IB 

Union Calendar No. 272

108TH CONGRESS 

2D SESSION H. R. 4061

[Report No. 108–479] 

To amend the Foreign Assistance Act of 1961 to provide assistance for 

orphans and other vulnerable children in developing countries. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 30, 2004

Ms. LEE (for herself, Mr. ROHRABACHER, Mr. LANTOS, Mr. HYDE, Ms. 

MCCOLLUM, and Mr. LEACH) introduced the following bill; which was referred to the Committee on International Relations 

MAY 5, 2004

Additional sponsors: Mr. PAYNE, Mr. LAMPSON, Mr. KILDEE, Mr. 

MCDERMOTT, Ms. WATSON, Mr. CONYERS, Mr. RUSH, Mrs. 

CHRISTENSEN, Mr. FALEOMAVAEGA, Mr. RODRIGUEZ, Ms. CORRINE

BROWN of Florida, Mr. ANDREWS, Mr. BROWN of Ohio, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. TOWNS, Mrs. NAPOLITANO, Ms. JACKSONLEE of Texas, Mr. SMITH of Washington, Ms. WATERS, Mr. HOUGHTON, 

Mr. BRADY of Pennsylvania, Ms. MILLENDER-MCDONALD, Ms. HARRIS, 

Mr. HONDA, Mr. HASTINGS of Florida, Mr. GREENWOOD, Mr. HOEFFEL, 

Mr. MCGOVERN, Mr. DOGGETT, Mr. GEORGE MILLER of California, Mr. 

MEEK of Florida, Mr. FILNER, Mr. DICKS, Mr. OWENS, Mr. BURTON of 

Indiana, Mr. MCCOTTER, Mr. BEREUTER, Mr. GREEN of Wisconsin, Mr. 

MORAN of Virginia, Mr. SIMMONS, Mr. TANCREDO, Mr. SANDERS, Mr. 

KUCINICH, Mr. PUTNAM, Ms. CARSON of Indiana, Mr. WELLER, Mr. 

SHIMKUS, Ms. SCHAKOWSKY, Mr. STARK, Mr. RAMSTAD, Mr. WOLF, Mr. 

BELL, Mr. LINCOLN DIAZ-BALART of Florida, Mr. EHLERS, Mr. PENCE, 

Ms. KAPTUR, Mr. WYNN, Mr. RANGEL, Mr. SMITH of New Jersey, Mr. 

WHITFIELD, Mrs. BONO, Mr. WAXMAN, Mr. KING of New York, Mr. 

SULLIVAN, Ms. NORTON, Mr. GRIJALVA, Mr. WAMP, Ms. ROS-LEHTINEN, 

Mrs. BIGGERT, Mr. ACKERMAN, Mrs. JONES of Ohio, Ms. WOOLSEY, Ms. 

MCCARTHY of Missouri, Mr. SABO, Mr. MEEKS of New York, Mr. MCINTYRE, Mr. MCHUGH, Mr. GALLEGLY, Mr. CUMMINGS, and Ms. DELAURO
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MAY 5, 2004

Committed to the Committee of the Whole House on the State of the Union 

and ordered to be printed 

A BILL

To amend the Foreign Assistance Act of 1961 to provide 

assistance for orphans and other vulnerable children in 

developing countries.

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Assistance for Orphans 

5 and Other Vulnerable Children in Developing Countries 

6 Act of 2004’’. 

7 SEC. 2. FINDINGS AND DECLARATIONS OF POLICY. 

8 Congress finds and declares the following: 

9 (1)(A) According to estimates by the United 

10 Nations Children’s Fund (UNICEF), there are more 

11 than 132,000,000 children in the world under the 

12 age of three. 

13 (B) Of these children, 4,000,000 will die in 

14 their first month of life and another 7,000,000 will 

15 die each year before reaching the age of five. Thus 

16 an average of 30,000 children under the age of three 

17 die each day. 
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1 (2) According to a report developed by the 

2 United Nations Joint Programme on HIV/AIDS 

3 (UNAIDS), UNICEF, and the United States Agen4 cy for International Development, in 2001 there 

5 were more than 110,000,000 orphans living in sub6 Saharan Africa, Asia, Latin America, and the Carib7 bean. 

