II 

108TH CONGRESS 

1ST SESSION S. 250

To address the international HIV/AIDS pandemic. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 30, 2003

Mr. DURBIN introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL

To address the international HIV/AIDS pandemic.

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 Coordination 

5 of HIV/AIDS Response Act’’ or the ‘‘Global CARE Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) In a span of only 20 years the AIDS pan9 demic has infected 60,000,000 people around the 

10 globe and continues to spread. More than 

11 22,000,000 people around the world have died from 

12 this disease. 
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1 (2) More than 14,000,000 children have been 

2 orphaned as a result of AIDS and this number is ex3 pected to grow to more than 25,000,000 by the year 

4 2010, more AIDS orphans than the entire popu5 lation of the State of Texas. 

6 (3) The impact of the AIDS epidemic is not 

7 only a health issue but a moral issue, fundamental 

8 to development, to human security, and the security 

9 of the United States. 

10 (4) Prevention, care, and treatment are all nec11 essary components of an effective response to the 

12 global AIDS epidemic and the opportunistic infec13 tions that result. 

14 (5) Microenterprise development and other in15 come-generating programs assist communities af16 flicted by the HIV/AIDS pandemic and increase the 

17 productive capacity of communities and affected 

18 households. 

19 (6) Microenterprise programs are also an effec20 tive means to support the productive activities of 

21 healthy family members caring for the sick and or22 phaned. Such programs should give priority to 

23 women infected with the AIDS virus or in HIV/

24 AIDS affected families, and to women in high risk 

25 categories. 
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1 (7) There is currently no effective, single locus 

2 to coordinate the many United States Government 

3 agencies contributing to global HIV/AIDS activities, 

4 to foster strategic collaboration among them, or to 

5 communicate policies and plans with other vested 

6 constituents, including nongovernmental organiza7 tions and private interests. 

8 (8) Continued United States leadership and in9 vestment is needed to meet the serious challenge of 

10 HIV/AIDS in the global community. 

11 SEC. 3. INTERAGENCY WORKING GROUP ON HIV/AIDS. 

12 (a) IN GENERAL.—There is established a Federal 

13 interagency working group (hereafter referred to in this 

14 Act as the ‘‘Working Group’’) to ensure coordination of 

15 all Federal programs related to the prevention, treatment, 

16 and monitoring of HIV/AIDS in foreign countries, and to 

17 conduct global HIV/AIDS activities in a coordinated, stra18 tegic fashion. 

19 (b) MEMBERSHIP.—Members of the Working Group 

20 shall be appointed by—

21 (1) the Secretary of Health and Human Serv22 ices; 

23 (2) the Secretary of State; 

24 (3) the Secretary of Defense; 

25 (4) the Secretary of Agriculture; 
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1 (5) the Administrator of the Health Resources 

2 and Services Administration; 

3 (6) the Administrator of the United States 

4 Agency for International Development; 

5 (7) the Director of the Centers for Disease 

6 Control and Prevention; 

7 (8) the Director of the National Institutes of 

8 Health; 

9 (9) the Director of the Peace Corps; 

10 (10) the United States Executive Director of 

11 the International Bank for Reconstruction and De12 velopment; 

13 (11) the Secretary of Labor; 

14 (12) the Secretary of Commerce; and 

15 (13) the heads of such other Federal depart16 ments and agencies as the President determines ap17 propriate. 

18 (c) CHAIRPERSON.—The chairperson of the Working 

19 Group shall be designated by the Secretary of Health and 

20 Human Services, in consultation with the Secretary of 

21 State. 

22 (d) DUTIES.—The Working Group shall—

23 (1) review all Federal programs related to the 

24 prevention, treatment, and monitoring of HIV/AIDS 

25 in foreign countries to ensure proper coordination 
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1 and compatibility of the activities, strategies, and 

2 policies of such programs; 

3 (2) exchange information regarding the design 

4 and impact of such programs to ensure the United 

5 States Government can determine the best possible 

6 practices for HIV/AIDS prevention, treatment, and 

7 monitoring to improve the effectiveness of such pro8 grams in countries in which they operate; 

