[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1009 Placed on Calendar Senate (PCS)]
Calendar No. 88
108th CONGRESS
1st Session
S. 1009
To amend the Foreign Assistance Act of 1961 and the State Department
Basic Authorities Act of 1956 to increase assistance for foreign
countries seriously affected by HIV/AIDS, tuberculosis, and malaria,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 7, 2003
Mr. Lugar (for himself, Mr. Biden, Mr. Kerry, Mr. Daschle, and Mr.
Sarbanes) introduced the following bill; which was read the first time
May 8, 2003
Read the second time and placed on the calendar
_______________________________________________________________________
A BILL
To amend the Foreign Assistance Act of 1961 and the State Department
Basic Authorities Act of 1956 to increase assistance for foreign
countries seriously affected by HIV/AIDS, tuberculosis, and malaria,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``United States
Emergency Plan for AIDS Relief 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.
TITLE I--POLICY PLANNING AND COORDINATION
Sec. 101. Development of a comprehensive, five-year, global strategy.
Sec. 102. HIV/AIDS response coordinator.
Sec. 103. Coordination with foreign policy.
Sec. 104. Reporting requirements.
Sec. 105. Authorization of appropriations.
Sec. 106. Authority to consolidate and combine reports.
TITLE II--PUBLIC-PRIVATE PARTNERSHIPS
Sec. 201. Sense of Congress regarding public-private partnerships.
Sec. 202. Participation in the Global Fund to Fight AIDS, Tuberculosis
and Malaria.
Sec. 203. Voluntary contributions to international vaccine funds.
TITLE III--MULTILATERAL EFFORTS
Sec. 301. Authority for debt relief for qualified HIPC countries.
Sec. 302. Sense of Congress regarding the enhanced HIPC initiative.
Sec. 303. Definitions.
Sec. 304. Authorization of appropriations.
TITLE IV--BILATERAL EFFORTS
Sec. 401. Assistance to combat HIV/AIDS.
Sec. 402. Assistance to combat tuberculosis.
Sec. 403. Assistance to combat malaria.
Sec. 404. Department of Defense HIV/AIDS prevention assistance program.
TITLE V--BUSINESS PRINCIPLES
Sec. 501. Findings.
Sec. 502. Sense of Congress regarding principles for United States
firms operating in countries affected by
the HIV/AIDS pandemic.
Sec. 503. Principles and practices.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) During the last 20 years, the HIV/AIDS pandemic has
spread from the most severely affected regions, sub-Saharan
Africa and the Caribbean, to all corners of the world, leaving
an unprecedented path of death and devastation. Sub-Saharan
Africa remains the hardest hit region in the world.
(2) According to UNAIDS, more than 60,000,000 people
worldwide have been infected with HIV since the epidemic began,
more than 22,000,000 of these have lost their lives to AIDS,
and more than 13,000,000 children have been orphaned by that
disease.
(3) HIV/AIDS is the fourth-highest cause of death in the
world.
(4) At the end of 2002, an estimated 42,000,000 people were
infected with HIV or were living with AIDS. More than 75
percent of those people live in Africa or the Caribbean region,
and more than 3,000,000 were children under the age of 15 and
more than 17,600,000 were women.
(5) Fifty percent of the total number of individuals
infected with HIV or living with AIDS worldwide and 70 percent
of such individuals living in Africa reside in one of the
following fourteen countries: Botswana, Cote d'Ivoire,
Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria,
Rwanda, South Africa, Tanzania, Uganda, and Zambia.
(6) An estimated 2,000,000 people in Latin America and the
Caribbean region and another 7,200,000 people in Asia and the
Pacific region are infected with HIV or living with AIDS.
(7) Infection rates are rising alarmingly in Eastern Europe
(especially in the Russian Federation), Central Asia, China,
and India.
(8) Rape, sexual assault, sexual abuse, and prostitution
place women and children at heightened risk for HIV infection
and other health risks in many countries. Women and children
who are refugees or are internally displaced persons are
especially vulnerable to sexual violence. Spouses or partners
of men who solicit prostitutes are also put at risk as a result
of the sex trade.
(9) Effective measures are needed to empower women,
including discouraging the sex industry and the trafficking of
individuals in that industry which contributes to the spread of
and devastation caused by HIV/AIDS.
(10) HIV/AIDS has a devastating impact on the social
cohesion and economic well-being of the family. When a family
member infected with HIV develops AIDS, limited family
resources are expended on care and treatment. The economic
impact is more severe if the infected family member is the
primary source of income for the family. Other family members
are forced to work to support the family and children often
drop out of school to serve as caregivers. Care, treatment, and
support of families affected by AIDS are critical elements of
an effective strategy to reduce the spread and impact of HIV/
AIDS.
(11) HIV/AIDS undermines the economic security of a country
and the vitality of individual businesses by weakening the
productivity and longevity of the labor force across a broad
array of economic sectors and by reducing the potential for
economic growth over the long term.
(12) HIV/AIDS destabilizes communities by striking at the
most mobile and educated members of society.
(13) HIV/AIDS weakens national defenses of countries that
are severely affected by the pandemic through high infection
rates among members of their military forces. According to
UNAIDS, in sub-Saharan Africa, many military forces have
infection rates as much as five times the rates of the civilian
population.
(14) The devastation wrought by the HIV/AIDS pandemic is
compounded by the prevalence of tuberculosis and malaria,
particularly in developing countries where the poorest and most
vulnerable members of society, including women, children, and those
with HIV/AIDS, become infected with tuberculosis or malaria. According
to the World Health Organization HIV, AIDS, tuberculosis, and malaria
accounted for approximately 6,000,000 deaths in 2002 and caused
debilitating illnesses in millions more.
(15) Tuberculosis is the cause of death for one out of
every three persons who have AIDS worldwide and is a highly
communicable disease. HIV infection is the leading threat to
control of tuberculosis. Because HIV infection so severely
weakens the immune system, individuals with HIV and latent
tuberculosis infection have a 100 times higher 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.
(16) 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, effective drugs and, concurrently, increasing
resistance of mosquitoes to standard insecticides. 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 difficulties of controlling resurgence of the drug
resistant malaria parasite.
(17) The HIV/AIDS pandemic is first and foremost a public
health problem. Successful strategies to stem the spread of the
pandemic will require direct medical interventions, as well as
the strengthening of health care delivery systems and
infrastructure, determined national leadership, and increased
budgetary allocations for the health sector in countries
affected by the pandemic. Effective prevention measures are
also needed to address the social and behavioral factors that
contribute to the spread of HIV/AIDS.
(18) Effective HIV prevention activities require a variety
of strategies, including those that eliminate the risk of
infection and those that reduce it.
