SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘United States Leadership Against HIV/AIDS, Tuber-
culosis, and Malaria Act of 2003’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows:
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Definitions. 
Sec. 4. Purpose. 
Sec. 5. Authority to consolidate and combine reports. 
TITLE I—POLICY PLANNING AND COORDINATION 
Sec. 101. Development of a comprehensive, five-year, global strategy. 
Sec. 102. HIV/AIDS Response Coordinator. 
TITLE II—SUPPORT FOR MULTILATERAL FUNDS, PROGRAMS, AND 
PUBLIC-PRIVATE PARTNERSHIPS 
Sec. 201. Sense of Congress on public-private partnerships. 
Sec. 202. Participation in the Global Fund to Fight AIDS, Tuberculosis and Ma-
laria. 
Sec. 203. Voluntary contributions to international vaccine funds. 
TITLE III—BILATERAL EFFORTS 
Subtitle A—General Assistance and Programs 
Sec. 301. Assistance to combat HIV/AIDS. 
Sec. 302. Assistance to combat tuberculosis. 
Sec. 303. Assistance to combat malaria. 
Sec. 304. Pilot program for the placement of health care professionals in overseas 
areas severely affected by HIV/AIDS, tuberculosis, and malaria. 
Sec. 305. Report on treatment activities by relevant executive branch agencies. 
Subtitle B—Assistance for Children and Families 
Sec. 311. Findings. 
Sec. 312. Policy and requirements. 
Sec. 313. Annual reports on prevention of mother-to-child transmission of the 
HIV infection. 
Sec. 314. Pilot program of assistance for children and families affected by HIV/
AIDS. 
Sec. 315. Pilot program on family survival partnerships. 
TITLE IV—AUTHORIZATION OF APPROPRIATIONS 
Sec. 401. Authorization of appropriations. 
Sec. 402. Sense of Congress. 
Sec. 403. Allocation of funds.
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) During the last 20 years, HIV/AIDS has as-
sumed pandemic proportions, spreading from the 
most severely affected regions, sub-Saharan Africa 
and the Caribbean, to all corners of the world, and 
leaving an unprecedented path of death and devasta-
tion. 
(2) According to the Joint United Nations Pro-
gramme on HIV/AIDS (UNAIDS), more than 
65,000,000 individuals worldwide have been infected 
with HIV since the epidemic began, more than 
25,000,000 of these individuals have lost their lives to 
the disease, and more than 14,000,000 children have 
been orphaned by the disease. HIV/AIDS is the 
fourth-highest cause of death in the world. 
(3)(A) At the end of 2002, an estimated 
42,000,000 individuals were infected with HIV or liv-
ing with AIDS, of which more than 75 percent live 
in Africa or the Caribbean. Of these individuals, more 
than 3,200,000 were children under the age of fifteen 
and more than 19,200,000 were women. 
(B) Women are four times more vulnerable to in-
fection than are men and are becoming infected at in-
creasingly high rates, in part because many societies 
do not provide poor women and young girls with the
social, legal, and cultural protections against high 
risk activities that expose them to HIV/AIDS. 
(C) Women and children who are refugees or are 
internally displaced persons are especially vulnerable 
to sexual exploitation and violence, thereby increasing 
the possibility of HIV infection. 
(4) As the leading cause of death in sub-Saharan 
Africa, AIDS has killed more than 19,400,000 indi-
viduals (more than 3 times the number of AIDS 
deaths in the rest of the world) and will claim the 
lives of one-quarter of the population, mostly adults, 
in the next decade. 
(5) An estimated 2,000,000 individuals in Latin 
America and the Caribbean and another 7,100,000 
individuals in Asia and the Pacific region are in-
fected with HIV or living with AIDS. Infection rates 
are rising alarmingly in Eastern Europe (especially 
in the Russian Federation), Central Asia, and China. 
(6) HIV/AIDS threatens personal security by af-
fecting the health, lifespan, and productive capacity 
of the individual and the social cohesion and eco-
nomic well-being of the family. 
(7) HIV/AIDS undermines the economic security 
of a country and individual businesses in that coun-
try by weakening the productivity and longevity of
the labor force across a broad array of economic sec-
tors and by reducing the potential for economic 
growth over the long term. 
(8) HIV/AIDS destabilizes communities by strik-
ing at the most mobile and educated members of soci-
ety, many of whom are responsible for security at the 
local level and governance at the national and sub-
national levels as well as many teachers, health care 
personnel, and other community workers vital to com-
munity development and the effort to combat HIV/
AIDS. In some countries the overwhelming challenges 
of the HIV/AIDS epidemic are accelerating the out-
ward migration of critically important health care 
professionals. 
