In the Senate of the United States,

July 12 (legislative day, July 10), 2002.

Resolved, That the bill from the House of Representatives (H.R. 2069) entitled ‘‘An Act to amend the Foreign Assistance Act of 1961 and the Global AIDS and Tuberculosis

Relief Act of 2000 to authorize assistance to prevent, treat,

and monitor HIV/AIDS in sub-Saharan African and other developing countries.’’, do pass with the following

AMENDMENTS:

Strike out all after the enacting clause and insert:

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

2 (a) SHORT TITLE.—This Act may be cited as the

3 ‘‘United States Leadership Against HIV/AIDS, Tuber4 culosis, and Malaria Act of 2002’’.
 †

2

HR 2069 EAS

1 (b) TABLE OF CONTENTS.—The table of contents for

2 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

Sec. 3. Definitions.

Sec. 4. Purpose.

TITLE I—POLICY PLANNING AND COORDINATION

Sec. 101. Development of a comprehensive, five-year, global strategy.

Sec. 102. Comprehensive plan to empower women to prevent the spread of HIV/

AIDS.

Sec. 103. HIV/AIDS Response Coordinator.

Sec. 104. Report on reversing the exodus of critical talent.

TITLE II—PUBLIC-PRIVATE PARTNERSHIPS

Sec. 201. Sense of Congress on public-private partnerships.

Sec. 202. Participation in the Global Fund to Fight AIDS, Tuberculosis, and

Malaria.

Sec. 203. Voluntary contributions to international vaccine funds.

TITLE III—MULTILATERAL EFFORTS

Sec. 301. Improvement of the Enhanced HIPC Initiative.

Sec. 302. Reports on implementation of improvements to the Enhanced HIPC

Initiative.

TITLE IV—BILATERAL EFFORTS

Subtitle A—General Assistance and Programs

Sec. 401. Assistance to combat HIV/AIDS.

Sec. 402. Assistance to combat tuberculosis.

Sec. 403. Assistance to combat malaria.

Sec. 404. Pilot program for the placement of health care professionals in overseas

areas severely affected by HIV/AIDS, tuberculosis, and malaria.

Sec. 405. Department of Defense HIV/AIDS prevention assistance program.

Sec. 406. Report on treatment activities by relevant Executive branch agencies.

Subtitle B—Assistance for Children and Families

Sec. 411. Findings.

Sec. 412. Policy and requirements.

Sec. 413. Annual reports on prevention of mother-to-child transmission of the

HIV infection.

Sec. 414. Pilot program of assistance for children and families affected by HIV/

AIDS.

TITLE V—BUSINESS PRINCIPLES

Sec. 501. Principles for United States firms operating in countries affected by the

HIV/AIDS pandemic.
†

3

HR 2069 EAS

TITLE VI—ADDITIONAL AUTHORITIES

Sec. 601. Authority of the Department of Health and Human Services.

Sec. 602. Microbicide research at the National Institutes of Health.

Sec. 603. Authority of the Department of Labor.

Sec. 604. Authority for international programs.

1 SEC. 2. FINDINGS.

2 Congress makes the following findings:

3 (1) During the last 20 years, HIV/AIDS has as4 sumed pandemic proportions, spreading from the

5 most severely affected region, sub-Saharan Africa, to

6 all corners of the world, and leaving an unprece7 dented path of death and devastation.

8 (2) According to the Joint United Nations Pro9 gramme on HIV/AIDS (UNAIDS), more than

10 60,000,000 people worldwide have been infected with

11 HIV since the epidemic began; more than 22,000,000

12 of these have lost their lives to the disease; and more

13 than 13,000,000 children have been orphaned by the

14 disease. HIV/AIDS is the fourth-highest cause of death

15 in the world.

16 (3) At the end of 2001, an estimated 40,000,000

17 people were infected with HIV or living with AIDS.

18 Of these, more than 2,700,000 were children under the

19 age of fifteen and more than 17,600,000 were women.

20 Women are four times more vulnerable to infection

21 than are men and are becoming infected at increas22 ingly high rates because in many societies women
†

4

HR 2069 EAS

1 lack control over sexual encounters and cannot insist

2 on the use of protective measures. Women and chil3 dren who are refugees or are internally displaced per4 sons are especially vulnerable to sexual violence,

5 thereby increasing the possibility of HIV infection.

6 (4) As the leading cause of death in sub-Saharan

7 Africa, AIDS has killed more than 17,000,000 people

8 (more than 3 times the number of AIDS deaths in the

9 rest of the world) and will claim the lives of one-quar10 ter of the population, mostly adults, in the next dec11 ade.

12 (5) An estimated 1,800,000 people in Latin

13 America and the Caribbean and another 7,100,000

14 people in Asia and the Pacific region are infected

15 with HIV or living with AIDS. Infection rates are

16 rising alarmingly in Eastern Europe (especially in

17 the Russian Federation), Central Asia, and China.

18 (6) HIV/AIDS threatens personal security by af19 fecting the health, lifespan, and productive capacity

20 of the individual and the social cohesion and eco21 nomic well-being of the family.

22 (7) HIV/AIDS undermines the economic security

23 of a country and individual businesses in that coun24 try by weakening the productivity and longevity of

25 the labor force across a broad array of economic sec-
†

5

HR 2069 EAS

1 tors and by reducing the potential for economic

2 growth over the long term.

3 (8) HIV/AIDS destabilizes communities by strik4 ing at the most mobile and educated members of soci5 ety, many of whom are responsible for security at the

6 local level and governance at the national and sub7 national levels as well as many teachers, health care

8 personnel, and other community workers vital to com9 munity development and the effort to combat HIV/

10 AIDS. In some countries the overwhelming challenges

11 of the HIV/AIDS epidemic are accelerating the out12 ward migration of critically important health care

13 professionals.

14 (9) HIV/AIDS weakens the defenses of countries

15 severely affected by the HIV/AIDS crisis through high

16 infection rates among members of their military

17 forces. According to UNAIDS, in sub-Saharan Africa,

18 many military forces have infection rates as much as

19 five times that of the civilian population.

20 (10) HIV/AIDS poses a serious security issue for

21 the international community by—

22 (A) increasing the potential for political in23 stability and economic devastation, particularly

24 in those countries and regions most severely af25 fected by the disease; and
†

6

HR 2069 EAS

1 (B) decreasing the capacity to resolve con2 flicts through the introduction of peacekeeping

3 forces because the environments into which these

4 forces are introduced pose a high risk for the

5 spread of HIV/AIDS.

6 (11) The devastation wrought by the HIV/AIDS

7 pandemic is compounded by the prevalence of tuber8 culosis and malaria, particularly in developing coun9 tries where the poorest and most vulnerable members

10 of society, including women, children, and those liv11 ing with HIV/AIDS, become infected. According to the

12 World Health Organization (WHO), HIV/AIDS, tu13 berculosis, and malaria accounted for more than

14 5,700,000 deaths in 2001 and caused debilitating ill15 nesses in millions more.

16 (12) Tuberculosis is the cause of death for one

17 out of every three people with AIDS worldwide and

18 is a highly communicable disease. HIV infection is

19 the leading threat to tuberculosis control. Because

20 HIV infection so severely weakens the immune system,

21 individuals with HIV and latent tuberculosis infec22 tion have a 100 times greater risk of developing active

23 tuberculosis diseases thereby increasing the risk of

24 spreading tuberculosis to others. Tuberculosis, in turn,
†

7

HR 2069 EAS

1 accelerates the onset of AIDS in individuals infected

2 with HIV.

3 (13) Malaria, the most deadly of all tropical

4 parasitic diseases, has been undergoing a dramatic

5 resurgence in recent years due to increasing resistance

6 of the malaria parasite to inexpensive and effective

7 drugs. At the same time, increasing resistance of mos8 quitoes to standard insecticides makes control of

9 transmission difficult to achieve. The World Health

10 Organization estimates that between 300,000,000 and

11 500,000,000 new cases of malaria occur each year,

12 and annual deaths from the disease number between

13 2,000,000 and 3,000,000. Persons infected with HIV

14 are particularly vulnerable to the malaria parasite.

15 The spread of HIV infection contributes to the dif16 ficulties of controlling resurgence of the drug resistant

17 malaria parasite.

18 (14) Although HIV/AIDS is first and foremost a

19 health problem, successful strategies to stem the

20 spread of the pandemic will require not only medical

21 interventions, the strengthening of health care delivery

22 systems and infrastructure and determined national

23 leadership and increased budgetary allocations for the

24 health sector in countries affected by the epidemic but

25 also measures to address the social and behavioral
†

8

HR 2069 EAS

1 causes of the problem and its impact on families,

2 communities, and societal sectors.

3 (15) Basic interventions to prevent new HIV in4 fections and to bring care and treatment to people liv5 ing with AIDS, such as voluntary counseling and

6 testing and mother-to-child transmission programs,

7 are achieving meaningful results and are cost-effec8 tive. The challenge is to expand these interventions

9 from a pilot program basis to a national basis in a

10 coherent and sustainable manner.

11 (16) The magnitude and scope of the HIV/AIDS

12 crisis demands a comprehensive, long-term, inter13 national response focused upon addressing the causes,

14 reducing the spread, and ameliorating the con15 sequences of the HIV/AIDS pandemic, including—

16 (A) prevention and education, care and

17 treatment, basic and applied research, and

18 training of health care workers, particularly at

19 the community and provincial levels, and other

20 community workers and leaders needed to cope

21 with the range of consequences of the HIV/AIDS

22 crisis;

23 (B) development of health care infrastruc24 ture and delivery systems through cooperative
†

9

HR 2069 EAS

1 and coordinated public efforts and public and

2 private partnerships;

3 (C) development and implementation of na4 tional and community-based multisector strate5 gies that address the impact of HIV/AIDS on the

6 individual, family, community, and nation and

7 increase the participation of at-risk populations

8 in programs designed to encourage behavioral

9 and social change and reduce the stigma associ10 ated with HIV/AIDS; and

11 (D) coordination of efforts between inter12 national organizations such as the Global Fund

13 to Fight AIDS, Tuberculosis and Malaria, the

14 Joint United Nations Programme on HIV/AIDS

15 (UNAIDS), the World Health Organization

16 (WHO), national governments, and private sec17 tor organizations.

18 (17) The United States has the capacity to lead

19 and enhance the effectiveness of the international com20 munity’s response by—

21 (A) providing substantial financial re22 sources, technical expertise, and training, par23 ticularly of health care personnel and commu24 nity workers and leaders;
†

10

HR 2069 EAS

1 (B) promoting vaccine and microbicide re2 search and the development of new treatment

3 protocols in the public and commercial pharma4 ceutical research sectors;

5 (C) encouraging governments and commu6 nity-based organizations to adopt policies that

7 treat HIV/AIDS as a multisectoral problem af8 fecting not only health but other areas such as

9 education, the economy, the family and society,

10 and assisting them to develop and implement

11 programs corresponding to these needs; and

12 (D) encouraging active involvement of the

13 private sector, including businesses, pharma14 ceutical and biotechnology companies, the med15 ical and scientific communities, charitable foun16 dations, private and voluntary organizations

17 and nongovernmental organizations, faith-based

18 organizations, community-based organizations,

19 and other nonprofit entities.

20 SEC. 3. DEFINITIONS.

21 In this Act:

22 (1) AIDS.—The term ‘‘AIDS’’ means the ac23 quired immune deficiency syndrome.

24 (2) APPROPRIATE CONGRESSIONAL COMMIT25 TEES.—The term ‘‘appropriate congressional commit-
†

11

HR 2069 EAS

1 tees’’ means the Committee on Foreign Relations of

2 the Senate and the Committee on International Rela3 tions of the House of Representatives.

4 (3) DESIGNATED CONGRESSIONAL COMMIT5 TEES.—The term ‘‘designated congressional commit6 tees’’ means the Committee on Foreign Relations and

7 the Committee on Health, Education, Labor, and

8 Pensions of the Senate and the Committee on Inter9 national Relations and the Committee on Energy and

10 Commerce of the House of Representatives.

11 (4) GLOBAL FUND.—The term ‘‘Global Fund’’

12 means the public-private partnership known as the

13 Global Fund to Fight AIDS, Tuberculosis and Ma14 laria that was established upon the call of the United

15 Nations Secretary General in April 2001.

16 (5) HIV.—The term ‘‘HIV’’ means the human

17 immunodeficiency virus, the pathogen that causes

18 AIDS.

19 (6) HIV/AIDS.—The term ‘‘HIV/AIDS’’ means,

20 with respect to an individual, an individual who is

21 infected with HIV or living with AIDS.

22 (7) RELEVANT EXECUTIVE BRANCH AGENCIES.—

23 The term ‘‘relevant Executive branch agencies’’ means

24 the Department of State, the United States Agency for

25 International Development, the Department of Health
†

12

HR 2069 EAS

1 and Human Services (including the Centers for Dis2 ease Control and Prevention, the Health Resources

3 and Services Administration, the National Institutes

4 of Health, the Agency for Health Care Research and

5 Quality, and the Food and Drug Administration), the

6 Department of Labor, the Department of Commerce,

7 the Department of the Treasury, and the Department

8 of Defense.

9 SEC. 4. PURPOSE.

10 The purpose of this Act is to strengthen United States

11 leadership and the effectiveness of the United States re12 sponse to certain global infectious diseases by—

13 (1) establishing a comprehensive, integrated five14 year, global strategy to fight HIV/AIDS that encom15 passes a plan for phased expansion of critical pro16 grams and improved coordination among relevant

17 Executive branch agencies and between the United

18 States and foreign governments and international or19 ganizations;

20 (2) providing increased resources for multilateral

21 efforts to fight HIV/AIDS;

22 (3) providing increased resources for United

23 States bilateral efforts, particularly for technical as24 sistance and training, to combat HIV/AIDS, tuber25 culosis, and malaria;
†

13

HR 2069 EAS

1 (4) encouraging the expansion of private sector

2 efforts and expanding public-private sector partner3 ships to combat HIV/AIDS; and

4 (5) intensifying efforts to support the develop5 ment of vaccines and treatment for HIV/AIDS, tuber6 culosis, and malaria.