(19) Uganda has implemented a successful strategy to
prevent the spread of HIV that includes a nationwide education
campaign, the use of a model that encourages individuals to
practice abstinence, be faithful, and use condoms (the ``ABC''
model), and the provision of care and treatment. The ABC model
emphasizes behavior change, including sexual abstinence,
delaying sexual debut, fidelity to one's partner, limiting the
number of sexual partners, and using condoms. As a result,
Uganda has experienced the most significant decline in HIV
infection rates of any country in Africa. Other nations,
including Jamaica, Zambia, Ethiopia, and Senegal, have
implemented the ABC model with positive results. Uganda's
success demonstrates that the ABC model can be an effective
approach to prevent HIV infection in some countries and is,
therefore, an important component of a global strategy to
prevent the sexual transmission of HIV.
(20) In 2002, the President initiated a mother-to-child
transmission prevention program to combat the global tragedy of
HIV/AIDS being transmitted to newborns by their mothers. The
President's program recognizes that approximately 2,000
children around the world are infected each day with HIV
through mother-to-child transmission and that mother-to-child
transmission is largely preventable with the proper application
of pharmaceuticals, therapies, and other public health
interventions. The United States Government is already
supporting programs to prevent mother-to-child transmission in
resource-poor nations.
(21) Efforts to prevent mother-to-child transmission have
provided the basis for a broader response that includes care
and treatment of mothers, fathers, other family members, and
the population-at-large, that are infected with HIV or living
with AIDS.
(22) Advances in treatment for HIV/AIDS provide the
opportunity, for the first time, for meaningful clinical
interventions on a large scale in developing countries.
Experience in Uganda and Haiti shows that interventions based
upon a progressive, tiered model of health care delivery
emanating from a central health care facility that is extended
through expanding circles of delivery using local mechanisms
and local capacity, thus allowing delivery of care and
treatment through basic levels of expertise, are critical to
increasing access to treatment in resource-poor countries. Such
a model is highly cost-effective and maximizes utilization of
local resources.
(23) The magnitude and scope of the HIV/AIDS crisis demands
a comprehensive, long-term, international response that is
focused on providing an integrated program of treatment, care,
and prevention that recognizes recent medical insights and
includes--
(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 challenges in the HIV/AIDS
crisis;
(B) development of health care infrastructure and
delivery systems through cooperative and coordinated
public efforts, and public and private partnerships;
(C) development and implementation of national and
community-based multisector strategies 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
associated with infection with HIV and living with AIDS;
(D) use of all available expertise and experience
within the United States Government to assist in the
development of an international response to the HIV/
AIDS crisis; and
(E) coordination of efforts between international
organizations such as the Global Fund to Fight AIDS,
Tuberculosis and Malaria, UNAIDS, the World Health
Organization, national governments, and private sector
organizations (including nonprofit, community-based, or
faith-based organizations).
(24) Leadership of the international community's response
to the HIV/AIDS pandemic requires the United States--
(A) to continue to provide substantial financial
resources, technical expertise, and training;
(B) to promote vaccine and microbicide research and
the development of new treatment protocols in the
public and commercial pharmaceutical research sectors;
(C) to encourage governments and community-based
organizations to adopt policies that treat HIV/AIDS as
a public health problem with multisectoral impacts,
including impacts on education, the economy, the
family, and society;
(D) to ensure that--
(i) the particular vulnerabilities of women
are addressed when designing appropriate HIV/
AIDS prevention and treatment programs, given
the fact that women face a high risk of HIV
infection due, in part, to rape, sexual
assault, prostitution, the sex trade, and the
sexual exploitation of women; and
(ii) no microbicide is procured or
distributed until such microbicide is proven
both effective to reduce a woman's risk of
contracting HIV or other sexually transmitted
disease and safe for human use; and
(E) to encourage active involvement of the private
sector, including businesses, pharmaceutical and
biotechnology companies, the medical and scientific
communities, charitable foundations, private and
voluntary organizations, nongovernmental organizations
(including nonprofit, community-based, or faith-based
organizations) and other nonprofit entities.
(25) The Emergency Plan for AIDS Relief, announced by the
President in January 2003, presents a bold, new bilateral
initiative to help countries in Africa and the Caribbean region
address the HIV/AIDS pandemic by providing substantial
financial resources, technical expertise and training. The
Emergency Plan for AIDS Relief recognizes the critical link
between HIV/AIDS care, treatment, prevention, and education
efforts, and the need for health care systems with the capacity
to provide treatment.
SEC. 3. DEFINITIONS.
In this Act:
(1) AIDS, HIV, HIV/AIDS.--
(A) AIDS.--The term ``AIDS'' means acquired immune
deficiency syndrome.
(B) HIV.--The term ``HIV'' means the human
immunodeficiency virus, the pathogen that causes AIDS.
(C) HIV/AIDS.--The term ``HIV/AIDS'' means the
disease characterized by HIV infection, or by HIV
infection and onset of AIDS.
(2) Appropriate congressional committees.--The term
``appropriate congressional committees'' means the Committee on
Foreign Relations of the Senate and the Committee on
International Relations 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 Malaria that was established under the
laws of Switzerland in January 2002.
(4) Relevant executive branch agencies.--The term
``relevant executive branch agencies'' means the Department of
State, the United States Agency for International Development,
the Department of Health and Human Services, the Department of
Labor, the Department of Commerce, the Department of the
Treasury, and the Department of Defense.
(5) UNAIDS.--The term ``UNAIDS'' means the Joint United
Nations Program on HIV/AIDS.
SEC. 4. PURPOSE.
The purpose of this Act is to strengthen United States leadership
and the effectiveness of the United States response to global HIV/AIDS,
tuberculosis, and malaria by--
(1) providing resources for United States bilateral efforts
to combat HIV/AIDS, in order to provide, during the five-fiscal
year period beginning with fiscal year 2004--
(A) antiretroviral treatment for HIV infection,
symptoms of HIV/AIDS, and opportunistic infections
associated with HIV/AIDS to at least 2,000,000
individuals;
(B) support services to at least 10,000,000
individuals affected by HIV/AIDS, including the
caregivers of individuals infected with HIV or living
with AIDS, and children orphaned by HIV/AIDS and the
caregivers of such children; and
(C) strategies to prevent at least 7,000,000
individuals from becoming infected with HIV, including
strategies to prevent the transmission of HIV from
mothers to infants;
(2) improving coordination among relevant executive branch
agencies to combat the HIV/AIDS pandemic;
(3) providing resources for United States bilateral efforts
to combat tuberculosis and malaria;
(4) providing resources for multilateral efforts to fight
HIV/AIDS, tuberculosis, and malaria;
(5) encouraging private sector efforts and public-private
partnerships to combat HIV/AIDS, tuberculosis, and malaria; and
(6) providing resources for the development and, when
feasible, distribution of safe and effective microbicides and
vaccines for HIV/AIDS, and vaccines for tuberculosis and
malaria.
TITLE I--POLICY PLANNING AND COORDINATION
SEC. 101. DEVELOPMENT OF A COMPREHENSIVE, FIVE-YEAR, GLOBAL STRATEGY.
