121 
this Act. Such activities shall complement, rather than du-
plicate, the work of the World Health Organization. 
‘‘(h) ANNUAL REPORT.— 
‘‘(1) SUBMISSION.—Not later than 1 year after 
the date of the enactment of the Tom Lantos and 
Henry J. Hyde United States Global Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Reau-
thorization Act of 2008, and annually thereafter, the 
President shall submit a report to the appropriate 
congressional committees that describes United States 
assistance for the prevention, treatment, control, and 
elimination of malaria. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall describe— 
‘‘(A) the countries and activities to which 
malaria resources have been allocated; 
‘‘(B) the number of people reached through 
malaria assistance programs, including data on 
children and pregnant women; 
‘‘(C) research efforts to develop new tools to 
combat malaria, including drugs and vaccines; 
‘‘(D) the collaboration and coordination of 
United States antimalarial efforts with the 
World Health Organization, the Global Fund,
122 
the World Bank, other donor governments, major 
private efforts, and relevant executive agencies; 
‘‘(E) the coordination of United States anti-
malarial efforts with the national malarial strat-
egies of other donor or partner governments and 
major private initiatives; 
‘‘(F) the estimated impact of United States 
assistance on childhood mortality and morbidity 
from malaria; 
‘‘(G) the coordination of antimalarial ef-
forts with broader health and development pro-
grams; and 
‘‘(H) the constraints on implementation of 
programs posed by health workforce shortages or 
capacities; and 
‘‘(I) the number of personnel trained as 
health workers and the training levels achieved.’’. 
SEC. 305. AMENDMENT TO IMMIGRATION AND NATIONALITY 
ACT. 
Section 212(a)(1)(A)(i) of the Immigration and Na-
tionality Act (8 U.S.C. 1182(a)(1)(A)(i)) is amended by 
striking ‘‘, which shall include infection with the etiologic 
agent for acquired immune deficiency syndrome,’’ and in-
serting a semicolon.
123 
SEC. 306. CLERICAL AMENDMENT. 
Title III of the United States Leadership Against HIV/ 
AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 
7631 et seq.) is amended by striking the heading for subtitle 
B and inserting the following: 
‘‘Subtitle B—Assistance for Women, 
Children, and Families’’. 
SEC. 307. REQUIREMENTS. 
Section 312(b) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 
(22 U.S.C. 7652(b)) is amended by striking paragraphs (1), 
(2), and (3) and inserting the following: 
‘‘(1) establish a target for the prevention and 
treatment of mother-to-child transmission of HIV 
that, by 2013, will reach at least 80 percent of preg-
nant women in those countries most affected by HIV/ 
AIDS in which the United States has HIV/AIDS pro-
grams; 
‘‘(2) establish a target that, by 2013, the propor-
tion of children receiving care and treatment under 
this Act is proportionate to their numbers within the 
population of HIV infected individuals in each coun-
try; 
‘‘(3) integrate care and treatment with preven-
tion of mother-to-child transmission of HIV programs 
to improve outcomes for HIV-affected women and
124 
families as soon as is feasible and support strategies 
that promote successful follow-up and continuity of 
care of mother and child; 
‘‘(4) expand programs designed to care for chil-
dren orphaned by, affected by, or vulnerable to HIV/ 
AIDS; 
‘‘(5) ensure that women in prevention of mother- 
to-child transmission of HIV programs are provided 
with, or referred to, appropriate maternal and child 
services; and 
‘‘(6) develop a timeline for expanding access to 
more effective regimes to prevent mother-to-child 
transmission of HIV, consistent with the national 
policies of countries in which programs are adminis-
tered under this Act and the goal of achieving uni-
versal use of such regimes as soon as possible.’’. 
SEC. 308. ANNUAL REPORT ON PREVENTION OF MOTHER- 
TO-CHILD TRANSMISSION OF HIV. 
Section 313(a) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 
(22 U.S.C. 7653(a)) is amended by striking ‘‘5 years’’ and 
inserting ‘‘10 years’’.
125 
SEC. 309. PREVENTION OF MOTHER-TO-CHILD TRANS-
MISSION EXPERT PANEL. 
Section 312 of the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
U.S.C. 7652) is amended by adding at the end the following: 
‘‘(c) PREVENTION
OF
MOTHER-TO-CHILD
TRANS-
MISSION EXPERT PANEL.— 
‘‘(1) ESTABLISHMENT.—The Global AIDS Coor-
dinator shall establish a panel of experts to be known 
as the Prevention of Mother-to-Child Transmission 
Panel (referred to in this subsection as the ‘Panel’) 
to— 
‘‘(A) provide an objective review of activi-
ties to prevent mother-to-child transmission of 
HIV; and 
‘‘(B) provide recommendations to the Global 
AIDS Coordinator and to the appropriate con-
gressional committees for scale-up of mother-to- 
child transmission prevention services under this 
Act in order to achieve the target established in 
subsection (b)(1). 