7 TITLE I—POLICY PLANNING AND

8 COORDINATION

9 SEC. 101. DEVELOPMENT OF A COMPREHENSIVE, FIVE10 YEAR, GLOBAL STRATEGY.

11 (a) STRATEGY.—The President shall establish a com12 prehensive, integrated, five-year strategy to combat global

13 HIV/AIDS that promotes the goals and objectives of the

14 Declaration of Commitment on HIV/AIDS, adopted by the

15 United Nations General Assembly at its Special Session on

16 HIV/AIDS in June 2001, and strengthens the capacity of

17 the United States to be an effective leader of the inter18 national campaign against HIV/AIDS. Such strategy

19 shall—

20 (1) include specific objectives, multisectoral ap21 proaches, and specific strategies to treat individuals

22 infected with HIV/AIDS and to prevent the further

23 spread of HIV infections, with a particular focus on

24 the needs of women, young people, and children;
†

14

HR 2069 EAS

1 (2) assign priorities for relevant Executive

2 branch agencies;

3 (3) improve coordination among relevant Execu4 tive branch agencies and foreign governments and

5 international organizations;

6 (4) project general levels of resources needed to

7 achieve the stated objectives;

8 (5) expand public-private partnerships and the

9 leveraging of resources; and

10 (6) maximize United States capabilities in the

11 areas of technical assistance and training and re12 search, including vaccine research.

13 (b) REPORT.—

14 (1) IN GENERAL.—Not later than 180 days after

15 the date of enactment of this Act, the President shall

16 submit to designated congressional committees a re17 port setting forth the strategy described in subsection

18 (a).

19 (2) REPORT ELEMENTS.—The report required by

20 paragraph (1) shall include a discussion of the fol21 lowing:

22 (A) The objectives, general and specific, of

23 the strategy.

24 (B) A description of the criteria for deter25 mining success of the strategy.
†

15

HR 2069 EAS

1 (C) A description of the manner in which

2 the strategy will address the fundamental ele3 ments of prevention and education; care and

4 treatment, including increasing access to phar5 maceuticals and to vaccines and microbicides

6 when available; research, including incentives for

7 vaccine development and new protocols; and

8 training of health care workers, and the develop9 ment of health care infrastructure and delivery

10 systems.

11 (D) A description of the manner in which

12 the strategy will promote the development and

13 implementation of national and community14 based multisectoral strategies and programs, in15 cluding those designed to enhance leadership ca16 pacity particularly at the community level.

17 (E) A description of the specific strategies

18 developed to meet the unique needs of women, in19 cluding the empowerment of women in inter20 personal situations, young people and children,

21 including those orphaned by HIV/AIDS.

22 (F) A description of the programs to be un23 dertaken to maximize United States contribu24 tions in the areas of technical assistance, train25 ing particularly of health care workers and com-
†

16

HR 2069 EAS

1 munity-based leaders in affected sectors, and re2 search including the promotion of research on

3 vaccines.

4 (G) An identification of the relevant Execu5 tive branch agencies that will be involved and

6 the assignment of priorities to those agencies.

7 (H) A description of the role of each rel8 evant Executive branch agency and the types of

9 programs that the agency will be undertaking.

10 (I) A description of the mechanisms that

11 will be utilized to coordinate the efforts of the

12 relevant Executive branch agencies, to avoid du13 plication of efforts, to enhance on-site coordina14 tion efforts, and to ensure that each agency un15 dertakes programs primarily in those areas

16 where the agency has the greatest expertise, tech17 nical capabilities, and potential for success.

18 (J) A description of the mechanisms that

19 will be utilized to ensure greater coordination be20 tween the United States and foreign governments

21 and international organizations including the

22 Global Fund, UNAIDS, international financial

23 institutions, and private sector organizations.

24 (K) The level of resources that will be need25 ed on an annual basis and the manner in which
†

17

HR 2069 EAS

1 those resources would generally be allocated

2 among relevant Executive agencies.

3 (L) A description of the mechanisms to be

4 established for monitoring and evaluating pro5 grams and for terminating unsuccessful pro6 grams.

7 (M) A description of the manner in which

8 private, nongovernmental entities will factor into

9 the United States Government-led effort and a

10 description of the type of partnerships that will

11 be created to maximize the capabilities of these

12 private sector entities and to leverage resources.

13 (N) A description of the manner in which

14 the United States strategy for combating HIV/

15 AIDS relates to and promotes the goals and ob16 jectives of the United Nations General Assembly’s

17 Declaration of Commitment on HIV/AIDS.

18 (O) A description of the ways in which

19 United States leadership will be used to enhance

20 the overall international response to the HIV/

21 AIDS pandemic and particularly to heighten the

22 engagement of the member states of the G–8 and

23 to strengthen key financial and coordination

24 mechanisms such as the Global Fund and

25 UNAIDS.
†

18

HR 2069 EAS

1 (P) A description of the manner in which

2 the United States strategy for combating HIV/

3 AIDS relates to and enhances other United

4 States assistance strategies in developing coun5 tries.

6 SEC. 102. COMPREHENSIVE PLAN TO EMPOWER WOMEN TO

7 PREVENT THE SPREAD OF HIV/AIDS.

8 (a) STATEMENT OF POLICY.—It is in the national in9 terest of the United States—

10 (1) to assist in empowering women socially, eco11 nomically, and intellectually to prevent coercive prac12 tices which contribute to the spread of HIV/AIDS;

13 (2) to ensure that there are affordable effective fe14 male controlled preventative technologies widely avail15 able;

16 (3) to assist in providing adequate pre- and

17 post-natal care to women infected with HIV or living

18 with AIDS to prevent an increase in the number of

19 AIDS orphans; and

20 (4) to educate communities in order to lessen the

21 stigma facing women who are infected with HIV or

22 living with AIDS.

23 (b) DEVELOPMENT OF PLAN.—The United States

24 Agency for International Development, working in conjunc25 tion with other relevant Executive branch agencies, shall
†

19

HR 2069 EAS

1 develop a comprehensive plan to empower women to protect

2 themselves against the spread of HIV/AIDS. The plan shall

3 include—

4 (1) immediately providing women greatly in5 creased access to and program support for currently

6 available prevention technologies for women and

7 microbicides when they become available;

8 (2) providing funding for research to develop

9 safe, effective, usable microbicides, including support

10 for—

11 (A) development and preclinical evaluation

12 of topical microbicides;

13 (B) the conduct of clinical studies of can14 didate microbicides to assess safety, accept15 ability, and effectiveness in reducing the HIV in16 fection and other sexually transmitted infections;

17 (C) behavioral and social science research

18 relevant to microbicide development, testing, ac19 ceptability, and use; and

20 (D) introductory studies of safe and effective

21 microbicides in developing countries;

22 (3) increasing women’s access to microfinance

23 programs;

24 (4) comprehensive education for women and girls

25 including health education that emphasizes skills
†

20

HR 2069 EAS

1 building on negotiation and the prevention of sexu2 ally transmitted infections and other related repro3 ductive health risks and strategies that emphasize the

4 delay of sexual debut;

5 (5) community-based strategies to combat gen6 der-based violence and sexual coercion of women and

7 minors;

8 (6) expansion of peer education strategies for

9 men which emphasize responsible sexual behavior and

10 consultation with their wives and partners in making

11 decisions about sex and reproduction;

12 (7) resources for households headed by females

13 caring for AIDS orphans;

14 (8) followup monitoring of and care and support

15 for post-natal women living with HIV or at high risk

16 of infection; and

17 (9) targeted plans to reduce the vulnerability of

18 HIV/AIDS for women, young people, and children

19 who are refugees or internally displaced persons.

20 (c) REQUIREMENT.—The plan shall specify, for the as21 sistance to achieve each of the objectives set forth in para22 graphs (1) through (9) of subsection (b), the section of the

23 Foreign Assistance Act of 1961 or other law that authorizes

24 such assistance.
†

21

HR 2069 EAS

1 (d) STAFFING.—The Administrator of the United

2 States Agency for International Development shall ensure

3 that the Agency dedicates a sufficient number of employees

4 to implementing the plan described in subsection (b).

5 (e) REPORT.—Not later than 270 days after the date

6 of enactment of this Act and every year for the next 3 years

7 thereafter, the Administrator of the United States Agency

8 for International Development shall submit to the appro9 priate congressional committees a report on the plan being

10 implemented by the United States Agency for International

11 Development on empowering women in order to prevent the

12 spread of HIV/AIDS. The report shall include a description

13 of—

14 (1) the programs being carried out that are spe15 cifically targeted at women and girls to educate them

16 about the spread of HIV/AIDS and the use and avail17 ability of currently available prevention technologies

18 for women, together with the number of women and

19 girls reached through these programs;

20 (2) the steps taken to increase the availability of

21 such technologies; and

22 (3) the progress on developing a safe, effective,

23 user-friendly microbicide.
†

22

HR 2069 EAS

1 SEC. 103. HIV/AIDS RESPONSE COORDINATOR.

2 (a) ESTABLISHMENT OF POSITION.—Section 1 of the

3 State Department Basic Authorities Act of 1956 (22 U.S.C.

4 265(a)) is amended—

5 (1) by redesignating subsections (f) and (g) as

6 subsections (g) and (h), respectively; and

7 (2) by adding after subsection (e) the following:

8 ‘‘(f) HIV/AIDS RESPONSE COORDINATOR.—

9 ‘‘(1) IN GENERAL.—There shall be within the De10 partment of State a Coordinator of United States

11 Government Activities to Combat HIV/AIDS Glob12 ally, who shall be appointed by the President, by and

13 with the advice and consent of the Senate. The Coor14 dinator shall report directly to the Secretary of State

15 and shall have the rank and status of ambassador.

16 ‘‘(2) DUTIES.—

17 ‘‘(A) IN GENERAL.—The Coordinator shall

18 have primary responsibility for the oversight and

19 coordination of all activities of the United States

20 Government to combat the international HIV/

21 AIDS pandemic, including all programs,

22 projects, and activities of the United States Gov23 ernment under titles I through V of the United

24 States Leadership Against HIV/AIDS, Tuber25 culosis, and Malaria Act of 2002 or any amend26 ment made by those titles.
†

23

HR 2069 EAS

1 ‘‘(B) SPECIFIC DUTIES.—The duties of the

2 Coordinator shall specifically include the fol3 lowing:

4 ‘‘(i) Ensuring program and policy co5 ordination among the relevant Executive

6 branch agencies.

7 ‘‘(ii) Ensuring that each relevant Exec8 utive branch agency undertakes programs

9 primarily in those areas where the agency

10 has the greatest expertise, technical capa11 bilities, and potential for success.

12 ‘‘(iii) Avoiding duplication of effort.

13 ‘‘(iv) Enhancing onsite coordination.

14 ‘‘(v) Pursuing coordination with other

15 countries and international organizations.

16 ‘‘(vi) Resolving policy, program, and

17 funding disputes among the relevant Execu18 tive branch agencies.’’.

19 (b) FIRST COORDINATOR.—The President may des20 ignate the incumbent Special Representative of the Sec21 retary of State for HIV/AIDS as of the date of enactment

22 of this Act as the first Coordinator of United States Govern23 ment Activities to Combat HIV/AIDS Globally.
†

24

HR 2069 EAS

1 SEC. 104. REPORT ON REVERSING THE EXODUS OF CRIT2 ICAL TALENT.

3 (a) IN GENERAL.—Not later than one year after the

4 date of enactment of this Act, the President shall submit

5 a report to designated congressional committees analyzing

6 the emigration of critically important medical and public

7 health personnel, including physicians, nurses, and super8 visors from sub-Saharan African countries that are acutely

9 impacted by HIV/AIDS.

10 (b) ELEMENTS OF THE REPORT.—The report shall

11 include—

12 (1) an analysis of the causes for the exodus of

13 such personnel, the present and projected trend lines,

14 and the impact on the stability of health infrastruc15 tures; and

16 (2) a description of incentives and programs

17 that the United States could provide, in concert with

18 other private and public sector partners and inter19 national organizations, to stabilize health institutions

20 by encouraging critical personnel to remain in their

21 home countries.

22 TITLE II—PUBLIC-PRIVATE

23 PARTNERSHIPS

24 SEC. 201. SENSE OF CONGRESS ON PUBLIC-PRIVATE PART25 NERSHIPS.

26 (a) FINDINGS.—Congress makes the following findings:
†

25

HR 2069 EAS

1 (1) Innovative partnerships between governments

2 and organizations in the private sector (including

3 foundations, universities, corporations, faith-based

4 and community-based organizations, and other non5 governmental organizations) have proliferated in re6 cent years, particularly in the area of health.

7 (2) Public-private sector partnerships multiply

8 local and international capacities to strengthen the

9 delivery of health services in developing countries and

10 to accelerate research for vaccines and other pharma11 ceutical products that are essential to combat infec12 tious diseases decimating the populations of these

13 countries.

14 (3) These partnerships maximize the unique ca15 pabilities of each sector while combining financial

16 and other resources, scientific knowledge, and exper17 tise toward common goals which neither the public

18 nor the private sector can achieve alone.

19 (4) Sustaining existing public-private partner20 ships and building new ones are critical to the success

21 of the international community’s efforts to combat

22 HIV/AIDS and other infectious diseases around the

23 globe.

24 (b) SENSE OF CONGRESS.—It is the sense of Congress

25 that—
†

26

HR 2069 EAS

1 (1) the sustainment and promotion of public-pri2 vate partnerships should be a priority element of the

3 strategy pursued by the United States to combat the

4 HIV/AIDS pandemic and other global health crises;

5 and

6 (2) the United States should systematically track

7 the evolution of these partnerships and work with oth8 ers in the public and private sector to profile and

9 build upon those models that are most effective.

