H. R. 1298—18
(1) by striking ‘‘$50,000,000 for each of the fiscal years
2001 and 2002’’ and inserting ‘‘such sums as may be necessary
for each of the fiscal years 2004 through 2008’’; and
(2) by striking ‘‘Global Alliance for Vaccines and Immuniza-
tions’’ and inserting ‘‘Vaccine Fund’’.
(b) INTERNATIONAL AIDS VACCINE INITIATIVE.—Section 302(l)
of the Foreign Assistance Act of 1961 (22 U.S.C. 2222(l)) is amended
by striking ‘‘$10,000,000 for each of the fiscal years 2001 and
2002’’ and inserting ‘‘such sums as may be necessary for each
of the fiscal years 2004 through 2008’’.
(c) SUPPORT FOR THE DEVELOPMENT OF MALARIA VACCINE.—
Section 302 of the Foreign Assistance Act of 1961 (22 U.S.C. 2222))
is amended by adding at the end the following new subsection:
‘‘(m) In addition to amounts otherwise available under this
section, there are authorized to be appropriated to the President
such sums as may be necessary for each of the fiscal years 2004
through 2008 to be available for United States contributions to
malaria vaccine development programs, including the Malaria Vac-
cine Initiative of the Program for Appropriate Technologies in
Health (PATH).’’.
TITLE III—BILATERAL EFFORTS
Subtitle A—General Assistance and
Programs
SEC. 301. ASSISTANCE TO COMBAT HIV/AIDS.
(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.) is amended—
(1) in section 104(c) (22 U.S.C. 2151b(c)), by striking para-
graphs (4) through (7); and
(2) by inserting after section 104 the following new section:
‘‘SEC. 104A. ASSISTANCE TO COMBAT HIV/AIDS.
‘‘(a) FINDING.—Congress recognizes that the alarming spread
of HIV/AIDS in countries in sub-Saharan Africa, the Caribbean,
and other developing countries is a major global health, national
security, development, and humanitarian crisis.
‘‘(b) POLICY.—It is a major objective of the foreign assistance
program of the United States to provide assistance for the preven-
tion, treatment, and control of HIV/AIDS. The United States and
other developed countries should provide assistance to countries
in sub-Saharan Africa, the Caribbean, and other countries and
areas to control this crisis through HIV/AIDS prevention, treatment,
monitoring, and related activities, particularly activities focused
on women and youth, including strategies to protect women and
prevent mother-to-child transmission of the HIV infection.
‘‘(c) AUTHORIZATION.—
‘‘(1) IN GENERAL.—Consistent with section 104(c), the Presi-
dent is authorized to furnish assistance, on such terms and
conditions as the President may determine, for HIV/AIDS,
including to prevent, treat, and monitor HIV/AIDS, and carry
out related activities, in countries in sub-Saharan Africa, the
Caribbean, and other countries and areas.
H. R. 1298—19
‘‘(2) ROLE OF NGOS.—It is the sense of Congress that the
President should provide an appropriate level of assistance
under paragraph (1) through nongovernmental organizations
(including faith-based and community-based organizations) in
countries in sub-Saharan Africa, the Caribbean, and other coun-
tries and areas affected by the HIV/AIDS pandemic.
‘‘(3) COORDINATION OF ASSISTANCE EFFORTS.—The President
shall coordinate the provision of assistance under paragraph
(1) with the provision of related assistance by the Joint United
Nations Programme on HIV/AIDS (UNAIDS), the United
Nations Children’s Fund (UNICEF), the World Health
Organization (WHO), the United Nations Development Pro-
gramme (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 development
institutions, national, state, and local governments of foreign
countries, appropriate governmental and nongovernmental
organizations, and relevant executive branch agencies.
‘‘(d) ACTIVITIES SUPPORTED.—Assistance provided under sub-
section (c) shall, to the maximum extent practicable, be used to
carry out the following activities:
‘‘(1) PREVENTION.—Prevention of HIV/AIDS through activi-
ties including—
‘‘(A) programs and efforts that are designed or intended
to impart knowledge with the exclusive purpose of helping
individuals avoid behaviors that place them at risk of HIV
infection, including integration of such programs into
health programs and the inclusion in counseling programs
of information on methods of avoiding infection of HIV,
including delaying sexual debut, abstinence, fidelity and
monogamy, reduction of casual sexual partnering, reducing
sexual violence and coercion, including child marriage,
widow inheritance, and polygamy, and where appropriate,
use of condoms;
‘‘(B) assistance to establish and implement culturally
appropriate HIV/AIDS education and prevention programs
that focus on helping individuals avoid infection of HIV/
AIDS, implemented through nongovernmental organiza-
tions, including faith-based and community-based organiza-
tions, particularly those organizations that utilize both
professionals and volunteers with appropriate skills, experi-
ence, and community presence;
‘‘(C) assistance for the purpose of encouraging men
to be responsible in their sexual behavior, child rearing,
and to respect women;
‘‘(D) assistance for the purpose of providing voluntary
testing and counseling (including the incorporation of con-
fidentiality protections with respect to such testing and
counseling);
‘‘(E) assistance for the purpose of preventing mother-
to-child transmission of the HIV infection, including medi-
cations to prevent such transmission and access to infant
formula and other alternatives for infant feeding;
‘‘(F) assistance to ensure a safe blood supply and sterile
medical equipment;
H. R. 1298—20
‘‘(G) assistance to help avoid substance abuse and
intravenous drug use that can lead to HIV infection; and
(H) assistance for the purpose of increasing women’s
access to employment opportunities, income, productive
resources, and microfinance programs, where appropriate.
