125 
goals by 2015, estimated by the World Health 
Organization to require at least 2.3 doctors, 
nurses, and midwives per 1,000 population, and 
additional health workers such as pharmacists 
and lab technicians. 
‘‘(C) Activities to ensure that health work-
force strategies are aimed at creating appro-
priate distribution of health workers and 
prioritizing activities required to ensure rural, 
marginalized, and other underserved popu-
lations are able to access skilled and equipped 
health workers. 
‘‘(D) Activities to expand the capacity of 
public and private medical, nursing, pharma-
ceutical, and other health training institutions. 
‘‘(b) POSITIVE BROADER HEALTH IMPACT.—It shall 
be the policy of the United States to ensure to expand 
the capacity of the health workforce engaged in HIV/AIDS 
programming in ways that contribute to, and do not de-
tract from, the capacity of countries to meet other health 
needs, particularly child survival and maternal health. 
‘‘(c) SAFETY
FOR HEALTH WORKERS.—It is the 
sense of Congress that the United States should ensure 
that all health workers participating in programs that re-
ceive assistance under this Act and the amendments made 
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126 
by this Act have the proper training to create safe and 
sanitary working conditions in accordance with universal 
precautions and other forms of infection prevention and 
control. 
‘‘(d) HEALTH CARE FOR HEALTH WORKERS.—The 
Coordinator of United States Government Activities to 
Combat HIV/AIDS Globally shall ensure that comprehen-
sive and confidential health services shall be provided to 
all health workers participating in programs that receive 
assistance under this Act and the amendments made by 
this Act, including— 
‘‘(1) testing and counseling for all such employ-
ees; 
‘‘(2) providing HIV/AIDS treatment to HIV- 
positive employees; and 
‘‘(3) taking measures to reduce HIV-related 
stigma in the workplace. 
‘‘(e) TRAINING
AND COMPENSATION FINANCE.— 
Where the Coordinator determines such financial support 
is essential to fulfill the purposes of this Act, the Coordi-
nator shall finance training and provide compensation or 
other benefits for health workers in order to enhance re-
cruitment and retention of such workers. 
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127 
‘‘SEC. 603. EXEMPTION OF INVESTMENTS IN HEALTH FROM 
LIMITS SOUGHT BY INTERNATIONAL FINAN-
CIAL INSTITUTIONS. 
‘‘(a) COORDINATION WITHIN THE UNITED STATES 
GOVERNMENT.—The Coordinator of United States Gov-
ernment Activities to Combat HIV/AIDS Globally shall 
work with the Secretary of the Treasury to reform Inter-
national Monetary Fund macroeconomic and fiscal policies 
that result in limitations on national and donor invest-
ments in health. 
‘‘(b) POSITION OF THE UNITED STATES AT THE 
IMF.—The Secretary of the Treasury shall instruct the 
United States Executive Director at the International 
Monetary Fund to use the voice, vote, and influence of 
the United States to oppose any loan, project, agreement, 
memorandum, instrument, plan, or other program of the 
International Monetary Fund that does not exempt in-
creased government spending on health care from national 
budget caps or restraints, hiring or wage bill ceilings, or 
other limits sought by any international financial institu-
tion. 
‘‘SEC. 604. PUBLIC-SECTOR PROCUREMENT, DRUG REG-
ISTRATION, AND SUPPLY CHAIN MANAGE-
MENT SYSTEMS. 
‘‘(a) IN GENERAL.—The Coordinator of United 
States Government Activities to Combat AIDS Globally 
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shall work with the Partnership for Supply Chain Manage-
ment Systems, host countries, and nongovernmental orga-
nizations to develop effective, reliable host country-owned 
and operated public-sector procurement and supply chain 
management systems, including regional distribution, with 
ongoing technical assistance and sustained support to en-
sure the function of such systems, as well as the function 
of existing non-public sector supply chains, including those 
operated by faith-based and other humanitarian organiza-
tions that procure and distribute medical supplies. 
‘‘(b) AVAILABILITY
OF
EQUIPMENT
AND
SUP-
PLIES.—The public-sector procurement and supply chain 
management systems developed pursuant to subsection (a) 
should ensure that adequate laboratory equipment and 
supplies commonly needed to fight HIV/AIDS, including 
diagnostic tests for CD4 and viral load counts, x-ray ma-
chines, mobile and facility-based rapid HIV test kits and 
other necessary assays, reagents and basic supplies such 
as sterile syringes and gloves, are available and distributed 
in a manner that is accessible to urban and rural popu-
lations. 
‘‘(c) DRUG REGISTRATION.—The Coordinator shall 
work with host country partners and development partners 
to support efficient and effective drug approval and reg-
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129 
istration systems that allow expeditious access to safe and 
effective drugs, including antiretroviral drugs. 
‘‘(d) REPORT.—The Coordinator shall submit to the 
appropriate congressional committees an annual report on 
the implementation of this section, including progress to-
ward specific benchmarks established by the Partnership 
for Supply Chain Management Systems, and the projec-
tion of when host countries can fully sustain their own 
procurement and supply chain management and distribu-
tion systems at a scale necessary for national primary 
health needs. 
‘‘SEC. 605. AUTHORIZATION OF APPROPRIATIONS. 
‘‘(a) IN GENERAL.—Of the amounts authorized to be 
appropriated under section 401 for HIV/AIDS assistance, 
there are authorized to be appropriated to the President 
such sums as may be necessary for each of the fiscal years 
2009 through 2013 to carry out this title. 
‘‘(b) AVAILABILITY.—Amounts appropriated pursu-
ant to the authorization of appropriations under sub-
section (a) are authorized to remain available until ex-
pended.’’. 
SEC. 502. CLERICAL AMENDMENT. 
The table of contents for the United States Leader-
ship Against HIV/AIDS, Tuberculosis, and Malaria Act 
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of 2003 (22 U.S.C. 7601 note) is amended by inserting 
after the items relating to title V the following: 
‘‘TITLE VI—SUSTAINABILITY AND STRENGTHENING OF HEALTH 
CARE SYSTEMS 
‘‘Sec. 601. Findings. 
‘‘Sec. 602. National health workforce strategies and other policies. 
‘‘Sec. 603. Exemption of investments in health from limits sought by inter-
national financial institutions. 
‘‘Sec. 604. Public-sector procurement, drug registration, and supply chain man-
agement systems. 
‘‘Sec. 605. Authorization of appropriations.’’. 
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Union Calendar No. 333 
110TH CONGRESS 
2D SESSION 
H. R. 5501 
[Report No. 110–546, Part I] 
A BILL 
To authorize appropriations for fiscal years 2009 
through 2013 to provide assistance to foreign 
countries to combat HIV/AIDS, tuberculosis, and 
malaria, and for other purposes. 
MARCH 10, 2008 
Committee on Financial Services discharged; committed 
to the Committee of the Whole House on the State of 
the Union and ordered to be printed 
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