(11) Reaching men who have sex with men, 
transgender people, people who inject drugs, sex 
workers, and other vulnerable populations with effec-
tive HIV prevention and treatment is critical to 
bringing the AIDS epidemic under control. 
(12) In February 2013, the Institute of Medi-
cine releases a report evaluating PEPFAR and 
found that PEPFAR, which has provided care and 
treatment for more than 5 million people, has been 
‘‘globally transformative’’, a ‘‘lifeline’’ that is ‘‘re-
storing hope’’. 
TITLE I—GLOBAL HIV/AIDS-FREE 
GENERATION STRATEGY 
SEC. 101. GLOBAL HIV/AIDS-FREE GENERATION STRATEGY. 
(a) STRATEGY.—The President, acting through the 
Coordinator of United States Government Activities to 
Combat HIV/AIDS Globally, shall establish a comprehen-
sive, integrated, 5-year strategy to expand and improve 
efforts to combat global HIV/AIDS, while promoting effi-
ciency and maximizing results. The strategy shall be re-
ferred to as the ‘‘Global HIV/AIDS-Free Generation 
Strategy’’. 
(b) CONTENTS.—The strategy shall— 
(1) accelerate progress toward achieving the 
United States goal of an AIDS-free generation; 
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(2) establish a limited number of measurable 
targets to accelerate reductions in HIV incidence 
and HIV/AIDS-related morbidity and mortality; 
(3) strengthen existing and future compacts 
and framework agreements authorized under section 
104A(d)(8) of the Foreign Assistance Act of 1961 
(22 U.S.C. 2151b–2(d)(8)); 
(4) strengthen engagement with diplomatic ef-
forts at all levels of government to— 
(A) continue to identify and promote link-
ages between efforts to combat HIV/AIDS and 
other health development issues and human 
rights issues; 
(B) encourage and assist national govern-
ments to pursue policies and legal frameworks 
that facilitate and enable effective responses to 
HIV prevention, care, and treatment services; 
and 
(C) increase financial accountability; and 
(5) provide a plan to— 
(A) support early diagnosis and initiation 
of HIV treatment to achieve accelerated reduc-
tions of incidence and morbidity; 
(B) eliminate vertical transmission of HIV 
from mother to child and support early diag-
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nosis and initiation of HIV treatment in infants 
and children; 
(C) intensify efforts to expand access to 
voluntarily medical male circumcision, male and 
female condoms and other proven-effective HIV 
prevention interventions, in combination with 
other evidence-based modalities and structural 
interventions; 
(D) reduce the risk of HIV infection and 
address the HIV-related needs of sex workers, 
men who have sex with men, transgender peo-
ple, and people who inject drugs; 
(E) increase gender equity in HIV/AIDS 
programs and services, including access to vol-
untary family planning and reproductive health 
services and reducing violence and coercion; 
(F) expand partnership with implementers, 
researchers, and academic organizations to im-
prove the science that guides the global re-
sponse to HIV/AIDS; 
(G) provide capacity development support 
to increase meaningful engagement of civil soci-
ety, especially local indigenous organizations, 
that work in the areas of human rights, wom-
en’s and young people’s health and rights, and 
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gay, lesbian, bisexual, and transgender rights, 
in the development, implementation, moni-
toring, and evaluation of United States-funded 
programs; 
(H) advance the efforts of developing coun-
tries to develop health systems capable of man-
aging their epidemics, respond to broader 
health needs impacting affected communities, 
and address new and emerging health concerns; 
and 
(I) defend, protect, and fulfill the human 
rights of people living with HIV and those most 
at risk of HIV infection. 