(a) In General.--The President shall develop a comprehensive,
integrated five-year strategy to strengthen the capacity of the United
States to be an effective leader of the international campaign against
HIV/AIDS and to promote the stabilization or reduction of the global
incidence of HIV/AIDS and the morbidity and mortality related to HIV/
AIDS. The strategy should include programs to prevent HIV infection
(including preventing mother-to-child transmission), and to provide
care and treatment of individuals infected with HIV, and care of
children orphaned by AIDS. The strategy should be designed to respond
to the changing nature of the HIV/AIDS pandemic and to the specific
needs of countries impacted by the pandemic.
(b) Content.--The strategy required by subsection (a) shall--
(1) include specific objectives, multisectoral approaches,
and strategies to treat individuals infected with HIV and to
prevent the further spread of HIV infections, with a particular
focus, where appropriate, on clinical interventions based upon
a tiered approach to direct delivery of care and treatment
through a system that is based upon central facilities and is
augmented by expanding circles of local delivery of care and
treatment through local systems and capacity;
(2) provide for the use of effective and proven models that
address the specific characteristics of the spread of the HIV/
AIDS pandemic in countries that will receive assistance
pursuant to the strategy;
(3) use all available expertise and experience within the
United States Government to develop an effective response to
the global HIV/AIDS crisis, and assign priorities to activities
related to HIV/AIDS that will be carried out by the relevant
executive branch agencies;
(4) improve coordination among relevant executive branch
agencies, foreign governments, and international organizations;
(5) require agencies to project the level of resources that
will be needed to implement such strategy;
(6) expand public-private partnerships and efforts to
combine funds from the Federal Government with funds from other
sources to carry out programs related to HIV/AIDS;
(7) maximize United States capabilities in the areas of
direct delivery of care and treatment, technical assistance,
training, and research;
(8) emphasize behavioral changes to reduce the risk of HIV
infection including utilizing a model that encourages
individuals to practice abstinence, be faithful, and use
condoms (the ``ABC'' model);
(9) address the vulnerabilities of women to HIV/AIDS,
including through prevention and education programs that
protect women against HIV/AIDS; and
(10) provide for tracking measurable results and outcomes
from the activities carried out under the strategy.
(c) Report.--
(1) Requirement.--Not later than 180 days after the date of
the enactment of this Act, the Coordinator of United States
Government Activities to Combat HIV/AIDS Globally appointed by
the President under section 1(f) of the State Department Basic
Authorities Act of 1956 (22 U.S.C. 2651a), as added by section
102, shall submit a report to the appropriate congressional
committees setting forth the five-year strategy required by
subsection (a).
(2) Content.--The report shall describe the programs and
activities that will be implemented under the strategy to
address the requirements set out in paragraphs (1) through (10)
of subsection (b).
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. 2651a) is amended--
(1) by redesignating subsection (f) as subsection (g); and
(2) by inserting after subsection (e) the following new
subsection (f):
``(f) HIV/AIDS Response Coordinator.--
``(1) In general.--There shall be established within the
Department of State, in the immediate office of the Secretary
of State, the position of Coordinator of United States
Government Activities to Combat HIV/AIDS Globally (the
`Coordinator'). The Coordinator shall be appointed by the
President, by and with the advice and consent of the Senate,
shall report directly to the Secretary of State, and shall have
the rank and status of ambassador.
``(2) Authorities.--The Coordinator is authorized--
``(A) to coordinate the prevention, care,
treatment, support, capacity development, and other
activities for combatting the global HIV/AIDS pandemic;
``(B) to designate specific countries to receive
assistance related to HIV/AIDS authorized under this
Act;
``(C) to transfer and allocate funds in the account
established by section 102(c) of the United States
Emergency Plan for AIDS Relief Act of 2003 to relevant
executive branch agencies; and
``(D) to award grants and contracts, in accordance
with Federal law and policy governing the awarding of
grants and contracts, to nongovernmental organizations
(including nonprofit, community-based, or faith-based
organizations) to carry out the duties of the
Coordinator.
``(3) Duties.--
``(A) In general.--The Coordinator shall have
primary responsibility for the oversight and
coordination of all activities of the United States
Government to combat the international HIV/AIDS
pandemic, including all programs, projects, and
activities of the United States Government related to
HIV/AIDS under the United States Emergency Plan for
HIV/AIDS Relief Act of 2003 or any amendment made by
such Act.
``(B) Specific duties.--The duties of the
Coordinator shall include the following:
``(i) Interagency coordination.--Ensuring
program and policy coordination among the
relevant executive branch agencies, including
audit and evaluation of all such programs.
``(ii) Nongovernmental organizations.--
Ensuring that any nongovernmental organization
(including a faith-based organization) seeking
to participate in a program subject to the
authority of the Coordinator--
(I) is not required to support or
perform elements of the program that
are contrary to the principles of such
organization and that such organization
will not be precluded, by not
participating in one aspect of a
program, from participating in any
other aspect of such program as long as
the failure of such organization to
participate in one aspect of the
program does not prejudice the
comprehensiveness and effectiveness of
the program or of the overall United
States effort to combat global HIV/
AIDS; and
(II) provides services on a non-
discriminatory basis to persons who are
eligible to participate in the program.
``(iii) Agency expertise.--Ensuring that
each relevant executive branch agency
undertakes programs primarily in those areas
where the agency has the most expertise,
technical capabilities, and potential for
success relative to other executive branch
agencies.
``(iv) Efficiency.--Avoiding duplication of
effort.
``(v) International coordination.--Pursuing
coordination with other countries and
international organizations.
``(vi) Disputes resolution.--Resolving
policy, program, and funding disputes among the
relevant executive branch agencies.
``(vii) Financial oversight.--Establishing
appropriate financial accounting criteria for
oversight of funds in the account established
by section 102(c) of the United States
Emergency Plan for AIDS Relief Act of 2003.
``(viii) Monitoring and evaluation of
outcomes.--Establishing appropriate monitoring
and evaluation criteria to assess the
measurable outcomes of all activities subject
to the authority of the Coordinator.
``(4) Definitions.--In this subsection:
``(A) AIDS.--The term `AIDS' means acquired immune
deficiency syndrome.
``(B) HIV.--The term `HIV' means the human
immunodeficiency virus, the pathogen that causes AIDS.
``(C) HIV/AIDS.--The term `HIV/AIDS' means the
disease characterized by HIV infection, or by HIV
infection and onset of AIDS.
``(D) Relevant executive branch agencies.--The term
`relevant executive branch agencies' means the
Department of State, the United States Agency for
International Development, the Department of Health and
Human Services, the Department of Labor, the Department
of Commerce, the Department of the Treasury, and the
Department of Defense.''.
(b) Resources.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of State shall designate the
necessary financial resources from funds authorized to be appropriated
under this Act, together with the personnel resources, that should be
assigned to and under the direct control of the Coordinator of United
States Government Activities to Combat HIV/AIDS Globally.
