IIB
106TH CONGRESS
2D SESSION
H. R. 3519
IN THE SENATE OF THE UNITED STATES
MAY 16, 2000
Received; read twice and referred to the Committee on Foreign Relations
AN ACT
To provide for negotiations for the creation of a trust fund
to be administered by the International Bank for Recon-
struction and Development or the International Develop-
ment Association to combat the AIDS epidemic.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
HR 3519 RFS
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘World Bank AIDS
Marshall Plan Trust Fund Act’’.
SEC. 2. FINDINGS AND PURPOSES.
(a) FINDINGS.—The Congress finds the following:
(1) According to the Surgeon General of the
United States, the epidemic of human immuno-
deficiency virus/acquired immune deficiency syn-
drome (HIV/AIDS) will soon become the worst epi-
demic of infectious disease in recorded history,
eclipsing both the bubonic plague of the 1300’s and
the influenza epidemic of 1918–1919 which killed
more than 20,000,000 people worldwide.
(2) According to the Joint United Nations Pro-
gramme on HIV/AIDS (UNAIDS), 33,600,000 peo-
ple in the world today are living with HIV/AIDS, of
which approximately 95 percent live in the devel-
oping world.
(3) UNAIDS data shows that among children
age 14 and under worldwide, 3,600,000 have died
from AIDS, 1,200,000 are living with the disease;
and in one year alone—1999—an estimated 570,000
became infected, of which over 90 percent were ba-
bies born to HIV-positive women.
(4) Although sub-Saharan Africa has only 10
percent of the world’s population, it is home to
HR 3519 RFS
23,300,000—roughly 70 percent—of the world’s
HIV/AIDS cases.
(5) Worldwide, there have already been an esti-
mated 16,300,000 deaths because of HIV/AIDS, of
which 13,700,000—over 80 percent—occurred in
sub-Saharan Africa.
(6) According to testimony by the Office of Na-
tional AIDS Policy, an entire generation of children
in Africa is in jeopardy, with one-fifth to one-third
of all children in some countries already orphaned
and the figure estimated to rise to 40,000,000 by
2010.
(7) The 1999 annual report by the United Na-
tions Children’s Fund (UNICEF) states ‘‘[t]he
number of orphans, particularly in Africa, con-
stitutes nothing less than an emergency, requiring
an emergency response’’ and that ‘‘finding the re-
sources needed to help stabilize the crisis and pro-
tect children is a priority that requires urgent action
from the international community.’’.
(8) A 1999 Bureau of the Census report states
that the average life expectancy in the Republic of
Botswana, the Republic of Zimbabwe, the Kingdom
of Swaziland, the Republic of Malawi, and the Re-
public of Zambia has decreased from approximately
HR 3519 RFS
age 65 to approximately age 40—the lowest life ex-
pectancy in the world—due to high mortality rates
from HIV/AIDS.
(9) A January 2000 unclassified United States
National Intelligence Estimate (NIE) report on the
global infectious disease threat concluded that the
economic costs of infectious diseases—especially
HIV/AIDS—are already significant and could re-
duce GDP by as much as 20 percent or more by
2010 in some sub-Saharan African nations.
(10) According to the same NIE report, HIV
prevalence among militias in Angola and the Demo-
cratic Republic of the Congo are estimated at 40 to
60 percent, and at 15 to 30 percent in Tanzania.
(11) The HIV/AIDS epidemic is of increasing
concern in other regions of the world with UNAIDS
reporting, for example, that there are 6 million cases
in South and South-east Asia, that the rate of HIV
infection in the Caribbean is second only to sub-Sa-
haran Africa, and that HIV infections have doubled
in just two years in the former Soviet Union.
(12) Despite the grim statistics on the spread
of HIV/AIDS, some developing nations—such as
Uganda, Senegal, and Thailand—have implemented
HR 3519 RFS
prevention programs that have substantially curbed
the rate of HIV infection.
(13) AIDS, like all diseases, knows no bound-
aries, and there is no certitude that the scale of the
problem in one continent can be contained within
that region.
(14) According to a 1999 study prepared by
UNAIDS and the Francois-Xavier Bagnoud Center
for Health and Human Rights at the Harvard
School of Public Health, HIV/AIDS is spreading
three times faster than funding available to control
the disease.
(15) The United Nations Secretary General has
stated ‘‘[n]o company and no government can take
on the challenge of AIDS alone,’’ and that ‘‘what is
needed is a new approach to public health—com-
bining all available resources, public and private,
local and global.’’.