(9) HIV/AIDS weakens the defenses of countries 
severely affected by the HIV/AIDS crisis through high 
infection rates among members of their military 
forces and voluntary peacekeeping personnel. Accord-
ing to UNAIDS, in sub-Saharan Africa, many mili-
tary forces have infection rates as much as five times 
that of the civilian population. 
(10) HIV/AIDS poses a serious security issue for 
the international community by—
(A) increasing the potential for political in-
stability and economic devastation, particularly
in those countries and regions most severely af-
fected by the disease; 
(B) decreasing the capacity to resolve con-
flicts through the introduction of peacekeeping 
forces because the environments into which these 
forces are introduced pose a high risk for the 
spread of HIV/AIDS; and 
(C) increasing the vulnerability of local 
populations to HIV/AIDS in conflict zones from 
peacekeeping troops with HIV infection rates sig-
nificantly higher than civilian populations. 
(11) The devastation wrought by the HIV/AIDS 
pandemic is compounded by the prevalence of tuber-
culosis and malaria, particularly in developing coun-
tries where the poorest and most vulnerable members 
of society, including women, children, and those indi-
viduals living with HIV/AIDS, become infected. Ac-
cording to the World Health Organization (WHO), 
HIV/AIDS, tuberculosis, and malaria accounted for 
more than 5,700,000 deaths in 2001 and caused de-
bilitating illnesses in millions more. 
(12) Together, HIV/AIDS, tuberculosis, malaria 
and related diseases are undermining agricultural 
production throughout Africa. According to the 
United Nations Food and Agricultural Organization,
7,000,000 agricultural workers throughout 25 African 
countries have died from AIDS since 1985. Countries 
with poorly developed agricultural systems, which al-
ready face chronic food shortages, are the hardest hit, 
particularly in sub-Saharan Africa, where high HIV 
prevalence rates are compounding the risk of starva-
tion for an estimated 14,400,000 people. 
(13) Tuberculosis is the cause of death for one 
out of every three people with AIDS worldwide and 
is a highly communicable disease. HIV infection is 
the leading threat to tuberculosis control. Because 
HIV infection so severely weakens the immune system, 
individuals with HIV and latent tuberculosis infec-
tion have a 100 times greater risk of developing active 
tuberculosis diseases thereby increasing the risk of 
spreading tuberculosis to others. Tuberculosis, in turn, 
accelerates the onset of AIDS in individuals infected 
with HIV. 
(14) Malaria, the most deadly of all tropical 
parasitic diseases, has been undergoing a dramatic 
resurgence in recent years due to increasing resistance 
of the malaria parasite to inexpensive and effective 
drugs. At the same time, increasing resistance of mos-
quitoes to standard insecticides makes control of 
transmission difficult to achieve. The World Health
Organization estimates that between 300,000,000 and 
500,000,000 new cases of malaria occur each year, 
and annual deaths from the disease number between 
2,000,000 and 3,000,000. Persons infected with HIV 
are particularly vulnerable to the malaria parasite. 
The spread of HIV infection contributes to the dif-
ficulties of controlling resurgence of the drug resistant 
malaria parasite. 
(15) HIV/AIDS is first and foremost a health 
problem. Successful strategies to stem the spread of 
the HIV/AIDS pandemic will require clinical medical 
interventions, the strengthening of health care delivery 
systems and infrastructure, and determined national 
leadership and increased budgetary allocations for the 
health sector in countries affected by the epidemic as 
well as measures to address the social and behavioral 
causes of the problem and its impact on families, 
communities, and societal sectors. 
(16) Basic interventions to prevent new HIV in-
fections and to bring care and treatment to people liv-
ing with AIDS, such as voluntary counseling and 
testing and mother-to-child transmission programs, 
are achieving meaningful results and are cost-effec-
tive. The challenge is to expand these interventions
from a pilot program basis to a national basis in a 
coherent and sustainable manner. 
(17) Appropriate treatment of individuals with 
HIV/AIDS can prolong the lives of such individuals, 
preserve their families, prevent children from becom-
ing orphans, and increase productivity of such indi-
viduals by allowing them to lead active lives and re-
duce the need for costly hospitalization for treatment 
of opportunistic infections caused by HIV. 
(18) Nongovernmental organizations, including 
faith-based organizations, with experience in health 
care and HIV/AIDS counseling, have proven effective 
in combating the HIV/AIDS pandemic and can be a 
resource in assisting indigenous organizations in se-
verely affected countries in their efforts to provide 
treatment and care for individuals infected with HIV/
AIDS. 
