IIB

107TH CONGRESS

1ST SESSION H. R. 2069

IN THE SENATE OF THE UNITED STATES

DECEMBER 12, 2001

Received; read twice and referred to the Committee on Foreign Relations

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.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE.

2 This Act may be cited as the ‘‘Global Access to HIV/

3 AIDS Prevention, Awareness, Education, and Treatment

4 Act of 2001’’.

5 SEC. 2. FINDINGS; SENSE OF CONGRESS.

6 (a) FINDINGS.—Congress makes the following find7 ings:

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

10 58,000,000 people worldwide have already been in11 fected with HIV/AIDS, a fatal disease that is dev12 astating the health and economies in dozens of coun13 tries in Africa and increasingly in Asia, the Carib14 bean region, and Eastern Europe.

15 (2) The HIV/AIDS pandemic has erased dec16 ades of progress in improving the lives of families in

17 the developing world and has claimed 22,000,000

18 lives since its inception.

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

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

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

22 Africa has grown beyond an international public

23 health issue to become a humanitarian, national se24 curity, and developmental crisis.

25 (5) The HIV/AIDS pandemic is striking hard26 est among women and girls. According to UNAIDS,
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1 by the end of 2000, fifty-five percent of the HIV2 positive population in sub-Saharan Africa and 40

3 percent of such population in North Africa and the

4 Middle East were women, infected mainly through

5 heterosexual transmission. In Africa, 6 out of 7 chil6 dren who are HIV positive are girls.

7 (6) An estimated 1,400,000 children under age

8 15 were living with HIV/AIDS at the end of 2000,

9 of which 1,100,000 were children living in sub-Saha10 ran Africa. An estimated 500,000 children died of

11 AIDS during 2000, of which 440,000 were children

12 in sub-Saharan Africa. In addition there are an esti13 mated 13,200,000 children worldwide who have lost

14 one or both of their parents to HIV/AIDS, of which

15 12,100,000 are children in sub-Saharan Africa.

16 (7) Mother-to-child transmission is the largest

17 source of HIV infection in children under age 15

18 and the only source for very young children. The

19 total number of births to HIV-infected pregnant

20 women each year in developing countries is approxi21 mately 700,000.

22 (8) Counseling and voluntary testing are critical

23 services to help infected women accept their HIV

24 status and the risk it poses to their unborn child.

25 Mothers who are aware of their status can make in-
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1 formed decisions about treatment, replacement feed2 ing, and future child-bearing.

3 (9) Although the HIV/AIDS pandemic has im4 pacted the sub-Saharan Africa disproportionately,

5 HIV infection rates are rising rapidly in India and

6 other South Asian countries, Brazil, Russia, Eastern

7 European countries, and Caribbean countries, and

8 pose a serious threat to the security and stability in

9 those countries.

10 (10) By 2010, it is estimated that approxi11 mately 40,000,000 children worldwide will have lost

12 one or both of their parents to HIV/AIDS.

13 (11) In January 2000, the United States Na14 tional Intelligence Council estimates that this dra15 matic increase in AIDS orphans will contribute to

16 economic decay, social fragmentation, and political

17 destabilization in already volatile and strained soci18 eties. Children without care or hope are often drawn

19 into prostitution, crime, substance abuse or child sol20 diery. The Council also stated that, in addition to

21 the reduction of economic activity caused by HIV/

22 AIDS to date, the disease could reduce GDP by as

23 much as 20 percent or more by 2010 in some coun24 tries in sub-Saharan Africa.
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1 (12) The HIV/AIDS epidemic is not just a

2 health crisis but is directly linked to development

3 problems, including chronic poverty, food security

4 and personal debt that are reflected in the capacity

5 of affected households, often headed by elders or or6 phaned children, to meet basic needs. Similarly,

7 heavily-indebted countries are stripped of the re8 sources necessary to improve health care delivery

9 systems and infrastructure and to prevent, treat,

10 and care for individuals affected by HIV/AIDS.

11 (13) On March 7, 2001, the United States Sec12 retary of State testified before Congress that the

13 United States has an obligation ‘‘ . . . if we believe

14 in democracy and freedom, to stop this catastrophe

15 from destroying whole economies and families and

16 societies and cultures and nations’’.

