820 
‘‘(I) the increase in the number 
of individuals with HIV/AIDS receiv-
ing antiretroviral treatment above the 
goal 
established 
under 
section 
402(a)(3) and increased pursuant to 
paragraphs (1) through (3) of section 
403(d); and 
‘‘(II) 
additional 
treatment 
through coordinated multilateral ef-
forts; 
‘‘(iii) support care for 12,000,000 in-
dividuals infected with or affected by HIV/ 
AIDS, including 5,000,000 orphans and 
vulnerable children affected by HIV/AIDS, 
with an emphasis on promoting a com-
prehensive, coordinated system of services 
to be integrated throughout the continuum 
of care; 
‘‘(iv) provide at least 80 percent of 
the target population with access to coun-
seling, testing, and treatment to prevent 
the transmission of HIV from mother-to- 
child; 
‘‘(v) provide care and treatment serv-
ices to children with HIV in proportion to 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00820
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
821 
their percentage within the HIV-infected 
population of a given partner country; and 
‘‘(vi) train and support retention of 
health 
care 
professionals, 
paraprofes-
sionals, and community health workers in 
HIV/AIDS prevention, treatment, and 
care, with the target of providing such 
training to at least 140,000 new health 
care professionals and paraprofessionals 
with an emphasis on training and in coun-
try deployment of critically needed doctors 
and nurses; 
‘‘(B) strengthen the capacity to deliver pri-
mary health care in developing countries, espe-
cially in sub-Saharan Africa; 
‘‘(C) support and help countries in their 
efforts to achieve staffing levels of at least 2.3 
doctors, nurses, and midwives per 1,000 popu-
lation, as called for by the World Health Orga-
nization; and 
‘‘(D) help partner countries to develop 
independent, sustainable HIV/AIDS programs. 
‘‘(2) COORDINATED
GLOBAL
STRATEGY.—The 
United States and other countries with the sufficient 
capacity should provide assistance to countries in 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00821
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
822 
sub-Saharan Africa, the Caribbean, Central Asia, 
Eastern Europe, and Latin America, and other 
countries 
and 
regions 
confronting 
HIV/AIDS 
epidemics in a coordinated global strategy to help 
address generalized and concentrated epidemics 
through HIV/AIDS prevention, treatment, care, 
monitoring and evaluation, and related activities. 
‘‘(3) PRIORITIES.—The United States Govern-
ment’s response to the global HIV/AIDS pandemic 
and the Government’s efforts to help countries as-
sume leadership of sustainable campaigns to combat 
their local epidemics should place high priority on— 
‘‘(A) the prevention of the transmission of 
HIV; 
‘‘(B) moving toward universal access to 
HIV/AIDS prevention counseling and services; 
‘‘(C) meaningful cost-sharing assurances 
by the partner country; and 
‘‘(D) the inclusion of transition strategies 
to ensure sustainability of such programs and 
activities, including health care systems, under 
other international donor support, or budget 
support by respective foreign governments. 
‘‘(c) AUTHORIZATION.— 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00822
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
823 
‘‘(1) IN
GENERAL.—Consistent with section 
1321 of the Global Partnerships Act of 2013, the 
President is authorized to furnish assistance, on 
such terms and conditions as the President may de-
termine, for HIV/AIDS, including to prevent, treat, 
and monitor HIV/AIDS, and carry out related ac-
tivities, in countries in sub-Saharan Africa, the Car-
ibbean, Central Asia, Eastern Europe, Latin Amer-
ica, and other countries and areas, particularly with 
respect 
to 
refugee 
populations 
or 
those 
in 
postconflict settings in such countries and areas with 
significant or increasing HIV incidence rates. 