(19) Faith-based organizations are making an 
important contribution to HIV prevention and AIDS 
treatment programs around the world. Successful HIV 
prevention programs in Uganda, Jamaica, and else-
where have included local churches and faith-based 
groups in efforts to promote behavior changes to pre-
vent HIV, to reduce stigma associated with HIV in-
fection, to treat those afflicted with the disease, and
to care for orphans. The Catholic Church alone cur-
rently cares for one in four people being treated for 
AIDS worldwide. Faith-based organizations possess 
infrastructure, experience, and knowledge that will be 
needed to carry out these programs in the future and 
should be an integral part of United States efforts. 
(20)(A) Uganda has experienced the most signifi-
cant decline in HIV rates of any country in Africa, 
including a decrease among pregnant women from 
20.6 percent in 1991 to 7.9 percent in 2000. 
(B) Uganda made this remarkable turnaround 
because President Yoweri Museveni spoke out early, 
breaking long-standing cultural taboos, and changed 
widespread perceptions about the disease. His leader-
ship stands as a model for ways political leaders in 
Africa and other developing countries can mobilize 
their nations, including civic organizations, profes-
sional associations, religious institutions, business 
and labor to combat HIV/AIDS. 
(C) Uganda’s successful AIDS treatment and 
prevention program is referred to as the ABC model: 
‘‘Abstain, Be faithful, use Condoms’’, in order of pri-
ority. Jamaica, Zambia, Ethiopia and Senegal have 
also successfully used the ABC model. Beginning in 
1986, Uganda brought about a fundamental change
in sexual behavior by developing a low-cost program 
with the message: ‘‘Stop having multiple partners. Be 
faithful. Teenagers, wait until you are married before 
you begin sex.’’. 
(D) By 1995, 95 percent of Ugandans were re-
porting either one or zero sexual partners in the past 
year, and the proportion of sexually active youth de-
clined significantly from the late 1980s to the mid-
1990s. The greatest percentage decline in HIV infec-
tions and the greatest degree of behavioral change oc-
curred in those 15 to 19 years old. Uganda’s success 
shows that behavior change, through the use of the 
ABC model, is a very successful way to prevent the 
spread of HIV. 
(21) The magnitude and scope of the HIV/AIDS 
crisis demands a comprehensive, long-term, inter-
national response focused upon addressing the causes, 
reducing the spread, and ameliorating the con-
sequences of the HIV/AIDS pandemic, including—
(A) prevention and education, care and 
treatment, basic and applied research, and 
training of health care workers, particularly at 
the community and provincial levels, and other 
community workers and leaders needed to cope
with the range of consequences of the HIV/AIDS 
crisis; 
(B) development of health care infrastruc-
ture and delivery systems through cooperative 
and coordinated public efforts and public and 
private partnerships; 
(C) development and implementation of na-
tional and community-based multisector strate-
gies that address the impact of HIV/AIDS on the 
individual, family, community, and nation and 
increase the participation of at-risk populations 
in programs designed to encourage behavioral 
and social change and reduce the stigma associ-
ated with HIV/AIDS; and 
(D) coordination of efforts between inter-
national organizations such as the Global Fund 
to Fight AIDS, Tuberculosis and Malaria, the 
Joint United Nations Programme on HIV/AIDS 
(UNAIDS), the World Health Organization 
(WHO), national governments, and private sec-
tor organizations, including faith-based organi-
zations. 
(22) The United States has the capacity to lead 
and enhance the effectiveness of the international com-
munity’s response by—
(A) providing substantial financial re-
sources, technical expertise, and training, par-
ticularly of health care personnel and commu-
nity workers and leaders; 
(B) promoting vaccine and microbicide re-
search and the development of new treatment 
protocols in the public and commercial pharma-
ceutical research sectors; 
(C) making available pharmaceuticals and 
diagnostics for HIV/AIDS therapy; 
(D) encouraging governments and faith-
based and community-based organizations to 
adopt policies that treat HIV/AIDS as a multi-
sectoral public health problem affecting not only 
health but other areas such as agriculture, edu-
cation, the economy, the family and society, and 
assisting them to develop and implement pro-
grams 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, pharma-
ceutical and biotechnology companies, the med-
ical and scientific communities, charitable foun-
dations, 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 individ-
uals into such industry, and sexual violence are addi-
tional 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 vic-
timization 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 effec-
tive and efficient use of financial and technical re-
sources within the United States Government with re-
spect to the provision of international HIV/AIDS as-
sistance.
(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, treat-
ing 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 or-
phaned by HIV/AIDS. 
(26) In this address to Congress, the President 
stated the following: ‘‘Today, on the continent of Afri-
ca, 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 infection. 