‘‘(2) MEMBERSHIP.—The Panel shall be con-
vened and chaired by the Global AIDS Coordinator, 
who shall serve as a nonvoting member. The Panel 
shall consist of not more than 15 members (excluding 
the Global AIDS Coordinator), to be appointed by the
126 
Global AIDS Coordinator not later than 1 year after 
the date of the enactment of this Act, including— 
‘‘(A) 2 members from the Department of 
Health and Human Services with expertise re-
lating to the prevention of mother-to-child trans-
mission 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 organizations 
implementing 
prevention 
of 
mother-to-child 
transmission activities under this Act; 
‘‘(E) 2 health care researchers with expertise 
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-
127 
eign countries in which programs under this Act 
are administered. 
‘‘(3) DUTIES OF PANEL.—The Panel shall— 
‘‘(A) assess the effectiveness of current ac-
tivities in reaching the target described in sub-
section (b)(1); 
‘‘(B) review scientific evidence related to the 
provision of mother-to-child transmission preven-
tion services, including programmatic data and 
data from clinical trials; 
‘‘(C) review and assess ways in which the 
Office of the United States Global AIDS Coordi-
nator collaborates with international and multi-
lateral 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 challenges; 
‘‘(E) identify the extent to which stigma has 
hindered pregnant women from obtaining HIV 
counseling and testing or returning for results, 
and provide recommendations to address such 
stigma and its effects;
128 
‘‘(F) identify opportunities to improve link-
ages between mother-to-child transmission pre-
vention services and care and treatment pro-
grams; and 
‘‘(G) recommend specific activities to facili-
tate reaching the target described in subsection 
(b)(1). 
‘‘(4) REPORT.— 
‘‘(A) IN GENERAL.—Not later than 1 year 
after the date on which the Panel is first con-
vened, the Panel shall submit a report con-
taining a detailed statement of the recommenda-
tions, findings, and conclusions of the Panel to 
the appropriate congressional committees. 
‘‘(B) AVAILABILITY.—The report submitted 
under subparagraph (A) shall be made available 
to the public. 
‘‘(C) CONSIDERATION BY COORDINATOR.— 
The Coordinator shall— 
‘‘(i) consider any recommendations 
contained in the report submitted under 
subparagraph (A); and 
‘‘(ii) include in the annual report re-
quired under section 104A(f) of the Foreign 
Assistance Act of 1961 a description of the
129 
activities conducted in response to the rec-
ommendations made by the Panel and an 
explanation of any recommendations not 
implemented 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 the appropriate con-
gressional committees under paragraph (4).’’. 
TITLE IV—FUNDING 
ALLOCATIONS 
SEC. 401. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 401(a) of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and Malaria 
Act of 2003 (22 U.S.C. 7671(a)) is amended by striking 
‘‘$3,000,000,000 for each of the fiscal years 2004 through 
2008’’ and inserting ‘‘$48,000,000,000 for the 5-year period 
beginning on October 1, 2008’’. 
(b) SENSE OF CONGRESS.—It is the sense of the Con-
gress that the appropriations authorized under section 
401(a) of the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003, as amended by sub-
130 
section (a), should be allocated among fiscal years 2009 
through 2013 in a manner that allows for the appropria-
tions to be gradually increased in a manner that is con-
sistent with program requirements, absorptive capacity, 
and priorities set forth in such Act, as amended by this 
Act. 
SEC. 402. SENSE OF CONGRESS. 
Section 402(b) of the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 
(22 U.S.C. 7672(b)) is amended by striking ‘‘an effective 
distribution of such amounts would be’’ and all that follows 
through ‘‘10 percent of such amounts’’ and inserting ‘‘10 
percent should be used’’. 
SEC. 403. 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) by amending subsection (a) to read as fol-
lows: 
‘‘(a) BALANCED FUNDING REQUIREMENT.— 
‘‘(1) IN GENERAL.—The Global AIDS Coordi-
nator shall— 
‘‘(A) provide balanced funding for preven-
tion activities for sexual transmission of HIV/ 
AIDS; and
131 
‘‘(B) ensure that activities promoting absti-
nence, delay of sexual debut, monogamy, fidelity, 
and partner reduction are implemented and 
funded in a meaningful and equitable way in the 
strategy for each host country based on objective 
epidemiological evidence as to the source of infec-
tions and in consultation with the government of 
each host county involved in HIV/AIDS preven-
tion activities. 
