IB

Union Calendar No. 78

107TH CONGRESS

1ST SESSION H. R. 2069

[Report No. 107–137]

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

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

developing countries.

IN THE HOUSE OF REPRESENTATIVES

JUNE 6, 2001

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

on International Relations

JULY 12, 2001

Additional sponsors: Mr. LANTOS, Ms. MILLENDER-MCDONALD, Mr. HOUGHTON, Mr. KING, Mrs. MINK of Hawaii, Mrs. MORELLA, Mrs. MCCARTHY

of New York, Mr. GILMAN, Mr. GALLEGLY, Mr. COOKSEY, Mr.

TANCREDO, Mr. SMITH of New Jersey, Ms. ROS-LEHTINEN, Mr. KIRK,

Mr. CANTOR, Mr. EHRLICH, Ms. LEE, Mrs. NAPOLITANO, Mr. LEACH,

Mr. WEXLER, and Mr. BLUMENAUER

JULY 12, 2001

Reported with an amendment, committed to the Committee of the Whole

House on the State of the Union, and ordered to be printed

[Strike out all after the enacting clause and insert the part printed in italic]

[For text of introduced bill, see copy of bill as introduced on June 6, 2001]

A BILL

To amend the Foreign Assistance Act of 1961 to authorize

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

sub-Saharan African and other developing countries.
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

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

5 AIDS Prevention, Awareness, Education, and Treatment

6 Act of 2001’’.

7 SEC. 2. FINDINGS; SENSE OF CONGRESS.

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

9 (1) According to the Joint United Nations Pro10 gramme on HIV/AIDS (UNAIDS) more than

11 58,000,000 people worldwide have already been in12 fected with HIV/AIDS, a fatal disease that is dev13 astating the health and economies in dozens of coun14 tries in Africa and increasingly in Asia, the Carib15 bean region, and Eastern Europe.

16 (2) The HIV/AIDS pandemic has erased decades

17 of progress in improving the lives of families in the

18 developing world and has claimed 22,000,000 lives

19 since its inception.

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

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

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

23 Africa has grown beyond an international public

24 health issue to become a humanitarian, national secu25 rity, and developmental crisis.
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1 (5) The HIV/AIDS pandemic is striking hardest

2 among women and girls. According to UNAIDS, by

3 the end of 2000, fifty-five percent of the HIV-positive

4 population in sub-Saharan Africa and 40 percent of

5 such population in North Africa and the Middle East

6 were women, infected mainly through heterosexual

7 transmission. In Africa, 6 out of 7 children who are

8 HIV positive are girls.

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

10 15 were living with HIV/AIDS at the end of 2000, of

11 which 1,100,000 were children living in sub-Saharan

12 Africa. An estimated 500,000 children died of AIDS

13 during 2000, of which 440,000 were children in sub14 Saharan Africa. In addition there are an estimated

15 13,200,000 children worldwide who have lost one or

16 both of their parents to HIV/AIDS, of which

17 12,100,000 are children in sub-Saharan Africa.

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

19 source of HIV infection in children under age 15 and

20 the only source for very young children. The total

21 number of births to HIV-infected pregnant women

22 each year in developing countries is approximately

23 700,000.

24 (8) Counseling and voluntary testing are critical

25 services to help infected women accept their HIV sta-
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1 tus and the risk it poses to their unborn child. Moth2 ers who are aware of their status can make informed

3 decisions about treatment, replacement feeding, and

4 future child-bearing.

5 (9) Although the HIV/AIDS pandemic has im6 pacted the sub-Saharan Africa disproportionately,

7 HIV infection rates are rising rapidly in India and

8 other South Asian countries, Brazil, Russia, Eastern

9 European countries, and Caribbean countries, and

10 pose a serious threat to the security and stability in

11 those countries.

12 (10) By 2010, it is estimated that approximately

13 40,000,000 children worldwide will have lost one or

14 both of their parents to HIV/AIDS.

15 (11) In January 2000, the United States Na16 tional Intelligence Council estimates that this dra17 matic increase in AIDS orphans will contribute to

18 economic decay, social fragmentation, and political

19 destabilization in already volatile and strained soci20 eties. Children without care or hope are often drawn

21 into prostitution, crime, substance abuse or child sol22 diery. The Council also stated that, in addition to the

23 reduction of economic activity caused by HIV/AIDS

24 to date, the disease could reduce GDP by as much as
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1 20 percent or more by 2010 in some countries in sub2 Saharan Africa.

