II 

110TH CONGRESS 

1ST SESSION S. 805 

To amend the Foreign Assistance Act of 1961 to assist countries in subSaharan Africa in the effort to achieve internationally recognized goals 

in the treatment and prevention of HIV/AIDS and other major diseases 

and the reduction of maternal and child mortality by improving human 

health care capacity and improving retention of medical health professionals in sub-Saharan Africa, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 7, 2007 

Mr. DURBIN (for himself, Mr. COLEMAN, Mr. FEINGOLD, Mr. DODD, Mr. 

KERRY, and Mr. BINGAMAN) 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 assist 

countries in sub-Saharan Africa in the effort to achieve 

internationally recognized goals in the treatment and prevention of HIV/AIDS and other major diseases and the 

reduction of maternal and child mortality by improving 

human health care capacity and improving retention of 

medical health professionals in sub-Saharan Africa, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘African Health Capac3 ity Investment Act of 2007’’. 

4 SEC. 2. DEFINITIONS. 

5 In this Act, the term ‘‘HIV/AIDS’’ has the meaning 

6 given such term in section 104A(g) of the Foreign Assist7 ance Act of 1961 (22 U.S.C. 2151b–2(g)). 

8 SEC. 3. FINDINGS. 

9 Congress makes the following findings: 

10 (1) The World Health Report, 2003, Shaping 

11 the Future, states, ‘‘The most critical issue facing 

12 health care systems is the shortage of people who 

13 make them work.’’. 

14 (2) The World Health Report, 2006, Working 

15 Together for Health, states, ‘‘The unmistakable im16 perative is to strengthen the workforce so that 

17 health systems can tackle crippling diseases and 

18 achieve national and global health goals. A strong 

19 human infrastructure is fundamental to closing to20 day’s gap between health promise and health reality 

21 and anticipating the health challenges of the 21st 

22 century.’’. 

23 (3) The shortage of health personnel, including 

24 doctors, nurses, pharmacists, counselors, laboratory 

25 staff, paraprofessionals, and trained lay workers is 


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1 one of the leading obstacles to fighting HIV/AIDS in 

2 sub-Saharan Africa. 

3 (4) The HIV/AIDS pandemic aggravates the 

4 shortage of health workers through loss of life and 

5 illness among medical staff, unsafe working condi6 tions for medical personnel, and increased workloads 

7 for diminished staff, while the shortage of health 

8 personnel undermines efforts to prevent and provide 

9 care and treatment for those with HIV/AIDS. 

10 (5) Workforce constraints and inefficient man11 agement are limiting factors in the treatment of tuberculosis, which infects over 1 12 ⁄3 of the global popu13 lation. 

14 (6) Over 1,200,000 people die of malaria each 

15 year. More than 75 percent of these deaths occur 

16 among African children under the age of 5 years old 

17 and the vast majority of these deaths are prevent18 able. The Malaria Initiative of President George W. 

19 Bush seeks to reduce dramatically the disease bur20 den of malaria through both prevention and treat21 ment. Paraprofessionals and community 

22 healthworkers can be instrumental in reducing mor23 tality and economic losses associated with malaria 

24 and other health problems. 


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1 (7) For a woman in sub-Saharan Africa, the 

2 lifetime risk of maternal death is 1 out of 16. In 

3 highly developed countries, that risk is 1 out of 

4 2,800. Increasing access to skilled birth attendants 

5 and access to emergency obstetrical care is essential 

6 to reducing maternal and newborn mortality in sub7 Saharan Africa. 

8 (8) The Second Annual Report to Congress on 

9 the progress of the President’s Emergency Plan for 

10 AIDS Relief identifies the strengthening of essential 

11 health care systems through health care networks 

12 and infrastructure development as critical to the 

13 sustainability of funded assistance by the United 

14 States Government and states that ‘‘outside re15 sources for HIV/AIDS and other development efforts 

16 must be focused on transformational initiatives that 

17 are owned by host nations’’. This report further 

18 states, ‘‘Alongside efforts to support community ca19 pacity-building, enhancing the capacity of health 

20 care and other systems is also crucial for sustain21 ability. Among the obstacles to these efforts in many 

22 nations are inadequate human resources and capac23 ity, limited institutional capacity, and systemic 

24 weaknesses in areas such as: quality assurance; fi25 nancial management and accounting; health netVerDate Aug 31 2005 20:25 Mar 10, 2007 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S805.IS S805

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1 works and infrastructure; and commodity distribu2 tion and control.’’. 

