138 
(6) 
promote 
learning 
and 
accountability 
through monitoring and evaluation; 
(7) accelerate results through research and in-
novation; 
(8) address the health-related challenges posed 
by climate change and other environmental trends; 
and 
(9) safeguard the rights and dignity of health 
workers and patients. 
SEC. 1304. ASSISTANCE FOR HEALTH. 
(a) AUTHORIZATION.—The Administrator is author-
ized to use funds made available under section 1015 to 
further the goal and objectives of this chapter in partner 
countries. 
(b) ACTIVITIES.—Assistance authorized under sub-
section (a) shall include— 
(1) supporting the development, implementa-
tion, monitoring and evaluation of a country’s na-
tional health strategy; 
(2) supporting the recruitment, training, man-
agement, retention, effectiveness and equitable dis-
tribution within each country of skilled health work-
ers; 
(3) facilitating the development of partnerships 
and collaboration with educational and research in-
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stitutions, private corporations, nongovernmental or-
ganizations, multilateral institutions and other do-
nors, both public and private; 
(4) building the capacity of local nongovern-
mental organizations to participate effectively in the 
planning, implementation, monitoring and evaluation 
of health strategies and systems; 
(5) strengthening financial management, ac-
counting, auditing and reporting systems; 
(6) establishing surveillance systems to detect, 
identify, and respond to emerging health threats, in-
cluding monitoring the spread of disease among ani-
mal and plant populations; 
(7) identifying, preparing for and responding to 
health-related threats posed by climate change, pol-
lution and other environmental factors; 
(8) improving the quality and availability of 
health facilities at the national and local level; 
(9) establishing and strengthening procurement 
and supply chain management systems to safely, ef-
ficiently, and equitably distribute medical and lab-
oratory supplies; 
(10) supporting the development and implemen-
tation of national health information systems to se-
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curely track, compile and manage data, with appro-
priate privacy safeguards; 
(11) supporting evidence-based public health 
education initiatives that teach healthy habits and 
behaviors, increase health literacy, and encourage 
better utilization of the health system; 
(12) building government capacity to coordinate 
and harmonize the delivery of health services pro-
vided by various donors; 
(13) developing and improving laboratory re-
search and testing capacity; and 
(14) promoting a legal, policy and regulatory 
framework conducive to the advancement of public 
health and sustainable health care financing. 
(c) PROGRAMS.—Assistance under this chapter in-
cludes programs— 
(1) for child survival and maternal health, as 
described in subchapter A; 
(2) to combat disease, as described in sub-
chapter B; 
(3) for family planning and reproductive health, 
as described in subchapter C; and 
(4) for research, innovation and development of 
health technologies, products and practices to ad-
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vance global health and the objectives of this chap-
ter. 
SEC. 1305. HEALTH PRINCIPLES AND RESTRICTIONS. 
(a) PRINCIPLES.—Funds made available to carry out 
this chapter shall be provided in accordance with the fol-
lowing principles: 
(1) Patients shall be provided with evidence- 
based, high-quality, courteous care that upholds 
internationally recognized human rights and protects 
human dignity. 
(2) Patients shall have their privacy respected 
and the confidentiality of their medical information 
protected to the maximum extent practicable, with 
free access to their own health records. 
(3) Patients shall be provided with accurate 
health information and quality care on an equitable 
basis, without discrimination of any kind, coercion 
or violence, and in a manner that prevents and re-
duces stigma. 
(4) Patients shall have the right to make their 
own decisions about their health, and shall be pro-
vided with relevant, current, medically accurate and 
understandable information concerning preventive 
health, diagnosis, all available treatments, and prog-
nosis, including the risks and benefits of each treat-
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ment and any costs involved, except in emergency 
situations where the patient lacks decisionmaking 
capacity and the need for an intervention is urgent, 
or where there is an imminent risk to public health. 
(5) Patients and individuals participating in 
biomedical research and experimental treatments 
shall do so on a strictly voluntary basis, with valid 
informed consent processes in place, and shall be 
fully advised of potential risks and benefits. 
(b) RESTRICTIONS.—None of the funds made avail-
able to carry out this title may be used— 
(1) to coerce any person to undergo an abor-
tion; 
(2) for the performance of involuntary steriliza-
tion as a method of family planning; or 
(3) to coerce any person to undergo steriliza-
tion. 
