[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3519 Engrossed Amendment Senate (EAS)]
In the Senate of the United States,
July 26, 2000.
Resolved, That the bill from the House of Representatives (H.R.
3519) entitled ``An Act to provide for negotiations for the creation of
a trust fund to be administered by the International Bank for
Reconstruction and Development or the International Development
Association to combat the AIDS epidemic.'', do pass with the following
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Global AIDS and Tuberculosis Relief
Act of 2000''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING HIV/AIDS
Sec. 101. Short title.
Sec. 102. Definitions.
Sec. 103. Findings and purposes.
Subtitle A--United States Assistance
Sec. 111. Additional assistance authorities to combat HIV and AIDS.
Sec. 112. Voluntary contribution to Global Alliance for Vaccines and
Immunizations and International AIDS
Vaccine Initiative.
Sec. 113. Coordinated donor strategy for support and education of
orphans in sub-Saharan Africa.
Sec. 114. African Crisis Response Initiative and HIV/AIDS training.
Subtitle B--World Bank AIDS Trust Fund
Chapter 1--Establishment of the Fund
Sec. 121. Establishment.
Sec. 122. Grant authorities.
Sec. 123. Administration.
Sec. 124. Advisory Board.
Chapter 2--Reports
Sec. 131. Reports to Congress.
Chapter 3--United States Financial Participation
Sec. 141. Authorization of appropriations.
Sec. 142. Certification requirement.
TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL
Sec. 201. Short title.
Sec. 202. Findings.
Sec. 203. Assistance for tuberculosis prevention, treatment, control,
and elimination.
TITLE III--ADMINISTRATIVE AUTHORITIES
Sec. 301. Effective program oversight.
Sec. 302. Termination expenses.
TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING HIV/AIDS
SEC. 101. SHORT TITLE.
This title may be cited as the ``Global AIDS Research and Relief
Act of 2000''.
SEC. 102. DEFINITIONS.
In this title:
(1) AIDS.--The term ``AIDS'' means the acquired immune
deficiency syndrome.
(2) Association.--The term ``Association'' means the
International Development Association.
(3) Bank.--The term ``Bank'' or ``World Bank'' means the
International Bank for Reconstruction and Development.
(4) HIV.--The term ``HIV'' means the human immunodeficiency
virus, the pathogen which causes AIDS.
(5) HIV/AIDS.--The term ``HIV/AIDS'' means, with respect to
an individual, an individual who is infected with HIV or living
with AIDS.
SEC. 103. FINDINGS AND PURPOSES.
(a) Findings.--Congress makes the following findings:
(1) According to the Surgeon General of the United States,
the epidemic of human immunodeficiency virus/acquired immune
deficiency syndrome (HIV/AIDS) will soon become the worst
epidemic of infectious disease in recorded history, eclipsing
both the bubonic plague of the 1300's and the influenza
epidemic of 1918-1919 which killed more than 20,000,000 people
worldwide.
(2) According to the Joint United Nations Programme on HIV/
AIDS (UNAIDS), more than 34,300,000 people in the world today
are living with HIV/AIDS, of which approximately 95 percent
live in the developing world.
(3) UNAIDS data shows that among children age 14 and under
worldwide, more than 3,800,000 have died from AIDS, more than
1,300,000 are living with the disease; and in one year alone--
1999--an estimated 620,000 became infected, of which over 90
percent were babies born to HIV-positive women.
(4) Although sub-Saharan Africa has only 10 percent of the
world's population, it is home to more than 24,500,000--roughly
70 percent--of the world's HIV/AIDS cases.
(5) Worldwide, there have already been an estimated
18,800,000 deaths because of HIV/AIDS, of which more than 80
percent occurred in sub-Saharan Africa.
(6) The gap between rich and poor countries in terms of
transmission of HIV from mother to child has been increasing.
Moreover, AIDS threatens to reverse years of steady progress of
child survival in developing countries. UNAIDS believes that by
the year 2010, AIDS may have increased mortality of children
under 5 years of age by more than 100 percent in regions most
affected by the virus.
(7) According to UNAIDS, by the end of 1999, 13,200,000
children have lost at least one parent to AIDS, including
12,100,000 children in sub-Saharan Africa, and are thus
considered AIDS orphans.