17 (14) A continuing priority for responding to the

18 HIV/AIDS crisis should be to emphasize and en19 courage awareness, education, and prevention, in20 cluding prevention activities that promote behavioral

21 change, while recognizing that behavioral change

22 alone will not conquer this disease. In so doing, pri23 ority and support should be given to building capac24 ity in the local public health sector through technical

25 assistance as well as through nongovernmental orga-
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1 nizations, including faith-based organizations where

2 practicable.

3 (15) Effective use should be made of existing

4 health care systems to provide treatment for individ5 uals suffering from HIV/AIDS.

6 (16) Many countries in Africa facing health cri7 ses, including high HIV/AIDS infection rates, al8 ready have well-developed and high functioning

9 health care systems. Additional resources to expand

10 and improve capacity to respond to these crises can

11 easily be absorbed by the private and public sectors,

12 as well as by nongovernmental organizations, com13 munity-based organizations, and faith-based organi14 zations currently engaged in combatting the crises.

15 (17) An effective response to the HIV/AIDS

16 pandemic must also involve assistance to stimulate

17 the development of sound health care delivery sys18 tems and infrastructure in countries in sub-Saharan

19 Africa and other developing countries, including as20 sistance to increase the capacity and technical skills

21 of local public health professionals and other per22 sonnel in such countries, and improved access to

23 treatment and care for those already infected with

24 HIV/AIDS.
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1 (18) Access to effective treatment for HIV/

2 AIDS is determined by issues of price, health care

3 delivery system and infrastructure, and sustainable

4 financing and such access can be inhibited by the

5 stigma and discrimination associated with HIV/

6 AIDS.

7 (19) The HIV/AIDS crisis must be addressed

8 by a robust, multilateral approach such as the one

9 envisioned by the Congress in the Global AIDS and

10 Tuberculosis Relief Act of 2000, which directed the

11 United States Government to seek to negotiate the

12 creation of an international HIV/AIDS trust fund

13 involving the World Bank.

14 (20) The Secretary General of the United Na15 tions has called for a global fund to halt and reverse

16 the spread of HIV/AIDS and other infectious dis17 eases. The Secretary General has also called for an18 nual expenditures of $7,000,000,000 to

19 $10,000,000,000, financed by donor governments

20 and private contributors, for all efforts to combat

21 the HIV/AIDS pandemic and, equally important,

22 called on leaders from developing countries to give a

23 much higher priority in their budgets to development

24 of comprehensive health systems.
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1 (21) The Administration has advocated a fidu2 ciary role for the World Bank in the Global Fund

3 to Fight AIDS, Tuberculosis, and Malaria and the

4 Transitional Working Group for that fund has de5 cided to invite the World Bank to play such a role.

6 (22) An effective United States response to the

7 HIV/AIDS crisis must also focus on the development

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

9 disease as well as the development of microbicides,

10 effective diagnostics, and simpler treatments.

11 (23) The innovative capacity of the United

12 States in the commercial and public pharmaceutical

13 research sectors is among the foremost in the world,

14 and the active participation of both these sectors

15 should be supported as it is critical to combat the

16 global HIV/AIDS pandemic.

17 (24) Appropriate treatment of individuals with

18 HIV/AIDS can prolong the lives of such individuals,

19 preserve their families and prevent children from be20 coming orphans, and increase productivity of such

21 individuals by allowing them to lead active lives and

22 reduce the need for costly hospitalization for treat23 ment of opportunistic infections caused by HIV.

24 (25) United States nongovernmental organiza25 tions, including faith-based organizations, with expe-
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1 rience in healthcare and HIV/AIDS counseling, have

2 proven effective in combatting the HIV/AIDS pan3 demic and can be a resource in assisting sub-Saha4 ran African leaders of traditional, political, business,

5 and women and youth organizations in their efforts

6 to provide treatment and care for individuals in7 fected with HIV/AIDS.

8 (26) Most of the HIV infected poor of the de9 veloping world die of deadly diseases such as tuber10 culosis and malaria. Accordingly, effective HIV/

11 AIDS treatment programs should address the grow12 ing threat and spread of tuberculosis, malaria, and

13 other infectious diseases in the developing world.

14 (27) Law enforcement and military personnel of

15 foreign countries often have a high rate of preva16 lence of HIV/AIDS, and therefore, in order to be ef17 fective, HIV/AIDS awareness, prevention, and edu18 cation programs must include education and related

19 services to such law enforcement and military per20 sonnel.