‘‘(2) ROLE OF NGOS.—It is the sense of Con-
gress that the President should provide an appro-
priate level of assistance under paragraph (1) 
through nongovernmental organizations (including 
faith-based and community-based organizations) in 
countries in sub-Saharan Africa, the Caribbean, 
Central Asia, Eastern Europe, Latin America, and 
other countries and areas affected by the HIV/AIDS 
pandemic, particularly with respect to refugee popu-
lations or those in post-conflict settings in such 
countries and areas with significant or increasing 
HIV incidence rates. 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00823
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
824 
‘‘(3) 
COORDINATION
OF
ASSISTANCE
EF-
FORTS.—The President shall coordinate the provi-
sion of assistance under paragraph (1) with the pro-
vision of related assistance by the Joint United Na-
tions Programme on HIV/AIDS (UNAIDS), the 
United Nations Children’s Fund (UNICEF), the 
World Health Organization (WHO), the United Na-
tions Development Programme (UNDP), the Global 
Fund to Fight AIDS, Tuberculosis and Malaria and 
other appropriate international organizations (such 
as the International Bank for Reconstruction and 
Development), relevant regional multilateral develop-
ment institutions, national, state, and local govern-
ments of partner countries, other international ac-
tors, appropriate governmental and nongovernmental 
organizations, and relevant executive branch agen-
cies within the framework of the principles of the 
Three Ones. 
‘‘(d) ACTIVITIES SUPPORTED.—Assistance provided 
under subsection (c) shall, to the maximum extent prac-
ticable, be used to carry out the following activities: 
‘‘(1) PREVENTION.—Prevention of HIV/AIDS 
through activities including— 
‘‘(A) programs and efforts that are de-
signed or intended to impart knowledge with 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00824
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
825 
the exclusive purpose of helping individuals 
avoid behaviors that place them at risk of HIV 
infection, including integration of such pro-
grams into health programs and the inclusion 
in counseling programs of information on meth-
ods of avoiding infection of HIV, including de-
laying sexual debut, abstinence, fidelity and mo-
nogamy, reduction of casual sexual partnering 
and multiple concurrent sexual partnering, re-
ducing sexual violence and coercion, including 
child marriage, widow inheritance, and polyg-
amy, and where appropriate, use of male and 
female condoms; 
‘‘(B) assistance to establish and implement 
culturally appropriate HIV/AIDS education and 
prevention programs that are designed with 
local input and focus on helping individuals 
avoid infection of HIV/AIDS, implemented 
through nongovernmental organizations, includ-
ing faith-based and community-based organiza-
tions, particularly those locally based organiza-
tions that utilize both professionals and volun-
teers with appropriate skills, experience, and 
community presence; 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00825
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
826 
‘‘(C) assistance for the purpose of encour-
aging men to be responsible in their sexual be-
havior, child rearing, and to respect women; 
‘‘(D) assistance for the purpose of pro-
viding voluntary testing and counseling (includ-
ing the incorporation of confidentiality protec-
tions with respect to such testing and coun-
seling) and promoting the use of provider-initi-
ated or ‘opt-out’ voluntary testing in accordance 
with World Health Organization guidelines; 
‘‘(E) assistance for the purpose of pre-
venting mother-to-child transmission of the 
HIV infection, including medications to prevent 
such transmission and access to infant formula 
and other alternatives for infant feeding; 
‘‘(F) assistance to— 
‘‘(i) achieve the goal of reaching 80 
percent of pregnant women for prevention 
and treatment of mother-to-child trans-
mission of HIV in countries in which the 
United States is implementing HIV/AIDS 
programs by 2013; and 
‘‘(ii) promote infant feeding options 
and treatment protocols that meet the 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00826
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
827 
most recent criteria established by the 
World Health Organization; 
‘‘(G) medical male circumcision programs 
as part of national strategies to combat the 
transmission of HIV/AIDS; 
‘‘(H) assistance to ensure a safe blood sup-
ply and sterile medical equipment; 
‘‘(I) assistance to help avoid substance 
abuse and intravenous drug use that can lead 
to HIV infection; 
‘‘(J) assistance for the purpose of increas-
ing women’s access to employment opportuni-
ties, income, productive resources, and micro-
finance programs, where appropriate; and 
‘‘(K) assistance for counseling, testing, 
treatment, care, and support programs, includ-
ing— 
‘‘(i) counseling and other services for 
the prevention of reinfection of individuals 
with HIV/AIDS; 
‘‘(ii) counseling to prevent sexual 
transmission of HIV, including— 
‘‘(I) life skills development for 
practicing abstinence and faithfulness; 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00827
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
828 
‘‘(II) reducing the number of sex-
ual partners; 
‘‘(III) delaying sexual debut; and 
‘‘(IV) ensuring correct and con-
sistent use of condoms; 
‘‘(iii) assistance to engage underlying 
vulnerabilities to HIV/AIDS, especially 
those of women and girls; 
‘‘(iv) assistance for appropriate HIV/ 
AIDS education programs and training 
targeted to prevent the transmission of 
HIV among men who have sex with men; 
‘‘(v) assistance to provide male and 
female condoms; 
‘‘(vi) diagnosis and treatment of other 
sexually transmitted infections; 
‘‘(vii) strategies to address the stigma 
and discrimination that impede HIV/AIDS 
prevention efforts; and 
‘‘(viii) assistance to facilitate wide-
spread access to microbicides for HIV pre-
vention, if safe and effective products be-
come available, including financial and 
technical support for culturally appropriate 
introductory programs, procurement, dis-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00828
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
829 
tribution, logistics management, program 
delivery, acceptability studies, provider 
training, 
demand 
generation, 
and 
postintroduction monitoring. 