More than 4,000,000 require immediate drug treat-
ment. 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 treatment of HIV/AIDS in his address to Con-
gress, stating the following: ‘‘Because the AIDS diag-
nosis is considered a death sentence, many do not seek 
treatment. Almost all who do are turned away. A doc-
tor in rural South Africa describes his frustration. He
says, ‘We have no medicines. Many hospitals tell peo-
ple, you’ve got AIDS, we can’t help you. Go home 
and die.’ In an age of miraculous medicines, no per-
son should have to hear those words. AIDS can be 
prevented. Anti-retroviral drugs can extend life for 
many years . . . Ladies and gentlemen, seldom has 
history offered a greater opportunity to do so much 
for so many.’’. 
(28) Finally, the President stated that ‘‘[w]e 
have confronted, and will continue to confront, HIV/
AIDS in our own country’’, proposing now that the 
United States should lead the world in sparing inno-
cent people from a plague of nature, and asking Con-
gress ‘‘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 af-
flicted nations of Africa and the Caribbean’’. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) AIDS.—The term ‘‘AIDS’’ means the ac-
quired immune deficiency syndrome. 
(2) 
APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.—The term ‘‘appropriate congressional commit-
tees’’ means the Committee on Foreign Relations of
the Senate and the Committee on International Rela-
tions 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 Ma-
laria established pursuant to Article 80 of the Swiss 
Civil Code. 
(4) HIV.—The term ‘‘HIV’’ means the human 
immunodeficiency 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 Development, and any other depart-
ment or agency of the United States that participates 
in international HIV/AIDS activities pursuant to the 
authorities of such department or agency or the For-
eign Assistance Act of 1961. 
SEC. 4. PURPOSE. 
The purpose of this Act is to strengthen United States 
leadership and the effectiveness of the United States re-
sponse to certain global infectious diseases by—
(1) establishing a comprehensive, integrated five-
year, global strategy to fight HIV/AIDS that encom-
passes a plan for phased expansion of critical pro-
grams and improved coordination among relevant ex-
ecutive branch agencies and between the United States 
and foreign governments and international organiza-
tions; 
(2) providing increased resources for multilateral 
efforts to fight HIV/AIDS; 
(3) providing increased resources for United 
States bilateral efforts, particularly for technical as-
sistance and training, to combat HIV/AIDS, tuber-
culosis, and malaria; 
(4) encouraging the expansion of private sector 
efforts and expanding public-private sector partner-
ships to combat HIV/AIDS; and 
(5) intensifying efforts to support the develop-
ment of vaccines and treatment for HIV/AIDS, tuber-
culosis, and malaria. 
SEC. 5. AUTHORITY TO CONSOLIDATE AND COMBINE RE-
PORTS. 
With respect to the reports required by this Act to be 
submitted by the President, to ensure an efficient use of re-
sources, the President may, in his discretion and notwith-
standing 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 submission 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 re-
quired 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 com-
prehensive, 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 cam-
paign 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 ap-
proaches, 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 pre-
vention 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 aug-
mented 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 be-
havioral risks shall be a priority of all prevention ef-
forts in terms of funding, educational messages, and 
activities by promoting abstinence from sexual activ-
ity and substance abuse, encouraging monogamy and 
faithfulness, promoting the effective use of condoms, 
and eradicating prostitution, the sex trade, rape, sex-
ual assault and sexual exploitation of women and 
children; 
(5) improve coordination among relevant execu-
tive branch agencies, foreign governments, and inter-
national organizations; 
(6) project general levels of resources needed to 
achieve the stated objectives; 
(7) expand public-private partnerships and the 
leveraging of resources; and
(8) maximize United States capabilities in the 
areas of technical assistance and training and re-
search, including vaccine research. 
(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 sub-
section (a). 
(2) REPORT CONTENTS.—The report required by 
paragraph (1) shall include a discussion of the ele-
ments described in paragraph (3) and may include a 
discussion of additional elements relevant to the strat-
egy described in subsection (a). Such discussion may 
include an explanation as to why a particular ele-
ment described in paragraph (3) is not relevant to 
such strategy. 
(3) REPORT ELEMENTS.—The elements referred 
to in paragraph (2) are the following: 
(A) The objectives, general and specific, of 
the strategy. 
(B) A description of the criteria for deter-
mining success of the strategy. 
(C) A description of the manner in which 
the strategy will address the fundamental ele-
ments of prevention and education, care, and 
treatment (including increasing access to phar-
maceuticals and to vaccines), the promotion of 
abstinence, monogamy, avoidance of substance 
abuse, and use of condoms, research (including 
incentives for vaccine development and new pro-
tocols), training of health care workers, the devel-
opment 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, in-
cluding those designed to enhance leadership ca-
pacity particularly at the community level. 
(E) A description of the specific strategies 
developed to meet the unique needs of women, in-
cluding the empowerment of women in inter-
personal situations, young people and children, 
including those orphaned by HIV/AIDS and 
those who are victims of the sex trade, rape, sex-
ual abuse, assault, and exploitation. 