(8) At current infection and growth rates for HIV/AIDS, the
National Intelligence Council estimates that the number of AIDS
orphans worldwide will increase dramatically, potentially
increasing threefold or more in the next 10 years, contributing
to economic decay, social fragmentation, and political
destabilization in already volatile and strained societies.
Children without care or hope are often drawn into
prostitution, crime, substance abuse, or child soldiery.
(9) Donors must focus on adequate preparations for the
explosion in the number of orphans and the burden they will
place on families, communities, economies, and governments.
Support structures and incentives for families, communities,
and institutions which will provide care for children orphaned
by HIV/AIDS, or for the children who are themselves afflicted
by HIV/AIDS, will be essential.
(10) The 1999 annual report by the United Nations
Children's Fund (UNICEF) states ``[t]he number of orphans,
particularly in Africa, constitutes nothing less than an
emergency, requiring an emergency response'' and that ``finding
the resources needed to help stabilize the crisis and protect
children is a priority that requires urgent action from the
international community.''.
(11) The discovery of a relatively simple and inexpensive
means of interrupting the transmission of HIV from an infected
mother to the unborn child--namely with nevirapine (NVP), which
costs US$4 a tablet--has created a great opportunity for an
unprecedented partnership between the United States Government
and the governments of Asian, African and Latin American
countries to reduce mother-to-child transmission (also known as
``vertical transmission'') of HIV.
(12) According to UNAIDS, if implemented this strategy will
decrease the proportion of orphans that are HIV-infected and
decrease infant and child mortality rates in these developing
regions.
(13) A mother-to-child antiretroviral drug strategy can be
a force for social change, providing the opportunity and
impetus needed to address often long-standing problems of
inadequate services and the profound stigma associated with
HIV-infection and the AIDS disease. Strengthening the health
infrastructure to improve mother-and-child health, antenatal,
delivery and postnatal services, and couples counseling
generates enormous spillover effects toward combating the AIDS
epidemic in developing regions.
(14) United States Census Bureau statistics show life
expectancy in sub-Saharan Africa falling to around 30 years of
age within a decade, the lowest in a century, and project life
expectancy in 2010 to be 29 years of age in Botswana, 30 years
of age in Swaziland, 33 years of age in Namibia and Zimbabwe,
and 36 years of age in South Africa, Malawi, and Rwanda, in
contrast to a life expectancy of 70 years of age in many of the
countries without a high prevalence of AIDS.
(15) A January 2000 United States National Intelligence
Estimate (NIE) report on the global infectious disease threat
concluded that the economic costs of infectious diseases--
especially HIV/AIDS--are already significant and could reduce
GDP by as much as 20 percent or more by 2010 in some sub-
Saharan African nations.
(16) According to the same NIE report, HIV prevalence among
militias in Angola and the Democratic Republic of the Congo are
estimated at 40 to 60 percent, and at 15 to 30 percent in
Tanzania.
(17) The HIV/AIDS epidemic is of increasing concern in
other regions of the world, with UNAIDS estimating that there
are more than 5,600,000 cases in South and South-east Asia,
that the rate of HIV infection in the Caribbean is second only
to sub-Saharan Africa, and that HIV infections have doubled in
just two years in the former Soviet Union.
(18) Despite the discouraging statistics on the spread of
HIV/AIDS, some developing nations--such as Uganda, Senegal, and
Thailand--have implemented prevention programs that have
substantially curbed the rate of HIV infection.
(19) AIDS, like all diseases, knows no national boundaries,
and there is no certitude that the scale of the problem in one
continent can be contained within that region.
(20) Accordingly, United States financial support for
medical research, education, and disease containment as a
global strategy has beneficial ramifications for millions of
Americans and their families who are affected by this disease,
and the entire population which is potentially susceptible.
(b) Purposes.--The purposes of this title are to--
(1) help prevent human suffering through the prevention,
diagnosis, and treatment of HIV/AIDS; and
(2) help ensure the viability of economic development,
stability, and national security in the developing world by
advancing research to--
(A) understand the causes associated with HIV/AIDS
in developing countries; and
(B) assist in the development of an AIDS vaccine.
Subtitle A--United States Assistance
SEC. 111. ADDITIONAL ASSISTANCE AUTHORITIES TO COMBAT HIV AND AIDS.
(a) Assistance for Prevention of HIV/AIDS and Vertical
Transmission.--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 new
paragraphs:
``(4)(A) Congress recognizes the growing international dilemma of
children with the human immunodeficiency virus (HIV) and the merits of
intervention programs aimed at this problem. Congress further
recognizes that mother-to-child transmission prevention strategies can
serve as a major force for change in developing regions, and it is,
therefore, a major objective of the foreign assistance program to
control the acquired immune deficiency syndrome (AIDS) epidemic.
``(B) The agency primarily responsible for administering this part
shall--
``(i) coordinate with UNAIDS, UNICEF, WHO, national and
local governments, and other organizations to develop and
implement effective strategies to prevent vertical transmission
of HIV; and
``(ii) coordinate with those organizations to increase
intervention programs and introduce voluntary counseling and
testing, antiretroviral drugs, replacement feeding, and other
strategies.
``(5)(A) Congress expects the agency primarily responsible for
administering this part to make the human immunodeficiency virus (HIV)
and the acquired immune deficiency syndrome (AIDS) a priority in the
foreign assistance program and to undertake a comprehensive,
coordinated effort to combat HIV and AIDS.
``(B) Assistance described in subparagraph (A) shall include help
providing--
``(i) primary prevention and education;
``(ii) voluntary testing and counseling;
``(iii) medications to prevent the transmission of HIV from
mother to child; and
``(iv) care for those living with HIV or AIDS.
``(6)(A) In addition to amounts otherwise available for such
purpose, there is authorized to be appropriated to the President
$300,000,000 for each of the fiscal years 2001 and 2002 to carry out
paragraphs (4) and (5).
``(B) Of the funds authorized to be appropriated under subparagraph
(A), not less than 65 percent is authorized to be available through
United States and foreign nongovernmental organizations, including
private and voluntary organizations, for-profit organizations,
religious affiliated organizations, educational institutions, and
research facilities.
``(C)(i) Of the funds authorized to be appropriated by subparagraph
(A), not less than 20 percent is authorized to be available for
programs as part of a multidonor strategy to address the support and
education of orphans in sub-Saharan Africa, including AIDS orphans.
``(ii) Assistance made available under this subsection, and
assistance made available under chapter 4 of part II to carry out the
purposes of this subsection, may be made available notwithstanding any
other provision of law that restricts assistance to foreign countries.
``(D) Of the funds authorized to be appropriated under subparagraph
(A), not less than 8.3 percent is authorized to be available to carry
out the prevention strategies for vertical transmission referred to in
paragraph (4)(A).
``(E) Of the funds authorized to be appropriated by subparagraph
(A), not more than 7 percent may be used for the administrative
expenses of the agency primarily responsible for carrying out this part
of this Act in support of activities described in paragraphs (4) and
(5).
``(F) Funds appropriated under this paragraph are authorized to
remain available until expended.''.
(b) Training and Training Facilities in Sub-Saharan Africa.--
Section 496(i)(2) of the Foreign Assistance Act of 1961 (22 U.S.C.
2293(i)(2)) is amended by adding at the end the following new sentence:
``In addition, providing training and training facilities, in sub-
Saharan Africa, for doctors and other health care providers,
notwithstanding any provision of law that restricts assistance to
foreign countries.''.
SEC. 112. VOLUNTARY CONTRIBUTION TO GLOBAL ALLIANCE FOR VACCINES AND
IMMUNIZATIONS AND INTERNATIONAL AIDS VACCINE INITIATIVE.
(a) Authorization of Appropriations.--Section 302 of the Foreign
Assistance Act of 1961 (22 U.S.C. 2222) is amended by adding at the end
the following new subsections:
``(k) In addition to amounts otherwise available under this
section, there is authorized to be appropriated to the President
$50,000,000 for each of the fiscal years 2001 and 2002 to be available
only for United States contributions to the Global Alliance for
Vaccines and Immunizations.
``(l) In addition to amounts otherwise available under this
section, there is authorized to be appropriated to the President
$10,000,000 for each of the fiscal years 2001 and 2002 to be available
only for United States contributions to the International AIDS Vaccine
Initiative.''.
(b) Report.--At the close of fiscal year 2001, the President shall
submit a report to the appropriate congressional committees on the
effectiveness of the Global Alliance for Vaccines and Immunizations and
the International AIDS Vaccine Initiative during that fiscal year in
meeting the goals of--
(1) improving access to sustainable immunization services;
(2) expanding the use of all existing, safe, and cost-
effective vaccines where they address a public health problem;
(3) accelerating the development and introduction of new
vaccines and technologies;
(4) accelerating research and development efforts for
vaccines needed primarily in developing countries; and
(5) making immunization coverage a centerpiece in
international development efforts.