‘‘(2) TREATMENT.—The treatment and care of 
individuals with HIV/AIDS, including— 
‘‘(A) assistance to establish and implement 
programs to strengthen and broaden indigenous 
health care delivery systems and the capacity of 
such systems to deliver HIV/AIDS pharma-
ceuticals and otherwise provide for the treat-
ment of individuals with HIV/AIDS, including 
clinical training for indigenous organizations 
and health care providers; 
‘‘(B) assistance to strengthen and expand 
hospice and palliative care programs to assist 
patients debilitated by HIV/AIDS, their fami-
lies, and the primary caregivers of such pa-
tients, including programs that utilize faith- 
based and community-based organizations; 
‘‘(C) assistance for the purpose of the care 
and treatment of individuals with HIV/AIDS 
through the provision of pharmaceuticals, in-
cluding antiretrovirals and other pharma-
ceuticals and therapies for the treatment of op-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00829
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
830 
portunistic infections, pain management, nutri-
tional support, and other treatment modalities; 
‘‘(D) as part of care and treatment of 
HIV/AIDS, assistance (including prophylaxis 
and treatment) for common HIV/AIDS-related 
opportunistic infections for free or at a rate at 
which it is easily affordable to the individuals 
and populations being served; and 
‘‘(E) as part of care and treatment of 
HIV/AIDS, assistance or referral to available 
and adequately resourced service providers for 
nutritional support, including counseling and 
where necessary the provision of commodities, 
for persons meeting malnourishment criteria 
and their families. 
‘‘(3) 
PREVENTATIVE
INTERVENTION
EDU-
CATION AND TECHNOLOGIES.—(A) With particular 
emphasis on specific populations that represent a 
particularly high risk of contracting or spreading 
HIV/AIDS, including those exploited through the 
sex trade, victims of rape and sexual assault, indi-
viduals already infected with HIV/AIDS, and in 
cases of occupational exposure of health care work-
ers, assistance with efforts to reduce the risk of 
HIV/AIDS infection including post-exposure phar-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00830
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
831 
maceutical prophylaxis, and necessary pharma-
ceuticals and commodities, including test kits, 
condoms, and, when proven effective, microbicides. 
‘‘(B) Bulk purchases of available test kits, 
condoms, and, when proven effective, microbicides 
that are intended to reduce the risk of HIV/AIDS 
transmission and for appropriate program support 
for the introduction and distribution of these com-
modities, as well as education and training on the 
use of the technologies. 