9 (3) set priorities across the Federal agencies 

10 represented in the Working Group; 

11 (4) annually identify measurable goals for 

12 United States policy and outcomes related to HIV/

13 AIDS in the global community; 

14 (5) foster discussions with academia, non15 governmental organizations, and industry to deter16 mine how Federal Government programs can be im17 proved; 

18 (6) serve as a liaison between the Global Fund 

19 for HIV/AIDS, tuberculosis and malaria prevention 

20 and treatment efforts, and other multilateral efforts 

21 relating to HIV/AIDS prevention and treatment; 

22 and

23 (7) coordinate with international groups, such 

24 as the International AIDS Society, the United Na25 tions Program on HIV/AIDS (UNAIDS), the World 
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1 Health Organization, and the Monitoring and Eval2 uation Reference Group to ensure that information 

3 about successful programs, and from applied and 

4 basic research, is disseminated to policymakers, re5 searchers, and practitioners in other nations. 

6 (e) REPORT.—

7 (1) IN GENERAL.—The Working Group shall 

8 prepare a report that—

9 (A) describes the actions that are being 

10 taken to coordinate the multiple roles and poli11 cies of, and foster collaboration among, the 

12 Federal agencies contributing to global HIV/

13 AIDS activities; 

14 (B) describes the respective roles and ac15 tivities of each of the working group member 

16 agencies; 

17 (C) describes actions taken to carry out 

18 the activities described in sections 4 and 5; 

19 (D) contains any recommendations for leg20 islative and funding actions that are needed to 

21 create a coherent, effective United States ap22 proach to global HIV/AIDS that achieves the 

23 goals for United States policy and outcomes as 

24 established by the Working Group; and 
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1 (E) includes the results of the HIV/AIDS 

2 goals and outcomes as established by the Work3 ing Group. 

4 (2) SUBMISSION TO CONGRESS.—Not later than 

5 1 year after the date of enactment of this Act, and 

6 annually thereafter during each year for which the 

7 Working Group is authorized, the chairperson of the 

8 Working Group shall submit the report described in 

9 paragraph (1) to the Committee on Foreign Rela10 tions, the Committee on Health, Education, Labor, 

11 and Pensions, and the Committee on Appropriations 

12 of the Senate, the Committee on International Rela13 tions, the Committee on Energy and Commerce, and 

14 the Committee on Appropriations of the House of 

15 Representatives. 

16 (f) TERMINATION.—The Working Group established 

17 under subsection (a) shall terminate on the date that is 

18 3 years after the date of enactment of this Act. 

19 SEC. 4. THE INTERNATIONAL HIV/AIDS PREVENTION AND 

20 CAPACITY DEVELOPMENT INITIATIVE. 

21 (a) GOAL.—The goal of the International HIV/AIDS 

22 Prevention and Capacity Development Initiative estab23 lished by this section, is to prevent the spread of HIV/

24 AIDS and opportunistic infections. 
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1 (b) ACTIVITIES.—The goal described in subsection 

2 (a) shall be achieved through the conduct of activities that 

3 include—

4 (1) education, voluntary testing and counseling 

5 (that includes the incorporation of confidentiality 

6 protections with respect to such testing and coun7 seling), including integration of such programs into 

8 women’s and children’s health programs; 

9 (2) providing assistance to ensure a safe blood 

10 supply and to provide post-exposure prophylaxis to 

11 victims of rape and sexual assault; 

12 (3) expanding the availability and use of 

13 condoms and other barrier methods for the preven14 tion of HIV transmission; 

15 (4) providing assistance through nongovern16 mental organizations, particularly those organiza17 tions that utilize both professionals and volunteers 

18 with appropriate skills and experience, to establish 

19 and implement culturally appropriate HIV/AIDS 

20 education and prevention programs; 

21 (5) providing for improved infrastructure and 

22 institutional capacity to develop and manage edu23 cation, prevention, care, and treatment programs, 

24 including resources to collect and maintain accurate 
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1 HIV/AIDS surveillance data to target programs and 

2 measure effectiveness of interventions; 

