In the Senate of the United States,
July 12 (legislative day, July 10), 2002.
Resolved, That the bill from the House of Representa-
tives (H.R. 2069) entitled ‘‘An Act to amend the Foreign As-
sistance Act of 1961 and the Global AIDS and Tuberculosis
Relief Act of 2000 to authorize assistance to prevent, treat,
and monitor HIV/AIDS in sub-Saharan African and other de-
veloping countries.’’, do pass with the following
AMENDMENTS:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘United States Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Act of 2002’’.
†
HR 2069 EAS
(b) TABLE OF CONTENTS.—The table of contents for
this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
Sec. 4. Purpose.
TITLE I—POLICY PLANNING AND COORDINATION
Sec. 101. Development of a comprehensive, five-year, global strategy.
Sec. 102. Comprehensive plan to empower women to prevent the spread of HIV/
AIDS.
Sec. 103. HIV/AIDS Response Coordinator.
Sec. 104. Report on reversing the exodus of critical talent.
TITLE II—PUBLIC-PRIVATE PARTNERSHIPS
Sec. 201. Sense of Congress on public-private partnerships.
Sec. 202. Participation in the Global Fund to Fight AIDS, Tuberculosis, and
Malaria.
Sec. 203. Voluntary contributions to international vaccine funds.
TITLE III—MULTILATERAL EFFORTS
Sec. 301. Improvement of the Enhanced HIPC Initiative.
Sec. 302. Reports on implementation of improvements to the Enhanced HIPC
Initiative.
TITLE IV—BILATERAL EFFORTS
Subtitle A—General Assistance and Programs
Sec. 401. Assistance to combat HIV/AIDS.
Sec. 402. Assistance to combat tuberculosis.
Sec. 403. Assistance to combat malaria.
Sec. 404. Pilot program for the placement of health care professionals in overseas
areas severely affected by HIV/AIDS, tuberculosis, and malaria.
Sec. 405. Department of Defense HIV/AIDS prevention assistance program.
Sec. 406. Report on treatment activities by relevant Executive branch agencies.
Subtitle B—Assistance for Children and Families
Sec. 411. Findings.
Sec. 412. Policy and requirements.
Sec. 413. Annual reports on prevention of mother-to-child transmission of the
HIV infection.
Sec. 414. Pilot program of assistance for children and families affected by HIV/
AIDS.
TITLE V—BUSINESS PRINCIPLES
Sec. 501. Principles for United States firms operating in countries affected by the
HIV/AIDS pandemic.
†
HR 2069 EAS
$24,000,000 for the fiscal year 2004 are author-
ized to be available to carry out section
104A(d)(1)(D) of the Foreign Assistance Act of
1961 (as added by subsection (a)), relating to re-
search on microbicides which prevent the spread
of HIV/AIDS.
(B) PHARMACEUTICALS.—Of the amounts
authorized to be appropriated by paragraph (1)
for the fiscal years 2003 and 2004, $100,000,000
for the fiscal year 2003 and $120,000,000 for the
fiscal year 2004 are authorized to be available to
carry out section 104A(d)(4) of the Foreign As-
sistance Act of 1961 (as added by subsection (a)),
relating to the procurement and distribution of
HIV/AIDS pharmaceuticals.
(4) TRANSFER OF PRIOR YEAR FUNDS.—Unobli-
gated balances of funds made available for the fiscal
year 2001 or the fiscal year 2002 under section
104(c)(6) of the Foreign Assistance Act of 1961 (22
U.S.C. 2151b(c)(6) (as in effect immediately before
the date of enactment of this Act) shall be transferred
to, merged with, and made available for the same
purposes as funds made available for fiscal year 2003
under paragraph (1).
†
HR 2069 EAS
SEC. 402. ASSISTANCE TO COMBAT TUBERCULOSIS.
(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.), as amended by section
401 of this Act, is further amended by inserting after section
104A the following new section:
‘‘SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.
‘‘(a) FINDINGS.—Congress makes the following find-
ings:
‘‘(1) Congress recognizes the growing inter-
national problem of tuberculosis and the impact its
continued existence has on those countries that had
previously largely controlled the disease.
‘‘(2) Congress further recognizes that the means
exist to control and treat tuberculosis through ex-
panded use of the DOTS (Directly Observed Treat-
ment Short-course) treatment strategy and adequate
investment in newly created mechanisms to increase
access to treatment, including the Global Tuberculosis
Drug Facility established in 2001 pursuant to the
Amsterdam Declaration to Stop TB.
‘‘(b) POLICY.—It is a major objective of the foreign as-
sistance program of the United States to control tuber-
culosis, including the detection of at least 70 percent of the
cases of infectious tuberculosis, and the cure of at least 85
percent of the cases detected, not later than December 31,
†
HR 2069 EAS
2005, in those countries classified by the World Health Or-
ganization as among the highest tuberculosis burden, and
not later than December 31, 2010, in all countries in which
the United States Agency for International Development
has established development programs.
‘‘(c) AUTHORIZATION.—To carry out this section and
consistent with section 104(c), the President is authorized
to furnish assistance, on such terms and conditions as the
President may determine, for the prevention, treatment,
control, and elimination of tuberculosis.