(c) Appropriate Congressional Committees Defined.--In subsection
(b), the term ``appropriate congressional committees'' means the
Committee on Foreign Relations and the Committee on Appropriations of
the Senate and the Committee on International Relations and the
Committee on Appropriations of the House of Representatives.
SEC. 113. COORDINATED DONOR STRATEGY FOR SUPPORT AND EDUCATION OF
ORPHANS IN SUB-SAHARAN AFRICA.
(a) Statement of Policy.--It is in the national interest of the
United States to assist in mitigating the burden that will be placed on
sub-Saharan African social, economic, and political institutions as
these institutions struggle with the consequences of a dramatically
increasing AIDS orphan population, many of whom are themselves infected
by HIV and living with AIDS. Effectively addressing that burden and its
consequences in sub-Saharan Africa will require a coordinated
multidonor strategy.
(b) Development of Strategy.--The President shall coordinate the
development of a multidonor strategy to provide for the support and
education of AIDS orphans and the families, communities, and
institutions most affected by the HIV/AIDS epidemic in sub-Saharan
Africa.
(c) Definition.--In this section, the term ``HIV/AIDS'' means, with
respect to an individual, an individual who is infected with the human
immunodeficiency virus (HIV), the pathogen that causes the acquired
immune deficiency virus (AIDS), or living with AIDS.
SEC. 114. AFRICAN CRISIS RESPONSE INITIATIVE AND HIV/AIDS TRAINING.
(a) Findings.--Congress finds that--
(1) the spread of HIV/AIDS constitutes a threat to security
in Africa;
(2) civil unrest and war may contribute to the spread of
the disease to different parts of the continent;
(3) the percentage of soldiers in African militaries who
are infected with HIV/AIDS is unknown, but estimates range in
some countries as high as 40 percent; and
(4) it is in the interests of the United States to assist
the countries of Africa in combating the spread of HIV/AIDS.
(b) Education on the Prevention of the Spread of AIDS.--In
undertaking education and training programs for military establishments
in African countries, the United States shall ensure that classroom
training under the African Crisis Response Initiative includes
military-based education on the prevention of the spread of AIDS.
Subtitle B--World Bank AIDS Trust Fund
CHAPTER 1--ESTABLISHMENT OF THE FUND
SEC. 121. ESTABLISHMENT.
(a) Negotiations for Establishment of Trust Fund.--The Secretary of
the Treasury shall seek to enter into negotiations with the World Bank
or the Association, in consultation with the Administrator of the
United States Agency for International Development and other United
States Government agencies, and with the member nations of the World
Bank or the Association and with other interested parties, for the
establishment within the World Bank of--
(1) the World Bank AIDS Trust Fund (in this subtitle
referred to as the ``Trust Fund'') in accordance with the
provisions of this chapter; and
(2) the Advisory Board to the Trust Fund in accordance with
section 124.
(b) Purpose.--The purpose of the Trust Fund should be to use
contributed funds to--
(1) assist in the prevention and eradication of HIV/AIDS
and the care and treatment of individuals infected with HIV/
AIDS; and
(2) provide support for the establishment of programs that
provide health care and primary and secondary education for
children orphaned by the HIV/AIDS epidemic.
(c) Composition.--
(1) In general.--The Trust Fund should be governed by a
Board of Trustees, which should be composed of representatives
of the participating donor countries to the Trust Fund.
Individuals appointed to the Board should have demonstrated
knowledge and experience in the fields of public health,
epidemiology, health care (including delivery systems), and
development.
(2) United states representation.--
(A) In general.--Upon the effective date of this
paragraph, there shall be a United States member of the
Board of Trustees, who shall be appointed by the
President, by and with the advice and consent of the
Senate, and who shall have the qualifications described
in paragraph (1).
(B) Effective and termination dates.--
(i) Effective date.--This paragraph shall
take effect upon the date the Secretary of the
Treasury certifies to Congress that an
agreement establishing the Trust Fund and
providing for a United States member of the
Board of Trustees is in effect.
(ii) Termination date.--The position
established by subparagraph (A) is abolished
upon the date of termination of the Trust Fund.
SEC. 122. GRANT AUTHORITIES.
