I
106TH CONGRESS
2D SESSION
H. R. 4140
To amend the Foreign Assistance Act of 1961 to authorize appropriations
for HIV/AIDS prevention efforts.
IN THE HOUSE OF REPRESENTATIVES
MARCH 30, 2000
Ms. MILLENDER-MCDONALD introduced the following bill; which was referred
to the Committee on International Relations
A BILL
To amend the Foreign Assistance Act of 1961 to authorize
appropriations for HIV/AIDS prevention efforts.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘International HIV/
AIDS Partnership Prevention Act of 2000’’.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1)(A) AIDS is potentially the greatest health
catastrophe to humankind since the indigenous com-
munities of South and Central America were re-
duced from 110,000,000 to 4,500,000 in 15 years
when conquered by the Spanish in the 1500s.
(B) More than 16,000,000 men, women and
children have died of AIDS. More than 33,600,000
people are living with HIV, and nearly all of them
will die of AIDS-related complications within the
next 2 decades. UNAIDS estimated that there were
5,600,000 newly-infected people with HIV in 1999,
including an estimated 2,300,000 women and ap-
proximately 570,000 children.
(C) AIDS has orphaned more than 11,000,000
children worldwide and UNICEF estimates that
their number will reach 40,000,000 in the next dec-
ade.
(2) 95 percent of people worldwide living with
HIV live in the world’s poorest countries. With poor
health systems, weak economies, poverty, and limited
access to resources, the epidemic will grow even fur-
ther over the next quarter century.
(3) It has been shown that HIV/AIDS does not
strike women and men equally. Heterosexual women
are 2 to 4 times more likely than their husbands or
partners to become infected with HIV. Many HIV-
infected women fear and experience domestic vio-
lence. Women’s fertility also is impacted by this dis-
ease since once infected, a woman can be expected
to bear 20 percent fewer children than she otherwise
would. In cities throughout the world, voluntary and
involuntary prostitution among women and girls fur-
ther exposes them to HIV/AIDS and other sexually
transmitted diseases.
(4) In 1999, the United Nations estimated that
570,000 children age 14 or younger became infected
with HIV. More than 90 percent were babies born
to HIV-positive women. Almost nine-tenths of these
babies were born in sub-Saharan Africa.
(5) Sub-Saharan Africa continues to bear the
brunt of HIV and AIDS, with approximately 75 per-
cent of the global total of HIV-positive people. Most
of these people will die in the next 10 years.
(6) As of December 1999, the Asian continent
had about 6,500,000 people living with HIV. This is
5 times the number of people who have already died
of AIDS in the region. According to UNAIDS, a rise
of just 0.1 percent prevalence among adults in India
would add over 500,000 people to the national total
of adults living with HIV.
(7) The Russian Federation and other countries
of the former Soviet Union had the world’s greatest
rate of increase in HIV infections in 1999 due pri-
marily to intravenous drug use.
(8) According to United Nations estimates, at
the end of December 1999 there were 1,300,000
adults and children living with HIV/AIDS in Latin
America and 360,000 in the Caribbean basin. Mex-
ico, our closest neighbor, had an estimated 180,000
new cases of HIV/AIDS at the end of 1999.
(9) Although statistics on HIV/AIDS prevalence
rates in North Africa and the Middle East are not
available, the insidious nature of the epidemic that
traverses geographic, social, and economic bound-
aries put Middle Eastern populations at risk.
(10) AIDS and secondary infectious diseases
like tuberculosis, are disproportionately draining na-
tional budgets and threatening development capac-
ity. The AIDS crisis has reversed decades of eco-
nomic and social development and threatens nascent
democratic institutions.
(11) There are potential security implications in
poor countries where the increase in HIV-infected
military personnel is gradually weakening the capac-
ity of militaries to defend their nations, maintain
civil order, and deploy peacekeepers. Child soldiers
and girl ‘‘wives’’, some also HIV-infected, are a by-
product of a dwindling pool of adult recruits.
SEC. 3. STATEMENTS OF POLICY.
The Congress declares the following:
(1)(A) The Congress recognizes the threat that
the global HIV/AIDS epidemic poses to international
security, and the need for public and private com-
mitments to provide equal access to HIV/AIDS edu-
cation, prevention, testing, diagnosis, and treatment
services in all regions of the world affected by the
epidemic without regard to age, ancestry, color, dis-
ability, gender, national origin, race, religion, sexual
orientation, or political status.
(B) It is in the interest of the United States to
provide leadership to foreign governments, inter-
national organizations, and the global private sector
to counteract the negative effects of HIV/AIDS
worldwide.
