I 

108TH CONGRESS 

2D SESSION H. R. 4191 

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

of a network of pediatric centers in certain developing countries to 

provide treatment and care for children with HIV/AIDS, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 21, 2004 

Ms. MILLENDER-MCDONALD introduced the following bill; which was referred 

to the Committee on International Relations 

A BILL 

To amend the Foreign Assistance Act of 1961 to provide 

for the establishment of a network of pediatric centers 

in certain developing countries to provide treatment and 

care for children with HIV/AIDS, and for other purposes. 

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 ‘‘International Pediatric 

5 HIV/AIDS Network Act of 2004’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 
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1 (1) HIV/AIDS causes the death of more indi2 viduals than any other infectious disease, surpassing 

3 even tuberculosis and malaria, the leading causes of 

4 death since antiquity. In 2003 HIV/AIDS caused 

5 the death of more than 3,000,000 individuals. 

6 (2) Worldwide, approximately 40,000,000 

7 adults and children are infected with HIV, and ap8 proximately 28,000,000 individuals have died of 

9 AIDS since the beginning of the epidemic, including 

10 approximately 5,600,000 children. 

11 (3) Approximately 50 percent of all new HIV 

12 infections occur among young people 15 to 24 years 

13 of age. 

14 (4) Each day more than 2,000 children are in15 fected with HIV and 16 percent of all new HIV in16 fections involve children. 

17 (5) In 2003 more than 700,000 children be18 came infected with HIV and a total of approximately 

19 2,500,000 children were living with HIV/AIDS. 

20 (6) In 2003 approximately 500,000 children 

21 died from AIDS. By the end of 2003 a total of more 

22 than 5,600,000 children had died from AIDS since 

23 the beginning of the epidemic. 

24 (7) The HIV/AIDS epidemic has a devastating 

25 impact on children and families. More than 
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1 14,000,000 children have been orphaned as a result 

2 of HIV/AIDS, of whom 95 percent live in sub-Saha3 ran Africa. 

4 (8) The following represents the approximate 

5 number of children under the age of 15 who are liv6 ing with HIV/AIDS in the countries indicated: 

7 270,000 in Nigeria, 250,000 in South Africa, 

8 230,000 in Ethiopia, 220,000 in Kenya, 170,000 in 

9 Tanzania, 150,000 in Zambia, 110,000 in Uganda, 

10 84,000 in Coˆte d’Ivoire, 80,000 in Mozambique, 

11 65,000 in Rwanda, 30,000 in Namibia, 170,000 in 

12 India, 2,000 in the People’s Republic of China, and 

13 800 in Guyana. 

14 (9) These countries are developing countries in 

15 which very few individuals infected with HIV have 

16 access to antiretroviral therapies. 

17 (10) Approximately 50 percent of all individuals 

18 who become infected with HIV acquire the virus be19 fore the age of 25 and die from AIDS or AIDS-re20 lated illnesses before the age of 35. The propensity 

21 of HIV to infect adolescents and young adults poses 

22 a unique threat to children for acquisition of the 

23 virus. 

24 (11) In addition, 95 percent of HIV/AIDS-asso25 ciated deaths occur in developing countries. Some 
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1 projections indicate that by 2005 the number of in2 dividuals infected with HIV in Africa may double to 

3 approximately 60,000,000 individuals. Asia, espe4 cially India and the People’s Republic of China, is 

5 acknowledged to represent the next region to experi6 ence a major increase in the HIV/AIDS epidemic. 

7 (12) There is also a lack of health care profes8 sionals with expertise or experience in treating chil9 dren infected with HIV, including the provision of 

10 therapy, dosing, administration, and monitoring. 

11 Treatment for children infected with HIV is not as 

12 widely available as it is for adults infected with HIV 

13 and thus children represent a disproportionate share 

14 of those individuals infected with HIV who do not 

15 have access treatment. 

16 (13) Most health care professionals in devel17 oping countries lack formal education or training in 

18 pediatric HIV/AIDS treatment, have limited access 

19 to relevant scientific and medical literature, and do 

20 not network or collaborate with their colleagues in 

21 other institutions on any regular basis. 

22 (14) Formal research training for such health 

23 care professionals is almost non-existent, as well as 

24 studies specifically designed to address practical and 

25 affordable approaches to the prevention and treat-
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1 ment of HIV/AIDS. Infrastructure for the conduct 

2 of HIV/AIDS clinical research is lacking in most de3 veloping countries. 

4 (15) The establishment of a network of pedi5 atric centers to provide treatment and care for chil6 dren with HIV/AIDS in developing countries and the 

7 training of pediatric health care professionals would 

8 be an important contribution to the prevention, 

9 treatment, and monitoring of HIV/AIDS cases in 

10 those countries. 

11 (16) The establishment of this network will 

12 mean that approximately 40,000 children with HIV/ 

13 AIDS will receive treatment and care at the pedi14 atric centers during the five year-period beginning 

15 immediately after the establishment of the network. 

16 This will dramatically enhance the global infrastruc17 ture and capacity for HIV/AIDS care and treatment 

18 and clinical research. Each center would become 

19 self-sustaining after the initial five year-period. 

20 (17) These centers will be developed and staffed 

21 collaboratively by United States and local profes22 sionals. The centers would be modeled after two 

23 landmark international pediatric HIV/AIDS care 

24 and treatment centers already established and oper-
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1 ating in Constanta, Romania, and Gaborone, Bot2 swana. 

3 (18) Based on the model of the pediatric HIV/ 

4 AIDS care and treatment centers in Constanta, Ro5 mania and Gaborone, Botswana, these centers will 

6 make a valuable contribution not only to the treat7 ment of HIV/AIDS, but also to routine care, psycho8 social care, and nutritional and other child life serv9 ices. 

10 SEC. 3. AMENDMENTS TO THE FOREIGN ASSISTANCE ACT 

11 OF 1961. 

12 (a) NETWORK OF PEDIATRIC HIV/AIDS CEN13 TERS.—Section 104A(d) of the Foreign Assistance Act of 

14 1961 (22 U.S.C. 2151b-2(d)) is amended by adding at the 

15 end the following new paragraph: 

16 ‘‘(8) NETWORK OF PEDIATRIC HIV/AIDS CEN17 TERS.—The establishment and operation by one or 

18 more public-private partnership entities described in 

19 paragraph (7) of a network of pediatric centers in 

20 countries in sub-Saharan Africa, the Republic of 

21 India, the People’s Republic of China, the Co-opera22 tive Republic of Guyana, and other countries and 

23 areas with high rates of HIV/AIDS to provide treat24 ment and care for children with HIV/AIDS in such 
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1 countries and areas and to provide training of pedi2 atric health care professionals at such centers.’’. 

3 (b) FUNDING.—Section 104A of the Foreign Assist4 ance Act of 1961 is amended— 

5 (1) by redesignating subsection (g) as sub6 section (h); and 

7 (2) by inserting after subsection (f) the fol8 lowing new subsection: 

9 ‘‘(g) FUNDING FOR NETWORK OF PEDIATRIC HIV/ 

10 AIDS CENTERS.—Of the funds made available to carry 

11 out this section for fiscal years 2005 through 2009, not 

12 less than $10,000,000 for each such fiscal year is author13 ized to be made available to carry out subsection (d)(8).’’. 

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