21 (28) Microenterprise development and other in22 come generation programs assist communities af23 flicted by the HIV/AIDS pandemic and increase the

24 productive capacity of communities and afflicted

25 households. Microenterprise programs are also an ef-
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1 fective means to support the productive activities of

2 healthy family members caring for the sick and or3 phaned. Such programs should give priority to

4 women infected with the AIDS virus or in HIV/

5 AIDS affected families, particularly women in high6 risk categories.

7 (29) The exploding global HIV/AIDS pandemic

8 has created new challenges for United States bilat9 eral assistance programs and will require a substan10 tial increase in the capacity of the United States

11 Agency for International Development and other

12 agencies of the United States to manage and mon13 itor bilateral HIV/AIDS programs and resources. To

14 meet this challenge, the Agency will need to recruit

15 and retain appropriate technical expertise in the

16 United States as well as in foreign countries to help

17 develop and implement HIV/AIDS strategies in con18 cert with multilateral agencies, host country govern19 ments, and nongovernmental organizations.

20 (b) SENSE OF CONGRESS.—It is the sense of Con21 gress that—

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

23 countries in sub-Saharan Africa and other devel24 oping countries should be a global effort and include

25 the financial support of all developed countries and
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1 the cooperation of governments and the private sec2 tor, including faith-based organizations; and

3 (B) the United States should provide additional

4 funds for multilateral programs and efforts to com5 bat HIV/AIDS and also seek to leverage public and

6 private resources to combat HIV/AIDS on a global

7 basis through the Global Development Alliance Ini8 tiative of the United States Agency for International

9 Development and other public and private partner10 ships with an emphasis on HIV/AIDS awareness,

11 education, prevention, and treatment programs;

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

13 education, and prevention programs, the United

14 States Government should make its best efforts to

15 support programs that safely make available to pub16 lic and private entities in countries in sub-Saharan

17 Africa and other developing countries pharma18 ceuticals and diagnostics for HIV/AIDS therapy in

19 order—

20 (i) to effectively and safely assist such

21 countries in the delivery of HIV/AIDS therapy

22 pharmaceuticals through the establishment of

23 adequate health care delivery systems and

24 treatment monitoring programs; and
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1 (ii) to provide treatment for poor individ2 uals with HIV/AIDS in such countries; and

3 (B) in carrying out such programs, priority

4 consideration for participation should be given to

5 countries in sub-Saharan Africa;

6 (3)(A) combatting the HIV/AIDS pandemic re7 quires that United States Government programs

8 place a priority on the vulnerable populations at

9 greatest risk for contracting HIV;

10 (B) these populations should be determined

11 through qualitative and quantitative assessments at

12 the local level by local government, nongovernmental

13 organizations, people living with HIV/AIDS, and

14 other relevant sectors of civil society; and

15 (C) such assessments should be included in na16 tional HIV/AIDS strategies;

17 (4) the United States should promote efforts to

18 expand and develop programs that support the grow19 ing number of children orphaned by the HIV/AIDS

20 pandemic;

21 (5) in countries where the United States Gov22 ernment is conducting HIV/AIDS awareness, pre23 vention, and education programs, such programs

24 should include education and related services to law

25 enforcement and military personnel of foreign coun-
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1 tries to prevent and control HIV/AIDS, malaria, and

2 tuberculosis;

3 (6) prevention and treatment for HIV/AIDS

4 should be a component of a comprehensive inter5 national effort to combat deadly infectious diseases,

6 including malaria and tuberculosis, and opportun7 istic infections, that kill millions annually in the de8 veloping world;

9 (7) programs developed by the United States

10 Agency for International Development to address the

11 HIV/AID pandemic should preserve personal privacy

12 and confidentiality, should not include compulsory

13 HIV/AIDS testing, and should not be discrimina14 tory;

15 (8)(A) the United States Agency for Inter16 national Development should carry out HIV/AIDS

17 awareness, prevention, and treatment programs in

18 conjunction with effective international tuberculosis

19 and malaria treatment programs and with programs

20 that address the relationship between HIV/AIDS

21 and a number of opportunistic diseases that include

22 bacterial diseases, fungal diseases, viral diseases and

23 HIV-associated malignancies, such as Kaposi sar24 coma, lymphoma, and squamous cell carcinoma; and
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1 (B) effective intervention against opportunistic