(c) Establishment of Separate Account.--There is established on the
books of the Treasury an account to be known as the Activities to
Combat HIV/AIDS Globally Fund, which shall be administered by the
Coordinator of United States Government Activities to Combat HIV/AIDS
Globally. There shall be deposited into the account all amounts made
available pursuant to section 105. Amounts in the Fund shall be
available for the purposes of this Act, and may be transferred to other
relevant executive branch agencies under the authority of section 632
of the Foreign Assistance Act of 1961 (22 U.S.C. 2392).
(d) Use of Funds.--Amounts authorized to be appropriated under
section 105 shall be distributed by the Coordinator of United States
Government Activities to Combat HIV/AIDS Globally in a manner so that--
(1) not less than 55 percent of such amounts are used for
activities related to the treatment of HIV with antiretroviral
therapies and treatment of symptoms and infections related to
HIV/AIDS; and
(2) any amounts not distributed for the activities
described in paragraph (1) are used for other activities
related to the provision of care, treatment, or support
services for individuals affected by HIV/AIDS, including
children orphaned by HIV/AIDS and caregivers of such children,
and activities related to the preventing the transmission of
HIV infection, including assistance to prevent the
such transmission from mothers to infants by providing medications and
infant formula or other alternatives for infant feeding that prevent
such transmission.
SEC. 103. COORDINATION WITH FOREIGN POLICY.
Nothing contained in this Act shall be construed to infringe upon
the powers and functions of the Secretary of State.
SEC. 104. REPORTING REQUIREMENTS.
(a) Annual Report.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, and annually thereafter, the
Coordinator of the United States Government Activities to
Combat HIV/AIDS Globally shall submit to the appropriate
congressional committees a report on the activities of the
United States Government to combat the global HIV/AIDS
pandemic.
(2) Content.--The report shall include the following
matters:
(A) An assessment of the progress made toward
implementing the strategy required by section 101.
(B) A discussion of the specific policies,
programs, and activities undertaken to implement the
strategy, including activities relevant to treatment
and to prevention of mother-to-child transmission of
HIV.
(C) An evaluation of the effectiveness of United
States assistance in achieving the purpose of the
assistance, including a discussion of any modifications
that should be made to the strategy required by section
101 to enhance its effectiveness.
(D) The amounts obligated, and the specific
programs and activities undertaken, by each relevant
executive branch agency to combat the global HIV/AIDS
pandemic, including entities receiving assistance under
section 104A of the Foreign Assistance Act of 1961, as
added by section 401(a)(2).
(E) The amounts of any grants awarded or funds
provided under a contract to nongovernmental
organizations (including nonprofit, community-based, or
faith-based organizations) by the Coordinator, pursuant
to section 1(f) of the State Department Basic
Authorities Act, as added by section 102(a)(2), and a
description of the use of such grants or funds.
(3) Public dissemination.--The Coordinator shall make
available to the public, through electronic media and other
publication mechanisms, a description of the use of assistance
received by a person pursuant to an application approved under
section 104A of the Foreign Assistance Act of 1961, as added by
section 401(a)(2), and any grant awarded or contract entered
into by the Coordinator under section 1 of the State Department
Basic Authorities Act, as amended by section 102(a), as
follows:
(A) For an application approved, grant awarded, or
contract entered into during the 9-month period
beginning on the date of the enactment of this Act, not
later than one year after such date.
(B) For an application approved, grant awarded, or
contract entered into after the 9-month period
beginning on the date of the enactment of this Act, not
later than 180 days after such application is approved.
(b) Report on Treatment Activities.--
(1) In general.--Not later than 15 months after the date of
the enactment of this Act, the Coordinator of the United States
Government Activities to Combat HIV/AIDS Globally shall submit
to the appropriate congressional committees a report on the
programs and activities of the relevant executive branch
agencies that are directed to the treatment of individuals in
foreign countries who are infected with HIV or living with
AIDS.
(2) Report elements.--The report described in paragraph (1)
shall include--
(A) a description of the activities of the relevant
executive branch agencies with respect to--
(i) the treatment of opportunistic
infections;
(ii) the use of antiretrovirals;
(iii) the status of research into
successful treatment protocols for individuals
in the developing world; and
(iv) technical assistance and training of
health care workers in foreign countries to
administer antiretrovirals, manage side
effects, and monitor patients viral loads and
immune status;
(B) information on existing demonstration projects,
including for each project a discussion of the reasons
a given population was selected to participate in the
project, the number of people treated, the cost of
treatment, the mechanisms established to ensure that
treatment is being administered effectively and safely,
and plans, if any, for expanding the demonstration
project, including projected schedules and the
necessary resources; and
(C) an explanation of how the activities and
projects described in subparagraphs (A) and (B) relate
to efforts to prevent the transmission of HIV
infection.
SEC. 105. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated $1,460,000,000 for fiscal
year 2004 and $1,610,000,000 for fiscal year 2005 for United States
Government programs and activities to combat HIV/AIDS globally,
including activities to carry out the Emergency Plan for AIDS Relief
announced by the President in January 2003. Funds made available under
this section may remain available until expended.
SEC. 106. AUTHORITY TO CONSOLIDATE AND COMBINE REPORTS.
Notwithstanding any other provision of this Act, the President may
consolidate or combine any report provided for under this Act, other
than the report required by section 101(c), with any other such report
in order to ensure an efficient use of resources. The President may
enter into contracts with organizations with relevant expertise to
develop, originate, or contribute to any such report.
TITLE II--PUBLIC-PRIVATE PARTNERSHIPS
SEC. 201. SENSE OF CONGRESS REGARDING PUBLIC-PRIVATE PARTNERSHIPS.
(a) Findings.--Congress makes the following findings:
(1) Innovative partnerships between governments and
organizations in the private sector (including foundations,
universities, corporations, nonprofit, community-based, or
faith-based organizations, or other nongovernmental
organizations) have proliferated, particularly in the area of
health.
(2) Public-private partnerships multiply local and
international capacities to strengthen the delivery of health
services in foreign countries and to accelerate research for
vaccines and other pharmaceutical products that are essential
to combat infectious diseases that can decimate populations.
(3) Public-private partnerships maximize the unique
capabilities of each of the public and private sectors while
combining financial and other resources, scientific knowledge,
and expertise toward common goals which neither the public nor
the private sector can achieve alone.
(4) Sustaining existing public-private partnerships 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.
(5) The Global Fund is a means for significantly
supplementing United States bilateral assistance programs by
funding programs and activities to combat HIV/AIDS,
tuberculosis, and malaria worldwide.
(b) Sense of Congress.--It is the sense of Congress that--
(1) the sustainment and promotion of public-private
partnerships should be an important element of the strategy
pursued by the United States to combat the HIV/AIDS pandemic
and other global health crises;
(2) the United States should systematically track the
evolution of these partnerships and work with others in the
public and private sectors, including nonprofit, community-
based, or faith-based organizations, to profile and build upon
partnership models that are most effective;
(3) the United States must demonstrate leadership in
multilateral efforts to fight the HIV/AIDS pandemic through
significant financial participation in the Global Fund and
other public-private partnerships;
(4) public-private partnerships should ensure that any
decisions of the partnerships that relate to the provision or
funding of health services are made in a manner that is open
and accountable to the public and to any governmental entity
that provides funding or assistance to the partnership; and
(5) the Global Fund should continue to have independent
audits that employ widely acceptable auditing standards and
practices of contributions to the Fund.
SEC. 202. PARTICIPATION IN THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS
AND MALARIA.
(a) Authority for United States Participation.--
(1) United states participation.--The United States is
authorized to participate in the Global Fund.
(2) Privileges and immunities.--The Global Fund shall be
considered a public international organization for purposes of
section 1 of the International Organizations Immunities Act (22
U.S.C. 288).
(b) Public Dissemination.--Not later than 180 days after the date
of the enactment of this Act, and regularly thereafter for the duration
of the Global Fund, the Coordinator of the United States Government
Activities to Combat HIV/AIDS Globally shall make available to the
public, through electronic media and other publication mechanisms, the
following documents:
(1) Any proposal approved for funding by the Global Fund.
(2) A list of all organizations that comprise each country
coordinating mechanism, as such mechanism is recognized by the
Global Fund.
(3) A list of all organizations that received funds from
the Global Fund, including the amount of such funds received by
each organization.
(c) Annual Report.--Not later than one year after the date of the
enactment of this Act, and annually thereafter, the Coordinator of the
United States Government Activities to Combat HIV/AIDS Globally shall
submit to the appropriate congressional committees a report on the
Global Fund. The report shall include, for the reporting period, the
following elements:
(1) Contributions pledged to or received by the Global Fund
(including donations from the private sector).
(2) Efforts made by the Global Fund to increase
contributions from all sources other than the United States.
(3) Programs funded by the Global Fund.
(4) An evaluation of the effectiveness of such programs.
(5) Recommendations regarding the adequacy of such
programs.
(d) United States Financial Participation.--
(1) Authorization of appropriations.--There are authorized
to be appropriated for United States contributions to the
Global Fund, in addition to any other amounts authorized to be
appropriated under any other provision of law for such purpose,
$1,000,000,000 for fiscal year 2004 and $1,200,000,000 for
fiscal year 2005.
(2) Availability of funds.--
(A) Certain fiscal year 2004 funds.--Of the amount
authorized to be appropriated by paragraph (1) for
fiscal year 2004, $500,000,000 shall be available only
if the Global Fund receives, during the period
beginning on April 1, 2003, and ending on March 31,
2004, pledges from all donors other than the United
States for funding new grant proposals in an amount not
less than $2,000,000,000.
(B) Certain fiscal year 2005 funds.--Of the amount
authorized to be appropriated by paragraph (1) for
fiscal year 2005, $600,000,000 shall be available only
if the Global Fund receives, during the period
beginning on April 1, 2004, and ending on March 31,
2005, pledges from all donors other than the United
States for funding new grant proposals in an amount not
less than $2,400,000,000.
(C) Receipt of pledges before period end.--If the
Global Fund receives in a period described in
subparagraph (A) or (B) the pledges described in such
subparagraph in the amount required by such
subparagraph as of a date before the end of such
period, the United States contribution specified in
such subparagraph shall be available as of such date.
(D) Availability of amounts.--Amounts authorized to
be appropriated by paragraph (1), and available under
that paragraph or this paragraph, shall remain
available until expended.
(3) Prior fiscal year funds.--Any unobligated balances of
funds made available for fiscal years 2001 and 2002 under
section 141 of the Global AIDS and Tuberculosis Relief Act of
2000 (22 U.S.C. 6841)--
(A) are authorized to remain available until
expended; and
(B) shall be merged with, and made available for
the same purposes as, the funds authorized to be
appropriated by paragraph (1).
SEC. 203. VOLUNTARY CONTRIBUTIONS TO INTERNATIONAL VACCINE FUNDS.
(a) Vaccine Fund.--Section 302 of the Foreign Assistance Act of
1961 (22 U.S.C. 2222) is amended by striking subsection (k) and
inserting the following:
``(k) There are authorized to be appropriated $70,000,000 for
fiscal year 2004 and $75,000,000 for fiscal year 2005 for United States
contributions to the Vaccine Fund.''.
(b) International AIDS Vaccine Initiative.--Section 302 of the
Foreign Assistance Act of 1961 (22 U.S.C. 2222) is amended by striking
subsection (l) and inserting the following:
``(l) There are authorized to be appropriated $20,000,000 for
fiscal year 2004 and $25,000,000 for fiscal year 2005 for United States
contributions to the International AIDS Vaccine Initiative.''.
(c) Malaria Vaccine Initiative of the Program for Appropriate
Technologies in Health (PATH).--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) There are authorized to be appropriated $5,000,000 for fiscal
year 2004 and $5,000,000 for fiscal year 2005 for United States
contributions to the Malaria Vaccine Initiative of the Program for
Appropriate Technologies in Health (PATH) are authorized to be made
available for that purpose.''.
TITLE III--MULTILATERAL EFFORTS
SEC. 301. AUTHORITY FOR DEBT RELIEF FOR QUALIFIED HIPC COUNTRIES.
The Secretary of the Treasury should immediately commence efforts
within the Paris Club of Official Creditors, the International Bank for
Reconstruction and Development, the International Monetary Fund, and
other appropriate multilateral development institutions to modify the
Enhanced HIPC Initiative so that the amount of debt stock reduction
approved for a country eligible for debt relief under the Enhanced HIPC
Initiative is sufficient to reduce, for each of the first 3 years after
the date of the enactment of this Act or the Decision Point, whichever
is later--
(1) the net present value of the outstanding public and
publicly guaranteed debt of the country to not more than 150
percent of the annual value of exports of the country for the
year preceding the Decision Point; and
(2) the annual payments due on such public and publicly
guaranteed debt to not more than--
(A) 10 percent or, in the case of a country
suffering a public health crisis, five percent of the
amount of the annual current revenues received by the
country from internal resources; or
(B) a percentage of the gross national product, or
another benchmark, that will yield a result
substantially equivalent to that which would be
achieved through application of subparagraph (A).
SEC. 302. SENSE OF CONGRESS REGARDING THE ENHANCED HIPC INITIATIVE.
(a) Sense of Congress Regarding Programs To Combat HIV/AIDS and
Poverty.--It is the sense of Congress that a country otherwise eligible
to receive cancellation of debt under the modifications to the Enhanced
HIPC Initiative described in section 301 should receive such
cancellation only if the country has agreed--
(1) to ensure that the financial benefits of debt
cancellation are applied to programs to combat HIV/AIDS and
poverty, in particular through concrete measures to improve
basic services in health, education, nutrition, and other
development priorities, and to redress environmental
degradation; and
(2) to ensure that the financial benefits of debt
cancellation are in addition to the higher of--
(A) the total amount spent by the government of
that country for poverty reduction for the year
preceding the year of the debt cancellation; or
(B) the amount equal to the average of the total of
the amounts spent annually by such government for each
of the 3 years preceding such year of debt
cancellation.