3 (9) Vertical disease control programs represent 

4 vital components of United States foreign assistance 

5 policy, but human resources for health planning and 

6 management often demands a more systematic ap7 proach. 

8 (10) Implementation of capacity-building initia9 tives to promote more effective human resources 

10 management and development may require an ex11 tended horizon to produce measurable results, but 

12 such efforts are critical to fulfillment of many inter13 nationally recognized objectives in global health. 

14 (11) The November 2005 report of the Working 

15 Group on Global Health Partnerships for the High 

16 Level Forum on the Health Millennium Development 

17 Goals entitled ‘‘Best Practice Principles for Global 

18 Health Partnership Activities at Country Level’’, 

19 raises the concern that the collective impact of var20 ious global health programs now risks ‘‘undermining 

21 the sustainability of national development plans, dis22 torting national priorities, diverting scarce human 

23 resources and/or establishing uncoordinated service 

24 delivery structures’’ in developing countries. This 

25 risk underscores the need to coordinate international 


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1 donor efforts for these vital programs with one an2 other and with recipient countries. 

3 (12) The emigration of significant numbers of 

4 trained health care professionals from sub-Saharan 

5 African countries to the United States and other 

6 wealthier countries exacerbates often severe short7 ages of health care workers, undermines economic 

8 development efforts, and undercuts national and 

9 international efforts to improve access to essential 

10 health services in the region. 

11 (13) Addressing this problem, commonly re12 ferred to as ‘‘brain drain’’, will require increased in13 vestments in the health sector by sub-Saharan Afri14 can governments and by international partners seek15 ing to promote economic development and improve 

16 health care and mortality outcomes in the region. 

17 (14) Virtually every country in the world, in18 cluding the United States, is experiencing a shortage 

19 of health workers. The Joint Learning Initiative on 

20 Human Resources for Health and Development esti21 mates that the global shortage exceeds 4,000,000 

22 workers. Shortages in sub-Saharan Africa, however, 

23 are far more acute than in any other region of the 

24 world. The World Health Report, 2006, states that 

25 ‘‘[t]he exodus of skilled professionals in the midst of 


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1 so much unmet health need places Africa at the 

2 epicentre of the global health workforce crisis.’’. 

3 (15) Ambassador Randall Tobias, now the Di4 rector of United States Foreign Assistance and Ad5 ministrator of the United States Agency for Inter6 national Development, has stated that there are 

7 more Ethiopian trained doctors practicing in Chi8 cago than in Ethiopia. 

9 (16) According to the United Nations Develop10 ment Programme, Human Development Report 

11 2003, approximately 3 out of 4 countries in sub-Sa12 haran Africa have fewer than 20 physicians per 

13 100,000 people, the minimum ratio recommended by 

14 the World Health Organization, and 13 countries 

15 have 5 or fewer physicians per 100,000 people. 

16 (17) Nurses play particularly important roles in 

17 sub-Saharan African health care systems, but approximately 1 18 ⁄4 of sub-Saharan African countries 

19 have fewer than 50 nurses per 100,000 people or 

less than 1 20 ⁄2 the staffing levels recommended by the 

21 World Health Organization. 

22 (18) Paraprofessionals and community health 

23 workers can be trained more quickly than nurses or 

24 doctors and are critically needed in sub-Saharan Af25 rica to meet immediate health care needs. 


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1 (19) Imbalances in the distribution of countries’ 

2 health workforces represents a global problem, but 

3 the impact is particularly acute in sub-Saharan Afri4 ca. 

5 (20) In Malawi, for example, more than 95 per6 cent of clinical officers are in urban health facilities, 

7 and about 25 percent of nurses and 50 percent of 

8 physicians are in the 4 central hospitals of Malawi. 

