H. R. 1298—22
and implementing HIV/AIDS prevention, treatment, and
monitoring programs in accordance with its national HIV/
AIDS strategy;
‘‘(D) provide technical assistance, consultant services,
financial 
planning, 
monitoring 
and 
evaluation, 
and
research in support of the national HIV/AIDS strategy;
and
‘‘(E) establish local human resource capacities for the
national HIV/AIDS strategy through the transfer of med-
ical, managerial, leadership, and technical skills.
‘‘(e) ANNUAL REPORT.—
‘‘(1) IN GENERAL.—Not later than January 31 of each year,
the President shall submit to the Committee on Foreign Rela-
tions of the Senate and the Committee on International Rela-
tions of the House of Representatives a report on the
implementation of this section for the prior fiscal year.
‘‘(2) REPORT ELEMENTS.—Each report shall include—
‘‘(A) a description of efforts made by each relevant
executive branch agency to implement the policies set forth
in this section, section 104B, and section 104C;
‘‘(B) a description of the programs established pursuant
to such sections; and
‘‘(C) a detailed assessment of the impact of programs
established pursuant to such sections, including—
‘‘(i)(I) the effectiveness of such programs in
reducing the spread of the HIV infection, particularly
in women and girls, in reducing mother-to-child trans-
mission of the HIV infection, and in reducing mortality
rates from HIV/AIDS; and
‘‘(II) the number of patients currently receiving
treatment for AIDS in each country that receives
assistance under this Act.
‘‘(ii) the progress made toward improving health
care delivery systems (including the training of ade-
quate numbers of staff) and infrastructure to ensure
increased access to care and treatment;
‘‘(iii) with respect to tuberculosis, the increase in
the number of people treated and the increase in
number of tuberculosis patients cured through each
program, project, or activity receiving United States
foreign assistance for tuberculosis control purposes;
and
‘‘(iv) with respect to malaria, the increase in the
number of people treated and the increase in number
of malaria patients cured through each program,
project, or activity receiving United States foreign
assistance for malaria control purposes.
‘‘(f) FUNDING LIMITATION.—Of the funds made available to carry
out this section in any fiscal year, not more than 7 percent may
be used for the administrative expenses of the United States Agency
for International Development in support of activities described
in section 104(c), this section, section 104B, and section 104C.
Such amount shall be in addition to other amounts otherwise avail-
able for such purposes.
‘‘(g) DEFINITIONS.—In this section:
‘‘(1) AIDS.—The term ‘AIDS’ means acquired immune defi-
ciency syndrome.
H. R. 1298—23
‘‘(2) HIV.—The term ‘HIV’ means the human immuno-
deficiency virus, the pathogen that causes AIDS.
‘‘(3) HIV/AIDS.—The term ‘HIV/AIDS’ means, with respect
to an individual, an individual who is infected with HIV or
living with AIDS.
‘‘(4) RELEVANT EXECUTIVE BRANCH AGENCIES.—The term
‘relevant executive branch agencies’ means the Department
of State, the United States Agency for International Develop-
ment, the Department of Health and Human Services (including
its agencies and offices), and any other department or agency
of the United States that participates in international HIV/
AIDS activities pursuant to the authorities of such department
or agency or this Act.’’.
(b) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—In addition to funds available under sec-
tion 104(c) of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b(c)) for such purpose or under any other provision of
that Act, there are authorized to be appropriated to the Presi-
dent, from amounts authorized to be appropriated under section
401, such sums as may be necessary for each of the fiscal
years 2004 through 2008 to carry out section 104A of the
Foreign Assistance Act of 1961, as added by subsection (a).
(2) AVAILABILITY OF FUNDS.—Amounts appropriated pursu-
ant to paragraph (1) are authorized to remain available until
expended.
(3) ALLOCATION OF FUNDS.—Of the amount authorized to
be appropriated by paragraph (1) for the fiscal years 2004
through 2008, such sums as may be necessary are authorized
to be appropriated to carry out section 104A(d)(4) of the Foreign
Assistance Act of 1961 (as added by subsection (a)), relating
to the procurement and distribution of HIV/AIDS pharma-
ceuticals.
(c) RELATIONSHIP
TO
ASSISTANCE
PROGRAMS
TO
ENHANCE
NUTRITION.—In recognition of the fact that malnutrition may hasten
the progression of HIV to AIDS and may exacerbate the decline
among AIDS patients leading to a shorter life span, the Adminis-
trator of the United States Agency for International Development
shall, as appropriate—
(1) integrate nutrition programs with HIV/AIDS activities,
generally;
(2) provide, as a component of an anti-retroviral therapy
program, support for food and nutrition to individuals infected
with and affected by HIV/AIDS; and
(3) provide support for food and nutrition for children
affected by HIV/AIDS and to communities and households
caring for children affected by HIV/AIDS.
(d) ELIGIBILITY FOR ASSISTANCE.—An organization that is other-
wise eligible to receive assistance under section 104A of the Foreign
Assistance Act of 1961 (as added by subsection (a)) or under any
other provision of this Act (or any amendment made by this Act)
to prevent, treat, or monitor HIV/AIDS shall not be required, as
a condition of receiving the assistance, to endorse or utilize a
multisectoral approach to combatting HIV/AIDS, or to endorse,
utilize, or participate in a prevention method or treatment program
to which the organization has a religious or moral objection.
(e) LIMITATION.—No funds made available to carry out this
Act, or any amendment made by this Act, may be used to promote
H. R. 1298—24
or advocate the legalization or practice of prostitution or sex traf-
ficking. Nothing in the preceding sentence shall be construed to
preclude the provision to individuals of palliative care, treatment,
or post-exposure pharmaceutical prophylaxis, and necessary
pharmaceuticals and commodities, including test kits, condoms, and,
when proven effective, microbicides.