(16) The World Bank, declaring AIDS not just
a public health problem but ‘‘the foremost and fast-
est-growing threat to development’’ in Africa, has
launched a new strategy for HIV/AIDS in Africa,
declaring it a top priority for the Bank on that con-
tinent.
HR 3519 RFS
(17) The World Bank estimates that for Africa
alone $1,000,000,000 to $2,300,000,000 annually is
needed for prevention in contrast to the approxi-
mately $300,000,000 a year in official assistance
currently available for HIV/AIDS in Africa.
(18) Accordingly, United States financial sup-
port for medical research, education, and disease
containment as a global strategy has beneficial rami-
fications for millions of Americans and their families
who are affected by this disease, and the entire pop-
ulation which is potentially susceptible.
(b) PURPOSES.—The purposes of this Act are to pre-
vent the spread of HIV/AIDS and promote its eradication,
prevent human suffering, and to mitigate the devastating
impact of the disease on economic and human develop-
ment, social stability, and security in the developing world,
through the creation of a trust fund which is designed
to—
(1) work with governments, civil society, non-
governmental organizations, the Joint United Na-
tions Program on HIV/AIDS (UNAIDS), the Inter-
national Partnership Against AIDS in Africa, other
international organizations, donor agencies, and the
private sector to intensify action against the HIV/
AIDS epidemic and to support essential field work
HR 3519 RFS
in the most affected countries to assist in the devel-
opment of AIDS vaccines; and
(2) seek to leverage financial commitments by
the United States in order to mobilize additional re-
sources from other donors, the private sector, non-
governmental organizations, and recipient countries
to combat the spread of HIV/AIDS.
TITLE 
I—NEGOTIATIONS 
FOR
THE CREATION OF A WORLD
BANK AIDS TRUST FUND
SEC. 101. TRUST FUND TO ASSIST IN HIV/AIDS PREVEN-
TION, CARE AND TREATMENT, AND ERADI-
CATION.
The Secretary of the Treasury shall seek to enter into
negotiations with the International Bank for Reconstruc-
tion and Development or the International Development
Association, and with the member nations of such institu-
tions and with other interested parties for the creation of
a trust fund which would be authorized to solicit and ac-
cept contributions from governments, the private sector,
and nongovernmental entities of all kinds and use the con-
tributions to address the HIV/AIDS epidemic in countries
eligible to borrow from such institutions, as follows:
(1) PROGRAM
OBJECTIVES.—The trust fund
would provide only grants, including grants for tech-
HR 3519 RFS
nical assistance, to support measures to build local
capacity in national and local government, civil soci-
ety, and the private sector to lead and implement ef-
fective and affordable HIV/AIDS prevention, edu-
cation, treatment and care services, and research
and development activities, including affordable
drugs. Among the activities the trust fund would
provide grants for would be programs to promote
best practices in prevention, including health edu-
cation messages that emphasize risk avoidance;
measures to ensure a safe blood supply; voluntary
HIV/AIDS testing and counseling; measures to stop
mother-to-child transmission of HIV/AIDS, includ-
ing through diagnosis of pregnant women, access to
cost-effective treatment and counseling and access to
infant formula or other alternatives for infant feed-
ing; and deterrence of gender-based violence and
provision of post-exposure prophylaxis to victims of
rape and sexual assault. In carrying out these objec-
tives, the trust fund would coordinate its activities
with governments, civil society, nongovernmental or-
ganizations, the Joint United Nations Program on
HIV/AIDS (UNAIDS), the International Partner-
ship Against AIDS in Africa, other international or-
HR 3519 RFS
ganizations, the private sector, and donor agencies
working to combat the HIV/AIDS crisis.
(2) PRIORITY.—In providing such grants, the
trust fund would give priority to countries that have
the highest HIV/AIDS prevalence rate or are at risk
of having a high HIV/AIDS prevalence rate, and
that have or agree to carry out a national HIV/
AIDS program which—
(A) has a government commitment at the
highest level and multiple partnerships with
civil society and the private sector;
(B) invests early in effective prevention ef-
forts;
(C) requires cooperation and collaboration
among many different groups and sectors, in-
cluding those who are most affected by the epi-
demic, religious and community leaders, non-
governmental organizations, researchers and
health professionals, and the private sector;
(D) is decentralized and uses participatory
approaches to bring prevention care programs
to national scale; and
(E) is characterized by community partici-
pation in government policymaking as well as
design and implementation of the program, in-
HR 3519 RFS
cluding implementation of such programs by
people living with HIV/AIDS, nongovernmental
organizations, civil society, and the private sec-
tor.