‘‘(d) COORDINATION.—In carrying out this section, the
President shall coordinate with the World Health Organiza-
tion, the Global Fund to Fight AIDS, Tuberculosis, and
Malaria, the Department of Health and Human Services
(including the Centers for Disease Control and Prevention
and the National Institutes of Health), and other organiza-
tions with respect to the development and implementation
of a comprehensive tuberculosis control program.
‘‘(e) ANNUAL REPORT.—Not later than January 31 of
each year, the President shall submit a report to the Com-
mittee on Foreign Relations of the Senate and the Com-
mittee on International Relations of the House of Rep-
resentatives specifying the increases in the number of people
treated and the increases in number of tuberculosis patients
cured through each program, project, or activity receiving
†
HR 2069 EAS
United States foreign assistance for tuberculosis control
purposes.
‘‘(f) PRIORITY TO DOTS COVERAGE.—In furnishing
assistance under subsection (c), the President shall give pri-
ority to activities that increase directly observed treatment
shortcourse (DOTS) coverage, including funding for the
Global Tuberculosis Drug Facility and the Stop Tuber-
culosis Partnership.
‘‘(g) DEFINITIONS.—In this section:
‘‘(1) DOTS.—The term ‘DOTS’ or ‘Directly Ob-
served Treatment Short-course’ means the World
Health Organization-recommended strategy for treat-
ing tuberculosis.
‘‘(2) GLOBAL TUBERCULOSIS DRUG FACILITY.—
The term ‘Global Tuberculosis Drug Facility (GDF)’
means the new initiative of the Stop Tuberculosis
Partnership to increase access to high-quality tuber-
culosis drugs to facilitate DOTS expansion.
‘‘(3) STOP
TUBERCULOSIS
PARTNERSHIP.—The
term ‘Stop Tuberculosis Partnership’ means the part-
nership of the World Health Organization, donors in-
cluding the United States, high tuberculosis burden
countries, multilateral agencies, and nongovernmental
and technical agencies committed to short- and long-
term measures required to control and eventually
†
HR 2069 EAS
eliminate tuberculosis as a public health problem in
the world.’’.
(b) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—In addition to funds available
under section 104(c) of the Foreign Assistance Act of
1961 (22 U.S.C. 2151b(c)) for such purpose or under
any other provision of that Act, there are authorized
to be appropriated to the President $150,000,000 for
the fiscal year 2003 and $200,000,000 for the fiscal
year 2004 to carry out section 104B of the Foreign
Assistance Act of 1961, as added by subsection (a).
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated pursuant to paragraph (1) are authorized to
remain available until expended.
(3) TRANSFER OF PRIOR YEAR FUNDS.—Unobli-
gated balances of funds made available for the fiscal
year 2001 or the fiscal year 2002 under section
104(c)(7) of the Foreign Assistance Act of 1961 (22
U.S.C. 2151b(c)(7) (as in effect immediately before
the date of enactment of this Act) shall be transferred
to, merged with, and made available for the same
purposes as funds made available for fiscal year 2003
under paragraph (1).
†
HR 2069 EAS
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated pursuant to paragraph (1) are authorized to
remain available until expended.
(3) TRANSFER OF PRIOR YEAR FUNDS.—Unobli-
gated balances of funds made available for the fiscal
year 2001 or the fiscal year 2002 under section 104(c)
of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b(c) (as in effect immediately before the date of
enactment of this Act) and made available for the
control of malaria shall be transferred to, merged
with, and made available for the same purposes as
funds made available for fiscal year 2003 under para-
graph (1).
(c) CONFORMING AMENDMENT.—Section 104(c) of the
Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)), as
amended by section 401 of this Act, is further amended by
adding after paragraph (3) the following:
‘‘(4) RELATIONSHIP
TO
OTHER
LAWS.—Assist-
ance made available under this subsection and sec-
tions 104A, 104B, and 104C, and assistance made
available under chapter 4 of part II to carry out the
purposes of this subsection and such other sections of
this Act, may be made available in accordance with
this subsection and such other provisions of this Act
notwithstanding any other provision of law.’’.
†
HR 2069 EAS
SEC. 404. PILOT PROGRAM FOR THE PLACEMENT OF
HEALTH CARE PROFESSIONALS IN OVERSEAS
AREAS SEVERELY AFFECTED BY HIV/AIDS, TU-
BERCULOSIS, AND MALARIA.
(a) IN GENERAL.—The President shall establish a pro-
gram to demonstrate the feasibility of facilitating the serv-
ice of American health care professionals in sub-Saharan
Africa and other parts of the world severely affected by HIV/
AIDS, tuberculosis, and malaria.
(b) REQUIREMENTS.—Participants in the program
shall—
(1) provide basic health care services for those
infected and affected by HIV/AIDS, tuberculosis, and
malaria in the area in which they are serving;
(2) provide on-the-job training to medical and
other personnel in the area in which they are serving
to strengthen the basic health care system of the af-
fected countries;
(3) provide health care educational training for
residents of the area in which they are serving;
(4) serve for a period of up to two years; and
(5) meet the eligibility requirements in sub-
section (d).
(c) ELIGIBILITY REQUIREMENTS.—To be eligible to
participate in the program, a candidate shall—
†
HR 2069 EAS
(1) be a national of the United States who is a
trained health care professional and who meets the
educational and licensure requirements necessary to
be such a professional such as a physician, nurse,
nurse practitioner, pharmacist, or other individual
determined to be appropriate by the President; or
(2) a retired commissioned officer of the Public
Health Service Corps.