3 (6) the conduct of vaccine research and develop4 ment partnership programs with specific plans to de5 velop a safe, effective, accessible, preventive HIV 

6 vaccine for use throughout the world; 

7 (7) research and development of microbicides to 

8 prevent the transmission of HIV and other sexually 

9 transmitted infections; 

10 (8) the development and expansion of finan11 cially sustainable micro-finance institutions and 

12 other income generation programs that strengthen 

13 the economic and social viability of communities af14 flicted by the HIV/AIDS pandemic, including sup15 port for the savings and productive capacity of af16 fected poor households caring for orphans; 

17 (9) promoting evaluation and intervention ef18 forts and providing training to support program as19 sessment; and 

20 (10) other activities as determined necessary by 

21 the Working Group established under section 3(a). 

22 (c) COORDINATED EFFORTS.—From amounts made 

23 available under section 6 for each fiscal year, the Sec24 retary of State (in consultation with the United States 

25 Agency for International Development), the Secretary of 
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1 Health and Human Services and other Federal members 

2 of the Working Group (established under section 3(a)) 

3 shall coordinate activities as part of the International 

4 HIV/AIDS Prevention and Capacity Development Initia5 tive under this section consistent with host country needs 

6 and in conjunction with host country plans, with programs 

7 to prevent, treat and monitor HIV/AIDS in foreign coun8 tries. 

9 SEC. 5. THE INTERNATIONAL AIDS CARE AND TREATMENT 

10 ACCESS INITIATIVE. 

11 (a) GOAL.—The goal of the international AIDS care 

12 and treatment access initiative established by this section 

13 is to prolong the lives of individuals with HIV/AIDS, to 

14 preserve the families of these individuals, to prevent chil15 dren from becoming orphans and to increase the produc16 tivity of these individuals by allowing them to lead active 

17 lives and reduce the need for costly hospitalizations for 

18 treating opportunistic infections caused by HIV/AIDS. 

19 (b) ACTIVITIES.—The goal described in subsection 

20 (a) shall be achieved through the conduct of activities that 

21 include—

22 (1) creating or improving the medical, public 

23 health, and physical infrastructures needed to ensure 

24 that care and treatment for individuals affected by
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1 HIV/AIDS can be delivered efficiently, effectively 

2 and safely; 

3 (2) mobilizing communities to provide much 

4 needed services ranging from home based palliation 

5 to assistance with housing and nutrition; 

6 (3) encouraging the adoption of policies and 

7 practices that reduce stigma against HIV-infected 

8 individuals; 

9 (4) providing a comprehensive package of care 

10 and treatment for those living with HIV/AIDS in11 cluding antiretroviral drugs, treatment of opportun12 istic infections, and optimum nutrition; 

13 (5) helping preserve families, which will con14 tribute to stability within homes and across devel15 oping nations and will help diminish the growing 

16 AIDS orphan crisis; 

17 (6) providing training and education to civilian 

18 and military health care providers and laboratory 

19 workers from developing nations for the purpose of 

20 promoting safe and effective use of antiretroviral 

21 drugs and quality medical support services; 

22 (7) linking care and treatment services to prov23 en prevention programs, including expanded vol24 untary counseling and testing efforts; 
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1 (8) assisting governments with policy develop2 ment and resource allocation; 

3 (9) promoting evaluation of intervention efforts 

4 and providing training to support program assess5 ment; and 

6 (10) other activities as determined necessary by 

7 the Working Group established under section 3(a). 

8 (c) COORDINATED EFFORTS.—From amounts made 

9 available under section 6 for each fiscal year, the Sec10 retary of State, the Secretary of Health and Human Serv11 ices and other Federal members of the Working Group 

12 (established under section 3(a)) shall coordinate activities 

13 as part of the international AIDS care and treatment ac14 cess initiative under this section, consistent with host 

15 country needs and in conjunction with host country plans. 

