[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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