(2) The Congress further recognizes the inex-
tricable link between the HIV/AIDS epidemic and
political and economic development in the poorest
countries of the world and the need for collaborative
partnerships between traditional aid and develop-
ment programs and HIV/AIDS program funding.
(3) A major purpose of this Act is to prevent
the transmission of HIV/AIDS, to treat persons in-
fected with HIV/AIDS, to assist persons affected by
this disease, and to keep the economically active
HIV-infected population viable. An individual with
AIDS, provided that he or she receives all necessary
treatment and care, can survive for many years, 3
or 4 times more than was previously possible.
(4)(A) While national coordination is required
to address the epidemic, funding priorities will also
seek more effective responses at the local level that
build upon local government and civil society’s ca-
pacity to help relieve the enormous suffering caused
by HIV/AIDS and to prevent further spreading of
the epidemic.
(B) Critical efforts to contain the epidemic
must include primary prevention and psychological
and social support programs, clinical and medical
treatment, and programs that recognize the broader
social and economic dimensions of the disease.
(5) Behavior alone will not conquer this disease.
The world needs an affordable AIDS vaccine. Re-
search toward a safe, effective, affordable, and ac-
cessible vaccine to prevent the onset of the disease
is vital to our human survival. The best long-term
hope for eradicating AIDS is through the develop-
ment and widespread distribution of a preventive
vaccine. Vaccines have been effective in helping to
solve public health problems such as the smallpox
epidemic, polio, influenza and hepatitis B. Signifi-
cant advances in molecular biology and basic HIV
research have led to the development of several
promising strategies for designing safe and effective
vaccines for the prevention of HIV/AIDS.
(6) Human rights is a primary basis for caring
for individuals with HIV/AIDS and controlling the
spread of this disease. A program will be eligible for
funding under this Act only if the program does not
engage in compulsory testing, is nondiscriminatory,
and preserves privacy and confidentiality.
(7) The United States, through collaborative ef-
forts in education, prevention, treatment, and vac-
cine research with highly impacted countries, can
substantially reduce new HIV infections and provide
a continuum of appropriate services and support for
those individuals infected and affected by HIV/
AIDS.
(8) The Congress recognizes the need for con-
sultation and collaboration among the United States
Government, the private sector, and nongovern-
mental organizations, and with their counterparts
throughout the world, to further address the HIV/
AIDS epidemic.
SEC. 4. AMENDMENT TO THE FOREIGN ASSISTANCE ACT OF
1961.
Section 104(c) of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b(c)) is amended by adding at the end
the following:
‘‘(4)(A) The Congress declares that the United States
Agency for International Development shall undertake a
comprehensive, coordinated effort to combat HIV/AIDS
and mitigate the epidemic’s impact on sustainable develop-
ment through effective partnerships with international or-
ganizations, donors, national and local governments, and
nongovernmental organizations.
‘‘(B)(i) In order to meet the requirement of subpara-
graph (A), the Administrator of the United States Agency
for International Development (hereinafter in this para-
graph referred to as the ‘Administrator’) shall establish
and carry out HIV/AIDS education, prevention, treat-
ment, and research programs in foreign countries, includ-
ing programs to build community capacity to slow the
spread of the epidemic. Such programs and activities shall
include strengthening existing programs and promoting
innovate community-based programs.
‘‘(ii) The Administrator shall take all appropriate
steps to enhance cooperative efforts among foreign coun-
tries and to assist in fostering human rights with respect
to the establishment and conduct of programs and initia-
tives described in clause (i).
‘‘(C)(i) In carrying out the programs and initiatives
described in subparagraph (B), the Administrator shall
make grants to national governments, units of local gov-
ernment, and nongovernmental and multilateral organiza-
tions to initiate, develop, expand, or strengthen HIV/AIDS
prevention and education programs.
‘‘(ii) In determining eligibility for grants under clause
(i), a nongovernmental or multilateral organization shall
not be subject to requirements that are more restrictive
than requirements applicable to a foreign government.
‘‘(iii) A government or organization may receive a
grant under clause (i) only if the government or organiza-
tion, as the case may be, certifies that its laws, policies,
and practices, as appropriate, do not punish or deny serv-
ices to victims based on age, ancestry, color, disability,
gender, national origin, race, religion, sexual orientation,
and political status.
‘‘(iv) In making grants under clause (i), the Adminis-
trator shall provide technical assistance, evaluation, and
data collection with respect to the programs established
and carried out from amounts provided under such grants.