9 Yet the population of Malawi is estimated to be 87 

10 percent rural. 

11 (21) In parts of sub-Saharan Africa, such as 

12 Kenya, thousands of qualified health professionals 

13 are employed outside the health care field or are un14 employed despite job openings in the health sector in 

15 rural areas because poor working and living condi16 tions, including poor educational opportunities for 

17 children, transportation, and salaries, make such 

18 openings unattractive to candidates. 

19 (22) The 2002 National Security Strategy of 

20 the United States stated, ‘‘The scale of the public 

21 health crisis in poor countries is enormous. In coun22 tries afflicted by epidemics and pandemics like HIV/ 

23 AIDS, malaria, and tuberculosis, growth and devel24 opment will be threatened until these scourges can 

25 be contained. Resources from the developed world 


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1 are necessary but will be effective only with honest 

2 governance, which supports prevention programs and 

3 provides effective local infrastructure.’’. 

4 (23) Public health deficiencies in sub-Saharan 

5 Africa and other parts of the developing world re6 duce global capacities to detect and respond to po7 tential crises, such as an avian flu pandemic. 

8 (24) On September 28, 2005, Secretary of 

9 State Condoleezza Rice declared that ‘‘HIV/AIDS is 

10 not only a human tragedy of enormous magnitude; 

11 it is also a threat to the stability of entire countries 

12 and to the entire regions of the world.’’. 

13 (25) Foreign assistance by the United States 

14 that expands local capacities, provides commodities 

15 or training, or builds on and enhances community16 based and national programs and leadership can in17 crease the impact, efficiency, and sustainability of 

18 funded efforts by the United States. 

19 (26) African health care professionals immi20 grate to the United States for the same set of rea21 sons that have led millions of people to come to this 

22 country, including the desire for freedom, for eco23 nomic opportunity, and for a better life for them24 selves and their children, and the rights and motiva25 tions of these individuals must be respected. 


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1 (27) Helping countries in sub-Saharan Africa 

2 increase salaries and benefits of health care profes3 sionals, improve working conditions, including the 

4 adoption of universal precautions against workplace 

5 infection, improve management of health care sys6 tems and institutions, increase the capacity of health 

7 training institutions, and expand education opportu8 nities will alleviate some of the pressures driving the 

9 migration of health care personnel from sub-Saharan 

10 Africa. 

11 (28) While the scope of the problem of dire 

12 shortfalls of personnel and inadequacies of infra13 structure in the sub-Saharan African health systems 

14 is immense, effective and targeted interventions to 

15 improve working conditions, management, and pro16 ductivity would yield significant dividends in im17 proved health care. 

18 (29) Failure to address the shortage of health 

19 care professionals and paraprofessionals, and the 

20 factors pushing individuals to leave sub-Saharan Af21 rica will undermine the objectives of United States 

22 development policy and will subvert opportunities to 

23 achieve internationally recognized goals for the 

24 treatment and prevention of HIV/AIDS and other 

25 diseases, in the reduction of child and maternal morVerDate Aug 31 2005 20:25 Mar 10, 2007 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S805.IS S805

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1 tality, and for economic growth and development in 

2 sub-Saharan Africa. 

3 SEC. 4. SENSE OF CONGRESS. 

4 It is the sense of Congress that— 

5 (1) the United States should help sub-Saharan 

6 African countries that have not already done so to 

7 develop national human resource plans within the 

8 context of comprehensive country health plans in9 volving a wide range of stakeholders; 

10 (2) comprehensive, rather than piecemeal ap11 proaches to advance multiple sustainable interven12 tions will better enable countries to plan for the 

13 number of health care workers they need, determine 

14 whether they need to reorganize their health work15 force, integrate workforce planning into an overall 

16 strategy to improve health system performance and 

17 impact, better budget for health care spending, and 

18 improve the delivery of health services in rural and 

19 other underserved areas; 

20 (3) in order to promote systemic, sustainable 

21 change, the United States should seek, where pos22 sible, to strengthen existing national systems in sub23 Saharan African countries to improve national ca24 pacities in areas including fiscal management, train25 ing, recruiting and retention of health workers, disVerDate Aug 31 2005 20:25 Mar 10, 2007 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S805.IS S805

