II 

109TH CONGRESS 

2D SESSION S. 3775 

To amend the Foreign Assistance Act of 1961 to assist countries in subSaharan Africa in the effort to achieve internationally recognized goals 

in the treatment and prevention of HIV/AIDS and other major diseases 

and the reduction of maternal and child mortality by improving human 

health care capacity and improving retention of medical health professionals in sub-Saharan Africa, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 2, 2006 

Mr. DURBIN (for himself, Mr. COLEMAN, Mr. DEWINE, Mr. FEINGOLD, and 

Mr. LEAHY) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To amend the Foreign Assistance Act of 1961 to assist 

countries in sub-Saharan Africa in the effort to achieve 

internationally recognized goals in the treatment and prevention of HIV/AIDS and other major diseases and the 

reduction of maternal and child mortality by improving 

human health care capacity and improving retention of 

medical health professionals in sub-Saharan Africa, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘African Health Capac3 ity Investment Act of 2006’’. 

4 SEC. 2. DEFINITIONS. 

5 In this Act, the term ‘‘HIV/AIDS’’ has the meaning 

6 given such term in section 104A(g) of the Foreign Assist7 ance Act of 1961 (22 U.S.C. 2151b–2(g)). 

8 SEC. 3. FINDINGS. 

9 Congress makes the following findings: 

10 (1) The World Health Report, 2003, Shaping 

11 the Future, states, ‘‘The most critical issue facing 

12 health care systems is the shortage of people who 

13 make them work.’’. 

14 (2) The World Health Report, 2006, Working 

15 Together for Health, states, ‘‘The unmistakable im16 perative is to strengthen the workforce so that 

17 health systems can tackle crippling diseases and 

18 achieve national and global health goals. A strong 

19 human infrastructure is fundamental to closing to20 day’s gap between health promise and health reality 

21 and anticipating the health challenges of the 21st 

22 century.’’. 

23 (3) The shortage of health personnel, including 

24 doctors, nurses, pharmacists, counselors, paraprofes25 sionals, and trained lay workers is one of the leading 


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1 obstacles to fighting HIV/AIDS in sub-Saharan Af2 rica. 

3 (4) The HIV/AIDS pandemic aggravates the 

4 shortage of health workers through loss of life and 

5 illness among medical staff, unsafe working condi6 tions for medical personnel, and increased workloads 

7 for diminished staff, while the shortage of health 

8 personnel undermines efforts to prevent and provide 

9 care and treatment for those with HIV/AIDS. 

10 (5) Workforce constraints and inefficient man11 agement are limiting factors in the treatment of tuberculosis, which infects over 1 12 ⁄3 of the global popu13 lation. 

14 (6) Over 1,200,000 people die of malaria each 

15 year. More than 75 percent of these deaths occur 

16 among African children under the age of 5 years old 

17 and the vast majority of these deaths are prevent18 able. The Malaria Initiative of President George W. 

19 Bush seeks to reduce dramatically the disease bur20 den of malaria through both prevention and treat21 ment. Paraprofessionals can be instrumental in re22 ducing mortality and economic losses associated with 

23 malaria and other health problems. 

24 (7) For a woman in sub-Saharan Africa, the 

25 lifetime risk of maternal death is 1 out of 16. In 


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1 highly developed countries, that risk is 1 out of 

2 2,800. Increasing access to skilled birth attendants 

3 is essential to reducing maternal and newborn mor4 tality in sub-Saharan Africa. 

5 (8) The Second Annual Report to Congress on 

6 the progress of the President’s Emergency Plan for 

7 AIDS Relief identifies the strengthening of essential 

8 health care systems through health care networks 

9 and infrastructure development as critical to the 

10 sustainability of funded assistance by the United 

11 States Government and states that ‘‘outside re12 sources for HIV/AIDS and other development efforts 

13 must be focused on transformational initiatives that 

14 are owned by host nations’’. This report further 

15 states, ‘‘Alongside efforts to support community ca16 pacity-building, enhancing the capacity of health 

17 care and other systems is also crucial for sustain18 ability. Among the obstacles to these efforts in many 

19 nations are inadequate human resources and capac20 ity, limited institutional capacity, and systemic 

21 weaknesses in areas such as: quality assurance; fi22 nancial management and accounting; health net23 works and infrastructure; and commodity distribu24 tion and control.’’. 