2 diseases requires not only the appropriate drug or

3 other medication for a given medical condition, but

4 also the infrastructure necessary to diagnose the

5 condition, monitor the intervention, and provide

6 counseling services; and

7 (9) the United States Agency for International

8 Development should expand and replicate successful

9 microenterprise programs in Uganda, Zambia,

10 Zimbabwe, and other African countries that provide

11 poor families affected by HIV/AIDS with the means

12 to care for themselves, their children, and orphans;

13 (10) the United States Agency for International

14 Development should substantially increase and im15 prove its capacity to manage and monitor HIV/

16 AIDS programs and resources;

17 (11) the United States Agency for International

18 Development must recruit and retain appropriate

19 technical expertise in the United States as well as in

20 foreign countries to help develop and implement

21 HIV/AIDS strategies in conjunction with multilat22 eral agencies, host country governments, and non23 governmental organizations;

24 (12) the United States Agency for International

25 Development must strengthen coordination and col-
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1 laboration between the technical experts in its cen2 tral and regional bureaus and foreign country mis3 sions in formulating country strategies and imple4 menting HIV/AIDS programs;

5 (13) strong coordination among the various

6 agencies of the United States, including the Depart7 ment of State, the United States Agency for Inter8 national Development, the Department of Health

9 and Human Services, including the Centers for Dis10 ease Control and the National Institutes of Health,

11 the Department of the Treasury, the Department of

12 Defense, and other relevant Federal agencies must

13 exist to ensure effective and efficient use of financial

14 and technical resources within the United States

15 Government; and

16 (14) to help alleviate human suffering, and en17 hance the dignity and quality of life for patients de18 bilitated by HIV/AIDS, the United States should

19 promote, both unilaterally and through multilateral

20 initiatives, the use of palliative and hospice care, and

21 provide financial and technical assistance to pallia22 tive and hospice care programs, including programs

23 under which such care is provided by faith-based or24 ganizations.
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1 SEC. 3. ASSISTANCE TO COMBAT HIV/AIDS.

2 (a) ASSISTANCE.—Section 104(c) of the Foreign As3 sistance Act of 1961 (22 U.S.C. 2151b(c)) is amended—

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

5 (2) by inserting after paragraph (3) the fol6 lowing:

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

8 of HIV/AIDS in countries in sub-Saharan Africa and

9 other developing countries is a major global health, na10 tional security, and humanitarian crisis. Accordingly, the

11 United States and other developed countries should pro12 vide assistance to countries in sub-Saharan Africa and

13 other developing countries to control this crisis through

14 HIV/AIDS prevention, treatment, monitoring, and related

15 activities, particularly activities focused on women and

16 youth, including mother-to-child transmission prevention

17 strategies.

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

19 Agency for International Development is authorized to

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

21 AIDS, and carry out related activities, in countries in sub22 Saharan Africa and other developing countries.

23 ‘‘(ii) It is the sense of Congress that the Adminis24 trator should provide an appropriate level of assistance

25 under clause (i) through nongovernmental organizations
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1 in countries in sub-Saharan Africa and other developing

2 countries affected by the HIV/AIDS pandemic.

3 ‘‘(iii) The Administrator shall coordinate the provi4 sion of assistance under clause (i) with the provision of

5 related assistance by the Joint United Nations Pro6 gramme on HIV/AIDS (UNAIDS), the United Nations

7 Children’s Fund (UNICEF), the World Health Organiza8 tion (WHO), the United Nations Development Programme

9 (UNDP), other appropriate international organizations,

10 such as the World Bank and the relevant regional multi11 lateral development institutions, national, state, and local

12 governments of foreign countries, and other appropriate

13 governmental and nongovernmental organizations.

14 ‘‘(C) Assistance provided under subparagraph (B)

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

16 out the following activities:

17 ‘‘(i) Prevention of HIV/AIDS through activities

18 including—

19 ‘‘(I) education, voluntary testing, and

20 counseling (including the incorporation of con21 fidentiality protections with respect to such

22 testing and counseling), including integration of

23 such programs into women’s and children’s

24 health programs;
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1 ‘‘(II) assistance to ensure a safe blood sup2 ply and to provide post-exposure prophylaxis to

3 victims of rape and sexual assault; and

4 ‘‘(III) assistance through nongovernmental

5 organizations, including faith-based organiza6 tions, particularly those organizations that uti7 lize both professionals and volunteers with ap8 propriate skills and experience, to establish and

9 implement culturally appropriate HIV/AIDS

10 education and prevention programs.

