where high HIV prevalence rates are compounding 
the risk of starvation for an estimated 14,400,00 
people. 
(13) Tuberculosis is the cause of death for one 
out of every three people with AIDS worldwide and 
is a highly communicable disease. HIV infection is 
the leading threat to tuberculosis control. Because 
HIV infection so severely weakens the immune sys-
tem, individuals with HIV and latent tuberculosis in-
fection have a 100 times greater risk of developing 
active tuberculosis diseases thereby increasing the 
risk of spreading tuberculosis to others. Tuber-
culosis, in turn, accelerates the onset of AIDS in in-
dividuals infected with HIV. 
(14) Malaria, the most deadly of all tropical 
parasitic diseases, has been undergoing a dramatic 
resurgence in recent years due to increasing resist-
ance of the malaria parasite to inexpensive and ef-
fective drugs. At the same time, increasing resist-
ance of mosquitoes to standard insecticides makes 
control of transmission difficult to achieve. The 
World Health Organization estimates that between 
300,000,000 and 500,000,000 new cases of malaria 
occur each year, and annual deaths from the disease 
number between 2,000,000 and 3,000,000. Persons
infected with HIV are particularly vulnerable to the 
malaria parasite. The spread of HIV infection con-
tributes to the difficulties of controlling resurgence 
of the drug resistant malaria parasite. 
(15) HIV/AIDS is first and foremost a health 
problem. Successful strategies to stem the spread of 
the pandemic will require medical interventions, the 
strengthening of health care delivery systems and in-
frastructure, and determined national leadership and 
increased budgetary allocations for the health sector 
in countries affected by the epidemic as well as 
measures to address the social and behavioral causes 
of the problem and its impact on families, commu-
nities, and societal sectors. 
(16) Basic interventions to prevent new HIV in-
fections and to bring care and treatment to people 
living with AIDS, such as voluntary counseling and 
testing and mother-to-child transmission programs, 
are achieving meaningful results and are cost-effec-
tive. The challenge is to expand these interventions 
from a pilot program basis to a national basis in a 
coherent and sustainable manner. 
(17) Appropriate treatment of individuals with 
HIV/AIDS can prolong the lives of such individuals, 
preserve their families, prevent children from becom-
ing orphans, and increase productivity of such indi-
viduals by allowing them to lead active lives and re-
duce the need for costly hospitalization for treatment 
of opportunistic infections caused by HIV. 
(18) Nongovernmental organizations, including 
faith-based organizations, with experience in health 
care and HIV/AIDS counseling, have proven effec-
tive in combating the HIV/AIDS pandemic and can 
be a resource in assisting indigenous organizations 
in severely affected countries in their efforts to pro-
vide treatment and care for individuals infected with 
HIV/AIDS. 
(19) Faith-based organizations are making an 
important contribution to HIV prevention and AIDS 
treatment programs around the world. Successful 
HIV prevention programs in Uganda, Jamaica, and 
elsewhere have included local churches and faith-
based groups in efforts to promote behavior changes 
to prevent HIV, to reduce stigma associated with 
HIV infection, to treat those afflicted with the dis-
ease, and to care for orphans. The Catholic Church 
alone currently cares for one in four people being 
treated for AIDS worldwide. Faith-based organiza-
tions possess infrastructure, experience, and knowl-
edge that will be needed to carry out these programs
in the future and should be an integral part of 
United States efforts. 
(20)(A) Uganda has experienced the most sig-
nificant decline in HIV rates of any country in Afri-
ca, including a decrease among pregnant women 
from 20.6 percent in 1991 to 7.9 percent in 2000. 
(B) Uganda made this remarkable turnaround 
because President Yoweri Museveni spoke out early, 
breaking long-standing cultural taboos, and changed 
widespread perceptions about the disease. His lead-
ership stands as a model for ways political leaders 
in Africa and other developing countries can mobi-
lize their nations, including civic organizations, pro-
fessional associations, religious institutions, business 
and labor to combat HIV/AIDS. 
(C) Uganda’s successful AIDS treatment and 
prevention program is referred to as the ABC model: 
‘‘Abstain, Be faithful, use Condoms’’, in order of 
priority. Jamaica, Zambia, Ethiopia and Senegal 
have also successfully used the ABC model. Begin-
ning in 1986, Uganda brought about a fundamental 
change in sexual behavior by developing a low-cost
program with the message: ‘‘Stop having multiple 
partners. Be faithful. Teenagers, wait until you are 
married before you begin sex.’’.