8 (3) Assessments carried out by the Inter9 national Labor Organization (ILO) to investigate 

10 the situation of children who are working found that 

11 orphans are much more likely than non-orphans to 

12 be working in commercial agriculture, the domestic 

13 service industry, the commercial sex industry, as 

14 street vendors, or in industries that violate inter15 nationally recognized rights of children. 

16 (4) Infants who are poor and malnourished are 

17 more likely to contract respiratory infections, diar18 rhea, measles, and other preventable diseases, and 

19 are less likely to receive needed health care. 

20 (5) According to UNAIDS and UNICEF, by 

21 the end of 2001 there were an estimated 14,000,000 

22 children under the age of 15 who had lost one or 

23 both parents to AIDS. 

24 (6) As the number of HIV cases increases in 

25 sub-Saharan Africa and the Caribbean, as well as in 
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1 Eastern Europe and Asia, the death rate from AIDS 

2 among adults in those regions is expected to in3 crease. By 2010 the total number of children in 

4 those regions who will lose one or both parents to 

5 AIDS is expected to be approximately 30,000,000. 

6 (7) One-third of children born from an HIV-in7 fected mother develop HIV/AIDS. Few of these chil8 dren have access to HIV/AIDS medications. 

9 (8) Globally, more than 11,800,000 young peo10 ple ages 15 to 24 were living with HIV/AIDS in 

11 2001, and each day another 6,000 young people be12 came infected with HIV. New estimates indicate that 

13 more than 70 percent of new HIV cases among this 

14 age group in sub-Saharan Africa are young women 

15 and girls. 

16 (9) As their parents fall progressively sick from 

17 HIV/AIDS, children generally must take on an in18 creasing number of responsibilities. Girls take re19 sponsibility for more household chores, often drop 

20 out of school, and care for their parents. 

21 (10)(A) Without an adequate diet, individuals 

22 infected with HIV often die at an earlier age. Indi23 viduals with HIV become increasingly weak and fa24 tigued, do not respond to drug treatment, and are 
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1 prone to other illnesses such as malnutrition and tu2 berculosis (TB). 

3 (B) Hunger can also cause previously HIV-neg4 ative people to engage in high-risk survival strate5 gies, such as work in the commercial sex industry, 

6 that increase their chances of becoming infected with 

7 HIV. 

8 (11) Extreme poverty and hunger coupled with 

9 the loss of one or both parents as a result of AIDS 

10 can force children from their families to a life on the 

11 streets, where the risk of HIV infection is extremely 

12 high.

13 (12)(A) A considerable number of United 

14 States and indigenous private voluntary organiza15 tions, including faith-based organizations, provide 

16 relatively modest amounts of assistance to orphans 

17 and other vulnerable children in developing coun18 tries, especially children affected by HIV/AIDS. 

19 (B) Many of these organizations have submitted 

20 applications for grants from the United States Agen21 cy for International Development in order to provide 

22 increased levels of assistance for orphans and other 

23 vulnerable children in developing countries but in 

24 most cases the Agency has not approved the applica25 tions. 
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1 (13)(A) Section 403(b) of the United States 

2 Leadership Against HIV/AIDS, Tuberculosis, and 

3 Malaria Act of 2003 (Public Law 108–25) estab4 lishes the requirement that for fiscal years 2006 

5 through 2008, not less than 10 percent of amounts 

6 appropriated for HIV/AIDS assistance for each such 

7 fiscal year shall be expended for assistance for or8 phans and other vulnerable children affected by 

9 HIV/AIDS. 

10 (B) Further, section 403(b) of Public Law 

11 108–25 requires that at least 50 percent of such 

12 amounts shall be provided through non-profit, non13 governmental organizations, including faith-based 

14 organizations, that implement programs on the com15 munity level. 

16 (14)(A) It is essential that the United States 

17 Government adopt a comprehensive approach for the 

18 provision of assistance to orphans and other vulner19 able children in developing countries. 

20 (B) This comprehensive approach should ensure 

21 that important services, such as basic care, treat22 ment for those children with HIV/AIDS, mental 

23 health and related services for those children af24 fected by HIV/AIDS, school food programs, in25 creased educational opportunities and employment 
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1 training and related services, and the protection and 

2 promotion of inheritance rights, are made more ac3 cessible. 