(f) LIMITATION.—No funds made available to carry out this
Act, or any amendment made by this Act, may be used to provide
assistance to any group or organization that does not have a policy
explicitly opposing prostitution and sex trafficking.
(g) SENSE OF CONGRESS RELATING TO FOOD ASSISTANCE FOR
INDIVIDUALS LIVING WITH HIV/AIDS.—
(1) FINDINGS.—Congress finds the following:
(A) The United States provides more than 60 percent
of all food assistance worldwide.
(B) According to the United Nations World Food Pro-
gram and other United Nations agencies, food insecurity
of individuals infected or living with HIV/AIDS is a major
problem in countries with large populations of such individ-
uals, particularly in African countries.
(C) Although the United States is willing to provide
food assistance to these countries in need, a few of the
countries object to part or all of the assistance because
of fears of benign genetic modifications to the foods.
(D) Healthy and nutritious foods for individuals
infected or living with HIV/AIDS are an important com-
plement to HIV/AIDS medicines for such individuals.
(E) Individuals infected with HIV have higher nutri-
tional requirements than individuals who are not infected
with HIV, particularly with respect to the need for protein.
Also, there is evidence to suggest that the full benefit
of therapy to treat HIV/AIDS may not be achieved in
individuals who are malnourished, particularly in pregnant
and lactating women.
(2) SENSE OF CONGRESS.—It is therefore the sense of Con-
gress that United States food assistance should be accepted
by countries with large populations of individuals infected or
living with HIV/AIDS, particularly African countries, in order
to help feed such individuals.
SEC. 302. ASSISTANCE TO COMBAT TUBERCULOSIS.
(a) AMENDMENT OF THE FOREIGN ASSISTANCE ACT OF 1961.—
Chapter 1 of part I of the Foreign Assistance Act of 1961 (22
U.S.C. 2151 et seq.), as amended by section 301 of this Act, is
further amended by inserting after section 104A the following new
section:
‘‘SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.
‘‘(a) FINDINGS.—Congress makes the following findings:
‘‘(1) Congress recognizes the growing international problem
of tuberculosis and the impact its continued existence has on
those countries that had previously largely controlled the dis-
ease.
‘‘(2) Congress further recognizes that the means exist to
control and treat tuberculosis through expanded use of the
DOTS (Directly Observed Treatment Short-course) treatment
strategy, including DOTS-Plus to address multi-drug resistant
H. R. 1298—25
tuberculosis, and adequate investment in newly created mecha-
nisms to increase access to treatment, including the Global
Tuberculosis Drug Facility established in 2001 pursuant to
the Amsterdam Declaration to Stop TB and the Global Alliance
for TB Drug Development.
‘‘(b) POLICY.—It is a major objective of the foreign assistance
program of the United States to control tuberculosis, including
the detection of at least 70 percent of the cases of infectious tuber-
culosis, and the cure of at least 85 percent of the cases detected,
not later than December 31, 2005, in those countries classified
by the World Health Organization as among the highest tuber-
culosis burden, and not later than December 31, 2010, in all coun-
tries in which the United States Agency for International Develop-
ment has established development programs.
‘‘(c) AUTHORIZATION.—To carry out this section and consistent
with section 104(c), the President is authorized to furnish assist-
ance, on such terms and conditions as the President may determine,
for the prevention, treatment, control, and elimination of tuber-
culosis.
‘‘(d) COORDINATION.—In carrying out this section, the President
shall coordinate with the World Health Organization, the Global
Fund to Fight AIDS, Tuberculosis, and Malaria, and other organiza-
tions with respect to the development and implementation of a
comprehensive tuberculosis control program.
‘‘(e) PRIORITY TO DOTS COVERAGE.—In furnishing assistance
under subsection (c), the President shall give priority to activities
that increase Directly Observed Treatment Short-course (DOTS)
coverage and treatment of multi-drug resistant tuberculosis where
needed using DOTS-Plus, including funding for the Global Tuber-
culosis Drug Facility, the Stop Tuberculosis Partnership, and the
Global Alliance for TB Drug Development. In order to meet the
requirement of the preceding sentence, the President should ensure
that not less than 75 percent of the amount made available to
carry out this section for a fiscal year should be expended for
antituberculosis drugs, supplies, direct patient services, and
training in diagnosis and treatment for Directly Observed Treat-
ment Short-course (DOTS) coverage and treatment of multi-drug
resistant tuberculosis using DOTS-Plus, including substantially
increased funding for the Global Tuberculosis Drug Facility.
‘‘(f) DEFINITIONS.—In this section:
‘‘(1) DOTS.—The term ‘DOTS’ or ‘Directly Observed Treat-
ment Short-course’ means the World Health Organization-rec-
ommended strategy for treating tuberculosis.
‘‘(2) DOTS-PLUS.—The term ‘DOTS-Plus’ means a com-
prehensive tuberculosis management strategy that is built upon
and works as a supplement to the standard DOTS strategy,
and which takes into account specific issues (such as use of
second line anti-tuberculosis drugs) that need to be addressed
in areas where there is high prevalence of multi-drug resistant
tuberculosis.
‘‘(3) GLOBAL ALLIANCE FOR TUBERCULOSIS DRUG DEVELOP-
MENT.—The term ‘Global Alliance for Tuberculosis Drug
Development’ means the public-private partnership that brings
together leaders in health, science, philanthropy, and private
industry to devise new approaches to tuberculosis and to ensure
that new medications are available and affordable in high tuber-
culosis burden countries and other affected countries.