(c) CONSULTATION.—In developing the strategy, the 
President, acting through the Coordinator of United 
States Government Activities to Combat HIV/AIDS Glob-
ally, shall consult with— 
(1) each executive branch agency administering 
United States foreign assistance related to— 
(A) improving global health; 
(B) strengthening financial management 
systems; and 
(C) monitoring and promoting human 
rights and democracy; 
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(2) personnel at United States embassies and 
country missions involved in the administration of 
the types of United States foreign assistance de-
scribed in paragraph (1); 
(3) the appropriate congressional committees 
with jurisdiction over the agencies described in para-
graph (1); 
(4) civil society and nongovernmental organiza-
tions engaged in improving health care and health 
outcomes in developing countries, including indige-
nous community and faith-based organizations; 
(5) international organizations engaged in im-
proving health care and health outcomes in devel-
oping countries and of which the United States is a 
voting member, with which the United States coordi-
nates the delivery of foreign assistance, or to which 
the United States contributes funding for the pur-
pose of providing such assistance; 
(6) academic organizations, private foundations, 
businesses, and other organizations engaged in im-
proving health care and health outcomes in devel-
oping countries and not receiving United States 
funding for such purposes; 
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(7) other donor nations engaged in improving 
health care and health outcomes in developing coun-
tries; 
(8) countries receiving health-related United 
States foreign assistance; 
(9) any other global, regional, or subregional 
organizations or partnerships engaged in improving 
health care and health outcomes in developing coun-
tries; and 
(10) small, disadvantaged, and women-owned 
businesses and United States minority-serving insti-
tutions, specifically historically Black colleges and 
universities. 
(d) REPORT.—Not later than 1 year after the date 
of the enactment of this Act, the President shall submit 
to Congress a report that sets forth the strategy described 
in this section. 
TITLE II—USING FUNDS STRATE-
GICALLY TO MAXIMIZE RE-
SULTS 
SEC. 201. SUPPORT FOR OPERATIONS RESEARCH TO IM-
PROVE PROGRAM DELIVERY, EFFICIENCY, 
IMPACT, AND EFFECTIVENESS. 
(a) SENSE OF CONGRESS.—It is the sense of the Con-
gress that there is a need and urgency to expand the range 
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of interventions for preventing the transmission of HIV, 
including behavioral prevention research, operations re-
search to optimize combination HIV prevention, and re-
search on medical technology to prevent HIV infection, in-
cluding microbicides, cost-effective female condoms, Pre- 
Exposure Prophylaxis (PrEP), multipurpose technologies 
for the prevention of HIV and unintended pregnancy, and 
vaccines. 
(b) STATEMENT OF POLICY.—It should be the policy 
of the United States to ensure that efforts to combat HIV/ 
AIDS globally should expand, intensify, and coordinate 
operations research to improve the quality, delivery, and 
impact of programming, including with respect to— 
(1) services appropriate for men who have sex 
with men, transgender people, people who inject 
drugs, and sex workers; 
(2) structural interventions to remove barriers 
that inhibit effective implementation of HIV/AIDS- 
related foreign assistance, including the analysis of 
laws and policies that have a negative health impact 
and put individuals at increased risk of HIV infec-
tion; 
(3) scalable combination of prevention and 
treatment approaches to HIV/AIDS; 
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(4) 
prevention 
and 
management 
of 
co- 
morbidities such as tuberculosis, malaria, and viral 
hepatitis; and 
(5) identification and follow up of HIV-positive 
infants and children in resource-limited settings to 
increase the proportion of children accessing HIV 
treatment and care services. 
SEC. 202. INCREASING COORDINATION AND INTEGRATION 
OF HIV/AIDS PROGRAMS WITH DEVELOP-
MENT PROGRAMS. 
(a) STATEMENT OF POLICY.—It should be the policy 
of the United States to ensure that efforts to combat HIV/ 
AIDS globally should maximize efficiencies and the inte-
gration of services and programs to achieve reduction in 
HIV transmission rates and the burden of HIV-related 
morbidity and mortality, by means that include— 
(1) ensuring that women and adolescent girls 
with HIV or who are at risk of HIV infection and 
who do not wish to become pregnant have access to 
voluntary contraceptive services, including a range of 
contraceptive options, and voluntary counseling to 
plan families, either directly or through meaningful 
referrals to existing United States Agency for Inter-
national Development or local family planning pro-
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grams that provide counseling and a range of con-
traceptive options; 
(2) integrating tuberculosis interventions with 
HIV services, including case-finding and tuberculosis 
treatment, expanding tuberculosis preventive ther-
apy, and reducing other opportunistic infections that 
accompany HIV/AIDS; 
(3) ensuring young people with HIV are pro-
vided with confidential and affordable access to 
youth-friendly comprehensive sexual and reproduc-
tive health services and supplies, including male and 
female condoms for the prevention of pregnancy and 
sexually transmitted diseases, as relevant; and 
(4) working to promote and protect the human 
rights of people living with HIV, including men who 
have sex with men, transgender people, people who 
inject drugs, sex workers, and other vulnerable popu-
lations, including indigenous people, migrants, inter-
nally displaced people, young people, incarcerated 
populations, and people with disabilities. 
(b) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of State shall 
submit to the appropriate congressional committees a re-
port describing the utilization of efficiencies in the delivery 
of HIV/AIDS treatment services within and between 
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United States-funded bilateral and multilateral programs 
and partner countries, including to the extent that such 
gains in efficiencies are being exhausted. 
SEC. 203. INCREASING PROGRAM EFFECTIVENESS AND 
SUSTAINABILITY TO ACHIEVE SUCCESSFUL 
COUNTRY OWNERSHIP. 
(a) STATEMENT OF POLICY.—It should be the policy 
of the United States to ensure that efforts to combat HIV/ 
AIDS globally should help developing countries signifi-
cantly decrease the burden of HIV, strengthen and im-
prove their health systems, help build country ownership, 
and increase financial accountability to ensure sustain-
ability and equitable access to health services, including 
by— 
(1) 
assisting 
developing 
countries 
create, 
strengthen, and implement their own evidence-based 
national HIV/AIDS strategies, by means that in-
clude— 
(A) supporting early diagnosis and initi-
ation of HIV and tuberculosis treatment to 
achieve accelerated reductions of incidence and 
morbidity; 
(B) eliminating the vertical transmission of 
HIV from mother to child and supporting early 
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diagnosis and initiation of HIV treatment in in-
fants and children; 
(C) intensifying efforts to expand access to 
voluntary medical male circumcision, male and 
female condoms, harm reduction services, and 
other proven-effective HIV prevention interven-
tions, in combination with other evidence-based 
modalities, including structural interventions; 
(D) intensifying efforts to eliminate HIV 
infections among populations that are often at 
greatest risk, including sex workers, men who 
have sex with men, transgender individuals, and 
people who inject drugs, and addressing the 
HIV-related needs, including access to ART, of 
those already infected; 
(E) ensuring young people are provided 
with comprehensive knowledge, skill-building 
programs, in and out of school, to make in-
formed and responsible decisions for their sex-
ual health, and are provided with confidential 
and affordable access to youth-friendly com-
prehensive sexual and reproductive health serv-
ices and supplies, including male and female 
condoms; 
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(F) ensuring women with HIV or who are 
at risk of HIV infection and who do not wish 
to become pregnant have access to voluntary 
contraceptive services and commodities, and 
women who desire pregnancy have access to 
family planning counseling and maternal health 
services free of judgment and discrimination; 
and 
(G) encouraging policy changes to elimi-
nate discriminatory and stigmatizing polices 
that stand in the way of access to health serv-
ices by marginalized and poor populations in-
cluding punitive laws against HIV exposure and 
potential transmission, sex work, same-sex be-
havior, drug use, and gender expression; 
(2) supporting meaningful community involve-
ment and participation, inclusive of poor, vulnerable, 
