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