(d) RECRUITMENT.—The President shall ensure that
information on the program is widely distributed, includ-
ing the distribution of information to schools for health pro-
fessionals, hospitals, clinics, and nongovernmental organi-
zations working in the areas of international health and
aid.
(e) PLACEMENT OF PARTICIPANTS.—To the maximum
extent practicable, participants in the program shall serve
in the poorest areas of the affected countries, where health
care needs are likely to be the greatest. The decision on the
placement of a participant should be made in consultation
with relevant officials of the affected country at both the
national and local level as well as with local community
leaders and organizations.
(f) EXTENDED PERIOD OF SERVICE.—The President
may extend the period of service of a participant by an
additional period of 6 to 12 months.
†
HR 2069 EAS
(g) INCENTIVES.—The President may offer such incen-
tives as the President determines to be necessary to encour-
age individuals to participate in the program, such as par-
tial payment of principal, interest, and related expenses on
government and commercial loans for educational expenses
relating to professional health training and, where possible,
deferment of repayments on such loans, the provision of re-
tirement benefits that would otherwise be jeopardized by
participation in the program, and other incentives.
(h) REPORT.—Not later than 18 months after the date
of enactment of this Act, the President shall submit a report
to the designated congressional committees on steps taken
to establish the program, including—
(1) the process of recruitment, including the
venues for recruitment, the number of candidates re-
cruited, the incentives offered, if any, and the cost of
those incentives;
(2) the process, including the criteria used, for
the selection of participants;
(3) the number of participants placed, the coun-
tries in which they were placed, and why those coun-
tries were selected; and
(4) the potential for expansion of the program.
(i) AUTHORIZATION OF APPROPRIATIONS.—
†
HR 2069 EAS
(1) IN GENERAL.—In addition to amounts other-
wise available for such purpose, there is authorized to
be appropriated to the President $10,000,000 for the
fiscal year 2003 and $20,000,000 for the fiscal year
2004 to carry out the program.
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated pursuant to paragraph (1) are authorized to
remain available until expended.
SEC. 405. DEPARTMENT OF DEFENSE HIV/AIDS PREVEN-
TION ASSISTANCE PROGRAM.
(a) EXPANSION OF PROGRAM.—The Secretary of De-
fense is authorized to expand, in accordance with this sec-
tion, the Department of Defense program of HIV/AIDS pre-
vention educational activities undertaken in connection
with the conduct of United States military training, exer-
cises, and humanitarian assistance in sub-Saharan African
countries.
(b) ELIGIBLE COUNTRIES.—The Secretary of Defense
may carry out the program in all eligible countries. A coun-
try shall be eligible for activities under the program if the
country—
(1) is a country suffering a public health crisis
(as defined in subsection (e)); and
(2) participates in the military-to-military con-
tacts program of the Department of Defense.
†
HR 2069 EAS
(c) PROGRAM ACTIVITIES.—The Secretary of Defense
shall provide for the activities under the program—
(1) to focus, to the extent possible, on military
units that participate in peace keeping operations;
and
(2) to include HIV/AIDS-related voluntary coun-
seling and testing and HIV/AIDS-related surveil-
lance.
(d) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—Of the amount authorized to
be appropriated to the Department of Defense for op-
eration and maintenance of the Defense Health Pro-
gram for the fiscal year 2003, $30,000,000 may be
available for carrying out the program described in
subsection (a) as expanded pursuant to this section.
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated pursuant to paragraph (1) are authorized to
remain available until expended.
(e) COUNTRY SUFFERING A PUBLIC HEALTH CRISIS
DEFINED.—In this section, the term ‘‘country suffering a
public health crisis’’ means a country that has rapidly ris-
ing rates of incidence of HIV/AIDS or in which HIV/AIDS
is causing significant family, community, or societal dis-
ruption.
†
HR 2069 EAS
SEC. 406. REPORT ON TREATMENT ACTIVITIES BY REL-
EVANT EXECUTIVE BRANCH AGENCIES.
(a) IN GENERAL.—Not later than 15 months after the
date of enactment of this Act, the President shall submit
to designated congressional committees a report on the pro-
grams and activities of the United States Agency for Inter-
national Development, the Centers for Disease Control and
Prevention, and other relevant Executive branch agencies
that are directed to the treatment of individuals in foreign
countries infected with HIV or living with AIDS.
(b) REPORT ELEMENTS.—The report shall include—
(1) a description of the activities of relevant Ex-
ecutive branch agencies with respect to—
(A) the treatment of opportunistic infec-
tions;
(B) the use of antiretrovirals;
(C) the status of research into successful
treatment protocols for individuals in the devel-
oping world; and
(D) technical assistance and training of
local health care workers (in countries affected
by the pandemic) to administer antiretrovirals,
manage side effects, and monitor patients’ viral
loads and immune status;
(2) information on existing pilot projects, in-
cluding a discussion of why a given population was
†
HR 2069 EAS
selected, the number of people treated, the cost of
treatment, the mechanisms established to ensure that
treatment is being administered effectively and safely,
and plans for scaling up pilot projects (including
projected timelines and required resources); and
(3) an explanation of how those activities relate
to efforts to prevent the transmission of the HIV infec-
tion.
