thorized 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) 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 Global Fund from the International Bank 
for Reconstruction and Development and the 
International Monetary Fund shall not be con-
sidered in determining compliance with this 
paragraph. 
(B) Any amount made available under this 
subsection that is withheld by reason of sub-
paragraph (A) shall be contributed to the Glob-
al Fund as soon as practicable, subject to sub-
paragraph (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 
national 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 For-
eign Relations of the Senate not less than 5 
days before making a determination under 
clause (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 estab-
lish in the Executive Branch an interagency tech-
nical review panel. 
(2) DUTIES.—The interagency technical review 
panel shall serve as a ‘‘shadow’’ panel to the Global 
Fund by—
(A) periodically reviewing all proposals re-
ceived by the Global Fund; and 
(B) providing guidance to the United 
States persons who are representatives on the 
panels, committees, and boards of the Global 
Fund, on the technical efficacy, suitability, and
appropriateness of the proposals, and ensuring 
that such persons are fully informed of tech-
nical inadequacies or other aspects of the pro-
posals that are inconsistent with the purposes 
of this or any other Act relating to the provi-
sion of foreign assistance in the area of AIDS. 
(3) MEMBERSHIP.—The interagency technical 
review panel shall consist of qualified medical and 
development experts who are officers or employees of 
the Department of Health and Human Services, the 
Department of State, and the United States Agency 
for International Development. 
(4) CHAIR.—The Coordinator referred to in 
paragraph (1) shall chair the interagency technical 
review panel. 
(e) MONITORING BY COMPTROLLER GENERAL.—
(1) MONITORING.—The Comptroller General 
shall monitor and evaluate projects funded by the 
Global Fund. 
(2) REPORT.—The Comptroller General shall 
on a biennial basis shall prepare and submit to the 
appropriate congressional committees a report that 
contains the results of the monitoring and evaluation 
described in paragraph (1) for the preceding 2-year 
period.
SEC. 
203. 
VOLUNTARY 
CONTRIBUTIONS 
TO 
INTER-
NATIONAL VACCINE FUNDS. 
(a) VACCINE FUND.—Section 302(k) of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2222(k)) is amended—
(1) by striking ‘‘$50,000,000 for each of the 
fiscal years 2001 and 2002’’ and inserting ‘‘such 
sums as may be necessary for each of the fiscal 
years 2004 through 2008’’; and 
(2) by striking ‘‘Global Alliance for Vaccines 
and Immunizations’’ and inserting ‘‘Vaccine Fund’’. 
(b) INTERNATIONAL AIDS VACCINE INITIATIVE.—
Section 302(l) of the Foreign Assistance Act of 1961 (22 
U.S.C. 2222(l)) is amended by striking ‘‘$10,000,000 for 
each of the fiscal years 2001 and 2002’’ and inserting 
‘‘such sums as may be necessary for each of the fiscal 
years 2004 through 2008’’. 
(c) SUPPORT FOR THE DEVELOPMENT OF MALARIA 
VACCINE.—Section 302 of the Foreign Assistance Act of 
1961 (22 U.S.C. 2222)) is amended by adding at the end 
the following new subsection: 
‘‘(m) In addition to amounts otherwise available 
under this section, there are authorized to be appropriated 
to the President such sums as may be necessary for each 
of the fiscal years 2004 through 2008 to be available for 
United States contributions to malaria vaccine develop-
ment programs, including the Malaria Vaccine Initiative
of the Program for Appropriate Technologies in Health 
(PATH).’’. 
TITLE III—BILATERAL EFFORTS 
Subtitle A—General Assistance and 
Programs 
SEC. 301. ASSISTANCE TO COMBAT HIV/AIDS. 
(a) AMENDMENT OF THE FOREIGN ASSISTANCE ACT 
OF 1961.—Chapter 1 of part I of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151 et seq.) is amended—
(1) in section 104(c) (22 U.S.C. 2151b(c)), by 
striking paragraphs (4) through (7); and 
(2) by inserting after section 104 the following 
new section: 
‘‘SEC. 104A. ASSISTANCE TO COMBAT HIV/AIDS. 