‘‘(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 pharmaceuticals and otherwise provide for the treat-
ment of individuals with HIV/AIDS, including clinical
training for indigenous organizations and health care pro-
viders;
‘‘(B) assistance to strengthen and expand hospice and
palliative care programs to assist patients debilitated by
HIV/AIDS, their families, and the primary caregivers of
such patients, including programs that utilize faith-based
and community-based organizations; and
‘‘(C) assistance for the purpose of the care and treat-
ment of individuals with HIV/AIDS through the provision
of pharmaceuticals, including antiretrovirals and other
pharmaceuticals and therapies for the treatment of
opportunistic infections, nutritional support, and other
treatment modalities.
‘‘(3) PREVENTATIVE INTERVENTION EDUCATION AND TECH-
NOLOGIES.—(A) With particular emphasis on specific popu-
lations 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, individuals
already infected with HIV/AIDS, and in cases of occupational
exposure of health care workers, assistance with efforts to
reduce the risk of HIV/AIDS infection including post-exposure
pharmaceutical prophylaxis, and necessary pharmaceuticals
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 commod-
ities, as well as education and training on the use of the
technologies.
‘‘(4) MONITORING.—The monitoring of programs, 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 pharma-
ceuticals and other appropriate medicines to poor individ-
uals with HIV/AIDS;
‘‘(B) appropriate evaluation and surveillance activities;
‘‘(C) monitoring to ensure that appropriate measures
are being taken to maintain the sustainability of HIV/
AIDS pharmaceuticals (especially antiretrovirals) and
ensure that drug resistance is not compromising the bene-
fits of such pharmaceuticals; and
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‘‘(D) monitoring to ensure appropriate law enforcement
officials are working to ensure that HIV/AIDS pharma-
ceuticals are not diminished through illegal counterfeiting
or black market sales of such pharmaceuticals.
‘‘(5) PHARMACEUTICALS.—
‘‘(A) PROCUREMENT.—The procurement of HIV/AIDS
pharmaceuticals, antiviral therapies, and other appropriate
medicines, including medicines to treat opportunistic infec-
tions.
‘‘(B) MECHANISMS FOR QUALITY CONTROL AND SUSTAIN-
ABLE SUPPLY.—Mechanisms to ensure that such HIV/AIDS
pharmaceuticals, antiretroviral therapies, and other appro-
priate medicines are quality-controlled and sustainably
supplied.
‘‘(C) DISTRIBUTION.—The distribution of such HIV/
AIDS pharmaceuticals, antiviral therapies, and other
appropriate medicines (including medicines to treat
opportunistic infections) to qualified national, regional, or
local organizations for the treatment of individuals with
HIV/AIDS in accordance with appropriate HIV/AIDS
testing and monitoring requirements and treatment proto-
cols and for the prevention of mother-to-child transmission
of the HIV infection.
‘‘(6) RELATED ACTIVITIES.—The conduct of related activities,
including—
‘‘(A) the care and support of children who are orphaned
by the HIV/AIDS pandemic, including services designed
to care for orphaned children in a family environment
which rely on extended family members;
‘‘(B) improved infrastructure and institutional capacity
to develop and manage education, prevention, and treat-
ment programs, including training and the resources to
collect and maintain accurate HIV surveillance data to
target programs and measure the effectiveness of interven-
tions; and
‘‘(C) vaccine research and development partnership pro-
grams with specific plans of action to develop a safe, effec-
tive, accessible, preventive HIV vaccine for use throughout
the world.
‘‘(7) COMPREHENSIVE
HIV/AIDS
PUBLIC-PRIVATE
PARTNER-
SHIPS.—The establishment and operation of public-private part-
nership entities within countries in sub-Saharan Africa, the
Caribbean, and other countries affected by the HIV/AIDS pan-
demic that are dedicated to supporting the national strategy
of such countries regarding the prevention, treatment, and
monitoring of HIV/AIDS. Each such public-private partnership
should—
‘‘(A) support the development, implementation, 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 results-driven programs;
‘‘(C) engage both local and foreign development part-
ners and donors, including businesses, government agen-
cies, academic institutions, nongovernmental organizations,
foundations, multilateral development agencies, and faith-
based organizations, to assist the country in coordinating