11 ‘‘(ii) The treatment and care of individuals with

12 HIV/AIDS, including—

13 ‘‘(I) assistance to establish and implement

14 programs to strengthen and broaden indigenous

15 health care delivery systems and the capacity of

16 such systems to deliver HIV/AIDS pharma17 ceuticals and otherwise provide for the treat18 ment of individuals with HIV/AIDS, including

19 clinical training for indigenous organizations

20 and health care providers;

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

22 transmission of HIV/AIDS from mother to

23 child, including medications to prevent such

24 transmission and access to infant formula and

25 other alternatives for infant feeding; and
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1 ‘‘(III) assistance to strengthen and expand

2 hospice and palliative care programs to assist

3 patients debilitated by HIV/AIDS, their fami4 lies, and the primary caregivers of such pa5 tients, including programs that utilize faith6 based organizations.

7 ‘‘(iii) The monitoring of programs, projects, and

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

9 including—

10 ‘‘(I) monitoring to ensure that adequate

11 controls are established and implemented to

12 provide HIV/AIDS pharmaceuticals and other

13 appropriate medicines to poor individuals with

14 HIV/AIDS; and

15 ‘‘(II) appropriate evaluation and surveil16 lance activities.

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

18 including—

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

20 are orphaned by the HIV/AIDS pandemic, in21 cluding services designed to care for orphaned

22 children in a family environment which rely on

23 extended family members;

24 ‘‘(II) improved infrastructure and institu25 tional capacity to develop and manage edu-
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1 cation, prevention, and treatment programs, in2 cluding the resources to collect and maintain

3 accurate HIV surveillance data to target pro4 grams and measure the effectiveness of inter5 ventions;

6 ‘‘(III) vaccine research and development

7 partnership programs with specific plans of ac8 tion to develop a safe, effective, accessible, pre9 ventive HIV vaccine for use throughout the

10 world; and

11 ‘‘(IV) the development and expansion of fi12 nancially-sustainable microfinance institutions

13 and other income generation programs that

14 strengthen the economic and social viability of

15 communities afflicted by the HIV/AIDS pan16 demic, including support for the savings and

17 productive capacity of affected poor households

18 caring for orphans.

19 ‘‘(D)(i) Not later than January 31 of each calendar

20 year, the Administrator shall submit to Congress an an21 nual report on the implementation of this paragraph for

22 the prior fiscal year.

23 ‘‘(ii) Such report shall include—

24 ‘‘(I) a description of efforts made to implement

25 the policies set forth in this paragraph;
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1 ‘‘(II) a description of the programs established

2 pursuant to this paragraph and section 4 of the

3 Global Access to HIV/AIDS Prevention, Awareness,

4 Education, and Treatment Act of 2001; and

5 ‘‘(III) a detailed assessment of the impact of

6 programs established pursuant to this paragraph, in7 cluding the effectiveness of such programs in reduc8 ing the spread of HIV infection, particularly in

9 women and girls, in reducing HIV transmission from

10 mother to child, in reducing mortality rates from

11 HIV/AIDS, and the progress toward improving

12 health care delivery systems and infrastructure to

13 ensure increased access to care and treatment.

14 ‘‘(iii) The Administrator shall consult with the Global

15 Health Advisory Board established under section 6 of the

16 Global Access to HIV/AIDS Prevention, Awareness, Edu17 cation, and Treatment Act of 2001 in the preparation of

18 the report under clause (i) and on other global health ac19 tivities carried out by the United States Agency for Inter20 national Development.

21 ‘‘(E)(i) There is authorized to be appropriated to the

22 President to carry out this paragraph $485,000,000 for

23 fiscal year 2002.

24 ‘‘(ii) Not more than six percent of the amount appro25 priated pursuant to the authorization of appropriations
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1 under clause (i) for fiscal year 2002, and not more than

2 four percent of the amount made available to carry out

3 this paragraph for any subsequent fiscal year, may be used

4 for the administrative expenses of the Agency in carrying

5 out this paragraph.