10 SEC. 202. PARTICIPATION IN THE GLOBAL FUND TO FIGHT

11 AIDS, TUBERCULOSIS, AND MALARIA.

12 (a) AUTHORITY FOR UNITED STATES PARTICIPA13 TION.—

14 (1) UNITED STATES PARTICIPATION.—The

15 United States is hereby authorized to participate in

16 the Global Fund to Fight AIDS, Tuberculosis and

17 Malaria.

18 (2) PRIVILEGES AND IMMUNITIES.—The Global

19 Fund shall be considered a public international orga20 nization for purposes of section 1 of the International

21 Organizations Immunities Act (22 U.S.C. 288).

22 (b) REPORTS TO CONGRESS.—Not later than one year

23 after the date of the enactment of this Act, and annually

24 thereafter for the duration of the Global Fund, the President

25 shall submit to the appropriate congressional committees a
†

27

HR 2069 EAS

1 report on the Global Fund, including contributions pledged,

2 contributions received (including donations from the pri3 vate sector), projects funded, and the mechanisms estab4 lished for transparency and accountability in the grant

5 making process.

6 (c) UNITED STATES FINANCIAL PARTICIPATION.—

7 (1) AUTHORIZATION OF APPROPRIATIONS.—In

8 addition to funds otherwise available for such pur9 pose, there are authorized to be appropriated to the

10 President $1,000,000,000 for the fiscal year 2003 and

11 $1,200,000,000 for the fiscal year 2004 for contribu12 tions to the Global Fund.

13 (2) AVAILABILITY OF FUNDS.—Amounts appro14 priated pursuant to paragraph (1) are authorized to

15 remain available until expended.

16 (3) REPROGRAMMING OF FISCAL YEAR 2001

17 FUNDS.—Funds made available for fiscal year 2001

18 under section 141 of the Global AIDS and Tuber19 culosis Relief Act of 2000—

20 (A) are authorized to remain available until

21 expended; and

22 (B) shall be transferred to, merged with,

23 and made available for the same purposes as,

24 funds made available for fiscal year 2002 under

25 paragraph (1).
†

28

HR 2069 EAS

1 (4) STATUTORY CONSTRUCTION.—Nothing in this

2 Act may be construed to substitute for, or reduce re3 sources provided under any other law for bilateral

4 and multilateral HIV/AIDS, tuberculosis, and ma5 laria programs.

6 SEC. 203. VOLUNTARY CONTRIBUTIONS TO INTERNATIONAL

7 VACCINE FUNDS.

8 (a) VACCINE FUND.—Section 302(k) of the Foreign As9 sistance Act of 1961 (22 U.S.C. 2222(k)) is amended—

10 (1) by striking ‘‘$50,000,000’’ and all that fol11 lows through ‘‘2002’’ and inserting ‘‘$60,000,000 for

12 the fiscal year 2003 and $70,000,000 for the fiscal

13 year 2004’’; and

14 (2) by striking ‘‘Global Alliance for Vaccines and

15 Immunizations’’ and inserting ‘‘Vaccine Fund’’.

16 (b) INTERNATIONAL AIDS VACCINE INITIATIVE.—Sec17 tion 302(l) of the Foreign Assistance Act of 1961 (22 U.S.C.

18 2222(l)) is amended by striking ‘‘$10,000,000’’ and all that

19 follows through ‘‘2002’’ and inserting ‘‘$12,000,000 for the

20 fiscal year 2003 and $15,000,000 for the fiscal year 2004’’.

21 (c) MALARIA VACCINE INITIATIVE OF THE PROGRAM

22 FOR APPROPRIATE TECHNOLOGIES IN HEALTH (PATH).—

23 Section 302 of the Foreign Assistance Act of 1961 (22

24 U.S.C. 2222)) is amended by adding at the end the fol25 lowing new subsection:
†

29

HR 2069 EAS

1 ‘‘(m) In addition to amounts otherwise available under

2 this section, there are authorized to be appropriated to the

3 President $5,000,000 for the fiscal year 2003 and

4 $6,000,000 for the fiscal year 2004 to be available only for

5 United States contributions to the Malaria Vaccine Initia6 tive of the Program for Appropriate Technologies in Health

7 (PATH).’’.

8 (d) EFFECTIVE DATE.—The amendments made by this

9 section shall take effect October 1, 2002.

10 TITLE III—MULTILATERAL

11 EFFORTS

12 SEC. 301. IMPROVEMENT OF THE ENHANCED HIPC INITIA13 TIVE.

14 (a) AMENDMENT OF THE INTERNATIONAL FINANCIAL

15 INSTITUTIONS ACT.—Title XVI of the International Finan16 cial Institutions Act (22 U.S.C. 262p–262p–5) is amended

17 by adding at the end the following new section:

18 ‘‘SEC. 1625. IMPROVEMENT OF THE ENHANCED HIPC INITIA19 TIVE.

20 ‘‘(a) AUTHORITY.—In order to ensure that the En21 hanced HIPC Initiative achieves the objective of substan22 tially increasing resources available for human development

23 and poverty reduction in heavily indebted poor countries,

24 the Secretary of the Treasury is authorized and requested

25 to conclude as soon as possible an agreement within the
†

30

HR 2069 EAS

1 Paris Club of Official Creditors, as well as the International

2 Bank for Reconstruction and Development (World Bank),

3 the International Monetary Fund, and other appropriate

4 multilateral development institutions to accomplish the

5 modifications in the Enhanced HIPC Initiative described

6 in subsection (b).

7 ‘‘(b) AGREEMENT.—The agreement referred to in sub8 section (a) is an agreement that provides the following:

9 ‘‘(1) LEVEL OF EXPORTS AND REVENUES.—

10 ‘‘(A) IN GENERAL.—The amount of debt

11 stock reduction approved for a country eligible

12 for debt relief under the Enhanced HIPC Initia13 tive shall be sufficient to reduce, for at least each

14 of the first 3 years after date of enactment of this

15 section or the Decision Point, whichever is

16 later—

17 ‘‘(i) the net present value of the out18 standing public and publicly guaranteed

19 debt of the country to not more than 150

20 percent of the annual value of exports of the

21 country for the year preceding the Decision

22 Point; and

23 ‘‘(ii) the annual payments due on such

24 public and publicly guaranteed debt to not

25 more than 10 percent or, in the case of a
†

31

HR 2069 EAS

1 country suffering a public health crisis (as

2 defined in subsection (c)), not more than 5

3 percent, of the amount of the annual cur4 rent revenues received by the country from

5 internal sources.

6 ‘‘(B) LIMITATION.—In financing the objec7 tives of the Enhanced HIPC Initiative, an inter8 national financial institution shall give priority

9 to using its own resources.

10 ‘‘(2) RELATION TO POVERTY AND THE ENVIRON11 MENT.—The debt cancellation under the Enhanced

12 HIPC Initiative shall not be conditioned on any

13 agreement by an impoverished country to implement

14 or comply with policies that deepen poverty or de15 grade the environment, including any policy that—

16 ‘‘(A) implements or extends user fees on pri17 mary education or primary health care, includ18 ing prevention and treatment efforts for HIV/

19 AIDS, tuberculosis, malaria, and infant, child,

20 and maternal well-being;

21 ‘‘(B) provides for increased cost recovery

22 from poor people to finance basic public services

23 such as education, health care, clean water, or

24 sanitation;
†

32

HR 2069 EAS

1 ‘‘(C) reduces the country’s minimum wage

2 to a level of less than $2 per day or undermines

3 workers’ ability to exercise effectively their inter4 nationally recognized worker rights, as defined

5 under section 526(e) of the Foreign Operations,

6 Export Financing and Related Programs Appro7 priations Act, 1995 (22 U.S.C. 262p–4p); or

8 ‘‘(D) promotes unsustainable extraction of

9 resources or results in reduced budget support for

10 environmental programs.

11 ‘‘(3) FOREIGN GOVERNMENT POLICIES.—A coun12 try shall not be eligible for cancellation of debt under

13 the Enhanced HIPC Initiative if the government of

14 the country—

15 ‘‘(A) has repeatedly provided support for

16 acts of international terrorism, as determined by

17 the Secretary of State under section 6(j)(1) of the

18 Export Administration Act of 1979 (50 U.S.C.

19 App. 2405(j)(1)) or section 620A(a) of the For20 eign Assistance Act of 1961 (22 U.S.C. 2371(a));

21 and

22 ‘‘(B) engages in a consistent pattern of

23 gross violations of internationally recognized

24 human rights (including its military or other se25 curity forces).
†

33

HR 2069 EAS

1 ‘‘(4) PROGRAMS TO COMBAT HIV/AIDS, TUBER2 CULOSIS, AND MALARIA.—A country that is otherwise

3 eligible to receive cancellation of debt under the En4 hanced HIPC Initiative may receive such cancellation

5 only if the country has agreed—

6 ‘‘(A) in the case of a country suffering a

7 public health crisis (as defined in subsection (c)),

8 to ensure that, where practicable, 10 to 20 per9 cent of the financial benefits of debt cancellation

10 are applied to programs to combat HIV/AIDS,

11 tuberculosis, and malaria in that country;

12 ‘‘(B) to ensure that the financial benefits of

13 debt cancellation are applied to programs to

14 combat poverty (in particular through concrete

15 measures to improve basic services in education,

16 nutrition, and health), and to redress environ17 mental degradation;

18 ‘‘(C) to ensure that the financial benefits of

19 debt cancellation are in addition to the govern20 ment’s total spending on programs to combat

21 HIV/AIDS and poverty reduction for the pre22 vious year or the average total of such expendi23 tures for the previous 3 years, whichever is great24 er;
†

34

HR 2069 EAS

1 ‘‘(D) to implement transparent and

2 participatory policymaking and budget proce3 dures, good governance, and effective

4 anticorruption measures; and

5 ‘‘(E) to broaden public participation and

6 popular understanding of the principles and

7 goals of poverty reduction.

8 ‘‘(c) DEFINITIONS.—In this section:

9 ‘‘(1) COUNTRY SUFFERING A PUBLIC HEALTH

10 CRISIS.—The term ‘country suffering a public health

11 crisis’ means—

12 ‘‘(A) a country in which HIV/AIDS, tuber13 culosis, or malaria is causing significant family,

14 community, or societal disruption; and

15 ‘‘(B) a country that has rapidly rising rates

16 of incidence of at least one of such diseases that

17 is likely to lead to conditions described in sub18 paragraph (A).

19 ‘‘(2) DECISION POINT.—The term ‘Decision

20 Point’ means the date on which the executive boards

21 of the World Bank and the International Monetary

22 Fund review the debt sustainability analysis for a

23 country and determine that the country is eligible for

24 debt relief under the Enhanced HIPC Initiative.
†

35

HR 2069 EAS

1 ‘‘(3) ENHANCED HIPC INITIATIVE.—The term

2 ‘Enhanced HIPC Initiative’ means the multilateral

3 debt initiative for heavily indebted poor countries

4 presented in the Report of G–7 Finance Ministers on

5 the Cologne Debt Initiative to the Cologne Economic

6 Summit, Cologne, June 18–20, 1999.’’.

7 (b) AUTHORIZATION OF APPROPRIATIONS.—

8 (1) IN GENERAL.—There are authorized to be ap9 propriated to the President such sums as may be nec10 essary for the fiscal year 2003 and each fiscal year

11 thereafter to carry out section 1625 of the Inter12 national Financial Institutions Act, as added by sub13 section (a).

14 (2) AVAILABILITY OF FUNDS.—Amounts appro15 priated pursuant to paragraph (1) are authorized to

16 remain available until expended.

17 SEC. 302. REPORTS ON IMPLEMENTATION OF IMPROVE18 MENTS TO THE ENHANCED HIPC INITIATIVE.

19 (a) INITIAL REPORT.—Not later than 180 days after

20 the date of enactment of this Act, the Secretary of the Treas21 ury shall submit to the appropriate congressional commit22 tees a report describing the progress made in concluding

23 an agreement under section 1625(b) of the International Fi24 nancial Institutions Act (as added by section 301 of this

25 Act) to modify the Enhanced HIPC Initiative.
†

36

HR 2069 EAS

1 (b) SUBSEQUENT REPORT.—Not later than one year

2 after the date of submission of the initial report under sub3 section (a), the Secretary of the Treasury shall submit to

4 the appropriate congressional committees a report describ5 ing the actions taken by countries to satisfy the conditions

6 set forth in the agreement referred to in subsection (a).

7 TITLE IV—BILATERAL EFFORTS

8 Subtitle A—General Assistance and

9 Programs

10 SEC. 401. ASSISTANCE TO COMBAT HIV/AIDS.

11 (a) AMENDMENT OF THE FOREIGN ASSISTANCE ACT

12 OF 1961.—Chapter 1 of part I of the Foreign Assistance

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

14 (1) in section 104(c) (22 U.S.C. 2151b(c)), by

15 striking paragraphs (4) through (7); and

16 (2) by inserting after section 104 the following

17 new section:

18 ‘‘SEC. 104A. ASSISTANCE TO COMBAT HIV/AIDS.

19 ‘‘(a) FINDING.—Congress recognizes that the alarming

20 spread of HIV/AIDS in countries in sub-Saharan Africa

21 and other developing countries is a major global health, na22 tional security, and humanitarian crisis.

23 ‘‘(b) POLICY.—It is a major objective of the foreign as24 sistance program of the United States to provide assistance

25 for the prevention, treatment, and control of HIV/AIDS.
†

37

HR 2069 EAS

1 The United States and other developed countries should pro2 vide assistance to countries in sub-Saharan Africa and

3 other countries and areas to control this crisis through HIV/

4 AIDS prevention, treatment, monitoring, and related ac5 tivities, particularly activities focused on women and

6 youth, including strategies to prevent mother-to-child trans7 mission of the HIV infection.

8 ‘‘(c) AUTHORIZATION.—

9 ‘‘(1) IN GENERAL.—Consistent with section

10 104(c), the President is authorized to furnish assist11 ance, on such terms and conditions as the President

12 may determine, to prevent, treat, and monitor HIV/

13 AIDS, and carry out related activities, in countries

14 in sub-Saharan Africa and other countries and areas.