4 (C) This comprehensive approach should also 

5 ensure that government agencies and the private 

6 sector coordinate efforts to prevent and eliminate 

7 duplication of efforts and waste. 

8 (15) As a result of the numerous United States 

9 Government programs under which assistance is spe10 cifically authorized or otherwise available for or11 phans and vulnerable children in developing coun12 tries, the United States Agency for International 

13 Development will be required to develop innovative 

14 methods for the conduct and monitoring of these 

15 programs, including through the collection, analysis, 

16 and reporting of information on the programs. 

17 SEC. 3. ASSISTANCE FOR ORPHANS AND OTHER VULNER18 ABLE CHILDREN IN DEVELOPING COUN19 TRIES. 

20 Title V of chapter 2 of part I of the Foreign Assist21 ance Act of 1961 (22 U.S.C. 2201) is amended to read 

22 as follows: 
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1 ‘‘Title V—Assistance for Orphans and Other Vulnerable 

2 Children 

3 ‘‘SEC. 241. FINDINGS; DECLARATION OF POLICY. 

4 ‘‘(a) FINDINGS.—Congress finds the following: 

5 ‘‘(1) By 2010, HIV/AIDS will orphan more 

6 than 25,000,000 children worldwide. 

7 ‘‘(2) Ongoing conflicts and civil wars in devel8 oping countries are adversely affecting children in 

9 these countries, the vast majority of whom currently 

10 do not receive humanitarian assistance or other sup11 port from the United States Government. 

12 ‘‘(3) Although the United States Government 

13 currently administers assistance programs for or14 phans and other vulnerable children in developing 

15 countries, for fiscal year 2002 the United States 

16 Agency for International Development reported that 

17 the United States Government provided assistance 

18 to only 462,000 such orphans and other vulnerable 

19 children, or less than one-half of one percent of the 

20 estimated 108,000,000 total number of such or21 phans and other vulnerable children. 

22 ‘‘(4) The United States Government should in23 crease its efforts to provide assistance for orphans 

24 and other vulnerable children in developing coun-
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1 tries, especially those children affected by HIV/AIDS 

2 or conflict. 

3 ‘‘(5) The United States Agency for Inter4 national Development should establish improved ca5 pacity to deliver assistance to orphans and other vul6 nerable children in developing countries through 

7 partnerships with private voluntary organizations, 

8 including faith-based organizations. 

9 ‘‘(6) Further, the United States Agency for 

10 International Development should be the primary 

11 United States Government agency responsible for 

12 identifying and assisting orphans and other vulner13 able children in developing countries. 

14 ‘‘(b) DECLARATION OF POLICY.—Congress, recog15 nizing that prompt and appropriate action by the United 

16 States to assist orphans and other vulnerable children in 

17 developing countries is an important expression of the hu18 manitarian concern and tradition of the people of the 

19 United States, affirms the willingness of the United States 

20 to assist such orphans and other vulnerable children—

21 ‘‘(1) by providing assistance for the purpose of 

22 improving the health, nutritional, shelter, edu23 cational, economic, and psychological status of or24 phans and other vulnerable children in such coun25 tries; and 
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1 ‘‘(2) by providing humanitarian and protection 

2 assistance to such orphans and other vulnerable chil3 dren affected by conflict or civil strife. 

4 ‘‘SEC. 242. ASSISTANCE TO PROVIDE BASIC CARE. 

5 ‘‘(a) FINDINGS.—Congress finds the following: 

6 ‘‘(1) The need for individuals and local organi7 zations in developing countries to assist households 

8 headed by children is necessary due to the increase 

9 in the number of such households. Millions of chil10 dren in these types of households lack basic care, 

11 such as access to food and shelter. 

12 ‘‘(2) When communities are responsible for 

13 raising orphans, these children are cared for in a 

14 rich and nurturing environment and remain con15 nected to the traditions and rituals of families and 

16 the community.

17 ‘‘(3) As the number of these children increases, 

18 the ability of communities to provide basic care for 

19 such children is limited. Assistance to support the 

20 provision of such basic care is therefore necessary in 

21 and of itself and also to facilitate the provision of 

22 other types of assistance for such children under this 

23 title. 