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1 tribution of resources, attention to rural areas, and 

2 education; 

3 (4) because foreign-funded efforts to fight HIV/ 

4 AIDS and other diseases may also draw health per5 sonnel away from the public sector in sub-Saharan 

6 African countries, the policies and programs of the 

7 United States should, where practicable, seek to 

8 work with national and community-based health 

9 structures and seek to promote the general welfare 

10 and enhance infrastructures beyond the scope of a 

11 single disease or condition; 

12 (5) paraprofessionals and community-level 

13 health workers can play a key role in prevention, 

14 care, and treatment services, and in the more equi15 table and effective distribution of health resources, 

16 and should be integrated into national health sys17 tems; 

18 (6) given the current personnel shortages in 

19 sub-Saharan Africa, paraprofessionals and commu20 nity health workers represent a critical potential 

21 workforce in efforts to reduce the burdens of ma22 laria, tuberculosis, HIV/AIDS, and other deadly and 

23 debilitating diseases; 


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1 (7) it is critically important that the govern2 ments of sub-Saharan African countries increase 

3 their own investments in education and health care; 

4 (8) international financial institutions have an 

5 important role to play in the achievement of inter6 nationally agreed upon health goals, and in helping 

7 countries strike the appropriate balance in encour8 aging effective public investments in the health and 

9 education sectors, particularly as foreign assistance 

10 in these areas scales up, and promoting macro11 economic stability; 

12 (9) public-private partnerships are needed to 

13 promote creative contracts, investments in sub-Saha14 ran African educational systems, codes of conduct 

15 related to recruiting, and other mechanisms to al16 leviate the adverse impacts on sub-Saharan African 

17 countries caused by the migration of health profes18 sionals; 

19 (10) colleges and universities of the United 

20 States, as well as other members of the private sec21 tor, can play a significant role in promoting training 

22 in medicine and public health in sub-Saharan Africa 

23 by establishing or supporting in-country programs in 

24 sub-Saharan Africa through twinning programs with 


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1 educational institutions in sub-Saharan Africa or 

2 through other in-country mechanisms; 

3 (11) given the substantial numbers of African 

4 immigrants to the United States working in the 

5 health sector, the United States should enact and 

6 implement measures to permit qualified aliens and 

7 their family members that are legally present in the 

8 United States to work temporarily as health care 

9 professionals in developing countries or in other 

10 emergency situations, as in S. 2611, of the 109th 

11 Congress, as passed by the Senate on May 25, 2006; 

12 (12) the President, acting through the United 

13 States Permanent Representative to the United Na14 tions, should exercise the voice and vote of the 

15 United States— 

16 (A) to ameliorate the adverse impact on 

17 less developed countries of the migration of 

18 health personnel; 

19 (B) to promote voluntary codes of conduct 

20 for recruiters of health personnel; and 

21 (C) to promote respect for voluntary agree22 ments in which individuals, in exchange for in23 dividual educational assistance, have agreed ei24 ther to work in the health field in their home 


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1 countries for a given period of time or to repay 

2 such assistance; 

3 (13) the United States, like countries in other 

4 parts of the world, is experiencing a shortage of 

5 medical personnel in many occupational specialties, 

6 and the shortage is particularly acute in rural and 

7 other underserved areas of the country; and 

8 (14) the United States should expand training 

9 opportunities for health personnel, expand incentive 

10 programs such as student loan forgiveness for people 

11 of the United States willing to work in underserved 

12 areas, and take other steps to increase the number 

13 of health personnel in the United States. 