Subtitle B—Assistance for Children
and Families
SEC. 411. FINDINGS.
Congress makes the following findings:
(1) Approximately 2,000 children around the
world are infected each day with HIV through moth-
er-to-child transmission. Transmission can occur dur-
ing pregnancy, labor, and delivery or through breast
feeding. Over ninety percent of these cases are in de-
veloping nations with little or no access to public
health facilities.
(2) Mother-to-child transmission is largely pre-
ventable with the proper application of pharma-
ceuticals, therapies, and other public health interven-
tions.
(3) The drug nevirapine, reduces mother-to-child
transmission by nearly 50 percent. Universal avail-
†
HR 2069 EAS
from the private sector, other national governments, and
international organizations.
(b) REQUIREMENTS.—The 5-year United States Gov-
ernment strategy required by section 101 of this Act shall—
(1) provide for meeting or exceeding the goal set
by the United Nations General Assembly Declaration
of Commitment on HIV/AIDS to reduce the rate of
mother-to-child transmission of HIV by 20 percent by
2005 and by 50 percent by 2010;
(2) include programs to make available testing
and treatment to HIV-positive women and their fam-
ily members, including drug treatment and therapies
to prevent mother-to-child transmission; and
(3) expand programs designed to care for chil-
dren orphaned by AIDS.
SEC. 413. ANNUAL REPORTS ON PREVENTION OF MOTHER-
TO-CHILD TRANSMISSION OF THE HIV INFEC-
TION.
(a) IN GENERAL.—Beginning 270 days after the date
of enactment of this Act, and annually thereafter for the
ensuing eight years, the President shall submit to des-
ignated congressional committees a report on the activities
of relevant Executive branch agencies during the reporting
period to assist in the prevention of mother-to-child trans-
mission of the HIV infection.
†
HR 2069 EAS
(b) REPORT ELEMENTS.—Each report shall include—
(1) a statement of whether or not all relevant
Executive branch agencies have adopted the targets set
by the United Nations General Assembly at the Spe-
cial Session for HIV/AIDS, held June 25 to 27, 2001,
with respect to mother-to-child transmission of the
HIV infection;
(2) a description of efforts made by the United
States Agency for International Development and the
Centers for Disease Control and Prevention to expand
those activities, including—
(A) information on the number of sites sup-
ported for the prevention of mother-to-child
transmission of the HIV infection;
(B) the specific activities supported;
(C) the number of women tested and coun-
seled; and
(D) the number of women receiving prevent-
ative drug therapies;
(3) a statement of the percentage of funds ex-
pended out of the budget of each relevant Executive
branch agency for activities to prevent mother-to-child
transmission of the HIV infection and, in the case of
United States Agency for International Development,
whether or not its expenditures on bilateral assistance
†
HR 2069 EAS
have 
met 
the 
8.3 
percent 
target 
in 
section
104(c)(6)(D) of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b(c)(6)(D)), as in effect immediately
before the date of enactment of this Act, with respect
to strategies to prevent mother-to-child transmission
of the HIV infection;
(4) a discussion of the extent to which the pro-
grams of the relevant Executive branch agencies are
meeting targets set by the United Nations General As-
sembly; and
(5) a description of efforts made by the Centers
for Disease Control and Prevention and the United
States Agency for International Development to ex-
pand care and treatment services for families at es-
tablished sites for the prevention of mother-to-child
transmission of HIV infection.
(c) REPORTING PERIOD DEFINED.—In this section,
the term ‘‘reporting period’’ means, in the case of the initial
report, the period since the date of enactment of this Act
and, in the case of any subsequent report, the period since
the date of submission of the most recent report.
SEC. 414. PILOT PROGRAM OF ASSISTANCE FOR CHILDREN
AND FAMILIES AFFECTED BY HIV/AIDS.
(a) IN GENERAL.—The President, acting through the
United States Agency for International Development, shall
†
HR 2069 EAS
establish a program of assistance that would demonstrate
the feasibility of the provision of care and treatment to or-
phans and other children and young people affected by
HIV/AIDS in foreign countries.
(b) PROGRAM REQUIREMENTS.—The program shall—
(1) build upon and be integrated into programs
administered as of the date of enactment of this Act
by the United States Agency for International Devel-
opment for children affected by HIV/AIDS;
(2) work in conjunction with indigenous commu-
nity-based programs and activities, particularly those
that offer proven services for children;
(3) reduce the stigma of HIV/AIDS to encourage
vulnerable children infected with HIV or living with
AIDS and their family members and caregivers to
avail themselves of voluntary counseling and testing,
and related programs, including treatments;
(4) provide, in conjunction with other relevant
Executive branch agencies, the range of services for
the care and treatment, including the provision of
antiretrovirals and other necessary pharmaceuticals,
of children, parents, and caregivers infected with HIV
or living with AIDS;
(5) provide nutritional support and food secu-
rity, and the improvement of overall family health;
†
HR 2069 EAS
(6) work with parents, caregivers, and commu-
nity-based organizations to provide children with
educational opportunities; and
(7) provide appropriate counseling and legal as-
sistance for the appointment of guardians and the
handling of other issues relating to the protection of
children.
