I 
110TH CONGRESS 
2D SESSION 
H. R. 5485 
To establish a program to evaluate HIV/AIDS programs in order to improve 
accountability, increase transparency, and ensure the delivery of evidence- 
based services. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 25, 2008 
Mr. MILLER of North Carolina introduced the following bill; which was 
referred to the Committee on Foreign Affairs 
A BILL 
To establish a program to evaluate HIV/AIDS programs 
in order to improve accountability, increase transparency, 
and ensure the delivery of evidence-based services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘PEPFAR Account-
ability and Transparency Act’’. 
SEC. 2. EVALUATION OF HIV/AIDS PROGRAMS. 
Subtitle A of title III of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 
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2003 (22 U.S.C. 7631 et seq.) is amended by adding at 
the end the following: 
‘‘SEC. 
308. 
PROGRAM 
MONITORING, 
OPERATIONS 
RE-
SEARCH, 
AND 
IMPACT 
EVALUATION 
RE-
SEARCH. 
‘‘(a) PROGRAM ESTABLISHED.—The Coordinator of 
United States Government Activities to Combat HIV/ 
AIDS Globally (referred to in this section as the ‘Coordi-
nator’) shall establish a mechanism to evaluate global 
HIV/AIDS programs financed by the United States Gov-
ernment in order to improve accountability, increase 
transparency, and ensure the delivery of evidence-based 
services. Such mechanism shall include program moni-
toring, operations research, and impact evaluation re-
search. 
‘‘(b) DEFINITIONS.—In this subsection: 
‘‘(1) IMPACT
EVALUATION
RESEARCH.—The 
term ‘impact evaluation research’ means the applica-
tion of research methods and statistical analysis to 
measure the extent to which a change in a popu-
lation-based outcome can be attributed to program 
intervention instead of other environmental factors. 
‘‘(2) OPERATIONS RESEARCH.—The term ‘oper-
ations research’ means the application of social 
science research methods and statistical analysis to 
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judge, compare, and improve policies and program 
outcomes, from the earliest stages of defining and 
designing programs through their development and 
implementation. 
‘‘(3) PROGRAM MONITORING.—The term ‘pro-
gram monitoring’ means the collection, analysis, and 
use of routine program data to determine how well 
a program is carried out and how much the program 
costs. 
‘‘(4) ELIGIBLE ENTITIES.—The term ‘eligible 
entities’ means public or private organizations, in-
cluding academic institutions, that have documented 
experience in analyzing and evaluating the effective-
ness of health, development, or other international 
aid programs. 
‘‘(c) USE OF FUNDS.—The Coordinator shall use 
amounts provided under this section, either directly or in-
directly through grants, contracts, or cooperative agree-
ments to eligible entities, to conduct program monitoring, 
operations research, and impact evaluation research re-
lated to programs authorized under this Act. Such activi-
ties shall be conducted to— 
‘‘(1) improve the coverage, efficiency, effective-
ness, quality, and accessibility of services provided 
under this Act; 
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‘‘(2) establish the cost-effectiveness of program 
models; 
‘‘(3) assess the population-level impact of pro-
grams implemented, including the impact of pro-
grams on women, children, and other at-risk or vul-
nerable populations; 
‘‘(4) ensure the transparency and accountability 
of services provided under this Act; 
‘‘(5) disseminate and promote the utilization of 
evaluation findings, lessons, and best practices in the 
implementation of the programs receiving financial 
assistance under this Act; 
‘‘(6) encourage and evaluate innovative service 
models and strategies to optimize the delivery of 
care, treatment, and prevention programs financed 
by the United States Government; and 
‘‘(7) strengthen ongoing program monitoring 
and enhance program quality through routine pro-
gram evaluations, such as midterm and final pro-
gram evaluations. 
