I

107TH CONGRESS

1ST SESSION H. R. 2069

To amend the Foreign Assistance Act of 1961 to authorize assistance to

prevent, treat, and monitor HIV/AIDS in sub-Saharan African and other

developing countries.

IN THE HOUSE OF REPRESENTATIVES

JUNE 6, 2001

Mr. HYDE introduced the following bill; which was referred to the Committee

on International Relations

A BILL

To amend the Foreign Assistance Act of 1961 to authorize

assistance to prevent, treat, and monitor HIV/AIDS in

sub-Saharan African and other developing countries.

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 ‘‘Global Access to HIV/

5 AIDS Prevention, Awareness, Education, and Treatment

6 Act of 2001’’.

7 SEC. 2. FINDINGS; SENSE OF CONGRESS.

8 (a) FINDINGS.—Congress makes the following find9 ings:
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1 (1) The HIV/AIDS pandemic has claimed

2 22,000,000 lives since its inception.

3 (2) More than 17,000,000 individuals have died

4 from HIV/AIDS in sub-Saharan Africa alone.

5 (3) More than 36,000,000 individuals are in6 fected with HIV, of which approximately 25,000,000

7 individuals live in sub-Saharan Africa.

8 (4) The HIV/AIDS pandemic in sub-Saharan

9 Africa has grown beyond an international public

10 health issue to become a humanitarian and develop11 mental crisis.

12 (5) Although the HIV/AIDS pandemic has im13 pacted the sub-Saharan region of Africa dispropor14 tionately, HIV infection rates are rising rapidly in

15 India and other South Asian countries, Brazil, Car16 ibbean countries, and Russia, and pose a serious

17 threat to the security and stability in those coun18 tries.

19 (6) By 2010, it is estimated that approximately

20 40,000,000 children worldwide will have lost one or

21 both of their parents to HIV/AIDS.

22 (7) In January 2000, the United States Na23 tional Intelligence Council released an intelligence

24 estimate that framed the HIV/AIDS pandemic as a
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1 security threat, noting the relationship between the

2 disease and political and economic instability.

3 (8) The overriding priority for responding to

4 the HIV/AIDS crisis should be to emphasize and en5 courage awareness, education, and prevention, in6 cluding prevention activities that promote behavioral

7 change. In so doing, priority and support should be

8 given to nongovernmental organizations, including

9 faith-based organizations.

10 (9) An effective response to the HIV/AIDS pan11 demic must also involve assistance to stimulate the

12 development of sound health service delivery infra13 structure systems in sub-Saharan African and other

14 developing countries.

15 (10) Access to effective treatment for HIV/

16 AIDS is determined by issues of price, health system

17 infrastructure, and sustainable financing and such

18 access can be inhibited by the stigma and discrimi19 nation associated with HIV/AIDS.

20 (11) An effective United States response to the

21 HIV/AIDS crisis must also focus on the development

22 of HIV/AIDS vaccines to prevent the spread of the

23 disease as well as the development of microbicides,

24 effective diagnostics, and simpler treatments.
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1 (12) The innovative capacity of the United

2 States in the commercial and public pharmaceutical

3 research sectors is among the foremost in the world,

4 and the active participation of both these sectors

5 should be supported as it is critical to combat the

6 global HIV/AIDS pandemic.

7 (13) Appropriate treatment of individuals with

8 HIV/AIDS can prolong the lives of such individuals

9 and increase their productivity by allowing them to

10 lead active lives and reduce the need for costly hos11 pitalization for treatment of opportunistic infections

12 caused by HIV.

13 (14) United States volunteers with skills in

14 healthcare and HIV/AIDS counseling and prevention

15 programs have proven effective in combating the

16 HIV/AIDS pandemic and can be a resource in as17 sisting sub-Saharan African leaders of traditional,

18 political, business, and youth organizations in their

19 efforts to prevent the spread of HIV/AIDS through

20 awareness and educational programs.

21 (15) Most of the HIV infected poor of the de22 veloping world die of deadly opportunistic diseases

23 such as tuberculosis. Accordingly, effective HIV/

24 AIDS treatment programs should address the grow25 ing threat and spread of tuberculosis in the devel-
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1 oping world. Malaria is also a major infectious dis2 ease that kills many individuals, particularly chil3 dren.

4 (16) Microenterprise development programs as5 sist communities afflicted by the HIV/AIDS pan6 demic and increase the productive capacity of com7 munities and afflicted households. Microenterprise

8 programs are also an effective means to support the

9 productive activities of healthy family members car10 ing for the sick and orphaned.