24 ‘‘(b) ASSISTANCE.—
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1 ‘‘(1) IN GENERAL.—The President is author2 ized to provide assistance for programs in developing 

3 countries to provide basic care for orphans and other 

4 vulnerable children. 

5 ‘‘(2) ACTIVITIES SUPPORTED.—Assistance pro6 vided under paragraph (1) should be used—

7 ‘‘(A) to support individuals and local orga8 nizations, including teachers, social workers, 

9 and representatives from religious institutions 

10 and nongovernmental organizations, to mobilize 

11 their own resources through the establishment 

12 of ‘community care councils’ to provide basic 

13 care for orphans and other vulnerable children, 

14 including day care, food assistance, protection 

15 assistance, and home visits; 

16 ‘‘(B) to increase the capacity of community 

17 care councils described in subparagraph (A) to 

18 meet on a regular basis to identify orphans and 

19 other vulnerable children and to facilitate the 

20 provision of services; and 

21 ‘‘(C) to establish and operate centers in 

22 such communities to provide basic care de23 scribed in subparagraph (A). 

24 ‘‘(3) DEFINITION.—In this subsection, the term 

25 ‘protection assistance’ means all appropriate meas-
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1 ures to promote the physical and psychological secu2 rity of an individual, provide equal access to basic 

3 services for the individual, and safeguard the legal 

4 and human rights and dignity of the individual. 

5 ‘‘SEC. 243. ASSISTANCE TO PROVIDE TREATMENT TO OR6 PHANS AND OTHER VULNERABLE CHILDREN 

7 WITH HIV/AIDS. 

8 ‘‘(a) FINDINGS.—Congress finds the following: 

9 ‘‘(1) Approximately 2,500,000 children under 

10 the age of 15 worldwide have HIV/AIDS. Every day 

11 another 2,000 children under the age of 15 are in12 fected with HIV. 

13 ‘‘(2) In 2002, approximately 2,500,000 children 

14 were at risk for infection with HIV through mother15 to-child transmission, which includes transmission at 

16 any point during pregnancy, labor, delivery, or 

17 breastfeeding. 

18 ‘‘(3) To date, more than 4,000,000 children 

19 worldwide are estimated to have died from AIDS, 

20 primarily contracted through mother-to-child trans21 mission. Every year, approximately 700,000 babies 

22 are infected with HIV, of which the majority are liv23 ing in Africa. 
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1 ‘‘(4) In southern Africa HIV/AIDS is now the 

2 leading cause of death among young children, ac3 counting for almost half of such deaths. 

4 ‘‘(5) Research has shown conclusively that initi5 ation in a timely manner of antiretroviral therapy 

6 for infants or young children with HIV/AIDS can 

7 preserve or restore their immune functions, promote 

8 normal growth and development, and prolong life. 

9 ‘‘(6) Few international development programs 

10 specifically target the treatment of children with 

11 HIV/AIDS in developing countries. Reasons for this 

12 include the perceived low priority of pediatric treat13 ment, a lack of pediatric health care professionals, 

14 lack of expertise and experience in pediatric drug 

15 dosing and monitoring, the perceived complexity of 

16 pediatric treatment, and mistaken beliefs regarding 

17 the risks and benefits of pediatric treatment. 

18 ‘‘(b) ASSISTANCE.—

19 ‘‘(1) IN GENERAL.—The President is author20 ized to provide assistance for the treatment of or21 phans and other vulnerable children with HIV/AIDS 

22 in developing countries. 

23 ‘‘(2) ACTIVITIES SUPPORTED.—Assistance pro24 vided under paragraph (1) should be used to carry 

25 out the following activities: 
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1 ‘‘(A) The treatment of orphans and other 

2 vulnerable children with HIV/AIDS through the 

3 provision of pharmaceuticals, including high4 quality, low-cost antiretrovirals and other thera5 pies, including generically manufactured phar6 maceuticals where appropriate. 

7 ‘‘(B)(i) The recruitment and training of in8 dividuals to provide the treatment described in 

9 subparagraph (A), including the recruitment 

10 and training of appropriate support personnel. 

11 ‘‘(ii) Such training should include appro12 priate methodologies relating to initial diag13 nosis, appropriate dosages of pharmaceuticals, 

14 monitoring, medication adherence techniques, 

15 and treatment for any complications resulting 

16 from such pharmaceuticals. 