‘‘(a) FINDING.—Congress recognizes that the alarm-
ing spread of HIV/AIDS in countries in sub-Saharan Afri-
ca, the Caribbean, and other developing countries is a 
major global health, national security, development, and 
humanitarian crisis. 
‘‘(b) POLICY.—It is a major objective of the foreign 
assistance program of the United States to provide assist-
ance for the prevention, treatment, and control of HIV/
AIDS. The United States and other developed countries 
should provide assistance to countries in sub-Saharan Af-
rica and other countries and areas to control this crisis
World Health Organization (WHO), the United Na-
tions Development Programme (UNDP), the Global 
Fund to Fight AIDS, Tuberculosis and Malaria and 
other appropriate international organizations (such 
as the International Bank for Reconstruction and 
Development), relevant regional multilateral develop-
ment institutions, national, state, and local govern-
ments of foreign countries, appropriate governmental 
and nongovernmental organizations, and relevant ex-
ecutive branch agencies. 
‘‘(d) ACTIVITIES SUPPORTED.—Assistance provided 
under subsection (c) shall, to the maximum extent prac-
ticable, be used to carry out the following activities: 
‘‘(1) PREVENTION.—Prevention of HIV/AIDS 
through activities including—
‘‘(A) programs and efforts that are de-
signed or intended to impart knowledge with 
the exclusive purpose of helping individuals 
avoid behaviors that place them at risk of HIV 
infection, including integration of such pro-
grams into health programs and the inclusion 
in counseling programs of information on meth-
ods of avoiding infection of HIV, including de-
laying sexual debut, abstinence, fidelity and mo-
nogamy, reduction of casual sexual partnering, 
and where appropriate, use of condoms; 
‘‘(B) assistance to establish and implement 
culturally appropriate HIV/AIDS education and 
prevention programs that focus on helping indi-
viduals avoid infection of HIV/AIDS, imple-
mented through nongovernmental organizations, 
including faith-based and community-based or-
ganizations, particularly those organizations 
that utilize both professionals and volunteers 
with appropriate skills, experience, and commu-
nity presence; 
‘‘(C) assistance for the purpose of pro-
viding voluntary testing and counseling (includ-
ing the incorporation of confidentiality protec-
tions with respect to such testing and coun-
seling); 
‘‘(D) assistance for the purpose of pre-
venting mother-to-child transmission of the 
HIV infection, including medications to prevent 
such transmission and access to infant formula 
and other alternatives for infant feeding; 
‘‘(E) assistance to ensure a safe blood sup-
ply and sterile medical equipment; and
‘‘(F) assistance to help avoid substance 
abuse and intravenous drug use that can lead 
to HIV infection. 
‘‘(2) TREATMENT.—The treatment and care of 
individuals with HIV/AIDS, including—
‘‘(A) assistance to establish and implement 
programs to strengthen and broaden indigenous 
health care delivery systems and the capacity of 
such systems to deliver HIV/AIDS pharma-
ceuticals and otherwise provide for the treat-
ment of individuals with HIV/AIDS, including 
clinical training for indigenous organizations 
and health care providers; 
‘‘(B) assistance to strengthen and expand 
hospice and palliative care programs to assist 
patients debilitated by HIV/AIDS, their fami-
lies, and the primary caregivers of such pa-
tients, including 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, in-
cluding antiretrovirals and other pharma-
ceuticals and therapies for the treatment of op-
portunistic infections, nutritional support, and 
other treatment modalities. 