‘‘(2) PREVENTION STRATEGY.— 
‘‘(A) ESTABLISHMENT.—In carrying out 
paragraph (1), the Global AIDS Coordinator 
shall establish an HIV sexual transmission pre-
vention strategy governing the expenditure of 
funds authorized under this Act to prevent the 
sexual transmission of HIV in any host country 
with a generalized epidemic. 
‘‘(B) REPORT.—In each host country de-
scribed in subparagraph (A), if the strategy es-
tablished under subparagraph (A) provides less 
than 50 percent of the funds described in sub-
paragraph (A) for activities promoting absti-
nence, delay of sexual debut, monogamy, fidelity, 
and partner reduction, the Global AIDS Coordi-
nator shall, not later than 30 days after the
132 
issuance of this strategy, report to the appro-
priate congressional committees on the justifica-
tion for this decision. 
‘‘(3) EXCLUSION.—Programs and activities that 
implement or purchase new prevention technologies or 
modalities, such as medical male circumcision, public 
education about risks to acquire HIV infection from 
blood exposures, promoting universal precautions, in-
vestigating suspected nosocomial infections, pre-expo-
sure pharmaceutical prophylaxis to prevent trans-
mission of HIV, or microbicides and programs and 
activities that provide counseling and testing for HIV 
or prevent mother-to-child prevention of HIV, shall 
not be included in determining compliance with 
paragraph (2). 
‘‘(4) REPORT.—Not later than 1 year after the 
date of the enactment of the Tom Lantos and Henry 
J. Hyde United States Global Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Reauthoriza-
tion Act of 2008, and annually thereafter as part of 
the annual report required under section 104A(e) of 
the Foreign Assistance Act of 1961 (22 U.S.C. 2151b– 
2(e)), the President shall— 
‘‘(A) submit a report on the implementation 
of paragraph (2) for the most recently concluded
133 
fiscal year to the appropriate congressional com-
mittees; and 
‘‘(B) make the report described in subpara-
graph (A) available to the public.’’; 
(2) in subsection (b)— 
(A) by striking ‘‘fiscal years 2006 through 
2008’’ and inserting ‘‘fiscal years 2009 through 
2013’’; and 
(B) by striking ‘‘vulnerable children affected 
by’’ and inserting ‘‘other children affected by, or 
vulnerable to,’’; and 
(3) by adding at the end the following: 
‘‘(c) FUNDING ALLOCATION.—For each of the fiscal 
years 2009 through 2013, more than half of the amounts 
appropriated for bilateral global HIV/AIDS assistance pur-
suant to section 401 shall be expended for— 
‘‘(1) antiretroviral treatment for HIV/AIDS; 
‘‘(2) clinical monitoring of HIV-seropositive peo-
ple not in need of antiretroviral treatment; 
‘‘(3) care for associated opportunistic infections; 
‘‘(4) nutrition and food support for people living 
with HIV/AIDS; and 
‘‘(5) other essential HIV/AIDS-related medical 
care for people living with HIV/AIDS.
135 
2(b)(1)(A)) shall be increased consistent with epide-
miological evidence and available resources.’’. 
TITLE V—MISCELLANEOUS 
SEC. 501. MACHINE READABLE VISA FEES. 
(a) FEE INCREASE.—Notwithstanding any other pro-
vision of law— 
(1) not later than October 1, 2010, the Secretary 
of State shall increase by $1 the fee or surcharge au-
thorized under section 140(a) of the Foreign Relations 
Authorization Act, Fiscal Years 1994 and 1995 (Pub-
lic Law 103–236; 8 U.S.C. 1351 note) for processing 
machine readable nonimmigrant visas and machine 
readable combined border crossing identification 
cards and nonimmigrant visas; and 
(2) not later than October 1, 2013, the Secretary 
shall increase the fee or surcharge described in para-
graph (1) by an additional $1. 
(b) DEPOSIT OF AMOUNTS.—Notwithstanding section 
140(a)(2) of the Foreign Relations Authorization Act, Fis-
cal Years 1994 and 1995 (Public Law 103–236; 8 U.S.C. 
1351 note), fees collected under the authority of subsection 
(a) shall be deposited in the Treasury.
136 
TITLE 
VI—EMERGENCY 
PLAN 
FOR 
INDIAN 
SAFETY 
AND 
HEALTH 
SEC. 601. EMERGENCY PLAN FOR INDIAN SAFETY AND 
HEALTH. 
(a) ESTABLISHMENT OF FUND.—There is established 
in the Treasury of the United States a fund, to be known 
as the ‘‘Emergency Fund for Indian Safety and Health’’ 
(referred to in this section as the ‘‘Fund’’), consisting of 
such amounts as are appropriated to the Fund under sub-
section (b). 