(F) A description of the programs to be un-
dertaken to maximize United States contribu-
tions in the areas of technical assistance, train-
ing (particularly of health care workers and 
community-based leaders in affected sectors), and 
research, including the promotion of research on 
vaccines and microbicides. 
(G) An identification of the relevant execu-
tive branch agencies that will be involved and 
the assignment of priorities to those agencies. 
(H) A description of the role of each rel-
evant executive branch agency and the types of 
programs that the agency will be undertaking. 
(I) A description of the mechanisms that 
will be utilized to coordinate the efforts of the 
relevant executive branch agencies, to avoid du-
plication of efforts, to enhance on-site coordina-
tion efforts, and to ensure that each agency un-
dertakes programs primarily in those areas 
where the agency has the greatest expertise, tech-
nical capabilities, and potential for success. 
(J) A description of the mechanisms that 
will be utilized to ensure greater coordination be-
tween the United States and foreign governments 
and international organizations including the 
Global Fund, UNAIDS, international financial 
institutions, and private sector organizations.
(K) The level of resources that will be need-
ed on an annual basis and the manner in which 
those resources would generally be allocated 
among the relevant executive branch agencies. 
(L) A description of the mechanisms to be 
established for monitoring and evaluating pro-
grams, promoting successful models, and for ter-
minating unsuccessful programs. 
(M) A description of the manner in which 
private, nongovernmental entities will factor into 
the United States Government-led effort and a 
description of the type of partnerships that will 
be created to maximize the capabilities of these 
private sector entities and to leverage resources. 
(N) A description of the ways in which 
United States leadership will be used to enhance 
the overall international response to the HIV/
AIDS pandemic and particularly to heighten the 
engagement of the member states of the G–8 and 
to strengthen key financial and coordination 
mechanisms such as the Global Fund and 
UNAIDS. 
(O) A description of the manner in which 
the United States strategy for combating HIV/
AIDS relates to and supports other United
States assistance strategies in developing coun-
tries. 
(P) A description of the programs to be car-
ried out under the strategy that are specifically 
targeted at women and girls to educate them 
about the spread of HIV/AIDS. 
(Q) A description of efforts being made to 
address the unique needs of families with chil-
dren with respect to HIV/AIDS, including efforts 
to preserve the family unit. 
(R) An analysis of the emigration of criti-
cally important medical and public health per-
sonnel, including physicians, nurses, and super-
visors from sub-Saharan African countries that 
are acutely impacted by HIV/AIDS, including a 
description of the causes, effects, and the impact 
on the stability of health infrastructures, as well 
as a summary of incentives and programs that 
the United States could provide, in concert with 
other private and public sector partners and 
international organizations, to stabilize health 
institutions by encouraging critical personnel to 
remain in their home countries. 
(S) A description of the specific strategies 
developed to promote sustainability of HIV/
AIDS 
pharmaceuticals 
(including 
antiretrovirals) and the effects of drug resistance 
on HIV/AIDS patients. 
(T) A description of the specific strategies to 
ensure that the extraordinary benefit of HIV/
AIDS 
pharmaceuticals 
(especially 
antiretrovirals) are not diminished through the 
illegal counterfeiting of pharmaceuticals and 
black market sales of such pharmaceuticals. 
(U) An analysis of the prevalence of 
Human Papilloma Virus (HPV) in sub-Saharan 
Africa and the impact that condom usage has 
upon the spread of HPV in sub-Saharan Africa. 
SEC. 102. HIV/AIDS RESPONSE COORDINATOR. 
(a) ESTABLISHMENT OF POSITION.—Section 1 of the 
State Department Basic Authorities Act of 1956 (22 U.S.C. 
265(a)) is amended—
(1) by redesignating subsection (f) as subsection 
(g); and 
(2) by inserting after subsection (e) the following: 
‘‘(f) HIV/AIDS RESPONSE COORDINATOR.—
‘‘(1) IN
GENERAL.—There shall be established 
within the Department of State in the immediate of-
fice of the Secretary of State a Coordinator of United 
States Government Activities to Combat HIV/AIDS
Globally, who shall be appointed by the President, by 
and with the advice and consent of the Senate. The 
Coordinator shall report directly to the Secretary. 
‘‘(2) AUTHORITIES AND DUTIES; DEFINITIONS.—
‘‘(A) AUTHORITIES.—The Coordinator, act-
ing through such nongovernmental organizations 
(including faith-based and community-based or-
ganizations) and relevant executive branch agen-
cies as may be necessary and appropriate to ef-
fect the purposes of this section, is authorized—
‘‘(i) to operate internationally to carry 
out prevention, care, treatment, support, ca-
pacity development, and other activities for 
combatting HIV/AIDS; 
‘‘(ii) to transfer and allocate funds to 
relevant executive branch agencies; and 
‘‘(iii) to provide grants to, and enter 
into contracts with, nongovernmental orga-
nizations (including faith-based and com-
munity-based organizations) to carry out 
the purposes of section. 