‘‘(4) MONITORING.—The monitoring of pro-
grams, projects, and activities carried out pursuant 
to paragraphs (1) through (3), including— 
‘‘(A) monitoring to ensure that adequate 
controls are established and implemented to 
provide HIV/AIDS pharmaceuticals and other 
appropriate medicines to poor individuals with 
HIV/AIDS; 
‘‘(B) appropriate evaluation and surveil-
lance activities; 
‘‘(C) monitoring to ensure that appropriate 
measures are being taken to maintain the sus-
tainability of HIV/AIDS pharmaceuticals (espe-
cially antiretrovirals) and ensure that drug re-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00831
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
832 
sistance is not compromising the benefits of 
such pharmaceuticals; 
‘‘(D) monitoring to ensure appropriate law 
enforcement officials are working to ensure that 
HIV/AIDS pharmaceuticals are not diminished 
through illegal counterfeiting or black market 
sales of such pharmaceuticals; 
‘‘(E) carrying out and expanding program 
monitoring, impact evaluation research and 
analysis, and operations research and dissemi-
nating data and findings through mechanisms 
to be developed by the Coordinator of United 
States Government Activities to Combat HIV/ 
AIDS Globally, in coordination with the Direc-
tor of the Centers for Disease Control, in order 
to— 
‘‘(i) improve accountability, increase 
transparency, and ensure the delivery of 
evidence-based services through the collec-
tion, evaluation, and analysis of data re-
garding gender-responsive interventions, 
disaggregated by age and sex; 
‘‘(ii) identify and replicate effective 
models; and 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00832
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
833 
‘‘(iii) develop gender indicators to 
measure outcomes and the impacts of 
interventions; and 
‘‘(F) establishing appropriate systems to— 
‘‘(i) gather epidemiological and social 
science data on HIV; and 
‘‘(ii) evaluate the effectiveness of pre-
vention efforts among men who have sex 
with men, with due consideration to stigma 
and risks associated with disclosure. 
‘‘(5) PHARMACEUTICALS.— 
‘‘(A) PROCUREMENT.—The procurement of 
HIV/AIDS pharmaceuticals, antiviral therapies, 
and other appropriate medicines, including 
medicines to treat opportunistic infections. 
‘‘(B) MECHANISMS FOR QUALITY CONTROL 
AND
SUSTAINABLE
SUPPLY.—Mechanisms to 
ensure that such HIV/AIDS pharmaceuticals, 
antiretroviral therapies, and other appropriate 
medicines are quality-controlled and sustainably 
supplied. 
‘‘(C) MECHANISM
TO
ENSURE
COST-EF-
FECTIVE DRUG PURCHASING.—Subject to sub-
paragraph (B), mechanisms to ensure that safe 
and 
effective 
pharmaceuticals, 
including 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00833
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
834 
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. 
‘‘(D) DISTRIBUTION.—The distribution of 
such 
HIV/AIDS 
pharmaceuticals, 
antiviral 
therapies, and other appropriate medicines (in-
cluding medicines to treat opportunistic infec-
tions) to qualified national, regional, or local or-
ganizations for the treatment of individuals 
with HIV/AIDS in accordance with appropriate 
HIV/AIDS testing and monitoring requirements 
and treatment protocols and for the prevention 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00834
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
835 
of mother-to-child transmission of the HIV in-
fection. 
‘‘(6) RELATED
AND
COORDINATED
ACTIVI-
TIES.—The conduct of related activities, including— 
‘‘(A) the care and support of children who 
are orphaned by the HIV/AIDS pandemic, in-
cluding services designed to care for orphaned 
children in a family environment which rely on 
extended family members; 
‘‘(B) improved infrastructure and institu-
tional capacity to develop and manage edu-
cation, prevention, and treatment programs, in-
cluding training and the resources to collect 
and maintain accurate HIV surveillance data to 
target programs and measure the effectiveness 
of interventions; 
‘‘(C) vaccine research and development 
partnership programs with specific plans of ac-
tion to develop a safe, effective, accessible, pre-
ventive HIV vaccine for use throughout the 
world; 
‘‘(D) coordinated or referred activities to— 
‘‘(i) enhance the clinical impact of 
HIV/AIDS care and treatment; and 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00835
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
836 
‘‘(ii) ameliorate the adverse social and 
economic costs often affecting AIDS-im-
pacted families and communities through 
the direct provision, as necessary, or 
through the referral, if possible, of support 
services, including— 
‘‘(I) nutritional and food support; 
‘‘(II) safe drinking water and 
adequate sanitation; 
‘‘(III) nutritional counseling; 
‘‘(IV) income-generating activi-
ties and livelihood initiatives; 
‘‘(V) maternal and child health 
care; 
‘‘(VI) primary health care; 
‘‘(VII) the diagnosis and treat-
