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(D) encouraging governments and faith-based and
community-based organizations to adopt policies that treat
HIV/AIDS as a multisectoral public health problem
affecting not only health but other areas such as agri-
culture, education, the economy, the family and society,
and assisting them to develop and implement programs
corresponding to these needs;
(E) promoting healthy lifestyles, including abstinence,
delaying sexual debut, monogamy, marriage, faithfulness,
use of condoms, and avoiding substance abuse; and
(F) encouraging active involvement of the private
sector, including businesses, pharmaceutical and bio-
technology companies, the medical and scientific commu-
nities, charitable foundations, private and voluntary
organizations and nongovernmental organizations, faith-
based organizations, community-based organizations, and
other nonprofit entities.
(23) Prostitution and other sexual victimization are
degrading to women and children and it should be the policy
of the United States to eradicate such practices. The sex
industry, the trafficking of individuals into such industry, and
sexual violence are additional causes of and factors in the
spread of the HIV/AIDS epidemic. One in nine South Africans
is living with AIDS, and sexual assault is rampant, at a victim-
ization rate of one in three women. Meanwhile in Cambodia,
as many as 40 percent of prostitutes are infected with HIV
and the country has the highest rate of increase of HIV infection
in all of Southeast Asia. Victims of coercive sexual encounters
do not get to make choices about their sexual activities.
(24) Strong coordination must exist among the various
agencies of the United States to ensure effective and efficient
use of financial and technical resources within the United
States Government with respect to the provision of inter-
national HIV/AIDS assistance.
(25) In his address to Congress on January 28, 2003, the
President announced the Administration’s intention to embark
on a five-year emergency plan for AIDS relief, to confront
HIV/AIDS with the goals of preventing 7,000,000 new HIV/
AIDS infections, treating at least 2,000,000 people with life-
extending drugs, and providing humane care for millions of
people suffering from HIV/AIDS, and for children orphaned
by HIV/AIDS.
(26) In this address to Congress, the President stated the
following: ‘‘Today, on the continent of Africa, nearly 30,000,000
people have the AIDS virus—including 3,000,000 children
under the age of 15. There are whole countries in Africa where
more than one-third of the adult population carries the infec-
tion. More than 4,000,000 require immediate drug treatment.
Yet across that continent, only 50,000 AIDS victims—only
50,000—are receiving the medicine they need.’’.
(27) Furthermore, the President focused on care and treat-
ment of HIV/AIDS in his address to Congress, stating the
following: ‘‘Because the AIDS diagnosis is considered a death
sentence, many do not seek treatment. Almost all who do
are turned away. A doctor in rural South Africa describes
his frustration. He says, ‘We have no medicines. Many hospitals
tell people, you’ve got AIDS, we can’t help you. Go home and
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die.’ In an age of miraculous medicines, no person should have
to hear those words. AIDS can be prevented. Anti-retroviral
drugs can extend life for many years * * * Ladies and gentle-
men, seldom has history offered a greater opportunity to do
so much for so many.’’.
(28) Finally, the President stated that ‘‘[w]e have con-
fronted, and will continue to confront, HIV/AIDS in our own
country’’, proposing now that the United States should lead
the world in sparing innocent people from a plague of nature,
and asking Congress ‘‘to commit $15,000,000,000 over the next
five years, including nearly $10,000,000,000 in new money,
to turn the tide against AIDS in the most afflicted nations
of Africa and the Caribbean’’.
SEC. 3. DEFINITIONS.
In this Act:
(1) AIDS.—The term ‘‘AIDS’’ means the acquired immune
deficiency syndrome.
(2) APPROPRIATE CONGRESSIONAL COMMITTEES.—The term
‘‘appropriate congressional committees’’ means the Committee
on Foreign Relations of the Senate and the Committee on
International Relations of the House of Representatives.
(3) GLOBAL
FUND.—The term ‘‘Global Fund’’ means the
public-private partnership known as the Global Fund to Fight
AIDS, Tuberculosis and Malaria established pursuant to Article
80 of the Swiss Civil Code.
(4) HIV.—The term ‘‘HIV’’ means the human immuno-
deficiency virus, the pathogen that causes AIDS.
(5) HIV/AIDS.—The term ‘‘HIV/AIDS’’ means, with respect
to an individual, an individual who is infected with HIV or
living with AIDS.
(6) RELEVANT
EXECUTIVE
BRANCH
AGENCIES.—The term
‘‘relevant executive branch agencies’’ means the Department
of State, the United States Agency for International Develop-
ment, and any other department or agency of the United States
that participates in international HIV/AIDS activities pursuant
to the authorities of such department or agency or the Foreign
Assistance Act of 1961.
SEC. 4. PURPOSE.