‘‘(d) REPORT.—Not later than 90 days after the date 
of the enactment of the PEPFAR Accountability and 
Transparency Act, the Coordinator shall submit a report 
to Congress that describes the resources provided under 
this Act for program monitoring, operations research, and 
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impact evaluation research during the 5-year period end-
ing on September 30, 2008, that describes— 
‘‘(1) the projects for which resources were obli-
gated and the outcomes of those projects; 
‘‘(2) the program improvements, including cost 
or other resource savings, which have been made as 
a result of program monitoring, operations research, 
and impact evaluation research; 
‘‘(3) how program monitoring, operations re-
search, and impact evaluation research priorities are 
determined and how input from external experts is 
incorporated; and 
‘‘(4) the process used to allocate funding for 
implementation of program monitoring, operations 
research, and impact evaluation research. 
‘‘(e) STRATEGIC PLAN.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of the enactment of the PEPFAR Account-
ability and Transparency Act, the Coordinator shall 
develop a 5-year strategic plan for program moni-
toring, operations research, and impact evaluation 
research. 
‘‘(2) PLAN
ELEMENTS.—The plan developed 
under this subsection shall include— 
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‘‘(A) the amount of funding provided for 
program monitoring, operations research, and 
impact evaluation research under this Act avail-
able through fiscal year 2009; 
‘‘(B) strategies to address the goals de-
scribed in subsection (c); 
‘‘(C) priorities for program monitoring, op-
erations research, and impact evaluation re-
search and a time line for completion of activi-
ties associated with such priorities; and 
‘‘(D) other information that the Coordi-
nator determines to be necessary. 
‘‘(3) CONSIDERATIONS.—In developing the plan 
under this subsection, the Coordinator shall consider 
a range of research priorities, including research 
in— 
‘‘(A) preventing new HIV infections by re-
ducing behavioral risks for HIV transmission, 
particularly in at-risk and vulnerable popu-
lations, including— 
‘‘(i) delaying sexual debut; 
‘‘(ii) reducing the number of sexual 
partners; 
‘‘(iii) practicing abstinence, fidelity, 
and monogamy; 
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‘‘(iv) using condoms, other effective 
protection methods that have been devel-
oped 
and 
are 
available, 
and 
female 
condoms; and 
‘‘(v) meeting the needs of discordant 
couples; 
‘‘(B) improving health care delivery sys-
tems and HIV/AIDS-related policies; 
‘‘(C) preventing mother-to-child trans-
mission, improving early identification of in-
fected children, and reducing the spread of HIV 
infections, particularly in women and girls; 
‘‘(D) reducing HIV-related mortality and 
morbidity of HIV; 
‘‘(E) treating adults and children infected 
by HIV more effectively, including establishing 
better approaches for increasing access to treat-
ment and increasing and sustaining treatment 
adherence; 
‘‘(F) addressing the vulnerabilities of mar-
ried and unmarried women and girls to HIV in-
fection, including those who are victims of rape, 
sexual violence, and coercion; 
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‘‘(G) integrating family planning into HIV/ 
AIDS prevention, care, and treatment strate-
gies and services; 
‘‘(H) encouraging men to be responsible 
for their sexual behavior and to respect women, 
including the reduction and elimination of sex-
ual violence and coercion; 
‘‘(I) developing models for scaling up HIV 
counseling, testing with informed consent, and 
other approaches that promote risk reduction 
and access to care and treatment; 
‘‘(J) addressing risks associated with sub-
stance use; 
‘‘(K) promoting the most effective models 
for scaling up care and treatment access; 
‘‘(L) ensuring a safe blood supply; 
‘‘(M) improving injection safety, including 
eliminating unnecessary injections and pro-
moting sterile injection practices and tech-
nologies; 
‘‘(N) improving health care workers’ occu-
pational health and safety; 
‘‘(O) strengthening hospice and palliative 
care; 
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‘‘(P) scaling up the provision of prevention, 
care and treatment services to children, includ-
ing those orphaned by HIV/AIDS; 
‘‘(Q) preventing HIV through male cir-
cumcision; and 
‘‘(R) other research that the Coordinator 
determines to be necessary. 