6 ‘‘(iii) Amounts appropriated pursuant to the author7 ization of appropriations under clause (i) are in addition

8 to amounts otherwise available for such purposes and are

9 authorized to remain available until expended.

10 ‘‘(F) In this paragraph:

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

12 human immunodeficiency virus.

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

14 deficiency syndrome.’’.

15 (b) AVAILABILITY OF ASSISTANCE UNDER SECTION

16 104(c).—Section 104(c) of the Foreign Assistance Act of

17 1961 (22 U.S.C. 2151b(c)) is amended—

18 (1) by redesignating paragraph (7) as para19 graph (5); and

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

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

22 of this subsection, and assistance made available under

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

24 of any paragraph of this subsection, may be made avail25 able notwithstanding any other provision of law.’’.
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1 SEC. 4. ASSISTANCE FOR PROCUREMENT AND DISTRIBU2 TION OF HIV/AIDS PHARMACEUTICALS AND

3 RELATED MEDICINES.

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

5 States Agency for International Development shall provide

6 assistance to countries in sub-Saharan Africa and other

7 developing countries for—

8 (1) the procurement of HIV/AIDS pharma9 ceuticals, anti-viral therapies, and other appropriate

10 medicines; and

11 (2) the distribution of such HIV/AIDS pharma12 ceuticals, anti-viral therapies, and other appropriate

13 medicines to qualified national, regional, or local or14 ganizations for the treatment of individuals with

15 HIV/AIDS in accordance with appropriate HIV/

16 AIDS testing and monitoring requirements and for

17 the prevention of transmission of HIV/AIDS from

18 mother to child.

19 (b) ADDITIONAL AUTHORITY.—The authority con20 tained in section 104(c)(6) of the Foreign Assistance Act

21 of 1961, as amended by section 3(b) of this Act, shall

22 apply to assistance made available under subsection (a).

23 (c) AUTHORIZATION OF APPROPRIATIONS.—There is

24 authorized to be appropriated to the President to carry

25 out this section $50,000,000 for fiscal year 2002.
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1 SEC. 5. INTERAGENCY TASK FORCE ON HIV/AIDS.

2 (a) ESTABLISHMENT.—The President shall establish

3 an interagency task force (hereafter referred to as the

4 ‘‘task force’’) to ensure coordination of all Federal pro5 grams related to the prevention, treatment, and moni6 toring of HIV/AIDS in foreign countries.

7 (b) DUTIES.—The duties of the task force shall

8 include—

9 (1) reviewing all Federal programs related to

10 the prevention, treatment, and monitoring of HIV/

11 AIDS in foreign countries to ensure proper coordi12 nation and compatibility of activities and policies of

13 such programs;

14 (2) exchanging information regarding design

15 and impact of such programs to ensure that the

16 United States Government can catalogue the best

17 possible practices for HIV/AIDS prevention, treat18 ment, and monitoring and improve the effectiveness

19 of such programs in the countries in which they op20 erate; and

21 (3) fostering discussions with United States

22 and foreign nongovernmental organizations to deter23 mine how United States Government programs can

24 be improved, including by engaging in a dialogue

25 with the Global Health Advisory Board established

26 under section 6 of this Act.
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1 (c) MEMBERSHIP.—

2 (1) COMPOSITION.—The task force shall be

3 composed of the Secretary of State, the Adminis4 trator of the United States Agency for International

5 Development, the Secretary of Health and Human

6 Services, the Secretary of the Treasury, the Director

7 of the National Institutes of Health, the Director of

8 the Centers for Disease Control, the Secretary of

9 Defense, and the head of any other agency that the

10 President determines is appropriate.

11 (2) CHAIRPERSON.—The Secretary of State

12 shall serve as chairperson of the task force.

13 (d) PUBLIC MEETINGS.—At least once each calendar

14 year, the task force shall hold a public meeting in order

15 to afford an opportunity for any person to present views

16 regarding the activities of the United States Government

17 with respect to the prevention, treatment, and monitoring

18 of HIV/AIDS in foreign countries. The Secretary of State

19 shall maintain a record of each meeting and shall make

20 the record available to the public.

21 (e) AVAILABILITY OF FUNDS.—Amounts made avail22 able for a fiscal year pursuant to section 104(c)(4)(E)(ii)

23 of the Foreign Assistance Act of 1961, as amended by sec24 tion 3(a) of this Act, are authorized to be made available

25 to carry out this section for such fiscal year.
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1 SEC. 6. GLOBAL HEALTH ADVISORY BOARD.