15 ‘‘(2) ROLE OF NGOS.—It is the sense of Congress

16 that the President should provide an appropriate level

17 of assistance under paragraph (1) through nongovern18 mental organizations in countries in sub-Saharan Af19 rica and other countries and areas affected by the

20 HIV/AIDS pandemic.

21 ‘‘(3) COORDINATION OF ASSISTANCE EFFORTS.—

22 The President shall coordinate the provision of assist23 ance under paragraph (1) with the provision of re24 lated assistance by the Joint United Nations Pro25 gramme on HIV/AIDS (UNAIDS), the United Na-
†

38

HR 2069 EAS

1 tions Children’s Fund (UNICEF), the World Health

2 Organization (WHO), the United Nations Develop3 ment Programme (UNDP), the Global Fund to Fight

4 AIDS, Tuberculosis and Malaria and other appro5 priate international organizations (such as the Inter6 national Bank for Reconstruction and Development),

7 relevant regional multilateral development institu8 tions, national, state, and local governments of for9 eign countries, appropriate governmental and non10 governmental organizations, and relevant Executive

11 branch agencies.

12 ‘‘(d) ACTIVITIES SUPPORTED.—Assistance provided

13 under subsection (c) shall, to the maximum extent prac14 ticable, be used to carry out the following activities:

15 ‘‘(1) PREVENTION.—Prevention of HIV/AIDS

16 through activities including—

17 ‘‘(A) education, voluntary testing, and

18 counseling (including the incorporation of con19 fidentiality protections with respect to such test20 ing and counseling), including integration of

21 such programs into health programs and the in22 clusion in counseling programs of information

23 on methods of preventing transmission of the

24 HIV infection, including delaying sexual debut,

25 abstinence, reduction of casual sexual
†

39

HR 2069 EAS

1 partnering, and, where appropriate, the use of

2 condoms;

3 ‘‘(B) assistance for the purpose of pre4 venting mother-to-child transmission of the HIV

5 infection, including medications to prevent such

6 transmission and access to infant formula and

7 other alternatives for infant feeding;

8 ‘‘(C) assistance to ensure a safe blood sup9 ply, to provide—

10 ‘‘(i) post-exposure prophylaxis to vic11 tims of rape and sexual assault and in

12 cases of occupational exposure of health care

13 workers; and

14 ‘‘(ii) necessary commodities, including

15 test kits, pharmaceuticals, and condoms;

16 ‘‘(D) assistance through nongovernmental

17 organizations, including faith-based organiza18 tions, particularly those organizations that uti19 lize both professionals and volunteers with ap20 propriate skills and experience, to establish and

21 implement culturally appropriate HIV/AIDS

22 education and prevention programs;

23 ‘‘(E) research on microbicides which prevent

24 the spread of HIV/AIDS; and
†

40

HR 2069 EAS

1 ‘‘(F) bulk purchases of available prevention

2 technologies for women and for appropriate pro3 gram support for the introduction and distribu4 tion of these technologies, as well as education

5 and training on the use of the technologies.

6 ‘‘(2) TREATMENT.—The treatment and care of

7 individuals with HIV/AIDS, including—

8 ‘‘(A) assistance to establish and implement

9 programs to strengthen and broaden indigenous

10 health care delivery systems and the capacity of

11 such systems to deliver HIV/AIDS pharma12 ceuticals and otherwise provide for the treatment

13 of individuals with HIV/AIDS, including clin14 ical training for indigenous organizations and

15 health care providers;

16 ‘‘(B) assistance to strengthen and expand

17 hospice and palliative care programs to assist

18 patients debilitated by HIV/AIDS, their families,

19 and the primary caregivers of such patients, in20 cluding programs that utilize faith-based and

21 community-based organizations; and

22 ‘‘(C) assistance for the purpose of the care

23 and treatment of individuals with HIV/AIDS

24 through the provision of pharmaceuticals, includ25 ing antiretrovirals and other pharmaceuticals
†

41

HR 2069 EAS

1 and therapies for the treatment of opportunistic

2 infections, nutritional support, and other treat3 ment modalities.

4 ‘‘(3) MONITORING.—The monitoring of pro5 grams, projects, and activities carried out pursuant to

6 paragraphs (1) and (2), including—

7 ‘‘(A) monitoring to ensure that adequate

8 controls are established and implemented to pro9 vide HIV/AIDS pharmaceuticals and other ap10 propriate medicines to poor individuals with

11 HIV/AIDS; and

12 ‘‘(B) appropriate evaluation and surveil13 lance activities.

14 ‘‘(4) PHARMACEUTICALS.—

15 ‘‘(A) PROCUREMENT.—The procurement of

16 HIV/AIDS pharmaceuticals, antiviral therapies,

17 and other appropriate medicines, including

18 medicines to treat opportunistic infections.

19 ‘‘(B) MECHANISMS FOR QUALITY CONTROL

20 AND SUSTAINABLE SUPPLY.—Mechanisms to en21 sure that such HIV/AIDS pharmaceuticals,

22 antiretroviral therapies, and other appropriate

23 medicines are quality-controlled and sustainably

24 supplied.
†

42

HR 2069 EAS

1 ‘‘(C) DISTRIBUTION.—The distribution of

2 such HIV/AIDS pharmaceuticals, antiviral

3 therapies, and other appropriate medicines (in4 cluding medicines to treat opportunistic infec5 tions) to qualified national, regional, or local or6 ganizations for the treatment of individuals with

7 HIV/AIDS in accordance with appropriate HIV/

8 AIDS testing and monitoring requirements and

9 treatment protocols and for the prevention of

10 mother-to-child transmission of the HIV infec11 tion.

12 ‘‘(5) RELATED ACTIVITIES.—The conduct of re13 lated activities, including—

14 ‘‘(A) the care and support of children who

15 are orphaned by the HIV/AIDS pandemic, in16 cluding services designed to care for orphaned

17 children in a family environment which rely on

18 extended family members;

19 ‘‘(B) improved infrastructure and institu20 tional capacity to develop and manage edu21 cation, prevention, and treatment programs, in22 cluding training and the resources to collect and

23 maintain accurate HIV surveillance data to tar24 get programs and measure the effectiveness of

25 interventions;
†

43

HR 2069 EAS

1 ‘‘(C) vaccine research and development

2 partnership programs with specific plans of ac3 tion to develop a safe, effective, accessible, pre4 ventive HIV vaccine for use throughout the

5 world; and

6 ‘‘(D) the development and expansion of fi7 nancially sustainable microfinance institutions

8 and other income generation programs that

9 strengthen the economic and social viability of

10 communities afflicted by the HIV/AIDS pan11 demic, including support for the savings and

12 productive capacity of affected poor households

13 caring for orphans.

14 ‘‘(e) ANNUAL REPORT.—

15 ‘‘(1) IN GENERAL.—Not later than January 31

16 of each year, the President shall submit to the Com17 mittee on Foreign Relations of the Senate and the

18 Committee on International Relations of the House of

19 Representatives a report on the implementation of

20 this section for the prior fiscal year.

21 ‘‘(2) REPORT ELEMENTS.—Each report shall

22 include—

23 ‘‘(A) a description of efforts made to imple24 ment the policies set forth in this section;
†

44

HR 2069 EAS

1 ‘‘(B) a description of the programs estab2 lished pursuant to this section; and

3 ‘‘(C) a detailed assessment of the impact of

4 programs established pursuant to this section,

5 including—

6 ‘‘(i) the effectiveness of such programs

7 in reducing the spread of the HIV infection,

8 particularly in women and girls, in reduc9 ing mother-to-child transmission of the HIV

10 infection, and in reducing mortality rates

11 from HIV/AIDS; and

12 ‘‘(ii) the progress made toward im13 proving health care delivery systems (in14 cluding the training of adequate numbers of

15 staff) and infrastructure to ensure increased

16 access to care and treatment.

17 ‘‘(f) FUNDING LIMITATION.—Of the funds made avail18 able to carry out this section in any fiscal year, not more

19 than 7 percent may be used for the administrative expenses

20 of the United States Agency for International Development

21 in support of activities described in this section. Such

22 amount shall be in addition to other amounts otherwise

23 available for such purposes.

24 ‘‘(g) DEFINITIONS.—In this section:
†

45

HR 2069 EAS

1 ‘‘(1) AIDS.—The term ‘AIDS’ means acquired

2 immune deficiency syndrome.

3 ‘‘(2) HIV.—The term ‘HIV’ means the human

4 immunodeficiency virus, the pathogen that causes

5 AIDS.

6 ‘‘(3) HIV/AIDS.—The term ‘HIV/AIDS’ means,

7 with respect to an individual, an individual who is

8 infected with HIV or living with AIDS.’’.

9 (b) AUTHORIZATION OF APPROPRIATIONS.—

10 (1) IN GENERAL.—In addition to funds available

11 under section 104(c) of the Foreign Assistance Act of

12 1961 (22 U.S.C. 2151b(c)) for such purpose or under

13 any other provision of that Act, there are authorized

14 to be appropriated to the President $800,000,000 for

15 the fiscal year 2003 and $900,000,000 for the fiscal

16 year 2004 to carry out section 104A of the Foreign

17 Assistance Act of 1961, as added by subsection (a).

18 (2) AVAILABILITY OF FUNDS.—Amounts appro19 priated pursuant to paragraph (1) are authorized to

20 remain available until expended.

21 (3) ALLOCATION OF FUNDS.—

22 (A) RESEARCH ON MICROBICIDES.—Of the

23 amounts authorized to be appropriated by para24 graph (1) for the fiscal years 2003 and 2004,

25 $20,000,000 for the fiscal year 2003 and
†

46

HR 2069 EAS

1 $24,000,000 for the fiscal year 2004 are author2 ized to be available to carry out section

3 104A(d)(1)(D) of the Foreign Assistance Act of

4 1961 (as added by subsection (a)), relating to re5 search on microbicides which prevent the spread

6 of HIV/AIDS.

7 (B) PHARMACEUTICALS.—Of the amounts

8 authorized to be appropriated by paragraph (1)

9 for the fiscal years 2003 and 2004, $100,000,000

10 for the fiscal year 2003 and $120,000,000 for the

11 fiscal year 2004 are authorized to be available to

12 carry out section 104A(d)(4) of the Foreign As13 sistance Act of 1961 (as added by subsection (a)),

14 relating to the procurement and distribution of

15 HIV/AIDS pharmaceuticals.

16 (4) TRANSFER OF PRIOR YEAR FUNDS.—Unobli17 gated balances of funds made available for the fiscal

18 year 2001 or the fiscal year 2002 under section

19 104(c)(6) of the Foreign Assistance Act of 1961 (22

20 U.S.C. 2151b(c)(6) (as in effect immediately before

21 the date of enactment of this Act) shall be transferred

22 to, merged with, and made available for the same

23 purposes as funds made available for fiscal year 2003

24 under paragraph (1).
†

47

HR 2069 EAS

1 SEC. 402. ASSISTANCE TO COMBAT TUBERCULOSIS.

2 (a) AMENDMENT OF THE FOREIGN ASSISTANCE ACT

3 OF 1961.—Chapter 1 of part I of the Foreign Assistance

4 Act of 1961 (22 U.S.C. 2151 et seq.), as amended by section

5 401 of this Act, is further amended by inserting after section

6 104A the following new section:

7 ‘‘SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.

8 ‘‘(a) FINDINGS.—Congress makes the following find9 ings:

10 ‘‘(1) Congress recognizes the growing inter11 national problem of tuberculosis and the impact its

12 continued existence has on those countries that had

13 previously largely controlled the disease.

14 ‘‘(2) Congress further recognizes that the means

15 exist to control and treat tuberculosis through ex16 panded use of the DOTS (Directly Observed Treat17 ment Short-course) treatment strategy and adequate

18 investment in newly created mechanisms to increase

19 access to treatment, including the Global Tuberculosis

20 Drug Facility established in 2001 pursuant to the

21 Amsterdam Declaration to Stop TB.

22 ‘‘(b) POLICY.—It is a major objective of the foreign as23 sistance program of the United States to control tuber24 culosis, including the detection of at least 70 percent of the

25 cases of infectious tuberculosis, and the cure of at least 85

26 percent of the cases detected, not later than December 31,
†

48

HR 2069 EAS

1 2005, in those countries classified by the World Health Or2 ganization as among the highest tuberculosis burden, and

3 not later than December 31, 2010, in all countries in which

4 the United States Agency for International Development

5 has established development programs.

6 ‘‘(c) AUTHORIZATION.—To carry out this section and

7 consistent with section 104(c), the President is authorized

8 to furnish assistance, on such terms and conditions as the

9 President may determine, for the prevention, treatment,

10 control, and elimination of tuberculosis.

11 ‘‘(d) COORDINATION.—In carrying out this section, the

12 President shall coordinate with the World Health Organiza13 tion, the Global Fund to Fight AIDS, Tuberculosis, and

14 Malaria, the Department of Health and Human Services

15 (including the Centers for Disease Control and Prevention

16 and the National Institutes of Health), and other organiza17 tions with respect to the development and implementation

18 of a comprehensive tuberculosis control program.

19 ‘‘(e) ANNUAL REPORT.—Not later than January 31 of

20 each year, the President shall submit a report to the Com21 mittee on Foreign Relations of the Senate and the Com22 mittee on International Relations of the House of Rep23 resentatives specifying the increases in the number of people

24 treated and the increases in number of tuberculosis patients

25 cured through each program, project, or activity receiving
†

49

HR 2069 EAS

1 United States foreign assistance for tuberculosis control

2 purposes.