3 (12) The HIV/AIDS epidemic is not just a

4 health crisis but is directly linked to development

5 problems, including chronic poverty, food security

6 and personal debt that are reflected in the capacity

7 of affected households, often headed by elders or or8 phaned children, to meet basic needs. Similarly, heav9 ily-indebted countries are stripped of the resources

10 necessary to improve health care delivery systems and

11 infrastructure and to prevent, treat, and care for in12 dividuals affected by HIV/AIDS.

13 (13) On March 7, 2001, the United States Sec14 retary of State testified before Congress that the

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

16 in democracy and freedom, to stop this catastrophe

17 from destroying whole economies and families and so18 cieties and cultures and nations’’.

19 (14) A continuing priority for responding to the

20 HIV/AIDS crisis should be to emphasize and encour21 age awareness, education, and prevention, including

22 prevention activities that promote behavioral change,

23 while recognizing that behavioral change alone will

24 not conquer this disease. In so doing, priority and

25 support should be given to building capacity in the
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1 local public health sector through technical assistance

2 as well as through nongovernmental organizations,

3 including faith-based organizations where practicable.

4 (15) Effective use should be made of existing

5 health care systems to provide treatment for individ6 uals suffering from HIV/AIDS.

7 (16) Many countries in Africa facing health cri8 ses, including high HIV/AIDS infection rates, already

9 have well-developed and high functioning health care

10 systems. Additional resources to expand and improve

11 capacity to respond to these crises can easily be ab12 sorbed by the private and public sectors, as well as by

13 nongovernmental organizations, community-based or14 ganizations, and faith-based organizations currently

15 engaged in combatting the crises.

16 (17) An effective response to the HIV/AIDS pan17 demic must also involve assistance to stimulate the

18 development of sound health care delivery systems and

19 infrastructure in countries in sub-Saharan Africa

20 and other developing countries, including assistance

21 to increase the capacity and technical skills of local

22 public health professionals and other personnel in

23 such countries, and improved access to treatment and

24 care for those already infected with HIV/AIDS.
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1 (18) Access to effective treatment for HIV/AIDS

2 is determined by issues of price, health care delivery

3 system and infrastructure, and sustainable financing

4 and such access can be inhibited by the stigma and

5 discrimination associated with HIV/AIDS.

6 (19) The HIV/AIDS crisis must be addressed by

7 a robust, multilateral approach. The Secretary Gen8 eral of the United Nations has called for a global fund

9 to halt and reverse the spread of HIV/AIDS and other

10 infectious diseases. The Secretary General has also

11 called for annual expenditures of $7,000,000,000 to

12 $10,000,000,000, financed by donor governments and

13 private contributors, for all efforts to combat the HIV/

14 AIDS pandemic and, equally important, called on

15 leaders from developing countries to give a much

16 higher priority in their budgets to development of

17 comprehensive health systems.

18 (20) An effective United States response to the

19 HIV/AIDS crisis must also focus on the development

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

21 disease as well as the development of microbicides, ef22 fective diagnostics, and simpler treatments.

23 (21) The innovative capacity of the United

24 States in the commercial and public pharmaceutical

25 research sectors is among the foremost in the world,
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1 and the active participation of both these sectors

2 should be supported as it is critical to combat the

3 global HIV/AIDS pandemic.

4 (22) Appropriate treatment of individuals with

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

6 preserve their families and prevent children from be7 coming orphans, and increase productivity of such in8 dividuals by allowing them to lead active lives and

9 reduce the need for costly hospitalization for treat10 ment of opportunistic infections caused by HIV.

11 (23) United States nongovernmental organiza12 tions, including faith-based organizations, with expe13 rience in healthcare and HIV/AIDS counseling, have

14 proven effective in combatting the HIV/AIDS pan15 demic and can be a resource in assisting sub-Saharan

16 African leaders of traditional, political, business, and

17 women and youth organizations in their efforts to

18 provide treatment and care for individuals infected

19 with HIV/AIDS.

