(1) in paragraph (3), by adding at the end the 
following: 
‘‘(D) In 2007, the rate at which children 
accessed treatment failed to keep pace with new pe-
diatric infections. While children account for almost 
16 percent of all new HIV infections, they make up 
only 9 percent of those receiving treatment under 
this Act.’’; 
(2) by amending paragraph (16) to read as fol-
lows: 
‘‘(16) Basic interventions to prevent new HIV 
infections and to bring care and treatment to people 
living with AIDS, such as voluntary counseling and 
testing, are achieving meaningful results and are 
cost-effective. The challenge is to expand these inter-
ventions to a national basis in a coherent and sus-
tainable manner.’’; and 
(3) by amending paragraph (20) to read as fol-
lows: 
‘‘(20) With no medical intervention, mothers in-
fected with HIV have a 25 to 30 percent chance of 
passing the virus to their babies during pregnancy 
and childbirth. A simple and effective intervention 
can significantly reduce mother to child transmission 
of HIV. A single dose of an anti-retroviral drug 
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given once to the mother at the onset of labor, and 
once to the baby during the first 3 days of life re-
duces transmission by approximately 50 percent. 
Other more complex drug regimens can further re-
duce transmission from mother-to-child. A dramatic 
expansion of access to prevention of mother-to-child 
transmission services is critical to preventing thou-
sands of new pediatric HIV infections.’’. 
SEC. 3. POLICY PLANNING AND COORDINATION. 
Section 101(b)(3) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (22 U.S.C. 7611(b)(3)) is amended by adding at the 
end the following: 
‘‘(X) A description of the activities that 
will be conducted to achieve the targets de-
scribed in paragraphs (1) and (2) of section 
312(b).’’. 
SEC. 4. BILATERAL EFFORTS. 
(a) ASSISTANCE TO COMBAT HIV/AIDS.—Section 
104A of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151b–2) is amended— 
(1) in subsection (d)(1)— 
(A) by amending subparagraph (E) to read 
as follows: 
‘‘(E) assistance to— 
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‘‘(i) achieve the target described in 
section 312(b)(1) of the United States 
Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Act of 2003; and 
‘‘(ii) promote infant feeding options 
for HIV positive mothers that are con-
sistent with the most recent infant feeding 
recommendations and guidelines supported 
by the World Health Organization;’’; 
(B) in subparagraph (G), by striking 
‘‘and’’ at the end; 
(C) in subparagraph (H), by striking the 
period at the end and inserting ‘‘; and’’; and 
(D) by adding at the end the following: 
‘‘(I) assistance to achieve the target de-
scribed in section 312(b)(2) of the United 
States Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Act of 2003.’’; and 
(2) in subsection (e)(2)(C)— 
(A) in clause (iii), by striking ‘‘and’’ at the 
end; 
(B) in clause (iv), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
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‘‘(v) the number of HIV-infected chil-
dren 
currently 
receiving 
antiretroviral 
medications in each country under the 
United States Leadership Against HIV/ 
AIDS, Tuberculosis, and Malaria Act of 
2003.’’. 
(b) ASSISTANCE
TO CHILDREN
AND FAMILIES.— 
Subtitle B of Title III of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 (22 U.S.C. 7651 et seq.) is amended by striking sec-
tions 311 and 312 and inserting the following: 
‘‘SEC. 311. FINDINGS. 
‘‘Congress makes the following findings: 
‘‘(1) Every day, approximately 1,100 children 
around the world are infected with HIV, the vast 
majority through mother-to-child transmission dur-
ing pregnancy, labor or delivery or soon after 
through breast-feeding. Approximately 90 percent of 
these infections occur in Africa. 
‘‘(2) With no medical intervention, mothers in-
fected with HIV have a 25 to 30 percent chance of 
passing the virus to their babies during pregnancy 
and childbirth. A single dose of an anti-retroviral 
drug given once to the mother at the onset of labor, 
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and once to the baby during the first 3 days of life 
reduces transmission by approximately 50 percent. 
‘‘(3) Providing the full range of interventions, 
as is the standard of care in the United States, 
could reduce the rate of mother-to-child transmission 
of HIV to as little as 2 percent. 
‘‘(4) Global coverage of services to prevent 
transmission from mother-to-child remains unaccept-
ably low. The Joint United Nations Program on 
HIV/AIDS (UNAIDS) reports that fewer than 10 
percent of pregnant women with HIV in resource- 
poor countries have access to prevention of mother- 
to-child transmission services. 
‘‘(5) Prevention of mother-to-child transmission 
programs provide health benefits for women and 
children beyond preventing the vertical transmission 
of HIV. They serve as an entry point for mothers 
to access treatment for their own HIV infection, al-
lowing them to stay healthy and to care for their 
children. Efforts to connect and integrate prevention 
of mother-to-child transmission and HIV care, treat-
ment and prevention programs are crucial to achiev-
ing improved outcomes for HIV-affected and HIV- 
infected women and families. 