16 SEC. 6. FUNDING FOR PREVENTION, CARE, TREATMENT, 

17 AND CAPACITY DEVELOPMENT ACTIVITIES. 

18 (a) CENTERS FOR DISEASE CONTROL AND PREVEN19 TION.—There is authorized to be appropriated to the Cen20 ters for Disease Control and Prevention, $275,000,000 for 

21 fiscal year 2004, $330,000,000 for fiscal year 2005, and 

22 such sums as may be necessary for each of fiscal years 

23 2006 and 2007, to carry out the provisions of sections 3 

24 through 5 and other global HIV/AIDS prevention, care, 

25 treatment, and capacity development activities determined 
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1 appropriate by the Secretary of Health and Human Serv2 ices. Any amounts so appropriated shall remain available 

3 until expended. 

4 (b) HEALTH RESOURCES AND SERVICES ADMINIS5 TRATION.— 

6 (1) IN GENERAL.—There is authorized to be 

7 appropriated to the Health Resources and Services 

8 Administration, $20,000,000 for fiscal year 2004, 

9 $22,000,000 for fiscal year 2005, and such sums as 

10 may be necessary for each of fiscal years 2006 and 

11 2007, to carry out the provisions of sections 3 

12 through 5 and other global HIV/AIDS activities de13 termined appropriate by the Secretary of Health and 

14 Human Services. Any amounts so appropriated shall 

15 remain available until expended. 

16 (2) ASSISTANCE TO FOREIGN COUNTRIES.—

17 From amounts appropriated under paragraph (1) 

18 for each fiscal year, the Administrator of the Health 

19 Resources and Services Administration, as part of 

20 the international AIDS care and treatment access 

21 initiative, may provide assistance to foreign coun22 tries and areas in developing, providing, and evalu23 ating—

24 (A) care, support, and treatment services 

25 with respect to HIV/AIDS, including those for 
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1 opportunistic infection related to HIV/AIDS in2 fections; 

3 (B) palliative HIV/AIDS care; 

4 (C) care for those who are affected by, al5 though not infected with, HIV/AIDS; 

6 (D) training of health care providers; and 

7 (E) other activities as determined appro8 priate by the Secretary of Health and Human 

9 Services and the Administrator of the Health 

10 Resources and Services Administration. 

11 (c) NATIONAL INSTITUTES OF HEALTH.—There is 

12 authorized to be appropriated to the National Institutes 

13 of Health, $90,000,000 for fiscal year 2004, 

14 $112,000,000 for fiscal year 2005, and such sums as may 

15 be necessary for each of fiscal years 2006 and 2007, to 

16 carry out the provisions of sections 3 through 5 that are 

17 related to the mission of the Institutes, and other global 

18 HIV/AIDS activities determined appropriate by the Sec19 retary of Health and Human Services, including vaccine 

20 research to develop a safe and accessible preventive HIV 

21 vaccine for use throughout the world. Any amounts so ap22 propriated shall remain available until expended. 

23 (d) AGENCY FOR HEALTHCARE RESEARCH AND

24 QUALITY.—There is authorized to be appropriated to the 

25 Agency for Healthcare Research and Quality, $20,000,000 
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1 for fiscal year 2004, $22,000,000 for fiscal year 2005, and 

2 such sums as may be necessary for each of fiscal years 

3 2006 and 2007, to carry out the provisions of sections 3 

4 through 5 that are related to the mission of the Agency, 

5 and other global HIV/AIDS activities determined appro6 priate by the Secretary of Health and Human Services, 

7 including evaluation of global HIV/AIDS programs and 

8 cost, use and access to HIV/AIDS treatment. Any 

9 amounts so appropriated shall remain available until ex10 pended. 

11 (e) FOOD AND DRUG ADMINISTRATION.—There is 

12 authorized to be appropriated to the Food and Drug Ad13 ministration, $45,000,000 for fiscal year 2004, 

14 $55,000,000 for fiscal year 2005, and such sums as may 

15 be necessary for each of fiscal years 2006 and 2007, to 

16 carry out the provisions of sections 3 through 5 that are 

17 related to the mission of the Administration, and other 

18 global HIV/AIDS activities determined appropriate by the 

19 Commissioner of Food and Drugs, including review of 

20 more sensitive tests and further efforts to ensure a safe 

21 blood supply. Any amounts so appropriated shall remain 

22 available until expended. 