3 ‘‘(f) PRIORITY TO DOTS COVERAGE.—In furnishing

4 assistance under subsection (c), the President shall give pri5 ority to activities that increase directly observed treatment

6 shortcourse (DOTS) coverage, including funding for the

7 Global Tuberculosis Drug Facility and the Stop Tuber8 culosis Partnership.

9 ‘‘(g) DEFINITIONS.—In this section:

10 ‘‘(1) DOTS.—The term ‘DOTS’ or ‘Directly Ob11 served Treatment Short-course’ means the World

12 Health Organization-recommended strategy for treat13 ing tuberculosis.

14 ‘‘(2) GLOBAL TUBERCULOSIS DRUG FACILITY.—

15 The term ‘Global Tuberculosis Drug Facility (GDF)’

16 means the new initiative of the Stop Tuberculosis

17 Partnership to increase access to high-quality tuber18 culosis drugs to facilitate DOTS expansion.

19 ‘‘(3) STOP TUBERCULOSIS PARTNERSHIP.—The

20 term ‘Stop Tuberculosis Partnership’ means the part21 nership of the World Health Organization, donors in22 cluding the United States, high tuberculosis burden

23 countries, multilateral agencies, and nongovernmental

24 and technical agencies committed to short- and long25 term measures required to control and eventually
†

50

HR 2069 EAS

1 eliminate tuberculosis as a public health problem in

2 the world.’’.

3 (b) AUTHORIZATION OF APPROPRIATIONS.—

4 (1) IN GENERAL.—In addition to funds available

5 under section 104(c) of the Foreign Assistance Act of

6 1961 (22 U.S.C. 2151b(c)) for such purpose or under

7 any other provision of that Act, there are authorized

8 to be appropriated to the President $150,000,000 for

9 the fiscal year 2003 and $200,000,000 for the fiscal

10 year 2004 to carry out section 104B of the Foreign

11 Assistance Act of 1961, as added by subsection (a).

12 (2) AVAILABILITY OF FUNDS.—Amounts appro13 priated pursuant to paragraph (1) are authorized to

14 remain available until expended.

15 (3) TRANSFER OF PRIOR YEAR FUNDS.—Unobli16 gated balances of funds made available for the fiscal

17 year 2001 or the fiscal year 2002 under section

18 104(c)(7) of the Foreign Assistance Act of 1961 (22

19 U.S.C. 2151b(c)(7) (as in effect immediately before

20 the date of enactment of this Act) shall be transferred

21 to, merged with, and made available for the same

22 purposes as funds made available for fiscal year 2003

23 under paragraph (1).
†

51

HR 2069 EAS

1 SEC. 403. ASSISTANCE TO COMBAT MALARIA.

2 (a) AMENDMENT OF THE FOREIGN ASSISTANCE ACT

3 OF 1961.—Chapter 1 of part I of the Foreign Assistance

4 Act of 1961 (22 U.S.C. 2151 et seq.), as amended by sections

5 401 and 402 of this Act, is further amended by inserting

6 after section 104B the following new section:

7 ‘‘SEC. 104C. ASSISTANCE TO COMBAT MALARIA.

8 ‘‘(a) FINDING.—Congress finds that malaria kills more

9 people annually than any other communicable disease ex10 cept tuberculosis, that more than 90 percent of all malaria

11 cases are in sub-Saharan Africa, and that children and

12 women are particularly at risk. Congress recognizes that

13 there are cost-effective tools to decrease the spread of ma14 laria and that malaria is a curable disease if promptly di15 agnosed and adequately treated.

16 ‘‘(b) POLICY.—It is a major objective of the foreign as17 sistance program of the United States to provide assistance

18 for the prevention, control, and cure of malaria.

19 ‘‘(c) AUTHORIZATION.—To carry out this section and

20 consistent with section 104(c), the President is authorized

21 to furnish assistance, on such terms and conditions as the

22 President may determine, for the prevention, treatment,

23 control, and elimination of malaria.

24 ‘‘(d) COORDINATION.—In carrying out this section, the

25 President shall coordinate with the World Health Organiza26 tion, the Global Fund to Fight AIDS, Tuberculosis, and
†

52

HR 2069 EAS

1 Malaria, the Department of Health and Human Services

2 (the Centers for Disease Control and Prevention and the

3 National Institutes of Health), and other organizations

4 with respect to the development and implementation of a

5 comprehensive malaria control program.

6 ‘‘(e) ANNUAL REPORT.—Not later than January 31 of

7 each year, the President shall submit a report to the Com8 mittee on Foreign Relations of the Senate and the Com9 mittee on International Relations of the House of Rep10 resentatives specifying the increases in the number of people

11 treated and the increases in number of malaria patients

12 cured through each program, project, or activity receiving

13 United States foreign assistance for malaria control pur14 poses.’’.

15 (b) AUTHORIZATION OF APPROPRIATIONS.—

16 (1) IN GENERAL.—In addition to funds available

17 under section 104(c) of the Foreign Assistance Act of

18 1961 (22 U.S.C. 2151b(c)) for such purpose or under

19 any other provision of that Act, there are authorized

20 to be appropriated to the President $70,000,000 for

21 the fiscal year 2003 and $80,000,000 for the fiscal

22 year 2004 to carry out section 104C of the Foreign

23 Assistance Act of 1961, as added by subsection (a).
†

53

HR 2069 EAS

1 (2) AVAILABILITY OF FUNDS.—Amounts appro2 priated pursuant to paragraph (1) are authorized to

3 remain available until expended.

4 (3) TRANSFER OF PRIOR YEAR FUNDS.—Unobli5 gated balances of funds made available for the fiscal

6 year 2001 or the fiscal year 2002 under section 104(c)

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

8 2151b(c) (as in effect immediately before the date of

9 enactment of this Act) and made available for the

10 control of malaria shall be transferred to, merged

11 with, and made available for the same purposes as

12 funds made available for fiscal year 2003 under para13 graph (1).

14 (c) CONFORMING AMENDMENT.—Section 104(c) of the

15 Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)), as

16 amended by section 401 of this Act, is further amended by

17 adding after paragraph (3) the following:

18 ‘‘(4) RELATIONSHIP TO OTHER LAWS.—Assist19 ance made available under this subsection and sec20 tions 104A, 104B, and 104C, and assistance made

21 available under chapter 4 of part II to carry out the

22 purposes of this subsection and such other sections of

23 this Act, may be made available in accordance with

24 this subsection and such other provisions of this Act

25 notwithstanding any other provision of law.’’.
†

54

HR 2069 EAS

1 SEC. 404. PILOT PROGRAM FOR THE PLACEMENT OF

2 HEALTH CARE PROFESSIONALS IN OVERSEAS

3 AREAS SEVERELY AFFECTED BY HIV/AIDS, TU4 BERCULOSIS, AND MALARIA.

5 (a) IN GENERAL.—The President shall establish a pro6 gram to demonstrate the feasibility of facilitating the serv7 ice of American health care professionals in sub-Saharan

8 Africa and other parts of the world severely affected by HIV/

9 AIDS, tuberculosis, and malaria.

10 (b) REQUIREMENTS.—Participants in the program

11 shall—

12 (1) provide basic health care services for those

13 infected and affected by HIV/AIDS, tuberculosis, and

14 malaria in the area in which they are serving;

15 (2) provide on-the-job training to medical and

16 other personnel in the area in which they are serving

17 to strengthen the basic health care system of the af18 fected countries;

19 (3) provide health care educational training for

20 residents of the area in which they are serving;

21 (4) serve for a period of up to two years; and

22 (5) meet the eligibility requirements in sub23 section (d).

24 (c) ELIGIBILITY REQUIREMENTS.—To be eligible to

25 participate in the program, a candidate shall—
†

55

HR 2069 EAS

1 (1) be a national of the United States who is a

2 trained health care professional and who meets the

3 educational and licensure requirements necessary to

4 be such a professional such as a physician, nurse,

5 nurse practitioner, pharmacist, or other individual

6 determined to be appropriate by the President; or

7 (2) a retired commissioned officer of the Public

8 Health Service Corps.

9 (d) RECRUITMENT.—The President shall ensure that

10 information on the program is widely distributed, includ11 ing the distribution of information to schools for health pro12 fessionals, hospitals, clinics, and nongovernmental organi13 zations working in the areas of international health and

14 aid.

15 (e) PLACEMENT OF PARTICIPANTS.—To the maximum

16 extent practicable, participants in the program shall serve

17 in the poorest areas of the affected countries, where health

18 care needs are likely to be the greatest. The decision on the

19 placement of a participant should be made in consultation

20 with relevant officials of the affected country at both the

21 national and local level as well as with local community

22 leaders and organizations.

23 (f) EXTENDED PERIOD OF SERVICE.—The President

24 may extend the period of service of a participant by an

25 additional period of 6 to 12 months.
†

56

HR 2069 EAS

1 (g) INCENTIVES.—The President may offer such incen2 tives as the President determines to be necessary to encour3 age individuals to participate in the program, such as par4 tial payment of principal, interest, and related expenses on

5 government and commercial loans for educational expenses

6 relating to professional health training and, where possible,

7 deferment of repayments on such loans, the provision of re8 tirement benefits that would otherwise be jeopardized by

9 participation in the program, and other incentives.

10 (h) REPORT.—Not later than 18 months after the date

11 of enactment of this Act, the President shall submit a report

12 to the designated congressional committees on steps taken

13 to establish the program, including—

14 (1) the process of recruitment, including the

15 venues for recruitment, the number of candidates re16 cruited, the incentives offered, if any, and the cost of

17 those incentives;

18 (2) the process, including the criteria used, for

19 the selection of participants;

20 (3) the number of participants placed, the coun21 tries in which they were placed, and why those coun22 tries were selected; and

23 (4) the potential for expansion of the program.

24 (i) AUTHORIZATION OF APPROPRIATIONS.—
†

57

HR 2069 EAS

1 (1) IN GENERAL.—In addition to amounts other2 wise available for such purpose, there is authorized to

3 be appropriated to the President $10,000,000 for the

4 fiscal year 2003 and $20,000,000 for the fiscal year

5 2004 to carry out the program.

6 (2) AVAILABILITY OF FUNDS.—Amounts appro7 priated pursuant to paragraph (1) are authorized to

8 remain available until expended.

9 SEC. 405. DEPARTMENT OF DEFENSE HIV/AIDS PREVEN10 TION ASSISTANCE PROGRAM.

11 (a) EXPANSION OF PROGRAM.—The Secretary of De12 fense is authorized to expand, in accordance with this sec13 tion, the Department of Defense program of HIV/AIDS pre14 vention educational activities undertaken in connection

15 with the conduct of United States military training, exer16 cises, and humanitarian assistance in sub-Saharan African

17 countries.

18 (b) ELIGIBLE COUNTRIES.—The Secretary of Defense

19 may carry out the program in all eligible countries. A coun20 try shall be eligible for activities under the program if the

21 country—

22 (1) is a country suffering a public health crisis

23 (as defined in subsection (e)); and

24 (2) participates in the military-to-military con25 tacts program of the Department of Defense.
†

58

HR 2069 EAS

1 (c) PROGRAM ACTIVITIES.—The Secretary of Defense

2 shall provide for the activities under the program—

3 (1) to focus, to the extent possible, on military

4 units that participate in peace keeping operations;

5 and

6 (2) to include HIV/AIDS-related voluntary coun7 seling and testing and HIV/AIDS-related surveil8 lance.

9 (d) AUTHORIZATION OF APPROPRIATIONS.—

10 (1) IN GENERAL.—Of the amount authorized to

11 be appropriated to the Department of Defense for op12 eration and maintenance of the Defense Health Pro13 gram for the fiscal year 2003, $30,000,000 may be

14 available for carrying out the program described in

15 subsection (a) as expanded pursuant to this section.

16 (2) AVAILABILITY OF FUNDS.—Amounts appro17 priated pursuant to paragraph (1) are authorized to

18 remain available until expended.

19 (e) COUNTRY SUFFERING A PUBLIC HEALTH CRISIS

20 DEFINED.—In this section, the term ‘‘country suffering a

21 public health crisis’’ means a country that has rapidly ris22 ing rates of incidence of HIV/AIDS or in which HIV/AIDS

23 is causing significant family, community, or societal dis24 ruption.
†

59

HR 2069 EAS

1 SEC. 406. REPORT ON TREATMENT ACTIVITIES BY REL2 EVANT EXECUTIVE BRANCH AGENCIES.

3 (a) IN GENERAL.—Not later than 15 months after the

4 date of enactment of this Act, the President shall submit

5 to designated congressional committees a report on the pro6 grams and activities of the United States Agency for Inter7 national Development, the Centers for Disease Control and

8 Prevention, and other relevant Executive branch agencies

9 that are directed to the treatment of individuals in foreign

10 countries infected with HIV or living with AIDS.

11 (b) REPORT ELEMENTS.—The report shall include—

12 (1) a description of the activities of relevant Ex13 ecutive branch agencies with respect to—

14 (A) the treatment of opportunistic infec15 tions;

16 (B) the use of antiretrovirals;

17 (C) the status of research into successful

18 treatment protocols for individuals in the devel19 oping world; and

20 (D) technical assistance and training of

21 local health care workers (in countries affected

22 by the pandemic) to administer antiretrovirals,

23 manage side effects, and monitor patients’ viral

24 loads and immune status;

25 (2) information on existing pilot projects, in26 cluding a discussion of why a given population was
†

60

HR 2069 EAS

1 selected, the number of people treated, the cost of

2 treatment, the mechanisms established to ensure that

3 treatment is being administered effectively and safely,

4 and plans for scaling up pilot projects (including

5 projected timelines and required resources); and

6 (3) an explanation of how those activities relate

7 to efforts to prevent the transmission of the HIV infec8 tion.

9 Subtitle B—Assistance for Children

10 and Families

11 SEC. 411. FINDINGS.

12 Congress makes the following findings:

13 (1) Approximately 2,000 children around the

14 world are infected each day with HIV through moth15 er-to-child transmission. Transmission can occur dur16 ing pregnancy, labor, and delivery or through breast

17 feeding. Over ninety percent of these cases are in de18 veloping nations with little or no access to public

19 health facilities.

20 (2) Mother-to-child transmission is largely pre21 ventable with the proper application of pharma22 ceuticals, therapies, and other public health interven23 tions.

