H. R. 5501—10 
‘‘(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 
programmatic 
decisions associated with that assistance; 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 
tuberculosis; and 
‘‘(B) improving coordination and integration of HIV/ 
AIDS and tuberculosis programming; 
‘‘(28) ensure coordination between the Global AIDS Coordi-
nator and the Malaria Coordinator and address issues of comor-
bidity between HIV/AIDS and malaria; and 
‘‘(29) include a longer term estimate of the projected 
resource needs, progress toward greater sustainability and 
country ownership of HIV/AIDS programs, 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 appropriate 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 following 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 out-
come-related performance measures of the strategy. 
‘‘(D) A description of future costs and resources needed 
to carry out the strategy. 
‘‘(E) A delineation of United States Government 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 harmoni-
zation and alignment. 
‘‘(G) A description of the manner in which the strategy 
will—
H. R. 5501—11 
‘‘(i) further the development and implementation 
of the national multisectoral strategic HIV/AIDS 
frameworks of partner governments; and 
‘‘(ii) enhance the centrality, effectiveness, 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 esti-
mates of numbers of persons in need of antiretroviral treat-
ment, country-level benchmarks for United States support 
for assistance for antiretroviral treatment, and numbers 
of persons enrolled in antiretroviral treatment programs 
receiving United States support. If global benchmarks are 
not achieved within the reporting period, the report shall 
include a description of steps being taken to ensure that 
global benchmarks will be achieved and a detailed break-
down 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 research is 
addressed in the strategy and how such research can most 
effectively be integrated into care, treatment, and preven-
tion activities in order to— 
‘‘(i) improve program quality and efficiency; 
‘‘(ii) ascertain cost effectiveness; 
‘‘(iii) ensure transparency and accountability; 
‘‘(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 meth-
odologies to promote abstinence, monogamy, faithfulness, 
the correct and consistent use of male and female condoms, 
reductions in concurrent sexual partners, and delay of 
sexual debut, and of intended monitoring and evaluation 
approaches to measure the effectiveness of prevention pro-
grams and ensure that they are targeted to appropriate 
audiences. 
‘‘(L) Within the analysis required under subparagraph 
(K), an examination of additional planned means of pre-
venting the transmission of HIV including medical male 
circumcision, maintenance of a safe blood supply, public 
education about risks to acquire HIV infection from blood 
exposures, promotion of universal precautions, investiga-
tion of suspected nosocomial infections and other tools. 
‘‘(M) A description of efforts to assist partner country 
and community to identify and address social, economic, 
or cultural factors, such as migration, urbanization, conflict, 
gender-based violence, lack of empowerment for women, 
and transportation patterns, which directly contribute to 
the transmission of HIV. 
‘‘(N) A description of the specific targets, goals, and 
strategies 
developed 
to 
address 
the 
needs 
and
H. R. 5501—12 
vulnerabilities 
of 
women 
and 
girls 
to 
HIV/AIDS, 
including— 
‘‘(i) activities directed toward men and boys; 
‘‘(ii) activities to enhance educational, micro-
finance, 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; 
‘‘(v) strategies to meet the particular needs of 
adolescents; 
‘‘(vi) assistance for victims of rape, sexual abuse, 
assault, exploitation, and trafficking; and 
‘‘(vii) programs to prevent alcohol abuse. 
‘‘(O) A description of strategies to address male norms 
and behaviors that contribute to the transmission of HIV, 
to promote responsible male behavior, and to promote male 
participation and leadership in HIV/AIDS prevention, care, 
treatment, and voluntary counseling and testing. 
‘‘(P) A description of strategies— 
‘‘(i) to address the needs of orphans and vulnerable 
children, including an analysis of— 
‘‘(I) factors contributing to children’s vulner-
ability to HIV/AIDS; and 
‘‘(II) vulnerabilities caused by the impact of 
HIV/AIDS on children and their families; and 
‘‘(ii) in areas of higher HIV/AIDS prevalence, to 
promote a community-based approach to vulnerability, 
maximizing community input into determining which 
children participate. 
‘‘(Q) A description of capacity-building efforts under-
taken by countries themselves, including adherents of the 
Abuja Declaration and an assessment of the impact of 
International Monetary Fund macroeconomic and fiscal 
policies on national and donor investments in health. 
‘‘(R) A description of the strategy to— 
‘‘(i) strengthen capacity building within the public 
health sector; 
‘‘(ii) improve health care in those countries; 
‘‘(iii) help countries to develop and implement 
national health workforce strategies; 
‘‘(iv) strive to achieve goals in training, retaining, 
and effectively deploying health staff; 
‘‘(v) promote the use of codes of conduct for ethical 
recruiting practices for health care workers; and 
‘‘(vi) increase the sustainability of health programs. 
‘‘(S) A description of the criteria for selection, objec-
tives, methodology, and structure of compacts or other 
framework agreements with countries or regional organiza-
tions, including— 
‘‘(i) the role of civil society; 
‘‘(ii) the degree of transparency; 
‘‘(iii) benchmarks for success of such compacts or 
agreements; and
H. R. 5501—13 
‘‘(iv) the relationship between such compacts or 
agreements and the national HIV/AIDS and public 
health strategies and commitments of partner coun-
tries. 
‘‘(T) A strategy to better coordinate HIV/AIDS assist-
ance with nutrition and food assistance programs. 
‘‘(U) A description of transnational or regional initia-
tives to combat regionalized epidemics in highly affected 
areas such as the Caribbean. 
‘‘(V) A description of planned resource distribution and 
global investment by region. 
‘‘(W) A description of coordination efforts in order to 
better implement the Stop TB Strategy and to address 
the problem of coinfection of HIV/AIDS and tuberculosis 
and of projected challenges or barriers to successful 
implementation. 
‘‘(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 EVALUATION.— 
The Global AIDS Coordinator shall enter into a contract with 
the Institute of Medicine of the National Academies that pro-
vides 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 consulta-
tion with the Global AIDS Coordinator and other relevant 
parties representing the public and private sector, shall provide 
the Global AIDS Coordinator with a design plan and budget 
for the evaluation 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 Lantos 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 efforts that are sup-
ported by United States funding, including multilateral 
and bilateral programs involving joint operations. 
‘‘(B) CONTENT.—The study conducted under this para-
graph 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;