14 SEC. 5. ASSISTANCE TO INCREASE HUMAN CAPACITY IN 

15 THE HEALTH SECTOR IN SUB-SAHARAN AFRI16 CA. 

17 Chapter 1 of part I of the Foreign Assistance Act 

18 of 1961 (22 U.S.C. 2151 et seq.) is amended— 

19 (1) by redesignating the section 135 that was 

20 added by section 5 of the Senator Paul Simon Water 

21 for the Poor Act of 2005 (Public Law 109–121; 22 

22 U.S.C. 2152h note) as section 136; and 

23 (2) by adding at the end the following new sec24 tion: 


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1 ‘‘SEC. 137. ASSISTANCE TO INCREASE HUMAN CAPACITY IN 

2 THE HEALTH SECTOR IN SUB-SAHARAN AFRI3 CA. 

4 ‘‘(a) ASSISTANCE.— 

5 ‘‘(1) AUTHORITY.—The President is authorized 

6 to provide assistance, including providing assistance 

7 through international or nongovernmental organiza8 tions, for programs in sub-Saharan Africa to im9 prove human health care capacity. 

10 ‘‘(2) TYPES OF ASSISTANCE.—Such programs 

11 should include assistance— 

12 ‘‘(A) to provide financial and technical as13 sistance to sub-Saharan African countries in de14 veloping and implementing new or strengthened 

15 comprehensive national health workforce plans; 

16 ‘‘(B) to build and improve national and 

17 local capacities and sustainable health systems 

18 management in sub-Saharan African countries, 

19 including financial, strategic, and technical as20 sistance for— 

21 ‘‘(i) fiscal and health personnel man22 agement; 

23 ‘‘(ii) health worker recruitment sys24 tems; 

25 ‘‘(iii) the creation or improvement of 

26 computerized health workforce databases 


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1 and other human resource information sys2 tems; 

3 ‘‘(iv) implementation of measures to 

4 reduce corruption in the health sector; and 

5 ‘‘(v) monitoring, evaluation, and qual6 ity assurance in the health field, including 

7 the utilization of national and district-level 

8 mapping of health care systems to deter9 mine capacity to deliver health services; 

10 ‘‘(C) to train and retain sufficient numbers 

11 of health workers, including paraprofessionals 

12 and community health workers, to provide es13 sential health services in sub-Saharan African 

14 countries, including financing, strategic tech15 nical assistance for— 

16 ‘‘(i) health worker safety and health 

17 care, including HIV/AIDS prevention and 

18 off-site testing and treatment programs for 

19 health workers; 

20 ‘‘(ii) increased capacity for training 

21 health professionals and paraprofessionals 

22 in such subjects as human resources plan23 ning and management, health program 

24 management, and quality improvement; 


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1 ‘‘(iii) expanded access to secondary 

2 level math and science education; 

3 ‘‘(iv) expanded capacity for nursing 

4 and medical schools in sub-Saharan Africa, 

5 with particular attention to incentives or 

6 mechanisms to encourage graduates to 

7 work in the health sector in their country 

8 of residence; 

9 ‘‘(v) incentives and policies to increase 

10 retention, including salary incentives; 

11 ‘‘(vi) modern quality improvement 

12 processes and practices; 

13 ‘‘(vii) continuing education, distance 

14 education, and career development oppor15 tunities for health workers; 

16 ‘‘(viii) mechanisms to promote produc17 tivity within existing and expanding health 

18 workforces; and 

19 ‘‘(ix) achievement of minimum infra20 structure requirements for health facilities, 

21 such as access to clean water; 

22 ‘‘(D) to support sub-Saharan African 

23 countries with financing, technical support, and 

24 personnel, including paraprofessionals and com25 munity-based caregivers, to better meet the 


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1 health needs of rural and other underserved 

2 populations by providing incentives to serve in 

3 these areas, and to more equitably distribute 

4 health professionals and paraprofessionals; 

5 ‘‘(E) to support efforts to improve public 

6 health capacities in sub-Saharan Africa through 

7 education, leadership development, and other 

8 mechanisms; 

9 ‘‘(F) to provide technical assistance, equip10 ment, training, and supplies to assist in the im11 provement of health infrastructure in sub-Saha12 ran Africa; 

13 ‘‘(G) to promote efforts to improve system14 atically human resource management and devel15 opment as a critical health and development 

16 issue in coordination with specific disease con17 trol programs for sub-Saharan Africa; and 

18 ‘‘(H) to establish a global clearinghouse or 

19 similar mechanism for knowledge sharing re20 garding human resources for health, in con21 sultation, if helpful, with the Global Health 

22 Workforce Alliance. 

23 ‘‘(3) MONITORING AND EVALUATION.— 

24 ‘‘(A) IN GENERAL.—The President shall 

25 establish a monitoring and evaluation system to 


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1 measure the effectiveness of assistance by the 

2 United States to improve human health care ca3 pacity in sub-Saharan Africa in order to maxi4 mize the sustainable development impact of as5 sistance authorized under this section and pur6 suant to the strategy required under subsection 

7 (b). 

