[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1032 Introduced in Senate (IS)]







107th CONGRESS
  1st Session
                                S. 1032

  To expanded assistance to countries seriously affected by HIV/AIDS, 
                       malaria, and tuberculosis.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 13, 2001

 Mr. Frist (for himself, Mr. Kerry, Mr. Helms, Mr. Leahy, Mr. Durbin, 
and Mr. Chafee) introduced the following bill; which was read twice and 
             referred to the Committee on Foreign Relations

_______________________________________________________________________

                                 A BILL


 
  To expanded assistance to countries seriously affected by HIV/AIDS, 
                       malaria, and tuberculosis.

    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 Infectious Diseases 
Control Act of 2001''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) AIDS.--The term ``AIDS'' means the acquired immune 
        deficiency syndrome.
            (2) Executive agency.--The term ``Executive agency'' has 
        the meaning given the term in section 105 of title 5, United 
        States Code.
            (3) Global fund.--The term ``global fund'' means the global 
        fund to fight HIV/AIDS, malaria, and tuberculosis established 
        consistent with section 4.
            (4) HIV.--The term ``HIV'' means the human immunodeficiency 
        virus, the pathogen that 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.
            (6) Secretary general.--The term ``Secretary General'' 
        means the Secretary General of the United Nations.
            (7) World bank.--The term ``World Bank'' means the 
        International Bank for Reconstruction and Development.

SEC. ____03. FINDINGS.

    Congress makes the following findings:
            (1) HIV/AIDS, tuberculosis, and malaria disproportionately 
        affect the world's poorest countries and together will cost the 
        lives of 6,000,000 people this year alone.
            (2) According to the Joint United Nations Programme on HIV/
        AIDS (UNAIDS), more than 58,000,000 people worldwide have 
        already been infected with HIV/AIDS, a fatal disease that is 
        devastating the health, economies, and social structures in 
        dozens of countries in Africa, and increasingly in Asia, the 
        Caribbean, and Eastern Europe.
            (3) AIDS has wiped out decades of progress in improving the 
        lives of families in the developing world. As the leading cause 
        of death in Africa, AIDS has killed 17,000,000 and will claim 
        the lives of one quarter of the population, mostly productive 
        adults, in the next decade. In addition, 13,000,000 children 
        have been orphaned by AIDS--a number that will rise to 
        40,000,000 by 2010.
            (4) The World Health Organization (WHO) estimates that 
        8,000,000 people each year become sick with tuberculosis, one 
        of the most dangerous contagious diseases, easily transmitted 
        through the air from those infected. Globally, tuberculosis 
        kills at least 2,000,000 each year, is the leading killer of 
        women between 15 and 44 years old, and is the most common cause 
        of death in Africa in those with HIV/AIDS.
            (5) More than 40 percent of tuberculosis cases in the 
        United States result from importation of tuberculosis from 
        foreign-borne persons. Multidrug-resistant tuberculosis spreads 
        because of inadequate control programs and inappropriate use of 
        anti-tuberculosis drugs--mostly in the developing world. 
        Without a concerted international effort to increase the 
        implementation of WHO-approved control strategies, the United 
        States risks importation of this particularly dangerous form of 
        tuberculosis.
            (6) Malaria is a third disease that saps the social and 
        economic strength tropical developing countries. Malaria 
        affects more than 500,000,000 people each year and undermines 
        not only the health and productivity of the world's poorest 
        countries; malaria kills at least 1,000,000 each year, about 
        3,000 each day. In Africa, malaria kills a child every 40 
        seconds.
            (7) Beyond the human toll, the economic impact of AIDS, 
        malaria, and tuberculosis on regional economies is severe. 
        According to UNAIDS, HIV/AIDS alone will reduce gross domestic 
        product (GDP) of South Africa by 17 percent, or $22,000,000,000 
        over the next 10 years, and WHO estimates that sub-Saharan 
        Africa's GDP would be 32 percent, or $100,000,000,000 higher 
        now if malaria had been conquered 35 years ago. The current 
        short term economic loss and direct cost of malaria is 
        estimated to be up to $12,000,000,000 each year.
            (8) The UNAIDS program estimates it will cost 
        $3,000,000,000 for basic AIDS prevention and care services in 
        sub-Saharan Africa alone, and at least $2,000,000,000 more if 
        anti-retroviral drugs are provided widely. But in Africa, only 
        $500,000,000 is currently available from all donors, lending 
        agencies, and African governments themselves.
            (9) For tuberculosis control, WHO estimates that a total of 
        $1,000,000,000 per year will be necessary to effectively fight 
        the tuberculosis epidemic, which will be spent to identify at 
        least 70 percent of the cases and curing 85 percent of them. 
        WHO indicates that an increase of $400,000,000 per year could 
        make this goal a reality.
            (10) The Secretary General of the United Nations, Kofi 
        Annan, has called for a global fund to halt and reverse the 
        spread of HIV/AIDS, malaria, and tuberculosis. The Secretary 
        General proposed a multibillion dollar ``war chest'' financed 
        jointly by donor governments and private contributors and, 
        equally important, called on leaders from developing nations to 
give a much higher priority in their budgets to development of 
comprehensive health systems.
            (11) The Secretary General has outlined the following five 
        objectives for the fight against AIDS:
                    (A) To ensure that people everywhere know what to 
                do to prevent infection.
                    (B) To prevent the transmission from mother to 
                child.
                    (C) To provide care and treatment to those 
                infected.
                    (D) To provide care to those affected by AIDS, 
                especially orphans.
                    (E) To deliver scientific breakthroughs, especially 
                vaccines.
            (12) Prevention of new infections is key, although 
        treatment and care for those infected by HIV/AIDS is an 
        increasingly critical component of the global response. 
        Improving health systems, providing home-based care, treating 
        AIDS-associated diseases like tuberculosis, providing for 
        family support and orphan care, and making anti-retroviral 
        drugs against HIV available will reduce social and economic 
        damage to families and communities.
            (13) Responding to the call from the Secretary General, the 
        African heads of state meeting at the African Summit on HIV/
        AIDS, tuberculosis, and other infectious diseases in Abuja, 
        Nigeria, April 25-27, committed to increasing to at least 15 
        percent the proportion of their budgets allocated to the health 
        sector.
            (14) Expanded United States financial support for new broad 
        based international partnerships to control HIV/AIDS, malaria, 
        and tuberculosis can help leverage substantial increases in 
        global commitments to narrow the gap between need and currently 
        available resources.
            (15) The World Bank and WHO have demonstrated that 
        investment in global public health activities to reduce HIV/
        AIDS, malaria, and tuberculosis not only is a humanitarian 
        imperative, it also helps bolster the economic and social 
        development necessary to build political and trade alliances. 
        Further, containment of international disease threats has 
        beneficial ramifications for Americans who are increasingly 
        susceptible to global infectious disease threats.