‘‘(D) Amounts provided under a grant under sub-
paragraph (C)(i) shall be used for activities such as—
‘‘(i) national and community-level AIDS pri-
mary prevention and education programs among sex-
ually vulnerable groups and the general population;
‘‘(ii) voluntary testing and counseling services
(with or without testing) that address the needs of
susceptible client groups, for example, women, cou-
ples, care givers, children (particularly orphans and
those living with HIV/AIDS), youth, intravenous
drug users, and sex-workers;
‘‘(iii) effective and economical treatment solu-
tions including new medications to prevent the
transmission of HIV/AIDS from mother to child;
‘‘(iv) care services for those living with HIV/
AIDS that also promote and maintain the emotional
well-being of all care-givers providing support to per-
sons living with HIV/AIDS;
‘‘(v) improved infrastructure and institutional
capacity to develop and manage education, preven-
tion, and treatment programs including the re-
sources to collect and maintain accurate HIV sur-
veillance data to target programs and measure the
effectiveness of interventions;
‘‘(vi) sustained education, prevention, and treat-
ment programs for military personnel;
‘‘(vii) city-to-city collaborative exchanges be-
tween United States municipal HIV/AIDS programs
and cities in highly impacted countries in order—
‘‘(I) to share experiences and build local
capacity to respond to the disease;
‘‘(II) to stimulate environments where
global partnerships can develop new problem-
solving strategies, with emphasis on prevention
and education; and
‘‘(III) to foster opportunities for local eco-
nomic development and mutual trade;
‘‘(viii) collaboration with multilateral and bina-
tional programs that have similar goals;
‘‘(ix) vaccine research and development partner-
ship programs with specific plans of action to de-
velop a safe, effective, accessible, preventive HIV
vaccine for use throughout the world;
‘‘(x) microbicide research, such as research to
develop new preventive technologies and products,
such as sexually-transmitted diseases and HIV diag-
nostic tools; and
‘‘(xi) evaluation programs that will include
participatory self-evaluation methodology to analyze
issues of program effectiveness and short term im-
pact on specific populations designed to generate
high quality and useful data to inform further re-
search.
‘‘(E) In providing assistance under this paragraph,
the Administrator shall give priority to those foreign coun-
tries with the highest incidence of HIV/AIDS cases.
‘‘(F)(i) The Administrator is authorized to establish
HIV/AIDS Technical Support Centers (in this paragraph
referred to as ‘‘Centers’’) in any country mission of the
United States Agency for International Development, as
determined to be appropriate by the Administrator, in
order to provide technical assistance to recipients of assist-
ance under this paragraph.
‘‘(ii) The duties of a Center shall be the following:
‘‘(I) Provide short-term technical and related
advisory services with respect to assistance provided
under this paragraph, including financial and mana-
gerial support (such as assistance relating to general
accounting principles and other bookkeeping prin-
ciples).
‘‘(II) Provide services relating to monitoring
and reporting requirements with respect assistance
provided under this paragraph.
‘‘(III) Provide access to comprehensive and reli-
able information on HIV/AIDS treatment, policy, re-
search, prevention, statistics, and epidemiology, in-
cluding such information provided in electronic for-
mat.
‘‘(IV) Support community-based HIV/AIDS re-
search activities that—
‘‘(aa) document best practices among HIV/
AIDS programs;
‘‘(bb) demonstrate prevention, treatment,
and delivery strategies; and
‘‘(cc) address issues of culture, religion,
and sexuality within the relevant socio-national
context.
‘‘(V) Establish facilities, in conjunction with a
local private financial institution or other local fi-
nancial intermediary, to encourage, accept, and ad-
minister private gifts of real or personal property, or
any income therefrom, or other interest therein, for
the benefit of, or in support of, programs funded by
assistance under this paragraph.
‘‘(G)(i) In addition to amounts otherwise available for
such purposes, there are authorized to be appropriated to
the 
Administrator 
to 
carry 
out 
this 
paragraph
$150,000,000 for fiscal year 2001, $175,000,000 for fis-
cal year 2002, $200,000,000 for fiscal year 2003,
$225,000,000 for fiscal year 2004, and $250,000,000 for
fiscal year 2005.
‘‘(ii) $10,000,0000 made available each fiscal year
under clause (i) shall be used for vaccine research develop-
ment partnerships to accelerate the development of glob-
ally accessible AIDS vaccines.
‘‘(iii) Not more than 8 percent of amounts made
available each fiscal year under clause (i) may be used for
administrative expenses of the United States Agency for
International Development for carrying out this para-
graph.
‘‘(iv) Funds appropriated pursuant to the authoriza-
tion of appropriations under clause (i) are authorized to
remain available until expended.’’.
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