(a) Program objectives.--
(1) In general.--In carrying out the purpose of section
121(b), the Trust Fund, acting through the Board of Trustees,
should provide only grants, including grants for technical
assistance to support measures to build local capacity in
national and local government, civil society, and the private
sector to lead and implement effective and affordable HIV/AIDS
prevention, education, treatment and care services, and
research and development activities, including access to
affordable drugs.
(2) Activities supported.--Among the activities the Trust
Fund should provide grants for should be--
(A) programs to promote the best practices in
prevention, including health education messages that
emphasize risk avoidance such as abstinence;
(B) measures to ensure a safe blood supply;
(C) voluntary HIV/AIDS testing and counseling;
(D) measures to stop mother-to-child transmission
of HIV/AIDS, including through diagnosis of pregnant
women, access to cost-effective treatment and
counseling, and access to infant formula or other
alternatives for infant feeding;
(E) programs to provide for the support and
education of AIDS orphans and the families,
communities, and institutions most affected by the HIV/
AIDS epidemic;
(F) measures for the deterrence of gender-based
violence and the provision of post-exposure prophylaxis
to victims of rape and sexual assault; and
(G) incentives to promote affordable access to
treatments against AIDS and related infections.
(3) Implementation of program objectives.--In carrying out
the objectives of paragraph (1), the Trust Fund should
coordinate its activities with governments, civil society,
nongovernmental organizations, the Joint United Nations Program
on HIV/AIDS (UNAIDS), the International Partnership Against
AIDS in Africa, other international organizations, the private
sector, and donor agencies working to combat the HIV/AIDS
crisis.
(b) Priority.--In providing grants under this section, the Trust
Fund should give priority to countries that have the highest HIV/AIDS
prevalence rate or are at risk of having a high HIV/AIDS prevalence
rate.
(c) Eligible Grant Recipients.--Governments and nongovernmental
organizations should be eligible to receive grants under this section.
(d) Prohibition.--The Trust Fund should not make grants for the
purpose of project development associated with bilateral or
multilateral bank loans.
SEC. 123. ADMINISTRATION.
(a) Appointment of an Administrator.--The Board of Trustees, in
consultation with the appropriate officials of the Bank, should appoint
an Administrator who should be responsible for managing the day-to-day
operations of the Trust Fund.
(b) Authority to Solicit and Accept Contributions.--The Trust Fund
should be authorized to solicit and accept contributions from
governments, the private sector, and nongovernmental entities of all
kinds.
(c) Accountability of Funds and Criteria for Programs.--As part of
the negotiations described in section 121(a), the Secretary of the
Treasury shall, consistent with subsection (d)--
(1) take such actions as are necessary to ensure that the
Bank or the Association will have in effect adequate procedures
and standards to account for and monitor the use of funds
contributed to the Trust Fund, including the cost of
administering the Trust Fund; and
(2) seek agreement on the criteria that should be used to
determine the programs and activities that should be assisted
by the Trust Fund.
(d) Selection of projects and recipients.--The Board of Trustees
should establish--
(1) criteria for the selection of projects to receive
support from the Trust Fund;
(2) standards and criteria regarding qualifications of
recipients of such support;
(3) such rules and procedures as may be necessary for cost-
effective management of the Trust Fund; and
(4) such rules and procedures as may be necessary to ensure
transparency and accountability in the grant-making process.
(e) Transparency of operations.--The Board of Trustees should
ensure full and prompt public disclosure of the proposed objectives,
financial organization, and operations of the Trust Fund.
SEC. 124. ADVISORY BOARD.
(a) In General.--There should be an Advisory Board to the Trust
Fund.
(b) Appointments.--The members of the Advisory Board should be
drawn from--
(1) a broad range of individuals with experience and
leadership in the fields of development, health care
(especially HIV/AIDS), epidemiology, medicine, biomedical
research, and social sciences; and
(2) representatives of relevant United Nations agencies and
nongovernmental organizations with on-the-ground experience in
affected countries.
(c) Responsibilities.--The Advisory Board should provide advice and
guidance to the Board of Trustees on the development and implementation
of programs and projects to be assisted by the Trust Fund and on
leveraging donations to the Trust Fund.
(d) Prohibition on Payment of Compensation.--
(1) In general.--Except for travel expenses (including per
diem in lieu of subsistence), no member of the Advisory Board
should receive compensation for services performed as a member
of the Board.