(c) REPORT.—Not later than 18 months after the date
of enactment of this Act, the President, acting through the
United States Agency for International Development, shall
submit a report on the implementation of this section to
the appropriate congressional committees. The report shall
include a plan for scaling up the program over the following
year.
(d) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—In addition to amounts other-
wise available for such purpose, there is authorized to
be appropriated to the President $15,000,000 for the
fiscal year 2003 and $30,000,000 for the fiscal year
2004 to carry out the program.
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated pursuant to paragraph (1) are authorized to
remain available until expended.
†
HR 2069 EAS
TITLE V—BUSINESS PRINCIPLES
SEC. 501. PRINCIPLES FOR UNITED STATES FIRMS OPER-
ATING IN COUNTRIES AFFECTED BY THE HIV/
AIDS PANDEMIC.
(a) FINDINGS.—Congress finds that the global spread
of HIV/AIDS presents not only a health crisis but also a
crisis in the workplace that affects—
(1) the productivity, earning power, and lon-
gevity of individual workers;
(2) the productivity, competitiveness, and finan-
cial solvency of individual businesses; and
(3) the economic productivity and development
of individual communities and the United States as
a whole.
(b) SENSE OF CONGRESS.—It is the sense of Congress
that United States firms operating in countries affected by
the HIV/AIDS pandemic can make significant contribu-
tions to the United States effort to respond to this pandemic
through the voluntary adoption of the principles and prac-
tices described in subsection (c).
(c) PRINCIPLES AND PRACTICES.—The principles and
practices referred to in subsection (b) are the following:
(1) With respect to employment and health poli-
cies and practices, the treatment of HIV/AIDS in the
same manner as any other illness.
†
HR 2069 EAS
(2) The promotion of policies and practices that
eliminate discrimination and stigmatization against
employees on the basis of real or perceived HIV/AIDS
status, including—
(A) assessing employees on merit and abil-
ity to perform;
(B) not subjecting employees to personal
discrimination or abuse; and
(C) imposing disciplinary measures where
discrimination occurs.
(3) A prohibition on compulsory HIV/AIDS test-
ing for recruitment, promotion, or career develop-
ment.
(4) An assurance of the confidentiality of an em-
ployee’s HIV/AIDS status.
(5) Permission for employees with HIV/AIDS-re-
lated illnesses to work as long as they are medically
fit and, when they are no longer able to work and sick
leave has been exhausted, an assurance that the em-
ployment relationship will be terminated in accord-
ance with antidiscrimination and labor laws and re-
spect for general procedures and full benefits.
(6) An assurance that employment practices will
comply, at a minimum, with national and inter-
national employment and labor laws and codes.
†
HR 2069 EAS
(7) The involvement of employees and individ-
uals infected with HIV or living with AIDS, drawn
from the workplace or the community, in the develop-
ment and assessment of HIV/AIDS policies and pro-
grams for the workplace.
(8) An offer to all employees of access to cul-
turally appropriate preventive education programs
and services to support those programs.
(9) An assurance that programs offered in the
workplace will support and be integrated into larger
community-based responses to the problems posed by
HIV/AIDS.
(10) Work with community leaders to expand the
availability of treatment for those employees and oth-
ers infected with HIV or living with AIDS.
TITLE VI—ADDITIONAL
AUTHORITIES
SEC. 601. AUTHORITY OF THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES.
(a) IN GENERAL.—Title III of the Public Health Serv-
ice Act (42 U.S.C. 241 et seq.) is amended by adding at
the end the following:
†
HR 2069 EAS
‘‘PART R—HIV/AIDS, TUBERCULOSIS, AND MA-
LARIA PREVENTION, CARE AND TREATMENT
IN DEVELOPING COUNTRIES
‘‘SEC. 399AA. GENERAL AUTHORITY OF THE CENTERS FOR
DISEASE CONTROL AND PREVENTION.
‘‘(a) PURPOSE.—It is the purpose of this section to
provide the Secretary, acting through the Director of the
Centers for Disease Control and Prevention, with the au-
thority to act internationally to carry out prevention, care,
treatment, support, capacity development, and other activi-
ties (determined appropriate by the Secretary) for HIV/
AIDS, tuberculosis, and malaria in countries determined
by the Secretary to have or be at risk for severe HIV epi-
demic with particular attention to resource constrained
countries.