24 (3) The drug nevirapine, reduces mother-to-child

25 transmission by nearly 50 percent. Universal avail-
†

61

HR 2069 EAS

1 ability of this drug could prevent up to 400,000 infec2 tions per year and dramatically reduce the number of

3 AIDS-related deaths.

4 (4) At the United Nations Special Session on

5 HIV/AIDS in June 2001, the United States com6 mitted to the specific goals with respect to the preven7 tion of mother-to-child transmission, including the

8 goals of reducing the proportion of infants infected

9 with HIV by 20 percent by the year 2005 and by 50

10 percent by the year 2010, as specified in the Declara11 tion of Commitment on HIV/AIDS adopted by the

12 United Nations General Assembly at the Special Ses13 sion.

14 (5) Several United States Government agencies

15 including the United States Agency for International

16 Development and the Centers for Disease Control are

17 already supporting programs to prevent mother-to18 child transmission in resource-poor nations and have

19 the capacity to expand these programs rapidly by

20 working closely with foreign governments and non21 governmental organizations.

22 (6) Efforts to prevent mother-to-child trans23 mission can provide the basis for a broader response

24 that includes care and treatment of mothers, fathers,
†

62

HR 2069 EAS

1 and other family members that are infected with HIV

2 or living with AIDS.

3 (7) HIV/AIDS has devastated the lives of count4 less children and families across the globe. Since the

5 epidemic began, an estimated 13,200,000 children

6 under the age of 15 have been orphaned by AIDS,

7 that is they have lost their mother or both parents to

8 the disease. The Joint United Nations Program on

9 HIV/AIDS (UNAIDS) estimates that this number

10 will double by the year 2010.

11 (8) HIV/AIDS also targets young people between

12 the ages of 15 to 24, many of whom carry the burden

13 of caring for family members living with HIV/AIDS.

14 An estimated 10,300,000 young people are now living

15 with HIV/AIDS. One-half of all new infections are oc16 curring among this age group.

17 SEC. 412. POLICY AND REQUIREMENTS.

18 (a) POLICY.—The United States Government’s re19 sponse to the global HIV/AIDS pandemic should place high

20 priority on the prevention of mother-to-child transmission,

21 the care and treatment of family members and caregivers,

22 and the care of children orphaned by AIDS. To the max23 imum extent possible, the United States Government should

24 seek to leverage its funds by seeking matching contributions
†

63

HR 2069 EAS

1 from the private sector, other national governments, and

2 international organizations.

3 (b) REQUIREMENTS.—The 5-year United States Gov4 ernment strategy required by section 101 of this Act shall—

5 (1) provide for meeting or exceeding the goal set

6 by the United Nations General Assembly Declaration

7 of Commitment on HIV/AIDS to reduce the rate of

8 mother-to-child transmission of HIV by 20 percent by

9 2005 and by 50 percent by 2010;

10 (2) include programs to make available testing

11 and treatment to HIV-positive women and their fam12 ily members, including drug treatment and therapies

13 to prevent mother-to-child transmission; and

14 (3) expand programs designed to care for chil15 dren orphaned by AIDS.

16 SEC. 413. ANNUAL REPORTS ON PREVENTION OF MOTHER17 TO-CHILD TRANSMISSION OF THE HIV INFEC18 TION.

19 (a) IN GENERAL.—Beginning 270 days after the date

20 of enactment of this Act, and annually thereafter for the

21 ensuing eight years, the President shall submit to des22 ignated congressional committees a report on the activities

23 of relevant Executive branch agencies during the reporting

24 period to assist in the prevention of mother-to-child trans25 mission of the HIV infection.
†

64

HR 2069 EAS

1 (b) REPORT ELEMENTS.—Each report shall include—

2 (1) a statement of whether or not all relevant

3 Executive branch agencies have adopted the targets set

4 by the United Nations General Assembly at the Spe5 cial Session for HIV/AIDS, held June 25 to 27, 2001,

6 with respect to mother-to-child transmission of the

7 HIV infection;

8 (2) a description of efforts made by the United

9 States Agency for International Development and the

10 Centers for Disease Control and Prevention to expand

11 those activities, including—

12 (A) information on the number of sites sup13 ported for the prevention of mother-to-child

14 transmission of the HIV infection;

15 (B) the specific activities supported;

16 (C) the number of women tested and coun17 seled; and

18 (D) the number of women receiving prevent19 ative drug therapies;

20 (3) a statement of the percentage of funds ex21 pended out of the budget of each relevant Executive

22 branch agency for activities to prevent mother-to-child

23 transmission of the HIV infection and, in the case of

24 United States Agency for International Development,

25 whether or not its expenditures on bilateral assistance
†

65

HR 2069 EAS

1 have met the 8.3 percent target in section

2 104(c)(6)(D) of the Foreign Assistance Act of 1961

3 (22 U.S.C. 2151b(c)(6)(D)), as in effect immediately

4 before the date of enactment of this Act, with respect

5 to strategies to prevent mother-to-child transmission

6 of the HIV infection;

7 (4) a discussion of the extent to which the pro8 grams of the relevant Executive branch agencies are

9 meeting targets set by the United Nations General As10 sembly; and

11 (5) a description of efforts made by the Centers

12 for Disease Control and Prevention and the United

13 States Agency for International Development to ex14 pand care and treatment services for families at es15 tablished sites for the prevention of mother-to-child

16 transmission of HIV infection.

17 (c) REPORTING PERIOD DEFINED.—In this section,

18 the term ‘‘reporting period’’ means, in the case of the initial

19 report, the period since the date of enactment of this Act

20 and, in the case of any subsequent report, the period since

21 the date of submission of the most recent report.

22 SEC. 414. PILOT PROGRAM OF ASSISTANCE FOR CHILDREN

23 AND FAMILIES AFFECTED BY HIV/AIDS.

24 (a) IN GENERAL.—The President, acting through the

25 United States Agency for International Development, shall
†

66

HR 2069 EAS

1 establish a program of assistance that would demonstrate

2 the feasibility of the provision of care and treatment to or3 phans and other children and young people affected by

4 HIV/AIDS in foreign countries.

5 (b) PROGRAM REQUIREMENTS.—The program shall—

6 (1) build upon and be integrated into programs

7 administered as of the date of enactment of this Act

8 by the United States Agency for International Devel9 opment for children affected by HIV/AIDS;

10 (2) work in conjunction with indigenous commu11 nity-based programs and activities, particularly those

12 that offer proven services for children;

13 (3) reduce the stigma of HIV/AIDS to encourage

14 vulnerable children infected with HIV or living with

15 AIDS and their family members and caregivers to

16 avail themselves of voluntary counseling and testing,

17 and related programs, including treatments;

18 (4) provide, in conjunction with other relevant

19 Executive branch agencies, the range of services for

20 the care and treatment, including the provision of

21 antiretrovirals and other necessary pharmaceuticals,

22 of children, parents, and caregivers infected with HIV

23 or living with AIDS;

24 (5) provide nutritional support and food secu25 rity, and the improvement of overall family health;
†

67

HR 2069 EAS

1 (6) work with parents, caregivers, and commu2 nity-based organizations to provide children with

3 educational opportunities; and

4 (7) provide appropriate counseling and legal as5 sistance for the appointment of guardians and the

6 handling of other issues relating to the protection of

7 children.

8 (c) REPORT.—Not later than 18 months after the date

9 of enactment of this Act, the President, acting through the

10 United States Agency for International Development, shall

11 submit a report on the implementation of this section to

12 the appropriate congressional committees. The report shall

13 include a plan for scaling up the program over the following

14 year.

15 (d) AUTHORIZATION OF APPROPRIATIONS.—

16 (1) IN GENERAL.—In addition to amounts other17 wise available for such purpose, there is authorized to

18 be appropriated to the President $15,000,000 for the

19 fiscal year 2003 and $30,000,000 for the fiscal year

20 2004 to carry out the program.

21 (2) AVAILABILITY OF FUNDS.—Amounts appro22 priated pursuant to paragraph (1) are authorized to

23 remain available until expended.
†

68

HR 2069 EAS

1 TITLE V—BUSINESS PRINCIPLES

2 SEC. 501. PRINCIPLES FOR UNITED STATES FIRMS OPER3 ATING IN COUNTRIES AFFECTED BY THE HIV/

4 AIDS PANDEMIC.

5 (a) FINDINGS.—Congress finds that the global spread

6 of HIV/AIDS presents not only a health crisis but also a

7 crisis in the workplace that affects—

8 (1) the productivity, earning power, and lon9 gevity of individual workers;

10 (2) the productivity, competitiveness, and finan11 cial solvency of individual businesses; and

12 (3) the economic productivity and development

13 of individual communities and the United States as

14 a whole.

15 (b) SENSE OF CONGRESS.—It is the sense of Congress

16 that United States firms operating in countries affected by

17 the HIV/AIDS pandemic can make significant contribu18 tions to the United States effort to respond to this pandemic

19 through the voluntary adoption of the principles and prac20 tices described in subsection (c).

21 (c) PRINCIPLES AND PRACTICES.—The principles and

22 practices referred to in subsection (b) are the following:

23 (1) With respect to employment and health poli24 cies and practices, the treatment of HIV/AIDS in the

25 same manner as any other illness.
†

69

HR 2069 EAS

1 (2) The promotion of policies and practices that

2 eliminate discrimination and stigmatization against

3 employees on the basis of real or perceived HIV/AIDS

4 status, including—

5 (A) assessing employees on merit and abil6 ity to perform;

7 (B) not subjecting employees to personal

8 discrimination or abuse; and

9 (C) imposing disciplinary measures where

10 discrimination occurs.

11 (3) A prohibition on compulsory HIV/AIDS test12 ing for recruitment, promotion, or career develop13 ment.

14 (4) An assurance of the confidentiality of an em15 ployee’s HIV/AIDS status.

16 (5) Permission for employees with HIV/AIDS-re17 lated illnesses to work as long as they are medically

18 fit and, when they are no longer able to work and sick

19 leave has been exhausted, an assurance that the em20 ployment relationship will be terminated in accord21 ance with antidiscrimination and labor laws and re22 spect for general procedures and full benefits.

23 (6) An assurance that employment practices will

24 comply, at a minimum, with national and inter25 national employment and labor laws and codes.
†

70

HR 2069 EAS

1 (7) The involvement of employees and individ2 uals infected with HIV or living with AIDS, drawn

3 from the workplace or the community, in the develop4 ment and assessment of HIV/AIDS policies and pro5 grams for the workplace.

6 (8) An offer to all employees of access to cul7 turally appropriate preventive education programs

8 and services to support those programs.

9 (9) An assurance that programs offered in the

10 workplace will support and be integrated into larger

11 community-based responses to the problems posed by

12 HIV/AIDS.

13 (10) Work with community leaders to expand the

14 availability of treatment for those employees and oth15 ers infected with HIV or living with AIDS.

16 TITLE VI—ADDITIONAL

17 AUTHORITIES

18 SEC. 601. AUTHORITY OF THE DEPARTMENT OF HEALTH

19 AND HUMAN SERVICES.

20 (a) IN GENERAL.—Title III of the Public Health Serv21 ice Act (42 U.S.C. 241 et seq.) is amended by adding at

22 the end the following:
†

71

HR 2069 EAS

1 ‘‘PART R—HIV/AIDS, TUBERCULOSIS, AND MA2 LARIA PREVENTION, CARE AND TREATMENT

3 IN DEVELOPING COUNTRIES

4 ‘‘SEC. 399AA. GENERAL AUTHORITY OF THE CENTERS FOR

5 DISEASE CONTROL AND PREVENTION.

6 ‘‘(a) PURPOSE.—It is the purpose of this section to

7 provide the Secretary, acting through the Director of the

8 Centers for Disease Control and Prevention, with the au9 thority to act internationally to carry out prevention, care,

10 treatment, support, capacity development, and other activi11 ties (determined appropriate by the Secretary) for HIV/

12 AIDS, tuberculosis, and malaria in countries determined

13 by the Secretary to have or be at risk for severe HIV epi14 demic with particular attention to resource constrained

15 countries.

16 ‘‘(b) ACTIVITIES AND ASSISTANCE.—In carrying out

17 the purpose described in subsection (a), the Secretary, act18 ing through the Director of the Centers for Disease Control

19 and Prevention, in coordination with the Administrator of

20 the United States Agency for International Development

21 and the Administrator of the Health Resources and Services

22 Administration, may provide support and assistance under

23 this section relating to—

24 ‘‘(1) HIV prevention services provided through—

25 ‘‘(A) education and voluntary counseling

26 and testing activities, including rapid testing,
†

72

HR 2069 EAS

1 the development and application of confiden2 tiality protections with respect to such coun3 seling and testing, and the integration of such

4 activities into programs serving women and chil5 dren;

6 ‘‘(B) programs to reduce the mother-to-child

7 transmission of HIV, including the treatment

8 and care of HIV-infected women, their children,

9 and families, and including the involvement of

10 fathers in such programs;

11 ‘‘(C) activities involving behavioral inter12 ventions for youth, women, and other vulnerable

13 populations;

14 ‘‘(D) programs to prevent the transmission

15 of HIV and other pathogens at health care facili16 ties (including the use of universal precautions,

17 equipment sterilization, post-exposure prophy18 laxis for health care workers and other individ19 uals determined to be appropriate, and other

20 interventions appropriate to the resources avail21 able), and to support the use of post exposure

22 prophylaxis, when indicated, for patients;

23 ‘‘(E) activities to ensure a safe blood sup24 ply;
†

73

HR 2069 EAS

1 ‘‘(F) programs to provide prevention, care,

2 treatment, and patient management services for

3 sexually transmitted infections to infected indi4 viduals and individuals at risk of infection; and

5 ‘‘(G) activities, including laboratory sup6 port, to collect and maintain accurate HIV/

7 AIDS surveillance and epidemiologic data, to

8 target and monitor programs, and to measure

9 the effectiveness of interventions;

10 ‘‘(2) HIV/AIDS care and treatment services pro11 vided through—

12 ‘‘(A) programs to provide care and treat13 ment, integrated with prevention services to fur14 ther reduce the transmission of HIV, for individ15 uals living with HIV/AIDS, including the treat16 ment of opportunistic infections (including tu17 berculosis) and the provision of antiretroviral

18 therapies and nutritional services;

19 ‘‘(B) programs to provide support services

20 that are needed to enhance the effectiveness of

21 health services and to promote family stability,

22 including services for family members affected

23 by, but not infected with, HIV such as children

24 orphaned by AIDS; and
†

74

HR 2069 EAS

1 ‘‘(C) programs that link care and treatment

2 services to proven prevention programs, includ3 ing linkages with voluntary counseling and test4 ing efforts (including rapid testing);

5 ‘‘(3) infrastructure and training through—

6 ‘‘(A) activities to improve the health infra7 structure and institutional capacity within par8 ticipating countries, including the training of

9 appropriate personnel, and to assist such coun10 tries in expanding and improving the avail11 ability of health care facilities, to enable such

12 countries to develop and manage HIV/AIDS edu13 cation, prevention, care and treatment programs

14 and to conduct evaluations of such programs;

15 and

16 ‘‘(B) activities to provide laboratory sup17 port as well as technical assistance and training

18 to increase the capacity for the diagnosis, care,

19 and treatment of HIV/AIDS and related health

20 conditions (including rapid testing);

21 ‘‘(4) HIV/AIDS treatment protocols through—

22 ‘‘(A) the provision of support and assistance

23 to countries determined by the Secretary to have

24 or be at risk for severe HIV epidemic with par25 ticular attention to resource constrained coun-
†

75

HR 2069 EAS

1 tries for the development of treatment protocols

2 for the delivery of HIV/AIDS treatment and pre3 vention services; and

4 ‘‘(B) the provision of assistance to countries

5 determined by the Secretary to have or be at risk

6 for severe HIV epidemic with particular atten7 tion to resource constrained countries, and to be

8 ready to implement the protocols described in

9 subparagraph (A); and

10 ‘‘(5) other activities determined appropriated by

11 the Secretary.