‘‘(B) DUTIES.—
‘‘(i) IN
GENERAL.—The Coordinator 
shall have primary responsibility for the 
oversight and coordination of all resources
and international activities of the United 
States Government to combat the HIV/
AIDS pandemic, including all programs, 
projects, and activities of the United States 
Government relating to the HIV/AIDS pan-
demic under the United States Leadership 
Against HIV/AIDS, Tuberculosis, and Ma-
laria Act of 2003 or any amendment made 
by that Act. 
‘‘(ii) SPECIFIC DUTIES.—The duties of 
the Coordinator shall specifically include 
the following: 
‘‘(I) Ensuring program and pol-
icy coordination among the relevant 
executive branch agencies and non-
governmental organizations, including 
auditing, monitoring, and evaluation 
of all such programs. 
‘‘(II) Ensuring that each relevant 
executive branch agency undertakes 
programs primarily in those areas 
where the agency has the greatest ex-
pertise, technical capabilities, and po-
tential for success.
‘‘(III) Avoiding duplication of ef-
fort. 
‘‘(IV) Ensuring coordination of 
relevant executive branch agency ac-
tivities in the field. 
‘‘(V) Pursuing coordination with 
other countries and international orga-
nizations. 
‘‘(VI) Resolving policy, program, 
and funding disputes among the rel-
evant executive branch agencies. 
‘‘(VII) Directly approving all ac-
tivities of the United States (including 
funding) relating to combatting HIV/
AIDS in each of Botswana, Cote 
d’Ivoire, Ethiopia, Guyana, Haiti, 
Kenya, Mozambique, Namibia, Nige-
ria, Rwanda, South Africa, Tanzania, 
Uganda, Zambia, and other countries 
designated by the President, which 
other designated countries may include 
those countries in which the United 
States is implementing HIV/AIDS 
programs as of the date of the enact-
ment of the United States Leadership
Against HIV/AIDS, Tuberculosis, and 
Malaria Act of 2003. 
‘‘(VIII) Establishing due diligence 
criteria for all recipients of funds sec-
tion and all activities subject to the co-
ordination and appropriate moni-
toring, evaluation, and audits carried 
out by the Coordinator necessary to as-
sess the measurable outcomes of such 
activities. 
‘‘(C) DEFINITIONS.—In this paragraph: 
‘‘(i) AIDS.—The term ‘AIDS’ means 
acquired immune deficiency syndrome. 
‘‘(ii) HIV.—The term ‘HIV’ means the 
human immunodeficiency virus, the patho-
gen that causes AIDS. 
‘‘(iii) HIV/AIDS.—The term ‘HIV/
AIDS’ means, with respect to an indi-
vidual, an individual who is infected with 
HIV or living with AIDS. 
‘‘(iv) RELEVANT
EXECUTIVE
BRANCH 
AGENCIES.—The term ‘relevant executive 
branch agencies’ means the Department of 
State, the United States Agency for Inter-
national Development, the Department of
Health and Human Services (including the 
Public Health Service), and any other de-
partment or agency of the United States 
that participates in international HIV/
AIDS activities pursuant to the authorities 
of such department or agency or this Act.’’. 
(b) RESOURCES.—Not later than 90 days after the 
date of enactment of this Act, the President shall specify 
the necessary financial and personnel resources, from funds 
appropriated pursuant to the authorization of appropria-
tions under section 401 for HIV/AIDS assistance, that shall 
be assigned to and under the direct control of the Coordi-
nator of United States Government Activities to Combat 
HIV/AIDS Globally to establish and maintain the duties 
and supporting activities assigned to the Coordinator by 
this Act and the amendments made by this Act. 
(c) ESTABLISHMENT OF SEPARATE ACCOUNT.—There 
is established in the general fund of the Treasury a separate 
account which shall be known as the ‘‘Activities to Combat 
HIV/AIDS Globally Fund’’ and which shall be adminis-
tered by the Coordinator of United States Government Ac-
tivities to Combat HIV/AIDS Globally. There shall be de-
posited into the Fund all amounts appropriated pursuant 
to the authorization of appropriations under section 401
for HIV/AIDS assistance, except for amounts appropriated 
for United States contributions to the Global Fund. 
