IIB 
108TH CONGRESS 
2D SESSION 
H. R. 4061
IN THE SENATE OF THE UNITED STATES 
JUNE 15, 2004
Received; read twice and referred to the Committee on Foreign Relations 
AN ACT 
To amend the Foreign Assistance Act of 1961 to provide 
assistance for orphans and other vulnerable children in 
developing countries.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Assistance for Orphans 
and Other Vulnerable Children in Developing Countries 
Act of 2004’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1)(A) According to estimates by the United 
Nations Children’s Fund (UNICEF), there are more 
than 132,000,000 children in the world under the 
age of three. 
(B) Of these children, 4,000,000 will die in 
their first month of life and another 7,000,000 will 
die each year before reaching the age of five. Thus 
an average of 30,000 children under the age of three 
die each day. 
(2) According to a report developed by the 
United Nations Joint Programme on HIV/AIDS 
(UNAIDS), UNICEF, and the United States Agen-
cy for International Development, in 2001 there 
were more than 110,000,000 orphans living in sub-
Saharan Africa, Asia, Latin America, and the Carib-
bean. 
(3) Assessments carried out by the Inter-
national Labor Organization (ILO) to investigate 
the situation of children who are working found that 
orphans are much more likely than non-orphans to
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be working in commercial agriculture, the domestic 
service industry, prostitution, as street vendors, or 
in industries that violate internationally recognized 
rights of children. 
(4) Infants who are poor and malnourished are 
more likely to contract respiratory infections, diar-
rhea, measles, and other preventable diseases, and 
are less likely to receive needed health care. 
(5) According to UNAIDS and UNICEF, by 
the end of 2001 there were an estimated 14,000,000 
children under the age of 15 who had lost one or 
both parents to AIDS. 
(6) As the number of HIV cases increases in 
sub-Saharan Africa and the Caribbean, as well as in 
Eastern Europe and Asia, the death rate from AIDS 
among adults in those regions is expected to in-
crease. By 2010 the total number of children in 
those regions who will lose one or both parents to 
AIDS is expected to be approximately 30,000,000. 
(7) One-third of children born from an HIV-in-
fected mother develop HIV/AIDS. Few of these chil-
dren have access to HIV/AIDS medications. 
(8) Globally, more than 11,800,000 young peo-
ple ages 15 to 24 were living with HIV/AIDS in 
2001, and each day another 6,000 young people be-
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came infected with HIV. New estimates indicate that 
more than 70 percent of new HIV cases among this 
age group in sub-Saharan Africa are young women 
and girls. 
(9) As their parents fall progressively sick from 
HIV/AIDS, children generally must take on an in-
creasing number of responsibilities. Girls take re-
sponsibility for more household chores, often drop 
out of school, and care for their parents. 
(10)(A) Without an adequate diet, individuals 
infected with HIV often die at an earlier age. Indi-
viduals with HIV become increasingly weak and fa-
tigued, do not respond to drug treatment, and are 
prone to other illnesses such as malnutrition and tu-
berculosis (TB). 
(B) Hunger can also cause previously HIV-neg-
ative people to engage in high-risk survival strategies 
that increase their chances of becoming infected with 
HIV. 
(11) Extreme poverty and hunger coupled with 
the loss of one or both parents as a result of AIDS 
can force children from their families to a life on the 
streets, where the risk of HIV infection is extremely 
high.
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(12)(A) A considerable number of United 
States and indigenous private voluntary organiza-
tions, including faith-based organizations, provide 
assistance to orphans and other vulnerable children 
in developing countries, especially children affected 
by HIV/AIDS. 
(B) Many of these organizations have submitted 
applications for grants from the United States Agen-
cy for International Development in order to provide 
increased levels of assistance for orphans and other 
vulnerable children in developing countries but in 
most cases the Agency has not approved the applica-
tions. 
(13)(A) Section 403(b) of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and 
Malaria Act of 2003 (Public Law 108–25) estab-
lishes the requirement that for fiscal years 2006 
through 2008, not less than 10 percent of amounts 
appropriated for HIV/AIDS assistance for each such 
fiscal year shall be expended for assistance for or-
phans and other vulnerable children affected by 
HIV/AIDS. 
(B) Further, section 403(b) of Public Law 
108–25 requires that at least 50 percent of such 
amounts shall be provided through non-profit, non-
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governmental organizations, including faith-based 
organizations, that implement programs on the com-
munity level. 
(14)(A) It is essential that the United States 
Government adopt a comprehensive approach for the 
provision of assistance to orphans and other vulner-
able children in developing countries. 
(B) This comprehensive approach should ensure 
that important services, such as basic care, treat-
ment for those children with HIV/AIDS, mental 
health and related services for those children af-
fected by HIV/AIDS, school food programs, in-
creased educational opportunities and employment 
training and related services, and the protection and 
promotion of inheritance rights, are made more ac-
cessible. 
(C) This comprehensive approach should also 
ensure that government agencies and the private 
sector coordinate efforts to prevent and eliminate 
duplication of efforts and waste. 
(15) As a result of the numerous United States 
Government programs under which assistance is spe-
cifically authorized or otherwise available for or-
phans and vulnerable children in developing coun-
tries, the United States Agency for International
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Development will be required to develop innovative 
methods for the conduct and monitoring of these 
programs, including through the collection, analysis, 
and reporting of information on the programs and 
the extent to which such programs provide assist-
ance directly and indirectly to such children. 
SEC. 3. PURPOSE. 
The primary purpose of this Act, and the amend-
ments made by this Act, is to provide assistance to or-
phans and other vulnerable children, especially such chil-
dren affected by HIV/AIDS, and in particular, for such 
children in countries heavily affected by HIV/AIDS. To 
the maximum extent practicable, such assistance shall be 
provided for the direct benefit to such orphaned and vul-
nerable children. 
SEC. 4. ASSISTANCE FOR ORPHANS AND OTHER VULNER-
ABLE 
CHILDREN 
IN 
DEVELOPING 
COUN-
TRIES. 
Title V of chapter 2 of part I of the Foreign Assist-
ance Act of 1961 (22 U.S.C. 2201) is amended to read 
as follows: