IB
Union Calendar No. 298
106TH CONGRESS
2D SESSION
H. R. 3519
[Report No. 106–548]
To provide for negotiations for the creation of a trust fund to be administered
by the International Bank for Reconstruction and Development or the
International Development Association to combat the AIDS epidemic.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 24, 2000
Mr. LEACH introduced the following bill; which was referred to the Committee
on Banking and Financial Services
MARCH 28, 2000
Additional sponsors: Ms. LEE, Ms. MILLENDER-MCDONALD, Mr. GUTIERREZ,
Ms. ROYBAL-ALLARD, Mr. EVANS, Mr. HALL of Ohio, Mr. GONZALEZ,
Ms. DELAURO, Mr. RUSH, Mr. HOUGHTON, Mr. FILNER, Ms. WATERS,
Mr. FROST, Mr. LAFALCE, Mr. CUMMINGS, Mr. NADLER, Ms. SLAUGH-
TER, Ms. SCHAKOWSKY, Mrs. MORELLA, Mr. WEXLER, Ms. MCKINNEY,
Mrs. JONES of Ohio, Ms. CARSON, Mr. CASTLE, Mr. BENTSEN, Ms.
WOOLSEY, Mr. WATT of North Carolina, Ms. NORTON, and Mr. RANGEL
MARCH 28, 2000
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on January 24, 2000]
A BILL
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,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘World Bank AIDS Mar-
shall 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, eclips-
ing both the bubonic plague of the 1300’s and the in-
fluenza 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 people
in the world today are living with HIV/AIDS, of
which approximately 95 percent live in the developing
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 be-
came infected, of which over 90 percent were babies
born to HIV-positive women.
(4) Although sub-Saharan Africa has only 10
percent of the world’s population, it is home to
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 num-
ber of orphans, particularly in Africa, constitutes
nothing less than an emergency, requiring an emer-
gency response’’ and that ‘‘finding the resources need-
ed to help stabilize the crisis and protect children is
a priority that requires urgent action from the inter-
national 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 Republic
of Zambia has decreased from approximately age 65
to approximately age 40—the lowest life expectancy
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 eco-
nomic costs of infectious diseases—especially HIV/
AIDS—are already significant and could reduce
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-Saha-
ran 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 Ugan-
da, Senegal, and Thailand—have implemented pre-
vention 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—combining 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 fastest-
growing threat to development’’ in Africa, has
launched a new strategy for HIV/AIDS in Africa, de-
claring it a top priority for the Bank on that con-
tinent.
(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 cur-
rently available for HIV/AIDS in Africa.
(18) Accordingly, United States financial sup-
port for medical research, education, and disease con-
tainment as a global strategy has beneficial ramifica-
tions for millions of Americans and their families
who are affected by this disease, and the entire popu-
lation 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 development,
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 Nations
Program on HIV/AIDS (UNAIDS), the International
Partnership Against AIDS in Africa, other inter-
national organizations, donor agencies, and the pri-
vate sector to intensify action against the HIV/AIDS
epidemic and to support essential field work in the
most affected countries to assist in the development 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 As-
sociation, and with the member nations of such institutions
and with other interested parties for the creation of a trust
fund which would be authorized to solicit and accept con-
tributions from governments, the private sector, and non-
governmental entities of all kinds and use the contributions
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-
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. In
carrying out this objective, the trust fund would co-
ordinate its activities with governments, civil society,
nongovernmental organizations, the Joint United Na-
tions Program on HIV/AIDS (UNAIDS), the Inter-
national Partnership Against AIDS in Africa, other
international organizations, the private sector, and
donor agencies working to combat the HIV/AIDS cri-
sis.
(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 pro-
gram 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-
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 International
Bank for Reconstruction and Development. Sub-
ject to general policy guidance from the Presi-
dent of the United States and representatives of
the other donors to the trust fund, the Trustee
would be responsible for managing 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, standards and cri-
teria regarding qualifications of recipients of
such support, as well as such rules and proce-
dures as would be necessary for cost-effective
management of the trust fund. The trust fund
would not make grants for the purpose of project
development associated with bilateral or multi-
lateral development bank loans.
(C) TRANSPARENCY OF OPERATIONS.—The
Trustee shall ensure full and prompt public dis-
closure of the proposed objectives, financial orga-
nization, 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 ap-
point to the Advisory Board renowned and
distinguished international leaders who
have demonstrated integrity and knowledge
of issues relating to development, 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-
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 Ad-
visory Board.
TITLE II—UNITED STATES
FINANCIAL PARTICIPATION
SEC. 201. LIMITATIONS ON AUTHORIZATION OF APPRO-
PRIATIONS.
In addition to any other funds authorized to be appro-
priated for multilateral or bilateral programs related to
AIDS or economic development, there are authorized to be
appropriated to the Secretary of the Treasury $200,000,000
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 pursuant
to section 101, the Secretary of the Treasury shall submit
to the appropriate committees of the Congress a written re-
port on the trust fund, the goals of the trust fund, the pro-
grams, projects, and activities, including any vaccination
approaches, supported by the trust fund, and the effective-
ness 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 Relations,
and on Banking and Financial Services of the House of
Representatives and the Committees on Appropriations, on
Foreign Relations, and on Banking, Housing, 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 PRE-
VENTION 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 and
vote of the United States to encourage the Bank to work
with Sub-saharan African countries to modify projects fi-
nanced by the Bank and develop new projects to build local
capacity to manage and implement programs for the pre-
vention of human immunodeficiency virus (HIV) and ac-
quired immune deficiency syndrome (AIDS) and the care
of persons with HIV/AIDS, including through health care
delivery mechanisms which facilitate the distribution of af-
fordable drugs for persons infected with HIV.’’.
Union Calendar No. 298
106TH CONGRESS
2D SESSION
H. R. 3519
[Report No. 106–548]
A BILL
To provide for negotiations for the creation of a
trust fund to be administered by the Inter-
national Bank for Reconstruction and Develop-
ment or the International Development Associa-
tion to combat the AIDS epidemic.
MARCH 28, 2000
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union,
and ordered to be printed