20 (24) Most of the HIV infected poor of the devel21 oping world die of deadly diseases such as tuber22 culosis and malaria. Accordingly, effective HIV/AIDS

23 treatment programs should address the growing threat

24 and spread of tuberculosis, malaria, and other infec25 tious diseases in the developing world.
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1 (25) Law enforcement and military personnel of

2 foreign countries often have a high rate of prevalence

3 of HIV/AIDS, and therefore, in order to be effective,

4 HIV/AIDS awareness, prevention, and education pro5 grams must include education and related services to

6 such law enforcement and military personnel.

7 (26) Microenterprise development and other in8 come generation programs assist communities af9 flicted by the HIV/AIDS pandemic and increase the

10 productive capacity of communities and afflicted

11 households. Microenterprise programs are also an ef12 fective means to support the productive activities of

13 healthy family members caring for the sick and or14 phaned. Such programs should give priority to

15 women infected with the AIDS virus or in HIV/AIDS

16 affected families, particularly women in high-risk cat17 egories.

18 (27) The exploding global HIV/AIDS pandemic

19 has created new challenges for United States bilateral

20 assistance programs and will require a substantial

21 increase in the capacity of the United States Agency

22 for International Development and other agencies of

23 the United States to manage and monitor bilateral

24 HIV/AIDS programs and resources. To meet this

25 challenge, the Agency will need to recruit and retain
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1 appropriate technical expertise in the United States

2 as well as in foreign countries to help develop and

3 implement HIV/AIDS strategies in concert with mul4 tilateral agencies, host country governments, and non5 governmental organizations.

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

7 that—

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

9 countries in sub-Saharan Africa and other developing

10 countries should be a global effort and include the fi11 nancial support of all developed countries and the co12 operation of governments and the private sector, in13 cluding faith-based organizations; and

14 (B) the United States should provide additional

15 funds for multilateral programs and efforts to combat

16 HIV/AIDS and also seek to leverage public and pri17 vate resources to combat HIV/AIDS on a global basis

18 through the Global Development Alliance Initiative of

19 the United States Agency for International Develop20 ment and other public and private partnerships with

21 an emphasis on HIV/AIDS awareness, education, pre22 vention, and treatment programs;

23 (2)(A) in addition to HIV/AIDS awareness, edu24 cation, and prevention programs, the United States

25 Government should make its best efforts to support
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1 programs that safely make available to public and

2 private entities in countries in sub-Saharan Africa

3 and other developing countries pharmaceuticals and

4 diagnostics for HIV/AIDS therapy in order—

5 (i) to effectively and safely assist such coun6 tries in the delivery of HIV/AIDS therapy phar7 maceuticals through the establishment of ade8 quate health care delivery systems and treatment

9 monitoring programs; and

10 (ii) to provide treatment for poor individ11 uals with HIV/AIDS in such countries; and

12 (B) in carrying out such programs, priority con13 sideration for participation should be given to coun14 tries in sub-Saharan Africa;

15 (3)(A) combatting the HIV/AIDS pandemic re16 quires that United States Government programs place

17 a priority on the vulnerable populations at greatest

18 risk for contracting HIV;

19 (B) these populations should be determined

20 through qualitative and quantitative assessments at

21 the local level by local government, nongovernmental

22 organizations, people living with HIV/AIDS, and

23 other relevant sectors of civil society; and

24 (C) such assessments should be included in na25 tional HIV/AIDS strategies;
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1 (4) the United States should promote efforts to

2 expand and develop programs that support the grow3 ing number of children orphaned by the HIV/AIDS

4 pandemic;

5 (5) in countries where the United States Govern6 ment is conducting HIV/AIDS awareness, prevention,

7 and education programs, such programs should in8 clude education and related services to law enforce9 ment and military personnel of foreign countries to

10 prevent and control HIV/AIDS, malaria, and tuber11 culosis;

12 (6) prevention and treatment for HIV/AIDS

13 should be a component of a comprehensive inter14 national effort to combat deadly infectious diseases,

15 including malaria and tuberculosis, and opportun16 istic infections, that kill millions annually in the de17 veloping world;

18 (7) programs developed by the United States

19 Agency for International Development to address the

20 HIV/AID pandemic should preserve personal privacy

21 and confidentiality, should not include compulsory

22 HIV/AIDS testing, and should not be discriminatory;

23 (8)(A) the United States Agency for Inter24 national Development should carry out HIV/AIDS