(b) Sense of Congress Regarding Source of Financing by
International Financial Institutions.--It is the sense of Congress
that, in financing the objectives of the Enhanced HIPC Initiative, an
international financial institution should give priority to using its
own resources for such purpose.
(c) Sense of Congress Regarding Conditions for Cancellation.--It is
the sense of Congress that a country should not be eligible for
cancellation of debt under modifications to the Enhanced HIPC
Initiative described in section 301 if the government of the country--
(1) has an excessive level of military expenditures;
(2) has repeatedly provided support for acts of
international terrorism, as determined by the Secretary of
State under section 6(j)(1) of the Export Administration Act of
1979 (50 U.S.C. App. 2405(j)(1)) or section 620A(a) of the
Foreign Assistance Act of 1961 (22 U.S.C. 2371(a));
(3) is failing to cooperate on international narcotics
control matters; or
(4) engages in a consistent pattern of gross violations of
internationally recognized human rights, including violations
by its military or other security forces.
SEC. 303. DEFINITIONS.
In this title:
(1) Country suffering a public health crisis.--The term
``country suffering a public health crisis'' means a country in
which the HIV infection rate, as reported in the most recent
epidemiological data for that country compiled by UNAIDS, is at
least five percent among women attending prenatal clinics or
more than 20 percent among individuals in groups with high-risk
behavior.
(2) Decision point.--The term ``Decision Point'', with
respect to a country, means the date on which the executive
boards of the International Bank for Reconstruction and
Development and the International Monetary Fund review the debt
sustainability analysis for a country and determine that the
country is eligible for debt relief under the Enhanced HIPC
Initiative.
(3) Enhanced hipc initiative.--The term ``Enhanced HIPC
Initiative'' means the multilateral debt initiative for heavily
indebted poor countries presented in the Report of G-7 Finance
Ministers on the Cologne Debt Initiative to the Cologne
Economic Summit, Cologne, held June 18-20, 1999.
SEC. 304. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--There are authorized to be appropriated for fiscal
year 2004 and for fiscal year 2005 such sums as may be necessary to
carry out this title.
(b) Availability of Funds.--Funds authorized to be appropriated
under subsection (a) may remain available until expended.
TITLE IV--BILATERAL EFFORTS
SEC. 401. ASSISTANCE TO COMBAT HIV/AIDS.
(a) Authority Under 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))--
(A) by striking paragraphs (4) through (7); and
(B) by adding at the end the following new
paragraphs:
``(4) Of the total amount made available to carry out this
subsection and sections 104A, 104B, and 104C in any fiscal year, not
more than 7 percent of such amount may be used for administrative
expenses. Amounts available for such expenses under the preceding
sentence shall be in addition to other amounts otherwise available for
such purposes.
``(5) Section 604(a) and all regulations and administrative rules
issued pursuant to that section do not apply to activities carried out
under this subsection and sections 104A, 104B, and 104C.
``(6) Assistance made available under this subsection and sections
104A, 104B, and 104C, and assistance made available under chapter 4 of
part II to carry out the purposes of this subsection and sections 104A,
104B, and 104C, may be made available in accordance with this
subsection and such other sections notwithstanding any other provision
of law.''; and
(2) by inserting after section 104 the following new
section:
``SEC. 104A. ASSISTANCE TO COMBAT HIV/AIDS.
``(a) Finding.--Congress recognizes that the alarming spread of
HIV/AIDS in countries in sub-Saharan Africa and the Caribbean region
and other countries is a pandemic that is a major global health,
national security, and humanitarian crisis.
``(b) Policy.--It is a major objective of the foreign HIV/AIDS
assistance program of the United States to provide assistance for the
prevention, care, treatment, and control of HIV/AIDS. The United States
and other countries should provide assistance to countries in sub-
Saharan Africa and the Caribbean region and other countries and areas
to control the HIV/AIDS pandemic through HIV/AIDS prevention, care,
treatment, monitoring, and related activities, including activities
focused on women and youth, and strategies to prevent mother-to-child
transmission of the HIV infection.
``(c) Authority.--
``(1) In general.--Consistent with section 104(c), the
President is authorized to furnish assistance related to HIV/
AIDS, on such terms and conditions as the President may
determine, including assistance to prevent, care for, treat,
and monitor HIV/AIDS, and to carry out related activities, in
countries in sub-Saharan Africa and the Caribbean region and in
other countries and areas.
``(2) Role of ngos.--It is the sense of Congress that the
President should provide an appropriate level of assistance
under paragraph (1) through nongovernmental organizations
(including nonprofit, community-based, or faith-based
organizations).
``(3) Coordination of assistance efforts.--The President
should coordinate the provision of assistance under paragraph
(1) with the provision of related assistance by the Joint
United Nations Programme on HIV/AIDS, the United Nations
Children's Fund, the World Health Organization, the United
Nations Development Programme, 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
development institutions, national, state, and local
governments of foreign countries, appropriate governmental and
nongovernmental organizations (including nonprofit, community-
based, or faith-based organizations), and relevant executive
branch agencies.
``(d) Activities Supported.--Assistance provided under subsection
(c) shall, to the maximum extent practicable, be used to carry out the
following activities:
``(1) Prevention.--Activities for the prevention of HIV/
AIDS, including--
``(A) education, voluntary testing, and counseling
programs with confidentiality protections, including--
``(i) education related to avoiding sexual
transmission of HIV infection, including the
use of the `ABC' model (abstinence, be
faithful, use condoms);
``(ii) education related to avoiding
nonsexual transmission of HIV infection,
including education that encourages abstention
from injection drug use and protection from
exposure to the virus from unsafe health-
related injections and other unsafe medical
practices; and
``(iii) voluntary HIV testing using rapid
testing protocols and the integration of such
testing activities into health care facilities
and programs;
``(B) assistance to ensure a safe blood supply and
the safety of health care workers, including--
``(i) the provision of, and training
regarding, appropriate testing materials and
pharmaceuticals;
``(ii) training in medical injection safety
procedures; and
``(iii) promotion of adherence to universal
precautions in medical settings;
``(C) the provision of post-exposure HIV infection
prophylaxis to victims of rape and sexual assault and
in cases of occupational exposure to health care
workers;
``(D) the provision of supplies, including test
kits, pharmaceuticals, and condoms;
``(E) assistance provided through nongovernmental
organizations (including nonprofit, community-based, or
faith-based organizations and, particularly,
organizations that utilize both professionals and
volunteers with appropriate skills and experience) to
establish and implement culturally appropriate HIV/AIDS
education and prevention programs;
``(F) programs to prevent the spread of HIV/AIDS by
focusing on the prevention or discouragement of rape,
sexual assault, prostitution, sex trafficking, the sex
industry, and the sexual exploitation of women;
``(G) assistance to prevent transmission of HIV
from mothers to infants, including the provision of
medications and infant formula and other alternatives
for infant feeding to prevent such transmission;
``(H) research on microbicides that prevent the
spread of HIV/AIDS; and
``(I) bulk purchases of safe and effective
prevention technologies for women, and the appropriate
program support for introduction and distribution of
such technologies, and education and training on the
use of the technologies.