12 ‘‘(c) UTILIZATION OF EXISTING CAPACITIES.—In car13 rying out activities under subsection (b), the Secretary, act14 ing through the Director of the Centers for Disease Control

15 and Prevention and in coordination with the Administrator

16 of the United States Agency for International Development

17 and the Administrator of the Health Resources and Services

18 Administration, shall, to the maximum extent practicable,

19 utilize existing indigenous capacity in developing countries,

20 including coordinating with relevant government ministries

21 and carrying out activities in partnership with non-govern22 mental organizations and affected communities.

23 ‘‘(d) HEALTH RESOURCES AND SERVICES ADMINIS24 TRATION.—In carrying out activities under paragraphs (2)

25 and (3) of subsection (b), the Secretary, acting through the
†

76

HR 2069 EAS

1 Director of the Centers for Disease Control and Prevention,

2 shall enter into interagency agreements, monetary transfers,

3 and contracts with the Administrator of the Health Re4 sources and Services Administration to ensure that such ac5 tivities benefit from the specialized expertise of such Admin6 istration related to the assessment of needs as well as the

7 development and implementation of community-based sys8 tems of care and appropriate infrastructure, including the

9 training of health care providers and community workers.

10 ‘‘(e) BLOOD SUPPLY.—In carrying out activities under

11 subsection (b)(1)(E), the Secretary, acting through the Di12 rector of the Centers for Disease Control and Prevention,

13 shall assist participating countries in developing national,

14 regional, or local systems to—

15 ‘‘(1) monitor, manage, and test the blood supply

16 to ensure that such supply is screened for HIV;

17 ‘‘(2) increase recruitment and retention of ap18 propriate blood donors; and

19 ‘‘(3) provide for technology transfer and capacity

20 building in proven best blood safety practices appro21 priate to local conditions, including anemia preven22 tion efforts.

23 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are

24 authorized to be appropriated to carry out this section,

25 $400,000,000 for fiscal year 2003, and such sums as may
†

77

HR 2069 EAS

1 be necessary for fiscal year 2004. Of the amount appro2 priated under the preceding sentence for each fiscal year,

3 the Secretary shall make available $45,000,000 in fiscal

4 year 2003 and $30,000,000 in fiscal year 2004 to carry

5 out section 399DD. Amounts appropriated under this sub6 section shall remain available until expended.

7 ‘‘SEC. 399BB. GENERAL AUTHORITY OF THE HEALTH RE8 SOURCES AND SERVICES ADMINISTRATION.

9 ‘‘(a) PURPOSE.—It is the purpose of this section to

10 provide the Secretary, acting through the Administrator of

11 the Health Resources and Services Administration, with the

12 authority to act internationally to carry out prevention,

13 care, treatment, support, capacity development, and other

14 activities (determined appropriate by the Secretary) for

15 HIV/AIDS, tuberculosis, and malaria in countries deter16 mined by the Secretary to have or be at risk for severe HIV

17 epidemic with particular attention to resource constrained

18 countries.

19 ‘‘(b) ACTIVITIES AND ASSISTANCE.—In carrying out

20 the purpose described in subsection (a), the Secretary, act21 ing through the Administrator of the Health Resources and

22 Services Administration, in coordination with the Director

23 of the Centers for Disease Control and Prevention and the

24 Administrator of the United States Agency for Inter-
†

78

HR 2069 EAS

1 national Development, may provide assistance under this

2 section relating to—

3 ‘‘(1) activities to assist communities in assessing

4 the strengths and capabilities of the existing system of

5 care and treatment relating to HIV/AIDS and other

6 opportunistic infections, including critical unmet

7 needs;

8 ‘‘(2) activities to assist communities in the devel9 opment and implementation of appropriate systems of

10 care that provide for a continuum of HIV/AIDS-re11 lated services for prevention, treatment, palliative

12 care, and hospice services based on an assessment

13 under paragraph (1);

14 ‘‘(3) activities to improve the health-related in15 frastructure and institutional capacity of partici16 pating countries, including the training of health care

17 providers and community workers, to enable such

18 countries to develop and manage HIV/AIDS edu19 cation, prevention, care and treatment programs and

20 to conduct evaluations of such programs;

21 ‘‘(4) activities to assist in the development of

22 training modules and curricula on HIV/AIDS and

23 associated conditions as part of the professional train24 ing programs for physicians, nurses, dentists, phar25 macists, and other health care providers;
†

79

HR 2069 EAS

1 ‘‘(5) activities to improve the coordination be2 tween American medical centers and hospitals and

3 indigenous hospitals and clinics in participating

4 countries; and

5 ‘‘(6) other activities determined appropriated by

6 the Secretary.

7 ‘‘(c) UTILIZATION OF EXISTING CAPACITIES.—In car8 rying out activities under subsection (b), the Secretary, act9 ing through the Administrator of the Health Resources and

10 Services Administration and in consultation with the Di11 rector of the Centers for Disease Control and Prevention

12 and the Administrator of the United States Agency for

13 International Development, shall, to the maximum extent

14 practicable, utilize existing indigenous capacity in coun15 tries determined by the Secretary to have or be at risk for

16 severe HIV epidemic with particular attention to resource

17 constrained countries, including coordinating with relevant

18 government ministries and carrying out activities in part19 nership with non-governmental organizations and affected

20 communities.

21 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There

22 are authorized to be appropriated to carry out this section,

23 $40,000,000 for fiscal year 2003, and such sums as may

24 be necessary for fiscal year 2004. Amounts appropriated

25 under this subsection shall remain available until expended.
†

80

HR 2069 EAS

1 ‘‘SEC. 399CC. HIV/AIDS TRAINING PARTNERSHIP.

2 ‘‘(a) IN GENERAL.—The Secretary, acting through the

3 Director of the National Institutes of Health and in coordi4 nation with the Administrator of the Health Resources and

5 Services Administration, shall award supplemental grants

6 to eligible entities to enable such entities to provide support

7 for clinical education and training in the delivery of HIV/

8 AIDS care and treatment services.

9 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive a

10 supplemental grant under subsection (a), an entity shall—

11 ‘‘(1) be a recipient of an international HIV/

12 AIDS clinical research, education, or training grant

13 awarded by the National Institutes of Health or the

14 Health Resources and Services Administration;

15 ‘‘(2) provide assurances to the Secretary that the

16 entity has developed a partnership with a hospital17 based or community-based health care entity in the

18 host country for the purpose of providing services

19 under each grant; and

20 ‘‘(3) prepare and submit to the Secretary an ap21 plication at such time, in such manner, and con22 taining such information as the Secretary may re23 quire, including a description of the activities to be

24 carried out with amounts received under the grant.

25 ‘‘(c) USE OF FUNDS.—An entity shall use amounts re26 ceived under a supplemental grant under subsection (a) to
†

81

HR 2069 EAS

1 provide clinical education and training in the delivery of

2 HIV/AIDS care and treatment services. Such education and

3 training shall be designed to develop health care provider

4 capacity to deliver HIV/AIDS care and treatment services

5 in a variety of institutional and community-based settings.

6 ‘‘(d) PRIORITY.—In awarding grants under subsection

7 (a), the Secretary shall give priority to applicants that will

8 carry out activities that assess existing provider capacity

9 and address the training needs of a range of health care

10 providers (from physicians to nurses to other health care

11 providers).

12 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are

13 authorized to be appropriated to carry out this section,

14 $50,000,000 for fiscal year 2003, and such sums as may

15 be necessary for fiscal year 2004. Amounts appropriated

16 under this subsection shall remain available until expended.

17 ‘‘SEC. 399DD. FAMILY SURVIVAL PARTNERSHIPS.

18 ‘‘(a) PURPOSE.—The purpose of this section is to pro19 vide support, through a public-private partnership, for the

20 provision of medical care and support services to HIV posi21 tive parents and their children identified through existing

22 programs to prevent mother-to-child transmission of HIV

23 in countries with or at risk for severe HIV epidemic with

24 particular attention to resource constrained countries, as

25 determined by the Secretary.
†

82

HR 2069 EAS

1 ‘‘(b) GRANTS.—

2 ‘‘(1) IN GENERAL.—The Secretary, acting

3 through the Director of the Centers for Disease Con4 trol and Prevention, is authorized to award a grant

5 to an eligible administrative organization to enable

6 the organization to award subgrants to eligible enti7 ties to expand activities to prevent the mother-to-child

8 transmission of HIV by providing medical care and

9 support services to HIV infected parents and their

10 children.

11 ‘‘(2) ADMINISTRATIVE ORGANIZATION.—To be el12 igible to receive a grant under paragraph (1), an ad13 ministrative organization shall—

14 ‘‘(A) have a demonstrable record in man15 aging large scale maternal and child health pro16 grams in countries with or at risk for severe

17 HIV epidemic with particular attention to re18 source constrained countries, as determined by

19 the Secretary, and sufficient HIV/AIDS exper20 tise;

21 ‘‘(B) have established relationships with

22 major international organizations and multilat23 eral institutions;

24 ‘‘(C) provide an assurance to the Secretary

25 that the organization will contribute (either di-
†

83

HR 2069 EAS

1 rectly or through private sector financial sup2 port) non-Federal funds to the costs of the activi3 ties to be carried out under this section in an

4 amount that is not less than the amount of funds

5 provided to the organization under a grant this

6 section; and

7 ‘‘(D) prepare and submit an application to

8 the Secretary at such time, in such manner, and

9 accompanied by such information as the Sec10 retary may require.

11 ‘‘(3) USE OF FUNDS.—Amounts provided under

12 a grant awarded under paragraph (1) shall be used—

13 ‘‘(A) to award subgrants to eligible entities

14 to enable such entities to carry out activities de15 scribed in subsection (c);

16 ‘‘(B) for administrative support and

17 subgrant management;

18 ‘‘(C) for administrative data collection and

19 reporting concerning grant activities;

20 ‘‘(D) for the monitoring and evaluation of

21 grant activities;

22 ‘‘(E) for training and technical assistance

23 for subgrantees; and

24 ‘‘(F) to promote sustainability.

25 ‘‘(c) SUBGRANTS.—
†

84

HR 2069 EAS

1 ‘‘(1) IN GENERAL.—An organization awarded a

2 grant under subsection (b) shall use amounts received

3 under the grant to award subgrants to eligible enti4 ties.

5 ‘‘(2) ELIGIBILITY.—To be eligible to receive a

6 subgrant under paragraph (1), an entity shall—

7 ‘‘(A) be a local health organization, an

8 international organization, or a partnership of

9 such organizations;

10 ‘‘(B) demonstrate to the awarding organiza11 tion that such entity—

12 ‘‘(i) is currently administering a prov13 en intervention to prevent mother-to-child

14 transmission of HIV in countries with or at

15 risk for severe HIV epidemic with par16 ticular attention to resource constrained

17 countries, as determined by the Secretary;

18 ‘‘(ii) serves a catchment area with a

19 minimum HIV seroprevalence of 3 percent

20 in pregnant women;

21 ‘‘(iii) has demonstrated support for the

22 proposed program from relevant government

23 entities;

24 ‘‘(iv) is able to provide HIV care, in25 cluding antiretroviral treatment when
†

85

HR 2069 EAS

1 medically indicated, to HIV positive

2 women, men, and children with the support

3 of the project funding; and

4 ‘‘(v) has the ability to enroll a min5 imum of 250 HIV infected women per serv6 ice site, based on the current uptake rate,

7 into existing HIV mother-to-child trans8 mission programs; and

9 ‘‘(C) prepare and submit to the awarding

10 organization an application at such time, in

11 such manner, and containing such information

12 as the organization may require.

13 ‘‘(3) LOCAL HEALTH AND INTERNATIONAL ORGA14 NIZATIONS.—For purposes of paragraph (2)(A)—

15 ‘‘(A) the term ‘local health organization’

16 means a public sector health system, non-govern17 mental organization, institution of higher edu18 cation, community-based organization, or non19 profit health system that provides directly, or

20 has a clear link with a provider for the indirect

21 provision of, primary health care services; and

22 ‘‘(B) the term ‘international organization’

23 means—

24 ‘‘(i) a non-profit international entity;
†

86

HR 2069 EAS

1 ‘‘(ii) an international charitable insti2 tution;

3 ‘‘(iii) a private voluntary inter4 national entity; or

5 ‘‘(iv) a multilateral institution.