25 awareness, prevention, and treatment programs in
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1 conjunction with effective international tuberculosis

2 and malaria treatment programs and with programs

3 that address the relationship between HIV/AIDS and

4 a number of opportunistic diseases that include bac5 terial diseases, fungal diseases, viral diseases and

6 HIV-associated malignancies, such as Kaposi sar7 coma, lymphoma, and squamous cell carcinoma; and

8 (B) effective intervention against opportunistic

9 diseases requires not only the appropriate drug or

10 other medication for a given medical condition, but

11 also the infrastructure necessary to diagnose the con12 dition, monitor the intervention, and provide coun13 seling services; and

14 (9) the United States Agency for International

15 Development should expand and replicate successful

16 microenterprise programs in Uganda, Zambia,

17 Zimbabwe, and other African countries that provide

18 poor families affected by HIV/AIDS with the means

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

20 (10) the United States Agency for International

21 Development should substantially increase and im22 prove its capacity to manage and monitor HIV/AIDS

23 programs and resources;

24 (11) the United States Agency for International

25 Development must recruit and retain appropriate
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1 technical expertise in the United States as well as in

2 foreign countries to help develop and implement HIV/

3 AIDS strategies in conjunction with multilateral

4 agencies, host country governments, and nongovern5 mental organizations;

6 (12) the United States Agency for International

7 Development must strengthen coordination and col8 laboration between the technical experts in its central

9 and regional bureaus and foreign country missions in

10 formulating country strategies and implementing

11 HIV/AIDS programs;

12 (13) strong coordination among the various

13 agencies of the United States, including the Depart14 ment of State, the United States Agency for Inter15 national Development, the Department of Health and

16 Human Services, including the Centers for Disease

17 Control and the National Institutes of Health, the De18 partment of the Treasury, the Department of Defense,

19 and other relevant Federal agencies must exist to en20 sure effective and efficient use of financial and tech21 nical resources within the United States Government;

22 and

23 (14) to help alleviate human suffering, and en24 hance the dignity and quality of life for patients de25 bilitated by HIV/AIDS, the United States should pro-
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1 mote, both unilaterally and through multilateral ini2 tiatives, the use of palliative and hospice care, and

3 provide financial and technical assistance to pallia4 tive and hospice care programs, including programs

5 under which such care is provided by faith-based or6 ganizations.

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

8 (a) ASSISTANCE.—Section 104(c) of the Foreign As9 sistance Act of 1961 (22 U.S.C. 2151b(c)) is amended—

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

11 (2) by inserting after paragraph (3) the fol12 lowing:

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

14 of HIV/AIDS in countries in sub-Saharan Africa and other

15 developing countries is a major global health, national secu16 rity, and humanitarian crisis. Accordingly, the United

17 States and other developed countries should provide assist18 ance to countries in sub-Saharan Africa and other devel19 oping countries to control this crisis through HIV/AIDS

20 prevention, treatment, monitoring, and related activities,

21 particularly activities focused on women and youth, includ22 ing mother-to-child transmission prevention strategies.

23 ‘‘(B)(i) The Administrator of the United States Agency

24 for International Development is authorized to provide as25 sistance to prevent, treat, and monitor HIV/AIDS, and
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1 carry out related activities, in countries in sub-Saharan Af2 rica and other developing countries.

3 ‘‘(ii) It is the sense of Congress that the Administrator

4 should provide an appropriate level of assistance under

5 clause (i) through nongovernmental organizations in coun6 tries in sub-Saharan Africa and other developing countries

7 affected by the HIV/AIDS pandemic.

8 ‘‘(iii) The Administrator shall coordinate the provision

9 of assistance under clause (i) with the provision of related

10 assistance by the Joint United Nations Programme on HIV/

11 AIDS (UNAIDS), the United Nations Children’s Fund

12 (UNICEF), the World Health Organization (WHO), the

13 United Nations Development Programme (UNDP), other

14 appropriate international organizations, national, state,

15 and local governments of foreign countries, and other ap16 propriate governmental and nongovernmental organiza17 tions.