23 (f) UNITED STATES AGENCY FOR INTERNATIONAL

24 DEVELOPMENT.—There is authorized to be appropriated 

25 to the United States Agency for International Develop-
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1 ment, $550,000,000 for fiscal year 2004, $655,000,000 

2 for fiscal year 2005, and such sums as may be necessary 

3 for each of fiscal years 2006 and 2007, to carry out the 

4 provisions of sections 3 through 5 and other global HIV/

5 AIDS prevention, care, treatment, and capacity develop6 ment activities determined appropriate by the Secretary 

7 of State. Any amounts so appropriated shall remain avail8 able until expended. 

9 (g) DEPARTMENT OF DEFENSE.—There is author10 ized to be appropriated to the Department of Defense, 

11 $20,000,000 for fiscal year 2004, $22,000,000 for fiscal 

12 year 2005, and such sums as may be necessary for each 

13 of fiscal years 2006 and 2007, to carry out the provisions 

14 of sections 3 through 5 that are related to mission of the 

15 Department, and other global HIV/AIDS activities deter16 mined appropriate by the Secretary of Defense including 

17 HIV/AIDS prevention and education with host country 

18 armed forces. Any amounts so appropriated shall remain 

19 available until expended. 

20 (h) DEPARTMENT OF AGRICULTURE.—There is au21 thorized to be appropriated to the Department of Agri22 culture, $25,000,000 for fiscal years 2004 and 2005, and 

23 such sums as may be necessary for each of fiscal years 

24 2006 and 2007, to carry out the provisions of sections 3 

25 through 5 that are related to the mission of the Depart-
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1 ment, and other global HIV/AIDS activities determined 

2 appropriate by the Secretary of Agriculture, including 

3 strengthening the capacity of organizations providing com4 munity-based nutrition services. Any amounts so appro5 priated shall remain available until expended. 

6 (i) DEPARTMENT OF LABOR.—There is authorized to 

7 be appropriated to the Department of Labor, $20,000,000 

8 for fiscal year 2004, $22,000,000 for fiscal year 2005, and 

9 such sums as may be necessary for each of fiscal years 

10 2006 and 2007, to carry out the provisions of sections 3 

11 through 5 that are related to the mission of the Depart12 ment, and other global HIV/AIDS activities determined 

13 appropriate by the Secretary of Labor, including work14 place-based HIV/AIDS prevention in host countries. Any 

15 amounts so appropriated shall remain available until ex16 pended. 

17 (j) DEPARTMENT OF COMMERCE.—There is author18 ized to be appropriated to the Department of Commerce, 

19 $10,000,000 for fiscal years 2004 and 2005, and such 

20 sums as may be necessary for each of fiscal years 2006 

21 and 2007, to carry out the provisions of sections 3 through 

22 5 that are related to the mission of the Department and 

23 other global HIV/AIDS activities determined appropriate 

24 by the Secretary of Commerce, including encouraging the 

25 involvement of multinational United States corporations 
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1 in the fight against HIV/AIDS. Any amounts so appro2 priated shall remain available until expended. 

3 (k) GLOBAL HEALTH FUND.—

4 (1) AUTHORIZATION.—There is authorized to 

5 be appropriated $2,100,000,000 for fiscal year 

6 2004, $2,550,000,000 for fiscal year 2005, and such 

7 sums as may be necessary for each of fiscal years 

8 2006 and 2007, to be used for United States con9 tributions to a global health fund negotiated by the 

10 United States consistent with the general principles 

11 contained in the Global AIDS and Tuberculosis Re12 lief Act of 2000 (22 U.S.C. 6801 et seq.) and the 

13 initiative of the Secretary General of the United Na14 tions or other multilateral efforts to prevent, treat, 

15 and monitor HIV/AIDS in countries in sub-Saharan 

16 Africa and other developing countries, including ef17 forts to provide hospice and palliative care for indi18 viduals with HIV/AIDS. 

