I
107TH CONGRESS
1ST SESSION
H. R. 1567
To encourage the provision of multilateral debt cancellation for countries
eligible to be considered for assistance under the Heavily Indebted Poor
Countries (HIPC) Initiative or heavily affected by HIV/AIDS, and for
other purposes.
IN THE HOUSE OF REPRESENTATIVES
APRIL 24, 2001
Ms. LEE (for herself and Ms. WATERS) introduced the following bill; which
was referred to the Committee on Financial Services
A BILL
To encourage the provision of multilateral debt cancellation
for countries eligible to be considered for assistance
under the Heavily Indebted Poor Countries (HIPC) Ini-
tiative or heavily affected by HIV/AIDS, 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. FINDINGS.
The Congress finds the following:
(1) According to the United Nations, economic
and social factors contribute to the spread of HIV/
AIDS, which now infects an average of 16,000 peo-
ple every day.
(2) Due to the debt crisis in the majority of im-
poverished countries, substantially more money is
spent on debt repayment each year than on HIV/
AIDS prevention and treatment programs.
(3) Structural adjustment programs in the de-
veloping world, in an attempt to enable the impover-
ished nations to repay their debt, have required gov-
ernments to impose failed and often harmful policies
including charging user fees for the use of medical
clinics. These user fees can create an obstacle to ef-
fective prevention and treatment programs.
(4) In Kenya, when user fees were imposed at
Nairobi’s Sexually Transmitted Disease clinics, at-
tendance decreased 35–60 percent.
(5) User fees have also been shown to decrease
the use of health clinics in Mozambique, the Congo,
Ghana, and Zimbabwe.
(6) Cuts in health clinic budgets, required by
structural adjustment programs, may also contribute
to the spread of HIV/AIDS.
(7) Structural adjustment programs have also
contributed to internal and international labor mi-
gration. Labor migration is associated with increase
in HIV transmission rates in Senegal, Ghana,
Benin, Nigeria, and Kenya.
(8) The HIV/AIDS pandemic will result in tens
of millions of orphaned children worldwide, creating
an unprecedented strain on the world’s economic re-
sources and relief efforts.
(9) Secretary General of the United Nations,
Kofi Annan, stated in 1999 that ‘‘the impact of
AIDS is no less destructive than that of warfare
itself, and by some measures, far worse’’.
(10) Many of the same nations in Sub-Saharan
Africa which are crushed beneath the weight of for-
eign debt are experiencing catastrophic loss of life
and negative economic growth due largely to the
HIV/AIDS pandemic.
(11) The decision of the G–8 countries at the
Cologne 
Summit 
in 
1999 
to 
reduce 
by
$100,000,000,000 the debt of the countries listed by
the World Bank and the International Monetary
Fund (IMF) as Heavily Indebted Poor Countries
(HIPCs) 
(which 
combined 
owe 
approximately
$220,000,000,000 in debt) is a measure for which
only 22 have qualified. These countries have seen
their annual debt service reduced by an average of
26 percent, a level of reduction which is neither al-
lowing these countries a sustainable exit from debt,
nor freeing up substantial resources to combat pov-
erty and the AIDS pandemic.
(12) Per capita government expenditure on
health care in most African countries is below $10,
and the per capita share of debt service to foreign
creditors is up to 5 times as high as public health
expenditure.
(13) The Congress enacted section 596 of the
Foreign Operations, Export Financing, and Related
Programs Appropriations Act, 2001. This dem-
onstrated the political commitment to eliminate user
fees for primary health care and education.
(14) A large-scale program of multilateral and
bilateral debt cancellation explicitly linked to HIV/
AIDS control would have minimal impact on creditor
country taxpayers and budgets.
(15) The active participation of all stakeholders
in the epidemic, in the process of negotiating debt
cancellation for HIV/AIDS prevention and care, is a
precondition for the implementation of effective pro-
grams.
(16) The United States has shown good faith
by providing $435,000,000 in fiscal year 2001 for
bilateral debt cancellation and multilateral debt re-
duction. This action should encourage international
financial institutions to match the debt cancellation
efforts of the G–8 countries to ensure burden shar-
ing.
SEC. 2. MULTILATERAL DEBT CANCELLATION EFFORTS
FOR COUNTRIES ELIGIBLE TO BE CONSID-
ERED FOR ASSISTANCE UNDER THE HEAVILY
INDEBTED POOR COUNTRIES (HIPC) INITIA-
TIVE OR HEAVILY AFFECTED BY HIV/AIDS.
The Secretary of the Treasury shall instruct the
United States Executive Directors at the International
Bank for Reconstruction and Development and the Inter-
national Monetary Fund to use the voice, vote, and influ-
ence of the United States to call for a vote in their respec-
tive institutions on (and call for the publication of the out-
come of any such vote)—
(1) negotiating a strategy for cancelling the
debts owed to the institution by any country that is
eligible to be considered for assistance under the
Heavily Indebted Poor Countries (HIPC) Initiative
or is heavily affected by HIV/AIDS, which should
ensure that the savings from debt cancellation are
used for poverty reduction in a process that is fair
and transparent, and that includes the participation
of national governments, including parliamentary