(D) By 1995, 95 percent of Ugandans were re-
porting either one or zero sexual partners in the 
past year, and the proportion of sexually active 
youth declined significantly from the late 1980s to 
the mid-1990s. The greatest percentage decline in 
HIV infections and the greatest degree of behavioral 
change occurred in those 15 to 19 years old. Ugan-
da’s success shows that behavior change, through 
the use of the ABC model, is a very successful way 
to prevent the spread of HIV. 
(21) The magnitude and scope of the HIV/
AIDS crisis demands a comprehensive, long-term, 
international response focused upon addressing the 
causes, reducing the spread, and ameliorating the 
consequences of the HIV/AIDS pandemic, includ-
ing—
(A) prevention and education, care and 
treatment, basic and applied research, and 
training of health care workers, particularly at 
the community and provincial levels, and other 
community workers and leaders needed to cope 
with the range of consequences of the HIV/
AIDS crisis; 
(B) development of health care infrastruc-
ture and delivery systems through cooperative
and coordinated public efforts and public and 
private partnerships; 
(C) development and implementation of 
national 
and 
community-based 
multisector 
strategies that address the impact of HIV/
AIDS on the individual, family, community, and 
nation and increase the participation of at-risk 
populations in programs designed to encourage 
behavioral and social change and reduce the 
stigma associated with HIV/AIDS; and 
(D) coordination of efforts between inter-
national organizations such as the Global Fund 
to Fight AIDS, Tuberculosis and Malaria, the 
Joint United Nations Programme on HIV/
AIDS (UNAIDS), the World Health Organiza-
tion (WHO), national governments, and private 
sector organizations, including faith-based orga-
nizations. 
(22) The United States has the capacity to lead 
and enhance the effectiveness of the international 
community’s response by—
(A) providing substantial financial re-
sources, technical expertise, and training, par-
ticularly of health care personnel and commu-
nity workers and leaders;
(B) promoting vaccine and microbicide re-
search and the development of new treatment 
protocols in the public and commercial pharma-
ceutical research sectors; 
(C) making available pharmaceuticals and 
diagnostics for HIV/AIDS therapy; 
(D) encouraging governments and commu-
nity-based organizations to adopt policies that 
treat HIV/AIDS as a multisectoral problem af-
fecting not only health but other areas such as 
agriculture, education, the economy, the family 
and society, and assisting them to develop and 
implement programs corresponding to these 
needs; 
(E) promoting healthy lifestyles, including 
delaying sexual debut, monogamy, marriage, 
faithfulness, use of condoms, and avoiding sub-
stance abuse; and 
(F) encouraging active involvement of the 
private sector, including businesses, pharma-
ceutical and biotechnology companies, the med-
ical and scientific communities, charitable foun-
dations, private and voluntary organizations 
and nongovernmental organizations, faith-based
organizations, community-based organizations, 
and other nonprofit entities. 
(23) Strong coordination must exist among the 
various agencies of the United States to ensure ef-
fective and efficient use of financial and technical re-
sources within the United States Government with 
respect to the provision of international HIV/AIDS 
assistance. 
(24) In his address to Congress on January 28, 
2003, the President announced the Administration’s 
intention to embark on a five-year emergency plan 
for AIDS relief, to confront HIV/AIDS with the 
goals of preventing 7,000,000 new HIV/AIDS infec-
tions, treating at least 2,000,000 people with life-ex-
tending drugs, and providing humane care for mil-
lions of people suffering from HIV/AIDS, and for 
children orphaned by HIV/AIDS. 
(25) In this address to Congress, the President 
stated the following: ‘‘Today, on the continent of Af-
rica, nearly 30,000,000 people have the AIDS 
virus—including 3,000,000 children under the age of 
15. There are whole countries in Africa where more 
than one-third of the adult population carries the in-
fection. More than 4,000,000 require immediate 
drug treatment. Yet across that continent, only
50,000 AIDS victims—only 50,000—are receiving 
the medicine they need.’’. 
(26) Furthermore, the President focused on 
care and treatment of HIV/AIDS in his address to 
Congress, stating the following: ‘‘Because the AIDS 
diagnosis is considered a death sentence, many do 
not seek treatment. Almost all who do are turned 
away. A doctor in rural South Africa describes his 
frustration. He says, ‘We have no medicines. Many 
hospitals tell people, you’ve got AIDS, we can’t help 
you. Go home and die.’ In an age of miraculous 
medicines, no person should have to hear those 
words. AIDS can be prevented. Anti-retroviral drugs 
can extend life for many years. And the cost of those 
drugs has dropped from $12,000 a year to under 
$300 a year—which places a tremendous possibility 
within our grasp. Ladies and gentlemen, seldom has 
history offered a greater opportunity to do so much 
for so many.’’. 