TITLE II—SUPPORT FOR MULTI-
LATERAL FUNDS, PROGRAMS, 
AND PUBLIC-PRIVATE PART-
NERSHIPS 
SEC. 201. SENSE OF CONGRESS ON PUBLIC-PRIVATE PART-
NERSHIPS. 
(a) FINDINGS.—Congress makes the following findings: 
(1) Innovative partnerships between governments 
and organizations in the private sector (including 
foundations, universities, corporations, faith-based 
and community-based organizations, and other non-
governmental organizations) have proliferated in re-
cent years, particularly in the area of health. 
(2) Public-private sector partnerships multiply 
local and international capacities to strengthen the 
delivery of health services in developing countries and 
to accelerate research for vaccines and other pharma-
ceutical products that are essential to combat infec-
tious diseases decimating the populations of these 
countries. 
(3) These partnerships maximize the unique ca-
pabilities of each sector while combining financial 
and other resources, scientific knowledge, and exper-
tise toward common goals which neither the public 
nor the private sector can achieve alone. 
(4) Sustaining existing public-private partner-
ships and building new ones are critical to the success 
of the international community’s efforts to combat 
HIV/AIDS and other infectious diseases around the 
globe. 
(b) SENSE OF CONGRESS.—It is the sense of Congress 
that—
(1) the sustainment and promotion of public-pri-
vate partnerships should be a priority element of the 
strategy pursued by the United States to combat the 
HIV/AIDS pandemic and other global health crises; 
and 
(2) the United States should systematically track 
the evolution of these partnerships and work with oth-
ers in the public and private sector to profile and 
build upon those models that are most effective. 
SEC. 202. PARTICIPATION IN THE GLOBAL FUND TO FIGHT 
AIDS, TUBERCULOSIS AND MALARIA. 
(a) AUTHORITY
FOR UNITED STATES PARTICIPA-
TION.—
(1) 
UNITED
STATES
PARTICIPATION.—The 
United States is hereby authorized to participate in 
the Global Fund.
(2) PRIVILEGES AND IMMUNITIES.—The Global 
Fund shall be considered a public international orga-
nization for purposes of section 1 of the International 
Organizations Immunities Act (22 U.S.C. 288). 
(b) REPORTS TO CONGRESS.—Not later than 1 year 
after the date of the enactment of this Act, and annually 
thereafter for the duration of the Global Fund, the President 
shall submit to the appropriate congressional committees a 
report on the Global Fund, including contributions pledged 
to, contributions (including donations from the private sec-
tor) received by, and projects funded by the Global Fund, 
and the mechanisms established for transparency and ac-
countability in the grant-making process. 
(c) UNITED STATES FINANCIAL PARTICIPATION.—
(1) AUTHORIZATION
OF
APPROPRIATIONS.—In 
addition to any other funds authorized to be appro-
priated for bilateral or multilateral HIV/AIDS, tuber-
culosis, or malaria programs, of the amounts author-
ized to be appropriated under section 401, there are 
authorized to be appropriated to the President up to 
$1,000,000,000 in the fiscal year 2004, and such sums 
as may be necessary for the fiscal years 2005–2008, 
for contributions to the Global Fund.
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated under paragraph (1) are authorized to re-
main available until expended. 
(3) REPROGRAMMING
OF
FISCAL
YEAR
2001 
FUNDS.—Funds made available for fiscal year 2001 
under section 141 of the Global AIDS and Tuber-
culosis Relief Act of 2000—
(A) are authorized to remain available until 
expended; and 
(B) shall be transferred to, merged with, 
and made available for the same purposes as, 
funds made available for fiscal years 2004 
through 2008 under paragraph (1). 
(4) LIMITATION.—
(A)(i) At any time during fiscal years 2004 
through 2008, no United States contribution to 
the Global Fund may cause the total amount of 
United States Government contributions to the 
Global Fund to exceed 33 percent of the total 
amount of funds contributed to the Global Fund 
from all other sources. Contributions to the Glob-
al Fund from the International Bank for Recon-
struction and Development and the International 
Monetary Fund shall not be considered in deter-
mining compliance with this paragraph.
(ii) If, at any time during any of the fiscal 
years 2004 through 2008, the President deter-
mines that the Global Fund has provided assist-
ance to a country, the government of which the 
Secretary of State has determined, for purposes 
of section 6(j)(1) of the Export Administration 
Act of 1979 (50 U.S.C. App. 2405(j)(1)), has re-
peatedly provided support for acts of inter-
national terrorism, then the United States shall 
withhold from its contribution for the next fiscal 
year an amount equal to the amount expended 
by the Fund to the government of each such 
country. 
(B) Any amount made available under this 
subsection that is withheld by reason of subpara-
graph (A) shall be contributed to the Global 
Fund as soon as practicable, subject to subpara-
graph (A), after additional contributions to the 
Global Fund are made from other sources. 