2 (a) ESTABLISHMENT.—There is established a perma3 nent Global Health Advisory Board (hereafter referred to

4 as the ‘‘Board’’) to assist the President and other Federal

5 officials, including the Secretary of State and the Adminis6 trator of the United States Agency for International De7 velopment, in the administration and implementation of

8 United States international health programs, particularly

9 programs relating to the prevention, treatment, and moni10 toring of HIV/AIDS.

11 (b) DUTIES.—

12 (1) IN GENERAL.—The Board shall serve as a

13 liaison between the United States Government and

14 private and voluntary organizations, other non15 governmental organizations, and academic institu16 tions in the United States that are active in inter17 national health issues, particularly prevention, treat18 ment, and care with respect to HIV/AIDS and other

19 infectious diseases.

20 (2) SPECIFIC ACTIVITIES.—In carrying out

21 paragraph (1), the Board—

22 (A) shall provide advice to the United

23 States Agency for International Development

24 and other Federal agencies on health and man25 agement issues relating to foreign assistance in
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1 which both the United States Government and

2 private and voluntary organizations participate;

3 (B) shall provide advice on the formulation

4 of basic policy, procedures, and criteria for the

5 review, selection, and monitoring of project pro6 posals for United States Government inter7 national health programs and for the establish8 ment of transparency in the provision and im9 plementation of grants made under such pro10 grams;

11 (C) shall provide advice on the establish12 ment of evaluation and monitoring programs to

13 measure the effectiveness of United States Gov14 ernment international health programs, includ15 ing standards and criteria to assess the extent

16 to which programs have met their goals and ob17 jectives and the development of indicators to

18 track progress of specific initiatives;

19 (D) shall review and evaluate the overall

20 health strategy for United States bilateral as21 sistance for each country receiving significant

22 United States bilateral assistance in the health

23 sector;

24 (E) shall recommend which developing

25 countries could benefit most from programs
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1 carried out under United States Government

2 international health programs; and

3 (F) shall assess the impact and effective4 ness of programs carried out under section

5 104(c)(4) of the Foreign Assistance Act of

6 1961, as amended by section 3(a) of this Act,

7 in meeting the objectives set out in the HIV/

8 AIDS country strategy established by the

9 United States Agency for International Devel10 opment.

11 (c) MEMBERSHIP.—

12 (1) COMPOSITION.—The Board shall be com13 posed of 12 members—

14 (A)(i) all of whom shall have a substantial

15 expertise and background in international

16 health research, policy, or management, par17 ticularly in the area of prevention, treatment,

18 and care with respect to HIV/AIDS and other

19 infectious diseases; and

20 (ii) of whom at least one member shall be

21 an expert on women’s and children’s health

22 issues; and

23 (B) of whom—

24 (i) three members shall be individuals

25 from academic institutions;
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1 (ii) five members shall be individuals

2 from nongovernmental organizations active

3 in international health programs, particu4 larly HIV/AIDS prevention, treatment and

5 monitoring programs in foreign countries,

6 of which not more than two members may

7 be from faith-based organizations;

8 (iii) two members shall be individuals

9 from health policy and advocacy institutes;

10 and

11 (iv) two members shall be individuals

12 from private foundations that make sub13 stantial contributions to global health pro14 grams.

15 (2) APPOINTMENT.—The individuals referred to

16 in paragraph (1) shall be appointed by the Presi17 dent, after consultation with the chairman and rank18 ing member of the Committee on International Rela19 tions of the House of Representatives and the Com20 mittee on Foreign Relations of the Senate.

21 (3) TERMS.—

22 (A) IN GENERAL.—Except as provided in

23 subparagraph (B), each member shall be ap24 pointed for a term of two years and no member
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1 or organization shall serve on the Advisory

2 Board for more than two consecutive terms.

3 (B) TERMS OF INITIAL APPOINTEES.—As

4 designated by the President at the time of ap5 pointment, of the members first appointed—

6 (i) six members shall be appointed for

7 a term of three years; and

8 (ii) six members, to the extent prac9 ticable equally divided among the cat10 egories described in clauses (i) through (iv)

11 of paragraph (1)(B), shall be appointed for

12 a term of two years.