(27) Finally, the President stated that ‘‘[w]e 
have confronted, and will continue to confront, HIV/
AIDS in our own country’’, proposing now that the
United States should lead the world in sparing inno-
cent people from a plague of nature, and asking 
Congress ‘‘to commit $15,000,000,000 over the next
five years, including nearly $10,000,000,000 in new 
money, to turn the tide against AIDS in the most 
afflicted nations of Africa and the Caribbean’’. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) AIDS.—The term ‘‘AIDS’’ means the ac-
quired immune deficiency syndrome. 
(2) APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.—The term ‘‘appropriate congressional com-
mittees’’ means the Committee on Foreign Relations 
of the Senate and the Committee on International 
Relations of the House of Representatives. 
(3) GLOBAL FUND.—The term ‘‘Global Fund’’ 
means the public-private partnership known as the 
Global Fund to Fight AIDS, Tuberculosis and Ma-
laria established pursuant to Article 80 of the Swiss 
Civil Code. 
(4) HIV.—The term ‘‘HIV’’ means the human 
immunodeficiency virus, the pathogen that causes 
AIDS. 
(5) 
HIV/AIDS.—The 
term 
‘‘HIV/AIDS’’ 
means, with respect to an individual, an individual 
who is infected with HIV or living with AIDS. 
(6) RELEVANT
EXECUTIVE
BRANCH
AGEN-
CIES.—The term ‘‘relevant executive branch agen-
cies’’ means the Department of State, the United 
States Agency for International Development, and 
any other department or agency of the United States 
that participates in international HIV/AIDS activi-
ties pursuant to the authorities of such department 
or agency or the Foreign Assistance Act of 1961. 
SEC. 4. PURPOSE. 
The purpose of this Act is to strengthen United 
States leadership and the effectiveness of the United 
States response to certain global infectious diseases by—
(1) establishing a comprehensive, integrated 
five-year, global strategy to fight HIV/AIDS that en-
compasses a plan for phased expansion of critical 
programs and improved coordination among relevant 
executive branch agencies and between the United 
States and foreign governments and international 
organizations; 
(2) providing significant resources for multilat-
eral efforts to fight HIV/AIDS; 
(3) providing increased resources for United 
States bilateral efforts, particularly for technical as-
sistance and training, to combat HIV/AIDS, tuber-
culosis, and malaria;
(4) encouraging the expansion of private sector 
efforts and expanding public-private sector partner-
ships to combat HIV/AIDS; and 
(5) intensifying efforts to support the develop-
ment of vaccines and treatment for HIV/AIDS, tu-
berculosis, and malaria. 
SEC. 5. AUTHORITY TO CONSOLIDATE AND COMBINE RE-
PORTS. 
With respect to the reports required by this Act to 
be submitted by the President, to ensure an efficient use 
of resources, the President may, in his discretion and not-
withstanding any other provision of this Act, consolidate 
or combine any of these reports, except for the report re-
quired by section 101 of this Act, so long as the required 
elements of each report are addressed and reported within 
a 90-day period from the original deadline date for sub-
mission of the report specified in this Act. The President 
may also enter into contracts with organizations with rel-
evant expertise to develop, originate, or contribute to any 
of the reports required by this Act to be submitted by the 
President.
TITLE I—POLICY PLANNING AND 
COORDINATION 
SEC. 101. DEVELOPMENT OF A COMPREHENSIVE, FIVE-
YEAR, GLOBAL STRATEGY. 
(a) STRATEGY.—The President shall establish a com-
prehensive, integrated, five-year strategy to combat global 
HIV/AIDS that strengthens the capacity of the United 
States to be an effective leader of the international cam-
paign against HIV/AIDS. Such strategy shall—
(1) include specific objectives, multisectoral ap-
proaches, and specific strategies to treat individuals 
infected with HIV/AIDS and to prevent the further 
spread of HIV infections, with a particular focus on 
the needs of families with children, women, young 
people, and children (such as unaccompanied minor 
children and orphans); 
(2) assign priorities for relevant executive 
branch agencies; 
(3) improve coordination among relevant execu-
tive branch agencies, foreign governments, and inter-
national organizations; 
(4) project general levels of resources needed to 
achieve the stated objectives; 
(5) expand public-private partnerships and the 
leveraging of resources; and
(6) maximize United States capabilities in the 
areas of technical assistance and training and re-
search, including vaccine research. 