(c) DEFINITIONS.—In this section— 
(1) the term ‘‘all available treatments’’ means 
all treatments that are legally available in the part-
ner country; and 
(2) the term ‘‘patients’’ includes the legal 
guardians of minors and persons who are incapaci-
tated. 
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Subchapter A—Child Survival and Maternal 
Health 
SEC. 1311. CHILD SURVIVAL. 
The Administrator is authorized, notwithstanding 
any other provision of law except for this chapter, to use 
funds made available under this chapter for programs to 
reduce child mortality, including the following: 
(1) Increasing access to and utilization of ap-
propriate interventions to treat life-threatening 
childhood illnesses, such as polio, measles, diarrhea, 
and respiratory infections. 
(2) Improving child and maternal nutrition, in-
cluding the delivery of iron, folic acid, zinc, vitamin 
A, iodine, and other key micronutrients and 
macronutrients. 
(3) Preventing the spread of childhood disease 
and improving child nutrition by expanding access to 
clean water, improving sanitation, and promoting 
good hygiene practices. 
(4) Reducing household dangers, including ex-
posure to environmental toxins and indoor smoke 
from cooking fires. 
(5) Strengthening early childhood development, 
including through early nutrition, parenting pro-
grams and early education. 
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(6) Enhancing the quality, availability and sus-
tainability of key child health interventions by im-
proving health care systems, building local capacity, 
and promoting positive health policies. 
SEC. 1312. MATERNAL AND NEWBORN HEALTH. 
The Administrator is authorized, notwithstanding 
any other provision of law except for this chapter, to use 
funds made available under this chapter for programs to 
reduce the mortality of, and improve the health of, moth-
ers and newborns, including the following: 
(1) Strengthening preparation for childbirth 
through education, antenatal care, access to skilled 
birth attendants, preventing, detecting, and treating 
infections, and planning for transport. 
(2) Improving maternal and child nutritional 
status through dietary improvements, nutrition edu-
cation and appropriate micronutrient interventions. 
(3) Actively discouraging, preventing and re-
sponding to harmful behaviors, such as gender-based 
violence, child marriage and female genital cutting. 
(4) Promoting safe delivery, birth spacing, and 
postpartum care, including recognition, referral, and 
treatment of maternal and newborn complications. 
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(5) Promoting healthy practices such as 
breastfeeding, proper rest, good hygiene, and nutri-
tion. 
(6) Preventing and responding to long-term dis-
ability as a result of pregnancy and birth, including 
obstetric fistula and anemia. 
(7) Improving long-term capacity and systems 
of local institutions to provide quality maternal 
health care. 
SEC. 1313. ASSISTANCE FOR ORPHANS AND OTHER VUL-
NERABLE CHILDREN. 
The Administrator is authorized to use funds made 
available under this chapter to provide basic care and serv-
ices for orphans and other vulnerable children, including: 
(1) Enabling community-based organizations to 
provide basic care for orphans and other vulnerable 
children. 
(2) Providing school feeding, including the pur-
chase of local or regional foodstuffs where appro-
priate. 
(3) 
Increasing 
primary 
school 
enrollment 
through the elimination of school fees, where appro-
priate, or other barriers to education while ensuring 
that adequate resources exist for teacher training 
and infrastructure. 
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146 
(4) Providing employment training and related 
services for orphans and other vulnerable children 
who are of legal working age. 
(5) Protecting and promoting the legal and in-
heritance rights of orphans, other vulnerable chil-
dren, and widows, and addressing discrimination 
they often face. 
(6) Providing culturally appropriate psycho-
social support to orphans and other vulnerable chil-
dren. 
(7) Treating orphans and other vulnerable chil-
dren with HIV/AIDS through the provision of phar-
maceuticals, the recruitment and training of individ-
uals to provide pediatric treatment, and the pur-
chase of pediatric-specific technologies. 
(8) Improving the capacity of foreign govern-
ment agencies and nongovernmental organizations to 
prevent child abandonment and provide permanent 
homes through family reunification, guardianship 
and adoptions, consistent with the Hague Conven-
tion on the Protection of Children and Co-operation 
in Respect of Inter-Country Adoption. 
(9) Increasing access to adequate housing and 
reliable, safe drinking water, sanitation, and hygiene 
education and supplies. 
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(10) Integrating gender to ensure the unique 
needs of girl and boy orphans and vulnerable chil-
dren are met. 