(C)(i) The President may suspend the ap-
plication of subparagraph (A) with respect to a 
fiscal year if the President determines that an 
international health emergency threatens the na-
tional security interests of the United States.
(ii) The President shall notify the Com-
mittee on International Relations of the House of 
Representatives and the Committee on Foreign 
Relations of the Senate not less than 5 days be-
fore making a determination under clause (i) 
with respect to the application of subparagraph 
(A)(i) and shall include in the notification—
(I) a justification as to why increased 
United States Government contributions to 
the Global Fund is preferable to increased 
United States assistance to combat HIV/
AIDS, tuberculosis, and malaria on a bilat-
eral basis; and 
(II) an explanation as to why other 
government donors to the Global Fund are 
unable to provide adequate contributions to 
the Fund. 
(d) INTERAGENCY TECHNICAL REVIEW PANEL.—
(1) 
ESTABLISHMENT.—The 
Coordinator 
of 
United States Government Activities to Combat HIV/
AIDS Globally, established in section 1(f)(1) of the 
State Department Basic Authorities Act of 1956 (as 
added by section 102(a) of this Act), shall establish in 
the executive branch an interagency technical review 
panel.
cluding programs that utilize faith-based and 
community-based organizations; and 
‘‘(C) assistance for the purpose of the care 
and treatment of individuals with HIV/AIDS 
through the provision of pharmaceuticals, includ-
ing antiretrovirals and other pharmaceuticals 
and therapies for the treatment of opportunistic 
infections, nutritional support, and other treat-
ment modalities. 
‘‘(3) PREVENTATIVE INTERVENTION EDUCATION 
AND TECHNOLOGIES.—(A) With particular emphasis 
on specific populations that represent a particularly 
high risk of contracting or spreading HIV/AIDS, in-
cluding those exploited through the sex trade, victims 
of rape and sexual assault, individuals already in-
fected with HIV/AIDS, and in cases of occupational 
exposure of health care workers, assistance with efforts 
to reduce the risk of HIV/AIDS infection including 
post-exposure pharmaceutical prophylaxis, and nec-
essary pharmaceuticals and commodities, including 
test kits, condoms, and, when proven effective, 
microbicides. 
‘‘(B) Bulk purchases of available test kits, 
condoms, and, when proven effective, microbicides 
that are intended to reduce the risk of HIV/AIDS
transmission and for appropriate program support 
for the introduction and distribution of these com-
modities, as well as education and training on the 
use of the technologies. 
‘‘(4) MONITORING.—The monitoring of pro-
grams, projects, and activities carried out pursuant to 
paragraphs (1) through (3), including—
‘‘(A) monitoring to ensure that adequate 
controls are established and implemented to pro-
vide HIV/AIDS pharmaceuticals and other ap-
propriate medicines to poor individuals with 
HIV/AIDS; 
‘‘(B) appropriate evaluation and surveil-
lance activities; 
‘‘(C) monitoring to ensure that appropriate 
measures are being taken to maintain the sus-
tainability of HIV/AIDS pharmaceuticals (espe-
cially antiretrovirals) and ensure that drug re-
sistance is not compromising the benefits of such 
pharmaceuticals; and 
‘‘(D) monitoring to ensure appropriate law 
enforcement officials are working to ensure that 
HIV/AIDS pharmaceuticals are not diminished 
through illegal counterfeiting or black market 
sales of such pharmaceuticals.
(1) IN GENERAL.—In addition to funds available 
under section 104(c) of the Foreign Assistance Act of 
1961 (22 U.S.C. 2151b(c)) for such purpose or under 
any other provision of that Act, there are authorized 
to be appropriated to the President, from amounts 
authorized to be appropriated under section 401, such 
sums as may be necessary for each of the fiscal years 
2004 through 2008 to carry out section 104A of the 
Foreign Assistance Act of 1961, as added by sub-
section (a). 
(2) AVAILABILITY OF FUNDS.—Amounts appro-
priated pursuant to paragraph (1) are authorized to 
remain available until expended. 
(3) ALLOCATION OF FUNDS.—Of the amount au-
thorized to be appropriated by paragraph (1) for the 
fiscal years 2004 through 2008, such sums as may be 
necessary are authorized to be appropriated to carry 
out section 104A(d)(4) of the Foreign Assistance Act 
of 1961 (as added by subsection (a)), relating to the 
procurement and distribution of HIV/AIDS pharma-
ceuticals. 
(c) RELATIONSHIP TO ASSISTANCE PROGRAMS TO EN-
HANCE NUTRITION.—In recognition of the fact that mal-
nutrition may hasten the progression of HIV to AIDS and 
may exacerbate the decline among AIDS patients leading