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‘‘(6) Access to comprehensive HIV prevention 
services must be drastically scaled-up among preg-
nant women infected with HIV and pregnant women 
not infected with HIV to further protect themselves 
and their partners against the sexual transmission of 
HIV/AIDS. 
‘‘(7) Preventing unintended pregnancy among 
HIV-infected women is recognized by the World 
Health Organization and the Office of the United 
States Global AIDS Coordinator to be an integral 
component of prevention of mother-to-child trans-
mission programs. To further reduce infection rates, 
women accessing prevention of mother-to-child 
transmission services must have access to a range of 
high-quality family planning and reproductive health 
care, so they can make informed decisions about fu-
ture pregnancies and contraception. 
‘‘(8) In 2007, the rate at which children were 
accessing treatment failed to keep pace with new pe-
diatric infections. While children account for almost 
16 percent of all new HIV infections, they make up 
only 9 percent of those on treatment under this Act. 
‘‘(9) Of the more than 2,500,000 people who 
were newly infected with HIV in 2007, more than 
420,000 were children. 
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‘‘(10) Without proper care and treatment, half 
of newly HIV-infected children will die before they 
reach 2 years of age, and 75 percent will die before 
5 years of age. 
‘‘(11) Because children are not just small 
adults, providing HIV care and treatment presents 
special challenges, including— 
‘‘(A) limited access to reliable HIV testing 
for the youngest children; 
‘‘(B) a shortage of providers trained in de-
livering pediatric care; 
‘‘(C) weak linkages between services to 
prevent mother-to-child transmission and care 
and treatment programs; and 
‘‘(D) the need for low-cost pediatric formu-
lations of HIV/AIDS medications. 
‘‘SEC. 312. POLICY AND REQUIREMENTS. 
‘‘(a) POLICY.— 
‘‘(1) IN GENERAL.—The United States Govern-
ment’s response to the global HIV/AIDS pandemic 
should place high priority on— 
‘‘(A) the prevention of mother-to-child 
transmission of HIV/AIDS; and 
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‘‘(B) the care and treatment of all children 
affected by HIV/AIDS, including children or-
phaned by AIDS. 
‘‘(2) COLLABORATION.—The United States 
Government should work in collaboration with for-
eign governments, donors, the private sector, non-
governmental organizations, and other key stake-
holders. 
‘‘(b) REQUIREMENTS.—The comprehensive, 5-year, 
global strategy required under section 101 shall— 
‘‘(1) establish a target for prevention of moth-
er-to-child transmission efforts that by 2013, in 
those countries most affected by HIV— 
‘‘(A) 80 percent of pregnant women receive 
HIV counseling and testing; and 
‘‘(B) all of the pregnant women receiving 
HIV counseling and testing who test positive 
for HIV receive anti-retroviral medications for 
prevention of mother-to-child transmission of 
HIV; 
‘‘(2) establish a target requiring that by 2013, 
children account for at least 15 percent of those re-
ceiving treatment under this Act; 
‘‘(3) integrate prevention, care, and treatment 
with prevention of mother-to-child transmission pro-
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grams, as soon as feasible and consistent with the 
national government policies of the foreign countries 
in which programs under this Act are administered, 
to improve outcomes for HIV-affected women and 
families and to promote follow-up and continuity of 
care; 
‘‘(4) expand programs designed to care for chil-
dren orphaned by AIDS; and 
‘‘(5) develop a time line for expanding access to 
more effective mother-to-child transmission preven-
tion regimens, consistent with the national govern-
ment policies of the foreign countries in which pro-
grams under this Act are administered and the goal 
of moving towards universal use of such regimens as 
rapidly as possible. 
‘‘(c) APPLICATION OF REQUIREMENTS.—All strategic 
planning documents and bilateral funding agreements de-
veloped under the authority of the Office of the United 
States Global AIDS Coordinator, including country oper-
ating plans and any subsequent mechanisms through 
which funding under this Act is obligated, shall be con-
sistent with, and in furtherance of, the requirements under 
subsection (b). 
‘‘(d) PREVENTION
OF MOTHER-TO-CHILD TRANS-
MISSION EXPERT PANEL.— 
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‘‘(1) ESTABLISHMENT.—The Coordinator of 
United States Government Activities to Combat 
HIV/AIDS Globally (referred to in this section as 
the ‘Coordinator’) shall establish a panel of experts 
to be known as the Prevention of Mother to Child 
Transmission Panel (referred to in this section as 
the ‘Panel’) to— 
‘‘(A) provide an objective review of activi-
ties to prevent mother-to-child transmission of 
HIV that receive financial assistance under this 
Act; and 
‘‘(B) provide recommendations to the Co-
ordinator and to the appropriate committees of 
Congress for scale-up of mother-to-child trans-
mission prevention services under this Act in 
order to achieve the target established in sub-
section (b)(1). 