Subchapter B—Combating Disease 
SEC. 1321. ASSISTANCE TO COMBAT HIV/AIDS, TUBER-
CULOSIS, AND MALARIA. 
(a) FINDINGS.—Congress finds that— 
(1) the global HIV/AIDS pandemic poses a hu-
manitarian, economic and security crisis of unprece-
dented magnitude that requires urgent and sus-
tained attention; 
(2) worldwide, women of childbearing age ac-
count for more than half of people living with HIV/ 
AIDS; 
(3) tuberculosis is the leading killer of people 
with HIV/AIDS, and the spread of drug resistant 
tuberculosis presents a persistent public health 
threat to the United States; 
(4) malaria imposes an enormous burden on the 
social and economic development of poor countries, 
can be prevented through cost-effective means, and 
can be cured if promptly diagnosed and adequately 
treated; 
(5) the creation of the United States Presi-
dent’s Emergency Plan for AIDS Relief (PEPFAR) 
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148 
in 2003 was the largest commitment by any nation 
to combat a single disease, establishing and expand-
ing the infrastructure necessary to deliver preven-
tion, care, and treatment services in low-resource 
settings; 
(6) due to PEPFAR and multilateral initiatives 
such as the Global Fund to Fight AIDS, Tuber-
culosis and Malaria, significant strides have been 
made in preventing new cases of disease, treating af-
fected persons, training health care workers, and 
educating families and communities; and 
(7) to be most sustainable and have the great-
est positive impact, programs to combat HIV/AIDS, 
tuberculosis and malaria should be coordinated and 
integrated with other global health and health-re-
lated programs, including maternal and child health, 
family planning and reproductive health, nutrition, 
and water, sanitation, and hygiene. 
(b) AUTHORIZATION.—The President is authorized to 
use funds made available under this chapter to— 
(1) carry out the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act 
of 2003 (Public Law 108–25), as amended by this 
Act, and other related laws, including the Tom Lan-
tos and Henry J. Hyde United States Global Lead-
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149 
ership Against HIV/AIDS, Tuberculosis, and Ma-
laria Reauthorization Act of 2008 (Public Law 110– 
293), the Global AIDS and Tuberculosis Relief Act 
of 2000 (Public Law 106–264), and the Inter-
national Malaria Control Act of 2000 (Public Law 
106–570); and 
(2) contribute to the Global Fund to Fight 
AIDS, Tuberculosis and Malaria and the GAVI Alli-
ance. 
(c) OTHER LAWS SUPERSEDED.—The President may 
exercise the authority of subsection (b) notwithstanding 
any other provision of law, except the United States Lead-
ership Against HIV/AIDS, Tuberculosis, and Malaria Act 
of 2003 (Public Law 108–25), as amended by this Act. 
(d) COORDINATION.—Assistance provided under the 
authorities of this section or the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (Public Law 108–25) shall be coordinated with all 
other health-related programs under this chapter and 
chapter 6, and shall be included in the Global Health 
Strategy required under section 1303. 
SEC. 1322. ASSISTANCE TO COMBAT NEGLECTED TROPICAL 
DISEASES. 
(a) FINDINGS.—Congress finds that— 
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(1) more than 1,000,000,000 people worldwide 
suffer from one or more painful, debilitating tropical 
diseases, which disproportionately impact poor and 
rural populations, cause severe sickness and dis-
ability, compromise mental and physical develop-
ment, contribute to childhood malnutrition, reduce 
school enrollment, and hinder economic productivity; 
(2) many of these neglected tropical diseases 
(NTDs) can be controlled and treated by providing 
safe and effective drug treatments, improving access 
to clean water and improved sanitation, and pro-
moting good hygiene practices for individuals in af-
fected communities; and 
(3) an integrated approach to controlling NTDs 
will address a root cause of poverty that affects a 
significant proportion of the world’s population. 
(b) AUTHORIZATION.—The Administrator is author-
ized to use funds made available under this chapter for 
the prevention, treatment, control, and elimination of, and 
research on, neglected tropical diseases. 
SEC. 1323. ASSISTANCE FOR DISEASE PREVENTION, CON-
TROL, AND TREATMENT. 