19 (2) CHARACTERISTICS OF GLOBAL HEALTH

20 FUND.—It is the sense of Congress that, consistent 

21 with the general principles outlined in the Global 

22 AIDS and Tuberculosis Relief Act of 2000 (22 

23 U.S.C. 6801 et seq.), United States contributions 

24 should be provided to a global health fund under 

25 paragraph (1) only if the fund—
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1 (A) is a public-private partnership that in2 cludes participation of, and seeks contributions 

3 from, governments, foundations, corporations, 

4 nongovernmental organizations, organizations 

5 that are part of the United Nations system, and 

6 other entities or individuals; 

7 (B) has the World Bank serving as the fi8 duciary agent of the fund and in any other ca9 pacity deemed appropriate by the international 

10 community; 

11 (C) includes donors, recipient countries, 

12 civil society, and other relevant parties in the 

13 governance of the fund; 

14 (D) contains safeguards against conflicts 

15 of interest in the governance of the fund by the 

16 individuals and entities described in subpara17 graph (A); 

18 (E) supports targeted initiatives to address 

19 HIV/AIDS, tuberculosis, and malaria through 

20 an integrated approach that includes prevention 

21 interventions, care and treatment programs, 

22 and infrastructure capacity-building; 

23 (F) permits strategic targeting of re24 sources to address needs not currently met by 

25 existing bilateral and multilateral efforts and
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1 includes separate subaccounts for different ac2 tivities allowing donors to designate funds for 

3 specific categories of programs and activities; 

4 (G) reserves a minimum of 5 percent of its 

5 grant funds to support scientific or medical re6 search in connection with the projects it funds 

7 in developing countries; 

8 (H) provides public disclosure with respect 

9 to—

10 (i) the membership and official pro11 ceedings of the mechanism established to 

12 manage and disburse amounts contributed 

13 to the fund; and 

14 (ii) grants and projects supported by 

15 the fund; 

16 (I) authorizes and enforces requirements 

17 for the periodic financial and performance au18 diting of projects and makes future funding 

19 conditional upon the results of such audits; and 

20 (J) provides public disclosure of the find21 ings of all financial and performance audits of 

22 the fund. 

23 SEC. 7. GLOBAL PHYSICIAN CORPS. 

24 (a) IN GENERAL.—The Secretary of Health and 

25 Human Services (referred to in this section as the ‘‘Sec-
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1 retary’’), in consultation with the Secretary of State, is 

2 authorized to establish a Global Physician Corps for the 

3 purpose of carrying out the activities described in sub4 section (d). 

5 (b) RECRUITMENT OF PHYSICIANS.—

6 (1) IN GENERAL.—The Secretary is authorized 

7 to recruit and employ for international assignments 

8 as part of the Global Physician Corps—

9 (A) physicians who—

10 (i) are trained in infectious diseases 

11 and other medical disciplines; and 

12 (ii) have demonstrated expertise in the 

13 treatment of HIV/AIDS; 

14 (B) retired commissioned officers of the 

15 Public Health Service Corps; and 

16 (C) physicians who are trained in such dis17 ciplines as the Secretary shall determine to be 

18 necessary. 

19 (2) RECRUITMENT AT SCHOOLS.—The Sec20 retary may conduct recruitment programs for the 

21 Global Physician Corps at schools of medicine. 

22 (c) TIME PERIODS.—

23 (1) IN GENERAL.—Physicians hired under sub24 section (b) shall be employed for periods of not more 

25 than 2 years. 
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1 (2) EXTENSIONS.—The Secretary may author2 ize extensions of employment under paragraph (1) 

3 as the Secretary determines appropriate. 

4 (d) ACTIVITIES.—The Global Physician Corps, using 

5 international assignments of physicians, shall—

6 (1) care for and treat individuals affected by 

7 HIV/AIDS; 

8 (2) train host country physicians in the safe 

9 and effective use of antiretroviral drugs to treat and 

10 care for infected individuals, and provide quality 

11 medical support services for such host country physi12 cians; 

13 (3) establish or adapt appropriate clinical proto14 cols for HIV prevention, care, and treatment, and 

15 train medical personnel in these protocols; and 

16 (4) carry out other activities as determined ap17 propriate by the Secretary. 