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1 (9) Vertical disease control programs represent 

2 vital components of United States foreign assistance 

3 policy, but human resources for health planning and 

4 management often demands a more systematic ap5 proach. 

6 (10) Implementation of capacity-building initia7 tives to promote more effective human resources 

8 management and development may require an ex9 tended horizon to produce measurable results, but 

10 such efforts are critical to fulfillment of many inter11 nationally recognized objectives in global health. 

12 (11) The November 2005 report of the Working 

13 Group on Global Health Partnerships for the High 

14 Level Forum on the Health Millennium Development 

15 Goals entitled ‘‘Best Practice Principles for Global 

16 Health Partnership Activities at Country Level’’, 

17 raises the concern that the collective impact of var18 ious global health programs now risks ‘‘undermining 

19 the sustainability of national development plans, dis20 torting national priorities, diverting scarce human 

21 resources and/or establishing uncoordinated service 

22 delivery structures’’ in developing countries. This 

23 risk underscores the need to coordinate international 

24 donor efforts for these vital programs with one an25 other and with recipient countries. 


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1 (12) The emigration of significant numbers of 

2 trained health care professionals from sub-Saharan 

3 African countries to the United States and other 

4 wealthier countries exacerbates often severe short5 ages of health care workers, undermines economic 

6 development efforts, and undercuts national and 

7 international efforts to improve access to essential 

8 health services in the region. 

9 (13) Addressing this problem, commonly re10 ferred to as ‘‘brain drain’’, will require increased in11 vestments in the health sector by sub-Saharan Afri12 can governments and by international partners seek13 ing to promote economic development and improve 

14 health care and mortality outcomes in the region. 

15 (14) Virtually every country in the world, in16 cluding the United States, is experiencing a shortage 

17 of health workers. The Joint Learning Initiative on 

18 Human Resources for Health and Development esti19 mates that the global shortage exceeds 4,000,000 

20 workers. Shortages in sub-Saharan Africa, however, 

21 are far more acute than in any other region of the 

22 world. The World Health Report, 2006, states that 

23 ‘‘[t]he exodus of skilled professionals in the midst of 

24 so much unmet health need places Africa at the 

25 epicentre of the global health workforce crisis.’’. 


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1 (15) Ambassador Randall Tobias, now the Di2 rector of United States Foreign Assistance and Ad3 ministrator of the United States Agency for Inter4 national Development, has stated that there are 

5 more Ethiopian trained doctors practicing in Chi6 cago than in Ethiopia. 

7 (16) According to the United Nations Develop8 ment Programme, Human Development Report 

9 2003, approximately 3 out of 4 countries in sub-Sa10 haran Africa have fewer than 20 physicians per 

11 100,000 people, the minimum ratio recommended by 

12 the World Health Organization, and 13 countries 

13 have 5 or fewer physicians per 100,000 people. 

14 (17) Nurses play particularly important roles in 

15 sub-Saharan African health care systems, but approximately 1 16 ⁄4 of sub-Saharan African countries 

17 have fewer than 50 nurses per 100,000 people or 

less than 1 18 ⁄2 the staffing levels recommended by the 

19 World Health Organization. 

20 (18) Paraprofessionals can be trained more 

21 quickly than nurses or doctors and are critically 

22 needed in sub-Saharan Africa to meet immediate 

23 health care needs. 

24 (19) Imbalances in the distribution of countries’ 

25 health workforces represents a global problem, but 


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1 the impact is particularly acute in sub-Saharan Afri2 ca. 