The purpose of this Act is to strengthen United States leader-
ship and the effectiveness of the United States response to certain
global infectious diseases by—
(1) establishing a comprehensive, integrated five-year,
global strategy to fight HIV/AIDS that encompasses a plan
for phased expansion of critical programs and improved
coordination among relevant executive branch agencies and
between the United States and foreign governments and inter-
national organizations;
(2) providing increased resources for multilateral efforts
to fight HIV/AIDS;
(3) providing increased resources for United States bilateral
efforts, particularly for technical assistance and training, to
combat HIV/AIDS, tuberculosis, and malaria;
(4) encouraging the expansion of private sector efforts and
expanding public-private sector partnerships to combat HIV/
AIDS; and
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(5) intensifying efforts to support the development of vac-
cines and treatment for HIV/AIDS, tuberculosis, and malaria.
SEC. 5. AUTHORITY TO CONSOLIDATE AND COMBINE REPORTS.
With respect to the reports required by this Act to be submitted
by the President, to ensure an efficient use of resources, the Presi-
dent may, in his discretion and notwithstanding any other provision
of this Act, consolidate or combine any of these reports, except
for the report required by section 101 of this Act, so long as
the required elements of each report are addressed and reported
within a 90-day period from the original deadline date for submis-
sion of the report specified in this Act. The President may also
enter into contracts with organizations with relevant expertise to
develop, originate, or contribute to any of the reports required
by this Act to be submitted by the President.
TITLE I—POLICY PLANNING AND
COORDINATION
SEC. 101. DEVELOPMENT OF A COMPREHENSIVE, FIVE-YEAR, GLOBAL
STRATEGY.
(a) STRATEGY.—The President shall establish a comprehensive,
integrated, five-year strategy to combat global HIV/AIDS that
strengthens the capacity of the United States to be an effective
leader of the international campaign against HIV/AIDS. Such
strategy shall maintain sufficient flexibility and remain responsive
to the ever-changing nature of the HIV/AIDS pandemic and shall—
(1) include specific objectives, multisectoral approaches, and
specific strategies to treat individuals infected with HIV/AIDS
and to prevent the further spread of HIV infections, with a
particular focus on the needs of families with children
(including the prevention of mother-to-child transmission),
women, young people, and children (such as unaccompanied
minor children and orphans);
(2) as part of the strategy, implement a tiered approach
to direct delivery of care and treatment through a system
based on central facilities augmented by expanding circles of
local delivery of care and treatment through local systems
and capacity;
(3) assign priorities for relevant executive branch agencies;
(4) provide that the reduction of HIV/AIDS behavioral risks
shall be a priority of all prevention efforts in terms of funding,
educational messages, and activities by promoting abstinence
from sexual activity and substance abuse, encouraging
monogamy and faithfulness, promoting the effective use of
condoms, and eradicating prostitution, the sex trade, rape,
sexual assault and sexual exploitation of women and children;
(5) improve coordination and reduce duplication among
relevant executive branch agencies, foreign governments, and
international organizations;
(6) project general levels of resources needed to achieve
the stated objectives;
(7) expand public-private partnerships and the leveraging
of resources;
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(8) maximize United States capabilities in the areas of
technical assistance and training and research, including vac-
cine research;
(9) establish priorities for the distribution of resources
based on factors such as the size and demographics of the
population with HIV/AIDS, tuberculosis, and malaria and the
needs of that population and the existing infrastructure or
funding levels that may exist to cure, treat, and prevent HIV/
AIDS, tuberculosis, and malaria; and
(10) include initiatives describing how the President will
maximize the leverage of private sector dollars in reduction
and treatment of HIV/AIDS, tuberculosis, and malaria.
(b) REPORT.—
(1) IN GENERAL.—Not later than 270 days after the date
of enactment of this Act, the President shall submit to the
appropriate congressional committees a report setting forth
the strategy described in subsection (a).
(2) REPORT CONTENTS.—The report required by paragraph
(1) shall include a discussion of the elements described in
paragraph (3) and may include a discussion of additional ele-
ments relevant to the strategy described in subsection (a).
Such discussion may include an explanation as to why a par-
ticular element described in paragraph (3) is not relevant to
such strategy.
(3) REPORT ELEMENTS.—The elements referred to in para-
graph (2) are the following:
(A) The objectives, general and specific, of the strategy.
(B) A description of the criteria for determining success
of the strategy.
(C) A description of the manner in which the strategy
will address the fundamental elements of prevention and
education, care, and treatment (including increasing access
to pharmaceuticals and to vaccines), the promotion of
abstinence, monogamy, avoidance of substance abuse, and
use of condoms, research (including incentives for vaccine
development and new protocols), training of health care
workers, the development of health care infrastructure and
delivery systems, and avoidance of substance abuse.
(D) A description of the manner in which the strategy
will promote the development and implementation of
national and community-based multisectoral strategies and
programs, including those designed to enhance leadership
capacity particularly at the community level.
(E) A description of the specific strategies developed
to meet the unique needs of women, including the empower-
ment of women in interpersonal situations, young people
and children, including those orphaned by HIV/AIDS and
those who are victims of the sex trade, rape, sexual abuse,
assault, and exploitation.
(F) A description of the specific strategies developed
to encourage men to be responsible in their sexual behavior,
child rearing and to respect women including the reduction
of sexual violence and coercion.
(G) A description of the specific strategies developed
to increase women’s access to employment opportunities,
income, productive resources, and microfinance programs.