off-site testing and treatment programs for 
health workers; 
‘‘(ii) increased capacity for training 
health professionals and paraprofessionals 
in such subjects as human resources plan-
ning and management, health program 
management, and quality improvement; 
‘‘(iii) expanded access to secondary 
level math and science education; 
‘‘(iv) expanded capacity for nursing 
and medical schools in sub-Saharan Africa, 
with particular attention to incentives or 
mechanisms to encourage graduates to 
work in the health sector in their country 
of residence; 
‘‘(v) incentives and policies to increase 
retention, including salary incentives; 
‘‘(vi) modern quality improvement 
processes and practices; 
‘‘(vii) continuing education, distance 
education, and career development oppor-
tunities for health workers; 
‘‘(viii) mechanisms to promote produc-
tivity within existing and expanding health 
workforces; and 
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‘‘(ix) achievement of minimum infra-
structure requirements for health facilities, 
such as access to clean water; 
‘‘(D) to support sub-Saharan African 
countries with financing, technical support, and 
personnel, including paraprofessionals and com-
munity-based caregivers, to better meet the 
health needs of rural and other underserved 
populations by providing incentives to serve in 
these areas, and to more equitably distribute 
health professionals and paraprofessionals; 
‘‘(E) to support efforts to improve public 
health capacities in sub-Saharan Africa through 
education, leadership development, and other 
mechanisms; 
‘‘(F) to provide technical assistance, equip-
ment, training, and supplies to assist in the im-
provement of health infrastructure in sub-Saha-
ran Africa; 
‘‘(G) to promote efforts to improve system-
atically human resource management and devel-
opment as a critical health and development 
issue in coordination with specific disease con-
trol programs for sub-Saharan Africa; and 
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‘‘(H) to establish a global clearinghouse or 
similar mechanism for knowledge sharing re-
garding human resources for health, in con-
sultation, if helpful, with the Global Health 
Workforce Alliance. 
‘‘(3) MONITORING AND EVALUATION.— 
‘‘(A) IN
GENERAL.—The President shall 
establish a monitoring and evaluation system to 
measure the effectiveness of assistance by the 
United States to improve human health care ca-
pacity in sub-Saharan Africa in order to maxi-
mize the sustainable development impact of as-
sistance authorized under this section and pur-
suant to the strategy required under subsection 
(b). 
‘‘(B) REQUIREMENTS.—The monitoring 
and evaluation system shall— 
‘‘(i) establish performance goals for 
assistance provided under this section; 
‘‘(ii) establish performance indicators 
to be used in measuring or assessing the 
achievement of performance goals; 
‘‘(iii) provide a basis for recommenda-
tions for adjustments to the assistance to 
enhance the impact of the assistance; and 
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‘‘(iv) to the extent feasible, utilize and 
support national monitoring and evaluation 
systems, with the objective of improved 
data collection without the imposition of 
unnecessary new burdens. 
‘‘(b) STRATEGY OF THE UNITED STATES.— 
‘‘(1) REQUIREMENT FOR STRATEGY.—Not later 
than 180 days after the date of the enactment of 
this Act, the President shall develop and transmit to 
the appropriate congressional committees a strategy 
for coordinating, implementing, and monitoring as-
sistance programs for human health care capacity in 
sub-Saharan Africa. 
‘‘(2) CONTENT.—The strategy required by 
paragraph (1) shall include— 
‘‘(A) a description of a coordinated strat-
egy, including coordination among agencies and 
departments of the Federal Government with 
other bilateral and multilateral donors, to pro-
vide the assistance authorized in subsection (a); 
‘‘(B) a description of a coordinated strat-
egy to consult with sub-Saharan African coun-
tries and the African Union on how best to ad-
vance the goals of this Act; and 
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‘‘(C) an analysis of how international fi-
nancial institutions can most effectively assist 
countries in their efforts to expand and better 
direct public spending in the health and edu-
cation sectors in tandem with the anticipated 
scale up of international assistance to combat 
HIV/AIDS and other health challenges, while 
simultaneously helping these countries maintain 
prudent fiscal balance. 
‘‘(3) FOCUS OF ANALYSIS.—The analysis de-
scribed in paragraph (2)(C) should focus on 2 or 3 
selected countries in sub-Saharan Africa, including, 
if practical, 1 focus country as designated under the 
President’s Emergency Plan for AIDS Relief (au-
thorized by the United States Leadership Against 
Global HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (Public Law 108–25)) and 1 country without 
such a designation. 
‘‘(4) CONSULTATION.—The President is encour-
aged to develop the strategy required under para-
graph (1) in consultation with the Secretary of 
State, the Administrator for the United States 
Agency for International Development, including em-
ployees of its field missions, the Global HIV/AIDS 
Coordinator, the Chief Executive Officer of the Mil-
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