or marginalized populations and their representative 
indigenous and civil society organizations, in deci-
sionmaking related to national HIV/AIDS strategies 
and the delivery of health services, including in deci-
sions related to the adoption of health policies and 
the total amount and distribution of health funding; 
(3) assisting countries to coordinate, regulate, 
and harmonize the delivery of health services pro-
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vided by the United States and nongovernmental or-
ganizations, including community and faith-based 
organizations, private foundations, international or-
ganizations, and other donors, and to coordinate or 
integrate such services with the health system to the 
maximum extent practicable; 
(4) using, to the maximum extent practicable, 
local and regional entities for the provision of tech-
nical assistance, and where the capacity of such enti-
ties is insufficient, supporting capacity building to 
enable such entities to provide such assistance; 
(5) strengthening procurement and supply 
chain logistics to help prevent drug and commodity 
stock outs, including male and female condom short-
ages, and to help ensure the eventual provision of 
microbicides for HIV prevention; and 
(6) providing technical assistance and support 
to national ministries of health, or their equivalents, 
and other relevant ministries in overseeing the 
health systems of their countries and monitoring and 
evaluating the effectiveness of such systems in re-
ducing mortality and improving health outcomes, in-
cluding preparing for the provision of HIV/AIDS, 
voluntary family planning, non-communicable dis-
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eases, and reproductive health services in emergency 
situations. 
(b) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of State shall 
submit to the appropriate congressional committees a re-
port identifying benchmarks that are directly relevant to 
significantly decreasing the burden of the epidemic in each 
country receiving HIV-related foreign assistance and pro-
vide context for helping countries and civil society to build 
country ownership. 
TITLE III—ADDRESSING LEGAL 
AND POLICY BARRIERS TO 
ACCESSING HEALTH CARE 
Subtitle A—General Provisions 
SEC. 301. SUPPORT FOR LAWS AND REGULATIONS THAT IM-
PROVE HEALTH OUTCOMES AND PROMOTE 
HUMAN RIGHTS. 
It should be the policy of the United States to ensure 
that United States foreign assistance should encourage 
and assist national governments of developing countries 
to pursue policies and legal frameworks that improve 
health outcomes, including policies and legal frameworks 
that— 
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(1) are medically accurate and evidence-based 
and adhere to the latest global public health stand-
ards for prevention, treatment, and care; 
(2) promote and improve the status of women 
and youth, ensuring their ability to access and use 
health services without fear or risk of gender-based 
violence, reprisal, discrimination, stigmatization, ar-
rest, or other mistreatment; 
(3) work to remove criminalization of, stig-
matization of, and discrimination against poor, vul-
nerable, or marginalized populations and enact laws 
and policies to promote and protect the rights of 
such populations; 
(4) avoid, to the maximum extent possible, reli-
ance on criminal laws and sanctions to address 
health issues; 
(5) incorporate relevant policy guidance that 
addresses structural barriers to accessing health 
care; and 
(6) prioritize the creation of a legal, political, 
and social environment that enables access to health 
services by all members of the population. 
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SEC. 302. INTENSIFYING EFFORTS TO ESTABLISH EFFEC-
TIVE PROGRAMS FOR ENGAGING KEY AF-
FECTED POPULATIONS. 
It should be the policy of the United States to ensure 
that efforts to combat HIV/AIDS globally should intensify 
efforts to establish effective programs for engaging men 
who have sex with men, transgender people, people who 
inject drugs, and sex workers in HIV prevention, care, and 
treatment initiatives, by means that include— 
(1) ensuring those eligible for treatment receive 
antiretroviral treatment; 
(2) providing sterile syringes, education, and 
outreach and treatment for drug dependence for in-
jecting drug users through a comprehensive package 
of services; 
(3) providing sexual health services, male and 
female condoms, and other HIV prevention services 
to sex workers, their clients, and partners; and 
(4) defending human rights and inherent dig-
nity by addressing laws and practices that prevent 
people from accessing services and providing legal 
and social services to individuals and communities to 
facilitate access to services and to reduce violence, 
stigma, and discrimination. 
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