3 (20) In Malawi, for example, more than 95 per4 cent of clinical officers are in urban health facilities, 

5 and about 25 percent of nurses and 50 percent of 

6 physicians are in the 4 central hospitals of Malawi. 

7 Yet the population of Malawi is estimated to be 87 

8 percent rural. 

9 (21) In parts of sub-Saharan Africa, such as 

10 Kenya, thousands of qualified health professionals 

11 are employed outside the health care field or are un12 employed despite job openings in the health sector in 

13 rural areas because poor working and living condi14 tions, including poor educational opportunities for 

15 children, transportation, and salaries, make such 

16 openings unattractive to candidates. 

17 (22) The 2002 National Security Strategy of 

18 the United States stated, ‘‘The scale of the public 

19 health crisis in poor countries is enormous. In coun20 tries afflicted by epidemics and pandemics like HIV/ 

21 AIDS, malaria, and tuberculosis, growth and devel22 opment will be threatened until these scourges can 

23 be contained. Resources from the developed world 

24 are necessary but will be effective only with honest 


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1 governance, which supports prevention programs and 

2 provides effective local infrastructure.’’. 

3 (23) Public health deficiencies in sub-Saharan 

4 Africa and other parts of the developing world re5 duce global capacities to detect and respond to po6 tential crises, such as an avian flu pandemic. 

7 (24) On September 28, 2005, Secretary of 

8 State Condoleezza Rice declared that ‘‘HIV/AIDS is 

9 not only a human tragedy of enormous magnitude; 

10 it is also a threat to the stability of entire countries 

11 and to the entire regions of the world.’’. 

12 (25) Foreign assistance by the United States 

13 that expands local capacities, provides commodities 

14 or training, or builds on and enhances community15 based and national programs and leadership can in16 crease the impact, efficiency, and sustainability of 

17 funded efforts by the United States. 

18 (26) African health care professionals immi19 grate to the United States for the same set of rea20 sons that have led millions of people to come to this 

21 country, including the desire for freedom, for eco22 nomic opportunity, and for a better life for them23 selves and their children, and the rights and motiva24 tions of these individuals must be respected. 


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1 (27) Helping countries in sub-Saharan Africa 

2 increase salaries and benefits of health care profes3 sionals, improve working conditions, including the 

4 adoption of universal precautions against workplace 

5 infection, improve management of health care sys6 tems and institutions, increase the capacity of health 

7 training institutions, and expand education opportu8 nities will alleviate some of the pressures driving the 

9 migration of health care personnel from sub-Saharan 

10 Africa. 

11 (28) While the scope of the problem of dire 

12 shortfalls of personnel and inadequacies of infra13 structure in the sub-Saharan African health systems 

14 is immense, effective and targeted interventions to 

15 improve working conditions, management, and pro16 ductivity would yield significant dividends in im17 proved health care. 

18 (29) Failure to address the shortage of health 

19 care professionals and paraprofessionals, and the 

20 factors pushing individuals to leave sub-Saharan Af21 rica will undermine the objectives of United States 

22 development policy and will subvert opportunities to 

23 achieve internationally recognized goals for the 

24 treatment and prevention of HIV/AIDS and other 

25 diseases, in the reduction of child and maternal morVerDate Aug 31 2005 04:16 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3775.IS S3775

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1 tality, and for economic growth and development in 

2 sub-Saharan Africa. 

3 SEC. 4. SENSE OF CONGRESS. 

4 It is the sense of Congress that— 

5 (1) the United States should help sub-Saharan 

6 African countries that have not already done so to 

7 develop national human resource plans within the 

8 context of comprehensive country health plans in9 volving a wide range of stakeholders; 

10 (2) comprehensive, rather than piecemeal ap11 proaches to advance multiple sustainable interven12 tions will better enable countries to plan for the 

13 number of health care workers they need, determine 

14 whether they need to reorganize their health work15 force, integrate workforce planning into an overall 