ment of other infectious or sexually 
transmitted diseases; 
‘‘(VIII) substance abuse and 
treatment services; and 
‘‘(IX) legal services; 
‘‘(E) coordinated or referred activities to 
link programs addressing HIV/AIDS with pro-
grams addressing gender-based violence in 
areas of significant HIV prevalence to assist 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00836
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
837 
countries in the development and enforcement 
of women’s health, children’s health, and HIV/ 
AIDS laws and policies that— 
‘‘(i) prevent and respond to violence 
against women and girls; 
‘‘(ii) 
promote 
the 
integration 
of 
screening and assessment for gender-based 
violence into HIV/AIDS programming; 
‘‘(iii) promote appropriate HIV/AIDS 
counseling, testing, and treatment into 
gender-based violence programs; and 
‘‘(iv) assist governments to develop 
partnerships with civil society organiza-
tions to create networks for psychosocial, 
legal, economic, or other support services; 
‘‘(F) coordinated or referred activities to— 
‘‘(i) address the frequent coinfection 
of HIV and tuberculosis, in accordance 
with World Health Organization guide-
lines; 
‘‘(ii) promote provider-initiated or 
‘opt-out’ HIV/AIDS counseling and testing 
and appropriate referral for treatment and 
care to individuals with tuberculosis or its 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00837
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
838 
symptoms, particularly in areas with sig-
nificant HIV prevalence; and 
‘‘(iii) strengthen programs to ensure 
that individuals testing positive for HIV 
receive tuberculosis screening and to im-
prove laboratory capacities, infection con-
trol, and adherence; and 
‘‘(G) activities to— 
‘‘(i) improve the effectiveness of na-
tional responses to HIV/AIDS; 
‘‘(ii) strengthen overall health systems 
in high-prevalence countries, including sup-
port for workforce training, retention, and 
effective deployment, capacity building, 
laboratory development, equipment mainte-
nance and repair, and public health and 
related public financial management sys-
tems and operations; 
‘‘(iii) encourage fair and transparent 
procurement 
practices 
among 
partner 
countries; and 
‘‘(iv) promote in-country or intra-re-
gional pediatric training for physicians and 
other 
health 
professionals, 
preferably 
through public-private partnerships involv-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00838
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
839 
ing colleges and universities, with the goal 
of increasing pediatric HIV workforce ca-
pacity. 
‘‘(7) COMPREHENSIVE
HIV/AIDS
PUBLIC-PRI-
VATE PARTNERSHIPS.—The establishment and oper-
ation of public-private partnership entities within 
countries in sub-Saharan Africa, the Caribbean, and 
other countries affected by the HIV/AIDS pandemic 
that are dedicated to supporting the national strat-
egy of such countries regarding the prevention, 
treatment, and monitoring of HIV/AIDS. Each such 
public-private partnership should— 
‘‘(A) support the development, implementa-
tion, and management of comprehensive HIV/ 
AIDS plans in support of the national HIV/ 
AIDS strategy; 
‘‘(B) operate at all times in a manner that 
emphasizes efficiency, accountability, and re-
sults-driven programs; 
‘‘(C) engage both local and foreign devel-
opment partners and donors, including busi-
nesses, government agencies, academic institu-
tions, nongovernmental organizations, founda-
tions, multilateral development agencies, and 
faith-based organizations, to assist the country 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00839
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
840 
in coordinating and implementing HIV/AIDS 
prevention, treatment, and monitoring pro-
grams in accordance with its national HIV/ 
AIDS strategy; 
‘‘(D) provide technical assistance, consult-
ant services, financial planning, monitoring and 
evaluation, and research in support of the na-
tional HIV/AIDS strategy; and 
‘‘(E) establish local human resource capac-
ities for the national HIV/AIDS strategy 
through the transfer of medical, managerial, 
leadership, and technical skills. 
‘‘(8) COMPACTS
AND
FRAMEWORK
AGREE-
MENTS.—The development of compacts or frame-
work agreements, tailored to local circumstances, 
with national governments or regional partnerships 
in countries with significant HIV/AIDS burdens to 
promote host government commitment to deeper in-
tegration of HIV/AIDS services into health systems, 
contribute to health systems overall, and enhance 
sustainability, including— 
‘‘(A) meaningful cost-sharing assurances 
by the partner country; and 
‘‘(B) transition strategies to ensure sus-
tainability of such programs and activities, in-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00840
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
841 
cluding health care systems, under other inter-
national donor support, or budget support by 
respective foreign governments. 