(a) FINDINGS.—Congress finds that— 
(1) infectious diseases such as avian and pan-
demic influenza not only cause death and debili-
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tating illness in the countries where new strains 
originate, but can quickly spread around the world; 
(2) the development and spread of antimicrobial 
resistance threatens to undermine global efforts to 
control tuberculosis and other bacterial diseases; 
(3) developing countries are undergoing a rapid 
epidemiological transition from infectious diseases 
such as diarrhea and pneumonia to noncommu-
nicable diseases such as cardiovascular disease, can-
cer and diabetes, which threatens to overwhelm their 
strapped health systems and cripple their fragile 
economies; 
(4) mental health is an important but fre-
quently overlooked or stigmatized aspect of health 
that requires effective and compassionate treatment 
and care; 
(5) improvement in the capacity of developing 
countries to obtain and use good quality data for 
surveillance and effective response to emerging 
health threats helps to protect the health of United 
States citizens as well as that of local populations; 
and 
(6) disease-focused interventions are most effec-
tive when they— 
(A) reflect an evidence-based approach; 
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(B) are integrated across health programs 
through a common delivery platform; and 
(C) support increased collaboration and co-
ordination among country-level stakeholders, in-
cluding partner country governments, other 
public and private donors, and international 
and nongovernmental organizations. 
(b) AUTHORIZATION.—The Administrator is author-
ized to use funds made available under this chapter to pro-
vide assistance for the prevention, treatment, control, and 
elimination of, and research on, infectious and noncommu-
nicable diseases in partner countries. 
Subchapter C—Family Planning and 
Reproductive Health 
SEC. 1331. ASSISTANCE FOR FAMILY PLANNING AND RE-
PRODUCTIVE HEALTH. 
(a) FINDINGS.—Congress finds that— 
(1) reproductive health care is essential to re-
ducing poverty, improving living standards and pro-
tecting human dignity; 
(2) throughout much of the world, the lack of 
access by women, particularly poor women, to repro-
ductive health care contributes to death and suf-
fering, limits women’s ability to make decisions that 
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affect their lives, and undermines the efforts of fam-
ilies to lift themselves out of poverty; 
(3) access to reproductive health care, including 
voluntary family planning, has a direct and impor-
tant impact on child mortality, especially infant mor-
tality; 
(4) closely spaced and ill-timed pregnancies and 
births contribute to high infant mortality rates, and 
when mothers die as a result of giving birth, their 
surviving infants have a greater risk of mortality 
and poor health status; 
(5) in many developing countries where there 
are few hospitals, few doctors, and poor transpor-
tation systems, and where women are not highly val-
ued, complications of labor often result in death of 
the mother; 
(6) lack of availability of emergency obstetric 
care, along with delays in seeking medical attention, 
in reaching a medical facility, and in receiving med-
ical care once arriving at a facility, contribute to the 
development of obstetric fistula, increasing the risk 
of death for both mother and child; 
(7) voluntary family planning allows women and 
couples to freely choose the number, timing and 
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spacing of pregnancies, giving families and individ-
uals greater control over their lives; 
(8) young people are particularly at risk of en-
gaging in unsafe sexual practices, and should be pro-
vided with clear and evidence-based information to 
help them make informed decisions about their sex-
ual and reproductive health and human rights, in-
cluding their right to be free from all forms of vio-
lence, coercion and discrimination; 
(9) practices such as child marriage and female 
genital cutting can harm the health of young people 
and deprive them of their dignity and human rights. 
Reproductive health care can play an important role 
in educating people about the dangers of these prac-
tices, and is often the entry point for identification 
of gender-based violence and sexual abuse; 
(10) integrating reproductive health care, in-
cluding voluntary family planning, with HIV preven-
tion programs is critical to combating HIV/AIDS, 
and can assist in decreasing the stigma associated 
with a seropositive HIV status; 
(11) integration of reproductive health care 
with other health-care and related social services in-
creases the effectiveness and efficiency of the health 
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system and meets people’s needs for accessible, ac-
ceptable, convenient, client-centered care; 
(12) international goals and targets for reduc-
ing poverty and improving maternal health require a 
significant investment in family planning and repro-
ductive health care; 
(13) international partnerships are required to 
provide adequate financing for family planning and 
reproductive health care; 
(14) cooperating with multilateral and bilateral 
donors and the private sector can make commodities 
such as antiretrovirals, maternal health equipment, 
and contraceptive supplies more accessible for hard- 
to-reach populations; and 
(15) by investing in reproductive health care, 
including voluntary family planning, the United 
States can improve maternal and child health, lower 
HIV infection rates, reduce poverty and hunger, ad-
vance girls’ education, promote gender equality, 
broaden civic participation in the development proc-
ess, and slow the depletion of natural resources. 
(b) AUTHORIZATION.—The Administrator is author-
ized to use funds made available under this chapter for 
reproductive health care programs, including voluntary 
family planning, in partner countries. 
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SEC. 
1332. 
REPRODUCTIVE 
HEALTH 
CARE 
IN 
EMER-
GENCIES. 
The Administrator is authorized to use funds made 
available under this subchapter and under subtitle B for 
programs to provide reproductive health care during hu-
manitarian emergencies and complex crises, including: 
(1) Life-saving priority activities set out in the 
Sphere Project’s Humanitarian Charter and Min-
imum Standards in Disaster Response. 
(2) Preventing sexual violence and providing 
medical care and psychosocial services to survivors 
of sexual violence. 
(3) Voluntary family planning for the duration 
of displacement. 
CHAPTER 4—EXPANDING QUALITY 
EDUCATION 
SEC. 1401. FINDINGS AND STATEMENT OF POLICY. 
(a) FINDINGS.—Congress finds the following: 
(1) Education is a basic human right, indispen-
sable for human capacity development and poverty 
eradication. 
(2) Basic education is fundamental to develop-
ment. No country has reached sustained economic 
growth without achieving near universal primary 
education. 
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(3) Quality education reduces poverty and in-
equity, lays the foundation for sound governance, 
civic participation, and strong institutions, and 
equips people with the knowledge, skills, and self-re-
liance they need to increase income and expand op-
portunities for employment. 
(4) While developing countries bear the ulti-
mate responsibility for educating their children, the 
United States and others donors can and should do 
more to help developing countries address their edu-
cation needs. 
(5) Investing in girls’ education delivers sub-
stantial returns not only in educational attainment 
but also in increasing women’s and household in-
comes, delaying the start of sexual activity, reducing 
infant mortality, increasing women’s political partici-
pation, spurring economic growth, and delaying mar-
riage. 
(6) Lack of access to adequate housing, safe 
drinking water close to home, and to private latrines 
near home and at school significantly impact girls’ 
attendance and retention at school. 
(7) Education can help to protect children in 
conflict situations from physical harm, exploitation, 
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(c) ACTIVITIES.—Assistance authorized under sub-
section (b) shall include the following: 
(1) INCREASING ENERGY EFFICIENCY.— 
(A) Development of sound national energy 
and electricity plans. 
(B) Improving the efficiency of electricity 
transmission, distribution, and consumption. 
(C) Building local capacity to monitor and 
regulate the energy sector. 
(2) EXPANDING
ACCESS
TO
CLEAN, RENEW-
ABLE ENERGY SOURCES AND TECHNOLOGIES.— 
(A) Improving the availability of renewable 
electricity 
generation 
from 
wind, 
solar, 
sustainably and locally produced biomass, geo-
thermal, marine, or hydrokinetic sources. 
(B) Expanding the deployment of low or 
zero emission technologies. 
(C) Increasing access to clean energy tech-
nologies, especially in rural areas. 
(D) Improving transportation system and 
vehicle efficiency. 
(E) Reducing black carbon emissions, in-
cluding through the use of clean cookstoves. 
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345 
defense article that has been set aside, reserved, or 
otherwise earmarked under the authority of this sec-
tion made available to or for use by a foreign coun-
try described in subsection (a), the President shall 
transmit a notification of the proposed transfer to 
the appropriate congressional committees and to the 
Committees on Armed Services of the House of Rep-
resentatives and the Senate. The notification shall 
identify the items to be transferred and the conces-
sions to be received. 
(2) EXCEPTION.—If the President determines 
that an emergency exists that requires making a de-
fense article available to a foreign country described 
in subsection (a), the President is authorized to 
make such defense article available immediately 
upon notification to the appropriate congressional 
committees. The President shall set forth the rea-
sons for determining that such an emergency exists 
that warrants the immediate use of this authority. 
(c) RULE OF CONSTRUCTION.—No defense article 
transferred from any stockpile which is made available to 
or for use by any foreign country under this section may 
be considered an excess defense article for the purpose of 
determining the value thereof. 
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