‘‘(3) 
PREVENTATIVE
INTERVENTION
EDU-
CATION AND TECHNOLOGIES.—(A) With particular 
emphasis on specific populations that represent a 
particularly high risk of contracting or spreading 
HIV/AIDS, including those exploited through the 
sex trade, victims of rape and sexual assault, indi-
viduals already infected with HIV/AIDS, and in 
cases of occupational exposure of health care work-
ers, assistance with efforts to reduce the risk of 
HIV/AIDS infection including post-exposure phar-
maceutical prophylaxis, and necessary pharma-
ceuticals 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 
provide HIV/AIDS pharmaceuticals and other 
appropriate medicines to poor individuals with 
HIV/AIDS; and 
‘‘(B) appropriate evaluation and surveil-
lance activities. 
‘‘(5) PHARMACEUTICALS.—
‘‘(A) PROCUREMENT.—The procurement of 
HIV/AIDS pharmaceuticals, antiviral therapies, 
and other appropriate medicines, including 
medicines to treat opportunistic infections. 
‘‘(B) MECHANISMS FOR QUALITY CONTROL 
AND
SUSTAINABLE
SUPPLY.—Mechanisms to 
ensure that such HIV/AIDS pharmaceuticals, 
antiretroviral therapies, and other appropriate 
medicines are quality-controlled and sustainably 
supplied. 
‘‘(C) DISTRIBUTION.—The distribution of 
such 
HIV/AIDS 
pharmaceuticals, 
antiviral 
therapies, and other appropriate medicines (in-
cluding medicines to treat opportunistic infec-
tions) to qualified national, regional, or local or-
ganizations for the treatment of individuals 
with HIV/AIDS in accordance with appropriate
HIV/AIDS testing and monitoring requirements 
and treatment protocols and for the prevention 
of mother-to-child transmission of the HIV in-
fection. 
‘‘(6) RELATED ACTIVITIES.—The conduct of re-
lated activities, including—
‘‘(A) the care and support of children who 
are orphaned by the HIV/AIDS pandemic, in-
cluding services designed to care for orphaned 
children in a family environment which rely on 
extended family members; 
‘‘(B) improved infrastructure and institu-
tional capacity to develop and manage edu-
cation, prevention, and treatment programs, in-
cluding training and the resources to collect 
and maintain accurate HIV surveillance data to 
target programs and measure the effectiveness 
of interventions; and 
‘‘(C) vaccine research and development 
partnership programs with specific plans of ac-
tion to develop a safe, effective, accessible, pre-
ventive HIV vaccine for use throughout the 
world. 
‘‘(e) ANNUAL REPORT.—
‘‘(1) IN GENERAL.—Not later than January 31 
of each year, the President shall submit to the Com-
mittee on Foreign Relations of the Senate and the 
Committee on International Relations of the House 
of Representatives a report on the implementation of 
this section for the prior fiscal year. 
‘‘(2) REPORT
ELEMENTS.—Each report shall 
include—
‘‘(A) a description of efforts made by each 
relevant executive branch agency to implement 
the policies set forth in this section, section 
104B, and section 104C; 
‘‘(B) a description of the programs estab-
lished pursuant to such sections; and 
‘‘(C) a detailed assessment of the impact 
of programs established pursuant to such sec-
tions, including—
‘‘(i)(I) the effectiveness of such pro-
grams in reducing the spread of the HIV 
infection, particularly in women and girls, 
in reducing mother-to-child transmission of 
the HIV infection, and in reducing mor-
tality rates from HIV/AIDS; and 
‘‘(II) the number of patients currently 
receiving treatment for AIDS in each
country that receives assistance under this 
Act.
‘‘(ii) the progress made toward im-
proving health care delivery systems (in-
cluding the training of adequate numbers 
of staff) and infrastructure to ensure in-
creased access to care and treatment; 
‘‘(iii) with respect to tuberculosis, the 
increase in the number of people treated 
and the increase in number of tuberculosis 
patients cured through each program, 
project, or activity receiving United States 
foreign assistance for tuberculosis control 
purposes; and 
‘‘(iv) with respect to malaria, the in-
crease in the number of people treated and 
the increase in number of malaria patients 
cured through each program, project, or 
activity receiving United States foreign as-
sistance for malaria control purposes. 