11 (b) SENSE OF CONGRESS.—It is the sense of Con12 gress that—

13 (1)(A) combatting the HIV/AIDS pandemic in

14 sub-Saharan African and other developing countries

15 should be a global effort and include the financial

16 support of all developed countries and the coopera17 tion of governments and the private sector, including

18 faith-based organizations; and

19 (B) the United States should provide additional

20 funds for multilateral programs and efforts to com21 bat HIV/AIDS and also seek to leverage public and

22 private resources to combat HIV/AIDS on a global

23 basis through the Global Development Alliance Ini24 tiative of the United States Agency for International

25 Development and other public and private partner-
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1 ships with an emphasis on HIV/AIDS awareness,

2 education, and prevention programs;

3 (2)(A) in addition to HIV/AIDS awareness,

4 education, and prevention programs, the United

5 States Government should support programs that

6 safely make available to public and private entities

7 in sub-Saharan African and other developing coun8 tries pharmaceuticals and diagnostics for HIV/AIDS

9 therapy in order—

10 (i) to effectively and safely and assist such

11 countries in the delivery of HIV/AIDS therapy

12 pharmaceuticals through the establishment of

13 adequate health care delivery systems and

14 treatment monitoring programs; and

15 (ii) to provide treatment for poor individ16 uals with HIV/AIDS in such countries; and

17 (B) in carrying out such programs, priority

18 consideration for participation should be given to

19 sub-Saharan African countries;

20 (3) the United States should promote efforts to

21 expand and develop programs that support the grow22 ing number of children orphaned by the HIV/AIDS

23 pandemic;

24 (4) treatment for HIV/AIDS should be a com25 ponent of a comprehensive international effort to
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1 combat deadly infectious and opportunistic diseases,

2 including malaria and tuberculosis, that kill millions

3 annually in the developing world;

4 (5) the United States Agency for International

5 Development should carry out HIV/AIDS awareness,

6 prevention, and treatment programs in conjunction

7 with effective international tuberculosis and malaria

8 treatment and eradication programs; and

9 (6) the United States Agency for International

10 Development should expand and replicate successful

11 microenterprise programs in Uganda, Zambia,

12 Zimbabwe, and other African countries that provide

13 poor families affected by HIV/AIDS with financial

14 services, such as life, health care, and credit insur15 ance, and the means to care for themselves, their

16 children, and orphans.

17 SEC. 3. ASSISTANCE TO COMBAT HIV/AIDS.

18 (a) ASSISTANCE.—Section 104(c) of the Foreign As19 sistance Act of 1961 (22 U.S.C. 2151b(c)) is amended—

20 (1) by striking paragraphs (4) through (6); and

21 (2) by inserting after paragraph (3) the fol22 lowing:

23 ‘‘(4)(A) Congress recognizes that the alarming spread

24 of HIV/AIDS in sub-Saharan African and other devel25 oping countries is a major global health threat and hu-
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1 manitarian crisis. Accordingly, the United States and

2 other developed countries should provide assistance to sub3 Saharan and other developing countries to control this cri4 sis through HIV/AIDS prevention, treatment, monitoring,

5 and related activities.

6 ‘‘(B)(i) The Administrator of the United States

7 Agency for International Development is authorized to

8 provide assistance to prevent, treat, and monitor HIV/

9 AIDS, and carry out related activities, in sub-Saharan Af10 rican and other developing countries.

11 ‘‘(ii) It is the sense of Congress that the Adminis12 trator should provide an appropriate level of assistance

13 under clause (i) through nongovernmental organizations

14 in Sub-African and other developing countries affected by

15 the HIV/AIDS pandemic.

16 ‘‘(iii) The Administrator shall coordinate the provi17 sion of assistance under clause (i) with the provision of

18 related assistance by the Joint United Nations Pro19 gramme on HIV/AIDS (UNAIDS), the United Nations

20 Children’s Fund (UNICEF), the World Health Organiza21 tion (WHO), other similar international organizations, na22 tional, state, and local governments of foreign countries,

23 and other appropriate governmental and nongovernmental

24 organizations.
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1 ‘‘(C) Assistance provided under subparagraph (B)

2 shall, to the maximum extent practicable, be used to carry

3 out the following activities:

4 ‘‘(i) Primarily the prevention of HIV/AIDS

5 through—

6 ‘‘(I) voluntary testing and counseling; and

7 ‘‘(II) assistance through nongovernmental

8 organizations, including faith-based organiza9 tions, particularly those organizations that uti10 lize volunteers, to establish and implement cul11 turally appropriate HIV/AIDS education and

12 prevention programs.