(2) United states representative.--Notwithstanding any
other provision of law (including an international agreement),
a representative of the United States on the Advisory Board may
not accept compensation for services performed as a member of
the Board, except that such representative may accept travel
expenses, including per diem in lieu of subsistence, while away
from the representative's home or regular place of business in
the performance of services for the Board.
CHAPTER 2--REPORTS
SEC. 131. REPORTS TO CONGRESS.
(a) Annual Reports by Treasury Secretary.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, and annually thereafter for the duration
of the Trust Fund, the Secretary of the Treasury shall submit
to the appropriate committees of Congress a report on the Trust
Fund.
(2) Report elements.--The report shall include a
description of--
(A) the goals of the Trust Fund;
(B) the programs, projects, and activities,
including any vaccination approaches, supported by the
Trust Fund;
(C) private and governmental contributions to the
Trust Fund; and
(D) the criteria that have been established,
acceptable to the Secretary of the Treasury and the
Administrator of the United States Agency for
International Development, that would be used to
determine the programs and activities that should be
assisted by the Trust Fund.
(b) GAO Report on Trust Fund Effectiveness.--Not later than 2 years
after the date of enactment of this Act, the Comptroller General of the
United States shall submit to the appropriate committees of the
Congress a report evaluating the effectiveness of the Trust Fund,
including--
(1) the effectiveness of the programs, projects, and
activities described in subsection (a)(2)(B) in reducing the
worldwide spread of AIDS; and
(2) an assessment of the merits of continued United States
financial contributions to the Trust Fund.
(c) Appropriate Committees Defined.--In subsection (a), the term
``appropriate committees'' means the Committee on Foreign Relations and
the Committee on Appropriations of the Senate and the Committee on
International Relations, the Committee on Banking and Financial
Services, and the Committee on Appropriations of the House of
Representatives.
CHAPTER 3--UNITED STATES FINANCIAL PARTICIPATION
SEC. 141. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--In addition to any other funds authorized to be
appropriated for multilateral or bilateral programs related to HIV/AIDS
or economic development, there is authorized to be appropriated to the
Secretary of the Treasury $150,000,000 for each of the fiscal years
2001 and 2002 for payment to the Trust Fund.
(b) Allocation of Funds.--Of the amounts authorized to be
appropriated by subsection (a) for the fiscal years 2001 and 2002,
$50,000,000 are authorized to be available each such fiscal year only
for programs that benefit orphans.
SEC. 142. CERTIFICATION REQUIREMENT.
(a) In General.--Prior to the initial obligation or expenditure of
funds appropriated pursuant to section 141, the Secretary of the
Treasury shall certify that adequate procedures and standards have been
established to ensure accountability for and monitoring of the use of
funds contributed to the Trust Fund, including the cost of
administering the Trust Fund.
(b) Transmittal of Certification.--The certification required by
subsection (a), and the bases for that certification, shall be
submitted by the Secretary of the Treasury to Congress.
TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL
SEC. 201. SHORT TITLE.
This title may be cited as the ``International Tuberculosis Control
Act of 2000''.
SEC. 202. FINDINGS.
Congress makes the following findings:
(1) Since the development of antibiotics in the 1950s,
tuberculosis has been largely controlled in the United States
and the Western World.
(2) Due to societal factors, including growing urban decay,
inadequate health care systems, persistent poverty,
overcrowding, and malnutrition, as well as medical factors,
including the HIV/AIDS epidemic and the emergence of multi-drug
resistant strains of tuberculosis, tuberculosis has again
become a leading and growing cause of adult deaths in the
developing world.
(3) According to the World Health Organization--
(A) in 1998, about 1,860,000 people worldwide died
of tuberculosis-related illnesses;
(B) one-third of the world's total population is
infected with tuberculosis; and
(C) tuberculosis is the world's leading killer of
women between 15 and 44 years old and is a leading
cause of children becoming orphans.
(4) Because of the ease of transmission of tuberculosis,
its international persistence and growth pose a direct public
health threat to those nations that had previously largely
controlled the disease. This is complicated in the United
States by the growth of the homeless population, the rate of
incarceration, international travel, immigration, and HIV/AIDS.
(5) With nearly 40 percent of the tuberculosis cases in the
United States attributable to foreign-born persons,
tuberculosis will never be controlled in the United States
until it is controlled abroad.
(6) The means exist to control tuberculosis through
screening, diagnosis, treatment, patient compliance,
monitoring, and ongoing review of outcomes.