8 ‘‘(B) REQUIREMENTS.—The monitoring 

9 and evaluation system shall— 

10 ‘‘(i) establish performance goals for 

11 assistance provided under this section; 

12 ‘‘(ii) establish performance indicators 

13 to be used in measuring or assessing the 

14 achievement of performance goals; 

15 ‘‘(iii) provide a basis for recommenda16 tions for adjustments to the assistance to 

17 enhance the impact of the assistance; and 

18 ‘‘(iv) to the extent feasible, utilize and 

19 support national monitoring and evaluation 

20 systems, with the objective of improved 

21 data collection without the imposition of 

22 unnecessary new burdens. 

23 ‘‘(b) STRATEGY OF THE UNITED STATES.— 

24 ‘‘(1) REQUIREMENT FOR STRATEGY.—Not later 

25 than 180 days after the date of the enactment of 


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1 this Act, the President shall develop and transmit to 

2 the appropriate congressional committees a strategy 

3 for coordinating, implementing, and monitoring as4 sistance programs for human health care capacity in 

5 sub-Saharan Africa. 

6 ‘‘(2) CONTENT.—The strategy required by 

7 paragraph (1) shall include— 

8 ‘‘(A) a description of a coordinated strat9 egy, including coordination among agencies and 

10 departments of the Federal Government with 

11 other bilateral and multilateral donors, to pro12 vide the assistance authorized in subsection (a); 

13 ‘‘(B) a description of a coordinated strat14 egy to consult with sub-Saharan African coun15 tries and the African Union on how best to ad16 vance the goals of this Act; and 

17 ‘‘(C) an analysis of how international fi18 nancial institutions can most effectively assist 

19 countries in their efforts to expand and better 

20 direct public spending in the health and edu21 cation sectors in tandem with the anticipated 

22 scale up of international assistance to combat 

23 HIV/AIDS and other health challenges, while 

24 simultaneously helping these countries maintain 

25 prudent fiscal balance. 


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1 ‘‘(3) FOCUS OF ANALYSIS.—The analysis de2 scribed in paragraph (2)(C) should focus on 2 or 3 

3 selected countries in sub-Saharan Africa, including, 

4 if practical, 1 focus country as designated under the 

5 President’s Emergency Plan for AIDS Relief (au6 thorized by the United States Leadership Against 

7 Global HIV/AIDS, Tuberculosis, and Malaria Act of 

8 2003 (Public Law 108–25)) and 1 country without 

9 such a designation. 

10 ‘‘(4) CONSULTATION.—The President is encour11 aged to develop the strategy required under para12 graph (1) in consultation with the Secretary of 

13 State, the Administrator for the United States 

14 Agency for International Development, including em15 ployees of its field missions, the Global HIV/AIDS 

16 Coordinator, the Chief Executive Officer of the Mil17 lennium Challenge Corporation, the Secretary of the 

18 Treasury, the Director of the Bureau of Citizenship 

19 and Immigration Services, the Director of the Cen20 ters for Disease Control and Prevention, and other 

21 relevant agencies to ensure coordination within the 

22 Federal Government. 

23 ‘‘(5) COORDINATION.— 

24 ‘‘(A) DEVELOPMENT OF STRATEGY.—To 

25 ensure coordination with national strategies and 


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1 objectives and other international efforts, the 

2 President should develop the strategy described 

3 in paragraph (1) by consulting appropriate offi4 cials of the United States Government and by 

5 coordinating with the following: 

6 ‘‘(i) Other donors. 

7 ‘‘(ii) Implementers. 

8 ‘‘(iii) International agencies. 

9 ‘‘(iv) Nongovernmental organizations 

10 working to increase human health capacity 

11 in sub-Saharan Africa. 

