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2 

AGENCY FOR INT’L DEVELOPMENT v. ALLIANCE FOR 
OPEN SOCIETY INT’L, INC. 

Opinion of the Court 

I 
Congress  passed  the  Leadership  Act  in  2003  after  find-
ing  that  HIV/AIDS  had  “assumed  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 
devastation.”  22 U. S. C. §7601(1).  According to congres-
sional  findings,  more  than  65  million  people  had  been 
infected  by  HIV  and  more  than  25  million  had  lost  their 
lives,  making  HIV/AIDS  the  fourth  highest  cause  of 
death worldwide.  In sub-Saharan Africa alone, AIDS had 
claimed the lives of more than 19 million individuals and 
was projected to kill a full quarter of the population of that
area  over  the  next  decade.  The  disease  not  only  directly 
endangered those infected, but also increased the potential 
for  social  and  political  instability  and  economic  devasta-
tion,  posing  a  security  issue  for  the  entire  international
community.  §§7601(2)–(10). 

In  the  Leadership  Act,  Congress  directed  the  President
to  establish  a  “comprehensive,  integrated”  strategy  to 
combat  HIV/AIDS  around  the  world.    §7611(a).  The  Act 
sets  out  29  different  objectives  the  President’s  strategy
should seek to fulfill, reflecting a multitude of approaches
to  the  problem.  The  strategy  must  include,  among  other 
things,  plans  to  increase  the  availability  of  treatment  for 
infected  individuals,  prevent  new  infections,  support  the
care of those affected by the disease, promote training for 
physicians  and  other  health  care  workers,  and  accelerate 
research  on  HIV/AIDS  prevention  methods,  all  while 
providing  a  framework  for  cooperation  with  international 
organizations and partner countries to further the goals of
the program.  §§7611(a)(1)–(29). 

The Act “make[s] the reduction of HIV/AIDS behavioral 
risks a priority of all prevention efforts.”  §7611(a)(12); see
also §7601(15) (“Successful strategies to stem the spread of 
the  HIV/AIDS  pandemic  will  require  . . .  measures  to