I
106TH CONGRESS
2D SESSION
H. R. 4038
To amend the Foreign Assistance Act of 1961 to address the issue of
mother-to-child transmission of human immunodeficiency virus (HIV)
in Africa, Asia, and Latin America.
IN THE HOUSE OF REPRESENTATIVES
MARCH 21, 2000
Mr. JACKSON of Illinois introduced the following bill; which was referred to
the Committee on International Relations
A BILL
To amend the Foreign Assistance Act of 1961 to address
the issue of mother-to-child transmission of human im-
munodeficiency virus (HIV) in Africa, Asia, and Latin
America.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Mother-to-Child HIV
Prevention Act of 2000’’.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) According to UNAIDS, nearly 4,500,000
children under 15 years of age have been infected
with the human immunodeficiency virus (HIV) since
the AIDS epidemic began. More than 3,000,000
have already died of AIDS. Children are becoming
infected at about the rate of 1 child every minute,
and the overwhelming majority of these children ac-
quire the infection from their mothers.
(2) The gap between rich and poor countries in
terms of transmission of HIV from mother to child
has been increasing. Moreover, AIDS threatens to
reverse years of steady progress of child survival in
developing countries. UNAIDS believes that by the
year 2010, AIDS may have increased mortality of
children under 5 years of age by more than 100 per-
cent in regions most affected by the virus.
(3) The discovery of a relatively simple and
cheap means of interrupting the transmission of
HIV from an infected mother to the unborn child—
namely with nevirapine (NVP), which costs US$4 a
tablet—has created a great opportunity for an un-
precedented partnership between the United States
Government and the governments of Asian, African
and Latin American countries to combat mother-to-
child transmission (also known as ‘‘vertical trans-
mission’’) of HIV.
(4) According to UNAIDS, this strategy will
decrease the proportion of orphans that are HIV-in-
fected and decrease infant and child mortality rates
in these developing regions.
(5) USAID, UNAIDS, and UNICEF are en-
gaged in 11 pilot projects around the world. These
studies will be completed within the year, and the
technical and ethical questions associated with
antiretroviral prevention strategies will be mastered
well enough in order for a significant increase in
scale to be undertaken.
(6) Primary prevention strategies should re-
main the top priority in the fight against AIDS and
no funds should be diverted away from it. Therefore,
new funding for vertical transmission should only be
additive in nature. Once appropriated, this funding
will facilitate widespread delivery of antiretroviral
strategies to address the vertical transmission prob-
lem.
(7) New antiretroviral drug strategy can be a
force for social change, providing the opportunity
and impetus needed to tackle often long-standing
problems of inadequate services and the profound
stigma associated with HIV-infection and the AIDS
disease. Strengthening the health infrastructure to
improve mother-and-child health, antenatal, delivery
and postnatal services, and couples counseling gen-
erates enormous spillover effects toward combating
the AIDS epidemic in developing regions.
SEC. 3. ASSISTANCE FOR PREVENTION OF VERTICAL
TRANSMISSION.
Section 104(c) of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b(c)) is amended by adding at the end
the following new paragraph:
‘‘(4)(A) Congress recognizes the growing inter-
national dilemma of children with the human immuno-
deficiency virus (HIV) and the merits of intervention pro-
grams aimed at this problem. Congress further recognizes
that mother-to-child transmission prevention strategies
can serve as a major force for change in developing re-
gions, and it is, therefore, a major objective of the foreign
assistance program to control the AIDS epidemic. The
agency primarily responsible for administering this part
shall—
‘‘(i) coordinate with UNAIDS, UNICEF,
WHO, local governments, and other organizations to
develop and implement effective strategies to prevent
vertical transmission of HIV; and
‘‘(ii) coordinate with those organizations to in-
crease in scale intervention programs and introduce
voluntary counseling and testing, antiretroviral
drugs, replacement feeding, and other strategies
more widely in due course.
‘‘(B) In addition to amounts otherwise available for
such purpose, there are authorized to be appropriated to
the President, $25,000,000 for each of the fiscal years
2001 through 2005 to be used to carry out this paragraph.
Funds appropriated under this paragraph are authorized
to remain available until expended.’’.
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