‘‘(2) MEMBERSHIP.—The Panel shall be con-
vened and chaired by the Coordinator, who shall 
serve as a nonvoting member. The Panel shall con-
sist of not more than 15 members (excluding the Co-
ordinator), to be appointed by the Coordinator not 
later than 60 days after the date of the enactment 
of this Act, including— 
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‘‘(A) 2 members from the Department of 
Health and Human Services with expertise re-
lating to the prevention of mother-to-child 
transmission activities; 
‘‘(B) 2 members from the United States 
Agency for International Development with ex-
pertise relating to the prevention of mother-to- 
child transmission activities; 
‘‘(C) 2 representatives from among health 
ministers of national governments of foreign 
countries in which programs under this Act are 
administered; 
‘‘(D) 3 members representing organiza-
tions implementing prevention of mother-to- 
child transmission activities under this Act; 
‘‘(E) 2 health care researchers with exper-
tise relating to global HIV/AIDS activities; and 
‘‘(F) representatives from among patient 
advocate groups, health care professionals, per-
sons living with HIV/AIDS, and non-govern-
mental organizations with expertise relating to 
the prevention of mother-to-child transmission 
activities, giving priority to individuals in for-
eign countries in which programs under this 
Act are administered. 
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‘‘(3) DUTIES OF PANEL.—The Panel shall— 
‘‘(A) review activities receiving financial 
assistance under this Act to prevent mother-to- 
child transmission of HIV and assess the effec-
tiveness of current activities in reaching the 
target described in subsection (b)(1); 
‘‘(B) review scientific evidence related to 
the provision of mother-to-child transmission 
prevention services, including programmatic 
data and data from clinical trials; 
‘‘(C) review and assess ways in which the 
Office of the United States Global AIDS Coor-
dinator and programs funded under this Act 
collaborate with international and multilateral 
entities on efforts to prevent mother-to-child 
transmission of HIV in affected countries; 
‘‘(D) identify barriers and challenges to in-
creasing access to mother-to-child transmission 
prevention services and evaluate potential mech-
anisms to alleviate those barriers and chal-
lenges; 
‘‘(E) identify the extent to which stigma 
has hindered pregnant women from obtaining 
HIV counseling and testing or returning for re-
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sults, and provide recommendations to address 
such stigma and its effects; 
‘‘(F) identify opportunities to improve link-
ages between mother-to-child transmission pre-
vention services and care and treatment pro-
grams; 
‘‘(G) evaluate the adequacy of financial as-
sistance provided under this Act for mother-to- 
child transmission of HIV prevention services; 
and 
‘‘(H) recommend levels of financial assist-
ance and specific activities to facilitate reaching 
the target described in subsection (b)(1). 
‘‘(4) REPORT.— 
‘‘(A) IN
GENERAL.—Not later than 14 
months after the date of the enactment of this 
Act, the Panel shall submit a report containing 
a detailed statement of the recommendations, 
findings, and conclusions of the Panel to the 
appropriate congressional committees. 
‘‘(B) AVAILABILITY.—The report sub-
mitted under subparagraph (A) shall be made 
available to the public. 
‘‘(C) CONSIDERATION BY COORDINATOR.— 
The Coordinator shall— 
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‘‘(i) consider any recommendations 
contained in the report submitted under 
subparagraph (A); and 
‘‘(ii) include in the annual report re-
quired under section 104A(e) of the For-
eign Assistance Act of 1961 (22 U.S.C. 
2151b–2(e)) a description of the activities 
conducted in response to the recommenda-
tions made by the Panel and an expla-
nation of any recommendations not imple-
mented at the time of the report. 
‘‘(5) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to the 
Panel such sums as may be necessary for each of 
the fiscal years 2009 through 2011 to carry out this 
section. 
‘‘(6) TERMINATION.—The Panel shall terminate 
on the date that is 60 days after the date on which 
the Panel submits the report to Congress under 
paragraph (4).’’. 
(c) ANNUAL REPORT ELEMENTS.—Section 313(b)(2) 
of the United States Leadership Against HIV/AIDS, Tu-
berculosis, and Malaria Act of 2003 (22 U.S.C. 
7653(b)(2)) is amended— 
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(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (D), by striking the period 
at the end and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(E) coordination and collaboration with 
governments, donors, the private sector, non-
governmental organizations, and other key 
stakeholders to achieve the target described in 
section 312(b)(1); and 
‘‘(F) the number of women offered and re-
ceiving the 4 components of a comprehensive 
strategy to prevent mother-to-child transmission 
of HIV, as recommended by the World Health 
Organization.’’. 
Æ 
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