‘‘(b) ACTIVITIES AND ASSISTANCE.—In carrying out
the purpose described in subsection (a), the Secretary, act-
ing through the Director of the Centers for Disease Control
and Prevention, in coordination with the Administrator of
the United States Agency for International Development
and the Administrator of the Health Resources and Services
Administration, may provide support and assistance under
this section relating to—
‘‘(1) HIV prevention services provided through—
‘‘(A) education and voluntary counseling
and testing activities, including rapid testing,
†
HR 2069 EAS
the development and application of confiden-
tiality protections with respect to such coun-
seling and testing, and the integration of such
activities into programs serving women and chil-
dren;
‘‘(B) programs to reduce the mother-to-child
transmission of HIV, including the treatment
and care of HIV-infected women, their children,
and families, and including the involvement of
fathers in such programs;
‘‘(C) activities involving behavioral inter-
ventions for youth, women, and other vulnerable
populations;
‘‘(D) programs to prevent the transmission
of HIV and other pathogens at health care facili-
ties (including the use of universal precautions,
equipment sterilization, post-exposure prophy-
laxis for health care workers and other individ-
uals determined to be appropriate, and other
interventions appropriate to the resources avail-
able), and to support the use of post exposure
prophylaxis, when indicated, for patients;
‘‘(E) activities to ensure a safe blood sup-
ply;
†
HR 2069 EAS
‘‘(F) programs to provide prevention, care,
treatment, and patient management services for
sexually transmitted infections to infected indi-
viduals and individuals at risk of infection; and
‘‘(G) activities, including laboratory sup-
port, to collect and maintain accurate HIV/
AIDS surveillance and epidemiologic data, to
target and monitor programs, and to measure
the effectiveness of interventions;
‘‘(2) HIV/AIDS care and treatment services pro-
vided through—
‘‘(A) programs to provide care and treat-
ment, integrated with prevention services to fur-
ther reduce the transmission of HIV, for individ-
uals living with HIV/AIDS, including the treat-
ment of opportunistic infections (including tu-
berculosis) and the provision of antiretroviral
therapies and nutritional services;
‘‘(B) programs to provide support services
that are needed to enhance the effectiveness of
health services and to promote family stability,
including services for family members affected
by, but not infected with, HIV such as children
orphaned by AIDS; and
†
HR 2069 EAS
‘‘(C) programs that link care and treatment
services to proven prevention programs, includ-
ing linkages with voluntary counseling and test-
ing efforts (including rapid testing);
‘‘(3) infrastructure and training through—
‘‘(A) activities to improve the health infra-
structure and institutional capacity within par-
ticipating countries, including the training of
appropriate personnel, and to assist such coun-
tries in expanding and improving the avail-
ability of health care facilities, to enable such
countries to develop and manage HIV/AIDS edu-
cation, prevention, care and treatment programs
and to conduct evaluations of such programs;
and
‘‘(B) activities to provide laboratory sup-
port as well as technical assistance and training
to increase the capacity for the diagnosis, care,
and treatment of HIV/AIDS and related health
conditions (including rapid testing);
‘‘(4) HIV/AIDS treatment protocols through—
‘‘(A) the provision of support and assistance
to countries determined by the Secretary to have
or be at risk for severe HIV epidemic with par-
ticular attention to resource constrained coun-
†
HR 2069 EAS
tries for the development of treatment protocols
for the delivery of HIV/AIDS treatment and pre-
vention services; and
‘‘(B) the provision of assistance to countries
determined by the Secretary to have or be at risk
for severe HIV epidemic with particular atten-
tion to resource constrained countries, and to be
ready to implement the protocols described in
subparagraph (A); and
‘‘(5) other activities determined appropriated by
the Secretary.
‘‘(c) UTILIZATION OF EXISTING CAPACITIES.—In car-
rying out activities under subsection (b), the Secretary, act-
ing through the Director of the Centers for Disease Control
and Prevention and in coordination with the Administrator
of the United States Agency for International Development
and the Administrator of the Health Resources and Services
Administration, shall, to the maximum extent practicable,
utilize existing indigenous capacity in developing countries,
including coordinating with relevant government ministries
and carrying out activities in partnership with non-govern-
mental organizations and affected communities.
‘‘(d) HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION.—In carrying out activities under paragraphs (2)
and (3) of subsection (b), the Secretary, acting through the
†
HR 2069 EAS
Director of the Centers for Disease Control and Prevention,
shall enter into interagency agreements, monetary transfers,
and contracts with the Administrator of the Health Re-
sources and Services Administration to ensure that such ac-
tivities benefit from the specialized expertise of such Admin-
istration related to the assessment of needs as well as the
development and implementation of community-based sys-
tems of care and appropriate infrastructure, including the
training of health care providers and community workers.
‘‘(e) BLOOD SUPPLY.—In carrying out activities under
subsection (b)(1)(E), the Secretary, acting through the Di-
rector of the Centers for Disease Control and Prevention,
shall assist participating countries in developing national,
regional, or local systems to—
‘‘(1) monitor, manage, and test the blood supply
to ensure that such supply is screened for HIV;
‘‘(2) increase recruitment and retention of ap-
propriate blood donors; and
‘‘(3) provide for technology transfer and capacity
building in proven best blood safety practices appro-
priate to local conditions, including anemia preven-
tion efforts.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are
authorized to be appropriated to carry out this section,
$400,000,000 for fiscal year 2003, and such sums as may
†
HR 2069 EAS
be necessary for fiscal year 2004. Of the amount appro-
priated under the preceding sentence for each fiscal year,
the Secretary shall make available $45,000,000 in fiscal
year 2003 and $30,000,000 in fiscal year 2004 to carry
out section 399DD. Amounts appropriated under this sub-
section shall remain available until expended.
‘‘SEC. 399BB. GENERAL AUTHORITY OF THE HEALTH RE-
SOURCES AND SERVICES ADMINISTRATION.