18 (e) ASSIGNMENTS.—

19 (1) IN GENERAL.—The Director of the Centers 

20 for Disease Control and Prevention, the Adminis21 trator of the Health Resources and Services Admin22 istration, and the Director of the National Institutes 

23 of Health shall collaborate with the Secretary and 

24 the United States Agency for International Develop25 ment to determine where physicians hired under this 
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1 section are most needed to serve and to appro2 priately place such physicians. 

3 (2) TRAVEL.—The Secretary shall determine 

4 travel requirements and any reimbursements to be 

5 provided under this section. 

6 (f) STAFF.—The Secretary shall ensure that ade7 quate staff is provided to effectively administer the Global 

8 Physician Corps. 

9 (g) PAY.—The Secretary shall determine pay and 

10 benefits to be provided under this section. 

11 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

12 authorized to be appropriated to carry out this section 

13 $5,000,000 for fiscal year 2003, and $25,000,000 for each 

14 of fiscal years 2004, 2005, and 2006. 

15 SEC. 8. AUTHORITY FOR INTERNATIONAL PROGRAMS. 

16 Section 307 of the Public Health Service Act (42 

17 U.S.C. 242l) is amended—

18 (1) in subsection (b)(7) by inserting ‘‘new’’ be19 fore ‘‘facility in any foreign country’’; 

20 (2) by striking subsection (b)(8); and 

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

22 ‘‘(d)(1) The Secretary is authorized to utilize authori23 ties contained in section 2 of the State Department Basic 

24 Authorities Act of 1956 (22 U.S.C. 2669), subject to the 

25 limitations set forth in subsection (e).
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1 ‘‘(2) The Secretary is authorized to use the authority 

2 in section 1 of the Act of April 18, 1930 (46 Stat. 177; 

3 22 U.S.C. 291) and section 1 of the Foreign Service 

4 Buildings Act (22 U.S.C. 292) directly or through con5 tract, grant, or cooperative agreement to lease, alter, or 

6 renovate facilities in foreign countries as necessary to con7 duct programs of assistance for international health activi8 ties, including activities relating to HIV/AIDS and other 

9 infectious diseases, chronic and environmental diseases, 

10 and other health activities abroad. 

11 ‘‘(e) In exercising the authority set forth in para12 graphs (1) and (2) of subsection (d), the Secretary shall 

13 consult with the Secretary of State to assure that planned 

14 activities are within the legal strictures of the State De15 partment Basic Authorities Act of 1956 and other applica16 ble laws.’’. 

17 SEC. 9. IMPROVING GLOBAL HEALTH THROUGH SAFE IN18 JECTIONS. 

19 Chapter 1 of part I of the Foreign Assistance Act 

20 of 1961 (22 U.S.C. 2151 et seq.) is amended by adding 

21 at the end the following: 

22 ‘‘SEC. 135. ASSISTANCE FOR THE IMPROVEMENT OF INJEC23 TION SAFETY. 

24 ‘‘There is authorized to be appropriated each fiscal 

25 year, $1,000,000 for the purpose of developing and imple-
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1 menting effective strategies to improve injection safety, in2 cluding developing and promoting technologies that im3 prove the safety of injections provided for preventive and 

4 curative services, developing robust, environmentally 

5 sound, reasonably priced means for improving the safety 

6 of the disposal of used injection supplies, and launching 

7 an intensive 5-year communication initiative, in conjunc8 tion with WHO, UNICEF, and the GAVI to promote the 

9 safe and appropriate use of injections.’’. 

10 SEC. 10. AIDS ORPHAN RELIEF. 

11 (a) SHORT TITLE.—This section may be cited as the 

12 ‘‘AIDS Orphans Relief Act of 2002’’. 