(b) REPORT.—
(1) IN
GENERAL.—Not later than 270 days 
after the date of enactment of this Act, the Presi-
dent shall submit to the appropriate congressional 
committees a report setting forth the strategy de-
scribed in subsection (a). 
(2) REPORT CONTENTS.—The report required 
by paragraph (1) shall include a discussion of the 
elements described in paragraph (3) and may in-
clude a discussion of additional elements relevant to 
the strategy described in subsection (a). Such dis-
cussion may include an explanation as to why a par-
ticular element described in paragraph (3) is not rel-
evant to such strategy. 
(3) REPORT
ELEMENTS.—The elements re-
ferred to in paragraph (2) are the following: 
(A) The objectives, general and specific, of 
the strategy. 
(B) A description of the criteria for deter-
mining success of the strategy. 
(C) A description of the manner in which 
the strategy will address the fundamental ele-
ments of prevention and education, care, and 
treatment (including increasing access to phar-
maceuticals and to vaccines), research (includ-
ing incentives for vaccine development and new 
protocols), training of health care workers, the 
development of health care infrastructure and 
delivery systems, and the promotion of absti-
nence, monogamy, faithfulness, use of condoms, 
and avoidance of substance abuse. 
(D) A description of the manner in which 
the strategy will promote the development and 
implementation of national and community-
based multisectoral strategies and programs, in-
cluding those designed to enhance leadership 
capacity particularly at the community level. 
(E) A description of the specific strategies 
developed to meet the unique needs of women, 
including the empowerment of women in inter-
personal situations, young people and children, 
including those orphaned by HIV/AIDS and 
those who are victims of the sex trade, rape, 
sexual abuse, assault, and exploitation. 
(F) A description of the programs to be 
undertaken to maximize United States con-
tributions in the areas of technical assistance,
training (particularly of health care workers 
and community-based leaders in affected sec-
tors), and research, including the promotion of 
research on vaccines and microbicides. 
(G) An identification of the relevant execu-
tive branch agencies that will be involved and 
the assignment of priorities to those agencies. 
(H) A description of the role of each rel-
evant executive branch agency and the types of 
programs that the agency will be undertaking. 
(I) A description of the mechanisms that 
will be utilized to coordinate the efforts of the 
relevant executive branch agencies, to avoid du-
plication of efforts, to enhance on-site coordina-
tion efforts, and to ensure that each agency un-
dertakes programs primarily in those areas 
where the agency has the greatest expertise, 
technical capabilities, and potential for success. 
(J) A description of the mechanisms that 
will be utilized to ensure greater coordination 
between the United States and foreign govern-
ments and international organizations including 
the Global Fund, UNAIDS, international finan-
cial institutions, and private sector organiza-
tions.
(K) The level of resources that will be 
needed on an annual basis and the manner in 
which those resources would generally be allo-
cated among the relevant executive branch 
agencies. 
(L) A description of the mechanisms to be 
established for monitoring and evaluating pro-
grams, promoting successful models, and for 
terminating unsuccessful programs. 
(M) A description of the manner in which 
private, nongovernmental entities will factor 
into the United States Government-led effort 
and a description of the type of partnerships 
that will be created to maximize the capabilities 
of these private sector entities and to leverage 
resources. 
(N) A description of the ways in which 
United States leadership will be used to en-
hance the overall international response to the 
HIV/AIDS pandemic and particularly to height-
en the engagement of the member states of the 
G–8 and to strengthen key financial and coordi-
nation mechanisms such as the Global Fund 
and UNAIDS.
(O) A description of the manner in which 
the United States strategy for combating HIV/
AIDS relates to and enhances other United 
States assistance strategies in developing coun-
tries. 
(P) A description of the programs to be 
carried out under the strategy that are specifi-
cally targeted at women and girls to educate 
them about the spread of HIV/AIDS. 
(Q) A description of efforts being made to 
address the unique needs of families with chil-
dren with respect to HIV/AIDS, including ef-
forts to preserve the family unit. 
(R) An analysis of the emigration of criti-
cally important medical and public health per-
sonnel, including physicians, nurses, and super-
visors from sub-Saharan African countries that 
are acutely impacted by HIV/AIDS, including a 
description of the causes, effects, and the im-
pact on the stability of health infrastructures, 
as well as a summary of incentives and pro-
grams that the United States could provide, in 
concert with other private and public sector 
partners and international organizations, to sta-