‘‘(f) FUNDING LIMITATION.—Of the funds made 
available to carry out this section in any fiscal year, not 
more than 7 percent may be used for the administrative 
expenses of the United States Agency for International 
Development in support of activities described in section
104(c), this section, section 104B, and section 104C. Such 
amount shall be in addition to other amounts otherwise 
available for such purposes. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) AIDS.—The term ‘AIDS’ means acquired 
immune deficiency syndrome. 
‘‘(2) HIV.—The term ‘HIV’ means the human 
immunodeficiency virus, the pathogen that causes 
AIDS. 
‘‘(3) 
HIV/AIDS.—The 
term 
‘HIV/AIDS’ 
means, with respect to an individual, an individual 
who is infected with HIV or living with AIDS. 
‘‘(4) RELEVANT
EXECUTIVE
BRANCH
AGEN-
CIES.—The term ‘‘relevant executive branch agen-
cies’’ means the Department of State, the United 
States Agency for International Development, the 
Department of Health and Human Services (includ-
ing the Public Health Service), and any other de-
partment or agency of the United States that par-
ticipates in international HIV/AIDS activities pursu-
ant to the authorities of such department or agency 
or this Act.’’. 
(b) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—In addition to funds avail-
able 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 subsection (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 
authorized 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 As-
sistance Act of 1961 (as added by subsection (a)), 
relating to the procurement and distribution of HIV/
AIDS pharmaceuticals. 
(c) RELATIONSHIP TO ASSISTANCE PROGRAMS TO 
ENHANCE NUTRITION.—In recognition of the fact that 
malnutrition may hasten the progression of HIV to AIDS 
and may exacerbate the decline among AIDS patients 
leading to a shorter life span, the Administrator of the
United States Agency for International Development shall, 
as appropriate—
(1) integrate nutrition programs with HIV/
AIDS activities, generally; 
(2) provide, as a component of an anti-
retroviral therapy program, support for food and nu-
trition to individuals infected with and affected by 
HIV/AIDS; and 
(3) provide support for food and nutrition for 
children affected by HIV/AIDS and to communities 
and households caring for children affected by HIV/
AIDS.
(d) ELIGIBILITY FOR ASSISTANCE.—An organization 
that is otherwise eligible to receive assistance under sec-
tion 104A of the Foreign Assistance Act of 1961 (as 
added by subsection (a)) or under any other provision of 
this Act (or any amendment made by this Act) to prevent, 
treat, or monitor HIV/AIDS shall not be required, as a 
condition of receiving the assistance, to endorse or utilize 
a multisectoral approach to combatting HIV/AIDS. 
SEC. 302. ASSISTANCE TO COMBAT TUBERCULOSIS. 
(a) AMENDMENT OF THE FOREIGN ASSISTANCE ACT 
OF 1961.—Chapter 1 of part I of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151 et seq.), as amended by sec-
tion 301 of this Act, is further amended by inserting after 
section 104A the following new section: 
‘‘SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS. 
‘‘(a) FINDINGS.—Congress makes the following find-
ings: 
‘‘(1) Congress recognizes the growing inter-
national problem of tuberculosis and the impact its 
continued existence has on those countries that had 
previously largely controlled the disease. 
‘‘(2) Congress further recognizes that the 
means exist to control and treat tuberculosis 
through expanded use of the DOTS (Directly Ob-
served Treatment Short-course) treatment strategy, 
including DOTS-Plus to address multi-drug resist-
ant tuberculosis, and adequate investment in newly 
created mechanisms to increase access to treatment, 
including the Global Tuberculosis Drug Facility es-
tablished in 2001 pursuant to the Amsterdam Dec-
laration to Stop TB and the Global Alliance for TB 
Drug Development. 
‘‘(b) POLICY.—It is a major objective of the foreign 
assistance program of the United States to control tuber-
culosis, including the detection of at least 70 percent of 
the cases of infectious tuberculosis, and the cure of at 
least 85 percent of the cases detected, not later than De-