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

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

20 out the following activities:

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

22 including—

23 ‘‘(I) education, voluntary testing, and coun24 seling (including the incorporation of confiden25 tiality protections with respect to such testing
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1 and counseling), including integration of such

2 programs into women’s and children’s health

3 programs; and

4 ‘‘(II) 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 treatment

18 of individuals with HIV/AIDS, including clin19 ical training for indigenous organizations and

20 health care providers;

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

22 transmission of HIV/AIDS from mother to child,

23 including medications to prevent such trans24 mission; 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 families,

4 and the primary caregivers of such patients, in5 cluding programs that utilize faith-based organi6 zations.

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 pro12 vide HIV/AIDS pharmaceuticals and other ap13 propriate 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 ac3 curate HIV surveillance data to target programs

4 and measure the effectiveness of interventions;

5 ‘‘(III) vaccine research and development

6 partnership programs with specific plans of ac7 tion to develop a safe, effective, accessible, pre8 ventive HIV vaccine for use throughout the

9 world; and

10 ‘‘(IV) the development and expansion of fi11 nancially-sustainable microfinance institutions

12 and other income generation programs that

13 strengthen the economic and social viability of

14 communities afflicted by the HIV/AIDS pan15 demic, including support for the savings and

16 productive capacity of affected poor households

17 caring for orphans.

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

19 year, the Administrator shall submit to Congress an annual

20 report on the implementation of this paragraph for the

21 prior fiscal year.

22 ‘‘(ii) Such report shall include—

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

24 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 Glob3 al Access to HIV/AIDS Prevention, Awareness, Edu4 cation, and Treatment Act of 2001; and

5 ‘‘(III) a detailed assessment of the impact of pro6 grams established pursuant to this paragraph, includ7 ing the effectiveness of such programs in reducing the

8 spread of HIV infection, particularly in women and

9 girls, in reducing HIV transmission from mother to

10 child, in reducing mortality rates from HIV/AIDS,

11 and the progress toward improving health care deliv12 ery systems and infrastructure to ensure increased ac13 cess 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 activi19 ties 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 $560,000,000 for fis23 cal 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 this

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

4 the administrative expenses of the Agency in carrying out

5 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 available

25 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 de7 veloping 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 apply

22 to assistance made available under subsection (a).

23 (c) AUTHORIZATION OF APPROPRIATIONS.—There is

24 authorized to be appropriated to the President to carry out

25 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 ‘‘task

4 force’’) to ensure coordination of all Federal programs re5 lated to the prevention, treatment, and monitoring of HIV/

6 AIDS in foreign countries.

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

8 include—

9 (1) reviewing all Federal programs related to the

10 prevention, treatment, and monitoring of HIV/AIDS

11 in foreign countries to ensure proper coordination

12 and compatibility of activities and policies of such

13 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 pos17 sible practices for HIV/AIDS prevention, treatment,

18 and monitoring and improve the effectiveness of such

19 programs in the countries in which they operate; and

20 (3) fostering discussions with United States and

21 foreign nongovernmental organizations to determine

22 how United States Government programs can be im23 proved, including by engaging in a dialogue with the

24 Global Health Advisory Board established under sec25 tion 6 of this Act.

26 (c) MEMBERSHIP.—
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1 (1) COMPOSITION.—The task force shall be com2 posed of the Secretary of State, the Administrator of

3 the United States Agency for International Develop4 ment, the Secretary of Heath and Human Services,

5 the Director of the National Institutes of Health, the

6 Director of the Centers for Disease Control, the Sec7 retary of Defense, and the head of any other agency

8 that the President determines is appropriate.

9 (2) CHAIRPERSON.—The Secretary of State shall

10 serve as chairperson of the task force.

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

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

13 to afford an opportunity for any person to present views

14 regarding the activities of the United States Government

15 with respect to the prevention, treatment, and monitoring

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

17 shall maintain a record of each meeting and shall make

18 the record available to the public.