16 strategy to improve health system performance and 

17 impact, better budget for health care spending, and 

18 improve the delivery of health services in rural and 

19 other underserved areas; 

20 (3) in order to promote systemic, sustainable 

21 change, the United States should seek, where pos22 sible, to strengthen existing national systems in sub23 Saharan African countries to improve national ca24 pacities in areas including fiscal management, train25 ing, recruiting and retention of health workers, disVerDate Aug 31 2005 04:16 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3775.IS S3775

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1 tribution of resources, attention to rural areas, and 

2 education; 

3 (4) because foreign-funded efforts to fight HIV/ 

4 AIDS and other diseases may also draw health per5 sonnel away from the public sector in sub-Saharan 

6 African countries, the policies and programs of the 

7 United States should, where practicable, seek to 

8 work with national and community-based health 

9 structures and seek to promote the general welfare 

10 and enhance infrastructures beyond the scope of a 

11 single disease or condition; 

12 (5) paraprofessionals and community-level 

13 health workers can play a key role in prevention, 

14 care, and treatment services, and in the more equi15 table and effective distribution of health resources, 

16 and should be integrated into national health sys17 tems; 

18 (6) given the current personnel shortages in 

19 sub-Saharan Africa, paraprofessionals represent a 

20 critical potential workforce in efforts to reduce the 

21 burdens of malaria, tuberculosis, HIV/AIDS, and 

22 other deadly and debilitating diseases; 

23 (7) it is critically important that the govern24 ments of sub-Saharan African countries increase 

25 their own investments in education and health care; 


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1 (8) international financial institutions have an 

2 important role to play in the achievement of inter3 nationally agreed upon health goals, and in helping 

4 countries strike the appropriate balance in encour5 aging effective public investments in the health and 

6 education sectors, particularly as foreign assistance 

7 in these areas scales up, and promoting macro8 economic stability; 

9 (9) public-private partnerships are needed to 

10 promote creative contracts, investments in sub-Saha11 ran African educational systems, codes of conduct 

12 related to recruiting, and other mechanisms to al13 leviate the adverse impacts on sub-Saharan African 

14 countries caused by the migration of health profes15 sionals; 

16 (10) colleges and universities of the United 

17 States, as well as other members of the private sec18 tor, can play a significant role in promoting training 

19 in medicine and public health in sub-Saharan Africa 

20 by establishing or supporting in-country programs in 

21 sub-Saharan Africa through twinning programs with 

22 educational institutions in sub-Saharan Africa or 

23 through other in-country mechanisms; 

24 (11) given the substantial numbers of African 

25 immigrants to the United States working in the 


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1 health sector, the United States should enact and 

2 implement measures to permit qualified aliens and 

3 their family members that are legally present in the 

4 United States to work temporarily as health care 

5 professionals in developing countries or in other 

6 emergency situations, as in S. 2611, of the 109th 

7 Congress, as passed by the Senate on May 25, 2006; 

8 (12) the President, acting through the United 

9 States Permanent Representative to the United Na10 tions, should exercise the voice and vote of the 

11 United States— 

12 (A) to ameliorate the adverse impact on 

13 less developed countries of the migration of 

14 health personnel; 

15 (B) to promote voluntary codes of conduct 

16 for recruiters of health personnel; and 

17 (C) to promote respect for voluntary agree18 ments in which individuals, in exchange for in19 dividual educational assistance, have agreed ei20 ther to work in the health field in their home 

21 countries for a given period of time or to repay 

22 such assistance; 

23 (13) the United States, like countries in other 

24 parts of the world, is experiencing a shortage of 

25 medical personnel in many occupational specialties, 


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1 and the shortage is particularly acute in rural and 

2 other underserved areas of the country; and 

3 (14) the United States should expand training 

4 opportunities for health personnel, expand incentive 

5 programs such as student loan forgiveness for Amer6 icans willing to work in underserved areas, and take 

7 other steps to increase the number of health per8 sonnel in the United States. 