6 ‘‘(4) SELECTION OF SUBGRANT RECIPIENTS.—In

7 awarding subgrants under this subsection, the organi8 zation shall—

9 ‘‘(A) consider applicants from a range of

10 health care settings, program approaches, and

11 geographic locations; and

12 ‘‘(B) if appropriate, award not less than 1

13 grant to an applicant to fund a national system

14 of health care delivery to HIV positive families.

15 ‘‘(5) USE OF SUBGRANT FUNDS.—An eligible en16 tity awarded a subgrant under this subsection shall

17 use subgrant funds to expand activities to prevent

18 mother-to-child transmission of HIV by providing

19 medical treatment and care and support services to

20 parents and their children, including—

21 ‘‘(A) providing treatment and therapy,

22 when medically indicated, to HIV-infected

23 women, their children, and families;

24 ‘‘(B) the hiring and training of local per25 sonnel, including physicians, nurses, other health
†

87

HR 2069 EAS

1 care providers, counselors, social workers, out2 reach personnel, laboratory technicians, data

3 managers, and administrative support personnel;

4 ‘‘(C) paying laboratory costs, including

5 costs related to necessary equipment and diag6 nostic testing and monitoring (including rapid

7 testing), complete blood counts, standard chem8 istries, and liver function testing for infants,

9 children, and parents, and costs related to the

10 purchase of necessary laboratory equipment;

11 ‘‘(D) purchasing pharmaceuticals for HIV12 related conditions, including antiretroviral

13 therapies;

14 ‘‘(E) funding support services including ad15 herence and psychosocial support services;

16 ‘‘(F) operational support activities; and

17 ‘‘(G) conducting community outreach and

18 capacity building activities, including activities

19 to raise the awareness of individuals of the pro20 gram carried out by the subgrantee, other com21 munications activities in support of the pro22 gram, local advisory board functions, and trans23 portation necessary to ensure program participa24 tion.
†

88

HR 2069 EAS

1 ‘‘(d) REPORTS.—Not later than 6 months after the

2 date of enactment of this section, and annually thereafter,

3 an administrative organization awarded a grant under

4 subsection (b)(1) shall submit to the Secretary and the ap5 propriate committees of Congress, a report that includes—

6 ‘‘(1) the progress of programs funded under this

7 section;

8 ‘‘(2) the benchmarks of success of programs fund9 ed under this section; and

10 ‘‘(3) recommendations of how best to proceed

11 with the programs funded under this section upon the

12 expiration of funding under subsection (e).

13 ‘‘(e) FUNDING.—In making amounts available under

14 section 399AA(f) to carry out this section, the Secretary

15 shall ensure that not less than—

16 ‘‘(1) $45,000,000 is made available to carry out

17 this section for fiscal year 2003; and

18 ‘‘(2) $30,000,000 is made available to carry out

19 this section for fiscal year 2004.

20 ‘‘(f) LIMITATION ON ADMINISTRATIVE EXPENSES.—An

21 administrative organization shall ensure that not more

22 than 12 percent of the amount of a grant received under

23 this section by the organization is used for the administra24 tive activities described in subparagraphs (B), (C), (D),

25 and (E) of subsection (b)(3) and subsection (b)(5)(E).
†

89

HR 2069 EAS

1 ‘‘SEC. 399EE. INTRA-AGENCY COORDINATION OF GLOBAL

2 HIV/AIDS INITIATIVES.

3 ‘‘(a) IN GENERAL.—The Secretary, acting through the

4 Director of the Office of Global Health Affairs (referred to

5 in this section as the ‘Director’) of the Department of

6 Health and Human Services (referred to in this section as

7 the ‘Department’), shall ensure—

8 ‘‘(1) the coordination of all Department pro9 grams related to the prevention, treatment, and moni10 toring of HIV/AIDS, tuberculosis, and malaria in

11 countries with or at risk for severe HIV epidemic

12 with particular attention to resource constrained

13 countries, as determined by the Secretary (referred to

14 in this section as ‘Department programs’); and

15 ‘‘(2) that global HIV/AIDS, tuberculosis, and

16 malaria activities are conducted in a coordinated,

17 strategic fashion, utilizing the expertise from the var18 ious agencies within the Department, to the max19 imum extent practicable.

20 ‘‘(b) DUTIES.—In carrying out this section, the Sec21 retary shall—

22 ‘‘(1) review all Departmental programs to ensure

23 proper coordination and compatibility of the activi24 ties, strategies, and policies of such programs; and

25 ‘‘(2) ensure that the Departmental programs uti26 lize the best possible practices for HIV/AIDS preven-
†

90

HR 2069 EAS

1 tion, treatment, and monitoring to improve the effec2 tiveness of Department programs in countries in

3 which the Department operates.

4 ‘‘(c) REPORT.—

5 ‘‘(1) IN GENERAL.—The Director shall prepare

6 an annual report that—

7 ‘‘(A) describes the actions that are being

8 taken to coordinate the multiple roles and poli9 cies of, and foster collaboration among, the of10 fices and agencies of the Department that con11 tribute to global HIV/AIDS activities;

12 ‘‘(B) describes the respective roles and ac13 tivities of each of the offices and agencies of the

14 Department;

15 ‘‘(C) contains any recommendations for leg16 islative and funding actions that are needed to

17 create a coherent, effective departmental ap18 proach to global HIV/AIDS that achieves the

19 goals for Department programs; and

20 ‘‘(D) describes the progress made towards

21 meeting the HIV/AIDS goals and outcomes as

22 identified by the Director.

23 ‘‘(2) SUBMISSION TO CONGRESS.—Not later than

24 1 year after the date of enactment of this part, and

25 annually thereafter, the Secretary shall submit the re-
†

91

HR 2069 EAS

1 port described in paragraph (1) to the appropriate

2 committees of Congress.’’.

3 (b) EXTENSION OF TUBERCULOSIS PREVENTION PRO4 GRAM.—Section 317E(g) of the Public Health Service Act

5 (42 U.S.C. 247b–6(g)) is amended—

6 (1) in paragraph (1)(A), by striking ‘‘2002’’ and

7 inserting ‘‘2004’’;

8 (2) in paragraph (2), by striking ‘‘2002’’ and in9 serting ‘‘2004’’; and

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

11 ‘‘(3) COORDINATION.—Activities under this sec12 tion shall, to the extent practicable, be coordinated

13 with related activities carried out under title VI of

14 the United States Leadership Against HIV/AIDS, Tu15 berculosis, and Malaria Act of 2002 (and the amend16 ments made by that title).’’.

17 SEC. 602. MICROBICIDE RESEARCH AT THE NATIONAL IN18 STITUTES OF HEALTH.

19 Subpart I of part D of title XXIII of the Public Health

20 Service Act (42 U.S.C. 300cc-40 et seq.) is amended by in21 serting after section 2351 the following:
†

92

HR 2069 EAS

1 ‘‘SEC. 2351A. MICROBICIDES FOR PREVENTING TRANS2 MISSION OF HIV AND OTHER SEXUALLY

3 TRANSMITTED INFECTIONS.

4 ‘‘(a) EXPANSION AND COORDINATION OF ACTIVI5 TIES.—The Secretary, acting through the Director of the Of6 fice of AIDS Research and in coordination with other rel7 evant institutes and offices, shall expand, intensify, and co8 ordinate the activities of all appropriate institutes and

9 components of the National Institutes of Health with respect

10 to research on the development of microbicides to prevent

11 the transmission of HIV and other sexually transmitted in12 fections (in this section referred to as ‘microbicide re13 search’).

14 ‘‘(b) RESEARCH PLAN.—The Secretary, acting through

15 the Director of the Office of AIDS Research and in consulta16 tion with the Director of the Institute of Allergy and Infec17 tious Diseases, shall expedite the implementation of the

18 strategic plan for the conduct and support of microbicide

19 research, and shall annually review and as appropriate re20 vise the plan. In developing, implementing, and reviewing

21 the plan, the Director of the Office of AIDS Research shall

22 coordinate with the heads of other Federal agencies, includ23 ing the Director of the Centers for Disease Control and Pre24 vention and the Administrator of the United States Agency

25 for International Development, involved in microbicide re-
†

93

HR 2069 EAS

1 search, with the microbicide research community, and with

2 health advocates.

3 ‘‘(c) MICROBICIDE RESEARCH AND DEVELOPMENT

4 TEAMS.—

5 ‘‘(1) IN GENERAL.—The Secretary, acting

6 through the Director of the National Institutes of

7 Health, shall award grants or contracts to public and

8 private entities for the development and operation of

9 multidisciplinary teams to conduct research on inno10 vative microbicide concepts, including combination

11 microbicides.

12 ‘‘(2) PEER REVIEW REQUIREMENT.—The Direc13 tor shall award a grant or contract to an entity

14 under paragraph (1) only if the grant or contract has

15 been recommended after technical and scientific peer

16 review in accordance with regulations under section

17 492.

18 ‘‘(d) REPORT.—Not later than 1 year after the date

19 of the initial submission of the research plan under sub20 section (b), and annually thereafter, the Secretary, acting

21 through the Director of the Office of AIDS Research and

22 in consultation with the Director of the Institute of Allergy

23 and Infectious Diseases, shall submit to the Committee on

24 Energy and Commerce and the Committee on Appropria25 tions of the House of Representatives and the Committee
†

94

HR 2069 EAS

1 on Health, Education, Labor, and Pensions and the Com2 mittee on Appropriations of the Senate a report that de3 scribes the activities of the National Institutes of Health

4 regarding microbicide research. Each such report shall

5 include—

6 ‘‘(1) an updated research plan;

7 ‘‘(2) a description and evaluation of the progress

8 made, during the period for which such report is pre9 pared, in research on microbicides;

10 ‘‘(3) a summary and analysis of expenditures

11 made, during the period for which the report is made,

12 for activities with respect to microbicides research

13 conducted and supported by the National Institutes of

14 Health, including the number of full-time equivalent

15 employees; and

16 ‘‘(4) recommendations as the Director of the Of17 fice of AIDS Research considers appropriate.

18 ‘‘(f) DEFINITION.—In this section, the term ‘HIV’

19 means the human immunodeficiency virus. Such term in20 cludes acquired immune deficiency syndrome.’’.

21 SEC. 603. AUTHORITY OF THE DEPARTMENT OF LABOR.

22 (a) PURPOSE.—It is the purpose of this section to pro23 vide the Secretary of Labor with the authority to carry out

24 workplace-based HIV/AIDS programs in countries with or

25 at risk for severe HIV epidemic with particular attention
†

95

HR 2069 EAS

1 to resource constrained countries, as determined by the Sec2 retary.

3 (b) ACTIVITIES AND ASSISTANCE.—In carrying out the

4 purpose described in subsection (a), the Secretary of Labor,

5 in coordination with the Secretary of Health and Human

6 Services and the Administrator of the United States Agency

7 for International Development, may provide assistance

8 under this section relating to—

9 (1) the establishment and implementation of

10 workplace HIV/AIDS prevention and education pro11 grams in countries with or at risk for severe HIV epi12 demic with particular attention to resource con13 strained countries, as determined by the Secretary,

14 including programs that emphasize protections

15 against discrimination and the creation of supportive

16 environments for individuals living with HIV/AIDS;

17 (2) the development and implementation of on18 site care and wellness programs that enhance the

19 health and productivity of the workforce in countries

20 with or at risk for severe HIV epidemic with par21 ticular attention to resource constrained countries, as

22 determined by the Secretary;

23 (3) activities to strengthen collaboration among

24 governments, business, and labor leaders to respond to

25 the HIV/AIDS pandemic; and
†

96

HR 2069 EAS

1 (4) other activities determined appropriated by

2 the Secretary.

3 (c) AUTHORIZATION OF APPROPRIATIONS.—There are

4 authorized to be appropriated to carry out this section,

5 $10,000,000 for fiscal year 2003, and such sums as may

6 be necessary for fiscal year 2004. Amounts appropriated

7 under this subsection shall remain available until expended.

8 SEC. 604. AUTHORITY FOR INTERNATIONAL PROGRAMS.

9 Section 307 of the Public Health Service Act (42

10 U.S.C. 242l) is amended—

11 (1) in subsection (b)—

12 (A) in paragraph (6), by adding ‘‘and’’ at

13 the end;

14 (B) in paragraph (7), by striking ‘‘; and’’

15 and inserting a period;

16 (C) in the flush sentence after paragraph

17 (7), by inserting ‘‘new’’ before ‘‘facility in any

18 foreign country’’; and

19 (D) by striking paragraph (8); and

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

21 ‘‘(d)(1) The Secretary is authorized to utilize the au22 thority contained in section 2 of the State Department

23 Basic Authorities Act of 1956 (22 U.S.C. 2669), subject to

24 the limitations set forth in subsection (e).
†

97

HR 2069 EAS

1 ‘‘(2) The Secretary is authorized to use the authority

2 contained in section 1 of the Act of April 18, 1930 (46 Stat.

3 177; 22 U.S.C. 291) and section 1 of the Foreign Service

4 Buildings Act (22 U.S.C. 292) directly or through contract,

5 grant, or cooperative agreement to lease, alter, or renovate

6 facilities in foreign countries as necessary to conduct pro7 grams of assistance for international health activities, in8 cluding activities relating to HIV/AIDS and other infec9 tious diseases, chronic and environmental diseases, and

10 other health activities abroad.

11 ‘‘(e) In exercising the authority set forth in paragraphs

12 (1) and (2) of subsection (d), the Secretary shall consult

13 with the Secretary of State to ensure that planned activities

14 are within the legal strictures of the State Department

15 Basic Authorities Act of 1956 and other applicable laws.’’.

Amend the title so as to read: ‘‘An Act to amend the

Foreign Assistance Act of 1961 to increase assistance for

foreign countries seriously affected by HIV/AIDS, tuberculosis, and malaria; to amend the Public Health Service

Act with respect to the authority of the Department of

Health and Human Services to act internationally with

respect to HIV/AIDS, tuberculosis, and malaria; and for

other purposes.’’.

Attest:

Secretary.
107TH CONGRESS

2D SESSION H. R. 2069

AMENDMENTS