H. R. 5501—26 
Systems 2020’ project. Recognizing that human and institutional 
capacity form the core of any health care system that can sustain 
the fight against HIV/AIDS, tuberculosis, and malaria, the plan 
shall include a strategy to encourage postsecondary educational 
institutions in partner countries, particularly in Africa, in collabora-
tion with United States postsecondary educational institutions, 
including historically black colleges and universities, to develop 
such human and institutional capacity and in the process further 
build their capacity to sustain the fight against these diseases.’’. 
(b) CLERICAL AMENDMENT.—The table of contents for the United 
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria 
Act of 2003 (22 U.S.C. 7601 note) is amended by inserting after 
the item relating to section 203, as added by section 203 of this 
Act, the following: 
‘‘Sec. 204. Combating HIV/AIDS, tuberculosis, and malaria by strengthening health 
policies and health systems of partner countries.’’. 
SEC. 205. FACILITATING EFFECTIVE OPERATIONS OF THE CENTERS 
FOR DISEASE CONTROL. 
Section 307 of the Public Health Service Act (42 U.S.C. 242l) 
is amended— 
(1) by amending subsection (a) to read as follows: 
‘‘(a) The Secretary may participate with other countries in 
cooperative endeavors in— 
‘‘(1) biomedical research, health care technology, and the 
health services research and statistical analysis authorized 
under section 306 and title IX; and 
‘‘(2) biomedical research, health care services, health care 
research, or other related activities in furtherance of the activi-
ties, objectives or goals authorized under the Tom Lantos and 
Henry J. Hyde United States Global Leadership Against HIV/ 
AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008.’’; 
and 
(2) in subsection (b)— 
(A) in paragraph (7), by striking ‘‘and’’ after the semi-
colon at the end; 
(B) by striking ‘‘The Secretary may not, in the exercise 
of his authority under this section, provide financial assist-
ance for the construction of any facility in any foreign 
country.’’ 
(C) in paragraph (8), by striking ‘‘for any purpose.’’ 
and inserting ‘‘for the purpose of any law administered 
by the Office of Personnel Management;’’; and 
(D) by adding at the end the following: 
‘‘(9) provide such funds by advance or reimbursement to 
the Secretary of State, as may be necessary, to pay the costs 
of acquisition, lease, construction, alteration, equipping, fur-
nishing or management of facilities outside of the United States; 
and 
‘‘(10) in consultation with the Secretary of State, through 
grant or cooperative agreement, make funds available to public 
or nonprofit private institutions or agencies in foreign countries 
in which the Secretary is participating in activities described 
under subsection (a) to acquire, lease, construct, alter, or ren-
ovate facilities in those countries.’’. 
(3) in subsection (c)— 
(A) by striking ‘‘1990’’ and inserting ‘‘1980’’; and
H. R. 5501—27 
(B) by inserting or ‘‘or section 903 of the Foreign 
Service Act of 1980 (22 U.S.C. 4083)’’ after ‘‘Code’’. 
SEC. 206. FACILITATING VACCINE DEVELOPMENT. 
(a) TECHNICAL ASSISTANCE FOR DEVELOPING COUNTRIES.—The 
Administrator of the United States Agency for International 
Development, utilizing public-private partners, as appropriate, and 
working in coordination with other international development agen-
cies, is authorized to strengthen the capacity of developing countries’ 
governmental institutions to— 
(1) collect evidence for informed decision-making and 
introduction of new vaccines, including potential HIV/AIDS, 
tuberculosis, and malaria vaccines, if such vaccines are deter-
mined to be safe and effective; 
(2) review protocols for clinical trials and impact studies 
and improve the implementation of clinical trials; and 
(3) ensure adequate supply chain and delivery systems. 
(b) ADVANCED MARKET COMMITMENTS.— 
(1) PURPOSE.—The purpose of this subsection is to improve 
global health by requiring the United States to participate 
in negotiations for advance market commitments for the 
development of future vaccines, including potential vaccines 
for HIV/AIDS, tuberculosis, and malaria. 
(2) NEGOTIATION
REQUIREMENT.—The Secretary of the 
Treasury shall enter into negotiations with the appropriate 
officials of the International Bank of Reconstruction and 
Development (World Bank) and the GAVI Alliance, the member 
nations of such entities, and other interested parties to establish 
advanced market commitments to purchase vaccines to combat 
HIV/AIDS, tuberculosis, malaria, and other related infectious 
diseases. 
(3) REQUIREMENTS.—In negotiating the United States 
participation in programs for advanced market commitments, 
the Secretary of the Treasury shall take into account whether 
programs for advance market commitments include— 
(A) legally binding contracts for product purchase that 
include a fair market price for up to a maximum number 
of treatments, creating a strong market incentive; 
(B) clearly defined and transparent rules of program 
participation for qualified developers and suppliers of the 
product; 
(C) clearly defined requirements for eligible vaccines 
to ensure that they are safe and effective and can be 
delivered in developing country contexts; 
(D) dispute settlement mechanisms; and 
(E) sufficient flexibility to enable the contracts to be 
adjusted in accord with new information related to pro-
jected market size and other factors while still maintaining 
the purchase commitment at a fair price. 