13 (b) PURPOSES.—The purposes of this section are—

14 (1) to make microfinance programs an impor15 tant component of United States policy in fighting 

16 the effects of the Acquired Immune Deficiency Syn17 drome (AIDS) pandemic worldwide; and 

18 (2) to encourage targeted use of food and food19 related assistance for humanitarian purposes and for 

20 sustainable development in communities affected by 

21 AIDS. 

22 (c) MICROCREDIT PROGRAMS.—Chapter 1 of part I 

23 of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 

24 et seq.), as amended by section 9, is further amended by 

25 adding at the end the following new section:
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1 ‘‘SEC. 136. ASSISTANCE FOR MICROCREDIT PROGRAMS FOR 

2 COMMUNITIES AFFECTED BY AIDS. 

3 ‘‘(a) IN GENERAL.—In addition to any other funds 

4 authorized to be appropriated by this chapter for micro5 enterprise activities or activities relating to Human Im6 munodeficiency Virus (HIV) or Acquired Immune Defi7 ciency Syndrome (AIDS), there is authorized to be appro8 priated each fiscal year, $50,000,000 for purposes of as9 sisting microcredit programs that serve the very poor, es10 pecially women, in communities heavily affected by AIDS. 

11 ‘‘(b) PROGRAM ELEMENTS.—

12 ‘‘(1) IN GENERAL.—The maximum amount of 

13 credit provided an individual under a microcredit 

14 program under subsection (a) may not exceed $600, 

15 and the average loan size for a program receiving re16 sources under this section may not exceed $300. 

17 ‘‘(2) PROGRAMS.—To the maximum extent 

18 practicable, amounts shall be provided under sub19 section (a) for programs that—

20 ‘‘(A) provide HIV prevention or AIDS care 

21 and support, whether directly or through link22 ages with other programs; 

23 ‘‘(B) employ best practices for assisting 

24 the very poor; and 

25 ‘‘(C) operate in a sustainable manner.’’. 
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1 (d) FOOD ASSISTANCE PROGRAMS.—Title IV of the 

2 Agricultural Trade and Development Assistance Act of 

3 1954 (7 U.S.C. 1731 et seq.) is amended by adding at 

4 the end the following: 

5 ‘‘SEC. 417. ASSISTANCE FOR COMMUNITIES AFFECTED BY 

6 AIDS. 

7 ‘‘(a) IN GENERAL.—The President may provide food 

8 assistance under this Act to developing countries in order 

9 to assist such countries in mitigating the effects of Ac10 quired Immune Deficiency Syndrome (AIDS) on commu11 nities in such countries, including—

12 ‘‘(1) assistance to address the nutritional needs 

13 of individuals in such communities who have AIDS; 

14 ‘‘(2) assistance for households affected by 

15 AIDS; and 

16 ‘‘(3) assistance as part of other aid or assist17 ance designed to create or restore sustainable liveli18 hood strategies in communities affected by AIDS. 

19 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—

20 ‘‘(1) AUTHORIZATION.—There is authorized to 

21 be appropriated to carry out this section 

22 $50,000,000 for fiscal year 2003 and for each subse23 quent fiscal year. 

24 ‘‘(2) RELATIONSHIP TO OTHER AUTHORIZA25 TIONS.—Amounts authorized to be appropriated for 
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1 a fiscal year under paragraph (1) are in addition to 

2 any other amounts authorized to be appropriated 

3 under this Act for such fiscal year.’’. 

4 SEC. 11. PILOT PROGRAM. 

5 (a) PROGRAM AUTHORIZED.—The Director of the 

6 Centers for Disease Control and Prevention shall create 

7 a pilot program to carry out the activities described in sub8 section (b). 

9 (b) ACTIVITIES.—The Director shall—

10 (1) capitalize on demonstrated successes in pro11 viding antiretroviral drugs to people living with HIV/

12 AIDS in resource-poor settings; 

13 (2) apply learning from the United States that 

14 treatment involving antiretroviral drugs must be ac15 companied by an array of medical and social services 

16 if such treatment is to be successful; 

17 (3) provide a limited procurement of pilot 

18 antiretroviral drugs and technical assistance to pilot 

19 programs designed to assess feasibility of large-scale 

20 programs; and 

21 (4) provide technical assistance to host country 

22 governments to foster partnerships with private-sec23 tor manufacturers for the purpose of assuring sus24 tained drug availability. 
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•S 250 IS 

1 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section, 

3 $50,000,000 for each of fiscal years 2003 and 2004, and 

4 such sums as may be necessary for each of fiscal years 

5 2005 through 2007.

Æ