services; 

22 ‘‘(F) the Department of Labor; 

23 ‘‘(G) other Federal agencies engaged in 

24 global HIV/AIDS programs; 


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1 ‘‘(H) multilateral structures, such as the 

2 United Nations and the Global Fund To Fight 

3 AIDS, Tuberculosis and Malaria; 

4 ‘‘(I) national governments of foreign coun5 tries in which programs under this Act are ad6 ministered; 

7 ‘‘(J) organizations implementing pro8 grammatic activities under this Act; and 

9 ‘‘(K) other organizations with expertise in 

10 monitoring and evaluating international HIV/ 

11 AIDS programs. 

12 ‘‘(5) MEETING AND PUBLIC COMMENT.—The 

13 Coordinator shall— 

14 ‘‘(A) not later than 180 days after the date 

15 of the enactment of the PEPFAR Account16 ability and Transparency Act, hold a public 

17 meeting at which the public may present its 

18 views on the current needs and gaps in program 

19 monitoring, operations research, and impact 

20 evaluation research; 

21 ‘‘(B) during the 30-day period following 

22 the public meeting held pursuant to subpara23 graph (A), collect written comments from the 

24 public; and 


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1 ‘‘(C) publish the comments received pursu2 ant to subparagraph (B) on the Office of the 

3 Global AIDS Coordinator’s Internet Web site. 

4 ‘‘(6) REVIEW OF STRATEGIC PLAN.—The Coor5 dinator shall— 

6 ‘‘(A) not later than 1 year after the date 

7 of the enactment of the PEPFAR Account8 ability and Transparency Act, present the stra9 tegic plan developed under this subsection to 

10 the appropriate congressional committees; 

11 ‘‘(B) publish the strategic plan in the Fed12 eral Register and on the Office of the Global 

13 AIDS Coordinator’s Internet Web site; 

14 ‘‘(C) during the 60-day period following 

15 the publication of the plan under subparagraph 

16 (B), solicit written comments on the plan from 

17 the public; 

18 ‘‘(D) hold a meeting at which the public is 

19 given an opportunity to present its views on the 

20 plan; and 

21 ‘‘(E) after consideration of the views and 

22 comments received from the public, make any 

23 necessary revisions to the plan. 

24 ‘‘(f) BEST PRACTICES REPORT.—The Coordinator 

25 shall annually publish a best practices report that highVerDate Aug 31 2005 21:50 Feb 26, 2008 Jkt 069200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H5485.IH H5485

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1 lights the programs that have the potential for translation, 

2 particularly at a low cost, across global AIDS programs, 

3 including those that focus on both generalized and local4 ized epidemics, receiving financial assistance from the 

5 United States. 

6 ‘‘(g) DISSEMINATION OF FINDINGS.— 

7 ‘‘(1) IN GENERAL.—The Coordinator shall dis8 seminate the full findings of the multiple operations 

9 research and impact evaluation research and pro10 gram level monitoring efforts on the Office of the 

11 Global AIDS Coordinator’s Internet website in order 

12 to improve transparency and public availability of in13 formation about operations research and impact 

14 evaluation research. 

15 ‘‘(2) DISSEMINATION GUIDANCE.—The Coordi16 nator shall develop guidance to ensure timely sub17 mission and dissemination of all impact evaluation 

18 research, operations research, and program moni19 toring findings. The time lines and processes in20 cluded in such guidance shall take into account the 

21 publication process for peer-reviewed scientific or 

22 academic journals and the discussion of such re23 search findings at a scientific meeting or any other 

24 public or private forum, so as to maintain the sciVerDate Aug 31 2005 21:50 Feb 26, 2008 Jkt 069200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H5485.IH H5485

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1 entific process without unduly restricting dissemina2 tion of information. 

3 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—In ad4 dition to funds made available under section 401(a), there 

5 are authorized to be appropriated such sums as may be 

6 necessary to carry out this section.’’. 

Æ 


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