SEC. 4. PURPOSES.

    The purposes of this Act are to provide for United States 
participation in a global effort to--
            (1) mitigate the effects, and control the spread, of HIV/
        AIDS, malaria, and tuberculosis by supporting programs for the 
        prevention of new infections and for the care and treatment of 
        individuals infected with those diseases in countries seriously 
        affected, especially programs that provide care for children 
        orphaned by the HIV/AIDS epidemic; and
            (2) provide the resources and leadership to control AIDS, 
        malaria, and tuberculosis through support of programs that 
        emphasize--
                    (A) a science-based integrated approach that 
                includes prevention of new infections and the treatment 
                and care of infected individuals;
                    (B) public-private partnerships; and
                    (C) good governance.

SEC. 5. GLOBAL FUND TO FIGHT HIV/AIDS, MALARIA, AND TUBERCULOSIS.

    (a) Efforts To Reach Agreement for Establishment of Global Fund.--
            (1) In general.--The President, in consultation with the 
        Secretary General and the heads of relevant Executive agencies, 
        shall work with foreign governments, the United Nations and its 
        relevant specialized agencies, the World Bank, and the private 
        sector to reach an agreement for the establishment of a global 
        fund to fight HIV/AIDS, malaria, and tuberculosis, to carry out 
        the purposes of section 4 (1) and (2).
            (2) Delegation of authority.--The President shall exercise 
        the authority of this subsection through the Secretary of State 
        and the Secretary of Health and Human Services, except that, 
        with respect to the World Bank, the President shall exercise 
        such authority through the Secretary of the Treasury.
    (b) Description of global fund.--The global fund should--
            (1) be a public-private partnership that includes 
        participation of, and seeks contributions from, governments, 
        foundations, the private sector, civil society, the United 
        Nations system, nongovernmental organizations, and other 
        parties;
            (2) pursue an integrated approach that includes the 
        prevention of new infections and the treatment and care of 
        infected individuals;
            (3) focus on promotion of ``best practices'' in the 
        prevention of new infections by funding a core group of 
        programs that have been proven effective and then funding 
        additional programs;
            (4) promote scientific and medical accountability by 
        requiring proposals to be reviewed and approved by medical and 
        public health experts; and
            (5) respect intellectual property rights as an important 
        incentive in the development of new drugs.
    (c) Composition.--The global fund should be composed as follows:
            (1) Board of trustees.--The global fund should be governed 
        by a board of trustees, which should be composed of 
        representatives of donors, recipients of funding, multilateral 
        agencies, and such other parties as may be authorized by the 
        agreement establishing the global fund.
            (2) Technical advisory group.--The board of trustees of the 
        global fund should establish a technical advisory group, 
        consisting of persons with demonstrated knowledge and 
        experience in the fields of public health, epidemiology, health 
        care delivery, health economics, and biomedical research, to 
        advise the board of trustees with respect to funding proposals 
        and other matters.
            (3) Secretariat and other bodies.--Other bodies, such as a 
        small secretariat, should be established to support the work of 
        the board of trustees of the global fund.
    (d) Program Objectives.--
            (1) Grant authority.--
                    (A) In general.--In carrying out the purposes of 
                section 4 (1) and (2), the global fund, acting through 
                its board of trustees with guidance from the technical 
                advisory group, 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, with respect to 
                the prevention of new infections and the care and 
                treatment of individuals infected with disease.
                    (B) Eligibility for grants.--Governments and 
                nongovernmental organizations shall be eligible to 
                receive grants from the global fund. Emphasis should be 
                given to facilitating the funding of nongovernmental 
                organizations, including both faith-based and secular 