‘‘(e) COMPACTS AND FRAMEWORK AGREEMENTS.— 
‘‘(1) FINDINGS.—Congress makes the following 
findings: 
‘‘(A) The congressionally mandated Insti-
tute of Medicine report entitled ‘PEPFAR Im-
plementation: Progress and Promise’ states: 
‘The next strategy [of the U.S. Global AIDS 
Initiative] should squarely address the needs 
and challenges involved in supporting sustain-
able country HIV/AIDS programs, thereby 
transitioning from a focus on emergency relief.’. 
‘‘(B) One mechanism to promote the tran-
sition from an emergency to a public health and 
development approach to HIV/AIDS is through 
compacts or framework agreements between the 
United States Government and each partici-
pating nation. 
‘‘(2) ELEMENTS.—Compacts on HIV/AIDS au-
thorized under subsection (d)(8) shall include the 
following elements: 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00841
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
842 
‘‘(A) Compacts whose primary purpose is 
to provide direct services to combat HIV/AIDS 
are to be made between— 
‘‘(i) the United States Government; 
and 
‘‘(ii)(I) national or regional entities 
representing low-income countries served 
by an existing United States Agency for 
International Development or Department 
of Health and Human Services presence or 
regional platform; or 
‘‘(II) countries or regions— 
‘‘(aa) experiencing significantly 
high HIV prevalence or risk of signifi-
cantly increasing incidence within the 
general population; 
‘‘(bb) served by an existing 
United States Agency for Inter-
national Development or Department 
of Health and Human Services pres-
ence or regional platform; and 
‘‘(cc) that have inadequate finan-
cial means within such country or re-
gion. 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00842
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
843 
‘‘(B) Compacts whose primary purpose is 
to provide limited technical assistance to a 
country or region connected to services provided 
within the country or region— 
‘‘(i) may be made with other countries 
or regional entities served by an existing 
United States Agency for International 
Development or Department of Health and 
Human Services presence or regional plat-
form; 
‘‘(ii) shall require significant invest-
ments in HIV prevention, care, and treat-
ment services by the host country; 
‘‘(iii) shall be time-limited in terms of 
United States contributions; and 
‘‘(iv) shall be made only upon prior 
notification to Congress— 
‘‘(I) justifying the need for such 
compacts; 
‘‘(II) describing the expected in-
vestment by the country or regional 
entity; and 
‘‘(III) describing the scope, na-
ture, expected total United States in-
vestment, and time frame of the lim-
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00843
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
844 
ited technical assistance under the 
compact and its intended impact. 
‘‘(C) Compacts shall include provisions 
to— 
‘‘(i) promote local and national efforts 
to reduce stigma associated with HIV/ 
AIDS; and 
‘‘(ii) work with and promote the role 
of civil society in combating HIV/AIDS. 
‘‘(D) Compacts shall take into account the 
overall national health and development and na-
tional HIV/AIDS and public health strategies of 
each country. 
‘‘(E) Compacts shall contain— 
‘‘(i) consideration of the specific ob-
jectives that the country and the United 
States expect to achieve during the term of 
a compact; 
‘‘(ii) consideration of the respective 
responsibilities of the country and the 
United States in the achievement of such 
objectives; 
‘‘(iii) consideration of regular bench-
marks to measure progress toward achiev-
ing such objectives; 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00844
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
845 
‘‘(iv) an identification of the intended 
beneficiaries, disaggregated by gender and 
age, and including information on orphans 
and vulnerable children, to the maximum 
extent practicable; 
‘‘(v) consideration of the methods by 
which the compact is intended to— 
‘‘(I) address the factors that put 
women and girls at greater risk of 
HIV/AIDS; and 
‘‘(II) strengthen elements such as 
the economic, educational, and social 
status of women, girls, orphans, and 
vulnerable children and the inherit-
ance rights and safety of such individ-
uals; 
‘‘(vi) consideration of the methods by 
which the compact will— 
‘‘(I) strengthen the health care 
capacity, including factors such as the 
training, retention, deployment, re-
cruitment, and utilization of health 
care workers; 
‘‘(II) improve supply chain man-
agement; and 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00845
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
846 
‘‘(III) improve the health systems 
and infrastructure of the partner 
country, including the ability of com-
pact participants to maintain and op-
erate equipment transferred or pur-
chased as part of the compact; 
‘‘(vii) consideration of proposed mech-
anisms to provide oversight; 
‘‘(viii) consideration of the role of civil 
society in the development of a compact 
and the achievement of its objectives; 
‘‘(ix) a description of the current and 
potential participation of other donors in 
the achievement of such objectives, as ap-
propriate; and 
‘‘(x) consideration of a plan to ensure 
appropriate fiscal accountability for the 
use of assistance. 