‘‘(a) PURPOSE.—It is the purpose of this section to
provide the Secretary, acting through the Administrator of
the Health Resources and Services Administration, with the
authority to act internationally to carry out prevention,
care, treatment, support, capacity development, and other
activities (determined appropriate by the Secretary) for
HIV/AIDS, tuberculosis, and malaria in countries deter-
mined by the Secretary to have or be at risk for severe HIV
epidemic with particular attention to resource constrained
countries.
‘‘(b) ACTIVITIES AND ASSISTANCE.—In carrying out
the purpose described in subsection (a), the Secretary, act-
ing through the Administrator of the Health Resources and
Services Administration, in coordination with the Director
of the Centers for Disease Control and Prevention and the
Administrator of the United States Agency for Inter-
†
HR 2069 EAS
national Development, may provide assistance under this
section relating to—
‘‘(1) activities to assist communities in assessing
the strengths and capabilities of the existing system of
care and treatment relating to HIV/AIDS and other
opportunistic infections, including critical unmet
needs;
‘‘(2) activities to assist communities in the devel-
opment and implementation of appropriate systems of
care that provide for a continuum of HIV/AIDS-re-
lated services for prevention, treatment, palliative
care, and hospice services based on an assessment
under paragraph (1);
‘‘(3) activities to improve the health-related in-
frastructure and institutional capacity of partici-
pating countries, including the training of health care
providers and community workers, to enable such
countries to develop and manage HIV/AIDS edu-
cation, prevention, care and treatment programs and
to conduct evaluations of such programs;
‘‘(4) activities to assist in the development of
training modules and curricula on HIV/AIDS and
associated conditions as part of the professional train-
ing programs for physicians, nurses, dentists, phar-
macists, and other health care providers;
†
HR 2069 EAS
‘‘(5) activities to improve the coordination be-
tween American medical centers and hospitals and
indigenous hospitals and clinics in participating
countries; and
‘‘(6) other activities determined appropriated by
the Secretary.
‘‘(c) UTILIZATION OF EXISTING CAPACITIES.—In car-
rying out activities under subsection (b), the Secretary, act-
ing through the Administrator of the Health Resources and
Services Administration and in consultation with the Di-
rector of the Centers for Disease Control and Prevention
and the Administrator of the United States Agency for
International Development, shall, to the maximum extent
practicable, utilize existing indigenous capacity in coun-
tries determined by the Secretary to have or be at risk for
severe HIV epidemic with particular attention to resource
constrained countries, including coordinating with relevant
government ministries and carrying out activities in part-
nership with non-governmental organizations and affected
communities.
‘‘(d) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated to carry out this section,
$40,000,000 for fiscal year 2003, and such sums as may
be necessary for fiscal year 2004. Amounts appropriated
under this subsection shall remain available until expended.
†
HR 2069 EAS
‘‘SEC. 399CC. HIV/AIDS TRAINING PARTNERSHIP.
‘‘(a) IN GENERAL.—The Secretary, acting through the
Director of the National Institutes of Health and in coordi-
nation with the Administrator of the Health Resources and
Services Administration, shall award supplemental grants
to eligible entities to enable such entities to provide support
for clinical education and training in the delivery of HIV/
AIDS care and treatment services.
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive a
supplemental grant under subsection (a), an entity shall—
‘‘(1) be a recipient of an international HIV/
AIDS clinical research, education, or training grant
awarded by the National Institutes of Health or the
Health Resources and Services Administration;
‘‘(2) provide assurances to the Secretary that the
entity has developed a partnership with a hospital-
based or community-based health care entity in the
host country for the purpose of providing services
under each grant; and
‘‘(3) prepare and submit to the Secretary an ap-
plication at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, including a description of the activities to be
carried out with amounts received under the grant.
‘‘(c) USE OF FUNDS.—An entity shall use amounts re-
ceived under a supplemental grant under subsection (a) to
†
HR 2069 EAS
provide clinical education and training in the delivery of
HIV/AIDS care and treatment services. Such education and
training shall be designed to develop health care provider
capacity to deliver HIV/AIDS care and treatment services
in a variety of institutional and community-based settings.
‘‘(d) PRIORITY.—In awarding grants under subsection
(a), the Secretary shall give priority to applicants that will
carry out activities that assess existing provider capacity
and address the training needs of a range of health care
providers (from physicians to nurses to other health care
providers).
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are
authorized to be appropriated to carry out this section,
$50,000,000 for fiscal year 2003, and such sums as may
be necessary for fiscal year 2004. Amounts appropriated
under this subsection shall remain available until expended.
‘‘SEC. 399DD. FAMILY SURVIVAL PARTNERSHIPS.
‘‘(a) PURPOSE.—The purpose of this section is to pro-
vide support, through a public-private partnership, for the
provision of medical care and support services to HIV posi-
tive parents and their children identified through existing
programs to prevent mother-to-child transmission of HIV
in countries with or at risk for severe HIV epidemic with
particular attention to resource constrained countries, as
determined by the Secretary.
†
HR 2069 EAS
‘‘(b) GRANTS.—
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director of the Centers for Disease Con-
trol and Prevention, is authorized to award a grant
to an eligible administrative organization to enable
the organization to award subgrants to eligible enti-
ties to expand activities to prevent the mother-to-child
transmission of HIV by providing medical care and
support services to HIV infected parents and their
children.