13 (4) CHAIRPERSON.—At the first meeting of the

14 Board in each calendar year, a majority of the mem15 bers of the Commission present and voting shall

16 elect, from among the members of the Board, an in17 dividual to serve as chairperson of the Board.

18 (d) TRAVEL EXPENSES.—Each member of the Board

19 shall receive travel expenses, including per diem in lieu

20 of subsistence, in accordance with applicable provisions

21 under subchapter I of chapter 57 of title 5, United States

22 Code.

23 (e) AVAILABILITY OF FUNDS.—Amounts made avail24 able for a fiscal year pursuant to section 104(c)(4)(E)(ii)

25 of the Foreign Assistance Act of 1961, as amended by sec-
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1 tion 3(a) of this Act, are authorized to be made available

2 to carry out this section for such fiscal year.

3 SEC. 7. AUTHORIZATION OF APPROPRIATIONS FOR MULTI4 LATERAL EFFORTS TO PREVENT, TREAT, AND

5 MONITOR HIV/AIDS.

6 (a) AUTHORIZATION.—There is authorized to be ap7 propriated to the President $750,000,000 for fiscal year

8 2002 for United States contributions to a global health

9 fund negotiated by the United States consistent with the

10 general principles in the Global AIDS and Tuberculosis

11 Relief Act of 2000 and the initiative of the Secretary Gen12 eral of the United Nations or other multilateral efforts to

13 prevent, treat, and monitor HIV/AIDS in countries in sub14 Saharan Africa and other developing countries, including

15 efforts to provide hospice and palliative care for individ16 uals with HIV/AIDS.

17 (b) CHARACTERISTICS OF GLOBAL HEALTH FUND.—

18 It is the sense of Congress that, consistent with the gen19 eral principles outlined in the Global AIDS and Tuber20 culosis Relief Act of 2000, United States contributions

21 should be provided to a global health fund under sub22 section (a) only if the fund—

23 (1) is a public-private partnership that includes

24 participation of, and seeks contributions from, gov25 ernments, foundations, corporations, nongovern-
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1 mental organizations, organizations that are part of

2 the United Nations system, and other entities or in3 dividuals;

4 (2) has the World Bank serving as the fiduciary

5 agent of the fund and in any other capacity deemed

6 appropriate by the international community;

7 (3)(A) includes donors, recipient countries, civil

8 society, and other relevant parties in the governance

9 of the fund; and

10 (B) contains safeguards against conflicts of in11 terest in the governance of the fund by the individ12 uals and entities described in subparagraph (A);

13 (4) supports targeted initiatives to address

14 HIV/AIDS, tuberculosis, and malaria through an in15 tegrated approach that includes prevention interven16 tions, care and treatment programs, and infrastruc17 ture capacity-building;

18 (5) permits strategic targeting of resources to

19 address needs not currently met by existing bilateral

20 and multilateral efforts and includes separate sub21 accounts for different activities allowing donors to

22 designate funds for specific categories of programs

23 and activities;

24 (6) reserves a minimum of 5 percent of its

25 grant funds to support scientific or medical research
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1 in connection with the projects it funds in developing

2 countries;

3 (7) provides public disclosure with respect to—

4 (A) the membership and official pro5 ceedings of the mechanism established to man6 age and disburse amounts contributed to the

7 fund; and

8 (B) grants and projects supported by the

9 fund;

10 (8) authorizes and enforces requirements for

11 the periodic financial and performance auditing of

12 projects and makes future funding conditional upon

13 the results of such audits; and

14 (9) provides public disclosure of the findings of

15 all financial and performance audits of the fund.

16 SEC. 8. DEFINITION.

17 In this Act:

18 (1) HIV.—The term ‘‘HIV’’ means infection

19 with the human immunodeficiency virus.

20 (2) AIDS.—The term ‘‘AIDS’’ means acquired

21 immune deficiency syndrome.

22 SEC. 9. EXTENSION OF TIME FOR GAO REPORT ON TRUST

23 FUND EFFECTIVENESS.

24 Section 131(b) of the Global AIDS and Tuberculosis

25 Relief Act of 2000 (22 U.S.C. 6831(b)) is amended by
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1 striking ‘‘of the enactment of this Act’’ and inserting ‘‘the

2 Trust Fund is established’’.

Passed the House of Representatives December 11,

2001.

Attest: JEFF TRANDAHL,

Clerk.