‘‘(F) For regional compacts, priority shall 
be given to countries that are included in re-
gional funds and programs in existence as of 
the date of the enactment of the Tom Lantos 
and Henry J. Hyde United States Global Lead-
ership Against HIV/AIDS, Tuberculosis, and 
Malaria Reauthorization Act of 2008. 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00846
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
847 
‘‘(G) Amounts made available for compacts 
described in subparagraphs (A) and (B) shall 
be subject to the inclusion of— 
‘‘(i) meaningful cost-sharing assur-
ances by the partner country; and 
‘‘(ii) transition strategies to ensure 
sustainability of such programs and activi-
ties, including health care systems, under 
other international donor support, and 
budget support by respective foreign gov-
ernments. 
‘‘(3) LOCAL INPUT.—In entering into a com-
pact on HIV/AIDS authorized under subsection 
(d)(8), the Coordinator of United States Govern-
ment Activities to Combat HIV/AIDS Globally shall 
seek to ensure that the government of a country— 
‘‘(A) takes into account the local perspec-
tives of the rural and urban poor, including 
women, in each country; and 
‘‘(B) consults with private and voluntary 
organizations, including faith-based organiza-
tions, the business community, and other do-
nors in the country. 
‘‘(4) CONGRESSIONAL AND PUBLIC NOTIFICA-
TION AFTER ENTERING INTO A COMPACT.—Not later 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00847
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
848 
than 10 days after entering into a compact author-
ized under subsection (d)(8), the Global AIDS Coor-
dinator shall— 
‘‘(A) submit a report containing a detailed 
summary of the compact and a copy of the text 
of the compact to— 
‘‘(i) the Committee on Foreign Rela-
tions of the Senate; 
‘‘(ii) the Committee on Appropriations 
of the Senate; 
‘‘(iii) the Committee on Foreign Af-
fairs of the House of Representatives; and 
‘‘(iv) the Committee on Appropria-
tions of the House of Representatives; and 
‘‘(B) publish such information in the Fed-
eral Register and on the Internet website of the 
Office of the Global AIDS Coordinator. 
‘‘(f) ANNUAL REPORT.— 
‘‘(1) IN GENERAL.—Not later than January 31 
of each year, the President shall submit to the Com-
mittee on Foreign Relations of the Senate and the 
Committee on Foreign Affairs of the House of Rep-
resentatives a report on the implementation of this 
section for the prior fiscal year. 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00848
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS
849 
‘‘(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 
302, and section 303; 
‘‘(B) a description of the programs estab-
lished pursuant to such sections; 
‘‘(C) a detailed breakdown of funding allo-
cations, by program and by country, for preven-
tion activities; and 
‘‘(D) a detailed assessment of the impact 
of programs established pursuant to such sec-
tions, including— 
‘‘(i)(I) the effectiveness of such pro-
grams in reducing— 
‘‘(aa) the transmission of 
HIV, particularly in women and 
girls; 
‘‘(bb) mother-to-child trans-
mission 
of 
HIV, 
including 
through 
drug 
treatment 
and 
therapies, either directly or by re-
ferral; and 
VerDate Mar 15 2010 
22:23 Apr 26, 2013
Jkt 029200
PO 00000
Frm 00849
Fmt 6652
Sfmt 6201
E:\BILLS\H1793.IH
H1793
tkelley on DSK3SPTVN1PROD with BILLS