19 (e) AVAILABILITY OF FUNDS.—Amounts made avail20 able for a fiscal year pursuant to section 104(c)(4)(E)(ii)

21 of the Foreign Assistance Act of 1961, as amended by sec22 tion 3(a) of this Act, are authorized to be made available

23 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 Devel7 opment, 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 li13 aison between the United States Government and pri14 vate and voluntary organizations, other nongovern15 mental organizations, and academic institutions in

16 the United States that are active in international

17 health issues, particularly prevention, treatment, and

18 care with respect to HIV/AIDS and other infectious

19 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 to

16 which programs have met their goals and objec17 tives and the development of indicators to track

18 progress of specific initiatives;

19 (D) shall review and evaluate the overall

20 health strategy for United States bilateral assist21 ance 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 car-
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1 ried out under United States Government inter2 national health programs; and

3 (F) shall assess the impact and effectiveness

4 of programs carried out under section 104(c)(4)

5 of the Foreign Assistance Act of 1961, as amend6 ed by section 3(a) of this Act, in meeting the ob7 jectives set out in the HIV/AIDS country strat8 egy established by the United States Agency for

9 International Development.

10 (c) MEMBERSHIP.—

11 (1) COMPOSITION.—The Board shall be composed

12 of 12 members—

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

14 expertise and background in international health

15 research, policy, or management, particularly in

16 the area of prevention, treatment, and care with

17 respect to HIV/AIDS and other infectious dis18 eases; and

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

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

21 issues; and

22 (B) of whom—

23 (i) three members shall be individuals

24 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 President,

17 after consultation with the chairman and ranking

18 member of the Committee on International Relations

19 of the House of Representatives and the Committee on

20 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 categories

10 described in clauses (i) through (iv) of para11 graph (1)(B), shall be appointed for a term

12 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 elect,

16 from among the members of the Board, an individual

17 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 of

20 subsistence, in accordance with applicable provisions under

21 subchapter I of chapter 57 of title 5, United States Code.

22 (e) AVAILABILITY OF FUNDS.—Amounts made avail23 able for a fiscal year pursuant to section 104(c)(4)(E)(ii)

24 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 fund

9 or other multilateral efforts to prevent, treat, and monitor

10 HIV/AIDS in countries in sub-Saharan Africa and other

11 developing countries, including efforts to provide hospice

12 and palliative care for individuals with HIV/AIDS.

13 (b) CHARACTERISTICS OF GLOBAL HEALTH FUND.—

14 It is the sense of Congress that United States contributions

15 should be provided to a global health fund under subsection

16 (a) only if the fund—

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

18 participation of, and seeks contributions from, gov19 ernments, foundations, corporations, nongovernmental

20 organizations, organizations that are part of the

21 United Nations system, and other entities or individ22 uals;

23 (2)(A) includes donors, recipient countries, civil

24 society, and other relevant parties in the governance

25 of the fund; and
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1 (B) contains safeguards against conflicts of in2 terest in the governance of the fund by the individuals

3 and entities described in subparagraph (A);

4 (3) supports targeted initiatives to address HIV/

5 AIDS, tuberculosis, and malaria through an inte6 grated approach that includes prevention interven7 tions, care and treatment programs, and infrastruc8 ture capacity-building;

9 (4) permits strategic targeting of resources to ad10 dress needs not currently met by existing bilateral

11 and multilateral efforts and includes separate sub-ac12 counts for different activities allowing donors to des13 ignate funds for specific categories of programs and

14 activities;

15 (5) reserves a minimum of 5 percent of its grant

16 funds to support scientific or medical research in con17 nection with the projects it funds in developing coun18 tries;

19 (6) provides public disclosure with respect to—

20 (A) the membership and official proceedings

21 of the mechanism established to manage and dis22 burse amounts contributed to the fund; and

23 (B) grants and projects supported by the

24 fund;
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1 (7) authorizes and enforces requirements for the

2 periodic financial and performance auditing of

3 projects and makes future funding conditional upon

4 the results of such audits; and

5 (8) provides public disclosure of the findings of

6 all financial and performance audits of the fund.

7 SEC. 8. DEFINITION.

8 In this Act:

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

10 with the human immunodeficiency virus.

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

12 immune deficiency syndrome.

Union Calendar No. 78

107TH CONGRESS

1ST SESSION H. R. 2069

[Report No. 107–137]

A BILL

To amend the Foreign Assistance Act of 1961 to

authorize assistance to prevent, treat, and monitor HIV/AIDS in sub-Saharan African and otherdeveloping countries.

JULY 12, 2001

Reported with an amendment, committed to the Committee of the Whole House on the State of the Union,

and ordered to be printed