17 ‘‘(C) Activities of medical laboratories re18 lating to the treatment described in subpara19 graph (A), including assistance for the purchase 

20 of necessary equipment. 

21 ‘‘SEC. 244. ASSISTANCE TO PROVIDE PSYCHOSOCIAL SUP22 PORT TO ORPHANS AND OTHER VULNER23 ABLE CHILDREN AFFECTED BY HIV/AIDS. 

24 ‘‘(a) FINDINGS.—Congress finds the following: 
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1 ‘‘(1) Many children who are orphaned as a re2 sult of AIDS blame themselves for the death of a 

3 parent and many children are separated from sib4 lings, sometimes for life. 

5 ‘‘(2) The trauma that results from the loss of 

6 a parent as a result of AIDS can trigger behavior 

7 problems of aggression or emotional withdrawal and 

8 negatively affect a child’s performance in school and 

9 the child’s social relations. 

10 ‘‘(3) Children living in families affected by 

11 HIV/AIDS are often stigmatized, teased, and ostra12 cized by peers. In Uganda, some children who are 

13 orphaned as a result of AIDS are called ‘walking 

14 corpses’ and discouraged from attending school. 

15 ‘‘(4) Children living in families affected by 

16 HIV/AIDS who are most vulnerable are those chil17 dren in households headed by children. In these 

18 households, trained community volunteers can play a 

19 major role through home visits.

20 ‘‘(5) In many African countries, religious lead21 ers are mobilizing individuals and local organizations 

22 within the community to identify and respond to the 

23 psychosocial needs of those children affected by 

24 AIDS. 
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1 ‘‘(b) ASSISTANCE.—The President is authorized to 

2 provide assistance for programs in developing countries to 

3 provide mental health treatment and related services to 

4 orphans and other vulnerable children affected by HIV/

5 AIDS. 

6 ‘‘SEC. 245. ASSISTANCE FOR SCHOOL FOOD PROGRAMS. 

7 ‘‘(a) FINDINGS.—Congress finds the following: 

8 ‘‘(1) In 2004, it is estimated that 125,000,000 

9 children worldwide do not attend school, in part be10 cause of hunger and malnutrition, and the vast ma11 jority of these children are young girls. 

12 ‘‘(2) School food programs, including take-home 

13 rations, in developing countries provide strong incen14 tives for parents to send their children to school and 

15 ensure that they continue with their education. 

16 School food programs may reduce short-term hun17 ger, improve cognitive functions, and enhance learn18 ing, behavior, and achievement. 

19 ‘‘(3) In 2004, more than 8,000,000 children in 

20 sub-Saharan Africa are underweight compared to 

21 1994. Malnutrition enhances the risk that orphans 

22 and other vulnerable children will be at risk for ill23 ness and infections, especially if these children are 

24 also infected with HIV. 
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1 ‘‘(4) Healthy members of families affected by 

2 HIV/AIDS in developing countries often leave the 

3 workforce to care for those family members with 

4 HIV/AIDS, which compounds the problem of access 

5 to food for the family. Food consumption has been 

6 shown to drop by as much as 40 percent in these 

7 families. 

8 ‘‘(5)(A) Although a number of organizations 

9 seek to meet the needs of children who are orphaned 

10 or vulnerable as a result of HIV/AIDS, local commu11 nities continue to be the primary providers of sup12 port for these children. 

13 ‘‘(B) According to a survey by the United 

14 States Agency for International Development, or15 phans and other vulnerable children relied on rel16 atives for food support 74 percent of the time and 

17 on friends for food support 19 percent of the time. 

18 ‘‘(b) ASSISTANCE.—

19 ‘‘(1) IN GENERAL.—The President is author20 ized to provide assistance for school food programs 

21 in developing countries. 

22 ‘‘(2) ACTIVITIES SUPPORTED.—Assistance pro23 vided under paragraph (1) should be used to pur24 chase local or regional foodstuffs, where appropriate, 

25 for school food programs. 
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1 ‘‘SEC. 246. ASSISTANCE TO INCREASE EDUCATIONAL OP2 PORTUNITIES AND PROVIDE EMPLOYMENT 

3 TRAINING. 

4 ‘‘(a) FINDINGS.—Congress finds the following: 

5 ‘‘(1) The lack of financial resources in families 

6 affected by HIV/AIDS prevents many orphans and 

7 other vulnerable children in developing countries 

8 from attending school because of the requirement to 

9 pay school fees and other costs of education. 

