I 
108TH CONGRESS 
2D SESSION 
H. R. 4191 
To amend the Foreign Assistance Act of 1961 to provide for the establishment 
of a network of pediatric centers in certain developing countries to 
provide treatment and care for children with HIV/AIDS, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 21, 2004 
Ms. MILLENDER-MCDONALD introduced the following bill; which was referred 
to the Committee on International Relations 
A BILL 
To amend the Foreign Assistance Act of 1961 to provide 
for the establishment of a network of pediatric centers 
in certain developing countries to provide treatment and 
care for children with HIV/AIDS, and for other pur-
poses. 
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 ‘‘International Pediatric 
HIV/AIDS Network Act of 2004’’. 
SEC. 2. FINDINGS. 
Congress finds the following:
(1) HIV/AIDS causes the death of more indi-
viduals than any other infectious disease, surpassing 
even tuberculosis and malaria, the leading causes of 
death since antiquity. In 2003 HIV/AIDS caused 
the death of more than 3,000,000 individuals. 
(2) 
Worldwide, 
approximately 
40,000,000 
adults and children are infected with HIV, and ap-
proximately 28,000,000 individuals have died of 
AIDS since the beginning of the epidemic, including 
approximately 5,600,000 children. 
(3) Approximately 50 percent of all new HIV 
infections occur among young people 15 to 24 years 
of age. 
(4) Each day more than 2,000 children are in-
fected with HIV and 16 percent of all new HIV in-
fections involve children. 
(5) In 2003 more than 700,000 children be-
came infected with HIV and a total of approximately 
2,500,000 children were living with HIV/AIDS. 
(6) In 2003 approximately 500,000 children 
died from AIDS. By the end of 2003 a total of more 
than 5,600,000 children had died from AIDS since 
the beginning of the epidemic. 
(7) The HIV/AIDS epidemic has a devastating 
impact on children and families. More than
14,000,000 children have been orphaned as a result 
of HIV/AIDS, of whom 95 percent live in sub-Saha-
ran Africa. 
(8) The following represents the approximate 
number of children under the age of 15 who are liv-
ing with HIV/AIDS in the countries indicated: 
270,000 in Nigeria, 250,000 in South Africa, 
230,000 in Ethiopia, 220,000 in Kenya, 170,000 in 
Tanzania, 150,000 in Zambia, 110,000 in Uganda, 
84,000 in Coˆte d’Ivoire, 80,000 in Mozambique, 
65,000 in Rwanda, 30,000 in Namibia, 170,000 in 
India, 2,000 in the People’s Republic of China, and 
800 in Guyana. 
(9) These countries are developing countries in 
which very few individuals infected with HIV have 
access to antiretroviral therapies. 
(10) Approximately 50 percent of all individuals 
who become infected with HIV acquire the virus be-
fore the age of 25 and die from AIDS or AIDS-re-
lated illnesses before the age of 35. The propensity 
of HIV to infect adolescents and young adults poses 
a unique threat to children for acquisition of the 
virus. 
(11) In addition, 95 percent of HIV/AIDS-asso-
ciated deaths occur in developing countries. Some
projections indicate that by 2005 the number of in-
dividuals infected with HIV in Africa may double to 
approximately 60,000,000 individuals. Asia, espe-
cially India and the People’s Republic of China, is 
acknowledged to represent the next region to experi-
ence a major increase in the HIV/AIDS epidemic. 
(12) There is also a lack of health care profes-
sionals with expertise or experience in treating chil-
dren infected with HIV, including the provision of 
therapy, dosing, administration, and monitoring. 
Treatment for children infected with HIV is not as 
widely available as it is for adults infected with HIV 
and thus children represent a disproportionate share 
of those individuals infected with HIV who do not 
have access treatment. 
(13) Most health care professionals in devel-
oping countries lack formal education or training in 
pediatric HIV/AIDS treatment, have limited access 
to relevant scientific and medical literature, and do 
not network or collaborate with their colleagues in 
other institutions on any regular basis. 
(14) Formal research training for such health 
care professionals is almost non-existent, as well as 
studies specifically designed to address practical and 
affordable approaches to the prevention and treat-
ment of HIV/AIDS. Infrastructure for the conduct 
of HIV/AIDS clinical research is lacking in most de-
veloping countries. 
(15) The establishment of a network of pedi-
atric centers to provide treatment and care for chil-
dren with HIV/AIDS in developing countries and the 
training of pediatric health care professionals would 
be an important contribution to the prevention, 
treatment, and monitoring of HIV/AIDS cases in 
those countries. 
(16) The establishment of this network will 
mean that approximately 40,000 children with HIV/ 
AIDS will receive treatment and care at the pedi-
atric centers during the five year-period beginning 
immediately after the establishment of the network. 
This will dramatically enhance the global infrastruc-
ture and capacity for HIV/AIDS care and treatment 
and clinical research. Each center would become 
self-sustaining after the initial five year-period. 
(17) These centers will be developed and staffed 
collaboratively by United States and local profes-
sionals. The centers would be modeled after two 
landmark international pediatric HIV/AIDS care 
and treatment centers already established and oper-
ating in Constanta, Romania, and Gaborone, Bot-
swana. 
(18) Based on the model of the pediatric HIV/ 
AIDS care and treatment centers in Constanta, Ro-
mania and Gaborone, Botswana, these centers will 
make a valuable contribution not only to the treat-
ment of HIV/AIDS, but also to routine care, psycho-
social care, and nutritional and other child life serv-
ices. 
SEC. 3. AMENDMENTS TO THE FOREIGN ASSISTANCE ACT 
OF 1961. 
(a) NETWORK
OF
PEDIATRIC
HIV/AIDS CEN-
TERS.—Section 104A(d) of the Foreign Assistance Act of 
1961 (22 U.S.C. 2151b-2(d)) is amended by adding at the 
end the following new paragraph: 
‘‘(8) NETWORK OF PEDIATRIC HIV/AIDS CEN-
TERS.—The establishment and operation by one or 
more public-private partnership entities described in 
paragraph (7) of a network of pediatric centers in 
countries in sub-Saharan Africa, the Republic of 
India, the People’s Republic of China, the Co-opera-
tive Republic of Guyana, and other countries and 
areas with high rates of HIV/AIDS to provide treat-
ment and care for children with HIV/AIDS in such
countries and areas and to provide training of pedi-
atric health care professionals at such centers.’’. 
(b) FUNDING.—Section 104A of the Foreign Assist-
ance Act of 1961 is amended— 
(1) by redesignating subsection (g) as sub-
section (h); and 
(2) by inserting after subsection (f) the fol-
lowing new subsection: 
‘‘(g) FUNDING FOR NETWORK OF PEDIATRIC HIV/ 
AIDS CENTERS.—Of the funds made available to carry 
out this section for fiscal years 2005 through 2009, not 
less than $10,000,000 for each such fiscal year is author-
ized to be made available to carry out subsection (d)(8).’’. 
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