                groups working in communities, except that national 
                authorities should set the overall plan and agenda for 
                dealing with public health and infectious diseases in 
                their countries.
            (2) Activities supported.--
                    (A) In general.--Activities supported under 
                paragraph (1) should include efforts to lead and 
                implement effective and affordable HIV/AIDS, malaria, 
                and tuberculosis programs, including programs focused 
                on prevention and health education and treatment and 
                care services, including access to affordable drugs.
                    (B) Emphasis on strong political leadership.--
                Emphasis should be given to ensuring strong political 
                leadership in recipient countries, through the 
                development and implementation of effective strategies 
                against HIV/AIDS, tuberculosis, and malaria; 
                development of well managed, transparently administered 
                health systems; and monitoring and evaluation of 
                programs supported by the global fund.
                    (C) Initial priority on combating hiv/aids.--In 
                view of the globalization of the AIDS epidemic, initial 
                priority should be given to programs to combat HIV/
                AIDS. Such programs should include the promotion of 
                ``best practices'' in the prevention of new infections, 
                including education that emphasizes risk avoidance such 
                as abstinence, measures to stop mother-to-child 
                transmission, and efforts to provide for the support 
                and education of AIDS orphans and the families, 
                communities, and institutions most affected by HIV/
                AIDS.
    (e) Reports to Congress.--
            (1) Annual reports by the president.--Not later than one 
        year after the date of the enactment of this Act, and annually 
        thereafter for the duration of the global fund, the President 
        shall submit to the appropriate committees of Congress a report 
        on the global fund, including its structure, objectives, 
        contributions, funded projects, and assessment of its 
        effectiveness.
            (2) Appropriate committees defined.--In paragraph (1), the 
        term ``appropriate committees of Congress'' 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.
    (f) United States Financial Participation.--
            (1) Authorization of appropriations.--In addition to any 
        other funds authorized for multilateral or bilateral programs 
        related to HIV/AIDS, malaria, tuberculosis, or economic 
        development, there is authorized to be appropriated to the 
        Department of State $200,000,000 for fiscal year 2002 and 
        $500,000,000 for fiscal year 2003 for payment to the global 
        fund.
            (2) Reprogramming of fiscal year 2001 funds.--Funds made 
        available for fiscal year 2001 under section 141 of the Global 
        AIDS and Tuberculosis Relief Act of 2000 (as in effect 
        immediately before the date of enactment of this Act)--
                    (A) are authorized to remain available until 
                expended; and
                    (B) shall be transferred to, merged with, and made 
                available for the same purposes as, funds made 
                available for fiscal year 2002 under paragraph (1).
            (3) Certification requirement.--
                    (A) In general.--Before the initial obligation or 
                expenditure of funds appropriated under paragraph (1) 
                or reprogrammed under paragraph (2), the President 
                shall certify that adequate procedures and standards 
                have been established to ensure accountability for and 
                monitoring of the use of funds contributed to the 
                global fund, including the cost of administering the 
                global fund.
                    (B) Transmittal of certification.--The 
                certification required by subparagraph (A), and the 
                bases for that certification, shall be submitted by the 
                President to Congress.
            (4) Statutory construction.--Nothing in this Act may be 
        construed to substitute for, or reduce resource levels 
        otherwise appropriated by Congress for, bilateral and 
        multilateral HIV/AIDS, malaria, and tuberculosis programs.

SEC. 6. REPEAL.

    Subtitle B of title I of the Global AIDS and Tuberculosis Relief 
Act of 2000 (22 U.S.C. 6821 et seq.) is hereby repealed.
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