(4) REPORT.—Not later than 1 year after the date of the 
enactment of this Act— 
(A) the Secretary of the Treasury shall submit a report 
to the appropriate congressional committees on the status 
of the United States negotiations to participate in programs 
for the advanced market commitments under this sub-
section; and
H. R. 5501—28 
(B) the President shall produce a comprehensive report, 
written by a study group of qualified professionals from 
relevant Federal agencies and initiatives, nongovernmental 
organizations, and industry representatives, that sets forth 
a coordinated strategy to accelerate development of vac-
cines for infectious diseases, such as HIV/AIDS, malaria, 
and tuberculosis, which includes— 
(i) initiatives to create economic incentives for the 
research, development, and manufacturing of vaccines 
for HIV/AIDS, tuberculosis, malaria, and other infec-
tious diseases; 
(ii) an expansion of public-private partnerships and 
the leveraging of resources from other countries and 
the private sector; and 
(iii) efforts to maximize United States capabilities 
to support clinical trials of vaccines in developing coun-
tries and to address the challenges of delivering vac-
cines in developing countries to minimize delays in 
access once vaccines are available. 
TITLE III—BILATERAL EFFORTS 
Subtitle A—General Assistance and 
Programs 
SEC. 301. ASSISTANCE TO COMBAT HIV/AIDS. 
(a) AMENDMENTS TO THE FOREIGN ASSISTANCE ACT OF 1961.— 
(1) FINDING.—Section 104A(a) of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151b–2(a)) is amended by inserting 
‘‘Central Asia, Eastern Europe, Latin America’’ after ‘‘Carib-
bean,’’. 
(2) POLICY.—Section 104A(b) of such Act is amended to 
read as follows: 
‘‘(b) POLICY.— 
‘‘(1) OBJECTIVES.—It is a major objective of the foreign 
assistance program of the United States to provide assistance 
for the prevention and treatment of HIV/AIDS and the care 
of those affected by the disease. It is the policy objective of 
the United States, by 2013, to— 
‘‘(A) assist partner countries to— 
‘‘(i) prevent 12,000,000 new HIV infections world-
wide; 
‘‘(ii) support— 
‘‘(I) the increase in the number of individuals 
with HIV/AIDS receiving antiretroviral treatment 
above the goal established under section 402(a)(3) 
and increased pursuant to paragraphs (1) through 
(3) of section 403(d); and 
‘‘(II) additional treatment through coordinated 
multilateral efforts; 
‘‘(iii) support care for 12,000,000 individuals 
infected with or affected by HIV/AIDS, including 
5,000,000 orphans and vulnerable children affected by
H. R. 5501—29 
HIV/AIDS, with an emphasis on promoting a com-
prehensive, coordinated system of services to be 
integrated throughout the continuum of care; 
‘‘(iv) provide at least 80 percent of the target popu-
lation with access to counseling, testing, and treatment 
to prevent the transmission of HIV from mother-to- 
child; 
‘‘(v) provide care and treatment services to children 
with HIV in proportion to their percentage within the 
HIV-infected population of a given partner country; 
and 
‘‘(vi) train and support retention of health care 
professionals, paraprofessionals, and community health 
workers in HIV/AIDS prevention, treatment, and care, 
with the target of providing such training to at least 
140,000 new health care professionals and paraprofes-
sionals with an emphasis on training and in country 
deployment of critically needed doctors and nurses; 
‘‘(B) strengthen the capacity to deliver primary health 
care in developing countries, especially in sub-Saharan 
Africa; 
‘‘(C) support and help countries in their efforts to 
achieve staffing levels of at least 2.3 doctors, nurses, and 
midwives per 1,000 population, as called for by the World 
Health Organization; and 
‘‘(D) help partner countries to develop independent, 
sustainable HIV/AIDS programs. 
‘‘(2) COORDINATED GLOBAL STRATEGY.—The United States 
and other countries with the sufficient capacity should provide 
assistance to countries in sub-Saharan Africa, the Caribbean, 
Central Asia, Eastern Europe, and Latin America, and other 
countries and regions confronting HIV/AIDS epidemics in a 
coordinated global strategy to help address generalized and 
concentrated epidemics through HIV/AIDS prevention, treat-
ment, care, monitoring and evaluation, and related activities. 
‘‘(3) PRIORITIES.—The United States Government’s response 
to the global HIV/AIDS pandemic and the Government’s efforts 
to help countries assume leadership of sustainable campaigns 
to combat their local epidemics should place high priority on— 
‘‘(A) the prevention of the transmission of HIV; 
‘‘(B) moving toward universal access to HIV/AIDS 
prevention counseling and services; 
‘‘(C) the inclusion of cost sharing assurances that meet 
the requirements under section 110; and 
‘‘(D) the inclusion of transition strategies to ensure 
sustainability of such programs and activities, including 
health care systems, under other international donor sup-
port, or budget support by respective foreign governments.’’. 
(b) AUTHORIZATION.—Section 104A(c) of such Act is amended— 
(1) in paragraph (1), by striking ‘‘and other countries and 
areas.’’ and inserting ‘‘Central Asia, Eastern Europe, Latin 
America, and other countries and areas, particularly with 
respect to refugee populations or those in postconflict settings 
in such countries and areas with significant or increasing HIV 
incidence rates.’’;