``(2) Care and 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 pharmaceuticals and otherwise
provide for the treatment 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 families, and the
primary caregivers of such patients, including programs
that utilize nonprofit, community-based, or faith-based
organizations; and
``(C) assistance for the provision of care and
treatment for individuals with HIV/AIDS through the
distribution of pharmaceuticals, including
antiretrovirals and other pharmaceuticals and therapies
for the treatment of opportunistic infections,
nutritional support, and other treatment modalities.
``(3) Monitoring.--The monitoring of programs, projects,
and activities carried out pursuant to paragraphs (1) and (2),
including--
``(A) monitoring to ensure the adequacy of controls
established and implemented to provide HIV/AIDS
pharmaceuticals and other appropriate medicines to
individuals with HIV/AIDS; and
``(B) appropriate evaluation and surveillance
activities.
``(4) 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
sustainment of supply.--The establishment of mechanisms
to ensure the quality of the HIV/AIDS pharmaceuticals,
antiretroviral therapies, and other appropriate
medicines, and the sustainability of the supply of such
pharmaceuticals, therapies, and medicines.
``(C) Distribution.--The distribution of HIV/AIDS
pharmaceuticals, antiviral therapies, and other
appropriate medicines (including medicines to treat
opportunistic infections) to qualified national,
regional, or local organizations 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
infection.
``(5) Related activities.--The conduct of related
activities, including--
``(A) care and support for children who are
orphaned by the HIV/AIDS pandemic, including services
that are designed to care for orphaned children in a
family environment and rely on extended family members;
``(B) improved infrastructure and institutional
capacity to develop and manage education, prevention,
and treatment programs, including training and the
resources for collecting and maintaining 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 action for the
development of a safe, effective, accessible,
preventive HIV vaccine for use throughout the world.
``(e) 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 the disease
characterized by HIV infection, or by HIV infection and onset
of AIDS.
``(4) Relevant executive branch agencies.--The term
`relevant executive branch agencies' means the Department of
State, the United States Agency for International Development,
the Department of Health and Human Services, the Department of
Labor, the Department of Commerce, the Department of the
Treasury, and the Department of Defense.''.
(b) Availability of Funds.--
(1) In general.--Of the funds authorized to be appropriated
under section 105, $750,000,000 for fiscal year 2004 and
$800,000,000 for fiscal year 2005 are authorized to be made
available to carry out section 104A of the Foreign Assistance
Act of 1961, as added by subsection (a).
(2) Available until expended.--Funds made available under
paragraph (1) may remain available until expended.
(3) Prior fiscal year funds.--Any unobligated balances of
funds made available for fiscal years 2001, 2002, and 2003
under section 104(c)(6) of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b(c)(6)), as in effect immediately before the
date of the enactment of this Act, shall be merged with and
made available for the same purposes as the amounts made
available under paragraph (1).
SEC. 402. ASSISTANCE TO COMBAT TUBERCULOSIS.
(a) Authority Under 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 section 401, is further amended by inserting after
section 104A the following new section:
``SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.
``(a) Findings.--Congress makes the following findings:
``(1) Tuberculosis and the impact its continued existence
has on countries that had previously controlled the disease to
a substantial extent is a growing international problem.
``(2) The means exist to control and treat tuberculosis
through--
``(A) expanded use of the treatment strategy
recommended by the World Health Organization and known
as `Directly Observed Treatment Shortcourse'; and
``(B) adequate investment in newly created
mechanisms to increase access to treatment, including
the Global Tuberculosis Drug Facility.
``(b) Policy.--
``(1) In general.--It is a major objective of the foreign
assistance program of the United States to control
tuberculosis--
``(A) in those countries classified by the World
Health Organization as having among the highest
tuberculosis burden by December 31, 2005; and
``(B) in all countries in which the United States
Agency for International Development has established
development programs, by December 31, 2010.
``(2) Control of tuberculosis defined.--For the purposes of
paragraph (1), the term `control', with respect to tuberculosis
includes--
``(A) detection of at least 70 percent of the cases
of infectious tuberculosis; and
``(B) cure of at least 85 percent of the detected
cases of tuberculosis.
``(c) Authorization.--To carry out this section and consistent with
section 104(c), the President is authorized to furnish assistance, on
such terms and conditions as the President determines appropriate,
including assistance for the prevention, treatment, control, and
elimination of tuberculosis.
``(d) Priority to DOTS Coverage.--In furnishing assistance under
subsection (c), the President shall give priority to activities that
increase the use of the Directly Observed Treatment Shortcourse
coverage, including funding for the Global Tuberculosis Drug Facility
and the Stop Tuberculosis Partnership.
``(e) Coordination.--In carrying out this section, the President
should coordinate with the World Health Organization, the Global Fund,
the Department of Health and Human Services, and other organizations to
develop and implement a comprehensive tuberculosis control program.
``(f) Annual Report.--Not later than January 31 of each year, the
President shall submit to the Committee on Foreign Relations of the
Senate and the Committee on International Relations of the House of
Representatives a report that specifies any increase in the number of
persons treated for tuberculosis, and any increase in the number of
tuberculosis patients cured through each program, project, and activity
receiving United States foreign assistance for tuberculosis control
purposes.
``(g) Definitions.--In this section:
``(1) Global fund.--The term `Global Fund' means the
public-private partnership known as the Global Fund to Fight
AIDS, Tuberculosis and Malaria that was established under the
laws of Switzerland in January 2002.
``(2) Global tuberculosis drug facility.--The term `Global
Tuberculosis Drug Facility' means the initiative of the Stop
Tuberculosis Partnership established in 2001 to increase access
to high-quality tuberculosis drugs and to facilitate expansion
of the Directly Observed Treatment Shortcourse pursuant to the
Amsterdam Declaration to Stop TB, adopted at Amsterdam March
24, 2000.
``(3) Stop tuberculosis partnership.--The term `Stop
Tuberculosis Partnership' means the partnership of the World
Health Organization, donors including the United States, high
tuberculosis burden countries, multilateral agencies, and
nongovernmental and technical agencies committed to taking the
short-term and long-term measures necessary to control and
eventually eliminate tuberculosis as a public health problem in
the world.''.
(b) Authorization of Appropriations.--
(1) In general.--There are authorized to be appropriated
$150,000,000 for fiscal year 2004 and $170,000,000 for fiscal
year 2005 to carry out section 104B of the Foreign Assistance
Act of 1961, as added by subsection (a).