‘‘(2) ADMINISTRATIVE ORGANIZATION.—To be el-
igible to receive a grant under paragraph (1), an ad-
ministrative organization shall—
‘‘(A) have a demonstrable record in man-
aging large scale maternal and child health pro-
grams in countries with or at risk for severe
HIV epidemic with particular attention to re-
source constrained countries, as determined by
the Secretary, and sufficient HIV/AIDS exper-
tise;
‘‘(B) have established relationships with
major international organizations and multilat-
eral institutions;
‘‘(C) provide an assurance to the Secretary
that the organization will contribute (either di-
†
HR 2069 EAS
rectly or through private sector financial sup-
port) non-Federal funds to the costs of the activi-
ties to be carried out under this section in an
amount that is not less than the amount of funds
provided to the organization under a grant this
section; and
‘‘(D) prepare and submit an application to
the Secretary at such time, in such manner, and
accompanied by such information as the Sec-
retary may require.
‘‘(3) USE OF FUNDS.—Amounts provided under
a grant awarded under paragraph (1) shall be used—
‘‘(A) to award subgrants to eligible entities
to enable such entities to carry out activities de-
scribed in subsection (c);
‘‘(B) 
for 
administrative 
support 
and
subgrant management;
‘‘(C) for administrative data collection and
reporting concerning grant activities;
‘‘(D) for the monitoring and evaluation of
grant activities;
‘‘(E) for training and technical assistance
for subgrantees; and
‘‘(F) to promote sustainability.
‘‘(c) SUBGRANTS.—
†
HR 2069 EAS
‘‘(1) IN GENERAL.—An organization awarded a
grant under subsection (b) shall use amounts received
under the grant to award subgrants to eligible enti-
ties.
‘‘(2) ELIGIBILITY.—To be eligible to receive a
subgrant under paragraph (1), an entity shall—
‘‘(A) be a local health organization, an
international organization, or a partnership of
such organizations;
‘‘(B) demonstrate to the awarding organiza-
tion that such entity—
‘‘(i) is currently administering a prov-
en intervention to prevent mother-to-child
transmission of HIV in countries with or at
risk for severe HIV epidemic with par-
ticular attention to resource constrained
countries, as determined by the Secretary;
‘‘(ii) serves a catchment area with a
minimum HIV seroprevalence of 3 percent
in pregnant women;
‘‘(iii) has demonstrated support for the
proposed program from relevant government
entities;
‘‘(iv) is able to provide HIV care, in-
cluding 
antiretroviral 
treatment 
when
†
HR 2069 EAS
medically 
indicated, 
to 
HIV 
positive
women, men, and children with the support
of the project funding; and
‘‘(v) has the ability to enroll a min-
imum of 250 HIV infected women per serv-
ice site, based on the current uptake rate,
into existing HIV mother-to-child trans-
mission programs; and
‘‘(C) prepare and submit to the awarding
organization an application at such time, in
such manner, and containing such information
as the organization may require.
‘‘(3) LOCAL HEALTH AND INTERNATIONAL ORGA-
NIZATIONS.—For purposes of paragraph (2)(A)—
‘‘(A) the term ‘local health organization’
means a public sector health system, non-govern-
mental organization, institution of higher edu-
cation, community-based organization, or non-
profit health system that provides directly, or
has a clear link with a provider for the indirect
provision of, primary health care services; and
‘‘(B) the term ‘international organization’
means—
‘‘(i) a non-profit international entity;
†
HR 2069 EAS
‘‘(ii) an international charitable insti-
tution;
‘‘(iii) 
a 
private 
voluntary 
inter-
national entity; or
‘‘(iv) a multilateral institution.
‘‘(4) SELECTION OF SUBGRANT RECIPIENTS.—In
awarding subgrants under this subsection, the organi-
zation shall—
‘‘(A) consider applicants from a range of
health care settings, program approaches, and
geographic locations; and
‘‘(B) if appropriate, award not less than 1
grant to an applicant to fund a national system
of health care delivery to HIV positive families.
‘‘(5) USE OF SUBGRANT FUNDS.—An eligible en-
tity awarded a subgrant under this subsection shall
use subgrant funds to expand activities to prevent
mother-to-child transmission of HIV by providing
medical treatment and care and support services to
parents and their children, including—
‘‘(A) providing treatment and therapy,
when 
medically 
indicated, 
to 
HIV-infected
women, their children, and families;
‘‘(B) the hiring and training of local per-
sonnel, including physicians, nurses, other health
†
HR 2069 EAS
care providers, counselors, social workers, out-
reach personnel, laboratory technicians, data
managers, and administrative support personnel;
‘‘(C) paying laboratory costs, including
costs related to necessary equipment and diag-
nostic testing and monitoring (including rapid
testing), complete blood counts, standard chem-
istries, and liver function testing for infants,
children, and parents, and costs related to the
purchase of necessary laboratory equipment;
‘‘(D) purchasing pharmaceuticals for HIV-
related 
conditions, 
including 
antiretroviral
therapies;
‘‘(E) funding support services including ad-
herence and psychosocial support services;
‘‘(F) operational support activities; and
‘‘(G) conducting community outreach and
capacity building activities, including activities
to raise the awareness of individuals of the pro-
gram carried out by the subgrantee, other com-
munications activities in support of the pro-
gram, local advisory board functions, and trans-
portation necessary to ensure program participa-
tion.