13 ‘‘(ii) The treatment of individuals with HIV/

14 AIDS, including—

15 ‘‘(I) assistance to establish and implement

16 programs to strengthen and broaden indigenous

17 health care systems infrastructure and the ca18 pacity of such systems to deliver HIV/AIDS

19 pharmaceuticals and otherwise provide for the

20 treatment of individuals with HIV/AIDS, in21 cluding clinical training for indigenous organi22 zations and health care providers; and

23 ‘‘(II) assistance aimed at the prevention of

24 transmission of HIV/AIDS from mother to

25 child.
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1 ‘‘(iii) The monitoring of programs, projects, and

2 activities carried out pursuant to clauses (i) and (ii),

3 including—

4 ‘‘(I) monitoring to ensure that adequate

5 controls are established and implemented to

6 provide HIV/AIDS pharmaceuticals and other

7 appropriate medicines to poor individuals with

8 HIV/AIDS; and

9 ‘‘(II) appropriate evaluation and surveil10 lance activities.

11 ‘‘(iv) The conduct of related activities,

12 including—

13 ‘‘(I) the care and support of children who

14 are orphaned by the HIV/AIDS pandemic, in15 cluding through innovative programs modeled

16 on foster care and other services designed to

17 care for orphaned children in a family environ18 ment; and

19 ‘‘(II) the development and expansion of fi20 nancially-sustainable microfinance institutions

21 that strengthen the economic and social viabil22 ity of communities afflicted by the HIV/AIDS

23 pandemic, including support for the savings and

24 productive capacity of affected poor households

25 caring for orphans and the provision of finan-
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1 cial services, such as life, health, and credit in2 surance.

3 ‘‘(D) The Administrator shall submit to Congress an

4 annual report of the implementation of this paragraph for

5 the prior year.

6 ‘‘(E)(i) There are authorized to be appropriated to

7 the President to carry out this paragraph $469,000,000

8 for each of the fiscal years 2002 and 2003.

9 ‘‘(ii) Not more than three percent of the amount ap10 propriated pursuant to the authorization of appropriations

11 under clause (i) for a fiscal year may be used for the ad12 ministrative expenses of the Agency in carrying out this

13 paragraph.

14 ‘‘(iii) Amounts appropriated pursuant to the author15 ization of appropriations under clause (i) are in addition

16 to amounts otherwise available for such purposes and are

17 authorized to remain available until expended.

18 ‘‘(F) In this paragraph:

19 ‘‘(i) The term ‘HIV’ means infection with the

20 human immunodeficiency virus.

21 ‘‘(ii) The term ‘AIDS’ means acquired immune

22 deficiency syndrome.’’.

23 (b) AVAILABILITY OF ASSISTANCE UNDER SECTION

24 104(c).—Section 104(c) of the Foreign Assistance Act of

25 1961 (22 U.S.C. 2151b(c)) is amended—
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1 (1) by redesignating paragraph (7) as para2 graph (5); and

3 (2) by adding at the end the following:

4 ‘‘(6) Assistance made available under any paragraph

5 of this subsection, and assistance made available under

6 chapter 4 of part II of this Act to carry out the purposes

7 of any paragraph of this subsection, may be made avail8 able notwithstanding any other provision of law.’’.

9 SEC. 4. ASSISTANCE FOR PROCUREMENT AND DISTRIBU10 TION OF HIV/AIDS PHARMACEUTICALS AND

11 RELATED MEDICINES.

12 (a) ASSISTANCE.—The Administrator of the United

13 States Agency for International Development shall provide

14 assistance to sub-Saharan African and other developing

15 countries for—

16 (1) the procurement of HIV/AIDS pharma17 ceuticals, anti-viral therapies, and other appropriate

18 medicines; and

19 (2) the distribution of such HIV/AIDS pharma20 ceuticals, anti-viral therapies, and other appropriate

21 medicines to qualified national, regional, or local or22 ganizations for the treatment of individuals with

23 HIV/AIDS in accordance with appropriate HIV/

24 AIDS testing and monitoring requirements and for
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1 the prevention of transmission of HIV/AIDS from

2 mother to child.

3 (b) AUTHORIZATION OF APPROPRIATIONS.—There

4 are authorized to be appropriated to the President to carry

5 out this section $50,000,000 for fiscal year 2002.

6 SEC. 5. AUTHORIZATION OF APPROPRIATIONS FOR MULTI7 LATERAL EFFORTS TO PREVENT, TREAT, AND

8 MONITOR HIV/AIDS.

9 There are authorized to be appropriated to the Presi10 dent for each of the fiscal years 2002 and 2003 such sums

11 as may be necessary for United States contributions to

12 multilateral efforts to prevent, treat, and monitor HIV/

13 AIDS in sub-Saharan African and other developing coun14 tries. The amount authorized to be appropriated under the

15 preceding sentence for any fiscal year may not exceed 25

16 percent of the aggregate amount proposed to be contrib17 uted for such fiscal year by all countries for such efforts.

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