10 ‘‘(2) Such children, in particular young girls, 

11 are often forced to miss school in order to serve as 

12 caregivers to relatives with HIV/AIDS or assume 

13 adult responsibilities for providing for the family. 

14 Younger children who lose a parent also lose the op15 portunity to learn skills that they will need to sup16 port themselves as they grow older. 

17 ‘‘(3) According to the International Labor Or18 ganization (ILO), approximately 250,000,000 chil19 dren and adolescents ages 5 to 14 in developing 

20 countries are working part-time and approximately 

21 120,000,000 children and adolescents ages 5 to 14 

22 in developing countries are working full-time. 

23 ‘‘(4) In many regions of Africa and other devel24 oping countries, non-formal education plays an im25 portant role to provide children who are unable to 
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1 attend school with the employment and related life 

2 skills training such children need to survive. 

3 ‘‘(5) Many organizations in Africa, including 

4 faith-based organizations, provide employment and 

5 related life skills training for older children to better 

6 prepare them to serve as caregivers for younger sib7 lings. 

8 ‘‘(6) Organizations that provide non-formal 

9 education can assist the thousands of children in de10 veloping countries who are not currently being as11 sisted by families or communities and are struggling 

12 to survive. 

13 ‘‘(b) ASSISTANCE.—

14 ‘‘(1) EDUCATION ASSISTANCE.—The President 

15 is authorized to provide assistance for programs in 

16 developing countries to increase enrollment in public 

17 primary schools by eliminating school fees and other 

18 costs of education, especially in developing countries 

19 heavily affected by HIV/AIDS. Amounts made avail20 able to carry out this paragraph are authorized to 

21 be made available to the President to make vol22 untary contributions to the United Nations Chil23 dren’s Fund to achieve the purposes of this para24 graph. 
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1 ‘‘(2) EMPLOYMENT TRAINING ASSISTANCE.—

2 The President is authorized to provide assistance for 

3 programs in developing countries to provide employ4 ment training and related services for orphans and 

5 other vulnerable children, especially in developing 

6 countries heavily affected by HIV/AIDS. 

7 ‘‘SEC. 247. ASSISTANCE TO PROTECT AND PROMOTE INHER8 ITANCE RIGHTS. 

9 ‘‘(a) FINDING.—Congress finds that orphans and 

10 other vulnerable children in developing countries, particu11 larly children who are orphaned as a result of AIDS, are 

12 routinely denied their inheritance or encounter difficulties 

13 in claiming the land and other property which they have 

14 inherited. 

15 ‘‘(b) ASSISTANCE.—The President is authorized to 

16 provide assistance in support of programs in developing 

17 countries to protect and promote the inheritance rights of 

18 orphans and other vulnerable children, particularly young 

19 girls and children who are orphaned as a result of AIDS.

20 ‘‘SEC. 248. ADMINISTRATION OF ASSISTANCE. 

21 ‘‘(a) OFFICE FOR ORPHANS AND OTHER VULNER22 ABLE CHILDREN.—

23 ‘‘(1) ESTABLISHMENT.—There is established 

24 within the United States Agency for International 

25 Development an Office for Orphans and Other Vul-
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1 nerable Children (hereafter in this title referred to 

2 as the ‘Office’), which shall be headed by a Director 

3 who shall be appointed by the Administrator of the 

4 Agency. 

5 ‘‘(2) DUTIES.—The Office shall be responsible 

6 for carrying out this title. 

7 ‘‘(b) APPROVAL OF APPLICATIONS.—The Director of 

8 the Office shall be responsible for reviewing or approving 

9 all applications submitted to the United States Agency for 

10 International Development for assistance under this title, 

11 including applications submitted to field missions of the 

12 Agency. 

13 ‘‘(c) PRIORITY.—In providing assistance under this 

14 title, priority should be given to assistance for developing 

15 countries in which the rate of HIV infection, as reported 

16 in the most recent epidemiological data for that country 

17 compiled by the United Nations Joint Programme on 

18 HIV/AIDS (UNAIDS), is at least 5 percent among women 

19 attending prenatal clinics or more than 15 percent among 

20 individuals in groups with high-risk behavior. 

