II

106TH CONGRESS

2D SESSION S. 2032

To amend the Foreign Assistance Act of 1961 to address the issue of

mother-to-child transmission of human immunodeficiency virus (HIV)

in Africa, Asia, and Latin America.

IN THE SENATE OF THE UNITED STATES

FEBRUARY 3, 2000

Mr. MOYNIHAN (for himself and Mr. FEINGOLD) 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 address

the issue of mother-to-child transmission of human immunodeficiency virus (HIV) in Africa, Asia, and Latin

America.

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 ‘‘Mother-to-Child HIV

5 Prevention Act of 2000’’.

6 SEC. 2. FINDINGS.

7 Congress makes the following findings:
2

•S 2032 IS

1 (1) According to UNAIDS, nearly 4,500,000

2 children under 15 years of age have been infected

3 with the human immunodeficiency virus (HIV) since

4 the AIDS epidemic began. More than 3,000,000

5 have already died of AIDS. Children are becoming

6 infected at about the rate of 1 child every minute,

7 and the overwhelming majority of these children ac8 quire the infection from their mothers.

9 (2) The gap between rich and poor countries in

10 terms of transmission of HIV from mother to child

11 has been increasing. Moreover, AIDS threatens to

12 reverse years of steady progress of child survival in

13 developing countries. UNAIDS believes that by the

14 year 2010, AIDS may have increased mortality of

15 children under 5 years of age by more than 100 per16 cent in regions most affected by the virus.

17 (3) The discovery of a relatively simple and

18 cheap means of interrupting the transmission of

19 HIV from an infected mother to the unborn child—

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

21 tablet—has created a great opportunity for an un22 precedented partnership between the United States

23 Government and the governments of Asian, African

24 and Latin American countries to combat mother-to-
3

•S 2032 IS

1 child transmission (also known as ‘‘vertical trans2 mission’’) of HIV.

3 (4) According to UNAIDS, this strategy will

4 decrease the proportion of orphans that are HIV-in5 fected and decrease infant and child mortality rates

6 in these developing regions.

7 (5) USAID, UNAIDS, and UNICEF are en8 gaged in 11 pilot projects around the world. These

9 studies will be completed within the year, and the

10 technical and ethical questions associated with

11 antiretroviral prevention strategies will be mastered

12 well enough in order for a significant increase in

13 scale to be undertaken.

14 (6) Primary prevention strategies should re15 main the top priority in the fight against AIDS and

16 no funds should be diverted away from it. Therefore,

17 new funding for vertical transmission should only be

18 additive in nature. Once appropriated, this funding

19 will facilitate widespread delivery of antiretroviral

20 strategies to address the vertical transmission prob21 lem.

22 (7) New antiretroviral drug strategy can be a

23 force for social change, providing the opportunity

24 and impetus needed to tackle often long-standing

25 problems of inadequate services and the profound
4

•S 2032 IS

1 stigma associated with HIV-infection and the AIDS

2 disease. Strengthening the health infrastructure to

3 improve mother-and-child health, antenatal, delivery

4 and postnatal services, and couples counseling gen5 erates enormous spillover effects toward combating

6 the AIDS epidemic in developing regions.

7 SEC. 3. ASSISTANCE FOR PREVENTION OF VERTICAL

8 TRANSMISSION.

9 Section 104(c) of the Foreign Assistance Act of 1961

10 (22 U.S.C. 2151b(c)) is amended by adding at the end

11 the following new paragraph:

12 ‘‘(4)(A) Congress recognizes the growing inter13 national dilemma of children with the human immuno14 deficiency virus (HIV) and the merits of intervention pro15 grams aimed at this problem. Congress further recognizes

16 that mother-to-child transmission prevention strategies

17 can serve as a major force for change in developing re18 gions, and it is, therefore, a major objective of the foreign

19 assistance program to control the AIDS epidemic. The

20 agency primarily responsible for administering this part

21 shall—

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

23 WHO, local governments, and other organizations to

24 develop and implement effective strategies to prevent

25 vertical transmission of HIV; and
5

•S 2032 IS

1 ‘‘(ii) coordinate with those organizations to in2 crease in scale intervention programs and introduce

3 voluntary counseling and testing, antiretroviral

4 drugs, replacement feeding, and other strategies

5 more widely in due course.

6 ‘‘(B) In addition to amounts otherwise available for

7 such purpose, there are authorized to be appropriated to

8 the President, $25,000,000 for each of the fiscal years

9 2001 through 2005 to be used to carry out this paragraph.

10 Funds appropriated under this paragraph are authorized

11 to remain available until expended.’’.

Æ