(7) Efforts to control tuberculosis are complicated by
several barriers, including--
(A) the labor intensive and lengthy process
involved in screening, detecting, and treating the
disease;
(B) a lack of funding, trained personnel, and
medicine in virtually every nation with a high rate of
the disease;
(C) the unique circumstances in each country, which
requires the development and implementation of country-
specific programs; and
(D) the risk of having a bad tuberculosis program,
which is worse than having no tuberculosis program
because it would significantly increase the risk of the
development of more widespread drug-resistant strains
of the disease.
(8) Eliminating the barriers to the international control
of tuberculosis through a well-structured, comprehensive, and
coordinated worldwide effort would be a significant step in
dealing with the increasing public health problem posed by the
disease.
SEC. 203. ASSISTANCE FOR TUBERCULOSIS PREVENTION, TREATMENT, CONTROL,
AND ELIMINATION.
Section 104(c) of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b(c)), as amended by section 111(a) of this Act, is further amended
by adding at the end the following:
``(7)(A) Congress recognizes the growing international problem of
tuberculosis and the impact its continued existence has on those
nations that had previously largely controlled the disease. Congress
further recognizes that the means exist to control and treat
tuberculosis, and that it is therefore a major objective of the foreign
assistance program to control the disease. To this end, Congress
expects the agency primarily responsible for administering this part--
``(i) to coordinate with the World Health Organization, the
Centers for Disease Control, the National Institutes of Health,
and other organizations toward the development and
implementation of a comprehensive tuberculosis control program;
and
``(ii) to set as a goal 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, in those
countries in which the agency has established development
programs, by December 31, 2010.
``(B) There is authorized to be appropriated to the President,
$60,000,000 for each of the fiscal years 2001 and 2002 to be used to
carry out this paragraph. Funds appropriated under this subparagraph
are authorized to remain available until expended.''.
TITLE III--ADMINISTRATIVE AUTHORITIES
SEC. 301. EFFECTIVE PROGRAM OVERSIGHT.
Section 635 of the Foreign Assistance Act of 1961 (22 U.S.C. 2395)
is amended by adding at the end thereof the following new subsection:
``(l) The Administrator of the agency primarily responsible for
administering part I may use funds made available under that part to
provide program and management oversight for activities that are funded
under that part and that are conducted in countries in which the agency
does not have a field mission or office.''.
SEC. 302. TERMINATION EXPENSES.
Section 617 of the Foreign Assistance Act of 1961 (22 U.S.C. 2367)
is amended to read as follows:
``SEC. 617. TERMINATION EXPENSES.
``(a) In General.--Funds made available under this Act and the Arms
Export Control Act, may remain available for obligation for a period
not to exceed 8 months from the date of any termination of assistance
under such Acts for the necessary expenses of winding up programs
related to such termination and may remain available until expended.
Funds obligated under the authority of such Acts prior to the effective
date of the termination of assistance may remain available for
expenditure for the necessary expenses of winding up programs related
to such termination notwithstanding any provision of law restricting
the expenditure of funds. In order to ensure the effectiveness of such
assistance, such expenses for orderly termination of programs may
include the obligation and expenditure of funds to complete the
training or studies outside their countries of origin of students whose
course of study or training program began before assistance was
terminated.
``(b) Liability to Contractors.--For the purpose of making an
equitable settlement of termination claims under extraordinary
contractual relief standards, the President is authorized to adopt as a
contract or other obligation of the United States Government, and
assume (in whole or in part) any liabilities arising thereunder, any
contract with a United States or third-country contractor that had been
funded with assistance under such Acts prior to the termination of
assistance.
``(c) Termination Expenses.--Amounts certified as having been
obligated for assistance subsequently terminated by the President, or
pursuant to any provision of law, shall continue to remain available
and may be reobligated to meet any necessary expenses arising from the
termination of such assistance.
``(d) Guaranty Programs.--Provisions of this or any other Act
requiring the termination of assistance under this or any other Act
shall not be construed to require the termination of guarantee
commitments that were entered into prior to the effective date of the
termination of assistance.
``(e) Relation to Other Provisions.--Unless specifically made
inapplicable by another provision of law, the provisions of this
section shall be applicable to the termination of assistance pursuant
to any provision of law.''.
Attest:
Secretary.
106th CONGRESS
2d Session
H. R. 3519
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AMENDMENT
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