I 
118TH CONGRESS 
2D SESSION H. R. 10365 
To extend certain authorities relating to United States efforts to combat 
HIV/AIDS, tuberculosis, and malaria globally, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 11, 2024 
Mr. JAMES introduced the following bill; which was referred to the Committee 
on Foreign Affairs 
A BILL 
To extend certain authorities relating to United States ef-
forts to combat HIV/AIDS, tuberculosis, and malaria 
globally, and for other purposes. 
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 Extension 
and Reform Act of 2024’’. 
SEC. 2. INSPECTORS GENERAL AND ANNUAL STUDY. 
Section 101 of the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7611) is amended— 
(1) in subsection (f)(1)— 
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(A) in subparagraph (A), by striking 
‘‘2023’’ and inserting ‘‘2028’’; and 
(B) in subparagraph (C)(iv)— 
(i) by striking ‘‘nine’’ and inserting 
‘‘14’’; and 
(ii) by striking ‘‘2018’’ and inserting 
‘‘2023’’; and 
(2) in subsection (g)— 
(A) in paragraph (1), by striking ‘‘2024’’ 
and inserting ‘‘2029’’; and 
(B) in paragraph (2)— 
(i) in the heading, by striking ‘‘2024’’ 
and inserting ‘‘2029’’; and 
(ii) by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2029’’. 
SEC. 3. PARTICIPATION IN THE GLOBAL FUND TO FIGHT 
AIDS, TUBERCULOSIS, AND MALARIA. 
Section 202(d) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (22 U.S.C. 7622(d)) is amended— 
(1) in paragraph (4)— 
(A) in subparagraph (A)— 
(i) in clause (i), by striking ‘‘2023’’ 
and inserting ‘‘2028’’; and 
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(ii) in clause (ii), by striking ‘‘2023’’ 
and inserting ‘‘2028’’; and 
(B) in subparagraph (B)(iii), by striking 
‘‘2023’’ and inserting ‘‘2028’’; and 
(2) in paragraph (5), by striking ‘‘2023’’ and 
inserting ‘‘2028’’. 
SEC. 4. ALLOCATION OF FUNDS. 
Section 403 of the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7673) is amended— 
(1) in subsection (b), by striking ‘‘2023’’ and 
inserting ‘‘2028’’; 
(2) in subsection (c), in the matter preceding 
paragraph (1), by striking ‘‘2023’’ and inserting 
‘‘2028’’; and 
(3) by adding at the end the following new sub-
section: 
‘‘(e) LIMITATION.—None of the funds appropriated 
or otherwise made available by this Act for global health 
assistance may be made available to any foreign nonprofit, 
nongovernmental, or quasi-autonomous nongovernmental 
organization that promotes, performs, or provides con-
sultation for— 
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‘‘(1) abortion, except in cases of rape or incest 
or when the life of the mother would be endangered 
if the fetus were carried to term; or 
‘‘(2) gender reassignment surgery or drug 
issuance.’’. 
Æ 
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