‘‘(4) CONSULTATION.—In developing the stra-
tegic plan and implementing, disseminating, and 
promoting the use of program monitoring, oper-
ations research, and impact evaluation research, the 
Coordinator shall consult with representatives of— 
‘‘(A) the National Institutes of Health; 
‘‘(B) the United States Agency for Inter-
national Development; 
‘‘(C) the Centers for Disease Control and 
Prevention; 
‘‘(D) the Agency for Healthcare Research 
and Quality; 
‘‘(E) the Department of Health and 
Human Services; 
‘‘(F) the Department of Labor; 
‘‘(G) other Federal agencies engaged in 
global HIV/AIDS programs; 
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‘‘(H) multilateral structures, such as the 
United Nations and the Global Fund To Fight 
AIDS, Tuberculosis and Malaria; 
‘‘(I) national governments of foreign coun-
tries in which programs under this Act are ad-
ministered; 
‘‘(J) 
organizations 
implementing 
pro-
grammatic activities under this Act; and 
‘‘(K) other organizations with expertise in 
monitoring and evaluating international HIV/ 
AIDS programs. 
‘‘(5) MEETING
AND
PUBLIC
COMMENT.—The 
Coordinator shall— 
‘‘(A) not later than 180 days after the date 
of the enactment of the PEPFAR Account-
ability and Transparency Act, hold a public 
meeting at which the public may present its 
views on the current needs and gaps in program 
monitoring, operations research, and impact 
evaluation research; 
‘‘(B) during the 30-day period following 
the public meeting held pursuant to subpara-
graph (A), collect written comments from the 
public; and 
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‘‘(C) publish the comments received pursu-
ant to subparagraph (B) on the Office of the 
Global AIDS Coordinator’s Internet Web site. 
‘‘(6) REVIEW OF STRATEGIC PLAN.—The Coor-
dinator shall— 
‘‘(A) not later than 1 year after the date 
of the enactment of the PEPFAR Account-
ability and Transparency Act, present the stra-
tegic plan developed under this subsection to 
the appropriate congressional committees; 
‘‘(B) publish the strategic plan in the Fed-
eral Register and on the Office of the Global 
AIDS Coordinator’s Internet Web site; 
‘‘(C) during the 60-day period following 
the publication of the plan under subparagraph 
(B), solicit written comments on the plan from 
the public; 
‘‘(D) hold a meeting at which the public is 
given an opportunity to present its views on the 
plan; and 
‘‘(E) after consideration of the views and 
comments received from the public, make any 
necessary revisions to the plan. 
‘‘(f) BEST PRACTICES REPORT.—The Coordinator 
shall annually publish a best practices report that high-
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lights the programs that have the potential for translation, 
particularly at a low cost, across global AIDS programs, 
including those that focus on both generalized and local-
ized epidemics, receiving financial assistance from the 
United States. 
‘‘(g) DISSEMINATION OF FINDINGS.— 
‘‘(1) IN GENERAL.—The Coordinator shall dis-
seminate the full findings of the multiple operations 
research and impact evaluation research and pro-
gram level monitoring efforts on the Office of the 
Global AIDS Coordinator’s Internet website in order 
to improve transparency and public availability of in-
formation about operations research and impact 
evaluation research. 
‘‘(2) DISSEMINATION GUIDANCE.—The Coordi-
nator shall develop guidance to ensure timely sub-
mission and dissemination of all impact evaluation 
research, operations research, and program moni-
toring findings. The time lines and processes in-
cluded in such guidance shall take into account the 
publication process for peer-reviewed scientific or 
academic journals and the discussion of such re-
search findings at a scientific meeting or any other 
public or private forum, so as to maintain the sci-
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entific process without unduly restricting dissemina-
tion of information. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—In ad-
dition to funds made available under section 401(a), there 
are authorized to be appropriated such sums as may be 
necessary to carry out this section.’’. 
Æ 
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