21 ‘‘(d) FORM OF ASSISTANCE.—Assistance under this 

22 title shall be provided in the form of—

23 ‘‘(1) grants, cooperative agreements, or con24 tracts; 
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1 ‘‘(2) contributions to international organiza2 tions; or 

3 ‘‘(3) assistance to the governments of devel4 oping countries. 

5 ‘‘(e) COORDINATION.—The provision of assistance 

6 under this title for children who are orphaned as a result 

7 of HIV/AIDS, or are children with HIV/AIDS, shall be 

8 undertaken in a manner that is consistent with assistance 

9 authorized under section 104A of this Act and assistance 

10 relating to HIV/AIDS authorized under the United States 

11 Leadership Against HIV/AIDS, Tuberculosis, and Malaria 

12 Act of 2003 (Public Law 108–25). 

13 ‘‘(f) OTHER ASSISTANCE.—

14 ‘‘(1) REVIEW AND APPROVAL OF OTHER USAID

15 ASSISTANCE.—The Director of the Office shall be re16 sponsible for reviewing or approving—

17 ‘‘(A) each component of the annual plan of 

18 a mission, bureau, or other office of the United 

19 States Agency for International Development as 

20 the component relates to assistance for orphans 

21 and other vulnerable children in developing 

22 countries; and 

23 ‘‘(B) each program, project, or activity re24 lating to such assistance. 
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1 ‘‘(2) COORDINATION OF ALL U.S. GOVERNMENT

2 ASSISTANCE.—The Director of the Office shall be re3 sponsible for ensuring coordination of all United 

4 States Government programs to provide assistance 

5 for orphans and other vulnerable children in devel6 oping countries. 

7 ‘‘SEC. 249. MONITORING SYSTEM. 

8 ‘‘(a) ESTABLISHMENT.—In order to maximize the 

9 sustainable development impact of assistance authorized 

10 under this title, the President shall establish a monitoring 

11 system that meets the requirements of subsection (b). 

12 ‘‘(b) REQUIREMENTS.—The requirements referred to 

13 in subsection (a) are the following: 

14 ‘‘(1) The monitoring system establishes per15 formance goals for the assistance and expresses such 

16 goals in an objective and quantifiable form, to the 

17 extent feasible. 

18 ‘‘(2) The monitoring system establishes per19 formance indicators to be used in measuring or as20 sessing the achievement of the performance goals de21 scribed in paragraph (1). 

22 ‘‘(3) The monitoring system provides a basis for 

23 recommendations for adjustments to the assistance 

24 to enhance the impact of the assistance. 
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1 ‘‘SEC. 250. REPORT. 

2 ‘‘(a) REPORT.—Not later than December 31, 2005, 

3 and each December 31 thereafter, the President shall 

4 transmit to Congress a report that contains a detailed de5 scription of the implementation of this title for the pre6 vious fiscal year. 

7 ‘‘(b) CONTENTS.—The report shall contain the fol8 lowing information: 

9 ‘‘(1) For each grant, cooperative agreement, 

10 contract, contribution, or other form of assistance 

11 awarded or entered into under this title—

12 ‘‘(A) the amount of the grant, cooperative 

13 agreement, contract, contribution, or other form 

14 of assistance, the name of each recipient and 

15 each developing country with respect to which 

16 projects or activities under the grant, coopera17 tive agreement, contract, contribution, or other 

18 form of assistance were carried out, and the ap19 proximate number of orphans and other vulner20 able children who received assistance under the 

21 projects or activities; and

22 ‘‘(B) the results of the monitoring system 

23 with respect to the grant, cooperative agree24 ment, contract, contribution, or other form of 

25 assistance. 
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1 ‘‘(2) For each grant, cooperative agreement, 

2 contract, contribution, or other form of assistance 

3 awarded or entered into under any provision of law 

4 other than this title for assistance for orphans and 

5 other vulnerable children in developing countries, the 

6 information described in paragraph (1)(A). 