9 SEC. 5. ASSISTANCE TO INCREASE HUMAN CAPACITY IN 

10 THE HEALTH SECTOR IN SUB-SAHARAN AFRI11 CA. 

12 Chapter 1 of part I of the Foreign Assistance Act 

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

14 at the end the following new section: 

15 ‘‘SEC. 135. ASSISTANCE TO INCREASE HUMAN CAPACITY IN 

16 THE HEALTH SECTOR IN SUB-SAHARAN AFRI17 CA. 

18 ‘‘(a) ASSISTANCE.— 

19 ‘‘(1) AUTHORITY.—The President is authorized 

20 to provide assistance, including providing assistance 

21 through international or nongovernmental organiza22 tions, for programs in sub-Saharan Africa to im23 prove human health care capacity. 

24 ‘‘(2) TYPES OF ASSISTANCE.—Such programs 

25 should include assistance— 


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1 ‘‘(A) to provide financial and technical as2 sistance to sub-Saharan African countries in de3 veloping and implementing new or strengthened 

4 comprehensive national health workforce plans; 

5 ‘‘(B) to build and improve national and 

6 local capacities and sustainable health systems 

7 management in sub-Saharan African countries, 

8 including financial, strategic, and technical as9 sistance for— 

10 ‘‘(i) fiscal and health personnel man11 agement; 

12 ‘‘(ii) health worker recruitment sys13 tems; 

14 ‘‘(iii) the creation or improvement of 

15 computerized health workforce databases 

16 and other human resource information sys17 tems; 

18 ‘‘(iv) implementation of measures to 

19 reduce corruption in the health sector; and 

20 ‘‘(v) monitoring, evaluation, and qual21 ity assurance in the health field, including 

22 the utilization of national and district-level 

23 mapping of health care systems to deter24 mine capacity to deliver health services; 


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1 ‘‘(C) to train and retain sufficient numbers 

2 of health workers, including paraprofessionals, 

3 to provide essential health services in sub-Saha4 ran African countries, including financing, stra5 tegic technical assistance for— 

6 ‘‘(i) health worker safety and health 

7 care, including HIV/AIDS prevention and 

8 off-site testing and treatment programs for 

9 health workers; 

10 ‘‘(ii) increased capacity for training 

11 health professionals and paraprofessionals 

12 in such subjects as human resources plan13 ning and management, health program 

14 management, and quality improvement; 

15 ‘‘(iii) expanded access to secondary 

16 level math and science education; 

17 ‘‘(iv) expanded capacity for nursing 

18 and medical schools in sub-Saharan Africa, 

19 with particular attention to incentives or 

20 mechanisms to encourage graduates to 

21 work in the health sector in their country 

22 of residence; 

23 ‘‘(v) incentives and policies to increase 

24 retention, including salary incentives; 


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1 ‘‘(vi) modern quality improvement 

2 processes and practices; 

3 ‘‘(vii) continuing education, distance 

4 education, and career development oppor5 tunities for health workers; 

6 ‘‘(viii) mechanisms to promote produc7 tivity within existing and expanding health 

8 workforces; and 

9 ‘‘(ix) achievement of minimum infra10 structure requirements for health facilities, 

11 such as access to clean water; 

12 ‘‘(D) to support sub-Saharan African 

13 countries with financing, technical support, and 

14 personnel, including paraprofessionals and com15 munity-based caregivers, to better meet the 

16 health needs of rural and other underserved 

17 populations by providing incentives to serve in 

18 these areas, and to more equitably distribute 

19 health professionals and paraprofessionals; 

20 ‘‘(E) to support efforts to improve public 

21 health capacities in sub-Saharan Africa through 

22 education, leadership development, and other 

23 mechanisms; 

24 ‘‘(F) to provide technical assistance, equip25 ment, training, and supplies to assist in the imVerDate Aug 31 2005 04:16 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S3775.IS S3775

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1 provement of health infrastructure in sub-Saha2 ran Africa; 