(b) TRANSFERS TO FUND.— 
(1) IN GENERAL.—There is authorized to be ap-
propriated to the Fund, out of funds of the Treasury 
not otherwise appropriated, $2,000,000,000 for the 5- 
year period beginning on October 1, 2008. 
(2) AVAILABILITY
OF
AMOUNTS.—Amounts de-
posited in the Fund under this section shall— 
(A) be made available without further ap-
propriation; 
(B) be in addition to amounts made avail-
able under any other provision of law; and 
(C) remain available until expended. 
(c) EXPENDITURES FROM FUND.—On request by the 
Attorney General, the Secretary of the Interior, or the Sec-
137 
retary of Health and Human Services, the Secretary of the 
Treasury shall transfer from the Fund to the Attorney Gen-
eral, the Secretary of the Interior, or the Secretary of Health 
and Human Services, as appropriate, such amounts as the 
Attorney General, the Secretary of the Interior, or the Sec-
retary of Health and Human Services determines to be nec-
essary to carry out the emergency plan under subsection 
(f). 
(d) TRANSFERS OF AMOUNTS.— 
(1) IN GENERAL.—The amounts required to be 
transferred to the Fund under this section shall be 
transferred at least monthly from the general fund of 
the Treasury to the Fund on the basis of estimates 
made by the Secretary of the Treasury. 
(2) ADJUSTMENTS.—Proper adjustment shall be 
made in amounts subsequently transferred to the ex-
tent prior estimates were in excess of or less than the 
amounts required to be transferred. 
(e) REMAINING AMOUNTS.—Any amounts remaining 
in the Fund on September 30 of an applicable fiscal year 
may be used by the Attorney General, the Secretary of the 
Interior, or the Secretary of Health and Human Services 
to carry out the emergency plan under subsection (f) for 
any subsequent fiscal year.
138 
(f) EMERGENCY PLAN.—Not later than 1 year after the 
date of enactment of this Act, the Attorney General, the Sec-
retary of the Interior, and the Secretary of Health and 
Human Services, in consultation with Indian tribes (as de-
fined in section 4 of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 450b)), shall jointly 
establish an emergency plan that addresses law enforcement, 
water, and health care needs of Indian tribes under which, 
for each of fiscal years 2010 through 2019, of amounts in 
the Fund— 
(1) the Attorney General shall use— 
(A) 18.5 percent for the construction, reha-
bilitation, and replacement of Federal Indian de-
tention facilities; 
(B) 1.5 percent to investigate and prosecute 
crimes in Indian country (as defined in section 
1151 of title 18, United States Code); 
(C) 1.5 percent for use by the Office of Jus-
tice Programs for Indian and Alaska Native pro-
grams; and 
(D) 0.5 percent to provide assistance to— 
(i) parties to cross-deputization or 
other cooperative agreements between State 
or local governments and Indian tribes (as 
defined in section 102 of the Federally Rec-
139 
ognized Indian Tribe List Act of 1994 (25 
U.S.C. 479a)) carrying out law enforcement 
activities in Indian country; and 
(ii) the State of Alaska (including po-
litical subdivisions of that State) for car-
rying out the Village Public Safety Officer 
Program and law enforcement activities on 
Alaska Native land (as defined in section 3 
of Public Law 103–399 (25 U.S.C. 3902)); 
(2) the Secretary of the Interior shall— 
(A) deposit 15.5 percent in the public safety 
and justice account of the Bureau of Indian Af-
fairs for use by the Office of Justice Services of 
the Bureau in providing law enforcement or de-
tention services, directly or through contracts or 
compacts with Indian tribes under the Indian 
Self-Determination and Education Assistance 
Act (25 U.S.C. 450 et seq.); and 
(B) use 50 percent to implement require-
ments of Indian water settlement agreements 
that are approved by Congress (or the legislation 
to implement such an agreement) under which 
the United States shall plan, design, rehabilitate, 
or construct, or provide financial assistance for 
the planning, design, rehabilitation, or construc-
140 
tion of, water supply or delivery infrastructure 
that will serve an Indian tribe (as defined in 
section 4 of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 450b)); and 
(3) the Secretary of Health and Human Serv-
ices, acting through the Director of the Indian Health 
Service, shall use 12.5 percent to provide, directly or 
through contracts or compacts with Indian tribes 
under the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 450 et seq.)— 
(A) contract health services; 
(B) construction, rehabilitation, and re-
placement of Indian health facilities; and 
(C) domestic and community sanitation fa-
cilities serving members of Indian tribes (as de-
fined in section 4 of the Indian Self-Determina-
tion and Education Assistance Act (25 U.S.C. 
450b)) pursuant to section 7 of the Act of August 
5, 1954 (42 U.S.C. 2004a). 
Attest: 
Secretary.