7 ‘‘(3) Any other appropriate information relating 

8 to the needs of orphans and other vulnerable chil9 dren in developing countries that could be addressed 

10 through the provision of assistance under this title 

11 or under any other provision of law. 

12 ‘‘SEC. 251. AUTHORIZATION OF APPROPRIATIONS; ADDI13 TIONAL PROVISIONS. 

14 ‘‘(a) AUTHORIZATION OF APPROPRIATION.—

15 ‘‘(1) IN GENERAL.—Of the amounts made 

16 available to carry out the provisions of law described 

17 in paragraph (2), there are authorized to be appro18 priated to the President to carry out this title such 

19 sums as may be necessary for each of the fiscal 

20 years 2005 and 2006. 

21 ‘‘(2) PROVISIONS OF LAW.—The provisions of 

22 law referred to in paragraph (1) are the following: 

23 ‘‘(A) The United States Leadership 

24 Against HIV/AIDS, Tuberculosis, and Malaria 
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1 Act of 2003 (Public Law 108–25) and the 

2 amendments made by that Act. 

3 ‘‘(B) Any other provision of law under 

4 which assistance is authorized for orphans and 

5 other vulnerable children in developing coun6 tries. 

7 ‘‘(b) ADDITIONAL PROVISIONS.—

8 ‘‘(1) AVAILABILITY.—Amounts appropriated 

9 pursuant to the authorization of appropriations 

10 under subsection (a) are authorized to remain avail11 able until expended and are in addition to amounts 

12 otherwise available for such purposes. 

13 ‘‘(2) MINIMUM FUNDING REQUIREMENT.—Not 

14 less than 60 percent of amounts appropriated pursu15 ant to the authorization of appropriations under 

16 subsection (a) for a fiscal year (other than amounts 

17 made available for assistance to eliminate school fees 

18 and other costs of education pursuant to section 

19 246) shall be provided through United States or in20 digenous private voluntary organizations that imple21 ment programs on the community level. Amounts 

22 provided by for-profit entities to not-for-profit enti23 ties from assistance under this title shall not be con24 sidered for purposes of satisfying the requirement of 

25 this paragraph. 
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1 ‘‘(3) ASSISTANCE UNDER OTHER PROVISIONS

2 OF LAW.—

3 ‘‘(A) IN GENERAL.—Notwithstanding any 

4 other provision of law, amounts made available 

5 for assistance for orphans or other vulnerable 

6 children in developing countries under any pro7 vision of law other than this title may be pro8 vided to further the purposes of this title. 

9 ‘‘(B) REPORT.—To the extent assistance 

10 described in subparagraph (A) is provided in 

11 accordance with such subparagraph, the Presi12 dent shall include, as part of the report re13 quired under section 250, a detailed description 

14 of such assistance and, to the extent applicable, 

15 the information required by subsection 

16 (b)(1)(A) of such section with respect to such 

17 assistance. 

18 ‘‘SEC. 252. DEFINITIONS. 

19 ‘‘In this title: 

20 ‘‘(1) AIDS.—The term ‘AIDS’ has the meaning 

21 given the term in section 104A(g)(1) of this Act. 

22 ‘‘(2) CHILDREN.—The term ‘children’ means 

23 persons who have not attained the age of 18. 

24 ‘‘(3) HIV.—The term ‘HIV’ has the meaning 

25 given the term in section 104A(g)(2) of this Act. 
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1 ‘‘(4) HIV/AIDS.—The term ‘HIV/AIDS’ has 

2 the meaning given the term in section 104A(g)(3) of 

3 this Act. 

4 ‘‘(5) ORPHAN.—The term ‘orphan’ means a 

5 child deprived by death of one or both parents. 

6 ‘‘(6) VULNERABLE CHILDREN.—The term ‘vul7 nerable children’ includes children who are ne8 glected, destitute, abandoned, homeless, disabled, 

9 suffering from malnutrition, are sexually exploited or 

10 abused, or are displaced or otherwise adversely af11 fected by armed conflict.’’.

Union Calendar No. 272

108TH CONGRESS 

2D SESSION H. R. 4061

[Report No. 108–479] 

A BILL

To amend the Foreign Assistance Act of 1961 to 

provide assistance for orphans and other vulnerable children in developing countries. 

MAY 5, 2004

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed