care programs, recognizing that prevention is of par-
ticular importance; 
‘‘(25) enhance the coordination of United States 
bilateral efforts to combat global HIV/AIDS with 
other major public and private entities; 
‘‘(26) enhance the attention given to the national 
strategic HIV/AIDS plans of countries receiving 
United States assistance by— 
‘‘(A) reviewing the planning and pro-
grammatic decisions associated with that assist-
ance; and 
‘‘(B) helping to strengthen such national 
strategies, if necessary; 
‘‘(27) support activities described in the Global 
Plan to Stop TB, including— 
‘‘(A) expanding and enhancing the coverage 
of the Directly Observed Treatment Short-course 
(DOTS) in order to treat individuals infected 
with tuberculosis and HIV, including multi-drug 
resistant or extensively drug resistant tuber-
culosis; and 
‘‘(B) improving coordination and integra-
tion of HIV/AIDS and tuberculosis program-
ming;
‘‘(28) ensure coordination between the Global 
AIDS Coordinator and the Malaria Coordinator and 
address issues of comorbidity between HIV/AIDS and 
malaria; and 
‘‘(29) include a longer term estimate of the pro-
jected resource needs, progress toward greater sustain-
ability and country ownership of HIV/AIDS pro-
grams, and the anticipated role of the United States 
in the global effort to combat HIV/AIDS during the 
10-year period beginning on October 1, 2013.’’. 
(b) REPORT.—Section 101(b) of such Act (22 U.S.C. 
7611(b)) is amended to read as follows: 
‘‘(b) REPORT.— 
‘‘(1) IN GENERAL.—Not later than October 1, 
2009, the President shall submit a report to the ap-
propriate congressional committees that sets forth the 
strategy described in subsection (a). 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include a discussion of the fol-
lowing elements: 
‘‘(A) The purpose, scope, methodology, and 
general and specific objectives of the strategy. 
‘‘(B) The problems, risks, and threats to the 
successful pursuit of the strategy.
‘‘(C) The desired goals, objectives, activities, 
and outcome-related performance measures of the 
strategy. 
‘‘(D) A description of future costs and re-
sources needed to carry out the strategy. 
‘‘(E) A delineation of United States Govern-
ment roles, responsibility, and coordination 
mechanisms of the strategy. 
‘‘(F) A description of the strategy— 
‘‘(i) to promote harmonization of 
United States assistance with that of other 
international, national, and private actors 
as elucidated in the ‘Three Ones’; and 
‘‘(ii) to address existing challenges in 
harmonization and alignment. 
‘‘(G) A description of the manner in which 
the strategy will— 
‘‘(i) further the development and im-
plementation of the national multisectoral 
strategic HIV/AIDS frameworks of partner 
governments; and 
‘‘(ii) enhance the centrality, effective-
ness, and sustainability of those national 
plans.
‘‘(H) A description of how the strategy will 
seek to achieve the specific targets described in 
subsection (a) and other targets, as appropriate. 
‘‘(I) A description of, and rationale for, the 
timetable for annual global treatment targets 
with country-level estimates of numbers of per-
sons in need of antiretroviral treatment, coun-
try-level benchmarks for United States support 
for assistance for antiretroviral treatment, and 
numbers of persons enrolled in antiretroviral 
treatment programs receiving United States sup-
port. If global benchmarks are not achieved with-
in the reporting period, the report shall include 
a description of steps being taken to ensure that 
global benchmarks will be achieved and a de-
tailed breakdown and justification of spending 
priorities in countries in which benchmarks are 
not being met, including a description of other 
donor or national support for antiretroviral 
treatment in the country, if appropriate. 
‘‘(J) A description of how operations re-
search is addressed in the strategy and how such 
research can most effectively be integrated into 
care, treatment, and prevention activities in 
order to—
‘‘(i) improve program quality and effi-
ciency; 
‘‘(ii) ascertain cost effectiveness; 
‘‘(iii) ensure transparency and ac-
countability; 
‘‘(iv) assess population-based impact; 
‘‘(v) disseminate findings and best 
practices; and 
‘‘(vi) optimize delivery of services. 
‘‘(K) An analysis of United States-assisted 
strategies to prevent the transmission of HIV/ 
AIDS, including methodologies to promote absti-
nence, monogamy, faithfulness, the correct and 
consistent use of male and female condoms, re-
ductions in concurrent sexual partners, and 
delay of sexual debut, and of intended moni-
toring and evaluation approaches to measure the 
effectiveness of prevention programs and ensure 
that they are targeted to appropriate audiences. 
‘‘(L) Within the analysis required under 
subparagraph (K), an examination of additional 
planned means of preventing the transmission of 
HIV including medical male circumcision, 
maintenance of a safe blood supply, public edu-
cation about risks to acquire HIV infection from
blood exposures, promotion of universal pre-
cautions, investigation of suspected nosocomial 
infections and other tools. 
‘‘(M) A description of efforts to assist part-
ner country and community to identify and ad-
dress social, economic, or cultural factors, such 
as migration, urbanization, conflict, gender- 
based violence, lack of empowerment for women, 
and transportation patterns, which directly con-
tribute to the transmission of HIV. 
‘‘(N) A description of the specific targets, 
goals, and strategies developed to address the 
needs and vulnerabilities of women and girls to 
HIV/AIDS, including— 
‘‘(i) activities directed toward men and 
boys; 
‘‘(ii) activities to enhance educational, 
microfinance, and livelihood opportunities 
for women and girls; 
‘‘(iii) activities to promote and protect 
the legal empowerment of women, girls, and 
orphans and vulnerable children; 
‘‘(iv) programs targeted toward gender- 
based violence and sexual coercion;
approach to vulnerability, maximizing com-
munity input into determining which chil-
dren participate. 
‘‘(Q) A description of capacity-building ef-
forts undertaken by countries themselves, includ-
ing adherents of the Abuja Declaration and an 
assessment of the impact of International Mone-
tary Fund macroeconomic and fiscal policies on 
national and donor investments in health. 
‘‘(R) A description of the strategy to— 
‘‘(i) strengthen capacity building with-
in the public health sector; 
‘‘(ii) improve health care in those 
countries; 
‘‘(iii) help countries to develop and im-
plement national health workforce strate-
gies; 
‘‘(iv) strive to achieve goals in train-
ing, retaining, and effectively deploying 
health staff; 
‘‘(v) promote the use of codes of con-
duct for ethical recruiting practices for 
health care workers; and 
‘‘(vi) increase the sustainability of 
health programs.
‘‘(S) A description of the criteria for selec-
tion, objectives, methodology, and structure of 
compacts or other framework agreements with 
countries or regional organizations, including— 
‘‘(i) the role of civil society; 
‘‘(ii) the degree of transparency; 
‘‘(iii) benchmarks for success of such 
compacts or agreements; and 
‘‘(iv) the relationship between such 
compacts or agreements and the national 
HIV/AIDS and public health strategies and 
commitments of partner countries. 
‘‘(T) A strategy to better coordinate HIV/ 
AIDS assistance with nutrition and food assist-
ance programs. 
‘‘(U) A description of transnational or re-
gional 
initiatives 
to 
combat 
regionalized 
epidemics in highly affected areas such as the 
Caribbean. 
‘‘(V) A description of planned resource dis-
tribution and global investment by region. 
‘‘(W) A description of coordination efforts 
in order to better implement the Stop TB Strat-
egy and to address the problem of coinfection of 
HIV/AIDS and tuberculosis and of projected
challenges or barriers to successful implementa-
tion. 
‘‘(X) A description of coordination efforts to 
address malaria and comorbidity with malaria 
and HIV/AIDS.’’. 
(c) STUDY.—Section 101(c) of such Act (22 U.S.C. 
7611(c)) is amended to read as follows: 
‘‘(c) STUDY OF PROGRESS TOWARD ACHIEVEMENT OF 
POLICY OBJECTIVES.— 
‘‘(1) DESIGN AND BUDGET PLAN FOR DATA EVAL-
UATION.—The Global AIDS Coordinator shall enter 
into a contract with the Institute of Medicine of the 
National Academies that provides that not later than 
18 months after the date of the enactment of the Tom 
Lantos and Henry J. Hyde United States Global 
Leadership Against HIV/AIDS, Tuberculosis, and 
Malaria Reauthorization Act of 2008, the Institute, in 
consultation with the Global AIDS Coordinator and 
other relevant parties representing the public and pri-
vate sector, shall provide the Global AIDS Coordi-
nator with a design plan and budget for the evalua-
tion and collection of baseline and subsequent data to 
address the elements set forth in paragraph (2)(B). 
The Global AIDS Coordinator shall submit the budget
and design plan to the appropriate congressional 
committees. 
‘‘(2) STUDY.— 
‘‘(A) IN GENERAL.—Not later than 4 years 
after the date of the enactment of the Tom Lan-
tos and Henry J. Hyde United States Global 
Leadership Against HIV/AIDS, Tuberculosis, 
and Malaria Reauthorization Act of 2008, the 
Institute of Medicine of the National Academies 
shall publish a study that includes— 
‘‘(i) an assessment of the performance 
of United States-assisted global HIV/AIDS 
programs; and 
‘‘(ii) an evaluation of the impact on 
health of prevention, treatment, and care ef-
forts that are supported by United States 
funding, including multilateral and bilat-
eral programs involving joint operations. 
‘‘(B) 
CONTENT.—The 
study 
conducted 
under this paragraph shall include— 
‘‘(i) an assessment of progress toward 
prevention, treatment, and care targets; 
‘‘(ii) an assessment of the effects on 
health systems, including on the financing
and management of health systems and the 
quality of service delivery and staffing; 
‘‘(iii) an assessment of efforts to ad-
dress gender-specific aspects of HIV/AIDS, 
including gender related constraints to ac-
cessing services and addressing underlying 
social and 
economic 
vulnerabilities 
of 
women and men; 
‘‘(iv) an evaluation of the impact of 
treatment and care programs on 5-year sur-
vival rates, drug adherence, and the emer-
gence of drug resistance; 
‘‘(v) an evaluation of the impact of 
prevention programs on HIV incidence in 
relevant population groups; 
‘‘(vi) an evaluation of the impact on 
child health and welfare of interventions au-
thorized under this Act on behalf of orphans 
and vulnerable children; 
‘‘(vii) an evaluation of the impact of 
programs and activities authorized in this 
Act on child mortality; and 
‘‘(viii) recommendations for improving 
the programs referred to in subparagraph 
(A)(i).
‘‘(C) METHODOLOGIES.—Assessments and 
impact evaluations conducted under the study 
shall utilize sound statistical methods and tech-
niques for the behavioral sciences, including ran-
dom assignment methodologies as feasible. Quali-
tative data on process variables should be used 
for assessments and impact evaluations, wherever 
possible. 
‘‘(3) CONTRACT
AUTHORITY.—The Institute of 
Medicine may enter into contracts or cooperative 
agreements or award grants to conduct the study 
under paragraph (2). 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated such sums as 
may be necessary to carry out the study under this 
subsection.’’. 
(d) REPORT.—Section 101 of such Act, as amended by 
this section, is further amended by adding at the end the 
following: 
‘‘(d) COMPTROLLER GENERAL REPORT.— 
‘‘(1) REPORT
REQUIRED.—Not later than 3 
years after the date of the enactment of the Tom Lan-
tos and Henry J. Hyde United States Global Leader-
ship Against HIV/AIDS, Tuberculosis, and Malaria 
Reauthorization Act of 2008, the Comptroller General
of the United States shall submit a report on the glob-
al HIV/AIDS programs of the United States to the 
appropriate congressional committees. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include— 
‘‘(A) a description and assessment of the 
monitoring and evaluation practices and policies 
in place for these programs; 
‘‘(B) an assessment of coordination within 
Federal agencies involved in these programs, ex-
amining both internal coordination within these 
programs and integration with the larger global 
health and development agenda of the United 
States; 
‘‘(C) an assessment of procurement policies 
and practices within these programs; 
‘‘(D) an assessment of harmonization with 
national government HIV/AIDS and public 
health strategies as well as other international 
efforts; 
‘‘(E) an assessment of the impact of global 
HIV/AIDS funding and programs on other 
United States global health programming; and 
‘‘(F) recommendations for improving the 
global HIV/AIDS programs of the United States.
‘‘(e) BEST PRACTICES REPORT.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of the enactment of the Tom Lantos and 
Henry J. Hyde United States Global Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Reau-
thorization Act of 2008, and annually thereafter, the 
Global AIDS Coordinator shall publish a best prac-
tices report that highlights the programs receiving fi-
nancial assistance from the United States that have 
the potential for replication or adaption, particularly 
at a low cost, across global AIDS programs, including 
those that focus on both generalized and localized 
epidemics. 
‘‘(2) DISSEMINATION OF FINDINGS.— 
‘‘(A) 
PUBLICATION
ON
INTERNET 
WEBSITE.—The Global AIDS Coordinator shall 
disseminate the full findings of the annual best 
practices report on the Internet website of the Of-
fice of the Global AIDS Coordinator. 
‘‘(B) 
DISSEMINATION
GUIDANCE.—The 
Global AIDS Coordinator shall develop guidance 
to ensure timely submission and dissemination 
of significant information regarding best prac-
tices with respect to global AIDS programs. 
‘‘(f) INSPECTORS GENERAL.—
‘‘(1) OVERSIGHT PLAN.— 
‘‘(A) DEVELOPMENT.—The Inspectors Gen-
eral of the Department of State and Broad-
casting Board of Governors, the Department of 
Health and Human Services, and the United 
States Agency for International Development 
shall jointly develop 5 coordinated annual plans 
for oversight activity in each of the fiscal years 
2009 through 2013, with regard to the programs 
authorized under this Act and sections 104A, 
104B, and 104C of the Foreign Assistance Act of 
1961 (22 U.S.C. 2151b–2, 2151b–3, and 2151b– 
4). 
‘‘(B) 
CONTENTS.—The 
plans 
developed 
under subparagraph (A) shall include a schedule 
for financial audits, inspections, and perform-
ance reviews, as appropriate. 
‘‘(C) DEADLINE.— 
‘‘(i) INITIAL PLAN.—The first plan de-
veloped under subparagraph (A) shall be 
completed not later than the later of— 
‘‘(I) September 1, 2008; or 
‘‘(II) 60 days after the date of the 
enactment of the Tom Lantos and 
Henry J. Hyde United States Global
Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Reauthorization 
Act of 2008. 
‘‘(ii) SUBSEQUENT
PLANS.—Each of 
the last four plans developed under subpara-
graph (A) shall be completed not later than 
30 days before each of the fiscal years 2010 
through 2013, respectively. 
‘‘(2) COORDINATION.—In order to avoid duplica-
tion and maximize efficiency, the Inspectors General 
described in paragraph (1) shall coordinate their ac-
tivities with— 
‘‘(A) the Government Accountability Office; 
and 
‘‘(B) the Inspectors General of the Depart-
ment of Commerce, the Department of Defense, 
the Department of Labor, and the Peace Corps, 
as appropriate, pursuant to the 2004 Memo-
randum of Agreement Coordinating Audit Cov-
erage of Programs and Activities Implementing 
the President’s Emergency Plan for AIDS Relief, 
or any successor agreement. 
‘‘(3) FUNDING.—The Global AIDS Coordinator 
and the Coordinator of the United States Government 
Activities to Combat Malaria Globally shall make
available necessary funds not exceeding $15,000,000 
during the 5-year period beginning on October 1, 
2008 to the Inspectors General described in para-
graph (1) for the audits, inspections, and reviews de-
scribed in that paragraph.’’. 
(e) ANNUAL STUDY; MESSAGE.—Section 101 of such 
Act, as amended by this section, is further amended by add-
ing at the end the following: 
‘‘(g) ANNUAL STUDY.— 
‘‘(1) IN GENERAL.—Not later than September 30, 
2009, and annually thereafter through September 30, 
2013, the Global AIDS Coordinator shall complete a 
study of treatment providers that— 
‘‘(A) represents a range of countries and 
service environments; 
‘‘(B) estimates the per-patient cost of 
antiretroviral HIV/AIDS treatment and the care 
of 
people 
with 
HIV/AIDS 
not 
receiving 
antiretroviral treatment, including a comparison 
of the costs for equivalent services provided by 
programs not receiving assistance under this Act; 
‘‘(C) estimates per-patient costs across the 
program and in specific categories of service pro-
viders, including— 
‘‘(i) urban and rural providers;
‘‘(ii) country-specific providers; and 
‘‘(iii) other subcategories, as appro-
priate. 
‘‘(2) PUBLICATION.—Not later than 90 days 
after the completion of each study under paragraph 
(1), the Global AIDS Coordinator shall make the re-
sults of such study available on a publicly accessible 
Web site. 
‘‘(h) MESSAGE.—The Global AIDS Coordinator shall 
develop a message, to be prominently displayed by each pro-
gram receiving funds under this Act, that— 
‘‘(1) demonstrates that the program is a commit-
ment by citizens of the United States to the global 
fight against HIV/AIDS, tuberculosis, and malaria; 
and 
‘‘(2) enhances awareness by program recipients 
that the program is an effort on behalf of the citizens 
of the United States.’’. 
SEC. 102. INTERAGENCY WORKING GROUP. 
Section 1(f)(2) of the State Department Basic Authori-
ties Act of 1956 (22 U.S.C. 2651a(f)(2)) is amended— 
(1) in subparagraph (A), by inserting ‘‘, partner 
country finance, health, and other relevant min-
istries,’’ after ‘‘community based organizations)’’ each 
place it appears;
(2) in subparagraph (B)(ii)— 
(A) by striking subclauses (IV) and (V); 
(B) by inserting after subclause (III) the 
following: 
‘‘(IV) Establishing an interagency 
working group on HIV/AIDS headed 
by the Global AIDS Coordinator and 
comprised of representatives from the 
United States Agency for International 
Development and the Department of 
Health and Human Services, for the 
purposes of coordination of activities 
relating to HIV/AIDS, including— 
‘‘(aa) meeting regularly to 
review progress in partner coun-
tries toward HIV/AIDS preven-
tion, treatment, and care objec-
tives; 
‘‘(bb) participating in the 
process of identifying countries to 
consider for increased assistance 
based on the epidemiology of HIV/ 
AIDS in those countries, includ-
ing clear evidence of a public 
health threat, as well as govern-
ment commitment to address the 
HIV/AIDS problem, relative need, 
and coordination and joint plan-
ning with other significant actors; 
‘‘(cc) assisting the Coordi-
nator in the evaluation, execution, 
and oversight of country oper-
ational plans; 
‘‘(dd) reviewing policies that 
may be obstacles to reaching tar-
gets set forth for HIV/AIDS pre-
vention, treatment, and care; and 
‘‘(ee) consulting with rep-
resentatives from additional rel-
evant agencies, including the Na-
tional Institutes of Health, the 
Health Resources and Services 
Administration, the Department 
of Labor, the Department of Agri-
culture, the Millennium Challenge 
Corporation, the Peace Corps, and 
the Department of Defense. 
‘‘(V) Coordinating overall United 
States HIV/AIDS policy and pro-
grams, including ensuring the coordi-
nation of relevant executive branch 
agency activities in the field, with ef-
forts led by partner countries, and 
with the assistance provided by other 
relevant bilateral and multilateral aid 
agencies and other donor institutions 
to promote harmonization with other 
programs aimed at preventing and 
treating HIV/AIDS and other health 
challenges, improving primary health, 
addressing food security, promoting 
education 
and 
development, 
and 
strengthening health care systems.’’; 
(C) by redesignating subclauses (VII) and 
VIII) as subclauses (IX) and (XII), respectively; 
(D) by inserting after subclause (VI) the fol-
lowing: 
‘‘(VII) Holding annual consulta-
tions with nongovernmental organiza-
tions in partner countries that provide 
services to improve health, and advo-
cating on behalf of the individuals 
with HIV/AIDS and those at par-
ticular risk of contracting HIV/AIDS,
including organizations with members 
who are living with HIV/AIDS. 
‘‘(VIII) Ensuring, through inter-
agency and international coordination, 
that 
HIV/AIDS 
programs 
of 
the 
United States are coordinated with, 
and complementary to, the delivery of 
related global health, food security, de-
velopment, and education.’’; 
(E) in subclause (IX), as redesignated by 
subparagraph (C)— 
(i) by inserting ‘‘Vietnam,’’ after 
‘‘Uganda,’’; 
(ii) by inserting after ‘‘of 2003’’ the 
following: ‘‘and other countries in which the 
United States is implementing HIV/AIDS 
programs as part of its foreign assistance 
program’’; and 
(iii) by adding at the end the fol-
lowing: ‘‘In designating additional coun-
tries under this subparagraph, the President 
shall give priority to those countries in 
which there is a high prevalence of HIV or 
risk of significantly increasing incidence of 
HIV within the general population and in-
adequate financial means within the coun-
try.’’; 
(F) by inserting after subclause (IX), as re-
designated by subparagraph (C), the following: 
‘‘(X) Working with partner coun-
tries in which the HIV/AIDS epidemic 
is prevalent among injection drug 
users to establish, as a national pri-
ority, national HIV/AIDS prevention 
programs. 
‘‘(XI) Working with partner coun-
tries in which the HIV/AIDS epidemic 
is prevalent among individuals in-
volved in commercial sex acts to estab-
lish, as a national priority, national 
prevention programs, including edu-
cation, voluntary testing, and coun-
seling, and referral systems that link 
HIV/AIDS programs with programs to 
eradicate trafficking in persons and 
support alternatives to prostitution.’’; 
(G) in subclause (XII), as redesignated by 
subparagraph (C), by striking ‘‘funds section’’ 
and inserting ‘‘funds appropriated for HIV/ 
AIDS assistance pursuant to the authorization of
appropriations under section 401 of the United 
States Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Act of 2003 (22 U.S.C. 
7671)’’; and 
(H) by adding at the end the following: 
‘‘(XIII) Publicizing updated drug 
pricing data to inform the purchasing 
decisions of pharmaceutical procure-
ment partners.’’. 
SEC. 103. SENSE OF CONGRESS. 
Section 102 of the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7612) is amended by adding at the end the following: 
‘‘(d) SENSE OF CONGRESS.—It is the sense of Congress 
that— 
‘‘(1) full-time country level coordinators, pref-
erably with management experience, should head each 
HIV/AIDS country team for United States missions 
overseeing significant HIV/AIDS programs; 
‘‘(2) foreign service nationals provide critically 
important services in the design and implementation 
of United States country-level HIV/AIDS programs 
and their skills and experience as public health pro-
fessionals should be recognized within hiring and 
compensation practices; and
‘‘(3) staffing levels for United States country- 
level HIV/AIDS teams should be adequately main-
tained to fulfill oversight and other obligations of the 
positions.’’. 
TITLE II—SUPPORT FOR MULTI-
LATERAL FUNDS, PROGRAMS, 
AND PUBLIC-PRIVATE PART-
NERSHIPS 
SEC. 201. VOLUNTARY CONTRIBUTIONS TO INTERNATIONAL 
VACCINE FUNDS. 
Section 302 of the Foreign Assistance Act of 1961 (22 
U.S.C. 2222) is amended— 
(1) by inserting after subsection (c) the fol-
lowing: 
‘‘(d) TUBERCULOSIS VACCINE DEVELOPMENT PRO-
GRAMS.—In addition to amounts otherwise available under 
this section, there are authorized to be appropriated to the 
President such sums as may be necessary for each of the 
fiscal years 2009 through 2013, which shall be used for 
United States contributions to tuberculosis vaccine develop-
ment programs, which may include the Aeras Global TB 
Vaccine Foundation.’’; 
(2) in subsection (k)—
(A) by striking ‘‘fiscal years 2004 through 
2008’’ and inserting ‘‘fiscal years 2009 through 
2013’’; and 
(B) by striking ‘‘Vaccine Fund’’ and insert-
ing ‘‘GAVI Fund’’. 
(3) in subsection (l), by striking ‘‘fiscal years 
2004 through 2008’’ and inserting ‘‘fiscal years 2009 
through 2013’’; and 
(4) in subsection (m), by striking ‘‘fiscal years 
2004 through 2008’’ and inserting ‘‘fiscal years 2009 
through 2013’’. 
SEC. 202. PARTICIPATION IN THE GLOBAL FUND TO FIGHT 
AIDS, TUBERCULOSIS AND MALARIA. 
(a) FINDINGS; SENSE OF CONGRESS.—Section 202(a) 
of the United States Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Act of 2003 (22 U.S.C. 7622(a)) is 
amended to read as follows: 
‘‘(a) FINDINGS; SENSE OF CONGRESS.— 
‘‘(1) FINDINGS.—Congress makes the following 
findings: 
‘‘(A) The establishment of the Global Fund 
in January 2002 is consistent with the general 
principles for an international AIDS trust fund 
first outlined by Congress in the Global AIDS
and Tuberculosis Relief Act of 2000 (Public Law 
106–264). 
‘‘(B) The Global Fund is an innovative fi-
nancing mechanism which— 
‘‘(i) has made progress in many areas 
in combating HIV/AIDS, tuberculosis, and 
malaria; and 
‘‘(ii) represents the multilateral compo-
nent of this Act, extending United States ef-
forts to more than 130 countries around the 
world. 
‘‘(C) The Global Fund and United States 
bilateral assistance programs— 
‘‘(i) are demonstrating increasingly ef-
fective coordination, with each possessing 
certain comparative advantages in the fight 
against HIV/AIDS, tuberculosis, and ma-
laria; and 
‘‘(ii) often work most effectively in con-
cert with each other. 
‘‘(D) The United States Government— 
‘‘(i) is the largest supporter of the 
Global Fund in terms of resources and tech-
nical support;
‘‘(ii) made the founding contribution 
to the Global Fund; and 
‘‘(iii) is fully committed to the success 
of the Global Fund as a multilateral public- 
private partnership. 
‘‘(2) SENSE OF CONGRESS.—It is the sense of 
Congress that— 
‘‘(A) transparency and accountability are 
crucial to the long-term success and viability of 
the Global Fund; 
‘‘(B) the Global Fund has made significant 
progress toward addressing concerns raised by 
the Government Accountability Office by— 
‘‘(i) improving risk assessment and 
risk management capabilities; 
‘‘(ii) providing clearer guidance for 
and oversight of Local Fund Agents; and 
‘‘(iii) strengthening the Office of the 
Inspector General for the Global Fund; 
‘‘(C) the provision of sufficient resources 
and authority to the Office of the Inspector Gen-
eral for the Global Fund to ensure that office has 
the staff and independence necessary to carry out 
its mandate will be a measure of the commit-
ment of the Global Fund to transparency and 
accountability; 
‘‘(D) regular, publicly published financial, 
programmatic, and reporting audits of the Fund, 
its grantees, and Local Fund Agents are also im-
portant benchmarks of transparency; 
‘‘(E) the Global Fund should establish and 
maintain a system to track— 
‘‘(i) the amount of funds disbursed to 
each subrecipient on the grant’s fiscal cycle; 
and 
‘‘(ii) the distribution of resources, by 
grant and principal recipient, for preven-
tion, care, treatment, drug and commodity 
purchases, and other purposes; 
‘‘(F) relevant national authorities in recipi-
ent countries should exempt from duties and 
taxes all products financed by Global Fund 
grants and procured by any principal recipient 
or subrecipient for the purpose of carrying out 
such grants; 
‘‘(G) the Global Fund, UNAIDS, and the 
Global AIDS Coordinator should work together 
to standardize program indicators wherever pos-
sible;
‘‘(H) for purposes of evaluating total 
amounts of funds contributed to the Global Fund 
under subsection (d)(4)(A)(i), the timetable for 
evaluations of contributions from sources other 
than the United States should take into account 
the fiscal calendars of other major contributors; 
and 
‘‘(I) the Global Fund should not support ac-
tivities involving the ‘Affordable Medicines Facil-
ity-Malaria’ or similar entities pending compel-
ling evidence of success from pilot programs as 
evaluated by the Coordinator of United States 
Government Activities to Combat Malaria Glob-
ally.’’. 
(b) STATEMENT OF POLICY.—Section 202(b) of such 
Act is amended by adding at the end the following: 
‘‘(3) STATEMENT OF POLICY.—The United States 
Government regards the imposition by recipient coun-
tries of taxes or tariffs on goods or services provided 
by the Global Fund, which are supported through 
public and private donations, including the substan-
tial contribution of the American people, as inappro-
priate and inconsistent with standards of good gov-
ernance. The Global AIDS Coordinator or other rep-
resentatives of the United States Government shall
work with the Global Fund to dissuade governments 
from imposing such duties, tariffs, or taxes.’’. 
(c) UNITED STATES FINANCIAL PARTICIPATION.—Sec-
tion 202(d) of such Act (22 U.S.C. 7622(d)) is amended— 
(1) in paragraph (1)— 
(A) by striking ‘‘$1,000,000,000 for the pe-
riod of fiscal year 2004 beginning on January 1, 
2004’’ and inserting ‘‘$2,000,000,000 for fiscal 
year 2009,’’; and 
(B) by striking ‘‘the fiscal years 2005– 
2008’’ and inserting ‘‘each of the fiscal years 
2010 through 2013’’; 
(2) in paragraph (4)— 
(A) in subparagraph (A)— 
(i) in clause (i), by striking ‘‘fiscal 
years 2004 through 2008’’ and inserting 
‘‘fiscal years 2009 through 2013’’; 
(ii) in clause (ii)— 
(I) by striking ‘‘during any of the 
fiscal years 2004 through 2008’’ and 
inserting ‘‘during any of the fiscal 
years 2009 through 2013’’; and 
(II) by adding at the end the fol-
lowing: ‘‘The President may waive the 
application of this clause with respect
to assistance for Sudan that is overseen 
by the Southern Country Coordinating 
Mechanism, 
including 
Southern 
Sudan, Southern Kordofan, Blue Nile 
State, and Abyei, if the President de-
termines that the national interest or 
humanitarian reasons justify such a 
waiver. The President shall publish 
each waiver of this clause in the Fed-
eral Register and, not later than 15 
days before the waiver takes effect, 
shall consult with the Committee on 
Foreign Relations of the Senate and 
the Committee on Foreign Affairs of 
the House of Representatives regarding 
the proposed waiver.’’; and 
(iii) in clause (vi)— 
(I) by striking ‘‘for the purposes’’ 
and inserting ‘‘For the purposes’’; 
(II) by striking ‘‘fiscal years 2004 
through 2008’’ and inserting ‘‘fiscal 
years 2009 through 2013’’; and 
(III) by striking ‘‘prior to fiscal 
year 2004’’ and inserting ‘‘before fiscal 
year 2009’’;
(B) in subparagraph (B)(iv), by striking 
‘‘fiscal years 2004 through 2008’’ and inserting 
‘‘fiscal years 2009 through 2013’’; and 
(C) in subparagraph (C)(ii), by striking 
‘‘Committee on International Relations’’ and in-
serting ‘‘Committee on Foreign Affairs’’; and 
(3) by adding at the end the following: 
‘‘(5) WITHHOLDING
FUNDS.—Notwithstanding 
any other provision of this Act, 20 percent of the 
amounts appropriated pursuant to this Act for a con-
tribution to support the Global Fund for each of the 
fiscal years 2010 through 2013 shall be withheld from 
obligation to the Global Fund until the Secretary of 
State certifies to the appropriate congressional com-
mittees that the Global Fund— 
‘‘(A) has established an evaluation frame-
work for the performance of Local Fund Agents 
(referred to in this paragraph as ‘LFAs’); 
‘‘(B) is undertaking a systematic assessment 
of the performance of LFAs; 
‘‘(C) has adopted, and is implementing, a 
policy to publish on a publicly available Web 
site— 
‘‘(i) grant performance reviews;
‘‘(ii) all reports of the Inspector Gen-
eral of the Global Fund, in a manner that 
is consistent with the Policy for Disclosure 
of Reports of the Inspector General, ap-
proved at the 16th Meeting of the Board of 
the Global Fund; 
‘‘(iii) decision points of the Board of 
the Global Fund; 
‘‘(iv) reports from Board committees to 
the Board; and 
‘‘(v) a regular collection and analysis 
of performance data and funding of grants 
of the Global Fund, which shall cover all 
principal recipients and all subrecipients; 
‘‘(D) is maintaining an independent, well- 
staffed Office of the Inspector General that— 
‘‘(i) reports directly to the Board of the 
Global Fund; and 
‘‘(ii) compiles regular, publicly pub-
lished audits of financial, programmatic, 
and reporting aspects of the Global Fund, 
its grantees, and LFAs; 
‘‘(E) has established, and is reporting pub-
licly on, standard indicators for all program 
areas;
‘‘(F) has established a methodology to track 
and is publicly reporting on— 
‘‘(i) all subrecipients and the amount 
of funds disbursed to each subrecipient on 
the grant’s fiscal cycle; and 
‘‘(ii) the distribution of resources, by 
grant and principal recipient, for preven-
tion, care, treatment, drugs and commod-
ities purchase, and other purposes; 
‘‘(G) has established a policy on tariffs im-
posed by national governments on all goods and 
services financed by the Global Fund; 
‘‘(H) through its Secretariat, has taken 
meaningful steps to prevent national authorities 
in recipient countries from imposing taxes or 
tariffs on goods or services provided by the Fund; 
‘‘(I) is maintaining its status as a financ-
ing institution focused on programs directly re-
lated to HIV/AIDS, malaria, and tuberculosis; 
‘‘(J) is maintaining and making progress 
on— 
‘‘(i) sustaining its multisectoral ap-
proach, through country coordinating mech-
anisms; and
‘‘(ii) the implementation of grants, as 
reflected in the proportion of resources allo-
cated to different sectors, including govern-
ments, civil society, and faith- and commu-
nity-based organizations; and 
‘‘(K) has established procedures providing 
access by the Office of Inspector General of the 
Department of State and Broadcasting Board of 
Governors, as cognizant Inspector General, and 
the Inspector General of the Health and Human 
Services and the Inspector General of the United 
States Agency for International Development, to 
Global Fund financial data, and other informa-
tion relevant to United States contributions (as 
determined by the Inspector General in consulta-
tion with the Global AIDS Coordinator). 
‘‘(6) SUMMARIES
OF
BOARD
DECISIONS
AND 
UNITED STATES POSITIONS.—Following each meeting 
of the Board of the Global Fund, the Coordinator of 
United States Government Activities to Combat HIV/ 
AIDS Globally shall report on the public website of 
the Coordinator a summary of Board decisions and 
how the United States Government voted and its posi-
tions on such decisions.’’.
graph (B), mechanisms to ensure that safe and 
effective 
pharmaceuticals, 
including 
antiretrovirals and medicines to treat opportun-
istic infections, are purchased at the lowest pos-
sible price at which such pharmaceuticals may 
be obtained in sufficient quantity on the world 
market, provided that such pharmaceuticals are 
approved, tentatively approved, or otherwise au-
thorized for use by— 
‘‘(i) the Food and Drug Administra-
tion; 
‘‘(ii) a stringent regulatory agency ac-
ceptable to the Secretary of Health and 
Human Services; or 
‘‘(iii) a quality assurance mechanism 
acceptable to the Secretary of Health and 
Human Services.’’; 
(5) in paragraph (6)— 
(A) by amending the paragraph heading to 
read as follows: 
‘‘(6) RELATED AND COORDINATED ACTIVITIES.— 
’’; 
(B) in subparagraph (B), by striking ‘‘and’’ 
at the end;