12 ‘‘(v) The World Bank. 

13 ‘‘(vi) The International Monetary 

14 Fund. 

15 ‘‘(vii) The Global Fund to Fight 

16 AIDS, Tuberculosis, and Malaria. 

17 ‘‘(viii) The World Health Organiza18 tion. 

19 ‘‘(ix) The International Labour Orga20 nization. 

21 ‘‘(x) The United Nations Development 

22 Programme. 

23 ‘‘(xi) The United Nations Programme 

24 on HIV/AIDS. 

25 ‘‘(xii) The European Union. 


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1 ‘‘(xiii) The African Union. 

2 ‘‘(B) ASSESSMENT AND COMPILATION.— 

3 The President should make the assessments 

4 and compilations required by subsection 

5 (a)(3)(B)(v), in coordination with the entities 

6 listed in subparagraph (A). 

7 ‘‘(c) REPORT.— 

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

9 the date on which the President submits the strategy 

10 required in subsection (b), the President shall sub11 mit to the appropriate congressional committees a 

12 report on the implementation of this section. 

13 ‘‘(2) ASSESSMENT OF MECHANISMS FOR

14 KNOWLEDGE SHARING.—The report described in 

15 paragraph (1) shall be accompanied by a document 

16 assessing best practices and other mechanisms for 

17 knowledge sharing about human resources for health 

18 and capacity building efforts to be shared with gov19 ernments of developing countries and others seeking 

20 to promote improvements in human resources for 

21 health and capacity building. 

22 ‘‘(3) FOLLOW-UP REPORT.—Not later than 3 

23 years after the date on which the President submits 

24 the strategy required in subsection (b), the president 

25 shall submit to the appropriate congressional comVerDate Aug 31 2005 20:25 Mar 10, 2007 Jkt 059200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S805.IS S805

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1 mittees a further report on the implementation of 

2 this section. 

3 ‘‘(d) DEFINITIONS.—In this section: 

4 ‘‘(1) APPROPRIATE CONGRESSIONAL COMMIT5 TEES.—The term ‘appropriate congressional com6 mittees’ means the Committee on Foreign Relations 

7 and the Committee on Appropriations of the Senate 

8 and the Committee on International Relations and 

9 the Committee on Appropriations of the House of 

10 Representatives. 

11 ‘‘(2) BRAIN DRAIN.—The term ‘brain drain’ 

12 means the emigration of a significant proportion of 

13 a country’s professionals working in the health field 

14 to wealthier countries, with a resulting loss of per15 sonnel and often a loss in investment in education 

16 and training for the countries experiencing the emi17 gration. 

18 ‘‘(3) HEALTH PROFESSIONAL.—The term 

19 ‘health professional’ means a person whose occupa20 tion or training helps to identify, prevent, or treat 

21 illness or disability. 

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

23 the meaning given such term in section 104A(g) of 

24 the Foreign Assistance Act of 1961 (22 U.S.C. 

25 2151b–2(g)). 


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1 ‘‘(5) PARAPROFESSIONAL.—The term ‘para2 professional’ means an individual who is trained and 

3 employed as a health agent for the provision of basic 

4 assistance in the identification, prevention, or treat5 ment of illness or disability. 

6 ‘‘(6) COMMUNITY HEALTH WORKERS.—The 

7 term ‘community health worker’ means a community 

8 based caregiver who has received instruction and is 

9 employed to provide basic health services in specific 

10 catchment areas, most often the areas where they 

11 themselves live. 

12 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

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

14 appropriated to the President to carry out the provi15 sions of this section— 

16 ‘‘(A) $150,000,000 for fiscal year 2008; 

17 ‘‘(B) $200,000,000 for fiscal year 2009; 

18 and 

19 ‘‘(C) $250,000,000 for fiscal year 2010. 

20 ‘‘(2) AVAILABILITY OF FUNDS.—Amounts made 

21 available under paragraph (1) are authorized to re22 main available until expended and are in addition to 

23 amounts otherwise made available for the purpose of 

24 carrying out this section.’’. 

Æ 


ycherry on PROD1PC64 with BILLS