(2) Available until expended.--Funds authorized to be
appropriated under paragraph (1) may remain available until
expended.
(3) Prior fiscal year funds.--Any unobligated balances of
funds made available for fiscal years 2001, 2002, and 2003
under section 104(c)(7) of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b(c)(7)), as in effect immediately before the
date of the enactment of this Act, shall be merged with and made
available for the same purposes as the amounts authorized to be
appropriated under paragraph (1).
SEC. 403. ASSISTANCE TO COMBAT MALARIA.
(a) Authority Under 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 sections 401 and 402, is further amended by
inserting after section 104B the following new section:
``SEC. 104C. ASSISTANCE TO COMBAT MALARIA.
``(a) Finding.--Congress makes the following findings:
``(1) Malaria kills more people annually than any other
communicable disease except tuberculosis.
``(2) More than 90 percent of all malaria cases are in sub-
Saharan Africa.
``(3) Children and women have a particularly high risk of
contracting malaria.
``(4) Malaria is a curable disease if promptly diagnosed
and adequately treated.
``(5) There are cost-effective tools for decreasing the
spread of malaria.
``(b) Policy.--It is a major objective of the foreign assistance
program of the United States to provide assistance for the prevention,
control, and cure of malaria.
``(c) Authority.--To carry out this section and consistent with
section 104(c), the President is authorized to furnish assistance, on
such terms and conditions as the President determines appropriate,
including assistance for the prevention, treatment, control, and
elimination of malaria.
``(d) Coordination.--In carrying out this section, the President
should coordinate with the World Health Organization, the Global Fund,
the Department of Health and Human Services, and other organizations
(including nonprofit, community-based, or faith-based organizations)
with respect to the development and implementation of a comprehensive
malaria control program.
``(e) Global Fund Defined.--The term `Global Fund' has the meaning
give than term in subsection (g) of section 104B.''.
(b) Authorization of Appropriations.--
(1) In general.--There are authorized to be appropriated
$95,000,000 for fiscal year 2004 and $115,000,000 for fiscal
year 2005 to carry out section 104C of the Foreign Assistance
Act of 1961, as added by subsection (a).
(2) Available until expended.--Funds authorized to be
appropriated under paragraph (1) may remain available until
expended.
(3) Prior fiscal year funds.--Any unobligated balances of
funds made available for fiscal years 2001, 2002, and 2003
under section 104(c) of the Foreign Assistance Act of 1961 (22
U.S.C. 2151b(c)), as in effect immediately before the date of
the enactment of this Act, for the purpose of combatting
malaria shall be merged with and made available for the same
purposes as the amounts authorized to be appropriated under
paragraph (1).
SEC. 404. DEPARTMENT OF DEFENSE HIV/AIDS PREVENTION ASSISTANCE PROGRAM.
(a) Expansion of Program.--The Secretary of Defense, with the
approval of the Coordinator of the United States Government Activities
to Combat HIV/AIDS Globally, is authorized to expand, in accordance
with this section, the Department of Defense program of HIV/AIDS
prevention educational activities that are undertaken in connection
with the conduct of military training, military exercises, and
humanitarian assistance activities by the United States Armed Forces.
(b) Eligible Countries.--A country shall be eligible for activities
under this section if the country--
(1) is a country suffering a public health crisis; and
(2) participates in the military-to-military contacts
program of the Department of Defense.
(c) Program Activities.--The Secretary of Defense shall ensure that
the activities under the program--
(1) focus, to the extent practicable, on units of the Armed
Forces that participate in peacekeeping operations; and
(2) include HIV/AIDS-related voluntary counseling and
testing and HIV/AIDS-related surveillance.
(d) Country Suffering a Public Health Crisis Defined.--In this
section, the term ``country suffering a public health crisis'' means a
country that has a rapidly rising rates of incidence of HIV/AIDS or in
which HIV/AIDS is causing significant family, community, or societal
disruption, as determined by the Coordinator of the United States
Government Activities to Combat HIV/AIDS Globally.
TITLE V--BUSINESS PRINCIPLES
SEC. 501. FINDINGS.
Congress finds that the global spread of HIV/AIDS presents not only
a health crisis but also a crisis in the workplace that affects--
(1) the productivity, earning power, and longevity of
individual workers;
(2) the productivity, competitiveness, and financial
solvency of individual businesses; and
(3) the economic productivity and development of
communities and the world as a whole.
SEC. 502. SENSE OF CONGRESS REGARDING PRINCIPLES FOR UNITED STATES
FIRMS OPERATING IN COUNTRIES AFFECTED BY THE HIV/AIDS
PANDEMIC.
It is the sense of Congress that United States firms operating in
countries affected by the HIV/AIDS pandemic are in a position to make
significant contributions to the United States effort to respond to the
HIV/AIDS pandemic through the voluntary adoption of the principles and
practices described in section 503.
SEC. 503. PRINCIPLES AND PRACTICES.
The principles and practices referred to in section 502 are as
follows:
(1) The application of the same employment and health
policies and practices to persons infected with HIV or living
with AIDS as apply to persons afflicted with any other illness.
(2) The promotion of policies and practices that eliminate
discrimination and stigmatization against employees on the
basis of real or perceived HIV/AIDS status, including policies
and practices that provide for--
(A) assessing employees on merit and ability to
perform;
(B) not subjecting employees to personal
discrimination or abuse; and
(C) imposing disciplinary measures where
discrimination occurs.
(3) A prohibition on compulsory HIV/AIDS testing as a
condition for employment, recruitment, promotion, or career
development.
(4) An assurance of the confidentiality of an employee's
HIV/AIDS status.
(5) Permission for an employee with an HIV/AIDS-related
illness to work as long as the employee is medically fit and,
when no longer able to work and sick leave has been exhausted,
an assurance that the employment relationship is to be
terminated in accordance with applicable antidiscrimination and
labor laws and the general procedures and benefit policies of
the employer.
(6) An assurance that employment practices comply, at a
minimum, with national and international employment and labor
laws and codes.
(7) Involvement of employees and individuals infected with
HIV or living with AIDS, drawn from the workplace or the
community, in the development and assessment of HIV/AIDS
policies and programs for the workplace.
(8) An offer to all employees of access to culturally
appropriate preventive education programs and services to
support those programs.
(9) An assurance that programs offered in the workplace
support and are integrated into larger community-based
responses to the problems posed by HIV/AIDS.
(10) Cooperation with community leaders to expand the
availability of treatment for employees and others infected
with HIV or living with AIDS.
Calendar No. 88
108th CONGRESS
1st Session
S. 1009
_______________________________________________________________________
A BILL
To amend the Foreign Assistance Act of 1961 and the State Department
Basic Authorities Act of 1956 to increase assistance for foreign
countries seriously affected by HIV/AIDS, tuberculosis, and malaria,
and for other purposes.
_______________________________________________________________________
May 8, 2003
Read the second time and placed on the calendar