3 ‘‘(G) to promote efforts to improve system4 atically human resource management and devel5 opment as a critical health and development 

6 issue in coordination with specific disease con7 trol programs for sub-Saharan Africa; and 

8 ‘‘(H) to establish a global clearinghouse or 

9 similar mechanism for knowledge sharing re10 garding human resources for health, in con11 sultation, if helpful, with the Global Health 

12 Workforce Alliance. 

13 ‘‘(3) MONITORING AND EVALUATION.— 

14 ‘‘(A) IN GENERAL.—The President shall 

15 establish a monitoring and evaluation system to 

16 measure the effectiveness of assistance by the 

17 United States to improve human health care ca18 pacity in sub-Saharan Africa in order to maxi19 mize the sustainable development impact of as20 sistance authorized under this section and pur21 suant to the strategy required under subsection 

22 (b). 

23 ‘‘(B) REQUIREMENTS.—The monitoring 

24 and evaluation system shall— 


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1 ‘‘(i) establish performance goals for 

2 assistance provided under this section; 

3 ‘‘(ii) establish performance indicators 

4 to be used in measuring or assessing the 

5 achievement of performance goals; 

6 ‘‘(iii) provide a basis for recommenda7 tions for adjustments to the assistance to 

8 enhance the impact of the assistance; and 

9 ‘‘(iv) to the extent feasible, utilize and 

10 support national monitoring and evaluation 

11 systems, with the objective of improved 

12 data collection without the imposition of 

13 unnecessary new burdens. 

14 ‘‘(b) STRATEGY OF THE UNITED STATES.— 

15 ‘‘(1) REQUIREMENT FOR STRATEGY.—Not later 

16 than 180 days after the date of enactment of this 

17 Act, the President shall develop and transmit to the 

18 appropriate congressional committees a strategy for 

19 coordinating, implementing, and monitoring assist20 ance programs for human health care capacity in 

21 sub-Saharan Africa. 

22 ‘‘(2) CONTENT.—The strategy required by 

23 paragraph (1) shall include— 

24 ‘‘(A) a description of a coordinated strat25 egy, including coordination among agencies and 


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1 departments of the Federal Government with 

2 other bilateral and multilateral donors, to pro3 vide the assistance authorized in subsection (a); 

4 ‘‘(B) a description of a coordinated strat5 egy to consult with sub-Saharan African coun6 tries and the African Union on how best to ad7 vance the goals of this Act; and 

8 ‘‘(C) an analysis of how international fi9 nancial institutions can most effectively assist 

10 countries in their efforts to expand and better 

11 direct public spending in the health and edu12 cation sectors in tandem with the anticipated 

13 scale up of international assistance to combat 

14 HIV/AIDS and other health challenges, while 

15 simultaneously helping these countries maintain 

16 prudent fiscal balance. 

17 ‘‘(3) FOCUS OF ANALYSIS.—It is suggested that 

18 the analysis described in paragraph (2)(C) focus on 

19 2 or 3 selected countries in sub-Saharan Africa, in20 cluding, if practical, 1 focus country as designated 

21 under the President’s Emergency Plan for AIDS Re22 lief (authorized by the United States Leadership 

23 Against Global HIV/AIDS, Tuberculosis, and Ma24 laria Act of 2003 (Public Law 108–25)) and 1 coun25 try without such a designation. 


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1 ‘‘(4) CONSULTATION.—The President is encour2 aged to develop the strategy required under para3 graph (1) in consultation with the Secretary of 

4 State, the Administrator for the United States 

5 Agency for International Development, including em6 ployees of its field missions, the Global HIV/AIDS 

7 Coordinator, the Chief Executive Officer of the Mil8 lennium Challenge Corporation, the Secretary of the 

9 Treasury, the Director of the Bureau of Citizenship 

10 and Immigration Services, the Director of the Cen11 ters for Disease Control and Prevention, and other 

12 relevant agencies to ensure coordination within the 

13 Federal Government. 

14 ‘‘(5) COORDINATION.— 

15 ‘‘(A) DEVELOPMENT OF STRATEGY.—To 

16 ensure coordination with national strategies and 

17 objectives and other international efforts, the 

18 President should develop the strategy described 

19 in paragraph (1) by consulting appropriate offi20 cials of the United States Government and by 

21 coordinating with the following: 

22 ‘‘(i) Other donors. 

23 ‘‘(ii) Implementers. 

24 ‘‘(iii) International agencies. 


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1 ‘‘(iv) Nongovernmental organizations 

2 working to increase human health capacity 

3 in sub-Saharan Africa. 

4 ‘‘(v) The World Bank. 

5 ‘‘(vi) The International Monetary 

6 Fund. 

7 ‘‘(vii) The Global Fund to Fight 

8 AIDS, Tuberculosis, and Malaria. 

9 ‘‘(viii) The World Health Organiza10 tion. 

11 ‘‘(ix) The International Labour Orga12 nization. 

13 ‘‘(x) The United Nations Development 

14 Programme. 

15 ‘‘(xi) The United Nations Programme 

16 on HIV/AIDS. 

17 ‘‘(xii) The European Union. 

18 ‘‘(xiii) The African Union. 

19 ‘‘(B) ASSESSMENT AND COMPILATION.— 

20 The President should make the assessments 

21 and compilations required by subsection 

22 (a)(3)(B)(v), in coordination with the entities 

23 listed in subparagraph (A). 

24 ‘‘(c) REPORT.— 


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1 ‘‘(1) IN GENERAL.—Not later than 1 year after 

2 the date on which the President submits the strategy 

3 required in subsection (b), the President shall sub4 mit to the appropriate congressional committees a 

5 report on the implementation of this section. 

6 ‘‘(2) ASSESSMENT OF MECHANISMS FOR

7 KNOWLEDGE SHARING.—The report described in 

8 paragraph (1) shall be accompanied by a document 

9 assessing best practices and other mechanisms for 

10 knowledge sharing about human resources for health 

11 and capacity building efforts to be shared with gov12 ernments of developing countries and others seeking 

13 to promote improvements in human resources for 

14 health and capacity building. 

15 ‘‘(d) DEFINITIONS.—In this section: 

16 ‘‘(1) APPROPRIATE CONGRESSIONAL COMMIT17 TEES.—The term ‘appropriate congressional com18 mittees’ means the Committee on Foreign Relations 

19 and the Committee on Appropriations of the Senate 

20 and the Committee on International Relations and 

21 the Committee on Appropriations of the House of 

22 Representatives. 

23 ‘‘(2) BRAIN DRAIN.—The term ‘brain drain’ 

24 means the emigration of a significant proportion of 

25 a country’s professionals working in the health field 


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1 to wealthier countries, with a resulting loss of per2 sonnel and often a loss in investment in education 

3 and training for the countries experiencing the emi4 gration. 

5 ‘‘(3) HEALTH PROFESSIONAL.—The term 

6 ‘health professional’ means a person whose occupa7 tion or training helps to identify, prevent, or treat 

8 illness or disability. 

9 ‘‘(4) HIV/AIDS.—The term ‘HIV/AIDS’ has 

10 the meaning given such term in section 104A(g) of 

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

12 2151b–2(g)). 

13 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

14 ‘‘(1) IN GENERAL.—There are authorized to be 

15 appropriated to the President to carry out the provi16 sions of this section— 

17 ‘‘(A) $100,000,000 for fiscal year 2007; 

18 ‘‘(B) $150,000,000 for fiscal year 2008; 

19 and 

20 ‘‘(C) $200,000,000 for fiscal year 2009. 

21 ‘‘(2) AVAILABILITY OF FUNDS.—Amounts made 

22 available under paragraph (1) are authorized to re23 main available until expended and are in addition to 


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1 amounts otherwise made available for the purpose of 

2 carrying out this section.’’. 

Æ 


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