(3) GOVERNANCE.—
(A) IN GENERAL.—The trust fund would
be administered as a trust fund of the Inter-
national Bank for Reconstruction and Develop-
ment. Subject to general policy guidance from
the President of the United States and rep-
resentatives of the other donors to the trust
fund, the Trustee would be responsible for man-
aging the day-to-day operations of the trust
fund.
(B) SELECTION OF PROJECTS AND RECIPI-
ENTS.—In consultation with the President and
other donors to the trust fund, the Trustee
would establish criteria, that have been agreed
on by the donors, for the selection of projects
to receive support from the trust fund, stand-
ards and criteria regarding qualifications of re-
cipients of such support, as well as such rules
and procedures as would be necessary for cost-
effective management of the trust fund. The
trust fund would not make grants for the pur-
HR 3519 RFS
pose of project development associated with bi-
lateral or multilateral development bank loans.
(C) TRANSPARENCY
OF
OPERATIONS.—
The Trustee shall ensure full and prompt public
disclosure of the proposed objectives, financial
organization, and operations of the trust fund.
(D) ADVISORY BOARD.—
(i) APPOINTMENT.—The President of
the United States and representatives of
other participating donors to the trust
fund would establish an Advisory Board,
and appoint to the Advisory Board re-
nowned and distinguished international
leaders who have demonstrated integrity
and knowledge of issues relating to devel-
opment, health care (especially HIV/
AIDS), and Africa.
(ii) DUTIES.—The Advisory Board
would, in consultation with other inter-
national experts in related fields (including
scientists, researchers, and doctors), advise
and provide guidance for the trust fund on
the development and implementation of the
projects receiving support from the trust
fund. Once the Advisory Board is estab-
HR 3519 RFS
lished, the Secretary of the Treasury shall
ensure that the Trustee provides the Advi-
sory Board complete access to all informa-
tion and documents of the trust fund nec-
essary to the effective functioning of the
Advisory Board.
TITLE II—UNITED STATES
FINANCIAL PARTICIPATION
SEC. 201. LIMITATIONS ON AUTHORIZATION OF APPRO-
PRIATIONS.
In addition to any other funds authorized to be ap-
propriated for multilateral or bilateral programs related
to AIDS or economic development, there are authorized
to be appropriated to the Secretary of the Treasury
$100,000,000 for each of fiscal years 2001 through 2005
for payment to the trust fund established as a result of
negotiations entered into pursuant to section 101.
TITLE III—REPORTS
SEC. 301. REPORTS TO THE CONGRESS.
(a) ANNUAL REPORTS.—Not later than 1 year after
the date of the enactment of this Act, and annually there-
after for the duration of the trust fund established pursu-
ant to section 101, the Secretary of the Treasury shall
submit to the appropriate committees of the Congress a
written report on the trust fund, the goals of the trust
HR 3519 RFS
fund, the programs, projects, and activities, including any
vaccination approaches, supported by the trust fund, and
the effectiveness of such programs, projects, and activities
in reducing the worldwide spread of AIDS.
(b) APPROPRIATE COMMITTEES DEFINED.—In sub-
section (a), the term ‘‘appropriate committees’’ means the
Committees on Appropriations, on International Rela-
tions, and on Banking and Financial Services of the
House of Representatives and the Committees on Appro-
priations, on Foreign Relations, and on Banking, Hous-
ing, and Urban Affairs of the Senate.
TITLE IV—HIV/AIDS
PREVENTION AND CARE
SEC. 401. STRENGTHENING LOCAL CAPACITY IN SUB-SAHA-
RAN AFRICA TO IMPLEMENT HIV/AIDS PRE-
VENTION AND CARE PROGRAMS.
Title XVI of the International Financial Institutions
Act (22 U.S.C. 262p—262p–7) is amended by adding at
the end the following:
‘‘SEC. 1625. STRENGTHENING LOCAL CAPACITY IN SUB-SA-
HARAN AFRICA TO IMPLEMENT HIV/AIDS
PREVENTION AND CARE PROGRAMS.
‘‘The Secretary of the Treasury shall instruct the
United States Executive Director at the International
Bank for Reconstruction and Development to use the voice
HR 3519 RFS
and vote of the United States to encourage the Bank to
work with sub-Saharan African countries to modify
projects financed by the Bank and develop new projects
to build local capacity to manage and implement programs
for the prevention of human immunodeficiency virus
(HIV) and acquired immune deficiency syndrome (AIDS)
and the care of persons with HIV/AIDS, including
through health care delivery mechanisms which facilitate
the distribution of affordable drugs for persons infected
with HIV.’’.
Passed the House of Representatives May 15, 2000.
Attest:
JEFF TRANDAHL,
Clerk.